REPORT OF THE JOINT COMMITTEE ON LUNATIC ASYLUMS.

Appendix to the Journals of the House of Representatives, 1871 Session I, H-10

H.—No. 10.

REPORT OF THE JOINT COMMITTEE ON LUNATIC ASYLUMS.

WELLINGTON.

1871.

PRESENTED TO BOTH HOUSES OP THE GENERAL ASSEMBLY, BY COMMAND OP HIS EXCELLENCY.

H.—No. 10.

Dr. Johnston,

Your Committee having considered, the evidence hereto appended, have unanimously agreed to the following Report:— 1. That the Asylums in the Colony have not (save in some localities) either proper or sufficient accomodation for the reception and care of Lunatics. 2. That it is expedient that the General Government should take measures to cause proper provision to be made in those parts of the Colony where the present provision is insufficient. 3. That a duly qualified Medical Officer from the United Kingdom, having special knowledge and experience in the treatment of the insane, be forthwith engaged and appointed, and who shall have the supervision and control of all the Lunatic Asylums in the Colony. 4. That the question of a General Central Asylum be postponed until next Session, by which time information will have been obtained from Reports of the Inspecting Medical Officer, which will serve to guide the action of Parliament. 5. That whilst steps should be taken to improve all the Asylums of the Colony, the state of that at Karori, near Wellington, urgently requires immediate attention and reform. A. Buchanan, M.D., Chairman.

MINUTES OF EVIDENCE. Tuesday, 29th Septembee, 1871. Dr. Alexander Johnston, M.E.C.S., in attendance. 1. The Chairman."] Have you any special acquaintance with the. subject of the management of lunatic asylums ? Not of late years. I had charge of the Karori Asylum about eight years ago, and since that time I, of course, have had only occasional insane patients placed in the hospital. 2. How many patients were there at Karori at that time: about eight years ago ? About thirteen. 3. "Were the buildings of the same extent as they now are? I think they have enlarged the place since. 4. Did you use any curative meanß when you were there ? No, I had no opportunity. 5. Tou simply attended them professionally ? Yes, once a week. 6. Tou are aware that the Committee has been appointed to endeavour to collect evidence with the view to improve the existing institutions, and to form a central one. Can you give any suggestions to further these objects? My chief suggestion would be that there should be a thorough investigation by the Government, and a report brought forward. It would take one year to get that thoroughly and well done. 7. How often did you visit Karori? I was supposed to go to the asylum once a week, to see if any patient were ill. That was my duty at that time. The present medical officer is, I think, supposed to go there twice a week, but I do not think he looks upon himself as being responsible for the curative treatment of the patients, which would be entirely under the supervision of the people there. I mean to say that when I visited the Karori Asylum, I had no moral control; i merely attended the patients professionally in the case of illness. 8. The Hon. Captain Fraser.] How were the patients exercised ? The quiet ones were out every day ; but those who were not quiet did not get out at all. 9. How were they confined, were they ever chained ? No, none of them. 10. "Were they clean ? Tes, the place was kept thoroughly clean. No chains were used. The strongest measures taken were using a strait jacket, just a canvas jacket. 11. "When were you there last? I was there last about two years ago. 12. The Chairman.] "When the patients were allowed out for exercise, were they allowed out in the yard only, or out in the fields ? There was a paddock of about four or five acres, and they were generally allowed to go into that, and they were generally employed in bringing water or anything of that kind. 13. "Would they be employed in the garden ? I had small gardens made when I was there, about a quarter of an acre. 14. The Son. Captain Fraser.] Had you any amusement for the patients ? any curative treatment ? No, none. 15. Had the attendants any special knowledge of the treatment of lunatics ? No, I believe those who had charge of them were uneducated, and not at all capable to administer curative treatment: they had no special knowledge. 16. Mr. Steivard.] Was there any classification attempted, between cases of confirmed lunacy and persons suffering from temporary insanity ? No, there was no opportunity for special classification, because we could not separate the patients.

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17. Is it your opinion, from experience of persons suffering from distinct kinds of insanity, that it is desirable to separate those classes ? Certainly. 18. The Chairman.] I think there is only one room for men, and one for women ? I had only one for men and women, but they have improved the place very much since that time. 19. Mr. Andrews.] Have you any insane persons in the gaol or hospital ? One woman has been in the gaol for several years. She was a very respectable and steady woman, and was sent there because Karori was crowded. 20. The Hon. Captain Fraser.] Are you aware that that is illegal, and contrary to the Act? For that I am not responsible ; I only found them there. 21. How many are there in the hospital? Two in the hospital, and three in the gaol. 22. By what authority were they admitted ? By the authority of the Superintendent. 23. Are they admitted on a medical certificate ? Yes :as patients to the hospital, but not as certified lunatics: not legal lunatics, lunatics not in law but in fact. 24. How many of them are certified lunatics ? The three in the gaol. 25. Were they admitted on a certificate ? I believe so ; that is, into the gaol; because they could not be admitted on anything else. They were not sent there for any crime. 26. "When was the last admitted ? About two or three months ago. 27. Upon a certificate of a medical officer, under Schedules 10 and 11 of the Act ? They were not committed on my certificate. I found them there. 28. The Chairman.] You say there are three in the gaol, and two in the hospital ? The two in the hospital are not certified lunatics. 29. The Hon. Dr. Benwick.] "Why were they admitted ? Because there was no accommodation and no room for them elsewhere. 30. Do you think the present asylum at Karori is at all fitted for the treatment of lunatics ? No, certainly not. 31. Will you give me an idea of the relative cost of large and small asylums? The cost of maintaining a lunatic asylum for twenty patients would be out of all proportion to the cost of one where you could keep one hundred. 32. And therefore is it your opinion that, for twenty or thirty patients, it would be necessary to have attendants specially trained for that purpose ? Certainly. 33. And that medical men generally have not a knowledge of the proper treatment? No, certainly not. A man must be naturally adapted, as well as being specially trained by education. 34. Would you recommend that there should be a General Lunatic Asylum ? I recommend a General Asylum for incurables. For those who would be likely to be amenable to treatment, there might be two or three, perhaps, for the whole of New Zealand. 35. The Hon. Captain Fraser.] Are you aware that any patient has been discharged as cured from the "Wellington Asylum ? I believe so, but Ido not know of my own knowledge. I think they have been left very much alone, and sometimes nature has reasserted itself. 36. The Hon. Dr. Remoickf] Can you form any idea of what the cost would be of an establishment for the treatment of lunatics, and capable of containing thirty or forty patients ? I would require time to consider that; but I could, of course, easily arrive at it. There would be the expense of extensive buildings, and the cost of certain officers who, in England, are highly paid for their services. They require to be specially adapted aud trained. It is very trying work for the brain ; for the supervision, to be satisfactory, must be constant. Patients should be led to take au interest in some amusement or. occupation, and it requires some special knowledge to do that. 37. The Chairman.] Do you think it would be better to have an asylum nearer town or out ? 38. I think it is an important matter to be near the town. The present place is most miserable. The site is rugged and damp, has no cheerful view, and it is not a fit place for any patients to live in. It seems out of reach of being visited, except by those who are obliged to go there. It is too far from town for people to visit it. 39. Do not you think it would be greatly to the advantage of the institution if people were enabled to visit ? Ladies might take an interest in the patients, and promote amusement ?—Yes. 40. Mr. Steward.] Is there anything like magisterial inspection at the Karori Asylum.—Yes, for the last two years an Inspector, appointed under the Act of 1868, has visited the asylum. The Inspector's name is Mr. Bowden. 41. The Hon. Captain Fraser.] Has he made a report ? I believe he has made a report. 42. Had he any previous knowledge of asylums ? Ido not know. 43. Are you aware there was an intention to send the lunatics from Karori to Otago ? Would it be better to send them to a central asylum ? Yes, and I believe that at Otago is a very good one. 44. Mr. Curtis.] Do you think it desirable or objectionable that patients should be removed from the neighbourhood of their friends and relations ? I do not see any objection to the removal of incurable patients. 45. But with reference to curable cases ? It is better, of course, that they should see their friends and be sufficiently near to be visited by them. That is why lam in favour of two or three asylums, so that the patients would be within reach of people who would visit them occasionally. 46. With regard to the inspection, do you think it desirable that an Inspector should have any special knowledge of lunatics ? He would not have charge of the lunatics, and therefore would not require to have any special training. 47. The Chamnan.] Do you think one Inspector would be able to inspect all the asylums in the Colony? There should be an Inspector for each Island, and he could inspect gaols, Government hospitals and asylums: that is the usual course. 48. The Hon. Dr. Benioick.] Have you any idea of the salary paid to such an officer as would be required ?—At home, Surgeon-Superintendents receive from £800 to £1,500. 49. The Chairman.] Do you allude to such an establishment as Colney Hatch?—Yes; at Colney Hatch they would have two or three men with £700 or £800 a year, and one with £1,500 or £2,000.

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Dr. Johnston.

Dr Kamp.

50. Have you any idea of the number of patients at Colney Hatch ? Ido not know what number there are there. 51. The Hon. Captain Fraser.] At Han well they have about 1,000? Yes; and I believe the number at Colney Hatch is larger. 52. Have you any idea of the number of lunatics in the Birmingham Asylum ? Yes ; about 400. 53. What population are they supposed to be derived from ? I thiuk the town alone has a population of 300,000. 54. The Hon Dr. Renwick.] Would you inform the Committee what number of patients one medical officer could fairly attend to, and give especial curative treatment ? I think a man could take charge of thirty to forty, with proper trained assistants. 55. Mr. Curtis.] Do I understand that the visits of relatives and friends of a lunatic supposed to be curable are advantageous to the chances of recovery, or otherwise ? According to the kind of case. It would be for the officer who attended the case to judge. I have often received complaints from the Warder of the Gaol that the noise made by lunatics there is sufficient to keep the hard labour prisoners awake all night, and gave them great reason for making excuses that they were not fit to go out to work. Keeping lunatics there was subversive of all discipline. 56. The Chairman.] Would you advise that it is more prudent to endeavour to improve the Provincial Asylums so as to make them better fitted for the curative treatment of lunatics, or establish at once a General Asylum for all such cases as would bear removal without detriment? Ido not think you could make the present asylums suitable. For instance, the Karori Asylum is quite unfitted for one, not only on account of its position, but on account of the construction of the buildings. 57. Ido not mean with reference to the buildings so much as to the locality. Is it desirable to have the asylums in different localities improved, and thereby make it possible to have treatment more effective, or to have one general asylum for all patients? I think it would be better to have two or three asylums altogether new, and for the whole of New Zealand to have one central establishment for incurables. 58. Then you think the local asylums would be indispensable, even if a central asylum were established ? Two or there Provinces might amalgamate, and have one asylum. Ido not consider Wellington, Nelson, or Taranaki, sufficiently large to have separate asylums. 59. The Hon. Mr. Menzies.] Suppose one local asylum were established in Canterbury or Otago, would not the class of cases that would most naturally and rightly be sent there be likely to suffer from the length of the journey from a remote place, say 200 miles? Certainly not. There would beno risk whatever to the lunatic, and the journey might tend to improve him. 60. If in the earlier stages of insanity ? I do not think travelling would be at all against a lunatic. 61. Mr. Parker.] How many cases should be under tho charge of a resident medical man ? I believe that is provided by the Act. 62. The Hon. Captain Fraser^] In the Dunedin Asylum there are 150 patients, and there is no resident medical officer. A medical man visits every day, or oftener if required. Do you approve of that? When cases are supposed to be curable a medical man should be with them more constantly than in a passing visit every day. A man's whole time should be given to the patients, whatever number he has in charge. (Witness withdrew.)

