Institution Information - Montrose Royal Asylum

Parish/County: Montrose, Angus

Alternative Names: Montrose Royal Lunatic Asylum; Sunnyside Royal Hospital

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Text from 1857 Royal Commission Report

“MONTROSE ROYAL ASYLUM; Resident Physician—Dr. James Gilchrist.

I.—Object, Origin, History, and Date of Opening.

A scheme for erecting a lunatic asylum at Montrose in connexion with a general hospital for the sick, was set on foot as early as the year 1779. It originated with some benevolent inhabitants of the town and neighbourhood, among whom Provost Alexander Christie, and Mrs. Carnegie of Pitarrow, took the most active part.

The Asylum was opened in 1782, together with an Infirmary and Dispensary for the sick poor.

II.—Constitution, Government, and Management.

Previous to 1811 the Institution was managed by Directors consisting of a committee, named by the subscribers and contributors to the Asylum. In 1811, however, it was incorporated by Royal charter under the title of the Royal Lunatic Asylum, Infirmary, and Dispensary of Montrose.

Under the charter there are fifty Directors, consisting of the provost and eldest bailie, and the first and second ministers of Montrose, thirty Directors elected from the inhabitants of the burgh, eleven gentlemen of landed property, and five clergymen of the parishes in the neighbourhood of the town.

The Directors hold office for life, provided they continue to possess the requisite qualification of office, property, or residence.

Monthly meetings are held on the first Tuesday of each month. The annual meeting takes place on the second Tuesday of June.

III.—Quantity and Appropriation of Land.

The Asylum-ground consists of about five acres and a half within the walls, of which an acre and a third are occupied by buildings, and the remainder as airing and garden-grounds. The Directors, considering the quantity of ground as too small, occupy on lease about twelve acres of arable ground in the neighbourhood, which is cultivated by the poorer class of patients.

IV.—Amount and Description of Accommodation for Patients of the several Classes and respective Sexes.

The Asylum is estimated to contain accommodation for—

Private patients, Males 18, Females, 24

Pauper patients, Males 80, Females 81

[Total] Males 98; Females 105

V.—Sources and Amount of Income.

The income for 1855 amounted to £4618, 15s. 7d., derived from the following sources—

1. From payments for private patients, £1360 14 0

2. From payments for pauper patients, £3004 6 0

3. From interest of money, £200 13 7

4. From subscriptions, donations, and legacies, £53 2 0

[Total] £4618 15 7

The funds from this last source are generally given or left to the Infirmary, which has been a separate establishment, though under the same charter and management, since the year 1831. The expenditure for the year was £4586, 6s. 10d., showing a surplus of £32, 8s. 9d.

VI.—Rates of Payment for Patients.

1. For private patients the rates vary from £20 to £100 per annum.

2. For pauper lunatics, chargeable on parishes within the synods of Angus and Mearns, the rate is £18 per annum.

3. For pauper lunatics from beyond these synods, the rate is £22, per annum.

A fixed charge of £2 per annum is made for each pauper to cover the expense of clothing and bedding.

Montrose has the privilege of sending to the Asylum ten paupers at £10 per annum each, and four at £12 per annum each.

Four parishes in the neighbourhood have the privilege of sending four paupers at £14 per annum each.

VII.—Medical and other Officers, Attendants, and Establishment, with Salaries, Wages, and Allowances.

1.—Officers.

Resident medical superintendent, annual salary, £200 0 0, with board and lodging.*

Treasurer, annual salary £25 0 0, non-resident.

Secretary, annual salary £17 17 0, non-resident.

2.—Household.

Head attendant, wages, £35

Matron, wages, £45

Ten male attendants; joint wages, £198 12 0

Twenty female attendants and domestic servants; joint wages, £176 8 0

* The Directors have given instructions to procure a resident medical assistant to Dr. Gilchrist. Dr. Gilchrist's duties do not extend to the Infirmary, which is under separate medical charge. The treasurer's and secretary's duties at the above salaries extend to the Infirmary.

The Directors do not contemplate making any addition to the present house; but they have for some time had under their consideration the propriety of building a new asylum, in a more suitable locality, and with more extensive grounds. With a view to this object they have obtained thirty acres of ground, situate about two miles north of Montrose, and have procured the requisite plans. It is intended to erect two separate buildings, one capable of accommodating 100 private patients, and the other 200 paupers. The expense is estimated at about £20,000. The internal arrangements of the proposed building are now under the consideration of medical men of great experience in the treatment of the insane, whose report the Directors expect soon to receive.

VIII.—Total Capital Expenditure on 14th May 1855.

