By Dr. Thomas W. Salmon
[Portion of an address delivered at the meeting of the Association of County Judges and Commissioners at Waxahachie, Texas, on February 11, 1916.]
This particular Poor Farm is in one of the richest counties of the state. The taxable property of that county is assessed at more than $45,000,000. It contains no large cities (the largest has a population of 15,000), all but two per cent. of the people are native-born and the proportion of negroes is much less than in the state as a whole. It would be difficult indeed to find in this wide land a county more prosperous, more pleasant to live in or more truly American than this one.
Four miles west of the county-seat is the Poor Farm. There is a substantial brick building for the poor and infirm which is heated by steam and lighted by acetylene gas. Scattered around the main building are some small wooden cabins, cheap in construction and not in very good repair, but, on the whole, comfortable for the old people, the paralytics and the epileptics who live in them. If we could leave this Poor Farm, having seen so much and no more, we could think of it again only with feelings of pleasure that the county’s unfortunates were provided for so comfortably; but standing alone is an old brick building in which the insane are kept and this must be visited too. It is a gloomy place, coming out of the bright October sun, but when your eyes become accustomed to the shadows, you see what this county has provided for the insane who are neglected by the great mother state. You see that there is a clear space running around three sides of the one large room which forms the entire interior of the building. In the center and across the rear end of this room are fourteen iron cages—four extending across the rear and ten back to back, down the center. They are made of iron bars, the tops, backs and adjoining sides being sheet metal. Near the top of each solid side, are seven rows of holes about an inch in diameter. Their purpose is ventilation but they serve also to destroy what poor privacy these cages might otherwise possess. Each cage contains a prison cot or two swinging from the wall while a few have cots upon the floor.
In these cages, which are too far from the windows in the brick walls for the sunlight to enter except during the short period each day when it shines directly opposite them, abandoned to filth and unbelievable misery lie the insane poor of this pleasant, fertile, prosperous American county. Color, age and sex have no significance in this place. All of those distinctions which govern the lives of human beings elsewhere are merged in common degradation here.
Men and women, black and white, old and young, share its horrors just alike. They are insane and that fact alone wipes out every other consideration and every obligation except that of keeping, with food and shelter, the spark of life alight. When, at dusk, the shadows deepen, the creatures in this place of wretchedness cower closer in the corners of their cages for there are no cheerful lights here as in the other buildings and when the darkness blots out everything there are only the moans of distressed human beings to tell you it is not a tomb. Through the night, when persons with bodily illnesses are attended by quietly treading nurses in the two fine hospitals which the nearby town supports, these unfortunate men and women, who are sick in mind as well as in body, drag through terrors which no human community would wish to have its worst criminals experience.
Each day brings to the poor creatures here light and food—as it does to the cattle in the sheds—but it does not bring to them the slightest hope of intelligent care, nor, to most of them, even the narrow liberty of the iron-fenced yard. One attendant, a cheerful young man, is employed by the county to look after the forty-odd inmates who at the least compose the Poor Farm population. He used to be a trolley car conductor but now he receives forty dollars a month for attending to the inmates, male and female, who cannot care for themselves. He brings back the feeble-minded when they wander off, he finds epileptics when they fall in their attacks and he sees that all are fed. He is called the “yard-man”; his duties are those of a herdsman for human beings. His predecessor, a man of about sixty years of age, is serving a term in the state penitentiary for an attack upon a little girl who was an inmate of this Poor Farm. At his trial it was brought out that he had served a previous term in another state for a similar offense.
The present “yard-man” has not the slightest knowledge of any other kind of treatment for the insane, nor has he had the slightest experience in practical nursing or in caring for the mentally or physically helpless. He has been employed here about a year. He found the insane in these cages and he knows of no other way of keeping them. All but three or four of them remain in their cages all day, crouching on the stone floors instead of on the green grass outside. A feeble white woman in bed, wasted and pale, who apparently has but a few months to live, was pointed out in one of the cages and the “yard-man” was asked if she would run away if she were permitted to have her bed outside. He admitted that it was not likely but said that she was weak and would fall out of bed. He was asked if it would be worse to fall out of bed on the grass or on the wooden floor of the main building than on the stone floor of her cage, but these matters were far outside his experience and he had no reply to make.
How much more knowledge and experience would have been required of this young man if the county had seen fit to maintain a menagerie! No one would think of entrusting the animals to one so wholly inexperienced in their care. This young man might be employed as an assistant, but he would never be placed in charge of an animal house full of valuable specimens.
