On Behalf of the Insane Poor in Kentucky
February 1846 — Frankfort KY
To the General Assembly of the Commonwealth of Kentucky:
GENTLEMEN: :— I ask the indulgence of placing before you some remarks suggested by repeated and careful inspection of the State Hospital for the Insane, at Lexington; and also the results of journeys recently made through forty four counties of your State, in view of ascertaining, as far as possible, the numbers and condition of this class of sufferers who have not been brought under remedial hospital care.
I would respectfully and earnestly urge the duty of providing a remedy for prominent defects and deficiencies in the present establishment, and suggest some reasons which appear absolute and consistent, for early additional provision in a southern district of the State for this numerous and increasing class of sufferers. Justice and humanity unite to present these claims, and it may be added, that both present and future economy in the administration of the public funds sustain their plea.
I approach you with confidence as the advocate of those who, alas, cannot plead their own cause — of those in whom the light of the understanding is darkened, and who are crushed under the weight of an overwhelming malady — yes, I approach you with confidence, for I am told that the citizens of Kentucky have heretofore been neither slow nor reluctant in responding to the calls of duty, and acknowledging the claims of those, who through privation and disease are made wards of the State — legalized dependents on its beneficent and guardian care.
Legislators of Kentucky, J do not now urge the necessities of these afflicted ones, so much in the hope of your effective and generous action, as in the belief that you will not hesitate to provide amply for those who, in the providence of God, cannot provide for themselves : yes, I believe that with united mind and will, you will act wholly upon that sacred rule of universal obligation, which enjoins upon Legislators no less than upon individuals in their social relations, to do for others what they in similar circumstances would have meted to themselves.
Of all the calamities to which ‘humanity is subject, none is so dreadful as insanity. Pinching want, hideous deformity, acute disease, mutilation, deafness, blindness; all these are distressing in their effects alike upon the suf ferer and those with whom he is connected ; but sad as are these distresses they leave to the unfortunate, human sympathies and priceless affections. They admit the assuaging influence of consolation and tender care, recognizing through these the love that prompts, and the hand that ministers. Not so is it with those who are smitten with the visitation of insanity — that disease which produces utter dependence for the supply of all physical wants, and rends away the noblest attributes of humanity.
The heart grows cold, and no gentle or generous affections flourish there. The brain no longer exercising its functions healthfully, reveals only distorted images of the mind. Healthful, intellectual vigor is prostrated, and man, from bearing, affinity with spiritual natures, becomes in an hour, trans formed to a mere brute existence, manifesting little beside low animal instincts. This malady, the offspring of civilization, increases annually in our country, and demands not on the solid ground of humanity, and the less stable basis of expediency, but through the uncompromizing law of necessity, that its progress be arrested and its controllable causes subdued. The evil and the remedy are both before us. Experience and observation have dispelled that long received error which ascribed to the mind the production of insanity, and have demonstrated thephysiological fact that the proximate cause of this disease bodily. The manifestations of the mind are distorted through physical disease, or disturbance of that organ through which the reasoning faculties find expression. Insanity in strict definition, has ceased to be called mental disease; it is rather mental disability. This fact established, we seek for insanity, as for other bodily ailments, those remedies which will soonest and most surely restore the lost balance of the system. Moral means in various measure, in all diseases, but eminently so in this, comes in aid of medical agents, and it’ both conceded and urged the highest authorities, that these can be effectually combined only in an establishment specially devoted to the remedial treatment the various forms this malady.
It is a prominent characteristic of insanity, manifested with rare exceptions, in all varieties of this disease, that many of the persons and objects amongst which developed, become sources of discomfort, or of serious annoyance and excitement to the patient, thereby nourishing and aggravating irritation and morbid susceptibilities.
