THE SIXTEENTH ANNUAL REPORT OF THE ASYLUMS COMMITTEE AS TO THE LONDON COUNTY ASYLUMS FOR THE YEAR...
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1859 THE SIXTEENTH ANNUAL REPORT OF THE ASYLUMS COMMITTEE AS TO THE LONDON COUNTY ASYLUMS FOR THE YEAR ENDING MARCH 31ST, 1905. THE total number of London pauper lunatics on Jan. 1st, 1905, in asylums, licensed houses, workhouses, with relatives or friends, and in the imbecile asylums of the Metropolitan Asylums Board was 24,652, or an increase of 704 in the year. Of these only 280 were in workhouses and 152 with relatives or friends. 17,770 were in asylums and licensed houses. The increase in patients certified for asylum treatment was 640, as compared with an average annual increase for the past 15 years of 512. The committee points out, as in previous reports, that the failure of the Metropolitan Asylums Board to provide accommodation has largely increased the proportion of the insane for whom the County Council has to build. Whereas in 1890 the Board provided for 34 per cent of the pauper lunatics in the county of London, on Jan. lst, 1905, it only provided for 26 per cent. Had the Council now to provide for 61 percent., as in 1890, the number to be accommodated in 1905 would have been 15,037, and on Jan. 1st, 1905, there was room for 17,060 in its asylums. The Board would, there- fore, appear to be the party really responsible for the inadequacy of accommodation for London’s pauper insane, although the Council is called to account in the matter. This comes of the anomaly of two public bodies providing for the insane of one area. The ratio of pauper lunatics per 1000 of the population in the various unions and parishes in the county of London varies from 2 ’ 2 to 8 8 ; the Strand district stands alone with a ratio of 14 1, which is curious, but no reference is made to this large proportion. The existing nine aylums of the Council, includ- ing the epileptic colony, provided accommodation for 17,060 on Jan. lst, 1905, whereas 18,168 patients had to be accom- modated. Efforts to overtake the increasing numbers are being made by way of additions to existing asylums and the erection of two additional ones. The newest or eleventh asylum is to be entirely on the villa principle, a new depar- ture so far as this country is concerned. Betters results are expected from the more home-like surroundings and greater facilities for classification which this method provides, whilst it is not thought that the cost of erection and adminbtra- tion will be greater. In common with asylums in general the London asylums have to complain of the increasing tendency to certify cases of senile decay. The subject of the discharge of relapsing cases is referred to ; their recovery, although temporary, necessitates discharge, a result ior which the recertification clause of the Lunacy Act is largely responsible. In this way the propagation of insanity is fostered. At one of the asylums a married female has been admitted 14 times within 21 years. The committee has made an attempt to board out patients but this proved unsuccessful owing to the cumbersome nature of the machinery provided by the lunacy law. It is rightly observed that this provision is practically a dead letter in England and Wales. It is thought possible that a number of patients might be boarded out if the Scottish procedure were adopted here. The total number of patients admitted during the year was 3813, as against 4502 in the previous year. The r. coveries were 33’59 per cent. of the admissions. The deaths were 6’76 per cent. of the total number under treatment. We agree with the committee that the tables of medical statistics need revision. As instances of existing defects may be men- tioned the tables dealing with the causation of insanity, with the causes of death, and the forms of mental disorder, in which the percentage occurrence of the causes and forms is not worked out, nor is a summary provided of the tables of the different asylums, for the curious reason that these tables are not uniform. It appears that a subcommittee is considering the best method of revising these tables and it is hoped that by next year new ones can be submitted. The weekly cost of maintenance was lls. 3 58rl. The general health of the asylums appears to have been very god. The Commissioners in Lunacy refer to overcrowding as existing in certain of them, notably in Hanwell, where the numbers in excess reach 215. Turning to items of special interest in the reports of the medical superintendents we find Dr. T. E. K. Stans- field of Bexley commenting, as in previous reports, on the hopeless character of the bulk of the admissions. He finds that hereditary taint and congenital defect become more marked year by year and considers that the free discharge from asylums of patients capable of procrea- tion is largely responsible for this. 53’9 9 per cent. of the admissions showed heredity of insanity and this is considered as an under-statement of the facts. Dr. Stansfield would have the question of the sterilisation of insanity" seriously entertained..33 per cent. of the male- and 6’6 per cent. of the female admissions gave evidence of syphilitic infection. As regards syphilis and general paralysis the statistics of six years are adduced to show that. the form ’r was present in 78’7 per cent. of the male and 70’ 23 of the female general paralytics. Dr. R. Jones, medical superintendent of Claybury Asylum, has made careful inquiry into the causative influence of alcohol (exciting and predisposing) and finds that this was operative in 33’ 7 per cent. of the males-a high proportion-and 18 3 per cent. of the females. The value of hydrotherapy is commented upon and Dr. Jones observes that the complete absence of means for applying this treatment at Claybury is remarked upon by foreign visitors. From the second