cash in treasurer's hands, Nov. 30, 1864,....

5,998 58

$126,637 10

FRED'K W. CURTENIUS,

Treasurer.

Treasurer's Office, Dec. 1st, 1864.

CERTIFICATE OF AUDITING

COMMITTEE.

We have carefully examined the foregoing statements of Frederick W. Curtenius, Treasurer of the Asylum. We have compared the same with his books and vouchers, and verified the same by a still further comparison with the books of the Steward, and hereby certify to the entire correctness thereof.

DANIEL L. PRATT,
W. BROOKS,

C. W. PENNEY,

Auditing Committee.

REPORT OF THE MEDICAL SUPERINTENDENT.

To the Board of Trustees of the Michigan Asylum for the Insane:

GENTLEMEN-The accompanying tables, arranged from our records, exhibit the operations of the Institution during the biennial period, closing November 30, 1864:

The largest number of patients under treatment on any one day was 182. The daily average has been 174. The rated capacity of those portions of the Institution now in use, is 120; we have, consequently, had under treatment during the entire two years, 54 patients beyond our capacity.

The condition of those discharged was as follows:

Although the claims of the insane to the special care and treatment they have been found to require, was many years

since duly recognized and acknowledged in this State, it is but five years since an institution was opened, and then with such limited capacity as scarcely to meet one-third of the demand upon it. The fact is, that this State has been, and still is, largely in arrears in the discharge of its obligations to this class, and in obedience to natural and invariable laws, is suffering severely from the neglect. This failure to secure prompt medical treatment, of the character universally acknowledged to be required in this particular disease, has resulted as it always does, in the accumulation of a large number of incurable insane, to be maintained somewhere during the remainder of their lives a fact of which any one will be fully satisfied, by referring to the returns of the census, which, imperfect and incomplete as they are, clearly show that such has been the result in our State.

Although the larger number of this class are now in the county poor-houses and jails, still, many have been forced into the Asylum, to the exclusion of recent and curable cases. They have occasionally been received when the condition of the wards rendered their admission a matter of no inconvenience; but they have generally come to us under circumstances which absolutely compelled us to provide for them. We have from time to time discharged as many of this class, and as rapidly as seemed prudent, and still have, at no time, been able to provide for more than one-third of those desiring admission. To this circumstance, in addition to the embarrassment, discomfort and unpleasantness it entails, is attributable the small number of admissions and discharges. Nothing can more forcibly demonstrate the necessity of the early completion of the entire Institution, and until this is accomplished, our capacity for usefulness must continue sadly restricted.

Through ignorance of the arrangements of Asylums and the classification so essential to successful treatment, county officers and private individuals are frequently led to make and urge suggestions which are altogether impracticable. They imagine that if there be a vacant bed in the Institution, it can

of course be appropriated to the use of the particular patient in whom they are interested, irrespective of disease or condition. Though aware that individuals in health are sometimes unpleasantly affected by intercourse with the violently deranged, it does not occur to them that the shattered nerves of their patient requires any special consideration. To surround a timid, apprehensive individual, trembling under a monomania of fear and distrust, or one of those more frequent cases of religious depression and gloom, with the noise and violent language of the more disturbed, would be a most exquisite torture, and to expect recovery with such associations would be preposterous.

In larger institutions, with abundant means for more extensive classification, no difficulty is experienced; but to meet all the requirements in this direction, of nearly two hundred patients of both sexes, in but eight wards, and all densely crowded, is impossible. It therefore often becomes necessary to defer the admission of certain patients for this reason alone, even though there may be at the time a vacant bed; and for the same reason, we cannot always oblige county officers in the reception of a particular patient in the place of some other whom it is proposed to remove. Hence, too, the absolute impossibility of relieving the Institution by the enactment, as has been proposed, of a law excluding those who have been insane a certain length of time.

Thus far in our efforts to create vacancies for more recent and urgent cases, no patient has been returned to county poorhouses, unless sufficiently improved, or in a condition to be comfortably cared for with the usual appliances of such buildings. If violent and destructive, or inclined to injure himself or those about him, we have hitherto been able to meet the wishes of the officers and retain him. Henceforth, however, without an increase in our accommodations, these circumstances cannot be taken into consideration. This is a matter of great regret to us, and will prove very embarrassing to county officers, since limited number of this class, even three or four, returned

a very