Dublin Core
Title
Proceedings of the meeting of the Joint Board of Trustees of the Asylums of Michigan held at Traverse City, July 16, 1908
Subject
Psychiatric hospitals.
Description
Meeting proceedings, mostly discussion amongst trustee members representing various asylums from across the state of Michigan.
Creator
Joint Board of Trustees of the Asylums of Michigan.
Source
Original document held by Traverse Area District Library.
Publisher
Lansing, Mich.: Press of the Industrial School for Boys.
Date
1908
Contributor
State of Michigan.
Rights
This document is in the public domain.
Relation
See other reports from the Board of Trustees at various institutions in the "Traverse City State Hospital" Digital Collection.
Format
PDF.
Language
English.
Type
Document.
Identifier
MSH0006
Coverage
Michigan, United States
PDF Text
Text
PROCEEDINGS
MEETING OF THE
Joint Board of Trustees
ASYLUMS OF MICHIGAN
TRAVERSE CITY,
JULY 16, 1908
LANSING, MICH.
PRESS OF THE INDUSTRIAL SCHOOL FOR BOYS
1908
NORTHERN MICHIGAN ASYLUM.
TRAVERSE CITY, MICH., July 16, 1908.
The regular semi-annual meeting of the Joint Board of Trustees of the
Michigan Asylums was called to order at 10:30 a. m., by Trustee Bates, President
of the Board of Trustees of the Northern Michigan Asylum for the Insane.
The Chairman welcomed the members and other guests with well chosen
remarks.
Invocation by Chaplain Cochlin.
Dr. Munson moved that the Chairman appoint a committee to invite the
ladies and other guests to the meeting. Motion supported and carried.
Chairman Bates appointed Trustees Vinton, Morgan and Edwards to
constitute this committee.
The following members of the Board and Medical Superintendents were
present:
From the Michigan Asylum—Trustees A. J. Mills, C. F. Cook, H. B,
Osborn, M. D., C. S. Palmerton, C. L. Edwards, C. E. Belknap, and Dr. A.
I. Noble, Medical Superintendent.
From the Eastern Michigan Asylum—Trustees G. J. Vinton, Edward M.
Murphy, Peter Voorheis, J. F. Cartwright, W. J. Kay, M. D., and Dr. E.
A. Christian, Medical Superintendent.
From the Upper Peninsula Hospital for the Insane—Trustees E. P. Bohn,
M. D., D. T. Morgan, J. H. Parks, Fred S. Case, Perry Leighton, and Dr.
E. H. Campbell, Medical Superintendent.
From the State Asylum—Trustee Belknap.
From the Northern Michigan Asylum—Trustees T. T. Bates, H. C. Davis,
M. F. Quaintance, William Lloyd, and Dr. James D. Munson, Medical
Superintendent.
There were present as invited guests, the Governor, the Honorable Fred M.
Warner; Dr. H. P. Mowry, wife and son, of the State Board of Corrections
and Charities; J. P. Draper, Superintendent of the University Hospital at Ann
Arbor; Dr. J. J. Marker, Superintendent of the Wayne County Asylum;
Stewards John Hoffman of Kalamazoo, E. C. Smith of Pontiac, R. C. Bradley
of Newberry, C. L. Whitney of Traverse City; Rev. D. Cochlin, Chaplain of
the Northern Michigan Asylum, Mrs. Edward M. Murphy, Mrs. J. F.
Cartwright and daughter Gladys, Miss Mills, Mrs. C. F. Cook, Mrs. F. P.
Bohn, Mrs. J. W. Belknap, Mrs. H. C. Davis and daughter Josephine, Mrs.
and Miss Quaintance, Mrs. William Lloyd, Miss Clara Bates, Mr. and Mrs.
Samuel Garland, Mrs. Elsie Hannah, Mrs. A. S. Rowley; and members of the
medical staff of the Noithern Michigan Asylum.
Chairman: The first order of business is the approval of the minutes of the
last Joint Board Meeting.
Moved and carried that the minutes stand approved.
6
PROCEEDINGS OF TRUSTEES
Chairman: The next order of business is the consideration of unfinished
business. No unfinished business.
The next in order will be the presentation and consideration of communications from Trustees.
THE TRUSTEES.
TRUSTEE A. J. MILLS
In 1848 the Legislature of this stale enacted: "That there shall be estatr
lished in this state, institutions under the title and style of the 'Michigan
Asylum for the Educating of the Deaf and Dumb and Blind,' and 'Michigan
Asylum for the Insane,' and that fifteen sections of the state salt-spring lands
be and are hereby appropriated for the erection of suitable buildings therefor."
"The government of said asylums shall be vested in a Board of Trustees, to
consist of five members, who shall be elected annually by the Legislature of this
State in joint convention: Provided, The Governor shall have the
authority to appoint the first Trustees under this act."
"The Trustees authorized pursuant to the foregoing section, shall constitute
a body corporate with the name and title of the Trustees of the Michigan
Asylum,' with the right as such of suing or being sued, of making and using a
common seal, and altering the same at pleasure."
So the first Board of trustees provided for in the management of the insane
asylums in this state was created a body corporate with a corporate seal.
"The Trustees shall have power, and it shall be their duty, to enact laws
for the government of said asylums, and also to appoint a principal for each
institution, whose respective salaries shall not exceed eight hundred dollars per
annum."
In 1850 the duties of the Boards evidently became quite onerous. We find
that the Legislature enacted: "That the Auditor General be, and he is hereby
authorized and required to audit and allow to the members of the board of
trustees of the Michigan Asylums, and to the members of the board of education,
the expenses necessarily incurred by them in the discharge of their duties; also,
twn dollars per day for their services actually and necessarily performed, upon
their certifying the same to be correct, and draw his warrant upon the treasury
therefor."
In 1855 the first provision for the actual care of the insane of this state was
taken up in a revision of the charter of the city of Detroit. I wish I had time
to call the attention of this Board to all the provisions of that act relating to
the insane and the care of defective people, because it shows that the people of
the city of Detroit as early as 1855 were alive to many of the things which are
now regarded as modern reforms.
"The common council are hereby vested with full power and authority to
provide by ordinance for the organization, regulation, control and support of an
alms house department, including therein an alms house proper, for the relief
and support of the poor ot said city, hospitals for the care of the sick, asylums
for the insane and blind, nurseries for poor and destitute children, houses for
the confinement, correction or punishment of males over sixteen and females
OF ASYLUMS OF MICHIGAN.
7
over fourteen years of age, who shall be convicted before any court of law, of
violating any law of the State of Michigan."
That is a pretty modern conception of things.
"Every person confined, supported, maintained or relieved in said department,
whose age and health will permit, shall be employed in some useful labor, and
the officers in charge thereof shall use their best endeavors to provide for all
persons under their care, such labor as on trial shall be found to suit the
capacity of the individual. It shall be the duty of the officers to keep and
employ separate and apart form each other, the paupers and criminais, and as
far as possible to classify the latter, so that the novice in crime may not be
contaminated by the evil example and converse of the more hardened and confirmed. There shall be an accurate account kept with all paupers, charging
them with the expenses incurred by fhe city for their board and maintenance,
and crediting them with a fair and reasonable compensation for tiie labor performed by them; and when they shall leave the department if any balance shall
be found due them it shall be paid to them in cash at the time of their discharge:
Provided, That the common council may, in their discretion, order said
balance to be paid to some discreet citizen, who shall expend or invest the
same for the benefit of such pauper, and shall fully report his action in the
matter to said council. The officers in charge of said department may receive
and provide for, or confine any insane, or blind or idiotic person, or male under
sixteen or female under fourteen years of age, who shall be brought to them by
the director of the poor, or other proper officer of any township in this state,
or by the parent, guardian, or friend of any such person." So you see the
institution provided for more than the city of Detroit in 1855, and became the
first legal custodian of the insane of the state as well as the city. "Provided,
That such officer, parent, guardian or friend, shall give ample and satisfactory
security for the payment, at least once a month, of all expenses that may be
incurred on account of the person so received; and provided further, that nothing herein contained shall be so construed as to make any person who may be
brought to said department for confinement or maintenance, a citizen of
Detroit." They are willing to receive the insane of the state, but they did
not propose to make them citizens of the city of Detroit.
In 1857 the law of 1848 was amended so, "That the Governor, by and with
the advice and consent of the Senate and House of Representatives, in joint
convention assembled, shall, during the session of the Legislature in the year
eighteen hundred and fifty-seven, appoint three Trustees for the Michigan
Asylum for the Insane, to hold their offices as follows: One shall be elected
for the term of six years, one shall be elected for the term of four years, and
one for the term of three years, whose terms of office shall commence on the
second Tuesday of February, of the year in which they are elected, and shall
continue untill their successors are appointed and qualified, and who shall
constitute the Board of Trustees of the said asylum; and at each succeeding
session of the Legislature there shall be appointed in like manner one Trustee,
who shall hold his office six years and until his successor is appointed and
qualified. The Legislature shall also fill, by election as aforesaid, all vacancies
that may occur in said board."
"The government and sole and exclusive control of the Michigan Asylum
for the Insane shall be vested in said Board of Trustees, and two of them shall
reside within five miles of said asylum." The law of 1859 then provided for an
appointed board.
g
P R O C E E D I N G S OK TRUSTEES
In 1859 or about that time, as I understand it, the Michigan Asylum for the
Insane was opened. Some 'days ago a lady who was one of the very first
patients, who lived in that institution for forty-nine years and one hundred ami
forty-four days, departed this life and was returned to Coldwater for buriai.
This illustrates the length of time that the State may be required to maintain
some patients, and the importance of seeing to it t h a t the rights of the State
in the matter of the support of such patients should be carefully conserved.
The law of 1859 continued without much change until 1877, when the
Eastern Michigan Asylum for the Insane was provided for and the law was
practically revised. That law provided that: "The district of the Eastern
Michigan Asylum shall be composed of all countries lying east of the meridian
line, or traversed by that line, excepting the countries of Jackson, Mackinaw,
and Chippewa. The district of the Michigan Asylun for the Insane shall be
composed of the remaining part of thf State."
,
"The Board of Trustees of the Michigan Asylum for the Insane shall consist of six, and be appointed and hold their offices in accordance with the laws
heretofore enacted organizing and regulating that institution."
"The Governor, on or before the completion of the Eastern Michigan
Asylum, shall appoint six trustees, who shall constitute the board for said
asylum." "The government and sole and exclusive control of the Michigan
asylums for the insane, shall be vested in said board of trustees, and two of
each board shall reside within three miles of their respective asylums."
With the passage of this act came the first law which delegated to the
trustees the right to fix the rate of maintenance. "The rate of charge per
week to be paid for the board and necessary treatment of all patients of the
asylums, who are residents of this State, shall be annually fixed by the trustees
of the asylums, and shall not exceed the actual cost of support and attendance, exclusive of officers' salaries; but this provision shall not be construed so
as to prevent the furnishing of extra care and attendance to patients by special
contracts with parties chargeable therefor." The law of 1877 continued in
force practically without amendment until 1885, when, owing to the establishment of this institution, it became necessary to revise the law, and to provide
an additional board of trustees.
In 1885 the Legislature enacted: "The board of trustees for each asylum
for the insane now or hereafter organized, shall consist of six members to be
appointed and hold office for a term of six years, two to be appointed every
succeeding two years." And then provided for the appointment of a board of
trustees for the Northern Michigan Asylum. "The government and sole and
exclusive control of the several asylums for the insane shall be vested in the said
several boards of trustees, and two of each board shall reside within three miles
of their respective asylums."
'Then came the creation of the Joint Hoard of Trustees in 1885.
"It shall
be the duty of the boards of trustees to meet jointly at least twice each year,
meetings being held at the different asylums, and at such times as may be
prescribed by their joint by-laws to adjust all questions that may arise pertaining
to said institutions; and the said joint board, acting under such rules and by-laws
as they may adopt, may transfer patients from one asylum to another if for any
cause it may become necessary or desirable; the expense of such transfer to be
chargeable to the person, or county, or state responsible for the maintenance of
the patient so transferred."
"The rate of charge per week to be paid for the board and necessary
OF ASYLUMS OF MICHIGAN.
9
treatment of all patients of the asylums, who are residents of this state, shall be
annually fixed by the trustees of the several asylums, in joint session, and shall
not exceed the actual cost of support and attendance, exclusive of officers'
salaries; but this provision shall not be construed so as to prevent the furnishing
extra care and attendance to patients by special contracts with parties chargeable
therefor."
I need not read any of the provisions of the subsequent acts of the Legislature
with reference to the duties of the joint board of trustees because you are all
familiar with them. I thought that I might as a preface to my paper call
attention to these early statutes and refresh the recollection of the members of
the Board of the early legislative history of the asylums and of the board of
trustees.
1 have traced in a general way the history of the governing boards of the
asylums for the care of the insane in this state covering a period of over fifty
years, during which time no public scandal has involved the management.
No dishonesty has been charged and a record has been inade which places them
in the first rank. This enviable standing has been made possible because from
first to last the activities of politics and politicians have not been permitted to
gain a footing in these homes of sorrow. The governors have for the most
part been wise enough to recognize that a place upon these boards, though one
of honor, ought not to be a reward for mere political service and that only
suitable men, willing to serve for the work's sake, are worthy of that opportunity.
A roll call of the men who have labored in this blessed work and laid down the
task would disclose names among the choicest of those who have graced the
roster of Michigan's citizenship.
The medical superintendents have always been men of excellent attainments,
strong executive officials, humane, progressive and distinguished alienists. They
have received the cordial and loyal assistance and encouragement of their
respective boards of trustees and in turn have faithfully carried out the directions
which have from time to time been given them by the boards.
Each hospital has maintained a medical staff composed in the main of gentlemen, who have not only been enthusiastic, well equipped and up to date, but
jealous of the advancement of the noble cause to serve which they educated
themselves and to which many of them have consecrated their lives. Certainly,
it cannot be truthfully said that only routine duty has been done or that there
has been stagnation in their labors along the lines of their specialty.
*(
The industrial departments have been honestly and efficiently officered. The
people of Michigan have never had just cause to accuse the stewards of grafting,
extravagance or of any lack of fidelity in the-discharge of their important and
most responsible duties. .1 must not be misunderstood as claiming that in all
the years gone by there have been no things done which ought not to have
been done, or no things left undone which ought to have been done, but as
insisting that on the whole exceedingly satisfactory results have been obtained.
I am emboldened to make, this assertion because at the gatherings of the
national associations of charities and of those who are informed, this has been
repeatedly conceded. You may perhaps wonder why I take your time to
applaud the accomplishments to which I have referred. I assure you it has not
been done in a spirit of boastfulness, but because as you are, so I am, jealous
«f this good work. It is near to our hearts. It is our great pride, for which
we would willingly make any reasonable sacrifice to insure its continuance and
excel the record. We all know that stagnation means retrogression and our
10
PROCEEDINGS OF TRUSTEES
motto is "Excelsior." We are not so self-satisfied as to proclaim that the best
results have been secured, or that no plan could be adopted which would not
place these hospitals upon a better or more humane and economical footing,
but in the light of what has been accomplished, we have the right to urge that
no mere experiments be tried and that well enough be let alone until the people
are convinced by something more substantial than the insistence of agitators
without experience in the work that the policies which have been so successfully
pursued in the past are wrong as applied to the future.
You all know that criticism has from time to time been made of our work
and that, generally, it has come from the mouths of the uninformed and from
those who have hardly seen the inside of one of the hospitals under our care and
management and have had no experience in the work.
We have been told by well-meaning people and through well-meaning agencies
that our duties have been perfunctorily performed and that the best commercial
methods have not been employed in the expenditure of the taxpayers' money in
the purchase of supplies. For one, I trust the day may never dawn when
Michigan's charitable hospitals and homes shall be cursed with a policy of
commercialism which would surely make of them poorhouses and the abode of
paupers. The mere commercializing and institutionalizing of these charities is a
microbe which has from time to time infected a good many people who are well
intentioned and others who are agitators and self-conceited reformers. The
disease is a contagious one and needs the prompt application of an efficient
anti-toxin if it is not to spread in Michigan to the detriment of the deserving
and afflicted people who must find their only refuge in the homes and hospitals
furnished by the state.
We have been informed that our tendencies have been to make local rather
than state institutions of the hospitals and that we who are striving, not for the
almighty dollar but in sweet charity's cause, have not and are not likely to
attain to the success which might attend the efforts of a highly salaried central
board of control.
It would be distictly un-American to adopt mere commercial and institutional
methods, overlooking as they generally do and most likely would, the permissable
and fitting homelike features and influences which ought to abound even more
than they do in the places which the people sustain as a charity not merely for
the poor but for all needing them within the meaning of the word "charity,"
which denotes "all the good affections men ought to bear to each other."
Our hospitals for the insane are not inhabited and will never be peopled by
mere paupers, but in the large majority by a class of unfortunates, most of
whom deserve well of the state, who have helped to bear its burdens and in
one way or another have contributed to its growth and material prosperity.
The desideratum is not tha minimum of cost, but sane economy within permissible and reasonable bounds. No humane thinking Michigan taxpayer has yet
had any just occasion for complaint as against the administration of Michigan's
charities, nor is any considerable number of the taxpayers finding their contributions toward the maintenance of her hospitals and homes upon present standards
unduly burdensome. On the contrary, they have evidenced their appreciation
and approval of what has been accomplished and are glad to provide means for
the proper and suitable support of them.
Our fellow citizens have, however, been urged in some quarters to dispense
with boards of trustees and to create a paid central board to administer the
public charities. If this cannot be defended, it is a heresy which we owe it to
OF ASYLUMS OF MICHIGAN.
H
ourselves to combat upon the basis not only of practical business, but of
humanity. For myself, I make bold to predict that it will presently be discovered
wherever the plan has been or will be tried, that it will not conserve the hopes
or predictions of its advocates anywhere, because I am convinced that it has
been the experience .wherever such boards have been created that local boards
of trustees cannot be dispensed with and proper standards maintained and that
the saving in the cost of maintenance has been very inconsiderable. This has
notably been the case in the States of New York and Minnesota and will be
so everywhere it is tried except possibly in places where the people are content
to house their afflicted friends or relatives in the sort of institutions which
abound in and disgrace Europe and against which most of our people would
rise in rebellion.
It has been found that each institution has its own peculiar requirements;
that local environments are an important factor; that the red tape methods
which necessarily accompany the work of a central board is often obstructive,
generally tends to friction, delay, unnecessary annoyances and many times to the
positive hardship and detriment of the inmates. Instances of such occurrences
have been given me by superintendents and trustees who have had experience
under such a system. A paid central board might remedy evils in some directions, but on the whole its remedial measures would turn out to be more
undesirable than the troubles intended to be remedied.
The system which has been in vogue in Michigan for so many years has
proven itself so far to be all right and is all right. We Michiganders are not
so wedded, however, to the accomplishments of the past as not to be willing to
consider the virtues of proposed reforms, nor do we shut our eyes as against
improved methods for the future, and I believe it will be the sentiment of the
members of this Board, as one matter of reform, that every state institution in
Michigan ought to be able to purchase as far as may be o.n equal terms and
that there might well be a closer union in the effort to furnish the most
possible to the inmates of all of them at minimum expense. We certainly have
not been dilatory in this regard.
