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There were two less in the Insane 7. .Is of the Kingston Penitentiary, and the insane in jails, awaiting r?'-poval, v/ere '"'wcr, viz., 34 instead of 47, There were 23 patients nt )u>rne on trid. In all there were 3,070 insane and idiotic persons o'lieJally recognised, b-^irg 137 more than in the previous year. Thev v*ere Chus distibrted : — M. Toronto xisyluni ... ... 358 London ^\syi:- - ... ... 440 Kingston Asylum ... ... 230 Hamilton Asylum ... ... 246 P. ... 345 ... 455 ... 219 ... 301 Total. ... 703 ... 895 ... 449 ... 547 Total insane in Asylums 1,274 Asylum for Idiots at Orillia * 122 1,320 ... 109 2,594 ... 231 Total 1,396 Insane Convicts in Kingston Penitentiary 29 Insane Idiots in Common Jails 21 1,429 2 ... 13 2,825 ... 31 ... 34 Total 1,446 1,444 2,890 If to the above numbers arc added the patients whoso names are on the files for admission into the above asylums, viz., 157, and the number of patients out on probation, viz., 23, we obtain the total number known to the authorities at the above -^ate, viz., 3,070. Dr. O'Keilly, of Toronto, the Inspector of Asylums, who provided me with this information, states that there were 2,837 beds in the asylums of the P.-ovince ; so that as 2,825 patients were resident at the time of this return, and a certain number were out on trial, it is clear that at that period the capacity of the institutions was pretty fully reached. More recently additional buildings have been erected, but * On Lake Simcoe. Dr. Bcatou is the fluperintondeut. 2 The Insane in Canada, as llic immlier of insane has increased, the relative proportion of supply and demand is probably about the same. It may be stated tliat tlie admissions during the year ending Heptemlter, 1883, were, as regards the asylums mentioned, 543 ; the number discliarged re- covered was 174 ; and improved, 52 ; and the number of deaths, 183. The ratio of recoveries to admissions, vi;^,, 33"52 per cent., is stated by L)r, (J'Koilly to be higher than any year since 1877. The idiots are, of course, excluded. The mortality, calculated upon the average nundjer resident, was 6'31 per cent., which is lower than for some years previously. Tlie total annual cost per patient in 1883, in the four asylums for the insane, varied from 127 dollars IG cents (Hamilton) to 145 dollars 12 cents (London) ; the weekly cost being respectively 2 dollars 44 cents and 2 dollars 79 cents. Dr. O'Reilly contrasts tlie low rate of expenditure in the Canadian asylums with that of the United States, where the lowest aveiage is 227 dollars 75 cents per annum per patient; while in Ontario the average is 134 dollars 68 cents. And lie cpiotcs the saying of one of the superintendents of tlie asylums in Ontario tliat this scale is " nearly poor-house rates." The same contrast has struck me as very remarkable, and the ex- planation is not altogether creditable to the Canadian Government. The salaries of attendants and servants are lower in Canada, but the explanation of the difference is to be found, according to the In- spector, in the relativ ■ character of the lodging, clothing, and, he proceeds to say, more e. pecially the food. The quality is said to be good, but it is " plain and unattractive," so as to become extremely distasteful to many patients. It is difficult for a stranger to form an opinion on this snl)Jcct, because he is unacquainted with their diet at home ; but the asylum dietary is as good as in our county asylums. The revenue from paying patients, of whom there were 538 in the asylums, amounts to a very considerable sum, viz., 5l),*J22 dollars (£12,485) during the last year. This certainly points to the )robable success of a pi'ivate asylum wliich lias recently been estab- ished at Guelph, and of wliich Dr. Lett is the superintendent. 1 find, from a return made of the number of patients employed in the asylums of Ontario, that 52*57 per cent, of the patients were engaged in some occupation ; being 1,479 out of an average popula- tion of 2,813. The largest percentage was at the London Asylum, viz., G989. The authorities in Ontario are not blind to the difliculties con- nected with the accunuilation of incurable patients, for whom the question of seiiarate accommodation arises. 1 am glad to observe that the latter difficulty is being met by the erection of small buildings; these being sometimes devoted to the curable class of cases, while the larger buildings are retained for the incurable. In some instances, however, small buildings or cottages an^, and may projierly be, devoted to the chronic insane ; while the iccent cases are treated in « i by D. Hack Tuke, M.D. tilt' ol. and nio.-e cxia'nsive buil.linfi:. Dr. O'Reilly bolieve.s that tho general feeling is enUrely in favour of detached wards or annexes and I certainly found this to be the case at the asylums which I visited. It will be advantf.geous to state liore a few of the leading provisions ot the existing statute relative to lunatics enacted in 1871 by the Legislative Assembly of the Province of Ontario, entitled " An Act Kespectuig Lunatic Asylums and the Custody of Insane Persons" (chapter 220). The Public Asylums arc established and acquired under a grant from the Legislature of the Province, ami are invested in the Crown. liie Lieutenant-Governor has the appointment of the Medical Superintendent. Among the duties of the Medical ^Superintendent are those of re- porting the condition of the asylum to the Inspector of Prisons and Public Chanties at each visit, and also to report annually to the Inspector upon the affairs of the institution. The financial affairs of asylums are conducted by the '< Uursar," who is appointed by the Lieutenant-Governor. The salaries of these officers are fixed by the Lieutenant-Governor, and do not exceed 2,0(i(j dollars for the Superintendent, and 1,200 dollars for the " Bursar." In regard to admissions, no patient can be admitted (except upon an order by the Lieutenant-Governor) without the certificates of two medical practitioners, each attested by two witnesses, and bearing date \vit/un three months of admission. Each certificate must state that the examination was made separately* from any other practitioner, and ii,fter (hie inquiry into all necessary facts; the medical practitioner specifying the facts upon which he has formed his opinion, and dis- tinguishing those observed by him>elf from those communicated to him by others. Dangerous lunatics may be committed to jail by a Justice's warrant on his receiving the necessary information, and alter evidence given with reference to the pri;ioner's state of mind, lie remains in jail until removed to an asylum ' y the Lieutenant-Governor, where he remains until dischar;^'ed by the same authority. The Inspector of Public Charities is cx-oiJkio the Committee of every lunatic having no other, and who is detained in any public asylum of the Province. The Court of Chancery may at any lime appoint a Committee of any such lunatic, if it considers it expedient, in i)hice of the Insi.ector. The Chancellor, who may call experts to his assist- ance, decides the question of mental uiisoundiuss and incapacity to manage his aflairs, without a jury. I understood that the number under the legal guardianship of the Chancellor is somewhat under 4U0. Ihey are placed in confinement under iiis warrant. For this class the legal checks are much more stringent. They are subjected to more * Ciuionsly [enough the previoua Act required the examination to be mado liy llio phyBicians together. " Three months " is a long period. 4 The Insane in Canada, official recognition, and tliey cannot be disdiargeil witliout tlie sanction of the Inspector. The ordinary patient, whatever may be his social position, is admitted into an asyhim on two in.odical certificates, and he may be discharged by the Superintendent witliciit reference to the Inspector, In regard to Private Lunatic Asylums, Justices of the Pence assembled in General Sessions may grant a license to any person to keep a house for the reception of lunatics within the county. The regulations of private asylums are mouldod npon those of the English Lunacy Laws, and need not, therefore, be given. Returns are made monthly by the asylums to the Inspector in regard to admissions, discharges, and deaths. It is obvious that if these returns are made with a view to prevent impioper admissions, or to allow of an inquiry in alleged deaths from violence, far '-^^ ^ong a period elapses before the Inspector has cognizance of an admission or death at an asylum. It is argued that in the case of the private institution at Guelph, a Committee has general oversight ovei it, and that this constitutes a sufficient guarantee against abuses. But however good it may be, and doubtless is, it does not supersede the necessity of an independent Government official receiving immediate mformation h regard to the admissions and deaths of patients in every asylum, for whose inspection he is responsible to the public. And, before dismiss- ing the subject of incpection, I would say :t is a great defect in the law which enacted it, that it is not made imperative to have one of the Commissioners a medical man. Passing to the asylums themselves, I will first refer to the asylum at Toronto, which I visited on ilie 2uth of August last. The contrast, as I have elsewhere intimated, between the asylums of the Province of Ontario and those of Quebec is really astonishing. The system is essentially different. The Legislature of Ontario