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Full text of "Annual report of the trustees of the State Lunatic Hospital at Worcester"

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REPORT 



RELATING TO 



LUNATIC HOSPITAL. 



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Digitized by the Internet Archive 

in 2010 with funding from 

University of IVIassachusetts Amherst 



http://www.archive.org/details/annualreportoftr03stat 



FIFTH 



ANNUAL REPORT OF THE TRUSTEES 



STATE LUNATIC HOSPITAL 



AT WORCESTER. 



DKCBMBER, 1837. 



DUTTON AND WENTWORTH, STATE PRINTERS. 

"""iss's""* 



FIFTH ANNUAL REPORT 



TRUSTEES OF THE STATE LUNATIC HOSPITAL 



DECEMBER, 1S37. 



To His Excellency, Edward Everett , Gove?-nor, and the Honorable 
Council of the Commonwealth of Massachusetts : 

The Trustees of the State Lunatic Hospital, at Worcester, respect- 
fully present their Fifth Annual 

REPORT: 

It is now nearly five years since the State Lunatic Hospital at Wor- 
cester was opened for the reception of patients. That period has 
afforded an opportunity for ascertaining, with a considerable degree of 
certainty, how far the institution has accomplished, or may be expected 
to accomplish, the object of its establishment. 

By a reference to the report of the Superintendent of the Hospital, 
which accompanies this report, it will appear, that the whole number of 
patients, admitted into the institution since January, 1833, is six hun- 
dred and seventy-eight ; that of this number, two hundred and sixty- 
seven have been discharged recovered ; ninety-two improved ; ninety- 
seven unimproved ; thirty-seven have died ; four have eloped, and one 
hundred and eighty-five remain ; that the proportion of cures of the 
whole number discharged is fifty-four and a half per cent, ; of the 
whole number of recent cases discharged, eighty-six per cent., and of 
the old cases discharged, tioenty per cent. ; that the whole number of 
deaths is seven and a half per cent, of the whole number discharged, and 
five and a half per cent, of the whole number of admissions. 



4 STATE LUNATIC HOSPITAL. 

Favorable as the general result for five years is, the result for the last 
year is still more so. It will be perceived that the proportion of recov- 
eries of all cases discharged during that year is ffty-seven per cent. ; 
of the recent cases, eighty-nine and three-fifths per cent., and of the old 
cases twenty-five and one-third per cent. : being an improvement of tvpo 
and a half per cent, upon the average, and a much greater upon the 
result of any one preceding year. 

It vv'ill be perceived also, that there has been a regular yearly im- 
provement in the treatment of recent cases, since the opening of the 
Hospital ; of these, in 1834, the recoveries vv^ere eighty-tivo per cent., 
in 1835, eighty-two and a half'^ex cent., in 1836, eighty-four and one- 
fifth per cent., and in 1837, eighty-nine and three-fifths per cent. In 
tMs estimate, all those are denominated recent cases, in which insanity 
has existed less than one year previous to admission to the Hospital. 

The same regular progressive improvement will not be found in the 
record of the old cases discharged. Of these, the cures, in 1834, were 
twenty and a half per cent. ; in 1835, fifteen and three-fourths per 
cent. ; in 1836, eighteen and tivo-fifths per cent. ; and in 1837, twenty- 
five and one-third per cent. The reason is to be found in the fact, that 
in 1835 and 1836, on account of the crowded state of the institution, 
a large number of incurable cases were discharged under the pro- 
vision of the Statute, which requires that room shall be thus made for 
the cases currently committed by the courts. 

The foregoing results, it is believed, will be found, upon comparison, 
to be as favorable as those exhibited by any other similar institution. 

The proportion of deaths of the whole number admitted to the Hos- 
pital since its commencement, is five and a half ^er cent. ; the propor- 
tion of the whole number in the Hospital during the last year, is only 
three per cent. In European hospitals, the proportion of deaths is 
much greater, amounting, in those whose reports have reached us, to 
twenty-two per cent, in France, and twenty-fonr per cent, in England. 
The small number of deaths in this institution affords evidence of the 
salubrity of its location, as well as the skilful treatment of its patients. 

These results cannot be considered otherwise than highly favorable, 
and as establishing, beyond question, the success of the Hospital as a 
curative institution. The large proportion of recoveries of recent cases 
affords additional evidence of the truth of a position, lately but little 
credited, that insanity may be treated with as much certainty of cure 
as any physical disease of equal severity, provided the proper skill and 
remedies are resorted to in its earliest stages. 

Two hundred and sixty-seven insane persons have, in five years, been 



STATE LUNATIC HOSPITAL. 5 

restored to their friends, to society, and to the enjoyment of the bles- 
sings of life, from all of which they had been cut off by the severest af- 
fliction which can befal suffering humanity. Were the institution to be 
this moment stricken out of existence, what philanthropist, what states- 
man would not admit, that this achievement, whether regarded in its 
relation to the interests of humanity, or to those of civil society, is more 
than a compensation for all the expense which the Commonwealth has 
incurred, in its erection and support. But when it is considered, that 
the institution is to continue its beneficent operations through an in- 
definite future, and to exert its healing energies upon thousands of our 
fellow-citizens, who might otherwise become the hopeless victims of 
madness, he must be something less than man, who can doubt the wis- 
dom of the government, or complain of its profuseness, in establish- 
ing it. 

The cure of insanity, however, is by no means the only object of this 
institution. An end scarcely secondary to this, intended to be attained 
by its establishment, and kept constantly in view in the laws and regu- 
lations which have from time to time been adopted for its management, 
is the safe keeping and amelioration of the wretched condition of those 
who are beyond all hope of cure. This amelioration has been effected 
in this class of cases at the Hospital, in a manner and to an extent that 
cannot fail to touch the heart of every lover of his race. For the evi- 
dence of the accomplishment of this end, the Trustees refer to the 
former reports of this board, adding only here, that in the incurable 
cases which have been continued in the Hospital, as well as in those which 
have been committed within the last year, the same amelioration con- 
tinues to manifest itself When it is considered to what an extent this 
unfortunate class, when at large, or improperly and imperfectly confined 
in private houses, are the cause of grief to their friends, and of uneasiness 
and alarm to the community, that in almost every such case the mem- 
bers of a whole family are rendered unhappy by the presence of so 
much suffering, and that often a whole neighborhood are put in fear 
and apprehension lest the maniac should break loose from his confine- 
ment, and set fire to their dwellings, or make violent attempts upon 
their lives, this object of the institution cannot fail to be regarded of 
great importance, in a civil point of view, to the people of the Com- 
monwealth. 

On account of this feature in its history, the proportion of old and 
incurable cases in this Hospital has always been, and undoubtedly will 
continue to be, large. 

Of this class no inconsiderable number are paupers, and persons 



6 STATE LUNATIC HOSPITAL. 

acquitted of crimes on account of their insanity. There are now fifty- 
one paupers supported here by towns, and twenty by the State. The 
laws regulating the institution provide, that the expense of maintaining 
all town paupers committed to the Hospital, shall eventually be borne 
by the towns where they have their legal settlement, but in no case at 
a rate exceeding the cost of their support at the Hospital. This ex- 
pense has heretofore been two dollars and fifty cents per week. It has 
been a subject of regret to the Trustees to perceive, that many towns 
incur this expense with considerable reluctance, and are desirous of 
removing their incurable patients, though they may be violent, and 
manifestly dangerous to be at large. There are certain cases of insan- 
ity, attended with no outbreakings of passion or excitement, in which 
the patient has settled down into a state of harmless imbecility. In 
these, with proper care and attention, the individual may be comfort- 
ably provided for in any well regulated alms-house; and, in such, the 
Trustees have never refused a discharge when applied for by the au- 
thorities of a town. But, in the more violent and dangerous cases, if 
the patient be removed to an ordinary poor-house, where there is a 
want of strong lodges well and safely warmed in the winter, and at all 
times properly ventilated, and where experienced attendants, who man- 
age this class without fear or alarm, are seldom found, it is evident that, 
on the first exhibition of violence, resort must be had to severe modes 
of confinement, — to handcuffs, to chains, and to dungeons, — by which 
there must be exposure to freezing in winter, and to great pain and 
suffering at all seasons. In such cases the Trustees, considering them- 
selves bound by the provisions of the statute, have refused to discharge, 
however pressing the application. It is to be hoped that when there 
shall prevail a more general acquaintance with the superior comfort 
and security which this class of insane enjoy in the Hospital ; when 
it shall be understood that the cold and cheerless cell is here exchanged 
for comfortable apartments ; that the chain is never used, that rarely 
the limbs are confined, even in the most gentle manner ; that in no 
instance is the sufferer deprived of the light of day, and in scarcely any 
of agreeable exercise in the open air; that in^ no case can there be 
severe physical suffering, but in almost all a great degree of physical 
comfort ; when this shall be more generally understood, it is to be 
hoped that no town which is obliged to support one of these unfortu- 
nate beings, will hesitate to pay the charge of his maintenance at the 
Hospital, though it be somewhat greater than the expense of providing 
for their ordinary poor. 

The Trustees would do injustice to their own feelings, as well as to 



STATE LUNATIC HOSPITAL. 7 

the Superintendent, did they fail to express their entire approbation of 
the mode of treatment which has been practised at the Hospital, and 
crowned with such eminent success. Formerly the " influence of fear 
and physical force" were the only means resorted to to keep the insane 
under control. Here, as in other similar establishments of modern 
date, the ancient system of rigor has never been introduced ; one of 
kindness and gentleness has been adopted in its place. No unneces- 
sary severity is ever resorted to, or allowed ; and punishment, as such, 
is absolutely prohibited. In the most violent cases, when the patient 
exhibits paroxysms of rage and bursts of uncontrollable passion, the 
necessary coercion and restraint are tempered with mildness and gen- 
tleness of manner. Even the destitution of madness seems to retain 
some sensibility to the appeals of sympathy. When the intellect is 
entirely overpowered, and lost " amid the thick coming fancies," the 
wild dreams and terrific visions, which, in legions, assail the maniac, 
the heart often retains its susceptibility to kind impressions, and, 
through appeals to this, the reason is at length reached, and gradually 
led to exercise its power in dispelling the illusions by which it has been 
mastered. When returning consciousness begins to manifest itself, the 
patient is encouraged by all the moral means which can be resorted to, 
to make and to persevere in efforts of self-control — confidence is re- 
posed in him ; he is permitted to walk unattended about the grounds 
of the establishment, to ride abroad, to engage in amusements, to have 
and use the implements of labor or sport, to enjoy social intercourse 
with the convalescent of his fellow patients, and with the officers and 
attendants : in fine, to be the master of his own actions, as far as his 
safety will allow. This confidence is rarely abused ; the patient, seeing 
that he is treated like a rational man, is ambitious of appearing to be 
such, and, by repeated efforts to control his insane propensities, often 
at length obtains a conquest over them. 

Employment is one of the most successful means of cure resorted to 
in this institution. Few patients are indisposed to engage in any use- 
ful occupation, and most esteem it a privilege. The men furnish labor 
sufficient to perform all the farming and gardening operations which 
our grounds admit of It is no uncommon thing to see twenty laborers 
under the charge of a single attendant, and so quietly and orderly do 
they conduct themselves, that a stranger would never suspect them to 
be the inmates of an insane hospital. 

The matron has weekly sewing parties for the females, which from 
thirty to forty of the eighty female patients regularly attend, — many 
of them while their insanity is yet so violent as to exhibit itself in par- 



8 STATE LUNATIC HOSPITAL. 

oxysms in the halls and in their own rooms. But so highly is the priv- 
ilege of these social and industrious parties esteemed, that rarely has 
any disturbance taken place in them, it being understood that any 
individual who violates the proprieties of the place will in future be 
excluded. At these parties all the bedding for the new wings of the 
Hospital has been made, amounting to a supply for more than one 
hundred beds. Here also, and in a room appropriated to the purpose, 
where many of the patients daily assemble under the direction of a 
seamstress, and in the halls, is made all the clothing for the patients in 
the whole establishment, except such as is supplied by their friends. A 
highly beneficial influence has in this way been exerted — that self- 
respect, which, in solitude, is so soon entirely lost, is here encouraged 
and exercised, and the habit of observing the decencies and civilities of 
society revived and strengthened. Strong motives are offered for the 
exertion of self-control, and, however difficult and painful the effort, it 
is made, and made with success. 

These parties present one of the most pleasing exhibitions afforded 
by this institution, and, for the success which has attended them, as 
well as for the faithful performance of her other arduous duties, great 
credit is due to our excellent matron, Mrs. Ellis, to whose indefatigable 
exertions, and kind and conciliating deportment, that success is princi- 
pally to be attributed. 

Amusements are encouraged as another means of cure. The males 
engage in a variety of athletic games and exercises in the open air. In 
these many take part with great animation and apparent enjoyment ; 
while more quiet games and reading and writing afford the recreation 
of the halls. Music is a source of much enjoyment to those who have 
practised it in health. We have tolerable proficients on a variety of 
instruments — a choir for the chapel has been formed entirely of patients ■ 
and attendants, principally of the former, by which all the parts of 
common church music, both vocal and instrumental, are performed 
with taste and accuracy. 

Walking is a favorite exercise. Parties with an attendant frequently 
walk four or five miles, and return refreshed and invigorated by their 
excursions. Individual patients among the convalescents, in whom 
confidence can be placed, are permitted to walk without an attendant, 
to visit any part of the village, and often to act as protectors to those 
more insane than themselves. It is not a little remarkable, that, not- 
withstanding the great number of instances in which such confidence 
has been reposed, it has rarely been abused by an attempt at elopement. 



STATE LUNATIC HOSPITAL. 9 

To the females, besides walking, are afforded the facilities of riding. 
A carriage, purchased within the last year, accommodating seven persons 
besides the driver, is almost constantly employed in the afternoon in 
pleasant weather, affording fresh air and exercise to the old and feeble, 
as well as amusement and change of scene to the young and more 
healthy. Dancing parties among the females have occasionally been 
resorted to with much gratification and success. 

Religious worship has been introduced within the last few months, 
as one of the moral means of cure, and, so far as a judgment can be 
formed from so short a trial, much is to be hoped from the experiment. 
At all events, a fact has been established, which the most sanguine 
were scarcely disposed to admit in anticipation, namely, that out of 
one hundred and eighty patients, afflicted with every degree of derange- 
ment, from the fading illusions of the almost recovered convalescent, 
up to the phrenzy of the raging madman, one hundred and thirty-five 
could be found, who could so far control themselves, as to attend, with 
propriety and apparent devotion, to the exercises of public worship, for 
the space of one hour and a half, and then leave the chapel in the quiet 
manner of other congregations, without any extraordinary exertion of 
vigilance on the part of their attendants, walk together through the 
open area of the establishment, and retire without disorder to their 
respective apartments. Extraordinary as this statement may appear, it 
has been verified by repeated exhibitions. Does not the experiment 
afford reason to hope, that the management of the insane by moral 
means, is destined to arrive at a degree of perfection, for which the 
most philanthropic have heretofore scarcely dared to hope? 

