CHAS. W. PILGRIM, M. D. 61 



pital care, and one will die during the attack. While 

 this may not at first sight appear to be a satisfactory 

 showing, we must remember that we have a grave dis- 

 order to deal with and that we do not generally receive 

 our patients until home treatment, water cures and sani- 

 tariums have failed. In addition, the foundations upon 

 which we have to work are often very defective. When 

 we take into consideration the influence of heredity and 

 imperfect development in the causation of insanity and 

 then add the large number of cases of general paresis, 

 idiocy, imbecility and epilepsy, I think the results 

 realized from treatment in hospitals for the insane will 

 compare favorably with those obtained in other 

 hospitals where diseases of a serious nature are treated. 

 When the heart, lungs or kidneys become gradually 

 and seriously affected, complete recovery is generally 

 out of the question, and the physician who manages 

 such cases so that his patients are able to pass the 

 balance of their days in comparative comfort has done 

 all that can be expected and no one thinks of complain- 

 ing of the futility of medical treatment. Why, then, 

 should it be different with diseases of the brain ? Surely 

 when that delicate organ becomes affected, if we succeed 

 in restoring nearly 33^ per cent, to home and friends and 

 in making the existence of fifty per cent, more useful, 

 and in many cases happy, even when they have outlived 

 their friends or been forgotten by them, has not some- 

 thing been accomplished, and is not the State justified in 

 assuming entire care of him who is often in a position to 

 exclaim in the touching language of Job, " My brethren 

 are far from me, and mine acquaintance are verily 

 estranged ; my kinsfolk have failed and my familiar 

 friends have forgotten* me ; Have pity upon me — have 

 pity upon me, for the hand of God hath touched me." 



