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 ()dMMISS10I 
 
 ON 
 
 LUNATIC ASYLUM 
 
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 OF THE 
 
 PROVINCE OF QUEBEOn^ 
 
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1 ' 
 
 if 
 
 COMMISSION 
 
 ON 
 
 LUNATIC ASYLUMS 
 
 OP THE PROVINCE OF QUEBEC 
 
 OF 
 
 Messes. DUEOCHER AND BOUEGOUIN. 
 
 To THE HONOBABLE A. E. ANGERS. 
 
 % Lieutenant-Governor of the 
 
 Province of Quebec, 
 
 May it please Your Honour. 
 
 "While admitting that the report of the Commission on Lunatic 
 Asylums, signed by the majority of the commissioners and submitted to 
 you, contains opinions generally which are in accordance with ours on 
 many subjects, and contains also a number of valuable documents and 
 interesting information, we, the undersigned, members of the Koyal 
 Commission, appointed and constituted on the 17th September 1887, under 
 an act passed in the 32nd year of Her Majesty's Reign, and intituled : 
 "An act respecting inquiries in public matters," to inquire into the difficul- 
 ties which had arisen in connection with lunatic astjlums and the putting into 
 Jorce of the statute respecting such asylums, on the real causes of such difficulties 
 and the means to be taken to put an end to them, ha'"'e the honour to submit 
 the following special report in consequence of our dissenting from tho 
 majority, on certain important points. 
 
 After having been sworn, the Commissioners spent the first days in 
 examining the reports of the visiting physicians, covering the past 12 years, 
 those of ^he inspectors of prisons and asylums, the correspondence between 
 
the proprietors of the asylums nnd the Government, and, finally, the 
 reports of the medical boards appointed under the Asylums act of 1885. 
 
 The oxaminatiou of these numerous documents necessitated consi- 
 derable study and occupied several sittings of the Commission. 
 
 Provided with the information so obtained, we visited the nsylumS' 
 of the Province, commencing by lieauport, thmSt-.Teaude Dieu, St«Ferdi- 
 uand d'Halil'ax, Belmont and finishing with St«Beuoit Joseph Asylum, at 
 LoDgue-Pointe. 
 
 In order to facilitate the holding of so comprehensive an investigation, 
 the Commission deemed it expedient and advisable to have a notice 
 published in the knuling newspapers of Quebec and Montreal, asking the 
 public to make any complaints audsuggestionsto the Commission which 
 they might deem proper. 
 
 Several persons whose names we did not learn, sent ns several ano- 
 nymous complaints, containing serious charges of immorality against the 
 proprietors of Beauport asylum and against the principal ollicers of that 
 institution. 
 
 As the Commission was anxicus to ascertain the truth of these 
 charges, they took every possible means to discover it and gave every 
 opportunity of bringing forward evidence to throw light upon the- 
 charges. The persons themselves who were mentioned in these anony- 
 mous communications, were summoned to appear as witnesses before the 
 Commission. " The proprietors, officers, keepers and all those specified in 
 the notices from outsiders, the Government physicians and officers, the 
 Catholic and Protestant Chaplains, w^ere all called upon to give their 
 evidence freely and express their opinion respecting the asylums, th^ 
 manner in which they were kept, the conduct of the officers, keepers, 
 proprietors, house physicians and finally respecting any matter which 
 might guide the Commission in their investigations and be of interest 
 to the public, as to the manner in which the insane and idiots are treated 
 in the various asylums of the Province. 
 
 During the interval betvA^een visits to the asylums and the exami- 
 nation of witnesses, the Commission continued to examine and study the 
 documents. 
 
 Finally, on the 28th February last, Doctors Duchesneau, Duro her and. 
 Lavoie, and Mr. N. H. Bourgoin, accompanied by a stenographer, Mr» 
 Boisvert, went to visit several asylums in the United States, namely : 
 
 ■J} 
 
the iJlizabeth Asylum, at Washinj^ton ; the Mount Hope Asyluco, at Bal- 
 timore ; two at Philadelphia ; three at New-York aud those of I'rovi* 
 deuce, Worcester, Uuca aud IJuiFalo. The Commisioners returned bytha- 
 Province of Ontario aud, on their way, visited the asylums of Loudon^ 
 Toronto dud Kingbtou. 
 
 During these visits, wo obtained valuable information ns to thd 
 keeping' and management of these asylums and brought back a quantity 
 of books and reports which have been of groat use to us, have placed na 
 in a position to appreciate the value of our asylums and have served to 
 show us the improvements which might be made in them. 
 
 It is an agroable duty for us to express our thanks to all the officers 
 of these various asylums, without exception, for the kind and polite- 
 manner with which they always received us and the willingness with, 
 which they gave the iul'ormatiou and reports we at^ked of them, Thisi 
 cordial reception was extended to us everywhere, iu the United States asjv 
 in the sister Province. 
 
 We will now, at once, enter fully into the question to be studied^ 
 following the programme traced out for us. 
 
 I. What are the causes op the difficulties which have atmsen' 
 
 BETWEEN THE OOVERNMBNT AND THE PROPRIETORS OF THfi 
 ASYLUMS. 
 
 Answer. The chief cause of the present difficulties ii. the act of ISS* 
 (48 Vict., chap, 34). 
 
 As soon as the bill was laid before the Legislature, the proprietors ; 
 of the asylums at once protested, declaring to the goverumeut of the day 
 that their contracts would be infringed upon ; that new obligitious were 
 sought to be imposed on them, etc. They have since continued to pro- 
 test and have adhered to their contracts. 
 
 We will state further on, iu the following replies, whether thes^- 
 protests were founded or not. 
 
 Various circumstances brought about the passing of that act. If.' 
 will suffice to mention a few of the more important ones. We will not; 
 go back further than 1883, as, that year, the Government renewed the 
 Beauport contract for 10 years and consequently acknowledged that there- 
 were no difficulties such as we are instructed to inquire into. 
 
I 
 
 Accusations which more rcBomblcd insinuations than precise or 
 definite chirgfs havo, lor some years, heen circulated amongst the public 
 flgainst the asylum.s. For instance, it has been said that the proprietors of 
 tlio asyhiras sought to make money, to spe<'ulate on the unfortunate, by 
 keeping in their establishments persons who wore cured or by admitting 
 Dane people. Tiie charge so brought was exceedingly malicious 
 towards the proprietors of the asylums. 
 
 We may add that it was unfounded, for the proprietors had no 
 right to dis(harg(X patients. The Government had an olfiecr, entirely 
 independent ol the proprietors, who alouc could admit or discharge the 
 patients. 
 
