The Express.
London, England, 1850-12-26 00:00:00

THE EXPRESS, THURSDAY EVENING, DECEMBER 26, 1860.

LUNACY IN ENGLAND.

The fifth annual report of thy Commissioners of
Lunacy to the Lord Chancellor, dated the 30th of June last,
which o• the moioa of Mr. Bouverie was preowned to the
Ilnuse of Commons ea the 16th of August, and ordered to be
printed, has now been inued. The report, in the fist in-
stance, proceeds to notice the changes that have *ekes plan
in the propeletonhip of private licensed establishments for
the reception of lunatics, to give • list of new licenses which
have been granted in the metropolitan and provincial
districts, of establishments the licenses to which have
been discontinued, and the houses to which licensee
have been granted for the first time. During the past
rear three additional public asylums have been opened
vie the Hull Borough, Birmingham Borough, and Man-
chester Royal Lunatic Hospital. Al regards the latter the
following statement is given : The Manchester Hospital for
the receptioa of lunatics, founded in the last century, has
been closed about four years. Situate is the centre of a
cleanly populated town, and badly constructed, the com-
mittee BMW time ago determined in lieu thereof to build •
new and enlarged streets» on more favourable site.
Having distrinuted their patients in several of the surround•
leg asylums, they disposed of the old premises and pur-
chased a large piece of land near the village of
Ch' adle, on which they erected • building suitable for the
upper classes, free from the imputation of interested motives
attributable to private asylums, and which also &traded
to persons of the same clam, but in reduced Mecum-
stances, accommodation and treatment agreeably to their
station. With regard to St. Peter's Hospital at Brie
MI, the commissioners observe on its extremely de-
fective elate, sad its being wholly inadequate to the
exigencies of the community, expressing the belief that
in the event of any further delay occurring in pro.
Tiding • proper asylum, the authority of the Secretary
of State will be invoked to enforce prompt and sub-
stantial obedience in the execution of the act in this respect.
The visitations by commissioners and Tulin' and boards to
the various establishments are then referred to, and with
respect to the entries of such visitors, it is observed that th.ir
general tenor has been favourable, and that it is satisfactory
to report that the various Mitituthine for the insane through-
out the country are in an improved state, and that the con.
duet of all the parties concerned in their management has
been for the most part humane and judicious. In several in-
stances, however, the visiting commissioners and justices
found it oftener, to animadvert upon the excessive
ass of mechanical restraint; on the neglect of
cleanliness; on inadequate ventilation; on want of
sufficient attendavts ; on improper or deficient diet; on
the dirty condition, or aunty supply of bedding and
clothing; on irregularities in the medical books, and
on other defects. In 70 instances these defects were deemed
of sufficient importance is require the special interference of
the board by wham direction letters were addressed to the
parties inculpated, the offset of which has been that the
defects referred to have been wholly or partially remedied.
The following special ezceptioaal cam are given in the exact
terms used in the report :
In certain eases the defects brought under our notice
were of to peculiar or aggravated a character, that we think
it right to advert to them more ie detail. On a visit to
l'iaberton House, near Salisbury, oa the 24th January last,
the visiting commissioners discovered that it had been the
practice to place clean sheets on certain beds during the
day, awl to remove them at night. Ot this occasion we felt
it to be our duty strongly to remonstrate with Dr. Finch (the
proprietor) against a practice which has the effect of deceiv-
tog the commissioners, junices, and other visitors
of the establishment, by giving • *Minute appear-
ance of comfort to the patients' been. Upon a
recent visit to Camberwell House, the visiting oom-
missioners found also that sheet' were placed on a few
beds in the refractory ward during the day, end removed
at night. On investigating the matter, it was found that
Mr. Paul (the proprietor) was altogether unacquainted with
this practice ; but we felt it our duty to censure the con-
duct of the medical attendant, and we feel confident that
the same or any similar practice witl not be allowed to take
place "gain in this establishment. The condition of the
licensed house, called Belle Vue House, near Devine, has
repeatedly given us great cane for dissatisfaction. The de-
tects from time to time brought under our notice have been
occasionally remedied in part, but at no period has the
state of this house met with sue entire approbation."
