« VorigeDoorgaan »
eral sermons every day. She professed a proximate one, the prevalence of an into be inspired by the Holy Ghost, and in tense and overpowering excitement, and the intervals of these preaching paroxysms, its contagious influence on persons of high would fall into a partial fainting fit, during nervous sensibility, and you have the newhich she professed to receive revelations cessary conditions for the production of from above.
such epidemics. Her sermons were never delivered when From the description we have already she was alone, but were generally quite given of the causes and symptoms of inwell arranged, and were beyond what her sanity, it will be evident to every person friends believed to be her ability when in of intelligence that its successful treatment health. On the 13th of November, she demands the highest skill of the physician, prophesied that on the 20th of that month and that, while different forms of the disshe should cease preaching, that a girl of ease require variations in the medication, thirteen whom she named was to continue large reliance must be placed on the influit, and that she should die soon afterward. ence of change of scene, exercise in the The predictions concerning the preaching open air, and such means of mental diverproved true, but she did not die.
sion and moral influence as may be proved A sister of this girl, two years older, by experience most salutary. and the girl whom she had designated as The treatment adopted by the priesther successor, were both soon affected in physicians of Thebes seems in part to have the same manner. From these causes accomplished this purpose. For the inthe epidemic spread, and the excitement sane excitement, they substituted the imwith it, until several thousands had been posing forms of a peculiar and secret woraffected, most of whom, at some stage of ship, which occupied the mind, while the the epidemic, attempted preaching, and physical exercise of the long marches, nearly all were affected with the other dances, and other exercises in the open symptoms of the American epidemic, dan- air, promoted healthy action, Melampus, cing, rolling on the floor, barking, howling, the Asclepiadeæ, and Hippocrates, though etc. The people seemed perfectly infatu- relying too much, perhaps, on the mediated, moving in crowds to hear these poor cinal effects of the white hellebore, a powlunatics preach, and listening with apparent erful purgative, still recognized the nereverence to their ranting and gibbering ; | cessity of physical exercise and mental often treating with great severity and vio- excitement, in recommending the chasing lence, physicians and clergymen who at the patients over the hills, playing to them tempted to check their excesses.
on musical instruments, etc. The epidemic finally reached the Lapps, Among the Romans, the reliance was and that singular people, half wild, ignor- mainly upon the medication, and the unant, superstitious, and fanatical, were pro- fortunate lunatic, instead of enjoying exerfoundly affected by it. Believing it to be cise in the open air, was bound with chains the result of a direct Divine interposition and scourged with whips. It was reserved, intended for their conversion, they crowded however, for a later period, the middle around the lunatics, and listened with in- ages, to add to the chains and the cruel tense interest to whatever they uttered; beatings with whips and clubs, confinement and though their faith, thus derived, has in foul, dank, and loathsome dungeons, no inconsiderable tinge of fanaticism, still where, but for their wonderful tenacity of this epidemic has been the means of lead- life, these poor wretches must have per ing them very generally to a higher re ished in a few days. For nearly fifteen ligious life.
centuries, those who were thus smitten of It is worthy of remark, that in every God were subjected to a tyranny so cruel instance in which these epideinics have that it seems incredible. We have noted taken place, they have been preceded a few exceptions to this general cruelty in among those who have become their sub- the treatment of the insane, but the excepjects, by a season of intense fatigue, and tions were confined almost exclusively to generally of mental distress ; that their Gheel, and to the monks of the Pyrenees. food has usually been insufficient in quan- At the Bethlem Hospital, England, a few tity and of inferior quality, and that gastric of the more harmless patients were perdifficulty has generally occurred previous- mitted to roam over the country, on a kind ly. To these predisposing causes, add, as of ticket-of-leave system, begging, and
were generally known as “Tom-o'-bed- have made within the past few years. lams," but the treatment of lunatics gener- Come with me to that extensive pile of ally, not only in the almshouses, but in the buildings which overlooks the valley of asylums and hospitals erected expressly the Connecticut. It is summer, and nafor their use, in England and on the Con- ture has donned her holiday attire ; the tinent, was, up to the very close of the last ample lawns exhibit their brightest green ; century, and in many instances to a still the stately elm, the graceful maple, the later period, cruel and inhuman almost be | beautiful horse-chestnut, with here and yond belief.
there the catalpa, the linden, the oak, and In this country the same cruelties were the willow, afford a shelter from the sun's practiced very generally as late as 1830 ; too ardent rays; graveled walks with though a few hospitals had begun to adopt beautiful borders of flowers, evidently sea milder course of treatment, of which we lected by a connoiseur, attract the eye, will say more presently. As a sample of while, in another part of the grounds, we the sufferings endured by the poor lunatics, find fruits and vegetables in the utmost in those states where there were no insane perfection. But it is not the scenery we asylums, take the following account of a have come to visit. We have learned that case described in 1846 by Miss D. L. Dix, this is an hospital for mind diseased ; that " the good angel of the insane." It is but here are gathered some hundreds who, one of hundreds which she had witnessed. | though once, perhaps, as gay, as graceful, It occurred in Illinois.
