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 Radar Systems
Analysis and Design
Using
MATLAB
Bassem R. Mahafza, Ph.D.
COLSA Corporation
Huntsville, Alabama

CHAPMAN & HALL/CRC

Boca Raton London New York Washington, D.C.
 Library of Congress Cataloging-in-Publication Data

Ma ha fza ,Ba s s e mR.

Ra da r s ys te ms& a na lys is a nd de s ign us ingMa tla b
p. cm.
Include s bibliogra phica l re fe re nce s a nd inde x.
IS BN 1-58488-182-8(a lk. pa pe r)
1. Ra da r. 2. S ys te m a na lys is —Da ta proce s s ingMATLAB.
3 I. Title .

TK6575 .M27 2000

521.38484—dc21 00-026914
CIP

This book conta ins informa tion obta ine d from a uthe ntic a nd highly re ga rde d s ource s . Re printe d ma te ria l
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 Preface

Numerous books have been written on Radar Systems and Radar Applica-
tions. A limited set of these books provides companion software. There is
need for a comprehensive reference book that can provide the reader with
hands-on-like experience. The ideal radar book, in my opinion, should serve as
a conclusive, detailed, and useful reference for working engineers as well as a
textbook for students learning radar systems analysis and design. This book
must assume few prerequisites and must stand on its own as a complete presen-
tation of the subject. Examples and exercise problems must be included. User
friendly software that demonstrates the theory needs to be included. This soft-
ware should be reconfigurable to allow different users to vary the inputs in
order to better analyze their relevant and unique requirements, and enhance
understanding of the subject.
Radar Systems Analysis and Design Using MATLAB® concentrates on radar
fundamentals, principles, and rigorous mathematical derivations. It also pro-
vides the user with a comprehensive set of MATLAB1 5.0 software that can be
used for radar analysis and/or radar system design. All programs will accept
user inputs or execute using the default set of parameters. This book will serve
as a valuable reference to students and radar engineers in analyzing and under-
standing the many issues associated with radar systems analysis and design. It
is written at the graduate level. Each chapter provides all the necessary mathe-
matical and analytical coverage required for good understanding of radar the-
ory. Additionally, dedicated MATLAB functions/programs have been
developed for each chapter to further enhance the understanding of the theory,
and provide a source for establishing radar system design requirements. This
book includes over 1190 equations and over 230 illustrations and plots. There
are over 200 examples and end-of-chapter problems. A solutions manual will
be made available to professors using the book as a text. The philosophy
behind Radar Systems Analysis and Design Using MATLAB is that radar sys-
tems should not be complicated to understand nor difficult to analyze and
design.
All MATLAB programs and functions provided in this book can be down-
loaded from the CRC Press Web site (www.crcpress.com). For this purpose,
create the following directory in your C-drive: C:\RSA. Copy all programs into
this directory. The path tree should be as in Fig. F.1 in Appendix F. Users can
execute a certain function/program GUI by typing: file_name_driver, where

1. All MATLAB functions and programs provided in this book were developed using
MATLAB 5.0 - R11 with the Signal Processing Toolbox, on a PC with Windows 98
operating system.

© 2000 by Chapman & Hall/CRC

file names are as indicated in Appendix F. The MATLAB functions and pro-
grams developed in this book include all forms of the radar equation: pulse
compression, stretch processing, matched filter, probability of detection calcu-
lations with all Swerling models, High Range Resolution (HRR), stepped fre-
quency waveform analysis, ghk tracking filter, Kalman filter, phased array
antennas, and many more.
The first part of Chapter 1 describes the most common terms used in radar
systems, such as range, range resolution, Doppler frequency, and coherency.
The second part of this chapter develops the radar range equation in many of
its forms. This presentation includes the low PRF, high PRF, search, bistatic
radar, and radar equation with jamming. Radar losses are briefly addressed in
this chapter. Chapter 2 discusses the Radar Cross Section (RCS). RCS depen-
dency on aspect angle, frequency, and polarization are discussed. Target scat-
tering matrix is developed. RCS formulas for many simple objects are
presented. Complex object RCS is discussed, and target fluctuation models are
introduced. Continuous wave radars and pulsed radars are discussed in Chapter
3. The CW radar equation is derived in this chapter. Resolving range and Dop-
pler ambiguities is also discussed in detail.
Chapter 4 is intended to provide an overview of the radar probability of
detection calculations and related topics. Detection of fluctuating targets
including Swerling I, II, III, and IV models is presented and analyzed. Coher-
ent and non-coherent integrations are also introduced. Cumulative probability
of detecting analysis is in this chapter. Chapter 5 reviews radar waveforms,
including CW, pulsed, and LFM. High Range Resolution (HRR) waveforms
and stepped frequency waveforms are also analyzed.
The concept of the matched filter, and the radar ambiguity function consti-
tute the topics of Chapter 6. Detailed derivations of many major results are pre-
sented in this chapter, including the coherent pulse train ambiguity function.
Pulse compression is in Chapter 7. Analog and digital pulse compressions are
also discussed in detail. This includes fast convolution and stretch processors.
Binary phase codes and frequency codes are discussed.
Chapter 8 presents the phenomenology of radar wave propagation. Topics
like multipath, refraction, diffraction, divergence, and atmospheric attenuation
are included. Chapter 9 contains the concepts of clutter and Moving Target
Indicator (MTI). Surface and volume clutter are defined and the relevant radar
equations are derived. Delay line cancelers implementation to mitigate the
effects of clutter is analyzed.
Chapter 10 has a brief discussion of radar antennas. The discussion includes
linear and planar phased arrays. Conventional beamforming is in this chapter.
Chapter 11 discusses target tracking radar systems. The first part of this chapter
covers the subject of single target tracking. Topics such as sequential lobing,
conical scan, monopulse, and range tracking are discussed in detail. The

© 2000 by Chapman & Hall/CRC

second part of this chapter introduces multiple target tracking techniques.
Fixed gain tracking filters such as the αβ and the αβγ filters are presented in
detail. The concept of the Kalman filter is introduced. Special cases of the Kal-
man filter are analyzed in depth.
Synthetic Aperture Radar (SAR) is the subject of Chapter 12. The topics of
this chapter include: SAR signal processing, SAR design considerations, and
the SAR radar equation. Arrays operated in sequential mode are discussed in
this chapter. Chapter 13 presents an overview of signal processing. Finally, six
appendices present discussion on the following: noise figure, decibel arith-
metic, tables of the Fourier transform and Z-transform pairs, common proba-
bility density functions, and the MATLAB program and function name list.
MATLAB is a registered trademark
of The MathWorks, Inc.
For product information, please contact:
The MathWorks, Inc.
3 Apple Hill Drive
Natick, MA 01760-2098 USA
Tel: 508-647-7000
Fax: 508-647-7001
E-mail: [email protected]
Web: www.mathworks.com

Bassem R. Mahafza
Huntsville, Alabama
January, 2000

© 2000 by Chapman & Hall/CRC

 Acknowledgment

I would like to acknowledge the following for help, encouragement, and

support during the preparation of this book. First, I thank God for giving me
the endurance and perseverance to complete this work. I could not have com-
pleted this work without the continuous support of my wife and four sons. The
support and encouragement of all my family members and friends are appreci-
ated. Special thanks to Dr. Andrew Ventre, Dr. Michael Dorsett, Mr. Edward
Shamsi, and Mr. Skip Tornquist for reviewing and correcting different parts of
the manuscript. Finally, I would like to thank Mr. Frank J. Collazo, the man-
agement, and the family of professionals at COLSA Corporation for their
support.

© 2000 by Chapman & Hall/CRC

 To my sons:
Zachary,
Joseph,
Jacob, and
Jordan
To:

My Wife,
My Mother,
and the memory of my Father

© 2000 by Chapman & Hall/CRC

 Table of Contents

Preface
Acknowledgment

Chapter 1
Radar Fundamentals
1.1. Radar Classifications
1.2. Range
MATLAB Function “pulse_train.m”
1.3. Range Resolution
MATLAB Function “range_resolution.m”
1.4. Doppler Frequency
MATLAB Function “doppler_freq.m”
1.5. Coherence
1.6. The Radar Equation
MATLAB Function “radar_eq.m”
1.6.1. Low PRF Radar Equation
MATLAB Function “lprf_req.m”
1.6.2. High PRF Radar Equation
MATLAB Function “hprf_req.m”
1.6.3. Surveillance Radar Equation
MATLAB Function “power_aperture_eq.m”
1.6.4. Radar Equation with Jamming
Self-Screening Jammers (SSJ)
MATLAB Program “ssj_req.m”
Stand-Off Jammers (SOJ)
MATLAB Program “soj_req.m”
Range Reduction Factor
MATLAB Function “range_red_fac.m”

© 2000 by Chapman & Hall/CRC

 1.6.5. Bistatic Radar Equation
1.7. Radar Losses
1.7.1. Transmit and Receive Losses
1.7.2. Antenna Pattern Loss and Scan Loss
1.7.3. Atmospheric Loss
1.7.4. Collapsing Loss
1.7.5. Processing Losses
1.7.6. Other Losses
1.8. MATLAB Program and Function Listings
Problems

