Though legislative enactment has made all asylums hospitals in name, it has not accomplished this in fact. To-day the tendency of the State care act, though noble and generous in its inception, has been to make the hospital treatment of the curable insane almost impossible, or at least most difficult. It has crowded all the State hospitals with a mass of patients for whom nothing medically can be done, thus essentially interfering with proper classification. It compels the placing of recent, curable, maniacal, and suicidal cases with old chronic patients who are violent, destructive, and filled with all kinds of delusions of persecution and various hallucinations. These tend not only to strengthen the newcomers in their own morbid ideas, but to implant many new ones. Their influence on the terrified, depressed, and deluded is especially pernicious. It is not necessary to paint a word-picture of the sad effect of such surroundings on these sufferers. Every asylum physician has been deeply touched by the descriptions by recovered patients of the shock upon them on admission of their surroundings; the shouts of their neighbors, the indescribable fear of other patients, the frightful thought, "This will be my fate," the baneful remarks of mischievous patients present in every institution who, with show of sympathy, say to the hypersensitive newcomer, "Such a one has been detained here these many years, and doubtless you will be."
These are not argument-made examples, but exist in every State hospital. They not only influence temporarily the imagination, but often do irremediable damage to the mind. The Pennsylvania State Lunacy Report, in considering this subject, says: "The acute are often heard to allude with horror to the condition of the chronic patients, dwelling most painfully upon the imminent probability of soon becoming hopelessly lost to home, friends, and society, and of passing the remainder of their lives in similar seclusion. Like begets like, and as the population of any hospital for the insane is chiefly chronic, there being relatively only a limited number of acute cases scattered through the various wards, this evil association must rob society of many a useful and productive citizen by placing him in daily contact with those who mar his chances for recovery." These are the mental and moral effects of such intercourse.
The chronic insane by the mere force of numbers also influence too much the character of the management of a State hospital and turn it from its true work, the cure of the insane. They constitute more than nine tenths of the entire number of patients in every mixed asylum, and receive more attention and care than the character of their condition demands, thus depriving the curable insane, who are less than one tenth the number, of much of what the hopefulness and acuteness of their sickness needs and requires.