Disagreeable thoughts are continually revived things with which they are associated, as well as by persons whose kindest attentions are construed into proofs of ill-will and ill-design. Thus the mind of the patient disquieted sufficiently to counteract any curative process the administration of medicine might be preparing. Withdrawal from all ‘outward and familiar disturbing causes counteracts morbid associations, and wholesome influences obtain predominance.
Friends at home rarely possess the means of relief which violent and sudden exhibition of insanity demands, even in all cases they can have the advantage of the services of skilful medical practitioner, familiar with the Protean phases of this disease. The discriminating and watchful hourly attention these often, for considerable periods require, can be had only within the walls of a judiciously organized and vigilantly governed Hospital. Here, where mild and gentle, but firm and decided influences are brought to bear, the raving maniac becomes yielding and calm, and the insensible are roused to an interest in the affairs of life, and throw off melancholy and inertia.
Although for a given time a patient may live at greater expense in a hospital than in a poor-house, or private family, this no argument against the former; for granting that expense alone the consideration, the number of cures wrought through the agency of hospital treatment timejy adopted, will in short period leave the balance-sheet of expense altogether in favor of the latter. But not question of expense which is to discussed, it is the rights of suffering humanity; in Kentucky it is no longer a question whether the poor and friendless maniac, and the helpless subject of dementia shall be provided for; and whether the well-established hospital shall open its doors to but a few favored ones, and reject the many; heretofore it has, I think, been the purpose to provide for all. But numbers have now increased vastly beyond the capacity of the present establishment to receive ; and it is well known to all who have inquired into the facts, that the lodging apartments are in many cases, crowded to the great disadvantage and discomfort of the occupants. What was once an ample provision is no longer sufficient. The increased population of the State, and of course the increased number of patients, call for accommodations in measure with this increase.
The first consideration however seems to be attention to the comfort and safety of the patients resident in the hospital which is already established, by adding such improvements as will place it in rank with the best institutions for the management of the insane in the United States, and put it in the power of, the able and devoted Superintendent to do that justice to his patients, and the cause of humanity, which his judgment and skill as a physician, and his kind and humane dispositions suggest.
Within the last three months, I have repeatedly visited the hospital at Lexington, and have been permitted freely to see every department of the entire establishment. With such ample opportunities for observation, I think I am able to do justice to all who share in the administration of the affairs of the institution. The judicious and watchful attention of the resi dent physician and his assistant, have commanded my confidence and re spect. The Commissioners, as official visitors, are as vigilant as they are disinterested. The Steward and Matron are devoted to their very onerous duties, through a hearty interest in the welfare of those whose daily com forts so much depend on their fidelity. One cannot sufficiently commend the neatness and order which are maintained in this large establishment ; and that these circumstances are preserved under existing inconveniences,’ must surprise even the most casual observer. This is done at an expense of manual labor and continual oversight, laborious in the extreme.
A transient visitor, passing through the Institution, giving perhaps but a few hours to an examination of its various departments, unacquainted with the details of domestic economy, and knowing little or nothing of the peculiar and unremitting care which most of those two hundred and twenty patients require seeing little of tire special labors which the defective construction, and the inconvenient arrangements of the present buildings produce, — such visitor may come away from the hospital, as many have known, even within the short period of my acquaintance with the Institution and believe that all as should be, and that nothing wanting to make this complete and effective establishment.
The most obvious defects may be briefly enumerated as follows: — The kitchen is much to [sic] small for the variety and amount of labor to be per formed in it. It is deficient in all arrangements which would facilitate the accomplishment of work in that department. For the want of well constructed range, with boilers and bakers, the cooking done by stove„ not the least objection to which the greater quantity of fuel which consumes than would properly adjusted fire, and cooking-apparatus. estimated that the saving fuel alone for year or eighteen months would cover the expense of erecting a well-constructed and commodious kitchen.