Chapter 2
Radar Cross Section (RCS)
2.1. RCS Definition
2.2. RCS Prediction Methods
2.3. RCS Dependency on Aspect Angle and Frequency
MATLAB Function “rcs_aspect.m”
MATLAB Function “rcs-frequency.m”
2.4. RCS Dependency on Polarization
2.4.1. Polarization
2.4.2. Target Scattering Matrix
2.5. RCS of Simple Objects
2.5.1. Sphere
2.5.2. Ellipsoid
MATLAB Function “rcs_ellipsoid.m”
2.5.3. Circular Flat Plate
MATLAB Function “rcs_circ_plate.m”
2.5.4. Truncated Cone (Frustum)
MATLAB Function “rcs_frustum.m”
2.5.5. Cylinder
MATLAB Function “rcs_cylinder.m”
2.5.6. Rectangular Flat Plate
MATLAB Function “rcs_rect_plate.m”
2.5.7. Triangular Flat Plate
MATLAB Function “rcs_isosceles.m”
2.6. RCS of Complex Objects
2.7. RCS Fluctuations and Statistical Models
2.7.1. RCS Statistical Models - Scintillation Models
Chi-Square of Degree 2m
Swerling I and II (Chi-Square of Degree 2)
Swerling III and IV (Chi-Square of Degree 4)
2.8. MATLAB Program/Function Listings
Problems

© 2000 by Chapman & Hall/CRC

Chapter 3
Continuous Wave and Pulsed Radars
3.1. Functional Block Diagram
3.2. CW Radar Equation
3.3. Frequency Modulation
3.4. Linear FM (LFM) CW Radar
3.5. Multiple Frequency CW Radar
3.6. Pulsed Radar
3.7. Range and Doppler Ambiguities
3.8. Resolving Range Ambiguity
3.9. Resolving Doppler Ambiguity
3.10. MATLAB Program “range_calc.m”
Problems

Chapter 4
Radar Detection
4.1. Detection in the Presence of Noise
MATLAB Function “que_func.m”
4.2. Probability of False Alarm
4.3. Probability of Detection
MATLAB Function “marcumsq.m”
4.4. Pulse Integration
4.4.1. Coherent Integration
4.4.2. Non-Coherent Integration
MATLAB Function “improv_fac.m”
4.5. Detection of Fluctuating Targets
4.5.1. Detection Probability Density Function
4.5.2. Threshold Selection
MATLAB Function “incomplete_gamma.m”
MATLAB Function “threshold.m”
4.6. Probability of Detection Calculation
4.6.1. Detection of Swerling V Targets
MATLAB Function “pd_swerling5.m”
4.6.2. Detection of Swerling I Targets
MATLAB Function “pd_swerling1.m”
4.6.3. Detection of Swerling II Targets
MATLAB Function “pd_swerling2.m”
4.6.4. Detection of Swerling III Targets
MATLAB Function “pd_swerling3.m”
4.6.5. Detection of Swerling IV Targets
MATLAB Function “pd_swerling4.m”
4.7. Cumulative Probability of Detection

© 2000 by Chapman & Hall/CRC

 4.8. Solving the Radar Equation
4.9. Constant False Alarm Rate (CFAR)
4.9.1. Cell-Averaging CFAR (Single Pulse)
4.9.2. Cell-Averaging CFAR with
Non-Coherent Integration
4.10. MATLAB Function and Program Listings
Problems

Chapter 5
Radar Waveforms Analysis
5.1. Low Pass, Band Pass Signals and Quadrature
Components
5.2. CW and Pulsed Waveforms
5.3. Linear Frequency Modulation Waveforms
5.4. High Range Resolution
5.5. Stepped Frequency Waveforms
5.5.1. Range Resolution and Range Ambiguity
in SWF
MATLAB Function “hrr_profile.m”
5.5.2. Effect of Target Velocity
5.6. MATLAB Listings
Problems

Chapter 6
Matched Filter and the Radar Ambiguity
Function
6.1. The Matched Filter SNR
6.2. The Replica
6.3. Matched Filter Response to LFM Waveforms
6.4. The Radar Ambiguity Function
6.5. Examples of the Ambiguity Function
6.5.1. Single Pulse Ambiguity Function
MATLAB Function “single_pulse_ambg.m”
6.5.2. LFM Ambiguity Function
MATLAB Function “lfm_ambg.m”
6.5.3. Coherent Pulse Train Ambiguity Function
MATLAB Function “train_ambg.m”
6.6. Ambiguity Diagram Contours
6.7. MATLAB Listings
Problems

© 2000 by Chapman & Hall/CRC

Chapter 7
Pulse Compression
7.1. Time-Bandwidth Product
7.2. Radar Equation with Pulse Compression
7.3. Analog Pulse Compression
7.3.1. Correlation Processor
MATLAB Function “matched_filter.m”
7.3.2. Stretch Processor
MATLAB Function “stretch.m”
7.3.3. Distortion Due to Target Velocity
7.3.4. Range Doppler Coupling
7.4. Digital Pulse Compression
7.4.1. Frequency Coding (Costas Codes)
7.4.2. Binary Phase Codes
7.4.3. Frank Codes
7.4.4. Pseudo-Random (PRN) Codes
7.5. MATLAB Listings
Problems

Chapter 8
Radar Wave Propagation
8.1. Earth Atmosphere
8.2. Refraction
8.3. Ground Reflection
8.3.1. Smooth Surface Reflection Coefficient
MATLAB Function “ref_coef.m”
8.3.2. Divergence
8.3.3. Rough Surface Reflection
8.4. The Pattern Propagation Factor
8.4.1. Flat Earth
8.4.2. Spherical Earth
8.5. Diffraction
8.6. Atmospheric Attenuation
8.7. MATLAB Program “ref_coef.m”
Problems

Chapter 9
Clutter and Moving Target Indicator (MTI)
9.1. Clutter Definition
9.2. Surface Clutter
9.2.1. Radar Equation for Area Clutter

© 2000 by Chapman & Hall/CRC

 9.3. Volume Clutter
9.3.1. Radar Equation for Volume Clutter
9.4. Clutter Statistical Models
9.5. Clutter Spectrum
9.6. Moving Target Indicator (MTI)
9.7. Single Delay Line Canceler
MATLAB Function “single_canceler.m”
9.8. Double Delay Line Canceler
MATLAB Function “double_canceler.m”
9.9. Delay Lines with Feedback (Recursive Filters)
9.10. PRF Staggering
9.11. MTI Improvement Factor
9.12. Subclutter Visibility (SCV)
9.13. Delay Line Cancelers with Optimal Weights
9.14. MATLAB Program/Function Listings
Problems

Chapter 10
Radar Antennas
10.1. Directivity, Power Gain, and Effective Aperture
10.2. Near and Far Fields
10.3. Circular Dish Antenna Pattern
MATLAB Function “circ_aperture.m”
10.4. Array Antennas
10.4.1. Linear Array Antennas
MATLAB Function “linear_array.m”
10.5. Array Tapering
10.6. Computation of the Radiation Pattern via the
DFT
10.7. Array Pattern for Rectangular Planar Array
MATLAB Function “rect_array.m”
10.8. Conventional Beamforming
10.9. MATLAB Programs and Functions
Problems

Chapter 11
Target Tracking
Part I: Single Target Tracking
11.1. Angle Tracking
11.1.1. Sequential Lobing
11.1.2. Conical Scan
11.2. Amplitude Comparison Monopulse

© 2000 by Chapman & Hall/CRC

 MATLAB Function “mono_pulse.m”
11.3. Phase Comparison Monopulse
11.4. Range Tracking

Part II: Multiple Target Tracking

11.5. Track-While-Scan (TWS)
11.6. State Variable Representation of an LTI System
11.7. The LTI System of Interest
11.8. Fixed-Gain Tracking Filters
11.8.1. The αβ Filter
11.8.2. The αβγ Filter
MATLAB Function “ghk_tracker.m”
11.9. The Kalman Filter
11.9.1. The Singer αβγ -Kalman Filter
11.9.2. Relationship between Kalman and αβγ
Filters
MATLAB Function “kalman_filter.m”
11.10. MATLAB Programs and Functions
Problems

Chapter 12
Synthetic Aperture Radar
12.1. Introduction
12.2. Real Versus Synthetic Arrays
12.3. Side Looking SAR Geometry
12.4. SAR Design Considerations
12.5. SAR Radar Equation
12.6. SAR Signal Processing
12.7. Side Looking SAR Doppler Processing
12.8. SAR Imaging Using Doppler Processing
12.9. Range Walk
12.10. Case Study
12.11. Arrays in Sequential Mode Operation
12.11.1. Linear Arrays
12.11.2. Rectangular Arrays
12.12. MATLAB Programs
Problems

Chapter 13
Signal Processing
13.1. Signal and System Classifications

© 2000 by Chapman & Hall/CRC

 13.2. The Fourier Transform
13.3. The Fourier Series
13.4. Convolution and Correlation Integrals
13.5. Energy and Power Spectrum Densities
13.6. Random Variables
13.7. Multivariate Gaussian Distribution
13.8. Random Processes
13.9. Sampling Theorem
13.10. The Z-Transform
13.11. The Discrete Fourier Transform
13.12. Discrete Power Spectrum
13.13. Windowing Techniques
Problems
Appendix A
Noise Figure
Appendix B
Decibel Arithmetic
Appendix C
Fourier Transform Table
Appendix D
Some Common Probability Densities
Chi-Square with N degrees of freedom
Exponential
Gaussian
Laplace
Log-Normal
Rayleigh
Uniform
Weibull
Appendix E
Z - Transform Table
Appendix F
MATLAB Program and Function Name List
Bibliography

