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diff --git a/.gitattributes b/.gitattributes new file mode 100644 index 0000000..d7b82bc --- /dev/null +++ b/.gitattributes @@ -0,0 +1,4 @@ +*.txt text eol=lf +*.htm text eol=lf +*.html text eol=lf +*.md text eol=lf diff --git a/LICENSE.txt b/LICENSE.txt new file mode 100644 index 0000000..6312041 --- /dev/null +++ b/LICENSE.txt @@ -0,0 +1,11 @@ +This eBook, including all associated images, markup, improvements, +metadata, and any other content or labor, has been confirmed to be +in the PUBLIC DOMAIN IN THE UNITED STATES. + +Procedures for determining public domain status are described in +the "Copyright How-To" at https://www.gutenberg.org. + +No investigation has been made concerning possible copyrights in +jurisdictions other than the United States. 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Murphy. - </title> - <link rel="coverpage" href="images/cover.jpg" /> - <style type="text/css"> - -body { - margin-left: 10%; - margin-right: 10%; -} - - h1,h2,h3 { - text-align: center; clear: both; -} - -p { - margin-top: .51em; - text-align: justify; - margin-bottom: .49em; -} - -hr { - width: 33%; - margin-top: 2em; - margin-bottom: 2em; - margin-left: 33.5%; - margin-right: 33.5%; - clear: both; -} - - -hr.chap {width: 65%; margin-left: 17.5%; margin-right: 17.5%;} - -hr.short {width: 10%; margin-left: 45%; margin-right: 45%;} - -div.chapter {page-break-before: always;} -h2.nobreak {page-break-before: avoid;} -h1.nobreak {page-break-before: avoid;} - -.pagenum { - position: absolute; - left: 92%; - font-size: smaller; - text-align: right; -} - -.center {text-align: center;} - - -.smcap {font-variant: small-caps;} - -.caption {font-weight: bold; text-align: center;} - -.figcenter { - margin: auto; - text-align: center; -} - -.transnote {background-color: #E6E6FA; - color: black; - font-size:smaller; - text-align: center; - margin-bottom:5em; - font-family:sans-serif, serif; } - </style> - </head> -<body> - - -<pre> - -The Project Gutenberg EBook of Colony Treatment of the Insane and Other -Defectives, by Patrick Livingston Murphy - -This eBook is for the use of anyone anywhere at no cost and with -almost no restrictions whatsoever. You may copy it, give it away or -re-use it under the terms of the Project Gutenberg License included -with this eBook or online at www.gutenberg.org/license - - -Title: Colony Treatment of the Insane and Other Defectives - -Author: Patrick Livingston Murphy - -Release Date: July 12, 2017 [EBook #55104] - -Language: English - -Character set encoding: ASCII - -*** START OF THIS PROJECT GUTENBERG EBOOK COLONY TREATMENT OF THE INSANE *** - - - - -Produced by Mary Glenn Krause, MFR, David E. Brown, -University of North Carolina at Chapel Hill and the Online -Distributed Proofreading Team at http://www.pgdp.net - - - - - - -</pre> - - - -<div class="figcenter"><img src="images/cover.jpg" alt="" /></div> - - -<div class="transnote"> -TRANSCRIBER'S NOTES:<br /> - -Inconsistencies in spelling and punctuation have been standardized.<br /> - -Some illustrations have been moved to paragraph breaks and may or may not be on their original page.<br /> - -The title page of the original book image was modified and used as the cover for this eBook.</div> - -<hr class="chap" /> - - - -<div class="chapter"> -<h1 class="nobreak">Colony Treatment<br /> - -<small>OF THE</small><br /> - -Insane and Other Defectives<br /></h1></div> - -<p class="center">—BY—</p> - -<p class="center">DR. P. L. MURPHY<br /> -MORGANTON, N. C.</p> - -<p class="center">Read Before the Meeting of the N. C. Medical Association<br /> -June, 1906, Charlotte, N. C.</p> - -<p class="center">(REPRINT FROM CAROLINA MEDICAL JOURNAL.)</p> - - -<hr class="chap" /> - - - - - -<div class="chapter"> -<span class="pagenum"><a name="Page_1" id="Page_1">[Pg 1]</a></span> -<h2 class="nobreak">Colony Treatment of the Insane and Other Defectives</h2></div> - - -<p>The subject of this paper might be -called "Employment as a means of -treating and caring for the insane and -other defectives" the colony being the -means of finding agreeable and profitable -work for the inmates.</p> - -<p>To many of you a description of -what is meant by the "colony treatment" -is needed to fully understand the -subject.</p> - -<p>As the expression is used in this -paper, and as it is generally understood, -it means the erection of buildings -some distance from the central hospital -plant and placing farm working patients -there, to be under the control -and management of the hospital officers.</p> - -<div class="figcenter"><img src="images/i_003.jpg" alt="FIRST BUILDING AT THE COLONY" /></div> - -<p class="caption">FIRST BUILDING AT THE COLONY</p> - -<p>Without discussing the origin of the -idea, and with no reference to Gheel, it<span class="pagenum"><a name="Page_2" id="Page_2">[Pg 2]</a></span> -is sufficient to say it was begun in Germany -in the sixties, and that it has -slowly found its way into other countries.