ACCOUNT OF THE ASYLUM 
FOR THE 
RELIEF OF PERSONS 
DEPRIVED OF THE USE OF THEIR REASON, 
NEAR FRANKFOED, PENNSYLVANIA; 
WITH THE 
STATISTICS OF THE INSTITUTION 
FROM ITS FOUNDATION TO THE SIST 12TH MONTH, 1838. 
BY CHARLES EVANS, M. D., 
ATTENDING PHYSICIAN TO THE ASYLUM. 
[EXTRACTED PROM THE AMERICAN JOURNAL OP MEDICAL SCIENCES, FOR MAY, 1839.] 
PHILADELPHIA: 
T. K. & P. G. COLLINS, PRINTERS, 
NO. 1 LODGE ALLEY. 
* 
1839. ACCOUNT OF THE ASYLUM 
FOR THE 
RELIEF OF PERSONS 
DEPRIVED OF THE USE OF THEIR REASON, 
NEAR FRANKFORD, PENNSYLVANIA. 
Of all the maladies to which the human system is obnoxious, those which 
affect the manifestations of mind have undoubtedly the strongest claim upon 
our sympathy and care. Notwithstanding this is now generally acknow- 
ledged, yet it is comparatively of but recent lime, that the public sympathy 
has been effectively demonstrated, by providing adequate and appropriate 
means for the cure of persons afflicted with those diseases; or for alleviating 
the distress and securing the comfort of such as may be beyond the reach 
of remedial aid. All experience has proved, that in the great majority of 
cases, separation from friends, and seclusion from society, are indispensable 
to the recovery of the insane; besides which the peace of their families, 
and the well being of society, demand their restraint; hence, places for their 
reception have been common in all Christian countries: but until the pre- 
sent century, these institutions appear to have been conducted, mainly, with 
a view to the security of their wretched inmates; provision for their medical 
and moral treatment, being altogether unheeded, or made of very secondary 
consideration. Left to the conduct of the ignorant, the selfish, and the 
unfeeling, whose principal aim was to escape trouble and secure their own 
emolument, the mad-houses (as the English termed them,) embraced more 
heart-sickening degradation, and more unheeded suffering, than could be 4 
Evans’s Account of the Frankford Asylum. 
found in any other receptacles of human misery. The real state of the 
houses for the reception and treatment of the insane, in Great Britain was 
first disclosed to the public by the report of a committee of the House of 
Commons, published in 1816, Credulity itself is staggered at the recital, 
of the before unheard of cruelty practised, and misery endured, within the 
walls of most of those institutions, many of which, the public had been 
accustomed to regard with pride, as monuments of their liberality and bene- 
volence. There were, however, a few honourable exceptions, and conspi- 
cuous among these wTas the Retreat near York, which was projected by 
the Society of Friends as early as 1793, the same year in which Pinel com- 
menced his celebrated reform in the Bicetre at Paris. The plan of that 
Institution originated with a few individuals in the society, who, having acci- 
dentally become acquainted with the manner in which the insane were 
habitually treated, resolved to rescue such of their fellow professors as suf- 
fered under that pre-eminent affliction, from the misery which surrounded 
them, and to place them in a situation where they would be subjected to a 
totally different course of management from that pursued in any of the 
existing establishments. Accordingly grounds were purchased, buildings 
erected, and in 1796 a considerable number of patients received, and a 
course of treatment carried out, such as had never before been practised 
towards the insane, and which gave a rational ground to hope that their cure 
would be effected, or, at all events, their comfort and welfare secured. The 
Retreat was soon resorted to by others than Friends,’ and in a short time the 
success obtained there, demonstrated beyond contradiction, the superior effi- 
cacy, both in respect of cure and security, of a mild and humane system of 
treatment in all cases of mental disorder. To the philanthropic members of 
that religious society, who founded and conducted the Retreat, belongs (toge- 
ther with Pinel, who made some reformation in the horrible abuses of one 
of the Paris hospitals,) the credit, whatever it may be, of changing the 
course of treatment long pursued toward those deprived of the use of their 
reason, and restoring to them that sympathetic kindness and control which 
their affliction peculiarly demands. The example thus set was slow in ex- 
tending its influence, as is evident from the state of the institutions through- 
out Great Britain, when the investigation before alluded to, took place. That 
it had, however, a decided effect in awakening the public mind to the im-. 
portance of a reformation in the insane hospitals, is shown by several parts 
of the evidence given before the committee of the Flouse of Commons. 
