THE SEACLIFF ASYLUM INQUIRY (PAPERS RELATING TO).

Appendix to the Journals of the House of Representatives, 1891 Session II, H-29

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Sbss. 11.—1891. NEW ZEALAND.

THE SEACLIFF ASYLUM INQUIRY (PAPERS RELATING TO).

Presented to both Houses of the General Assembly by Command of His Excellency.

Dr. MacGregor,— Inform Mr. Kitchen that a copy of his charges has been forwarded to Dr. King for explanation, and, after perusing Dr. King's reply, I do not consider it necessary to hold an inquiry into the matter, but it is my intention to lay a copy of the charges and reply before Parliament for public information. 9th September, 1891. A. J. Cadman.

Mr. W. F. Kitchen to the Hon. A. J. Cadman, Wellington. Bib,— Dunedin, 11th August, 1891. Be Seacliff Inquiry.—ln response to your request that I should formulate my charges in writing, I beg to do so as follows. I affirm— 1. That since Dr. Truby King has been Superintendent of the Seacliff Asylum, there has been upon his authority wasteful expenditure of public funds. 2. That the food supplied to the patients has been frequently poor in quality, and, in some cases, insufficient in quantity. 3. That the supervision of the patients has been so lax as to permit of the escape of numerous patients, including some considered dangerous. 4. That Dr. Truby King has been unduly harsh or insulting towards the relatives of some of the inmates of the Asylum. 5. That Dr. Truby King has behaved towards subordinates in a harsh or unfair manner. 6. That Dr. Truby King's supervision has been so inefficient as to permit of a patient or patients selling for their own benefit goods or farm produce belonging to the Institution. 7. That Dr. Truby King has been guilty of gross abuse of power by improperly causing attendants to be locked up. 8. That Dr. Truby King has conducted the Seacliff Asylum in such a manner as to be injurious to residents in the neighbourhood. 9. That Dr. Truby King has been guilty of cruelty to patients by allowing them to be worked under improper conditions. 10. That Dr. Truby King has issued orders by which patients were left without sufficient attendance. I undertake to prove these charges, or to find those who will prove them, before Mr. Beetham or any fair tribunal at anytime, provided Dr. King has at least three days before handed over charge of the Institution to a temporary relieving officer.* I make this condition because I hold a written and attested statement that under Dr. King's influence, and for fear of losing his situation, an attendant has made a false declaration; and I hold another statement setting forth that another attendant has been dismissed simply for giving a truthful answer to a question. It will be understood that, in accordance with Dr. Macgregor's original request, I make these charges in my private capacity, and not in any way as representing the Globe newspaper. Yours, &c, The Hon. A. J. Cadman, Wellington. William Freeman Kitchen.

Dr. Tbuby King to the Hon. the Minister of Native Affairs, Wellington. Sib,— Seacliff, 29th August, 1891. In response to a letter received from the Inspector-General of Asylums enclosing Mr. Kitchen's charges, I have the honour to submit the following reply, in which such comments will be found as may suggest themselves in the elucidation of various points. As far as possible I shall endeavour to make my report embrace a refutation or explanation, not only of the abridged list of

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* Mr. Kitchen had long before been informed that to insist on this condition would make any inquiry impossible, for to suspend Dr. King without any tittle of evidence against him was out of the question.

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charges, but also of other charges or insinuations publicly made, and certain statements which appear in Hansard, 17th July, 1891, in the debate in re Lunatics Bill. Indeed, were it not for the somewhat wide misconceptions which appear to exist in certain quarters, I should not feel justified in devoting much time to dealing with Mr. Kitchen's allegations :— Charge I. —" That since Dr. Truby King has been Superintendent of the Seacliff Asylum there has been upon his authority wasteful expenditure of public funds." This charge is very indefinite, and includes a long period of time—nearly two years and a half —during which, in spite of the careful administration of my predecessor, Dr. Eadford King, the expenditure has been steadily diminishing. In the House, on the other hand, exception appears to have been taken not to wasteful expenditure but to the undue parsimony supposed to characterise the Asylum administration. Taking these statements together they would appear to indicate that there has been an excessive expenditure on the one hand in unnecessary directions, and an undesirable saving on the other at the expense of the highest interests of the Institution. Before proceeding further it may be well to define broadly the main purposes for which expenditure has been incurred outside what would have been required in order to maintain the Asylum in the state in which I found it. These are simply the conditions essential to the preservation of life and health in man, viz.:— I. A pure and good supply of substances taken into the body for the purpose of sustaining its various energies: (1) Air, (2) water, (3) food. 11. Bodily environments: (1) A certain degree of light and warmth, (2) cleanliness. 111. Exercise, recreation, rest (bodily and mental). IV. Moral and other elevating, refining, and soothing influences. I.— A pure and good supply of substances taken into the body for the purpose of sustaining its various energies. (1.) Air. —Dr. Grabham, the late Inspector-General of Asylums, reported of Seacliff Asylum when leaving the colony in 1885, as follows : " Although I have been openly contradicted in Parliament, and received hints of intended law proceedings with demands for apologies, I will again assert that the site of the Asylum is ill-chosen, the establishment badly designed and out of date, the buildings defective in construction and showing everywhere bad workmanship, which should never have been accepted." This is referred to as affording a clue to the radical changes which were required in order to bring the Asylum into a healthy condition. It is difficult to decide whether the original designs of the sanitary arrangements or the manner in which these designs were carried out was more at fault. [Vide Appendix A.] The provisions for ventilation were such that the percentage of carbonic-acid gas rose in the dormitories as high as -5 per cent, during the night—a very alarming degree of impurity. This primary defect has been to a large extent remedied ; and in the course of the year we hope to complete the arrangements for the inlet of fresh air and the outlet of foul air. In our ventilated rooms a reasonable standard of purity is maintained. (Appendix A 1.) While the supply of fresh air was thus deficient a still greater evil existed in the contamination of the internal atmosphere by sewage effluvia. Nearly a mile of sewer-pipe, with only two ventilation apertures, poured its gases freely into the building in every quarter. This was due, not merely to the fact that almost every lead pipe leaked at the joints owing to bad workmanship, but also to a faulty design which ensured the emptying of a large number of the traps by the exhaust action of descending columns of water. Further, there was no safeguard anywhere in the form of a disconnecting trap to prevent the sewer gases passing into the building. Indeed, the drainage scheme was such that, had the workmanship been perfect, the practical advantage would have been very little, except in so far as the repairing of perished pipes (Appendix A 2) and joints has engrossed almost the whole time of one or more plumbers throughout my term of office. The changes which were needed in order to overcome these initial defects, and which have been carried out, are illustrated in the accompanying diagram, in which an endeavour has beenmade to represent the successive stages by which the sewer or soil-pipe gas (indicated by black arrows) ha,s been cut off from the building and a circulation of fresh air (indicated by red arrows) has been ensured in its place. The advantage of the latter is that the inevitable leakages which are constantly recurring from our faulty pipes are rendered practically harmless. (Appendices A and A3.) A third measure was necessary in order to prevent pollution of the air through emanations rising from within the building. This has been accomplished by polishing the floors with bees-wax and turpentine, thus rendering them impervious and easily cleaned, whereas formerly many of the floors were kept constantly damp owing to daily scrubbings with soap and water, and the dormitories of dirty patients became very foul. These various changes, when completed, will have entailed an extra expenditure of under £250, including the wages of artisan attendants while engaged upon the works. A fair index of the effectiveness of the alterations which have been made is to be found in the diminished number of erysipelas cases which have occurred during the last six months (23rd February to 23rd August) as compared with the corresponding period of last year—namely, eight cases with one death last year, and two cases with no death this year. (2) Water (as a beverage). —-Formerly (as shown in the diagram of one wing—Appendix A) the soil-pipes terminated in open fresh water-tanks cut off merely by a water-seal which in summer dried up, and at all seasons was liable to be syphoned out by the descent of columns of water from the closets. Now, separate overflow-pipes, having no connection with the drains, have been provided for the water-cisterns. The. soil-pipes have been carried up 4ft. above the tanks, and provided with exhaust cowls, and the tanks have been covered over. The pollution of drinking water is one of most fertile sources of disease. The expenses of the above improvements are included in the £250 before mentioned. (3.) Food. —Under this heading (Charge 2), "That the food supplied to the patients has been frequently poor in quality and in some cases insufficient in quantity," will also be answered.

