best could render; but an hospital alone could afford fit treatment for one so dangerous and so unmanageable.

At M, were five idiots and insane, ill kept, and very turbulent most of the time. Said one poor maniac, whose fetters and manacles. I had ordered to be removed, and whose aching, bruised limbs I was bathing, "Ah, now I am a human creature again: God is good-he sends you to free me: I will pray for you forever, and bright days shall shine for you." One woman, whose limbs bore marks of the cankering iron, worn for many years, said, "I could curse those who chain me, but the soft voice says, Pray for your enemies;' but, alas! my soul is dark, and the thoughts are black."

In the western part of the State I found a young man chained near his father's house, his bleeding limbs cut by the iron rings which confined the ankles ; he moaned, and howled, and cursed, and raved, so that horror filled the neighborhood.

A middle-aged woman, who was often greatly excited, was for months at a time confined in a smoke-house. Her condition was filthy to the last degree; she had neither change of raiment, nor water for bathing, for months. "She'll be found frozen to death some of these nights, I reckon," said the "care taker." Ten miles distant I found another case similar, but if possible more miserable.

In Pensylvania, in 1839, careful inquiry, followed by authentic reports, placed the number of insane and idiots at over twenty-three hundred: of these it was computed that more than twelve hundred were in the county poorhouses and prisons. I visited every county and considerable town in the State in the summer and autumn of 1844, and am satisfied that the number was much above the estimate of 1839.

In L——— I found above fifty insane, not counting idiots. The cells in the poorhouse, forty-four in number, measured four feet by seven, and twelve feet high; "chains and hobbles" were in constant use.

In Ywere above thirty insane: those in the basement of the poorhouse occupied cells of sufficient dimension, being fourteen by ten, and ten feet high; hobbles and chains in use. The physician estimated the number of insane in the county at more than one hundred, and added that cases of exceeding neglect and suffering often came to his knowledge. Sufficient provision in hospitals might save thousands of honest citizens from becoming a life-long burden to themselves and others, through permanent insanity. In this county above one hundred insane were found; there probably were other cases. In the poorhouse at G the insane were exposed and suffering; the basement cells measured eight by eight feet, and eight feet high. Chains, hobbles, and the miscalled "tranquillizing chain," were in use. There were more than forty insane in the

county.

In C, above twenty insane and idiots in the poorhouse; one was chained near the fireplace of a small room; a box filled with straw was near, in which she slept. Above 60 insane and idiots in this county. In B——— I found nearly 40; some chained, others confined in narrow cells. In S, several insane in the jail; one, heavily ironed, had been in close confinement there six years-another eleven months. In this county the insane and idiots were estimated to be 76 in 1840. I heard

of more than 100.

One woman has for months wandered in the woods

and fields in a state of raving madness.

At G, several cases in the jail; one chained; above forty in the county.

In N, in the jail, two madmen in chains; no furniture or decent care. One was rolling in the dust, in the highest excitement: he had been in close confinement for fifteen years. On one occasion he became exasperated at the introduction of a drunken prisoner into his cell, who perhaps provoked him. No one knows; but the keeper, on entering, found the insane man furious, covered with the blood of the other, who was murdered and mutilated in the most shocking manner. Another insane man had been in confinement seven years, and both are to this day in the same prison. In the poorhouse were above twenty insane and idiots; four chained to the floor. In the adjacent county were above fifty insane and epileptics; several cases of misery through brutal usage, by "kicks and beating," in private families.

met.

In W- were seven very crazy, and above twenty simple, insane, and idiotic. One, who was noisy, was in a small building in a field. The condition of all was degraded and exposed. In P, the insane in the jail were subject to great miseries. Many in the county were hashly confined; some wandering at liberty, often dangerous to the safety of all they The twelve counties next visited afforded corresponding examples.. The nine next traversed had fewer insane, and fewer, in proportion to whole numbers, in chains. In H, one case claimed special sympathy. Adjacent to a farm-house was a small shanty, slightly constructed of thin boards, in which lies an old feeble man, with blanched hair, not clad either for protection or decency; "fed," as said a poor neighbor very truly, "fed like the hogs, and treated worse." He is exposed to the scorching heats of summer, and pinching cold of the inclement winter; no kind voice cheers him, no sympathizing friend seeks to mitigate his sufferings. He is an outcast, a crazy man, almost at the door of his once cheerful, comfortable home. I pass by without detail nearly one hundred examples of insane men and woman in filthy cells, chained and hobbled, together with many idiots and epileptics wandering abroad. Some were confined in low, damp, dark cellars; some wasted their wretched existence in dreary dungeons, deserted and neglected. It would be fruitless to attempt describing the sufferings of these unhappy beings for a day even. What must be the accumulation of the pains and woes of years, consigned to prisons and poorhouses, to cells and dungeons, enduring every variety of privation-helpless, deserted of kindred, tortured by fearful delusions, and suffering indescribable pains and abuses. These are no tales of fiction. I believe that there is no imaginable form of severity, of cruelty, of neglect, of every sort of illmanagement for mind and body, to which I have not seen the insane subject in all our country, excepting the three sections already defined. As a general rule, ignorance procures the largest measure of these shocking results; but while of late years much is accomplished, and more is proposed, by far the largest part of those who suffer remain unrelieved, and must do so, except the general government unites to assist the several States in this work.

