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 TWENTY-FIVE YEARS 
 
 WITH 
 
 THE INSANE 
 
 BY DANIEL PUTNAM, 
 
 LATE CHAPLAIN OP MICHIGAN ASYLUM, AT KALAMAZOO. 
 
 DETROIT : 
 JOHN MACFAKLANE. 
 
 1885.
 
 COPYRIGHT BY 
 
 DANIEL PUTNAM, 
 
 1885. 
 
 WINN & HAMMOND, 
 
 PRINTERS AND BINDERS, 
 
 DETROIT, MICH.
 
 PREFATORY NOTE. 
 
 The author desires, in this way, to acknowledge 
 his obligations to the Superintendents of the asy- 
 lums for the insane in Michigan, and especially 
 to Dr. PALMER, of Kalamazoo, for his kindness in 
 examining the manuscript of the book, and for 
 many valuable suggestions. It should be stated, 
 however, that he is in no degree responsible for 
 any opinions and ideas expressed. 
 
 It is deemed necessary to make only this gen- 
 eral acknowledgment for the material derived 
 from historical and other books treating of men- 
 tal diseases, since those works are well known to 
 all familiar with the literature of insanity, and 
 most of the matter thus obtained is, to a large 
 extent, common property. 
 
 The author is under much obligation to H. A. 
 FOED, Esq., for his invaluable assistance in the 
 corrections of proofs, and for many typograph- 
 ical suggestions. 
 
 Messrs. Wiisrisr & HAMMOND also deserve grate- 
 ful mention for the beautiful form in which the 
 book appears.
 
 CONTENTS. 
 
 CHAPTER. PAGE. 
 
 I. INTRODUCTORY AND PERSONAL 1 
 
 II. INSANITY AND ITS TREATMENT AMONG THE AN- 
 CIENTS 12 
 
 III. THE INSANE DURING THE EARLY CHRISTIAN CEN- 
 
 TURIES 16 
 
 IV. THE FIRST HOSPITALS AND ASYLUMS FOR THE IN- 
 
 SANE AND THEIR CHARACTER 23 
 
 V. CURIOUS SUPERSTITIONS, AND STRANGE METHODS 
 
 OF TREATING THE INSANE 80 
 
 VI. THE BEGINNINGS OF REFORM AND IMPROVEMENT.. 38 
 VII. THE MODERN ASYLUM 47 
 
 VIII. GUARANTIES FOR THE SAFETY AND PROPER CARE 
 
 OF THE INSANE IN ASYLUMS 54 
 
 IX. TREATMENT OF THE INSANE OUTSIDE OF ASYLUMS. . 70 
 
 X. OPINIONS AND FEELINGS OF PATIENTS 76 
 
 XI. SCHOOLS AND INSANITY ' 86 
 
 XII. RELIGION AND INSANITY 94 
 
 XIII. ALCOHOL AND INSANITY 104 
 
 XIV. TOBACCO AND OTHER NARCOTICS AND INSANITY. . . 109 
 XV. INHERITED TENDENCIES AND INSANITY 116 
 
 XVI. INSANITY AND CRIME 128 
 
 XVII. CONCLUDING THOUGHTS . , 141
 
 TWENTY-FIVE YEARS WITH THE INSANE. 
 
 CHAPTER I. 
 INTRODUCTOEY AND PERSONAL. 
 
 The Michigan Asylum for the Insane, at Kalama- 
 zoo, was opened in August, 1859. A little later in 
 that year I was invited by the Medical Superintend- 
 ent, Dr. Yan Deusen, to conduct the first religious 
 service held in the institution. This was the begin- 
 ning of a connection with the asylum which con- 
 tinued for five-and-twenty years. Consequently, dur- 
 ing a large part of an ordinary lifetime I have been 
 brought into somewhat intimate relation with the 
 insane, and with the officers of an institution which 
 may justly claim to rank among the very best in the 
 country. These many years have given abundant 
 opportunities for observing many varieties of mental 
 disease, and for learning whatever an unprofessional 
 observer might be able to learn. .One would be 
 indeed beyond hope of forgiveness if nothing of 
 value to himself and others were gathered up with
 
 2 TWENTY-FIVE YEARS 
 
 such facilities. I have a desire, if possible, to render 
 this knowledge of some practical service to parents, 
 teachers, students, and others employed in the com- 
 mon pursuits and business of every-day life. It is 
 for this reason, chiefly, that I write these chapters. 
 
 I wish, at the outset, to guard against a possible 
 misconception of the nature and character of the 
 book. It is not necessary to say that I do not write 
 as a physician or a specialist, because that would be 
 readily understood. It might, however, on account 
 of the position which I have occupied, not unnatur- 
 ally be supposed that I have studied and observed as 
 a clergyman, and that I speak as a member of that 
 honored profession. I count it, on the whole, a 
 fortunate thing that I am only a layman, authorized 
 by the custom of the religious organization with 
 which I am connected to conduct the exercises of 
 social and public worship. My diities as a teacher 
 have brought me constantly, for more than thirty 
 years, into daily contact with young, healthy, and 
 vigorous mental and physical life. The means have, 
 therefore, been at hand for comparing, at pleasure and 
 day by day, normal and morbid mental activity. If 
 one had desired, it would have been impossible to avoid 
 such comparison, or to forbear drawing from it lessons 
 for the school-room and the home. I write, conse- 
 quently, especially as a teacher, and as a student, in a 
 very humble way, of the science of mind, in which pro- 
 fessional duties have required me to give instruction.
 
 WITH THE INSANE. 3 
 
 I do not speak upon the subject of insanity as an 
 expert. I wish distinctly and emphatically to disclaim 
 any such purpose. I have neither the knowledge nor 
 the inclination necessary to enable me to do a work 
 of that kind. Besides, perfect candor impels the con- 
 fession that observation, both within and without the 
 asylum, leads me to estimate at a very moderate 
 value the opinions of the majority of self-constituted 
 experts. I can not resist the conviction that so-called 
 expert testimony has been the occasion, if not the 
 cause, of much harm to the worthy and honest 
 insane, both in the courts and elsewhere. 
 
 Having thus guarded against misapprehension in 
 one direction, it may be allowable to say a word in 
 rejation to the position and duties of a chaplain in an 
 asylum for the insane, as they appear in the light of 
 experience and reflection. The impression is doubt- 
 less general, that the chaplain of an institution of any 
 kind is an officer charged with duties mainly, if not 
 exclusively, religious in their character. It is sup- 
 posed, not unnaturally, that he has to do almost 
 exclusively with the moral and spiritual condition 
 of the inmates, and that in this sphere he should 
 have the right to act with entire freedom from the 
 control or direction of any superior. Any inter- 
 ference, by dictation or by very earnest suggestion, 
 with his purposes, plans, or methods of labor, would 
 be considered by some persons as an infringement
 
 4 TWENTY-FIVE YEARS 
 
 upon prerogative, if not upon the province of con- 
 science itself. 
 
 This view of the position and rights of a chaplain 
 may be correct, for aught I know, in institutions 
 where inmates are free from any irregular activity, 
 either of the intellect or the emotions. 
 
 But experience and observation have gradually 
 brought me to the conviction that this officer can not 
 occupy such a position of independence and self- 
 direction in an asylum for the insane with safety to 
 the general interests of the institution, or with advan- 
 tage to the inmates themselves, unless he possesses 
 unusual soundness of judgment, great prudence and 
 discretion, and much practical knowledge of insanity 
 and the insane. This conclusion has not been reached 
 hastily, nor as a result of any expressions of opinion 
 on the part of the medical superintendents or other 
 officers with whom I have been associated. During 
 five-and-twenty years I received no dictation, no un- 
 pleasant or undesired suggestions, and no restraint of 
 any kind upon liberty of speech or action. Yet I am 
 sure my mistakes would have been much more fre- 
 quent and serious, in personal intercourse with 
 patients, but for wise and timely counsel given in 
 the most delicate and oftentimes indirect manner. 
 
 In his general duties the chaplain is not a pastor in 
 the common acceptation of that term. The ordinary 
 methods of a pastor, transferred to the halls of an 
 asylum, might easily work untold evil. In the
 
 WITH THE INSANE. 5 
 
 public services of the chapel the differences are 
 much less. The general truths of the gospel may be 
 spoken with ordinary freedom and plainness. It will 
 only be necessary to avoid exciting topics and excit- 
 ing manners and methods. It hardly needs to be sug- 
 gested that the distinctive doctrines and peculiarities 
 of sects and parties would be sadly out of place in 
 ministering to such an audience. 
 
 It is in the direct personal intercourse of the chap- 
 lain with patients that he finds the need of peculiar 
 wisdom and discretion. In this intercourse, with the 
 best of intentions, it will be easy to inflict much 
 injury, and to hinder the progress of recovery. To a 
 large extent, religious truth and religious instruction 
 and exhortation appeal to the emotional nature. 
 In many, perhaps in a majority of cases, especially 
 among females, mental disease touches directly or in- 
 directly this part of the nature. It will not be diffi- 
 cult, in cases of this sort, to excite a morbid and 
 harmful degree of emotional activity. This intensity 
 of feeling, of whatever nature it may be, produces 
 unfavorable results upon the nervous system, 
 prevents rest, and tends to create irritability and 
 even maniacal excitement. This illustration will be 
 sufficient to indicate some of the difficulties to. be met, 
 and the necessity of receiving advice and counsel 
 from the medical officers who have carefully studied 
 the peculiar conditions of individual inmates. Relig- 
 ious services and religious reading or conversation are,
 
 6 TWENTY-FIVE YEAES 
 
 at some times and in some circumstances, the occa- 
 sion, if not the cause, of much suffering and evil to 
 individuals. And not unfrequently such persons 
 have a very strong desire for such reading and 
 conversation. The chaplain will very likely be 
 reproached for apparently neglecting these patients, 
 and the officers in charge will be accused of cruelty 
 for refusing permission to attend church or chapel 
 exercises. 
 
 The inquiry has frequently been made of me by 
 those not familiar with the interior life of an asylum 
 for the insane, whether the services of a chaplain can 
 be of any real value to the inmates of such an insti- 
 tution. My present position will enable me to ex- 
 press an opinion upon this question free from the 
 supposed influence of personal interest. 
 
 The inquiry comes, in most cases, from persons 
 who do not know, or fail to keep in mind, the widely 
 differing classes of inmates and the numerous varieties 
 of mental disease. Patients suffering from complete 
 dementia, or from violent attacks of acute mania, are, 
 for the time, beyond the reach of instruction or of hu- 
 man consolation by any direct communication of mind 
 with mind by ordinary religious services. But 
 among almost all other classes of inmates there are 
 very many individuals who receive, directly or 
 indirectly, I believe, great benefit from personal con- 
 versation and from the chapel services. Not a few 
 of these are members of churches. They have been
 
 WITH THE INSANE. 7 
 
 accustomed to attend public and social worship. 
 Such periods of devotion and instruction have become 
 an important part of their conception of life and 
 duty. When these can not be enjoyed, the loss is 
 deeply and sorely felt, though it may not be very 
 clearly understood or expressed. The condition is 
 like that of which most of us have been conscious, at 
 one time or another: something is wanting, we may 
 not be able to tell what, but there is a feeling of 
 vague and distressing unrest which prevents all con- 
 tentment and repose of mind. This unrest is a 
 great obstacle to recovery, especially when the power 
 of self-control has been lost or seriously weakened. 
 
 Moreover, many patients suffer from mild or peri- 
 odic forms of mental disorder. Excepting at inter- 
 vals of greater or less frequency, they are in posses- 
 sion of a good degree of intellectual strength. In 
 addition to these, there are always persons nearly or 
 quite restored to their usual degree of health, waiting 
 for time to give confirmed vigor both of body and 
 mind. 
 
 To both these classes all truths have a familiar 
 and accustomed sound. The forms of worship, the 
 tones of prayer, the songs of praise, words of instruc- 
 tion and exhortation and comfort, are to them the 
 same here as elsewhere. By such well-known and 
 often highly prized services, assurance is constantly 
 given that they are not cast out from friendly and 
 Christian society and from personal and Christian
 
 8 TWENTY-FIVE YEAKS 
 
 sympathy, although sundered from home and the 
 ordinary relationships and associations of life. In 
 some cases this is a potent factor in stimulating effort 
 to recover self-control, and in keeping the soul 
 from sinking into apathy, if not into despair. In this 
 and in other ways, the chaplaincy, entirely apart from 
 any considerations of a moral and religious character, 
 takes an important place among the so-called moral 
 means of curing or alleviating insanity. It is quite 
 possible that its highest value is found here. I am 
 persuaded also that its good influence often reaches 
 even to the disturbed and demented patients. The 
 sympathizing and comforting utterances of the " Man 
 of Sorrows," falling upon ears accustomed elsewhere 
 and under happier circumstances to listen to them, 
 are like sweet strains of music heard long ago and 
 dimly and faintly remembered. They convey little 
 conscious instruction or consolation, and may hardly 
 be retained until the brief service is ended. But 
 even thus they are not altogether worthless. The 
 attention has been caught and held for a moment ; 
 the memory has been half awakened, and has groped 
 for an instant amid the mental darkness after the 
 forgotten. Over the vacant face and into the dull 
 eyes, has flashed a single gleam of returning intelli- 
 gence. Down into the brooding gloom has fallen 
 one ray of blessed light, and, for a brief interval, the 
 marvelous grasp of some strange, strong delusion has 
 been loosened. A little gleam of coming hope has
 
 WITH THE INSANE. 9 
 
 faintly illumined the darkness of the present. There 
 has been a little ray of blessed sunlight through 
 the clouds. An existence which, to an observer, 
 seems only a grievous burden, has been made tolera- 
 ble, at least for a passing moment. 
 
 These introductory and personal considerations 
 may find a fitting close in some statements concern- 
 ing the number of patients who have been under 
 treatment since my connection with the asylum 
 began. At the time of the first religious service, 
 only a small portion of one wing of the original 
 building had been completed, and only females 
 had been admitted. The number of patients 
 was but thirty-one, and the whole popula- 
 tion connected with the place was scarcely fifty 
 persons. On the first of October of this year (1884), 
 the number of patients was seven hundred and nine- 
 ty-eight, and the whole resident population more 
 than nine hundred. During these twenty-five years 
 3859 patients have been received. Of this large 
 number, nine hundred and thirty-six have been dis- 
 charged as restored to usual health, and seven 
 hundred and seventy as more or less improved. 
 
 The Eastern Asylum at Pontiac has been opened for 
 six years and two months. On the first of October, 
 1884, it had six hundred and fifty-three patients. 
 Since its opening it has admitted 1474, and dis- 
 charged as cured two hundred and fifty-six, and as 
 improved two hundred and seventy-eight.
 
 10 TWENTY-FIVE YEARS 
 
 Up to October 1, 1884, both asylums have admitted 
 5333 patients, and have discharged as restored 1182, 
 and as improved 1048. 
 
 These figures have, in one direction, an aspect of 
 peculiar and inexpressible sadness. They stand, in 
 many cases, for homes darkened and the most tender 
 ties rudely broken. Though silent, they speak of a 
 vast amount of human suffering and sorrow, and of 
 suffering and sorrow in forms which have hitherto 
 received less than a just share of pity and sympathy 
 and consideration. 
 
 In another aspect they afford a little light amid the 
 general gloom, a little sunshine in spite of the clouds. 
 The shadows remain, but they are much relieved. 
 Many who came to the asylum sick in mind and 
 body, have departed "clothed and in their right 
 minds." Hundreds of homes, scattered over the 
 State, have been made "exceeding glad" by the 
 return of a father or mother, a brother or sister, a 
 child or a companion. It has been permitted me to 
 see not a few come up out of the deepest darkness of 
 mental and sometimes spiritual night, into the 
 blessed daylight of hope and joy and peace. Some 
 such I have been allowed to meet in their own homes, 
 filled with overflowing gratitude and thankfulness. 
 
 What I have seen and heard has left a firm convic- 
 tion in my mind that asylums and hospitals for the 
 insane have done much for the relief of one of the
 
 WITH THE INSANE. 11 
 
 most pitiable forms of human suffering. I believe it 
 is possible for these institutions to do more and bet- 
 ter in the future. Improvements in means and 
 methods are to be expected in these, as in all other 
 human institutions. During the present century 
 wonderful progress has been made in many directions. 
 Much, doubtless, still remains to be accomplished. 
 
 To show what has already been done, I have intro- 
 duced several short historical chapters, the matter of 
 which is borrowed and condensed from various 
 authors, to whom I desire in this way to give all 
 due credit. 
 
 Observation has also impressed me with the belief 
 that much insanity might be prevented. This is 
 true, I suppose, of most forms of disease, but it seems 
 to me to be peculiarly true in respect to mental dis- 
 orders. The opinion is very general that insanity 
 has been for many years, and still is, increasing. 
 While I do not think the rate of increase is so great 
 as census reports appear to indicate, it is yet evidently 
 sufficient to justify alarm, and to call for serious in- 
 quiry into the causes and for means of prevention. 
 The object of the later chapters is to turn the thoughts 
 of parents, teachers, and others who are especially 
 responsible for the training of the young, in that 
 direction.
 
 12 TWENTY-FIVE YEARS 
 
 CHAPTER II. 
 
 INSANITY AND ITS TREATMENT AMONG THE 
 ANCIENTS. 
 
 Our knowledge of insanity among the earliest his- 
 torical peoples is very limited and unsatisfactory. 
 Incidental allusions in the oldest preserved writings, 
 both sacred and secular, indicate that the disease 
 manifested itself, at least occasionally, even in the 
 ages of primitive civilization and habits. Everything 
 which may be said as to the probable frequency of 
 such manifestations is pure conjecture, based upon 
 supposed conditions of society, modes of life, and 
 employments. 
 
 The legislation of Moses makes no mention of 
 lunacy, but references are found in the Hebrew Script- 
 ures to forms of madness which were obviously attacks 
 of insanity. King Saul undoubtedly suffered from 
 periodical outbursts of some species of mental dis- 
 order. His conduct on several occasions can be 
 explained on no other hypothesis. His jealousy, 
 irritability, and unreasoning acts of violence exhibit 
 peculiarities readily recognized by those who are 
 familiar with the behavior of insane men. The 
 employment of music for the relief of Saul, when 
 seized by these paroxysms, enables us to discover 
 one of the means used for the cure or mitigation of 
 insanity in that age.
 
 WITH THE INSANE. 13 
 
 David, when his life was in danger at the court of 
 Achish, feigned madness. This instance of assumed 
 imbecility, for such seems to have been the type of 
 David's insanity, has a twofold interest. It justifies 
 us in concluding that cases of real imbecility were so 
 frequent as to fall under general observation. David 
 could not have simulated successfully conduct with 
 which he had not a tolerably good acquaintance ; and 
 King Achish would not, at once, have pronounced him 
 mad if he had not often seen madmen before. The 
 inference is unavoidable that some forms of insanity 
 were common in that part of the ancient Ea'st. 
 
 The case of David throws light also upon the prob- 
 able treatment of the insane among the Hebrews and 
 Philistines. Among them, as among some other 
 nations of antiquity, it seems evident that a certain 
 degree of respect and reverence was felt for persons 
 afflicted with some types of madness. They were 
 believed to have been touched by the finger of some 
 divinity, and to be under his protection and guidance. 
 They were, in some cases, supposed to be partially 
 inspired and to be able to utter oracles. In other 
 cases, they were believed to be suffering special pun- 
 ishment, inflicted directly and immediately by a deity. 
 Consequently, to lay human hands on them in vio- 
 lence was impiety, and might bring divine vengeance 
 down upon the head of the offender. 
 
 Where such feelings and opinions prevailed, the 
 mild and harmless insane were allowed to go at large,
 
 14 TWENTY-FIVE YEARS 
 
 and were hedged about with a sort of invisible but 
 efficient protection. David's pretended madness, there- 
 fore, was sure to afford him temporary security from 
 any serious ill-treatment, and to give him opportunity 
 to make his escape. The violently insane were with- 
 out doubt at that time, as they certainly were at a 
 later period among the Jews, confined with fetters 
 and chains. 
 
 The condition of the insane in other countries of 
 the ancient East seems to have been essentially the 
 same as in Syria and Palestine. Nebuchadnezzar 
 suffered, for seven years, from an attack of that form 
 of lunacy which is now known as lycanthropia or 
 lycanthropy. This species of insanity is not uncom- 
 mon, and under its influence the poor victim imagines 
 himself to be a beast, and behaves, as far as possible, 
 like the animal into which he believes he has been 
 transformed. If the mightiest monarch of the time, 
 while laboring under a most pitiable delusion, was 
 turned out to wander over the fields with the cattle, 
 to eat grass like the ox, to go with uncut nails and 
 uncombed hair and beard, to be unsheltered and 
 totally neglected, it is not difficult to determine the 
 amount and kind of care and consideration bestowed 
 upon the insane in Babylonia and in the other great 
 Oriental kingdoms. 
 
 In Egypt, and also in Greece, it is said that some 
 temples, dedicated to the worship of certain deities, 
 were open for the admission of persons of disordered
 
 WITH THE INSANE. 15 
 
 intellects. If this were so, the practice probably orig- 
 inated in the belief that insanity was caused by the 
 direct purpose and act of some agency higher than 
 man. It is, moreover, affirmed by a few writers, 
 but upon questionable authority, that some 
 of the most enlightened of the Greek physicians 
 employed humane and scientific remedies in their 
 treatment of insanity. As a rule, in Egypt, Greece, 
 and Italy, the insane fared no better than in the East. 
 Everywhere they were treated with abuse or neglect. 
 If inoffensive, they were permitted to wander at will ; 
 if violent and dangerous, they were loaded with chains 
 and fetters. 
 
 Hospitals and asylums were unknown in the old 
 world. Near the temples of JEsculapius, the god of 
 medicine and patron of physicians, houses were some- 
 times built for the reception of visitors who came to 
 seek advice and direction of the deity, either for them- 
 selves or for suffering friends. But these were 
 merely places of shelter and refuge, and not hospitals, 
 in the modern acceptation of the name, where medi- 
 cal care and attendance could be had. Organized 
 charities, either of a public or private character, for 
 the support or relief of the aged, the unfortunate, the 
 destitute, the sick, the blind, or the insane, had no 
 place in the civilizations which preceded the Christian 
 era
 
 TWENTY-FIVE YEARS 
 
 CHAPTER III. 
 
 THE INSANE DURING- THE EARLY CHRISTIAN 
 CENTURIES. 
 
 In the olden times men loved their families, their 
 friends, their neighbors, and, in a less degree, their 
 countrymen. .The feelings of pity and compassion 
 existed in their souls. The impulses of good-will, 
 and benevolence, and charity were not wanting. But 
 love, and pity, and charity were confined within very 
 narrow bounds. Strangers were enemies, and enemies 
 might be hated and killed without blame. Men were 
 not regarded, protected, or cared for, simply because 
 they were men. The great majority " went by on the 
 other side" of wounded and bleeding humanity, unless 
 the kinship was very close and the tax upon resources 
 and effort was very light. 
 
 The "Galilean" imposed "a new commandment" 
 upon his followers, and emphasized, if He did not 
 introduce, a new principle of human action. His 
 disciples were to "love one another," not because 
 they were of kindred blood, not because they were 
 friends, neighbors, or countrymen ; but because 
 they were of one common humanity, children 
 of the same divine Father. There was to be in His 
 kingdom no Jew nor Gentile, no Greek nor Barbarian, 
 no bond nor free, but only citizens and brethren.
 
 WITH THE INSANE. 17 
 
 Moreover, the love, or charity, of the new com- 
 mandment was intensely practical in its character. 
 It was not a mere emotion or sentiment. It was not 
 to find expression in words alone. In deeds it was 
 to be embodied and manifested. The hungry were 
 to be fed, the naked were to be clothed, the sick were 
 to be healed. Blind eyes were to be opened, deaf 
 ears were to be unstopped, lepers were to be cleansed, 
 and demons to be cast out. These works of benef- 
 icence and mercy were to be done in all lands and 
 for all peoples. 
 
 The first manifestations of Christian charity were 
 unorganized. Individuals helped, according to their 
 means and opportunities, other individuals. Then 
 small local bodies helped the poor and unfortunate 
 immediately about them. Gradually the work became 
 reduced to system and order by the union of these 
 local societies over a considerable extent of territory. 
 As means increased, hospitals and other public recep- 
 tacles for the needy, the sick, and the suffering began, 
 for the first time in the history of the world, to be 
 built and opened to persons of all classes and creeds. 
 
 The first hospital is said to have been erected by a 
 Christian woman in Rome in the fourth Christian 
 century. Soon after, others were founded in all the 
 great centers of the Roman empire. Asylums were 
 established for lepers, for blind beggars, for the infirm 
 and aged, indeed, for almost every form of misfortune 
 and misery. The church in Antioch, in the time of 
 2
 
 18 TWENTY-FIVE YEARS 
 
 St. Chrysostom, besides caring for the sick and 
 strangers, supported three thousand widows and 
 young girls. About the same period the church in 
 Rome provided for fifteen hundred widows and other 
 indigent persons, at an expense of not less than 
 eighteen thousand dollars a year. Other churches, 
 in other great cities, engaged with equal zeal in the 
 same work of charity and mercy. A single collection 
 in Carthage for the ransom of prisoners yielded four 
 thousand dollars, although the Christians in that city 
 were neither numerous nor wealthy. The laws of the 
 new societies made it the duty of the officers and 
 overseers " to take care for the maintenance of all 
 who were in distress, and to let none of them want ; 
 to supply to orphans the care of parents, to widows 
 the care of husbands, to help to marriage those ready 
 for marriage, to procure work for those out of work, 
 to show compassion to those incapable of work, to 
 provide a shelter for strangers, food for the hungry, 
 drink for the thirsty, visits for the sick, and help for 
 the prisoners." 
 
 In all this grand development of practical love, 
 charity, and benevolence, the grandest which the 
 world has ever seen, the insane seem to have found 
 no remembrance, or, if any, so little that it has 
 escaped the notice of all historians. Those bereft of 
 sight were sheltered and fed ; those more sorely bereft 
 of reason were left to go homeless and hungry. 
 Lepers, though types of physical and moral unclean-
 
 WITH THE INSANE. 19 
 
 ness, shared a charity which was denied to the maniac. 
 This apparent inconsistency can not be explained on 
 the supposition that the insane were so few as to be 
 overlooked, or that their sufferings were so incon- 
 siderable as to need no relief and to make no appeal 
 to the feelings of pity and compassion. The mystery 
 finds its probable solution in quite another direction. 
 The ancient belief that the insane were influenced 
 by spiritual agencies, and were, in some way, pecu- 
 liarly related to superhuman powers, has already 
 been alluded to. Nearly allied to this doctrine was 
 the belief in witchcraft and demoniacal possession. 
 The early Christians received these beliefs by natural 
 inheritance, and they have been perpetuated, by tra- 
 dition and by an intuitive tendency of the human 
 mind towards the strange and marvelous, down to a 
 period within the memory of some now living. More- 
 over, the sacred writings, both of the Old and New 
 Testaments, as usually and most literally interpreted, 
 seemed to teach that demons could and did, by some 
 means, enter into the human body, if not into the 
 .soul. Probably the most generally accepted doctrine 
 of the present day, among those who adhere to a 
 pretty literal interpretation of the Scriptures, is that 
 such power of possession, once permitted to demons, 
 was limited to certain peculiar periods, conditions, 
 and circumstances, and has not been extended indefi- 
 nitely into the Christian centuries. The members 
 and teachers of the early churches saw no reason for
 
 20 TWENTY-FIVE YEARS 
 
 supposing such limitation. Demons and other infer- 
 nal powers were as mighty, and as much to be 
 dreaded, hated, and resisted in the fourth, and even 
 in the seventeenth, as in the first centuries. To express 
 a doubt of the reality of witchcraft was to expose 
 one's self to the charge of Sadduceeism. 
 
