PRESS OF

GLOBE PRINTING HOUSE,

PHILADELPHIA.

APPENDIX.-Report of the Governor Hoyt Lunacy Commission of Pennsyl-
vania, with proposed Act of Assembly

· 1095

NOTE.-Brackets in the text denote: 1. A conjectural emendation. 2. An
amendment to the original section. Punctuation is in every case that of the work
cited. Spelling and use of capital letters have been made uniform. The tables
of contents have been made without reference to the marginal notes, which are
those of the various statutes. In the tables the words "asylum," "insane" and
"indigent insane" have been uniformly used. The word "ibid" has been omitted
in the citations when the paragraphs have been taken from a revised statute or
code whose sections are numbered consecutively. Where a chapter is cited without
a date it refers to a revised statute or code already cited. When a date appears
it is cited from the pamphlet laws. The laws of England are exceptions to this.

LEGISLATION ON INSANITY.

PREFACE.

INSANITY is the saddest and most terrible of all diseases,the most pitiable and helpless of all the states and forms of human helplessness. And yet it is a condition to which all men are liable, and into which any man may at any time fall with or without premonition. Not only does it provoke the compassion of the philanthropist, but it appeals to and it tasks the highest medical skill; it demands and exhausts all the resources of legislative wisdom. In its relation to crime it presents one of the darkest and most mysterious problems of medical and criminal jurisprudence. In connexion with the poor and friendless, it imperatively calls upon the State for care and protection. But so complex and intricate is the subject in its various relations and aspects, it is no wonder that in regard to it the legislation of many States is very crude and defective, and of all States, as yet, more or less tentative and imperfect.

During my term of service upon the Board of Public Charities of Pennsylvania, mainly as its President, I had ample opportunities of observing the condition of the inmates of Hospitals and Asylums for the Insane, in this and other States, as well as that of all the other defective classes of the commonwealth, in their respective Institutions; and since my withdrawal from that office, I have had favorable opportunities in Great Britain and on the Continent of Europe, to indulge the interest which I felt in the subject, and to study it further by a comparison of the several methods of administering these various charities. Some of these questions were discussed in a volume which I printed (privately) in 1877,

under the title of "Chapters on Social Science in relation to State Charities," and the views which were then set forth are still entertained by me. The intimations which were given of the peculiar and unhappy relation of the Insane to the community, have assumed the character of distinctness and certainty upon further observation and reflection.

This relation is that of a ward, who is a stranger to his guardian, of a guardian who has no acquaintance with his ward. The system of "care and treatment" which rules in all Hospitals for the Insane, places in complete isolation from social intercourse with the sane, at the will of the Hospital officials, all classes of the Insane within their walls. The medical superintendent, under the laws which prevail generally in this country, and which, until recently, have been in force in this State, preserves a despotic power over the liberty, at least, of all who have been "committed" in proper form to his Hospital,-even so far as to justify the detention there, of a sane man throughout all his days, without responsibility for the enormous wrong. I desire simply to state facts. I am not questioning the honor, the integrity, or the humanity of any one. But the public has been sedulously taught that the mentally sick, however slight the malady may be, are subjects solely for the disposal of the members of the medical profession; it matters not how youthful, how inexperienced, or how occupied in their professional work. If the diplomas be but one hour old, if their branch of practice be dentistry or chiropody, two, at most, of such persons, if respectable in the opinion of a Justice of the Peace, have had the power to commit any member of the community to a hospital for the insane, there to be detained indefinitely and with impunity, at the will of the medical superintendent, unless liberated through the intervention of the court. This has been the law in Pennsylvania until recently.

The chief physician of one of the best institutions for the insane in this country says: "I have no knowledge of the wrongful detention of a sane person in this or any other hospital, but I can very well understand that this injustice may occur. Every superintendent of a hospital desires the wards to be full, and where the inmates are 'pay patients', there exists a temptation to detain them." These influences may