Editorials and Medical Intelligence

1843 Boston Medical and Surgical Journal  
Western Lunatic Asylum.-In western Virginia, at Staunton, near the centre of Augusta county, and towards the south-western extremity of the rich agricultural valley of the Shenandoah, is located an institution that has received the fostering care of the Legislature for some years. While the neighborhood wears the expression of neglect and a want of physical energy in man, as it regards the appearance of the private dwellings, the lunatic asylum presents a noble and cheerful aspect, indicative
more » ... spect, indicative of comfort and order within. From the experience of the medical superintendent, it is presumed that all the improvements known in the best-managed institutions of the North, have been introduced, and the report before us evinces the efforts of Dr. Stribling to meet the high expectations of the free-holders of Virginia. Although the annual report has come to hand at rather a late period, it affords us pleasure to notice its prominent features. In the year 1842, according to the tabular sheet, 152 insane persons were accommodated at the Asylum. Of that number, 99 were already lodged at the commencement of that year; and in 1842, 53 new cases were admitted. At the time of finishing the Report, 110 patients were under treatment, viz., 74 males and 36 females. Of these, 101 were chronic, and 9 only of recent origin. The great disproportion, says the report, exhibited between the sexes, was owing, solely, to the peculiar construction of the buildings, which rendered it " impracticable to afford safe and convenient accommodations for more than about 40 females." Table second, on the fifteenth page, is rather open to criticism, on account of the loose manner of making a return to the Court of Directors, of the discharges, deaths and elopements-all in a lump ! Thus it says -" patients discharged, eloped and dead, 42-males 31, females 11." The men popped off in various ways, it seems, whilst the women, who either liked their quarters better, or were more tenacious of life, stuck by to the end of Anno Domini 1842, as all crazy people should, till the annual report was fairly made up ! So much for the table : however, by following out the explanation, we there discover that 15 had died-an unusual mortality ; and that no prejudicial impressions might be made with respect to the prospect of health in the institution, Dr. Stribling remarks that it is proper to state " that all of them resulted from causes wholly unconnected with its locality, construction or general management." On the 21st page Dr. Stribling introduces an observation that is rather discouraging, although it may be true, viz. : " As experience has amply demonstrated that but few persons afflicted for a longer duration than two years, are ever restored to reason, we are, in view of the facts presented by this table (table 4th) forced to the painful conviction that more than one hundred of the patients now under our care, are doomed to continue insane for the remainder of their lives."
doi:10.1056/nejm184308020282606 fatcat:44xrze3jofdgbgox7lcattl7hm