In Maryland, large numbers are at this hour in the lowest state of

misery to which the insane can be reduced. At four different periods I have looked into the condition of many cases, counting hundreds there. Chains, and want, and sorrows, abound for the insane poor in both the western and eastern districts, but especially in the western.

In Delaware, the same history is only to be repeated, with this variation: as the numbers are fewer, so is the aggregate of misery less.

In the District of Columbia, the old and the new jails, and the almshouses, had, till very recently, their black, horrible histories. I witnessed abuses in some of these in 1838, in 1845, and since, from which every sense recoils. At present, most of these evils are mitigated in this immediate vicinity, but by no means relieved to the extent that justice and humanity demand.

In Virginia, very many cases of extreme suffering now exist. The most observing and humane of the medical profession have repeatedly expressed the desire for additional hospital provision for the insane. Like cases of great distress to those in Maryland and Pennsylvania were found in the years 1844 and 1845. In every county through which I passed were the insane to be found-sometimes chained, sometimes wandering free. In the large, populous poorhouse near R were spectacles the most offensively loathsome. Utter neglect and squallid wretchedness surrounded the insane. The estimate of two thousand insane idiots and epileptic patients in this State is thought to be below the actual number. The returns in 1840 were manifestly incorrect.

In the report upon the Western State Hospital of Virginia, at Staunton, for the year 1847, Dr. Stribling feelingly remarks upon the very insufficient means at command for the relief of the insane poor throughout the State, "We predicted," he says, "that during the present year, those seeking the benefits of this institution would far exceed our ability to receive. This anticipation, we regret to say, has been painfully realized, and we are now called upon to report the fact that within the last nine months one hundred and twenty-three applications have been received, whilst only thirty-nine could be admitted. What has become of the remaining eighty-four, it is impossible for us to report." I regret to say there is but one conclusion deducible from this statement; the rejected patients are suffering privations and miseries in different degrees in the narrow rooms or cells of poorhouses, or in the equally wretched sheds, stalls, or pens, attached to private dwellings, while some have been temporarily detained, for security, in the jails. The laws of Virginia forbid a protracted detention of the insane in the county prisons, at this period. Formerly, I have traced the most cruel sufferings in the confined apartments, uncleansed and unventilated, and in the still more neglected dungeons, into which the insane have been cast. The hospital physicians report patients often sent to their care painfully encumbered with cords and chains.

North Carolina has more than twelve hundred insane and idiots. I do not know by personal observation what is their condition; but within a few months sad details have been communicated from respectable and reliable sources.

South Carolina records the same deplorable abuses and necessities as New York. I have found there the insane in pens, and bound with cords and chains, and suffering no less than the same class in States already

referred to at the north, except through exposure to the cold in winter, the climate in the southern States sparing that aggravated misery. One patient was removed to the hospital after being confined in a jail more than twenty years. Another had for years been chained to a log: another had been confined in a hut ten feet square, and was destitute of clothing and of every comfort of life. A young girl was confined in a dismal cabin, filthy and totally neglected. Her hair was matted into a solid foul mass; her person emaciated, and uncleansed; nothing human could be imagined more entirely miserable, and more cruelly abandoned

to want.

Georgia has, so far as I have been able to ascertain, fewer insane, in proportion to population, than either North or South Carolina, but there is not less injudicious or cruel management of the violent cases throughout the State; chains and ropes are employed to increase security from escapes, in addition to closed doors and the bolts and bars which shut the dreary cells and dungeons of jails and other receptacles. I have seen the deep scars of former wounds produced by chains and blows; and those who have received patients, transported to the State hospitals, are as much at a loss for any decent language for describing the condition of these unfortunate beings as myself. Their condition is indeed indescribable. Patients have not seldom been transported to the hospital in open carts, chained and bound with heavy cords.

