men, if not cognizant of it himself, and that he is to have done for him what careful nursing, hygienic surroundings and medical science can do. The perfection to which this system has attained varies much in different states; but all are tending to the same end, and ere long the care of the acute insane in all enlightened lands will be based upon the same scientific plan. At the present time in Europe and America there is great activity within the walls of the hospitals for the insane. The study of the individual patient is more thorough than ever before. Not only are his mental symptoms diligently watched and recorded, but a careful systematic examination of all his bodily functions is undertaken. For this purpose laboratories are equipped and men trained to microscopical and chemical analysis are being more and more employed to carry on the work. The study of the physiology and pathology of the nervous system is being assiduously pursued and recent epoch-making discoveries in tissue-staining have stimulated this work, causing almost a revolution in the theories of nervous action; and it would seem that a better understanding of the functioning of the central nervous system was dawning. The defects of distant organs, of the blood vessels, the blood, the lymph and all abnormal bodily conditions, are known to often have a deleterious effect upon the nervous system and improvement in the mental condition to be coincident with their removal. The physician and the surgeon, the neurologist, the psychologist, the chemist and the pathologist are all at work hand in hand with the alienist to cure him who is the unhappy victim of mental disease.
In the modern hospital such moral measures are brought into operation as the companionship of a kind and congenial nurse, cheerful environment, the use of the minimum amount of restraint consistent with safety and efforts to amuse and divert the attention of the patient away from himself and his troubles, the attempt to arouse an interest in some light employment and the suggestive influence of a hopeful spirit. The therapeutic effect of exercise, massage, hydrotherapy and electrical influence are all called into use, and the medical treatment is directed to any complicating disorder of the bodily functions. No part is overlooked. The physical machine is restored as far as possible to working order in the hope that mental restoration will be the consequence. In a hospital thus conducted harsh or abusive treatment means the immediate dismissal of the offender.
The selection of an efficient corps of attendants is a matter of the greatest importance. Much improvement has been brought about by the establishment of training schools in hospitals for the insane with systematic instruction in the duties of the nurse. In a large and well organized institution an attendant entering the school is in a position to obtain instruction of so much general usefulness in the