133
Art. X.?LUNACY IN IRELAND.
The Twenty-fifth Keport on the District, Criminal, and Private Lunatic Asylums in Ireland has been sent to us for notice, and it contains many interesting particulars relating to the care and management of the insane in Ireland. On the 31st of December, 1875, there were 11,777 persons of unsound mind under the supervision of the Lunacy Board, making 194 more than last year at the same period. The following summary of the distribution of the insane is
given:? In In In In In In
District Asylums Central Criminal Asylums Lucan Government Asylum Private Asylums Poorhouses Gaols .
.
Male
Female
Total
4,142
3,599
7,741
38 12 382
172 29 653
1,275
1,904
3,179
5,840
5,937
11,777
134 17 271
1
2
3
The Commissioners give a comprehensive summary of the working of district asylums during the last twelve months. On the 1st January, 1875, there were located in district asylums 7,585 patients?4,072 males, 3,513 females. We are told that during the year 2,132 were admitted, namely, 1,095 males and 1,037 females, of whom 1,777
cases?906 males, 871 females ?and 355 cases 189 being men, and 166 women. During the same period 939 were discharged cured?470 males, and 469 females; and as improved 236?119 and 117 respectively of either sex. Fiftysix were brought home?41 males and 15 females?not recovered, but tranquil and amenable; while 3 males effected permanent escapes. Seven hundred and forty-two patients died?391 males and 351 females, all from natural causes, save 6?2 from accidents, and 4 from suicide ; on these exceptional deaths coroners' inquests were duly held, and, though with fully exonerating verdicts, the occurrences are to be regretted. There appears from the preceding general data that there was a total of 9,717 lunatics under treatment in the course of the year, and at its close 7,741, or 156 more than on the 31st December, 1874, in Irish district asylums ; of which total 4,412 were males and 3,599 were new
previously under treatment,
females.
The mortality has been greater among females than among The Commissioners report favourably on the general males.
134
management of therein adopted.
LUNACY IN IRELAND.
these The
institutions, and upon the treatment percentage of recoveries are nearly the
as last year, being 43*70 on the admissions, and 11*70 on the average resident in asylums; whilst the cures and discharges, amounting to 246, are equal to 53-30 per cent, on admissions, and to 12*18 on the total resident. The death rate in 1875 is 1 per cent, greater than in 1874. With regard to the probable cause of the increased mortality, the Commissioners
same
say:? On examining into the probable cause o? the increased mortality above adverted to, we attribute it in part to the number of hopeless, indeed it might be added, moribund cases transmitted under magisterial warrants to asylums as being dangerous and violent. So far as our experience goes, an injudicious exercise of power in committing lunatics has perceptibly increased, notwithstanding the issue of official circulars directing the attention of justices of the peace to the specific and intelligible clauses of the statute. Last Session, in order to obviate this objectionable practice, an Act was passed, by which two governors of any district asylum, in accordance with certain engagements on the part of the friends or relatives of an insane patient, could authorise an immediate admission into the district asylum where the party resided. Though this law has nominally been in operation for over nine months, little or no advantage has been taken of it. Notwithstanding the increased mortality from the causes already given, the sanitary condition of district asylums during the twelvemonth we are dealing with has been satisfactory. They were unvisited by any epidemic or contagious disease, save at Castlebar, where a low type of fever, affecting five attendants and over twenty patients, was rife for a few months. Every precaution was taken against its spread, the sick being completely isolated all through from the other inmates. It would not, however, be a fair criterion to calculate the percentage of deaths in hospitals for the insane on the basis of those which occur in the community at large, or indeed in other institutions. Taking the general annual averages in these countries, they may be set down as 24 in every 1,000, from infancy to old age, in all grades and classes. That they should considerably more than double that proportion among the