HEALTH AND DISEASE 347 



has laid stress upon the importance of attempting by proper training, 

 guidance and environment to overcome native handicaps, and much can 

 be done in that Hne. As for environment, it is quite hkely that the con- 

 stantly increasing pace of hfe has no particularly beneficial effect upon 

 the mental hygiene of the public; on the other hand, it can not be proved 

 to be the principal factor in any increase in mental disorder. The old myth 

 about farmers' wives, who were generally reputed to be particularly sus- 

 ceptible to mental disorder, has long since been exploded, and it has been 

 found that the rates for hospitalization are in general slightly higher in 

 urban than in rural communities. This, however, may be due in large 

 measure to the fact that peculiarities of conduct are much less well tolerated 

 in closely settled areas than they are in rural districts, with an increasing 

 likelihood of commitment. 



The modern mental hospital is as far different from the old asylum as 

 could well be imagined. It is a general hospital thoroughly well equipped, 

 surgically and medically, to deal with any physical disorder which may 

 arise among its patients. It is equipped in addition with occupational 

 therapy, with hydrotherapy and other speciaUzed forms of treatment de- 

 signed to remedy the disordered mental attitude of the individual. Padded 

 cells have not existed for many years, and seclusion and restraint have long 

 since been virtually abandoned, having been found to have a deleterious 

 effect on patients. As much freedom as possible is given to patients, and 

 the atmosphere of the hospital is one as nearly approaching normal com- 

 munity life as can well be secured in an institution. There are various types 

 of entertainment and social activities, all designed for the purpose of help- 

 ing the patient to readjust himself to mingling with his fellows in a normal 

 way. Recently considerable attention has been given, partly for economic 

 reasons, to the possibility of caring for the mentally ill in families after the 

 more acute problems have been dealt with in the hospital. The system of 

 family care, which was first introduced into Massachusetts in 1885, has at 

 last been adopted by several other states. 



It should not be thought, however, that all mental hospitals are the ideal 

 places that have been described. Unfortunately some states have been de- 

 cidedly backward in their care of the mentally ill, have been niggardly in 

 the appropriations voted, and have allowed partisan spoils politics to inter- 

 fere with efficiency and with the securing of adequately trained and in- 

 terested personnel. It is to be hoped that the new interest in public health 

 now being fostered by the Federal Government will bring about improve- 

 ment in those states in which it is needed. A4ental hospitals, in addition to 

 their intramural activities, are engaging constantly more and more in com- 

 munity activities, particularly with relation to child guidance and adult 

 mental hygiene cHnics. These activities are extremely important from the 

 preventive point of view, being designed in the case of children to over- 

 come habit difficulties, and in the case of adults to prevent mental break- 



