light wire movable screen. At Cheadle I was shown the old fenders, which had all been removed, and were doing duty as chickencoops. Even at Broadmoor, the great criminal-asylum of England, the gas is kept burning through the day for the accommodation of smokers, who in the English institutions are commonly permitted to light their pipes at pleasure, and smoke where they choose. The great advantages of open fires are, that they are less expensive than steam-heating, they are more cheerful, they obviate the necessity for forced or artificial ventilation, and they keep the wards much sweeter.

The principle of treatment illustrated by the instances just adduced is, that ceaseless personal vigilance and oversight is a better safeguard than any mechanical appliance or artificial rule of discipline.

The superior freedom of foreign institutions for the insane, in many respects at least, is shown in numberless ways. In close asylums the freedom is probably carried to the extreme limit of practicability, under what is known as "the open-door system," by which is meant that the wards are not locked during the day. The only asylums in which I saw this system in practical operation were Cupar-Fife and Lenzie, in Scotland. At Cupar I walked through the front gate and the front door, and into the wards, unannounced, and passed through first one and then another, until I came to the superintendent on his morning round, in the sewingroom. Every door was standing wide open. Dr. Brown, however, has two locked wards on the female side, and one on the other. The total number of patients present was two hundred and ninety-six; and of these sixty-eight only were under lock and key. Dr. Brown's defence of the system was in these words: "It is hard to sacrifice all one's patients to the wants of the worst class. If, out of one hundred and thirty-one men, twenty-two only are in a locked ward, not only do the one hundred and nine enjoy life better, but the twenty-two are better individualized, more closely watched, and from time to time liberated by way of experiment." At Lenzie there is not one locked ward. The superintendent carries no key; and all keys are taken away from the attendants on the male side, except, at night, dormitories are locked. There are no guards on the windows, either below or above. Yet, with five hundred patients, there are no more accidents than under a stricter rule, and Dr. Rutherford says that there are not so many. His position is: "Given a skilled physi

cian and attendants, with removal of the patient from his home, and I do not care what the house is." The question of the amount of liberty possible is very largely a question merely of responsibility of the attendants.

At Cheadle, in England (an institution which has not attracted the attention on this side of the water that it deserves), under Dr. Mould's superintendence, an interesting experiment is in progress. The farm contains one hundred and forty acres, and the number of patients is about two hundred. Of these one hundred and forty are in the main building, and sixty in cottages. Three of the cottages are on the grounds; the rest are private residences, scattered around through the neighborhood, some of them at a distance of several miles. They were not built with any reference to the care of insane persons, but for the occupation of farmers and of gentry-folk, in the ordinary condition of people of their respective stations, and have been bought or leased for the use of the asylum. I visited every one of these cottages, except one at the seaside, in North Wales, which can only be reached by rail. I saw no restraint upon the freedom of any of the patients occupying them, except the presence and oversight of an attendant. The doctor and his assistants visit them daily, on horseback or in a carriage, just as ordinary patients would be visited by their family physician, and enjoy the change and the exercise in the open air. The cottage by the sea is kept as a place to which to send patients from the asylum or from the outlying cottages around, when they need recreation. The result of this experiment is entirely satisfactory to the superintendent, who says, if he had charge of six hundred insane people, he would not want hospital-accommodation for more than one hundred; and that he finds it convenient to remove troublesome patients from the wards, and transfer them to cottages, because such transfers quiet them, and promote the peace of the house.

Of Gheel and of Clermont, both of which are better known, I will not speak at length. Neither of them is a model for us, and Gheel least of all; but at both one sees how far, with proper classification and oversight, the freedom of the insane may safely be carried.

It may be accepted as an axiom in the treatment of insanity, that, in order to the maximum of liberty, there must be a minimum of idleness. Idleness breeds discontent, and discontent danger.

