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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 

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EIGHT H 



ANNUAL REPORT OF THE TRUSTEES 



STATE LUNATIC HOSPITAL 



AT WORCESTER. 



DECEMBER. 1840. 



^0 IS ton: 

BUTTON AND WENTWORTH, STATE PRINTERS; 
1841. 



EIGHTH ANNUAL REPORT 



TRUSTEES OF THE STATE LUNATIC HOSPITAL. 



DECEMBER, 1840. 



To His Excellence/, Marcus Morton, Governor, and the Honorable 
Council of the Commonwealth of 31assachusctts : 

The Trustees of the State Lunatic Hospital respectfully present their 
Eighth Annual 

t 

11 E P O U T : 

In reviewing the last year, the trustees feel it to be a grateful duty 
to acknowledge the continued smiles of Providence upon that great 
enterprise of humanity, which has been going on with such happy 
results for eight years past in the State Lunatic Hospital. This glori- 
ous enterprise, conceived in a spirit of true philanthropy, and sus- 
tained by a humane public sentiment, has, by its beneficent influences, 
so reacted upon the public mind, and enlightened it, that a great change 
has already taken place in public opinion with regard to the nature and 
treatment of insanity. A generation has not yet passed away since 
insanity was regarded as synonymous with demonomy : and hence the 
neglect or cruel treatment of the insane. The idea that human skill 
was unavailing in a disordered mind was not confined to the unenlight- 
ened merely. Physicians and learned men either concurred in the 
sentiment, or were controlled by it. Under these views, the great 
object was to protect the community from those who were supposed to 
be "possessed," and confinement in darkness, dungeons and caves, 
away from the pleasant light of heaven, the beauty of earth, and the 



4 STATE LUNATIC HOSPITAL. 

cheerful face of man — with terror, blows and chains — these were the 
means employed in those dark days of error and superstition. But 
more enlightened views, and the brilliant light thrown on the brain by 
modern science, and consequently on the doctrine of mental pheno- 
mena, have greatly dispelled these illusions, and a derangement of the 
intellectual functions is now regarded as disease — disease, indeed, in- 
volving the higher faculties of man — but yet susceptible of successful 
treatment by means in delightful accordance with the benevolence of 
the divine Author of the mind, and means which he has graciously 
committed to his chosen ministers here on earth. 

The design of the State Lunatic Hospital, and the plan of treatment 
pursued in it, furnish a beautiful illustration of the successful results 
of the humane care and management of the insane. 

The Hospital building is a grand edifice, located in the heart of the 
Commonwealth, a fit emblem of the noble heart of the people, who 
generously founded and endowed it, — spacious in its dimensions — as 
well ventilated, warmed, and supplied with pure water, and every other 
necessary and comfort of life, as any public institution in the whole 
world — with an infirmary for the sick, and a chapel for religious w-or- 
ship — with comfortable and airy apartments for the inmates, always 
kept clean and neat — with lofty open halls for their recreation and ex- 
ercise, surrounded with ample grounds, and walks, and trees — placed 
on a high hill in full view of the magnificent amphitheatre of cultivated 
and ornamented highlands, which overlook and surround the beautiful 
town of Worcester — thus affording to the inmates of the hospital, a 
constant view of scenes well adapted to soothe, to delight and tranquil- 
lize their troubled minds. In this blessed refuge of mercy, for eight 
years past, the ministrations of humanity have been dispensed to more 
than eleven hundred and ninety of our unfortunate brethren, afflicted 
with all the various and terrible forms of mental malady — and, during 
the whole period, not a blow has been struck, not a chain has been 
used, nor a harsh word spoken, nor a hard look given. Every thing 
has been done by the intelligence, benevolence and firmness of the 
master mind of that extraordinary man, who superintends and sways, 
with consummate skill, the discordant elements over which he presides, 
and who has raised the reputation of the State Lunatic Hospital to the 
rank of a model institution, alike admirable for its humanity, econo- 
my and success. 

On the first day of December, the trustees went through the Hospi- 
tal thoroughly. The examination was highly satisfactory. The pa- 



STATE LUNATIC HOSPITAL. 5 

tients were very quiet — all of them clean and comfortable — and a 
large proportion of them appeared happy. The interesting report and 
statistical tables prepared by Dr. Woodward, and herewith annexed, 
present so accurate a view of the present state of the Hospital, that 
the trustees will give only a general outline. There have been in the 
Hospital in the course of the year, 891 patients ; 190 males, 201 fe- 
males. There have been admitted 162 ; 75 males, 87 females. There 
remained at the end of the year, 236 patients ; 122 males, 114 females. 
Of which, 208 are old cases, and 28 recent cases, 105 cases have been 
sent by the courts, 48 by friends, and 9 by Overseers of the Poor. 
There have been 30 foreigners, and 19 persons belonging to other 
States, in the Hospital the past year. There have been applications 
not received, 99 ; 58 of which, were citizens of this State. There 
have been discharged from the Hospital during the year, 155 persons; 
82 of which, were recovered, 29 improved, 29 discharged for want of 
room or harmless, 15 have died. Of the 82 recovered, 64 were recent 
cases, and IS old cases; the whole number of recent cases discharged, 
is 70. The per cent, of recoveries of the recent cases discharged, is 
91^ per cent ; the per cent, of all the cases discharged, is about 53 
per cent. The striking difference in the per centage of recoveries be- 
tween recent and old cases, is shown in a very interesting light in Dr. 
Woodward's Report, and is a fact of vast practical importance, which 
cannot be too often, nor too strongly pointed out to the public eye. 
During the last year, a fire engine has been purchased at the cost of 
$150. It proves to be an excellent one, is well managed by the pa- 
tients, and with an abundant supply of water from the great cistern in 
the back yard, is used to great advantage for various purposes of clean- 
liness, and may be regarded as an efficient security for the Hospital in 
case of fire. 

The labor department has been continued the past year with 
increased evidences of its utility. The produce of the farm is esti- 
mated at f 1,887 89, exclusive of the fine live stock on hand; great 
judgment and industry have been shown, in clearing and walling in, 
manuring and irrigating, and increasing the produce of the lands, 
showing that Mr. Ellis is en excellent farmer, as well as an excellent 
steward. The value of shoes rr anufactured, is about $900. A great 
amount of useful labor is daily performed by the patients in the house 
and about the premises, and during the year extensive improvements 
have been made, and the grove has been ornamented with paths and 
walks, and the surface made smooth and beautiful. But the true value 



6 STATE LUNATIC HOSPITAL. 

of labor is to be estimated by a higher standard than money. Labor 
is the health of the mind. It is that power in man, which unfolds and 
directs his capacities, and thus reveals and secures the sources of his 
happiness. The man who labors, shares first and largest in the fruits of 
his own toil, for, in every condition of human life, useful employment is 
the surest enjoyment, the best security of a " sound mind in a sound 
body." In a disordered state of mind, judicious occupation is among 
the best remedies, and agricultural and horticultural occupations are 
among the best of all. " Grain and fruit are God's bounty, the flow- 
ers are his smiles." This beautiful thought of the poet, may come over 
the troubled mind, when engaged in the field or the garden, in the midst 
of Heaven's gifts, with a divine power to dispel gloom, and infuse 
hope and peace and joy. The experiment of cultivating the gardens, 
and tilling the soil by the patients, has proved so beneficial to them, 
that the Trustees regard it as true humane economy, to purchase more 
land adjoining the Hospital farm, whenever favorable opportunities may 
oiTer. Another barn is now much needed for the use of the Hospital. 
The Report of the Treasurer, presents a clear, full, and satisfactory 
statement of the fiscal concerns of the Hospital. 
It appears that the amount of cash on hand, December 
1st, 1839, and receipts from all sources, from Decem- 
ber 1st, 1839, to November 30th, 1840, inclusive, is 130,046 16 
The amount of expenditure during the same term, is 27,844 98 



The amount of cash on hand, December 1st, 1840, 2,201 18 

30 046 16 



It appears that the cost of supporting the Hospital, ex- 
clusive of salaries paid from the State Treasury, was, 
for the year ending November 30th, 1839, 29,474 41 

For the year ending November 30th, 1840, 27,844 98 



Difference, 1,629 48 



The amount of cost of supporting the Hospital for 1840, $27,844 98, 
divided by the average number of patients, 229, gives as the cost of 
supporting each patient, a fraction less than $2.33 per week. This is 



STATE LUNATIC HOSPITAL. 7 

something less than the present charge. But as there is some uncer- 
tainty in regard to the future price of supplies, — as great inconvenience 
has been experienced on account of the crowded state of the Hospital, 
and as the present price of board is so very reasonable — the Trustees 
have decided to continue the same price of 2.50 per week for each 
patient, for the coming year, except in cases in which for special rea- 
sons it is enlarged or abated. 

Religious services have been regularly performed on the Sabbath 
in the chapel, during the past year, with gratifying confirmation of the 
good effect of public worship on the patients. The same blessed in- 
fluences of Christianity, which, in the days of its divine Author, 
brought quietly to his feet, " sitting and clothed in his right mind," 
the wild maniac, who had " plucked asunder his chains, and was al- 
ways, night and day, in the mountains, crying and cutting himself with 
stones, and no man could tame him," — this same blessed religion of 
love and mercy, by the labors of its faithful ministers, still continues 
to exert its healing and soothing power over the troubled soul. At 
the present time, the religious duties of the chapel are performed in a 
very acceptable manner by the Rev. George Allen. At the meeting of 
the Trustees on the first of December, Mr. King, a member of the 
board, presented a copy of the will of the late Mrs. Martha Johonnot, 
of Salem, containing the following clause: " I give, bequeath and de- 
vise all the residue of said estate, real and personal, to the Board of 
Trustees of the State Lunatic Hospital at Worcester, and their suc- 
cessors forever, upon the special trust and confidence, that they shall 
invest the same, and expend the annual income thereof, or so much 
thereof, as may be necessary for the relief and support of such poor 
insane persons as may, from time to time, be committed to said Hos- 
pital from the several towns in the county of Essex in said state — and 
who may, in the judgment of said Trustees, be unable to support them- 
selves therein — and if, from any cause whatever, the foregoing devise, 
for the benefit of such poor insane persons, cannot take effect consist- 
ently with the rules of law, I then give and devise all the residue of 
said estate, real and personal, to said Board of Trustees, and their suc- 
cessors in trust, for the Commonwealth of Massachusetts, to be used 
and improved for the maintenance of insane persons, and for the ben- 
efit of the institution." 

By the fourth section ofthe forty-eighth chapter ofthe Revised Statutes, 
it appears that " the Trustees may take and hold, in trust for the Com- 
monwealth, any grant or devise of lands, and any donation or bequest 



8 STATE LUNATIC HOSPITAL. 

of money, or other personal property, to be applied to the maintenance 
of insane persons, and the general use of the said institution." Upon 
examination of the law, it appears very doubtful whether the Trustees 
of the State Lunatic Hospital are authorized to accept this bequest for 
such special purposes — separate from the "general use of said institu- 
tion," and furthermore, it seems to be impracticable to carry into 
effect the benevolent design of the donor in favor of poor insane persons 
in the county of Essex. An attempt to execute this provision of the 
will would involve the Trustees in a joint trust, with all the overseers 
of the poor in all the towns in the county of Essex ! ! It is proper 
here to state, that, in Mrs. Johonnot's will, there are several annuities 
to be provided for — and the mode by which these shall be adjusted, 
will materially affect the amount of the residue of the estate. After 
careful reflection, the subject of Mrs. Jolwnnot's will is respectfully 
submitted. In conclusion, it only remains for the Trustees to ex- 
press their grateful conviction, that the Superintendent and his faith- 
ful assistant Dr. Chandler, together with the steward and matron, 
and, indeed, all the attendants in the various departments of duty, 
have given full proof of the faithful performance of the arduous 
and responsible duties of this great institution of humanity — an in- 
stitution preeminent among the noble charities which distinguish and 
bless our age, and which are alike deserving the fostering care of 
an enlightened government, and the generous support of a humane 
people. 

ABM. R. THOMPSON, 
A. D. FOSTER, 
MATURIN L. FISHER, 
DANIEL P. KING, 
HENRY GARDNER, 

Tmstees. 

December \$t, 1840. 



STATE LUNATIC HOSPITAL. 



TREASURER'S REPORT 



To His Excellency Marcus Morton, Governor, and to the Honorable 
Executive Council of the Commonwealth of Massachusetts. 