Tnis Board, in requiring the stewards to attend its meetings and in providing
for stated meetings by them for discussion and comparison of purchases and
experiences, took a step in the right direction from which much good has
resulted. The creation of our Finance Committee and the report which our
by-laws provide shall be furnished this Committee in advance of our Julymeeting was another step forward. The Legislature, in requiring the State
Board of Auditors to act with us in fixing the rate of maintenance and inrecognizing that the powers delegated to this Board in that regard being;
legislative in character should be subject to veto by the Executive, conserved
public interests and strengthened our hands.
The Governor took a most helpful and practical step in advance in requiring
stated monthly statements of the purchases made on account of the several public
institutions for the use and comparison of purchasing agents, superintendents
and boards of control. These statements could be much improved upon and
will no doubt in the near future be made more useful than at present. The
Governor lately supplemented these monthly statements by calling together the
superintendents and stewards of all the institutions at Lansing for a conference
and discussion concerning the economic affairs thereof and if such meetings
may become, so far as the stewards are concerned, at least a quarterly feature
of their work, out of them will grow a plan by which all the institutions can
12
PROCEEDINGS OF TRUSTEES
purchase, at least the staples used by them, on even terms, the smaller being
thus aided by the larger. In this manner, a correctly constituted and practical
purchasing board could be provided at little additional expense, which would
answer all legitimate purposes and avoid the objections which have been
experienced in the states that have experimented with a paid three man central
board. Under the plan suggested, a keen rivalry would be stirred up among
the stewards which might result in considerable benefit and saving to the state.
In the near future, is it not possible a way may be found without encroaching upon the rights of labor to provide as much employment as is rensonably
permissible and useful for those of our patients who can and are willing to
work. We do this to some extent, but not as completely I believe as is useful
and possible. I think you will agree that idleness is a feature which, as we pass
about our asylums, appeals to us as something in the conservation of the
contentment and health of the patients to be avoided as much as possible.
The strict and active enforcement and amplification of the laws which require
those who can without hardship to themselves or their families to contribute
to the cost of the support of patients under the visitation of insanity should
receive our constant encouragement as conducive to the best interests of the
patients, as conserving the rights of the tax payers and as being calculated to
place the burden of caring for the insane more nearly where it rightfully
belongs.
This work has been carried forward very successfully by the State of
Massachusetts and only indifferently in Michigan. C o u l d we not take
measures to secure the appointment of some person, or persons, who could give
attention steadily to this important matter. Might we not also, in the interest
of fairness and peace, employ the services of someone, a medical man by
preference, who could be detailed to visit each of the hospitals regularly to
hear, investigate and advise as to such complaints as are made by patients or
their friends; as is done in the State of New York, where the plan has resulted
beneficially, or might not this duty be delegated to the State Board of
Corrections and Charities or to some official directly answerable to it.
Experience has taught that it is most necessary to require the maintenance
'of sound discipline among the nurses and employes and to insist upon uniform
courtesy and kindness toward the patients at all times. This has been accomplished in large measure in the past through faithfulness, intelligence and loyalty
of our employes, but has not been followed up, I am inclined to believe, as
carefully in all respects as is really necessary to our safety. The investigations
which have been carried on in the State of Illinois and the disclosures which
have resulted therefrom surely mark this as a very important matter for our
candid consideration. On the other hand, it is but just to ask, have we done
all we might or could for our employes in requiring of them not only fair hours
of duty, in granting them adeqate compensation for good service and in
providing them with suitable resting places and homes when not on duty. I
believe we might and could do much more in this direction and that the people
of the State would, if made to understand the necessity, support us in any
reasonable recommendations we may make to conserve such ends. I call to
mind a paper, which I think was read at this place some two years ago, covering this topic in part. It was pigeon-holed, as most of the papers are which
we listen to at our meetings and very little, if any, attempt has been made to
carry out its suggestions. I wish the wealthy men of our state, when
bequeathing of their means to charity as so many do, would remember our
OF ASYLUMS OF MICHIGAN,
13
nurses and that a nurses' home might be deemed sometimes a fitting memorial
to the memory of good citizenship.
In conclusion, gentlemen, while the Michigan plan has been a success in the
past, its future record will depend upon the appointments which are made
upon the boards by future governors and the unselfiish zeal of their membership. If non-partisan gentlemen, who are really interested in the cause and are
ever ready at much sacriince to assist in an active, but non-officious manner, in
the work for the work's sake and for the chance it affords of being helpful to
their unfortunate fellowmen and women are appointed and serve, all will be
•well and continued success assured, while the reverse may be expected to follow
the appointment and service of a different class of men.
In the past, we have worked harmoniously for the common good of all our
institutions and this must be our watchword for the future. I am sure I am as
proud of the successes and the good things accomplished at any of the hospitals
as I am of what is done at the Michigan Asylum. Our rivalry is honorable,
well intentioned and good natured. We all strive for the best and we can afford
to be generous toward each other in our efforts as well as in our criticisms. As
we have pressed forward in the past with honor and success, so may we proceed
in the future and may the people of our state never have just cause to feel
anything less than pride in the manner of the performance of our duties and
may the generous and enlightened policies which have been pursued continue
for the future only with more zeal and intelligent persistence, and entitle
Michigan to retain the place she has maintained so long in the very front rank
among her sister states and the nations of the world in caring for the mentally
distressed and in advancing the cause of psychiatry.
Chairman: I am sure we have all listened with great interest to the historical and suggestive paper of Trustee Mills. The paper, if there are no
objections, will be accepted and placed on record. Discussion of the paper is
now in order.
Trustee Davis: There is one feature of that paper I want to speak about
that is very valuable, and that is the work that Judge Mills has put upon it in
bringing out the early legislation. This information cannot be obtained except
by a lot of investigation, and I think it is very valuable for future reference.
It gives the history of the asylums up to the present time, except the present
laws, and it is too valuable to be lost sight of.
Dr. Christian: The contents of that paper are likely to come in as very
valuable material in some future years. We do not know how soon we may
move for radical change in our methods. I think we should have of that paper
a sufficient number in print to make use of at any time, more than we would
care to have printed perhaps of the full proceedings of the Board, and I offer
this suggestion that if the full proceedings of the Joint Board are printed, that
an extra number of this paper be made.
Considerable discussion was elicited with reference to the printing of Joint
Board proceedings, and it developed that there was no provision of law whereby
proceedings of any Joint Board could be printed at state expense. Dr. Mowry,
of the State Board of Corrections and Charities, spoke as follows: "I think
the proceedings of the Joint Board can be printed at the Industrial School at
Lansing. From Mr. Lawson I learned that he is very glad to secure printing
for his boys simply for experience, and I believe he would be glad to do the
work. All the expenses necessary would be for the material used." After
14
PROCEEDINGS OF TRUSTEES
some discussion on these remarks if was decided to refer the question to Dr.
H. P. Mowry before any further action should be taken.
Chairman: The next matter for consideration will be the presentation and
consideration of communications from Medical Superintendents.
REPORTS OF SUPERINTENDENTS.
MICHIGAN ASYLUM FOR THE INSANE,
Kalamazoo, Mich., July 16, 1908.
To the Joint Board of Trustees:
Gentlemen—I present here with a brief report concerning themovement of
population and other conditions existing at the Michigan Asylum for the Insane
during the year ending June 30, 1908.
Men.
Women.
Total.
Patients remaining July 1, 1907
896
882
1778
Admitted during the year.
259
' 175
434
Discharged
Recovered
. Improved .,
Unimproved
Died
Transferred
Not Insane (Voluntary)
Escaped
Patients remaining June 30, 1908
1155
1057
2212
30
35
13
99
4
3
2
56
29
20
67
3
I
2
86
64
33
166
7
4
4
186
969
178
879
364
1848
The admissions this year were 434 as compared with 425 last year, while the
discharges this year were 364 and last year 404. We have, therefore, made a
net gain of seventy patients. This gain is confined wholly to the department
for men, since the discharges in the department for women exceeded the
admissions by three. The reverse of this was true last year, when there was a
loss of seven men and a gain of twenty-eight women.
This gain of ninety-one patients in the biennial period was anticipated in the
provisions of the last legislature, and the ordinary gain of the next two years
can be taken care of without asking for further special appropriations.
OF ASYLUMS OF MICHIGAN.
15
The recoveries exceed by seven those of last year, and represent a recovery
rate based upon the admissions, of twenty per cent. The deaths are less by
twenty-seven than they were the previous year and represent a mortality rate
based on the daily average census, af about nine per cent.
The general health of the household has been good, and we have suffered
from no serious epidemic, although nearly all the more common acute
infectious diseases including small pox, have been represented in the Asylum
by One or more cases during the year.
Tuberculosis was reported to the Board of Health in twenty-nine patients
and one male nurse, who contracted the disease elsewhere. Twelve patients
died of this disease, and we have thirty-four tuberculosis cases in the institution
at present.
Van Deusen Hospital has been finished and is now occupied. This building
will easily accommodate the one hundred and four patients specified in the
legislative enactment. In design and equipment it is well adapted to its
purpose, that of a receiving ward for women.
Hall L, one of the two new wards at the male department, gained by raising
the roofs over the extremities of the wings, 'was opened for patients in April.
The corresponding hall, M, can be finished at short notice whenever additional
room is required. Each of these wards is made up largely of a sitting room
and a dormitory. They prove to be very convenient and pleasant additions to
the department and afford comfortable quarters for forty patients each. This
in a measure, remedies the original defect the building of in lacking dormitory
space, and enables us to assemble certain of our epileptics and general paralytics
who need to be under constant observation night and day, one step in the
segregation of epileptics which we have lately undertaken.
A new continuous bath room was opened in the basement of Edwards
Hospital during the year. It practically constitutes an additional ward for
disturbed patients, and has a capacity of four tubs and ten beds. It has been
in constant use now six months and has fully met our expectations in affording
the most approved means for treating successfully some of our most trying
cases, not only recent admission, but chronic patients, subject to periodical
attacks of agitation and excitement, who may be thus rendered much more
comfortable during their disturbed episodes, while the outbreaks possibly may
be modified in duration and intensity.
Seven new porches contribute greatly to the comfort of the patients, while
other important improvements are well under way and when completed, will
give the Asylum a capacity.of twenty-one hundred patients.
The plan of caring for restless, destructive and otherwise vicious patients in
bed under observation has been extended. It is vastly superior to the common
recourse of single room seclusion, a form of solitary confinement, no more
conducive to the well being of an insane man than to that of a sane one. For
similar reasons we have extended the night service, locking in their rooms and
leaving to their fears and devices fewer patients at night.
While we are, and shall continue to be, largely engaged in the fundamental
work of the institution, yet it is a constant regret of the medical staff that we
have no suitable laboratory, autopsy room and morgue. This is an important
demand of continued scientific advancement, and it is our earnest hope that the
next legislature will take the same view of the situation.
Considering our facilities, however, the amount of laboratory work accomplished has been creditable. In a general way, this included the examination of
l-Q
PROCEEDINGS OF TRUSTEES
urine., blood, sputum, spinal fluid, stomach contents, stools, various inflammatory
ex.udates and the gross microscopical specimens obtained from autopsis,. of
which there were twenty-eight.
The therapeutic value of healthy occupation for a very large per cent of the
insane has not been lost sight of, and at the present time we have thus employed,
exclusive of bed patients, fifty three per cent of our inmates.
Most of the work done is that ordinarily preformed about an institution of
this sort, although we have successfully established basket making by the patients,
and it is our purpose to take up something further during the coming year
along the line of manual training and possibly during the winter, graded
calisthenics.
I am very glad to acknowledge continued cordial relations with the Psychopathic Hospital and valuable help from Dr. Albert M. Barrett, the Director, whose
efiorts to stimulate the institutions to work harmoniously along the scientific
lines are thoroughly appreciated.
Respectfully submitted,
A. I. NOBLE,
Medical Superintendent.
EASTERN MICHIGAN ASYLUM, Pontiac, Mich.
To the Joint Board of Trustees:
Gentlemen—The following table shows the movement of population for the
fiscal year, 1907-08.
Men. Women. Total.
Under treatment June 30, 1907
607
602
1209
Admitted from July 1, 1907 to June 30, 1908
155
133
288
Total number under treatment during 1908
Discharged:
Recovered
Improved
'Unimproved
Died-N o t insane--
Remaining under treatment June 30, 1908
762
22
30
17
49
.
735
1497
21
26
10
49
43
56
27
98
5
2
123
108
231
639
627
1266
The number of admissions, 288 in all represent 228 individuals who have
never before been received into the asylum, and is a larger admission rate than
the asylum has ever before been called upon to care for under normal conditions.
It cannot be accounted for by any considerable number awaiting the creation of
room for them, because at the close of the last fiscal period there was no
waiting list. A new building for women .had only-recently been opened for
occupancy, and for several years the demand for room for men had not outrun
our capacity. I am inclined to regard it as merely an instance of one of those
fluctuations, which, without apparent cause, now and then show themselves
independent of prevailing conditions. It will be noted by the above that the
net increase for the year has been fifty-seven.
OF ASYLUMS OF MICHIGAN.
17
The past year has been crowded with activity in lines of new construction
and in alterations in the existing plant. All this has not included new
buildings for patients. Only indirectly and incidentally to the carrying out of
other plans, will the institution secure an increase in its capacity for caring for
a larger number of the insane. Most of the work carried on has had for its chief
aims, increased efficiency and greater economy in the operating expenses of a
plant now a generation old. With the advent of winter we shall be in possession, for the first time, of a central heating plant for most of the detached
buildings and for the central block. This has involved the construction of
nearly half-a-mile of underground tunnels, together with the piping necessary
for-steam heat and for hot water consumption.
A steel water tower, destined for years to corne to be the most conspicuous
feature in the landscape for miles around, completed but not yet in commission,
will soon replace the old system of attic storage tanks. This only awaits the
near completion of the house piping to relieve us once and for all of the
constant vexations and expenses of the former system. The ever present fear
of fire, to be fought with a possibly insufficient water supply,—a fear amounting
to an obsession in the superintendent and imparted to his board of trustees, is
likely to receive its-quietus with the completion of work on two new ten inch
walls to be actuated by an air-lift apparatus already installed and ready for work.
With these in operation, it is expected that any default in the city water supply
will be compensated for by the delivery to our own fire pump of a thousand
gallons of water a minute. This work is still uncompleted. To the above
additions to the mechanical equipment must be added also in this relation, a
new power boiler and a small electrical unit for the night load.
A decidedly new departure for the institution,—one involving much in its
possibilities for good, we believe, is the construction out of our old chapel room,
(situated with respect to the wards somewhat like this assembly room,)of a
large central dining hall, where we expect to gather at meal hours, from six to
seven hundred patients. Room for this number has been secured by the building of wings on either side, affording, altogether, nearly 8,000 square feet of
floor surface. These wings are at this writing under roof.
To complete the scheme, a new building with an assembly room in a lower
story somewhat below grade, and a chapel on the second floor a trifle above
grade, is already erecting its front.
It is hoped that the discarding of most of the ward dining rooms for this
central gathering place, will effect a noticeable saving in food and in dishes,
a better'service of viands, and on the whole, a more wholesome atmosphere at
meal time. Incidentally, the institution gains considerable dormitory space.
In this connection may be mentioned an innovation which is perhaps not
yet beyond the experimental stage with us, but which we are planning to
extend to the new dining hall. Small square tables with polished tops and
without cloths, we are inclined to look upon as more attractive than the long
table with a cloth that is always objectionable unless immaculately white, and
much more apt to be "holey" than wholesome. Besides there is the saving
in the laundry account. Next to the abolition of the old dust shafts, which
unsanitary device we are no longer possessed of, I look to this move as most
promising of satisfactory results in the search for cleanliness, at not too great
a sacrifice of the esthetic.
A year ago we had just inaugurated, what was for us, a new system of caring
for our feeble and infirm women. No move for the better nursing and for
18
PROCEEDINGS OF TRUSTEES
greater comfort and convenience in the management of the bed-ridden and semibedridden body of patients (I do not speak of the acutely sick or hospital cases),
for the confused, restless and untidy ones has met with such signal success as
the creation of these two wards in an infirmary building, devoted exclusively to
these uses. It has been welcomed with such warmth of appreciation by nurses
and physicians, and has been commented on so pleasantly by visitors, and
especially by former nurses visiting the institution, as an addition to the nursing
equipment, notable for its convenience, its cheerfulness and general hospital
air, that I feel justified in referring to it in this report. There are no separate
rooms. Each floor is practically an open ward, with only such walls as are
necessary for supporting the floors above and for carrying the fire walls that
extend to the roof. Here, all the infirm and helpless are gathered, as many as are
necessary in beds, arranged along the walls. Former occupants of disturbed
wards are here. Many who were troublesome in smaller rooms here find that
comfort'in numbers that leads to quiet. Although not included in the original
plan, it has been found the ideal method of caring for cases of acute depression,
with anxiety, fear and suicidal tendencies; and at a minimum cost of attention
consistent with their needs. There is a noticable absence of odors. The
fewer corners, the lessened wall space and base, and the general openness all of
course lend themselves to this. Such privacy as is occasionally necessary, is
easily secured by light hospital bed screens. For those who are not bed-ridden,
spacious verandas are accessible, and on the coldest days of last winter, formerly
restless patients could be found seated there, bundled in blankets and shod with
felt boots. I feel that here we have found for 100 patients of a certain class,
the secret of combining the maximum of comfort with a minimum of cost of
construction.
Our experience with this open ward method of caring for a large group,
leads me to advocate its extension to other classes of patients. I recognize the
necessity for single rooms in certain cases, because of tumultuous behavior, or
for reasons of privacy in the convalescent or semi-convalescent patient, but I
look upon the small dormitory with its enclosed space, shut off from the main
ward, as an abomination and a relic of former days, when hospital ideas in the
care of the insane had not yet crystalized. There is among the insane, a
contagion of example, which often makes for peace in numbers when molded
by watchful and intelligent attendance. There is, too, for many, an assurance,
gained from large associations, that supports while it banishes mystery, secrecy
.and doubts. It is the night more than the day that loads with its sense of
responsibility, those who care for the insane. Open space and numbers bring
relief as witness the crowded day corridors, the large walking parties, the
gatherings at chapel and entertainments, and the associate dining halls.
Regular staff meetings have been the order through the year as they have
been for a number of years past with particular attention given to the study
and critical analysis of cases presented. The spirit of study and work in the
medical staff, with a desire to impart the same to the members of the training
school for attendants have been conspicuous. A close affiliation with the
pathological laboratory at the psychopathic ward has been striven for, and I
believe, with good results. Nearly forty per cent of the deaths have come to
autopsy. This is a decided increase over past years, and is itself evidence of
good faith. This coming year we expect to do even better.
In the basement of one wing of the dining room structure referred to above,
a set of rooms has been set apart for laboratory purposes. This will supply a
OF ASYLUMS OF MICHIGAN.
19
long felt want, and enable us to follow more closely the aims of the director of
the pathological laboratory.
No serious epidemics have visited the institution during the past year, and
but one incident has marred the uniform smoothness of operations in the
administration department. In June, the laundry was visited by fire. This
had its origin in the most vulnerable spot in all institutions of this character,
namely, the dry room. Before the flames were extinguished, the damage
wrought was sufficient to place the laundry almost completely out of commission, from which disastrous consequences we are but just now emerging.
Respectfully submitted,
E. A. CHRISTIAN,
Medical Superintendent.
UPPER PENINSULA HOSPITAL FOR THE INSANE,
Newberry, Michigan, July 16, 1908.
To the Joint Board of Trustees:
Gentlemen— I present you herewith a brief report concerning the movement
of population and other conditions existing at the Upper Peninsula Hospital
for the Insane, during the year ending June 30, 1908.
Men.
Women.
Total.