insane, admits of easy explanation, bearing in view that lunacy in itself is so largely associated with animal or physical debility, and is more a disease of advanced and enervated life?hence the double reaction of mind and body on each other, and with consequent multiplied results of a fatal character. In our official capacity, while anxious to render public institutions for the insane beneficial to society in every reasonable manner, we should regret if an uncalled-for expenditure of money, whether levied through local rates or granted by the Executive, were to be entailed, For one lunatic received without some commensurate utility. into an English asylum, on the ground alone of being dangerous, by direct magisterial warrant, and not in the ordinary and recognised
135
LUNACY IN IRELAND. mode of ten are so
application, transferred
we
that at least in which when once
apprehend, relatively speaking,
to our district
located, be they from the first quiet,
institutions,
naturally
inoffensive imbeciles,
or
from age and infirmity, they remain as a rule for life. To obviate the inconveniences likely to accrue thereon, a clause of the Act just named empowers the removal of a certain class of inmates from public asylums to poorhouses, on an understanding being arrived at between the Local Government Board, the Inspectors, and Union guardians; but as yet, we may say, no practical arrangements have been effected. Local guardians, as a rule, are too desirous to get rid of the insane o? all classes to accept with favour the proposition of receiving new cases, cognisant at the same time that the Government rate in aid would diminish taxation ?10. 4s. per annum in favour of each district asylum resident. It cannot, then, be a matter of surprise, from the irregular and constant influx of chronic cases of insanity, and also of imbeciles and epileptics, to asylums, together with the difficulty of procuring their removal (when no person is held responsible to do so from the mode of committal), that these institutions get crowded with hopeless inmates, to the exclusion, unhappily, and not unfrequently, of regular applicants in the early or acute stages of mental disease, as evidenced by the fact that of the 7,741 inmates on the 31st December last, the incurables numbered 5,243. It has been correctly remarked by a Scotch physician, Dr. Clouston, that the amount of admissions in any one year affords a much better test of asylum requirements and utility than the whole number chargeable ; so that, while every facility should be given to increase the former, patients should be discharged as speedily as possible, to prevent the accumulation of chionic cases. But though opposed to a malappropriation or an injudicious use of asylums, in the special erection of which large monetary outlays have been primarily incurred, with a current expenditure for their support much beyond that of others maintained for the poor out of public rates, we are not the less sensible to the care necessary, as we have stated on a former occasion, to ensure the relief and comfort of a class that of itself has a paramount claim on the community at large. To unite the double object of economy, and the well-being of that section of the insane who can derive no substantial benefit from a detention in ordinary district asylums, is a question of progressive importance. To a certain, but limited extent, for their actual capabilities are restricted, workhouses, under the authority and with the sanction of the Local Government Board, have been rendered more fitting receptacles for the demented?tranquil and infirm, as well as epileptics; still there are drawbacks in them, essentially so as regards want of space for exercise, day-room accommodation, and suitable sleeping provision for the parties themselves and those in charge of them. These deficiencies do not fail to escape our observation; and, while under existing circumstances they cannot be fully met, we bear a willing testimony to the considerate attention paid, on our recommendation, to the requirements of the insane inmates of poorhouses, in regard to dietary, raiment generally, and cleanliness, on our various visits of
helpless
inspection.
136
LUNACY IN IRELAND.
The Commissioners draw special attention to the deficiencies in the supply of furniture in asylums, to the want of amusements for the inmates, the absence of cheerfulness in the various rooms, and to the employment provided. On these
particulars
we
read
as
follows:?