Dr. Weir, Inspector of Naval Hospitals, stales in his testimony, that “the 
object of almost every insane institution, whether of a public or private 
description, had been the security of those pitiable objects; comfort, medi- 
cal and moral treatment being in great measure overlooked; happily, how- 
ever, for that class of society, the Quakers’ Retreat at York, has at last Evans’s Account of the Frankford Asylum. 
5 
convinced the world, how much may be done towards the amelioration of 
their condition.” 
From the time the subject was thus brought before the public, the 
arrangement and economy of asylums for the insane have become the sub- 
jects of attentive study and experiment, until, under the influence of an 
enlightened philanthropy, they have been radically changed, so that within 
the walls of every such institution properly conducted, are congregated, not 
only the various resources of medical science and art, and every thing calcu- 
lated to divert the mind from its erroneous associations, and give new vigour 
to its powers; but also all that needful care, decided control, and well-di- 
rected kindness, which, owing to perverted feelings, the sufferer rejects, or 
cannot appreciate while within his own domestic circle, but which are gene- 
rally accepted with thankfulness from the hands of a stranger, and contri- 
bute powerfully to lessen his distress and restore his health. 
In 1812, motives, similar to those which actuated the founders of the 
Retreat in England, induced a large number of the members of the same 
society in Pennsylvania, to attempt the establishment of a similar institu- 
tion. They associated themselves together under the title of “ The Con- 
tributors to the Asylum for the Relief of Persons deprived of the use of 
their Reason,” for the purpose (as expressed in their constitution,) of pro- 
viding for the suitable accommodation of that afflicted class of our (their) 
fellow members, and professors with us, (them) who are or may be deprived 
of the use of their reason; as well as the relief of their families and friends.” 
Subscriptions were opened, and in the course of a comparatively short time, 
a sufficient amount of funds having been collected, the' institution which I 
am about to describe was built, and in 1817 opened for the reception of 
patients. At that time there was no asylum in this country which could 
serve as a model for an institution of the kind, those existing only answer- 
ing to show how entirely inappropriate for the accommodation of the insane 
were the plans upon which they were constructed. 
The Asylum for the Relief of Persons deprived of the use of their Rea- 
son, is situated in a healthy and retired part of Oxford township, distant 
about five miles north from Philadelphia, and one mile westward from 
Frankford. The whole building, which faces the north, is three hundred 
and twenty-two feet eight inches in length, being made up as follows: 
The centre building is sixty feet square and three stories high above the 
basement; having two wings standing back about eighteen feet from its 
front, each one hundred feet long by twenty-four feet in depth, and two 
stories high; terminating in end buildings, which project four feet in ad- 
vance of each wing, and are thirty-one feet four inches in front, by twenty- 
eight feet four inches in depth, and three stories high, exclusive of the base- 
ment. From each of these end buildings, a wing, running south, at right 6 
Evans’s Account of the Frankford Asylum. 
angles with the front, extends twenty-six feet eight inches in length, by 
twenty-two feet six inches in depth, and corresponding in height with the 
front wings. 
The first story of the centre building contains four large rooms, divided 
from each other by halls running at right angles, one of which leads directly 
through the building from north to south, and has the staircase in it, while 
the other opens into each wing. The two front rooms are appropriated, 
the one as a parlour for the superintendant, the other as an office and re- 
ceiving room; the two in the rear, which respectively communicate with the 
wing of the side on which it is situated, are used as day-rooms for the 
patients. The second story of this building also contains two large rooms, 
situated with respect to the wings like the two below, and like them appro- 
priated as day-rooms for the patients, besides which, there are four smaller 
rooms used by the family of the superintendant. There are four large, and 
three smaller rooms in the third story. One of the larger is occupied by 
the resident physician, and one as a sitting room for the convalescent female 
patients; the apothecary shop is also on this story. The wings each con- 
tain twenty good-sized rooms for patients, with a lobby or passage ten feet 
wide, running the whole length in front of them, at the extremity of which 
is the staircase. The end buildings, or lodges, as they are called, though 
united to the wings by the front wall, yet have their other walls entirely dis- 
tinct; and in the lower story, are separated from the wings by a passage five 
feet wide, leading to the airing yards. Immediately over this passage, is 
the staircase leading from the second to the third story of the lodge. The 
rooms, both in the body of the lodges and their wings, are on the west 
side, with an entry six feet wide running in the rear of them on the east 
side; these entries are lighted by a window at each end, the wall on the side 
next the wings being unbroken and of extraordinary thickness. This sepa- 
ration of the two lodges from the rest of the building, is for the purpose of 
preventing the transmission of sound, and is found effectually to prevent the 
convalescent and quiet patients, who are kept in the wings, from being in- 
jured or annoyed by the noise of the violent and unruly ones, who are con- 
fined to the lodges. The first story of the lodges contains the bath rooms, 
a day room and two rooms for patients; the other rooms in the different 
stories, for the accommodation of the patients and their care-takers, are 
about twelve feet square. 