recognises the duty not merely of discovering iristitutions to wliich it can send its insane poor at so much a head, but of providing the institutions chomselves, and i.iaking the State responsible for their proper management. I do not maintain that all has been done that can be done, or in all instances on f, sufficiently liberal scale, nor yet that the asylums are perfect in their orgajiization and management, still less that the system of in- spection is the best that can de devised ; and I object to any alleged dangerous lui.atic who has not committed a crime being in the first instance sent to jail, and thereby branded as a criminal, but I have no hesitation in saying that there is a sincere endeavour to make adequate provision for the insane of the Province ; that the inmates of the asylums are carefully treated, and that there exists among the superin- tendents a real interest in their work, and a desire to do" their duty to their patients. At the Toronto Asylum, superintended by an active administrator (Dr. Daniel Clark), there are 710 patients, tlie sexes being almost equal. The spacious corridors (15 feet in width) and rooms are ■:■! J and hij D. Hack Tuke, M.D. ^ carpotecl, and altogether well furnished, and in those used by the dvistructive patients there is not the dismal bare; s '^o often wit- nessed There 18 strong evidence of tha great .a,e and atten- tion paid in this asylum to cleanliness, the dress and the general comfort of the inmates. 'ihere was hardly anything deservhig the name rf mechanical restraint. On the female side thox-e has been practically none for two years, and as regards the men patients there has been nour whatever, Dr. Clark informed me, for seven years. No patient was in seclusion td the time of my visit. Indeed, T)v. Chrk strongly objects to its use. There is one feature in the construciion ot the asylurn which attracts the notice of the visitor at first sight, not very pleasantly, ,t must be admitted, and that the succession of semi-circular spaces or verandahs at the end o. e corridors, pro- tected and enclosed as they are by strong iroxi y^.dsadcs. A blazed wooden frame partitions off these spaces from the corridor On the areas of these projecting spaces the patients stand or sit on ohairs gazing on the o-!-er world through i.e vertical bars. On those who look up to them from below, the impression of a cage in a zoological g«rdeu may be, and indeed has been, produced! At the same tin^e it is surely much better for the patients to be able to step outside the corridor into such an enclo ure and breathe the tresh air, than not. The vi.w over the Lake (Ontario), etc., is extensive, and aftords variety, while the objection which may bo made 111 regard to the effect produced upon other minds is rathe- sentimental than practical In a new building no doubt this precise construction would be avoided, o:. an ornamental guard would be constructed in place of simple bars. The pay of the attendants, with whose anpearance I was pleased both as regards personal expression and dress, is liberal— 18 to 26 dollars a month for males, and 10 to 12 for females. In the win-s there is 1 attendant to 12 pitients : not so many in the central arge wards. Iheie are also six night watches, three or. each side of til 3 house. J here are ^.ix galleries for private patients, ^^hey pay rom three to six dollars a week. There are also six free wards. Four uindred patients pay nothing. The weekly cost per patient is a little more than 2^ dollars a week, or 134 .. .liars (£27 6s) a year e:.clus.ve of the capital account or repairs. The patients are employed to a consideruble extent, namely, about A i^'fu ''''"^* ' ,*; ^'■*''' '^'"^'' ^^^"' '^''"^^ '"^'one work can be obtained. All the vegeta..les required for the asylum are raised on tiie grounds. Ihere are Uo acres. Dr. Clark, however, states in the reoort he avoured me with that the last potato crop had proved a failure, but tliat the otlier crops wore about the average, As there are about 2d acres under crop, the potato iiiilure was a serious one for the asylum As there are no crops of hay and oats, the cultivation of roots is mainly attended to, and Dr. Clark calls attention to the need of more arable iand. Ihe value of the produce of the present small farm was 13,7o8 *5 The Insane in Canada, dollars in 1883. Euiklings, including a prison, have grown up in the vicinity ; a regrettable circumstance, especially if, as I understand, land belonging to the instigation has been sold for building purposes. There are, distinct from the main buildings, three Cuttages, in which I'^O female and 50 male patients are accommodated. One is cheaply built, and is well adapted for the purpose. There are good day- rooms and dormito.ies. The floors arc partly carpeted, and there are a few ])ictures on the walls. The separation of cases which these ann(>xcs furnish, affords advan- tages which here, as elsewhere, are fully appreciated. This, as well as the other Ontario Asylums, is inspected by one of tvvo Inspectors of Public Charities and Prisons in the Province. He visits four or five times in the course of the year, and oftener if he sees fit. _ The Grand Jury have the power of visiting the asylum if they wish, and when they do so they make a presentment to the Court. Their visits, however, are, I believe of a somewhat formal character. This asylum was opened in 1843, and was at that time the only in- stitution for the insane in the Province. Indeed, this was the case when the well-known and universally esteemod Dr. Workman became superintendent in 1853. At that time there were only 300 patients. What the condition of the asylum was two years after it was oj)ened (and I have reason to believe up to the time Dr. Workman became superintendent) I have the means of stating, oi. the autiiority of my brother, Mr, J. H. Tuke, who, on visiting it in 1845, made the follow- ing entry in his diary : — " Toronto, ^tpt. 30, 1845.— Visited the lunatic asylum. It is one of the most painful and distressing phices 1 ever visited. The house has a terrible dark aspect within and without, and was intended for a prison. There were, perliaps, 70 patients, upon whoso faces misery, starvation, and suffering were imleiibly impressed. The doctor pursues the exploded system of constantly cupping, bleeding, blistering, and purging his i)atients ; giving them also the smallest quantity of food, and that of ilie poorest quality. No meat is allowed. "The foreheads and necks of the patients were nearly all scarred with the marks of former cnijpings, or were bandaged from the effects of more recent ones. Many patients were sulfering from sore legs, or from blisters on their backs and legs. Every onc! looked emaciated and wretched. iStrongly built men were shrunk toskeletims, and poor idiots were lying on their beds motionless, and as if hidf dead. Every patient has his or her head shaved. One mis-rable court-yard was tl e only airing court for the (iO or 70 patients— men or won'ien. The doctor, in response to my questions, and evident disgust, persisted that his was the only mcthodof treating lunatics, and boasted that ho employs vo restraint, and that his cures are larger tiiau thofse in any English or Continental Asylum. I left the place sickened with disgust, and could iiardly diecp at nigiit, ns the images of thesufl'ering 3 by D. Hack Tuke, M.D. 7 patients kept floating before my mind's eye in all the horrors of the revolting scenes I had witnessed." he?nl iTfTl'"'"" rr""-'^ '\^' ?''''""^' ""^^ ^'^"'^ «^ unvarnished tale bet P f r T^" "' ^i'''^'^ ''"^ ^°""^^ '^"d J" ^^I^i^li l^e left it, no better tribute could be paid to his character and work during the period ho superintended it. ^ ^ SO^Pn Jnf"'?''' H-' ''••'•'.'' ''^ •1"''""*°' '"^"^^ ^^^^ '•^t^^i"^d t" nearly 80 yea. s of age. His nn.id is still extraordina.ily active ; and his pen IS frequently in his hand engaged in both original wr ting and In making translations from foreign Medical Journ'als. A longev ty s of C^n "r ' '' "• r ;""" '"■"' '" ^^I^'-^'^« ^'-^ '-P<^ that tJ,ifNeft of Canadian specialists may pursue his literary work for many years to come. In makng Dr. Workman an Ro..n..n,.« M 1 c \ pi..tion nf ti... 1, f • '"""^'liin an iionoiary Meniher of our Asso- ciation at the last annual meeting, the latter honoured itself as well as h.m. In conversing with me on the provision requirod fo' the beirj "'"'"' '",r^ it as his decided opinion t1u:t he e Id mn 1 la o '"ort. "' "'■ "";"'"'' '"^^""^^ "'"•^t either the increase of population or the accumulation of chronic cases couhl explain 1)1. Wo-kman estimates that there is in reality one to 500. Formerly there was no general paralysis, now it is coinmon eno Hi not wr"t ^^Th"/"' " '; '"^'"•''' ''' '' '''' ^^--»to Asylum "ie ai^onv tin T "^"HV'"^ "^''^ than a dozen cases; and there V ar n ui-l^ ""'.'"'