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• For one moment more we entreat your attention to a class of per. sons whose importance in society, independent of all considerations of humanity, lays a moral obligation upon every good man to use his endeavours to encourage and protect them. We are about to speak of those young men in this town just beginning life, who often from too great ardor, industry, and too vehement a desire of success in their trade or craft

, fall sick, get in debt to landlords, physicians, nurses, and finally abandon themselves to drinking and vice and de. bauchery. These young men the Hospital would save. There proper care would be taken of them, and they would be restored to their occupations free from debt and disease and distress of mind. We solicit from you contributions for the sake of those persons whose sufferings cannot now be doubted,whose health and morals arë now often wasted and destroyed,and of whom many were born to be good fathers and brothers and citizens. As they now live and suffer and perish, it rarely falls to your lot to be able to succour and comfort them. But we offer you in the Hospital a means of exercising those charitable propensities with which most men are endued, and as you cannot doubt but that there is a great deal of suffering and sickness of which you never hear and which is never relieved, you may fail to perform those duties which your religion, reason and hamanity enjoin upon you, in listening with indifference to a charitable appeal,pure and unexceptionable in its objects and manner of dispensation.

• Though the Trustees have appropriated six beds to poor patients, they possess at this time no funds to provide for that expense, but they have thought proper to do it in a just expectation that the Hospital would be remunerated by the generosity of the public. The claims of the poor where they become known are irresistible. They are always assisted, but often improperly and at great expense. The Hospital furnishes just the assistance which is needed and at a cheap rate. Twenty persons subscribing only five dollars each, will enable the Trustees to appropriate such accommodations to the poor as to relieve and cure upon an average fifteen patients throughout the year. Surely this is a small sacrifice for the suffering which it always mitigates, and for the virtue and morality which it often preserves.

Though medicines and medical advice are always given and administered free from charge, by which arrangement more than two thirds of the whole expense of most fits of sickness will be saved, it is nevertheless true that the Hospital offers peculiar advantages to those who require surgical operations. The most wealthy individual in this town cannot obtain in his own house the comforts and conveniences which every man possesses in this particular at the Hos.' pital. There is a room expressly prepared for this purpose, with a light adapted to surgical operations, and in case of accident or emergency, there are instruments, dressings, medicines and skilful attendants, all within call and reach of the operator. And also in case

of pain or accident following an operation there is always a Physician in the place ready to administer relief both day and night. Tbis is a privilege not enjoyed in private houses. The success of many operations, particularly those of the eye, depends upon the attention, exactness and constancy with which the patient is watched and pursed. Different difficult operations have already been performed with perfect success. The Trustees consider this the most favourable arrangement in the Hospital, and one upon which great value deserves to be placed. No expense whatever attends the most complicated and protracted ones. And it is a consideration which deserves great weight that many of these operations performed in a private house would absorb many months earnings of the most industrious men.' pp. 16—20.

To the truth of all this we are for the most part ready, heartily to subscribe ; but there is one statement, from which we must beg leave to express our utter dissent. It is this, that we are to ascribe to sickness principally, the poverty which exists among us. Now we apprehend that nothing can be more wide from the absolute matter of fact, than this broad and naked statement, as set forth in the language of the address. That it is the suffering of the poor when sick, which our charitable societies and benevolent individuals are called upon to relieve, is to be sure very true. It is in the state of sickness, during its presence in families, that we are called upon to go among them, to witness their squalidness, their rags, their filth, and misery. But they undergo all these evils during sickness, because they are already poor, whilst the cause of that poverty lies deeper and further off-it is not the sickness. It is undeniable that we occasionally meet with families, whose poverty and suffering may be traced to the long continued and habitual infirmities of one of its heads. But this is certainly a very rare case--it is seldom, very seldom indeed, that where you find a family abjectly poor, miserably destitute of the common comforts of life, suffering in sickness for the want of kind and tender attention, pining and perhaps dying, solitary and neglected; that you do not ascertain, upon examination, that it may all be traced directly to imprudence, prodigality, idleness, or intemperance. You tind perhaps a family exceedingly poor, the husband dead, and the wife left with a flock of needy children. Here you may say is poverty, the direct consequence of sickness and death. So indeed it might appear. But inquire à little further. You find that the husband has been an idler and a drunkard—that he was poor and miserable when alive, and left his family so, now he is dead, from no other cause than these ; and that very probably his death itself was directly or indirectly occasioned by his intemperance. And within our own observa

tion we venture to say, that where there has been one such famí. ly left in a state of hopeless and irremediable poverty from the sickness and death of its head, there has been at least one other, where this loss has been the salvation of the family, has been a burthen removed; where the widow has, by her own honest exertions maintained and brought up her children in homely but comfortable and honorable independence, so that their last state has been better than their first.

We have thought it right to make these remarks, because if any thing is to be done for the amelioration of the state of the poor, any thing to lessen the extent or reinedy the evils of pauperism, it seems to us of the highest importance that no false views should gain ground with respect to its causes ; and nothing we conceive can be more diametrically opposite to the truth of the case, than the statement to which we have alluded. We wish to have as much charity of feeling, to entertain and express as much liberality of sentiment with regard to the poor as any; but we cannot shut our eyes to the evidence which is accumula: ting so thickly around us, which meets us in every street and at every corner, which fill the reports of every charitable society and dispensary, which stares us in the face from the crowds that throng our alms houses and people our jails ; evidence, that tells us plainer than language can speak it, that the main cause of poverty is to be found in vice and intemperance, and that we can only remedy the former, by banishing the latter.

