prehended, must bring with it the conviction that this hospital should be completed at the earliest possible day, and endowed with the full capacity of usefulness recently planned for it. The dictates of economy and humanity are alike clear and emphatic on this point. The economy of the immediate completion and occupancy of the building is apparent from a variety of considerations.

In the first place, this building, less than half completed as it is, and accomplishing less than half its full usefulness, requires much more than one-half the outlay which would be necessary for the whole-an amount of expenditure out of all proportion to the results attained, as well as to what it would require to administer its affairs in a completed state. It is already organized in great part with the apparatus and appointments as well as most of the officers and employees required for the completed institution; and a comparatively slight increase in kind and in number of what we are at present obliged to have would place the asylum on a footing for performing more than twice the services to the State. The same kitchen, and laundry, and sewing room, the same engine and boilers, and water works would answer for the whole building as now answer for one-half of it, with but few noticeable additions. The same superintendent, the same clerks, male and female; the same matron and house-keeper; the same watchmen and supervisors of each sex would, with slight assistance, serve the whole hospital as they now serve one-half of it; and while these facts show the wisdom of prompt completion of the building, they set in a clearer light another fact, viz: that the proportionate expenditure or the expenses per capita are greater in the present incomplete form of the institution than in the same or in a similar establishment completed. The resources of such an establishment are multiplied with the increased numbers. There is a large proportion of the inmates who lend their aid both in-doors and out. Among our small number of female patients (occupying only one floor) there are almost none from whom we receive any appreciable assistance, while in many hospitals of the kind a large part of the domestic labor is done by the inmates. In the same manner among our male patients, we find but few who are industrious and reliable, and are obliged to place the more dependence upon hired labor.

For these reasons we are unable and cannot be expected to subsist upon the same allowance which answers for a completed institution. In our estimates for the current expenses of the coming year, therefore, we have placed the allowance per capita at $250 instead of $225; the former figure and this sum will not appear unreasonable when our crippled resources and our new and needy condition are taken into account. We ask of the Legislature only a candid examination of the necessities here presented, and cannot doubt of their readiness to deal justly by us.

In the next place it is evident that the State must, in one way or another, support the indigent insane. They cannot be at large, and the chief part of them at the present time are herded together in the county houses. Now the difference between their support severally by the counties and their support collectively by the whole State, in institutions where every resource for their prudent maintenance and management, as well as for their comfort, is at command-I say the difference between these two methods, even upon economical grounds alone, is all in favor of the State Institution. A burden is assumed by the State, but it is lifted off the counties; and let any enlightened economist say whether it is better for the counties to divert and fritter away their resources in a hundred different channels, or for the State to wisely combine and concentrate them upon a single point and with a single noble aim.

It is just possible that the expense of supporting the insane of the State in a hospital provided for that purpose might slightly exceed the expense of keeping them as they are now kept in pens and cages, in wretched alms-houses and jails, or huddled together in squalor and filth, in what is termed the "insane department," in some of our county houses; but the Legislature of Illinois is certainly not capable of speculating upon such a difference!

To continue the present state of affairs from economical motives would be to ignore the true principles of economy as well as the rights of humanity, and it is safe to assume that the members of our Legislature are both too wise and too humane to fail in the faithful guardianship of the interests committed to their care, of her helpless and most unfortunate citizens, the indigent insane.

Other States have shown us examples of munificent liberality toward their insane deserving of our attention.

Many years since, Hon. Wm. H. Seward, then the wise and able executive of New York, addressed the Legislature as follows: "I cheerfully express my approbation of the undertaking. Nations are never impoverished by their charities. The number of the insane in this State is not exaggerated, and I am not prepared to say that erection less extensive would afford the space, light, tranquillity and cheerfulness indispensable to this interesting department of the healing art. Among all our blessings none call so loudly for gratitude to God as the preservation of our reason. Of all the inequalities in the social condition there is none so affecting as its privation. He sees fit to cast upon our benevolent care those whom he visits with that fearful affliction. It would be alike unfeeling and ungrateful to withhold it. Let, then, this noble charity be carried forward, with what measure of munificence it remains with you to determine."

Again, at the laying of the corner stone of the Buffalo State Asylum, in September last, Gov. Hoffman used the following language:

"In 1869, I made an earnest appeal to the Legislature to make additional provision for the insane poor; the rich can always be cared for, but the insane poor, alas! none so helpless, none so friendless. Their presence in most of the county poor houses is alike injurious to them and demoralizing to the neighborhood. Interest, duty and charity demand that liberal provision be made for them by the State. Within the past five years about three millions of dollars have been expended by the State of New York in caring and making provision for the insane, and within the next five it will expend as many millions more. We hope the time will soon come when no insane person shall be found in any county poor house, and all shall be treated and cared for in suitable asylums. Distinctions between riches and poverty should cease when the malady of madness begins.

"But I forbear further remarks. These public edifices, constructed by the State, testify alike its greatness and its virtue; the more numerous they are the more abundant the evidence that the people in their prosperity are mindful of what they owe to the Giver of all Good.

"Let them be multiplied and increased, and let it be the proud boast of the State that its charities are grand.

"States, like men, if they would be great, must be good. It is the broad spirit of charity which ennobles both!"

Our institution is now crowded beyond its proper capacity.

We can receive 150 with comfort and convenience, and that is the number originally calculated to be accommodated in this wing, but we have 183 now within our walls. The case is similar with almost all the institutions of the country, and the association of medical superintendents, at their annual meeting in May last, unanimously adopted the following resolutions deprecatory of this policy.

