CO885(2-3) — Page 197

PUBLIC RECORD OFFICE

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C.O.

Reference -

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a. Funds.

6. Structure and sanitary state.

c. Internal economy.

d. Constitution.

e. Supervision and reports.

6

NORTH AMERican Colonies.

14. The grosser defects which disgrace the West Indian hospitals and asylums do not exist at all so generally, or in the same degree, in those of the North American colonies.

·

It is remarkable that in the six colonies which have replied in this division there are twelve asylums, and only three public hospitals; New Brunswick, Nova Scotia, and Prince Edward Island being without hospitals. It can hardly be doubted that some public provision for the indigent sick is necessary in each of these cases.

The number of asylums is explained by the great and increasing amount of insanity, which, in Newfoundland, is sometimes said to be caused chiefly by the dangers and vicissitudes in summer, and the poverty and monotonous life in winter, of the fishing population, together with their habits of intermarriage with relations, and their want of education, but is generally regarded as inexplicable. It is calculated that there are at present, in the Lower Province of Canada alone, 130 insane persons who cannot be accommodated in the asylums, and that in Nova Scotia 223 out of a total of 340 are still unprovided for.*

15. The revenues are, in most cases, chiefly derived from fixed grants from the provincial treasury; but in Nova Scotia cach county is chargeable with the expense of maintaining its insane poor; and the medical superin- tendent, in a published report, strongly objects to a proposed plan of charging the province, as tending to relieve the nearer counties unfairly and at the expense of the rest.

16. There are in all these institutions great structural deficiencies. In no instance is sufficient space generally allowed. The bascinent cells in the

Prince Edward Island asylum give no more than 323 cubic feet to each patient, and this in a climate where the cold in winter may be supposed to be as preventive of ordinary ventilation as heat is within the tropics." "The St. John's asylum, in Canada, is so bad that the questions are said to be "inapplicable."

The Newfoundland hospital and Prince Edward Island asylum are without any but surface sewerage or drainage, discharged into cesspools.

17. Under the head of internal economy the only general defects which appear are the frequent insufficiency of attendance, and the want of amuse- ment and employment for the insane. The general cry is for more land, which provides the best kind of occupation, and is profitable when it can be obtained on fair terms. A situation where enough land cannot be had is not fit for an asylum.

Contagious and infectious cases are admitted into the Newfoundland hospital, and no mention is made of any inconvenience resulting from this practice.

18. The boards in which the government is in several cases vested are differently constituted from those of the West Indian colonies, and have less general powers, greater authority being entrusted to the medical superin- tendents. The Prince Edward Island asylum is governed on the West Indian model, and is the worst, after St. Jolm's, of the whole number of North American asylums.

All the Canadian institutions are under the general control of a central board of Inspectors of Asylums, Prisons, &c., to whom belongs the credit of the great improvements which have been made in those establishments.

19. The system of visitation and reports now in use in Canada cannot be improved, unless by the addition, in the case of asylums, of daily reports, by head wardsmen or keepers, in the form suggested by the Commissioners in Lunacy, and appended in note 5, p. 39.

Bat some better arrangements in these respects are very necessary in New Brunswick and Prince Edward Island, in neither of which are there any records of the employment of restraint, and in the first of which no visitation is ever made, except once by each Governor during his whole term of office.

It may be remarked that insanity seems in these colonies to be generally connected with consumption. Two-thirds of the deaths at the Beauport asylum, in Lower Canada, 60 out of 145 at Toronto, 13 in 25 at hfalden, and 18 in 105 in New Brunswick, were caused or hastened by puthionary disease. No such close relation is discoverable in other divisions.

20. The Bermudas asylum, perhaps the worst of all the cruelly ill-managed prisons for lunatics in the colonies, is a striking instance of the results which follow from the want of any recognized system of management and inspection, and from the policy which vests alt authority in persons too far removed from the immediate working of the establishment to be responsible or curious about the result. Otherwise it calls for no general remarks apart from the statement of its particular defects, for which see Part IV, s. 87.

21-COMPARATIVE TABLE of Hospitals and Asylums in the North American Division.

Name of the Institution.

CANADA. Quarantine Hospital

Mar Hospital

Toronto Asylum Orillia - Branch) Asylum

HI

University (Branch) Asylum Malden Asylum...

Rockwood (Criminal) Asylum, Bewport (Propcicky) Asylum

M John's Asylum

1H

In Associated.

baiwan Beds.

Size of Blue

Cabic Feet of

Space par Head,

BuperSid

wid

Aria, kad

Quantity

In Singid Boom

a

Interval

Aveng Number under Treatment

*

one Time.

Lauki.

ACT.

500

ૐ ! @ 8 { â

$

110

+

བ

&

-

Number of Medical Officers, and whether Resident and Bestricted in

Practice

Number of

Average

1

S

ar Keepers.

Treatment.

1) ft. interval 567 malemizaious

1 resident and 11 to 25 patimado

1 resident and

not resident

660-780

-

24 ft. interval 150 in summer

7

70 in winter

TİLLİON

300

1 resident (3)

1 to 15 patient

191

1 read! (7)

13

07

780 (general- rage,

800 (gebra re-i

zag)

|660 (general ure-

730

rege

Xaw BausaWICE. Asylum.

KEWFOUNDLAND.

Hospital...

6791

18 $40

80%

NOVA SCOTIA.

Asylum ...

65

610

1,160

Fuso Koward Island. Arhom...

10

183

++

thi

BZAMUDAS.

Aph...

|which 14|

be cul. trated

3

118

1 | 12 |

4-6 ft. Interval |

310-901 +

1

$91 gross cases

1 resident

#3

*

90

1 resident

1 to 11 patienta

1 resident and sa-

vert visiting

88

1 not resideni noe-

+

restricted

174

1 resident

95

$ not Ensident

3 resident

198

SILL

2) dayn

30 days

511 days

Incumbles

9 year

4 years

6 months

$5 Jays

268 days

190 (1)

1 resident

14

110 laye

I not resident

B

214 days

18

1 not resident noc

+

*stricted

year 19 days

MEDITERRANEAN AND AFRICAN COLONIES.

22. Whilst in the North American colonies, insanity almost engrosses public attention and care, the six African dependencies from which answers have been received, maintain only three asylums, and those ill-constructed and ill-managed. On the other hand, the eight public hospitals, though not without great defects, are for the most part managed with care and are generally more under the direct influence of the Governors than is usually the case in the other divisions.

The very small asylum at St. Helena is parochial, and to this its badness is to be attributed. The parochial authorities ought not to be suffered to retain the exclusive control of an institution which they can hardly have either the knowledge or the means to conduct properly.

The Cape asylum in Robben Island suffers both from want of connection with any central medical authorities who might exercise supervision and suggest improvements, and from an anomalous subordination to the Somerset hospital. The lunatics are admitted to the hospital and then handed over to the asylum, an arrangement which results in the frequent loss or detention of the certificates and other preliminary documents relating to the proofs, causes, and previous nature of the disease.

BERMUDAS.

23. The funds for the maintenance of the pauper patients are generally . Funds. derived from the colonial treasuries. It does not appear that there are fixed grants. The Albany and Port Elizabeth hospitals at the Cape are chiefly, if not entirely, supported by private endowments and private subscription. In St. Helena the parochial authorities are chargeable. They contract with a private person for the care of the insane. Amongst the many bad results to be expected from this arrangement, the following may be selected as the worst i. The management of the insane is withdrawn from publicity and

The Governor and Council appear to form the board of control,

885

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