It does not at all follow as a consequence from this view of the subject, that it is any the less our duty, either as individuals, or as a community, to take measures for the relief of the poor, especially when in a state of sickness and suffering. If we find poverty and misery to exist, it is our proper office to relieve it whatever may have been its cause--yet the course which we adopt, and the means we pursue, should certainly be modified by a consideration of that cause, and should have some relation, not merely to present alleviation of distress, but to its prevention in future. There is too much reason to think that the effect of most charitable institutions, as they have been managed, is of at least a doubtful character; that they have, upon the whole, rather a tendency to increase the number of those who live upon the benefactions of others ; but even admitting this to be the case, much and unequivocal good is produced by their existence upon the general character and tone of feeling in society--it assumes a more benevolent cast, a more liberal and free spirit of beneficence is excited and prevails and brings with it all its tribe of kindred and associated affections. And no charitable establishment seems to us to have, at the same time, so much of this tendency, and so Jittle of the former, as hospitals for the sick, wbich apply only to those who are already at the lowest point of suffering from poverty, and whose relief will have less tendency, than in cases of simple destitution of the comforts of life, to induce others to allow themselves to fall into a state of dependence.

The Asylum for the Josane seems to us by far the most interesting, the most important, and the most necessary of the two departments of the Hospital. For the cure of insanity, the most terrible, the most humiliating infliction with which it has pleased Providence to visit our species, there is among the poor no other possible resort, than to an Asylum expressly provided for that purpose. For their other diseases they may seek relief in a variety of ways, they may receive it at their homes from the Dispensary, or from the kindness and attention of individuals ; they may resort to the Alms-houses, where, although they cannot have the accommodations of a hospital, they will yet receive kind and effective assistance. But in cases of lunacy little can be expect. ed from these sources.

The home of the lunatic, especially when it is filled by prejudiced and injudicious friends, is the very last place where any treatment can be expected to meet with success. If he is to have any tolerable chance for the restoration of his shattered faculties, it is absolutely necessary that he should be sent away from the interference and caprice and tyranny of ignorant attendants. The situation of a poor man who is bereft of reason is truly pitiable, if forced to remain at home. The conduct of those around him only serves to irritate and increase his disorder. His family, his friends reason with and wrangle with him who with his reason, has lost perhaps his sense of moral right and wrong. He is constantly exasperated and made ten times more infuriated by unnecessary contradiction, by systematic and unreasonable restraints, and by cruel and barbarous • severity of discipline. Harsh and severe treatment has been too

long believed to be the only course adapted for the cure of disorders of the mind. We suspect that taken as a general method of treatment, there is none more likely to confirm and perpetuate the disease. The prejudice upon this subject, which is yet strong among the lower classes, is however gradually giving way, and the opinion of the faculty and the public undergoing an entire revolution. The most satisfactory experience of the latest observers seems decidedly in favour of a mild and rational treatment, addressed to the moral as well as to the physical system of the patient.

The success which has attended the practice of the Physician of the Asylum at Charlestown, has been such as to give much encouragement with regard to the future prospects of the estab. New Series-p01. IV.


lishment. The only circumstance to be lamented, is the want of funds, which prevents the reception of any patients who do not pay board. We trust that this, which so essentially diminishes the advantages to be expected, will not remain long without a remedy. We cannot better close this article than by extract. ing, in connexion with the remarks which we have made, a part of the Report of Dr. Wyman of the state and progress of the Asylum for the first three years after it went into operation.

• It is asserted by a late writer,* (A. D. 1817,) " that as many lunatics were discharged from the French Hospitals cured in the second and succeeding years, as were recovered the first year of trial. The report made to the General Committee of the French Hospitals and published by authority verifies this statement. Dr. Esquirol too reports, that, of 2804 lunatics admitted into La Salpetriere between the years 1804 and 1813, 604 were cured in the first year, 502 in the second, 86 in the third, and 41 in the fourth year.” Thence Dr. Esquirol determines, “that the medium term of cure is little less than a year; but that no period should permit of despair of recovery.”

In forming an estimate of the utility of this Institution, and ascertaining the proportion of crires. it is very obvious, that the unfit subjects and those who eloped should be taken from the whole number. It should also be considered that some boarders, who had eloped from their friends, have been sent to the Asylum as a place of safe keeping, until a convenient opportunity to remove them home should be offered. For others, the establishment has been considered a comfortable winter residence, where the boarders would enjoy the benefits of apartments well warned, well ventilated, and free from the dangers of fire, which could not be provided in a private house without great expense. Of 149 boarders receiped, 3 were not considered insane, and discharged accordingly. 96 had been subjects of insanity from 1 to 24 years, and in pearly the whole of the remaining 50, insanity had existed from 3 to 12 months. Of 121 removed, only 8 resided here 11 months, which is less than the average term of cure in Paris, as stated by Dr. Esquirol. Those removed by request (29) were not improved. Those improved (23) and those much improved (19) were also taken away by request of their friends, who believed they had recovered so much as to be manageable at home, and that a cure would be completed without additional expense. Of these, 6 continued to improve, and recovered in a few weeks. They and others would have been added to the number of cured, had they remained at the Asylum a reasonable time. Many, however, ceased to improve at home, and some relapsed into their former states of disease.

It is believed the public have much to learn respecting lunatics that insanity is curable—that a few weeks or months are not sufficient for a reasonable trial—that medical treatment and moral manage

* Dr. G. M. Burrows' Inquiry, &c. page 142.

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