Our Insane.

Hard work is wholesome, vigorous and persistent mental activity is ennobling, but energetic and ambitious people must learn when to "put on the brakes" and remember that "man is mortal."

Insanity does not necessarily imply nonsensical talk, well marked mental excitement or complete loss of self-control; it simply means more or less unsoundness of mind. Since this condition may come gradually and insidiously, the precursors of this disease should be recognized and acted upon. Rest is the panacea. It must not, however, be postponed until convenient to take it, but be secured when needed. Everybody should remember the Sabbath day, not only to keep it holy, but to rest the body from accustomed labor, to turn the thoughts away from worldly affairs at regular and frequent intervals.

Tendencies to become moody, to allow the mind to dwell on one subject, to get "cranky" (crooked), are counteracted by mingling in good society. Sociability begets cheerfulness, amusement turns the mind away from self, and contact with all kinds of people increases one's common sense. Human adaptability is thus acquired.

The insanity which comes, in a new country, to the farmer's wife is not so much the result of over-work as it is due to a monotonous life, an unattractive home, a lack of near and congenial neighbors, an absence of church privileges.

A liberal education develops all the faculties of the mind, it makes a man level-headed; it broadens the comprehension; it enables one to be independent in thought and act; it certainly prevents insanity. Intellectual superiority naturally creates self-respect, and self-respect encourages self-control; the habitual exercise of self-control enables one to preserve equanimity during the crisis of life.

The self-prevention of insanity, so far as self-management and control are possible, is then a great duty. If he who has fallen a victim to insanity could unroll the complete map of his former life, from the beginning to the end of his course, and patiently retrace the roads and by-paths by which he has arrived at his present mental condition, he might have to blame a neglected education, ill-regulated passions, vice, and consequent misery; or, if free from these causes, he would probably have to blame what I might best , express as the complete mismanagement of his mental functions.

Regular and exemplary habits, a noble aim in life, and a character built upon fixed moral principles, are safeguards against mental alienation. A reasonable belief in the doctrines of the Scriptures, and a uniform endeavor to live in accordance with the precepts of the Savior of mankind, tend to preserve rather than weaken the mind. By keeping the commandments we escape most of the vices and embarrassments of life, and with promises of the Good Book, we are comforted and strengthened in its unavoidable tribulations.

Preservation is, indeed, better than cure. Grand and god-like is it to restore the reason which has fled. It is still grander, and more god-like, to preserve the reason, and to hinder it from fleeing. Every step that you take in the path of preventive medicine will be a step in advance. The further

Our Insane.

you progress, the greater will be your power to discern and diminish the many causes of the disease which you try to prevent; and the more truthfully you will be able to sing, in the language of Oliver Wendell Holmes:

"And lo! the starry folds reveal

The blazoned truth we hold so dear:

To guard is better than to heal,

The shield is nobler than the spear.".

The following article by Mr. L. F. Andrews, Assistant Secretary of the State Board of Health, was prepared with great care, and is deserving of a careful reading and serious consideration. As Iowa is essentially an agricultural State, it is pertinent to ascertain whether or not the statements made, are sustained by the facts, and if So, what can be done in the way of prevention.

"There is no disguising the fact that insanity is alarmingly on the increase in Iowa. It is a matter worthy the earnest consideration of every thoughtful mind, both as to cause and possible prevention.

The expense consequent thereto is becoming a serious burden to the people. It is impossible for the State to keep pace with it in providing asylums for the cure and maintenance of those afflicted.

The first asylum in Iowa was established in 1860; the second in 1872. During the period from 1860 to June 30, 1887, there were admitted to these asylums ten thousand three hundred and seventy-two persons. From 1860 to 1870, one thousand nine hundred and forty-five persons; from 1870 to 1880, four thousand six hundred and four persons; from 1880 to June 30, 1887 (seven years), three thousand eight hundred and twenty-three persons.

