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POOR-LAW MEDICAL REFORM ASSOCIATION.
quay rose, added to the beauty of the scene. Surely, it struck me, here must even the troubled and weary mind find quiet and so(,thing peace. --The house, which is situated at some distance from the town, is well adapted for its present purpose. It is surrounded by a This is what we call writing round a corner; and as we are garden, and it affords easy access to the sands. The persons of ordinary mental vision, we do not profess to be able patients were cheerful, happy, and busily employed in a room to accomplish the feat of looking round it. large enough to dine forty people in comfort. All the conThe cases reported are in themselves very interesting, and valescing patients are sent for a time to this place before their final discharge; and it has been found that their removal from they are not badly described; but there is a great want of the asylum wards, together with the agreeable change of air cohesion in the essay itself. The style is meagre, and the and scene, has had a marked influence in promoting recovery punctuation is inexcusably defective. The most redeeming and establishing convalescence. Many patients in feeble bodily. features about the pamphlet are the evident interest the health, whose mental disease is chronic and inevitable, have author takes in the subject, and the careful industry with which gained strength and derived much benefit from the same in-
called into action by some mechanical exciting cause; and from its deep-seated situation, and the peculiar delicacy and excitable nature of the surrounding parts, is often obscure in its origin, and virulent in its character."
ease
that,
-
walled
fluences.
he has collated his authorities.
THE EXMOUTH SANATORIUM TO THE DEVON COUNTY LUNATIC ASYLUM. To the Editor
of THE LANCET. that the experience of the past SIR,-You ten years points to a steady increasing accumulation of chronic cases in our county lunatic asylums-cases which, however quiet and orderly under the healing discipline of an asylum, are yet totally unfit and unsafe to be entrusted either to their friends, or to the authorities of the parochial union-house. All attempts thus to clear the asylum invariably fail, and the patients so disposed of are generally within three months returned to the asylum as dangerous either to themselves or others, and with a great aggravation of the symptoms they presented on their disare
doubtless
aware
charge.
And yet to retain all such cases in the County Asylum is necessarily to close by degrees the door against the recent curable patient, and to convert the expensive building, with its varied appliances for the curative treatment of mental disease into a mere house of detention and safe-keeping for chronic
lunatics-the very state indeed into which the great metropolitan asylums of Hanwell and Colney Hatch are passing. This serious and increasing evil has not failed to attract the attention of the Commissioners in Lunacy, who, in their last Annual Report, recommend economically-constructed buildings, separate from the main structure of the asylum, for the use of the more quiet, orderly chronic and convalescing patients. It is to a fuller development of this idea, as carried out by Dr. Bucknill, at Exmouth, that I wish to direct attention. The over-crowding of the Asylum by chronic cases is an evil which, at the Devon Asylum, particularly in the female department, has been much felt. Now, Dr. Bucknill, to meet the difficulty, adopted the bold and novel expedient of hiring a large house at Exmouth, on the sea-side, capable of accommodating forty patients. To this house he has transferred thirtyeight of his quiet, harmless, and convalescing patients, placing the establishment under the charge of an assistant medical officer, Mr. Symes, to whose kindly and judicious treatment of his patients I here gladly bear testimony. The fittings and furnishings were sent from the stores of the Devon Asylum, about six miles distant. The diet scale is the same as at the Asylum, and the contracts are taken in the town of Exmouth, as near as may be at the same figure as in Exeter. The rental of the house, with rates and taxes, is £130, or Is. 3d. per head per week for each of the forty patients accommodated, while the expense of rental per head in the County Asylum stands at 3s. 6d. a week, as fixed in the contracts entered into by the Devon magistrates with the boroughs of Exeter, Plymouth, On this head, therefore, is a saving of seventy Bideford, &c. per cent. of rental. The rent charge of 3s. 6d. a week is calculated on the actual cost of the Devon Asylum, and this was by no means an expensive building of the kind. At Colney Hatch the rental calculated at only six per cent. interest on the cost of the building, would exceed 5s. a week for each ,
patient.