 Now, many of the external manifestations of acute 
 mania and epilepsy bear a most marked resemblance 
 to the conduct of persons who were believed to be pos- 
 sessed. Consequently maniacs, and those of the 
 insane laboring under many delusions, could not be 
 distinguished from demoniacs. It was not unnatural, 
 therefore, that the fear, distrust, and detestation felt 
 towards men and women believed to be in most inti- 
 mate association with evil spirits, or even to be 
 inhabited by demons, should be turned towards the 
 unfortunate victims of insanity, since the two classes 
 had, apparently, so many characteristics in common. 
 Here, without much reasonable doubt, is found the 
 true cause why, through many sad and desolate ages, 
 the insane were left almost entirely outside the widely 
 extended arms of human and Christian charity. 
 They received hatred in place of love. They were 
 punished rather than pitied. Scourges, chains, and 
 fetters were given them instead of food, and medicine, 
 and shelter. Occasionally the older belief that the 
 harmless and inoffensive insane were inspired and 
 protected by the Deity and by good spirits, secured 
 special favor and peculiar consideration for certain
 
 WITH THE INSANE. 21 
 
 classes of lunatics, and certain forms of lunacy. 
 During the confusions, and disorders, and violence of 
 the times when society seemed resolving itself into its 
 original elements, many more fled away from the 
 cities and towns, and dwelt alone in caves and in 
 other wild and secluded places. In the warm cli- 
 mate of the Bast and South nature demanded but 
 little clothing. Their garments were of the coarsest 
 and rudest kind, and their food simple and scanty. 
 Personal cleanliness was not esteemed among the 
 virtues, and their hair and beard were allowed to 
 grow long and shaggy. In many cases, advancing 
 years gave them a sort of rustic dignity, and common 
 opinion ascribed to them peculiar sanctity and 
 wisdom. 
 
 Living thus apart, with little human intercourse, 
 with no books, possessed with the generally received 
 belief that evil spirits frequented the wilderness and 
 deserts, they easily fell into an unbalanced state of 
 mind. They became subject to hallucinations and 
 delusions. They had struggles and contests with 
 demons. They were visited, helped, and comforted 
 by good angels. They saw and heard most marvel- 
 ous things. Coming occasionally out of their wild 
 retreats, they wandered over the country, and through 
 the streets of villages and cities. They were received 
 with great respect and reverence, not only by the 
 common people, but by the clergy and by others in 
 high places of influence and authority. Their disor-
 
 22 TWENTY-FIVE YEARS 
 
 dered fancies were accepted, to a considerable extent, 
 as veritable accounts of actual occurrences, and were 
 embodied and preserved in the legends and lives of 
 saints. Insane persons of this class, and of a few 
 other kindred classes, were treated, not indeed wisely, 
 but with humanity and kindness. Whatever suffer- 
 ings they endured were self-inflicted. For once 
 credulity and superstition performed the offices of 
 compassion and charity. 
 
 Equally harmless and innocent victims of other 
 forms of insane delusion were less fortunate. In 
 place of reverence and tenderness, they were treated 
 with punishments, and tortures, and death. It is not 
 uncommon now for insane men and women to imag- 
 ine themselves to be divine personages. Such 
 delusions are not considered, at the present day, more 
 dangerous or more blameworthy than a thousand 
 others. In earlier centuries less lenient views were 
 entertained of such vagaries of diseased minds. 
 They were believed to involve the sin of impiety and 
 blasphemy, and to deserve the heaviest penalties and 
 the most cruel torments, both here and hereafter. 
 To pity or spare such monsters of wickedness was to 
 incur a degree of guilt hardly less than their own. 
 The mercy of a peaceful and painless death was 
 denied them. Two or three examples will show the 
 temper of the times. 
 
 " In the year 1300, a beautiful English girl 
 appeared at Milan, laboring under the delusion that
 
 WITH THE INSANE. 23 
 
 she was the Holy Ghost, incarnated for the redemp- 
 tion of women." Instead of finding pity and refuge 
 in an asylum, she suffered death by fire. A Span- 
 iard, declaring himself to be a brother of the archan- 
 gel Michael, and affirming that he was to occupy the 
 high position in heaven which Satan had forfeited 
 and lost, was burned alive by the command of the 
 Archbishop of Toledo. The death of Joan of Arc 
 affords another illustration of native barbarism 
 intensified by political and religious hate. Great 
 numbers of the common people perished, year by 
 year, after having been exposed to every conceivable 
 species of insult and torture. The phenomena and 
 treatment of mediaeval and modern witchcraft, 
 so-called, present a marvelous admixture of honest 
 credulity, of wicked deception, of heartless and fiend- 
 ish cruelty, and of the illusions and delusions of 
 insanity. The insane shared the hatred and fate of 
 the wicked. 
 
 CHAPTER IV. 
 
 THE FIRST HOSPITALS AND ASYLUMS FOR THE 
 INSANE, AND THEIR CHARACTER. 
 
 In the sixth centur} 7 a house of shelter or refuge 
 is said to have been opened at Jerusalem for insane 
 monks. Amid the turmoil of that period large num- 
 bers of these monks were wandering over the East
 
 24 TWENTY-FIVE YEARS 
 
 So far as now known, no hospital or asylum for the 
 insane existed in Europe till after the year 1400. 
 
 In 1409, a man of humane spirit observed the rab- 
 ble following and hooting at some maniacs in the 
 streets of the city of Valencia, in Spain. Moved 
 with compassion, he secured the erection of a house 
 into which they might be received and protected 
 from insult and abuse. In 1425, an asylum was 
 founded in Saragossa ; in 1436, others in Seville and 
 Valladolid, and one in Toledo in 1483. Previous to 
 this time the Mohammedans had made some organ- 
 ized provision for the insane among them. A writer 
 of the seventh century states that several buildings 
 were erected for lunatics in Fez, in which the more 
 violent were confined in chains. It is reported that 
 a hospital was founded in Cairo in 1304. Doubtless 
 receptacles existed in other Mohammedan cities. Of 
 the military orders, the Knights of Malta alone 
 admitted insane patients into their hospitals. An 
 asylum was built at Eome in 1548, and gradually 
 receptacles were opened in all the countries of 
 Europe. 
 
 In England the first house of a public, or semi- 
 public, character established for the insane, was 
 Bethlehem Hospital, in London. Some shadows of 
 doubt and uncertainty have gathered about the ori- 
 gin of this institution. Statements put forth by dif- 
 ferent writers do not harmonize with each other. 
 The hospital seerns to have been founded, about
 
 WITH THE INSANE. 25 
 
 1247, as a priory, or place of refuge, for the relig- 
 ious order of St. Mary of Bethlehem. There is no 
 satisfactory evidence of the admission of insane 
 patients until about the year 1400. At that time, in 
 consequence of some misbehavior of an officer, a 
 royal commission examined into the condition of 
 the hospital. Their report disclosed the fact that six 
 men, who were lunatics, were found there, and the in- 
 ventory of furniture and other appurtenances includes 
 "six chains of iron, with six locks, four pairs of manacles 
 of iron, and two pairs of stocks." These articles are 
 only too suggestive of the treatment to which the 
 unfortunate inmates were probably subjected. The 
 next asylum in England was not opened till 1751, 
 and up to the year 1792 only fifteen hospitals of all 
 kinds for the insane had been established in Great 
 Britain. 
 
 It is a matter of grave doubt whether the establish- 
 ment of these so-called hospitals and asylums im- 
 proved the condition and treatment of persons afflicted 
 with mental disease. They were perhaps necessary 
 steps along the road of slow progress towards humane 
 and scientific treatment. But they were little else 
 than prisons, and most of them were prisons of 
 the worst description. They were erected and filled, 
 not from considerations of humanity and mercy 
 towards their inmates, but for the protection of society 
 and the relief of relatives and friends. In not a few 
 cases the buildings were absolutely unfit for habita-
 
 26 TWENTY-FIVE YEARS 
 
 tions of the vilest animals, mere gloomy, frightful 
 dens. Men, and sometimes women, cowered in nar- 
 row, cold, damp cells of stone, without light or air, 
 furnished with only a bed of straw, which was rarely 
 renewed. In some receptacles the attendants were 
 convicts from prisons, and the wretched insane were 
 entirely at their mercy. They were heavily chained 
 and fettered. Day and night the places echoed with 
 cries, howlings, and clankings of chains. Not all the 
 hospitals were so terrible, but even the best of those 
 days would not now be tolerated for an hour. One 
 would be glad, for the honor of our common human- 
 ity, to tear out and destroy the historic pages upon 
 which such humiliating records are found ; but it is 
 necessary to recall and open them in order to estimate 
 justly the rate and character of the progress which 
 the present century has made in the care and treat- 
 ment of insanity and the insane. 
 
 For many years Bethlem Hospital, or Bedlam, as 
 it was usually called, was one of the public shows of 
 London. It was visited for the same reasons, and 
 with the same feelings and curiosity, with which the 
 menagerie and the cock-pit were frequented. The 
 admission fee was one or two pennies, and the income 
 from this source was sometimes two thousand dollars 
 annually. Strange to say, this barbarous custom 
 continued as late as 1770, and, from incidental allu- 
 sions in English literature, it is evident that all 
 classes regarded maniacs just as they did caged and
 
 WITH THE INSANE. 27 
 
 chained wild beasts. Evelyn writes in one place, 
 "I stepped into Bedlam, where I saw several poor 
 creatures in chains ; one of them was mad with mak- 
 ing verses." Ned Ward, in his "London Spy," gives 
 an extended account of a visit to the place. "We 
 were admitted in through an iron gate, within which 
 sat a brawny Cerberus of an indigo color, leaning 
 upon a money-box; we turned in through another 
 iron barricade, where we heard such a rattling of 
 chains, drumming of doors, ranting, hollowing, sing- 
 ing, and running, that I could think of nothing but 
 Don Quevedo's Vision, where the lost souls broke 
 loose and put hell in an uproar." 
 
 In one of his famous pictures in the " Rake's Prog- 
 ress," Hogarth represents two ladies of fashion visit- 
 ing this hospital while the keeper is putting fetters 
 upon the poor rake. Near by stands a person sup- 
 posed to be the doctor, and the miserable woman 
 who has followed the rake in his downward course 
 is looking on. A conspicuous figure in the picture is 
 a maniac, lying on straw in one of the cells, with a 
 chain distinctly in view. A man, who imagines him- 
 self a king, is seen in another cell, wearing a crown 
 of straw. Several other insane characters can be 
 readily recognized, among them an astronomer, a 
 musician, and a high ecclesiastic. The whole repre- 
 sentation has a profound historical interest. Hogarth 
 seems to have drawn from life.
 
 28 TWENTY-FIVE YEARS 
 
 Of medical treatment, in the proper sense of that 
 term, there was none in any of these institutions. 
 Of moral means for restoring " minds diseased," it is 
 difficult to discover that any were employed. Over 
 the portals of these abodes of misery might well have 
 been written, " Who enters here leaves hope behind." 
 
 The early history of the treatment of the insane in 
 the United States is little else than a repetition of 
 European history during the same time. Until very 
 late in the colonial period no special provisions were 
 made anywhere in the country for the cure or the 
 comfort of lunatics. No hospitals or asylums existed. 
 The insane wandered abroad, were cared for by 
 friends, or were confined in jails, almshouses, stables, 
 and out-buildings. They endured neglect, abuse, 
 chains, fetters, filth, and frost. Among us, as among 
 all other peoples, exceptional cases received humane 
 and Christian consideration and care; but here, as 
 elsewhere, the great majority suffered without pity 
 and died without consolation. Investigations in New 
 York and in some other States, in the early years of 
 the present century, proved that all the horrors of 
 European receptacles were duplicated in our own 
 jails, poor-houses, and other places of detention, both 
 private and public. 
 
 The first hospital into which insane patients were 
 regularly admitted, in the then colonies, was the 
 Pennsylvania General Hospital, opened in 1752. 
 Only a limited number were received. It is claimed,
 
 WITH THE INSANE. 29 
 
 I hope with truth, that the treatment of the insane in 
 that institution anticipated, in a good degree, the 
 reforms and improvements which began nearly half 
 a century later in France and England. It is certain 
 that the atmosphere of Philadelphia was then thor- 
 oughly permeated by the humane and kindly influ- 
 ence of the Society of Friends, and that Dr. Franklin 
 was greatly interested in the establishment and man- 
 agement of this Hospital. The first asylum, exclu- 
 sively for the insane, was built by the colony of 
 Virginia, in 1773, at Williamsburg. This was estab- 
 lished and supported at public expense, and still 
 remains as the Eastern Asylum of that State. Insane 
 patients were received into the hospital at the city of 
 New York as early as 1797. Out of that institution 
 grew the present Bloomingdale asylum, opened in 
 1821. " The Friends' Asylum, opened for the relief 
 of persons deprived of the use of their reason," was 
 established near Philadelphia in 1817. The McLean 
 asylum at Somerville, near Boston, was opened in 
 1818. A small asylum was erected by the State of 
 South Carolina, at Columbia, in 1822. The Con- 
 necticut Eetreat for the Insane, at Hartford, was 
 founded in 1824, and the Kentucky asylum, at 
 Lexington, was established in the same year. Since 
 this last date numerous hospitals and asylums, both 
 public and private, have been founded in all parts of 
 the United States.
 
 TWENTY-FIVE YEARS 
 
 CHAPTER V. 
 
 CURIOUS SUPERSTITIONS, AND STRANGE METHODS OF 
 TREATING THE INSANE. 
 
 Until insanity took its place among recognized 
 diseases of the physical organism, its origin was 
 shrouded in mystery which excited and, at the same 
 time, baffled inquiry and investigation. Its phenom- 
 ena were so strange, so utterly inexplicable by any 
 known laws of mental action, that, not very unnatu- 
 rally, the remedies employed for its cure, especially 
 by the ignorant and superstitious, were of the most 
 absurd and irrational character. The use of such 
 means may have had a beginning in some lucky acci- 
 dent, or in some sudden caprice as wild as the vaga- 
 ries of insanity itself. Once begun, the practice 
 could easily be kept alive. Soon tradition would 
 come in to repeat marvelous tales of its efficacy, and 
 to exaggerate the evidences of its power and virtue. 
 Habits, customs, rites, however fantastic and even 
 repulsive, thoroughly established among a rural and 
 unenlightened people, have great tenacity of life. 
 They survive in spite of the hottest fires of persecu- 
 tion, and the plainest teachings of science and philos- 
 ophy. Like the seeds of noxious plants, they take 
 root and spring up in the most unexpected places, 
 and under circumstances apparently the most unpro-
 
 WITH THE INSANE. 31 
 
 pitious. In regard to matters of this kind, our own 
 age, with all its self-laudation, has little reason for 
 casting reproaches upon earlier times. 
 
 We can claim for our Saxon ancestors, no more 
 than for our Celtic, any superabundance of either 
 humanity or wisdom in their dealings with the crimi- 
 nal and the unfortunate. The prescriptions of their 
 physicians, educated in the learning of their times, 
 were singular admixtures of castigation, medicine, 
 superstition, and religion. Emetics, cathartics, herbs, 
 and masses were administered with impartial liberal- 
 ity. A man troubled with hallucinations was fed 
 with properly prepared wolf's flesh. Mixtures of ale 
 and holy water were given to possessed persons. 
 Scourgings and chains found frequent use. The 
 moon had influence both upon the disease and upon 
 the efficacy of remedies. 
 
 Faith in the curative influence of the waters of cer- 
 tain wells and springs was very wide-spread and long 
 continued. Indeed, this faith, perhaps slightly dis- 
 turbed and a little weakened, still survives in obscure 
 nooks and corners of the Old World, and possibly in 
 the New. Insane patients were plunged into these 
 waters with appropriate and mystic rites. Into one 
 pool it was prescribed that the victim should be 
 thrown backwards, should be violently tossed up and 
 down by strong attendants until thoroughly ex- 
 hausted, then conveyed to a church near at hand, 
 that masses might be sung over him. If one expe-
 
 32 TWENTY-FIVE YEARS 
 
 * 
 
 rience of this sort did not effect a cure, the treatment 
 was repeated. This method of cure was practiced, in 
 Great Britain, late in the last century. 
 
 Scotland has been, probably, more celebrated than 
 any other country for its mind-healing wells and 
 springs. The superstitious observances connected 
 with some of these have hardly yet entirely dis- 
 appeared. St. Fillan's pool in Perthshire was 
 one of the most famous of these. In "Marmion," 
 Scott makes one of his characters say : 
 
 "Then to St. Fillan's blessed well, 
 Whose spring can frenzied dreams dispel, 
 And the crazed brain restore." 
 
 Into this pool patients were plunged three times, 
 then securely bound hand and foot, and left alone 
 for the night in a chapel near by. If the poor 
 maniac could contrive to free himself from the cords, 
 his recovery was confidently expected; if he was 
 found still tied, little hope was entertained of his 
 restoration. Sometimes death followed the exhaus- 
 tion produced by the process, and brought a happy 
 deliverance from troubles. 
 
 As recently as 1793, it is stated that "about two 
 hundred persons, afflicted with insanity, were 
 brought to try the salutary influence of these sacred 
 waters annually." 
 
 In Ross-shire, on a small island in Loch Maree, is 
 another famous well. Whittier, in his inimitable
 
 WITH THE INSANE. 33 
 
 manner, has sung the virtue of these waters, fie 
 says, 
 
 " Calm on the breast of Loch Maree 
 
 A little isle reposes ; 
 A shadow, woven of the oak 
 And willow, o'er it closes. 
 
 "Within, a Druid's mound is seen, 
 Set round with stony warders; 
 A fountain, gushing through the turf, 
 Flows o'er the grassy borders. 
 
 ' ' And whoso bathes therein his brow, 
 
 With care or madness burning, 
 Feels once again his healthful thought 
 And sense of peace returning." 
 
 Pennant, who visited the spot in 1769, writes, 
 " The curiosity of the place is the well of the saint, 
 of power unspeakable in cases of lunacy. The 
 patient is brought into the sacred island, is made to 
 kneel before the altar, where his attendants leave an 
 offering of money; he is then brought to the well 
 and sips some of the holy water ; a second offering is 
 made ; that done, he is thrice dipped into the lake, 
 and the same operation is repeated every day for 
 some weeks." Dr. Mitchell, Commissioner of Lunacy 
 in Scotland, in giving an account of. this island in 
 1862, says : " About seven years before (that is, 
 about 1855), a furious madman was brought there. 
 A rope was passed round his waist, and with a couple 
 of men at one end in advance, and a couple at the
 
 34 TWENTY-FIVE YEARS 
 
 other behind, like a furious bull to the slaughter- 
 house, he was marched to the Loch side and placed 
 in a boat, which was pulled once round the island, the 
 patient being jerked into the water at intervals. He 
 was then landed, drank of the water, attached his 
 offering to the tree, and, as I was told, in a state of 
 happy tranquillity went home." Performances nearly 
 as absurd and incredible as these are reported, on 
 good authority, to have taken place at some of the 
 Lochs of Scotland within fifteen years. 
 
 Ireland can claim to rival its sister kingdom in the 
 abundance and efficacy of its sacred waters. In Kerry 
 is a glen known as the "Yalley of the Lunatics," in 
 which are two wells called the "Lunatics' Wells." 
 It was an old tradition, very generally received by 
 the common people, that all the insane in the coun- 
 try, if left to themselves, would find their way to this 
 valley, and that the waters and other mysterious vir- 
 tues of the glen would restore them to mental sound- 
 ness. The continental countries of Europe are probably 
 not surpassed by Great Britain in the number and 
 character of their popular traditions and superstitions 
 relating to the relief of mental maladies, and the 
 treatment appropriate to the insane. 
 
 Everything among us is comparatively new. We 
 have few lakes, wells, or valleys around which tradi- 
 tions have been able to gather. Besides, the reaction 
 following the witchcraft excitement introduced an era 
 of doubt and caution. Yet superstitious notions and
 
 WITH THE INSANE. 35 
 
 observances, of a somewhat milder and less offensive 
 character, touching the causes and treatment of insan- 
 ity, might easily be gathered up, which would con- 
 siderably lessen our native inclination to compare 
 ourselves with the older nations to their disadvantage. 
 Reference has already been made to remedies 
 anciently employed by physicians of education and 
 intelligence. This point will bear a little additional 
 illustration, which will render the progress of recent 
 years more obvious. In 1542, a London physician, 
 one. Dr. Borde, published a medical work, in which 
 he says, " I do advertise every man the which is mad, 
 or lunatic, or frantic, or demoniac, to be kept in safe- 
 guard in some close house or chamber where there is 
 little light ; and that he have a keeper the which the 
 mad man do fear." He further directs that no pic- 
 tures of man or woman be placed upon the walls of 
 the room, and that the patient be not allowed to have 
 any instrument with which he could do himself 
 harm. He is to be shaved once a month, to drink 
 no strong liquor, and to be provided with a simple 
 diet. This doctor was evidently much in advance of 
 his age in his ideas and methods. Allusions in liter- 
 ature indicate a generally received opinion that the 
 insane should be confined in darkened rooms. In 
 " Twelfth Night," Shakespeare makes one of his actors 
 say, "Come, we'll put him in a dark room, and 
 bound. My niece is already in the belief that he is 
 mad." And in "As You Like It," another says,
 
 36 TWENTY-FIVE YEARS 
 
 " Love is merely a madness ; and, I tell you, deserves 
 as well a dark house and a whip, as madmen do." 
 
 The medical treatment prescribed in Burton's 
 famous work, " The Anatomy of Melancholy," con- 
 sists mainly in the use of herbs, some to affect the 
 heart, some the head, some the liver, some the stom- 
 ach, and others to purify the blood. Hellebore is a 
 favorite remedy, as it was among the old Romans. 
 
 Another author recommends for epilepsy and 
 lethargy, poultices of figs and mustard applied to the 
 head. Feverfew was said to be " good for such as be 
 melancholy, sad, pensive, and without speech." 
 Bachelors' buttons were prescribed to be " hung in a 
 linen cloth about the neck of him that is lunatic, in 
 the wane of the moon, when the sign shall be in the 
 first degree of Taurus or Scorpio." 
 
 An intimate connection was believed to exist 
 between the liver and insanity, and hence it was of 
 much importance " to get rid of the black bile." For 
 this purpose purges, emetics, bleeding, issues, and 
 shaving the head were advised. " A choice balsam 
 of earth-worms or bats" was recommended for anoint- 
 ing the backbone. 
 
 The belief in witchcraft as one of the most common 
 and virulent causes of insanity colored the medical as 
 well as the legal practice of many centuries. Burton 
 recognized this as active in producing melancholy. 
 Coke and Hale recognized it in the conclusions and 
 decisions of the courts of law. King James I. was
 
 WITH THE INSANE. 37 
 
 violently angry with Eeginald Scot for daring to 
 oppose ' the prevalent belief, and for affirming that 
 proper medicines and wholesome diet were more 
 needed than tortures and punishments. 
 
 The treatment thus far described was that given 
 outside the so-called hospitals and asylums. The 
 practice inside these institutions was scarcely, if at all 
 better, even late in the eighteenth century and in the 
 early part of the nineteenth. An English practi- 
 tioner, for many years visiting physician to one of the 
 oldest hospitals, testified before the Committee of the 
 House of Commons in 1815, " Patients are ordered 
 to be bled about the latter end of May, according to 
 ths weather; and after they have been bled, they 
 take vomits once a week for a certain number of 
 weeks ; after that we purge the patients. That has 
 been the practice invariably for years long before my 
 time ; it was handed down to me by my father, and I 
 do not know any better practice." In the institution 
 to whose inmates these enlightened gentlemen pre- 
 scribed, there were five "keepers," three male and two 
 female, for a hundred and twenty -two patients. The 
 kindly efforts of the physician were supplemented by 
 the liberal use of manacles and chains. The violent 
 were chained about the legs, the arms, the wrists; 
 chained to the floor, the bed, or the wall. 
 
 One has well said, "It is difficult to understand 
 why and how they continued to live ; why their care- 
 takers did not, except in the case of profitable
 
 38 TWENTY-FIVE YEARS 
 
 patients, kill them outright; and why, failing this 
 which would have been a kindness compared with 
 the prolonged torture to which they were subjected 
 death did not come sooner to their relief." 
 
 CHAPTER VI. 
 
 THE BEGINNINGS OF REFORM AND IMPROVEMENT. 
 
 Humanity changes for the better slowly, and usually 
 under some sort of compulsion. The compulsion may 
 be from within, the power of ideas ; or it may be from 
 without, the rougher stimulus of muscular force and 
 violence. Customs and habits are ruts, out of which 
 institutions, societies, communities, and governments 
 liave to be pulled or lifted. The process is generally 
 unpleasant, often painful, sometimes apparently destruc- 
 tive. Some objects, old and venerated, are sure to be 
 broken in pieces and trodden into the mire; some 
 things of real beauty and utility, on account of their 
 relations and surroundings, are ruthlessly destroyed. 
 Men who have wrought well, according to their con- 
 ceptions of truth and duty, are rudely thrust aside or 
 visited with unmerited abuse and insult Many inter- 
 ests suffer for a while, and society is unsettled and dis- 
 turbed. The new paths are untrodden, and the surface 
 is uneven. Unexpected obstacles are encountered; 
 mistakes and blunders are made. The new leaders, 
 with the best of intentions, are frequently more abun-
 
 WITH THE INSANE. 39 
 
 dantly endowed with zeal than wisdom. Conservatism 
 naturally laments, protests, and predicts all manner of 
 direful consequences. Even hopeful and sympathizing 
 men, of timid and fearful temperament, are overbur- 
 dened with doubts and anxieties. 
 
 All these and other conditions hedged up and ob- 
 structed proposed reforms and improvements in the 
 treatment of the insane. It required confidence and 
 courage, bordering on rashness and presumption, to 
 take the first steps. It would, however, be a gross 
 libel upon human nature to suppose that humane and 
 Christian men and women were, or could be, satisfied 
 with things as they existed. The apathy of the great 
 body of the people is explained by the fact that very 
 few knew how bad matters really were. The insane 
 could not speak for themselves, and nobody had yet 
 come forward to speak and act for them. Somebody 
 must be found who dared to begin, and who had 
 patience "to labor and to wait" Success, even in a 
 most righteous cause, is not secured in a moment, nor 
 without a struggle. It took years to rouse the public 
 mind to a comprehension of the horrors and barbarism 
 of the slave-trade ; it took other long years to break 
 down the iron doors of the filthy dungeons in which 
 "prisoners for debt" were hopelessly immured. The 
 task of cleaning out the reeking cells in which many of 
 the insane were confined, of breaking off their fetters 
 and chains, of bringing them out into the pure air and 
 bright sunlight, and securing for them rational and
 
 40 TWENTY-FIVE YEARS 
 
 scientific treatment, was not to be accomplished in a 
 day, nor by weak and intermittent efforts. Old preju- 
 dices were exceedingly strong, and medieval ideas 
 about insanity still lingered in many places, both low 
 and high. Slaves were men; debtors were fellow- 
 citizens ; but the insane were not even yet quite free 
 from the suspicion of evil associations. They were, 
 undoubtedly, unfortunate and miserable ; possibly they 
 might also be wicked and blameworthy. Such feelings 
 were rather felt than expressed ; but none the less they 
 influenced conduct and conclusions. 
 