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

The Treasurer charges himself, from December 1, 1839, to Novem- 
ber 30th, 1840, inclusive, as follows : 

For cash on hand, December 1, 1839, bal- 
ance of last account, - - . |3,797 68 

For receipts from Cities, Towns, and indi- 
viduals, 25,729 80 

For credits on sundry bills, for shoes, flour 

barrels, grease, ashes, old iron, pigs, 2 

cows and various other things, - - 518 68 

$30,046 16 



He credits himself, as follows : 

For payments for Improvements and Repairs, 957 43 

" " " Salaries, Wages and Labor, 7,030 50 

" " " Furniture and Bedding, 1,482 57 

" Clothing, Linen, &c. 1,625 27 

" Fuel and Lights, 3,822 13 

" " " Provisions and Groceries, 11,081 09 

" " " Medical Supplies, 802 91 

" Hay, $84 24, Straw, $94 52, 178 76 

" " " Miscellaneous, 864 32 

Cash on hand, balance to new account, 2,201 18 

$30,046 16 

Deducting the balance on hand, - ■ 2,201 18 

The cost of supporting the Institution for 

the year, appears to be - - - $27,844 98 

The item of furniture is increased by the cost of a fire engine, 
which the Trustees thought requisite for the protection of the build- 
ings, as well as for other purposes ; and by the repairs or re-placing of 
articles injured, or worn with several years' use. 

The item of clothing, linen, &lc., includes, as usual, the stock of 
the shoe shop, purchased within the year. 
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STATE LUNATIC HOSPITAL. 



13 



Provisions and Grocei'ies include 



Apples, pean 


3, peaches, berries, grapes, raisins, lemons. 




oranges, 


- 


. 


- 


- 


$462 56 


Spices, salt. 


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lall groceries. 


- 


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146 46 


Soap, 


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- 


277 85 


Honey 


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142^ lbs. 


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12 75 


Vinegar and Cider, 


11^ barrels. 


4 bottles 


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45 50 


Milk, 


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1,486 quarts, 


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73 67 


Beans, 


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75 75 


Peas, 


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6 14-32 bushels, 


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15 71 


Eggs, 


- 


- 457 7-12 dozen. 


- 


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68 14 


Butter, 


- 


8,831 11-16 lbs. 


- 


- 


1,578 12 


Cheese, 


- 


8,424 8-16 lbs. 


- 


- 


760 58 


Tea, 


- 


644 lbs. 


- 


- 


295 23 


Coffee, 


- 


1,363 lbs. 


- 


- 


145 46 


Brown Sugar 


> 


9,654 lbs. 


- 


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773 21 


Loaf Sugar, 




- 609 13-16 lbs. 


- 


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70 93 


Molasses, 


- 


631 gallons, 


- 


- 


208 71 


Rye, 


- 


216^- bushels. 


- 


- 


203 58 


Corn, 


- 


935^ bushels. 


- 


- 


843 80 


Oats, 


- 


218^ bushels, 


- 


- 


99 83 


Barley, 


- 


24 bushels, 


- 


- 


20 


Biscuit, 


- 


- 


- 


- 


126 


Potatoes, 


^ 


1,374 bushels. 


- 


- 


394 89 


Rice, 


- 


1,852 lbs. 


- 


- 


72 49 


Flour, 


- 


246.^^ barrels. 


' 


- 


1,552 93 


Poultry, 


' 


- 750 12-16 lbs. 


- 


- 


71 66 


Mackerel, 


- 


2^ barrels. 


' 


- 


32 25 


Fresh Fish, 


- 


1,284 lbs. 40 shad, oysters and clams. 


96 39 


Salt Fish, 


- 


5,239 lbs. 


- 


- 


150 82 


Ham, 


- 


907 lbs. 


» 


- 


103 48 


Tripe, 


- 


334 lbs. 


- 


- 


31 56 


Beef, 


- 


20,692 8-16 lbs. 


- 


- 


1,472 72 


Sausages, 


- 


- 304 4-16 lbs. 


- 


. 


33 21 


Pork, 


- 


1,732 lbs. 


- 


- 


131 26 


Salt Pork, 


- 


8 barrels, 


- 


- 


149 00 


Mutton and Lamb, 


2,441 lbs. 


- 


- 


202 37 



14 



STATE LUNATIC HOSPITAL. 



Salt beef, 

Veal, 

Liver, 

Smoked Beef, 

Tongues and Sounds, 

Salmon, 



1 barrel, lbs, 
3,439 lbs. 

52 lbs. 

- 1 barrel, 

- 1 barrel, No. 1, 



20 


59 


228 40 




25 


5 


98 


7 00 


20 


00 


$11,081 


09 



Wood, 

Charcoal, 

Anthracite, 

Oil, 

Candles, 

Wicking, 

Peat, 



Fuel and Lights include 

609 cords, 5 feet, 10 inches, 2,872 70 

1,698 J bushels, - - 184 68 

64,500 lbs. - - 358 38 

333 gallons, - - 377 04 

47^- lbs. - - 20 34 

99 

- 2 cords, - - 8 00 



J,822 13 



The amount of wood in the account this year is larger than usual, 
because of contracts not fulfilled at the close of last year. The aver- 
age amount for each of the three years that both wings of the Hospi- 
tal have been occupied, is 503 cords, 7 feet, 8 inches, costing $2,324 71. 



Miscellaneous includes 

Expenses of Trustees' visits, 2 bills for 1839 included, 
Money paid to patients when discharged, or advanced to 

them, and charged in their accounts. 
Expenses of pursuing and returning elopers. 
Expenses of returning patients discharged to the places 

whence they were sent to the Hospital, or to Houses of 

Correction, 
Funeral Expenses, . . . . - 

Four Cows, ---.-. 

Books, Periodicals, Stationery, Advertising, &lc. 
Postage, ------- 

Ice in 1839, and filling Ice Cellar in 1840, 

Sundries, -...-. 



il31 82 



109 40 


29 70 


47 41 


110 


135 


119 36 


51 56 


45 50 


84 57 



f 864 32 



STATE LUNATIC HOSPITAL. 15 

Of the appropriation for current expenses made by the Legislature 
in 1839, the balance, $4000, which was in the State Treasury, at the 
date of the last Report, still remains there ; and the Treasurer of the 
Hospital has in his hands, a balance of account to Nov. 30th, inclu- 
sive, of more than two thousand dollars. 

This gratifying result was not anticipated, and will render any ap- 
propriation for the current expenses of the Hospital unnecessary for 
the next year. 

There appears to be no reason to calculate upon the receipt of a 
less nor the expenditure of a larger sum for the support of patients the 
ensuing, than the past year. 

Should the Legislature think it wise to purchase more land, or to 
erect a larger and more convenient barn, both which are desirable, it 
may be proper to make a specific appropriation, for one or both of those 
objects. 

The Treasurer has pleasure in saying, that with rare exceptions, the 
bills for the support of patients, have uniformly been paid with great 
cheerfulness and punctuality, by the towns and individuals liable. The 
Trustees, some years since, made it his duty, annually, on the first 
week in January, to submit all the accounts of more than a year's stand- 
ing, to the District Attorney of the Middle District, for his examina- 
tion and advice. But, during eight years the Hospital has been open, 
in only three cases, has it been necessary to resort to legal process, to 
obtain payment. And no account, except for State Paupers, has been 
lost to the Hospital, nor is any one, now outstanding, supposed to be 
insecure of payment. 

A memorandum respecting the expenses, and the average price of 
board, prepared for the Trustees, is, at their request, annexed to this 
Report. 

ALFRED D. FOSTER, 

Treasurer of the State Lunatic Hospital. 

Worcester, Dec. 25, 1840. 



16 . STATE LUNATIC HOSPITAL. 



MEMORANDUM 

Respecting the Expenses and Price of Board at the State Lunatic 

Hospital. 

The price of board from January 1, to December 1, 1833, was ar- 
bitrarily fixed by the Trustees at 12 50 per week, it being, of course, 
impossible to determine the actual cost before it was incurred. 
From December 1, 1833, to December 1, 1834, 
the actual cost, according to the average given 
in the Report, was ^2 60J per week each. This 
average was made on the whole expenditures, in- 
cluding salaries of Superintendent, assistant Phy- 
sician, and Steward and Matron. These amount- 
ed to ^2, 173 77, which, deducted from the amount 
on which the average was made, leaves f 13,66650 1834. 

to be divided by 117, giving as the average per 
week, each, a fraction less than §2 25. $2 25 per week. 

From December 1, 1834, to December 1, 1835, the 
whole cost of supporting the establishment, was 
$16,576 44 ; deducting the same salaries as be- 
fore, $2,200, leaves $14,376 44 to be divided by 1835. 
the average number of patients, 120, which gives 
a fraction over $2 30 per week, each. $2 30 per week. 

From December 1, 1835, to December 1, 1836, the 
whole cost of supporting the establishment, taken 
as before, was ... $23,272 61 

Extra repairs that year, - - 1,877 33 



Leaving as expense to be paid by pa- 
tients, - . - - $21,395 33 
the average per week, each, was that year report- 
ed to be $3 23J, deducting the same salaries as 
before, then amounting to $2,300, the sum of 
$19,095 28 is left to be divided by the average 
number of patients, 127 1-5, which gives a frac- 
tion less than $2 89 per week, ea«h. Still tho 
charge was kept down to $2 50 per week, a fur- 1836. 
ther allowance being made for article^ i;iiarged 
particular patients. $2 89 per week. 



STATE LUNATIC HOSPITAL. 17 

From December 1, 1836, to December I, 1837, 
■deduciing the same salaries as before, the cost of 
supporting the Institution, was 24,667 65, which 
sum divided by the average number of patients, 
163, gives a fraction over $2 91 per week, each. 
In their "Report that year, the Trustees say, that 
t^e average is $2 73 per week each, after deduct- 1837. 

ing the salaries as before mentioned, and the items 
charged for individuals. $2 91 per week. 

From December 1, 1837, to December 1, 1838, 
the cost of supporting the Institution, not include 
ing salaries paid from the State Treasury, was 
$28,739 40, Theaveragenumber of patients was 1838. 

211, giving a fraction less than $2 62 per week 
each, as the average cost. $2 62 per week. 

From December, 1, 1838, to December 1, 1839, 
the cost of supporting the Institution as before, 
was $29,474 41. The average number of pa- 1839. 

tients was 223J^, giving a fr?.ction more than $2 50 
per week each, as the ave.^ge cost. $2 50 per week. 

From December 1, 1839 to December 1, 1840, 
the cost of supporting the institution as before, was 
$27,844 98. The average number of patients 
this year whose names were borne on the Register, 
was 229. But, in several instances, individuals 
were permitted to be absent on visits to their 
friends, or on trial, and during their absence, no 
charge was made for their boaid. These absentees 
reduced the number by which the cost is to be di- 
vided, to 225, and the average cost per week for 1840. 
that number varies only a small fraction from $2 38 
each. $2 38 per week. 

For the eight years taken together, exclusive of 
the first, the average per week for each patient is Av, for 7 years. 
$2 55, $2 55 per week. 

It is to be remarked, that ail these averages are inclusive of the 

special charges to individual patients. These charges are principally 

included in the items *' clothing, linen, &-c.," " cash paid patients," and 

^' elopements." Private patients are charged with " damages." It 

3 



J8 STATE LUNATIC HOSPITAL. 

would be difficult to determine with precision, how much should be 
deducted, on this account, from the sum of the cost, before the aver- 
age is made, and I have not attempted to do it. It might, or it might 
not, for the seven years, be more than five cents per week, each. 

It is also to be remarked, that no account is taken of the produce of 
the land belonging to the Hospital, in ascertaining the cost of support- 
ing the Institution, because so much of the labor of its production is 
performed by the patients. But, whatever it may amount to, it goes, 
so far, to diminish the general expenses. 

A. D. F. 



STATE LUNATIC HOSPITAL. 



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STATE LUNATIC HOSPITAL. 29 



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STATE LUNATIC HOSPITAL. 



31 



Another fiscal year of the State Lunatic Hospital has closed, and 
Ave present our Eighth Annual Report. 

The past year has been a season of prosperity, affording an unu- 
sual proportion of recoveries, almost entire exemption from acute 
disease, no accident, and comparatively few deaths. 

The success of our efforts in this field of benevolence calls loudly 
for gratitude to our Heavenly Benefactor, whose smiles have ever 
attended our labors. 