In the centre building are the refectory, kitchen, ironing-room, and store- 
room; rooms for cooking, washing, <fec., are adjoining under the wings, 
where also are the furnaces; furnaces are likewise located in the basement 
of the lodges. The whole building is covered with slate, and may be 
said to be nearly fire-proof. The basement story is paved with brick or 
flags, and arched, while the bottoms of the floors, and the joists in all parts Evans’s Account of the Frankford Asylum. 
7 
of the house are thickly plastered with mortar, and then ceiled in the usual 
manner. In all parts of the building accessible to the patients, the window 
sash is of cast iron, and stationary. The lower one in each window is 
glazed, and outside of the upper is a wooden sash, glazed, which is hung, 
so as to be raised or lowered at pleasure. This arrangement, while it en- 
sures security from escape, prevents the appearance of a place of confine- 
ment. The rooms in the centre building, and the patients’ day rooms, ex- 
cept those in the lodges, are warmed by means of stoves and grates. The 
wings and lodges have heated air, conducted from the furnaces before men- 
tioned, as located in the basement story, into the lobbies and each room. 
The openings for the admission of the warm air into the rooms, are near 
the ceiling, and covered with wire-gauze, and the air can be stopped off at 
any time by means of dampers, situated so as to be regulated only by the 
attendants. Some of the rooms are provided with shutters for the exclusion 
of light when required, as also with wire protection to the glass.' 
Immediately under the roof in each wing is a large reservoir for water, 
supplied by means of a forcing-pump, from a never-failing stream, which 
issues forth a short distance from the house. From these reservoirs the 
water is conveyed to the bath rooms, and various other parts of the 
building. 
The great extension of front in a building intended for the accommoda- 
tion of but sixty-five patients, was deemed necessary in order to give to 
each, a separate, well proportioned room, having all the advantages to be 
derived from the free admission of light and air. Where the rooms are 
arranged on both sides of an entry of the usual width, these two essential 
requisites to health and cheerfulness cannot be commanded; added to which, 
the patients occupying opposite rooms are very liable to be mutually annoy- 
ing, and in every respect (unless it be that of saving money), that mode of 
building for the insane is highly objectionable. On this account the plan 
adopted at the Friends’ Asylum is worthy of imitation. 
On one side of the wings are situated the chambers, ten feet square, each 
having a window, four feet six inches in height, by two feet ten inches in 
width. These rooms open on to the lobby, ten feet wide (as before mention- 
ed), and directly opposite the door of each room is a window corresponding 
in size with that in the room. Over each door is fixed a cast iron sash, 
thirty-two by twenty inches in size, fitted with a moveable glazed sash, to 
be opened or shut at pleasure. By this arrangement, a full supply of light 
and a free circulation of air are secured, and the lobbies being comfortably 
warmed in cold weather, they afford pleasant places for walking and exer- 
cise of different kinds. 
The kitchen and refectory, situated on the back part of the basement 
story of the centre building, open on to an area, which is fifteen feet wide 8 
Evans’s Account of the Frankford Asylum. 
opposite the centre building, and connects with one ten feet wide running 
the whole length of the western, and past that of the eastern wing. These 
areas are paved with brick, and have a well, fitted with a pump in them. 
The outside of the area is sodded, and rises regularly to a level with the 
garden and yards in the rear. 