 The honor of instituting and leading in reform and 
 improvement belongs to Pinel in France and to 
 Tuke in England. Each of these men labored, for 
 some time, apparently with little or no knowledge of 
 the purposes and efforts of the other. They wrought 
 with different means and under widely different condi- 
 tions ; but both are entitled to much credit and to grate- 
 ful remembrance. The blessings of many ready to 
 perish have rested upon them and upon their associates 
 and co-laborers. 
 
 Pinel was a thoroughly educated physician, and, 
 after having had an experience of a few years in a pri- 
 vate institution for the insane, was put in charge of the 
 Bicetre in Paris, in the year 1792. This establishment 
 was at the same time a prison, almshouse, nursery, 
 hospital, and asylum for the insane. The various 
 classes of inmates were mingled together in the greatest 
 confusion, although the more violent maniacs were
 
 WITH THE INSANE. 41 
 
 confined in a separate quarter of the buildings. Cru- 
 elty had rendered these so furious that few persons 
 ventured to approach them, and no one dreamed of 
 freeing them from their chains. 
 
 The following extract will show the character of the 
 work which Pinel undertook, and its results. Having 
 obtained permission of the proper authorities, he pro- 
 posed to try the experiment of liberating some of those 
 who had been longest in confinement Accompanied 
 by a friend he entered the door of the " great Bedlam 
 of France." 
 
 " They were received by a confused noise, the yells and angry 
 vociferations of three hundred maniacs mixing their sounds with 
 the echo of clanking chains and fetters through the dark and 
 dreary vaults of the prison. Couthon, his attendant, turned 
 away with horror, but permitted the physician to incur the risk 
 of his undertaking. He began by unchaining twelve persons. 
 The first was an English officer who had been bound in his 
 dungeon forty years, and whose history everybody had forgotten. 
 His keepers approached him with dread ; he had killed one of 
 his comrades by a blow with his manacles. Pinel entered his 
 cell unattended, and told him he should be at liberty to walk at 
 large, on condition of his promising to put on the camisole or 
 strait waistcoat. The maniac disbelieved him, but obeyed his 
 directions mechanically. The chains of the miserable prisoner 
 were removed, the door of his cell was left open. Many times 
 he was seen to raise himself and fall backward, his limbs gave 
 way ; they had been fettered during forty years. At length he 
 was able to stand and to walk to the door of his dark cell. He 
 gazed with exclamations of wonder and delight on the beautiful 
 sky. He spent the day in walking to and fro, was no more con- 
 fined, and during the remaining two years he spent at Bice*tre 
 assisted in the management of the house.
 
 42 TWENTY-FIVE YEARS 
 
 "The next man liberated was a soldier of the French Guard, 
 who had been in chains ten years, and was an object of general 
 terror. His disorders had been kept up by cruelty and bad 
 treatment. When liberated, he assisted Pinel in breaking the 
 chains of his fellow-prisoners; he became kind and attentive 
 immediately, and was ever after the devoted friend of his deliv- 
 erer. In a few days Pinel liberated fifty-three. The result was 
 beyond all hope. Tranquillity and harmony succeeded to tumult 
 and disorder; even the most furious maniacs became tractable." 
 
 Subsequently Pinel took charge of the Salpetriere, 
 a similar place of confinement for females, into which 
 he introduced the same humane principles and spirit of 
 reform. The improvement in the condition and treat- 
 ment of the insane in France commenced with the 
 beginning of Pinel's labors in Paris. He was ably 
 seconded in his efforts by Bsquirol, who became his 
 assistant in the Salpetriere. This gentleman founded 
 an asylum for the insane in 1799, which served as a 
 model for all similar institutions afterwards established 
 in France. Without doubt the great experiment of 
 Pinel had its origin in the feelings and impulses of a 
 generous humanity, more than in the conclusions of 
 scientific medical knowledge, although subsequent in- 
 vestigations and discoveries have proved that his 
 methods were in harmony with the true principles of 
 the science of medicine as well as of the science of 
 mind. In the hands of wise men science, in all depart- 
 ments of human activity, is the handmaid and servant 
 of humanity. 
 
 To William Tuke of York, a member of the Society 
 of Friends, belongs the high honor of establishing the
 
 WITH THE INSANE. 4 
 
 first asylum for the insane in England in which humane 
 and rational methods of treatment were regularly and 
 systematically employed. He commenced his efforts in 
 1792, the same year which saw the beginnings of Pinel's 
 public labors in Paris. The institution was opened for 
 the reception of patients four years later. The happy 
 suggestion of a woman gave to the hospital the name 
 of Eetreat, " to convey the idea of what such an insti- 
 tution should be, namely, a place in which the unhappy 
 might obtain a refuge, a quiet haven in which the 
 shattered bark might find the means of reparation or of 
 safety." It was located on elevated ground in the 
 neighborhood of York. The edifice was surrounded by 
 a garden, and sufficient land was secured for a farm. 
 The prospect was pleasant and extensive, and pure air 
 and excellent water were abundant. The building was 
 unpretentious, like its founder and like the society to 
 which he belonged. For several years Mr. Tuke per- 
 sonally superintended the affairs of the Retreat, and 
 continued to visit it frequently till his death at an 
 advanced age. 
 
 Like most departures from the established order of 
 things, this pioneer reform asylum encountered some 
 bitter opposition, and met with serious obstacles and 
 difficulties. Fortunately, its founder possessed the 
 somewhat rare combination of a determined, iron will 
 closely united with a kind heart His sympathy had 
 been thoroughly excited, and his sensibilities both 
 shocked and quickened, by a visit to a hospital in
 
 44 TWENTY-FIVE YEARS 
 
 which he found inmates lying "on straw and in chains." 
 He had, moreover, that peculiar constitution of mind 
 which impelled him to believe that whatever ought to 
 be and needed to be done, could be accomplished by 
 perseverance and hard work. 
 
 The nature and extent of the reforms in the treat- 
 ment of the insane begun at the York Ketreat can not 
 be fully appreciated by persons familiar only with the 
 appliances and methods of well-conducted modern 
 asylums. The management of Mr. Tuke and his asso- 
 ciates must be contrasted, by means of examples and 
 illustrations, with the prevailing modes of that day. 
 It is, however, profoundly humiliating to be obliged to 
 confess that, after the lapse of nearly a century, con- 
 trasts almost as striking can be found between the 
 treatment endured in local receptacles, county houses, 
 and jails, and that employed in our best asylums. The 
 statement of a gentleman who visited at that period a 
 large number of British asylums, for the purpose of 
 examining plans of construction, will be sufficient to 
 indicate, in a general way, the changes and improve- 
 ments made in the Eetreat He says : 
 
 " In some asylums which I have visited, chains were affixed 
 to every table and to every bedpost; in others they are not to be 
 found within the walls. At the Retreat they sometimes have 
 patients brought to them frantic and in irons, whom they at once 
 release and by mild arguments and gentle arts reduce almost 
 immediately to obedience and orderly behavior. A great deal of 
 delicacy appears in the attention paid to the smaller feelings of 
 patients. The iron bars which guarded the windows have been
 
 WITH THE INSANE. 45 
 
 avoided, and neat iron sashes, having all the appearance of 
 wooden ones, have been substituted in their places ; and when I 
 visited them, the managers were occupied in contriving how to 
 get rid of the bolts with which the patients were shut up at night, 
 on account of their harsh, ungrateful sound, and of their com- 
 municating to the asylum somewhat of the air and character of 
 a prison. The effects of such attention, both on the happiness of 
 the patients and the discipline of the institution, are more impor- 
 tant than may at first view be imagined. Attachment to the 
 place and to the managers, and an air of comfort and content- 
 ment, rarely exhibited within the precincts of such establishments, 
 are consequences easily discovered in the general demeanor of the 
 patients. It is a government of humanity and of consummate 
 skill, and requires no aid from the arm of violence and the exer- 
 tions of brutal force." 
 
 Under this treatment a man who had been kept 
 chained and naked for twenty years, soon came to wear 
 clothes and to be orderly in his habits and conduct. 
 The change in many others was as marked and as 
 happy. 
 
 In addition to the points already mentioned, efforts 
 were made to provide constant employment for those 
 inmates who were able to work. The convalescents 
 were employed as assistants in the care of others; 
 knitting, sewing, and other domestic labors were 
 assigned to female patients ; and the men were occupied 
 with such industries as would be most agreeable, as far 
 as means and circumstances would allow. 
 
 This experiment at York and a " Description of the 
 Eetreat," published by Samuel Tuke in 1813, aroused 
 much public interest in England, and excited some 
 vigorous and angry discussions. Periodicals and news-
 
 46 TWENTY-FIVE YEARS 
 
 papers entered into the details. The House of Com- 
 mons appointed committees and commissions to inquire 
 into the condition of asylums and hospitals for the 
 insane. Acts of Parliament were passed ; new insti- 
 tutions were established, and old ones were forced to 
 recognize the progress of the age and the claims of 
 humanity. 
 
 Reform and improvement were thoroughly inaugu- 
 rated, and the condition of the insane began to be 
 rendered more tolerable. Great advances have since 
 been made, but it is not to .be supposed that the end 
 has even yet been reached. Progress is still possible. 
 
 At the time when Pinel and Tuke commenced their 
 reformatory labors in Europe, only a single asylum 
 existed in the United States devoted exclusively to the 
 insane. A few insane patients were admitted into two 
 or three general hospitals. Of these two or three, the 
 Pennsylvania Hospital was the most prominent and 
 important As has been elsewhere remarked, it is 
 claimed that the improved and humane methods of the 
 reformers were employed in this institution from the 
 very first. The probabilities are that the claim is well 
 founded. Kefonn in our own country was needed, 
 not so much in correcting the bad management of 
 existing institutions as in creating a public sentiment 
 which should demand the erection, at public expense, 
 of a sufficient number of asylums to receive and prop- 
 erly care for the victims of insanity who were wander- 
 ing at large, or were cowering in filth and nakedness in
 
 WITH THE INSANE. 47 
 
 jails and in rude out-buildings, in receptacles of all 
 kinds. The abuse and neglect of the insane among 
 us have never been, to any considerable extent, within 
 the hospitals. Rare and infrequent instances have 
 occurred in these institutions, without doubt ; but such 
 cases bear no comparison to those which have taken 
 place, almost daily, in almshouses and other places of 
 detention, and, with shame it must be said, in the seclu- 
 sion of private and domestic life. 
 
 CHAPTER VII. 
 THE MODERN ASYLUM. 
 
 Of any specific form and arrangement of buildings 
 for an asylum I shall not presume to speak. Only a 
 specialist of intelligence and experience can determine, 
 with any authority, matters of that kind. My remarks 
 will have reference merely to such things as an inter- 
 ested observer, under favorable conditions, can readily 
 discover and appreciate. 
 
 First of all, it will be universally conceded that the 
 location of an institution for the insane should be 
 healthful and pleasant. The grounds should be ample 
 in extent and, if possible, varied in character. The 
 wearisome monotony of a dead level of surface or of 
 entire sameness of scenery should be avoided. An 
 abundant supply of pure water must be near at hand, 
 and the facilities for drainage and for the removal of
 
 48 TWENTY-FIVE YEARS 
 
 all filth must be excellent The site should be suffi- 
 ciently retired to secure freedom from noise and con- 
 fusion and from undue observation. At the same time 
 it should be easy of access, both for the convenience of 
 patients and their friends, and also for the ready trans- 
 portation of material and supplies. A farm of two or 
 three hundred acres of rolling land, with a fertile soil,. 
 not too clayey, with a fair proportion of groves and 
 woodland, just on the outskirts of some city or village 
 of considerable size, will best satisfy the requirements 
 as to location. 
 
 The buildings should be, of course, substantial and 
 durable in character, but the style of architecture 
 should be light and tasteful. Care should be taken to 
 avoid all prison -like appearance. Excessive ornament- 
 ation adds nothing in respect of beauty, and is incon- 
 gruous as a matter of good taste. Local pride takes 
 an unfortunate direction when it demands unnecessary 
 expenditure upon the external means and appliances 
 of public charity and benevolence. 
 
 The interior arrangements ought to provide, in the 
 best possible manner, for the care, comfort, and safety 
 of the inmates. Danger from fire should be especially 
 guarded against The horror of a burning asylum for 
 the insane can be equaled only by that of a burning 
 receptacle of helpless orphan children. Humanity 
 shudders at the sight, or even the thought, of either. 
 Buildings of many stories in height, with narrow doors
 
 WITH THE INSANE. 49 
 
 and steep and winding stairways, are unsuitable for 
 asylums and hospitals. 
 
 Judicious classification of patients is one of the im- 
 perative necessities for the proper treatment of mental 
 disease. This must be fully provided for, or the main 
 purpose for which asylums exist will be defeated. On 
 many accounts, the gathering of large numbers of the 
 insane in one institution is not desirable. The possi- 
 bility of more complete classification, however, is in- 
 creased by this arrangement; and the advantages 
 derived from the separation of those whose peculiar 
 mental condition renders them unfit associates, will 
 probably offset many real disadvantages. The abso- 
 lute impossibility of making any tolerable classification 
 of their inmates is a fatal objection to county and other 
 small receptacles,' into which all forms of mental dis- 
 order are crowded promiscuously together. 
 
 An experienced Medical Superintendent says, " Every 
 asylum should have separate accommodations for the 
 following classes of patients: 1. Those convalescing 
 from various forms of mental disease. 2. Those suf- 
 fering from mild excitement 3. Those suffering from 
 acute excitement 4. Those suffering from epilepsy 
 and the advanced stages of paresis. 5. Those suffer- 
 ing from chronic mania 6. Those suffering from 
 melancholia and states of depression. 7. Those suf- 
 fering from senile and other quiet forms of dementia. 
 8. Those suffering from the more active forms of de- 
 mentia (irritable dementia)." ,
 
 50 TWENTY-FIVE YEARS 
 
 One of the most characteristic features of the mod- 
 ern, improved asylum is this perfect separation of the 
 various classes of patients. The lack of it has been 
 very painfully impressed upon me in visiting several 
 county receptacles for insane paupers. A strong and 
 violent female, gesticulating and shouting under the 
 influence of maniacal excitement, may be seen near by 
 a weak and timid old lady suffering from senile de- 
 mentia. And in the same apartment may be an epi- 
 leptic in the midst of a terrible and frightful convul- 
 sion. All the better feelings of humanity revolt at 
 the pain inflicted by this promiscuous herding together 
 of the unfortunate and distressed. 
 
 In addition to provision for proper classification, the 
 model asylum will have all its rooms, which patients 
 are to occupy, well-lighted, warmed, and ventilated. 
 It ought to be unnecessary to say that no " cells," or 
 apartments of cell-like character, exist in any really 
 modern .institution for the insane. Such prison -like 
 arrangements belonged to the age of "chains and fet- 
 ters," the iron age which preceded the reforms of Pinel 
 and Tuke. If any so-called asylum still tolerates and 
 finds use for them, its managers should speedily give 
 place to others, whose birth and education have been 
 within the present century. 
 
 The halls and all the rooms will be made as cheerful 
 as possible by inexpensive ornamentation. If encour- 
 aged, many of the inmates will take an active interest 
 in rendering everything as home-like as circumstances
 
 WITH THE INSANE. 51 
 
 will permit The floors will be painted or oiled, and 
 in some cases carpeted. The walls will be pleasantly 
 tinted, and hung with paintings and pictures. The 
 halls occupied by convalescent and other quiet and 
 orderly patients will be supplied with musical instru- 
 ments, with papers, periodicals, and books. Conven- 
 iences for games and sports will be provided, both 
 within doors and on the grounds. Amusements and 
 recreations of a social character will be frequent, and 
 will be open to all whose condition will allow them to 
 participate, or to enjoy relaxation in this way. Officers, 
 physicians, and attendants all unite to give to a life, 
 which at best must have much of monotony, as much 
 variety and cheerfulness as the circumstances and sur- 
 roundings will permit 
 
 I am not trying to paint an ideal institution, man- 
 aged by ideal officers and peopled by an ideal class of 
 inmates. I am only speaking of what I have observed, 
 and of what is practicable in any institution where 
 there is a hearty, earnest purpose to do all that can be 
 done to comfort and to cure. 
 
 No asylum or hospital can be made a home in the 
 highest and best sense of that word ; but it can be 
 made to resemble a real home, and to surpass almost 
 infinitely scores and hundreds that are called by that 
 name. If there were more true homes inhabited and 
 animated by the spirit of tenderness, forbearance, and 
 mutual helpfulness, fewer asylums would be required, 
 and the existing ones would be less crowded.
 
 52 TWENTY-FIVE YEARS 
 
 By means of detached cottages and other devices, it 
 will undoubtedly be found possible to add, in many 
 respects, to the home-like character of institutions for 
 the insane, and also of institutions for other classes of 
 the unfortunate and dependent In public schools for 
 neglected and dependent children, and in reformatories, 
 this is already attempted with a fair degree of success. 
 Beyond certain limits, however, this is not desirable. 
 Life in a public institution, of whatever form and how- 
 ever organized, is not like, and can not be like, real out- 
 of-door, every-day life. To the child or the youth, it 
 is not the best preparation for the actual life into which 
 he must presently enter. The aim should be to keep 
 the child, or the adult even, unless it be for crime, in 
 the institution the shortest possible time. There is 
 less danger of fostering unreal notions of ordinary life 
 in an asylum for the insane than in most other public 
 institutions ; but its arrangements should not be such 
 as to create distaste for the kind of life to which the 
 patient must return, or to present too strong tempta- 
 tions for prolonging his residence in the institution. 
 It is due to truth to add that danger in this direction 
 can not become of a serious nature under any conditions 
 at present conceivable. 
 
 The modern asylum, I am persuaded, will continue 
 to put forth more and more effort to provide suitable 
 employment for its patients who are able to labor. 
 This will not be attempted for economic reasons. It is 
 not probable that the labor of the insane can be made
 
 WITH THE INSANE. 53 
 
 a source of profit to the institution. For the present, 
 at least, it is more likely to cause an increase of ex- 
 penditure. Employment will be provided for the 
 same reasons that books and music, amusements and 
 recreations are provided, as a curative agency. En- 
 forced idleness is not merely irksome to men and 
 women in early or middle life and of fair physical 
 health and vigor, who have been accustomed to an 
 active and laborious manner of living, but is a posi- 
 tive source of danger, more especially when the 
 mental balance has been lost. Industrial pursuits of 
 some sort are needed to give an outlet for energy 
 which will otherwise be consumed in acts of destruc- 
 tion and violence, or will find vent in maniacal ex- 
 citement and disorder. Without doubt, such occu- 
 pations will enable the managers of asylums to 
 dispense almost entirely with all forms of mechanical 
 or medical restraints. It will be readily conceded 
 that many difficulties must be encountered in pro- 
 viding employment for all classes of the insane. 
 Indeed, I do not conceive it possible to do so with 
 any means now at the command of the officers in 
 charge of existing institutions. I am confident, how- 
 ever, that the near future will see great improvement 
 in this direction. 
 
 Some other important characteristics of modern 
 asylums will be touched upon, directly or incident- 
 ally, in subsequent chapters.
 
 54 TWENTY-FIVE YEARS 
 
 CHAPTER VIII. 
 
 GUARANTIES FOR THE SAFETY AND PROPER CARE OF 
 THE INSANE IN ASYLUMS. 
 
 Many of the insane are utterly helpless and de- 
 fenseless. The infant in the cradle is not more so. 
 Their mental condition is such that they can neither 
 comprehend nor make known to others their wants ; 
 and their physical state is such that, if left to them- 
 selves, they would soon perish or become repulsive 
 and loathsome. Patients of this class are entirely 
 dependent upon their attendants for cleanliness, for 
 food, and for clothing, while, in not a few cases, they 
 are unable to appreciate kindness or to express grati- 
 tude. Even near relatives and personal friends find 
 it not easy to escape the charge of neglect in caring 
 for such pitiable victims of disease. 
 
 Other classes of the insane, not so weak in body or 
 mind, are nearly as defenseless and dependent as 
 these. In consequence of the delusions under which 
 they are suffering, or for other obvious reasons, little 
 reliance can be put in what they say. Their stories 
 of the treatment received by them at home are too 
 improbable, and often monstrous, to admit of belief 
 even for a moment. The same inability to distin- 
 guish delusions from realities characterizes their 
 statements concerning affairs connected with the
 
 WITH THE INSANE. 55 
 
 asylum. I have myself listened to recitals which, if 
 true, would curdle the blood and kindle hot indigna- 
 tion. It required, however, very little discernment 
 to enable one to see that the things stated could not, 
 by any possibility, have occurred. The result is that 
 suspicion and doubt are thrown over all statements 
 of the insane, and of those who have fallen into any 
 form of mental unsoundness. Consequently reports 
 of neglect or abuse coming from patients, even though 
 well founded, will have little weight unless corrobo- 
 rated by other testimony. However much to be 
 regretted, this is inevitable. In the great majority 
 of cases no injustice will be done ; but occasionally, 
 under these circumstances, a genuine and truthful 
 charge of wrong-doing will be discredited. No can- 
 did observer, with ordinary knowledge of human 
 nature, will be disposed to deny this possibility. 
 Where escape from detection is easy, or even seems 
 so, the power of temptation is greatly increased. 
 Experience teaches that bad and heartless men and 
 women, in every relation of life, take advantage of 
 this state of affairs. The family affords illustrations 
 of this as frequently as the asylum or the hospital. 
 The way by which danger from this source can be 
 entirely avoided has not yet been discovered. The 
 practical problem is how to reduce it to the minimum. 
 Still another fact increases the helplessness and 
 dependence of one class of patients. The probabil- 
 ity of restoration from certain forms of mental disease
 
 56 TWENTY-FIVE YEARS 
 
 is undoubtedly much greater if the patient can be 
 completely secluded, for a time, from all association 
 with relatives and intimate friends. The chances of 
 recovery may be increased many times over to the 
 wife and mother, by separation for weeks, perhaps 
 for months, from every familiar scene and face, from 
 husband and children and life-long friends. The 
 same may be true of a father and husband, of a son 
 or a daughter. The necessity and advantage of such 
 entire seclusion will naturally be denied by some, 
 and probably questioned by very many. It seems 
 heartless and positively cruel. Observation, how- 
 ever, has left no doubt in my own mind that such a 
 course is sometimes the only one which affords good 
 grounds for hope of ultimate restoration to mental 
 health. The condition is peculiarly sad and trying 
 for the patient and distressing for the friends. /It 
 imposes, also, peculiar responsibility upon the officers 
 of an asylum. It is inconceivable that any officer, 
 possessed of the ordinary feelings of humanity, 
 would recommend or advise such separation, unless 
 he deemed it an absolute necessity to successful 
 treatment. Such cases, not unfrequently. open the 
 flood-gates of criticism and abuse. Out of these 
 have grown most of the harrowing tales concerning 
 the horrors of asylum life. It will be freely admitted 
 that patients of this class are, for the time, placed 
 without reserve in the hands of those in charge of the 
 institution. In accepting such trusts, obligations are
 
 WITH THE INSANE. 5.7 
 
 entered into which a good man would gladly avoid, 
 and which a bad man may violate. 
 
 It would be easy to multiply illustrations of the 
 helpless and defenseless condition of a very large pro- 
 portion of the inmates of any institution for the 
 insane. It would also be easy to show that the con- 
 dition of the insane outside of asylums is, in a major- 
 ity of cases, still more helpless and defenseless. This 
 ought always to be kept in mind in considering the 
 subject under discussion. Mental disease, when ser- 
 ious in its character, exposes the sufferer to neglect, 
 or injustice, or abuse, at all times and in all places, in 
 the family, in the community, in the court-room, and 
 in the hospital. Wisdom and humanity demand that 
 all known precautions shall be taken to secure pro- 
 tection and safety. 
 
 I have purposely written with plainness. With 
 human nature as it is, there is everywhere danger to 
 the weak and helpless. It were worse than folly to 
 deny its existence in asylums. The question is how 
 to guard against it most effectively. Upon this 
 question I desire to speak with the utmost frankness, 
 because I believe it concerns the well-being of the 
 most unfortunate class of sufferers in human society, 
 and also because I believe the means employed to 
 avert danger often increase it, and the measures 
 adopted to secure safety render the attainment of this 
 next to impossible.
 
 58 TWENTY-FIVE YEARS 
 
 The public mind is justly sensitive in respect to 
 the management of all public institutions. But any 
 institution whose doors can not all be thrown open 
 freely to promiscuous visitation and inspection, about 
 which there is something of reserve and exclusive- 
 ness, is in danger of exciting feelings of jealousy and 
 distrust in the ignorant and credulous, and even in 
 those who resent the imputation of ignorance or 
 credulity. Asylums for the insane necessarily belong 
 to this class of institutions. Grant, what is often 
 asserted, that the system of reserve and exclusion has 
 sometimes been carried to an unnecessary extreme ; 
 grant that doors have been kept closed which might 
 more wisely have been left open ; after all possible 
 admissions, it remains evident to any person of 
 common intelligence that the halls of such an institu- 
 tion can not be exposed unreservedly to the public 
 gaze. 
 
 As a result of this necessary exclusion and of other 
 causes, against which no wisdom or prudence can 
 effectually guard, periodical outbursts of popular 
 feeling against asylums and their management are 
 liable to occur. Violent abuse is heaped upon trus- 
 tees, superintendents, officers, and employees gener- 
 ally. Newspapers are filled with stories of the most 
 fearful and terrible nature. Eeports, gathered from 
 all sources, are eagerly received and accepted as 
 reliable evidence of shocking neglects and abuses. 
 Upon such testimony men and women of the noblest
 
 WITH THE INSANE. 59 
 
 character and purest lives are condemned and de- 
 nounced as monsters of iniquity and cruelty. Legis- 
 lative and other investigations follow, and elaborate 
 reports are made and published. Some new laws are 
 enacted, and additional provisions are made for visit- 
 ing and examining boards and commissions. 
 
 It would be too much, probably, to affirm that no 
 good results come from such excitements and investi- 
 gations. But it is beyond question that, in most 
 cases, the evil results greatly outweigh the good. 
 Some bad men may be exposed, removed, and pun- 
 ished. Some abuses may be corrected. But the 
 work of the institution has been thrown into con- 
 fusion; the inmates have been stirred into feverish 
 excitement; friends of patients have been alarmed 
 and pained ; and the community has been filled with 
 false or exaggerated statements, calculated to create a 
 lasting feeling of suspicion and distrust. And, worst 
 of all, the men and women best qualified by nature 
 and acquirements to care for the insane quietly retire, 
 or decline to enter positions where they will be ex- 
 posed to unmerited detraction and abuse. 
 
