Reprinted from the Journal of Nervous and Mental Disease, August, 1892. 
Progress in the Care and 
Colonization of Epileptics. 
• BY 
FREDERICK PETERSON,"M.D., 
Chief of Clinic, Nervous Department, College of Physicians and Surgeons. Reprinted from the Journal of Nervous and Mental Disease, August r, 1S92. 
PROGRESS IN THE CARE AND COLONIZATION 
OF EPILEPTICS.1 
By FREDERICK PETERSON, M.D., 
Chief of Clinic, Nervous Department, College of Physicians and Surgeons. 
DURING some years’ residence as First Assistant 
Physician at the Hudson River State Hospital 
for the Insane, I became deeply impressed with 
the necessity of separate provision for epileptics. I had 
in the neighborhood of thirty or forty epileptics under 
my charge, some of whom could scarcely be called in- 
sane, although legally committed as such, for the reason 
that there was no other sort of hospital which would 
receive them. I noted at the time the unpleasant effects 
such patients would often have upon my other patients 
who were convalescing from various forms of insanity, 
and I believed it wrong in every way that cases of 
mental disease should be subjected to intercourse with 
persons who were often peevish and disagreeable and 
mischievous, and who also often caused general excite- 
ment and distress by falling in convulsions in the wards 
or in the sitting-rooms, or at the tables at meal time. 
Afterward I grew to feel the need of separation on their 
own account. I saw that something had been done for 
the care or improvement in greater or less degree for 
almost every defective class, for the insane, for idiots, 
for the deaf and dumb and blind, for the sick and the 
crippled, for the aged and infirm, for young malefactors 
in reformatories, for the negro and for the Indian. But 
the sufferer from epilepsy had been left to shift for him- 
self, often an outcast from his family, usually expelled 
from the schools, denied industrial employment, shunned 
to a great extent by his fellows, left to grow up in igno- 
1 Read before the American Neurological Association, June 22, 1892, 
and before the Association of Superintendents of the Poor of New York 
State, at Utica, August meeting, 1892. 2 
FREDERICK PETERSON. 
ranee and idleness, companionless and friendless, a prey 
to one of the most dreadful and hopeless of maladies, 
refused admission to general hospitals, and only at last 
given refuge in either an almshouse or insane asylum. 
He was driven to find shelter in an asylum, not, as a 
rule, because he is deprived of reason, but because there 
is no other place for him to go. There are thousands of 
epileptics in insane asylums to-day who do not belong 
there, for many will be found among them who are not 
insane, and it is an injustice to them as well as a detri- 
ment to the insane, to associate the two classes. 
The question of separate provision for epileptic pa- 
tients deserves, therefore, at our hands particular consid- 
eration, since, from the peculiar nature of the disease, it 
involves not only their treatment by skilled experts, but 
also their education for the ordinary pursuits of life; for 
epilepsy is a remarkable malady. It robs the victim of 
his mental and physical powers for a comparatively small 
period of time, sometimes but for a few minutes in a week 
or a month, and at the most but for a limited proportion 
of the patieut’s daily activity. It is not a continuous dis- 
ease ; and terrible as are the few moments of fainting 
and spasm that come upon the sufferer unexpectedly, 
they do not necessarily incapacitate him for all of the 
duties and pleasures of life. 
It is, indeed, true, that in the course of years epilep- 
tics may become mentally enfeebled by the frequent 
recurrence of these seizures; but this is often due not so 
much to the ravages of the malady itself as to the unfortu- 
nate social conditions to which the invalid becomes subject. 
His attacks do not permit of his being among his fellows 
in school, and when he has grown to manhood no one 
will give him employment. He cannot go to church, he 
is excluded from the schools, no one will bear him com- 
pany, work is denied him, and as he grows in years he 
is a burden to his family. Small wonder, then, that he 
degenerates morally, that his intellect is stunted, that he 
learns no trade, and that he finally drifts to the only 
places that our public charities afford him for shelter, CARE AND COLONIZATION OF EPILEPTICS. 
3 
to almshouses and insane asylums, where the hapless 
creature sinks into deeper apathy and profounder men- 
tal decay. 
