sibility and power of government is placed directly in the hands of the superintendent and trustees. It is true there are powers lodged in other bodies, and provisions made for some oversight of these institutions, but they are so constituted that they are not often exercised or made available for purposes of improvement and reform. The law provides in most States that the Governor and Council shall have a general oversight of public institutions, making regular or occasional visits. The Legislatures in all the States not only enact laws for the support and management of these establishments, but appoint committees from time to time to visit them. But the oversight and visitation of both these bodies are rather formal and ceremonious. Their visits are generally made at set times, in a body, with previous notice, and not unfrequently in a hurried manner. It is impossible for them to make a thorough examination into all the internal affairs of an institution, or into all the details concerning the condition and treatment of its inmates. Unless some charges of abuse or complaints have been made, these bodies seldom, if ever, make special examinations, or interfere with the government and management of hospitals. No great improvements or real reforms can be expected from such oversight. There is another agency established in several States, intended to exercise some care and supervision of these institutions, viz.: Boards of Charities. The original design in the establishment of these boards was a most wise and beneficent one. It was found by large experience and wise counsels, that something was wanting in the management of institutions, that there was need of far greater watchfulness and more definite information and statistics, whereby comparisons could be made, extravagance checked, abuse prevented, and improvements of various kinds started. These boards have already done immense good, and, with some modifications, their usefulness may become more permanent and widely extended. But as the organization of these boards confine their duties almost wholly to visitation and report, without compensation, and with very. limited powers, they cannot exercise that supervision over lunatic hospitals for improvement and reform which is absolutely necessary. The labors and reports of these boards have brought before the public such information, facts and statistics concerning these hospitals, as to show the great need of some changes or improvements for which legislation, as yet, has made no adequate provisions.

It

What, then, is the kind or character of the supervision required? It may be very properly designated a Lunacy Commission. should consist of three or more persons, according to the number of institutions or extent of the field. Its members should be compensated according to services rendered. They should be appointed for a series of years by the executive of each State, without regard to political party or personal favoritism. This appointment should be based solely on their qualifications or fitness for, and interest in, such work. They should hold at the time no official connection with any local institution. Their powers and duties should be co-extensive. They should have a general supervision, with full power over everything concerning not only the management and government of the institution, but also the care and treatment of its inmates.

A commission thus constituted might justly be held responsible to the public, and to the higher powers of appointment. Its recommendation to Legislatures, with respect to appropriations and the enactment of laws would be valuable. Its reports would serve to enlighten the public in such matters, creating everywhere greater interest and confidence in these institutions.

The question may be asked why lunatic hospitals require different or more supervision than other institutions? The following may be given as some of the reasons:

The appropriations for this class are greater than for any other, and the expense upon each individual is larger. The insane are more dependent and helpless, and require different treatment. It

is not the body mainly to be provided and cared for, but mental disorders which involve interests of a far higher nature and more important in results. The rights of the insane in respect to personal liberty, family relations and property, are taken away under circumstances in which there is danger of injustice and wrong-doing; besides, they are brought together in large numbers and confined in close quarters, placed under attendants where there is liability to abuse of various kinds. The difficulties and responsibilities attending the proper treatment of the insane are so great, that they require constant watchfulness and the most careful oversight. Experience proves this. Cases of improper committal and detention, of wrong treatment and abuse, are often brought to public notice, showing the need of constant vigilance and the most careful oversight. The need and importance of such

oversight is very clearly stated by the Rev. Dr. Bellows, of New York. Says Dr. B.: "Insanity and insane asylums require far more inspection, study and attention, far more publicity in all that touches their management, than they now receive in this State or county. The public is profoundly interested in being reassured by persons whose testimony is beyond suspicion, that this helpless and wretched class, the insane, are not neglected, abused and made worse, instead of better, by our public institutions. They need and demand to know that persons of the highest character, and enough of them to guarantee sound judgment, are incessantly busy, looking into the state, studying the complaints, and protecting the rights of those who are incarcerated in public asylums. It is in the nature of things that abuses from pressure of call, from induration of sensibility, from force of routine, from pride of authority, from limited experience, from the inertia of custom, should creep into asylums for the insane. Eternal vigilance from the representatives of the public anxiety, who have no interest except that of humanity, can alone keep either prisons or asylums from degenerating, or from becoming stereotyped in effete prejudices of management." That we may have a better and clearer view of the subject, let us take different points of observation. There are four great interests, or parties, that require such supervision :