Such are some of the means which enter into the mode of treatment 
at this institution. They are singled out, and particularly alluded to 
here, that the public may be made more generally acquainted, than 
they are supposed to be, with what passes within the walls of a well- 
conducted Insane Hospital of the present day, and that they may be 
disabused of the notion which perhaps yet prevails to some extent in 
this Commonwealth, that an asylum for the deranged is still, what in 
former ages it has been, the seat of cruelty and oppression. 

For the successful employment of these means and all others adopt- 
ed at this institution, the public are indebted to the skill, the intelli- 
gence and philanthropy of the superintendent, Dr. Woodward, whose 
untiring exertions in its management, and zeal in its welfare, through- 
out its entire existence, are above all praise, and beyond all price. He 
has been ably and constantly seconded in his labors by our excellent 
assistant-physician. Dr. Chandler, whose five years experience, under 
2 



10 STATE LUNATIC HOSPITAL. 

such an instructer, has rendered his services of great value to the estab- 
lishment. 

Within the last year the additional buildings, authorized by a resolve 
of the Legislature passed in 1835, have been completed by the com- 
missioners appointed for that purpose. The additions consist of two 
wings to the original building, at right angles with it, as represented 
in the drawings prefixed to the edition of former Reports published by 
order of the Senate during the last summer. The South wing, con- 
taining accommodations for fifty-seven patients, was completed previ- 
ous to the date of the last report. The North wing, containing ac- 
commodations for fifty-nine, was ready for occupation in the month of 
September last. These additions are a great improvement to the in- 
stitution; not only on account of the greater number of inmates accom- 
modated, but of the means for a more perfect classification afforded by 
them. One entire half of the Hospital is now occupied by males dis- 
tributed into the variety of classes which their condition and the state of 
their disease require. The other half is occupied exclusively by fe- 
males classified in the same manner. Before these new accommoda- 
tions were furnished, the females were crowded into two halls, neces- 
sarily almost without classification. They now are distributed in six, 
and the males in an equal number. 

The whole number of rooms for patients is now two hundred and 
six, the number of lodges for the violent, twenty-three, making, in all, 
accommodations for two hundred and twenty-nine. The number of 
patients in the Hospital on the thirtieth of November last was one 
hundred and eighty-five ; at the date of this report it is one hundred 
and ninety. The apartments for males are already nearly full, with 
the exception of a part of the lodges, which are intended never to be 
occupied except by the very violent cases. The female apartments 
will be filled with less rapidity, but will probably be fully occupied in 
the course of a few months. It is considered highly important that 
the separation, between the male and female wards, be as complete as 
possible, and therefore, though some of the latter may be for a time 
unoccupied, no temporary change in their appropriation is contem- 
plated. 

The chapel, which by the munificence of the Legislature at its last 
session was ordered to be erected, has been completed, and is a neat 
and tasteful structure, so situated in reference to the other buildings 
as to contribute essentially to the order and beauty of arrangement of 
the whole. The Superintendent states in his Report the manner in 
which the desk has thus far been supplied. The trustees take this op- 



STATE LUNATIC HOSPITAL. 11 

portunity to suggest, that the appointment of a permanent Chaplain, 
with a moderate salary, may hereafter be highly beneficial to the inter- 
ests of the institution. A gentleman, selected with reference to his 
peculiar qualifications for such a trust, would be abl"" o exert upon the 
patients an influence highly salutary, not only by his ministrations 
upon the sabbath, but by his daily intercourse with them. He would 
be, not only a religious teacher, but a moral physician, exerting his 
energies in unison with the other moral means which form a part of 
the general treatment adopted here. Another reason for such an ap- 
pointment is, that though no great difficulty has yet been experienced 
in procuring the assistance of clergymen, a voluntary service of this 
kind will eventually become burthensome in this community, where 
few are without constant engagements in their own pulpits. Again it 
can scarcely be expected that the instructions of gentlemen, but little 
acquainted with the character and peculiarities of our inmates, with 
their treatment, and with the delicacy necessary to be exercised in al- 
luding to their unfortunate condition, will be productive of that happy 
effect which may be anticipated from the efforts of one exclusively de- 
voted to the object. Our chapel is, in a great measure, an experi- 
ment; — for though religious services have been before partially intro- 
duced into hospitals of this character, this, it is believed, is the first 
house of worship ever erected exclusively for the insane. The experi- 
ment ought to be fairly and fully tried. For these reasons it may be 
thought expedient hereafter by the Board of Trustees to make such an 
appointment, subject however under the provision of the statute, to the 
approval of the Governor and Council. 

A wash-house, with a convenient store-room adjoining, entirely sep- 
arate from the principal buildings, has also been completed within the 
last year, an arrangement which has obviated some serious inconve- 
niences resulting from its former location in the basement of the cen- 
tre building. 

Of the appropriation made by the Legislature for the purchase of 
land, the Trustees have expended four thousand seven hundred twelve 
dollars and fifty cents, with which they have purchased thirty-four 
acres and a fraction, consisting of twenty-five acres of pasturage, of 
excellent quality, situated within a short distance of the Hospital ; five 
acres of mowing, adjoining the pasturage, and so located as easily to 
admit of irrigation ; and four acres and a fraction intended for garden- 
ing, situated contiguous to our present garden, and capable, with our 
means of cultivation, of being made, with little expense, equal to the 
best in the vicinity. The remainder of the appropriation for this pur- 



12 STATE LUNATIC HOSPITAL 

pose, the Trustees have reserved in the expectation of soon being able 
to procure arable land more conveniently located than any which has 
thus far been otfered. 

By the steward's memoranda, it appears that the avails of male labor 
supplied by the institution, with the aid only of one farmer employed 
to superintend it, has, at a moderate estimate of the value of the several 
products, amounted, during the past year, to more than eleven hundred 
dollars. This amount will undoubtedly be increased another year, 
since we have many more laborers than sufficient to cultivate our land. 
In addition to the labor employed in farming and gardening, the pa- 
tients cut and secure all the wood used in the establishment, amount- 
ing to more than four hundred cords in the year, attend to the barns, 
stables and piggeries, perform much of the hard work in washing, and 
do a great variety of other work about the establishment. 

During the last year, we have erected a building containing a shoe- 
maker's shop, and a carpenter's shop. In the former, we expect here- 
after to be able to manufacture and repair all the shoes necessary to 
supply the Hospital, and in the latter to perform much of the work 
requisite to keep the buildings and furniture in repair. There are 
some good mechanics among our incurable as well as curable patients, 
and others are capable of being made so notwithstanding their insanity. 
Thus we are enabled to combine profit to the institution, with the best 
and most successful means of cure and enjoyment to its inmates. In 
this connection, the Trustees take occasion to express their approba- 
tion of the manner in which the steward, Mr. Ellis, has discharged the. 
responsible and difficult duties of his office, only a part of which are 
included in the superintendence of the exterior concerns of the estab- 
lishment. 

A supply of .water has formed one of the topics of almost every re- 
port submitted by this board. They are now enabled to state, that, 
since the laying of the new pipe in the aqueduct in the summer of 
1836, there has been an abundant and constant supply, notwithstand- 
ing the enlarging of the establishment has rendered necessary nearly 
double the quantity formerly used. It is estimated that four thousand 
gallons are delivered daily by the aqueduct, a fact of primary impor- 
tance, since an abundant supply of pure water is absolutely essential to 
the health and successful management of such an institution. 

By the treasurer's report it appears that the amount of expenditures 
paid by him during the past year is $26,027 07. To this amount 
should be added f 1360 62, the amount of salaries accrued since the 
19th of May last, paid by the treasurer of the Commonwealth, making 



STATE LUNATIC HOSPITAL. 13 

the total expenditure for the year $27,387 69 : being an advance of 
$3167 35 upon the expenditure of the year preceding, occasioned by 
the additional number of patients received in consequence of the new 
accommodations. 

After deducting from the gross amount of expenditure, the salaries 
of officers, and those items which are charged to individuals, the 
remainder, divided among the average number of patients for the year, 
which is one hundred and sixty-three, will make the cost of board for 
each patient §2 73 per week. The Trustees, however, feeling a reluc- 
tance to increase the price of board at a time of general pecuniary 
embarrassment, and confidently believing that the circumstances herein 
after alluded to, together with the probable reduction in the price of 
provisions, will soon reduce the expense to $2 50 per week, have not 
directed the treasurer to charge more than that sum. 

The expenditure for improvements and repairs is §1185 52. This 
includes the expense of fitting up our mechanics' shops, the building 
of new fences, and a variety of alterations rendered necessary by the 
erection of the new wing, an outlay which will not probably soon 
recur. The expense of repairs and improvements, however, in so ex- 
tensive an establishment, must always be considerable. 

Fuel is another large item, and must always be so. It is one of the 
first requisites in an Insane Hospital that it be thoroughly warmed in a 
manner to ensure safety to the worst class of patients from suffering 
either by frost or fire. Perhaps there is no other cause from which the 
insane, in our climate endure so much physical suffering as from cold 
in winter. Many patients have been received into this institution who 
have been badly frozen ; some in such a manner as to have lost their 
limbs, others a part of them. Within a week of the date of this report 
a man was sent here who had been confined three years in a cage, 
where he had been repeatedly badly frozen, and in the late severe 
weather so much so, that his extremities were actually in a state of 
mortification when he arrived. He survived but two days. The ar- 
rangements here are such that since the opening of the institution not 
one instance of burning or freezing has occurred, or in which there has 
been any suffering from cold. This result, in an establishment intend- 
ed to accommodate two hundred and twenty-nine patients, cannot be 
accomplished without a large consumption of fuel. 

The item of furniture deserves a remark. Much new furniture has 
become necessary as the wants of the institution have become develop- 
ed by experience. In future it is probable that this expense will be 
considerably diminished, but the repairs and additions required, on ac- 



14 STATE LUNATIC HOSPITAL 

count of the damage and destruction resulting from violence and mis- 
chief, will always form a considerable item in the treasurer's account. 

With regard to the other items of expenditure we must always have 
a sufficient supply of wholesome food and comfortable clothing, of expe- 
rienced attendants and necessary medicine; these are all indispensable, 
and, with fuel, are the particulars which principally swell the sum total. 

Large however as our expenditure seems to be, it will be found to 
be small, in proportion to our numbers, in comparison with that of al- 
most any other well conducted curative institution for the insane in 
this or any other country. 

The Treasurer estimates the appropriation necessary for the current 
expenditure of the year ensuing at ^8000, the sum which was appro- 
priated for that purpose last year. In this estimate the trustees concur. 

The Trustees, with great cheerfulness, repeat, what has often been 
stated in former reports, that the internal policy and conduct of the 
establishment deserve the highest commendation of this Board and 
the public, and evince, in the order, regularity and efficiency which 
prevail in every department and ward, a control and supervision in 
the directing mind, constant, active and energetic. To the Report 
of the Superintendent they would refer for more minute informa- 
tion in relation to many of the topics alluded to in this Report, for 
many interesting facts and deductions concerning the subject of insan- 
ity, and for the evidence of the general prosperity and success of the 
institution. 

In conclusion they would again commend this interesting charity to 
the Government of the Commonwealth as deserving its continued guar- 
dianship and protection. 

THOMAS KINNICUTT, 
HORACE MANN, 
ABRAHAM R. THOMPSON, 
MYRON LAWRENCE, 
STEPHEN SALISBURY. 

Worcester, Dec. 20, 1837. 



STATE LUNATIC HOSPITAL. 



15 



TREASURER'S REPORT, 



To His Excellency Edward Everett, Governor, and to the Honorable 
Executive Coimcil of the Commonwealth of Massachusetts. 



The Treasurer of the State Lunatic Hospital respectfully presents 
his Fifth Annual Report. 

The Treasurer charges himself with re- 
ceipts amounting to . . . 824,685 72 

Balance overdrawn at Bank carried to the 

credit of the Treasurer in next account, 1,341 35 



He credits himself with payments amounting to 

The receipts were — from cities, towns and 
individuals, .... 
from the State Treasury, 
Credited on sundry bills, for horse in ex- 
change, ashes, grease, and articles sold, 
Balance, 



The payments were for. 
Improvements and repairs. 
Salaries, wages and labor, 
Furniture and bedding. 
Clothing, linen, &c. . 
Fuel and lights. 
Provisions and groceries. 
Medical supplies. 
Hay and straw. 
Miscellaneous, 



17,424 


46 


7,000 


00 


201 


26 


1,341 


35 


1,185 


52 


6,397 


97 


1,000 


77 


1,153 


11 


3,372 


15 


10,534 


29 


551 


64 


325 


89 


1,505 


73 



26,027 07 
26,027 07 



26,027 07 



26,027 07 



16 



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STATE LUNATIC HOSPITAL. 



19 



Provisions and Groceries include 



Apples, pears, raisins, figs, lemons, 
oranges, berries, pickles, apple- 



sauce, cranberries, 




$278 74 


Vinegar, 


. 7 bis. and 37 gallons, 


31 18 


Soap, 




194 23 


Salt, honey, spices, and smc 


dl groce- 




ries. 




144 53 


Milk, 


. 2901 quarts. 


148 09 


Butter, 


. 6461 lbs. 


1266 16 


Cheese, 


. 5766 lbs. 


634 49 


Eggs, 


175 3-12 dozen. 


36 19 


Beans and peas, 


55 1-4 bushels, 


134 84 


Potatoes, 


. 1020 3-4 bushels, 


418 21 


Turnips and parsnips, 


55 3-4 bushels. 


18 55 


Onions, 


20 bushels, 


18 25 


Oats, 


51 1-2 bushels, 


26 25 


Rye, 


73 bushels. 


95 36 


Corn, 


. 852 1-2 bushels, 


1033 70 


Rice, 


. 1994 lbs. 


87 07 


Biscuit, 




188 25 


Flour, 


179 barrels. 


1920 90 


Tea, 


. 490 1-2 lbs. 


145 23 


Coffee, 


. 1153 lbs. 


137 73 


Brown Sugar, 


, 5318 lbs., 9 oz. 


478 77 


Loaf Sugar, 


471 lbs., 6 oz. 


74 08 


Molasses, . 


565 gallons, 


263 01 


Poultry, 


. 616 3-4 lbs. 


76 21 


Ham, 


. 1072 1-4 lbs. 


157 15 


Fresh fish, 1827 1-2 lbs., 


2 lobsters, 16 shad. 


68 41 


Mackerel and salmon, 


3 barrels, 86 lbs. 


53 46 


Herring, tongues and soui 


ids, liv- 




ers, tripe, and oysters, . 




21 96 


Salt fish, . 


. 3629 lbs. 


149 64 


Salt beef, . 


3 barrels, 211 lbs. 


56 59 


Sausages, . 


67 lbs. 


11 17 


Beef, . 


. 19,969 3-4 lbs. 


1450 86 


Pork, 


. 143 1-4 lbs. 


20 68 



20 



STATE LUNATIC HOSPITAL. 



