Footnotes:[Skip][224]Particulars respecting Switzerland and Germany were obtained for the Charity Organization Committee by Drs. Ireland and Beach.[225]It is due to the late Dr. Poole, of Montrose, to state that so early as 1819 he drew attention to the education of idiots in an article in theEdinburgh Encyclopædia.[226]Dr. Ireland has now removed from Larbert to Preston Lodge, Prestonpans, near Edinburgh, and receives imbeciles into his house.
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[224]Particulars respecting Switzerland and Germany were obtained for the Charity Organization Committee by Drs. Ireland and Beach.
[224]Particulars respecting Switzerland and Germany were obtained for the Charity Organization Committee by Drs. Ireland and Beach.
[225]It is due to the late Dr. Poole, of Montrose, to state that so early as 1819 he drew attention to the education of idiots in an article in theEdinburgh Encyclopædia.
[225]It is due to the late Dr. Poole, of Montrose, to state that so early as 1819 he drew attention to the education of idiots in an article in theEdinburgh Encyclopædia.
[226]Dr. Ireland has now removed from Larbert to Preston Lodge, Prestonpans, near Edinburgh, and receives imbeciles into his house.
[226]Dr. Ireland has now removed from Larbert to Preston Lodge, Prestonpans, near Edinburgh, and receives imbeciles into his house.
Ourreference in a previous chapter to the singular superstitions connected with the treatment of the insane in Scotland, renders it unnecessary to do more than point out in this place the substratum of popular opinion and feeling, upon which the infusion of new ideas and a scientific system of treatment had to work. To some extent it was the same in other countries, but judging from the records of the past, as given or brought to light by writers like Heron, Dalyell, and Dr. Mitchell, no country ever exceeded Scotland in the grossness of its superstition and the unhappy consequences which flowed from it. When we include in this the horrible treatment of the insane, from the prevalent and for long inveterate belief in witchcraft, we cannot find language sufficiently strong to characterize the conduct of the people, from the highest to the lowest in the land, until this monstrous belief was expelled by the spread of knowledge, the influence of which on conduct and on law some do not sufficiently realize.
The lunatic and the witch of to-day might aptly exclaim—
"The good of ancient times let others state;I think it lucky I was born so late."
"The good of ancient times let others state;I think it lucky I was born so late."
As regards the property of the insane, the Scotch law, from a remote period, appears to have been that the ward and custody of it belonged to the prince aspater patriæ. In the beginning of the fourteenth century, the keeping and custody of persons of "furious mind," by a statute of Robert I., devolved upon their relatives, and, failing them, on the justiciar or sheriff of the county. The custody of "fatuous persons" is said to have been committed to the next agnate (nearest male relative on the father's side), while that of the "furious" was entrusted to the Crown, "as having the sole power of coercing with fetters."[227]
An Act passed in 1585, c. 18, in consequence of abuses in regard to the nominations of tutors-at-law, provided that the nearest agnate of the lunatic should be preferred to the office of tutor-at-law. The practice was originally to issue one brieve, applicable to both furiosity and fatuity. The statute just mentioned continues theregula regulans, as to the appointment of tutors-at-law for lunatics.
Passing over two centuries, I must observe that in 1792 Dr. Duncan (the physician mentioned atp. 122of this work), then President of the Royal College of Physicians of Edinburgh, laid before that body a plan for establishing a lunatic asylum in the neighbourhood of Edinburgh. That plan, after due consideration, metwith the unanimous approval of the Colleges of Physicians and Surgeons, and a subscription was at once set on foot to carry it into execution, nearly every Fellow of both Colleges contributing something. But enough money was not then raised to start the project in a practical way. Fourteen years afterwards, the attention of the legislature was directed to the provision for the insane in Scotland, when (in 1806) an Act (46 Geo. III., c. 156) was passed for appropriating certain balances arising from forfeited estates in that country to two objects, not apparently allied—the use of the British fisheries and the erecting a lunatic asylum in Edinburgh—ichthyology and psychology. The Act provided, among other clauses, that the Barons of Exchequer should pay out of the unexhausted balance or surplus of the moneys paid to them in 1784, by the Act 24 Geo. III., c. 57 (relating to forfeited estates placed under the board or trustees), the sum of £2000 to the city of Edinburgh towards erecting a lunatic hospital. A royal charter was obtained in 1807, and subscriptions were raised not only from Scotland, but England, and even India, Ceylon, and the West Indies. Madras alone subscribed £1000. The idea of the originators of the institution was a charitable and very far-reaching one. They made provision for three classes—paupers, intermediate, and a third in which the patient had a servant to attend him. It may be mentioned that the establishment of the Retreat of York and its success were constantly referred to in appealing to the public for subscriptions. The building which is now the "EastHouse" was opened in 1813, and the plan of that building was greatly superior to the prison-like arrangement of some of the asylums built twenty or thirty years afterwards. From the beginning the teaching of mental disease to students was considered, as well as the cure and care of the inmates. The management was a wise one. There were three governing bodies—the "ordinary managers," for transacting the ordinary business; the "medical board" of five, consisting of the President and three Fellows of the Colleges of Physicians and Surgeons; and the "extraordinary managers," consisting of official and representative men in and about Edinburgh, who had, along with the ordinary managers, the election of the board every year. At first there was a lay superintendent and visiting physicians.
Then there was an Act "regulating mad-houses in Scotland" (55 Geo. III., c. 69), passed in the year 1815—that important epoch in lunacy legislation in the British Isles—brought in by the Lord Advocate of Scotland (Mr. Colquhoun), Mr. W. Dundas, and General Wemyss, and which received the royal assent, after several amendments from the House of Lords, June 7, 1815.
This Act provided that sheriffs should grant licences for keeping asylums; that no person should keep one without a licence; that the money received for licences should form part of the rogue money in the county or stewartry, and that out of it all the expenses required for the execution of the Act should be defrayed; that inspectors should be elected within a month after the passing of the Act, and thereafter should annuallyinspect asylums twice a year—four by the Royal College of Physicians in Edinburgh from their ordinary resident members, and four by the faculty of physicians and surgeons in Glasgow from their ordinary resident members; that sheriffs should ascertain whether patients are properly confined; that the sheriff should make an order for the reception of lunatics, upon a report or certificate signed by a medical man (no statutory form was ordered for the medical certificates or the warrants of the sheriffs; a medical man signing a certificate without due examination of the patient was to forfeit £50); that the sheriff or stewart might set persons improperly detained at liberty; that a licence might be recalled upon report made to the sheriff by two of the inspectors; that the sheriff might make rules for the proper management of asylums; that the Act should not extend to public hospitals, nor to single patients; that the Procurator Fiscal should enforce the Act and recover penalties. The friends of patients were required to pay an annual fee £2 2s.
