20
ANNUAL REPORT ON LUNATIC ASYLUMS.
as the next most important point ? I say certainly not clothing, except in one or
two months of the year, but scavenging. Now, our number of toties is fixed at 1
to 20 general patients and so necessary are they with the filthy nature of many
lunatics, that were we to have a sudden strike of toties, we should be as we are now
situated utterly unable to really remove the filth; there is no efficient mechanical
means of doing so wholesale, and our blocks are so situated that most are distinct
units, requiring individual cleaning; this is a most crying evil, as it puts us at
the mercy of these men, and one of our greatest needs is to be able to dispense
with toties to a great extent and have a complete system of flushing, and drainage
drawn up for the whole Asylum by which manual labour could be minimized, the
supervision of toties done away with to the greatest extent instead of having as
now, one of the greatest difficulties and responsibilities to see that toties do their
work adequately.''
" Patients.—Another grave difficulty of supervision is the ease with which
patients glide into ill health from their childish helplessness, which often prevents
their complaining at all about their food and as often makes their complaints
simply nonsensical—often they dislike all food, often they dislike one food or
another, at times they seem to like one food and then dislike it. This causes
endless trouble in meeting their wants and much writing and supervision of both
food and accounts of food. The system of dieting must of course be checked, but
I think too much time is consumed in watching the details of the feeding by the
Superintendent, making the most important duty fall too heavily on him, so that
it becomes not a matter of general superintendence, but a minute wearisome
checking of each diet and its administration, that is, after carefully ordering a
diet to see for yourself that the patient really receives it, a thing which is prac-
tically impossible to do from the disconnected nature of the blocks and the distance
from the kitchen. We need, in my opinion, better kitchen arrangements and more
stewards, so that besides the European attendant there should be more constant
supervision of all the meals in every section at the same time, and no large amount
of the Superintendent's time ought to be taken up in trying to perform such a
task as this, as he has practically to do now, going from one section to another
section and not at all sure that having put matters, as he thinks, right in the
one, the next section will not in the same way require a careful checking which
has to be continually maintained and equally applies to any one to whom he
delegates the same work. The feebleness of the patients and their vagaries always
keeps the supervision at a high strain to prevent a patient being slowly starved
before one's eyes—sinking into an anæmic state from which he slowly, if at all
recovers."
"Buildings.—In
themselves answer their purpose of safely confining and
housing lunatics. Having said that, I must add they are not well drained, they are
not well lighted at night, and they cannot any of them be heated, an important
point in rainy cold nights and early mornings with delicate patients who will
throw off their clothes and blankets even though they lie in the cold without
them. The whole scheme of the buildings of the Asylum seems never to have
been consistently and definitely worked out, it bears in its arrangement a haphazard
appearance, a block here, another there, some drained, some undrained, some con-
nected and enclosed, others partly connected and as if built one after the other
at uncertain intervals of time to meet pressing wants and with no idea of definite
finality in their purpose or dimensions. Originally private property, the Asylum
has grown up in the same area, block by block, until its numbers which ten years
ago were 380 within the enclosing wall are now (1st January 1895) 473 in the same
area, with lines for 75 native attendants with their families adjoining and a prospect
of lines for 20 toties to be hereafter added."
" European Patients.—Are too much confined, have no suitable occupation or
amusement, no bagatelle, cricket or lawn-tennis. No means of letting them out
except in a comparatively small space, as if allowed to wander to the further
side of the Asylum, they might easily get over the wall, and if violent and
abusive, they have to be shut up in their own cottages and there is not enough,
guard of European attendants to allow of the degree of liberty that they might
have if the attendants were more numerous. Hence I consider that there is a