© 2000 by Chapman & Hall/CRC

Chapter 1 Radar Fundamentals

1.1. Radar Classifications

The word radar is an abbreviation for RAdio Detection And Ranging. In
general, radar systems use modulated waveforms and directive antennas to
transmit electromagnetic energy into a specific volume in space to search for
targets. Objects (targets) within a search volume will reflect portions of this
energy (radar returns or echoes) back to the radar. These echoes are then pro-
cessed by the radar receiver to extract target information such as range, veloc-
ity, angular position, and other target identifying characteristics.
Radars can be classified as ground based, airborne, spaceborne, or ship
based radar systems. They can also be classified into numerous categories
based on the specific radar characteristics, such as the frequency band, antenna
type, and waveforms utilized. Another classification is concerned with the
mission and/or the functionality of the radar. This includes: weather, acquisi-
tion and search, tracking, track-while-scan, fire control, early warning, over
the horizon, terrain following, and terrain avoidance radars. Phased array
radars utilize phased array antennas, and are often called multifunction (multi-
mode) radars. A phased array is a composite antenna formed from two or more
basic radiators. Array antennas synthesize narrow directive beams that may be
steered, mechanically or electronically. Electronic steering is achieved by con-
trolling the phase of the electric current feeding the array elements, and thus
the name phased arrays is adopted.
Radars are most often classified by the types of waveforms they use, or by
their operating frequency. Considering the waveforms first, radars can be

© 2000 by Chapman & Hall/CRC

Continuous Wave (CW) or Pulsed Radars (PR). CW radars are those that con-
tinuously emit electromagnetic energy, and use separate transmit and receive
antennas. Unmodulated CW radars can accurately measure target radial veloc-
ity (Doppler shift) and angular position. Target range information cannot be
extracted without utilizing some form of modulation. The primary use of
unmodulated CW radars is in target velocity search and track, and in missile
guidance. Pulsed radars use a train of pulsed waveforms (mainly with modula-
tion). In this category, radar systems can be classified on the basis of the Pulse
Repetition Frequency (PRF), as low PRF, medium PRF, and high PRF radars.
Low PRF radars are primarily used for ranging where target velocity (Doppler
shift) is not of interest. High PRF radars are mainly used to measure target
velocity. Continuous wave as well as pulsed radars can measure both target
range and radial velocity by utilizing different modulation schemes.
Table 1.1 has the radar classifications based on the operating frequency.

TABLE 1.1. Radar frequency bands.

Letter New band designation

designation Frequency (GHz) (GHz)
HF 0.003 - 0.03 A
VHF 0.03 - 0.3 A<0.25; B>0.25
UHF 0.3 - 1.0 B<0.5; C>0.5
L-band 1.0 - 2.0 D
S-band 2.0 - 4.0 E<3.0; F>3.0
C-band 4.0 - 8.0 G<6.0; H>6.0
X-band 8.0 - 12.5 I<10.0; J>10.0
Ku-band 12.5 - 18.0 J
K-band 18.0 - 26.5 J<20.0; K>20.0
Ka-band 26.5 - 40.0 K
MMW Normally >34.0 L<60.0; M>60.0

High Frequency (HF) radars utilize the electromagnetic waves’ reflection off
the ionosphere to detect targets beyond the horizon. Some examples include
the United States Over The Horizon Backscatter (U.S. OTH/B) radar which
operates in the frequency range of 5 – 28MHZ , the U.S. Navy Relocatable
Over The Horizon Radar (ROTHR), see Fig. 1.1, and the Russian Woodpecker
radar. Very High Frequency (VHF) and Ultra High Frequency (UHF) bands are
used for very long range Early Warning Radars (EWR). Some examples
include the Ballistic Missile Early Warning System (BMEWS) search and
track monopulse radar which operates at 245MHz (Fig. 1.2), the Perimeter
and Acquisition Radar (PAR) which is a very long range multifunction phased

© 2000 by Chapman & Hall/CRC

array radar, and the early warning PAVE PAWS multifunction UHF phased
array radar. Because of the very large wavelength and the sensitivity require-
ments for very long range measurements, large apertures are needed in such
radar systems.

Figure 1.1. U. S. Navy Over The Horizon Radar. Photograph obtained

via the Internet.

Figure 1.2. Fylingdales BMEWS - United Kingdom. Photograph

obtained via the Internet.

© 2000 by Chapman & Hall/CRC

 Radars in the L-band are primarily ground based and ship based systems that
are used in long range military and air traffic control search operations. Most
ground and ship based medium range radars operate in the S-band. For exam-
ple, the Airport Surveillance Radar (ASR) used for air traffic control, and the
ship based U.S. Navy AEGIS (Fig. 1.3) multifunction phased array are S-band
radars. The Airborne Warning And Control System (AWACS) shown in Fig.
1.4 and the National Weather Service Next Generation Doppler Weather Radar
(NEXRAD) are also S-band radars. However, most weather detection radar
systems are C-band radars. Medium range search and fire control military
radars and metric instrumentation radars are also C-band.

Figure 1.3. U. S. Navy AEGIS. Photograph obtained via the Internet.

Figure 1.4. U. S. Air Force AWACS. Photograph obtained via the Internet.

© 2000 by Chapman & Hall/CRC

 Example 1.1: A certain airborne pulsed radar has peak power P t = 10KW ,
and uses two PRFs, f r1 = 10KHz and f r2 = 30KHz . What are the required
pulse widths for each PRF so that the average transmitted power is constant
and is equal to 1500Watts ? Compute the pulse energy in each case.
Solution: Since P av is constant, then both PRFs have the same duty cycle.
More precisely,

1500
d t = -------------------3- = 0.15
10 × 10

The pulse repetition intervals are

1
T 1 = -------------------3- = 0.1ms
10 × 10
1
T 2 = -------------------3- = 0.0333ms
30 × 10

It follows that

τ 1 = 0.15 × T 1 = 15μs

τ 2 = 0.15 × T 2 = 5μs

3 –6
E p1 = P t τ 1 = 10 × 10 × 15 × 10 = 0.15Joules

3 –6
E p2 = P 2 τ 2 = 10 × 10 × 5 × 10 = 0.05Joules .

1.3. Range Resolution

Range resolution, denoted as ΔR , is a radar metric that describes its ability
to detect targets in close proximity to each other as distinct objects. Radar sys-
tems are normally designed to operate between a minimum range R min , and
maximum range R max . The distance between R min and R max is divided into
M range bins (gates), each of width ΔR ,

R max – R min
M = --------------------------- (1.6)
ΔR
Targets separated by at least ΔR will be completely resolved in range, as illus-
trated in Fig. 1.8. Targets within the same range bin can be resolved in cross
range (azimuth) utilizing signal processing techniques.

