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riots and firemen's mobs in Philadelphia; and the last presidential elections throughout the country levied heavily on the mental health of its citizens.

Abroad, discontents in Scotland, civil and religious; agitations in Wales, social and civil; wide-spread disturbances in the manufacturing and agricultural districts of England; tumultuous and riotous gatherings in Ireland-all have left abiding evidence of their mischievous influence upon the records of every hospital for the insane. France, too, unfolds a melancholy page of hospital history. Subsequent to the bloody revolution which marked the close of the eighteenth century, the hospitals for the insane were thronged, showing that where the effect of exalted mental excitement failed to produce insanity in the parents, it was developed in the children, and children's children-a fearful legacy, and sure!

The political disturbances which convulsed Canada, several years since, were followed by like results.

In law, idiots are ranked with the insane. I have remarked, throughout our country, several prevailing causes of organic idiocy; of these the most common, and the most surely traced, is intemperance of parents, and 'the marriage and intermarriage of near relatives and kindred. Abounding examples exist on every side throughout the land.

In calculating the statistics of mental aberration, from the best authorities, it is found impossible to arrive at exactly correct results; approximation to facts is all that can be attained.

There is less maniacal insanity in the southern than in the northern States, for which disparity various causes may be assigned. Two leading causes, obvious to every mind, is the much larger amount of negro population, and the much less influx of foreigners, in the former than in the atter. While the tide of immigration sets towards the north Atlantic States with almost overwhelming force, one cannot witness the fact and not note its sequence.

Our hospitals for the insane are already receiving a vast population of uneducated foreigners; and most of these, who become the subjects of insanity, present the most difficult and hopeless, because the least curable cases. Take for example the following records, which are gathered from the city hospitals for the insane poor, passing by for the present all the State and general hospitals:

In 1846, the Boston City Hospital for the insane poor received 169 patients; 90 of which were foreigners, 35 natives of other States, and 44 alone resi dents of the city. Of the 90 foreigners, 70 were Irish. The New York City Hospital for the insane poor, on Blackwell's island, which went into opera

intemperance, 14 religious anxiety, 12 domestic afflictions, 10 pecuniary troubles.

Of 1,247 patients received at the Hartford Retreat, 103 became insane through intemperance, 178 through ill health, 110 through religious anxiety, 65 through trouble and disappointment, 46 puerperal.

Irreligion, and the abuse of religion, are frequently the cause of insanity and suicide. Pure religion, more than any other power, tends to arrest, and assists to cure insanity. Of this fact there is constant evidence and illustration abroad in society, and within the limits of every well organized asylum.

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tion in 1839, had, in the autumn of 1843, about 300 patients. Of 284 admitted the following year, 176 were foreigners, viz: 112 Irish, 21 English, 27 Germans; and besides these were 38 natives of New York. On the first of January, 1846, there were in the institution 356 patients, of whom 226 were foreigners. In January, 1847, there were 410 insane patients, 328 of whom were foreigners. The cost to the city of supporting this institution, in 1846, was $24,179 67.

In the Philadelphia poorhouse hospital, at Blockley, there were received in one year 395 insane patients; at the present time there are actually resident there 350 idiots, epileptics, and insane. At the Baltimore city almshouse, there are at the present time more than 85 individuals in various stages of insanity, the whole number of inmates reported being 1,726; of whom 873 are Americans, and 853 Europeans. In the Charity Hospital at New Orleans, in 1845-'46, were above 73 insane; in 1847-'48 there were above 80, chiefly foreigners, and presenting mostly chronic cases. The whole number of patients received at this institution the past year was 8,044: of these, 1,773 were Americans by birth, 6,150 were foreigners,.and 121 were not recorded.

The report of the Commercial Hospital at Cincinnati shows, for 1844-'45, that of 1,579 patients, 85 were insane and idiotic. The report of 1846 exhibits the following summary: "Of 2,028 patients, 102 were insane." The last returns show yet an increase of this afflicted class, notwithstanding the enlarged accommodations in the State Hospital at Columbus, and the new buildings for the insane at the excellent asylum for persons in necessitous circumstances in the same city. I might adduce additional records, but believe the above are sufficient to extablish the correctness of my position.

Allowing at the present time 22,000,000 inhabitants in the United States, (which is below the estimated number,) and supposing only one in every thousand to be insane or idistic, we have then 22,000 to take charge of; a majority of whom are in needy or necessitous.circumstances. Present hospital provision relieves (if we do not include those institutions not considered remedial) less than 3,700 patients. Where are the remainder, and what is their condition ? More than 18,000 are unsuitably placed in private dwellings, in jails, in poorhouses, and other often most wretched habitations.

