MODEL LUNTIC ASLUMS.

Press, Volume XXXI, Issue 4204, 18 January 1879, Page 5 (Supplement)

MODEL LUNTIC ASLUMS.

[« Pall Mall Budget*'.! f

A model luriatio asylum may be described as a place where the managing doctor his his heart in his work and is seconded by aimiaMa equally zealous for tho cure of patients. These conditions may be found .as well in a small and poor asylum as in a large and «eh one: but given a good medical staff, and the lunatics will of course get extra chances of cure if they bo surrounded by all ■ that can make them happy by furnishing them with employment and recreation. In some former remarks on the condition of the, mentally afflicted we endeavoured to show why large State asylums were so much preferable to small private ones; but; the large, asylums have their abuses too; and chief among these, in places where the doctors are not alive to their duties, is the tendency to screw as much wortas possibi* but of the lunatics, in order that the directors vbf an asylum may be able to publish imposing; tables of; ; financial statistics every year. instance of this niay be cited in conngction ipifh the famous lunatic colony of "Gheel, in Belgium. Gheel, which; issituated in the midst oxtheCampipsinthe! province of Antwerp, has been a lunatic > Jsjarxs for ages, an 4 pMMUte.iare. aarit.to&iti of the imgdera. They'ire-bf three classes: .those aunported.by Government, those at tbe and those £O0f; s yew for tiieif ooard/

60f. for clothing, 12f. for medical attecdancs, aud. some odd sums for extras, which bring up the total to £12 per annum: tho lunatics at the charge of tlveir families pay according to tho comforts and small luxuries stipulated for them, but the scales aro always moderate oven when the patients come of wealthy families. Tho colony is managed on tho boardiag-oufc system. Ev«ry pttient is sent to reside in tho family of a peasant or farmer, aud, whim fit to work, is employed on agricultural labour. Now, some, time ago a patient who bad spent six months at Q-heel and got ourod published some'startling diacluaurea as to tho neglect and ill-treatment to which tho lunatic colo» njsta were subjected. Many of them had sunk into the condition of mere bondsmen under harsh taskmasters. Tlu»y were forced to do the most repulsive sorts of work ; beiug often confined indoors when they ought to hare been in the fialde, and at the least murmur of discontent they wero threatened with tho "infirmary," which had beoomo a name of terror in their ears becauso it was nothing else but a filthy prison. Here the refractory were put into shackles nud straitwaistcoats, afflicted with "douches," nud locked up in uhwarmed cells. But the evil did not stop here j for it seems that tho doctors, who ought to have exercised a close supervision over the cottages and farms to soo that they were properly kept,seldom troubled themselves to pay any domiciliary visits, but oontented themselves with going an occasional round of the field', so that they were ignorant as to ho* tbe lunatics were lodged or fed; and sometimes they would hear that a patient had'died of a slow disease before thoy had even been informed tbot ho was ill. These rovclations, when token up by tho Belgian press, naturally produced a sonsutiou, and a Royal Commission was appointed, which, it seems, has since set the. colony of Gheel to rights; but such facts will show how soon an excellent institution may de« generate if the medical staff be incompetent or lttzy. There cannot possibly bo a better system for tho treatment of lunatics than that theoretically prevailing at Gheel; and if the regulations lately drawn up by the Eoyal Commission be enforced, the place will become once more a beneficent institution. But it did undoubtedly decline some time .ago.; and it is a proof of how much statistics , are worth that, at the time when the condition of the place was at its worst, the .official reports showed it to be in a splendid state of financial prosperity, the labor of the .lunatics being more than enough to dofray all i