© 2000 by Chapman & Hall/CRC

Exploring the Variety of Random
Documents with Different Content
the establishment, with the circumstances affecting the patients,
with their occupations and amusements, irrespective of the medical
officer; when they suffer themselves to be appealed to, and to act as
referees in matters of internal discipline; when they assume to
themselves the hiring and discharging of attendants; and when,
without taking counsel with the medical superintendent, they
determine on alterations and additions to their asylum,—they are
most certainly pursuing a policy calculated to disturb and destroy the
government and the successful operation of the establishment. A
meddling policy is in all ways mischievous and bad; it irritates
honourable minds, and deters them in their praiseworthy and noble
endeavours to merit approval and reward; whilst it at the same time
acts as an incentive to apathy, indolence, and neglect: for freedom
and independence of action, a feeling of trust reposed, and of merit
appreciated, are necessary to the cheerful, energetic and efficient
performance of duties. So soon as the zeal of any man of ordinary
moral sensibility is doubted, so soon as his competency for his office
is so far questioned by the activity and interference of others in his
particular field of labour, so soon is a check given to his best
endeavours in the discharge of his duties, his interest in them
abates, and a blow is inflicted upon his feelings and self-respect. In
short, it cannot be disputed, that if an asylum have a duly qualified
and trustworthy superintendent, the less a committee of visitors
interferes with its internal organization and the direction of its
details, the more advantageous is it for the well-being of the
institution.
Again, many asylums have grown to such a magnitude, that their
general management is unwieldy, and their due medical and moral
care and supervision an impossibility. They have grown into lunatic
colonies of eight or nine hundred, or even of a thousand or more
inhabitants, comfortably lodged and clothed, fed by a not illiberal
commissariat, watched and waited on by well-paid attendants,
disciplined and drilled to a well-ordered routine, gratified by
entertainments, and employed where practicable, and, on the whole,
considered as paupers, very well off; but in the character of patients,
labouring under a malady very amenable to treatment, if not too
long neglected, far from receiving due consideration and care.
Although the aggregation of large numbers of diseased persons, and
of lunatics among others, is to be deprecated on various grounds,
hygienic and others, yet the objections might be felt as of less
weight, contrasted with the presumed economical and administrative
advantages accruing from the proceeding, were the medical staff
proportionately augmented, and the mental malady of the inmates
of a chronic and generally incurable character. But, in the instance of
the monster asylums referred to, neither is the medical staff at all
proportionate to the number of patients, nor are their inmates
exclusively chronic lunatics. The medical officer is charged with the
care and supervision of some three, four, or five hundred insane
people, among whom are cases of recent attack, and of bodily
disease of every degree of severity, and to whom a considerable
accession of fresh cases is annually made; and to his duties as
physician are added more or fewer details of administration, and all
those of the internal management of the institution, which bear
upon the moral treatment of its inmates, and are necessary even to
an attempt at its harmonious and successful working.
Now, little reflection is needed to beget the conviction, that a
medical man thus surcharged with duties cannot efficiently perform
them; and the greater will his insufficiency be, the larger the number
of admissions, and of recent or other cases demanding medical
treatment. He may contrive, indeed, to keep his asylum in good
order, to secure cleanliness and general quiet, to provide an ample
general dietary, and such like, but he will be unable to do all that he
ought to do for the cure and relief of the patients entrusted to him
as a physician. To treat insane people aright, they must be treated
as individuals, and not en masse; they must be individually known,
studied, and attended to both morally and medically. If recent
insanity is to be treated, each case must be closely watched in all its
psychical and physical manifestations, and its treatment be varied
according to its changing conditions. Can a medical man, surrounded
by several hundred insane patients, single-handed, fulfil his medical
duties to them effectively, even had he no other duties to perform,
and were relieved from the general direction of the asylum? Can he
exercise a vigilant and efficient superintendence over the inmates?
Can he watch and personally inform himself of their mental, moral
and bodily condition, prescribe their appropriate treatment, diagnose
disease and detect its many variations; secure the due
administration of medicines and of external appliances; order the
necessary food and regimen; feed those who would starve
themselves; attend to casualties and to sanitary arrangements;
judiciously arrange the classification, the employments and
recreations; keep the history of cases, make and record autopsies,
and watch the carrying out of his wishes by the attendants? Can, we
repeat, an asylum superintendent properly perform these, and those
many other minor duties of his office, conceivable to all those who
experimentally understand the matter, though not readily conveyed
by description? Can any person perform these duties, if they were
separable, without injury to the working of the institution, from the
many details of general management which the position of
superintendent has attached to it? Can he be justly held
accountable, if the huge and complex machine goes wrong in any
part? Can he feel sure that his patients are well looked after,
attended to according to his wishes, and kindly treated? Can he do
justice, lastly, as a physician, to any one afflicted patient, whose
restoration to health and to society depends on the efficient exercise
of his medical skill, and do this without neglecting other patients and
other duties? To these questions, surely, every thinking, reasoning
man will reply in the negative.
The consequence is, that asylum superintendents, who thus find
themselves overburdened with multifarious and onerous duties, and
feel the hopelessness of a personal and efficient discharge of all of
them, are driven to a system of routine and general discipline, as the
only one whereby the huge machine in their charge can work, and
look upon recoveries as casual successes or undesigned coincidences
(see further, p. 119).
The inadequacy of the medical staff of most asylums is a
consequence, in part, of the conduct of superintendents themselves,
and in part of the notions of economy, and of the little value in
which medical aid is held by Visiting Justices in general. The contrast
of a well-ordered asylum at the present day, with the prison houses,
the ill-usage and neglect of the unhappy insane at a period so little
removed from it, has produced so striking an effect on mankind at
large, that public attention is attracted and riveted to those
measures whereby the change has been brought about; in other
words, to the moral means of treatment,—to the liberty granted, the
comforts of life secured, the amusements contrived, and the useful
employment promoted,—all which can, to a greater or less extent,
be carried out equally by an unprofessional as by a professional
man. It is therefore not so surprising that the importance of a
medical attendant is little appreciated, and that the value of medical
treatment is little heeded.
There has, in fact, been a revulsion of popular feeling in favour of
the moral treatment and employment of the insane; and, as a
popular sentiment never wants advocates, so it has been with the
one in question; and by the laudation by physicians of the so-called
moral means of treatment, and the oblivion into which medical aid
has been allowed to fall, magistrates, like other mortals, have had
their convictions strengthened, that medical superintendents,
considered in their professional capacity, are rather ornamental than
essential members of an asylum staff; very well in their way in cases
of casual sickness or injury, useful to legalize the exit of the inmates
from the world, and not bad scape-goats in misadventures and
unpleasant investigations into the management, and in general not
worse administrators, under the safeguard of their own magisterial
oversight, than would be members of most other occupations and
professions.
As before remarked, the magnitude of an asylum, and the paucity of
its medical officers, are matters of much more serious import where
recent cases of insanity are under treatment. In a colossal refuge for
the insane, a patient may be said to lose his individuality, and to
become a member of a machine so put together as to move with
precise regularity and invariable routine;—a triumph of skill adapted
to show how such unpromising materials as crazy men and women
may be drilled into order and guided by rule, but not an apparatus
calculated to restore their pristine condition and their independent
self-governing existence. In all cases admitting of recovery, or of
material amelioration, a gigantic asylum is a gigantic evil, and,
figuratively speaking, a manufactory of chronic insanity. The medical
attendant, as said before, is so distracted by multitudinous duties,
that the sufferer from the acute attack can claim little more attention
than his chronic neighbour, except at the sacrifice of other duties. No
frequent watching several times a day, and no special interest in the
individual case, can be looked for. There is such a thing as a facility
in observing and dealing with the phenomena of acute mental
disorder, acquired by experience; but it would be well nigh unjust to
expect it in a medical officer, in whose field of observation a case of
recent attack is the exception, and chronic insanity the rule, among
the hundreds around.
The practical result of this state of things is, that the recently
attacked patient almost inevitably obtains less attention than he
needs from the physician, who, from lack of sufficient personal
observation, must trust to the reports of others, to the diligence, skill
and fidelity of his attendants, and who, in fine, is compelled to
repose work in others’ hands which should rightly fall into his own.
This being the case, the character of the attendants for experience,
knowledge, tact and honesty acquires importance directly
proportionate to the size of asylums, and the degree of inability of
the medical superintendents to perform his duties personally. Now,
though we need testify to the excellent qualities of some asylum
attendants, yet, notwithstanding any admissions of this sort, it is a
serious question how far such agents should be employed to supply
the defects and omissions of proper medical supervision and
treatment. The class of society from which they are usually derived;
their common antecedents, as persons unsuccessful or dissatisfied
with their previous calling, or otherwise tempted by the higher
wages obtainable in asylums, are circumstances not calculated to
prepossess the feelings in favour of their employment in that sort of
attendance on the insane alluded to. They have no preliminary
instruction or training, but have to learn their duties in the exercise
of them. Many are their failures, many their faults, and often are
they very inefficient, as the records of every asylum testify; yet, on
the whole, considering their antecedents, and the nature of the
duties imposed upon them, their success is remarkable. However,
