By the acts lately passed, the power which the justices who had the control of different asylums possessed of passing rules at any meeting which entirely changed the system of management, or of summarily dismissing any officer, is done away with. The caprices of the go vernors of some asylums have changed their entire constitution in a few years.
A great improvement has been made of late years in the class of persons ap pointed as attendants, or, according to the old phraseology, keepers. That all such persons should possess benevolence and intelligence is essential to the effective working of a humane and enlightened system; and they should be liberally paid. The proportion of attendants to patients in the different English public asylums varies from one to ten, to one to twenty ; the former does not seem too much, and is far less than that in all well-managed private asylums. No ward, however small, should have less than two attendants, in order that it should never be left ; this is enforced by the rules of several asylums. A large number of attendants renders a vigilant superintendence by night practi cable, which is no less important than by day, although it is entirely omitted in some institutions.
Every part of the treatment of the in sane has of late years been much modi fied by the introduction of a much milder mode of management. The total aboli tion of personal coercion, known as the non-restraint system, was first introduced at the Lincoln asylum in 1887, and its complete success there led to its adop tion at Hanwell in 1839, and shortly afterwards at Northampton. Gloucester, Lancaster, Stafford, and Glasgow. This sp,..em has since been adopted at Has lar Hospital, and also at Armagh, Lou donderry, and Maryborough ; and very little restraint is used at the other Irish district asylums. The asylums which do not agree to the disuse of restraint as a principle, have effected it in prac tice, with very few exceptions ; thus the reports of Nottingham, Dorset, Mont rose, Edinburgh, and Dumfries speak of the advantages of restraint, although the writers abstain from availing themselves of it ; while on the contrary the autho rities of Bethlem, St. Luke's, Kent, Ox ford, and the Retreat at York, profess the non-restraint system, although they do not entirely practise it.
It would far exceed the limits of this article to point out the progress of this system, and the circumstances which rendered it desirable ; from the year 1792, when Pinel struck off the chains of the patients at the Bicetre, a gradual improvement has been going on in the Vestment of these, the most unfortunate of human beings ; but the declaration that mechanical restraints were "never necessary, never justifiable, and always injurious," made by Mr. Hill of Lincoln, has caused this march of improvement to proceed much more rapidly. The reports of the asylums in which the new system has been introduced, especially those of Hanwell, give all particulars as to the mode of management substituted for co ercion.
However much opinions may differ as to the advantages of the abolition of re straint in those asylums which have not yet tried the experiment, we have before us the facts that many thousand patients have been treated entirely without it ; that in no asylum where the new system has been introduced has it been found necessary to abandon it ; that the reports of all these asylums state their general condition to be improved ; that the cures have not decreased ; and, which we con sider of equal importance, that the com fort of the incurables is much increased : and we may therefore be justified in con sidering that within a few years the in struments of restraint now remaining in use will disappear like those much more severe ones which preceded them.
Whilst many excellent asylums exist for the rich, and the law is providing an increase of accommodation for the poor, benevolent individuals are making efforts to secure the benefits of proper treat ment for the middle classes. It is pro posed to build an asylum in the neigh bourhood of London for 300 patients, at a cost of 30,000/., which sum is to be raised by donations and subscriptions. When once established, it will be self supporting, and it is expected that pay ments of from 11. to 11. 10s. per week for each patient will cover all the expenses. No existing asylum offers to persons able only to pay such a sum the comforts to which their position in society has ac customed them.