Tuesday, 19th September, 1871. Dr. W. G. Kemp, M.R.C.S., L.S.A., in attendance. 63. The Chairman.] You had charge of the Nelson Lunatic Asylum ? Yes, for about twenty months. 64. How many patients were there under your charge? The greatest number I had, I think, was about 35, and the average number 25. 65. Had you any previous special knowledge of the treatment of lunatics ? I was in the Leicestershire Asylum for a short time, a month or two, when I had temporary charge. 66. What sort of buildings had you at Nelson? Not at all fitted for a lunatic asylum. There was not adequate accommodation for the number of patients, and there were often two people in a small cell. There was a great want of sufficient room. 67. I suppose men and women, had separate rooms ? Yes ; quite separate. The airing yards were close together. 68. Did you adopt any special curative means ? In so far as I was able, I did. 69. What means did you employ ? Out-of-door exercise as much as possible: gardening, chopping wood, and anything the patients had a turn'for ; and if they had no special turn, they used to do anything that was wanted about the place. . 70. Were any employed doing anything to the buildings ? No, except in helping to clear away the rubbish, not directly in the building. 71. Could you give an idea of the number in a year you cured, and a certain number would be received, and a certain percentage would leave the Asylum cured? I cannot tell the percentage. J remember several cases that were sent away, and I never heard anything more about them. 72. Did you discharge them? I think I had to send in a report to the Superintendent, and he used to discharge them. ■-..'.: 73. During the time you were there, what means were adopted.in the case of a patient being violent? They were put in a padded room, or a strait waistcoat, was put on. 74. Do you know of any patient there being chained ?-^I am certain not when I was there in charge. 75. There is a padded room ? Yes. 2

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Dr. Kemp,

76. Was the diet of the patients liberal ? Yes, very : they were well fed, and used to get quite fat. We had medical comforts. 77. The Hon. Captain Fraser.] Did you give liberal allowance of wine and beer ? I did not often order it, only in cases where I thought it really necessary as a medical comfort. 78. Did you use imported or colonial ale? As far as I can remember, it was colonial. 79. Have you any knowledge of the asylum at Karori ? I have never been there. 80. Mr. Parker.] Would you recommend that a resident surgeon should be attached to a lunatic asylum ? Yes, if of a sufficient size. 81. How many patients could one look after ? At home, with 400 patients, there would be the surgeon-superintendent with an assistant and trained keepers. At the Leicester Asylum, there were 400 to 500 patients. There was a surgeon-superintendent, with trained keepers under him. 82. Do you recommend any particular size for a lunatic asylum —whether would it be better to have four capable of containing 100 patients each, or one for 400 patients? If there were sufficient attendants, tho large one would work best. 83. Mr. Curtis.] Do you think patients would suffer from being removed from the immediate neighbourhood of their friends and relations ? Do you think that such removal would have a good effect ? In some cases it would do harm, and in some good. , In some cases lunatics brought from the coast, who have been inoffensive before the journey, have arrived at the asylum at Nelson raving lunatics. 84. Might that not have arisen from the march of the disease, and not from the journey ? No. 85. The Hon. Captain Fraser.] Might they not have taken stimulants on the way ? No, because they were under the charge of a constable. 86. Mr. Parker.] They must, of course, be brought some distance ? I think the less travelling they have the better, as a general rule. 87. The Hon. Mr. Menzies.] Would it be well to maintain the local establishments for a particular class of cases ? Yes, cases of short standing. 88. Might I ask what proportion of 100 cases would recover shortly, and within what period ? I was looking at some tables in my journal, and I found a record that of 500 patients, 300 were sent out in two years, some cured, and some more or less cured. 89. So far as your knowledge goes, about 60 per cent, were cured in two years ? Yes, very nearly 60 per cent, were cured in two years. 90. Would it be advisable to maintain the local class of asylum for that class of disease ? Certainly, I think many would be cured in a much shorter time than that. Cases of over six months standing should be sent off to a central asylum, because lunacy would be pretty well confirmed. 91. The Hon. Dr. Renwick. —Should tho attendant, in the Provincial establishment, be a specially trained medical officer?... Yes, if possible. 92. In the event of not having an officer who had been specially trained, do you think the chances of recovery would be as great as in a lunatic asylum where there was a specially trained medical officer, with proper appliances? No, not nearly so great. 93. Under the circumstances in which the Colony of New Zealand is placed, with a number of outlying districts, do you think it would be the best mode of treatment to establish a large central asylum where there would be properly trained officers ? Yes, I think so. It would be much more beneficial to the patients, and a larger number would be likely to recover, the appliances would bo better, and the medical man should be one thoroughly educated for his position. 94. Mr. Parker.] I suppose, in an asylum with 100 to 150 patients, it would bo worth while to keep a resident medical officer ? Certainly. 95. If an asylum were as large as that, would it be worth while to retain it (for it would not be too small) ? would you rather have the patients kept in one of that size, or sent to one where there would be 400 ? Cases that are of long standing, or likely to bo incurable, it would be preferable to send to a large establishment: if they retained a spark of intellect they would have a better chance. In other cases I would prefer a local asylum. 96. The Chairman.] Is there any suggestion you would make on the subject ? In the first place, as to a central lunatic asylum, and as to local ones, I should certainly suggest either one asylum for each Island, or one for the whole Colony, according to requirements, and they should have properly trained medical men at the head all day, to carry them out efficiently. All cases of long standing should be sent to those asylums, and the smaller ones should be put in a thorough state of repair, and made efficient for short cases. That would save expense, and increase the chance of recovery. 97. Do you think that, besides the resident surgeon, with a proper staff of trained servants, there should be an Inspector-General, to visit the Provincial asylums ? Yes ; there ought to be, to inspect the central and all asylums. 98. Mr. Andrew.] The same officer would have sufficient time to inspect tho gaols as well? I would rather see that made a separate appointment, but it would depend greatly on the salary he would be paid. 99. The Chairman.] Could he inspect all the gaols and asylums in tho Colony ? Yes; he could do it. 100. Of course it must be his solo and special work ? Yes. 101. Mr. Parker.] Would you think it advisable to combine the Inspectorship of Gaols and Hospitals in one officer ? I should think it would be almost more preferable to have in each Province an Inspector of Hospitals. 102. The Hon. Dr. Renwick.] Perhaps the Inspectorship of Gaols and Asylums might bo combined ? Yes. 103. Are you not of opinion that hospitals require inspection ? In England they are not inspected, being generally managed by a Board of Governors. (The witness withdrew.)

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Dr. Frante.

Wednesday, 20th September, 1871. Dr. France, M.R.C.S., in attendance. 104. Tfie Chairman.] You arc the surgeon of the Karori institution? Yes, the medical attendant. 105. How long have you been so ? Nearly ten years : ten years next November. 106. How often are you in the habit of visiting ? At the least twice a week. Sometimes every day in a fortnight, if there is illness. Igo out on the arrival of a new case. I think I had occasion to go out every day for a fortnight; and once or twice, at all events, every day for a week, or five or six days in succession. 107. I suppose you do not enter your name in any book ? I used to do so until the new Act came in force. That was only to show I had been there according to instructions :at least twice a week.' In accordance with the present Act, I have to make a statement at least once a week in a journal, so I always take care on one day when I am visiting to comply with that. 108. What is your opinion about the fitness of the buildings at Karori ? They are very inadequate, and the position is ineligible. They are at their best just now. 109. How many patients are there at the asylum now ? Twenty-four ; one wms admitted since you were there. 110. How many do you think the asylum could conveniently accommodate ? Not more than twelve or thirteen. There were seventeen wards altogether ; but four were intended for the purpose of transferring noisy or dirty patients to them out of the main building; but we have to use them as dormitories. There are about double the number of patients there that ought to be. We have to place two men, and in one case three men, in one room. 111. The Hon. Captain Fraser.] What is tho size of that room ? About fifteen by ten feet, with walls twelve feet high. 112. Is there any ventilation: any proper means of ventilation at the top of the room ? It is ventilated owing to the building being of wood ; but not well and properly ventilated. 113. I understand you simply go there to treat the patients in case of illness? I suppose my visit may be looked upon as inspectorial, because hardly any one else ever goes. Mr. Bowden went for the last six months. 114. The Chairman.] What means do you use for violent patients ? Generally confine them in a room, and scarcely ever use the jacket; we never handcuffed them, wo found tho jacket sufficient. 115. Is there any danger of a violent patient knocking his head about? We are supposed to have a padded room; but really it is not one, it is merely lined with canvas, and stuffed with hay. It would be a great expense to get a proper padded room, one lined with india rubber. When we have too violent patients we show them that their behaviour is not right, and treat them by putting the jacket on until they promise to behave themselves, which they do in a few hours, so far as I have experienced. 116. Are you aware that females are shut up for clays consecutively ? Tes, wo have had two shut up for days together, but separated from each other. I once saw a woman naked there. 117. How was that ? Tou will often find that in large asylums, even at Colney Hatch and Han well, we put a locked dress on them, but some will destroy a strong dress very quickly, and strip themselves. Being naked is their own doing, and some would destroy two or three suits of clothing before you could stop then. We had strong canvas dresses made, lined with flannel and fastened with a lock; but I think a staylace is better. lIS. The Chairman.] What means have the patients for washing themselves ? Wo have washhouses, not proper baths. 119. The Hon. Captain Fraser.] Any warm baths ? No, nor a shower bath. 120. The Chairman.] No bath of any kind, no proper bath ? There are tubs. The patients are kept very clean, and are washed daily. 121. The Hon. Captain Fraser.] Their persons, all over ? Not all over daily ; once a week, and sometimes twice a week ; but they are washed every day all over if they soil themselves, or if it is necessary they should be washed ; they never hesitated to do it. 122. The Chairman.] Have you any suggestion to make for the improvement of tho asylum? That matter is referred to in a report I have already sent to the Government. I recommended a removal to a new building altogether. 123. Where would you think a good site for the buildings ? They ought to have a pleasant view, and the only pleasant and cheerful prospect I know of is overlooking the bay and the harbour. I think the patients ought to see the bay and harbour. 124. Is there any particular site that is eligible, and might be obtained ? There is one in the Wesleyan Reserve, in the neighbourhood of the Grammar School, and overlooking the Botanical Gardens. I think there is a position there that would be eligible and available. 125. The Hon. Captain Fraser.] Could carriages go there ? I fancy a road could be made. A bridge would be required ; but that could be made easily. 126. Are you aware that there was an intention to send the lunatics from Karori to Otago ? lam aware that an application was made to the authorities. I think it was found that the removal and cost of keeping them would bo moro expensive than erecting new buildings. It would cost more per head. 127. The Chairman.] How many female patients are there ? Eleven. 12S. I think you have no female attendant? We had one, but she was not a success, and we are now waiting for one who had three years experience in Tasmania ; she is tho sister of a settler's wife who lives in Wellington, aud wc expect she will prove to be a useful woman. We had to wait in order to communicate with her ; she had written to her friends to say she preferred coming to Wellington if she could ; and, as she had been three years in one asylum in Tasmania, it was thought best to write to her. 129. She is still in Tasmania ? She will be hero in two or three weeks.

