CHAS. W. PILGRIM, M. D. 69 



an " After-Care Association " and in the latter "Con- 

 valescent Homes," where suitable cases are provided for 

 for a period of from four to six weeks. Friendless ones 

 are helped to obtain employment and assistance is 

 rendered in many ways. 



Another accusation made by the same neurologist is 

 that hospital physicians foster the belief that there is a 

 sort of "mysterious therapeutical influence" behind 

 asylum doors unknown to those outside. We, of course, 

 make no claim to having " ways of curing" unknown to 

 other members of the profession but we do claim, in the 

 language of Sir Clifford Allbutt, that there is more in the 

 medical care of the insane than mere "bottle medicine," 

 and that "the established regimen and discipline of a 

 hospital are felt for good by the patient as soon as he 

 comes under their influence. They tend to establish 

 habit and automatism and the annihilation of self. He 

 sees everything about him moving with system and regu- 

 larity, obedient to one will, subservient to established 

 rules. He finds it more comfortable to fall into line and 

 follow, rather than move in the erratic tracks which 

 fancy dictates, and gradually his delusions and impulses 

 lose control and sane ideas gain the ascendency." The 

 same views are expressed by Clouston, Bucknill and 

 Tuke, Spitzka and other eminent authorities. 



In addition to the regular methods the dietary holds 

 an important place in hospital management and is receiv- 

 ing each year more and more attention. In this State 

 the experience of the various superintendents and stew- 

 ards has been combined with the theories of one of the 

 most eminent physiologists of the times, and a dietary 

 table has been prepared which fulfills all physiological 

 requirements while it gives sufllcient variety to satisfy 

 the most capricious ax)petite. 



From what I have said it might be imagined that 

 medicine plays but a small part in the treatment of in- 



