Sunnyside
WASHINGTON HEIGHTS, NEW YORK CITY. A PRIVATE MEDICAL HOME FOR NERVOUS INVALIDS, UNDER THE MANAGEMENT OF Dr Edward C. Mann, late Medical Superintendent N.Y. State Em. Insane Asylum, and Dr Wm. H. B. Post.
Tin’s Home, unsurpassed for its beauty of location and surroundings, and with handsomely furnished apartments, receives a limited number of cases of either sex, of mental and nervous diseases, Dipsomania and Opium Habit, and offers to such patients all the attentions, comforts, and attractiveness of a homo, together with medical treatment.
This private institution was started one year ago by the advice of several of the most eminent professional gentlemen of New York, who considered that such an institution whs much needed, and owing to their kind co-operation, it has already proved highly successful. As a new year is being entered upon, it is proposed, while extending our most hearty thanks to the members of the profession for the interest they have manifested in our success, to briefly explain the class of -ases which are received and treated at Sunnyside, and our success in the treat- ment of such cases during the past year leads us to hope for the continuance of the support of our professional friends.
MENTAL DISEASES.
In the treatment of mental disease, which, if properly ciired for and treated, is one of the most curable of serious diseases, the strict privacy of our institution enables the friends or relatives of patients from the higher ranks of society to place them at Sunnyside, thus providing for them the necessary care and treatment at the onset of the disease, and they thus avoid the mistake so often made, of keeping patients at home during the early stages of mental disease, a plan fatal to the prospects of recovery of the unfortunate patient, who is finally, when ho has become perfectly unmanageable, sent to an asylum with deeply seated and incurable disease, which might easily have been cured had the patient been placed under treatment in the inception of the disease. In treating mental disease, a long experience has shown us that the best health, the least mortality, and the most recoveries, result from systematic wholesome exercise of body and mind as a remedial agency. This, which is a law of nature, is an indispensable condition upon which depend general health and soundness of mind, and we resort to it to the fullest extent. We invariably ascertain what bodily and intellectual exercises have been pursued by our patients in early life, and endeavour by proper appliances to bring these external aids to treatment to bear appropriately upon each individual case. In mental disease we have an abnormal state of nervous tension and pent-up nerve force, which must expend itself in some direction, and must generate an equivalent manifestation of force either in feeling, thought, or bodily action. If we can cause the nervous excitement or pent-up nerve force to be expended in bodily or muscular action by means of wholesome bodily and intellectual exercises, we shall decrease correspondingly the morbid thoughts and feelings which are caused by the intensity of the cerebral excitement. If w? allow our patients to remain idle, the whole pent-up nerve force is expended and concentrated upon thought and feeling, which become morbidly intensified and perverted, and at last produce organic and incurable changes in tho brain, which might have been arrested by drawing off the nerve force in the channels of pleasant bodily and intellectual employment, giving a new direction to the thoughts and feelings. The treatment of mental disease necessarily needs to be of a varied character to meet the requirements of each case at different periods. Medical, moral, and hygienic means must all be used, as circumstances may dictate, to remove the disease, to build up the health, to draw off the mind from morbid fancies and lead on to clearer light, and brighter and more healthy views of life and its surroundings. The medical means which are employed at Sunnyside, include all those appliances of the materia medica necessary to remove diseased action, produce sleep, and strengthen the system, so as to regain the proper healthy action. The moral means include amusement, recreation, and everything of a pleasant, cheerful character which can tend to draw the mind from morbid views and lead to healthier thought and more pleasant views of life and of indi- viduals; while the hygienic means embrace the proper regulation of the diet, regular systematic exercise of various kinds and degrees, and the formation and cultivation of those habits which lead to a careful, regular, and more healthy course of life Our endeavour is, while gathering round those entrusted to our charge everything which can make our institution home-like and agreeable, at the same time to give the greatest variety and the most cheering, soothing, elovating, and refininu character to the associations and surroundings of our patients. Patients suffering from mental disease, who are naturally refined and sensitive, “When sent to Insane Asylums, often feel that they are captives for a long time?it may be for ever?in what they regard, notwithstanding the amenities of such asylums, as prisons, among companions whom they loathe, and with surroundings foreign to their nature and habits, incompatible with their prospects and desires, and where no ray of comfort from the future can penetrate through bolts, bars, administrative vigilance and management. How different is the .condition of patients, who, instead of being left alone as is unavoidable in our asylums, their solitude disturbed by the sense of desertion, by fears or forebodings under which, in the darkness or twilight which broods over them, they must grope around for some hope or stay on which to lean, have the hourly home companionship of a counsellor, companion, and friend who is their physician, and it is not an accident but a triumph of moral treatment which makes the physician the confidant and confessor of his patient. With such patients, their comfort, happiness, and iesignation rest in the hands of their physician, and his powers, responsibilities, and usefulness should increase in the same ratio as the years, helplessness, and hopelessness of his patients. In strength and excitement the physician must restrain, and in weakness, waywardness, and exhaustion he must support, soothe, and solace; ar.d patients certainly have the right to expect from tneir physician delicate forbearance, attention, and sleepless watchfulness and when th? mists of disease pass away, how mutual the pleasure and gratification of both patient and physician!
