NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
76
LUNATIC ASYLUMS.
[SECT. XVII.
SUB-SECTION III.
32. Criminal Lunatics.—A criminal lunatic can only be received
into an asylum under a special order of Government, which should be
accompanied with a copy of the order of the Court before which he stood his
trial, a medical history of his case, and a medical certificate of insanity.
33. Criminal lunatics will be kept distinct from all others in a special
yard of sufficient dimensions, and are under no circumstances to be permitted
to go beyond the bounds of this enclosure. They will be required to perform,
within their own yard, such menial duties as can be delegated to them, and
each, fit for work, must have a specific daily task of intramural labour assigned
to him.
34. When the sentence of a criminal lunatic expires during his detention
in an asylum, the orders of Government regarding the disposal of him must
be obtained through the usual channel.
35. When a criminal lunatic recovers before the expiry of his sentence,
the superintendent shall report the circumstance to the Inspector General,
Indian Medical Department, who will direct two or more of the official
visitors to examine the patient, and on their being satisfied as to his perfect
recovery, the orders of Government will be solicited regarding the disposal
of his person.
SUB-SECTION IV.
36. Clothing, Bedding, and Furniture.—Clothing and bedding will
be supplied, on indent, by the Commissariat for military, and by contract for
civil patients. Furniture will be furnished, on indent, by the contractor for
Civil Hospitals.
37. Officers and others, who may have occupied a superior position in
society, will be furnished with appropriate clothing and bedding, and the value
of such extra articles will be included in the charges recovered for the cost
of their maintenance.
38. The superintendent may supply aged or weakly patients with extra
articles of clothing, when such are considered necessary.
39. European and East Indian male patients manifesting a persistent
tendency to tear clothing, will be provided with smocks and trowsers made
of strong canvas. Female patients of these classes, having destructive
habits, will be furnished with canvas gowns. Native patients of destructive
habits should, during the night, be deprived of all clothing, except the cloth
round the loins. In many cases, however, close attention on the part of the
keepers during the day, so that the patient can have no opportunity for
SECT. XVII.]
LUNATIC ASYLUMS.
77
tearing clothes, and the withdrawal of some luxury, such as tobacco or snuff,
by way of punishment, will cure the bad habit.
40. As a rule, European and East Indian patients are to have clean
clothing every second day, and Natives, twice weekly. Bedding must be
changed at least once a week. When patients manifest a propensity to
dirty bedding, clothing, or rooms with their excreta, the keepers should be
instructed to take them to a latrine at regular intervals, as in this way the
acquisition of a troublesome and offensive habit may be prevented.
41. Clothing for European and East Indian patients.
Males.
1 White shirt.
1 Pair socks, worsted or cotton,
according to season.
1 Pair gingham trowsers.
1 Pair flannel drawers (if neces-
sary).
1 Cap (gingham).
1 Towel (dimity).
1 Loose jacket.
1 Pair slippers.
1 Flannel shirt.
1 Pairshoes for out-door exercise.
Females.
1 White shift.
1 Pair stockings, worsted or
cotton, according to season.
1 White gown.
1 Chintz petticoat.
1 Towel (dimity).
1 Flannel shirt.
1 Pair slippers.
1 White jacket.
1 Pair shoes for out-door exercise.
42. Clothing for Native patients.
Males.
1 Flannel jacket (if necessary).
1 White jacket.
1 Pair short white trowsers.
Females.
1 Flannel jacket (if necessary).
1 White cloth, 12 cubits long,
2½ cubits broad.
43. Bedding, furniture, &amp;c., for European and East Indian patients.
Males and Females.
1 Straw bed.
1 Chair.
1 Gingham quilt.
1 Brass basin (if there be no
lavatory).
1 Red blanket.
2 Pillows stuffed with cotton.
2 Plates.
1 White sheet.
1 Bowl.
1 Iron cot.
1 Spoon.
1 Table for each cottage.
44. Bedding, furniture, &amp;c., for Native patients.
78
LUNATIC ASYLUMS.
[SECT. XVII.
Males and Females.
1 Mat (coir, if not furnished
with cot).
