Dr. Bucknill returns to the discussion of this point in his just published report (Rep. Devon Asylum, 1858, p. 11). He puts the question, "Would a number of small asylums, under the denomination of lunatic wards, be more economical than one central asylum?" and, thus proceeds to reply to it:--"The great probability is that they would not be; 1st, on account of the larger proportion of officials they would require; 2nd, on account of the derangement they would occasion to the severe economy which is required by the aim and purpose of union-houses as tests of destitution. Where lunatics do exist in union-houses in consequence of the want of accommodation in the County Asylum, the Commissioners in Lunacy insist upon the provision of what they consider things essential to the proper care of insane persons wherever they be placed. The following are the requirements which they insisted upon as _essential_ in the Liverpool Workhouse:--a sufficient staff of responsible paid nurses and attendants; a fixed liberal dietary sanctioned by the Medical Superintendent of the asylum; good and warm clothing and bedding; the rooms rendered much more cheerful and better furnished; the flagged court-yards enlarged and planted as gardens; the patients frequently sent to walk in the country under proper care; regular daily medical visitation; and the use of the official books kept according to law in asylums. If the direct cost of such essentials be computed with the indirect cost of their influence upon the proper union-house arrangements, it will require no argument to prove that workhouse lunatic wards so conducted would effect no saving to the ratepayers. The measures needed to provide in the union-house kitchen a liberal dietary for the lunatic wards and a restricted one for the sane remainder, to control the staff of paid attendants, to arrange frequent walks into the country for part of the community, while the other part was kept strictly within the walls;--these would be inevitable sources of disturbance to the proper union-house discipline, which would entail an amount of eventual expenditure not easily calculated."
If, on economical grounds, the system of Lunatic Wards has no evident merit, none certainly can be claimed for it on the score of its adaptation to their wants and welfare.