 It is not by such methods that safety and proper 
 care can be secured for the insane. Various means 
 have been devised, and others have been suggested 
 and zealously advocated. Among such means are 
 laws, and rules and regulations for the organization of 
 asylums, for the admission of patients, and for their 
 proper care, oversight, and discharge. Laws for
 
 60 TWENTY-FIVE YEARS 
 
 these purposes are absolutely necessary, and without 
 doubt afford some measure of protection to certain 
 classes of the insane, and particularly to persons who 
 may, for sinister purposes, be accused of mental 
 unsoundriess. But legislative enactments, however 
 wisely drawn, can give little guaranty for right treat- 
 ment of patients within the halls of an institution. 
 They are not, like the laws of nature, endowed with 
 a self-enforcing vitality and virtue. To a consider- 
 able extent, they must be executed by those whose 
 conduct they are designed to control and regulate. 
 
 Boards of control, commissioners, and visitors are 
 also accounted among the agencies of safety and pro- 
 tection. Some of these are necessary, and others 
 may be desirable. There must be some organizing 
 and managing body, some power to appoint and dis- 
 charge officers and employees, to exercise oversight, 
 and to administer generally the financial and other 
 affairs of an institution. A competent board, intelli- 
 gent in the direction of its trust, free from partisan 
 and political influence and dictation, above self-seek- 
 ing, and not afraid of incurring temporary popular 
 displeasure, will be a source of confidence to the pub- 
 lic, and a guaranty of wise external administration 
 and of a careful selection of officers to perform the 
 delicate and varied duties of internal management. 
 Men of business, practitioners of law and medicine, 
 students of the science of mind, and practical phi- 
 lanthropists, may well be united in the formation of
 
 WITH THE INSANE. 61 
 
 such a board. In a general way this body stands 
 between the community and the officers and inmates 
 of the asylum. It is a standing and perpetual " com- 
 mittee of examination and investigation." It should 
 be better able than any other number of persons pos- 
 sibly can be, to protect the innocent and to discover 
 and punish the guilty, if there be any guilty. 
 
 Other agencies, supposed to be protective, might be 
 mentioned, but observation has led me to consider 
 them of little real worth. There is, in my judgment, 
 but one guaranty upon which any firm reliance can 
 be placed, and that is the character and intelligence of 
 the officers in immediate charge of the institution. Of 
 those officers the Medical Superintendent is the repre- 
 sentative and chief. He is the direct executive offi- 
 cer and the responsible head of the asylum. Its 
 spirit and its tone are embodied and incarnated in 
 him. He should have the right to nominate all sub- 
 ordinate officers, and to appoint and dismiss all 
 attendants and other employees. He should be 
 clothed with ample authority, should be allowed 
 abundant room for the exercise of his individual 
 judgment and discretion, and should be held to a 
 corresponding accountability. He should be re- 
 stricted in his methods of administration bv no rules, 
 
 tf 
 
 except such as are clearly necessary. A multitude 
 of petty regulations in respect to the details of inter- 
 nal management, enacted by legislators or govern- 
 ing boards, will often embarrass and hamper a con-
 
 62 TWENTY-FIVE YEARS 
 
 scientious, good man, but are only ropes of sand in 
 the way of a bad one. The guaranty of right conduct 
 must be looked for in the man himself, and not in the 
 fetters with which he may be shackled. 
 
 I am not presumptuous enough to attempt a fin- 
 ished portrait of an ideal Asylum Superintendent. 
 It is mere commonplace to say that he should possess 
 ability, integrity, and intelligence; that he should 
 have a thorough knowledge of everything which con- 
 cerns the care and treatment of the insane ; and that 
 he should be well acquainted with all forms of both 
 healthy and morbid mental activity, and with the 
 relations of such activity to bodily conditions, so far 
 as these have been discovered. It ought to be safe 
 to assume so much of any person who is permitted to 
 be a candidate for the Superintendency. In addition 
 to all qualifications of this nature, he should be a 
 thoroughly good man, in the best and highest sense of 
 the word good a man into whose hands a husband 
 would be willing to place the health, life, and honor 
 of a helpless and defenseless wife or daughter. He 
 should be the embodiment of kindness and tender- 
 ness, united with great firmness and decision of 
 character. His sensibilities should be keen and 
 quick, while he needs to be free from maudlin senti- 
 mentality. It is of the highest importance, also, that 
 he have power, with no apparent or even conscious 
 effort, to impress these qualities upon his associates 
 and employees. His purpose, spirit, tone, and temper
 
 WITH THE INSANE. 63 
 
 should pervade, like the unseen essence of peace, 
 love, and mercy, every nook and corner of the institu- 
 tion. Out of him, as out of the greater Physician, 
 should go virtue to heal, calm, and restrain. He 
 should possess that half -divine something which, like 
 a hidden magnet, draws out into spontaneous activity 
 the very best of everything there is in his assistants 
 and subordinates. He thus multiplies himself a 
 hundred-fold, and is constantly, though invisibly, 
 present everywhere in the institution. 
 
 In such men, and in the associates and helpers 
 whom they naturally gather about themselves, are 
 found the only sufficient guaranties for the wise and 
 humane treatment of the inmates of an asylum. 
 Without these, all other provisions will have little 
 value ; with these, the danger of neglect or abuse is 
 reduced to the lowest possible limit. With the im- 
 perfections of human nature, it can never be wholly 
 removed from public institutions or from private 
 homes. 
 
 A lady patient of most excellent spirit, a personal 
 friend, writes as follows: 
 
 " I understand, as I could not without having been an inmate 
 of such an institution, how entirely a patient is in the power of 
 doctors and attendants. I should be very unwilling to trust 
 myself or my friends to an institution, without knowing the 
 
 character of its managers. Dr. is one of the kindest of 
 
 men. As one of the ladies, seven years a patient, expressed it, 
 ' He is a father to us all; ' and it was a general feeling among the 
 patients that he was their friend and protector. In fact, kindness
 
 64 TWENTY-FIVE YEARS 
 
 was one of the essential things in treating patients, as it was very 
 difficult to do anything for them without first gaining their con- 
 fidence." 
 
 This extract, which expresses the feelings of every 
 intelligent patient with whom I ever conversed in 
 respect to the relation of the inmates to the physi- 
 cians and employees, suggests a few words touching 
 the position and duties of the attendants in an asy- 
 lum. The importance of their character and duties 
 to the immediate comfort and well-being of patients 
 can not be rightly estimated by any one unacquainted 
 with the interior organization and arrangements of an 
 institution for the insane. They stand nearer to 
 the patients, in many respects, than the physicians. 
 It is in their power to make life to the inmates not 
 only tolerable, but comparatively happy. It is 
 equally within their power to render life anything 
 but tolerable and happy. 
 
 A Medical Superintendent says, "Of all the means 
 used in the institution for the comfort and restoration 
 of the inmates, the most important, perhaps, is per- 
 sonal attendance. It alone is applicable to each 
 individual case, and is available by night as well as 
 by day. Upon its character and efficiency, and, more 
 than all else, upon its spirit, the success of treatment 
 in many cases largely depends. With the most com- 
 plete architectural arrangements, unlimited resources, 
 and skillful medical care, discouraging failure may 
 often attend when remedial effort is applied through
 
 WITH THE INSANE. 65 
 
 harsh, ill-mannered, and ill-tempered attendants. The 
 spirit in which a request for even a drink: of water or 
 the adjustment of a pillow is met, may give to a fee- 
 ble, depressed patient quiet, health, restoring sleep, or, 
 on the other hand, a night of restless irritability." 
 
 Another says, " It is undeniable that the efficiency 
 and usefulness of an asylum are largely promoted by 
 a careful, painstaking corps of attendants. From the 
 peculiar nature of mental disease, it is inevitable 
 that patients must be, to a great extent, dependent 
 upon their attendants for companionship, personal 
 care, and direction in occupation and amusement. 
 In sickness the attendant is the assiduous nurse ; in 
 convalescence, the faithful and attached friend ; and 
 at all times the intimate companion of the patient. 
 It is consequently extremely important that faithful, 
 efficient, self-denying, conscientious attendants be 
 engaged. In selecting them the effort is constantly 
 made to secure the services of persons of unexcep- 
 tionable habits, and with fitness for the special work. 
 The attendant lives with his patients, eats at the 
 same table from the same fare, occupies rooms simi- 
 larly furnished and arranged, and is in every sense of 
 the word an attendant. 
 
 "The effort is constantly made to develop the fam- 
 ily spirit, as it may be termed. Each ward is under 
 the special charge of a person of experience, who for 
 all practical purposes is like the head of a family in 
 the best sense of the word. He is made responsible
 
 66 TWENTY-FIVE YEARS 
 
 for the work of the hall and for the comfort and 
 welfare of the patients committed to his care, and is 
 furnished with as much assistance as the work 
 requires." 
 
 In the character, habits, and training of these 
 attendants is found a guaranty for the comfort and 
 humane treatment of the insane, scarcely less valu- 
 able than that found in the character of the Superin- 
 tendent and his immediate associates. The lady from 
 whose communication I have already quoted says, 
 
 "In the fall of 1873, finding I was losing control of my mind, 
 and fearing to lose it wholly, I went to the asylum voluntarily. 
 I had all confidence in the institution, from long acquaintance 
 with some of the attendants who had been there for years. I 
 was placed in the convalescent hall, and can speak confidently 
 of that. I received the most careful attention and kindest possi- 
 ble treatment from doctors and attendants; and my case was not 
 exceptional. In this hall were gathered ladies from all the other 
 wards, who had been removed there from time to time, as their 
 condition warranted. As there was no restriction placed upon 
 our social intercourse, I gathered from the general tone of remark 
 by patients and attendants from different halls, that harsh treat- 
 ment was censured, and that any attendant who was not uni- 
 formly kind to the patients was certain of dismissal, if the facts 
 were known at bead-quarters." 
 
 There is a most unfortunate inclination in the com- 
 munity generally to criticise and censure the attend- 
 ants employed in an asylum. They are, in some 
 quarters, still spoken of as "keepers," and are pic- 
 tured as hardened, unfeeling wretches. Nothing 
 could be more unjust than such imputations upon
 
 WITH THE INSANE. 67 
 
 those with whom I have been acquainted. With 
 only very rare exceptions, they have been young 
 men and women of unusual excellency of character, 
 of refined manners, and of good taste. They will 
 rank in culture and intelligence, not with the ordi- 
 nary domestics of the family, but with the average 
 pupils of our grammar and high schools. Many of 
 them have been teachers, and have exchanged the 
 uncertain position of the school for a more perma- 
 nent one in the asylum. To secure and retain such 
 attendants, a rate of wages must be paid fully equal 
 to that received by teachers in the common schools. 
 To say nothing of justice to the employees, true 
 economy and the highest interests of the institution 
 unite in demanding such compensation, since good 
 attendants can be secured and retained in no other 
 way. 
 
 Many of the duties necessarily required of the 
 employees upon some of the wards of an asylum are 
 of the most 'taxing and trying nature. The sick are 
 to be cared for night and day. Patients of degrad- 
 ing and uncleanly habits are to be kept in a whole- 
 some condition of body and clothing. Excited and 
 disturbed patients are to be quieted and prevented 
 from doing injury to themselves or to others, and all 
 parts of the hall are to be kept in good order and free 
 from dirt. Some of these duties are so distasteful, 
 not to say repulsive, to the finer feelings and delicate 
 sensibilities of our nature, that even near relatives
 
 68 TWENTY-FIVE YEARS 
 
 and personal friends find it not easy to continue to 
 perform them for any protracted period. There is 
 need of a character permeated through and through 
 with the noblest of principles, and reinforced by all 
 available motives, if such work is to be done thor- 
 oughly and conscientiously, day by day and night by 
 night, when there is no rational human eye to see, 
 nor ear to hear, nor tongue to report That divine 
 love which " suffereth long and is kind, which bear- 
 eth all things, endureth all things, and is not easily 
 provoked," will here find excellent opportunity for 
 exercise. I am glad to bear witness to the self-re- 
 straint, zeal, fidelity, patience, and tenderness of many 
 attendants whom I have known. The outside world 
 and the casual visitor can never properly estimate 
 this service. 
 
 The securities afforded by the guaranties here 
 described will be greatly increased by the force of an 
 enlightened and just public sentiment in the commu- 
 nity at large. Under the influence of such a senti- 
 ment, there will be a disposition to provide all 
 necessary means for the protection and care of the 
 insane, a correct estimate of the value of proper 
 and timely treatment of those attacked with mental 
 disease, and a more generous appreciation of the ser- 
 vices of physicians and others employed in asylums. 
 Civilized men are not, unless overcome by passion of 
 some sort, deliberately and needlessly cruel to their 
 fellows. Misfortune and suffering touch their pity
 
 WITH THE INSANE. 69 
 
 and sympathy, and helplessness does not -usually 
 appeal in vain for succor and protection. But intel- 
 ligence is needed, that pity, sympathy, and compas- 
 sion may be wisely directed. 
 
 Public sentiment has undoubtedly improved within 
 the last few years. More correct notions are enter- 
 tained of the nature of insanity, of its causes, and of 
 the means by which it may be relieved or cured. 
 Facts, however, compel the humiliating confession 
 that much of ignorance and of old prejudice still sur- 
 vives, and is sometimes found in quarters where we 
 would not expect to meet it. Physicians and clergy- 
 men, on account of the peculiar and intimate rela- 
 tions which they sustain to the sick and their families 
 and friends, can do more than persons in other pro- 
 fessions and employments to enlighten the people. 
 Next to these, teachers, especially in the higher insti- 
 tutions of learning, have the largest opportunities to 
 do valuable service in this direction. In schools 
 where mental science is taught, attention should be 
 directed to the most obvious causes and peculiarities 
 of morbid mental action, and to the influence of harm- 
 ful habits, both of mind and body.
 
 70 TWENTY-FIVE YEARS 
 
 CHAPTER IX. 
 
 TREATMENT OF THE INSANE OUTSIDE OF ASYLUMS. 
 
 As already remarked, the disposition to criticise the 
 interior management of asylums is very general. 
 There is a singular readiness to accept, "without ques- 
 tioning, all tales of abuse and neglect, however im- 
 probable they may appear. Less eagerness is mani- 
 fested to learn facts concerning the condition and 
 treatment of the insane in and about our own homes, 
 in the immediate communities and neighborhoods 
 where misfortune has overtaken them. The character 
 of private places of confinement and of public recep- 
 tacles is not often a subject of examination or com- 
 plaint. Much unnecessary suffering could easily be 
 prevented, if attention should turn itself, with wise 
 discrimination, to local occurrences and circumstances, 
 and should insist upon the removal or cure of evils 
 within sight and hearing of one's own doors, with the 
 same zeal and earnestness which it manifests for the 
 correction of those at a greater distance. A few cases 
 which have come to my personal knowledge may be 
 safely taken as types of a multitude of others which 
 have found no record. These indicate the existence 
 of a wide field open for cultivation in the interests of 
 humanity and charity, and so near at hand as to be 
 accessible to all.
 
 WITH THE INSANE. 71 
 
 A soldier from one of the rich counties of my 
 adopted State died of starvation and disease in a 
 prison-pen during the civil war. He left a young 
 widow with two little children in destitute circum- 
 stances, in the midst of a well-to-do community. 
 Within a short time the little ones sickened and died, 
 and the widow was alone and childless. She was of 
 unblemished life and reputation, and not altogether 
 uncultivated in mind and tastes. The shock of these 
 repeated sorrows was too much for her weakened 
 body and unstrung nerves. Her mind gave way, and 
 a mild and inoffensive form of insanity came upon 
 her. She heard voices calling her the voices of her 
 martyred husband and her lost children. She wan- 
 dered about the neighborhood, and at night went into 
 the grave-yard near by and slept, if sleep came to her 
 relief in her sadness, with her head pillowed upon the 
 new-made graves of her children. The neighbors 
 pitied and sympathized, and did what uninstructed 
 kindness could do. The chill evenings and biting 
 frosts of autumn and early winter came; and one 
 morning she was found helpless and half-dead from 
 exposure to the cold night air. Restored a little, she 
 was sent, in a farmer's wagon, to the county officer 
 whose duties included the care of the poor and unfor- 
 tunate. When she was brought, he happened to be 
 sitting in a public place with some boon companions. 
 In the most unfeeling manner, he jested on her visits 
 to the "bone-yard," as, in his refined vernacular, he
 
 72 TWENTY-FIVE YEARS 
 
 named the resting-place of her lost little children. 
 "Voices call me," she said in weak and piteous tones. 
 "Whose voices? what voices? where do they come 
 from?" said the humane conservator of the public 
 interests. "I can not tell whence they come," she 
 replied in the same sad tones. "Perhaps," said the 
 officer, ''they come from Chicago; may be your hus- 
 band calls you there. Would you like to go and 
 see?" "0, anywhere to find my husband," said she; 
 "O, send me to him." The price of a railroad ticket 
 to Chicago was paid ; the impoverished county was 
 freed from the charge of an insane pauper; the faith- 
 ful public officer chuckled at his economical shrewd- 
 ness, and the soldier's widow and bereaved mother 
 went alone, friendless and penniless, bereft of hope 
 and reason, to plunge into the seething vortex of a 
 great and wicked city. Language is utterly inade- 
 quate to make fitting comment on a case like this. 
 
 Another example, less piteous in its termination, 
 illustrates the same tendency to allow considerations 
 of so-called economy to outweigh all regard for 
 humanity. The home of a wife and mother had 
 been wrecked and ruined by a drunken husband. 
 The widow depended upon the labor of her children 
 and her own efforts for her support. Two stalwart 
 sons enlisted in the ranks of the army which saved a 
 nation's life. They died victims of lingering disease 
 and starvation, in the delirium which hunger often 
 produces. A surviving comrade told the harrowing
 
 WITH THE INSANE. 73 
 
 tale to the mother. Its horrors were too much for 
 powers weakened by anxiety and suffering. She 
 became insane. Her disease was not violent in form, 
 but unfitted her to care for herself, and the remain- 
 ing members of the family were unable to provide 
 suitably for her support and protection. Her resi- 
 dence happened to be on the borders of the Common- 
 wealth. She was consequently tossed across State 
 lines and then over county lines, finding no rest and lit- 
 tle pity. At last she was fortunate enough to fall 
 among public officers who did not forget that they were 
 men and were born of mothers, and who did not lay 
 aside humanity when they assumed a little brief official 
 responsibility. Through their efforts she found in an 
 asylum a home, more than earned by the sacrifice of 
 her sons, where proper care will smooth the path 
 down which tottering age goes to its quiet resting- 
 place. 
 
 As I am writing, my eye rests upon the following 
 item in a daily paper published in the present year of 
 grace. The circumstances are not within my per- 
 sonal knowledge, but they seem well authenticated. 
 
 "There has been found in , confined in a filthy pen, in 
 
 a nude condition, a woman sixty years of age and a lunatic. 
 She owns considerable property. She has been kept in her 
 present condition from the economy of relatives.' 
 
 It would be easy to multiply instances of a simi- 
 lar and of a more shocking nature. These are suffi- 
 cient to indicate the need of circumspection which
 
 74 TWENTY-FIVE YEARS 
 
 can see things near at hand. A superintendent of 
 the Kalamazoo Asylum, in speaking of some persons 
 received into the institution, says: 
 
 " They have sometimes come to us in a condition 
 not pleasant even to describe often with but few 
 traces of humanity left. To bring these emaciated, 
 broken-down individuals up to their previous stand- 
 ard of physical health, without which improvement 
 is impossible, and to recall habits of personal cleanli- 
 ness and propriety, is generally a long and tedious 
 process ; yet a fair proportion of them have left the 
 institution so much improved as to become again 
 pleasant members of the family circle, and not a few 
 were subsequently able to provide for themselves." 
 
 Of the patients received during the first years after 
 the opening of the asylum, he says, "Of the adult 
 females, fully ninety per cent are much broken in 
 health and constitution. Very many are faithful, 
 self-sacrificing wives and mothers, prostrated by toil 
 and anxiety, and maternity met under peculiarly try- 
 ing circumstances, where the only nursing received is 
 the few hours snatched by kind neighbors from their 
 own duties. In regarding these we can not help but 
 feel a deeper and tenderer sympathy than is enlisted 
 in behalf of those whose sufferings are the result of 
 their own imprudence." 
 
 Sometimes, without doubt, such lack of proper 
 care for the wife and mother has been through no 
 fault of the husband and father, or of other friends ;
 
 WITH THE INSANE. 75 
 
 "but in too many cases it has been the result of 
 thoughtlessness or of criminal neglect on the part of 
 those who had abundant means to furnish all needed 
 care, and who may justly be held responsible for the 
 suffering which their neglect has caused. 
 
 An early report states that, referring to the record 
 of applications for those admitted, it is shown that 
 two had been confined for many months in cages, 
 one of them, as it was expressed, having become like 
 a wild animal. In nine cases homicide had been 
 attempted, though successfully in but one. In 
 reference to two, it was stated that no one could with 
 safety enter the place in which they were confined ; 
 in case of twenty-one of the small number admitted, 
 confinement in a jail had been deemed necessary. 
 The devices of restraint and punishment of many 
 presented for admission certainly surpass those 
 depicted by sensational writers. Intentional cru- 
 elty is not charged upon those who have had the 
 care of these persons. The bruises, excoriations, and 
 fractures found upon their bodies ; the fetters crowd- 
 ing into the flesh; the firmly rusted irons, and the 
 ridges left by the policeman's club, give evidence 
 rather of thoughtless ignorance, or of that strange 
 fear with which the insane are sometimes still 
 regarded." 
 
 These things did not occur in the " dark ages " of 
 the far-off past. They are not imaginary fictions con- 
 jured up "to point a moral or adorn a tale." They
 
 76 TWENTY-FIVE YEARS 
 
 are simple recitals of facts existing about us and 
 among us in the last half of the nineteenth Christian 
 century, in the very bosom of a so-called Christian 
 civilization, only a stone's throw from the school- 
 house and the church. 
 
 There is need of guarding, with jealous care, the 
 security and welfare of the inmates of asylums. 
 This is freely conceded. But there is equal, if not 
 greater, need to devise safeguards for the protection 
 and humane treatment of the insane in the jails, 
 receptacles, strong-rooms, cages, and other places 
 where ignorance, fear, or false economy has confined 
 them. 
 
 CHAPTER X. 
 OPINIONS AND FEELINGS OF PATIENTS. 
 
 All intimate relationships involve communications 
 of a confidential character. No honorable man, under 
 any ordinary circumstances, will make these known 
 even to personal friends, much Jess to the public. 
 The physician owes silence to his patients; the clergy- 
 man to his parishioners ; more than these, the officer 
 of an asylum is bound to seal his lips and his pen to 
 anything the relation of which might bring a blush 
 to the cheek or a pain to the heart. The interior of 
 many a home is thrown open to the superintendent 
 and to others, in an institution whose inmates have 
 been forsaken by judgment and discretion. Skeletons
 
 WITH THE INSANE. 77 
 
 are uncovered whose existence few even suspect. All 
 such revelations are buried and, as far as may be, for- 
 gotten. I shall, consequently, speak only of things 
 which belong outside the veil of confidence, but 
 which none the less enable one to understand a little 
 of the experience of the insane themselves. 
 
 My observation has left no doubt in my own mind 
 that to some patients the asylum is a place of intense 
 mental suffering. To them it is a "palace-prison" of 
 most irksome restraint and confinement. They al- 
 most constantly fret and chafe against necessary rules 
 and regulations. In their own estimation they are 
 not mentally diseased, but are unjustly and wrongly 
 deprived of liberty, either by the machinations of 
 enemies or by the treachery of relations and pretended 
 friends. 
 
 These patients have usually a good degree of 
 mental activity, often speak fluently and rationally, 
 excepting upon some particular topic, and write with 
 much vigor and sharpness. The casual visitor will 
 look upon them with great interest, and will be 
 likely, if he does not tarry too long, to question their 
 insanity. In most cases they seem to have inherited 
 a defective physical organization and a predisposition 
 to some form of cerebral disease. Under some un- 
 fortunate combination of circumstances their nervous 
 systems have been overtaxed. They have lost self- 
 control, and have fallen under the power of some 
 absorbing delusion. In this condition they become
 
 78 TWENTY-FIVE YEA^S 
 
 unsafe members of society, frequently a source of 
 danger to their friends, and often incapable of caring 
 properly for self-protection. If educated and ambi- 
 tious, it is not unusual for them to imagine that some 
 great and peculiar mission has been imposed upon 
 them, to the accomplishment of which life should be 
 sacredly devoted. Of this class more females than 
 males have come to my notice. The extracts given 
 below from letters addressed to me by a young lady 
 will show the intensity of feeling to which patients, 
 suffering under this form of mental impairment, are 
 subject. The lady was a graduate of a literary insti- 
 tution of high rank, and possessed, in certain direc- 
 tions, ability above the average of her associates. 
 My acquaintance with her began before her admission 
 to the asylum. 
 
 SIR: I wish I might stir your heart and the hearts of your 
 coadjutors to justice and humanity. Not to weakly give my 
 confidence that it may be used against me shall I write as I do, 
 hut I have depended on you, almost in a frenzy of despair, to 
 liberate me. Can you fail me? I can not, can not stay. They 
 have hurt me so. It kills me. Only superlatively painful ex- 
 periences await me here, and to succeed in their schemes for me 
 is as im/wssible to them as it would be to turn the planets from 
 their courses. You can arrange for my friends to come for me 
 and take me to their owa tender care, or rather to liberty and 
 long rest from disturbing causes, that systematic labor may once 
 more be possible to me, and the right be mine to live according 
 to the dictates of reason and conscience, and sway the, influence 
 a responsible being should, untrammeled by authority and bru- 
 tality. I believe in myself, and will not yield to the conspiracy 
 against me, though all the world were in the league.
 
 WITH THE INSANE. 79 
 
 I can not be ruined so. I must go. Keep me, if you dare. 
 They need not fear what I will say. They can say I was insane. 
 But all the imputations of insanity placed on me are false, and 
 with eyes intelligently open I have tried to save my brain. 
 Talent and character were to make my way, and they have tried 
 to rob me of both. . . . Can you imagine anything 
 worse than a heart and brain crushed by all the hellish devices 
 the arch-fiend could prompt, under the regime of a beastly dragon 
 of a woman? In the effort to make me of like passions with 
 themselves they have spared no pains to tear me from my moor- 
 ings of religion and eradicate all I hold dear. 
 Could you know all of thought, emotion, and purpose that have 
 been born and died within me the past year, you would surely 
 say, this brain-wear were better devoted to practical purposes. 
 It never can be here. Shall any tell of good deeds wrought here 
 by me? No! They thwarted it by their fiendish malignity and 
 brutality. I long for release to care for myself, and do my duty 
 t>y those who have done so much for me. Those who have done 
 all they could to ruin, need pretend no solicitude for my future. 
 I have none. But I am not the woman to be so trifled with, and 
 will not endure it longer. It is fearful to have them prevent my 
 honest industry, and ruin one of the best brains God ever gave a 
 woman. I must not plead in vain any longer. 
 
