Illinois. General Assembly. Senate. -Sel. Cmte. upon the 111. Retreat for. the Insane. Report, Feb. 6, 1847. ILLINOIS HISTORICAL SURVEY r* !'- u ' v<)IS > SENATE. < 15th ASSEM. SESSION. < 15th ASSE MST SESSIO OF THE SELECT CO31-MITTEE, UPOK THE ILLINOIS RETREAT FOR THE INSANE, &c., &c. FEBRUARY 6, 1847. Laid on the table, and 3,000 copies ordered to bo printed for the use of the General Assembly, The Select Committee to whom \vas referred the bill to incorporate the Illinois Retreat for the Insane, the memorial of Miss Dix on the subject of the Insane, and a number of petitions praying the establishment of a State Hospital for the Insane, having had the same under consideration, beg leave respectlully to REPORT : From the results of inquiries instituted with a view to the ascertainment of facts on the subject of Insanity, your committee are of opinion, that if there is anyone class among the proper objects of public beneficence, which at the pre- sent time demands the enlistment of the warmest sympathy and commisseration of the Legislature, more than another, it is that class of persons who are bereft of reason. According to the census returns for 1840, there were at that period, in the western and south-western States, and the territories o*' Wisconsin and Iowa, two thousand one. hundred and sixty-seve-i insane persons, exclusive of idiots and imbeciles. The increase of population, during the six subsequent years, togeth- er with the ordinary causes that give birth to Insanity, have great y augmented this number. In addition to this, the operation of certain extraordinary agencies that have overspread the country, have exerted a deleterious influence, so that a careful estimate of the actual number at the present lime, in this vast territory, has placed the minimum at 2,500. This whole region is, with the exception of three States, almost entirely destitute of facilities for the relief of this class of persons. In the States of Ohio, Kentucky and Tennessee, there are public Asylums established by those States respectively, for* the accommodation of their own insane population, and supported it the public expense. The original de- sign in their establishment was chiefly to provide means of relief for the indi- gent. Indiana is nobly following the example set, by erecting a large edifice for the care of her insane. There is also a small institution in Missouri, sup- ported, as we are informed, by private contribution. These institutions, in the aggregate, will afford accommodations for but little over (iOO patients; so that there are probably 2,000 unfortunate beings, in this portion of the territory of the United States, suffering from mental derangement, with but very imperfect and ineffectual means of relief at command; their friends compelled, indeed, to re- main in anxious suspense, until a vacancy occur in some one of those crowded asylums before admittance can be gained for them; and, perhaps, when that time arrives, the fell destroyer has fastened himself immovably upon the brain, and banished reason from her seat forever. The State Institutions having been established and endowed by the State Le- gislatures for the benefit of their own citizens, and the accommodations provided being insufficient even for them, the Directors have been compelled to refuse all applications from other States. In the Ohio Asylum alone, during the seven years that it has been in operation, there have been about 600 applications re- fused for want of room. During the first six years, thirteen are mentioned from this State; and many having been informed of the adoption of the rule above stated, have never made application. The eastern asylums are generally crowd- ed, so that it is seldom that opportunity is afforded to obtain admission for luna- tic patients from this State. In relation to the insane of this State, your committee have been enabled to as- certain statistical and other facts of great importance, from a gentleman who has been for some years diligently engaged in making investigations on the subject. By the statements thus furnished, it appears that the aggregate number of insane persons in the State, whose mental disease is of such a character as renders them fit subjects for an Insane Hospital, is upwards of 300. By the census of 1840, it appears that there were at that period, in the State, 293 insane persons and idiots. Many inaccuracies have been detected in that report, the occurrence of which was doubtless unavoidable. These, however, make but little variation in the aggregate, from the actual number. A small portion of the idiots and imbeciles are of that harmless and inoffensive character, which does not reouire their se- clusion in an asylum, as a measure of public safety; and they are, therefore, not included in the estimate made of the actual number existing at the present time. The following table exhibits the number of those in each county, for whose re- covery to reason, hospital care and treatment is indispensable. In most instances, the numbers are given from special returns, and in the few remaining counties, in order to make the estimate as complete as possible, the census returns have been made the basis of calculation. rt OM TABLE showing the number of Lunatics in each, County, exclusive of Idiots, See. Adams, 2 Jackson, Ogle, 1 Bond, 4 Jasper, 2 Peoria, 9 Boone, 1 Jefferson, 4 Perry, 2 Brown, 3 Jersey, 2 Piatt, 1 Bureau, 1 Joe Daviess, 3 Pike, 8 Calhoun, 2 Kane, 4 Putnam, 2 Cass, 4 Kendall, 3 Randolph, 8 Champaign, 1 Knox, 9 Rfchland, 3 Christian, 1 Lake, 1 Rock Island, 2 Clay, 1 La Salle, 3 Sangamon, 10 Clinton, 4 Lawrence, 5 Schuyler, 5 Cook, 5 Lee, 1 Scott, 3 Crawford, 5 Logan, 6 Shelby, 7 De Kalb, 3 Macon, 3 Stephenson, 1 De Witt, 7 Macoupin, 7 St. Clair, 4 Du Page, 3 Madison, 4 Tazewell, 1 Edgar, 9 Marion, 6 Union, 7 Edwards, 