81 pitals." By a detention hospital we mean a place where the alleged insane may have temporary accommodation and treatment while the question of their commitment is pending, or where cases which are considered doubtful may be under observation for a few weeks. At present, you know, there is no place provided for the detention of such patients except our county and city jails. I think you will agree with me that it is cruel and degrading, and often fraught with serious consequences, to place an insane person in such an institution as a jail. Yet our officials can do nothing else, as the law has not provided for any other place. There are cases of alleged insanity where all that is needed is rest or a change of environment to restore them to mental health, and we claim that, by having this detention hospital, many people would consent to their friends being taken to such a place who would not allow them to go to an asylum. While we grant it is right for friends to send patients there, we cannot control them; we cannot make them think so. By a brief sojourn in such a place of detention we could satisfy them that their friends were in need of the treatment afforded in a permanent institution. I have in mind a case which came under my own care last year of a woman who became insane three days after the birth of her child. We gained the consent of the authorities of one of our hospitals to place her there. She became very violent and noisy, so that we were informed that "she must be taken away," but the examining physicians said she should not be moved, and they allowed her to remain. In three weeks' time that woman was home and in her right mind, taking care of her baby, and never had any relapse. Now, had it been possible to send her to our state institution, I think the superintendent would not have felt at liberty to return her to her home and friends so soon lest he make himself liable to censure, while in his own mind he would think it was safe; so he detains the patient until there can be no doubt of her recovery. And this is only one case of many that might recover if placed in a detention hospital for a brief time. This state is relieved of the expense of caring for them. Then there is a social and business phase of it. You know there is a stigma in the minds of the public attached to persons who have been committed to an insane asylum. There is also a business embarrassment. A person who goes there must have a guardian, and their business passes into the hands of another person. Often this is a great detriment to them. By a sojourn in the detention hospital, where they might recover in a very short time, this requirement might be deferred or made unnecessary. Now, in offering this we do not desire to create the impression that we are in any way entrenching on the rights of those in charge of our state asylums. Rather we wish to cooperate with them and help them. Certainly, we would be able to relieve the congested condition which exists in them now by preventing many from going there. There is an economic phase of the question. I understand that it costs The bill also provides that these hospitals or wards should be under the 6 a ghate, we hub engang ♬ "we Kawear Ann & trava u te Made Arbut bonger in 100 **** 302 vntuna, carrying de xget the mali Wake Wake ga Nach Hard for Sue rondson of Weture. From the rearing Gf Vjitolb jerskra, hill she comme paakjon* 164 with the parlara during all to gbare the mod empleng w w tenebato, I waseen the marken derson that ILaLy of them bed fan they were with wfully or wrongfully restrained of their Benny 1 wAAAIBE FORrzed that tus harmful dension was in many inwhores produced by the very prezanton rendered omigatory by a judicial For Mot pegen 1 deem 11 any duty to advocate on all appropriate occasions ***** # *-fiving of the method for the commitment of the insane to hospital Part me will rebe * 1 from the appearance in any mammer of a criminal I am glad to listen to the plen of one of your hospital specialists, That the Twine should be treated me sick people, and not as criminals, and I indope 10w deduration that, if it be an infringement upon the personal lib*ty pounded by the constitution to commit an insane patient to hospital ware salhout the formality of a full judicial process, it is in like manner unbreful to disturb the shuius of any other sick person by quarantine detennom Recept bg indlar proceding. Can we wonder that a mental organism disturbed by decause should fail to recognize the benevolent intent of medicine when if we donded with the mystery of a jury room? Let us follow the Portums A father lims become insane. His family strive with the affliction In the hopes Hurt if my puss, but the elbuns of disturbance comes, and action mmd be imben. A complaint is lodged with the judge of probate; a warrant For the apprehendous ba bessured and placed in the hands of the sheriff, who is The Getmind offer of the county. The sheriff proceeds to the home in the performance of an comburinssing duty. If the patient proves refractory, the aleer often, from a mistaken sense of kindness, resorts to deception in order to poreunde tus distracted citizen to necompany him without a resort to force. To mujority of enses of violent muuta. The county jail offers the only safe and conventont places of detention. The machinery of the court is prepared, and the del muni duly ushered into the presence of a jury of his peers, where dacreddon done not all upon the bench. He may hear the testimony of memher of his family to add to the bewilderment of his tired brain. Then folTown This Journey to the Dual place of detention, and the reception in the pront bullding which resembles the prison. Is there any wonder that in the Hoy lume and hospitals whore such methods of committal prevail there are man who fool that they have been unlawfully dealt