Tag Archives: Dr. John S. Billings

Asylums and Public Inspections, part 2

Pamphlet for Visiting Board Members

Pamphlet for Visiting Board Members

When Drs. Billings and Hurd created a short pamphlet with suggestions for Boards of Hospital and Asylum Visitors (see last post), they were anxious to help these independent “eyes and ears” of the public understand what they should look for during their inspections. Though they urged these visitors not to come in with preconceived ideas or to be excessively judgmental, the doctors did urge them to take their responsibilities seriously and really look at conditions.

One detailed admonition was for visitors to “rub or press a surface [such as the tops of cabinets and shelves or the valves of fresh air registers] with the tips of the fingers, or with a white handkerchief,” to see whether the surface had been actually cleaned, rather than merely dusted. Visitors were to take note of odors and try to discover what caused them: “. . . iodoform or some other drug; to a recent discharge from the bowels; . . . or is it merely a vague, slightly dusty odor, which gives a sense of oppression, indicating insufficient ventilation?” The authors asked them to note whether rooms were neat and clean, if bedside tables were in the proper position, whether dishes or clothes were ever rinsed in the bathroom tubs, etc. First-time offenses should be brought to the attention of the superintendent so he could have a chance to correct them, rather than immediately to outside authorities.

Dr. Henry M. Hurd

Dr. Henry M. Hurd

When Billings and Hurd moved on specifically to asylums, their concern for the well-being of patients was evident. Many questions concerned attendants. Besides asking if they were well-trained, tactful, and respectful, the doctors asked: “Do they have the manner of nurses upon the sick, or of guards in a house of detention?”

Boards of Visitors Were Created to Prevent Scenes Like These at Byberry Farms in 1938, courtesy Historical Society of Pennsylvania

Boards of Visitors Were Created to Prevent Scenes Like These at Byberry Farms in 1938, courtesy Historical Society of Pennsylvania

The answer to this question would have likely made all the difference in the world to patients.

Facebooktwittergoogle_pluspinterestlinkedintumblr

Asylums and Public Inspection

Staff at the Illinois Asylum for the Incurable Insane, 1903

Staff at the Illinois Asylum for the Incurable Insane, 1903

Public insane asylums and hospitals were monitored in part by committees whose members inspected the facilities and made recommendations for changes and improvements. These committee members were laypeople who took an interest in a particular institution and volunteered their time to visit and inspect it.

Sometimes outsiders get a different sense of a situation than people who are immersed in the field, and can be useful in pointing out conditions professionals have gotten used to seeing. However, asylum and hospital professionals were wary of these public “visitors” simply because they didn’t understand institutions and their limitations. In 1895, two physicians (Dr. John S. Billings and Dr. Henry M. Hurd) created a short pamphlet with suggestions for hospital visitors. They urged these laypeople to come “in a friendly spirit”–not to find fault or with preconceived notions, but with an open mind that sought to understand what was going on.

John Shaw Billings, circa 1896

John Shaw Billings, circa 1896

The authors explained that any visitor would find shortcomings. “No hospital, however wealthy it may be, has means sufficient to furnish the best known means of treatment and the best care to all who apply to it for relief,” they acknowledged. Few, if any, hospitals (or asylums) had all the medical equipment its doctors wanted, or served the best food, and so on. With these limitations in mind, the authors asked visitors to go through the institution with the idea that they could help its administrators improve its function.

Patients Playing Billiards at Bryce Hospital in Alabama, 1916

Patients Playing Billiards at Bryce Hospital in Alabama, 1916

Though Drs. Billings and Hurd may have begun their pamphlet sounding as though they wanted to protect medical institutions from hard scrutiny, they made it plain that visitors were to examine the place thoroughly. Some of the things visitors were to look out for will be mentioned in my next post.

Facebooktwittergoogle_pluspinterestlinkedintumblr