A neat vestibule, having its sides enclosed with Venetian shutters, sixteen 
feet in length, and corresponding in width with the large hall running 
through the ground floor of the centre building, is thrown over the widest 
part of the area, and leads directly into a flower-garden. In the rear of the 
wings and lodges are the airing yards, each surrounded by walls ten feet in 
height, enclosing about half an acre of ground, for the use of such of each sex, 
as are not well enough to be allowed to walk, unattended, in the gardens 
and pleasure grounds. Each yard is subdivided by a board fence, cutting 
off about one-third of it; into which the idiotic and filthy patients are put, 
that they may not offend those who take more care of themselves. These 
yards are made pleasant with trees and summer-houses, the passages leading 
to them, as before mentioned, are between the wings and end-buildings. 
The entrances to the privies are from these yards: a door opening through 
the wall into them; there are no water-closets or other accommodation of 
the kind, within, the buildings. Between these yards is a large flower- 
garden, and immediately beyond them the vegetable garden; the two con- 
taining about two acres of ground. At the termination of a gravel walk 
leading directly from the house through these two gardens, at the distance 
of about three hundred feet, is an ornamental house, surrounded on all sides 
by a piazza, fitted up as a library and reading room, and containing nume- 
rous specimens of natural history, maps, drawings, &c. &c., affording a 
most agreeable resort for such patients as may be considered by the physi- 
cian well enough to enjoy it. 
Over the spot where rises the stream that Supplies the institution with 
water, at a short distance from the eastern end of the building, is erected a 
stone house, two stories in height, beside a basement; the lower story of 
which contains a forcing-pump so arranged, as to be easily worked by four 
of the patients; while the upper one is fitted up as a work-shop, with a 
turning lathe, tools, &c. Here many of the patients find interesting em- 
ployment. 
Connected with the various buildings described, is a farm of sixty-one 
acres, the greater part of which is under cultivation, and by giving the pa- 
tients the opportunity for various agreeable and active out-door employ- 
ments, affords the most powerful means for their restoration to health and 
reason. The woodlands cover about eighteen acres of ground, and are 
made up principally of the chestnut, beach and oak, affording a deep and 
delightful solitude and shade. A broad serpentine walk, more than a mile Evans’s Account of the Frankford Asylum. 
9 
in length, winds throughout them, and a large summer-house and seats in 
various situations, are provided for the accommodation of the patients. 
Near the entrance to the woods, and enclosing a small part of them, is a 
park containing some fine deer. 
Experience having proved that the comfort and cure of the insane are 
materially affected by the construction of the building in which they are 
placed, numerous plans have been suggested and acted upon, each of 
which has its admirers. All however who have had any practical know- 
ledge of the treatment of those labouring under the disease, and their liability 
to be acted upon by the objects which surround them, unite in the senti- 
ment, that that Iplan will prove the best, which, with equal conveniences, 
combines the most means for introducing well-adapted employment and ex- 
ercise, with the best arrangement for an extensive classification which can 
be kept permanently distinct. 
Where the conveniences for classification are wanting, the most lamenta- 
ble consequences must necessarily be witnessed even in institutions which 
may otherwise be conducted in the most unexceptionable manner. The 
employment of moral remedial means, is either absolutely precluded or ren- 
dered nugatory, when the patient upon the first dawn of reason feels the 
horror of being constantly surrounded by his pitiable associates, in all the 
different gradations of maniacal phrenzy and idiotic imbecility. These 
evils are guarded against at the Asylum by such a classification as is allow- 
ed of by the arrangement of the building. 
The male patients occupy the eastern, and the female the western side of 
the house, both sides being arranged alike. The end buildings, or lodges, 
are occupied (as before mentioned), exclusively by the noisy and imbecile. 
Such of them as are fit to be out of their own rooms, have the liberty of a 
well-lighted and cheerful day room, situated in the southern extremity of 
the lower story of the wing of the lodge. Another class of patients oc_ 
cupy the lower story of the main wing, and have for their sitting room the 
large room described as forming part of the lower story of the centre build- 
ing. The upper story of the wing is devoted to a third class who are more 
nearly well, and such as show no violence, and conduct themselves gene- 
rally with propriety; they likewise have a day room for their peculiar 
accommodation, situated on the second story of the centre building, corres- 
ponding with the one below. All these patients, however, have access to 
the same yard, excepting that the worst are confined to a small part of the 
yard, which is boarded off, as before described. 
