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Library of Congress Subject Headings, 21st edition, 1998
LC Subject Headings:
To the General Assembly of the
State of North Carolina:
I respectfully ask your attention to the subject herein presented and discussed; and solicit your prompt and favorable action upon the same.
I come not to urge personal claims, nor to seek individual benefits; I appear as the advocate of those who cannot plead their own cause; I come as the friend of those who are deserted, oppressed, and desolate. In the Providence of God, I am the voice of the maniac whose piercing cries from the dreary dungeons of your jails penetrate not your Halls of Legislation. I am the Hope of the poor crazed beings who pine in the cells, and stalls, and cages, and waste rooms of your poor-houses. I am the Revelation of hundreds of wailing, suffering creatures, hidden in your private dwellings, and in pens and cabins--shut out, cut off from all healing influences, from all mind-restoring cares.
Could the sighs and moans, and shrieks of the insane throughout your wide-extending land reach you here and now, how would your sensibilities to the miseries of these unfortunates be quickened: how eager would you be to devise schemes for their relief --plans for their restoration to the blessing of a right exercise of the reasoning faculties. Could their melancholy histories be spread before you as revealed to my grieved spirit during the last three months, how promptly, how earnestly would you search
out the most approved means of relief; how trifling, how insignificant, by comparison, would appear the sacrifices you are asked to make; how would a few dimes and dollars, gathered from each citizen, diminish in value as a possession, compared with the certain benefits and vast good to be secured for the suffering insane, and for their afflicted kindred, by the consecration and application of a sufficient fund to the construction of a suitable hospital in which the restoring cares of skilfully applied physical and moral treatment should be received and in which humane and healing influences should take the place of abuse and neglect and of galling chains and loathsome dungeons.
North Carolina, hailed of her sons, "the glorious Old North,"--North Carolina, unburthe ned by State debts, untouched by serious misfortunes, is last and latest of the "old thirteen," save the small terrirory of Delaware, to make provision for the care and cure of her insane citizens, and almost the last embracing all the New States in our broad Union.
But it is not to the State pride of the intelligent citizens of North Carolina that my appeal comes; it is to the liberal and humane hearts of this portion of my fellow citizens, its plea reaches; it cannot be rejected, it dares not consent to be put off, it claims with earnest importunity that its merits may be discussed, it would merge in oblivion the multiplied miseries resulting from past neglects and procrastination, by wakening to action the efficient energies of humanity and justice.
At present there are practiced in the State of North Carolina, four methods of disposing of her more than one thousand insane, epileptic, and idiot citizens, viz: In the cells and dungeons of the County jails, in comfortless rooms and cages in the county poor-houses, in the dwellings of private families, and by sending the patients to distant hospitals, more seasonably established in sister States. I ask to represent some of the very serious evils and disadvantages of each and all these methods of disposing
of the insane, whether belonging to the poor or to the opulent classes of citizens.
It may be here stated that by far the larger portion of the insane epileptics, and idiots, are detained in or near private families, few by comparison, being sent to Northern or Southern State hospitals, and yet fewer detained in prisons and poor-houses, yet so many in these last, and so melancholy their condition, that were the survey taken of these cases alone, no stronger arguments would be needed to incite energetic measures for establishing an institution in North. Carolina adapted to their necessities, and to the wants of the continually recurring cases, which each year swell the record of unalleviated unmitigated miseries.
If the plea of suffering humanity is insufficient to quicken Legislative interposition, an argument based on indisputable evidence, may be advanced, whose force can not be slighted; I mean the economy, directly to individuals towns, and counties, and remotely, but not less actually to the State, of establishing without delay, a Hospital for the treatment and protection of the insane.
In order precisely and definitely to present this subject in an economical point of view, I quote from carefully prepared tables furnished by the experienced Superintendant of one of the most successfully conducted Hospitals in the Union. The cases affording the following results are taken in their order of successive admission. The first twenty were the first incurable cases which were received at the institution: the last, those latest received. The expense of the first, cost before admission one dollar and fifty cents per week. They had in the aggregate cost to the State each, one thousand five hundred and fifty dollars and fifty cents. On the other hand, the actual expense of the last twenty cases which have been discharged from the Hospital cured amounts only to forty-seven dollars and a half each. Hence, it appears that the expenses already incurred for taking care of twenty, cases suffered by delay and neglect to become incurable, has
been more than thirty-two times greater than the same number of cases for which early and proper provision had been made. The recent cases are well; the old ones will doubtless continue a charge through life. Strange as it may appear, it is not the less true, that taking an average chance for cures it would have been a pecuniary saving to the State to have had seasonable care of these old cases, though at an expense of eighty dollars a week, rather than by neglect to have incurred the necessity of supporting them to the present time, and till their decease.
The incarceration of insane men and women in County Prisons, whether furiously mad or otherwise, is objected to, first as subverting the uses for which these prisons are constructed, second, as placing the innocent on a level with the guilty making misfortune and crime, disease and health go hand in hand. I said on a level, I mistake; the felon looks forward to a period of enlargement, and notes the time when his prison bonds shall be broken; the insane whose imprisonment is aggravated and prolonged by consequence of sickness, not for his crimes anticipates no season of liberty, no period of release.
Again, many persons adopt the idea that the insane are not sensible to external circumstances that to their perceptions the dungeon, chains, cold, nakedness, and harsh epithets are as acceptable as a comfortable apartment, freedom from shackles a pleasantly tempered atmosphere, decent clothing, kindly speech, and a courteous address. They assert that coarse, ill-prepared food is as palatable as that which is wholesome and well cooked, that cold and heat, sunshine and cloud, pure air and that loaded with noisome exhalations, liberty and confinement ;are all one and the same to the insane, producing like impressions and results on the deranged intellect. Greater error of belief was never adopted; more serious mistakes, and conducting to more fatal results could not be propagated. The insane in most cases fell as acutely and distinguish as readily as the sane.
Nor are we to conclude that because a man is insane that he is not in a large majority of cases, able to appreciate the advantages of good associates. or that lie is obtuse under the contact of ill-chosen companionship. I recollect a gentleman who had enjoyed a liberal education, and possessed a refined mind, who became insane and shortly furiously mad; for a little time he was conveyed to a jail, and exposed to the daily observation of a crowd of criminals whose base language and coarse manners constantly exasperated his temper; finally he was removed to a well ordered hospital, and after some months his recovery being complete, he was restored to his family and friends; but he could not forgive them his detention in the prison; he spoke with bitterness and severity on his having been subject to such a degradation. On the contrary, he dwelt with tender gratitude upon his situation in the hospital, (that of Bloomingdale near New York) and spoke with continual pleasure of the comforts which there surrounded him. But he never has relinquished the opinion that his malady would have yielded much more promptly to the mental and moral treatment in that Institution, had he been at once conveyed thither, "I object absolutely, says Ellis, to the inhuman custom of confining insane persons and idiots in the same buildings as prisoners and criminals; the usage cannot be too strongly censured." Many examples might be adduced to illustrate the correctness of this position, and for other reasons than those already stated.
In 1844, I found a furious madman in one of the dungeons of the old jail in Fayette County, Penn. His disposition was homicidal; he had been in prison nearly fifteen years. On one occasion a man was brought into the prison intoxicated, having committed some offence while under the influence of ardent spirits; he was thrown into the cell of the maniac who it is supposed was provoked by him, but no one knows: this only is certain, he fell upon the involuntary intruder and murdered him in the excitement of a most ferocious temper. When the jailer
entered, a horrible spectacle presented itself, the murdered drunkard, mangled and lifeless, the insane murderer covered with gore, and exulting over the reeking, remains of his victim!
In Philadelphia, some months since, the officers of the Moyamensing prison were roused from sleep by the cries of murder proceeding from a cell occupied by an insane man and a prisoner who had been committed for disorderly conduct. This unfortunate man was found lying upon the floor weltering in blood, while the murderer, in the highest state of phrenzy stood over him, brandishing a bloody knife. The head of the victim was nearly severed from the body, and the body covered with frightful gashes. In reply to the enquiry what had led him to perpetrate this horrid deed, he answered that it was that he might not himself be killed.
An insane man has for many years been confined in the jail at Germantown, Stokes County, in this State. On one occasion some time past, a negro prisoner was put into the same room as the crazy man; he did not like the companionship, and murdered him in a shocking manner yet he seemed quite insensible to the turpitude of the deed, and rather exulted in the entire success of the act, as I was informed on a recent visit at the prison.
I admit that public peace and security are seriously endangered by the non-restraint of the maniacal insane. I consider it in the highest degree improper that they should be allowed to range the towns and country without care or guidance; but this does not justify the public in any State or community, under any circumstances or conditions, in committing the insane to prisons; in a majority of cases the rich may be, or are sent to Hospitals; the poor under the pressure of this calamity, have the same just claim upon the public treasury, as the rich have upon the private purse of their family as they have the need, so have they the right to share the benefits of Hospital treatment. Urgent cases at all times, demand, unusual and ready expenditures in every community.