!;' ^'■"'"/'"■'^ "^'''''^ •" the cmirso of a tSthepoo,' '""'''■' "'"'■' ^''^^"'"^ 'tniongthe better classes I visited with much interest the London Asylum, ^^hich Dr Bucke superintends with great energy and enthusiasm.' N<.t on^y fs the town .tselt called after London, but the river upon which it stands s lte.ul illl"" 'ti'"^ '' \T'' f ''' Westminster Bridge and i liccablly._ Ibo resemblance does not end here: for if it be allowed tha there is a good asylum in or near our Metropolis, it vWU ot bj denied by an; one who inspects Dr. Bucke's i istitu on hat its ^87 f :';, iT'' '" '\" ^'"M-tieular also. It wa^ op ned t ■11'' and the present sup..rintendent entered on his duties in 1H77 lie whole establishment, the main building, the separa e one for the refractory ,,atients, the cottages ami tla' far.n. em.vey the impression o a.nve lif... and of the suslaine.l interest of an il le h'..d. Dr. Bneke has resolutely set himself to employ the p ie ' lu some way or other especially on the farm-with great adva ta«^e it need scarcely be «„id, to their mental and bodily^ieal 1 , n ^wi\ the vesult of emptyn,. the wants of those helpless, hop kss oa .vhoso drear existence in the dead-alive asvl -ms of any coin^frv suggests en bono to tbe pessimist, and makes even t le o i,^ sad at heart. Jf Dr. Bueke is asked how he employs a m, inT L ol acute mama be replies. - Uh, 1 make him br'eak sto,";"" ' V. ifhuut taking the reply too iiioruliy, it may serve to show 8 The Insane in Canada, the exceeding but just importance attacl.ed to labour or being out of doors, as has been so long and froqucntiv maintained in the Mother Country. I gathered from (Miqiiiries that very few cases of mania with exhaustion are admitted to tl.is asylum, a 'very important fact in this connection, which miglit have been expected as a point of contrast between the admissions into an asylum in old and new J.ondon. Mama in some form is abouc four times as frequent as mejanclioha. Only one patient was instrumentally fed last year. ihe number of patients in this asylum is 8^8 ; 438 males and 450 lemaies It has a capacity for 906. The estate consists of 300 acres, 200 being occupied by the farm, 40 by the gardens, while the buildings cover the remainder. The main building cost a little more than £100 per bed. (Land is here about £30 an acre.) It accommodates about 500 patients of both sexes of the quieter class and an assistant medical oflicer. l>r. liurgess, resides here. It consists of the usual arrangementa -corridor (12ft. in width), recess, day, and bedrooms. Some of these are dormitories containing 16 beds. The number of single rooms in the whole establishment i^; 250. As 1 went through the men s side as many as 250 patients were at dinner in an associated dining-room. All had meat, and I fonnd this was usual. ibere is a distinct three-storied building for patients of a more or less excited character, mule and female. The first assistant physician, Dr. Beemer, resides here. There is nothing special in the arrangement of the wards. There are 184 single bedrooms, nftordmg 720 cubic feet oi breathing space per patient. The windows were unnecessarily guarded by iron bars and net work. No donbt these are survivnis of the past, and if rooms for the refractory were now l.uilt^ at_ this asylum, no trebly guarded window would i)e in- troduced, for It 18 out of character with the air of freedom which now everywhere prevails in the institution. More light would be also admitted into the building. There is a good airing court, shaded by trees, and provded with a shed and seats. Jn this asylum, as m most others on the other side of the Atlantic, the number of epileptics IS small-oniy about 25. There was no pati, nt in re- straint and none in sechision. Dr. iJucke observed that it was rare to luve b lack eyes among the p«ti..ntH since be determined not to resort to meeliaiiual restraint uiih.ss absolutely necessary. No patients were crouching on the ilouis in strong dress... 1 mu.st ad.l that ''chemical restraint is not resorte.l t tl,e asylum. .S.datives are rarely ge m-n in small doses. In add.li..n to the morning round, I wen hrough the wards after the patient, were in bed, ami there was very ill le noise iiMleed. llHore quitting this building, for the excited patients I should state that, of U2 men residing in it, from 75 to Vo are on an average employed. Dr. l{i.ol?I-^tor, Dr. OReilly, able to put me n the w^y of obtauung t us information valuable and interesting as he felt irto be A c ear estimate of ;he net profit would greatly redound I doub not* 200 pigs on the day T was there Over inn n,.. i -i i Rnmo p (\i\(\ T 1 1 « nitit. uvei luu are kied every vear amounted to 140 tons. The asylum has 40 cows! ^ ^ asyllT'it is cW./'f''"''-^''^ " ^^"'' ^'"'' ^^ ^^ ^ ^^""i»« pauper S- 1- «^'"bt.ess easier to induce them to work than in mixed aHo^rt',-:;; s^'^ Vo^'"' "^^^ r-"-^^-^^ ^^ ^-™. and :: b^ zt JloJ-. ?• • -^^ compare the amount of work done at sueh nn ns itut|on with one for private or np-xed patients woul be v ^ ,m" lair. It will not, however be flpn;<. l +),..+ *i -^ aware tha fiJ. rs i n '' ^''""^'''^ '''^'''^ *" "^«' ^ «" ^vell icnnul that, n^'odd: ttT ^^^ ' r;,.,^;/' r'^ir = "^ '"-' '''"-"^^ him or her to work tim ea... v ii '.'"'^'^"^ "^' 'f y"" t^an once get in ♦l,.w .,.,/ ^'''^^' ;"" tai'f \mII give you very little further trouMe ^^ -^^'^ ^''^^^ i"^"ents have been engaged in afrtho I ^^n j^«wr>pn^,i '^Ttl asylum in , liut the IV it, nor 3 way of t it to be. loubt not, ' made to me. Dr. i gardens lere were ery year, as many 3 of hay e pauper in mixed be handy ; such an very un- 3 pauper no work m of the together hich the specially constant ' with us )ne by a II insist score of 1 appeal outside cnt and I found lilo out to that need to im well rn satis- iiuoh. liMU of of the nt the III ways 2e get rouble ill the I hy D. Hac^ Tfke, M.D. JJ various kinds of farm and garden work ; they work with the carpenter mason, painter, tailor, engineer, baker and butcher ; they work in the horse and cow stables, and do most of the milking ; they assist ia dining-room, kitchen and laundry ; they sew, knit, make r.nd mend shoes, boots, and slippers ; seat chairs with cane and reed • make mats; they do tinsmithing, blacksmithing, locksmithing, upholster- ing, cerking ; all kinds of work in the halls, a, bed-making, sweeping scrubbing, sawing and splittin.r wood, shovelling coal, giading laud,' making roads, feeding and tending two hundred pigs, working in the store picking hair for mattresses, and doing all sorts of odd jobs The temale patients are largely engaged in sewing and knitting • and besides tney work in the kitchen, laundry, and dining-rooms t 'do all sorts of work in the halls, as bed-making, sweeping and scrubbing ; milk, pick hair for matresses, and gather fruit and vegetables in the gardens. ° The proportion of attendants to patients is certainly not hi-h in the Londo. Asylum ; in fact, the Province ought not to complain if the Ir^uperintondont should increase the number. For the violent patients, the proportion was one in nine— considerably less for the others. It ought, howevor, to be remembered that the number of ward attendants does not adequately represent the services rendered to ilie patients inasmuch as those workmen who labour on the .^rounds or at any handicraft exercise surveillance over some of the patients at the same time beveral years ago, Dr. Eames, the President of the Me( .co-1 sychological Association, urged upon his Committee the need of more attendants, and he states that while the proportion of attendants, with the above-mentioned helps, was one to eleven in his asylum It averaged about one to eight in the asylums of Ireland generally. Ihe maximum pay of male attendants at the London Asylum is about £bO a-year ; that of the females is about £30. On the male side are several femah, attendants-uot the wives of atten- dants, as at Jiiookwood and some other asykuus in England, but respectab e widows. Dr. Uueke attaches great importance to this feature of his management, as ensuring cleanliness, tidiness, and con sidcration. He states thai he has had no diflieulty in (in.ling suitable persons. He is fortunate, for he requires pleasant leanner. in- dnstrious haluts good feeling, and, above all, good sense, in midition o widowhood. Ihey must be widows indeed. To do him full justice however, 1 must cite a lew passages irom his last annual report •- ' Ihe hrst was engaged in January, 188;j, and became the super- visor of the upper storey, and does all the wm-k that a man in hat posuu.n would do am besides that she has a gvneral supervision over the tidiness and eleanlmess of the whole wing ; the other two wome'n act as her assistants on the other two Hats. They look after he men s clothing, sc to the tidiness of the b.ds, cleanness of the floo a Are. A:c. ; and especially, they oversee the indo<,r work of a lar^ra 'l^T ."' ? l^^tiei.ts, who pick hflir. Hew, knit, make mats. .^ But the active duties of these women, though imi.ortant, are scarcely 12 The Insane in Canada^ hel hill „ .P fff-""^;""T ""^ ""r^^^ *^'k ^"^ «<^"'^'^^t. «" that these halls a,^ .afferent places now from what they used to be before these women took service m tliem Down to the present time non3 of them have been by speech or action eitlier inj^ireror nsulted by any patient. Almost universally the patients likp if. hl^l fi amongst them and I find tl .t ofte/the 4m:n l^n'^t^tlt "^e S to work when the male atten.lants can get them to do nothing'' In an institution where the gospel of fresh air and employment is theS^;"^^^ ^«^'« especially inlreseSn tiie ciietaiy. Ihe meals are taken at 6 30 am 19 on.l a r w, +i pat ents going to bed after supper up to 9 ocb k pi" Vap^e'd Z dietary m detail but rnust premise that work, whet^ier outTr^ indoor IS not encouraged by the stimulus of beer, for Dr. Bucke L an out aiu-out teetotaler. He has not used alcdiol in a^y form, even as a" meaicine, for three years. Wlien he became SupeWntendint a con! siderable sum was expeiuied on beer ; more food is now given but not more milk, which is, I think, to be regretted. The attfmknts ne" liad any beer, so no money equivalent has been necessary. ^^i^^^:^:tz:::i-'-'- ^^y ^^^^^ ^ chose, BREAKFAST. bunday.