Nearly eight years have now passed away, since this Hospital was 
made the receptacle of the insane, during which time there have 
been received, eleven hundred and ninety-six patients; discharged, 
nine hundred and sixty ^ including deaths ; of which Jive hundred and 
six have recovered, leaving at present tivo hundred and thirty-six in- 
mates, filling, and more than filling, every apartment designed for 
their occupancy. 

As it is made the duty of the Superindent to present a tabular report 
annually to the Trustees, I have endeavored, in the preceding tables, 
to condense as much statistical information as possible, that the 
nature and benefit of the institution may be correctly appreciated. 

Compared with a number of similar institutions in Great Britain, 
we have reason to be gratified with our success in promoting the 
recovery of the insane, and especially with our great exemption 
from mortality. 

The following table is from a work recently published in Lon- 
don, by Dr. Crowther, giving the per cent, of recoveries and deaths 
in thirteen public institutions in that kingdom. 







Admitted. 


Recovered. 


Per cent, of 
Recoveries. 


Died. 


Per cent, of 
Deaths. 


Bedford, - 


5 years, 


191 


61 


31.9 


29 


15.1 


Cheshire, - 


5 


do 


209 


87 


41.6 


44 


21 


Cornwall, - 


5 


do 


175 


80 


457 


34 


19.4 


Dorset, 


4 


do 


145 


41 


28.2 


15 


103 


Gloucester, 


5 


do 


2G8 


156 


58.2 


25 


9.3 


Kent, 


3 


do 


254 


35 


13.8 


45 


18.8 


Lancaster, - 


5 


do 


779 


301 


38.6 


396 


50.8 


Middlesex, - 


5 


do 


1183 


181 


15.3 


326 


27.5 


Norfolk, - 


5 


do 


293 


127 


43.3 


135 


46. 


Nottingham, 


5 


do 


274 


100 


36 


42 


15.3 


Stafford, - 


5 


do 


634 


295 


46.6 


110 


17.3 


Suffolk, - 


5 


do 


362 


167 


461 


104 


28.7 


West Riding, 


5 


do 


709 


303 


42.7 


257 


36.2 



32 STATE LUNATIC HOSPITAL. 

In the State Lunatic Hospital for the eight years which we now 
report, we have received eleven hundred and ninety-six patients, of whom 
jive hundred and six have recovered, forty-two and three-tenths per 
cent., ninety have died, which is about seven and one-half t^qx cent. 

The average recovery, in the thirteen British institutions, is thirty- 
seven and five-tenths per cent., and the average deaths, twenty-seven and 
three-tenths. 

The Middlesex asylum, near London, received, in five years, eleven 
hundred and eighty-three patients, had one hundred and eighty-one 
recoveries, and three hundred and tioenty-six deaths. 

In the State Lunatic Hospital, eleven hundred and ninety-six patients 
have been received, J?t?e hundred and six recovered, and ninety died. 



STATE LUNATIC HOSPITAL. 



33 



TABLE I. 

Showing the number of Admissions, and the state of the Hospital, from 
December \st, 1839, to November 30<A, 1840. 



Patients in the Hospital in the course 
Males, 
Females, . - _ 



of the year, 
190 
201- 



-391 



391 



At the commencement of the year, - 

Males, - . . 

Females, - - - 

Admitted in the course of the year, - 
Males, 

Females, - . - 

Old, 

Recent, _ . . 

Remain at the end of the year. 

Males, ... 

Females, _ - _ 

Old, 

Recent, . - _ 



Patients admitted, 

Males, - ; 

Females, - 



75 

87- 



Cases of less duration than 
1 year, - - ■ -. 
Males, - 't- 28 

Females, - - 47- 



162 
-162 

75 
-75 



Cases of longer duration 

than 1 year, - . - 87 
Males, - r i,-, 46 

Females, - • - 41 87 

Cases admitted by the Court, 105 

" " Overseers, 9 

" « Friends, 48 



Foreigners in the Hospital 
in the course of the year, 
Males, - - 18 

Females, - - 12—30 



30 



Natives of other States, 

Males, - - 12 
Females, - - 7—19 

49 

5 '"7' 



113 
116- 



229 



-229 



75 

87- 

87 

75- 



122 
114- 

208 
28- 



-162 
-162 






-236 



Patients now in the Hospital, 
Males, - - 122 
Females, - - 114 — 



162 



trr 



236 



236 
-236 



Cases of less duration than 

1 year, - - - . 28 

Males, - - 14 
Females, - - 14 28 

Cases of longer duration 

than 1 year, - - - 208 
Males, - - 107 
Females, - - 101 208 



Applications not received, 99 


From this State, - 


58 


Males, 


29 


Females, - 


29—58 


From other States, 


41 


Males, 


21 


Females, 


20-^1 



-99 



3'i 



34 STATE LUNATIC HOSPITAL. 

From this table may be seen, that, in the course of the past year, 
there have been in the Hospital three hundred and ninety-one patients, 
one hundred and ninety of whom were males, and two hundred 
and one females. Two hundred and twenty-nine remained at the close 
of the year, one hundred and thirteen males, and one hundred and six- 
teen females. 

There have been admitted, in the course of the year, one hundred 
and sixty-two patients, seventy-Jive males, and eighty-seven females ; 
eighty-seven of which were old cases, and seventy-Jive were recent 
cases. 

There remain, at the end of the year, two hundred and thirty-six 
patients, one hundred and ticenty-two of whom are males, and one hun- 
dred and fourteen females. Two hundred and eight of these cases are 
of more than one year's duration, and twenty-eight of them of less dura- 
tion than one year. 

Of the old cases, one hundred and seven are males, and one hundred 
and one are females. 

There have been one hundred and Jive cases admitted by order of 
courts, nine by overseers, and forty-eight by friends, usually denomi- 
nated private boarders. 

There have been in the Hospital, during the year, forty-nine persons 
not residents in this State, thirty of whom were foreigners, eighteen 
males, and twelve females : nineteen were natives of other states, twelve 
males, and seven females. 

The applications for admission at the Hospital, not received, have 
been ninety-nine, fifty-eight from this State, twenty-nine males, and 
twenty-nine females ', forty-one from other states, twenty-one males, and 
twenty females. 



STATE LUNATIC HOSPITAL. 



35 



TABLE 2, 

Showing the number of Discharges and Deaths, and the condition of 
those who have left the Hospital, from December Ist, 1839, to No- 
vember 30</j, 1840. 





No. of 
each sex 


Recov- 
ered. 


Im- 

prov'd 


Not im- 
proved. 


Harm- 
less. 


Want of 
room. 


Died. 


Total. 


Patients discharged, 155 

Males, - ---' 
Females, - - / 


68 
>87 


M 


•55 
tl4 


^ 




6 
9 




'19 
10 


7 


12 

(3 


* 


Patients discharged of 
duration less than 1 


155 

; 

25 
45 


82 


29 


29 


14 


15 


15 


155 


year, . - 70 
Males, - ,, - 
Females, - 


>23 
41 


1 

1 














1 
3 




Patients discharged of 
duration more than 


70 


64 


2 











4 


70 


1 year, - - 85 
Males, 
Females, - 


43 
42 


5 
13 


13 
13 


19 

10 


' 7 
7 


12 
3 


5 

6 


■ 




85 


18 


26 


29 


14 


15 


11 


85 



There have been discharged, in the course of the last y^ar, one 
hundred and fifty-five patients, sixty-eight males, and eighty-seven 
females. Of these, eighty-two had recovered, twenty-eight males, 
ditiA fifty-four females. Twenty-nine had not improved, but were dis- 
charged as harmless, and for want of room ; of these, nineteen were males, 
and ten were females. Fifteen have died, six males, and nine females. 

Of the patients discharged, seventy had been insane less than one 
year, ttoenty five males, and jTor/y^we females ; of this number, sixty- 
four recovered, tioenty-three males, and ybr/y-one females; two were 
improved, one male, and owe female; ^xxAfour died, one male, and three 
females. 

Of the patients discharged, eighty-five had been insane more than 
one ye^r, forty-three males, and forty-two females ; of these, ci^A^cew 
recovered, ^we males, and thirteen females; twenty-six were improved, 
thirteen males, and thirteen females ; twenty-nine were not improved, 
mostly harmless, or sent to Boston to enter the new Hospital, being 



36 STATE LUNATIC HOSPITAL. 

paupers, supported by the city, and belonging to Boston ; of these, 
nineteen were males, and ten were females ; eleven have 6\eA,Jive males, 
and six females. 

Of the deaths that have occurred in the course of the year, one took 
place mjive days after admission, of apoplexy ; one in nine days, a case 
of inflammation of the brain, with delirium, mistaken for mania, and 
an improper subject for an insane Hospital ; one in ten days after 
admission, also an improper subject, completely paralyzed, when she 
came to the Hospital, deprived of sense, and the power of motion, by 
previous disease, and the fatigue and suffering of a journey of seventy 
miles, on a cold day in winter. ^|fcother patient died in eight days after 
a long journey in winter, so insani^ that the best efforts of her friends 
could not prevent her suffering. Two others were brought in a hope- 
less state, with incurable disease upon them, one of these survived three 
weeks, and the oiher, four. 

In an institution like the State Lunatic Hospital, such cases must 
always be found, and having no power to exclude any who come by 
authority of courts, will always be liable to receive improper subjects 
and to have its catalogue of deaths enlarged. Notwithstanding these 
disadvantages, the per cent, of deaths in the Hospital has been less than 
eight on the whole number of patients admitted. 



STATE LUNATIC HOSPITAL. 



37 



TABLE 3. 



Showing the number of Admissions and Discharges 
each month of the year. 


Average of Patients in the Hospital, 
the year. 


each month in 




Admitted. 


Discharged. 


Monthly Average. 


December, 
January, 
February, 
March, 


10 
10 
12 
13 


14 
15 

6 
12 


December, 
January, - 
J'ebruary, 
March, 


223f 
2201 
227 
225 


April, 

May, 

June, 


16 
13 
17 


16 
16 

9 


April, 

May, 

June, 


226 

226^ 

229 


.>*July, 

August, 

In September, 

October, 


13 
14 
22 
14 


22 
11 

8 
12 


July, 

August, - 
September, 
October, - 


2--*8 
226 
2J6I 
241 


■^Ntovember, 


8 


14 


November, 


23fei 


• 


162 


155 


Yearly Average 


229 



This table shows the number received and discharged the past 
year, the number that came in, and the number that left the Hos- 
pital each month, and the average number each month, and for the 
year. The number admitted is one hundred and sixty-two, and the 
number discharged, one hundred and fifty-five, making an aggregate 
of three hundred and seventeen patients, amounting to more than one 
change every business day of the year. During the last three years, 
there have been admitted into the Hospitalise hundred and eighteen 
patients ; and discharged, in various ways, four hundred and sixty- 
seven. 

The average number of patients the last year was two hundred and 
ttventy-nine, greater by six nearly, than the year before. We have 
recently had on our list of patients, almost constantly, from ten to 
fifteen more than we had rooms to accommodate them, and closed the 
year with two hundred and thirty-six. 



STATE LUNATIC HOSPITAL. 



TABLE 4. 

Statistics of the State Lunatic Hospital, from January, 1833, to No- 
vember SOth, 1840. 





ents 


1833. 


1834. 


1835. 


1836. 


1837. 


1838. 


1839. 


1840. 


Total. 


Whole number of Pati 




















admitted, - 


- 


153 


119 


113 


125 


168 


177 


179 


162 


1196 


Discharged, includ'g deaths 




















and elopements, - 


- 


39 


115 


112 


106 


121 


144 


168 


155 


960 


Discharged recovered. 


- 


25 


64 


52 


58 


69 


76 


80 


82 


506 


Discharged improved, 


- 


7 


22 


23 


17 


23 


24 


29 


29 


174 


Died, - 


- 


4 


8 


8 


8 


9 


16 


22 


15 


— ^ 


Eloped, - - - 


- 


1 


1 


] 


1 














- ^^ 


Patients in the Hospital in 




















the course of each year, 


153 


233 


241 


245 


306 


362 


397 


391 


1196 


Patients remaining at 


the 




















end of each year, 


- 


114 


118 


119 


138 


185 


218 


229 


236 





Males admitted. 


._ 


96 


79 


51 


66 


94 


96 


80 


75 


637 


Females admitted, - 


- 


57 


39 


62 


59 


75 


81 


99 


87 


559 


Males discharged, - 


_ 


19 


58 


57 


56 


66 


74 


66 


68 


463 


Females discharged, 


- 


15 


48 


46 


41 


47 


54 


80 


87 


418 


Males died, 


_ 


3 


5 


4 


6 


6 


10 


14 


6 


54 


Females died, 


- 


1 


3 


4 


2 


3 


6 


8 


9 


36 


Patients sent by Courts, 


_ 


109 


55 


89 


117 


129 


123 


123 


105 





Private, - - - 


- 


44 


64 


21 


8 


39 


54 


56 


56 





Recoveries : 






















Males, 


. 


