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On the Separate Care and Special Medical Treatment of the Acute and Curable Cases in Asylums; with Proposals and Suggestions for a Detached Hospital, for special purposes, in connection with every large Public Lunatic Asylum

Published online by Cambridge University Press:  19 February 2018

J. Wilkie Burman*
Affiliation:
Wilts County Lunatic Asylum, Devizes

Extract

Throughout the length and breadth of the kingdom, from the “Dan” of Inverness to the “Beersheba” of Bodmin, if there is one universal wail, and one that is more continuously and persistently than any other given vent to in asylum reports, it is that which refers to the fact that our asylums are becoming, day by day, more and more transformed into receptacles for the care of the insane rather than hospitals for the cure of insanity, and that the more important and paramount object in view is being gradually swallowed up and thwarted under circumstances over which, at present, we seem to have but very insufficient control. Coincidently with this general lament, we find that the separate care and treatment of the chronic and harmless cases in asylums, in some less expensive manner, is urging itself into a prominent position—as a desirable object to be attained for certain economic and other reasons; and it is, to my mind, a matter for some considerable regret that, at the present time, our efforts seem, apparently, to be directed principally, if not entirely, in this channel, to the comparative neglect of the more important and paramount object to which I have referred. That is to say, of the two principal objects at present more particularly engaging our attention, such practical steps as are being taken are rather in the direction of securing a cheaper care of the incurable great majority than towards effecting the cure of the small minority, which I am sanguine enough to believe it is within our power to recall more largely to a state of health, if only more determined and special efforts be made in such a grand and worthy undertaking. Of course institutions for the insane must ever continue to fulfil their desirable function as asylums or safety-houses, and I certainly have no wish to underrate the importance of endeavouring to effect, as far as possible, such economical reforms as may be brought about by the separate and less expensive care and treatment of the chronic and incurable cases of insanity, which are of interest principally (and deservedly so) from a humane point of view; nor do I but consider that the care of the great majority must ever, very largely and very properly, engage attention in Public Asylums; but I do desire, at the present time, to lift up my humble voice in deprecation of the pre-eminence of the practical efforts that are now being made in this direction over those being made to secure a greater rescue of curable cases from life-long insanity, which, after all, should be the object most worthy of the special attention and best energies of the Asylum Physician. Indeed, the separate care of the chronic and incurable majority cannot but hasten the advent of a system, of separate and special treatment of the curable minority, which I am now desirous of advocating.

Type
Part I.—Original Articles
Copyright
Copyright © Royal College of Psychiatrists, 1879 

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