Salt pork, . 
Mutton and lamb, 
Veal, 



14 barrels, 
1281 lbs. 
2372 1-2 lbs. 



397 50 
111 54 
185 26 

^10,534 29 



Charcoal, . 

Anthracite, 

Wood, 

Wicking, . 

Oil, 

Candles, 



Fuel and Lights include 



1182 bushels, 146 12 

15 tons, 189 37 

544 cords, 6 inches, 2767 83 

90 

287 1-2 gallons, 260 45 

59 1-2 lbs. 7 48 



$3372 15 



Miscellaneous includes 

Expenses of pursuing elopers, returning patients dis- 
charged, and money advanced to patients discharged, 
and charged in their account. 
Oxen, 110; 3 cows, 130; swine, 19 26; 2 horses, 250, 

chariot, 210, 
Stationary and books. 
Postage, 

Funeral expenses, 
Pasturing, 

E.xpenses of Trustees, Thomas Kinnicutt, 
Thomas A. Green, 
A. R. Thompson, 
Horace Mann, 
Sundries, .... 



311 33 





719 26 




68 59 




28 78 




51 00 




43 77 


13 06 




17 65 




17 00 




24 00— 


171 71 




111 29 




$1505 73 



The accounts which had been due more than a year, on the first day 
of January, 1837, were, by direction of the Trustees, submitted to the 
investigation of Pliny Merrick, Esq., District Attorney, and remain in 
his hands. It is presumed, that very few, if any of them, which re- 
main now unpaid, will ever be collected. 



STATE LUNATIC HOSPITAL. 21 

The balance of accounts to Dec. 1, 1837, which the Treasurer sup- 
poses collectable, amount to -f 10,531 20. 

The whole receipts for the ensuing year, from cities, towns, and in- 
dividuals, he estimates at f 20,000. On the 1st instant, there remained 
in the State Treasury, of the appropriation of last year, $4000. 

The expenditures for the year, supposing all the wards of the Hospi- 
tal to be occupied, will not be less than .$30,000, and may be more. 
It appears, therefore, that a further appropriation will be required for 
the current expenses of the institution. The same sum which was 
appropriated last year will, the Treasurer thinks, be sufficient for this. 
That sum was §8000. 

A. D. FOSTER, 

Treasurer of the Stale Lnnatic Hospital. 
Worcester, December 20, 1837. 



23 



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t: "far o o t c "bb— t: c"hco o j; bjoo tTco t "So o o t-c'bcS'bJoo o t:~co o-^Tjob c"SJDt: 
g'-Z g -Z^S t« gig S':^ geo Sg'oigic gi« gmS ^g 

*q3 qj a^ OJ ]^ 11^ ^^ [^ ]^ ^ 

cJJpiioopJ>pO'OC.«oooqooc^_o_ocoooJ^_o^JJpJisJ:J^ocoo 

fcg[i.g b.g[^ ^ Ci^ e= fa es Ci-^fcgsfag fa 

'-^coco'oo'-'ccos^coos^'ooccor— co-f-*tr: — ooo — O'OCic^cn-j't— r- lOOG^t^ioco 

t-criO'*C^r-iS^Tj<iotot^COCOCOC^'-<j3COC50 — COCOOCOCOWiO'OC-i>0-T't— t-O — S^iO^O 
Ti "^ 

boococ-cooocooooooooooocc-ooooooooooooooo 
3 -o -a -o -o 3"Tj x; — -OTS'c-c-D-C'U'O'D'CTS — ■a-o-oo'C-D'o-o'u's-aTj-o-a-c-D'u-o'O 

^ ^ _o 



30 



STATE LUNATIC HOSPITAL, 





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years 

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years 

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years 

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years 




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(e;0^lO;0;0tCt0«CtS;StO<Oti9CS(Ot0U3 



STATE LUNATIC HOSPITAL. 



31 



TABLE 1. 

Shoicing the state of the Hospital from December \st, 1836, to Novem- 
ber 30#/j, 1837, inclusive. 



Patients admitted. 

Males, 
Females, . 

Recent cases, . 


94 
74— 

7.3 
95— 


168 
—168 

-168 


Patients in the Hos- 
pital in the course 
of the year, 

Admitted, . 

Remained, 


168 
138 


-306 


Old cases, 








Remains at the end of 
the year, 

Foreigners in the Hos- 
pital this year. 
Natives of other States, 


13 

8— 


J85 
— 23 


Deaths during the 
year, . 

Per cent, of all in the 
Hospital dm-ing 
the year. 




9 
3 


Sent by the Courts, . 
Private, 


129 

39— 


—168 ' 


Per cent, of the dis- 
charged, . 


• 


7i 






! 

: 


One of 34 of the w^hole. 
One of 13^ of the discharged. 





TABLE 2. 





No. of each sex. 


Recov'd. 


Improv'il. 


Notlmprv'il. 


No Room. 


Died. 


Patients disch'd, 


121 














Males, 




71 


37 


11 


4 


11 


6 


Females, 




50 


32 


13 


2 


1 


3 


Recent cases : 
















Discharged, 


58 














Males, 




27 


25 


1 








1 


Females, 




31 


27 


3 








1 


Old cases : 
















Discharged, 


63 














Males, 




43 


12 


10 


4 


11 


5 


Females, 




20 


5 


10 


2 


1 


2 


Remains, 


185 














Males, 




106 












Females, 




79 













Per cent, of recoveries of all discharged in the course of the year, 57 
Per cent, of recent cases dischai'ged of less than one year's duration, 89 3-5 
Per cent, of old cases dischai'ged of more than one yeai''s duration, 25 1-3 



32 



STATE LUNATIC HOSPITAL. 



TABLE 3. 



Duration of Insanity with those remaining in the 


Ages 


of Patients in the Hospital, December 1st, 


Hospital, December 1st 


1837. 




1837. 


Less than 1 year. 


29 


Under 20, .... 6 


From 1 to 5 years, 


51 


Fr 


om 20 to 25, 






22 


5 to 10 years. 


38 




25 to 30, 






18 


1 to 15 years, . 


24 




30 to 35, 






26 


15 to '^0 years, . 


17 




35 to 40, 






31 


20 to 30 years, . 


11 




40 to 45, 






21 


Over 30 years, 
Unknown, . 


2 
13 

185 




45 to 50, 
50 to 55, 
55 to CO, 
60 to 65, . 
65 to 70, 
70 to 75, 






20 
10 

8 
8 
8 
5 








75 to 80, 




2 














185 



TABLE 4. 



Number admitted and discharged each month. 


Average of Patients in the Hospital .'each month. 




Admitted. 


Discharged. 




December, 


6 


8 


December, . . . 137 


Januaiy, 
February, 


13 

7 


3 
4 


January, 
February, 






141 2-3 

148 3-4 


March, 


20 


8 


March, 






156 1-2 


April, 

May, 

June, 


14 
15 
11 


11 

18 
12 


April, . 
May, . 
June, . 






162 1-3 

106 
162 1-2 


July, 


12 


10 


July, . 






] 65 3-4 


August, 


17 


9 


August, 






16!> 1-5 


September, 
October, 


19 
18 


11 
12 


September, 
October, 






174 2-3 

184 1-3 


November, 


16 

168 


15 
121 


November, 






186 1-2 




Average 


abo 


ut 


163 



STATE LUNATIC HOSPITAL. 



33 



TABLE 5. 
Statistics of the State Lunatic Hospital^ from Jan. 1833, to Dec. 1837. 





678 


1833. 


1831. 


18 .3. 


1836. 


1837. 


■rotii. 


Admitted, . 


153 


119 


113 


125 


IGS 


678 


Discharged, 


452 


34 


106 


103 


97 


112 


452 


Discharged recovered. 


267 


25 


64 


52 


57 


69 


267 


Discharged improved. 


92 


7 


22 


23 


17 


23 


92 


Died,. 
Eloped, 


37 
4 


4 

1 


8 
1 


8 
1 


8 
1 


9 


37 
4 


Patients in the Hospi- 
tal in tlie com-se of 
each year. 




153 


233 


241 


245 


306 


078 


Patients remaining at 
the end of each year. 




114 


118 


119 


138 


185 




Males admitted. 
Females admitted, 


386 

292 


57 


79 
39 


51 

62 


59 


94 
75 


386 
292 


Males discharged, 
Females discharged, . 


260 
199 


2:i 
16 


59 
49 


57 
AQ 


56 
41 


65 
47 


260 
199 


Males died, 
Females died, . 


24 
l;i 


3 
1 


5 
3 


4 

4 


6 
2 


6 
3 


24 
13 


Patients sent by Courts, 
Private patients. 


499 
i;9 


109 
44 


55 
6t 


89 
21 


117 

8 


]?9 

39 


J 678 


Old cases, . 
Recent cases, 


3?3 

£0a 


108 
45 


47 
74 


58 
54 


65 
60 


95 
75 


373 

306 


Recovery : 

Males, 
Females, 


141 
126 


13 
12 


3-i 
31 


27 
25 


31 

26 


37 
32 


141 

126 



34 



STATE LUNATIC HOSPITAL, 



TABLE 6. 

Showing the statistics for the different Seasons. 





Touil. 


1833. 


lf34. 


1835. 


1836. 


18:7. 


jAd missions in Winter, . 


I'ifi 


'27' 


20 


24 


23 


26 


Afliriissions in S|)niig, . 


^•^Q 


71 


3-) 


:U 


30 


49 


Admissions in Summer, 


i(i;3 


21 


30 


30 


42 


40 


Aduli^■sions in Autumn, 


1U4 


21 


28 


28 


24 


53 


Disci largfcs in Winter, . 


78 




22 


21 


20 


15 


Discharges in Spring, . 


1-11 


7 


3} 


30 


33 


:8 


Discliargcs in Summer, , 


vr.i 


]() 


28 


31 


24 


30 


Discljarges in Autumn, . 


129 


24 


24 


22 


21 


38 


Recoveries in Winter, . 


47 




12 


14 


11 


10 


Recoveries in Spring, 


64 




20 


T.i 


14 


17 


Recoveries in Summer, . 


68 


9 


16 


10 


ii 


15 


Recoveries in Autunm, . 


90 


Iti 


15 


12 


•AO 


27 


Deatlis in Winter, . 


G 




4 


1 




1 


Deaths in Spring, . 


8 


1 


2 


2 


1 


2 


Deaths in Summer, 


V> 


2 


3 


2 


4 


1 


Deatiis in Autunm, 


11 






3 


3 


5 



Average of deaths. 
Per cent, of deaths, 



1 of 18^. 
5^ 



Per cent, of Recoveries. 



Average for the whole time, 
of recent cases. 


pr. d. 

80 




82 


8Qh 


811-5 


893-5 


Per cent, of recoveries of all 
cases discharged. 


55i 




551 


m 


53 1-4 


57 


Per cent of recoveries of old 
cases discharged, 


20 


• 


20i 


151 


182-5 


251-3 



STATE LUNATIC HOSPITAL. 



35 



TABLE 7. 
Shoioing the duration of Insanity before adinitted to the Hospital. 





Tttai. 


1833. 


1834. 


15f5. 


1:3G. 


1837. 


Less thfin one year, 


2eo 


i 

48 


56 


49 


54 


73 


From 1 to 5, 


Irl 


20 


29 


37 


37 


5:^ 


5 to 10, ... 


f6 


27 


14 


17 


13 


15 


lOto'.O, 


71 


M 


8 


6 


11 


15 


SOto.-O, 


23 


12 


4 


1 


2 


4 


yO to 40, ... 


8 


3 


1 


1 


2 


1 


Unknown, .... 


3(i 


12 


6 


7 


6 


5 


Durallun with those j-emain- 














h)g at llio end of each year, 














Less than one year. 


ir> 


59 


22 


21 


11 


29 


From ] to 5, 


].=)/ 


20 


25 


2> 


39 


51 


5 to 10, 


ir.i 


20 


24 


34 


35 


38 


lOtoV'O, 


159 


30 


24 


29 


35 


41 


?Oto;iO, 


35 


9 


5 


3 


7 


11 


Over 30, .... 


13 


3 


2 


4 


2 


2 


Unknown, .... 


52 


8 


16 


6 


9 


13 


The aiires of ])atienfs when ad- 














mitted — Milder "0, 


35 


2 


6 


3 


11 


13 


Between 20 and :i0, 


160 


34 


23 


22 


29 


58 


30 and 4l), 


li)8 


48 


44 


42 


:-;o 


34 


40andfO, . 


1-18 


34 


28 


30 


25 


31 


50 and CO, 


G;{ 


14 


9 


11 


](i 


13 


(iO and 70, 


51 


17 


6 


6 


10 


12 


Over 70, .... 


19 


5 


2 


5 


00 


7 


Civil state of patients admit- 














ted — Siii>:le, 


3:7 


92 


71 


52 


m 


94 


Married, 


231 


38 


40 


AQ 


49 


61 


Widows, . 


41 


12 


4 


8 


(5 


11 


Widowers, 


26 


11 


4 


7 


2 


2 



36 



STATE LUNATIC HOSPITAL. 



TABLE 8. 
Showing the occupation of the inmates of the Hospital. 



Farmers, 


91 


Cooy)ers, .... 2 


Laborers, 


7() 


Harness maker, 




1 


MaiiLilactiirers, 


21 


Tanners, . 




2 


Slioeinakers, 


32 


Pedlars, . 






2 


Seamen, . 


24 


Currier, 






1 


Merchants, 


21 


J5ricklayer, • 






1 


Carpenters, 


17 


Clergy, 






3 


TeacFiers, 


14 


Lawyer, 






1 


Blacksmitlis, 


10 


I'hy^'cians, . 






2 


Machinists, 


7 


Jeweller, . 






1 


Printers, . 


8 


Broom makers, 






2 


Tailors, 


4 


Painters, . 






2 


Paper makers, 


3 


Watchman, 






1 


Clothiers, 


4 


Drover, 






1 


Millers, . 


3 


Copper smiths. 






2 


Calico printers, 


3 


Coaclimen, . 






2 


Cabinet makers, 


3 


Stiideiiis, . 






5 


Bakers, 


2 


Sail makers, 






2 


Stevedores, 


2 


News Collector, 






1 


Stone Ciiiter, . 


1 


Vagrants, . 






19 


Comb makers, 


2 











A few females, only, are classified. 



TABLE 9. 

Shewing the diseases 7chich have proved fatal, and the numher of cases. 



Marasmus, .... 


9 


Brain disease from anotber 




Epilepsy, . 
Consumjition, 
Aj>oplexy, . 
Suicide, 
Cholera Morbus, 




6 
5 
3 
3 
2 


cause, .... 
Disease of the beart, . 
Disease of the bladder, 
Inflammutiou of bowels, . 
Lung fever, 




Hemorrlingy, 
Mortification of tlie limbs. 
Brain fever from intenip 


er- 


2 
1 


Total, 


37 


ance, 




1 







STATE LUNATIC HOSPITAL. 



37 



TABLE 10. 