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Dr. France.

130. Suppose a female patient was violent, would men have to be called in ? They could not help doing so, if she was very violent. The matron would get one man to assist her, and she would have to call in more if force was required, but probably she would get one of the female patients to assist her. 131. The Chairman.] Tou have only two assistant-keepers?' The force has been increased lately very much. There are two assistant-keepers and a cook, as well as the master. The cook would not, unless a fourth man was required, interfere in any such matter. The general form of violence on the part of females is that they tear their clothes. 132. Does the matron never leave the buildings ? She leaves less frequently perhaps than anyone, once in two months, but there is nothing to prevent her going out whenever she thought proper to do so. 133. In that case the women would be left without a female attendant ? Tes. 134. And what rule is there for the keepers ? They go out alternately. 135. But it is only since June you have had two there? Only since June: formerly there was only one there, and he acted as cook. 136. Will you be good enough to state how many patients were cured? During nine years, up to January this year, there were forty-eight admissions and twenty-nine were discharged, and there were nine deaths. There were ten patients in the asylum when I went there. Two died soon after they were admitted. One was a case of acute mania, a case of general paralysis brought on by intoxication. They were really sent to the Asylum to die. 137. I suppose you had no special knowledge of insanity before you went there? No. 138. Do you adopt any plan of treatment? We do not shave their heads, blister or purge them, or anything of that sort. We adopt the plan used in any well-managed asylum, restraining them gently, and in case of any bodily ailment, treating them for it. 139. Do the patients ever get out; leave the asylum ? No, there is no arrangement for their going away. 140. The Hon. Captain Fraser.] Do they never leave the asylum ? No. 141. Have you any yard for exercise? They go out of the buildings into a paddock containing about five acres. There are two enclosed yards attached to the rear of the buildings. There is'a front garden of about a quarter of an acre in which they walk about. 142. I saw a man walking about in the yard barefooted, and his feet were quite blue and covered with chilblains? Originally that man was dangerous in this way. When visitors were there he would suddenly become violent aud kick them, and would sometimes break his boots to pieces. The peculiar colour was caused by exposure, and was what is called pigmentary. It was not from chilblains, for his feet were that colour in the warmest weather, and you sec this with sailors' feet. He was a sailor, and the fact of the matter is he would not have boots on. 143. Female patients were also walking upon the bare floor and had no covering to their feet? Some will kick their shoes off and destroy them. 144. The women are not. most refractory? One is very violent, she has been there for ten years. 145. Do the female patients never get out? The females get out in the front, in the garden more particularly. I had a croquet ground prepared and a bagatelle table, but the men have the best of the amusements at present: they have a pack of cards and a set of draughts. We want the amusements increased, and especially the out of door amusements, but there is no suitable place at Karori. 146. If the site were nearer the town the inhabitants would take some interest in the Asylum ? Nobody ever goes to Karori, and people never talk about it except from hearsay. 147. I looked at the book for visitors, and saw very few names since I was there two years ago ? At present the roads are passable, but last winter they were impassable in places. 148. Do you require more female attendants ? We ought to have three female attendants including the matron. Some female patients are very troublesome, and one of the three violent women is the most filthy in her habits. Otherwise they are all in good bodily health. The one I refer to has been in three years, and she is the daughter of a lunatic. Her mother has been one for sixteen or eighteen years, aud her father died in a lunatic asylum. 149. The Hon. Captain Fraser.] Do you allow the patients out of control occasionally ? Wo have no means for doing so. 150. How do you mean no means? No means of letting them out excepting as cured. 151. If their friends gave a guarantee? They have no friends, they aro paupers. 152. Are there any out with friends at present ? No, none are out. We cannot send them out to get a living or employment. In one instance a man went away to the neighbourhoood of the place he came from, but he, 1 think, got tipsy, for he came back, and was worse than he was previously. A man who was a patient two years ago came there again and wanted to stop. He slept there, and said he had not slept so well for a long time. He was as shabby as possible, did not \\ish to leave, and was quite at home. Ido not know whether the mau ought to have been sent there. In a week's time he might be as well as we are. 153. The Hon. Mr. Menzies.] What is the most common cause of insanity here ? Perhaps an hereditary tendency. A great many suffer from blows on the head and other violence. Several of the men have severe scars on their scalps. The head of one was so covered with scars that it appeared as though he had had severe bouts at single stick. 154. The Hon. Captain Fraser.] Was he not able to explain how he got the scar? No, he would say nothing for days, lie was suffering from aphasia, but he improved very much. 155. The,Hon Mr. Menzies.] Is drink a common cause ? Drink is the most common exciting cause. 156. As regards men or women I think drink has had a great deal to do with the origin of the attack in both, but the tendency to drink is brought on by the previous condition of mind. ■' (The witness then withdrew.)

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Son. Dr. Grave.

The Hon. Dr. Grace in attendance. The Hon. Dr. Grace read a report on the subject under the investigation of the Committee, in reply to letter from the Chairman, asking for a report on the frequency and nature of lunacy in the Colouy, and the respective advantages of local general asylums. 157. The Chairman.] Of course our object is to endeavour to make out such a case as to convince the General Government of the necessity of assisting to put Lunatic Asylums in a much better condition than they now are. We want evidence for that. I think you told me yesterday you had been to Karori, and had seen a patient there who had been locked up for a week in a state of nudity ?— I saw a female patient of my own who had a species of hysterical mania. She was confined for a period of three' weeks perfectly naked in a cell. She was in the habit of daily smearing herself with her fceces. There was no proper accommodation ;no means or facilities for the treatment of that woman. lam sure that if she could have been dealt gently with, her recovery would have been much more rapid, and her condition never would have been so degrading. She knew me at once, and remembered the circumstances of our former acqaintanceship. In spite of all the adverse circumstances, she subsequently recovered. She is now a married woman, and settled in life, and has two or three children. In the case of that woman it was simply because it was impossible in such a place to treat her judiciously that she became so bad. Mr. Thomas A. Bowden in attendance. 15S. The Chairman.] I think you are the Inspector at tho Karori Asylum ? I have been a kind of honorary Inspector for the last twelve months. 159. Mr. Andreiv.] Do you mean by "honorary" without salary ? Tes, the institution at Karori is the only one I inspect, as it is the only one in the Province of Wellington. 160. The Chairman.] Do you inspect gaols and hospitals also? My duties are confined to the Asylum at Karori, and my instructions were to inspect that one. 101. Have you been in the habit of going there at stated times ? The Act requires that I should visit each institution quarterly; but I have visited more frequently than that, because I felt it necessary that I should do so, in order to acquaint myself with the condition of the buildings and state of the inmates. 162. When you pay your visit, do you put your name in a book ? Tes, a set of books are provided in accordance with the Act, and I am careful to see that they have been kept. 163. That is not in the ordinary visitors' book ? No, there is a book specially for the Inspector, and a set of books for the medical officer and keeper to make entries in. Such entries havo been duly made. 164. How long have you been Inspector ? A little more than a year. 165. How many times, do you think, you have been there' ? Six or eight. 166. What has been your impression as to the state of the iYsylum ? I have reported fully oh the Asylum, as the Act instructs tho luspector to do. If my report was before the Committee it would give nearly all the information I can furnish. 167. Has your report been printed ? I forwarded it to the Provincial Secretary for the purpose of being printed. Ido not know whether it has been printed. 168. Perhaps you would give the Committee some idea of its contents ? The Report was drawn out in January last, and there have been some changes since that time. I have not visited the institution since those changes were made. [Witness read extracts from memoranda from which report was compiled.] 169. The Hon. Captain Fraser.] When were you there last ? In July. 170. When was the last patient admitted there ? 1 do not know, I have not visited the Asylum since July. I may mention, in justification of what may appear on my part an omission, that I found that the duties interfered so much with my other avocations, that I resigned the appointment about three months ago. It may not be convenient to the Provincial Government to appoint anyone else at the time, and I continue to act until the end of the present month, and then I consider myself freed from all further obligation. 171. The Chairman.] Tou are not aware that a patient was admitted two days ago ? I should not be aware of it unless 1 went out to the institution and gathered the information from the cook. 172. The Hoiu Captain Fraser.] Are not the certificates submitted to you ? Tes ; when Igo out there I endorse them, if I find them according to the 10th and 11th Schedules of the Act. 173. But if irregular ? I require them to be corrected. 174. Mr. Andrew.] Had you any special experience of Lunatic Asylums beforeyouwere appointed to the Inspectorship ? No more nor less than an ordinary person would have—nothing special. The office was not sought by me. I accepted it at the request of the Deputy Superintendent. (The witness then withdrew.) t f " 3

lI.—No. 10.

