The medical superintendent could determine on the admission of patients which were incurable and which gave hope of cure. The State should then appropriate such moderate sum per person for all incurable patients, whether of recent admission or of longstanding disease, as to enable these sufferers to receive kindly care and a few of the pleasures of life. For the curable cases in the hospital annexes no reasonable expense should be spared. This is true economy regarded either from the philanthropic, economic, or scientific point of view. The curable patients come entirely from the strong people who have earned their own livelihood, and have done their part in the world until, loaded down by ill-health, trouble, or care, they break down and go to a State hospital for treatment. The mental weaklings, the victims of the degeneracy of their ancestors, the last step before the extinction in them of the species—these, who have always been a burden on the community, are all to be found in the incurable class.
It has been estimated that the average duration of life of a chronic insane person is twelve years. This represents in money expended for care and in lost productiveness about five thousand dollars. The economic importance, therefore, of saving every patient possible from lapsing into chronic insanity becomes apparent. It is reasonable also to suppose that with such hospital care the duration of sickness in curable cases would be lessened, and that many would more quickly resume their former occupations.
The moral effect, too, upon the general public would be marvelous, and the strictly medical aspect of insanity would be appreciated by the lay mind. It is an accepted scientific fact that insanity, in curable cases, is curable directly in proportion to its early medical treatment away from home associations. The public, when the character of the hospital annex for recent cases and the importance of early treatment were understood, would not regard a State hospital as a place of living death, only to be resorted to when all other means fail, and often after all hope of recovery or possibility of accomplishing any curative measure is past.
The cost per patient in the hospital annex would not be more than is now expended in any good general hospital, and would not exceed nine or ten dollars per week for such patient. Such a method would not be any more expensive than the present system, and when the permanent effects are considered would give the best results and would also be a positive saving. The average weekly cost under the present conditions per patient is three dollars and a half, or $3,500 for a State hospital of one thousand patients. Under the separate plan of treatment, the curable patients, numbering not more that eighty, could be maintained at a weekly cost of ten dollars per patient, or $800; the nine hundred and