— Bread and butter, tea and coffee. Monday and Wednesday.- Porridge and milk, luesday.— Boiled rice and syrup. Thursday.— Oatmeal porridge and syrup * Friday and Saturday.— Porridge and milk. „ , DINNEK. bunday.— Stew, potatoes. Monday.— Corn-beef, potatoes and beans, luesday.— Roast beef, potatoes, bread pudding. Wednesday. -Boiled beef, potatoes and peas. Ihursday.— Haricot, potatoes, and bread pudding. Friday -Fish, boiled beef, pickles and potatoes, baturday.— Roast beef, j.otatoes, bread puddi-ig. bunday.— Bread and butter. Monday and (Saturday.— Bread and butter. Juesday.—btewed rhubarb. Wednesday.— Bread and butter. Thursday.— Currant rolls. Friday.— Apple sauce. „ UREAKPAST. tor males.— Cocoa, bread and butter, i^ or Icuiales.— Tea, bread and butter. "" Molaiiei. i IS a strong let, so that be before esent time or insulted bave them le patients ing." loyment is erested in ' p.m., the ippend the or indoor, is an out- even as a nt a con- n, but not nts never I chose, pauper by D. Hack Tuke, M.D. |g DINNER. Sunday.— Roast pork, beef, or mutton. f.iiin"'^?'""^?^' ^^'l')''''^ T'^'^ °^^"^""'' "^«' «"d peas, and con- taming 2 oz. of meat for each patient ; also 6 oz. currant pudding or 10 oz. baked rice pudding. ° Tuesday. — Meat pies. Wednesday.— St. Louis corned beef. Thursday.— Boiled bacon or pickled pork. Friday.— Fish, fried or boiled, with melted butter. featurday. — Irish stew. SUPPER. Tea, bread and butter. For patients who are employed, luncheon, consisting of bread and cheese and beor (ha f-pint), is provided in addition ;"and for Mon- day s dinner, boiled bacon or pickled pork is given instead of soup. London As Zi?-- P^i^cipal salaries and wages allowed at the Jl^'^^'Ll^^fT}, ^"Pfi'V^t^ndent £420; first assistant physician, £210 ; second di to, £210 ; third ditto, £154 ; bursar, £290 steward and storekeeper £16G; engineer, £154; two carpenters f^O 'hnl '/Jo ' f'''^'''''i ^«^ ; assistant ditto, £50; butcher £oO; baker, £83; farmer, £125 ; two ploughmen, £115 cowman £45; three night-watchmen, £157; three chief attendants, £195 twenty-nine ordinary male attendants, £1,389 Females.- Matron £105 ; assistant diito (refractory ward). fnt« ioVn ;f ""^'"t."^' i^'\ ^''- 5 '^''''y ^^'^'"^'•y f«"^«l' attend- cool Si ^7' ^Y''\'''^^l attendants, £82 ; five cooks and assistant cook, £1.^7 five laundresses, £115 ; nine housemaids, £l95 ; one dairymaid, £25 ; two seanistres.ses, £50. With the foregoing may l.e compared the following salaries, &c., at the Hanwell Asylum (750 men, 1,143 women) :_ ' .r.^ni^'lilT^"^ liosido.it medical superintendent (female depart- ment) £700 P^i- /mnum ; («) resident medical superintendent (male dqn.rtment) £70(); (./) chaplain, £350; (/) clerk to the Connnittee ot Visitors £2^0 ; assistant medical officer, £200 ; ditto, £200 ; ditto, £lbo ; ditto, £150; {e) npothoca;y, £120 ; (/>) engineer, £45); (« c ewf 7.%',^?^ ' ^'^ '^r^ °^ ''"' "^^'"•"' ^^^^ ' (0 ti'-st assistant clerk llU .'llH^ 'in! ff^^t'^J't-clerk, £ll0; (.) storekeeper's cktk £110; ditto, £(,0; outdoor insp,.ctor, £74; (e) matron, £345; assistant matron ami organist, £GG ; junior assistant matron, £40 s .crmrnulentot laundry, £55 ; superintendent of workroom £50 J '';''?' '?o^' ^^^'^"^''"t' ^^« ; ditto. £34 ; ditto, £30 ; workroom f^wlJt".?inn';m^"H>•/''^"' ^'"■^ ^''";f '"'"• ""'*'«' ^^^' "''"^' •^"^^ vegetables, mo,u« at ' ' T' ""'"'""^'•• """"• '^"^ vogotabl..8 , (,•) furnisLe.l apart- niouLH, uttetuiatico. ooala. u-aa. wnsliiiicr milk o.-d ^e—'-l'-a - -^ - i • iioi .odged. Ihe othors have board, lodgintf, aud washing. I 14 The Insane in Canada, f (.a) One nuit of uniform evei-y ei"■h^ mnnfh. „ i •. „ years under certain conditions ^° •■'So To?^,^';-?'^.'' "''' "^ ««'•?« ^^^^y two locl^in^. ,.nd washin.., 6x000^10 t o case of ? "^,^7'Q«»; f-) have board, allowed £1 per ,nonth in lieu of tl eu- lodo^n. .1° ""^ .*''° attendants, who are eighteen receive Ml. (d) These attednnl '"'^'^L'^^-u '^^'^^ ^-^^ of the . , T^ ' *.«; liiese attendants are neither boarded nor lodged. .ove„t,-o'„e o.li„a,./att'l,!,°s il'o IrS'aa.'' """' "^'^ '° *^' ' «l?tht" "^ ''"'"■''' '»''='■'=.=""' "-^i,.,. , tUreo ,ait, of „„if„™ „erj. rfjM diio:'i2™Stb™etr;„7-,7i?'"'"^^ ™°'V ^«' o-e assistant je2o, with' ditto two" , i::tTu rtV'"''/," ^".r ""'»• £25, with ditto rololcm'uttol'Vs tr/Zf'-lV ?.'"°' ^'« '" laimdry maids il5 to £«!>";, *?°' ""* '^'"'' i «'«'>'«■> to JliO. ' '"' '''"" ; S"'"" Jomestio servants, £14 (o) All board, lodging, and washing £1 (is. and 17t • rVono'Zl '•■'"'i', fl '''- (*^ '>'» '=»kers, W -0 carter and'diril'^^S^^^ one ditto, £1 U.\ one ditto, 18s. ; one gardener 'air^^u^; ™« ->™-. ^^ Is-i (a) Breakfast anddinnn- rloiiTr . n\ u -, , . ('0 lodged and allowed coals. S n Ik vS'.^' ^'^ ^^^^^^ vegetables- allowance of beer. ' ^ ' ""^' ^"^etables, and beer. All have an I next visited the /Taw/Z/on A <5vlnm ti • • .-. .. 1875, i,s boautifully sitirit o nvtJ i r '?" 'f ^^'^ntion. opened in tageous. ^It is i'conv ; ;': ; ";r''''V"'1'''^''''^^''^ approach to the asyhim i L '1 :] ^T'^'''"''' '^««<=«>it' ^n^i the signed for au ineb.it. a ^ "t tf l7f J' "'" ^^'''^''"^^"^^ ^^- decmod more prossin- and rt i^!- , f ' ""^ the .nsano wore justly I>r. Wallace is t fm ! ' i ■^''"" *''"'" °^ dipsomaniacs, been ^ut l^todH ^tu TT^f "?•'•, Unfortunately ho has abroad, but he is now nuu^rsU.g:;. ' "'"'' ^" ^''^^ ^"^^ ^° ^''^^l 297 fiir ' Ali;ut 5';Lr'c.''t 'T^ ^' "''"'" "^^ ^^ ^^'^^ -^^ 6s. to lOs. a w(M.lc The cons r\ p ^?'':"'' J^'^^' ''"^ '^"'^ ^"'-^'n nary asylum plan and a In "\ "" ^"''^*'"^' ''^ °" ^'»« «'-^^i- hoi is d.st!nct'l^;;m,1,:''r^ -« ^'^^ • ;!^;uu'-" -l-;ntendent's .omg round a number of patients of bc^h ^1;;:^:::^ JJ^to'^Z i h B. Haci Tuke, M.D. ; (c) eigh- ^ ditto, £25 ;o £72. ?e every two • have board, ints, who are ■ee out of the id nor lodged. 39 ; twenty- '19 to £32; L every tight le assistant ; one ditto, ditto ; one ;to, £18 to to ; eleven vants, £14 o, £1 4s. ; ailor, £1 ; 9s. ; one '■0 bakers, , £1 4s.; , £1 Is.; egetableaj 11 have an opened in tile point 31" advan- and the nally do- M-e justly IGS. ly lie lias to travel lak's and nly from the ordi- ■ondent's ii I was to^'^ether 16 — 105 men and 95 wompn tk« j- ^ ventilation of the hou^the fornL 1 '7 ^^' ^T^' ^^'^ ^'^^^^"8 ^nd the roof, are well secured ^ ''"' ^''^ ^^'' ''^"«^' ^7 Aues to In the refractory trallprins +]ir> i ,„ i -,1 to observe, placed in^;;e^stoZ "fI ' ^^t"*^ ^'^l ' "'^^ ^'^^ American C.mtinent the most v Lh nf '..• T ^"'T^'^ 1" '"^'^""^^ «» the house, a practice very lik dy J> '- 1 ^ i' ^^ ^^'' ""''^ ^"P ^^ ^^'^ proi)er outdoor exerc .^ Tl e ti'- /l^^^''' ^"^^ ^he omission of downstairs is in itse Iv/eque t cS,'? f '^'V^""'' '^ P^^'^«"^« "P ^"^ struggling. ^"'"* '•""'« ^f outbursts of excitement and re^lf'l i:^^,^?^t^,j:;^^-^ infV.med. me that when he cauusole for the woiLn "itl t ^^t ^^ ''' '''' "'^'^ '^"^^ ^1- Ht night, if not in the dav be nln^T / '^"^'^^^ '"•"'''^'' ^"^ ^^«"ld gent'patient v.. hi be placed n tU '" '"'^'"'''''' ''^''^' ^ "'^''^ ^''t^-^i- ehipsed since a nutle pati nt h 1 . '^^•"^^•"«'"-., ^^°'^'« months had time of my visit was re t^^^^^^^ i " •"'^^train.^a. A won.an a^, the Whenthecamiso „^s ro Zl 1" P^^''^^^^-'^ '""tilated her lace rious work. Judginrf^^om tr^tno'f.'JTr'^^'^ ''^'^"™^^^ ^'^' i"i- elude that there has beeTa LaC ' ' -^"^P^^'^"^'' ^ «''0"ld c-on- the hHst few years. ^emaikable dm.inution of restraint during paS;;.'' ^cSr^Sj^^^i^: a sewing-room, where many of the bere. As I am speakim^ ofZ 1 ^"Tt ^^ ^^'' institution is ,ione patients, in additSft^; ^w ^'/tl ' L'T "^'' ^'^^ ''' ''^ '"^^^ them in winter, when it kZT'vmuT'^ convenient to employ breaking stones' rdj;- a sied' ^''^'"'' '" "^PP'"^ employment, ij FEMALE PATIENTS. Nature of Employment. Number of Patients Working, Larndry Kitchen Sewing-room.. Dining-room . Mending Generp] Work Knitting Work in Halls Store-room .., Total 16 7 12 13 6 6 30 3") 8 131 Number of Days Worked. 1170 516 me lOH 4U8 390 2340 2745 624 10233 16 The Insane in Canada, MALE PATIENTS. Nature of Employment. Number of Patients Working. Number of Days Worked. Wood Laundry Kitchen Tailor's Shop, Dining-rooms Carpenters Engineers Masonry Roads Coal and Bakery Dairy Butcher Piggery Painting Farm Gf rden Grounds Stable Halls Store-room ,. General Work Quarry 5 5 2 8 6 4 12 12 20 1 2 12 20 6 1 60 26 60 390 465 147 728 292 281 465 849 78 646 91 182 112 524 746 ill 91 6460 156 1652 1400 Total 262 15177 « rest™:,,,,, but none wL i„ seoh Jon :ri k"' „ ,fdr "ICr occupied, jin nsc of onf r-mUntil ^«;,» • ■ • " "^n tne DUihlirifr is i> ,. „,nt medical officer is to uu .esident in this building. h D. Hack Tuke, M.D. of Days ced. ber of the no patient A separ- lias been stration of of classes in Great basement, . It will h some of a bed, but i designed Jes of the rpose, but lit. The e noisiest 3n admis- lihiing- is building. 5;^n:nrtf:i:::;!^cs^his?f:^;; f^^^^ ?t7 ^--^ ^^« sane from the rest of the hou eho Id stirfu • 1 T '"' '^T' '[ '^' ^"- be from the superintendent^ q„ AeJ^^ blessing. That such an Pvil ,-/i ! • ' • H ^^ ^""^^ ^^^ioad of a I bavelitne s d fsoL 1 L'^^V.T'^'T''^ ^ '^ '''''' ^''^ ^^at idea seems to be to r" 1";^ St\ J ^ sible from the centre of the I vlum 'Tnd b^.^ I?"''/' ^'' "^ P^^" officer. ^'""'' *"'* *^^* without any medical c^ToZst:'7:^!