The commissioners then give various reasons for the an-
satisfactory opinions they express. They then refer to their
former reports with respect to another licensed house, called
Kingsland Asylum, near Shrewsbury, in which the lunatics
of that borough have long been coifined, stating that it is
unnecessary to detail the steps they took to bringthe very
discreditable condition of this establishmeut under the con,
sideration of the authorities of the borough of Shrewsbury,
as they are happy to state that the molt of their commu-
nication has been that • union has been effected between
that borough and the county of Salop, and that the borough
pauper lunatics will shortly be transferred from Kings! end
to the county asylum. The commissioners then proceed th
state with regard to St. Luke's Hospital, that in their
last report they called attention to the burial ground adjoin-
ing one of the airing grounds of the establishment, express.
log • hope that the Bishop of L indon would interfere in the
matter, now expressing
°their gatiefaction that his lord-
ship did as interfere in the most prompt and de.
hided manner, the result being that this objectionable
buryinground containing only 1,600 equate yards, and in
which 200 bodies were on the average annually deposited,
was elomd altosether in the month of August last year. In
reference to thi management of the bospiml, the commis.
donors say that in consequence of certain defects which were
observed on • visit in April last • correspondence rook place
between the board and the general committee of governors,
and that on a further visit being made by two members of
the board in the mouth of June, it was satisfactory to find
from their report that some of the recommendations pre-
viously suggested by the board had been attended to, and
express toe hope that others calculated to benefit
the patients will be eventually carried out. They
also point out what they consider an important error
in the management of the hospital, which is, that while the
act of 8 & 9 Vict. requiree that the resid. at medical officer
should be styled the "superintendent" of the hospital, he
is here called the resident " apethegary," expressing their
hope that the governors who humanely devote so much time
and attention to the management of St. Luke's will take
this subject also into their serious consideration. The prac-
tice of placing sheets on certain straw beds during the day
having prevailed in this establishment, without the know-
ledge of the resident medical officer or the visiting
physicians, the following correspondence took place in re-
ference thereto. On the 16th of April last • report was for-
warded to the general and house committee of governors
to this effect: "The commissioners have ascertained
irons their inquiries this day that • clean sheet
is placed upon all the loose straw beds during
the day and is withdrawn at night, leaving the
patient only the straw and blankets for his use. The
effect of this is to give the anpearattee of comfort and
cleanliness to the beds appropriated to the dirty patients
which they de not possess, and thus to deceive the go-
vernors and other visitors of the establishment as to the
extent and quality of the accommoistion afforled to these
patients." To this remonstrance on the part of the board
the following answer was returned by the house committee:
—"The committee report that heretofore a clean sheet has
been placed by the attendant upon the pillows of the
straw beds of the dirty patients solely for the pupaee
of giving the room a tidy appeannce during the day ;
that it has been withdrawn at night simply because, if per-
mitted to remain, it would absolutely decrease the comfort,
and, in some instances, the safety of the patients; but in
order to prevent the recurrence 01 so unmerited an imputa-
tion as that of deception the committee have given orders
that the then be removed, and Ds use altogether discon-
tinued for the future." With reference to Guy's Hospital
lunatic ward for females, the ninitniuithers state that the
defects pointed out in their report of 1848 have been materi-
ally amended, that baths have b. en fitted up, and b, doing of
e
restraint
their
se:toil:true
u patientshaTit
aai
.cnt
greatly
condition
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nd:
Ice
.oh
htdbt.
and
tdh wioffaaore
amount
and
eat
diot
nehf eteou rteimechanicalaabtclmrees.nt
• superior description provided, that a great improve
o
condition
ectandaihoit
inmates,
promote
taeaddstffdiomi
and
tranquillity.
idrnaoavqt day::tidtl
ele
better means
materially
easi solLowyarmibt
oth usitt
n. t op i separatingoinebe
v,ge cat,.
hhpun
an
:Pdpsiarremolpvi
various
oc-
cupations—aid
consider it their duty to add, that the ward appropriated
to the insane in this hospital must, in their opt-
nioo, owing to its situation coniinue to be very
defective In several important requirements, and fail
to afford the inmates many of the advantages which
are calculated to alleviate disorders of the mind.