as intelligent, and as accomplished as any " It was an intensely hot day when I visited F. |
of those who visit them, are now but He was confined in a roofed pen, which inclosed wrecks of their former selves, and we an area of about eight feet square; the interstices come to see what processes art, science, between the unhewn logs admitted the scorch
and humanity have adopted, to restore ing rays of the sun there, as they would open way for the fierce winds, and drenching rains,
reason to its throne, and to bring back these and the frosts of the later seasons. The place
| mental wanderers to society and to the was wholly bare of furniture, no bench, no bed, delights of home. We enter a neatly furno clothing. His food, which was of the coarsest
nished parlor, and presently a fine, gentlekind, was pushed through spaces between the logs ; fed like the hogs, and no better,' said a
manly man, with a quick but mild gray stander-by. His feet had been frozen by ex eye, and a look which speaks of ardent posure to cold in the winter past. Upon the zeal in his profession, and a sympathy for shapeless stumps, aided by his arms, he could suffering humanity which no trials or disraise himself against the logs of the pen. In
appointments can overcome, welcomes us. warm weather, this wretched place was cleansed once a week or fortnight; not so in the colder
He inquires if we wish to look through seasons. We have men called,' said his sister, the wards. We reply that it would give
and they go in and tie him with ropes, and us pleasure ; and bearing in mind the throw him out on the ground, and throw water
| cruelty which has so recently been pracon him, and my husband cleans out the place.' But the expedient to prevent his freezing in
ticed on the poor lunatic, we ask, with winter was the most strangely horrible. In something of a shudder, to be shown the the center of the pen was excavated a pit, six apartments where the most violent patients feet square and deep; the top was closed over
are kept ; half expecting and half dreading securely; and into this ghastly place, entered through a trap door, was cast the maniac, there
to see some cold, cheerless dungeon, or, to exist till the returning warm weather induced at least, some dark basement, where gloom his care-taker to withdraw him; there, with ever prevails, and where the screams of out heat, without light, without pure air, was
the furious maniac, and the clanking of his left the pining, miserable maniac, whose piteous groans and frantic cries might move to pity the
chains, will be the only sounds that break hardest heart."
the deathly silence. The physician takes Well might the mild and gentle Cowper,
us through the corridor of the main build
ing, and passes out into a yard of considerhimself afflicted with insanity, though hap
able extent, with its trees and flowers. pily spared such a terrible experience, say:
Here sitting, or lying under the trees, we “There is no pity in man's obdurate heart; see several patients, whose countenances It does not feel for man.”
proclaim their disordered minds, but to Contrast this horrible picture with what whom perfect freedom of motion, together may be witnessed daily in any of our well with the pleasantness of the day, seems to conducted asylums, and see what progress have imparted a degree of contentment. the principles of humanity and kindness | “There," whispers the superintendent,
“ Because you
when we have passed them, “are some of juncture, a female patient (this was the the worst patients which we have." We female ward) approaches, and with the enter a building of a single story in height, sly look which characterizes certain forms but containing high, pleasant apartments of insanity, began to importune the doctor on one side, and a large, wide, and well- to permit her removal to the main building. lighted hall extending nearly its whole “ Not yet,” said he pleasantly, yet firmly. length. The furniture is plain but neat, “But why not?" she urged with considerand well secured to the floor. Around the able pertinacity, her voice rising with each walls are hung a series of beautifully col- repetition of the question, till its treble ored French lithographs, heads of children, notes approximated a higher octave than pictures of animals, or landscapes. On was altogether pleasant. the benches, and around the tables, are cannot yet control yourself,” was the reseated a number of patients, whose hag- ply ; “people in the house behave themgard countenances show that their minds selves quietly.” The reproof was suffiare disordered; but they are quiet, and two cient. She sank to her seat, and sobbed of them are playing at a game of draughts. out, “I will control myself, doctor; I forgot We look into the bed-rooms; no patients to-day.” are in them now, though the physician tells But we have lingered long enough us that sometimes they are obliged to put among these poor wrecks of humanity. them in even in the daytime ; no great Many of them will yet recover, pitiable as hardship, it seemed to us. We have often, seems their present condition. We return even in fashionable hotels, lodged in worse to the main building. Here, in one ward,
