■Memorial Soliciting a State 
 [Hospital 
 
THE LIBRARY OF THE 
 
 UNIVERSITY OF 
 
 NORTH CAROLINA 
 
 FROM THE LIBRARY OF 
 
 ALEXANDER B. ANDREWS 
 
 Class of 1893 
 
 TRUSTEE OF THE UNIVERSITY 
 
 FRIEND OF THE LIBRARY 
 
 C P 362.2 
 
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 UNIVERSITY OF N.C. AT CHAPEL HILL 
 
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 [HOUSE OF COMMONS DOCUMENT, NO, 2/f' 
 
 MEMORIAL 
 
 toLiciTrsa a 
 
 STATE HOSPITAL 
 
 FOR THE PROTECTION AND CURE OF THE INSANE, 
 
 SUBMITTED TO THE 
 
 GENERAL ASSEMBLY OP NORTH CAROLINA, 
 
 lOVEIVBEB, 1848 
 
 RALEIGH s 
 
 3EATQN GALES, PRINTER FOR THE STATE, 
 
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 •« 
 
 MEMORIAL. 
 
 To the General Assembly of the 
 
 State of North Carolina : 
 
 Gentlemen : — 
 
 I respectfully ask your attention to the subject 
 herein presented and discussed ; and solicit your prompt 
 and favorable action upon the same. 
 
 I come not to urge personal claims, nor to seek indi- 
 vidual benefits ; I appear as the advocate of those who 
 cannot plead their own cause ; I come as the friend of 
 those who are deserted, oppressed, and desolate. In 
 the Providence of God, 1 am the voice of the maniac 
 whose piercing cries from the dreary dungeons of your 
 jails penetrate not your Halls of Legislation. I am the 
 Hope of the poor crazed beings who pine in the cells, and 
 stalls, and cages, and waste rooms of vour poor-houses. 
 I am the Revelation of hundreds of wailing, suffering 
 creatures, hidden in your private dwellings, and in pens 
 and cabins — shut out, cut off from all healing influences, 
 from all mind-restoring cares. 
 
 Could the sighs, and moans, and shrieks of the insane 
 throughout your wide-extending land reach you here and 
 now, how would your sensibilities to the miseries of these 
 unfortunates be quickened ; how eager would you be to 
 devise schemes for their relief — plans for their restoration 
 to the blessing of a right exercise of the reasoning facul- 
 ties. Could their melancholy histories be spread before 
 you as revealed to my grieved spirit during the last three 
 months, how promptly, how earnestly would you Eearoh 
 
out the most approved means of relief; how trifling, how 
 insignificant, by comparison, would appear the sacrifices 
 you are asked to make ; how would a few dimes and. 
 dollars, gathered from each citizen, diminish in value as 
 a possession, compared with the certain benefits and vast 
 good to be secured for the suffering insane, and for their 
 afflicted kindred, by the consecration and application of 
 a sufficient fund to the construction of a suitable hospital 
 in which the restoring cares of skilfully applied physical 
 and moral treatment should be received, and in which 
 humane and healing influences should take the place of 
 abuse and neglect ; and of galling chains and loathsome 
 dungeons. 
 
 North Carolina, hailed of her sons, " the glorious Old 
 North," — North Carolina, unburlhe ned by State debts, 
 untouched by serious misfortunes, is last and latest of 
 the "old thirteen," save the small terrirory of Dela- 
 ware, to make provision for the care and cure of her 
 insane citizens, and almost the last embracing all tho 
 New States in our broad Union. 
 
 But it is not to the State pride of the intelligent citi- 
 zens, of North Carolina that my appeal comes ; it is to 
 the liberal and humane hearts of this portion of my 
 fellow citizens, its plea reaches ; it cannot be rejected, it 
 dares not consent to be put off. it claims with earnest 
 importunity that its merits may be discussed, it would 
 merge in oblivion the multiplied miseries resulting from 
 past neglects and procrastination, by wakening to action 
 the efficient energies of humanity and justice. 
 
 At present there are practiced in the State of North 
 Carolina, four methods of disposing of her more than one 
 thousand insane, epileptic, and idiot citizens, viz : In the 
 cells and dungeons of the County jails, in comfortless 
 rooms and cages in the county poor-houses, in the dwell- 
 ings of private families, and by sending the patients to 
 distant hospitals, more seasonably established in sister 
 States. I ask to represent some of the very serious evils 
 and disadvantages of each and all these methods of dis- 
 
posing of the insane, whether belonging to the poor or ts 
 the opulent classes of citizens. 
 
 It may be here stated that, by far the larger portion of 
 the insane, epileptics, and idiots, are detained in or near 
 private families, few by comparison, being sent to North- 
 ern or Southern State hospitals, and yet fewer detained 
 in prisons and poor-houses, yet so many in these last, and 
 so melancholy their condition, that were the survey ta- 
 ken of these cases alone, no stronger arguments would 
 be needed to incite energetic measures for establishing 
 an institution in North Carolina adapted to their neces- 
 sities, and to the wants of the continually recurring 
 cases which each year swell the record of unalleviated 
 unmitigated miseries. 
 
 If the plea of suffering humanity is insufficient to 
 cmicken Legislative interposition, an argument based on 
 indisputable evidence, may be advanced, whose force can- 
 not be slighted ; I mean the economy, directly to individ* 
 uals, towns, and counties, and remotely, but not less ac- 
 tually to the State, of establishing without delay, a Hos- 
 pital for the treatment and protection of the insane. 
 
 In order precisely and definitely to present this subject 
 in an economical point of view, 1 quote from carefully 
 prepared tables furnished by the experienced Superinten- 
 dant of one of the most successfully conducted Hospitals 
 in the Union. The cases affording the following results 
 are taken in their order of successive admission. The 
 first twenty were the first incurable cases which were 
 received at the institution : the last, those latest received. 
 The expense of the first, cost before admission, one dollar 
 and fifty cents per week. They had in the aggregate 
 cost to the State each, one thousand five hundred and fifty 
 dollars and fifty cents. On the other hand, the actual ex- 
 pense of the last twenty cases which have been discharg- 
 ed from the Hospital cured, amounts only to forty-seven 
 dollars and a half each. Hence, it appears that the ex- 
 penses already incurred for taking care of twenty cases 
 suffered by delay and neglect, to become incurable, has 
 
6 
 
 been more than thirty-lico times greater than the same 
 number of cases for which early and proper provision 
 had been made. The recent cases are well ; the old ones 
 will doubtless continue a charge through life. Strange 
 as it may appear, it is not the less true, that taking an 
 average chance for cures, it would have been a pecuniary 
 saving to the State to have had seasonable eare of these 
 old cases, though at an expense of eighty dollars a week, 
 rather than by neglect to have incurred the necessity of 
 supporting them to the present time, and till their de- 
 cease. 
 
 The incarceration of insane men and women in Coun- 
 ty prisons, whether furiously mad or otherwise, is object- 
 ed to, first as subverting the uses for which these prisons 
 are constructed, second, as placing the innocent on a 
 level with the guilty, making misfortune and crime, dis- 
 ease and health, go hand in hand. I said on a level, I 
 mistake ; the felon looks forward to a period of enlarge- 
 ment, and notes the time when his prison bonds shall be 
 broken ; the insane whose imprisonment is aggravated 
 and prolonged by consequence of sickness, not for his 
 crimes, anticipates no season of liberty, no period of re- 
 lease. 
 
 Again, many persons adopt the idea that the insane are 
 not sensible to external circumstances, that to their per- 
 ceptions the dungeon, chains, cold, nakedness, and harsh 
 epithets are as acceptable as a comfortable apartment, 
 freedom from shackles, a pleasantly tempered atmos* 
 phere, decent clothing, kindly speech, and a courteous 
 address. They assert that coarse, ill-prepared food is as 
 palatable as that which is wholesome and well cooked, 
 that cold and heat, sunshine and cloud, pure air and that 
 loaded with noisome exhalations, liberty and confine- 
 ment are all one and the same to the insane, producing 
 like impressions and results on the deranged intellect. 
 Greater error of belief was never adopted ; more serious 
 mistakes, and conducting to more fatal results could not 
 be propagated. The insane in most cases full as acute- 
 ly, and distinguish as readily as the sane. 
 
Nor are we to conclude that because a man is insane 
 that he is not in a large majority of cases, able to ap- 
 preciate the advantages of good associates, or that he is , 
 obtuse under the contact of ill-chosen companionship. I 
 recollect a gentleman who had enjoyed a liberal education, 
 and possessed a refined mind, whobecame.insane and 
 shortly furiously mad; for a little time he was conveyed 
 to a jail, and exposed to the daily observation of a crowd 
 of criminals, Avhose base language and coarse manners 
 constantly exasperated his temper ; finally he was re- 
 moved to a well ordered hospital, and after some months 
 his recovery being complete, he was restored to his fam- 
 ily and friends ; but he could not forgive them his deten- 
 tion in the prison; he spoke with bitterness and severity 
 on his having been subject to such a degradation. On 
 the contrary, he dwelt with tender gratitude upon his sit- 
 uation in the hospital, (that of Bloomingdale.War New 
 York) and spoke with continual pleasure of the comforts 
 which there surrounded him. But he never has relin- 
 quished the opinion that his malady would have yielded 
 much more promptly to the mental and moral treatment 
 in that Institution, had he been at once conveyed thither. 
 " I object absolutely, says Ellis, to the inhuman custom 
 of confining insane persons and idiots in the same builds 
 ings as prisoners and criminals ; the usage cannot be too 
 strongly censured." Many examples might be adduced 
 to illustrate the correctness of this position, and for other 
 reasons than those already stated. 
 
 In 1844, I found a furious madman in one of the dun- 
 geons of the old jail in Fayette County. Perm. His disposi- 
 tion was homicidal ; he had been in prison nearly fifteen 
 years. On one occasion a m,in was brought into the 
 prison intoxicated, having committed some offence while 
 under the influence of ardent spirits ; he was thrown into 
 the cell of the maniac, who it is supposed was provoked 
 by him, but no one knows : this only is certain, he fell 
 upon the involuntary intruder and murdered him in the 
 excitement of a most ferocious temper. When the jailer 
 
8 
 
 entered, a horrible spectacle presented itself, the murder- 
 ed drunkard, mangled and lifeless, the insane muderer 
 covered with gore, and exulting over the reeking remains 
 of his victim ! 
 
 In Philadelphia, some months since, the officers of the 
 Moyamensing prison were roused from sleep by the cries of 
 murder proceeding from a cell occupied by an insane man 
 and a prisoner who had been committed for disorderly 
 conduct. This unfortunate man was found lying upon 
 the floor weltering in blood, while the murderer, in the 
 highest state of phrenzy stood over him, brandishing a 
 bloody knife. The head of the victim was nearly sever- 
 ed from the body, and the body covered with frightful 
 gashes. In reply to the enquiry what had led him to per- 
 petrate this horrid deed, he answered that it was that he 
 might not himself be killed. 
 
 An insane man has for man}- years been confined in 
 the jail at Germantown, Stokes County, in this State. 
 On one occasion some time past, a negro prisoner was put 
 into the same room as the crazy man; he did not like the 
 companionship, and murdered him in a shocking manner, 
 yet he seemed quite insensible to the turpitude of the 
 deed, and rather exulted in the entire success of the act, 
 as I was informed on a recent visit at the prison. 
 
 I admit that public peace and security are seriously en- 
 dangered by the non-restraint of the maniacal insane. I 
 consider it in the highest degree improper that they 
 should be allowed to range the towns and country with- 
 out care or guidance ; but this does not justify the pub- 
 lic in any State or community, under any circumstances 
 or conditions, in committing the insane to prisons ; in a 
 majority of cases the rich may be, or are sent to Hospitals ; 
 the poor under the pressure of this calamity, have the 
 same just claim upon the public treasury, as the rich have 
 upon the private purse of their family ; as they have the 
 need, so have they the right to share the benefits of Hos- 
 pital treatment. Urgent cases at all times, demand, un- 
 usual and ready expenditures in every community. 
 