Shotoing the comparative curability of Insanity attacking at different 

ases. 











1 


Total of Ca- 
ses. 


Total of 
each stx. 


Ciireil or 
Cur.ible. j 


\' tCuredor 
Iiicuraulc. 


Under 20, 
Males, 
Females, . 

From 20 to 25, 
Males, 
Females, . 








t'"' 


75 

98 


40 
35 

58 
40 


13 
24 

24 
19 


27 
11 

34 
21 


From 25 to 30, 

Males, . 
Females, . 










104 


56 

48 


25 

26 


31 
22 


From 30 to 35, 
Males, . 
Females, . 










92 


64 

28 


26 
15 


38 
13 


From P5 to 40, 

Males, 
Females, . 










65 


32 
43 


15 

18 


17 
25 


From 40 to 45, 

Males, 
Females, . 










50 


27 
23 


17 

16 


10 
7 


From 45 to 50, 
Males, . 
Females, . 










41 


22 

19 


17 
16 


5 

3 


From 50 to 55, 

Males, 
Females, . 










39 


18 
21 


8 
13 


10 

8 


From ^5 to 60, 
MaL-e, . 
Females, . 










23 


11 
12 


8 
6 


3 
6 


From 60 to 65, 

Males, . 
Females, . 










12 


7 
5 


7 
4 



1 


From 65 to 70, 

Males, 
Females, . 










12 


9 
3 


7 
3 


2 



From 70 to 75, 
Males, 
Females, , 










3 


2 
1 


1 
1 


1 



Over 75, 


2 






2 



38 



STATE LUNATIC HOSPITAL. 



TABLE XL 

Showing the comparative curability of cases healed at different periods 

of Insanity. 



Less than 1 year's duration, 

Mules, . 
Females, . 

From 1 to 2 years, 

Males, ' . 
Females, . 

From 2 to 5 years, 
Males, . 
Females, . 

From 5 to 10, . 

Males, 
Females, ^ 

From 10 to 15, 

Males, 
Females, . 

From 15 to 20, 
Males. . 
Females, . 

From 2!) to 25, 
Males, 
Females, . 

From 25 to 30, 
Males. 
Females, . 

Over 30, . 
Male, 
Female, . 



Total of 


Toialofeach 


Cured or 


C.SL'S. 


sex. 


Cur.ihle. 


232 








193 


no 




109 


100 


94 








49 


31 




45 


52 


109 








65 


18 




44 


18 


76 








40 


5 




36 


4 


56 






1 


35 


2 


1 


21 


1 


24 








16 


1 




8 





11 








7 







5 





5 








4 







1 





1 
















1 






' ot cured or 
Iniur.ible. 



13 

9 



18 
13 



47 
Ji6 



35 
32 



33 
20 



15 

8 



STATE LUNATIC HOSPITAL, 



39 



TABLE 12. 

Showing the causes of Insanity, 8^c. 



Intemjierance, , 




li29 


Periodical, .... 


112 


Masturbation, 




75 


Homicidal, .... 


]5 


111 health, . 




122 


Actual homicides, 


11 


Religious, . 




53 


Suicidal, or having a strong 
lirupensiiy to self-de- 




Loss of property, 




48 


1 slruction. 


69 


Disappointed affection. 




24 


Actual suicides, 


3 


Disappointed anjbition. 




20 


Many unknown, 




Hereditary, or having 


in- 








sane ancestors or near 








kindred, . 




210 







Of 312 Patients in the Hospital, whose cases have been examined, 149 had 
dark complexion, and other peculiarities as noted in the table. 



25 
121 



Dark hair, . 


141 


Full habit, . 


Dark complexion, 


149 


Spare habit, 


Dark eyes, . 


140 





Of the 312 above named, 165 have light eyes, and other peculiarities as 
rioted in the table. 



Light hair, . 


160 ; 


Full habit, . 


76 


Light complexion, 


163 t 


Spare habit, . 


88 


Light eyes. 


105 







40 



STATE LUNATIC HOSPITAL, 



TABLE 13. 

Shoicing the relation between tlic paroxysms of excitement in 50 cases of 
pei'iodical insanity, amounting to 35D paroxysms distinctly tnarked,and 
the state of the moon on the day of their occurrence. Also the rela- 
tion of the moon to the 37 deaths that have occurred in the Hospital. 



Numbr if p.. 


■oxy.-n 


s on each day. 


Number of deaths on each day 




D.iy of ilie Moou. 


1 1VI..K- 

1 


Fe- 

mi e 


irp , I First 


: Day of Ihe M on. 


Mae 


Pe- 
mu e 


Toial 


I First 
quar er. 


1 


i 

4 


3 


7 


1 


1 


1 





1 


1 


2 


1-^ 


1 


go 


2 


2 


2 


1 


.3 


2 


3 


10 


4 


14 


3 


3 


1 


1 


2 


3 


4 


9 


7 


16 


4 


4 


1 


3 


4 


4 


5 


5 


4 


9 


5 


5 


1 





1 


5 


G 


6 


6 


12 


6 


6 


1 





1 


6 


7 


7 


12 


19 


7 


7 





2 


2 


7 


End of First Quar- 








Second 


End of First Quar- 








Second 


ter. 








qua.te:. 


ter. 








quarter. 


8 


9 


4 


13 


1 


8 











1 


9 


6 


8 


15 


2 


9 


1 





1 


2 


10 


3 


3 


(> 


3 


10 


1 





1 


3 


11 


8 


5 


13 


4 


11 











4 


V2 


8 


7 


15 


5 


12 


1 





1 


5 


]3 


8 


5 


13 


6 


13 


3 





3 


a 


44 


6 


5 


11 


7 


14 


1 





1 


7 


End of Second Quar- 








'J'l.ird 


End of Second Quar- 








Tliird 


ter. 








quarter 


ter. 








quarter. 


15 


8 


6 


14 


1 


15 


1 





1 


1 


16 


7 


3 


10 


2 


16 


2 





2 


2 


17 


]l 


6 


17 


3 


17 





1 


1 


3 


18 


5 


5 


10 


4 


18 











4 


19 


3 


2 


5 


5 


19 





1 


1 


5 


20 


10 


2 


1-2 


6 


20 


2 


1 


3 


6 


21 


9 


5 


14 


7 


21 

Endof Tliird Qujr- 


1 





i^ 


7 


End<if Third Quar- 


Fourtl] 


Fourth 


ter. 








quarter 


ter. 








quarter. 


22 


10 


4 


14 


1 


22 


] 


'. 


1 


1 


23 


5 


7 


12 


2 


23 











2 


24 


12 


5 


17 


3 


24 


1 


1 i 


2 


3 


25 


5 


8 


13 


4 


25 


1 


1 i 


2 


4 


26 


8 


7 


15 


5 


26 


1 


I 


1 


5 


27 


1 


4 


5 


6 


27 





1 





6 


28 


4 


3 


7 


7 


28 

End of Fourth Quar- 


1 


1 


1 


7 


End of Fourth Quar- 


25 


12 


37 




ter. 








i 


ter. 











Jn 25 cases, the jjaroxysms occur at very nearly regular periods of 4, 6, 8, and 12 weeks. 
Ten of these occurred at nearly regular monthly periods, six at periods of from 6 to S weeks. 
Pne occurred every other day. — Some every third month, some every fourth, and 2 every 6 months. 
There are also many cases that occur every year, and many oth«r» at periods of 2, 3, 4 and even JO 
f«ar«. JU»ny such eases ar« not regular. 



STATE LUNATIC HOSPITAL. 



41 



TABLE 14. 

Classification referring to the kind of Insanity. 



Mania, . 
Males, 
Females, 



Monomania, or Melancholia, , 
Males, . . . . 
Females, . . . . 



Demented, 
Males, 
Females, 



Idocy, . 
Males, 



Whole 


No. ofesich 


Cured or 


Number. 


sex. 


Curable. 


364* 








199 


102 




170 


102 


171 








99 


53 




72 


42 


103 








63 


2 




40 


3 


5 


5 





Tot il of Cur- 
ed or Cur- 
able. 



204 



95 



Per cent, of recoveries of Mania, . . . 56 2-3. 

Per cent, of recoveries of Monomania or Melancholia, 55 1-2. 

Per cent, of recoveries of Demented, ... 5 



One third probably Aloral Insanity. 



42 



STATE LUNATIC HOSPITAL. 



TABLE 15. 

Shoiving the relation between Cause and Recovery. 



Intemperance, 
Males, 
Females, . 

Domestic afflictions of various kinds 
Domestic broils. Ill requited love 
Anxiety about property, &c. 

Males, . . . . 

Females, .... 

Ill health, including wounds, puer 
peral, amenorrhcea, 
Males, 
Females, . 

Religious of all kinds, 
Males, 
Females, . 

Masturbation, . 

Males, 
Females, . 

Epileptics, 

Males, . 
Females, . 

Palsy, . 

Males, . 
Females, . 



Whole 
Number, 



128 



154 



121 



53 



75 



24 



11 



No. Of each 

St'X. 


Cureil or 
Curable. 


Ill 

17 


57 

8 


65 

89 


37 
49 


31 

90 


14 

60 


32 
21 


17 
11 


63 
12 


9 
1 


22 

2 


4 



11 




2 





Ni't Cured or 
incurable. 



54 
9 



28 
40 



17 
30 



15 
10 



54 
11 



18 
2 



STATE LUNATIC HOSPITAL. 43 

Another year of prosperity is added to the records of the Hospital, 
and we here present our annual tabular view, which will show what has 
transpired in our wards for the past year, and in what condition we 
commence another. 

In less than five years, we have received six hundred and seventy- 
eight patients, making more than what is equal to an entire change ev- 
ery year. 

We have sent back to society and their friends, a large number en- 
tirely restored to health and a sound mind, and many more whose con- 
dition has been essentially improved. With this large number of the 
insane, many of whom were furious and dangerous, so as to make it 
quite unsafe that they should be at large, we have been preserved from 
any serious accident and from dangerous disease. 

Table L By the extracts from our records here presented, it will 
appear that we have admitted into the Hospital, in the course of the 
last year, one hundred and sixii/'cight patients ; ninety-fimr of whom 
were males, and seventy four, females. Seventy-three of these were re- 
cent cases, in which insanity had existed less than one year, aiidnincty- 
five were from one to thirty years duration ; while only thirty-nine pri- 
vate boarders have been received, one hundred and twenty-nine have 
been sent to us by the courts, as of the class considered dangerous to 
be at large. 

The number of patients that remained in the Hospital at the end of 
the last year, was one hundred and thirty-eight ; which, added to the 
number admitted this year, makes the number that were in the Hospital 
during the year, to be three hundred and six. 

The number of deaths has been 7iinn, which is 07ie of thirty-four of 
all who have been in the Hospital the last year. 

It may not be improper here to remark, that in the copy of our re- 
cords, which immediately precedes this table, many are recorded as 
" not improved." The term is used in these tables to signify, that the 
delusions of insanity remain as they were, and that in this respect only, 
they are not improved, for in many of these cases, all the habits and 
feelings, and indeed the whole physical and moral being is changed ; 
many who were violent and boisterous are calm and kind in their feel- 
ings, many who were filthy and degraded, are now cleanly in their hab- 
its and have sufficient self-respect to prevent any impropiiety of con- 
duct, unless unduly excited. 

Table 2. By the second table it will be seen, that one hundred and 
tioenty-one patients have been discharged from the Hospital during 
the last year. Of whom, seventy-r>ne were males, and ffty, females , 



44 STATE LUNATIC HOSPH^AL. 

sixty-nine of these recovered, twenty-four were improved, eighteen were 
not improved, and nine have died. Oi the fifty-eight recent cases dis- 
charged, ffty-two recovered, four were improved, and fz^^o died soon 
after they entered the Hospital. 

Of the sixty-three old cases discharged, .seytniee/z recovered, iioenty 
were improved, eighteen were not improved, and seven died ; leaving, at 
the end of the year, one hundred and eighty-five inmates of the insti- 
tution. 

The success of the Hospital as a curative institution has been greater 
than any former season, amounting to ffiy-seven'^er cent, of all the ca- 
ses, eighty-niyie per cent, of recent cases of less than one year's dura- 
tion, and twenty-five per cent, of old cases, of the duration of one year 
or more. 

The number of curable cases rarely exceeds twenty-five in the Hos- 
pital at one time ; and this number is changed usually at least twice, 
and, sometimes, three times a year. It will be observed that we predi- 
cate our ratio of cures upon the discharged. As our accommodations 
have often been extending, we have supposed this the fairest mode of 
estimation ; the number admitted having increased as our accommoda- 
tions have been made ready. In an institution full of patients, as this 
has been for some two or three years, it will be obvious that the dis- 
charged and received must be equal, or nearly so; in this case, it is 
quite immaterial on which the per cent, of cures is estimated. 

Tables 3 and 4. From these tables, various statistical facts can be 
obtained, which will in some measure explain the foregoing remarks. 

The year commenced with one hundred and thirty-seven patients, and 
closed with one hundred and eighty-five, notwithstanding the discharge 
of owe hundred and ticenty-one, leaving in the }iios^'\td\ forty-eight more 
at the end of the year, than were in it at the commencement. The av- 
erage for the year 1836, was one hundred and twenty-seven. The aver- 
age for 1837, has been about one hundred and sixty-three. Notwith- 
standing that nearly sixty apartments were added to the Hospital in the 
summer of 1836, all its wards were crowded in a few months, and in 
the spring of 1837, twelve patients were sent away for want of room. 
During the summer, we suffered much inconvenience from numbers, in 
anticipation of the completion of the unfinished wing of the Hospital, 
which, in September of the present autumn, was finished and ready for 
the reception of patients. At the present time, the male wing is full of 
patients, but the female wing will admit twenty-five more without in- 
convenience. 

Tm 5t,«Ij, pTp ANp 7th Tables. Thg ftatisji^al tttJes of ^ Ups- 



STATE LUNATIC HOSPITAL, 45 

pital met with such general approbation last year, that I have thought 
it expedient to continue them. 

From the tables above enumerated, many interesting facts can be 
learned, and many useful deductions can be made. They are, in fact, a 
map of our condition, from the commencement of operations to the close 
of this year. From them it can be shown what all our efforts have ef- 
fected in recovering and improving the condition of those consigned to 
our care. They show that the success of the present year has raised 
the general average of recoveries ^xom Jifty-twoio fifty-four and a half, 
the average of recent cases, from eighty-three to eighty-six, and the av- 
erage of old cases from eighteen to twenty. 

The whole number of recoveries since the Hospital was opened, has 
been two hundred and sixty-seven. The number discharged improved, 
in the same time, has been ninety-two, many of whom were nearly well, 
and others still improving. 

The facts embodied in these tables continued from year to year, it is 
conceived, will throw much light on insanity, should other institutions 
adopt this mode of reporting, the comparative success would be easily 
discovered. 

