BELIEVING that, as Homoeopathists, we are all interested in the work done by our public institutions, I have brought together, in the following paper, certain statistical facts concerning one of the most prominent HOmoeopathic institutions in the State of New York -the Middletown State Homoeopathic Hospital.
Your attention is invited to the results, along certain lines, of insanity under Homoeopathic treatment, as seen at the above-named hospital during the last nineteen years.
The Middletown State Homoeopathic Hospital was the first institution of its kind in the world, and though several other States now have Homoeopathic hospitals for the insane, it still remains the most extensive Homoeopathic institution of its kind.
This hospital was opened for patients in April, 1874, the first patient being received May 7, 1874. During the balance of that hospital year, there were treated a total of 69 patients. During the last hospital year, ending September 30, 1892, there were treated 1104 patients.
The average number under treatment during the last nineteen years has been 323. To care for these patients, the daily census at present being about 100, requires large buildings, valued at over 81,000,00; a medical superintendent and staff of six physicians-five men and one woman; about 150 male and female nurses, and other employees enough to swell the number of 200; making the total number resident at the hospital, including patients and employees, about 1200.
The establishment was maintained last year at a cost for current expenses of 168, 292, the income for this purpose being derived from amounts paid by counties and private individuals for the care of patients.
Witnessing the growth of this, and other great State and municipal hospitals for the insane throughout the land, we are led to inquire if insanity is not rapidly increasing?.
The last census of the United States discloses an increase during nine years previous to 1890 of 41,330 insane persons in public and private asylums, being an increase of 73,53 per cent. over that of the previous census. Concerning this fact, however, the superintendent of the census says: “The percentage of increase, when compared with the percentage of increase of population in the last decade-namely, 24.86 per cent. -does not indicate an increase in the proportion of insane persons to the population, but rather a great increase in the amount of asylum accommodation provided, and a willingness on the part of the public to make a full use of all the facilities thus provided.” [Robert P. Porter, Census Bulletin, May 9, 1891, p. 1.
Just here we digress to remark upon the misleading nature of statistics when not properly interpreted. Most of us would have inferred that an increase of 41,330, or 73,53 per cent., in the asylum population during nine years might be construed into a warrant for the belief that insanity was increasing; but the kind-hearted superintendent of the census allays our fears, and assures us that this means simply that the people have built more asylums, and are willingly patronizing them. Thus early we learn the lesson that it is unsafe to roam in statistical fields without a guide.
The whole number of patients admitted to the Middletown State Homoeopathic Hospital during nineteen years was 3629, of whom 2775 were discharged-1352 having recovered. Analyzing these recoveries, we find one very important fact-a fact well worth remembering, one in which all alienists are agreed, and which, after all allowances have been made, statistics seem to confirm- namely, that a majority of recoveries among the insane come from among those patients who are put under hospital treatment and regimen early. Of those who came under treatment during the first six months of disease, over 53 per cent. recovered; while still earlier hospital treatment gives still better results.
On the contrary, the longer treatment is delayed, the smaller does the percentage of cures become. So that, it may be considered as true, that recovery from insanity is in an inverse ratio to the duration of the disease. Still further analysis shows that 76 per cent. or more than three-fourths of those who recovered did so in less than one year; while 48 (per cent.?) of the number recovered in less than six months, which would seem to show very clearly that the chances of recovery diminish quite rapidly after the expiration of the first year of the disease.
Of the different forms of insanity, acute melancholia has been the most numerous, there having been 907 cases, with a recovery rate of 56 per cent. Cases of acute mania, while not quite so numerous , have given a larger number of recoveries, namely, 69 per cent. There have been treated 449 cases of subacute mania, of whom 201, or 45 per cent., recovered. Under the head of subacute mania are included cases of paranoia. Of acute delirious mania, or typhomania-the delire aigu of the French- we have had 25 cases. Three only have recovered, a percentage of 12; while 20, or 80 per cent., have died, thus demonstrating the severity and extreme fatality of this form of insanity. Of 337 cases of chronic mania, 12, or 3.5 per cent., have recovered.
Recovery from chronic mania is very rate, but does sometimes occur, and may do so after long periods. And yet these patients, even though capable of performing with propriety the duties belonging to their social or civil position, are likely upon minute examination to disclose traces of mental weakness or mental disorder. Our statistics show that recurrent mania, which includes circular mania, is practically incurable, although the periods of remission in this form of insanity are undoubtedly oftentimes of such great length that cases have frequently been reported as recoveries by careful and conscientious observers, being classified, of course, under some other designation.
Alcoholic insanity shows a recovery rate of 89 per cent., there having been 51 recoveries from 85 cases. These cases, however, furnish a large number of recurrent cases, because the patient quickly returns to his unfortunate habits n being released from the hospital. Of insanity from masturbation, 23 per cent. of our cases have recovered. Epileptic insanity has furnished 115 cases, with but two recoveries; while general paresis, though present to the number of 186 cases, has thus far defined all efforts at cure, and we are unable to report a single recovery from this protean disease.
By careful hospital treatment, however, the duration of life of the paretic has been lengthened, so that now it is not uncommon for these patients to live eight or nine years, whereas formerly two or three years was considered the limit of their lives. Acute primary dementia, though a rare disease, has a large recovery rate. Of 37 cases, 33 recovered-a ratio of nearly 90 per cent. (82.2). Terminal dementia furnishes 527 cases, with no recoveries but with 102 deaths, being a death-rate of about 20 per cent.
Concerning these recoveries, it should be stated that the rate is fully as high as the results obtained at any of the Old- School hospitals, and they have all been obtained under purely Homoeopathic treatment-a fact which, if it proves nothing else, seems clearly to demonstrate that the hypnotics, opiates and neurotics, and multitudinous drug-preparations of our Old-School brethren are, to say the least, unnecessary in the treatment of insanity.
Concerning the cause of insanity, it cannot be claimed that statistics add much to our knowledge. Under the head an attempt has been made to give the assigned causes only, and in obtaining these the authorities have been guided largely by the statements of the relative or friend who happened to accompany the patient to the hospital. Such persons are frequently entirely ignorant, while some ar guided in their statements by personal theories and opinions, and fail to make a scientifically accurate statement.
Thus a person who had at one time in his life been intemperate, and at another time very religious, would be likely to have his insanity attributed either to intemperance or excessive religious zeal, according as the person giving the information happened to be a ‘temperance fanatic” or an anti-religionist; whereas the facts might be that the intemperance, the religious excess, and the insanity were all due to an inherited or acquired neurotic condition predisposing to these peculiar manifestations.
The Middletown tables show that of the remote causes heredity plays an important part; while predisposition duet to the long continued action of vicious habits, exhausting diseases, or neurotic tendencies of various kinds, swells the list.
Among the exciting causes, worry, intemperance, masturbation, overwork, and domestic troubles contribute the largest numbers in the order named.
The relation of marriage to insanity, if it has any, is shown by the following table:.
Male. Female. Total.
Single 47.3 35.6 41.6.
Married 46. 50. 48.4.
Widowed 5.4 12.8 9.
Showing that among that admission at Middletown, the percentage of single men has been larger than that of single women; while among the married, the percentage of women has been larger than that of men.