10

REPORT OE JOINT COMMITTEE

Karori Asylum,

APPENDIX. The Chairman read tho following Report of a personal inspection ho had made of tho Lunatic Asylum at Karori. There are at present-twenty three inmates, twelve men and eleven women. All tho females married but one. The keeper said there is in tho buildings accomodation for eighteen only ; having regard to any degree of safety, as he added. The medical officer says there is room only for twelve. Two male attendants, and a cook, besides the keeper; but no female attendant except the matron although there are eleven female patients. Thirteen bedrooms, two sitting rooms (exclusive of the private rooms of the keeper and matron), and four cells for those who are violent or of unclean habits. No bath room, or any other appliance for the cleansing of the skin, which is so essential to health, especially in persons who are labouring under disease of any kind. There is a large open cess-pool, close to the paling of the exercising yards, into which all tho filth of the Asylum is discharged. There is a good kitchen and wash-house. The premises are apparently kept very clean, and as far as I could observe, I believe the patients are kindly treated; I saw, however, a man walking about in the yard without shoes or stockings, and his feet looked very blue, as if covered with chilblains. I inquired of the keeper why this was so, and he answered that the man sometimes kicks violently. Three women, who were locked up in refractory cells, were also barefooted on the bare boards without fire, which on the cold day when I paid my visit, was painful to see. The keeper said tho reason for this was that they would tear up and destroy any covering put upon their feet. On a formal visit I saw a female patient quite naked in a cell. They were well fed : the following, as reported to me, being the daily ration of each—l2 oz. of meat without bone, bread and potatoes 1 lb. of each, 6 oz. rice, J oz. tea, 1$ oz. sugar, 1 gill of milk, they get besides soup five times a week, made out of the meat, and 10 lbs. of butter per week for the whole establishment. The keeper and matron appear to bo kind and gentle in manner, and evinced the utmost readiness to show every part of the premises. Every locked door was immediately opened at my request. They have been at the Asylum thirteen years, at a yearly salary of £150, without rations. The assistant keeper has been there three years, the other since Ist of June last. Wages ss. a clay each, with rations. As far as I could learn there is no attempt at curative treatment, neither keeper or matron having any special knowledge of the subject. I was told that such of the men as were sufficiently well are employed in the garden on fine days'; but the females never go outside tho house. When I. was there the men were sitting idly iu their rooms, where there was a small bagatelle table, and a few old copies of the Illustrated News. I cannot help thinking it would have been much better if they had been at work out of doors, emploved, or in some way, so as to prevent them brooding over their own sad thoughts. Until within tho last week, no Justice or official, except the medical officer, had visited the institution since the middle of July. Indeed there are very i'aw names inscribed in the visiting book. In my opinion it would tend greatly to the advantage of the Asylum, if the site of it were much nearer the town. In which case it would be much more readily inspected. The general public, especially ladies, would take more interest in it, and by contribution of books, and encouraging cheerful amusements, they would greatly assist Dame Nature, who in this case appears to be the only physician as regards the vis medicairix. In fact, as far as my information goes at present, they are kept only like so many animals might be kept, in order to prevent them from injuring the rest of the community. It will of course be inferred, that besides removing the asylum to another site, the buildings ought to be much enlarged; the number of attendants increased; means adopted to warm the refractory cells; to give the female patients exercise; and also to have baths for the purpose of cleanliness. In short, while I would cast no slur on the Provincial authorities, nor on those who have, tho immediate management, it would be a blot on humanity if the Colonial Government should fail to step in and remedy such a state of things as I have described. The Hon. Dr. Grace, read at the request of the Committee, the following memorandum containing his views as to the causes and frequency of lunacy in the Colony: — Insanity is much more common in this country than it is at home, chiefly on account of the limited range of sympathy which the isolation of individuals and families in the country gives rise to, and also on account of the oppressive loneliness which many new comers experience even in our crowded towns. Many immigrants too, form the most extravagant anticipations of their new home, and are proportionably depressed by the result of actual experience. Again, the migratory population from our gold fields, excited, by the varying chances of their fortune, and exhausted by hardship and exposure, swell the numbers of our lunatics out of all proportion to the population. However, the great point to be dwelt upon is, that all these causes gives us an enormous number of lunatics functionally not organically mad, and therefore curable. Now our present system tends to make these latter worse, and aggravates the diseased condition of the incurable. Frequently incurable lunatics enjoy a very considerable amount of innocent happiness, but when brought in contact with violent people who are organically sounder than themselves, or perhaps, suffering merely from tho mania of nervous exhaustion, the little childish happiness of the former is gone, and they cower in the corner in terror and alarm, whilst the latter, on recovering from fits of excitement, are plunged into the very depths of despair by the contrast of their gnawing sensitiveness and depression with tho childish folly of their habitual companions, whoso condition in this morbid state they dread worse than death.

UPON LUNATIC ASYLUMS.

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H.—No.. 10

By way of illustration, I shall endeavour to sketch the sequence of events which tends to insanity in the country districts: and with strange uniformity it will be found that somewhat similar conditions obtain in originality all the forms of insanity referred to above. An ignorant man goes into the country, aud from comparing himself with himself, and contemplating in solitude the grand sights of nature, he becomes depressed; his hard fare and constant exposure, and the newness of everything around adds to his depression ; he becomes careless of food, and occasionally goes without, then gets dyspepsia; he grows weak and miserable, a terrible craving for excitement seizes upon him, and if he cannot get to a public-house and company, he commonly practices masturbation. The seminal discharge for a time does him good, but very soon he is quite exhausted ; then comes the loss of the balance of reason, and insanity is at hand. The whole of his selfrespect is not yet quite gone ; he has the grace to wish to conceal his degradation, and often succeeds in doing so for years; but when, from some quasi involuntary eccentricity, he is discovered and informed upon : that man becomes violent on the spot, and immuring him in a dismal lunatic asylum makes him almost: incurable. Now, what we waut in our ordinary asylums is gentleness, capacity for extending sympathy, and restoring self-respect to ail. Sunny, bright houses we want for the mentally distressed, with everything like restraint carefully in the background. We want, by the.harmony of civilization and concord, to feranquilize the nervous systems of the functionally insane. We want to preserve to society all those people who, in an old country, would never have gone mad. We want, in fact, discrimination, and must bear in mind that dozens who are put in lunatic asylums in this Colony would be kept in their own houses in more domestic England, and that wo aro daily ruining the intellects of citizens by crowding all classes together in hopeless confusion, and ministering to their wants by tho rudest tools our rough-hewn civilization places in our hands. It is quite a common thing to hear in this Colony, "That man is a capital assistant; he can throttle any one of them at a push." Such a man is a living cause of terror, and insanity to tho insane, and a few such in an asylum must very materially increase the difficulty of preserving order, not to mention the enormous injury they inflict on the nervous system of all classes of patients. Hysteria, which commonly takes a religious turn, is the chief cause of insanity among unmarried females; the smallest coercion, or even appearance of immurement, makes them violent at once, and the indecent lengths to which they proceed when rendered violent, forces those institutions where accommodation is limited to confine them rigidly : the consequence is, their patients, under such circumstances, remain mad for years, and in some instances no doubt for ever; whereas, under proper treatment, they ought to recover within a few months. The conclusion I arrive at is, that a great deal of the insanity we meet with is curable, and tho opinion that I had originally formed was strengthened by the inspection of Mr. Seager's series of photographs in Christchurch. Persons unacquainted with the importance of the considerations I have been attempting to sketch, would scarcely believe in the genuineness and fidelity to truth of theso photographs. "The lunatics photographed look as if they suffered originally from organic disease, whilst their recoverv, and the restoration of their natural expression, proves the affection to have been simply functional, and therefore capable of being speedily removed. Now, what I contend for is, that this condition is the rule rather than the exception, and that Ve make our lunatics incurable by our mode of treatment. Therefore, I would urge that our local institutions should be unprecedentedly homely ; that comfort and happiness should shine in the faces of servants and attendants ; that miserable crowding in yards, and horrible prevalence of the idea of something hidden, should be removed ; that all show of power of coercion should be abstained from, ami tho idea of confidence impressed in the minds of inmates. At some distance from the ordinary dwelling there should be a place where new arrivals, violent at tho time, should be temporarily confined, and submitted to the cold douche on the head. The very moment they showed any collectedness, I would set them free in the garden amongst the most trustworthy of the ordinary patients, and I am convinced the result would be good. To effect all this, careful and constant inspectional supervision would be necessary, and a General Lunatic Asylum would have to be established, to which incurables could be drafted. The industry of these incurables could be made reproductive on a farm, and to it, in little offices of trust, could bo drafted to advantage those patients from local institutions tho permanence of whose recovery could in any sense be doubted. For, as a rule, lam of opinion that the restoration of self-respect is the most important element in the recovery of patients. Memorandum by Dr. France. I think a Central Asylum for the treatment of all tho lunatics in the Colony would be a mistake, but might be better adapted to the management of violent chronic cases, and those of filthy habits, as also the reception of criminal cases. It would be unkind to remove most of our chronic patients, who have been a long time in the asylum, which they have come to look upon as their home, and are accustomed to their present attendants and condition. Then, again, an unnecessary expense would be incurred by the removal of the majority of them from tho Provinces where they have lived, and who only require moral control, with good diet, for a comparative short period, to insure their recovery. Their friends also would object, and the establishment of large asylums is condemned by the best authorities. The system of small asylums for the reception of patients living in their districts, is some mitigation of the wrong inflicted upon many incurable harmless lunatics, who might safely be at large but for the waut of means of support: they have the satisfaction of seeing persons with whom they have been acquainted perhaps for years. And in curable cases it is more possible to give the individual treatment necessary, each having a particular character and bodily disposition, which are more likely to be observed by the attendants of

S.-i-Hd.-10.

