44 POPULAR SCIENCE MONTHLY. 



"'great and rapid advances were made throughout the United States in 

 methods of caring for the insane. The reforms then accomplished 

 attracted the attention of Europe, and it may be said, without any 

 egotism, that they were in advance of contemporary progress in other 

 countries." Much of this reform was due to the exertions of Dorothea 

 L. Dix, wlio about 1837 began a career of remarkable success in arous- 

 ing public attention and securing legislative action for the betterment 

 of the condition of the insane. She is said to have been influential 

 in the establishment of thirty-two asylums for the insane. But 

 unfortunately this high standard of achievement was not maintained. 

 During the civil war and the early period of reconstruction this reform 

 suifered a reaction, and the country failed to keep pace with the 

 progressive movement in other lands. Within the last thirty years of 

 the century, however, rapid advance was made, and to-day the standard 

 of work done for the insane in America is not lower than that attained 

 in other countries. 



The period of large and imposing buildings, palatial in exterior 

 appearance, has passed. The buildings erected twenty or thirty years 

 ago were uniformly massive, three- or four-story structures, the interiors 

 often monotonous and cheerless. To-day the tendency is to place the 

 patient in surroundings as cheerful and homelike as possible. To have 

 smaller buildings, comfortably furnished, with pictures on the walls, 

 with books, games and the means for light amusements and employ- 

 ment. No longer is the patient forced to pace ceaselessly long cheerless 

 corridors, the walls lined with benches and heavy chairs and bare of all 

 adornment. 



Now, instead of large blocks of buildings, the modern hospital con- 

 sists of a group of cottages, best of two stories, separated or connected 

 by a low corridor. Here the patients are separated into small groups 

 carefully classified as to their mental condition. These buildings are 

 surrounded by nicely kept grounds, with green lawns dotted with 

 shrubbery and flowers. There are groves to afford a shady retreat, and 

 here the patients spend much time every pleasant day. Many of them 

 have the parole of the grounds and come and go without oversight. 

 Freedom is allowed as far as is consistent with safety. In many places 

 the usual iron gratings have been removed from the windows and doors 

 left unlocked. 



But the institutions for the insane of to-day are not places merely 

 of detention. The insane asylum, except for the chronic cases, in most 

 states both here and abroad, has passed away and in its place has arisen 

 a hospital to which the patient comes as a sick mxan to have the kind 

 care and systematic treatment that the word hospital implies. He 

 is received and cared for by nurses trained to the work and is at once 

 impressed with the idea that he is a sick man, so regarded by his fellow 



