A Detention Hospital

A DETENTION HOSPITAL

Dr. Herdman Very Strongly Urges It Upon.

THE INSANE MANAGERS

His Able Paper Written on the Lines Judge Newkirk Advocated.

Judge Newkirk's recent letter published in the Argus, advocating a county detention hospital for the insane while they are waiting for admission to an asylum in order to keep them from contact with criminals in the jail, has attracted much attention not only throughout Washtenaw but through the state as well. It appears that the same thing has occurred to others also especially with reference to the points in Judge Newkirk's second letter which appeared in the Argus a few days ago. Dr. Herdman is in hearty accordance with what the judge has said as is shown by the following paper which was written last November.

Some suggestions respectfully submitted to the joint board of asylum managers regarding the establishment of a detention ward at the University hospital for cases of mental disorder, Nov. 15, '98.

Gentlemen:--The managers and superintendents of our state hospitals for insane and the members of the faculty of the department of medicine and surgery of the university are in charge of institutions established and sustained by the benevolent spirit of the citizens of the state.

We are all working, to the best of our ability, to discover the causation, prevention, cure and best management of cases of mental diseases.

We have at each of these institutions gathered special knowledge and are prepared to contribute something of value to this end.

We are all disposed to mutual helpfulness in the work and desire to enter into closer and more effective relations in prosecuting it.

We have now at the university very creditable arrangements for dealing with the post mortem facts bearing upon insanity, its causes and consequences, and to this we all freely contribute our knowledge and our aid.

Ought we not, in the interests of those we are attempting to help, to have at the same place an opportunity to unite our experience in dealing with the ante-mortem facts so that, before it is too late, we may give our patients the benefit of all that medical science and art has taught us?

This could be accomplished by establishing on the hospital grounds at the university a detention ward where a limited number of cases of mental diseases could be sent. Provision for not more than thirty (30) at one time would, I think, be ample.

To this detention ward might be sent, from any part of the state where the transfer was practicable, such cases as, one, in the judgment of the judge of probate are doubtful cases of insanity and yet which present such features as render detention in a suitable hospital for a brief period advisable as a precautionary measure; and, two, such other cases as seem to require the services or examination of trained and well recognized specialists in the treatment of disorders outside of the nervous system.

The detention ward should be an additional ward to the present University hospital, under its management and rules, but especially fitted up for the proper care of this class of cases; and the superintendents of the state hospitals for the insane should be members of the clinical staff.

In the ward should be provision for special nurses and attendants and accommodations for the pathologist of the state hospital for the insane and his laboratory.

Briefly stated, the advantages of the establishment of such a detention ward would be:

1. To the patient.

(a). He would have the benefit, if thought necessary or advisable, of an examination by specialists in any branch of medicine or surgery, who are responsible to the state for the performance of these duties, and among these, the experienced superintendents of the various asylums.

(b). He would have the benefit of this examination at that stage in his disorder when it would be most likely to prove helpful.

(c). Every means of investigation as to the nature and cause of this disorder which is afforded by modern laboratory methods could be brought to bear upon his cause.

(d). It would tend to eradicate from the public mind the misconception as to mental disorders and impress the fact that diseases of the mind are to be put in the same category as diseases of the body, and thus relieve the patient of the opprobrium which is now attached to asylum confinement. In other words it would bring forcibly home to the public mind the fact that our asylums for the insane are hospitals and not prisons.

2. To the asylum.

(a). As the primary object of such a ward is to assist in an accurate diagnosis of the case--it would in no respect prove other than helpful to the after treatment of the patient in the asylum to which he may be subsequently sent and thus enable the members of the asylum staff to do their work more effectively.

(b). The pathologist of the asylums would have an opportunity to investigate the abnormalities of the blood, secretions and excretions in their relation to the clinical symptoms.

(c). The addition of several experienced alienists would greatly strengthen the hospital clinical staff and their consultations could not but be broadening and helpful at all.

3. To the medical student.

(a). The advantages that would be given him tor the study of diseases of he mind would excel those anywhere now furnished.

(b). The student would see cases in their beginning stage and have the opportunity to see them examined and the cases discussed by the most experienced alienists.

4. To the science of psychiatry.

It would be the means of focusing at a germinal point all knowledge and experience bearing upon this important subject and of spreading abroad the results of its fruits in the most effectual way.

Many other considerations, pro and con, will no doubt present themselves to your minds, but it has appeared to me that you have already taken an important step forward, both wise and opportune, in dealing with the vital interests with which you are charged and which you have so faithfully and effectually managed, and that what is now proposed is but a further advance along the natural line of progress.

Very truly,
W. J. HERDMAN,
Professor of diseases of the Mind and Nervous System.