There were under treatment June 30, 1907
390
285
675
Admitted from July 1, 1907 to June 30, 1908-- - 109
65
174
Total number under treatment during the year
Discharged:
Recovered
Improved
Unimproved
Died
Total number under treatment June 30, 1908-
499
350
849
32
32
4
18
20
5
50
52
9
23
13
36
91
408
56
294
147
702
-
The above table shows a net increase in our population of twenty-seven
during the year. The total number of admissions is four less than during the
former year, while the discharges are twenty-three less. The deaths, thirty-six
in all, is a little more than four per cent of the whole number under treatment.
The majority of deaths were due to chronic diseases. Ten were due to
paresis. Five to general pulmonary tuberculosis. Seven to exhaustion
incident to their mental disease, and six to organic brain disease other than
paresis. Twelve patients have been deported during the year. Figuring the
number of recoveries on the number of first admissions, during the year, the
percentage is thirty-six and two-tenths per cent. I regret to report one death
from suicide. The cases of tuberculosis seem to have increased with us
during the past two years, and we are, at present, building a small tubercular
pavillion with canvas drop curtains for side walls. The buildings is connected
with our infirmary in such a way that, should the weather become too severe,
fhe beds may be run into the cottage. We have had a few cases of typhoid
tever, but, aside from this, we have been free from acute infectious diseases.
The medical work has been conducted along the same lines as last year.
20
PROCEEDINGS OF TRUSTEES
Regular meetings of the medical staff have been held, and I believe the
insane are receiving much more individual attention than ever before. Quite a
number of improvements have been made; such as an extension to the green
house, also the erection of a milk house, and a hennery, placing burlap on the
walls of the cottages, and steel ceilings have been put up in various places.
Our per capita cost has exceeded our per capita income considerably, but
this is largely due to the almost total failure of our farm crops last year. From
the legislative appropriations of last year, we are erecting an administration
building, and a cottage. When these buildings are completed our capacity
will be increased by one hundred. We have at the present time thirty eight
patients over our normal capacity.
Respectfully submitted.
E. H. CAMPBELL,
Medical Superintendent.
NORTHERN MICHIGAN ASYLUM,
Traverse City, Mich., July 16, 1908.
To the Joint Board of Trustees.
Gentlemen:—The movement of population at the Northern Michigan Asylum
for the fiscal year just passed was as follows:
Men.
Women. Total.
Census June 30, 1907
Admitted during the year
Discharged:
Recovered-Improved
Unimproved-
Died
Census June 30, 1908
-- 709
597
1306
148
105
253
857
702
1559
21
21
14
26
28
8
47
49
22
62
42
104
118
739
104
598
222
1337
From this table it may be shown that three and a half per cent of the whole
number under treatment were discharged recovered, three per cent improved,
one and a half per cent unimproved, and six and six-tenths per cent died.
The death rate while large, was not so great as that of the previous year,
notwithstanding a goodly number of aged people and patients suffering from
organic diseases were received. The deaths from tuberculosis were seventeen
and three-tenths per cent of the deaths from all causes;—a decrease of three
and a half per cent over last year. On the male side, where isolation was
imperfect, there was an increase in tuberculosis cases;—on the women's side,
where provisions for isolation were more perfect, the number of deaths from
tuberculosis was only half as many as last year. It would not be fair to assume
that this lessened death rate was due solely to better isolation, but it may be
assumed that it was princpally due to this cause. In this connection I may say
that during the last two or three years the amount of draperies, carpets, etc., on
the wards has been lessened, believing that they harbored germs and that the
OF ASYLUMS OF MICHIGAN
21
hospital would be more sanitary without them. It is possible that the absence
of these furnishings lessens, to a certain extent, the comfort of the patients,
but it certainly lessens the danger from infection from tuberculosis and other
germ diseases. On the men's side, during the last year, greater efforts than
ever have been made to isolate tuberculous cases. A part of Hall Six was set
apart for this purpose, and dishes of special coloring, and special bedding have
been furnished for the tuberculosis cases, that others could not be endangered
from the use of dishes or bedding used in the care of these patients. With the
instruction to the nurses, in the training school, relative to the care of tuberculous cases, a much better comprehension of the hygiene in the care of this
class of patients has been developed.
The financial statement of the receipts and disbursements of the institution
for the fiscal year has been placed in the hands of the Finance Committee.
The year just passed was a difficult one from a financial standpoint in some
ways. The cost of the up keep of the institution has been great, owing to the
fact that much of the heating plant had to be rebuilt, and the general repairs
were more than usual. The price of food supplies was higher than for years; but
if the cost of preparation of food is deducted, the cost per patient per day does
not much exceed the average of the last ten years. The change in the manner
of classifying accounts, which came into effect this year, makes exact comparison
of cost under separate ledger headings impossible; and it cannot be determined
exactly what the food stuffs cost per day in comparison with last year, since the
preparation and cost of foods are included in the same heading. I believe,
however, we may deduct three cents a day for preparation, which brings the
cost of food to about twelve and a half cents or thirteen cents per patient per
day. Greater stndy has been given to foods and their economic value than
ever before, and notwithstanding the high prices that have prevailed, neither
the quality nor the variety of food furnished to patients has been lessened, and
if anything the cooking has been better than in years gone by.
The general improvements have been great. At the greenhouse a new boiler
was installed. A portion of the greenhouse was destroyed by the falling of the
chimney during a tornado. This necessitated quite a large outlay. A large
percentage, however, of the cost of repairs has been' in connection with the
heating plant. The fact is, the entire heating system will have to be replaced
in the very near future.
During the year, a Stirling boiler, with automatic stoker, was installed, and
many changes effected in the boiler room. After the new boiler was installed
it was found that the hot-water pumps were too small, and consequently a new
pump had to be installed.
The extensions to the asylum are in process of construction. These
extensions have been designed with special reference to hospital purposes.
They will be provided with electric elevators,—with hydrotherapeutic rooms
and appliances,—with offices for stenographers and doctors, and with mortuary
rooms; in fact with every convenience of the up-to-date hospital. Separate
dining rooms are being constructed for each flat, on both the north and south
wings. By this means twelve dining rooms will be abandoned and converted
into dormitories. By these means the tranportation of food from the central
kitchen to the wards through cold corridors and elevators will be obviated. It
should be added that in these new buildings, diet kitchens will be Constructed,
so that special cooking may at all times be provided for the sick.
22
PROCEEDINGS OF TRUSTEES
An additional section has been built to the greenhouse, and you are cordially
invited to inspect it as well as all other parts of the institution.
I would respectfully report that a training school for nurses has been carried
on successfully, and marks a step forward in the care of the insane at this
hospital. I may add that the medical work has improved in quality, and much
of the obscurity of mental diseases has been cleared away, thanks to better
clinical methods and researches of psychiatric clinics and laboratories throughout
the world.
In this connection I would like to present a few words concerning "The
New Asylum." It seems to me that the last year has been the turning point
in asylum methods, and marks the advent of the hospital for the insane, in the
broadest sense of the word, in contradistinction to the asylum for the insane as
it has existed for so many years. The day has passed when a nervous or mentally sick person can be placed in an asylum, and his feeding, nursing and medical
treatment carried out in a perfunctory routine manner. Everything that
pertains to the patients' welfare must receive constant supervision from trained
men and women, which adds comforts immensely to the patient, at less cost to
the public and with immensely increased prospects of recovery. To accomplish
this requires trained physicians, skilled nurses, pleasing environment, hygienic
surroundings and the best of foods scientifically prepared; and all these things
with reference to the highest good of the individual. If the individual patient
receives such care, then the mass of patients will receive such care.
I would speak a moment of the medical work. Here, as in all other lines of
human effort, progress has been slow, but to demonstrate that progress, and
progress of very great value, has been made in the knowledge of mental diseases,
one need only to compare the written records of patients of ten years ago with
those of today. With the advent of the laboratory, a new era commenced in
psychiatry, and a great stride forward was taken for the relief and cure of
mental and nervous conditions. Many of you can bear witness to the fact that
it was hard to break away from the traditions of years; from the routine path
that had been followed so long, and take the new road science was carving out.
I remember when striving for the establishment of a laboratory at this institution that the question was immediately propounded, and with much force,
whether laboratory methods and other research work would enable the hospital
to cure more patients. An affirmative answer could not be positively given; it
could only be stated more recoveries should result. It can now be positively
asserted that more patients are restored to a comfortable degree of health than
ever before. Our records show that the net gain in patients for the last two
years has been fourteen and a half patients per year,—for the previous twenty
years and a half the average yearly net gain was forty-six and a half, and for the
last preceding biennial period there was a net gain of seventy-five and a half
patients per year. The saving to the state on the basis of the difference in the
averages given for twenty years and a half and the last two years, at $180 per
patient, was $5,760 per year, and over the last preceding biennial period it was
$10,980 per year, or almost enough to pay the salaries of the medical staff. I
am pleased to state that the number of insane women has decreased in the
district during the last two years, and so far as I know there is no insane person
awaiting admission to the institution. It may be said that these results are
accidental, but if we take into consideration the fact that the admissions to the
institution have increased, it is only fair to assume that such results are due to
better work on the part of the hospital. These results are extremely stimulat-
OF ASYLUMS OF MICHIGAN.
23
ing; and it is not believable that any one would seriously wish to hamper, or
abandon the work. I believe the value of the work will be still greatly enhanced
as time goes on. In addition to the methods in use, chemical pathology and
chemical research are beginning to take an important part in the diagnosis,
prognosis and treatment of many diseases, and they cannot be left out of
consideration in the work of the new asylum.
This new science promises brilliant results to the mentally afflicted. The
modern methods of the examination and treatment of patients, require much
more knowledge on the part of the physicians than formerly, and have led to
some changes in the mode of conducting the medical work. No attempt is
made to take the mental status of a case in longhand. The mental examination requires a stenographer, so that questions and answers may be recorded
verbatim. Anything less than verbatim reports of these examinations render
the work worthless from a scientific standpoint. Every physician on the staff
if not a shorthand writer himself, should be furnished a stenographer to assist
in his work and to write out the examinations. This has been done during
the last two years at this institution, with great advantage to the patients. It
has been stimulating to all of us to further and better efforts, and certainly
tends to increase our insight into the activities of the mind whether normal or
abnormal. This departure from the old way has been quite revolutionary. It
has led to the establishment on the hospital wards of an office for the examination of patients, and insures to every patient. not only a thorough examination immediately after admission, but it assures him of the friendship and
interest of the physicians in his recovery. These methods bring the staff in
very close relationship with the patients, brings out all that is best in them,
often enables the physician to give special direction to nurses, and often excites
a deep interest, in the patient himself, in the welfare of fellow-patients. The
trend at this hospital is to the establishment of regular hours of service for the
staff and for each physician to spend the time on the ward, or in the laboratory, as his work may necessitate. It is believed that in this way still better
results will be attained, and that our asylums will become hospitals: in fact
great centers for investigation and research work in psychiatry, and also centers
for instruction in mental and nervous diseases, that shall be open to physicians
and to all directly interested in the work.
The introduction of better clinical methods, and of the training school, has
brought about another important improvement in the institution, i.e., the
establishment of a domestic science department. The object of this department is not only to instruct nurses and others in the science of dietetics, but to
teach that intelligent, systematic supervision of the domestic duties in public
institutions means economy in the running expenses, and greater proficiency
in the performance of duty. It has already been found that this department
renders it possible to train workers to realize food values, to prepare wholesale
diet and serve it acceptably, and it has also taught that there are personaidiosyncrasies among the insane that must not be despised under any
circumstances. It has been found that the work already done has brought an
atmosphere of contentment among patients, and enthusiasm on the part of
employes; which is but the natural consequence of bringing these people into
touch with the achievements of scientific men and women by means of lectures,
bulletins, text books and other literature bearing on the science of not simply
nutrition, but hygienic living. We are quite sure that in this department
progress will be slow but certain, just as experience has taught that progress
24
PROCEEDINGS OF TRUSTEES
has been slow in all lines of asylum improvement. Young men and women
are glad to learn the best there is to be taught. Such knowledge lessens the
drudgery in household duties, it will produce more faithful service in the institution, and it will tell in the sick-room; and further it will educate home makerst
which is another item of value to the state, for whatever elevates the home raise,
the standard of good citizenship. Every person, whether patient or attendans
or worker in any department of the institution, when he leaves it, carries with
him a better, a higher standard of good living as a result of his training in the
hospital. I believe the day has forever gone when coarse foods, unskilfully
prepared, will be furnished, or that men and women who are uneducated and
untrained, will be allowed to care for people who are bereft of any part of their
senses.
I believe from these few remarks that you will gain some idea at least of
what I mean by "The New Asylum."
All of which is respectfully submitted.
JAMES D. MUNSON.
Medical
Superintendent.
STATE ASYLUM, Ionia, Mich.
Hon. Joint Board in session,
Gentlemen: In addition to the report to the Finance Committee, I herewith
briefly summarize some items pertaining to the Institution for the fiscal year
ended June 30, 1908:
Number of patients in the Institution at close June 30, 1907: males, 298;
females, 49; total, 347. Number of patients in the institution at close of June
30, 1908: males 320; females, 54; total, 374. Number admitted during the
year, 46. Discharged during the year, as follows: by death, 7; not insane, 1;
recovered, 8; improved, 2; eloped, 1; total, 19.
T^egular Employes and Salaries Paid.
HOW EMPLOYED
NO. OF
Clerk and Bookkeeper
Assistant Clerk
Stenographer
Interne
Atts., Male (Total, 19)
Supervisor
Ward Attendant
Ward Attendant
Ward Attendants
Ward Attendant
Ward Attendants
Atts.,'Female (Total, 7)
Supervisoress
Ward Attendant
Ward Attendants
Ward Attendants
Seamstress
1
1
1
1
PER YEAR
RATE
PER MONTH
$1200 00
$35 00,
30 00'
60 00
1
1
1
5
1
9
60 00
35 00
32 00
30 00
28 00
26 00
1
1
2
2
1
35 00
30 00
20 00
18 00
16 00
PER DAY
OF ASYLUMS OF MICHIGAN.
HOW EMPLOYED
NO. OF
PER YEAR
25
, RATE
PER MONTH.
Engineer
Fireman
Fireman
Carpenter
Painter
Launderer
Laundress
Laundress
Cook
Cook
Cook (Supt. Res.)
Housemaid (Supt. Res.)
Baker
Farmer
Assistant Farmer
Dairyman
Teamster
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Gardner
Nightwatchman
Nightwatchman
1
1
1
30 00
50 00
45 00
Nightwatchman
1
40 00
p£R DAy
$1000 00
40 00
35 00
$2 50
50 00
40 00
20 00
14 00
800 00
50 00
16 00
16 00
40 00
45 00
30 00
32 00
34 00
(Above taken from pay roll June 30, 1908, and shows less number attendants than average niontly pay roll.)
Total value of farm products for the fiscal year ending June 30, 1908, was
$6,641.33
O. R. LONG,
Medical Superintendent,
The report of Dr. C. R. Long was read by Trustee J. W. Belknap, who
added the following:
"During the past year we have made some improvements in our institution.
First, to our water system. Today we have wells with a flowage of thirty-three
gallons per minute. We have constructed a tank on the lower lands and we
force this water three thousand feet to a tank on the upland, and by gravity
we supply Our institution with water. We have put in during the past year a
refrigerating and ice plant, which I believe to be one of the most economical,
and best equipped of any institution in the country. It is capable of holding
all our meat, butter, eggs and all things necessary, at the proper temperature,
and is running smoothly without any expense except the electricity. Ten hours'
run of dynamo produces twenty-four hours of refrigeration. I invite an
inspection of the plant, and eventually I believe that all of our institutions will
be equipped in this manner. We are building this year a womans' building
from an appropriation of $40,000, and we are endeavoring to make it as near
fire proof as possible with wood floors. I believe our buildings of the future
should be fire proof and built for the future, not today. It is not economy to
build shabby buildings. I hope the buildings in the future will be built with a
view to permanency, and it will likewise be economy."
26
PROCEEDINGS OF TRUSTEES
Chairman: Comments on the preceding papers are now in order.
No comments.
Chairman: The next order of business will be the report of committee on
paper of Trustee Vinton, by E. C. Smith, Secretary of Board of Stewards,
chairman.
EASTERN MICHIGAN ASYLUM,
Pontiac, Mich., July 16, 1908..
To the Joint 'Board of Trustees.
Gentlemen—The paper on asylum purchases presented by President Vinton
to the Joint Board in January and referred to the stewards with instructions to
report at this meeting, has been the principal subject of discussion at the two
quarterly meetings of the stewards since that time. Papers have been presented and carefully discussed, and even while inspecting the institutions where
the meetings where held, as it is customary for us to do, to compare prices and
qualities of commodities purchased, the chief subject of conversation was along
the lines of this paper.
While there are differences of opinion among the different stewards on some
of the questions raised by this paper, on others there is a remarkable unanimity.
On the question of a central purchasing agency- there seems to be but one
opinion, especially since the convention of purchasing agents of all the
institutions in the state held at Lansing upon the call of the governor, where
these matters were very thoroughly discussed. Mr. Clark, at the instance of
Governor Warner, had visited and inspected all the state institutions, especially
with regard to their business methods, and when the superintendents, and
purchasing agents were convened at Lansing we had the benefit of his
experience and opinions gained in these institutions. Both he, and Governor
Warner oppose a central purchasing agency, but all seem to favor an occasional
meeting, such as that held at Lansing, of all the purchasing agents for the
purpose of consultation and comparison of methods. This would be simply an
enlarged copy of the system for many years in use by the stewards of the four
larger asylums, of meeting quarterly.
The paper under discussion has been divided under ten headings, and the
views of each of us upon each of the ten subjects has been tabulated, and the
tabular statement is presented herewith.
There are some radical differences in the views of different individuals as to
the methods of providing beef, clothing, and some other items, also on the
question of the use of butterine; but since there is a law at present on the
statute book forbidding the institutions to use it, there is very little likelihood
that any Michigan legislature can be prevailed upon to repeal that law for a
long time.
OF ASYLUMS OF MICHIGAN.
27
1 Is it better to purchase supplies in open market month by month or to make
contracts covering a long period?
MICHIGAN
ASYLUM
EASTERN ASYLLM
G e t quotations
on as many commodities as possible a n d g e t
them often; groceries, p r o v i sions, etc. every
month, B u t t e r
and E g g s every
Watch the markets closely, and
t a k e advantage
of favorable conditions; get bids
on coal only.
NORTHERN
ASYLUM
UPPER PENINSULA
HOSPITAL -
STATE PSYCHOPATHIC HOSPITAL
Would ask quotations and buy
on open market
when it would be
to the advantage
of the institution
to do so. Most
of the purchases
should be in
quantities for 3
months.
I believe it better to buy in
open market on
bids as far as pos
sible than by
contract with the
exception of coal
Contract for one
or two or three
months s u p p l y
after getting
competitive bids
2 What quality of meat ought Asylums to buy? Is it better to buy beef on the
hoof or dressed beef?
1
Buy young feeders and f a t t e n
them as rapidly
as possible.
Well meated not
too fat steers of
575 Ibs to 600 Ibs
Buy fat cattle
and slaughter, Or Would buy fat buy beef on hoof
buy dressed beef, cattleandslaugh- if r e a d y to kill
w h i c h e v e r i s t e r , when t o and near home.
cheapest. N o t an advantage to Would not be of
land enough to purchase in that advantage to us
to ship cattle in
fatten beef pro- form.
and feed' to fatfitably.
ten as is necessary at present.
