Workmen's advocate. (New Haven, Conn.) 1883-1891, 1890-02-08

slcians employed; in onl four or five
others were physicians required to visit
daily. In majority of these institu-
tons the physicians visit from one to
three times weekly, according to the
terms Of their contract with the surerin
tendent OF the poor or other authority.
These institutions are, in most cases in
the charge of a "keeper", while few
of them are directly controlled hy the
superintendent Of the poor, or, if there
bo more than one superintendent in a
county, by the resident uperintendent.
1t is not pretended that these keepers
are in any way qualified, either by train
ing on previous experience, for the care
and supervision of insane patients, even
assuming that such patients are not sick
persons. as they concededlv are. The
qualifications and capacity of these keep
ers for the particular work-and here it
may be proper to state that there is no
disposition on the part of the commits
sion to unduly critiCise the intelligence
or the requirements of the officers in
charge of the insane departments of the
poorhouses- may be Judged when it is
stated that their compensation does not
on the average amount to more than
$500 or 500 per annum. In fairness,
however, it should be added that they
also receive maintenance for themselves
and their families. They have the gen.
eral oversight and charge of these insti.
tutions their word is law and they are
subject to no control other than the
power that appoints them.
prospecting the use Of mechanical re
straints in the treatment of the violent
or disturbed insane, a matter which,
perhaps, has engaged the attention of
the public mind more than any other
in connection with the management of
asylums, it is well established that, if
permitted at all, they should be supplied
only under the direction of medical
officer in each instance. Yet the com.
mission found in these county aims,
houses that it was the exception rather
than the rule for restraint to be pra-
scribed by physician. the common
practice being to apply restraint at the
will of an unframed attendant or EN-
ploye; in other words, restraint is ap- |
Piled whenever, in the discretion of |
such employe or attendant, it is sup
posed to be needed. No record is kept
of such application. In one instance the
physician present was not able to give
the name or mode of application Of a
certain kind of restraint which was
exhibited In fact, he claimed that he
did not know of its existence in the in
stitution, and yet the attendant said
that he (the attendant) had frequently
used it,.
The Commissioners conclude that the
present system has proved most COM
pIete and inhumane failure, and recon-
mend that all the insane in the county
poorhouses, except New York and Kings
be transferred to State Asylums. Why
New York and Kings should be exempt
does not clearl y appear, in view of the
monstrous abuses and actual crimes
which recent Investigations have dis
closed in the public and private insti-
tutions of these two counties.
Owing to the insutficiency of statist.
cal records the rate at which insanity is
increasing cannot be given but the fact
of an increase is admitted by the Com
missioners and attributed by them to
"the conditions peculiar to civilization,
which tend to undermine both bodily
and mental health" They should have
said the conditions peculiar to civil
ization under copitaiiSns''; for it is GER
tainly possible to conceive of civiliza-
ton under system that would not
drive people naturally virtuous into
debauchery, that would not constantly
overtax the nervous machinery of the
human being by constant fear of ruin,
idleness, starvation, and other like evils
peculiar to capitalism.