In 1864, an investigation was made concerning the treatment of the “insane” confined in the county poor houses of New York State. Dr. Sylvester D. Willard’s Report was the instrument that persuaded the New York State Legislature to pass, on April 8, 1865, The Willard Act, “An Act to authorize the establishment of a State asylum for the chronic insane, and for the better care of the insane poor, to be known as The Willard Asylum for the Insane.” What follows is the original report to the New York State Legislature by Dr. Sylvester D. Willard, Secretary of the Medical Society.