Resolved, That this association regards the custom of admitting a greater number of patients than the buildings can properly accommodate, which is now becoming so common in hospitals for the insane in nearly every section of the country, as an evil of great magnitude, productive of extraordinary dangers, subversive of the good order, perfect discipline and greatest usefulness of these institutions, and of the best interests of the insane.

Resolved, That this association, having repeatedly affirmed its well matured convictions of the humanity, expediency and economy of every State making ample provision for all its insane, regards it as an important means of effecting this object that these institutions should be kept in the highest state of efficiency, and the difference in condition of patients treated in them, and those kept in alms-houses, jails, or even private houses, be thus most clearly demonstrated.

Resolved, That while fully recognizing the great suffering and serious loss that must result to individuals by their exclusion from hospitals when laboring under an attack of insanity, this association fully believes that the greatest good will result to the largest number, and at the earliest day, by the adoption of the course now indicated.

Resolved, That the Boards of management of the different hospitals on this continent be urged earnestly to adopt such measures as will effectually prevent more patients being admitted into their respective institutions, than in the opinion of their superintendents can be treated with the greatest efficiency and without impairing the welfare of their fellow-sufferers.

In the present state of accommodations for the insane in our State, it is only possible to admit that portion of the cases applying, which are considered of recent origin, and likely to be benefited by treatment. To all others, no matter how pressingly they need the care and custody of the asylum, the overcrowded condition of the hospitals compels them to turn a deaf ear. The attitude toward the insane and their friends which we are forced to assume, is represented by the following language of Dr. Wilkins, Commissioner in Lunacy for the State of California, used in reference to the institutions of that State:

"Large numbers of insane who desired to gain admission have been turned away and told, not in words, but in acts which speak louder than words, to wait until somebody gets well or dies, and then after the disease has fastened itself upon your brain so firmly that it cannot be moved, when all hope of recovery has passed, you may come in and in your turn keep some other equally unfortunate person out till he too becomes incurable and hopeless-lost to himself, lost to his family, lost to the State-yet a burden to the public treasury so long as he shall live." It is true that in this State we endeavor in every instance to receive recent and hopeful cases, but we have no means of arriving at certain knowledge of the nature or duration of the disease before the case arrives. We are often deceived and our good intentions defeated by ignorance, or something worse, in the proceedings of the parties interested. We crowd the little space at our disposal so full that we practice injustice to those admitted as well as to those declined. Moreover, the advancement of knowledge and experience in the treatment of the insane shows a constantly increasing ratio of recoveries after periods of time had elapsed which were previously supposed to destroy all hope of restoration. So that in declining one case simply because it is of two or four years' duration, and admitting another purporting to be only of two or four months' duration, we may be turning from our doors in the first instance, one that would have been ultimately restored, and receiving in the second, one whom no amount of skill or length of treatment can benefit.

Another obstacle in the way of our doing full justice to our inmates in the present incomplete condition of the hospital, is the impossibility of our making proper classification of those we receive. We can make but seven divisions of our male patients and but four of our females-both numbers below what is considered absolutely essential by the medical authorities best versed in the specialty, as we have set forth in a preceding portion of this report. Our female patients, in particular, suffer from this misfortune. We can only divide them into four classes, and there are in every ward those who are improperly placed, or would be if it were possible to place them otherwise.

Vol. IV-4

The reiteration of the appalling figures which show the insufficiency of our provision for the insane may have become wearisome, but to forget them, or disregard them, only aggravates the evil, and they are, in themselves, the most powerful argument which it is possible to bring in favor of speedy and thorough measures of relief.

The institution at Jacksonville accommodates 450. In our present condition we receive 180. The hospital at Anna, when filled, will care for 400 more. The Cook County Asylum has 200 crowded within its walls.

The total number thus provided for is 1,230, but the accurate and reliable statistics of the STATE BOARD OF PUBLIC CHARITIES place the total of insane in the State, at 3,000, of whom 2,500, or at the least possible calculation, 2,000, are in crying need of hospital treatment and care. Taking 2,000 as the lowest admissible figure, we have, (when the the Southern Asylum shall have commenced operation,) seven hundred and seventy at the most moderate computation, as the number of insane in the State, for whom there is absolutely no hospital accommodation.

To these figures the thoughtful consideration of our legislature is most respectfully invited in the full belief that they will see the propriety and expediency of taking prompt and active measures to relieve the necessities of this important class.

GEOGRAPHICAL DIVISIONS.

The wisdom of dividing the State into sections, which shall have, as nearly as possible, an institution central to themselves, is everywhere approved by the experience of hospitals so established, and ours is no exception to the rule. Our own county and those immediately adjacent are much more largely represented by cases, both recent and chronic, and we are obliged to refuse many more applications from our immediate vicinity than from a distance. The mere fact of the existence of an asylum brings to light and public knowledge, considerable numbers of cases which would otherwise have remained entirely unknown. The friends and family of an insane person are always reluctant to remove the unfortunate one to a great distance and will much more readily avail themselves of hospital treatment where access is easy, and intimate personal knowledge of the institution and its officers are possessed.

AMUSEMENT AND EMPLOYMENT OF INMATES.

Although our resources and appliances for the diversion of our patients have been small, and we have of necessity lacked numberless facilities which older and better endorsed institutions can command, we have succeeded in providing recreation and occupation for our inmates to an extent very gratifying in its nature and results. Out door exer