« ForrigeFortsæt »
Similar to the asylum for males, the medical staff at this institution consists of one attending physician, M. Guislain-its presiding genius-one consulting surgeon, and Dr. Vermuelen, the assistant physician; all being non-resident. Besides the "Sœur Supérieure" there are also thirty-one Sisters of Charity; of whom one is secretary, another music-mistress, while others are teachers of various 'departments, and chief superintendents; as also in other capacities, throughout different wards. To these, ten lay-female servants, with seven assistants, must be added; thus making altogether forty-eight actual attendants for 269 patients, or one to every six lunatic inmates."
Of this same establishment, the writer of the "Flemish Interiors" gives the following account :
Having obtained an introduction for the other house, which from the nature of its œuvre (the care of the insane), is even less shown than this, I proceeded thither at once.
It is an old and picturesque building, and part of it being castellated and constructed on a bridge which crosses the canal, it has the appearance of an ancient fortress. One side rises from a green turf bank on the water's edge, and the old dark russet wall is partly covered with ivy, from which peep out the battlements crowning it. The gate is studded with nails, but scarcely in consequence of the present use of the house, as kind and gentle usage of the mentally afflicted, has here entirely superseded force and restraint.
Nevertheless there are upwards of three hundred aliénées in this house, under the supervision of forty Sisters. The patients are of three classes or grades in society. The most numerous is, of course, that of the indigens; next in number is that of the bourgeoisie, or middle class, who pay a moderate sum, and enjoy the advantage of semi-private apartments; and, lastly, that of persons of family and fortune, who can, if they please, be accommodated with salons, chambres â couches and cabinets de toilette, as elegant as anything to which they may be accustomed in their own luxurious abodes. Besides these divisions, there are special wards, padded rooms and private gardens for those whose condition render them dangerous and undesirable companions for the rest. The house is very extensive, and we were occupied a long time in merely walking over it. Above the cloister, which as it were lines the quadrangle, is an outer gallery, very prettily trellised and intertwined with creepers, serving both for ornament and security.
There is an aumônier, and mass is said daily in the chapel, to which the inmates are allowed access at all times. During the service, however, for fear of interruptions, they occupy a large tribune or chamber, divided off with a grating. While we were in the chapel, one of them stole quietly in, and having signed himself with holy water, knelt before the altar. This the Rev. Mother told me was their constant practice, and they never misconducted themselves at any time, while there, generally speaking evincing much devotional feeling.
Of the lower class of patients, those who are sufficiently sane are employed in various ways in the menage. A large number were employed in washing in the laundry; but the Rev. Mother told me that they often did much mischief, and required so much watching, that their assistance was of very little service, and the work was only given them as an occupation, being a real trial of patience to all who were concerned with them. Of the second class, about forty were manufacturing lace, and appeared perfectly rational. One of them exhibited her work, and remarked that when her eyesight was better, she had made some much finer than that. This lace is all sold for their own benefit, and the proceeds as the Rev. Mother observed, serve to supply them with such little douceurs as the charity can not afford them. In another room some were making clothes for their own wear, while parties of others were amusing themselves with cards or dominoes. Of the upper class, many remain in their own apartments, either from choice, or because they are not fit to leave them; but about half a dozen were seated in an arbour, formed in their own private
garden, which is very tastefully laid out. One or two were engaged in fancy work, two were conversing apparently very rationally, and another was reading. A Sister was with them. The Rev. Mother told me these were all personnes de considération. There is a common dining room for these patients, where all who are not confined to their own apartments meet for meals; unless, as in some cases, they prefer solitude. There is a separate kitchen for this portion of the house, of which the Sisters have the charge, as well as of the others, but are assisted by servants.
I understood the Rev. Mother to say that out of three hundred, for the house is always full, about twenty are cured annually, and about as many die. She told me that they rarely died without a lucid interval; which, of course, is taken advantage of to administer to them the last Sacraments of the Church. Besides their own aumônier, they are visited by the Pères Recollets.* A Nun sits up each night, going the rounds of the wards, and only calling up the Nursery Sisters if necessary. One curious fact she told me, was that of their having noticed the rule of silence observed by the community, and of their having in consequence volunteered, though not apparently in a spirit of penance, to keep a three hours silence daily, and what was more surprising, they had religiously observed it. The Rev. Mother told me that as far as her experience went, need and affliction of various kinds were the ordinary causes of insanity among the lower classes, and among the upper, for the most part, la lecture des mauvais livres."