The establishment affords but one dining-room, and in this long and cheerless hall must be congregated nearly all the patients, both from the men and women’s departments, to partake their meals at one and the same time. That these should be disposed with less comfort than is requisite for a large part of the patients under existing arrangements inevitable. And here we see congregated all classes of patients, the, incurable and the convalescent the mirthful and the sad the unconscious and those whose keen sensibilities are quickened to acutest suffering; these all must come together, and on these are wrought healthful, or oftener injurious influences, according to the form of the malady under which the patient labors. deemed an imperative necessity in all well-organized hospitals that the patients be classified with reference to their mental condition and physical wants. Here your Superintendent has no choice; it cannot be done, so remarkably defective is the internal construction of these buildings.
There are in this whole establishment, neither bathing-rooms nor washing-rooms of any description. In ordinary domestic arrangements these are needful for comfort and refreshment, as well as for their essential hygienic influences how much more at all seasons, must this be the case in establishments which receive several hundred inmates, and most of these variously diseased. In the class of diseases indeed, either warm or cold bathing considered so essential to the curative process, as that of insanity yet we have here hospital which should be complete in all remedial appliances, wholly destitute of even the most simple accommodations for water-bathing. How the benefits of personal cleanliness are commanded at all here, the wonder. First, laboriously, the water must be ” packed” from the spring to the kitchen; next heated small quantities at time, receiver upon the cooking-stove; thirdly, must be conveyed in buckets over two flights of stairs for the women’s department, for the men’s, across the yards, &c.,) into one of the day-rooms, where, after use, must again and finally, be borne buckets over one flight of stairs to some waste-drain on the premises. cannot be necessary to enlarge upon this subject.
The necessity is urgent for the early introduction of water throughout the State hospital requisite in the culinary department, and all beside. Here again would be diminution of expense in the item of labor. The quantity of water required for daily consumption large institutions not comparable with that demanded in private households. Of thirteen hospitals, with the internal arrangements of which am acquainted, there is daily consumed in each, for all purposes, from one hundred and twenty, to one hundred and sixty barrels, and this for purposes only of absolute necessity. At Utica, N. York, “when the number of patients as yet did not reach two hundred, the daily consumption of water was nearly four thousand gallons. Nor did this, in whole, supply the baths, the house-cleansing, washing, and cooking departments. The water at Utica was forced from well means of pump driven horse-power, to the attic story of the centre building, and thence distributed through pipes over the entire establishment. One horse will force from forty-five to fifty hogsheads in an hour. Every arangement made to guard against conflagration. The roofs are all fire proof. An engine, and large number of buckets are always in order and in place, for instant use. There an engine at the State Hospital here, but the distance from the spring to the rear buildings, would render its use of little avail. In fine, the first and greatest necessity is to secure an ample supply of water in the buildings, as well for security, as for health and convenience.
The laundry is very defective. The ground floor, occupied for cleansing the apparel, &c., is so imperfectly constructed that the health of those who labor there is seriously exposed. The ironing-room is but half the size necessary for the ready and convenient performance of that branch of labor. There is no drying nor airing room at. all. In damp and wet weather, therefore, several days sometimes intervene before the requisite changes of body or of bed-garments can be had. A properly constructed washing- house appears desirable, not less for health than for the reduction of labor, and the great reduction in the expenditure of fuel. There is no infirmary in the hospital, nor are there apartments either in the men, or the women’s ward, where, in the event of special sickness from fevers, or other incidental nesses, patients might be kept quiet, and receive all the cares their condition would claim.
Dr. Luther V. Bell, whose reputation not only our own country but Europe, gives authority to his opinions, remarks as follows, upon the ‘treatment of the insane ” The value of properly adapted architectural arrangements of complete classification of patients of well educated,’ morally elevated, and well paid class of attendants of well directed and perseveringly applied employment; of mechanical and of agricultural labor; of such amusements of mind and body as experience proves to be best adapted to occupy and direct the .diseased intellectual functions and moral susceptibilities; and lastly, such an intercommunication with the sane, course, public and private devotional exercises, and in the lighter and gayer re-unions of life, as the peculiarities of each case demand, must be felt and acknowledged, wherever the insane are entrusted to the care of the refined, the well-informed, and the conscientious. Beyond the judicious, energetic, and experienced application of such moral agents as these, and an adequate medical treatment, there and can be no mystery in the treatment of the insane.”