The amount of labor of which the insane are capable has been greatly underrated in America. At Morningside, in Scotland, with seven hundred and fifty inmates, of both sexes, one hundred and eighty men are at work on the farm, and fifty are engaged in mechanical pursuits, besides others who do odd jobs about the house. In a shed were one hundred and fifty wheelbarrows, piled in rows, for the use of patients in wheeling dirt and gravel, than which there is no better exercise possible for excited or demented men. The patients in this institution manufacture all the clothing, nearly all the boots and shoes, and do all the smith-work and all the printing, for the entire establishment. At Cupar-Fife, ninety out of one hundred and thirty male patients were usefully employed, seventy on the farm, and twenty in shops; and on the female side, in order to have work for patients to do, no washing-machines had been purchased. At Lenzie I saw patients in gangs working on the grounds, and in the stone-quarry, and upon the buildings, under the direction of their attendants who were working side by side with them, at the same employments. In this institution, insane men, and women work together in the laundry and at the tailor's bench; and it may be added here, though out of this immediate connection, that at Cheadle there is a dining-room for patients of both sexes, where about twenty of them meet and chat together daily, at their meals, to the great enjoyment of both: there is no danger, where the supervision is thorough. At Cheadle, the number of private patients being large, and since it is impossible to compel patients of this class to labor, they are encouraged to engage in athletic sports, and a pack of hounds is kept for their particular benefit. At Broadmoor, to induce patients to work, the value of all labor performed. by them is computed, and one and a half pence in each shilling is allowed them as a peculium to be spent as they may elect, subject to the superintendent's approval. Each patient has a pass-book, in which his earnings are entered, and the disposition made of them. This system is said to give satisfactory results, and the institution finds it profitable to continue it. Even in the Earlswood institution for idiots, the half-witted inmates are busy printing, lithographing, making matting, baskets, brushes, tinware, clothing, and furniture. They make all the furniture, clothing, boots and shoes, required by the establishment. If now we cross the Channel, we find in France workshops connected with every public asylum, where the inmates follow the trades to which they

have previously been accustomed. At Clermont Dr. Labitte assured me that of 1,622 inmates present that day, all had useful employment of some sort, according to their capacity, except one hundred and seventy, who were either epileptic, superannuated, violent, indecent, or sick. At Quatre-Mares, out of an insane population of seven hundred and fifty, more than one-fifth were engaged in useful labor.

It is not easy to comprehend the contrast in this respect between the European asylums and our own. The insane need employment; and the furnishing them with it diminishes or obviates the necessity for seclusion, restraint, and drugs. Idleness is one of their greatest perils. There does not seem to be, when one thinks about it, any sufficient reason why an insane man should be supported in idleness, at public expense, in America any more than in Europe. Is it not possible that we take away the domestic and farm work from our patients, by making such use of machinery as we do; and that the liberality of the State is drawn upon to furnish clothing and furniture ready-made, when it would be better for the insane themselves if they were required to help themselves by their own exertions?

In what has been said respecting foreign institutions for the insane, I have confined myself almost entirely to general observations, not of universal application; and any impression made upon the reader's mind is subject to correction, were it possible to go more into detail. I have said very little about special points of construction and management. I was much interested in the farmbuildings, so different from our own; in the disposition made of sewage, in drying-pits or by irrigation; in the apparatus for domestic labor, especially in the French kneading-troughs and baskets for baking bread, as well as the laundry-machinery, and the gas-ovens in use in England; in the Porter-Clark process of softening hard water by the addition of lime-water, and by an ingenious system of filters; in the remarkable water-tower at Quatre-Mares, built in stories, with a separate tank for each level; and in many other things seen and remembered, but which I cannot here describe.

Autopsies of insane patients are much more frequent than with us. There is a growing sentiment of doubt as to the value of airing-courts. In England the walls of these courts are frequently sunk, in such manner that patients can look over them, and enjoy the beauty of the landscape, without feeling themselves hemmed

in by artificial barriers. At Banstead there are separate yards for the occupants of the several sections or blocks, but they are divided only by a low wire fence. In Scotland they have been practically abandoned.

The most offensive sight to an American who visits the French asylums is the mode in which seclusion is practised, even in the best of them, as at St. Anne in Paris. The cells for violent and excitable patients are arranged in a semi-circular building, with a hall on the inner and the cells on the outer side. Each cell has a small yard with a high wall, and these yards radiate from a common centre, like those seen in cellular prisons for criminals. Even more painful to me was the visit paid to the insane-hospital . at Konradsberg, in Sweden, where I found fifty-eight patients confined in solitary cells, a large proportion of them entirely destitute of clothing. The total number of insane in the institution is two hundred and sixty.

A word now as to the number of insane in our country compared with England, Scotland, and France. To read the criticisms in some of our public newspapers, one would suppose that the State administration in Illinois had engaged in the manufacture of lunatics for purposes of private speculation. The injustice of such attacks is very great. We are simply endeavoring to take care of material which accumulates upon our hands more rapidly than we can make provision for handling it. With a population of nearly or quite three and a half millions, the estimated insane population is only four thousand, or one to every nine hundred. In this estimate are included not only the insane who are in institutions and upon the county-farms, but all who reside at home with their friends. Contrast our condition with that of Scotland. The population of Scotland is 3,360,018, or but little less than our own; and, according to the last report of the commissioners in lunacy, Scotland has over nine thousand insane, as follows: