Popular Science Monthly/Volume 42/March 1893/The Story of a Colony for Epileptics
SOME twenty-seven years ago, a number of gentlemen interested in social and philanthropic questions met together at Bielefeld, in Westphalia, to consider what could be done to alleviate the sufferings of epileptic patients, and prevent their being a burden to themselves and to their fellows. Epilepsy was at that time alarmingly prevalent in North Germany, no less than one tenth per cent of the population being afflicted with the disease. There was hardly a village but had its epileptics, men, women, and children, who passed their days just waiting for the coming of those awful paroxysms, which rendered them at once the terror and the derision of their neighbors. Many of these people were full of life and energy, willing, nay, eager to work, for, as they well knew, in steady work lay their one chance of warding off the doom that threatened them. Every day epileptics sit with folded hands brings them the nearer to hopeless idiocy. It is this that renders their fate so infinitely pathetic. Work they must, unless they are to become insane; and there is no work for them to do! Masters do not care to run the risk of employing men who, at any moment, may be stricken helpless. Thus thousands are compelled to pass their days in enforced idleness, an idleness fraught with disaster to themselves, and with the loss of much good service to the community. It was to put an end to this state of things, so far at least as Westphalia was concerned, that the Bielefeld committee began its work. The problem its members had to face was how to arrange a condition of life under which the labor of epileptic patients might be rendered economically productive. This they set to work to solve in an eminently practical fashion, by opening a labor home for epileptics. This home, Bethel as it is called, has now developed into one of the most important labor colonies in Europe. What gives a special interest at present to Bethel is that a committee has just been formed for the purpose of establishing a similar institution in England.
Bethel was started in a very humble way. A small farm was bought at Sparenberg, near Bielefeld, with money raised by voluntary subscriptions, and there the first patients were installed. A committee of management was appointed to watch over the working of the Home, which was placed under the direction of Herr Unsöld, a kindly, energetic man, a practical farmer, too, as well as a skillful organizer. There were at first only four patients, but before many weeks had passed the house was full. The inmates all lived together as one family, and cultivated the land attached to the homestead. The discipline maintained was of the least irksome kind, the men being allowed as much as possible to go their own way, so long as they obeyed the doctor's orders. Steady work and regular hours were, however, insisted upon, and the patients were required to pass the greater part of their time in the open air. They were supplied with light, nourishing food, and a moderate quantity of tea and coffee. No intoxicants were allowed to be brought to the farm, and only a limited amount of tobacco. The men were carefully guarded from everything that could excite or irritate them; and, at the same time, infinite trouble was taken to render their lives as bright and cheerful as possible. The beneficial effects of this régime were soon apparent. The physical and mental condition of the patients improved rapidly, and the attacks to which they were liable became less frequent and less severe. The fact of all around them being subject to the same misfortune as themselves, seemed to deprive that misfortune of half its terrors; a fit became merely an unimportant episode in life when it no longer rendered him whom it befell a pariah among his fellows.
The fame of the Labor Home, and of the good work being done there, soon spread through North Germany, and applications for admission arrived from all parts. By 1870 the success of the undertaking was so marked that the committee of management felt justified in reorganizing it on a much more extensive scale. An appeal for funds having been liberally responded to, a small estate adjoining the old homestead was bought, and on it a building was erected large enough to receive one hundred and eighty patients. The new home was placed under the care of the Westphalian Brotherhood, an order of laymen who devote themselves entirely to practical philanthropic work. So far the institution had been reserved entirely for men; it was now, however, resolved to admit both women and children. The new departure was not an unqualified success. Female epileptics are, oddly enough, much more difficult to manage than male: they are more passionate and less tractable; they seem, too, less able to grasp the fact that rules must be obeyed. Their somewhat flighty ways made them a disturbing element in Bethel; and it soon became evident that they must not be allowed to remain there in the same building as the men. Difficulties also arose in connection with the children, owing to the impossibility of keeping them apart from the older patients, some of whom were by no means desirable companions for them. A brief experience showed, too, that many disadvantages result from clubbing together in the same house a large number of patients of different ranks in life and in different stages of their common disease. The patients are required to contribute to the expenses of the Home according to their means. This necessitates their being divided into classes; and it was found very difficult, when they were all living together, to provide first and second class patients with the comforts for which they paid, without exciting the jealousy of the third-class patients, many of whom are admitted free. And, what was much more serious, it was proved that people subject only to occasional attacks suffered severely from being brought into close contact with those who were already sunk in idiocy. Thus, there were strong reasons for making a radical change in the organization of the Labor Home; and, after much anxious consideration, its managers, principally by the influence of Dr. von Bodelschwingh, decided on a bold move. They resolved to give up the large new house entirely to the female patients, and to provide other homes for the boys and the men.
On one side of the Bethel estate the great Teutoburgian Forest stretches for miles away, forming a barrier, as it were, between it and the outside world. The forest is traversed by little valleys, each separated from its fellows by high ridges densely covered with trees. Before the colony was started the only human habitations to be found in these valleys were a few small homesteads and some Jäger-huts. Although, here and there, little patches had been cleared, no serious attempt had been made to bring the forest land under cultivation, the amount of labor required for the work being too great for any ordinary capitalist to be willing to undertake it. The Bethel institution, however, occupies a different position from that of an ordinary capitalist; its difficulty is to provide work for its workers, not workers for its work. Thus the forest offered it the very thing it stood most in need of—an almost boundless field for the employment of the unskilled labor of its epileptic patients. The land was supposed to be of little value; the managers of Bethel, therefore, secured upon easy terms the two valleys which lay nearest their estate, together with the houses and other buildings which stood there. Hither, by degrees, they transferred all their male patients. In compliance with the strongly expressed wish of the men, instead of building a few large houses for them to live in, it was decided to utilize the little homesteads which were already there and to erect others of a similar kind. The patients themselves were set to work, and soon quite an important village sprang up. There are cottages for the old, for the young, and for the middle-aged; for the mentally or physically feeble, and for the mentally or physically strong. Some are reserved entirely for imbeciles, while others, remote from the rest, are set aside for the hopelessly insane. There are, in fact, homes for people in all stages of the disease, homes, too, for people of all ranks and stations; for one of the great advantages of the cottage system now in force in Bethel— the whole colony is Bethel—is that it admits of the most minute classification of patients. Each house is, to a certain extent, autonomous, the ten or twelve persons who live in it forming, as it were, a separate family. At the head of it is a House Father, generally a Westphalian Brother, who passes his whole time with the patients, working with them, and throwing himself heart and soul into their interests.
Meanwhile, Dr. von Bodelschwingh and his colleagues had been compelled to grapple with another serious difficulty. As the colony increased in size it became evident that, if it were to continue a success, other occupations besides agriculture must be provided. Some of the patients were too weak physically to bear the fatigue and exposure of an out-of-door life in winter; others, especially the artisans, manifested a decided distaste for the work. As it is of the utmost importance that epileptics should have congenial occupation, it was decided to open workshops, so that the men might be able to practice the special craft in which they had been trained, or for which they had the most natural aptitude. One by one various industries have been established in the colony. In very early days a regular building department was organized, and attached to it are now workshops for painters, joiners, locksmiths, and cabinet-makers, as well as a brick-kiln and a sawmill. Shoemakers' and tailors' shops have also been opened. A linen mill, too, now gives occupation to a number of the colonists, while the printing office and the book-binding works are the pride of the whole place. Thus, when an artisan now arrives in Bethel he can at once be set to some work to which he is accustomed, a fact which contributes not a little to his happiness, for an epileptic, after a certain age, seems almost incapable of turning his hand to a new occupation. Most of the things made are consumed in the colony, but if there is any surplus stock it is sold in Bielefeld. The organizing of these industries was no easy task. An attempt was made at first to employ as overseers in the workshops such of the patients as were skilled artisans, but it proved a failure. Epileptics are, as a rule, lacking in initiative; and they have neither the patience nor the self-control necessary for directing the labor of others, especially when these others are themselves of defective intellect. It therefore became necessary to appoint a paid overseer for each factory, an arrangement which has materially increased the working expenses of the colony. From first to last, in fact, these workshops have proved a somewhat costly experiment. In spite of the most rigid economy in their management, not only are they now worked at a loss, but there is no prospect of their ever becoming self-supporting. One serious expense in connection with them is the salaries of the labor overseers, another is the enormous amount of raw material that is wasted. It must not be forgotten that a number of the people employed, even the most skilled among them, are at times quite irresponsible for their actions. A man may do good steady work for months, and then, for some inexplicable reason, suddenly seize the coat he is sewing or the book he is binding and tear it into atoms. Work done under such conditions can never be lucrative. But although financially the workshops are a failure, in every other respect they are a decided success. They give variety and interest to life in the colony, and they have indirectly a most beneficial effect upon the morale of the patients, many of whom have become much more alert and mentally vigorous since they have been working at their old trades.
