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Joint Counties Asylum, Carmarthen.

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Joint Counties Asylum, Carmar- then. A quarterly meeting of the Committee of Visitors of the Joint' Counties Asylum, Gar- mart'ip-i w held at the Institution oa Thursday in last, when there were pre- oCnt: 1r J. Howard Griffiths, St. David's (in the c^aJr) Mr J. V. Colby, Rhosygil- won; Dr He-.veil Reos, Glangarnant; Rev. Professor D. E. Jones, Carmarthen Mr H. Jones. Davies, Glyneiddan; Dr Lloyd, Adpar Mr J. Lloyd, Penybank Mr W. Jones, Llamlilo; Mr C. M. Williams, Abery.stwith Mr J. Lewis, Mciros Hall Mr Sketch, Pembroke Dock Rev J. Williams, Cardi- gan Dr Williams, Drim Dr Griffiths, Milfcrd Haven together with the Clerk (Mr W. Morgan Griffiths), and the Medical Supt. (Dr. E. Goodall). REPORT OF LUNACY COMMISSIONERS. The annual report of the Commissioners in I' Lunacy was presented, as follows: We have to-day inspected this Asylum, and have seen and spoken with all the patients in residency including those who; are at present lodged at. Job's Well and Jlhydygorse. In the matter of dress and personal tidiners, the condition of the patients wa.s satisfactory. No complaints were made to us calling for mention, and the behavicus was orderly. There are on the I books the names of G57 patients, 329 being men, and 323 women. Of these 29 an changeable to Cardiff Union, 4 to' Cardiff Corporation 30 patients are received under contract frcm Abergavenny Asylum, and three paitients respectively are chargeable to the Machynlleth, Brecknock, and Hampstead Unions; 40 patients are on the private list, I and three are absent on trial. The health of the nstitution is at present good, 19 patients being confined to bed. The Asylum however is overcrowded, there being 26 patients in excess of the proper number, and this over-crowding is especially noticeable in the female hospital sick-room, where the beds 17 in number are occupied, and 12 patients are sleeping on the floor. This condition of things is in our opinion most unsatisfactory, and insanitary. The dinner served to the patients to-day consisted of apple pudding and bread, and wa.s in our judgment insuffi- cient. In this 'connection we may mention that according to the Diet Table this dinner and t,wo soup dinners are given to the patients weekly, and that for tea. and break- fast the meagre allowance of one-third* ounce butter to which. attention was drawn last year has not. been increased. In view of these facts and having regard to the some- wha,t poorly nourished condition of many of the patients we recommend very strongly that the dierta,r ybe improved. At the pre- sent, time, there are 1.5 per cent of the entire patients who are suffering from General Paralysis; 8.2 per cent. Epileptics, and 5.9 per cent are believed to be actively suicidal. The two classes last-mentioned sleep under constant supervision. 52 per cent. usually attend Divine Service of some kind or other on Sunday. 50 per cent. usually attend the associated entertainments 41 per cent, usually walk out weekly or oftener beyond the Asylum estate, while about 3 per cent. are altogether confined to the Airing Courts for exercise. 57 per cent. of the, men, and 61 per cent, of the women are usefully employed. Since the last visit to this Institution by two members of our Boar1, 115 patients have been admitted, 56 discharged, 37 having recovered, and 55 have died. With one exception the deaths were due to natural causes. General paraly- sis accounted for 7.2 per cent, and Phthisis for 23.6 per cent. Post mortem examina- tions followed death in the satisfactory pro- portion of 89 per cent cf the cases bed Bores existed in no less than 12.7 per cent. of the deaths. The exceptional death, that of a man, was due to a fractured thigh, occasioned by a, fall during a scuffle," with a fellow patient. In this a, Coroner's inquest was held. Serious, but non-fatal, casualties were limited to the cases of two women. each of whom accidentally sustained a frac- ture of the leg. As regards zymotic disease, a. male attendant has been attacked with Diphtheria., a nurse with Scarlatina., and a male patient with Eryspelas. No patient has been secluded, but one man and five women have been mechanically restrained for surgical reasons on 69 occasions for 1,529 hours in aJi. At, our visit to-day, we found the Wards and Dormitories in a generally satisfactory condition, the former being for the most part, bright and cheer- ful, and the latter sweet and clean. Some* important improvements have been effected since October last, when this nstitution was visited by two members of our Board. Two substantial