1 Straw pillow.
1 Gingham quilt (if necessary).
1 Cumbly.
1 Iron cot (if necessary).
1 Straw bed (if necessary).
1 Tin bowl.
45. The superintendent shall make a yearly inspection of Clothing,
bedding, and furniture, noting such articles as may be repairable, and such as
are unserviceable. Such of the unserviceable articles as may have been
supplied by the Commissariat must then be submitted to a Committee of
Survey, and such as were got by contract, to the Deputy Inspector General,
Indian Medical Department, and if condemned by these authorities, they will
be sold on the public account.
For repairs necessary on articles of furniture, a special indent must be
submitted to the Inspector General, Indian Medical Department, and the
repairs will be effected by the oontractor for Civil Hospitals.
SUB-SECTION V.
46. Diet. —All articles of diet for the patients will be furnished by the
contractor for Civil Hospitals, and the daily supplies must be submitted
every morning to the superintendent, who will satisfy himself that the bread,
m e a t , & a m p ; c . , a r e i n v a r i a b l y o f t h e v e r y b e s t q u a l i t y .
47. No article should be received from the contractor until it has been
carefully measured or weighed, and care should then be exercised that the
food is properly cooked, and that each patient gets his due allowance.
48. Meals must be supplied punctually at the specified hours, and in
case of any patient not eating a due quantity, or refusing food, the circum-
stance must be brought to the notice of the superintendent.
49. The following are the hours at which the meals are to be served:—
Europeans and East Indians.
Natives.
Breakfast
... 8 A. M.
Morning meal ... 10 A. M.
Dinner
...
... 1 P. M.
Evening meal ... 4 P. M.
Supper
...
... 6 P. M.
50. The diet of Europeans and East Indians shall be regulated by the
Diet Table below, and that of natives, by the Diet Table for natives in Lock
Hospitals.
SECT. XVII.] LUNATIC ASYLUMS.
79
DIET Table for European Sick.
Meal.
Full Diet.
Half Diet. Low Diet. Spoon or
Fever Diet. Milk Diet. Remarks.
Breakfast ... Tea ½ oz.
Bread 1 lb.
Butter 1 oz.
Sugar ¾ oz.
Tea ½ oz.
Bread 1 lb.
Butter ½ oz.
Sugar ¾ oz.
Tea ½ oz.
Bread 8 oz.
Sugar ¾ oz.
Tea ¼ oz.
Sugar ¾ oz.
Tea ½ oz.
Bread 1 lb.
Butter ½ oz
Sugar ¾ oz.
Dinner ...
A pint of
broth, with
barley, greens
and onions,
and 1 lb. of
meat, either
mutton or
beef.
A pint of
broth, with
rice, barley,
greens or
onions, and
8 oz. of mut-
ton of good
and edible
quality, or
a pint of
chicken soup,
with vege-
tables as
above ; a
chicken or
half a fowl,
weighin g,
when ready
for being
dressed, not
less than 8
ozs.
A pint of
mutton or
chicken
broth.
Bread ½
lb., to be
made to
panado or
pudding,
or 4 ozs. of
sago, with
¾ oz. of
sugar.
A pint
of milk
(new), or
a pint of
rice and
milk,
with ¾ oz.
of sugar.
N. B.—In
both these
cases the
meat from
which the
broth is
prepared
is given
to the
patient.
Supper ... A pint of
rice gruel,
with ¾ oz. of
sugar, sea-
soned with
ginger or
nutmeg, and
a glassful of
wine, should
any be al-
lowed him.
Do. do.
Do. do. The same
as at break-
fast.
The same
as at din-
ner.
In specifying the quantity of each item of meat for the several kinds of diet, it is to
be distinctly understood that meat in a raw state is intended, and not meat which has
already been boiled.
80
LUNATIC ASYLUMS.
[SECT. XVII.
Explanations.
The quantities of raw rice allowed under the different denominations of
diet are as follows:—
—
Full Diet.
Reduced Diet.
Spoon Diet.
B r e a k f a s t .
D i n n e r .
S u p p e r .
Total.
B r e a k f a s t .
D i n n e r .
S u p p e r .
T o t a l .
B r e a k f a s t .
S u p p e r .
T o t a l .
Oz.
oz.
oz.
oz.
oz.
oz.
oz.
oz.
oz.
oz.
oz.
Adults............
4
12
8
24
4
8
6
18
4
6
10
Youths............
3
8
6
17
3
6
3½
12½ 3
3 ½
6½
Children...........
