On the State of Lunacy and the Legal Provision for the Insane

Оглавление

Arlidge John Thomas. On the State of Lunacy and the Legal Provision for the Insane

Chap. I. – Of the Number of the Insane

Chap. II. – On the Increase of Insanity

Chap. III. – state of the present provision for the insane in asylums. – its inadequacy

Chap. IV. – on the curability of insanity

Chap. V. – on the causes diminishing the curability of insanity, and involving the multiplication of chronic lunatics

Chap. VI. – Causes diminishing the curability of insanity, and involving the multiplication of chronic lunatics

Chap. VII. – on the future provision for the insane

Chap. VIII. – Registration of Lunatics

Chap. IX. – Appointment of District Medical Officers

Chap. X. – On the Lunacy Commission

Chap. XI. – On some Principles in the Construction of Public Lunatic Asylums

Отрывок из книги

This inquiry must be preliminary to any consideration of the provision made or to be made for the Insane. In carrying it out, we have chiefly to rely upon the annual Reports of the Commissioners in Lunacy along with, so far as pauper lunatics are concerned, those of the Poor-Law Board. However, these reports do not furnish us with complete statistics, and the total number of our insane population can be only approximately ascertained. The Lunacy Commission is principally occupied with those confined in public asylums and hospitals, and in Licensed Houses, and publishes only occasional imperfect returns of patients detained in workhouses or singly in private dwellings. On the other hand, the Poor-Law Board charges itself simply with the enumeration of pauper lunatics supported out of poor-rates, whether in asylums or workhouses, or living with friends or elsewhere. Hence the returns of neither of these public Boards represent the whole case; and hence, too, the chief apparent discrepancies which occur when those returns are compared.

To show this, we may copy the tables presented in Appendix H of the Report of the Commissioners in Lunacy for 1857, p. 81.

.....

This quotation is really a reiteration of Dr. Bucknill’s conclusions as advanced in 1857, in an excellent paper in the ‘Asylum Journal’ (vol. iv. p. 460), and as a pendent to it the following extract from this paper is appropriate; viz. “that the cost of a chronic lunatic properly cared for, and supplied with a good dietary, in a County Asylum, is not greater than that of a chronic lunatic supplied with a coarse and scanty dietary, and detained in neglect and wretchedness as the inmate of a union workhouse.”

Another most important circumstance to be borne in mind when the cost of workhouses and asylums is contrasted, is that in the former establishments more than two-thirds of the inmates are children. Thus the recipients of in-door relief on the 1st of January, 1858, consisted, according to the Poor-Law Returns, of 74,141 adults, and 50,836 children under sixteen years of age. Now as the rate of maintenance is calculated on the whole population of a workhouse, adults and children together, it necessarily follows that it falls much within that of asylums, in which almost the whole population is adult. This very material difference in the character of the inmates of the two institutions may fairly be valued as equivalent to a diminution of one-fourth of the expense of maintenance in favour of workhouses; and without some such allowance, the comparison of the cost per head in asylums and union-houses respectively is neither fair nor correct.

.....