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In the latest edition of  the Journal of the History of Medicine and Allied Sciences (1/2010) Jonathan Goodheart publishes an article on Insane Poor in Nineteenth-Century Connecticut.The Abstract: Connecticut was the exception among the Northeastern and Middle Atlantic  states in not founding a public institution for the insane until after  the Civil War when it opened the Hospital for the Insane at Middletown  in 1868, a facility previously neglected by scholars. The state had  relied on the expedient of subsidizing the impoverished at the private  Hartford Retreat for the Insane that overtaxed that institution and left  hundreds untreated. Despite abundant evidence to the contrary, well  meaning officials oversold the idea that the Middletown site would  promote cures and be cost effective. A number of unanticipated  consequences occurred that mirrored fundamental changes in  nineteenth-century psychiatry. The new hospital swelled by 1900 to over  2,000 patients, the largest in New England. Custodianship at the  monolithic hospital became the norm. The hegemony of monopoly capitalism  legitimated the ruling idea that bigger institutions were better and  was midwife to the birth of eugenic responses. Class based  psychiatry—the few rich at the Retreat and the many poor at  Middletown—was standard as it was in other aspects of the Gilded Age.  Public policy toward the insane poor in Connecticut represents an  outstanding example of the transition from antebellum romanticism to fin  de siècle fatalism.