Dr. Channing pleads with much force for the wider establishment of out-patient departments for the treatment of mental affections in connection with hospitals and dispensaries. Such departments, besides giving treatment and instruction (a very important part of their work), would serve as a “repository for the troublesome, a clearing house for doubtful cases, and a bureau of information in regard to the necessary machinery to be made use of in committing or otherwise disposing of patients.” Those who have had charge of our overcrowded out-patient rooms will appreciate to the full the need which Dr. Channing points out, for it is absolutely impossible under present conditions to give the mental cases which now and again present themselves as out-patients the attention they require. As it is these sufferers have to content themselves with a dose of mistura alba or calomel, or perhaps a dose of bromide and some hasty words of reassurance, and then the “next patient.” Perhaps the greatest service which these mental departments promise is in connection with defective children, some of whom “furnish a portion of the dullards in the schools, who are such an injury to the advance of the average pupils. Others become tramps or criminals. The girls often become the mothers of illegitimate children, and so spread the circle of degeneration and defect wider and wider.” Dr. Channing accentuates the importance of the last-mentioned work, and in order to utilise more effectually the proposed department he systematises in tabular form the investigation of the defective child.
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