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Various alterations in the food arrangements have been made from time to time, and may be regarded from two aspects— (a) As contributing to the well-being of the patients, (b) as economic measures. The quantity of new milk and eggs supplied to invalid patients may be taken as an index of the dietetic treatment of special cases, and I therefore give the following list, showing the consumption of those articles in March, 1889 (the month prior to my taking charge), March, 1890, and March, 1891 :— Pints New Milk. Eggs, March, 1889 ... ... ... ... 280 ... 116 March, 1890 ... ... ... ... 1,738 ... 420 March, 1891 ... ... ... ... 3,483 ... 741 A careful check upon the consumption of such articles is kept by having a form, which was specially printed for the purpose, laid upon my table daily for revision. (Vide Appendix B.) Further, special dietaries are provided for recent and recoverable cases. The first alteration in the general food arrangements was an economic measure carried out in September, 1889—namely, the centralising of the cooking at the lower building, whereby a saving of two salaries and one maintenance, amounting to more than £120 per annum, was effected, and a considerable simplification of meal arrangements attained. Early in 1890 a radical change, involving hygienic and economic considerations, was effected; and, as the system then introduced has been carried out since with few modifications and with the best results, it may be well to give an outline of the principles involved in the change. In comparing the Seacliff dietary with those of the asylums of other countries, especially with the English asylum dietary, it was found that patients here received an undue proportion of meat—almost double the Home allowance. This appeared not only unnecessary, but even objectionable, on the ground that the consumption of flesh by the insane should be limited as compared with that used by the general community, because it is desirable to lessen rather than to foster the animal propensities. On the other hand, the volume of the food, while comparing favourably with the English dietary, was decidedly inferior in that respect to the Irish. Dr. E. Maziere Courtenay, in an article on "Irish Asylum Dietary," published in the " Journal of Mental Science," April, 1886, says, "I cannot but think that the food given in Irish asylums is to be commended on one point, and that is, for its bulk. My belief is, that in institutions of the kind bulk of simple food, such as porridge, bread, milk, and potatoes, gives much more general satisfaction than a highly concentrated diet." The economic purpose of the change was mainly to include in the new dietary a larger proportion of vegetable substances, which could for the most part be grown on the estate, and the culture of which would form a useful, healthy, and interesting outlet for the energies of the patients. The net result of this change, disregarding the alteration in potatoes, was a saving of about £250 per annum, in spite of the fact that the new dietary was much more nutritious and satisfying than that which it replaced, and infinitely more generous in all respects than the English dietary. Thus meat was more than one-third higher than at Home, cereals more than one-fifth higher, potatoes and other vegetables more than double, and milk more than double. As to ultimate chemical constituents : the comparative quantities of carbon and nitrogen in the, daily ration per patient are mw rn in the following table : — Carbon. Nitrogen. Seacliff original ... ... ... ... 4,953 263 Seacliff modified ... ... ... ... 5,498 283 English asylums ... ... ... ... 4,125 188 For detailed table, see Appendix C. Various extras are not included in the above Seacliff dietaries, and no allowance is made for eggs, sago, rice, &c, given to invalids. The English dietary is the average of fourteen scales tabulated in Dr. Courtenay's article above referred to, and I have added extra bread, cheese, and beer, usually issued to working patients at Home. The English scale certainly appears somewhat meagre, and I was therefore not entirely guided by it; but probably six years ago there was considerably less work done by patients at Home than is now carried out at Seacliff. Further, the conditions at an asylum seem to resemble in certain respects those reported by the Committee on Prison Dietaries quoted by Dr. Burney Yeo in his recent book on " Foods." " Imprisonment, as now generally conducted (in England), is a condition more or less akm to that of ' physiological rest.' The struggle for survival is suspended, and the prisoner appears to feel that the prayer for daily bread is rendered unnecessary by the solicitude of his custodians. Tranquillity of mind and freedom from anxiety are leading characteristics of his life. From the moment that the prison gates close behind him the tendency in most cases is to lessen waste of tissue. He lives, in fact, less rapidly than before. He is sensibly subdued To settled quiet, and finds, in many instances, a peace and repose to which, as a law-abiding citizen, he was perchance a stranger !" I feel that I might be called upon with more reason to defend our dietary because of its excess rather than on account of its insufficiency; but this is easily justified. (1.) In changes of dietary to meet local circumstances the greatest care should always be exercised to safeguard the health of those who may be said in the meantime to be the subjects, in one sense, of a hygienic experiment. (2.) The appetite of the insane, and especially of chronic demented patients (a class largely represented at Seacliff), is on the whole decidedly greater than that of sane persons placed in similar surroundings. (3.) The greatest safeguard against the onset of insanity, and a very important factor in inducing tranquillity of mind in those actually insane, is to maintain a high standard of bodily nutrition. " However, I am not disposed to uphold our dietary scale as an absolutely ideal one. It is decidedly better than the average, but it is in the experimental stage, and needs modification in at

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least two directions, viz. : (1.) The introduction of a greater variety of viands, which is being gradually effected. (2.) The supply of a larger amount of fat, particularly in winter (for this purpose we have over a ton of fat bacon curing at the present time), and an adequate quantity of fruit, especially for summer. A reduction in the amount of potatoes should be made coincidently with the extra supply of fat. When these changes have been fully adjusted I venture to think that there will be nothing for the most exacting hygienist to cavil at. The cooking is now all that could be desired. The estimated energy developed by several daily rations when oxidised in the body is shown in the following table:— Foot tons. Seacliff original ... ... ... ... ... 3,355 modified ... ... ... ... ... 3,796 English asylums ... ... ... ... ... 2,973 English soldier ... ... ... ... ... 3,542 To arrive at the energy available for external mechanical work and other purposes, that devoted to maintaining animal heat, &c. (say 2,500 ft. to 3,000 ft. tons), would have to be deducted from the above figures. For detailed table see Appendix D. It will be noticed that the present Seacliff dietary supplies 3,796 ft. tons of energy as compared with 3,542 ft. tons for the English soldier's ration, and even this excess of 254 ft. tons in favour of Seacliff is less than the reality, because the Seacliff dietary is taken on the average of men and women, and the men get one-tenth more than the women. Ever since the dietetic changes were initiated the whole of the male patients have been weighed every month, and the weight-register shows conclusively the highly nutritious nature of the new dietary. Thus seventy-five male patients were admitted during the eighteen months following the Ist January, 1890. Seven were fatally ill, and died soon after admission; two were on the round voyage, and remained less than one month in the asylum, and one was a boy of fifteen, who cannot be included in a calculation based upon adults. Of the remaining sixty-five the following table shows the changes in weight:— Number of Patients from which Length of Time in Average Increase in Weight Averages are made up. Asylum. Per Man in Pounds. 24 ... ... ... 5 months ... 91b. 3 ... ... ... 4 „ ... 241b. 7 ... ... ... 3 „ ... 141b. 15 ... ... ... 2 „ ... 111b. 16 ... ... ... 1 „ ... 91b. For detailed table see Appendix E. It will be seen that, on the average, male patients increase about a stone in weight in the first three months after admission. By the sixth month a standard weight is reached, and little further variation takes place in the average. A second list has been made out of all chronic patients who had been in the Asylum six months or upwards, when the first weighing took place, and as this list includes a large number of old decrepit persons, and a few suffering from advanced bodily disease, one would naturally expect to find a diminution in average weight. Actually the table shows that the result has been decidedly favourable. Thus from the summer of 1890 to summer of 1891 there was an increase in weight of more than lib. per man; and from winter of 1890 to winter of 1891 an increase of over 41b. per man. These figures are further commented upon in Appendix F. The introduction of a bone-digestor to the kitchen, at a total cost of less than £20, has resulted in a saving of over twenty pounds' worth of fat and gelatin per annum. (Vide Appendix G.) Until May, 1890, no use was made of rabbits. Since then, rabbits to the value of about £50 per annum have been included in the dietary, thus giving a variety, which has been highly appreciated, while effecting a saving. With the quality of the food supplied to our patients it would be difficult to find any fault. Potatoes and other vegetables are entirely grown upon the estate, and are of excellent quality. The statement that patients are supplied with diseased vegetables is absolutely incomprehensible and preposterous. Flour and groceries are procured from a firm of very high standing; and good Ceylon tea is used, whereas formerly we had inferior Chinese tea. The meat has been specifically assailed, and it has been insinuated that an improper saving is effected by supplying patients with "fat, scraggy, and disgustingly gristly mutton," unfit for human use. To say that there is no foundation for this would be simply misleading, and it is difficult to convey how diametrically opposed such an insinuation is to the truth; The most scrupulous care has been exercised with regard to the meat supply ; and, under a former contract, it was considered necessary to frequently return carcases to Dunedin, as being below the standard which we could accept. On one occasion, actually the whole supply of beef and mutton for several days was sent back, and meat was purchased locally to supply immediate wants. Further, several letters were written by me from time to time upon the subject. The meat received under the present contract is of a quality to which no exception could honestly be taken. I unhesitatingly affirm that no public institution with which I have been connected has been so uniformly well served as we have during the last twenty months. Only once in that time has our butcher—a very exacting patient—complained of the meat not being up to his ideas of what it should be ; and even then the single carcase of mutton was objected to merely on the ground of its being rather lean and undersized. Appended is the statement of the official directly connected with the meat department. (Appendix H.) As bearing upon the quality of meat supplied to patients, I may mention that formerly the best joints were cut off for the attendants, whereas early in 1890 a rule was made that in the case of mutton entire carcasses were to be set aside for the use of attendants, and measures were likewise taken to ensure a fair distribution of other meat. Further, it had been customary, in order to

