742 THE POPULAR SCIENCE MONTHLY. 



in the humanitarian care of the insane by the State and the recog- 

 nition of the obligation of the State to these unfortunates. It 

 was designed that the Utica Asylum should receive all the recent 

 cases of insanity. Those who, after a period of treatment, were 

 deemed incurable were to be returned to the county houses, thus 

 making room for all the recent cases. This condition lasted until 

 1865, when public opinion, shocked and horrified by the treatment 

 in almshouses of the chronic insane, who then numbered 1,300, 

 demanded that these, the most wretched of all God's creatures, 

 should receive at least kindly care. The Willard Asylum was 

 therefore established in 1865 for the care of the chronic insane, 

 who were to be there maintained at the lowest rate conformable 

 with a plain, simple diet and humane care. All the counties were 

 required to send their chronic insane to the Willard Asylum 

 except those which furnished suitable maintenance for them. 

 Twenty counties, largely because of inadequacy of accommoda- 

 tions in State institutions, were accordingly temporarily exempted 

 from the operation of this act. The State, however, continued to 

 build State asylums : at Poughkeepsie in 1870 ; at Middletown in 

 1874; at Buffalo in 1880; at Binghamton, the State Inebriate Asy- 

 lum, first used as a State asylum, in 1879 ; and the St. Lawrence 

 Asylum in 1890. 



The State asylum for insane criminals, formerly at Auburn, 

 now at Matteawan, has not been considered in the following sta- 

 tistics, as the conditions there, on account of the character of the 

 patients, are peculiar to itself and different from the other State 

 hospitals. 



The same general principle was carried into effect in their 

 design — that is, the Utica, Poughkeepsie, Buffalo, and Middle- 

 town asylums were for the recent cases, while the chronic incura- 

 ble cases were sent to the Willard and Binghamton asylums. The 

 reason for this was the recognition of the difference in the require- 

 ments of these two classes of patients — the acute and the chronic 

 insane. The acute insane are often dangerously sick, and should 

 receive all the strictly medical care and attention which the char- 

 acter of their mental disease demands, the custodial supervision 

 being here entirely secondary and kept as much as possible in the 

 background. The chronic insane are incapable of living at home, 

 and almost no hope of their recovery is entertained. These re- 

 quire custodial care, with incidental medical supervision. Their 

 care is purely a question of sociology, of interest to the philan- 

 thropist rather than the physician. The supervising spirit, how- 

 ever, must always be medical, as only a scientifically trained mind 

 can properly appreciate the influence of surroundings on their 

 welfare, and can wisely and humanely classify them as their 

 mental condition gradually changes. 



