The daily morning journal and courier., 1905-05-22
INSANITY AND SANITY.
DR. KENIsTON TELLS OF TESTS
 AND TREATMENT.

Oyerwork are the Principal Causes of
 Mental Disorders-Tendency Towards
 Removing Restraint.
 Dr. James N. Keniston, superinten- dent of the Hartford hospital, but for a good while connected with the State Hospital for the Insane. gave an inter esting talk Thursday evening in ths South church lecture rooms on insani- ty, the tests for 1t and its treatment. The insane, he said, are very much like the sane. If five hundred sane and five hundred insane persons should be mingled it would require an expert to tell them apart. An ordinary per son would fail utterly unless very care ful. t-'. a
 He regretted the feeling of mystery and dread with which institutions Tor the care of insane have been regarded, and said he believed the mystery was due to the attitude of doctors, who un- til comparatively recently have al lowed few visitors to the institutions. The old time treatment used to be 1so- lation from people, from literature and from work, and also mechanical re- straint. Now at the best hospitals all that is changed. ,s5
 Taking up the causes of insanity, as they appealed to him, not as any sta tistics might seem to show, he said ne placed first hereditary, not necessarily an influence of 8 parent, but from something wrong in the parents pre- decessors, possibly intemperance in a grandfather. Next he placed alcohol, @ most fertile source and a great curse to the earth Then he named vice., oyer-work and defective development. Modern hurry and the complexity of modern times had good deal of influ- ence, too, he said. In many cases there is no known cause for the insan- ity, often many causes combining to produce the disorder.
 As to definition of what insanity is, the speaker said that out of a col lection of three hundred there was none that would be accepted in court of law. To say a person is insane is about as sensible as to say he is sick. The word insane he hoped to see abol- ished in time and something else like mental disorder used instead, The le- gal test for insanity-the knowledge of right and wrong--is a relic of barba- rism The patients at the Retreat and the State hospital, outside of the actu- ally denented, know the difference. Many know a thing is wrong, but can L. z1,, ,l1s,. 4t teJ nyxyfi that insanity is due to or accompanies some disorder of the brain. Often 1t cannot be demonstrated in q post nor tenn, but sometimes 1t can be, yet it is really due to an organic disease in the brain cells.
 Where to draw the line between sanity and insanity is impossible to know. A mild form of insanity could be made out for any one. There is no line between tho two, but a broad ter ritory A German, who has the best possible system for getting at insanity begins with looking into the family history of the patient, back to the brothers and sisters of the grandpa rents, the education, training, abilities and occupation of the patient. Every thing is of importance. In examining ception the the patient himself, the very simplest thing is begun with, the fac ulty of perception. It is essential to find out if patient knows what he sees
 All persons have illusions, but the sane reason them away. Then comes a percention, or the formation of ideas. How the brain does. things is an un- fathomable mystery, but all know that it does do them. Then comes memory, for the failure of memory or the falsi- fication of it are all important and may be tested by questions. Then the judg- 1nent of a patient is looked into, that being the power of comparing one thing with another and reasoning therefrom Then there is the will to judge from. Often the conduct of in sane persons is what strikes the ordi- nary observer most, but it is only sec ondary to the experts. Dr. Keniston added that every one has probably some defect in some one of these fields. He never saw a perfect man. yet it would be hard to call a person lacking in one of these faculties insane Each case has to be judged on it's own mer- Its.
 Touching on the care of patients, pr. Keniston said that it is good assur- ance that person is a fit subject for an institution when two reputable doc tors sign certificate. Every effort is made to have proper nurses at an in stitution, but some of the things pa- tients say or do are very hard to bear, and if a nurse occasionally does strike patient it is very likely that any oth- CT person in the same situation would do the same. Institutions are open to examination at any time, and members of the state board of charities have been known, he said, to visit the State hospital at midnight without warning While ill old days patients used to be shackled, now the effort is towards re moving restraint. When Dr. Page who strongly believes in doing without restraint, went to the State hospital he found nothing to condemn there Dr. Keniston said. The percentage o1 restraint among the patients is one quarter of one per cent. and that is largely to prevent patients tearing bandages from broken limbs, etc. I.
 Patients are being more and more G -