PUBLIC RECORD OFFICE
Reference -
C.O.885
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3PUBLIC RECORD OFFICE, LONDON
d. Constitution.
e. Supervision and reports.
10
but one instance. This exception is Castlemaine, which, giving only an average of 533 cubic feet to each of 90 patients, provides no more than four nurses for them: two defects which seem to connect themselves with the fac that the average stay of the patients is here about 60 days, which is double the average of the other Australian hospitals.
The Fremantle asylum is almost destitute of land, or any other means for the employment of the insane; and the management of that at Yarra Bend must be impeded by the wide dispersion of the buildings. The state of this asylum is said to have improved much since Mr. Paley's arrival.
36. The four hospitals of Victoria are governed by boards, but very different ones from those which are responsible for the abuses permitted to exist in the West Indian institutions. Here the boards are not committees unconnected, except by their office, with the establishments of which they engross all the control, and uniting in themselves both the interest and the power to repress expenditure, but representatives elected by the subscribers, and responsible to them, placed in their position only by their own liberality, and likely to econo ise only to the extent of making the money which they have already contributed extend to do the greatest amount of good. In addition, these hospitals are immediately managed by resident medical officers, and are further protected by the public interest which they excite.
The Fremantle Convict hospital has been governed by the Comptroller- General; the asylum at the same place, and that at Yarra Bend, with the Perth hospital. are managed by paramount medical chiefs.
It is to be observed, in reference to the unsatisfactory condition of the Castlemaine hospital, that the Managing Committee complain that the action taken by the Government with reference to private contributions has helped to prevent them from adding a new female ward and making other necessary improvements; but there is no explanation of what is the action referred to.
37. The provisions for visitation and reports are generally insufficient. The Yarra Bend asylum is inspected by a visiting board of five members (of whom two are medical) appointed by the Governor in council; but the Melbourne, Geelong, and Ballarat hospitals seem never to be visited by superior civil authorities; and the rest require a more systematic supervision than that to which they are at present subject.
38. The Governor of Victoria expresses his regret that a design of building three new lunatic asylums in different parts of that colony has been postponed.
39.—COMPARATIVE TABLE of Hospitals ami Asylumus in the Australian and Eastern Division.
per Fond.
* Anted,
Sure of | Calve Fret of Space
te
sopterdeal
Name
of the fronta
Ingle flooms.
Sura, had Interval
between Bedd
Average Numbers nude:) Treatment at une Time.
ju
Flow K
Gearn! Hospital...
Lock Hospital
Land
rei
TADWANIA
Elospati
kaykuma
41
VIII.
Mzibourne klong «^4!
0
AGO
***
| al aerem (*) | 1,200-1,50-
300-1.5461
Number of
Number of
Avernes
媒
Duration
on Keepers.
Trantrest.
Machical Odlerro,
and wheth Reedeat and Restricted in Prandico
I resident and ta
Na
Sit, JALATAL
17
Istricted xml 1 not re-
Jaden norrentinelodi
Į 1 not rendent nor
restricted
3
99 days
1:6
† 1 madoal and re-
1+
30 day
srvcted und not
TAKİTA
2014
1 rast, pot TE-
440 days
d
2
éretlent and re- |12 day, 5 might
-inacted and 14
kamorkry
| 2 resdent and re- -1 to 11 patiqnis) 37 days
stricted
774-1,163
Leaking. Loupel
Castlemaniga. Berpisat
0500
ft. oleval
1.55
bonorary
TWT
533 (general an orage-
1 interval
J
¡E resistant and re
↓
no days
stricted and
Oscary
Bulberna Hoopti
1,300
4ft interval
TH
| E TEHłowi mil re
15 days
el
honorary
9 m.
Tarrs Band Aeptem
66) serve | 2016 (posaoul average)
A KATAN AI TERSUJA
Ferth Humpstal
Permania Besgottal ((2006-)
Maka!
