that in the beginning, the Governors of the Hospital looked upon the moral treatment of the patients, which was the object for which the institution was established, as the task of the Physicians.  The aim was to furnish employment, diversion, discipline, and social enjoyment, without much attempt at precision or close medical direction and control.  For a time the results were considered to be satisfactory.  In 1824, however, a joint Committee of the Board reported that they were impressed by the necessity of improving the moral treatment, and recommended that two discreet persons be appointed to take charge of such of the patients as might from time to time be in a condition to be amused or employed on the farm or in walking exercises in the open or in classes to be designated by the Resident Physician “with,” however, “the approbation of the Superintendent,” who you will recall was not a physician.  These patients were, the report recommends, to be particularly under the charge of the Resident Physician when thus employed or amused “out of the Asylum.”  At this time, the Attending and Resident Physicians were placed on a small salary, and the Resident Physician was instructed to “devote a greater portion of his time and attention to the moral part of the establishment and to communicate to the Committee such improvements as his experience shall suggest to be useful and necessary in carrying into more complete effect the system of moral treatment and to report from time to time to the Committee the effect of the measure adopted.”  This seems to have been the beginning of a realization that the moral management of the patients was inseparable from medical treatment and must necessarily be the task of the physician.  Seven years after this, in 1831, the Committee found it advisable to spread upon the minutes an “interpretation and regulations,” relating to the Superintendent and Matron of the Asylum and to the Asylum physicians, to the effect that the Committee understood that the regulations “placed the moral treatment on the physician alone, under the direction of the Asylum Committee, and that the responsibility remains with him alone, that this treatment commenced with the reception of the patient, the ward where he shall be placed, his exercises, amusement, admission of friends, the time of discharge from the house....  And that all orders to nurses and keepers which the physicians may think necessary to carry these orders into effect shall be communicated through the Superintendent” (or Warden).  In 1832, the Resident Physician, Dr. James Macdonald, who had just returned from Europe after having spent a year in visiting the institutions for mental disorders there, made a report in which he rather significantly referred to the impracticability of making a sharp distinction between the medical and moral treatment of the patients, it being difficult to say where the one ended and the other began, or to put one into successful operation without bringing in the other.  At this