Asylum (facility)

“ It is of great importance not merely to exclude from the [district] asylums those who, by reason of violence or irritability, are proper subjects for the county asylum, but also those who, from old age or disease, are unfit for the journey to the asylum, or who, from the slight degree to which their mind is affected, might more properly remain in the workhouse. ”

“ She represents to him the outer world; for she is the only creature belonging to it who ever crosses the threshold of his prison. The asylum chaplain, the asylum doctor, the keepers and the officials belonging to the asylum—all these are part and parcel of this great prison-house of stone, brick, and mortar and seem to be about as capable of feeling for him, listening to him, or understanding him, as the stones, bricks, and mortar themselves. ”

“ To the eye of a casual visitor of an asylum, there does certainly appear a large number of patients, so quiet, so orderly, so useful and industrious, that, although there is something evidently wrong about their heads, yet the question crosses the mind, whether asylum detention is called for in their case. The doubt is not entertained by the experienced observer, for he knows well that the quiet, order, and industry observable are the results of a well-organized system of management and control ”

“ I am aware that there are many innocent ones who are suffering in these institutions who are proper subjects for a prayer-meeting and not for a penitentiary. There are many received into these lunatic asylums that are more fit for State prison or penitentiaries than places like these, and these are they that cause so much bloodshed, as did Haly and Mrs. Anderson, in my case, being appointed attendants by the government of the asylum.
I have stated that about the time the civil war broke out I was placed upon a hall near the dining-room, the patients in this hall were more quiet at times. ”

“ While there are drawbacks unavoidably arising from the congregating of so many of the insane in one establishment, there is nothing connected with Seacliff Asylum to justify the common expression, "the horrors of a lunatic asylum." It is a home, as far as such a large institution of the kind can be made a home, where everything possible is done for the welfare and recovery of the unfortunate people on whose account it exists. ”

“ Some were on foot, bearing in their countenances the tokens of their recent terror, and filled with mournful reflections on the forlornness of their state. Few had secured to themselves an asylum; some were without the means of paying for victuals or lodging for the coming night; others, who were not thus destitute, yet knew not whither to apply for entertainment, every house being already overstocked with inhabitants, or barring its inhospitable doors at their approach. ”

“ Where to provide for the lunatic population of a county considerably exceeds the legitimate dimensions of a single asylum, and yet the proportion of recent cases is too small to warrant the construction of a distinct institution for them, we have proposed the establishment of two asylums, each of a mixed character. ”

“ If a gendarme accosted me at night in the streets, I shook all over in the expectation of being removed to a French [Pg 122] asylum. If I saw an advertisement relating to an asylum in a casual newspaper, it was to lay it down in terror. There seemed to me but one power in the world—the power of the lunacy ‘law.’ Such is the confidence which our vaunted system, which professes to know no wrong without a remedy, could inspire in one who needed its protection so sorely as I. In one respect its might was certainly vindicated, for, abroad and at home, I thought that it could reach me anywhere. ”

“ Can it be proved that the above named cities ever had sixty patients in that asylum at any one time? It would take a hundred such asylums to take all that the State of New York would furnish if each county should send as many as the city of Utica, according to their number of inhabitants. ”

“ An average of seventeen hundred women this asylum harbors; the asylum for men up on Ward's Island even more. Altogether 1,419 patients were admitted to the city asylums for the insane in 1889, and at the end of the year 4,913 remained in them. There is a constant ominous increase in this class of helpless unfortunates that are thrown on the city's charity. ”

“ A chronic, or a moderate, manageable-sized, mixed asylum must form the nucleus of the ‘cottage system’ of providing for the insane. The cases must be selected from the asylum-residents, and the selection be left with the medical superintendent. The persons receiving patients must be held responsible to the superintendent, and to the members of the Lunacy Board, for their proper care and management, and they must enter into some sort of covenant with the Visitors of the asylum. ”

“ Disappointment too is felt by patients rather at discovering that on their discharge from one asylum they are to be [Pg 128] transferred to another, instead of being set at liberty and returned to their homes; for few of the insane recognize their malady, and they will think much less about the character of the asylum they are in, than their confinement and restricted liberty. Again, it is not at all necessary to contrast the two institutions, by calling the one an asylum for curables, and the other an asylum for incurables ”

“ But some one will say, there is a Board of Charities or some such arrangement by which the asylums are visited and such patients liberated. In most cases such visitors do not visit in the way the public imagines or the law requires. I have yet to learn of a case of deliverance effected by any such board. They go to the asylum, glance through the "crack wards," and then partake of a sumptuous dinner got up for their benefit by the superintendent, and that is all. ”

“ When he took charge of the Richmond Asylum it was insanitary and overcrowded, and more like a prison than a hospital. He introduced a humane regime, made the wards bright and comfortable, and found regular occupation for some 75 per cent, of the patients. By his advice a large branch asylum was built a few miles away in the country. In 1894, and again in 1896, 1897, and 1898, the asylum was visited by beri-beri, the outbreak in 1894 being specially severe. ”

“ If the law were so amended that asylum relief should be afforded to all on the appearance of their malady, the majority of those to be provided for in lodgings would come from the class of chronic, imbecile patients, accounted harmless, whose discharge from the asylum under proper surveillance might be recommended. ”