The window-sashes are iron, to we find those who are but a step higher be sure, but it requires quite close inspec- than the maniacs we have just left; yet tion to distinguish them from ordinary some of them are sewing quietly, while sashes; there is a network grating, but it others are reading works from a wellrequires but little imagination to trans- selected library in the ward. Here, too, form that into musquito bars. The bed is a are pictures, scattered along the walls of good one, and though the bedstead is firm- the ward, and in each room, occasionally, ly secured to the floor, it sleeps none the we are reminded that we are not among worse for that. Each corner has its seat. the sane, by seeing a patient crouched in The ventilation is perfect, and can be con one corner, with that fearful, wild extrolled from without, as can also the tem- pression, which tells at once of reason perature, which is regulated by thermome- dethroned. ter. A small window opening into the We pass next into another ward, where hall enables the attendant to watch the we find carpeted halls, libraries, musical patient. There is nothing in the room instruments, and the evidences of mental which the patient can use for his own in- and bodily occupation, in the sewing and jury. At either end of the hall are bath- fancy work around the room. ing rooms, where the soothing influence tastefully attired ladies, whose manners of water, warm or cold, as the patient can and address would do no dishonor to any bear it, is applied to calm the perturbed drawing-room, and we are tempted to ask spirit and dispose to quietness and repose. our guide, whether we have not, by mis“ But where is your restraining apparatus," take, intruded into a sewing circle, instead we inquire; "your hand-cuffs, muffs, co of passing through the wards of an insane ercion-chairs, strait-jackets, etc. ?” “We asylum. On visiting the male wards we do not use such things,” replies our medic behold equal evidence of refinement, intel cal friend, with a smile; "the day is past ligence, and comfort; and although occuwhen they were deemed necessary. The pation in the open air, in gardening or only restraining apparatus we ever find farming, or in the more active games, occasion for, and this only in rare instances, seems better suited to the tastes of many is a canvas apron with sleeves attached of them, still, here and there a quiet stupartly to the sides, and this only to pre- dent may be seen poring diligently over a vent the patients from doing themselves book, and beguiling thus the weary hours. injury. Our aim is to induce the patient In one room an artist (insane like the to exercise his own will in restraining his rest) has set up his studio, and portrays insane impulses, and our success in this is from nature landscapes such as never beyond what you would expect.” At this gleamed 'neath Italian or Scandinavian
skies. “ His devotion to art is gradually qualification in the “cheap” help emdrawing him out of his insanity,” says our ployed, were not fitted to make the insane friend.
patient regard it as other than a prison, in We next proceed to the chapel, where which he was unwilling to be confined. every evening the chaplain conducts the Through the efforts of Dr. Conolly, Dr. devotional exercises of this invalid family, Thurman, and others in England ; Docand on the Sabbath ministers with gentle tors Damerow, Jacobi, Roller, and others and soothing admonition and encourage- in Germany; and Doctors Bell, Kirkbride, ment to sorrow-stricken hearts. Here, Ray, Earle, Butler, and others in this countoo, are occasional concerts held, and try, a complete change has taken place in the accomplished assistant physician lec- these particulars, in all the recently contures during the winter evenings on structed buildings for the insane in Europe natural science, illustrating his subjects and this country. by drawings, by the oxy-hydrogen micro The new insane hospitals bear no rescope, and by the magic lantern.
semblance to a prison. Their graceful Such are the reminiscences of a visit to architecture and imposing appearance a modern lunatic hospital; a place so give them rather the semblance of some pleasant, that, as a lady of our party said, palace in which royalty has provided for “If it were not for the name of being the comfort of its numerous retinue ; but crazy, one would be better off there than no royal palace was ever built with such at home.”