</p> - -<div class="figcenter"><img src="images/i_004.jpg" alt="THE COLONY BUILDINGS" /></div> - -<p class="caption">THE COLONY BUILDINGS</p> - -<p>Such a colony was established in -connection with the Morganton Hospital -three years ago, or rather it was -ready for occupancy about that time. It -took several years of talk to get the idea -adopted, and as many more to get the -colony built. The plan of conducting it -by the hospital authorities was largely -experimental, and was made to suit the -people of Western North Carolina, but -it is, after all, a modification of the original -German conception.</p> - -<p>The first building was for 30 men -with rooms for a man and his family, -the man to have general supervision of -the place and the wife to cook and do -the household work. Afterwards -a small cottage was built for the<span class="pagenum"><a name="Page_3" id="Page_3">[Pg 3]</a></span> -manager and his family, and his rooms -were used for patients and later still -another building was erected so that -now 75 patients can be accommodated. -It would have been much better to have -limited the rooms to 30 as first intended. -No single colony plant for the insane -should much exceed that number. -As many colonies as are needed may be -had if land is sufficient, the number depending -on the size of the hospital, as -only a certain proportion of patients, -about 25 per cent., can thus be cared -for, or at the outside 40 per cent.</p> - -<div class="figcenter"><img src="images/i_005.jpg" alt="PATIENTS WORKING RASPBERRIES" /></div> - -<p class="caption">PATIENTS WORKING RASPBERRIES</p> - -<p>The colony buildings, outhouses and -surroundings at the Morganton colony -were made as near as possible like the -farm houses in this section of the State. -This was done to give it a home-like -appearance, and the management has -been such as to make each patient -feel at home; they are free to sit on the<span class="pagenum"><a name="Page_4" id="Page_4">[Pg 4]</a></span> -porches and the lawn in the summer, in -the sitting room before open fires in the -winter. They smoke, have games, read -or do what pleases them during these -hours of recreation. They have their -own garden, orchard, vineyard, berry -patches, poultry, pigs and cows, which -they attend to. Every effort is to make -each one feel that these things are his -own, he can gather berries, pull the -fruit when he wants it or as he pleases. -Every one is expected to do something -if no more than pick up chips for the -cook.</p> - -<div class="figcenter"><img src="images/i_006.jpg" alt="GENERAL VIEW OF COLONY" /></div> - -<p class="caption">GENERAL VIEW OF COLONY</p> - -<hr class="short" /> - -<h3><span class="smcap">Early Experiments.</span></h3> - -<p>The first party of patients sent to the -colony, about 15, were quiet, industrious -men who were expected to be the -nucleus of the organization. After -these became accustomed to their new -surroundings, others who were quiet -and who had some remnant of mind<span class="pagenum"><a name="Page_5" id="Page_5">[Pg 5]</a></span> -left, but who did little or no work were -tried. These readily dropped into the -ways of those who preceded them and -who set the pace. Further experiment -was made by sending those who seemed -incurably demented, incapable by reason -of their weakened minds of doing any -kind of work. Most of the last mentioned -had been residents of the hospital -for years and years in whom the last -vestige of hope for any improvement -had long vanished. Strange as it may -seem to you, as it did to us, acquainted -with these men and their disease, they -immediately went to work and are to-day -profitably employed. They have -gained in health and self-confidence, -they are happier because they feel there -is yet something in life for them.</p> - -<div class="figcenter"><img src="images/i_007.jpg" alt="COLONY PATIENTS CULTIVATING STRAWBERRIES" /></div> - -<p class="caption">SNAP SHOT—COLONY PATIENTS CULTIVATING STRAWBERRIES</p> - -<p>It may occur to some to ask why -these men had not been sent out to work -before and given an opportunity. It -has been the invariable custom since -the hospital opened to try to induce -every one to engage in some kind of -employment and it had been tried repeatedly -with these very men with complete -failure. To conjecture why they -were willing to work in one place<span class="pagenum"><a name="Page_6" id="Page_6">[Pg 6]</a></span> -and not in another might be profitless, -it is sufficient to know it is true.</p> - -<div class="figcenter"><img src="images/i_008.jpg" alt="RESTING AFTER THE DAY'S WORK" /></div> - -<p class="caption">RESTING AFTER THE DAY'S WORK</p> - -<p>After the work was well under way, -it was strange to see the development of -the different fancies of the different -men. Each one was allowed, so far as -possible, to follow his own inclination -and to select his own work. One fancied -painting and whitewashing and -building fires under the heating apparatus. -He studied economy in the use of -fuel as much as the average head of a -family, and is as intelligent in his work -as could be expected of any ordinary -man. Another patient has become -greatly interested in poultry and shows -more than ordinary intelligence in following -his bent. He reads journals on -poultry, and not only builds coops, box -nests, etc., but has actually invented -several useful contrivances. Another -hauls wood to the kitchen in a little<span class="pagenum"><a name="Page_7" id="Page_7">[Pg 7]</a></span> -wagon he made himself, and so on almost -indefinitely.