THIRTY-FOURTH REPORT ^ ) iT " r'> r~' A r"> V' f%*» "E-;/ f ip- OP THE r U jQ 1 Q ^ O O DEBBTSHfl/i LjU/ fW; fij ffyrfg €tsmty |)attpcr ’Cmratic AsmIimi:, FOR THE YEAR 1885. ---•$—-- COMMITTEE OF VISITORS : Lieut.-Col. MOBLEY, Burnaston House, Derby (Chairman). T„ W. EYANS, Esq., Allestree Hall, Derby. CHAS. EDMUND NEWTON, Esq., Mickleover, Derby. N. C. CURZON, Esq., Lockington Hall, Derby. COLONEL NEWDIGATE, Byrkley, Burton-on-Trent. Sir H. F. EYERY, Bart., Egginton Hall, Burton-on-Trent. W. EYANS, Esq., Darley Abbey, Derby. G. F. MEYNELL, Esq., Meynell Langley, Derby. E. SUTTON, Esq., Shardlow Hall, Derby. A. F. HURT, Esq., Alderwasley Hall, Derby. REGINALD CHANDOS POLE, Esq., Radbourn, Derby, Treasurer ............ Superintendent Physician . Bom. Consulting Physician. Assistant Medical Officer Chaplain................. Clerk and Steward........ Housekeeper.............. Chief Attendant.......... Chief Nurse.............. ..George Crompton, Esq. .J. Murray Lindsay, M.D,, F.R.C.S.E., M.R.C.P.E., .J. Hitchman, M.D., F.R.C.P. R. J. Legge, M.D,,L.R.C.S.E. .The Rev. R. C. Bindley, M.A. .Mr. John Langley. .Miss Martin. Mr. John Elliott. .Miss Geissler. B. SCOTT CURREY, Clerk to the Committee.REPOET OF THE VISITING COMMITTEE, Your Committee beg to present the 34th Report in reference to the County Lunatic Asylum. The Lunacy Commissioners have not visited the Asylum since the 14th February, 1885. On the occasion of that visit they continued to urge, as they had previously done, the erection of a Hospital for Infectious cases. Plans were prepared and Estimates obtained for such a Building, and application was made to Quarter Sessions last year for the money for that purpose, when the subject was referred back to your Committee for reconsideration. It was found impracticable to provide any building at a less cost that would really be efficient to meet the Commissioners’ require- ments, and your Committee decided to tide over the difficulty by substituting a disinfecting room, fitted with Lyon’s Patent Steam Disinfector, for which a grant of £800 was made at the October Sessions in 1885. Your Committee are glad to report that the Disinfector appears to be a most satisfactory Apparatus, and will, it is hoped, do arvay with the necessity for any further outlay as a precaution against any infectious diseases for the present. The New Boilers and Boiler House referred to in last years5 Report have been completed, and are found to work most satis- factorily. A New Organ in the Chapel has been provided, and a new Conservatory is now being built, both of them without any expense to the County, and will it is expected add materially to the welfare and comfort of the patients. Other improvements of a minor character, and which are referred to in the report of the Medical Superintendent, have been made during the past year. Your Committee would again express their satisfaction with the general arrangements of the Asylum under Dr. Lindsay’s manage- ment, assisted by a whiling and efficient staff, and they would draw the special attention of the Magistrates in Quarter Sessions to the very favourable recovery rate referred to in Dr. Lindsay’s Report, not only as most satisfactory in itself, but as a feature confirming the expression of satisfaction before referred to. ASHTON MOSLEY, Chairman. Since the above report vras agreed to by your Committee, the Lunacy Commissioners visited the Asylum, on the 19th March inst. They still persistently urge the necessity for erecting a de- tached Hospital for infectious cases, although they vrarmly approve of the disinfecting apparatus recently erected, and which it was hoped might have satisfied them for the present. It may be added that the latter is really essential for the well-being of the Asylum, even if a detached Hospital should be added at some future time.5^2,2 144 ms 3 of tl;r dammxmmm lit Untacg. Dekby Counts Asylum, 19th March, 1886. We have this day visited the Derby County Asylum and find the patients detained therein on the whole well dressed, tidy, quiet and contented, the day rooms very bright and cheerful, the dormitories in good order, and in the majority of rooms the beds well attended to. An excellent dinner was provided this day, and was evidently relished. No complaint except on the score of undue detention was brought before us, and no charge of harsh treatment in either division at the hands of the attendants, and the majority of the patients were quiet and orderly. No one was wearing a strong dress, and black eyes and bruises were rare. Oh the books this day are 430 patients in equal proportion of sexes, and all except 3 males on leave were addressed by us this day. Tjrere is one patient in either division belonging to the private class, and 12 patients, 6 of each sex, have been admitted here from Nottingham Borough Asylum. The rest all belong to this County. T^he changes which have taken place since the last visit, which took place about 13 month ago have been the following :. 1 M. F. T. / Admitted 70 65 135 | Discharged Recovered 18 30 48 1 ,, Relieved or not Improved 6 3 9 ,, Not Insane 1 1 2 ( Died ... 44 24 68 | All the deaths except one were from ordinary causes. The elxception was of a man who committed suicide by cutting his throat, tli.his death formed the subject of correspondence between the Asylum authorities and our Board and needs no further remark. In this pase the coroner held an Inquest, and in one other because the jpatient died 5 hours after admission. Post-mortem examination4 lias verified tlie assigned cause in 42 of the male and 23 of the female patients deaths, in one case of a male patient leave was refused, and in the other two cases death has been so recent, that there has been no time to make autopsy. In the male division general Paralysis and Phthisis account for 9 deaths each, and in the female division 9 women died from Phthisis also. During our visit to the wards we found 5 men and 8 women in bed; under medical treatment last week were recorded the names of 13 men and 28 women, and 47 men and 30 women suffered from Epileptic Fits, whilst 25 men and 24 women are considered actively Suicidal. With regard to the Epileptic nnd Suicidal patients, we wish we could report that they were all under continuous supervision by night, but this is not the case, we think, however, one of the two large dormitories in either division might be used for this class, and with a night attendant sitting up in the. room, the greater number of these patients might have the requisite supervision by night. This would entail an extra night attendant on both sides, and this we strongly recommend. They should then be thus divided, ope constantly in the Epileptic dormitory, one in the infirmary, and one partrolling