9 
 
 If County Jails ?nust be resorted to for security against 
 the dangerous propensities of madmen, let such use of 
 prison-rooms and dungeons be but temporary. It is not 
 long since I noticed in a Newspaper, published near the 
 borders of this State, the following paragraph: "It is our 
 fate," writes the Editor, " to be located opposite the Coun- 
 ty Jail, in which are now confined four miserable crea~ 
 tures, bereft of the God-like attribute of reason : two of 
 them females ; and our feelings are daily excited by 
 sounds of woe, that would harrow up the hardest souL 
 It is horrible that for the sake of a few thousand dollars 
 the waitings of the wretched should be suffered to issue 
 from the gloomy walls of our jails without pity and with* 
 out relief. Were our law-makers doomed to listen for a 
 single hour each day to the clanking of chains, and the 
 piercing shrieks of these forlorn wretches, relief would 
 surely follow, and the character of our State would be 
 rescued from the foul blot that now dishonors it." In near- 
 ly every jail in North Carolina, have the insane at dif- 
 ferent times, and in periods varying in duration, been 
 grievous sufferers. In Halifax County, several years 
 since, a maniac was confined in the jail ; shut in the dun. 
 geon, and chained there. The jail was set on fire by 
 other prisoners : the keeper, as he told me, heard frantic 
 shrieks and cries of the madman, and "might have saved 
 him as well as not, but his noise was a common thing ; 
 he was used to it, and thought nothing out of the way 
 was the case." The alarm of fire was finally spread ; the 
 jailer hastened to the prison: it was now too late; 
 every effort, (and no exertions were spared,) to save the 
 agonized creature, was unavailing. He perished in 
 agony, and amidst tortures no pen can describe. 
 
 In Wentworth, Rockingham County, is an aged crazy 
 man whose history even carefully abridged would fill too 
 many pages to be introduced here. The principal facts 
 of his troubled life are known to many in all the adjoin- 
 ing Counties. Can it be credited ? crazed and wretched, 
 he has been the inmate of a prison for more than thirty 
 years ! and that not for the commission of crimes, 
 
10 
 
 In Stokes jail, at Germanton, was a very crazy man, 
 confined in an unventilated, dreary dungeon. Being tol- 
 erably quiet about that time, his chains had been re- 
 moved, and he was rejoicing in being able to reach the 
 low gratfd door, because, said he *'I can put my mouth 
 close to the bars and draw in some air : dont you like 
 fresh air," he enquired, " Oh it is so good"! " but oh is'nt 
 it pleasant to look out and see the sky, and see the pretty 
 fields; I cant see them here, now you are come to let me 
 out; I know you have; I want to get out; I want to walk 
 about; I don't want to stay here." Alas I could render 
 no relief, the unfortunate man was incapable of self con- 
 trol, and endangered life and property when at large, and 
 there was no hospital to receive him in Carolina — he 
 was poor, and so could not be conveyed to that of 
 another State. 
 
 I recollect, of many examples, one recorded in a 
 Report to the Virginia Legislature, by Dr. Stribling, 
 which serves to illustrate what might have been, in 
 all probability, the benefits of timely Hospital care for 
 theis suffering madman. 
 
 In 1841, a patient was conveyed from a jail in 
 
 County, where he had been confined loaded with irons for 
 six months. He had been temperate and industrious, but 
 was unfortunate and insanity ensued. He was convey- 
 ed to the Hospital bound hand and foot, screaming vo- 
 ciferously, and seeming a very demon in look and act. 
 For days he was furious, but his malady yielded, at first 
 by medical means, and finally by moral influences. In 
 one month he was freed from all restraints, passed in 
 and out of the building at pleasure, and soon cheerfully 
 occupied himself upon the grounds of the Institution, in 
 useful labor, without even an attendant. In four and a 
 half months his cure was perfect, and he was discharged. 
 His gratitude and attachment to his physician and nurse 
 seemed unbounded. He returned to his home and set- 
 tled his affairs there, and after a few months returned to 
 offer his services as attendant in the Hospital, and has 
 continued in the daily and hourly exercise of those kind 
 
11 
 
 and humane cares which were so grateful and soothing 
 in his own experience. He has the responsibility of 
 guarding, protecting, employing, and amusing a class of 
 fifteen patients, all of whom are devoted to him. Com- 
 ment upon this case is needless. 
 
 In the miserably dilapidated jail in Surry, was also a 
 crazy man, quiet at the time of my visit, but subject to 
 access of violent and alarming paroxysms. Before com- 
 mittal he often declared to his wife that " he felt mighty 
 strange, that he was bound to kill somebody, that he felt 
 dreadfully, that he had a desire to kill her." He was 
 not malicious, did not entertain emnity towards any one 
 individual, but had a morbid and almost uncontrolla- 
 ble desire " to see blood run." Of course, being looked 
 upon as dangerous to the lives of others, he was com- 
 mitted to the jail for an indefinite period, where the ap- 
 plication of moral and medical means was unattainable. 
 In a Hospital, he would have been an indn.strions and 
 useful inmate, and probably in a short period might have 
 been perfectl}' restored to mental and physical health. 
 
 Since I was in Rowan, an insane man, possessed of a 
 moderate fortune has been committed to the jail ; I will 
 not attempt to depict his sufferings in the dismal dungeon 
 into which he has been cast. 
 
 From the comfortless, and old jail in Wilkes, an insane 
 women had been discharged some time previously to my 
 visit. At that period and since, I have received the fol- 
 lowing facts of her history. Mrs. B- is now above 35 
 years of age, and had for many years been eccentric, at 
 last deranged, and finally has hecome a decided ma- 
 niac. While her husband lived, he was ever kind and 
 indulgent,. and often said to his neighbors, in excuse for 
 her wayward conduct and ill-speech, that they must 
 not mind her, for she was deranged, as he believed. 
 More than a year since, she had been ill for sometime, 
 her husband was exhausted from loss of sleep, and, as he 
 thought at a favorable moment threw himself down to 
 rest. She perceived him sleeping, she went out and re- 
 turned with a large stone, with which she beat him upon 
 the head so as to cause almost immediate death, Her 
 
12 
 
 insanity was fully proved upon her trial, and she was 
 remanded to jail ; after considerable detention her broth- 
 er decided to take charge of her, and removed her to his 
 house. Recently in a state of high excitement she at- 
 tempted the life of her sister-in-law, and but for the 
 timely arrival of her brother would have accomplished 
 the shocking purpose. Her physician has lately written 
 to me, that he regards her as a confirmed maniac, and 
 dangerous at all times to be at large, as well as danger- 
 ous to all who unguardedly approach her when she is 
 excited. 
 
 An insane man has lately been discharged from th6 
 jail in Beaufort County, and sent to Hyde, where he be- 
 longed. One also from Carteret, as I am told. In Craven 
 County, I found a crazy man incarcerated in a noisome, 
 damp, cold dungeon ; "placed there for safe keeping!'' 
 His condition was very wretched ; and his prospects of 
 relief and appropriate treatment no better: if left there 
 he must become a confirmed madman* 
 
 In a dark, dreary and filthy dungeon, in Northampton 
 County, I lately found an insane man who had been con- 
 fined closely for several years. I did not persevere in en- 
 tering this dungeon, though I examined others corres- 
 ponding with it in dimensions, but cleanly kept. The 
 keeper doubted the safety or decency of opening the 
 doors , and no advantage could have been derived from 
 doing so, merely to attempt the near survey of a place, 
 that must assure permanence to disease ; and agravation 
 to bodily and mental disability. I am disposed to believe 
 that the keeper conceived himself in the performance of 
 his duty, to the extent such means as he possessed allow- 
 ed. This case I recollect, was repeatedly described, be- 
 fore I reached Jackson, by humane and intelligent citi- 
 zens in adjacent Counties, better possessed of facts than 
 myself, and speaking from personal observation of his 
 sufferings, noted in professional calls at the jail, during 
 the session of the Courts. 
 
 If Jails are unfit institutions for the treatment and re- 
 straint of the Insane, County poor-houses are but a de- 
 gree, if indeed at all more suitable. 
 
 / 
 
13 
 
 At ihc present tirru 1 , there are no insane persons either 
 in the Jail or poor-house of Wake County, but a conside- 
 rable number of individuals in private families, in more 
 or less suffering and exposed states, according to the abil- 
 ity of their friends to provide for them, and several are 
 wandering at large, gathering a precarious subsistence, 
 and not safe to be trusted .with their liberty. The case 
 of several requires prompt care One woman, whose pro- 
 pensities are homicidal, resides with her family, to their 
 manifest hourly peril. 
 
 The Jail of Orange is well built, and was in good order, 
 comparing well with the best kept Jails in the State. 
 The reverse exists, in regard to the poor-house, which 
 was neither clean nor comfortably furnished. I believe, 
 sufficient food is supplied, and in sufficient quantities. 
 A little expenditure by the County, and a little care, 
 would render the establishment more comfortable. 
 There were six insane ; three in close confinement, and 
 much excited. The most violent, a man long a maniac 
 and caged, was clean, but so noisy as to disturb all on 
 the premises ; a large part of the time, the room in which 
 his cage was built, could be made light, but was com- 
 monly dark and close, " to keep him more quiet!" A ne- 
 gro girl, a most pitiable case, was in the opposite build- 
 ing ; and a white woman also, in a separate compart- 
 ment, vociferous and offensive in the extreme. In the 
 passage, between their cells or cages, was a stove in which 
 fire was maintained when necessary. The place was 
 very offensive. The keeper could not altogether be 
 blamed for this ; he was hired to direct a poor-house, and 
 not qualified to rule a mad-house, and should not be ex- 
 pected to do it. Very many cases of insanity, in various 
 conditions, exist in this County. 
 
 Tn Granville County poor-house, is an unfortunate man, 
 who for years has been chained to the floor of a wretched 
 room ; miserable and neglected, his now deformed and 
 palsied limbs attest the severity of his sufferings through 
 these cruel restraints ; flesh and bone are crushed out of 
 shape by the unyielding irons. He was a man of food 
 
11 
 
 character, industrious, frugal habits ; a good citizen, and 
 respectable as respected ; he became insane, and soon 
 the malady assumed a maniacal character: he was car- 
 ried to the poor-house, loaded with chains, and left like 
 a wild beast to live or perish : no care was bestowed to 
 advance his recovery or to secure his comfort ! 
 
 Caswell Jail was in good order, safely constructed, and 
 vacant of prisoners. The family of the keeper reside in 
 the building. The county poor-house establishment, not 
 distant from Yanceyville, consists of a series of decent 
 one story buildings, kept remarkably clean and neat, and 
 reflecting credit at once upon the county, and those who 
 have the immediate charge. Of the four insane residents 
 here, two were in close confinement; a woman in a room 
 of sufficient size. Who was in a highly excited state. 
 The insane man was in a sort of stall or cage, and at the 
 season of my visit the place was clean. The noise, per- 
 versity, and bad habits of these unfortunate persons was 
 a source of much disquiet in the establishment. 
 
 In illustration of the blessing and benefit of Hospital 
 care in cases long and most cruelly neglected, I adduce 
 the following examples recorded by Dr. Hill, and corres- 
 ponding with many cases under my own immediate ob- 
 servation since 1840. "Two patients," writes the Dr. 
 "were brought to me in 183G, wiio had been confined in 
 a poor-housejbetween eighteen and twenty years. During 
 this period they had not known liberty. They had been 
 chained day and night to their bedsteads, and kept in a 
 state so filthy that it was sickening to go near them. — 
 They were usually restrained by the strait- waistcoat, and 
 with collars round their necks, the collars being fastened 
 with chains or straps to the upper part of the bedstead, 
 to prevent, it was said, their tearing their clothes. The 
 feet were fastened with iron leg-locks and chains. One 
 poor creature was so whqlly disabled by this confinement, 
 that it was necessary for the attendants to bear her in 
 their arms from place to place after she was brought to 
 the Hospital; she shortly acquired good habits, and was 
 long usefully employed in the sewing- room. The other 
 
15 
 
 was more difficult of management, but soon gained clean- 
 ly habits, and now occupies herself in knitting and sew- 
 ing, and that, after having been treated for years like the 
 lowest brute. Another case was brought in chains, high- 
 ly excited ; five persons attended her; in six days all re- 
 straints were removed ; and she walked with her nurse, 
 in the patients' gallery. In June, she was discharged 
 from the wards quite cured, and engaged as assistant in 
 the kitchen. 
 
 The Jail of Rockingham is in tolerably good order, the 
 poor-house, but a short distance from Wentworth, is sin- 
 gularly neat, and well-ordered ; the inmates sufficiently 
 well-clad and very neat and respectable. The build- 
 ings require repairs. The house is well kept, but more 
 comforts might well be supplied. 
 
 The Jail of Stokes is in tolerably good condition, but 
 badly constructed for the admission of light and air 
 in the dungeons ; there should be a stove in the passage, 
 to dry the walls in damp weather. 
 
