A SURVEY OF EARLY AMERICAN PRACTICES IN TREATING CRIMINALS AND MENTALLY ILL PERSONS REVEALS THE IMPETUS FOR 19TH CENTURY REFORM MEASURES, INCLUDING THE CONSTRUCTION OF CORRECTIONAL FACILITIES (PENITENTIARIES) AND INSANE ASYLUMS, AND SHOWS THAT INSTITUTIONAL ABUSE AND FAILURE DID NOT IN THEMSELVES PROMOTE INNOVATIONS OR ALTERNATIVES. REHABILITATION REMAINED SO APPEALING A GOAL THAT ITS PROSPECT SUSTAINED THE LEGITIMACY OF BOTH PENITENTIARIES AND INSANE ASYLUMS. HOWEVER, BY 1900-1920'S, NEW IDEAS AND PROCEDURES TO COMBAT CRIME, DELINQUENCY, AND MENTAL ILLNESS TOOK HOLD. AMERICANS ENACTED PROBATION, PAROLE, AND INDETERMINATE SENTENCES FOR ADULT OFFENDERS, ESTABLISHED JUVENILE COURTS FOR DELINQUENTS, AND FOUNDED OUTPATIENT CLINICS FOR THE MENTALLY ILL. THEY ALSO REDESIGNED PRISONS, REFORMATORIES, AND INSANE ASYLUMS. THESE REFORM MEASURES RESULTED IN THE WIDE USE OF INDETERMINATE SENTENCES AND BROAD DISCRETIONARY AUTHORITY. IN PRACTICE, THE JUVENILE COURTS VARIED IMMENSELY IN THEIR PROCEDURES AND IN THE JUDICIAL COURTS VARIED IMMENSELY IN THEIR PROCEDURES AND IN THE JUDICIAL DISCRETION EXERCISED. DUE TO REFORMISTS' PRESSURE, REFORMATORIES OSTENSIBLY CHANGED INTO 'TRAINING SCHOOLS,' BUT VIOLENCE AND SEXUAL ABUSE AMONG INMATES REMAINED A PERVASIVE PROBLEM. ALSO, THE RIGID ROUTINES OF SUCH FACILITIES WERE ALTERED VERY LITTLE, BUT THE PHYSICAL FACILITIES CAME TO RESEMBLE A CAMPUS SETTING, WITH COTTAGE RESIDENCES RATHER THAN CELL BLOCK BUILDINGS. DESPITE THESE BASICALLY COSMETIC CHANGES, THE REAL PROBLEM CONFRONTING THE PROGRESSIVE REFORMISTS WAS NOT ACKNOWLEDGED. THIS ONGOING CONFLICT ROSE FROM THE IRONIC SITUATION OF THE SAME INSTITUTION TRYING TO DELIVER CARE AND CORRECTIONS, SIMULTANEOUSLY. EXAMINATION OF REFORM MEASURES IN CARING FOR THE MENTALLY ILL REVEALS THAT, ON THE WHOLE, BETWEEN THE YEARS 1900-1940, NEITHER THE INSANE NOR THEIR DOCTORS RETURNED TO THE COMMUNITY OR OUTPATIENT SETTING. OUTPATIENT FACILITIES AND AFTERCARE MEASURES FAILED TO HELP THE CHRONICALLY INSANE. RECORDS OF STATE MENTAL HOSPITALS SHOW THAT INSTITUTIONAL SURVIVAL, AND NOT PATIENT WELFARE, REMAINED THE ULTIMATE CONSIDERATION. AN ANALYSIS OF A DIARY CREATED AT THE NORFOLK, MASS., PENITENTIARY COVERING THE YEARS 1932-33 SHOWS WHAT HAPPENED WHEN REFORMIST IDEALS WERE TRANSLATED INTO PRACTICE. EXTENSIVE FOOTNOTES AND AN INDEX ARE INCLUDED. (PRG)