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supply hot freshly-cooked meat to attendants, to invade the patients' supply, and to make this up to them by handing over the cold residue from the attendants' tables for the patients' breakfast. This practice was stopped. It appears from the paragraph below* that samples purporting to have been meals of patients at Seacliff were secured by the representative of the Globe newspaper. I feel that it would be out of place'for me to comment here upon the inevitable dishonesty involved in such a statement. On the one hand we have the deliberate corruption of a public servant, and on the other the deprivation of food resulting from the abstraction of a patient's ration from the dining-hall. Why was an open and honest application not made to see the patients at dinner? No such scales as reported ever existed here, but the meaning of the so-called first and fourth classes may be explained as having some foundation. Until recently the partition of the food into rations proportionate to the requirements of the various individuals was left for the most part to the judgment of the attendants ; but this seemed to be an undesirable arrangement, because there was a tendency for each attendant to try and get the lion's share for the patients under him. I therefore carefully considered each patient's case with the head-attendant, and the dietaries of chronic patients were arranged in four grades according to their special requirements. II. — Bodily Environments. — A certain degree of Light and Warmth. (1.) Light. —A larger number of men are kept in the open air instead of being inside the building or in high-walled airing-courts ; and at the north end of the Asylum a large area has been enclosed (with sft. open pickets) for women, and laid out with flower-beds, shell-paths, and lawn, a portion of which is daily used for croquet. A long verandah has been, erected in the same yard, with work-tables, &c, in order to enable women to do sewing and knitting in the open air in summer. An expenditure of about £25 was incurred in this direction. Although many patients remain up till 8.30 p.m., playing billiards, &o. (whereas they used to go to bed at 7 p.m.), and a larger number of lamps are used in the rooms and corridors throughout the building, and in the hall on dance and entertainment-nights, the kerosene bill has considerably decreased. The reason of this is that formerly large quantities of kerosene disappeared through there being no lock on the kerosene store and attendants using it freely for lighting fires. (Appendix X.) (2.) Warmth. —The temperature of rooms not specially heated falls in winter far below the standard which should be maintained for many of the acutely-insane and for invalids or old decrepit persons. The risks attendant upon allowing open fires, guarded only by iron gratings, to lunatics at night are too great to permit of our using fireplaces where they exist in bed-rooms, except in special cases, and then attendants have to sit up to watch the fires rather than the patients. (Appendix L.) For the last few months female patients have had the benefit of seventeen rooms heated to about 60 deg. Fahr. by means of hot-water pipes, the apparatus for which had been lying useless in Wellington for six or seven years, having been imported for the purpose of maintaining a genial warmth in the cells of prisoners who were to be kept in a projected central convict-prison at New Plymouth. Before next winter the New Plymouth apparatus will have been completely fitted up, and we shall have bedrooms for about sixty or seventy patients efficiently heated. The apparatus having been sent from Wellington, we do not know the cost of this improvement. Formerly few fires were allowed in the daytime owing to the risks entailed, but now extra precautions are observed and a large number of fires are maintained in winter. Cleanliness. —No effort is spared to maintain as high a standard of cleanliness as possible under the very unfavorable circumstances with which we have to contend in having no adequate watersupply. The latter subject is fully dealt with in Appendix M, and as the spring there referred to has been purchased we only await the passing of a grant for, say, £1,000 in order to proceed with the necessary works. At the latter end of 1889 a sum of about £50 was expended in fitting up a large room with baths, shampooing apparatus, &0., in terms of letter. (Appendix N.) Since that time the old practice of bathing two men in a bath at once has been absolutely disallowed, and the shampooing lias done away with the necessity of washing the face and head of a patient in water which had already been used by another. 111. — Exercise, Recreation, Best (bodily and mental). (1.) Exercise and Recreation (bodily and mental). —The various outdoor works on which the men are engaged—such as bush-falling, bush-grubbing, wood-carrying, farm, garden, and dairy work, earth-work, handicrafts, &o. —partake almost as largely of the element of recreation as they do of work. Patients are not, on the average, engaged in these occupations more than five or six hours a day, are usually allowed two spells in the day for smoking, and for the most part do their work in a somewhat leisurely fashion. Even although a man cannot be induced to do any work, he is sent out with a working gang if possible, merely for the sake of the benefit which arises from keeping him in the open air.

*We have, however, seen samples of food supplied for dinner to a first-class patient, and we have not the slightest hesitation in denouncing the mess of potatoes, cabbage, and miserable little pieces of fat, scraggy, and disgusting looking mutton as unfit for patients' use. Only the hungriest of hungry men would care about devouring it. On this point we have taken some pains to obtain the dietary scales for first- and fourth-class patients, and here they are in all their naked grandeur : First-class patients. —Breakfast: A pint of porridge, with separated milk ; a ninth part of a 41b. loaf, with a little butter and a little chopped meat. (From the sample of this last shown to us we can honestly say we have seen much better thrown to dogs). Dinner: One pint of soup and a plate of meat, &c, aa above described. On Sundays a piece of pudding. Tea: Three-eighteenths of a 41b. loaf, thinly buttered. No tea at dinner time, plenty at other timgs, but poor in quality. Fourth-class patients. —Breakfast: An eighteenth part of a 41b. loaf, very thinly buttered ; one pint of porridge with separated milk, and a pint of weak tea. Dinner: One pint of meat soup three times per week, with potatoes, cabbage, or turnips. Vegetable soup four times a week, with potatoes and cabbage or turnips. No meat, but a piece of .pudding, known as " duff," on Sundays. Tea: A ninth part of a 41b. loaf with butter, and a pint of very poor tea. It will thus be seen that if these scales are rigidly adhered to, patients at Seacliff are not likely to get either too strong or too fat. But, judging by the samples secured by our representative, they are not followed at all.

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With the women, unfortunately, the case is different, it is impracticable to supply insane women with much outdoor employment, especially upon an estate where both sexes are maintained; and the lack of this causes an extremely marked difference in the demeanour of the women as a whole, as compared with the men. One can frequently go through the asylum without coming across a single obstreperous male patient, but it is never so with the women. Walks in the grounds, or even-definite forms of recreations, such as croquet, rounders, dancing, &c, bear no comparison with useful outdoor work in influencing the insane in a healthy direction. It is to be remarked, however, that those women, who are entirely employed in the laundry and kitchen, and even those who will busy themselves with " still '•' work indoors—such as sewing, knitting, &c.—are, as a rule, happy and contented enough. The following is a list of the recreations provided for patients : — (a.) Sports, with the band playing on the front lawn, every Saturday afternoon, unless too wet or cold. (b.) Croquet for women on all fine mornings. (c.) Tennis for special patients. (Two asphalte tennis courts have been made at a total expenditure of about £30.) (d.) General picnic in summer. (c.) Fortnightly dance during six colder months. Music by band. (/.) Entertainments tendered by companies from Dunedin, or given by the staff, throughout the year. ((/.) Optical Lantern Entertainments.- —The first lantern-entertainment devised at Seacliff was given last Christmas Eve by means of an apparatus which we have for the most part constructed in the establishment. The lantern is provided with oxy-hydrogen lime-light, and the image is projected from the gallery of the large hall to the stage, a distance of 80ft., on to a screen 24ft. in diameter—probably the largest in the colony. Total expenditure, £27 9s. Bd. (Vide Appendix 0.) I regret that these and other entertainments have not been so frequent during the last few months as they should have been, owing mainly to the extra work and distraction caused by the long series of newspaper attacks which have been made upon the Asylum. Attendants have been too much occupied with'the small excitements caused b) 7 these articles to devote their wonted attention to providing amusements, and otherwise working voluntarily for the well-being of the establishment. (h.) The Billiard-room. —The billiard-table at the main building was originally in a comparatively small room, reserved solely for the use of attendants, and all the men, with the exception of possibly a dozen, were got to bed as soon as possible after tea, only the favoured few staying up later than 7 p.m. There was no form of evening recreation whatever, except a possible game of cards or draughts in a cold, dimly-lighted corridor. Early in 1890 the principal men's day-room—■ then a bare, barn-like place, without blinds, provided only with wooden tables, forms, and a few sofas in black American cloth—was repainted, polished, decorated, and comfortably furnished to accommodate fifty patients. A large portion of the floor was laid with the best linoleum, the billiard-table was transferred to it, two large tables were provided for newspapers, periodicals, &c; four small tables for cards, draughts, dominoes, steeplechase, and other games; cane chairs, six cretonne-covered sofas, hearth-rugs, cornices, vallances, blinds, pictures, and bracket and hanginglamps. Less than £40 were expended in effecting this change. (Photographs, Appendix P.) At first about thirty patients availed themselves of the privilege of using this room, a large proportion actively engaging in games, and the rest occupying themselves with illustrated papers, smoking, or merely sitting round the fires. The room has been kept open on all week evenings, and the numbers frequenting it have steadily increased, until now there are usually between forty and fifty present. The patients, with as many attendants as care to join them—in addition to the attendant in charge—occupy the room till 8.30 p.m., after which it is reserved for the use of attendants 01113 7. This simple reform, when instituted, caused a storm of indignation among a certain section of the attendants, who considered it a gross infringement of their privileges, and threatened to revenge themselves by spending their evenings at the hotel. Very soon, however, the malcontents succumbed to the inevitable, and I should say that there are now few if any who would wish to revert to the old arrangement. This incident will serve, as well as any other, to illustrate the fact that inside asylums we are not exempt from the law of "survival of the fittest." Indeed, if there are any institutions in the world in which, without necessarily any bad intentions, the stronger tend to override the weaker, unless the balance of privilege be firmly maintained, it is dn lunatic asylums. In the instance which I have quoted the attendants had, during the lapse of time, and no doubt by insensible degree, acquired the sole right with regard to a billiard-table which was presented to the patients as a reward for their own labours by the Eoslyn Corporation. There is also a billiard- and card-room at the upper buildings, with a somewhat inferior billiard-table, which has always been used by some of the patients at meal-times ; but whereas formerty only two sat up, now about twenty engage in games till 8.30 p.m. Besides these there are three other sitting-rooms, with fires, for male patients, and corridors and recesses without fires. All these places are lit up, and are more or less occupied of an evening by, say, from ten to a dozen patients. (i.) The library sitting-room, for patients and attendants, which was opened about a year ago, is a cosy room, furnished in a better style than the main billiard-room, and supplied with a good selection of books. It is mainly frequented by better class of patients. The library, to which we are constantly adding, consists at present of 128 books, and the number lent out to the staff is to-day : nurses, 17 ; attendants, 22. Certain patients have the free use of the library, and others have books lent to them. The following papers have always been received for patients —viz. : three copies Illustrated London Netus"; three copies Graphic, one copy English Punch, and nine copies of daily papers; in addition we have taken since the beginning of the year five copies Otago Witness. Old magazines and periodicals have been purchased from the Athenasum, and recently two copies of the Review of Beviews have been ordered. Besides providing books for recreation, a large number of standard works upon farming,