At a recent visit which I paid Dr. Bucknill, at Exminster, I thrice visited with him the Sanatorium at Exmouth. ThE drive from Exminster to Starcross (five miles), with the view all the road, of the estuary lying like some quiet island lake. with its watching hills around, was a glad contrast with th( dismal London pavement. And, then, the sail over the noblE estuary, and the glorious view from the windows of the Sana torium, of ocean and clouds, as the sun sunk behind those brighl red lights which are so lonely in our winter sunsets, right over the hollow of the bay, whence the distant smoke of Tor
This success, pecuniary as well as medical, leads me to direct, attention to the advantage which Dr. Bucknill’s plan affords of alike relieving the surplus population of an asylum, and of providing a sanatorium or house of trial for convalescents. And specially does the suggestion apply to counties distant from London, where large empty country houses are often to be had at a nominal rental. I would just add, that it is only in connexion with a larger asylum, from the wards of which suitable inmates for such a sanatorium can be selected, that I recommend the plan. It is as an adjunct to the county asylum, not as a substitute, that it merits attention and trial. The benefits which the Commissioners in Lunacy state to result from the adoption of their suggestion of apartments detached from the main building of asylums, must trebly follow the influences of the sanatorium-the distinct house, the change, of air and scene, of Dr. Bucknill’s plan :" As a means of treatment, we consider this species of separate residence of the utmost importance, constituting, in fact, a probationary system for patients who are convalescing; giving them greater liberty of action, extended exercise, with facilities for occupation; and thus generating self-confidence, and becoming not only excellent tests of the sanity of the patient, but operating powerfully to promote a satisfactory cure. The want of such an intermediate place of residence is always much felt; and it often happens, that a patient just recovered from an attack of insanity, and sent into the world direct from a large asylum, is found so unprepared to meet the trials he has to undergo, by any previous use of his mental faculties, that he soon relapses, and is under the necessity of being again Ieturned within its walls." I am, Sir, your most obedient servant, C. LOCKHART ROBERTSON, M.B., Cantab. Cantab.,.
Berkeley-square, January, 1857.
Hon. Sec. See. to the Association of Medical Officers of Asylums and Hospitals for the Insane.
POOR-LAW MEDICAL REFORM ASSOCIATION. AT
meeting of the Committee, which was most numerously by members from various parts of the country, (R. Griffin, Esq., in the chair,) held at No. 37, Soho-square, on a
attended
10th inst., several letters were read from nobleand other members of Parliament, expressive of their sympathy and willingness to co-operate with the Committee for an improved system of Poor-law medical relief. The present position of the question having been considered, it was resolved to convene a general meeting of the Union Medical Officers and other members of the profession, to petition the Legislature for a redress of the grievances complained of. A sub-committee was appointed to frame a petition for presentation to the House of Commons ; also one to be signed by the magistrates, and other ratepayers, who feel that the present system is unjust both to the poor and to the medical officers.
Tuesday, the men
clergy,
THE STUDENTS OF ST. GEORGE’S. of the students of St. George’s Hospital was held on Tuesday last-Charles Roberts, Esq., in the chair-for the purpose of supporting Mr. Griffin’s movement, when, considering that each hospital making a different set of resolutions only tended to complication, it was resolved to adopt those passed at the London Hospital (a report of which will be found in THE LANCET of Jan. 17th, p. 75), as they were considered the best to answer the end in view. A committee was then formed to represent the hospital, consisting of Mr. Charles Roberts, Mr. Wintle, and Mr. Clifton, and Mr. Hooper, hon. secretary. The thanks of the meeting were then given to the chairman for the able manner in which ) he had conducted the proceedings.
A
MEETING
169
called into action by some mechanical exciting cause; and from its deep-seated situation, and the peculiar delicacy and excitable nature of the surrounding parts, is often obscure in its origin, and virulent in its character."
ease
that,
-
walled
fluences.
he has collated his authorities.
THE EXMOUTH SANATORIUM TO THE DEVON COUNTY LUNATIC ASYLUM. To the Editor
of THE LANCET. that the experience of the past SIR,-You ten years points to a steady increasing accumulation of chronic cases in our county lunatic asylums-cases which, however quiet and orderly under the healing discipline of an asylum, are yet totally unfit and unsafe to be entrusted either to their friends, or to the authorities of the parochial union-house. All attempts thus to clear the asylum invariably fail, and the patients so disposed of are generally within three months returned to the asylum as dangerous either to themselves or others, and with a great aggravation of the symptoms they presented on their disare
doubtless
aware
charge.