If County Jails must be resorted to for security against the dangerous propensities of madmen, let such use of prison-rooms and dungeons be but temporary. It is not long since I noticed in a Newspaper, published near the borders or this State, the following paragraph: "It is our fate," writes the Editor, "to be located opposite the County Jail, in which are now confined four miserable creatures bereft of the God-like attribute of reason: two of them females; and our feelings are daily excited by sounds of woe, that would harrow up the hardest soul. It is horrible that for the sake of a few thousand dollars the wailings of the wretched should be suffered to issue from the gloomy walls of our jails without pity and without relief. Were our law-makers doomed to listen for a single hour each day to the clanking of chains, and the piercing shrieks of these forlorn wretches, relief would surely follow, and the character of our State would be rescued from the foul blot that now dishonors it." In nearly every jail in North Carolina, have the insane at different times, and in periods varying in duration, been grievous sufferers. In Halifax County, several years since, a maniac was confined in the jail; shut in the dungeon, and chained there. The jail was set on fire by other prisoners: the keeper, as he told me, heard frantic shrieks and cries of the madman, and "might have saved him as well as not, but his noise was a common thing he was used to it, and thought nothing out of the way was the case." The alarm of fire was finally spread; the jailer hastened to the prison: it was now too late; every effort, (and no exertions were spared,) to save the agonized creature, was unavailing. He perished in agony, and amidst tortures no pen can describe.
In Wentworth, Rockingham County, is an aged crazy man whose history even carefully abridged would fill too many pages to be introduced here. The principal facts of his troubled life are known to many in all the adjoining Counties. Can it be credited? crazed and wretched, he has been the inmate of a prison for more than thirty years! and that not for the commission of crimes.
In Stokes jail, at Germanton, was a very crazy man, confined in an unventilated, dreary dungeon. Being tolerably quiet about that time, his chains had been removed, and he was rejoicing in being able to reach the low, grated door, because, said he "I can put my mouth close to the bars and draw in some air: dont you like fresh air," he enquired, "Oh it is so good"! " but oh is'nt it pleasant to look out and see the sky, and see the pretty fields; I cant see them here, now you are come to let me out; I know you have; I want to get out; I want to walk about; I don't want to stay here." Alas I could render no relief, the unfortunate man was incapable of self control, and endangered life and property when at large, and there was no hospital to receive him in Carolina--he was poor, and so could not be conveyed to that of another State.
I recollect, of many examples, one recorded in a Report to the Virginia Legislature, by Dr. Stribling, which serves to illustrate what might have been, in all probability, the benefits of timely Hospital care for theis suffering madman.
In 1841 a patient was conveyed from a jail in--County, where he had been confined loaded with irons for six months. He had been temperate and industrious, but was unfortunate and insanity ensued. He was conveyed to the Hospital bound hand and foot, screaming vociferously and seeming a very demon in look and act. For days he was furious, but his malady yielded at first by medical means and finally by moral influences. In one month he was freed from all restraints, passed in and out of the building at pleasure, and soon cheerfully occupied himself upon the grounds of the Institution in useful labor, without even an attendant. In four and a half months his cure was perfect, and he was discharged. His gratitude and attachment to his physician and nurse seemed unbounded. He returned to his home and settled his affairs there, and after a few months returned to offer his services as attendant in the Hospital, and has continued in the daily and hourly exercise of those kind
and humane cares which were so grateful and soothing in his own experience. He has the responsibility of guarding, protecting, employing, and amusing a class of fifteen patients, all of whom are devoted to him. Comment upon this case is needless.
In the miserably dilapidated jail in Surry, was also a crazy man, quiet at the time of my visit, but subject to access of violent and alarming paroxysms. Before committal he often declared to his wife, that "he felt mighty strange, that he was bound to kill somebody, that he felt dreadfully, that he had a desire to kill her." He was not malicious, did not entertain emnity towards any one individual, but had a morbid and almost uncontrollable desire "to see blood run." Of course, being looked upon as dangerous to the lives of others, he was committed to the jail for an indefinite period, where the application of moral and medical means was unattainable. In a Hospital, he would have been an industrious and useful inmate and probably in a short period might have been perfectly restored to mental and physical health.
Since I was in Rowan an insane man, possessed of a moderate fortune has been committed to the jail; I will not attempt to depict his sufferings in the dismal dungeon into which he has been cast.
From the comfortless, and old jail in Wilkes, an insane women had been discharged some time previously to my visit. At that period and since, I have received the following facts of her history. Mrs. B. is now above 35 years of age, and had for many years been eccentric, at last deranged, and finally has become a decided maniac. While her husband lived, he was ever kind and indulgent, and often said to his neighbors, in excuse for her wayward conduct and ill-speech, that they must not mind her, for she was deranged as he believed. More than a year since, she had been ill for sometime, her husband was exhausted from loss of sleep, and, as he thought at a favorable moment threw himself down to rest. She perceived him sleeping, she went out and returned with a large stone, with which she beat him upon the head so as to cause almost immediate death. Her
insanity was fully proved upon her trial, and she was remanded to jail; after considerable detention her brother decided to take charge of her and removed her to his house. Recently in a state of high excitement she attempted the life of her sister-in-law, and but for the timely arrival of her brother would have accomplished the shocking purpose. Her physician has lately written to me, that he regards her as a confirmed maniac, and dangerous at all times to be at large, as well as dangerous to all who unguardedly approach her when she is excited.
An insane man has lately been discharged from the jail in Beaufort County, and sent to Hyde, where he belonged. One also from Carteret, as I am told. In Craven County, I found a crazy man incarcerated in a noisome, damp, cold dungeon; "placed there for safe keeping!" His condition was very wretched; and his prospects of relief and appropriate treatment no better: if left there he must become a confirmed madman.
In a dark, dreary and filthy dungeon, in Northampton County, I lately found an insane man who had been confined closely for several years. I did not persevere in entering this dungeon, though I examined others corresponding with it in dimensions, but cleanly kept. The keeper doubted the safety or decency of opening the doors, and no advantage could have been derived from doing so, merely to attempt the near survey of a place, that must assure permanence to disease; and agravation to bodily and mental disability I am disposed to believe that the keeper conceived himself in the performance of his duty, to the extent such means as he possessed allowed. This case I recollect, was repeatedly described, before I reached Jackson, by humane and intelligent citizens in adjacent Counties, better possessed of facts than myself, and speaking from personal observation of his sufferings, noted in professional calls at the jail, during the session of the Courts.
If Jails are unfit institutions for the treatment and restraint of the Insane, County poor-houses are but a degree, if indeed at all suitable.
At the present time, there are no insane persons either it, the jail or poor-house of Wake County, but a considerable number of individuals in private families, in more or less suffering and exposed states, according to the ability of their friends to provide for them, and several are wandering at large, gathering a precarious subsistence, and not safe to be trusted with their liberty. The case of several requires prompt care. One woman, whose propensities are homicidal, resides with her family, to their manifest hourly peril.
The Jail of Orange is well built, and was in good order comparing well with the best kept Jails in the State. The reverse exists, in regard to the poor-house, which was neither clean nor comfortably furnished. I believe sufficient food is supplied, and in sufficient quantities. A little expenditure by the County, and a little care, would render the establishment more comfortable. There were six insane; three in close confinement, and much excited. The most violent, a man long a maniac and caged, was clean, but so noisy as to disturb all on the premises; a large part of the time, the room in which his cage was built, could be made light but was commonly dark and close,"to keep him more quiet!" A negro girl, a most pitiable case, was in the opposite building; and a white woman also, in a separate compartment vociferous and offensive in the extreme. In the passage between their cells or cages, was a stove in which fire was maintained when necessary. The place was very offensive. The keeper could not altogether be blamed for this; he was hired to direct a poor-house, and not qualified to rule a mad-house, and should not be expected to do it. Very many cases of insanity, in various conditions exist in this County.
In Granville County poor-house, is an unfortunate man, who for years has been chained to the floor of a wretched room; miserable and neglected, his now deformed and palsied limbs attest the severity of his sufferings through these cruel restraints; flesh and bone are crushed out of shape by the unyielding irons. He was a man of good
character, industrious, frugal habits; a good citizen, and respectable as respected; he became insane, and soon the malady assumed a maniacal character: he was carried to the poor-house, loaded with chains, and left like a wild beast to live or perish; no care was bestowed to advance his recovery or to secure his comfort!
Caswell Jail was in good order, safely constructed, and vacant of prisoners. The family of the keeper reside in the building. The county poor-house establishment, not distant from Yanceyville, consists of a series of decent one story buildings, kept remarkably clean and neat, and reflecting credit at once upon the county, and those who have the immediate charge. Of the four insane residents here, two were in close confinement; a woman in a room of sufficient size. Who was in a highly excited state. The insane man was in a sort of stall or cage, and at the season of my visit the place was clean. The noise, perversity, and bad habits of these unfortunate persons was a source of much disquiet in the establishment.
In illustration of the blessing and benefit of Hospital care in cases long and most cruelly neglected, I adduce the following examples recorded by Dr. Hill, and corresponding with many cases under my own immediate observation since 1840. "Two patients," writes the Dr. "were brought to me in 1836, who had been confined in a poor-house between eighteen and twenty years. During this period they had not known liberty. They had been chained day and night to their bedsteads, and kept in a state so filthy that it was sickening to go near them.--They were usually restrained by the strait-waistcoat, and with collars round their necks, the collars being fastened with chains or straps to the upper part of the bedstead, to prevent, it was said their tearing their clothes. The feet were fastened with iron leg-locks and chains. One poor creature was so wholly disabled by this confinement, that it was necessary for the attendants to bear her in their arms from place to place after she was brought to the Hospital; she shortly acquired good habits, and was long usefully employed in the sewing-room. The other
was more difficult of management but soon gained cleanly habits, and now occupies herself in knitting and sewing, and that, after having been treated for years like the lowest brute. Another case was brought in chains, highly excited; five persons attended her; in six days all restraints were removed; and she walked with her nurse, in the. patients' gallery. In June, she was discharged from the wards quite cured, and engaged as assistant in the kitchen.
