ASYLUM INQUIRY.

Dominion, Volume 7, Issue 1868, 30 September 1913, Page 9

ASYLUM INQUIRY.

DOCTOR'S EVIDENCE. OTHER SIDE OF THE STORY. PATIENTS AND THEIR WAYS. NATURE OF THE TREATMENT.. (By Telegraph—Preea Association.) Christchurch, September 29. Tho Sunnysido Mental Hospital inquiry was continued to-day before Mr. .V. U.' Day, Commissioner. ' ■ Dr. Ilamsbottoin, assistant-medical officer, was the first witness called. Ho said that when a patient caino. in lie was put to bed for the first two or three days until'the caso was observed. ■_ For the first twonty-eight days his friends could not visit him except in caso of sickness, tho reason being to allow tho patient to settle down uninterrupted, by converse with his friends. Tho patient Howio was put into a -singlo room as he was restless and would have interfered with other patients if ho had been put into a dormitory. Ho used to wander round his room most of the night.

Was Howie's deterioration to bp expected from tho condition he was in? ■ Witness: Yes. It was impossible that ho should do anything else. He, had excessive mental and muscular activity with very little sleep.' ! Do you remember the'fact /that he' had black eyes?—'' Yes." _ . _ You got a report' concerning it? — To what effect ?—"That ho had been falling about his room ; during the night." ; : ; _ ■ ' .... You were satisfied \yith that explanation? —"Yes." Ho was in a condition of mania?— "Yes; but more restless than violent.". You go tho rounds with tho head attendant every'morning?—"Yes." . , v And any patients requiring attention you see to ?—"Yes." . Later on in. tho morning you K° round with the medical superintendent? -"Yes." ... In the. afternoon you attend to any cases that need "attention?—" Yes;" Continuing witness said that he was busy with other work for the rest of tho afternoon. In the evening he went round again to see if any case required attention. Ho also made tho rounds of tho building at night.

• Howie's Treatment and Diet. Did; you inquire from Howie about the black eye?—"l expert I did, but I don't know what reply ho gave." If ho had made a reply, in the shapo !of a complaint would you be able to recall it?—" Yes." What would you have-done in that case?—" When .an ordinary ■ patient r lake a a-complaint I hayo him brought into the ward and stripped to' see if he has any injury." And if he made, a complaint regarding ill-treatment r 1 — I "That;would "be gone into, aikl I would report .to tho ■medical superintendent." What wa3 his condition as to dress P— "Ho was untidy." He was in a state of irritability "Yes." ' • 1 ■/' ' ; A statement was made that he got nothing between . meals P —"That is wrong." What did he get?—" Generally bread and milk for breakfast, some beof tea at ll a.irf., dinner; at 12.30 an egg and milk in the afternoon, and tea at 5 p.m. During the niglit lie had hot milk'frequontly. : \ and "'SortSinTy. &rf-foftß occasion—probably got brandy' wild', milk. ' ; • On the Saturday before . his death he' bad an'attack of pnetim'onia?—"He got - it on .Saturday evening, and his . temperature. was then 102.' It was much better, witness added, in reply to a question on the subjett, for old men patients to be up' and dressed a3 much as possible. It prevented bed sores.' You saw the patient on ' Saturday night?—'"Yes,, and on Sunday at : least twice—probably three times. On Monday morning his heart gave out. He was too old, to .resist an attack of pneumonia." ' ! , '''■ 1 As to his swelled "feet P—"That was due to heart disease, and consequent deficient active' circulation.!' . _ | Witness here oppressed the , opinion that, in .special cases, women nurses, should be engaged. I 1 , The Commissioner! Not for general cases?—" No." '• For special occasions women are better than menP—"Yes. Thq avorago woman makes a better nurse./

The Barrett Case. Was Sidney Lionel Barrett in a state of melancholia when lie was admitted? —"Yes—agitated melancholia. Ho (Barrett) had, a delusion that ho had different kinds of disease, that he was wasting away, and would only live for a few days. He said that ho never slept, but, several nights when I went to his room I found hi'm 'asleep. Next morning when I asked him how ho had slept he replied: "Not a wink." I never said that he was.not fit for work. 'The reason that he was not working was that he was under special observation. As far as his bodily health was concerned ho was quite fit for work.

Those Black Eyes.' Regarding tho Tribe case witness said ■ that he saw Mr. Tribe shortly after he was admitted. From the first Tribe had . delusions of various sorts. He would . be coherent for a fow. minutes,' and then becomo delusional. Afterwards ho lost his delusions to a largo extent, but he ; also lost his memory. He was extremely ' excitable,-and interfered with other pa- ... tionts, tho result being that he r.eceiv•cd a black eye from another patient under Tribo was a pationt who should havo been kept apart from others, but it was impossible to isolate him. There were 120 patients in the airing court (about 40 yards square) at tho time the trouble happened, and . it was impossible to do moro than was done to keep patients apart. Such a thing as a black eyo was bound to occur'in the case of an excitable patient who interfered with others. Habits of Mr. Tribe.