</p> - -<div class="figcenter"><img src="images/i_009.jpg" alt="PATIENT TENDING BRONZE TURKEYS" /></div> - -<p class="caption">PATIENT TENDING BRONZE TURKEYS</p> - -<p>A brief report of two cases will partly -illustrate what has been done. The -following is quoted from a report to the -Board last December: "A boy, -J. B., 13 years old, came to -the hospital in June, 1895. He had a -form of insanity (Dementia praecox) -which rarely improves; indeed, its tendency -is generally to deterioration. This -boy was no exception to the rule and he -grew worse and worse until hope for -any improvement had been given up. -Three months ago he was sent to the -colony, but it was considered a desperate -chance. To the astonishment of -everyone he immediately began to improve, -and this has steadily gone on until -to-day he is a strong, vigorous young -fellow of 23, full of hope and energy, -whereas when he went there he was -dull, indifferent and listless; he never -inquired of his home or home people -and seemed to care for nothing. Recently -he has written home telling of his -marvelous improvement and of his joy -in life. 'He testified as one risen from<span class="pagenum"><a name="Page_8" id="Page_8">[Pg 8]</a></span> -the dead,' after ten years of mental -darkness. It is not certain that the improvement -will continue; in fact, it is -not expected, but even if he improves -no more, great good has been accomplished -in relieving this young fellow of -such suffering as we shudder to think -of." Six months after this report was -written this young man has gained but -little and it is probable he is as well as -he will ever be. He enjoys life as much -as the average man, taking part and interest -in baseball and other amusements -we are able to furnish our people. The -second case is of a man who was committed -to the hospital in November, -1898, this being his second admission. -He complained of great discomfort in -his head which he described as being -unbearable, so much so, that he begged -to be killed. His appetite was poor, he -was anaemic and greatly run down in<span class="pagenum"><a name="Page_9" id="Page_9">[Pg 9]</a></span> -health and evidently was a great sufferer. -Every effort to relieve him failed. -We were sure if he could be induced to -exercise he would improve, but nothing -we could do would cause him to take -the slightest interest in anything. He -was finally forced to go out with the -working party, but he would lie on the -ground complaining of his head. He -was a few months ago sent to the colony -along with nine other men almost as -bad as he. To the amazement of us all, -the man went to work, his health improved, -the pain and discomfort disappeared -and his face is ruddy and he -gives every evidence of health and -vigor. He works cheerfully, seems perfectly -satisfied, never complaining of -any bad feeling and is as comfortable -as he can be. These two cases are only -two of many as unpromising, who have -been greatly relieved and some few -cured by the colony treatment.</p> - -<p><span class="pagenum"><a name="Page_10" id="Page_10">[Pg 10]</a></span></p> - -<div class="figcenter"><img src="images/i_010.jpg" alt="PATIENTS INTERESTED IN GRAPE GROWING" /></div> - -<p class="caption">PATIENTS INTERESTED IN GRAPE GROWING</p> - -<p>All this seems so simple and is so -obviously the right course that we wonder -why it had not long ago been tried.</p> - -<div class="figcenter"><img src="images/i_011.jpg" alt="BARNYARD AND POULTRY HOUSES AT COLONY" /></div> - -<p class="caption">BARNYARD AND POULTRY HOUSES AT COLONY</p> - -<p>Two ideas are prominent in this system, -the first to find agreeable, healthful -employment for the patients and to -give them a home.</p> - -<div class="figcenter"><img src="images/i_012.jpg" alt="CHICKEN RUNS" /></div> - -<p class="caption">CHICKEN RUNS</p> - -<hr class="short" /> - -<h3><span class="smcap">Show Appreciation.</span></h3> - -<p>This working class, while too defective -to take up the burden of life, are yet -appreciative of their surroundings and -of most things that make life happy to -the people in the outside world. They -require the minimum amount of care -and discipline and with this given they -conduct themselves as well, indeed, better, -than the same number of sane men. -Some under this treatment recover that -otherwise would not, but the majority -must remain under hospital care, this -being their refuge and their home. How -much need therefore that every effort -should be put forth to make it pleasant -to these afflicted men.</p> - -<p>In general hospitals, in institutions -for children, and in reformatories we -have a different class to deal with. A -large number under one roof is not so<span class="pagenum"><a name="Page_11" id="Page_11">[Pg 11]</a></span> -objectionable, but these cases of chronic -insanity are not children in whom -the desire for a home is small, nor are -they malefactors in prison for punishment.