external staircases have been pro- vided as exits in case of fire at Rhydygors, but nothing has yet been dene either to pro- vide similar means of escape from the Dor- mitories attached to Female Ward VII, the Hospital 'Ward, and the Laundry, or to is- crrase the pressure of water in the Fire mains. We consider these matters of great importance, and again commend them to the attention of the, Committee. An agree- ment has been entered into between the Asylum Committee and the Town Counel of Carmarthen, by which the Asylum drainage is to be conveyed into the River Towy, and plans for the conversion of the existing laundry into the steam laundry have been passed, but these matters are at present in abeyance in consequence of the disagreement between the representatives of the several counties concerned. We regret to report tha,t little progress has been made with the new Isolation hospital. When it is completed we think that the existing Isolation hospital would form a, very suitable building for the segregation of patients of patients suffering from Phthisis. The staff comprises for day duty 31 men and 30 women. These figures give a proportion of one male attendant to every 10 V men, and one nurse to every 11 women. There are also three attendants cf each sex employed on night duty. Of the total staff 17 per cent of the men and 30 per cent of the nurse shave been in the service of the Asylum under one year, and 53 per cent. of the former and 9 'per cent. of the latter reckon over. fire: years service. One attendant of each sex have been dis- missed tor misconduct, the offence being in the case of the nurse an assault on a patient, which was duly reported to our Board. The Case books and other medical records con- tinue to be very well kept.—Hardinge F. Giffard, E. Marriott Cooke, Commissioners in fiutnacy. THE DIETARY. Referrin gto the report, Dr Griffiths said he was sorry to read the paragaph relating to the dietary. He quite agreed with the Commissioners. The; first duty they had to perform, inside that institution was to look after the unfortunate inrniat s. They cught to appoint a committe, or leave it to the Finance Committee, to go thoroughly into the question, and lie hoped not a day would be lost is looking after the dietary cf the inmates. They should do all in their power to make them, comfortable and to give them good food. He moved that the matter be referred to the Finance Committee, and that the members should meet at an early date to consider the question. Mr J. Lloyd seconded. they tliould deal with the question at once. It was an urgent matter. Dr Griffiths I don't propose the "Finance Committee particularly, but I think we should take steps as soon as possible, to remedy the matter. The Chairman said that although ho agreed with thepirit of the resolution, lC did not quite identify himself with the re- marks made. Ic was an important matter and should be locked into thoroughly. They did not always follow everytring that the Commissioners 'said, end it was possible that they had made a mistake in that matter. It was rather a. grave charge to make against the Asylum. It might of course, be a matter they ought to have looked into earlier. Mr C. M. Williams said he would like to ask for Dr Goodall's opinion on that para- graph first of all He might have something to say in reference to these particular meals. Other meals appeared fo be very ample. If there was anything inadequate in that, Dr Goodall would tell them. Rev J. Williams thought, the matter ought to be settled at once. The Finance Committee could not take action before their report came before the next quarterly meeting. Dr GoodaJl said that the auditor had been I there before the Commsisioners came round. He had made enquiries, and had ascertained the fact that cut of 56 asylums only seven gave 3-ounce of butter, and the rest. half-an- ounce of butter. Twenty four asylums gave soup twice weekly out of about 70, and the others added .pudding to it. To add on the extra butter to make half-an-ounce would mean, JE219 a year, and the increase in giving puddisg with the soup—he would suggest suet pudding as most economical-would be JE78. making a, total of £297. Mr C. M. Williams thought they ought to allow the Supt. to increase the' food as re- commended, and that he. shov.'d prepare a new and adequate dietary taUe to be sub- mitted to the Finance Committee. Professor Jones supported the resolution. There were several little things which per- haps they ought to consider, raid which they did not like to enter into and mention in public. He fancied it would be very much better for Da Gooda-11 and a committee to consider1 the whole question, because