748 THE POPULAR SCIENCE MONTHLY. 



The nurses, too, should be especially selected for this service 

 among the curable insane. Those who have, by work among the 

 chronic insane, shown that they possess the aptitude and tact neces- 

 sary to care intelligently for such patients could easily be select- 

 ed for this special work. Then with these nurses could be placed 

 several nurses who have had general hospital training and who 

 would therefore be more apt to regard insane patients from the 

 purely medical side. The number of nurses, too, should depend 

 upon the need of each case ; if necessary, a single nurse should be 

 assigned to a patient, though this, probably, would rarely be 

 required. The criterion, however, should be, What will be most 

 helpful in a curative way to the patient ? The nurses would thus 

 feel the great importance of the work they were doing, because 

 every case would be considered as a curable case, and there is no 

 greater incentive to good work than the feeling that the work is 

 of great value. By a slight increase in the wages in addition to 

 the importance attached to the work, the very best nurses em- 

 ployed in the hospital could be secured for this work, and easily 

 made most enthusiastic about it. The effect also upon the medi- 

 cal staff would be most beneficial. Any one who has seen the 

 tendency to the undermining of the medical spirit in talented, 

 brilliant, and ambitious physicians who have accepted State hos- 

 pital positions, will appreciate the importance of anything that 

 would increase the medical spirit in State hospitals. 



In a discussion before the British Medico-Psychological Society 

 on the subject How can the medical spirit best be kept up in 

 asylums for the insane ? the following means were most strongly 

 dwelt upon : 



1. Classification that is, separation of the curable from the 

 incurable asylum population. 



2. Necessity for hospital treatment for the curable. 



3. Necessity for training the attendants. 



4. Necessity for more physicians to asylums, and a rearrange- 

 ment of their duties. 



Such purely medical treatment of the curable insane can be 

 best carried out in annexes to the present State hospitals and 

 under the same management. The State in each State hospital 

 has a most valuable plant, with large, handsome grounds, conven- 

 iently situated to the section of country from which it receives its 

 patients. They are in charge of well-equipped and competent 

 medical officers who have given their lives to this work, and es- 

 pecially appreciate the needs of this class of patients. Then, too, 

 there is the body of trained nurses from whom the special nurses 

 could be selected. There are also in existence various industries 

 and means of amusement, which, though hurtful in certain stages 

 for some, might be and are used with great advantage in the con- 