</p> - -<p>You will pardon a little digression, -which, after all, leads to this subject -from another and a practical standpoint.</p> - -<div class="figcenter"><img src="images/i_013.jpg" alt="TWO COLONY BUILDINGS" /></div> - -<p class="caption">TWO COLONY BUILDINGS</p> - -<p>In North Carolina there are not less -than 4,000 white insane; of this number -1,500 are in two hospitals, leaving 2,500 -uncared for by the State. To properly -house all these people means the expenditure -of a million dollars, and the -annual cost of maintaining them will be -$500,000. It is well then to consider -carefully how this burden on the taxpayers -may be lightened. Without discussing -the question of the increase of -insanity, there can be no doubt that -there is an increased demand to have -these persons cared for and properly so. -All insane persons are dangerous in<span class="pagenum"><a name="Page_12" id="Page_12">[Pg 12]</a></span> -some degree to their neighbors, more so -to themselves. Insanity is the cause -of many suicides, while sexual crimes, -arson, assault, impostures, are often -committed by those mentally deranged.</p> - -<div class="figcenter"><img src="images/i_014.jpg" alt="PEACH ORCHARD AND GARDEN, SEEN FROM A COLONY PORCH" /></div> - -<p class="caption">PEACH ORCHARD AND GARDEN, SEEN FROM A COLONY PORCH</p> - -<p>Too often families are ruined by -some insane member, the bread winner -having to devote his whole time to -the control of wife or child, or a crime -is committed and every energy and the -savings of a lifetime must be devoted -to the cost of courts. Whole communities -are frequently terrorized by an insane -person and the lives of the women -and children made miserable.</p> - -<p>Only a few recover at once or die, -they live on for years not only imbecile -and helpless themselves, but a -burden on the family and community, -a severe drain which must tend to -weaken the general welfare of the -State.</p> - - - -<p><span class="pagenum"><a name="Page_13" id="Page_13">[Pg 13]</a></span>There are sufficient reasons for you -as physicians, men of standing in your -respective communities, not only to -make yourselves familiar with the disease -in order that you may prescribe intelligently -for those suffering from it, -but to use your influence, which is -great, to see that proper provision is -made for them by the public.</p> - -<div class="figcenter"><img src="images/i_015.jpg" alt="PATIENTS PLAYING BASEBALL" /></div> - -<p class="caption">PATIENTS PLAYING BASEBALL</p> - -<p>Much insanity is caused by alcohol -and drugs. This touches you more -closely, for you are largely responsible -for these habits. You may do something -by preventing unwise marriages -of those whose heredity is not good.</p> - -<p>It should be your special province to -recognize dangerous symptoms in time -and by prompt action prevent suicides -and accidents and to send to the hospitals -at once these patients who have -infinitely more chances to recover when<span class="pagenum"><a name="Page_14" id="Page_14">[Pg 14]</a></span> -placed under the care of competent -alienists.</p> - -<div class="figcenter"><img src="images/i_016.jpg" alt="MAKING FIRST BASE" /></div> - -<p class="caption">MAKING FIRST BASE</p> - -<hr class="short" /> - -<h3><small>2,500 WHITE INSANE UNCARED FOR.</small></h3> - -<p>The conclusions we reach are that -2,500 white insane people in North Carolina -are uncared for, that a great outlay -of money will be required to build -for this number and after that the never -ending expense of maintaining them -begins. If it can be demonstrated that -the colony system is the best and the -cheapest, it should by all means be -adopted.</p> - -<p>There is an end to the willingness and -even ability of the taxpayers to provide -for the defectives in expensive hospitals -and asylums, and it is clearly the duty -of those who have these matters in hand -to use proper economy. What is done -by the Legislature will depend on the -demand of the people and the wisdom -of the Legislators. It will require great -deliberation and the wisest action to -solve this question.</p> - -<p>In North Carolina no more hospitals -ought to be built at present, those now -in existence should be enlarged if possible.</p> - - - -<p><span class="pagenum"><a name="Page_15" id="Page_15">[Pg 15]</a></span>Unfortunately at Morganton no -more land can be purchased and that -institution cannot with advantage be -greatly increased in size. The last opportunity -to buy land there has been -allowed to pass. This is to be deplored -for the plan there has been so successful -that much was hoped for in the -judicious extension of these colonies.</p> - -<p>Much more might be said on the -general subject of caring for the insane, -but time forbids. Perhaps on -some future occasion this will be taken -up and discussed.</p> - -<p>Hospitals for the insane cannot properly -care for epileptics or idiots. I use -the term idiot in the sense in which it -is defined by the North Carolina statutes -"a person born deficient or who -became deficient before the completion -of the twelfth year of age."