May 2. To cash received from Mercer Co. Med. Soc., on acc't for 1875 $19 85 12 40 33 80 7 80 15 60 15 60 37 70 52.00 32 50 20 80 June 10. By cash paid Dr. R. L. Sibbett, for printing, stationery, etc., for Com. on Memorializing the Legislature in $2502 46 $39 50 MEMORIAL. AT a meeting of the Medical Society of the State of Pennsyl vania, held in Pottsville, on June 10, 1875, a committee was appointed to memorialize the Legislature in favor of a Hospital for the Insane of the counties of Berks, Bucks, Chester, Delaware, Lehigh, Montgomery, and Northampton, and to urge the passage of a law to establish the same. In pursuance of the duty thus assigned them, the Committee beg leave to present the reasons which, in the view of the Medical Society, appear conclusive to their minds, and also to the minds of all who have given attention to the subject, in favor of such a hospital. In the seven counties named above there was, at the last census, a population of four hundred and eighty-eight thousand, and, by the usual rate of increase, it would now exceed five hundred thousand; and it will readily be admitted that these counties were the earliest settled in the State, and are now as fully, if not more fully, populated as any other equal number of counties in the State. It has usually been estimated that, in any given number of the population, there will always be found a certain given number of insane, dependent, in various communities, on a variety of causes, in some greater and in others less. It may be assumed, without any reasonable degree of doubt, judging from facts collected from different sections of the country, that in these counties there will be found one insane person to every one thousand of the community, though some persons would probably estimate it greater than that. But, taking that as a convenient and probably nearly correct number, it will be seen that there are in that district at least five hundred insane persons. What are the accommodations for that number? The State Hospitals for the Insane are now all full, and in fact crowded, and that at Harrisburg, where those who become insane in these counties are as a general rule sent, and where a large number now are, has been crowded to its full capacity for more than a year past. There are also a certain number confined in the almshouses in each of the counties, but for them no course of medical treatment is provided, and they are mostly those who have been insane for a period of years; and even these accommodations are all full, and in several of the counties the authorities have been obliged to provide additional accommodations, and when these are finished, they will not be sufficient for the requirements. It has also been found, by a careful comparison of figures, that there will always be a certain number who become insane in each year. By a careful calculation, made by Dr. Edward Jarvis, of Massachusetts, one of the most eminent and accurate statisticians in this country, after a thorough examination of the reports of a large number of hospitals, it has been shown that one person in every sixteen hundred and ninety of the population will become insane in each and every year, and in that proportion there would be nearly three hundred persons become insane in these counties in each year who should have proper medical care and treatment in the earliest stages of the disease. But, by a subsequent calculation, made within a year, under the direction of the Board of Public Charities of Pennsylvania, that proportion has been stated to be one person in thirty-nine hundred and eighty-six, and that would give about one hundred and twentyfive persons becoming insane in each year. It is well known that, for a long period, it was held by many persons that insanity was caused by some mysterious agency which could not be clearly traced, but which was very certainly instrumental in the production of the trouble, and that this mysterious agency could only be driven out or removed by some of the means used for exorcising evil spirits; or that those thus disturbed were in this way punished by the Divine displeasure, by reason of some sin which they or their progenitors had committed; and it will readily be seen that those who held these views would not resort to any special means for the removal of a punishment thus inflicted, for fear they might incur the same displeasure, and be visited by the same consequences. Unfortunately, the belief in both these views is even now far too common in a large class of persons, and influences them in the course which they pursue towards those who may unfortunately become insane. It is a fact established by the most positive medical testimony and an extended course of careful and accurate investigation, that insanity is to be traced to, or is caused by, a diseased or disordered condition of the nervous system, which may be produced by any of the causes which ordinarily give rise to disease of any other organs of the body. The great difference between insanity and the ordinary diseases of the body is, that, in insanity, the powers of the mind, and all the affections, passions, and emotions are more or less disordered, and lead the person to a course of conduct and conversation totally foreign to his natural disposition and character, and to the ordinary observer there does not appear to be sufficient bodily disease to produce all this change. But the nervous system is frequently very much disordered by a variety of causes, which very gradually and insidiously, but very surely, undermine it, and derange all its healthy functions. The brain sympathizes very quickly and very strongly with the diseases. of other organs, as is so frequently seen in the delirium of fever, and various diseases of the stomach, liver, and lungs; and this sympathy arises from its intimate nervous communication with all these organs. And, as the brain is the organ through which the manifestations of mind are made known to us, it is of the highest consequence that everything which can tend to disorder the action of the brain should be carefully watched, and every effort made to correct any deviation from the natural healthy action of any of the organs of the body. As every disease is more readily cured by being taken in the earliest stages, before it has had time to change the structure of the organ attacked, so it is of the greatest importance to use every means to correct the condition of the system on which any mental disorder may depend, and thus avoid injury to the brain and mind. Besides, as the structure of the brain is so extremely delicate, and the supply of pure, good blood, so necessary to enable the brain properly to exercise its functions, is so nicely and accurately adjusted, and the healthy action of the brain, and consequently of the mind, depends on this accurate adjustment, it will be obvious that whatever will produce any derangement of this adjustment must be carefully guarded against and removed. On this account, it is so important that, when any symptom of insanity or any unusual change in the conduct and character of any person is noticed, prompt and careful medical treatment should be at once resorted to, to correct the disordered action, before it can have any injurious influence on the delicate structure of the brain. It is too often said, and more frequently acted than said, that it is only a slight matter, which will wear off in a few days; but if it be true and all sound medical observation confirms it-that these deviations from the natural healthy action of mind are caused by some disordered condition of the body, acting either directly or indirectly on the brain, it would seem to be the dictate of sound wisdom to use every effort to put the diseased condition right, and remove in this way the disordered action of the mind. It has been clearly established, by the most extended experience, that mental disorders are as readily cured as any other bodily diseases, provided they receive proper care and treatment in the earliest stages; but it must be distinctly understood that by the earliest stages are meant when the first deviations from the conduct and conversation natural to the person are noticed, and not when these deviations have existed for months, or even years, and some violent outbreak first calls for interference and restraint. Taking the disease at that early day, it will be found that eighty out of every hundred persons attacked will be restored to sound health in the course of a few months, and able to attend to their duties again, and be useful citizens and members of the community. The reason why so many persons are not restored who are said to have been attacked recently is that the term recent is too often applied to the first violent demonstration, and not to the earliest appearances of unnatural conduct or conversation, and a state of disease has been set up which cannot after so long a period be removed. It would seem to be the most natural desire and feeling in every one to have every member of the family, when diseased, restored to sound health, so that they may contribute to the general well-being of the family, and not be a burden, but many persons seem inclined to hide every evidence of any disordered state of mind from all about them, even from their family physician, looking upon any evidences of insanity as a disgrace, as if a disease, not caused by wilful indulgence, was any disgrace, and by such a course they prolong the resort to a course of treatment and render the case much more difficult, if not impossible to cure. While every principle of benevolence and philanthropy actuates to a resort to proper medical treatment as soon as any unnatural evidences are discovered, because it is humane and right to do all in our power to relieve suffering and cure disease, yet there are certain principles of political economy which should be considered in addition to the benevolent aspect of the question, and these may have a tendency to arouse the members of the community to the use of more prompt means for the restoration of cases of insanity, simply as a means of reducing the expenses of the body politic. No one will deny the correctness of the statement that it is much better to have every member of the community in good |