Nothing would please me more than to express specifically my indebtedness to many others who have assisted me in the preparation of my work.  But, aside from calling attention to the fact that physicians connected with the State Hospital and with the private institution referred to—­the one not run for profit—­exhibited rare magnanimity (even going so far as to write letters which helped me in my work), and, further, acknowledging anonymously (the list is too long for explicit mention) the invaluable advice given me by psychiatrists who have enabled me to make my work authoritative, I must be content to indite an all-embracing acknowledgment.  Therefore, and with distinct pleasure, I wish to say that the active encouragement of casual, but trusted acquaintances, the inspiring indifference of unconvinced intimates, and the kindly scepticism of indulgent relatives, who, perforce, could do naught but obey an immutable law of blood-related minds—­all these influences have conspired to render more sure the accomplishment of my heart’s desire.

XXXII

“My heart’s desire” is a true phrase.  Since 1900, when my own breakdown occurred, not fewer than one million men and women in the United States alone have for like causes had to seek treatment in institutions, thousands of others have been treated outside of institutions, while other thousands have received no treatment at all.  Yet, to use the words of one of our most conservative and best informed psychiatrists, “No less than half of the enormous toll which mental disease takes from the youth of this country can be prevented by the application, largely in childhood, of information and practical resources now available.”

Elsewhere is an account of how my plan broadened from reform to cure, from cure to prevention—­how far, with the co-operation of some of this country’s ablest specialists and most generous philanthropists, it has been realized, nationally and internationally, through the new form of social mechanism known as societies, committees, leagues or associations for mental hygiene.

More fundamental, however, than any technical reform, cure, or prevention—­indeed, a condition precedent to all these—­is a changed spiritual attitude toward the insane.  They are still human:  they love and hate, and have a sense of humor.  The worst are usually responsive to kindness.  In not a few cases their gratitude is livelier than that of normal men and women.  Any person who has worked among the insane, and done his duty by them, can testify to cases in point; and even casual observers have noted the fact that the insane are oftentimes appreciative.  Consider the experience of Thackeray, as related by himself in “Vanity Fair” (Chapter LVII).  “I recollect,” he writes, “seeing, years ago, at the prison for idiots and madmen, at Bicetre, near Paris, a poor wretch bent down under the bondage of his imprisonment and his personal infirmity, to whom one of our party gave a halfpennyworth of snuff in a cornet or ‘screw’ of paper.  The kindness was too much ...  He cried in an anguish of delight and gratitude; if anybody gave you and me a thousand a year, or saved our lives, we could not be so affected.”