Such were the main provisions of this Act, which proved to be an important advance in the right direction, though far from perfect. It was amended by 9 Geo. IV., c. 34, and 4 and 5 Vict., c. 60. The three Acts were repealed and other provisions made by the 20 and 21 Vict., c. 71, an "Act for the Regulation, Care, and Treatment of Lunatics, and for the Provision, Regulation, and Maintenance of Asylums."
I may add here, though anticipating the future course of events, that the General Board of Commissioners in Scotland was established by the Acts 20 and 21 Vict.,c. 71, and 21 and 22 Vict., c. 54, both Acts being amended by 25 and 26 Vict., c. 54, and 27 and 28 Vict., c. 59, the latter continuing the appointment of Deputy Commissioners, and making provisions for salaries, etc. The statutes now in force in Scotland are the 20 and 21 Vict., c. 71; 21 and 22 Vict., c. 89; 25 and 26 Vict., c. 54; 27 and 28 Vict., c. 59; Act for the protection of property of persons under mental incapacity, 12 and 13 Vict., c. 51; Act providing for the custody of dangerous lunatics in Scotland, 4 and 5 Vict., c. 60 (repealed and other provisions made by fore-mentioned Acts); Act to amend the law relating to lunacy in Scotland and to make further provision for the care and treatment of lunatics, 29 and 30 Vict., c. 51; Act to amend the law relating to criminal and dangerous lunatics in Scotland, 34 and 35 Vict., c. 55 (1871).
But we must retrace our steps to pursue the course of legislation a little more in detail.
On the 3rd of February, 1818, a Bill for the erecting of district lunatic asylums in Scotland for the care and confinement of lunatics, brought in by Lord Binning and Mr. Brogden, was read the first time. A few days after, a petition of the noblemen, gentlemen, freeholders, justices for the peace, Commissioners of Supply, and other heritors of the county of Ayr was presented against it, setting forth that the petitioners, "from the first moment that they were made acquainted with the principle and provisions of the proposed Bill, were deeply alarmed for their own interests and those of Scotland in general, by the introduction of a measure uncalled forand inexpedient, novel in its application and arrangement, and substituting regulations of compulsion, to the exclusion of the more salutary exertions of spontaneous charity, and this, too, at a time when, by the gradual progress of enlightened philanthropy, so many admirable institutions have been so lately established in various parts of Scotland by voluntary contributions; and that the petitioners are most willing to pay every just tribute of respect to the humane views which may have dictated the proposed measure, but they are satisfied that it must have owed its origin to exaggerated and false representations of the state of the lunatics in Scotland, and an unjust and groundless assumption of a want of humanity in the people of Scotland toward objects afflicted with so severe a calamity. The House cannot fail to remark that the proposed Bill recognizes a systematic assessment, which it has been the wise policy of our forefathers to avoid in practice, and that, too, to an amount at the discretion of Commissioners ignorant of local circumstances, and perhaps the dupes of misinformation; entertaining, as the petitioners do, deep and well-grounded repugnance to the means proposed for carrying this measure into execution, partly injudicious and partly degrading to the landholders of Scotland, for it does appear to be a humiliating and, the petitioners may venture to say, an unconstitutional Act, which would place the whole landholders in Scotland in the situation of being taxed for any object and to any amount at the discretion of any set of Commissioners whatever; the petitioners therefore, confiding in the wisdom of theHouse, humbly pray that the proposed Bill for providing places for the confinement of lunatics in Scotland may not pass into law."
Another petition against the Bill, from the magistrates and council of the royal burgh of Ayr, was presented and read, praying that the same may not pass into a law; or that if the House should think proper to pass the said Bill, they would exempt the burgh and parish of Ayr from its enactments.
Later on, another petition of the magistrates and town council of the royal burgh of Montrose was presented against the Bill; and subsequently one from Stirlingshire, Renfrew, Wigton, Edinburgh, Elgin, Glasgow, Perth, Dumfries, and many other places.
The second reading was again and again deferred until the 1st of June, when it was ordered "that the Bill be read a second time upon this day three months." Thus persistent obstruction triumphed.
Sir Andrew Halliday, who took from an early period a lively interest in the insane, writes in 1827: "I cannot but regret that the public refused the adoption of a law for erecting district or county establishments, proposed some years ago by that excellent nobleman, Lord Binning. The rejection of this Act arose, I believe, neither from the parsimony nor the poverty of the freeholders, but from a dread of introducing into the kingdom that system which has been denominated the nightmare of England, the poor's rates."[228]
How much legislation was needed at this period is well shown by the description, by a philanthropist, of the condition of the lunatics in the Perth Tolbooth, for which I am indebted to the late lamented Dr. Lauder Lindsay, who observes: "Here is exactly what Mr. J. J. Gurney says, and it is of special interest to us, as showing the sort of provision made for the comfort of our local insane prior to the establishment of the Murray Royal Institution in 1877, nine years afterwards. In all probability Mr. Gurney's report, which was published in his 'Notes on a Visit made to some of the Prisons of Scotland,' led directly or indirectly to Mr. Murray's fortune being devoted to the institution of an Hospital for the Insane. 'The old Jail of Perth is built over a gateway in the middle of the town. Although this dark and wretched building had been for some time disused as a prison, it was not at the period of our visit' (Mr. Gurney's sister, Mrs. Fry, accompanied him) 'without its unhappy inhabitants. We found in it two lunatics in a most melancholy condition; both of them in solitary confinement, their apartments dirty and gloomy; and a small dark closet, connected with each of the rooms, filled up with a bed of straw. In these closets, which are far more like the dens of wild animals than the habitations of mankind, the poor men were lying with very little clothing upon them. They appeared in a state of fatuity, the almost inevitable consequence of the treatment to which they were exposed.No one resided in the houseto superintend these afflicted persons, some man, living in the town,having been appointed to feed them at certain hours of the day. They were, in fact, treatedexactly as if they had been beasts. A few days after our visit, one of these poor creatures was found dead in his bed. I suppose it to be in consequence of this event that the other, though not recovered from his malady, again walks the streets of Perth without control. It is much to be regretted that no medium can be found between so cruel an incarceration and total want of care.'"
