REPORT OF THE ACTING MEDICAL SONYEA, N. Y., October 12, 1909. To the Board of Managers of the Craig Colony for Epileptics: The annual report of the acting medical superintendent for the fiscal year ending September 30, 1909, is submitted herewith: Changes in Population. As a result of the opening of the service building in January, we were able to provide two much needed sitting rooms, one at Aster, and the other at Bluet. We were also able to supply room for additional beds for thirty female patients. With the completion of the two pavilions for tubercular patients, now under course of construction, we expect to have room for about seventy additional patients, thus bringing our capacity near the 1,400 mark. Admission of Patients. The pressure for the admission.of patients to the Colony has continued during the year. This emphasizes the advantages to be obtained by developing Letchworth Village at the earliest possible date. That institution would provide for a great number of the mental defectives, whether epileptic or not, who are now unable to be cared for as they should. (We know there are over 1,200 epileptics alone who are waiting an opportunity for Colony care.) It would, besides, we hope, give us a chance to select our patients more carefully, so that the Craig Colony could have more admitted who are capable of instruction and improvement. Letchworth Village, according to the law creating it, should also relieve us of several hundred low-grade cases now here, thus making room for more of the type for which Craig Colony was planned. Daily average attendance during fiscal year. . . . . 1273.347 196 1 to 6.6 Total. $87,105 30 60,921 82 71,864 39 $219,891 51 PER CAPITA COST. Our gross per capita cost is somewhat lower this year than it was in 1907-09. The reason for this is given at some length in the Steward's report. The following is a comparison of the per capita cost, gross and net, during the past six fiscal years: The weekly per capita for 1909 was, with home product, $3.81; without home product, $3.32. There is a minimum per capita cost which will permit the running of an institution in a proper manner without any extravagance. Anything below this amount would argue that the inmates of the institution are being deprived of many things conducive to their welfare. In my opinion we cannot expect to properly maintain the Colony on a hospital basis at the present cost of supplies, etc., for a smaller sum than $180 per year per capita, exclusive of home product. The highest daily population during the year was 1,307, and the lowest 1,227. During the year ending September 30, 1909, there were discharged as Recovered... 3 28 68 8 1 109 217 Since the opening of the Colony in January, 1896, to October 1, 1909, there have been admitted 1,667 males and 1,194 females total, 2,861. This difference in sexes has been largely due to the Colony having had more accommodations for males than for females. During the same period 1,562 have been discharged as follows: Recovered. Improved. Unimproved. Insane Died.. Total ... 46 382 416 125 593 1,562 Of the number now present there are 104 who reimburse for maintenance in whole or in part, the remaining 1,197 being supported entirely by the State. Age at Onset and on Admission. Deducting 88 readmissions, the average age on admission of the 2,861 patients thus far admitted is found to be 24.1 years. Deducting still further 71 cases in whom age at onset was unknown, we find the average age at onset in the remaining 2,702 patients as being 12.1 years. These figures show conclusively that as a rule the epilepsy is of long duration when the patient comes to the Colony. Deaths During the Year. The death rate, 7.1 per cent., is somewhat higher than in former years, but in the table of deaths for 1908-09 it will be noted that a considerable number were due to pulmonary tuberculosis. A large per cent. was, as might be expected, due more or less directly to their epilepsy. The pathologist, Dr. Munson, presents in his report considerable data relative to death in epilepsy, particularly sudden deaths. The low temperature found in so many cases is worthy of extended study, not only among epileptics but also other defectives. Hereditary Factors in Epilepsy. In a majority of the epileptics the symptoms of that disorder are but concomitant with the mental defect in a subnormal individual. The apparent increase during our century, in the number of cases of syphilis, alcoholism, insanity, epilepsy and similar conditions should be an incentive to those familiar with the situation to make constant efforts toward preventing at least a part of the development of such disorders. Laws to prevent marriage or cohabitation of mental defectives, epileptics, etc., and instructing the public regarding the effects of alcoholism, syphilis, epilepsy, insanity, etc., in the parent on the children, will not at once bring about a complete cessation of the occurrence of these disorders, and, so far as our present-day knowledge goes, never can. These measures would, however, if carried out intelligently, cause a material reduction of such conditions as the people in general learn of the great necessity of taking an active part along preventive lines. Coöperation of All Required. It should be recognized by the various governments, municipal, county, state or national, that persevering, concerted effort along the lines of prophylaxis of epilepsy, insanity, mental deficiency and allied disorders is required. Controlling the sexual instinct by education or by law tends naturally to prevent to a limited extent the procreation of the unfit by the unfit. But a large number of this class cannot be controlled unless placed under suitable supervision in special institutions. This applies particularly to the female. A great desideratum is thorough education of the mass of the people regarding the proper steps to be taken toward thus preventing the great numbers of unfit from being brought into the world. Another thing to be remembered is that no matter in what walk or station of life we search, whether we observe the educated class or the ignorant mass, the religious or irreligious, the white or black, the dweller in the town or in the country, among all we discover the degenerate of one type or another. While we cannot in all probability hope to obtain results so marked as those seen in connection with the crusade against tuberculosis, we should make the start by appealing directly to the public for coöperation in preventive measures along the lines of public health. It will take many years of persistent and patient effort before material results can be obtained. Dr. W. P. Spratling endeavored, some few years since, to have a law passed in this State restricting the marriage of defectives, etc., but failed because the lawmakers did not appreciate the great importance of such a measure. In a recent instance a feeble-minded young woman was removed from the Craig Colony by her brother. Two months later I rereived a letter advising me she had been married. example of what is a fairly common practice. what offspring may result from such a union. This is but one Try to imagine |