CHAS. W. PILGRIM, M. D. 61 



weary of asking when he will be well enough to go 

 away. If his question is answered by his transfer to an 

 asylum whose , very name suggests the unhappy words 

 " all hope abandon, ye who enter here," the effect can 

 be readily imagined. We are all aware of the powerful 

 influence of hope in the cure of disease and in no class 

 of maladies is it more potent than in mental disorders. 

 Even when the disease is apparently chronic, efforts 

 toward cure should not be abandoned, for recovery after 

 insanity has existed for several years is by no means un- 

 common. This fact has done much to make alienists of 

 to-day firm in the belief that advancement lies not in the 

 establishment of separate plants for the supposedly cur- 

 able and incurable, but in having mixed institutions so 

 planned and equipped as to give to each patient every 

 possible chance for recovery. Small, well-arranged hos- 

 pitals, reception wards in the administration building, 

 and other wards or buildings near by adapted to the care 

 of the untidy, the excited, the demented and the epi- 

 leptic, to which and from which transfers can be made 

 according to the exigencies of each, particular case, is the 

 arrangement which a modern hospital for the insane 

 should present. 



Statistics show that the majority of those who become 

 ingane belong to the ranks of the hard working, indus- 

 trious and self-supporting classes who until the visita- 

 tion of insanity contributed their share towards the pros- 

 perity of the State. While about eighty per cent of all 

 the patients in the various State hospitals are supported 

 wholly at public expense, not more than five per cent of 

 the whole number belong properly to the pauper class, 

 with its accompanying improvidence, vagrancy and vice. 

 It must be admitted that quite a number owe their in- 

 sanity to intemperance in drink and other excesses, but 

 even they, as a general thing, have been able to maintain 

 themselves without public aid and cannot therefore be 



