Historical Newspapers of South Carolina

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INVESTIGATION OF ASYLUM KFFKTKN'CY FXl'FKT KKPOKTS TO (iOVKKNOIl. Radical Changes Recommended in Message to General Assembly. The efficiency expert, employed by Governor Manning to study conditions at the State Hospital for the Insane, has made his report, which is incorporated in a message to the general assembly. The message follows: I have the honor of submitting herewith the report of Dr. A. P. Herring on the condition and needs of the Hospital for the Insane. You have doubtless read in the public prints of my purpose to secure a thorough, scientific, non-partisan investigation of this institution. I realize that we have been fortunate in securing the services of Dr. Her* ring, who has both technical training and practical experience necessary for 6uch work. He has a national reputation and is endorsed by the highest authorities. I requested Dr. Herring to give a calm statement of existing conditions; 1 wanted nothing sensational or hysterical. In the accompanying report you will find a strong presentation of what I want you to inspect personally and verify for yourselves. The general requirements for treatment of patients suffering from mental diseases, and suggestions for improvement in the physical condition of the hospital, and treatment of the insane as offered by Dr. Herring, will, I am confident, commend themselves to you as wise and practical, and nothing short of a plain and mandatory duty?a sacred debt to these suffering and impotent patients. Keynote of Investigation. Here is the keynote of the investi gation: "The duty of South Carolina to its . insane is a cardinal, a supreme obligation to do all and everything without stint for their benefit that its financial resources possibly permit or enable it to do: to exercise in their 'VT interests, through the public officials, every effort and labor they are capable of. and to put into effect all the means and resources at its command to perform most effectually this great debt to humanity, this direct and immediate obligation to its people and ' this noble duty to all the future." Dr. Herring says that the fundamental principles underlying the entire plan of reorganization proposed in the report is to make certain changes in the law relating the control of the State Hospital for the Insane. Amendments Recommended. The following amendments to the constitution governing the asylum are recommended: 1. The superintendent should be onnnintoH hv tho hna rH r>f rpsrpnt-S. J ?rt>vuvv? ~" " "" ' and not by the governor, removable only for cause and after a hearing. 2. The board of regents should consist of five members, appointed a by the governor, with the sanction of the senate. They should be apponited, at first, one for two years, > two for four years, two for six years, subsequent appointments to be made for a period of six years. The members of this board are not removable except for cause and after a hearing. S/ The superintendent to make all appointments, with the sanction of the board of regents, and to have the power of dismissal of same, to be approved by the board. The superintendent is to report to the board of regents the activities of the hospital; and the board of regents to report to.the governor and general assembly. Briefly, the governor will appoint a board of regents in whom he has absolute confidence. They p in turn will select a superintendent in whom they have every confidence, and who, of course, has had train ins in the care and treatment of the insane and in hospital management, and it will then be up to the superintendent to conduct the hospital in a proper manner. There should be no dual authority or divided responsibility. Formulated by Board. 4. All rules and regulations for the hospital are to be formulated by the board and executed by the superintendent and his assistants. There is no reason why the general assembly should be asked to approve or reject the rules governing the conduct of a hospital for the insane. 5. To change the name from the "State Hospital for the Insane" to '< the "Columbia State Hospital," while the hospital for the negroes will be known as "State Park Colony." 6. To provide for voluntarv admissions. 7. To provide for a fiscal agent, whose duty will be to see that every patient who has relatives or an estate responsible for his support will be made to reimburse the State. This might well be done in connection with the "State board of charities." 8. No female patient to be brought ( the hospital unless accompanied by her father, husband, adult son or brother or by some relative, friend or nurse of the same sex. 9. To provide for a system of after care or placing out of patient! who are able to leave the institution, and, while not entirely recovered, yet are able to live satisfactorily under proper supervision away from the hospital. 