Under the authority of the statute the commissioners
have during the past year, at different times, per-
mitthd the temporary removal of eighty-eight patients Mum
various institutions within the metropolitan di/trims to the
sea aide, or on visits to their friends for limi•ed periods for
the begat of their health, which has been attended by the
best regatta, not only as contributing to the health
and comfort of the patients, but as affordieg a means
of testing their recovery in those cases where the com-
missioners did not feel themselves justified in order-
ing their discharge until they bed undergone tome
previous probation under the immediate eye of their relatives
or friends. On the subject of the Idiot Asylum at Highgate,
and its branch establishment at Colchester, the commissioners
speak is high terms of commendation. On the head of
" Wet/kilotons," during the past year 268 have been visited
by the sommissionen, and they report that the cases of
insanity of recent date or unto form which have been allowed
to remain for a conaderable period in workhounte, instead
of being promptly trrissferr. d, as the law requires, to •
lunatic asylum, have been of late years sensibly diminishing
in number, and are now somperatively rare ; a diminution
which we believe is mainly to be attributed to the super-
vision exercised by the commieei ners over these establish-
moots. The instances that have occurred of such detention
were generally to be suribed rather to the difficulty of pro-
curing accommodation for the lunatics in a curative asylum
within • reasonable distance, than to disinclinatith on the
part of the local authorities to incur the trouble and expense
of the removal. A few cases, however, of that kind hate
beet met with in the worse of our visitations during the
last year, and in nearly all of them our representations,
which have been effectually seconded by the poor law board,
have led to a farther and successful effort to effect the desired
re=s:Tateleohvealloo.....mmsaisissioaamn.ed.nabettleaodmatp of rof6dt.oo:to.
vpuisatauot.e:tl::::
thametkehodeathewhis:
by wields In the asylums, &e., during the past year asiosated
ts
to be highly credttable to the superinmadeate.
Me the lassie, to whose vigilsues and ears this result
easy be mainly attributed. The cue of "Hondas v. Ripley,"
sal the Lord Cbief Boron's judgment relative to the themes
of
dm legality of confining in outages musette sot
diegiveras to themselves or others" is thus re shed us. mad
40 amuse tails by the board in sowesquene• detailed.

They state that such was the erroneous impression for a time
produced by the promulgation of the dictum of the Chief
Huron, that they cite an example where same of the pauper
patients in a public asylum were examined by the guardians
with a view to ascertain bow many of them ought to he die.
&urged as "not dangerous to themselves or others," and add
the following illustration confirmatory of the visas of the
emantimioners promulgated in the last annual report of the
Royal Edinburgh Asylum:
"The cue of • Nottidge v. Ripley.' decided in the En-
glish courts, excited a good deal of interest among theme
°Pulsated with lunatic aeyluss, and no little anxiety on the
part of those who had friends in such institutions. There
seemed to be a general apprehension that all lunatics who
were not actually and immediately elanw-roue t, theense.lves
or others were forthwith to be set at large, to vex the
world with their follies, and to expose themselves to insult,
imposition, and injury. The influence of the decision re.
lured to seems to have so ter affected the better judgment
and experience of some parties, that not a few removals
from asylum' was the consequence ; for during the pest
year not lies than four patients were admitted into this
asylum who had been dismissed from confinement (I should
rather say, deprived of protection) under this Nottidge
mania, and had subsequently been breaking windows,
knocking down policemen, carrying loaded pistols on their
persons to shoot doctors with, or wandering through the
streets under the belief that they were royal or divine
personages."