The Jail of Rockingham is in tolerably good order, the poor-house, but a short distance from Wentworth, is singularly neat, and well-ordered; the inmates sufficiently well-clad and very neat and respectable. The buildings require repairs. The house is well kept, but more comforts might well be supplied.
The Jail of Stokes is in tolerably good condition, but badly constructed for the admission of light and air in the dungeons; there should be a stove in the passage, to dry the walls in damp weather.
The poor-house about three miles from Germanton, is extremely comfortless, the apartments are entirely too much crowded, and the arrangements are not suited to promote the comfort or good order of the inmates.--Rooms of the poor all ill-furnished and out of repair. Residence of the Superintendant very neat and comfortable. There was one insane woman then at liberty but often confined in a cell, in all respects, unfit for one in her condition. I cannot forbear the remark, that when not in close confinement, she was very improperly situated in the room she occupied. There were several others in the house in a demented state.
The Jail of Surry, is an isolated old two-story wooden building, and in some parts dilapidated; the poor-house is about three miles from Rockford, the Superintendent resides in town, and keeps several negroes to look after the poor, of whom there were in September, about 30. There were no insane in close confinement, but two who are allowed the freedom of the place.
The jail of Guilford, is isolated, but very well built and well kept: in addition to the dungeons and other strong rooms was the unusual provision of a large chapel room for religious services, when circumstances should make it desirable to hold such therein. The old poor house several miles from Greensboro' is about to be abandoned, being utterly comfortless and out of repair. New buildings on the Hillsboro road are nearly completed, and there is no doubt that the establishment will be in all respects well-ordered, and fitly conducted.
The jail of Davidson, a new, secure, and substantial building was found in excellent order; the common mistake of insufficient air and light in the dungeons exists here. The County poor house about six miles from Lexington, was pretty well ordered, but too little visited. The supplies of food and clothing seemed sufficient for both health and comfort: but there, as elsewhere, the insane, were out of place, and in a bad state. For this no blame is to be attached to the superintendant, so far as I could judge One very crazy man was chained to his bedstead; he was noisy, filthy, and truly repulsive. A crazy woman but quiet, was rolled in a quantity of soiled bed clothing. These like many others would be useful, and decent in their habits, if resident in the hospital expressly designed for the insane. Besides those are two demented patients.
Rowan jail, on the first floor of which resides the jailor, is a substanial building--not clean when I saw it; chiefly commended, I was told, as a secure prison. An insane man has recently been committed here. The poor house about two miles from Salisbury, requires so much to render it comfortable that it would be difficult to know how to enumerate its deficiencies: the house occupied by the keeper was quite the most comfortless abode, that I have seen in North Carolina, except repaired, certainly not habitable for the Winter. No insane man in confinement in this institution.
Iredell jail, is isolated and had just passed into the charge of a newly appointed officer, it would hardly be
just to remark severely upon very dirty and neglected condition. The County poor-house, a few miles from Statesville, is situated in a singularly secluded spot, remote from supervision and often observation, and is a model of neatness, comfort, and good order: having a most efficient master and mistress, especially the latter, upon whose cares in these institutions by far the most is dependent. All in all, this was in much the best condition of any poor-house I have seen in North Carolina, neat, plain, and decent, it would do credit to any State; but it is no fit place for the insane. Since I was there, in September, a highly respected citizen writes me that a young woman has been sent to the poor-house so violently insane, that it is quite unfit she should remain there. Also a man has in that County, very recently become so violently mad as to be quite unmanageable, and having no Hospital in the State, they have confined him, with, chains and manacles, hand and feet, and do as best they can. A subscription paper has been circulated for the purpose of raising funds to send him to Columbia, S. C. Other painful cases exist in this, as in the counties which I have visited, and from which I have heard; most of which I do not feel at liberty, through their domestic and social position, to designate; but they plead in heart-reaching language for the early establishment of a State Hospital.
Wilkes jail is an old building, and so far as the jailor is accountable, is well kept: it is isolated, and a wretched place whether for the prisoner, or the insane who are sometimes confined here. There is no poor-house in this County. Five or six cases of insanity have been reported to me. One, a man named Dowell, is said by a respectable physician of Wilkesboro' to have been crazy for more than 12 years: the malady is gaining force gradually, and now exhibiting itself in furious mania; he is a very dangerous person to be at large, has proved himself to be mischievous, and once attempted to commit homicide.
The Jail of Caldwell is well built, was in good order, and has sufficient light and air in every part. There are no violently excited insane in the poor house, which is some miles from Lenoir, and but few cases in the County.
In the Jail of Davie, is one insane man; in the poor-house beyond Mocksville I was informed, was a case of insanity truly pitiable, beside many others in the County.
The Jail of Bertie is an exceedingly well built edifice, sufficiently lighted and aired, and well-kept; the Jailor and family reside on the first floor; the County poor-house, about three miles from Morganton is not well situated; the buildings are out of repair, and ill-arranged within, for either comfort or convenience in times of sickness or of health. I should think that the Superintendent was kind and faithful in the discharge of all his duties towards the poor. Here as in most of the poor houses in North Carolina services are frequently holden.
The jail of McDowell, like most of the County prisons in this part of the State found well built and well kept; there is no county house in or near Marion; and my inquiries reached but few insane in the County. One man often violently excited but ordinarily for the last few years so tranquil as to be at large, I found beyond Pleasant Gardens. At one time he was closely shut up.
The jail of Buncombe is a large substantial building; formerly there was a county poor-house six or seven miles from Asheville, but its remote situation and serious discomforts through bad management led to the entire breaking up of the establishment some time since. A plan succeeded this, somewhat original, which when I was in Asheville, had not been fully carried into effect; having no perception of its merits, and claims to commendation, I shall dwell but slightly upon the subject, merely stating on authority of the citizens, that it was considered in constructing the new jail expedient to make it of sufficient capacity to accommodate at one and the same time and place the vagrants and felons of the county, and the unfortunate poor. The enclosed yard, "at present unimproved," is of sufficient extent to permit the erection
of additional buildings "if needful." "It is believed," said my informant, "that the wardens and overseers consult economy by this arrangement in various ways, especially as one man can keep the prisoners and the poor, saving the cost of hiring a second individual for the latter service." "But one pauper has been sent to jail and he ran away dissatisfied with his quarters, in about three weeks."
Rutherford jail is an old and poor building, but now serves sufficiently for the County. It is quite isolated; but the jailer seemed fitted to fulfil his duties with humanity and fidelity. The County poor-house, a short distance from Rutherfordton, is not so comfortable as respects the buildings and furnishing as it should be made. The Superintendant seemed a favorite of the poor there.
Cleaveland Jail is excellently built, cleanly kept, and the Jailer, as should always be arranged, resides in one part of the building, having thereby the more immediate and efficient care of the prison. The County poorhouse about three miles from Shelby is a small but neatly kept and seemingly comfortable establishment. It seemed to me that the Superintendent received an insufficient recompense for the difficult charge the situation of several of the inmates involved.
Lincoln jail is a well-built, well-planned prison, well arranged, and apparently well kept. The poor-house, several miles from Lincolnton, had but three inmates in October; their condition was uniformly represented as not good, and the establishment described as being objectionable. Perceiving influential citizens, prompt to admit existing evils, I did not personally visit it. No insane at present are confined there. Several in distressed conditions in the County, in private families.
Gaston Jail is as yet unfinished, but appears to be a well-planned building. No poor-house in or near Dallas; but one such needed for the County poor. Several insane in the County.
Mecklenburg Jail is remarkably well planned and well built, but less well kept than are most County prisons in
North Carolina, as respects cleanliness. The county poor-house several miles from Charlotte, was nearly deserted in October, having but two of the County poor; a partially insane woman and a paralytic man.
Cabarrus Jail is a large, well constructed building--in tolerable order; the Jailor occupies commodious apartments upon the first story, The County poor-house about two and a half miles from Concord is very deficient in means for promoting the comfort of the infirm inmates. In a miserably dilapidated out-building, perhaps ten feet square, open on all sides to the ingress of the winds, rain, and snow, I found a crazy man chained to the floor, filthy and disgusting. At times he is suffered to go at large, but is at once troublesome and dangerous to those he meets, or whose house he frequents. In a Hospital, this crazy man would, under judicious care, be able to perform more labor than would suffice for his own maintenance. I did not visit the insane scattered in private families.
Stanly Jail is a small new building, neat and secure, but the dungeons so planned and constructed as almost to assure the destruction or health to any who might be long in detention; there is hardly a possibility for the admission of sufficient air to support the absolute demands of the animal structure. There are in the County several cases of insanity requiring Hospital treatment. At present, there is no poor-house in or near Albemarle.
