by Boards of Guardians, 71, 81.—The further construction of lunatic wards should be stopped, 72.—Necessity for the supervision of the Lunacy Commissioners over workhouses, 72.—Several amendments of the Lunacy Laws suggested, 73.—Proposed regulations for supervision of workhouses containing lunatics, 73, 82.—Lunatics in workhouses should be under certificates, 73.—Proposal to increase powers of Lunacy Commissioners over workhouses, 74.—On the Supplement to the ‘Twelfth Report’ (1859) ‘of the Commissioners in Lunacy,’ on workhouses, 74.—Abstract of its contents:—unfitness of workhouses for lunatics, 75.—Workhouses in large towns most objectionable, 76.—Lunatic wards more objectionable than the intermixture of the insane with the other inmates, 76.—Miserable state of the insane in lunatic wards, 76, 79.—No efficient visitation of workhouse lunatics, 77.—Insufficiency of the dietary for insane inmates, 77.—Medical treatment and nursing most defective, 78.—Fearful abuse of mechanical restraint in workhouses, 78.—Wretched neglect and want in the internal arrangements for lunatics in workhouses, 79.—Abuse of seclusion in workhouses, 80.—Varieties of mechanical restraint employed, 80.—Absence of all means for exercise and occupation, 80.—Lunatics in workhouses committed to gaol, 80.—Neglect and contravention of the law by parish officers, 81.—Amendments in the law suggested by the Lunacy Commissioners, 81.—Proposal to erect asylums for chronic cases, 82, 126.—Visiting Justices of Asylums to supervise workhouse lunatic inmates, 73, 82.

  § Pauper Lunatics living with relatives or strangers. Number of such lunatics, 83.—Neglect of their condition, 83.—Question of insanity should be left to the district medical officer, 84, 175.—This officer should visit and report on their condition, 85, 87.—Indications of the unsatisfactory state of this class of pauper lunatics, 85.—Evidence from Dr. Hitchman’s Reports, 85.—Wretched state of ‘single’ pauper patients in Scotland, 87.—Neglect of Poor-law medical officers towards such patients, 87.—Objections to boarding pauper lunatics with strangers, 88.—District medical officer to select their residence, 89, 146.—Advantage of keeping them in lodgings near asylums, 89, 146.—Distribution of lunatics in cottage homes, 90, 145.—Notice of the colony of insane at Gheel, 90, 145.   § Unfit cases sent to asylums.—Improper treatment prior to admission. Recklessness and cruelty in transmitting patients, 91.—Non-lunatic cases sent to asylums, 91.—Cases of very aged persons sent, 92.—Previous horrible neglect of patients, and their moribund state on admission, 93.—Extracts from Reports of asylum superintendents illustrative of the facts, 91-96.—Transfer of lunatics to asylums must be committed to some competent and independent officer, 97.—Want of instruction for medical men in insanity, 97;—Errors committed owing to the want of it, 98.—Neglect of psychological medicine in medical education, 98.—Law regulating transfer of weak cases to asylums, 99.—An amendment of the law requisite, 99.   Chap. VI.—CAUSES OPERATING WITHIN ASYLUMS TO DIMINISH THE CURABILITY OF INSANITY, AND INVOLVING A MULTIPLICATION OF CHRONIC LUNATICS. § Magisterial interference and § Excessive size of asylums. Defective medical staff in large asylums, 102.—Efficient treatment impossible, 102, 121.—Degeneration of management into routine, 103.—Exclusive estimation of so-called ‘moral treatment,’ 103.—A very large asylum especially prejudicial to recent cases, 104.—Delegation of medical duties to attendants, 105.—Evils of absence of medical supervision over individual patients, 105.—Evils of large asylums upon character of attendants, 106.—Routine character of medical visits, 107, 143.—Necessity of medical supervision being complete, 107, 115, 121.—Distinction of asylum attendants into two classes—attendants proper, or nurses, and cleaners, 108.—Objections advanced by the Lunacy Commissioners to large lunatic asylums, 109.—The erection of large asylums supposed to be economical, 110.—The supposition fallacious, public@vhost@g@gutenberg@html@files@44320@[email protected]#Page_110" class="pginternal"