New York and Its Institutions, 1609

In their report of 1868, the Commissioners presented a detailed statement of the capacity of the buildings constituting the Lunatic Asylum. This was stated to be sufficient for 576 patients, but no less than 1,035 were in custody at that time, and the year 1869 closed with 1,181, of whom 150 were lodged in the Workhouse. Having received the requisite authority from the Legislature, the Commissioners have just completed the erection of a new Asylum building on Ward's Island, a few hundred yards west of the Inebriate Asylum. The edifice, a three-story English Gothic, with Mansard roof, was constructed of brick and Ohio free-stone. The central section and two wings present an imposing front of 475 feet, with accommodations for 500 patients. It has cost in its erection $700,000. This building, which may still be indefinitely enlarged, contains every improvement yet devised for the safety and comfort of the insane, and will no doubt be a credit to the metropolis. But as over 1,300 patients were committed to the care of the Commissioners during 1870, they still need another Institution. In the early history of the Asylum, convicts from the Penitentiary were largely employed in taking charge of the lunatics. A violent prejudice naturally arose against this class of nurses, both among the patients and their friends, which very seriously detracted from the success of the Institution. It was difficult convincing the insane that they were not in prison when constantly surrounded by convicts. But it was found that for the restoration of reason, the ministries of persons eminent for their intelligence and goodness were required, and not of those whose whole career had shown an abandonment of the very quality they were now employed to restore. In 1849, the power to appoint and remove attendants was vested in the physician, from which period there has been a steady advancement in the management of the Institution. In 1850, a night watchman was appointed; the Croton water was introduced; knives and forks, and various other articles of comfort were supplied in the halls; and hired attendants substituted for convicts in most of the departments. The halls were many years without lights, and the inmates compelled to retire early or spend their evenings in the dark; but in 1868, oil lamps were introduced, which have since been displaced by gas fixtures, marking an important change in the history of the Institution. In the early years of the Asylum scurvy frequently prevailed, adding greatly to the mortality of the inmates. With the abundant supply of fresh vegetables and other dietary and sanitary regulations, this form of disease has now almost entirely disappeared. During 1868, eight deaths occurred from scorbutic difficulties, and in 1869 but one.

The rate of mortality in 1847 amounted to 19 per cent.; in 1848 to 13 per cent.; in 1849 cholera prevailed in the Institution, and over 23 per cent. of the inmates died. In 1868, the death rate was 8 ½ per cent., and in 1869, but 7 per cent. In the autumn of 1864, typhus fever appeared in the Asylum, which caused the death of the chief physician, and of many subordinate officers and some of the inmates. The number of recoveries are usually reported in Institutions of this kind, though it is a matter very difficult to correctly ascertain. Of the 905 treated during 1852, 208 were discharged "recovered," 90 "improved," and ten "unimproved." The number reported "cured" amounted at that time to 23 per cent. of the number under treatment. In 1868 the cured amounted to 31½ per cent. of all under treatment, and in 1869 to 27 per cent. The smaller percentage of cases during the last year was caused by the over-crowding of the Asylum, and the necessity of dismissing many as "improved" who would soon have been pronounced "cured," if space had allowed them to remain.

A very large proportion of those admitted into the Institution are in a diseased or debilitated condition. Some have organic diseases of the lungs, others are epileptic, or anæmic. As they are usually unwilling to submit to thorough examination and treatment, the acumen and skill of the medical attendants are often severely taxed. Careful medical treatment is administered in all such cases, and a history of the treatment of each case written in a book and preserved. But having counteracted with medicine manifest physical disease, the treatment becomes simply moral. The patients are classified according to the nature of their disease and their susceptibilities. Appropriate employment is provided for those who have sufficient strength, and can be induced to labor with their hands, mental toil for others, and sufficient recreation and sources of amusement for all. A large amount of labor is annually performed by these persons. The men toil at building sea-wall, assist in the erection of buildings, follow their respective trades in the shops, and are made generally useful around the grounds. The women are no less useful.