 That officer had all thft responsability of admissions and discharges, 
 and it was uniair for certain newspapers to seek by insinuations to place 
 that responsibility on other shoulders. If there had been any abuse in 
 this respect, the public should have blamed the Governm(*ut officials and 
 no one else. Has there really been any abuse '{ We have been, unable to 
 find any. The Rose Lynam matter made a great noise and after a law'suit 
 to which the papers gave great importance and publicity, that person 
 was handed over by the court to the care of a specially selected guar- 
 dian. But the report of the expert appointed by the court, Dr Vallee. did 
 not declare her to be sane. Ho merely expret-sed the opinion 
 that she <'ould be cared for outside of an asylum and the judgment was 
 based on that report. It is a publicly known fact that after having libe- 
 rated, Rose Lynam escaped from the control of her guarditai and com- 
 mitted acts of excentricity which in the end again rendered judicial 
 intervention necessary. 
 
 Consequently, it is hard to say whether there was any abuse in that 
 case. The opinions of the doctors who examined Rose Lynam, were 
 greatly divided. The physician of the proprietors of St Jean do Dieu 
 was of opinion that she was not insane, the Government physician, Dr 
 Howard, was of a contrary opinion. 
 
 This diversity of opinion continued before the court amongst the 
 other iihysicians who were examined. 
 
 tn any case, every one will admit that the Lynara matter could 
 not serve as a foundation for the charges against the St Jean de Bieu 
 asylum, as was afterwards attempted. 
 
 Some time afterwards, in 181^4, an English specialist, Dr Tuke, visited 
 the asylums of this Province and made a report which created a eensa- 
 
I 
 
 tion. The English newspapers of Quebec and Montreal, especially, 
 seemed to endorse all that thiu phyaiciau had said aud took pleasure in 
 repeating his iusiuuatious. 
 
 Dr Tuke came from a country whore the systom of farming out does 
 not exist, and from tho only «;ouutry iu the world where the non-res- 
 traint system is generally adopted. Considering that the latest improve- 
 ment ot contemporary science on the treatment of the insane, lies ia 
 the Kuglish system, he could not find to his tuiste asylums on a different 
 system. 
 
 l)r Tuke's report is well-known ; it was the subject of a remarkable 
 criticism from the pen of Dr J. C Tache, of Ottawa, 
 
 Until Dr Tuke's visit, the physicians charged by the government 
 with the supervision of the asylums do not appear to have asked fur any 
 change or made any complaint ; but then, as il'hrf were afraid of beiujj 
 held responsible, Dr Howard commenced to make suggestions in connec- 
 tion with St Jean de Dieu, and to ask for more powers as regards res- 
 traint and in other respects. It was this same Dr Howard, however, 
 who had instituted, applied and approved restraint. At the same time 
 the English papers in Montreal published articles against the farming out 
 system. It is strange that St-Jean de Dieu should have been the object of 
 all these insinuations aud accusations And yet it must be admitted that 
 this is the best kept of all our asylums. How is it, that IJeauport, which 
 was at that time, the largest establishment, should have been overlooked 
 and that nearly all the remarks should have been made about St-Jeau. 
 de Dieu. 
 
 For many years, the. Protostants of Montreal or a certain nnrnborof 
 them, have been desirous of having an asylum for tlie insane of th>'ir 
 religion, and they are right. Until lately their ellbrts have been un.suo- 
 cessiul notwithstanding the repeated appeal o£ the newspap.Ts of their 
 belief. 
 
 Did any one]|consider that it was necessary to cry out against St- 
 Jean de Dieu, iu order to get more subscriptions ? Wo regret to state 
 that these appeals to Protestant capitalists were sometimes accompanied 
 by unlbuuded accusations, as, for instance, when it was said that the 
 Protestant insane were not properly treated, aud l)y criticisms fouudedon 
 theories alone, such as absolute coudemuatiou of the fanning out system 
 and even by insinuations, like those above mentioued, that the proprie- 
 tors of asylums had a right to detain patients who wore cured, which 
 was not the case. 
 
Th« estahlishmeut of an ftsylum for th© Prot»»«tant insane is a desir- 
 Able objt'ct, which may be eHected by praiseworthy means and by truth- 
 ful !i)>in'al8. "We are happy to see that the idea is about to be realized. 
 M will prevent many recriminations and remove many difftculties, "We 
 will only refer casually to some other charges, such as the following: 
 that the Sisters of St-Jean d«» Dieu detained patients eveu after they 
 "Were discharijed ; that they had their board paid to them; that they 
 j'detained children of female patients born after the admission of inch 
 patients and charged their board to the Government ; that they gave 
 ispoiled pork to patients, etc., etc., because there never was the slightest 
 louiidatiou for these charges. 
 
 Dr Ferreault has stated, in his evidence, that sometimes his pre- 
 .scriptions could not be carried out. Although we asked him to do so, he 
 f'ould not give the circumstances, time, name of the persons, etc,, in cen- 
 ivectiou with these statements. 
 
 "We questioned the Sisters ; we examined the prescription book ; wo 
 iSpeciiiUy questioned the sister in charge of the dispensary and after this 
 iuvestigatiun we cannot say that Dr Ferreault's statement is proved. 
 
 The public agitation which we have mentioned probably led the 
 Crovernment of 1885 to get the Act, 48 Vict., chap. 84, passed, which is 
 the <hief cause of the difficulty which still exists between the Govem- 
 inont and the proprietors of the asylums. 
 
 2. Does the act op 1885 exceed the biohts which the Governj 
 ment acquired in the asylums, bycontbact? 
 
 Answer — ^Yes. 
 
 The Commission obtained, on this point, the opinion of two eminent 
 .advocates of t^uebec, Messrs .Tacques Malouiu and C. B. Langlois. The 
 proprietors of the asylums had themselves consulted several eminent 
 legal authorities. 
 
 It is evident that the act of 1885 has exceeded the rights which 
 4he Government had acquired under the contracts. 
 
 It is evident that, in an agreement, a party cannot be called upon to 
 perform more than he has agreed to or to accept changes which he has 
 not contemplated and which have not been provided for. 
 
 The pioprittors of asylums objected to the act of 1885 chiefly on two 
 
a desir- 
 y trwth- 
 r»»alized. 
 t's. "We 
 lowing: 
 ;er they 
 hat they 
 
 of auch 
 ey gave 
 slightest 
 
 his pre- 
 do so, he 
 , in con- 
 
 5ok ; we 
 ifter this 
 ved. 
 
 led the 
 
 which is 
 
 GoTern- 
 
 GovernJ 
 
 eminent 
 
 is. The 
 
 emiueut 
 
 its which 
 
 id upon to 
 h he has 
 
 ly on two 
 
 important points. They say that tho law takes away the treatment from 
 them ; that the troatmont in au iiiHano asylum compriaes everything or 
 nearly everything relating to the administration. There cannot be a 
 separate control over the treatment and another over the administration, 
 which would mean having two heads lor one body, These two things 
 cannot be done independently one from the other. The selection of phy- 
 sicians which the law leaves to the Government, is another source of 
 complaint, for under the contract, this selection rests with the proprie- 
 tors. The legal opinions are iu favour of the latter and say that the act 
 is wrong. 
 
