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REPORTS FROM THE STATES.
The States were then called upon to report, in connection with Gen. Brinkerhoff's Paper.
ILLINOIS.-BY GEORGE S. ROBINSON.
The principal, and a very sad event in the history of the Illinois charitable institutions, since the last Conference, has been the burning of the north wing of the Southern Hospital for the Insane, located at Anna, on the night of April 18, 1881. It was occupied by 240 male patients. One life only, was lost, and great credit is due to those in charge and to others, for securing the exit of the inmates without more fearful loss of life. The legislature was in session at the time and promptly provided for the emergency, as far as practicable, by appropriating $12,000 for the erection of temporary wooden barracks, and the purchase of necessary furniture for the accommodation of the patients during the summer. By using portions of the main building and south wing for a time (although crowded), none of the inmates had to be removed to other hospitals or to other respective homes. The legislature at once appropriated $90,000 for rebuilding the north wing which will probably be ready for occupancy before the approach of cold weather; $3,000 also for furniture to replace that destroyed by fire, and $1,000 to repair damage to the main building.
Among the various special appropriations made by the last General Assembly, are $33,000 for the construction of the east wing of the Institution for the Blind at Jacksonville; $12,000 for barns, coal-house and shops, and $2,500 for school apparatus, musical instruments and furniture; $5,000 for the erection of a suitable hospital building for the Soldiers' Orphans' Home at Normal, and $4,300 for a new boiler house and steam boiler; $1,775 for the introduction and construction of the mercurial fire alarm to the main building, wings, rear and outbuildings of the Asylum for Feeble Minded at Lincoln; $2,500 for the construction of veranda fire escapes there, and $1,300 for construction of veranda fire escapes at the Institution for the Deaf and Dumb at Jacksonville; finally, $5,000 for the construction of an artesian well at the Northern Hospital for Insane at Elgin, of sufficient depth and capacity to furnish a necessary supply of pure water. The Institution for Feeble Minded has been visited the past year by a serious epidemic of measles, 100 or more of the pupils being down sick at one time. Dr. Wilbur, the Superintendent, writes me:
"We are greatly in need of accommodations for pupils. We should have a farm to put our boys on, who have graduated from our school-room. We need land to develop their capacity for agricultural labor; that is our great need. We also need a depart
ment exclusively for girls who have grown beyond our school, but who have no places to go to, and who should be cared for by the State."
There is in the city of Chicago a school for the education of deaf mutes under the management and control of the Board of Education of the city, and the last legislature appropriated $5,000 as a donation to be used in the support and maintenance thereof. This school, so far as its accommodations will admit, receives mutes of school age, from any portion of the State.
One section of the north wing for females at the Eastern Hospital for the Insane, at Kankakee, is now completed and has 83 inmates, with capacity for 85 or 90. Four cottages, or rather detached wards for male patients, have been occupied for nearly a year. The success in this new departure has been thus far, not only highly gratifying, but has exceeded the expectations of its most sanguine advocates. Dr. Bannister, one of the assistant physicians, writes me:
"The cottages, or rather the detached wards already built, are capable of accommodating 110 patients. The male ward building or south wing can, by crowding, accommodate 100; it ought to have only about 85. The detached wards cost a little over $30,000, the ward building about $70,000. The ward building as at present arranged, requires 8 attendants, the detached wards 7 attendants. The proportionate cost of the two classes of buildings may be roughly estimated, for the detached wards, $300, and the ward building, $700 to $800 for each patient. This is apart from the cost of the administrative buildings, which are equally essential to both. The common dining room for the detached wards works well; it is neater and more attractive than the ward dining rooms, and the food is as well or better served.
There was no complaint about its condition even in the severe cold weather of last winter, notwithstanding it had to be carried more than 100 yards in the open air, from the main kitchen; it is conveyed by hand by the patients or in a hand-cart. The patients in these wards are of all classes of the insane, only the violent and very untrustworthy being unsuitable. In wards 1 and 2 they are free to come and go as they please. In the others they are watched, though the doors are not kept locked as a rule."
Dr. Dewey, the Superintendent, says:
"For the past eight months, at the hospital at Kankakee, about 33 per cent. of the total of male patients have been kept in the detached wards,― buildings made as nearly as possible like an ordinary residence without guards at the windows, and where the doors are not kept locked during the day. The patients are paroled, and more than half of them are kept steadily employed. Much care has been exercised in selecting the patients for these wards. They are for a considerable time under observation in the Close
Hospital, and it is made an essential condition of their being placed in the detached wards, that there shall not have been at any time violent or dangerous tendencies of any kind developed. Their present condition is a somewhat stable and settled one; usually the condition left after subsidence of all acute symptoms in mania, when a demented but mild disposition remains. Cases in which recovery is nearly established are also sent for a time to these wards before their return home.
The general results or conclusions arrived at may be briefly stated:
"1st. It is impossible in the limited time that this experiment has been in progress to draw any final conclusions. Only a period of probation, extending over a term of years, can settle the questions of efficiency and economy in this method of caring for the insane. This much, however, is in my opinion clearly demonstrated that the "Kirkbride" or Close Hospital plan is not a necessity in the provision for all the insane. It remains to be seen how large a proportion can be provided for in other forms of buildings, and to work out and adjust the details of some new form of detached construction.
