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Though I was not discharged from the State Hospital until September l0th, 1903, during the preceding month I visited my home several times, once for three days. These trips were not only interesting but steadying in their effect. I willingly returned to the hospital for the remaining days of my confinement. Though several friends expressed surprise at this willingness to enter again an institution where I had experienced so many hardships, to me my temporary return was not in the least irksome. As I had penetrated and conquered the mysteries of that dark side of life, it no longer held any terrors for me. Nor does it to this day. I can contemplate the future with a greater degree of complacency than can those whose lot in life has been uniformly fortunate. In fact, I said at that time that, should my condition ever demand it, I would again enter a hospital for the insane, quite as willingly as the average person now enters a general hospital for the treatment of a bodily ailment.

It was in this complacent and confident mood, and without any sharp line of transition, that I again began life in my old world of companionship and of business.

PART II

XXVI

AFTER again becoming a free man, my mind would not abandon the miserable ones whom I had left behind. I thought with horror that my reason had been threatened and baffled at every turn. Without malice toward those who had had me in charge, I yet looked with contempt upon the system by which I had been treated.

The word "hospital" should be one of the most comforting in the language. Yet I know that probably in every State in the Union men and women on the verge of collapse have killed themselves to escape commitment -- and others, having survived confinement, have deliberately chosen death rather than re-commitment. As a patient, in my hearing, once remarked: "I'd rather be hung than killed an inch at a time." This thought was more forcefully expressed by an ex-patient whose case was brought to my attention by the Kentucky lawyer-attendant already referred to. He had been temporarily cured, but seemed threatened with a return of his malady. Divining the secret purpose of his relatives to return him to an asylum, where he had formerly been terribly abused, he shot himself through the heart. A message left by this victim of public indifference, or (shall I say?) ignorance, read as follows:

"I'd rather die than go back there."

Only within about twenty years has the public taken kindly even to "general" hospitals, and only within the last decade have hospitals for the insane begun to lose their forbidding suggestiveness. Even to-day they are almost universally regarded with dread. Why? Partly because of man's instinctive dread of insanity itself; but quite as much, I think, because of the terrifying air of mystery which, for generations has enshrouded these institutions. This air of mystery, fostered by the secretive conduct of our asylums, has been perpetuated and, indeed, in a large degree, created, by rumors and occasional proof of abuses appearing now and then in the public print. Thus it is that the shortcomings of the State itself often force a desperately despondent man to take that life which it is the duty of the State to protect. For these avoidable suicides we cannot, however, wholly blame the present managements of our existing hospitals. They are partly the result of that dread of insanity and asylums which has been bequeathed to us by past centuries -- a dread that will continue to force men to a self-inflicted death until a universal confidence in such hospitals, and a rational view of insanity itself, shall obtain.

XXVII

I HAVE authority for the statement that there is no specific for insanity or for any phase or type thereof. For the most part, all that any system of treatment can hope to do is to give nature a chance to right itself by surrounding the patient with the best possible conditions. Yet, in most instances, this is precisely what is not done.

What then are some of the causes for this state of things, and what are some of the remedies? Of improved sanitary equipment I shall speak later. Here let me speak at length only of food and of dining facilities.

During the past century the insane, as a class, have perhaps been the poorest fed. Not many generations ago it was universally the custom to feed them on veritable husks, scarce fit for swine. In some communities to-day they have to be content with the coarsest food, frequently of such quality that a sane person would refuse to eat it. Attendants, whose fare is little, if any better, can testify to this fact. Indeed they do occasionally testify forcefully by threatening to stop work unless the management improve the quality of their rations. Such protests are usually effective. But what can patients do to emphasize their protest? Nothing, except to stop eating -- a course which many of them take from time to time, until the instinct of self-preservation overcomes their eminently sane disgust.