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gardening, engineering, and handicrafts have been procured mainly for the use of the staff. Though this has led to some sneering upon the part of those who have no idea of improving themselves and their ways of doing things, I have the best evidence, in the high appreciation shown by the more intelligent officials, that great good is resulting from the comparatively small expenditure in this direction. As an instance of the tangible benefit which may result in an establishment of this kind from higher class studies, I may mention that the farm manager was enabled to point out definitely, through a study of Trautwine's book on Engineering, a serious structural defect in the new farm building, which, though easily remedied now it has been detected, might have resulted in very grave consequences. Cost of books to date about £15. The rest presented to asylum. (Vide Appendix Q.) (/.) On wet days, instead of hanging disconsolately about damp gloomy airing-courts, a number of the patients occupy themselves at billiards, &c, as in the evening, and the majority are sent up to the large hall, where fires are lit and bagatelle and bull-boards are provided. Members of the band generally play some pieces during the day. (k.) The Band. —A band, consisting of piano, 'cello, double bass, lour violins, two cornets, clarionet, and euphonium, was organized fifteen months ago, and has made excellent progress, especially under the present bandmaster-attendant. One would have expected that such a humanizing and elevating institution would not have been cavilled at, but I find that it has not escaped contemptuous public denunciation. Curious as it may seem, our action.in this direction (extravagant as it has been regarded) really results in a considerable saving. We pay less for our music now than we did two years and a half years ago, when a lady came once a fortnight to play a hired piano. Then it cost £32 15s. Bd,, now it costs £30 9s. lid., and we can have music at any time. The latter sum allows fully for interest and wear and tear of instruments, bandmasterattendant's cottage, &c. (Vide Appendix E.) Recreation for nurses need not be dwelt upon, except in so far as the providing for extra recreation has involved a considerable annual expenditure. A year ago two extra nurses were engaged, causing an additional expense of about £120 per annum, for the sole purpose of enabling all female employes to have an hour's exercise in the open air daily (during daylight), and it was especially for this purpose that a second tennis-court, before referred to, was made. This had a most beneficial effect on the health and spirits of the female staff, and it was followed later by an additional hour granted for tennis every other evening. Rackets and tennis-balls are provided by the Asylum. If this change were regarded from no higher ground than the economic standpoint it would have to be admitted a, success. Last year for a considerable time we had to employ six temporary supernumerary nurses on account of sickness, and the general health of the nurses throughout the year was such that they were not nearly so capable as they are now. There is not at the present time a single case of even delicate health among the whole staff of nurses. (Vide Appendix S.) The only privileges in this connection which the male attendants enjoy, over and above what they had origiuallv, are limited to charge attendants, who, owing to the trying nature of their indoor work, are given a day's additional half-holiday in the week, and are also allowed reasonable assistance from patients in cultivating their private gardens. So far as practicable other indoor attendants are given spells of outdoor work from time to time. It may be mentioned that as heretofore, besides the regular patients' dances, in which the staff and neighbours join, there is a fortnightly dance during winter for the staff and their friends only. (2.) Best. —Obviously general recreation and bodily work bear with them a large measure of mental rest. A release from strain, caused by constant attendance upon the insane, it will be noted, has been effected as above described at some little expense where it appeared to be unduly felt by nurses and attendants. IV.-— Moral, and other Elevating, Refining and Soothing Influences. A somewhat large expenditure has been incurred by treating a considerable number of the patients admitted on the so-called isolation system for many months, largely for the sake of moral influence. In these instances the whole time of a specially-selected attendant has been devoted to the individual patient, although, in the majority of cases, no money whatever has been received for maintenance. In one case three nurses were devoted solely to a single patient for over a fortnight. One cannot help feeling that, upon such and many other grounds, a statement made in the House to the effect that under the present parsimonious arrangement in New Zealand lunatic asylums there is no attempt to cure patients at all, and that the asylums are simply detaining houses, was scarcely called for. (Vide Appendix T.) I may say that the majority of cases treated. on the isolation principle have recovered, and thus more than justifies the expense incurred. Obviously many institutions, such as the band and library already described, should be regarded in the light of elevating, refining, and soothing influences. In addition may be named the painting of the building throughout in light, pleasant colours (each corridor and room, as far as possible, different from another), instead of the sombre green and strong blue which prevailed almost everywhere ; polishing the floors, decorating rooms and corridors with pictures, flowers, and ferns, and the introduction of singing-birds. The expense involved in this has been inconsiderable, as the painting has been carried out by patients under one attendant. All picture-frames and fern-baskets are made by patients, and the pictures have, for the most part, been given to the Institution. (Photograph, Appendix U.) Other items of Avoidable Expenditure. (1.) Shrubs and trees to beautify garden and grounds. A vote for £20, not yet expended, was obtained for this purpose. (2.) A fountain, to which particular exception has been taken on the ground that it is being erected on a slippery site, and will not be worth £15 when completed, although costing £120. This needs some explanation. The fountain in question was begun about four months ago, our object being to

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try and induce on old patient, who had shown a decided taste for wood-carving, and who used to be confined in a walled airing- court, to carve a fountain in Oamaru stone. I had seen one which was erected at the Tiinaru Hospital some years ago, and which was not only a great ornament to the place, but appeared to be thoroughly durable. I need only say that our patient has far excelled his own and our highest expectations, and has a work more than half completed for which no apologies whatever need be made. Even if the fountain had come to nothing the fine enthusiasm and great pleasure in his work displayed by this old patient, who was formerly melancholy and misanthropic, would be almost a sufficient reward for the small expenditure of £26 6s. 7d. staked in the venture. As it is, in three months' time we expect to have a fountain completed which will be a great ornament to the grounds, and which will have an intrinsic value of at least £100. As to the site slipping, that is nothing unusual at Seacliff; most of the ground slips, more or less, and so long as large blocks of brick-buildings move en masse without damage, there need be no great anxiety about our fountain. (For photograph and detailed expenses of fountain vide Appendix V.) The main items of expenditure were for material and labour to form the concrete basin. 3. Farm Buildings. —A fine farm steading, the shell of which is constructed of materials from Exhibition Building, has been erected during the past year, and has engrossed a large share of work in building, asphalting, painting, glazing, &c. The cost may be ascertained on application to the Inspector-General, as the portion of Exhibition Building was purchased by the central authorities, and the accounts have not passed through our office. (4.) Sewage Irrigation. —This provides for the efficient irrigation of half an acre of land for garden purposes. Expenditure of about £7 10s., for pipes, cement, &c. (o.) Cottage to serve as a Lodge for Bandmaster-attendant. —This is situated at the main entrance to the grounds, and at the corner of the large orchard, from which almost the whole of the fruit has been stolen every year. Cost of cottage, say, £60. (Vide Appendix W.) Economies not already mentioned have been effected, mainly by systematizing and concentrating the work of the institution, instituting a proper system of check in clothing and other departments, preventing waste in numerous directions, and getting a larger number of patients to employ themselves, and assume responsible duties. (Vide Appendix X.) Why reasonable economy in the expenditure of public money, which does not benefit the individual, should be regarded as improper and cheese-paring, while similar carefulness in private life is generally approved, lamat a loss to understand. There certainly is a tendency to look askance at all public saving, and to regard lavish expenditure in the light of generosity. On the other hand outlay upon reforms, however urgently needed, is censured as wasteful. Charge 3. —" That the supervision of the patients has been so lax as to permit of the escape of numerous patients, including some considered dangerous." Under this heading will also be considered remarks made in print or otherwise with regard to suicides. Escapes and Suicides. —The average number of escapes from Seacliff Asylum has been sixteen per annum for the last two years and a half, and of these only one was a dangerous lunatic. (Vide Appendix V.) Considering that we have usually had from 210 to 220 male patients employed out-of-doors daily upon a bush farm, the greater number actually at bash-clearing, our list of escapes can scarcely be regarded as unduly large. The average number of escapes in Scotland for four asylums is given by Dr. J. A. Campbell as 5 per cent. (" Journal of Mental Science," July, 1884, " Escapes, Liberty, Happiness, &c"), or exactly half as many again as escape from here—that is to say, the average for an asylum with the same number of patients at Seacliff would be twentyfour per annum. In the Fife and Kinross District Asylum, with 327 patients, the number of escapes for the year ending the 31st December, 1883, was thirty-two, or rather more than three times the proportion escaping from Seacliff. If immunity from escapes and accidents were taken as the sole index of efficiency we should be forced to place Ireland in the front rank as regards treatment of the insane, because there suicides and escapes are (or were until recently) very rare; and yet a large proportion of the Irish asylums have been an opprobrium, medicines, because safety has been attained (?) only by the sacrifice of liberty. What that means it is impossible for any one not intimately acquainted with the insane to realise. Dr. Maudsley, speaking on the passion for liberty among the insane, says : "As I feel most earnestly that I should infinitely prefer a garret or a cellar for lodgings, with bread and water only for food, than to be clothed in purple and fine linen and to fare sumptuously every day as a prisoner, I can well believe that all the comforts which an insane person has in his captivity are but a miserable compensation for his entire loss of liberty*—that they are petty things which weigh not at all against the mighty suffering of a lifelong imprisonment." And yet we are practically asked to close our doors upon our patients, and place them under lock and key—we are expected to become, in a word, the gaolers, not the guardians, of the insane. There would be no other alternative if a reasonable number of escapes were disallowed, for liberty without escapes could not be attained on such an estate as this however large the staff might be. I now turn to the citation of authority for liberal asylum treatment, and it may seem remarkable that one is obliged to go back to old reports in order to find articles dealing comprehensively with the principles which lam called upon to defend. A little reflection shows that this is due to the fact that in the last decade the whole matter has advanced a stage further, and the lightness of according a large share of liberty to the insane is no longer questioned at Home. In the " Journal of Mental Science," January, 1882, is an editorial review of the " Twentythird Annual Report of the General Board of Commissioners in Lunacy for Scotland for the Year 1880," from which the following extracts are taken : " The Scotch Lunacy Blue-book is this year of unusual interest, and is well worth the careful perusal of every one who is interested in the treatment of the insane. In addition to the usual information there is an attempt made carefully