10. To provide for the admission, care and treatment of inebriates. State Perk Colony. According to tl e report by A. P. Herring, M. D., uuder the present plans a colony fo? the negro insane of both sexes would be established at State Park. There is a building at this place which is now occupied by less than 100 negro women. -\one or tne worn on tins Dunaing," says the report, "was done by the labor of patients. Under our proposed plan at least 100 able-bodied negro male patients would be transferred to State Park and housed in the small wooden building now on the place. These patients would be utilized in doing all of the general labor, such as excavating, clearing the land, unloading cars, mixing cement, etc. This would save the State a great deal of money and by erecting a permanent and comparatively inexpensive building all of the negro patients could be housed in the nekr future and at a comparatively small cost. I would say within $400 a bed. This, to my mind, is one of the most important things connected with the entire nlan nf renreaniza tion. "The negroes could be used for farming purposes, and there is no reason why most of the produce used in the hospital could not be produced on this farm by the patients' labor. By occupying the negroes in this manner restraint could be absolutely abolished; the patients would be happier and more contented; there would be a large number of recoveries, and at the same time they would become a valuable asset to the institution and the State. "In addition to the colony for the negroes there could be erected at I State Park a building tor the idiotic and imbecile children, who are nowliving with the patients iji the State ! hospital. .The importance of segre! gating the imbecile and feeble mind ed children from the adults has never been questioned. There should also be constructed at State Park a separate building for cases of tuberculosis and pellagra. There is a splendid opportunity, both at the present hospital and at State Park, to develop farm colonies." I>r. Herring's R?i>ort. Dr. Herring in his report makes the following statements relative to conditions at the State Hospital for the Insane in this State: 1. The present superintendent is a gentleman who was in general practice in the rural districts before his appointment to his present position. He is kind and courteous in his manner toward the patients, and I am firmly convinced thatheisdoingeverything in his power for the comfort and well being for those under his care, but he has certainly not had sufficient executive experience or psychiotric training to be held responsible for the proper management of an institution of nearly 1,700 patients. 2. The present staff Consists of four physicians in direct charge of the patients. The first assistant is in charge of the 400 white male patients and has no assistant. The second assistant is a woman physician, who has had no previous hospital experience with the insane. She is responsible for the treatment of over 600 white female patients and has no assistant. These two physicians and the superintendent live on the | hospital grounds. The physician in charge of over 400 negro male patients does not live at the institution, but visits every day for a few hours or more, as may be necessary. He has no assistant. The physician in charge of the negro women has about 300 patients under his charge, in addition to visiting the negro women at State Park. He does not live at the institution and has no assistant physician. To expect four physicians to look after nearly 1,700 patients in addition to their other enormous clinical duties, and only two l af whnm rievntp all their time tn the work, isr not only a physical impossibility, but i6 evidently so unjust and absurd, to the patients and to the physicians,'that it needs no argument. There is a pathologist and a dentist, who spends a part of each day at the hospital. Staff Conferences. 3. It is impossible, Dr. Herring eays, under the present condition to have regular and frequent conferences of the medical staff. 4. There is a receiving ward for the white men and one for the white women, neither are being equipped for the proper examination and treatment of the jiatients. They are receiving wards in name only and in no sense meet the requirements. 5. There can be no satisfactory classification of the patients under the present conditions, due primarily to the overcrowding and lack of a' tendante, except to have a ward fc the excited, infirm and demente cases and wards for the quiet pt tienta. 6. The system of clinical record is not uniform, some department using a hook, while others use a hit tory sheet, and a great deal of th clerical work must be done by th doctors. This entire department wi have to be reorganized. Xeetl Pathologist. 7. A laboratory has been recent! established in the main buildini where a limited amount of satisfa* tory work can be performed. Thei is, however, sufficient work in a ho! pital of this kind to require the sei vices or an experienced pauiuiugisu. S. There is no provision for an form of special treatment. 9. There is a dentist in reguls attendance, but no regular visitin consulting stafT. A small operatin room has been equipped in the hoi pital ward of the women's depar ment. This room is neat, clean an apparently satisfactory for the pre ent needs. 