| Show TENT TREATMENT FOR INSANE superintendent of large eastern hospital has demonstrated its efficiency macdonald L L medical superintendent 0 the manhat tan state hospital east gives a graphic account of tent life as tried under his direction for a large number of insane the follow ing extracts are from his paper in the directory of institutions and societies dealing with tuberculosis in the united states and canada that consumptive insane patients may be kept and treated to their ad vantage and incidentally to the ad vantage of their fellow inmates in canvas tents and throughout the sev eral seasons of the ear has been demonstrated in the recent history 0 the manhattan state hospital east the experiment upon the success of which this claim Is advanced has cov ered a period of tort months in all hospitals for the insane the in mates are classified according to the form of mental disturbance to take from all these classes any suffering from tuberculosis and put them together in one tent was a serious lem this however has been very successfully done the original plan was to use the camp only about five months during each summer the camp first established consist ed of two large dormitory tents twenty by forty feet each containing twenty beds with smaller tents of different shapes about ten by ten feet for the accommodation of the nurses the care of the hospital stores pantries and a dining tent for such patients as were able to leave their beds and tents and go to the table for their meals running water was secured by means of underground pipes and the safe disposition of waste and sewage was also provided for As has been said it was expected to continue the camp only through the summer and as far into the autumn as favorable weather might render justifiable but when in the late au dumn it was found that the favorable experience continued it was decided to attempt to carry the experiment on a moderate scale into or even through the approaching winter the camp as first established had been placed upon an elevated knoll adjacent to the riverside and purposely exposed to the full force of the summer breezes for the winter experiment its site was removed to the center of the island where trees and buildings interposed to act as a wind break to the severe storms from the east and northeast which are to be expected in that locality the number of patients was reduced to twenty those in whom tha disease was most active being retained and the others being returned for the time being and much against their will to the buildings one large tent suffices for the housing at night of the reduced number of patients and one was set apart as a sitting room for day use with the accessory tents before mentioned and large stoves were placed in them here and there with wire screens surrounding them to protect the patients and a liberal use of asbestos and other fire proof material and arrangements tor the prevention of fire to make a long story short it has remained in continuous use not only throughout the first winter but through the two succeeding winters and intervening seasons up to the date of the present writing the scope of its employment has been gradually enlarged until all patients in whom there are active manifestations of tuberculosis an average of forty three out of a total census of about 2 are isolated therein and there has been parallel enlargement of the elements of the plant the isolation of the tuberculosis pa has reduced to a minimum the danger of infection of other patients and of employed emp loyes the patients them selves have suffered no injury or hard ship but have barthe contrary been unmistakably benefited this Is shown among other ways by a decrease in the death rate from pulmonary tuber both absolute and relative and by a marked general increase in bodily weight amounting in the case of one patient to an actual doubling of the weight from eighty three to one hundred and sixty six pounds in four teen months of camp residence mental improvement has as a gener al rule been the concomitant of phyll cat not only among the patients in tae tuberculosis camp but also in he others and in the former class this has been somewhat of an anomaly my experience and I 1 think that of others has been that when phthisis and insanity coexist co exist they are apt to alternate as to the prominence of their several manifestations the mental symptoms being more pronounced whilst the physical are in abeyance and vice versa under the tent treat ment we have found a general dis position tow ard accord in the manutes tationa improvement in both respect proceeding concurrently and bome ot the discharges from the hospital which gave most satisfaction to us at the time and most assurance for the pa tient s future were of ot the tuberculosis camp it was apprehended that not only might the patients themselves resent their transfer but that similar object alon might come from their relatives and friends since innovations evear progressive ones are apt to be frowned upon by those who the majority in the clientele of a pub he hospital in a cosmopolitan city even at the outset however the pro tests whether from patients or their friends were surprisingly few and latterly Jat terly they have been more apt to arise if at all over the patient s re turn to the buildings when that be came necessary the question of medication may la the present writing be dismissed w th a very brief reference it has been found unnecessary to extend it great ly and it has been limited mainly to the treatment of symptoms alon alcoholic and the like has been found of but little demand or use andi the quantities consumed always der individual medical prescription have been insignificant on the other hand the dietary h as been made as liberal as the imposed restrictions ot the state hospital schedule have permitted both in the way of regular diet and extras and in the leading es milk and eggs private do nations have supplemented the regular supply but dependence after all has been mainly placed upon the rigid isolation and and upon the unlimited supply of fresh air As an interesting incidental fact it may be mentioned that not only the patients but also the nurses living in the camp have enjoyed almost complete immunity from other pulmonary diseases not a single case of pneumonia has developed in the camp in its ex istance of over three years though it causes deaths in the hospital proper in that time the common colds so frequent among their fellows living upon the wards or in the attendants home have been unknown among the tent dwellers the popular idea that the consumptive is a doomed man unless he can at once abandon home and family and business and betake himself to some remote rei ion would seem to be nega elved by our ward s island expert ence th ward s island camp la but a few feet above the tidewater level its site Is swept in winter by winds of high velocity coming over the ice bound waters of the rivers and the sound which surround it and it sut fers a much as or more than any other part of the city of new york from the trying changes of temperature and humidity which are so char of its climate if in spite of all these drawbacks what has been done can be done and that tor insane patients what may not be hoped the extension ot the same methods to the ordinary consumptive of sound mind anxious for recovery and capa ble of giving intelligent assistance la the struggle |
