[Footnote: Read at the late meeting of the National Association for the Protection of the Insane and translated for the American Psychological Journal by Carl Sieler, M.D., of Philadelphia.]

By A. BAER, M.D., of Berlin, Germany.

The benevolent efforts of your society diverge in two different directions, which have totally different aims and purposes, and which require different means in order to attain lasting success. Since the number of insane has increased alarmingly within the last few years, in all civilized countries, so that the responsibility of the proper charge of them occupies continually not only the community, but also the State; and since the public as well as the private asylums are filled almost before they are finished, it becomes necessary to rid the institutions, as soon as possible, of those patients which have been cured, as well as of those which are improved. Patients of this kind are, as early as possible, returned to the unrestrained enjoyment of liberty with the expectation that the new scenes and surroundings may have a beneficial influence, besides having the advantage of relieving the overcrowded institutions. Unfortunately, however, it has been frequently found that the hut suddenly restored mental and emotional equilibrium is not of sufficient stability to withstand the storm of conflicting interests.

Frequently it happens that the but recently discharged patient returns to the institution, after a short lapse of time, because the "rudder" (steuer) of his intelligence was soon shattered in the turmoil of life. How can, for instance, the indigent and poor patient, after his discharge from the institution in which he has found a shelter and the proper care, stand up in the struggle for existence and the support of his family? Is it not to be expected that a large proportion of those who have been discharged as improved, or even cured, cannot withstand the ever-moving sea of the outside life and bear up under the turmoil which constantly stirs mind and soul?

Starting with the recognition of this fact, societies of benevolent people have been formed in all countries in which true civilization and humanity are at work, to diminish or abolish social evils, whose object is to assist the restored patient who has been discharged from the institution, at a time when he is most in need of help and assistance. Switzerland has taken the lead of all countries by her brilliant example, and there these societies found the greatest encouragement. It should be looked upon as a good sign of the spirit of modern times, that the seed of true humanity, with astonishing rapidity, found its way, far and wide, for the benefit of suffering mankind. Everywhere, in all European countries, and also on the American continent, has this branch of a truly noble thought become acclimated, and many societies have been organized for the purpose of assisting cured insane patients, by aiding them in obtaining suitable occupations, or by direct donations of money, etc., with a view of preventing, if possible, a relapse of the disease.

May this portion of the work of your society be an ever-flowing fountain of joy and satisfaction to your members!

Of much greater importance is the best portion of your work, namely, the prevention of insanity. It is nevertheless true, and cannot be doubted, that in all civilized countries insanity increases in a manner which is out of proportion to the increase of the population. Much thought has been given to the cause of this phenomenon, and physicians as well as moralists, national economists as well as philosophers and philanthropists, have endeavored to fathom the connection between this fact and the conditions of modern social life. According to all observations, it is certain that the cause of this phenomenon is not a single etiological condition, but that it is the sum of a number of influences which act upon the human race and produce their travages in the mental and moral life of our patients. The conditions which give rise to this increase of insanity may be looked for in the manner in which modern civilization influences mankind, in its development and culture, in the family and in the school-room, in its views of life and habits; also in the manner in which civilization forces a man to fight a heavier and harder battle for pleasure and possessions, power and knowledge, and causes him to go even beyond his powers of endurance.

More than even civilization itself, are at fault those pernicious abnormities, rare monstrosities, which are transmitted from generation to generation, or are also often newly developed and appear to belong to our civilization. If we want to prevent the increase of insanity, we must endeavor to do away with these monstrosities and eccentricities from our social life which remove mankind more and more, in a pernicious manner, from its natural development and from the normal conditions of moral and physical life; we must endeavor to kill these poisonous offshoots of pseudo civilization, which are the enemies of the normal existence of man. It is necessary to liberate the individual, as well as the entire society of modern times, from the potentiated egotism which spurs man on in overhaste, and in all departments of mental and physical life, to a feverish activity, and then leads to an early senile decay of both body and mind; from that terrible materialism which causes the modern individual in every class of society to find satisfaction in over excited taste and ingenious luxury.

It is necessary to strengthen more than has been done heretofore the young, by means of their education, in their physical development, and at the same time to diminish, in proper proportion, the amount of mental over-exertion; and finally it is necessary to fight against, to do away with, those habits of modern society-life which have a pernicious influence upon the physical as well as the mental and moral organization of man. And of these latter, there is none so lasting in its effects, none so harmful to the physical as well as moral life, as the abuse of intoxicating liquors.