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JOINT-COUNTIES ASYLUM, CARMARTHEN. The Commissioners in Lunacy have recently issued their annual report, and with regard to the Asylum for the Counties of Carmarthen, Cardigan, Pembroke, and Haverfordwest, it is said that on the 1st January 1867, there were 174: lunaticsin the Asylum (92 males and 82 females) all pauper patients; its admission in the year 1867 numbered 55 its discharges 19 and the number recovered, 18. No less than 21 deaths ocurred during the year, two from suicide. On the 1st January 1866, 189 lunatics remained in the Asylum (100 male and 89 females), of whom 11 were deem'd incurable. The avetage weekly cost of maintenance was 12s. 2irl per 4' head. In the course of that General Report the Com- missioners observe :-The next case which we have specially to notice is one wherein Miss Lewis, the matron of the Joint Counties Asylum, Carmarthen, was, in accordance with the suggestion of this Board, to whom the case was submitted by the Visitors, prosecuted for gross assaults upon M. A. Bowers, a patient, summniilv convicted, and fined £ 10. According to the statement of the night nurse and two attendants, M. A. Bowers, who was in a very violent and excited state, was undressed and placed in a sirgle room. Between five and six o'clock in the evening Miss Lewis was seen to strike her with her fist on the chest Miss Lewis then went out and borrowed a bunch of keys with which she beat M 'A. Bowers across the thighs until blood came. The above statment having been laid before this Board, a letter was, by their direction, addressed to the visitors pressing for the decision of the committee upon the suggestion previously made, that they should at once take steps to institute a prosecution agianst Miss Lewis, and adding that. if the committee should not be disposed to give directions for such a prosecution, the commissioners would consider it to be their duty themselves to under- take it. The result was as above stated. The Commissioners made the following special report on the Asylum at Carmarthen 21st June, 1867. Since the visit of our colleagues on the 26th of April, j 1868, 41 male and 45 female patients have been admitted 6 males and 12 females have been discharged, of whom 12 were recovered, and 14 males and 13 males have died. Of the deaths one man is reported to have died of Asiatic Cholera, and there were two cases, one in each division, of choleraic diarrhoea. The other deaths were from ordinary causes, except that of a malepntient who,having made his escape, was drowned it is believed accidentally, in crossing the River Tave on his way to his own home. An inquest was held on the bodv, An.1 a verdict of accidental death returned. The somewhat large mortality is no doubt to be accounted for, in a great measure, by the feeble and debilitated con- dition of the patients on their admission. The numbers now on the bc ks are 101 of the male, and 93 of the female sex; total 194: but of these, one male and four females are absent on trial. Taking the accomoda- tion at the original calculation of 106 patients of each sex and for this number beds lmve been provided, there remains vacancies for six men and 18 females: hut there are empty rooms in both divisions which if properly furnished, would afford sleeping accomodation for at Ie; 20 patients more so (hat there does not appear to he my present necessity for enlargement. We have been much disappointed at the little progress which has been made towards the completion of the Asylum as regards the building, the furniture, and the airing courts. Nothing has been done towards painting the woodwork or papering the rooms. There is scarcely a watereloset on the women's side in proper repair, and many of those in the mule division are out of order. The sinks which are simple wooden troughs do not retain the water, and the floors of many of the slop rooms are decaying from damp. The steps hitherto taken to render the south western walk impervious to moisture have not been successful. The drains arc out of order, and for several months past have been left open, in three places on the north side of the male division. The odour from these openings was distinctly perceptible within the building to-day, and will doubtless ultimately predjudictdly affect the health of the Patients. They should at once he attended to, and the deep holes, which are dangerous, be covered over, There was an effen- five smell of drains in one of the lavatories of the men's ward evidently the result, of defective trapping. Little or nothing has been done to supply the numerous deficiencies- in the way of furnitnre, and the wards still present a very bare and comfortless appearance. The laundry block is now occupied by patients at night but the excellent day room provided for this department remains quite unfurnished. As yet a very small portion of the beds are of flock, and many of these are insufficiently filled. We believe however, that it is intended gradually to substitute flock for the coir now so largely used. No drying yard for the laundry has yet been provided, Rnd the clothes are hung out in the small,airing court, the only one as yet provided for all classes of women. There is only one yard of similar dimensions on the men's side, and both are insufficiently provided with scats, and they have no sunshades. We beg to suggest, for the consideration of the committee of Visitors, that a careful general inspection of the wtmle of the building should forthwith be made bv a competent per- son, so that all the existing structural defects may be immediately noted'and effectually remedied. Making every allowance for the comparatively short time which the Asylum has been opened, we yet feel it our duty to state that it is far behind other similar institutions in mailers appertaining to the comfort and proper treat- meat of the patients. During our visit this day we have seen and spoken to every patient in the building, and have to report favourably of their quiet and orderly derapanour. In the general dining hall there were 75 men and 72 women dining together, and the meal passed off with the greatest tranquility and decorum. The food, which consisted of Irish stew, appeared to be good, and was generally approved of. The clothing of the worst class of patients in both divisions reauired, we thought more attention on the part of the attendants, as regards neatness and repair. Al- though the stock of extra clothing has very recently been in- creased it is still insufficient, especially to meet the wants of the very unfavourable class of patients who are now here. iWe are pleased to observe that a large proportion of the women were engaged in needlework, although the means of recreation seemed very scanty. From the return of employment furnished to ua we find that 36 of the men work on the land, six at trades, and 43 at other occupations. Of the women, 49 are engaged in sewing and knitting, or are employed in the kitchen and laundry, and 21 at other domestic work. The chapel services are on Sunday attended by about 70 patients of each sex, and prayers are also read by the chaplain on Wednesdays and Fridays. Dances have been held in the hall weekly during the winter months, but are now discontinued. It would be well, we think, if during the present season also some gen- eral means of amusement could be introduced so as to con- tinue the practice of assembling the patients togsther every week. As yet no walk has been formed round the property and therefore the women are restricted to the small airing court for exercise, as are also such of the men as do not work on the land. It is not the practice to take parties of patients for extended exercise beyond the Asylum premises. Our attention has been called to the case of a young woman whom the medical officers suspect to be pregnant, and wbo has been in the Asylum since the 19th of May 1866, and has for some time past been employed in the laundry. In making inquiries into.this matter we observed that the fires for heating the drying closet are inside the building and we recomtnend that the heating apparatus be changed, so as to be accessible from the outside only, and thus prevent the necessity of male servants entering this department. As recommended by our colleagues at their last visit, the ventilation of the larder has been improved night attendants have been engaged; and regulations have been drawn up and placed in the bath rooms. The other suggestions have not yet been attended to. We are assured that mechanichal restraint is never em- ployed, and the instances of seclusion comprise not more than 9 men on 13 occasions, and 8 women upon 14 occasions. One woman was in seclusion to-day. The average number of patients under medical treatment seems to be about 10 of eacli sex, but there has been no entry in the Medical Journal for the last two weeks. We are sorry to be obliged to report that the Case Books have been almost entirely neglected. Beyond the facts copied from the statement and certificates on the admission of the patients, in most of the oases, no entry whatever has been made. In the absence of Mr. Wilton we were accompanied ovar the Asylum by Mr Davies, the Assistant Medical Officer, who seemed well acquainted with the patients, and afforded I us every assistance in his power.


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