twenty chronic incurable patients could be humanely and kindly cared for at three dollars per week for each person, or $2,760, thus making the total cost of treatment, under probably the best conditions, 83,500.
This mode of treatment of the insane, far from being Utopian, is at present in successful operation in Strasburg and Heidelberg, and is about to be carried into effect in some of the Scotch asylums. The most eminent alienists in Great Britain and America have strongly advocated it.
Lord Shaftesbury, before a select committee of the House of Commons in 1887, thus explained the intention of the promoters of the early lunacy laws: "The asylum was to be divided into two; there was to be the principal asylum, which was for the acute cases; and there was to be a chronic asylum alongside of it, which was for old, chronic, incurable cases. All the recent cases were to be sent to the principal asylum, which was to have a full medical staff, and everything which could be necessary for treatment and cure."
Dr. J. Wigglesworth, superintendent of an English asylum, in the discussion on The Future Provision for the Chronic Insane before the British Medico-Psychological Society, said: "A more important question than the care of the chronic insane was whether they could not make a more determined effort to do more for the cure of the recent cases. To do this they must hospitalize asylums more. They must have small buildings properly officered and equipped, to which all recent cases should first be sent. The increased knowledge thus obtained would without doubt in time bring about an increase of the recovery rate."
Dr. H. Hayes Newington, in his presidential address delivered at the annual meeting of the Medico-Psychological Society of Great Britain in 1890, advocated the hospital annex for curable cases within easy distance of the main building. He stated that, in a hospital of one thousand patients, not more than sixty on an average would need such treatment.
Dr. D. Hack Tuke, in discussing the above address, said: "There should be means of treating acute cases in a separate hospital block, one in the construction of which no reasonable expense should be spared; or there should be a hospital at some distance from the asylum, on the lines laid down by Dr. Newington."
Dr. E. B. Whitcomb, in his presidential address before the British Medico-Psychological Society in 1801, stated: "The hospital treatment of the acute insane would insure the separation of acute from chronic insanity, sustain and encourage the more rational treatment of insanity as a symptom of physical derangement; but above these a well-constituted hospital would be the means of promoting to a greater extent and in a more elab-