Family care for the chronic insane : Miss Alice Cooke and her patients / by F. B. Sanborn.

  • Sanborn, F. B. (Franklin Benjamin), 1831-1917.
Date:
[1902]
Catalogue details

Licence: Public Domain Mark

Credit: Family care for the chronic insane : Miss Alice Cooke and her patients / by F. B. Sanborn. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    taken, in some instances, to board out their own patients, under the supervision of their own phy- sicians and nurses,—a step which might have been taken, and is now advocated by most of the hospitals of Massachusetts, which are over- crowded, and would be slightly relieved in this way; as they also are by the establishment of colonies (branch establishments of no great size, not far from the main hospital edifice). The two systems,—of farm colonies for 50 or 100 patients, and of boarding one or two patients in each family of suitable character and situation, in different parts of Massachusetts,—might go on side by side, and probably will. Convenience and the condition of the patient in each case would determine whether he may be lodged in a farm-colony nearby the hospital, or sent to a greater distance under family care. The princi- ple in each system is the same, —to remove from the close asylum and its rigid rules those pa- tients who can be allowed greater freedom, and whose labor can be better employed than in the overcrowded monster hospital. A reaction against these monster hospitals has shown itself where it was little expected, in the Lunacy Commission of New York, which, for ten years, had been increasing the size and diminishing the employment of the state hospi- tals and their patients. The new president of this commission, an enlightened physician of European birth and experience, in his annual report for 1901, just made public, favors small hospitals for the curable, and farm-colonies for the chronic. If this change shall be made in the great state of New York, with its 25,000 insane, it will not be long before the initial steps towards family care will there be taken. Indeed, the boarding-out system, as practised now in Massa- chusetts, Scotland, France, Germany, and Bel- gium, gives the best opportunity for what the English call After-Care, so far as the poor are concerned. I recall with great pleasure the two visits,—or rather three,—that I have made to Gheel, near Antwerp; in the winter of 1890, again in the sum- mer of that year, and finally in the summer of 1893, before going down into Holland to visit the asylum at Meerenberg, near Haarlem. In both these years I also visited the Scotch cottages where the insane are boarded,—in 1890 at Kenno- way and Starr in the county of Fife, and in 1893 at Balfron near Glasgow. In the two visits I saw nearly 100 of the patients under family care, and satisfied myself that,good as the Scotch system is, our Massachusetts arrangements for the comfort and discipline of the patients boarded out were quite as good. The Gheel system, though I agree with Sir Arthur Mitchell in praising it, is not so well adapted to America as the Scotch system, which I had followed in Massachusetts, upon the advice of Dr. Howe, and the reports of others, before I ever saw it in operation in Scot- land. Both systems, and also the village asylum system, as I saw it in 1893 at Morningside near Edinburgh, at Alt Scherbitz in Saxony, and at Gabersee in Upper Bavaria, are great improve- ments on the monster-hospital system which prevails in England, France, and I regret to say in the United States. At Toledo, in Ohio, is a village hospital which the authorities of that state greatly praise, and which, I have no doubt, is well managed. But I have never seen a better asylum than that of Alt Scherbitz in Germany, and much prefer its methods to those at Toledo, so far as they differ from each other. The three systems so well exemplified in Europe,—that of Gheel, of Scotland, and of Alt, Scherbitz,—are not inconsistent with each other. They might be combined profitably; and to some extent they are so combined in Scotland, and soon will be, I trust, in the United States. I imagine that the international congress in Ant- werp, which I regret I cannot attend, and for which I have written this hasty paper, will do something to promote such a combination. No exclusive system,—least of all that of the close asylums,—can do for the increasing numbers of the insane all that their unfortunate condition requires. In breaking up this exclusive system, the family care methods of Belgium, of trance, and of Scotland are most useful; and I congratu- late the congress in advance for the good I am sure it will accomplish. F. B. Sanborn. Concord, Mass., August 20,1902. The instance of the three patients cared for by Miss Alice Cooke of Sand- wich (at the head of Cape Cod), de- serves to be more fully treated than in the above concise account it could be. Miss Cooke was a trained nurse who had been employed for a time in the state almshouse (now called the State Hospitalw) at Tewksbury; while there she had seen much of the chronic insane, and occasionally had the care of them in one large ward of the women's insane asylum. Her home family consisted of an elderly mother and a sister not in robust health; and it was Miss Cooke's wish to return and live with them in the old family house which her grand- father, a retired shipmaster, had bought in Sandwich, not far from Spring Hill, that ancient resort of the Wings, Hoxies, and other Quakers, who had founded there one of the oldest Quaker meetings in America. The view of this house, a century and a half old at least, here given, is the end