 Yours, etc., 
 
 'i Mingled with the entreaties, which came from 
 her very so ill, were passages indicating the fearful 
 hold which the fatal delusion had upon her mind. 
 Later, after it was evident to her that hope of libera- 
 tion through me had failed, she wrote as follows : 
 
 SIR: Because you mocked my last hope that you would do 
 what you could in remedying the wrong you did in sending me 
 here, by informing my friends of my desire to be with them, my 
 faith in your character is completely shivered. Two months 
 and a half since, that letter implored your aid, and now I am
 
 80 TWENTY-FIVE YEARS 
 
 going to write a letter for you to keep and read to revive your 
 drooping energies and spur your zeal for humanity. . . * . 
 If you can demonstrate that it is wise to come in contact with 
 vice, except to rebuke it; or sickness, except to relieve it; or to live 
 degraclingly when one might live nobly, then could you be guilt- 
 less in allowing me to remain* But because you have suffered 
 me to languish here, I want you to think of me when you gather 
 around your well-spread table in the society of cultured friends. 
 I want you to see pictures of mad-house revels in the fire-light. 
 I hope the wild winds of winter will shriek in your ears of my 
 misery. When you retire to rest think of maniac shrieks, 
 moans, and coughs I sometimes hear. In your honored position 
 of usefulness, think how I am wasting my time and talents. 
 The suttee is abolished; the horrors of the 
 Inquisition have ceased ; American slavery is dead. Russia owns 
 no serfs; but Michigan has an institution where sane, innocent 
 women may be thrown into a smelting furnace among seething 
 
 specimens of humanity, to be molded into such shape as 
 
 thinks proper. Every softened lineament may be stricken from 
 the features; nearly every noble emotion from the soul. Remem- 
 ber all this when thankful men and women come to you and 
 say, "You have saved me, under God." Remember that man 
 may praise and admire you, but God looks on the heart. To 
 him you must answer for this wrong; with him I leave you; as 
 for me I have learned that it is better to trust him ' ' than to put 
 confidence in princes." 
 
 Yours, with all due respect, 
 
 P. 8. The subject is inexhaustible. Go your way! Wrap 
 the filthy rags of your righteousness closely about you, and be 
 careful about sending another sane, virtuous woman to be 
 placed in the hands of those who were more respectably occu- 
 pied in cock-fighting and bull-baiting than in doing violence to 
 all the holiest, best feelings of a woman's nature. 
 
 This letter also contained, in the suppressed pas- 
 sages, striking illustration of the strength of her
 
 WITH THE INSANE. 81 
 
 delusion. It is a well-recognized fact that insanity of 
 certain types manifests itself much more fully and 
 clearly in the writing than in the conversation of the 
 patient. I can hardly imagine a situation more tor- 
 turing to the soul than that of a person afflicted with 
 this form of mental disorder. Trust in humanity and 
 trust in God usually die. Hope gradually fades 
 away, and relief comes, in a majority of cases, only 
 through the decay of mental power which confine- 
 ment probably hastens. Heart-rending tales like 
 that of the " Palace-prison " have their origin in cases 
 of this kind. 
 
 The extracts next following indicate a type of 
 mental aberration which not only does not give pain 
 mentally to the patient, but on the contrary seems to 
 afford an almost unlimited source of enjoyment. The 
 imaginary possession of divine power is a delusion 
 not uncommon, particularly among males. 
 
 To THE MEDICAL FRATERNITY THROUGHOUT THE EARTH: 
 
 Glory to God in the Highest ! ! ! Peace, good will unto all men 
 that shall obey my royal will and pleasure, from this time hence- 
 forth and forever. Amen! Amen!! Amen!!! I am the Alpha 
 and the Omega, the beginning and the end, the first and the last. 
 "I am the vine." I am the fulfillment of God's promise to 
 David, 1st Book of Chronicles, 17 chapter, llth to and including 
 the 15th verse; Psalms the 2d, 7th verse to the end; Revelation, 
 19th chapter, 16th verse. I am the Lord thy God, and thou shalt 
 have none other God beside me. My yoke is easy and my burden 
 is light. Love one another. 
 
 (Signed) , 
 
 King of Kings and Lord of Lords.
 
 82 TWENTY-FIVE YEARS 
 
 ORDER No. 2. 
 
 To E. H. Van Deusen, M. D., Principal; George C. Palmer, M. D., 
 1st Assistant; E. O. Marshall, M. D., 2d Assistant. 
 
 KALAMAZOO, MICHIGAN, INSANE ASYLUM. 
 MY DEAR SIRS, BROS., COMPS., AND SIR KNIGHTS: You will 
 instruct all in authority under you, from this time, henceforth 
 and forever, to obey my royal will and pleasure in all things that 
 I may desire or ask for; to open all Doors at my command, fur- 
 nish all necessary information, and attend in every respect to my 
 royal will and pleasure. For my yoke is easy and my burden is 
 light. Amen! Amen!! Amen!!! 
 
 Royal Palace of the King of Kings and Lord of Lords, Kala- 
 mazoo, Mich. 
 
 (Signed) , 
 
 King of Kings and Lord of Lords. 
 
 KALAMAZOO INSANE ASYLUM, 
 
 FEB. 28, 1874. 
 
 Shortly after I was thirty-five, I took up the Lord's Power, or 
 the Power which the Lord Jesus laid down; which gave me full 
 Power, which is the Power of the Lord. And at that time, the 
 10th of April, 1866, I received a mark on my left side like unto a 
 wound, which was healed, which indicated and signified that the 
 head which was wounded unto death was healed and restored to 
 power. . . . . 
 
 SEPT. 17, 1875. 
 
 To DR. : I have transmitted evidence to you that a 
 
 general doom is settling on the human race, unless certain con- 
 ditions are complied with; if those conditions are not complied 
 with, the doom of the human race will be sealed the last day of 
 next February. 
 
 Now, the way to prevent the doom of the human race from 
 settling down is to comply with what is demanded and required. 
 Submit to the burdens which the Lord imposes. 
 
 I demand and require of you to force the battle and doom on 
 to the President and Vice-President with sword and saber, and
 
 WITH THE INSANE. 83 
 
 with shot and shell, and horse and rider, and to strike for life. 
 Authority is found in being the Lord. 
 Written by the Creator of all things. 
 
 Truly, . 
 
 The feelings of many restored patients, toward the 
 asylum and its officers, may be gathered from the 
 tone of the letters which follow. These are samples 
 of letters frequently received by the Superintendent 
 and others connected with the institution. They 
 were addressed to me with no expectation of their 
 publication. 
 
 DEAR SIR: In the hope of seeing and conversing with you 
 again before departing from the asylum, I bade you adieu 
 without expressing the great obligations I am constrained to feel 
 myself under to you, in common with my other kind friends, 
 whose instruction and influence contributed so much to my 
 restoration to health and, what is of almost infinitely greater 
 value, to reason. You may be surprised when I tell you that of 
 all the influences brought to bear upon my wandering mind and 
 despairing heart, none were more effective in restoring that 
 mind to a healthy tone, and illumining that heart with the light 
 of hope, than the simple religious exercises conducted by your- 
 self. It had been many months since I had listened to any relig- 
 ious exercises, and the very name of Jesus was like a sweet but 
 long-forgotten strain of music to my ear. I always feel that I 
 should like of all things to converse with you upon the themes so 
 dear to every soul that has once realized its own siufulness, or 
 sought and hoped for mercy at the feet of a loving Saviour. But 
 whenever you came there seemed to be so many who were really 
 greater sufferers than myself, to claim your sympathy and atten- 
 tion, that I was fain to deny myself the pleasure of seeking 
 words of instruction and encouragement for myself during your 
 -very welcome visits. Having lost this very desirable opportunity, 
 I will endeavor to make amends to myself by talking with you a
 
 84 TWENTY- FIVE YEARS 
 
 little bit on paper, with your consent, upon subjects of vital 
 importance to me, as they involve my spiritual well-being. I 
 said to you that I hoped that I was a Christian, and I do trust I 
 am not presumptuous in thus hoping, still less in trying to regulate 
 my life by the law of Christ, seeking to bring every thought into 
 captivity to his will. But when I look back upon my past life, 
 when I for a moment turn my eye upon my own heart, I become 
 doubtful, and that heart fails me for fear. My Christian expe- 
 rience (if I have had any genuine religious exercises) has been of 
 a somewhat extraordinary character, in which mere feeling had, 
 I fear, too great a share. You may, however, be better able to 
 judge of this when you know something of my education and 
 training. [Here is given a frank recital of personal history and 
 experience, deeply interesting and touching in its character, but 
 intended, as indeed the whole letter was, only for the eye of a 
 sympathizing friend.] 
 
 Excuse my prolix epistle, and be so kind as to answer. 
 Ever your grateful friend, 
 
 MY DEAR FRIEND AND BROTHER: My only apology for this 
 intrusion is that I know it will rejoice your heart to hear from 
 me that my reason is perfectly restored, and my physical health 
 is much improved, my confidence in the blessed God more firmly 
 established than ever, and the precious promises of the dear 
 Savior a more perfect rest to my soul. I also thought it would 
 encourage your heart and strengthen your efforts in your labors 
 of love with those poor afflicted ones, with whom I was so long 
 associated, to know that your self-denial has not been in vain. 
 Your weekly visits, prayers, and exhortations were so refreshing 
 to me, and seemed to be the blessed means of re-awakening that 
 light, love, joy, and peace which I had before enjoyed, and which 
 I still retain. Last Sabbath I received the Holy Sacrament of the 
 Lord's Supper, for the first time in two years. You may be sure 
 it was to me not only a solemn, but also a most delightful season. 
 The elders received me at the sacred altar with tears of sympathy
 
 WITH THE INSANE. 85 
 
 and holy joy. Bless the Lord, O my soul, and forget not all his 
 benefits. 
 
 Though I have severe trials that often blind my eyes with tears, 
 they are, thanks to our heavenly Father, all outward, and only 
 serve to increase and confirm the imperishable treasure within. 
 "In the world ye shall have tribulation," is a part of the promise, 
 " but in me ye shall have peace." Dear brother, my heart is full, 
 and I would say much more, but fear I am already trespassing. 
 I would be affectionately remembered to Mrs. Putnam. I always 
 think of the pleasant visits at your house with grateful pleasure. 
 
 Yours, . 
 
 CHAPTER XI. 
 
 SCHOOLS AND INSANITY. 
 
 In this and some following chapters I wish, if pos- 
 sible, to direct attention to a few topics of practical 
 importance. It is not anticipated that any new 
 truths will be presented, but only that some familiar 
 ones may be looked at from a different direction. 
 
 The schools have been accused of many and grave 
 faults. Like scape-goats, they have been loaded 
 down with a huge burden of "transgressions and 
 sins." It has not, however, been charged that they 
 are directly responsible for any considerable amount 
 of mental disease. It would be rank treason for a 
 teacher to whisper that such a charge could have the 
 shadow of foundation. But a practiced observer 
 will, in many cases, discover the real, original cause 
 of insanity far back of the assigned one, in some
 
 86 TWENTY-FIVE YEARS 
 
 native tendency of mind, fed and fostered by unwis- 
 dom of parents and teachers. Considerable numbers 
 of both students and teachers are found in the asy- 
 lums. It would not be strange that I should have 
 had a special interest in studying such cases. I have 
 no hesitation in affirming that the arrangements and 
 methods of work in the schools are pretty directly 
 responsible, in a majority of instances, for the insan- 
 ity of the teachers whose cases have fallen under my 
 own observation. Other causes, without doubt, have 
 conspired with these, but to those the sad result has 
 been mainly due. To put the matter in the briefest 
 possible form, in many schools the organization and 
 administration are such that some of the teachers, 
 usually ladies, are subjected to overwork and over- 
 anxiety. Unreasonable demands are made upon both 
 the physical and mental powers. As a consequence, 
 the vital energies are prematurely exhausted ; the 
 nervous system is broken down ; the power of self- 
 control is weakened ; depression of spirits follows, 
 and finally melancholia, or some other species of 
 mental disease, supervenes. Recovery, in these 
 cases, is doubtful. The best that can ordinarily be 
 hoped for is partial restoration, and a few subsequent 
 years of painful and enforced inactivity and depend- 
 ence. It would be easy to recall and describe spe- 
 cific examples by way of illustration, but the sanctity 
 of official obligations and other obvious reasons for- 
 bid this.
 
 WITH THE INSANE. 87 
 
 Many female teachers are required to control and 
 instruct too many pupils, to teach too many subjects, 
 to do too much work outside the school-room in pre- 
 paring matter for lessons, in looking over and 
 marking "examination papers," in filling up blank 
 reports, and in other kindred labor. They are com- 
 pelled, by methods of examining, grading, and pro- 
 moting pupils, to undergo too much, too frequent, and 
 too long-continued anxiety, and they are, in not a 
 few cases, left with too little freedom for the exercise 
 of individuality. The responsibility for these evils 
 rests partly upon teachers themselves, more upon 
 principals and superintendents, and largely upon 
 school-boards and the general public. 
 
 Little interest has been manifested in this feature 
 of the school question. It has received no discussion 
 in reports, periodicals, or newspapers. It has seemed, 
 therefore, the more needful to give utterance to a few 
 words of unvarnished truth in this connection. 
 Teachers have claims upon justice and humanity, in 
 common with the children whom they help to fash- 
 ion into manhood and womanhood. 
 
 The effects of school requirements and discipline 
 upon the whole nature, physical, mental, and moral, 
 of pupils have been topics of frequent and free dis- 
 cussion. Viewed from a teacher's position, these 
 discussions have involved much of truth, and not a 
 little of misapprehension ; and occasionally they 
 have manifested a lamentable ignorance of facts and
 
 88 TWENTY-FIVE YEARS 
 
 principles. Schools and teachers and educational 
 methods are justly chargeable with grave faults, but 
 they are not the sources of all the ills under which 
 society suffers. Some things they do which ought 
 not to be done ; they leave undone more which they 
 should do. 
 
 Education of the right sort, the harmonious devel- 
 opment and training of the whole complex being of 
 the child, should conduce to mental health and vigor, 
 and should do much to prevent insanity. Schools 
 are not hospitals or asylums, and it is not their prov- 
 ince to reform criminals, to cure bodily diseases, or 
 to heal mental maladies. But it is a part of their 
 legitimate business to prevent all these. They are 
 very near the fountain out of which character and 
 conduct flow. They should help to guard this from 
 pollution. The stream of young life ought not to be 
 poisoned at its source. In the interests of mental 
 health a few things may be demanded, with a good 
 deal of emphasis, of the home and school, of parents 
 and teachers. Some of these are so obvious that 
 their mention may excite surprise. 
 
 (1) Children should be taught, beginning in the 
 home, obedience and respect for authority. The 
 general interests of society demand this ; but it is not 
 urged here for that reason. A child who frets and 
 fumes at every command which crosses his inclina- 
 tions, at every requirement for which he can not 
 comprehend the purpose, is in a state of constant
 
 WITH THE INSANE. 89 
 
 nervous irritation. The organs of the body most 
 closely related to mental life can not perform their 
 functions properly. The condition of mind corres- 
 ponds to the condition of body. Neither has a nor- 
 mal and healthy growth. The habit of rebellion 
 becomes chronic. The child resists the authority of 
 home and the school, and later of society and the 
 state. He is in a condition of perpetual warfare. 
 There is no quiet rest of nerve or brain, and no 
 steady action of the intellect or moral nature. 
 
 Let such a person be attacked by some acute disease, 
 the proper treatment of which requires perfect rest 
 of body and mind, and complete submission to the 
 directions of a physician ; and the chances of recovery 
 are seriously lessened by his character and habits. 
 There can be no question that a mind permitted to 
 grow up in this way is more liable to insanity, and 
 has fewer chances of recovery. 
 
 (2) Children should be taught self-control. Self- 
 control is more than simple mastery over one's 
 temper. That is of prime importance, but it is only 
 the first step. That must be acquired, if the 
 child is to have a well-balanced mental organ- 
 ization. There must be also control of appetites, 
 both natural and acquired ; control of all the passions ; 
 control of every feeling ; control of the mental powers ; 
 in a word, of the whole being. One of the highest 
 ends of education, so far as the individual himself is 
 concerned, is to bring every power and faculty into
 
 90 TWENTY-FIVE YEARS 
 
 perfect submission to the will. Then self-control is 
 fully attained. To all children, but especially to 
 those of nervous and highly sensitive organizations, 
 the proper mastership over the sensibilities is of vital 
 importance. If there should be a tendency in the 
 nature to give way to morbid feelings, to " brood " 
 over things, to be moody and capricious and irritable 
 without apparent cause, the greatest possible care 
 should be taken to counteract this tendency by wise 
 methods. With such an inheritance, the beginnings 
 of positive mental disease will be very easily made. 
 Right instruction and training in this respect by 
 parents and teachers, would have saved many of the 
 inmates of our asylums from a fate worse than death. 
 (3) Moral instruction and training should be given. 
 These must begin in the home, where the life of the 
 child begins. The school must second and carry 
 forward the work of the home. Right impulse must 
 be given ; the seeds of right habits must be planted ; 
 sound principles must be inculcated. Feelings of 
 duty and obligation must be excited, moral judgment 
 instructed, and conscience quickened. The connec- 
 tion between the moral and intellectual natures is so 
 intimate that disease in one can hardly fail to be 
 communicated to the other. It is doubtful if moral 
 corruption, in certain directions, can co-exist with 
 perfect mental health. Certain it is that some forms 
 of moral pollution and degradation are precursors or 
 attendants of some forms of mental disease.
 
 WITH THE INSANE. 91 
 
 (4) Instruction should be given in respect to the 
 nature and effects of alcohol, tobacco, and other nar- 
 cotics, both in the home and in all institutions of 
 learning where pupils are old enough to be profited 
 by it. The relation of these articles to insanity has. 
 been discussed elsewhere. 
 
 (5) In institutions of higher learning instruction 
 should be given in respect to the action of mind, 
 both in health and in disease, in respect to the rela- 
 tion of body and mind, and the influence of the one 
 over the other. The importance and power of inher- 
 ited tendencies should be so explained and illustrated 
 ac to produce, if possible, a practical effect upon con- 
 duct, not only during student-life, but subsequently 
 in a business or professional career, and in the forma- 
 tion of the most intimate domestic relations. 
 
 (6) Artificial incitements to study, such as prizes, 
 etc., should very seldom, if ever, be employed. I am 
 not unaware that excellent men and successful in- 
 structors hold different views. None the less, how- 
 ever, I have a deeply rooted conviction that such 
 means of stimulating the activity of students are 
 open to the most serious objections, both upon moral 
 and mental grounds. The moral objections are not 
 in place here. Their natural influence upon the 
 intellect is the primary consideration, and, as neces- 
 sarily related to this, their effect upon the bodily 
 health and vigor. Referring to this subject, a writer 
 says,
 
 92 TWENTY-FIVE YEARS 
 
 "Let me tell you what I have seen in Christian New England. 
 Two brilliant, high-hearted youths, the rival leaders of their 
 class, all the rest left behind, stretching across the four-years' 
 course neck and neck, stimulated by the spirit of an eager emu- 
 lation, sacrificing health and peace, only to drop, one into a grave 
 and the other into mental perversion, at the end of the heat." 
 
 This is an extreme case, but hardly less sad ones 
 can be found in every asylum. I have in mind 
 examples of hopeless imbecility, resulting from un- 
 wise stimulation of faculties precociously developed, 
 and consequently immature and unable to endure the 
 strain of steady and continued effort. In almost all 
 such cases the mental, and often the physical, organ- 
 ization is defective and unstable. Less, and not 
 more, than the usual amount of intellectual labor 
 should be imposed upon children of this sort. Out- 
 of-door sports, and not in-door reading and study, 
 should be prescribed and encouraged. 
 
 In primary and secondary schools any system of 
 examinations and markings which causes constant 
 anxiety and strong nervous excitement, on the part 
 of pupils of average abilities and attainments, is to be 
 condemned, and ought to be forthwith abolished. 
 Possibly " average standings " may be lower, though 
 this is not certain ; but the average health, tone, and 
 spirits of scholars will be vastly higher. 
 
 The physical and mental health of both pupils and 
 teachers will be kept in better condition, and more 
 work of real value will be accomplished, if school 
 arrangements, methods, and lessons are such that the
 
 WITH THE INSANE. 93 
 
 school-room, with its perplexities and tasks, can be 
 wholly forgotten during twelve out of every twenty- 
 four hours. 
 
 It is unnecessary to say that I have little sympathy 
 with the indiscriminate abuse heaped upon schools 
 and teachers by some writers whose knowledge of the 
 actual requirements and interior workings of schools 
 is derived from hasty casual visits, or from the state- 
 ments of over-ambitious scholars returning home 
 with "armfuls of books and bundles of papers" cov- 
 ered with historical questions and mathematical prob- 
 lems, or from the stories of parents whose children 
 are suffering from evening parties, and late hours, and 
 unwholesome diet, more than from school tasks and 
 regulations. I arn speaking from the inside, from the 
 teacher's desk, and from abundant means of observa- 
 tion. With rare exceptions, it is not overwork by 
 which children are harmed. The evils result from 
 the unfavorable conditions under which the work is 
 done conditions which violate the laws of mental 
 hygiene as well as of common sense. The friction of 
 an ill-fitting harness exhausts the draught-horse more 
 than a heavy load. The necessity of keeping step 
 with those whose gait is altogether unlike our own 
 tires more than the walking. Intellectual gaits differ 
 as widely as physical ones. 
 
 By some means the lower schools must afford more 
 room for individuality, both in teachers and scholars; 
 personal mental peculiarities should receive more
 
 94 TWENTY-FIVE YEARS 
 
 study and attention ; less value should be attached to 
 the results of stated or occasional examinations, and 
 more to the character of daily work. "The acquisi- 
 tion of mental power is more to be desired than the 
 acquisition of knowledge. The power to do is worth 
 more than the power to tell what others have done. 
 The ability to comprehend and apply principles out- 
 ranks, in practical importance, the ability to remem- 
 ber facts and repeat them in chronological order." 
 
 CHAPTER XII. 
 RELIGION AND INSANITY. 
 
 Among the assigned causes of insanity in asylum 
 reports "religious excitement" appears. Cases of 
 mental disorder classed under this head usually have 
 their recognized beginnings in close connection with 
 those seasons of special religious interest and activity 
 called "revivals." A peculiar sensitiveness in regard 
 to cases of this kind exists in some quarters. A dis- 
 position is manifested occasionally to deny, or at least 
 to doubt, the correctness of the classification. It 
 seems to be supposed that, in some way, the imputa- 
 tion of insanity to this cause casts reproach upon 
 religion. There is also, on the part of those who reject 
 certain doctrines and disapprove certain methods, an 
 inclination to over-estimate the number of cases thus 
 produced, and to exaggerate the evils springing from
 
 WITH THE INSANE. 95 
 
 methods which they condemn. They who deny too 
 much and they who affirm too much are, so far as 
 observation enables me to judge, about equally in 
 fault. The cause of truth is never harmed by a frank 
 admission of well-established facts, nor benefited by 
 the assumption as authentic of that which, at best, is 
 only possible or probable. 
 
 It is undeniable that attacks of violent insanity 
 can be directly traced to so-called "religious excite- 
 ment." It is equally certain that such cases are 
 infrequent. Out of one thousand and twenty patients 
 admitted to an asylum, eighteen cases were attributed 
 to this as the probable exciting cause. In some insti- 
 tutions the percentage will be greater, in others less. 
 It is only an act of justice to add that tables of 
 assigned and probable causes are usually very un- 
 satisfactory to those who prepare them. Compara- 
 tively few attacks of insanity are due to a single 
 definite cause. More frequently the disease is pro- 
 duced by a combination of conditions and circum- 
 stances, no one of which alone would have brought 
 about the result. Some of the causes may have been 
 in operation, entirely unsuspected, for a long time. 
 The assigned cause may be merely the accidental 
 occasion of the final outbreak. This is, without 
 doubt, true of a considerable proportion of the vic- 
 tims of so-called religious insanity. 
 
 A few statistics of a somewhat general character 
 may be of interest. Up to the time when four hun-
 
 96 TWENTY-FIVE YEARS 
 
 dred and seventy-three patients had been received into 
 the Michigan Asylum, just about one-half were mem- 
 bers of some religious organization. Of these seventy- 
 one were Methodists, forty were Roman Catholics, 
 thirty-three were Presbyterians, twenty-three were 
 Baptists, twenty-one were Episcopalians, nineteen 
 were Congregationalists, six were Friends (Quakers), * 
 five were Universalists, and the remainder were 
 divided, by ones and twos, among various other 
 denominations. As would naturally be expected, a 
 much larger proportion of females than of males were 
 communicants of churches. My impression is, also, 
 that forms of insanity which would be called religious 
 are relatively more frequent among women than 
 among men. This would be anticipated when it is 
 remembered that the emotional element is stronger in 
 the female mind, as a rule, than in the male. 
 
 Both the records of asylums and personal observa- 
 tion will justify the general conclusion, I believe, 
 that no one recognized form of religious faith can be 
 specially charged with the production of insanity. 
 It does not appear that the members of one church 
 are more liable to attacks of mental aberration than 
 members of any other. Nor does it appear that the 
 peculiar doctrines of an accepted creed exert an 
 appreciable influence upon the character of mental 
 delusions. 
 
 It is due, however, to truth to say that individuals 
 of peculiarly nervous and unstable organizations can
 
 WITH THE INSANE. 97 
 
 not safely be exposed to long-continued excitement 
 of any sort. The danger will be still greater if such 
 an unfortunate organization has been inherited. Ex- 
 haustion from over-work, from disease, from loss of 
 sleep, from anxiety, or from any other cause, brings 
 many persons into a most critical condition. Under 
 such circumstances, any intense excitement may des- 
 troy the mental equilibrium and fatally weaken the 
 power of self-control. Undoubtedly religious truths 
 are calculated to stir the sensibilities more profoundly 
 than any others. These truths may be, and some- 
 times are, so presented as to appeal to the emotions 
 and the imagination more than to the judgment 
 and reason. The resulting state, of both body and 
 mind, is one of peculiar danger to persons of delicate 
 health and of highly nervous temperament, especially 
 if exhausted by labor and harassed with cares and 
 anxieties. In some cases, without question, insanity 
 follows insanity which might probably have been 
 avoided, if all parties concerned had possessed more 
 knowledge and exercised more judgment and pru- 
 dence. Some such cases, though not a large number, 
 have fallen under my own observation. 
 
 The spiritual nature is so closely allied, at all 
 points, with the intellectual, and both these are so 
 intimately associated with the physical organization, 
 that those who are dealing with one need to under- 
 stand something, at least, of the laws which govern 
 the others, of the mutual relations between them, and
 
 98 TWENTY-FIVE YEARS 
 
 of the influence exerted by each over the others. 
 Without such knowledge the religious character and 
 condition of many persons can not be justly estimated, 
 nor can they be wisely advised and guided. It is 
 clearly the duty of pastors and other religious 
 teachers and guides to become acquainted with the 
 whole complex nature of man, and to study also the 
 individual characteristics of the members of their 
 churches and congregations. It is a deed of greater 
 kindness to save one from disease than to heal him 
 after he has been attacked. Limits must sometimes 
 be put to the religious exercises and labors of indi- 
 viduals of peculiarly impressible and excitable organ- 
 izations. They are exposed to the danger of being 
 " religious overmuch " in certain directions, a danger 
 from which men in general are entirely free. Such 
 persons, under the reaction which is sure to follow 
 too protracted and exhaustive labors, even for the 
 best of objects, easily fall into a state of mental 
 depression. This assumes the form of spiritual de- 
 pression and darkness. Light, joy, and peace are 
 gone. They imagine themselves the greatest of 
 sinners. For them there is no hope ; they are beyond 
 the reach of mercy or love. They may be of the 
 purest religious character and of spotless lives, may 
 have abounded in practical good works ; all this 
 serves to increase, rather than to diminish, the crush- 
 ing load which weighs them down. They affirm, 
 with the utmost sincerity, that their whole past lives
 
 WITH THE INSANE. 99 
 
 have been hollow, meaningless shams ; that they have 
 never known true religion, or, if they have, are now 
 fallen below the possibility of recovery. Only the 
 " blackness of darkness " is in reserve for them. 
 
