New-York tribune. [volume] (New York [N.Y.]) 1866-1924, 1889-05-20
THE CARE OF THE INSANE.
TILE SYSTEMS OF OTHER LANDS.

ga @. p Putnam's Sons.
This interesting volume contains the results Vi
An investigation of foreign charitable
and especially of the various xmas oi psO.
made for the insane poor, made during an go -
tour BY the president Of the New 10TH 80
Charities; and the volume is prin'eo ~ WV sipb
of fpsthering the calculation OF suolecI "n''n
,ns,s,;aI,v concerns. not only the State as d
,,hola but each one Of its citizens" reuo-
.,.o,.,. ,ntroduotion serves to remind the reader
80 ,.~,, raccnt is the growth OF the enhsnoeheu
continent which has amclorated the lou VI QUO
,rsane In nearly oil civilized countries Less 'i
a hundred wears ago sufferers from uleh'"i ui''a90
were treated worse than were wiz oeis's' "
sootlapd the last burning OF woman Us Nltcn
,oot nlaee. In England, France and otner EURO
,cop countries the insane were chained IN niIhS
nrisons. floggcd half starved, bedded on olr'y
straw confined in straitjackets, ana In every way
abused and tormcnted. Even down 10 ieaV INC
,bcoyy Of mechanical restraint was cfung 10 IN inc
English asylums, though in France flnei nao
aar,onstrated. a generation previously, the fu
.n,,,, and mischieyousness Of this treatment The
heHcf in force was very slow TO die everywhere
10, p,pel md Connolly succeeded at last IN over
coming 4. and as the scientific study OF aliemsin
aoyeloned a more humane system replaced the oIu
barbarous methods
The advance from the time when the uniorI
unate patients of Bethlehem Hospital commonly
called Bedlam) were regularly eXhlDlted W ','e
unhlic like q men0gerie OF Wild anlmalS' :" VIZ
modes of treatment described here by Mr. Ae'cu
worth. is certainly great enough 10 DC ehcoul"o
,nc. Int il would evidently be mistake W GU"
clude TINT thoroughly satisfactory soiuVion
a most difficult problem has yet been a''"iN. ~,
MIR Ietchworth's investigation took nun o'o, W
nrincipal insane asylums OF England "ooU"%N
ireland, France and Germany. EVery"hoi0 A0
fonnd conscientious effort 10 alleviate 'he coh
dition OF the insane ard TO restore them 10 SahiN'
In the English institutions particularly inc COIL
fort OF the pat ,ntS is carefully cohsu'ou' anu
notb,nu is ueglc ed which can maintain high sani-
.a,y condition Many of the aSymms appear to
he as well arranged and equipped as SO many
hotsls The provisions for warmth, ventlatlon'
cIoanliocss. supervision, amusement occuphuon'
sxcrc,se are thorough The employment oI drugs
IN ouirt noisy patients is almost as obsolete as tc
use OF mechanical restraints. In some asy nuns
even. the padded room is scarcely ever useu' Uile
rractice heinz TO multiply attendants IN Vlolen1
coses and BY ceaseless vigilance prevent them
from iniuring either themselves or others
In scotland, and at Gheel in Belgium and Alt
Scberbisch in Germany the boardlnG-ouu SS
tenn is being largely followed. or course inns can
ne ayailed Of only with mild cases. anu uie
manner in which it is applied varies greatly Inc
Scotch method is the most primitive, the p"HeL'e
being simply apportioned among cottasers' "Hs
arc clad TO increase their income in this way and
,rho r,ovide humble accommodations for class
meyer accustomed to comfort or luxury Inc
,.,roirls OF course is that 1t Is
rorch hotter for the insane To hNe
n life differing in few respects from tha'
familiar 20 them when they were sane than 10
have all their conditions radically changed as
must be the case with those who are kept IN
Ioroe ASYLUM. At the French colony OF flu
lanes. as at Alt-Sclerbisch and most OF inc
English a>ylumS it is sought 10 occupy the patients
in healthy outdoor work as much as Possi'ie'
No compulsion is used, and frequently ~ uakcS
some time to persuade the patients 70 WORK.
but gradually the majority interest themselves
in the occupation and then they become accus-
toned to it, and rs rule, benefit by II physicaiy
Gradually the "open door system" Is oelng an
troduced That is to say, bolts ana bHrs arc
being dispensed with throughout these inseit''
lions walls being lowered in the exercising courts
or even removed altogether. Kindness ana morai
suasion are substituted for force and while there
can be no doubt that the change involves increased
expense and much higher standard OF intelh-
pence and self.control in the attendants Its ad-
vantares are beyond question, aud its practical
In the colony OF Fitz-Jsmes the asylum supports
i,self a large tract of fertile land being Guilt
waited by the patients under the direction OF
sane assistants. In this way fruits, vegetables
cereals, and dairy products are raised IN arse
quantities Many industries are also carried
on in this and other asylums, and IL is ionhd
,hnt the fullest and steadiest occupation Is most
conducive to recovery. MIR. Letchworth gives
illustrations of many Of the dinirs -halls dormi'
tories, cottages and general arrangements OF
these institutions Several Of the dinng.halls
would be considered noble apartments II found IL
fashionable hotels and the service is generally
excellent. Dancing and other social recreation'
are freely resorted to and greatly enjoyed Plenty
OF exercise is one Of the strctest rules On th'
system most general and with the means at dis
posa it is difficult to see how the treatment coulC
be improved But here arises most importan
onestion, namely is the congregate system on
the results OF which Justify It's deflnitve adop
,ionp Judging from the opinions of many DIS
tinpujshed aEcnists collected by Mr.. LetchwoIt h
this yftal question must be answered IN the mega
tive and this is the more serious because, both II
opr own country and Europe, the tendency TO
years past has been more and more in the direC
ton of huge buildings inclosing crowds OF pa
tients.
where there are several hundreds Of patient
nnaer one roof it nay be possible to malntal
order and discipline. but it is not practicable I
secure the conditions most favorable to recover,
In these cases the medical men in charge are ur
able to bestow careful attention upon the insan
committed TO them. They cannot find time
study individuals, to aequaint themselves wit
their past history. 10 learn the exact LaSlre {
the Alterations Thus the superintendent Of th
great Hanwcll Asylum declared that he did ne
and could not know the faces Of his patients, muc
less the history Of their cases. Nor is this ii
only disadvantage Of the congregate systems. Ii
evitably the life Of sreat asylum is one Of disc
piinc and strict regulation. 1t is a public inst
tuition. and resembles prison in many ways I'll
patients are necessarily not free from excitin
causes. The association with lunatics is motor