 The poor-house about three miles from Germanton, 
 is extremely comfortless, the apartments are entirely too 
 much crowded, and the arrangements are not suited to 
 promote the comfort or good order of the inmates. — 
 Rooms of the poor all ill-furnished and out of repair. 
 Residence of the Superintendant very neat and comfort- 
 able. There was one insane woman then at liberty but 
 often confined in a cell, in all respects, unfit for one in 
 her condition. I cannot forbear the remark, that when 
 not in close confinement, she was very improperly situa- 
 ted in the room she occupied. There were several oth- 
 ers in the house in a demented state. 
 
 The Jail of Surry, is an isolated old two-story wooden 
 building, and in some parts dilapidated ; the poor-house 
 is about three miles from Rockford, the Superintendent 
 resides in town, and keeps several negroes to look after 
 the poor, of whom there were in September, about 30. 
 There were no insane in close confinement, but two who 
 are allowed the freedom of the place. 
 
16 
 
 The jail of Guilford, is isolated, hut very ive 11 built 
 and well kept : in addition to the dung-eons # and other 
 strong rooms, was the unusual provision of a large chap- 
 el room lor religious services, when circumstances should 
 make it desirable to hold such therein. The old poor- 
 house several miles from Greensboro' is about to be 
 abandoned, being utterly comfortless and out of repair. 
 New buildings on the Hillsboro road are ^nearly com - 
 pleted, and there is no doubt that the establishment will 
 be in all respects well-ordered, and fitly conducted. 
 
 The jail of Davidson, a new, secure, and substantial 
 building was found in excellent order ; the common mis- 
 take of insufficient air and light in the dungeons exists here. 
 The County poor house about six miles from Lexing- 
 ton, was pretty well ordered, but too little visited. The 
 supplies of food and clothing seemed sufficient for both 
 health and comfort: but there, as elsewhere, the insane 
 were out of place, and in a bad state. For this no blame 
 is to be attached to the superintendant, so far as I could 
 judge. One very crazy man was chained to his bedstead ; 
 he was noisy, filthy, and truly repulsive. A crazy wo, 
 man, but quiet, was rolled in a quantity of soiled bed 
 clothing. These like many others would be useful, and 
 decent in their habits, if resident in the hospital expressly 
 designed for the insane. Besides these are two demented 
 patients. 
 
 Rowan jail, on the first floor of which resides the jail- 
 or, is a substanial building — not clean when I saw it ; 
 chiefly commended, I was told, as a secure prison. An 
 insane man has recently been committed here. The poor 
 house about two miles from Salisbury, requires so mueh 
 to render it comfortable that it would be difficult to know 
 how to enumerate its deficiencies : the house occupied 
 by the keeper was quite the most comfortless abode, that 
 I have seen in North Carolina, except repaired, certainly 
 not habitable for the winter. No insane man in con- 
 finement in this institution. 
 
 Iredell jail, is isolated and had just passed into the 
 charge of a newly appointed officer, it would hardly be 
 
IT 
 
 just to remark severely upon its very dirty and neglected 
 condition. The County poor-bouse, a few miles from 
 Statesville, is situated in a singularly secluded spot, re- 
 mote from supervision and often observation, and is a 
 model of neatness, comfort, and good order ; having a 
 most efficient master and mistress, especially the latter, 
 upon whose cares in these institutions by far the most is 
 dependent. All in all, this was in much the best condi- 
 tion of any poor-house I have seen in North Carolina, 
 neat, plain, and decent, it would do credit to any State ; 
 but it is no fit place for the insane. Since I was there, 
 in September, a highly respected citizen writes me that 
 a young woman has been sent to the poor-house so vio« 
 lently insane, that it is quite unfit she should remain 
 there. Also a man has in that County, very recently 
 become so violently mad as to be quite unmanageable, and 
 having no Hospital in the State, they have confined him 
 with, chains and manacles, hand and feet, and do as best 
 they can. A subscription paper has been circulated for 
 the purpose of raising funds to send him to Columbia, 
 S. C. Other painful cases exist in this, as in the counties 
 which I have visited, and from which I have heard; most 
 of which I do not feel at liberty, through their domestic 
 and social position, to designate ; but they plead ia 
 heart-reaching language for the early establishment 
 of a State Hospital. 
 
 Wilkes jail is an old building, and so far as the jailor 
 is accountable, is well kept : it is isolated, and a wretch- 
 ed place whether for the prisoner, or the insane who are 
 sometimes confined here. There is no poor-house in this 
 County. Five or six cases of insanity have been report- 
 ed to me. One, a man named Dowel!, is said by a re= 
 spectable physician of Wilkesboro' to have been crazy 
 for more than 12 years: the malady is gaining fore* 
 gradually, and now exhibiting itself in furious mania; 
 he is a very dangerous person to be at large, has proved 
 himself to be mischievous, and one© ^attempted to 
 commit homicide, 
 
 2 
 
18 
 
 The Jail of Caldwell is well built, was in good order, 
 and has sufficient light and air in every part. There are 
 no violently excited insane in the poor house, which is 
 some miles from Lenoir, and but few cases in the County. 
 
 In the Jail of Davie, is one insane man ; in the poor- 
 house beyond Mocksville, I was informed, was a case of 
 insanity truly pitiable, beside many others in the Count}'. 
 
 The Jail of Bertie is an exceedingly well built edifice, 
 sufficiently lighted and aired, and well-kept; the Jailor 
 and family reside on the first floor ; the County poor- 
 house, about three miles from Morgartton, is not well sit- 
 uated ; the buildings are out of repair, and ill-arranged 
 within, for either comfort or convenience in times of sick- 
 ness or of health. I should think that the Superinten- 
 dent was kind aud faithful in the discharge of all his du- 
 ties towards the poor- Here as in most of the poor houses 
 in North Carolina religious services are frequently holden. 
 
 The jail of McDowell, like most of the County prisons 
 in thi3part of the State, I found well built and well kept ; 
 there is no county poor-house in ov near Marion , and 
 my inquiries reached but few insane in the County. One 
 man often violently excited, but ordinarily for the last few 
 years so tranquil as to be at large, I found beyond Plea- 
 sant Gardens. At one time he was closely shut up. 
 
 The jail of Buncombe is a large substantial building : 
 formerly there was a county poor-house six or seven miles 
 from Asheville, but its remote situation and serious dis- 
 comforts through bad management led to the entire break- 
 ing up of the establishment some time since. A plan suc- 
 ceeded this, somewhat original, which when I was in Ashe- 
 ville, had not been fully carried into effect ; having no 
 perception of its merits and claims to commendation, I 
 shall dwell but slightly upon the subject, merely stating 
 on authority of several of the citizens, that it was con- 
 sidered in constructing the new jail, expedient to make it 
 of sufficient capacity to accommodate at one and the same 
 time and place, the vagrants and felons of the county, and 
 the unfortunate poor. The enclosed yard, "at present 
 unimproved," is of sufficient extent to permit the erection 
 
19 
 
 of additional buildings "if needful." '-It is belived," said 
 my informant, "that the wardens and overseers consult e^ 
 conomy by this arrangement in various ways, especially as 
 one man can keep the prisoners and the poor, saving the 
 cost of hiring a second individual for the latter service." 
 "But one pauper has been sent to jail, and he ran away 
 dissatisfied with his quarters, in about three weeks." 
 
 Rutherford jail is an old and poor building, but now 
 serves sufficiently for the County. 1». is quite isolated; 
 but the jailer seemed fitted to fulfil his duties with hu- 
 manity and fidelity. The County poor-house, a short 
 distance from ilutherfordton, is not so comfortable as 
 respects the buildings and furnishing as it should be 
 made. The Superintendant seemed a favorite of the 
 poor there. 
 
 Cleaveland Jail is excellently built, cleanly kept, and 
 the Jailer, as should always be arranged, resides in one 
 part of the building, having thereby the more immediate 
 and efficient care of the prison. The County poor-house 
 about three miles from Shelby, is a small but neatly kept, 
 and seemingly comfortable establishment. It seemed to 
 me that the Superintendent received an insufficient re- 
 compense for the difficult charge the situation of several 
 of the inmates involved. 
 
 Lincoln Jail is a well-built, well-planned prison, well 
 arranged, and apparently well kept. The poor-house, 
 several miles from Lincointon, had but three inmates in 
 October ; their condition was uniformly represented as 
 not good, and the establishment described as being ob- 
 jectionable. Perceiving influential citizens, prompt to 
 admit existing evils, I did not personally visit it. No in- 
 sane at present are confined there. Several in distressed 
 conditions in the County, in private families. 
 
 Gaston Jail is as yet unfinished, but appears to be a 
 well-planned building. No poor-house in or near Dal- 
 las ; but one such needed for the County poor» Several 
 insane in the County. 
 
 Mecklenburg Jail is remarkably well planned and well 
 built, but less well kept than are most County prisons in 
 
20 
 
 Kortb, Carolina; as respects clean tineas. The County 
 poor-house, several miles from Charlotte, was nearly de- 
 serted in October, having but two of the County poor ; a 
 partially insane woman, and a paralytic man. 
 
 Cabarrus Jail is a large, well constructed building — id 
 tolerable order ; the Jailor occupies commodious apart- 
 ments upon the first story.; The County poor-house about 
 two and a half miles from Concord, is very deficient in 
 means for promoting the comfort of the infirm inmates. 
 In a miserably dilapidated out-building, perhaps ten feet 
 square, open on all sides to the ingress of the winds, rain, 
 and snow, I found a crazy man chained to the floor, filthy 
 and disgusting. At times he is suffered to go at large, 
 but is at once troublesome and dangerous to those he 
 meets, or whose house he frequents. In a Hospital, this 
 crazy man would, under judicious care, be able to per- 
 form more labor than would suffice for his own mainten- 
 ance. I did not visit the insane scattered in private fam- 
 ilies. 
 
 Stanly Jail is a small new building, neat and secure, 
 but the dungeons so planned and constructed as almost 
 to assure the destruction of health to any who might be 
 long in detention ; there is hardly a possibility for the 
 admission of sufficient air to support the absolute demands 
 of the animal structure. There are in the County seve- 
 ral cases of insanity requiring Hospital treatment. At 
 present, there is no poor-house in on near Albemarle. 
 
 Montgomery Jail, like that of Stanly, is a neat sub- 
 stantial building, and well-kept, but not well planned 
 for health, as respects the admission of light and air, 
 though it assures security. 
 
 The County poor-house, at Lawrenceville requires, it 
 appeared to me, much more careful attention on the part 
 of the Wardens, to supply comfortable and necessary at- 
 tendance upon the aged and infirm, who alone occupy 
 the buildings. Nothing could be more creditable to t hese 
 feeble women than the neatness and care with which 
 they kept their apparel and their apartments. An in 
 $?me man bad been removed to some other situation in tha 
 
County. Several cases of insanity were related to mo 
 on authority. 
 
 Moore jail seemed a secure prison; its want of cleanli- 
 ness was excused on the ground of there being no pris- 
 oners, and being occupied as a lodging for servants. 
 The dungeons, which did not serve this use, were by 
 comparison with the majority of prisons in the State, in 
 bad order. The County poor-house, not distant from 
 Carthage was excellently kept by a conscientious and 
 kind-hearted family, to whose cares the comforts of the 
 inmates are aseribable, rather than to the provision made 
 by county officials. The buildings are much out of re- 
 pair and unfit for winter habitation, or for stormy days 
 at any season. The custom so worthy of entire condem- 
 nation, that of setting off the poor in mass, by lots or sin- 
 gly, to the lowest bidder exists in Moore County. The 
 poor are fed, clothed, supplied with bed, clothing and fuel 
 and waited on at the rate of 8 cents the day each ; a sum 
 which cannot pay those who undertake this charge. 
 That I found the poor well supplied with food and well 
 clad, I repeat was certainly aseribable to the liberality 
 and Christianity of the present keepers, rather than to 
 the just guardianship of the public. 
 