13 


33 


27 


32 


37 


45 


32 


28 


247 


Females, 




12 


31 


25 


26 


32 


31 


48 


54 


259 




25 


64 


52 


58 


69 


76 


80 


82 


506 


Average in the Hospital < 


sach 




















year, - 


" 


107 


117 


120 


127 


163 


211 


223 


229 





'} 



STATE LUNATIC HOSPITAL. 



39 



For two or three years past, a table has been prepared, which may 
be considered a summary of all that occurs at the Hospital. It is 
a condensed view of our state from year to year. It shows the 
number of admissions, discharges, deaths and recoveries, that have 
taken place since the Hospital was opened. From it we learn that the 
whole number of males admitted has been six hundred and thirty-seven, 
the number of females, J?yc hundred and fifty-nine. The number of 
males discharged has been jTowr hundred and sixty-three, and the num- 
ber of females discharged has been /bwr hundred and eighteen. The 
recoveries of males have been two hundred and forty-seven, and the 
recoveries of females, two hundred and fifty-nine. The deaths have 
he&a fifty four males, and thii'ty-six females. 

The average number of patients has increased every year to the past, 
but it cannot be expected in future, as the average of the past year has 
been such as to keep every room, of all descriptions, full, every day of 

the year. 

The recoveries of males, exclusive of deaths, have heen fifty-one and 
one-fifth per cent, of the discharged ; the recoveries of females have 
been a little short of sixty-two per cent, of the discharged ; average, 
fifty-seven per cent. 

TABLE 5. 



Duration of Insanity with those remainin 


g in tlie 


Ages of Patients in the 


Hospital, 


December 1st. 


Hospital, 


December 1st, 


1840. 






1840. 








Less duration than one year, 


28 


Under 20, - 








6 


From 1 to 2 


years, 


- 


- 


23 


From 20 to 25, 


- 


- 


. 


26 


« 2 to 5 


(C 


_ 


- 


55 


(( 


25 to 30, 


_ 


. 


. 


33 


« 5 to 10 


« 


. 


. 


56 


<( 


30 to 35, 


. 


_ 


_ 


29 


« 10 to 15 


(( 


- 


- 


40 


« 


35 to 40, 


. 


_ 


_ 


37 


« 15 to 20 


« 


. 


- 


11 


(( 


40 to 45, 


- 


. 


. 


30 


« 20 to 25 


u 




- 


11 


(( 


45 to 50, 


- 


. 


_ 


23 


« 25 to 30 


u 


- 


. 


3 


(( 


50 to 55, 


. 


_ 


_ 


17 


Over 30, 


u 


. 


- 


5 


<( 


55 to 60, 


. 


_ 


. 


9 


Unknown, 


_ 


. 


- 


4 


» 


60 to 65, 


- 


_ 


_ 


9 












(( 


65 to 70, 


- 


- 


_ 


9 










236 


(( 


70 to 75, 


. 


. 


_ 


3 












Over 75 - 


. 


. 


. 


1 












Unknown, - 


- 


- 


- 


4 






















236 



40 STATE LUNATIC HOSPITAL. 

It will be seen, by this table, that the proportion of recent cases 
of less duration than one year, is small in comparison, being only 
twenty-eight of two hundred and thirty-six. 

The number of recent cases remaining the same, there must be a 
change, at least, three times a year, to make a list o^ sixty -four recove- 
ries annually. Were it not that provision has been made for removing 
the harmless and violent incurable cases, the Hospital would have long 
since been filled with incurables, almost to the entire exclusion of recent 
cases; notwithstanding that many such have been removed, particularly, 
all the paupers from the city of Boston to their new hospital, the pro- 
portion of old cases is greater at the close of this year, than the last. 
It is exceedingly desirable that all persons insane should find accom- 
modations in hospitals ; but, if any must be excluded, the old and hope- 
less cases, the demented and idiotic had better be with their friends, 
and in other places of security and comfort, to afford to the recent 
cases that may occur in the community the best chance to recover. 
Three curable cases occupy but the place of one old one, each year ; 
on this rule, in the place of one old and hopeless case of insanity, 
occupying an apartment from the time the Hospital was opened, at 
least twenty recent cases would occupy the same room, and have 
recovered, and returned to friends and usefulness in society. While 
we should be careful, then, to retain all old cases that will be likely to 
suffer, and be neglected abroad, it is exceedingly desirable that all 
recent cases should find early admission to the Hospital, on the most 
favorable terms, that the greatest good may be done to the greatest 
number of sufferers, and society and families be benefited by the res- 
toration of valuable members. 

The Hospital commenced the laSt year with two hundred and twenty- 
nine patients, and closed with tivo hundred and thirty-six, a difference 
of seven. The average of the previous year vvas two hundred and twenty- 
three, and a fraction : this year the average has been two hundred and 
twenty-nine, a diffierence of about six. 

There are, at present, jifly-one patients in the Hospital, who have 
been insane less than two years, and one hundred and eighty-Jive, who 
have been insane from tioo to thirty years. 



STATE LUNATIC HOSPITAL. 



41 



TABLE 6. 

Classificatwn of Insanity, 





Whole Number. 


Each Sex. 


Curable 


Total of Curable. 


Mania, - - - 
Males, 
Females, 


585 


312 
273 


188 
187 


375 


Melancholia, 
Males, 
Females, 


375 


181 

194 


103 
111 


214 


Dementia, 
Males, 
Females, 


164 

_ 


100 
64 


4 
4 


8 


Idiots, - - - 
Males, 
Females, 


9 


8 
1 











A few cases not classified. 



All divisions of insanity into nosological classes, are somewhat arbi- 
trary. In looking over our list, it is not easy to say, where many cases 
should be classed. Many cases commence with high maniacal excite- 
ment, and result in deep and distressing melancholy ; others are dull, des- 
ponding, and gloomy, for a longer or shorter period, and then become 
greatly excited for a season before the mind assumes a proper balance. 

So also many recent cases appear demented for some time, and 
come out gradually from a state, which, if it had existed long, would 
be considered utterly hopeless; such cases ive do not class with the 
demented, although others may do so; many such cases recover, and 
return to perfect health and a sound mind. 

There have been^uc hundred and eiglity-Jive cases of mania in the 
Hospital, of which three hundred and seventy-Jive have recovered or 
are considered curable, which is sixty-Jive and three Jifths per cent. 
There have been three hundred and seventy-Jive cases of melancholy in 
the Hospital, of which two hundred and fourteen have recovered, or 
are considered curable, which is shoni ffty -seven per cent. There 
have been in the Hospital one hundred and sixty-four cases demented, 
oi which on\y eight have recovered, which is but ^ue percent. As 
before observed, others may class a different set of cases under demen- 
tia, which will make a great difference in the per cent, of recoveries in 
cases of this description. 
6 



42 



STATE LUNATIC HOSPITAL. 



TABLE 7. 
Statistics of the different Seasons. 





1833. 


1834. 


1835. 


1836. 


1837. 


1838. 


1839. 


1840. 1 


Total. 


Admissions in winter, 


27 


26 


24 


23 


26 


46 


39 


32 


243 


Admissions in spring, 


71 


35 


31 


36 


49 


46 


38 


42 


348 


Admissions in summer, 


21 


30 


30 


42 


40 


47 


59 


44 


313 


Admissions in autumn, 


21 


28 


28 


24 


53 


38 


43 


44 


279 


Discharges in winter, 





22 


21 


20 


15 


18 


36 


35 


167 


Discharges in spring, 


7 


33 


30 


33 


38 


37 


43 


44 


265 


Discharges in summer, 


10 


28 


31 


24 


30 


43 


55 


42 


263 


Discharges in autumn. 


24 


24 


22 


21 


38 


32 


34 


34 


229 


Recoveries in winter, 





12 


14 


11 


10 


15 


13 


18 


93 


Recoveries in spring, 





20 


13 


14 


17 


23 


24 


22 


133 


Recoveries in summer. 


9 


16 


16 


12 


15 


18 


24 


20 


130 


Recoveries in autumn, 


16 


15 


12 


20 


"27 


20 


20 


22 


152 


Deaths in winter. 





3 


1 





1 


3 


5 


6 


19 


Deaths in spring. 


2 


2 


2 


1 


2 


5 


5 


6 


25 


Deaths in summer. 


2 


3 


2 


4 


1 


5 


7 


1 


25 


Deaths in autumn. 








3 


3 


5 


3 


5 


2 


21 



It is interesting to know in what manner the seasons affect 
the insane, to ascertain which, this table was made out. No 
very important conclusions can be drawn from the records here pre- 
sented. 

The number of admissions has been greatest in spring, and the num- 
ber of discharges equal or nearly so in spring arid summer. Autumn 
has afforded the greatest number of recoveries, and spring and summer 
the greatest number of deaths. 

The temperature of the Hospital is so uniform, that we are greatly 
exempt from the diseases arising from changes of temperature, and in- 
deed, from most acute diseases. 

With twelve hundred patients, we have had but three cases of pleu- 
risy or lung fever in the Hospital ; and of ninety deaths, ten only have 
been the result of acute febrile disease or inflammation. 



STATE LUNATIC HOSPITAL. 



43 



TABLE 8. 
Causes of Insanity. 



Intemperance, — Males, 164 




Hereditary, or having insane 




Females, 21- 


-185 


ancestors or near Uindred, 


361 


111 health, - 


185 


Periodical, 


239 


Masturbation, 


103 


Homicidal, 


18 


Domestic afflictions. 


129 


Actual Homicides, 


13 


Religious, - - - 


84 


Suicidal, or having a strong 




Loss of property, fear of pov- 




propensity to self destruc- 




erty, &c. 


71 


tion, - . - 


134 


Disappointed affection. 


53 


Actual suicides, 


5 


Disappointed ambition, 


27 






Epilepsy, - - - 


35 


Of 663 cases that have been 




Puerperal, 


30 


examined, — 




Injuries of the head, 


16 


Have dark complexion, hair 




Abuse of snuff" and tobacco. 


7 


and eyes. 
Light complexion, hair and 


344 


Arising from physical causes, 


567 


eyes, - _ _ 


319 


Arising from moral causes, 


364 







There is no subject connected with insanity more interesting 
than the causes of it. Of these the first inquiry is made in 
every case ; its importance, both to the case itself and to the commu- 
nity, is not over estimated. There are difficulties connected with it, 
however, that increase the obscurity beyond that of most other dis- 
eases. 

Insanity often comes on slowly and imperceptibly ; the workings of 
disease are hidden from our view, and the real cause actually lies be- 
hind the apparent one. In this way intemperance, religious feeling, 
the solitary vice, and many others, are the supposed causes, when in 
fact they are only the effect of the first impulses of disease ; so often is 
this true of the latter cause, that in my reports, (and I find some of my 
friends have done the same,) I have always said, "produced or per- 
petuated" by this cause. 

That they all are fruitful causes of insanity, however, is undeniable, 
and perhaps, although they may sometimes be wrongfully accused, 
they may, nevertheless, not be more frequently applied than the truth 
will warrant. It is doubtless often true that one cause does not come 
alone in the production of insanity. 

Ill health, the derangement of a man's affairs, misfortunes of one 
kind or another, afflictions, disappointments, often come in clusters, 



44 STATE LUNATIC HOSPITAL. 

and their combined influence disturbs that condition of the brain and 
nervous system upon which the integrity of the mind depends. 

There is another difficulty, hardly less formidable, in arriving at the 
true cause of insanity ; it is the unwillingness of friends to disclose all 
they know of the origin and progress of the disease ; this is particu- 
larly true of all causes which are considered disreputable. In all cases 
we get the best information in our power, and make our record ac- 
cordingly. 

Intemperance still stands at the head of our list, having produced 
one liundrcd and eighty-five cases in the whole, and added fourteen the 
last year, to the previous number. 

To ill health are also attributed one hundred and eighty-Jive cases ; 
this is rather a compound than a simple cause, embracing wounds of 
the head, and all varieties of disease that affect the. nervous system, 
either directly or remotely. This is also a cause that is not considered 
disreputable, and we are able to get at it more easily than many others 
of a different description ; for this reason it may sometimes be assigned 
as a cause, when in reality it is not so. The remarks applicable to ill 
health apply with equal propriety to domestic affliction, for under this 
term are also collected a number of influences, similar in effect, but 
unlike in kind; and if any serious evil of this kind has occurred to a 
patient, it may not unfrequently be assumed as a cause when some 
other less prominent influence has given rise to the disease. 