For the accommodation of such of the females as are nearly restored, 
there is a large room in the third story of the centre building fitted up as a 
drawing room, where they can pursue their various amusements and em- 
ployments entirely undisturbed by the other inmates of the house. There 10 
Evans’s Account of the Frankford Asylum. 
is no such room for the men, but the same class of patients among them, 
usually resort to the library, when circumstances will not admit, or they are 
not disposed to walk abroad. Such of the patients as do not eat in their own 
rooms, take their meals in the day rooms attached to the respective parts 
of the building where they are placed. 
The government of the institution is lodged in the hands of a steward 
and matron, and resident physician, whose whole time is devoted to fulfil- 
ling the various duties of their respective stations. An attending physician 
visits the patients regularly twice a week, and as much oflener as the urgen- 
cy of a case may require. A Board of twenty Managers, appointed yearly 
by the Association, have the supervision of the whole, and by a 
committee of three, inspect every part of the establishment once in each 
week. 
In the treatment pursued at the Asylum, endeavours are used, so to com- 
bine medical and moral agents, that each shall render the other its most 
efficient aid, and jointly exert their remedial powers with the greatest cer- 
tainty and effect. The therapeutical treatment of course varies accord- 
ing to the disease, which by affecting the brain, disturbs the manifestations 
of the mind. An accurate account of such treatment and its results, is con- 
stantly kept, and at some future day may afford data for ascertaining the 
relative advantages of the course pursued. 
The moral means employed are various. Where it is found necessary, 
mild and gentle yet firm restraint is imposed, while the earliest gleams of 
returning reason are watched and cherished. 
In the house, there are provided, games of different kinds; reading, 
writing, drawing, &c. The females sew, knit, quilt, &c. The library is 
furnished with books, periodicals, drawings, &c. Exercise in the open air 
is always promoted, and the patients encouraged, whenever the weather 
will permit, to engage in walking and riding. A carriage and horses are 
always in readiness, morning and evening, for their accommodation. In the 
lawn fronting the house, is located a circular rail-road about four hundred 
and fifty feet in circumference, with a pleasure-car on it, large enough to 
accommodate two, which is moved by hand. Riding upon this road is a 
very favourite amusement, and as it is attended with considerable exercise, 
it is found highly advantageous. Every exertion is made to interest the 
male patients in gardening, and in the various employments afforded in the 
cultivation of the farm. The diet of the patient of course varies according 
to the prescription of the physician, but in general it is plain and nutritious; 
fresh meat and a variety of vegetables being served up every day. Tea, 
coffee, and milk are all abundantly supplied. 
The Asylum was opened for the admission of patients in the sth month 
of 1817, and the following table exhibits the number, sex, and social state 
of those received yearly, up to the conclusion of 1838. Evans’s Account of the Frankford Asylum. 
V-J '_J I—( )__l M I—* h—1 1—* (—1 H-1 
GO 00 00 00 CC 00 GQ 00 00 GO CO 
ivSfOiOtOfOtOUUUS^-1 
c; Ci w W w o ® co -J 
Year. 
Whole 
MOJOOOOODO(OW<|MCO 
number. 
— H- *— »—• H-* CO 
Men. 
O Cn CO O O CO CO O CO 
mh-^iCOCO^CCO-IODW 
Women. 
C JO C O W Oi o w 
OOOOCOC*^IC*C*OOC**OC* 
Married. 
MrfiOlMMKIMMOWO 
Widows. 
oi3S3MooooK)Ho 
Widowers- 
• 
I—* I—ii 1—i I—* u—* C-J k—* k—* 
«! 
GOOOOOGOOCCT'GCGO 00 GO GO 
03 Co Co CO CO 00 00 Co Co iO ( O 
Q0-lO3Cn£*OiiOi—‘OtOOO 
o Oi Crr^iOOOiOjH-^)-. 
Whole 
OJtOcrs OjOlpiWOC'O^OD 
number. 
CJJOCOiOlO^M>w^UJ 
OOh-OOO-^fOOOO 
Men. 
CO lO fO to iO — >— •-» >-* 
W O CTO c iMO O <) o O 
Women. 
CO i03 CO iO l“* r—1 ►— -— — ■—* 
W^COiQOtnOiHH0 
■Single. 