DIPSOMANIA.
In the treatment of Dipsomania, or, as it is more commonly termed, Inebriety, we admit at Sunnyside not cases where intemperance is a vice, but cases in which the Dipsomania is a neurosis?a functional disease of the nervous system?where the patient’s will is overborne by tho irresistible impulse and craving for intoxi- cants, so that he is pursuing a course against which his reason and conscience alike rebel, but which he is powerless to control. We invariably treat such cases on the same principles as other and allied nervous diseases, and with the most gratifying results. Owing to the abuse of alcohol, the blood plasm conveys to the brain cells a noxious and poisonous, in place of a nutritive, substance, stimulating the brain cells so as to hasten the progress of decay and waste beyond the power of reparation and renovation, and impressing a pathological state on them We find, as a natural result, a change of healthy function? disease?induced, with marked and often serious impairment of the general ner- you8 sy&tem. We provide for this class of cases, cheerful, pleasant, and tran- quil surroundings and -wholesome exercise of body and mind, and have thus far been eminently successful in leading patients to a better and higher life, and have had the pleasure of restoring such patients to their homes and to society. In building up the system after the wonted stimulus has been with- drawn, which is invariably from the first, and in combating the nerve-exhaust- ing tendencies which are invariably present in a marked degree in such cases, in addition to nerve sedatives and tonics, we have had surprising results from the use of electricity to the brain and spinal cord, and by its use we avoid the terrible nervous prostration, which, as it is well known, follows the withdrawal of liquor from an inebriate. Our patients who have applied for treatment in fear and trembling, dreading the ordeal they must pass through in the beginning of treatment by reason of such withdrawal, have been as much surprised as pleased to find the use of electricity supplied to the nervous system an agreeable and invigorating substitute for the stimulus which they were debarred from using in such a marked degree that little or no suffering was experienced.
OPIUM HABIT.
The use of opium as a luxury, which to day prevails to an alarming extent among the higher and more cultivated classes of society, who soon get to that point where it is taken in order to be freed for a brief time from the torments to which the opium habituate is subjected when deprived of his stimulant, dates back to the Arabs, who communicated its use to the other Eastern nations, more especially as a substitute for stimulants, so that the absence of one species of intoxicants became provocative for excess in another far more formidable and fatal. From being known as a medicinal substance to the Greek physicians centuries before the Christian Era, it has now become a means of sensual indulgence and a scourge to millions, so that to-day, one fifth of the opium sold by retail druggists would cover all the prescriptions of physicians in this country. Opium, as it is generally in- dulged in, is taken to stimulate but not to disturb the mind ; to soothe irritability, to induce placidity, pleasurable feelings, gentle and friendly relations, to restore the strength and activity enfeebled by previous indulgence, and to render the par- taker himself capable of discharging his duties and occupations by imparting an artificial and temporary health, which at once deceives the victim and baffles the keenest scrutiny. A wan and withered man or woman will apply for treatment with bent figure, slow step, tremulous hand, features pale and haggard, eyes sunken and lustreless, and they would appear to the ordinary observer as a man or woman tottering on the verge of life. Let such an one take his ordinary dose of a solution of morphine and observe the result. The transformation, to a non-professional observer, is something miraculous. The gait is firm and assured, the muscular system is re-strung, the face has grown in roundness and fulness and is flushed as in youth, the eye is clear, sparkling and restless, and the conversation of our patient cheerful and fascinating. But in a short time his rejuvenescence will fade away into the former spectral appearance. Many druggists mako a diluted laudanum for the purposes of drink, and are in the habit of selling it to persons who bike it instead of alcoholic liquors, but as yet inebriation by opium is not known to the public as alcoholic excess is, although in foreign countries, and especially iu China, millions have become infected with this ruinous propensity. Opium is resorted to among the higher classes of our own country to blunt care, to dry the tears of grief, to calm the tremors of the