ART. III. Lunatic Asylums, Ireland. Report on the District, Local, and Private Lunatic Asylums in Ireland, 1848, with Appendices, presented to both Houses of Parliament, by command of her Majesty. Dublin: Thorn. 1849. THE state of lunacy in Ireland has been repeatedly a matter of parliamentary inquiry, and now, when distress, famine, pestilence, and voluntary self-expatriation are spreading desolation through that unhappy land, the subject appears to us invested with a deeper and more solemn interest than heretofore. The want of proper accommodation for the insane and the lunatic poor of Ireland was long ago a national grievance. Prievous to the year 1810, no provision had been made by the legislature for this class of sufferers beyond a few cells in the workhouses, and county prisons, and St. Patrick's Hospital, which was opened upon the 19th of September, 1757, and is now capable of receiving 150 patients. In the year 1810, a grant was made by parliament for establishing the Richmond Lunatic Asylum in Dublin, for the accommodation of 200 patients, [55 Geo. III. c. 107,] which was opened in 1815; but the sphere of its operation, extending through the counties of Dublin, Meath, Wicklow, and Louth, embraces a population of 180,984 persons, and it is shown by the tables before us that its institution is wholly inadequate to meet the wants of so extensive a district. In 1817, a committee of the House of Commons reported that the only effectual mode of relief would be the establishment of district asylums, eleven of which are now open; but although they have been considerably enlarged and extended, the provision they afford is wholly inadequate to meet the wants of the lunatic poor in each district. The result is that patients are still consigned to gaols and cells in workhouses, "where these poor creatures are often obliged thus to remain until vacancies occur in the asylums proper for their reception."-(Report, p. 5.) The impropriety, or rather the absolute inhumanity, of such a system is obvious. In these temporary places of refuge, proper care and medical treatment in the early stages of the disease are impracticable; the disorder, consequently, becomes aggravated and confirmed, and to this cause may now be ascribed the fact that the district lunatic asylums are now encumbered with hopeless and incurable cases. The Report states "The evils arising from the practice of committing lunatics to gaols, and the want generally of adequate asylum relief, increased to such an extent as to be made the subject of a parliamentary inquiry, in the year 1843, when a select committee of the House of Lords was appointed to examine into the state of the Irish asylums, with the view of remedying these defects. "The result of their labours will be seen in their report of the evidence taken before them, and their views, after a careful examination of that evidence, are generally embraced in the following resolutions-viz., "The committee are desirous of impressing on the House, as the result of their inquiries, the following propositions, on which they have formed the strongest opinion 1. The necessity of discontinuing, as soon as practicable, the committals of lunatics to gaols and Bridewells. 2. The necessity of amending the Act of the 1 Vict. c. 27, which appears, on the authority of the Lord Chancellor of Ireland, to have led to the most serious abuse. 3. The inexpediency of appropriating the union workhouses as places either for the custody or the treatment of the insane, for both which purposes they appear wholly unsuited. 4. The necessity of providing one central establishment for criminal lunatics, under the immediate control and direction of the government of Ireland, to be supported from the same funds and under the system adopted in respect to criminal lunatics in England. 5. The necessity of increasing the accommodation for pauper lunatics in Ireland, and of providing for the cases of epilepsy, idiotcy, and chronic disease, by an increased number of the district asylums, by an enlargement of those asylums, or by the erection of several establishments specially appropriated for these classes of patients.' The valuable suggestions thus thrown out by the committee were taken up by the Irish government the following year, and a correspondence opened with the grand juries of each county, and their opinion requested on the elegibility and centrality of certain sites proposed for the new asylums, which the inspectors-general of prisons were instructed to inspect, and report on for the information of the lord-lieutenant. "The limited powers of the Executive under the existing enactments, interposed an obstacle to any further progress beyond mere preliminary arrangements, with the exception of some additions to the asylums, called for by the pressure of demands for admission in some of the districts. But it is now gratifying to state, that the evil has been at length remedied, by the Act of last session, 8 & 9 Vict., c. 107, which removes the legal restriction that has hitherto limited the accommodation of each asylum to 150 inmates, and thus prevented their enlargement to any sufficient extent. It also provides for the erection and establishment of a central asylum for criminal lunatics, which will relieve the existing asylums from this class of patients."