The large number of cases denominated hereditary, require a pass- 
ing remark ; strong constitutional tendencies, derived from ancestors, 
affecting physical condition and mental and moral development, are 
discoverable more or less in all mankind; certain forms of disease af- 
fect certain families, and none more than insanity. This is what is, 
in these reports, denominated hereditary predisposition. It is not ne- 
cessary to the existence of this influence upon the offspring, that the 
parents be actually insane, but that they, having peculiarity of nervous 
constitution, have entailed on their descendants this predisposition so 
strongly, that it exhibits itself in one or many of their descendants. 

In many reports hereditary predisposition is placed, in some cases, 
as the sole cause of insanity ; I question greatly whether this is ever 
true ; in my opinion there must be some exciting cause in all cases to 
bring into action this latent constitutional principle before disease is 
actually developed ; when individuals are predisposed to this, or any 
other disease, they should studiously avoid these exciting causes, by 
which course they may generally be safe ; they cannot always do this 



STATE LUNATIC HOSPITAL. 45 

effectually, but in a large proportion of instances they will, by great 
prudence, keep clear of this great calamity. 

Many medical men disbelieve wholly in hereditary predisposition, 
while others refer to it half the evils that " flesh is heir to ;" the truth 
in this, as in most other cases, probably lies between. 

The following cases, from one family, have come under my care in 
the course of the last twelve months. 

Towards the close of November, 1839, a young woman aged eigh- 
teen was brought into the Hospital in a state of complete dementia ; 
she was not conscious where she was, nor who were around her ; she 
would remain statue-like wherever she was placed, and neither ate nor 
drank, nor attended to the calls of nature, without being fed, or moved, 
by others ; she gradually improved under efficient medical treatment, 
and in four months, some time in March, she returned to her friends, 
completely recovered. 

In April following, a little more than a month after this young 
woman left the Hospital, her mother was brought to our care, in a sit- 
uation nearly like that of her daughter. Nothing could be worse than 
the situation of this woman. She improved slowly at first, but rapidly 
afterwards, and at the end of three months was restored to health and 
soundness of mind. She also returned to her home, and gave joy to 
afflicted friends in a restoration perfect and entire. She left the Hos- 
pital towards the close of July. 

In October, a son of the last named patient, and own brother of the 
first, aged hventy-lwo, was brought to the Hospital a furious maniac. 
The case was a bad one, the excitement continued long and severe : 
he is now improving favorably, with a fair prospect of recovery. 

Before there was any essential amendment in this last formidable 
case, another victim, from the same devoted household, came to our 
charge ; the sister of the last named, and daughler of the one preced- 
ing, an interesting young woman of ttoerity-four years of age ; and 
this was the worst case of all, for, in addition to common symptoms, 
was the debility and susceptibility of the puerperal state; her infant 
was one week old only, when the symptoms of this formidable species 
of mania were rapidly developed ; the excitement was extreme, the 
mind perfectly chaotic, and jactitation so great as to require, in addi- 
tion to restraint usual in such cases, the active vigilance of two experi- 
enced nurses. This patient is now convalescing, and we have reason- 
able ground to hope that both the brother and sister will return in less 
than a year from the time of the first sister's complete recovery ; so 



46 STATE LUNATIC HOSPITAL. 

that the four may be in a hospital, in the very worst circumstances, 
and all be well, in one year. 

Such cases as this are rare, although it is by no means uncommon 
that as many individuals of one family are successively insane. 

Some time in the year 1838, a young lady was taken suddenly in- 
sane, on a journey to the west ; she was detained a few days in one of 
the institutions in the middle states. In a few weeks she was brought 
to our care ; before there was any change in the case, a brother was 
also brought to the Hospital, who had been long insane, but who had 
then frozen his feet so badly that his friends determined to afford him 
better winter quarters ; before the necessary arrangements were made, 
however, mortification commenced in the frozen feet, and by the time 
he reached the Hospital he was in a dying state, and did not survive 
his journey twenty-four liours. The sister convalesced favorably, but 
by this and other trials, relapsed, and was again as bad as ever. Be- 
fore she became calm and tranquil again, another sister, older than 
herself, was brought to the Hospital ; the case was violent, but the 
amendment rapid, and in a few weeks she was recovered, and went to 
her friends before the sister first committed was entirely well ; the lat- 
ter continued to convalesce, and was finally completely restored to 
sanity of mind. Before she finally left the Hospital, a messenger came 
to us, post haste, to say that another brother of this afflicted woman 
was a furious maniac ; papers were immediately prepared for his ad- 
mission to the Hospital ; before the messenger arrived with them this 
brother died in the greatest possible excitement. 

The sister who endured all this affliction, steadily convalesced and 
has since returned to her friends, quite well. 

The evidence of a constitutional predisposition to insanity, in such 
cases, is too strong to be resisted ; but the strength and activity of the 
hereditary taint is very different in different cases, and in different 
individuals in the same family. 

All cases that have had a recurrence of insanity, once or more than 
once, are placed in the table as periodical : the interval between these 
occurrences is extremely various ; from a few months to many years. 
Strictly, the term periodical should be applied to such cases only, as 
recur at regular periods. There are many such cases; but they hardly 
amount, as far as we have known, \.olen per cent, of the number in the 
table. 

In the British Report, much is said about relapse ; one third, and in 
some instances, one half their cases relapse. I am not able to say, 



STATE LUNATIC HOSPITAL. 47 

what is the precise meaning which they attach to this word. From the 
very great number of relapses reported by some of their institutions, I 
have supposed that any recurrence of insanity, after one attack, was 
considered a relapse. 

In my opinion, this is a wrong view of the case. If, on a patient's 
return from an institution as recovered, some traces of disease are 
found to remain, or if, after a certain period of appearing quite well, 
the symptoms of insanity recur before perfect health has been estab- 
lished, it is, strictly speaking, a relapse. But if the period of a year, 
or many years, elapses before this recurrence takes place, and the indi- 
vidual has enjoyed a rational mind the whole time, and pursued his 
occupation, and appeared to all around him a rational being, the recur- 
rence should not be called a relapse. The rule applicable to other 
diseases is applicable to insanity. No physician considers a second 
attack of pleurisy, rheumatism, or colic, a relapse, if months, and par- 
ticularly if one or more years have elapsed between the two attacks; 
although the predisposition or susceptibility is much increased by this 
first attack, and a second will occur from a much slighter cause. 

In case the individual is exposed a second time to the cause of in- 
sanity, which produced the disease in the first instance, such as intem- 
perance, disappointment in business, domestic affliction, or ill health, 
there would be the strongest reason to believe, that the disease was 
wholly of new origin, independent entirely of the previous attack. 

The true physiological view of the case is this : certain derange- 
ments of the brain and nervous system produce insanity of one kind or 
another ; while these derangements continue, insanity continues with 
as much certainty as lameness continues from gout or rheumatism ; 
when this derangement is removed, so that the functions of the brain 
and nerves are restored, then insanity disappears, as lameness disap- 
pears when the inflammation of gout or rheumatism subsides. 

I present these views to explain the table, and to show the rule 
adopted by us relative to relapses and periodicity. 

Since the opening of the Hospital, we have had thirteen patients 
who have actually attempted homicide ; except in ttco instances, the 
dangerous wounds inflicted proved fatal ; eleven were immediately fatal. 
Of these, tico have died, and two have been discharged recovered — in 
both instances, by the high courts of the Commonwealth. 

It is a question of very serious import, whether an insane man, who 
has taken life in the excitement and from the impulse of his disease, 
should ever be enlarged. If he has not recovered from his insanity, 



48 STATE LUNATIC HOSPITAL. 

the case to me is a clear one ; the tendency to a recurrence of the act 
would be very strong, the circumstances of the case being the same. 
Every case of insanity has its peculiarities, — the appetites, propensi- 
ties, and passions are affected in different ways, in different cases. We 
will not stop to inquire, whether this arises from different conformation 
of the brain in different individuals, the fact is undeniable. One will 
tear his clothes and bedding, one will ornament his person, another 
will besmear himself with all kinds of filth ; in one, benevolence will 
be active, in another a propensity to mischief will predominate ; in a 
few the propensity is to kill, although such individuals may be gener- 
ally harmless, yet at periods they are not so ; and in many cases these 
impulses are so sudden that no precautions can prevent danger. Other • 
cases, no less unsafe, are those who suppose that they are commis- 
sioned to execute the commands of Heaven by destroying a fellow- 
being ; their plans are devised and executed with so much art and 
secrecy, that no vigilance will detect the danger, the fatal stroke is 
struck without warning, and the hapless victim knows not the agent 
that has inflicted the deadly blow. 

All such cases should be perpetually confined ; no argument should 
weigh for a moment with a court of justice in favor of liberating such 
an individual. The fact that life has been taken, should overbalance 
all motives to send such a person into society again while the delusions 
and estrangements of insanity continue. 

There is another case which, if not as clear, is one in which the 
propriety of liberation is very questionable, — it is a case of insanity mk 
arising from a specific cause, liable to recur at any time when that 
cause is brought to operate, in which the first impulse is a desire or 
disposition to kill. It is extremely questionable, whether such an indi- 
vidual should be permitted to have liberty again ; in my view all right 
to liberty is forfeited by such an act, unless there is the clearest evi- 
dence of entire restoration, and the strongest probability that the cause 
of the disease will hereafter be avoided. If the cause is a voluntary 
one, the case is rendered still stronger as, in general, there is a greater 
probability of its future influence than such as are strictly involuntary. 
By voluntary causes I mean intemperance, the secret vice, speculation, 
and all others that it is in the power of the individual to avoid. 

In the course of the last year, two cases of homicidal insanity were 
discharged from the Hospital. One was an unfortunate female, who, 
under the delusions of disease, supposed it her duty to destroy her 
children, to rid them from the suffering and degradation of living with 



STATE LUNATIC HOSPITAL. 49 

a drunken, worthless, and abusive parent. She inflicted dreadful 
wounds on two lovely children, and also on a female friend who went 
to their rescue; fortunately, but very unexpectedly, all recovered, and 
she was saved the agonizing suffering which must have unavoidably 
been her portion, if, on recovering, she had found that her own oflT- 
spring had been destroyed by her own hand. She was not conscious 
for a long time what she had done, but had a dreamy impression that 
she had assailed and wounded her children ; she hoped, and half be- 
believed, it was a dream. When far advanced toward recovery, a vio- 
lent patient got angry with her, and called her a "murderer;" the 
dreadful reality flashed upon her mind and she was in an agony of suffer- 
ing. I was sent for; after awhile she was quieted, and heard with 
composure the truth of the case ; the circumstance that the children 
were living and well, was impressed forcibly upon her mind — had it 
been otherwise, had they died, I now fear that her mind would have 
been entirely overset by the intelligence. She recovered very favora- 
bly, and went to her friends in the care of her judicious spiritual guide, 
and has since lived happily in the enjoyment of her children, a most 
exemplary and worthy woman. 

The other case was a temporary violent insanity, the result of intem- 
perance. The man was under a delusion that a voice came to him 
from one whom he felt bound to obey, commanding him to take an 
axe and destroy a neighbor, to whom he was not at all hostile, with all 
possible despatch. He executed the bloody deed, and was immediately 
arrested and placed in confinement, from whence, by order of court, 
he was soon transferred to the Hospital ; by this lime the delusion and 
the insanity had departed. One year after his confinement, application 
was made to the Supreme Court for his discharge, but the discharge 
was not granted ; six months after, the Court of Common Pleas granted 
his release. He will probably be a safe man till he returns to his 
cups; if he should again become intemperate, neither his friends nor 
the community will be for a moment secure from danger. 



50 



STATE LUNATIC HOSPITAL. 

TABLE 9. 

Occupation. 