* Dr. Maudsley was referring to a time when it was not fully realised how large a share of liberty could be accorded to asylum patients.

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to describe what is special to Scotland in the management of asylums and in the treatment of the insane. In short, the Scotch system is analysed, and in concise terms we are told what it is, and. what results have followed. In the body of the report, under the heading of ' Recent Changes in Modes of Administering Scotch Asylums,' we have fourteen pages that well deserve and will attract much attention. They will stand as a landmark in history of the treatment of mental disease. We use the expression 'treatment of mental disease,' because that is what is really described, and we wish the writer of the report had used this medical expression instead of ' administration of Scotch asylums,' which is a mode of putting it that does not necessarily excite much interest in the profession of medicine. The Scotch Board being essentially a medical Board, we expect that medical phraseology will be used, and a medical spirit run through the whole. But it is the wording only we criticise. That portion of the report is a most carefully-written piece of true scientific work, containing the facts themselves, the history of their application, the inferences to be deduced from them, and the reasons why the particular results have happened, or the medical philosophy of the matter. . . ." We now come to the really original and important part of the report to which we have alluded:— " Recent Changes in the modes of administering Scotch Asylums. — .. . The most important changes that have taken place of late have been manifested chiefly in three directions. (1.) In the greater amount of liberty accorded to the patients. (2.) In the increased attention that is devoted to their industrial occupation. (3.) In the more liberal ai'rangements that are made for their comfort. " The Abolition of Airing-courts. — . . . Most of the public asylums in Scotland are already without them (walled airing-courts), while in several where they still exist, they are seldom used. . . . It is indeed a thing of common experience that the mere feeling of being locked-in is sufficient to awaken a desire to get out. This happens both with the sane and the insane ; but it is certain that the mental condition of many patients in asylums renders them likely to be influenced in an especial manner by such a feeling. With many, however, the desire to escape dies away when it ceases to be suggested by forcing upon their attention the means of preventing it. ... "Liberty on Parole. —The practice of permitting certain patients to walk or work in the grounds without constant supervision, and of permitting some to take exercise beyond the grounds on parole, has been general in Scotch asylums for many years, but it is now much more extensively adopted in them than it used to be. Like the other removals of restrictions to which we have referred, this has found favour in the eyes of superintendents on account of the beneficial effect which it has on the patients, not merely in making their residence in the asylum less irksome, but also by improving their mental condition. " Benefits arising from the Removed of Restrictions.-- . . . But it must also be recognised that the freedom from irksome discipline and restriction tends to remove one of the sources of violent conduct in asylums, and consequently to diminish the number of accidents which results from it. Many patients have, under the freer conditions of their life, become calm and orderly in behaviour, to whom the imprisonment in wards under lock and key, the confinement within highwalled airing-courts, and even the feeling of being under the constant supervision of attendants, were sources of irritation and excitement and causes of violent conduct. . . . " Industrial Occupation. —One effect of the removal of physical restriction has been to stimulate as well as aid the Superintendents of asylums in their efforts to develop the industrial occupation of the patients. The disadvantages of prolonged idleness, to the insane as well as to the sane, and the advantages that result from such occupation as gives exercise to the physical and mental energies without overstraining them, are too obvious to require discussion. . . . The more restless patients often spent much of their day in pacing the galleries or the airing-courts, nursing their morbid irritability, while others lounged on the benches or crept into corners, and so drifted downwards through the dreary stages of physical and mental decay. " Advantage of the Farm as a Source of Occupation. —. . . . It is impossible to dismiss the subject of asylum farms without some reference to the way in which they contribute to the mental health of the inmates by affording subjects of interest to many of them. Even among patients drawn from urban districts, there are few to whom the operations of rural life present no features of interest; while to those drawn from rural districts the horses, the oxen, the sheep, and the crops, are unfailing sources of attraction. The healthy mental action which we try to evoke in a somewhat artificial manner, by furnishing the walls of the rooms in which the patients live with artistic decoration, is naturally supplied by the farm. For one patient who will be stirred to rational reflection or conversation by such a thing as a picture, twenty of the ordinary inmates of asylums will be so stirred in connection with the prospects of the crops, the points of a horse, the illness of a cow, the lifting of the potatoes, the laying out of a road, the growth of the trees, the state of the fences, or the sale of the pigs. . . . "Difficulties met with in carrying out Improvements. —In relaxing restrictions upon the liberty of the insane, there is a certain amount of prejudice in the public mind to be met and overcome. There is a feeling of timidity in regard to persons labouring under insanity, which leads to their being regarded, as without exception and in all circumstances, unfit to be trusted with any degree of liberty. As a result of this, there is a tendency, when a patient in an asylum inflicts injury on others or on himself, to blame the Superintendent for having permitted the patient to have such liberty of action as made the inflicting of the injury possible; and there is consequently a temptation, to a Superintendent who wishes to avoid adverse public criticism, to adopt restrictive measures of the most complete character. It was under the influence of such views that strait-jackets, manacles, and chains were used before tlie introduction of what is called the system of non-restraint. When such restraints were used it was said that no blame could be attached to persons in charge of a patient for any violent deed which might be perpetrated, because it was held that every possible precaution had been taken to prevent it. The error that lurked beneath this statement was not perceived. It was not recognised that in taking precautions against one set of evils, other evils of a graver character were created. Even the evils which it was sought to avoid were not avoided. The 2—H. 29.

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first man from whom Pinel removed the manacles had, with those very manacles, killed one of his keepers. The Superintendent who really takes most precautions against violence is not the man who applies the most complete restrictions upon liberty, but he who weighs the general results of different modes of treatment, and selects that which proves in practice most successful in decreasing the number of violent acts." In connection with one of the Scotch asylums referred to in the fourteenth report of the General Board of Lunacy for Scotland three suicides and one accidental death from swallowing carbolic acid occurred in the year, the average number of patients being only 175 ;* and yet no reflection was made upon the management, the report simply stating that " the list of deaths presents an unusual number from accidents, but it is satisfactory to be able to report that this unfortunate result is not due to any laxity of management, but mainly to an unfortunate concatenation of events." Dr. Manning's report of the Asylums of New South Wales for 1890, just received, shows that there were two suicides last year at Callan Park, one of the model asylums of the colony, and not the slightest reflection is made by the Inspector upon the asylum. As to the suicides which are supposed to have occurred every week for three weeks running at Seacliff, I need only say that there have been but two during the last two years and a half, and these occurred at an interval of two months and a half, both considerably more than a year ago. The clipping from the Otago Daily Times, of the 26th June, 1890, + explains the matter, and shows that one of the two suicides occurred while I was absent on holiday—in other words, there has been one suicide during my charge of the Asylum. It is useless to dwell upon the case, but I may quote a short passage from my letter to the Inspector to show that the bearings of the accident were carefully gone into at the time : "In view of the recent suicide upon the female side, I feel specially worried at this unfortunate accident. Nothing short of cooping every insane person up in a yard can provide against casualties of this kind. No one had any doubts as to the man's safeness, and, moreover, he was in the smallest gang we had. Had we been keeping only twenty patients at work on the farm instead of two hundred, neither the present nor the former suicide would have been prevented." Dr. Yellowless, of Gartnavel (Glasgow), says that " a fatal accident might occur at any moment in any Asylum, which no human foresight could prevent; " and almost every authority on insanity, while enjoining all reasonable precautions, warns Superintendents against letting " caution degenerate into cowardice." Charge 4. —" That Dr. Truby King has been unduly harsh or insulting towards the relatives of some of the inmates of the asylum." Without foundation. Doubtless it refers to Emerson's case. Charge S. —" That Dr. Truby King has behaved towards subordinates in a harsh or unfair manner." Untrue. I think it should be clearly understood that, in spite of all that has been said and done to create distrust and disaffection, the staff has remained true and loyal to the Institution throughout the recent agitation, and the statements about a wide-spread spirit of mutiny and rebellion have been simply concocted. There are a few —a very few, certainly not more than half a dozen —discontented officials in the asylum, but these have no reason for feeling aggrieved at the management. Censure and disrating are usually ill borne by those who deserve them. A very contemptible effort was made to turn the attendants against the Superintendent by stating that the friends of the latter represented him as having to contend with a staff that was " bad throughout." This insinuation was directly contrary to the truth, for I have always spoken in the highest terms of the staff. But for the hearty co-operation of able and energetic officials the improvements which have been effected could never have been carried out. As to grievances, I informed the staff at the beginning of the present winter that they could never have any grievance (either individually or as a body) against the management until they had brought the ground of complaint before me, and had been refused relief. This was said at a general meeting which took place on account of a request for half-an-hour more time in the morning (which was granted). I availed myself of this opportunity to exhort the men to always bring any similar matter frankly before me as they had just done, instead of keeping silent or grumbling, and persuading themselves that they were hardly used—a tendency to which I had occasionally noticed on the part of one or two of them. The staff has always been liberally treated, and I believe there are few services in which equal advantages obtain. I may instance the fact that two attendants remained ill and incapable of doing anything—one for six and the other for nine months successively—and yet no mention was made either of lowering their wages or dispensing with their services. Men very rarely resign, and we always have many applications for the positions. Charge 0. —"That Dr. Truby King's supervision has been so inefficient as to permit of a patient