whatever their character as a body, as individuals they require the
direct and ever-active oversight and control of the superintendent.
The institution of head-attendants is a great relief to the labour of
the latter, but rightly affords him no opportunity to relax his own
inspection and watchfulness.
In a large asylum there must be general routine: it can be conducted
only by routine; and the attendants are the immediate agents in
carrying it out. Their duties necessarily partake largely of a
household character; they are engaged in cleaning and polishing, in
bed-making and dressing, in fetching and carrying, and in serving
meals. But along with these they are entrusted with certain parts of
the ‘moral treatment’ of the patients,—in enforcing the regulations
as to exercise, employment, amusement, the distribution of meals,
and the general cleanliness and order both of the wards and their
inmates; and in the exercise of these functions acquire much
knowledge respecting the character and habits of those under their
care. Yet withal, they are not fit and efficient persons to have
medical duties delegated to them. They are not qualified to observe
and record the symptoms of disease, to note its changes, nor, except
under close surveillance, to apply remedies externally or internally.
Such is the onset or the serious march of bodily sickness not
unfrequently, that even the experienced medical observer is prone to
overlook it. This is true where disease attacks those sound in mind,
and able to express their sufferings, and to lend the aid of their
intelligence towards the discovery of the nature and seat of their
malady; but the danger of oversight is increased tenfold when the
insane are the subjects of bodily lesion. Where the mind is enfeebled
and sensibility blunted, and where melancholy broods heavily over
its victim, disease is to be discovered only by a watchful and
experienced practitioner of medicine; for the unfortunate patient will
make no complaint, and the fatal malady may evince itself to the
ordinary uninstructed observer by no sufficient symptom to awaken
attention; and even where the mind is not imbecile, nor weighed
down by its fears and profound apathy, yet the features of its
disorder will interfere, in most instances, with the appreciation and
interpretation of the symptoms which may reach the knowledge of
those about the sufferer, and thereby mask the disease from the
non-professional looker-on, and render its diagnosis even difficult to
the medical examiner.
With respect to the female attendants of asylums, it may also be
observed, that they are frequently young women without experience
in disease, and rarely qualified as nurses conversant with certain
medical matters; and, from our own observation, they are found to
be often backward and shy in reporting particulars respecting the
female patients, and badly qualified in administering to their wants
when sick. Moreover, equally with the male attendants, there is, by
their education and training, no security for a well-governed temper,
for long suffering, patience and sympathy. Indeed, the wages given
in most asylums are not sufficient to induce a higher class of young
women to accept the onerous and often painful and disagreeable
duties of attendants on the insane, than that which furnishes
housemaids and kitchenmaids to respectable families. If, therefore,
their origin be only looked to, it would be contrary to experience to
expect from the nurses of asylums, as a body, the possession of high
moral principle and sensibility, of correct notions of duty, and of a
hearty interest in their duties. We make these remarks, with no
intention to censure the whole race of asylum nurses, among whom
are many meritorious women; but merely to enforce the opinion that
something may be done to improve their character and condition,
and that, as a class, they are not rightly chargeable with duties of
the kind and to the extent we are engaged in pointing out. On the
contrary, their history, position, and education conspire to make
them servants in tone and character, unfit often to exercise the
discipline and authority entrusted to them; whilst the general duties
connected with the cleanliness and order of their wards and rooms,
and the observation of the universal routine of the asylum,
contribute to the same effect, and the more so in large
establishments, where the almost constant supervision of the
superintendent is wanting, where individual interest in patients is all
but dead, and where their number renders the inmates mere
automatons, acted on in this or that fashion according to the rules
governing the great machine.
From the necessity of the case, the medical superintendent of a
colossal asylum is compelled mainly to trust to the observation of his
attendants to discover disease, and to report mishaps. He has his
mile or upwards of wards and offices to perambulate daily, and, to
keep up some connexion with their four or five hundred inmates,
must adopt some general plan. For instance, he refers to the
attendant of each ward he enters, demands from him if he has
anything to report, wends his way through the apartment, looks
right and left, remarks if the floor and rooms are duly swept and
garnished; now and then inspects the bed and bedding, bids good
morning to more or fewer of the patients who may be present, and
unless Brown or Jones has something to report of any one of them,
bids good day to all, to recommence the same operation in the next
ward. Now Brown or Jones might have had something to report had
they medical eyes, and information to detect the first symptoms of
disease in one of their patients; but as they have not, the disorder
has a fair opportunity to steal a march upon the doctor, and possibly
to take such firm possession of its victim before this or that
attendant is persuaded something is going wrong, that the doctor
only commences his professional operations against it in time to
render his certificate of death satisfactory, and the result explicable
without a coroner’s inquest.
We do not blame the medical men for not doing more, but we
deprecate the system which places it out of their power to do so. No
one can gainsay the possibility, nay, the actual occurrence, of
avoidable deaths in the large asylums we condemn; and those who
know the working of such institutions, know also that the duties are
performed much after the sketch delineated, and could be got
through in no greatly improved fashion.
But it must not be supposed, that it is only when disease exists or
has to be discovered, that the delegation of the principal part of the
supervision of patients to ordinary asylum attendants operates
injuriously to their well-being; far from it, for many are the cases
which require the presence of a more instructed and more
sympathizing mind; of a person to appreciate their moral and mental
condition; to overrule by his official position disorderly
manifestations, to pacify the excitable, to encourage and cheer the
melancholy; to espy and anticipate the wants of all; to hear the
complaints of some, and to be the confidant of others; to mark the
mental changes of individuals, and to adapt surrounding
circumstances, their occupations and amusements accordingly. To
give such superintendence, or, in other words, to apply such moral
and mental treatment, the medical officer is the only fitting person;
from him the patients will and do naturally look for it. Let any one
follow a medical superintendent in his ordinary visits through the
wards; and he will observe how ardently the visit is anticipated by
many; how numerous are the little troubles and ailments they wish
to disclose to the physician, and only to him; how often he can
arrest excitement and calm irritation, only aggravated by the
interposition of attendants; how often he can recognize mental and
bodily symptoms demanding attention, and, in general, how largely
he can supply those minutiæ of treatment, insignificant as they
appear, and unthought of as they are by others, whose moral
feelings, whose intellectual acumen, whose education and manners,
and whose position are deficient to conceive them, and insufficient
to put them in force.
There is no question, it must be granted, but that whatever medical
supervision may be supplied, yet that the carrying out of most of the
details of management must always devolve upon the attendants; it
becomes, therefore, a matter of paramount importance to render
that class of asylum functionaries as efficient as possible. They need
be encouraged by good wages and good treatment; and, what is of
great moment, these should be sufficiently good, to induce persons
of a better class than that which usually furnishes attendants, to
accept such posts. This idea will probably be scouted by the stickler
to “a due regard for economy,” at first sight; but we think his
economical penchant might be gratified by the plan of carrying out
more fully in the wards the distinction of attendants upon the insane
and of household servants. For is it not practicable to import the
system adopted in the large London Hospitals, where the office of
‘sisters,’ to nurse the patients, is separated from that of under-nurse,
to whom the cleanliness of the wards is committed? If so, the
immediate attendants on the insane might receive higher wages
without increasing the general expenditure of the asylum; for those
concerned in the cleaning of the wards would only earn the wages of
common household servants. We throw out this suggestion, in
passing, for the nature of our treatise forbids our enlarging upon
such matters of asylum organization; otherwise, much might be
written respecting the duties and the remuneration of attendants,
and the advantages of pensions for them after a certain term of
faithful service.
To conclude this topic, we may remark that it would be easy, did the
subject stand in need of proof, to multiply illustrations, showing that,
to transfer the work of medical and moral supervision to attendants,
in any similar extent and measure to that which must of necessity
prevail in the excessively large asylums which County Magistrates
rear in opposition to the decided opinion of those best able to judge,
is to frustrate the object of those institutions as curative asylums,
and to detract from their advantages as refuges for the incurable.
The evils of overgrown asylums have not, as might be expected,
escaped the observation and reprobation of the Commissioners in
Lunacy, who have referred to them in several of their Annual
Reports, but more at large in that of 1857, wherein they detail their
contest with the Middlesex magistrates respecting the further
enlargement of the enormous asylums of Hanwell and Colney Hatch,
and their strange defeat, the magistrates having contrived to
influence the Home Secretary in opposition to the decided opinion of
the Commissioners, though seconded by experience, by the general
assent of all asylum physicians, and by their position as the referees
appointed by the State in all matters touching the erection and
management of asylums. With this acquiescence in the erroneous
scheme of a County Magistracy in opposition to a Government
Commission, we have at present no immediate concern, and may
content ourselves with reporting it as an anomalous proceeding
which ought never to have occurred: but to revert to the sentiments
of the Commissioners, they are expressed in the following quotation
from the Report mentioned.
“It has always been the opinion of this Board that asylums beyond a
certain size are objectionable: they forfeit the advantage which
nothing can replace, whether in general management or the
treatment of disease, of individual and responsible supervision. To
the cure or alleviation of insanity, few aids are so important as those
which may be derived from vigilant observation of individual
peculiarities; but where the patients assembled are so numerous
