orate manner than at present exists a scientific and wider knowledge of the disease. Such a hospital should be administered on the most liberal principles, not as you see at the present time in a competing spirit as to the smallest cost, but having a due regard to frugality in its truest and most economical aspect—the cure of the insane."
Mr. William P. Letchworth, formerly President of the New York State Board of Charities, in a scholarly and careful résumé in his admirable work. The Insane in Foreign Countries, advocates thorough remedial measures in small hospitals, no matter how expensive, for the acute insane, as not only more humane, but in the end more economical.
Dr. Chapin, Superintendent of the Pennsylvania Hospital for the Insane, in his presidential address before the superintendents of institutions for the insane, said: "Every hospital should have a special organization for the medical treatment of its recent curable cases. Is it the better way to continue our recent cases in the wards of large hospitals in constant contact with hundreds of chronics? To this serious and important interrogatory I must enter an emphatic negative answer, and believe it is not too soon to sound a note of warning. The needs of the recent and acute cases may be best met by the erection in connection with our State asylums of small and well-appointed hospital wards for the strictly medical treatment of such cases."
The late Dr. Bancroft, Superintendent of the New Hampshire State Asylum, thus wrote on this subject: "I have little doubt that moderate-sized hospitals constituted and operated either independently or as annexes would return increased ratios of recovery while adding vastly to the comfort and happiness of patients during hospital residence. Such adjustment would diminish routine, secure the largest degree of personal freedom and indulgence, and guarantee to each individual the best remedial influences as well as protection from such as are both distasteful and detrimental."
Dr. Godding, in an address before the National Conference of Charities and Corrections, thus spoke on this question: "The provision, then, should include one building, or preferably one group of buildings, designed especially for the acute and curable cases. No detail in construction should be omitted, no liberality of arrangement curtailed, that may be held to in any way assist in the treatment and cure of these cases."
The last fifty years have witnessed a work of which we have reason to be proud: the evolution of the care and treatment of the insane out of the mist and darkness of superstition and ignorance, when the insane were chained, beaten, and burned, to the present kindly care which seeks to treat them as very sick people. The