The commiesiours then pus to the subject of private
paeten's in licensed houses, stating, that in making their
visitations to these establishments they had reason to believe
that in some instances the patients had not the benefit of
that suitable acesommodation and those c =forts to which
they were entitled from their circumstances and situation in
life. It some cues it appeared on inquiry that the relit•
ns were unable to afford a remuneration adequate to the
expenditure incesury tot proper acconunedadm and treat-
' meet ; and in others, that they neglected to appropriate a
sufficient part of the patient's income in promoting his cure
or adding to his general comforts. A few cues also
were brought under observation in which it was
evident that the sums paid were amply sufficient to provide
everything peculiars for the ra-mfort and restoration of the
patienc,.but the benefit of which they did not envoy. A
marked instance of the latter description having been
brought under notice, the hosed issued a circular on the
subject to the proprietors of private asylums in the metro-
politan district, and while remonstrating on the necessity
of an amendment of the practice on this head, think
it their duty to state, as regards some prorrieton
of licensed houses, that in various instances superior
comforts and accouildivion have been off ceded to pa
tient', mole with reference to their former habits
and station in life, than to the mere amount of
money received for their maintenance. Oa the head
of criminal er state lunatics, the commissioners ob-
serve that although the arrangement with the proprietors
of Fisherton Rouse, Salisbury, has been carried out for
receiving harmless criminal lunatics, yet the small number so
received ones very inadequate relief to the asylum., ices
much se, exclusive of more than 100 in Bethlem, 264 such
patients were confined in them on the let of Jatuary list.
It is also pointed:out that the effectual security against the
escape of criminals cannot be provideu tor, without restricting
the liberty of other patients with whom they are necessarily
associated, and materially interfering with that treatment,
and general arrangement which ought to be adopted for
their benefit, and many instaaces have been brought under
the notice of the commissioners, as well by the friends of as
by the pati nts themselves, in confirmation of their obit io
tions to this principle of association, that the consciousness
of so being associated with criminal lunatics is considered as
a great and unnecessary aggravation of their calamity. One
instance is cited of a criminal lunatic who escaped for the
fint time from Roston Rouse in February lost. The report
then proceeds to notice the outbreak and progress of cholera
in several of the asylums daring the last and preceding
years ; with respect to which full details and
statistics are given in an appeadix. Also to notice
the detective state of the law with respect to the pro-
petty of lunatics, and urges the necessity of the amend.
meat of the act referring to county asylums and pauper
lunatics. The concluding paragraph on the subjected luna-
tics at large, is to the following effect :—The commissioners
remind the Lord Chancellor that no amendments (though
more than once suggested in their former reports) of the
49th and other sections of the 8 & 9 Vie. c. 126, have been
submitted to parliament. They deem it most important that
the public should be protected from the perils arising from
the neglect of friends or pariah ttlieers to place lunatics under
proper care. Instances have during the last year occurred
which confirm their formerly expressed opinion, that danger
or serious annoyance may be apprehended, especially to pub.
lic charaeten or individuals of high station, owing to the
defects Lathe law ; defects which they have been mush dis-
appointed to find no measures have been taken to remedy.
The following is a summary of the number and classes of
insane peis.ins confined in asylums, hospitals, and licensed
nooses on the Ist of January last :—Asylums: private
pcieots, melee 120, females 112; paupers, males 3,160,
tamales 3,768, total 7,140. Hospitals: private patients,
males 412, females 453 ; pauper., males 175, females 168,
total 1,208. Metropolitan licensed houses : private patients,
males 674, finagles 546 ; paupers, males 737, females 1,038,
total 2,945 Provincial licensed houses : private patients,
males 800, females 757 ; paupers, males 1,106, females, 1,123,
total 3,788. Grand total of sues and chimes, 16,079 ; of this
number 238 have been found lunatic by inquisition, 284 are
criminals, and 1,036 are chargeable to counties or bereave".