The State Hospital at Lexington pleasantly situated, and at convenient distance from the city. There attached to this institution about thirty acres of land, but much to be regretted that has not the advan age of owning farm of one or two hundred acres, whereon those of the patients who are able to labor, and who would be benefited thereby, might be employed. All recent experience shows that tract of land for agricultural purposes almost, not quite, indispensable to the interest both of the patients, and to the domestic economy of the hospital. What ever shall seem to aid remedial measures, and advance recovery to health, seems demanded at the hands of those who, possessed of this priceless bless ing, owe as thank-offering to heaven, every care to such as are smitten with disease.
Dr. Earle, of the Bloomingdale Asylum refers repeatedly his valuable reports, to the advantage of well-directed employment for the insane, andwffers examples illustrative of this opinion, from which select the following, ” During the Spring of 1844, two farmers, each of whom possessed a good farm, were admitted to our Asylum within week of each other. They were laboring under the most abject form of melancholy, and had both attempted suicide. In less than a month, their condition being somewhat improved, they expressed a willingness, and one of them a strong de sire to work out of doors. Being furnished with implements, they daily went out together, an*d worked upon the farm with as much apparentinterest as if it belonged to themselves. Under this course they continued rapidly to improve, and both were discharged recovered, one at the end of six weeks, the/other at the expiration of three months from the time of their respective admissions.”
“Another man was brought to the Asylum, laboring Under a high degree of active mania. His appetite was poor, and his frame emaciated. He was careless of his personal appearance, restless, turbulent, and almost incessantly talking, in an incoherent manner, upon the delusions attending upon his dis ease. When out of doors, he was constantly wandering to and fro, talking to himself, and digging the earth with his hands, without end or object, and generally having his mouth filled with grass. For some months there was but little change in his condition. At length, having become somewhat less bewildered, his attendant succeeded in inducing him to assist in making beds. Shortly afterwards he was employed with the painters and glaziers upon the green-house; after this, he went into the carpenter’s, shop, where he worked regularly for several weeks. Meanwhile, his bodily health improved, his mind gradually returned to its former integrity, and he was discharged cured of his mental disorder.”
“These cases are fair examples of the utility of a combination of medical and moral treatment, for in all of them medicine was regularly administered until within a comparatively short period before their departure from the institution. They are presented also as cogent arguments in favor of giving to manual labor that preeminence which has already been assigned to it.”
The following schedule of the productions from fifty acres of the Bloomingdale farm, cultivated by the patients under the direction of the farmer and gardener, may be read with interest.
Hay, 40 tons.
Oats cut in the milk, 4 tons
Butter, 728 lbs.
Milk, 4700 gallons.
Pork, 2706 lbs.
Potatoes, 500 bushels.
Corn, 75 bushels.
Sugar Beets, 250 bushels.
Blood Beets, 125 bushels.
Mangel Wurtzel, 50 bushels.
Turnips, 325 bushels.
Parsnips, 100 bushels.
Carrots, 30 bushels.
Onions, 50 bushels.
Cabbages, 3000 heads.
Leeks, 4000 heads.
Celery, 2600 heads.
Salsify, 1500 heads.
Besides these there was a full supply, for the whole establishment, of peas, beans, squashes, tomatoes, radishes, cucumbers, asparagus, spinach, lettuce, egg-plant, and turkey-plant, beside a good supply of water-melons and musk-mellons. Of fruits, we had
Apples, 500 bushels.
Pears, 60 bushels.
Peaches, 18 bushels.
Cherries, 100 bushels.
Grapes, 800 lbs.