Convinced, as we are, that the employment of the insane on the land attached to asylums is at once the healthiest and most remunerative occupation for the patients, and that best suited to their previous habits of life, the enlargement of the area available for farm operations has ever been regarded by us as an object, when practicable, of the greatest importance, and we are happy to be able to report that useful outdoor employment is now generally provided on a large scale in the various institutions under our supervision. The system of school education, originated in one of the hospitals for the insane of this country, makes favourable progress. This education, combined with religious instruction and observances, now generally recognised in public asylums, cannot but prove, with judicious control, beneficial; although it may not exercise a directly curative agency, it must at least prevent many of the insane from constantly brooding over the delusions with which they are afflicted, and relieve what otherwise would be the almost unbroken monotony of a listless existence. In some of the larger asylums the Resident Medical Superintendents have formed musical bands, whose performances are on the whole very creditable, notwithstanding the changes which constantly occur in their composition by reason of the not unfrequent resignation of attendants, and the discharge of recovered lunatics who had acted as musicians. The formation and maintenance of bands of this description should, in our opinion, be more liberally encouraged, as we know of no greater or more certain boon to the insane than that afforded by the frequent opportunity of listening to, or taking part in, music, and of no recreation better qualified to produce order and tran-
quillity.
But, perhaps, no more gratifying indication can be afforded of a progressive and more humanising treatment of the insane, than can be derived from the fact that the inmates of our public asylums, instead of being restricted as' lately within the immediate grounds, however spacious, that are attached to these institutions, now not unfrequently visit places of amusement, or make excursions into the open country in parties, under the care of watchful attendants.
Special attention is drawn to the insufficient remuneration given to those in immediate charge of the insane, who have such continuous and irksome duties to perform, and whose temper and forbearance are so often put to the test by violent or illconditioned patients." There appear to be two unsatisfactory results derived from insufficient payment: first, that a good class of applicants is certain not to present itself; and secondly, that "
LUNACY IN IRELAND.
137
when the attendants have gained their experience, they frequently seek employment elsewhere. The Commissioners make the following remarks upon private
asylums:?
There has been but little variation between the respective number of patients in private asylums during the past and the year preceding it. At the close of 1874 an aggregate of 672, between both sexes, was under treatment?296 males and 376 females. In 1875, 186 were admitted?88 males and 103 females, making a total of 858 under treatment during the year, of which 165 were discharged; one female escaped, and 39 died. There consequently remained on the 1st January 653 of both sexes. The recoveries exceeded in the year under review those of the preceding one by five, Avhile the mortality was less by three?both satisfactory results. It is also gratifying to us to report that no accident of a serious character occurred. On the management of these institutions generally we are'enabled to report in satisfactory terms, the great majority of them being conducted with carefulness and a becoming attention to the well-being of their inmates. So much, however, depends on the cost of maintenance, and the means of families to meet it, that a perceptible difference cannot but exist in the interior organisation of private asylums, some of which are replete with domestic requirements for the higher and more opulent classes of society; while others, from lesser stipends, do not present a like appearance of comfort. To make amends as far as lies in our power for the difference, and particularly, too, as not unfrequently the friends of patients consider they have fulfilled their duty to afflicted relatives by placing them under a safe control, without taking further trouble in their regard, entails no inconsiderable amount of responsibility on the Inspectors. Our ordinary visits to private asylums are made quarterly, and at irregular periods; but under certain contingencies, and in furtherance of the provisions of the statute, they are rendered much more frequent, so as thereby to secure not alone the liberty of the subject, but to guard against any irregular procedure either as to the admission or subsequent detention of the reputed insane, who possess unrestricted privileges to communicate with us by letter. It occasionally, but rarely, occurs that a justifiable cause of complaint on investigation is brought before us for inquiry. In some few we have had much ground for hesitation in adjudicating on their merits, and when in the absence of actual delusions the causes of disease were what come under the designation of moral, or were distinctly referable to habits of dissipation An Inspector in such inor of an unsubdued indulgence in drink. stances can only exercise a fair discretion, and by temporary means, as a warning, protect the individual from a repetition of his own culpabilities. Indeed it has happened on three or four occasions in the past year that persons themselves, feeling the impending chances of a return of insanity from drunkenness, and to escape an urgent tendency to it, have not only not objected to being placed under restraint, but voluntarily sought it; still, shortly after admission, threatened proceedings
138
LUNACY IN IRELAND.
