O. Larsell

“ The proprietors seem to be zealously engaged in having the grounds graded and improved, and it is their intention to surround the whole with a neat and substantial enclosure. The rooms for the insane are spacious, cleanly, and well ventilated. The wardens affable and efficient, and the inmates almost unexceptionally express themselves as being well cared for. Upon the whole, general management by the resident physicians seems to be such as to merit our general approbation. ”

“ An offer had been received to build a good wooden building for $6,400, and to have it ready for occupancy when the current contract with the Oregon Insane Hospital expired. It was proposed, according to one of the letters to the Oregonian, that Doctors Carpenter and McAfee can put the patients into this building and care for them under their bid, or some of the many doctors here [Salem] can be employed by the year to run the institution for a salary which is a better way. ”

“ A new building for tuberculosis cases was completed in 1932, adding one hundred sixteen beds, but the increase of hospital population was so great that the need of a building program was emphasized. A proposal to erect a third state hospital in Multnomah County was defeated in the primary election of May, 1934, and Doctor Steiner recommended a new fire-proof wing of two hundred beds at Salem in his biennial report of the year. The legislature made the needed appropriation, in spite of the difficult financial condition of the state due to the business depression general throughout the country. ”

“ Even though the insane were kept on Blackwell's Island for two dollars per week, it was recognized that these unfortunates were given very inadequate care. The idea seemed to prevail at that time that insane people eat more than those mentally normal, and that this might explain the higher cost of keeping them. Finally on October 25, 1880 the legislature passed a bill pro viding for a state institution for the care of the insane, appro priating $25,000 from general funds, and levying a tax of one mill for the purpose. ”

“ No other specific cases of insanity appear to be mentioned in the early records of Oregon, but the provisional government at Champoeg, on July 5, 1843, adopted statutes, based upon the laws of Iowa Territory, in which is found the first official reference to the care of the insane. "An Act concerning Insane Persons" was passed, section 4 of which makes it the duty of the probate courts, on receipt of proper information in cases of suspected insanity, to direct the sheriff of the county to summon 2 A. C. Stewart and H. A. Dickel, Northwest Medicine, XLI :284. ”

“ He stated, "Many chronic insane have periods of improvement, lasting weeks or months, when they are harm less and can be cared for at home with pleasure and benefit to themselves and great saving of expense to the State, but they hesitate to go and relatives do not like to take them when they must go through the annoyance and subject the county to the extra expense of a new commitment every time they have to be returned to the hospital."29 The legislature of 1915 enacted a parole law which remedied ^Portland Telegram, October 27, 1913. ”

“ The true inter ests of the state demand that the insane should be placed under the immediate control of the state and that the ruinous and unjust contract system be at once and forever abolished. The future management of the insane is the most important matter before the legislature as one-half of the state taxes during the last two years have gone to enrich Hawthorne and Loryea. ”

“ In the dedicatory address Doctor Loryea stated that in his opinion the common wealth should authorize the establishment of an insane hospital, and when that was done he and Doctor Hawthorne would turn over their institution and its patients to the state, but for the present it was the state's duty to lend its support to the new venture. A special contract had been arranged by the doctors, with Multnomah, Linn, Lane and Washington counties8 for the care of insane from these units. ”

“ The medical center which had gradually developed around the Medical School in Portland was seriously handicapped by lack of hospital facilities for psychiatric patients for use in training physicians and for research in a rapidly advancing branch of medicine. The legislature of 1945 passed a bill including an item of $750,000 for a University hospital of two hundred beds, sixty of which would be used for psychiatric cases and fifteen for mentally retarded children. ”

“ The words "insane per son" being intended to include every idiot, person not of sound mind, lunatic, or distracted person. If a positive decision be forthcoming, the probate court will have the power of appoint ing three guardians of the person and his property, which, on proper presentation may be sold or disposed of to pay for the care of the insane person or in his best interests. ”

“ Food for the hogs is kept and prepared for use in the same buildings, econo mizing the labor and utilizing all the waste from the hospital. The pens are kept in a cleanly condition, and at a sufficient distance from the dwelling, so that they cannot offend. Barns for the keeping of the cattle and storage of hay and straw for bedding, a very large quantity of the latter being required, as each day more or less has to be furnished new, in consequence of the habits of the patients. ”

“ Tabor Sanitarium was opened with facilities for about sixty patients. Doctor R. L. Gillespie became one of the medical directors, with Doctor Coe. In 1903 a reorganization was effected, the name was changed to Crystal Springs Sanatorium and Doctor W. T. Williamson, who had served since 1886 as assistant physician at the State Asylum in Salem was added to the staff.42 After the Lewis and Clark Exposition of 1905 in Portland, the Crystal Springs management purchased the Massachusetts Building on the fairgrounds and re-erected it as part of the sanatorium to be used exclusively for nervous cases. ”

“ They corresponded with men of experience both in Europe and America as to the best means of caring for the insane. It was said of Doctor Loryea, who with his family resided at the asylum, that he spared no effort in being kind to its inmates, walking and playing with them, amusing them with various games, and endeavoring to keep them from brood ing over their cares.
Doctors Hawthorne and Loryea made their first biennial re port of the hospital to Governor Gibbs under date of September 1, 1864. They called attention to the difficulties they had faced at first. ”

“ If there is no estate or if the father or mother of such person shall not be of sufficient ability, nor the children, grand-children, or grand parents, to maintain him at their own charge, the unfortunate shall be entitled to relief as paupers and be maintained under the care of the overseers of the poor. ”