with? Is there, in fact, muy pronoms which could be more discouraging to needed rest or perplexing to hofpfut frontment than the one prescribed as a safeguard to personal liberty? When Front the title of Dr Tomlinson's paper, my attention was immediately arrested, because It ausgested a need which I did not imagine to exist In Monosuba hand come to recognize the advance which you have made in developing wlop plans of state soctology, and had given testimony to the procrase which fois placed Minnesota well to the front of the states of the →refore was curious enough to write Dr. Tomlinson a letter to inquire is comforting to our hope of progress that a few logicians refuse to an interpretation of a law which destroys that which it was created teet. Some states have avoided the process complained of by the subon of wiser methods, and their insane are spared the ordeal of being fonted by accusers, and "judged by their peers." If the committal to al care of the insane sick may be brought about by a quiet and humane Dedure, sanctioned by medical jurisprudence, there need be no waiver of served right of the more formal inquiry when demanded. If there is ly any constitutional hindrance to so desirable a reform, its removal is a ze upon the intelligence and humanity of the day. MR. GATES, St. Paul: I would like to add one word more of testimony on this subject, and more especially upon the abuse that the insane patient s through before he gets to the hospital. I have had occasion during the at two years to visit the hospitals a great deal, and I have had occasion to sit the insane in the county jails a great deal, and I can say from my exefence that the insane suffer more than is generally imagined before they ach the hospital. I wish to relate as an illustration but one case. I might ention many, but I will take one case that illustrates the whole subject. I Tas called to Minneapolis to see an insane colored man, who was confined the city prison. I found there a man, who was very wild and excited, ked up in a small, dark cell, and his great trouble seemed to be the inatice of his being locked up there. When I went to talk to him I could hardly get any attention at all. He demanded that I go immediately for the mayor, and for the governor, and for every other official of the state who could get him out of that position; said he had been greatly abused and misused. I told him that I could not get the governor nor the mayor, but I thought I could get him a writ of habeas corpus. As I intended to take him to Chicago the next day I thought that would ease his mind until the next morning. When I went up the next morning to get him I found that he was wet from head to foot, and I could get no explanation from the police department of Minneapolis as to the cause of it, and I drew my conclusion which at present I have no doubt is true) that that man had been sprinkled with the hose in order to quiet him from his wild delusions. I, of course, could not take him to Chicago in that condition, and I requested that he be taken at once from there to the county jail. He was taken to the county jail, and at my request his clothes were cleaned and dried. I went back the next morning to get him, and I found him still wild. But I told him I had that writ of habeas corpus, and, although he seemed to be very wild and dangerous, the doors were unlocked, he thought he was at liberty, and he went to Chicago without a word; no trouble with him at all. His great trouble at that time seemed to be the injustice in locking him up in the cell. Now, I might mention mauy cases. Dr. Tomlinson, and other superintendents of our hospitals will tell you many instances of abuse where insane people have been brought to the hospital perhaps bound or in handcuffs. Officers who are inexperienced with the insane seem to be afraid of them, I wish to add this testimony: that I have personally taken out of the state, since I commenced my work, nearly fifty insane people, and I have never yet put one in restraint. I have had people ask me if I did not think it was dangerous. Sometimes I have taken two and sometimes three at a time. "Don't you think it is dangerous?" No, it is not dangerous. Insane people are mostly like children, and it is a great deal easier to treat them humanely -that is, to take a part in their fancies, to humor them-than it is to en deavor to force them. Almost every insane person can be handled by prope humoring. This colored man,-after we got him started, Mr. Hart took hin to Chicago; he went down alone. He imagined he was president of the United States, appointed his cabinet, and before he got to Chicago had made Mr. Hart chief justice. All that was humorous, but it didn't do any harm The man went without any trouble at all, and seemed to be pleased to go. Now, the fiction that Mr. Tomlinson speaks of has grown up from the fact that in former times (and there are some cases now) people would try to get a relative or a friend, or some one they didn't want at home, into any insane hospital, to get rid of him. And this fiction, as it is called, of having an examination in court is to keep people from being confined in an insane · asylum or hospital unjustly when they ought not to be. I think we have now reached the time when that should be done away with. I think there is more injustice in the other course than there is to suspend the legal proceedings almost entirely. There are some difficulties in the way of reaching that course. Now, the matter has been criticised, and yet we have no bill offered that will exactly meet the case. I think all agree that something of the kind ought to be done, but how are we going to reach it? How will it be done so that there will be no friction or trouble? I wish to make one point that I ought to have made before this, namely, that I believe that in this state