 Cumberland jail is an old building, well lighted and 
 well ventilated: it is said that more attention will be 
 paid to the preservation of cleanliness than heretofore, 
 the keeper and famlj" now residing upon the premises. 
 The county poor house within three miles of Fayetteville 
 is well situated, and apparantly excellently kept : clean- 
 liness, that crowning excellence in house-keeping, prevail- 
 ed in every room save one, and I imagine might with the 
 exercise of a sufficient determination, be secured even in 
 that. In a log building well constructed, and admitting 
 sufficient light and air, planned so as to be warmed in 
 damp and cold weather : were two small apartments for 
 the insane : at the time I was there one room was vacant, 
 the other was occupied by a violently excited and noisv 
 insane man, whose shouts and vociferations reached ma 
 at a distance from the p-oor-house. In a hospital this 
 
<¥} 
 
 poor creature's energies would tind exercise in useful em- 
 ployment ; in a poor-house it is not to be expected that 
 the superintcndants should have the qualifications which 
 pertain to a judicious control of maniacs: moreover 
 the noise and disturbance these create, banish comfort 
 and repose from the infirm, the sick, the dying , and the 
 demoralizing influence, through use of profane language 
 and additional evils. In this poor-house religious services 
 are regularly and frequently holden, and one has evi- 
 dence that the ministers of the various religious denomi- 
 nations in the vicinity had not overlooked that scripture, 
 " To the poor the Gospel is preached which foretold the 
 advent of Jesus the Saviour, and comforter." 
 
 The jail of Sampson is said to be decently kept. The 
 county poor are said to be well clothed and supplied with 
 wholesome food. Several cases of insanity have been 
 related in this county 
 
 The jail of Duplin is defective. The wardens of the 
 county poor-house which is situated east of Warsaw, sev- 
 eral miles from Kenansville, have the reputation of giv- 
 ing uncommon attention to the temporal and spiritual 
 comforts and consolations of the poor. Religious ser- 
 vices are holden at the poor house. At present there are 
 no insane persons there. 
 
 The jail of New Hanover appeared to be tolerably 
 ■well kept. It is a large commodious building. Too lit- 
 tle light and air are admitted into the dungeons. The 
 county poor-house on the confines of Wilmington is in a 
 miserable and dilapidated condition ; fallen wholly from 
 its former well deserved reputation of being one of 
 the best Institutions for the poor ia the country. Ap- 
 parently the acting wardens are responsible for its de- 
 cline. There are affecting and suffering cases of insani- 
 ty in several private families in this County. 
 
 Wayne jail is an old dilapidated building,-shortly to be 
 replaced by a new prison. Found in miserable condi- 
 tion. The County poor-house several miles from Golds- 
 boro'. seemed quite decently kept, and in many respects 
 bore an air of comfort. There seemed to be neglect from 
 
abroad in the attendance upon the sick ; several individ- 
 uals were evidently suffering from want of medical ad- 
 vice and prescription. This establishment is but seldom 
 visited, and the comforts enjoyed seemed chiefly referable 
 to the caro of occupants. One of the poor, an insane 
 man, had wandered away : an insane woman was so far 
 controllable as to be steadily and usefully occupied. 
 
 Lenoir jail, a very old and isolated building, but strong^ 
 seemed pretty decently kept ; it has some very great de- 
 fects of construction. The poor of the county are not 
 numerous, by comparison with the adjacent Country. 
 
 Craven jail, a very large brick building, promising ex- 
 teriorly a better condition than the interior revealed. 
 The dungeons were very bad, offensive, dirty, ill-lighted, 
 and not ventilated. A very insane man, considered dan- 
 gerous to be at large, was in one of them ; he was cold, 
 exposed, and suffering ; his condition was such as to as- 
 sure agravation, if not permanent confirmation of his 
 malady. There are no means of maintaining either 
 dryness or warmth in the passages or in the dungeons. 
 The county poor-house, a short distance from Newbern, 
 is well situated, and has the reputation of being well 
 kept in general. The keeper's house, and several rooms 
 occupied by the poor, were neat and well-ordered; others 
 were in a poor condition. A Sunday school is taught 
 here by persons from Newbern, whose Christianity is il- 
 lustrated in their practice of its precepts. There are here 
 in Craven Count}', many cases of insanity. 
 
 Beaufort jail is a neat brick structure ; the jailor oc- 
 cupies the lower floor in front. The plan of the prison is 
 not good, though it assures security when properly at- 
 tended to. 
 
 A letter received from a physician resident in Wash- 
 ington, informs me that since I left that town a week 
 since, an insane man in a state of high excitement, has 
 been committed to the jail there for public security, and 
 occupies a dreary, wretched cell. I cannot question the 
 willingness of the jailor to perform his duty as humanely 
 as possible ; but there is no mercy nor humanity in com- 
 mitting the insane to prisons. 
 
34 
 
 The unfortunate man above alluded to might, in a wejl 
 ordered Hospital, undoubtedly in a short time be sufficient- 
 ly recovered, if not cured, to pursue some useful and pro- 
 fitable employment. 
 
 Recently fifteen cases of insanity have been stated, ex- 
 isting in this section of the State — that is in Beaufort, 
 and adjacent Counties. 
 
 An insane person with whom I was conversing two 
 weeks since, dwelt with profound feeling upon the trials 
 and sufferings she endured, conscious of her state, and 
 sensible of ail that occurred around her : that which most 
 moved my feelings at the time was, the indescribable pa- 
 thos with which she related the sufferings and hardships 
 of a crazy man confined in the Jail in her native County. 
 She concluded, " I, in my troubles, have friends — he has 
 none." 
 
 The county poor-house not distant from Washington, 
 and reached over a good road, is pleasantly situated, but 
 in a spot well known for its unhealthiness, having been 
 abandoned by the former owner of the property, for its 
 liability to create fevers, and for the general insalubrity 
 of the place. The establishment needs an efficient Su- 
 perintendant, competant in mind and body to carry for- 
 ward the interests of the place. Offering at first glance 
 the appearance of a comfortable institution, it fails to 
 show forth either private or public efficient and fit direc- 
 tion. The sick and the children certainly suffer ; and 
 those able to work need a director to insist upon their 
 action. I found one woman here insane, but quiet. 
 
 Pitt jail is a neat, two story building painted white, 
 and sufficiently large for present county purposes. The 
 poor of this county are said to be well cared for. Sad 
 and distressing cases of insanity were brought to my no- 
 tice existing in private families, in conditions of extreme 
 suffering and exposure, of which I do not feel at liberty 
 to give the history. 
 
 Edgecombe jail is a well constructed, isolated prison ; 
 well and cleanly kept : its defects of plan and arrange* 
 ment are fewer than ordinary in county prisons. I did not 
 
25 
 
 visit the poor-house of this county established some dis- 
 tance from Tarboro, but it bears a good reputation, and 
 at present there are no violently excited insane there -, 
 cases are known abroad in the county. 
 
 Halifax Jail is a well built prison seemingly, though 
 isolated, securely kept, but bears the reputation of being 
 deficient in cleanliness. At present no insane detained 
 there. The poor-house nearly three miles from Halifax, 
 has much need of competent care, and efficient superin- 
 tendence. Most of the inmates are aged and infirm. 
 The buildings are well situated and conveniently plan- 
 ned for the oocu pants, but deficiently furnished, except 
 one room furnished by the individual who dwells in it. 
 The sick need nursing, care, and comforts ; and all re- 
 quire supervision. 
 
 Northampton Jail is well-built, but defectively plan- 
 ned — the dungeons, of which there are four, are insuffi- 
 ciently lighted and ventilated, and however cold or damp 
 are never warmed and dried. Here is an insane man con- 
 fined for years in this dreary abode ; from his sight, the 
 genial sun, the beautiful sky, and the green fields are 
 forever shut out ; darkness, and foul air, and solitude, 
 heaviness and misery are his portion. Kindred and 
 friends are put far from him, and his acquaintance into 
 darkness. May the merciful God compassionate those 
 who are so cruelly abandoned by their fellow-men, and 
 may no heavy retributions crush those, who so unhesita- 
 tingly and unpityingly consign a helpless, crazed crea- 
 ture, to such a hapless doom. 
 
 The poor-house, a mile and a half from Jackson, con- 
 sists of five dilapidated, unfurnished rooms, at pre- 
 sent abandoned. The Superintendant who resides in 
 a pleasantly situated comfortable house, distributes 
 quarterly, to one hundred beneficiaries an allowance of 
 meat, meal, and clothing, at a cost to the county of about 
 $2,500 00. Several insane poor, B and others in better 
 circumstances are in this County. 
 
 The jail of Nash is a small two story decent building; 
 no insane now confined therein. The poor=house I had 
 4 
 
26 
 
 sot time tc visit, but understand it is comfortable. Sever- 
 al cases of insanity were reported to me existing in the 
 county. 
 
 Time would fail in the narration, even were it proper 
 to unveil the miseries, protracted, and indiscribably va- 
 ried, of the insane in private families, and the distress of 
 families thrown into sorrow and trouble unequalled, 
 through the affliction and sore perplexities arising out of 
 care over the demented, the epileptic, and the maniac. 
 A detailed description of their personal condition, horri- 
 ble as it must be, could not present the half of the woes 
 which exist in every county throughout North Carolina, 
 Loathing and horror would overwhelm the reader, sue • 
 cessively introduced to dreary apartments, loathsome cells, 
 and foul cabins, whence issue the most horrible sounds 
 and poisonous effluvia, and wherein are spectacles of 
 protracted bodily and mental misery language is poor 
 to represent. 
 
 Of the few examples of many which exist, to which I 
 shall now refer in private families, the following have 
 quite recently come under my observation : A poor but 
 industrious farmer in the western part of this State, the 
 father of a numerous family, became insane; it was in 
 vain to control him in his own dwelling, he was furious 
 and he was conveyed to the County jail ; here his suffer* 
 ings were aggravated and his malady exasperated; I can* 
 not tell for how long a time the lone dark dungeon echo- 
 ed to his moans and cries, nor at what cost the county 
 maintained human life, unaiding its sufferings and neces- 
 sities. In process of time the paroxysms of violence sub- 
 sided, and finally he was transferred to the humble log 
 cabin of his aged widowed mother, alone woman dwell- 
 ing upon the mountains. There I found the infirm, af- 
 flicted mother, and the insane son. Amidst tears and 
 sighs she recounted to me her troubles, and as she wept 
 she said, M the Lord above only knows my troubles, and 
 what a heap of sorrow I have had in my day, and none 
 tofgive me help. There he lay in the jail, cold and dis- 
 tressed, nnd mightily misused ; if I could have got mo- 
 
27 
 
 ney to send him off to where they cure such spells, for 
 they do say crazy folks can be cured, I should have had 
 him in my old age to take care of me, but I am poor and 
 always was, and there is no help here. Ah well, many 
 and many is the long night I am up with him and no 
 sleep or rest, anyhow; this cant last always; I shall die, 
 and I dont know what is to come of him then." It is 
 for Legislators to determine whether such as these shall 
 drag out troubled existences, and no succour until the 
 Angel of death brings release, and seals the long record 
 of "man's inhumanity to man." A respectable citizen in 
 the same quarter of the county, by very slow degrees lost 
 his reason. First was a nervous restlessness, next un« 
 wonted irritability, then a craving for stimulants, which 
 were in time used to excess, and quickened the malady, 
 yet none then traced the real cause of the growing evil : 
 but the type of a deranged intellect was shortly devel- 
 oped beyond doubt, and in a few months the distress and 
 trouble, of the household knew no alleviation nor interval. 
 Finalty, removal from home, under most grievous cir- 
 cumstances, ensued, and I have not long since been wit- 
 ness to the afflictions of this worthy and respectable fam- 
 ily whose efforts to sustain themselves are as affecting 
 as praiseworthy. Had there been in North Carolina, a 
 State Hospital, timely care might have secured a perma- 
 nent cure. It is almost too late to assure this now, but in- 
 stead of restoration is life-long expense, and life-long 
 suffering. 
 
