Colonial hospitals and lunatic asylums.

  • Great Britain. Parliament.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Colonial hospitals and lunatic asylums. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    3/42 (page 3)
    From the tone of the answers, it would appear that there is a general ignorance of the necessity for any extraordinary care in these respects, and of the existence of any settled principles regarding them. The efiects are not the less manifest in the prevalence and destructiveness of gangrene, dysentery, and skin and bowel complaints generally, which, as is well known in European hospitals, are the invariable concomitants, and often the first indications, of sanitary defects.* There is one of these institutions the sanitary condition of which calls for particular remark as an instance of inveterate neglect in the face of warning, and as a proof of the necessity for strong measures of reform. In November 1861, tlie Commissioners appointed to examine into the state of the hospital and asylum at Kingston in Jamaica, reported that— “ No doubt can exist as to the unsuitableness of the Female Hospital as a place of medical treatment. It may be almost said to reverse every condi- tion which ought to be observed under such circumstances. The wards, which are of wood, are small, low in the roof, close, and ill-ventilated. They are so slightly raised above the ground tliat the earthy exhalations, after rain, cannot but act injuriously on the patients. Except by closing the windows, and substituting one evil for another, no efficient protection exists against tlie damp or cold. Ungla7.ed, few in number, and badly constructed for the admission of light and air, those windows are only apertures. Of Ward No. 5, the position is such as to expose its inmates to the rays of the western sun, which beat in upon it with a glare and intensity certain to cause suffering. To remedy this inconvenience by a screen, or other contrivance, no attempt lias yet been made. As regards sewerage, matters could not possibly be in a more unsatis- factory condition. Of the privy, when we visited the institution, the state was such as to make it disgusting to approach it. No apartment is provided for the performance of operations, but only a shed, open at the sides, in which formerly, from the pure necessity of the case, this nice and delicate department was conducted. Originally (1850) the subject of these remarks was nothing but a makeshift (having been formerly what is known as a negro yard) to relieve temporarily the Male Hospital, and was never intended as a permanent institution,” &c. (Page 10 of Report.) Nothing appears to have been as yet done to destroy the applicability of these strictures. 7. Defects of internal economy are very difficult to discover, and in estimating them many allowances must be made both in excuse and in aggrava- tion. The hospitals uniformly make a merit of entirely excluding “ contagious ” or “infectious ” cases : an exploded prejudice where the wards are roomy and well-ventilated, but one whicli may not be groundless where tlie atmosphere is of itself enougli to breed fever, though it can be no apology for not providing proper wards for the treatment of such cases with others.f Some of the hospitals are crow'ded with incurables, and the asylums with mere idiots w’ho take nothing but harm from confinement and association with the insane. In the majority of instances there is no resident medical officer, a want which is the occasion of great evils. The proportion of nurses or keepers to patients, though not always of itself apparently insufficient, is yet really so in many cases if all the circum- stances are taken into account. Many fewer nurses in proportion are required w'here there are a great number of patients properly classified in large wards with every appliance for economy of labour and time than are necessary in these small and inconvenient and ill-found establishments. Lastly, the asylums are generally without provision for religious services, and uniformly without proper means for the amusement and employment of the insane. Curative treatment of insanity is, indeed, not yet in its infancy in the West Indian colonies. It is, howe\’er, satisfactory to find that the idea of excessive restraint is generally repudiated even in them. 8. The government is in almost all cases vested in boards which are composed partly of ex officio members, partly of nominees of the Governors, and • At the Roseau infirmary in Dominica, 12 out of 29 deaths, in 1862, were from skin diseases and dysentery; and diarrhoea was the cause of 2 deaths out of 3 at the Bermuda asylum. f Small-pox must be excepted from the general rule; and see p. 20, c. Internal Eco' nomy. d. Constitution.