the whole division, recording the visits round the building every hour. The infirmaries al’e rather large for their purpose, and so the night watching even in these is not satisfactory. It is with grave regret we have to report that the proposal which was brought forward to erect a detached Hospital was not carried, wje again urge the subject as one of the utmost importance upon the attention of the Committee, and can only express our earnest hope that the need for such a Hospital may not arise before the building has been erected. There has been a disinfecting apparatus set up in lieu thereof, and though fully acknowledging the usefulness &f this disinfector, it can never be made to supply the place of aja Infectious Hospital. Amongst other improvements and additions we have to notice have been the following -(a) An organ has been erected in the Chapel, the post of Oraanist being kindly undertake^ by Dr. Legge; (b) a Conservatory is in course of erection; \g) neyv Boilers have been placed in the engine house, and above ground, at the same time opportunity was taken to make alterations in the5 Laundry, and better means of communication between the stokers at the boiler house and the kitchen and laundry. The drains pass- ing under the buildings have been overhauled, and are supposed to be now so arranged that no escape of sewer gas can occur, and the brick drain under the kitchen has been diverted. The large sewage tank in the front field near the wards has been filled up, and the sewage is now turned on where required on the farm in a fresh state. Much painting and decoration is in progress, and we were pleased with the work, but many parts of the Asylum require attention in this respect. There are 20 ordinary attendants in each division, two from either side doing night duty. They show a fair record of service, only 3 men and 6 women have not had as yet one year’s experience. Usefully employed are 123 men and 114 women, the ward cleaners being 53 in the male and 47 on the female side : 44 men work on the land, and 26 in the kitchen, stores, and shops ; 21 women assist the laundress, and 46 are engaged in needle-work; 70 men and 78 women take exercise only in the airing courts ; 145 men and 137 women walk in the grounds ; and 75 men and 98 women go at times beyond the walls. The Church Services on Sunday are attended by about 110 men and 113 women, 60 men and 50 women join in the week-day prayers, whilst the associated entertainments, which are frequent and varied, attract 129 men and 116 women. We ought not to omit to notice that no seclusion or restraint has been found necessary since the last visit, and serious casualties have been rare. One woman was in bed with a broken arm, how occasioned we could not with certainty ascertain, but we satisfied ourselves that it was not caused by any of the nurses. No change has taken place amongst the Officers since the last visit, and we think the condition of the Asylum is very creditable to Dr. Lindsay, whose efforts seem to be well seconded by the rest of the staff. A word of praise is certainly due to Dr. Legge for the way in which the Case Books are kept0 W. E. FRERE, [Commissioners REGD. SOUTHEY, ) in Lunacy.«9*-O0GS'--fr CHESTERFIELD. 2nd Feb., 1885. We, the undersigned, a deputation from Chesterfield Union, have this day visited the County Asylum at Mickleover, and desire to express our entire satisfaction with all arrangements made for the treatment and comfort of the patients, and to express our thanks to Dr. Lindsay and Mr. Langley for their kindness and courtesy in conducting us over the establishment. SHARDLOW. 6th Feb., 1885. We, the undersigned members of the Shardlow Union Board of Guardians, have visted the County Asylum to-day, and seen all the patients belonging to our Union, and find them well cared for and comfortable. We desire to express our full satisfaction with all the arrangements, and to sincerely thank Dr. Lindsay for his kindness and pleasant reception. ASHBA-DE-LA-ZOUCH. 19th Feb., 1885. We, the undersigned five members of the Ashby-de-la-Zouch Board of Guardians, accompanied by their clerk (Mr. George Farmer), forming a committee appointed by that board to visit the County Asylums of Leicester and Derby, have to-day visited the latter, accompanied by Dr. Murray Lindsay (whose obliging courtesy they beg cordially to acknowledge). They visited each portion of the establishment, and besides seeing all the patients in the different wards, both male and female, they saw separately each patient belonging to the Ashby-de-la Zouch Union. The committee feel that this unhappy malady could not be treated more admirably than it is in the Asylum at Mickleover, and they beg to express their entire satisfaction with all the arrangements.MANSFIELD. 20th Feb., 1885. We, a committee of the Mansfield Board of Guardians, desire to record our satisfaction with the condition of the patients from our Union, and our sense of the courtesy of Dr. Murray Lindsay, who has afforded us every facility for inspecting the arrangements of the Asylum and the care and treatment which the patients receive. BURTON-ON-TRENT. 21st October, 1885. We, the committee of the Burton Board of Guardians, have to- day paid a visit through the various wards and dormitories, and are much pleased with the order cleanliness and comfort apparent amongst the inmates. SHARDLOW. 22nd Feb., 1886. The undersigned members of the Shardlow Board of Guardians have this day visited the County Asylum at Mickleover, and we wish to record our satisfaction with the condition of all our patients, and our confidence in the attention and care bestowed upon them, and with all the arrangements and appliances for their comfort. We also wish to thank Dr. Lindsay for his courtesy and kind- ness in personally conducting us through the establishment. -H|C V 3jK-8 fhjjart d id JltrMral ^njjrnnten&ntit* TO THE COMMITTEE OF VISITORS OF THE DERBY COUNTY ASYLUM. Gentlemen— I beg to submit the Thirty-Fourth Report of the Asylum for the year 1885. On 1st January, 1885, the Asylum contained 481 patients. The admissions during the year have been 112, the discharges 59, and the deaths 62, leaving 422 patients in the Asylum at the close of the year, which shows a decrease of 9 upon the number remaining at the end of the previous year. Of the 422 patients remaining on 81st December, 404 (202 males and 202 females) are chargeable to Unions in Derbyshire, 2 men are chargeable exclusively to the County Rates, 12 (6 males and 6 females) belong to Nottingham, and are received here under an arrangement with the Nottingham Borough Asylum Authorities, 2 men are Criminal Lunatics chargeable to Government, and 2 (1 male and 1 female) are private patients. These figures show a decrease