By the labor of the patients and gardener three years since, I observe from the annual report of the Connecticut Hospital, that the garden, which contains an acre and a quarter of land, surrounded by a carriage-road, and a border planted with evergreens, rose-bushes, and other flowering plants, produced as follows:
Lettuce, 1100 large solid heads.
Cabbages, 1400 do.do.
Radishes, 700 bunches.
Asparagus, 2800 do.
Rhubarb, 300 lbs.
Marrowfat peas, 14 bushels.
Sweet Corn, 419 dozen ears.
Summer Squash, 715 dozen.
Squash peppers, 48 dozen.
Cucumbers, (table) 756 dozen.
Cucumbers for pickles, 7 barrels.
Beets, 147 bushels.
Carrots, 24 bushels.
Parsnips, 25 bushels.
Onions, 120 bushels.
Turnips, 80 bushels.
Tomatoes, 40, bushels.
Early potatoes, 35 bushels.
Winter squashes, 7 wagon loads.
Celery, 500 large heads.
These articles, all of the very best and earliest kinds, and valued at market prices in Hartford, would have amounted to more than 625 dollars. The farm was like the garden, well cultivated.” I have quoted these examples, which might be greatly multiplied, to show the excellent economy of a judicious cultivation of the lands pertaining to public institutions, and to enforce the double argument for attaching good farming and gardening land to Hospitals for the treatment of the insane.
I have referred at some length to the special wants and deficiencies of the only establishment for the reception of the insane within the bounds of this wide Commonwealth, and have urged perhaps with importunity, that these wants should be supplied, and that these deficiencies should be remedied. I leave this subject with those whose good sense and convictions of justice will, I trust, conduct to such effectual legislation as shall be in harmony with the humane sentiments of the citizens at large, creditable to the Legislators, and honorable to the Commonwealth.
Many States are active in laying broad and deep the foundations of nu merous charitable institutions ; in enhancing that real greatness which knows no decline or extinction; let not these outstrip Kentucky in moral elevation, and enlightened “wisely directed beneficence. Let it not be said here as of old, in Attica: The Athenians know what is right; but the Lacedemonians practice it.
I have yet another plea to urge, another boon to crave. It is for yourselves and your children that I ask additional benefits. More complete and entire provision is needed for the unruly or unconscious idiot, the helpless epileptic”, and the raving maniac. Heretofore your appropriations from the State Treasury since the establishment of the Hospital, have appeared to keep pace with the public need, at least it seems to me that this has been the . intention. The Report of the Superintendent of the Hospital reveals the I facts of an overcrowded institution, and of numerous applications for admission, for which, of course, there is now no provision. Several hundred insane persons according to the most moderate estimate, are now suffering, in various parts of the State, for want of well-directed remedial treatment. As yet, I have visited but forty-four counties; but from the best sources of information I have been able to consult, it is evident that much suffering exists, and many patients are annually becoming hopelessly insane through want of seasonable appropriate care. Friends are often indisposed to place f the patient away from home, but if the dispositions were usually favorable to hospital treatment, there at present exists no accommodations for receiving them. In Kentucky alone, of all the States I have traversed, it has not been my painful experience to find the insane poor, filling the cells of poor- houses, or thedungeons of the jails. I have not a single example to offer of an insane person found either in a poor-house or jail, except one patient, whose violent paroxysms and homicidal propensities made it necessary to place him for his own safety, and that of his family, in a county jail, till the session of the court, when the legal measures required for his transfer to the hospital could be adopted. The fact that the Stale assumes the expenses of the pauper insane, explains the entire absence of similar cases of culpable neglect, and dreadful suffering and privation, exposure and distress, which are to this hour frequent in almost, if not quite, every State in the Union.
In Kentucky the affluent and self-supporting classes are the severest sufferers. Just views respecting the healing and kindly influence of hospital care are not so widely diffused as could be wished, and except in the event of sudden and very violent attacks of this fearful malady, the patient is de tained by mistaken tenderness within the family circle, till the disease is confirmed, and hope of cure is extinct.