1. The institutions themselves. In all large establishments, evils and abuses of some kind will spring up. The fault may not be directly on the part of the managers, but more with the subofficers and attendants. The most effectual way to discover and correct these evils has been found by authorities outside, charged with such duties. Correction or reform seldom come from local officers. Besides, such is the peculiar relation of lunatic hospitals to the public, that prejudices and distrust will prevail more or less in the community in respect to them, unless arrangements are made for proper supervision. This distrust is not only exceedingly annoying to the officers of the hospitals, but causes great injury to the public and the best interests of the insane. It frequently prevents persons in the first stages of insanity from being sent to the hospital, when they might be cured. It impairs the confidence of the insane in the physician and his treatment.

Again, there is always room for some improvement in every institution. This is less likely to come from persons constantly

occupying the same point of view, and following day after day the same routine of duties, than from those looking from different and distant points of view, who can compare one institution with another, and make careful observations over a large field. Hence, the necessity in such management of more diversified experience, more general knowledge and larger observation than local officers usually have, whose labors and interest are almost wholly identified with one single establishment.

In no other institution or corporation in the country, are individuals charged with duties and responsibilities of such magnitude as the officers of lunatic hospitals, and nowhere else are counsel, skill and wisdom of the highest order, so much needed as here. The lunatic hospitals of Great Britain are provided with these advantages in a Commission of Lunacy. Superintendents, trustees and commissioners all work harmoniously together for the best interests of the insane. The Lunacy Commission has been in operation in England over thirty years, and that in Scotland over twenty years. It is admitted on all sides that the most beneficial results have been brought about by the agency of these commissions in the improved management of hospitals and the better treatment of the insane.

2. But the class that need such supervision most are the inmates of these hospitals, the unfortunate insane, the most helpless and dependent of all human beings. They are forcibly removed from home and friends. The law takes away from them their rights in respect to personal liberty and the use of their own property; it unsettles them in all business relations and in the duties they owe to their families; it destroys the confidence which the public once reposed in them, and excludes them in a great measure from intercourse and communication with their friends, as well as exposes them to personal abuse from attendants and others. Where such personal and fundamental rights are taken away or very much abridged, should not legislation make better provision for protection, defence and appeal than are now made? No proper provision is made by the courts that is available to the insane. They certainly cannot look to the Governor and Council at a great distance, nor to a legislative committee meeting once in a year or two, and making occasionally a formal visit to these hospitals. It should be a provision available and ready at hand, one in which the insane have confidence.

It may be said the insane have always the superintendent and trustees for counsel and protection. This may be true to some extent, but, then, how frequently are the insane brought to hospitals by deception, cherishing strong prejudices against these establishments as prisons, conscious that they are deprived of their rights, and looking upon the hospital officials as their oppressors? Besides, such is frequently the type or nature of insanity, that it leads the insane to distrust those immediately about them, and to look elsewhere for aid and counsel. That the insane may receive the full benefit of treatment, whatever the means may be, whether medicine or other appliances, how important it is that they have confidence in these means, and in those having a constant oversight of them? In the treatment of other diseases, this confidence is regarded as indispensable, and great pains are taken to secure it by counsel, and in many other ways. In diseases of the mind

it is still more important.

But the distrust of hospital officials cherished by the insane does not arise wholly from prejudice or a diseased mind, but from the fact that they find, by experience and a variety of circumstances, that everything affecting their interests is virtually placed in the hands of one man or one body of men. It is true there are local trustees, having care and oversight of the hospital and its officers, but as a general thing they know very little about insanity or the needs of individual patients, making short and formal visits, depending almost wholly upon the superintendent for information. He is, moreover, appointed by the trustees, and is their executive officer. The interests, business and reputation of both parties are so closely identified that they constitute really one governing body. Such is the interpretation placed upon it, not only by the insane, but by large numbers outside of the hospitals. Though a great difference may be found in different hospitals as to the relations and acts existing between these two parties, the impression prevails very generally, that the power, in its real and controlling influence, is exercised by the executive officer. It is needless to dwell here upon the objections to a one man power.

Two years since, an English gentleman, who had been a government inspector over twenty years in Great Britain, and whose constant business it was to visit hospitals and workhouses, came to the United States to obtain information about our public institutions. After inspecting carefully several lunatic hospitals, he