"The experience at Kankakee thus far can only be said to have been an agreeable surprise. Not a single untoward or unpleasant occurrence, in connection with these buildings, or the patients occupying them, has taken place. A few have wandered away, but in every instance have been recovered, or, reaching their friends, have remained at home at their friends' request. In many instances benefit to the patients has been marked, and in some where it was hardly expected. The conveying of food to these wards has been readily and promptly performed by the patients themselves, under the supervision of an attendant. The per cent. of these patients employed has been over 60; indeed, employment has been made a marked feature of the system.
"Regarding the comparative expense of running, nothing as yet can be decisively stated. The proportion of attendants is somewhat smaller, and the mode of feeding the patients, all in one dining room, is certainly more economical. Other points will only be determined, in regard to expense, as separate accounts can be kept for a reasonable length of time. It is to be said as an offset to the above that only male patients have as yet been subjected to the working of this system, and that the number has thus far been comparatively small; thus giving facilities for closer study of individuals by the physicians." $38,000 was appropriated by the last General Assembly for the building of four detached wards for female patients at this hospital.
There is a constantly growing feeling in our State to have a separate hospital department erected, adapted to the custody and care of insane convicts, and in obedience to this sentiment, the legislature of 1879 appropriated $150,000 for the completion of the
Southern Penitentiary, located at Chester, and authorized the Commissioners of the Penitentiary to use such portion thereof as might be available for the purpose of such a department on the penitentiary grounds at that place. The Commissioners did not expend any of the appropriation for that purpose. It was confidently expected that the last General Assembly would have appropriated a sum sufficient for the erection and completion thereof; but, for reasons peculiar to legislative bodies, it failed so to do. The ball, however, has been set in motion, and the people of Illinois will never relax their efforts until they have elected men who will make the necessary appropriations, and this department shall have been completed as originally designed by its advocates and friends.
Further accommodations for the insane in our State are necessary, and with a view to provide for this demand, a bill appropriating $200,000 was introduced in the last legislature, and its passage recommended by the committee appointed to consider the subject, but it failed to pass. The increase of insanity in our State, and the growing sentiment that humanity demands such accommodations will ere long force the passage of a bill providing them. A joint Committee of two from the Senate, and three from the House of Representatives was appointed to consider the whole question of the condition and necessities of the insane of the State of Illinois, and to make a report to the next General Assembly.
Renewed efforts were made at the last Session to repeal the law requiring a trial by jury, in every case, before an insane person can be committed to an asylum; and to substitute in lieu thereof the law introduced in 1879, and passed by the Senate, which authorized the judges of the respective County Courts to order such commitment upon the examination and certificate of insanity, under oath, of three reputable and skilled physicians or a majority thereof, appointed by the judge, giving in writing the facts and reasons upon which such certificate is based; not, however, taking away, but authorizing in every case the right of trial by jury, upon the application of any relative, guardian or friend of such insane person, and giving to the judge the right to order a trial, whenever he may deem it necessary. These efforts also proved unsuccessful, but they will, in my judgment, be renewed at each successive legislature until the object, so equitable, so just, and so humane, shall have been accomplished.
Under our present financial system, prescribed by the Board of Public Charities, in pursuance of a law passed by the General Assembly, authorizing the Board so to do, the annual per capita cost of the inmates in our charitable institutions has been constantly and gradually reduced from $334 in 1874, to a trifle over $200 the past year; and, with the exception of the one at Kankakee, which is only partially completed, it is less than $200.
In the three hospitals for insane which are completed with an
average of 548 patients each, the per capita cost the past year has been $191.18, and I hazard nothing in saying that in no institutions in the country are the insane better cared for than in Illinois.
Dr. John N. McCord, of Vandalia, the last of the original members of the Board of State Commissioners of Public Charities in our State, save one, an estimable gentleman and worthy member, has recently resigned his position as such, and Dr. F. B. Haller, of the same place, has been appointed his successor.
Mrs. SPENCER: It is the desire of the District Commissioners to have a Board of Charities established in the District of Columbia. But we must depend for all action on a body of men who are not responsible to the District, but represent each a district of his own. The District is not cared for as it should be, but has to stand aside and wait the action of Congress, as if it had no claims of its own. So we still wait for those grand and beautiful things, such as our friends here tell us of.
Mr. GEORGE A. CASWELL, Commissioner of the Washington Asylum, said: I think Mrs. Spencer has stated the question fairly, as to the disposition of the Commissioners. We intend to work with Congress from year to year, and hope, between now and the next centennial, to have a Board of Charities, but it is doubtful whether we shall accomplish it unless Congress takes more interest than it has in the past. There has been recently organized an association to look particularly after the general charities of the District, and while it is hardly in working order yet, I have no doubt it is going to be successful, and fill a very great need in the community. We have a great number of charitable institutions, but no central management, and I have no doubt that sixty per cent. of all the funds that have been distributed have been wasted, for the want of such an association as has been recently formed.
Gen. BRINKERHOFF: I have just come from the District of Columbia, where I have visited its institutions, and I advise anyone going there to visit the jail. The officer in charge is one of the wisest men I ever knew. There are two jails in the United States where separation of prisoners is practically and intelligently enforced, one is in Boston, the other is in the District of Columbia. The institutions for the insane there have helped to solve the problem of cheap buildings for that class. The inmates are admirably cared for.
The PRESIDENT: I will report in part for the State of Massachusetts, since I occupy the position of a delegate representing the Board of Health, Lunacy and Charity. The members and officers of that Board will report from time to time on their special work. My own work relates, among other things, to the general