Agriculture, however, is, and always must be, the staple industry of the colony; and as agriculturists these epileptics are certainly doing good work—work, too, which from year to year tends to become more productive. They have already cleared and brought to a state of high cultivation much of the land they possess in the forest, and they have completely transformed the great Senne. Until they took it in hand this marshy common produced nothing but thistles and heather; now it yields fairly good crops of barley, oats, and potatoes. Parts of it have even been turned—and with the best results—into vegetable gardens, flower gardens, and fruit orchards. Market gardening is undoubtedly the most profitable industry carried on in the colony. It is, too, the calling for which the majority of male epileptic patients show the most marked preference. Men who are dead to all other emotions seem to derive intense delight from their own special allotments. They will work in them from morning until night, and there is neither bound nor limit to the care they bestow on them. They watch over their plants and seedlings with infinite tenderness, and talk about their early vegetables and first strawberries with enthusiasm. The crops they obtain are surprisingly good considering the soil they have to deal with. Not only do they supply the entire colony with the fruit and vegetables it requires, but they carry on a thriving trade with the manufacturing towns in the neighborhood. For fifty miles around the fruit and the flowers raised in the Bethel hothouses are in great request. In connection with the flower garden, a large building is set aside for drying seeds and storing bulbs, a most profitable undertaking. The colonists, in addition to raising their own vegetables, grow their own corn, feed their own cattle, and make their own butter and cheese. Their well-stocked farms are most delightful places, and the dairies attached to them are perfect models of what dairies should be.
One of the most difficult tasks which fall to the lot of the managers of Bethel is that of providing suitable occupation for the women. There are few things female epileptics are capable of doing. They can wash, clean, and sew, though only under supervision; but they dislike gardening, and cooking is entirely beyond their power. They can not be relied upon to lay tables, or to do anything, in fact, which requires memory or attention. Their helplessness, however, is evidently merely the result of previous neglect; for the young girls who are trained at Bethel exhibit comparatively few of the defects which characterize the women who go there later in life. First and second class female patients are now lodged in large cottages, but the third class still remain in the great building which was originally assigned to them. The first floor of it has been turned into a sort of restaurant for the whole of the colony, six hundred of the patients dining there every day, and the food for all the houses in the immediate neighborhood being cooked there. The women and girls are entirely under the care of the Deaconesses, some fifty of whom are stationed in the colony.
The pleasantest part of Bethel—the one, too, in which perhaps the most valuable work is being done—is that set aside for children. The brightness and gayety which prevail there are simply indescribable. Far from being depressed by their affliction, the little patients seem to look at life through glasses of even brighter rose than healthy children. They are more excitable, more keenly alert, more easily moved by every passing emotion. They literally dance with delight at the merest trifles, and make their playground ring with peals of the merriest laughter. Not but that there are specks in the sunshine even there, for on one and all the fell disease casts its shadow. There are wild outbursts of grief just when the games go most gayly, heart-breaking sobs of which no one knows the cause. In the midst of a class, a bright, intelligent girl falls to the ground a shrieking maniac; a boy, beaming with light-hearted fun, lifts his bat, and in a trice he is a thing strong men might shrink from. Wherever these children may be, whether at work or at play, some guardian must always be at hand, for no one knows the moment at which they may be stricken. About one hundred and fifty children are now attending the schools in Bethel. There they are thoroughly well taught according to their capacity. Some of them learn with quite marvelous quickness; but, unfortunately, they forget what they learn with equal speed. The greatest care is taken in cultivating any talent they may possess; and special importance is attached to their acquiring dexterity in the use of their fingers. When they have passed through the ordinary course of study, they are sent to a sort of technical school, where they are regularly trained for some handicraft which will enable them later to take their place as self-supporting colonists.
