The Site selected has been formally approved in writing by the Governor and by the Board of Public Charities.

Act 255, entitled "An act to provide for the expense of the care and treatment of the indigent chronic insane in county or city almshouses, and making an appropriation therefor," was vetoed by Governor Pattison, who gave the following as his reasons for declining to approve the bill:

This bill appropriates the sum of $190,000 to be paid to such counties of the Commonwealth as maintain their indigent chronic insane in county or city almshouses. The policy which it contemplates is directly in conflict with that which has been established by the Commonwealth in the development of the subject of the treatment of its insane. Gradually during the past few years the indigent insane inmates of county almshouses have been removed therefrom into State hospitals for reasons that have recommended themselves to the approval of the most intelligent and experienced students of the proper treatment of this unfortunate class. Humane and disinterested investigation of the condition of the insane in county almshouses has abundantly proved that the system of treatment in State institutions is vastly preferable to that of local As a result there are now but sixteen counties in the State where the chronic insane are maintained in the local almshouses, and it is undeniable that the average standard of care in them is far below that which is manifested in the treatment of the inmates of the State institutions. Three-fourths of the number of insane persons for whom this bill provides are in four counties of the State. I am thoroughly convinced that the bill recently framed by the Board of Public Charities and the Committee on Lunacy for a State Asylum for the Chronic Insane, which has also been enacted by the Legislature at its last session, provides a much better system of treatment than that contemplated in the bill under review.

care.

That act, to which I have given my approval, makes the present act wholly unnecessary. The experience, not only of our own commonwealth but of others in which the most advanced methods of treating the question of State management of the insane have been tested, has confirmed the wisdom of the plan of maintaining the incurable insane in the larger State institutions instead of in the county almshouses, and I am not willing to approve a measure which involves a backward step.

The additional wards for insane at the Philadelphia Hospital, Blockley, which are about ready for occupancy, will afford additional accommodation for the insane of this County.

INVESTIGATIONS.

During the past year the committee have made numerous investigations of complaints from various sources, in regard to insane improperly detained at home; and, on account of complaints made against the

Warren Hospital a special inquiry was made at this institution on June 12.

After careful investigation, in which the trustees of the hospital participated, the Committee found that the charges of abuse of a patient by attendants were not sustained, and so reported to the Board of Public Charities, which had referred the complaint to the Committee for inquiry.

In consequence of allegations of improprieties existing in the State Lunatic Hospital, Harrisburg, made by Dr. John C. Stevens, a member of the medical staff, the Committee on Lunacy made an investigation at the institution on July 2, 1891.

The information upon which the Committee acted was given voluntarily by Dr. Stevens to the Secretary at Williamsport, on June 14, where they chanced to meet, and was quite unsolicited as well as unexpected.

The allegations were written down at the time by the Secretary as they were related. They were of so grave a character that the Secretary asked Dr. Stevens whether he was prepared to substantiate them at a public investigation, which would certainly follow. Dr. Stevens replied that he could do so and was prepared to appear at an investigation at any time, for that purpose.

After careful consideration of the testimony elicited, the following communication was forwarded to the hospital trustees and also to Governor Pattison:

PHILADELPHIA, July 30, 1891.

To the Board of Trustees, State Lunatic Hospital, Harrisburg:

GENTLEMEN: The Committee on Lunacy, after a very thorough investigation of the charges of improper management of the Harrisburg hospital made upon July 2, 1891, finds distinctly proven by the evidence of sworn witnesses that at least two assaults had been made upon patients by attendants, involving very serious bodily harm: that though the first assistant physician, Dr. Milton U. Gerhard, and the superintendent, Dr. J. Z. Gerhard, were fully aware of these circumstances, they failed to dismiss the offending attendants or to notify the Committee on Lunacy so that legal steps might be taken for the conviction and punishment of said attendants as prescribed by section XVI of the Rules and Regulations of the Committee on Lunacy. This neglect was also in violation of section XII of the Lunacy Law of 1883.

It is further in evidence from the voluntary statement of Dr. J. Z. Gerhard, the medical superintendent, that he knowingly neglected to obey the regulations laid down by your board in not reporting the assaults upon and improper treatment of patients.

The Committee had ocular proof of the fact that the system of keeping the hospital books as required by section XVII of the Lunacy Law of 1883 was imperfect and not in accordance with the forms given

in the Rules and Regulations; that it was impossible to obtain from them a true reflex of the details of the medical management of the hospital. It also appeared, in accordance with the testimony of Dr. J. Z. Gerhard, that for years past the dispensing and compounding of medicines for the patients and the responsibility of the hospital pharmacy had been in the hands of an employe who was not qualified legally nor actually for such a responsible duty, and that, in so permitting, the medical superintendent violated the State Pharmacy Law. It is only within a brief period, and after repeated remonstrances from the Committee on Lunacy, that a qualified resident apothecary was appointed by your board.