This is no overdrawn picture, nor does it concern a 
very limited number of persons. There are at this 
present moment over 1,000 epileptics who are inmates of 
insane asylums and almshouses in this single State of 
New York; and there are many thousands more in the 
State who, more fortunate than their brethren, are, 
through the help of friends and relatives, or because of 
the infrequency of their attacks, permitted to support 
themselves or to remain in their families. It is estimated 
that there are fully 120,000 epileptics in the United 
States. 
There is but one kind of institution which can meet 
the case of those who suffer from this disease. No 
asylum, no large hospital, no single vast building in a 
great city, is appropriate for the purpose. It must be an 
establishment combining many unusual features. It 
must have schools and teachers for the education of the 
young epileptics; it must have offices, shops of all kinds, 
stores, dairy, farm, gardens, granaries, for as they grow 
up these patients should acquire trades or professions; 
it must have a group of small hospital and asylum build- 
ings where such as are sick or mentally infirm may be 
cared for; it must have skilled physicians; it must have 
a church, a theatre, a gymnasium, and a bathing estab- 
lishment ; it must have, finally, a pathological laboratory 
presided over by the keenest pathologist obtainable, so 
that in the course of time a cause and a cure may be dis- 
covered for this terrible disease. Such a place would not 
be a hospital in the ordinary sense of the term; it would 
be a village in itself, a colony for epileptics. 
In 1886 I was granted a leave of absence for some 
months from the Hudson River State Hospital, to spend 
in the examination of European Hospitals and Asylums,2 
and among these institutions one interested me above all 
2 Some European Asylums : Am. Journal of Insanity, July, 1887. 4 
FREDERICK PETERSON. 
others, viz., one that seemed to realize my ideal of what 
separate care of the epileptic should be—the colony for 
epileptics at Bielefeld, in Hanover, Germany. As soon 
as I returned home I published a description of it in the 
N. Y. Medical Record for April 23, 1887, afterward elabo- 
rating it in the Journal of Nervous and Mental Disease for 
December, 1889. 
This deservedly famous colony was founded some 
twenty-six or twenty-seven years ago by a Lutheran 
clergyman, Pastor von Bodelsehwingh, who by the way 
is not only known for this wonderful charity, but stands 
in high repute among social economists for his attempts 
to rescue the tramp in his Arbeiter-Colonien. 
This wise and beneficent man began his epileptic col- 
ony with four patients on a small farm near Bielefeld. 
To him, as to others doubtless also, had occurred some of 
the ideas mentioned above, and he determined to carry 
out practically his conceptions of what proper provision 
for this class should be. 
It seemed to this benignant man that it was feasible 
to create a refuge where these sufferers might be cured, 
if curable; where their disease might be ameliorated, 
their intellectual decay prevented; where they might 
have a comfortable home if recovery were impossible; 
where they might develop their mental faculties to the 
utmost; might acquire trades, or engage in whatever oc- 
cupation they cared to choose; finally growing into a 
community of educated, useful, industrious, prosperous 
and contented citizens. From that small beginning there 
has been a gradual evolution and expansion of the colony. 
In 1878 it had 250 epileptics; in 1880,458; in 1882, 556; 
in 1886, 830; and at the time of this writing considerably 
over 1,200. 
During the twenty years from 1867 to 1887, 2,407 epi- 
leptics had been received and treated at the colony. Of 
these 156, or per cent., were discharged recovered, and 
over 450 improved. 
One of the chief features of the colony is the system 
of decentralization, the division of the patients as much CARE AND COLONIZATION OF EPILEPTICS. 
5 
as possible into small families, occupying cottages, the 
separation of the sexes, of the feeble-minded from those 
with normal mental faculties, separation according to age, 
social standing, former occupations, etc.,—a system like- 
wise applicable, I may say, to the insane in the ideal 
psychopathic hospitals of the future, and already to some 
extent applied in the Saxon institution Alt-Sclierbitz, and 
in the new Manicomio di Roma. 
For the purpose of securing a sufficient number of 
male and female nurses, and of a superior order of kindly 
and sympathetic care, it was deemed expedient to found 
at the Bielefeld colony also nurses’ training schools, and 
as a result of this, not only have they well-trained 
brothers and sisters forming an order of deacons and dea- 
conesses for their own use, but they have been enabled to 
supply various hospitals and insane asylums with a high 
class of care-takers. For my own part, and from my ex- 
perience in institutions, I shall always feel that the high- 
est order of care and nursing for such unfortunates as the 
insane and epileptics can only be obtained by the em- 
ployment of those who enter upon these most arduous of 
duties from a deeply religious motive. 