For House, Land, and Furniture*, £11,536 7 6

* A yearly feu-duty, of £10 per annum, is payable to the Magistrates and Town Council of Montrose.

The proportion of this expenditure for each patient, on the estimated accommodation for 203, is £56, 16s. 7d.

IX.—Condition of the Asylum and Patients when visited by the Commissioners.

This Asylum stands on the links of Montrose, close to the harbour. Its site is flat, and very little above the level of the sea. It fronts the west, and the back is very much exposed to cold east winds.

It consists of a central building of four stories, two advancing wings of two stories, and two lateral wings also of two stories. The house has been altered and added to at different periods, to accommodate the always increasing number of patients. A house for the resident physician, in the rear of the Asylum, has just been finished, and, though not intended for the reception of patients, is at present partially occupied by them. The Asylum, when visited on 25th July 1855, contained 227 inmates, of whom 40 were private patients.

The demand for accommodation is very great, and the house is in consequence over-crowded. Owing partly to this, and partly to other causes, the condition of the patients is not altogether satisfactory.

The central part of the house was originally intended as apartments for the resident physician, and for the accommodation of private patients, while the wings were appropriated to the paupers. Owing, however, to the increasing pressure for accommodation for pauper patients,' a great part of the central building has been given up to them, and the more manageable of the private patients have been removed to the new house of the resident physician. These arrangements are only temporary, till the new asylum be completed.

The pauper patients are divided into four classes, beginning with the convalescent and quiet, and descending gradually to the refractory and dirty.

The males occupy the north side of the house. The private patients are in the central building, along with some of the better class of paupers. In the rear of the central house is a projecting building that contains two day-rooms for the private male patients. The one is carpeted, has a large table, benches with cushions, an open fire-place, and is tolerably comfortable. The other has no carpet, and no furniture except a few chairs and a book-case. It serves as a smoking-room, or as a place of exercise in bad weather.

The male paupers occupy principally the two north wings. Their day-rooms, of which there are four, are situated in the lateral wing, two on the ground-floor, and the other two immediately above them. They are tolerably comfortable, furnished with tables and benches with backs, and those for the quieter patients have pictures on the walls, and a few other ornaments. The room for the worst class of patients is flagged, and here the fire-place and windows are guarded. There are two small dormitories in this part of the house, but the principal sleeping accommodation is in the central building and in the front wing.

The upper story of the front wing consists of a passage with a single range of rooms, and, at its further extremity, a dormitory measuring about 40 feet long, 16 feet wide, and 11 feet high. This dormitory is clean and neat, and is occupied by twelve patients and one attendant. The windows are secured at night with shutters. Ventilation is, in a great degree, dependent upon perforated panes. There are two other dormitories in this ward, one with six beds for patients, and a double bed occupied by two attendants; the other with seven beds. The ventilation of these rooms is bad. The remaining rooms are single, and are also very imperfectly ventilated. They have in general perforated panes; but when these small rooms arc occupied by refractory patients, and the shutters are closed, they become excessively close and offensive. On this floor there are only three single rooms; in the corresponding ward below their number is greater, as there is there only one dormitory at the extremity of the gallery, which contains beds for twelve patients.

The mattresses and pillows are filled with chaff. Until lately it has been the custom for the friends of the pauper patients, or the parochial boards, to supply the bedding and clothing, and hence it has been impossible to have them according to uniform pattern. The Asylum, however, now furnishes the clothing and bedding of all pauper patients, except those belonging to the parish of Montrose, who are still supplied by the parochial board. Private patients provide their own bedding. The beds for paupers have each only one sheet. For the dirty patients the beds more recently provided have stretched canvas bottoms, but there is still a number of wooden trough beds in use, which are impregnated with urine and imperfectly cleaned. Several dirty and refractory patients have no bedding, except loose straw and a blanket; and we ascertained that it is the custom in this Asylum, when patients are violent and destructive, to remove all their clothing, and to supply them with no clothes, coverings, or bedding, except blankets and straw.

On the female side the front wing contains single rooms and dormitories, laid out nearly on the same plan as the male wards. Several females were in seclusion: three who were much excited, were without any clothing or covering, except a blanket; and were lying on loose straw, or on a straw mattress placed on the floor. On our opening the shutters of one of the cells, in order better to see its condition, the patient sprang naked from her straw, and attacked the female attendant with great violence. This patient had been about nine months in the house, and for several weeks had been confined to her cell, never taking any exercise, and never leaving it except at night, when she was moved to another, in order that the one occupied through the day might be cleaned.* These cells are very small, and exceedingly close and offensive; they are almost entirely without ventilation. The windows, indeed, have perforated panes, and above the door is an opening, communicating with the passage, intended for the admission of air; but this opening is almost entirely closed by a perforated metal plate, and, when the cells are occupied, the closed shutters prevent the ingress of fresh air through the perforations in the window. There is an apparatus for introducing heated air into the passages of the house, which is said to work tolerably well; but the impediments that prevent the free ventilation of the cells, must also interfere with their due warming in winter. On the female side there are nine cells up stairs and seven below, one containing two beds.