Tribe, was .always untidy, but cot worse, and his clothes had to bo changed several times a day. At times ho threw off his clothing and lost all sense ' ,of respectability. This state of affairs was not told the patient's friends when ithe.v camo to see him, for it was not desired to distress them. The attendants frequently complained of Tribe's habits. Classification according to rank was an impossibility, but there was classification according to derangement and that was the only, system possible. A man brought tip in- refinement froqucritlv made the worse natient, and that was what happened "in Tribe's case. The ordinary feelings and instincts were all gono or perverted. Tlio bedclothes which Tribe had woro finite sufficient. He had . three pood blankets. The bed was on the floor which was the usual practice. , There vis iin artificial heat in tlio room, but there was a fire in the ward. There was; l'licheated rooms available for Mr. Tribe The: enileptio ward, .with 22 beds, was heated, but was _ quite full. Tribe's room was similar to a _ series of ' rooms ' in . thp building.

■ , ' A Safoty Measure With Patients. In D, ward the patients undressed in ihe ward and in 0 ward in tho corridor, tho doors being locked while the ' patients undressed. That was a measure of safety 'to prevent injury to patients or warders in case of patients

who had suicidal or homicidal tendencies. Cases had happened where patients had tried to smuggle stones, and other ( things in with tneir clothes, it would not oo liccessary in all cases to compel patients to undress in tho corridors, >ut somo regular practico nad to be followed, and ono never knew when a patient might develop suicidal tendencies. Such patients were of coiirso kept under special obervation, and tho doctors knew best, what to do in such cases. Tho corridors, were not open corridors, but were well sheltered, bach patient undressed outside his own door. JLc was beneficial for a patient not to bo seen for a certain time after admission. Mr. Tribe was on special diet while in D ward. Tho ordinary diet was bread and butter and tea for breakfast, two courses for dinner, and bread and buttor and tea for tea. No special record was kept of tho dieting or infirmary patients, and no record was kopt- in the caso of Mr. Tribo, for ho showed no special symptoms. Ho died from exhaustion through emaciation. He was not tho sort of patient who would havo appreciated being shaved. When the doctors went their rounds all patients had full opportunity to speak to them. Tribe's physical condition became weaker on account of excessive mucular action. His feet were injured for tho reason that ho often went about without his shoes .or stockings on. On June 12 an attendant mentioned 'tho injury to his'toe. ■On June 19 Mrs. Tribo complained about her husband's foot, and he told her that it was tho first that ho had heard of it. After that day Tribe was transferred from , C to D ward. Witness saw Tribe, and asked him " why ho had not spoken about his foot, and Tribe'replied that he., wanted to tell his wife first. The foot was swollen and inflamed and there were one or two cracks in the skin. It would be painful, but not excessively so. Thero was no broken skin with the exception'of, the cracks,iand no Suppuration. Tho caso was merely one of ordinary inflammation and did not affect Tribe's general health. Tho foot was treated and, next day, was slightly improved. On Saturday, Juno 21. lie saw tho foot again and found that tho swelling and inflammation wefo subsiding. On Sunday, June 22, ho saw Tribo again . and found him in low physical condition. Up till that day he had no reason to think that death was ' near. Ho had Been many patients quito as emaciated as Tribe recover, but tho emaciation would perhaps lead outsiders to think that Tribo was dying. He saw Dr. Gow on' Sunday amf told him' what Tribe's condition was. On Thursday orders were given for a special diet, and on the day before he died, brandy was given. On the Monday, when it was riecidod to remove' Trite from the institution, an injection of morphia and strychnine was given. Tribe was then in a comatose state. He knew on Sunday night that Tribe was, dying. It would not be tho duty of an attendant to call the . doctor when a patient becamo i comatose. , To the Commissioner: It would bo an attendant's duty to call tho doctor when any gravo change took place in a patient's condition. ' \ Continuing, witness said that tho caso was not one which required a post mortem. i ' Regarding . Gourley's caso witness said, that tho first notes (on Gourlay's admission in May, 1912) were to 'thii effect that l the , patient was emotionul and argumentative, and was quito rightly retained, not being sane. Complaints made regarding Gourlay's bed-, clothes would have been'attended to but he (witness) had received no complaints.

A Patient's Ears. < Regarding Herlihy witness said that the case was one of chronic insanity. The state of Herlihv's ears might have been caused by'violence or by . natural means. Tho ear) however,' constituted what was known as "insane ears." He had' never 'heard of Herlihy being 'illtreated, for ho was a general favourite with the patients and staff. The attendants did for Herlihy what they would not do for other patients. Part of the treatment of the patients was to make them go out, to work. • Continuing, witness said that Gourlay, on admission, was put in F ward. That was the ordinary admission ward, and was the ward where the most refractory patients were kept. In reply to counsel Dr. Ramsbottom said that Tribo was rational occasionally, but his habits and speech were distinctly abnormal. There were 700 patients at Sunnyside, and that number was too largo lor two medical moil to attond to'. He was of opinion that , the lolothea. provided 'for patients should fit them better than they do.. Dr. Ramsbottom admitted that, if tho money were availablo, it would be possible to ..provide for tno classification of patients 'at Sunnyside. There' was a ward at the institution that approximated tho German system of villa wards. Of tho patients admitted to Sunnyside last year 60 per cent, had recovered. :

Evidence as.to the careful way in which the attendants.treated the patients was g'iven by the Rev. F. Rule, and tho inquiry was- then adjourned. The commissioner will visit Sunnyside to-morrow, and further ovideiico will be heard on Wednesday.