Volume 1

The care and cure of the insane : being the reports of The Lancet Commission on Lunatic Asylums, 1875-6-7 for Middlesex, the City of London and Surrey with a digest of the principal records extant and a statistical review of the work of each asylum from the date of its opening to the end of 1875 / by J. Mortimer Granville.

  • Granville, J. Mortimer (Joseph Mortimer), 1833-1900.
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: The care and cure of the insane : being the reports of The Lancet Commission on Lunatic Asylums, 1875-6-7 for Middlesex, the City of London and Surrey with a digest of the principal records extant and a statistical review of the work of each asylum from the date of its opening to the end of 1875 / by J. Mortimer Granville. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    question of hours : days are as months or years in this emergency. The three days allowed by the law before a relieving officer brings a case before a magistrate costs the country annually enough to maintain a large asylum. All cases of insanity should be removed at once and directly to a curative asylum ; and in a large proportion of instances if this course were pursued a lengthy detention would be unnecessary. The first step forward is the adoption of a policy which shall render the asylum or hospital built last in any county or borough a curative establishment, and immediately relegate the older and less efficient houses to the position of homes for chronic and incurable cases. The second step must be the enacting of a law by which the reception or detention of a lunatic, or person supposed to be of unsound mind, in a workhouse more than twenty-four hours, without a certificate from the medical superin- tendent of some asylum that the patient has been discharged from his care as incurable, shall be made a misdemeanour, and punishable as such ; the relieving officer of the district from which the patient has been removed, and the master of the workhouse in which he or she has been lodged, being jointly and severally responsible. The third step will obviously be to secure room in the curative asylum by the removal of incurable cases. This must be a task of delicacy and difficulty, but it is one the medical superintendents of public institutions for the insane are fully competent to perform. It would probably be necessary to divide the outgoing patients into two classes. The first, comprising cases which, although hopeless, may require medical aid—such as confirmed epilep- tics, general paralytics, and those suffering periodic exacerbation and needing close medical supervision and care—might be transferred to the chronic establishments, which, I propose, should be the older houses in a district. I think the plan of turning obsolete asylums like Wandsworth into refuges or depots for incurables will be less costly than building new ones of inexpensive character. When a county speculates in building, it should be to the best possible purpose. It is not fair to the victims of insanity, or just to the ratepayers, to employ machinery proved to be out of date and inefficient. Besides, the older houses are unsuitable for use as curative establishments. With all the money spent in patching, repairing, and beautifying, they are effete. The original buildings at Brookwood scarcely escape this condemnation, and should be replaced by better. It is waste to improve them. The second class of cases removable from asylums devoted to curative work, including those for whom nothing can be done or is necessary beyond ordinary watching and tending, should be sent into the so-called lunatic wards of a workhouse, or boarded with friends. The reasons which induce me to believe that it is not expedient to build asylums for imbeciles, to which paupers supposed to be lunatics may be sent direct from workhouses, will be given in another place. The general aspects of the additional asylum question are now fairly indicated from the stand- point I conceive to be the most reasonable. Meanwhile, the matter is so important, not only in its bearings on Surrey, but many other counties,