 Now, first of all, in dealing with such cases, the 
 wise friend and guide will enter into no arguments or 
 reasonings. The border line between sanity and 
 insanity has been crossed. These present manifesta- 
 tions are not causes, but consequences, of disease. 
 The remaining hope is that the delusion, whose hold 
 may not yet be very firmly fixed, can be shaken off. 
 Arguments, by keeping the attention of the patient 
 di r ected toward the false notion, will only serve to 
 fasten it more deeply and thoroughly in the mind. 
 The current of thought must be changed, and set 
 running in some other direction. Worldly employ- 
 ments will be better than spiritual ones for this 
 purpose. Almost any other conversation will be 
 more wholesome than religious exhortations or con- 
 solations in this morbid condition. Fitting amuse- 
 ments and recreations will be more salutary than 
 fastings, and prayers, and self -examinations. 
 
 The following extract, from a long letter written to 
 me by a restored patient, will illustrate the danger of 
 which I have spoken. After describing some con- 
 ditions and exercises to which she had been subjected 
 for a considerable time, she says: 
 
 "But this state of things did not long continue. One morn- 
 ing there suddenly fell upon me a trembling consciousness of
 
 100 TWENTY-FIVE YEARS 
 
 sin, and an indefinable fear took possession of me. But as I 
 stoutly resisted what seemed to me a weak and unworthy feeling, 
 it soon passed away, to return in a few hours with an array of 
 terrors that could not be allayed. Suddenly as the lightning 
 illuminates the sky, it seemed to me that the very heavens were 
 opened, and I saw the awful majesty of God. Involuntarily I 
 closed my eyes, as if to shut out the terrible brightness of the 
 vision. For one single moment my whole soul was drawn 
 upward in aspirations towards that unapproachable holiness, 
 but the next, the fearful conviction that it could never be, that I 
 was not only a sinner, but the very chief of sinners, rushed upon 
 me with such crushing weight that I should have been helplessly 
 stricken to the earth, but for the supporting arms of those 
 about me. I gave expression to my mental agony, and was 
 pointed by a single Christian friend to the Saviour, when I found, 
 to my horror, that I did not and never had believed in his ability 
 to save. 
 
 "My great sufferings threw me quickly into a brain fever, 
 from which I only slowly recovered after weeks of the most 
 painful sickness, and such mental and spiritual conflict as I pray 
 God I may never know again. For many long months I found 
 no spiritual peace. I felt myself abandoned of God and man, 
 secluded myself from society, and gave myself up to remorse 
 and despair. In vain I prayed; in vain I wept tears of bitter- 
 ness; in vain I listened to exhortations and prayers. I actually 
 believed that God's infinite power could never save me, his 
 mercy never reach me. I reasoned that God could never love me 
 because I was a sinner, and it was his nature to hate what was 
 sinful and unholy. It is not my purpose to recapitulate all the 
 conflicts through which I passed, the long and painful process of 
 reasoning and reading through which I at last became convinced 
 of the possibility of an atonement; for, spite of my education, I 
 now saw an atonement to be absolutely requisite even for the 
 purest saint, much more for such a rebel as I felt myself to be. But 
 I did believe it at length, intellectually at least; but yet I had 
 gained nothing, for this Saviour, loving and all-sufficient as he
 
 WITH THE INSANE. 101 
 
 was, could avail me nothing. I was all sinfulness, and he must 
 everlastingly hate me. 
 
 ' ' But there came a change, and for many weeks my heart was 
 literally burdened with a sense of Christ's love, though I still 
 felt he could never save me from sin and misery. I felt he had 
 waited all my life long to be gracious, and was finally forced to 
 yield to the overwhelming consciousness that, despite my wicked 
 heart, he could make me loving and submissive; and, in all 
 humility, I gratefully accepted the cup of salvation from his 
 bountiful hand. 
 
 "But my periods of enjoyment were comparatively brief, 
 though intensely rapturous, so much so as to make me fear that 
 they were merely the excitement of highly wrought feelings. 
 While they continued I could not doubt their genuineness, but 
 when they passed away I grew doubtful and rebellious. After 
 more than a year of such intense suffering, relieved only by brief 
 intervals of spiritual exaltation, I was again attacked with brain 
 fever, during which I lay at the point of death for many days, 
 being constantly delirious, and was left in a state of confirmed 
 insanity which was not relieved until after I came to the 
 Asylum." 
 
 It is more than probable that all this intense suf- 
 fering and many long months of almost hopeless 
 insanity might have been prevented, if parents and 
 teachers and spiritual guides had understood better 
 the laws of physical and mental and religious life. 
 
 A singular phenomenon presents itself in some 
 cases of mental disease. The delusion under which 
 a patient labors is of a religious or a semi-religious 
 character, although the previous life has not been in 
 any respect, not even by profession, religious; nor 
 has the mind of the person, so far as can be ascer- 
 tained, ever been specially inclined to dwell upon
 
 102 TWENTY-FIVE YEARS 
 
 religious subjects. I recall a stout and somewhat 
 florid gentleman, whose life, as I understood, had not 
 been remarkable for piety or regularity, who often 
 insisted on removing his garments so as to allow me 
 to examine the scar remaining from the wound 
 inflicted by the spear of the Eoman soldier. At one 
 time two gentlemen, each of whom believed himself 
 to be possessed of supreme power, were associated 
 upon the same ward of the asylum. Neither of these 
 patients, as appeared by the history of their cases, had 
 been distinguished for reverence and regard for the 
 Deity. One unacquainted with the vagaries of the 
 insane would naturally conclude that delusions of 
 this sort must have their origin in religious causes. 
 No conclusion could be farther from the truth. The 
 notions upon which the mind fastens in its unbal- 
 anced condition seem to have as little relation to the 
 ideas of the previous sane state as dreams have to the 
 every-day occurrences of waking life. Some occult 
 law may act in both cases, but no such law has yet 
 been discovered. 
 
 Not unfrequently the moral nature appears to be 
 completely changed by an attack of mental disease. 
 Persons, even ladies, who have been above all 
 reproach, pure in deed and word and thought, become 
 offensive in conduct, and profane and vulgar in 
 speech. Modesty, piety, and good taste seem to have 
 been wiped out of the soul for the time. Though 
 deeply and profoundly religious when in health,
 
 WITH THE INSANE. 103 
 
 every vestige of religious faith and character van- 
 ishes. No connection, so far as I know, can be 
 traced between these abnormal manifestations and 
 the causes of insanity. As in the cases previously 
 mentioned, the insane condition furnishes but little 
 indication of the original disposition, temper, training, 
 or habits. It would be quite possible for "religious 
 excitement " or intellectual over- work to be followed 
 by mental disorder of a gross and repulsive form. 
 Such facts have to be borne in remembrance when 
 considering cases of so-called religious insanity. 
 
 Leaving aside peculiar and exceptional cases, I am 
 confident that an intelligent religious faith tends to 
 preserve mental health, and, when this health has 
 been impaired, helps the process of restoration. A 
 firm belief in a wise and just and good over-ruling 
 Power, who can be trusted and loved, even though 
 his ways are sometimes " past finding out," gives to 
 the weakened and trembling mind a much-needed 
 resting-place. A consciousness of the presence and 
 personal friendship of this Divine Being supplies a 
 haven of refuge when alarms, confusions, and anxie- 
 ties come in to annoy and disturb. The testimony of 
 not a few restored patients has served to confirm my 
 confidence in the healing power of true religion.
 
 104 TWENTY-FIVE YEARS 
 
 CHAPTER XIII. 
 ALCOHOL AND INSANITY. 
 
 If one were seriously to affirm that he had some- 
 thing new to say of alcohol and its influence upon 
 human society, he would expose himself to the sus- 
 picion of laboring under a mental delusion. The 
 subject has been discussed apparently in all its 
 aspects. If any good comes, or can come, from the 
 use of alcohol, it is safe to conclude that somebody 
 has discovered and made it known. The catalogue 
 of evils with which it stands charged is already so 
 long and so fearful that the addition of another to the 
 list would hardly be noticed. I am not so presumpt- 
 uous as to expect to make such addition, or to darken 
 the shadows in the picture of human woes produced 
 by the use of intoxicating liquors. 
 
 The mind is so constituted, however, that some 
 truths have to be impressed upon it, or thoroughly 
 fastened in it, by dint of repetition. This is espe- 
 cially the case when appetite and passion stand 
 opposed to judgment and reason, and when gratifica- 
 tion is immediate and evil consequences are remote 
 and partially hidden. Besides, new members of 
 society are constantly taking their places upon the 
 stage of human activity, and children do not inherit 
 the wisdom of their parents. At best they only
 
 WITH THE INSANE. 105 
 
 receive by transmission the capacity and disposition 
 to learn. They must be taught the same lessons 
 which have been already taught over and over again. 
 Just here many most excellent and zealous reformers 
 and other good people fall into a natural but unfor- 
 tunate fallacy. They declare that certain things " are 
 settled." But the fact is, however much we may 
 regret it, that nothing is ever finally and perma- 
 nently settled which has its basis in the deductions of 
 reason, or in conclusions drawn from experiment, so 
 long as every man does his own reasoning and makes 
 his own experiments. Things which depend upon 
 instinct, upon intuition, and upon authority, may be 
 settled ; but authority must be uniform and absolute, 
 or it goes for nothing. 
 
 The war against alcohol and its brood of evils and 
 horrors will consequently have to go on, and be 
 fought over with each successive generation, unless 
 human nature shall meet with some happy transfor- 
 mation. The greed of appetite and the greed of gain 
 are mighty forces, and are alike deaf to the appeals of 
 reason. Men will continue to manufacture and sell, 
 and other men will continue to drink alcohol in vari- 
 ous forms, though every draught helps to produce 
 idiocy, insanity, and murder. 
 
 Statistics prove, beyond all reasonable doubt, that 
 intemperance is one of the prolific causes of mental 
 disease. Its work, however, is largely indirect, and 
 is not to be estimated by the number of inebriates
 
 106 TWENTY-FIVE YEARS 
 
 committed, during any given period, to asylums for 
 the insane. Alcohol poisons the blood and corrupts 
 the very fountain of life. The drunkard transmits to 
 his posterity woes from which premature death may 
 kindly relieve him. Yet the cases of disease caused 
 directly are very numerous. Dr. Take, in speaking 
 of insanity among the laboring classes in England, 
 says, "Among the causes, intemperance unmistakably 
 takes the lead." In France the consumption of alcohol 
 doubled from 1849 to 1869. During the same period 
 mental disease increased fifty-nine per cent, among 
 men, and fifty-two per cent, among women. A larger 
 part of this increase could be traced pretty directly to 
 the increased use of alcohol. At the Worcester asy- 
 lum nineteen per cent, of the admissions were 
 charged to intemperance during four years, when the 
 habit of drinking liquor was very general. During 
 four years when the temperance movement was at its 
 greatest height, only four per cent, were due to this 
 cause. 
 
 Dr. Stearns states that more than ten per cent of 
 5000 cases in the Hartford Retreat were caused by 
 the use of alcohol, without including cases of inher- 
 ited tendency produced by the habits of parents. In 
 all asylums cases of the latter sort are much more 
 numerous than those attributed directly to intemper- 
 ance. If to the cases caused directly and by inheri- 
 tance we add the cases produced by want, by over- 
 work, by sufferings both of body and mind among the
 
 WITH THE INSANE. 107 
 
 families and friends of drunkards, certainly one 
 fourth, and probably fully one third, of all the insan- 
 ity in the country must be charged to alcohol. I do 
 not include in this statement cases of idiocy and 
 imbecility, of which it is, without question, the most 
 prolific cause. 
 
 If zeal which outruns judgment is ever excusable, 
 or even rises to the rank of a virtue, it is when the 
 question of dealing with the production, sale, and use 
 of intoxicating liquors is under consideration. What 
 to do about the traffic in such liquors, and their use 
 as beverages, is the great problem of our age, and its 
 solution requires all the practical wisdom of statesmen 
 and philanthropists. The question is too broad and 
 deep to be " settled " by narrow partisanship or angry 
 denunciation. Genuine humanity and sound political 
 economy must join in the final solution. Meanwhile 
 a great work of education is to be done for and upon 
 the young in our homes and in the schools. The 
 nature of alcohol and its effects, both upon the 
 drinker and upon his offspring, must be thoroughly 
 taught, as well as the enormous taxation which it 
 inflicts upon society. It will not be sufficient simply 
 to give instruction. Knowledge is not all, or even 
 the most, that is needed. The moral nature of the 
 growing citizen must be reached and enlightened. A 
 feeling of responsibility must be excited and prop- 
 erly directed. It may as well be frankly admitted 
 that mere intellectual education does not arm men
 
 108 TWENTY-FIVE YEARS 
 
 with the power and disposition to resist the cravings 
 of appetite, or the seductive influence of supposed 
 self-interest. If experience ever settles anything, 
 that has been finally decided by the results of the 
 education of the last half-century. The springs of 
 human action lie either above or below the intellect 
 either above in the moral and religious nature, or 
 below among the appetites and passions. If the 
 higher nature is not developed, strengthened, and 
 directed, the lower will be certain to secure the mas- 
 tery, in spite of the veneering and polish which come 
 of the culture of intellect and taste. If public senti- 
 ment will not tolerate moral instruction in the public 
 schools, and if teachers are not prepared to give and 
 enforce such instruction, both by principle and con- 
 duct, then text-books on the "Effects of Alcohol and 
 Narcotics upon the Human System," though approved- 
 by all the "Boards" in the State, will have little 
 practical value. Children, and those older than 
 children, must, if they are to be moved to action, not 
 only know that a specific indulgence of appetite or a 
 certain course of life results in bodilv harm arid loss. 
 
 / 
 
 but they must also feel that the indulgence and 
 course of life involve moral responsibility and guilt. 
 Charles Lamb, writing out of his own bitter expe- 
 rience, says, " Could the youth, to whom the flavor of 
 his first wine is delicious, look into my desolation, 
 and be made to understand what a dreary thing it is 
 when a man feels himself going down a precipice
 
 WITH THE INSANE. 109 
 
 with open eyes and a passive will, to see his 
 destruction and to have no power to stop it, and yet 
 to feel it, all the way, emanating from himself; to 
 perceive all goodness emptied out of him, and yet 
 not to be able to forget a time when it was otherwise, 
 
 to bear about the piteous spectacle of self-ruin," 
 he might be saved from entering upon the 
 downward path. In this extract Lamb touches 
 the core of the matter. Alcohol destroys the 
 power of the will, and thus destroys the vital 
 essence of all true manhood. Of the confirmed ine- 
 briate there is little hope : the foundation is terribly 
 shattered, if not absolutely swept away. " When he 
 would do good, evil is present with him." He is 
 wretched, and is an object of pity. But he is also guilty 
 
 guilty of slow and deliberate suicide. Humanity, 
 religion, patriotism bid us, by all possible means, 
 save the young save them from dishonor, degrada- 
 tion, crime, insanity, idiocy. 
 
 CHAPTER XIV. 
 TOBACCO AND OTHER NARCOTICS AND INSANITY. 
 
 The consumption of tobacco has gone on steadily 
 increasing for many years. Old men and young men 
 use it; boys, and even children, use it Clergymen, 
 lawyers, doctors, teachers indeed, " all sorts and con- 
 ditions " of people unite in worshiping at the shrine of
 
 110 TWENTY-FIVE YEAKS 
 
 "the weed." It is chewed, and smoked, and snuffed. 
 It is presented in forms enticing and forms disgusting. 
 
 Kecent investigations have proved that a considera- 
 ble portion of the boys in many of our public and 
 other schools use tobacco either habitually or occasion- 
 ally. In some schools fully forty per cent have begun 
 to acquire the habit of either chewing or smoking. In 
 not a few cases they commence the practice as early as 
 at eight years of age. 
 
 It produces little effect to declaim against this use of 
 tobacco on moral or economical grounds. To say that 
 the habit is offensive and filthy is only repeating what 
 has been reiterated a thousand times to no purpose. 
 If this pernicious habit is to be checked, other consid- 
 erations and arguments must be employed ; and it is a 
 hopeful omen that the influence of tobacco upon the 
 physical organism is beginning to attract serious 
 attention. 
 
 Its immediate effects upon one not habituated to its 
 uses are well known. "A biting sensation, more or 
 less marked, in the mucous membrane of the mouth, 
 tongue, and throat, a feeling of warmth and faintness, 
 nausea, vomiting, and headache, presently a coolness 
 of the skin, perspiration on the forehead, hurried res- 
 piration, and feeble action of the heart," are symptoms 
 familiar to observation and experience. It is well 
 established that the nicotine of tobacco, one of the 
 most active of poisons, acts directly upon the brain and 
 nervous system, producing at first a partial paralysis.
 
 WITH THE INSANE. Ill 
 
 Fortunately, or perhaps unfortunately, for the physi- 
 cal vigor of the race, the system in maturity has 
 power to adjust itself to this poison, and the peculiar 
 effects just alluded to soon cease to appear. In place 
 of these a soothing and pleasing influence is felt, which 
 probably comes from a very slight paralysis of the 
 nerves, just sufficient to allay the sense of discomfort 
 and irritation produced by exhaustion or other causes. 
 The power of resistance and adjustment is so great in 
 the adult body that the moderate use of tobacco may 
 be continued for a long time with little observable 
 harm. The excessive use, even in the adult, soon 
 yields a prolific harvest of evil ; and the poor victim 
 of artificial appetite is compelled to choose between the 
 pain of breaking off a habit not easily broken and pre- 
 mature death, or physical, if not mental, imbecility. 
 
 It is hardly possible to exaggerate the pernicious 
 effects of the constant use of tobacco upon the young. 
 The 'immature brain, nerves, and muscles have little 
 power of resistance or adjustment The inevitable 
 consequence is that the organs of the body do not 
 attain their normal growth or reach a vigorous matur- 
 ity. The boy who commences the habitual use of 
 tobacco in any form &t eight years of age, never 
 becomes the man he might have been. His vitality 
 has been sapped and weakened. The result is a gen- 
 eral flabbiness, to employ a word more expressive than 
 elegant, of the whole man, mental and moral as well as 
 physical Both the intellectual and moral powers are
 
 112 TWENTY-FIVE YEARS 
 
 less active, keen, and sensitive, than they otherwise 
 would have been. 
 
 So thoroughly has this been proved that in France 
 and Germany legal enactments have been made forbid- 
 ding the use of tobacco by pupils in many of their 
 schools. During some years its use has not been 
 allowed in the naval and military schools of the United 
 States. To say nothing of individual welfare, the pub- 
 lic interests demand that effectual restrictions be put 
 upon the sale of tobacco, in any form, to young boys r 
 and that some effectual means be devised to prevent 
 its use by the pupils in our public schools. It is not 
 so much a question of morals as of manhood ; patriot- 
 ism is as much concerned as purity; the State has a 
 deeper interest than even the family. It is time, cer- 
 tainly, that the pulpit and the desk, the preacher and 
 the teacher, were purified from the sight and smell of 
 tobacco; if not for moral and religious considerations, 
 then for the sake of physical manhood and political 
 economy. 
 
 It is not claimed that the use of tobacco is, in any 
 large number of cases, the direct cause of insanity. 
 Indirectly, and associated with other causes, it is respon- 
 sible for much mental as well as physical suffering. 
 It inflicts its harm, chiefly, by preventing the proper 
 maturing of the system, especially the nervous system, 
 and by reducing its tone and vigor, and thus exposing 
 it, with weakened powers of defense, to the attacks of 
 other enemies. While it may not, to any considerable
 
 WITH THE INSANE. 118 
 
 extent, directly originate mental disease, it certainly 
 breaks down the barriers, opens the doors, and invites 
 such disease to enter, and makes its progress more easy, 
 sure, and deadly. It acts the part of a pretended 
 friend, who does not, indeed, set fire to your house, but 
 who does surreptitiously remove all means of extin- 
 guishing the flames. 
 
 Moreover, by the laws of heredity, the effects of the 
 habitual use of tobacco go beyond the immediate vic- 
 tim and the present generation, and entail a load of ills 
 and a possible burden of woes upon posterity. An 
 unstable physical and mental organization is a sad 
 patrimony to bequeath to one's children, and a fearful 
 price to pay for a little temporary gratification of an 
 unnatural appetite. 
 
 While speaking thus plainly and emphatically of the 
 evils resulting from the habitual use of tobacco, more 
 particularly to the young, I wish to guard against a 
 possible misapprehension. Nothing is gained, even to 
 a good cause, by exaggeration. The harmful effects of 
 
 * *J 
 
 tobacco are bad enough, are surely alarming, but they 
 are not to be compared to those resulting from the use 
 of alcohol. It is, in my opinion, most unwise to con- 
 fuse and mislead by denouncing both with equal zeal 
 and violence. Alcohol has no peer in capacity and 
 power to work damage to all the interests of humanity. 
 Intemperance begets and perpetuates a greater and 
 more hideous brood of human ills than any other 
 habit, unless it be that of sexual license and impurity.
 
 114 TWENTY-FIVE YEARS 
 
 Between the offspring of these kindred monsters a 
 choice would be difficult Let them enjoy their unen- 
 viable pre-eminence. 
 
 Of other narcotics opium, of which morphine is the 
 most essential principle, is the most common and the 
 most important in its relations to mental disease. In 
 limited quantities and under certain conditions, opium 
 and morphine produce a species of enticing and pleas- 
 urable intoxication. The eater or smoker revels in 
 delightful day-dreams and wondrous flights of fancy. 
 But the "opium habit" is of the most dangerous char- 
 acter. It is seductive, alluring, and fascinating. It 
 seems to cast a fatal spell over its victim, and drags 
 him slowly, but steadily and surely, down to degrada- 
 tion and ruin, physical, intellectual, and moral The 
 power of self-control and self-direction is soon lost, and 
 the ability to resist the raging demands of unnatural 
 appetite utterly disappears. The natural sensibilities 
 are blunted, and moral distinctions gradually fade 
 away. The habitual user of opium becomes a pitiable 
 wreck, driven hither and thither by the demon which 
 he has himself evoked 
 
 Samuel Taylor Coleridge affords an illustrious exam- 
 ple of the depth of misery and helplessness into which 
 a man may be plunged by this terrible habit. For 
 fifteen years he is reported to have been its slave. He 
 made, De Quincey says, "prodigious efforts to deliver 
 himself from this thraldom; and went so far, at one 
 time, as to hire a man for the express purpose, and
 
 WITH THE INSANE. 115 
 
 armed with the power of resolutely interposing between 
 himself and the door of any druggist's shop." A con- 
 test actually took place between Coleridge and this 
 "external conscience," who proved faithful to his trust 
 What an abdication of all manhood is indicated by 
 such a condition! And yet Coleridge, when master 
 of himself, was one of the most brilliant men of his 
 time. Saddest of all, his son Hartley inherited the 
 weakness of the father, and wasted life, as he himself 
 says, "in the woful impotence of weak resolve." 
 
 The use of opium in some form is said to have greatly 
 increased in this country within the last few years. 
 The importation in 1881 was 85,075 pounds; in 1883 
 it amounted to 298,152 pounds. The "opium habit" 
 is probably more common among women than among 
 men, though it is not by any means confined to females. 
 A druggist in one of our cities is reported to have said, 
 " Hundreds of ladies belonging to the best families in 
 the city are addicted to the habit, but the number of 
 men is comparatively small." It is to be hoped that 
 this is a libel upon the women of that city. If true, 
 the accommodations for imbeciles will need to be greatly 
 enlarged in our asylums at an early day. The quan- 
 tity of morphine taken by persons long accustomed to 
 its use is almost incredible. A dealer in drugs states, 
 " There are women in this city who take enough mor- 
 phine in a day to kill half a dozen people unac- 
 customed to it. I have in mind a lady who began 
 coming to my store about five years ago. She began
 
 116 TWENTY-FIVE YEARS 
 
 buying packages of fifty cents' worth. She is now an 
 imbecile, and consumes ten dollars' worth in two 
 months. There is -no such thing as a maximum dose. 
 There are numbers of frail women among my customers, 
 each of whom can take enough morphine at one dose 
 to kill the strongest man in the city." 
 
 Such excessive indulgence brings loss of regular and 
 natural appetite, derangement of the organs of diges- 
 tion, torpor of the intellectual and moral faculties, hal- 
 lucinations, and confirmed and degrading disease of 
 both body and mind. If the use of this drug contin- 
 ues to increase, it will obviously be the duty of the 
 civil authorities to interfere, in some vigorous way, 
 with its importation and sale. The duty of parents, 
 teachers, and others who understand the use and influ- 
 ence of opium, is sufficiently clear. The young, the 
 weak, and the ignorant are entitled to protection from 
 the danger of contracting a habit whose evil influence 
 can hardly be over-estimated. 
 
 CHAPTER XV. 
 
 INHERITED TENDENCIES AND INSANITY. 
 
 Among my acquaintances and friends are several 
 excellent persons who live constantly under a dark 
 shadow. In some cases a parent, in other cases a more 
 remote ancestor, suffered from insanity, perhaps died 
 in an asylum. They have read the recent discussions
 
 WITH THE INSANE. 117 
 
 upon "heredity" and "environment," and are fully 
 persuaded that they are cursed with a fatal inheritance. 
 This idea disquiets them by day and haunts them by 
 night. It is like a perpetual nightmare or an ever- 
 present skeleton. It tends to destroy happiness, to 
 paralyze energy, and, worst of all, to bring upon them 
 the very evil which they so much dread. If possible, 
 I should be glad to present some considerations which 
 might help to dispel the shadow that hangs over indi- 
 viduals of this class. More than anything else, they 
 need courage and grounds upon which to predicate a 
 reasonable hope of escaping the fate impending, as they 
 believe, over them. 
 
 Upon this subject of transmitted and inherited ten- 
 dencies no one except a specialist is qualified to speak 
 with authority. I shall not presume to place any 
 reliance upon the lessons of my own observation in a 
 matter of this sort. I shall, therefore, borrow freely 
 and literally the opinions of those who are competent 
 to instruct. 
 
 The doctrine of heredity, in its general form, is not 
 new. A law has always been recognized "by which 
 all beings endowed with life tend to repeat themselves 
 in their descendants." It is not a recent discovery 
 that, "in transmitting the germ of life, parents trans- 
 mit to their children their own resemblance, physical, 
 mental, and moral; the children are a part of our- 
 selves; it is our flesh, our blood, our souls, our 
 examples, our lessons, our passions, which relive in
 
 118 TWENTY-FIVE YEARS 
 
 them." Physical features reappear generation after 
 generation. Intellectual peculiarities live on through 
 many successive fathers and sons. Moral traits appear 
 over and over again. Deformities, weaknesses, idiosyn- 
 crasies, and morbid tendencies are also, by the same 
 law, transmitted. All these facts have been understood 
 for ages by intelligent. observers. Cultivators of plants 
 and breeders of animals have turned such knowledge 
 to profitable account They have learned that even 
 special and apparently accidental variations from the 
 normal type may also be transmitted and rendered 
 more or less permanent by the law of inheritance. 
 