 In Lincoln County, near a public road, stands a decent 
 dwelling ; near by is a log cabin, strongly built, and 
 about ten feet square, and about seven or eight feet high ; 
 no windows to admit light ; the square logs are compact- 
 ly laid ; no chimney indicates that a fire can be kindled 
 within, and the small low door is securely locked and 
 barred. Two apertures at right angles, ten inches long 
 by four wide, are the sole avenues by which light and 
 air are admitted within this dreary cabin, so closely se- 
 cured, and so cautiously guarded. You need not ask to 
 what uses it is appropriated ; the shrill cri6S, and tern- 
 
28 
 
 pestuous vociferations; of an incarcerated maniac Will 
 arrest you on the way, and if you alight, and so far as 
 the light received as before described will allow, exam- 
 ine the interior of this prison, you will discern a fero- 
 cious, filthy, unshorn, half-clad creature, wallowing in 
 foul, noisome straw, and craving for liberty. The horrors 
 of this place may not be more definitely descibed ; they 
 can hardly be imagined : the state of the maniac is re- 
 volting in the extreme. This creature, is a man — insane 
 for more than thirteen years — for a longtime suffered to 
 range the country far and wide, addicted to mischief and 
 disposed to violent acts. For assuring public and pri- 
 vate safety, his family have adopted the only alternative 
 of confining him upon their own farm, rather than see- 
 ing him thrown into the dungeon of the County jail. Of 
 these two evil conditions, I confess, I see no choice. The 
 family though enjoying the means of decent livelihood, 
 when unburthened by extra expenses, have not the means 
 of sending him to a distant Hospital. The rich may 
 partake the benefits such institutions afford : the poor 
 must suffer, agonize, and bear heavily out, by slow-kill- 
 ing tortures, their unblessed life ! Are there no pitying 
 hearts, and open hands that can be moved by these mis- 
 eries ? 
 
 Well and truly may it be said of the insane : whose 
 sorrows are like unto their sorrows, and whose griefs are 
 like unto their griefs? Friend and companion are re- 
 moved far from them, and their acquaintances are hid 
 from their view ! 
 
 Of thirteen cases of insanity in and near Raleigh, there 
 is one to which my attention has within a few days been 
 called, which especially illustrates the want of a Hospital 
 
 for individuals in narrow circumstances. Mrs. ~— 
 
 has for several years had rather feeble health. Some- 
 time in February last, she manifested peculiar restless- 
 ness by day and night, became agitated and nervous, and 
 her mind was subject to strange and harrassing delusions 
 From that time she became incapable of attending to'the 
 affairs of her household ; neglected her child, and passsd 
 
29 
 
 most of the time night and day in traversing the small 
 apartments of her dwelling. Her husband, dependent 
 upon daily industrious labor for a decent support, found 
 himself embarrassed by the distresses of his home and the 
 claims of business. He is unable to pay her expenses at 
 any Hospital ; meanwhile, she is sinking into a conditiou 
 of hopeless and permanent insanity. She who was neat, 
 modest, industrious, and kind, is now through this most 
 afflictive malady, utterly transformed ; her garments are 
 rent in tatters, her person neglected, her hair dishevelled, 
 falls in tangled locks about her head ; her speech is no 
 longer gentle, true and kind; but violent, profane, and inde- 
 cent ; in that humble, once pleasanthome, is now neither 
 peace, nor rest, nor security : there is constant danger of 
 destruction by fire, and acts of personal violence often 
 recurring, indicate the increasing liability to deeds in- 
 volving fatal consequences : in train with these alarming 
 manifestations, are symtoms of a suicidal disposition. It 
 has been found necessary at times to confine her move- 
 ments by the application of painful modes of restraint 
 upon the limbs ; which, though preventing present mis- 
 chief, continually aggravate the malady. Hospital treat- 
 ment might restore this patient to her family blessings, to 
 society, and to usefulness. 
 
 Many cases of maniacal insanity have been removed to 
 Southern and Northern Hospitals. Hitherto, North 
 Carolina has been willing to be dependent upon other 
 States for her afflicted children, while in possession of 
 ample means to succor and heal their maladies within 
 her own-borders. But there are other objections to trans- 
 porting patients to distant Hospitals for remedial care, 
 beside the fact of encroachment upon the Institutions of 
 other States. Expenses are vastly increased in making 
 long and always difficult journeys under circumstances so 
 harrassing and painful ; and an experienced physician of 
 a celebrated Hospital has informed me that the fatigues, 
 excitement, and exposures of several patients, conveyed 
 long distances, have within the present year resulted in 
 death. "Want of sleep and exhaustion, have reduced them 
 
30 
 
 to the most dangerous condition before being received ; 
 and not seldom depleting remedies injuriously adopted, 
 have hastened dissolution. If there is cruelty and gross 
 injustice in holding the insane in jails, poor-houses, and 
 private families, there is serious risK: of property and of 
 life in leaving them to range at large. Plainly, there is 
 but one remedy. 
 
 In Aberdeen, Ohio, an insane man, left in the room 
 where a little girl three years old was sleeping, in the 
 absence of the mother, threw down the Bible which he 
 was reading, seized an axe. and deliberately chopped the 
 little victim into five pieces. 
 
 In Rowan County, N. C, a maniac cut her husband's 
 throat. In Wilkes bounty another beat her husband up- 
 on the head so as to cause his death. In Rockingham 
 an insane man killed his neighbor. A man in Kentueky 
 killed two of his children, and attempted the life of his 
 wife. Another in Indiana cut his wife's throat and gashed 
 her face so that she died. Besides these, I recollect more 
 than thirty similar cases in which homicide was attempt- 
 ed and committed by individuals known to be insane. 
 
 1 adduce a few, from many thousand examples on re- 
 cord, which illustrate the benefits of Hospital residence 
 and of remedial treatment of the Insane, in both curable 
 and incurable cases. 
 
 "There has been," writes Dr. Bates of the Maine State 
 Hospital, "in this Institution for some years, an individ- 
 ual whose family is strongly disposed to maniacal insan- 
 ity. By many years neglect this patient became incura- 
 ble ; the powers of the brain seem to exist in fragments. 
 He is, and probably always will be a public charge. Two 
 of his sons have been attacked, seasonably brought under 
 treatment, and cured. These young men during the ab- 
 sence of disease, were industrious and frugal citizens. 
 They are both liable to a recurrence of the hereditary 
 malady. If brought to the Hospital soon after each at- 
 tack, there are nine chances in ten, that they will always 
 soon recover and return to their occupations and former 
 place in society ; if neglected until functional derange- 
 
31 
 
 ment changes to organic disease, they will become a pub- 
 lic charge for life," These cases are selected plainly to 
 illustrate the fact that economy not less than humanity 
 calls for early and efficient action in assuring appropriate 
 remedial treatment for the insane. 
 
 Dr. Stribling, the excellent physician and friend of the 
 insane, and Superintendant of the Western State Hospi- 
 tal in Virginia, states several cases of much interest in 
 his published reports to the Legislature. From these 
 documents I quote the following examples : In 1842, a 
 young gentleman, twenty-one years ot age, the son of a 
 highly respectable individual who was formerly a prom- 
 inent and efficient member of the Legislature of Virgin- 
 ia, was brought to our Hospital. Possessed of a good 
 natural understanding, improved by education and such 
 other advantages as wealth had supplied, and with a dis- 
 position uniformly cheerful, he was at all times a most 
 interesting patient and companion. In the Autumn of 
 1842, he was attacked with bilious intermittent fever, 
 which although speedily arrested, was followed by de- 
 pression and neglect of fill accustomed duties and care of 
 property. In about two months the mind became haras- 
 sed by the most distressing delusions, such as being sur- 
 rounded by foes who were plotting his destruction ; his 
 friends were regarded as enemies, and he believed himself 
 doomed to eternal punishment, &c. He remained in this 
 state for some time, when suddenly he passed into the 
 highest degree of cheerfulness and gaiety. Affection for 
 his family revived ; he fancied himself by turns poet, 
 philosopher, and statesman; at one time he was an angel 
 in Eden, at another Noah defying the destroying flood, 
 and finally he conceived himself the Creator of the Uni- 
 verse. He was removed to the Hospital where the ap- 
 plication of moral and medical means in a short period 
 assured his recovery : he left us rejoicing in the blessing 
 of restored health. 
 
 A respectable gentleman who had been esteemed bv 
 all who knew him, as an affectionate husband and father. 
 a generous friend and worthy citizen, was received as a 
 
32 
 
 patient in the Western Hospital, in 1843. He was a 
 merchant, and through unavoidable misfortunes rather 
 than ill management, sustained heavy losses: he became 
 depressed, was attacked with bilious fever, which left his 
 health materially impaired ; after some months his friends 
 became satisfied that his mind was seriously diseased ; evi- 
 dences of insanity were multiplied ; he became maniacal 
 and his family under the advice of an intelligent physician, 
 placed him in the Hospital. He was feeble, emaciated, 
 sleepless, and suicidal. His delusions varied, and were 
 of a most distressing character. Demons seemed to sur- 
 round him and to multiply their torments. In a short 
 time his malady seemed to yield to remedial measures. 
 His physical health improved ; his mind gradually be- 
 came tranquil ; one delusion after another disappeared ; 
 his spirits revived, and soon he was pronounced cured, 
 and returned to his family, and to his business, a cheerful 
 and happy man." As he was from that class of society 
 which possesses extensive influence, and who in this part 
 of the country, unfortunately, are too apt to regard insti- 
 tutions for the insane with aversion, and who consent to 
 place their afflicted friends therein only when all other 
 means have failed, and all other sources of hope cut off, 
 it may not be amiss to quote a passage from one of his 
 letters received by a friend after his recovery and by him 
 communicated to his physician. 
 
 '•I am truly happy to inform you that my health is now 
 perfectly restored. I cannot say too much in praise of 
 this institution, nor too earnestly express my gratitude to 
 my friends for having placed me here. Instead of a 
 place approximating to a prison, as I once considered it, 
 when influenced as many are by ignorance and preju- 
 dice, I now view the establishment in the light of a 
 pleasant hotel. 1 gratefully acknowledge comforts sup- 
 plied and kindness received." 
 
 •'Last year the wife of a respectable and independant 
 farmer was brought to the Hospital in a most painful 
 condition. She was endued by nature with a clear and 
 vigorous intellect, being emphatically, a strong-minded 
 
33 
 
 woman," remarkable for her industry, discretion, and 
 good management. She had not encountered those diffi- 
 culties and disturbing cares that often wear out^the 
 heart, but had led a life of peace and enjoyment. Some 
 time in the year before insanity was manifested, her 
 strength seemed to diminish without apparent cause. 
 Finally her mind became a prey to the most harassing 
 delusions; she fancied herself given over to everlasting 
 condemnation : believed herself the destroyer of a friend ; 
 attempted suicide, and after six months lost in unavail- 
 ing attempts to restore her, she was placed in the Hospi- 
 tal at Staunton. There was a continual conflict between 
 her feelings and her reason, her affective and her 
 intellectual faculties, which rendered her case one of 
 care and interest. In a few months she was perfectly 
 restored. 
 
 In 1848, a young lady of cultivated mind and accom- 
 plished manners sunk into a state of agitated depression. 
 Change of scene, cheerful society, exercise and medical 
 skill were employed in vain. Her affections towards her 
 friends passed into indifference, and so to settled aver- 
 sion. To her distempered fancy her husband, parents, 
 and sisters appeared transformed to demons. The dis- 
 tressed mother could not see her child transferred to a 
 Hospital, and long resisted the entreaties of wise-judging 
 friends. The disease became for seven months continu- 
 ally more aggravated, till finally amidst lamentations 
 and anguish her family consented to her removal. Her 
 improvement was rapid, and restoration finally complete, 
 and instead of distress at the thought of finding herself 
 the inmate of a Hospital for the insane, she often exclaim- 
 ed, " Oh why did not my friends place me sooner here." 
 To a relative she wrote, " this is no prison, but a refuge 
 for the distressed, where every comfort is furnished, and 
 only the most soothing attentions experienced. I will 
 ever cherish the most grateful recollection of this Hos- 
 pital and of the excellent physician through whose skill 
 by Heaven's blessing I am recovered "' 
 
34 
 
 " A rnaaborn of respectable and pious parents instruct- 
 ed from his youth in lessons of morality and religion, 
 grew up a peaceable, industrious, and u seful citizen. 
 His disposition was mild and gentle, his feelings affec- 
 tionate, and his habits exemplary. The decease of his 
 mother overwhelmed him with affliction : he fell into a 
 state of what is termed religious melancholy, and grad- 
 ually became agitated and furious ; suddenly attempted 
 the life of his wife and children, killed one of the latter, 
 and seriously wounded the others. He destroyed at a 
 blow a neighbor, who attempted with others to secure 
 him, and was at last with difficulty secured, and lodged 
 in the jail, and shortly brought to the Hospital. Months 
 passed and he continued excited and dangerous. Very 
 gradually a change took place ; his habits improved ; his 
 physical health improved, and from being one of the most 
 loathsome and offensive patients ever introduced into 
 the institution, he became decent, quiet, cleanly, and 
 finally rational, peaceable, and in all respects well 
 behaved. He remained in the Hospital five months af- 
 ter the recovery of his reason, to ensure the safely of his 
 return to society, and was finally, through the solicita- 
 tion of his family and friends, upon their special appli- 
 cation, discharged by the Court of Directors. Thus far 
 his recovery seems to be permanent." The danger of 
 delay in placing the insane under remedial Hospital 
 treatment cannot be too strongly insisted upon. Hun- 
 dreds and thousands of cases attest the cruelty and the 
 folly of procrastination. However writers upon insan- 
 ity, and medical men may differ upon some points, on 
 this question all agree, and deprecate with forcible argu- 
 ments the dangers of piocrastination. Esquitol, Pinel, 
 Falret, Jacobi, Conolly, Bell, Brigham, Awl, Kirkbride, 
 Stribling, and a host of others, have earnestly and re- 
 peatedly enforced, and continue to enforce this truth ; 
 and employ the most eloquent persuasions to induce 
 friends and guardians to take advantage of Hospital treat- 
 ment in the early stages of the malady. Willis, the cel- 
 ebrated physician to George the III, dismissed the king's 
 