In 1880, the United States census gives the total population of Iowa as one million six hundred and twenty-four thousand six hundred and eleven. The proportion of insane to total population in 1870 was one to one thousand six hundred and nine; in 1880 it was one to six hundred and thirty-nine, an increase of two hundred and forty-two per cent, while the increase of population was but thirty-six per cent.

The total increase of insane population in 1880 was two thousand five hundred and fifty-four, of whom but one thousand and seventy-six were in the asylums, or less than one half.

In 1885 the census report gives the population as one million seven hundred and fifty-three thousand nine hundred and eighty. In that year there were in the asylums one thousand and fifty-two persons, and according to the ratio of previous years the total insane would be three thousand and fifty-six, or one to five hundred and seventy-three of the total population.

At the ratio of increase of population of three per cent from 1885, the total population in 1887 would be one million eight hundred and fifty-nine thousand two hundred and eighteen. In 1887, there were in the asylums one thousand four hundred and eighty-nine, with a total increase of four

Our Insane.

thousand four hundred and ninety-four, or one to four hundred and fortythree.

From 1880 to 1887 the increase of population was twenty-one per cent, while the increase of insane was forty-three per cent.

A noticeable feature is the increase of insane among the agricultural population. Unfortunately, the classification in the reports of the asylums is not sufficient to give an exact statement. The asylum at Mt. Pleasant reports all cases among women under the general term of "domestic duties." So, also, does the asylum at Independence from 1873 to 1881, when a more distinct classification was adopted, and which may be made a fair basis of estimate for the State at large.

During the period of 1884 and 1885 there were admitted to the Independence Asylum one hundred and eighty-three farmers and one hundred and seventeen farmers' wives and daughters. For 1886 and 1887, there were two hundred and nine farmers and one hundred and fifty-three farmers' wives and daughters, an increase of seventeen per cent in four years.

In 1882-3, there were admitted to the Independence Asylum one hundred and eighty farmers; in 1884–5, one hundred and eighty-three; in 1886–7, two hundred and nine farmers' wives and daughters; in 1882-3, eighty; in 1884–5, one hundred and seventeen; in 1886-7, one hundred and fifty-three; others' wives and daughters, in 1882-3, seventy-one; in 1884-5, seventy-seven; in 1886-7, seventy. Domestics in 1882-3, twenty-six; in 1884-5, twenty-eight; in 1886-7, twenty-five. Per cent increase from 1883 to 1887, farmers, thirteen and ninety-three hundredths; farmers' wives and daughters, forty-seven and nine-tenths. All other women, decrease three and twenty-two hundredths per cent.

During the period of 1880 and 1881 there were admitted to the Mt. Pleasant Asylum one hundred and fifty-one farmers and two hundred and eight classed as "domestic." Assuming the same ratio of the latter to farmers as shown at the Independence Asylum, we have a total of two hundred and eighty-one. For the period of 1886 and 1887, there were admitted one hundred and ninety-eight farmers and one hundred and eighty farmers' wives and daughters, a total of three hundred and seventy-eight, making an increase of twenty-four per cent.

In 1880 the total agricultural population was three hundred and three thousand five hundred and sixty-seven. Assuming that the agricultural insane in the asylums is two thirds of the total insane, the insane of the agricultural population is one to four hundred and five. And this is probably below the fact, as the United States census fixes the ratio at thirty-six per cent, or less than one half.

Allowing an increase of agricultural population of three per cent we have, in 1885, an agricultural population of three hundred and forty-nine thousand one hundred and two. There were in the State of this population, one thousand and forty-two insane, or one to three hundred and three.

Deducting the agricultural population in 1880 from the total population and we have one million three hundred and eleven thousand and forty-four.

Our Insane.

Deduct the agricultural insane from the total insane and we have of the insane one to nine hundred and fourteen of non-agricultural population, against one to three hundred and ninety-three of the agricultural population. In 1887 the estimated population, at a three per cent increase, was one million eight hundred and fifty-nine thousand two hundred and eighteen, and the farm population three hundred and sixty-seven thousand three hundred and sixteen. Following the ratio of the census report, the insane of the agricultural population was one thousand three hundred and fifty-six, or one to two hundred and eighty-two, or an increase of forty-seven per cent from 1880.

