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this increasing class led to the passage of a law which authorized the county treasurer to raise funds to erect a new insane asylum at Flatbush. The need of additional accommodations led to further enabling legislation in 1851,2 1853,3 1855,* 1860,5 and 1867. Accommodations were thus provided for about 600 patients.

Like New York and Kings, Monroe County was authorized in 1863 to provide for all its dependent insane and construct a separate and distinct institution from that of the county poor-house, to be known as the Monroe County Asylum at Rochester. Of the other counties in the state, not one made adequate provision for their own insane. There was an increasing disposition on the part of the counties to resume the care of their chronic insane, in many instances, an assumption also of the right of treating acute cases of insanity. This was done by county officers who, on the plea of economy, evaded the law relating to the speedy commitment of recent cases to state asylums, and thus converted the poor-house asylums into institutions for the insane.8

Despite the establishment of the State Asylum at Utica, the number of insane in almshouses increased steadily, due to the rapid increase in the population of the state. In 1855 the county superintendents of the poor held a convention at the Utica State Asylum in order to consider what action they should take to remedy the difficulties they were having in providing for their insane. Their recommendations were

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that two additional state institutions should be contructed. At the following session of the legislature a bill was introduced creating two more asylums; it was favorably reported, but the premature adjournment of the legislature arrested its further progress.1 At last, mainly through the efforts of Miss Dorothea L. Dix and Dr. Sylvester D. Willard, secretary of the State Medical Society, the legislature in 1864 authorized an investigation by Dr. Willard of the condition of the insane in the state. The report was submitted to the legislature in 1865 and dealt at some length with the appalling condition of the insane in the county institutions, and the crowded condition of the state asylum.3 The result of the report was the establishment of the Willard Asylum for the insane poor of the chronic classes,* and the further provision that acute cases were to be sent to the Utica State Hospital. After the completion of the Willard Asylum no more chronic cases were to be sent to the county poor-houses from the Utica institution, but to the Willard Asylum instead. The creation of the distinction between acute and chronic cases persisted until it was finally abolished by the State Care Act of 1890.

Further steps leading to the establishment of other asylums were being taken, and in 1867 a law was passed authorizing the establishment of the Hudson River Asylum at Poughkeepsie." This institution was opened in 1871 for the reception of the so-called acute cases. In 1870 a law

'Hurd, Henry W., Institutional Care of the Insane, vol. iii, p. 110. 'Laws of 1864, chap. 418, entitled An Act in relation to insane persons in poor-houses, insane asylums and other institutions in the State of New York, the purpose of which was to obtain statistics of the insane.

3 Assembly Doc., vol. xix, Session of 1865.

was passed establishing a homeopathic asylum at Middletown, New York,' this being the first attempt in the United States to establish such a hospital. It was erected with the aid of private contributions, and received its first patients in 1874. An act to establish the Buffalo State Asylum for the Insane was passed in April, 1870. This institution was officially opened in November, 1880.

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(c) 1873-1888. A turning point in the history of lunacy affairs in New York came as the result of the passage of a law in 1873, whereby the office of the State Commissioner in Lunacy was created. This law also required that private asylums be licensed.* It was the duty of the Commissioner in Lunacy to examine into the condition of the insane and idiotic, the management and conduct of the asylums and other institutions for their custody, and to submit a report to the State Board of Charities.

Chapter 571, Laws of 1873, was found to impose exceedingly cumbrous and confused powers upon the Commissioner in Lunacy. Among other things, although he was a state official, instead of reporting his official acts to the legislature, he was required to render a report to the State Board of Charities, at whose direction only such reports could reach the law-making power. Furthermore, in

1 Laws of 1870, chap. 474.

2 Ibid., chap. 378.

3 Laws of 1873, chap. 571, entitled An Act further to define the powers and duties of the Board of State Commissioners of Public Charities, and to change the name of the Board to the State Board of Charities. Sec. 13 created the office of State Commissioner in Lunacy. John Ordronaux, LL.D., professor of medical jurisprudence in the Law School of Columbia College, was appointed to the office.

* Laws of 1873, chap. 571, sec. 9, requiring that private asylums be licensed by the newly created State Board of Charities.

5 Laws of 1873, chap. 571, sec. 14.

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spite of the fact that the office had been established to discover and redress wrongs committed in asylums, no method was provided to do this, as reports had to be submitted, as above noted in a round-about and time-consuming manner. These facts soon became so obvious that the next legislature radically altered the powers and duties of the Commissioner in Lunacy.1 This was done by the enactment of a law in 1874,2 based upon recommendations made by the Commissioner in Lunacy, John Ordronaux, and the AttorneyGeneral, Daniel Pratt. Section 1 of this law provided that no person should be committed to or confined as a patient in any asylum public or private, or in any institution, home or retreat for the care and treatment of the insane, except upon the certificate of two physicians, under oath, setting forth the insanity of such person. But no person should be held in confinement in any such asylum for more than five days, unless within that time such certificate be approved by the judge or justice of a court of record of the county or district in which the alleged lunatic resides; and said judge or justice may institute inquiry and take proofs as to any alleged lunacy, before approving or disapproving of such certificate, and may, in his discretion, call a jury in each case to determine the question of lunacy.

Section 2 required that "the examining physicians be of reputable character, graduates of some incorporated medical college, permanent residents of the state and engaged in the actual practice of their profession for at least three years, and such qualifications had to be certified to by a judge of a court of record. Section 3 prohibited any physicians from certifying to the insanity of any person for the purpose of 1 Laws of 1874, chap. 446.

2 Ibid.

8 Report on a codification of the Laws relating to the Insane, with proposed amendments thereto, Senate Doc. 86, Session 1874.

committing him to an asylum of which the said physician was either superintendent, proprietor, an officer, or a regular professional attendant therein.

Previously, county judges or superintendents of the poor had committed patients without the certificates of physicians, and up to this time legislation had been considered chiefly with a view to protecting the public against dangerous persons.

In order that the Commissioner in Lunacy might have proper assistance when making any investigation into the general management and administration of any asylum, public or private, in which insane persons were detained, a law was passed in 1878,1 providing that "whenever he shall undertake any such investigation, he shall give due notice thereof to the district attorney of the county in which the institution is located, and that it shall be the duty of such district attorney to appear at such investigation in behalf of the people."

On May 13, 1879, a law was passed abolishing the New York State Inebriate Asylum and converting it into the Binghamton Asylum for the Chronic Insane.2 The latter was opened for the reception of patients of the chronic pauper class from poor-houses in October, 1881. There was no further legislation of importance until 18873 when the St. Lawrence State Asylum at Ogdensburg was established. This institution was opened to receive patients in 1890.

III. COUNTY CARE OF INSANE

There were at this time seven state and three county asylums for the insane. Despite this fact, the number of

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1 Laws of 1878, chap. 47, sec. 2.

* Laws of 1879, chap. 280.

3 Laws of 1887, chap. 375.

* State Commissioner in Lunacy, Annual Report, 1888, p. 99.