UPON LUNATIC ASYLUMS.

19

H.—No. 10.

Auckland Asylum.

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