July 28, 1916] 



SCIENCE 



139 



Arnold, under the influence of Benan, ridiculed 

 the "bold, bad men" who frequent social- 

 science congresses; but it was largely through 

 foregatherings of this order, their patient en- 

 deavors with legislative bodies, that we get 

 this record 



Of labor, that in lasting fruit outgrows 



Par noisier schemes, accomplished in repose. 



The history, from the crude pioneer condi- 

 tions to the advent of the psychopathic hos- 

 pital, where insane patients are no longer 

 pauperized or imprisoned but treated as so 

 many cases of acute disease, traces the slow 

 evolution of a definite series of ideas. It be- 

 gins with the foundation of the Association of 

 Medical Superintendents of American Insti- 

 tutions for the Insane (October 16, 1844), and 

 the subsequent history of this body, which be- 

 came the American Medico-Psychological 

 Association on June 6, 1893. A careful 

 synoptic account of all the transactions is 

 given. Among the items of note are Luther 

 Bell's original description of phrenitis or 

 " Bell's mania " (1849), the introduction of the 

 famous " propositions " by T. S. Kirkbride 

 (1851), Field's discussion of haamatoma auris 

 in the insane (1894), a condition which he 

 showed to be identical with the aural deform- 

 ity found in antique statues of athletes and 

 in modern boxers and wrestlers (Pancrati- 

 astenohr), and Weir Mitchell's drastic arraign- 

 ment of the status of American asylums 

 (1894), which, at the time, was adjudged some- 

 what premature and captious by our alienists. 

 A chapter on the history of the American 

 Journal of Insanity (founded 1844) is fol- 

 lowed by chapters on the early and colonial 

 care of the insane, the evolution of institu- 

 tional care, of the administration of hospitals 

 and their construction, of training schools for 

 nurses and attendants, of state and private 

 care, of the psychopathic hospital and of legis- 

 lation, the latter part of the volume being 

 taken up with the psychiatric aspects of immi- 

 gration, insanity in the negro, the Indian, the 

 Chinese and Japanese, the census of the insti- 

 tutional population and the history of Cana- 

 dian psychiatry. In the Colonies, the psychia- 



tric burden was thrown mainly upon the town 

 councils, which usually meant the pauperiza- 

 tion of the insane in county jails, work-houses 

 and almshouses. Under the healthy plein air 

 conditions of colonial life, this burden was 

 probably light. It is of record that a large 

 donation for an asylum was declined by 

 colonial Boston on the ground that there were 

 no insane to put in it. In Maryland and Vir- 

 ginia, the custody of the pauper insane and the 

 poor was delegated to the Established Church. 

 The first state hospital (incorporated 1768) 

 was opened at Williamsburg, Va., in 1773. 

 The " era of awakening " (an important chap- 

 ter) came slowly. It comprised the erection 

 of such hospitals as the Bloomingdale Asylum 

 (1821), the McLean Hospital (1818), the 

 asylum at Lexington, Ky. (1824), the Hart- 

 ford (1828), and Brattleboro Betreats (1836), 

 and above all the wonderful propagandist 

 labors of Miss Dorothea L. Dix, of whose life 

 a full account is in preparation by Dr. C. W. 

 Page, of Hartford. This remarkable woman 

 practically created institutional psychiatry in 

 Massachusetts, Bhode Island, ISTew Jersey, 

 through the south and west, and even accom- 

 plished much in Scotland and England. Her 

 efforts were based upon most careful investiga- 

 tion beforehand and her success was due to the 

 fact that she was an eminently reasonable per- 

 son, with the unique power of producing con- 

 vincing facts and of making unanswerable 

 statements at the right moment. This was 

 something different from the usual course of 

 " making a noise like a reformer." After a 

 brief conference with her, a rough ISTew Jersey 

 legislator said : "I do not want to hear any- 

 thing more. Tou've conquered me out and out.- 

 I am convinced." In Scotland, where the fro- 

 wardness of women is eyed askance, she in- 

 curred the enmity of the Lord Provost of 

 Edinburgh, beat the hostile official in a mid- 

 night race to London, and so impressed the 

 statesmen there, that she secured Queen Vic- 

 toria's order for two commissions of investiga- 

 tion (1885). In Parliament, the member from 

 Glengarry, Mr. Edward Ellice (Prosper Meri- 

 mee's old friend), said that " the commissiou 

 was entirely due to Miss Dix's exertions'' 