2
6
3 ½
11½ 1½ 3½ 2 ½
7½
1 ½
2 ½
4
Adults.............15 years and upwards.
Youths..............from 8 to 15 years.
Children...............under 8 years.
Computation.
16 Ounces to the pint.
16 Ounces to the pound.
16 Drachms to the ounce, Avoirdupois.
Rotation of Diet.
Sunday......
Meat curry.
Tuesday.....
Friday......
Monday......
Vegetable curry.
Wednesday
Thursday...
Saturday...
Eight ounces of raw rice, by weight, computed to boil into 20 ounces dry, by
weight, and 28 ounces by measure. Mutton for curries to be inclusive of
bones.
51. As insanes are frequently capricious as regards their food, and often
anæmic, the superintendent may, in particular cases, vary the diet to meet
the wishes of the patient, or order such extras as he may consider necessary.
When, however, the diet is changed to suit the caprice of a patient, the
articles substituted for the ordinary rations must not in value exceed the cost
of the latter.
SECT. XVII.]
LUNATIC ASYLUMS.
81
52. Wine, beer, or other liquors may be ordered when considered requi-
site, and monthly Nominal Returns of the expenditure of these articles must
be sent through the usual channel for sanction.
Tobacco, snuff, or betel and nut, may be given to patients who have
been accustomed to the use of them, but the giving of these articles is to be
held out as a reward for correct conduct and industry; and in the case of
idleness or misbehaviour, they should generally be withheld.
53. European, East Indian, and Native patients, whose means will
allow of their paying for their diet, or who may have friends capable of
supporting them, will be charged according to the scale authorized in the
Proceedings of the Madras Government, Public Department, dated 21st
March 1862, No. 363. Native Non-commissioned officers and sepoys,
whether borne on the strength of the Army, or pensioned, will be charged at
the uniform rate of 2 annas each per diem for rations. A pensioner, however,
whose pension does not amount to Rupees 5 per mensem, will be received as
a pauper.
SUB-SECTION VI.
54. Medicines, &amp;c.—Medicines and surgical instruments will be
furnished from the Presidency or Divisional Medical Stores on annual indent.
55. Patients are to be strictly prohibited from entering the dispensary,
and the doors must be kept constantly locked when a Medical Subordinate,
may not be present in it.
56. External applications, containing dangerous substances, must either
be applied by, or under the immediate superintendence of, a Medical
Subordinate ; and never more than one dose of a medicine for internal use
should be entrusted to a patient. For blistering purposes a fluid preparation
should be preferred to a plaster, as there is some risk attending the use of
the latter.
SUB-SECTION VII.
57. Records and Returns. —The Superintendent will keep the
following Records, and furnish the following Returns :—
Records.
Letter Book.
Circular Book.
Return Book.
Miscellaneous Return Book.
Journal for European and East Indian patients.
Journal for Native patients.
Prescription Book.
Historical Register.
VOL. II
L
82
LUNATIC ASYLUMS.
[SECT. XVII.
File Book.
Contingent Bill Book.
Pay Abstract Book.
Nominal Register and Index of the sick.
Steward's Book.
Diet Roll Book.
Book for Official Vistors' remarks, &amp;c.
Printed Cholera Reports in Cheque Book.
Cholera Register.
Returns.
Monthly Return of European and Native sick.
Nominal Return of expenditure of wines and spirits
.
Diet Rolls for European and Native sick.
Monthly Indent on Contractor.
Salary Bill of Establishment.
Retrospective Indent.
Return of Medical Officers and Subordinates.
Receipt for materials for diets for European patients
.
Receipt for materials for diets for Native patients.
General Contingent Bill for diet, &amp;c., &amp;c.
Stoppage Rolls and Abstracts.
Statement of expenses incurred for dieting Native
Military insane patients.
Register of petty offences.
Receipt for wines and spirits.
Half-yearly Return of Surgical Instruments
.
Annual Return of European sick.
Do. of Native sick.
Do. of state of mind.
Do. of state of mind of Native sick.
Annual Medical Report.
Return of patients received, discharged, died
.
Annual Financial Statement.
Do. Indent for medicines.
Abstract Annual Return of sick, and concise Medical Report
.
Statement of the Establishment to Civil Paymaster.
Statement and Return of Uncovenanted Europeans attached
.