of 28 (11 males and 12 females) in the number of Derbyshire patients remaining at the close of the year, compared with the numbers remaining at the corresponding period of the previous }7ear. Comparing the admissions of the last two years, we find that there has been an unusually large decrease of 87 (27 males and 10 females) in the number of Derbyshire admissions in 1885, as compared with 1884, in which latter year, there was a considerable increase of 17 males, and a decrease of 15 females.9 These figures are striking as exemplifying the uncertain fluctuations in the admissions, and are not easily explained. It is not improbable, however, that in some measure they may be attributable to a variety of causes, and may have some connection with the changing opinions of Public Boards, the suspense and un- certainty in which Lunacy Legislation has of late years been kept, and the increasing objection on the part of Parochial Authorities and Relatives of the insane to look upon the Asylum as a Curative Hospital, combined with the increasing disposition to regard the Asylum more as a last resort for the hopelessly incurable, or a prospective cemetery for the dying. The effect of this is not to make legitimate use of the Asylum to the fullest extent, but to detain insane persons in Workhouses and at home as long as possible, only sending them to the Asylum when they become in- tractable, dangerous to themselves or others, dirty, destructive, extremely debilated, their malady becoming chronic, and too often incurable. This feeling of objection to the Asylum is perhaps also fostered by recent prosecutions and decisions in Courts of Justice, which tend to create suspicion in the mind of the general public with regard to the admission and detention in Asylums even of Pauper Lunatics. At the close of the year, the total accommodation amounted to 468 beds, 287 for men and 281 for women, of which number there were 24 vacant beds in the male division, and 22 in the female division. Of the 422 patients remaining in the Asylum at the close of the year, not more than 83 (16 males and 17 females), including some doubtful cases, or 7*8 per cent., are deemed curable. Admissions.—The admissions of the past year have been 112, being a decrease of 21 compared with the previous year. Among the admissions there were 12 (6 males and 6 females) from Nottingham, 2 private patients (1 male and 1 female), 2 Govern- ment patients (males), and 2 men who had shown no indication of insanity in the Asylum, any symptom of mental aberration or30 excitement they may have previously exhibited having passed away, and who were consequently after a short residence discharged not insane. With reference to the principal causes of insanity (taken from the histories of the cases) in those admitted, Table X. shows that hereditary predisposition was ascertained in 34 per cent. In 28 per cent, there had been previous attacks of insanity; and intempe- rance was assigned as the cause in 8 per cent, of the men, and 9 per cent, of the total of both sexes. Discharges.—59 were discharged, of whom 45 were recovered, 9 were discharged to the care of their relations, of whom 6 were relieved, 1 was transferred to another Asylum, 2 were discharged not insane, and 2 men, Criminal Cases, were transferred from the private to the pauper register, their term of sentence having expired. The patient Charles Oliver, who made a murderous assault on the Medical Superintendent, was removed on 5th January from Derby Prison to Broadmoor Criminal Asylum. The recoveries are at the rate of 46*87 per cent, to admissions (excluding transfers from other Asylums), 80*18 per cent, for men, and 67*44 per cent, for women, being 5 per cent, higher than the recovery-rate of the previous year. This should be considered a very satisfactory recovery-rate, especially taking into account the large proportion of unfavourable cases admitted, and is 7 per cent, higher that the average recovery- rate—89*77 per cent, in County and Borough Asylums, as given in the last published Report of the Commissioners in Lunacy. Deaths.—The deaths amount to 62, being at the rate of 14-98 per cent, to daily average number resident, which is rather over 1 per cent, higher than the death-rate of the previous year. Calculated on the total number under treatment during the year, the death-rate is 11*41 per cent. The high mortality is again attributable to the excessive number of deaths from Pulmonary Consumption, and to the very unfavour- able character of the cases admitted, many of whom were in such a11 debilitated or diseased condition that they died within short periods of admission, one man only surviving five hours, and another nine days, 18 dying within 12 months of admission. As many as 16 died at advanced ages, from 60 to 78 years of age, and 18 more from 50 to 60, including several old residents, one of whom had been an inmate for the long period of 82 years, whilst three others had resided in the Asylum, 25, 20, and 19 years. Next to Pulmonary Consumption, which carried off the same number as the previous year, the most frequent causes of death were Cerebral Diseases and General Paralysis, The average age at death was 49, Two inquests have been held during the year—the first, W. D. committed suicide by cutting his throat with a knife at the Farm where he was employed ; and the second, J. F. was suffering from Broncho-Pneumonia on admission, he was in an extremely emaciated condition from refusal of food, only survived five hours, and died from Broncho-Pneumonia and Melancholic Exhaustion. During the past year, deputations from five Board of Guardians, Chesterfield, Shardlow, Ashby-de-la-Zouch, Mansfield, and Burton- on-Trent visited the patients in the Asylum chargeable to their Unions, and left favourable records of their visits. A birth took place during the year. A. E. M., a married woman, admitted on 20th March, gave birth on 25th April to a healthy female child, subsequently removed by the father. At the Quarter Sessions on 80th June, a pension of £40 a year was granted to James Badcock, who faithfully performed the trying duties of attendant for the long period of 26 years. New Boilers.