Institution Information - Elgin Asylum

Parish/County: Elgin, Moray

Alternative Names: Elgin Pauper Lunatic Asylum; Elgin District Lunatic Asylum; Gray's Hospital; Bilbohall Hospital

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Text from 1857 Royal Commission Report

“ELGIN PAUPER LUNATIC ASYLUM; Physician.—Dr. John Paul; Surgeon.—Dr. J Axes Boss; Resident Medical Officer.—Dr. J. W. N. Mackay, House Surgeon of Gray's Hospital.

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

The want of an asylum for the treatment of pauper lunatics in the town and county of Elgin having been long felt, the Trustees of Gray's Hospital, anxious, in as far as they had the power, to supply this defect, made a proposition about the year 1826, of the following tenor to the landholders of the county:— "If the landholders of the county will contribute liberally to "the erection of a Pauper Lunatic Asylum, and if the plan is generally approved of by the public, the Trustees will grant a sufficient extent of ground, in a very eligible situation, for the site, and court-yard of an Asylum, give a handsome subscription towards the buildings, and assist in paying the wages and maintenance of a keeper."

This proposal was laid before the heritors at a county meeting on the 18th April 1830, and was referred by them to a committee, which, on 8th June of the same year, reported that "after fully discussing the different points of inquiry, they were of opinion that, in the event of the Trustees of Gray's Hospital succeeding in raising such a fund by general subscription, as shall produce an interest equal to making; a proper provision for ensuring a fitting establishment of superintendence and servants, to which subscription they trust the individual heritors will give furtherance—the committee recommend to the county to agree to a voluntary assessment for the necessary"buildings, on the ground to be granted by Dr. Gray's Trustees," &c. At a future meeting, the recommendation of the committee was adopted, and the county agreed to a voluntary assessment of £642, 0s. 7¾ d., to defray the expense of the building.

On receiving a copy of this resolution, the Trustees of Gray's Hospital applied themselves diligently to obtain subscriptions to the charity at home and abroad; and, in the course of two years, they were so successful, as to feel themselves warranted to undertake the providing and paying a sufficient establishment of officers and servants for the Asylum, and to call upon the county gentlemen to proceed with the buildings, which were accordingly completed. The total amount raised by subscription was £1639, 4s. 10d. The original contract price of the buildings was £825, 6s. 6d.

The Asylum was opened in the year 1835.

In the year 1850, the buildings having been found too limited for the accommodation of the increased number of patients, an additional story was added to the house, which, with other improvements, cost £825. 14s. 3d. Besides these extensions, additions have been, from time to time, made to the Asylum buildings, the total cost of which may now be estimated at £1700.

II.—Constitution, Government, and Management.

From the obligations undertaken by the Trustees of Gray's Hospital, they, with the gentlemen annually elected by the Commissioners of Supply, are permanent Directors of the charity. They have the power of investing and drawing the interest of the money subscribed for the maintenance of the establishment, satisfying the public, by vouchers produced at the meetings, that the funds are in safe hands.

III.—Quantity and Appropriation of Land.

The extent of ground belonging to the Asylum is about one acre, occupied as airing-courts and garden. The Directors, however, rent a field of eleven acres adjoining the Asylum, for the employment of the patients.

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

The accommodation for patients is as follows:—

[table not shown]

The upper floor is laid out on the same plan as that on the male side.

V.—Sources and Amount of Income.

The Directors have at present invested the sum of £1000, the interest of which is applied in payment, pro tanto, of the current expense. The rest is made up by payments on account of patients.

There are no other sources of income.

VI.—Rates of Payment for Patients.

The expense of patients admitted into the Asylum is defrayed by the parochial boards which send them. From the date of opening till 1st September 1854, the rate for each patient was £12 yearly, exclusive of clothing and bedding; but owing to the high price of provisions, the rate of payment has since been £13.

The Directors are enabled to carry on the establishment at this low rate, partly from the assistance they derive from interest of the invested money, and partly from Dr. Gray's Trustees paying the medical officers of the Institution.

