St. Paul daily globe. [volume] (Saint Paul, Minn.) 1884-1896, 1896-01-31
THESE CLASSES GET MUCH ATTEN-
TION IN SECRETARY HARRIS
NEW BULLETIN.
NO RESTRAINT BY DEVICES.
PRACTICALLY THE PRESENT POL
ICY IN THE MINNESOTA HOS
PITFALLS FOR INSANE.
PAUPER INCREASE TERRIBLE
Urban Districts Show Double the
Number There Were In
- 1890.


| ntS
An elaborate and hitherto imprinted
statement of the extent to which in
sane patients are restrained by force
in this state is an interesting feature
of the quarterly bulletin of the state
beard of corrections and charities
which was presented at the meeting of
the board yesterday for the first time.
The article is as follows:
A great change has occurred in the prac-
| tice of the Minnesota state hospitals in the
use of mechanical restraints during the past
twelve years In 1888, out of 500 patients,
usually twenty-five or thirty would be either
| shut up in rooms or in grated GRID Deds,
strapped down to chairs or wearing CANT
soles, muffs belts, wristlets, etc. A similar
practice existed at Rochester
! All this was gradually changed, until the
use of mechanical appliances has been prac-
tically discarded. At the Rochester state
hospital, Dec. %. 1885, out of l12O patients
one had her hands confined to prevent in
jury to herself. One very weak patient In
advanced stages of consumption had her feet
fastened because she exhausted herself by
confined to their rooms for part OF the
day. The superintendent of the st. Peter
state hospital stated that all mechanical ap-
pliances had been discarded there for the
past three years, and this practice conforms
to that of many of the best hospitals in the
United States.
The officers and nurses in both hospitals
testify that the new system is greatly prefer
able to the old one; that it prevents needless
suffering, and that the number OF accidents
is not increased but decreased. Wherever
possible exercise, baths and other diversions
are employed instead Of force, but when 9TH
er measures fail the violent patient Is held
by the hands of one more nurses until the
violent paroxysm passes away Under this
method the nurse is under no temptation 10
continue the restraint any longer than is
absolutely necessary, but is likely to use ev-
cry device that experience and tact can sug-
gest to induce the patient to control hlmseI
The Fergus Falls hospital has been one OF
the foremost hospitals to advocate ana prac-
tice the treatment of insane patients as sick
persons and the introduction of hospital
methods and the rest cure but the physl-
clans of that institution do not practice non
restraint after the methods of the other hos
pitfalls.
At the last two visits to the Fergus Falls
hospital, Aug. 16 and Nov ~ 1893, particular az
there were TAO patients in the hospital ana
about fortyfve empty beds On that Gay
six women were in restraint or "secluslon'
No. l. In seclusion. Kept In her room be-
cause she uses vile and abusive language. =.
No. 2. In seclusion. Strikes and fights II
kept on the ward. Is kept In secluslon 10
avoid severe restraint.
No. 8. In seclusion and wears a camisole.
noisy and violent acute case.
NOS. 4 ana D. wear CdllllSOicS. DSSsiOJ
clothing.
No. 6. Wears muff. Reason not given.
Sixteen men were in restraint or "seclu-
sion," as follows:
No. 1. In seclusion. Violent.
Nos 2 and 8. In seclusion. Noisy.
No. 4. In seclusion. Violent and destruct-
i've
No. s. In seclusion. Homicidal.
No. 6. In restraint sheet" Epileptic.
No. Z. In restraint sheet" Eloper
No. g. In restraint sheet. Destructive
int CHI
No TO- In restraint sheet" Destructive
and fighting.
No. 10: Wearing "muff" Pounds his
own head
Nos. IA and 15 Wearing "muffs'' Violent.
No. 16. Wearing wristlets. Violent
This gives a total of twenty-five patients
in restraint or seclusion. The six men
in restraint sheets were in separate rooms
in "seclusion.'' There is notable differ
ence between the sexes. The number in re-
straint seclusion included one man IN
every thirty-fve. but only one woman In
every fifty-eight, difference of nearly two
to one in favor of the women.
1t is stated by way of definition that 'in
seclusion'' means being shut up in a room
alone usually with the door locked A
"camisole" is duck jacket. laced in the
back and having sleeves much longer than
the arms, which are crossed IN front ana
fas+ened behind.
The "muff'' is made of sole leather or can
vas and is locked on to prevent the use OF
the hands. The "wristlets" are of leather,
made to slide on leather belt, permitting a
limited use of the hands, but preventing
striking. The restraint sheet" or "protec-
ton sheet" is sheet of strong ducking with
eyelets whereby it can be firmly secured to
the bedstead. To the under side of this sheet
is firmly sewn jacket of the same material,
which fits the body and is laced to the back.
There are also two long, wide pockets sewed
A. 20 xI,o to hi f1,4
hands and arms are inserted. patient
wearing the protection sheet can move the
legs freely, can shift the position Of the body
slightly and can move his hands and arms
in the canvas pockets, about as much as a man
can move his hands in his overcoat pockets.
Those who use this apparatus consider it
more humane than either the old-fashioned
"crft bed or the old-fashioned bed har-
ness" which were formerly used to keep
violent patients in bed. The duck sheet is
rather heavy, stiff and cold. Some of the
patients wearing it appeared to be suffering
somewhat from cold.
Supt Weleh stated frankly that, in his
opinion, there was a limit to the practicability
of the 'non-restraint'' idea; and that man
ual restraint i. e., holding by the hands Of
nurses, often more irritating and more
injurious than the proper use of mechanical
appliances, under the direction of the medical
officers. In cases where mechanical restraint
was likely to be injurious, manual force was
substituted.
He stated that there had never been dose
of hypnotics given at the Fergus Falls hos
pital since 1t was opened, at least during his
administration, and that, in his opinion me
ehanical restraint was preferable to "chemi-
caP or manual" restraint. He said that
when maniac patient had been held by
nurses, even for three four days his wrists
would be abraded and black and blue spots
would be found on his arms and other parts
of the body. He had seen a patient with
broken ribs caused by the nurse being thrown
into the air and landing on the patients chest
during his violent struggles. The nurses
would be sweating and angry Even good
nurses are liable to lose their temper in doins
such work.
The bulletin also contains a list of
papers published by inmates of state
institutions, showing forty-two pub
lished in schools for the deaf, three in
insane hospitals, nineteen in Juvenile
reformatories and eight in state prisons
or adult reformatories. Minnesota is
represented In each class except the
insane hospitals.
The bulletin also contains a sympos-
ium Of Minnesota sheriffs on the wis
dom of the plan of separate confine-
ment in county jails Only one sheriff.
A. Stevenson, of Polk county, Is OBJ
posed to it,
It also contains some startling revel-
atoms as to the extent of pauperism in
the state.
The following are the figures for the
state Of Minnesota:
Estimated Number of (Paupers in