Library Collections: Document: Full Text

There is thus a clearly defined line between patients needing treatment and those subject to custodial care. For the former the intervention of the court is unnecessary except in rare cases, and then when an infraction has occurred or is threatened; for the latter every technical requirement should be observed. It is not intended to urge that the laws should be ignored, or that an individual who resists treatment should be made forcibly to accept it, without opportunity for adjudication; but it is most imperative that patients who are willing or anxious to receive medical treatment should have it, and should have free access to institutions conducted upon such a basis that they may voluntarily and with confidence seek admission. The fault is not with the statute, but with conditions which make harmful its application.

In the enlistment of the general hospital in this service certain requirements are to be observed. The institution should be of high standing and command the respect of the community. The department for mental diseases should be established upon the standard of excellence prevailing throughout. It should be somewhat removed from the other wards that the distressing incidents of acute bodily sickness, particularly the critical events of surgical service, should not create or intensify apprehension and suspicion. The wards differ in design from general hospital wards, and should be more attractively equipped. Tastefully furnished sitting rooms, with books, games and magazines for diversion, may be provided. The custodial feature should be reduced to a minimum, and intelligent visitation should be encouraged that the patient may always have the assurance that an appeal to his friends may be made.

It is of first importance that the attitude of officers and nurses should be one of service upon the patient, and never one of dictation or assumption of superiority or command. When the doors swing easily both ways there need be little anxiety. Finally, in critical cases, there is no substitute for the unremitting personal attendance of skilful and sympathetic nurses.

The function of a general hospital is the treatment of acute disease. The question is now presented whether there should be any limitation of this duty; that is, whether certain forms of disease should be denied admission. For large cities with numerous hospitals it may be expedient to specialize, and to designate different acute diseases to different hospitals. In smaller cities, of population varying from fifty thousand to two hundred thousand, the two or three good hospitals represent the purpose of the members of the community to secure for themselves proper treatment when sick or injured. The contribution of each individual, whether through private or public channels, is his measure of protection for himself or for some one near and dear. If the calamity which sends him to this institution is mental in character, he might demand, and he would be justified in demanding, that he be not spurned, when his neighbor with a surgical lesion or an infectious disease has at his disposal every means known to science for the restoration of his health.

It is not to be expected that the work of a hospital for the insane can be done in a general hospital. Nor can the work of a general hospital be done in a hospital for the insane, But there are many forms of mental disorder having the character of an acute illness, and there are many forms of actue -sic- physical disease with disturbance of mental function, for which the general hospital should provide. Otherwise, it is not a general hospital.

TABLE -- SHOWING THE FORMS OF DISEASE AND THE RESULTS OF TREATMENT FROM THE OPENING OF PAVILION F, FEBRUARY 18, 1902, TO FEBRUARY 28, 1907