The Portland daily press., 1894-09-12

1
Minds - Trouble From Trying to Get
Along With Lunatics at Home.
The following mastery and interesting
article, written by DR.. Joseph j. O'Con-
nell, examiner of the insane for the de-
| partment of charities and correction, upon
Asylums as the Proper Place For the
Treatment of Alienation of the Mind, "
was published in the New York Medical
journal Dr. O'Connell is one of Brook
lyn's rising physicians:
Practitioners are often called upon to
treat patients with diseased minds and are
then confronted with this problem: Is
asylum treatment more beneficial, or can
they be treated and receive equally good
care at home? l take the liberty Of an
swering this question from my experience
~ examiner of the insane for the depart
ment of charities and correction in Kings
county, in which capacity have commit
ted some 4, 200 or 5, 900 persons to asylums
In New York and vicinity.
The institutions in this state, both pri-
yats and public, are under the jurisdic-
tion of the state commission in lunacy,
and the first important step in the ad-
vancement of the treatment of the insane
dates from the time when commissioners
were appointed to supervise the manage
ment of these institutions A few years
ago any person, whether physician or lay
man, citizen or foreigner, could establish
retreat for the insane and employ what
ever treatment he pleased with the unfor-
tunates who came under his charge, and
1T was not always SO much question as
to the recoveries affected as it was as to
how long could the patient be retained
under the plea of insanity-while the rev.
enue came in.
The amount of room allowed to each in
mate or the number over which each at
tendant should have charge was never
considered. If patients were not over
crowded, it was due quite as much to the
lack Of demand for the extra space which
they temporarily enjoyed as to the good
Judgment of the person in charge. With
but few exceptions the state and county
institutions were no better governed The
superintendents and subordinates were
not selected on account Of their fitness for
the positions, but were appointed through
political influence. I am pleased to say
that at the present day the public and pri-
vate asylums in New York state are equal
to If not better than any others in the
world
The state commission does not grant
permission to any individual to conduct
private asylum unless it is in charge Of a
physician who has had considerable ex-
perience In the treatment Of the insane
and who is well qualified to manage such
an institution. These asylums are licensed
for limited number of persons in order
that each may receive proper attention and
raY, on lo+f o. i
must be of the best quality and sanitary
requirements are very exacting. Asylums
are In the treatment of the insane what
hospitals are to the sick-in fact, they are
combination Of hospital and home.
The insane are very cunning They
often know that their ideas differ from
those of the persons with whom they con-
verse; that they are alone in their belief
and for that reason, when questioned by
physicians or others, will not answer ac-
cording to their belief, but in accordance
with the ideas of the questioner. At home
the family feeling toward them is well
known to them; they will refuse to do as
impose upon the good nature of their rela-
t1yes. If the physician recommends GER
tain work for them to occupy their time
<SAA>A
of their mania, or if walks at certain hours
of the day are advised, they feel that their
movements are closely watched, and it is
useless to try to convince them to the con-
trary. If these simple Recommendations
cannot be carried out at home, how can
any systematic treatment be given with
out the use of forcei And the continued
use of force with the insane SO affects the
fo ,xI%
covery doubtful question. The principle
rule to be followed is that the insane must
be led and not driven.
The estimate entertained of the insane
by the public renders it an enemy to asy-
lums. They are supposed to be wild set
confined in building like wild animals,
who are restrained at night by chains or
by some other means; that the mild and
the violent are placed together and that
the latter are always ready to pounce upon
others when they approach them.
1t should be considered that the insane
are classified; that, on entering an asy-
lum they are placed in a receiving ward
for several days in order that their form of
insanity may be studied by the physician
in charge. They are then transferred to
wards set aside for the treatment of their |
special mental disorder, and as they i'm
prove they are gradually advanced. The |
erroneous idea of asylums entertained by |
the public, as I have stated, prevents the |
incarceration Of many of the SO called |
cranks who are allowed to roam at large.
Their relatives think they are not fit sub |
iects for asylums because they offer no vi |
olence to the family and do not break fur
niture or tear clothes, but only go about |
ventilating their hobbies whenever they |
,an find a listener. More harm has come |
from this class of people during the past |
few years than from any other class of in |
sane. The attacks upon banker in New |
York and upon the late mayor of Chicago |
are still fresh in the minds Of the public.
In both cases the progress Of the disease |
was slow, but SO well marked that the Pc |
,uliar actions and ideas Of the individuals |
we're known to the relatives and friends /
months prior to the commission of their |
grimes.
1t must not be forgotten that insanity |
Is often communicated from one member |
Df the family to another when there is |
hereditary basis for it's development In /
such families prompt action is necessary. /
Two cases illustrating this came under
my notice as examiner of the insane. One
was that of young widow who had been
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