the proprietors of private asylums for an illegal confinement. But of all the difficult cases to be dealt with, none are so great as those of perverted minds, with a considerable amount of intellect, reasoning, and education, as found in the better classes, but whose acts, when free, are offensive to others, and highly injurious to their own interest, and who are unrestrained by any sense of propriety or foresight. Discharged for a time, and comparatively much improved, they frequently relapse, and for the most part with more discouraging symptoms. Taking the large number of private patients in the licensed establishments of this country, we believe in no instance that has come under supervision since the date of our last Report has an injustice been committed through an unduly prolonged detention. Of the existing private asylums, four being on a charitable foundation continue exempt from the charge for licence : namely, Swift's or St. Patrick's Hospital; the Friends' Retreat, similar to that in York; the Richmond Retreat for Ladies, under the superintendence of a religious community of nuns; and the Lucan Spa Institution. The residents in these on the 1st January, between males and females, numbered 323. The new asylum for imbecile children, to be supported by voluntary contributions, and established through most liberal donations from Dr. Stewart, is in a very forward state towards completion, and in the coming spring will be fit for occupation. It is intended to accommodate 200 inmates, with all requisite appurtenances. The site of the buildings themselves at Palmerston, four miles from Dublin, in the centre of about forty acres of farm and pleasure grounds, is highly salubrious.
against
The
large central asylum at Dundrum is reported as being satisfactory state, and on the 1st January, 1875, there were 123 males and 35 females; the average number resident during the year was 165. The male convicts admitted during the year have not manifested dangerous or destructive propensities, and no instance of restraint is reported on, and seclusion is sparingly resorted to. On the other hand, the female convicts have been destructive and violent in conduct, inflicting injuries on their attendants, restraint and seclusion being both resorted to. The report concludes with a number of most interesting and instructive statistical tables, most carefully worked out, and of themselves form valuable records on insanity; and in conclusion we wish to express our thanks to the Commissioners, Dr. Nugent and Dr. Gr. W. Hatchell, for their earnest work in the cause of Lunacy. in
a
Art. X.?LUNACY IN IRELAND.
The Twenty-fifth Keport on the District, Criminal, and Private Lunatic Asylums in Ireland has been sent to us for notice, and it contains many interesting particulars relating to the care and management of the insane in Ireland. On the 31st of December, 1875, there were 11,777 persons of unsound mind under the supervision of the Lunacy Board, making 194 more than last year at the same period. The following summary of the distribution of the insane is
given:? In In In In In In
District Asylums Central Criminal Asylums Lucan Government Asylum Private Asylums Poorhouses Gaols .
.
Male
Female
Total
4,142
3,599
7,741
38 12 382
172 29 653
1,275
1,904
3,179
5,840
5,937
11,777
134 17 271
1
2
3
The Commissioners give a comprehensive summary of the working of district asylums during the last twelve months. On the 1st January, 1875, there were located in district asylums 7,585 patients?4,072 males, 3,513 females. We are told that during the year 2,132 were admitted, namely, 1,095 males and 1,037 females, of whom 1,777
cases?906 males, 871 females ?and 355 cases 189 being men, and 166 women. During the same period 939 were discharged cured?470 males, and 469 females; and as improved 236?119 and 117 respectively of either sex. Fiftysix were brought home?41 males and 15 females?not recovered, but tranquil and amenable; while 3 males effected permanent escapes. Seven hundred and forty-two patients died?391 males and 351 females, all from natural causes, save 6?2 from accidents, and 4 from suicide ; on these exceptional deaths coroners' inquests were duly held, and, though with fully exonerating verdicts, the occurrences are to be regretted. There appears from the preceding general data that there was a total of 9,717 lunatics under treatment in the course of the year, and at its close 7,741, or 156 more than on the 31st December, 1874, in Irish district asylums ; of which total 4,412 were males and 3,599 were new
previously under treatment,
females.
The mortality has been greater among females than among The Commissioners report favourably on the general males.
134
management of therein adopted.