—With the sum of £650 granted at the April Sessions, the following alterations have been effected :■—Alteration of the boiler house, removal of the two old steam boilers (subse- quently sold for £81) from the inconvenient depth below the ground level where they were originally placed, as they were becoming worn out, inefficient, and inadequate for the proper steam requirements of12 the establishment, having been in use since 1858, and the substi- tution of two new improved boilers placed on the ground level, made by W. and J. Galloway and Sons, Manchester, at a cost of £860 delivered, working pressure 601bs. per square inch, and previously tested by hydraulic pressure to lOOlbs. per square inch. The boilers are insured with “ The Boiler Insurance and Steam Power Company, Limited,” Manchester. In connection with the alteration of boiler house, an improve- ment was effected at the laundry. An addition was built to the foul laundry to compensate for space given up to the boiler house, an improved drying closet constructed, and a new passage made connecting the foul laundry with the central passage, so as to facilitate the working of that department, and obviate the necessity of the male attendants having to go a longer distance outside to the back of the foul laundry, a bell-pull having been fixed in the passage outside the foul laundry door for the use of the male attendants. At the. same time, it was arranged to provide better means of communication with the stokers in the boiler and engine houses, for the purpose of regulating the supply of steam to th© laundry and kitchen, by fixing a speaking tube and bell-pull in the kitchen passage near the housekeeper’s work room. New Organ for the Chapel. With the interest on the Jones bequest, amounting to £159 16s. 7d., an important addition has been made to the chapel, by the purchase of anew “ Chancel Organ of one manual and pedals, bracketted case, and decorated speaking front pipes,” made by Messrs. Bevington & Sons, London, at a cost of £120. A brass altar desk, and two polished engraved brass vases have also been purchased for the chapel, at a cost of£5 7s, 6d. The balance left after defraying all expenses connected with the Organ, See., has been devoted to the Band Fund, for the purpose of purchasing musical instruments and music for the band and choir. The New Organ, at which Dr, Legge so ably officiates, was first used for service on Sunday, 6th September, it has greatly aided the improvement in the musical portion of the chapel services, and there can be no doubt of the beneficial influence of the improvedIB services upon the congregation, patients as well as staff. The attendants forming the choir, so zealously conducted by Miss Geissler, are deserving of commendation for their musical services. New Conservatory.—With the sum of £400, part of the Jones bequest of £450, a new conservatory, 40ft. by 20ft. is in course of erection near the chapel, “ with span roof, bed for plants in centre, stage all round, and heated by four pipes all round, also a small tank and pump inside.” It is being erected by Messrs. Messenger and Co., Loughborough, as per estimate, amounting to £807 10s., to include everything except bricklayer’s work. A kind contribution has already been made by Colonel Newdigate of 96 stove and greenhouse plants, including some ferns, azaleas, heaths, &c., for the new conservatory, in which there will be ample room for further contributions from any kind friends of the Institution who may have spare plants to bestow upon so good an object, and which will be gratefully received. Infectious Diseases Hospital.—The important question of the erection of a detached Hospital for the isolation and treatment of infectious diseases, a matter so urgently pressed by the Lunacy Commissioners, has received the careful consideration of the Com- mittee on several occasions during the past year, the result being that an application was made to Quarter Sessions, on 80th June, for a grant oi £2,600 for the erection, fitting and furnishing complete of an Infectious Hospital (£2,000 for building, and £600 for furniture, fittings, architects’ charges, &e0), as per estimate of County Surveyor, but the proposal of the Asylum Committee on the motion of the Chairman, Colonel Mosley, was lost by 11 votes for to 15 against, and the matter was referred back to the Committee for the reduction of their estimate. An amended plan at a reduced estimate was submitted by the County Surveyor, which, however, was abandoned by the Committee at their meeting on 8rd October, and a decision arrived at to substitute another proposal to apply to Quarter Sessions for a grant of £800 to provide a disinfecting room and apparatus. This sum was granted by Quarter Sessions on 20th October (the motion being agreed to, writh only two14 dissentients) on the motion of Colonel Mosley who “ urged that this would obviate for the present the necessity for the erection of a detached Infectious Diseases Hospital.” As Superintendent-Physician of the Institution, and its Medical Officer of Health, I may be permitted to express my regret that a matter so repeatedly and urgently pressed by the Lunacy Com- missioners, and considered so essential by your Medical Officer, should be further delayed and not carried into effect. I am thankful for the disinfecting apparatus, but it is only one weapon, and that not the strongest, in the necessary armour with which to fight the battle of infectious disease. I view so seriously the risk incurred in neglecting to make this necessary provision that I feel I should be lacking in my duty if I failed to record my opinion that, should un- fortunately infectious disease attack us, the resources of the Asylum are utterly inadequate to enable us to meet the enemy, for we are not properly equipped or fully prepared, as there is no proper separate accommodation for the isolation and treatment of such disease. There is certainly a small empty cottage in the front field which is damp, does not contain a single really good room, and is quite unsuitable for the purpose. This will at once be seen from the following statement giving the cubic space of the rooms :—The cottage contains two rooms, one has J ,070 cubic feet, the other 900 cubic feet; the kitchen has 1,480 cubic feet, the passage between the kitchen and scullery has 900 cubic feet, these four places being 10 feet high, the scullery has 665 cubic feet and is 7 feet high. When it is considered that the highest Medical and Sanitary Authorities recommend from 1,500 to 2,000 cubic feet of air space per bed for fever cases and infectious diseases, which is the space usually given, it will be at once apparent how utterly unsuitable the cottage would be for the purpose of an Infectious Hospital. Disinfecting Appakatus.