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Further Information:-

Cork lunatic asylum was one of the pioneers in treatment of insanity by use of the Turkish Bath.



March 10, 1900

INSANITY AND THE TURKISH BATH.

BY CHARLES H. SHEPARD, M.D.


Centuries of neglect and mismanagement have emphasized the fact that insanity is an affliction both singular and terrible, and at the same time a reproach to society, but modern science has proved that the early stages of the disease are as tractable as are those of other diseases, and we are not without hope in the more advanced stages.


While the increase of insanity may be due to heredity, and the strain of modern civilization on weak brains is a most potent factor, certainly the enormous use of narcotics in the shape of tea, coffee, tobacco, and alcohol, not to mention the indiscriminate use of other drugs, is responsible for 75 per cent. of this disease.


In ordinary disease the physician can derive much aid and information from the patient, but with insanity he is more frequently obliged to draw his deductions entirely from existing external conditions, and rely on general principles for the correction of the morbid action. For this purpose constitutional treatment is not only safe but most efficacious. It is also of great advantage to regulate the diet that the nervous forces shall not be further drawn upon to dispose of unnecessary aliment. Out-door life, including available exercise, ought to be considered a necessity, in order that a sufficiency of oxygen may be imbibed to vitalize the blood in its circulating and renovating course. Not least in the list of constitutional agencies is that of baths, and pre-eminent among all baths is the hot-air, otherwise called the Turkish bath.


As insanity is characterized by abnormal mental action and condition, it follows that there must necessarily be more or less congestion of the brain substance. To change this condition would seem to be the first requisite. If the blood is loaded with impurities, it necessarily affects the nourishment of the brain. If we can call the blood in greater force to the extremities and surface of the body, it is but reasonable to suppose that thereby an overcrowded brain may be relieved. How much more so when we can at the same time purify this circulating fluid. There is no such thing as isolation in physiology. Perfect work is united work, and the good influences of the Turkish bath, or any other treatment, can never be confined to one organ or one part of the body.


It is claimed by good authority that it is the diseased condition of the blood, acting on the brain in the same way that alcohol does, which causes the morbid ideas of lunacy, and accordingly it is readily shown that no remedy for lunacy exists which is at all comparable to the bath, owing to its purifying action on the blood. . . .


We know very well, when there is a fever to deal with, that the crisis is passed when the sweating stage is reached. With heat applied to the surface of the body, we can bring on that stage at once. If the system is loaded with poison of any kind, whether it be of rheumatism, malaria, or other virus, the first thing in order is to eliminate that poison from the body, and no way has yet been found at all comparable to the heat-cure as found in the Turkish bath. The heat produces a perfect action of the skin. If the skin is not at all times in order, there is a danger of poisoning one's self by the non-removal of the disintegrated tissues that are being generated every moment. . . .


By the action of the bath we produce the results sought to be obtained by drugs; that is to say, it removes the symptoms for which they are administered, whether the drug be a cathartic, a diuretic, a tonic, a detersive or a narcotic, without any of the unpleasant sequel that too often follow their administration. The bath will bring sleep to one suffering from insomnia, but will not, like opium, make the healthy man drowsy. Furthermore, when a patient has recourse to the bath for any special disease, he is not only relieved of that trouble, but his whole system is placed in an improved condition. In applying the bath to man in his normal state of mind and body, only the most beneficial results have been produced. Still more so will it apply to man in an abnormal condition.


But little has yet been accomplished in the way of placing Turkish baths in the asylums of this country. Much, however, has been done in Great Britain and Ireland. Dr. Powers, superintendent of the lunatic asylum at Cork, Ireland, reports that by the use of the Turkish bath the cures rose from 59 to 76 per cent. After a few applications the patients like the treatment and ask for it. The deaths have diminished one-half. . . .


It was well said by Walter Savage Landor: "This is the grandest matter of modern times, because even the cleansing of the mind from error is inferior to the purification of the body itself, for unless the body is well conditioned, the mind never can be so."