A return, signed "H. Hobhouse," was made in this year (1818) from the parochial clergy in Scotland, showing the number of lunatics in each county, and other particulars, which now possesses considerable interest historically. The most important figures are as follows:—
From this table it will be seen that the total number was 4628, of whom 2304 were males and 2324 females. With regard to their distribution, there were—
Two thousand one hundred and forty-nine were maintained wholly or in part by the parish. Fiftyparishes failed to send any return. In one parish in the city of Edinburgh, from which we have no return, were situated the "Edinburgh Bedlam" and the Charity Workhouse. In these two places were confined eighty-eight lunatics and idiots. From Glasgow the returns did not include ninety-five lunatics and idiots confined in the Glasgow Asylum and Towns Hospital; 187 patients must therefore be added to the foregoing, making a total of 4815.
Considering the period at which it was made, this is a very remarkable return, and was much more complete than some later ones; for instance, in 1826 the Parliamentary returns were ridiculously below these figures, and Sir Andrew Halliday could only after diligent inquiry bring up the number to 3700.[229]
Two years later (1828), a Bill was brought into the House of Commons to amend the Act 55 Geo. III., c. 69,[230]by the Lord Advocate, Mr. H. Drummond, and Mr. Robert Gordon. It passed the House of Lords, and received the royal assent June 27th.
This constituted the Act 9 Geo. IV., c. 34, and reduced the fees paid for persons confined from £2 2s.to 10s.6d.; admission and discharge books were ordered to be kept in every asylum, and an entry made of every act of coercion; the books of the asylum were to be submitted to the inspectors; no insane person was to be received into a hospital without a warrant from the sheriff, who was to inspect hospitals; houses were to be visited by medical men—those containing less than onehundred patients, in case such house should not be kept by a physician or surgeon, were to be visited twice in every week by a physician or surgeon—signing in a register the condition of the house and state of health of the patients; a register was also to be kept by the resident physician or surgeon, and such register was to be regularly laid before the inspectors, who were required to sign the same in testimony of its production; ministers were empowered to visit mad-houses in their parishes; regulations were made as to persons with whom lunatics were privately confined; the justices might appoint three of their number to inspect hospitals and private mad-houses; lastly, a weekly register was to be kept in each house, and to be laid before the inspectors, stating the number of curable and incurable cases, and the number under restraint, the necessity thereof being certified by a medical man.
I wish to record here that, so far back as 1838, some of the Scotch asylums were remarkable for the extent to which labour was introduced. Being engaged in writing an introduction to Jacobi's work "On the Construction of Asylums," the editor (Mr. S. Tuke) visited the asylums of Scotland in that year, accompanied by Mr. Williams, the visiting medical officer of the York Retreat, and found at Perth, Dundee, and Aberdeen, the men's wards nearly empty, so large a proportion of their inmates were in one way or other engaged in labour. "At Perth," he writes, "more than twenty came in together to dinner from the labours of the farm; others were employed in the garden and about the premises. At Dundee at nine o'clock in the morning, out of fifty-sevenmen patients of the lower class, twelve were engaged in stone-breaking, eight in gardening, thirteen in weaving, one in tailoring, two as shoemakers, whilst a few were engaged in the preparation of tow for spinning, and several in the various services of the house. In the Aberdeen Asylum, in which the labour system is extensively introduced, we were particularly pleased with the state of the lowest class of women patients—chiefly in an idiotic and demented state. All of these but one, and she was in a state of temporary active mania, were employed in picking wool or some other simple occupation. Indeed, in the three asylums which I have just mentioned, the state of the lowest class of patients offers a striking contrast to that in which they have been usually found in our asylums. Those dismal-looking objects, cringing in the corners of the rooms or squatting on the ground, almost lost to the human form, are here not to be seen. I must not omit to mention that at Aberdeen the manager had succeeded in inducing the higher class of patients to engage in gardening, etc. At Glasgow the governors were contemplating arrangements for the more extensive introduction of the labour system. In all these asylums the superintendents expressed their decided conviction of the benefit which, in a great variety of ways, was derived from the employment of the patients, more especially in outdoor labour."
In connection with the Dundee and Glasgow asylums, the great services rendered by Dr. McIntosh ought not to be forgotten, as also those of Dr. Poole (Montrose), Dr. Malcolm (Perth), and Dr. Hutcheson (Gartnavel).
Scotland south of Edinburgh and Glasgow had not, until 1839, any retreat or place of confinement for the insane, except six squalid stone cells attached to the public hospital of Dumfries. Violent or vagrant lunatics were physically restrained in their own houses, allowed to roam at large, or incarcerated in prisons or police stations. In the year mentioned, the Crichton Institution was opened for the reception of patients of all ranks and means, from the pauper to the peer, in other words, at rates of board from £17 to £350. In those days the building was regarded as magnificent, commodious, and much in advance of the prevalent psychiatry in Scotland, in the provision for the restoration of mental and physical health, and for securing the comfort and happiness of the inmates. The funds providing this building and surrounding fields, had been bequeathed by Dr. Crichton, of Friars Carse, Dumfriesshire, to his widow, who determined the precise application of the magnificent legacy, which it is reported amounted to £120,000. The benevolent foundress caused the structure to have the Bible as a foundation, instead of a stone, and announced her solemn intention that the establishment should be conducted, not merely in accordance with science, but the principles of Christian philanthropy. The first medical superintendent, Dr. W. A. F. Browne, who had made a critical examination of European asylums, and had acted as the chief officer in the Montrose Lunatic Asylum during four years, opened the Crichton Institution in 1839, with what were regarded as sound but advanced views, and with the resolution of carrying intoeffect all that had been discovered or suggested for the amelioration, cure, and care of those who might require treatment or seclusion.
Before the close of the first year of his management, there would appear to have been about a hundred individuals, of various stations and in various mental conditions, consigned to his charge. For these and the gradually increasing numbers of the population, he instituted daily exercise, amusement, occupation in the open air and in the grounds of the establishment, and during winter or inclement weather, billiards, bagatelle, "summer ice," and walking in the protected balconies connected with every ward or gallery in the house. Collections of books were contemporary with the laboratory, and the medical officers invariably carried a catalogue, along with a prescription book, in their daily medical visits to every patient. As a rule, remuneration was ordained for every description of labour, whether it was mental or manual, and might take a pecuniary or honorary form. From the commencement no personal restraint was resorted to, although the medical director did not bind himself either by rules or avowed opinions to prohibit mechanical resources, should they appear to be demanded for the preservation of life or strength, or quiet, or in any respect as a remedial agent. In 1840 a medical assistant or pupil was appointed. The experiment proved eminently successful, and the course thus foreshadowed has been universally adopted, and improved upon by increase in the number of such fellow labourers, by the addition of clinical clerks, and so forth. Thenext advance was in instituting recorded observations of the state of patients during the night as well as the day; in the addition of carriages as a means of enjoyment and distraction, one of these being an omnibus, so that groups of the inmates might be conveyed to distant parts of the surrounding country; and in the multiplication of hygienic and moral influences, music, painting, translation, study of medicine, acquisition of languages, teaching, reading prayers, etc. The next stage of development may be described as the separation of different classes of patients; provision for the agitated, for abstainers; mental culture for all capable of receiving impressions, lectures, public readings, the production of a monthly periodical which is still continued. Of this institution we shall have to speak again.