LUNACY IN IRELAND.
these The
institutions, and upon the treatment percentage of recoveries are nearly the
as last year, being 43*70 on the admissions, and 11*70 on the average resident in asylums; whilst the cures and discharges, amounting to 246, are equal to 53-30 per cent, on admissions, and to 12*18 on the total resident. The death rate in 1875 is 1 per cent, greater than in 1874. With regard to the probable cause of the increased mortality, the Commissioners
same
say:? On examining into the probable cause o? the increased mortality above adverted to, we attribute it in part to the number of hopeless, indeed it might be added, moribund cases transmitted under magisterial warrants to asylums as being dangerous and violent. So far as our experience goes, an injudicious exercise of power in committing lunatics has perceptibly increased, notwithstanding the issue of official circulars directing the attention of justices of the peace to the specific and intelligible clauses of the statute. Last Session, in order to obviate this objectionable practice, an Act was passed, by which two governors of any district asylum, in accordance with certain engagements on the part of the friends or relatives of an insane patient, could authorise an immediate admission into the district asylum where the party resided. Though this law has nominally been in operation for over nine months, little or no advantage has been taken of it. Notwithstanding the increased mortality from the causes already given, the sanitary condition of district asylums during the twelvemonth we are dealing with has been satisfactory. They were unvisited by any epidemic or contagious disease, save at Castlebar, where a low type of fever, affecting five attendants and over twenty patients, was rife for a few months. Every precaution was taken against its spread, the sick being completely isolated all through from the other inmates. It would not, however, be a fair criterion to calculate the percentage of deaths in hospitals for the insane on the basis of those which occur in the community at large, or indeed in other institutions. Taking the general annual averages in these countries, they may be set down as 24 in every 1,000, from infancy to old age, in all grades and classes. That they should considerably more than double that proportion among the insane, admits of easy explanation, bearing in view that lunacy in itself is so largely associated with animal or physical debility, and is more a disease of advanced and enervated life?hence the double reaction of mind and body on each other, and with consequent multiplied results of a fatal character. In our official capacity, while anxious to render public institutions for the insane beneficial to society in every reasonable manner, we should regret if an uncalled-for expenditure of money, whether levied through local rates or granted by the Executive, were to be entailed, For one lunatic received without some commensurate utility. into an English asylum, on the ground alone of being dangerous, by direct magisterial warrant, and not in the ordinary and recognised
135
LUNACY IN IRELAND. mode of ten are so
application, transferred
we
that at least in which when once
apprehend, relatively speaking,
to our district
located, be they from the first quiet,
institutions,
naturally
inoffensive imbeciles,
or
from age and infirmity, they remain as a rule for life. To obviate the inconveniences likely to accrue thereon, a clause of the Act just named empowers the removal of a certain class of inmates from public asylums to poorhouses, on an understanding being arrived at between the Local Government Board, the Inspectors, and Union guardians; but as yet, we may say, no practical arrangements have been effected. Local guardians, as a rule, are too desirous to get rid of the insane o? all classes to accept with favour the proposition of receiving new cases, cognisant at the same time that the Government rate in aid would diminish taxation ?10. 4s. per annum in favour of each district asylum resident. It cannot, then, be a matter of surprise, from the irregular and constant influx of chronic cases of insanity, and also of imbeciles and epileptics, to asylums, together with the difficulty of procuring their removal (when no person is held responsible to do so from the mode of committal), that these institutions get crowded with hopeless inmates, to the exclusion, unhappily, and not unfrequently, of regular applicants in the early or acute stages of mental disease, as evidenced by the fact that of the 7,741 inmates on the 31st December last, the incurables numbered 5,243. It has been correctly remarked by a Scotch physician, Dr. Clouston, that the amount of admissions in any one year affords a much better test of asylum requirements and utility than the whole number chargeable ; so that, while every facility should be given to increase the former, patients should be discharged as speedily as possible, to prevent the accumulation of chionic cases. But though opposed to a malappropriation or an injudicious use of asylums, in the special erection of which large monetary outlays have been primarily incurred, with a current expenditure for their support much beyond that of others maintained for the poor out of public rates, we are not the less sensible to the care necessary, as we have stated on a former occasion, to ensure the relief and comfort of a class that of itself has a paramount claim on the community at large. To unite the double object of economy, and the well-being of that section of the insane who can derive no substantial benefit from a detention in ordinary district asylums, is a question of progressive importance. To a certain, but limited extent, for their actual capabilities are restricted, workhouses, under the authority and with the sanction of the Local Government Board, have been rendered more fitting receptacles for the demented?tranquil and infirm, as well as epileptics; still there are drawbacks in them, essentially so as regards want of space for exercise, day-room accommodation, and suitable sleeping provision for the parties themselves and those in charge of them. These deficiencies do not fail to escape our observation; and, while under existing circumstances they cannot be fully met, we bear a willing testimony to the considerate attention paid, on our recommendation, to the requirements of the insane inmates of poorhouses, in regard to dietary, raiment generally, and cleanliness, on our various visits of
helpless
inspection.