The cause of this increase of insanity is a pertinent inquiry. Generally, as applied to the total population, it may be ascribed largely to the unwarrantable and outrageous importation of diseased paupers from Europe, who gradually drift into the asylums. The reports of the asylums show the least insanity among the professions, and the least causes among those disorders incident to professional life, as nervous diseases, so that as to farmers there must be some other cause. It is fair presumption that the farmers have not yet learned to live in accordance with hygienic laws. Their dwellings are generally in bad location, poorly drained, improperly ventilated, and badly heated, necessitating alternate freezing and heating. There is undue exposure in inclement weather. There is want of physical comfort, and social enjoyment is neglected. Their diet is restricted and badly prepared, thus burdening the blood and digestive organs with indigestible food, and deranging the whole digestive system. The wives and daughters have fewer comforts, less protection from severe and sudden atmospheric changes, less recreation and social enjoyments than those who live in towns. Theirs is a never-changing daily tread-mill round of toil, broken only by a few short hours of sleep, fewest in the most enervating season of the year. With everything conducive to health at command, and with nothing necessarily prejudicial, except the isolation, the statistics show that the physical and mental force of those who live on farms is below that of those who live in towns. It is probably true that, to isolation and overwork of farm life, is due much of this condition. Solitary confinement-complete isolation-of the criminal is more dreaded, and kills faster than hard work.

The records of our insane asylums will show that the ratio of increase of insane is greater than that of the population; that the ratio of recoveries of the total number admitted is less than twentyfive per cent; so that our asylums are but little less than places where these unfortunate beings may be isolated from society, kindly treated, and guarded against injury to themselves or others.

It must be apparent to every reflective mind that the multiplication of asylums secures no reduction in insanity. The seventy-five

Our Insane.

per cent of incurables increases every year, and it becomes a serious question what to do with them.

With all this lavish expenditure of money for the care and cure of insanity, comparatively nothing has been given to prevent insanity; for it is undoubtedly a preventable disease.

The Commissioners for Lunacy for Scotland say:

It is impossible to come to any other opinion than that insanity is, to a large extent, a preventable malady, and it appears to us that it is in the direction of preventing its occurrence, and not through the creation of institutions for its treatment, that any sensible diminution can be effected in its amount. Lunacy is always attended with some bodily defect or disorder, of which it may be regarded as one of the expressions, or symptoms. We must, therefore, attempt to prevent its occurrence in the same way as we attempt to prevent the occurrence of what are called ordinary bodily diseases: and if it be admitted that to a large extent preventable diseases exist among us in consequence of the ignorance of the people, it is clear that we can convert the preventable into the prevented, by the removal of that ignorance through a sounder education. In short, we can only hope that preventable diseases will be diminished in amount when the education of men is so conducted as to render them both intelligent and dutiful guardians of their own physical, intellectual and moral health. To this, and not to any machinery, however good it may be, for the treatment and care of insanity, can we reasonably look for any diminution in its amount.

Says one who had long experience in one of the Massachusetts hospitals for insane, and who is an expert in mental diseases: "Lunatic hospitals do not prevent insanity, because they do not seek to enlighten the people on its predisposing causes, its hereditary tendencies, its relations to intemperance, poverty and crime, and therefore do not improve the community in this respect.

To what source, then, shall we look for reform in this matter? What presents greater encouragement than the sanitary movement now going on throughout the civilized world? Great advancement has been made during the last decade even, in ascertaining the the causes of diseases having their origin in filth, bad air, impure water, foul gases, poison from decaying vegetable and animal matter. It has been discovered that the spread of infectious and contagious diseases can be completely controlled by isolation and disinfection. To carry into effect these discoveries, it is necessary to