58 THE CAEB AND TEEATMENT OF THE INSANE. 



sane is made easier and freer from legal restrictions. Our 

 pressing need, in my opinion, is for a law, such as they 

 already have in some states, permitting voluntary com- 

 mitment on the part of those who realize their need of 

 hospital treatment. There should then be established in 

 connection with each large state plant a small detached 

 hospital and a convalescent cottage for each sex. The 

 former need not be large but should contain everything 

 possible in the way of structural arrangement and equip- 

 ment to insure the highest degree of care and treatment 

 for acute and hopeful cases. An important step looking 

 towards this result has been taken in this State by the 

 appointment by the Commission in Lunacy of a State 

 pathologist, and the equipment at the different institu- 

 tions of laboratories for the accurate and scientific study 

 of insanity in all its aspects. 



The convalescent homes it would be well to have some 

 distance from the parent insiitution and far enough 

 away to insure a complete change of scene and mode of 

 living. My experience leads me to believe that it is ex- 

 ceedingly difficult to tell just when a patient should be 

 discharged and returned to his old life, and I believe the 

 difficulty would be overcome if we had cottages for con- 

 valescents where doubtful cases, especially the friendless 

 ones, could be sent for a time to be prepared for renew- 

 ing the struggles of outside life. It is true that we have 

 a partial solution to this difficulty in the system of pa- 

 role by which we are enabled to permit patients to go 

 home on a trial visit of thirty days before final discharge. 

 This practice, however, cannot be put in force where the 

 patient is without home and friends, and it is such cases 

 that occasion us the most anxiety. In England and 

 France they recognize the fact that 



" 'Tis not enough, to help the feeble up, 

 But to support him after," 



and in the former country they have what is known as 



