“The year embraced in the report of the Alms House Insane Asylum is for September 1, 1863, to September 1, 1864. The number of paupers varies from four hundred and twenty-five in summer to six hundred and fifty in winter. There have been during the fiscal year one hundred and fifty-five lunatics in the poor house asylum. The ratio of insane is about one in four. Fourteen have died; twenty-eight have been discharged. Ninety-nine of the whole number were mild cases; twenty-one were filthy; sixty-two were males and seventy-three were females; fifty-seven were native and eighty-eight of foreign birth. All have been admitted since 1848. Of the whole number only nine had been treated in the State asylum. Twelve males and twenty females were capable of labor. The large number who were unable to work had no amusement or employment. Only six were destructive to their clothing, and required the straight jacket restraint, or locking in cells. The house has two bath tubs, one for each department, and a full supply of water from the city water works. The insane are required to bathe weekly, and to wash hands and face daily. The rooms are supplied with iron bedsteads, and straw in ticks for bedding. The diet is intended to be ample, and all who are able go to a common table to eat. The change of clothing is made every week. The rooms in summer are well ventilated. All have shoes in winter. Twelve escaped during the year who were not returned; three were removed by friends. The asylum was built to accomodate thirty-one lunatics. There are in confinement at the present time in this space, designed only for thirty-one, One Hundred And Three. The greatest number in confinement at any one time was ONE HUNDRED AND TWENTY, designed to accomodate thirty-one!—the alms house asylum of the capital! of Albany!! Dr. W.H. Bailey, who made the inspection, remarks: “The asylum is a modest two-story and basement brick structure, entirely separated from the other buildings in which are the county poor. There is a small yard for the males and another for the females, into which those who are able may go at pleasure, but the yards are too small and too barren either for the health or amusement of the inmates; that for the males is 53×90, and that for the females 84×102 feet. In them there is neither a tree or a shrub to shield them from the scorching sun in summer, nor a bench or a seat on which to rest. They are inclosed by a close board fence about twelve feet high, over which the inmates cannot see, and they stretch themselves on the ground like animals, or creep under the shade of the prison-like enclosure. The sexes are separated; the males occupy the first and the females the second story, the dining room for each sex being in the basement. The sleeping rooms open on each side from a hall extending through the centre of the building. Each of these rooms is lighted by a window. The halls are heated by hot air from two furnaces in the basement, and the rooms receive heat through the doors from the hall. Unless the weather is severe, the heat is ordinarily sufficient, and the unfortunate inmates are comfortable. All who are able are compelled to leave their rooms and occupy the halls during the day time. I regard it as unfortunate that some arrangement was not made in the construction of this building for the weak and feeble. When a lunatic is sick or feeble the heat from the hall is often insufficient, unless the door is constantly open, which is to expose the patient to the noise and gibberish of fifty insane and demented, who are congregated in a single room, making it resound with their vacant laughs and shouts. In summer the windows are a ready and effectual means of ventilation, but in winter the furnaces are not of sufficient capacity to permit a flow of cold fresh air sufficient for the requirements for health. The basement rooms have no means of being warmed or ventilated. In these the boisterous, the vicious and the violent, are confined. None are confined here continually; but every new patient is placed here for two or three days “for the purpose of becoming acquainted with his habits.”
Dr. J.R. Boulware, the present efficient alms house physician, in his recent report to the common council, says:
“The insane asylum was built originally to accomodate seventeen females and fourteen males. There are thirty lodging rooms intended for the inmates, and each room was made of the smallest dimensions, compatible with the physical health of a single occupant, nor was it ever intended that more than one should be put into a room. We are now compelled to crowd from three to five of these creatures, who are in the greatest state of helplessness and dependence, into one room, also obliged to use some of the small, damp, air-tight cells, which are below ground, as lodging rooms, whose aerial capacity was never more than barely sufficient to sustain the health of one individual, thus making it appear that the Alms House physician, or those responsible for the management of this important and most sacred of all trusts, are not only willing to leave them in the unfortunate condition of insanity which simply makes them suitable for entrance into an Insane Asylum, but add to it the greater misery which results from the loss of bodily health. This loss of health is but the natural and inevitable result of such abuse. To realize more fully the important bearing of this subject, every individual should make a practical application of it to himself, and imagine a kind relative or dear friend as one of the one hundred and three who are compelled in cold or stormy weather, to crowd into a mere hall or passage way, whose cubic dimensions are such that the air, in twenty minutes, becomes vitiated and rendered unfit to support health, and in the course of the day becomes in the highest degree deleterious and loathsome.