Steers and Heifers of good quality more economical than cheaper
'
3 What quality of tea and coffee should we use?
Good quality, not
fancy. Same for
p a t i e n t s as for
officers and employes.
Good q u a l i t y .
Fix price and
have s a m p l e s
submitted at that
price; select the
best and buy it.
W o u l d always
get the best quality for the price.
We have found
a blend of our
own make the
best.
A good quality
but not a fancy
article for general use. Use a
better quality for
officers.
Fair grade which
will be consumed
not wasted, as it
will be if not
good.
4 What is the most economical kind of coal to use?
Smokeless -New
River, or Pocahontas.
C o n t r a c t for
units of heat and
pay according to
B. T. U. Calorimeter tests.
Quality of coal
must depend upon heating apparatus used.
We a r e using
traveling grates
or stokers and
can use a cheaper quality of coal
Owing to limited
e x p e r i e n c e in
coal burning can
not discuss this
intelligently.
Buy the coal that
will produce the
greatest number
of heat units to
the ton.
28
PROCEEDINGS OF TRUSTEES
5 What ought to be done about lumber combine?
Has had no difficulty in obtaining p r i c e s on
lumber.
Dealers and
Manufacturers
bid all right, but
Pontiac bidders
are almost a l wavs lowest.
Have no difficulty in obtaining
fair p r i c e s on
l u m b e r , especially when t h e
Manufacturers
are s e e k i n g a
market.
Do not have this
difficulty.
If present laws
a r e insufficient
amend the laws.
'
6 Would an occasional meeting of Asylums Stewards with those of other Institutions be ol value?
Y e s . Meetings
should be held ; The recent meeta-t frequent in- mg at Lansing
t e r v a l s and a | was proof of its
general consul- being of value.
tation take place
Emphatically,
Yes. Has been
u r g i n g it for
some time.
Recent meeting
at Lansing called
by the Governor
demonstrates the
great benefit of
such meetings.
7 What are the advantages of our present system over a Central Board for all?
'Our present system seems to us I ha-;0 seen but
T ,. .
. _, ,
to be far better l i t t l e of
the
Buffalo ^,
,•
£ ^
Advantages too Visited
,
, ,
than any central workings of the
n u m e r o u s t o Asylum and the board <, an . b e . Centra? B o a r d
mention. H a s Steward pointed From
knowl_
svst
j saw a
v i s i t e d many out many defects edge of Jthe cen ^ b l a n k e t bought
States that have m the Central f r a l board by t h e MinnesoBoards of Con- ; B o a r d system. tem {n w j s
ta Board at $2.00
trol and they do Governor \\ar- Iowa and ^ y ; tha{ was QQt as
not get best re- ner is opposed to j wou](l m o s t ; , good asMichigan
sults.
Central system. ce rt a inlv fa v o r asylums w e r e
continuing the ' buyng for $1.75
system we have.
Mr. J . B. Clark
after v i s i t i n g
every Institution
says a Central
Board would not
be as economical
as the present
system.
8 What is the best method of providing clothing?
Jielievesitis better for each Institution to make
its own clothing.
Believesit is better to buy men's
suits and overcoats.
Believe it is better to buy suits
and overcoats in
the market, selecting those best
adapted for purposes for which
t h e y a r e purchased.
Make the men's
. ,
, . ^
as much of women's apparel as
possible.
Buy
men's suits, overcoats etc , ready
made.
Make it or buy it
whichever is
cheapest for the
taxpayers.
9 Should the law be changed allowing Institutions to use butterine?
No, does not believe in substitutes of any kind.
Yes; would use
it if the law allowed, and save
taxpayers thousands of dollars
yearly.
Must say no, as
in buying creamery b u t t e r we
know about what
we are buying.
Yes; would use
it if permitted
to; for cooking
purposes. Butter
for table use.
Yes; Mr. Vinton
has shown that
it would save the
t a x p a y e r s $40,
ooo a year.
OF ASYLUMS OF MICHIGAN.
29
10 Suggestions relative to checking and auditing.
•
Likes the system
in use at Kalamazoo.
Have a system
of checking and
auditing in use
I-ikes the system at this institution
in nse at Pontiac many years and
believe it to answer our pu rpose well.
'
Our storekeeper
records in a book
the goods reed.
Billsare checked
and goods examined by steward.
The storekeeper
does not handle
t h e invoices.
Bills subject discount are vouchered and paid at
once. Other bills
approved by
Auditing Committee before being paid.
Advocates a uniform sv.stem of
c h e c k i n g and
auditing.
Very respectfully.
E. C. SMITH,
Secretary.
Chairman: The next order of business will be a report of committee on
papers of Trustee Cook and Wash burn, by Trustee Vinton.
Mrr. Chairman, Members of the Joint Board, Ladies and Gentlemen:
At the January meeting of the board we listened to some very important
papers, and Dr. Christian, in accordance with his often expressed opinion that
the excellent papers read before this board, in the past, had not been fully
digested and appreciated, made the following motion which was unanimously
adopted: "I move that the papers of Trustee Cook and Trustee Washburn
be referred to a committee of trustees which will report back to this board at
the next meeting, what action, if necessary, shall be taken on these papers."—
The chairman appointed to act on this committee: Trustees Vinton, C. E.
Belknap, J. W. Belknap, Quaintance and Case. Your committee has carefully considered these papers and believe that the paper read by Trustee Washburn, last January, and omitted from the printed reports of that meeting,
should be printed in the report of the July meeting of the joint board, and this
committee especially commands the attention of the board to the paragraph
referring (1) to the building of permanent structures, (2) the beautifying'and
improving of the grounds and (3) some sort of a club or library, etc., for the
attendants; and this committee recommends that all permanent buildings in
the f u t u r e should be of fire proof construction, that everything possible should
be done to improve and beautify the grounds, and that the board of each asylum
should do more for the amusement and recreation of the attendants.
Trustee Cook's paper we have taken up in detail. He says:
"Having the power to fix the rate of maintenance, how should we exercise
it? The law of 1905 attempted to lay down a method. As far as it applied to
the improvement and repair account, the Legislature undoubtedly intended to
extend our authority so that we would not have to get special appropriations for
30
PROCEEDINGS OF TRUSTEES
many small items which, it was thought, we would not charge to maintenance
account. Under that law we are allowed to make and charge to maintanance
all such improvements to buildings as do not amount to a new structure.
The authority given us to make repairs and improvements is very general.
We should all act under the authority, or we should all limit the authority to
the keeping of our buildings in repair as they are and go the Legislature for any
betterments to the plants, a position that the Legislature did not want us to take
or they would not have passed the law of 1905.
I am of the opinion that we
should make all improvements we can under the law and charge to improvement and repair account, and see to it that the rate of maintenance provides for
it."
This committee believes that every member of the joint board will realize the
importance and justice of this idea, and all boards act according to the above
suggestion.
He says: "To bring about uniformity it might be best to have the Insanity
law so amended that all requests for appropriations be passed on by the joint
board before being submitted to the Legislature. The trustees of the joint
board would certainly be qualified to act intelligently. They would refuse to
recommend appropriations when the expenditure should come from one of the
current funds, and the refusal would likely defeat the request.
If the joint board was directed to act on all of the appropriations and either
recommend or withhold its recommendation we could get the one advantage
that a single board of control would have, that is the limitation of the appropriations for additional room to the wants of the entire state, and the keeping
within reasonable limits other requests."
This committee is in sympathy with this suggestion, but feels that the board
of corrections and chatities now has general supervision ofQappropriations, and
further action by this board would only complicate the method of getting such
appropriations. The committee recommends that each board ask for only what
they absolutely need and be able to prove such need.
Mr. Cook says: "Returning to the subject of fixing the rate of maintenance.
The trustees, heretofore have not considered carefully the amount of cash on
hand the statements should show an June 30, of each year. When one of the
members of your finance committee attempted to persuade the governor and
the state board of auditors that we should be allowed forty-nine cents per day,
the statement came out very quickly that the institution he represented could
run at a loss of a cent a day and still have a good working balance, and the
statement was true.
"June 30 is not, in my opinion, the best day on which to estimate what the
cash balance should be. It is often thought best tojfill up the coal bins in the
fall and early winter to provide against blockades of any kind, and certain of the
food supplies are purchased in the fall for the winter and spring use. Our
asylum books always show that under normal conditions our per capita cash
outlay is larger the first six months. To determine then what the lowest cash
balance should be I would say that on December 31st there should be enough
cash in the treasury to meet the pay roll due January 1st, if the payment is to be
made before the 7th. If the pay roll is paid before the 1st, it should not be considered. Add to that amount such a sum as will pay all outstanding bills on
which there is a discount which must be taken advantage of before the 10th of
the month and you have all that you should have. Any monies that you have
above such a total first benefits your banks, and second the institution to the
OF ASYLUMS OF MICHIGAN
31
amount of interest the banker pays. Such benefits would hardly justify the
accumulating of a large working balance."
Your committee believes that the exact application of this idea would be impracticable and that each institution should have a cash balance on hand January 1, to carry on the business and take care of emergencies such as we have
met in the high prices of the past year. The cash balance on hand should be
enough to pay pay rolls and all bills for a month provided the state pays the institutions monthly or enough to pay the same items for a quarter, if the state
pays the institution quarterly, and in addition to these sums, cash balances on
hand should include five per cent, of the total expenses of the year to provide
for a rise in prices or other emergencies.
Mr. Cook says: "Our yearly financial statement perhaps should have a little
notice before I close. These statements have ever been a source of annoyance.
As chairman of your finance committee I have given much thought on the subject and have assisted in getting out blanks which I thought would provide for
sufficient data to enable the committee to make a close estimate on the per
capita cost of several institutions. The old form we know did not. When
they were in use, an institution could by increasing or decreasing supplies near
the end of the year and by holding out or anticipating bills, make the per diem
show very near the fixed rate. The printed reports did net show the net cost.
Under the new form I think we have arrived at more accurate results but yet
not entirely satisfactory. There has not been a year, since we changed the
form that all the asylums have made their reports to conform therewith.
Whether the bookkeeper in making the report could not understand the blank
or thought it was of little account, I am unable to say. The repeated action
of the board directing that they should be filled out seems to have been of no
avail.
"I realize that with the reports properly made it is impossible to get an
accurate balance from which we could figure the exact cost of maintaining a
patient. To some extent we are obliged to rely on annual inventories of supplies and materials on hand. The inventories are made by different persons
and in a different way. There is always some loss and there are some profits.
The estimating of these will vary somewhat. But allow all those slight variations, yet the report should be near enough to use as a basis in fixing the
rate.
"The form of the report doubtless can be improved upon and the finance
committe would gladly receive suggestions to that end. It is important, however, that whatever form is sent out by the finance committee should be fully
and accurately filled out. If there are any deductions to be made not provided
for or qualifications to be considered let them be in a supplementary report."
Your committee believes that the finance committee has achieved admirable
results in the new form of statements and that each institution should fill out
the accepted form of blanks in exactly the same manner. We recommend
that in order that this matter should be fully understood and that all figures
should be made on the same basis, the finance committee send an expert
accountant to all the institutions or that the accountants of all the institutions
meet with the finance committee soon, on a date to be set by the chairman of
the finance committee, for instruction and consultation. The finance committee
to be empowered to make any necessary changes and put them into immediate
effect.
32
PROCEEDINGS OF TRUSTEES
Your committee earnestly recommends the serious consideration of these
matters by the joint board.
G. Jay Vinton.
Chairman..
J. W. Belknap.
M. F. Quaintance.
Fred S. Case.
Committee.
Chairman: The report will be accepted if there are no objections.
Trustee Mills: I move that the recommendations contained in the paper be
adopted. Motion supported and carried.
Chairman: It will be next in order to fix the rate of maintenance for the
ensuing year. We will hear from the finance committee.
Trustee Cook: The finance committee had a lengthy session last evening
and compared the cost of maintenance at the different institutions and found it
to be as follows:—Kalamazoo 48.01 cents, Pontiac 51.77 cents, Traverse City
50.93 cents, Newbury 54.25 cents; and Ionia including the officers' salaries
50.81 cents. Your finance committee by unanimous vote recommend that
the rate of maintenance for the asylnms of the lower peninsula be fixed at
fifty cents per day, and in addition thereto the cost of clothing, expense of
returning patients home and elopement expenses; and for the upper peninsula
hospital for the insane that the rate be fifty-two cents per day, and in addition
thereto the cost of clothing, expense of returning patients home and elopement
expenses.
Trustee Mills: I move that the report of the finance committee be adopted,
and that the secretary of the joint board be directed to notify the governor of
said action, as required by law. Motion supported and carried.
Chairman: The next order of business will be the reports of committees.
The first is the Committee on the Psychopathic Hospital with Trustee Cook as
chairman.
Trustee Cook: I was not aware that there was any report due from the
Psychopathic Board at this time. Originally the report was made by a joint
committee, and then I think the committee reported from one meeting of the
Joint Board to another. Under the new law they are elected for one year,
and I think a report is not due from that board until the end of the year. Dr.
Barrett is not present today on account of his absence from the country. I
wish to express my appreciation for the kindly reference made to the work in
the Superintendents' reports.
Chairman: The next committee is on Uniformity of Classification of official
reports, Dr. E. A. Christian, chairman.
Dr. Christian: This Committee has already reported to the Joint Board the
adoption of one table. No further progress has been made in the matter, owing
to the absence of the Director of the Psychopathic Ward, who is now in
Europe. The committee will have to be continued. The committee has one
suggestion: We note there is a scarcity of copies of the report allowed each
institution by statute. Five hundred copies go to each institution. The
number of institutions for the insane in the country is steadily increasing, which
calls for a larger exchange list. There are over two hundred institutions in the
country now that we wish to exchange with, besides there are many individuals
who are interested along these lines, libraries and organizations of various kinds,
who desire the report. We feel that each institution should be allowed a
OF ASYLUMS OF MICHIGAN
33
sufficient number to distribute to the employes, especially those of long service.
We therefore request of the Joint Board that this matter be considered with a
view to securing an amendment to the statute which will allow a larger number of the reports so each institution.
Chairman: The report will be referred to the Committee on Legislation.
The Committee on legislation will bear in mind the suggestion made by Dr.
Christian, and take the matter up at the proper time.
Chairman: The next will be a report from the Committee on Legislation, •
Trustee A. J. Mills, chairman.
Trustee Mills stated that there was nothing to report at this time.
Chairman: The next in order is miscellaneous business, At this time we
shall fix the salaries of the officers. The secretary will please call the roll of the
asylums, and the reports will be made. ,
The chairmen of the various asylums presented the following salary tables
for officers for the ensuing year:
MICHIGAN ASYLUM.
Medical superintendent Assistant medical superintendent
First assistant physician
Second assistant physician - -- —
Third assistant physician
Fourth assistant physician-Woman physician
Steward
Chaplain.. ..
....
—
$3,500.00 with maintenance
2,000.00
- - - 1,800.00
1,800.00
- - 1,300.00
800.00 "•
800.00 "
2,500.00 without
250.00 non-resident
EASTERN MICHIGAN ASYLUM.'
Medical superintendent —
Assistant superintendent First assistant physician--•
Second assistant physician
Third assistant physician
Fourth assistant physician
Woman physician-—
Steward - - -'
Chaplain $5.00 for each service.
— —
-•--
Non-resident
$3,500.00 with maintenance
, 2,000.00
1,200.00
1,000.00
800.00
700.00
900.00
1,800.00 without
.
UPPER PENINSULA HOSPITAL FOR THE INSANE.
Medical superintendent - —
Assistant superintendent —
Assistant physician
Assistant physician (Woman)
Steward
Chaplain
-
$3,000.00 with maintenance
1,800.00
1,000.00
1,000.00
1,800.00 without
260.00 non-resident
NORTHERN MICHIGAN ASYLUM.
Medical Superintendent
Assistant superintendent
-First assistant physician
Second assistant physician (Woman)
$3,500.00 with maintenance
2,800.00 without
1,600.00 with
1,200.00
34
PROCEEDINGS OF TRUSTEES
Third assistant physician
Fourth assistant physician
Fifth assistant physician
Steward
Chaplain
1,200.00
1,200.00
800.00
1,800.00
260.00
with maintenance
without
with
without
non-resident
Report accepted and placed on file.
Moved and carried that the officer's salaties of the several asylums be approved
as presented.
Trustee Mills: At this time and under this head, I submit the following for
consideration of the board, and move its adoption: That it is the sense of
this board that the words "Asylum for the Insane," as applied to the Michigan
Asylum, State Asylum, Eastern Michigan Asylums, and Nothern Michigan
Asylum be dropped; that the words "Hospital for Mental and Nervous
Diseases," be substituted; and in regard to the Upper Peninsula Hospital for
the Insane, that the words "For the Insane," be dropped and that the words
"For Mental and Nervous Diseases," be substituted. And that the Legislature be asked to sanction this change, in order to get rid of the words "Insane
Asylum."
Dr. Noble: To make it more brief, how would it be to leave out the words
"For Mental and Nervous Diseases?"
Dr. Christian: I think we have got to come to this in time. I believe in
natural response to public s e n t i m e n t we have got to adopt the word
"Hospital." I think the change should come with little hinderance to our
bookkeeping, etc., and I sanction Dr. Noble's suggestion. I would like to see
a system adopted like that in use in New York state. Why not in speaking of
the Kalamazoo Asylum, say the Kalamazoo State Hospital, or the Pontiac
State Hospital, etc.
Trustee Mills: I think that is a good suggestion.
Trustee Voorheis: Would that name be at all misleading to people? It
would be a state hospital, but would not the people think it was for other
things than mental and nervous diseases,—otherwise I think the abbreviation is
all right.
Trustee Mills: I move that this be referred to the committee on legislation for report at the next meeting. Motion supported and carried.
Trustee Vinton: I ask that the legislative committe be allowed to introduce
a law whereby any part of the minutes or any important papers of the joint
board may be printed. Motion supported and carried.
Trustee Mills: I move t h a t the committees of the joint board be
continued. Motion supported and carried.
Trustee J. W. Belknap: In behalf of the management of the state asylum,
I would invite the joint board to meet with us at the January meeting.
Chairman: You have heard the invitation as presented to the board.
What is your pleasure?
Trustee Mills: I move that it be accepted. Motion supported and carried.
There being no futher business to come before the joint board the meeting
adjourned.
A. S. ROWLEY,
Secretary.
OF ASYLUMS OF MICHIGAN
35
TRAVERSE CITY, MICH.
To the Honorable Fred M. Warner, Governor:
You are hereby respectfully notified that at the meeting of the Joint Board
of Trustees of the several asylums for the insane, of this state, held at the
Northern Michigan Asylums for the Insane pursuant to law, on the sixteenth
day of July, inst., the rate of maintenance for the ensuing year was fixed as
follows:
For the asylums of the lower peninsula the rate fixed is fifty cents ($.50)
per day, and the charge per week perscribed is three dollars and fifty cents
($3.50), and in addition thereto the cost of clothing, elopement expenses and
expenses of returning patients home.
The rate for the Upper Peninsula Hospital for the Insane was fixed at fiftytwo cents ($.52) per day, and the charge per week prescribed is three dollars
and sixty-four cents ($3.64), and in addition thereto the cost of clothing,
elopement expenses and expenses of returning patients home.
And the Secretary was directed to notify you thereof as required by law, and
this notice is given in accordance therewith.
Dated July 16, 1908.
A. S. ROWLEY,
Secretary.