that no medical officer can bring them within the range of his
personal examination and judgment, such opportunities are
altogether lost, and amid the workings of a great machine, the
physician as well as the patient loses his individuality. When to this
also is added, what experience has of late years shown, that the
absence of a single and undivided responsibility is equally injurious
to the general management, and that the rate of maintenance for
patients in the larger buildings has a tendency to run higher than in
buildings of a smaller size, it would seem as if the only tenable plea
for erecting them ought to be abandoned. To the patients,
undoubtedly, they bring no corresponding benefit. The more
extended they are, the more abridged become their means of cure;
and this, which should be the first object of an asylum, and by which
alone any check can be given to the present gradual and steady
increase in the number of pauper lunatics requiring accommodation,
is unhappily no longer the leading characteristic of Colney Hatch or
of Hanwell.”
As may be supposed, the disposition to build huge asylums is due to
the same cause as that of the detention of insane persons in
workhouses, viz. to the plea of economy; a plea, which we believe to
be about as fallacious in the one case as in the other. The economy
is supposed to arise from the saving in commissariat matters and in
the governing staff; and it is no doubt proportionately cheaper to
provision 1000 persons than 500, other things being the same. But,
on the one hand, very competent persons assert that the cost of
officers and servants for a population of 1000 insane is more than
double that for one of half that amount, when proportionately
compared. The multiplication of inferior officers beyond a certain
point entails that of superior ones in a higher ratio to overlook them;
there is not the same amount of productive labour considering the
number employed. The capability of the superintendent to supervise
his attendants and the patients stops at a certain point, and he need
call to his aid a head attendant at superior wages, and so add an
extra person to the staff; if the extent of his charge is farther
increased by additional patients and their necessary attendants, then
an officer of a higher grade is called for, and other overlookers of
attendants and of the régime of the house. But figures showing the
relative costs presently appealed to will do more to convince the
reader of the fact under notice than any ‘aids to reflection’ we can
supply.
There can be no question, that to build asylums for the insane above
a certain size is a fallacy when viewed even in an economical aspect;
but when regarded in relation to its ulterior consequences, the plan
is not only erroneous, but reprehensible. Were it really the case that
a pecuniary saving resulted from the aggregation of large masses of
mentally disordered folk, according to the figures in the ledger of the
institution, yet no positive gain could be boasted of until it was
proved that every case was placed in the most favourable conditions
for recovery. Can it be pretended that the very extensive asylums of
this country, with their present corps of medical officers, furnish such
conditions? Certainly not, if there be any truth in the account we
have published of their evils and defects. And if those conditions are
not supplied, the primary object of these institutions, i. e. the cure of
the insane, is frustrated, and chronic lunacy increased. Where, then,
is the economy, if patients, failing to receive the means of recovery,
by reason of the constitution of the asylum on so large a scale, fall
into chronic disease, and become permanent burdens on its funds?
Where is the economy of a system, which, by standing in the way of
efficient treatment, reduces the proportion per cent. of recoveries to
twenty or thirty, when under different arrangements that proportion
may equal 60 per cent. or upwards?
It will be a happy day for the insane, and for the contributors to
their maintenance, when Visiting Justices arrive at the conviction,
that they have not done all they can on behalf of the poor
disordered people under their guardianship, when they have
provided good lodging, board and clothing for them, and such a
system of routine and discipline as to check the manifestation of
their mental vagaries; and that it is not enough for a recent case, to
introduce it into an asylum and the companionship of lunatics, with
practically no positive provision for its medical treatment. It will be
well, too, for the insane, when the truth becomes more generally
assented to, that their malady is no mythical, spiritual alteration, but
the consequence of a material lesion of the brain, the marvellous
instrument, the subject and servant of the immortal soul, which can
by its divine essence know no disorder.
This is perhaps, strictly speaking, a digression from the subject; yet
erroneous ideas are the parents of erroneous practices, and those
we have hinted at form no exception to the rule. But, to return, we
have some excellent illustrative remarks on the fallacy of the belief in
the economy of very large asylums, contained both in the Report of
the American and of the English Lunacy Commissioners. The former
thus write in their Report (op. cit. p. 136):—
“The policy which has built large establishments for the insane is a
questionable one as applied to economy. After having built a house
sufficiently large, and gathered a sufficient number of patients for
their proper classification and for the employment of a competent
corps of officers and attendants, and allowing each to receive just as
much attention as his case requires, and providing no more, any
increase of numbers will either crowd the house, or create the
necessity of building more rooms; and their management must be
either at the cost of that attention which is due to others, or must
create the necessity of employing more persons to superintend and
to watch them.
“If the house be crowded beyond the appropriate numbers, or if the
needful attention and the healing influences due to each individual
are diminished, the restorative process is retarded, and the recovery
is rendered more doubtful; and if additional provision, both of
accommodations and professional and subsidiary attendance, is
made to meet the increase of patients beyond the best standard, it
would cost at least as much per head as for the original number. Dr.
Kirkbride thinks it would cost more, and that the actual recoveries of
the curable, and the comfortable guardianship of the incurable, are
not so easily attained in large hospitals as in such as come within
the description herein proposed. ‘It might be supposed that
institutions for a much larger number of patients than has been
recommended could be supported at a less relative cost; but this is
not found to be the case. There is always more difficulty in
superintending details in a very large hospital; there are more
sources of waste and loss; improvements are apt to be relatively
more costly; and, without great care on the part of the officers, the
patients will be less comfortable.’
“Besides the increased cost of maintaining and the diminished
efficiency of a large establishment, there is the strong objection of
distance and difficulty of access, which must limit the usefulness of a
large hospital in the country, and prevent its diffusing its benefits
equally over any considerable extent of territory to whose people it
may open its doors.”
Having pointed out the evils of large asylums to their inmates, the
English Commissioners, in their Eleventh Report (p. 11), remark,
“that the rate of maintenance for patients in the larger buildings has
a tendency to run higher than in buildings of a smaller size,” ... and
that it therefore “would seem as if the only tenable plea for erecting
them ought to be abandoned.” To substantiate this assertion, they
appeal to the table of weekly charges of the several county asylums,
set forth in the Appendix C.C. of the same Report, which certainly
shows that the cost per head is at its maximum in those which
receive the largest number of patients. This being so, surely no one
can withhold assent to the just conclusion of the Commissioners,
that the system of erecting asylums above certain dimensions ought
to be abandoned, inasmuch as the only plea that can be urged in its
behalf, that, namely, of its economy,—a bad plea, by the way, if the
real interests of patients and ratepayers are concerned,—is founded
in error.
One more topic needs a few words, viz. the very inadequate
remuneration of the medical superintendents in some asylums,—a
circumstance, confirmatory of the small value assigned by their
Committees of Visitors to professional qualifications. The worst
instances of underpayment are, in fact, met with in those very
asylums where the number of inmates attains its maximum, and the
medical provision for their care is at its minimum; where the
administrative power of the medical men is the most limited and
most interfered with, and their ability to discharge their duties
conscientiously and efficiently, utterly crippled by the multitude of
claimants upon their attention surrounding them; and where, in fine,
they are merely accessory officials, useful in cases of sickness and
accident. It must, indeed, be gratifying to the advocates of the rights
of women to know, that in one asylum, at least, female labour is
rated as equal to male professional labour; that the matron is as well
paid as the medical officers, and more valued in the estimation of
the Committee of Visitors. But, however this circumstance may be
viewed by the partisans of the interests of the fair sex, we venture
to believe that to most people it will appear a gross anomaly. For our
own part, we consider also that it would be to the interests both of
patients and rate-payers to elevate the position of the medical
superintendents of asylums, and to pay them liberally.
As this section of our work is passing through the press, we have got
the Report, just printed, “from the Select Committee on Lunatics,”
and are most happy in being able to extract from its pages a very
decided opinion expressed by the Earl of Shaftesbury respecting the
scanty salaries of medical superintendents. His Lordship, in reply to
the question (765), “Have you any other remedies to apply to county
asylums?” said,—“I do not know whether it is a matter that could be
introduced into the Bill, but I think the attention of the public should
be very much drawn to the state of the medical superintendents in
these asylums. It is perfectly clear, that to the greater proportion of
the medical superintendents in these asylums, very much larger
salaries should be given; and unless you do that, you cannot
possibly secure the very best service.... The great object must be to
raise the status and character of the superintendents to the highest
possible point.” In the course of further examination on this subject,
his Lordship repeats and adds to the opinion just recorded. For
instance, he remarks,—“One of the great defects of the present
system is, that the salaries of the medical officers are much too low
for the service they perform. I think that the county ought to secure
the very best talent and responsibility that can be found, and they
ought to raise their salaries higher. I believe in some of the asylums
the salaries are higher, but I hardly know one where the salary is
adequate to the work done.... I cannot think that any superintendent
ought to receive much less than from £500 to £600 a year, besides a
house and allowances.”
In this matter, we hope the liberal views of the noble Chairman of
the Lunacy Commission will sooner or later be reciprocated by the
Visitors of Asylums; in the mean time, the thanks of the medical
profession are heartily due to his Lordship for his able advocacy of
its just claims.

