Nashville union and American. [volume] (Nashville, Tenn.) 1868-1875, 1875-03-03
CARING FOR THE INSANE.
The System Of Centralized Hospital
Accommodation -ImPortant sug.
sestiOus by ~. z. Jones.

Sestious BY y. Il. Jones
To the General ASSaaJlu Of the Slate Of
Tu0csSf6-Gentlemen Some years AGO
the idea of centralizinE hospital acc5mm5-
datiOus for the insane Was both prevalent
and popular; indeed the Legislature Of The
state Of New York, following in toe wake
Of this general clam9r, was really aprOpos-
ing 10 establish another large central hos
pital for the care Of The insane OF the whole
state, making il necessary for The people Of
every COBHty, however near or remote, 10
send their durable patients TO one iustitu-
lion, AZ Utica, and all their incurable pa
ticu-s % another central institution" At
this iuucture, Dr. Edward JlrviS-whose
CJutTiJui ions TO medical literature and ef-
ficieuJ services in behalf Of the insane had
caused him 10 be known and loved through
ont Ams-iCa-Came forward. and with his
Characteristic accuracy and painstaking,
prepared and presented paper, which, as a
Continental rule Of action, has been more
effective than an act Of Congress could
have been; for that paper alone he well de-
serves TIE gratitude Of every philauthrOpic
heart.
To use his modest language, be thought
il "WOTh while TO examine the history Of
the past, and see what has been the effect
of this endeayOr 10 concentrate al the
llmGtics Of the State IN one place, and how
far the blessings Of such an institution, its
privileges and advantages, have been practi-
Cally given 70 and enjoyed by the people in
the various parts Of the State
AT the same time it will be WELL" said
he, "tO examine the history Of similar in
stItutiOns in other States, and see bow far
they have accomplished the whole purpose
Of theil erection, in healing or caring for
the mental maladies of their people in all
their near and remote districts"
Recognizing then, rs you do now, the
fac, that a hospital is, and TO a certain ex-
tent must be, local institution, he pro-
ceeded by carefully analyZing the hospital
reports of tweuty-One States and those of
two Of the British Provinces, and he has
shown, beyond controversy, that sshospitals
have been, and are used, by those who live
near by, much more than by those who
live farther of; and consequently they are
practically much more local in their use
fuluess than they are intended or supposed
to be-
In order, however, to exhibit most ex-
pliCi,ly the extent aud application Of dis
lance in the use Of State hospitals. he COM
menced with the State Of New York, and
the hospital at Utica; he then divided that
State-aud subsequently Others, into sever
al ConcentTic circles OF districts, making
the county in which the hospital is situated
the first and central, and The contiguous
counties the Second District, and so forth,
until the whole State was embraced.
After carefully recording and tabulating
the population Of each district and for
every year embraced in the estimate. be
gave the result in the State Of New York
In the following language:
"FOr these tWenty-three years, 1913 to
1865, in Oneida county, the sum Of the an
nual populations was 2,292,G42 who sent
81 patients, or I IL 2,T72 Of this number,
TO ting hospital, In the Second Distric.,
the sum 0: the annual populations was TO-
52o+}G, who sent 1,SO9 patients, or Lin
$50 Of this number, to the hospital. In
the Third District, the SUM Of the annual
populations was lG,33T,5Z0, who sent 2,222
patients, or / in 1851 Of their number, to
The hospital. IN the Fourth District, the
sum Of The annual populations was 2S,l4G,-
AZ, who sent ,, 40 patients, or ia II, 535
Of their number, to the hospital.
"The advantages ofthe hospital enjoyed by
Oneida county have been more than double
those enjoyed by the counties next beyond,
but within 90 miles; they are nearly
lhIeef0ld those enjoyed by the counties
which are from 60 to 120 miles distant;
and more than four times as great as those |
enjoyed by the people Of the counties
which are more than 40 miles distant.
"This diversity Of advantage of an insane |
hospital enjoyed by the people Of near and |
remote districts, is nOt an accident, nor a |
peculiarly Of New York alone. 1t is a |
general and probably universal principle |
2 natural and necessary law Of nature or of |
in all other Statas whose !
hospital records Of patients residence have |
been obtained, the same law is found to be |
in operation, and the people send their pa
Ijents 10 these institutions in proportion to |
their nearness.
But your patience will not permit ex-
tended reference 70 all the States, the /
records Of which were examined and re- |
ported upon by DR.. Misunderstanding, |
therefore. statistical mater, but preserving /
The most important facts, I present a few |
others and hasten to his conclusions.
The Hospital for the State Of Maine is /
located at Augusta, and has a record Of /
.weniv-siX years. The First District, con-
;Isting of kennebec county, sent TO the
Hospital one in 2,S3j; Second District, one
n j.l71; Third District, one in $500;
Fourth District, one in 1890, Of the PEG
be. annually.
New Hampshire Hospital had been in
operation tWenty-three years; is located in