 The act 48 Vict., chap. 84, by section 65, gives a recourse to the 
 asylum proprietors, in the event of the carrying out of the law giving 
 them occasion to make a claim. This clause could not redeem the act iu 
 the eyes of the proprietors because, although the article does apply in the 
 case of changes in the buildings where a special account may be kept, it 
 is quite impossible to apply it to the thousands o^ details of the treat- 
 ment, viz : the food, clothing, exercise, labour, re<<^ime, etc., etc. In 
 order to avoid extravagant expense, all this has to be managed on a well 
 'Organized system with all the economy consistent with the required 
 efficiency. But no system can work well if a stranger has the power 
 from time to time and of his own accord, to suspend or hinder its 
 working. 
 
 The Government is not without guarantees. It may and should 
 
 ■^exercise all the necessary supervision to ensure the proper observance of 
 
 the contract, to see that the patients are properly treated and cared for in 
 
 every respect. It may, if necessary, perfect and increase this surper- 
 
 vision to make it as detailed as possible. 
 
 This right, if properly exercised, should be quite sufficient. 
 
 ■3. WHAT IS THE OPINION OF THE BELTGIOUS AUTHORITIES BESFEOTINa 
 
 Tilld LAW ? 
 
 Ansiver. This opinion was publicly expressed at the electoral dis- 
 cussion of the law in the Autumn of 1886. It does not appear to have 
 altered since. We will pay no more on this point, merely referring to 
 the letter* of the bishops who were good enough to reply to our 
 •questions. Their opinion may be resumed as follows : " This law should, 
 not he applied." 
 
.8 
 
 4. HAS THIS LAW BEEN PUT IN OPERATION ? 
 
 Ansvjer. No. The first six sections which contained the important"- 
 changes to the previous laws have not been applied. They conld not 
 be because they are the sections which the legal advisers condemn as- 
 violating the contracts. The medical boards of Saint-Jean-de-Dieu and 
 Beauport have been uselessly organized, in this sense that the six 
 physicians who compose them, have merely performed the duties of 
 the two former visiting physicians. Like the latter, they have only had 
 to see that the contracts are observed and to sanction the admissions and. 
 discharges. The asylum proprietors have adhered to their contracts in 
 accordance with their protests before and after the act. Tlie Proviiice ha$ 
 therefore since 1885 had to pat/, unnecessarily or almost unnecessarily^ six ol/iciab 
 instead of tivo. 
 
 We think that one competent physician in each asylum is sufficient 
 to see that the stipulations are complied with and to sanction the 
 admissions and discharges. This officer might have an assistant if.' 
 necessary. 
 
 6. HOW ARE THESE ASYLUMS KEPT? 
 
 A. Are they on ':» efficient footing ? B. Are they kept in as satisfactory manner 
 as can be expected in view of the price paid to the proprietors for each 
 patient ? 
 
 Answer. "We have three lunatic asylums under contract, viz : Beau- 
 port, Saint-Ferdinand-d'Halifax and Saiut-Jean-de-Dieu. 
 
 The following is the result of our observations : 
 
 BEAUPORT 
 
 The members of the Commission visited the Beauport asylum im 
 October last (188t). 
 
 This asylum consists of two main buildings ; the principal one- 
 contains the lodgings and offices of the managing officials and the female 
 patients ; the other is for the male patients. 
 
 These buildings, which have been built and enlarged at various 
 periods, according to the requirements or number of patients, are far 
 from having all the accommodations and conveniences of modern asylums 
 built on a plan adapted to the object for which they are intended. The 
 iirst thing that strikes one is the over-crowding and the too limited^, 
 space for the number of patients the asylum contains. 
 
 W 
 
9 
 
 The number of keepers seemed to us to be insufficient and they are 
 not paid a reasonable remuneration. Moreover, it appears from the 
 evidence adduced, that these keepers are not constantly at their posts, 
 being called upon by the proprietors to do work foreign to their duties 
 as keepers. The result of this is that the supervision is insufficient both 
 by day and by night, and many accidents happen. This defective 
 supervision is also the cause of several things occurring which are con- 
 trary to morality, 
 
 Ventilation is imperfect and there is always a bad emell in many 
 of the wards. The closets and baths are in bad order ; in a word, the 
 state of cleanliness is not what it should be, especially in the men's 
 department. Some wards are defective and the cells should be im- 
 proved. 
 
 The food is insufficient and not varied enough ; it is also defective 
 in qualify. The meals are eaten too hurriedly and here again the super- 
 vision is insufficient. The result is that some patients have not suffi- 
 cient time to take their meals. It would be therefore desirable, in their 
 interest, to have more dining-rooms. These are not suitable, especially 
 the men's, which is iu the basement, badly lighted and not at all 
 finished. 
 
 Beau- 
 
 "u 
 
 The clothing is insufficient, especially in "Winter, and it is not 
 cleanly enough. Restraint is sometimes abused of. It should be 
 exclusively controlled by the physician. 
 
 The chapel is too small and is inadequate for the establishment. 
 This is also the opinion of the chaplain himself The medical service 
 is inadequate and almost ttil, because one physician has not time enough 
 to do all the work which falls on him and which would keep three 
 physicians occupied. The present incumbent, notwithstanding his will- 
 ingness, cannot do all the work. 
 
 We are also of opinion that there is no unity of action in the 
 exercise of authority iu this asylum. While admitting that the pro- 
 prietors have made some improvements necessary for the comfort and 
 safety of the patients, we think that this asylum might be better kept, 
 considering the price it receives from the Government for each patient. 
 Moreover, all these desirable improvements should have been asked for 
 by the 
 contracts. 
 
 rious Governments which had the right to do so under the 
 
 We mentioned above that some things had occurred which were 
 

 10 
 
 contrary to morality. After a minute investigation we must say, iu 
 justice to the warden, the proprietors and the principal officers of the 
 asylum, that they cannot be personally blamed in this respect. 
 
 SAINT FERDINAND-D'HALIFAX 
 
 After Beauport, we visited the asylum of Saint- Ferdinand-d'HalifaX, 
 in the county of Megantic, about twenty miles from any railway com- 
 xnunicatiou. 
 
 This asylum is intended only for female idiots and at the time of 
 our visit, thore were 84. Some of them should not be there because, 
 properly speaking, they cannot be said to be really idiots. This asylum 
 can contain from 50 to 60 patients, It is over-crowded and has no 
 system of ventilation. The cells are narrow, badly lighted and are only 
 four and a half feet by seven. 
 
 We are surprised that the Montreal Medical Board should have 
 made such high-ilown reports about this asylum, which is the least 
 suitable in the Province. "We noticed nothing reprehensible la the 
 manner iu which the patients are kept. 
 
 BELMONT. 
 
 "We also visited the Belmont asylum, situated a few miles from 
 Quebec. 
 
