Correspondence of the Philadelphia North American and U. S. Gazette.
THE ASSOCIATION OF MEDICAL SUPERINTENDENTS OF AMERICAN IN-
STITUTIONS FOR THE INSANE.
Baltimore, May ll<7i, 1853.
In October, 1844, a number of the medical gentlemen connected with
the institutions for the insane, in different parts of the United States,
assembled in Philadelphia, and formed the Association whose title is
given above, and which now holds annual meetings in different parts of
the country. The association now numbers among its members the chief
medical officers of thirty-one respectable institutions for the insane in
nearly every part of the United States and of the British Provinces, and
has already held two meetings in Philadelphia, one in Washington City,
one in Utica, N. Y., one in Boston, two in the city of New York, and
is now holding its eighth in Baltimore.
Much good has already resulted from the members contributing the
results of their very extended experience in mental diseases, and by the
free discussion of all subjects connected with the welfare of the insane,
and especially in reference to the construction, organization and general
management of institutions for their treatment. Wherever the meetings
have been held, the members of the Association have invariably visited
and carefully examined all the institutions for the insane in the vicinity,
and have thus become familiar, not only with their good qualities, but also
with the defects which have sometimes existed, and which the influence
of the Association has often been instrumental in removing. Various
valuable essays have been read at the different meetings, and been pub-
lished in the journals specially devoted to insanity, or in the other me-
dical periodicals of the country ; and the sentiments of the Association
have of late been frequently quoted as authority, by various officers of
the General and State governments, as well as others interested in the
preparation and management of hospitals for the insane.
Since the formation of the Association, in 1844, it has had to mourn
the death of some of the most distinguished of American Physicians who
have devoted themselves to the treatment of the insane, and whose labors
have been recognized wherever insanity has been studied, or those suf-
fering from it been properly cared for. The names of Woodward, Brig-
ham, Macdonald, and others, will take a place on the scroll of fame with
those of Pinel, Tuke, Esquirol, Rush, and all the worthies whose be-
nevolence and determined energy led to a new system of treating the in-
sane, based upon reason, humanity, and the plainest principles of prac-
tical Christianity.
This Association, whose history and objects have been briefly sketched
above, commenced its Sth meeting, at the Eutaw House, Baltimore, on
Tuesday, the 10th of May, 1853, at 10 o'clock A. M.
’The meeting was called to order by Dr. Buttolph, of New Jersey, (the
Secretary,) and in the temporary absence of the President and Vice
President, on motion of Dr. Kirkbride, of Philadelphia, Dr. F. T. Strib-
lers, of the Western Asylum of Virginia, was appointed President pro
tern.
On motion of Dr. Fonerden, of Maryland, a committee to prepare and
arrange business for the meeting was appointed by the chair : Drs. Fo-
nerden, Kirkbride and Buttolph being the committee.
On motion of Dr. Kirkbride, the members were authorized to invite
visitors to attend the sessions of the Association.
On motion of Dr. Tyler, of New Hampshire, a committee, consisting
of Drs. Tyler, Nicholls and Curwen, were appointed to select a place
and designate the time for the next meeting of the Association.
Dr. Kirkbride exhibited and explained the plans of the new Alabama
Hospital for the Insane, prepared under his direction, and which build-
ing is now being erected at Tuscaloosa, under the supervision of Messrs.
Sloan and Stewart, architects of Philadelphia.
Dr. Nicholls presented and described the drawings for the new United
States Hospital for the Insane of the Army and Navy, and of the Dis-
trict of Columbia, authorized by an act of the last Congress, and which
has been already commenced.
Dr. Nicholls is the Superintendent of this Hospital, and the drawings
are from his sketches, by Thomas U. Walter, Esq., the Government
Architect.
Dr. Stewart, President of the Maryland Hospital for the Insane, ex-
hibited, and had described by Mr. Niernstein, the architect of the build-
ing, the plans for the new Maryland State Institution for the Insane,
which has just been located on a fine farm a few miles from the city of
Baltimore.
All these plans differ somewhat in their details, but are very similar
in their general character, and exhibit very strikingly the immense pro-
gress that lias been made in planning this very important class of public
institutions. Each is intended to accommodate 250 patients, with the
necessary officers and attendants.
It is quite safe to say that, if the plans are faithfully carried out,
these three hospitals will be the best, and most convenient, as well as
most truly economical, to be found in any country. The plans presented
are believed to conform in every essential respect to the principles here-
tofore adopted by the Association, and which arc now pretty generally
regarded as authority on the subject.