^::^'^ p^--^ ---- close to the of the patient , towhom ev ,v J , ^™.f"-e t''at for the interests ficed, this arrangement sbeJ'r '"'''f'^^r °"^^'^ ^« ^e sacri- of sound and siglT I was ' h 1 to fi" /'Jf "^ /V"' "'^^""^ *'•« ^'^^^h an assistant n.fdical oK s^^^^^^ wards for the refractory mail mt' nts I .7" ^""'^'"§^ "^^•' ^^^ is rot the case in every iSuUonfn. .1 "^ ^" ''^':'"^^ *^'«* ^^'^ cited patients are armitt el H^oult to'lir"" •" ^'"'i^ ''^^"^'^'^ «^- unusual, and to be within asyc.H^ It wS^^"-?'; f T'' '^' "^ ^« ment of night-watcbes renXr{ Iv ' '''^"^ *'''''* ^^^« ^oint- putirely deny No asvlum L t 1 "' 'i*;^^'''* ""Possible. This I bableJll-treL,ent^7pat"n^wll^^^^^ patiptsanfthf aSd:^;l:^lr3^LSo^ " ^^^" ^^« patients of a Lrmless Id Tt' In { X' "^^V^'^P'*^^ ^'^ ^^ ^'^'^^^ inmates, who C mi of a Wl lo o1 ' T^ '^'^"' ^"^ ^^'« and contented. T./is'^het^^rtt Jbt^brl^ri^^'^'^'^ lescent class. It is comparatively infxpens^^;;. ^"^ '^'' '""^"- :ct r;-; £^^^^^^ v„.^K- '^fi';;l.!^_."^^'^^ "^ ^l'i« «^3J"n, except medicinallv, nnd that 18 The Inmne u. Canada, ^^^^^^Tr"'" ^' ^'^' ^tteadauts. Their salaries reach £50 for men and ±2o for Tvomen per annum. The hist asjiuui I visited in Ontario was that at Kinq.ton In the absence of the snperinten.lent, Dr. Metealf, his brotlier-in^law Dr Clarke the assistant medical officer, obligingly showed me nvlr tl,. inst.tut.on . It is situated on the north bank of^l^U;' On .lio T Wo 2o5 male and 2oU female patients. These 505 > atients a e miners with ^the exception of a very few who pay the cos. of n a ntena^e ^viz two dollars, or near y 8s Gd n vhhA- T1,„ i "' ".", V^"*i^' ^^^-^ was OT)enpr in i«ro I* • i u ^ '•, "^^"^ a^jli™, Avhich IS of stone, was opened in 18o9 It is built m the usual corridor style and has pT eitr'Vw ^^^^ '"^""'"^' ^'"^'^ '^ -t "-d for th cliss Tho , ?^ ^^"^ 'T""'^ ^'^ «f "'l^icl^ «re for the worst one of th m "^^!;;;:t ^l """^"•^^^^ ^"'-« "«t "-^- than 1 1 beds in any feci ^ t:^.^ ^ to i,;s;n.iuer' l' ;r-'°"'i ^° V'^^ ^^^^ patients are scattered in don, , t^^jt, c^ ''" S ""on "l"""''^ liance can to a considerable extent be Xed Tn • 1 r • .1 '^ ''" came , ^.j noric on tlie roT()« • fivo ou -.;.<■ ai • i^ , . iu>iuh , nve assist t e eniiineers! • twn m-o nn,. women, upwards of 150 arc employe-] ^ ''''^''- ^^ *^^ ib/c:sgi lii:r:/:;2s!^ ^:!:^::t:;S"^ '^ ontano^otta^es of the quiet and incurable class In £. ""7^''"'^ ^^ '{ ^^"^'^^^ for 70 patients of both sexes autluTaf\ " i'^'"''''' '^''' ^'''''' dollarsJncludingwarndn./a^ ;rusn f ^■T'''''''' T' ^^'^^^ per bed. There fre no ^^^^^^^'J^. "Wishing, or about £100 of four and the wings of h e sto ey U l?"''' ^^V"'"' '''''''"' The general api^^.-anc; f th^atien s t "HT^^ T '' " '"^^• satisfactory. Evidently tlu^y are undeHml nH^^?^ "'"' """^ The asylum is inspected four t me 1 iet * \1/o!p ^T ''T'''''' na ly by the Grand Jury at the Assize^ '' ''"^ '"'- "^'"^^^ It IS a matter of some intcr("llt\S-' ^^^ JJ^^^^ f t;J;^f jrn%:tratfen^^^^^^^^^^^^^^ aundJf^Jl ^nnf'i'.n^'""^?^ ^' ^^^^' ^^*^^ "^^-'«5 assistant^ two^dritti^'^r^^^^^^^^^^^^ dairymaid, £20; in mind irjZl,^''^l ^" T^' ^'' ' P^"^^^"' ^^'^^ "^"^^ bo borne Fortho sn f ^ these figures with those of English asylums. \Jil I ^ f ""^ comparison I add the following table fro n tl ^ .iswSri",tif /?l™'^!''!"'^««» Pf -!">"-.. with unfur. clerk of tl,o o 1 ^ ', ^"'*i""'"' *^o" per annum, non-res denl anmrn^;; r^^''%'^'P^''"^'"*)--^"« bead attendant £40 per danri8 .^"^ ^"'Y^'- r'^''''^ ''''■ ""'^^''"^ 5 three night atten- char:; attln^ nnfir''^' ''''^ ""^ ""''^ ^'' "^-^t, non-resident ; one one dittW9n ^? P-^.y, «»"»»', one ditto £27, two ditto £28 lOs., or^e sernn/? ' '"if J^^^ board, lodging, washing and uniform each with hn^'", ^Tf'"'^ ^^^' '"'° ^^^'^ ^23 l<^«-^^° ^'tto £23 atte„drnt>^.T ' ^°;?r?"^',Y'^''"^^ ^"^ ""^^^^ ? «"« tbird class h rw. l-f ' T '^- ' ^^^' '^'^ ^^^"" ^^21, each with board, lodg- cafhTvl hS 'T 1 !;"'• "'^' ' r ^^^" P°'-^«^ ^^7, one ditto £19 5?., eacn with board, lodging, washing and un^orm. iNUESEs (female dopartment).-One housekeeper and chief nurse, ^J3f> per annum, with furnished apartments, board, washin/-, &c • on orgamst, £30 per annum, with ditto ; on^ needle mistrS, £27 nr.P iT'' ^''"'^^' ^^''^'"^^' ^''^^bing and uniform , one night TZ'lfi ^'' ''''^' '''^^' "^"^ ""'"^^ P*^^ "'fe^bt, non-resident ; one night wn.ll PJ'' ''"?""'' "'"' '""" ^^1 1^«-' '-^•'^cb with board, lodging, ditt i?i'' "ri^'Sl °"' "''"''^^ ""^^« £24. four ditto £22; one ft m? / ' ''"' \"°, '^^^' '""'^ ^'^^b board, lodging, warhing and uni. nnp H-friTn ^^ass nurses £24, two ditto £20, one ditto £19 10s., fl ;!.^ 1 ' ^''''^ "^'^b board, lodging, washing and uniform: two di o If? ""p«s f 17 10s two ditto £17, one ditto £16 10s., six aitto i,16, each with board, lodging, washing and uniform. It IS stated m the last report of the Kingston Asylum that the va ue ol .he produce of the farm and garden amounted to upwards of A.i,6tv. Iwo hundred and twenty three patients porfnrmod 57 244 days work during the year. When I visited this asylum, a circum- stance which had just occurred displays in its alter-history a curious condition ot Canadian law. A male patient escaped from the asylum 20 The Insane in Canada, and made a cnminal assault, for which he was arrested and tried. In- ciedible as it may seem, the opinion of the medical superintendent of X Slhs' Wfr'r" ^«^^''>^/I^-- f-"-' ^-'i'^y, .-id sentenced to ^nL?-? • "^•°"'' "' -1'"^ "'^'''°"^ t''« •l"<'^ti..n of the prisoner's nsa ty ben.g gone mto. The Judge stated that he must be lelnt hL''' ?■?/'"/";"''' '1\ ■'^''' '''''' ""■'^ '"^-^ ->' been stated. (W four,. 7f '".'"'"'' ^ ^''""'^^ ■•^^-••^••^l ^'^"1 «^^ - '"o^t on^ St "' ^"^^^'«"/^' be surprised if he does not eonm.it Serst m w V T'"' ""^"^ \' ''?"'"' ^''^ '^berty. It is difficult to wo d o;:"f i^ ^ T ""* ^'^''''^ '" ^be criminal asylum, where he would ce.taiuly have been prevented doing any injury to society I am mformod that in the old Lunacy Act (prior to 187 Uhere maae toi tl e detention ot crunuial 'unatics in the criminal asvlum as soon as then- sentonees expired. At present the asylum^X ies a.e forced to receive all criminal lunatics and insane erin.inal be o o TSi^:^Tr "^ ^^"^-^^V^c tin,e their sentence: lu'ee^S K i; to'^A v^ un'^^^ ^?, "^l^^"'"'' "'^^^^ unfortunate fir the ivingstoa Asjlum, for it is made the repository for all these ciminals and ti.eir influence is anything but salutary. cnnmals, Jufy'iSs yeL':-"'^' '"'^'" '' '^^ ^^"^"'"" ^^^^^'^ ^'^ «"« ^«^k in Days of Week. BreakfaBt. Mouciay Rico and milk. Coffee, broad and butter. Tuesday ...j Porridge and milk. Coffee, bread and butter. Dinner, Tea. Wednesday.. Thursday .., Friday Cold meat. C'.iffee, brend and butter. Porridge and milk, Coffec!, bread and butter. Porridge and milk. CcilTee, bread and butter. Unrley sonp. Beef, potatoes and bread. RoHst bpof, pota- toes, and bread. f'n.tnrday ,..| lorridpe and milk. Coffee, bread and butter. SnnUay ...| Coffee, bread and bnttor. — . I Parley soup. Peef, potatoes and brea(b Plum pudding. Hoast beef, pota. toes and bread, Poiled tJHli. Heef, potatooa and bread. Pea sonp. Pork, lieef, pofa- looH and bread. Heans, Uoast bcof and bread. Tea, bread and bnttor. ChceRe. Tea, bread and buttor. Rhubarb. 'I'ea, bread and butter. Ten, bread and butter. Puns. 'J'ea, broad and butter. T"a, bread and butter. Klinbrrb. Tea, bread and butter. hy D. HA.CK TuKE, M.D. With this dietary may be compared that of the Porl 21 Acvi»v., /T? 1 '/, ""V- T .""'"i^"'^'^ Kuuiui Luu I'ortsmouth Boroueh ,, , BREAKFAST (daily). Females.~6ozs. broad, i.z. butter, 1 pint tea, coHee or cocoa. SUPPER (daily). Males -8ozs. bread, 2ozs. cheese or loz. butter ; 1 pint tea Fcmales.-6ozs. bread, 2ozs. cl.ee.se or loz. butter ; 1 pint ta. ad.mi'nn'nT/^*- If^'"' '"'^ ^'"^'^^''"^^' ^^'*^'^ ^''^''^^'^ «^"««» ^ud the an ma^oV io"' 1' "''T'^ '^"^^ ^^'"'^^^ ^^'"^^ "^ '^' winte'r-males ana temales. 3ozs. ot meat where ordered. tba^Tlb^^'""^""'* "'^''"^'"^'^l^'^^^^l^^^^. females ; vegetables not less Momkv''''^"""^''^'" ^""'"'^ ''''''^' "'''^'' """'^ ^^^^^\^^-. vegetables as on Wednesday.— 2 pints soup, 2ozs. meat, 5ozs. bread-males. U pint ^'-u]), 4ozs. bread— females. ^ toerrinf'nT^fr*^^''' ^^:f^-"'«l«^; lOozs.-females. lib. pota^ toes or ^Ib. ot other vegetables. Friday.— Same as Monday. ^^^ Saturday.-Ub. fish, males and females ; vegetables same as Mon- IL'if-pint of nlo dai;y for dinner, except on Wednesday, for both mahis and females. ^ Women working in laundry have bread and choese and half-pint of tea aTy"'''m' '"'"*' '"''^ '''" ^''''' '^'""''' ''" ^^''''»"«^i«y ; ^^'^^ «xtra Women scrubbing in yards have bread and cheese daily for lunch, with hall-pmt ot ale. iMon the same. ]\Ien ^^'xn•lcing in the shops or on the farm have half-pint of alo and breml and cheese at 10 a.m., anave failed, and in which a goore4tnL of '' ''"':^ "''^'^•' »^^>«»« the usually constructed asyC Ih^^^ ( «^g«-egation is exhibiteu, cottages adapted for partia ela ;^ supplemented by an annexe o v^orks well, no one who has s en t n .^lUl- ''''^' 'l,^^'^*^'"' «« this asylums will be surprised to hear. ^ ^'"" '" ^''^''^ ^' other ^ ^>'ovhire of Quebec • At (lie rote of 1(K) dollnrn or i-on , „ -"viiice B'oney has beri. borrowL \. ,, ^' '"*"■'»' AnjIu,.. }„m been rof,,,,,!,, .. < ''? additional builUi^^r '' '""' ^^•""*^« ^"^^^-s to aH«i«t i. tLeetlion of t,;' h D. Hack Tuke, M.D. g§ into Wllich it '" flivi/larl . +T. 1 providing siu.ii;i.i;7or the o't^r'Tstrtt'^'^^'l' "^^^. Q"^^-' admitted. The buildin^r w1.;m ^'^^nct Pnvute patients are prominent ob c r;i:e sf ' W °""'-'^ ^' **"^^ ^"P"'-^' i« a from Quebec-lis bu It of ml hil f "'' '" ^PP^-^aching Montreal Some of the latt^ L^/ been ad L^'lr^'^'^^ '^"^^^ «"^ "•"^«- are now in course of erection and w fT ^T-T^'' ^^^'^ ^^^^''^ tbe year. Dr. Henry How u^ 'tl . v ''V^' ^"^''^''^ *'" ^^e end of my desire to see tl^a^y^m ' / H ^ ^''''^"' ^'"'^'^ ^"«'''^^*«d Dr. R(,ss of Mon reaT Dr 'S LT -^ '/^'" P^''*^' ^«"«i«*i"g of the institution, rmust express to D?R "^ i^'"^?"' ^"^ ^^^^^f' *« for his attention and assX fC W ""'^ ""-^ ^"'*'"^ obhgations Superior, Ste. TlSse wl t h^. J '''''' ''T"^ ^^ *^« Mother conducted us through tl.ehnldfli '^'^"''^ "^ °"'' ''''^^- ^^^ manner and in Snito t^' ,?' '"'^ '"^^ "^'^.' ^^^^^^^^^ ^ her troubled her. I am Xd to hi ! / ""r'f ^"'^*^°"« ^^^h which I Ler^and the nuns ^t^^lIZ:^'^::^^:!