In addition to the testimony elicited at the investigation, the Committee on Lunacy has had corroborative evidence furnished of gross mismanagement and brutality. Mr. J. C. Reitman, a young man of unusual refinement and intelligence, was connected with the hospital as an attendant. His private diary reveals shocking and outrageous cruelty and oppression of helpless patients by attendants, together with instances of professional neglect on the part of Dr. Milton U. Gerhard, first assistant physician, as to lead to the conviction that the hospital under your charge has so far lapsed from proper discipline and control as to require the most radical change in the medical supervision before it can become a safe and proper refuge for helpless and irresponsible humanity and have the confidence of the community.

Every allowance having been made for possible exaggerations and misstatements, the Committee on Lunacy find, upon careful consideration of the evidence, that the medical control of the hospital is lax and inefficient; that the regulations imposed by the Lunacy Law have been repeatedly violated and set at naught; that barbarous and cruel practices upor patients by attendants have gone unreported and unpunished, and that inefficient care has been bestowed in the selection and training of attendants in their responsible duties.

It is. therefore, the opinion of the Committee that a very radical change in the medical staff of the male department is required. We would recommend the selection of a new medical superintendent and a first assistant physician. The Committee also recommend the prompt removal of all attendants who have been shown to be guilty of any form of ill-treatment or abuse of any insane person.

Very respectfully yours,

(Signed)

THOMAS G. MORTON, Chairman,
THOMAS W. BARLOW,

GEORGE I. MCLEOD,

JAMES B. SCOTT,

HENRY M. BOIES.

On August 28 the following report of the Hospital Trustees was re

ceived:

HARRISBURG, Pa., August 28, 1891.

To the Committee on Lunacy of the Board of Public Charities:

GENTLEMEN: Your communication of July 30 to this Board recommending a change in the medical staff of the Pennsylvania State Lunatic Hospital, giving your reasons therefor, and what, in your opinion, was the evidence justifying such recommendation, has received the most careful attention of this board.

Feeling that the long and useful services of Dr. J. Z. Gerhard, the confidence reposed in him by this Board, and the fact that the abuses mentioned in your report had never come to the knowledge of the Trustees, required a more careful and thorough investigation than was possible for your Committee to make in the limited time at your disposal, this Board has made a most searching investigation, not only as to the alleged abuses and lack of discipline mentioned, but as to all details of the hospital management.

This Board, therefore, after having had hearings extended through several weeks, and after having taken the testimony of a very large number of sworn witnesses, is able to report the following as the actual state of facts as to the matters contained in your report:

First. That there were no assaults committed, as alleged, nor has there ever been more force used than was necessary to restrain refractory and dangerous patients. In the case of the patient Blouse, the testimony taken before your Committee and that since taken by this Board, shows him to be a dangerous man, who was injured by falling on a bench while being controlled by two attendants. The superintendent has always instructed attendants and employes that no more force should be used than was absolutely necessary.

That neither of the cases mentioned by you is within the rules of the Lunacy Committee or the Lunacy Law, requiring a report to the Committee on Lunacy, that action might be taken by the proper legal authorities, as was stated by the District Attorney at the time of your investigation. Second. That at the time of the visit of your Committee to the hospital there was a legally qualified pharmacist in charge of the drug and medicine department.

Third. The report of your Committee has the following: 'In addition to the testimony elicited at the investigation the Committee on Lunacy has had corroborative evidence furnished of gross mismanagement and brutality.' This 'corroborative evidence' seems to consist of translations of extracts from the alleged diary of a young German, J. C. Reitman, who was for a short time an attendant at the hospital, but who had since left, and was at the time of your investigation, and still is, in Europe.

This Board feels that a gross wrong was perpetrated in thus receiving as evidence the translations from the alleged diary of a person not present to be sworn, with the original alleged diary not produced, and,

without calling a single witness as to the truth of the charges therein contained, making it the basis of a report imputing 'gross mismanagement' of the hospital.

This Board has called every witness who could have knowledge of the abuses alleged in this diary, who, by their own sworn testimony, disprove positively every charge contained therein. The charge therein that Dr. Milton Gerhard was guilty of professional neglect, based upon the fact that he did not treat several patients as indicated by the diag nosis of the attendant Reitman, is further disproved by the discharge, some time since, of the patients mentioned in excellent physical condition, one recovered mentally, the other much improved.

We find that there has been no brutality, or neglect and abuse of patients, and that there has been none other than necessary force used in restraining violent patients, and that the general management and control of the hospital is good."

We exceedingly regret that the Committee on Lunacy had not the time to make a more thorough and extensive investigation, feeling assured that had they done so, they would have arrived at the conclusions contained herein.

At the same meeting at which this action was taken, the Trustees accepted the resignation of Dr. J. Z. Gerhard and elected Dr. H. L. Orth, a member of the Hospital Trustees, as superintendent of the hospital for a term of ten years.

Subsequently Governor Pattison, having considered both the above reports, requested the Board of Public Charities to institute an investigation into the condition of the hospital and report to him.

Upon September 24 the Board of Public Charities met in Harrisburg and held an official investigation, upon which the following report was submitted to Governor Pattison on October 23, 1891:

"The investigation was held in the Senate chamber, at Harrisburg, on the 24th of September last, and at our request was conducted by the Hon. James A. Stranahan, Assistant Attorney General of the State.

The Board of Trustees of the hospital, at our invitation, were present, and participated in the examination. Patient and exhaustive hearing was given to all the witnesses who could be produced, some of whom