ficient food, insufficient play, and insufficient relaxation may all serve as predisposing causes of insanity, as may also faulty thinking. We see, then, that excessive or unrestrained virtues, as well as vices, are dangerous. It is safer to keep in the middle of the road. It is wiser if one does not strive to become more successful in business, law, literature, etc., than the average individual, unless he is certain that his capacity and his resistance are sufficient to enable him to carry an unusually heavy mental load, just as it is wiser to realize that it is dangerous to try to see how devilish one can be as both are liable to lead, sooner or later, to an institution for the insane. Judgment, rather than ambition, should be the controlling factor.

The alleged causes of insanity are manifold, the real, or exciting, causes are few. Probably in the vast majority of cases of mental failure there exists as a predisposing cause a constitutional defect, an inherent weakness. The embers of a fire which burned in an ancestor one or more generations back and which have lain dormant, covered with the ashes of the past, need but the winds of excess in some form of work, indulgence, or stress and strain of study, competition, financial loss, or emotional shock, to blow away the ashes and cause the glowing coals of a mental disease to burst into flame. If one would but learn early in life what is a safe load to attempt to carry. In other words, if one could measure, or have some one measure for him, his mental capacity, or point out just where the danger zone lies, and he would govern himself accordingly, and therein remain content, there would, in all probability, be many less mental shipwrecks along the coast of ambition. I have always had a great respect for the camel. When he is loaded too heavily, he will refuse to budge, and will lie down until the burden is reduced to his strength to carry it. Oh, that men were as wise or possessed that instinct! ***

CARE OF PATIENTS IN STATE HOSPITALS

Any person needing care and treatment for mental disease may be received at a State hospital on a certificate made by two physicians who are examiners in lunacy and whose

certificate is approved by a judge of a court of record. Forms for this purpose are prescribed and furnished by the State Hospital Commission, and may be obtained from the Commission or from any of the hospitals.

In extraordinary emergencies, patients are received at a State hospital on the application of health officers on a form prescribed by the State Hospital Commission; but an order of commitment, or voluntary application, must be obtained within ten days of the date of admission.

Patients may also be admitted in an emergency for ten days upon the regular form of petition and certificate of two examining physicians, a copy of which should be at once sent to a judge of a court of record for his approval, and must thereafter be received at the hospital within ten days from the date of the admission of the patient.

Any person suitable for care and treatment who voluntarily makes written application therefor, and whose mental condition is such as to render him competent to make such application, may be admitted to a State hospital, but can not be detained under such agreement more than ten days after having given notice in writing of his desire to leave the institution.

Private patients are admitted to the hospital upon the consent of the superintendent. The rates for private patients are from $6.00 a week upward. A surety company's bond, guaranteeing payments, must be provided.

When the papers for the commitment of a patient are completed they are sent to the hospital, which dispatches a trained attendant or nurse to accompany the patient to the hospital. A woman must always accompany a woman patient.

When a patient reaches the hospital he is received by a physician and carefully examined to ascertain his immediate needs. He is usually placed in bed under the immediate care of trained nurses and there cared for until he has been thoroughly examined, or so long as his condition may demand. He is examined within the first five days after his admission by the superintendent. His case history is carefully and fully written up and presented by the physi

cian at a staff meeting, when the question of diagnosis, prognosis and treatment is considered and determined. He is visited twice daily by a physician. If able, an effort is made to induce him to engage in some useful and suitable occupation. Various forms of diversion, recreation, and amusement are furnished. He may write

to and receive letters from friends and relatives, and also correspond without restriction with the county judge and district attorney of the county from which he was committed.

The State has wisely endeavored to place every legal safeguard about the insane. There are just two reasons to justify the depriving an individual alleged to be insane of his liberty. The first, because you may render him a service which he otherwise could not obtain; and the second, because society would be endangered by permitting him to remain at large. The two reasons are these then-to protect the individual and to protect society. The State strives to furnish skillful and humane care to each one of the 36,000 men and women in its hospitals. It does not tolerate politics in any department. Graft is unknown.

