As a rule they enter upon the study with interest, and soon a skilled corps is formed, who are competent to fill the responsible positions, and control the unstable class that drift in and out of an asylum. Even the dullest are awakened to new zeal, and are advanced to positions of trust they could not otherwise have filled. A brief outline of the course of instruction of the school may be of interest. The first year is spent in learning the routine of ward work and filling minor positions. The attendants are changed from ward to ward, and have the care of all classes of the insane. They first receive instruction in the printed rules of the asylum. Every rule relating to the duties of attendants is read and explained, and special attention is called to the performance of the following duties: _a._ Duties to officers. _b._ Duties to each other. _c._ Duties to patients. _d._ Duties to the institution. Thus the new attendants early get an outline of their duties in the special care of the insane. After this comes instruction in elementary anatomy and physiology. They are taught of the bones, joints, muscles, and organs of the body, food and digestion, the circulation and respiration, waste and repair, animal heat, and the nervous system. In order to be ready for advanced instruction the elements of physiology must be thoroughly learned. The teaching must be adapted to the ability and wants of those instructed. Having fixed the limit of duties required of an attendant, it is easy to fix the limit of instruction. It is an error to teach too much medicine, for then we begin to make physicians. All that is needed is attendants who are able to do their work intelligently, and, keeping this object in mind, lectures by a physician, devoid of too much detail, but simple, direct, and plain, are better than instruction from any of the text-books. With notes of the lectures furnished, and with repeated recitations, any lesson is readily learned. This way of instructing, by lectures, notes, and recitations, is continued throughout the entire two years. A course in hygiene follows the lectures in physiology. Instruction in these three studies occupies the first year. An attendant who, at the end of this time, successfully passes an examination in them, and who has been faithful in his duties, is ready to receive the advanced instruction of the second year. This includes the nursing of the sick, the management of emergencies, and finally the special work of caring for the insane. The wits of an attendant upon the insane have to be sharpened in many directions not required of a general nurse. The text-books on nursing may properly be followed by another, which shall aid one skilled as a nurse to perform the varied and difficult duties incident to the care of the insane and the wards of an asylum. To furnish this is the object of this manual.