 It is a private asylum intended especially for ini-brintos. It occupies 
 a splendid site, but the building is old. Jlowevfr, with some improve- 
 ments it might be made to contain a i!;v^'-,\t many patients, about a 
 hundred. There are also some insane patients iu it. 
 
 saintbenoit-josi:ph. 
 
 After Belmont, we visited the Saint-Benoit-.Toscph asylum, k'^pt by 
 the Freres de In Cluirite at Lougue Poiure and situated a short distance 
 from the Saiut-Jean-de-Dieu asylum. Only private patients are admitted. 
 
 The buildings are new and jp^endid, The manner in which the 
 asylum is kept and the discipline leave nothing to be desired. 
 
 It can accommodate about 150 patients. 
 
 ■W3 
 
11 
 
 t say, in 
 3 of the 
 
 SAINT-.IEAN-DE-DIEU. 
 
 'Halifax, 
 ay corn- 
 
 time of 
 because, 
 
 asylum 
 L has no 
 are only 
 
 lid have 
 
 he least 
 
 ia the 
 
 les from 
 
 occupies 
 mprove" 
 about a 
 
 ic'^pt by 
 distance 
 Imitted. 
 
 tch the 
 
 "We made a minute inspection of this asylum and spared no pains 
 to ascertain how it is kept in every respect. 
 
 It is the best kept of all oiir asylums, although it has been the 
 object of more accusations than any other. 
 
 It is well situated and surrounded by extensive farms. Althouo-h 
 built of brick, it has an imj^osing appearance. 
 
 An avenue bordered by several rows of trees, leads up to the build- 
 ings which are nearly half a mile from the main road. 
 
 The asylum of Saint-Jean-de-Dieu is unexcelled as regards order 
 and cleanliness. 
 
 "We will say, furthur on, what remains to be done in other respects 
 to make it equal to the best asylums in the United States. 
 
 This asylum commenced as a refuge for idiots in 18tS, Two years 
 afterwards, the Government obtained the right to send insane there for 
 the same price as that paid for the idiots viz : $100,00 per head per 
 annum. 
 
 We found this asylum over-crowded like Beauport. 
 
 However, considering the amount paid it is oar duty to state that 
 the Government cannot exact more than it receives. We may even say 
 that, in many respects, the Sisters do more than they are obliged to do. 
 
 Wo noticed that great care is poid to ventilation which is generally 
 good throughout the wards of St .lean de Dieu. Tlv-i food is wholesome 
 and abundant ; the keepers are competent and paid a reasonable remu- 
 neration. They should wear a uniform which would increase their con- 
 trol over the patients (1). 
 
 The clothes supplied to the patients leave nothing to be desired in 
 any respect. The walls are covered with pictures and look quite gay. 
 
 (1) Since our inspection the keepers have been provided with a neat unirorm. 
 
.12 
 
 The furniture, and bed clothes are most comfortable both as regard* 
 quantity and quality. All the beds are provided with improved spring; 
 
 mattresses. 
 
 There is a library for the patients, while a band and orchestra amuse 
 them during the long winter evenings. A special professor of music 
 has charge of this departement. There are also o'her games, such as, 
 dominoes, draughts, cards, bagatelle, &c. The reverend Sisters are also 
 in the habit of getting up musical and dramatic entertainments for tha 
 patients in a large hall set apart for the purpose. 
 
 In addition to ordinary inside and household work, there are sewing 
 rooms and shoemaker's shop, a forge, a bakery, an abattoir, a joiner's 
 shop, a laundry and a clothing room, in which a good many patients 
 are at work. In summer time a greater number are employed on the 
 farm. 
 
 The asylum is well lighted. The hot water apparatus for heating 
 the building, works very well and gives full satisfaction. The dispen- 
 sary is one of the finest and best supplied we have seen in America. 
 The store-rooms are full of provisions and there is no lack of dainties. 
 
 The supplies of clothes and blankets are the most complete of any 
 we have seen. 
 
 We must specially mention the chapel which surpasses in every res- 
 pect all those we have seen in any institution of the kind. 
 
 Two physicians devote all their time to treating the patients. Dr 
 Bourque, the head physician, performs his duties in the most competent 
 manner. 
 
 The proportion of cures, considering that this asylum admits idiots 
 as well as insane, is satisfactory ; we w^ould like, in view of the rapid 
 increase in the niamber of patients, to see the proprietors secure the 
 cervices of a third physician. 
 
 We are not quite in a position to recommend improvements in that 
 asylum, inasmuch as the proprietors already do more than they are obliged 
 to do in proportion to the small price paid to them. If, however, the 
 Provincecousiders that it can increase the amount allowed for the insane, 
 we express the opinion that the price given to St Jean de Dieu should be 
 raised, so as to enable the Sisters to make certain improvements which 
 they have in view, amongst others to improve their cells, which they 
 
have already commenced to do, so as to coustantly keep up with the 
 progress of science. 
 
 We must admit that they have already, without being asked, made 
 constant changes and effected considerable improvements. It would be 
 unreasonable to ask for more, considering the slender resources at their 
 disposal. 
 
 By raising the price per head the Government would probably be 
 able to give the St .lean Dieu patients the services of another physician 
 and to have the number of keepers increased so as to allow of work 1 ing 
 organized on a larger scale, as for extensive industries for instance. 
 
 In order to remove existing prejudices, the Government might, in a 
 new contract, stipulate I'l ttthe physicians should have the control of the 
 pharmaceutical treatment and restraint and also of diet, in the infirmaries 
 and should alone decide what patients can and should work ; this, in fact, 
 is now done. It might also probably, be possible either to get the pro- 
 prietors of St Jean de Dieu to erect separate buildings for the violent 
 patients and for the idiots, or to separate, in the asylum itself, the curable 
 from the incurable. However, we must say that the opinion of special- 
 ists, all over the world, is greatly divided on that point. Some think 
 that the separation of the curable from the incurable has a good effect, 
 while others find that the mixing together of both classes, and even of 
 the idiots with the insane, produces a greater number of cures. 
 
 6. Should any changes be made which, while respectino vested 
 rights, would make the present system more effective and 
 oive fuller guarantees to the j't'hlic ? 
 
 Answer. — AVe have made a good many important suggestions \n 
 our preceding answers and we will now complete them with the follow- 
 ing remarks. 
 
 Reninrks on the admissions. 
 
 that 
 
 ged 
 
 the 
 
 sane, 
 
 d be 
 
 ^hich 
 
 they 
 
 There are in the asylums a considerable number of persons who 
 ehould not be there, but who might have been left with their families or 
 placed in refuges for the aged. To what must this be attributed ? Is it 
 to ignorance or misinterpretation of the law, want of decision or of inde- 
 pendence on the part of the medical boards ? 
 
 Under the law as it stands, the medical board has absolute control 
 over the admissions, even when the patients are sent by the magistrates. 
 
14 
 
 "We must therefore conclude that the Government officials have not 
 applied the law as thoy should have done. They must consequently 
 bear all the responsibility which it has been unjustly sought to throw 
 upon the proprietors of the asylums. 
 