•M ' Farmers, 
U I Laborers, - - - ■ 
Ij/ Shoemakers, 
J I ^j Seamen, 
^y» Merchants, 
}i il Carpenters, 
^ Manufacturers, 
p f Teachers, - 
Blacksmiths, 
Printers, 
/ / Students, - 
/ Tailors, 
/ Machinists, 

Clothiers, - 
/ Coopers, 

Bricklayers, 
f Millers, 
/ Cahin it makers, 
^J Clergymen, 
a" Bakers, 
Musicians, 
Pedlers, 
Painters, 
Paper-makers, 
Calico Printers, 
Sail-makers, 
Tanners, 
Comb-makers, 
Turners, 
Harness- makers, 
Physicians, 
Coachmen, 
Butchers, - 
y Lawyers, - 



145 

106 

47 

43 

39 

31 

28 

23 

16 

14 

16 

10 

8 

7 

6 

5 

4 

4 

3 

4 

4 

4 

4 

3 

3 

3 

3 

3 

3 

3 

3 

3 

3 

3 



Innkeepers, - - 2 

Stevedores, - - 2 

Stonecutters, - - 2 

Broom-makers, - - 2 

Coppersmiths, - - 2 

Jewellers, / - - 2 

Watchmen, . . 2 

Drovers, - - - 2 

^Rope-makers, // - - 2 

Currier, _ - . 
News Collector, 
Engineer, - 

Hatter, . - - 

Gardener, - - - 
Mat-maker, 

Stocking-weaver, - 
Bellows-maker, 

Idiots, / - - - 1 

Vagrants, // - - 34 

Females who have no regular 
employment, who are unac- 
custonjed to labor, &c. 105 

Females accustomed to seden- 
tary employments that are 
laborious, an I to factory la- 
bor, - . . 96 

Females accustomed to active 
employments, the wives and 
danghters of farmers, me- 
chanics, &c. - - 161 

Many not classified. 



The individuals who have been admitted as inmates of the Hos- 
pital are from Jiftij-one trades or occupations, exclusive of females. 
It is difficult to estimate the comparative number from each dis- 
tinct occupation with the individuals who pursue these employments 
in the community ; nothing of any great importance can yet be gath- 
ered from the facts here presented. It would seem, that when we find 
on the list thirty-nine merchants, fourteen printers, sixteen blacksmiths, 
ten tailors, thirty-one carpenters, twenty-jive teachers, and onlyybwr 
painters, four cabinet makers, three tanners, tiDo inn keepers, five 
bricklayers, three physicians, and one hatter, that the per cents of those 
following these last occupations must be decidedly less than those of 



STATE LUNATIC HOSPITAL. 



51 



the former ; but the records of all the institutions in the Common- 
wealth must be consulted, before any definite information can be 
obtained. 

Those employments which have the greatest stability and the least 
excitement are most conducive to health ; and those occupations which 
lead people to congregate, which are quite profitable when employment 
is had, but in which employment is not steady, tend greatly to irregu- 
larity of life, licentious habits, and consequent disease. 

On the whole, no inference can be drawn from the table that any 
one occupation, in itself considered, has any particular tendency to 
produce insanity. 

Exemption from this, as from many other diseases, is best secured 
by a calm dispassionate course of life, strict temperance in diet and 
drink, steady industry, and a cheerful temper. 



TABLE 10. 

Diseases tnhich have proved fatal. 



Marasmus, - 


21 


Brain fever from intemper 


ance, 


2 


Epilepsy, - 


14 


Dysenteric fever, 


- 


2 


Consumptiou, 


9 


Disease of the bladder, 


- 




Apoplexy, - - - 


7 


Lung fever, - 


- 




Suicide, . - - 


5 


Old age, 


- 




Diseases of the heart, 


4 


Chronic bronchitis, - 


- 




Cholera morbus. 


4 


Gastric fever, 


_ 




Mortification of the limbs, - 


3 


Land scurvy, 


- 




Hemorrhage, 


3 


Congestive fever, 


- 




Inflammation of the bowels, 


2 


Erysipelas, - 


- 




Disease of the brain, 


2 






- — 


Diarrhcea, - _ _ 


2 






90 


Dropsy, . - . 


2 









The Hospital has been remarkably exempt from acute febrile 
diseases and inflammations ; we have had a few cases of erysepe- 
las, one of which proved fatal : a few cases of scarlet fever, all of 
which recovered. No epidemic has ever visited us; and to-day, while 
this sheet is being written, there is but a single individual who-is not 
able to take regular meals with a comfortable appetite. Ninety 
deaths, in the whole, have occurred, of tioelve hundred patients who 
have now been in the Hospital ; of these, more than eighty have been 
the result of chronic disease. 

Many cases of marasmus were far advanced before they came to 



62 



STATE LUNATIC HOSPITAL. 



the Hospital ; and the consumptions, epilepsies, and other chronic dis- 
eases had their origin before insanity commenced. 

In the Hanwell institution for the insane, near London, with eleven 
hundred and eight y-three patients, in five years, they had three hun- 
dred and twenty-six deaths. In our institution, with eleven hundred 
and ninety-iix patients at the close of the year, thirteen more than the 
foreign institution, we have had nimty deaths, less by two hundred and 
thirty-six. 

TABLE 11. 

Shoioing the duration of Insanity, the ages and civil state of patients 
admitted from December \st, 1S33, to November o^th, 1840. 





1833. 


1S3-1. 


183.). 


1£36. 


1837. 


1838. 


1839. 


1840. 


Total. 


Duration l)efore admitted: 




















Less than 1 year, 


41 


56 


49 


54 


73 


82 


84 


75 


514 


From 1 lo .5 years, 


27 


29 


37 


37 


58 


50 


63 


56 


357 


" 5 to 10 « - 


27 


14 


17 


13 


15 


16 


18 


15 


135 


« 10 to 20 « - 


31 


8 


6 


11 


15 


8 


10 


10 


99 


" 20 to 30 " - 


12 


4 


1 


2 


4 


7 


1 


3 


34 


" 30 to 40 " - 


3 


1 


1 


2 


1 


1 


1 


2 


12 


Unknown, . . _ 


12 


6 


7 


6 


5 


13 


2 


1 


52 


Duration with those remaining 




















at the end of each year : 




















Less Than 1 year, 


29 


22 


21 


11 


29 


28 


34 


28 


202 


From 1 to o years. 


20 


25 


23 


39 


51 


65 


69 


75 


366 


" 5 to 10 " - 


20 


24 


34 


35 


38 


44 


44 


52 


304 


" 30 to 20 " - 


30 


24 


29 


35 


41 


41 


52 


52 


304 


« 20 to 30 " - 


9 


5 


3 


7 


11 


18 


14 


13 


80 


Over 30 " - 


3 


2 


4 


2 


2 


3 


4 


5 


25 


Unknown, ... 


8 


16 


6 


9 


13 


19 


12 


11 


94 


Ages of patients when admit- 




















ted : 




















Under 20 years. 


2 


6 


3 


11 


13 


17 


10 


10 


72 


From 20 to 30 years, 


34 


23 


22 


29 


58 


47 


47 


46 


306 


" 30 to 40 " - 


48 


44 


42 


30 


34 


51 


49 


40 


338 


" 40 to 50 " - 


34 


28 


30 


25 


31 


32 


30 


34 ' 244 


« 50 to 60 " - 


14 


9 


11 


16 


13 


20 


21 


21 125 


» 60 to 70 " - 


17 


6 


6 


10 


12 


8 


14 


6 79 


" • 70 to 80 " - 


5 


2 


5 





7 


2 


8 


5 34 


Civil state of patients admitted : 




















Single, - - . - 


92 


71 


52 


68 


94 


101 


80 


75 


633 


Married, - - - - 


38 


40 


46 


49 


61 


65 


75 


71 445 


Widows, - - . - 


12 


4 


8 


6 


11 


5 


17 


12 ! 75 


^^dowers, ... 


" 


4 


7 


2 


2 


6 


7 


4 1 43 



STATE LUNATIC HOSPITAL. 



53 



By tlie table it will be seen that the number of admissions, 
of duration less than one year, has been, the past year, stvuity- 
jive ; which is about the average for the last/r/wr years. A majority 
of the cases are old, having existed more than one year. 

At the close of the year, there remained twenty-eight cases only that 
are called recent, or of less duration than one year, — a less proportional 
number than we have had since 1S36, when only elcvai recent cases 
remained. 

The number of single persons who were never married, that have 

been in the Hospital from the commencement has been six hnndi-ed 

and thirty-three ; the number married, at the time of their residence, 

four hundred and forty-five ; the number of widows seventy-five, and 

-viidowexs forty-tlirtt. 

TABLE 12. 

Shelving the condition of old and permanent residents loho have been 

long incurable. 





Improved in health 
and hahit. 


Improved in mind. 


Not improved. 


Of 101 cases, - - - 


73 


42 


38 


Males, - - - 


34 


19 


25 


Females, 


39 


23 


13 


^_ 









Of the 667 patients that have been in the Hospital since th§ chapel was 
openra, 579 have attended religious worship more or less, and 88 have not 
mended. 1^^->J-^ ^ y g g— ^/^S^ 

(P/J U M. CP 

It is now about eight years since individuals, now in the Hos- 
pital, became permanent residents. Taking the first one hundred 
and one, that remained on our records at the close of the year, it 
will be seen by the table, that seventy-three have improved in health 
and habits, oi whom thirty-four are males, and thirty-nine are females; 
of these, forty-two have manifested decided improvement in mind, 
although they have not recovered, of whom ninetetn are males, and 
ttoenty-thrce are females ; thirty-eight have remained nearly stationary, 
or have gradually grown worse, of whom twenty-five are males, and 
thirteen are females. It is proper to remark that most of these thirty- 
eight are, in all respects, comfortable; many labor regularly about the 



54 



STATE LUNATIC HOSPITAL. 



establishment, and nearly all observe the decencies of life; the habits of 
many of them were never bad. 

In the month of November, 1837, we opened a chapel for religious 
worship on the Sabbath. Since that time, there have been in the 
Hospital, six hundred and sixty-seven patients, of whom Jive hundred 
and seventy-nine have attended the religious meetings more or less, 
and eighty-eight have not attended : a much greater proportion, it is 
believed, than attend to such solemnities in the community at large. 
Of the one hundred old cases recorded in the table, nearly ninety per 
cent, have attended chapel more or less, and many very constantly. 

TABLE 13. 

Showing the comparative Curability of Insanity, treated at different 
periods of disease. 





Total of 




Cuiahle or 


Incurable or 




Cases 


Of each Sex 


Cured. 


not Cured. 


Of less duration than 1 year, 


493 








Males, . . - 


. 


247 


218 


29 


Females, 


- 


246 


220 


26 


From 1 to 2 years, 


192 








Males, - - - 


- 


94 


48 


46 


Fetnales, - _ _ 


- 


98 


63 


35 


From 2 to 5 years. 


190 








Males, 


- 


ly 


35 


76 


Females, - . - 


- 


7^ 


30 


49 


From 5 to 10 years, 


136 








Males, _ . . 


- 


71 


9 


62 


Females, - - - 


"• 


65 


7 


58 


From 10 to 15 years, 


80 








Males, 


. 


44 


4 


40 


Females, - . - 


- 


36 


2 


34 


From 15 to 20 years, 


28 








Males, 


. 


19 


1 


18 


Females, - - - 


- 


9 





9 


From 20 to 25 years. 


21 








Males, 


- 


11 





11 


Females, . - - 


. 


10 





10 


From 25 to 30 years. 


7 








Males, ... 


. 


5 





5 


Fern-riles, , . - 


. 


2 





2 


Over 30 years, - - - 


6 








Males, 


. 


3 





3 


Females, ^ - - 


- 


3 





3 



STATE LUNATIC HOSPITAL. 55 

From this table, we learn that four hundred and ninety-three 
patients have been admitted into the Hospital, whose insanity 
had existed less than one year : of these, ttoo hundred and forty-seven 
are males, and ttco hundred and forty-six are females; four hundred 
and thirty-tight of these recovered, and fifty-five failed to recover ; 
twenty-ttro died, leaving, of those living, only thirty-three that failed to 
recover ; and making the recoveries, exclusive of the deaths, more than 
7iinety-five per cent. This supposes, however, that the tvunty-eight 
recent cases now in the Hospital will all recover ; this will not proba- 
l)Iy prove true, as some may die, and a few may fail to get well: this 
may diminish the per cent, one or two but can hardly fail to leave it 
above ninety. 

Many of the individuals of this class, not recovered, were removed 
by their friends prematurely, when the prospect of recovery was en- 
couraging. There remain novv' not exceeding/y«r cases that came 
into the Hospital before insanity had existed one year, and but two 
that are certainly incurable. 

There have been in the Hospital, one hundred and nimty-iwo cases, 
that have been insane from one to t%oo years, of which one hundred and 
eleven have recovered, and eighty-one have failed to recover, or have 
died. The recoveries of this class have ho^en fifty -eight percent., and, 
exclusive of deaths, (nhouX. sizty-two per cent. 