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

The medical officers of the Asylum are the same as those of Gray's Hospital, consisting of a resident house surgeon, and two non-resident medical men who visit daily. The annual salaries and wages are as follows:—

House surgeon, £40 0 0, with board and washing. *

First non-resident medical officer, £50 0 0 *

Second non-resident medical officer, £40 0 0 *

House attendant and matron £36 0 0 with certain privileges.

Two male attendants at £17 each, £34 0 0 with board and lodging.

Two female attendants at £6 each, £12 0 0 with board and lodging.

• The salaries of these officers are entirely defrayed by Gray's Hospital.

The buildings having been greatly enlarged about four years ago, the Directors do not contemplate any immediate additions, but they have repeatedly had under their consideration the subject of enlarging and multiplying the airing-courts.

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

For House and Land, £1700 0 0

For Furniture, about £200 0 0

Total, £1900 0 0

The proportion of this expenditure for each patient, on the estimated accommodation for 46, is £41, 6s. 1d.

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

The Asylum is well situated, near Gray's Hospital, and within a short distance of the town of Elgin.

On the day of our visit, 4th August 1855, the house contained 21 males and 18 females, who are classified as quiet and refractory patients. The former occupy the upper story, the latter the ground-floor of the building.

Patients from the county of Moray have a preference, and none from other counties are received, until all from Morayshire are accommodated. No patients are admitted except through the application of the inspectors of the poor, even although they may not be actually paupers. When they are such, the friends of the patient repay the inspector the cost of maintenance. All the patients, therefore, are received at pauper rates. The Directors contemplated, at one time, providing accommodation for a superior class of patients, but this intention has never been carried into effect. Even at the low pauper-rates, however, some saving has been effected, and funds thus accumulated have been applied to increase the accommodation of the Asylum.

The ward for quiet and convalescent male patients contains eight inmates. The day-room is furnished with tables, chairs, and benches with backs, and the walls are ornamented with rude paintings executed by one of the patients. The windows overlook the country, and afford a cheerful prospect. The room has an open fire-place partially guarded; the windows have wooden frames, with small panes, and are not barred.

The attendant's room is on one side of the day-room, and has a small window communicating with it.

The corridor, or passage, is about four feet wide, with a single range of rooms on one side. On the other it overlooks the country.

The single rooms are very imperfectly ventilated, and are not heated in any way. The shutters are all closed at night, so that, although the windows are frequently left open, with the view of admitting fresh air, none can enter. An attempt was at one time made to introduce warm air, but the apparatus did not work satisfactorily, and it is now never used. In winter, flasks filled with hot water are placed in the beds of the weakly patients. The bedsteads are of wood; the bedding of chaff. The beds have each only one sheet, but, on the whole, they appear to be tolerably comfortable. At present only four patients sleep in the dormitory, but it is intended for eight. In a corner of the seat of the water-closet is a leaden basin, which serves as washing accommodation for all the patients in the ward.

The day-room of the convalescent ward is used also as the chapel; the precentor of the established church officiating as chaplain. He receives a salary of £7 per annum. He attends on Sunday, for an hour in the morning and another hour in the afternoon. He reads a chapter of the Bible, of which he gives an explanation, and sings two psalms. Both males and females are present.

The female convalescent ward is laid out exactly in the same way as that on the male side. The day-room contains a table and some chairs, but it is less cheerful than the men's dayroom. Four patients were occupied—two in mending blankets, one in spinning, and another in carding wool. The single rooms, dormitory, water-closet, and means of washing, are similar to those on the male side. Neither of the convalescent wards have any entrance, except through their respective dayrooms.

The refractory wards are larger, and contain more sleeping accommodation. In the female division there were eleven patients. The day-room contains two benches with backs, and a table. There is an open fire-place strongly guarded. The window looks into the airing-court. In the recess of the window is a single basin which serves as washing accommodation for all the patients in the ward.