All experience shows that insanity seasonably treated is as certainly curable as a cold or a fever. Recovery is the rule; permanent disease the exception.
Dr. Bell, in one of his Reports of the McLean Hospital, at Somerville, states that the records of the institution justify the declaration, that “all cases certainly recent, that whose origin does not directly or obscurely run back more than year, recover under a fair trial.” In this opinion Dr. Ray,formerly of the Maine State Hospital, now physician elect to the Butler Asylum, R. Island, fully concurs.
The Directors of the Ohio Hospital, at Columbus, observe in their third annual report, ” that the importance of remedial means in the first stages of insanity, cannot be too strongly impressed upon the public mind.”
Dr. Woodward, of the Massachusetts State Hospital, repeats in nearly every report, and renews arguments, for the seasonable treatment of the insane.
Dr. Chandler, late of the New Hampshire Hospital, says, in the report of 1843, that “it is “well established, that the earlier patients are placed under curative treatment in hospitals, the more sure and speedy the recovery.”
Dr. Brigham, Superintendent of the State Asylum at N. York, states that, “few things relating to the management of the insane are so well established, as the necessity of their early treatment, and their removal from home, in order to effect recovery. By examining the records of well constructed lunatic asylums, appears that more than eight in ten recent cases recover, while not more than one in six of the old cases are cured.”
Dr. Awl, of Ohio, remarks his fifth report, ” that fearful as the dis ease of insanity, the experience of this and other institutions of the United States, have clearly shown, that with seasonable aid, no means an in curable disease that under proper medical and moral treatment, a large proportion do perfectly recover. And of those who are absolutely incurable, vast number can always be greatly improved, and made comfortable and useful. We unhesitatingly conclude, that the only safe and correct course, either for the insane themselves, or for their friends and society, to provide ample accommodations for them, where there will be opportunity for every one to experience comfort and relief.”
Dr. Earle, of the Bloomingdale Hospital, in the report for 1844, states that “it appears to be very satisfactorily proved, that of cases where there is no eccentricity or constitutional weakness of intellect, and where the proper remedial measures are adopted in the early stages of the disorder, no less than eighty of every one hundred are cured. There are few acute diseases from which so large a per centage of the persons attacked are restored.”
“One of the chief obstacles to a more general recovery of the patients admitted into public institutions, and one of the principal causes of the great accumulation of deranged people in the community, is the neglect of removing them to an Asylum, as soon as possible after the commencement of the disease. The mistaken kindness of friends in detaining the patient at home until the period most favorable to recovery is past, has undoubtedly been the cause of rendering the disease of hundreds of maniacs permanent.” “After the first three months of the existence of derangement, the probabilities of cure rapidly diminish, and at the expiration of a year, it is believed that they are not half so great as at first. If continued beyond that time, the diminution progresses, so that of such as have been deranged more than two years, the number that recover is comparatively very small; supposed by some physicians to be about one in thirty; yet hope is left, and cures are sometimes effected of those whose disorder has existed five, ten, and even fifteen years. It would seem that every consideration of humanity and duty requires a greater practical attention to these” important truths.”
An experienced writer on insanity, says, It appears to me, that no idea relating to this unfortunate portion of our fellow beings is more essential to keep before the community, than the importance of attending to the first indications of insanity, and the immediate adoption of judicious medical and moral treatment. The records of hospitals establish the fact that insanity is a disease that can be generally cured, if early and properly treated, while it is equally well established, that if the disease is neglected, or suffered to continue for two or three years it is difficult of remedy. That such should be, the result is evident from the nature of the disease. Insanity is a disease of the physical system —a disease of the brain, and the mental disorder is but one of its symptoms. Insanity never arises till the brain, the organ of the mind, becomes affected.”
Dr. Rockwell, of the Vermont Asylum says, “It is very important that the insane should be placed under treatment in the early stages of the disease.”
