From the FOREWORD
IN the year 1882 I was appointed the "State Commissioner in Lunacy" of New York by Gov. Alonzo R. Cornell. On assuming the duties of the office the Governor informed me there was a popular and growing belief that many inmates of the Asylums for the Insane were sane but have never had an opportunity to relate their grievances except to officers who gave little or no credence to the patients' statements. Therefore, he advised me to keep constantly in mind when visiting an Asylum the question, "Who is Insane?" In carrying out his instructions I became quite obsessed with these three words and hence the title of this book.
The insane of the State of New York, in custody, were at that time about 12,000 in number and were confined in State Asylums, in County Asylums, in Poor Houses and in private institutions. They were found in every condition hitherto known in the history of this unfortunate class from that of the pauper of the County Alms House, in filthy cells and stalls, shackled hands and feet, and fed like swine, to the kindly care, good food, clean, sanitary dormitories and freedom from cruel forms of restraint, of those in the palatial State Asylums.
The most important reforms effected by my service were: 1. The introduction of the Training School for Attendants; 2. The creation of a State Commission in Lunacy; 3. The removal of the insane from County to State care. The Training School raised the grade of qualification of attendants and has become a permanent feature of State institutions for the insane. The Commission in Lunacy has so reorganized the service of the former State Institutions for the Insane as to change them from 'Custodial' "Asylums" to 'Curative' "State Hospitals." The "State Care Act" permanently removed the insane from the beastly quarters and care of the "Poor-Houses" to the humane treatment of the State.
These three reforms have raised the standard of care and treatment of the insane in the State of New York to the highest grade yet attained. Nor is this reform limited to the "State Hospitals" of this State, but fortunately, their example is being copied so widely as to give the assurance that the time is not distant when the institutions for the insane in this country will take the first rank.
This Book is a commentary on my experiences as an official visitor of the Institutions for the Insane and the Charities and Reformatories of the State. Its intent and purpose are to illustrate with as few technicalities as possible the illusive nature of insanity, its origin in the derangement of the functions of the brain-cells, the extreme impressibility of these cells and our power to increase or repress their activities. In these facts, which modern science has developed, are found the scientific principles on which the prevention of insanity, and its successful treatment, must be based. The same principles are shown to be applicable to the education of the mentally defective classes and to the reform of criminals.
This Book should prove helpful in the prevention of insanity at the different periods of life and hopeful of the time when biology shall be able to completely unfold the mysterious mechanism of the brain, physiology to explain the function of every nerve centre and psychology to interpret the significance of all mental phenomena.
–THE AUTHOR.