The Indianapolis journal. [volume] (Indianapolis [Ind.]) 1867-1904, 1883-12-14
DIR. FLETCHER'S REPORT.
The Condition of the States Asylum
for the Insane.
Restraints Said To Be Practically Aban dOned
Suggestions and Recommendations
of the Superintendent.

The thirty fifth annual report from the super
intendent of the Indiana Insane Hospital was
submitted to the Governor yesterday by Dr. W.
b. Fletcher. There were, at the beginning OF
the year, he reports, 1,oS5 patients-626 males
and 459 females-in the hospital. During the
year 394 males and 304 females have been ad-
mitted, $40 patients were discharged and there
were 10s deaths. The number treated was l.
095 males and sos females, making the total l.
1885, There are now In the hospital LILO pa
TENTS, and the average number daily is 1,112
The average expense per capita is $194 a year
DR.. Fletcher dismisses the discussion of these
statistics with the statement that "the practical
management of so large a hospital for the
period of five months would not warrant one in
writing essays upon the definition of insanity,
the pathology of the mind or etiology OF the
various forms of mental disease. In fact, it is
of doubtful utility to display strictly professional
knowledge in report which is intended TO give
information to the people rather than to the
profession"
In speaking of the changes which have been
made in the institution, the superint enden5 says
that for the more economical storing and issuing
OF supplies, the large diniDg-rUom OF the depart
ment for men has been added to the store ROOM
thus doing away with the former method of
issuing In bulk to several persons in as many
places. This arrangement makes it necessary
for the employees Of the farm and department
Tor men to take their meals in the general
dintng-room In the department for women. The
two dispensaries, one for each house, have been
consolidated The use of medicinal agents has
been much reduced. Stmulants and tonics are
mostly required, because patients brought TO the
hospital are in a condition of debility. The
stimulan5 formerly used was whisky, either
diluted with water or combined with cod-liver
OIL About three gallons day was consumed.
Now one pint is quite sufficient, an extra malt
beer having been substituted with marked ben
eht to the class of patients who lack appetite.
An Improvement has been observed, specially
among the female patients, since the change.
Religious services are held regularly. In no
instance, the superintendent says, has any pa
uent been made worse, whilst the beneficial in
huence has been felt by all. The former custom
OF secret bur1als has been abolished and public
funeral services are now held by the chaplain.
Thls change has given Satisfaction to the friends
of the deceased and has had kindly influence
upon the minds of all.
Whatever benefits the patients derive from
medical treatment, DIR. Fletcher thinks, should
charge of the case, and he makes special
acknowledgements of the value OF the services of
each of the assistants.
Moral-force methods he says, are stronger
than physical restraint, and this belief has
caused the superintendent Co abolish the use of
209 restraint chairs, 120 cribs, 101 camisOles,
10Y restraint straps, So waistlets, 80 pairs of
gloves, IL pairs OF anklets and leather collars.
While just few cases are restrained by some OF
the gentler means, during short periods
OF their occasional excitement, 1t
IS hoped that in short time,
rooms, no vestige of the restraint method or
treatment will remain. The sympathetic asso-
citation OF the attendants with the patients has a
good effect, and this is of the most essential
features to successful treatment. "Without at
tendants," Doctor Fletcher says, "who pure
minded lovers of the work, no hospital for IN
sane can be successfully managed ON the hu-
name plan of non-restraint."
1t is found by examination that the insanity
of the female patients Is attributed in the ma
ority of the cases. to the diseases peculiar their
sex. II is important that female physician
ne says, should have charge of the womens de-
partmenJ.
By the completion of eight new wards In the
department for women space will be given for
all acute cases that may be received for some
time TO come. The department for men, how
ever, is not so cOmmOdious. Its capacity is
much overestinated. II is supposed to have a
capacity OF 64O. whereas IL Is actually only 900
One of the additions to the hospital will be pushed
TO completion as early as possible, but it will not
be ready for occupancy for the next two years.
and there will be much suffering among the in
durable insane throughout the State until then |
Changes will be made in number of the |
wards by converting the dormitory in each into
ID eort of work and play house for the patients.
The funds appropriated for the maintenance |
of the institution the superint endent says, WILL
by ee0nomlcal management ne sum clent but |
there will be surplus at the end of next year. |
After speaking of the changes which nave been |
made in the organization OF the institution by
the death of DIR. Walker, and the resignation of
Drs. Rogers and Hubbard, the superintendent
makes grateful acKnowle dgement of the services
of his assistants, Drs. Thomas, Smith, Brown aud
Brandt, and TO Others.
The trustees of the hospital report that an in |
ventory OF the property shows an estimated val |
ne real estate of 1882, $50. and of personal |
property $l10,464. The appropriation for main |
tenanee was $245, 900. and of this amount S2l s.
Ara 05 was expended. OF the appropriation of |
So 500 for repairs there is unexpected bal |
ance of 1915. The amount spent for clothing |
was $10.OS1.22, and there is a |
balance to the credit of this fund |
OF $4,5S0,30. The total revenue of the |
Institution for the fiscal ear was 1926. 4S0l6 |
of which there is an unexpended balance of |
$62, 42S.73. The trustees call attention to the |
adjustment of nearly all mechanical restraints |
in the treatment of the insane. and state that |
ga long step has been taken in the direction of |
progress and reform" They hope soon be |
able to report the use of restraints whatever |
The capacity of the hospital will soon be in |
creased to 1,450 patients. The appropriation |
for the maintenance of this increased number is |
but they hope to be able under strict
economy, to care for many more than have been |
formerly provided for, "even under the unwise |
working of the law, making continuous apprO |
priarions, which restricts the use to One-twefth
of the amount for any one month OF the fiscal |
year. The law works hardship when the |
amount Is close. 1t is not in accord with econom |
ical management"
Mysteriously Missing.