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46 treatment of the sick that the hospital benefits not only by the more efficient service rendered, but also by the attraction of a superior class of applicants for the positions. "Much has been accomplished in rescuing the insane from chains, gloomy cells and scourgings," says Letchworth, "but the measure of reform in their behalf will not be complete until there is no possibility of their being subjected to the humours of ignorant, unfeeling and incompetent attendants." That training schools are an efficient means of accomplishing this reform there can be no doubt.

A most notable advance in the treatment of the insane was the introduction of the system of non-restraint—the disuse of all mechanical devices for restraining the freedom of bodily movement. This was first demonstrated to be practicable by Mr. Gardner Hill at the Lincoln Asylum, England, in 1836, and Dr. Connolly put the system into full operation at Hanwell in 1840. At first ridiculed as "the freak of an enthusiastic mind, that would speedily go the way of all such new-fangled notions" it was bitterly opposed for years by the superintendents of the large county asylums of England, and to Dr. Connolly is due the honor of having demonstrated its practicability and of having overcome after a prolonged struggle the opposition and prejudice against it. Men like Todd, Woodward, Butler, Ray—names memorable in the history of American psychiatry—were not unmindful of the remedial value of sympathetic and kindly treatment, and, while the controversy over non-restraint was waged abroad, were independently carrying out the same humane doctrine and conducting their institutions on the same 'enlightened principles of conciliation and kindness.' At the present day the system of absolute non-restraint is more in vogue in England than here where the necessity for some form of restraining appliance is still maintained to exist in certain instances. But it is evident from the annual reports of the American hospitals that the use of restraint is lessening each year. In some institutions it is entirely abolished; in all it is used to a very limited extent and only upon the order of the attending physician. The means of restraint employed consist chiefly of the canvas camisole to restrain the movements of the hands and arms, the canvas or leather muff for the hands and the use of a strong sheet fastened across the bed if the patient is not in a conditoncondition [sic] to be up and about the rooms. In place of the sheet the hands and the feet may be restrained while the patient is in bed by soft rolls of cheesecloth.

The most recent advance in the care of the acute insane is in the movement toward the establishment of psychopathic hospitals for treatment and for clinical and pathological research in or near the large centers of population. In this most advanced work Europe has taken the lead, and such hospitals have been in existence for some years in