The Dolores star., 1905-06-02

A. E. Macdonald, l.. L. B., NJ. ",
medical superintendent OF the Manhat-
tan State Hospital. East, gives q
graphic account OF tent life as tried
under his direction for q large number
of insane consumptives. The follow
ing extracts are from his paper in the
dealing with Tuberculosis in the
United States and Canada:
That consumptive insane patients
may be kept, and treated, to their ad-
vantage and incidentally to the ad-
vantage Of their fellow-inmates. In
canvas tents. and throughout the sew
eral seasons Of the year. has been
the Manhattan State Hospital, East
The experiment upon the success of
which this claim is advanced has COW
cred a period Of forty months.
In all hospitals for the insane the in
mates are classified according to the
form Of mental disturbance. To take
from all these classes any suffering
from tuberculosis and put them to-
getSsr in one tent was a serious prob
lem. This. however. has been very
successfully done. The original plan
was to use the camp only about five
months during each summer.
The camp first established consist
ed Of two large dormitory tents
twenty by forty feet-each containing
twenty beds, with smaller tents OF
different shapes, about ten by ten
feet, for the accommodation of the
nurses. the care of the hospital stores,
pantries and dining tent for such
patients as we're able to leave their
beds and tents, and go to the table for
their meals. Running water was se-
cured by means Of underground pipes.
and the safe disposition Of waste and
sewage was also provided for.
As has been said, It was expected to
continue the camp only through the
summer and as far into the autumn
as favorable weather might render
5ustihable. But when in the late au-
tumn 1t was found that the favorable
experience continued, 1t was decided
to attempt to carry the experiment,
on a moderate scale, into, or even
through. the approaching winter. The
camp. as first established, had been
placed upon an elevated knoll adjacent
to the riverside and purposely exposed
to the full force of the summer
breezes. For the winter experiment
Its site was removed to the center of
the island, where trees and buildings
interposed to act as q wind-break to
the severe storms from the east and
northeast which are to be expected in
that locality. The number of patients
was reduced to twenty, those in whom
the disease was most active being re-
tanned and the others being returned,
for the time being, and much against
their will, to the buildings. One large
tent sufnces for the housing at night
Of the reduced number of patients,
and one was set apart as sitting
room for day use, with the accessory
tents before mentioned, and large
stoves were placed in them, here and
there, with wire screens surrounding
them to protect the patients, and a
liberal use of asbestos and other fire.
proof material and arrangements for
the prevention Of fire.
To make q long story short, it has
remained in continuous use, not only
throughout the first winter, but
through the two succeeding winters
and intervening seasons, up to the
date of the present writing. The scope
Of Its employment has been gradually
enlarged until all patients in whom
there are active manifestations Of
tuberculosis-an average of forty
three out of total census of about
2.000-are isolated therein, and there
has been parallel enlargement Of the
elements Of the plant.
The isolation of the tuberculosis pa
tients has reduced to minimum the
danger of infection of other patients
and Of employees. The patients them
selves lave suffered no injury or hard
ship. but have, on the contrary, been
unmistakably benefited. This is shown,
among other ways, by decrease in
the death rate from pulmonary tuber-
culosis, both absolute and relative,
and by q marked general increase in
bodily weight, amounting in the case
of one patient to an actual doubling of
the weight-from eighty-three to one
hundred and sixty-six pounds-in four
teen months Of camp residence.
Mental Improvement has as gener-
al rule been the concomitant of physi-
cal, not only among the patients in tae
tuberculosis camp, but also in the
others. and in the former class this
has been somewhat Of an anomaly.
My experience, and think that of
others, has been that when phthisis
and insanity co-exist they are apt to
alternate as to the prominence Of their
several manifestations-the mental
symptoms being more pronounced
whilst the physical are In abeyance,
and vice versa. Under the tent treat
ment we have found = general dis
position toward accord In the manifes-
tations, Improvement in both respects
proceeding concurrently, and some OF
the DISCHARGES from the hospital which