e of work. But he can readily take a share in the best
appreciation of the general philosophy and policy of it all.

The shaping of the policy of a semiprivate hospital is not quite as
simple as shaping that of a State Hospital with its well-defined
districts and geographically marked zones of responsibility.
Bloomingdale has its sphere of influence marked by qualitative selection
rather than by a formal consideration. It does not pose as an invidious
contrast to the State Hospital, and yet it is intended to solve in a
somewhat freer and more privileged manner the problem of providing for
the mentally sick of a more or less specific hospital constituency, the
constituency of the New York Hospital; and since it reaches the most
discriminating and thinking part of our population, it has the most
wonderful opportunity to shape public opinion. Like all psychiatrical
institutions, it has to live down the traditional notions of the
half-informed public; it has to make conspicuous the change of spirit
and the better light in which we see our field and responsibilities.
This organization can show that it is not mere insanity but the working
out of life problems that such a hospital as this is concerned with. The
conditions for which it cares are many. Some of them are all that which
tradition and law stamp as insanity. But see what a change.
Seventy-five per cent of the patients are voluntary admissions; and more
and more will be able to use the helps when they begin to feel the need,
not merely when it becomes an enforced necessity.

By creating for this Hospital a liberal foundation, by completing its
equipment so as to make possible a free exchange of patients and of
workers from the Hospital in the city and this place in the country,
much has been done and more will be done to set a living example of the
very spirit of modern psychopathology and psychiatry. We know now that
from 10 to 40 per cent of the patients of the gynecologist, the
gastroenterologist, and the internist generally would be better treated
if a study of the life problems were added to that of the special organs
and functions. To meet this need it should be possible to have enough
workers in this branch of the Hospital to take their share of the
consulting and co-operation work in the wards and dispensary of the
General Hospital, and perhaps even in the schools provided for the same
type of people from which you draw your patients. The grouping of the
pati