REPORT OE JOINT COMMITTEE

12

Sunnyside Asylum.

a smaller establishment'than in a larger one, and so diminish the tendency to permanent lunacy, which there is room to suppose is one of the effects of incarceration in an asylum, especially a large one. Many of the objections in the management of the smaller asylum, might be removed by the appointment of one General Inspector. Charles France, Medical Attendant, Lunatic Asylum, Wellington. Memorandum by W. Rolleston, Esq. In compliance with the request of the Committee, I beg leave to submit the following notes of the evidence given by me this morning, on the subject of lunatic asylums and their mangement. The points adverted to were: — (1.) The working of tho present " Lunatic Act, 1863." (2.) The advisableness of establishing a Central Lunatic Asylum. (3.) The feasibleness of a system of farming out patients in private houses, as is done in Belgium. (1.) With regard to the first point, I expressed my opinion that the present Act, which T believe is an adaptation of the Victorian Act, is very ill adapted to tho circumstances of the Colony; an amendment is urgently required, with a view to efficiency and economy; and that I was convinced that the direction which the amendment should take should be the placing of the lunatic asylums uuder the inspection and direction of tho Colonial Government. At present the inspection is by officers appointed by tho Superintendents of Provinces, under delegation from the Governor. The Registrars ,of the Supremo Court collect payments, and administer estates of patients under no supervision or check from the .Superintendents who are interested in those payments ; and generally, there is a confusion between the position of the Colonial officers, the Provincial authorities, and the delegate of tho Governor, and Colonial Secretary, under which, if difficulties have not arisen, it is in spite of, not because of, the provision of the Act under which the asylums have been administered. I am of opinion that the funds necessary for the efficient management of asylums should be secured by the Colony. That the estates of the patients should be managed by some one appointed to manage these and other trust estates, and who has special qualification for the office. That an active and effective system of inspection by some highly and specially qualified officer should be instituted, so as to maintain a uniform standard and system throughout the Colony. (2.) With regard to the establishment of a Central Lunatic Asylum, lam of opinion that it is rather desirable to secure theefficieucyof thelocal asylums,which mustcontinue to exist, tomeet the requirements of the centres of population in respect of chronic and temporary cases of lunacy ; that efficiency would not be promoted by increasing the numbers beyond the point when each patient can be the subject of close personal observation and study on tho part of the manager and medical officer. That the first step towards bringing the asylums under a uniform and efficient system is to appoint some specially qualified person as Inspector, and to take the asylums into the Colonial management. It cannot long continue to be satisfactory that the provision of the funds for asylums should rest with the Provinces, and be liable to be curtailed in favour of other liabilities. (3.) The question as to the farming out of patients is one of which I have no knowledge. It seems probable that in certain cases patients would be more likely to recover under homo treatment; but it appears open to great question whether sufficient guarantee could be obtained of proper treatment. There is a point alluded to in the report of the Inspector of the Sunnyside Asylum which requires attention : namely, proper provision for drunkards placed in asylums under sections 20 and 25 of the Act. If it be right either to the drunkards or the lunatics to place the former in lunatic asylums, there can be no doubt that provision should be made to keep them entirely separate. For my own part, Ido not think any good will como of calling drunkards lunatics, and treating them as such. It may precipitate their becoming so. W. Rolleston, 28th September, 1871. Superintendent, Canterbury. Mr. E. W. Seageu to the Hon. Dr. Buchanan. Sir, — Sunnyside Lunatic Asylum, 23rd September, IS7I. In compliance with your request, I have the honor to offer a few observations upon the question of the desirability of establishing a Central Lunatic Asylum in New Zealand. Ido not think a Central Asylum for the whole of New Zealand is desirable, for the following reasons: — 1. Considerable expense would be incurred in conveying patients to, and in the event of recovery from the asylum —there would also be the expenses of the constable or person in charge of patients. • 2. During my experience I have noticed many patients derive great benefit from the visits of their friends to them. This is particularly applicable to melancholy and morose lunatics. In this asylum it is usual to hold weekly entertainments, to which the friends and relatives of inmates are especially invited, and it is very gratifying to see the zest with which these meetings are looked forward to, and the good results which in many cases attend them. In the event of a Central Asylum being erected, much of this would of necessity be prevented: in most cases by the distance of the patients from their friends. It is also usual for discharged patients to revisit the asylum after their recovery, and these visits do much to encourage hope in those who still suffer. Another pleasure would also be denied the patients, viz., that of paying short visits to their friends, which privilege is allowed the patients in this asylum during their lucid intervals, and patients in a convalescent state are permitted to go home for a few weeks on trial. This would not bo practicable in a Central Asylum.

UPON LUNATIC ASYLUMS.

13

H.—No. 10.

Sunnyside Asylum.

Lord Shaftesbury, in his evidence before the Select Committee on Lunacy, 1859, dwells on the advantages derived by lunatics who are confined in asylums, from the visits of their friends, and he even goes so far as to suggest that visits should be made compulsory by Act of Parliament. The Royal Commissioners in Lunacy, in their 12th Report, give examples of the distress not unfrequently attending the removal of lunatics to a long distance from their friends. Such distress often operates to the disadvantage of patients, particularly females. It also increases the sorrow of their friends. 3. In a Central Asylum it would be impossible to pay the same individual attention to patients as is done in asylums on a smaller scale. In England and Scotland it has been found a great mistake to have large asylums. It is thought that no asylum should contain more than 500 inmates. Having just returned from a tour of inspection of all the lunatic asylums in Victoria, and those of New Zealand, excepting Wellington and Auckland, and there seen my opinion confirmed, I am the more strengthened in it. In Victoria, asylums are built in various part of the Colony, namely, at Tarra Bend, Kew, Collingwood (all within a radius of four miles), Beechworth, and Ararat, also a small asylum at Bendigo, thus ignoring a Central Asylum. Dr. Paley, Inspector-General of Lunatic Asylums in Victoria, whom I had the opportunity of consulting on the general treatment of the insane, gave me as his opinion, derived from many years' practical experience, that no asylum should contain more than 500 patients. This opinion is also entertained by all medical and other gentlemen of practical experience I have had the honor to converse with upon the subject, both in Australia and New Zealand. There is something to be said in favour of a Central Asylum for chronic cases. But a strict classification of lunatics is not desirable, further than dividing the epileptic and idiotic. When in Victoria, I visited an asylum set apart for the reception of such cases, and witnessed, with great interest and pleasure, the practical good resulting from such a system. But it must be remarked that all the transit is there by land. If a Central Asylum is established, I would recommend that the local asylums, as far as possible, be retained. Then, after a patient has been confined for six months, and no improvement in tho case is discernible, for him to be removed to the Central Asylum. The change of scene and surrounding circumstances might possibly act beneficially. I venture to submit this is the only argument bearing on the central system, other than economy in the cost of supervision and uniform mode of treatment, which, however, is not always possible. I think one asylum for the North, and another for the South, would be better than one Central Asylum. I have, &c., E. W. Seager, Steward and Keeper. Report of Inspector upon the Sunnyside Lunatic Asylum, near Christchurch, Canterbury. 30th May, 1871. I have much gratification in being able to report that, on visiting the above-named asylum for an inspection, I found that preparations were begun by the Provincial Government for the erection of a new and substantial building in stone, in lieu of the present wooden one. Ample accommodation will at once bo provided, on a plan carefully devised beforehand, and suited to the requirements of an establishment of this kind, and to the mode of treatment by which it is hoped to effect the cure of the persons admitted into it. The present building, began at a time when the public funds could be spared for it in only small and inadequate amounts, and added to from time to time, as emergencies arose, but not on any general systematic plan, is necessarily defective in many respects, wanting in both room and conveniences. The good management and talent for contriving of the present keeper, Mr. E. W. Seager, has, however, gone far towards supplying a partial remedy for what is wanting in regard to a sound plan of building worked out from the very first. What is now so much needed, as the number of patients will continue to increase with the growth of population, is abundant room for the more minute classification of patients, according to their different conditions of mental aberration, arid their progress towards full recovery. It is satisfactory to note that a large quantity of stone for the new building is already stacked on the ground. Since my previous inspection, the dwelling accommodation for the keeper and his family has been increased, and a visitors' room provided, as recommended by me. In addition to the amusements already provided for the patients, and which serve to contribute in so important a degree to their recovery, an organ has been just erected in the large recreation hall. The acquisition of this instrument at a moderate cost, and within the resources of the asylum, is owing to the exertions of the keeper, and to the kindly interest taken in his work by bis brother, Mr. Seager. This gentleman procured the organ at home, took charge of it thence out to the Colony, and himself undertook the labour of setting it up in the hall and getting it into order. The keeper reports to me that one result of the performance of the organ at Divine Service on Sundays, there has been more attendance on the part of the patients, as well as an increase to the number of the choir. Great assistance is also afforded at the evening musical recreation of the convalescent patients during the week days. Mr. G. Inwood continues to play for the patients at every Sunday Service, and at the weekly choir practices of the patients. This gentleman, who is closely engaged in his business all the week, has for many years past, in the most generous spirit, volunteered to give up his Sundays, and also one evening in the week days, to the performance of the duties of organist and leader of the asylum choir. lam impelled to suggest that some notice should be taken, • either by the General or Provincial Government, of the very valuable service he has thus rendered to the patients for so great a length of time, and with so much self-denial. There seems to be no room for doubting that these Sunday Services, conducted with the usual choir singing of other well-appointed places of worship, have a marked beneficial effect on a considerable number of the patients. I found, on inspecting the several rooms and court-yards, and other parts of the building, that the matters I had previously had occasion to remark on had been duly attended to. The offensive smell in the 4

H.—No. 10.

