Produced by The Online Distributed Proofreading Team at https://www.pgdp.net (This file was produced from images generously made available by The Internet Archive.) HOW TO CARE FOR THE INSANE A MANUAL FOR NURSES BY WILLIAM D. GRANGER, M.D. PROPRIETOR-PHYSICIAN, VERNON HOUSE, MT. VERNON, N. Y. FORMERLY FIRST ASSISTANT PHYSICIAN BUFFALO STATE HOSPITAL, BUFFALO, N. Y. MEMBER AMERICAN ASSOCIATION OF SUPERINTENDENTS OF HOSPITALS FOR THE INSANE. MEMBER NEW YORK NEUROLOGICAL SOCIETY. _SECOND EDITION. REVISED._ G. P. PUTNAM'S SONS NEW YORK 27 WEST TWENTY-THIRD ST. LONDON 27 KING WILLIAM ST., STRAND The Knickerbocker Press 1891 COPYRIGHT G. P. PUTNAM'S SONS 1886 Press of G. P. PUTNAM'S SONS New York NOTE TO SECOND EDITION. At the time of starting a training school, in 1883, the author was unaware that like work was commencing at the McLean Asylum, Somerville, Mass., by Dr. Campbell Clark and others in Scotland, and in New South Wales. Each was independent, and each worked out the problem independently. Thus, far separated efforts showed the time had come when attendants must be evolved into trained nurses. The most gratifying feature has been the unanimous approval by American superintendents and the establishment of training schools in almost every asylum in the land, often under the most difficult conditions and at a great sacrifice of the precious time and strength of the medical staff. The increasing number of these schools and pupils demands a second edition of this little manual. VERNON HOUSE, MT. VERNON, N. Y., March 21, 1891. INTRODUCTION. The writer began in October, 1883, at the Buffalo State Asylum for the Insane, a course of instruction to the women attendants upon their duties and how best to care for their patients. This has been regularly continued till it has become a fixed part of the asylum life, and has developed into a system of training, and now a class of attendants has nearly completed its studies. Since July, 1885, instruction has been given to men attendants. In April, 1885, the Superintendent, Dr. J. B. Andrews, who had encouraged the school from its conception, asked the Board of Managers to officially recognize it. They adopted the recommendation and fixed the qualifications for admission, the pay and privileges of its members, and provided for a certificate as a trained nurse and an attendant upon the insane, to be given to all, who at the end of two years successfully finished the full course of instruction. The writer believes that all attendants should be regularly instructed in their duties, and the highest standard of care can be reached only when this is done. He also believes that every person who is allowed to care for the insane will be greatly benefited by such instruction, and will be able to learn every thing taught, if the teacher uses simple methods and is patient to instruct.