in an associate dormitory, the others are in single rooms. The number of patients who may be congregated in one sleeping apartment is smaller than in the general wards of the Hospital.

The comment was made by one of our medical visitors that the design of the wards resembles that of an institution for the insane rather than of a general hospital. It need hardly be said that the experience of institutions for the insane cannot be ignored wherever mental cases are to be treated. If this class of patients could be managed in general hospitals, as now constructed and organized, the need of special institutions would cease. The difference lies in the fact that our patients are not usually bed-ridden. It has consequently been necessary to provide tastefully furnished sitting-rooms, with books, games and magazines, for diversion. The victims of general diseases, when able to be out of bed, may return home if they desire, and there is not this demand upon the Hospital for their entertainment. The gifts to Pavilion F have been helpful on this account, and it is hoped that this peculiar want will continue to appeal to the friends of the Hospital that our wards may be attractive and home-like.

INSTRUCTION IN MENTAL DISEASES

In common with other departments of the Hospital, Pavilion F has been opened to the students of the Albany Medical College for their instruction. On Monday afternoon of each week during the College session, sections of the senior class attend. Cases are assigned to groups of two or three students, who make an examination of the mental symptoms, after a scheme prepared for their use, and before the assembled class, discuss the case and defend the diagnosis. This work is essentially clinical, and arranged to throw light upon the facts met by the physician in the routine of practice, rather than to theorize upon the mysteries of the morbid mind. tunities thus afforded for observation of patients during a period of several weeks, perhaps through the entire attack, have been rarely, if ever, given to undergraduate students. Incidentally the analytical reports upon the symptoms of mental disease constitute a valuable addition to the case records of the Hospital.

The oppor

Instruction is also given to nurses by a few lectures in which the methods of care are pointed out, and by bed-side directions for the observation of both mental and physical symptoms. This instruction is a part of the three-year course for nurses, and all nurses are required to spend several weeks upon the mental wards before the grant of the diploma of the Training School.

COMMENT UPON PAVILION F.

The publication of the first report, one year ago, excited general comment among physicians and others interested in the problem of the care and treatment of patients afflicted with mental disease. It is with no little satisfaction we are able to say that from the general expression of approval we have not found one dissenting voice. The agitation for provision for mental cases in general hospitals has become active and widespread, and the subject has been officially discussed, as far as our information goes, in several States, in Great Britain and in France. Dr. Frederick Peterson, President of the New York State Commission in Lunacy, has on several occasions expressed entire approval, and physicians from hospitals in the larger cities of the State have written and visited. We have been especially honored by Dr. E. Régis, of Bordeaux, the well-known French authority on mental medicine, who makes extended reference to Pavilion F in a communication to La Presse Médicale, of September 12, 1903. The following communication, under date of July 19, 1902, has been received from Dr. John Macpherson, Commissioner in Lunacy for Scotland:

I have to thank you for your kind letter and for the several reprints of your article from the American Journal and from the Albany Medical paper, which duly reached me. These papers have been freely exhibited to the leading medical authorities, and others, in Edinburgh, who are most interested in the treatment of early cases of insanity in the general hospital here. They have, I am in a position to inform you, greatly strengthened our hands: for, as I formerly explained to you, a precedent from our American cousins has much more weight than any continental expressions we have been able to quote. I am glad to say that the medical opposition to our scheme has become considerably modified since I last wrote to you. The Infirmary Staff have issued a memorandum generally approving of the proposal, but suggesting certain difficulties which we, at least, do not regard as insurmountable. We are therefore constrained to hope that, with

ROOM FOR EXCITED PATIENT, PAVILION F, SHOWING SLIDING WIKE SCREEN FOR WINDOW

perseverance and with the help of time, we shall, at no great interval, follow your good example.

The following remarks from different sources may be quoted:

The Journal of Mental Science, London, July, 1903: Women nurses have been entrusted with the care of both men and women, an arrangement that is reported to have worked satisfactorily. The experiment has been so successful that it is to be continued, and we urgently hope that similar additions may soon be made to British hospitals.

American Medicine, Philadelphia, May 9, 1903: Many valuable ideas originate in the Albany hospital, but those in charge are to be especially congratulated upon the inception and splendid showing of Pavilion F.

Journal of the American Medical Association, Chicago, May 2, 1903: He speaks highly of putting the male wards in charge of female trained nurses. Philadelphia Medical Journal, July 12, 1902: We believe that such hospitals have a legitimate field.

Ibid, April 11, 1903: The plan of treatment is not given in detail, but we judge from the good results that it was largely by rest and isolation, and by improving nutrition. The further work of "Pavilion F" will be watched with interest.

ARNOLD E. SMITH, ESQ., Ogdensburg, N. Y., for several years associated with the management of the St. Lawrence State Hospital: I desire to congratulate you on the results of the first year of your emergency Pavilion, the report of which I note, and have read with much interest, in the April ANNALS. How ideas grow and develop! How slowly and yet how surely the progress!

One hundred and seventy-four mentally ill people have come voluntarily to the "Albany Hospital" for help which otherwise as a rule, except for your Pavilion F, they would have been unable to obtain without being officially declared “insane," and you have demonstrated that over one hundred of the number did not deserve that mark. If nothing more, this is enough to justify your project and cause you and me to exult and be glad in recalling our many conferences and mental speculations upon the subject of such provision for such cases, especially our ideal of an annex, under suitable legal authority, to each of our State hospitals. It will come, and the Commission will amplify in the reports its concertion and development of this humane provision.

But, Doctor, you are making a record that cannot be wiped out. They may appropriate your plans, adopt the methods of your administration, fail to give credit, but "Pavilion F" of the Albany Hospital will nevertheless stand as the "pioneer" of this idea.

The number of transfers to the State Hospitals, a part of the anticipation and design, is a less per cent. than I expected and therefore a gratifying justification of the project. It demonstrates the prudence and humanity of a more deliberate and cautious selection in committing to institutions especially designed for the insane.