it was a very serious charge which had been brought against the asylum. The Commissioners had stated that, the condition of things in their opinion was unsatisfactory and insaintary. Well, nothing could be more serious than that. To add one-third ounce of butter to present amount was easily done, but he thought they ought to consider the whole report; as given, to them. Therefore he strongly supported the prop ■ al of Dr Griffiths. Dr Griffiths: A special meeting of the Finance Committee could be called to deal with the' matter. The Chairman advised the members to be careful in discussing the report. They always had some items in the report, which they did not like. If they spoke at any length on the matter they might make a mistake. It was the duty of the Commissioners to find fault, and to pick out everything that, required remedying, and their remarks there might go out and make matters: more serious than the Commissiones really meant. In the para- gra.pl where they say the building is insani- ta,ry, he: was told they only referred to one ward. Dr Goodall Yes; in the female ward. The Chairman Therefore I think we should be a little bit, careful, as a wrong construction might be put on our remarks. Professor Jones said that it. was: not their report. Dr Williams said that such reports were nothing new. The same quantity of butter had been given in years gone by. The Com- missioners only consisted of one doctor, and they l:4',d three doctors: there. He did not think there was really anything serious in that, complaint or Dr Goodall or Dr Gibbon would have brought the question before them. Mr C. M. Williams proposed that Dr Goodall should increase the quantity of the butter at once, and that he should make out a new dietary table and forward a copy of it to each member. He was the only man who could help them. There was no cause for alarm, and some remarks had been made to lead the public to think those pepole had been ill-treated. All he had to say was that they were treated far better than a good many outside. Dr Howell Rees seconded. Mr Sketch said that, would avoid calling a special finance committee, and he agreed with Mr Williams. Dr Griffiths said they would leave it to Professor Jones to call a special meeting. Professor Jones You leave it to me, and you wont be called to a, special meeting (laughter). On a division five voted for the, amend- ment, and seven for Dr Griffiths' motion, which was declared carried. Mr J. Lewis ipropcsed that the butter be increa ed to half an ounce. Mr C. M. Williams seconded, and the mctio-T was agreed to. ADDITIONAL ACCOMMODATION. Dr Howell Rees moved that a sub-com- mittee be appointed to enquire and report upon (a) the utilization of any portion of the Asylum buildings as wards for the accommo- dation of private patients, or as an alterna- tive (b) the building of an additional wing for private; patients, and what land, if any, available, and the probable cost of land and buildi igs for providing requisite .accommo- dation."—Dr Re:es was proceeding to give his reasons for placing the motion on the agenda, when he was interrupted by Mr J. Lloyd with the remark tfvat they were all in sympathy with the. resolution. Mr C. M. Williams The time has now come when Mr Lloyd and Mr Davies should be suspended in order that a. speaker might be allowed to go on (laughter). Mr John Lewis seconded. Mr Lloyd supported, and moved that the question be now put." The resolution was carried, and the follow- I ing committee were appointed Chairman, Dr Rees, Dr Lloyd, Dr Williams, and Dr 4 Griffiths, RUBBER TYRES NOT WANTED. Dr Howell Roes ha,d the following motion in his name on the agenda: That the wheels of the asylum omnibus be rubber tyred." Dr Rees said that since placing the mo on on the agenda., he had ascertained that the omnibus was not so frequently used for the conveyance of patients to and from the Asylum as h had imagined. Many unions sent their patients in private convey- ances, and under the circumstances, he did not fed justified in asking the ratepayers to cover the wheels with rubber for the use of the Committee. But. that, did not alter his opinion that the. omnibus was an aggravating irritable conveyance to ride in, and he would be (prepared to subscribe towards the rubber tyres for the sake of the' committee. Dr Griffiths said he was glad the motion had been withdrawn. PAUPER LUNATICS. Mr C. M. Williams moved the following resolution That, the Asylum Clerk do pre- pane forthwith a. return showing the number cf pauper lunatics resident at the asylum _c: -=L&¡,r.I>'I"I'i!'L; 'J": ,1'

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Joint Counties Asylum, Carmarthen.