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Memorial Of Miss D. L. Dix To the Senate And House Of Representatives Of The United States
For years, Dorothea Dix collected information on the abuse and neglect of people with cognitive and psychiatric disabilities. Her efforts resulted in the construction of numerous insane asylums at the state level, but she began to believe that the states needed help in financing these projects. Beginning in 1848, Dix used this information to submit a memorial to the United States Congress seeking federal support for the maintenance of insane asylums. Her proposal called for the distribution of five million acres of federal land to the states. This land was to be sold as a means of raising the necessary funds to care for the indigent insane. Her memorial, excerpted here, was successful in persuading Congress to pass a law in 1854 by which the federal government would provide ten million acres according to Dix’s plan. It would have been the first time that the federal government assumed responsibility for its destitute citizens. Because of President Franklin Pierce’s veto, Dix’s plan was never put into effect, and it would be over a century before the federal government would be involved in the care of people with mental disabilities.
The report of the Commercial Hospital at Cincinnati shows for 1844-'45, that of 1,579 patients, 85 were insane and idiotic. The report of 1846 exhibits the following summary: "Of 2,028 patients, 102 were insane." The last returns show yet an increase of this afflicted class, notwithstanding the enlarged accommodations in the State Hospital at Columbus, and the new buildings for the insane at the infirmary for persons in necessitous circumstances in the same city. I might adduce additional facts, but believe the above are sufficient to establish the correctness of my position.
Allowing at the present time 22,000,000 inhabitants in the United States, (which is below the estimated number,) and supposing only one in every thousand to be insane or idiotic, we have then 22,000 to take charge of; a majority of whom are in needy or necessitous circumstances. Present hospital provision relieves (if we do not include those institutions not considered remedial), less than 5,000 patients. Where are the remainder, and what is their condition? More than 17,000 are unsuitably placed in private dwellings, in jails, in poorhouses, and other often most wretched habitations.
Dr. Kirkbride who has carefully reviewed this subject, writes as follows: "In regard to whole numbers, my own inquiries lead me to believe that one in every six or seven hundred inhabitants would be a nearer approximation to correct estimate than one in every thousand, which has hertofore been assumed as the common rule."
The liability of communities to insanity should not, I suppose, be estimated by the number of existing cases at any one time; for insanity does not usually hasten the termination of life. Take, for example, Massachusetts, New York, and Virginia, where are found so large numbers of established, long-existing cases. These are counted again and again, every year, every five, or every ten years. A fairer test of the liability of communities to insanity is to be found in the occurring cases in corresponding given periods.
There are twenty State hospitals, besides several incorporated hospitals, for the treatment of the insane, in nineteen States of the Union, Virginia alone having two State hospitals. The following is a correct list, omitting several small establishments conducted by private individuals, and several pretty extensive poorhouse and prison departments, which cannot properly be classed with regularly organized hospitals, being usually deficient in adequate remedial appliances.
The first hospital for the insane in the United States was established in Philadelphia, as a department of the Penn Hospital, in the year 1752. This has been transferred to a fine district near the village of Mantua, in the vicinity of Philadelphia, since 1832: number of patients 208. A bill was passed in 1846 for the erection of a State hospital at Harrisburg, Pennsylvania, which will, it is believed, be occupied in 1851.
The second institution receiving insane patients, and the first exclusively for their use, was at Williamsburg, Virginia, in 1773: number of patients 164.
The third was the Friends' Hospital, at Frankfort, near Philadelphia, in 1817: number of patients about 95.
The next was the McLean Hospital, at Charlestown , (now Somerville,) in Massachusetts, in 1818. This valuable institution is second to none in America. Number of patients 180.
Bloomingdale Hospital, near the city of New York, was established in 1821: number of patients 145. South Carolina Hospital, at Columbia, in 1822: number of patients 104. Connecticut Hospital, at Hartford: patients 122: and Kentucky Hospital, at Lexington: patients' monthly average in 1849 was 252.
In 1845-'46, the legislature of Kentucky passed a bill to establish a second State institution in the Green river country: it is located it Hopkinsville, and will be completed in 1851.
Virginia Western Hospital was opened in Staunton in 1828: number of patients 217. Massachusetts State Hospital, at Worcester, was opened in 1833, and enlarged in 1843: it has 449 patients. Maryland Hospital, at Baltimore, was founded in 1834: it has 109 patients. Vermont State Hospital, at Brattleborough, was opened for patients in 1837, and enlarged in 1846-'47: it has 320 patients. New York City Hospital for the poor, on Blackwell's island, was occupied in 1838; it is now being considerably enlarged: above 400 patients.
The grand jury (June, 1848) made the following presentment: in relation to the Blackwell's island hospital for the insane poor: "We found no less than 425 afflicted children of humanity suffering under the most terrible of all privations, and, we observed with regret, less adequately cared for than their situation and the dictates of humanity require."
The same document places before the public the concurrent testimony of Drs. Macdonald, Williams, and Ogden, who in a clear and true report show that "the accommodations for the insane poor of New York city are at present inadequate and miserable; and the imperfect manner of their treatment is such as to be a disgrace to the city, which otherwise is deservedly famed for its liberal benevolent institutions. In the present state of affairs it is useless to attempt the recovery of any patients here."