Montgomery Jail, like that of Stanly, is a neat substantial building, and well-kept, but not planned for health, as respects the admission of light and air, though it assures security.
The County poor-house, at Lawrenceville requires, it appeared to me, much more careful attention on the part of the Wardens, to supply comfortable and necessary attendance upon the aged and infirm, who alone occupy the buildings. Nothing could be more creditable to these feeble women than the neatness and care with which they kept their apparel and their apartments. An insane man had been removed to some other situation in the
County. Several cases of insanity were related to me on authority.
Moore jail seemed a secure prison; its want of cleanliness was excused on the ground of there being no prisoners, and being occupied as a lodging for servants. The dungeons, which did not serve this use, were by comparison with the majority of prisons in the State, in bad order. The County poor-house, not distant from Carthage was excellently kept by a conscientious and kind-hearted family to whose cares the comforts of the inmates are ascribable, rather than to the provision made by county officials. The buildings are much out of repair and unfit for winter habitation, or for stormy days at any season. The custom so worthy of entire condemnation, that of setting off the poor in mass, by lots or singly to the lowest bidder exists in Moore County. The poor are fed, clothed, supplied with bed, clothing and fuel and waited on at the rate of 8 cents the day each; a sum which cannot pay those who undertake this charge. That I found the poor well supplied with food and well clad, I repeat was certainly ascribable to the liberality and christianity of the present keepers, rather than to the just guardianship of the public.
Cumberland Jail is an old building, well lighted and well ventilated: it is said that more attention will be paid to the preservation of cleanliness than heretofore, the keeper and famly now residing upon the premises. The county poor house within three miles of Fayetteville is well situated, and apparantly excellently kept: cleanliness, that crowning excellence in housekeeping, prevailed in every room save one, and I imagine might with the exercise of a sufficient determination, be secured even in that. In a log building well constructed, and admitting sufficient light and air, planned so as to be warmed in damp and cold weather; were two small apartments for the insane: at the time I was there one room was vacant, the other was occupied by a violently excited and noisy insane man, whose shouts and vociferations reached me at a distance from the poor-house. In a hospital this
poor creature's energies would find exercise in useful employment in a poor-house it is not to be expected that the superintendants should have the qualifications which pertain to a judicious control of maniacs: moreover the noise and disturbance these create, banish comfort and repose from the infirm, the sick, the dying, and the demoralizing influence, through use of profane language and additional evils. In this poor-house religious services are regularly and frequently holden, and one has evidence that the ministers of the various religious denominations in the vicinity had not overlooked that scripture, "To the poor the Gospel is preached which foretold the advent of Jesus the Saviour, and comforter."
The jail of Sampson is said to be decently kept. The county poor are said to be well clothed and supplied with wholesome food. Several cases of insanity have been related in this county.
The jail of Duplin is defective. The wardens of the county poor-house which is situated cast of Warsaw, several miles from Kenansville, have the reputation of giving uncommon attention to the temporal and spiritual comforts and consolations of the poor. Religious services are holden at the poor house. At present there are no insane persons there.
The jail of New Hanover appeared to be tolerably well kept. It is a large commodious building. Too little light and air are admitted into the dungeons, The county poor-house on the confines of Wilmington is in a miserable and dilapidated condition; fallen wholly from its former well deserved reputation of being one of the best Institutions for the poor in the country. Apparently the acting wardens are responsible for its decline. There are affecting, and suffering cases of insanity in several private families in this County.
Wayne jail is an old dilapidated building, shortly to be replaced by a new prison. Found in miserable condition. The County poorhouse several miles from Goldsboro, seemed quite decently kept, and in many respects bore an air of comfort. There seemed to be neglect from
abroad in the attendance upon the sick; several individuals were evidently suffering from want of medical advice and prescription. This establishment is but seldom visited, and the comforts enjoyed seemed chiefly referable to the care of occupants. One of the poor, an insane man, had wandered away: an insane woman was so far controllable as to be steadily and usefully occupied.
Lenoir jail, a very old and isolated building, but strong, seemed pretty decently kept; it has some very great defects of construction. The poor of the county are not numerous, by comparison with the adjacent Country.
Craven jail, a very large brick building, promising exteriorly a better condition than the interior revealed. The, dungeons were very bad, offensive, dirty, ill-lighted, and not ventilated. A very insane man, considered dangerous to be at large, was in one of them; he was cold, exposed and suffering; his condition was such as to assure agravation, if not permanent confirmation of his malady. There are no means of maintaining either dryness or warmth in the passages or in the dungeons. The county poor-house, a short distance from Newbern, is well situated, and has the reputation of being well kept in general. The keeper's house and several rooms occupied by the poor, were neat and well-ordered; others were in a poor condition. A sunday school is taught here by persons from Newbern, whose Christianity is illustrated in their practice of its precepts. There are here in Craven County, many cases of insanity.
Beaufort jail is a neat brick structure; the jailor occupies the lower floor in front. The plan of the prison is not good, though it assures security when properly attended to.
A letter received from a physician resident in Washington informs me that since I left that town a week since, an insane man in a state of high excitement, has been committed to the jail there for public security, and occupies a dreary, wretched cell. I cannot question the willingness of the jailor to perform his duty as humanely as possible; but there is no mercy nor humanity in committing the insane to prisons.
The unfortunate man above alluded to might, in a well ordered Hospital, undoubtedly in a short time, be sufficiently recovered, if not cured, to pursue some useful and profitable employment.
Recently fifteen cases of insanity have been stated, existing in this section of the State--that is in Beaufort, and adjacent Counties.
An insane person with whom I was conversing two weeks since, dwelt with profound feeling upon the trials and sufferings she endured, conscious of her state, and sensible of all that occurred around her: that which most moved my feelings at the time was, the indescribable pathos with which she related the sufferings and hardships of a crazy man confined in the Jail in her native County. She concluded, I, in my troubles, have friends--he has none."
The county, poor-house not distant from Washington, and reached over a good road, is pleasantly situated, but in a spot well known for its unhealthiness, having been abandoned by the former owner of the property, for its liability to create fevers, and for the general insalubrity of the place. The establishment needs an efficient Superintendant, competant in mind and body to carry forward the interests of the place. Offering at first glance the appearance of a comfortable institution, it fails to show forth either private or public efficient and fit direction. The sick and the children certainly suffer and those able to work need a director to insist upon their action. I found one woman here insane, but quiet.
Pitt jail is a neat, two story building painted white, and sufficiently large for present county purposes. The poor of this county are said to be well cared for. Sad and distressing cases of insanity were brought to my notice existing in private families, in conditions of extreme suffering and exposure, of which I do not feel at liberty to give the history.
Edgecombe jail is a well constructed, isolated prison; well and cleanly kept: its defects of plan and arrangement are fewer than ordinary in county prisons. I did not
visit the poor-house of this county established some distance from Tarboro, but it bears a good reputation and at present there are no violently excited insane there; cases are known abroad in the county.
Halifax Jail is a well built prison seemingly, though isolated, securely kept, but bears the reputation of being deficient in cleanliness. At present no insane detained there. The poor-house nearly three miles from Halifax, has much need of competent care, and efficient superintendence. Most of the inmates are aged and infirm. The buildings are well situated and conveniently planned for the occupants, but deficiently furnished, except one room furnished by the individual who dwells in it. The sick need nursing, care, and comforts; and all require supervision.
Northampton Jail is well-built, but defectively planned--the dungeons of which there are four are insufficiently lighted and ventilated, and however cold or damp are never warmed and dried. Here is an insane man confined for years in this dreary abode; from his sight, the genial sun, the beautiful sky, and the green fields are forever shut out; darkness, and foul air, and solitude, heaviness and misery are his portion. Kindred and friends are put far from him, and his acquaintance into darkness. May the merciful God compassionate those who are so cruelly abandoned by their fellow-men, and may no heavy retributions crush those, who so unhesitatingly and unpityingly consign a helpless, crazed creature, to such a hapless doom.
The poor-house, a mile and a half from, Jackson, consists of five dilapidated, unfurnished rooms at present abandoned. The Superintendant who resides in a pleasantly situated comfortable house, distributes quarterly, to one hundred beneficiaries an allowance of meat, meal, and clothing, at a cost to the county of about $2,500 00. Several insane poor, and others in better circumstances are in this County.
The jail of Nash is a small two story decent building; no insane now confined therein. The poor-house I had
not time to visit but understand it is comfortable. Several cases of insanity were reported to me existing in the county.
Time would fail in the narration, even were it proper to unveil the miseries, protracted, and indiscribably varied, of the insane in private families, and the distress of families thrown into sorrow and trouble unequalled through the affliction and sore perplexities arising out of care over the demented, the epileptic, and the maniac. A detailed description of their personal condition, horrible as it must be, could not present the half of the woes which exist in every county throughout North Carolina, Loathing and horror would overwhelm the reader, successively introduced to dreary apartments, loathsome cells, and foul cabins, whence issue the most horrible sounds and poisonous effluvia, and wherein are spectacles of protracted bodily and mental misery language is poor to represent.