 Recently, however, there has been a tendency on the 
 part of writers upon "social science" to attach more 
 importance to the law of heredity in its applications to 
 the human race, and to emphasize, if not to exaggerate, 
 its influence. The purpose which these authors de- 
 sired to accomplish was a laudable one, and one to 
 which the public mind needed to be directed. They 
 have abundantly proved that diseased tendencies of 
 the worst description are propagated from parents to 
 children, and that by this means the most fearful 
 evils are constantly and rapidly increasing. It has 
 been shown, beyond all question, that the drunkard, 
 whether habitual or only occasional, entails upon his 
 posterity an inheritance of woes positively frightful to 
 contemplate. In no other disease are the hereditary 
 influences so fatally sure as in alcoholism. 
 
 Dr. Morel says :
 
 WITH THE INSANE. 119 
 
 ' ' Defective nerve-power and an enfeebled, debilitated morale 
 form the favorite legacy of inebriates to their offspring. Some of 
 the circle, generally the daughters, may be nervous and hysteri- 
 cal; others, generally sons, are apt to be feeble and eccentric, 
 and to fall into insanity when an unusual emergency takes place. 
 That the impairment of the bodily or mental faculties arises from 
 intemperance of one or both heads of the family is demonstrated 
 by the healthfulness and intellectual vigor of the children born 
 while the parents were temperate, contrasted with the sickliness 
 and mental feebleness of their brothers and sisters born after the 
 parent or parents became intemperate. The most distressing 
 aspect of the heredity of alcohol is the transmitted narcotic or 
 insatiable craving for drink, the dipsomania of the physician, 
 which is every day becoming more and more prevalent." 
 
 It is stated upon apparently .good authority that 
 "the records of asylums all indicate that the tendency 
 to insanity, in some of its forms, is one of those most likely 
 to be inherited. It is thought that more than one half 
 of the admissions to English asylums present evidence 
 of an inherited taint The same is probably true in 
 reference to admissions to asylums in the United 
 States." 
 
 It would be strange if statements of this kind, 
 fortified by statistics of the most formidable character, 
 and left without explanation or qualification, did not 
 produce a deep and depressing influence upon the 
 minds of those who have reason to suppose such a 
 taint to run in their blood. 
 
 This depressing effect is deepened by the further 
 application of the doctrine of heredity to the depraved, 
 vicious, and criminal classes. Transmitted tendencies
 
 120 TWENTY-FIVE YEARS 
 
 and environment are made responsible for a very large 
 percentage of all violations of law and order. Theft 
 and robbery, assault and murder, larceny and lechery, 
 flow concealed in the veins, and only wait provocation 
 and opportunity to make themselves manifest. 
 
 Undoubtedly there is a large measure of truth in this 
 view, enough to demand for it the careful consideration 
 of the law-making and law-administering powers, as 
 well as of the common citizen and practical philan- 
 thropist. But it is quite possible to draw from this 
 doctrine deductions and inferences of the most unfor- 
 tunate and harmful nature. Man may be reduced to a 
 mere automaton, impelled to act by forces over which 
 he has no control, the mere slave of inherited tenden- 
 cies and of external surroundings. Powerless to resist, 
 unable to direct, why should yielding incur guilt or be 
 visited with penalties? Machines are not blamed or 
 punished ; and, under this theory followed to an easily 
 reached extreme, the human being becomes a mere 
 piece of animated mechanism. Moral distinctions van- 
 ish; right and wrong are obsolete and meaningless 
 terms ; virtue and vice are fictions of the imagination. 
 So-called bad men are only weak, not wicked ; unfor- 
 tunately organized, not morally culpable; victims of 
 heredity, and not of self-created habits of evil-doing. 
 
 This is a phase of scientific fatalism toward which a 
 class of very honest and zealous reformers will find 
 themselves drifting, unless we are allowed to suppose 
 that some conservative and preservative forces exist in
 
 WITH THE INSANE. 121 
 
 men and in society which are strong enough to resist, 
 at some point, inherited tendencies to physical and 
 moral degradation. I am confident that such forces do 
 exist I believe that heredity itself, when rightly 
 understood and correctly interpreted, is a conserva- 
 tive and not a destructive force. The normal condi- 
 tion of any organism is a state of health, and not of 
 disease. The native, natural tendency is to perpetuate 
 the normal condition, unless the whole organism is 
 totally corrupted, vitiated beyond all possibility of 
 restoration. In this case, by a merciful provision of 
 nature, death soon intervenes, and the ruined individ- 
 ual or family or race disappears. 
 
 Except in such extreme cases, inherited physical ten- 
 dencies can to- a considerable extent, at least, be suc- 
 cessfully resisted and overcome by persistent and intel- 
 ligent efforts. The same is true of transmitted intel- 
 lectual and moral traits. It is not affirmed that the 
 task will be an easy one, or that the struggle will be 
 of short duration; but it is most emphatically affirmed 
 that every sane man's consciousness revolts against the 
 imputation that he is a mere automaton, destitute of 
 all self-directing power. We seem to ourselves, at any 
 rate, to have a form of mental activity called choice, 
 and to be able to give "preponderance to motives." 
 We are able, consciously and voluntarily, to check 
 some impulses and to yield to others, to give to one 
 motive more weight than to another. We feel, when 
 in a state of ordinary mental and moral soundness,
 
 122 TWENTY-FIVE YEARS 
 
 that we are not irresistibly impelled to pursue a certain 
 course or to do certain things. It is easy for a theorist 
 to assert that we are cheated by what we call con- 
 sciousness ; but it is not easy to discover by what 
 means, or by what course of argument, such an asser- 
 tion can be satisfactorily established. There is noth- 
 ing behind or below consciousness in the soul to 
 which an appeal can be made. Its decisions are of 
 necessity final in all matters of this kind. 
 
 Of the influence of this specious form of fatalism, 
 Dr. Carpenter says : 
 
 "I can imagine nothing more paralyzing to every virtuous 
 effort, more withering to every noble aspiration, than that our 
 children should be brought up in the belief that their characters 
 are entirely formed by heredity and environment; that they must 
 do whatever their respective characters impel them to do; that 
 they have no other power of resisting temptations to evil than 
 such as may spontaneously arise from the knowledge they have 
 acquired of what they ought or ought not to do; that if this 
 motive proves too weak they can do nothing of themselves to 
 intensify and strengthen it; that the notion of 'summoning their 
 resolution,' or 'bracing themselves for the conflict,' is altogether 
 a delusion; that, in fine, they are in the position of a man who is 
 floating down stream without oars, towards a dangerous cataract, 
 and can only be rescued by some external power." 
 
 How this doctrine weighs "like an incubus" on the 
 soul is well stated by J. S. Mill in his autobiography. 
 He says, " I felt as if I was scientifically proved to be 
 a helpless slave of antecedent circumstances ; as if my 
 character and that of all others had been formed for us 
 by agencies beyond our control, and was wholly out of 
 our own power."
 
 WITH THE INSANE. 123 
 
 This is essentially the condition in which some of 
 the persons of whom I have spoken believe themselves 
 to be. They are scientifically proved to be helpless, 
 "fore-ordained" to a fate which horrifies them, but 
 against which it is worse than useless to struggle. It 
 is hardly necessary to say that I am not a believer in 
 this crushing species of " fore-ordination." This is not 
 the teaching of the doctrine of heredity, interpreted by 
 reason or consciousness. 
 
 Even J. S. Mill, on reflection, reached another 
 conclusion. " I saw," he says, " that though our char- 
 acters are formed by circumstances, our own desires can 
 do much to shape those circumstances ; and that what is 
 really inspiriting and ennobling in the doctrine of 
 Free-will, is the conviction that we have real power 
 over the formation of our own characters; that our 
 will, by influencing some of our circumstances, can 
 modify our future habits and capacities of willing." 
 
 Mr. Mill here touches the heart of the whole matter. 
 In spite of all theorizing, we feel that the will, unless 
 utterly destroyed by the most vicious and degrading 
 habits, has some self-directing power ; that we can 
 modify and, to some extent, control circumstances ; 
 that we are not doomed to drunkenness because an 
 ancestor has unfortunately been an inebriate, or to 
 insanity because a father or mother, or some remote 
 relative, has suffered from mental disease. It is freely 
 conceded that hidden tendencies course in our veins ; 
 that a taint vitiates our blood ; that concealed enemies
 
 124 TWENTY-FIVE YEARS 
 
 lurk to pounce upon us at some unguarded moment ; 
 that constant watchfulness is the only guaranty of 
 safety; but we are not utterly helpless, mere floating 
 wrecks, with no power of self-direction and no possi- 
 bility of escape from the dangers which threaten us. 
 
 I recall in my native neighborhood, in a country 
 town of New England, two families, in one of which 
 the father was frequently and habitually intoxicated, 
 and in the other the father was habitually a constant 
 and hard drinker. In both families the mother was 
 of most excellent character and habits. Each family 
 had a half-dozen children, a majority of them boys, 
 nearly all of whom grew up to manhood, and several 
 of whom are still living quite advanced in years. 
 Not one child in either family has been addicted to 
 the use of intoxicating drinks, nor has any one, so 
 far as I have been able to learn, suffered from any 
 form of mental disease. It is true that some of the 
 children were born before the fathers had fallen into 
 the confirmed habit of inebriety; but not all of them. 
 The latest-born inherited less vigorous physical con- 
 stitutions, but otherwise there was no difference in 
 character. Examples can be recalled in abundance, 
 where children have followed in the unhappy foot- 
 steps of their besotted parents. I have adduced this 
 one to show that such following is not a "fore-or- 
 dained " necessity ; that there is an innate power by 
 which one can, if he will, overcome inherited inclina- 
 tions and dispositions.
 
 WITH THE INSANE. 125 
 
 This view is confirmed by the testimony of a mul- 
 titude of competent witnesses among specialists and 
 physicians generally. 
 
 Dr. Parish says : 
 
 "The law of heredity recdgnizes periods of limitation, as a 
 necessity for the continuance of the race. If it were not for such 
 a law, and the degenerative process were to be continued, with- 
 out deviation or exhaustion, the reproductive powers would 
 sooner or later terminate, and the race become extinct. 
 
 "It is evident that the individual who is conscious of an 
 inherited tendency to alcoholic excess, may do much to modify, 
 if not to control its force, by placing himself under such condi- 
 tions of living as will tend to increase his constitutional vigor in 
 the direction in which it is most needed. A person coming into 
 the world with a tendency to pulmonary consumption will, as 
 soon as he knows it, begin to correlate himself with the most fav- 
 orable conditions of climate, occupation, etc., that the progress 
 of the morbific element within him may be arrested, if possible, 
 and that the normal forces that are antagonistic to this manifest- 
 ation of disease may be strengthened. The same is true of other 
 disorders. 
 
 "A person with a direct hereditary taint for insanity may pur- 
 sue a course of life, under professional guidance, which will 
 secure him against a public exhibition of his infirmity, with more 
 certainty than a person with an alcoholic diathesis can be kept from 
 indulgence and exposure. In the former there is no physical 
 craving to overcome, no struggle with an internal and positive 
 demand, which, strong and imperious itself, is rendered more so 
 by the allurements of social and the attractive displays of public 
 life. All that is required in case of the insane tendency is, in the 
 very outset, to submit to intelligent guidance as to mental and 
 physical hygiene, so as to preserve a normal equipoise." 
 
 Dr. Hitchcock, writing upon the fearful "Entail- 
 ments of Alcohol," says:
 
 126 TWENTY-FIVE YEARS 
 
 "Can a young man who, from some taint of blood, has inher- 
 ited from his parents or ancestors that morbid desire for 
 stimulants, be secured from this brood of evils? Yes, if the 
 taint of blood is not so strong as to wholly enervate the will; 
 but he only by total abstaining. And is it not possible that by 
 so doing, and by intermarrying with a person in whose blood 
 there is no such taint, he may do much towards eliminating that 
 taint from his descendants?" 
 
 That which must be done in respect to the " taint " 
 of alcohol, can more surely be done in respect to the 
 less terrible taint of insanity. 
 
 Dr. Van Deusen writes: 
 
 "To have an inherited capacity for mental disease is one 
 thing, and to have a parent or relative who may have been insane 
 may be quite another. The somewhat general impression that 
 the child of a parent who has been insane, is quite sure to suffer 
 in the same manner, is by no means correct; it is often mischiev- 
 ous, in suspending over the child a painful and ever-present 
 apprehension, generally morbid in its influence, and of service, 
 perhaps, when it leads to a judicious and healthful system of 
 development and discipline, and more carefully regulated 
 habits of life. It is evident enough that there can be no possible 
 direct transmission to offspring in the case of a parent who, 
 many years after the birth of a child, from purely physical 
 causes, may suffer from an attack of mental disease. 
 
 "In this connection it may be of some advantage to suggest to 
 the friends of insane parents the importance of preventing 
 intimate and protracted association with their children in the 
 early years of their development. The sadly depressing effect 
 of such association has very frequently been demonstrated, 
 especially in case of an insane mother and her daughter. The 
 fact of the existence of such an influence is too important to be 
 disregarded." 
 
 "Our experience leads to the conclusion that, (1), about one- 
 third of all presented for treatment have immediate relatives who
 
 WITH THE INSANE. 127 
 
 have been insane; (2), that most forms of mental disease are 
 equally curable, whether the patient has sane or insane relatives ; 
 (3), that individuals of ordinarily good mental and physical con- 
 stitution, in whom recovery is perfect, are less likely to have a 
 second attack; while, (4), those who inherit an unhealthy organ- 
 ization will probably suffer from subsequent attacks. " 
 
 Dr. Hard says : 
 
 "In many instances persons possessing susceptible nervous 
 organizations suffer much unnecessary apprehension because an 
 immediate relative has been insane, when the fact may not have 
 any bearing upon their own prospect of developing insanity. 
 The insanity of old age or of the climacteric period can not be 
 regarded as transmissible. 
 
 "What does an insane parent transmit to his offspring? In a 
 vast majority of cases there is transmitted only a predisposition to 
 mental disease; mental disease itself is not transmitted, but an 
 impressible mental organization which, under favoring circum- 
 stances, is prone to take on diseased action. The inheritance of a 
 predisposition to mental disease does not affect unfavorably the 
 prospect of recovery in case of attack. 
 
 ' ' Insanity is not invariably developed where a predisposition 
 exists. The person who inherits such predisposition should 
 form careful habits of living. Excesses should be avoided; 
 everything which produces mental strain or worry should be 
 scrupulously shunned, and the individual should, as far as pos- 
 sible, be contented to lead a quiet life, subjected to the fewest 
 possible disturbing influences." 
 
 Such testimony ought to relieve, in good measure, 
 those who may have been unduly anxious on account 
 of some real or supposed inherited tendency. At the 
 same time, the imperative necessity of taking all pos- 
 sible precaution against uncalled-for exposure to phy- 
 sical exhaustion, or nervous and- mental excitement, 
 should be impressed upon them and upon their friends.
 
 128 TWENTY-FIVE YEARS 
 
 CHAPTER XVI. 
 INSANITY AND CRIME. 
 
 It will appear to border closely on presumption for 
 one who is neither a lawyer, physician, or a specialist, 
 to express with much freedom opinions touching the 
 responsibility of the insane and the treatment by the 
 courts of person's charged with crime and defended 
 on -the plea of mental disease. 
 
 It is freely conceded that only those who have 
 made insanity a subject of profound study, and have 
 had opportunities to observe, for protracted periods 
 and under favorable conditions, the conduct of the 
 insane and the peculiar and varied manifestations of 
 disordered mental and moral activity, are fully con> 
 petent to prescribe and apply tests of responsibility 
 in cases where misconduct or criminal acts are laid to 
 the charge of persons suspected of mental unsound- 
 ness. The question of responsibility in such cases is 
 confessedly surrounded with very great and grave 
 difficulties, and justice and humanity unite in de- 
 manding of those who are to give answer to it the 
 utmost candor, the most unwearied patience, and a 
 willingness to be instructed even at the risk of 
 acknowledging previous ignorance. 
 
 The problem is rendered more perplexing to the 
 ordinary observer, and its solution is made more
 
 WITH THE INSANE. 129 
 
 hopeless, by the fact that in cases which come before 
 the courts specialists, apparently equally well-in- 
 formed and equally well-intentioned, give opinions 
 and reach conclusions of a widely different character. 
 One is very forcibly reminded of the antiquated 
 adage, ""When doctors disagree." The confusion is 
 still further confounded by contentions, charges, and 
 counter-charges, between the medical and legal pro- 
 fessions. The doctors propose one standard of 
 responsibility and the lawyers insist upon another. 
 In the din which often arises the common people not 
 unnaturally conclude that nothing is positively 
 known about the matter, and fall back contentedly 
 and complacently upon the traditional notions which 
 they have inherited from the ignorance and prejudice 
 of the past. Juries composed of such people, and 
 perhaps unconsciously influenced by the passions and 
 sentiments of the hour, alternate in their verdicts 
 from severity which borders on barbarism to leniency 
 which more than borders on impunity to disorder and 
 crime. In one case a man obviously insane is con- 
 demned to death, while in another case a criminal 
 worthy of the severest punishment is set free on the 
 convenient but shallow plea of "emotional insanity." 
 The height of absurdity was reached, and the mock- 
 ery of legal forms was completed, when a jury 
 declared, in substance, " We find that the accused 
 was entirely sane the moment before and the moment 
 after the act [deliberate killing] was committed, but 
 
 9
 
 130 TWENTY-FIVE YEARS 
 
 we have doubt of his sanity at the instant when the 
 deed was done." The prisoner was allowed the bene- 
 fit of the doubt, and turned loose into the community 
 to repeat the act, if a similar impulse should seize 
 upon him under some real or supposed provocation. 
 
 Under all the circumstances it seems to me to be 
 within the limits of forgiveness if an untrained lay- 
 man, a mere common observer, should venture the 
 expression of an opinion or the utterance of some 
 inquiries. I can not resist the impression that in the 
 treatment of insanity and the insane, the legal profes- 
 sion and the courts of law have not kept abreast of 
 the general progress of the age. The impression may 
 be a false one, but it is, nevertheless, deeply fixed. 
 The scenes connected with the trial of the assassin of 
 President Garfield, and scenes connected with the 
 trials of less famous criminals, have served to inten- 
 sify this into a nearly settled opinion. The opinion 
 or belief of an obscure individual is of little impor- 
 tance, but if it should be true that the same impres- 
 sion is fastening itself upon the minds of the great 
 body of fairly intelligent citizens, the opinion, or 
 belief, becomes of consequence to the law-making and 
 law-administering powers. Trials can not degenerate 
 into broad farces and courts into objects of ridicule 
 and contempt without serious danger to the highest 
 interests of the whole body of the people, to say 
 nothing of the safety of the unfortunate or the crimi- 
 nal. It may be of service here, to the unprofessional
 
 WITH THE INSANE. 131 
 
 reader, to borrow some statements of the principles 
 and rules by which the courts have been, and still are, 
 governed in the administration of justice in cases 
 involving, or supposed to involve, the question of 
 insanity. 
 
 In the seventeenth century, Lord Hale, one of the 
 most learned and upright judges of England, said : 
 
 ' ' There is a partial insanity and a total insanity. Some per- 
 sons that have a competent use of reason in respect of some 
 subjects, are yet under a particular dementia in respect of 
 some particular discourses, subjects, or applications; or else it 
 is partial in respect of degrees; and this is the condition of very 
 many, especially melancholy persons, who for the most part dis- 
 cover their defects in excessive fears and griefs, and yet are not 
 wholly destitute of the use of reason; and this partial insanity 
 seems not to excuse them in the committing of any offence for its 
 matter capital ; for, doubtless, most persons that are felons of 
 themselves and others are under a degree of partial insanity 
 when they commit these offences. It is very difficult to define 
 the invisible line that divides perfect and partial insanity; but it 
 must rest upon circumstances duly to be weighed by judge and 
 jury, lest, on the one side, there be a kind of inhumanity towards 
 the defects of human nature , or, on the other side, too great an 
 indulgence given to great crimes." 
 
 It is assumed in this declaration that an insane 
 man may properly and justly be punished for any 
 acts committed, provided his insanity is partial and 
 not total. Under this principle a large majority, 
 indeed nearly all, of those charged with crimes and 
 defended on the plea of mental disease, would be 
 classed among the partially insane. At a later pe-
 
 132 TWENTY-FIVE YEARS 
 
 riod, in 1723, the doctrine of Lord Hale was expressed 
 in plainer language by Justice Tracy. He said : 
 
 " It is not every kind of frantic humour, or something unac- 
 countable in a man's actions, that points him out to be such a 
 madman as is exempted from punishment. It must be a man 
 that is totally deprived of his understanding and memory, and 
 doth not know what he is doing, no more than an infant, than a 
 brute or a wild beast; such a one is never the object of punish- 
 ment. " 
 
 This was very naturally known as "the wild 
 beast theory." 
 
 The unprofessional mind is perplexed to discover 
 that the same rule in relation to insanity did not 
 apply to both criminal and civil cases. A person 
 might be adjudged unfit to take proper care of him- 
 self, or to manage his business affairs, to make 
 bargains or to dispose of property, and yet be hanged 
 for murder or imprisoned for theft. This is ex- 
 pressly stated by Chief Justice Mansfield in a 
 remarkable trial which occurred in 1812. He says, 
 " Upon the authority of the first sages in the country, 
 and upon the authority of the established law in all 
 times, which has never been questioned, that although 
 a man might be incapable of conducting his own 
 affairs, he may still be answerable for his criminal 
 acts, if he possess a mind capable of distinguishing 
 right from wrong." There is in this declaration a 
 slight advance from the doctrine of Lord Hale. Such 
 knowledge as the infant or the brute may be supposed
 
 WITH THE INSANE. 133 
 
 to have, is exchanged for the somewhat higher knowl- 
 edge of "right and wrong." 
 
 Yet most unfortunately this knowledge is of a gen- 
 eral and not of a specific character. That is, the 
 person is held responsible if he can distinguish right 
 from wrong in ordinary affairs, no matter how con- 
 fused or warped his judgment may be in respect to 
 the crime with which he is charged. Lord Mansfield 
 himself, in speaking of a case in which a patient, 
 laboring under the delusion of having been injured, 
 takes revenge by violence, says, "If such a person 
 were capable, in other respects, of distinguishing right 
 from wrong, there was no excuse for any act of 
 atrocity which he might commit under this descrip- 
 tion of derangement. It must be proved beyond all 
 doubt that at the time he committed the atrocious 
 act, he did not consider that murder was a crime 
 against the laws of Grod and nature." Very few, if 
 any, insane homicides could escape conviction for 
 murder in a court governed by this rule. The over- 
 mastering power of a delusive idea, driving one on 
 over the opposing forces of knowledge, judgment, 
 conscience, and natural affection, is not recognized. 
 The point upon which the whole question of respon- 
 sibility depends has thus far eluded the legal mind. 
 In commenting upon the doctrine of Lord Mansfield, 
 Dr. Kay says : 
 
 "That the insane mind is not entirely deprived of this power 
 of moral discernment, but on many subjects is perfectly rational
 
 134 TWENTY-FIVE YEARS 
 
 and displays the exercise of a sound and well-balanced mind, is 
 one of those facts now so well established, that to question it 
 would only display the height of ignorance and presumption. 
 The first result, therefore, to which the doctrine leads is, that no- 
 man can successfully plead insanity in defence of crime; because 
 it can be said of no one who would have occasion for such a 
 defence, that he was unable in any case to distinguish right from 
 wrong. . . The purest minds can not express greater horror 
 and loathing of various crimes than madmen often do, and from 
 precisely the same causes. Their abstract conceptions of crime, 
 not being perverted by the influence of disease, present its hide- 
 ous outlines as they ever were in the healthiest condition; and 
 the disapprobation they express at the sight arises from sincere 
 and honest convictions. The particular criminal act, however, 
 becomes divorced in their minds from its relations to crime in 
 the abstract; and being regarded only in connection with some 
 favorite object which it may help to obtain, and which they see 
 no reason to refrain from pursuing, is viewed, in fact, as of a 
 highly laudable and meritorious nature. Herein, then, consists 
 their insanity, not in preferring vice to virtue, in applauding 
 crime and deriding justice, but in being unable to discern the 
 essential identity of nature between a particular crime and all 
 other crimes, whereby they are led to approve what, in general 
 terms, they have already condemned. It is a fact, not calculated 
 to increase our faith in the 'march of intellect,' that the very 
 trait peculiarly characteristic of insanity has been seized upon as 
 a conclusive proof of sanity in doubtful cases; and thus the 
 infirmity that entitles one to protection, is tortured into a good 
 and sufficient reason for completing his ruin." 
 
 At a later period the English judges declared that 
 " to establish a defence on the ground of insanity, it 
 must be clearly proved that, at the time of commit- 
 ting the act, the party accused was laboring under 
 such a defect of reason from disease of the mind as
 
 WITH THE INSANE. 135 
 
 Dot to know the nature and quality of the act he was 
 doing, or, if he did know it, that he did not know he 
 was doing what was wrong." 
 
 This is a long stride in advance of the rule that an 
 accused person is to be held responsible for his acts, 
 however insane he may obviously be, provided he 
 has a general knowledge of right and wrong. Unfort- 
 unately the doctrine enunciated in the statement 
 quoted was seriously modified by subsequent rules, 
 and was made less favorable to the ends of justice. 
 An English writer of high standing says of trials in 
 the English courts : 
 
 " It is notorious that the acquittal or conviction of a prisoner, 
 when insanity is alleged, is a matter of chance. Were the issue 
 to be decided by tossing up a shilling, instead of by the grave pro- 
 cedure of a trial by court, it could hardly be more uncertain. 
 The less insane person sometimes escapes, while the more insane 
 person is sometimes hanged; one man laboring under a particu- 
 lar derangement is acquitted at one trial, while another having 
 an exactly similar form of derangement is convicted at another 
 trial. No one will be found to uphold this state of things as 
 satisfactory, although there is great difference of opinion as to 
 the cause of the uncertainty; the lawyers asserting that it is 
 owing to the fanciful theories of medical men who never fail to 
 find insanity where they earnestly look for it, the latter protest- 
 ing that it is owing to the absurd and unjust criterion of re- 
 sponsibility which is sanctioned by the law." 
 
 The same language might be used in describing 
 the state of affairs in the United States and probably 
 in all civilized countries. Surely it may be pardon- 
 able to suggest that such a condition of things is
 
 136 TWENTY-FIVE YEARS 
 
 humiliating in the extreme, if not positively dis- 
 graceful to the intelligence of two of the learned 
 professions. Happily the administration of law is 
 often better than the law itself, and innocence, 
 exposed to injustice by the letter of the statute or 
 the rule, is protected by the intervention of a court 
 where the presiding justice has the humanity and 
 courage to set aside the authority of technical defini- 
 tions and antiquated rulings, and to decide in accord- 
 ance with the teachings of modern science and with 
 the spirit of an age more humane than that of Lord 
 Hale or Lord Mansfield. But the sense of right and 
 justice in individual judges is usually powerless, 
 under existing laws and rules of proceeding, to prevent 
 injustice or to correct erroneous verdicts. Some rad- 
 ical changes are needed. Only thoroughly trained 
 specialists in the law and in mental disease are com- 
 petent to suggest the details of such changes ; but it 
 may be allowable for any one whose attention has 
 been turned in that direction, to make inquiries or 
 even to express an opinion. Such inquiries and 
 expressions may help towards the formation of a pub- 
 lic sentiment which shall demand improvements in 
 the laws and in the methods of their adminis- 
 tration. 
 
 In cases of crime in which insanity is claimed as a 
 ground of defence, ought not the question of sanity 
 or insanity to be examined and determined entirely 
 apart from the question of the criminal act itself?
 