—With the grant of £800, a disinfecting room has now been provided, fitted up with u Washington Lyon’s Patent Steam Disinfector,” made by Manlove, Alliott, Fryer, and Co., Nottingham, at a cost of £191. In this disinfector, articles of clothing, bedding, &c., are subjected15 to a moist heat of high temperature 260° Fahrenheit by means of super-heated steam, at which temperature the germs of disease are destroyedo It is considered the most efficient disinfector, more economical than any apparatus heated by gas, and not so detrimental to linen and clothing. The blacksmith’s shop, 24ft. Bin. by 10ft., opposite the boiler house has been converted into the disinfecting room, and the old gas retort house has been converted into the blacksmith’s shop which is larger than the old shop, being 24ft. Bin. by 18ft. Bin, This is a great improvement, for a much better and more roomy shop has been obtained by the alteration. In connection with these alterations other improvements have been effected, the workmen’s mess-room and place adjoining, measuring 24ft. by 10ft. lin. are being converted into a larger and more convenient shop for the plumber, and the old plumber’s shop, 13ft. 4in. by 10ft. Bin., is being converted into the workmen’s mess-room. A shed measuring B8ft, by 14ft. has also been built at the back of the coal shed for storing cement, lime, ropes, and material belonging to the department of the Engineer and Clerk of Works, it having become necessary to remove this material from the gas retort house and lime shed in consequence of the alterations already re- ferred to. Among other alterations and improvements effected during the year, the following may be mentioned :— 1.—The completion of the Sanitary Improvements which have been in progress for several years past, by a careful examination and alteration of the drainage system wherever defective. The brick culverts passing under No. 1 and 2 male and female wards have been covered on top so as to completely encase them with hydraulic lime 9 inches thick. The 9in. drain pipes passing under No. 2 male and female wards have been encased in concrete 12 inches thick all round. The brick drain passing under kitchen has been diverted, and now delivers into an inspection shaft which has been built in the culvert m centre of kitchen yard, all drains made to deliver into it. The16 overflow from soft (rain) water tank also delivers into it, is trapped and provided with a cast iron tide valve, so that in the event of the sewer being stopped the sewage could not back into the tank. This overflow was previously connected with and passed direct into the sewer. All the drainage from kitchen now passes through 6in glazed earthenware pipes direct into inspection shaft, over which is placed one of Jacob's patent sewer ventilators. Sinks outside and close to kitchen and top scullery doors have been altered, and removed to centre of yard to receive all vegetable water. An inspection shaft has been built on sewer in store yard where the overflow from soft water tank is situated, and a cast iron tide valve has been inserted in overflow for the same purpose as that in kitchen yard. The old inspection shaft outside the female entrance door in kitchen yard has been repaired, and rendered inside with Portland Cement, and one of Jacob’s Patent Sewer Ventilators placed on top. 2.—Abolition of the Large Sewage Tank in front field, which was too near the wards, 210 feet from front of building, and contained 50 cubic yards of sewage matter. The outlets being situated on the same level as the inlets, the Tank always remained full of decomposing sewage matter, which was apt to be a source of danger to health. This has now been removed, and the Tank filled up. The Tank used to be emptied at long intervals, having been emptied 16 months previously, The three main drains were inter- cepted, and carried round the position ot Old Tank, with 15 inch Sanitary (xlazed Pipes laid in concrete, and connected together at an inspection and cleaning shaft constructed for that purpose, the outlet being carried into the old drain passing under cricket ground, which drain formerly received overflow from old tank and extends to sewage outfall at farm. The sewage on arriving at farm was formerly distributed to different parts of the fields, where required, along open channels and furrows made with a plough, the consequence being that the head- lands of the fields along which the sewage travelled, and especially near the sewage outfall, were saturated with sewage, the offensive17 smell from which was certainly a nuisance to many, patients and others, who frequently passed that way along the regular walk round the farm. To remedy this nuisance, and to facilitate distribution of the sewage, a sewer carrier was constructed with 9 inch Sanitary Glazed Pipes, for a distance of *250 yards from outfall, and at every 40 feet a blue brick eye in cement was formed, with a 6 inch outlet and valve provided for each, so that the sewage can be turned on where required. These alterations and improvements in connection with the abolition of the large sewage tank have been carried out at the moderate cost of £60., as per estimate of the County Surveyor. 3. —Abolition of Out-Door Privies in the south male airing court and north female airing court, and the cesspools filled up, as they were objectionable, and considered unnecessary. 4. —Fire Arrangements.-—With regard to precautions against fire, in accordance with the suggestion of the Lunacy Commissioners the two observation windows in the Nurses’ bedrooms, looking into the large dormitory in No. 8 female ward have been removed, and doors substituted so as to facilitate egress in case of fire, the windows in these bedrooms opening wide so as to admit of the use of a canvas shoot escape, which is kept ready in each room. The purchase of 1 dozen hatchets and 1 dozen leather belts for the Fire Brigade, and four Rose’s Corridor Wheel Pumps with Hose attached for No. 7 and 8 male and female wards, has completed the fire arrangements, and exhausted the sum of £350 granted at Quarter Sessions in January, 1885, for precautionary arrangements against fire. 5. —A better and more healthy bedroom for the cowman has been obtained by partitioning off* a portion of the barn looking east, in place of his old objectionable and badly situated bedroom over the steamer, close to the piggeries, and looking towards the cemetery. The foregoing statement of alterations and improvements will18 show that the past year has been one of progress and of special activity in the department of the Resident Engineer and Clerk of Works, who has economically and energetically carried them out, acting under the instructions of the County Surveyor. The committee granted the application of Mr. Dennis, Engineer, for increased remuneration, by an addition of £20 a year to bis salary, Mr. Dennis having been over seven years in the service of the Asylum. Acknowledgments.