14

REPORT OE THE JOINT COMMITTEE

Sunnyside Asylum.

female lavatory and sleeping ward had been got rid of by alteration in the drainage of the closets closo by ; the air in the lavatory and the ward adjoining were now perfectly sweet and fresh, leaving nothing to be desired on this score. The attendants' rooms were also in excellent order. The whole of the rooms, passages, and outbuildings belonging to the asylum presented the same remarkable appearance of neatness and scrupulous cleanliness aud care, as I had occasion to notice to you specially in a former report, except in regard to some of the attendants' room. These, on the present inspection, were in the same satisfactory condition as all the others. The sleeping and day wards are all well ventilated, and while the latter are well warmed at this cold season, a free circulation of fresh air is kept up throughout. The patients themselves are noticeably neat and clean in appearance, both as regards person and dress. The bath accommodation is very ample in the male and female wards alike, and is made use of abundantly. To all this provision made for thorough cleanliness and ventilation in all departments of the asylum, must be attributed in a large degree the healthful appearance of the patients; and there must doubtless follow more or less indirectly a correspondingly beneficial effect upon their mental condition. The Register of Patients, in the form required by section 24 of " The Lunatics Act, 1868 " (Schedule 12), which was being written up at the time of my previous inspection, has been duly completed. All the cases from the first opening of the asylum in Canterbury have been transcribed from the old register, which contained substantially all the information required in the new one. The " Case Book " referred to in section 25, seems to require some direction by order in Council as to the form in which it should be kept. Practically, however, the " Medical Journal" supplies pretty near all that the " Case Book " would contain. The whole of the premises and outbuildings were inspected under section 53, also the order and certificates of admission of patients. All the patients were seen at their evening meal, beside being seen during the day in the wards at the several occupations allotted to those capable of engaging in any. The lists under section 56 were examined, and the other documents required ; and full inquiry also under clause 55 as to the care treatment, <fec, of the patients. The copy of the plan of the buildings, required by clause 57 to be hung up in some conspicuous place, is not yet completed. There is, however, nothing complicated about the arrangement of the different rooms, yards, and passages. Any visitor could satisfy himself easily that every portion had been under his notice, or that if there were any place in which patients were concealed, it could not escape his observation, or at least his very strong suspicion. Notwithstanding this, however, lam of opinion that the letter of the Act should be strictly carried out, as soon as a place can be procured. A plan would at once show to every visitor that there is nothing in the asylum about which concealment is desired by the managing authorities. In regard to the dietary, which clause 50 requires should be inquired into by the Inspector, I should state that everything supplied is of good quality. The lower storerooms, kitchen, and scullery are specially noticeable for neatness and perfect cleanliness in all the arrangements. Everything is calculated to ensure the patients' food being served up to them in a sound and palatable condition. I wish to suggest the introduction, for those patients who might prefer it, of brown bread, or at least of bread made from flour of which only the coarsest particles of bran have been sifted out, in lieu of that now used, and made from the very whitest flour. There are abundant medical and chemical reasons for believing that brown bread, or bread made of " seconds " flour, is by far the most wholesome for daily use; at all events it is little likely to be adulterated with unwholesome alum, to make it look white. Whilst I have been acting provisionally as Inspector, several applications have been granted for the delivery to the care of friends of patients who have progressed far towards complete recovery. They have mostly been allowed a month's absence on leave, or trial (under clause 64 of the Act) under the medical officer's certificate. The results have been satisfactory in each case, excepting one, and the patients have not required to be taken back. The friends have all given bond, in £50 penalty, under clause 66. The present inspection was made on a day when there was little possibility of its being expected by the keeper, so that everything was certain to be going in ordinary every day course. Only a few days previously I had made a special visit with His Honor Mr. Justice Gresson, in reference to a patient placed there by his order some months back for curative treatment, under clause 21 of the Act. The patient had been addicted to the excessive use of intoxicating drinks, to the great injury of his health and of his estate, and had been placed in the asylum on friends applying to the Judge. There could be no doubt, from the patient's own admission, of the great benefit to his health which the treatment had effected ; his great complaint was, and it must be conceded to be a very serious one, that there was no place where he could be set apart from those who were actually lunatics. The keeper had made arrangements for this patient messing with the attendants, and not with the lunatics. But it will readily be conceived that any regulation that may tend to keep up an irritating feeling of degradation must greatly tend to retard the cure of this class of patients. Any asylum in which curative treatment is to be undertaken under clause 21, of those addicted to excessive and continued use of intoxicating drinks, ought most unquestionably to be so planned that the patients need not be compelled to occupy the same wards and mess and associate with the ordinary lunatics. This curative treatment, to be successful, seems to require a long term in order that the patients may have the power of self-control thoroughly restored, and his mental faculties so reinvigorated, that on his discharge he may be safely counted on as able to resist temptation. Now, so long as the patient, knowing himself to be sane, feels that in every respect but that of sanity, his position is simply that of any lunatic confined in the asylum, that on visitors arriving there, he will be seen possibly by old acquaintances in the ward with the lunatics, as if he were actually one of them, it is inevitable that his rapid progress towards a sound and vigorous state of health will be checked, and his arrival at a right feeling as to the moral probation he has been

UPON LUNATIC ASYLUMS.

15

H—No. 10

Sunnyside Asylum.

Dunedin Asylum,

sent to undergo must be seriously interfered with. He will become despondent, his patience will give way, and there will arise a rancorous and bitter feeling that he is unjustly detained beyond the time required for a complete cure. This feeling will gain strength with brooding over it, or for want of associates, when there is but one patient of his class. This " curative treatment" under clause 21 has once previously been applied at Sunnyside Asylum, and with success. There was every reason to feel assured that the patient whose case is now under notice, would shortly be in a fit state to release. I feel it my duty to represent very urgently that in every asylum an effort should be made to provide separate wards for such patients. Friends and relatives of habitual drunkards would then feel less scruple and hesitation about placing them under treatment. Judging from the two cases mentioned above, it would appear that nothing should be left undone by which the fullest effect can be given to so humanely-conceived a portion of the Lunatics Act, as that by which it is attempted to reclaim the habitual drunkard from a vice which, in the Colonies especially, is known to bring about the ruin of so many families, and the commission of so much aggravated crime. J. W. Hamilton. Inspector provisionally. Mr. J. Heene to Mr. Stowe. Dear Sir, — Dunedin Lunatic Asylum. I beg to forward you last Annual Report of this Asylum. In reference to central establishment, my opinions are already embodied in Dr. Alexander's report supplied to Hon. D. Bell, Esq., and the Inspector's report to Mr. Cooper. By next steamer, I will forward to you, statements " Queries and answers," upon the above important subject. I have, &c, L. Stowe, Esq., Clerk, Legislative Council, James Herne, Wellington. • Manager. The Manager, Dunedin Lunatic Asylum. Dunedin, 30th September, 1871. 1. The General Government has under its consideration the establishment of a Colonial Lunatic Asylum. Are you of opinion that such an asylum is required ? lam of opinion that the time has arrived that such an institution should be erected. 2. State your reasons ? The three principal lunatic asylums in the Colony, are Auckland, Dunedin, and Canterbury; the other places where the insane are kept, are not fit for their proper treatment: namely, gaols, and inconvenient places, where the necessary appliances do not exist for the comfort of the lunatic. (2.) A class of patients called " Wanderers," who have no relatives in the Colony, and who are chronic cases, should be supported by the State. There also will crop up in course of time criminal lunatic patients, for whom the State will be responsible for their safe keeping and support. (3.) Patients could be admitted into the central establishment from the surrounding districts in which it is situated, and from Provinces where the number of patients are too small for them to be kept with economy. The patient would have the advantage of all the best means of treatment for their recovery in a large asylum. 3. Are you of opinion that all chronic incurable patients should be sent to the Central Asylum ? I think it would be injudicious that chronic cases, whose relatives are in or settled in the Provinces, be sent to the Central Asylum, when they could not visit them excepting at great expense, and unnatural to be cut off from them. I have observed form long experience, that very many of the insane are pleased, and show signs of delight when their relatives and friends call to see them. Another reason I give that the principal lunatic asylum should have their fair share of chronic insane, and none should be sent to the Central Asylums without careful and satisfactory investigation : as managers of asylums would show a particular weakness to have their most troublesome and dirty cases sent off to the central establishment. There are other reasons could be given, if necessary, that all incurables should not be sent to the Central Asylum. 4. Tou say the three principal lunatic asylums are Auckland, Dunedin, and Canterbury. In your opinion, where would be the proper place for a central establishment ? Somewhere in Cook Strait, and easy of access, near the seat of Gevernment, and would take in the lunatic patients from all the neighbouring Provinces, and the County of Westland. 5. Being conversant with the management of lunatic asylums, can you state in this case the amount of land and accommodation for lunatic patients required to make a beginning ? I would recommend that at least 200 acres of land should be selected of fair quality—good aspect, with sloping grounds, looking north, the building standing on the rise, so that, with other benefits, a good fall for sewage, irrigation, can be commanded. The accommodation for patients at first might extend to 150 acres ; the building can be so designed that additional room can be provided at a small cost. I would recommend the buildings to be plain, roomy, and all parts easy of access from outside; covered corridors. Each ward to contain all the comforts of a home within itself, viz., large day and dining room, large room at least, two associated dormitories, bath room, pantry, water-closet, and attendant's room ; the outside door of each ward to open into a large and enclosed airing court (two or more wards can use one airing court). Furniture, bedding, clothing, neat and clean, without going into the expenses of luxury. 6. At per head, what do you estimate the above would cost ? £100 per head, in my opinion, would more than cover the entire cost to begin, and as the building extended, the cost would become less from utilizing the labour of the staff of attendants and patients. 7. Do you comprise in the above the cost of farming stock and implements ? No ; the stock and implements do not require to be extensive; at first a good deal would be done by spade culture. There would also be required work-shops, bake-house, brewery, &c. The great object to be obtained is, whde

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REPORT OE THE JOINT COMMITTEE

Dunedin Asylum.

the patient is made comfortable, his labour, as far as possible, will be utilized, and the institution, by economy, made self-supporting. I may say that the cost per head would not be more than Is. per day, including everything. 8. To attain this object, what, in your opinion, would be the staff required ? —A visiting medical officer, manager, matron, attendants, and servants, in all an average of twelve patients to each individual in the staff. 9. Give your opinion on the asylum being visited by the Inspector, or otherwise ?—I am of opinion that two Inspectors (one medical and one legal) under the General Government could visit the Central Asylum, and inspect all other asylums in the Colony. They do not require to be experts from home, as they for a long time could not be expected to know or fully understand the requirements of the Colony, granting that they were fully conversant with all phases of insanity ; yet in this young Colony many things are to be taken into consideration, that only those who have been for years here can fully grasp any difficulty that might arise. Such, I believe, can be found in New Zealand, to carry out the most philanthropic views in the treatment of the insane. 10. Are you of opinion that insanity is on the increase in this Colony ?—Tes, during the eight years I have been manager of the Dunedin Lunatic Asylum : first year was daily average 37 ; last year the same was 123. In other asylums in the Colony they have increased in proportion ; and even laying aside the proposed increased immigration, I believe that during the next eight years the three principal asylums at present will have each from 300 to 400 inmates, and the central establishment, if erected, even greater than that number. 11. Are you prepared to give further information if required ?—Tes, I will feel pleased to give the experience of twenty-eight years in asylums, and full information as to their construction, management (including farms, &c), also treatment of the insane. James Herne.