Dr. Kirkbride, who has carefully reviewed this subject, writes as follows: "In regard to whole numbers, my own inquiries lead me to believe that one in every six or seven hundred inhabitants would be a nearer approximation to correct estimate than one in every thousand, which has heretofore been assumed as the common rule." According to the latest Parliamentary returns taken with the report of the Metropolitan Commissioners on Lunacy, which give the numbers of all classes of insane in the hospitals of England and Wales, it is ascertained that in these two countries" there is one insane pauper to every one thousand inhabitants alone."

The liability of communities to insanity should not, I suppose, be estimated by the number of existing cases at any one time; for insanity does not usually hasten the termination of life. Take for example Massachusetts, New York, and Virginia, where are found so large numbers of established, long-existing cases, These are counted again and again, every year, every five, or every ten years. A fairer test of the liability of com

munities to insanity is to be found in the occurring cases in corresponding given periods.

There are twenty State hospitals, besides several incorporated hospitals, for the treatment of the insane, in nineteen States of the Union, Virginia alone having two government institutions of State and incorporated hospitals. The following is a correct list, omitting several small establishments conducted by private individuals, and several pretty extensive poorhouse and prison departments, which cannot properly be classed with regularly organized hospitals, being usually deficient in remedial appliances.

The first hospital for the insane in the United States was established in Philadelphia, as a department of the Penn Hospital, in the year 1752. This has been transferred to a fine district near the village of Mantua, in the vicinity of Philadelphia, since 1832: number of patients 188.

The second institution receiving insane patients, and the first exclusively for their use, was at Williamsburg, Virginia, in 1773: number of pa tients 164.

The third was the Friends' Hospital, at Frankfort, near Philadelphia, in 1817: number of patients 95.

The next was the McLean Hospital, at Charlestown, (now Summerville,) in Massachusetts, in 1818. This valuable institution is second to none in America. Number of patients 180.

Bloomingdale Hospital, near the city of New York, was established in 1821; number of patients 145: South Carolina Hospital, at Columbia, in 1822; number of patients 74: Connecticut Hospital at Hartford, patients 122, and Kentucky Hospital at Lexington, patients 247, in 1824.

In 1845-'46, the legislature of Kentucky passed a bill to establish a second State institution in the Green River country.

Virginia Western Hospital was opened at Staunton in 1828; number of patients 217. Massachusetts State Hospital, at Worcester, was opened in 1833, and enlarged in 1843; it has 370 patients. Maryland Hospital, at Baltimore, was founded in 1834; it has the present year 109 patients. Vermont State Hospital, at Brattleborough, was opened for patients in 1837, and enlarged in 1846-'47; it has at present 320 patients. New York City Hospital for the poor, on Blackwell's island, was occupied in 1838; it is now being considerably enlarged: above 400 patients.

The grand jury this month (June, 1848,) have made the following presentment in relation to the Blackwell's island hospital for the insane poor: "We found no less than 425 afflicted children of humanity suffering under the most terrible of all privations, and, we observed with regret, less adequately cared for than their situation and the dictates of humanity re

quire.

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The same document places before the public the concurrent testimony of Drs. Macdonald, Williams, and Ogden, who in a clear and true report show that "the accommodations for the insane poor of New York city are at present inadequate and miserable; and the imperfect manner of their treatment is such as to be a disgrace to the city, which otherwise is deservedly. famed for its liberal benevolent institutions. In the present state of affairs it is useless to attempt the recovery of any patients here."

The same remark holds good of the department for the insane connected with the commercial hospital in Cincinnati.

Well organized hospitals are the only fit places of residence for the insane of all classes; ill-conducted institutions are worse than none at all.

The New York City Hospital for the Insane, and the State hospitals of Georgia and Tennessee, cannot take present respectable rank as curative or comfortable hospitals.

Tennessee State Hospital, at Nashville, was opened in 1839. According to an act of the legislature the present year, this hospital is to be replaced by one of capacity to receive 250 patients. In the old hospital are 64 patients. Boston City Hospital for the indigent, which has 150 patients, and Ohio State Hospital at Columbus, were severally opened in 1839. The latter has been considerably enlarged, and has now 329 patients. Maine State Hospital, at Augusta, 1840; patients 130. New Hampshire State Hospital, at Concord, was opened in 1842, and has 100 patients. New York State Hospital, at Utica, was established in 1843, and has since been largely extended, and has 600 patients. Mount Hope Hospital, near Baltimore, 1844-45; has 72 insane patients. Georgia has an institution for the insane at Milledgeville, and at present 128 patients. Rhode Island State Hospital opened, under the able direction of Dr. Ray, early in 1848. New Jersey State Hospital, at Trenton, 1848. Indiana State Hospital, at Indianapolis, will be opened in 1848. State Hospital of Illinois, at Jacksonville, will be occupied before 1849. The Louisiana State Hospital will be occupied perhaps within a year.