35 
 
 family, courtiers, officers, and domestics ; procured stran- 
 gers as nurses and attendants, and thus first succeeded 
 in controlling the delusions which distracted the insane 
 monach. " To separate the insane from the objects sur- 
 rounding them at the origin of the disease, writes M. 
 Pinal, to entirely disconnect them from their habitual 
 intercourse with their relatives, friends, and servants, is 
 the imperative and indispensable plan for commencing a 
 course of treatment which shall be attended with favor- 
 able results:" and Falret, says, "it is demonstrated by 
 repeated experience, that the kind of isolation preferable 
 to all others, is that of an establishment especially devo* 
 ted to the insane." "Few," writes Hallaran, "very 
 few patients are fouud to recover under domestic treat- 
 ment." There can be but one opinion as to the solemn 
 duty of the removal and non-intercourse of the insane, 
 with their intimate friends and family j and their familiar 
 homes. The superintendant of an English Hospital 
 writes in 1842, as follows: "In a large proportion of 
 cases admitted the present year, owing to long detention 
 by friends, or by parish officers, the prospects of recov- 
 ery have been entirely precluded, and in successful cases, 
 the period of treatment bears generally an accurate ratio 
 to the prior duration of the disorder." The visiting com- 
 missioners of the sane Hospital report, that "they cannot 
 too strongly express their conviction, from experience, 
 that the hope of cure is materially lessened, and not unfre* 
 quently defeated, by the delay which is suffered to take 
 place in sending patients to the Hospital after first con- 
 firmation of their malady." The physician of the York 
 Retreat, states in an annual report, that "forty-nine years 
 of experience establishes the fact of recovery of four 
 cases to one brought under cure within three months of 
 the first attack, while it is less than one to four in cases 
 of more than twelve months duration when admitted." 
 The superintendant of the Edinburgh Hospital shows 
 that " to be treated successfully, insanity must be treated 
 early ; ill founded prejudices, and false sensibility often 
 operate to prevent this being done." These remarks ars 
 
as general and as often reiterated as are the establish- 
 ment of Hospitals and the issue of reports emanating 
 therefrom. Dr. Earle, shows from his experience in the 
 treatment of the insane, that, " after the three first 
 months of insanity are passed the probabilities of entire 
 restoration rapidly diminish." Not only do delays in 
 placing patients in suitable Hospitals involve the risk of 
 permanently establishing the malady, but the safety of 
 property and security of life is hazarded in a vast many 
 instances. 
 
 Dr. Gait records an example in point, as occurring in 
 Virginia. An insane woman, the mother of a family, be- 
 came so much the victim of distressing delusions, that her 
 family perceiving danger from her being at large, took 
 her before the justices for examination in view of placing 
 her in the Hospital at Williamsburg. The following 
 letter was addressed by one of these to the President and 
 Directors of that institution. "Sirs — at the time an ex- 
 amination was had into the state of Mrs. mind, she 
 
 seemed so lucid that one of the magistrates, who had not 
 seen her previously, dissented from the opinion of the 
 other two, imagining that the public were in no danger 
 from her going at large; and had the examination taken 
 place one hour later, no doubt would have been felt upon 
 the subject by that gentleman, as she became so furious 
 shortly after, as to render it necessary to confine her in the 
 public jail. After a few days she became importunate to 
 return to her husband and children : and a call of her hus- 
 band at the jail increased her supplications to be set 
 free. He finally prevailed with the jailor to take her 
 home, promising to return the next day to give bond and 
 security for her restraint and safe-keeping. In the night 
 she rose unperceived, proceeded to the yard and pro- 
 cured an axe. and after calling the servant who slept in 
 the room, and finding him asleep, gave her husband ma- 
 ny blows over the head, fractured his skull in seve- 
 ral places, and left him senseless. She left the house 
 and ran unremittingly for several hours ; affirmed her- 
 self dead, and declares that she has been buried these 
 
37 
 
 five years. 1 have made these remarks to illustrate her 
 case and assist treatment of the same." Another case 
 occurring in Eastern Virginia, seems worthy of notice ; 
 there are but too many parallel cases in North Carolina. 
 The friends of the young woman referred to were in lim- 
 ited circumstances, and even by making considerable 
 sacrifices could not succeed in rendering her comfortable 
 at home: they entertained the strongest prejudices 
 against Hospitals for the insane. .She was violently ma- 
 niacal, breaking in pieces and tearing every thing upon 
 which she could lay her hands ; and vociferated perpet- 
 ually in the most harsh and discordant tones. She was 
 almost constantly confined in a small closet or cell con. 
 structed in a small apartment in her mother's house : oc- 
 casionally, for change, she was taken into the open air 
 and confined to a tree by heavy chains. At the time she 
 was removed to the Hospital, she had contracted the 
 most loathsome habits, and had plucked the whole of the 
 hair from her head. For more than two years she had ex - 
 hibited a most pitiable spectacle, and every day her misery 
 seemed to be increased. After several months residence 
 in the Hospital, her improvement commenced : her recove- 
 ry is slow, but it is hoped will ultimately be complete. 
 
 In a report from Dr. Stribling, the following statement 
 is on record : "Of all the cases received, ninety-seven 
 were recent cases, of whom eighty-three were restored to 
 reason ; jive remain in an improved condition ; three are 
 unimproved ; and six died before any opportunity was 
 offered to test the use of remedies in their behalf. These 
 results correspond with those of other institutions. Of 
 one hundred and fifty -eight, cases remaining in the Hospi- 
 tal at Staunton in 1845, and in all probability doomed 
 for life to endure the weary burthen of remediless dis- 
 ease, how many might have been restored to reason, hap- 
 piness and usefulness, had they been subject to early 
 and appropriate moral and physical treatment. In ma- 
 ny cases the morbid sentiment of friends led them to re- 
 ject Hospital aid 9 and now the care and skill are all too 
 late ! 
 
38 
 
 The following Table, writes Dr. Allen of the Kentucky 
 Hospital, shew the Cases of less than One Years Duration 
 admitted into the Asylum, from July 1st, 1830, to Septem- 
 ber 30th, 1847; the Number of those cured, Relieved, Un- 
 improved and Died, and the Per Cent- of Cures to Admis- 
 sions and Discha?'ges. 
 
 ADMITTED. 
 
 Recov- 
 ered. 
 
 94 
 51 
 
 Reliev- 
 ed. 
 
 Unim- 
 proved. 
 
 8~ 
 2 
 
 Died. 
 
 9 
 
 7 
 
 Per ct. of 
 Cures to 
 Admissions. 
 
 74.15 
 69.86 
 
 Per ct. of 
 
 Cures to 
 Discharges. 
 
 Males, 127 
 
 Females, 73 
 
 200 
 
 16 
 13 
 
 91.23 
 87.93 
 
 145 
 
 29 
 
 10 
 
 16 
 
 72 05 
 
 90.62 
 
 "I have intimated," says the same judicious physician, 
 "that such public institutions for the insane, as afforded 
 every facility lor their successful treatment, and such as 
 to invite the early committal of them to Asylum discipline, 
 were demanded on the score of economy. I would not, 
 in the mean time, have it forgotten, that the illustration 
 of this position, applies to persons who maintain their 
 insane friends at private charge, as well as to the State. " 
 
39 
 
 The following Table shows the truth of the intima= 
 tion, and the reason why it is so : 
 
 A Tabic showing the comparative cost to the State of twenty old and twen- 
 ty recent cases of insanity, illustrating the importance, in an economical 
 point of view, of placing such persons under treatment at an early period 
 of their disease, and of providing every means of treating the?n success- 
 fully in an Asylum. 
 
 OLD CASES. | 
 
 
 RECENT CASES. 
 
 
 
 Cost of 
 
 
 
 
 
 
 
 
 each case 
 
 
 
 
 Cost of each 
 
 -Vo. 
 
 Age. 
 
 Time'spent 
 
 at 65 dol- 
 
 No. 
 
 Duration before. 
 
 Time spent in 1 
 
 oase at 1 dol- 
 
 
 
 In Asylum. 
 
 lars per 
 
 admission. 
 
 Asylum. 
 
 lar and fifty 
 
 
 
 
 annum. 
 
 
 
 
 cents per week 
 
 "1 
 
 47 [20 years, 
 
 #1,300 
 
 ~ ] 
 
 1 week, 
 
 36 weeks, 
 
 £54 00 
 
 2 
 
 48 
 
 20 years, 
 
 1,300 
 
 2 
 
 ! 7 weeks, 
 
 1 6 weeks, 
 
 24 00 
 
 3 
 
 52 
 
 17 years, 
 
 1,105 
 
 3 
 
 3 months, 
 
 32 weeks, 
 
 4S 00 
 
 4 
 
 54 
 
 16 years, 
 
 1,140 
 
 4 
 
 9 months, 
 
 40 weeks, 
 
 60 00 
 
 5 
 
 47 
 
 17 yenrs, 
 
 1,005 
 
 5 
 
 2 months, 
 
 20 weeks, 
 
 30 00 
 
 6 
 
 46; 15 years, 
 
 975 
 
 6 
 
 2 months, 
 
 20 weeks, 
 
 30 00 
 
 7 
 
 51 1 14 years, 
 
 910 
 
 7 
 
 3 months, 
 
 12 weeks, 
 
 18 00 
 
 8 
 
 31 
 
 13 years, 
 
 845 
 
 8 
 
 1 month, 
 
 20 weeks, 
 
 30 00 
 
 9 
 
 33 
 
 11 years, 
 
 715 
 
 9 
 
 2 months, 
 
 28 weeks, 
 
 42 00 
 
 10 
 
 45 
 
 12 years, 
 
 780 
 
 10 
 
 3 months, 
 
 24 weeks, 
 
 36 00 
 
 11 
 
 37 
 
 10 years, 
 
 650 
 
 11 
 
 6 months, 
 
 24 weeks, 
 
 36 00 
 
 12 
 
 39 
 
 10 years, 
 
 650 
 
 12 
 
 6 months, 
 
 32 weeks, 
 
 48 00 
 
 13 
 
 33 
 
 12 years, 
 
 7S0 
 
 13 
 
 4 months, 
 
 2S weeks, 
 
 42 00 
 
 14 
 
 45 
 
 15 years, 
 
 975 
 
 14 
 
 4 months, 
 
 12 weeks, 
 
 18 00 
 
 15 
 
 48 
 
 16 years, 
 
 1,040 
 
 15 
 
 6 months, 
 
 8 weeks, 
 
 12 00 
 
 16 
 
 56' 12 years, 
 
 780 
 
 16 
 
 1 month, 
 
 8 weeks, 
 
 12 00 
 
 17 
 
 44 13 years, 
 
 715 
 
 17 
 
 2 months, 
 
 24 weeks, 
 
 36 00 
 
 18 
 
 47 15 years, 
 
 975 
 
 18 
 
 1 month, 
 
 20 weeks, 
 
 30 00 
 
 19 
 
 36 13 years, 
 
 845 
 
 19 
 
 6 months, 
 
 12 weeks, 
 
 18 00 
 
 20 
 
 36 9 years, 
 
 580 
 
 20 
 
 1 month, 
 
 20 weeks, 
 
 30 00 
 
 
 ""1 
 
 .$18,030 
 
 
 
 
 t $654 00 
 
 Aggregate cost of 20 old ca- 
 ses, #18,030 00. 
 
 Average time spent in Asy- 
 lum by>ach, 14 years, 
 
 Average cost of each case, 
 S901 50. 
 
