PROCEEDINGS 
- OF THE - 
Thirty-Ninth Annual Meeting 
- OF THE - 
feociatioq s IV edical Superintendent 
- OF - 
American Institutions for the Insane, 
- HELD AT - 
UH IT ED STATES HOTEL, JI. Y. 
JUNE 16th, 1885. 
REPRINT FROM 
THE ALIENIST AND NEUROLOGIST, 
z St. Louis, October, 1885. PROCEEDINGS 
OF THE 
THIRTY-NINTH ANNUAL MEETING 
OF THE 
AssociaiionofMBdicalSwintenileDis 
OF 
AMERICAN INSTITUTIONS FOR THE INSANE, 
Held at the United States Hotel, Saratoga, New York, 
June 16, 1885. 
Reprint from 
The Alienist and Neurologist, 
St. Louis, Oct., 1885. PROCEEDINGS 
OF THE 
THIRTY-NINTH ANNUAL MEETING OF THE 
ASSOCIATION OF MEDICAL SUPERINTEN- 
DENTS OF AMERICAN INSTITUTIONS 
FOR THE INSANE. 
The Thirty-ninth Annual Meeting of the Association 
was called to order by the President, Dr. Pliny Earle, at 
io o'clock A. M., June 16th, 1885, at the United States 
Hotel, Saratoga, New York. 
In the absence of the Secretary, Dr. C. F. MacDonald 
was appointed Secretary pro tern. 
The reading of the minutes was postponed for the 
present. 
Dr. Gray, from the Committee on Business, made a 
verbal report. 
At this point the Secretary entered and took his place. 
On motion of Dr. Gray the physicians of Saratoga 
were invited to attend the sessions of the Association. 
The following members were present during the 
sessions of the Association : 
J. B. Andrews, M. 1)., Buffalo State Asylum for the Insane, Buffalo, 
New York. 
J. P. Bancroft, M. D., Concord, New Hampshire. 
J. W. Barstow, M. D., Sanford Hall, Flushing. New York. 
W. J. Bland, M. D., Hospital for the Insane, Weston, West Virginia. 
J. E. Bowers, M. D., Hospital for the Insane, Rochester, Minnesota. 
J. P. Brown, M. D., Taunton Lunatic Hospital, Taunton, Massachusetts. 
P. Bryce, M. D., Hospital for the Insane, Tuskaloosa, Alabama. 
11. A. Buttolph, M. D., Short Hills, Essex Co., New Jersey. 
J. H. Callender, M. D., Hospital for the Insane, Nashville, Tennessee. 
John B. Chapin, M. D., Pennsylvania Hospital for the Insane, Philadelphia, 
Pennsylvania. 
R. C. Chenault, M. D., Eastern Lunatic Asylum, Lexington, Kentucky. 
Walter Channing, M. D., Brookline, Massachusetts. 
Daniel Clark, M. D., Asylum for the Insane, Toronto, Ontario. 
3 4 
Proceedings. 
Edward Cowles, M. D. McLean Asylum, Somerville, Massachusetts. 
John Curwen, M. D., State Hospital for the Insane, Warren, Pennsylvania. 
A. N. Denton, M. D., Hospital for the Insane, Austin, Texas. 
Joseph Draper, M. D., Asylum tor the Insane, Brattleboro, Vermont. 
Pliny Earle, M. D., Northampton Lunatic Hospital, Northampton, Massa- 
chusetts. 
O. Everts, M. D., Cincinnati Sanitarium, College Hill, Ohio, 
A. M. Fauntleroy, M. D., Western Lunatic Asylum, Staunton, Virginia. 
C. M. Finch, M. D., Asylum for the Insane, Columbus, Ohio. 
Theo. W. Fisher, M. D., Boston Lunatic Hospital, Boston, Massachusetts. 
T. M. Franklin, M. D., New York City Lunatic Asylum, Blackwell's 
Island. 
J. Z. Gerhard, M. D., Pennsylvania State Lunatic Hospital, Harrisburg, 
Pennsylvania. 
H. A. Gilman, M. D., Hospital for the Insane, Mt. Pleasant, Iowa. 
W. B. Goldsmith, M D., Danvers Lunatic Hospital, Danvers, Massachusetts. 
John P. Gray, M. D., State Lunatic Asylum, Utica, New York. 
W. B. Hallock, M. D., Cromwell Hall, Cromwell, Connecticut. 
G. H. Hill, M. D., Hospital for the Insane, Independence, Iowa. 
Edwin A. Kilbourne, M. D., Northern Illinois Hospital for the Insane, 
Elgin, Illinois. 
C. W. King, M. D., Asylum for the Insane, Dayton, Ohio. 
J. D. Lomax, M. D., Marshall Infirmary, Troy, New York. 
S. B. Lyon, M. D., Assistant Physician, Government Hospital for the 
Insane, Washington, D. C. 
Carlos F. MacDonald, M. D., State Lunatic Asylum, Auburn, New York. 
H. P. Mathewson, M. D., Hospital for the Insane, Lincoln, Nebraska. 
C. A. Miller, M. D., Longview Asylum, Carthage, Ohio. 
T. J. Mitchell, M. D., Lunatic Asylum, Jackson, Mississippi. 
James D. Munson, M. D., Assistant Physician, Eastern Michigan Asylum, 
Pontiac, Michigan. 
P. L. Murphy, M. D., Lunatic Asylum, Morganton, North Carolina. 
C. H. Nichols, M. D., Bloomingdale Asylum, New York City. 
Geo. C. Palmer, M. D., Asylum for the Insane, Kalamazoo, Michigan. 
H. K. Pusey, M. D., Central Lunatic Asylum, Anchorage, Kentucky. 
C. A. Bice, M. D., Lunatic Asylum, Meridian, Mississippi. 
A. B. Richardson, M. D., Asylum for the Insane, Athens, Ohio. 
S. H. Rogers, M. D., Assistant Physician, Insane Asylum, Raleigh, North 
Carolina. 
F. E. Roy, M. D., Lunatic Asylum, Quebec, Canada. 
Ira Russell, M. D., Winchendon Highlands, Massachusetts. 
B. T. Sanborn, M. D., Hospital for the Insane, Augusta, Maine. 
John W. Sawyer, M. D., Butler Hospital, Providence, Rhode Island. 
S. S. Schultz, M. D., State Hospital for the Insane, Danville, Pennsylvania. 
A. M. Shew, M. D., Hospital for the Insane, Middletown, Connecticut. 
Henry P. Stearns, M. D., Retreat for the Insane, Hartford, Connecticut. 
J. T. Steeves, M. D., Provincial Lunatic Asylum, St. John,New Brunswick. 
W. H. Stokes, M. D., Mount Hope Retreat, Baltimore, Maryland. 
J. Strong, M. D., Asylum for the Insane, Cleveland, Ohio. Proceedings. 
5 
Selden H. Talcott, M. D., State Homoeopathic Asylum for the Insane, Mid- 
dletown, New York. 
A. J. Thomas, M. D., Assistant Physician, Hospital for the Insane, Indian- 
apolis, Indiana. 
H. Wardner, M. D., Southern Illinois Hospital for the Insane, Anna, 
Illinois. 
J. W. Waughop, M. D., Hospital for the Insane, Fort Steilacoom, Wash- 
ington Territory. 
P. M. Wise, M. D., Willard Asylum for the Insane, Willard, New York. 
Dr. Shew introduced to the Association Rev. Samuel 
G. Willard, Secretary of the Board of Trustees of the 
Connecticut Hospital for the Insane. 
Dr. Palmer introduced to the Association Dr. Foster 
Pratt, Trustee of the Asylum for the Insane at Kalamazoo, 
and Mr. W. G. Vinton of Detroit, President of the Board 
of Trustees of the Eastern Michigan Asylum. 
All of these gentlemen were invited to take seats with 
the Association. 
On motion of Dr. Gray, Dr. Foster Pratt was elected 
an Honorary Member of the Association. 
On motion of Dr. C. F. MacDonald, Dr. Stephen 
Smith, Commissioner of Lunacy of New York, was elected 
an Honorary member of the Association. 
The Secretary read a letter from Dr. Hurd, regretting 
his inability to attend this meeting and stating that Dr. 
James D. Munson would represent the Institution. 
The Secretary also read the following letter received 
by the President, Dr. Earle, from Dr. D. Hack Tuke: 
Lyndon Lodge, Hanwell W., June 2,1885. 
Dear Mr. President:-A distinguished member of your Association, 
in writing to me the other day, expresses a hope that I and some other 
English alienists may be present at your meeting. 1 can only speak for 
myself in saying that, had it been possible, it would have afforded me the 
greatest pleasure to comply with the kind wisli so expressed. I cannot, 
however, do less than express on paper what, bad I been present, 1 
should have endeavored (however inadequately) to convey to my 
American friends my sense of their most kind and hospitable welcome 
during my visit last year to the Hospitals for the Insane in the United 
States. Some may have read my impressions of what I saw in your 
country, and will have recognized how mucli I appreciated many of the 
features of those institutions, and the services rendered to humanity by 
the medical superintendents of asylums. Allow me to repeat here my 6 
Proceedings. 
good wishes for the success of the endeavors made to advance the 
interests of the insane, and to assure you that I shall always retain a 
grateful sense of the kindness of my American confreres. Wishing you a 
very successful meeting, I remain, Yours, very truly, 
D. HACK TUKE. 
The Secretary then read a letter from the Board of 
Trustees of Eastern Kentucky Lunatic Asylum, inviting 
the Association to meet in Lexington, Kentucky, which 
was referred to the Committee on Time and Place of Next 
Meeting. 
Dr. Kilbourne : Mr. President-If this is the proper time I would 
like to extend a very cordial invitation to this Association to hold its next 
annual meeting at the city of Chicago. Elgin is distant but thirty-five miles 
from Chicago, about an hour's run; and Kankakee only a little farther 
removed. I hope the Association will look favorably upon this request, 
and in advance of their action, I promise the members, should their choice 
be Chicago, that we will give them a cordial western welcome. I move, 
sir, that this invitation be referred to tlie appropriate committee for 
consideration and report. 
The motion was adopted. 
On motion of Dr. Schultz, the courtesies of the 
Association were extended to Dr. A. J. Ourt, Secretary 
of the Committee on Lunacy of Pennsylvania. 
The Secretary then read the minutes of the last 
meeting, which were adopted. 
The Secretary read letters from Drs. Carriel and 
Godding expressing their regret that they could not 
attend this meeting. 
The President announced the following Standing 
Committees: 
On Nominations : Drs. Gray, Schultz and Bryce. 
On Time and Place of Next Meeting: Drs. Draper, 
Mitchell and Kilbourne. 