One hundred and ninety patients have been in the Hospital, whose 
insanity had existed from two to five years ; of whom sixty-five have 
recovered, and one hundred and twenty-five have failed to recover, are 
considered incurable, or have died. The recoveries of this class are 
thirty-four per cent 

One hundred and thirty-six patients have been in the Hospital, the 
duration of insanity with whom has been from five to ten years ; of 
these, sixteen have recovered, and one hundred and nineteen have failed to 
recover, are considered incurable, or have died. The recoveries of 
this class are about eleven and three-fourths per cent. 

One hundred and forty -lie o patients have been in the Hospital, who 
have been insane more than ten years, of whom seven only have recov- 
ered, which is less thanj?ve per cent. 



56 



STATE LUNATIC HOSPITAL. 



TABLE 14. 

Shoioing the number of' persons employed in the different departments 

of labor. 



MALES 


FEMALES. 


Farmers, - 


- 25 


Knitters, 




61 


Laborers, - 


- 30 


Sempstresses, 


- 


51 


Shoemakers, 


- 10 


Washers, 


- 


4 


Kitchen, - 


5 


Kitclien, 


- 


6 


Washer, 


1 
71 


Scrubbers, 




- 5 

127 
71 






Laborers, 


- 


- 198 



Indulged abroad, more or less, about 95, a part of whom are laborers. 



There have been in the Hospital, in the course of the year, one hun- 
dred and ninctij-eight individuals, who have done more or less labor in 
the different dep.irtments of industry ; of this number, twenty-five were 
regular fiirmers, thirty were common laborers, who worked in the 
garden, on the grounds, upon the wood, and in various ways, when- 
ever their services were required ; ten were shoemakers ; five worked 
in the kitchen, and one in the wash-room. The above, including sev- 
enty-one male patients, were regularly employed, whenever labor was 
found for them. Other individuals have at all times been taken out to 
saw wood, and do other small jobs, have worked in the halls, &c., an 
hour or more at a time, for exercise, but these have not been consid- 
ered regular laborers. 

In the female department there have been sixty-one knitters, who 
have made many hundred socks and stockings Fifty-one sempstresses, 
who have assisted in making and mending clothes, bedding, &c., be- 
sides doing considerable labor for individuals employed in and about 
the Hospital, and elsewhere. These two classes contributed very hand- 
somely to the Bunker Hill Monument Fair, to which they sent many 
handsome and valuable articles. Four females have been regularly 
employed in the wash-room daily, when that business called for their 
aid, and many others have occasionally assisted in this department of 
labor. 



STATE LUNATIC HOSPITAL. 57 

Our object is, as far as possible, to keep patients employed, and the 
more labor they perform, the better off they are, generally. Many 
who are not laborers, are indulged with liberty to walk abroad unat- 
tended, on a pledge to return ; one goes regularly to the post office, 
two or three times a day when the mails arrive. Two intelligent and 
respectable men have driven the carriage for the female patients to ride, 
most of the last season. Without employment, the daily state of the 
inmates of the Hospital would be a dull monotony; with labor and 
books, papers, implements for writing, and various amusements, time 
passes cheerfully with many, and all are made as happy as the nature 
of the case will allow 



58 



STATE LUNATIC HOSPITAL. 



TABLE 15. 

Showing the comparative Curability of Insanity attacking at different 

ages. 





Total of Cases 


Total of each 
Sex. 


Curable. 


Incurable. 


Under 20, 


150 








Males, 


- 


78 


29 


49 


Females, 


. 


72 


46 


26 


From 20 to 25, - 


182 








Males, 


- 


97 


47 


50 


Females, 


. 


85 


50 


35 


From 25 to 30, - 


159 








Males, 


- 


88 


45 


43 


Females, 


_ 


71 


42 


29 


From 30 to 35, - 


160 








Males, 


. 


97 


45 


52 


Fetnalcs, 


_ 


63 


36 


27 


From 35 to 40, - 


142 








Males, 


. 


62 


31 


31 


Females, 


. 


80 


45 


35 


From 40 to 45, - 


94 








Males, 


- 


51 


35 


16 


Females, 


_ 


43 


32 


11 


From 45 to 50, 


83 








Males, 


- 


38 


28 


10 


Females, 


_ 


45 


38 


6 


From 50 to 55, - 


70 








Males, 


_ 


33 


23 


10 


Females, 


_ 


37 


26 


11 


From 55 to 60, - 


39 








Males, 


- 


17 


12 


5 


Females, 


. 


22 


15 


7 


From 60 to 65, - 


30 








Males, 


. 


16 


13 


3 


Females, 


_ 


14 


11 


3 


From 65 to 70, - 


20 








Males, 


- 


13 


7 


6 


Females, 


. 


7 


5 


2 


From 70 to 75, - 


n 








Males, 


_ 


8 


4 


4 


Females, 


. 


3 


3 





Over 75, - 


9 








Males, 


. 


5 


2 


3 


Females, 


- 


4 





4 



J have been careful to collect the facts in this table, as they prove so 
difFei<;nt from what are found to be the results in many other Hospi- 
tals for the insane. 



STATE LUNATIC HOSPITAL. 59 

One fact is prominent, that persons attacked over forty years of age, 
are more likely to recover from insanity, than those under forty ; the 
table will show this to be the case. 

One hundred and fifty cases of insanity have come to the Hospital, 
the subjects of which were less than twenty years of age ; of these, 
seventy-eight are males, and seventy-tivo are females ; twuity-nine of 
the former recovered, or are curable, which is thirty-seven per cent. ; 
forty-six of the latter are recovered, or are curable, which is about 
sixty four per cent. Of the whole, the recovered and curable are fifty 
per cent. 

One hundred and eighty-two patients have been in the Hospital, who 
have become insane between twenty and twenty-five years of age ; of 
these, ninety-seven recovered; which is something more than j^i!?/-^/wee 
per cent. 

One hundred andfifty-nine patients have been under our care, who 
became insane between twenty-five and thirty years of age ; of these, 
eighty-seven recovered, or are curable, which is almost fifty-five per 
cent. 

One hundred and sixty patients have been in the Hospital, who have 
become insane between the ages of thirty and thirty five ; of this 
number, eighty-one recovered, or are curable, which is a little more 
ihnn fifty per cent. 

One hundred and forty-two patients have been under our care, who 
become insane between the ages of thirty-five ?^nA forty ; of this num- 
ber, seventy-six recovered, or are curable, which is fifty-three and one 
haf per cent. 

One hundred and seventy-seven patients have been in the Hospital, 
who became insane between the ages o^ forty and fifty ; of whom, 
one hundred and thirty-three recovered, which is seventy-five per cent. 

One hundred and nine patients have been in the Hospital, who be- 
came insane between the ages of fifty and sixty; of whom, seventy-six 
recovered, which is sixty-nine and three-fourths per cent. 

Fifty patients have been in the Hospital, who became insane be- 
tween the ages of sixty and seventy; of whom, thirty-six recovered, 
which is seventy-two per cent. 

Twenty patients have been in the Hospital between the age's of sev- 
enty .and eighty, when they became insane; of whom, nine recovered, 
which is forty-five per cent. , 

The above list will show, that there have been seven hundred and 
ninety-three cases recorded in the table, of less than/or/y years of age, 



60 



STATE LUNATIC HOSPITAL. 



when they became insane ; of whom, four hundred and sixteen recov- 
ered, or are curable, which is Jifti/-two and one half per cent. 

Three hundred and fifty-six patients have been in the Hospital, who 
became insane between the ages oi forty and eighty ; of whom, two 
hundred and fifty-four recovered, which is seventy-one per cent. 

TABLE 16. 

Showing the Relation of Cause to Recovery. 





Whole No^ 


No. of each 
Sex. 


Curable. 


Incurable. 


Intemperance, - _ - 
Males, - - - - 


190 


168 


85 


83 


Females, ... 


- 


22 


11 


11 


Domestic afflictions of various kinds, 










family troubles, love, fear of death, 










poverty, &c. ... 
Males, . - - - 


294 


117 


70 


47 


Females, ... 


- 


177 


104 


73 


Ill health, wounds, puei-peral, &c. - 

Males, . - - . 


243 


56 


27 


29 


Females, ... 


- 


187 


127 


60 


Rehgious of all kinds, 


85 








Males, .... 


. 


44 


27 


17 


Females, _ _ _ 


- 


41 


24 


17 


Masturbation, ... 


107 








Males, ... - 


. 


95 


28 


67 


Females, . . - 


- 


12 


1 


11 


Epilepsy, - . . . 
Males, - - . . 


34 


31 


4 


27 


Females, ... 


- 


3 





3 


Palsy, 

Males, - - - - 


19 


15 


2 


13 


Females, ... 


- 


4 


1 


3 



The recoveries of insanity arising from intemperance, are about^^- 
ty per cent., and show that this cause produces a disease, admitting an 
average of cures. The recent cases from intemperance often recover 
favorably. Cases of delirium tremens are rare with us, so much so, 
that we have not been able to found any calculation upon them. Old 
cases of insanity from this cause, in which there is delusion of the 
senses, are extremely unlikely to get well. 



STATE LUNATIC HOSPITAL. 



61 



The recoveries from insanity occasioned by domestic afflictions, of 
various kinds, such as family trouble, disappointed affection, fear of death, 
fear of poverty, future punishment, &-c., are greater than the forego- 
ing, being one hundred and seventy-four , of two hundred and ninety- 
four, which '\s fifty-nine per cent. 

The cases arising from ill health, excepting epilepsy and palsy, are 
the most favorable of any that come under our care ; by persevering 
with the means of relief of the several forms of disease connected with 
insanity, the health is restored and the insanity cured. Of the tioo 
hundred and forty-three cases, arising from this cause, one hundred and 
fifty-four recovered, which is something more than sixty-three per 
cent. 

From religious causes also, the recoveries have been quite favorable, 
amounting io fifty-one of eighty-five cases, which is precisely sixty per 
cent. 

The " secret vice" gives us the darkest catalogue of cases, amount- 
ing, in all, to one hundred and seven ; of which, twenty-nine only have 
recovered, which is but about ttoenty-seven per cent. 

TABLE 17. 

Showing the per cent, of cases from the 7nost prominent causes each year. 





1833. 


1834. 


1835. 


1836. 


1837. 


1838. 


1839. 


1840. 


Intemperate drinking, 


241 


24 


221 


Uh 


10 i 


161 


7i 


12i 


111 health, 


8* 


m 


211 


22i 


21^ 


28 


26^ 


25 


The afFections, 


131 


m 


176. 


16 


16 


141 


25 


I6i 


Concerning property, 


eh 


101 


8| 


5k 


6h 


lO.i 


5i 


41 


Religious, 


8d 


6i 


7^ 


6i 


6* 


9 


U 


4f 


Masturbation, - 


5 


51 


71 


16^ 


2U 


5h 


81 


61 



This table is too plain and simple to need comment. Throwing to- 
gether the relative number of cases from the various causes of insanity, 
it is conceived, will not be without interest, as all may here be seen at 
a glance, and it requires no effort to come at the facts. The results 
of our last year's experience do not vary essentially from those imme- 
diately preceding. The number of cases from intemperance is some- 
what increased ; and from the affections, somewhat diminished. 






a/ 



. IL^- 



iiJ$^'^£y I ^ 



fmn/'^rHiwn n) 



1)1 1\ 



62 



STATE LUNATIC HOSPITAL. 



TABLE 18. 



Shoioing the state of the Moon on the occurrence of a paroxysm of ex- 
citement in about 66 cases of Periodical Insanity, amounting in all 
to 532 paroxysms. Also the relation of the Moon to the 90 deaths 
that have occurred in the Hospital. 




We have continued to record facts on the subject of lunar influence, 
and are able to present a list of /ye hundred and thirty-tioo paroxysms 
of insanity, as occurring in sixty-six periodical cases ; in which there 



STATE LUNATIC HOSPITAL. 63 

were from two to twelve paroxysms each, in the course of the year. 
We present the following results. 

On the eighth day of the moon, which is i\\Q first day of the second 
quarter, there have occurred the greatest number of paroxysms of any 
one day, viz. thirty-one. 

On the second day of the moon, which is the second day of i\\e first 
quarter, there occurred twintii-dght paroxysms ; which is the second 
greatest number that occurred on one day. 

On the sevcutk day of the moon, which is the last day of the first 
quarter; and on the tioenty-fourth day of the moon, which is the tldrd 
day of the last quarter, an equal number of paroxysms occurred, which 
was twenty-six ; and these make the third and fourth days in point of 
numbers. 