studious regard to the health of its inIt is impossible to impress too strongly mates. upon the minds of the public the para Pure air, rendered cool by forced ventimount importance of early treatment in lation in summer, and warmed by unseen, insanity. To wait till the patient becomes but not the less effective agencies in windangerous before placing him in an insane ter, pervades with its life-giving agencies asylum is, in a majority of cases, to de- every part of the edifice. Water is supprive him of a reasonable hope of recovery. plied in the utmost abundance in every The statistics of insane institutions are part of the building ; the cells are abol. full of instruction on this point. It is ished ; the instruments of terror and torsatisfactorily ascertained, from observa- ture are banished ; the harsh medication of tions made for long series of years, both former times relinquished, and physicians in American and foreign institutions, that and attendants selected for their gentleof the cases admitted to insane hospitals ness, patience, and intelligence, minister within less than one year after the onset to the comfort and welfare of the insane of the disease, over eighty per cent. re- patient; while books, pictures, maps, cover; of those admitted within six months, recreations, and light and agreeable labor full ninety per cent. are cured ; while of divert his mind. As to medication, it those which have continued from two to seems to be the generally-received opinion five years, before being subjected to treat- of superintendents of insane hospitals that ment, not more than from fifteen to twen no medicines, devoted especially to the ty per cent. are ever restored. The great cure of insanity, are of much use. It improvements which have been made may, and does often happen, however, that within a few years past in the construc some attendant symptom may require the tion and organization of insane 'hospitals, administration of remedies. Narcotics, and in the laying out of the grounds around in some forms of the disease, may allay them, has greatly increased the per cent. excitability and produce sleep; tonics may age of recoveries, while it has also aided increase the strength of the system, and in promoting the health and comfort of thus enable the patient to throw off the those who are incurably insane. Former- insanity caused by exhaustion ; or astringly, and at no very remote period either, ents, and even vinous stimulants, may be the lunatic hospital was only a better sort indicated in particular cases; but mental of jail. Its cells for refractory patients, disease, as such, can seldom be driven called by courtesy “strong rooms," its from the system by physic. coercive apparatus of tranquilizing chairs, The whole subject of insanity in its strait jackets, handcuffs, muffs, carnisoles, symptoms, history, prognosis, legal : straps, and bolt baths, its imperfect ven- tions, and treatment, has been tilation and drainage, and the want of few years past very thorough
gated and discussed by the host of com- tion, (forced ventilation, and steam, or hot petent writers and observers at the head / water, heating are preferred,) construction of the various hospitals. A very large of wards for the excitable patients, etc. number of works on insanity have been 2. As to Organization.—The Board of published in Europe and in this country, Trustees should be the general controlling and five very able quarterlies are devoted power ; should be composed of individexclusively to this subject. There are uals distinguished for liberality, intellithe American Journal of Insanity, publish- gence, and active benevolence; should be ed at Utica ; Dr. Forbes Winslow's Journal | so elected, as not to be influenced by politof Psychological Medicine, and Dr. Buck- ical measures or changes, and not more nill's Asylum Journal of Mental Science, than one third of the number should go published in England ; . Professor Dame- out of office in any one year. row's Journal fur Psychiatrie, published at The Board of Trustees should appoint Halle ; and the Annales Medico-Psycho- | the superintendent, and on his nomination, logiques, published at Paris. Associa- and not otherwise, the assistant physician, tions of the superintendents of lunatic steward, and matron. They should exerhospitals, too, have been established in cise a strict supervision over the instituthis country, and also in Europe, where, tion in all its departments. The superinby a free interchange of opinions, and the tendent should be a physician, and should discussion of carefully-prepared essays, be selected for his superior fitness for the much light has been thrown upon every post in all respects. His term of service department of mental disease. The Amer- should be during good behavior ; he should ican Association, at their session, May 10, reside on, or very near the premises; and 1852, laid down certain " propositions” his compensation should be so liberal as relative to the construction, organization, to enable him to devote his whole time and arrangement of insane hospitals, and energies to the welfare of the instiwhich receiving the cordial assent of the tution. After defining the duties of the members, have come to be regarded as subordinate officers, the “propositions" principles to be adopted in the establish- require that there should be a general sument of new hospitals. We have room pervisor (in each hospital of two hundred only to give an abstract of a few of the patients) of each sex, to have charge of most important:
the attendants, and to communicate di1. In regard to Construction.—Hos- rectly with the superintendent, and that pitals for the insane should be in the coun- there should be not less than one attendtry, not less than two miles from a large ant to every ten patients, while a larger town, and easily accessible. No hospital number would be preferable. (Several inshould have less than fifty acres of land stitutions actually have one for every seven for farm and pleasure-grounds, and none in- | patients. The attendants should be acttended for two hundred patients or more, ive, vigilant, cheerful, and in good health. should have less than one hundred acres. They should be intelligent and trustworthy,
Not less than ten thousand gallons of and the compensation should be such as water daily should be provided, and this to secure such persons. contained in reservoirs which will supply Dr. Kirkbride, superintendent of the the highest parts of the building.
Pennsylvania Hospital for the Insane, in The highest number of patients for one a valuable essay on the “Construction and institution, should be two hundred and Organization of Hospitals for the Insane," fifty, while two hundred would be a prefer- has made a very commendable effort to able maximum.
induce a more correct nomenclature in The hospital should be constructed of speaking of these institutions and their stone, or brick, with metal or slate roofs ; inmates. He insists, and certainly with should have at least eight distinct wards justice, that the terms lunatics and lunacy, for each sex, and should have in each although in common use, are inappropri ward all necessary means for comfort and ate ; that insane is the only proper term proper treatment of patients. (These are to describe those who are of unsound mind, specified in the propositions, and also their | and that the names of Lunatic Hospital, mode of construction.)
Lunatic or Insane Asylum, Retreat, etc., Then follow special directions in regard often applied to the institutions for their to mode of construction, heating, ventila- | care and cure, are likewise incorrect; that