 WITH THE INSANE. 137 
 
 Let the trial of one question, the question of insanity, 
 either precede or follow the trial as to the act or 
 crime charged. Let the tribunal be one having some 
 fitness for the examination and decision of such a 
 question, and not an ordinary jury. It is no imputa- 
 tion upon the intelligence or honesty of the members 
 of an ordinary jury to say that they have no compe- 
 tency for the determination of such a question. In- 
 sanity is either itself a disease, or it is the result of a 
 disease, as much as diphtheria or typhoid fever. A 
 jury of farmers, mechanics, or merchants, would 
 hardly be expected to decide satisfactorily whether 
 an alleged case of typhoid fever were that disease 
 or some other. It is hardly less absurd to set the 
 same men to determine whether an act of brutal 
 assault is the offspring of a violent insane delusion, 
 or of an ungovernable feeling of ill-will and revenge. 
 Should not a court, when it is claimed that a pris- 
 oner is insane, or was insane at the time the offence 
 was committed, be authorized, and under some cir- 
 cumstances be required, to summon a small jury 
 of men familiar with all forms and peculiarities of 
 mental disorders, and to submit to them the simple 
 question of responsibility ? Is the prisoner of 
 unsound mind? and, if so, is the unsoundness of 
 such a character as to render him legally irresponsi- 
 ble for the supposed crime? In many cases this 
 question could be determined before any other pro- 
 ceedings were had, and if the irresponsibility were
 
 138 TWENTY-FIVE YEARS 
 
 clearly established, no further trial would be neces- 
 sary. In this way, in many cases, much time, great 
 expense, and often unwholesome excitement would be 
 saved, and the ends of justice would be easily and 
 promptly attained. 
 
 In cases where insanity is obscure or doubtful, 
 this jury of experts might be summoned to attend, 
 observe the prisoner, the witnesses, and the whole 
 proceedings during the trial as to the fact before the 
 usual jury, and, in case of conviction, might after- 
 wards render their verdict in respect to sanity and 
 responsibility. The ordinary jury takes no cogni- 
 zance of the question of insanity. It considers the 
 question of guilt or innocence as in any other case, 
 and that alone. 
 
 It is not to be anticipated that this or any simi- 
 lar method of dealing with criminals suspected of 
 insanity will be immediately adopted. Meanwhile 
 may we not hope for a less radical, but still an 
 important improvement in legal practice ? As mat- 
 ters now are, in trials involving the plea of insanity, 
 expert witnesses are employed by both sides, and 
 these witnesses are examined and cross-examined 
 very much as other witnesses are. The position is a 
 humiliating one to intelligent, honorable, and high- 
 minded gentlemen. The result does not always tend 
 to further the ends of justice. The spectacle some- 
 times becomes little less than disgraceful if the advo- 
 cates happen to be of that peculiar character fre-
 
 WITH THE INSANE. 
 
 quently found in what are known as " criminal 
 lawyers." It will be permitted, even for a very 
 common observer, to affirm that this mode of con- 
 ducting such trials ought to be changed at once. 
 
 When such witnesses are asked to give opinions, 
 they should be invited by the court itself. Questions 
 should be propounded by the court. Interrogations 
 should relate, not merely to supposed and hypothet- 
 ical cases and conditions, but to the case in hand and 
 to the prisoner at the bar. Paid advocates should 
 stand aside, whether of the prosecution or the de- 
 fence. The object is not to convict or acquit, but to 
 secure, if possible, exact justice to all parties. 
 
 It is difficult to see why so much of reform and 
 improvement might not easily be made. It is evi- 
 dent that the interests of the community would 
 thereby be better guarded, and the insane themselves- 
 be put in a position of greater safety. 
 
 It is not likely that any single principle can ever 
 be laid down by the courts, or any statement can be 
 made by specialists in the study of mental disease,, 
 which shall serve as a practical test of sanity or 
 insanity when applied by .ordinary juries, or by 
 unprofessional men in the common relations of life. 
 While it is possible that some characteristics may 
 pertain to all patients suffering from insanity, it i& 
 yet probably true that each case exhibits many 
 peculiarities of its own, and must be considered by 
 itself. The responsibility or irresponsibility of each.
 
 140 TWENTY-FIVE YEAES 
 
 accused man or woman, in whose case insanity is 
 alleged or suspected, must be determined, not by 
 specific rules, but by competent men after the fullest 
 possible investigation of all the conditions, and cir- 
 cumstances, and indications of that individual case. 
 No more perplexing problem confronts students of 
 moral philosophy and political economy and social 
 science, than the question of the responsibility and 
 proper treatment of, not only the recognized insane 
 when charged with crime, but of that large and grow- 
 ing class which inhabits a sort of borderland, where 
 insanity, and crime, and defective physical and men- 
 tal organization, and inherited evil tendencies, and 
 vile surroundings, and filthy habits all meet and 
 mingle in one common cesspool of indescribable pol- 
 lution and degradation. Civilization and society 
 must be defended against the unthrift and marauding 
 depredations of this unfortunate class. Restraints 
 must be imposed, and penalties must be inflicted ; but 
 mercy and compassion surely have some place in 
 dealing with this corrupt and corrupting mass of 
 humanity. Eestraints and penalties, as usually in- 
 flicted, have little tendency to elevate, purify, and 
 reclaim. The field is not an inviting one, but there 
 is need that it be fully explored. To what extent 
 does legal and moral responsibility attach to the 
 members of this class ? Can they be, in some way, 
 segregated, and educated, and trained up into decency 
 and manhood ? Must we have a horde of criminals
 
 WITH THE INSANE. 141 
 
 propagating itself, warring against society, a constant 
 source of danger, a standing and perpetual menace 
 against good order and prosperity ? These and kin- 
 dred questions are fast becoming of vital importance 
 to the statesman, the philanthropist, and the Chris- 
 tian, and they are crowding themselves forward and 
 demanding some sort of solution. 
 
 CHAPTER XVII. 
 CONCLUDING THOUGHTS. 
 
 Increase of Insanity. The figures of each successive 
 census seem to show an increase in the relative num- 
 ber of the insane in all the States of the Union. The 
 apparent is probably somewhat greater than the act- 
 ual increase, from the fact that more care has been 
 taken during the last decades to obtain full and trust- 
 worthy information in relation to this subject. There 
 is, also, less unwillingness on the part of relatives and 
 friends to admit the existence of mental disease in 
 their families, and to afford facilities for learning the 
 exact truth in respect to persons thus afflicted. Not 
 very far back in the past the feeling prevailed that, 
 in some unexplained way, something of disgrace 
 attached itself to this form of suffering. Under the 
 influence of this feeling men and women put their 
 friends, who had become insane, out of their own 
 sight and the sight of others, as far as possible. They
 
 142 TWENTY-FIVE YEARS 
 
 seldom spoke of them. The insane were, in many 
 cases, practically dead and buried. Unless by acci- 
 dent their existence could not be ascertained by 
 public officers. 
 
 To a considerable extent this unfortunate impres- 
 sion has been effaced. With other inherited relics of 
 old superstitions it has either entirely disappeared, 
 or, at any rate, is confined mostly to the dark nooks 
 and by-ways of society. Insanity is regarded as a 
 result of physical disease ; and this disease carries 
 with it no more of reproach or disgrace than other 
 disorders. It is possible, therefore, to obtain statistics 
 relating to the insane, upon which a fair degree of 
 reliance may be placed. 
 
 Another reason for this reported increase readily 
 suggests itself to one at all acquainted with former 
 and present methods of treating the insane. Under 
 the system of neglect and barbarism practiced in not 
 very remote times, all except those of hardy and 
 vigorous constitutions soon died. There was no 
 accumulation in private places of detention, or in 
 public receptacles, of the weak and feeble. The con- 
 dition of affairs is now entirely different. More 
 humane and wiser treatment lengthens, by many 
 years, the lives of large numbers of incurable patients. 
 A few of the inmates of the Michigan Asylum have 
 been there twenty-five years, and probably the older 
 institutions have patients who have survived for a 
 still longer period. In consequence of this preserva-
 
 WITH THE INSANE. 143 
 
 tion of chronic invalids, the increase in the relative 
 number of the insane, without doubt, appears to be 
 greater than it really is. 
 
 But after making all possible reduction from the 
 results of census figures, for the reasons mentioned 
 and for others which might be given, it remains true, 
 beyond reasonable doubt, that mental disease has 
 increased during the last half-century, and is still 
 increasing. The rate of increase, while not such as to 
 give occasion for serious apprehension, is sufficient to 
 challenge attention and to demand a careful examina- 
 tion of probable causes. It is not within my purpose 
 to enter upon any extended discussion of these causes. 
 Some of them are easy to discover, and have been 
 necessarily touched upon in previous chapters. Others 
 are more obscure, and their profitable discussion 
 would call for knowledge which I can not claim to 
 possess. Too many crude and half-digested theories 
 have already been put forth by persons whose zeal 
 and good intentions have greatly outrun their wisdom 
 and discretion. One may be pardoned, however, for 
 hesitating to admit that insanity is a necessary 
 product of civilization. 
 
 Prevention of Insanity. The true province of gov- 
 ernment is to prevent rather than to punish crime. 
 So, it seems to me, the great purpose of medical 
 science and of physicians should be the prevention 
 rather than the cure of disease. This is especially
 
 144 TWENTY-FIVE YEARS 
 
 true in respect to insanity. The erection and sup- 
 port of asylums, in addition to institutions of a penal 
 and reformatory character, are imposing heavy bur- 
 dens upon the community. It is impossible to 
 provide accommodations enough to meet the growing 
 demands. One asylum is hardly completed before 
 another is called for. As a matter of mere economy, 
 to say nothing of the question of humanity, the State 
 could well afford to provide for the most extensive 
 and thorough investigation into the causes and con- 
 ditions of mental disease, and the means and 
 measures by which it may be prevented. It would 
 be for the economical interests of the State to publislj 
 the results of such investigations, and to employ 
 efficient agencies to circulate this information among 
 the people. It is easy to discover difficulties in the 
 way of prosecuting a work of this kind, but they 
 are not insurmountable. It is morally certain that 
 ignorance is responsible for a large percentage 
 of suffering in this as well as in other directions. 
 While waiting for competent authorities to make 
 other and more extended investigations, it will be 
 profitable for us to sum up briefly some of the con- 
 clusions already reached, and to make practical use 
 of the lessons which they teach. 
 
 Intermarriage of near Relatives, etc. A very wide 
 diversity of opinion is found, in works of medical 
 and other writers, in respect to consanguineous mar-
 
 WITH THE INSANE. 145 
 
 riages. Some affirm, with great positiveness, that 
 the effects of such marriages upon offspring are gen- 
 erally, if not always, harmful. Others question, if 
 they do not deny, the correctness of this conclusion. 
 The predominance of testimony, however, is decid- 
 edly against the advisability of intermarriage by 
 persons nearly related by blood. If it were certain 
 that the parties to such a union were both perfectly 
 sound in every respect, in body and mind, it might 
 reasonably be expected that the offspring would have 
 no unfortunate physical or mental inheritance. Such 
 cases, if ever found, are very infrequent. The dan- 
 ger is that the husband and wife, coming, at so little 
 remove, from the same stock, will have the same or 
 similar diseased tendencies. In the great majority of 
 instances this will undoubtedly be true. Under 
 such conditions the children can hardly escape inher- 
 ited tendencies to disease of body, and probably of 
 mind also. Common observation affords abundant 
 confirmation of the unhappy results of such unions. 
 For the sake of posterity, public sentiment, if not 
 statute law, should render marriages of this kind 
 impossible. 
 
 But some other marriages are fraught with almost 
 as much of probable danger to offspring as those 
 between persons near of kin. Two individuals with 
 similar and highly nervous organizations incur great 
 risk in forming the marriage relation with each other. 
 
 They should seek as partners persons of different 
 10
 
 146 TWENTY-FIVE YEARS 
 
 temperaments and of strong and steady nerves. It is 
 little short of positive madness for those who have 
 inherited an insane tendency to intermarry. Under 
 such circumstances this tendency is much more likely 
 to be fully developed in the parties themselves, and 
 it would be almost a miracle if their children should 
 escape some permanent form of mental unsoundness. 
 Love is proverbially blind and deaf, and the teach- 
 ings of wisdom and experience go for nothing when 
 confronted by passion and fancy and personal inter- 
 est; but it is none the less an imperative duty to use 
 all the means within one's power to enlighten the 
 ignorant, to excite the attention of the heedless, and 
 to warn the wilful and reckless. Some may be saved : 
 some will be saved ; though many will doubtless 
 "pass on and be punished," as the foolish have been 
 doing in all the ages. It were better for themselves, 
 for their friends, and for the world, if some individ- 
 uals should remain even as Paul, unmarried, though 
 for quite another reason. Says Dr. Godding; "I do 
 not expect to recover love from his blindness, but all 
 the more I recognize how far up in ' the glorious pro- 
 cession of saints and martyrs ' some souls will here- 
 after stand whose lives, like their devotions, have been 
 single, whose silent purpose has been that the inher- 
 ited taint of their blood should die out of the world 
 with them."
 
 WITH THE INSANE. 147 
 
 Treatment of the Young. This topic necessarily 
 received some consideration in a previous chapter, 
 but its importance will justify a few additional 
 remarks. Many serious nervous and mental diseases 
 have their origin in early childhood, or in that critical 
 period when childhood verges into maturity. In 
 many cases children are permitted practically to pre- 
 scribe their own diet. x Subject to no steady and 
 efficient control, gratified in every caprice for the 
 sake of immediate temporary quiet, they are allowed 
 to eat highly seasoned food and to drink tea and 
 coffee and, perhaps, other more stimulating and ex- 
 citing liquids. In early youth they are taken into 
 what is called society, are cheated of needed rest and 
 sleep by late hours, and are frequently placed in cir- 
 cumstances calculated to over-tax, in many ways, a 
 delicate and only partially developed physical organ- 
 ization. The brain, and the nervous system generally, 
 are especially liable to receive permanent injury at 
 this p'eriod. Precocious children are exposed to 
 additional danger from an unwise and almost unpar- 
 donable stimulating of their brain activity by parents 
 and teachers. I am aware that this is merely the 
 repetition of a tale more than "twice-told." Those 
 who have need to receive warning will very likely 
 read and smile, if they read at all, and still believe 
 that such writing is mostly " cant." These are, never- 
 theless, words of "truth and soberness." "I speak 
 that which I do know, and testify to that which I
 
 148 TWENTY-FIVE YEAES 
 
 have seen." I recall the dull, vacant stare of more 
 than one or two patients, mere boys and girls, in the 
 Asylum, whom this criminal folly had transformed 
 from bright, quick, sparkling pets of the household 
 into hopeless imbeciles. This is one of the sins for 
 which there is little room for forgiveness, unless 
 repentance is deep and bitter, and sought with many 
 tears. While teachers are guilty, the largest measure 
 of responsibility and blame in cases of this kind rests 
 upon parents. 
 
 It is universally agreed by intelligent witnesses, 
 that the period of approaching puberty is a season of 
 peculiar exposures and danger to girls. I do not 
 write as a physician, but as a father of grown-up 
 daughters, and as an observer of many years in 
 schools and elsewhere. I do not sympathize pro- 
 foundly with the periodic outcries against school 
 arrangements and requirements which are made re- 
 sponsible for the largest ghare of the ills which afflict 
 female humanity. Let teachers, and schools, and 
 studies, and examinations bear all the opprobrium 
 which belongs to them and it is freely conceded that 
 not a little is due to them ; yet the homes and 
 mothers and society must consent, however unwil- 
 ling, to be held responsible for most of the suffering 
 entailed upon maturing girlhood. The demands of 
 society are often more imperative and more exacting 
 than those of the teacher, however unwise the latter 
 may happen to be in his requirements. All parties
 
 WITH THE INSANE. 149 
 
 are in fault, and mutual crimination and recrimina- 
 tion will not "atone for the past nor give proper 
 guaranties for the future." 
 
 If the evils produced by bad management at this 
 period were confined to the body, there would be less 
 reason for earnestness and plainness of speech ; but 
 many cases of insanity can be traced pretty directly 
 to unnecessary exposure, unreasonable demands, and 
 improper treatment at this time. Physicians, well-in- 
 formed mothers, and experienced and trained nurses 
 can give all needed information in respect to this por- 
 tion of a girl's life. Boys need oversight, restraint, 
 caution, and proper instruction at this period, but 
 their exposure to physical and mental harm is less 
 than that of the sisters in the family. In respect to 
 moral danger, the exposure is probably about equal to 
 both sexes. 
 
 General Care of Health. It is not proposed to 
 encroach, under this topic, upon the province of 
 the medical adviser, in any measure. Some things 
 belong in common to all persons of ordinary intelli- 
 gence, and especially to those in any profession 
 whose attention has, by force of circumstances, been 
 directed to them. 
 
 I am persuaded that one of the most essential con- 
 ditions of the preservation and enjoyment of good 
 health is not to think too much and too constantly 
 about the matter of health and sickness. This is as
 
 150 TWENTY-FIVE YEAKS 
 
 true of the mind as of the body, and is of special 
 importance in cases of inherited tendencies. It is a 
 very common saying that under some circumstances 
 "we always find what we look for." If the object of 
 our search does not exist in reality, the imagination 
 will easily create it, oftentimes in fearfully exagger- 
 ated form. If one expects his dinner to " set hard " 
 in the stomach, and watches intently for coming dis- 
 comfort, he will probably not watch in vain. Should 
 something happen to divert his attention for an hour 
 or two from the subject of food and digestion, he 
 may escape all inconvenience and pain. If one 
 expects to find some symptom of mental disorder 
 which a parent may possibly have transmitted, and 
 scrutinizes every thought and feeling, looking at 
 everything in the most unfavorable light, he will 
 probably discover that for which he is waiting, at 
 first only in fancy, but soon in bitter reality. This 
 process of introspection, continued day after day, per- 
 haps month after month, finally turns the action of 
 the mind into the direction of the morbid tendency. 
 The person has brought upon himself the very evil 
 which he feared ; and has done this in the most expe- 
 ditious manner and in accordance with the well- 
 known laws of mental activity. The inclination to 
 " brood " over anticipated feelings is, in some cases, 
 the cause and, in other cases, the consequence of 
 aberration of mind. In either case safety demands 
 that the inclination shall be vigorously and persist-
 
 WITH THE INSANE. 151 
 
 ently resisted by all the means in one's power. The 
 only effectual resistance is the pre-occupation of the 
 mind by other subjects. To secure this is sometimes 
 extremely difficult, especially if the current of mor- 
 bid thought and feeling has become thoroughly 
 established. Each individual case has its own pecu- 
 liarities, and no general rule for treatment can be 
 suggested. The advice of an intelligent student of 
 nervous and mental diseases should be sought in all 
 serious and doubtful cases. 
 
 Another condition of mental as well as of physical 
 health is sufficient sleep. Sleeplessness is a signal of 
 danger. If long-continued, it can hardly fail to 
 result in serious harm. The nervous force becomes 
 rapidly exhausted; the power of self-control is 
 weakened, and the mind is easily unbalanced. The 
 human system requires and must have periods of 
 complete repose, and other seasons when relaxation 
 can be secured by interchanging one mode of activity 
 for another. Only in sleep can absolute rest be 
 obtained ; and whoever defrauds nature and himself 
 of the requisite hours of sound and refreshing sleep, 
 is sure, in the end, to pay a terrible penalty. 
 Shakespeare's lines are as true as they are familiar : 
 
 "Sleep, that knits up the ravell'd sleave of care, 
 The death of each day's life, sore labor's bath, 
 Balm of hurt minds, great nature's second course, 
 Chief nourisher in life's feast."
 
 152 TWENTY-FIVE YEARS 
 
 It is pretty generally agreed that, while no abso- 
 lute rule can be given, the average time required by 
 the ordinary adult is not less than eight hours of the 
 twenty-four. Some persons need even more, and a 
 few can retain good health with less. The demand 
 of the system for sleep is modified by age and, to 
 some extent, by employments. It was formerly 
 taught that brain-workers could satisfy the wants' of 
 nature with fewer hours of sleep than men engaged 
 in mere manual labor. This idea has been aban- 
 doned, and it is now universally conceded that 
 vigorous mental activity exhausts the vital force and 
 the nervous energy more than muscular exercise, and 
 calls fora corresponding increase in the time set apart 
 for rest. 
 
 The quality of sleep is believed to be of as much 
 importance as the quantity. The most refreshing 
 sleep is that of which memory gives us no account 
 when we are awake, a quiet, dreamless, uncon- 
 scious state of complete repose. More, if possible, 
 than others, the student, the teacher, and brain-work- 
 ers in general, have need of this unconscious and 
 absolute sleep. 
 
 The so-called sleep during which one continues the 
 mental work with which he has been occupied 
 during the day and evening, or with which he is 
 excited and harassed by continuous and half-waking 
 dreams, and tormented by dangers and difficulties, 
 brings little real rest, and has little restorative power.
 
 WITH THE INSANE. 153 
 
 Such, a condition, if long permitted, can not fail to 
 produce serious evils. A person suffering in this 
 way should question his habits of life and his 
 methods of work, in order to discover and remove 
 the causes of this unnatural state of body and mind, 
 before they have wrought permanent and irreparable 
 damage. 
 
 So far as experience and observation enable me to 
 judge, no general rules of much value can be sug- 
 gested for "going to sleep." Each individual will 
 require advice suited to his own peculiarities, and to 
 the immediate causes of his sleeplessness, and to the 
 conditions and circumstances by which he is sur- 
 rounded. Resort to sleep-producing drugs should be 
 had only in extreme cases, and then under the direc- 
 tion of a wise medical adviser. 
 
 Under ordinary circumstances few things contrib- 
 ute more to mental health than cheerfulness and 
 proper mental activity. A cheerful, hopeful disposi- 
 tion is so much a native endowment that it may be 
 doubted whether one can have this happy temper 
 unless it has come to him as a blessed inheritance. 
 Observation, however, justifies the conclusion that, by 
 persistent and rightly directed effort, a person may 
 attain to a good degree of this health-giving and 
 health-preserving quality of mind. 
 
 If one side of the path along which we are obliged 
 to go day by day, is bordered with flowers and all 
 beautiful things, and the other side with repulsive
 
 154 TWENTY-FIVE YEAKS 
 
 and disgusting objects, it is within our own power to 
 choose which we will see. It is as easy to look one 
 way as the other. It is as easy to be charmed and 
 delighted as it is to be disgusted and pained. Even 
 if the classes are intermingled upon the same side, it 
 is still largely left for us to determine upon which the 
 the eye shall feast itself. Real human life has much 
 the same possibility of selection; and the choice 
 which one makes goes to determine very largely the 
 habitual tone and spirit of his mind. Some persons 
 insist on seeing and remembering only the disagree- 
 able incidents of a journey, only the faults and foi- 
 bles of their friends, and only the inconveniences and 
 discomforts of their surroundings. Others have a 
 native or acquired faculty of discovering and treasur- 
 ing up things just the reverse of these. It is possible 
 to cultivate either of these tendencies, and thus to 
 cultivate cheerfulness or its opposite. 
 
 It will not be questioned by any intelligent thinker 
 that proper mental activity must be a condition of 
 mental health as certainly as appropriate physical 
 exercise is a condition of bodily vigor and strength. 
 As surely as an arm unused fails to develop in pro- 
 portion and harmony with other properly exercised 
 members of the body, and soon becomes practically 
 useless, so surely any unemployed intellectual faculty 
 becomes dwarfed and powerless. Allow all the 
 faculties to lie dormant, or to be exercised only 
 in a dull, tread-mill round of petty duties, into which
 
 WITH THE INSANE. 155 
 
 no change or variety ever comes, every succeeding 
 day being an exact reproduction and repetition of 
 yesterday, and mental life and vigor will, in a major- 
 ity of cases, gradually become enfeebled, and in some 
 cases the man or woman will become a hopeless, and 
 usually a harmless imbecile. If to this mental stag- 
 nation be added hard, continuous, and exhausting 
 physical labor, deprivation of congenial society, and 
 neglect on the part of friends, the process of mental 
 degeneration will be hastened, and the result will be 
 more profound and pitiable wretchedness. Not a few 
 of the inmates of asylums have found their way to 
 these institutions along this cheerless track, in conse- 
 quence of the ignorance or insensibility of near rela- 
 tives and friends. Most of these sufferers are women, 
 many of them are wives and mothers. Dr. Stearns 
 gives an illustrative example in the case of a mother 
 of eight children brought by her husband to the asy- 
 lum of which he was in charge. The husband was at 
 loss to conceive any possible cause for the insanity of 
 his wife. In speaking of her he said, "Her is a 
 most domestic woman, is always doing something for 
 her children ; her is always at work for us all ; never 
 goes out of the house, even to church on Sundays ; 
 her never goes gadding about at neighbors' houses, 
 or talking from one to another ; her always had the 
 boots blacked in the morning ; her has been one of 
 the best wives and mothers, and was always at home." 
 A more graphic description of mental suicide, if the
 
 156 TWENTY-FIVE YEARS 
 
 course of life was altogether voluntary on the part of 
 the wife, or of mental homicide, if the manner of 
 living was compelled, directly or indirectly, by the 
 husband, could hardly be written. 
 
 If either physical, or mental, or even moral health is 
 to be preserved, something of variety, of relaxation, 
 of amusement and recreation, must be provided to 
 break up the dull monotony of an unchanging round 
 of daily labors, which come and go with the unbroken 
 regularity of day and night. Every impulse of the 
 soul cries out against this everlasting sameness, and 
 struggles, in some way, to be rid of it as of a fright- 
 ful nightmare. 
 
 Of the many other particulars which might find 
 place under this head, I will, in closing, mention 
 only one : Cultivate a spirit of faith and trust. ID 
 the nature of things, as we find them, " offences will 
 come," occasions of distrust, doubt, perplexity. 
 What we know is bounded, on all sides, by that 
 which we do not and can not know fully and posi- 
 tively ; we can, at best, only believe and hope ; and, 
 in some directions, we find ground merely for con- 
 jectures and guesses. It is not difficult to keep one's 
 self in a state of perpetual disquiet and unrest by 
 grasping after that which is quite beyond our reach, 
 by striving to comprehend the incomprehensible, to 
 know the unknowable, and to fathom the unfathom- 
 able. Proper mental effort is not to be discouraged, 
 nor is the disposition to search and inquire to be
 
 WITH THE INSANE. 157 
 
 blamed; but while all things may be lawful, some 
 things are inexpedient for individuals of certain 
 temperaments and organizations. When the bound- 
 ary line of the sure and certain has been reached, it 
 will be safer and better for the most of us to pause, 
 turn back, and rest in the assurance that He, whose 
 care extends to the lilies and the sparrows, will not 
 leave us unprotected. Faith in God and in humanity, 
 trust in Providence and in friends, will often save the 
 mind from wreck and the soul from despair. 
 
 "O Lord! how happy should we be, 
 If we could leave our cares to Thee, 
 
 If we from self could rest, 
 And feel at heart that One above, 
 In perfect wisdom, perfect love, 
 
 Is working for the best. 
 Oh ! would these heartless souls of ours 
 The lesson learn from birds and flowers, 
 
 And learn from self to cease ; 
 Leave all things to our Father's will, 
 And in His mercy trusting still, 
 
 Find, in each trial, peace."
 
 
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