—(Report, p. 6.) Notwithstanding these laudable intentions promulgated in 1846, we perceive by the present Report, that on the 31st December, 1848, there were, out of an aggregate of 5678 patients-338 confined in gaols, and 1940 in union workhouses. Furthermore, from another table, exhibiting the number of committals of lunatics to gaols, and their discharges, we observe that during the years 1847 and 1848, there were as many as 1041 lunatics committed to gaol, without being convicted of any offence beyond their being unhappily so afflicted. This is not all. The inspectors report that they "have also reason to believe that family disputes, particularly where land and other property is in question, have occasionally led to the confinement of individuals, [under the Act, 1 Vict. cap. 27,] some provocation to an act of violence being given in order to bring the parties within the more effectual cognizance of the law."-(Report, p. 8.) To provide against this evil, the inspectors require a copy of the certificate of admission of every dangerous and criminal lunatic; but even this appears to us insufficient. The practice of committing lunatics to gaol ought to be abolished; nay, although a majority of them be minor culprits, their offences are probably the result only of their insanity. We regret, therefore, that such a system as this should still exist in Ireland. The provision for the insane in workhouses, although only temporary, is equally objectionable; indeed we cannot conceive a more deplorable picture than the inspectors themselves give us in the following statement: "The wards allocated to lunatics in the workhouses of this country, however ill-constructed and ill-adapted to the purpose, may be looked upon as so many subsidiary depots affording a temporary shelter to the insane, in the absence of suitable accommodation. Originally intended for idiots, as their name implies, these wards become from time to time receptacles for patients labouring under every type of mental disease. On our visitations, we have occasionally found in them cases of the most acute mania, requiring a care and vigilance that could not be expected from a class of attendants taken out of the general mass of paupers, frequently aged and infirm themselves, and whose services are for the most part unrequited. If admission to the district asylum cannot be procured for individuals thus acutely affected, no alternative is left, but to await a vacancy, unless in the interim, as usually happens, they are committed to the nearest prison, as dangerous, or perhaps as criminal lunatics. The great majority, however, of the insane in unions, may be classified as idiotic, epileptic, and demented, amounting in all to 1943. There being no law nor fixed regulation to confine persons labouring under these different grades of mental aberration to a continued residence in unions, when once admitted, their numbers in them are necessarily subject to much fluctuation. Of 130 poorhouses, 124 at present contain a certain proportion of lunatics, ranging from four to over sixty. In some unions, during the two past years, such was the pressure from without, and so great the necessity of hospital accommodation, that the idiot divisions, when not fully occupied, were done away with altogether, and made available for general purposes, their former inmates being diffused through the paupers at large. We are aware that the Commissioners for the Relief of the Poor in Ireland, as well as the local authorities, are alike sensible of the great inconvenience caused by the residence of the insane, no matter of what class, in workhouses, where, generally speaking, cooped up in gloomy cells, without any provision for exercise, comfort, or employment, any attempt at classification, or moral treatment on their behalf, is quite impracticable.' Such a description as this-the sane mingling with the insanethe poor idiot with the pauper-cooped up in gloomy cells, and wholly unprovided for with either moral or medical treatment, carries us back to the remoter and darker age when insanity was little understood, and the unhappy victim was left, as in Hogarth's picture, to pine away in straw and misery. Such is at this moment, it would seem, the state of lunacy in Ireland. Another point for regret which is suggested by the Report before us is, the want of any definite statistical account; inasmuch as we find by the Report of 1846, that the number of pauper and other lunatics in Ireland were disposed of as follows: |