—In addition to the members of the com- mittee who have given liberal supplies of evergreens for the decoration of the wards at Christmas, our thanks are also due to Mr. John Coleman, Heanor. I beg to acknowledge with thanks the following gifts :—106 magazines and periodicals from Mr. Marsden, Derby, for the use of the patients ; 21 pictures from B. Scott Currey, Esq. ; the annual Christmas box, containing over 400 oranges from a lady; 420 Christmas cards for the inmates and 50 Christmas cards for the attendants, from Miss Edith Newton, Mickleover. Amongst those who have kindly given entertainments to the patients, we have to thank Mr. J. Siggall, Russian Violinist, with friends, and the “ Derby Rifle Volunteer Band” for excellent concerts of vocal and instrumental music, and the “ Derby Garrick Society” for two very amusing dramatic entertainments. From my colleague, Dr. Legge, I continue to receive very efficient assistance in the medical work of the Asylum. He also continues to render valuable service by devoting his musical abilities to the benefit of the patients, and in training and conducting the new Band which he organised. Miss Geissler also, by her dramatic and musical abilities, con- tributes largely to the enjoyment of the patients, trains the choir, and assists in the musical portion of the chapel services. To them, as well as to the chief-attendant, Mr. John Elliott, and the other members of the stall; who devote so much of their time to taking part in dramatic and musical entertainments for the benefit of the inmates, my bert thanks are due.19 I have pleasure in acknowledging Mr. John Langley’s lengthened and valuable services as clerk and steward. I beg to thank the chairman and committee of visitors for tbeir valuable aid and support during the past year in the management of the Asylum. I have the honour to be, gentlemen, Your obedient servant, J. MURRAY LINDSAY, M.D. Mickleover, February, 1886. -h}c v20 MEDICAL STATISTICS. STATISTICAL TABLES OF THE Jltetoar- psijdioiflgkai Jbaartattfltt. 1885.21 TABLE 1 Showing the Admission^ Re-adnihsions, Discharges, and Deaths during the Year ending 8Dt December, 1885. M. F. T. M. F. T. In the Asylum, January 1st, 1885. 217 214 431 Cases admitted— First Admissions.., 53 44 97 Not first admissions 8 7 15 Total Cases admitted during the year 61 51 112 Total cases under care during the year 278 265 543 Cases discharged— Recovered 16 29 45 Relieved 4 2 6 Not improved 4 2 6 Not insane... 2 0 2 Died 39 23 62 Total cases discharged and died during the year ... 65 56 121 Remaining in the Asylum 31st December, 1885. 213 209 422 Average number resident during the year ... 209 206 415 Persons under care during the year 278 265 543 Persons admitted ,, ,, 61 51 112 Persons recovered ,, ,, 16 29 45 Transferred from other asylums... 2 2 4 I » to „ 1 1 22 TABLE 1A. Showing the Number of previous Attacks among those Admitted during the Year 1885, distinguishing those Attacks that have been treated to Recovery {and Discharge) in this and other Asylums. Persons having had previous Attacks. Number ot previous Attacks. All Attacks. d Have had 1 previous Attack Attacks28 TABLE II. Showing the Admissions, Re-admissions, Discharges, and Deaths, from the opening of the Asylum to the 81 st December, 1885. Persons admitted during the 1 period of 54 years........J Re-admissions ...... Total cases admitted Discharged cases — Recovered ...... Relieved....... Not improved .. Died .............. M. Total cases discharged and died since the opening of the Asylum .............. Remaining 31st December, 1885 Average number resident \ during the 34 years.........J Transferred from other asylums to 1976 265 805 164 201 858 166 F. 1805 237 902 183 162 586 T. M. 3781 502 1707 347 363 1444 173 339 2241 2042 2028 213 1833 209 T. 4283 3861 422TABLE III.—Showing the Admissions, Discharges, and Deaths, with the mean Annual Mortality, and Proportion of Recoveries per cent, of the Admissions for each year, since the opening of the Asylum, 21 st August, 1851. 24 "!h co a a ft H o CO a ft O 04 00 © rH ft 05 ft ft ft a rH o o a ft a OD 05 00 05 03 K> SO 05 ^ n a d EH co »o ft o ft o rH 00 05 04 CO o 04 do a cb a cb o o rH rH cb a ft a cb cb 04 04 CO o to a fcD O a co 00 o CO cb 05 o CO cb 04 ft 05 o ft cb CO a ft cb ft cb ft cb ft 05 ft ft CD cb o ft ft cb c CD 05 00 ft 03 03 a vO 00 ft 1-1 rH 04 rH r_l rH rH 1 1 tH 1-1 a a 04 a a a a a a a a rH 04 a a r_‘ rH a 1—1 o A b g o ft a CO CO ft co 05 co rH co CO 04 co 00 00 a ft a ft a ft o ft rH ft ft o cp Oj 03 CO o CO ° o - CO co ft o o 04 04 rH 03 03 to a S) ” "a H 04 04 04 04 04 04 04 04 CO co co co CO co co CO CO co CO co co a a a a a a a a a a a 03 _Q ft CO 05 CO 04 co 00 05 04 CO a o 05 ft CO 04 ft CO GO co 00 00 o o 05 o 05 ft ft CD a LO o o H cl a pr | hH ft 05 04 CO CO CO CO an a co ft CO CO CO ft 00 00 00 05 00 GO o i—i o 04 a 03 03 03 o 0 *02 CD i—1 H rH H r—1 H i—i a a a 1—1 a a 1—1 1—1 1—1 04 04 04 04 04 04 04 C LQ 05 •S co [Vj co CO rH a a CO co a ft ft ft CO ft co 00 CO 00 05 o 00 GO o 04 a a 04 03 03 7—| o c3 • a o ft CD rH rH H rH rH r—1 i—1 r—1 H a a a 1—1 1-1 1—1 a 04 a a 04 04 04 04 04 04 04 04 03 03 OQ 03 a to Aft CO a 04 CO CO CO CO co a co ft a CO CO ft 00 00 05 00 00 ft GO 05 rH o 05 05 o 05 o rH rH ft PH H H 1-1 H rH H H rH rH a 1—1 rH rH a a a a a rH i—1 a 04 04 a a 04 a 03 03 03 C-j co ft 04 00 O CO CO CO 00 CO 04 00 05 ft 00 CO CO o o 05. rH o 05 00 rH O o co CO lO 5-j- 05 03 i—i 04 CO 04 1—1 04 04 04 CO a* a CO 04 CO a a ft a CO a a ft ft CD ft ft ft ft rc> LO 30 a s t>QO«OI>t>\HCOt>»OlOOH05VOr rH rH Hr—iHCqCQ Hr I Q (M 05 xfi lO ■ -tftcDC4acoco©c4ftcoo3to H id H r-> O 00 00 00 CIS-Jft .rH 00 H US CO 05 05CO(Xi!M)OCOCOH^HCOHCO H ^OHCOH CO H 04 ^.!>00l>(M(N(M05l>00e(5i0Ov0N COOOOCOt>^(M>OHHCqHH ^NH(MeOxH(MC0005l>Tflt>HCOT COU5I>00t>CM I>lO00^ C003KM05 00H)0t}(Hi©^C0MOK)10IOCQ !COCO(MOCCCOOUON^TtiHHN^HCt)lOLO 1(M(M«5COiCi0505l>OCOOW»omcO(MOOI>a> ,H(MC^H^OOCOT((rJO)HCOvO iH(MH(M(M(M(M(M(MCOmco^^(MHCQ03H a a <1 r, WHHfl5 03 ©H00OWi H HCOIOCOH t>© 00 05(M' H ft O ^ CO t> 05 O l> W CT5 r-i OD O ITJIO O 00 i—I 00 H IO 03 H0SC0L'- 0505C0HlMOOt>m00NI>0D«. ft a tO tO a cot-'ocqt-coio^jc^xHt^cocacqt-c^'oriio^oooococQiooooscscQHociLococd-H 05«5i>i>,'Oco^^cooioio^THm^focoiocoioot£)cooooDaoiooSS tD^OH(M?DC0a M(MCOcOQOI>OitOKin5r-i Ht-l>C0i0^W^OC0>0C0TH^a5>0C£)©i0»CH0i01>CD05OO05l>dv0v0^3 V* I m-^iocot>ooo50Hoico-^«50t>ooo50Hoico^iocoi>coo50r*((xitoH-in HM5lOOiO»OW»OCCOCCCCOCDCOecOOt>M>l>Nt't>t«l>NODODCOOOOOm lOOOOOQOOOOOOOOOCOOOCOOOOOOOQOOOQOOOOOOOOOOOOOOOQOoOOOOOOOOOmmmm (i ) rH r-i rH rH rH r-I r-irHT-Hr—Jr—< r—1 *—J 4 —i J —-4 _j j _j _i _i _i _, _» Z_7, . . .25 TABLE IV. Showing the History of the Annual Admissions since the opening of the Asylum, 21 st August, 1851, with the Discharges and Deaths, the numbers of each year remaining on the 81 st December of the year reported on. 1 ADMITTED. Of each year’s Admissions Discharged and Died in 1885. Total Discharged and Died of each year’s Admissions. Bemaining of each year’s A dmis sion s 31st Decem- ber, 1885. Years. New Cases. Belapsed i Cases 'o3 Beco- vered. Believed. Not Improved. Died. Becovered. Believed. Not | Improved. I j Died. M. F. M. F. 1 * M F. Tot. M F. Tot. M F. Tot. M F. Tot. M. F. Tot. M. F. Tot. M. F. Tot. M. F. Tot. M. F. Tot. 1851-2 113 93 3 5 1 212 0 1 1 23 38 61 11 10 21 21 7 28 58 37 95 4 3 7 1853 69 54 5 3 I 131 31 28 59 8 8 16 13 4 17 20 16 36 1 1 2 1854 | 74 72 2 3 151 36 36 72 5 12 17 6 3 9 28 18 46 0 1 1 1 1855 60 70 1 2 133 16 22 38 9 7 16 5 6 11 17 26 43 0 2 2 I 1856 51 60 1 7 | lid 16 28 44 3 17 20 9 12 21 33 19 52 2 0 2 1 1857 41 31 5 2 79 23 18 41 3 1 4 0 2 2 16 10 26 1 1 2 1858 32 44 4 i ! 