Table 8. This table is devoted to the subject of employments, [t 
shows that there have been in the Hospital, ninety-one farmers, seventy- 
six \3hoxexs ; thirty-two shoemakers; tiventy-f our se?imen, rnidi twenty- 
one merchants, &:-c. 

From a former report in which we alluded to the subject of employ- 
ment, incorrect inferences were made by the public from the number of 
farmers found on our list. 

It must be recollected, that in this institution a large proportion of 
the patients come from the middle and lower classes of society. It will 
be found, upon inquiry, that the proportion of farmers in the institution 
is less than their proportion in the community from which our patients 
are derived. No one can deny that there are more farmers than mechanics 
in this community, and yet there have been one hundred and iwelveme' 
chanics, and but ninety-one farmers. 

There is another fact on this subject, also worthy of regard. The 
farmers are almost exclusively of our own people, native citizens, their 
occupation is known, and our record is complete in reference to 
them. In other employments it is not as much so; trades become 
blended, the Blacksmith is a Machinist, and so is the Carpenter; many 
tra^desmen are occasionally laborers or teachers, and sometimes farmers. 

It has been a common remark, that those persons who are engaged 
in iogenipus §naploymeQt§j aijd vx iwvestigaung iutrlQats subjeQts, jaave 



46 STATE LUNATIC HOSPITAL. 

been more frequently the subjects of insanity than others. Whether 
this be true or not, the cause of disease in such cases is generally mis- 
taken. Those employments which confine the individual in unnatural 
positions for a long time, or that are sedentary or inactive, tend to the 
production of disease, and insanity with others. So also those em- 
ployments which expose to the vicissitudes of climate and weather, and 
to the various irregularities of the seaman's life, may be likely to pro- 
duce the same results, yet we have known but few seamen insane, who 
were temperate in their habits. 

I am disposed to attribute much less to employments in the produc- 
tion of insanity, especially those employments which call forth ingenuity 
and skill, than to that restlessness of temperament, which leads men to 
exert themselves to acquire wealth and renown in unusual ways. The 
high expectations excited in many such cases, are not realized, success 
does not attend their efforts, and a failure produces mortification, and 
disappointment. From this high pitch of excitement, and unwearied, 
incessant effort, the mind suddenly falls into new and depressing trains 
of thought. Such changes must be as hazardous to the integrity of 
intellect, as speculation is to morals, and insanity comes in the one 
case, as bankruptcy and crime do in the other. More depends upon 
temperament than employment ; much ulso depends upon a want of 
discipline of the feelings in early life; that disappointments should not 
overwhelm, and a want of success produce discouragements that de- 
stroy ambition and sink us into apathy and imbecility. 

During the last year, there have occured many instances of insanity 
from the depression of business and the disastrous results of specula- 
tion. The radical difficulty consists in the spirit which impels to haz- 
ardous adventure, and the want of that discipline of mind which will 
buoy it above the vicissitudes of fortune. 

Very few of the steady, industrious and temperate members of our 
coiTimunity become insane. This is not a rule however without some 
exceptions, though perhaps fewer than would be thought, without reflec- 
tion upon the subject. 

Table 9. Reference to this table will shew that the number of 
deaths is comparatively small, while those that have occured have been, 
with a few exceptions, from chronic disease. Cases from febrile and 
inflammatory disease have rarely occurred ; for months together we 
have not had a solitary case. No epedetnic has ever visited us, unless 
it be diarrhoea and jaundice, the former of which prevails to some ex- 
tent every summer and autumn in a mild form. 

During the last quarter of the present season, ten or twelve cases of 



STATE LUNATIC HOSPITAL. 47 

jaundice occured in the Hospital, a large proportion of which were at- 
tendants ; most of them were mild in their character, and all recovered. 

Table 10. This table does not vary the result of last years' expe- 
rience, and shows, what seems hardly credible, that patients over fifty 
are more sure to recover than those attacked in earlier life; particularly 
than males under twenty, so many of whom are subject to masturba- 
tion, which almost wholly precludes the hope of recovery. This rule 
does not hold true of females. Oi forty males under twenty years of 
age, thirteen only recovered ; which is but thirty-tico and a half per 
cent. Of thirty-five females under twenty, twenty four recovered, which 
is sixty-eight and two-thirds per cent. 

Of two hundred and seventy-seven patients under thirty years of age, 
one hundred and thirty-one recovered, which is forty-seven and one- 
third per cent. Of two hundred and forty-eight patients between the 
ages of thirty and fifty ^ one hundred and forty recovered ; which is 
fifty-six and two-thirds per cent. 

Of ninety-one patients between the ages of fifty and seventy-five, 
fifty-eight recovered, which is sixty-three and two-thirds per cent. 

Table 1L From this table we derive the following valuable facts. 
Oi two hundred and thirty-tiro patients whose insanity is of less than 
one year's duration, ttco hundred and te7i recovered, or are likely to re- 
cover : which will make about ninety per cent. Should however one 
or tiDo, now in the Hospital, considered curable, fail to recover, it may 
make a slight variation from this estimate. There are but three patients 
who came into the Hospital as recent cases, that now remain, the dis- 
ease having become chronic; and two of these had been for many 
years periodical, before the attack of which they have not yet recovered. 

Of the ninety-four cases of from one to two years' duration, sixty- 
three recovered ; which is sixty -six and three-fourths per cent. Of one 
hundred and nine cases, of from two to five years' duration, thirty-six 
recovered ; which is thirty -three per cent. Of seventy-six cases of from 
five to ten years' duration, nine only recovered, which is less than 
twelve per cent. 

Of ninety seven cases of more than ten years' duration, four only 
recovered, which is about four per cent. 

These are important and interesting facts to those who have friends 
affected with this formidable disease, no time should be lost in placing 
all recent cases in institutions of this character, where the most effect- 
ual remedial means can be applied, before the brain and nervous sys-* 
tem undergo those organic changes, which preclude the hope of re- 
covery. 



48 STATE LUNATIC HOSPITAL. 

Table 12. Has reference to the causes of insanity and the pecu- 
liarities of constitution, temperament, and hereditary taint which pre- 
dispose to insanity. 

Intemperance takes the lead of causes, at present, although the pro- 
portion of cases, from this cause has been very perceptibly diminishing 
for the last two years. The number of cases of delirium tremens, has 
not exceeded half a dozen since the opening of the Hospital. The 
number noted as hereditary is quite large, comprising nearly one-third 
of the patients that have been in the Institution. It will be observed 
that we do not confine the term to insane ancestors, merely, but to 
other collateral kindred ; showing rather the peculiar liability of fami- 
lies to insanity, than any direct hereditary taint. 

By periodical insanity, in this table, is meant, all cases that are dis- 
posed to periodicity, whether in paroxysms of a few v.'^eeks, or in periods 
of one or many years. 

There is something very interesting in this subject of periodical in- 
sanity which is as inexplicable as it is curious. 

That an individual should, once a month, or once in two, three or 
more months, be affected with insanity, so violent as to be outrageous 
and dangerous, destroying every thing that comes in his way, and strip- 
ping off his garments, clothing himself in rags, or remaining destitute 
of covering, this paroxysm lasting a definite period, and then leaving 
him rational, decent in appearance, and modest and quiet in demeanor, 
is one of those unaccountable circumstances of disease, which is hidden 
from human scrutiny. Such, however, is the fact, and such the hidden 
workings of the causes of disease, that many of its phenomena are in- 
explicable although perfectly apparent. More than tioenty per cent, of 
the patients in the Hospital have apparent periodicity of disease, and at 
least half that number, a distinct and marked periodical character. A 
greater number of these occur at about a monthly period than any 
other : this, in females, is often connected with other circumstances of 
health, but not uniformly so. The periodicity has been ascribed to lu- 
nar influence, some facts connected with which, are given in a table, 
which we shall notice in due time. 

Next to epileptics, old periodical cases of a bad character are the 
most uncomfortable inmates of an institution, as every new occurrence 
of disease has all the violence and severity of a recent attack. 

On the subject of homicidal insanity, I would merely remark in this 
place, that none are so denominated, but those by whom a homicide 
has been effected, or seriously attempted, and nearly effected. The 
mere threatening to kill, in a moment of passion or excitement, does. 



STATE LUNATIC HOSPITAL. 49 

not signify a serious intention to commit homicide, and in no case is 
here denominated homicidal insanity. 

To the physician, the lawyer and the judge, homicidal insanity is a 
subject of deep interest, and, even in this enlightened age, is very im- 
perfectly understood. In the sequel, it is my intention to remark upon 
it briefly, and detail some cases illustrative of the principle of insane 
impvhe, which may throw some light on this interesting question of 
medical jurisprudence. 

There have been in the Hospital since it was opened, eleven cases of 
insanity, the subjects of which have actually committed homicide ; and 
four others in which dangerous wounds were inflicted, where escapes 
nearly miraculous saved the lives, perhaps, in each case of two individ- 
uals. 

The propensity to suicide is far more common. A great proportion 
of melancholies contemplate it, and the various modes by which it may 
be effected. Many actually attempt it, and many more suffer much 
from fear that they shall, in a moment of desperation, be left to commit 
a deed which they contemplate with the utmost horror. 

Sixty-nine cases are here recorded as suicidal ; many more have 
doubtless been so. Three suicides only have taken place in the Hos- 
pital, and these were all effected by strangulation. One of these per- 
sons talked about it every moment, and was watched with the utmost 
vigilance, but eluded it for a very few minutes, by feigning sound sleep, 
and thus effected the design. The other two had never mentioned it, 
and were not suspected of suicidal intentions; one had been in the 
Hospital less than two days. 

The remaining part of the table is occupied by some facts on the 
subject of complexion, color of the hair and eyes. 

Of three hundred and twelve patients whose cases have been noted, 
one hundred and forty-nine had dark complexion, and most of them 
dark hair and dark eyes ; twenty-five of them were of full habit, and 
one hundred and ticenty-one were spare. 

One hundred and sixty-five had light eyes, and most of them light 
complexions and light hair. Seventy-six oi i\\Qm were of full habit, and 
eighty-eight were spare. In New England, I believe it is conceded, 
that there are more than two individuals of light complexion, hair 
and eyes, to one with dark ; if so, the commonly received notion, that 
persons of dark complexion are more liable to insanity, is confirmed by 
the table. It is interesting to record fiicts that may prove the accuracy 
or fallacy of popular opinions ; for what are at this day popular and 
even vulgar notions on these subjects, have at some time in the history 



50 STATE LUNATIC HOSPITAL. 

of mankind been considered sound philosophy and the oracles of truth. 

From this table we have one fact, which I believe will hold true 
elsewhere. Of one hundred and forty-nine cases of dark complexion, 
twenty-jive only were found of full habit, while one hundred and twenty- 
one were lean and spare. 

Of one hundred and sixty-Jive with light eyes, complexion, &c., sev- 
enty-six were found inclined to corpulency, and eighty-eight were spare. 

In asylums of this character, as before remarked, it is considered 
proper and important to test by facts, the commonly received opinions 
of mankind with respect to insanity. If true, important considerations 
may result from them ; if not true, they should be discarded and re- 
jected. In all the institutions of our country, such a number of facts 
may, in time, be accumulated, as to settle any question of this kind, 
which may influence the public mind. 

Considerations like these, influenced me to collect the facts in the 
following table, upon the influence of the moon in producing excite- 
ment with the insane. A late medical writer* has devoted a long 
chapter of his work on insanity to the consideration of this subject, and 
has collected much testimony to show that lunar influence is as appa- 
rent in the physical system of man, producing changes and disease, as 
it is in the physical system of nature in the production of tides, tem- 
perature, the variations of atmospheric pressure, &c. The truth or 
fallacy of such conclusions can only be tested by facts, aad we offer 
the following table, to show what is the best record of facts that we 
can produce on this topic. 

Table 13. Fifty periodical cases have been selected, who have had 
three hundred and Jifiy paroxysms of excitement, distinctly marked. 
These paroxysms occurred on the day of the moon, as noted in the ta- 
ble. The greatest number of paroxysms in the table, which occurred 
on any day of the moon, was the second of the new moon, to wit, 
twenty-two. 

The next greatest number occurred on the seventh or last day of the 
Jirst quarter, to wit, nineteen. On the third day of the third quarter, 
and on the third day of the fourth quarter, an equal number occurred 
on each, to wit, seventeen. 

The first, the tenth, the nineteenth, the ticenty-stventh and twenty- 
eighth show the occurrence of the least number of paroxysms. The 
two extremes are twenty -two andjjyf. 

Of the thirty-seven deaths that have occurred in the Hospital, twenty- 

* Allen on Insanity. 



STATE LUNATIC HOSPITAL. 51 

Jive have been males, and twelve have been females. The greatest 
number of deaths occurred on the fourth day of i\\e first quarter, viz., 
four. On the second day of the first quarter, on the sixth day of the 
second quarter, and on the sixth day of the third quarter, an equal 
number of deaths occurred on each, viz., three. On the first day of 
the second quarter, on the fourth day of the second quarter, on the 
fourth day of the third quarter, on the second and sixth day of the 
fourth quarter, no deaths have occurred. 

We leave these facts without comment, and simply remark, that in 
bright, pleasant moon-light nights, patients are more inclined to be up 
and about their rooms in our wards, than in dark and gloomy weather ; 
in summer they spend more hours out of bed, in the night time, than in 
winter. 

To those who are affected with visual illusions, the flickering of the 
clouds in a moon-light night, and the rapid movements of their shadows 
upon the walls and floors of their apartments, with the help of an ex- 
cited and distempered imagination, may awaken fancies calculated to 
excite either the most pleasant emotions, or the most appalling and 
alarming fears, of which the insane are susceptible, such we know to 
be reality. 

Table 14. This table shows the proportion of the different kinds 
of insanity that have been in the Hospital. Mania very much predom- 
inates; Monomania has increased during the last season, in a greater 
ratio than before. The strongly marked cases of these forms of insan- 
ity, are very unlike, and are easily recognized. The milder cases are 
far less so, and in many the symptoms are so blended or present them- 
selves so distinctly in each form at different times, as to make it diffi- 
cult and uncertain what the classification should be. Monomania is 
probably more frequently characterized by delusion, than Mania; yet 
the impulses of excitement in Monomania often have no perceptible 
connexion with that delusion. 

If by Mania, be understood only that form of insanity, which is at- 
tended by an equal disorder of all the faculties of the mind, — then, in- 
deed, there are few cases of Mania. The most violent and chaotic 
state of the mind, is often attended by a lucid action of some one or 
more of the faculties, the recollection of persons, events, and circum- 
stances, which is quite surprising. Many cases are not classified in 
this table, it not being satisfactorily ascertained where they would pro- 
perly belong. 

So far as this table is a guide, the recoveries are about equal in 
these two forms of insanity. 



53 STATE LUNATIC HOSPITAL. 

In the sequel, I propose to speak briefly of that form of insanity in 
which there is no delusion; together with some cases illustrative of its 
character. It is denominated by Penel, 3Iania without delirium ; but 
is now better known by the term Moral Insanity. 

