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No one will be bold enough to say that in no hospital in our country has there ever been an abuse of trust, or any arrangements of construction, direction, or discipline, calculated to defeat the object in view, -- the comfort and restoration of the patients. Instead of blinking the matter, it is better to admit the facts so far as they are true, ascertain their causes, and fix the responsibility where it fairly belongs. If our attendants abuse their trust, let us acknowledge the fact and present it as a reason for employing a better and more expensive class of persons, consequently establishing a higher rate of payment from the patients. If an incompetent or time-serving building committee has adopted a plan of construction which leads to casualties, and, in one way or another, prevents us from attaining the highest practicable results, I see no reason why the fault should not be laid at the proper door. When the trustees or directors, in order to advance some political intrigue, are ready to strike a blow at the usefulness of an institution, I am for letting the public know how their confidence is abused. Admitting then the general fact, that the ill-feeling towards hospitals for the insane, so prevalent in the community, is not altogether without foundation, I proceed to consider those usages, arrangements and events which are calculated to produce it.

It cannot be denied by any candid person, that in some of our establishments there are arrangements of one kind or another, that furnish legitimate grounds of complaint and do much to weaken the confidence of the public. They indicate a misconception of the true character of the insane and of the exact objects to be obtained in secluding them from their families and the world. The buildings must necessarily present some prison-like features, and the safety of the inmates forbids many of those provisions which long habit has associated with their notions of domestic comfort. This must be regarded as a necessary evil, but any degree of it not implicitly required by the circumstances of the case, is a justifiable ground of complaint. Let me ask if our establishments are faultless in this respect; if everything has been done to make the patient feel as little as possible, the want of domestic comfort, the deprivation of liberty, the control of another's will, and the separation from those who did whatever he would permit to gratify his wishes, to allay his irritation, and minister to his infirmities. To this question, I apprehend that a hearty, unqualified affirmative cannot always be returned, and hence a fruitful occasion of distrust and aversion towards hospitals for the insane.

Let us observe for a moment, the change to which the patient is at first subjected. Against his own will probably, and not without the use of some force, he is taken from his own home, -- a home to which, notwithstanding his seeming disregard of all its claims and proprieties, he still retains some strong attachments, -- and placed in an apartment of unusual size and form. It is scantily provided with furniture, and the walls are as bare and cheerless as unpapered and unpainted surface can make them. A range of bed-rooms on each side shut out the light and obstruct the view without. No open fire invites him to forget his troubles, for a moment, in the range of its genial rays, and a crowd of persons, by their strange looks and stranger conduct, appear to make a mock of his calamity. At night, cries and other unaccountable noises disturb his rest, and fill him with suspicion and fear. Friends, while visiting him, bear a tale of wrongs and indignities, in the investigation of which, unnecessary annoyance may be brought to light, and the unfavorable impression strengthened by the screams of some excited patient, or the sight of one peculiarly repulsive and disagreeable. That such impressions would frequently be made, under any system of arrangements, I do not doubt, for the insane, as a class, are wonderfully fault-finding and difficult to please, in which qualities they are frequently excelled by their friends, but I believe they would occur less often, if, in some points, our establishments were differently ordered.

In the first place, in the plan and details of construction, the single consideration of cheapness has been too much allowed to prevail over that of perfect adaptedness to the purpose. The question that over-rides every other is, not how the proposed object can be best accomplished, but how much it will cost. When the friends of humanity have presented to a State-Legislature a project for establishing a hospital for the insane, the voice which rests the claims of this unfortunate class of our fellow-men, upon moral obligation, is feeble, compared with that which shows how cheap it can be done. The estimate of cost is made far lower than it should be, an appropriation is voted, and the gentlemen go home exceedingly well pleased that so much good may be done for so little money. Whether the end would not be better accomplished by a more liberal expenditure, is a question never asked. In no single instance, I venture to say, has any one been bold enough to say to a State- Legislature, -- "The insane within your borders require your aid; you are bound by the great law of humanity and by every sense of obligation to give it, as cheaply as you can consistently with the perfect accomplishment of the object, but cheap or dear, it must be given to the utmost extent which the progress of improvement has shown to be possible." The result has been that most of our establishments have wanted architectural arrangements that would have promoted the comfort of their inmates and left less unfavorable impressions upon their minds. On this point it is high time that our views should be definite and well-settled, because sooner or later the country will look to us for instruction on all subjects connected with our vocation.