 Aggregate cost of 20 recent cases, ,^654 00, 
 Average time spent in Asylum, nearly fiva 
 
 mouths. 
 Average cost of each case, $32 14. 
 
 Moral treatment of the insane with a view to induce 
 habits of self-control, is of the first importance. Uni- 
 form firmness and kindness towards the patient are of 
 absolute obligation. The most exact observance of truth 
 should be preserved in all intercourse with the insane. 
 They rarely violate a promise, and are singularly sensitive 
 to truthfulness and fidelity in others. They rarely for- 
 give an injury and as seldom betray insensibility to kind- 
 ness and indulgence. Once deceived by a nurse or atten- 
 
40 
 
 dant, they never a second time bestow their confidence 
 upon the same individual. 
 
 Moderate employment, moderate exercise, as much free- 
 dom as is consistent with the safety of the patient, and as 
 little apparent anxious watchfulness, with cheerful so- 
 ciety should be sought. The condition of the patients 
 must determine the number of nurses in a ward. The 
 general opinion is holden that all patients do better with- 
 out special nurses, wholly devoted to their care. 
 
 •'The proper mental and physical employment of the 
 insane," says Dr. Kirkbride, " is of so much importance 
 that the full treatment of this subject would be to give 
 at once a treatise on the insane and ou insanity. What- 
 ever it maybe, it must embrace utility, and it is well to 
 combine both physical and mental occupation. Active 
 exercise in the open air, moderate labor in the gardens, 
 pleasure grounds, or upon the farm, afford good results. 
 Short excursions, resort to the work shops, carpentering, 
 joining, turning, the use of a good library &c. &c, are 
 aids in advancing the cure of the patient." Sedentary 
 employments are not in general favorable to health. 
 The operations of agriculture seem liable to the least 
 objection. There is a limit to beobserved in the use of 
 labor as a moral means; for there are always some pa- 
 tients to whom it is decidedly injurious. This effect is 
 manifested oftenest in recent cases. 
 
 Or. Ray says that it is an error to suppose that the in- 
 sane can labor as productively and as uniformly as the 
 sane man. The working hours of a patient should sel- 
 dom exceed six or seven per diem, and not seldom work 
 is altogether intermitted. 
 
 The manner in which labor exerts a beneficial in- 
 fluence upen the insane mind differs no doubt in different 
 forms of the disease. In highly excited patients the sur- 
 plus nervous energy will be consumed, if no other way'is 
 provided, in mischief and noise ; but let it be expended in 
 useful labor, and although the work may not always be 
 perfectly well done, yet the patient thinks it is, and ex- 
 periences the gratification of having done what he be- 
 
41 
 
 Sieves is a good thing, and consequently, so far as it goes 
 it is beneficial. 
 
 This sentiment of satisfaction in being useful, the 
 guardian of the insane cannot too carefully watch over and 
 loster, since it conducts to self-control and self-respect. 
 Incurables who are able and willing to work, are much 
 more contented and enjoy better health when employed. 
 Even some of the most demented and idiots are 
 found capable of doing something. A young man be- 
 came a raving maniac, and in three months was convey- 
 ed to the hospital, but was already declining into idiocy; 
 soon complete imbecility supervened. He was classed 
 with the idiots in the institution ; and considered as past 
 hope of benefit or cure. One day he was observed to 
 amuse himself with some rude coloring and odd figures 
 upon the walls of his room. He was supplied with col- 
 ours, brushes, and canvass, and soon commenced a por- 
 trait : he was now roused, and eager to accomplish his 
 new and attractive work. He was encouraged to renew 
 and repeat his attempts, and finally his mind was 
 restored to its early and rational condition. Thus, care- 
 ful attention to the daily state of the patient, suggested 
 a method of treatment which resulted in a decided cure. 
 The diseased organs were suffered to rest and their re- 
 cuperative energies recovered action. 
 
 The physician of the hospital at Staunton, in a report 
 of his institution, says, that during the past year, the 
 men patients were chiefly emplo}'ed in cultivating the 
 farm, working the garden, improving the gronuds, con- 
 structing fences, cutting wood, and attending to stock. 
 The women were engaged in sewing, knitting, spinning, 
 and assisting in various departments of house-work, and 
 other occupations and recreations suited to their sex. 
 
 " A patient, insane for more than ten years, and be- 
 3'ond hope of recovery, considered dangerous to the pub- 
 lic safety, and therefore detained at a hospttal, converses 
 incoherently and raves wildly, yet finds constant and pro- 
 fitable employment upon the farm ; has charge of a 
 stockof cattle and hogs and is scrupulously'faithful in the 
 discharge of his duties. Instead of confinement in a 
 county jail, from whence he was removed to the Hospi- 
 tal, in a most filthy, and abject condition, at a cost of 
 little less than three hundred dollars per annum, he is 
 here a genteel, orderly, and industrious individual, cheer- 
 ful, happy, and useful : his labor more than pays all his 
 expenses, and supplies him with sufficient indigencies." 
 6 
 
 
42 
 
 Prichard, in a work on insanity, says that '*atthe Rich- 
 mond Asylum, out of 217 patients, 130 were actively and 
 usefully employed viz: 18 in gardening, 16 in spinning, 
 12 in knitting, 18 in needlework, 12 in washing, 16 in 
 carrying tools, white-washing the wards, tailoring and 
 wearing ; and 12 were learning to read." 
 
 The following table exhibits the results of productive 
 labor last year upon the Bloomingdale Hospital farm near 
 New York, 8 or 10 acres being only cultivated. 
 
 Potatoes, 1952 bushels, 
 
 900 bushels, sound, at $0 75 | 
 
 675J 
 
 00 
 
 
 Sugar Beet, 
 
 180 « 
 
 » 
 
 37J 
 
 67 
 
 50 
 
 
 
 Blood Beet, 
 
 100 " 
 
 a 
 
 50 
 
 50 
 
 JO 
 
 
 
 Turnips, 
 
 460 " 
 
 u 
 
 31$ 
 
 143 
 
 75 
 
 
 
 Carrots, 
 
 28 " 
 
 a 
 
 50 
 
 14 
 
 00 
 
 
 
 Parsnips, 
 
 120 « 
 
 a 
 
 
 60 
 
 00 
 
 
 
 Onions, 
 
 45 « 
 
 tt 
 
 75 
 
 67 
 
 00 
 
 
 
 Corn, 
 
 150 " 
 
 u 
 
 37$ 
 
 56 
 
 25 
 
 
 
 Egg Plant, 
 
 20 " 
 
 u 
 
 50 
 
 10 
 
 00 
 
 
 
 Radishes, 
 
 125 « 
 
 a 
 
 1 00 
 
 125 
 
 00 
 
 
 
 Beans, 
 
 120 " 
 
 ct 
 
 50 
 
 60 
 
 00 
 
 
 
 Peas, 
 
 65 « 
 
 ct 
 
 75 
 
 48 
 
 75 
 
 
 
 P unking, 
 
 75 " 
 
 ct 
 
 37$ 
 
 28 
 
 12 
 
 
 
 Squashes, 
 
 130 " 
 
 tt 
 
 " 
 
 48 
 
 75 
 
 
 
 Spinach, 
 
 210 " 
 
 ct 
 
 75 
 
 157 
 
 50 
 
 
 
 Asparagus, 
 
 40 « 
 
 ec 
 
 3 00 
 
 120 
 
 00 
 
 
 
 Tomatoes, 
 
 140 " 
 
 u 
 
 50 
 
 70 
 
 00 
 
 
 
 Cucumbers, 
 
 100 « 
 
 ec 
 
 75 
 
 75 
 
 00 
 
 
 
 Nasturtiums, 
 
 1 « 
 
 tt 
 
 2 00 
 
 2 
 
 00 
 
 
 
 Peppers, 
 
 4 « 
 
 (I 
 
 75 
 
 3 
 
 00 
 
 
 
 Rhubarb, 
 
 52 « 
 
 tt 
 
 2 00 
 
 104 
 
 00 
 
 
 
 Citron Melon, 
 
 75 « 
 
 tt 
 
 10 
 
 7 
 
 50 
 
 
 
 Celery, 
 
 2500 heads, 
 
 tt 
 
 3 
 
 75 
 
 00 
 
 1 
 
 
 Cabbages, 
 
 3000 !' 
 
 It 
 
 4 
 
 120 
 
 00 
 
 
 
 Leeks, 
 
 1000 « 
 
 C( 
 
 0£ 
 
 5 
 
 00 
 
 
 
 Salsify, 
 
 2000 « 
 
 it 
 
 1 00 
 
 20 
 
 00 
 
 
 
 Lettuce, 
 
 4000 " 
 
 tt 
 
 2 00 
 
 80 
 
 00 
 
 1,293 
 
 62 
 
 Hay, 
 
 40 tons, 
 
 a 
 
 10 00 
 
 400 
 
 00 
 
 
 
 Pork, 
 
 1296 pounds. 
 
 e: 
 
 6 
 
 77 
 
 76 
 
 
 
 Butter, 
 
 663 " 
 
 a 
 
 25 
 
 165 
 
 75 
 
 
 
 Milk, 
 
 4488 gallons, 
 
 (C 
 
 16 
 
 718 
 
 OS 
 
 
 
 Eggs, 
 
 30 -J 1 dozen, 
 
 <! 
 
 12$ 
 
 37 
 
 ss 
 
 
 
 Poultry, 
 
 150 lbs. 
 
 C! 
 
 6 
 
 9 
 
 00 
 
 
 
 
 
 
 
 
 I— 1,408 
 
 47 
 
 fruits. 
 
 
 
 
 [ 
 
 
 Apples, 
 
 200 bushels^ 
 
 IC 
 
 50 
 
 100 
 
 ' 
 
 
 
 Pears, 
 
 20 « 
 
 (i 
 
 1 00 
 
 20 
 
 -.,.. 
 
 
 
 Cherries, 
 
 150 " 
 
 cc 
 
 1 00 
 
 150 
 
 00 
 
 
 
 Currants, 
 
 25 " 
 
 tt 
 
 1 00 
 
 25 
 
 00} 
 
 
 Peaches, 
 
 15 « 
 
 tt 
 
 1 00 
 
 15 
 
 Ou 
 
 
 Grapes, 
 
 1200 pounds, 
 
 tt 
 
 6} 
 
 75 
 
 ooj- 
 
 
 Strawberries, 
 
 8 bushels, 
 
 t. 
 
 2 00 
 
 16 
 
 ooj 
 
 
 
 
 
 
 
 
 — 
 
 401 
 
 00 
 
 Tot*;, 
 
 
 
 
 
 
 * OS 
 
 09 
 
43 
 
 The able and distinguished Superintendant of the 
 Ehode Island Hospital writes, that "no form of labor ap- 
 pears so well calculated to promote the comfort and res- 
 toration of such patients as have had habits of employ- 
 ment, as working on a farm, and no institution can fully 
 accomplish these purposes without plenty of land, and at- 
 tendants to assist in cultivation." All patients, whether 
 men or women, whose minds have been cultivated, and 
 who have had habits of active industry and employment, 
 possess high advantages in chances of recovery from at- 
 tacks of insanity, over thejignorant, the indolent, and the 
 inert. So also those whose habits have been methodical, 
 and temperate in eating and drinking, have better chances 
 of permanent restoration than those who possess their 
 opposites. 
 
 The standard of sound health is elevated by the disuse 
 of stimulating food, and of all intoxicating drinks ; and 
 by avoiding the use of Tobacco in any forms. 
 
 Stimulants even not inordinately used, excite to undue 
 mental and physical action. It might seem that the Apos- 
 tle of old. apart from the morale of life, had comprehend- 
 ed animal physics when he exhorted brethren to adhere 
 to "moderation in all things." 
 
 •'We have a patient, writes the Superintendant of the 
 Maryland Hospital, " who had for many months been in 
 a state of profound depression from which no efforts on. 
 our part could rouse him. He had repeatedly attempt- 
 ed suicide. He was a farmer, and when well, was en- 
 terprising, industrious, and devoted to the pursuit. He 
 walked out to the hay-field, and after much persuasion, 
 lie was induced to amuse himself by mowing a little. 
 Finding hisjinterest in the work increase, he continued to 
 ply the scythe for two hours with short intervals. He 
 now became cheerful and communicative ; ate with ap- 
 petite at dinner; after which he expressed a wish to re- 
 turn to the hay-field, where he continued mowing until 
 evening. This labor was followed by a night of profound 
 and refreshing sleep. The next morning he hastened to 
 the field, and from that time was seldom unemployed ; 
 his convalescence was rapid, and in about four weeks he 
 returned to his lamily entirely restored. Similar cases 
 are of frequent occurrence. Of ninety nine men patients, 
 forty-five are habitually employed in useful work : And 
 of fifty-seven women patients, all save eleven are for a 
 great part of the time employed in the halls, in the kitchen, 
 she washing and the ironing rooms, or in mending and 
 
^repairing garments and house-linen, and various sorts of 
 needle-work. Thirty-eight of the women, and fifty-five 
 of the men have been habitual readers, and find great 
 benefit and satisfaction in the use of the library; indeed 
 several patients seem to owe their restoration to adopt- 
 ing a regular course of reading and study. 
 