 We have also observed that there are patients at Government 
 expense, whose relatives are able to pay their board. Such preference is 
 unfair and should disappear. Steps should be taken to prevent such 
 abuses in future and put a stop to those that already exist. The Govern- 
 ment officials should be made to do their duty with respect to the admis- 
 sions. If the law had been applied as it should have been, our asylums 
 would not be overcrowded, the harmless patients would not be so 
 numerous and w^uld not take the place of those who are entitled to 
 admission. 
 
 As regards admissions, there are two objects to be attained : 1. To 
 secure the prompt placing in the asylum of patients who are suffering 
 from the fire-t attacks of the disease, as this has an important effect upon 
 their cure ; 2. To admit only such idiots and demented persons as are 
 dangerous, epileptic, a source of scandal or deformed monsters. 
 
 Our law as it now stands is quite sufficient in this respect. It has- 
 only to be applied justly and strictly, paying no heed to the recrimina- 
 tions of relatives, to solicitations, to political or any other extraneous 
 iulluences whatsoever. 
 
 Remarks on disrfiarf^es. 
 
 The Government, through the medical boards, has exclusive control 
 over the discharges. The visiting physician also had such control. Con- 
 sequently in thiis also, if there has been any abuse, the public officials ar© 
 to be blamed and not the proprietors of the asylums. 
 
 "We are of opinion that a single physician for each asylum would, 
 be sufficient for supervision and in this respect, a saving can be effected. 
 But this physician should retain the absolute right of deciding upon the 
 discharges, either in consequence of cure, or of improvement or of other 
 reasons. However, we think that it would be advisable that such phy- 
 sician should have the opinion of the physician under whose treatment 
 the patient is and that such opinion should be entered in a book kept at 
 the asylum. As the latter physician would know the patient better 
 than any one else, his advice would be useful to the Government officer. 
 
15 
 
 Organisation of the Medical Service. 
 In our opinion the followiug system should 1)fi adopted : 
 
 I. The resident physicians to be appointed hy the proprietors and 
 to be three iu number lor each of the asylums of Beauport and St. Jeau 
 de Dieu ; 
 
 II. The visiting physician tobeappointed by the Government andhave 
 alone the right to admit and discharge the patients. lie might appoint, 
 an assistant, if neces.-ary, with the approval of the Government. The 
 visiting physician should perform all the duties assigned to (he medical 
 board, with the exception of the treatment of the patients. 
 
 III. The inspectors of asylums to continue, with their present duties* 
 
 IV. We would further advise, as the crowning part of the system, 
 and in order to secure its more ellicient working and give fuller security 
 to the public, that a supervising committee be appointed, such as they 
 have in the United States, consisting of persons removed from political 
 influences and charges. The magistrates of the districts of Quebec and 
 Montreal, the recorders of the two cities, the batonnier-general of the 
 Bar, the president of tach Faculty of Medeciue selected by the Facility 
 itself, and the chaplains of the asylums might be ex qlficio members. 
 
 The committee should have fhe right of inquiring into the manner 
 in which the system works throughout all its details, receive complaints, 
 and make investigations when necessary, settle all dilficulties which 
 might arise and, in the event of failure to do so, report to the Govern- 
 ment. It might have a secretary selected from among the visiting 
 physicians. Its members would receive no remuneration but would be 
 allowed their travelling expenses. The committee would by by-law^ 
 determine the date and place of its meetings. 
 
 Remarks respecting Private Patients. 
 
 The relatives of these patients ask nothing from the Government 
 and the latter does not assist them iu any way. In the regulations res- 
 pecting the admission and discharge of these patients, two things must 
 be borne in mind : 
 
 1. To prevent sane people from being placed or kept in the asylums ; 
 
16 
 
 2. To protect, as far as possible, the rif^hts of the relatives and family 
 It is therefore necessary to take every reasonable precaution to prevent 
 abuses which may occur, but not to go beyond that. It if» necessary 
 that a Government officer should have the right to visit the private 
 asylums from time to time, to have access to the patients, to question 
 and examine them and order their discharge if he deems it advi- 
 sable. However, it is not at all necessary for that purpose that the 
 names of private patients be sent to the public departments and kept in 
 the Government recurds. In our opinion this is a useless exaction which 
 may hurt the feelings of the relatives. 
 
 If frequently happens that a young girl, a young mother, a young 
 man at the beginning of his career or a person of mature age occupying 
 a high social position, may be compelled by sudden illness to be placed 
 for some time under the care of the specialists in the asylums. Why 
 should this fact be made public, be recorded in the public archives ? 
 There is nothing to justify such a proceeding. An aiHicted father, a hus- 
 band, wounded in his tenderest aftectious, does not wish his disgrace to be 
 known and the future of tliose who are dear to him be irretrievably com- 
 promised, and he is right. 
 
 Let the public authority take measures to make sure that no sane 
 persons are confined in the asyhams but it is not necessary for that pur- 
 pose to know either the names or the relatives of the patients. 
 
 The inspectors of asylums should be charged with this particular 
 supervision over private patients ; it is within the scope of their functions 
 The powers of the visiting physician should be confined to seeing to the 
 execution of the contracts made for public patients. 
 
 Several private asylums maybe founded, other than those with which 
 the Government makes contracts — in fact there are some already — and in 
 these asylums ihe Government would not have the special officer called 
 the visiting ^ .ysician. 
 
 The inspectors of asylums are therefore, from the very nature and 
 extend of their duties, the. proper persons to perform that office. It 
 would also be a good thing to bind them under oaih not to reveal the 
 names of the patients or family secrets. 
 
 Remarks on the method of payment hij municipalities. 
 The precautions taken by the present law, with respect to the 
 
11 
 
 amily 
 •event 
 essary 
 rivatc 
 estiou 
 advi- 
 at the 
 :ept iu 
 which 
 
 young 
 apying 
 placed 
 Why 
 hives ? 
 , a hus- 
 ce to be 
 ly com- 
 
 no sane 
 lat pur- 
 
 Irticular 
 nctions 
 to the 
 
 which 
 
 -and in. 
 
 called 
 
 lire and 
 i^ce. It 
 ^eal the 
 
 to the 
 
 admission of public patients, soem to us to ba quite sufficient. Never* 
 theless, we would observe that the law requires the signature of the 
 tnayor of the locality in which the patient is domiciled. The object of 
 this is probably that the Government may have its recourse against 
 the municipality for one-half of the patients' maintenance. This clause 
 has given rise to various abuses. 
 
 In some cases, the mayors have refased, without reason, to sign the 
 certificate required by law ; in other cases the patients have been sent 
 inside the limits of an adjoining municipality or town and left at liberty 
 in the road or public streets. Then, when arrested by the police and 
 taken to the asylums, their domicile has remained unknown and the 
 Government has hud no recourse. 
 