An Act to alter and amend certain Acts regulating mad-houses in Scotland, and to provide for the custody of dangerous lunatics, was passed in June, 1841 (4 and 5 Vict., c. 60). It amended 55 Geo. III., c. 69, and 9 Geo. IV., c. 34. A penalty of £200 and the expenses of recovering the same might be imposed on persons sending any lunatic to a mad-house without a licence; persons convicted of receiving lunatics without a licence, or the required order, might be imprisoned in default of penalty; the sheriff on application of the Procurator Fiscal might commit dangerous lunatics; the expenses were to be defrayed out of the rogue money, if the person had not the means of defraying, or if it could not be recovered out of his estate, then the same was to be defrayed by the parish which would be liable for the maintenance of suchlunatic if he or she were a pauper; lunatics might be removed on application by the Procurator Fiscal; parish pauper lunatics were to be confined in public hospitals; if no public hospital in the county, the sheriff might send lunatics to an adjoining county; the death of a lunatic was to be intimated to the sheriff in writing by the person keeping the licensed mad-house; fees of licences might be diminished if the moneys received exceeded the sums required for carrying this Act into execution.
A form of register was to be kept in all licensed mad-houses in Scotland, indicating the house; where situated and kept; names and designations of individuals confined; date of reception; at whose instance confined, and on whose medical certificate; whether curable or incurable; date of removal or discharge, and authority for either; date of death; disease or cause of death, and duration of disorder; name of medical practitioner; when first called to give special attendance, and how often he afterwards visited the deceased, with the place of burial.
We must not omit to mention that in 1848 further legislation was attempted—an attempt, the failure of which was frequently deplored in the debates of succeeding years. A good Bill designed to amend the law of Scotland relative to the care and custody of the insane, and to regulate existing asylums, and to establish asylums for pauper lunatics, was brought in by the Lord Advocate (Lord Rutherfurd), Sir George Grey, and the Secretary at War. After the second reading it was referred to a Select Committee, which included the namesof the Lord Advocate, Lord Ashley, Sir James Graham, Mr. E. Ellice, Mr. Stuart Wortley, and Mr. H. Drummond. Petitions now poured in from almost every shire in Scotland, and the Bill had unfortunately to be withdrawn. Undaunted, the Lord Advocate made another attempt in the following year, but with the same result.
It is not necessary to dwell longer on the condition of the insane, or the legislation adopted on their behalf, till we come to the year 1855, which proved to be the commencement of a new departure in the care taken for them by the State. Unfortunately, in spite of legal enactments, the state of the insane in Scotland, at this time, outside the asylums was as bad as it could be, and even in some asylums it was deplorable. At this period a well-known American lady, Miss Dix, who devoted her life to the interests of the insane, visited Scotland, and the writer had the opportunity of hearing from her own lips, on her return from her philanthropic expedition, the narration of what she saw of the cruel neglect of the pauper lunatics in that country. She caused so much sensation by her visits and her remonstrances, accompanied by the intimation that she should report what she had witnessed at head-quarters in London, that a certain official in Edinburgh decided to anticipate "the American Invader," as Dr. W. A. F. Browne called her. Miss Dix was, however, equal to the occasion, and, hurriedly leaving the scene of her investigations, she took the night mail to London, and appeared before the Home Secretary on the following day, when the gentleman from Edinburgh was still onthe road, quite unconscious that the good lady had already traversed it.[231]The facts she laid before the Home Office were so startling that they produced a marked effect, and, notwithstanding counter allegations, the conclusion was very soon arrived at that there was sufficientprimâ facieevidence to justify an inquiry. A Royal Commission was appointed, dated April 3, 1855, "to inquire into the condition of lunatic asylums in Scotland, and the existing state of the law of that country in reference to lunatics and lunatic asylums."
The statutes forming the code of lunacy law for Scotland at that period were, for all practical purposes, the 55 Geo. III., c. 69; 9 Geo. IV., c. 34; and 4 and 5 Vict., c. 60.
The number of ascertained patients at this period (1855) amounted to 7403. The classification was as follows:—Private patients, 2732; paupers, 4642; criminals, 29 = 7403. Curable, 768; incurable, 4032; congenital idiots and imbeciles, 2603 = 7403. Males, 3736; females, 3667 = 7403. The proportion of the insane and idiotsto the population was 1 in 390. The number of congenital idiots was greatest in proportion to the population in those counties remote from influences that incite to mental activity—the Highland population containing more than three times the number found in an equal Lowland population.
The 2732 private patients were thus distributed: In chartered asylums, 652; licensed houses, 231; poor-houses, 9; reported houses, 10; school for idiots, 12; unlicensed houses, 18; with relatives, 1453; with strangers, 297; not under any care, 50; total, 2732.
The 4642 paupers were thus distributed: In chartered asylums, 1511; licensed houses, 426; poor-houses, 667; reported houses, 31; school for idiots, 3; unlicensed houses, 6; with relatives, 1217; with strangers, 640; not under any care, 141; total, 4642.
The receptacles for the insane were thus distributed:—
A. Chartered asylums. The Royal Asylums at Aberdeen, Dundee, Edinburgh, Glasgow, Montrose; the Crichton Institution, Dumfries, including the Southern Counties Asylum; James Murray's Royal Asylum, Perth.
B. Public asylums not incorporated. The only institution of the kind, that of Elgin, was exclusively for paupers.
C. Poor-houses with separate wards for the insane (twelve given in the table).
D. Prisons. The only one specially adapted for the reception of the insane was the lunatic department of the general prison at Perth.