§ Limit to be fixed to the size of Asylums.

One remedy against extending the evil consequences of large
asylums, is to restrict the size of future buildings within certain
limits. We do not hope to persuade the advocates of gigantic
asylums, by any representation we can offer of their ill-effects to the
patients and their false economy, to abandon their notions; but we
do hope that there will be a parliamentary interdiction to their
perpetuation, or that the Commissioners in Lunacy will have
sufficient authority lodged in their hands to limit the size of future
asylums.
Although all persons conversant with the treatment and
requirements of the insane concur in condemning such huge
asylums as Hanwell and Colney Hatch, yet there is some difference
in opinion, of no very great extent indeed, among them with regard
to the number of patients who should be assigned to the care of a
single superintendent. Moreover, the number who may be treated in
the same building and by one physician, will differ according to the
nature of the cases—whether all acute, or all chronic, or mixed,
acute and chronic together. In this country all the asylums are of a
mixed character, but, excepting two or three hospitals for the insane,
contain a large preponderance of chronic cases. They are, moreover,
all spoken of by the Lunacy Commissioners as Curative Asylums.
Let us now examine the opinions of some of the best authorities
upon the subject, so that a tolerably accurate judgment may be
formed of the limits within which the size of asylums should be
restricted.
In 1844, the Metropolitan Commissioners in Lunacy laid it down as a
rule that “no asylum for curable lunatics should contain more than
250 patients, and 200 is, perhaps, as large a number as can be
managed with the most benefit to themselves and the public in one
establishment.”—Report, 1844, p. 23. The present Commissioners
have expressed similar views, which also were clearly stated before
the Special Committee of the House of Commons this year, by the
noble Chairman, the Earl of Shaftesbury.
If we look to American opinion, we find (Rep. Commiss. Massachus.
1855, p. 135) that “it is the unanimous opinion of the American
Association of Medical Superintendents of Insane Asylums that not
more than 250 patients should be gathered into one establishment,
and that 200 is a better number. When this matter was discussed,
there was no dissent as to the maximum; yet those who had the
charge of the largest hospitals, and knew the disadvantages of large
numbers, thought that a lower number should be adopted.
“Taking the average of the patients that now present themselves in
Massachusetts, of whom 80 per cent. are supposed to be curable,
and need active treatment, and 82 per cent. incurable, and require
principally general management and soothing custodial
guardianship, and having ‘due regard to the comfort and
improvement of the patients,’ this limit of 250 should not be
exceeded.
“The principal physician is the responsible manager of every case,
and should therefore be personally acquainted with the character
and condition of his patients, the peculiarities of the diseased mind,
as manifested in each one, and the sources of trouble and
depression, or exaltation and perversity. This knowledge is
necessary, in order that he should be able to adapt his means of
medical or of moral influence with the best hope of success.”
Dr. Kirkbride, in his special treatise on the Construction and
Organization of Asylums, thus expresses his views (p. 10):
—“Whatever differences of opinion may have formerly existed on
this point (the size of the Institution), I believe there are none at
present. All the best authorities agree that the number of insane
confined in one hospital, should not exceed 250, and it is very
important that at no time should a larger number be admitted than
the building is calculated to accommodate comfortably, as a crowded
institution cannot fail to exercise an unfavourable influence on the
welfare of its patients. The precise number that may be properly
taken care of in a single institution, will vary somewhat, according to
the ratio of acute cases received, and of course to the amount of
personal attention required from the chief medical officer. In State
Institutions, when full, at least one half of all the cases will
commonly be of a chronic character, and require little medical
treatment. Even when thus proportioned, 250 will be found to be as
many as the medical superintendent can visit properly every day, in
addition to the performance of his other duties. When the proportion
of acute or recent cases is likely to be much greater than that just
referred to, the number of patients should be proportionately
reduced, and 200 will then be found to be a preferable maximum.
While no more patients should be received into any hospital than
can be visited daily by the chief medical officer, it is desirable that
the number should be sufficiently large to give an agreeable
company to each class, and to permit a variety of occupations and
amusements that would prove too costly for a small institution,
unless filled with patients paying a very high rate of board, or
possessed of some permanent endowment. It might be supposed
that institutions for a much larger number of patients than has been
recommended, could be supported at a less relative cost; but this is
not found to be the case. There is always more difficulty in
superintending details in a very large hospital—there are more
sources of waste and loss; improvements are apt to be relatively
more costly; and without great care on the part of the officers, the
patients will be less comfortable.
“Whenever an existing State Institution built for 250 patients,
contains that number, and does not meet the wants of the
community, instead of crowding it, and thereby rendering all its
inmates uncomfortable, or materially enlarging its capacity by
putting up additional buildings, it will be found much better at once
to erect an entirely new institution in another section of the State;
for under any circumstances, the transfer of acute cases from a
great distance, is an evil of serious magnitude, and constantly
deplored by those who have the care of the insane.”
French authorities take the same views. M. Ferrus, who wrote so
long back as 1834, and is now one of the Inspectors of Asylums in
France, says, in his book, ‘Des Aliénés,’ that an asylum for the
treatment of mental disorder ought not to contain above 150, or at
most 250 patients; but that one having a mixed population of cases
requiring treatment of incurables and idiots, may receive 400 or
even 500 such inmates, provided the physician is afforded sufficient
medical assistance. However, his brother inspector, M. Parchappe,
whose able work, ‘Des principes à suivre dans la fondation et la
construction des Asiles d’Aliénés’ (published so recently as 1853),
forms the most valuable treatise on those subjects, does not
approve so large a number of inmates to be collected in an asylum
as M. Ferrus would sanction. He writes:—“After taking every
consideration into account, I think the minimum of patients ought to
be fixed at 200, and the maximum at 400. Below 200, the
economical advantages decline rapidly without a compensatory
benefit; above 400, although the economical advantages augment, it
is at the detriment of the utility of the institution in its medical
character.”
M. Guislain, the eminent Belgian physician, in his grand work on
Insanity, remarks (vol. iii. p. 347), “It would be absurd to attempt to
bring together in the same place a very large population; it would
tend to foster an injurious degree of excitement; would render the
management difficult or impossible; would destroy the unity of plan,
and neutralize all scientific effort. The maximum ought not to exceed
300 or 350 insane persons. This limit cannot be exceeded without
injury to the well-being of the inmates; but unfortunately this has
been but too often disregarded, under the plea of certain views of
organization or of economy.”
Jacobi placed the maximum of asylum population at 200 (Ueber die
Anlegung und Errichtung von Irren-Heil-anstalten, p. 24); Roller
expressed his opinion (Grundsätze für Errichtung neuer Irren-
anstalten, p. 84) that one instituted for the treatment of cases (Heil-
anstalt) should not at the most receive above 200; but that an
asylum for chronic cases (Pflege-anstalt), connected with the other,
may admit from 250 to 300, making a total population, under the
same general direction, of 450 or 500; and Damerow (Ueber die
Relative Verbindung der Irren-Heil-und Pflege-anstalten) unites in
the same opinion.
It would be useless to multiply quotations; for, in short, there is
complete unanimity among all those concerned in the direction of
asylums, that such institutions, when of large size, are prejudicial to
their inmates and withal not economical. There is likewise a very
near coincidence of opinion perceptible with reference to the
question of the number of patients which ought to be placed in the
same building. Supposing the asylum to be specially devoted to the
reception of recent cases, it is agreed that it ought to accommodate
not more than 200, and that the smaller number of 150 inmates
would be preferable. If a receptacle for both acute and chronic
mental disease, some would limit the population to 250, whilst
others would extend it to 400, provided the medical officers were
increased in proportion.
The example of the German asylums under the direction of
Damerow and Roller is peculiar; for the curable and chronic cases
are not mixed, but placed separately in two sections or two
institutions under a general medical direction within the same area.
This is the system of ‘relative connexion’ of the “Heil-anstalt,”—
institution for treatment, or the Hospital, and the “Pflege-anstalt,”
the ‘nursing’ institution, or the asylum; to the former they would
allot 200, and to the latter 300 as a maximum, making a total of 500
inmates under the same physician in chief and the same general
administration, but each division separately served by its own staff
and specially organized.