To Audit the Accounts of the Treasurer: Drs. 
Clark, Franklin and Chenault. 
On Resolutions: Drs. Chapin, Fauntleroy and Shew. 
On motion, a recess was taken for fifteen minutes. 
On re-assembling, the Secretary read the following 
report: 
The Committee on Business respectfully report that the sessions of Proceedings. 
7 
Tuesday and Wednesday be devoted to the reading of papers. On 
Thursday, an excursion to Ticonderoga and down Lake George; in the 
evening, hold a meeting for business. On Friday, that the sessions be 
devoted to the reading of papers. 
On motion, the report was adopted. 
The Committee on Nominations made the following 
report: They would recommend for President, Dr. O. 
Everts; for Vice President, Dr. H. A. Buttolph; and for 
Secretary, Dr. John Curwen. 
On motion of Dr. Nichols, it was 
Resolved, That the report of the Committee be accepted, and that its 
acceptance carry with it the nomination just made. 
Dr. Kilbourne: Inasmuch as I preferred the request to have the 
Association hold its next annual meeting at Chicago, and Dr. Chenault 
on behalf of his Board of Trustees has preferred a similar request for the 
Association to go south to Lexington, I think I could not do less in 
courtesy to him than to ask that my name be withdrawn from the 
Committee on Time and Place of next meeting, and some disinterested 
member appointed in my place. I now, therefore, ask that this action be 
taken by the Association. 
Dr. Earle : Dr. Kilbourne requests to be excused from the com- 
mittee named, and gives a very proper reason for it. I will therefore 
appoint Dr. Catlett, of Missouri, on the committee in Dr. Kilbourne's place. 
The President then read his address, at the conclusion 
of which he introduced to the Association, Dr. O. Everts, 
President-Elect, who said: 
Gentlemen, I have but a word of thanks. To be appointed to this hon- 
orable position is more than I have aspired to. To be worthy of it is as 
high as any of us can aspire. I thank you sincerely for the honor conferred. 
On motion, the Association adjourned to 3 o'clock P. M. 
The Association was called to order at 3:30 P. M., by 
the President, Dr. Everts. 
Dr. Curwen stated that he had a copy of the notices 
of the original thirteen members with photographs of 
each member, and if any one wished a copy he would 
please notify him of his wish. 
Dr. Curwen then read the biographical memoir of Dr. 
Kirkbride, prepared by direction of the Asociation. 
Dr. Everts: The next business in order will be the report of the 
Committee of Necrology. 8 
Proceedings. 
Dr Richardson: Mr. President-I am not chairman of the com- 
mittee, but I was informed about three weeks ago by Dr. Grissom, that he 
would not be present, and that I would be expected to make a report for 
the committee. Dr. Cowles is on the committee with me, and in the 
length of time previous to my departure from home, I was not able to 
consult with him. From what I can gather from the members, there was 
only one death during the year, Dr. Reed of Dixmont. If I had had the 
time to consult on the subject, I would have pursued a different course, 
and had some one more intimate with Dr. Reed, write a memoir of him. 
I secured what I could from the family, and have written a short 
memorial. But I would make this request: that members of the 
Association who knew him better than myself, and who have been 
connected with the Association for many years, supplement this by 
further remarks, particularly those long acquainted with his relations to 
the Association, of which I comparatively know nothing. 
Dr. Richardson then read the memoir: 
Joseph Allison Reed, M. D., of Dixmont, Allegheny County, Penn., 
was born in Washington, Penn., December 31st, 1823. He died November 
6th, 1884. Dr. Reed's grand-parents were among the early settlers of 
Pennsylvania. His father, Mr. James Reed, of Washington, Penn., was of 
Scotch descent, a silversmith by occupation, and developed a remarkable 
talent for mechanics. 
Dr. Reed was the third son of a family of ten children. In 1849, his 
father removed to Pittsburgh, where he resided till his death in 1878. He 
was much beloved for his piety and many estimable qualities, and gave to 
his children careful and valuable training, the results of which are seen in 
the high character and noble purpose of the subject of this sketch. 
At the early age of thirteen Dr. Reed entered Washington College, 
from which he graduated with the degree of Bachelor of Arts at the age 
of nineteen, receiving the degree of Master of Arts, in course, three years 
later. He was a diligent student. In his twentieth year he commenced 
the study of medicine, under the tutorship of Dr. Julius Le Moyne, of 
Washington, Penn. He attended a course of lectures at the University of 
Pennsylvania, Philadelphia, and a three years' course at the Jefferson 
Medical College, from which he graduated in the year 1847, being then 
twenty-four years of age. He removed to Allegheny City the same year 
and commenced the practice of his favorite profession, which he pursued 
in that city for ten years. He speedily developed an excellent reputation 
in the treatment of nervous and mental diseases, for which he appears to 
have had an especial taste from the commencement of his professional 
career. During his residence in Allegheny City he was, for three years, 
physician to the Western Pennsylvania House of Refuge, and for two 
years, visiting physician to the Insane Department of the Western 
Pennsylvania Hospital, at Pittsburgh. Here the qualities which have 
characterized him through all the years of his connection with the insane 
became early prominent. His sympathetic nature was touched by the 
condition in which he found the unfortunate beings confined in that 
department, and he set to work with his usual energy to assist them. Proceedings. 
9 
His interest, and the success following it, caused him to be elected by the 
Board of Managers, in 1857, to take charge of the institution. He found 
the hospital with but twenty-three inmates and eight thousand dollars in 
debt. He induced a number of leading business men to take an interest in 
the institution; secured from them liberal contributions, and was enabled 
within a short time to put it on a sound financial footing. 
He was also one of the leading spirits in the movement to induce the 
legislature to build another hospital, especially for the insane, and on an 
improved basis. The result of his efforts in tins direction was the opening, 
in 1862 of the Hospital for the Insane at Dixmont. He was placed in 
charge and remained as its worthy head until death. This hospital is his 
monument, and its success and high standing are the evidence of his 
assiduous care and thorough attention to every feature of its welfare. 
Dr. Reed was a member of the American Medical Associaton. the 
Association of Medical Superintendents of American Institutions for the 
Insane, the American Academy of Medicine, and the State and County 
Medical Societies. 
He was consulted by the State authorities on all subjects relating to 
the care of the insane; was a member of the commission to build the State 
Hospital for the Insane at Danville, and was appointed by Governor 
Hoyt, a commissioner to investigate and report upon the laws of the 
State relating to the insane and assisted in framing the present lunacy law. 
He was the delegate from the State to the National Conference of Charities 
and Correction, held at Madison, Wisconsin, in 1882. 
He was a member of the Presbyterian Church, presided at the Board 
of Deacons of the church to which he belonged and an earnest and 
conscientious Christian. His life was an example of the Christian virtues. 
His respect for the Sabbath and his implicit confidence in the wisdom of 
an AU-Wise Providence-were characteristics of his religious experience. 
These were impressed upon all about him by the sincerity with which he 
lived them. For many years he conducted religious services in the chapel 
of the institution, until authorized by the Legislature to employ a minister, 
and was a firm believer in the value of religious instruction in the care of 
the insane. 
Dr. Reed was married October 3,1848, to Miss Eliza J. Hay, of Troy, 
New York, who died August 11,1858, leaving two children, James H. Reed 
and Mrs. Clara E. Hengst. On November 13,1860,he was again married to 
Miss Mary F. Fahnestock, daughter of Dr. W. M. Fahnestock of Borden- 
town, New Jersey, who survives him with four children: Sarah F., Fanny 
H., Joseph Allison and William F. Reed. In his domestic relations he 
was a faithful exponent of the principles which controlled him in all 
things. Kind and loving, indulgent as a father, and faithful to all trusts 
his situation imposed. His chief characteristics were patient devotion 
and indomitable energy. He was controlled by high and unswerving 
principles, and let nothing influence him to step aside from the path of 
duty which he had marked out for himself. He had a wonderful execu- 
tive capacity, and was possessed of a peculiarly fascinating presence, by 
which all who met him were drawn toward him irresistibly. In his 
administration of the trust imposed upon him, he was particularly noted 10 
Proceedings. 
for his faithful attention to details and the zeal he displayed in looking 
after the interests of his patients. Helplessness and misfortune always 
excited his warmest sympathy, and he was untiring and wholly unselfish 
in his efforts to relieve the unfortunate objects of his care. He was 
devoted, body and mind, to the interests of his helpless wards and his 
institution was a model of hospital administration. His sympathetic 
nature gave him a wonderful control over the insane, for they recognized 
in him a faithful nnd kind protector and friend. 
He did not, however, escape the shafts of unfeeling and unjust public 
criticism. Yet, though sensitive to its stings, he did not waver in his 
course, and as a consequence of his faithful adherence to duty, stands to-day 
among the first in the land in our chosen specialty. Amid all the trials 
and perplexities of his responsible position he had an abiding faith in the 
rulings of his Divine Guide and a quiet confidence in the justice of his 
course. Could the unthinking public but realize the anguish of spirit that 
their careless and rash expressions, founded upon the most uncertain and 
unworthy testimony, caused in the helpless object of their malignancy, we 
would be spared many a heart-ache we must now endure. 
Uncomplaining and with quiet devotion Dr. Reed pursued his way, and 
has left behind him an enduring fame in the noble institution of which he 
was the father and constant protector; and in the strong and faithful love 
of his grateful patients, the evidences of which constantly cheered him on 
his way, and can to-day be found in almost every hamlet in Western Penn- 
sylvania. 
His faith was strong to the last, and in the fullness of a ripe experience 
and with the calm confidence of a work well done, he fell asleep in the 
quiet repose of the Saint to awaken in the Great Hereafter to the enjoy- 
ment of a rich reward. 
On motion of Dr. Nichols, it was' 
Resolved, That the memoirs which have been read be published, and 
the fact, that they have been read, be entered on the minutes. 
On motion of Dr. Chapin, Mr. G. W. Jones and Judge 
Mason, Trustees of the Willard Asylum for the Insane, 
were invited to take seats with the Association. 
On motion of Dr. Nichols, it was 
Resolved, That it is the judgment, the rule, and the fixed principle of 
the Association, that the opinions in papers or reports, read by members, 
shall not be considered as deliverances of the Association unless formally 
endorsed by a vote of the Association. 
Dr. D. Clark, of Ontario, read a report on " The Pro- 
gress in Cerebro-Spinal Pathology for the last Forty 
Years," prepared for the meeting of 1884, but which he 
was prevented from presenting. The President then 
called for the report of the Committee on Therapeutics 
of Insanity and New Remedies. Proceedings. 