E. Poor-houses without separate wards for the insane (fourteen given).
F. Private asylums (twenty-three in number).
G. Private houses reported to the sheriff.
H. Houses of relatives and strangers.
I. Schools for idiots. Baldovan, near Dundee; and Gayfield Square, Edinburgh.
This Commission did not report until 1857, and unhappily the evidence more than justified the necessity of the appointment of the Committee, and of a sweeping measure of reform. The difficulty in selecting passages from the Report is to know where to stop. We shall restrict ourselves within moderate bounds; and first let us cite the reference to the condition of the insane and idiotic not in asylums. "It is obvious," says the Report, "that an appalling amount of misery prevails throughout Scotland in this respect. When estimating the condition of the insane not in establishments, it should be remembered that the details furnished by us give only an imperfect representation of the true state of matters. They form only a part of the picture of misery; and, had we been able to extend our investigations, it would, we are convinced, have assumed a much darker shade.
"A practice prevails in some workhouses, as in a few of the licensed asylums, of fastening the hands behind the back, by which much unnecessary pain is inflicted on the patient."
Of the methods employed inasylumsto repress violence, etc., the Report thus speaks:—
"Instrumental Restraint and Seclusion.—Personalrestraint by the application of the strait waistcoat, or of the straps or muffs, is almost entirely banished from the chartered asylums; but we have reason to think that seclusion for long periods is frequently used. This remark applies more especially to the asylums of Montrose, Glasgow, Aberdeen, and Edinburgh. In Montrose we found, on one occasion, eleven patients in seclusion out of a population of 174, several of them having been so secluded for considerable periods, and one woman for several months; and it is to be observed that the seclusion rooms in this asylum aremere cells, with stone floors and darkened windows, and that the patients who are placed in them are frequently allowed no other covering than blankets, and no other bedding than loose straw cast on the floor."
Here is a picture of the way in which one asylum was conducted: "We have grounds for fearing that the patients suffered from cold. The house is carelessly conducted and the state of the patients very unsatisfactory. The bed-frames, which are about the ordinary size with only spars of wood at the lower part, were dilapidated and saturated with filth; and the quantity of straw in them was very scanty and mixed with refuse; it was wet, offensive, and broken into small portions, and had clearly not been renewed for a considerable time. A certain number of the patients, males as well as females, were stripped naked at night, and in some cases two, and in one case even three, of them were placed to sleep in the same bed-frame, on loose straw, in a state of perfect nudity." Theproprietor in his evidence says, "I never go into the rooms at night. The floor is constantly soaked with wet. There is an epileptic lad who is frequently fastened to the rings in the wall. The nurses keep the muffs in their custody. I dare say half of the dirty patients would sleep naked; seven would, therefore, sleep with others, I cannot say that more did not sleep together in a state of nudity.I consider the treatment is proper for them."
Again: "The bad treatment of the patients, and the very unsatisfactory treatment of the patients, are not fully known to the official inspectors. Indeed, it would appear that in some houses the instruments of restraint are systematically removed from the persons of the patients after the arrival of the sheriff at the asylum, for we find in Dr. Renton's evidence that, speaking of L—— Asylum, in which two male patients are kept constantly in restraint by means of handcuffs, he says, 'There are not many patients under restraint at L——.' And, further, in reference to Mrs. B——'s house at N——, he states, 'In Mrs. B——'s house I don't think there are many cases of restraint. There is a Miss W—— lately come, and a Miss M——. I don't think restraint is used to them.' We have ascertained, however, that these two patients were frequently restrained. These instances might be multiplied.
"Rent is savedby placing patients in small houses, making them use the same rooms both as day and sleeping accommodation; they are also crowded into small airing-courts, inadequate to afford proper exerciseand a proper separation of the sexes. The inmates during the winter months pass the greater part of each twenty-four hours in their bed,whereby candle-light is saved. In L—— Asylum, the patients are not allowed candle-light at any season.
"We cannot doubt that in many instances practices obviously wrong, and detrimental to the patients, have been adopted in licensed houses, because an increased profit would thereby be obtained by the proprietor."
In short, both as regards licensed houses and unlicensed houses, the Report winds up by giving a dismal picture; for, as to the former, "they are crowded in an extreme degree, profit is the principal object of the proprietors, and the securities against abuse are very inadequate;" and as to the latter, they "have been opened as trading concerns, for the reception of certain classes of patients who are detained in them without any safeguard whatever against ill-treatment and abuse." Strange to say, the persons properly authorized to inspect, did not avail themselves of the powers of inspection granted them by law; and the officials chose to interpret the law "in conformity with their respective views." Such was the unfortunate condition into which Scotch lunacy had drifted, at so comparatively recent a date as 1857, and out of which those who drew up the Report—Alexander E. Monteith, James Coxe, Samuel Gaskell, and William George Campbell—proposed to deliver it by the following remedial measures:—The erection of district or county asylums for pauper lunatics, including accommodation for the insane belonging to the labouring classes,who are not strictly paupers. Likewise, more suitable accommodation for criminal lunatics. Means for insuring greater caution and discrimination as regards the licensing of houses for the reception of the insane; for imposing some check upon the licensing of new houses; and for conferring powers to close those already opened for paupers so soon as public asylums shall be erected, or at any other time, if not properly conducted. Regulations by which all pauper lunatics not in asylums shall be brought under proper visitation and care, and periodical reports be made as to their condition by medical men, so as to afford a safeguard against abuse and ill-treatment, and secure the ready and careful transmission of all proper cases to asylums. An accurate definition of the powers and duties of sheriffs in reference to the insane, so as to secure a more uniform practice and united action amongst them. Rules for the guidance of the Board of Supervision, parochial boards, inspectors of poor, and district medical officers in all matters relating to the management of the insane. More complete regulations in reference to medical certificates; to prevent interested parties signing them; to specify the length of time the document shall remain in force; and to require a statement of the facts or evidence upon which the opinion as to the patient's insanity is founded. Also a limitation of the time during which the sheriff's order shall remain in force, previous to the admission of the patient, and also in case of escape. The formation of a complete system of schedules and returns, together with full records of all admissions, discharges, deaths,and accidents. Also the institution of registers and case-books, showing the medical treatment pursued in each case, and whether, and to what extent, restraint and seclusion were employed. Comprehensive regulations applicable to licensed houses and poor-houses, while continuing to receive lunatics, for securing to the patients sufficient medical and other attendance; kind and appropriate treatment; proper diet, clothing, bedding, exercise, and recreation; and adequate means of religious consolation. A requirement that, on recovery, patients shall be discharged by the medical attendant of the establishment. Restrictions on the removal of pauper patients by inspectors before recovery. Precautions for preventing injustice in transporting aliens. Better regulations as to dangerous and criminal patients. Measures by which persons labouring under insanity may voluntarily place themselves under care in an asylum. Special regulations for prolonging control over cases of insanity arising from intoxication. Enactments for extending further protection to the property of lunatics, and for insuring the proper application of their funds. The imposition of suitable penalties for infringement of the law, and power to modify them according to circumstances. Powers to raise sufficient funds for the purposes of the Act. The creation of a competent board, invested with due authority, to whom the general superintendence of the insane in Scotland shall be entrusted, including power to license houses for the reception of the insane; to visit all asylums, licensed houses, poor-houses, and houses containing only single patients; toorder the removal of patients to or from an asylum, or from one asylum to another; to give leave of absence to convalescent patients; to regulate the diet in asylums and licensed houses for pauper patients; to make regulations for their management, etc., etc.; with direction to report to the Secretary of State for the Home Department. The formation of local boards for the management of individual asylums, which shall act in conjunction with the general board.
