A SCOTCH ASYLUM FOR THE INSANE. 
H. B. WILBUR, M. D. 
[From the Northern Christian Advocate, June 16, 1881.] 
Insanity is a disease that visits so many 
households that I am sure that some of 
your readers will be interested in an ac- 
count of the method of management and 
treatment pursued in one of the Scotch 
asylums. I therefore send some extracts 
from the annual report for 1880, of the 
Barony Parochial Asylum, at Lenzie. It 
was built in 1875 by a wealthy parish of 
Glasgow, and is one of the finest structures 
for the purpose in Great Britain, Having 
myself had the opportunity of visiting it 
just before its opening, I can speak intelli- 
gently of the perfection of its arrangements 
and the excellence of its equipment. Fur- 
thermore I had an opportunity of making 
the acquaintance of its superintendent, Dr. 
Rutherford, and can testify to his ability 
and zeal. He was selected for the position 
on account of his successful management 
of the Argyll and Bute Asylum, where 
his peculiar methods had been conceived 
and put in practice. 
The report was sent me by an English 
physician, who is also superintendent of a 
large institution. The letter accompanying 
it has this language: ‘‘l have lately had oc- 
casion to go to Glasgow, and I spent two 
days with Dr. Rutherford, at Lenzie. His 
asylum is my beau-ideal of what an asylum 
should be. In case you do not get his re- 
ports, I send you a copy of the last. I can 
vouch for the correctness of his state- 
ments.” 
The average number of patients in the 
asylum, sometimes known as Woodilee, 
during the year was 470. 
The ratio of recoveries to admissions was 
44 per cent., a proportion that compares 
very favorably with the recoveries in 
American asylums. So, too, the death-rate 
compares favorably with that of our hos- 
pitals. 
On this point Dr. Rutherford remarks: 
“A year has again passed without the 
occurrence of any serious accident to pa- 
tients or attendants; indeed, no untoward 
event of any kind has occurred to disturb 
the harmony of the Institution. The weath- 
er was very favorable to the health and 
comfort, particularly of the male patients, 
who spend their time chiefly out of doors. 
The fine weather and abundant out-door 
exercise have had an undoubted influence 
on the results of treatment. It is note- 
worthy that the death-rate of males has 
been the lowest on record (8.1), and the re- 
covery rate the highest (52.1 per cent,.) It 
is rare in an asylum to find the male death- 
rate lower than the female, but during the 
past year this has been the case. It seems 
attributable to the circumstance that, 
amongst the men, no death occurred from 
consumption or pneumonia, diseases which 
caused six deaths amongst the females. 
There is little doubt that consumption is a 
disease of indoor and sedentary life, and 
that its absence as a cause of mortality 
amongst the 880 males is, to a certain ex- 
tent, due to the abundant outdoor exercise 
which they have enjoyed. 
“The most important event of the year has 
been the purchase of the adjoining farms 
of Muckroft and Fauldhead, by which 178 acres have been added to the available re- 
sources for the outdoor and 
recreation of the patients. From this I antic- 
ipate the best results, both from a curative 
and from a financial point of view. The 
additional land will be cultivated by the 
labor of the patients, with little, if any, 
addition to the existing number of horses 
and ploughmen. The farm staff has not 
been increased during the past five years, 
while the land has been more than doubled 
in extent. The pecuniary results, there- 
fore, can scarcely fail to be advantageous, 
and I hope this will soon be apparent in the 
diminished cost of the maintenance of the 
patients. 
“But it is rather as a great and beneficial 
means of treatment that this extension of 
the asylum grounds is to be regarded. With 
382 acres of land surrounding the asylum, 
there can be no lack of means of employ- 
ment for the patients, and of such a kind 
as cannot fail to still further develop those 
principles of treatment in which this asy- 
lum has taken a decided lead, and stands 
out prominently among similar Institutions 
in the country. Although Woodilee draws 
its patients from a large commercial and 
manufacturing city, and receives 200 new 
cases yearly, a large proportion of whom 
are of the acute, dangerous and suicidal 
class, yet a visitor may, go through the 
whole house without seeing any of these 
disagreeable manifestations of excitement 
and fury so often associated with restraint, 
confinement and idleness; while in the 
grounds all the men who are physically 
able will be found with their attendants 
working together like ordinary laborers. 
“One hundred and fifty of the men are 
.regularly employed at outdoor work in 
parties of eight or ten, each under the care 
of an attendant. The number of ordinary 
resident attendants is seventeen. Twelve 
of these, and three non-resident attendants, 
regularly accompany and work with the 
patients, under the direction of the chief 
outdoor attendant, whose duty it is to reg- 
ulate and supervise all work other than the 
ordinary cultivation of the farm and gar- 
den, which is conducted under the surveil- 
lance of the farm steward and the garden- 
er. Five attendants remain indoors, and, 
along with twelve able-bodied patients who 
occupy themselves as house-cleaners, per- 
form all indoor duties under the direction 
of the chief indoor attendant. The pro- 
portion of attendants to patients is certain- 
ly not greater than would be required were 
the patients treated on the old system of 
confinement in airing courts and with 
locked doors. 