annual report of Dr. C. H. Bond, the medical superintendent, it appears that the recently opened epileptic colony of the Council is fulfilling its primary purpose and, furthermore, there are already grounds for the belief that the sale of the produce of the colonists’ work will reduce the cost of maintenance. The daily average number resident was 301 and 94 cases were admitted, of which 25 were direct admissions, the remainder being transfers from other asylums. Out of 91 admissions 54 showed heredity of insanity or epilepsy or alcoholism. Dr. Bond refers to the totally inadequate provision which is made for the sane epileptic, epilepsy per se not being recognised as requiring State control or even State cognisance. The patients at the colony are well employed, chiefly in farm and garden work, shoe- making, tailoring, basket-making, and domestic work. The report of the director of the pathological laboratory and pathologist to the asylums (Dr. F. W. Mott) deals, amongst other matters, largely with the topics of tuber- culosis, dysentery, and diarrhaea in the asylums. Dr. Mott has formed the opinion from examination made at two of the latter that the great majority of those who die with active or obsolescent tubercle show the disease on admission. The number of cases of dysentery at the asylums remains practically the same as last year when a marked improvement on all preceding years was shown. The report contains some interesting observations upon heredity and insanity. Dr. Mott considers that no trustworthy statistics of the relation between heredity and insanity will be forth- coming until a series of family trees is collected showing the temperament and life-history of males and females for at least three generations. Data collected from asylums and also from the general population should be investigated by a statistical expert. Work has been carried on by Dr. Mott and Dr. G. A. Watson, the assistant pathologist, upon the visual cortex and the minute structure of the cortex cerebri in the lower animals. ROYAL COLLEGE OF SURGEONS OF ENGLAND. AN ordinary meeting of the Council was held on Dec. 14th, Mr. JOHN TWEEDY, the President, being in the chair. The SECRETARY reported the death, on Nov. 21st, of Mr. John Croft, past member of the Council and of the Court of Examiners. It was resolved :- That the Council do hereby record their deep regret at the death of their former colleague, Mr. John Croft, and their sincere sympathy with his widow in her bereavement. The Council do also record their- appreciation of the services rendered by Mr. Croft to the College in the conscientious discharge of the several duties which devolved upon’ him as a member of the Council and of the Court of Examiners. It was resolved to issue diplomas of Fellowship to the 23 candidates found qualified. It was resolved to issue Licences in Dental Surgery to the- 42 candidates found qualified. On the recommendation of the Board of Examiners in Dental Surgery it was resolved to recognise the dental,
Transcript of THE SIXTEENTH ANNUAL REPORT OF THE ASYLUMS COMMITTEE AS TO THE LONDON COUNTY ASYLUMS FOR THE YEAR...
1859
THE SIXTEENTH ANNUAL REPORT OFTHE ASYLUMS COMMITTEE AS TOTHE LONDON COUNTY ASYLUMS
FOR THE YEAR ENDINGMARCH 31ST, 1905.
THE total number of London pauper lunatics on Jan. 1st,1905, in asylums, licensed houses, workhouses, withrelatives or friends, and in the imbecile asylums of the
Metropolitan Asylums Board was 24,652, or an increase of704 in the year. Of these only 280 were in workhouses and152 with relatives or friends. 17,770 were in asylums andlicensed houses. The increase in patients certified for
asylum treatment was 640, as compared with an averageannual increase for the past 15 years of 512. The committee
points out, as in previous reports, that the failure of theMetropolitan Asylums Board to provide accommodation haslargely increased the proportion of the insane for whom theCounty Council has to build. Whereas in 1890 the Boardprovided for 34 per cent of the pauper lunatics in the
county of London, on Jan. lst, 1905, it only provided for26 per cent. Had the Council now to provide for 61 percent.,as in 1890, the number to be accommodated in 1905 wouldhave been 15,037, and on Jan. 1st, 1905, there was roomfor 17,060 in its asylums. The Board would, there-
fore, appear to be the party really responsible forthe inadequacy of accommodation for London’s pauperinsane, although the Council is called to account in thematter. This comes of the anomaly of two public bodiesproviding for the insane of one area.The ratio of pauper lunatics per 1000 of the population in
the various unions and parishes in the county of London variesfrom 2 ’ 2 to 8 8 ; the Strand district stands alone with a ratioof 14 1, which is curious, but no reference is made to this largeproportion. The existing nine aylums of the Council, includ-ing the epileptic colony, provided accommodation for 17,060on Jan. lst, 1905, whereas 18,168 patients had to be accom-modated. Efforts to overtake the increasing numbers are beingmade by way of additions to existing asylums and theerection of two additional ones. The newest or eleventhasylum is to be entirely on the villa principle, a new depar-ture so far as this country is concerned. Betters results are
expected from the more home-like surroundings and greaterfacilities for classification which this method provides, whilstit is not thought that the cost of erection and adminbtra-tion will be greater. In common with asylums in generalthe London asylums have to complain of the increasingtendency to certify cases of senile decay. The subject ofthe discharge of relapsing cases is referred to ; their recovery,although temporary, necessitates discharge, a result iorwhich the recertification clause of the Lunacy Act is largelyresponsible. In this way the propagation of insanity isfostered. At one of the asylums a married female has beenadmitted 14 times within 21 years. The committee has madean attempt to board out patients but this proved unsuccessfulowing to the cumbersome nature of the machinery providedby the lunacy law. It is rightly observed that this provisionis practically a dead letter in England and Wales. It is