11 
Dr. Andrews: Mr. President and Gentlemen-I have a short paper 
that was presented by Dr. Hurd, as a member of the committee. He was 
unable to be present and send it to me to be read. I will preface my own 
paper with this short paper of the Doctor's. I suppose most of the 
members of the Association know that Dr. Hurd spent a short time in 
California during the last winter for his health, and while there his atten- 
tion was directed to this plant. 
After reading the paper of Dr. Hurd's, on "The Pecu- 
liar Properties of the Loco or California Rattle-weed," Dr. 
Andrews read the report of the Committee on Thera- 
peutics of Insanity and New Remedies. 
Dr. Gray : I would like to say a word in regard to the therapeutic 
use of tea, and the extract made by Dr. Squibb. Dr. Andrews has 
referred to the administration of a strong infusion of tea prescribed by me 
in certain cases when he was an assistant at Utica. I have given it 
to children in conditions of partial collapse after exhaustion, the result of 
diarrhoea and in semi-coma from over-heating, where the action of the 
heart was feeble, and to adults after prostration by the heat of the sun. I 
have found nothing more useful in such cases than tea as strong as it could 
be made, giving two or three teaspoonfuls every hour or more if required. 
I have given it also to old people with weak heart in combination with a 
little whiskey or brandy. Either added to the infusion will preserve it for 
a few days while being taken, though it is quite as well to make it fresh 
each day. Some sixteen years ago I tried also very strong coffee for the 
same conditions, one case being that of a young man who had almost 
constant headache from meningeal hyperaemia. following the sunstroke, 
and whose heart was irregular and feeble in action. I had a druggist in 
the city procure the very best quality of coffee, carefully browned and 
ground very fine, and the infusion made by filtering until he had as strong 
an infusion of coffee as could be obtained. I used this in combination 
with elixir of gentian, giving ergotin night and morning, and with good 
results. I have used it since frequently for a similar class of ca-es, espe- 
cially with disturbed and feeble heart. I have administered an infusion of 
coffee in connection with elixir of cinchona, or combined with whiskey, 
with great benefit. I took the infusion of tea myself experimentally at 
the first time spoken of in very large doses. 
In respect to the camellia, some time ago, when it first came out, I 
procured some of Dr. Squibb's.extract, and took a teaspoonful at a dose in 
a little cream about ten in the morning and at two and five in the afternoon. 
After continuing this three days I took two teaspoonfuls one day at the 
same hours, and afterwards three at a dose. I found the first day that there 
was no diminution in the number of respirations, but that they were fuller 
and the pulse was lowered in frequency, but increased in fullness. It gave 
me no sensation of discomfort in the head, and was rather stimulating. It 
induced slight perspiration the first day, but did not then or afterwards 
increase or diminish the action of the kidneys. On the second and third 
days it produced greater perspiration, and at times a sort of bounding of 12 
Proceedings. 
the pulse and reduced its frequency. The fourth day, after three tea- 
spoonfuls were taken at a time, profuse perspiration was induced with a 
sense of lightness of the head and a little uncomfortable feeling when 
sitting up. I was not drowsy or any thing of that kind, but, on the con- 
trary, felt stimulation, but also a little swaying when standing or walking, 
and I did not pursue further the investigation. At no time did I take 
beyond three teaspoonfuls of Squibb's extract at a dose. At one time the 
pulse fell to 56. It will be observed I kept the use of the tea continuously 
through the day, and the pulse did not resume its normal standard, which 
with me is from 69 to 74, until 9 or 10 o'clock in the evening. When taking 
the large doses the breathing was slower, but the inspirations were full. 
It produced neither headache nor nausea. A week afterwads I tried a 
pitcher of strong >tea taken in large doses in the afternoon and evening, 
aiming to get as much as would equal a teaspoonful dose of the extract 
each time. Whether I got that much or not, I certainly did not get the 
same effects as from the extract; simply the stimulating effect of tea with 
a little fullness of the head and, after going to bed, profuse perspiration. 
Dr. Nichols: Did you sleep on the strong tea? 
Dr. Gray: Yes; I went very quickly to sleep on going to bed. My 
idea was that it ■would keep me awake, but it did not. I not only went to 
sleep, but slept very soundly. 
Dr. Chapin : Referring to that portion of Dr. Andrew's report which 
relates his experience in the use of hyoscine, I think we are under 
obligations to him for bringing to our notice this new remedy and for the 
care with which he has made his observations. All experimental results 
fairly obtained have a great value. For several weeks I have had an 
opportunity of observing somewhat carefully the effects of hyoscine, and 
am able to confirm, to a great extent, the results with its use which he has 
reported. Some of the unsatisfactory results which have been noticed, not 
only in the use of hyoscine, but hyoscyamine, may have been owing to the 
character of the leaves from which the alkaloids are obtained, as it is 
well known that the physiological effects of the tincture of hyoscyamous 
leaves differ according to the habit of the plant. Two classes of patients 
have taken the drug-one made up of maniacal, noisy, excitable persons, 
with more or less motor activity; and the other, melancholic patients 
including those who were passive, suffering from nervous prostration and 
insomnia. The doses in the first class have rarely exceeded 1-100 of a 
grain hypodermically, and in the later 1-240 of a grain by the mouth. 
These doses it will be observed are not as large as Dr. Andrews has used, 
and I would not be disposed to prescribe a fiftieth of a grain, without try- 
ing a smaller dose first, and then only, when great motor excitement was 
present. The effect is to depress the pulse, lower the respiration, reduce 
the muscular activity, and when sleep is produced it continues for eight 
or nine hours. I have observed its administration in insomnious patients 
whose strength was impaired, in doses of 1-240 of a grain by mouth, with 
excellent results. There has been no unpleasant complication, no dysuria, 
headache or nausea, attending its administration as stated. 
In comparing the effects of hyoscine and hyoscyamine, it has been 
observed that patients do not acquire a toleration of the former as readily Proceedings. 
13 
as the latter, and in proper cases the same dose may be relied upon for a 
longer time without an increase. 
I cannot but hope that in this new remedy, the hydro-bromate of 
hyoscine (Merc) we may have a valuable medicine for the relief of those 
insomnious conditions we have so often to deal with, as well as in the 
treatment of those maniacal cases which come to our asylums, and as such 
I add my commendation of its value. 
An invitation was received from the New York 
Pharmaceutical Association to attend their sessions, which 
was referred to the Committee on Business. 
A note was also received from Miss Dix tendering 
her kindest regards to the Association. 
On motion the Association adjourned to meet at 
10 A. M. Wednesday. 
The Association was called to order on Wednesday, 
June i/th, at 10 A. M., by the President. 
Dr. Earle, from the committee appointed last year in 
reference to the admission of assistant physicians as 
members of the Association, made the following report: 
The committee to which was referred the question of opening the 
doors of membership of the Association to assistant physicians in the 
institutions for the insane, have given the subject their careful and 
thoughtful consideration and hereby respectfully present their report. 
This Association was formed in thje comparative infancy of the great 
enterprise for the amelioration of the insane in the United States, and was 
called into existence by one of the shortest and simplest organic laws that 
ever gave vitality to the specific aims, actions and ends of a body of men 
united in a common and worthy purpose. Both, psychology and psychia- 
try, not only among the people at large, but to the profession outside of 
the institutions, were matters of almost universal ignorance. Even in the 
specialty there was, if we are not mistaken, but one physician who had 
had an experience of ten years at the head of a public institution, and but 
five others whose similar experience excteded five years. That of a 
majority of the superintendents ranged from two to four years. Of the 
eleven original members of the Association who were at the head of 
public institutions, the aggregate time of service in that capacity was 
about fifty-three years, or an average of less than five years each. 
But small as was the united term of practical work of the medical 14 
Proceedings. 
superintendents of the hospitals, still those superintendents were the pos- 
sessors of the greater part of the knowledge, by Americans, of the care 
and treatment of the insane, and hence, as well as from their position and 
their prospects of continuing in the specialty, they and they alone were 
the persons especially conspicuous as the proper condidates for member- 
ship of a society for the promotion of the cause. Prior to that time there 
were few assistant physicians and their experience was very limited. The 
position had previously been sought less frequently than of late years with 
an intention of continuing long in the specialty; and of all the physicians, 
who then occupied that position, only two, so far as we can learn, were 
subsequently promoted to the office of superintendent. 
It is unnecessary for us to attempt a detailed exposition of the wonder- 
ful changes in the psychopathic enterprise during the existence of the 
Association and minutely to contrast the circumstances of the present 
with those of the past of forty years ago. You are already sufficiently 
familiar with the subject in general. In order, however, to bring it to your 
attention in perhaps a new, and certainly a stricking aspect, as well as to 
adduce one of the strongest arguments in favor of the opinion to which 
your committee has arrived, permit us to present you with a few facts. 
A little more than two weeks ago, letters were addressed to the super- 
intendents of nearly one hundred public institutions in the United States 
and the British Provinoes, requesting the names of their assistant physi- 
cians, and the time of service of each of them respectively. Notwithstanding 
the brevity of the intervening time, replies have been received from eighty- 
four of them and the results of the inquiry are as follow: 
In these eighty-four institutions no less than two hundred and nine 
assistant physicians are employed, and their terms of service are indicated 
in the subjoined schedule. Less than one year in thirty-five instances; 
from one to two years in thirty-eight; from two to three years in twenty- 
eight; from three to four years in twenty; from four to five years in 
fifteen; from five to six years in fourteen; from six to seven years in 
sixteen; from seven to eight years in thirteen; from eight to nine years 
in seven ; from nine to ten years in four; from ten to eleven years in five; 
from eleven to twelve years in three; from fourteen to fifteen years in 
one; from fifteen to sixteen years in three; from sixteen to seventeen years 
in one; from nineteen to twenty years in one; from twenty to twenty-one 
years in two; twenty-six years in one; twenty-eight years in one, and 
thirty-two years in one. Should the officer last mentioned retain his 
position but two years longer, his term of service in the specialty will 
exceed the united terms, at the origin of the Association, of Drs. Bell 
Awl, Butler, Brigham, Kirkbride, Ray, Galt. Stedman and Earle; nine of 
the eleven original members who were at the heads of public institutions. 
These two hundred and nine assistants have performed their duties as 
such officers during an aggregate period of nine hundred and eighteen 
years or an average of four years, four months and twenty-one days each. 
Such then, so far as relates to personal experience, are the claims of this 
large number of physicians to membership iu this Association, and thus 
to be co-workers with us here as they are at home. Aside from this are 
many and diverse considerations which enlarge and strengthen that claim. Proceedings. 
