13

H.-9

be remembered that madness recruits its most numerous victims not from the temperate, the orderloving, and the law-abiding classes of society (though they are to be found among the number) ; that mental disease generally has the effect of developing the bad qualities and repressing the good by lessening the power of self-restraint; that constant association with persons of degraded mental faculties exercises a deteriorating influence on those who are submitted to it; and that Medical Superintendents of asylums have no special opportunities of securing the services of persons who have a more just appreciation of the principles of the Christian religion, who are more imbued with ' Enthusiasm of Humanity,' than are to be found in the ordinary walks of life; but, notwithstanding, I confidently believe that a large proportion of asylum attendants perform their duties with a conscientiousness and a singleness of purpose that would do credit to any class of the community; and the kind expressions towards attendants contained in the numerous letters that I receive from discharged patients is evidence at least as worthy of credit as any statement made by ex-attendants, who have probably themselves been dismissed from their situations for misconduct. But, whilst taking a favourable view of the character and conduct of attendants generally, I consider that the supervision over them should be most vigilant; and this as much for the benefit of the painstaking and conscientious, whose merits will thus be better appreciated, as for the indolent and indifferent, who will thereby be stimulated to greater exertions." Here I expect much of my attendants, and their remuneration is not equal to that given to prison warders, although their task and trials are more severe. Considering the hitherto overcrowded state of this asylum, and the rough characters in such close quarters, I am thankful that more dreadful accidents have not happened, especially in the dormitories at night. I have insisted on the constant presence of attendants among the patients in the airing-courts. It is a matter of satisfaction that the patient referred to was in the infirmary ward. I have to report that one male patient broke his arm struggling with another patient. I attach no blame to any person, as the combatants were at once separated, and the sufferer was a Prenchman of so morose and savage disposition that some days afterwards he kicked me on the head, and it required the greatest caution to approach him whenever it was necessary to alter or adjust the bandages and splints. Another fracture occurred in frosty weather: a heavy patient (male) slipped down and broke his leg. He was carried to bed with the greatest care, so that the bones did not protrude through the skin, and, in spite of his protestations that " it was only the rheumatics," his leg was placed in splints. Both cases were attended by special extra attendant, and the fractures united kindly under appropriate treatment. Several small wounds and bruises were occasioned by fighting, but all healed satisfactorily. A large amount of liberty has been allowed to the patients. The escapes have not been numerous, although an attempt is often made. One male patient who worked at the laundry escaped six times. He generally walked home up country to his brother's, who, on several occasions, kindly brought him back. One male escaped twice and one female twice. Eight other males and two other females escaped. They were all recaptured, either by the police, attendants, or courteous assistance of informants. One patient escaped on the 27th January, and has eluded all endeavours to find him. He was much improved in mental condition, but I was not quite satisfied with him. However he became impatient of restraint and escaped. No doubt he is earning his living satisfactorily under an assumed name. An epidemic of typhoid fever visited the asylum during the winter months, and attacked the patients fed on milk diet, and also some of the attendants and their children who obtained their milk from the asylum-supply as their daily ration. I regret very much that two deaths occurred during the epidemic. The cases were isolated, and well nursed by nurses McGill and Knight, in the rooms of the new buildings, and large fires kept up night and day. The first case attacked was an idiot, on the 27th June; the last case was an inebriate, on the Ist September. Every precaution was taken, and no fresh cases occurred after September. The presence of typhoid fever in the family of the milkman supplying the milk having been reported to me, I stopped the supply from that source until the milkman was able to produce a certificate that it was safe for him to supply milk. In all there were fourteen undoubted cases of typhoid fever, and several other patients and attendants and children were, as is usual in typhoid epidemics, variously affected with abortive symptoms, varying in severity, and which I considered necessary at the time to report as likely to spread the disease unless proper precautions were taken. The patients' annual treat was held on the 19th March; a cricket match was played between two teams of lunatics, captained by attendants ; and over forty lunatics were drilled." Out of 167 males and 92 females, there were present out-of-doors 165 males and 86 females. The doors of the asylum were thrown open to visitors to inspect at their leisure. No untoward circumstance of any importance occurred. During the winter-months, on Wednesday evenings, the patients danced, sang, and recited. In consequence of the overcrowding but few visitors were admitted. The patients were first drilled on the 2nd Pebruary; this is now of daily occurrence. I have had as many as 70 to 80 male lunatics out at drill, and have had them paraded for inspection in their Sunday clothes. In March a second ward was opened, and a further relay of patients removed to the new buildings. At the present date all five wards in the new building are occupied, and only one ward (the refractory) is remaining empty until an airing-court can be made, for which the ground has been prepared. Without doubt the greater liberty allowed in the presence of attendants has been of the greatest service in promoting health and tranquillity. The officers and attendants of the institution have been bitten, kicked, and struck, and the Matron received a blow on the head from a violent female. The worst and most troublesome case (who has been discharged, recovered) was that of a man who boasted with great glee that he had been in the Yarra Bend and Nelson Asylums; he was at his best a wild Irishman, and took the greatest delight, while insane, in all kinds of devilment and mischief. On one occasion he had to be rescued at great risk from an old wooden cell, the flooring of which he had broken up, jamming the door, and assaulting the officers and attendants with sticks and stones, and when captured, biting like a monkey. You were pleased to specially reward the attendants who effected his release from the broken timbers amidst a shower of stones, &c. '