thought possible that a number of patients might be boardedout if the Scottish procedure were adopted here.The total number of patients admitted during the year was
3813, as against 4502 in the previous year. The r. coverieswere 33’59 per cent. of the admissions. The deaths were6’76 per cent. of the total number under treatment. Weagree with the committee that the tables of medical statisticsneed revision. As instances of existing defects may be men-tioned the tables dealing with the causation of insanity, withthe causes of death, and the forms of mental disorder, inwhich the percentage occurrence of the causes and forms isnot worked out, nor is a summary provided of the tablesof the different asylums, for the curious reason that thesetables are not uniform. It appears that a subcommitteeis considering the best method of revising these tables andit is hoped that by next year new ones can be submitted.The weekly cost of maintenance was lls. 3 58rl. The generalhealth of the asylums appears to have been very god. TheCommissioners in Lunacy refer to overcrowding as existingin certain of them, notably in Hanwell, where the numbersin excess reach 215.Turning to items of special interest in the reports of
the medical superintendents we find Dr. T. E. K. Stans-field of Bexley commenting, as in previous reports, on thehopeless character of the bulk of the admissions. He findsthat hereditary taint and congenital defect become moremarked year by year and considers that the free
discharge from asylums of patients capable of procrea-tion is largely responsible for this. 53’9 9 per cent. ofthe admissions showed heredity of insanity and thisis considered as an under-statement of the facts. Dr.Stansfield would have the question of the sterilisation ofinsanity" seriously entertained..33 per cent. of the male-and 6’6 per cent. of the female admissions gave evidenceof syphilitic infection. As regards syphilis and generalparalysis the statistics of six years are adduced to show that.the form ’r was present in 78’7 per cent. of the male and70’ 23 of the female general paralytics. Dr. R. Jones,medical superintendent of Claybury Asylum, has made carefulinquiry into the causative influence of alcohol (exciting andpredisposing) and finds that this was operative in 33’ 7 percent. of the males-a high proportion-and 18 3 per cent. ofthe females. The value of hydrotherapy is commented uponand Dr. Jones observes that the complete absence of meansfor applying this treatment at Claybury is remarked
upon by foreign visitors.From the second annual report of Dr. C. H. Bond,
the medical superintendent, it appears that the recentlyopened epileptic colony of the Council is fulfilling its
primary purpose and, furthermore, there are alreadygrounds for the belief that the sale of the produce ofthe colonists’ work will reduce the cost of maintenance.The daily average number resident was 301 and 94 cases
were admitted, of which 25 were direct admissions, theremainder being transfers from other asylums. Out of 91admissions 54 showed heredity of insanity or epilepsy oralcoholism. Dr. Bond refers to the totally inadequateprovision which is made for the sane epileptic, epilepsyper se not being recognised as requiring State control oreven State cognisance. The patients at the colony arewell employed, chiefly in farm and garden work, shoe-making, tailoring, basket-making, and domestic work.The report of the director of the pathological laboratory
and pathologist to the asylums (Dr. F. W. Mott) deals,amongst other matters, largely with the topics of tuber-culosis, dysentery, and diarrhaea in the asylums. Dr.Mott has formed the opinion from examination made attwo of the latter that the great majority of those who diewith active or obsolescent tubercle show the disease onadmission. The number of cases of dysentery at the asylumsremains practically the same as last year when a marked
improvement on all preceding years was shown. The reportcontains some interesting observations upon heredity andinsanity. Dr. Mott considers that no trustworthy statisticsof the relation between heredity and insanity will be forth-coming until a series of family trees is collected showing thetemperament and life-history of males and females for atleast three generations. Data collected from asylums andalso from the general population should be investigated by a
statistical expert. Work has been carried on by Dr. Mottand Dr. G. A. Watson, the assistant pathologist, upon thevisual cortex and the minute structure of the cortex cerebriin the lower animals.
ROYAL COLLEGE OF SURGEONS OFENGLAND.
AN ordinary meeting of the Council was held on Dec. 14th,Mr. JOHN TWEEDY, the President, being in the chair.The SECRETARY reported the death, on Nov. 21st, of Mr.
John Croft, past member of the Council and of the Court ofExaminers. It was resolved :-
That the Council do hereby record their deep regret at the deathof their former colleague, Mr. John Croft, and their sincere sympathywith his widow in her bereavement. The Council do also record their-appreciation of the services rendered by Mr. Croft to the College inthe conscientious discharge of the several duties which devolved upon’him as a member of the Council and of the Court of Examiners.
It was resolved to issue diplomas of Fellowship to the23 candidates found qualified.
It was resolved to issue Licences in Dental Surgery to the-42 candidates found qualified.On the recommendation of the Board of Examiners in
Dental Surgery it was resolved to recognise the dental,