Dr. Kirkbride expressly urges in his reports of the Pennsylvania Hospital for the Insane, “the exceeding importance under every aspect-of the case, of early, prompt removal to suitable hospitals; by which large numbers would be restored to health and to society, who now are a burthen to them selves and their friends.”
Drs. Allen, Stribbling, Fisher, Butler, Stedman, Gait, and others who conduct the hospitals in the United States, concur in these viewsf and urge them in all or nearly all the reports which are annually issued from their respective institutions.
In the Ohio State Asylum, 1842, twenty-five old cases, suffered to become incurable, had cost to the State and counties $50,600, while twenty-five recent cases, brought under seasonable treatment, had cost but SI,130, that forty-five dollars twenty cents for each individual.
In the Massachusetts State Hospital, twenty-five old cases had cost the State $54, 157, which the whole average number of recent cases recovered, cost but fifty-eight dollars, forty-five cents. Similar facts are exhibited upon the records of other institutions, and we have thus positive demonstration of the usefulness of hospital treatment in the two-fold, but not comparable results of health-restoring, and property-saving advantages.
Surely, if partial deafness, or failing sight, or inflammation upon the lungs assail our friend, we do not rashly defer calling on the physician to aid,by his superior knowledge our own cares, nor do we fail to surround the invalid with all those circumstances which shall seem most likely to control, and cure the disease. On the access of fever or pneumonia, we lose no time in applying the most approved remedies, together with the most skilful nursing, yet we venture, with a strange hardihood, to tamper with that delicate organ, the brain, and delay the remedial measures till the case becomes, if not quite hopeless, nearly so. I have paused longer on this topic than I was aware, but its exceeding importance, the influence the decisions of friends and relatives exert on life and health, and all life’s dearest interests, urge all who have knowledge on this subject,to enforce earnestly and firmly the duty of seasonable attention to appropriate care, and medical treatment for the insane. Numerous and deeply affecting examples of domestic trial, and individual suffering, through ill-judging and ill-judged management of the in sane, exist in many privatefamilies in Kentucky. These cases not being a public charge, and not under official control, I do not feel at liberty to record ; but sure I am, that there will be few readers of these pages who will not be able to furnish, through their own recollection, examples which will sustain my position, — examples powerfully appealing to every just and humane sentiment in the community.
Are there not many who will read this page, who, like myself, can recall the lone husband and father wearing out a woful life in the dreary block house, almost within the shadow of his own roof; « without clothes, for if he was furnished, he would rend them in pieces ; without bed, for if that was supplied, it would be destroyed; without bathing or shaving, till he resembles the beasts of the forest; without fire, for with it he would burn the building; in a cheerless block-house, for if a less solid structure, he would break through it!”
Are there none who remember the dull victim of melancholy delusions, harrassed by unreflecting neighbors, hurrying away to find refuge from their thoughtless persecutions, beneath the waters of the nigh flowing river? Are there none who recollection the son and brother, swinging his clanking chain within a slight and comfortless cabin, clamoring and hooting at the passersby, vociferous, dangerous, and destitute of all appropriate care ; dangerous when at large, and wretched under the weary bondage of his chains? Will none have heard of the delirious epileptic girl, whose troublesome habits and mischievous propensities bring upon her the cutting lash, and who, driven by this merciless discipline, to wilder freaks, and more frequent paroxysms, is an object of deepest pity. These scenes, these hapless conditions of the insane are terrible, but these, and others not dissimilar, are not unusually the result, so much of barbarious dispositions on the part of kindred, (the last case excepted,) as the consequence of ignorance upon the right treatment demanded for the insane, and a failure to realize the great sufferings which ill-directed management create and aggravate. Let all, and each, through out our country, learn the benefits of hospital treatment, and unite to secure these benefits to all the insane, of whatever rank or condition.