</p> - -<p>Many of these defectives are capable -of doing common labor and can be -made very nearly self-sustaining if -properly managed in such a colony for -the insane as has been described. In -many of the States where this is tried, -it has been successful. In North Carolina, -where we have such good climate -and where land can be purchased -cheaply, more can be done than in other -less fortunate communities. I believe -in the cotton and truck section of the -State such a colony could be nearly -self-sustaining, but leaving that out of -the question, there can be no doubt it -is the best for these people to live outdoor -lives with proper employment. I -would like also to enlarge on this feature -of my paper, but time will not -permit.</p> - -<p>I trust, gentlemen, that you will become -enough interested in these subjects -to give them your hearty support. -If you do, then the labors of those of us -who are immediately responsible, will -be greatly lightened and these afflicted -fellow citizens will be happier and your -State will be a better State.</p> - -<p>Since this paper was written my attention -was drawn to a statement in a -medical journal of the number of insane -sent to the hospitals in Massachusetts -during the year 1904. It bears so -closely on what has been said I repeat -it and compare it with our State and -hospitals. During that year 2,426 insane -persons were admitted into the -hospitals of Massachusetts, none of -whom had ever before been inmates of -any hospital for insane. Adding to -these the number of re-admissions,<span class="pagenum"><a name="Page_16" id="Page_16">[Pg 16]</a></span> -which could not have been less than -600, we see 3,000 persons sent yearly -to the hospitals of that State. Between -7,000 and 8,000 patients are cared for -by the public hospitals.</p> - -<p>As compared with North Carolina -the population of Massachusetts is -twice that of the white people of our -State. We should have 1,500 white -patients sent to our hospitals every -year and we ought to have accommodation -for 4,000. As it is, less than -400 are admitted and only 1,500 can be -cared for in our hospitals. There is -some differences, I believe, in the proportion -of insane to the population in -the two States, but not that much. -Massachusetts gives her insane citizens -proper care. North Carolina does -not.</p> - -<div class="figcenter"><img src="images/i_018.jpg" alt="" /></div> - -<hr class="chap" /> - - - - - - - - - -<pre> - - - - - -End of the Project Gutenberg EBook of Colony Treatment of the Insane and -Other Defectives, by Patrick Livingston Murphy - -*** END OF THIS PROJECT GUTENBERG EBOOK COLONY TREATMENT OF THE INSANE *** - -***** This file should be named 55104-h.htm or 55104-h.zip ***** -This and all associated files of various formats will be found in: - http://www.gutenberg.org/5/5/1/0/55104/ - -Produced by Mary Glenn Krause, MFR, David E. 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You may copy it, give it away or -re-use it under the terms of the Project Gutenberg License included -with this eBook or online at www.gutenberg.org/license - - -Title: Colony Treatment of the Insane and Other Defectives - -Author: Patrick Livingston Murphy - -Release Date: July 12, 2017 [EBook #55104] - -Language: English - -Character set encoding: ASCII - -*** START OF THIS PROJECT GUTENBERG EBOOK COLONY TREATMENT OF THE INSANE *** - - - - -Produced by Mary Glenn Krause, MFR, David E. Brown, -University of North Carolina at Chapel Hill and the Online -Distributed Proofreading Team at http://www.pgdp.net - - - - - - - - - - Colony Treatment - - OF THE - - Insane and Other Defectives - - --BY-- - - DR. P. L. MURPHY - MORGANTON, N. C. - - Read Before the Meeting of the N. C. Medical Association - June, 1906, Charlotte, N. C. - - (REPRINT FROM CAROLINA MEDICAL JOURNAL.) - - - - -Colony Treatment of the Insane and Other Defectives - - -The subject of this paper might be called "Employment as a means of -treating and caring for the insane and other defectives" the colony -being the means of finding agreeable and profitable work for the -inmates. - -To many of you a description of what is meant by the "colony treatment" -is needed to fully understand the subject. - -As the expression is used in this paper, and as it is generally -understood, it means the erection of buildings some distance from the -central hospital plant and placing farm working patients there, to be -under the control and management of the hospital officers. - -[Illustration: FIRST BUILDING AT THE COLONY] - -Without discussing the origin of the idea, and with no reference to -Gheel, it is sufficient to say it was begun in Germany in the sixties, -and that it has slowly found its way into other countries. - -[Illustration: THE COLONY BUILDINGS] - -Such a colony was established in connection with the Morganton Hospital -three years ago, or rather it was ready for occupancy about that time. -It took several years of talk to get the idea adopted, and as many more -to get the colony built. The plan of conducting it by the hospital -authorities was largely experimental, and was