It is noteworthy that none of the children who have been brought up in Bethel have ever lost their reason, at least not so long as they have remained in the institution. Indeed, the medical statistics prove that not three per cent of the epileptic patients, of all ages, who take up their permanent residence in the colony, become insane. Unfortunately, thirty per cent of them are already imbecile when they arrive, and of these very few recover their senses. This success in warding off insanity is not so much the result of any special medical treatment the patients receive in Bethel as of their being kept steadily at work and being preserved from all unwholesome excitement. But cheering as the medical reports on the condition of the patients are in one respect, in another they are decidedly depressing. The investigations into the causes and symptoms of epilepsy which have been carried on in Bethel have led to the adoption of remedies by which the sufferings it entails are materially lessened, but, so far at least, no cure for the disease has been discovered. By submitting to the conditions of life as arranged in the colony, epilepsy may be rendered dormant for years; those suffering from it may, for all practical purposes, become as able as their fellows; but the taint of the disease still remains. Worry or excitement may at any time lead to a return of the disorder. Out of 3,300 patients treated in Bethel, only 228 were dismissed as cured, and even of these several were obliged later to return to the institution.
Great hopes are entertained by the managers of Bethel that in time the colony may become self-supporting. So far, however, its expenses have been twice as great as its regular income. During the year 1890 there were 1,277 patients in Bethel, 1,073 of whom were there on January 1, 1891. Of these, the first class paid one hundred pounds a year, the second class fifty pounds, and the third class twenty-one pounds a year or less. These terms include board, lodging, and medical attendance for all classes, as well as clothing and washing for the third class. Only twenty-five per cent of the patients belong to the first and second classes, and the remaining seventy-five per cent to the third class. Although theoretically the terms for the lowest class are twenty-one pounds a year, as no one is refused admittance merely because he can not pay the fees, the majority of those belonging to it pay considerably less, and many of them nothing at all. During the year 1890 the patients, roughly speaking, paid on an average twelve pounds per head, whereas they cost on an average twenty-five pounds per head. The working expenses of the colony for that year were £31,155, while the fees paid by the patients amount only to £12,351. To this amount must be added the value of the articles produced in the colony and sold—viz., £3,452. At the end of the year there would thus have been a deficit of £15,352, if outside aid had not been given. The Provincial Stände, which send their pauper imbeciles to Bethel, however, voted a contribution of £2,838, and £12,260 was raised by voluntary subscriptions. Three thousand four hundred and fifty-two pounds does not, of course, represent the full value of the work done by the colonists in the course of a year. Their labor is in a great measure embodied in the real property now held by the institution, in the two thousand acres of land which have been brought under cultivation, and the various houses and other buildings which have been erected in the colony, together with their furniture, etc. Much of this real property is the produce of epileptic labor, and its value is estimated at £133,429. If Bethel had restricted its enterprise to farming and market gardening, its balance-sheet would no doubt be more satisfactory reading; but, on the other hand, its usefulness as an institution would have been impaired. The colony was established as a philanthropic experiment, and as such it is a brilliant success. Those responsible for its management have acted wisely in choosing to postpone indefinitely the day of its economic independence, rather than sacrifice, in the slightest degree, the interests of the sufferers under their care.
The colony is at present in a most flourishing state, and it is increasing in size and usefulness from year to year. The village itself is charming, with its quaintly formed, bright-colored houses, which stand out in bold relief from the dark forest behind them. The Church, the headquarters of the Westphalian Brothers, and Sarepta, the home of the Deaconesses, are quite imposing buildings; and there are also public baths, a hospital, a museum, and even a savings-bank. Hermon and Bethany, the cottages reserved for first-class patients, are most attractive abodes; they stand in the midst of beautiful gardens, and have lawn-tennis courts attached. It is, however, the air of general prosperity about the place which renders it so delightful. All the people are well clothed—well fed, too, as one may see by their faces. All sorts and conditions of men are there, all hard at work—at work, too, with their hands, be they princes or beggars. That is the law as of the Medes and Persians: there is no "leisured" class in Bethel. It is this incessant work and bustle that makes the village so cheerful. The people have no time to brood, no time to wonder why their lot should be cast thus apart from their fellows. Considering their condition, it is startling to note the expression of content—nay, happiness—on the faces of many of these colonists; even the imbeciles among them seem at least, to have found rest. Of course, it is not always thus; ghastly scenes are witnessed from time to time; and here and there—but only in those hidden nooks remote from other dwellings—one comes across a something that is hardly human. These eleven hundred colonists form a wonderfully united little community. The sense of their common affliction seems to draw them very close together, while the knowledge of their own dependence teaches them to be ever ready to give a helping hand—to give it, too, gently, tenderly. Epileptics have a terrible cross to bear at the best; but in Bethel it is lighter than elsewhere. In the world such people are burdens on the labor of others, pariahs whom all men shun; in their own colony, however, they are respected citizens doing good work in the world, and living upon terms of equality and sympathy with their fellows.—The Contemporary Review.