A model -asylum muoh commended at tho recorit Congress' of Alienist Physioians in is that Or Clermont, Oise, managed by MM. Labille Brothers. Here, again, , the patients are employed at ttgrioulturaXlabor, and are boarded out in large farms,, The asylum is under State control, being used, in faetjipr the,reception of all pauper lunatics in the Oise ; but there are detacnod pavilions surrounded with private gardens for the accommodation of patients who can afford to pay from £100 to £240 a year. There are also workshops,, where some of the lunatics are ( employed at manual crafts. All the arrangements at this place appear to be] good; for the lunatics are allowed to enjoy two-thirds ol . ther earnings, asmall percentage being given , them to buy small luxuries during their confinement, while the rest is remitted to them lipon their discharge or is bestowed for the support of their families. Nothing can be better than this; but such ■ liberality (economical liberality,'after all, if the general results be considered) is very far from being oOmmbn 7 in somp other largo asylums, which seem to bo oouduoted solely with a view to making lunatic r labor profitable. It has been found that iv some of these r places a. skilled mechanic had the greatest s difficulty in obtaining," Eia'.d&oharge. ( ,Ha , was employed, to , make boots, clothes,' ! or furniture, and the ' more he worked so,much the less inclined Were the authorities to dismiss him j and often the wretohed fellow was not paid at all for hig : esertions. A commission instituted by , the municipality of Lyons two yoars ago discovered some deplorable abuses of this nature in a large asylum of' the Bhone. In the private residence of the ohief physician they •[ found a. oook, a gardener, and a cabinetpiaVer, all three perfectly boeo, though alleged lunatics, who were employed in unpaid -, service. The cabinet-maker, who whs a clove!? artiaan, had fabricated quite a collection of chain, tables, and bureaus for his master j • hud all this while his family, who might easily have been supported by the proceeds of his labor, had become chargeable to the ; Bureau' de Bienfaisahoe. When taxed with ' having done a very irregular thing, the doctor' answered,breezily that his three'servants conjsidered it a fayor to work in his houses and that had they been discontented with their lot they' might easily have escaped from tho < asylum, since there was no rojtraint on them,, ; ilt was, found' on inquiry, however, that onj) T |oi, the servants had, after recovering his ■reason, attempted to (.scape, and been severely. : ;punished;for it by "douches" and confinejment in, a cell with a etraifc-waietooafc on j in fact, the truth was that tie servants had only, accepted drudgery in the doctor's house as an • alternative to the worse fate of being shut up in the wards along with- the really mad' patients,. This was a very,bad case and' it "Is eatftfaoldr£ to add that tho doctor „ was dismissed}.but his conduct only proves: once again • liow Heceasary it is-that asylums jshould be inspeoted , often, and that tho should keep then* eyes open during |their visits.. M- Maxime Dv Camp, in his iwork: oii Paris,: deals exhaustively with the Iquestipnjof asylums, and unfolds,a plan 1 o£. Baron Hauismann for building" ten large, Impdel aeyliiniflneajr.BarU, whioh should hay«: :completely • done. away with the private. mauong demnU. ! Three of these establish*. Anne, Vauoluse, and Vfllo id*AVray~were completed; but the Baron lefjr' I office before he had time to .build throfheMi? t and'thereby execute the whole of B;gsheM&! ■which wouldihayemad?-France the;foreraoafc jof nations in respect of this particular kind of ) charity/; Am -ifeta; M, Dv geema to?t»j iof opinion that his country has no aeylud, ,'not even that -of Clermont, which fully? '• realises the ideal of what a lunatio institution 1 'should bo; and he cites as a model to be ! copied; the asylum of Illenau, near Acbem, ; Jin' 'the, Grand Duchy of, Baden. Dr» 'Roller, ' who founded the place in 183 ft ! a^d, waa still managing . ifc -two'- yeais itffc ma/jle, it a rulp to receive no more , than. 600 patients -, and his .staff- was r oomiposed of 175>attendante f tenphysicians,: an<| I six medical; students. The attendants were ! all carefully Selected and well paid; and the. physicians were all required to live among the patients all hours of the dayy Dr.-'Molle* himielf did si j and he required that however the lunatics were employed,' whether at work or at play, thwro should be two or three doctors among them to exercise a cbtifrm over the warders and set them an example of kindness and good manners. Hot'only that, but Br. Boiler busied himself about bis patients after their, dis--ohaJg { } JPor he corresponded with their friers periodically until he was assured that a perfect curejbad been effected; and if he hoard that a former patient was ailing he sent one of his 'dojojfeors to see him, or went himself, witiym? caring what tho distance might bfr and without charging anything for his visit* Here was a genuine philanthropist; and the excellence of his system was proved; by the fact that among She patients whb were discharged | from his asylum the average of relapses was only four per cent. ' In'eonie of the French departmental asylums the averages 25 per cent., and in private maUoiis 'de-smt*it m said to be'even higher. It cannot bs expected of »p. asylum doctor* that i&ey should bo devoted philanthropists; bntaoTuefchißg might at least be done to make them all adhere to duties plainly marked out for them by regulations more stringent and sensible than any Which now exist lor the goveroanco'of aeylums." ."' '.' '" '"',.v'l .''