made to suit the people -of Western North Carolina, but it is, after all, a modification of the -original German conception. - -The first building was for 30 men with rooms for a man and his family, -the man to have general supervision of the place and the wife to cook -and do the household work. Afterwards a small cottage was built for -the manager and his family, and his rooms were used for patients and -later still another building was erected so that now 75 patients can be -accommodated. It would have been much better to have limited the rooms -to 30 as first intended. No single colony plant for the insane should -much exceed that number. As many colonies as are needed may be had if -land is sufficient, the number depending on the size of the hospital, -as only a certain proportion of patients, about 25 per cent., can thus -be cared for, or at the outside 40 per cent. - -[Illustration: PATIENTS WORKING RASPBERRIES] - -The colony buildings, outhouses and surroundings at the Morganton -colony were made as near as possible like the farm houses in this -section of the State. This was done to give it a home-like appearance, -and the management has been such as to make each patient feel at home; -they are free to sit on the porches and the lawn in the summer, in -the sitting room before open fires in the winter. They smoke, have -games, read or do what pleases them during these hours of recreation. -They have their own garden, orchard, vineyard, berry patches, poultry, -pigs and cows, which they attend to. Every effort is to make each one -feel that these things are his own, he can gather berries, pull the -fruit when he wants it or as he pleases. Every one is expected to do -something if no more than pick up chips for the cook. - -[Illustration: GENERAL VIEW OF COLONY] - - -EARLY EXPERIMENTS. - -The first party of patients sent to the colony, about 15, were -quiet, industrious men who were expected to be the nucleus of the -organization. After these became accustomed to their new surroundings, -others who were quiet and who had some remnant of mind left, but who -did little or no work were tried. These readily dropped into the ways -of those who preceded them and who set the pace. Further experiment -was made by sending those who seemed incurably demented, incapable by -reason of their weakened minds of doing any kind of work. Most of the -last mentioned had been residents of the hospital for years and years -in whom the last vestige of hope for any improvement had long vanished. -Strange as it may seem to you, as it did to us, acquainted with these -men and their disease, they immediately went to work and are to-day -profitably employed. They have gained in health and self-confidence, -they are happier because they feel there is yet something in life for -them. - -[Illustration: SNAP SHOT--COLONY PATIENTS CULTIVATING STRAWBERRIES] - -It may occur to some to ask why these men had not been sent out to work -before and given an opportunity. It has been the invariable custom -since the hospital opened to try to induce every one to engage in some -kind of employment and it had been tried repeatedly with these very men -with complete failure. To conjecture why they were willing to work in -one place and not in another might be profitless, it is sufficient to -know it is true. - -[Illustration: RESTING AFTER THE DAY'S WORK] - -After the work was well under way, it was strange to see the -development of the different fancies of the different men. Each one -was allowed, so far as possible, to follow his own inclination and to -select his own work. One fancied painting and whitewashing and building -fires under the heating apparatus. He studied economy in the use of -fuel as much as the average head of a family, and is as intelligent -in his work as could be expected of any ordinary man. Another patient -has become greatly interested in poultry and shows more than ordinary -intelligence in following his bent. He reads journals on poultry, and -not only builds coops, box nests, etc., but has actually invented -several useful contrivances. Another hauls wood to the kitchen in a -little wagon he made himself, and so on almost indefinitely. - -[Illustration: PATIENT TENDING BRONZE TURKEYS] - -A brief report of two cases will partly illustrate what has been done. -The following is quoted from a report to the Board last December: "A -boy, J. B., 13 years old, came to the hospital in June, 1895. He had -a form of insanity (Dementia praecox) which rarely improves; indeed, -its tendency is generally to deterioration. This boy was no exception -to the rule and he grew worse and worse until hope for any improvement -had been given up. Three months ago he was sent to the colony, but it -was considered a desperate chance. To the astonishment of everyone -he immediately began to improve, and this has steadily gone on until -to-day he is a strong, vigorous young fellow of 23, full of hope -and energy, whereas when he went there he was dull, indifferent and -listless; he never inquired of his home or home people and seemed to -care for nothing. Recently he has written home telling of his marvelous -improvement and of his joy in life. 