These two accounts of visits to the same asylums present very interesting contrasts. The travelling psychologist, with his calm record of the facts that met his eye, bears the same relation to the sympathising life-like story of the modern pilgrim, as the page of Hume does to the cotemporary letters and documents of each period. The one gives us an historical induction from his facts, and tells us that these asylums are well conducted and their patients cared for; while, from the little hints that the other drops by the way, as of the bright sunshine falling on quiet forms in the cloister walks at the Hospice St. Julien, of the noisy mirth and hilarity which the costume of a party of visitors of Sisters of St. Vincent de Paul called forth, of the friendly salutations which all paid to the Mother Superior, we are ourselves led to draw similar conclusions as to the manner in which these institutions are conducted, and to see that love and kindness. are the cords which bind these societies into order. The pleasant reality of the life-like picture, and the story of the day's doings, comes out in the "Flemish Interiors;" the psychologist adds to it the assurance of his practically enlightened judgment, that humanity and science really do hold the sway in the Belgian asylums for the insane.
It may be interesting to subjoin an account of the rules of the two religious orders who thus devote themselves to the care of the insane.
*The duties of this order are to visit the sick, to travel about on preaching missions, to visit prisoners, to accompany convicts to the scaffold, and to attend funerals.
1. Sœurs Hospitalières.-The writer of the "Flemish Interiors" states that the Sisters at the Hospice St. Julien are Hospitalières of the order of St. Augustine, by whom, indeed, most of the hospitals in Belgium are tended. There is, perhaps, no order so varied and numerous as that of the Hospitallers; and even those who retain the name of sœurs grises are not all clothed in uniform, some wearing a habit of light grey, others of black, and others again of dark blue. Those who attend the sick in hospitals are simply called Hospitalières.
In the year 1483 statutes were drawn up for their regulation by the provincial vicar and visitor of the order. Their rule obliges them to rise at midnight, to recite matins and the "Little Office of the Blessed Virgin," and to remain in meditation and prayer until two o'clock, when they return to bed until five o'clock in summer, and six in winter. After their second rising they say prime, tierce and text, followed by mass, after which they go to their daily occupations, observing silence until dinner-time. After dinner they return to their work till three o'clock, and then say vespers, occupying themselves with their duties again till supper. When they are sent to visit the sick they always go two together, and may not separate.
2. The Asylum of Ghent is under the care of the Sœurs de la Charité de Jésus et Marie.-This order consists of 400 sisters, all in Belgium, where the entire number of their houses is twenty-four. They were founded by M. le Chamoine, Priest, about thirty-five years ago. They wear the habit of St. Bernard, and follow his rule, but to it they add the œuvres of St. Vincent de Paul, i.e., the care of the sick and needy. The dress is of white cloth, and being made long behind, is looped up when they are engaged in their active duties; they have a white linen cap and scapular. In the hospital they wear a blue checked apron and sleeves of the same material, from the wrist to the elbow. Silence is one of their rules, and the word is painted in visible characters over the entrances to the cloisters and corridors, the refectory and work-room. Their noviciate lasts a year, after which they remain postulants for six months; when, if they take their vow, it is for life. Notwithstanding their active works and the bodily labour they go through, their rule includes contemplative exercises, and the recital of the Divine office. They rise at half-past three, and go to rest at nine, sleeping on straw. They are allowed meat except on certain
days, over and above the ordinary abstinences of the Church.
Would that we in Protestant England could point, not to four hundred, but even to forty sisters thus engaged for the love of the Lord Jesus, and without any thought of self or gain in the tending on our insane poor.
C. Lockhart Robertson.
FOREIGN PSYCHOLOGICAL LITERATURE.
On the Present Condition and Future Prospects of Idiot Education. By Dr. Ferdinand Kern, Superintendent of the Idiot School at Gohlis, near Leipsig. (From the Allgemeine Zeitschrift für Psychiatrie.)
The author is unable to determine to whom belongs the credit of having first attempted the education of idiot children. Saegert, of Berlin, believed that he had demonstrated scientifically the curability of idiocy in 1846. Seguin, of Paris had made known his efforts in the cause about the same period. Gug.. genbühl opened his institution upon the Abendberg in 1836; but Voisin in Paris had preceded him, and even Voisin was not the first labourer in the field. The Government of Saxony has been the first to found an idiot institution, at the cost of the State. The Government of Wurtemburg has given its support to the institutions of Mariaburg and Winterbach. The Government of the kingdom of Sardinia has proved its lively interest in this question by issuing in 1848 a Royal Commission to inquire into the nature and the causes of cretinism; and it has thus set an example to other Governments.
