56 THE CAKE AND TREATMENT OF THE INSANE. 



tal for the insane to move with quietness and regularity 

 and to present many pleasant features. 



The majority of the wards have pianos or other musi- 

 cal instruments, and games, such as cards, dominoes, 

 checkers, shuffle-board and billiards are freely provided. 

 The rooms and wards are attractively furnished, many 

 being supplied with carpets and rugs ; the windows are 

 draped ; easy chairs and settees abound, and the walls of 

 even the most disturbed wards are well supplied with 

 pictures, which are seldom broken or destroyed. Enter- 

 tainments and dances are provided two or three times a 

 week and an excellent on^chestra furnishes suitable music 

 whenever desired. In summer ball-games, field sports, 

 croquet, open air concerts, boat sails on the river and 

 picnics take the place of the indoor entertainments of the 

 winter. In fact it is the constant effort of all alienists to 

 find occupation and diversion for their patients, for they 

 all agree in thinking that under proper supervision it is 

 one of the most important measures in the treatment of 

 the insane. 



I would not, however, be understood as advocating 

 employment, or even recreation, in all cases. In the 

 acute stages of mania and melancholia the power of at- 

 tention and concentration of thought may be so weak- 

 ened that the slightest effort results in extreme fatigue. 

 That is why travel and change of scene, with the neces- 

 sary bodily and mental restlessness, so rarely accomplish 

 any good in the acute stages of mental disease. Such 

 cases need rest and quiet and all our efforts should at 

 first be spent in improving their general condition and 

 restoring their exhausted forces. When improvement 

 begins, or if the result be less fortunate and symptoms 

 of chronicity supervene, efforts should be made to turn 

 their thoughts into regular and healthy channels by the 

 use of manual and mental occupation. 



It may not be inappropriate here to say a few words in 