* It should be noted that this is the case of an asylum twenty years ago, when far greater restrictions upon the insane existed than in the present day. tAn error has crept into the report of the Inspector-General with reference to the Seacliff Asylum. The report states that three suicides took place at Seacliff, whereas, in reality, there were only two. Further, che suggestion conveyed in our leading article of Wednesday that these suicides might possibly be associated with the increased liberty now accorded to patients is not borne out by the circumstances connected with the two suicides which actually did take place. One of the cases was that of a woman under special supervision, who managed to kill herself during the absence on leave of the Medical Superintendent, and at a time when the institution was disorganized through influenza. So severe was the epidemic that half the female staff, including the matron, and all the senior attendants, were prestrated simultaneously, and six inexperienced temporary hands had to be engaged to tide over the emergency. The other case was that of a man who had been working outside for years, and who, without previous warning, suddenly developed a suicidal impulse. He was working cutting piles at the margin of the bush, with a small party of eight patients under one of the most experienced attendants, when during the confusion caused from a shower of rain coming on and the men having to seek cover, ho managed to get out of sight, made for tho nearest water, and drowned himself before aid could be rendered.

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or patients selling for their own benefit goods or farm produce belonging to the institution." This evidently refers to something which occurred during my last holiday. A patient disposed of somo vegetables owing to the negligence of the man who then had charge of the garden, and whose removal from that position by me has been strongly criticised. Charge 7. —" That Dr. Truby King has been guilty of gross abuse of power by improperly causing attendants to be locked-up." I have never on any occasion either authorised or ordered attendants to be locked-up. Charge 8. —"That Dr. Truby King has conducted the Seacliff Asylum in such a manner as to be injurious to residents in the neighbourhood." No complaint of injury or annoyance has ever been made to me by any resident in the neighbourhood. I know on the contrary that the Asylum is regarded as a great boon to the district, quite apart from the fact that for several miles round Seacliff the inhabitants have the advantage of free medical attendance in all cases of serious illness. The best spirit has always prevailed between us and our neighbours, and I feel greatly indebted to them for the sensible kindly manner in which they mingle with the patients at our various entertainments and dances, and for the hospitalities they dispense towards patients allowed out on parole. They have long since goc over the prejudice which I understand existed when the Asylum was first established here—a prejudice founded upon a very common misconception, and one which agitators have recently tried with no great success to rekindle. Dr. Mercier (" Sanity and Insanity," Scott, 1890), says: "The usual conception that the laity have of a lunatic is somewhat as follows : He is usually raving, shouting at the top of his voice, and smashing the furniture ; when not in this state, he is controlling himself, and in the plenitude of his cunning—for he is no lunatic if not cunning—he is lulling the surrounding people into a sense of false security, until he can get a convenient opportunity of cutting their throats ; instead of a hat he wears straw in his hair, speaks of himself in the third person, and talks in ingenious and complicated parables. . . . Having now spent many years in daily and hourly contact with the insane, the one fact about them which continually impresses me with more and more conviction is the wonderfully little difference that there is between them and other people." Exception has been taken to my dispensing with the services of a rabbiter and giving a patient the work to do. The fact is that the patient working alone caught many more rabbits than the rabbiter did when assisted by the same patient. The insane man delivered nearly four times as many rabbits to the Asylum as the two men had produced previously. (Vide Appendix Z.) Charge 9. " That Dr. Truby King has been guilty of cruelty to patients by allowing them to be worked under improper conditions." I cannot conceive what this refers to. Charge 10. " That Dr. Truby King has issued orders by which patients were left without sufficient attendance." lam probably the better judge as to what constitutes sufficient attendance. Penultimate paragraph. —The meaning of the first part I have no clue to. The latter portion, that an " attendant has been dismissed simply for giving a truthful answer to a question," can only refer to ex-attendant John Buchanan, who was dismissed for very aggravated falsehoods. A misconception appears to have arisen through a compassionate allowance, which was granted to this man on account of his crippled condition and long service, being interpreted as compensation for wrongful discharge. A list of all dismissals for the last two years and a half, with reasons therefor, is appended. (Appendix Za.) In conclusion, I would simply state that the various charges made against the Asylum and myself, taken as a whole, have been directly contrary to the truth. The wild stories of a few spiteful men have been eagerly accepted, and though it is possible that Mr. Kitchen really believed much of what he heard against the Asylum, he certainly never troubled to verify statements, and kept himself wilfully in the dark. The only names he produced were those of Emerson and Captain Stewart, and it should surely have suggested itself to him that possibly the others who did not wish to appear might have been even less reliable. As a matter of fact, the principal agitators were a few exofficials who had been dismissed, a few discredited employes, and two or three settlers in the district who sympathised with these. It is worthy of remark that, while they and their supporters have been straining every nerve to demoralise the staff and disorganize the Asylum, everything here has been going on almost as smoothly and quietly as usual. As I have said before, the petty excitements of sensational articles have diverted attention from more useful trains of thought, and much time and energy have been wasted, but so far as the Asylum itself is concerned, little more can be said. On the public a harmful effect must have been produced. The ravings about rapes and homicides cannot but have alarmed timid people, and assertions about starving and ill-treating patients can scarcely have been reassuring to the friends of patients. I have, &c, The Hon. A. .1. Cadman, Minister of Native Affairs, Wellington. F. Truby King.

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APPENDIX. [It has been thought unnecessary to print all the Aqpendioes to the Keport.]

APPENDIX C. Comparative Statement of Food consumed in Lunatic Asylums by each Patient Weekly. Averages.

Cereals in above Dietaries calculated in terms of Bread.

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6 ■I I 4 1 a) o 1 i 4 \ i I 1 1 : s M 13 1 o 1 ! . Seacliff. Dietary before modification. Ounces Carbon Nitrogen 70 6,961'. 690 128 15,800 704 37-5 1,796 51 24 654 20 8-75 1,612 56 1,533 150 14 339 38-5 7-5 1,327 64 •5 Dietary after modification. Ounces Carbon Nitrogen 51 4,97: 49: •7 151 56 103 12,714 566 111 5,321 152 39-3 1,056 32 11-3 2,011 35 (l,310 96 60 1,642 161 14 339 38-5 21'06 3,727 179 i-5 England. 50 2,400 68 11-3 303 9 7 1,293 33.5 1,250 92 2-8 475 12 Ounces Carbon Nitrogen a 3,62' 35! 1-3 14, .21 136 >66 i-5 'A 1 « 3 6 O E •a P "cs n o H i ejj Eh Seaoliff. 'ietary before modification. Ounces Carbon Nitrogen 4 665 23 2 337 31 1,700 1-75 261 10 1,688 73 1-75* 1.5 34^673 1,844 4,953 263 'ietary after modification. Ounces Carbon Nitrogen 4 6C5 23 6 1,012 98 4-4 1,253 1-5 224 •3 65 6 12 2,025 87 l-63f 2-2 38,487 1,982 5,498 283 England. 6-4 1,834 3-2 672 61 6-7 1,180 48 56 958 1 1-05 Ounces Carbon Nitrogen 28,878 1,317 4,125 1S8 * Chinei ie. + Heylon.

