CHAS. W. PILGRIM, M. D. 49 



them. The county authorities, however, were not long 

 satisfied with this exemption and several counties shortly 

 afterwards obtained, directly from the Legislature, per- 

 mission to care not only for their own chronic insane but 

 to take those from other counties. Thus the important 

 step in advance taken by the State in 1865 was com- 

 pletely nullified, and in less than a decade no fewer than 

 one-third of al^l the counties in the State were caring for 

 their chronic insane, and in some instances for the acute 

 insane as well, and boasting that they were doing it for 

 less than one dollar a week per capita. In the mean- 

 time, however, there was a quiet but powerful sentiment 

 at work which was ultimately to bring about an entire 

 change in the policy of the State in regard to its insane. 

 Much of this good work emanated from the State Chari- 

 ties Aid Association, a voluntary organization founded 

 in 1872. In 1886 this association attemj)ted to secure the 

 passage of a bill providing for tlie removal of all the 

 insane from the poor houses of the State, but the effort 

 met with defeat on account of the determined opposition 

 incited by local and selfish interests. In 1889 a State 

 Commission in Lunacy, consisting of three members, 

 was created and many of the powers heretofore vested 

 in the State Board of Charities were transferred to them. 

 They immediately took up the question of State Care 

 and refused to grant any further exemptions to the 

 Willard Act, Their first annual report glows with 

 indignation at the sufferings of the insane in the poor 

 houses of ihe State, and their influence in helping to 

 secure the passage of the State Care Act, which had 

 again been brought forward by the State Charities Aid 

 Association under the able leadership of Miss Louisa 

 Lee Schuyler, cannot be over-estimated. This Act, in 

 brief, provided for dividing the State into hospital dis- 

 tricts so that each hospital would receive all of the insane 

 of its own district, thus doing away with the unscien- 