^ ^^ ^^^^ me. I y^m Z^l^tZ^STI^r r^ '"'"^'^' *° P^«-^«"^'« ^^as:t::^.;:r^S^^^^^^ TliiT,'.«^ „. 1 • ^" ,'* '" "'" ■AMIiecavr. were shown to us bv Ste nub, 1^^ '' ""l"-.-"'r."', "" '- "•.= .».|'l'"«» >va» l„a„|,o t ,e vest time. That nuch an e.stal)lisl IlllliK jiiiiwl "t-pn la ■'■I reniarkatile to thuso who are iinent should bo conducted bv rge part taken by Winters of Cliarity in th unacquainted with the management of hospitals I 24 The Insane in Canada, in conntrios wliere tlio inflnonop of tlio Bomiin Catholic Church extendi. Theoretically, it would seem to be an admirable system, and to afford, in this way, a wide field for the employment of vom.m in occupations congenial to their nature, and calculated to confer great advantages upon the sick, whether in mind or body. That women have h\\ important vole in this field will not be denied ; but experience j>roves only too surely that to entrust those of a religious order with administrative power is a practical mistake, and leads to abuses which ultimately necessitate the intervention of civil power. The asylum ^.onsists of a succession of corridors and rooms similarly arranged, there being dining rooms, recesses, and single and associate dormitories. There are four stories uniform in construction, exclusive of the basement and the rooms in the roof, and these four are supplied with openouter gallerios or verandahs, protected by palisades. The lower stories are clean and well furnished, and the patients appeared to be comfortable. The ai)artments of the private patients were, of course, the best furnished. It was curious to see in the day rooms on the male side a nun with a female assistant. Tliey are in the wards all building that the eharaeter of the nccomnio- datioa changes fnr the worse. The higher the ward, the more unmnnagc"ble is the patient supposed to bo, i galleries and rooms bee )me more and more crowded, and they look l)ure and comfortless. The patients were for the most ))art sitting listlessly on forms by the wall of the corridor, while others were pacing tlie open gallery, which miiBt afford an aoco|)tabIe nsoapo frotu the dull mouotony of the hy D. Hack Tuke, M.D. 25 i corridor. The outlook is upon similar galleries in the quadrangle at the back of the building, Mid to a visitor, the sight of four tiers of palisaded verandahs, with a number of patients walking up and down the enclosed spaces, has a strange effect. These outside galleries a - indeed, the airing courts of the asylum. There are no others. If t' e patients are allowed to descend, and to go out on the estate, t^ v ;.^ ally do so in regular order for a stated time, in charge of attendants, like a procession of charity school children. Those who work on the farm must be the happiest in the establishment. In the fourth tier were placed the idiots and imbeciles — a melancholy sight necessarily, even when cared for and trained in the best jiossible manner, but especially so when there is no attempt made, so far as I could learn, to raise them to a higher level or edncate them. If, however, they are kindly treated and kept clean, I should feel much less regret for educational neglect than I should feel pained by the state of the patients and their accommoda- tion in the parts of the establishment next described. Far be it from me to attribute to these Sistrrs of Charity any intentional unkind- ness or conscious neglect. I am willing to assume that they are actuated by good motives in undertaking the charge of the insane, that they are acute and intelligent, and that their administrative powers are highly respectable. Their farming capacities are, I have no doubt, very creditable to them. It is not this form of farming to which I have any objection or criticism to offer. In the vegetable Idngdom I would allow them undisputed sway. It is the farming out of human beings by the Pruvinco to these or any other proprietors against which I venture to protest. It is impossible to convey an adequate idea of the condition of the patients confined in the gallery in the roof, and in the basement of this asylum. They constitute the refractory class— acute and chronic maniacs. Tliey and the accommodation which has so long been pro- vided for them must be seen to be fully realized. To anyone accus- tomed to n well-ordered institution for the insane, the spectacle is one of the most painful character. In the course of seven-and- thirty years I have visited n, large number of asylums in Europe, but I have rarely, if ever, seen anything more depressing than the conilition of the patients in those portions of the asylum at Longue Pointo to which I now refer. I saw in the highest storey, that in the roof, an ill-lighted corrdor, in which at least forty refractory mca were crowded tog(>ther ;* some were walking al)OUt, but most were sitting on benches against the wall or in restraint-cluurs fixed to the floor, the tccupants being secured to them by straps. Of these seated on the benciics o; pacing the gallery, a considerable number were restrained * I substitute thlH flK'ire for that oriKinuUy given, in conseqnonoe of the Btatomcni of «.iio of my criiiuM. I coiicludo tliat this numl.or ^l>.'Ot> m tho roof, and, that tho othoi's whom I saw occupy boila in tho storey below. Of oourae thu number of rofiuctory mou patients groatly exoeods 40. i 26 The Insane in Canada^ by handcuffs attacliod to a belt, some of tlie cuffs being the ordinary iron ones used for prisoners, the others bein- leather. Restraint I should <^aym passing, was not confined to the so-called refracto'ry wards ; for instance, in a lower and quieter ward, a man was tightly secured by a strait-waistcoat. Dr. Howard Had him released, and he did not evince any indications of violence. It was said he would tear his clothes— a serious matter in an asylum conducted on the contract system ! The walls and floor of the corridor in the roof were abso- lutely bare. But if the condition of the corridor and the patients pre- sented a melancholy sight, what can be said of the adjoining cells in which they sleep and are secluded by day ? They are situated between the corridor and a narrow passage lighted by windows in the roof. Over each door is an opening the same length as the top of the door and 3 to 4 nichos m height, which can be closed or not as the atten- dant wishes llns aperture is, when open, the only means of liyhting the cell. The door IS secured by a bolt above and below, and by a padlock in the nnddle. In the door itself is a guichet or wicket, secured, when c osed, by a button. When opened, a patient is just able to protrude the head. There is, as I have intimated, no window in the room, so hat when the ai.erture over the door is closed, it is abso- lutely dark. 1^ or ventilalion, there is an opening in the wall opposite the door, which communicates above with the cupola; but whatever the conmuinication may be with the outer air, the ventilation must be very imperfect. Indeed, I understood that the ventilation only comes into operation when the heating api-aratus is in action. What the con- dition of tuese cells must be in hot weather, and after b.ung occupied all night^nd, in some instances, day and night, may be easily con- ceived When the bolts of the door of the first cell which I saw opened were drawn back and the padlock removed, a man wis seei crouching on a straw mattress rolled up in the corner of the ix)om, a loose cloth at his feet^, and I e stark naked, rigorously restrained by aiHCuffs and be t. On being spoken to he rose up, dazzled with the light and looked pale and thin. Tiie reason assignid for his seclusion and his manacles was the usual one, namely, "he would tea- his clo hes If free. Ihe door being closed upon this unfortunate man, we heard sounds proceeding ficni neighbouring cells, and saw some of and w s designated I havmc nmuwu, was similarly manacled, lu his cell there was not anything whatever for him to lie or sit apon but the bare loor. He was clothed. Some of the cells in this gallery riall In 1 n'' ?' l""'1r;''^' *Y'"" ^Vi"^J-t room to stand between the^vullaIul he bed. When there is no bedstead a loose palliasse 18 lai.l 01. (he floor, which may be quite proper. In reply to my enquiry, the Mother Superior informed me that it was f^rcLeutly necessary to strap the patients d<.wn in their beds at niVht ^ Tassmg from this gallery, which I can only reganl as a "chamber of horrors, we proceeded to the corresponding portion of the build- hy D. Hack Tuke, M.D. 2f ing on the female side. This was to me even more painful, for \rhen, after seeing the women who were crowded together in the gallery, on benches, and in fixed chairs, many of whom were re- strained by various mechanical appliances, we went into the narrow passage between the pens and the outer wall, the frantic yells of the patients and the banging against the doors, constituted a veritable