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A Mind That Found Itself: An Autobiography

Creator: Clifford Whittingham Beers (author)
Date: 1910
Publisher: Longmans, Green, and Co., New York
Source: Available at selected libraries

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Page 110:


"The medical staff of the Munich Psychiatrical Clinic includes as director Prof. Dr. Emil Kraepelin, one of the foremost German specialists in mental diseases; First Assistant Physician Doctor Gaupp, and Doctor Altzheimer, assistant physician and director of the laboratory. These and two other assistant physicians are paid; the others are young physicians who receive for their services free board and lodging, but no other compensation. The educational advantages offered by the clinic form one of its most valuable assets. These include oral and clinical instruction not only to medical students, but to practicing physicians who wish to become competent practitioners or specialists in mental diseases, and to lawyers who seek to specially qualify themselves for practice in the large and unfortunately growing class of cases that involve questions of mental responsibility. The clinic also serves as a tribunal of highest authority to determine the condition of patients who are involved by charges or litigation which hinge on the fact or degree of mental aberration. Such a patient is kept under expert observation and subjected to tests that finally give a definite diagnosis of his condition, which is no longer left to be decided by the academic opinion of a medical expert, caught by the artful hypothetical questions of a shrewd opposing attorney.


"Thus constructed, equipped and administered the modern psychiatrical clinic in Germany meets and fulfils two fundamental needs that exist in greater or less degree in every city or large town in the United States, namely, that of better facilities for the skilful treatment, care, and possible cure of cases of incipient and acute insanity; and, secondly, adequate provision for instruction in treatment and in the investigation of practical problems upon the solution of which must depend the arrest of increasing insanity among the people of the State. Its inestimable service to the community is that it provides for saving an indefinite but considerable percentage of the victims of incipient mental disease, and restores them to lives of usefulness, instead of leaving them to degenerate into a menace to society and a burden to the State. It provides the most consummate examination and treatment at a stage of the disease when there is the most chance of averting or arresting an attack of real insanity. It detects and takes timely charge of the smaller but important class of patients who, without the knowledge of their friends, are on the border line of insanity, and liable at any time to become suddenly dangerous to themselves or others.


"Its beneficent function is the prompt application of every known resource of detection and prevention to the whole insidious group of mental diseases which have become a penalty of the intense, over-wrought life of modern society, or are induced by poverty, self-indulgence, or inherited tendencies. Public benevolence and private philanthropy can fulfil no higher or more valuable purpose than to bring the ultimate resources of science to the support of a cause like this.


"FRANK H. MASON, Consul-General"
Berlin, Germany, April 8, 1905.




IN a report issued July, 1906, by the Department of Commerce and Labor, under the heading: "Insane and Feeble-minded in Hospitals and Institutions 1904," the following illuminating facts appear:


"On June 1, 1890, there were in the United States 74,028 insane patients distributed among 162 hospitals, of which 119 were public (maintained, as shown elsewhere in the report, at an annual expense of $10,595,567), and 43 private institutions. On December 31, 1903 (less than fourteen years later) there were in the United States 150,151 insane patients distributed among 328 hospitals, of which 226 were public (maintained, as shown elsewhere in the report, at an annual expense of $21,327,228.41) and 102 private institutions." This "increase of more than 100 per cent in the number of insane in hospitals, being accompanied by a corresponding increase in the number of institutions involved. . . . According to the best information available only 20 of the present state hospitals for the insane in the United States were established prior to 1850. ... To this number 17 hospitals were added in the decade 1850 to 1859; 18, in the decade 1860 to 1869; 26, in the decade 1870 to 1879; and 33, in the decade 1880 to 1889. During the last decade the growth of private asylums for the insane has also been very marked. The number given in this report is more than double that returned in 1890. . . . That this movement toward hospitals for the insane has probably not reached its height may be inferred from the fact that commitments were relatively more frequent in the years comprised in the second half of the period 1890 to 1903 than in those included in the first half." The government compiler then admits that the ratio of actual increase for the whole country is not in reality as much as 100 per cent -- but notice what follows: "While it is probable that relatively a much smaller number of insane escape institutional restraint than some twenty years ago -- otherwise the accumulation 'in hospitals would be inexplicable -- it is indisputable that even at the present time there are thousands who, although recognizable as insane, have not been placed in the care of hospitals or other institutions for that class. To offer any estimate of the probable number of insane that would have been disclosed by an investigation which included those not in institutions in addition to those in hospitals on December 31, 1903, would be a mere guess. But it is certainly within the truth to say that there were as many on that date as were found outside of hospitals in 1890, or some 30,000. In 1903 the number of insane in hospitals per 100,000 of population exceeded by 16.2 the ratio of all insane to population in 1890. ... At the end of the decade 1880 to 1890, the number of insane in hospitals had increased from 40,942 to 74,028 or 33,086, and the number of insane per 100,000 of population had risen from 81.6 to 118.2, or 36.6. In 1903, thirteen years later, the number of insane in hospitals had further increased by 76,123 patients, or more than the number found in 1890, and the number per 100,000 of population had increased by 68. These figures are, of course, for the most part merely illustrative of the larger utilization of hospitals for the treatment of the insane, and not direct proof of a corresponding increase of insanity. If the enumeration of 1903 had been made to include the insane outside of the hospital population it is evident

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