All patients who are in condition to leave the institution and who have relatives or friends who are able and willing to receive them into their homes and care for them are paroled; and if their condition warrants, they are discharged at the expiration of the parole period.

SOCIAL SERVICE CONDUCTED BY THE STATE HOSPITALS

A social worker renders every possible assistance to former patients; she visits them at their homes and assists them in securing suitable environment and employment. Whenever she sees conditions in the home, at business, or in recreation tending to endanger the patient's mental health, she works in unison with the family to alter this state of affairs. In addition to the oversight of the patient's mental and physical health, the social worker obtains further information concerning the history of the case to assist in a medical diagnosis, and cooperates with other social agencies.

Out-patient departments are maintained in two cities of our hospital district-one in Middletown on each Tuesday afternoon, and the other in Kingston on the afternoon of the third Friday of each month. Similar clinics are being held in various cities of the State by the medical officers of the other State hospitals. They are free to all who may wish to make use of them. Physicians, parents and others are urged to send to the clinics any one who they may believe is in need of the advice and treatment we can offer. There are many persons in the State who are laboring under doubts, fears and anxieties, or who are unable to adjust themselves to their environment, or feel that they are misfits in society, or who for some other reason think they are no longer normal and that they are breaking down mentally. Such persons may properly come to the clinic and obtain help for the asking. It is said that confession is good for the soul, and I assert that confession is good for the mind, and that one should seek relief from mental colic as well as from any other kind. Often an individual is met early enough to prevent an actual breakdown, is saved from a sojourn in an institution, and is able to readjust himself to conditions and to continue a useful member of society.

Men and women possessing to an unusual degree a keen sense of duty and devotion to their work are giving the bloom of their lives to the care of the most afflicted of God's people. Enormous strides have been made in the care and treatment of the insane since it has been the speaker's lot to have been an observer. Many of you recall when the almshouses were filled with men and women who did not and could not under the circumstances receive the care and treatment their deplorable conditions demanded. About 28 years ago the State assumed the care and custody of the insane and they were all removed to the State hospitals. The strait-jacket, muff, wristlets, anklets and Utica crib have all been discarded, and trained nurses are found gently, humanely and skillfully ministering to the patients' needs. Bunks have been replaced by beds of pure white; comfortable hair or cotton mattresses and woven-wire springs are

found on each bed. Room doors are no longer locked at night. The outside doors of many wards are no longer locked during the day, and wholesome food is prepared by a skilled chef and served in an attractive manner. Potted plants and cut flowers are seen about the wards. Pictures adorn the walls, carpets and rugs are found on many of the floors. Wood fires in open grates send cheer and warmth through some of the halls. An extensive library for the use of patients and employees is maintained. Religious services are held for all who are able and who wish to attend each Sabbath day, and occasionally on other days of the week. Motion pictures and dances weekly and other entertainments are furnished. Each able-bodied patient is out daily for exercise. A physical instructor is employed whose duty it is to endeavor to awaken and stimulate to activity inert, deteriorated patients and those who are seclusive and physically enfeebled, and to try so to train and develop them that they may not only become more healthy and enjoy life to some extent but, that they may also become useful even though in a very small degree. The walls are painted in pleasing combination of colors. The lawns are closely cut and trimmed, and each season thousands of foliage and blooming plants are put out and cared for, largely by the patients. Order and system is maintained. The highest degree of efficiency, skill and ecomomy is striven for.

So, my friends, should misfortune ever overtake you or your friends and you are compelled to surrender them to the custody and care of the State, for your own comfort please know that the State, through its agents, is ever jealously and zealously guarding its good name, and that you or the one dear to you will have, not only all the tender care and skill that may be bestowed at home, but much more.

I have tried to point out to you some of the things that the State is doing for those of her citizens who have become mental invalids to such a degree as to require her aid. We have told you of the millions of dollars annually spent in their behalf and of the army of nurses and others required