15 
Many of the assistants have come from the medical schools at a recent 
or comparatively recent date, bringing with them the advantages of the 
most advanced knowledge of the profession and not a few have been 
trained in the general hospitals before their entrance into the specialty. 
As the boy is father to the man, so the assistant is father to the future 
superintendent, and, in the time to come still more than in the past, the 
offices of physician-in-chief will be filled by men selected from the ranks 
of the assistants, because, primarily of their superior qualifications for 
the most responsible and important office. When we regard, on the one 
hand, the actual members of the Association, and find, as we do at all 
times among them, a number, greater or less, whose practical knowledge 
of the specialty does not extend over a period of two years, and, on the 
other a body of more than seventy assistant physicians whose similar 
knowledge embraces the acquisitions of from five to thirty-two years, it is 
with no disparagement of either party that we are led to ask if there is 
not a very easily perceptible trace of incongruity and inconsistency in the 
aspect. 
It is a well-known fact that discoveries in science, improvements in 
art, and striking achievement in many of the spheres of human activity 
have been very largely made in comparatively early manhood; the period 
of enthusiasm and of ambition, when toil is a pleasure and investigation 
and research, even if they are devoid of more important fruitage, furnish 
their own reward. Shall we then, if sincere in our desire for the 
attainment of the ends which ostensibly we seek, still continue to keep a 
bolted door against this large mass of activity, energy and intellectual 
vigor, which stands in patient expectance without, awaiting that bidding 
to our companionship, the results of which will be beneficial, not alone to 
its possessors, but to us as well, and ultimately, as we have abundant 
reason to believe, to the beneficent enterprise in which we are engaged? 
Your committee offer the following as an addition to the organic law 
of the Association: 
Five years continuous service as assistant medical officer in one or 
more of the institutions, the superintendents of which are members of 
this Association, shall entitle said assistant to membership so long as he 
shall continue in the specialty. 
PLINY EARLE. 
ORPHEUS EVERTS. 
JOHN CUR WEN. 
Dr. Gilman: Mr. President-I have been very much interested in 
the report submitted by Dr. Earle, and confess that 1 am surprised at the 
large number of assistant physicians who have been in continuous service 
for five years or more. It seems to me that there should be but one voice 
in this matter, and that a cordial invitation be extended to these assistant 
physicians to join us in the work of this Association. 
For nearly twenty years I was engaged as an assistant physician, com- 
mencing in hospital work as an attendant with my friend Dr. Bancroft, of 
Concord, New Hampshire, and after graduation, for sixteen years with 
Drs. McFarland and Carriel, of Jacksonville, Illinois; and I confess that 
during the last fifteen years in that service, I felt the need of meeting you 
gentlemen for the purpose of exchanging views and obtaining that benefit 16 
Proceedings. 
which is to be desired from such a meeting. I remember that at one 
time the question was agitated of forming an association of assistants, as 
we were debarred from becoming members of this Association and parti- 
cipating in its work. I felt that something of that kind would be decidedly 
beneficial in carrying forward our part of the work. But this covers the 
ground, and I feel the time has come when we certainly ought to invite 
these men to become a part of us. Besides what I have said, they are 
fresh from the medical schools, and with the vigor of young manhood are 
entering into that scientific research which we so much need. 
There is another point in this connection, which seems to me, is 
patent to us. and that is the selection, from assistants, of superintendents 
for new institutions throughout the country. By admitting to this Asso- 
ciation the assistant physicians as proposed, they are brought to the front, 
and make up a list of men who have had actual experience in the work, 
from whom may be selected proper candidates for such positions ; thus 
helping to avoid what we know to have happened in the past-many dis- 
astrous failures in institutions from the selecting of material without any 
actual experience in the work. I feel that this is an important matter, and 
that in the presentation of these names material will be selected to be 
placed in institutions, to carry forward the work, as they may be con- 
structed from time to time, hereafter. 
On motion of Drs. Denton and Nichols, the report 
was unanimously adopted. 
The President next announced a paper by Dr. But- 
tolph. 
Dr. Buttolph: Mr. President and Members of the Association-I 
desire, by way of introduction, to express regret that during the last few 
years circumstances have been unfavorable to my attending the meetings 
of the Association, also, to express my pleasure that I am able to be 
present on this occasion. 
Mr. President-The subject of the paper 1 have to present is the 
Physiology of the Brain and its Relations in Health and Disease to the 
Faculties of the Mind. 
Before commencing the reading, I have to apologize for the great 
length of my paper. The subject I have chosen, in its different aspects, 
embraces so much ground, that it was impossible to do less. The paper 
was prepared very hastily and from the course of the discussion adopted, 
i composed, to a considerable extent, of selected material. 
I will, also, make allusion to one other matter, which is, that for some 
time past, I have been troubled with hoarseness, from a slight chronic 
affection of the vocal chords, but which sometimes renders it impossible 
for me to continue speaking. For this I must beg your indulgence. 
During the reading of his address, Dr. Buttolph said 
at one place : 
It is understood that the brain is developed from all paits together, 
and that theie is no practical mystery, in fact, of its development in the Proceedings. 
17 
way explained by Spurzheim. The reason why one man's brain is 
developed, relatively, long or short (measured from a central point, that is, 
the Medulla Oblongata) upward, forward and backward, we cannot 
explain. 
This accounts, however, largely for the different mental characters of 
individuals of the same family, as well as of minds in general; giving rise 
to practical genius in various directions, according to the greater or less 
development of a region or part of the brain, in a given case. It will also 
be seen that the differences in mental manifestation iu individuals, can be 
better accounted for on the principles of this system than by those of 
any other. 
I am now to speak of the bearing of the physiology, or the healthy 
state of the brain, on mental philosophy, one branch of my subject. 
At the close of his address, Dr. Buttolph said : 
I desire to say, gentlemen, before resuming my seat, that in another 
and the closing part of my paper, 1 have prepared biographical sketches of 
Gall and Spurzheim, the founders of the system set forth, which I consider 
as highly important, and which I desire to present to the Association, and 
all the more, because many of the facts and incidents to be mentioned 
relate to a past age and century even, and therefore, are not accessible 
to all. 
Dr. Gray: 1 desire, Mr. President, at this point, to make some 
remarks in reference to the report of the committee on the expediency of 
the admission of assistant physicians, as fellows or members of this 
Association. I was in favor of the measure, but not of the resolution, but 
voted for it with the intention of moving a reconsideration. I intended 
to move as a substitute for the resolution, that all assistant physicians of 
regularly constituted institutions for the insane, be considered members of 
the Association while in service. The question has occurred to me also, 
whether the committee by giving five years as a period, at the end of 
which assistant physicians could be received into membership, .might not 
have some effect in preventing assistant physicians from coming as 
representatives of institutions, who had not been five years in service. I 
have thought they might feel some delicacy about it. The intention of 
the report and the resolution was not, I suppose, to have any such influ- 
ence on the rule of representation, which has hitherto been adopted, but 
rather to leave that practice undisturbed; it has been the custom for any 
institution to send an assistant when the superintendent could not 
attend, whether he had been in the asylum one or twenty years ; and any 
assistant thus delegated would be as acceptable a representative and 
member during the time, as one who was five years in the service, or the 
superintendent himself. As all the committee are here, I would like to 
know whether such is the full understanding. 
Dr. Earle: So far as I am concerned, Dr. Gray's interpretation is 
correct. Authority to send delegates still remains as before. It rests 
upon the institution. Whether, under the circumstances, it would be 
better to give expression to that fact is a matter to be thought of. It 
may be the authorities of the institutions will suppose that, inasmuch 18 
Proceedings. 
as the older assistants are members, the junior assistants might not be 
received as delegates. I am very glad that the doctor mentioned the 
matter, and it seems to me that it would be better to announce it, in some 
way, in the report of the proceedings. 
Dr. Gray : If you will permit me, 1 would suggest that the com- 
mittee, before any further action, ask to withdraw their report and amend 
■or change their resolution to this proposed, and report back to the 
Association, if that is expedient. 
Dr. Everts: I do not see that anything is necessary. The practice 
of the Association will continue just as it has been, and these gentlemen 
will not become members of the Association, until they signify a disposi- 
tion to do so. 
Dr. Gray: Still without some action or recognition they will feel 
some delicacy in taking part in the discussion, in view of the fact that the 
Association had fixed as the length of service before membership five 
years. 
Dr. Everts: When an assistant was delegated to come under the 
old rules, notice was given by the Secretary, that such was the rule I do 
not think any assistant will become a member until he presents himself 
under this new order. I see no u-e in any motion, but still I have no 
objection. 
Dr. Steeves: The action of the committee has suggested a question 
to my mind, whether the Association will change its name or not. It will 
not now be definitely an Association of Superintendents of Asylums, 
but Superintendents and Assistants. I would like to ask the Committee 
whether they contemplated any change? It seems to suggest such a 
question. 
Dr. Earle: I am glad the gentleman has mentioned the subject. 
There was no conference between the members of the committee in 
regard to it. But, while drawing up the report, it struck me that, if this 
resolution was adopted, the name of the Association would no longer be 
correct. I generally endeavor to come to the point as soon as practicable, 
and consequently assert that, in my opinion, the name of the Association 
should be changed. I think it is the best policy to change it. I think 
that, unless the change be made, another society will spring up, with a 
more appropriate name, and this will be obliged to retain its present title. 
I think this should be a " Psychological Society," or a " Medico-psycho- 
logical Society," that the title should be based upon the objects of the 
society, and not upon a name which simply signifies the official position 
■of its members. 
Dr. Gray : Mr. President-I would offer a resolution that the name of 
the Association shall hereafter be the Association of Medical Superinten- 
dents and Assistant Physicians of American Institutions for the Insane. 
Dr. Curwen: Why not follow the English rule and make it the 
American Medico-Psychological Association. 
Dr. Earle: I believe that the name of this Association should be 
the American Psychological Association. 
Dr. Gray : There is such an association now. 
Dr. Earle: There is the Neurological Association or Society in Proceedings. 
19 
New York, and there is the New England Psychological Society, and this 
Association should be for America what the New England Society is for 
New England. I think it would be a step in advance if this change should 
be made. Probably all of you know that the Association has been 
accused of being a close corporation. The name signifies as much. Under 
a different title that impression might be removed. The name itself is an 
unwieldy one. It is a long name. In order to use economy of words it is 
easier to speak of it as "the Association with a long name." . I remember 
the history of the origin of the name very well. It was compounded in 
the chamber, at Jones' Hotel, and it took some time to make the com- 
pound satisfactory. It was written out, at first, in one shape, and I 
remember that Dr. Bell added one word which still remains in it. It was 
the word "American," suggested for the purpose of including the Cana- 
dian superintendents. 1 added the word " Medical," because Dr. Butler 
and I were not, technically, superintendents of the institutions with which 
we were connected. My title was " Resident Physician," but I was the 
principal medical officer. The institution was then under the administra- 
tion of three officers, each independent of the other-the physician, the 
warden and the matron. The name was finally brought into a shape that 
was satisfactory so far as all these matters were concerned. It was truth- 
ful. I have nothing more to say, other than again to express my belief 
that it is the best policy of this Association to change its name. 
