the university towns of Germany and Austria. That at Giessen, opened in 1896, is thus described by Dr. Frederick Peterson, president of the New York State Lunacy Commission—"It is in the town of Giessen, near the other hospitals used for teaching purposes, adjacent to the pathological institute, and consists-of ten or eleven cottages for 116 patients, in a beautiful garden. The central building contains pathological, chemical, microscopical, photographic and psychophysical laboratories, besides a mechanical workshop, clinical auditorium, library, and a dispensary or polyclinic for outdoor patients. The necessary administrative offices and rooms for the director and assistant physicians are also here. There are cottages for private cases, and for quiet, suicidal, restless, and disturbed patients of each sex. This is probably the most complete hospital of its kind in existence at the present time." Although as yet in Great Britain and America this work has not received the attention it merits, a beginning is being made. At Albany, New York, a pavilion has been opened in connection with the Albany General Hospital for the reception of the acutely insane, and in Michigan the last legislature passed an act to "Provide for the Construction of and Equipping of a Psychopathic Ward upon the Hospital Grounds of the University of Michigan." In Boston and Philadelphia out-patient departments have been in successful operation for several years. There is no doubt but that the next few years will see the general opening of such hospitals and out-patient departments in the larger cities throughout the country.
Another movement that is ripening to fruition in America is that for the establishment of 'After-care Associations' for the protection and help of needy patients upon discharge from hospitals, recovered, but without means of support. This idea originated in Germany as far back as 1829, with Hofrath Lindpaintner, who organized in that year a 'Society of Patronage' which exercised a paternal care over, and rendered assistance to, such persons for a period of two years following their recovery. Such associations were later formed in France, and in recent years the system has been in general operation in Germany, France, England and notably in Switzerland. The work of these organizations, the establishment of which in this country has already been discussed by the American Neurological Association, consists in finding proper homes and employment for discharged patients, maintaining a general supervision over them and offering such financial or other aid as may be necessary again to put them in the way of earning a livelihood.
In spite of all efforts put forth to cure the acute mental troubles a large percentage of the cases prove rebellious and drift into chronic states of mental deterioration. The patients do not die, but live in good bodily health with intellect dulled to the higher interests of life