Legislation followed in due time.
On the 29th of May, 1857, Mr. Ellice,[232]the member for St. Andrew's, asked the Government what steps they intended to take for securing to pauper lunatics in Scotland proper protection and maintenance, in order to alleviate the sufferings of the persons to whom the recent Report of the Commissioners of Inquiry into the state of Lunatics in Scotland related. He was ashamed to have to admit that in that country, unfortunately, the state of things had been lamentably different from England and Ireland, where boards had been appointed under which, generally speaking, the law for the protection of lunatics had been satisfactorily administered. In Scotland, instead of a Board of Commissioners specially appointed to take care of lunatics, the charge had devolved upon the sheriffs of counties and the Board of Supervision, which latter body stood in the place of the Poor Law Board in this country. He charged the Scotch authorities with an almost total neglect of the duties which were incumbent upon them under the law,which "in a great measure was very ample for the protection of the great proportion of the pauper lunatics in Scotland, if it were properly administered." The powers and duties of the sheriffs, as laid down in the Act, were amply sufficient. Yet the granting of licences, which was their duty, formed the exception, and, in fact, houses were opened generally without any licence whatever; the patients were detained without any order, or without even any medical certificate; if they died, their friends were not informed of their deaths, which were not reported to any constituted authority, "the unfortunate persons disappearing in that mass of misery and filth which he should shortly depict." The pauper lunatics were under the charge of the parochial boards. These were under the control of the Board of Supervision, sitting in Edinburgh, and similar to the Poor Law Board in London. The statute enacted that whenever any poor person chargeable on the parish should become insane, the parochial board should, within fourteen days of his being certified, take care that he was properly lodged in an asylum. The Board of Supervision had, under the same Act, peculiar power with respect to lunatics, and it was competent for them to dispense with an asylum, and allow the patient to remain with his friends under due inspection.
The Board of Supervision had absolute powers to dismiss any inspectors of the poor neglecting their duty to pauper lunatics. They acknowledged their obligation. In their first Report (1847) they, among other positive statements, affirm that they, in all cases in which they dispensedwith the removal of pauper lunatics to asylums, were careful to preserve the necessary safeguards against abuse, by requiring a satisfactory medical certificate as to treatment, and so on. Mr. Ellice then showed that "these statements had no foundation in fact; that they were positively untruths, and entirely deceptive, year after year, as to the real state of the lunatics in Scotland." In subsequent Reports the Board boasted that it had endeavoured, not unsuccessfully, to improve the condition of the insane, but Mr. Ellice showed that "the condition and treatment of the pauper lunatics was diametrically opposite to what was there stated." He knew that more legislation would be promised by the Government, but the thing was to see that the law was enforced, and that due notice should be taken of the conduct of the authorities who had neglected their duties. He asked that a direct condemnation should be passed upon them, and that they should be compelled, as in duty bound, to protect pauper lunatics from continued neglect and abuse. The member for Aberdeen characterized the Report of Commissioners regarding the state of the insane in his county as "one of the most horrifying documents he had ever seen."[233]It was "a state of things which they could not before have believed to prevail in any civilized country, much less in this country, which laid peculiar claims to civilization, and boasted of its religious and humane principles."[234]"Distressing as were the cases which he had mentioned, there were others ten times worse remaining behind—so horrible, indeed, that hedurst not venture to shock the feelings of the House by relating them."[235]Sir George Grey, after saying that the Report on the treatment of lunatics in Scotland contained statements of facts calculated to cast very great discredit upon that portion of the United Kingdom, admitted that the Board of Supervision was not free from blame, but thought the Report proved that the guilt must be shared by the parochial boards, the inspectors of the poor, the sheriffs, the clergy, the justices of the peace, and by the Commissioners of Supply. By this ingenious homœopathic dilution of the blame, it was easy to show that individual responsibility was infinitesimal, and could not, therefore, be detected and punished in the way it so richly merited. Sir George Grey promised to introduce a Bill calculated to remove the defects in the law established by the Reports, and deplored the fate of the Bill brought in by Lord Rutherfurd,[236]when Lord Advocate, which would, in his opinion, have remedied all the evils now complained of. It was "referred to a Select Committee, but the opposition roused to it in Scotland, on the miserable ground of the expense it would incur, proved fatal to the measure. I trust the disgrace that now attaches to Scotland in this matter will be removed, and that this and the other House of Parliament will cordially co-operate with the Government in the adoption of those measures that are necessary for the relief and protection of the unfortunate class of persons referred to in the Report."[237]Mr. H. Drummond, who said he had assistedLord Rutherfurd to pass his Bill, also deplored its rejection. "Both he and the Lord Advocate were beaten by the systematic opposition of every single person who was connected with the administration of the system in Scotland. They would not give the returns sought for ... and the ground of the opposition was the dread of the dirty expense which might be incurred. From one to the other it appeared that the object of care in Scotland was property, not persons. The way in which they treated the poor in Scotland was perfectly scandalous, and in nothing did the system appear so bad as in the treatment of pauper lunatics, the rich lunatics being sufficiently well taken care of." Mr. Drummond asked how it was "that throughout the whole of Scotland there was not one clergyman who could find time to visit these poor creatures? True, there was one, but when he went to the asylum he was refused admittance; and why? Because he was a Papist. The Poor Law, as managed by the Board of Supervision, had been well defined to be 'a law for depriving the poor of their just rights.'"[238]Sir Edward Colebrooke, as one of the members for Scotland in the previous Parliament, took his share of the blame that attached to the House in reference to Scotch asylums. In the Report issued in 1844, it was recommended that more stringent provisions should be introduced into the law, but they had not been attended to. Mr. Kinnaird, the member for Perth, thought that the Scotch members owed a debt of gratitude to Mr. Ellice for the manner in which he had laidthe disgraceful feature in the administration of the Scotch Poor Law before the House. He was glad to find that the Perth Asylum was not one which had disgraced Scotland.[239]The Lord Advocate rejoiced at the publication of the Report, and the statements of Mr. Ellice, from the bottom of his heart, because the state of things had for a long time been a disgrace and a scandal to Scotland. "The people of that country had known that it was a disgrace and a scandal, and he regretted to add that it was not the first time that statements had been made similar to those to which they had just listened. Had Lord Rutherfurd's Bill of 1848 been passed, this disgraceful state of things would have been put an end to. But not a single petition was presented in its favour, while twelve of the largest and most important counties of Scotland petitioned against it! That noble-minded lady, Miss Dix, went to Edinburgh and visited the asylums at Musselburgh. After seeing them, she said there was something wrong, and she wished to be allowed to visit them at the dead of night, when she would not be expected. He felt a difficulty about giving a permission of that kind to a non-official person, and accordingly she applied to the Home Secretary. When asked by him his opinion of the subject, he at once stated that the whole system with regard to the treatment of lunacy in Scotland was utterly disgraceful, and that the evil could only be reached by a Commission of Inquiry. The facts were now so clearly proved that if he proposed the very remedy which was rejected in 1848, it wouldbe adopted by both Houses of Parliament without any important opposition."
