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Under well-directed hospital care, recovery is the rule -- incurable permanent insanity the exception.

Dr. Luther V. Bell, in one of his reports, shows that "all cases certainly recent, whose on origin does not date back, directly or obscurely, more than one year, recover under a fair trial." And again, in his report of 1843-'44, he remarks, that "in regard to the curability of insanity, in its different manifestations, there can be no general rule better established than this in direct ratio of the duration of the symptoms."

Dr. Ray repeats and confirms these opinions.

Dr. Chandler stated, in 1843, that his experience proved that the earlier the patient was placed under hospital treatment, the more sure and speedy was the recovery.

Dr. Brigham repeatedlv states, in his reports, that more than eight out of ten recent cases recover while not more than one six of the old cases are cured.

Dr. Rockwell's reports corroborate these views.

Dr. Butler states that delay of appropriate treatment rapidly diminishes the chances of recovery.

Dr. Kirkbride declares that the general proposition that "truly recent cases of insanity are speedily curable, and chronic only occasionally, ought to be everywhere understood."

Dr. Awl, writing on this subject, says: Public safety, equity, and economy alike require that this should be so."

Dr. Earle shows that "there are few acute diseases from which so large a per centage of the persons attacked are restored."

Drs. Woodward, Stribling, Parker, Allen, Buttolph, Stedman, and others, also support, in this country, the same opinions; while the long list of able and well-known distinguished writers on insanity, and the physicians of the hospitals, on the other side of the Atlantic, place the question beyond doubt.

The following tables, prepared from the records of one hospital, afford a single illustration of the views above advanced, and show the duration of insanity before the admission of the 280 patients received in five consecutive years.

TABLE

Showing the duration of insanity before admission into the hospital.

TABLE

Showing the comparative curability of a given number of cases healed at different periods, as introduced to hospital care.

An author of profound research and high intellectual endowments, in a work which was first published some years since in several foreign languages, and has since been reproduced in this country, states that "the general certainty of curing insanity in its early stage is a fact which ought to be universally known, and then it would be properly appreciated and acted upon by the public."

Dr. Ellis, director of the West Riding Lunatic Hospital, England, stated in 1827, that of 312 patients afflicted within three months after their first attack, 216 recovered; while, in contrast with this, he adds that of 318 patients admitted, who had been insane for upwards of one year to thirty, only 26 recovered. In La Salpetriere, near Paris, the proportion of cures of recent cases was, in 1806-'7, according to Dr. Veitch's official statement, as nearly two to three cured, while only five out of 152 old cases recovered. Dr. Burrows stated, in 1820, that of recent cases under his care, 91 in 100 recovered; and in 1828, that the annual reports of other hospitals, added to his own larger experience, confirmed these observations. Dr. Willis made to Parliament corresponding statements. At the Senavra hospital, near Milan, the same results appeared upon the annual records.

But cure alone, manifestly, is not the sole object of hospital care: secondary indeed, but of vast importance, is the secure and comfortable provision for that now large class throughout the country, the incurable insane. Their condition, we know, is susceptible of amelioration, and of elevation to a state of comparative comfory and usefulness.

Insanity prevails, in proportion to numbers, most among the educated, and, according to mere conventional distinctions, in the highest classes of society. But those who possess riches and a liberal competency are few, compared with the toiling millions; therefore the insane who are in necessitous circumstances greatly outnumber those whose individual wealth protects them usually from the grossest exposures and most cruel sufferings.

I have seen very many patients who has been confined for years in stalls, cages, and pens, and who were reduced to the most abject moral, physical, and mental prostration, removed to hospitals, divested of chains, fetters, and filthy garments; bathed, clothed, nursed, and nourished with careful kindness; whose improvement was, according to constitution and the nature of the disease, more or less rapid, and who in a few months became the most able laborers, under constant direction, upon the hospital farms, in the gardens, shops, and barns ; and while these labors engaged the men, the women were no less busily engaged in the washing and ironing-rooms, in the seamstress and dress-making apartments, and various household daily recurring labors. These might never recover the right exercise of reason might never be able to bear the excitements of society and the vicissitudes of life abroad ; but, subject to judicious direction, be as cheerful and comfortable as the malady permits; occasional recurrence of paroxysms sometimes disqualifying from the exercise of ordinary enjoyments. A few examples may not be without interest. A young man who for ten years had been confined in an out-building of a poorhouse in Rhode Island, who was chained and neglected, by the interposition of a visitor was released and removed to the McLean Asylum, in Massachusetts. In a few weeks he recovered the use of his limbs, so as to adopt a little voluntary exercise. Gradually he improved so as to follow the gardener; at first merely as an observer, but after a time as an efficient laborer, always cheerful and ready fur employment; but he was never restored to mental health. In the same institution a young lady, insane for several years, and classing with the incurables, supports her own expenses by the use of her needle, making the most tasteful and beautiful articles, which find a ready sale. Many besides are employed variously; several draw very beautifully, observing the proportions and rules of art with great exactness.