Alabama reveals in her jails, and in many poor dwellings, corresponding scenes. In 1846 and 1848, I traced there poor creatures in situations truly revolting and horrible. To record cases is but to repeat sad histories differing only in time and place, not in degrees of misery. So also in Louisiana and Mississippi, in the same years. There are not, at the lowest estimate, less than fourteen hundred in these three last named States.

In Texas, it is said, insanity is increasing. I have seen several patients brought hence for hospital treatment, bound with cords and sorely bruised.

In Arkansas the insane and idiots are scattered in remote districts. I found it often exceedingly difficult to ascertain precisely their circumstances; these were no better-and worse they could not be-than were the indigent, and not seldom the affluent, in other States.

In Tennessee the insane and idiotic population, as in Kentucky, is numerous and increasing. The same methods of confinement to cabins, pens, cells, dungeons, and the same abandonment to filth, to cold, and exposure, as in other States.

In Kentucky I found one epileptic girl subject to the most brutal treatment, and many insane in perpetual confinement. Of the idiots alone, supported by the State at a cost of $17,500 62, in indigent private families, and of which class there were, in 1845, four hundred and fifty, many were exposed to severest treatment and heavy blows from day to day and from year to year. In a dreary blockhouse was confined, for many years, a man whose insanity took the form of mania. Often the most furious paroxysms prevented rest for several days and nights in succession. No alleviation reached this unhappy being; without clothes, without fire, without care or kindness, his existence was protracted amidst every horror incident to such circumstances. Chains in common use.

In Ohio the insane population, including idiots, has been greatly underated, as I am fully satisfied by repeated but interrupted inquiries in different sections of the State. The sufferings of a great number here are very distressing, corresponding with those referred to in New York and in Kentucky, Cells and dungeons, unventilated and uncleansed apartments, severe restraints, and multiplied neglects, abound.

Michigan, it was stated, had sixty-three insane in 1840. I think it a moderate estimate, judging from my investigations, reaching no further north than Jackson and Detroit, that the number in 1847 exceeded two hundred and fifty. I saw some truly afflicted and lamentable cases.

Indiana, traversed through its whole length and breadth in 1846, exbits the usual forms of misery wherever the insane are found; and of this class there cannot be, including idiots and epileptics, less than nine hundred. I found one poor woman in a smoke-house, in which she had been confined more than twenty years. In several poorhouses the insane, both men and women, were chained to the floors, sometimes all in the same apartment. Several were confined in mere pens, without clothing or shelter; some furious, others for a time comparatively tranquil. The hospital now about to be opened, when finished, will not receive to its care one patient in ten of existing cases.

Illinois, visited also in its whole extent in 1846, has more than four hundred insane, at the most moderate estimate. Passing into a confined room, in the poorhouse at G, I saw a cage, constructed upon one side of the room, measuring six feet by three. "There," exclaimed the keeper, with emotion, "there is the best place I have to keep a madman; a place not fit for a dog; a place where they grow worse and worse, and, in defiance of such care as I can give, become a nuisance to themselves and every one in the neighborhood. We want hospitals, Miss; we want hospitals, and more means for the crazy everywhere." I found crazy men and women in all sorts of miserable conditions; sometimes, as in Georgia, &c., &c., strapped upon beds with coarse, hard strips of leather; sometimes chained to logs, or to the floor of wretched hovels; often exposed to every vicissitude of the climate; but I limit myself to one more example. It was an intensely hot day when I visited F.— He was confined in a roofed pen, which enclosed an area of about eight feet by eight. The interstices between the unhewn logs admitted the scorching rays of the sun then, as they would open way for the fierce winds and drenching rains and frosts of the later seasons. The place was wholly bare of furniture-no bench, no bed, no clothing. His food, which was of the coarsest kind, was pushed through spaces between the logs; "fed like the hogs, and no better," said a stander-by. His feet had been frozen by exposure to cold in the winter past. Upon the shapeless stumps, aided by his arms, he could raise himself against the logs of the pen. In warm weather this wretched place was cleansed once a week or fortnight; not so in the colder seasons. "We have men called," said his sister, "and they go in and tie him with ropes, and throw him out on the ground, and throw water on him, and my husband cleans out the place." But the expedient to prevent his freezing in winter was the most strangely horrible. In the centre of the pen was excavated a pit, six feet square and deep; the top was closed over securely; and into this ghastly place, entered through a trap-door,