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First half of a letter written by "Physician" and published in NZMJ 1914 March;13(49):60–62.Correspondence(To the Editor "New Zealand Medical Journal.")Sir,—I observe that in your December issue you deal with the question of treatment of the insane. It is high time the profession took the matter up seriously and endeavoured to arouse the public to the shameful treatment of the insane in our asylums.What Mr. Day reported in regard to Sunnyside is true of other asylums. It sounds bad enough in a very guarded and moderate report, but it is doubtful if the casual medical reader forms, on reading it, any adequate conception of the real state of things—of the overcrowding, the, criminal neglect of all modern methods, and the consequent suffering entailed on these unhappy mental cases.Let us look at some of the points in Mr. Day's report on Sunnyside:—"I. No reception ward-patients received in refractory ward.…"—That is to say the new and perhaps curable patient is at once placed among "refractory" lunatics. To the layman this may not convey much; to the initiated any comment is superfluous. As every medical man knows, or should know, all new patients in modern asylums are treated on admission practically as they would be on admission to the ward of a general hospital as ordinary hospital patients. In New Zealand this beneficial and humane practice has yet to be generally adopted."II. Classification. Impossible because of overcrowding…"—Truly, Sir, the Commissioner is a very moderate person. If he had said that the lack of classification in our asylums was the blackest scandal and shame he would not have materially overstated the case. One may see any and every day what this means. For example, I have in mind one particular "exercise" ward. In it are herded dements, idiots, imbeciles, and all manner of filthy and repulsive human derelicts. Into this yard also are put the possibly curable, and others who, although perhaps incurable, are yet able to keenly appreciate the horror of the place. At meals they are herded together much in the same way. Recently I observed a table at which were four women of education and refinement (two of whom at any rate were curable) among some twenty or thirty chronics, a considerable proportion of whose table manners, talk, and appearance were disgusting."III. Hospital Treatment…Friends of patients in Government institutions have a right to expect adequate hospital accommodation, which is not to be found in Sunnyside." (The italics are mine)—In other words, they lack what the lowest dregs of humanity have always available in their need. To offer comment would be to paint the lily.The Commissioner in conclusion thinks \"that ... the enquiry should allay fears that patients are subjected to ill-treatment,\" I sincerely hope that it will do nothing of the kind, though in the sense that Mr. Day intended the remark, viz., that attendants do not ill-treat patients, one may cheerfully concede its truth.Anyone who knows anything' of our New Zealand asylums knows that they are overcrowded, and that the buildings and general arrangements are totally inadequate. Thus there is no proper classification of patients, and in consequence the delicate, the refined, the educated, the curable, the incurable, the low, the coarse, the foul-mouthed and filthy are to a large extent mixed up together—a gruesome state of affairs. Exaggerated? Ask any half-dozen assistant physicians in our asylums if it is, but ask them privately in the inviolable sanctity of your smoking den.It is not too much to say that the best New Zealand asylums are where the worst English ones were 30 years ago. How vastly they differ now must be common knowledge to every asylum physician.Not long ago I had occasion to visit a recent admission to a certain mental hospital. She was a young lady of education and refinement with delusions, and said to be suicidal, but had made no attempt on her life. She had at the time of my visit been three days in solitary confinement in a little den with shutters up, the only light and air being admitted through small apertures (filled with perforated zinc) near the top. It was too dark to read, the air was foul, and there was a rubber urinal pot on the floor.In such cases the night attendant flashes a lantern in at frequent intervals during the night. It must greatly help these cases who are often suffering from insomnia to have a bright light thrown on them every hour or two during the night! Was Bedlam much worse? Formerly I was inclined to hope that this sort of thing was exceptional even in New Zealand, but observation and enquiry have shown me that it is not.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

Contact diana@nzma.org.nz
for the PDF of this article

View Article PDF

First half of a letter written by "Physician" and published in NZMJ 1914 March;13(49):60–62.Correspondence(To the Editor "New Zealand Medical Journal.")Sir,—I observe that in your December issue you deal with the question of treatment of the insane. It is high time the profession took the matter up seriously and endeavoured to arouse the public to the shameful treatment of the insane in our asylums.What Mr. Day reported in regard to Sunnyside is true of other asylums. It sounds bad enough in a very guarded and moderate report, but it is doubtful if the casual medical reader forms, on reading it, any adequate conception of the real state of things—of the overcrowding, the, criminal neglect of all modern methods, and the consequent suffering entailed on these unhappy mental cases.Let us look at some of the points in Mr. Day's report on Sunnyside:—"I. No reception ward-patients received in refractory ward.…"—That is to say the new and perhaps curable patient is at once placed among "refractory" lunatics. To the layman this may not convey much; to the initiated any comment is superfluous. As every medical man knows, or should know, all new patients in modern asylums are treated on admission practically as they would be on admission to the ward of a general hospital as ordinary hospital patients. In New Zealand this beneficial and humane practice has yet to be generally adopted."II. Classification. Impossible because of overcrowding…"—Truly, Sir, the Commissioner is a very moderate person. If he had said that the lack of classification in our asylums was the blackest scandal and shame he would not have materially overstated the case. One may see any and every day what this means. For example, I have in mind one particular "exercise" ward. In it are herded dements, idiots, imbeciles, and all manner of filthy and repulsive human derelicts. Into this yard also are put the possibly curable, and others who, although perhaps incurable, are yet able to keenly appreciate the horror of the place. At meals they are herded together much in the same way. Recently I observed a table at which were four women of education and refinement (two of whom at any rate were curable) among some twenty or thirty chronics, a considerable proportion of whose table manners, talk, and appearance were disgusting."III. Hospital Treatment…Friends of patients in Government institutions have a right to expect adequate hospital accommodation, which is not to be found in Sunnyside." (The italics are mine)—In other words, they lack what the lowest dregs of humanity have always available in their need. To offer comment would be to paint the lily.The Commissioner in conclusion thinks \"that ... the enquiry should allay fears that patients are subjected to ill-treatment,\" I sincerely hope that it will do nothing of the kind, though in the sense that Mr. Day intended the remark, viz., that attendants do not ill-treat patients, one may cheerfully concede its truth.Anyone who knows anything' of our New Zealand asylums knows that they are overcrowded, and that the buildings and general arrangements are totally inadequate. Thus there is no proper classification of patients, and in consequence the delicate, the refined, the educated, the curable, the incurable, the low, the coarse, the foul-mouthed and filthy are to a large extent mixed up together—a gruesome state of affairs. Exaggerated? Ask any half-dozen assistant physicians in our asylums if it is, but ask them privately in the inviolable sanctity of your smoking den.It is not too much to say that the best New Zealand asylums are where the worst English ones were 30 years ago. How vastly they differ now must be common knowledge to every asylum physician.Not long ago I had occasion to visit a recent admission to a certain mental hospital. She was a young lady of education and refinement with delusions, and said to be suicidal, but had made no attempt on her life. She had at the time of my visit been three days in solitary confinement in a little den with shutters up, the only light and air being admitted through small apertures (filled with perforated zinc) near the top. It was too dark to read, the air was foul, and there was a rubber urinal pot on the floor.In such cases the night attendant flashes a lantern in at frequent intervals during the night. It must greatly help these cases who are often suffering from insomnia to have a bright light thrown on them every hour or two during the night! Was Bedlam much worse? Formerly I was inclined to hope that this sort of thing was exceptional even in New Zealand, but observation and enquiry have shown me that it is not.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