81 17 20 37 I 3 7 10 2 3 5 14 13 27 0 2 2 I 1859 40 38 4 6 i 88 21 21 42 2 4 6 1 6 7 21 11 32 0 1 1 1 1860 51 29 7 3 90 1 0 1 29 13 42 5 4 9 2 0 2 22 12 34 0 1 1 I 1861 63 44 6 10 123 36 19 55 4 10 14 3 2 5 25 30 55 2 3 5 1862 49 55 5 2 ml 23 24 47 8 5 10 3 2 5 18 18 36 1 4 5 ! ' 1863 53 46 9 7 1161 20 25 45 5 6 11 2 2 4 30 18 48 2 0 2 1864 39 38 9 4 90* 13 19 32 1 5 6 4 1 5 26 15 41 4 0 4 1865 34 33 8 9 84 0 1 1 12 23 35 2 2 4 2 0 2 21 12 33 3 3 6 1866 30 33 6 4 73 0 1 1 17 18 35 0 3 3 1 2 3 j 17 12 29 1 4 5 1867 48 38 7 4 97 0 1 1 21 17 38 1 5 6 1 0 1 I 24 > 17 41 4 2 6 1868 60 36 0 3 99 18 16 34 3 2 5 3 1 4 1 ! 31 11 42 4 5 9 1869 63 60 6 5 134 1 0 1 0 1 1 19 27 46 11 14 25 16 6 22 ! ! 20 12 32 1 5 6 1870 46 52 10 2 110* 26 28 54 4 2 6 2 2 4 16 15 31 5 2 7 1871 54 57 5 11 127 1 1 2 26 33 59 5 4 9 6 8 14 16 12 28 3 4 7 1872 | 51 39 6 9 109 1 1 2 17 20 37 2 0 2 5 6 11 23 11 34 2 7 9 1873 48 40 8 13 109 19 24 43 1 1 2 5 3 8 15 13 28 1 7 8 1874 57 83 12 9 171 1 3 4 21 23 44 3 2 5 2 , 3 5 17 16 33 1 14 15 1875 | 55 65 8 10 138 0 1 1 15 26 41 3 2 5 6 4 10 16 16 32 2 1 3 1876 74 71 18 17 180 0 1 1 32 44 76 4 9 13 14 16 30 37 17 54 5 2 7 1877 92 93 14 6 175 2 0 2 40 30 70 10 2 12 38 1 28 66 40 28 68 6 4 10 1878 1 89 62 17 7 175 1 1 2 42 33 75 7 5 12 9 1 8 17 31 16 47 15 6 21 1879 77 75 21 7 180 1 1 2 41 35 76 9 9 18 14 n 25 33 19 52 9 10 19 1880 65 67 12 14 158 1 1 2 0 0 0 3 1 4 22 33 55 7 7 14 10 14 24 24 19 43 14 8 22 1881 62 70 7 12 151 0 0 0 1 0 1 5 1 6 18 33 51 8 10 18 5 1 8 13 43 31 74 17 14 31 1882 48 44 15 11 118 1 1 2 0 0 0 0 1 1 30 50 80 5 4 9 22 8 30 34 21 55 20 11 31 1883 55 57 7 12 131 0 3 3 0 2 2 5 1 6 19 26 45 3 5 8 3 2 5 21 13 34 16 24 40 1884 70 43 9 11 133 11 9 20 1 0 1 8 4 12 27 19 46 6 1 7 1 ' 1 2 19 9 28 26 •24 50 1885 53 44 8 7 112 3 15 18 3 0 3 |4 2 6 10 1 11 3 15 18 3 0 3 4 1 2 i 6 i° 1 11 41 33 74 Total 1976 1805 265 237 4283 16 29 45 6 2 8 1 4 2 1 6 [39 23 62 ho5 902 1707 164 183 347 ■201 ' 1621363 J858 686 1444 213 209 U22 Summary of Total Admissions. Male. Female, i ! Both Sexes. L Per-centage of Cases Becovered 35*92 44*17 39*85 ,, Believed 7*31 8*96 8*10 „ Not Improved .......... 8*96 7*93 8*47 ,, Died 38*28 28*69 33*71 ,, Bemaining ..... 9*53 10*25 9*87 j 100*00 100-00 100*00TABLE Y.—Showing the causes of Death during the Year 1885, together with the ages at Death. 26 P it. oo io co m CM l—1 iC » rH-. rH rH rH 1 © 1 ?l . 1 P CC 00 ^ CO rH CM ico —i C—CM __ " © © IS 1 •gs P i ° ~ 05 fa i ° iO - 00 ~ i ° *d f-4 P i ° eJ'd ^ 00 fa i ° O M 00 ° a i ® -d U P -< -H rH iw c3 y o fa rH r—< O I CM a O © fa | M © ^ P rH I CM oa 'TT- lO fa © 1 ^ a © rH 1 rH 'd n p - 00 rH | ICO ^ o fa - © l T""* © s a ~~ ' - M 1 ^ -d ^ H rH r-l CM 1 50 fa o o © rH © 1 ^ o 3 CD r3 a © CM | ICO •d p r-l i-l CM 1 ICO fa ©o' © 1 7-1 S3 S t-’ © _ ^ 1 ^ d * 1 p CM fa —I CM r-l 1 00 03 d | 1 fa r-i O fa rH O rH 1 ^ lO ^ j la fa fa © r-l r-l © 1 Tt’ « * p r~t • p CM t-c TH 1 00 as d 5 >5 »2 o B fa © © -* CM I CO 1 a CM r-1 © CM I ICO X lD03lOO^(MlOC003HK3H rHOC3K)K)'d-vOLOK)K)hOCNIrH OHOOiCOODWvOOlXIiOMOO H H W W CM CQ H (M H H rHOQ5l>a5'3-a>CC!CNetCNIHO OOK)iOUDCO0O)^^CMHOOHO OOvOK)hWK)OCOl>iOH^O]00 LCOLOOIOOLOOIOQIOOIOOLO ■ rsr% rv-I KA NTS r-f- C-h i O i o vO h- Is* CO CO lOO^OlOOiOOLOO^OiOOjOO ^ . i o-i orI no no c-4- c—8 i o i N Is* COShowing the Condition as to Marriage in the'Patients Admitted, Discharged, Recovered and Died during the Year 1885, 80TABLE X. Showing the Probable Causes of Insanity in the Patients Admitted during the Year 1885. 81 "o CO 00 3 P ■a.2oM 2£ §.a Total. 0 O OOOO OOOOOOOOOOCOOOOO 10 m 5 P CO hhcoh(m^oooo DD « O •r*< OS CD H cn 55 h -3 a CO CO H W 13 p A 03-P" O UDUDHOOHO OCM^OOH K3 O 03 CO 03 iH rH O O fOHLQO WfOOOOHO O O rH O O O O O OlOO rH OOO i_H HHQO 03 03 H O O O O ONKJOOH K> O 03 K) 03 O rH O O i^ A 00030 03 03 O O H O 03 l> O O O 03 O O O O O rH O OOO OOrHO 00^1-00000 KDOOOOO O O OOO O OOO P HLOlOOWH 03 O O vO K) 03 HOH A OOOO HLOOO^OH OMOOWH rH O OWH O OOO rH 03 Pf [> l> 03000000 H CO 03 O O O rH O O JO 03 03 rH O rH ® m '—j ^ ^ Ph v ^ ^ :P 13 P3 £ .23 . . : | o : : H 8 CD : p .3 : : . CJ • - f-4 -+=> Qj ■ P P £7- o Ph cd , .P O Ph P 02 | P ' t—I K P P O z. P b PhJH O P H !PJ ' 9 © P • P w. > y* <1 Ph p s °P ® P © -« «4H I I §'3 ffl © , Ph m m ~ cd a g o §p Ph g , ® 5- O rH ^ L_J O *02 P r rj CO J r P m p P 3 ~ P 73 M *13 88 TABLE XII. Showing the Station or Occupation of Patients admitted during the year 1885. MALES. FEMALES. Accountant ... 1 Charwoman ... ... 1 Coal Miners ... 7 Cotton Factory Hands ... 2 Cotton-workers ... 2 Cook ... ... 1 Farmers ... 3 Lace Factory Hands ... 3 Gardeners ... 2 Nursemaid ... 1 Groom ... 1 Housekeeper ... 1 Ironworkers. ... 6 Milliner ... 1 J oiner ... 1 Seamstress ... 1 Labourers, Brewery ... I Stocking Seamer ... ... 1 ,, Colliery ... 2 Unknown ... ... 4 ,, General ... 9 Daughter of General Labourer ... 2 „ Farm ... 6 5 1 Surveyor ... 1 Lacemakers... ... 2 ’’ Tobacco mill hand ... 1 Pensioner ... 1 Farmer ... 1 Policeman ... 1 Wife of Carter ... 1 Potter ... 1 55 Calico printer ... 1 Quarryman ... ... 2 Clerk ... 1 Railway Fireman ... ... 1 5 5 Commercial Traveller ... 1 Shoemakers ... ... 2 5 5 Coalminer ... 6 Silk worker ... 1 5 5 French polisher ... .. 1 Tailor ... 1 ) ) Groom ... 1 Unknown ... 3 5 5 Bath chairman ... ... 1 Son of Drover ... 1 55 Ironworker ... 3 ,, Farmer ... 1 5 5 Labourer, general ... 3 ,, Lace worker ... ... 1 55 ,, railway ... 2 Nailmaker .. 1 55 Painter ... ... ... 1 5 5 Pensioner ... 1 Shoemaker ... 1 55 Silversmith ... 1 5 5 Tobacco mill hand ... 1 Widow of Cashier ... 1 n Bookbinder ... 1 11 Master Mariner .. ... 1 Total ... ... ... 59 Total ... ... 51 J. MURRAY LINDSAY, M.D.3 O Q O < z UJ a cc < o a z < QC < LL ft GO 00 I £ N £ o o o © O O 'A P CO p O W P tn EH O EH CO p M g PH P CO n-('tOOOO,x)-HHHOON)OivOOOC50CDOLOO^M^OOO^OCDO^ "3 r_l i-H r-( rH rn timrHO>«>tOO>Cft^NrH!>-^CqOOl£>!2!