Bread, Oatmeal. Barley. Flour. Total Weekly. Total Daily. Seacliff. Before modification. Dunces.. 3arbon.. Nitrogen 128 15,800 704 18 1,688 73 j 157 19,480 864 11 1,327 64 5 665 23 22-3 2,783 109 After modification. Dunces.. 3arbon.. Nitrogen . .. England. 103 12,714 566 30 3,727 179 5 665 23 16 2,025 87 154 19,131 855 22 2,783 108 Dunces.. Carbon.. Nitrogen 121 14,936 666 9 1,130 48 i 130 16,066 714 18-4 2,295 102 'In

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Appendix D. Estimated energy developed by Daily Ration when oxidized in the body

N.B.—The meat supplied to soldiers is fatter than prime meat, and therefore shows somewhat higher in energy developed per ounce. The above Seaoliff dietaries do not include—(l.) Bread, butter, sugar, and coffee on dance and entertainment nights ; (2.) Eggs, sago, and rice for sick patients ; (3.) Currants and raisins.

Appendix L. The Supeeintendent, Lunatic Asylum, Seaeliff, to the Inspector-Genebal of Asylums, Wellington. Ec Building and Improvements. Sib,— Seaeliff, 7th July, 1890. 1. Workshops. —These are nearly finished. The carpenter, painter, and plumber are working in their respective shops. 2. Farm-buildings. —The piles are sunk, and the carpenters will commence building this week. All the material will come in very handily, and we shall have an excellent steading providing ample accommodation. 3. Drainage Alterations. —These have been further simplified, and we expect to have the work nearly finished by the end of the month. 4. Ventilation. —Owing to other more urgent matters we have been unable to effect much in this direction. Eadical improvements are needed throughount the building, but Ido not purpose asking for any special vote at present. Probably £50 for material in the near future will cover our more pressing requirements. 5. Heating. —This matter is very pressing, and is my main reason for writing. From our conversations upon this subject I know that you concur with me in the view that reasonable provisions for warming are urgently called for. The hopes which I expressed at your last visit of being able to effect the heating of a few rooms by hot-pipes before midwinter have not been fulfilled. The influenza epidemic and the work at the Exhibition Buildings severely handicapped us. Now, however, we have several good plumbers here, and I trust you will sanction the carrying out of the following works which appear to me absolutely necessary : (a.) The heating by steam-pipes of twenty-two single rooms on the female side ; seventeen of these rooms are wooden, and during the winter they are bitterly cold. Further, they are strong rooms occupied by patients who frequently have attacks, during which they are wet and dirty, and cannot be induced to remain in bed or to wear anything except canvas garments ; the other five rooms are intended to serve for classifying the more recent acute and favourable cases from the chronics—a hospital ward, in fact. I thought at first that steam from the central boiler beside the bakehouse might be economically used, but both the plumber and engineer have brought conclusive arguments against this, and we have decided that the best plan will be to place a saddle boiler similar to the one we have in the greenhouse, only somewhat larger, in the basement of the new north addition. Four-inch iron piping would be carried from this to the rooms which are on the fiat above, as shown in rough diagrammatic sketch enclosed. As to further details the sketch will explain itself, and I need merely mention that we have arranged matters so that no hopeful patients need ever come into contact with the chronics. If it weresmerely as a precaution against fire I consider that we should be justified in expending a considerable sum in warming these rooms. At present bedrooms can only be.warmed by having fires in rooms provided with fire-guards. The guards we have are, unfortunately, insecure, and only last week a woman managed by shaking the door to slip the lock and then crept inside. She was fortunately discovered in time, but her clothes were burned nearly to.

Sei .cliff Original. Seacliff Modified. Eni ;lish Asylums. English So! Idier. Ounces per diem. Foottons per Ounce. Total Foottons. Ounces Foot- Total per tons per Footdiem. Ounce. tons. Dunces per diem. Foot- I Total jons per FootOunce tons. Ounces Footper tons per diem. Ounce. Total Foottons. Meat (boned) Extra gelatine Bread Potatoes(peeled) .. Vegetables (average) Sugar New milk Bkirnmed milk Butter-milk Datmeal Bice Barley Peas Butter rreacle Dheese ., Flour Beer Extras—Bread Cheese Beer 8-5 53 450-5 6-07 •1 14-71 15-86 5-61 1-61 5 8-57 2 3 53 150 87-5 33 15 126-4 26-9 20-4 17-9 130 321-71 1 15 1,287-12 ; 523-38 84-15 203-5 ; 134-5 I 174-82 35-8 390 4-43 53 234-79 9-6 C7-8 554-88 18-28 5-36 3-43 1-25 87-5 33 15 126-4 1,599-5 176-88 51-45 158 16 7-14 1-61 1 4-79 87-5 33 15 126-4 26-9 1,400 235-62 24-15 126-4 128-85 24 16 8 1-33 3-25 87-5 33 13 126-4 26-9 2,100 528 104 168-11 87-42 8 2 1.07 20-4 17-9 130 163-2 35-8 139-1 •57 •29 •79 •25 125 118-9 344-5 102-3 71-25 34-48 272-15 25-57 125 118-9 344-5 102-3 149-9 123-6 ■4 126*5 50-6 •57 | -86 I -62 •21 ■04 1-71 i 71-25 102-25 ! 213-59 21-48 6 211-36 ■91 344-5 313-49 1-43 123-6 176-74 ■03 •96 3-71 1-29 ■43 4-2 149-9 123-6 20 87-5 149-9 20 4-5 118-65 74-2 112-87 64-4G 84 •■ I • • .. Foot-tons.. 3,542 3,355 3,796 2,973

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the skin. In most cases we have to keep the unfortunates in the cold, and my predecessor's anxiety upon the subject was so great that no fires were allowed even in the day-rooms. As a direct pecuniary argument in favour of heating the rooms by hot-pipes, I may point out that for several months never less than two attendants and sometimes three have been employed solely in firewatching—i.e., we have had to keep them in the rooms of sick patients, not because the cases urgently, needed such special attention, but because a fire was indispensable, and we dare not leave them alone with it. The cost of materials for what I have indicated would be, roughly speaking, about £100 —viz., say, boiler, £20; iron piping, £75; junction-valves, &c., £5 to £10. (b.) Similar works should be carried out upon the male side, but could be considered after the completion of the above. 1 trust that you will enable me to proceed with the work as soon as the drainage alterations are completed, as we have good workmen here, and I should be sorry to dismiss them until everything was carried out. I have, &c, F. Teuby King, The Inspector-General of Asylums, Wellington. Medical Superintendent.

The Supeeintendent, Lunatic Asylum, Seacliff, to the Inspectob-Genebal of Asylums, Wellington. Sib,— Seacliff, 13th July, 1890. Eeferringjto my letter of 7th instant, I have the honour to request that immediate attention be given to the subject of " heating" therein dealt with. You will recall that I stated: "If it were merely as a precaution against fire I consider we should be justified in expending a considerable sum in warming these rooms. At present bedrooms can only be warmed by having fires in rooms provided with fire-guards. The guards are unfortunately insecure." How many times Seacliff Asylum has narrowly escaped being burned down it would be rash to conjecture ; but, judging from my own experience during the past fifteen months, lam led to suppose that serious accidents in connection with fire have occurred with appalling frequency. The risks which have been run in the past are not to be estimated by the recorded fires, as will be borne out by the following fact related to me to-day by the head-attendant: About three years ago a fire took place through burning wood falling out of a fireplace, and a hole 3ft. or 4ft. in diameter was burned in the bedroom floor before it was discovered. After the fire was put out an attendant stayed up all night reflooring the room, and until the present time the fact of an accident having occurred at all remained unrevealed. Mr. Stewart pointed out to me the square patch put in the floor, which was until recently covered with linoleum. Cases such as this in bygone times may not appear much to the point, but I instance this case specially because a parallel accident happened early this morning. A patient named Eoots, suffering from pyamia, has been sleeping for some weeks in a single room off the main corridor in Ward 11. The man has been in a somewhat critical condition, and it was absolutely necessary that he should have a fire in his room. There was no risk of his leaving his bed, and therefore we thought he might be left with reasonable safety with a fire burning in the guarded fireplace. The night-attendant had instructions to visit the room at frequent intervals every hour or so. Acting Night-attendant Fred Buckley reported this morning :"I put wood on Boots's fire a little after 1 a.m.; at twenty minutes to 2 when going my rounds everything was right, an ordinary fire burning in Eoots's room. Had supper, and after going to the upper building went to Eoots' room at 3 a.m. with milk, and found flames about 6in. high issuing from a hole in the floor in front of the fireplace. I threw the two pannikins of milk on the fire, closed the door, and then ran for water, then put out the fire with the assistance of Duncan. The door of the boot'cellar, which is immediately below Eoots's room, was shut." The last-mentioned point that the door of the room below was closed is of importance, because had it been open, which is frequently the case, the access of air to the fire would have been much freer, and possibly it would have got beyond control before it was discovered. (Until quite recently there was no door to the boot-cellar.) The inclosed photographs will convey to you better than a description the appearance the room presented after the fire and also the relation of the room to the main corridor. The greatest measurements of the hole in the floor are 2ft. 9in. by 19in. That the whole Asylum was not burned down can only be regarded as a matter of chance, and I think I may safely say that the law of probabilities would not usually permit a building to remain undemolished after more than ten such accidents. If this be the case, and the Asylum be worth £100,000, then the value of this morning's accident was £10,000. It is unnecessary to dwell upon the more serious considerations connected, with the special horrors liable to attend upon a fire at a lunatic asylum, as these have been sufficiently emphasised by the recent disaster at Tongue Point. In regard to the rough estimate supplied to you last week, I have to inform you that probably £125 would be needed to carry out what I proposed upon the female side, as we shall have to pay a higher price for the iron-piping than was calculated upon. I trust that the extreme urgency of the matter will be deemed a sufficient excuse for my again insisting upon the necessity for prompt action before receiving a reply to my former letter. I have, &c, The Inspector-General of Asylums, Wellington. F. Teuby King.