terror-stricken, and lull clamorous consciences to the coveted rest. The sensations of the opium habituate are alleged to be those of exquisite enjoyment and the brilliant fancies that for a time obtain, transcend all real and healthy impressions received in the sober and waking state. But what is the price that is paid for this dearly bought indulgence ? An opium eater is also an opium sufferer. When the opium eater or indulger awakos to a conscious- ness of his real position and misery, when the languor, lassitude, loathing of food, aching of the limbs, and indefinable wretchedness succeed, it is pitiable in the ex- treme to know that this state can only be mitigated by new and perhaps increased indulgence. There is probably no more terrible suffering than the complete exhaustion, the prostration of mind and body which these patients suffer. The control over the muscles, is lost, and epilepsy, paralysis, and an unsteady and ill- balanced gait are all frequent symptoms of this terrible disease. Such patients have a full consciousness of their position, but are powerless to emancipate them- selves from the opium habit. Their miseries and anguish are extreme, but in spite of all effort they find themselves forced back again into the habit. It is such cases that we receive for medical aid and systematic treatment. We endeavour to lift such patients from the depths of their suffering and provide for them careful nursing, consideration, care, and attention. The opium habit will yield to the proper treatment and can be thoroughly eradicated if the patient will put himself under the necessary control and desires a cure himself. Unlike the treatment of dipsomania, we do not insist upon the patient abandoning totally and peremptorily the use of opium as we do with alcohol, but in the cure of the opium habit wo diminish gradually the dose of opium, thus avoiding much suffering and nervous prostration, and, as in dipsomania we have found that the daily use of electricity applied to the central nervous system in addition to other treatment, so stimulates and invigorates the system that in a measure it supplies the place of the opium, and is a very effective agent in the removal of the craving for it.
NHBVOUS DISEASES.
Patients are’received at Sunnyside suffering from nervous exhaustion, paraplegia or hemiplegia, cases of general nervous diseases and especially cases of hysteria and conditions allied to hysteria occurring in ladies, and the greatest care and at- tention devoted to their cure. Probably there is no disease affecting females which tends to make life, both to the patient and her friends, a greater source of misery and existence more of a burden than does hysteria. The mental state is as much diseased as is the condition of the muscular system, as there is a defective and perverted will, and increased activity of emotion and of thought, while the general sensibility is altered and perverted. There is generally distinct perversion of the physical health. Hysterical patients may suffer from hysterical vomiting fur years, alternating with other hysterical symptoms. They may remain hemiplegic or para- plegic and bedridden for years, or they may suffer from loss of voice, joint affections, or violent fits for a number of years, if not relieved by treatment. The treatment of aggravated hysteria is almost impossible in the home of the patient and in the midst of the usual surroundings, as the moral and bodily condition rapidly deterio- rates under the influence of the pity, sympathy, and over-attention which hysterical patients live for, and which they are constantly laying plans to attract from their friends. There is no radical cure for hysteria but judicious firmness of management, combined with the kindness and friendliness of manner on the part of the physician. This is much more easily accomplished by a change of scene and surroundings. At Sunnyside we endeavour, in addition to improving the general health, to make the patient take an interest and pleasure in some occupation, intellectual recreation or study, and to remove the mental or emotional cause of the disease, and we have thus far had the satisfaction of restoring such patienis to their customary health. Patients, while in their own homes in this excited mental and emotional state, may assert for years, perhaps, that they cannot control their thoughts, emotions, expressions, and general movements, while after appropriate treatment away from home, they soon do the very things that were said to be impossible. These patients manifest listless indifference to everything of ordinary interest, while on the other hand they will sometimes become absorbed in very trivial objects. They are restless and impatient while at home, and manifest extremo irritability of temper on any effort being made at control or any suggestion