STATE OF MICHIGAN,
COUNTY OF GRAND TRAVERSE
A. S. Rowley, being sworn, says that on the 16th day of July, 1908, he
served Hon. Fred M. Warner, as governor of the State of Michigan, a notice of
which that hereto attached is a true copy, delivering the same to him personally
at the Northern Michigan Asylum for the Insane on said day.
A. S. ROWLEY
Subscribed and sworn to before me this sixteenth day of July,
1908.
A. L. WHITNEY,
Notary Public.
MEETING OF THE
Joint Board of Trustees
ASYLUMS OF MICHIGAN
TRAVERSE CITY,
JULY 16, 1908
LANSING, MICH.
PRESS OF THE INDUSTRIAL SCHOOL FOR BOYS
1908
NORTHERN MICHIGAN ASYLUM.
TRAVERSE CITY, MICH., July 16, 1908.
The regular semi-annual meeting of the Joint Board of Trustees of the
Michigan Asylums was called to order at 10:30 a. m., by Trustee Bates, President
of the Board of Trustees of the Northern Michigan Asylum for the Insane.
The Chairman welcomed the members and other guests with well chosen
remarks.
Invocation by Chaplain Cochlin.
Dr. Munson moved that the Chairman appoint a committee to invite the
ladies and other guests to the meeting. Motion supported and carried.
Chairman Bates appointed Trustees Vinton, Morgan and Edwards to
constitute this committee.
The following members of the Board and Medical Superintendents were
present:
From the Michigan Asylum—Trustees A. J. Mills, C. F. Cook, H. B,
Osborn, M. D., C. S. Palmerton, C. L. Edwards, C. E. Belknap, and Dr. A.
I. Noble, Medical Superintendent.
From the Eastern Michigan Asylum—Trustees G. J. Vinton, Edward M.
Murphy, Peter Voorheis, J. F. Cartwright, W. J. Kay, M. D., and Dr. E.
A. Christian, Medical Superintendent.
From the Upper Peninsula Hospital for the Insane—Trustees E. P. Bohn,
M. D., D. T. Morgan, J. H. Parks, Fred S. Case, Perry Leighton, and Dr.
E. H. Campbell, Medical Superintendent.
From the State Asylum—Trustee Belknap.
From the Northern Michigan Asylum—Trustees T. T. Bates, H. C. Davis,
M. F. Quaintance, William Lloyd, and Dr. James D. Munson, Medical
Superintendent.
There were present as invited guests, the Governor, the Honorable Fred M.
Warner; Dr. H. P. Mowry, wife and son, of the State Board of Corrections
and Charities; J. P. Draper, Superintendent of the University Hospital at Ann
Arbor; Dr. J. J. Marker, Superintendent of the Wayne County Asylum;
Stewards John Hoffman of Kalamazoo, E. C. Smith of Pontiac, R. C. Bradley
of Newberry, C. L. Whitney of Traverse City; Rev. D. Cochlin, Chaplain of
the Northern Michigan Asylum, Mrs. Edward M. Murphy, Mrs. J. F.
Cartwright and daughter Gladys, Miss Mills, Mrs. C. F. Cook, Mrs. F. P.
Bohn, Mrs. J. W. Belknap, Mrs. H. C. Davis and daughter Josephine, Mrs.
and Miss Quaintance, Mrs. William Lloyd, Miss Clara Bates, Mr. and Mrs.
Samuel Garland, Mrs. Elsie Hannah, Mrs. A. S. Rowley; and members of the
medical staff of the Noithern Michigan Asylum.
Chairman: The first order of business is the approval of the minutes of the
last Joint Board Meeting.
Moved and carried that the minutes stand approved.
6
PROCEEDINGS OF TRUSTEES
Chairman: The next order of business is the consideration of unfinished
business. No unfinished business.
The next in order will be the presentation and consideration of communications from Trustees.
THE TRUSTEES.
TRUSTEE A. J. MILLS
In 1848 the Legislature of this stale enacted: "That there shall be estatr
lished in this state, institutions under the title and style of the 'Michigan
Asylum for the Educating of the Deaf and Dumb and Blind,' and 'Michigan
Asylum for the Insane,' and that fifteen sections of the state salt-spring lands
be and are hereby appropriated for the erection of suitable buildings therefor."
"The government of said asylums shall be vested in a Board of Trustees, to
consist of five members, who shall be elected annually by the Legislature of this
State in joint convention: Provided, The Governor shall have the
authority to appoint the first Trustees under this act."
"The Trustees authorized pursuant to the foregoing section, shall constitute
a body corporate with the name and title of the Trustees of the Michigan
Asylum,' with the right as such of suing or being sued, of making and using a
common seal, and altering the same at pleasure."
So the first Board of trustees provided for in the management of the insane
asylums in this state was created a body corporate with a corporate seal.
"The Trustees shall have power, and it shall be their duty, to enact laws
for the government of said asylums, and also to appoint a principal for each
institution, whose respective salaries shall not exceed eight hundred dollars per
annum."
In 1850 the duties of the Boards evidently became quite onerous. We find
that the Legislature enacted: "That the Auditor General be, and he is hereby
authorized and required to audit and allow to the members of the board of
trustees of the Michigan Asylums, and to the members of the board of education,
the expenses necessarily incurred by them in the discharge of their duties; also,
twn dollars per day for their services actually and necessarily performed, upon
their certifying the same to be correct, and draw his warrant upon the treasury
therefor."
In 1855 the first provision for the actual care of the insane of this state was
taken up in a revision of the charter of the city of Detroit. I wish I had time
to call the attention of this Board to all the provisions of that act relating to
the insane and the care of defective people, because it shows that the people of
the city of Detroit as early as 1855 were alive to many of the things which are
now regarded as modern reforms.
"The common council are hereby vested with full power and authority to
provide by ordinance for the organization, regulation, control and support of an
alms house department, including therein an alms house proper, for the relief
and support of the poor ot said city, hospitals for the care of the sick, asylums
for the insane and blind, nurseries for poor and destitute children, houses for
the confinement, correction or punishment of males over sixteen and females
OF ASYLUMS OF MICHIGAN.
7
over fourteen years of age, who shall be convicted before any court of law, of
violating any law of the State of Michigan."
That is a pretty modern conception of things.
"Every person confined, supported, maintained or relieved in said department,
whose age and health will permit, shall be employed in some useful labor, and
the officers in charge thereof shall use their best endeavors to provide for all
persons under their care, such labor as on trial shall be found to suit the
capacity of the individual. It shall be the duty of the officers to keep and
employ separate and apart form each other, the paupers and criminais, and as
far as possible to classify the latter, so that the novice in crime may not be
contaminated by the evil example and converse of the more hardened and confirmed. There shall be an accurate account kept with all paupers, charging
them with the expenses incurred by fhe city for their board and maintenance,
and crediting them with a fair and reasonable compensation for tiie labor performed by them; and when they shall leave the department if any balance shall
be found due them it shall be paid to them in cash at the time of their discharge:
Provided, That the common council may, in their discretion, order said
balance to be paid to some discreet citizen, who shall expend or invest the
same for the benefit of such pauper, and shall fully report his action in the
matter to said council. The officers in charge of said department may receive
and provide for, or confine any insane, or blind or idiotic person, or male under
sixteen or female under fourteen years of age, who shall be brought to them by
the director of the poor, or other proper officer of any township in this state,
or by the parent, guardian, or friend of any such person." So you see the
institution provided for more than the city of Detroit in 1855, and became the
first legal custodian of the insane of the state as well as the city. "Provided,
That such officer, parent, guardian or friend, shall give ample and satisfactory
security for the payment, at least once a month, of all expenses that may be
incurred on account of the person so received; and provided further, that nothing herein contained shall be so construed as to make any person who may be
brought to said department for confinement or maintenance, a citizen of
Detroit." They are willing to receive the insane of the state, but they did
not propose to make them citizens of the city of Detroit.
In 1857 the law of 1848 was amended so, "That the Governor, by and with
the advice and consent of the Senate and House of Representatives, in joint
convention assembled, shall, during the session of the Legislature in the year
eighteen hundred and fifty-seven, appoint three Trustees for the Michigan
Asylum for the Insane, to hold their offices as follows: One shall be elected
for the term of six years, one shall be elected for the term of four years, and
one for the term of three years, whose terms of office shall commence on the
second Tuesday of February, of the year in which they are elected, and shall
continue untill their successors are appointed and qualified, and who shall
constitute the Board of Trustees of the said asylum; and at each succeeding
session of the Legislature there shall be appointed in like manner one Trustee,
who shall hold his office six years and until his successor is appointed and
qualified. The Legislature shall also fill, by election as aforesaid, all vacancies
that may occur in said board."
"The government and sole and exclusive control of the Michigan Asylum
for the Insane shall be vested in said Board of Trustees, and two of them shall
reside within five miles of said asylum." The law of 1859 then provided for an
appointed board.
g
P R O C E E D I N G S OK TRUSTEES
In 1859 or about that time, as I understand it, the Michigan Asylum for the
Insane was opened. Some 'days ago a lady who was one of the very first
patients, who lived in that institution for forty-nine years and one hundred ami
forty-four days, departed this life and was returned to Coldwater for buriai.
This illustrates the length of time that the State may be required to maintain
some patients, and the importance of seeing to it t h a t the rights of the State
in the matter of the support of such patients should be carefully conserved.
The law of 1859 continued without much change until 1877, when the
Eastern Michigan Asylum for the Insane was provided for and the law was
practically revised. That law provided that: "The district of the Eastern
Michigan Asylum shall be composed of all countries lying east of the meridian
line, or traversed by that line, excepting the countries of Jackson, Mackinaw,
and Chippewa. The district of the Michigan Asylun for the Insane shall be
composed of the remaining part of thf State."
,
"The Board of Trustees of the Michigan Asylum for the Insane shall consist of six, and be appointed and hold their offices in accordance with the laws
heretofore enacted organizing and regulating that institution."
"The Governor, on or before the completion of the Eastern Michigan
Asylum, shall appoint six trustees, who shall constitute the board for said
asylum." "The government and sole and exclusive control of the Michigan
asylums for the insane, shall be vested in said board of trustees, and two of
each board shall reside within three miles of their respective asylums."
With the passage of this act came the first law which delegated to the
trustees the right to fix the rate of maintenance. "The rate of charge per
week to be paid for the board and necessary treatment of all patients of the
asylums, who are residents of this State, shall be annually fixed by the trustees
of the asylums, and shall not exceed the actual cost of support and attendance, exclusive of officers' salaries; but this provision shall not be construed so
as to prevent the furnishing of extra care and attendance to patients by special
contracts with parties chargeable therefor." The law of 1877 continued in
force practically without amendment until 1885, when, owing to the establishment of this institution, it became necessary to revise the law, and to provide
an additional board of trustees.
In 1885 the Legislature enacted: "The board of trustees for each asylum
for the insane now or hereafter organized, shall consist of six members to be
appointed and hold office for a term of six years, two to be appointed every
succeeding two years." And then provided for the appointment of a board of
trustees for the Northern Michigan Asylum. "The government and sole and
exclusive control of the several asylums for the insane shall be vested in the said
several boards of trustees, and two of each board shall reside within three miles
of their respective asylums."
'Then came the creation of the Joint Hoard of Trustees in 1885.
"It shall
be the duty of the boards of trustees to meet jointly at least twice each year,
meetings being held at the different asylums, and at such times as may be
prescribed by their joint by-laws to adjust all questions that may arise pertaining
to said institutions; and the said joint board, acting under such rules and by-laws
as they may adopt, may transfer patients from one asylum to another if for any
cause it may become necessary or desirable; the expense of such transfer to be
chargeable to the person, or county, or state responsible for the maintenance of
the patient so transferred."
"The rate of charge per week to be paid for the board and necessary
OF ASYLUMS OF MICHIGAN.
9
treatment of all patients of the asylums, who are residents of this state, shall be
annually fixed by the trustees of the several asylums, in joint session, and shall
not exceed the actual cost of support and attendance, exclusive of officers'
salaries; but this provision shall not be construed so as to prevent the furnishing
extra care and attendance to patients by special contracts with parties chargeable
therefor."
I need not read any of the provisions of the subsequent acts of the Legislature
with reference to the duties of the joint board of trustees because you are all
familiar with them. I thought that I might as a preface to my paper call
attention to these early statutes and refresh the recollection of the members of
the Board of the early legislative history of the asylums and of the board of
trustees.
1 have traced in a general way the history of the governing boards of the
asylums for the care of the insane in this state covering a period of over fifty
years, during which time no public scandal has involved the management.
No dishonesty has been charged and a record has been inade which places them
in the first rank. This enviable standing has been made possible because from
first to last the activities of politics and politicians have not been permitted to
gain a footing in these homes of sorrow. The governors have for the most
part been wise enough to recognize that a place upon these boards, though one
of honor, ought not to be a reward for mere political service and that only
suitable men, willing to serve for the work's sake, are worthy of that opportunity.
A roll call of the men who have labored in this blessed work and laid down the
task would disclose names among the choicest of those who have graced the
roster of Michigan's citizenship.
The medical superintendents have always been men of excellent attainments,
strong executive officials, humane, progressive and distinguished alienists. They
have received the cordial and loyal assistance and encouragement of their
respective boards of trustees and in turn have faithfully carried out the directions
which have from time to time been given them by the boards.
Each hospital has maintained a medical staff composed in the main of gentlemen, who have not only been enthusiastic, well equipped and up to date, but
jealous of the advancement of the noble cause to serve which they educated
themselves and to which many of them have consecrated their lives. Certainly,
it cannot be truthfully said that only routine duty has been done or that there
has been stagnation in their labors along the lines of their specialty.
*(
The industrial departments have been honestly and efficiently officered. The
people of Michigan have never had just cause to accuse the stewards of grafting,
extravagance or of any lack of fidelity in the-discharge of their important and
most responsible duties. .1 must not be misunderstood as claiming that in all
the years gone by there have been no things done which ought not to have
been done, or no things left undone which ought to have been done, but as
insisting that on the whole exceedingly satisfactory results have been obtained.
I am emboldened to make, this assertion because at the gatherings of the
national associations of charities and of those who are informed, this has been
repeatedly conceded. You may perhaps wonder why I take your time to
applaud the accomplishments to which I have referred. I assure you it has not
been done in a spirit of boastfulness, but because as you are, so I am, jealous
«f this good work. It is near to our hearts. It is our great pride, for which
we would willingly make any reasonable sacrifice to insure its continuance and
excel the record. We all know that stagnation means retrogression and our
10
PROCEEDINGS OF TRUSTEES
motto is "Excelsior." We are not so self-satisfied as to proclaim that the best
results have been secured, or that no plan could be adopted which would not
place these hospitals upon a better or more humane and economical footing,
but in the light of what has been accomplished, we have the right to urge that
no mere experiments be tried and that well enough be let alone until the people
are convinced by something more substantial than the insistence of agitators
without experience in the work that the policies which have been so successfully
pursued in the past are wrong as applied to the future.
You all know that criticism has from time to time been made of our work
and that, generally, it has come from the mouths of the uninformed and from
those who have hardly seen the inside of one of the hospitals under our care and
management and have had no experience in the work.
We have been told by well-meaning people and through well-meaning agencies
that our duties have been perfunctorily performed and that the best commercial
methods have not been employed in the expenditure of the taxpayers' money in
the purchase of supplies. For one, I trust the day may never dawn when
Michigan's charitable hospitals and homes shall be cursed with a policy of
commercialism which would surely make of them poorhouses and the abode of
paupers. The mere commercializing and institutionalizing of these charities is a
microbe which has from time to time infected a good many people who are well
intentioned and others who are agitators and self-conceited reformers. The
disease is a contagious one and needs the prompt application of an efficient
anti-toxin if it is not to spread in Michigan to the detriment of the deserving
and afflicted people who must find their only refuge in the homes and hospitals
furnished by the state.
We have been informed that our tendencies have been to make local rather
than state institutions of the hospitals and that we who are striving, not for the
almighty dollar but in sweet charity's cause, have not and are not likely to
attain to the success which might attend the efforts of a highly salaried central
board of control.
It would be distictly un-American to adopt mere commercial and institutional
methods, overlooking as they generally do and most likely would, the permissable
and fitting homelike features and influences which ought to abound even more
than they do in the places which the people sustain as a charity not merely for
the poor but for all needing them within the meaning of the word "charity,"
which denotes "all the good affections men ought to bear to each other."
Our hospitals for the insane are not inhabited and will never be peopled by
mere paupers, but in the large majority by a class of unfortunates, most of
whom deserve well of the state, who have helped to bear its burdens and in
one way or another have contributed to its growth and material prosperity.
The desideratum is not tha minimum of cost, but sane economy within permissible and reasonable bounds. No humane thinking Michigan taxpayer has yet
had any just occasion for complaint as against the administration of Michigan's
charities, nor is any considerable number of the taxpayers finding their contributions toward the maintenance of her hospitals and homes upon present standards
unduly burdensome. On the contrary, they have evidenced their appreciation
and approval of what has been accomplished and are glad to provide means for
the proper and suitable support of them.
Our fellow citizens have, however, been urged in some quarters to dispense
with boards of trustees and to create a paid central board to administer the
public charities. If this cannot be defended, it is a heresy which we owe it to
OF ASYLUMS OF MICHIGAN.
H
ourselves to combat upon the basis not only of practical business, but of
humanity. For myself, I make bold to predict that it will presently be discovered
wherever the plan has been or will be tried, that it will not conserve the hopes
or predictions of its advocates anywhere, because I am convinced that it has
been the experience .wherever such boards have been created that local boards
of trustees cannot be dispensed with and proper standards maintained and that
the saving in the cost of maintenance has been very inconsiderable. This has
notably been the case in the States of New York and Minnesota and will be
so everywhere it is tried except possibly in places where the people are content
to house their afflicted friends or relatives in the sort of institutions which
abound in and disgrace Europe and against which most of our people would
rise in rebellion.
It has been found that each institution has its own peculiar requirements;
that local environments are an important factor; that the red tape methods
which necessarily accompany the work of a central board is often obstructive,
generally tends to friction, delay, unnecessary annoyances and many times to the
positive hardship and detriment of the inmates. Instances of such occurrences
have been given me by superintendents and trustees who have had experience
under such a system. A paid central board might remedy evils in some directions, but on the whole its remedial measures would turn out to be more
undesirable than the troubles intended to be remedied.
The system which has been in vogue in Michigan for so many years has
proven itself so far to be all right and is all right. We Michiganders are not
so wedded, however, to the accomplishments of the past as not to be willing to
consider the virtues of proposed reforms, nor do we shut our eyes as against
improved methods for the future, and I believe it will be the sentiment of the
members of this Board, as one matter of reform, that every state institution in
Michigan ought to be able to purchase as far as may be o.n equal terms and
that there might well be a closer union in the effort to furnish the most
possible to the inmates of all of them at minimum expense. We certainly have
not been dilatory in this regard.
Tnis Board, in requiring the stewards to attend its meetings and in providing
for stated meetings by them for discussion and comparison of purchases and
experiences, took a step in the right direction from which much good has
resulted. The creation of our Finance Committee and the report which our
by-laws provide shall be furnished this Committee in advance of our Julymeeting was another step forward. The Legislature, in requiring the State
Board of Auditors to act with us in fixing the rate of maintenance and inrecognizing that the powers delegated to this Board in that regard being;
legislative in character should be subject to veto by the Executive, conserved
public interests and strengthened our hands.
