REPORTS ON LUNATIC ASYLUMS IN NEW ZEALAND.

5

D.—No. 29

£ s. d. Matron ... ... ... ... ... ... ... 60 0 0 Two Female Nurses, £42 each ... ... ... ... S4 0 0 Cook ... ... ... ... ... ... ... 66 0 0 Musical Instructor ... ... ... ... ... ... 25 0 0 Eations ... ... ... ... ... ... ... 1,410 0 0 Light and Fuel ... ... ... ... ... ... 130 0 0 Clothing, Bedding, &c. ... ... ... ... ... 350 0 0 Amusements ... ... ... ... ... ... 20 0 0 Contingencies ... ... ... ... ... ... 50 0 0 £1,990 0 0 On this year's Estimates, I find the following under the head of Lunatic Asylums:— £ s. d. Eesident Surgeon ... ... ... ... ... ... 250 0 0 Inspector ... ... ... ... ... ... ... 52 0 0 Head Keeper ... ... ... ... ... ... ]20 0 0 Senior Keeper ... .. ... ... ... ... 66 0 0 Four Eesident Keepers, £54 each ... ... ... ... 216 0 0 Matron ... ... ... ... ... ... ... 60 0 0 Two Female Nurses... ... ... ... ... ... 84 0 0 Cook ... ... ... ... ... ... ... 60 0 0 Musical Instructor ... ... ... ... ... ... 25 0 0 Eations ... ... ... ... ... ... ... 1,600 0 0 Fuel and Light ... ... ... ... ... ... 140 0 0 Clothing and Bedding ... ... ... ... ... 400 0 0 Amusements ... ... ... ... ... ... 25 0 0 Contingencies ... ... ... ... ... ... 90 0 0 Additional Cells, &c. ... ... ... ... ... 200 0 0 Expenses under Lunacy Act ... ... ... ... ... 50 0 0 £3,438 0 0 General Observations. Under this heading I intend to mention, as briefly as possible, several matters of great importance in connection with the institution. The first is with reference to Inquests upon Beceased Patients. In this respect a difference of opinion has arisen between myself and Dr. Goldsboro', the Coroner for the Asylum. That gentleman considers it to be his duty to hold an inquest upon every patient dying at the Asylum. I hold, and have maintained, that it is only necessary that inquests should take place in cases iv which they would be necessary if the death took place outside ; and that it was only putting the Province to an unnecessary expense to hold inquests on the deaths of patients ailing for many months, and dying of known diseases. I deemed it my duty to object to the holding of inquests in such cases, and beg to forward herewith copies of correspondence which has taken place between the Asylum authorities, the Provincial Government, and myself upon the subject. The matter is also alluded to in my half-yearly report for June, 1869. In the event of any alteration or amendment of the Act, I would suggest that this subject should bo dealt with in such a way as to remove any doubt. Alterations and Improvements in the Treatment of Patients. In reply to a memorandum forwarded by me to the Eesident Surgeon, requesting that he would furnish mo with such observations and suggestions as ho considered the Government should be made acquainted with in connection with the future management of the Asylum, I have received a very full report. I make the following extracts, bearing upon the subject of alteration and improvements in the general system of treatment: — " There are certain patients in the Asylum to whom confinement is irksome, and who would certainly be more likely to improve were they placed in a position where, under a certain surveillance, they might enjoy the feeling of being at liberty. Tho class of patients to whom I more particularly allude embraces some cases of melancholia, with or without a suicidal character. Although afflicted with delusions, they are conscious of their position, and occasionally manifest a strong desire to escape, as much, perhaps, from the belief that by so doing they would leave their sorrows behind them, as from any dislike to the Asylum as such. These patients are, for the most part, less disposed to inflict an injury upon others than upon themselves, and require the closest possible surveillance. I have known several cases in private life which, after being subjected to years of the most careful surveillance, were at last terminated by suicide, the unhappy victims, having contrived to elude the vigilance of their guardians. It is my impression that there is less risk of the latter occurring in an Asylum than in a private house. " There is another class of patients which would most likely derive benefit from a removal from the Asylum at a particular stage of their complaint, namely, those who having passed through the primary stage of acute mania, and been relieved from the urgency of the symptoms peculiar to it, begin to appreciate the peculiarity of their position, and to express their opinions upon the imaginary injustice of which they are the victims. These patients must either progress more or less steadily towards recovery, or lapse into dementia. The latter is much to be feared, except some decided change is induced by bringing them under the influence of new and, if possible, varied impressions ; where means permit, travelling is the appropriate remedy at this stage of the disease. It is quite certain, 2