being offered of change. Hyperajsthesia, or exalted keenness of the different senses, but more particularly of hearing, sight, and smell, is generally associated with the hysterical condition; and also painful sensation, or dysesthesia, which renders patients preternaturally sensitive to the sensations of light, sound, odours, or certain tastes. These patients always complain of pain, which they invariably describe as intense in character and which they locate on the top of the head, the left mammary region, and tho hypogastric or the sacral region. They will also complain that they feel the want of breath; they complain of palpitation of the heart, when its action is perfectly normal; and also of the distress which they experience in relieving the bladder or the rectum, when there is nothing abnormal about these processes. Diminished sensibility, or anaesthesia, may sometimes extend over a part or the whole of the body or to the nerves of special sense. In these cases patients complain of loss of sight, hearing, smell, and taste. In hysteria we find an excess of involuntary motility and a diminution of volitional motility. The emotional movements aro all highly exaggerated, while voluntary movements are sluggish, the patient complaining that she is incapable of doing any work, while she manages to do a great many irrational things that she could not do under ordinary circumstances. Hysterical paralysis sometimes occurs and persists for years, but its symptoms differ widely from paralysis in persons suffer- ing from organic disease of the brain or spinal cord. A patient, for instance, ?with hysterical paraplegia, when making the attempt to walk, will fall to within a short distance of the ground, and then recover herself without any help which would be quite impossible if she was really paraplegic. With regard to disease of the generative organs in hysteria.it is the exception and not the rule as many think, to find any definite trouble. Hysterical convulsions and mania often occur and are quite troublesome to manage at home, as in the case of a young ladv who while in her own home, -would threaten to ” have a fit” if her most trivial demands were not complied with, which invariably resulted in the immediate gratification of her most exacting whims. Under appropriate treatment her convulsions and maniacal paroxysms were in a few months completely cured. Our primary object in the treatment of hysteria at Sunnyside is to make strenuous efforts to draw the patient out of herself and to develop self-control, and this is insisted upon as the business of daily life. Such patients require to be watched, attended, and unconsciously guided away from self and into new grooves of thought, feeling, and action at once interesting to the mind while not fatiguing to the body, and this can be done, not by harshness or discipline, but by kindness, firmness, and wise regard to the feelings of the patient. Particular attention in these cases is paid to diet, rest, exercise, recreation, and intellectual pursuits as well as to the regu- lating of the various functions of the body; and, finally, we endeavour to supply to such patients some motive or purpose in life, which can easily be done by studying their character, thus stimulating them to make co-operative endeavours for their own cure unknown to themselves. All this requires strong will and great patience on the part of the physician, but success is certain if such treat- ment be persevered in, and is not interfered with by over-anxious friends or rela- tives.
Sunnyside is reached either by the Hudson River Railroad?the depot in New York being at the foot of 30th Street and Ninth Avenue, tickets being obtained for 152nd Street, -where it is but a few moments’ walk or ride to the villa?or by the line of the Boulevard stages, which leave Broadway and 32nd Street every twenty minutes. In driving to Washington Heights the way leads through Central Park, up St. Nicholas Avenue to 152nd Street, the institution being located on that street, between 10th Avenue and the Boulevard. Washington Heights is located on the east bank of the Hudson River, is covered with beautiful villas, and is one of the most elegant and fashionable suburbs of New York. The walks and drives are of great beauty. The real interest of the Hudson River begins at Fort Lee, opposite to Washington Heights, which is on the western bank of the Hudson, and is the lower boundary of the Palisades, which, commencing at this point, stretch in an unbroken line for twenty- four miles along the western shore of the river, varying in height from three to five hundred feet.
REFERENCES:
Dr Wm. A. Hammond, New York. Dr S. Weie Mitchell, Philadelphia. Dr Willakd Pauker, New York. Dr Alfurd C. Post, New York. Dr Alfeed L. Loomis. New York.
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