The Bismarck tribune. [volume] (Bismarck, N.D.) 1916-current, 1925-06-17
GUEST GIVES
ADDR ESS TO
KIWANIS CLUB
Old and New Treatment OF
Insane Persons Explained
BY Superintendent

ent of the North Dakota State Hos
pital at jamestown, in an address
delivered at the meeting OF the Al
wants club yesterday.
DR.. Guest said in part:
"The term insane is amblguousiy
used. In the lay sense, 1t means
strange and unusual behavior, be,
hayior that is regarded as antlsocial
or dissocial. In the earliest times
such behavior was looked upon as
the result of a visitation either from
Heaven or He'll Later the mystical
colorine was discarded and INSANITY
was considered a moral or mentai
peryersion. When the unusual be
hayior was anti-social, the deviation
was viewed as manifestation Oh
ruptured personality in which the
brutal or animal attributes had been
criminally allowed to overcome the
higher or social elements. However,
if the behavior was not dlstasteiui.
socially speaking, it was frequently
regarded as merely amusing OF clown
ish. or if it had religious or pollti-
cal hearing, was sometimes heralded
as allied to genius or the superna-
tural. Many leaders OF crowds, up
,isings, cults, and so on, have been
psychopathic individuals.
"The antisocial insane were at
first treated as criminals or as de-
moniacally possessed, and were inn
prisoned. executed or punished IN
other ways that were considered mt
ting at the time. shocking as they
seem now in the light Of our present
day standards.
"The next stage in the evolution of
the attitude Of society toward the IN.
sane was represented by wave OF
humanitarian enthusiams associated
with the doctrine Of the moral or re-
ligious causation Of insanity. ms
led to the establishment Of asylums
or hospitals in which the natlents
were treated by moral means so
called-that is by persuasion, by be-
ing placed in beautiful surroundings,
and by isolation, which was consld-
cred conducive to meditation.
A Change in the Treatment
with the rise Of materialism in
science in general and the develop
ment Of the concept of cellular path
olopy in medicine in particular the
formulation that disordered function
was due to organic defect began to
be applied TO the insane also. The
realization grew that insanity was a
medical problem. and the hospitals in
which the insane were segregated
were placed under medical manage
ment.
During both of those periods, ad-
mission to such hospitals was easy,
by voluntary application or by the
application of relatives or friends. 1t
was in dealing with the antisocial in
sane that the legal concept of insan-
ity crystallized. finally becoming the
only precise definition Of the word.
Insanity came to mean nothing more
or less than mental condition that
called for segregation and subsequent
detention and legal declaration OF
insanity was resorted to only when
patients antisocial behavior became
grave enough to warrant this deflnl-
ton. Otherwise the solution of the
problem was left to the patient or
to those interested in him.
From an attitude of optimism and
confidence in the hospitals, public
opinion-in the face Of many disap-
pointments, after high hopes had
been raised by unaided promises and
erroneous statistics-changed to one
first of skepticism and then OF sus-
picion. The idea that patients were
unjustly detained, that corruption
existed in the hospitals, that incar-
ceration could be brought about by
bribery and the like, gradually
spread and resulted in Legislation
that aimed to safeguard the persons
of those who were accused OF In
sanity.
Commitment Became Medical Matter
THUS began movement that not
only made it more difficult to be-
come a patient in hospital but at
the same time made commitment
more of legal and less Of medical
matter. People were charged, wlth
insanity and were dealt with in the
same manner as those who had COM
mitted crimes. Complaint, arrest
detention in Jail, trial, guard OF
police officers or deputy sheriffs the
exhibition of handouts, all the sor-
did Accomplishments OF conflict with
the law, became the recognized and
eventually the only means of dealing
with the insane. Court procedure IN
cases of insanity came to parable
that in criminal cases, in order to in
sure two things: first, that society
should be protected from an indlvld.
ual supposedly dangerous to lite ano
property, SecoHu, tHaI VIC az u'eI
individual should not be deprived OF
his liberty without due process OF
law.
fortunately, the idea that insani
ty was ultimately a medical problem
persisted and grew. A few reverec
medical pioneers, studying the seq
repated cases from a scientific stand
point, developed the theory Of menta
disorder as biological reaction. In
sane behavior was to them not 81
much q disease in the ordinary sense
of the word, though disease Nigh
enter in as factor; it was the re
suit of the reaction of an individual
-perhaps handicapped by heredity
environment and physical disease
to the situations, that he was force'
to meet in life.
Action of Handicapped PersOnalitie
"Once this notion became rec0g
nized, it was soon seen that actuall
insane behavior was merely an ex
treme type or end product, separate
from normal or average behavior
not by an impossible gulf, but b
various gradations Of abnormal be
havior. Ordinary nervousness, eN
aggerated moods, tantrums, the US
Of alcohol and drugs, religious fan
aticism, various forms of delinquen
cy, and the like. were recognized a
primitive, unhealthy, or inferio
modes of reaction Of handicappe
personalities. different, not in kint
but in degree from insanity.
Present TTeatulent Of Insane
"The treatment and care given.
patients in all modern state hosp
tails in the United States and Canad
at the present time consist Of lin
Of treatment suggested by the Amer
lean Psychiatric Association of whic
have the honor Of being membe
and is essentially Is follows: Tn
chief aim Of those who are in chars
10, first, that they are made to fee
.sftsr they have arrived, that the
are not in jail but in q hospital thu