“The total number of the insane poor of the county of Orange is thirty-eight; twenty-five of them are in the poor-house at Goshen, and thirteen are cared for at an asylum in Newburgh. The county supports four at the Marshall Infirmary at Troy. A large majority of the whole number are of American birth. Of those at Goshen eight males and four females are capable of labor; the others are furnished with no amusement; only three are destructive to their clothing; the restraint used is by straight jacket or shutting in the cells. The house is without a bath tub, and all are not required to wash hands and feet daily. The windows may be dropped to obtain ventilation; [are they?] In all the rooms occupied by insane there are bedsteads, and straw bedding is used; the straw is changed once in two or three months. There is no regular system of diet, but ordinarily good fare is furnished, which is served at a common table to a part, and to others it is taken to their cells. No attention is paid to uniformity of temperature, nor are there any accommodations for the various grades of insane. The sexes are kept separated, but the only immediate superintendence is from an inmate of the poor-house. The rooms are kept comfortably clean. “Some of the male inmates are believed to have vermin” on them. The institution receives recent cases—several having been admitted in 1804, but no medical attention is bestowed with reference to the ultimate recovery of each case.
The building at Goshen was erected in 1850, and though adjoining the main building is separated from it. It is two stories high, of stone, and through the center in each story a hall extends, with windows at each end for light and ventilation. The rooms open from each side upon these halls. Each room has a window. Inmates are allowed the free use of the halls and of the yards.
In 1853 the town of Newburgh withdrew its paupers from the county, and provided for their maintenance by the purchase of lands and the erection of suitable buildings; a residence for the superintendent, and sane paupers, and a wing, communicating by a hall with the main building, for the insane. The building for the insane is two stories, of brick, with a hall through the centre, and rooms opening out on either side. Each room has a window, and a ventilation in the hall. There are here eighty-one paupers, of which thirteen are lunatics; six are able to do some labor. There are none who require constant restraint. The house has a supply of water, and three bathing tubs, and the insane are required to bathe their whole bodies once in each week, besides washing hands and face daily. The building is heated with a furnace, the temperature regulated by a thermometer; the inmates are comfortably bedded on husks or straw for bedding—each one having a single bedstead; they are also sufficiently and comfortably fed—the diet being changed every day in the week. There is no accommodation for the various grades of the insane, but in each ward there is an attendant for the males, and one for the females. The condition of the rooms are cleanly and neat. There are rooms for thirty-two, but eighteen is the highest number there confined. The institution does not take recent cases. All are kept comfortable. A physician visits the house about four times a week, but the insane do not receive treatment with reference to recovery.
Dr. Wm. P. Townsend, who visited these institutions, in a very able report, remarks “that the selection of persons to superintend these institutions is too often based upon considerations of business capacity to the exclusion of any apparent estimate of moral fitness.” And again, the management of the domestic, dietetic, and other internal arrangements, are most carefully studied, to the neglect or exclusion of the moral, mental, or even humane necessities of the unfortunate persons compelled by want, destitution, or disease to reside therein.
Questions of economy alone explain why such incompetent and morally unfit persons, “selected from the paupers,” are assigned to the immediate care of the insane poor. Even if they possessed sufficient capacity for the position, want of interest in the well-being of the lunatics, coupled with the well known infirmities of temper usually belonging to these individuals, should, except in rare instances, forbid their employment in the capacity of nurse. Dr. Townsend urges, however, that keepers should be exempt from the responsibility, since they have no authority in the selection of capable attendants.
“The asylum at Goshen is sadly deficient in means and appliances for promoting bodily cleanliness in the persons of its inmates.”
The population of Orange county in 1860 was 63,812, giving one insane pauper to every 1,680 of its inhabitants to be treated and provided for in our charitable asylums. These facts may well start the inquiry, what can be done to mitigate or improve their condition, or, if possible, restore to them reason enthroned, and capacity for self support? The moral impossibility of giving the insane proper care, or suitable medical treatment, under the present system of county houses is set forth by Dr. Townsend, the inadequate compensation to physicians, and the necessity of doing something to improve the present state of things, is set forth; and yet, imperative as this necessity appears, the lunatics in Orange are better cared for than in most of the other counties.”