Dr. Chapin : If it is proposed to change the name of this Associa- 
tion, it is an important question for us to consider what its title shall be. 
It appears the composition of this body is about to be changed, but I am 
not in favor of a change in our name, if, by so doing, we are to surrender 
any of the traditions or associations which attach to our present title. It 
may be an easy matter to adapt a name to the newly established composi- 
tion of this Association. It may be called the American Association of 
Physicians, or, Association of Physicians of American Institutions of the 
Insane. 
Dr. Gray: Wouldn't you say medical officers? 
Dr. Chapin: I do not think it advisable to use two words where one 
may answer, as the physicians are medical officers. Neither do we desire 
to become exactly a psychological association as there are many questions 
coming before us that are not psychological. We ought not to limit the 
range of subjects. I would be glad to have the subject referred again to 
the committee for a repoit. 
Dr. Channing : It strikes me that the suggestion of Dr. Curwen is a 
very good one, that is, to call this Association the American Medico- 
Psychological Association, if that was exactly Dr. Curwen's suggestion. 
That is, to be sure, following the English precedent, and we certainly 
could not follow a better one. I do not think, Mr. President, that we 
should be limited to the discussion of psychological matter by adopt- 
ing that name. We want a name covering the proceedings of the Asso- 
ciation. The present name in the past has been the best; the question 
now is what will be the best one for the future. It strikes me, we could do 
no better than follow the example of the British Association, because, as 
Dr. Earle has said, if not adopted by this Association the chances are it 20 
Proceedings. 
will be done somewhere else; it is a thing, I feel certain, as one of the 
members of this Society, and having seen outside societies, is going to 
come. We have an American Neurological Association and we have an 
New England Psychological Association, but we have no general society 
with the name "psychological" in it. I think the word "Medico" an 
important one, as it more exactly defines the scope of the Association. I 
would therefore move to amend Dr. Gray's resolution by declaring that 
the name of the society shall be " The American Medico-Psychological 
Association." 
Dr. Bryce : The proposition to change the name of the Association, 
which has been so suddenly sprung upon us is a very important one, 
and should be considered with much care and deliberation. My present 
impressions are that no such change is either necessary or desirable. 1 
have no objection to the formation of an American Psychological Society, 
but the functions of such a body would be entirely different from ours, 
and the name would be neither distinctive nor appropriate. We have a 
specific work to do, and our present name designates, perhaps better than 
any other that we could adopt, the true nature and extent of that work. 
Change that name to the American Psychological Society, as has been pro- 
posed, and you destroy the distinctive character of the Association. 
I know it has been objected that we are at present a sort of close cor- 
poration, but that is inevitable in view of the specific character of the 
work we have in hand ; and I have no hesitation in saying that much of 
our present influence, and the good we have done in the past, are due to 
the close character of our organization. The incongruity of admitting 
assistant physicians tomembership of the Association, under its present 
name, can be remedied, I think, by a slight change in the wording of the 
resolution offered by the committee. It would be better, for many rea- 
sons other than those we are now discussing, that there should be no 
restrictions placed upon the membership of assistant physicians to this 
Association. They are as much interested in the work as we are, and are 
presumably well qualified to take part in our proceedings. 1 should, 
therefore, prefer to see a resolution passed, making them ex-officio mem- 
bers of this body, without reference to their time of service. When their 
official connection with hospitals and institutions for the insane ter- 
minated, their membership of this Association should also cease. They 
should be members by courtesy, so to speak; and the term ex-officio, it 
seems to me, sufficiently expresses that relation and limitation. 
I hope the Association will move cautiously and deliberately in this 
matter, and that, for the present at least, no change will be made in the 
title of the Association. « 
Dr. Clark : The suggestion of Dr. Bryce is a very good one. The 
old name is the best for the society. It covers all the ground. To call 
our Association Psychological, or any other purely scientific name would 
include, as members, many who take little interest and may have no 
experience in the executive work, construction and every-day life in 
asylums. It is well to confine our membership to asylum officers, and let 
our designation only cover such. We do not wish to make it possible for 
professional arabs to become members, and thereby bring our society into Proceedings. 
21 
disrepute. [A member: "Such as cranks."] The name American covers 
the whole ground. In one sense, we are all Americans, although in a 
geographical and political sense we are Canadians. Seeing we (Canadians) 
possess the largest part of North America, as we extend to the North 
Pole, let me suggest the name of Americo-Canadians. 
Dr Earle: It is a very serious matter. I have only expressed my 
opinion, and I do not pretend that my opinion is better than that of any 
other man. If it is best to take the subject into consideration at all, I 
would refer it to a committee to report a year hence; and if it is referred to 
a committee, I would refer to the same committee one or two other things. 
We profess to have a constitution, It is a very brief one. It is sufficiently 
long, however, for our purpose, so far as I know, but part of it is in the 
shape of resolutions, and this, that you have just adopted, is not in the 
shape of a resolution. I think it would be better to put it into a little more 
organic form. Then again,it is not definite in respect to the requisitions for 
membership. It declares that " the medical superintendents of the various 
incorporated or other legally constituted institutions for the insane " 
shall be eligible; shall be members. But what is a legally constituted 
institution ? 
When the society was organized, it was thought that no insti- 
tution that was not incorporated by an act of the legislature was 
legally constituted, that the proprietor or director of no private insti- 
tution had a right to membership. Until within a few years, the 
private institutions in Massachusetts could in no way be considered 
as legally constituted. In one sense they now are, because no one 
can open a private institution, without a license through a legal chan- 
nel. 
Dr. Gray : I would like to say one word here on this question. I 
voted for the resolution with the intention of moving its reconsideration. 
I should have done so at the time, but the pressure of the immediate 
business of the Association induced me to delay it. 
My intention was to move that assistant physicians, without respect 
to period of service, while connected with institutions and when attending 
meetings, be considered members and have a voice and vote in the 
deliberations. I think that is the wisest thing now. I should not be 
afraid of a word. I do not think there is anything so attractive in 
" psychological," as to induce us to drop out the word "American" in 
favor of it. As Dr.. Chapin suggested, this Association has a history. No 
one can claim that it is a weak association in any respect. It has been one 
of steadily increasing strength and vigor in every direction, whether 
relating to membership, character, progress in management, quality of 
papers, or their discussion, or its organization. I should certainly insist 
on retaining our distinctive title, as the Association of Medical Super- 
intendents of American Institutions for the Insane, though a hundred 
other societies were to appropriate the word "psychological." 
Touching a question which Dr. Earle has raised, 1 have always been 
under the impression that Drs. Cutter and White were men connected 
with private institutions. Whether Dr. Cutter's asylum was a "legally 
constituted " institution or not, I do not know. Dr. White's, I know, was 22 
Proceedings. 
simply a private establishment, opened without license. Dr. White was 
the first vice-president elected in the Association. My understanding has 
always been that superintendents or medical heads of institutions, of 
whatever character, public or private, devoted to the care of the insane, 
were included as members. This has certainly been the practice. There 
was a discussion in the Association at Baltimore a number of years ago, 
arising out of a letter written by the late Dr. Wilbur, of Syracuse, request- 
ing the admission of superintendents of idiot schools. The rejection of the 
proposition created some bitterness on his part at the time and afterwards, 
which he never overcame. I remember Dr. Ray very distinctly, then 
maintaining the position that this Association was for the promotion of 
all interests relating to the insane, and that to gather in other institutions 
would be, after a while, to multiply membership and multiply institutions 
represented to such a degree that the Association would become unwieldy 
and break down of itself. 
I sincerely hope that, whatever we do, we shall maintain our distinc- 
tive title, and without postponement, determine the question here and 
now. We shall not be any wiser a year hence than we are now. I trust 
that any action taken towards admitting assistant physicians to member- 
ship in the Association, will not involve a change of the title or name of 
the Association. The introduction of the words " and assistant physi- 
cians," after " superintendents," would not alter the title of the Asso- 
ciation. 
Dr. Gilman : 1 am in entire sympathy with the remark that have 
been made in regard to the retaining of our distinctive name as an Asso- 
ciation ; and I do not think it is necessary that any radical change be made 
on account of the resolution which we have adopted this morning. It 
seems to me that the work we have in view, as superintendents of these 
institutions throughout the country, is a specific one, and to change the 
name to Psychological Association, or to Medico-Psychological Associa- 
tion, would be a misnomer. The Association has been attacked by 
so-called reformers, who would gladly see its name extinguished. I am 
not in favor of yielding to cranks, either long-haired or short-haired; and 
I trust that some such proposition, as has been presented by Dr. Gray, 
will be adopted, and will be sufficient to cover the ground. 
Dr. Nichols: I desire to express my sympathy in the main, with the 
views which that have fallen from Dr. Chapin, Dr. Bryce, Dr. Clark, Dr. 
Gilman and others, and to express the strong desire I feel that no material 
change shall be made in the name of this Association. There is much in 
the point made by Dr.'Chapin, as to holding to the traditions of the 
Association. As Dr. Clark remarked, there is a great deal in a name. 
The name is known and honored and the usefulness of this Association 
has without doubt depended largely upon the sphere of activity described 
by its name. 
It was originally organized to promote the treatment of the insane 
with reference to the amelioration of their condition, in institutions 
of whatever kind, and a great many of the questions that have been dis- 
cussed and occupied whole sessions of this Association-and very properly 
-have not been psychological questions; but they have been proper ques- Proceedings. 
23 
tions for it to discuss under its name, and in view of the purpose of its 
organization; questions in relation to sites, water supply, construction 
and the details of fitting up and furnishing, which, in the early years 
of the Association, when these things were less understood than they 
are now, occupied whole sessions of the Association, and parts of many 
sessions. It seems to me that the charge is not of the slightest import- 
ance. It was organized for a purpose, has kept strictly to it, and I think 
it better, by all means, to continue to do so. If it is necessary to change 
the name of the Association to make it consistent with the admission of 
assistant physicians, it might be done, because it will be small, but there 
should not be any change thqt will admit people or subjects that are 
foreign to the purposes of this Association, nor that will exclude any 
subjects that come within the purposes of this Association. If this is 
called a Psychological association, the name will seem to exclude subjects 
within the purview, and that should be within the purview of this Asso- 
ciation. 