Contact diana@nzma.org.nz
for the PDF of this article

View Article PDF

First half of a letter written by "Physician" and published in NZMJ 1914 March;13(49):60–62.Correspondence(To the Editor "New Zealand Medical Journal.")Sir,—I observe that in your December issue you deal with the question of treatment of the insane. It is high time the profession took the matter up seriously and endeavoured to arouse the public to the shameful treatment of the insane in our asylums.What Mr. Day reported in regard to Sunnyside is true of other asylums. It sounds bad enough in a very guarded and moderate report, but it is doubtful if the casual medical reader forms, on reading it, any adequate conception of the real state of things—of the overcrowding, the, criminal neglect of all modern methods, and the consequent suffering entailed on these unhappy mental cases.Let us look at some of the points in Mr. Day's report on Sunnyside:—"I. No reception ward-patients received in refractory ward.…"—That is to say the new and perhaps curable patient is at once placed among "refractory" lunatics. To the layman this may not convey much; to the initiated any comment is superfluous. As every medical man knows, or should know, all new patients in modern asylums are treated on admission practically as they would be on admission to the ward of a general hospital as ordinary hospital patients. In New Zealand this beneficial and humane practice has yet to be generally adopted."II. Classification. Impossible because of overcrowding…"—Truly, Sir, the Commissioner is a very moderate person. If he had said that the lack of classification in our asylums was the blackest scandal and shame he would not have materially overstated the case. One may see any and every day what this means. For example, I have in mind one particular "exercise" ward. In it are herded dements, idiots, imbeciles, and all manner of filthy and repulsive human derelicts. Into this yard also are put the possibly curable, and others who, although perhaps incurable, are yet able to keenly appreciate the horror of the place. At meals they are herded together much in the same way. Recently I observed a table at which were four women of education and refinement (two of whom at any rate were curable) among some twenty or thirty chronics, a considerable proportion of whose table manners, talk, and appearance were disgusting."III. Hospital Treatment…Friends of patients in Government institutions have a right to expect adequate hospital accommodation, which is not to be found in Sunnyside." (The italics are mine)—In other words, they lack what the lowest dregs of humanity have always available in their need. To offer comment would be to paint the lily.The Commissioner in conclusion thinks \"that ... the enquiry should allay fears that patients are subjected to ill-treatment,\" I sincerely hope that it will do nothing of the kind, though in the sense that Mr. Day intended the remark, viz., that attendants do not ill-treat patients, one may cheerfully concede its truth.Anyone who knows anything' of our New Zealand asylums knows that they are overcrowded, and that the buildings and general arrangements are totally inadequate. Thus there is no proper classification of patients, and in consequence the delicate, the refined, the educated, the curable, the incurable, the low, the coarse, the foul-mouthed and filthy are to a large extent mixed up together—a gruesome state of affairs. Exaggerated? Ask any half-dozen assistant physicians in our asylums if it is, but ask them privately in the inviolable sanctity of your smoking den.It is not too much to say that the best New Zealand asylums are where the worst English ones were 30 years ago. How vastly they differ now must be common knowledge to every asylum physician.Not long ago I had occasion to visit a recent admission to a certain mental hospital. She was a young lady of education and refinement with delusions, and said to be suicidal, but had made no attempt on her life. She had at the time of my visit been three days in solitary confinement in a little den with shutters up, the only light and air being admitted through small apertures (filled with perforated zinc) near the top. It was too dark to read, the air was foul, and there was a rubber urinal pot on the floor.In such cases the night attendant flashes a lantern in at frequent intervals during the night. It must greatly help these cases who are often suffering from insomnia to have a bright light thrown on them every hour or two during the night! Was Bedlam much worse? Formerly I was inclined to hope that this sort of thing was exceptional even in New Zealand, but observation and enquiry have shown me that it is not.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

Contact diana@nzma.org.nz
for the PDF of this article

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