Table 15. Showing the relation between cause and recovery, ex- 
hibits much that is interesting. The cases from intemperance, being 
principally males, show a very large proportion of this sex are made 
insane by this cause. The number of males that have been in the in- 
stitution since its occupancy, has been three hundred and seventy-six ; 
the number of males whose disease was produced by intemperance, is 
one hundred and eleven; almost one-third of the whole. 

In cases from domestic affliction, the number of females is still great- 
er than of males ; there being eighty-nine females to sixty-Jive males. 

In cases from ill-health, the disparity is still greater ; there being 
ninety females, and only thirty-one males. 

Insanity from religious causes is found, as heretofore, to affect males 
more than females; in the proportion of thirty-two males to twenty-nne 
females ; a great disparity. In this Hospital we have always admitted 
the Bible freely into all our apartments; we have permitted all our pa- 
tients to read it as much as they choose, no evil that is appreciable has 
arisen from it, far less, it is believed, than would arise from withhold- 
ing it. 

The conflicting systems of religious belief, may confound and dis- 
tract the mind of an anxious inquirer, who searches every thing, and 
inquires of all, to ascertain the way of truth. But the pure, gentle, and 
benign principles of the Prince of Peace, have the most soothing and 
consoling influence upon the mind and feelings of those who seek re- 
lief from the thousand ills to which we are incident, in the pilgrimage 
of life. 

The caviller may accuse religion of producing insanity : but he does 
not see how many causes of insanity it averts, how much comfort it af- 
fords to the weary and heavy-laden, how effectually it buoys up the 
desponding, and how directly it points to the transgressor, the way of 
pardon and of peace. If, by a mistaken view of Christianity, a few are 
led into the mazes of delusion, how many thousands, by relying with 
confidence upon its promises, as an anchor of hope, sure and steadfast 
in every trial, have avoided that shipwreck of the mind, which nothing 
else under heaven could have averted! 

Religion, instead of having a tendency to produce insanity, affords 
the surest and most effectual security amid all the trials of life, which 
tend directly to distract the mind. 



STATE LUNATIC HOSPITAL. 53 

The number of cases of insanity, from masturbation has been even 
greater than usual the past year, and our ill success in its treatment, 
the same. No good, whatever, arises in such cases, from remedial 
treatment, unless such an impression can be made upon the mind, and 
moral feelings of the individual, as to induce him to abandon the habit. 
In this attempt, even with the rational mind, we have to encounter mis- 
taken views as well as active propensities. No effectual means can be 
adopted to prevent the devastation of mind and body, and the debase- 
ment of moral principle from this cause, till the whole subject is well 
understood and properly appreciated by parents and instructors as well 
as by the young themselves. 

During the last year, we have had an unusual number of Epileptics, 
in the Hospital. In the whole time they have amounted to hccnty-fovr , 
four of whom have been recorded as curable. 

It is doubtful whether insanity arising from epilepsy or from that 
condition of the brain which produces epilepsy, is ever cured. In the 
cases above alluded to, as being cured, the insanity was supposed to 
arise from other causes, in two at least from intemperance, in one, from 
masturbation, which habit being removed, both the epilepsy and insan- 
ity disappeared, and have never returned. 

The recoveries from insanity arising from intemperance, are about 
fifty per cent. ; arising from domestic afflictions, something more than 
fifty-jive per cent. ; arising from ill-health, something more than sizty- 
two per cent. ; from religious causes, about fifty-two per cent. ; from 
masturbation, about thirteen per cent. 

On the subject of causes, it may be remarked in general, in this 
place, that we have not the information in all cases that is desirable. 

Many patients are brought into the Hospital by strangers, who have 
no knowledge of their previous history. The friends, when they have 
them, are careless and negligent; many foreigners have no friends in 
the country who take an interest in their welfare. 

Having, at some length, gone through with an explanation of these 
tables, I hope in such a manner as to make them intelligible, I will now 
very briefly examine the subject referred to in the former part of this 
report. 

Moral Insanity has, to this time, received very little attention in this 
country, although many decisions of our courts have been predicated 
upon it, because the evidence of insanity, displayed in all the conduct 
of the individuals arraigned before them, has been marked and une- 
quivocal, though no delusion or hallucination has been proved. When 
an insane man is brought before the proper tribunal for committal to 



54 STATE LUNATIC HOSPITAL. 

this Hospital, the question — whether the man is under the influence of 
a delusion of the senses or of the judgment — is not asked — but whether 
he is dangerous to be at large. With direct reference to this subject, 
I have examined the records of this Hospital, and am satisfied, that at 
least one fourth of the cases of mania committed by the courts, belong 
strictly to the class of moral insanity. In practice, therefore, this class 
of insanity is recognized, although in theory it is not. 

Insanity is a physical disease. The operation of the feelings and 
passions depends upon the physical system no less than the understand- 
ing. By physical disease the understanding becomes affected. The 
senses often become false guides, the perceptions are mistaken, and the 
judgment becomes false and impaired. Is it not well known, that the 
passions and propensities are even more affected by disease than the 
mental powers? Is it unphilosophical or irrational to suppose, that 
these faculties can be subject to such impairment, as to be beyond the 
control of the reasoning powers and the judgment? If not, then, when 
in that condition, they must render the individual irresponsible. 

It is rare that the paroxysm of excitement, with an insane man, is so 
great as to be beyond the power of control, if a motive sufficiently 
strong could be presented at the moment. This has often led me to 
remark, that no insane man is beyond the reach of a motive, if the 
motive is presented in the right time and the right manner. 

The case No. 8, in the report for 1836, is one that illustrates this 
view of the subject, as well as being a fair case of moral insanity. It 
was a long time before the influence used with this man could induce 
him even to wear clothes, or be an hour with a companion. Difficul- 
ties were constantly arising with him from the most trifling causes, 
motives were frequently presented to him, in the kindest manner, which 
would greatly promote his comfort and happiness, but in vain ; he 
could not control his feelings or passions. After a long time, he was 
persuaded to accept a highly advantageous offer ; the motive proved 
sufficient for his self-control, and he now, for the first time, fulfilled his 
pledge. From a naked, raving maniac, he was soon transformed into 
a respectable mechanic, continued to perform all that was desired of 
him for a suitable time, and was discharged from the Hospital. I late- 
ly received a letter from this man ; he has labored constantly since he 
was discharged, and is now in all respects well. 

Case 2d. Another person, the subject of a cure not less remarka- 
ble, left the Hospital in the autumn. The patient was a seaman ; when 
on a voyage, he had received an abuse from his captain, for which he 
received one thousand dollars damages. By his friends, and by the 



STATE LUNATIC HOSPITAL. 55^ 

court, he was considered insane when this outrage was committed. 
When in the Hospital for a year, he was a most troublesome and dan- 
gerous man ; his disposition to injure others, both attendants and in- 
mates, was such, that we were compelled to confine him, much of the 
time, in a strong room. He would frequently converse rationally, and 
express deep regret that he was not able to command his temper. 
Some time in the summer, having committed a serious assault on his 
attendant, he had been confined for a length of time. On my visit to 
him one morning, I said to him, " I am now about to make you a new, 
and perhaps the last proposal for indulgence, I have taken your word 
many times, but you have violated your pledge ; I make you this offer, 
because I believe it to be in your power to govern yourself better. I 
believe you can be useful to your friends, and a respectable member of 
society. I also wish to show you that we all feel deeply interested in 
your welfare and happiness." He heard the proposal with deep inter- 
est, and with considerable feeling promised to conduct in all respects 
with propriety and decorum. He was admitted into the wing, and 
received every indulgence consistent with the rules of the Hospital. 
For some days he conducted well. At this time I took a journey of a 
few days; on my return I found him in the strong room; he had had 
an outbreaking in my absence, and my assistant found it necessary to 
confine him. On my first visit to him after my return I said little to 
him, on the second I expressed my regret at finding him again seclud- 
ed, and said to him, as I was not present myself to see how well he 
could conduct under his new pledge, I would again permit him to go 
into the wing if he chose. He said in a subdued tone that he should 
be grateful to do so, and burst into a flood of tears. I then renewed 
my promise to him, and ofl^ered him every indulgence and every en- 
couragement in my power. He was deeply affected, and assured me, 
in the most solemn manner, that he would never again abuse my con- 
fidence, but would effectually control himself From this time he 
behaved with perfect propriety, labored regularly every day, and fre- 
quently quite alone. After some weeks he left the Hospital, a very 
pleasant, grateful and happy man. 

In these and many similar cases we could never discover any hallu- 
cination of the mind. In this form of insanity, moral means, rightly 
adapted, can accomplish much. The inculcation of self-respect and 
self-control, daily and constantly, will have its influence, and effect 
its object, if persevered in with a right spirit, after the confidence of 
the patient is gained. 

Besides this disease of the moral powers, there seems to be, in some 



5& STATE LUNATIC HOSPITAL. 

cases, something like Moral Idiocy, or such an imbecile state of the 
moral faculties, from birth, as to make the individual irresponsible for 
his moral conduct. The persons to whom I allude have rarely much 
vigor of mind, although they are by no means idiots in understanding. 
Of the idiots that have come under my care, there have been some, 
whose minds are very imbecile, who seem to have considerably correct 
views of moral obligation, and whose moral powers are susceptible of 
culture. There are others, who, having much better powers of under- 
standing, are capable of learning to read, and of understanding what 
they read, yet seem to have little or no moral sense. 

We have had both these forms of idiocy in the Hospital. I have 
also been consulted in a number of similar cases abroad, and have seen 
a few young children, considered insane or idiotic, whose propensity 
to mischief was remarkable, and constituted the principal feature of 
disease. 

There is also what I denominate Insane Impulse, which is an 
uncontrollable propensity, as transitory as it is sudden, by which an 
act is committed without one moment's reflection or premeditation, the 
individual being sometimes perfectly conscious of what he is domg, 
and sometimes apparently not at all so. The mind, in such a case, 
may be under the influence of a delusion, or it may not ; even when it 
exists, the delusion does not always impel to the deed of outrage, nor 
has it in many cases, as far as can be discovered, any connection with 
it in the mind. To illustrate this principle more clearly, and to show 
how remarkably some of the faculties of the mind are retained, when 
others are entirely under the influence of disease, I relate the following 
cases, which were given to me, in detail, in the course of the present 
season, by the individuals themselves now under my care. 

No. 1 was a shipmaster. In his early life he was industrious and 
persevering, and accumulated a comfortable estate. Whether he was 
insane before he left this employment, is unknown, but, from some cir- 
cumstances detailed by himself, it is quite probable that he was. About 
the year 1800, he abandoned the seaman's life, and attended to his farm. 
Soon after he commenced this new employment, he received the ap- 
pointment of collector of taxes, and was also constituted an agent to 
adjust some difficulties with a neighboring town. We have no evi- 
dence respecting the manner in which he did this business, probably 
satisfactorily, as he was afterwards placed on the list of jurymen, and 

drawn to attend a court in the neighboring town of . These 

appointments seemed strange to him, as he had led a seaman's life, and 
knew little of the transactions of cpurts pr the duties of a juryman. 



STATE LUNATIC HOSPITAL. 57 

He, however, concluded to go to the court, seventeen miles from his 
own dwelling, and started on foot, on the morning of the day of the 
session, before dawn. While on his way his head became painful and 
confused, he stepped into a lawyer's office where a number of men 
were doing business, in a few minutes his mind became confused, and 
all persons about him seemed to be devils; he hurried out of the house, 
and proceeded onward to the court-house, where he found many persons 
assembled, but the court was not in session. In a few minutes he again 
became confused, and suddenly blind; every thing appeared strange 
to him ; as soon as his sight was sufficiently restored, he left the room 
in haste, and went out upon the village green ; every person that ap- 
peared about him looked strangely, and seemed a devil. After a while 
a stage-driver came to him, and urged him to go into the court-house, 
which he was finally persuaded to do. When he entered the house 
the court was in session and the jury in their seats. He thought it 
very strange that he should not be called upon to act as juryman, as 
he had been regularly summoned, and had the paper in his pocket at 
the time. While in this perplexing and unpleasant situation, his head 
became again confused, and all persons present seemed to be devils; 
his sight was again lost, and in the utmost confusion he rushed from 
the court room. As soon as he recovered his sight and presence of 
mind, he took the road to his own home, and proceeded at a rapid 
pace for a considerable distance, till he reached a burying ground, 
where he again lost his sight, stopped, and lay down upon the ground. 
Overcome with fatigue, he probably slept soundly for some time, he 
was not at all conscious how long. When he awoke, he found a man 
of genteel appearance by his side, who urged to be employed ; he then 
believed, as he now does, that this unwelcome companion was a ghost. 
He endeavored to get rid of this disagreeable person, but he still con- 
tinued by his side, and urged his claims for employment ; he was 
repeatedly told that no employment could be furnished him, yet he 
continued by his side a long way on his journey, when he suddenly 
disappeared, and no more was seen or known of him. Soon after the 
curious stranger left him, he seated himself on a piece of ship-timber 
by the way side, and was again lost in sleep or reverie. He was sud- 
denly aroused by a noise, and, waking, found a coach standing before 
him, the driver of which, the man who accompanied him into the 
court-house, invited him to get into the carriage and ride ; he drove 
him directly to his own home. It was night when he arrived, and his 
wife had taken tea with her father and mother, who were then in the 
house. He was invited to take his supper, which he did, as he had not 



58 STATE LUNATIC HOSPITAL. 

eaten during the day, and felt the need of food. After supper, he took 
a pail, went to the barn and milked his cow. When he returned, he 
heard his wife's father say to her, that he would send some watchers, 
the meaning of which he did not understand. The father stayed in the 
house, while the mother returned home alone, which was unusual, and 
appeared strange and perplexing to him. The watchers came, and re- 
mained in a separate room from the one which he occupied ; he retired 
early; soon his wife came to his bedside, and asked him if she might 
come to bed, this appeared to him singular and unaccountable; he 
knew no reason why she did not come to bed as usual. Such was the 
painful and confused state of his head, that he could not sleep, his wife 
also appeared anxious, restless and wakeful. Early in the morning, 
he arose, took his pail, and again milked his cow. One of the 
watchers left early ; the other, a brother of his wife, remained, and took 
breakfast with them ; nothing occurred to disturb the harmony of the 
interview. After breakfast, the brother spoke of returning home ; he 
proposed to our patient to take his wife's shoes to his shop and mend 
them, for he was a shoemaker; his wife urged him to do this, evidently 
wishing him to accompany her brother. He objected, and said that 
the shoes were not worth mending. The brother soon returned to 
his home, and left no one behind, except our patient, his wife, and 
their two small children. After some time, he heard his wife tell the 
little boy to go and call his grandfather, who lived at the distance 
of a quarter of a mile. 