1 Marshall, 1 Vermillion, 10 Effingham, 2 Mason, 1 Wabash, 5 Franklin, 6 McHenry, 1 Warren, 6 Fulton, 9 McLean, 4 Wayne, 5 Gallatin, 7 Menard, 5 White, 7 Greene, 8 Mercer, 2 Whiteside, '2 Hamilton, 1 Monroe, 3 Will, 2 Hancock, 4 Montgomery, 1 Williamson, 4 Hardin, 1 Morgan, 12 Winnebago, 1 ^ Iroquois, 2 --""TO The condition in which these poor sufferers are found, is in many instances revolting to humanity. The want of a suitable place of safety has rendered it necessary for those having charge of lunatics to resort to jails, prisons and dun- geons. In one instance, an insane man has been confined in a hole dug in the ground, for the purpose of safe-keeping, and to prevent him from freezing to death. In others, cages of logs have been erected to prevent escape. They are bound down with ropes and chains, the hands fastened together with pieces of rope, and the body fixed by another rope to the wall, or floor of their prison- house. Frequently, they have been kept nearly or entirely denuded, and desti- tute of the most common physical comforts of life. The difficulty and liability to danger incurred by keeping fire in such apartments, and the unfaithfulness of keepers, has exposed them in inclement seasons, to the most extreme atmos- pheric vicissitudes, until the feet were so badly frozen, that they were unable to stand. Similar instances of suffering are known, from experience, after escape from confinement, presenting a melancholy spectacle, calculated to awaken the deepest sympathy in the bosom of every true philanthropist. Whether rich or poor, there is comparatively but little variation in the degree of privation suffered; for in the one case, the fear of personal danger apprehend- ed by friends, together with ignorance of proper management, or inability to pur- sue it when known, and, on the other, a regard for public safety, and a desire to regulate the expenditure of public money in the most economical manner, causes the most rigid scrutiny, and coercion to be exercised. Without refer- ence to the employment of proper curative means, this vigilance is without judg. t- or p 31 074 ment, palpable to the unfortunate subject of it, and seemingly employed for no other purposo than to resist, in the most obstinate manner, every innocent desire that may be formed. This operates as a new source of irritation to the unfortu- nate maniac. He regards himself as a persecuted prisoner; his raving becomes wilder; he destroys his clothing, and every object within his reach; utterly re- lusjiig the small moiety of comfort that may occasionally be extended to him; until, in the bitterness of his soul, he sinks down in despair, or becomes an un- controllable madman. The pauper has, of course, less of sympathy extended to him than the wealthy lunatic; and his Bufferings, consequently, are in some in- stances, greatly augmented. The motives above mentioned, being chiefly oper- ative in the minds of County Commissioners, the only oilicial duty imposed is to provide a place of security, and means to preserve animal existence, at the cheapest rate, in the same way as would be done for a wild beast. Accumulated experience has established a series of facts in relation to In- sanity, and a series of principles of treatment based thereupon, which ought to be understood by every enlightened Legislative body. Insanity is a phys- ical disease, and is subject to the same laws in regard to its progress which gov- ern other diseases. When the substance of the brain is involved in disease, the most active means become necessary to restore its functions; otherwise an organ- ic change takes place, and it can never again resume its functions as connected with the operations of the mind. Growing out of this, there is a fact of the first importance, which should never be lost sight of. The chances of cure diminish in a rapidly increasing ratio, in proportion to the duration of 1he disease. The lon- ger it is allowed to remain before suitable means are employed for recovery, the more difficult it becomes to effect a cure; so that cases, which in the onset were remediable, will, after the lapse of time, resist all efforts made for recovery. Hence it is of the greatest importance, that the disease should be vigorously met as early after the development as possible. It is confidently asserted by the highest medical authority, that acute mania, when properly treated, according to the most approved modern method, in its earliest stage, is not more difficult of cure, and has been cured in as many in- stances out of a given number, as any other form of severe acute disease. By reference to the Reports of Lunatic Hospitals in Great Britain, France and the 'United States, it will be seen that the amount of success obtained since the intro- duction of this system of management, is, in recent cases, as high as from 86 to '90 per cent., and in old cases, from 30 to 44 per cent. By recent cases, is meant those whose insanity has commenced within one year from the time of their ad- mission into the Hospital. These results, however, cannot be obtained without the employment of all the curative influences, both moral and physical, which can be brought to bear in the management of the disease. The moral agencies made use of, consist of the following details: The early removal of the patient from the scenes and personal associations to which he has been accustomed; the careful exclusion of every thing of an exciting nature; the classification of the patients according to the grades of their disease, each class being kept separate from the others; the constant presence of a proper number of attendants; uniform cheerfulness and kindness on the part of the su- perintendent and his subordinates, religious worship, music, reading, amusements, agreeable company, and similar influences. The physical a