When I visited it it consisted of fifty-five houses and 
cottages scattered in pretty gardens over some three hun- 
dred and twenty acres of beautiful woodland and meadow. 
It was like a country village. 
Here schools are to be found in which instruction is 
given in all the branches usually taught in ordinary pub- 
lic schools, and opportunities are afforded for even higher 
studies in the languages, arts and sciences for tho.se who 
desire them. 
Here are stores and shops of many kinds, such as a 
seed store, grocery, drug store, joinery, bakery, tailor 
shop, paint shop, locksmith shop, blacksmith shop, foun- 
dry, tin shop, shoe shop, saddlery, dairy, brickyard, print- 
ing office and bookbindery. Floriculture, agriculture 
and fruit-raising require large numbers of epileptic em- 
ployees. 
Some of the houses have been planned by epileptic 6 
FREDERICK PETERSON. 
architects, the hrick made by sixty epileptic patients at 
the brick-kiln, the masonry done by epileptic workmen, 
the woodwork made by their own carpenters, the iron 
work by their own smiths, the painting, glazing furnish- 
ing by their own adepts in these various trades. 
For men alone there are over thirty different callings. 
The women are busied with the manifold cares of the 
households, manufacture of wearing apparel and bed- 
linen. and the rearing of flowers and garden produce. 
Thus it will be seen how nobly philanthropic has been 
the conception and carrying out of this project. And it 
is not only in the multiplicity of occupations that the 
genius of its conceiver has been made manifest, but also 
in all those avocations that tends to divert the minds of 
the patients from contemplation of their misfortunes. 
Games and amusements are many ; walks in the groves 
and gardens ; out-of-door sports'; evening entertainments ; 
singing schools; an orchestra made up from their own 
number ; a museum for the collection of stamps, coins, 
gems, autographs, bronzes, antiquities, articles of ethno- 
graphic or historical interest, and specimens from the an- 
imal, vegetable and mineral kingdoms—all have been 
carefully thought out for the perfect evolution of this lit- 
tle social world. 
When the evil disorder attacks one in the field or gar- 
den, willing hands are near to attend to him, and every 
workshop and schoolroom has its cushions within conven- 
ient reach on occasions of emergency. 
Taking the Bielefeld colony as a model, nine other 
epileptic colonies have been established in Germany, one 
in Holland ; one in Switzerland; and one institution for 
epileptics was created by a French clergyman, John Bost, 
near Lyons, in France, some forty years ago, but it has 
not the model village character of that of Bielefeld. 
Up to the time that I began the propaganda for such 
an establishment on the colony, or at least villa system, 
in April, 1887, absolutely nothing had been done for the 
special care of this class of dependents in this country— 
either privately or by State authorities, but it is fair to CARE AND COLONIZATION OF EPILEPTICS. 
7 
say that as long ago as 1869 the Board of State Charities 
of Ohio had the matter in mind and wrote thus in their 
second annual report: 
“ In view of the foregoing statements—for the sake of 
the epileptics as a class, as well as for the sake of their 
immediate friends and society at-large—the Board feel 
that some provision ought to be made whereby the com- 
fort of the one and the safety of the other could be se- 
cured. . . . An asylum consisting of a farm, ample 
in size and productive in character, upon which plain, 
neat and substantial pavilions might be erected, under 
the general direction of an accomplished agriculturist 
and of good administrative ability, aided by efficient skill 
and competent foremen and attendants, would fully meet 
the demand.” 
In 1890 Governor Campbell appointed a committee to 
select a site and prepare plans for an institution for epi- 
leptics, and this commission visited me in New York in 
that year for suggestions as to these matters. On Nov. 
12, 1891, General Brinkerhoff, President of the Ohio 
Board of State Charities, laid the corner-stone of the first 
special separate State Hospital for epileptics in this 
country at Gallipolis. Here a good farm site had been 
selected and plans for a model institution on the pavil- 
ion plan have been made, in which as many of the ideal 
details mentioned above as possible have been carried out. 
The Board of Trustees of the California Home for the 
Care and Training of Feeble-Minded Children, at Santa 
Clara, has caused to be erected the first of a series of sep- 
arate pavilions for epileptics (Sixth Annual Report for 
the year 1890, by Dr. A. E. Osborne). 
