PSYCHIATRY. 47 



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 assist- 

 ant 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 connec- 

 tion 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, main- 

 taining 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 



