Part I of the following article about Springfield Hospital, from the November 5, 1898 issue of The Philadelphia Medical Journal, appeared in last week’s column:

“At the sound of the tattoo, the inmates of the several cottages ascend to the dormitory-floor, strip off their day-clothes, each article having its appropriate hook, wash at the lavatory on this floor, which in appointments would not be out of place in a first-class club or hotel, and donning their night-shirts go to bed.   The long line of day suits exposed to the current of air sweeping through the open windows in the ante-room outside the dormitory thus becomes thoroughly ventilated during the night.  At ‘taps’ lights are extinguished, save at the attendant’s table, where he sits awake, with every bed in view, until relieved, when he goes to his own room in the service building to sleep, as no one but patients is allowed to sleep in the cottages.   Within the reach of the attendant are the switches controlling the electric lights and telephone-calls communicating with the service-building and the superintendent’s quarters.  A characteristic feature of the dormitories is the long row of open windows, checked only enough to prevent the egress of a body, but with no suggestion of bolt or bar.  On the living floor below, numerous doors without locks open freely outward, a catch on the exterior knob only preventing entrance from the outside.   Stone and brick passage-ways from the dormitories without bends or angles, locked and unused except in emergencies, provide a rapid means of escape from fire to the outside without the necessity of traversing the buildings.   An automatic register in the office in the service-building records the progress of the night-watchman in his hourly rounds, indicating the time and the place of his several visits.

What can be accomplished toward humanizing these unfortunates who have come here, to be made well if that be possible, or to be cared for if incurable, is most strikingly illustrated at the general weekly inspection by the superintendent on Sunday morning, when every nook and corner are explored with a thoroughness that bespeaks the military antecedents of Major Rohe.  Having been more than once invited to act as inspecting officer and urged to indicate defects and oversights, for which 20 years’ experience in charge of United States Naval Hospitals perhaps qualified me, I bear witness to the wonderful results that have been here accomplished.

One hundred and fifty cleanly-appareled, clean–skinned men, mostly of the humbler class, decorously sitting on comfortable chairs upon the porches in pleasant weather; waxed floors unsoiled by expectoration; spotless window-panes and lavatory-mirrors; the ridges and hollows of the moldings of steam-registers, the angles and bends of the stairs, the tops of door-jambs and window-frames, and the narrow spaces behind pipes, which invite dust and neglect, all without evidence of either, even at places only to be reached by chair an ladder; balusters and brasswork, which give no smear to the pocket handkerchief, all these tell their story to the alert inspecting officer.  Once only I found a stray dust cloth under a steam-coil, where it had been hastily left by an attendant unexpectedly called away.  In attic and basement, in dormitory and living-room, in ante-room and dining-room the same incredible order prevailed.  Even in the attendants’ closets the paraphernalia of service were neatly arranged and the folder bedcovers and pillow-cases on the long line of beds, all but one unoccupied, would have been the envy of a housewife or the head chambermaid of a hotel, which both these would have appreciated the fact there is no such thing as a chamber-pot in the dormitories.  Not the least interesting display of the Sunday inspection were the rows of workday clothes and hats and shoes, each in its assigned place in the basement, where their owners had placed them the previous Saturday on ceasing work.

In each cottage on the dormitory-floor there is a single ample-sized porcelain bathtub standing well into the room, so as to be accessible on every side, and used only by the very sick and feeble or others unable to bathe themselves; but an abundance of rain-baths (appropriate and desirable for private residences) is provided, where general ablution can be performed decently and thoroughly.  When the weather permits, it is the custom to march the several squads for out-door bathing, for which the numerous watercourses of the domain furnish facility.

Here, then, the problem has been solved, so far as human intelligence can do it, of the humane treatment of those unfortunates, whose minds have gone adaft.  Here amid the placid surrounding of rural life, away from ever exciting cause, with agreeable out-door occupation, the unbalanced mind may recover its equilibrium, or, if that cannot be, if healthy living, wholesome food, and generous indulgence cannot effect a cure, the inveterate sufferer can at least live peacefully, decently, and as far as the fantasies shaped by his seething brain will permit, contentedly.

But these are selected cases, an old-time keeper suggests. Is it probable that the almshouse from whose overcrowded insane-wards most of them have been received would transfer any but the most unruly and least orderly and least serviceable of its inmates?  I saw myself a patient admitted, an acute case, whose wrists still showed the marks of the handirons he had worn, and put to bed in an open ward and kept there by a watchful attendant, or as many as might be required, and who in three days had become tractable and responded to the usual clinical questions of the physician; while another who, as soon as he landed from the wagon that brought him, made a break to escape and thrice repeated his attempt the same day, before a week had passed was sitting quietly among the others and taking part in their work or play.

Great was the indignation when the people of Carroll County learned that the aristocratic Paterson estate was to become a ‘lunatic-asylum.’  The village-shopkeepers refused their wares to the pestiferous invaders.  Immediate neighbors declared their intention of moving away.  Those who had to pass along the roads watched askance the groups of laborers who had been put to work utilizing the farm-building on the grounds.  Soon they learned from their own employees that these very laborers were the dreaded crazy men.  Today the brilliantly lighted buildings on the hill, visible for many miles around, are the pride of the county and the envy of adjoining ones, while railroad and express, local dealers and post-office rejoice over the thrifty newcomers.

The State of Maryland has great reason to be proud of the unrivaled establishment, and the Board of Managers may congratulate themselves upon the trust they so implicitly placed in the judgment and acquirements of the Superintendent, who himself has the rare satisfaction of having seen his plans and promises fulfilled to the very letter.  What has already been accomplished in this superb institution betokens what may be expected in its further development.  Simple, chaste, elegant in architecture and appointments, its broad halls, lofty rooms and admirable proportions and equipment cannot fail to please the critical visitor, while the man whose monument all this is, may justly boast that without stint of what was necessary, with lavishness only in the direction of the sanitary provision of cleanliness, not one dollar has been expended for which a full equivalent is not in evidence.

Is this a sketch of fancy?  Let the doubter defer his verdict until he can ‘come and see.’”