Invitations were received and accepted to visit the site of the new
State Hospital for Maryland, and the Mount Hope Asylum this after-
noon, the Maryland Hospital on Thursday afternoon, and the site of the
United States Hospital at Washington on Friday. Adjourned to meet
at the site of the new hospital at 4 P. M.
In the afternoon the members of the Association visited the in-
sane in the Baltimore Alms House, situated on a beautiful farm of more
than 300 acres, and about two miles from the city. The general hos-
pital appears to be well conducted, but the condition of the insane is a
reproach to the age, and a foul blot on the noble and enlightened city
and county to which it belongs. Here are seen some of the horrors of
a past age—fellow beings, male and female, chained by the leg, and
permanently secured in low, damp, underground apartments, that ought
never to be inhabited by those afflicted with any disease,—or exposed
like wild beasts under a shed in the small, cheerless yards. Surely such
a state of things cannot long be permitted, and a visit bv the Maryland
Legislature ought to be sufficient to induce them to make any appropria-
tion, or to pass any laws necessary to prevent such a state of things so
near her beautiful and hospitable Capital, or in any section of the State.
The Association then proceeded in carriages, under the guidance of
Dr. Stewart, President of the Board of Trustees, to visit the site of the
new State Hospital, six miles from Baltimore, and were highly gratified
with the good judgment which has been exercised in the selection of a
spot on which it is proposed to erect the noble structure which is to con-
tribute so essentially to the comfort of the afflicted, and the benefit of
the whole community. There are one hundred and thirty acres of land
in the tract, and the views from it are of peculiar beauty, embracing
Baltimore, the Chesapeake bay, with its shipping, and various other ob-
jects of interest.
The following members, representing the various institutions men-
tioned, are present at the meeting, viz : Dr. Bell, of the McLean Asy-
lum, near Boston; Dr. Ray, of the Butler Hospital, at Providence, R. I.;
Dr. Tyler, of the N. II. Asylum at Concord; Dr. Walker, of the South
Boston Hospital; Dr. Benedict, of the New York State Hospital at Utica;
Dr. Brown, of the Bloomingdale Asylum, N. Y.; Dr. Bullock, of the
King’s County Hospital, near Brooklyn, N. Y.; Dr. Buttolph, of the
N. J. Hospital at Trenton ; Dr. Kirkbride, of the Pennsylvania Hospital
for the Insane at Philadelphia; Dr. Worthington, of the Friends’ Asy-
lum at Frankford, Pa.; Dr. Curwen, of the Pennsylvania State Hospital
at Harrisburg; Dr. Stewart, of the Philadelphia Hospital, Blockley ;
Dr. Fonerden, of the Maryland Hospital; Dr. Stokes, of Mount Hope
Asylum, Md.; Dr. Nichols, of the U. S. Hospital, Washington City;
Dr. Stribling, of the Western Asylum of Virginia; Dr. Jarvis, of the
Private Institution of Dorchester, Mass.; Dr. Patterson, of the Indiana
Hospital; Dr. Kendricks, of the Ohio Hospital at Columbus, and Dr.
Smith, of the Missouri Hospital at Fulton. Dr. Bell is President of the
Association ; Dr. Ray, Vice President; Dr. Buttolph, Secretary, and Dr.
Kirkbride, Treasurer.
Several gentlemen connected with the management of Hospitals for
the insane arc also present by invitation of the Association.
Evening Session—May 10.
A paper on the Lincoln (English) Lunatic Asylum, and a discussion
of some of the peculiar views there entertained, prepared by Dr. Galt,
of the Eastern Asylum of Virginia, was read, and the principles con-
tained in the paper were critically examined in the discussion which fol-
lowed, and which was participated in by Drs. Kirkbride, Benedict, Strib-
ling, Jarvis, Stewart and Bell; the sentiments of all these gentlemen
being, on many points, entirely at variance with those of the writer.
Dr. Kirkbride read a paper on night watching, and the general care of
the patients at night in Institutions for the Insane, strongly urging its
importance, and recommending a material extension of the means com-
monly employed. The Association then adjourned till 9 A. M. to-mor-
row.
J/orn w? g Session—May 11.
The paper, read by Dr. Kirkbride last evening, led to an animated
and very interesting discussion, participated in by Drs. Benedict, Smith,
Stewart, Ray, Jarvis, Walker, Kendricks, Worthington, Brown, Curwen,
Fonerden, Stribling, Stokes, Nicholls, Buttolph, Bell and Kirkbride.