Dr. Aickln to Dr. Buchanan. Provincial Lunatic Asylum, Auckland, 4th October, 1871. Sir, —I have the honor to state, that a letter addressed to the Provincial Secretary of this Province by the Clerk of the Legislative Council, acting under your direction, has been referred to me " For views upon the subject of a Central Establishment for Lunatics." Permit me to express my regret that the views I have the honor to submit to the Committee, aro not quite so full and precise as they might have been, had I received notice at an earlier date that my views upon the subject would be required. They, however, embody the practical conclusions I have arrived at, together with some corroborative observations of a few of the most respectable authorities upon the subject. I have, &c, Tho Hon. the Chairman, Thomas Aickln, M.D. Committee on Lunatic Asylums, Legislative Council. Vieics upon the subject of a Central Establishment for Lunatics. Admitting, in limine, the necessity of erecting a Central Asylum for the accommodation of lunatics from the several Provinces of New Zealand, it is advisable, in the first place, to determine whether it shall be made available for the accommodation and treatment of all classes of lunatics, or for one or more classes in particular. The classification of lunatics into criminal and harmless, and also into curable and incurable, although not the most scientific, is apparently quite sufficient for all practical purposes, so far as the distribution of the various phases of insanity is concerned. There are, however, two other classes which require to be considered in a distinct point of view, as they aro not founded on the character of the malady, but upon tho social status of its victims. These are the pauper and non-pauper classes. I shall endeavour to offer a few observations upon the special differences of treatment adapted to each of these classes, so far as domiciliary accommodation and arrangements may be brought to bear upon the treatment of the insane. Curable Cases. —It is admitted, by everj r reliable authority upon the treatment of insanity, that the proportion of recoveries in cases admitted into asylums bears a certain ratio to the length of time intervening between the first appearance of the malady and the date of admission into an asylum. The limited experience derived from our provincial institutions enables me to arrive at this conclusion, which has been so often set forth by the first European physicians. I shall take the liberty of quoting from one of the most recent works upon the subject by Dr. Sankey, late physician to Hanwell: —" I have no doubt, iu my own mind, that, for the patient's sake, the earlier he can be admitted into an asylum the better; this is the advice I have always given. I am convinced of its soundness, and therefore unhesitatingly repeat it. The statistics of every asylum show that the discharges by cure aro always the greater, the earlier, in the period of attack, the patient is admitted."—(Sankey. Lectures on Mental Diseases?) It may be necessary to explain that, in many cases of acute mania, the outburst of violence may he so great that the patient must be restrained by force : this can only be effected, without endangering the patient, by the only means at the disposal of his relatives and friends, as ropes, cords, &c, by placing him in the nearest asylum, where padded rooms and other appliances are ready to prevent him from injuring himself or others. Such patients would, as a general rule, suffer much injury, and the chances of their ultimate recovery would be greatly diminished by their removal to a distant asylum. Hence I venture to conclude, that a Central Asylum could not be rendered available for the treatment of acute cases in general, save only for those occurring in its immediate neighbourhood. The local or provincial asylums should constitute the receiving-houses (so to speak) for patients afflicted with mental diseases, in which, after sufficient time being allowed for observation, the medical officer might, with great advantage to his curable cases, transfer the incurable and hopeless cases to a central establishment; always holding fa view, as his chief object, the speediest cure of every acute

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Auckland Asylum.

case. All acute cases occurring for the first time are presumed to be curable. The medical officer of an asylum should endeavour to remove every obstacle in the way of effecting so desirable a result; but the greatest obstacle to the recovery of curable cases in a mixed multitude of lunatics is the presence of tho incurable, noisy, and refractory cases, which crowd the wards, and sadly interfere with the arrangements for the bettor treatment of curable cases. The idiotic, imbecile, and demented, are unavoidably mixed up with those who retain sufficient intelligence to feel the degradation and irksomeness of their position, and who, by a few nights' quiet sleep, might be rescued from the horrors of confirmed madness. It must be always borne in mind that one noisy and turbulent patient has the power to disturb all the occupants of an associated ward. It may, therefore, be confidently affirmed that tho want of accommodation calculated to permit of the classification of lunatics, according to the requirements of individual cases, constitutes the chief difficulty in the treatment of curable cases in asylums, which arc merely constructed for the reception of cases in general, without due regard to the requirements of particular classes. Incurable Cases. —These unfortunately constitute the majority of inmates in most asylums. They admit of a sub-division into two classes—the quiet and harmless, and the noisy and destructive. Amongst the first may be found some who have become, as it were, domesticated, and who, without any compulsion whatever, perform their allotted duties with hearty good will. These patients enjoy as much liberty within the precincts of the institution as it is possible to concede; and in very few instances indeed are they ever know-n to transgress. Some of these chronic cases are really valuable servants in an asylum ; but when subject to paroxysms of recurrent mania cannot be safely discharged, and in most instances they are life inmates. Provision should bo made for these chronic cases. Thoso who have learned a trade should be provided with proper workshops, tools, &c. Others cau be employed in agricultural work. In erecting a central establishment it will be indispensable to make proper provision for the healthy occupation of this class. Noisy and Refractory Incurables. —Some of these cases are perfect pests in an asylum, they cannot rest themselves, and will not allow others to rest. So far as the accommodation furnished in single rooms or " cells " (as they have improperly been termed) permits, it is the usual practice to confine these patients during the night, even by day, except urgently required. It is unfortunate that a sufficient number of these single rooms has not been provided in most pauper asylums. They should be placed, as far as possible, from the associated dormitories, which are occupied by the quiet and harmless class. The patients belonging to this class, although not strictly belonging to the criminal class of lunatics, constitute a class in themselves, for which it is most desirable that distinct and ample accommodation should be provided in the erection of a central establishment. Criminal Lunatics.— -We have, fortunately, very little experience of this class of lunatics in this asylum ; and, although a few cases of homicidal and suicidal mania have been placed under our charge, we have only one instance of homicidal mania, which resulted in the death of its victim. There was also one case of suicidal mania wnich terminated fatally, the patient having suddenly effected his purpose by breaking a window, and inflicting a severe wound on his throat with a piece of broken glass. It has hitherto been the usual practice of Judges in the criminal courts to sentence criminal lunatics to imprisonment forlife. Hence,owing to the number of these cases, the home Government foundit necessary to erect central establishments for their exclusive reception. Having had frequent opportunities of visiting the Central Criminal Asylum in Ireland previous to my coming to this Colony, I am enabled to state that it was conducted on the most enlightened principles, which should invariably constitute our guidance in the treatmentoftheinsane. Thegreatmajority of both maleand female patients in thisasylum were convicted of capital crimes. They were, nevertheless, treated in every respect similar to harmless patients in the best district or county asylums : the result being that many of the most ferocious and perverse amongst them became quiet and amenable, and engaged in their respective labours with as much alacrity as if pecuniarily remunerated for them. Even the most hopeless cases should, if possible, be employed in some useful occupation, and provision may be made to that effect in a central establishment and its immediate surroundings. Owing to the peculiar circumstances in which criminal lunatics are placed, it will bo advisable to have their exercising grounds surrounded by walls. It was found quite possible, however, to remove the gaol-like aspect of the garden and grounds in the Central Asylum for Ireland, by planting trees and evergreen shrubs on a border inside the walls, by which means their view was effectually excluded. In the limited exercising grounds of many asylums, the unfortunate patients are too frequently under the impression that they are incarcerated for some criminal offence, an impression which I have too frequently failed to remove whilst surrounded by brick or stone walls. It is now universally admitted that lunatics should be very differently treated from criminal prisoners, or the ordinary occupants of a gaol. They are the irresponsible victims of mental disease, to which the most amiable, intellectual, and religious members of a community are, without any offence or fault of theirs, liable to be subjected. Pauper and Non-pauper Patients. —A good deal of attention has of late been directed to the real or imaginary " ill-treatment" of lunatics confined in private asylums. There has evidently been an increasing disposition on the part of the relatives and friends of the insane in favour of public or Government asylums; the reasons for such feelings are too obvious to require enumeration. In the reports of certain English asylums which I have lately had the opportunity of perusing, I find that the practice of receiving non-pauper patients into general asylums is gradually gaining ground. So far back as the year 1859, the Earl of Shaftesbury, then Chairman of the Select Committee of the English House of Commons, testified as follows: "It is the result of very long experience in these matters that a large proportion of the difficulties iu legislation, and almost all the complications that we have to contend with, arise from the principle upon which these licensed houses are founded. The licensed houses are founded on the principle of profit to the proprietor, and the consequence is that any speculator who undertakes them, having a view to profit, is always eager to obtain patients and unwilling to discharge them, and he has the largest motive to strip them in every possible way during the time they are under his care." 5

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REPORT OE THE JOINT COMMITTEE

Auckland Asylum.