A Government Bill was brought in by the Lord Advocate, June 9, 1857, "to alter and amend the laws respecting lunatics in Scotland." In introducing it, he summarized the then law as follows:—The sheriffs of the counties, the justices, and some other parties had the power and duty of inspection once or twice a year; certain registers were ordered to be kept and certain regulations made. But there was no uniformity; every sheriff might interpret the Act as he pleased, and there was no obligation to erect asylums for the maintenance of lunatics. The duty was thrown on the Procurator Fiscal of seeing the Act executed, but no power was given him to ascertain whether it was executed or not, and there was no power of visitation. He need not say that these safeguards entirely failed, and the remedy he now proposed was that there should be appointed a Commission, an inspector-general who should be a medical man, a secretary, and a clerk; and that these should constitute the Lunacy Board for Scotland, though not under that name. They would have the power of granting and refusing licences for asylums. The sheriffs and the justices would retain the powers conferred on them already. Scotland would be divided into districts, in which asylums would be erected by an assessment laid on for the purpose. The Lord Advocate made a sort of formal defence of the Board of Supervision, of which he himself had been a member, and pointed out that in their first Report they had stated that the accommodationin the asylums was not equal to that required for one-tenth of the number of pauper lunatics. Sir John McNeill, who presided over the Board, when examined before the Select Committee on Miscellaneous Expenditure in 1848, stated this fact strongly. Mr. Ellice, however, adhered to the remarks he had previously made, reasserted his accusations, and repeated that if the question were put to a jury, they would come to no other decision than that gross culpability existed on the part of the authorities, and he only regretted that the Government had not had the courage to say that the Board of Supervision had deserved the condemnation of the House. Leave was given to bring in the Bill.[240]
On the second reading[241](June 9, 1857) no serious opposition was offered to the Bill, although an attempt was made to show that the Commission had been carried away by exaggerated statements. Mr. Bruce, the member for Elginshire, who alleged this, hoped the Bill would not be hurried through the House that session. Mr. Blackburn, the member for Stirlingshire, said he agreed with every Scotch member that a permanent board would be of no use; it would be coercing the people by centralization. Mr. Cowan, member for Edinburgh, said that he had been requested to present a petition, signed by the Lord Provost and magistrates of Edinburgh, seeking for delay, but he did not like to incur that responsibility, and would therefore supportthe second reading. Mr. Dunlop, the member for Greenock, assumed, for the sake of argument, that all persons in Scotland had done their duty; but even if this were so, it was impossible but that cruelty and ill-treatment must have taken place when they considered the way in which pauper lunatics were treated, and he rejoiced that another session was not likely to pass over without something being done to remove what was at once a national calamity and a national crime, from Scotland.[242]Mr. Mackie, the member for Kirkcudbrightshire, protested against the creation of a new Board and the expensive machinery contemplated by the Bill. Sir William Dunbar, the member for Wigton, agreed, and maintained that the existing system was sufficient to insure all that was required. Sir John Ogilvy, member for Dundee, said a strong feeling existed in Scotland that the Board of Supervision furnished an efficient machinery capable of supplying all the defects of the present system, without the creation of a new Board. Mr. Hope Johnstone, member for Dumfriesshire, enforced these remonstrances, by stating that he had representations made to him from every quarter in opposition to the appointment of a new Board. Mr. Drummond hereupon made an observation, greatly to his credit, which deserves to be remembered. He said that the question was not so much what would be the most expensive as what would be the most efficient machinery. There were plenty of representatives of the ratepayers in that House,but no representatives of the lunatics of Scotland. They seemed to have nofriends there, while really they were the persons who stood most in need of being represented.
The Act (20 and 21 Vict., c. 71) was passed August 25, 1857. It was entitled "An Act for the Regulation of the Care and Treatment of Lunatics, and for the Provision, Maintenance, and Regulation of Lunatic Asylums in Scotland." It repealed the Acts 55 Geo. III., c. 69; 9 Geo. IV., c. 34; and 4 and 5 Vict., c. 60.
To give a complete analysis of this most valuable Act, which consists of no less than 114 sections, would be wearisome to the reader. Its chief provisions were these:—
A Board of Commissioners in Lunacy for Scotland was to be appointed, consisting of three unpaid and two paid Commissioners; the Secretary of State was empowered to appoint one or two medical men as Deputy Commissioners; public asylums founded after the passing of this Act were to be subject to it; the duties of the Commissioners as to inspection were laid down; the sheriff was to visit and inspect asylums; private asylums were to be licensed by the Board; the patient was to be admitted by order of the sheriff on medical certificates; five shillings were to be paid for the sheriff's order for the admission of a patient not being a pauper, and half that sum for a pauper; the medical certificate was to specify the facts on which opinion of insanity was founded; no certificate was to be granted without examination, under penalty not exceeding £50, and if falsely granted, under a penalty not exceeding £300; houses where lunatics were detained under the order of thesheriff might be visited by the Board; one medical man was to be resident in every asylum licensed for a hundred patients or more, and a physician was obliged to visit daily those for more than fifty patients; those for fifty or less were to be visited at least twice in every week.