The dread of severe measures, in the treatment of the insane in hospitals is passing away from the minds of all who seek information concerning them. In these the rule of right, and the law of kindness are known to prevail. Severity and harsh measures of coersion are long since abandoned. Gentleness and persuasion unite with a mild decision, to control the way ward and the perverse, and to quiet the raving maniac.
The good and truly noble St. Vincent de Paul, was the first apostle in this holy work to turn men’s thoughts in Europe, to more humane and more rational modes of treatment. With a devotion which no hardships could subdue, he traversed vast regions, and taught men the sublime lesson, that to be humane, was to be allied to Deity. Pinel, in France, carried to this blessed reform the manly tenderness and clear reasonings of his noble heart and intellect ; thousands owe to his determined exertions their salvation from a bondage more terrible than death; their recovery of the lapsed powers of the mind; their restoration to reason, to usefulness, and to happiness. England and the United States are far advanced in this humane work; but, all is not done; too much remains to be done; let none supinely rest while such loud calls are raised through the land for the succour of these afflicted beings.
Gentlemen of the Legislature, I ask of you such an appropriation from the State Treasury for the hospital at Lexington, as shall place that, your first and most liberally established institution for the insane, upon a suitable foundation. As this, when completed, will be altogether inadequate to the necessities of your citizens, I ask for the establishment of a new hospital in the Southern, or Green River Country; and to this end, solicit the early adoption of such preliminary measures as shall enable you the next year, rapidly to carry forward and complete that work. The evils of delay are incalculable; they must be obvious; they should not be allowed to increase. I ask, that in the choice of a site for a new hospital, the very important appropriation of a tract of land of sufficient extent to furnish labor for the patients, and supplies for the institution, may be a first consideration. This should be chosen in a healthful district, command cheerful views, be accessible to and from a shire-town, be of convenient access by good stage-routes and water conveyances from different portions of the State ; it should have an ample and unfailing supply of pure water; be so situated as to command fuel at moderate rates ; and abundant stores of provisions at reasonable cost. It is worthy of consideration to embrace in this view the advantage of vicinity to a stone-quarry, or to clay strata suitable for the manufacture of brick. I respectfully suggest the appointment of an efficient Board of Commissioners to carry these objects into effect.
Legislators of Kentucky, from the discussions arising out of conflicting interests, and diverse opinions, questions of various weight, and some, possibly, of doubtful advantage ; before you shall dissolve this session, consecrate • one hour, uninfluenced by selfish aims, local prejudices, orpolitical differentces to the solemn and sacred interests of suffering humanity. United by ‘ an exalted motive, be the instruments of a wide spreading happiness, and the creators of enduring benefits. The heart of many a child of misfortune, released from pangs of deep distress, through your just legislation, shall up bear you daily to the gates of heaven in prayers of gratitude. To use the language of one of our high-souledcitizens,” the truest tokens of grandeur in a State are, the diffusion of the greatest happiness among the greatest number; and that God-like JUSTICE which controls the relations of the State to all the people who are committed to its charge.” Let your hospitals and your asylums rival your schools and your colleges; so multiply the “links in that golden chain by which Humanity shall connect itself with the throne of God!”
The clarion note of “Kentucky, old Kentucky” ! rings through the land. She claims eminence in the political station amidst her Star-crowned Sisters ; she exults in the far told history of her military renown: but there is a moral eminence far transcending political distinctions ; and a more glorious renown than is sounded from the trumpet of victorious battles:— bid her to a place in the firmament of heaven ; there enthroned by her holy deeds of charity and love, inscribe her name on that scroll of history borne by angels — and sealed by arch-angels for the archives of eternity!
D. L. DIX.
Frankfort, February, 1846.
Source: Dix, Dorothea, Memorial Soliciting an Appropriation for the State Hospital for the Insane, at Lexington; and Also Urging the Necessity for Establishing a New Hospital in the Green River Country (Frankfort, KY: A.G. Hodges), 1846, pp. 1-16.