It is scarcely 20 years since those interested in asylum administration in Scotland began to realise that the interests of the sick and infirm were not so adequately provided for in asylum construction as the requirements of such patients demanded. The desire to improve the efficiency of asylums by providing ampler accommodation for the treatment of that class of patients gradually extended itself so as to include within its scope the treatment of the acutely insane in combination with the sick and infirm, that is, all the inmates of asylums who especially require the services of the physician and the nurse. This idea again expanded itself until a rearrangement of the whole asylum population into two main portions was proposed. The smaller portion was to consist of the newly-admitted cases, of cases requiring special medical attention for any reason, and of the sick and infirm cases. The larger portion was to consist of the quieter chronic and industrious cases for whom the same active medical and nursing supervision was unnecessary. This, which may be called the hospital movement in the Scottish Asylums, has now attained practical expression, and has with considerable variety certainly, yet with conspicuous uniformity in its main principles, been adopted in upwards of 50 per cent. of the public asylums of the country.
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