§ Increase of the Medical Staff of Asylums.

In the next place, the medical staff of an asylum should be large
enough to secure daily medical observation and attendance for each
individual patient, along with a complete supervision of his moral
condition, his amusements and employment. We have said that this
provision is deficient in many English asylums, a statement amply
confirmed by the opinions of others.
Dr. Kirkbride (op. cit. p. 44) lays it down as a rule, that “where there
are 250 patients, especially if there is a large proportion of recent
cases, besides the chief physician, two assistant physicians will be
required, one of whom should perform the duties of apothecary. In
some institutions, one assistant physician and an apothecary will be
sufficient. If the full time of two assistant physicians, however, is
taken up by their other duties among the patients, an apothecary
may still be usefully employed in addition; and to him, other duties
among the male patients may with propriety be assigned.”
French writers coincide in these views. M. Parchappe assigns to an
asylum containing 200 to 250 patients, a physician with an assistant,
besides a dispenser; to one having 300 to 360 inmates, a physician,
two assistants and a dispenser, besides a director to superintend the
general administration, who in some institutions is also a medical
man.
In Germany, and generally in Italy, the medical staff is still larger in
proportion to the number of patients. Jacobi apportions to an asylum
for 150 or 200 lunatics, a chief physician, a second, and an assistant,
besides the dispenser. Roller coincides with this, and the asylum at
Illenau under his superintendence, consisting of two divisions, one
for recent, the other for chronic cases, and containing in all 414
patients, has three physicians besides two assistants or ‘internes.’ So
at Leubus, in Silesia, there are three physicians, although the
inmates are only 150 in number; and the rule is, in other German
asylums, containing 100 inmates, to have two physicians, besides
one or two internes and a dispenser (pharmacien).
Allowing the opinions and practice of the eminent men quoted, and
which in truth are shared in by every asylum superintendent, their
due weight, it would seem no extravagant arrangement to allot to an
asylum accommodating from 150 to 200 patients (recent and chronic
cases together), a physician superintendent and an assistant; and a
similar medical staff to an institution for 300 or 350 inmates, all in a
state of confirmed chronic insanity, imbecility, and dementia. If the
population in an asylum for chronic cases is further augmented to
450 or 600,—the latter number we hold to represent the maximum
which can economically and with a just regard to efficient
government and supervision and to the interests of the patients, be
brought together in one establishment,—the medical superintendent
will require the aid of two assistants and a dispenser.
Such aggregations as of 1000 to 2000 insane people are unwieldy
and unmanageable with the best appointed medical staff, unless this
be so numerous as utterly to invalidate the plea of economy, the
only one, fallacious as it is, that can be produced by the advocates
for their existence. And not only are they unmanageable, but also
hygienically wrong; for it is a well-recognized fact, that the
accumulation of large numbers of human beings in one place, tends
to engender endemic disease, uniformly deteriorates the health, and
favours the onset, progress, and fatality of all disorders. The history
of large asylums bears testimony to the truth of this; for cholera has
scourged more than one most severely, and dysentery and chronic
or obstinate diarrhœa are pretty constant visitants in their wards.
The contrast between the opinions and practice of the distinguished
men referred to and those of some Committees of Visitors respecting
the value of medical attendance on the insane, the nature of the
duties to be performed, and the amount of labour the
superintendent of an asylum may accomplish, is most remarkable.
What those of the former are, is stated already; what those held by
the latter are, we have an illustration in the administration of the
Colney Hatch and of the Hanwell Asylums. In the latter
establishment we find two medical men appointed to superintend
1020 insane inmates, besides nearly 200 persons employed about it.
True, we are informed by the Committee, that the superintendent of
the female department, who has the larger number, some 600,
under his charge, is assisted by the matron; and we are sure he
must be thankful for any assistance rendered him; yet it is the first
time that we have been called upon to recognize a matron as an
assistant medical officer. However, we must accept it as a fact,—
gratefully we cannot,—but with a protest against placing a
subordinate officer on such an independent footing, against
entrusting her with duties incompatible with her education and
position, and with the relations which should subsist between her
and the superintendent, and against making her his equal in the
remuneration for her services.
Did occasion offer, we might ponder over this new development of
the matronly office; inquire respecting the medical qualifications
demanded, and the manner in which the Hanwell Committee have
ascertained them; and meditate at length on the notions which
govern the Visiting Justices in organizing and directing an asylum;
but for the present, we will, for further example’s sake, note some of
their opinions and doings in the management of the sister ‘refuge for
lunatics’ at Colney Hatch. We shall, for this purpose, appeal to the
Report for 1856, and to make the quotations used intelligible, will
premise, that the steward, at that date, had turned architect, and
produced a plan for the extensive enlargement of the asylum as
proposed by the Magistrates; and that, very naturally, when writing
about it, he was intent to prove that his plan was the best, the
cheapest and the most convenient even to the medical
superintendents who would be called upon to officiate in it when
completed. This much being premised, we will quote the steward’s
own words.
“I must also remind the Committee,” he observes, “that some three
years since it was with them a matter of serious deliberation,
whether it was advisable that the male and female departments
should be placed under the care of one medical superintendent, and,
in fact, whether one medical officer should have the supervision and
direction of 1250 inmates, and an extended range of building; or
whether the two departments should continue, as they are at
present, separate and distinct.” What an excellent insight does this
revelation of the cogitations of the Committee-room of the Middlesex
Magistrates afford us of the sentiments these gentlemen entertain of
the requirement and value of medical skill in an asylum; of the
capacity, bodily and mental, of a superintendent for work! But,
without waiting to fill up a sketch of the wondrous virtues and
faculties which the superintendent of the 1250 insane patients need
to possess in order to know all, supervise them, direct them, and
attend to the multitudinous duties of his office as a physician and
director, we will by a further extract gather clearer notions of the
extent of the work thought to be not too much for him. The gist of
the ensuing paragraph is, that the steward strives to prove that by
adding a new story here and there, besides spurs from the previous
building, he will increase greatly the accommodation without much
augmenting the ambulatory labours of the medical officer. And
alluding to one, the male division of the establishment, he proceeds
to argue, that “if it is considered feasible for one person to
superintend 1250 patients of both sexes in a building extending from
one extreme to the other, nearly two-thirds of a mile, would it not be
equally feasible to superintend 840 patients in a building one half
the extent [here Mr. Steward forgets to count the number of furlongs
added by his proposed new wards], provided they are conveniently
and safely located, although these patients are all males?”
To this we may be allowed to subjoin some remarks we penned in a
critique published in the ‘Asylum Journal’ (vol. ii. p. 271) for 1856,
and in which many of the observations contained in the present
work were briefly sketched. “Who, we ask, can dispute the feasibility
of a medical or of any other man superintending 840, 1250, or two
or three thousand patients, collected in an asylum or in a town, in
the capacity of a director or governor, if subordinate agents in
sufficient number are allowed him? But we think the question in
relation to asylums is not, how we can govern our insane population
most easily and at the least possible cost, but by what means can
we succeed in curing the largest number of cases of insanity as they
arise, and thus permanently keep down expenditure and save the
rates. These results are certainly not to be attained by persevering in
the old scheme of congregating lunatics by tens of hundreds, but by
making suitable provision for the immediate treatment of the pauper
insane in asylums properly organized for it, and under the direction
of a sufficient medical staff.”
How totally different, too, are the views of Jacobi to those of the
Middlesex Magistrates concerning the office of superintendent, and
the extent of work of which he is capable! In his treatise on Asylum
Construction (Tuke’s Translation, p. 23), he presents the following
sensible remarks:—“It is not that I should consider a more numerous
family (than 200) incompatible with the right management of the
farming and household economy, nor with the domestic care of the
patients; both these might perhaps be organized in an establishment
containing a number equal to the largest just named (four or six
hundred), in such a manner as to leave nothing to be desired; but it
is in regard to the higher government of the establishment, and the
treatment of the patients as such, in its widest signification, which
must rest upon the shoulders of a single individual,—the director of
the establishment,—that I am convinced the number of patients
should not exceed two hundred. For when it is considered that the
duties of the governor embrace the control of all the economical and
domestic arrangements, as well as of the whole body of officers and
servants; that he must devote a great share of his time to the
writing, correspondence, and consultations connected with his office;
that as first physician, he is entrusted with the personal charge and
medical treatment of every individual committed to his care; that he
must daily and hourly determine, not only the general outlines, but
the particular details of the best means for promoting the interests
of the collective community, as well as of every separate person
composing it; and that, besides all this, he is responsible to science
for the results of his medical observations in the establishment over
which he presides; nor less so for the promotion of his own
advancement as a man and a philosopher;—it will be readily
granted, that the given maximum of two hundred patients for a
single establishment ought never to be exceeded. Indeed, a man of
even extraordinary abilities would find himself unequal to the task of
discharging these duties, in an establishment containing two
hundred patients, were he not supported by such assistance as will
hereafter be described; and were there not a great number amongst
even this multitude of patients requiring not constant, or at least, a
less degree of medical attention.”
Many writers on asylum organization, particularly those of the
Continent, insist very strongly on so far limiting the size of asylums
for the insane, that they may be superintended by one chief medical
officer, aided indeed by assistants, but without colleagues of
coordinate powers. The venerable Jacobi took this view, and desired
that the director of an asylum should be the prime authority in all its
details of management, and insisted that the institution should not
by its size overmatch his powers to superintend it and its inmates as
individuals. Thus, after reviewing the nature of the duties devolving
on the chief physician, he observes (p. 192, Tuke’s translation), “It
follows as a necessary consequence that one man must be placed at
the head of the establishment,” ... and that “his mind must pervade
the whole establishment.” Likewise M. Parchappe joins in the same
opinion; and after speaking (Des Principes, p. 43) of the impossibility
of proper medical supervision in a very large asylum, observes, “that
to divide the medical direction among two or more physicians is
extremely detrimental to the superiority which the medical
superintendent ought to hold in the general administration of
asylums, and to that unity of purpose and opinions required in the
interests of the patients.”
Without citing other foreign writers to substantiate the view under
consideration, we may call attention to the fact, that the Lunacy
Commissioners, who have always so stoutly advocated the position
of the medical officer as the superintendent of an asylum, likewise
appear to accept the same principle; for in their Eleventh Report (p.
11), they remark, that besides the direct injury inflicted upon
patients when congregated in excessive numbers in the same
institution, “experience has of late years shown, that the absence of
a single and undivided responsibility is equally injurious to the
general management.”
Lastly, the Committee of Visitors of the Surrey County Asylum
appear,—judging from their recent appointment of a chief physician
to their institution, paramount to the medical officers of the
divisions, and invested with full powers as director,—to have arrived
at the just conviction that there must be unity and uniformity in the
management of an institution. However, we regret to say that this
conviction is unaccompanied by that other which Jacobi and
Parchappe would associate with it, viz. that the size of the asylum
should be no larger than will admit of the chief physician acquainting
himself with every case individually, and treating it accordingly.
Whilst, indeed, by their proceeding, they constitute the chief
physician a governor of a large establishment, and the director of
the household and of its economy, they at the same time deprive
him of his professional character by removing the opportunities of
exhibiting it beyond his reach, both by the relations they place him
in to the other medical officers, and by the enormous aggregation of
patients they surround him with.
Few objections, we presume, are to be found to the principle of
having a chief medical officer paramount to all others engaged in the
work of an asylum; and although, considered as a medical
superintendent, his professional qualities are not in much requisition
in so large an institution as the Surrey County Asylum, yet we regard
such an appointment as most desirable, and as preferable to the
system of dividing the management between two medical officers,
as pursued in the Middlesex County Asylums. Indeed, the value of
the principle of concentrating power in the hands of a chief officer,
under the name of governor, or of some equivalent term, is
recognized by its adoption in large institutions of every sort in the
country. Such enormous asylums as those referred to, partake rather
of the nature of industrial than of medical establishments. Their
primary object is to utilize the population as far as practicable, and
this end can be attained in a large majority of the inmates;
consequently an able director is of more consequence than a skilful
physician; for the latter is needed by a very small minority, by such a
section, in fact, as is represented by the inmates of a workhouse
infirmary only compared with its entire population. Therefore, since
the enormous asylums in existence are not to be got rid of, it is
desirable to give them an organization as perfect as practicable; and
it is under this aspect that we approve the plan of the Surrey
Magistrates in appointing a director paramount to every other officer.
The approval of this proceeding, however, does not minish aught
from our objections to such enormous institutions, considered as
curative asylums for the insane. As a refuge for chronic lunatics, an
asylum so organized and superintended as is the Surrey, may
subserve a useful purpose; but we hold it to be an unsuitable place
for recent cases demanding treatment as individuals suffering from a
curable disease, and requiring the exercise of the skill and
experience of a medical man specially directed to it.
While the system of congregating so many hundreds of lunatics in
one establishment, and the magisterial principle of providing for the
care and maintenance and of non-intervention in the individual
treatment of the insane prevail, no objection can be taken to the
practice of Committees of Visitors in according the first merit when
candidates come forward for the office of medical superintendent of
an asylum, to qualifications for the routine government of large
masses, for the allotment of labour, for the regulation of the
domestic economy of a house, for the profitable management of the
farm; in short, for qualities desirable in a governor of a reformatory-
school or prison. Indeed, they are right in so doing, when they wish
to have a well-disciplined and profitably worked asylum; and when
their institution attains the dignity of a lunatic colony, it is the best
course they can adopt, for medical qualifications in such an
establishment sink into insignificance amidst the varied details of
general administration, which fall to the lot of the superintendent.
But the case would be materially changed were the primary object of
an asylum the successful treatment of its inmates, and were its
dimensions within the limit to afford its superintendent the
opportunity to know all, and to treat all its patients as individuals to
be benefited by his professional skill. In selecting the physician of
such an asylum, the administrative and agricultural qualifications he
might possess, though far from being unnecessary or unimportant,
should occupy a secondary place in the estimation of Committees of
Visitors; and the primary requirement should be the possession of
properly certified medical skill, of experience in the nature and
treatment of insanity, in the wants and management of the insane,
and of asylums for them; of evident interest and zeal in his work,
and of those intellectual and moral endowments adapted to minister
to the mind diseased, to rule by kindness and forbearance, and at
the same time with the firmness of authority.
 Chap. VII.—on the future provision for
the insane.

The only apology permissible for detaining lunatics in workhouses, is

that there is no asylum accommodation for them to be had; and the
only one attempted on behalf of the construction of colossal asylums
is, that the demands for admission and the existing numbers are so
many, and the majority of cases chronic and incurable, that the most
economical means of providing for them must be adopted, which
means are (so it is supposed) found in aggregating masses under
one direction and one commissariat. Now, whilst we have, on the
one hand, contended that workhouses should be as soon as possible
disused as receptacles for the insane, we have, on the other hand,
endeavoured to prove that very large asylums are neither
economical nor desirable, especially if the cure of lunatics, and not
their custody only, is contemplated by their erection. Indeed the
attempt to keep pace in providing accommodation for the insane
poor with their multiplication by accumulation and positive increase
or fresh additions, has failed, according to the mode in which the
attempt has hitherto been made. New asylums have been built and
old ones enlarged throughout the country, and between 1843 and
the end of 1857, the accommodation in them had been increased
threefold; whilst, at the same time, pauper lunatics had so
multiplied, that their number in licensed houses remained almost the
same, and the inmates of workhouses and chargeable imbeciles and
idiots residing with their friends or with strangers, had very largely
increased. The history of pauper lunacy in Middlesex furnishes one
of the most striking commentaries upon the system pursued to
provide for its accumulation, and on its failure. “When (we quote the
11th Report of the Commissioners in Lunacy, 1857, p. 12), in 1831,
Hanwell was built for 500 patients, it was supposed to be large
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