Year: 1878

OF the nOSpltal unuef your cnarSe, ant


to make such suggestions, and recon


mendations, as in my judgment, shoul'


be considered in your report to the leg


islature


By an act of the last General Assem-
bly,, making the fiscal year of State In


stitutions end September Both insteat
of October 31st, as heretofore. this re


port will cover period OF only twenty
three months.


On the 31st day of October, 1875
there were in the hospital two hundred
and fifty-one patients; one hundred anc
twenty-four men, and one hundred TWEEN
ty-seven women. There haye been ad
mitted since that time, two hundred anC
fifty men, and one hundred and seventy
eight women. OF those admitted, TWEEN
ty-eight were transferred from Mt
Pleasant, and four hundred and two
were sent from their homes, or from hous
es of detention, jails, aims houses, etc
Since the last report, the counties o1
Story, Marshall and Boone, have beer
added to the district sending patients t
this hospital The territory now includ
es fifty connties, with population, ac
cording to the last census, OF five hun
dred and ffty-six thousand eight hun
dred and eighty-six.


Three hundred and ffty-nine have
been discharged. OF those discharged
ninety-two were recovered, one hundred
and twenty-nine were improved, seventy
two were unchanged, and siXty-siX were
removed by death. A greater portion OF
chronic incurable patients has been ad
mitted within the last year than hereto
fore. No doubt the hard times have
compelled many to thus part with their
friends, who would in times of prosper.
ity have been kept at home. But it is
probably, in part attributable to the fact
that hospitals for the insane are gaining
in favor and confidence with the com
munity. Eight hundred and ninety-foul
have been admitted since the opening
of the hospital OF these, one hundred
and ninety-nine were transferred from
Mt. Pleasant. Whether the proportion
ate number of the insane to the whole
population is increasing, is question
still undecided. Certain it is that the
number applying for hospital treatment,
and seclusion, is rapidly on the in
crease.


TO provide for all the insane whose
friends are unable or unwilling to care
for them, is clearly the duty of the State.
1t is rare that an insane person can be
kept in private family without risk,
and the community has S right, if not a
duty to perform, to see that the insane
are not only placed under the most ia
vorable circumstances for recovery, but
isolated in measure. How far the
State should interfere in the social re-
lations of those families or individuals
whose tendency is to insanity, is a deli
cate question, but one which will event
ually have to be decided. My own be-
lief is that insanity is increasing, that
the State should assume the guardian
ship of all insane who are not self sup
porting, that the marriage of all who
have been at any time insane, cpileptic,
or inebriated. should be made a penal
offense, and that all persons acquitted
of crime on the ground of insanity,
should be kept in custody the remainder
of their lives.


There are now in this hospital three
hundred and twenty-five. In the hos
pital at Mt. Pleasant, six hundred and
eight. By the report of the State Wis
iting Committee for the period ending
October 81, 1873, we learn there were,
at that time, one hundred and twenty
three known insane who were provided
for elsewhere than in hospital. The
number has undoubtedly increased dur
ing the last two years. 1t has been
necessary to discharge from this hos
pital, during the last two years, forty
five incurable patients to make room
for more recent and needy eases. No
doubt proportlonatc number have been
discharged from Mt. Pleasant, each OF
of these would have been better provid-
ed for in hospital There are no less
than eleven hundred in this State, de-
serving and properly requiring hospital
seclusion and restraint Were this hos
pital finished to-day, filled to it's utmost
capacity, and the hospital at Mt. Pleas,
ant relieved of its excess, there would
still be one hundred needy and deserv-
ing insane unprovided for. 1t is not too
soon for our legislators to decide upon
some plan for the maintenance OF the
fast accumulating numbers OF chronic
insane, who can be quite as well and
much more economically treated in less
expensive hospitals. The separation of
the durable from the incurable is not
practicable, but a large class in hospital
and cared for in aims houses, jalls, and
by friends, could be as well, and more
economically supported in an institution
built expressly for them. The matter
is no longer an experiment. 1t has been
carefully tested in Willard Asylum,
New York, and elsewhere. During the
last biennial period larger number have
been employed in indoor and outdoor
labor, and the number will continue to
increase as we have more and better
facilities for furnishing the means and
opportunity. AS many as thirty men
are at times at work on the farm, gar
den, in the various out-buildings, laun-
dry, boiler room, &c, and it is not un-
usual for twenty female patients to be
employed at one time i'll the kitchen,
laundry and sewing-room. A large
amount of work in the wards is done by
patients. They are encouraged as much
as possible to do light work, in the be-
lief that for many of them employment
is the best remedial agent. Nearly all
male patients, except those confined to
bed, go out of doors daily in summer
when the weather is not wet, some to
walk in the fields, but most to the exer-
else grounds in rear of the hospital.
Many of the females are in the airing
court or garden daily. More might be
taken out but for the fact that all OF
our female patients are on the third
and fourth floors, and the fatigue incur
red in making the ascent and decent
deters many from making the trial. Ii
the hospital was completed, giving suit,
able separation of the sexes, we could
throw open the doors of most OF the
wards, giving free access to the airing
courts during pleasant weather. The
more freedom and out door air patients
can have, the less need is there for me
chanical restraint. From our disturbed
wards all the men 60 out of doors, and
during the last summer season we have
rarely had more than one man in re-
straint, and often for days not one,
while in the female wards of the same
class, as many as six or eight wear the
camisole, or waist to prevent destruc-
ton of clothing, breaking of glass, NC
Our records will show that from the
first history of the hospital, there has
been gradual decrease in the use OF
mechanical restraints, and while then
on+;ro .hnlitiou cannot he safely or