136
LUNACY IN IRELAND.
The Commissioners draw special attention to the deficiencies in the supply of furniture in asylums, to the want of amusements for the inmates, the absence of cheerfulness in the various rooms, and to the employment provided. On these
particulars
we
read
as
follows:?
Convinced, as we are, that the employment of the insane on the land attached to asylums is at once the healthiest and most remunerative occupation for the patients, and that best suited to their previous habits of life, the enlargement of the area available for farm operations has ever been regarded by us as an object, when practicable, of the greatest importance, and we are happy to be able to report that useful outdoor employment is now generally provided on a large scale in the various institutions under our supervision. The system of school education, originated in one of the hospitals for the insane of this country, makes favourable progress. This education, combined with religious instruction and observances, now generally recognised in public asylums, cannot but prove, with judicious control, beneficial; although it may not exercise a directly curative agency, it must at least prevent many of the insane from constantly brooding over the delusions with which they are afflicted, and relieve what otherwise would be the almost unbroken monotony of a listless existence. In some of the larger asylums the Resident Medical Superintendents have formed musical bands, whose performances are on the whole very creditable, notwithstanding the changes which constantly occur in their composition by reason of the not unfrequent resignation of attendants, and the discharge of recovered lunatics who had acted as musicians. The formation and maintenance of bands of this description should, in our opinion, be more liberally encouraged, as we know of no greater or more certain boon to the insane than that afforded by the frequent opportunity of listening to, or taking part in, music, and of no recreation better qualified to produce order and tran-
quillity.
But, perhaps, no more gratifying indication can be afforded of a progressive and more humanising treatment of the insane, than can be derived from the fact that the inmates of our public asylums, instead of being restricted as' lately within the immediate grounds, however spacious, that are attached to these institutions, now not unfrequently visit places of amusement, or make excursions into the open country in parties, under the care of watchful attendants.
Special attention is drawn to the insufficient remuneration given to those in immediate charge of the insane, who have such continuous and irksome duties to perform, and whose temper and forbearance are so often put to the test by violent or illconditioned patients." There appear to be two unsatisfactory results derived from insufficient payment: first, that a good class of applicants is certain not to present itself; and secondly, that "
LUNACY IN IRELAND.
137
when the attendants have gained their experience, they frequently seek employment elsewhere. The Commissioners make the following remarks upon private
asylums:?