Dr. Earle : Is it not psychological? 
Dr. Nichols: Yes, and of course, a psychological society could dis- 
cuss water closets and ventilation, but I think there is a great deal in hold- 
ing on to sacred associations, and I cannot see the slightest reason for 
changing our name, given to it by its founders more than forty years ago ; 
by which it is known wherever in all the world any attempt is made to 
give the insane an enlightened humane treatment and under which it has 
done a work of incalculable benefit to mankind, and had a membership 
that has given it high character and honor. I do not think it is necessary 
to alter the name and 1 hope it will not be done, except possibly, to 
substitute the word officers for superintendents, so that the title of the 
Association will be, The Association of the Medical Officers of American 
Institutions for the Insane. 
Dr. Goldsmith : To take up a matter that has been passed over, 
concermng which Dr. Gray spoke, it seems to be the opinion of many 
members, as it was mine, that it is rather unfortunate to make the duration 
of service the criterion for admission to the Association. Of course, the 
duration of service is no criterion of ability, and a person who has been 
less than five years in service and has a desire to attend the meetings of 
the Association, ought certainly to have, it seems to me, the same privilege 
as he who has been in the service five years and has no desire to attend. 
I, therefore, if it is in order, to test the feeling of the Association, move 
that the action of the Association, in accepting the report of the committee 
appointed to consider the question of the admission of assistant medical 
officers of asylums, be reconsidered. I do this with the supposition that, 
in case it shall be reconsidered, a motion will be offered similar to that 
which Dr. Gray suggested-constituting all assistant medical officers as 
members. Of course it will be recognized immediately that this will not 
so enlarge the Association, practically, as to make it unwieldy, because 
not more than one medical officer aside from the superintendent can leave 
a hospital at the same time with the superintendent. 
Dr. Chapin. I would ask Dr. Goldsmith to withdraw his motion a 
moment, and 1 will offer an amendment to the resolution proposed by 24 
Proceedings. 
Dr. Gray that the title of this Association be so amended as to include 
superintendents and physicians It is now " The American Association of 
Medical Superintendents of Institutions for the Insane." With the 
amendment proposed the title will be in full, " The American Association 
of Medical Superintendents and Physicians of Institutions for the Insane," 
the words " and Physicians" being added. 
Dr. Gray. I accept that amendment. 
Dr. Nichols. You would insert the word " medical " before " super- 
intendents," the same as before? 
Dr. Gray. Certainly ; 1 would not change one word in the title, but 
simply add "and physicians," or better "assistant physicians" after 
" superintendents." 
Dr. Chapin. The amendment would be the insertion of the words 
"and physicians," which I think would cover assistant physicians and all 
medical officers. 
Dr. Bryce. I do not think it is necessary to do that. The matter can 
be arranged satisfactorily by reconsidering the resolution offered by the 
committee, and adopting as a substitute "that all assistant physicians of 
American institutions be considered est-officio members of this Association." 
It seems to me that the substitution of this resolution, for the one offered 
by the committee, will cover the whole ground and obviate the necessity 
of any change in the present name of the Association. 
Dr. Earle: There is no objection to that, if you would limit it 
as this resolution is limited-as long as they continue in connection with 
asylums. 
Dr. Bryce. The word " ex-officio " sufficiently expresses that 
limitation. 
Dr. Earle : Very well. Would it not be a shorter way for the 
Committee to adopt that amendment in their resolution? 
Dr. Bryce: That would be entirely satisfactory. 
Dr. Everts : The question before the Association now is on Dr. 
Gray's motion to change the title or name of this Association in the way 
he has proposed to amend: that it shall be known as " The Association of 
Medical Superintendents and Physicians of American Institutions for the 
Insane." 
Dr. Schultz: The theory on which this discussion appears to 
proceed, on the one side, that the title of an organization, or society, ought 
to express the character or qualifications of its members, I do not think is 
tenable. Practically it would probably be found that that work is done 
by some part of the constitution or by-laws; and I think that, if any 
change is to be made in view of the admission bf a new class of members, 
it should be done in this way. I am in sympathy with Dr. Bryce's 
remarks that the old name be adhered to, and I would do it more 
tenaciously because it has been unfavorably commented upon by 
unfriendly critics. 
Dr. Andrews: I would like to have the resolution read that was 
adopted in regard to assistant physicians. 
The resolution was again read by the Secretary. Proceedings. 
25 
Dr. Pratt: As one of the honorary members, I believe I am entitled 
to say a word, I shall certainly not presume to vote upon the question. 1 
wish to ask a question which perhaps contains a suggestion: Does not 
your very organization imply, although your constitution does not, 
perhaps, clearly and distinctly express it, that the asylum is tlie unit of 
organization, and that your object is not to include any other than those 
medically employed in insane hospitals? If it be the fundamental idea 
that asylums are represented here, it seems to me that you do not need to 
change your name very much, in order to provide in your constitution 
that all medical officers of asylums will be admitted as your brethren. 
Dr. Franklin: May I throw out one suggestion before the vote is 
taken? There is one point bearing upon some institutions, which should 
be thought of in reference to the word "physicians" in the resolution. 
Is it contemplated to take into this Association all consulting boards and 
visiting boards that may be connected with any of our institutions ? In 
the city of New York the inclination is towards appointment of visiting 
boards and consulting boards. We already have a consulting board for 
our institutions for the insane. Should we have a visiting board, we 
would have men of all complexions, and we might have some men who 
have maligned this Association, and who ought not to be in it. 
The question being put to the Association it was 
decided in the negative. 
Dr. Andrews moved for a reconsideration of the 
first resolution, which was agreed to. 
Dr. Bryce offered the following resolution- as a sub- 
stitute for the previous one : 
Resolved, That all assistant physicians connected with regularly 
constituted institutions for the insane in Ametica be considered ex-offieio 
members of this Association. 
This resolution was unanimously adopted. 
The Secretary then read the report of the Committee 
to audit the accounts of the Treasurer, which was : 
Resolved, That they had performed that duty, had found the accounts 
correct, and recommended an assessment of five dollars on each member to 
•meet the expenses of the Association. 
After considerable discussion, it was on motion of 
Dr. Kilbourne, 
Resolved, That all matters in reference to assessment be referred to a 
Committee of three, to be appointed by the President. 
The President appointed on said Committee, Drs. 
Kilbourne, Nichols and Clark. 
On motion, the Association adjourned to 4 p. m. Proceedings. 
26 
The Association was called to order at 4 p. m., by the 
Vice-President, Dr.' Buttolph. 
The Secretary read a lette'r from Dr. John C. Hall, 
regretting his inability to attend this meeting. 
Dr. Curwen : While I am up I wish to make a statement in regard 
to reporting the proceedings of the Association. In 1867, at a meeting in 
Philadelphia, this Association passed a resolution relative to the reporting 
of the proceedings of this Association. This resolution is definite and 
distinct, and as offered by Dr. Earle, it reads that the Secretary shall 
employ a phonographer to make the reports of the proceedings of the 
Association. Those reports, when so made, were to be copied, and the 
remarks of each member sent to him for correction; when corrected, the 
Secretary should put them in shape and publish them over his signature, 
as the official proceedings of the Association. Several reporters were 
employed by the Secretary, who did not give accurate reports. Finally I 
employed Colonel Demming to make the reports. His reports have been 
in the main correct; as correct as it was possible to make under the cir- 
cumstances. Gentlemen will remember, who have attended the meetings 
of the Association, that they have complained oftentimes of the impossi- 
bility of hearing what was going on. Discussions were interrupted and 
remarks drowned by the noises in the streets, and consequently it was 
impossible during those times to have entirely perfect reports; but the 
reports were first corrected by the members themselves before being 
printed-for certain gentlemen would not be satisfied with the report the 
way others would correct their remarks,-the rule being, however, under 
this resolution that no new matter was to be added. A gentleman might 
abridge his remarks, or remove part, under the rules of the Association, 
but he could not add any new matter; but gentlemen often wished to add 
new matter which could not be inserted under the rule, and the Secretary 
was in duty bound always to prevent the report being changed in 
that way. 
Transcripts of last year's report of the phonographer, employed by 
Dr. Gray, were sent out to the different members. That report was not as 
correct in many particulars as the one made by Colonel Demming ; that 
is, so far as it came under my notice, and 1 saw the greater part but not 
the whole of it. 
I say this simply in justice to Colonel Demming himself. 
Dr. Strong read his report on Cerebro-Spinal Physi- 
ology, taking for his subject: "Is Education a Factor in 
the Prevention of Insanity?" 
Dr. Channing read the report of the Committee on 
Bibliography of Insanity. 
Dr. Draper, from the Committee on Time and Place 
of Next Meeting, reported in favor of Lexington, 
Kentucky, as the place, and the first Tuesday in June, Proceedings. 
27 
1886, as the time; which was, on motion, received and 
adopted. 
Dr. Kilbourne, from the Committee on Assessments, 
reported : That the Committee on Assessments would 
respectfully recommend that all Medical Superintendents 
of American Institutions for the Insane be assessed three 
dollars, to meet the expenses of the Association for the 
current year. 
On motion the Association adjourned to 8 o'clock P. M. 
Me Association was called to order, at 8130 o'clock 
P. M., by the President. 
Dr. Richardson: As a member of the Committee on Necrology of 
the Association, I would like to ask leave to have Dr. Fisher make a report 
of a death that was overlooked by the Committee, on which he has pre- 
pared a short memorial. 
Dr. Everts: The additional report of the Committee on Necrology 
is in order and Dr. Fisher will proceed to read his paper. 
Dr. Fisher : It is not a paper, Mr. President, but at Dr. Earle's 
request I collected a few facts in the life of Dr. Edward Jarvis, recently 
deceased, to be furnished for publication at the request of Dr. Tuke, editor 
of the Journal of Mental Science. As a statistician he was perhaps better 
known abroad than at home. I have prepared a short sketch of his life 
and character, leaving a detailed account of his labors for Dr. Earle. In 
the absence of any other memorial notice, I will read to you that which 1 
have prepared. 
Dr. Edward Jarvis was born in Concord, Massachusetts, January 9th, 
1802. He graduated at Harvard in 1826 and took his degree in Medicine in 
1830. He practiced medicine two years in Northfield, Massachusetts ; five 
in Concord, Massachusetts; and five in Louisville, Kentucky, with but 
moderate success. His tastes inclined to the study of mental science and 
anthropology and he lacked confidence in the effects of his remedies. He 
was early interested in the cause of education and started public libraries 
in Concord and Louisville. In 1836, while at Concord, he received an insane 
young man from Cambridge into his house for treatment and in a few 
months he was well. Several other patients were afterwards received and 
he then became interested in the treatment of insanity, which specialty he 
resumed at his home in Dorchester and continued for many years success- 
fully. Dr. Jarvis was disappointed several times in obtaining the 
superintendency of certain insane asylums in Massachusetts, for which 
positions he brought the highest recommendations and for which his 28 
Proceedings. 
tastes strongly inclined him. He felt these disappointments keenly, but 
was not deterred from pursuing his favorite studies, as far as possible, in 
the community at large. He removed to Dorchester, Massachusetts, in 1843, 
where he remained until his death. In 1840 his attention had been directed 
to the apparently excessive amount of insanity among the free colored 
population of the Norm. This excess had been used by Southern States- 
men in Congress, to show the probable effect of emancipation upon the 
negro. Dr. Jarvis showed thdt the census of 1840 was grossly in error in 
this respect. His aid was solicited in preparation for the census'of 1850 
and, without official authority, he gave one-third of his time for three 
years to perfecting the reports. In 1874, the government acknowledged his 
claim by paying for his services. He was again employed on the censuses 
of 1860 and 1870, and became the leading authority on vital statistics, and 
was recognized as such at home and abroad. In 1854 he was made a 
member of the Lunacy Commission to inquire into the number and 
condition of the insane in Massachusetts, and the Northampton Hospital 
was erected in consequence of their recommendation. 
In 1843, he became a member of the corporation of the School for Idiots, 
in Boston, and in 1849, was appointed physician to the Institution tor the 
Blind. He continued to be associated with Dr. S. G. Howe in the super- 
vision and care of these two institutions for many years, bis services 
being largely gratuitous. 
in 1860, Dr. Jarvis visited Europe, where he traveled extensively in 
charge of an insane gentleman of wealth, who was accompanied by his 
family. He was commissioned a delegate to the International Statistical 
Congress in London, where he made the acquaintance of many distin- 
guished foreign physicians and scientists. He was chosen one of the two 
vice-presidents on that occasion. He visited a large number of the hospi- 
tals, insane a ylums and prisons in England, forming an acquaintance with 
Sir James Clark, Florence Nightingale and other philanthropists of the 
period. The private insane asylums, of which there were one hundred 
and thirteen, especially interested him, on account of the comparative 
absence of restraint and the home-like appearance of the old mansion- 
houses which had been remodelled for the care of the insane. On his 
return from Europe, he opened correspondence and established exchanges 
with many foreign institutions. In 1874, his labors were suddenly arrested 
by a stroke of paralysis. He remained in comfortable health, however, till 
October 20th, 1884, when a second attack occurred, which terminated 
fatally, October 31st. His wife died the second day after, and they were 
both buried the same day in their native town of Concord. 
Dr. Jarvis' writings were voluminous and embraced a wide range of 
subjects. His papers on vital statistics, hygiene and insanity number 
over one hundred and fifty. He wrote, also, a school physiology which 
was translated into Japanese, and is in use in Japan. His library was 
extensive and unique, of its kind. It was donated with all his books, 
works and pamphlets, to the American Statistical Association of Boston, 
of which he was, for thirty-one years, President, except certain special 
donations of Books to Harvard College, the Concord Public Library, and 
the N. E. Hospital for Women and Children. Proceedings. 
29 
Dr. Jarvis was a fellow of the American Academy of Arts and 
Sciences; member of the Association of Medical Superintendents of 
American Institutions for the Insane; of the American Social Science 
Association; of the British Medico-Psychological Association, etc., etc. 
I am indebted to Dr. Robert Wood, of Boston, for many of the above facts. 
He was a connection of Dr. Jarvis, and wrote a memorial of him for the 
American Statistical Association. I was somewhat acquainted with Dr. 
Jarvis and knew him to be an earnest and life-long seeker after the exact 
truth with reference to man in his highest interests and relations. He was 
painstaking and industrious in the extreme as his statistical labors proved. 
He was not only an anthropologist and a pioneer in this country in 
statistical science, but a philanthropist also, having deeply at heart the 
welfare of all the helpless and dependent classes of society. 
Dr. Gray then read a paper on " Some of the 
Preventable Causes of Insanity." 
Dr. Goldsmith next read a paper on " The Relation 
of Syphilis to Insanity." 
Dr. Gray: Gentlemen-I crave your indulgence for a moment to 
make a few remarks in reference to that part of my paper treating of 
maternity. The Women's Christian Association, of Utica, has undertaken 
the matter of organizing a Maternity Branch of the Association, with a 
view to supplying help to all poor and indigent persons, who might 
apply through a physician. They created this as a special branch, calling 
it "The Maternity Branch of the Women's Christian Association," and 
stated that their experience fully justified my suggestion of a special 
branch, and the employment of persons in the house of the mother to do the 
general labor and ordinary household duties ; a person of the same social 
class. In this way the responsibility, and especially the worry and care of 
the household, would be taken off the sick woman, and she would recover 
far more favorably, having this relief, and her health as well as the better 
nourishment and care of the child would be better secured. Trained 
nurses in such cases would not be advisable or needeu the patient would 
be under the direction of the physician, and the aid proposed is all that 
would be necessary with such visitation as members of this Association 
would give. In a large proportion of such cases the professional work 
would be voluntary and unremunerative. Such rules could be printed 
and promulgated for the use and guidance of those unde taking the work, 
that there would be no difficulty in carrying out th. object of the 
Association-the care of this class of poor mothers. 
Dr. Draper, from the Committee on Time and Place 
of Next Meeting, reported that the Committee desired 
to amend their report by changing the time to the third 
Tuesday in May, 1886, which was accepted. 
Dr. Goldsmith: Mr. President-I want to take time for one 
moment, as I am not sure that 1 shall have another opportunity to speak 30 
Proceedings. 
to the Association, to make a communication. Some members of the 
Association may remember that two years ago, at Newport, I read a 
paper on what I called " A Case of Moral Insanity," or what might per- 
haps more properly be called "Hysterical Insanity." 
The case was one of a girl who, from nine to nineteen years of age, 
had been continually in hospitals where she had been considered the most 
troublesome patient in each of the hospitals where she had been. She 
had on several occasions been tried at home, but without success. I 
stated that her attacks frequently occurred at the periods of menstruation, 
and that she usually had some disturbance then. There was some tender- 
ness about the ovaries, and I asked the opinion of the society about double 
ovariotomy, and although there was not a great deal of encouragement then 
given, and I did not have any great hope of the success of the operation, as 
she was such an excessively uncomfortable individual, I decided to try it. 
Dr. John Homans, of Boston, kindly performed the operation in July, 
1883, and pronounced the ovaries perfectly normal, after having exam- 
ined them microscopically. About one month after the operation she 
appeared well and was taken to her home, where she has since lived in 
precisely the same way as the other members of the family without dis- 
closing the slightest evidence of mental unsoundness. She had never 
shown the least loss of self-control, or unusual excitement, and says that 
she seems to herself "entirely another person," because she before felt 
herself continually in danger from slight irritations, which do not now 
disturb her in the least. Her mother and another friend confirm this 
statement, and say that she is not at all "nervous or peculiar," but help- 
ful, dutiful and judicious in the family and in her social and church duties. 
I could observe no loss of femininity in voice, appearance or manner, and 
her friends tell me that there has been none. She has not menstruated 
since the operation. I have waited two years before reporting the result 
in this case, but think that now sufficient time has elapsed to prove the 
value of the operation. 
On motion, the Association adjourned to 8 o'clock 
P. M., Thursday. 
The Association spent Thursday in an excursion on 
Lake George. 
The Association was called to order on ' Thursday, 
Junp 18th, at 8 o'clock P. M., by the President. 
On motion of Dr. Curwen, it was 
Resolved, That the necessary certificate as delegate to the British 
Medico-Psychological Association be given to Dr. Sawyer, and any other 
member intending to visit England during the summer. Proceedings. 
31 
The President announced as the Committee on 
Arrangements of the next meeting: Drs. Chenault, Rod- 
man, Callender, A. B. Richardson and Curwen. 
Dr. Clark : Mr. President-If I am in order at this stage of the pro- 
ceedings, I would just ask your attention for a minute to a practical fact. 
I refer to the possibility of the physicians of this Association being able 
to tabulate, from year to year, all the post-mortems made by members of 
this Association. It has been charged, but without truth, that we never 
take up pathological and histological subjects, and other subjects of great 
practical importance. If we could form a committee through which we 
could get the different results of post-mortems, in a crude way, even if 
not from microscopic examinations, and then tabulate them in conjunction 
with the mental symptoms of those who died, we could possibly be able 
to secure from the seven or eight hundred post-mortems examinations of 
the more than three thousand deaths a year (I estimate the number at 
about three thousand,) much information of great value. I ask the Asso- 
ciation to appoint a committee of gentlemen to utilize to the best of their 
power the results of post-mortems, even, as I have said, of the most crude 
forms, held in the different institutions in North America. I think it 
would bring before the Association, in a practical way, results, by classifi- 
cation, that we possibly could not get in any other way. That would also 
be the means of inducing and stimulating physicians to make post-mor- 
tems, and with good results. I throw out the suggestion as a subject of 
importance. 
Dr. Everts: Has any gentleman any remark to make upon'this 
subject, or any motion ? 
Dr. Hill : I am heartily in favor of such an attempt. I hope such a 
committee will be appointed and that that committee will prepare a blank 
or form stating what data they would like to have recorded of post-mor- 
tems, so that the points of importance will not be omitted in making them, 
but put down properly on paper and that there maybe some uniformity in 
the records if they should be brought together for comparison. 
On motion of Dr. Curwen, it was 
Resolved, That a committee of three be appointed to take into consider- 
ation the whole subject of making autopsies and prepare the proper form 
of blank for the tabulation of such records. 
The President appointed on said committee: Drs. Clark, 
Andrews and Schultz. 
The President announced as the next thing in order, 
the report of the Committee on the Treatment of Insan- 
ity, by Dr. Shew of Connecticut. 
Dr. Shew: Mr. President and Gentlemen-About three weeks ago £ 
received a letter from Dr. Carriel, chairman of this Committee, stating that 
he could not be present and that he had prepared no report for the Assc - 
ciation. A few days later Dr. Burrell, of Canandaigua, wrote me to the 32 
Proceedings. 
same effect. Dr. Carriel requested that I should furnish something. It 
was too late in the day to prepare a regular report, but T, just previous to 
that date, had been engaged in the reading of the annual reports of Insane 
Hospitals for 1884, and had taken some notes in regard to points of interest 
and thoughts from most of the reports, and it occured to me that it might 
possibly cover the ground or fulfill the object of such a committee; and in 
my paper I shall only try to show what has been done by American 
superintendents during the past year, as shown by their reports. 
