H.—l

6

part, sufficiently neat and clean in dress and person. Making allowance for defects attributable to the numerical insufficiency of the staff, and to the faulty construction, of the building, the establishment was in a tolerably satisfactory condition. I feel it my duty, however, to offer the following observations and suggestions respecting the Asylum. The buildings, in my opinion, are altogether inadequate to the safe keeping and proper treatment of insane persons. Originally designed for a totally different purpose, additions have been made from time to time under pressing necessities, but these having formed no part of a well-devised general plan, are in nearly every respect wanting in the essential characters of a hospital for the insane. After very careful examination and consideration, I would advise that no further outlay be made on the existing buildings, except for such repairs as may be absolutely and urgently necessary to preserve them in a temporarily habitable condition. In place of the present structure, I would recommend that a new Asylum be built on elevated ground behind the old site, and that as much land be secured in its immediate vicinity as will give ample space for airing courts, gardens, and pleasure grounds, for the recreation and employment of the patients, as well as pasturage for one or two horses and some cows for the service of the establishment. Nothing more conduces to the health and happiness of insane persons, who have been used to agricultural life, than regular work on a small Asylum farm. In many cases the employment is curative in its agency, whilst it has this additional recommendation, that under judicious management it materially contributes towards the maintenance of the institution. The following was the strength of the resident staff at the time of my visit: —1 keeper, who is also general manager; 1 matron, who is also general housekeeper and cook; 3 male assistants, and 1 female assistant. I learned on inquiry that the salary of the keeper was £150 a year; of the matron, £70; of the male assistants, from £60 to £70 each; and of the female assistant (a girl fifteen years old), £30. Quarters and rations are also allowed to each member of the resident staff. I was informed that the keeper always slept on the premises, as also did one of the male assistants, but that two of the latter were allowed to go home every night, unless they were kept on duty for a special case by order of the keeper. I was further told that the matron and the female assistant always slept on the premises; but if either of them were absent on leave at any time during the day, and difficulty arose with a female patient, it was the practice to call for help from the keeper or one of the male staff. I was surprised to find that no systematic provision was made for watching the patients or premises by night. It is highly desirable to make arrangements for supplying this deficiency without delay, partly with a view to the proper care of epileptic and feeble patients, who need attention in the night as well as in the day, but chiefly to protect the inmates from the fearful consequences which must ensue if a fire were to take place at a time when they were locked within their rooms and no one was on the alert. I think a man (in addition to the present staff) should be specially employed for night duty. He should move through the male division, and round the outside of the female divisions, at frequent intervals. His movements should be checked by means of tell-tale clocks placed at suitable points, and he should have very exact instructions as to his course of proceeding in case of fire. With regard to the female staff, I would suggest that two additional assistants be appointed who should assist the matron as occasion may require in the care of the patients, and in the general domestic duties of the house. It is wrong in principle, and utterly objectionable in practice, to employ male assistants in the management of excited insane women. If suitable female assistants were selected, of ages between twenty-five and thirty-five years, there would be no need for them to seek assistance from the male staff unless under very rare and exceptional circumstances. In answer to questions about supplies of medical comforts, provisions, clothing, bedding, &c, I was told by the keeper,—l. That the medical officer ordered whatever he considered necessary for the proper treatment of invalid patients. 2. That provisions were supplied under contract, but that there was no fixed dietary scale. I would recommend the adoption of a regular diet scale in accordance with the almost universal usage in large institutions. 3. That clothing and bedding were purchased by the keeper, who passed accounts monthly. These articles appeared to be good in quality and sufficient in quantity. I would, however, suggest the advisability of taking supply by contract, as tending to secure uniformity and economy of service. Medical visitation of the Asylum is made daily (as I was informed) by Dr. Boor, the resident surgeon of the adjacent hospital. This arrangement appears to work well, and may be deemed satisfactory for the present small number of patients. Increase of number, and the opening of a new establishment, will, however, in all probability necessitate, at no distant period, a complete change in the mode of medical attendance and management. E. Paley.

APPENDIX I.—D. . Dunedin Lunatic Asylum. On the 22nd of August, and on the 25th, 26th, and 27th of September, 1872,1 made official