During nineteen years the number of admission shows that the sexes have been very equally represented, the total for the entire period showing an excess of only sixty-five males.
Concerning the nativity of the patients, the following is true:.
Two thousand seven hundred and fifty-two, or 75 per cent, are native born; while 875, or about 25 per cent., are foreign born. Of the foreign born, Ireland furnished the largest number, viz., 334, being 38 per cent.; Germany coming next with 206, or 23 per cent. of the foreign born.
Thirty different countries have been represented among the patients at Middletown. patients have been received from fifty-four of the sixty counties, comprising the State of New York. The largest number of patients have been residents of Orange, the county in which the hospital is located; while New York, Ulster, Suffolk, Sullivan, KIngs and Queens counties, have contributed in large numbers, and stand numerically in the order named.
The average annual mortality rate during entire period has been 4.99 per cent. upon the whole number treated; while the mortality rate, computed upon the whole number of admissions, has been about 11 per cent. These facts are not particularly valuable as demonstrating the mortality of insanity, per se, because a large number of the deaths arose from causes having little or no connection with insanity.
Of the deaths, it appears that 28 per cent. occurred between the ages of forty and fifty years, 19 per cent, between thirty and forty years, and 18 per cent between fifty and sixty years of age.
If we examine the admission with respect to the ages, we find 946 patients, or above 25 per cent. were between the ages of thirty and forty years when admitted; 819 or 22 per cent. between twenty and thirty years of age; 718 or 21 per cent. were between forty and fifty years old; while 574 to 15 per cent. admitted were between the ages of fifty and sixty years. The years of greatest mental and physical activity are, therefore, as we should expect, the years which contribute the largest quota to the numbers of the insane.
The statistics showing the relation between age and recovery are somewhat imperfect, but so far as kept they tend to show that the greater number of recoveries are form among the young, and that age is an important factor in the prognosis of insanity, for, other things being equal, the younger person has the best chance of recovery.
In the matter of education, about 3.5 per cent. of those admitted have received a collegiate education; 14 per cent. have received academic education; 63 per cent. have been educated in the common schools. Less than 6 per cent. are reported as absolutely illiterate, having no education whatever.
These tables have not been carried further so as to ascertain the relative recovery and death-rates among those possessing different degrees of education, but a report upon that subject from a series of observations by Dr. Hugh G. Stewart, of the Crichton Royal Institutions, Dumfries, gives a smaller recovery-rate and a higher death rate among those patients who have enjoyed the highest degree of mental culture, and the same seems to be true of brain workers generally in comparison with artisans.
Of the patients admitted, it appears that about 75 per cent. were suffering from their first attack of insanity; 12.5 per cent. from their second attack; about 4.5 per cent. from their third attack; while 3 per cent. has four or more attacks of insanity at the time of admission.
For the four years ending September 30, 1892, ninety-nine cases, or about 8.5 per cent. of those admitted, have previously been discharged recovered, from one to four times. These figures show the marked tendency to recurrence of the disorder, as well as the possibility of recovery, even after several attacks.
Concerning 1232 cases admitted since 1888, we find the following facts can be gleaned: 10 1/2 per cent. of the women admitted are said to have inherited insanity from the paternal branch of their ancestry, and 12 1/2 per cent. from the maternal branch. Of the males, 10 per cent. inherited from the father, and 11 per cent. from the mother. Less than 2 per cent. inherited from both ancestors, and 8 per cent. from collateral branches. No hereditary tendencies existed in 57 per cent., and in 10 per cent. of the cases no information could be gained.
In the matter of occupation, it does not appear from the Middletown statistics that any particular occupation predisposes to insanity. To be sure, a large number of the women patients are put down as “housekeepers,” and men as “laborers.” But we know that in every community these occupations make up the majority of the population. We receive a good many farmers and farmer’s wives, but not a number out of proportion to the numbers represented by these callings, and it is probable that overwork and scanty fare, combined with worry, would contribute an equal number of insane people from any other calling that made up so large a part of the population.
The average period of residence for each individual, if the calculations cover the entire period of the hospital’s history, is 1.69 years; while the average period of residence of those remaining in the hospital September 30, 1892, is four years and one month.
The foregoing statistics are not comparative. They show simply the results obtained in certain directions at the Middletown State Homoeopathic Hospital. And while the results obtained are highly satisfactory from a medical standpoint, a glance at the financial management will show a like satisfactory condition of things. Without going into details, it will suffice for any business man to known that the institution has been practically self-supporting.
The managers keep within the income, and do not ask for appropriations for deficiencies an maintenance. This is very gratifying to us as Homoeopathists, for it demonstrates the possibility of conducting great State and municipal hospitals under Homoeopathic management in a manner satisfactory to the patients, their friends, and the public at large.
The charter of the Middletown State Homoeopathic Hospital was granted by the Legislature of the State of New York, because the Homoeopathists of that State wanted such an institution for their own use, and they demonstrated to the Legislature the fact that their numbers, wealth, and influence were such as to entitle them to what they asked. That was true nineteen years ago, and the result has demonstrated the wisdom of the Legislature in acceding to this request of the Homoeopathists, and establishing the institution they desired. Moreover, the example of the State of New York, and the result of the experiment at Middletown, has inspired similar action in other States, and it is to be hoped that still others will soon follow New York, Massachusetts, Minnesota, and California in their demand upon their respective legislatures for State hospitals for the Homoeopathic treatment of the insane of the Homoeopathic faith.
And here let me suggest that the thing to ask for is, not the privilege of having a Homoeopathic physicians or physicians allowed to practice in one of several State hospitals, but rather a hospital set apart and dedicated to the use of that portion of the citizens of the State who are Homoeopathists. An institution for Homoeopathists, in the interests of Homoeopathists, managed and superintended by Homoeopathists. Let the demand be made, and the appeal reiterated in unmistakable terms, backed by the combined Homoeopathic influence of the entire State, brought to bear in the most available way, whether by political, social, or personal agency, and sooner or later the desired result will be attained. It will be better to wait and renew the appeal for exactly what, as Homoeopathists, you want than to accept any compromise which fails in securing medical liberty and full justice to Homoeopathy.