Dr. Shew then proceeded to read his paper, after 
which Dr. Cowles read a paper on "The Insanity of 
Fixed or Insistent Ideas." 
On motion the Association adjourned to 9:30 A. M., 
Friday. 
The Association was called to order on Friday, June 
19th, at 9:30 A. M., by the President. 
The minutes of the preceding session were read and 
approved. 
The Secretary then read the following letter from 
Dr. Dewey : 
Illinois Eastern Hospital eor the Insane, I 
Kankakee, June 15th, 1885. J 
John Curwen, M. D., Secretary, etc. 
My Dear Sir:-To my great regret I find it will be impossible for 
me to attend the meeting of our Association this year. 
The labor of occupying the twelve new buildings, which bring the 
capacity of the institution up to 1500, is not quite completed (we have 13G9 
patients to-day,) and the internal organization will require closest atten- 
tion for some time to come, as, owing to the detached system of 
construction, there are many questions coming up of which previous 
experience does not furnish a ready solution. For the above reasons it is 
out of my power to be absent from home at this time. 
One of the things which I suppose will engage attention during the 
meeting is the subject of fire protection, and the question of how far 
buildings for the insane should and can be built 
Three things impress themselves on my mind in this connection. 
First: All three-story buildings, which have hundreds of insane under 
one roof, should, if possible, be thoroughly fire-proof in their construction. 
Second : Owing to the greater expense of this method of construction 
one of two things must happen, either a larger amount than heretofore 
must be appropriated or a less number provided for, if it is adopted. 
Finally: In constructing two-story buildings in the detached form it Proceedings. 
33 
will be possible, so far as such buildings are feasible, to build more 
cheaply and secure the advantage that at least not more than one 
building will suffer from fire at a time. 
With regard to the method of heating all buildings for the insane, it 
would seem very clear that steam heating was preferable to any 
other form. 
Now, if I may be permitted, a word with reference to the fire which 
occurred at Kankakee in January last, in which seventeen lives were lost. 
1 will say first that the building in which the fire occurred, was one of the 
twelve put up under the following conditions. An appropriation of 
$400,000 was made in 1883 requiring this institution to provide for one 
thousand additional patients within that amount, including the heating of 
the buildings, furniture, and all else involved in the accommodation for 
the above number, completed and in use. It was found that the smallness 
of the amount, per capita, absolutely precluded heating with steam, and at 
the same time building in the detached form as the law required. This 
was the reason for the adoption of warm air furnaces. 
The fire originated in such a way as to point with reasonable 
probability to the furnaces as the source from which it sprung, although 
no evidence could be obtained making it positively certain that the fire 
commenced in this way, and in fact the exact origin of the fire still 
remains a mystery. 
In regard to the rescue of patients, it may be said, that almost with- 
out exception the patients who lost their lives were in dormitories on 
the second floor, that they were physically able-bodied patients, that 
the second floor was immediately filled with a dense smoke, in which 
no person could breathe, before the fire was discovered on the first floor, 
where the watchman was stationed. The patients sleeping soundly at 
4 A. M., were rendered unconscious and suffocated, with the exception 
of a few who made their escape or were rescued. There were no iron 
guards or bars on any of the windows, and there were no patients, who 
might not readily have been rescued from the outside who possessed 
sufficient presence of mind and intelligence to break out a light of glass 
and let their whereabouts be known. 
There was but one stairway in the building-another economy, 
which it w as found necessary to practice in order to build the buildings 
at all within the amount appropriated. 
Unfortunately, up to the time of the fire, the appropriations for fire 
apparatus had only been sufficient to put up the hydrants and bring the 
water to them, and in doing this, a considerable amount had been used 
from the ordinary fund. Furthermore, these buildings having been 
occupied but a short time, the equipment and organization of fire ser- 
vice had not yet been possible. 
There was a watchman or night-nurse constantly employed in this 
building, and on the night of the fire, his record in the electric watch- 
clock shows, that he had registered within fifteen minutes of the time 
when the fire broke out. To sum up : The loss of life which occurred 
is accounted for by the fact that at 4 A. M., almost all patients were 
soundly sleeping, many with their heads covered up, as is so common 34 
Proceedings. 
with the insane; that the rooms on the second floor, where nearly the 
whole of the loss of life occurred were immediately filled with smoke, 
owing to size and situation of flues, before anything amiss was apparent 
to the watchman on the first floor; that there was but one stairway, 
and that was situated directly over the fire and immediately rendered 
impassable; that fire apparatus was lacking owing to insufficient 
appropriations; finally, the building itself, though a substantial stone 
structure, with slate roof, had wooden floors and stairway, which were 
consumed with astonishing rapidity. Several of the above difficulties 
resolve themselves into the all-pervading one of lack of funds, from 
which there seems to be no escape. 
I desire in this connection to express to the many members of the 
Association, who advised me at the time of the fire of their kindly sym- 
pathy, my heartfelt thanks, and to explain that I have never since that 
time seen an interval of sufficient leisuie to allow me to write to each 
of them personally, as I would have been glad to do. 
I may add that the building, which was damaged by the fire, will 
probably be at once rebuilt, as the bill introduced in the legislature for 
an appropriation for that purpose meets with no opposition 
Another subject upon which 1 wish it might be my privilege to hear 
the views of the members of the Association is the better training of 
attendants. I would say in this connection, that I have asked for and 
received the authority of the Board of Trustees of this Institution to 
establish for each sex a training ward, in which I expect to make 
arrangements for giving more thorough and ample instruction to as 
many as possible of the newly engaged attendants, by means of having 
a head attendant of much more than usual qualifications in charge, and 
a trained nurse from whom the details of the proper and skillful care 
of the patients can be learned. In this ward a more than ordinary 
range and variety of cases of insanity and physical complications will 
be placed, not only for the b tter care of the patients, but for the bet- 
ter instruction of the attendants. 
With an apology for my "long-winded" communication, and in 
the hope that the Association may have a profitable as well as an 
agreeable session, I remain, Yours sincerely, 
RICHARD DEWEY, 
Medical Superintendent. 
Dr. Hill read a paper containing the relation of a 
case of long continued artificial respiration. 
Dr. Chapin, froth the Committee on Resolutions, made 
the following report: 
This Association, being now about to close its thirty-ninth session, 
congratulates itself upon the continued zeal of its members and their 
loyalty to its original purposes, which have co-operated to bring 
together more than sixty Superintendents and officers of the American 
Institutions for the Insane, from the extreme confines of the United 
States and the provinces of Canada, having in charge the interests of Proceedings. 
35 
.more than twenty-two thousand insane persons; believed to be the 
largest assembly of members in the history of this body. It congratu- 
lates itself upon the fellowship and harmony which have characterized 
this and all preceding meetings. 
It deems it also a fitting occ ision to place on record its appreciation 
of the continued usefulness of an organization which is a medium for 
the presentation of papers and experience in the treatment of the 
insane; consultations about the perplexing questions constantly 
arising in the discharge of our difficult duties, as well as a more 
general diffusion of knowledge respecting the vexed social problems 
about which we are engaged. 
With no disposition to exercise what might be considered a 
censorship of the proceedings of the Association, the committee cannot, 
in view of the largest interests of this organization and the probable 
addition to our membership, refrain from respectfully offering a 
suggestion that in the presentation of voluntary papers some reasonable 
limit, as thirty minutes, should be held to exist; also that the President 
and committee of arrangements might profitably set apart some 
portion of each session for the consideration of miscellaneous business, 
which may come before this body, as well as to announce before the 
annual meeting a probable programme of the ensuing meeting. 
The following resolutions are submitted for your consideration : 
1. .Resofoed, That the thanks of this Association are tendered to 
our late President, Dr. Pliny Earle, for the satisfactory manner in 
which he has presided, and for the valuable annual address which he 
delivered before us. 
2. Resolved, That the resolution adopted at the meeting held in 
Cincinnati, in 1S82, relative to standing committees, be hereby rescinded, 
and all members of the Association be invited to prepare voluntary 
papers, and furnish the Secretary with the title of the paper they pro- 
pose to present, one month prior to the annual meeting. 
3. Resolved, That the thanks of the members of the Association are 
due to Messrs. Tompkins, Gage & Co., managers of the United States 
Hotel, for their personal attention to our comfort and the use of the 
parlors of the Hotel for the purposes of the meeting, and to the officers 
of the Delaware and Hudson Railway Company, for an excursion to 
Lake George, at a reduced rate. 
JOHN B. CHAPIN, 
A. M. SHEW. 
The report was, on motion, unanimously accepted and 
adopted. 
Dr. Everts then read a paper entitled "New Wine in 
Old Bottles.'' 
Dr. Chenault moved a re-consideration of the resolu- 
tion relating to autopsies, but not having voted on the 
resolution, his motion was not sustained. 36 
Proceedings. 
Dr. Buttolph : Nothwithstanding the extreme length of my paper,, 
as read, yet an important part of the matter directly connected with it, 
is contained in another branch of the subject, consisting of biographi- 
cal descriptions of Gall and Spurzheim; also statements by the 
believers in and advocates of their system at that period and since, 
and which will serve to substantiate the truth and illustrate the 
importance of the views presented in the paper already before the 
Association. 
In view, however, of the late period in the meeting and of the dimin- 
ished number in attendance, if the latter paper may be recognized in 
connection with what has gone before, I shall be satisfied. 
Dr. Everts: No doubt it will be so without any action. 
Dr. Buttolph: I think there has never been-at least there is not 
now-in the medical profession in general or, indeed, in any profession or 
department of scientific men, a proper knowledge and appreciation of Gall 
and Spurzheim, who, for twenty or thirty years, labored most assiduously 
to establish the truth and great importance of a correct physiology of the 
brain and of a system of mental philosophy based thereon. 
On motion of Dr. Nichols, it was 
Resolved, That Dr. Buttolph be authorized to have the paper prepared' 
by him, in relation to Drs. Gall and Spurzheim. considered as presented by 
him to the Association, and that he be permitted to publish it as so 
presented. 
Dr. Hill asked for information relative to statistical 
tables, to be used in preparing the reports of institutions. 
Dr. Gray suggested that the Committee on Autopsies- 
be enlarged to five members, and on motion, it was- 
adopted. 
The President appointed Dr. Theo. W. Fisher and 
Dr. Bryce, the additional members. 
On motion of Dr. Nichols, it was 
Resolved, That this Association adjourn to meet in Lexington, Ken- 
tucky, on the third Tuesday of May, 18S6. 
JOHN CURWEN, Secretary.