540 



INSANITY. 



and very few attempt to escape. The recoveries 

 here have been so numerous and rapid, that the 

 fame of the institution has extended far, and many 

 persons of distinction have been sent to it for re- 

 covery. 



In Bavaria and Saxony, much has been done by 

 government for the welfare of the insane. In Den- 

 mark and Sweden there are several lunatic hospi- 

 tals. Those in the former, and especially the one 

 at Copenhagen, merit high commendation. Many 

 of the large towns of Italy have one or more asy- 

 lums for lunatics. At Milan there is a well 

 conducted lunatic hospital, containing near 500 

 patients, most of whom are employed in gardening 

 and in manufacturing clothing. At Genoa, part 

 of the hospital of incurables is given up to the 

 insane. About 250 are kept here in a wretched 

 condition. 



At Florence, the average number of the insane 

 in the Spedale di Bonifacio, the hospital appro- 

 priated to them, is about 300. The patients are 

 clothed alike, in white woollen dresses, and have 

 their apartments kept very neat. When it becomes 

 necessary to confine a patient, his hands are placed 

 in a wooden case, and bound to the abdomen by a 

 strap around the body. Furious patients are con- 

 fined in dark rooms with well padded walls. The 

 darkness is thought to be very serviceable in ren- 

 dering them more tranquil. The management of 

 this institution appears to be good. Many of the 

 male patients are employed in gardening, or at their 

 trades, and the women in knitting and spinning. 

 At Rome, the hospital for lunatics consists of two 

 separate buildings, one for each sex. The number 

 of patients is about 400. The most furious are 

 confined by chains. All varieties of insanity are 

 mixed together, and no moral measures are re- 

 sorted to in their treatment. At Naples is the 

 celebrated Aversa, an hospital for lunatics. The 

 sexes are here in different buildings, above 200 in 

 each. Great regularity prevails throughout the 

 institution. On ringing a bell, the patients rise, 

 breakfast with decorum, and the more quiet are 

 present at religious worship. Though the advan- 

 tages of this institution are said to have been ex- 

 aggerated, it is the most extensive and best regu- 

 lated hospital for the insane in Italy. 



In Germany, some of the lunatic hospitals are well 

 conducted, and others not so. At the one in Berlin, 

 containing 150 patients, no moral treatment appears 

 to be adopted. There being no grounds for exer- 

 cise, the patients are constantly confined to the 

 house. At Sonnenstein, about four leagues from 

 Dresden, there is a government establishment for 

 insane patients, and the most celebrated and best 

 conducted institution in Germany, if not in Europe. 

 It consists of an ancient castle, situated on a hill, 

 with extensive adjacent grounds. The number of 

 patients is about 200 ; most of whom are occupied 

 in good weather out of doors, in walking about the 

 grounds, cultivating flowers, digging, &c. The, 

 women have a flower-garden in their department, 

 which serves to occupy and amuse many of them ; 

 and others sew, knit, and spin. None are confined 

 to the house ; even the most furious patients are 

 allowed to walk about with the others, with 

 cloaks that conceal the apparatus that confines 

 their hands. This measure is said to tranquilize 

 them more than any thing else. The whole estab- 

 lishment is kept extremely neat, and contains 

 workshops, a saloon of amusement, with books, 

 a piano, draught boards, and a billiard room. At 



a distance from the large building, in a lovely gar- 

 den at the base of the hill, is the house for the 

 convalesoents, furnished with musical instruments, 

 and other things for the amusement of those who 

 are recovering 



A few miles from Bonn is another excellent 

 hospital for lunatics, on the same plan as the one 

 at Sonnenstein. It contains about 200 patients. 

 Dr Jacobi is the superintending physician, and 

 resides in an adjoining house. 



In the United States, hospitals exclusively for 

 the insane are of quite recent origin. That estab- 

 lished by the Society of Friends near Frankford, 

 in the vicinity of Philadelphia, in 1817, may be 

 considered the first ; though a separate building 

 was allotted to those at the New York hospital in 

 1808. But previous to this, the general hospitals 

 of Philadelphia and New York received lunatics. 

 Ever since the establishment of the Pennsylvania 

 hospital in 1752, lunatics have been received there 

 as patients, though not until 1796 was a part of 

 the building exclusively appropriated to them. At 

 this time upwards of seventy rooms were opened 

 for their accommodation. From its establishment 

 in 1752 until 1836, 4116 lunatics were received, 

 of which number 1349 were cured, 810 were re- 

 lieved, and 548 died. More than twice as many 

 males as females have been admitted to this hos- 

 pital. 



Too much attention cannot be given by the pro- 

 per authorities to the prevention of abuses in 

 lunatic hospitals. There are no institutions where 

 abuses are more likely to arise ; none where they 

 are more difficult to detect. This the history of 

 such institutions, in England and other countries, 

 but too painfully testifies. Some patients are fre- 

 quently so violent and vindictive, that it requires 

 great command of temper in their overseers not to 

 retaliate sometimes; while others, instigated by 

 appetite and passion, increased by their insanity, 

 are perpetually on the watch to seduce those ap- 

 pointed to guard them, from their duty. Attend- 

 ants of the most unblemished moral character, and 

 remarkable for kind disposition, for calmness and 

 intelligence, should be procured, and well instructed 

 in their responsible duties; and be induced by proper 

 compensation to devote themselves perpetually to 

 the care of the insane. 



Notwithstanding the attention hitherto given to 

 the subject of insanity, much still remains to be 

 learned. The medical superintendents of the in- 

 stitutions for the insane will have it in their 

 power to add essentially to our knowledge of this 

 important disease. Much, we have no doubt, is 

 yet to be learned by autopsical examinations, made 

 with the carefulness and minuteness which dis- 

 tinguish modern researches in pathology. It is 

 already rendered probable, that in all cases of 

 insanity there are specific alterations of the brain. 

 These, with the symptoms of the disease, should 

 be accurately ascertained and described. At the 

 same time, the treatment adopted, and its effects, 

 should be faithfully recorded, and occasionally 

 made public. It is gratifying, to be sure, to learn 

 from the Reports of Lunatic Asylums, that many 

 of the insane are cured; but surely it would be 

 more gratifying, and of far greater utility to the 

 public, to be informed what were the means which 

 produced such results. Is separation from home, 

 from relatives and acquaintance, all that is required 

 for the cure ? If so, this should be known. Many 

 would prefer, and in many cases it would be bet- 



