H.—No. 10.

16

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