The author knows of no other Governments which have taken any steps in this matter. He distinguishes between cretinism, idiocy, and imbecility; and he defines imbecility as the psychical condition of weakness which prevents a human being, on account of its influence on his moral life, (innerhalb seiner Lebensphare,) from thinking and acting like healthy men. The question remains open, whether this condition is a normal psychical development or not. He distinguishes imbecility into acquired and congenital forms. He doubts, however, the actual correctness of the last term, since the condition may take its origin in early infancy, before the mental functions have become active. He thinks that there can be as little question of the congenitality of idiocy, (we shall use the term idiocy, as it undoubtedly corresponds to the word blödsinn,) as of congenital quickness of the intellectual functions, since there can be little doubt that the nature of the intellect is not at birth what we see it after its development; that the cultivated intellect of man is indeed a product of education, and not an original endowment. The possibility of perfect development in his psychical functions is the undoubted right of every child capable of living. But the original, free, and complete, or the arrested psychical development, above all things, depends on the normal or abnormal constitution of the brain and of the nervous system, the cause of which is to be sought for in the finer or coarser organization of the bodily organ. Mistakes in the intellectual and moral education can easily introduce false elements into the psychical formation; but the mind of the new-born
infant cannot commence its existence diseased and arrested-that would con
tradict its very essence. But if the actual congenitality of idiocy in the sense of a psychical arrest cannot be entertained, the question remains, when and in what manner does the mind become impeded in its development? The answer to this question is in concrete cases extremely difficult, and often impossible; for although the viable child has, from the first moment of its life to its death, been sufficiently active in shewing and developing its double nature, yet with the first breath and cry the commencing psychical development is by no means so clear as the corporeal. In early infancy one child is so like another that it is not easy to perceive a difference, unless there are actual defects or deformities in the bodily organs. We often hear the parents of idiot children declare that at first there was nothing by which they could be distinguished from other children in whom the psychical development has been normal.
No certain scale can be laid down for such children. A child surrounded by monotony, poverty, and misery, in the period of its early growth, cannot receive the due bodily care, nor will those mental impressions necessary to arouse the mental activity be experienced; and it will remain, at least to appearance, for a longer time in such an apathetic condition as can be taken neither for one of mental activity, nor yet for idiocy. On the other hand, the infant placed in advantageous circumstances, in which it has enjoyed reasonable care of its physical condition, in which the thoughtful mother has known how to make those mental impressions so useful to the child, the awaking and formation of the mental functions display themselves at a very early period; in such circumstances, an abnormal development, either in the physical or psychical condition, will be much sooner recognized.
The time of the first dentition is that at which any physical weakness is most frequently recognized. This period of life exercises, indeed, the greatest influence upon the development of the child; affording, in its purely physiological course, the conditions of so many diseased actions. Whenever plastic new formations are taking place in the organism, an hyperæmic condition is present. In the organism of children, the tendency to plastic formation is so rife, that hyperæmia proceeding from it must, to a certain point, be considered as natural. But hyperæmia is readily disturbed by injurious external influences, so that it no longer stands in relation to the physiological and anatomical constitution of the organ implicated, so much as to the economy of the organs in general. During the period of dentition, the whole organism of the child is urged to increased activity, and often into a state of excitement; but of all the organs in the child, the brain is so large, so tender, and so full of blood, that the greatest injury is inflicted upon it. Its anatomical and physiological connexion with the whole organism is so intimate, that either directly or through the influence of the reflex function, it is drawn into sympathy with every abnormal action of the body; and this the more readily in proportion to the intimacy of relation existing between it and the diseased organ. In the period of dentition, besides many other disturbances of health, hyperæmia exists near the brain, and this easily affects and draws into sympathy the brain, so little protected, and exposed through its commencing functions, to violent impressions. We see this in the change of nervous tone which takes place during the period of dentition in nearly all healthy children. If the unfavorable situation of the brain and of its extremely vascular membranes, in a natural course of dentition, is increased by any other adverse circumstances, then hyperæmia proceeds to inflammation, and exudations are the result, of which the greater or less resorption depends upon the energy of the system; this scarcely takes place, in the most fortunate cases, so completely as to leave no tendency to relapse. These events concur with congenital conditions of disease, in accordance with the degrees in which they are present, to occasion not only the disposition to disease of the brain, but scrophulous and rachitic disease, which often shew themselves, even in foetal life. The stamp of feebleness is often more or less impressed upon a child, even at birth. One child is indeed weakly, but psychical indications do not commonly develope at this early period, in consequence of any excitement of the brain dependent upon