* This patient was brought from the Inverness Infirmary, where she had been detained far six months. Her case is referred to in the description of that house.

In the south lateral wing are the day-rooms for the females. The private patients have a day-room corresponding to that on the male side. There are besides four day-rooms for the paupers, two below and two up stairs. They were over-crowded, especially one which contained no fewer than forty-seven patients. This room serves also as the chapel, and is then very much over-crowded. There is, besides these day-rooms, a female work-room, above the day-room of the private patients. About twenty patients were engaged in sewing, knitting, and other employments. The number of female patients somewhat exceeds that of the males; and there is a large dormitory for them in this wing, which has no corresponding room on the male side. It contains sixteen beds, besides a bed like a chest, into which an epileptic patient is locked at night. The lid of the chest is formed of crossed straps.

The central building contains two ranges of rooms separated by a central passage. There are about eight rooms on each side for the better class of patients, which are furnished according to the rate of payment. Four patients were here in seclusion—one of them, a female, had a shirt of strong linen fastened by a strap and buckle. The top story was formerly the infirmary, but it is now occupied as ordinary dormitories, one for males, the other for females.

There are five airing courts; one at the back of each lateral wing for the quieter patients, and one in front of each for the refractory patients. The court behind the central building is for the private male patients. These courts are each about a quarter of an acre in size. Some of them have raised mounds, which enable the patients to see the surrounding country, and on the female side, they are neatly kept, and contain plants and flowers.

The house is badly supplied with water, which in summer is apt to fail altogether; and there is only one drain to receive all the sewage of the house, which provides a great inconvenience to the servants. There are several water-closets, within doors, most of them of recent construction; and there are also lavatories adjoining the dormitories. Baths are also provided in both sides of the house, and the patients are regularly bathed once a week. Gas is laid on in the day-rooms and dormitories.

Some of the male patients work in the fields, and a few are engaged in picking oakum and making nets. A few females are occupied in the washing-house and laundry, and others are employed in sewing and knitting. We were informed that some of the patients have the benefit of frequent excursions, and that there is generally a dance once a week. Some of the pauper patients, who can be trusted, are permitted to play at quoits and bowls of an evening on the links. There is also a billiard room for the private patients.

The resolution for erecting a new asylum must be of very recent date, as the new house for the resident physician had, at the time of our visit, been finished and occupied only about two months. It is separated from the Asylum by the airing courts, and is at present used principally for the accommodation of female private patients. The only patient paying the highest rate (£100) has a bed-room and parlour here; but, at the period of our visit, she was labouring under a paroxysm of mania, and in seclusion in one of the cells in the principal house. Another room of this house contains four beds, and is occupied by patients paying £25 a year each; while another, divided by a screen, accommodates two patients, paying respectively £30 and £32. The dining-room serves as the day-room for these patients, who are, in general, quiet and well-behaved; and, considering the small sums paid by them, very well lodged and accommodated. The day-room contains a piano, and is comfortably furnished. The ladies were engaged in sewing and knitting.

Except those who were in seclusion, the patients were in general clean in their persons, and sufficiently clothed, and they appeared well fed and attended to. A large number of patients, however, are habitually secluded, the necessity for which Dr. Gilchrist attributes to the defiencies of accommodation in the building.

On a second visit to this Asylum, we found eleven patients in seclusion, several of them being in a state of complete nudity, lying on the floor with no other bedding than loose straw and a blanket.

The Sheriff visits the house twice a year, generally accompanied by a medical man, a practitioner in Montrose. He inspects the warrants to see that no patient is illegally confined, but takes no cognizance of the state of the house, or the condition of the patients.

The books kept are the Madhouse Register, and the private note-books of the superintendent.

No mechanical restraint is employed in this Asylum, but, in its stead, recourse is had to lengthened seclusion. There is no reliable record of the time during which the patients are secluded; but we have reason to think that it frequently continues for weeks, and even months. The seclusion cells are very offensive, from the patients relieving nature on the floor. The condition of the Asylum is very injuriously affected by the number of incurable and degraded cases which are sent in by Highland parishes, only when it has become impossible any longer to retain them at home. There is a deficiency of the means of exercise and occupation.”

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