“The nature of the work necessarily varies 
with the season of the year. It consists of 
the cultivation of the farm and garden, to- 
gether with ordinary estate work, such as 
road-making, planting, fencing, draining, 
quarrying, building, etc. In quarrying, 
building, and conveying the materials, 
about forty men and their attendants have 
been regularly employed during the past 
two years, and the value of the work of the 
two years has been estimated by Mr. John 
Duncanson, a leading Glasgow builder, and 
a member of the Board, at £741 4s. 3d. It 
is not easy to put a price on the work done 
by the other 100 men, but it is in its way 
proportionately valuable. 
“Besides the 150 men who thus work out 
of doors under the care of ordinary at- 
tendants, and the 12 able-bodied men who 
act as house-cleaners, about 30 are em- 
ployed as tailors, upholsterers,storekeepers, 
shoemakers, bakers, plumbers, blacksmiths, 
painters, joiners, engineers and stokers, 
under skilled artizans, who are required 
primarily for necessary tradesman’s work 
in connection with the Institution, and are 
attendants only in the sense that they em- 
ploy the patients of their respective trades. 
“Many years ago I used to adopt short 
hours of work, and had the patients more 
in the house, but my experience is that it 
is more satisfactory to keep to the hours 
that working men are accustomed to, as it 
makes the work more natural and real.” 
“This full employment of the patients ren- 
ders it possible to give greatly extended 
liberty, and to do away with all remaining 
forms of mechanical or chemical restraint, 
such as walled courts, locked doors, stimu- 
lants, narcotics and sedatives. 
“No airing court or enclosed space of a 
like nature has ever existed at this asylum. 
The doors from the wards open directly into 
the grounds, and the whole estate is the pa- 
tients’ exercising ground. 
“From fuller employment and increased 
liberty, with their accompanying dimin- 
ished manifestation of insane acts, there 
proceeds a greater capacity for self-control. 
On this principle, all the doors of this asy- 
lum were originally constructed to open 
with ordinary handles and without a key. 
An unfortunate accident occurred shortly 
after the opening, due to a patient escap- 
ing, not through a door, but through a win- 
dow, and it was considered prudent to alter 
those doors opening to the grounds by re- 
moving the inside handle. Two years ago 
these locks were restored to their original 
condition, and the asylum has, as your 
Committee are aware, since been conducted 
with open doors, with fewer accidents, a 
smaller proportion of attendants, and with 
fewer attempts at escape than formerly. It 
is with pleasure that I am able to say that many Scotch asylums are now conducted 
largely on the open-door system, and some 
of them very largely; but Woodilee is so 
far as I am aware, the only public asylum 
which is conducted entirely on the open- 
door system, for in it there is not even a 
closed ward where so-called refractory pa- 
tients are confined. It is to be remembered 
that this condition of matters exists in an 
asylum building situated within 90 yards of 
the Edinburgh and Glasgow Railway, which 
passes for three-quarters of a mile through 
the grounds, fenced by a light iron railing, 
and along which 195 trains pass daily. 
“From the same causes the use of wine 
and spirits is gradually diminishing. Dur- 
ing the past year their use has been almost 
entirely confined to newly admitted cases, 
chiefly females. The actual quantity used 
was 4 bottles of whisky for the males, and 
16 bottles of whisky and 13 bottles of wine 
for the females. Beer is not used as an ar- 
ticle of diet, water only being drunk by 
the patients and attendants at dinner. Forty 
gallons of new milk is consumed daily; it 
constitutes the chief element of sick diet. 
“Sedative and narcotic drugs have not 
been used except as an occasional draught 
at bedtime, in cases where sleep could not 
otherwise be obtained. The actual num- 
ber of patients who have received draughts 
does not exceed 13. I have long been of the 
opinion that stimulants and narcotics are 
rarely necessary in the treatment of insani- 
ty when conducted on these principles.” 
The report also gives extracts from the 
reports of the Scotch Commissioners of 
Lunacy, of visits made at two different pe- 
riods of the year, confirming the good re- 
sults of Dr. Rutherford’s management. 
These gentlemen mention that there were 
no cases where restraint was applied and 
but three instances of seclusion during the 
year, and these three for short periods. It 
is also mentioned incidentally that “the 
whole visit was made without opening a 
door with a key, and it was found that a 
large number of the attendants did not car- 
ry a key.” 
The above extracts do not require much 
comment. If the methods described are 
judicious and practicable, surely there is a 
chance for improvement in the manage- 
ment of American asylums.