*0 IO «SD •— lO H- »— 
0»^MC5MtnQbOtfJ^I05 
Married. 
tl I-* rf». 00 OS CD O iO o cs w 
Widows. 
'-‘OOrfi.OOOi-'MH-'O 
Widowers.. 
Whole number of admissions, - - - - - 634 
“ Men, ----- 331 
“ Women, - 303 
“ Single, ----- 326 
“ Married, ----- 234 
“ Widowers, - - - - 17 
“ Widows, 57 
Of these there were below 20 years of age, - - 28 
From 20 to 30 years, - - 187 
“ 30 to 40 “ - - 141 
“ 40 to 50 “ - - 126 
“ 50 to 60 “ - - 83 
“ 60 to 70 “ 48 
“ 70 to 80 “ 15 
“ 80 to 90 “ - - 5 
“ 90 to 100 “ - - 1 
634 
Of these 634 admissions, 127 were re-admissions granted to 81 individuals, 
and leaving 507 persons who have been under care. 
The following table shows the duration of the disease at the time of ad- 
mission of these 507 cases, and the results of treatment. 12 
Evans’s Account of the Frankford Asylum. 
Duration. 
IS’umber. 
Restored. 
P, 
HH 
3 
§ 
Improved. 
Stationary 
Remaining 
Died. 
Less than 1 year, 
261 
152 
26 
27 
18 
4 
34 
From 1 to 2 years, 
57 
18 
8 
8 
9 
7 
7 
From 2 to 3 years, 
36 
17 
3 
3 
4 
5 
4 
From 3 to 5 years, 
45 
14 
7 
6 
9 
3 
6 
From 5 to 10 years, 
47 
13 
7 
3 
8 
11 
5 
Over 10 years, 
61 
0 
7 
5 
22 
13 
14 
Aggregate, 
,507 
214 
52 
52 
70 
43 
70 
The proportion of cures in these cases is 42.21 in every hundred; but if 
we deduct the sixty-one cases, which at the time of admission had been 
deranged over ten years (and which included twenty who either were idiots, 
or had been imbecile from puberty), five cases complicated with epilepsy, 
and five which entered the institution with the paralysis peculiar to the 
insane, it leaves 436 cases, properly subject to treatment, and the cures are 
in the proportion of 49 in every hundred. 
The per centage of cures in cases of less than a year’s duration, taking 
the whole twenty-two years is 58.23. Within the last six years, it has been 
66. Nearly all of this class, discharged as “ much improved,” were almost 
well; but either pecuniary considerations, or the anxiety of their friends, oc- 
casioned their removal as soon as the disease was so far overcome as to 
render their perfect restoration probable; and in many instances information 
was afterwards received of their perfect recovery. 
Of the seventy deaths, six occurred within a week of the time of their 
admission; nine within two weeks; seven within three weeks; and three 
within four weeks; these were mostly cases of acute inflammation of the 
brain, or its meninges, many of them being brought to the Asylum after 
all hope of relieving them at home was abandoned. Ten died between a 
month and a year’s residence, and the remainder varying from one year to 
twenty. 
Of the eighty-one patients re-admitted, there wmre discharged 
Restored, 3G 
Much Improved, 4 
Improved, - 6 
Stationary, - - - -- -- 7 
Died, - 17 
Remaining in the House, - - - - 11 
Twenty-two returned a third time; of whom there were discharged—Re-> 
stored, 14. Improved, 3. Stationary, 3. Died, 3—and one remains in Evans’s Account of the Frankford Asylum. 
13 
the house. The other re-admissions, were of three individuals, who being 
liable to periodical insanity, have been accustomed to resort to the Asylum 
at the commencement of an attack, and to remain there until again restored to 
the use of their reason. 
The following table exhibits the ages of the persons re-admitted, and the 
duration of the attack at the time of their first admission. 
Age. 
No. 
Duration of Disease. 
No. 
Below 20 years, 
2 
Less than 1 year, 
3y 
From 20—30 
24 
From 1 to 2 years, 
7 
From 30—40 
21 
From 2 to 3 years, 
7 
From 40—50 
15 
From 3 to 5 years, 
7 
From 50—60 
10 
From 5 to 10 years, 
10 
From 60—70 
4 
Above 10 years, 
11 
From 70—80 
4 
From 80—90 
1 
81 
81 
Forty-one of the eighty-one had been originally discharged cured. The 
interval between the discharge and re-admission, was as follows. 