10. The Nurses' Training Scho< in the female department is the mo: hopeful and attractive feature aboi the institution. The superintendei of nurses is a graduate nurse an well equipped for her duties of gem ml trninine\ T'nfnrtnnatelv she hi had no previous experience in a hoi pital for the insane. The ma' nurses are not required to take tt training nor do they wear any di tinctive uniforms. 11. Female nurses are not en ployed on the male wards. Lack of System. 12-13. There is no systematic u< of occupation and recreation. Son of the patients work about the ware and in various departments ' t' hospital and farm. The most di tressing phase of life in this inst tution is the utter lack of work an play for the patients, under the si pervision of a teacher. The week dances are given in winter and tl moving picture shows during sun mer. Diversional occupation is ui known. 14. During the past year 224 p; tients were discharged as improve and 109 as unimproved, while 5( died. There .is no after care < placing out system. 15. There is no special provisic for the tuberculosis insane. 16. Ther^ is no way to segrega the pellagrins. The importance < this is shown in the following tabl taken in part from the 90th annu; report of the hospital: Pellagra' Statistics. Admitted. Recovered. Die 1907 4 1908 46 0 2 1909 112 4 6 1910 213 14 10 1 911 284 28 15 1912 273 35 22 1913 366 36 16 1914 462 7 35 Dr. Herring says that from tl above statements it is evident thi the asylum does not "in any wa conform to the standards existic in a modern hospital for the insane. Points Out Defects. Dr. Herring calls attention to "se1 eral defects which need immediate a tentiofi" as follows: 1. The fire protection is entire] inadequate. Xot only are thes buildings veritable firetrap6 in the present condition, but the lack of fii extinguishers and the condition < the hose, as found in some of th tMoboo V>rv f rnrvi firn v? ai UO) xuanco cue uuuo^i n vm *1* v real and terrible disaster to conten plate. Only recently has the threa on the standpipes been standardize* so that now the hose of the city fii department can be used on any of tb fire plugs. 2. The sanitary conditio! throughout the entire institution ai in bad repair and entirely inadequate The free and constant use of rece] tacles is practiced. With one bat tub on each ward to accommodat over forty patients, it is self-evidei that the bathing facilities are n< saisfactorv. . > Heating and Ventilating. 3. The heating and ventilatin system is old, out of repair and ii adequate. The buildings are heate by about eighty stoves and furnace 4. The method of cooking an serving the food in several kitcher and numerous dining rooms, delive ad eh tnnnpls in thp liaspmM and then by dumb waiters to th wards, renders it absolutely impo: sible to have the food hot and pah table when served. 5. The floors, ceilings and interic walls in nearly every part of the ii stitution are badly in need of repair 6. In their present physical coi dition many of the buildings are n( fit for human beings to be house in, and immediate repairs should I made. The present run-down coi dition of the interior of the building is due to the fact that adequate r< pairs have not been made for seve: al years. Summing up the conditions at th Asylum, Dr. Herring has the follov ing to say: That the physical condition of tt t- interior of the buildings is very bad: ir that the internal organization of the d hospital needs a thorough reorgan i- ization to bring it up to the require ments of a modern hospital; and, thai Is with all of these handicaps, it H s hardly to be expected that modern !- care and treatment for the insane e can be secured. So that 1 wish tc e? make it perfectly plain that we 11 should not criticise those who are in immediate attendance of these patients, but that, on the other hand lv they should be given credit for doing y as much as they do under the unsurmountable difficulties. The over>e crowding of the wards and lack of 3_ attendants and need of sufficient r_ money are all contributing factors in the present state of affairs, y Discusses Plans. Discussing the plan for reorganiLr zation of the State Hospital for the g Insane, A. P. Herring, M. D., Goverg nor .Manning's efficiency expert, says s- that he has ever kept in mind the t- fact that, first of all, it must be pracd tical and at the same time sufficients_ ly adequate and elastic to meet all future requirements, and in the second place it should be within reason3t able financial limits. Dr. Herring it first considers the general plan of it arrangement of the buildings and the (d distribution of the patients. The e. internal organization is included un- i ls der a separate head. = s- The report declares that the most [e evident steps at the present time is ie to remove all of the negro insane, s- the idiots and imbeciles, the tuberculocus and pellagrous patients to i- State Park. He says by doing this that there will be plenty of room for me wnue insane ai me oia Asyium 5e for many years to come. "In