The evening herald. [volume] (Shenandoah, Pa.) 1891-1966, 1894-09-13


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, 3"
was published in the New York Medical
journal. DR.. O'Connell is one Of Brook
lyns rising physicians;
Practitioners are often called upon to
treat patients with diseased minds and arc
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
as examiner of the insane for the depart
ment Of charities and correction in Kings
county, in which capacity have commit
ted some 4, 600 or 5, 900 persons to asylums
In New York and vicinity.
The institutions in this state, both pri-
vate 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
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
it was not always so much a 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. / 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 a
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 a limited number Of persons in order
| that each may receive proper attention and
| have proper accommodations. The food
| 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
a 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
those in attendance may request and will
impose upon the good nature of their rela-
| tives. If the physician recommends GER
! tain work for them to occupy their time
| and to divert their minds from the subject
| 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 force? And the continued
| use of force with the insane so affects the
nervous system as to render ultimate re-
covery a 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 OF
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 receiving ware
for several days in order that their form O
insanity may be studied by the physician
in charge. They are then transferred tC
wards set aside for the treatment of theil
special mental disorder, and as they i'm
prove they are gradually advanced The
erroneous idea Of asylums entertained by
the public, as have stated, prevents Tho
incarceration of many Of the so calleC
cranks who are allowed to roam at large
Their relatives think they are not fit sub
jects for asymms because they offer no vi
olence to the family and do not break fur
niture or tear clothes, but only go abou
ventilating their hobbies whenever the,
can find listener. More harm has CONF
from this class of people during the pas
few years than from any other class of in
sane The attacks upon a banker in New
York and uDOn the late maVOr of Chicau,