'He testified as one risen from -the dead,' after ten years of mental darkness. It is not certain that -the improvement will continue; in fact, it is not expected, but even if -he improves no more, great good has been accomplished in relieving this -young fellow of such suffering as we shudder to think of." Six months -after this report was written this young man has gained but little and -it is probable he is as well as he will ever be. He enjoys life as much -as the average man, taking part and interest in baseball and other -amusements we are able to furnish our people. The second case is of a -man who was committed to the hospital in November, 1898, this being -his second admission. He complained of great discomfort in his head -which he described as being unbearable, so much so, that he begged to -be killed. His appetite was poor, he was anaemic and greatly run down -in health and evidently was a great sufferer. Every effort to relieve -him failed. We were sure if he could be induced to exercise he would -improve, but nothing we could do would cause him to take the slightest -interest in anything. He was finally forced to go out with the working -party, but he would lie on the ground complaining of his head. He was a -few months ago sent to the colony along with nine other men almost as -bad as he. To the amazement of us all, the man went to work, his health -improved, the pain and discomfort disappeared and his face is ruddy -and he gives every evidence of health and vigor. He works cheerfully, -seems perfectly satisfied, never complaining of any bad feeling and is -as comfortable as he can be. These two cases are only two of many as -unpromising, who have been greatly relieved and some few cured by the -colony treatment. - -[Illustration: PATIENTS INTERESTED IN GRAPE GROWING] - -[Illustration: BARNYARD AND POULTRY HOUSES AT COLONY] - -[Illustration: CHICKEN RUNS] - -All this seems so simple and is so obviously the right course that we -wonder why it had not long ago been tried. - -Two ideas are prominent in this system, the first to find agreeable, -healthful employment for the patients and to give them a home. - - -SHOW APPRECIATION. - -This working class, while too defective to take up the burden of life, -are yet appreciative of their surroundings and of most things that -make life happy to the people in the outside world. They require the -minimum amount of care and discipline and with this given they conduct -themselves as well, indeed, better, than the same number of sane men. -Some under this treatment recover that otherwise would not, but the -majority must remain under hospital care, this being their refuge and -their home. How much need therefore that every effort should be put -forth to make it pleasant to these afflicted men. - -In general hospitals, in institutions for children, and in -reformatories we have a different class to deal with. A large number -under one roof is not so objectionable, but these cases of chronic -insanity are not children in whom the desire for a home is small, nor -are they malefactors in prison for punishment. - -You will pardon a little digression, which, after all, leads to this -subject from another and a practical standpoint. - -[Illustration: TWO COLONY BUILDINGS] - -In North Carolina there are not less than 4,000 white insane; of -this number 1,500 are in two hospitals, leaving 2,500 uncared for by -the State. To properly house all these people means the expenditure -of a million dollars, and the annual cost of maintaining them will -be $500,000. It is well then to consider carefully how this burden -on the taxpayers may be lightened. Without discussing the question -of the increase of insanity, there can be no doubt that there is an -increased demand to have these persons cared for and properly so. -All insane persons are dangerous in some degree to their neighbors, -more so to themselves. Insanity is the cause of many suicides, while -sexual crimes, arson, assault, impostures, are often committed by those -mentally deranged. - -[Illustration: PEACH ORCHARD AND GARDEN, SEEN FROM A COLONY PORCH] - -Too often families are ruined by some insane member, the bread winner -having to devote his whole time to the control of wife or child, or a -crime is committed and every energy and the savings of a lifetime must -be devoted to the cost of courts. Whole communities are frequently -terrorized by an insane person and the lives of the women and children -made miserable. - -Only a few recover at once or die, they live on for years not only -imbecile and helpless themselves, but a burden on the family and -community, a severe drain which must tend to weaken the general welfare -of the State. - -There are sufficient reasons for you as physicians, men of standing in -your respective communities, not only to make yourselves familiar with -the disease in order that you may prescribe intelligently for those -suffering from it, but to use your influence, which is great, to see -that proper provision is made for them by the public. - -[Illustration: PATIENTS PLAYING BASEBALL] - -Much insanity is caused