Appendix-Iowa's Duty to the Insane. IOWA'S DUTY TO THE INSANE. BY H. A. GILMAN, M. D., SUPERINTENDENT HOSPITAL FOR THE I am happy to be called upon to present the claims of the unfortunate class, with whom my life work has been cast for a period of twenty-five years. A brief resume of what has already been done for the care of this class by our State may not be out of place at this time. In 1854, the fifth general assembly of this State made an appropriation for the construction of a hospital for the insane, and the location selected was Mt. Pleasant. For a period of nearly seven years that institution was undergoing the process of construction and was not formally opened for the reception of patients until March, 1861. At least one political campaign was fought over this enterprise, and the stump resounded with the statement that a huge building, nearly one mile in area, and capable of accommodating all of the insane of the State for the next fifty years, was being constructed, and it was dubbed "Grimes' folly." The work was, however, continued, and the people builded better than they knew, as the rapid increase of those requiring such care and accommodation demonstrated. In March, 1861, the institution was formally and appropriately opened, under the superintendency of the devoted and able Dr. Patterson, who still survives, having devoted his entire life to the cause of humanity in this and other States, to be followed by the lamented and consecrated Dr. Ranney, who fell a martyr to the cause, literally yielding up his life in his devotion. It was only intended to accommodate three hundred and fifty patients in this hospital, but four hundred were crowded in, and the demand was for Read before the annual meeting of the Iowa State Medical Society, and by unanimous resolution referred to the State Board of Health for publication in the Sixth Biennial Report of the Board. Appendix-Iowa's Duty to the Insane. more room; and in 1868, I think it was, the legislature made the first appropriation for the hospital at Independence, which was to accommodate a like number, and when opened was placed in charge of Dr. Reynolds, who most faithfully labored in placing the new plant in line with the best institutions of the country, ably seconded by our friend, Dr. Hill, who succeeded him. Thus up to eight years ago the actual capacity for the care and treatment of the insane, provided by the State, was about eight hundred. The terribly crowded condition of the two hospitals at that time, and the pressure of other cases, constantly demanding treatment, called loudly for still further room, and as a result appropriations were made by the twentieth and twenty-first general assemblies for additions to both the hospitals, and for a third institution, which was located at Clarinda. By this action, the capacity of the two older hospitals has been doubled, and provision already made at Clarinda for three hundred, so that in the past eight years, the increased accommodation provided has been from eight hundred to nearly two thousand. But still the cry goes forth from the almshouses of the State, and from the families struggling to care for their loved ones in their own homes, for more room, while the hospitals are all crowded, and the boards of trustees are compelled to order many cases discharged and returned to the counties from whence they came. The demands of humanity and the economy of the hour alike call for prompt action in still further providing for these afflicted ones, who can not speak for themselves, and who, in members of this society and kindred associations, must find champions. While tardy in commencing and carrying forward the work of providing accommodation and care, yet the retrospect of the last eight years, affords much satisfaction to the participants in the service, and reflects much credit upon the great heart of our commonwealth. If the same policy, with the additional wisdom which experience brings, can be pursued for a like period in the future, the problem of proper care for all of the insane of Iowa will have been solved, and all will enjoy that comfort, treatment, and so far as possible, immunity from suffering, which their misfortune entitles them to. To accomplish this, however, requires an amount of presistent effort which no one can realize who has not been actively engaged in the effort, and the combined forces of this society should be |