Budget Estimate, Civil.
Budget Estimate, Military.
Do. for Stationery.
Annual Indent for Stationery.
SECT. XVII.]
LUNATIC ASYLUMS.
83
Miscellaneous.—Report of admission of any patient to the Deputy
Inspector General of Hospitals, Indian Medical Department.
Report of discharge or transfer of a patient to the authority by whom
his admission was ordered.
Report of death to Deputy Inspector General of Hospitals, of Military
patients and casualties from violence.
Report of death of Military patients to Brigade-Major, and to the Officer
or Magistrate who sent the patient to the asylum.
Mortuary Report to the Mortuary Department, Sanitary Commission.
Insanes to England.—Return recommending patient to England.
Nominal Roll for separate berth, and letter forwarding the above.
Indent for equipment for the voyage, and letter forwarding the above
for sanction to the Inspector General, British Medical Service.
Report to Brigade-Major on intimation being received of passage engaged.
Stoppage Roll and Abstract up to date of embarkation to Brigade-Major.
Letter to Brigade-Major for an escort.
Receipt for clothing and list of clothing, and embarkation certificate, and
letter to Officer Commanding Troops on board. Medical history of each
patient, and letter to the Medical Officer on board.
The signed. embarkation certificate, receipt of clothing and Stoppage
Roll and Abstract, with a letter to Deputy Inspector General, Indian Medical
Department.
Stoppage Rolls and Abstracts of patients in Her Majesty's Service, to
the Paymaster, Poonamallee.
Return of Native Military patients considered unfit for further service,
and letter forwarding the above to Deputy Inspector General of Hospitals.
Report discharge of pensioned Native Soldier to Brigade-Major.
Report discharge of Native pensioned Soldier to Superintendent of
Pensions.
Letter applying for pay of Military patients, and certificate to Brigade-
Major.
SUB-SECTION VIII.
58. Means of moral treatment, &C.— A s o c c u p a t i o n a n d r e c r e a t i o n
are most useful means in the treatment of insanity, the Superintendent will
spare no pains to provide the patients with suitable work and amusement.
59. For Native patients in general, gardening, stone-breaking, rope-
making, mat-making, carpentering, basket-making, road-repairing, water-
drawing, and sweeping of leaves, &c., will be found appropriate kinds of
labour. In giving a patient a particular kind of work, his mental and
LUNATIC ASYLUMS.
[SECT. XVII.
physical capabilities, and its probable therapeutical influence must receive due
consideration ; and, in all cases, the remedial effects of labour are to be more
regarded than the pecuniary gain. For carrying out the varieties of industry
specified above, the necessary tools, and a sum of money for the purchase of
materials, will be sanctioned on the first introduction of the labour system
into an asylum, but thereafter it will be expected that the proceeds of work
will more than cover all attendant expenses. To give encouragement to
industry, a reasonable proportion of the profits may be devoted to the purchase
of extra articles of diets, &c., for patients who have been diligent.
The hours for labour, and all minor details, will be left to the discretion
of the superintendent.
For the recreation of native patients, native musical instruments and
games are sanctioned ; but mere amusement must never be permitted
to trespass on the hours for labour: For educated natives, books in the
vernaculars and writing materials will be supplied.
60. For the mental occupation and recreation of Europeans and East
Indians, periodicals, books, musical instruments, games, and writing and
drawing materials will be provided. Every effort should also be made to
induce patients of these classes to take regular exercise, and engage in some
appropriate out-door occupation, such as tending a garden plot and range of
flower-pots, or superintending a gang of native patients at work.
61. Tractable and well-behaved patients may, at the discretion of the
superintendent, be allowed to go out for a few hours of the day on parole,
accompanied by a Keeper. Native patients, who are quiet, may, in charge
of Keepers, be employed in carrying things to or from the bazaar.
62. The relatives or friends of patients will be allowed to see them at
stated intervals, when the visit is not likely to prove prejudicial ; but some
official of the asylum staff must be present during the interview.
63. No one unconnected with the establishment, except the official and
ex-officio visitors, shall be permitted to enter an asylum without an express
order from the superintendent.
Letters for, or from, patients must always be submitted to the superin-
tendent, prior to delivery or despatch. In case of a letter for a patient con-
taining anything likely to produce or aggravate excitement, it should be
returned to the writer with an explanatory note ; and letters from patients
may be forwarded or not, as the superintendent thinks proper.