The single sleeping-rooms are ranged on one side of the passage, and the wall on the other is pierced with four small windows, at a height of about eight feet from the ground. The cells are flagged, and in the centre of each is a grated opening, originally intended to carry off the urine of the patients into a drain, but said not to be now used. In one or two of the cells, these openings have been closed, as the patients made use of them, and the rooms, in consequence, became infected with a disagreeable smell. The windows are small, measuring perpendicularly 1 1/4 foot, by 3 feet horizontally, and are eight feet from the ground. In the roof of the cells is a small square aperture leading into a ventilating flue, and the doors are pierced with holes to admit air. This part of the house is heated by flues running under the pavement of the cells, an arrangement which is said to answer well. The bedsteads are of wood, the bedding of chaff, and the coverings are good and ample. There is, at present, no wet patient among the females; but when there is, chaff bedding is used, attention being paid to change it frequently. The bedsteads for wet patients have sloping bottoms, with pipes leading into a tray or tub.

A part of the ward is shut off by a door in the passage for the more noisy patients. It contains two rooms lined with wood, a padded room, and a dormitory which has an open fire-place. The walls of the dormitory were damp. There was no patient in seclusion.

The general effect produced by this ward is dreary and depressing. The only window accessible to the patients is that of the day-room, which looks into the airing-court. There is no water-closet within doors. The airing-court, which serves for both the quiet and refractory patients, is about 20 yards long and 14 yards broad. It is surrounded by buildings and high walls, and affords no prospect.

The male refractory ward is laid out nearly in the same way as that of the females, and the furniture and fittings are of a similar description. The rooms for single patients are like those on the female side, but are even more gloomy, owing to the roof of a covered walk in the airing-court partially intercepting the light. One larger cell contains two beds, and there is a dormitory containing eight beds, which is very gloomy and cheerless, from the high position of the windows. In the middle of the floor it has the usual grated opening. There is no watercloset or necessary within doors in this ward. The airingcourt has a covered walk, with a seat. It measures about 25 yards long, and 20 broad, and is gloomy from being completely shut in by buildings and high walls. Some patients, both on the male and female side, have not been beyond the airing-courts for years.

There is a bath on both sides in the lower wards. That for the males has only borrowed light from the passage. The patients are bathed once a week. The shower-bath is also occasionally used, but not without medical sanction.

The chief occupation for the male patients is agricultural labour in the adjacent field. The workers have a separate dayroom in which they take their meals, and there is a third small airing-court, laid out as a flower-garden, of which they have the separate use. It measures about 15 yards long, and 12 yards broad. About nine males are employed in the fields, and three females do light field-work. The females, however, are mostly occupied in the laundry and washing-house, and in sewing, spinning, &c. In winter, when field-labour is interrupted, the patients make mats, &c.

The means of amusement are very scanty, and the supply of books very small. The precentor attends for an hour every Wednesday, for the purpose of playing the violin and singing with the patients; but, except some small festivity at Christmas, they have no social meetings within the Asylum; nor do they ever make excursions in the country. The provision for clothes’ washing is bad, as there is only one small room that serves both for laundry and washing-house; but it is intended to provide better accommodation. There were no patients in the sick-room.

The patients appear to be sufficiently fed and clothed; the workers have bread and beer at twelve o'clock, as an additional meal. Mechanical restraint is in occasional use.

The Sheriff visits the house regularly, accompanied by Dr. Paul, who is one of the non-resident medical officers of the Asylum, as medical inspector. The only books kept are the "Register for Patients," and the private case-book of the surgeon. The instances of restraint are recorded in the latter, which, however, is never submitted to the Sheriff.

The chief faults of construction in this house, consist in the gloomy nature of the refractory wards, and the small size and confined character of the airing-courts. There is a great deficiency of the means of recreation; and, in a smaller degree, of those of occupation. The means for washing and personal cleanliness are very scanty. On the whole, however, considering the defective accommodation, the patients are well cared for.”

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