Of the few examples of many which exist, to which I shall now refer in private families, the following have quite recently come under my observation: A poor but industrious farmer in the western part of this State, the father of a numerous family, became insane; it was in vain to control him in his own dwelling, he was furious and he was conveyed to the County jail here his sufferings were aggravated and his malady exasperated: I can not tell for how long a time the lone dark dungeon echoed to his moans and cries, nor at what cost the county maintained human life, unaiding its sufferings and necessities. In process of time the paroxysms of violence subsided, and finally he was transferred to the humble log cabin of his aged widowed mother, a lone woman dwelling upon the mountains. There I found the infirm, afflicted mother, and the insane son. Amidst tears and sighs she recounted to me her troubles, and as she wept she said, " the Lord above only knows my troubles, and what a heap of sorrow I have had in my day, and none to give me help. There he lay, in the jail, cold and distressed, mightily misused; if I could have got money
to send him off to where they care such spells, for they do say crazy folks can be cured, I should have had him in my old age to take care of me, but I am poor and always was, and there is no help here. Ah well, many and many is the long night I am up with him and no sleep or rest, anyhow; this cant last always; I shall die, and I dont know what is to come of him then." It is for Legislators to determine whether such as these shall drag out troubled existences, and no succour until the Angel of death brings release, and seals the long record of "man's inhumanity to man." A respectable citizen in the same quarter of the county, by very slow degrees lost his reason. First was a nervous restlessness, next unwonted irritability, then a craving for stimulants, which were in time used to excess, and quickened the malady, yet none then traced the real cause of the growing evil but the type of a deranged intellect was shortly developed beyond doubt, and in a few months the distress and trouble of the household knew no alleviation nor interval. Finally, removal from home, under most grievous circumstances, ensued, and I have not long since been witness to the afflictions of this worthy and respectable family whose efforts to sustain themselves are as affecting as praiseworthy. Had there been in North Carolina, a State Hospital, timely care might have secured a permanent cure. It is almost too late to assure this now, but instead of restoration is life-long expense and life-long suffering.
In Lincoln County, near a public road, stands a decent dwelling; near by is a log cabin, strongly built, and about ten feet square, and about seven or eight feet high; no windows to admit light the square logs are compactly laid; no chimney indicates that a fire can be kindled within, and the small low door is securely locked and barred. Two apertures at right angles, ten inches long by four wide, are the sole avenues by which light and air are admitted within this dreary cabin, so closely secured, and so cautiously guarded. You need not ask to what uses it is appropriated: the shrill cries and tempestuous
vociferations of an incarcerated maniac will arrest you on the way, and if you alight, and so far as the light received as before described will allow, examine the interior of this prison, you will discern a ferocious, filthy unshorn, half-clad creature, wallowing in foul, noisome straw, and craving for liberty. The horrors of this place may not be more definitely described; they can hardly be imagined: the state of the maniac is revolting in the extreme. This creature, is a man--insane for more than thirteen years--for a long time suffered to range the country far and wide, addicted to mischief and disposed to violent acts. For assuring public and private safety, his family have adopted the only alternative of confining him upon their own farm, rather than seeing him thrown into the dungeon of the County jail. Of these two evil conditions, I confess, I see no choice. The family though enjoying the means of decent livelihood, when unburthened by extra expenses, have not the means of sending him to a distant Hospital. The rich may partake the benefits such institutions afford: the poor must suffer, agonize, and bear heavily out, by slow-killing tortures, their unblessed life! Are there no pitying hearts, and open hands that can be moved by these miseries?
Well and truly may it be, said of the insane: whose sorrows are like unto their sorrows, and whose griefs are like unto their griefs? Friend and companion are removed far from them, and their acquaintances are hid from their view!
Of thirteen cases of insanity in and near Raleigh, there is one to which my attention has within a few days been called, which especially illustrates the want of a Hospital for individuals in narrow circumstances. Mrs.-- has for several years had rather feeble health. Sometime in February last, she manifested peculiar restlessness by day and night, became agitated and nervous, and her mind was subject to strange and harrassing delusions From that time she became incapable of attending to the affairs of her household; neglected her child, and passed
most of the night and day in traversing the small apartments of her dwelling. Her husband, dependent upon daily industrious labor for a decent support, found himself embarrassed by the distresses of his home and the claims of business. He is unable to pay her expenses at any Hospital; meanwhile, she is sinking into a condition of hopeless and permanent insanity. She who was neat, modest, industrious, and kind, is now through this most afflictive malady, utterly transformed; her garments are rent in tatters, her person neglected, her hair dishevelled, falls in tangled locks about her head; her speech is no longer gentle, true and kind; but violent, profane, and indecent; in that humble, once pleasanthome, is now neither peace, nor rest, nor security: there is constant danger of destruction by fire, and acts of personal violence often recurring, indicate the increasing liability to deeds involving fatal consequences: in train with these alarming manifestations, are symtoms of a suicidal disposition. It has been found necessary at times to confine her movements by the application of painful modes of restraint upon the limbs; which, though preventing present mischief, continually aggravate the malady. Hospital treatment might restore this patient to her family blessings, to society, and to usefulness.
Many cases of maniacal insanity have been removed to Southern and Northern hospitals. Hitherto, North Carolina has been willing to be dependent upon other, States for her afflicted children, while in possession of ample means to succor and heal their maladies within her own borders. But there are other objections to transporting patients to distant Hospitals for remedial care, beside the fact of encroachment upon the Institutions of other States. Expenses are vastly increased in making long and always difficult journeys under circumstances so harrassing and painful; and an experienced physician of a celebrated Hospital has informed me that the fatigues, excitement, and exposures of several patients, conveyed long distances, have within the present year resulted in death. Want of sleep and exhaustion, have reduced them
to the most dangerous condition before being received; and not seldom depleting remedies injuriously adopted, have hastened dissolution. If there is cruelty and gross injustice in holding the insane in jails, poor-houses, and private families, there is serious risk of property and of life in leaving to range at large. Plainly, there is but one remedy.
In Aberdeen, Ohio, an insane man, left in the room where a little girl three years old was sleeping, in the absence of the mother, threw down the Bible which he was reading, seized an axe and deliberately chopped the little victim into five pieces.
In Rowan County, N. C., a maniac cut her husband's throat. In Wilkes County another beat her husband upon the head so as to cause his death. In Rockingham an insane man killed his neighbor. A man in Kentucky, killed two of his children, and attempted the life of his wife. Another in Indiana cut his wife's throat and gashed her face so that she died. Besides these, I recollect more than thirty similar cases in which homicide was attempted and committed by individuals known to be insane.
I adduce a few, from many thousand examples on record, which illustrate the benefits of Hospital residence and of remedial treatment of the Insane, in both curable and incurable cases.
"There has been," writes Dr. Bates of the Maine state Hospital, "in this Institution for some years, an individual whose family is strongly disposed to maniacal insanit.y By many years neglect this patient became incurable; the powers of the brain seem to exist in fragments. He is, and probably always will be a public charge. Two of his sons have been attacked, seasonably brought under treatment, and cured. These young men during the absence of disease, were industrious and frugal citizens. They are both liable to a recurrence of the hereditary malady. If brought to the Hospital soon after each attack, there are nine chances in ten, that they will always soon recover and return to their occupations and former place in society; if neglected until functional derangement
changes to organic disease, they will become a public charge for life." These cases are selected plainly to illustrate the fact that economy not less than humanity calls for early and efficient action in assuring appropriate remedial treatment for the insane.
Dr. Stribling, the excellent physician and friend of the insane, and Superintendant of the Western State Hospital in Virginia, states several cases of much interest in his published reports to the Legislature. From these documents I quote the following examples: In 1842, a young gentleman, twenty-one years of age, the son of a highly respectable individual who was formerly a prominent and efficient member of the Legislature of Virginia, was brought, to our Hospital. Possessed of a good natural understanding, improved by education and such other advantages as wealth had supplied and with a disposition uniformly cheerful, he was at all times a most, interesting patient and companion. In the Autumn of 1842, he was attacked with bilious intermittent fever, which although speedily arrested, was followed by depression and neglect of all accustomed duties and care of property. In about two months the mind became harassed by the most distressing delusions such as being surrounded by foes who were plotting, his destruction; his friends were regarded as enemies, and he believed himself doomed to eternal punishment,&c. He remained in this state for some time, when suddenly he passed into the lightest degree of cheerfulness and gaiety. Affection for his family revived; he fancied himself, by turns poet, philosopher, and statesman; at one time he was an angel in Eden, at another Noah defying the destroying flood and finally he conceived himself the Creator of the Universe. He was removed to the Hospital where the application of moral and medical means in a short period assured his recovery: he left us rejoicing in the blessing of restored health.
A respectable gentleman who had been esteemed by all who knew him, as an affectionate husband and father a generous friend and worthy citizen, was received as a
patient in the Western Hospital in 1843. He was a merchant, and through unavoidable misfortunes rather than ill management sustained heavy losses: he became depressed, was attacked with bilious fever, which left his health materially impaired; after some months his friends became satisfied that his mind was seriously diseased; evidences of insanity were multiplied; he became maniacal and his family under the advice of an intelligent physician placed him in the Hospital. He was feeble, emaciated sleepless and suicidal. His delusions varied, and were of a most distressing character. Demons seemed to surround him and to multiply their torments. In a short time his malady seemed to yield to remedial measures. His physical health improved; his mind gradually became tranquil one delusion after another disappeared; his spirits revived, and soon he was pronounced cured, and returned to his family and to his business, a cheerful happy man." As he was from that class of society which possesses extensive influence, and who in this part of the country unfortunately, are too apt to regard institutions for the insane with aversion, and who consent to place their afflicted friends therein only when all other means have failed, and all other sources of hope cut off, it may not be amiss to quote a passage from one of his letters received by a friend after his recovery and by him communicated to his physician.
