PSYCHIATRY. 45 



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 con- 

 ditions, 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, l^o part 

 is overlooked. The physical machine is restored as far as possible to 

 working order in the hope that mental restoration will be the conse- 

 quence. 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 



