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Published online by Cambridge University Press: 19 February 2018
I have been frequently obliged to give expression to my views on asylums and their future organisation. These views are expressed in official documents and private letters, which have never been published. A few observations which I made cursorily at the Naturforscher-Versammlung, in Hanover (“Zeitschr. f. Psychiatrie, “XXII., p. 390), as an indication of my point of view, were much too briefly and aphoristically given not to be subject to misconception. I therefore propose to devote the following pages to a connected, though necessarily brief, explanation of what I believe to be necessary or advantageous in the immediate future arrangement of lunacy matters in Germany, and to indicate towards which side I lean in the undoubted crisis which the question of the public provision for the insane has now reached. I apprehend neither detriment nor danger in this crisis, which is merely the progress towards more complete organisation. To wish to ignore it would not improve the matter. The predetermined conclusion to see the only good and right possible in things as they now exist is a far greater hindrance to the discovery of truth. If science can present new points of view, if urgent wants are brought to light, which cannot be satisfied by the present means of publicly providing for the insane, the requirements must not, in such circumstances, be ignored or denied, but the means must be made to suit the necessities. It was in this way that things were treated when the present asylums were founded; and is it possible that at the present time no further advance can be made ? It is, however, to be remarked, as was said a few years ago by Damerow, who was for the most part an authority with the opponents of reform (“Zeit-schr. f. Psychiatrie, “XIX., 1862, p. 187), “There is nothing further to be obtained in the future with the present public institutions for the cure and care of the insane.”
∗ Chronic patients are not necessarily incurable. What is understood by cure may take place in many of them after several years. The beneficial influence of prolonged and completely rural life ia highly valuable in such cases. Google Scholar
∗ It is not to be objected that by Article 27 of the Bye-Laws of 1st May, 1851, no dangerous patient can be admitted into Gheel. This article cannot be practically carried out, and is necessarily broken through in many cases. How can the insane be so generally dangerous as many believe, if over one thousand who are not dangerous are brought together with facility? Google Scholar
∗ This also mm grano salis. I do not believe that a man who in his twentieth year committed manslaughter while suffering from a paroxysm of epileptic mania, should pass his whole future life—perhaps fifty years—in an asylum. Civil society would, in such a case, pay very dear for exaggerated caution. Google Scholar
∗ Compare the excellent remarks on this point in the English Commissioners' Report, XVII., 1862,p. 41 Google Scholar
∗ For instance, incoherent (verrckte), or slightly imbecile persons, who appear quite tranquil and able to take care of themselves for eleven months of the year, and are excited for one month, belong, during the latter period, to th” clinical or town asylum; for the rest of the time they should be at home. Google Scholar
∗ It was there that I first saw it. 1 shall rejoice all my life overthat evening, when my theoretical notirms, in presence of these small beginnings, first gave way to the force of facts. “Yes. it is not only ponsihle. but actual I” I could have exclaimed. The errors of years were destro)ed in a single hour. And even if the thing were again given up in that place, and renounced by thobe who had instituted it, it has been working, and it will work for all time. Google Scholar
∗ In Gheel the same principle essentially exists; but there is only a general valuation. In less extensive conditions, such as those immediately under consi deration, a more exact calculation might be made. Google Scholar
∗ According to Article 1 of the Bye-Laws. I cannot refrain here from con tradicting the completely erroneous idea that the erection of the infirmary at Gheel has approximated the system to that of a close establishment, and taken away its peculiar character. In the autumn of 186'i out of more than ouo thousand patients in Gheel I found somewhere over thirty in the infirmary. The regulations, the practice of the present chief physician Dr. Bulckens, and tha views of the permanent commission for the supervision of the Belgian asylums, (Ducpctiaux, Vermeulen, and Oudart) are equally opposed to this false conception. See “Neuvime Rapport de la Commission Permanente, &c.” Bruxelles, 1866, p. 10., et seq. Google Scholar
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