And yet to retain all such cases in the County Asylum is necessarily to close by degrees the door against the recent curable patient, and to convert the expensive building, with its varied appliances for the curative treatment of mental disease into a mere house of detention and safe-keeping for chronic
lunatics-the very state indeed into which the great metropolitan asylums of Hanwell and Colney Hatch are passing. This serious and increasing evil has not failed to attract the attention of the Commissioners in Lunacy, who, in their last Annual Report, recommend economically-constructed buildings, separate from the main structure of the asylum, for the use of the more quiet, orderly chronic and convalescing patients. It is to a fuller development of this idea, as carried out by Dr. Bucknill, at Exmouth, that I wish to direct attention. The over-crowding of the Asylum by chronic cases is an evil which, at the Devon Asylum, particularly in the female department, has been much felt. Now, Dr. Bucknill, to meet the difficulty, adopted the bold and novel expedient of hiring a large house at Exmouth, on the sea-side, capable of accommodating forty patients. To this house he has transferred thirtyeight of his quiet, harmless, and convalescing patients, placing the establishment under the charge of an assistant medical officer, Mr. Symes, to whose kindly and judicious treatment of his patients I here gladly bear testimony. The fittings and furnishings were sent from the stores of the Devon Asylum, about six miles distant. The diet scale is the same as at the Asylum, and the contracts are taken in the town of Exmouth, as near as may be at the same figure as in Exeter. The rental of the house, with rates and taxes, is £130, or Is. 3d. per head per week for each of the forty patients accommodated, while the expense of rental per head in the County Asylum stands at 3s. 6d. a week, as fixed in the contracts entered into by the Devon magistrates with the boroughs of Exeter, Plymouth, On this head, therefore, is a saving of seventy Bideford, &c. per cent. of rental. The rent charge of 3s. 6d. a week is calculated on the actual cost of the Devon Asylum, and this was by no means an expensive building of the kind. At Colney Hatch the rental calculated at only six per cent. interest on the cost of the building, would exceed 5s. a week for each ,
patient.
At a recent visit which I paid Dr. Bucknill, at Exminster, I thrice visited with him the Sanatorium at Exmouth. ThE drive from Exminster to Starcross (five miles), with the view all the road, of the estuary lying like some quiet island lake. with its watching hills around, was a glad contrast with th( dismal London pavement. And, then, the sail over the noblE estuary, and the glorious view from the windows of the Sana torium, of ocean and clouds, as the sun sunk behind those brighl red lights which are so lonely in our winter sunsets, right over the hollow of the bay, whence the distant smoke of Tor
This success, pecuniary as well as medical, leads me to direct, attention to the advantage which Dr. Bucknill’s plan affords of alike relieving the surplus population of an asylum, and of providing a sanatorium or house of trial for convalescents. And specially does the suggestion apply to counties distant from London, where large empty country houses are often to be had at a nominal rental. I would just add, that it is only in connexion with a larger asylum, from the wards of which suitable inmates for such a sanatorium can be selected, that I recommend the plan. It is as an adjunct to the county asylum, not as a substitute, that it merits attention and trial. The benefits which the Commissioners in Lunacy state to result from the adoption of their suggestion of apartments detached from the main building of asylums, must trebly follow the influences of the sanatorium-the distinct house, the change, of air and scene, of Dr. Bucknill’s plan :" As a means of treatment, we consider this species of separate residence of the utmost importance, constituting, in fact, a probationary system for patients who are convalescing; giving them greater liberty of action, extended exercise, with facilities for occupation; and thus generating self-confidence, and becoming not only excellent tests of the sanity of the patient, but operating powerfully to promote a satisfactory cure. The want of such an intermediate place of residence is always much felt; and it often happens, that a patient just recovered from an attack of insanity, and sent into the world direct from a large asylum, is found so unprepared to meet the trials he has to undergo, by any previous use of his mental faculties, that he soon relapses, and is under the necessity of being again Ieturned within its walls." I am, Sir, your most obedient servant, C. LOCKHART ROBERTSON, M.B., Cantab. Cantab.,.
Berkeley-square, January, 1857.
Hon. Sec. See. to the Association of Medical Officers of Asylums and Hospitals for the Insane.
POOR-LAW MEDICAL REFORM ASSOCIATION. AT
meeting of the Committee, which was most numerously by members from various parts of the country, (R. Griffin, Esq., in the chair,) held at No. 37, Soho-square, on a
attended
10th inst., several letters were read from nobleand other members of Parliament, expressive of their sympathy and willingness to co-operate with the Committee for an improved system of Poor-law medical relief. The present position of the question having been considered, it was resolved to convene a general meeting of the Union Medical Officers and other members of the profession, to petition the Legislature for a redress of the grievances complained of. A sub-committee was appointed to frame a petition for presentation to the House of Commons ; also one to be signed by the magistrates, and other ratepayers, who feel that the present system is unjust both to the poor and to the medical officers.
Tuesday, the men
clergy,
THE STUDENTS OF ST. GEORGE’S. of the students of St. George’s Hospital was held on Tuesday last-Charles Roberts, Esq., in the chair-for the purpose of supporting Mr. Griffin’s movement, when, considering that each hospital making a different set of resolutions only tended to complication, it was resolved to adopt those passed at the London Hospital (a report of which will be found in THE LANCET of Jan. 17th, p. 75), as they were considered the best to answer the end in view. A committee was then formed to represent the hospital, consisting of Mr. Charles Roberts, Mr. Wintle, and Mr. Clifton, and Mr. Hooper, hon. secretary. The thanks of the meeting were then given to the chairman for the able manner in which ) he had conducted the proceedings.
A
MEETING
169