by alcohol and drugs. This touches you more -closely, for you are largely responsible for these habits. You may do -something by preventing unwise marriages of those whose heredity is not -good. - -It should be your special province to recognize dangerous symptoms in -time and by prompt action prevent suicides and accidents and to send to -the hospitals at once these patients who have infinitely more chances -to recover when placed under the care of competent alienists. - -[Illustration: MAKING FIRST BASE] - - -2,500 WHITE INSANE UNCARED FOR. - -The conclusions we reach are that 2,500 white insane people in North -Carolina are uncared for, that a great outlay of money will be required -to build for this number and after that the never ending expense of -maintaining them begins. If it can be demonstrated that the colony -system is the best and the cheapest, it should by all means be adopted. - -There is an end to the willingness and even ability of the taxpayers -to provide for the defectives in expensive hospitals and asylums, and -it is clearly the duty of those who have these matters in hand to use -proper economy. What is done by the Legislature will depend on the -demand of the people and the wisdom of the Legislators. It will require -great deliberation and the wisest action to solve this question. - -In North Carolina no more hospitals ought to be built at present, those -now in existence should be enlarged if possible. - -Unfortunately at Morganton no more land can be purchased and that -institution cannot with advantage be greatly increased in size. The -last opportunity to buy land there has been allowed to pass. This is -to be deplored for the plan there has been so successful that much was -hoped for in the judicious extension of these colonies. - -Much more might be said on the general subject of caring for the -insane, but time forbids. Perhaps on some future occasion this will be -taken up and discussed. - -Hospitals for the insane cannot properly care for epileptics or idiots. -I use the term idiot in the sense in which it is defined by the North -Carolina statutes "a person born deficient or who became deficient -before the completion of the twelfth year of age." - -Many of these defectives are capable of doing common labor and can be -made very nearly self-sustaining if properly managed in such a colony -for the insane as has been described. In many of the States where this -is tried, it has been successful. In North Carolina, where we have -such good climate and where land can be purchased cheaply, more can -be done than in other less fortunate communities. I believe in the -cotton and truck section of the State such a colony could be nearly -self-sustaining, but leaving that out of the question, there can be no -doubt it is the best for these people to live outdoor lives with proper -employment. I would like also to enlarge on this feature of my paper, -but time will not permit. - -I trust, gentlemen, that you will become enough interested in these -subjects to give them your hearty support. If you do, then the labors -of those of us who are immediately responsible, will be greatly -lightened and these afflicted fellow citizens will be happier and your -State will be a better State. - -Since this paper was written my attention was drawn to a statement in -a medical journal of the number of insane sent to the hospitals in -Massachusetts during the year 1904. It bears so closely on what has -been said I repeat it and compare it with our State and hospitals. -During that year 2,426 insane persons were admitted into the hospitals -of Massachusetts, none of whom had ever before been inmates of any -hospital for insane. Adding to these the number of re-admissions, -which could not have been less than 600, we see 3,000 persons sent -yearly to the hospitals of that State. Between 7,000 and 8,000 patients -are cared for by the public hospitals. - -As compared with North Carolina the population of Massachusetts is -twice that of the white people of our State. We should have 1,500 -white patients sent to our hospitals every year and we ought to have -accommodation for 4,000. As it is, less than 400 are admitted and only -1,500 can be cared for in our hospitals. There is some differences, -I believe, in the proportion of insane to the population in the two -States, but not that much. Massachusetts gives her insane citizens -proper care. North Carolina does not. - -[Illustration] - - - - - TRANSCRIBER'S NOTES: - - Inconsistencies in spelling and punctuation have been standardized. - - Some illustrations have been moved to paragraph breaks and may or may - not be on their original page. - - - - - - - -End of the Project Gutenberg EBook of Colony Treatment of the Insane and -Other Defectives, by Patrick Livingston Murphy - -*** END OF THIS PROJECT GUTENBERG EBOOK COLONY TREATMENT OF THE INSANE *** - -***** This file should be named 55104.txt or 55104.zip ***** -This and all associated files of various formats will be found in: - http://www.gutenberg.org/5/5/1/0/55104/ - -Produced by Mary Glenn Krause, MFR, David E. 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