to show signs of mental disorder, and a prison physician trained
in psychiatry will be able to recognize these early signs, or as soon as
there is the least suspicion of mental disorder, the patient could be
transferred without delay to the psychiatric department. Here they
should be kept under observation for at least six months. This will be
sufficiently long in most instances to enable the physician to determine
whether he is dealing with a progressive deteriorating psychosis or with
one of those transitory prison psychoses. In the cases of the former,
_i.e._, if it is definitely established that the patient is a dementing
praecox or a paretic, the fact that he happens likewise to be a criminal
is really of little or no importance. A demented individual is never
dangerous enough to require confinement in an especially secure
hospital, though he is a prisoner, and unless he is criminally insane,
_i.e._, unless he manifests dangerous or criminal tendencies as a result
of his mental disorder, really forms no special administrative problem.
He could be kept either in the prison annex until the expiration of his
sentence, if there be room for him, or could be transferred to the
nearest hospital for the insane and treated the same as any other insane
patient.

It is the second group, however, _i.e._, those patients suffering from
the transitory prison psychoses, which especially justify the
establishment of psychiatric annexes in connection with prisons. We have
seen how detrimental to prison discipline these individuals are, even
when in a condition which might be considered normal to them, and we can
easily surmise what it must mean to care for them in prison during one
of their mental upsets. It is therefore of the utmost importance, both
for the prison administration and for the individual, that these
patients should be transferred to a properly appointed hospital in as
short a time as possible, and this can be done most readily when the
hospital and prison are within the same walls, and more or less under
the same management. On the other hand, we owe it to the prisoner to
bring him under proper care as soon as possible. The practice of sending
these individuals to criminal departments of general hospitals for the
insane has many objections. In the first place, no matter how modern the
equipment of such departments, most of them cannot afford the proper
kind of treatment to these individuals. The idea that the removal