PROVISION FOR THE INSANE 105 



of this idea in his book on 1 ho rnrahihty of tho Insane. Thoro 

 is to-day such a hroacUMiinfi; in tho appHoation of the term in- 

 sanity that it inohidos many poopio that a pjonoration a,ii;o 

 would not havo \)vcn considonMl appr()i)riatc candichitos for 

 admission to hospitals of this kind. The very general aboli- 

 tion of mochanioal restraint, tho ehanfi^o of methods of care and 

 treatment, the establishment of training classes and in a word, 

 tho hospitalization of asylums has begotten in the public 

 mind a confidence in them that did not exist twenty five years 

 ago. In any hospitnl of the ordinary type that has boon es- 

 tablished a quarter of a century or more we shall find to-day, 

 besides a large accumulation of chronic insane, that the admis- 

 sion of old, feeble or paralyzed persons prevails to such a de- 

 gree that less than 25 per cent of those entered in a given period 

 may be considered curable. Formerly the recovery rate was 

 greater than we are able to attain at present and such admis- 

 sions account in part for this. Another factor causing this 

 earlier excess was the recovery of periodical cases and their 

 temporary departure only to return again sooner or later for 

 further treatment. 



The management and medical officers of our hospitals 

 have been freely criticised in the past for not effecting a greater 

 number of cures or for not doing more for the relief of patients. 

 The neurologist has had many suggestions to offer us, the g>Tie- 

 cologist has criticised freely and pronounced us derelict in duty 

 because we did not remove the ovaries of our women patients, 

 the surgeon would have had us trephine the skull of every 

 epileptic or operate on him in some other manner. The fad- 

 dist and quack are always ready with some suggestion of a cure- 

 all and even the lajonan thinks he can see many opportunities 

 for improvement in the care and treatment of the insane. In- 

 telligent criticism and suggestion are most gladly welcomed, 

 but fault finding per so, advocacy of change and mere theories, 

 without suggestion as to improvement, avail but little in solving 

 the very important question involved in caring for defective 

 or dependent people. I am sure that I can say, without fear of 

 successful challenge, that no class of public workers are more 

 earnestly and intelligently interested in obtaining that which 

 shall benefit their charges than are those administering our 