Appendix N. The Supeeintendent, Lunatic Asylum, Seacliff, to the Insfectob-Genebal of Asylums, Wellington. Sib,— Seacliff, 10th September, 1889. The existing arrangements for bathing patients are so very inadequate and unsatisfactory that I have to request your sanction to a scheme for coping more comprehensively with this import-

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ant work. A change is especially necessary at the present time because our efforts to concentrate the energies of the institution without the necessary fittings will tend to aggravate rather than lessen the difficulties which have previously existed. It has been the custom on the male side to put two patients in the baths at the same time and to allow from two to three minutes to each man. Each lot of water has had to serve for from five to ten patients, and much time has been wasted during emptying and refilling. In spite of over-pressure and over-crowding the bathing of three hundred men has absorbed almost the entire energies of two out of six working mornings per week. If you will allow me to have one of the small dormitories on the groand floor (measuring 18ft. by 16ft.) converted into a combined bathing-room with six baths, every objection which now exists will be met. The following are the proposed alterations with estimated cost of materials : Asphalt or concrete floor faced with cement, £6; six galvanised-iron baths, with wooden fittings, at £2 10s., £15; plumber's materials needed for leading water, connection with drain, &c, £15; extras, £4: total, £40. The baths may cost a trifle above £2 10s., but really we shall only need five, because there is an extra one on the upper flat which can be shifted. With regard to the material (galvanised iron), I am quite pleased with the baths already fitted, which have been in use for many years, and are still in thoroughly good repair. They are easily kept clean if properly cleaned after each day's bathing, and are fully as durable as the ordinary enamelled baths, the facing of which is apt to become rough, and to wear away or come off after a time. The advantage of limiting bathing operations to the ground floor would be very great because leakages frequently occur and saturate the ceiling of the room below. A cement floor is not absolutely needed, but the dampness would soon rot the flooring timbers, and in the end a greater expenditure would be entailed. Further, the seasoned flooring would be valuable for other purposes. Covering the floor with lead would cost twice as much as providing cement floor. I may mention that the adjacent large day-room with a couple of fires on in winter would afford an excellent drying- and dressing-room, and this would do away with any objection which there might otherwise be to selecting wet days for bathing purposes. As the whole of this work could be overtaken in one morning, there could be no harm in constituting the first wet day in the latter half of the week "bathing day " —the work to be done on Saturday in any case if the two previous days should have been fine. I am convinced, if the above scheme is carried out, it will increase the useful energies of the staff and patients by fully a tenth. Should you approve the expenditure I shall be much obliged if you will kindly telegraph me. I have, &c, The Inspector-General of Asylums, Wellington. F. Tbujjy King.

Eetubn of Cost of fitting up new Bath-boom in C Ward, Male Side. £ s. d. Iron fittings and material ... ... ... ... ... 34 13 9 Two new baths ... ... ... ... ... ... 2 10 0 Plumber, attendant's wages ... ... ... ... ... 422 Timber ... ... ... ... ... ... ... 5 8 10 Cement ... ... ... ... ... ... ... 5 5 0 Sand ... .. ... ... ... ... ... 0 9 0 Earthenware pipes ... ... ... ... ... ... 0146 Buchan trap... ... ... ... ... ... ... 012 0 Bricklayer, attendant's wages ... ... ... ... ... 326 £56 17 9 Four of the six baths fitted up were old stock on hand and are not charged in the above account. The carpenter's wages are not charged as value of wooden flooring taken out more than counterbalances them.

Appendix E. Expenses incurred in Providing Music for Patients at Seacliff Asylum for the Years 1888-89 and 1890-91 respectively. 1888-89. 1890-91. Miss Kochfort, salary and expenses for playing at Seacliff Asylum (fort- £ s. d. £ s. d. nightly) ... ... :.. ... ... ... ... 16 2 8 .;. Miss Gow, nurse, extra yearly salary as pianist ... ... ... ... 5 0 0 Yearly interest on organ (£35) at 7 per cent. ... ... ... ... 2 9 0 2 9 0 Yearly interest on old piano (£10) at 7 per cent. ... ... ... 014 0 014 0 Yearly interest on band instruments and one new piano (£126) at 7 per cent. ... ... ... ... ... ... ... ... 8 16 5 Hire of piano (returned January, 1891) ... ... ... ... 12 00 300 Tuning piano ... ... ... ... ... ... ... 015 0 110 New stop to organ (7s. 6d.), new pedal to same (7s. 6d.) ... ... 015 0 Violin strings ... ... ... ... ... ... ... ... 150 New music ... ... ... ... ... ... ... ... 370 Yearly interest on cottage for bandmaster (£6O) at 7 per cent. ... ... ... 440 Sundries : Clarionette reeds, 55.;" pads, 3s. 6d,; rosin, Is. 6d.; music paper, Is.; tail-piece, Is. 6d.; bridges, Is. ... ... ... ... ... 0 13 6 £32 15 8 £30 9 11

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A piano, purchased early this year, for the sole use of nurses (who previously had no musical instrument), and placed in their sitting-room, is not included in the above list. If the interest for this, at 7 per cent, per annum, viz., £2 95., were added to the above estimate, it would practically bring the present expenditure on music up to the original cost.

Appendix S. The Supekintendent, Lunatic Asylum, Seacliff, to the Inspector-Genekal of Asylums, Wellington. Sic,— Seacliff, 13th July, 1890. I have the honour to inform you that I consider it necessary to increase the staff of the female attendants by two or three. Hitherto (long as the hours are during which attendants have to work) no provision has been made for out-door relaxation and exercise. The result of this has been frequent sickness, and a general lowness of tone among a large proportion of the attendants. I purpose keeping two attendants solely for relieving purposes, by which means we shall be enabled to give each female attendant an hour for recreation and exercise during daylight every day. For some months I have been giving the attendants lectures upon health, nursing, &c, and this really forced upon me the necessity of enabling the women to carry out what was absolutely required for the preservation of their health and strength. With the men the case is different, because most of them are employed regularly out of doors, and we can give all of them spells of out-door work. Another attendant will be needed to look after the more recent and recoverable cases, which I purpose isolating from the herd of chronic patients. Trusting that you will sanction the above additions to the staff, I have, &c, Inspector-General of Asylums, Wellington. F. Teuby King.

Appendix V. Estimated Cost of Fountain being erected on Seacliff Asylum Grounds. Description. Amount. Expenditure to Ist August— £ s. d. £ s. d. Oamaru stone, 100 ft. 6in., at Is. per foot ... ...5 0 6 Freight on stone ... ... ... ... 1 13 8 Cement, 8i casks, at 16s. 6d. ... ... ... 7 0 3 Sand, 4 loads ... ... ... ... 0 8 0 Freight on sand ... ... ... ... 0 16 0 Lime, 3 bags, at 3s. ... ... ...090 Tools for carving ... ... ... ... 0 13 8 Labour, 12 days of mason, at Bs. 4d. per day ... 5 0 0 Board of mason, 12 days, at 10s. per week ... 017 2 — — 21 18 3 Estimated expenditure to finish— Galvanized-ironpipe, fin., 50 yards ... ... 2 5 0 Galvanized-iron pipe, l^n,, 15ft. ... ... 010 11 Reducing sockets, 2ft. litin. ... ... ...011 Bend, lft. l^in. ... ... ... ... 0 1 4 Labour, say ... ... ... ... 1 10 0 4 8 4 £26 6 7 Note. —The stones for base existed in situ, being an accumulation of piled up stones taken out of garden in trenching. The bricks used were some refuse from the portion of Asylum which was condemned and pulled down, the soundest of the bricks having been selected by the Public Works Department for rebuilding the part taken down. —F. T. K.

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Appendix W. ExPENDITUBE Oil BaNDMASTEe'S COTTAGE. £ s. a. Timber ... ... ... ... ... ... 12 15 0 Hardware... ... ... ... ... ... 1 10 2 Eoofing ... ... ... ... ... ... 10 0 0 Spouting ... ... ... ... ... ... 2 3 4 Lime and cement ... ... ... ... ... 7100 Sand ... ... ... ... ... ... 0 6 0 Glazing ... ... ... ... ... ... 112 0 Papering ... ... ... ... ... ... 112 1 Paints and oils ... ... ... ... ... 385 Drain-pipes ... ... ... ... ... ... 119 Painter, attendant's wages ... ... ... ... 192 Carpenter, attendant's wages ... ... .. ... 217 7 Bricklayer's wages ... ... ... ... ... '11 5 0 £57 10 6 Bricks, Oamaru stone, sashes and doors, which came from the ruined part of the Asylum and had been rejected by the Public Works Department in rebuilding, are not charged in the above account. Approximate Cost of Paper. —Preparation, not given ; printing (1,250 copies), c£ll lGs. 6d.

By Authority : George Didsbusy, Government Printer, Wellington.—lB9l. Price 9d.]

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