£5;OrH3C-2CqN^t-tDOOt00>00S*-I3£S£i3rt3’H!Ht0SS*~0*JHS0S;*} in T-i rtHHHH HHH HHH HH rH rH r-H HHHrtrtHH r-l r-lrl i—in r—i fJCOLOHHl>fOlO^'t(MN2HU:CD'!tNOHOCi50^0^0'd‘(00)Or H fO CS1 r rH iH SN^OJ'd-OlMHNXM'd'OOOOoOHOHOOhOiC rH rH w ^ c8 ^9 c3 • -43 c3 r o ~ ^ * U od c6 \ tO ft 03 -rd P P %-eS3 "g&S OJ "03 r-l Co . § co^rf ft _tsf r-T ;£ 2 S? d 3 8 $g © 8>1 ^£>^ppp >3 ~ ~ PQ ~ ~ : *rS^T*S £^I=S^ ■s°c”s j ®0 co 25 S §"§ oT.3 4§ P> ^ -■« -2 d CO O & j> a ® s 0 2 ^-^lS QqiPPM ,dp, *id c8 8ft CO ■5 " 03 rid £ a 03 g T^J % H H pp ft I >3 o '& . a •s . ft O CO J“aJ S W hW B-e S o ° c8 O P 0 £ ft 7-s d g 5 ft ia-5 08 ©,M ,2 0rd 3*0 3 > “ ft . oo o • ®9 © >, ^ppp o '?!£■ LfDn^v ^d- Ty,^ rEB 1 8 1937 ^rnmvcFmwruINCOME AND EXPENDITURE FROM THE 1st OF JANUARY TO THE 31st OF DECEMBER, 1885. EXPENDITURE FROM WEEKLY RATE . QUARTERS ENDING FOR THE 1 31st March I 30th June 30th Sept. 31st Dec. Total. | £ s. d. £ s. d. S. d. £ s. d. £ s. c h 324 10 0 308 8 8 298 7 5 320 8 5 1251 14 6 59 10 0 37 16 0 58 15 3 46 12 0 202 13 3 21 15 2 28 5 8 30 10 3 40 19 0 121 10 1 174 14 1 176 13 6 170 13 0 | 182 9 6 704 10 1 14 15 5 11 13 3 9 11 0 19 14 0 55 13 8 91 11 0 86 4 6 85 5 8 79 18 6 342 19 8 27 2 4 24 3 10 38 17 8 34 1 1 124 4 11 19 16 11 18 3 3 14 2 2 31 1 3 83 3 7 21 19 10 21 9 0 23 5 2 23 1 8 89 15 8 160 11 8 153 6 8 168 17 4 162 2 10 644 18 6 7 1 6 8 19 0 8 7 0 8 4 4 32 11 10 4 12 6 32 18 0 43 8 3 25 6 7 106 5 4 42 6 9 41 17 6 39 14 1 37 18 10 161 17 2 243 10 4 176 10 4 75 18 8 206 6 5 702 5 9 121 5 6 71 18 6 76 6 0 138 16 2 408 6 2 25 14 0 25 14 0 27 8 0 21 18 0 100 14 0 1 14 0 3 6 3 2 17 3 4 6 10 6 4 11 7 9 10 13 4 6 14 1 15 14 7 44 9 9 91 19 1 76 6 10 98 1 9 80 6 6 346 14 2 82 5 7 54 15 4 42 9 5 30 4 5 209 14 9 17 1 9 3 10 0 7 9 9 12 5 6 40 7 0 23 6 11 35 12 10 32 7 11 24 10 4 115 18 0 3 4 4 1 17 5 2 13 10 3 1 7 10 17 2 7 1 0 7 1 0 14 2 0 8 14 6 11 1 6 6 6 6 3 15 6 29 18 0 6 10 0 6 10 0 13 0 0 3 0 0 16 3 6 19 3 6 34 13 11 44 13 7 25 15 8 34 13 2 139 16 4 286 17 3 228 15 0 250 12 4 228 15 0 994 19 7 458 1 7 456 14 7 460 18 8 455 12 2 1831 7 0 t 285 6 5 228 17 9 238 1 4 350 6 4 1102 11 10 . 20 1 11 20 10 7 17 2 1 15 2 3 72 16 10 4 4 0 4 4 0 22 8 6 6 10 0 24 7 0 30 6 0 83 11 6 18 0 0 70 7 6 88 7 6 33 9 0 41 2 0 45 4 0 120 5 0 25 5 0 25 5 0 120 8 4 115 12 9 69 7 11 136 11 9 442 0 9 20 0 0 20 0 0 59 15 0 58 5 3 118 0 3 ; 9 1 5 3 0 0 13 13 3 25 14 8 4 12 6 12 10 8 13 3 20 3 10 38 10 3 6 7 6 2 9 6 8 17 0 4 10 7 7 2 7 4 0 1 4 7 9 20 1 0 5 12 11 28 19 10 15 16 11 27 1 8 77 11 4 2 11 7 13 13 1 8 14 10 8 11 4 33 10 10 ! 29 8 8 9 16 6 39 5 2 56 10 3 61 13 10 60 4 0 49 11 8 227 19 9 10 0 0 10 0 0 10 0 0 10 0 0 40 0 0 £ From Unions and Parishes Contributing Ashbourne ........... Asliby-de-la-Zouch .. Basford ............. Belper............... Burton-on-Trent Bake well ........... Chesterfield ........ Chapel-en-le-Frith--- Ecclesall BJerlow---- Glossop ............. Hayfield............. Mansfield ........... Shardiow ............ Tamworth ............ Uttoxeter ........... Worksop.......... • • • • From County Treasurer for Unsettled Cases. From Unions and Parishes not Contributing. Leeds From Prison Com- missioners .......... From Private Patients For Funerals , INCOME FJtiOM WEEKLY KATE FOK THE QUARTERS ENDING £. 135 54 176 521 190 325 698 152 64 98 53 93 242 13 20 20 8 11 7 0 16 9 7 5 12 11 9 2 4 6 0 8 9 6 8 8 4 3 13 9 6 3 6 0 12 4 0 233 6 21 19 13 3 6 30il i June 30th Sept. £. s. d. £. s. d. 124 11 9 114 8 8 ! 55 9 8 53 6 0 ! 161 13 11 131 18 7 i 485 4 3 491 12 0 j 188 5 3 172 5 4 1 301 4 0 301 3 10 i 704 16 0 701 16 8 | 155 19 7 159 13 7 ! 52 16 11 50 8 10 ! Ill 11 1 116 6 8 1 52 14 0 53 6 0 i 84 9 4 71 16 5 18 0 0 247 6 10 6 13 3 19 19 9 25 18 4 13 6 6 10 16 0 31st Dec. £. s. 126 19 43 8 128 13 524 5 184 6 301 12 11 682 12 0 157 6 57 18 107 2 53 18 71 3 239 14 10 6 14 9 20 4 3 26 19 0 13 9 6 14 6 0 11 1 0 Total. £. s. 501 9 206 15 599 3 2022 15 735 15 1229 9 2787 11 625 16 225 11 433 13 213 7 320 13 10 962 5 5 33 9 3 81 12 10 92 16 10 <]. 9 4 1 8 5 8 8 0 8 5 2 53 9 0 3 6 0 35 6 0 11 1 0 32 10 0 Total. £. s. d. 11072 7 0 53 9 0 Provisions. Meat ................ , Australian...... Fish. Poultry........ Flour ............... Oatmeal,Bice,& Barley Tea and Coffee....... Sugar and Treacle.. Other Groceries...... Tobacco and Snuff____ Butter, Cheese, Bacon, and Eggs ______ Ale, Ginger Wine, and Beer ......... Potatoes, Carrots, and Onions ....... Money Paid to Atten- dants, Nurses and Servants in li Beer ............ House d‘ other Expenses Coals ............ Gas ................ Soap ............... Starch and Soda.... Candles and Cleaning Articles ........... 3 6 0 55 6 0 11 1 0 32 10 0 £ 11,227 19 0 HEADS OF EXPENDITURE. Repairs ...... Ironmongery, Cutlery, and Earthenware .. Brooms and Brushes.. Periodicals, Printing, Carriage of Goods Omnibus Hire .. Funeral Expenses Sweeping Flues. Insurance ...... Miscellaneous . Salaries and Wages. Officers ............. Servants ............. Clothing (inclu din Wages of Tailor an Shoemaker)........... Extras for Sick. Drugs & Instruments. Medical Fee ........ Wines and Spirits ... Farm and Garden. Cows ............... Sheep.............. Pigs .............. Provender ......... Hay................ Straw.............. Seeds, Seed Potatoes and Plants......... Veterinary Surgeon.. Carriage of Goods .. Implements, Repairs | and Shedding ... Asphalte & Shoeing-' Harvesting, Thrashing and Miscellaneous.. Wages........ Farm Manager . Total. £ s. d. 3760 1 1 161 17 2 2205 12 11 2826 6 7 1102 11 10 160 12 4 1325 8 6 11,542 10 5 JOHN LANGLEY, Clerk & Steward. (Signed) ( HENRY FLOWER EVERY, l N. O. OURZON,PATIENTS’ ORDINARY DIET. 86 CQ 0 •RaX 1 ft 1 ^ - rH rn r3 a •jawng § j Hoi HO He H« He» He. HO. w 0 Pq - •pRaig; N * 0 JO JO JO JO O JO JO P4 t) 03 "89X & t-H rH rH rH rH rH rH QD 0 'oS •jajjng N 0 Him HM HW H®» HoJ Ho? Ho* •pRajg N 0 CO CO CO CO CO CO CO ♦sajqR^aSa^ N O Cv? H o? 0? rH C4 rH aotiRS jaams qjiAi ‘Snippnx J9ns N O •••••• r}< **•*♦• rH •dnog ft ♦ 4-+ ..... 0 "eg s •Ma^g Ph fS •aiX aojRjox pnR yean* N O • • • . . . ^ • • • • • • pH •(auoqmojjaajj) ^0M ps^ooonfj N O O co CO CO « •pRa.ig N O JO * JO JO JO JO JO 10 g s j •sajqR^aSa^ N O c\? pH' 0? O? 0? : aoiiRS jaaA\.s qjm ‘Snxppnx jang N O . • . . . . -a^H • • • • • • iH •dnog ft . 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Clerk & Steward. oignea, | ^ CURZON.89 AYERAGE WEEKLY COST OF MAINTENANCE, MEDICINE* CLOTHING, AND CAEE OF PATIENTS DURING THE YEAR ENDING THE 81st DECEMBER, 1885. Provisions .............................. 0 8 9 Clothing (including wages of Tailors and Shoemaker) 0 0 9f Salaries and Wages ...................... 0 2 7f Necessaries, Fuel, Light, Washing ...... 0 1 1 Surgery and Dispensary ,.............. 0 0 Of Wines and Spirits ....................... 0 0 Of Furniture and Bedding ................... 0 0 5f Garden and Farm ........................ 0 1 If Miscellaneous, viz.:—Periodicals, Print- ing, Stamps, Stationery, Car- riage of Goods, Insurance, Picnics, Entertainments ......... 0 0 8f 0 10 2J Less Receipts ............................ 0 0 3f 0 9 Ilf Average Daily Number of Patients, 415.