“ The situation of the building itself is upon an eminence, surrounded upon all sides with ravines sloping to the river bank, giving perfect natural drainage, as well as a command ing view of the river, with its busy life and scenes of varying interest. The effect of this alone upon the health can hardly be estimated, as such an institution possesses tendencies on the part of the patients always towards the inception of disease. The perfect cleanliness that is so rigidly enforced within the building, is a continuation of these hygienic measures. ”

“ From 1920 to 1940 the legislatures had ap propriated funds providing for an average increase of twenty eight beds per year, while the annual growth of patient popula tion had averaged fifty per year. The housing of the criminal insane continued as another acute problem. A psychiatric ward in the penitentiary had been recommended many times, but in 1940 twenty-six convicts still were kept in one of the wards of the hospital. The State Boards of Parole and Probation obtained a consulting psychiatrist in 1939 to give psychiatric assistance to the criminally insane when necessary. ”

“ Save for a brief period he had served the State of Oregon, first at the Oregon State Hospital at Salem and then at the Eastern Oregon State Hospital from its beginning, throughout his professional life. Doctor Donald Wair, who had been assistant superintendent at Pendleton since 1933, was appointed superintendent as his successor. Due no doubt to the constant demands for additional build ing space because of the continual increase in number of patients from the beginning, the other facilities of the institution had not developed as rapidly as was desirable. ”

“ The tank is filled every night, by the use of horse-power, with the purest of water from a never-failing spring upon the premises, and distributed to all parts of the house by iron pipes. About fifty gallons of the water are used daily for each patient. ”

“ This made it necessary to place the burden of responsibility of passing upon an individual's financial status upon the county courts, in cases of proposed voluntary commitment. The plan resulted in a reduction of such commitments. ”

“ When so com mitted by the county courts, the hospital had no choice or dis cretion-it must receive them. The superintendent pointed out that some legal provision was needed by which patients who were not insane could be sent back to their respective counties, which were passing on to the state a burden they found it inconvenient to carry. Convicts from the penitentiary, who had developed insanity, were sent to the hospital, and others who had been excused from crimes because of insanity also were committed to it. ”

“ Instead of killing and scalping him, as would have been the fate of a normal individual under the circumstances, the superstitious attitude of the savages toward the mentally deranged caused them to care for him. ”

“ Apparently only one visiting physician was appointed after 1864, Doctor W. H. Watkins being named in the second re port, while J. S. Giltner, A. D. Ellis and C. C. Strong are men tioned in successive biennial reports, serving one or more terms each, but alone. Their reports to the governor are invariably favorable. In 1867 Mr. John Kenworthy was named superin tendent. In the annual report of Doctor J. S. Giltner, as inspecting physician, in 1866, a ratio of about three male patients to one female is indicated. ”

“ Gardens are adjacent to the grounds, that furnish vegetables for the use of the inmates, and of every variety, to last the year. Eight to ten cows furnish milk for the establishment, and forty hogs are fattening in the stalls for the winter's use. ”

“ Almost all nationalities were represented, including Chinese and half-breed Indians, but the greater number were Americans. The inmates were of all voca tions, but most of them had been farmers, housewives or labor ers. The inference was drawn, since most of them were of the laboring class, that continuous physical labor, without an ade quate amount of mental work or recreation, was one of the most frequent causes tending to bring on insanity. ”

“ Some of the elderly people who were senile rather than insane also were taken home by their families be 84Eastern Oregon State Hospital, 1st Biennial Report, in Oregon State Board of Control, 1st Biennial Report, (1914) 87-104.
cause of better economic conditions in the state. With the introduction of metrazol and insulin treatment for certain types of insanity about 1938, a larger number of cures and improvements in patients further increased the number of patients discharged from the hospital, as also was true at Salem. ”

“ By 1870 the hospital had a capacity of 120 to 130 beds, and a personnel of fifteen, including the attending physician, Doctor J. C. Hawthorne. In spite of the healthy situation described in the medical journal some of the patients became ill with vari ous diseases while in the hospital. These are described as thnee or four attacks of intermittent fever and several lung affections. CARE OF INSANE 307 Diseases of the lungs were the most frequent causes of death. Rheumatism occurred to a small extent, but paralytics were few.18 The number of patients increased each year. ”

“ By 1898 the institution housed nearly 1200 patients. The gold rush to Alaska, beginning in 1897, had burdened the federal government with responsibility for gold seekers whose minds broke under the hardships and strain of their search for quick wealth. The nearest mental hospitals were at Steilacoom, Washington, and Salem, Oregon. On January 16, 1901, the ^Medical Sentinel, (1898) VI: 185. 314 0. LARSELL Oregon State Insane Asylum, at the request of the United States government, entered into a contract to care for the Alaska in sane at $20.00 per month per patient. ”

“ On December 1, 1885, he was succeeded by Doctor Josephi, whose greater experience, coupled with more intensive study of insanity, gave him greater knowl edge of the needs of the patients. Political preferment, however, was considered more important than ability. When Sylvester Pennoyer, a Democrat, took office as governor of the state in 1886, he undertook to reward his supporters by placing deserv ing Democrats in appointive state positions. ”

“ Fewer commitments from Multnomah County, demand for workers in war industry and on the farms due to war condi tions, together with the factors of better financial conditions and briefer hospitalization because of improved methods of treatment already mentioned, continued to reduce the number in the hospital so that in June, 1944, there were but 1205, in spite of increased population in the state. On May 1, 1941, Doctor McNary retired as superintendent because of ill health. ”