system of administration
in which the chief physician is also the chief executive officer of the
institution was a result of an evolution which took many years to reach
its full consummation.

Pinel, many years before Bloomingdale Asylum was opened, had shown by
the most careful observation and practice that the management and
discipline of the hospital was a most powerful agent in the treatment of
the patients. The manner in which he was led to this conclusion is a
remarkable example of the scientific method. When he became physician to
the Bicetre he found that the methods of classification and treatment
recommended in the books seemed to be inadequate, and, desiring further
information, he says: "I resolved to examine myself the facts which were
presented to my attention; and, forgetting the empty honor of my titular
distinction as a physician, I viewed the scene that opened to me with
the eye of common sense and unprejudiced observation.... From systems of
nosology, I had little assistance to expect; since the arbitrary
distributions of Sauvages and Cullen were better calculated to impress
the conviction of their insufficiency than to simplify my labor. I,
therefore, resolved to adopt that method of investigation which has
invariably succeeded in all the departments of natural history, viz., to
notice successively every fact, without any other object than that of
collecting materials for future use; and to endeavor, as far as
possible, to divest myself of the influence, both of my own
prepossessions and the authority of others. With this view, I first of
all took a general statement of the symptoms of my patients. To
ascertain their characteristic peculiarities, the above survey was
followed by cautious and repeated examinations into the condition of
individuals. All our new cases were entered at great length upon the
journals of the house." Having thus studied carefully the course of the
disease in a number of patients who were subjected only to the guidance
and control made possible by the management of the hospital under the
direction of a remarkably highly qualified Governor, it came to him with
the force of a new discovery that this man who was not a physician was
doing more for the patients than he was, and that insanity was curable
in many instances by mildness of treatment and attention to the state of
mind exclusively. "I saw with wonder," he says, "the resources of nature
when left to herself, or skilfull