Aaybe
24 meres
I
ادات
201
strated
5 rondont and 20-
stricted
ب
344 matmansanaĮ 1 noć rezidens nor
restricted
34-1.4 19.fucferent) 3:05 gerana comes) 1 resident, bet ev. 11 to 10 patients
-
(
stricted
|1 aut resident, ume
1
91 day
11
PART II-SUMMARY OF THE CLASSES OF DEFECTS MOST GENERALLY PREVAILING.
40. The apparent condition of the colonial hospitals and asylums may be summed up in a few words. There are few, if any of them, in which positive cruelties, deliberately committed, can be asserted actually to find place, but there is hardly a single institution in which, in a greater or less degree, primary sanitary requirements are not neglected; and few in which there is any sufficient security, in the nature of inspections and reports, against the The present or the possible existence of even the grossest secret abuses. worst cases are the small institutions of the West Indian colonies, Bermuda, and Gibraltar; but even the largest establishments in the richest colonies, with a few exceptions, show something of a make-shift character, and of utility narrowed by mistaken economy. The asylums, except in Canada, which has only two general hospitals, are almost universally worse than the hospitals, and sometimes suggest the impression that they are, perhaps unconsciously, regarded too much as means of relief from a troublesome class, without care for curative treatment. They are apt to be considered, on the one hand, as less imperatively requiring specific skill in their management; and, on the other, as dangerous subjects for the interference of lay reformers. Nor does insanity appeal so strongly to common sympathy as those diseases to which men ordinarily feel themselves liable. It cannot be a matter of wonder that the evils which till lately disgraced the asylums of this country should occasionally repeat themselves in the colonies.
41. Following the order of the five heads above distinguished, it is to be a. Funds. observed, first, that the endowments being almost always supplied or supple- mented by the colonial treasuries, the enforcement or neglect of reforms rests in the power of the Legislatures.
Not It is not
42. With regard, next, to sanitary arrangements, it appears that the . Structure and sites are, in many cases, bad; but bad sites often mean convenient situations, sanitary state. and the site is often of comparatively small consequence if the buildings are good and well-arranged. Of this the Port of Spain hospital, in Trinidad, is an instance, which, though occupying the site of the once deadly Orange Grove. Barracks, is not only the best managed, but the most healthy of all the West Indian hospitals. But no such corrective is generally applied to the natural evils of the sites. In general the buildings are ill-arranged and ill- cleansed. Open sewerage and cesspools adjoining the houses, bad enough in this country, are fatal in tropical climates, or when aggravated, as at Gibraltar and Bermuda, by the absence of any provisions for determining the course or position of filth, which, being left to make away with itself, breeds pestilence, and renders the hospitals centres of disease.* second to this is the crowding and smallness of the wards. merely that, without a certain capacity in the ward, proper ventilation is impossible, but the space allowed to the patients is so small that it would still In eight instances be destructive, even if ventilation could be supplied. there are associated wards in which the sick poison themselves and one another in an average of less than 400 feet of cubic space per head; and there are two where, what is worse, the space of single cells falls below the same amount and of the ten institutions thus deficient five are in hot climates. Equally deficient, in many cases, is the area or superficial space allotted to each bed. On this, quite as much as on cubical space or artificial ventilation, and more than on the height of the rooms, depends the purity of the air, and it is this easily cured defect which is the only excuse for the non-admission of contagious and infectious diseases which are, in general, dangerous only when beds are crowded too closely together. If any of these sanitary defects were to exist, even for a short time, in a London hospital, they would speedily make themselves felt in the prevalence of hospital gangrene, and in the general In the Lariboisière hospital aggravation of many classes of disorders.
in Paris, a wind blowing for a few hours from the direction of a malarious quarter of the town was enough to give a malignant character to healthy sores. Yet in such influences the diseased in many colonial hospitals and asylums, pass their weeks or years.
* The custom of the country is often pleaded by way of apology for such defects; and certainly this plex is of weight as an excuse for those whose duties do not require them to inform themselves, though not for others.
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