 Would it not, then, be bettor, that the Government should have 
 recourse againt the county municipalities and the amount recoverable 
 be equally distributed among all the parishes of the county '{ 
 
 Unfortunately, it often happens that the poorest parishes are those 
 which send the greatt^st number of patients to the asylums and this is 
 the cause of the fraud practised to evade the law and not have to pay. 
 
 We therefore think that by transferring the responsibility from 
 the parish to the county, these frauds would in a great measure, cease ; 
 the parishes would not complain so much about the charges and the 
 mayors would not refa-e to sign. On the other hand, the Government 
 would have greater facilities for recovering the amounts payable. 
 
 The Farming out Si/slem. 
 
 Although this subject is not, strictly speaking within the sphere of 
 the duties of the Commission, it is howver so intimately connected 
 with it and is of such inportance, that w^o have deem it our duty to 
 my a word about it. 
 
 The farming out system has its detraclros and it has its defenders. 
 
 I Its advantages and disadvantages have frequently been discussed and 
 
 weighed, but like all other questions of the kind it will never be settled. 
 
 Its solution depends upon the particular circumstances iu which the 
 
 various countries of the civilized world are placed. 
 
 We will therefore state facts and leave th« deductions, as far as 
 regards this Province, to be drawn for themselves. 
 
18 
 
 Tho oslttblishmont and support of luuatic asylums have two fuuda* 
 mental objects : 1, To obtain the greatest number of cures po^hible, in cu- 
 rable cases ; 2. With r«'<j;ard to incurable cases, to give to the unlortunates, 
 whose seclusion is ne< ts^ary in the interests of public salt ly, jjroper 
 food and care, in vii \v, ;i.s much as possible of their former pnhition. 
 All unnecessary exp» uses and improvements, which are not likely to 
 attain these ends in a more ell'ective manner, may be considered useless. 
 
 The majority of the patients of the Province come from the poorer 
 classes. Those whose parents can ali'ord to pay, provide for themselves. 
 
 Now, it does not appear that exaggerated luxuryor princely comfort 
 have any effect on the number of cures amongst these patients. Th6 
 experiment has been tried in our day. 
 
 In some States of the American Union, whore money is plentiful, real 
 palaces have been built for the insane. They are very fine to look at, 
 not for the patients, the majority of whom are not ia a condition to do 
 BO, but for the visitors. 
 
 Nevertheless, these palaces do not, as regards cures, do one whit 
 more than other asylums, which are less wealthy and more modest. 
 
 This is shown by the following figures : 
 
 A II mini price ATornire of 
 
 ASYLUMS 1.1'r lu-iia cures 
 
 by hvud 
 
 188Y.— Buffalo Asylum $357.00 22.00 
 
 Elizabeth " at Washington. . 228.00 26 86 
 
 " Mount Hope " at Baltimore. 62.00 
 
 " Utica; N.-.Y " 212.00 18.87 
 
 « Worcester, Mass, Asylum 185.00 23.49 
 
 1886.— Blackwell's Island, N.-Y. Asylum 18.00 
 
 " Harrisburg Asylum 205.79 19.00 
 
 •• Dixmont " 212.51 3100 
 
 " Danville " 180.44 9.00 
 
 " Norristown " 198.89 15.00 
 
 " Warren " 190.69 13.00 
 
 " Friends " 698.00 22.00 
 
 " Pennsylvania Hospital for Insane. 509.60 19.00 
 
 «* Toronto Asylum 124,90 28.00 
 
 '• Loudon " 123 77 35.00 
 
 " Kingston " 124.40 20.00 
 
 « Hamilton " 131.31 27.00 
 
 " Saint-Jean de Dieu Asylum 100.00 82.62 
 
 *' Beauport Asylum 132.00 (10.50 
 
19 
 
 )0 
 
 )0 
 
 )0 
 
 )0 
 
 )0 
 
 )0 
 
 
 
 
 
 
 
 r 
 
 )2 
 
 
 Ihose figures are taken from the last reports which have been sent ue. 
 
 Oiiv asylums compare favorably in this table with the asylums in 
 other countries. It sliould also \n\ obsfrvinl that, in Ontario and in tlie 
 United States, the idiots are placed in special asylums, while at Beauport 
 and St-Jean d«' Dieu there are a great many. As the idiots are incurable, 
 the result is that the statistics of cures, iu our asylums, are very 
 fttvorablo. 
 
 It is a singular thing that of the four Ontario asylums, that of Lou- 
 don, which is the least in accordance with the newest ideas of great com- 
 fort, is precisely that which, last year, gave the best results as regards 
 the number of cuies. 
 
 The Kingston asylum is the most perfect, Work is admirably orga- 
 nized. Some trades are carried on on a large scale by the patients and 
 yet, last year, the average of cures was very low, 20 percent. 
 
 It should also be observed that Mount Hope Asylum, Baltimore, 
 vrhere the average of cures is the highest, is a private asylum, kept by a 
 sisterhood of nuns. They take iu only curable patients and the j^rico 
 charged is very high. 
 
 By comparing the amount of annual cost, we must, in order to 
 thoroughly understand the matter, recollect that the Government has 
 nothing to expend in the wny of capital ou our asylums. 
 
 We should therefore add to the amount of annual expenditure on 
 the State asylums the amount of interest ou the capital invested, which 
 would bring up the figure to a larger amount and make the comparison 
 ■till more favorable for our asylums. 
 
 The conclusion to be drawn from these statistics is that the system 
 followed in our Province, is much more economical and yields satisf\iO" 
 tory results on the score of cures. 
 
 The farming out system is followed in several European countries. 
 It is especially liked in Catholic countries, which have the advantage of 
 possessing religious communities and whose social condition.conscquently, 
 Tcssembles that of the Province ot Quebec. There are also some of thn 
 ^^tates of the American Union, which have no public asylums, such, for 
 instance, as Vermont, Delaware and others, as well as some of the terri- 
 tories. The Brattleboro Asylum, which does not belong to the State, 
 receives all the iusauo from Vermout. This asylum has been in exis- 
 
20 
 
 tence for fifty years mid hns b fii both nttackcd and praised. 
 etatisticB are us good an thf other aBylum» of the United States. 
 
 It! 
 
 What has happened here has been pretty mueh what has happened 
 in Vermont. In \S12, a joint committee of both IIouseM of that State was 
 appointed to study the question and report. Its opinion was unfa- 
 vorable. The discussion continued and in IHTti the Houses appointed 
 another joint committee to consider the same question. This committee 
 made an elaborate report which we cannot quote iu full, but wo give 
 the conclusiou : 
 
 " At this point, we may be pardoned for venturing an opinion upon 
 " the question of the propri«ty of ostabli.shing a State asylum. If one 
 •' were be erected, its capacity should undoul)tedly be equal to the ac- 
 ** commodation of three hundred patients. According to the best author- 
 " ities, the expense for buildings, apparatus and appliances, at the lowest 
 '• estimate, would be. at the rate of one thousand dollars for each patient 
 ** to be accommodated, making the cost, if authority and experience of 
 " other States are at all reliable, three hundred thousand dollars. 
 