There has been but little variation between the respective number of patients in private asylums during the past and the year preceding it. At the close of 1874 an aggregate of 672, between both sexes, was under treatment?296 males and 376 females. In 1875, 186 were admitted?88 males and 103 females, making a total of 858 under treatment during the year, of which 165 were discharged; one female escaped, and 39 died. There consequently remained on the 1st January 653 of both sexes. The recoveries exceeded in the year under review those of the preceding one by five, Avhile the mortality was less by three?both satisfactory results. It is also gratifying to us to report that no accident of a serious character occurred. On the management of these institutions generally we are'enabled to report in satisfactory terms, the great majority of them being conducted with carefulness and a becoming attention to the well-being of their inmates. So much, however, depends on the cost of maintenance, and the means of families to meet it, that a perceptible difference cannot but exist in the interior organisation of private asylums, some of which are replete with domestic requirements for the higher and more opulent classes of society; while others, from lesser stipends, do not present a like appearance of comfort. To make amends as far as lies in our power for the difference, and particularly, too, as not unfrequently the friends of patients consider they have fulfilled their duty to afflicted relatives by placing them under a safe control, without taking further trouble in their regard, entails no inconsiderable amount of responsibility on the Inspectors. Our ordinary visits to private asylums are made quarterly, and at irregular periods; but under certain contingencies, and in furtherance of the provisions of the statute, they are rendered much more frequent, so as thereby to secure not alone the liberty of the subject, but to guard against any irregular procedure either as to the admission or subsequent detention of the reputed insane, who possess unrestricted privileges to communicate with us by letter. It occasionally, but rarely, occurs that a justifiable cause of complaint on investigation is brought before us for inquiry. In some few we have had much ground for hesitation in adjudicating on their merits, and when in the absence of actual delusions the causes of disease were what come under the designation of moral, or were distinctly referable to habits of dissipation An Inspector in such inor of an unsubdued indulgence in drink. stances can only exercise a fair discretion, and by temporary means, as a warning, protect the individual from a repetition of his own culpabilities. Indeed it has happened on three or four occasions in the past year that persons themselves, feeling the impending chances of a return of insanity from drunkenness, and to escape an urgent tendency to it, have not only not objected to being placed under restraint, but voluntarily sought it; still, shortly after admission, threatened proceedings
138
LUNACY IN IRELAND.
the proprietors of private asylums for an illegal confinement. But of all the difficult cases to be dealt with, none are so great as those of perverted minds, with a considerable amount of intellect, reasoning, and education, as found in the better classes, but whose acts, when free, are offensive to others, and highly injurious to their own interest, and who are unrestrained by any sense of propriety or foresight. Discharged for a time, and comparatively much improved, they frequently relapse, and for the most part with more discouraging symptoms. Taking the large number of private patients in the licensed establishments of this country, we believe in no instance that has come under supervision since the date of our last Report has an injustice been committed through an unduly prolonged detention. Of the existing private asylums, four being on a charitable foundation continue exempt from the charge for licence : namely, Swift's or St. Patrick's Hospital; the Friends' Retreat, similar to that in York; the Richmond Retreat for Ladies, under the superintendence of a religious community of nuns; and the Lucan Spa Institution. The residents in these on the 1st January, between males and females, numbered 323. The new asylum for imbecile children, to be supported by voluntary contributions, and established through most liberal donations from Dr. Stewart, is in a very forward state towards completion, and in the coming spring will be fit for occupation. It is intended to accommodate 200 inmates, with all requisite appurtenances. The site of the buildings themselves at Palmerston, four miles from Dublin, in the centre of about forty acres of farm and pleasure grounds, is highly salubrious.
against
The
large central asylum at Dundrum is reported as being satisfactory state, and on the 1st January, 1875, there were 123 males and 35 females; the average number resident during the year was 165. The male convicts admitted during the year have not manifested dangerous or destructive propensities, and no instance of restraint is reported on, and seclusion is sparingly resorted to. On the other hand, the female convicts have been destructive and violent in conduct, inflicting injuries on their attendants, restraint and seclusion being both resorted to. The report concludes with a number of most interesting and instructive statistical tables, most carefully worked out, and of themselves form valuable records on insanity; and in conclusion we wish to express our thanks to the Commissioners, Dr. Nugent and Dr. Gr. W. Hatchell, for their earnest work in the cause of Lunacy. in
a
