Colony Treatment OF THE Insane and Other Defectives

—BY—

DR. P. L. MURPHY MORGANTON, N. C.

Read Before the Meeting of the N. C. Medical Association June, 1906, Charlotte, N. C.

(REPRINT FROM CAROLINA MEDICAL JOURNAL.)

Colony Treatment of the Insane and Other Defectives

The subject of this paper might be called "Employment as a means of treating and caring for the insane and other defectives" the colony being the means of finding agreeable and profitable work for the inmates.

To many of you a description of what is meant by the "colony treatment" is needed to fully understand the subject.

As the expression is used in this paper, and as it is generally understood, it means the erection of buildings some distance from the central hospital plant and placing farm working patients there, to be under the control and management of the hospital officers.

FIRST BUILDING AT THE COLONY

Without discussing the origin of the idea, and with no reference to Gheel, it is sufficient to say it was begun in Germany in the sixties, and that it has slowly found its way into other countries.

THE COLONY BUILDINGS

Such a colony was established in connection with the Morganton Hospital three years ago, or rather it was ready for occupancy about that time. It took several years of talk to get the idea adopted, and as many more to get the colony built. The plan of conducting it by the hospital authorities was largely experimental, and was made to suit the people of Western North Carolina, but it is, after all, a modification of the original German conception.

The first building was for 30 men with rooms for a man and his family, the man to have general supervision of the place and the wife to cook and do the household work. Afterwards a small cottage was built for the manager and his family, and his rooms were used for patients and later still another building was erected so that now 75 patients can be accommodated. It would have been much better to have limited the rooms to 30 as first intended. No single colony plant for the insane should much exceed that number. As many colonies as are needed may be had if land is sufficient, the number depending on the size of the hospital, as only a certain proportion of patients, about 25 per cent., can thus be cared for, or at the outside 40 per cent.

PATIENTS WORKING RASPBERRIES

The colony buildings, outhouses and surroundings at the Morganton colony were made as near as possible like the farm houses in this section of the State. This was done to give it a home-like appearance, and the management has been such as to make each patient feel at home; they are free to sit on the porches and the lawn in the summer, in the sitting room before open fires in the winter. They smoke, have games, read or do what pleases them during these hours of recreation. They have their own garden, orchard, vineyard, berry patches, poultry, pigs and cows, which they attend to. Every effort is to make each one feel that these things are his own, he can gather berries, pull the fruit when he wants it or as he pleases. Every one is expected to do something if no more than pick up chips for the cook.

GENERAL VIEW OF COLONY

Early Experiments.

The first party of patients sent to the colony, about 15, were quiet, industrious men who were expected to be the nucleus of the organization. After these became accustomed to their new surroundings, others who were quiet and who had some remnant of mind left, but who did little or no work were tried. These readily dropped into the ways of those who preceded them and who set the pace. Further experiment was made by sending those who seemed incurably demented, incapable by reason of their weakened minds of doing any kind of work. Most of the last mentioned had been residents of the hospital for years and years in whom the last vestige of hope for any improvement had long vanished. Strange as it may seem to you, as it did to us, acquainted with these men and their disease, they immediately went to work and are to-day profitably employed. They have gained in health and self-confidence, they are happier because they feel there is yet something in life for them.

SNAP SHOT—COLONY PATIENTS CULTIVATING STRAWBERRIES

It may occur to some to ask why these men had not been sent out to work before and given an opportunity. It has been the invariable custom since the hospital opened to try to induce every one to engage in some kind of employment and it had been tried repeatedly with these very men with complete failure. To conjecture why they were willing to work in one place and not in another might be profitless, it is sufficient to know it is true.

RESTING AFTER THE DAY'S WORK

After the work was well under way, it was strange to see the development of the different fancies of the different men. Each one was allowed, so far as possible, to follow his own inclination and to select his own work. One fancied painting and whitewashing and building fires under the heating apparatus. He studied economy in the use of fuel as much as the average head of a family, and is as intelligent in his work as could be expected of any ordinary man. Another patient has become greatly interested in poultry and shows more than ordinary intelligence in following his bent. He reads journals on poultry, and not only builds coops, box nests, etc., but has actually invented several useful contrivances. Another hauls wood to the kitchen in a little wagon he made himself, and so on almost indefinitely.

PATIENT TENDING BRONZE TURKEYS

A brief report of two cases will partly illustrate what has been done. The following is quoted from a report to the Board last December: "A boy, J. B., 13 years old, came to the hospital in June, 1895. He had a form of insanity (Dementia praecox) which rarely improves; indeed, its tendency is generally to deterioration. This boy was no exception to the rule and he grew worse and worse until hope for any improvement had been given up. Three months ago he was sent to the colony, but it was considered a desperate chance. To the astonishment of everyone he immediately began to improve, and this has steadily gone on until to-day he is a strong, vigorous young fellow of 23, full of hope and energy, whereas when he went there he was dull, indifferent and listless; he never inquired of his home or home people and seemed to care for nothing. Recently he has written home telling of his marvelous improvement and of his joy in life. 'He testified as one risen from the dead,' after ten years of mental darkness. It is not certain that the improvement will continue; in fact, it is not expected, but even if he improves no more, great good has been accomplished in relieving this young fellow of such suffering as we shudder to think of." Six months after this report was written this young man has gained but little and it is probable he is as well as he will ever be. He enjoys life as much as the average man, taking part and interest in baseball and other amusements we are able to furnish our people. The second case is of a man who was committed to the hospital in November, 1898, this being his second admission. He complained of great discomfort in his head which he described as being unbearable, so much so, that he begged to be killed. His appetite was poor, he was anaemic and greatly run down in health and evidently was a great sufferer. Every effort to relieve him failed. We were sure if he could be induced to exercise he would improve, but nothing we could do would cause him to take the slightest interest in anything. He was finally forced to go out with the working party, but he would lie on the ground complaining of his head. He was a few months ago sent to the colony along with nine other men almost as bad as he. To the amazement of us all, the man went to work, his health improved, the pain and discomfort disappeared and his face is ruddy and he gives every evidence of health and vigor. He works cheerfully, seems perfectly satisfied, never complaining of any bad feeling and is as comfortable as he can be. These two cases are only two of many as unpromising, who have been greatly relieved and some few cured by the colony treatment.

PATIENTS INTERESTED IN GRAPE GROWING

All this seems so simple and is so obviously the right course that we wonder why it had not long ago been tried.

BARNYARD AND POULTRY HOUSES AT COLONY

Two ideas are prominent in this system, the first to find agreeable, healthful employment for the patients and to give them a home.

CHICKEN RUNS