Asylum reports

Dorset County Asylum (Report for 1904-05). - The year began with 761 patients on the register and ended with 810. The increase took place chiefly amongst out-county and private patients. The admissions from the county numbered 125, of whom 104 were first admissions. 44 private patients were received. Not for many years have the cases admitted been so hopeless. Dr. P. W. MacDonald, the medical superintendent, comments on the practice of sending people over 70 and 80 years of age to an asylum simply because they are peevish and irritable. These cases are not fit to be amongst the insane proper. He says: “The growing disposition on the part of the home circle to be relieved of the burden of caring for the aged is much to be regretted.” Of the cases admitted 13 per cent. were over 65 years and several were over 80 years. Dr. MacDonald rightly considers that the workhouse infirmary is the proper place for such cases if they cannot be kept at home. The subject of the deficiency of workhouse accommodation and the practice resulting the refrom of sending these old people to asylums is dwelt upon in some detail by the Commissioners in Lunacy in their last report, which was dealt with in The Lancet of Nov. 18th, p. 1500. Cases of premature dementia are much more frequent now amongst the admissions at this asylum than formerly and cases of epileptic insanity have also greatly increased. This last-mentioned fact is connected with the considerable rôle played by heredity in the county of Dorset. Over 50 per cent. of the epileptics resident are of the congenital class. The continued rise in numbers resident at the asylum is ascribed less to any increase in the number of first admissions than to an accumulation of senile and feeble-minded cases. Amongst causes of insanity, hereditary predisposition was present in over 50 per cent. of the cases received. Alcohol is not regarded as responsible for more than between 3 and 5 per cent. of the cases of insanity occurring in Dorset. The recovery-rate for in-county patients was 38.9 per cent., which is surprisingly good considering the nature of the cases admitted. Of the total admissions (192) 76, or nearly 40 per cent., were in the most favourable class for treatment (first attack and within three months of admission). Of the recoveries (58) 47 had been in residence from one to nine months. In a number of these recoveries there is thought to be but little hope of permanency. Deaths during the year numbered 65, or 8.29 per cent. on the average number resident. Of these 30 per cent. were patients over 70 years of age, showing the accumulation of aged cases.