Gloucester County Democrat. (Woodbury, N.J.) 1878-1932, 1898-12-29

Following is letter written to Mr.. E. l..
Leonard, of the Pauisboro Press, by John
Ward, State Medical Director, on the advis-
ability Of county insane asylums.
g While I have no personal objections to
such establishments he saws II think upon
the whole, it is better that the dependent
and criminal classes should be at all time
under State supervision. / see no reason
why patients might not b. cared for COM
fortabIy nd properlys under county super
vision, if the counties 60 to the expense of
making the necessary arrangement for
their proper care / do not approve,
aud think the practice is bad, of keeping
the insane in an almshouse, although even
there, as / have even seen in your own
county, the insane are well fed and clothed,
and give evidence that they had comforts
able home. / am of the opinion that under
all circumstances when the county assumes
the care of its own insane that it should
have separate building and be under daily
medical supervision. / do not think that
the insane, take them as they come to us,
both acute and chronic cases, can be more
economically kept, if properly kept, than
they are in the State institutions. Inc
fact exists. however, that the State allows
two dollars per capita per week Tor the
maintenance of the insane in county
asylums. This materially lessons the
eest, even should it be the same that OBJ
tains in the State institutions, to the coun.
ties themselves TO about one third what lt
COSTS the county to maintain them IN the
State institution. In only one State IN the
union, one of the northwestern States, 80
far as l am informed, except New Jersey,
are the insane cared for by the county sys-
tenn. 1t is quite possible that in some Of
the States there may be county institutions,
but they draw no support from the state,
as they do in New Jersey. The general
idea of keeping the insane IN the several
counties is that il is not only more econoEns
icai. but that it is better for the patients
themselves than in so large number con-
gregated together under one 70 t. This IS
asserted by some to be fact. It has not
yet been proven. however
The cottage system kand mean BY this
system the plan adopted in very few
hospitals in our own country and quite
commonly in Europe) of having a few pa
tienis only in building, eight or ten at
most. The expression, cottage SYSTEM
is greatly misunderstood in this country
believe that the cottage system proper IS
the very best method for the care and
treatment of the insane. 1t is also the
most expensive system II properly con
Quoted. In some counties 10 our own
State can be found well conducted institu-
tions. Essex county is caring for about
eight hundred of its insane and is well
organized, taking proper medical care and
otherwise OF their patients, and doing so at
a much less expense to the county tnan
would result if placed under care IN State
institutions, from the fact, as already stated,
they receive two dollars per week per
capita for each and every patient they have
under care. The actual per capita cost OF
caring for the patients, however, in the
abstract is about the same as IN State
hospitals. Atlantic county is caring for it's
own insane doing well by them. The
patients are visited daily by physician
who gives much time and attention to)
them, and is within a very short distance
of the asylum, subject to call at any time
in case of accident or any circumstance
arising requiring prompt medical attention
or interference. The patients are wen
clothed, we'll fed and very comfortable
housed.
The most pernicious thing in regared to
the establishing of county institutions ISL
the liability to frequent changes Of the
resident officers through POLITICAL changes
in the Board Of Freeholders. II competent
officers can be selected for county institu-
ton, and their tenure of Office is not de-
pendent upon the within or political com
pIexion of aboard of Freeholders. | can
see no valid objection to county institutions
II they are to be subject, however, to re-
moval for political causes, think the
result would be eventually, most perniclous
and unfortunate.
Very respectfully,
JOHN W. WARD,
State Medical Director.