pandemonium. The effect was lieightened when the guichets in the doors were unbuttoned, and the heads of the inmates were protruded in a row, like so many beasts, as far as they could reach. Into this human menagerie, what ray of hope can ever enter? In one of the wards of the asylum I observed on the walls a card, on which were inscribed words to the effect that in Divine Providence alone were men to place their hopes. The words seemed to me like a cruel irony. I should, indeed, regard the Angel of Death as the most merciful Visitant these wretched beings could possibly welcome. The bolts and padlocks were removed in a few instances, and some of the women were seen to be confined by leathern muffs, solitary confinement not being sufficient. One of the best arguments in favour of restraint by camisole or muff is that the patient can walk about and need not be shut up in a room, but wo see here, as is so often seen, that unneces- sary mechanical restraint does not prevent recourse being had to seclusion. A cell, darkness, partial or total, a stifling atmosphere, utter absence of any humanizing influence, absolute want of treat- ment, are but too often the attendants upon camisoles, instead of being dispensed with by their employment. When such a condition of things as that now described is witnessed, one cannot help appreciat- ing, more than one has ever done before, the blessed reform in the treatment of the insane whicli was commenced in England and France in 1792, and the subsequent labours of Hill, Charlesworth and Conolly. But it is amazing to rellect that although the superiority of the humane mode of treating the insane, inaugurated nearly a century ago, has been again and again demonstrated, and has been widely adopted throughout the civilized world, n colony of England, so rennirkabie for its progress and intelligence as Canada, can present such a spectacle as that I have so inadequately described as existing, in the year of grace 188-4, in the Montreal Asylum. Before leaving the asylum, 1 vi.sited the baseuieut, and found some seventy men and as numy women in dark, low roouis. Tiieir condi- tion was very similar to tliat already described as existing in the top- most ward. A good numy were restrained in one way or another, for what reason it was dilHcult to understand. Many were weaktninded, as well as supposed to be excitable. The patievits sat on benches by the wall, the roomn being bare and dismal. A large number of beds were crowded together in a part i)f the basement contiguous to the room in which the patients were congregated, while there were single cells or pens in which patients were secluded, to whom I spoke through the door. The herding together of these patients is pitiful ^8 The Insane in Canada, to behold, and tlie condition of this nether region in the night must be bad in th*^ extreme. I need not describe the separate rooms, as they are similar to those in the roof. The amount of restraint and seclusion resorted to is, of course, large. Yet I was informed that it ■was very nnicli less than formwrly. To the statement in regard to the crowding of the patients in this asylum, it will be objected that I have given a description of a state of things which will shortly disappear, as additional wards are being provided i'or their accommodation. While I am glad to hear that other rooms will be available before long, I am not by any moans convinced that the lowest and topmost wards of this asylum will be disused for patients. There are now, the Mother Superior said, about 1,000 lunatics in the build- ing, and when first informed that new wings were being prepared, I concluded that it was for the purpose of providing increased accom- modation for the existing number of iimiates onl). That hope, however, was greatly lessened, if not wholly dispelled, when I learnt from this lady that when those new Hvards are ready there will be room in the institution for 1,400 patients. It is said the new rooms will contain GOO beds, but how many cubic feet are allowed in this calculation I do noc know. I have no hesitation in saying that when the patients are removed who now occupy the two portions of the building 1 have doscribtd, and when the occupants of the other galleries are reducotl lo the number the latter ought properly to accommodate, there would be at least 400 patients who should bo removed from the old to the new building. If I am correct in this opinion, the jjrosent lamentabL evils will continue after the opening of the additional apartments, or if they are mitigated for a time, they will but too surely be renewed as fresh admissions take place. Assum- ing, however, that ovorc/owding is lessened, and that these dark cells should cease to be used, what guarantee — what probability — is there, that the manacles will fall frum the wrists of the patients of this asylum ? I am not now siioi king from the standpoint of absolute non-rostraint in every concoivaMe instance of destructive mania. It is snflicient to hold that the necessity for mechanical restraint is excep- tional, and that in proportion as an asyhmi is really well managed, the number whose movonionts are confined by muffs, strait-waistcoats and handcuffs will become fewer and fewer. The old system of treating the insane like felons has boon so completely discarded by enlightened physicians devoted to the troatmont of the insane, that it can no longer be regarded as peiniissible in a civilized country. The astonishment which I experienced in witnessing this relic of barbarism in the Province of Quoboc is still further inoi'Oi(sointment of a resident medical officer. The official x.sspection of this institution must now be referred to. When I was at the Quebec Asylum (Beauport) I obtained a copy of the report of that establislnnen"'t. The names of three inspectors of the asylums and ]irisons of the Province are there given, namely, Drs. L. L. L. Desaulniers, A. de iMartigny, and Mr. Walton Smith. They report to tlie Provincial Secretary, who resides at Quohec, and is the Government officer to whose department these institutions pertain. I was informed that the visits of the inspectors are due three times in the year. The Grand Jury are empowered, when they meet, to visit asylums and niidce a presentment to the Court in regard to their con- dition, but I understood that this is generally a very formal proceeding. With regard to the authority of the visiting physician apiiointed and paid by the Government, it has been hitherto, so far as I could ascer- tain, almost, if not entirely, nil. His hands have been so tied that he could not he held respons'ible for tlie way in which the asylum has been managed. Tie (Quebec .egislature passed an Act in June last which has only just come into f n-ce, and which, among other provi- sions, extends and eufoi'ces the authority of this ollieer. It remains to be'seen wnether tl.i-. Act iuvests him with suflicient power to earry out any system of troatmout or classidoatiou of the patients which lie may deem requisite. 80 The Insane in Canada, ^ There should, however, in any case, be a medical superintendent, with competent knowledge of the treatment, moral and medical, of the insane, with undivided authority and responsibility inside the institu- tion, although subject to the Government, aided by efficient medical inspection. Should the contract system be abolished, should capable medical men be placed at the head of the institutions of the Quebec Province, and should inspection made by efficient men be sufficiently frequent and searching, the asylums for the insane of this Province would be- come institutions of which Canadians may be justly proud, instead of institutions of which they are now, with gooil reason, heartily ashamed. Beaupu.t 4-oi'liim, Quebec. I visited the Beauport Asylum, at Quebec, Aug. 18, 1884. It was established in 1845 ; additions were made to the original building in 18Go for the male patients, and iii 1875 for the female patients. The medical &uperintendents reside in the city, several miles away, and I had not the pleasure of seeing tliem. There are two visiting physicians. The asylum is inspected by Dr. Desaulniers, Dr. A. de Martigny, and Mr. Walton 8mith. Resident on the premises is the warden, and in the vicinity is an assistant physician. I have to ex- press to both these gentlemen my obligations for the kind way in which they received me, the time they devoted to my visit, and their readiness to show me the various parts of the building. My thanks are especially due to Mr. A. Thomson, of Quebec, for the assistance he rendered and for accompanying me. The asylum is a striking object to visitors to the Montmorency Falls as they pass along the road where it is situated. The approach is pleasant and the entrance attractive, being marked by the taste and cleanliness which characterise the dwellings of the Canadians gener- ally. The warden received us politely, and took us round the building devoted to female patients. His wife occu{)ies the post of matron, and has two assistants under her. The corridors into which we first Avcnt are sufficiently spacious, and serve the purpose of day- rooms to a large extent, the patients being seated or walking about. The patients here were well dressed, and appeared to be ..s comfortable as their condition would allow. The associated dormitories are large, cheerful rooms, well ventilated, and the beds neat and clean. I sup- posed that the linen had been clean that morning, but was informed th:it it was the last day in use, and was changed weekly. Strips of carpet and mats in the dormitories, as well as in the corridors, relieved the bareness of the floor. Tlie position and construction ' a series of single bedrooms attached to the wards are most uni> rtuuate. They are placed back to back, so that there is no window in J\e\n, the narrDW passage which skirts them receiving light from a window at either end. There is an by D. Hack Tuke, M.t). SI aperture over the door, and a small one in the door itself. The ventilation is most imperfect, and it was not denied that in the morn- ing their condition is the reverse of sweet. Home of these cells — for cells they must be called — were very close when I visited them. How such rooms came to be built for lunatic patients, for w.iom good uir and sufficient light are so important, it is difficult to comprehend. I was informed that they were planned to expedite the escape of the inmates in casi of fire, there having been a conflagration some years ago in which twenty-six patients perished, but I failed to see the fit- ness of such an arrangement. It appt-ared to me to be due to the desire to economise room, and I am not suri)rised to find, from one of the annua^ rep.'