 Jn our times, when knowledge is so widely diffiused, it 
 seems almost superfluous to dwell upon the benefits of 
 hospital treatment above all private and domestic man- 
 agement. It cannot be questioned, that suppose know- 
 ledge, experience, and all domestic arrangements favor- 
 able, one might decide in favor of treatment for the insane 
 in their own families. This, however, cannot be assured 
 even when all the appliances wealth may procure are at 
 command, and therefore all persons who are familiar 
 with these subjects, do not hesitate in advocating Hospi- 
 tal residence for the insane of all conditions in society, 
 whether rich or poor, educated or ignorant. Some ob- 
 ject that associations of a painful nature may dwell upon 
 the recollection of the recovered patient. Whatever ap- 
 parent force this idea may possess, it is a well establish- 
 ed fact that patients rarely entertain other than pleasant 
 and grateful memories of their residence in weli-regnla- 
 ted Hospitals. When these are not well organized, an/] 
 wisely and carefully conducted, no patient under any cir- 
 cumstances should be sent to them. 
 
 Jacobi affirms that "the magnitude of anticipated evils 
 has been greatly exaggerated" ; "as regards these," he 
 says, "I can positively affirm that of six hundred cases 
 which I have had the opportunity of accurately exami- 
 ning in this establishment, (that of Siegberg, in Ger- 
 many) I have never witnessed a single one in which the 
 patient sustained any material injury from his residence 
 in the establishment as a lunatic asylum, or from an}' in- 
 fluence exercised upon him by other patients. Such 
 ideas only are true of badly ordered Hospitals and these 
 may always be known from those of good organization. 
 The time has gone by, thanks to Heaven, when the un- 
 happy insane could be cast into mismanaged Hospital?, 
 and, as too often is the case, left, in jails, and poor-houses, 
 festering in heaps of filthy straw, chained to the walls of 
 dark and dreary cells, unworthy of solicitude, and vic- 
 tims of the idle and interested maxim-that insanity is an 
 incurable disease, and that insane people are unconsci- 
 ous of the treatment they receive, and the cruel miseries 
 to which they are so needlessly subjected. Much has 
 been done, but more, much more, remains to be accon« 
 
45 
 
 plished for the relief of these sufferers, in our own United 
 States, as in other countries. With a population rating 
 at more than 22,000 000, our insane and idiots number 
 at the lowest estimate 22,000 ; and not 4,000, at this lime 
 have the advantages of appropriate care in well organ- 
 ized hospitals, or comfortable situations adapted to their 
 condition and circumstances elsewhere. 
 
 In 1844, the number of inmates in the hospitals of En- 
 gland and Wales was 11,272. Additional accommoda- 
 tions have been called for and provided to a large extent. 
 The oldest hospital founded in England is that of Beth- 
 lem, which king Henry the VIII presented to the City of 
 London, in 1547. 
 
 There are twenty State hospitals, besides several in- 
 corporated hospitals, for the treatment of the insane, in 
 nineteen States of the Union, Virginia alone having two 
 government State hospitals. The following is a correct 
 list, omitting several small establishments conducted by 
 private individuals, and several pretty extensive poor- 
 house and prison departments. 
 
 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 trans- 
 ferred to a fine district near the village of Mantua, in 
 the vicinity of Philadelphia, since 1S32 : number of pa> 
 tients 1S8. 
 
 The second institution recieving insane patients, and 
 the first exclusively for their use, was at Williamsburg, 
 Virginia, in 1773: number of patients 105. 
 
 The third was the Friends' Hospital, at Frankfort, near 
 Philadelphia, in 1817: number of patients 95. 
 
 The next was the McLean Hospital, at Charlestown, 
 (now Summerville,) in Massachusetts, in t! 18l8. This 
 valuable institution is second to none in America. Num- 
 ber of patients 180. 
 
 Bloomingdale Hospital, near the city of New York, 
 was established in 1S21 ; number of patients 146 : South 
 Carolina Hospital, at Columbia, in 1S22 ; number of pa- 
 tients 74: Conneticut Hospital at Hartford, patients 122 
 and Kentucky Hospital at Lexington, patents 247, in 
 1824. 
 
 In 1845-46, the legislature of Kentucky passed a bill 
 to' establish a second State institution in the Green Riv- 
 er country. 
 
 Virginia Western Hospital was opened at Staunton in 
 1S2S ; number of patients 217. Massachusetts State 
 Hospital, at Worcester, was opened in 1833, and enlarg- 
 
46 
 
 ed in 1843 ; it has 370 patients. Maryland Hospital, at 
 Baltimore, was founded in 1834; it has the present year 
 109 patients. Vermont State Hospital, at Battleborough, 
 was opened for patients in 1S37, and enlarged in 184G-'47; 
 it has at present. 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 pa- 
 tients. 
 
 Tennessee State Hospital, at Nashville, was opened in. 
 1830. According to an act of the legislature the present 
 year, this hospital is to be replaced by one of capacity to 
 receive 250 patients. In the old hospital are 64 patients. 
 Boston City Hospital for the indigent, which has 150 pa- 
 tients, and Ohio State Hospital at Columbus, were se- 
 verally opened in 1839. The latter has been considera- 
 bly enlarged, and has now 329 patients. Maine State 
 Hospital, at Augusta, 1S40; patients 130. New Hamp- 
 shire State Hospital, at Concord, was opened in 1842. and 
 has 100 patients. New York State Hospital, at Utica, 
 was established in 1843, and has since been largely ex- 
 tended, and has 000 patients. Mount Hope Hospital, near 
 Baltimore, 1844-45; has 72 insane patients. Georgia 
 has an institution for the insane at Milledgeville, and at 
 present 12S patients. Rhode Island State Hospital open- 
 ed, under the able direction of Dr. Ray, early in 1848. 
 New Jersey State Hospital, at Trenton, 1848. Indiana State 
 Hospital, at Indianapolis, will be opened in 1848. State Hos- 
 pital of Illinois, at Jacksonville, will be occupied before 1849. 
 The Lousiana. State Hospital will be occupied perhaps within a 
 year. 
 
 These institutions, liberally sustained as are most of them, can- 
 not accommodate the insane population of the United States who 
 require prompt remedial care. 
 
 Such being the facts, one can hardly employ language too im- 
 portunate, arguments too persuasive, to secure such increased 
 accommodations for the Insane throughout the United States, but 
 especially in those States in which no Hospitals have been eslab. 
 lishea, as shall assure their sufficient care and protection; their 
 remedial treatment so as to procure recovery when recovery is 
 possible; and their safety and guardianship in all cases where 
 the terrible calamity of incurability crowds them forever from 
 all the bland affections, and social enjoyments of domestic and 
 friendly association. 
 
 As ye would that others should do for you in like circumstan- 
 ces, so do ye for these helpless ones, cast through the Providence 
 of God, on your sympathy and care ! Be the guardians and ben- 
 efactors of those, who as a writer in the 17th century finely ex- 
 
47 
 
 presses himself, M are a particular rent charge upon the great 
 family of mankind; left by the maker of us all like younger 
 children, who though the Estate be given from them, yet the 
 Father expected the heir to take care of them I" 
 
 To see the mind once brilliant, and in the exercise of fine 
 energies, obscured and inert ; or if quickened to action, trans- 
 formed from the consistent bearing of a being possessed of ration- 
 al understanding to the fury of a demon, or to the raging of an 
 untamed brute — this is fearful, this is truly to behold the drain- 
 ing to the dregs the cup of bitterness ! Oh with what ready 
 zeal, with what wisdom and humanity should not every one di- 
 rect himself to prevent miseries which no skill can wholly heal, 
 & of which no foresight nor prudence can prevent the recurrence. 
 
 " Weep not pale moralist o'er desert plains, 
 Strewed with the wreck of grandeur's mouldering fanes, 
 Arches of triumph long with weeds o'ergrown, 
 And regal cities — now the serpent's own ; — 
 Earth has more dreadful ruins, — one lost mind, 
 Whose star is quenched, has lessons for mankind 
 Of deeper import than each prostrate dome 
 Mingling its marble with the dust of Rome" ! 
 
 Bereft of reason, man loses every thing that renders 
 life valuable. Naturally endowed with capacities for 
 the highest enjoyment, he is suddenly through an attack 
 of insanity, disabled from partaking the rational pleas- 
 ures of life, and <*f exercising his noble faculties for his 
 benefit or for the good of society. 
 
 Though plunged in the most profound grief, — assailed 
 by every form of trial and misfortune, while reason is 
 spared, hope may cheer his dreary hours, — and faith 
 support him through every trouble ; but dethrone reason 
 and he is utterly prostrate. The merest infant is not 
 more dependant on parental care, than is the maniac 
 upon the tender ministrations of kindred or of friends. 
 In an hour he becomes the beneficiary of humanity : the 
 helpless ward of his fellow-men : him must nursing, and 
 watching, and skilfulj cares surround, else is he the 
 most pitiable of human beings — out-cast and forlorn — 
 smitten of a terrible malady, exposed to sufferings, and 
 woes, and tortures of which no language however vigo- 
 rously^eombined can be the representation. Have pity up- 
 on him, have pity upon him for the hand of God hath smit- 
 ten him ! Talk not of expense — of the cost of support- 
 ing and ministering remedies for these afflicted ones. 
 Who shall dare compute in dollars and cents the worth 
 of one mind ! Who will weigh gold against the price- 
 less possession of a sound understanding ? You turn not 
 away from the beggar at your door, ready to perish : 
 
48 
 
 you open your hand, and he is warmed, and fed, and 
 clothed : will } T ou refuse to the maniac the solace of a 
 decent shelter, the protection of a fit asylum, the cares 
 that shall raise him from the condition of the brute, 
 and the healing remedies that shall re-illume the temple 
 of reason ? Who amongst you is so strong that he may 
 riot become weak ? Whose reason so sound that mad- 
 ness may not overwhelm in an hour the noblest intellect? 
 
 You will not, Legislators of North Carolina — Senators and Representatives 
 of a noble State, you will not forget amidst the heat of debate, the clash of 
 opinion, and the strife for political snpremacy ; you will not forget the ma- 
 jesty of your station, the dignity of that -trust confided to you by the suf- 
 frages of your fellow-citizens. 
 
 It is not often that you are solicited to exercise your functions in behalf of 
 the unfortunate. That you possess the power, and now the opportunity of 
 exercising a gracious, benignant, and God-like influence upon the present 
 and future destiny of hundreds, nay of thousands, who pine in want and 
 misery, under privations and sufferings, wearily borne through heavy months 
 and years — the light of whose reason is quenched, and whose judgment is a9 
 the stubble upon a waste field ; this it is believed is a sufficient argument to 
 determine your decisions in favor of justice, and of humanity, and of un- 
 questionable civil obligation. 
 
 As benefactors of the distressed whose mental darkness may, through your 
 agency, be dispersed, how many blessings and prayers from gratefnl hearts 
 will enrich you ! As your last hours shall be slowly numbered, and the re- 
 view of life becomes more and more searching, amidst the shades of uncom- 
 promising memories, how beautiful will be the remembrance that of the ma- 
 ny of this life's transactions, oftenest controlling txfensient and outward af- 
 fairs, frequently conducting to disquieting results, and sometimes to those of 
 doubtful good, you have aided to accomplish a work whose results of wide- 
 diffused benefits are as sanctifiying as they are permanent: blessing through all 
 Time — consecrating through all Eternity ! 
 
 Gentlemen, the sum of the plea of your Memoralist is embodied in the so- 
 licitation for an adequate appropriation for the construction of a Hospital for 
 the remedial treatment of the Insane in the State of North Carolina. 
 
 Respectfully submitted, 
 
 D. L. DIX. 
 
 Raleigh, November, 1848. 
 
 

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