Massachusetts and Pennsylvania have also interested 
themselves in the movement. 
In New York excellent progress has been made. In 
1890 I was able to secure the influence of the N. Y. State 
Charities Aid Association, and Dr. Jacoby and myself 
were appointed a sub-committee to report to that body 
upon the subject of State Provision for Epileptics. From 
this report I make the following abstracts: 8 
FREDERICK PETERSON. 
Of the various plans which have been suggested as 
useful for the care of epileptics, the following only are 
worthy of consideration: 
(1) The creation of special colonies. 
(2) Special hospitals for epileptics. 
(3) Epileptic wards in existing insane asylums. 
It has been practically shown that the first mentioned 
of these plans is not only the most feasible one, but can 
be made to fulfill all legitimate demands. 
That hospitalization is impracticable is the opinion of 
all who have investigated the subject; those epileptics 
who are only slightly affected by their disease will not 
remain in a hospital without occupation and systematic 
employment, and those who are severe sufferers with 
marked mental affection cannot be kept there. Even the 
care of simple epileptics without any insanity differs 
greatly from that of any other class of patients, and 
makes their care in any hospital a difficult matter. With 
the organization of epileptic wards in general asylums 
matters are in the same unsatisfactory condition. The 
plea of certain supporters of the asylum system, that 
every epileptic should be legally placed in confinement, 
because he is either insane or may become so eventually, 
is a plea which is contrary to every principle of right and 
wrong. If a hospital for epileptics were consolidated 
under one management with an asylum, it would be 
necessary to make a distinction between temporarily 
mentally deranged epileptics and purely convulsive ones, 
a distinction which is decidedly artificial, as thus the 
temporarily mentally disordered epileptic would be con- 
stantly transferred from hospital to asylum and from 
asylum to hospital. On the other hand, the entire ques- 
tion can be solved by the creation of colonies, the admis- 
sion to which is not to be regulated by the mental condi- 
tion of the patient, but in which after admission a classi- 
fication could be made of those afflicted with severe 
mental defects, of those who are able to work, and of 
those requiring education. Further classification, accord- 
ing to general aptitude, frequency of attack, tempera- CARE AND COLONIZATION OF EPILEPTICS. 
9 
ment and educational status, would, of course, be advis- 
able. The main principles to be observed in the organi- 
zation of such a colony would be: 
(1) —Land.—To consist of at least 200 or 300 acres of 
farm and woodland, well adapted to agricultural and 
horticultural pursuits. This land should be situated 
near a large city, not only on account of convenience of 
access, but on account of facilities for obtaining expert 
advice and study. 
(2) —Small buildings, cottages.—These to be arranged 
into separate divisions for the male and female patients ; 
each of these divisions to make provision in separate 
cottages for the demented, the feeble-minded, the con- 
valescents, the school children, the workers and private 
patients of the higher classes. 
(3) —Larger buildings. 
(a) —A hospital or infirmary for the sick, injured and 
mentally affected, Every patient, without exception, 
should be placed under medical care, and at least a sys- 
tematic attempt should be made to cure the disease. 
(b) An educational building for epileptic children. 
{c) Workshops for adult epileptics. 
(d) Farm buildings, dairy and granaries. 
{e) A special laboratory for the study of epilepsy by 
an expert pathologist. 
The State Commission in Lunacy in their third an- 
nual report spoke very favorably of the subject, and 
although a bill failed to pass the New York Legislature 
in the winter of 1890 and 1891, I am happy to say that 
this last spring a law has gone into effect giving power 
to the State Board of Charities to select a site and pre- 
pare plans for the establishment of such an institution 
as is required by these wards of the State. The follow- 
ing is the law in question : IO 
FREDERICK PETERSON. 
HOSPITALS FOR EPILEPTICS. 
Chapter 503 of the Laws of 1892. 
An Act providing for the appointment of a Commission to locate an 
institution for epileptics in the State of New York. 
The People of the State of New York, represented in Senate and Assem- 
bly, do enact as follows : 
Section i. The of the State Board of Charities are 
hereby directed to select a suitable site in the State of New York, on 
which to establish an institution on the colony plan for the medical treat- 
ment, care, education, and employment of epileptics. 