Less than three months, 17 of whom 8 had been discharged cured. 
Between three and six months, 9 of whom 2 do. 
“ six months and 1 year, 14 do. 11 do. 
“ 1 and 2 years, - 11 do. 8 do. 
“ 2 and 3 years, - 8 do. 2 do. 
“ 3 and 5 years, - 7 do. 4 do. 
“ 5 and 10 years, 13 do. 5 do. 
Over 10 years, - 2 do. 1 do. 
In some of the cases where this interval was so short as to be within 
three months, the second indisposition should no doubt be considered as a 
relapse; the organs not having been restored to perfect soundness after the 
original attack. But when we recollect how prone an organ which has 
once been diseased, and especially the brain, is, to resume the morbid action 
upon the occurrence of even a trivial cause, and also that that organ is liable 
to be affected not only by the causes which produce disease in other parts 
of the system, but likewise by the moral feelings and emotions of the mind; 
it is not to be wondered at, that a recurrence of disease should often be 
witnessed where persons are taken from the seclusion and regular habits 
of an Asylum, and ushered into the cares and excitement of society, as 
soon as healthy action is believed to have been restored. It is a difficult 14 
Evans’s Account of the Franlford Asylum. 
matter to convince a patient, or his friends, that prudence dictates his stay 
should be prolonged for a considerable time after he is apparently well, yet 
it cannot be doubted, that where such a course is pursued, the security of 
health is greatly increased. 
As has been before observed, the Asylum was originally intended for the 
accommodation of those in membership or profession with the Society of 
Friends alone; and it continued thus exclusive, until the year 1834, when 
the contributors withdrew the restriction, and opened the institution for the 
benefit of all, with the proviso, that “ in no case should a member or pro- 
fessor be excluded.” 
An accurate record of the place of nativity of each patient, and whether 
member or not, has been kept from the opening of the institution. By this 
it appears that the average number of the members of the General Meeting 
of Friends held annually in Philadelphia, which were under care (including 
idiots) during the first ten years in which the Asylum was opened, was 
thirty-one. That meeting includes the greater part of Pennsylvania, New 
Jersey and Delaware, and during those ten years was composed of between 
twenty and twenty-three thousand members; which, taking the medium, 
twenty-one thousand five hundred, which I believe is nearly correct, gives 
the proportion of one in every six hundred ninety-three and a half. In 
1827, a large body seceded from that meeting, and its numbers are not now 
so accurately known; the ratio, however, has not increased. 
Dr. Burroughs in his Commentaries, gives currency to the opinion that 
insanity occurs in a greater proportion among the members of the Society 
of Friends, than the population generally, and assigns as a reason, their 
intermarriage with each other. This however would be entirely insufficient 
to account for the greater prevalence of the disease among them, if such 
were really the case, as in Great Britain, from whence he draws his data, 
there are nearly if not quite twenty-five thousand members; a number so 
large as to do away the probability of its being attributable to hereditary 
taint. 
As the records of the two institutions for the insane, belonging to the So- 
ciety, show that intemperance and want, so productive of mental derange- 
ment among others, cannot be assigned as the causes of it, in more than one 
case in every hundred and fifty occurring in the members of that society, 
and as they are known to be exempted, at least equally with others, from 
the sources of anxiety which disturb the social state; there wmuld appear to 
be no other causes for the disproportion of diseases affecting the manifesta- 
tions of mind, did it really exist, than either defective cerebral organization, 
or some peculiarity in their religious principles or practices. The former, no 
one will believe to be the case, and religious mania, as it is commonly but 
improperly called, is a form of the disorder which so rarely occurs among 
them, that as a community they may be said to be almost exempt from it. Evans’s Account of the Frankford Asylum. 
15 
The true reason of the apparent disparity in the proportional number of 
hose afflicted with derangement in that society, and the community at large, 
lies in the very defective statistical information obtained of the latter rela- 
tive to a disease which the ignorance and prejudices of the people lead them 
to conceal, and upon which incorrect data, a false estimate has heretofore 
been made. While in the Society of Friends, an accurate knowledge of all 
the members, liberal provision for the support of their poor, and institutions 
for its cure under their own care and government, bring nearly every case 
of idiocy or insanity which occurs among them, under notice.