In early 19th century America, care for the mentally iii was almost non-existent: the afflicted were usually relegated to prisons, almshouses, or inadequate supervision by families. Treatment, if provided, paralleled other medical treatments of the time, including bloodletting and purgatives. However, in a wave of concern for the oppressed, some took action. Among these, Dorothea Dix was the leading crusader for the establishment of state-supported mental asylums. Through her efforts, the first state hospitals for the insane were built in New Jersey and Pennsylvania. She and other reformers sought humane, individualized care, with the rich and the poor housed together to insure high standards for all. The movement was generated by social reform, but throughout the century, mental illness was probed and analyzed, and" cures" prescribed by both the scientific and lay communities. "Moral treatment" was the predominating philosophy to cure the insane.
This system was developed in late 18th century Europe, and by Benjamin Rush in the United States. It challenged the demonic explanations for insanity and emphasized the role of environment in determining character: improper external conditions could induce derangement. The "moral treatment" system was optimistic that an appropriate environment could facilitate cure, especially for those with acute (not chronic) afflictions. Essential to this theory was a physiological basis for mental disorder: insanity was caused by brain damage. The brain's surface was soft and malleable and physically altered by outward influence. This idea was closely related to phrenology, which assigned specific faculties to sections of the brain.
The notion that mental illness resulted from physical impairment was rarely challenged, but the nature and treatment of ailments were continually debated. To find physical evidence for mental deficiencies, autopsies were performed on mental patients to discover lesions or other abnormalities. Although progress was made in the diagnosis of somatic diseases like tumors or syphilitic derangement, these efforts were frustrating and subjective. Also controversial was the fate of the chronically versus acutely iii: the differences between them, whether they should be housed together, and whether the chronically ill should be treated at all.
According to paragraph 1, the movement to establish state-supported mental asylums was motivated by concern for______.

A. inadequate care by families
B. social reform
C. the effects of medical treatment
D. those who were not mentally iii