The Governor took a most helpful and practical step in advance in requiring
stated monthly statements of the purchases made on account of the several public
institutions for the use and comparison of purchasing agents, superintendents
and boards of control. These statements could be much improved upon and
will no doubt in the near future be made more useful than at present. The
Governor lately supplemented these monthly statements by calling together the
superintendents and stewards of all the institutions at Lansing for a conference
and discussion concerning the economic affairs thereof and if such meetings
may become, so far as the stewards are concerned, at least a quarterly feature
of their work, out of them will grow a plan by which all the institutions can
12
PROCEEDINGS OF TRUSTEES
purchase, at least the staples used by them, on even terms, the smaller being
thus aided by the larger. In this manner, a correctly constituted and practical
purchasing board could be provided at little additional expense, which would
answer all legitimate purposes and avoid the objections which have been
experienced in the states that have experimented with a paid three man central
board. Under the plan suggested, a keen rivalry would be stirred up among
the stewards which might result in considerable benefit and saving to the state.
In the near future, is it not possible a way may be found without encroaching upon the rights of labor to provide as much employment as is rensonably
permissible and useful for those of our patients who can and are willing to
work. We do this to some extent, but not as completely I believe as is useful
and possible. I think you will agree that idleness is a feature which, as we pass
about our asylums, appeals to us as something in the conservation of the
contentment and health of the patients to be avoided as much as possible.
The strict and active enforcement and amplification of the laws which require
those who can without hardship to themselves or their families to contribute
to the cost of the support of patients under the visitation of insanity should
receive our constant encouragement as conducive to the best interests of the
patients, as conserving the rights of the tax payers and as being calculated to
place the burden of caring for the insane more nearly where it rightfully
belongs.
This work has been carried forward very successfully by the State of
Massachusetts and only indifferently in Michigan. C o u l d we not take
measures to secure the appointment of some person, or persons, who could give
attention steadily to this important matter. Might we not also, in the interest
of fairness and peace, employ the services of someone, a medical man by
preference, who could be detailed to visit each of the hospitals regularly to
hear, investigate and advise as to such complaints as are made by patients or
their friends; as is done in the State of New York, where the plan has resulted
beneficially, or might not this duty be delegated to the State Board of
Corrections and Charities or to some official directly answerable to it.
Experience has taught that it is most necessary to require the maintenance
'of sound discipline among the nurses and employes and to insist upon uniform
courtesy and kindness toward the patients at all times. This has been accomplished in large measure in the past through faithfulness, intelligence and loyalty
of our employes, but has not been followed up, I am inclined to believe, as
carefully in all respects as is really necessary to our safety. The investigations
which have been carried on in the State of Illinois and the disclosures which
have resulted therefrom surely mark this as a very important matter for our
candid consideration. On the other hand, it is but just to ask, have we done
all we might or could for our employes in requiring of them not only fair hours
of duty, in granting them adeqate compensation for good service and in
providing them with suitable resting places and homes when not on duty. I
believe we might and could do much more in this direction and that the people
of the State would, if made to understand the necessity, support us in any
reasonable recommendations we may make to conserve such ends. I call to
mind a paper, which I think was read at this place some two years ago, covering this topic in part. It was pigeon-holed, as most of the papers are which
we listen to at our meetings and very little, if any, attempt has been made to
carry out its suggestions. I wish the wealthy men of our state, when
bequeathing of their means to charity as so many do, would remember our
OF ASYLUMS OF MICHIGAN,
13
nurses and that a nurses' home might be deemed sometimes a fitting memorial
to the memory of good citizenship.
In conclusion, gentlemen, while the Michigan plan has been a success in the
past, its future record will depend upon the appointments which are made
upon the boards by future governors and the unselfiish zeal of their membership. If non-partisan gentlemen, who are really interested in the cause and are
ever ready at much sacriince to assist in an active, but non-officious manner, in
the work for the work's sake and for the chance it affords of being helpful to
their unfortunate fellowmen and women are appointed and serve, all will be
•well and continued success assured, while the reverse may be expected to follow
the appointment and service of a different class of men.
In the past, we have worked harmoniously for the common good of all our
institutions and this must be our watchword for the future. I am sure I am as
proud of the successes and the good things accomplished at any of the hospitals
as I am of what is done at the Michigan Asylum. Our rivalry is honorable,
well intentioned and good natured. We all strive for the best and we can afford
to be generous toward each other in our efforts as well as in our criticisms. As
we have pressed forward in the past with honor and success, so may we proceed
in the future and may the people of our state never have just cause to feel
anything less than pride in the manner of the performance of our duties and
may the generous and enlightened policies which have been pursued continue
for the future only with more zeal and intelligent persistence, and entitle
Michigan to retain the place she has maintained so long in the very front rank
among her sister states and the nations of the world in caring for the mentally
distressed and in advancing the cause of psychiatry.
Chairman: I am sure we have all listened with great interest to the historical and suggestive paper of Trustee Mills. The paper, if there are no
objections, will be accepted and placed on record. Discussion of the paper is
now in order.
Trustee Davis: There is one feature of that paper I want to speak about
that is very valuable, and that is the work that Judge Mills has put upon it in
bringing out the early legislation. This information cannot be obtained except
by a lot of investigation, and I think it is very valuable for future reference.
It gives the history of the asylums up to the present time, except the present
laws, and it is too valuable to be lost sight of.
Dr. Christian: The contents of that paper are likely to come in as very
valuable material in some future years. We do not know how soon we may
move for radical change in our methods. I think we should have of that paper
a sufficient number in print to make use of at any time, more than we would
care to have printed perhaps of the full proceedings of the Board, and I offer
this suggestion that if the full proceedings of the Joint Board are printed, that
an extra number of this paper be made.
Considerable discussion was elicited with reference to the printing of Joint
Board proceedings, and it developed that there was no provision of law whereby
proceedings of any Joint Board could be printed at state expense. Dr. Mowry,
of the State Board of Corrections and Charities, spoke as follows: "I think
the proceedings of the Joint Board can be printed at the Industrial School at
Lansing. From Mr. Lawson I learned that he is very glad to secure printing
for his boys simply for experience, and I believe he would be glad to do the
work. All the expenses necessary would be for the material used." After
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PROCEEDINGS OF TRUSTEES
some discussion on these remarks if was decided to refer the question to Dr.
H. P. Mowry before any further action should be taken.
Chairman: The next matter for consideration will be the presentation and
consideration of communications from Medical Superintendents.
REPORTS OF SUPERINTENDENTS.
MICHIGAN ASYLUM FOR THE INSANE,
Kalamazoo, Mich., July 16, 1908.
To the Joint Board of Trustees:
Gentlemen—I present here with a brief report concerning themovement of
population and other conditions existing at the Michigan Asylum for the Insane
during the year ending June 30, 1908.
Men.
Women.
Total.
Patients remaining July 1, 1907
896
882
1778
Admitted during the year.
259
' 175
434
Discharged
Recovered
. Improved .,
Unimproved
Died
Transferred
Not Insane (Voluntary)
Escaped
Patients remaining June 30, 1908
1155
1057
2212
30
35
13
99
4
3
2
56
29
20
67
3
I
2
86
64
33
166
7
4
4
186
969
178
879
364
1848
The admissions this year were 434 as compared with 425 last year, while the
discharges this year were 364 and last year 404. We have, therefore, made a
net gain of seventy patients. This gain is confined wholly to the department
for men, since the discharges in the department for women exceeded the
admissions by three. The reverse of this was true last year, when there was a
loss of seven men and a gain of twenty-eight women.
This gain of ninety-one patients in the biennial period was anticipated in the
provisions of the last legislature, and the ordinary gain of the next two years
can be taken care of without asking for further special appropriations.
OF ASYLUMS OF MICHIGAN.
15
The recoveries exceed by seven those of last year, and represent a recovery
rate based upon the admissions, of twenty per cent. The deaths are less by
twenty-seven than they were the previous year and represent a mortality rate
based on the daily average census, af about nine per cent.
The general health of the household has been good, and we have suffered
from no serious epidemic, although nearly all the more common acute
infectious diseases including small pox, have been represented in the Asylum
by One or more cases during the year.
Tuberculosis was reported to the Board of Health in twenty-nine patients
and one male nurse, who contracted the disease elsewhere. Twelve patients
died of this disease, and we have thirty-four tuberculosis cases in the institution
at present.
Van Deusen Hospital has been finished and is now occupied. This building
will easily accommodate the one hundred and four patients specified in the
legislative enactment. In design and equipment it is well adapted to its
purpose, that of a receiving ward for women.
Hall L, one of the two new wards at the male department, gained by raising
the roofs over the extremities of the wings, 'was opened for patients in April.
The corresponding hall, M, can be finished at short notice whenever additional
room is required. Each of these wards is made up largely of a sitting room
and a dormitory. They prove to be very convenient and pleasant additions to
the department and afford comfortable quarters for forty patients each. This
in a measure, remedies the original defect the building of in lacking dormitory
space, and enables us to assemble certain of our epileptics and general paralytics
who need to be under constant observation night and day, one step in the
segregation of epileptics which we have lately undertaken.
A new continuous bath room was opened in the basement of Edwards
Hospital during the year. It practically constitutes an additional ward for
disturbed patients, and has a capacity of four tubs and ten beds. It has been
in constant use now six months and has fully met our expectations in affording
the most approved means for treating successfully some of our most trying
cases, not only recent admission, but chronic patients, subject to periodical
attacks of agitation and excitement, who may be thus rendered much more
comfortable during their disturbed episodes, while the outbreaks possibly may
be modified in duration and intensity.
Seven new porches contribute greatly to the comfort of the patients, while
other important improvements are well under way and when completed, will
give the Asylum a capacity.of twenty-one hundred patients.
The plan of caring for restless, destructive and otherwise vicious patients in
bed under observation has been extended. It is vastly superior to the common
recourse of single room seclusion, a form of solitary confinement, no more
conducive to the well being of an insane man than to that of a sane one. For
similar reasons we have extended the night service, locking in their rooms and
leaving to their fears and devices fewer patients at night.
While we are, and shall continue to be, largely engaged in the fundamental
work of the institution, yet it is a constant regret of the medical staff that we
have no suitable laboratory, autopsy room and morgue. This is an important
demand of continued scientific advancement, and it is our earnest hope that the
next legislature will take the same view of the situation.
Considering our facilities, however, the amount of laboratory work accomplished has been creditable. In a general way, this included the examination of
l-Q
PROCEEDINGS OF TRUSTEES
urine., blood, sputum, spinal fluid, stomach contents, stools, various inflammatory
ex.udates and the gross microscopical specimens obtained from autopsis,. of
which there were twenty-eight.
The therapeutic value of healthy occupation for a very large per cent of the
insane has not been lost sight of, and at the present time we have thus employed,
exclusive of bed patients, fifty three per cent of our inmates.
Most of the work done is that ordinarily preformed about an institution of
this sort, although we have successfully established basket making by the patients,
and it is our purpose to take up something further during the coming year
along the line of manual training and possibly during the winter, graded
calisthenics.
I am very glad to acknowledge continued cordial relations with the Psychopathic Hospital and valuable help from Dr. Albert M. Barrett, the Director, whose
efiorts to stimulate the institutions to work harmoniously along the scientific
lines are thoroughly appreciated.
Respectfully submitted,
A. I. NOBLE,
Medical Superintendent.
EASTERN MICHIGAN ASYLUM, Pontiac, Mich.
To the Joint Board of Trustees:
Gentlemen—The following table shows the movement of population for the
fiscal year, 1907-08.
Men. Women. Total.
Under treatment June 30, 1907
607
602
1209
Admitted from July 1, 1907 to June 30, 1908
155
133
288
Total number under treatment during 1908
Discharged:
Recovered
Improved
'Unimproved
Died-N o t insane--
Remaining under treatment June 30, 1908
762
22
30
17
49
.
735
1497
21
26
10
49
43
56
27
98
5
2
123
108
231
639
627
1266
The number of admissions, 288 in all represent 228 individuals who have
never before been received into the asylum, and is a larger admission rate than
the asylum has ever before been called upon to care for under normal conditions.
It cannot be accounted for by any considerable number awaiting the creation of
room for them, because at the close of the last fiscal period there was no
waiting list. A new building for women .had only-recently been opened for
occupancy, and for several years the demand for room for men had not outrun
our capacity. I am inclined to regard it as merely an instance of one of those
fluctuations, which, without apparent cause, now and then show themselves
independent of prevailing conditions. It will be noted by the above that the
net increase for the year has been fifty-seven.
OF ASYLUMS OF MICHIGAN.
17
The past year has been crowded with activity in lines of new construction
and in alterations in the existing plant. All this has not included new
buildings for patients. Only indirectly and incidentally to the carrying out of
other plans, will the institution secure an increase in its capacity for caring for
a larger number of the insane. Most of the work carried on has had for its chief
aims, increased efficiency and greater economy in the operating expenses of a
plant now a generation old. With the advent of winter we shall be in possession, for the first time, of a central heating plant for most of the detached
buildings and for the central block. This has involved the construction of
nearly half-a-mile of underground tunnels, together with the piping necessary
for-steam heat and for hot water consumption.
A steel water tower, destined for years to corne to be the most conspicuous
feature in the landscape for miles around, completed but not yet in commission,
will soon replace the old system of attic storage tanks. This only awaits the
near completion of the house piping to relieve us once and for all of the
constant vexations and expenses of the former system. The ever present fear
of fire, to be fought with a possibly insufficient water supply,—a fear amounting
to an obsession in the superintendent and imparted to his board of trustees, is
likely to receive its-quietus with the completion of work on two new ten inch
walls to be actuated by an air-lift apparatus already installed and ready for work.
With these in operation, it is expected that any default in the city water supply
will be compensated for by the delivery to our own fire pump of a thousand
gallons of water a minute. This work is still uncompleted. To the above
additions to the mechanical equipment must be added also in this relation, a
new power boiler and a small electrical unit for the night load.
A decidedly new departure for the institution,—one involving much in its
possibilities for good, we believe, is the construction out of our old chapel room,
(situated with respect to the wards somewhat like this assembly room,)of a
large central dining hall, where we expect to gather at meal hours, from six to
seven hundred patients. Room for this number has been secured by the building of wings on either side, affording, altogether, nearly 8,000 square feet of
floor surface. These wings are at this writing under roof.
To complete the scheme, a new building with an assembly room in a lower
story somewhat below grade, and a chapel on the second floor a trifle above
grade, is already erecting its front.
It is hoped that the discarding of most of the ward dining rooms for this
central gathering place, will effect a noticeable saving in food and in dishes,
a better'service of viands, and on the whole, a more wholesome atmosphere at
meal time. Incidentally, the institution gains considerable dormitory space.
In this connection may be mentioned an innovation which is perhaps not
yet beyond the experimental stage with us, but which we are planning to
extend to the new dining hall. Small square tables with polished tops and
without cloths, we are inclined to look upon as more attractive than the long
table with a cloth that is always objectionable unless immaculately white, and
much more apt to be "holey" than wholesome. Besides there is the saving
in the laundry account. Next to the abolition of the old dust shafts, which
unsanitary device we are no longer possessed of, I look to this move as most
promising of satisfactory results in the search for cleanliness, at not too great
a sacrifice of the esthetic.
A year ago we had just inaugurated, what was for us, a new system of caring
for our feeble and infirm women. No move for the better nursing and for
18
PROCEEDINGS OF TRUSTEES
greater comfort and convenience in the management of the bed-ridden and semibedridden body of patients (I do not speak of the acutely sick or hospital cases),
for the confused, restless and untidy ones has met with such signal success as
the creation of these two wards in an infirmary building, devoted exclusively to
these uses. It has been welcomed with such warmth of appreciation by nurses
and physicians, and has been commented on so pleasantly by visitors, and
especially by former nurses visiting the institution, as an addition to the nursing
equipment, notable for its convenience, its cheerfulness and general hospital
air, that I feel justified in referring to it in this report. There are no separate
rooms. Each floor is practically an open ward, with only such walls as are
necessary for supporting the floors above and for carrying the fire walls that
extend to the roof. Here, all the infirm and helpless are gathered, as many as are
necessary in beds, arranged along the walls. Former occupants of disturbed
wards are here. Many who were troublesome in smaller rooms here find that
comfort'in numbers that leads to quiet. Although not included in the original
plan, it has been found the ideal method of caring for cases of acute depression,
with anxiety, fear and suicidal tendencies; and at a minimum cost of attention
consistent with their needs. There is a noticable absence of odors. The
fewer corners, the lessened wall space and base, and the general openness all of
course lend themselves to this. Such privacy as is occasionally necessary, is
easily secured by light hospital bed screens. For those who are not bed-ridden,
spacious verandas are accessible, and on the coldest days of last winter, formerly
restless patients could be found seated there, bundled in blankets and shod with
felt boots. I feel that here we have found for 100 patients of a certain class,
the secret of combining the maximum of comfort with a minimum of cost of
construction.
Our experience with this open ward method of caring for a large group,
leads me to advocate its extension to other classes of patients. I recognize the
necessity for single rooms in certain cases, because of tumultuous behavior, or
for reasons of privacy in the convalescent or semi-convalescent patient, but I
look upon the small dormitory with its enclosed space, shut off from the main
ward, as an abomination and a relic of former days, when hospital ideas in the
care of the insane had not yet crystalized. There is among the insane, a
contagion of example, which often makes for peace in numbers when molded
by watchful and intelligent attendance. There is, too, for many, an assurance,
gained from large associations, that supports while it banishes mystery, secrecy
.and doubts. It is the night more than the day that loads with its sense of
responsibility, those who care for the insane. Open space and numbers bring
relief as witness the crowded day corridors, the large walking parties, the
gatherings at chapel and entertainments, and the associate dining halls.
Regular staff meetings have been the order through the year as they have
been for a number of years past with particular attention given to the study
and critical analysis of cases presented. The spirit of study and work in the
medical staff, with a desire to impart the same to the members of the training
school for attendants have been conspicuous. A close affiliation with the
pathological laboratory at the psychopathic ward has been striven for, and I
believe, with good results. Nearly forty per cent of the deaths have come to
autopsy. This is a decided increase over past years, and is itself evidence of
good faith. This coming year we expect to do even better.
In the basement of one wing of the dining room structure referred to above,
a set of rooms has been set apart for laboratory purposes. This will supply a
OF ASYLUMS OF MICHIGAN.
19
long felt want, and enable us to follow more closely the aims of the director of
the pathological laboratory.
No serious epidemics have visited the institution during the past year, and
but one incident has marred the uniform smoothness of operations in the
administration department. In June, the laundry was visited by fire. This
had its origin in the most vulnerable spot in all institutions of this character,
namely, the dry room. Before the flames were extinguished, the damage
wrought was sufficient to place the laundry almost completely out of commission, from which disastrous consequences we are but just now emerging.
Respectfully submitted,
E. A. CHRISTIAN,
Medical Superintendent.
UPPER PENINSULA HOSPITAL FOR THE INSANE,
Newberry, Michigan, July 16, 1908.
To the Joint Board of Trustees:
Gentlemen— I present you herewith a brief report concerning the movement
of population and other conditions existing at the Upper Peninsula Hospital
for the Insane, during the year ending June 30, 1908.
Men.
Women.
Total.
There were under treatment June 30, 1907
390
285
675
Admitted from July 1, 1907 to June 30, 1908-- - 109
65
174
Total number under treatment during the year
Discharged:
Recovered
Improved
Unimproved
Died
Total number under treatment June 30, 1908-
499
350
849
32
32
4
18
20
5
50
52
9
23
13
36
91
408
56
294
147
702
-
The above table shows a net increase in our population of twenty-seven
during the year. The total number of admissions is four less than during the
former year, while the discharges are twenty-three less. The deaths, thirty-six
in all, is a little more than four per cent of the whole number under treatment.
