Colonies for the chronic insane are established in the country, but in the neighbourhood of the cities having psychopathic hospitals, to receive the overflow of the latter when the acute stage has passed. The true colony is constructed on the principle of a farming hamlet, without barracks, corridored buildings, or pavilions. It is similar in most respects to any agricultural community. The question here is one of humane care and economical administration. Humane care includes medical supervision, agreeable home-life, recreation, and, above all things, regular manual and out-of-door occupation in garden, farm and dairy, in the quarry, clay-pit or well-ventilated shop. Employment for the patients is of immense remedial importance, and of great value from the standpoint of economical administration. In the colony system the small cottage homes of the patients are grouped about the centres of industry. The workers in the farmstead live in small families about the farmstead group of buildings; the tillers of the soil adjacent to the fields, meadows and gardens; the brickmakers, quarrymen and artizans in still other cottages in the neighbourhood of the scenes of their activities. In addition to these groups of cottages, which constitute the majority of the buildings in the village, an infirmary for bedridden, excited and crippled patients is required, and a small hospital for the sick. All the inhabitants of the colony are under medical supervision. A laboratory for scientific researches forms a highly important part of the equipment. The colony is not looked upon as a refuge for the incurable; it is still a hospital for the sick, where treatment is carried on under the most humane and most suitable conditions, and wherein the percentage of recoveries will be larger than in asylums and hospitals as now conducted. In respect of the establishment of colonies for the insane upon the plan outlined here, Germany has, as in the case of the psychopathic hospital, led the world. It has been less difficult for that country to set the example, because she had fewer of the conditions of the past to fight, and with her the progress of medical science and of methods of instruction in all departments of medicine has been more pronounced and rapid.
Among the German colonies for the insane, that at Alt-Scherbitz, near Leipzig, is the oldest and most successful, and is pre-eminent in its close approach to the ideal village or colony system. In 1899 Professor Kraeplin of Heidelberg stated (Psychiatrie, 6th edition) that the effort was made everywhere in Germany to give the exterior of asylums, by segregation of the patients in separate home-like villas, rather the appearance of hamlets for working-people than prisons for the insane, and he said, further, that the whole question of the care of the insane had found solution in the colony system, the best and cheapest method of support. “I have myself,” he writes, “had opportunity to see patients, who had lived for years in a large closed asylum, improve in the most extraordinary manner under the influence of the freer movement and more independent occupation of colony life.”
In America the colony scheme has been successfully adopted by the state of New York at the Craig Colony for Epileptics at Sonyea and elsewhere.
That the tendency nowadays, even outside of Germany, in the direction of the ideal standard of provision for the insane is a growing one is manifested in all countries by a gradual disintegration of the former huge cloister-like abodes. More asylums are built on the pavilion plan. Many asylums have, as it were, thrown off detached cottages for the better care of certain patients. Some asylums have even established small agricultural colonies a few miles away from the parent plant, like a vine throwing out feelers. What is called the boarding-out system is an effort in a similar direction. Patients suffering from mild forms of insanity are boarded out in families in the country, either upon public or private charge. Gheel is an example of the boarding-out system practised on a large scale. But the ideal system is that of the psychopathic hospital and the colony for the insane.
Authorities.—Sir J. B. Tuke, Dictionary of Psychological Medicine, (London and Philadelphia, 1892); W. P. Letchworth, The Insane in Foreign Countries (New York, 1889); Care and Treatment of Epileptics (New York, 1900); F. Peterson, Mental Diseases (Philadelphia, 1899); “Annual Address to the American Medico-Psychological Association,” Proceedings (1899).
(F. P.*)
[1] The word for “lunatic” in several other languages has a similar etymology. Cp. Ital. lunatico, Span. alunado, Gr. σεληνιακός (epileptic), Ger. mondsüchtig.
[2] It has sometimes been stated that this power, which ought clearly, in the interests alike of prisoners and of the public, to be exercised with caution, is in fact exerted in an unduly large number of cases. The following figures, taken from the respective volumes of the Criminal Judicial Statistics, show the number of criminal lunatics certified insane before trial. In 1884-1885, out of a total of 938 criminal lunatics, 169 were so certified; in 1885-1886, 149 out of 890; in 1889-1890, 108 out of 926; in 1890-1891, 95 out of 900; in 1894, 78 out of 738; in 1895, 84 out of 757; in 1896, 88 out of 769; in 1897, 85 out of 764; in 1898, 17 out of 209; in 1899, 13 out of 159; in 1900, 12 out of 185; in 1901, 15 out of 205; in 1902, 7 out of 233; in 1903, 11 out of 229.