In the mean time, to use his own expression, our patient " was chor- 
ing about the yard and barn." Before the child returned or the father 
made his appearance, his wife had prepared something to drink in a 
large china bowl, and invited him to partake with her; what the liquor 
was, he could not exactly tell ; but he could perceive that it had "cher- 
ry rum" in it. He observed that the last business he did before he 
went to court, wp.s to "top his stalks and prepare his cherry rum." 
He remarked, " we sat down together in as much love as ever, (a word 
which he always uses for kindness, regard, and affection,) and there 
had never been any difficulty between us ; both sipped the liquor and 
sat sometime talking in love or occasionally tasting the contents of the 
bowl." All at once, his wife appeared and acted strangely, as he 
thought, and, as he said, " every thing was hurly-biirly " his head was 
terribly confused and he was very angry. He got up quickly from the 
table, took a billet of wood that lay upon the hearth, and stepped into 
the pantrv : he then set the wood down, his mind was as confused 
as ever ; he again took up the wood, and advancing silently behind his 



STATE LUNATIC HOSPITAL. 59 

wife gave her the fatal blow as she stood facing the fire. She instantly 
fell before him ; he then stepped into the pantry, took his razor and 
cut his own throat. His wife groaned bitterly ; he ran into the street 
and towards his father's house to inform him of what had happened ; 
his wound bled freely all the way. When he returned, which he soon 
did, he found the house surrounded with people; they took hold of him, 
laid him on the grass in his own door yard, and, to use his own expres- 
sion, "sewed his head on." He was then carried into the house and 
laid on a bed ; hearing the groans of his wife, he requested to see her, 
which was refused him. 

When sufficiently recovered of his wounds he had his trial; and went, 
as he states, "eight times" to the court. He does not recollect the 
names of the Judges, but the prosecuting attorney, he says, was Par- 
sons, and the attorney in his defence, Wheaton. 

Before he came to the Hospital he had been twcntij-eight years in 
confinement, suffering every thing from cold, hunger, thirst, the damp- 
ness of his prison cell, and, worse than all, from the provocation and 
insults of the vile and vicious. He thinks no man's sufferings can have 
been equal to his. 

He recollects distinctly, and relates many circumstances that occured 
during his protracted imprisonment. He is now comfortable, walks 
abroad frequently, is neat and cleanly in his person and apparel, keeps 
his room in the best order, associates with sixtcin others without mo- 
lesting them, attends public worship, all day, on every sabbath, and yet 
has all the delusions which he had when he committed the homicide 
and was confined a furious and dangerous maniac in the cell of a pris- 
on twenty-eight years. 

No. 2. Is a case of Hereditary Insanity. His ancestors and family 
connections having been, to an unusual extent, affected with this dis- 
ease. His grandfather, his father, one uncle, one aunt, and two sisters 
have been insane. He is, by trade, a carpenter. He was born in the 
year 1784. His parents were poor, but industrious, frugal, and relig- 
ious people. When he was nine years />ld he had a short attack of in- 
sanity, which occurred immediately after a season of religious excite- 
ment in the town where he resided. Almost every subsequent attack, 
of which he has had many, occurred after devoting close, particular, 
and anxious attention to the subject of religion. The first attack was 
of short duration, the next, which was also short, was in 1810. From 
this time to 1818, he had repeated short paroxysms, and often spent a 
night or two in the woods, wandering from place to place, highly ex- 
cited, and often confined, bound with cords, and treated harshly. In 



60 STATE LUNATIC HOSPITAL. 

the winter following, he spent much time in studying the Scriptures, 
and often became greatly perplexed in his inquiries on the subject of 
religion. During the summer and autumn of 1819 he was very insane. 
He has detailed to me, minutely, the following account of himself, 
which I relate as nearly as possible as I have obtained it from him. 

In July of this season, while very insane, he commenced erecting a 
house. The building was far remote from other houses, and he would 
permit no individual, whatever, to assist him in the work. He scored 
and hewed the timber, framed the building, covered, and finished it, 
without any assistance, in nine or ten months, during which time he 
was constantly insane. When most rational and self-possessed, he was 
able to lay out the work, and he improved every opportunity to do so, 
when his mind was in a fit state for it. When more insane he could 
do nothing at this part of the labor, but could beat a mortise, make a 
tenon, hew and score, when he was totally incompetent to lay out the 
work. Many times, in the progress of the labor, he suspended his 
work and betook himself to the woods. After a while the frame of the 
building was completed and ready to be raised ; the day was fixed and 
the raisers were invited. About twelve o'clock of the day previous to 
the raising, the work was all finished, his tools were scattered over the 
frame, and he stood contemplating the work and endeavoring to recol- 
lect if any thing had been overlooked or neglected. In a moment, 
suddenly as lightning, he was seized with an impulse of insanity, he 
immediately left all and hurried to the woods ; he travelled a great dis- 
tance, through bushes, briers, and swamps, and over rocks, till, quite 
exhausted, he threw himself down in a thicket, and sank into a reverie 
or sleep, from which he did not awake for twenty-four hours. He re- 
collects, perfectly, that a certain bush shaded his face when he sank 
down upon the ground ; while in this situation, he took his knife from 
his pocket, and cut up every bush and weed within his reach. When 
he awoke to consciousness, he was satisfied that he had been in that posi- 
tion twenty-four hours, from the fact that the same bush again shaded 
his face from the sun. When he arose he recollected that it must be 
the day appointed for the raising of his house, and that the hour Avas 
approaching when the raisers would be on the spot, to render their aid. 
He hastened, with all possible despatch, out of the wood, and soon 
came within sight of his frame ; no person v/as there except the son of 
his host, who was looking for him. His tools were scattered as he left 
them the day before. He inquired of the boy " Where are the raisers ?" 
"I do not know," he replied, " but one hundred men are in the fields 
and woods in search of you, and have been, all day and all night." 



STATE LUNATIC HOSPITAL. 61 

Our patient then went immediately towards his lodgings, and, on as- 
cending an eminence, was surprised to hear all the dinner horns in the 
neighborhood sounding at once. He afterwards learned that this was 
the signal to be given to those who were in search of him if he should 
return. On arriving at his lodgings he took a little refreshment, the 
first which he had had for more than thirty hours. The neighbors 
who had been in search of him, began to come in, and finally arrived 
in such numbers that he proposed going to raise his house. Many re- 
fused to go, and all thought it impossible to do any thing about it, 
while he was in this state ; no one supposed that the frame could be 
put together, even if he was in a condition to superintend the work, 
as it had been framed while in such an insane state. After a while, a 
few friends were persuaded to go with him, others followed, he, being 
all this time, in the greatest excitement. It was found upon trial, that 
the work went well together, and in the course of the afternoon the 
raising was completed ; not a single mistake was found in the work, 
and the whole was pronounced by judges to be well done. In the 
course of the year he covered the frame and finished this tenement 
completely. 

From this time till 1829, he had frequent turns of insanity of greater 
or less violence, and of longer or shorter duration , but in no essential 
particular different from those which preceded them. 

In August, 1829, he had a slow and mild fever, which lasted him 
three weeks or more. In September, he got better and undertook to 
build a stone fence between his land and that of one of his neighbors. 
He worked upon this fence till the night of the 23d of September, his 
two sons affording him all the aid in their power. During the day, 
(Sept. 23d,) he labored hard and constantly ; before night he felt 
strangely, but kept steadily at his work, and betrayed nothing of ex- 
citement to his sons. At sun-set he returned home, and asked his 
wife to get him some supper, she inquired what he would have ; he 
replied, "sweet apples and milk." The supper was soon ready, he ate 
it, arose from the table, and put on his great coat and hat. His wife 
said to him, " where are you going 1 " He replied, " to take a walk." 
She inquired, " how long will you be gone 1 " He replied, " not long," 
and left the house. He said to me, " I was conscious I was going to 
have a turn of insanity and was determined to go into the woods and 
stay till I felt better, because I made so much disturbance when at 
home." The " woods," of which he spoke, were his own property, 
about a mile from his house. 

He proceeded towards the wood, but was unable to reach it ; he 



63 STATE LUNATIC HOSPITAL. 

threw himself down by the side of a wall, and rolled about in agony. 
After lying for some time in this situation, he arose and proceeded on- 
ward through the wood, over fields and swamps, a part of the time in 
the road, and a part of the time not, until he reached a part of the 
country which he knew, and passed a bridge, which he recognized as 
one that he had frequently crossed. During this ramble he saw many 
curious images and visions, which he in vain attempted to describe. 
As he went on, he passed a large white house on the left, and a barn 
on the right side of the road; beyond, at a short distance, was a large 
watering trough, on which he seated himself, being greatly exhausted, 
and anxious as to what he should do to throw off the accumulated suf- 
fering which pressed upon him. He saw many strange sights and 
singular appearances in the heavens. Proceeding onward, he met a 
man of whom he inquired the time of night, and was told that it was 
twelve o'clock; the man was on a white horse, and he ascertained that 
he was a mason. He went on a short distance and came to a barn, 
which was fastened by a wooden latch; he opened the door, entered 
the barn, threw himself down upon some straw, and, as he supposes, 
slept some time, he was awakened by the rustling of the fowls and 
crowing of the cocks, which induces him to suppose that it was nearly 
day light. He left the barn immediately, and continued his journey ; 
soon his attention was arrested by the appearance of a star in the 
heavens, which was very splendid, and which twirled like a fire brand 
moved in a circle; this star moved towards him, diminishing in size 
till it appeared a mere luminous point in the heavens, then vanished 
away. Following this star was an angel, in the form of a man, splen- 
didly arrayed in glittering gold, which approached near to him and 
vanished ; this angel appeared three times in the form of a man, and 
three times in the form of a woman, more gorgeously and splendidly 
apparelled than any thing he had ever seen ; it was each time preceded 
by the star. For a long time his mind was overwhelmed with wonder 
and amazement at this display of celestial light and imagery. To 
guide him to this place at a future time, he got over a fence into a lot 
and made a pile of stones as a monument. He advanced some dis- 
tance, when his attention was again arrested by the appearance of a 
wheel, of great size and beauty, which remained before him about three 
minutes, then disappeared. 

It now began to be twilight, and no more imagery appeared to him 
that morning. 

He wandered abouJ. during the day, in various directions, through 
fields, over streams and morasses, and, at night, arrived at the house of 



STATE LUNATIC HOSPITAL. 63 

an old friend in Connecticut. The name of his host he recollects dis- 
tinctly. He was kindly received, and treated with great hospitality. 
His friend gave him supper and provided him a bed, to which he re- 
tired early, but passed a sleepless night, so extremely harassed and per- 
plexed was his mind. 

He arose early on the following morning, opened his window, and 
immediately saw one of the most splendid visions that was ever pre- 
sented to human view ; he looked at it with great delight for a few min- 
utes, and it vanished. " This," says he, " is the first time I ever men- 
tioned this vision to any one." 

The morning was rainy ; he had wandered twenty-four hours when 
he reached this house, and yet was but five miles from home. After 
breakfasting with his friend, he determined to proceed directly to his 
own house. It was now the 25th of September ; he wandered all day 
in the fields and roads, sometimes in one direction, then in another, and 
did not reach his home till evening. His wife met him with a smile, 
inquired where he had been, and prepared his supper, which he ate 
and went early to bed. This night was passed without sleep. He arose 
early on the morning of the 26th greatly confused, his head feeling 
strangely. He undertook to go to the house of his nearest neighbor, 
but lost his way and wandered about in the fields and woods till noon, 
when he arrived at home, and found dinner on the table. He recol- 
lects perfectly, that this dinner consisted of pork, and corned lamb or 
mutton, boiled, with turnips and other vegetables. He ate well, felt 
more composed, and, after dinner, concluded to go to the field and 
complete the fence upon which he was engaged some days before. He 
accordingly went his way, but when he arrived at the place of his labor 
he was so much exhausted and bewildered, that he was obliged to de- 
sist without accomplishing any thing. He wandered from the fields to 
his favorite " woods," and reached home at dark, where he found 
much company ; many persons came in and went away in the course of 
the evening, and some tarried through the nio-ht. 

This night was one of great confusion and perplexity of mind. He 
arose on the morning of the 27th of September in the worst condition 
which his disease ever presented. His mind and feelings were entire- 
ly overwhelmed by the weight of anguish and distress. He recollects 
distinctly to have directed his little son to bring his arms full of hay 
and place it in the potato bin, in the cellar. The lad remonstrated 
and said, " why, father do you wish to have hay placed in the cellar?" 
His mother, vwho was always conciliating, said to him, " do as your 
father wishes," and the boy immediately left the room. 



64 STATE LUNATIC HOSPITAL, 

Under these circumstances the noise of children always disturbed 
him. In order to render all quiet the children were sent into the field 
to play or labor ; he and his wife sat by the fire ; he, on one side, in- 
dulging in the gloomiest forbodings; she at her work on the other side, 
doing all in her power to console and comfort him, as she always did, 
in the kindest and mildest manner. After a while, she arose, went to 
the cupboard and poured some wine into a tumbler, brought it to him, 
and said, in the most cheerful manner, " come, let us drink and forget 
our sorrow and remember our poverty no more." She tasted the wine 
and handed it to him, and he drank and said, in reply, " I wish it 
might kill me," or " I might die." She took her seat again by the fire 
and went to her work ; he arose, soon after without any particular ob- 
ject or design, and walked into an adjoining room ; in a moment the 
idea of "Sampson and the weaver's beam" rushed into his mind, he 
instantly seized a weapon which was before him, stepped behind his 
wife and gave her a fatal blow which laid her senseless on the floor, 
totally unconscious of what had hurt her. She survived one hour, en- 
tirely insensible, and in the agonies of death. 

He was first disturbed by the entrance of his eldest daughter ; who 
seeing her mother lying on the floor covered with blood, ran into the 
street and screamed ; the other children followed. He put on his great 
coat and went out after them ; he met his nearest neighbor and said to 
him, "I have killed my wife; she lies dead on the floor in the house." 
His friend went directly into the house, he followed near to the door 
and threw himself upon the ground, greatly lamenting what he had 
done and bewailing the calamity which had befallen him. 

The whole neighborhood soon assembled, placed his wife on the bed, 
and he with others sat down by the bed-side, moaning bitterly ; while 
here, he recollected the directions that he had given his son about the 
hay, and hastened down cellar to see if he had been obedient; finding 
the hay in the bin, he laid himself upon it in great distress. In a few 
minutes he heard an outcry above, "where is he, where is he?" Soon 
a number of men came into the cellar, took him before the magistrate, 
who bound him over for trial. He was taken to the jail on the morn- 
ing of the 29th of September, 1829. 

In a subsequent conversation with him, he declared that he had no 
direction from higher powers, to kill his wife ; that the thought never 
entered his mind till that impulse came upon him, and that was as sud- 
den as possible, and wholly irresistible. 

He always bears decided testimony to the excellent character and 
kind disposition of his wife, and often laments, with deep feelings of 



STATE LUNATIC HOSPITAL. 65 

sorrow, the fatal act which deprived him of her society, and his child- 
ren of a faithful guardian and instructer. In this conversation, he 
spoke of his contemplations as being always of a religious character. 
When insane, and roving over the country, he usually carried his hymn 
book and bible with him. He says he was often mischievous when in- 
sane, and delighted to frighten and injure people, although he was na- 
turally kind and amiable. He spoke of many attempts to commit sui- 
cide, and of one paroxysm of homicidal impulse before the fatal one, in 
which his little son would have been the victim had he been within his 
reach. 