"I am truly happy to inform you that my health is now perfectly restored. I cannot say too much in praise of this institution, nor too earnestly express my gratitude to my friends for having placed me here. Instead of a place approximating to a prison, as I once considered it, when influenced as many are by ignorance and prejudice, I now view the establishment in the light of a pleasant hotel. I gratefully acknowledge comforts supplied and kindness received."
"Last year the wife of a respectable andindependant farmer was brought to the Hospital in a most painful condition. She was endued by nature with a clear and vigorous intellect, being emphatically, a strong-minded
woman," remarkable for her industry, discretion, and good management. She had not encountered those difficulties and disturbing cares that often wear out the heart, but had led a life of peace and enjoyment. Some time in the year before insanity was manifested, her strength seemed to diminish without apparent cause. Finally her mind became a prey to the most harassing delusions; she fancied herself given over to everlasting condemnation, believed herself the destroyer of a friend; attempted suicide, and after six months lost in unavailing attempts to restore her, she was placed in the Hospital at Staunton. There was a continual conflict between her feelings and her reason, her affective and her intellectual faculties, which rendered her case one of care and interest. In a few months she was perfectly restored.
In 1843, a young lady of cultivated mind and accomplished manners sunk into a state of agitated depression. Change of scene, cheerful society, exercise and medical skill were employed in vain. Her affections towards her friends passed into indifference, and so to settled aversion. To her distempered fancy her husband, parents, and sisters appeared transformed to demons. The distressed mother could not see her child transferred to a Hospital, and long resisted the entreaties of wise-judging friends. The disease became for seven months continually more aggravated, till finally amidst lamentations and anguish her family consented to her removal, Her improvement was rapid, and restoration finally complete, and instead of distress at the thought of finding herself the inmate of a Hospital for the insane, she often exclaimed, "Oh why did not my friends place me sooner here." To a relative she wrote," this is no prison, but a refuge for the distressed, where every comfort is furnished, and only the most soothing attentions experienced. I will ever cherish the most grateful recollection of this Hospital and of the excellent physician through whose skill by Heaven's blessing I am recovered"
"A man born of respectable and pious parents instructed from his youth in lessons of morality and religion, grew up a peaceable, industrious, and useful citizen. His disposition was mild and gentle, his feelings affectionate, and his habits exemplary The decease of his mother overwhelmed him with affliction: he fell into a state of what is termed religious melancholy, and gradually became agitated and furious; suddenly attempted the life of his wife and children, killed one of the latter, and seriously wounded the others. He destroyed at a blow a neighbor, who attempted with others to secure him, and was, at last with difficulty secured, and lodged in the jail, and shortly brought to the Hospital. Months passed and he continued excited and dangerous. Very gradually a change took place; his habits improved; his physical health improved and from being one of the most loathsome and offensive patients ever introduced into the institution, he became decent, quiet, cleanly, and finally rational, peaceable, and in all respects well behaved. He remained in the Hospital five months after the recovery of his reason, to ensure the safety of his return to society, and was finally, through the solicitation of his family and friends upon their special application, discharged by the Court of Directors. Thus far his recovery seems to be permanent." The danger of delay in placing the insane under remedial Hospital treatment cannot be too strongly insisted upon. Hundreds and thousands of cases attest the cruelty and the folly of procrastination. However writers upon insanity, and medical men may differ upon some points, on this question all agree, and deprecate with forcible arguments the dangers of procrastination. Esquitol, Pinel, Falret, Jacobi, Conolly, Bell, Brigham, Awl, Kirkbride, Stribling, and a host of others, have earnestly and repeatedly enforced, and continue to enforce this truth; and employ the most eloquent persuasions to induce friends and guardians to take advantage of Hospital treatment in the early stages of the malady. Willis, the celebrated physician to George the III, dismissed the king's
family, courtiers, officers and domestics; procured strangers as nurses and attendants, and thus first succeeded in controlling the delusions which distracted the insane monach. "To separate the insane from the objects surrounding them at the origin of the disease, writes M. Pinal, to entirely disconnect them from their habitual intercourse with their relatives, friends, and servants, is the imperative and indispensable plan for commencing a course of treatment which shall be attended with favorable results:" and Falret says, "it is demonstrated by repeated experience, that the kind of isolation preferable to all others, is that of an establishment especially devoted to the insane. "Few," writes Hallaran "very few patients are found to recover under domestic treatment." There can be but one opinion as to the solemn duty of the removal and non-intercourse of the insane, with their intimate friends and family, and their familiar homes. The superintendant of an English Hospital writes in 1842, as follows: "In a large proportion of cases admitted the present year, owing to long detention by friends, or by parish officers, the prospects of recovery have been entirely precluded, and in successful cases, the period of treatment bears generally an accurate ratio to the prior duration of the disorder." The visiting commissioners of the sane Hospital report, that "they cannot too strongly express their conviction, from experience, that the hope of cure is materially lessened, and not unfrequently defeated, by the delay which is suffered to take place in sending patients to the Hospital after first confirmation of their malady." The physician of the York Retreat, states in an annual report, that "forty-nine years of experience establishes the fact of recovery of four cases to one brought under cure within three months of the first attack, while it is less than one to four in cases of more than twelve months duration when admitted." The superintendant of the Edinburgh Hospital shows that "to be treated successfully, insanity must be treated early; ill founded prejudices, and false sensibility often operate to prevent this being done," These remarks are
as general and as often reiterated as are the establishment of Hospitals and the issue of reports emanating therefrom. Dr. Earle, shows from his experience in the treatment of the insane, that, " after the three first months of insanity are passed the probabilities of entire restoration rapidly diminish." Not only do delays in placing patients in suitable Hospitals involve the risk of permanently establishing the malady, but the safety of property and security of life is hazarded in a vast many instances.
Dr. Galt records an example in point, as occurring in Virginia. An insane woman, the mother of a family, became so much the victim of distressing delusions, that her family perceiving danger from her being at large, took her before the justices for examination in view of placing her in the Hospital at Williamsburg. The following letter was addressed by one of these to the President and Directors of that institution. "Sirs--at the time an examination was had into the state of Mrs.--mind, she seemed so lucid that one of the magistrates, who had not seen her previously, dissented from the opinion of the other two, imagining that the public were in no danger from her going at large; and had the examination taken place one hour later, no doubt would have been felt upon the subject by that gentleman, as she became so furious shortly after, as to render it necessary to confine her in the public jail. After a few days she became importunate to return to her husband and children: and a call of her husband at the jail increased her supplications to be set free. He finally prevailed with the jailor to take her home, promising to return the next day to give bond and security for her restraint and safe-keeping. In the night she rose unperceived, proceeded to the yard and procured an axe, and after calling the servant who slept in the room, and finding him asleep, gave her husband many blows over the head, fractured his skull in several places, and left him senseless. She left the house and ran unremittingly for several hours; affirmed herself dead, and declares that she has been buried these
five years. I have made these remarks to illustrate her case and assist treatment of the same." Another case occurring in Eastern Virginia, seems worthy of notice there are but too many parallel cases in North Carolina. The friends of the young woman referred to were in limited circumstances, and even by making considerable sacrifices could not succeed in rendering her comfortable at home: they entertained the strongest prejudices against Hospitals for the insane. She was violently maniacal, breaking in pieces and tearing every thing upon which she could lay her hands; and vociferated perpetually in the most harsh and discordant tones. She was almost constantly confined in a small closet or cell constructed in a small apartment in her mother's house: occasionally, for change, she was taken into the open air and confined to a tree by heavy chains. At the time she was removed to the Hospital, she had contracted the most loathsome habits, and had plucked the whole of the hair from her head. For more than two years she had exhibited a most pitiable spectacle, and every day her misery seemed to be increased. After several months residence in the Hospital, her improvement commenced: her recovery is slow, but it is hoped will ultimately be complete.
In a report from Dr. Stribling, the following statement is on record: Of all the cases received, ninety-seven were recent cases, of whom eighty-three were restored to reason; five remain in an improved condition; three are unimproved; and six died before any opportunity was offered to test the use of remedies in their behalf. These results correspond with those of other institutions. Of one hundred and fifty-eight cases remaining in the Hospital at Staunton in 1845, and in all probability doomed for life to endure the weary burthen of remediless disease, how many might have been restored to reason, happiness and usefulness, had they been subject to early and appropriate moral and physical treatment. In many cases the morbid sentiment of friends led them to reject Hospital aid, and now the care and skill are all too late!
The following Table, writes Dr. Allen of the Kentucky Hospital, show the Cases of less than One Year's Duration admitted into the Asylum, from July 1st, 1836 to September, 30th, 1847; the Number of those cured, Relieved, Unimproved and Died, and the Per Cent of Cures to Admissions and Discharges.
|Per ct. of Cures to Admissions.
|Per ct. to Cures of Discharges.