The late Dr. Conolly, whose name is celebrated as one of the greatest reformers in the treatment of lunacy, writes as follows : "As there are very few public asylums even for persons of .moderate circumstances, yet above pauperism, and none at all for the rich, those who take a sincere interest in the proper treatment of the insane, still wishing to avoid private asylums, become captivated by suggestions for richer patients being treated in detached residences, where no other patient is received. The evils incurred by such arrangements are many and great, and such indeed as to make tho position of tho lunatics of wealthy families inferior to that of the lunatic pauper." Dr. Bucknill, author of one of the most recent and valuable works on Insanity, writes thus : " The need of asylums for the treatment of patients of small means is indeed so urgent that, on some plea or other, it will be sooner or later supplied." Barnwood House was established not many years ago, near the town of Gloucester, for the reception of non-pauper patients. "It is a public institution for private lunatic patients, conducted on the principles of treatment which have been found so effectual in our county asylums, for, — (te) Persons in easy circumstances, for whom superior accommodation will bo afforded, for which they will be charged something less than at private asylums. (2.) Educated persons of moderate means, who will be received at low rates, proportioned to their means, by the aid of the surplus payment over cost, from Class I." In the Fifteenth Annual Report, that for 1871, of the United Lunatic Asylum for the County and Borough of Nottingham, I find as follows : " Many persons, not of the poorest class but of limited means, avail themselves of the improved accommodation afforded by the asylum to place their relatives therein, repaying the unions the expenses of certificates and the weekly maintenance, so long as they are able to do so." In the Report of the Royal Lunatic Asylum of Aberdeen, for 1869, it is stated : " The pressure for admission as boarders at the lower rates was very great, and taxed to the utmost tho capacity of the establishment." From the evidence thus furnished, and for reasons almost too obvious to require enumeration, it appears to be most desirable that, in the contemplated central establishment for lunatics in New1 Zealand, ample provision should be made for the victims of insanity who are not only above pauperism, but also for those whose education and previous position in society necessarily render their confinement together with the ignorant and too frequently almost brutalized inmates of the lower classes exceedingly irksome and injurious, during the more lucid moments of their complaint. House and Grounds. —Premising that a sufficient quantity of ground is available for the surroundings of a central establishment, which should bo at least in the proportion of one acre to every four patients, I cannot furnish any suggestions of a general character upon the requirements of an asylum, beyond those embodied in the work of Dr. Sankey, late Medical Superintendent of Hanwell, which I shall take the liberty of quoting, inasmuch as I heartily concur in his views on the subject:—" The requirements of an asylum for the insane aro the following: the site of the building should lie healthy; a chalky, gravelly, or rocky subsoil is most desirable ; the site should be moderately elevated, bo removed from noisy neighbourhoods, and sufficiently in tho country, yet not too far for the access of friends, and not so near to populated localities as to be intruded on by passers-by or idlers." A supply of good water, and facilities for obtaining a complete system of drainage. The building should consist of—l. Living or day rooms ; 2. Dormitory or sleeping rooms; 3Rooms for industrial occupations ; 4. Chapel; 5. Rooms for entertainments ; 6. Offices—Kitchen* bakehouse, dairy, brewery, laundry. In the arrangement, a close resemblance to the usual appearance of ordinary houses is to be maintained. Certain of the bedrooms must bo supplied with doors which open outwards. Staircases should be constructed without walls. Water-closet doors to open outwards. In the day room 10 feet superficial is allowed to each patient, i.e., 10 feet by 20 for twenty patients ; this is a minimum. In the department for the educated or non-pauper class, " I think the furniture, ornaments, &c. r &c, cannot be too good for those accustomed to such luxuries." Ample corridors, and leading passages cannot be too ample to admit of indoor exercise in bad weather. The dormitories might be all upon the upper floor, or second story, should the house be so constructed. (I have a dislike to a two-storied asylum.) The refractory and noisy patients disturb those sleeping in the lower story. The sleeping apartments of two kinds, i.e., the single and associated. The single should be numerous. The Commissioners of Lunacy say " one-third of the whole." Colney Hatch Asylum cost £350 a bed; the London Fever Hospital under £100 a bed ; the difference arises out of the division into single rooms. A single room should be 9 feet G inches long by 6 feet 6 inches wide, and 12 feet high. The associated dormitories should, according to the Commissioners, have "576 cubic feet to each patient," 800 cubic feet better; but where there are ample corridors, the spaces over the bedroom doors should be furnished with windows turning on .pivots, to allow a free circulation of air. There should be an infirmary, or sick ward, supplied with all requisites. It is essential that the water should be of good quality, and also a duo supply of hot water for bathing purposes, this alone will require forty gallons to each patient per week. " The asylum must be supplied with varied means for occupation and amusement, according to the class of patients. Workshops, entertainment rooms, ball rooms, billiard rooms, reading rooms, will be required, and should be provided in a large Government asylum." Lastly, it is'essential that all the patients should bo under one medical superintendent. " I think no asylum should contain more than 500 patients, of whom at least 400 should be in the chronic stage." The Commissioners approved of a spacious gallery for exercise : or, in other woi'ds, a well-lighted corridor, the more roomy the better. In the department appropriated to the pauper class, the less gaol-like in its general aspect it can bo constructed the better ; it may possess a home-like appearance, which materially assists in soothing and elevating the minds of tho patients. In exercising grounds, which it may be advisable to surround with

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H.—No. 10.

Auckland Asylum.

a wall, it may be possible, should the nature of tho surface permit, to have at least one side at a lower level, so as to permit patients to obtain a more extensive view of tho adjacent country. This would be preferable to raised mounds in the centre of the yards, which have been recommended for that purpose. Thomas Aickin, M.D., 6th October, 1871. Resident Surgeon, Auckland Asylum. Remarks by Mr. H. 11. Turton on the Establishment of a Central Asylum in New Zealand. 1. The establishment of such an institution for tho curative treatment of lunatics should, in my opinion, not only be beneficial to the classes concerned, but at the present time is absolutely necessary for the furtherance of the object desired, in consequence of the limited and imperfect condition of the several Provincial Asylums now in occupation. 2. These buildings and interior arrangements may well enough serve for the reception and treatment of all temporary or violent cases, but for the comfort or cure of such as are of a peculiar or more confirmed character, they are evidently insufficient; even the best of them are quite unfit for the promotion of such a purpose. Either the erections themselves are too small for the number admitted, or the site is too contracted, or the prospect too gloomy, or the size and situation of the rooms too badly arranged to admit such a classification as is required in the cases attended to. In fact, the Provincial Asylums have out-grown themselves, and hence the necessity for such a central institution as the one in contemplation, into which all tho quieter or better classes of patients can be drafted from time to time. 3. In reference to our own asylum, near Auckland, the difficulties would have been less, had tho building been completed on the original plan, and the left wing been erected as well as the right. As it is, much inconvenience and great loss of time is occasioned by having both sexes located on the same side of the building : tho males occupying the lower part of it, and the females the upper. This plan is objectionable on many accounts, but chiefly so, because it frustrates the original intention as to suitable classification, both as to the position and previous habits of the patients themselves, as well as to tho peculiar character of their respective complaints. It allows only of a very imperfect separation of the noisy and violent from the quiet and convalescent of tho lunatics, who, after all, cannot be removed out of hearing, and so a general excitement is kept up, and cure retarded. This I have noticed on my weekly visits during the past twenty months. 4. The erection and furnishing of the new wing might cost about £6,000, and this is required under any circumstances ; but an enlargement might be made in another direction for one-tenth the amount, which as a temporary measure would serve, in some degree, to relieve tho pressure on our present over-crowded establishment. But supposing the funds will not permit the erection of the more permanent structure, the immediate necessity of a central institution elsewhere is more than ever indicated, in regard to ourselves, where a really efficient and satisfactory kind of treatment could be adopted. Unless some such provision be speedily rendered, I feel certain that many of our apparently curable cases will degenerate into a state of confirmed lunacy, and every chance of restoration be hopelessly cut off. There arc also other cases of a calm or sensitive or intelligent character, apparently incurable, to whom the rest and quiet of such an asylum would be highly beneficial. A. greater personal attention, and more real comfort as to food, dress, lodgings, out-door exercise, and in-door occupations, could be offered, than what is at all possible where the number of attendants is so limited and the building so ill-constructed as ours is. We have at present, I suppose, about thirty such cases, twenty male and ten female, who could be at once removed to a central establishment with much advantage to themselves, besides leaving more room and attendance for the remainder, who would also benefit by it in a proportionate degreo. The more violent (which aro generally the more curable) cases could remain where they are without much danger of doing injury to others. 5. I think the general outside opinion as to the treatment of lunatics is often very wrong, especially as to many of those who have formerly occupied a superior position in society. It is assumed, in every instance, that these people know the difference of the present from the past, and feel it accordingly. But this is not the case. There are many patients from the lower orders who feel their present deprivations and seclusions much more acutely than many of those who have been accustomed to the comforts of a higher position. They are often better behaved, use bettor language, are of cleaner habits, and show more intelligence and natural affections than many of their fellow inmates from the more educated circle of society. Visitors generally do not pay much attention to this class of snfferers, but single out and confine their observations to what they call tho "respectable" patients, as if I lie rest were undeserving of remark and sympathy, and had no claim whatever on their regard or benevolence. They do not consider that where the luxuries of life are unappreciated thev aro useless, and their absence unfelt, and that even when prized the most they are not to be had without money. Audit is not by the friends of the " respectable " patients that the maintenance fees are most readly paid. 6. The comforts and conveniences of ordinary life can only be had in a building erected for tho purpose, and where proper order can be enforced, or in connection with detached cottages where separate attendance can be provided, as at Hobart Town, and elsewhere. And it is presumed that tho plan of the proposed institution will embrace all cases which require such treatment, whether the friends can pay for it or not; otherwise it will be of little use in the present state of the Colony. With the class of patients ii will receive, it cannot be made a self-supporting establishment; and if none should be admitted but those who can pay well and regularly for their maintenance, &c, it will afford but little relief to the Provincial Asylums at present in operation, or to very many patients who require its benefits the most. AVhere a man's relatives can afford to provide for his comfort and safety elsewhere, it is generally done; but even in most cases of this character, a medical man would advise the patients being sent to a, large Central Asylum erected for the purpose, where there would bo the certainty of medical oversight and security, if not of cure.

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Auckland Asylum.

Sokitika Asylum.

7. If the estate be only large enough, and well situated at a short distance from town, and tho building subdivided into many private and convenient rooms, with plenty of light and cheerful prospect, and with suitable grounds and gardens for exercise and work, such an institution would be a glory to the Colony ; and though it would certainly bo a great annual expense, it would still afford some outlet for the people's beneficence, like the hospitals and old mens' homes, instead of being ranked with gaols and reformatories as " self-supporting " establishments, where the work which pays is but the result of crime. The labour of a lunatic, of one afflicted by God, should be for the benefit of his health, both mental and bodily, and as a reward for good behaviour, and not exacted from him arbitrarily as the punishment of evil doing. At the same time it is to be hoped that the Central Asylum will be supplied with all kinds of workshops and appliances, for the exersiso and mental occupation of the patients without reference to the expense incurred ; for it is only when working with a will (and they will not work without it), or when absorbed in quiet and pleasant meditation, that these afflicted ones seem to be supremely happy. To get them to work is a privilege, and not as a task, would appear to be the great rule for asylum labour, whether the product of that labour be remunerative or not, so that a large grant in aid will require to be voted by the Assembly for many years to come. I have only to remark in conclusion, that I hope the building will be commenced forthwith, and made ready for patients without unnecessary delay. 11. Hanson Turton, Inspector of Asylums, Parnell, 4th October, 1871. Province of Auckland. Telegram from Dr. Dermott, of Hokitika. 1. There are twenty-five male patients in the County Lunatic Asylum, and ten female patients in asylum connected with management of Hospital. 2. Accommodation for male patients consists of nine sleeping rooms, men's room, two securely inclosed yards, bath room, recreation ground in extent one acre, on margin of a terrace overlooking the sea, surrounded by a fence fourteen feet high ; arrangements now in progress for addition. Budding for male and female patients conjointed. 3. One chief attendant and two assistants. 4. Have ample means for curative treatment. 5. My views are opposed to large asylums, and in favour of general local ones, to be visited periodically by ono or more Inspectors, after the system prevailing in England, and in the Colony of Victoria, Australia. Dr. Dermott, County Surgeon, and Medical Officer to Lunatic Asylum.

REPORT OE JOINT COMMITTEE ON LUNATIC ASYLUMS.

20