 " The cost of (he asylums in Massachusotts, with one or two e^cep- 
 " tions, have been largely in excess of the above estimate, 
 
 " In view of those facts, we do not feel self-sacrificing enough to 
 " take upon ourselves the burden of attempting to secure the necessary 
 " appropriation for that purpose." — Annual of the Vermont Asijlim for the 
 •Insane, page 201. 
 
 The question was finally settled in favour of the farming out sys- 
 tem. The legislature merely increased the price paid for the patients, first 
 to $8.60 and then to $-).l5 a week, to enable thei)roprielorsof Brattleboro 
 to keep their institution on the same footing as otlier asylums. 
 
 In the Province of Quebec, .'it Si-.Tean de Dieu for instance, the 
 price paid is not proportionate to wliat is done for the patients. In other 
 countries, an asylum kept on that footing costs about double the amount, 
 considering of course the amount of capital invested. It is therefore not 
 reasonable to recriminate when the price is considen d. The capital iu- 
 vested at St-.Tean de Dieu is about one million dollars. If we deduct 
 the interest at 4 per cent on this capital, from the amount paid yearly 
 to the Sisters, there remains but $00.00 for each patient. 
 
 The Sisters have even paid six and seven per cent, on their debt, 
 which would still more reduce the amount paid for each patient. AYith*. 
 
91 
 
 hiT 
 unt, 
 
 not 
 iu- 
 Uuct 
 
 ebt, 
 ithr 
 
 out tho amount thoy receive from privatfl patieuis, they could not have 
 4one what they luivo lor Ihi' public patients. 
 
 Wo nay w ithout fear of contradictiou, Hmt there In not a single 
 asylum among thom we have viHited, which can ho kopt on tho same 
 looting for the same amount. If wn want to exact more from the uuns, 
 it isbutjuHt to commence by giving them more. 
 
 If, however, the Trovince of Quebec should adopt the system of 
 State Asylums, it would have to invest a capital of two millions of 
 dollars and consequently to increase the already heavy amount voted for 
 the insane by au additional expense of about eighty thousand dollars 
 par annum. 
 
 Moreover, the expense per head would probably bo greater than it 
 now is, for experience has proved that a Government can never manage 
 as economically as private individuals. AVe may, therefore, say without 
 exaggeration, that the increase in expenditure would be about one hundred 
 and lifty and perhaps two hundred thousand dollars per annum, without 
 any appreciable beuetit for the insane. 
 
 We have had a striking example of this in the asylum of St-Johu 
 Dorchester, a State Asylum kept by the late l)r Howard. Each patient 
 cost $232.00, to say nothing of the repairs to the buildings and the inte* 
 rest on capital invested. 
 
 It is easy to understand why the Province put an end to this 
 system. It was an excellent reason for justifying the Government of 
 the day for having applied to a religious community. 
 
 Since we have the advantage of having large religious communities 
 in our midst, we need not be afraid of having recourse to them for the 
 relief of the unfortunate insane. 
 
 Now^ that our Proteslant triends are about to have au asylum of 
 their own, all dilliculties will be smoothed over and greater liberty will 
 be left in this respect to the Catholic majority. 
 
 The groat argument used against the farming out system is that the 
 proprietors are interested in doing the least they can in return for the 
 ftmount they get. Theorically this is true, but practically the argument 
 remains without force when the proprietors are a charitable community, 
 a community of women whose members come from the best of our 
 Canadian families and have consecrated their lives, ou» of love of God and 
 
of their neighbour, to relieving the misery of their fellow-oreatures. Have 
 they not proved it and is it necessary to look around upon the wonders 
 ^vhich surround us V AVe see the Sisterhood of Providence, with the 
 assistance of a very small grant, giving to about three hundred female 
 deaf-mutes the most complete and the highest education which these 
 unfortunates can acquire. We see the Brothers of St. Viateur doing the 
 same for the male deaf-mutes and the Grey Nuns for the blind. In other 
 countries these institutions would be supported by the Stnte at consider- 
 able expense. 
 
 Who takes care of the foundlings, the orphans, the aged and the 
 infirm? What remarkable deeds of thaiity are performed by the 
 a&ylums of the Sisters of Providence, of the (rroy Nuns, of the Sisters of 
 the Good Shepherd and of so many others, which are scattered about 
 everywhere ? What grants do they receive and have their zeal and 
 self-sacrifice slackened in any way for all that ? 
 
 Without seeking for examples outside the subject Avith which we 
 are now dealing, is not Saint-Jean-de-Dieu a convincing proof that the 
 Sisters are doing, not the least, but the utmost, that they can for the 
 price paid ? Does the Government not get even more than it has a right 
 to exact in proportion to the remuneration granted ? 
 
 We are bound, in all fairness, to state here that the Sisters of Saint- 
 Jean-de-Dieu keep twenty-five insane, on an average, gratuitously and 
 out of pure charity ; that, moreover, they give private rooms and better 
 accommodation than usual to about twenty-five public pa ients, without 
 receiving anything extra for it. The latter are persons who have belonged 
 to the liberal professions or have occupied a superior social position. 
 Keduced to poverty by the vicissitudes of fortune, a prey to mental 
 disease, they would suffer, in their lucid moments, if they found themselves 
 mixed up with the others. Tne Sisters ha, e not waited until requests 
 were made to show their compassion and to alleviate as much as possible 
 the misfortune of these poor people. One can readily understand that 
 such delicate attention and care and a thousand other similar things 
 have sometimes had a great effect upon the restoration of intell ctual 
 faculties. 
 
 It must not be thought that the State asylums, although the samft 
 theoretical argument may not 1)9 applied to them, are unassailabli! for 
 all that, and that they have not given rise to commissions of inquiry. 
 
 We have already observed that thty are expensive ; we will further 
 say that they may and do lend themselves to serious abuses as regards 
 
morality. The same may be said, in this latter respect, of private 
 asylums under the charge of laymen. However, with a religious com- 
 munity, this dang'^r is almost entirely removed. In every ward, in 
 every department, there are religious or nuns, whose presence renders 
 materially impossible any offence against morality, either on the part of 
 the keepers or employees, or on the part of the superior officers connected 
 with the institution. Charges have been made against Beauport in this 
 respect. No one has ever dreamt of making auy against Saint-Jean-de- 
 Dieu or Saint-Ferdinaud-d'lIalifax. 
 
