and nourriciers of the commune, is then consulted. The hôtes (hosts) are those who take lunatics as boarders; the nourriciers (fosterers) those who take indigent insane. As a rule, each hôte or nourricier is expected to take only one patient; but many exceptions are allowed, and a liberal construction is indulged in. The food is usually about the same as that of the family with which the patient lives; consequently, the comfort of the latter is to a large extent dependent on the pecuniary condition of his host, though the price he pays for maintenance may be the same. In this point the close asylums, where the table-provision is uniform, or is varied according to a system, may have some advantage over Gheel; but this advantage is probably more than offset by the freedom of the open air and exercise, and the country life which the sojourner at Gheel enjoys.
The air capacity, the furnishing, the cleanliness, and hygienic condition of the patient's lodgings are carefully provided for in the regulations and secured by the inspections-at-will of the sectional guards. Patients able to pay a larger than the usual price can secure quarters to suit them; then the administration, being informed of the stipulations of the bargain that has been made for them, see that they are carried out. The board, whether of the self-paying or of the indigent patients, is paid through the permanent committee. The price of board is fixed anew at the beginning of each year. It is not absolutely uniform for any class of patients, but is subject to variation, according to the particular circumstances that may exist.
A considerable responsibility is incurred by those among whom a lunatic is put to board, and in many instances the position of his guardians is no sinecure. They are at once furnished by the administration with a register, in which are recorded his name, age, sex, civil state, and profession; and in this register the physician, inspector, and guard of the section have to enter their names every time they visit the patient, with such notes as will constitute a kind of history of the case and a financial account-current.
The nourricier has to answer for all the waste and damage his patient may commit, and, together with the guard of the section, is held responsible if he escapes; and he is liable to punishment in case he allows himself to commit any act of violence or hardship against his ward. Only in case of extreme danger from a raving lunatic is he permitted, in self-defense, to exercise restraint upon him. The physician has the sole right to prescribe coercive measures. Like all other institutions of the kind, Gheel has passed through a period when measures and instruments of coercion were freely employed; but they are disused now, here as elsewhere.
Instances occasionally occur where the attendants use force toward the insane, but they are made cases for discipline. It is to be observed, with reference to this question, that each patient at Gheel has not one or two only, but several thousand persons observing him. In
