Report of the London, Ontario, Asylum
322 REVIEWS AND BIBLIOGRAPHICAL NOTICES.
The London Asylum is a large institution, gauged by English standards, containing as it does over seven hundred patients. During the year ending September 30, 1879, 80 men and 88 women were admitted as new patients, making the aggregate population 875. Of this number, 48 men and 40 women were discharged, 40 deaths took place, and 2 escaped.
Of the admissions, 79 were transfers from gaols, and 89 from private families under medical certificates; while of the dis- charged patients 64 are reported cured, 16 improved, and 8 not improved. The ratio of recoveries, 7*31 per cent, of the entire population, shows an improvement on that of the year pre- ceding, viz., 5*75. The probation system, which is a favourite one in America, provided 60 patients, of whom 31 were finally cured, 9 improved, 15 returned to the asylum, and 5 remained on probation at the end of the year. The death-rate exhibits improvement, having fallen from 5*38 to 4’91. The greatest care seems to be constantly taken, judging from the in- spector’s report, and that of the medical officer, to secure the health and comfort of the patients, by adding to and altering the buildings for their accommodation. These, as described in the report, seem admirably adapted for the purposes to which they are put, and we can judge somewhat of their efficiency from the knowledge afforded that the cost of construction of the cottages which are employed in part of the institution amounts to about ?60 per head. In connection with the cottage system of treatment, it is said there have been ” no elopements from any of the cottages, and no accident of any kind as the result of too much freedom.”
The medical officer makes a demand, in his report, for a pathological laboratory, and this, it can hardly be doubted now, should be part of the arrangement of every considerable asylum. The intimate dependence of psychology on pathological anatomy and histology, makes it a matter of supreme importance to pos- sess the best information and the most extensive, on the intimate structure of the diseased organs under the physician’s care.
Some valuable and well-considered remarks are made, when speaking of visitors, in reference to the popular errors regarding asylums, but Dr Uucke expresses as his opinion, that the anta- gonism to these institutions is yielding to a better appreciation of their benefits. Dr Bucke’s words are so much to the point with respect to the public feeling in this country, it will be well to give them verbatim:?
“If the doors of the asylums are kept closed, people will always think that there is something to hide; and it is just this impression which it is so important to remove. There are many other reasons why the public should be encouraged to visit lunatic asylums, such as the constant inspection so main- tained by the public ; the variety which is in this way intro- duced into the horribly monotonous life of the patients ; the constant assurance thus given to the public that there is nothing to conceal in the manner in which the patients are used. But the reason first mentioned is the most cogent, though there are many others of great force, all tending in the same direction. The reasons given against admitting visitors are : first, that the public curiosity in regard to the care and treatment of lunatics is a contemptible weakness which ought not to be gratified; secondly, that the patients do not like to be visited ; and, thirdly, that it does harm to the patients to have strangers pass through the halls where they are and look at them. While I give the gentlemen who urge these objec- tions credit for perfect candour, and a desire equal to my own to render good service to the public and to the patients in their charge, and while I declare that I have weighed this matter carefully and impartially in my own mind, I must acknow- ledge that these objections seem to me trivial and without force. The first of them I think I have already answered. Jn regard to the second and third, I have only to say that I have never yet known a single patient object to the admission of strangers into the halls, and that I have never known a patient to be injured by these visits.”
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