fact," he says, "by developing the farm jg colony idea there will never be the overcrowding of'these buildings that s_ exists at the present time, i- First Thing Necessary. "The first thing that is absolutely [i- necessary," says the report, "in a lv hospital for the insane is a psychole'pathic reception hospital building, a- This is the active medical centre a- which controls and stimulates the life of the entire institution. Herej a. the patiehts who enter'the hospital: d.jare first received, thoroughly examJO! ined, and, if need be, detained for 3r treatment. All patients who are acj tually disturbed receive in this build)n - ing hydfo-therapeutic treatment and J any other treatment indicated; in te 1 other words, they are treated as sick nf individuals. In this building are al-! e, so located laboratories, examining al rooms, operating rooms and every j facility needed for the proper treatI ment of the mentally sick. In this A ' connection Iwould also suggest ! that an out-patient department be 13 inaugurated in this building for the: ;g purpose of doing any important work i 10 in preventive psychiatry. The close J 14 proximity of the hospital to the city! ;g renders it especially adaptable for 15 this new field of medicine. The ,0 building which could be used for this1 le purpose is the old asylum building,1 the walls of which are substantially iy i constructed and the general outline lg of the building well adapted for this ?j purpose. Internal Arrangement. I | f. "The internal arrangement vill, of t_' course, be changed and practically an 1 ? | entire new interior Installed. The; !y details concerning the arrangement ;e of the interior of this building will ir;have to be taken up later with an e architect. We would make provision >f j for a hundred patients, none of whom iej would remain in this building for a:any great length of time. Leaving i- this building for the present, we will ,d j consider next the central building, and this description will apply to ej both wings of this building. ie| "No very radical changes need be j made in these buildings so far as is their general arrangement is con e'cerned. Of course, nearly all of the e. buildings throughout the entire in>; stitution require new floors and an h j entire new sanitary equipment and ;e new heating. A number of small it j rooms would be thrown into one )t large room. Attractive day rooms and dormitories would result from abolishing a large number of cells g and small rooms. I i- Business Office. I d "The rearrangement of the busi- I s< ness office in the central portion of I d this building will also be necessary. a 1S "The Parker building, which is ? p. now occupied by the negro men, will it have to be extensively renovated, and I ie will be used to relieve the conges3_ tion now existing in the wards for the white men. The Parker annex, a two-story brick building, will be )r converted into an industrial ghop and !- placed under the supervision of a S- competent teacher. In this building !- the patients will make brooms, mat)t tresses, rugs, shoes, baskets and a d great many other things necessary ,e in a large institution. This would * e ..AI.IOKIA A nno ' D6 one 01 uie must vaiuauic uo^ui wrs menta, both from a therapeutic and a. financial standpoint. Without a r- building of this kind no hospital is complete. ie "The building for women need not k-_ be changed except for the general repairs as suggested on the men's ie (Continued on page 3, column 3.) STEEL'S CAKE | Light, refreshing, delicious, none better. Sultana, Gold, Silver, Mandalay, 1 * * and Chocolate, per package 1 \/C i Extra Select Large Mack- [J erel, each 00 Asparagus Tips, large Off ^ cans, each mOC Wesson's Cooking Oil, Q/\ delightful, economical, ?J\/C < ? i Delk's Market Phone No. 2 Bamberg, S. C. I =1 . fTHE 'PRUDENT MAN'BANKS ff/S 1 NO^/t I cr * ? / . i Burglars, thieves snd hold-up men make it their v BUSINESS to learn who keeps money in their pockets, or houses, or in holes in the ground. ' V They will not tackle the man who has his money SAFE in our bank. BANK your money and be free from FEAR?fear of burglars, sickness, OLD AGE, or that your wife and children may some day be-in WANT. Make OUR bank YOUR bank We pay 4 per cent, interest, com- # > pounded quarterly on savings depsits Farmers #& Merchants Bank ENRNARDT, S. C. Handing Out Checks. paying bills than canting out PAif> the money. Much quicker, too, ^\y==== fIBSTCay' and there is no possibility of \ "Q* ^KgjPiil and reap all these and other adi Enterprise Bank 5 per cent Paid on Savings Deposits. Bamberg, S. C, t ~ ?, don't experiment admmmmjm ^ with your car ulifiwi Many autoists have taken their - | ' cars to unreliable repair shops only to find the work unsatis- /? factory. To those, especially, f=& we wish to serve. We aye ex- \ ^ perts and will positively repair fTj? ) 'V*"~ I your car as it should be. Fur- yvy/ 'M H thermore, our charges will be j /A I ? no more than you have been I paying for inferior work. ^HBiD E J. B. BRICKLE Bicycles, Guns and Automobiles Repaired. Bamberg, S. C. \ ' j ;c nrtar Kti,