The majority of deaths were due to chronic diseases. Ten were due to
paresis. Five to general pulmonary tuberculosis. Seven to exhaustion
incident to their mental disease, and six to organic brain disease other than
paresis. Twelve patients have been deported during the year. Figuring the
number of recoveries on the number of first admissions, during the year, the
percentage is thirty-six and two-tenths per cent. I regret to report one death
from suicide. The cases of tuberculosis seem to have increased with us
during the past two years, and we are, at present, building a small tubercular
pavillion with canvas drop curtains for side walls. The buildings is connected
with our infirmary in such a way that, should the weather become too severe,
fhe beds may be run into the cottage. We have had a few cases of typhoid
tever, but, aside from this, we have been free from acute infectious diseases.
The medical work has been conducted along the same lines as last year.
20
PROCEEDINGS OF TRUSTEES
Regular meetings of the medical staff have been held, and I believe the
insane are receiving much more individual attention than ever before. Quite a
number of improvements have been made; such as an extension to the green
house, also the erection of a milk house, and a hennery, placing burlap on the
walls of the cottages, and steel ceilings have been put up in various places.
Our per capita cost has exceeded our per capita income considerably, but
this is largely due to the almost total failure of our farm crops last year. From
the legislative appropriations of last year, we are erecting an administration
building, and a cottage. When these buildings are completed our capacity
will be increased by one hundred. We have at the present time thirty eight
patients over our normal capacity.
Respectfully submitted.
E. H. CAMPBELL,
Medical Superintendent.
NORTHERN MICHIGAN ASYLUM,
Traverse City, Mich., July 16, 1908.
To the Joint Board of Trustees.
Gentlemen:—The movement of population at the Northern Michigan Asylum
for the fiscal year just passed was as follows:
Men.
Women. Total.
Census June 30, 1907
Admitted during the year
Discharged:
Recovered-Improved
Unimproved-
Died
Census June 30, 1908
-- 709
597
1306
148
105
253
857
702
1559
21
21
14
26
28
8
47
49
22
62
42
104
118
739
104
598
222
1337
From this table it may be shown that three and a half per cent of the whole
number under treatment were discharged recovered, three per cent improved,
one and a half per cent unimproved, and six and six-tenths per cent died.
The death rate while large, was not so great as that of the previous year,
notwithstanding a goodly number of aged people and patients suffering from
organic diseases were received. The deaths from tuberculosis were seventeen
and three-tenths per cent of the deaths from all causes;—a decrease of three
and a half per cent over last year. On the male side, where isolation was
imperfect, there was an increase in tuberculosis cases;—on the women's side,
where provisions for isolation were more perfect, the number of deaths from
tuberculosis was only half as many as last year. It would not be fair to assume
that this lessened death rate was due solely to better isolation, but it may be
assumed that it was princpally due to this cause. In this connection I may say
that during the last two or three years the amount of draperies, carpets, etc., on
the wards has been lessened, believing that they harbored germs and that the
OF ASYLUMS OF MICHIGAN
21
hospital would be more sanitary without them. It is possible that the absence
of these furnishings lessens, to a certain extent, the comfort of the patients,
but it certainly lessens the danger from infection from tuberculosis and other
germ diseases. On the men's side, during the last year, greater efforts than
ever have been made to isolate tuberculous cases. A part of Hall Six was set
apart for this purpose, and dishes of special coloring, and special bedding have
been furnished for the tuberculosis cases, that others could not be endangered
from the use of dishes or bedding used in the care of these patients. With the
instruction to the nurses, in the training school, relative to the care of tuberculous cases, a much better comprehension of the hygiene in the care of this
class of patients has been developed.
The financial statement of the receipts and disbursements of the institution
for the fiscal year has been placed in the hands of the Finance Committee.
The year just passed was a difficult one from a financial standpoint in some
ways. The cost of the up keep of the institution has been great, owing to the
fact that much of the heating plant had to be rebuilt, and the general repairs
were more than usual. The price of food supplies was higher than for years; but
if the cost of preparation of food is deducted, the cost per patient per day does
not much exceed the average of the last ten years. The change in the manner
of classifying accounts, which came into effect this year, makes exact comparison
of cost under separate ledger headings impossible; and it cannot be determined
exactly what the food stuffs cost per day in comparison with last year, since the
preparation and cost of foods are included in the same heading. I believe,
however, we may deduct three cents a day for preparation, which brings the
cost of food to about twelve and a half cents or thirteen cents per patient per
day. Greater stndy has been given to foods and their economic value than
ever before, and notwithstanding the high prices that have prevailed, neither
the quality nor the variety of food furnished to patients has been lessened, and
if anything the cooking has been better than in years gone by.
The general improvements have been great. At the greenhouse a new boiler
was installed. A portion of the greenhouse was destroyed by the falling of the
chimney during a tornado. This necessitated quite a large outlay. A large
percentage, however, of the cost of repairs has been' in connection with the
heating plant. The fact is, the entire heating system will have to be replaced
in the very near future.
During the year, a Stirling boiler, with automatic stoker, was installed, and
many changes effected in the boiler room. After the new boiler was installed
it was found that the hot-water pumps were too small, and consequently a new
pump had to be installed.
The extensions to the asylum are in process of construction. These
extensions have been designed with special reference to hospital purposes.
They will be provided with electric elevators,—with hydrotherapeutic rooms
and appliances,—with offices for stenographers and doctors, and with mortuary
rooms; in fact with every convenience of the up-to-date hospital. Separate
dining rooms are being constructed for each flat, on both the north and south
wings. By this means twelve dining rooms will be abandoned and converted
into dormitories. By these means the tranportation of food from the central
kitchen to the wards through cold corridors and elevators will be obviated. It
should be added that in these new buildings, diet kitchens will be Constructed,
so that special cooking may at all times be provided for the sick.
22
PROCEEDINGS OF TRUSTEES
An additional section has been built to the greenhouse, and you are cordially
invited to inspect it as well as all other parts of the institution.
I would respectfully report that a training school for nurses has been carried
on successfully, and marks a step forward in the care of the insane at this
hospital. I may add that the medical work has improved in quality, and much
of the obscurity of mental diseases has been cleared away, thanks to better
clinical methods and researches of psychiatric clinics and laboratories throughout
the world.
In this connection I would like to present a few words concerning "The
New Asylum." It seems to me that the last year has been the turning point
in asylum methods, and marks the advent of the hospital for the insane, in the
broadest sense of the word, in contradistinction to the asylum for the insane as
it has existed for so many years. The day has passed when a nervous or mentally sick person can be placed in an asylum, and his feeding, nursing and medical
treatment carried out in a perfunctory routine manner. Everything that
pertains to the patients' welfare must receive constant supervision from trained
men and women, which adds comforts immensely to the patient, at less cost to
the public and with immensely increased prospects of recovery. To accomplish
this requires trained physicians, skilled nurses, pleasing environment, hygienic
surroundings and the best of foods scientifically prepared; and all these things
with reference to the highest good of the individual. If the individual patient
receives such care, then the mass of patients will receive such care.
I would speak a moment of the medical work. Here, as in all other lines of
human effort, progress has been slow, but to demonstrate that progress, and
progress of very great value, has been made in the knowledge of mental diseases,
one need only to compare the written records of patients of ten years ago with
those of today. With the advent of the laboratory, a new era commenced in
psychiatry, and a great stride forward was taken for the relief and cure of
mental and nervous conditions. Many of you can bear witness to the fact that
it was hard to break away from the traditions of years; from the routine path
that had been followed so long, and take the new road science was carving out.
I remember when striving for the establishment of a laboratory at this institution that the question was immediately propounded, and with much force,
whether laboratory methods and other research work would enable the hospital
to cure more patients. An affirmative answer could not be positively given; it
could only be stated more recoveries should result. It can now be positively
asserted that more patients are restored to a comfortable degree of health than
ever before. Our records show that the net gain in patients for the last two
years has been fourteen and a half patients per year,—for the previous twenty
years and a half the average yearly net gain was forty-six and a half, and for the
last preceding biennial period there was a net gain of seventy-five and a half
patients per year. The saving to the state on the basis of the difference in the
averages given for twenty years and a half and the last two years, at $180 per
patient, was $5,760 per year, and over the last preceding biennial period it was
$10,980 per year, or almost enough to pay the salaries of the medical staff. I
am pleased to state that the number of insane women has decreased in the
district during the last two years, and so far as I know there is no insane person
awaiting admission to the institution. It may be said that these results are
accidental, but if we take into consideration the fact that the admissions to the
institution have increased, it is only fair to assume that such results are due to
better work on the part of the hospital. These results are extremely stimulat-
OF ASYLUMS OF MICHIGAN.
23
ing; and it is not believable that any one would seriously wish to hamper, or
abandon the work. I believe the value of the work will be still greatly enhanced
as time goes on. In addition to the methods in use, chemical pathology and
chemical research are beginning to take an important part in the diagnosis,
prognosis and treatment of many diseases, and they cannot be left out of
consideration in the work of the new asylum.
This new science promises brilliant results to the mentally afflicted. The
modern methods of the examination and treatment of patients, require much
more knowledge on the part of the physicians than formerly, and have led to
some changes in the mode of conducting the medical work. No attempt is
made to take the mental status of a case in longhand. The mental examination requires a stenographer, so that questions and answers may be recorded
verbatim. Anything less than verbatim reports of these examinations render
the work worthless from a scientific standpoint. Every physician on the staff
if not a shorthand writer himself, should be furnished a stenographer to assist
in his work and to write out the examinations. This has been done during
the last two years at this institution, with great advantage to the patients. It
has been stimulating to all of us to further and better efforts, and certainly
tends to increase our insight into the activities of the mind whether normal or
abnormal. This departure from the old way has been quite revolutionary. It
has led to the establishment on the hospital wards of an office for the examination of patients, and insures to every patient. not only a thorough examination immediately after admission, but it assures him of the friendship and
interest of the physicians in his recovery. These methods bring the staff in
very close relationship with the patients, brings out all that is best in them,
often enables the physician to give special direction to nurses, and often excites
a deep interest, in the patient himself, in the welfare of fellow-patients. The
trend at this hospital is to the establishment of regular hours of service for the
staff and for each physician to spend the time on the ward, or in the laboratory, as his work may necessitate. It is believed that in this way still better
results will be attained, and that our asylums will become hospitals: in fact
great centers for investigation and research work in psychiatry, and also centers
for instruction in mental and nervous diseases, that shall be open to physicians
and to all directly interested in the work.
The introduction of better clinical methods, and of the training school, has
brought about another important improvement in the institution, i.e., the
establishment of a domestic science department. The object of this department is not only to instruct nurses and others in the science of dietetics, but to
teach that intelligent, systematic supervision of the domestic duties in public
institutions means economy in the running expenses, and greater proficiency
in the performance of duty. It has already been found that this department
renders it possible to train workers to realize food values, to prepare wholesale
diet and serve it acceptably, and it has also taught that there are personaidiosyncrasies among the insane that must not be despised under any
circumstances. It has been found that the work already done has brought an
atmosphere of contentment among patients, and enthusiasm on the part of
employes; which is but the natural consequence of bringing these people into
touch with the achievements of scientific men and women by means of lectures,
bulletins, text books and other literature bearing on the science of not simply
nutrition, but hygienic living. We are quite sure that in this department
progress will be slow but certain, just as experience has taught that progress
24
PROCEEDINGS OF TRUSTEES
has been slow in all lines of asylum improvement. Young men and women
are glad to learn the best there is to be taught. Such knowledge lessens the
drudgery in household duties, it will produce more faithful service in the institution, and it will tell in the sick-room; and further it will educate home makerst
which is another item of value to the state, for whatever elevates the home raise,
the standard of good citizenship. Every person, whether patient or attendans
or worker in any department of the institution, when he leaves it, carries with
him a better, a higher standard of good living as a result of his training in the
hospital. I believe the day has forever gone when coarse foods, unskilfully
prepared, will be furnished, or that men and women who are uneducated and
untrained, will be allowed to care for people who are bereft of any part of their
senses.
I believe from these few remarks that you will gain some idea at least of
what I mean by "The New Asylum."
All of which is respectfully submitted.
JAMES D. MUNSON.
Medical
Superintendent.
STATE ASYLUM, Ionia, Mich.
Hon. Joint Board in session,
Gentlemen: In addition to the report to the Finance Committee, I herewith
briefly summarize some items pertaining to the Institution for the fiscal year
ended June 30, 1908:
Number of patients in the Institution at close June 30, 1907: males, 298;
females, 49; total, 347. Number of patients in the institution at close of June
30, 1908: males 320; females, 54; total, 374. Number admitted during the
year, 46. Discharged during the year, as follows: by death, 7; not insane, 1;
recovered, 8; improved, 2; eloped, 1; total, 19.
T^egular Employes and Salaries Paid.
HOW EMPLOYED
NO. OF
Clerk and Bookkeeper
Assistant Clerk
Stenographer
Interne
Atts., Male (Total, 19)
Supervisor
Ward Attendant
Ward Attendant
Ward Attendants
Ward Attendant
Ward Attendants
Atts.,'Female (Total, 7)
Supervisoress
Ward Attendant
Ward Attendants
Ward Attendants
Seamstress
1
1
1
1
PER YEAR
RATE
PER MONTH
$1200 00
$35 00,
30 00'
60 00
1
1
1
5
1
9
60 00
35 00
32 00
30 00
28 00
26 00
1
1
2
2
1
35 00
30 00
20 00
18 00
16 00
PER DAY
OF ASYLUMS OF MICHIGAN.
HOW EMPLOYED
NO. OF
PER YEAR
25
, RATE
PER MONTH.
Engineer
Fireman
Fireman
Carpenter
Painter
Launderer
Laundress
Laundress
Cook
Cook
Cook (Supt. Res.)
Housemaid (Supt. Res.)
Baker
Farmer
Assistant Farmer
Dairyman
Teamster
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Gardner
Nightwatchman
Nightwatchman
1
1
1
30 00
50 00
45 00
Nightwatchman
1
40 00
p£R DAy
$1000 00
40 00
35 00
$2 50
50 00
40 00
20 00
14 00
800 00
50 00
16 00
16 00
40 00
45 00
30 00
32 00
34 00
(Above taken from pay roll June 30, 1908, and shows less number attendants than average niontly pay roll.)
Total value of farm products for the fiscal year ending June 30, 1908, was
$6,641.33
O. R. LONG,
Medical Superintendent,
The report of Dr. C. R. Long was read by Trustee J. W. Belknap, who
added the following:
"During the past year we have made some improvements in our institution.
First, to our water system. Today we have wells with a flowage of thirty-three
gallons per minute. We have constructed a tank on the lower lands and we
force this water three thousand feet to a tank on the upland, and by gravity
we supply Our institution with water. We have put in during the past year a
refrigerating and ice plant, which I believe to be one of the most economical,
and best equipped of any institution in the country. It is capable of holding
all our meat, butter, eggs and all things necessary, at the proper temperature,
and is running smoothly without any expense except the electricity. Ten hours'
run of dynamo produces twenty-four hours of refrigeration. I invite an
inspection of the plant, and eventually I believe that all of our institutions will
be equipped in this manner. We are building this year a womans' building
from an appropriation of $40,000, and we are endeavoring to make it as near
fire proof as possible with wood floors. I believe our buildings of the future
should be fire proof and built for the future, not today. It is not economy to
build shabby buildings. I hope the buildings in the future will be built with a
view to permanency, and it will likewise be economy."
26
PROCEEDINGS OF TRUSTEES
Chairman: Comments on the preceding papers are now in order.
No comments.
Chairman: The next order of business will be the report of committee on
paper of Trustee Vinton, by E. C. Smith, Secretary of Board of Stewards,
chairman.
EASTERN MICHIGAN ASYLUM,
Pontiac, Mich., July 16, 1908..
To the Joint 'Board of Trustees.
Gentlemen—The paper on asylum purchases presented by President Vinton
to the Joint Board in January and referred to the stewards with instructions to
report at this meeting, has been the principal subject of discussion at the two
quarterly meetings of the stewards since that time. Papers have been presented and carefully discussed, and even while inspecting the institutions where
the meetings where held, as it is customary for us to do, to compare prices and
qualities of commodities purchased, the chief subject of conversation was along
the lines of this paper.
While there are differences of opinion among the different stewards on some
of the questions raised by this paper, on others there is a remarkable unanimity.
On the question of a central purchasing agency- there seems to be but one
opinion, especially since the convention of purchasing agents of all the
institutions in the state held at Lansing upon the call of the governor, where
these matters were very thoroughly discussed. Mr. Clark, at the instance of
Governor Warner, had visited and inspected all the state institutions, especially
with regard to their business methods, and when the superintendents, and
purchasing agents were convened at Lansing we had the benefit of his
experience and opinions gained in these institutions. Both he, and Governor
Warner oppose a central purchasing agency, but all seem to favor an occasional
meeting, such as that held at Lansing, of all the purchasing agents for the
purpose of consultation and comparison of methods. This would be simply an
enlarged copy of the system for many years in use by the stewards of the four
larger asylums, of meeting quarterly.
The paper under discussion has been divided under ten headings, and the
views of each of us upon each of the ten subjects has been tabulated, and the
tabular statement is presented herewith.
There are some radical differences in the views of different individuals as to
the methods of providing beef, clothing, and some other items, also on the
question of the use of butterine; but since there is a law at present on the
statute book forbidding the institutions to use it, there is very little likelihood
that any Michigan legislature can be prevailed upon to repeal that law for a
long time.
OF ASYLUMS OF MICHIGAN.
27
1 Is it better to purchase supplies in open market month by month or to make
contracts covering a long period?
MICHIGAN
ASYLUM
EASTERN ASYLLM
G e t quotations
on as many commodities as possible a n d g e t
them often; groceries, p r o v i sions, etc. every
month, B u t t e r
and E g g s every
Watch the markets closely, and
t a k e advantage
of favorable conditions; get bids
on coal only.
NORTHERN
ASYLUM
UPPER PENINSULA
HOSPITAL -
STATE PSYCHOPATHIC HOSPITAL
Would ask quotations and buy
on open market
when it would be
to the advantage
of the institution
to do so. Most
of the purchases
should be in
quantities for 3
months.
I believe it better to buy in
open market on
bids as far as pos
sible than by
contract with the
exception of coal
Contract for one
or two or three
months s u p p l y
after getting
competitive bids
2 What quality of meat ought Asylums to buy? Is it better to buy beef on the
hoof or dressed beef?
1
Buy young feeders and f a t t e n
them as rapidly
as possible.
Well meated not
too fat steers of
575 Ibs to 600 Ibs
Buy fat cattle
and slaughter, Or Would buy fat buy beef on hoof
buy dressed beef, cattleandslaugh- if r e a d y to kill
w h i c h e v e r i s t e r , when t o and near home.
cheapest. N o t an advantage to Would not be of
land enough to purchase in that advantage to us
to ship cattle in
fatten beef pro- form.
and feed' to fatfitably.
ten as is necessary at present.
Steers and Heifers of good quality more economical than cheaper
'
3 What quality of tea and coffee should we use?
Good quality, not
fancy. Same for
p a t i e n t s as for
officers and employes.
Good q u a l i t y .
Fix price and
have s a m p l e s
submitted at that
price; select the
best and buy it.
W o u l d always
get the best quality for the price.
We have found
a blend of our
own make the
best.