The customs of all the institutions represented, in reference to the care
of their patients at night, were fully examined, and very general uni-
formity of sentiment seemed to prevail as to what was desirable, although
there is considerable difference still existing in practice on some points
connected with the subject.
Some observations made by Dr. Kendricks, of Ohio, relative to modes
occasionally adopted to break up the bad habits of the insane, led to re-
marks by Drs. Bell, Kirkbride, Stribling, Jarvis and Benedict, iu the
strongest reprobation of the use of any means in our institutions which
partook of the character of punishment. Although temporary benefit
might undoubtedly sometimes result, it was believed by the speakers,
that this could not be received as a justification of such practices.
Dr. Nicholls read a paper, prepared by Dr. Galt, on “ Pledges by the
Insane,” which, after a brief discussion, was laid on the table.
Dr. Jarvis read a very elaborate and valuable paper on the effects of
over or perverted action of the Brain or Nervous System on Mental
Health, which was fully discussed by.Drs. Kirkbride, Fonerden, Ray,
Buttolph, Bell, Smith and Jarvis, in decided commendation of the prin-
ciples of education and modes of life recommended. This discussion led
to a reference to the phrenological doctrines of the agency of the brain
in the action of the mind, on which point the members were found to
entertain quite different sentiments. At 2 P. M. the Association ad-
journed to 3.} P. M., and then repaired to the Mouut Hope Asylum,
which the members were invited to visit yesterday. This institution is
in the suburbs of Baltimore, but the extension of the city, and the open-
ing of its streets will soon compel its removal to a more private location. It
is under the entire control of the Sisters of Charity, Dr. Stokes, its excel-
lent physician, having charge only of the medical department.
The Association was received in the kindest manner, and elegantly
entertained by the Sisters and Dr. Stokes, who exhibited and explained
the uses of every part of the establishment, which is kept in the neatest
order; and the general appearance of the patients is creditable to all con-
cerned in their care. After returning from Mount Hope, the Associa-
tion re-assembled at the Eutaw House, when Dr. Ray read a valuable
paper “ on undescribed forms of acute cerebral disease,” detailing a
large number of cases, and skilfully analyzing the views of various
writers on the subject. The discussion of this paper was deferred for
the present. Adjourned till 9 A. M. to-morrow.
The members of the Asssociation accepted the invitation of Dr. R. S.
Stewart, the indefatigable and veteran friend of the insane, and were
elegantly entertained at his hospitable mansion during the evening.
Morning Session—May 12.
After the reading of the minutes, the Association proceeded to a dis-
cussion of the paper of Dr. Ray, on certain forms of cerebral disease, in
which Drs. Kirkbride, Patterson, Walker, Kendrick, Stribling, Bene-
dict, Brown, Ray and Bell participated. The form of disease referred
to by Dr. Ray, seemed to differ from that heretofore described to the
Association by Dr. Bell, and which, although quite prevalent in some
districts, is entirely unknown in other sections of the United States.
On motion of Dr. Stribling, a Committee of finance, consisting of Drs.
Stribling, Kirkbride and Buttolph were appointed.
Letters from Drs. Earle and Chandler, relative to reports from Hos-
pitals, were read and laid on the table.
The Committee to select a place and proper time for the next meeting
of the Association, recommended that it be held at the city of Washing-
ton, on the second 'Tuesday of May, 1854, at 10 o’clock A. M.
Dr. Ray moved to amend by substituting Providence, and fixing the
time in 1855, but the amendments were lost, and the recommendation
of the committee subsequently agreed to, with great unanimity.
Dr. Kirkbride, by appointment of the Association last year, read a
series of propositions relative to the proper organization of Hospitals for
the Insane, which, after mature consideration and a very full discussion,
and various amendments at the afternoon and evening sessions, were
unanimously adopted. The proper organization of Institutions for the
Insane is one of the most important measures that can engage the atten-
tion of those getting up new Hospitals, or promoting the welfare and
prosperity of the old; and the sentiments of the Association on the sub-
ject, the result, as they are, of long practical experience in every section
of the country, and thus formally expressed, will, it is hoped, lead to
important results-
Dr. Stewart, the President of the Board of Trustees of the Maryland
Hospital, by invitation, explained the organization of that institution,
and gave an interesting statement of his views on the whole subject.