HOSPITAL, Psychopathic. Psychopathic hospitals (psychiatric clinics, psychiatric insti tutes) are institutions for the specialized care and investigation of mental disease. They represent the application of general hospital ideals and investigative standards to the problems of disorders of mind. They are in stitutions for the first care and observation of mental cases, for treatment of the acute and curable cases, for special investigation into the causes, types and treatment of the mentally dis ordered, for the study of cases in which nervous or mental disease or defect is suspected to be the cause of conduct• disorder, and for the in struction of students and physicians.
There are about 60 such institutions in the world, over half of them in German-speaking countries. Sonic have grown out of general medical clinics, many (especially in Prussia) from the necessities of teaching in insane hos pitals, others as specialized institutions, be cause of elevating the standards of care and study of the insane. Eight such clinics were established in Germany from 1866 to 1882. The first specially constructed institute was that at Halle, opened in 1891 under the direc tion of Hitzig, who was famous for the dis covery of the electrical stimulability of the brain cortex. At the present time there are some 25 such clinics in Germany with capaci ties from 60 to 300 beds.
Institutes of a somewhat similarhave been opened in practically all the countries and in Japan. Some of them are ad ministered as departments of general hospitals, others are related to insane hospitals.
There are six institutions of this general type in the United States. The Psychiatric (originally Pathological) Institute of the New York State Commission on Insanity was reorganized with clinical as well as pathologi cal aims in 1902, under Dr. Adolf Meyer. This is almost purely a research and instruction in stitute, since the patients are derived from among those sent to the Manhattan State Hos pital where the institute occupies quarters.
Cases which the institute desires to study are sent to special wards.
The Albany, N. Y., General Hospital opened a ward called Pavilion F, for the observation and treatment of mental cases in 1902. In the same year the Bellevue and Allied Hospitals were established in New York and the psycho pathic service was augmented. This service now deals with a great number of patients in the course of a year, chiefly as an observation or detention ward prior to commitment In 1906, the State Psychopathic Hospital at the University of Michigan, Ann Arbor, was opened with Dr. A. M. Barrett as director. This hospital comes very close to the European ideal but its bed capacity is somewhat limited and there are certain restrictions on the volun tary admission law which interfere to some ex tent with its work.
In 1913, the Phipps Psychiatric Clinic at Johns Hopkins University in Baltimore, Md., was opened under the direction of Prof. Adolf Meyer. It approximates closely the ideals of the foreign clinics.
In 1912, the Psychopathic Department of the Boston State Hospital, or as it is commonly called, the Boston Psychopathic Hospital, was opened under the direction of Prof. E. E Southard, and maintains an active clinical service as well as pathological service for the State Commission on Mental Diseases.
Such institutions are important forces in the modern movement for mental hygiene. They are valuable centres for the mental health of the community. They represent the appli cation of the highest standards to the problems of mental disease and such an institution should be provided for every large city.
LAwsoN G. LOWREY, M.D.