Progress And Ethos Of North Wales Lunatic Asylum 1855

Medical Officer's Report 1855

(extracts)

Although many and most important improvements have been affected or are in course of completion since our last report amongst the most valuable of which are the new and commodious wash-house, and the conversion of the old one into an excellent laundry, mangle, and drying room, and the removal of shoemakers and tailors to new shops out of the house we must most earnestly call the attention of the Visitors to the absolute necessity for the erection of joiners and carpenters shops; as the increased number of patients renders it imperative upon us to appropriate the room now used for that purpose, to the use of the patients, who are already overcrowded, both as regards day rooms and dormitories.
Whilst these and other offices are, we hope, about to be built, we must again remind the Visitors, that the stables, so long contemplated, together with cow-houses, piggeries. &c., are much required; as those now in use are mere temporary sheds and very imperfect and dilapidated.

The patients continue to be employed as heretofore the able-bodied males in spade husbandry, gardening, and other out-door work. Some are occupied in assisting the engineer; others in shoemaking, and tailoring; and those who are not to be trusted out of the enclosed airing grounds, in pumping, and picking cocoa-nut fibre, &c.&c.

The women are employed in the kitchen, the wash-house, the laundry, and the sewing rooms; spinning is a favourite occupation with others. All the clothing is made by them, of which the matron keeps an account.
We have considerable difficulty in finding suitable in-door occupation for the private male patients in wet weather. That ever ready refuge from the tedium of confinement, the needle so successfully resorted to by the weaker sex, is not open to their male fellow sufferers under misfortune; and well might the pious and gifted Robert Hall have lamented that he was never taught to hem a pocket-handkerchief; for, said he, “I should never have been insane if I had.”

In order to afford an additional source of occupation and amusement for the class of patients above mentioned, we would strongly recommend the purchase of a good turning lathe for their use.

Frequent excursions into the country are made by the patients during the spring, summer, and autumnal months. These walks tend to amuse and enliven the poor creatures in a degree scarcely to be credited, lessening the tedium of their confinement, and producing new ideas and associations, to the exclusion of morbid ones. The long and joyfully anticipated Christmas party, or, as it is called, ‘The Ball’ was, if possible, more than usually enjoyed, and was attended with the happiest results.

* ˜The Commissioners in Lunacy during the last year, addressed a list of questions to the superintendents of every Asylum in the kingdom, requesting information as to the practice pursued by them, particularly as to the use of restraints, &c. &c.
This long mooted subject has been revived, and much discussion and difference of opinion still exist amongst the medical officers of Asylums.
We find we are classed amongst the advocates for the abolition of all restraint, although we are not of the number of those who would dogmatically condemn the limited use of mechanical restraint nor would we venture to deny that cases may possibly occur which might render it necessary: yet, we have no hesitation in saying, that we have hitherto never had occasion to resort to any beyond a short confinement in a padded room, and even that remedy is now very sparingly and cautiously used.

We find exercise in the open air the best sedative, in promoting sleep and tranquillity even during the most violent maniacal paroxysms.

 R. LLOYD WILLIAMS, MD., Visiting physician.
GEO. T. JONES, Superintendent

The asylum, a public / private establishment, continued to benefit from gifts and bequests, and a special fund was set up from money donated by Joseph Ablett’s widow (Llanbedr hall, Ruthin) for the purpose of providing a form of after care for patients. This was an innovative idea for the treatment of the mentally ill in the mid nineteenth century. Prior to this pauper patients were discharged without any pecuniary provision, whereas now tools, equipment and clothes were collected to enable patients to earn a living.
The flow of patients being sent to the asylum steadily increased and by 1861 the asylum was severely overcrowded with a proposed extension still not built. The medical superintendent was directed by the committee of visitors to identify, and then remove, all suitable patients to the workhouse. A practice repeated time and again over the coming decades when overcrowding occurred.

Extensions to the building followed, but staffing did not increase to match the growing number of patients. Not enough occupation was provided for the patients and many were kept in seclusion. Competent servants and suitable nurses were attracted to higher wages paid in the large English towns; travel made easy by rail. It was recommended that higher wages should be paid and uniforms provided.

The main treatment for many years was the development of a regime of minimal restraint and kind and humane treatment. However, Dr. Jones also made use of a variety of medications such as, iodine, quinine, hyoscene, and digitalis. He also frequently prescribed brandy and port wine, believing them to have medicinal properties. He also favoured prescribing a mixture of morphia, beef tea and wine.

By 1871 the use of Turkish baths was in operation in the belief that it would have beneficial effects in cases of insanity, but especially when combined with, scrofula, and rheumatism, and consumption, claiming that the use of Turkish baths actually cured these diseases. Dr. Turner Jones reported the peculiarly disagreeable odour which is emitted from the secretion in the skin of the insane is perceptibly modified by the Turkish bath.

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