the hospital ought to send an attendant after every insane person, and the sheriff should in no instance be permitted to take an insane person to the hospital. South Dakota has reached that point already. In South Dakota, in every instance where a man is to be conveyed to the hospital, an attendant is sent from the hospital to accompany him. In looking over the records of this state I find that it costs the counties a great deal to send an insane person to the hospital. We had one case in a county of this state where a man had to be taken to Omaha. As the county was half way to Omaha I thought it would be very advisable to have the sheriff take the man to Omaha and save expense. I wrote him a very kind letter, told him of the smallness of our appropriation, and necessity of economy, and asked him if he could not take the man. He did. It would have cost me to have gone from St. Paul to that county and taken the man to Omaha and got back home about forty dollars. The sheriff's bill was eightyseven dollars. He took an attendant with him; he could not go alone. It took two of them to take one man to Omaha. No use in it at all. Simply afraid of the man; that was all. Now I don't blame the sheriff, but he simply didn't know anything about handling an insane man. And for that reason I say the insane should be handled by those who are acquainted with insane people; consequently, an attendant should be sent for them in all instances. Now, I think the laws in reference to commitment can be greatly modified. I think they can be modified so that a person can go to an insane hospital voluntarily. That should be the first thing. Or that a relative or friend could take a man there, if he did not refuse to go. But there comes a time when a man will stand back and absolutely refuse to go himself. The relatives can't get him there. Then what is going to be done? You must then take him to the hospital by force, in some way. You must then have some process by which you can forcibly get him there. Now, how we are going to do that is a thing I have not got through my own mind yet. I was in hopes that one of the speakers would tell us how. MR. FAULKNER: Why cannot any citizen exercise the same degree of force that a sheriff can? Why can't anyone be designated by the probate judge to do that duty-say, an attendant from the hospital, or the coroner, or draft somebody else into the service? Why take the sheriff? A sheriff isn't built of any better bone or muscle than any other man. It is only his omce that stands up as a terror, and that has no effect on an insane person. An insane person does not respect the office of sheriff. MR. GATES: I was going to make another suggestion, and ask why this would not do: I don't say that it will, but it occurs to me that it might. Why not have the probate judge appoint two physicians, who would repair the insane man's house, instead of bringing him to the probate court; and probate judge could go himself if he saw fit. But let the two physicians to the man's house, and examine him, and come back and make their re, and then if the probate judge finds from the report of the physicians the man is insane, then he shall send word to the hospital, and the hosal shall send an attendant to the man's house and get him. MR. FAULKNER: That would do. MR. GATES: Now, I merely suggest that for want of a better plan, but I Tould like to see these things brought down into practice. Let us get someing that we can present before the legislature or the public. We must get me practical measure before we can enact it into law. Now, 1 don't know any better plan than that, but some plan that is practicable must be sugested. Something ought to be done at once. But what shall be done? Let s mature a statute, and go before the legislature with something that is tangible and practicable, and then we will be able to accomplish something. DR. TOMLINSON: The point that I tried to make in my paper seems not to have been comprehended. The insane man is a sick man; therefore no legislation of any kind is necessary. MR. GATES: Doctor, you have got to wipe out the laws now on the statute books. DR. TOMLINSON: And here is another point: If a man has diphtheria or smallpox you do not institute proceedings before a judge of probate before you take him to the pesthouse. PUBLIC DAY SCHOOLS FOR THE DEAF. BY PROF. JAMES N. TATE, SUPERINTENDENT SCHOOL FOR THE DEAF, FARIBAULT. In appearing before this conference to discuss public day schools, I do not mean to be understood as being willing to classify the deaf and blind with the criminal, tramp or imbecile. The deaf and blind are normal, except that in the one case they do not hear and in the other they do not see. The importance attached to any subject is measured both by the number of persons interested and the extent of that interest. The deaf of this country are vitally concerned in the question of their education, and, through them, the whole country. The whole number of deaf persons in the United States is, perhaps, not less than 40,000. On Nov. 10, 1897, there were in the state institutions in the United States 8,893 pupils, with 1,047 instructors; in the day schools, 438 pupils, with sixtysix instructors, and in the denominational and private schools, 418 pupils, with seventy-five instructors. In the state institutions, similar to that at Faribault, without exception, we believe, board and tuition are free. Every state has such an institution, and some of them more than one. In round numbers, over 40,000 pupils have been trained in these schools. The first was established in Hartford, Conn., in 1817, and was called the "American Asylum," it being supposed then that one school would afford ample facilities for educating the deaf of the whole country for all time. The first state to establish day schools was Wisconsin, in 1885. In most cases |