-ts given me, that credit is claimed on the ground that the cost for care and maintenance is less than at ten asylums with which the Beauport Asylum is compared. I have spoken favourably of the associated dormitories opening into the corridors. Those, however, in the attic were very gloomy and crowded with beds. I have also referred favourably to the dress of certain patients, I must add that in some parts of the house they were barely clad, n.nd pres''nted a very neglected appearance altogether. The number of women in restraint was very considerable. Some wore the manchon or muff, others the close glove {mitaine) ; others were restrained by leather wristbands Qwignet) fastened to a belt, while some were secured by the gilet de force, so that movements of the arms were effectually prevented. Several were secured to the bench on which they were seated. In one small airing court upon which I looked down, not a few were restrained ; the whole company appeared to be unattended, or if there were attendants, the latter did not consider it a part of their duty to keep their dress in decent order. In referring to mechanical restraint, I do not judge of the condition of the patient, from the total non-restraint point of view. The amount resorted to in this asylum would not be seriously justified by any physician of the insane with whom T acquainted, whatever his views on non-restraint may be. After leaving the building in which the women are located, we walked into the grounds over a stream to a steep, grassy, airing court, which was fortunately shaded from the blazing sun of that day. Here a number of female patients were congregated, with one or two attendants. A wooden fence separates this ground from a correspond- ing grass plot for the men. From a window in the building for the latter sex I looked down subsequently, and the sight of the female patients lying or sitting on the grass in uii& ^mly attitudes, and with scant and neglected attire, did not commend itself as one altogether desirable. The number of attendants is quite insufficient, and I cannot say I was favourably inipiesse i with their appearance. Where 60 much importance is attached to economy, this cannot excite eurprise. Their pay is very insufficient, a.'- well as their number. ^ The Insane in Canada, Passing to the building for the male patients, over which the resident physician escorted ns and manifested the greatest willingness to show every corridor and room, I would observe that there are certain wards which, like those for the corresponding class of women, are both clean and respectably furnished ; but when I have done justice to the accommodation afforded in these galleries, I have said all that I can say in the way of commendation. The higher one ascended in the building, the lower the condition of the patient — the corridors were much crowded, and the anvunt of mechanical restraint excessive. In the worst ward, the sight was in the last degree painful to witness. Here were some thirty patients. Some had leathern mnffs, others the belt and poignet, while seve'-:.! were in cells as dark as those on the women's side, and were also /estrained. One had his legs fettered at the ankles. There were also several men in restraint- chairs, to which they were fastened, and not only so, but they wore muffs. They were in their shirts, and over their exposed persons flies were crawling in abundance — a spectacle which it must suffice to describe without characterizing further. Among patients of the class now referred to, I counted fourteen restrained, but I do not pretend to have noted them all. For a man who was given to scratching his face, it was considered necessary not only to secure his hands by the muff, but to place him in a crib-bed. But it is needless to describe in more detail an institution which, however willingly I may praise where praise is due, is so radically defective in structure and so fundamentally differe 'u from any well- conducted institution of the present day, in the maUer of moral, to say nothing of medical, treatment, that no tinkering oi the present system will ever meet the requirements of humanity and science. I regret to write thus. It is a thankless task for a visitor, courteously treated as I was, to criticise any institution which the officers permi*- him to inspect. But I write in the hope of hel})ing, in howev/ numble away, to bring about a reform in the injurious practice of the State contracting with private individuals for the maintenanc >f its insane poor. The proprietors receive 11 dollars (4:58. lOd.) per liead per month for maintenance and clothing. This system involves the probability of patients being sacrificed to the interests of the proprietors. It has the diastrous tendency to keep the dietary as low as possible, to lead to a deficiency in the supply of clothing, and to a minimum of atteiulants, thus inducing a want of proper attention to the patients and an excessive resort to mechanical restraint, instead of that individual personal care which is no needful for their happiness and the promo- tion of their recovery. I consider that the number of attendants in such an asylum should not be less than 1 in 8,* instead of I in 15 ; and that a higher class sliould bo obtained by giving higher wag s. At present tiiey are as follows : 9 to 10 dollars a month iu winter for * So in original MS., but iu tlie " Canada Modicid and Surgical Journal " the number 7 appears, owing to the writer's hnaty oovrectiou ot proof isi travelling. by D. Hack Tuke. M.D. m male attendants ; 12 to 14 in summer. Women attendants have 5 to 6 dollars a month, or £12 to £15 a year. With a higher class, it iniglit no longer be an irony to speak, as the chaplain does in one of the Ixeports, of " tlie good and virtuous keepers who are selected with great discernment." I venture also to express llie hope, in conclusion, that the Province of Quebec will itself umlectake the responsibility of [)roviding the necessary acconiiuodation fur its insane poor and their skilful treat- ment, that a resident medical superintendent, with full authority, will be appointed, and that there will be a Board of ]\[rnagement, as well as really efficient inspectors. Since this article was written, the following has appeared in the " Canada Medical and Surgical Journal," November, 1884 : — " At a largely attended meeting of the Medico- Cliirurgical Society of Montreal, held on Nov. 7, the following resolutions were unani- mously passed : — '* 1. That this Society has every reason to believe that the state- ments contained in the lieport of Dr. 1). Hack Tuke, of London, England, upon our Provincial Lunatic Asylums, are, in every material respect, true and well-founded. " 2. That these statements show a most lamentable state of things as regards the general, and especially the medical, management of these Listitutions. " 3. That it appear^ to this Society to be the imperative duty of the Provincial Government to institute a thorough investigation by com- petent persons into the entire system of management of the insane poor in this Province. " 4. That the ' farming ' or ' contract ' system, either by privjite individuals or by private corporations, has been everywhere practically abandoned, as bei':g prr judicial to the best interests of the insane, and producing the minimum of cures. " 5. Tiiat in the opinion of this Society all establishments for the treatment of the insane should be owned, directed, controlled and sufiervlsed by the Government itself, without the intervention of any intermediate {larty. " 6. That the degree of restraint known to bo employed in our provincial asylums is, according to the views of the best modern authorities, excessive. That the ablest European, American, and also Canadian alienists have almost entirely given up any method of mechanical restraint. That these facts call urgently, in the name of humanity, for reform in this direction in our provincial asylums. " That this Society concurs fully in the opinion already expressed by Dr. Tuke in his Report, to the effect that ' the authority of the Visiting Physician (Dr. Henry Howard), appointed and paid by the Government, has been hitherto almost, if not entirely, nil. His hands have been so tietl that he could not be held responsible for the way in which the asylum has been managed.' " i