Scotland was divided into districts, set forth in a schedule, and a district board was to be appointed within six months, which should inquire into the necessities of the district; the Board was to require the district boards to provide district asylums; the provisions of 2 and 3 Vict., c. 42, were to be applied to this Act; district asylums were to be vested in district boards, and district inspectors were to be appointed.
Power was given to Public Works Loan Commissioners to lend money for purposes of the Act, provision being made for the money borrowed being paid off within thirty years.
In case the district asylum could accommodate more than the lunatics of the district, other lunatics, it was enacted, might be admitted.
Whether the property of a lunatic was or was not under judicial management, if it was not property applied for his benefit, application was to be made to the Court of Session.
Provision was also made for cases where insanity stands in bar of trial; the finding of the Court that the prisoner cannot be tried, to be followed by an order to be kept in strict custody during her Majesty's pleasure; a lunatic acquitted of a criminal charge on the ground of insanity, to be kept in custody by order of court in suchplace as it may see fit, during her Majesty's pleasure; prisoners exhibiting insanity when in confinement to be removed to an asylum, to remain there until it should be certified to one of her Majesty's Principal Secretaries of State by two medical men that such person has become of sound mind; whereupon the Secretary of State was authorized, if such person's term of imprisonment had not ended, to issue his warrant to the superintendent, directing that such person should be removed back to prison, and if no longer subject to imprisonment, that he should be discharged.
With regard to the liberation of patients from asylums, the certificates of two medical men approved by the sheriff were required, eight days' notice being given to the person at whose instance such lunatic was detained; the patient released to be entitled to a copy of order, certificate, etc., on which he was confined.
The punishment of maltreating any lunatic was a fine not exceeding £100, or imprisonment for any period not exceeding six months, without prejudice to action for damages.
Power was granted to the Secretary of State to order a special visitation of any place where a lunatic was represented to be confined.
The inspectors of the poor were to give intimation of pauper lunatics within their parishes.
The importance of this Act is enhanced by the fact that its framers had the advantage of a knowledge of the working of the great Acts of 1845 and 1852 in England and Wales.
Availing ourselves now of the first Report of the Commissioners[243]who were appointed under the foregoing Act, we shall present a statement of the number and distribution of the insane in Scotland on the 1st of January, 1858.
The above table does not include private single patients; their number could not be accurately ascertained.
The Commissioners, as might be expected, report the state of the insane to have altered little since the Report of the Royal Commission. In the pauper licensed houses, if not in others, the overcrowding was great, though diminishing. "The patients, when within doors, are generally found sitting in cheerless rooms, ranged on benches, listless and without occupation; and when out of doors, they are usually lounging sluggishly about the airing-courts, or are crouching in corners." Among favourable indications noted by the Commissioners it is pleasant to read the following:—"Mechanical restrainthas been entirely banished from the licensed houses, and patients who are recorded in the Report of the Royal Commissioners as almost always under restraint, are now habitually free from their bonds. The improvement in the condition of these cases under the more humane treatment now in use has been most remarkable, and is especially exemplified in the case of A. S——, a patient in M—— Asylum."
Subsequent Acts were passed, called for by the experience of the Commissioners in regard to the working of the Act of 1857, some imperfections in which were naturally discovered in the course of years.
The Lord Advocate and Sir George Grey brought in a Bill in 1862 to make further provision respecting lunacy in Scotland, which received the royal assent July 29 (25 and 26 Vict., c. 54).
By this Act, consisting of twenty-five sections, the Board was empowered to license lunatic wards of workhouses; to sanction the reception of pauper lunatics in workhouses; to grant special licences for reception in houses of not more than four lunatics; to grant licences to charitable institutions for imbecile children without fee; to sanction detention of pauper lunatics in asylums beyond the limits of their district; to take such steps as the Board may consider requisite towards providing accommodation for the district, etc., etc. Not to cite other sections, certain provisions of the recited Acts as were inconsistent with the Act were repealed, and the General Board of Commissioners was, of course, continued.
In their Report of this year (1862) the Commissionersobserve, relative to the supposed increase of insanity, "Judging from the evidence which the tables afford, the increase is almost entirely due to the accumulation of the numbers of the insane, and certainly not, to any marked degree, to a greater disposition in modern times to mental disease; for while in the years 1858, 1859, 1860, and 1861, theadmissionsinto asylums scarcely varied in number, the patients resident in such establishments showed every year a large and steady increase. Thus, on January 1, 1858, their number amounted to 3765; on January 1, 1859, to 4114; on January 1, 1860, to 4350; and on January 1, 1861, to 4462."
We have already noted the fact that more idiocy appears to be found in the counties least exposed to mental activity. In this Report, however, the Commissioners state that, as regards lunacy, its occurrence is considerably more frequent inurbanthan inruraldistricts. The wordoccurringis here used advisedly in contradistinction to existing lunacy. The explanation offered by the Commissioners is that there is a greater proportion of recoveries and deaths taking place among the patients of the rural district. They contrast the number of pauper lunatics intimated from urban populations with the number intimated from rural districts, and they find that in the former, the occurrence of pauper lunacy as compared with its occurrence in the latter, is as 100 to 54, whereas the proportion of existing pauper lunatics, January 1, 1861, in the corresponding districts was as 100 to 106. The Commissioners regarded as urban those parishes containing towns, or partsof towns, having more than 20,000 inhabitants, and as rural all other parishes.
We need not dwell on the Act passed in 1864 (27 and 28 Vict., c. 59) to continue the Deputy Commissioners in Lunacy in Scotland, and to make further provision for their salaries and the clerk of the Board.
In 1866 another Act was passed (29 and 30 Vict., c. 51) to amend the Acts relating to lunacy in Scotland, and to make further provision for the care and treatment of lunatics. One or two of the provisions made merit notice. Any person keeping a lunatic in a private house, although not for gain, longer than one year, was obliged, if the malady required compulsory confinement or restraint or coercion, to report to the Board, that it might make inspection and obtain an order for the removal of such lunatic to an asylum. Regulations were made as to persons entering voluntarily as boarders, whose mental condition is not such as to render it legal to grant certificates of insanity. Letters from patients to the Board, and from the Board to patients, were to be delivered unopened. Power was given to apply to the Court of Sessions to obtain improved treatment and care of any lunatic. Patients committed as dangerous lunatics might be liberated on the certificates of two medical men, approved by the Procurator Fiscal, that such lunatic may be discharged without risk of injury to the public or the lunatic. This is a valuable provision. Power was given to the directors of asylums to grant superannuations to officers, etc.