I repeat that these institutions, liberally sustained as are most of them, cannot accommodate the insane population of the United States who require prompt remedial care.

It may be suggested that though hospital treatment is expedient, perhaps it may not be absolutely necessary, especially for vast numbers whose condition may be considered irrecoverable, and in whom the right exercise of the reasoning faculties may be looked upon as past hope. Rather than enter upon a philosophical and abstract argument to prove the contrary to be the fact, I will ask permission to spread before you a few statements gathered, without special selection, from a mass of records made from existing cases, sought out and noted during eight years of sad, papatient, deliberate investigation. To assure accuracy, establish facts beyond controversy, and procure, so far as possible, temporary or permanent relief, more than sixty thousand miles have been traversed, and no time or labor spared which fidelity to this imperative and grievous vocation demanded. The only States as yet unvisited are North Carolina, Florida, and Texas. From each of these, however, I have had communications, which clearly prove that the conditions of the indigent insane differ in no essential degree from those of other States.

I have myself seen more than nine thousand idiots, epileptics, and insane, in these United States, destitute of appropriate care and protection; and of this vast and most miserable company, sought out in jails, in poorhouses, and in private dwellings, there have been hundreds, nay, rather thousands, bound with galling chains, bowed beneath fetters and heavy iron balls, attached to drag-chains, lacerated with ropes, scourged with rods, and terrified beneath storms of profane execrations and cruel blows; now subject to gibes, and scorn, and torturing tricks-now abandoned to the most loathsome necessities, or subject to the vilest and most outrageous violations. These are strong terms, but language fails to convey the astounding truths. I proceed to verify this assertion, commencing with the State of Maine. I will be ready to specify the towns and districts where each example quoted did exist, or exists still.

In B., a furious maniac confined in the jail; case doubtful from long delay in removing to an hospital; a heap of filthy straw in one corner served for a bed; food was introduced through a small aperture, called a slit, in the wall, through which also was the sole source of ventilation and avenue for light.

Near C., a man for several years in a narrow filthy pen, chained; condition loathsome in the extreme.

In A., insane man in a small damp room in the jail; greatly excited; had been confined many years; during his paroxysms, which were aggravated by every manner of neglect, except want of food, he had torn out his eyes, lacerated his face, chest, and arms, seriously injured his limbs, and was in a state most shocking to behold. In P., nine very insane men and women in the poorhouse, all exposed to neglect and every species of injudicious treatment; several chained, some in pens or stalls in the barn, and treated less kindly than the brute beasts in their vicinity. At C., four furiously crazy; ill treated, through the ignorance of those who held them in charge. 47 cases in the middle district, either scattered in poorhouses, jails, or in private families, and all inappropriately treated in every respect; many chained, some bearing the marks of injuries selfinflicted, and many of injuries received from others. In New Hampshire, on the opening of the hospital for the reception of patients, in 1842, many were removed from cages, small unventilated cells in poorhouses, private houses, and from the dungeons of county jails. Many of these were bound with cords, or confined with chains; some bore the marks of severe usage by blows and stripes. They were neglected and filthy; and some, who yet remain in remote parts of the State, through exposure to cold in inclement seasons, have been badly frozen, so as to be, maimed for life. Details in many cases will not bear recital.

In New Hampshire, a committee of the legislature was named in 1832, whose duty it was to collect and report statistics of the insane. Returns were received from only one hundred and forty-one towns: in these were returned the names of one hundred and eighty-nine persons bereft of their reason, and incapable of taking care of themselves; ninety men and ninety-nine women. The number confined was seventy-six, twenty-five of whom were in private houses, seven in cells and cages, six in chains and irons, and four in the jails. Of the number at liberty, many had at various times been confined. Many of the facts represented by this com mittee are too horrible to repeat, and would lead many to the belief that they could not be correct, were they not so undeniably authenticated. The committee remark that from many towns no returns had been made, and conclude their report with the declaration "that they could not doubt that the numbers of the insane greatly exceeded the estimates rendered." Where were these insane? "Some were in cells or cages; some in outbuildings, garrets, or cellars; some in county jails, shut up with felons and criminals; some in almshouses, in brick cells, never warmed by fire, nor lighted by the rays of the sun." The facts presented to this committee not only exhibit severe unnecessary suffering, but utter neglect, and in many cases actual barbarity.

Most of the cases reported, I could authenticate from direct investigation. One very insane woman was confined all winter in a jail without fire; and from the severity of the cold, and her fixed posture, her feet were so

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