Think of the effect, mentally, physically and morally of promiscuously huddling together so large a number of individuals, of all grades of insanity, from mere partial mental derangement, to that complete idiotcy, where nothing is left of that intellectual force by which man is characterized and distinguished from the lower order of animals. Many of them obeying the calls of nature without reference to time or place, some perhaps in convulsions, others roaming whilst the timid and retreating are trying to escape from the screams and vociferations of the more turbulent. There being no provision for their proper classification, the noisy, the violent, and the filthy; the quiet, the timid, and the convalescent, have to remain in this hall together during the long weary hours of the day.
The standing committee of the Association of Medical Superintendents, in their report on the construction of hospitals for the insane, say that apartments provided for the confinement of the violent insane, should be entirely above ground, and when used for a single patient, should contain not less than 960 cubic feet of air, nor should the ceiling be less than twelve feet in height, with a window communicating directly with the external atmosphere, and well ventilated. Now I find on measurement that these cells instead of containing 960 cubic feet of air, contain about 760 cubic feet, instead of the ceiling being twelve feet in height, it is but seven feet, instead of being entirely above ground they are nearly entirely below ground, and instead of being well ventilated, they are made air-tight. In these cells the violent insane, whose insanity is manifested paroxysmally, are temporarily confined until their paroxysms of excitement have subsided. Frequently they have to be confined in these damp, air-tight cells twenty-four hours, when the air becomes vitiated by the offensive exhalations and excrementitious matter. The ingress of air shut off, the effluvia in the cell prevented from escaping, the helpless inmate is thus compelled to breathe into the system this poisoned air, twenty-four or perhaps forty-eight hours, and the effect is not only ill health and a stupid mind, but the prostration of all the powers of the individual, both physical and mental, is the unavoidable and inevitable consequence; and this dreaded cell becomes the alembic, in which is double distilled their most bitter cup of affliction.
This picture sad as it is, falls short of presenting this matter in all of its unpleasant features, but enough has been said to make it apparent that this building is entirely inadequate to afford that relief to those for whose aid this department was designed.
Were your honorable body fully aware of this matter as it really exists, I cannot but suppose that the warmest sympathies of your nature would be aroused to respond to the urgent necessities of these insane poor, for surely no affliction appeals more strongly to our sympathy and generosity than this fearful malady.
The improvements deemed most essential, are a building whose relative dimensions to the number of patients, are such that each inmate will be supplied with enough of atmospheric air to support health, and the building so constructed as to admit of their proper classification. Indeed the importance of having enough of pure air to breathe, and the necessity of having the quiet, the timid and the convalescent separated from the noisy and turbulent, so as not to be affected by their screams and vociferations, are so palpable, that they need only to be mentioned to be properly appreciated.
I also wish to mention that there is much credit due the alms house superintendent and the attendants of this institution for the cleanliness of the different apartments of this building. When we take into consideration the great disadvantage of having to keep the turbulent, the destructive and the filthy in the same apartments with the other inmates, this Insane Asylum, in point of cleanliness, will compare advantageously with the best in the State. As far as the patients themselves are concerned, although somewhat ragged, each rag is kept clean.
In this case the physician, no matter how diligent and attentive, or how well he understands the subject, is nearly or quite powerless. He can order no healthful exercise nor any system of profitable amusement. He can only prescribe for the absolutely sick. The keeper has done his duty when he turns the key and locked the unhappy inmates fast, or gone in and by intimidation, threats or blows quieted some turbulent demented incurable. The superintendent of the alms house has done his duty when he has provided for their daily living, at the cheapest possible rate, and supplied the wants that keep them from perishing more rapidly, or from a more speedy recovery. The alms house committee look at the figures and the quarterly expenses of the Institution, and if they have not exceeded the preceding quarter, they have done their duty, or passing speedily through the hall of the Institution they see the inmates neat and clean and do not stop to think that crazy people need anything more —or if one more benevolent, humane and thoughtful than the rest suggests an improvement, it fails to meet anything more than the discouragement of the board, and nothing is the result. The board of common council still leave all to the committee, and the people leave all to the common council. The police justice is obliged nearly every week to relieve the jail of a lunatic; he must be disposed of; the superintendent of the alms house has no discretion, he must receive him, and another deranged person is thrust in the overcrowded apartments and left to his own gloomy hopeless condition to become a confirmed lunatic. The humane and philanthropic learn these facts and lament them, but can do nothing. The time has come when calm judicious legislation is demanded, to interpose and prevent these alarming evils.”