 )le 
 lat 
 
 Here is another very important consideration which we deem it our 
 duty to submit frankly and plainly. If the asylums belonged to the 
 Province, would we not see, as in other public departments, at each 
 change of Government, the replacing of all the employees who are 
 not permanent, such as keepers, nurses, &c.? Who, knowing our political 
 customs, can give a negative answer to this question ? Would even the 
 higher officers be safe from political vicissitudes ? There is nothing 
 more opposed to the proper administration of institutions like asylums, 
 than these periodical changes, this uncertainty as to the morrow. This 
 is an axiom which does not need demonstration. We do not wish to say 
 anything against appointments due to politics, but it must be admitted 
 that, in this respect as in many others, the State is a worse manager 
 than private individuals ; its selections are not generally as happy as 
 those made by the latter. Without going beyond the subject with whioh 
 we are now dealing, have we not S'^en a lumber merchant attain, at one 
 step, the high position of inspector of prisons and asylums ? 
 
 What a private individual can do with, two or three employees, the 
 State cannot do except with three or four, or perhaps more. 
 
 There would therefore be an increase of expenditure as the result 
 of frequent changes in the staff and of the incapacity of the new-comers. 
 And yet, in our opinion, the service would not be more efficient ; far 
 from it. 
 
 There are so many other institutions like the schools for deaf mutes 
 and the blind, the refuges for the age which are supported by public 
 charity and receive only nominal aid from the Government. Should we 
 not, while caring properly for the most infirm of our fellow-creatures, 
 those who are deprived of their reason, avoid incurring too heavy an 
 expenditure in order to allow the Government to grant suitable aid to 
 the various institutions whose mission is to relieve other infirmities ? 
 Do we not find, tor instance, in Montreal, that the number of schools is 
 entirely inadequate to the requirements of the population and that a 
 
24 
 
 great many children can find no room in them ? Must we ignore all these 
 wants and think only of the insane which are the intirm by for the best 
 t eated by the State. 
 
 It is probable that even, at Beauport and at St. Ferdinand d'HalifaX 
 three fourths of the patients are better treated and better fed than they 
 were at home and have many more comforts than they had while with 
 their families. As regards comfort, food and care, their condition is as 
 good, if not better, than that of the majority of our population. 
 
 We, therefore, as the conclusion of this portion of our report, recom- 
 mend that the Government take measures to transfer the control of 
 Beauport Asylum to a religious community, securing the repayment by 
 annual instalments, or otherwise, of the amount which may be paid. 
 
 Amongst other weighty reasons in support of this conclusion, there 
 are the following ; 
 
 1. The Protestants have their asylum and there is no longer any fear 
 of clashing with religious beliefs ; 
 
 2. Since we leave, with confidi-nce, the education of our children, 
 boys and girls, to religious communities, colleges and convents, we are 
 equally right in confiding our sick to their care. 
 
 3. The members of our religious communites take the vow of cha- 
 rity and self-sacrifice, have no family to support, no position to aspire to, 
 they have no other object to fullfiU than to carry out the purposes of the 
 institution viz : charity, teaching, the care of the sick, etc, etc. What 
 difference between them and mercenary hands, howsoever devoted they 
 may be ! For the religious, the work is the object of his life, while he 
 who serves for pay performs the work as a means of acquiring a position, 
 of providing for the future. 
 
 4. So long as our population shall retain its Catholic feelings, it is 
 and shall be the duty of a Christian Government not to offend its beliefs 
 and inclinations, all the more so that the devotedness of our religious 
 bodies secures considerable economy and a greater safeguard as regards 
 morality. 
 
 6. Let us not imitate those European countries, which seek to secti- 
 larize every thing, education and charity ; which seek to replace the reli- 
 gious in asylums by hirelings, banish the Brothers and Sisters from 
 the schools, as well as every emblem of the faith of our fathers ; which 
 
25 
 
 s 
 s 
 
 8 
 
 s«H'k, in finp, to replace Charitj' by Philantrophy. The miibrtunate 
 and the noor rociuire, not only bread, but also consolation to prevent their 
 robrlling- against their position and to pri'A'ent their letting hatred enter 
 thi'ir hearts and corrupt their good tseutiments. By this means great 
 social comniotious are avoided. 
 
 6. The Government has the right, under the contract entered into 
 "with the proprietors ol' Beauport to purchase that asylum I'or a sum to 
 be determined by experts. It would thereby do away with certain 
 clauses which have never received the ajiproval of the Legislature or 
 even of the Executive Conseil, amongst others the unjust clause which 
 forbids the transfer ofjiatients from one asylum to another and that 
 which establishes the minimum number of patients at 850 instead of 650. 
 
 GENERAL CONCLUSIONS. 
 
 I The cause of existing difFieuUies lies in the act of 1885, which 
 was brought about as the result of certain prejudices among the public. 
 
 II The act of 1885 exceeds the rights which the Government has 
 acquired in these asylums. Its important provisions have not been car- 
 ried out. 
 
 III Tht* asylum of St .Tean-do-Dieu is kept on a better footing than 
 could be expected in view of the price per head paid to the proprietors 
 ($100 00). 
 
 Although the Beauport asylum has, strictly speaking, been kept 
 according to the letter of tht? contracts, it is nevertheless inferior to St. 
 Jeau-de-Uicu in many respects, 
 
 Con>ideTing the price paid, ($182 00), we cannot pay that the pro- 
 prietors of Bi'auport could not have improved their asylum to a more 
 considerable extent. But the various Governments have never availed 
 themselves of a clause in the contract which allowed them to insist upon 
 such improvements. 
 
 The asylum of St. Ferdinand d'IIalil\vx is small, overcrowded, badly 
 ventilated and too far from the centres of population and means of rapid 
 communication. 
 
 IV To resume, if the Province is in a position to increase the expen- 
 diture for the insane, we suggest : 
 
26 
 
 1. To pay a higher rate to the Sisters of St. .Tean-de-Dieu in ordt r that 
 that asylum may, as regards comfort and modern improvements, become 
 and remain the equal of the best asylums iu America and that the nuas 
 may en arge their establishment ; 
 
 2. To place Beauport under the charge of a religious community, 
 taking the necessary steps to secure the repayment to the Goveruraeut 
 of the moneys expended for that purpose ; 
 
 8. To transfer the asylum for idiots at St. Ferdinand d'Halifax to 
 some place possessing easy means of communication such, for instance, 
 as Somerset, where the same Sisters already have a large establishment ; 
 
 4. We recommend that the six officers of the medical boards be 
 replaced by two visiting physicians or superintendents, since the law 
 which renders their appointment necessary, cannot be put into execution. 
 
 We think that the organization of a committee of supervision, com- 
 posed as we have above suggested, would have the effect of preventing 
 many difficulties from arising and of securing the more efficient working 
 of the whole system. 
 
 Finally, we recommend that the act of 1885, which has given rise 
 to all these difficulties, be at once repealed and that the old one, which 
 gave more satisfaction, be re-enacted, until the question has been pro- 
 perly studied and the amendments made which may be deemed necessarys 
 to improve and perfect the law on lunatic asylums. 
 
 The whole respectfully t^ubmitted, 
 
 LOUIS B. DUROCHER M I). 
 
 Commissioner 
 
 Quebec, .3rd July, 1888. 
 
 N. H. BOURGOIN. 
 
 Commissioner.