SEC. 2. The said Commissioners of the State Board of Charities shall 
have power to receive by gift or to contract for the purchase of such site 
for the location of buildings of said institution, subject, however, to the 
approval of the next Legislature, to whom they shall report their action 
in the premises within ten days after the commencement of the session, 
together with plans and estimates for constructing buildings suitable for 
the purpose named in section one of this act; such site to include not less 
than three hundred acres, and such plans to provide for the accommoda- 
tion of six hundred inmates and to admit such further extension of the 
buildings as may be necessary to meet future requirements of the State 
in providing for the epileptics. 
Sec. 3. The said Commissioners shall be entitled to the payment of 
their traveling expenses while engaged in the performance of their duties 
under this act, and their account for such expenses shall be audited and 
paid out of the treasury, but they shall receive no compensation for their 
services. And the sum of one thousand five hundred dollars, or so much 
thereof as may be necessary, is hereby appropriated out of any moneys 
in the treasury not otherwise appropriated, payable on the warrant of 
the Comptroller, for the purposes of this act. 
This act shall take effect immediately. 
Thus within a very short period of time a great ad- 
vance has been made, and soon the hundred thousand and 
more epileptics of this country who hitherto have had 
none of the advantages of their brethren in the social 
struggle for education, livelihood and happiness will re- 
joice in the existence of several places where they can 
learn trades, acquire knowledge, be treated, perhaps be 
cured of their malady, and in any event have a pleasant 
asylum wherein to spend the years allotted to them. Who 
knows what benefit some of them may not confer in re- 
turn upon humanity? These new opportunities given CARE AND COLONIZA TION OF EPILEPTICS. 
11 
them may well bring out in time talents and even genius 
that otherwise might have fallen into fatuity and decay. 
Although it is not given to every epileptic to describe 
his own sufferings as Dostoiewsky does in his novel, 
“ The Idiot,” or to delight the world with music as did 
the epileptic Handel, or with comedy as did Moliere, or 
with poetry as did Petrarch, -or with military exploits as 
did Caesar and Napoleon, or with religion as did Mahom- 
med and St. Paul, still it is a consolation to those afflicted 
with this malady to know that epilepsy and genius may 
co-exist, and that the possession of the disease does not 
necessarily lead to mental or moral degeneration. The 
patient may not reach the highest position among man- 
kind, but under the new dispensation he will not be de- 
barred from any attainment in education, nor prevented 
from exercising all of his capabilities for his own support 
and for his own welfare and happiness. 
LITERATURE OF THE SUBJECT. 
The Bielefeld Epileptic Colony. By Frederick Peterson, M.D. “ New 
York Medical Record,” April 23, 1887. 
The Colonization of Epileptics. By Frederick Peterson, M.D. ‘‘Jour- 
nal of Nervous and Mental Disease,” December, 1889. 
A Plea for the Epileptics. By Frederick Peterson, M.D. ‘‘State 
Char. Record,” June, 1890. 
Report of the Commission to select site and prepare plans for the 
accommodation of the epileptic and epileptic insane to the Governor of 
the State of Ohio. By J. L. Vance and C. C. WAite, commissioners, and 
J. W. Yost, architect, December 31, 1890. 
State Provision for Epileptics. Address of Dr. Frederick Peterson, 
Char, of Health Dept., Am. Soc. Science Association, at Saratoga meet- 
ing, September, 1891. 
State Care for Epileptics. By Frederick Peterson, M.D. ‘‘New 
York Sun,” January 11, 1891. 
The Care of the Epileptic. Report of sub-committee (Drs. Jacoby 
and Peterson) of State Char. Aid Association. “Record,” Feb., 1891. 
A Much-Needed Philanthrophy. By Rev. Peter Stryker. “111. 
Christian Weekly,” Jan. 31, 1891. 
Address of Gen. R. Brinkerhoff on laying corner-stone of Gallipolis 
Institution for Epileptics. “ Ohio State Journal,” Nov. 13, 1891. 
Dr. Ewart: Colonization of Epileptics. “Journal Mental Science,” 
June, 1892. 
Outline of a Plan for an Epileptic Colony. By Frederick Peterson, 
M.D. “ N. Y. Medical Journal,” July 23, 1892. 
Other articles by Drs. J. Madison Taylor in the “ Univ. Med. Maga- 
zine,” and by Drs. W. N. Bullard and D. W. Barber have appeared 
recently. PRESS OF RAFF & CO. 
539 & 541 Eighth Avenue, Cor. 37th Street, 
newYork.