The salutary effect of the bath is a matter of plain evidence. It is an agent at once simple and powerful, agreeable and economical, fully tested by experience, as incomparable in relieving various phases of the most terrible disease with which humanity can be afflicted, and it needs only a full recognition of these facts to make it available to thousands of sufferers throughout the country.










Account of the terrible conditions inside the hospital:-


1935 - 1936

"Each unit was roofed in the manner of a stall and each door was closed by three farmyard bolts. Mattresses were generally on the floor. These units did not have external windows or fresh air. There was a padded cell with a mattress on the floor of this ward. Toilets had no seats and there was no soap available to patients.

Another dormitory had eight beds with no curtains. There was no ward programme and the whole ward lacked any visual stimulation. St. Ita's 1, female with 20 patients; the enclosed courtyard attached to the ward was littered with old clothing, toilet rolls and plastic bottles which had accumulated over several months. We were informed that patients do not get out of doors in winter time. The dormitory with seven beds had no curtains. Many patients were in bed for the night at the time of our visit ó 5.15 p.m. Another dormitory housed ten patients and was also without curtains. Five beds were placed along one wall while on the opposite wall a structure had been erected in which five patients were separately incarcerated.

In some wards there is no adequate facility for storing food. In one ward we saw bread being stored in dustbins, most of it stale.

St. Kevin's, 9, male, 28 patients ó there is no activity in the day room. The patients sat around in armchairs waiting for bed time, which was somewhere between 5.30 p.m. and 6.30 p.m. The washhand basin area was used to store all sorts of rubbish. One window had four broken panes of glass."



1937

"The exterior of Our Lady's Hospital can only be described as filthy. Rubbish, litter, discarded toilet rolls are to be seen in profusion around the bases of the building, behind the grey building, behind St. Kevin's and in internal courtyards. Connecting corridors and walkways are dirty beyond description. Saucers of milk and other food are left out for cats. However, those cats must fulfil some function as many of the wards are mice-infested. One of our party saw some mice during the inspection and there may even be rats around. We did see one carcase. Internally, some but not all wards are dirty with windows grimed with opaque matter and walls peeling. These latter states of affairs were particularly evident in the main mentally handicapped ward in the grey building, St. Patrick's 1. Generally wards, particularly male wards, lacked curtains. There was a general feeling of crowdedness and a great single open space in some of the dormitories and in none of them was there any satisfactory attempt at dividing sleeping areas into warm, homely comfortable subdivisions. Lavatories, too, were generally unsatisfactory with lavatory seats missing and in some cases floors dirty and wet"


1939

"Then we come to general comments on Cork psychiatric services. This is the comment of the Inspector of Mental Hospitals:

Our impression of the approach to the delivery of mental health care in Cork city and county is that it is seriously deficient from a planning point of view. No clear objectives appear to have been identified, no priorities delineated and their solutions adopted. There appears to be a lack of clear lines of command and proper structured consultation. In addition, there seems to be industrial unrest which has never been adequately dealt with. This has hindered progress in providing adequate services and bringing about change. This is most notably evident in the illegal opposition to the transfer of patients from Our Lady's to Sarsfield Court. This was a disgraceful episode which reflects no credit on anybody and exemplifies management's inability or unwillingness to direct the service in the interests of the patients.

The service provided by the hospital is extremely poor and for the most part appears to provide the worst form of custodial care. The majority of patients are unoccupied and no attempt is made to provide appropriate rehabilitative inputs for them on their wards. It is our view that the board should establish and operate proper management techniques in relation to the whole Cork service. This should involve as primary objectives the prevention of further admissions to Our Lady's, which cannot provide up-to-date psychiatric care of a standard commensurate with proper human dignity, and an intensive rehabilitation programme for existing in-patients."

Documenting our Heritage

Our Lady's Hospital, Cork District Asylum

Sundays Well, Cork.

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