SUB-SECTION IX.
64. Classification of Patients. —Patients are to be classified as
follows, and. arranged accordingly:—
SECT. XVII.]
LUNATIC ASYLUMS.
85
I . M i l i t a r y a n d C i v i l
L u n a t i c s .
1. Females.. 1. Europeans...
1. Tranquil and convalescent.
2. East Indians 2. Troublesome, violent, and noisy.
1. Convalescent, and tranquil and
industrious.
2. Males ... 3. Natives
...
2. Impetuous, irritable, and not
regularly industrious, and those
under observation.
3. Violent, noisy, and idle.
4. Of dirty habits.
C r i m i n a l
L u n a t i c s .
1. Females* 1. Europeans.
2. East Indians 1. Tranquil and industrious.
2. Males ...
3. Natives
...
2. Violent and idle.
SUB-SECTION X.
65. Sanitary Arrangements —The cubic capacity and superficial
area of all the rooms of an asylum are to be accurately ascertained and entered
in a Register, which shall also specify the number of patients that each is
capable of containing, and under no circumstances is the regulated number
of inmates to be exceeded.
66. The space and area allowed for each patient shall not be less than
as follows :—
European and East Indian Patients.
Superficial area ...
100 feet.
Cubic space ... ... 1,500 feet.
Native Patients.
Superficial area ...
60 feet.
Cubic space ... ...
800 feet.
67. Care must be taken that there is ample provision for side and roof
ventilation. During the day, doors and windows should be kept constantly
open, and the bedding freely exposed to light and air.
68. The dry-earth conservancy system is to be carried out in all
asylums, one or more latrines being provided for Europeans and East Indians,
and a suff icient number for native patients.
69. For use during the night, every room inhabited by European or
East Indian patients shall be provided with self-acting earth closets. Rooms
occupied by natives shall be provided with an urinal, earth closet (of simple
construction), earth reservoir, and wooden scoop, and the patients are to be
*Must be kept in a distinct enclosure, and all interview with males strictly pro-
hibited.
86
LUNATIC ASYLUMS.
[SECT. XVII.
instructed in the use of them. The part of the floor on which these vessels
are placed must be protected by a coating of asphalte or coal tar, and over
this a thick layer of dry earth should be put down and removed daily.
70. The night vessels must be put in their proper places at 4 P.M.
daily, and removed as soon as the doors are opened in the morning to some
suitable places, where their contents will be disposed of in the prescribed
manner. The vessels are then to be thoroughly cleaned and scrubbed with
dry earth, and exposed to the sun during the day.
71. When the patients go out in the morning, the rooms are to be
swept and cleaned, and the bedding spread out for airing. In case of any
patient having soiled the walls, floor, or bedding with excreta, proper means
must be taken for the thorough cleansing of these, and the circumstance be
brought to the notice of the superintendent.
72. Great attention should be paid to secure pure water for drinking
and cooking purposes. A due proportion of country filters will be allowed
for every asylum, and care must be taken to keep these in a clean and
efficient condition.
73. An ample supply of water for bathing purposes must also be secured,
as there are few secondary remedial means more useful in the treatment of
insanity than bathing. Douche and shower-baths, and bath tubs will be
provided for all asylums. All patients should be required to take a bath
daily ; and native patients who may have been engaged in work, should be
washed before being shut up in their rooms for the night.
74. The conservancy of wells by the removal of mud and other filth,
and preventing the entrance of leaves, storm water, and sewage, is to be
carefully attended to.
SUB-SECTION XI.
75. General Rules. —On the arrival of a new patient, he is to be
washed, have his hair cut or shaved, and receive asylum dress. He will then
be left for a short time under observation, until his habits, disposition, &c.,
have been ascertained, so as to admit of his being placed in the appropriate
class.
76. The doors are to be opened under the immediate inspection of a
Medical Warrant Officer at 5 A.M., or day-light ; and every room and its
furniture, as well as the person of every patient, must be carefully examined.
If any patient show signs of excitement or sickness, he is to be brought to
the notice of the superintendent at the morning visit.
77. The patients will then be taken out for exercise or labour, working
patients being formed into small gangs. Each gang will be put in charge of