"I have intimated," says the same judicious physician, "that such public institutions for the insane, as afforded every facility for their successful treatment, and such as to invite the early committal of them to Asylum discipline, were demanded on the score of economy. I would not, in the mean time, have it forgotten, that the illustration of this position, applies to persons, who maintain their insane friends at private charge, as well as to the State."
The following Table shows the truth or the intimation, and the reason why it is so:
A Table showing the comparative cost to the State of twenty old and twenty recent cases of insanity, illustrating the importance, in an economical point of view, of placing such persons under treatment at an early period of their disease, and of providing every means of treating them successfully in an Asylum.
|Time spent in Asylum
|Cost of each case at 65 dollars per annum.
|Duration before admission.
|Time spent in Asylum.
|Cost of each case at 1 dollar and fifty cents per week
Moral treatment of the insane with a view to induce habits of self-control, is of the first importance. Uniform firmness and kindness towards the patient are of absolute obligation. The most exact observance of truth should be preserved in all intercourse with the insane. They rarely violate a promise, and are singularly sensitive to truthfulness and fidelity in others. They rarely forgive an injury and as seldom betray insensibility to kindness and indulgence. Once deceived by a nurse or attendant
they never a second time bestow their confidence upon the same individual.
Moderate employment, moderate exercise, as much freedom as is consistent with the safety of the patient, and as little apparent anxious watchfulness with cheerful society should be sought. The condition of the patients must determine the number of nurses in a ward. The general opinion is holden that all patients do better without special nurses, wholly devoted to their care.
"The proper mental and physical employment of the insane," says Dr. Kirkbride, "is of so much importance that the full treatment of this subject would be to give at once a treatise on the insane and on insanity. Whatever it maybe, it must embrace utility, and it is well to combine both physical and mental occupation. Active exercise in the open air, moderate labor in the gardens, pleasure grounds, or upon the farm, afford good results. Short excursions, resort to the work shops, carpentering, joining turning, the use of a good library&c.,&c., are aids in advancing the cure of the patient." Sedentary employments are not in general favorable to health. The operations of agriculture seem liable to the least objection. There is a limit to beobserved in the use of labor as a moral means; for there are always some patients to whom it is decidedly injurious. This effect is manifested oftenest in recent cases.
Dr. Ray says that it is an error to suppose that the insane can labor as productively and as uniformly as the sane man. The working hours of a patient should seldom exceed six or seven per diem, and not seldom work is altogether intermitted.
The manner in which labor exerts a beneficial influence upon the insane mind differs no doubt in different forms of the disease. In highly excited patients the surplus nervous energy will be consumed, if no other way is provided, in mischief and noise; but let it be expended in useful labor, and although the work may not always be perfectly well done yet the patient thinks it is, and experiences the gratification of having done what he believes
is a good thing, and consequently, so far as it goes it is beneficial.
This sentiment of satisfaction in being useful, the guardian of the insane cannot too carefully watch over and foster, since it conducts to self-control and self-respect. Incurables who are able and willing to work, are much more contented and enjoy better health when employed. Even some of the most demented and idiots are found capable or doing something. A young man became a raving maniac, and in three months was conveyed to the hospital, but was already declining into idiocy; soon complete imbecility supervened. He was classed with the idiots in the institution; and considered as past hope of benefit or cure. One day he was observed to amuse himself with some rude, coloring and odd figures upon the walls of his room. He was supplied with colours, brushes, and canvass, and soon commenced a portrait: he was now roused, and eager to accomplish his new and attractive work. He was encouraged to renew and repeat his attempts, and finally his mind was restored to its early and rational condition. Thus, careful attention to the daily state of the patient, suggested a method or treatment which resulted in a decided cure. The diseased organs were suffered to rest and their recuperative energies recovered action.
The physician of the hospital at Staunton, in a report of his institution, says, that during the past year, the men patients were chiefly employed in cultivating the farm, working the garden, improving the gronuds constructing fences, cutting wood. and attending to stock. The women were engaged in sewing, knitting, spinning, and assisting in various departments of house-work, and other occupations and recreations suited to their sex.
"A patient, insane for more than ton years, and beyond hope of recovery, considered dangerous to the public safety, and therefore detained at a hospital, converses incoherently and raves wildly, yet finds constant and profitable employment upon the farm; has charge of a stock of cattle and hogs and is scrupulously faithful in the discharge of his duties. Instead of confinement in a county jail, from whence he was removed to the Hospital, in a most filthy, and abject condition. at a cost of little less than three hundred dollars per annum he is here a genteel, orderly, and industrious individual, cheerful, happy, and useful: his labor more than pays all his expenses and supplies him with sufficient indulgencies."
Prichard, in a work on insanity, says that "at the Richmond Asylum, out of 217 patients, 130 were actively and usefully employed viz: 18 in gardening, 16 in spinning, 12 in knitting, 18 in needlework, 12 in washing. 16 in carrying tools, white-washing the wards, tailoring and wearing; and 12 were learning to read."
The following table exhibits the results of productive labor last year upon the Blommingdale Hospital farm near New York, 8 or 10 acres being only cultivated.
|Potatoes, 1952 bushels,
|900 bushels, sound, at $0.75
|180 bushels, sound, at 0 37 1/2
|100 bushels, sound, at 0 50
|460 bushels, sound, at 0 31 1/4
|28 bushels, sound, at 0 50
|120 bushels, sound, at
|45 bushels, sound, at 0 75
|150 bushels, sound, at 0 37 1/2
|20 bushels, sound, at 0 50
|125 bushels, sound, at 1 00
|120 bushels, sound, at 0 50
|65 bushels, sound, at 0 75
|75 bushels, sound, at 0 37 1/2
|130 bushels, sound, at 0 37 1/2
|210 bushels, sound, at 0 75
|40 bushels, sound, at 3 00
|140 bushels, sound, at 0 50
|100 bushels, sound, at 0 75
|1 bushels, sound, at 2 00
|4 bushels, sound, at 0 75
|52 bushels, sound, at 2 00
|75 bushels, sound, at 0 10
|2500 heads, sound, at 0 3
|3000 heads, sound, at 0 4
|1000 bushels, sound, at 0 0 1/2
|2000 bushels, sound, at 1 00
|4000 heads, sound, at 2 00
|40 tons, sound, at 10 00
|1296 pounds, sound, at 0 6
|663 sound, at 0 25
|4488 gallons, sound, at 0 16
|303 dozen, sound, at 0 12 1/2
|150 lbs. sound, at 0 6
|200 bushels, sound, at 0 50
|20 bushels, sound, at 1 00
|150 bushels, sound, at 1 00
|25 bushels, sound, at 1 00
|15 bushels, sound, at 1 00
|1200 pounds, sound, at 0 6 1/2
|8 bushels, sound, at 2 00
The able and distinguished Superintendant of the Rhode Island Hospital writes, that "no form or labor appears so well calculated to promote the comfort and restoration of such patients as have had habits of employment, as working on a farm, and no institution can fully accomplish these purposes without plenty of land, and attendants to assist in cultivation." All patients, whether men or women, whose minds have been cultivated, and who have had habits of active industry and employment, possess high advantages in chances of recovery from attacks of insanity, over the ignorant, the indolent, and the inert. So also those whose habits have been methodical, and temperate in eating and drinking, have better chances of permanent restoration than those who possess their opposites.
The standard of sound health is elevated by the disuse of stimulating food, and of all intoxicating drinks; and by avoiding the use of Tobacco in any forms.
Stimulants even not inordinately used, excite to undue mental and physical action. It might seem that the Apostle of old, apart from the morale of life had comprehended animal physics when he exhorted brethren to adhere to "moderation in all things."
"We have a patient, writes the Superintendant of the Maryland Hospital, "who had for many months been in a state of profound depression from which no efforts on our part could rouse him. He had repeatedly attempted suicide. He was a farmer, and when well, was enterprising, industrious, and devoted to the pursuit. He walked out to the hay-field, and after much persuasion, he was induced to amuse himself by mowing a little. Finding his interest in the work increase, he continued to ply the scythe for two hours with short intervals. He now became cheerful and communicative; ate with appetite at dinner; after which he expressed a wish to return to the hay-field, where he continued mowing until evening. This labor was followed by a night of profound and refreshing sleep. The next morning he hastened to the field, and from that time was seldom unemployed his convalescence was rapid, and in about four weeks he returned to his family entirely restored. Similar cases are of frequent occurrence. Of ninety-nine men patients, forty-five are habitually employed in useful work: And of fifty-seven women patients, all save eleven are for a great part of the time employed in the halls, in the kitchen, the washing and the ironing rooms, or in mending and
repairing garments and house-linen, and various sorts of needlework. Thirty-eight of the women and fifty-five of the men have been habitual readers, and find great benefit and satisfaction in the use of the library; indeed several patients seem to owe their restoration to adopting a regular course of reading and study.
In our times, when knowledge is widely diffused, it seems almost superfluous to dwell upon the benefits of hospital treatment above all private and domestic management. It cannot be questioned, that suppose knowledge experience, and all domestic arrangements favorable, one might decide in favor of treatment for the insane in their own families. This, however, cannot be assured even when all the appliances wealth may procure are at command, and therefore all persons who are familiar with these subjects, do not hesitate in advocating Hospital residence for the insane of all conditions in society, whether rich or poor, educated or ignorant. Some object that associations of a painful nature may dwell upon the recollection of the recovered patient. Whatever apparent force this idea may possess, it is a well established fact that patients rarely entertain other than pleasant and grateful memories of their residence in well-regnlated Hospitals. When these are not well organized, and wisely and carefully conducted, no patient under any circumstances should be sent to them.