He informed me, when he came into the Hospital, which was on the 
16th of March 1833, that he had been in confinement twelve hundred 
and sixty-seven days, having kept an accurate account of the time. 
This must have been very nearly or quite accurate. Since he has 
been in the Hospital, he has had a number of paroxysms of insanity. 
His mind is probably never quite free from delusion, but he speaks of 
his insanity freely and frequently, by which he means these paroxysms 
of excitement. Although he knows that he is insane, he probably be- 
lieves, that the visions which he sees are realities, and that he has spe- 
cial, direct communications from heaven, and lives in closer commu- 
nion with his Maker than other men. 

He is generally a pleasant quiet man ; an ingenious mechanic and 
rational observer of common affairs, although he discovers a spiritual 
meaning in much that is ordinary and common. 

He has always had great indulgencies at the Hospital, walks abroad 
and works when he pleases; attends public worship on the sabbath, 
and takes great satisfaction in reading his bible and the public papers. 

He was greatly affected and much gratified this season by a visit 
from his children, some of whom he had not seen since his confinement. 

There is one fact, in this connection, worthy of remark. In the 
cases above related, it will be observed, that both the individuals par- 
took of intoxicating drink immediately before the fatal deed was com- 
mitted ; in a moment after, in each case, the fatal impulse was excited. 
These individuals were considered temperate men, and were undoubt- 
edly so, according to the common acceptation of the term at that time; 
although they used ardent spirits in the way that was then customary 
with seamen and mechanics. 

With the excitement of disease under which the brain was then la- 
boring, a very moderate use of stimulating drink might have been the 
principal if not the sole cause of that irresistible impulse which impel- 
led to the homicide. 



66 STATE LUNATIC HOSPITAL. 

In case No. 1, every unusual excitement, on the day previous to the 
homicide, produced confusion and blindness, and converted men into 
devils. Even at this day any great irritation produces an incontrollable 
excitement, although there is apparently no disposition to injure others. 

In some of the other cases that have been under our care, the indi- 
viduals were intemperate. In one, some idle and wicked associates 
had, for a long time, endeavored to excite in his mind a jealousy of 
his wife. Aided by liquor they were, at last, too successful : he took 
her life while under the influence of this delusion. 

Without the influence of intoxicating liquor, taken at the time of 
such excitement, and while the mind was under such delusions, I can 
hardly believe that either of these homicides would have been committed. 

If it is indeed true that half the cases of homicidal insanity have re- 
sulted from the use of intoxicating drink, as nine-tenths of criminal 
homicides are supposed to do, it is a fact worthy of record in the 
chronicles of intemperance, and cannot be too forcibly impressed upon 
the public mind. 

It may be thought that I have gone too minutely into detail of the 
incidents and circumstances of these two cases of homicidal insanity. 
These facts, as related by the individuals, being confirmed as far as 
possible by all other testimony, are deemed of no trifling importance, 
throwing light as they do upon an obscure subject, and one in which 
individuals and legislators are deeply interested. If not considered 
valuable, they must certainly be allowed to be rare and curious. 

Nine other cases of Homicidal Insanity have been in the Hospital 
Tinder my care. In three of them there was delusion, which had a di- 
rect agency in producing the homicide. In one case, there was a sup- 
posed command from Heaven to destroy the unfortunate victim. When 
brought into court, to the question of guilty or not guilty, this man 
answered, " I gave him three blows, one in the name of the Father, 
one in the name of the soil, and one in the name of the Holy Ghost." 
The other two were cases of jealousy ; both were intemperate. The 
one killed the man who was the object of his suspicion, the other killed 
his wife ; it is said that the last was partly intoxicated at the time. 

In another case, there was probably delusion, but it is unknown 
whether this delusion had any influence on the conduct of this despe- 
rate man. He killed three convicts in the prison where he was confin- 
ed, two of whom went into his room at his request to read the bible to 
him. It is not known with certainty, that he had ever seen these men 
before, and there was no suspicion, before or after the homicide, that 
he had any antipathy against them. 



STATE LUNATIC HOSPITAL. 67 

In three of the remaining cases, there seemed to be no premeditation 
of the act at all, no malice existing, and no collision of any sort; a mo- 
mentary impulse of passion, or a propensity to destroy, hurried the 
unfortunate individual to the desperate act, and regret, anguish and 
deep sorrow followed almost immediately the perpetration of the deed. 
Of the two remaining cases, we know little, as the mind in both is too 
much demented to throw any light upon the subject. 

My object in this paper, is to present facts and illustrate principles, 
and not to discuss theories. 

From the many cases of Homicidal Insanity that have come under 
my observation, and from the record of cases which I have examined, 
I cannot resist the conviction, that many, very many irresponsible in- 
dividuals, both in this country and in Europe, have been sentenced to 
the severest punishments. 

If this be true, it is evident, that the definition of insanity has been 
too limited, rejecting many that were innocent, and consigning them 
to punishment as guilty. 

It is certainly not desirable, that these limits should be suddenly or 
extensively enlarged; while, on the one hand, the definition of insanity 
should not be so circumscribed as to release from confinement half the 
inmates of our Hospitals; it should not, on the other hand, be so ex- 
tended, as to embrace every eccentricity of character, every unaccount- 
able ebullition of passion, or estrangement of feeling. There is a middle 
ground that is right ; there is a point where responsibility ends, and 
irresponsibility begins, and every fact that has a relation to this ques- 
tion, is important and valuable. With the obscurity and doubt, which 
hangs over this subject, no one ought to presume to decide with great 
confidence where responsibility ends. The victim of mental aberration 
simulates reason as far as possible, for no one is willing to be consid- 
ered insane. 

There are delusions without any active state of the passions and 
propensities, and there are delusions with it : even in such cases the 
passions may act, and the propensities be excited, independently of the 
delusion. 

An insane man may consider himself a prophet, a saint, or a com- 
mander of armies, and yet destroy a fellow being, in a moment of great 
excitement, against whom he had no grudge, no antipathy, without a 
pretence of any authority from a higher power ; but from a condition 
of the passions rendered incontrollable by the operations of disease in 
the same way that the illusion of the understanding is produced. Why 
should he be more responsible for this condition of the passions, than 



68 STATE LUNATIC HOSPITAL. 

for this illusion of the understanding? and if there can be hallucination 
of the mind without exciting the feelings, why not a morbid excitement 
of the feelings, the passions, and the propensities, without involving 
the integrity of the mental powers? In such cases, the same causes 
that render the one active, may produce inactivity or imbecility in the 
other ; both depend upon physical phenomena, which are beyond the 
ken of human scrutiny. 

In very many homicidal cases of insanity, all the natural feelings of 
the individual are violated by the act. How often is it, that the victim 
is a child, innocent and helpless; or a wife, kind and affectionate. 
Against these helpless and harmless persons, no feeling of hostility has 
existed or is excited. What better proof can we have, that the feelings 
are all estranged, and the passions in a morbid state? 

I am sensible, that it is now, and has long been, an opinion of many 
learned men, as well as of the ignorant and unreflecting, that an indi- 
vidual, who shall commit so great an outrage upon society, is unworthy 
of life, and therefore should be put out of the way. 

" I am clear for hanging all criminal madmen," said an educated 
gentleman to a high officer of the criminal law in Scotland. Nearly the 
same sentiment lately appeared in one of the medical journals in this 
country. 

I admit the propriety and necessity of confinement for the homicidal 
insane in the wards of a hospital ; very few, if any, ought to be at lib- 
erty. But to the individual, and to his circle of friends, is it of no 
consequence, whether he suffer the imputation of crime, and is pun- 
ished with ignominy, or whether he be declared innocent, because 
diseased and irresponsible, and confined as a lunatic? 

This is no question of expediency, but of principle and right. 

The good reputation of every individual is dear to him; if he has 
done an act under circumstances which involve the question of his 
sanity, how important to him that the question be settled correctly. If 
the case be homicide, it is a momentous question whether he was actu- 
ated by the diabolical malice of the murderer, or was influenced by the 
illusions or excitement of disease. 

I am aware that complaints are made that the plea of insanity is so 
often resorted to in criminal cases. The attorney and advocate gene- 
ral of France, in a case of homicide a few years ago, declared, that 
" the plea of insanity is dangerous; that it leads to encourage simula- 
tion, and defraud justice."* 

* Simpson. , 



STATE LUNATIC HOSPITAL. 69 

In my view, the question should arise in every case of criminal pros- 
ecution, and should be settled satisfactorily before the jury render a 
verdict. The principles of the criminal law are correct, but the appli- 
cation of them is often erroneous and absurd. The courts should look 
well to it, that the law be construed so as not to involve the innocent 
and irresponsible. One more consideration in this connection, and I 
shall dismiss the subject. 

After an act of great enormity, it is often matter of surprise, how 
calm, rational and self-possessed, the individual is found to be. This 
has often operated to the prejudice of the insane man in a court of 
justice ; but the explanation is easy, for the effect is natural. 

Before the homicide is committed, the excitement is generally at the 
highest pitch, and the feelings are exasperated to the utmost. When the 
deed is done, all the appalling circumstances of the act are before him. 
The wife or the child, weltering in its blood, lies at his feet; the death- 
groans fall upon his ear with terror, and lill his soul with anguish ; all 
is changed in a moment; every thing around him is calculated to calm 
his feelings, and awaken contemplation and remorse. He stands 
aghast ; and, as excitement wears away, reason and reflection will be 
likely to assume their sway. No sedative can be so powerful to calm 
the excited and agitated faculties. 

We often see the same effect, from an outbreaking of petty mischief, 
in a less degree. 

A man breaks his window or his door in a moment of high excite- 
ment, and becomes instantly calm and filled with regret at the outrage. 
The maniacal excitement in this way is expended, and the devastation 
before him makes a new and strong impression upon his mind. 

On the subject of labor, the experience of the past year has been as 
favorable as ever. The amount of labor done, has been equal or 
greater than in any former year. 

The fostering care of the Legislature has been extended to us durinor 
the year, in providing the means of procuring suitable lands ; which 
means the Trustees, very judiciously, have partly expended, in procur- 
ing pasturing and meadow lands, and adding largely to our garden. 
This purchase was exceedingly desirable, as it will enable us to double 
our horticultural operations, and these are altogether the most favora- 
ble for the insane, and the most profitable to the institution. 

A well cultivated garden is a beautiful object in itself. Witnessing 
the progress of improvement in it, and the growth of all the culinary 
plants and roots which it produces, is most gratifying to those who 
participate in the culture, and partake of the fruition. No employment 



70 STATE LUNATIC HOSPITAL. 

is so favorable as the cultivation of the land. We are fully satisfied of 
its utility as a remedy, and we hope to show the propriety of the invest- 
ment from its pecuniary results. The work shops are now completed 
and ready for occupancy. 

During the last year, a chapel has been erected for religious worship 
on the sabbath. A plain, but neat and commodious building, very 
conveniently located, was finished for this object about the first of No- 
vember. 

Under the direction of the Trustees, it was solemnly dedicated to 
the sacred use for which it was designed, on the eighth day of the 
month. Up to this time we have had two appropriate religious services 
on each sabbath. Our choir of music, consisting of from fifteen to 
twenty-five persons, all from our establishment, have performed accord- 
ing to the custom of New England churches, to the acceptance of 
all who have heard them. Many patients have united in this agreeable 
part of religious worship. 

On the day of dedication, about one hundred and ticentyfive inmates 
were present. It was the first assemblage that had ever taken place to 
so great an extent, and was a most interesting meeting. 

There were present, besides our own family, about one hundred gen- 
tlemen and ladies, mostly from the village of Worcester. All the per- 
formances were interesting, and the appearance of the patients decent 
and respectful through the whole. 

At each subsequent religious meeting, about the same number have 
attended, not always composed of the same individuals. In the whole, 
about one hundred and forty have attended these meetings, and nothing 
has occurred to disturb the quiet, or to distinguish this from any other 
religious assembly. The inmates have been much gratified with this 
indulgence and proof of confidence. 

The favorable influence of these meetings upon the feelings and 
habits of our family, has been all and more than was anticipated. 

Individuals have attended regularly, who had not before been pres- 
ent in a church, or attended religious worship, for ten, fifteen, twenty, 
thirty, and in more than one instance thirty five years. Numbers have 
attended, who in the halls are noisy, talkative and profane, and have 
conducted with the greatest decorum. We have tried this experiment 
successfully, but not so fully as we shall hereafter. We will add to our 
number of worshippers, by bringing forward new individuals, till but a 
remnant shall be left behind. 

Thus far, the chapel has been supplied by the clergymen of the 
town and vicinity. They have laid us under the deepest obligations 



STATE LUNATIC HOSPITAL, 71 

by the promptitude with which they have acceded to our wishes, no 
less than by the acceptable and judicious manner in which they have 
conducted the services. 

To be useful, the preaching and other religious services of our chap- 
el must be select and well-adapted. The supply should also be regular. 
The influence of a single individual, who should be looked upon as a 
spiritual guide, would probably be greater than that of a stranger, 
whose performances were equally appropriate and unexceptionable. 
. For our own benefit, as well as an example to others, we feel most 
anxious that this experiment should be fairly and faithfully tried. 

With the fullest conviction that the principles of Christianity, rightly 
conceived and properly dispensed, can never injure the minds nor dis- 
turb the feelings of the insane, I am confident, that, if a judicious 
course be pursued, all that has been anticipated of good will be fully 
realized in the religious worship of our chapel. 

Can we contemplate a more interesting spectacle, than this assembly 
of the insane, a large proportion of whom had been incarcerated for 
years in prisons and in dungeons, or confined with chains and mana- 
cles, the object of terror and dread to all around them, convened on 
the sabbath for public worship, all decently clad and respectable in ap- 
pearance, calm and self-possessed, listening with apparent attention to 
the messages of truth, uniting in the devotions, and joining in the songs 
of praise; all going to and returning from the chapel with order and 
decorum? Such a spectacle we have witnessed on each returning 
sabbath, since our chapel was consecrated. Who can longer doubt 
that Christianity brings its consolations to the insane as well as to the 
rational mind ? 

The Hospital is now completed in all its parts, and taken as a whole 
is probably the most perfect establishment of any in the country. It is 
a noble monument of the munificence and public spirit of the state of 
Massachusetts. The duties of its supervision and care are arduous 
and responsible. In these, I have been ably sustained and cheerfully 
assisted by its officers in all the departments. We are encouraged not 
to shrink from these duties, while sustained by a wise and liberal Board 
of Trustees, the approbation of the public voice, and the smiles of a 
beneficent Providence. 



SAMUEL B. WOODWAF.D. 



State Lunatic Hospital, ^ 
Worcester, Mass., Nov. 20th, 1837. S 



I 



MAR "51?