A good quality
but not a fancy
article for general use. Use a
better quality for
officers.
Fair grade which
will be consumed
not wasted, as it
will be if not
good.
4 What is the most economical kind of coal to use?
Smokeless -New
River, or Pocahontas.
C o n t r a c t for
units of heat and
pay according to
B. T. U. Calorimeter tests.
Quality of coal
must depend upon heating apparatus used.
We a r e using
traveling grates
or stokers and
can use a cheaper quality of coal
Owing to limited
e x p e r i e n c e in
coal burning can
not discuss this
intelligently.
Buy the coal that
will produce the
greatest number
of heat units to
the ton.
28
PROCEEDINGS OF TRUSTEES
5 What ought to be done about lumber combine?
Has had no difficulty in obtaining p r i c e s on
lumber.
Dealers and
Manufacturers
bid all right, but
Pontiac bidders
are almost a l wavs lowest.
Have no difficulty in obtaining
fair p r i c e s on
l u m b e r , especially when t h e
Manufacturers
are s e e k i n g a
market.
Do not have this
difficulty.
If present laws
a r e insufficient
amend the laws.
'
6 Would an occasional meeting of Asylums Stewards with those of other Institutions be ol value?
Y e s . Meetings
should be held ; The recent meeta-t frequent in- mg at Lansing
t e r v a l s and a | was proof of its
general consul- being of value.
tation take place
Emphatically,
Yes. Has been
u r g i n g it for
some time.
Recent meeting
at Lansing called
by the Governor
demonstrates the
great benefit of
such meetings.
7 What are the advantages of our present system over a Central Board for all?
'Our present system seems to us I ha-;0 seen but
T ,. .
. _, ,
to be far better l i t t l e of
the
Buffalo ^,
,•
£ ^
Advantages too Visited
,
, ,
than any central workings of the
n u m e r o u s t o Asylum and the board <, an . b e . Centra? B o a r d
mention. H a s Steward pointed From
knowl_
svst
j saw a
v i s i t e d many out many defects edge of Jthe cen ^ b l a n k e t bought
States that have m the Central f r a l board by t h e MinnesoBoards of Con- ; B o a r d system. tem {n w j s
ta Board at $2.00
trol and they do Governor \\ar- Iowa and ^ y ; tha{ was QQt as
not get best re- ner is opposed to j wou](l m o s t ; , good asMichigan
sults.
Central system. ce rt a inlv fa v o r asylums w e r e
continuing the ' buyng for $1.75
system we have.
Mr. J . B. Clark
after v i s i t i n g
every Institution
says a Central
Board would not
be as economical
as the present
system.
8 What is the best method of providing clothing?
Jielievesitis better for each Institution to make
its own clothing.
Believesit is better to buy men's
suits and overcoats.
Believe it is better to buy suits
and overcoats in
the market, selecting those best
adapted for purposes for which
t h e y a r e purchased.
Make the men's
. ,
, . ^
as much of women's apparel as
possible.
Buy
men's suits, overcoats etc , ready
made.
Make it or buy it
whichever is
cheapest for the
taxpayers.
9 Should the law be changed allowing Institutions to use butterine?
No, does not believe in substitutes of any kind.
Yes; would use
it if the law allowed, and save
taxpayers thousands of dollars
yearly.
Must say no, as
in buying creamery b u t t e r we
know about what
we are buying.
Yes; would use
it if permitted
to; for cooking
purposes. Butter
for table use.
Yes; Mr. Vinton
has shown that
it would save the
t a x p a y e r s $40,
ooo a year.
OF ASYLUMS OF MICHIGAN.
29
10 Suggestions relative to checking and auditing.
•
Likes the system
in use at Kalamazoo.
Have a system
of checking and
auditing in use
I-ikes the system at this institution
in nse at Pontiac many years and
believe it to answer our pu rpose well.
'
Our storekeeper
records in a book
the goods reed.
Billsare checked
and goods examined by steward.
The storekeeper
does not handle
t h e invoices.
Bills subject discount are vouchered and paid at
once. Other bills
approved by
Auditing Committee before being paid.
Advocates a uniform sv.stem of
c h e c k i n g and
auditing.
Very respectfully.
E. C. SMITH,
Secretary.
Chairman: The next order of business will be a report of committee on
papers of Trustee Cook and Wash burn, by Trustee Vinton.
Mrr. Chairman, Members of the Joint Board, Ladies and Gentlemen:
At the January meeting of the board we listened to some very important
papers, and Dr. Christian, in accordance with his often expressed opinion that
the excellent papers read before this board, in the past, had not been fully
digested and appreciated, made the following motion which was unanimously
adopted: "I move that the papers of Trustee Cook and Trustee Washburn
be referred to a committee of trustees which will report back to this board at
the next meeting, what action, if necessary, shall be taken on these papers."—
The chairman appointed to act on this committee: Trustees Vinton, C. E.
Belknap, J. W. Belknap, Quaintance and Case. Your committee has carefully considered these papers and believe that the paper read by Trustee Washburn, last January, and omitted from the printed reports of that meeting,
should be printed in the report of the July meeting of the joint board, and this
committee especially commands the attention of the board to the paragraph
referring (1) to the building of permanent structures, (2) the beautifying'and
improving of the grounds and (3) some sort of a club or library, etc., for the
attendants; and this committee recommends that all permanent buildings in
the f u t u r e should be of fire proof construction, that everything possible should
be done to improve and beautify the grounds, and that the board of each asylum
should do more for the amusement and recreation of the attendants.
Trustee Cook's paper we have taken up in detail. He says:
"Having the power to fix the rate of maintenance, how should we exercise
it? The law of 1905 attempted to lay down a method. As far as it applied to
the improvement and repair account, the Legislature undoubtedly intended to
extend our authority so that we would not have to get special appropriations for
30
PROCEEDINGS OF TRUSTEES
many small items which, it was thought, we would not charge to maintenance
account. Under that law we are allowed to make and charge to maintanance
all such improvements to buildings as do not amount to a new structure.
The authority given us to make repairs and improvements is very general.
We should all act under the authority, or we should all limit the authority to
the keeping of our buildings in repair as they are and go the Legislature for any
betterments to the plants, a position that the Legislature did not want us to take
or they would not have passed the law of 1905.
I am of the opinion that we
should make all improvements we can under the law and charge to improvement and repair account, and see to it that the rate of maintenance provides for
it."
This committee believes that every member of the joint board will realize the
importance and justice of this idea, and all boards act according to the above
suggestion.
He says: "To bring about uniformity it might be best to have the Insanity
law so amended that all requests for appropriations be passed on by the joint
board before being submitted to the Legislature. The trustees of the joint
board would certainly be qualified to act intelligently. They would refuse to
recommend appropriations when the expenditure should come from one of the
current funds, and the refusal would likely defeat the request.
If the joint board was directed to act on all of the appropriations and either
recommend or withhold its recommendation we could get the one advantage
that a single board of control would have, that is the limitation of the appropriations for additional room to the wants of the entire state, and the keeping
within reasonable limits other requests."
This committee is in sympathy with this suggestion, but feels that the board
of corrections and chatities now has general supervision ofQappropriations, and
further action by this board would only complicate the method of getting such
appropriations. The committee recommends that each board ask for only what
they absolutely need and be able to prove such need.
Mr. Cook says: "Returning to the subject of fixing the rate of maintenance.
The trustees, heretofore have not considered carefully the amount of cash on
hand the statements should show an June 30, of each year. When one of the
members of your finance committee attempted to persuade the governor and
the state board of auditors that we should be allowed forty-nine cents per day,
the statement came out very quickly that the institution he represented could
run at a loss of a cent a day and still have a good working balance, and the
statement was true.
"June 30 is not, in my opinion, the best day on which to estimate what the
cash balance should be. It is often thought best tojfill up the coal bins in the
fall and early winter to provide against blockades of any kind, and certain of the
food supplies are purchased in the fall for the winter and spring use. Our
asylum books always show that under normal conditions our per capita cash
outlay is larger the first six months. To determine then what the lowest cash
balance should be I would say that on December 31st there should be enough
cash in the treasury to meet the pay roll due January 1st, if the payment is to be
made before the 7th. If the pay roll is paid before the 1st, it should not be considered. Add to that amount such a sum as will pay all outstanding bills on
which there is a discount which must be taken advantage of before the 10th of
the month and you have all that you should have. Any monies that you have
above such a total first benefits your banks, and second the institution to the
OF ASYLUMS OF MICHIGAN
31
amount of interest the banker pays. Such benefits would hardly justify the
accumulating of a large working balance."
Your committee believes that the exact application of this idea would be impracticable and that each institution should have a cash balance on hand January 1, to carry on the business and take care of emergencies such as we have
met in the high prices of the past year. The cash balance on hand should be
enough to pay pay rolls and all bills for a month provided the state pays the institutions monthly or enough to pay the same items for a quarter, if the state
pays the institution quarterly, and in addition to these sums, cash balances on
hand should include five per cent, of the total expenses of the year to provide
for a rise in prices or other emergencies.
Mr. Cook says: "Our yearly financial statement perhaps should have a little
notice before I close. These statements have ever been a source of annoyance.
As chairman of your finance committee I have given much thought on the subject and have assisted in getting out blanks which I thought would provide for
sufficient data to enable the committee to make a close estimate on the per
capita cost of several institutions. The old form we know did not. When
they were in use, an institution could by increasing or decreasing supplies near
the end of the year and by holding out or anticipating bills, make the per diem
show very near the fixed rate. The printed reports did net show the net cost.
Under the new form I think we have arrived at more accurate results but yet
not entirely satisfactory. There has not been a year, since we changed the
form that all the asylums have made their reports to conform therewith.
Whether the bookkeeper in making the report could not understand the blank
or thought it was of little account, I am unable to say. The repeated action
of the board directing that they should be filled out seems to have been of no
avail.
"I realize that with the reports properly made it is impossible to get an
accurate balance from which we could figure the exact cost of maintaining a
patient. To some extent we are obliged to rely on annual inventories of supplies and materials on hand. The inventories are made by different persons
and in a different way. There is always some loss and there are some profits.
The estimating of these will vary somewhat. But allow all those slight variations, yet the report should be near enough to use as a basis in fixing the
rate.
"The form of the report doubtless can be improved upon and the finance
committe would gladly receive suggestions to that end. It is important, however, that whatever form is sent out by the finance committee should be fully
and accurately filled out. If there are any deductions to be made not provided
for or qualifications to be considered let them be in a supplementary report."
Your committee believes that the finance committee has achieved admirable
results in the new form of statements and that each institution should fill out
the accepted form of blanks in exactly the same manner. We recommend
that in order that this matter should be fully understood and that all figures
should be made on the same basis, the finance committee send an expert
accountant to all the institutions or that the accountants of all the institutions
meet with the finance committee soon, on a date to be set by the chairman of
the finance committee, for instruction and consultation. The finance committee
to be empowered to make any necessary changes and put them into immediate
effect.
32
PROCEEDINGS OF TRUSTEES
Your committee earnestly recommends the serious consideration of these
matters by the joint board.
G. Jay Vinton.
Chairman..
J. W. Belknap.
M. F. Quaintance.
Fred S. Case.
Committee.
Chairman: The report will be accepted if there are no objections.
Trustee Mills: I move that the recommendations contained in the paper be
adopted. Motion supported and carried.
Chairman: It will be next in order to fix the rate of maintenance for the
ensuing year. We will hear from the finance committee.
Trustee Cook: The finance committee had a lengthy session last evening
and compared the cost of maintenance at the different institutions and found it
to be as follows:—Kalamazoo 48.01 cents, Pontiac 51.77 cents, Traverse City
50.93 cents, Newbury 54.25 cents; and Ionia including the officers' salaries
50.81 cents. Your finance committee by unanimous vote recommend that
the rate of maintenance for the asylnms of the lower peninsula be fixed at
fifty cents per day, and in addition thereto the cost of clothing, expense of
returning patients home and elopement expenses; and for the upper peninsula
hospital for the insane that the rate be fifty-two cents per day, and in addition
thereto the cost of clothing, expense of returning patients home and elopement
expenses.
Trustee Mills: I move that the report of the finance committee be adopted,
and that the secretary of the joint board be directed to notify the governor of
said action, as required by law. Motion supported and carried.
Chairman: The next order of business will be the reports of committees.
The first is the Committee on the Psychopathic Hospital with Trustee Cook as
chairman.
Trustee Cook: I was not aware that there was any report due from the
Psychopathic Board at this time. Originally the report was made by a joint
committee, and then I think the committee reported from one meeting of the
Joint Board to another. Under the new law they are elected for one year,
and I think a report is not due from that board until the end of the year. Dr.
Barrett is not present today on account of his absence from the country. I
wish to express my appreciation for the kindly reference made to the work in
the Superintendents' reports.
Chairman: The next committee is on Uniformity of Classification of official
reports, Dr. E. A. Christian, chairman.
Dr. Christian: This Committee has already reported to the Joint Board the
adoption of one table. No further progress has been made in the matter, owing
to the absence of the Director of the Psychopathic Ward, who is now in
Europe. The committee will have to be continued. The committee has one
suggestion: We note there is a scarcity of copies of the report allowed each
institution by statute. Five hundred copies go to each institution. The
number of institutions for the insane in the country is steadily increasing, which
calls for a larger exchange list. There are over two hundred institutions in the
country now that we wish to exchange with, besides there are many individuals
who are interested along these lines, libraries and organizations of various kinds,
who desire the report. We feel that each institution should be allowed a
OF ASYLUMS OF MICHIGAN
33
sufficient number to distribute to the employes, especially those of long service.
We therefore request of the Joint Board that this matter be considered with a
view to securing an amendment to the statute which will allow a larger number of the reports so each institution.
Chairman: The report will be referred to the Committee on Legislation.
The Committee on legislation will bear in mind the suggestion made by Dr.
Christian, and take the matter up at the proper time.
Chairman: The next will be a report from the Committee on Legislation, •
Trustee A. J. Mills, chairman.
Trustee Mills stated that there was nothing to report at this time.
Chairman: The next in order is miscellaneous business, At this time we
shall fix the salaries of the officers. The secretary will please call the roll of the
asylums, and the reports will be made. ,
The chairmen of the various asylums presented the following salary tables
for officers for the ensuing year:
MICHIGAN ASYLUM.
Medical superintendent Assistant medical superintendent
First assistant physician
Second assistant physician - -- —
Third assistant physician
Fourth assistant physician-Woman physician
Steward
Chaplain.. ..
....
—
$3,500.00 with maintenance
2,000.00
- - - 1,800.00
1,800.00
- - 1,300.00
800.00 "•
800.00 "
2,500.00 without
250.00 non-resident
EASTERN MICHIGAN ASYLUM.'
Medical superintendent —
Assistant superintendent First assistant physician--•
Second assistant physician
Third assistant physician
Fourth assistant physician
Woman physician-—
Steward - - -'
Chaplain $5.00 for each service.
— —
-•--
Non-resident
$3,500.00 with maintenance
, 2,000.00
1,200.00
1,000.00
800.00
700.00
900.00
1,800.00 without
.
UPPER PENINSULA HOSPITAL FOR THE INSANE.
Medical superintendent - —
Assistant superintendent —
Assistant physician
Assistant physician (Woman)
Steward
Chaplain
-
$3,000.00 with maintenance
1,800.00
1,000.00
1,000.00
1,800.00 without
260.00 non-resident
NORTHERN MICHIGAN ASYLUM.
Medical Superintendent
Assistant superintendent
-First assistant physician
Second assistant physician (Woman)
$3,500.00 with maintenance
2,800.00 without
1,600.00 with
1,200.00
34
PROCEEDINGS OF TRUSTEES
Third assistant physician
Fourth assistant physician
Fifth assistant physician
Steward
Chaplain
1,200.00
1,200.00
800.00
1,800.00
260.00
with maintenance
without
with
without
non-resident
Report accepted and placed on file.
Moved and carried that the officer's salaties of the several asylums be approved
as presented.
Trustee Mills: At this time and under this head, I submit the following for
consideration of the board, and move its adoption: That it is the sense of
this board that the words "Asylum for the Insane," as applied to the Michigan
Asylum, State Asylum, Eastern Michigan Asylums, and Nothern Michigan
Asylum be dropped; that the words "Hospital for Mental and Nervous
Diseases," be substituted; and in regard to the Upper Peninsula Hospital for
the Insane, that the words "For the Insane," be dropped and that the words
"For Mental and Nervous Diseases," be substituted. And that the Legislature be asked to sanction this change, in order to get rid of the words "Insane
Asylum."
Dr. Noble: To make it more brief, how would it be to leave out the words
"For Mental and Nervous Diseases?"
Dr. Christian: I think we have got to come to this in time. I believe in
natural response to public s e n t i m e n t we have got to adopt the word
"Hospital." I think the change should come with little hinderance to our
bookkeeping, etc., and I sanction Dr. Noble's suggestion. I would like to see
a system adopted like that in use in New York state. Why not in speaking of
the Kalamazoo Asylum, say the Kalamazoo State Hospital, or the Pontiac
State Hospital, etc.
Trustee Mills: I think that is a good suggestion.
Trustee Voorheis: Would that name be at all misleading to people? It
would be a state hospital, but would not the people think it was for other
things than mental and nervous diseases,—otherwise I think the abbreviation is
all right.
Trustee Mills: I move that this be referred to the committee on legislation for report at the next meeting. Motion supported and carried.
Trustee Vinton: I ask that the legislative committe be allowed to introduce
a law whereby any part of the minutes or any important papers of the joint
board may be printed. Motion supported and carried.
Trustee Mills: I move t h a t the committees of the joint board be
continued. Motion supported and carried.
Trustee J. W. Belknap: In behalf of the management of the state asylum,
I would invite the joint board to meet with us at the January meeting.
Chairman: You have heard the invitation as presented to the board.
What is your pleasure?
Trustee Mills: I move that it be accepted. Motion supported and carried.
There being no futher business to come before the joint board the meeting
adjourned.
A. S. ROWLEY,
Secretary.
OF ASYLUMS OF MICHIGAN
35
TRAVERSE CITY, MICH.
To the Honorable Fred M. Warner, Governor:
You are hereby respectfully notified that at the meeting of the Joint Board
of Trustees of the several asylums for the insane, of this state, held at the
Northern Michigan Asylums for the Insane pursuant to law, on the sixteenth
day of July, inst., the rate of maintenance for the ensuing year was fixed as
follows:
For the asylums of the lower peninsula the rate fixed is fifty cents ($.50)
per day, and the charge per week perscribed is three dollars and fifty cents
($3.50), and in addition thereto the cost of clothing, elopement expenses and
expenses of returning patients home.
The rate for the Upper Peninsula Hospital for the Insane was fixed at fiftytwo cents ($.52) per day, and the charge per week prescribed is three dollars
and sixty-four cents ($3.64), and in addition thereto the cost of clothing,
elopement expenses and expenses of returning patients home.
And the Secretary was directed to notify you thereof as required by law, and
this notice is given in accordance therewith.
Dated July 16, 1908.
A. S. ROWLEY,
Secretary.
STATE OF MICHIGAN,
COUNTY OF GRAND TRAVERSE
A. S. Rowley, being sworn, says that on the 16th day of July, 1908, he
served Hon. Fred M. Warner, as governor of the State of Michigan, a notice of
which that hereto attached is a true copy, delivering the same to him personally
at the Northern Michigan Asylum for the Insane on said day.
A. S. ROWLEY
Subscribed and sworn to before me this sixteenth day of July,
1908.
A. L. WHITNEY,
Notary Public.
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