increasing ratio. It becomes, therefore, a very important question whether we cannot relieve ourselves of a portion, at least, of this financial burden. To relieve ourselves of it altogether is beyond our power; neither do we wish to relieve ourselves at the expense of humanity, or of those unfortunates who, from inability to care for themselves, are at our mercy. But we cannot afford to lavish money upon the insane, in the form of luxurious surroundings, palatial residences, and costly furniture and fixtures. Extravagance in the care of the insane is a crime; because whatever amount is wasted upon one portion of the insane is taken from the mouths and the backs of another portion, who are robbed, in order that lunatics who are more fortunate may live in splendor. What we desire to do, and are under obligation to do, is to see that all the insane, and not a part, are properly cared for; that is, that they are cared for as well as the resources of science and our financial ability will enable us to care for them.

We have not supposed that the failure on the part of the legislature to make adequate provision for the insane has been due to any uncertainty with respect to the policy to be pursued; but only to a want of appreciation of the magnitude of the demand. The policy of the state, though subject to change at any time, appears to be pretty well settled. The general assembly undertook, in 1869, to meet the demand then existing, by the creation of two additional hospitals, one in the northern and one in the southern extremity of the state. This action was an admission that the existing provision for the insane, at Jacksonville, was inadequate. It was also a notification to the people of the state, and to the county authorities, that the people, by their representatives, were animated by an intention to care for the insane through the agency of the state government, rather than by the employment of the machinery of county boards. It was everywhere said that the state intended to take care of all its insane, and that Illinois had adopted the motto of Horace Mann, of Massachusetts, namely: "The insane are the wards of

THE STATE.'

The action of the general assembly, in 1875, when it enacted "that all residents of the state of Illinois who are, or may be, inmates of any of the state charitable institutions, shall receive their board, tuition, and treatment free of charge during their stay," was a fresh recognition of the obligation resting upon the state in this regard. The policy here outlined received additional confirmation when, in 1877, the general assembly created the hospital at Kankakee. That hospital was laid out in the conviction that it would become, measurably at least, a receptacle for chronic pauper lunatics; and that in that character it might safely grow to a total capacity of not less than fifteen hundred inmates.

The state board, then, believing this to be the policy of the state, aware of the great number of insane within our borders, and impressed with the conviction that they can never all be provided for in establishments as costly as those at Elgin, and at Anna, could not do otherwise than seek after some cheaper method of caring for them.

We are familiar with the condition of the insane in the county almshouses, removed from the observation of the superintendents

of our state hospitals. If the superintendents of hospitals for the insane are entitled to claim for themselves a peculiar knowledge of insanity from the medical point of view, in consequence of their long and intimate association with lunatics under their charge, we too may claim a peculiar knowledge of the insane, from the administrative and governmental point of view, gained by a still wider observation of lunatics outside as well as inside of the state institutions. The medical aspect of this question is not its sole aspect. The alienist who confines his attention to the study of insanity as a disease, and whose experience has no wider range than the limits of the hospital with which he is connected, or even of insane hospitals generally, may gain depth of insight at the expense of breadth of comprehension. Our experience in the visitation of county almshouse wards satisfies us of the necessity which exists for removing from the county farms very many of the insane who are now there. dragging out a wretched existence; and it has also taught us that for many of the insane the expensive appliances which are thought to be essential in state institutions are not requisite. We have therefore desired to abolish, if possible, the insane department attached to the county almshouses, but to substitute for them something very much simpler than the ordinary hospital ward. No man can make a tour of the counties, year after year, without coming to the fixed belief that lunatics are locked up, in state hospitals and asylums, who do not need to be locked up; and that there is no necessity for afflicting all the insane with the yoke which is essential for a part.

It will therefore be understood that the establishment of the hospital at Kankakee is due, not so much, after all, to a desire to reduce the pecuniary burden which lunacy entails upon the people of the state, as to a feeling of sympathy for the insane themselves, and a purpose to do all in our power to secure for every one of them the largest practicable amount of personal freedom, of useful occupation and of life in the open air.

What is it that the majority of the insane require? treatment in a hospital? or the comforts of an asylum?

The insane may be roughly divided into three classes, as follows: First, recent cases, who may, with proper attention and treatment, be restored to reason, if taken in time. But of the total number of insane, how many belong to this class? A very small percentage. Recent cases either recover, or they very soon cease to be recent cases. But it is for this first class, recent and curable cases only, that hospital provision, in the strict sense of the term, is necessary.

Second, incurable cases, of a dangerous or troublesome type, who require incarceration, not because confinement behind bolts and bars will do them any good, but because it will protect them or protect others from injury. In this class may be included the homicidal, the suicidal, the obscene, the quarrelsome and violent, and the incorrigibly vagrant.

Third, chronic, incurable cases, who are inoffensive and harmless, except it may be at regular or irregular intervals.

We do not undertake to say what proportion of the insane is included in each of these three divisions, but the number of the class last named is undoubtedly large. They should not be subjected to the same rigid restraint and confinement as either of the other two classes. Some superintendents think that they should not be retained in state institutions for the insane: they must exist, somewhere, and if they can be made more comfortable in state institutions than elsewhere, and at no greater cost for their support, humanity would seem to suggest the propriety of retaining them instead of discharging them. At the same time we are of the opinion that the Illinois law, which requires the retention of dangerous and troublesome cases in the hospital, rather than patients of the class indicated, is a humane law. If any patients are to be discharged, the mild ones should be.

In planning the institution at Kankakee, we had this class specially in mind, and it is for their benefit that the detached wards, with their unlocked doors, unbarred windows, and large associated dormitories are designed.

We present herewith some illustrations of the plan of organization of the Kankakee hospital.

The first is a diagram showing the general arrangement of the grounds and buildings. In the foreground may be noted the Kankakee river, on the bank of which the state farm is situated. At the edge of the river, and at the entrance of the grounds, are the water-works and gas-works, which have a sufficient capacity for the entire establishment. Between the river and the institution is a lawn, with shrubs and young trees, which will in time form a delightful recreation ground for the patients. Facing the lawn is the hospital proper, with its centre building and wings, one for male and one for female patients, each of them consisting of two sections and no more.

This hospital proper is designed to accommodate about three hundred patients. It is three stories in height, as may be seen by the accompanying elevation. Each wing contains six wards, besides three short wards at the extreme end. One section of the male wing is not yet built.