Jacobi affirms that "the magnitude of anticipated evils has been greatly exaggerated"; "as regards these," he says, "I can positively affirm that of six hundred cases which I have had the opportunity of accurately examining in this establishment, (that of Siegberg, in Germany) I have never witnessed a single one in which the patient sustained any material injury from his residence in the establishment as a lunatic asylum or from any influence exercised upon him by other patients. Such ideas only are true of badly ordered Hospitals and these may always be known from those of good organization. The time has gone by, thanks to Heaven, when the unhappy insane could be cast into mismanaged Hospitals and, as too often is the case, left, in jails, and poor-houses, festering in heaps of filthy straw, chained to the walls of, dark and dreary cells, unworthy of solicitude, and victims of the idle and interested maxim, that insanity is an incurable disease, and that insane people are unconscious of the treatment they receive, and the cruel miseries to which they are so needlessly subjected. Much has been done, but more, much more, remains to be accomplished
for the relief of these sufferers, in our own United States, as in other countries. With a population rating at more than 22,000 000, our insane and idiots number at the lowest estimate 22,000; and not 4,000, at this time have the advantages of appropriate care in well organized hospitals, or comfortable situations adapted to their condition and circumstances elsewhere.
In 1844, the number of inmates in the hospitals of England and Wales was 11,272. Additional accommodations have been called for and provided to a large extent. The oldest hospital founded in England is that of Bethlem, which King Henry the VIII presented to the City of London, in 1547.
There are twenty State Hospitals, besides several incorporated hospitals, for the treatment of the insane, in nineteen States of the Union, Virginia alone having two government State hospitals. The following is a correct list omitting several small establishments conducted by private individuals, and several pretty extensive poorhouse and prison departments.
The first hospital for the insane in the United States was established in Philadelphia, as a department of the Penn Hospital, in the year 1752. This has been transferred to a fine district near the village of Mantua, in the vicinity of Philadelphia, since 1832: number of patients 188.
The second institution recieving insane patients, and the first exclusively for their use, was at Williamsburg Virginia, in 1773: number of patients 165.
The third was the Friends' Hospital, at Frankfort, near Philadelphia, in 1817: number of patients 95.
The next was the McLean Hospital, at Charlestown, (now Summerville,) in Massachusetts, in 1818. This valuable institution is second to none in America. Number of patients 180.
Bloomingdale Hospital, near the city of New York, was established in 1821; number of patients 146: South Carolina Hospital, at Columbia, in 1822; number of patients 74: Connecticut Hospital at Hartford, patients 122 and Kentucky Hospital at Lexington, patents 247, in. 1824.
In 1845-'46, the legislature of Kentucky passed a bill to establish a second State institution in the Green River country.
Virginia Western Hospital was opened at Staunton in 1828; number of patients 217. Massachusetts State Hospital, at Worcester, was opened in 1833, and enlarged
in 1843; it has 370 patients. Maryland Hospital, at Baltimore, was founded in 1834; it has the present year 109 patients. Vermont State Hospital, at Battleborough, was opened for patients in 1837, and enlarged in 1846-'47; it has at present 320 patients. New York City Hospital for the poor, on Blackwell's island, was occupied in 1838; it is now being considerably enlarged: above 400 patients.
Tennessee State Hospital, at Nashville, was opened in 1839. According to an act of the legislature the present year, this hospital is to be replaced by one of capacity to receive 250 patients. In the old hospital are 64 patients. Boston City Hospital for the indigent, which has 150 patients, and Ohio State Hospital at Columbus, were severally opened in 1839. The latter has been considerably enlarged, and has now 329 patients. Maine State Hospital, at Augusta, 1840; patients 130. New Hampshire State Hospital, at Concord, was opened in 1842 and has 100 patients. New York State Hospital, at Utica, was established in 1843, and has since been largely extended, and has 600 patients. Mount Hope Hospital, near Baltimore, 1844-'45; has 72 insane patients. Georgia has an institution for the insane at Milledgeville, and at present 128 patients. Rhode Island State Hospital opened, under the able direction of Dr. Ray, early in 1848. New Jersey State Hospital, at Trenton, 1848. Indiana State Hospital, at Indianapolis, will be opened in 1848. State Hospital of Illinois, at Jacksonville, will be occupied before 1849. The Lousiana State Hospital will be occupied perhaps within a year.
These institutions, liberally sustained as are most of them, cannot accommodate the insane population of the United States who require prompt remedial care.
Such being the facts, one can hardly employ language too importunate, arguments too persuasive, to secure such increased accommodations for the Insane throughout the United States, but especially in those States in which no Hospitals have been established, as shall assure their sufficient care and protection; their remedial treatment so as to procure recovery when recovery is possible; and their safety and guardianship in all cases where the terrible calamity of incurability crowds them forever from all the bland affections, and social enjoyments of domestic and friendly association.
As ye would that others should do for you in like circumstances so do ye for these helpless ones, cast through the Providence of God, on your sympathy and care! Be the guardians and benefactors of those, who as a writer in the 17th century finely expresses
himself, "are a particular rent charge upon the great family of mankind; left by the maker of us all like younger children, who though the Estate be given from them, yet the Father expected the heir to take care of them!"
To see the mind once brilliant, and in the exercise of fine energies, obscured and inert; or if quickened to action, transformed from the consistent bearing of a being possessed of rational understanding to the fury of a demon, or to the raging of an untamed brute--this is fearful, this is truly to behold the draining to the dregs the cup of bitterness! Oh with what ready zeal, with what wisdom and humanity should not every one direct himself to prevent miseries which no skill can wholly heal,& of which no foresight nor prudence can prevent the recurrence.
"Weep not pale moralist o'er desert plains,
Strewed with the wreck of grandeur's mouldering fanes
Arches of triumph long with weeds o'ergrown,
And regal cities--now the serpent's own;--
Earth has more dreadful ruins,--one lost mind,
Whose star is quenched, has lessons for mankind
Of deeper import than each prostrate dome
Mingling its marble with the dust of Rome!"
Bereft of reason, man loses every thing that renders life valuable. Naturally endowed with capacities for the highest enjoyment, he is suddenly through an attack of insanity, disabled from partaking the rational pleasures of life, and of exercising his noble faculties for his benefit or for the good of society.
Though plunged in the most profound grief,--assailed by every form of trial and misfortune, while reason is spared, hope may cheer his dreary hours,--and faith support him through every trouble; but dethrone reason and he is utterly prostrate. The merest infant is not more dependant on parental care, than is the maniac upon the tender ministrations of kindred or of friends. In an hour he becomes the beneficiary of humanity: the helpless ward of his fellow-men: him must nursing, and watching, and skillful cares surround, else is he the most pitiable of human beings--out-cast and forlorn--smitten of a terrible malady, exposed to sufferings, and woes, and tortures of which no language however vigorously combined can be the representation. Have pity upon him, have pity upon him for the hand of God hath smitten him! Talk not of expense--of the cost of supporting and ministering remedies for these afflicted ones. Who shall dare compute in dollars and cents the worth of one mind! Who will weigh gold against the priceless possession of a sound understanding? You turn not away from the beggar at your door, ready to perish:
you open your hand, and he is warmed, and fed, and clothed: will you refuse to the maniac the solace of a decent shelter, the protection of a fit asylum, the cares that shall raise him from the condition of the brute, and the healing remedies that shall re-illume the temple of reason? Who amongst you is so strong that he may not become weak? Whose reason so sound that madness may not overwhelm in an hour the noblest intellect?
You will not, Legislators of North Carolina--Senators and Representatives of a noble State, you will not forget amidst the heat of debate, the clash of opinion, and the strife, for political supremacy; you will not forget the majesty of your station, the dignity of that trust confided to you by the suffrages of your fellow-citizens.
It is not often that you are solicited to exercise your functions in behalf of the unfortunate. That you possess the power, and now the opportunity of exercising a gracious, benignant, and God-like influence upon the present and future destiny of hundreds, nay of thousands, who pine in want and misery, under privations and sufferings, wearily borne through heavy months and years--the light of whose reason is quenched, and whose judgment is as the stubble upon a waste field; this it is believed is a sufficient argument to determine your decisions in favor of justice, and of humanity and of unquestionable civil obligation.
As benefactors of the distressed whose mental darkness may, through your agency, be dispersed, how many blessings and prayers from grateful hearts will enrich you! As your last hours shall be slowly numbered, and the review of life becomes more and more searching, amidst the shades of uncompromising memories, how beautiful will be the remembrance that of the many of this life's transactions, oftenest controlling transient and outward affairs frequently conducting to disquieting results, and sometimes to those of doubtful good, you have aided to accomplish a work whose results of wide diffused benefits are as sanctifying as they are permanent: blessing through all Time--consecrating through all Eternity!
Gentlemen, the sum of the plea of your Memoralist is embodied in the solicitation for an adequate appropriation for the construction of a Hospital for the remedial treatment of the Insane in the State of North Carolina.
D. L. DIX.Raleigh, November, 1848.