Do not make the mistake of thinking that the wretched people who are confined in these cages were selected from a larger number of insane inmates of the Poor Farm on account of exceptional intractability or because their brains have been so dulled by the final stages of dementia that they are no longer conscious of their surroundings. These people are not a few selected for such reasons; they constitute all but one of the avowedly insane who are housed in this Poor Farm. They include persons as appreciative as you or I would be of the loathesomeness of their surroundings and of the personal humiliation of being confined in such a place. In one cage is a man who has delusions which doubtless make it unsafe for him to have his liberty in the community. He has not been allowed outside his cage for a single hour in three years.
This place was built twenty years ago. Perhaps the brain which planned it is now dust, nevertheless its ignorant conception of the nature of mental disease still determines the kind of care this county affords the most unfortunate of all its helpless sick. Perhaps, too, the hands which laid these bricks and forged these iron bars are now dead, nevertheless they still stretch out of the past and crush the living in their cruel grasp. The conception of mental diseases which gave to this county this dreadful place did not even reflect the enlightenment of its own period. Eighty years earlier Esquirol had stirred the pity of France by a recital of miseries no worse than those which you can see in this county to-day. Many years before this place was built, Conolly had aroused public opinion in England to such an extent that it was possible for cages such as these to exist in only the darkest corners of the land. Thirty years before this grim structure arose from the fair soil of Texas, Dorothea Dix was showing the inhumanity of almshouse care of the insane in this country and members of our legislatures were profoundly stirred by her descriptions of conditions less abhorrent than those which exist to-day in the Poor Farm which I have just described. Great reforms in the care of the insane have extended over the entire country ever since these walls were built but they have left this place untouched and it stands to-day, not a pathetic but disused reminder of the ignorance and inhumanity of another age and of another kind of civilization, but an actual, living reality reproducing, with scarcely a detail lacking, conditions which were described in pitying terms by the writers of four centuries ago.
Standing in the doorway of this building you can see evidences of the material greatness of the twentieth century; taking a single step inside you can see exactly what the superstition, fear and ignorance of the sixteenth century imposed upon the insane.
The sufferings of the insane in the county Poor Farms would so stir the compassion of the humane people of this state, could they but walk among these fellow-citizens of theirs and witness the misery to which they have been abandoned, that almshouse care would not survive the next session of the legislature. Take away, however, the meager attention given in the Poor Farms by those who, while they know nothing of mental diseases or of how to care for them, are moved by kindly impulses and recognize that the insane are sent to them for care and not for punishment; take away this and substitute the harsh discipline of the prison which is designed, by its painful memories, to restrain evildoers from crime. Then some picture can be formed of the lot of these poor sick people in county jails. Almost without exception, they have committed no crime, unless it be a crime to suffer from mental illness, but they share the lot of criminals and in many cases through the fears of their jailers they are denied even the small liberties allowed the criminals. Men and women, white people and negroes, those scarcely out of childhood and those filled with the pains and infirmities of age, those with types of mental disease which would yield readily to even the simplest treatment and those doomed to mental darkness all their days, I have seen them in the cells of the county jails of Texas and learned their needs and witnessed their sufferings at first hand. I can only say that I have never witnessed such depths of misery as those in which these unfortunate people drag out the months and years. Death releases some—the more fortunate—but the others continue to exist in filthy cells without that hope of release after a definite period, which cheers the criminals whose lot they share. The rigors of the jail are intended to impress evildoers with the terrors of the law but with few exceptions the prisoners in county jails are young men, most of them in sturdy health. It is needless to point out how much more severe punishment confinement in such places is to the unfortunate insane, broken in health, many of them acutely conscious of the terrible wrong which their state is inflicting upon them and the prey to delusional and hallucinatory terrors, as well as to those which depend upon actuality.
In not a few instances I found the insane in solitary confinement, simply on account of their mental disease, while the criminals enjoyed the companionship of their fellows. Every convention of life is swept away when these unfortunate people enter the jails. Women are bathed by men in the presence of male prisoners, persons with elusions of sin and impending punishment lie in cells which face the gallows, the weak and helpless are not even protected from physical violence, and, in most cases, there is not the slightest semblance of personal care or nursing. The jailers feel that they have discharged their full duty if the insane are prevented from escaping. Persons convicted of serious crimes enter the jails, serve their sentences and regain their liberty while the insane, who have led upright lives and have contributed by their honest toil to the prosperity of their state, lie in their cells without hope of release. A pathetic fact is that the counties pay the sheriffs more just for feeding the poor people than their care would cost in the state hospitals for the insane. It is needless to dwell further on the inhumanity and the injustice of confining the insane in the county jails. It constitutes a blot upon the honor of the state which every citizen would demand erased were the actual facts widely known.