“ In the most of cases the patient is not consulted in the matter. In some cases, however, the patient is consulted, and consents to go; is made to believe that the asylum is like any other infirmary or hospital, where patients are taken to be nursed and cared for, and cured if possible. In the most of cases, perhaps, there is a kind of dread and horror attending a patient taken to the asylum, and very many go against their will. This opposition is generally attributed to their insanity, and is too generally received as evidence that such an one is a fit subject for a lunatic asylum. ”

“ In fact, the annual returns of county asylum experience demonstrate that the transmission to asylums is regulated by no rule, and is attended by great abuses.
The practical lesson deducible from this is, that the matter must be placed in other hands, and guided according to some rational principles. The insane poor must no longer be left to pine in neglect and misery in their own homes, until their friends tire of the trouble of them, or some casual circumstance class them, in a relieving officer’s opinion, as proper candidates for an asylum ”

“ This is the same as saying that if lunatics are to reside in workhouses, a special asylum must be instituted in the establishment for their care, and the comfort and safety of the other inmates.
If the well-being of the insane were the only question to be settled, no difficulty would attend the solution, for experience has most clearly evidenced the vast advantages of asylums over workhouses as receptacles for insane patients, whatever the form or degree of their malady. ”

“ There are many out in the world doing business quite as crazy as they. These, I know, are all groaning to get free, but their friends prefer to keep them there, and as property doubtless has much to do with the matter, they will be likely to die in the institution. Were they county patients, they would long before now have been set at liberty.
There is one case in the asylum that I will venture to name, because I am quite sure he would prefer to have me do so. ”

“ Those at one time considered to be fit only to be congregated together in the most dreary rooms of the asylum, with tables and benches fastened to the floor, and with nothing to interest or amuse them, are now in many asylums placed in wards as well furnished as those occupied by the more orderly patients, with birds, aquariums, plants, and flowers in them, and pictures on the walls; communicating also with such wards are now very generally to be found well-planted and well-kept airing-courts. ”

“ For me to undertake to describe this asylum fully would be useless; to say the least it is a monster, and answers to the bottomless pit, I saw in my vision; beneath my window was a pit or yard, with from fifteen to twenty men; some bound; some up, and some down; some with naught but their shirt, and some with none—burnt to the quick by the rays of the sun. In this asylum hell I learn, by hearsay, there were five hundred patients, besides the bull-dog. I suppose [130] the club attendants were reckoned in the number, at least the lunatic barber was, most assuredly. ”

“ Yet, in all probability, this restriction as to the district for [Pg 90] receiving patients as boarders, would not always be practicable; and frequently, where the insane poor had near relatives capable and willing to receive them under their care, though at a distance from the asylum, it would not be desirable to sacrifice the advantages of the guardianship of friends to those obtainable by vicinity to the asylum; and, from these or other causes, many poor insane people would be found distributed here and there throughout a county under the charge of cottagers and others. ”

“ The argument is, that many great and noted men have been inmates of the asylum, such as Gerrit Smith, Esquire W., General B. and Judge C. This was the argument used on me while on my way to the prison. I would go still further. I would require that the [Pg 36] managers of such an institution should not leave to one man the destinies of so many hundreds of souls; that they should be required to see for themselves all the internal workings of the institution, that its evils may not become chronic and incurable. ”

“ It is no trifle, quite half of the quarter of a million dollars contributed annually by the city for the support of the asylum. The procession of these nurse-mothers, when they come to the asylum on the first Wednesday of each month to receive their pay and have the babies inspected by the sisters, is one of the sights of the city. The nurses, who are under strict supervision, grow to love their little charges and part from them with tears when, at the age of four or five, they are sent to Western homes to be adopted. ”

“ At last the gates open narrowly, and sturdy men admit the wretched few for whom there is still room in the asylum; however, a small coin pressed into the hand of the door-keeper will let in twice the number.
The village paupers have been admitted to the asylum. They are marched with others through dark, mud-covered courtyards, ascend iron stairs, and enter the "office," where their passports are inspected, and where they receive the number of their rooms. ”

“ There is a state of mind that is not unfavorably affected [Pg 141] by placing them in the asylum—such for instance as one under the influence of hallucinations—there are many in that institution who believe they own the asylum, they think they run the institution with all its machinery! ”

“ They only want rest, and to be kept clear from excitement; any other place would be as good as the asylum if they could be controlled. Another comes into the asylum gloomy and sober, with his head down; is still and harmless; talks to none; shows no marks of insanity; except, perhaps, you hear him groan or sigh occasionally; he sets down alone. He stops perhaps on the first hall when he first comes to the institution; stays there three months, and perhaps a year; when he is found to be no better, but worse, he is finally placed on some of the back halls ”

“ It thus appears that a low rate of maintenance in an asylum is practically prejudicial to the liberty of the chronic insane.
"'The Supply of Guardians.—This feature of the system of boarding out the insane will appear to many to be all-important. The excuse which inspectors frequently advance for their lack of co-operation with medical officers of asylums is their inability to find suitable guardians. ”

“ But it is a base deception to pretend that patients are not obliged to work in the asylum.
I would recommend that all men who are sent to the asylum be permitted and advised to let their beards grow, and not shave at all during their stay there, especially on any other hall except the first, for the attendants do all the shaving; the patient is not permitted to shave himself, except on one or two of the halls, and [Pg 179] so far as my experience goes, it is more like skinning than shaving ”