the climate has on the sexes. In reply, I have to say that I have not been able to notice much difference. The rate of admissions is very much the same. Neither have I been able to recognize much difference between the climate of Texas and those of Northern and Eastern States. So far as percentage goes, they are nearly the same. This matter was discussed at a conference on insanity last year, and this was one of the facts brought out.

23-Trans.

THE CRIMINAL INSANE.

G. H. MOODY, M. D.,

First Assistant Superintendent, Southwestern Insane Asylum,

SAN ANTONIO, TEXAS.

There are confined within our Texas asylums today about three thousand patients. Through the wise foresight of its individual members, and guided by the counsel of the best medical thought of our great State, our two recent State Legislatures have provided for an institution for the maintenance and treatment of our epileptics separately. This institution, when completed, will stand throughout endless time as a fitting monument to the memory of those who voted its existence, as well as to those who are supervising its construction,—not so much on account of its adaptation in design and construction to the purposes for which it is intended, which within themselves command much commendation, but rather more on account of its imperative need in order that the epileptics, the majority of whom are so disagreeable that they can not be kept with other patients except with great difficulty and detriment to all, may be isolated and more satisfactorily treated.

Of the whole number of the insane population there are at least eight per cent., or about 250, who are known as the criminal insane. This term is not meant to signify any one clear-cut, classified form of insanity, but it is merely an underlying tendency, which, in some insane individuals is ever present, which may exist in any one of the various forms of insanity, and which is ever ready to manifest itself whenever the circumstances and environments conduce to its precipitation. It is probably enough to say that, associated with whatever form of insanity in which it may be found, it is a morbid tendency which ever exists in some individuals, which is due to brain disease or defect, and which renders the patient constantly dangerous, or constantly liable to become dangerous, to public safety.

This class should be eliminated from our present asylums and placed in an institution especially constructed and equipped in accordance with the necessities of their demands. This institution should be known as the State hospital for criminal insane, and should be as centrally and healthfully located as possible, upon fertile land, and should be built upon the latest approved plans with reference to hygienic conditions, and so constructed and equipped that facilities for occupation may be had for all, and that the possibilities of escape may be reduced to a minimum. It should be the purpose of this hospital to care for all insane persons, convicted or unconvicted, who are charged with crime, whether the disease of insanity is known to exist at the time of arraignment or trial, or subsequently develops while undergoing sentence. And from the time of the completion of this hospital, our laws should be so amended as to provide that commitment by the courts should be made directly to this institution in all cases where the plea of insanity prevails as a defense for criminal acts, and that all the insane now confined in our asylums in whom can be discovered criminal tendencies should be immediately transferred to this institution, as well as all those who might develop insanity in our State reformatory and penitentiaries. And it should also provide that the management be required to retain indefinitely this latter class, even after the expiration of their sentence, or until they shall have fully recovered.

All individuals meeting any one of the above conditions should be promptly committed to this institution for treatment, and kept there securely until they shall have become restored to health beyond all question and capable of normal moral citizenship, or until they shall have become harmless dements, when they should be transferred to one of the present asylums.

The two fundamental reasons for the existence of insane asylums are the welfare of the insane and the protection of the public. In support of the necessity of these changes whereby this class of the insane may be thus isolated and the efficacy of all our asylums improved thereby, there are many good reasons to be offered.

In addition to what drugs we may be able to give them with

benefit, and other adjuvant therapeutic measures, such as electricity, massage, scientific bathing, etc., which we may be able to apply when proper equipments will permit, there is one other measure which is constantly receiving increasing attention, and which is sure to yield favorable results in proportion to the extent to which it can be applied, and that is occupation, which implies exercise, and which should be had in the sunshine and fresh air as much as is practicable. Through its favorable influences on sleep and appetite especially it conduces to improved physical health, one of the first advance steps desired in the hope for mental improvement. There is nothing more universally and wholesomely accepted by them than occupation. They constantly beg for it and esteem it a great favor when provided for them. It diversifies their daily experiences and takes them from their morbidly acting minds, their delusions, illusions, hallucinations, suspicions, sorrowful remembrances and various eccentricities of thought, and helps them to forget temporarily their loss of liberty.

As it is, we not only can not take the great bulk of harmless patients out as much as is desirable, but are often forced to place some of the worst criminals in solitary confinement, which is not only detrimental to their treatment, but is most, horrifying punishment to them, notwithstanding the lack of such intention, but which often becomes unavoidable by reason of the urgent necessity for the protection of all and the safe keeping of such patients, thus militating against the application of one of the best therapeutic measures for the treatment of all classes.

Aside from its decided commendable therapeutic feature, there is an economical feature worthy of much consideration in connection with this question of occupation. The few criminals in solitary confinement, and the other criminal class, all of whom do nothing for their support by reason of their danger to each other and to the public, can be taken out and given occupation and could be protected from the constant dangers of doing violence by reason of better equipments and especially qualified help; and the results of their labor could become in a measure remunerative, thereby relieving approximately the already over-burdened tax-payers of a

class of delinquents who are amply able in every particular to maintain their own support themselves.

Then, with this class eliminated from our asylums, the inmates could be taken out in great numbers and with small help, and various kinds of labor provided for them aside from farming, such as could be done in various workshops, with which every institution should be provided, where much of the material needed for running the institution could be made.

Thus it is plain that by isolating this criminal class measures now wholly impossible can be put in successful operation, which will conduce greatly to economy, as well as to the increased comfort of all and to the final restoration of many.

Then there is a humane consideration which probably merits more attention than any other point yet mentioned: to have a few criminals mixed up on the same wards and in the same rooms with the great bulk of our insane population is not right. Most all of these patients come from the moral element of our country, and they are men and women, young and old, who are innocent, submissive and law-abiding, and are by nature, training and mental construction as sensitive to indecencies and immoralities as are sane individuals. These better elements in them should be nurtured and developed rather than ignored. They constantly write letters home asking what crime it is they have committed that they must be locked up with such people, and constantly make personal pleas begging protection from the violence of certain patients who have previously assaulted them. "Because I was born unfortunate and diseased I have to be kept locked up with some of the most indecent and dangerous scoundrels on earth." "Just because I am unfortunately nervous I have to stay here constantly, even in the same wards and same rooms, with women with whom my people outside would not be caught for one moment."

Expressions like these are heard almost daily. This state of things should not be. It develops still more the perverted tendencies in the young. It makes the viciously inclined, both young and old, more vicious. It increases and confirms in many the already existing opinion of injustice being done them, and justly