On ihe fourth day of the moon, which is the fourth day of the first 
quarter, and on the seventeenth day of the moon, which is the fhirddny 
of the third quarter, twenty-three paroxysms occurred, which are the 
fifth and sixth in point of numbers. 

It is worthy of remark, that the same days, to the number of six, 
which had the precedence of numbers last year, have the greatest 
number this year, and that there is no change in the order in which 
the number of paroxysms appeared. It is also true, that the day on 
which the fewest number of paroxysms occurred the former years, was 
the day on which the fewest occurred the last year. 

The greatest number of deaths, occurring on any one day, took 
place on the thirteenth day of the moon, which is the sixth day of the 
second quarter, viz. seven. 

On the second and third days of the moon, and on the twentieth and 
twenty first days, which are the last two days of the third quarter, and 
on the twenty-fifth day, which is ihe fourth day of the last quarter, an 
equal number of deaths occurred, viz. six. 

On the sixth day of the moon, which is the last day but one of the 
first quarter, on ihe sixteenth day, which is the seco«rf day of the third 
quarter, and on the twenty-fourth day, which is the third day of the 
last quarter, an equal number of deaths occurred, v\z.five. 

Four deaths occurred on ihe fifth, seve^ith, ninth and twenty-eighth 
days of the moon. The six days on which have, heretofore, occurred 
the greatest number of deaths, have the greatest number this year; 
and the three days which have had no deaths occur upon them hereto- 
fore, have none this past year. 

Having carefully noted these facts as matters of curiosity, if not of 



64 



STATE LUNATIC HOSPITAL. 



importance, we leave the table with its remarkable coincidences, be- 
lieving that no conclusions can be derived from it, showing the correct- 
ness of popular opinion with respect to the moon's influence in produc- 
ing the periods of excitement with the insane. 



TABLE 19. 

Shoioing the causes of Insanity as affecting individuals of different 
occupations. 



Occupation or busi- 
ness. 


Intem- 
per- 
ance. 


Mas- 
turlia 
tion. 


Religious 
of ..11 
kinds. 


Domestic 
afflict, of 
all kinds. 


Fear of fiov- 
erty or los? 
of 'property. 


111 health. 


Disap- 

pi limed 
affection. 


others. 


., 


34^ 17/ 


"^ 




*' 


& 


-■v 


C Palsy, 1 


'///Farmers, 100 


14/ 


12 / 


9 / 


8 


i; 


^ Jeai'sy, 1 


2/ 2.Shoe makers, 41 


'i 


.18,^ 


4 


3 


3 


4 


1 


( Epilep. 3 
Epilepsy, 1 


Printers, 10 





9 














1 




2 Laborers, 67 


4sr^ 


12/ 


5 


2 


4 





2 




3 2 Seamen, 29 












Wound on 






L195 


2/ 


1 


' 


5 


1 





Jealousy, 1 


2 2 Merchants, 39 


9 


18Z 


f ' 


2 


9/ 





1 


/ 


y^ Carpenters ^ 
and Joiners, 25 


11/ 


6 


1 


Of 


4 


2 2 


o; 


Epilepsy, 1 


Blacksmiths, 7 


2 


1 








2 





2 




■ -' Students, 16 





13- 


' 1 


0/ 





1 / 


Poor diet, 1 



I have supposed that an interesting inquiry might be instituted as to 
the causes of insanity with men of different occupations. For the pur- 
pose of embodying the facts on this subject, I have prepared the table 
which exhibits the following results. 

Of one hundred farmers, thirty-four became insane by intemperance, 
which is thirty-four per cent. ; seventeen became insane by masturba- 
tion, which is seventeen per cent. ; fourteen became insane by religious 
causes, which is fourteen per cent ; nine by loss of property and fear 
of poverty, which is nine per cent. ; twelve by domestic afflictions of 
various kinds, which is twelve per cent.; eight from ill health, which is 
eight per cent.; one from disappointed affection; three from epilepsy; 
one from palsy, and one from jealousy. Intemperance, as a cause, great- 
ly predominates with the farmers. 



STATE LUNATIC HOSPITAL. 65 

From the table we learn that, oi forty -one shoemakers, seven be- 
-came insane by intemperance; eighteenhy masturbation, which is near- 
ly forty-four per cent., and quite the most prevalent cause with this 
•class of laborers. 

In the table we have placed ten printers, one of whom became insane 
in a matter of love ; and nine by the " secret vice," which is ninety 
per cent. 

Of the sixty-seven laborers in the i2^Ae, forty-two became insane by 
intemperance, which is about sixty-tioo and one half per cent., and 
quite the most common cause with this class of men. 

Of twenty-nine seamen who have been in the Hospital, nineteen be- 
came insane by intemperance, which is more than sixty-five per cent., 
and by far the most prominent cause of insanity with the sailor ; tv)o 
only became insane by masturbation, and^we from anxiety about prop- 
erty. 

Of the thirty-nine merchants 'wlio have been in the Hospital, the 
cause of whose disease has been ascertained,, nine became insane by 
intemperance, eighteen by masturbation, and nine by anxiety about 
property ; the " secret vice" being by far the most prominent cause, 
and making more ih.m\ forty-six per cent, of the causes. 

Of the twenty-five carpenters and joiners who have been in the Hos- 
pital, eleven became insane by intemperance, six by masturbation, and 
four by anxiety about property. The most prominent cause with this 
class of men is intemperance, which is a little less th?Lnfffy per cent, 
of the whole. 

Of the sixteen students that have been in the Hospital, thirteen have 
become insane by masturbation, which is an appalling proportion, at 
the rate of eighty-one per cent. 

By the table it will appear that of those who pursue active employ- 
ments in the open air, comparatively few become insane but by the 
agency of intemperance, the great source of physical imbecility 
and disease, of moral degradation, vice, and crime in our country. 
The seamen have, in times past, been particularly obnoxious to this 
cause. 

On the other hand it will be seen, that of those who pursue sedentary 
and effeminate employments, few, comparatively, become insane from 
this cause; but a large proportion become so by masturbation, an evil, 
the secret influence of which is unquestionably undermining the health 
and intellect of many a promising youth in this, and every community. 



STATE LUNATIC HOSPITAL, 



TABLE 20. 



Showing the comparative expense of supporting Old and Recent cases 
of Insanity, from lohich loe may learn the economy of placing the 
insane in inslitutiuns in early periods of disease. 



OLD CASES. 




RECENT CASES. 








Totnl expense of 
















old cases at $100 












No. of old Present 


Time in- 


a year before com- 


No. of recent 


Present 


Time in- 


Cost of support 


cases. 


age. 


sane. 


ing to the Hospj- 


cases. 


age. 


sane. 


at $2 50 a week. 








lal, and at $132 


















since. 












2 


661 


1 25 ^-^rs, 


$2828 -^ 


1171 


34 


9 weeks, 


$22 50 


3 


34 1 


11 ^ 


1320 /=#. 


(- 1168 


50 


32 


u 


80 


7 


45 J 


14 -^ 


1620 yU 


fi 1142 


20 


17 


<e 


42 50 


8 


57 V 


18 ■«* 


2120 ^53* 


:*- 1138 


48 


S2 


(( 


80 


12 


42, 


22 # 


2510 .% 


. 1134 


28 


28 


(( 


70 


18 


68 


31 -iL 


3410 ^ 


* 1132 


56 


15 


a 


37 50 


19 


56 


15"^ 


1820 m 


' 1131 


45 


20 


<( 


50 


21 


36 


13 ^ 


1610 'S^ 


' 1126 


30 


16 


<( 


40 


27 


44 


13 "^ 


1610 <£* 


' 1122 


51 


12 


a 


30 


44 


53 1 24 <' 


2700 rr 


1119 


47 


32 


u 


80 


45 


57 


22 *« 


2450 -/« 


1118 


17 


55 


i( 


137 50 


•^se- 


— 4g. 


14 "^ 


-j$@$s)aai 


1109 


47 


21 


a 


52 50 


101 


48 


18 "«- 


2550 ^ 


'- 1108 


28 


32 


11 


80 


102 


50 


22 «- 


2450 ^ 


* 1107 


33 


16 


(( 


40 


133 


41 


10 *^ 


1050 *»? 


^ 11C6 


• 26 


21 


(( 


52 50 


176 


52 


17 -^ 


2100 fW 


f 1104 


40 


16 


(( 


40 


-jQCi - 

2^^ 209 


47 


10 " 


""""T^^ 


1090 

1089 


59 

48 


26 

18 


11 


65 
45 


36 i 13 « 


1580 


1085 


24 


20 


(t 


50 


223 


47 


17 « 


1980 


1062 


40 


16 


(C 


40 


247 


39 


15 « 


1730 


1060 


17 


26 


u 


65 50 


-ggS" 


•"-4^"- 


-i:^" 


•*99«- 


1058 


39 


11 


ii 


27 50 


260 


44 


15 " 


1500 


1057 


18 


16 


u 


40 


, 274 


37 ! 12 " 


1400 


1049 


28 


16 


a 


40 


278 


47 


7.-^" 


1040 


1047 


63 


40 


u 


100 




4134k' 








563 weeks,; 


[years. 
= nearly 11 


Average expense of old 


Average 


exper 


se of rece 


nt 


cases, - - $1903 60 


cases, 


- 


- 


. 


$56 00 


Whole 25 old cases have 


Whole 


25 re 


jcent 


cag 


es 


• 


lost, 


- 


$47,590 00 1 


have c 


ost, 


- 


- 


$1400 00 



On a former occasion, I collected some facts relative to the e.xpense 
of an equal number of old and recent cases, to show the advantage of 
the early application of the means of recovery. For the same pur- 
pose, this table has been made, showing the expense of supporting the 



STATE LUNATIC HOSPITAL. 67 

twenty-jive cases now first on the records of the Hospital, at one hun- 
dred dollars a year, previous to their being placed in the Hospital, and 
at two dollars and a half a week, since being in the Hospital : and the 
twenty-five recent cases, last on the records, who have been discharged 
recovered. 

It appears that the expense of supporting the old cases, in the aggre- 
gate, IS forty-seven thousand five hundred and ninety dollars, an average 
of one thousand nine hundred and three dollars ayid sixty cents. 

The twenty five recent cases cost, in the aggregate, after they be- 
came insane, one thousand four hundred and eight dollars, an average 
oi fifty-six dollars. 

The twenty-five old cases have been insane, in the aggregate, /wi«r 
hundred and thirteen years, an average period of sixteen and one half 
years each. 

The twenty-five recent cases have been insane, ^t"e hundred and six- 
ty three weeks in the aggregate, and twenty-tico and one half weeks on 
the average, not two-thirds of which time was spent in the Hospital. 

On the score of political economy alone then, how desirable thr.t in- 
stitutions be furnished, so that all the recent insane may be placed in 
them and have the opportunity for cure, by which, not only may great 
suffering be avoided, but heavy expenses be saved. And if three-fourths 
of these individuals, now doomed to be the perpetual victims of dis- 
ease while life shall last, had been restored to the enjoyments of socie- 
ty and active usefulness, they might have been producers of at least an 
equal sura to that of which they have now been the expenders; the 
difference would iiave been great, and worthy of all consideration. 

But who can estimate the sufferings of a mind diseased, laboring for 
years under delusions, vitiated appetites, morbid sensibilities, perverted 
tastes, and estranged and excited feelings and propensities? 

Such are the sufferings which are removed by curing insanity. 
What community can neglect this great good and not feel deep regret, 
and assume an awful responsibility ? 



68 



STATE LUNATIC HOSPITAL. 



TABLE 2L 

Of Per Cent, 



RECOVERIES. 


Average. 


1834. 


1835. 


1836. 


1837. 


1838. 


1839. 


1840. 


Per cent, of cases discharged re- 


















covered, of duration less than 


















one year, - _ _ _ 


87,i 


82 


82^ 


84.^ 


894 


86i 


90i 


911 


Per cent, of recoveries &f all dis- 


















charged, - . - _ 


52 


531 


mh 


53i 


57 


524 


47 


53 


Per cent, of recoveries of old 


















cases discharged, - 


m 


20a 


151 


i8i 


25d 


15^ 


16^ 


22^ 



There have been admitted, since the Hospital was opened, 488 cases of 
less duration than one year. 

There have been discharged recovered, of recent cases, in the same, 404 j 
(404 of 488) ; which is 82^ per cent. 

Deduct from these, 23 deaths of recent cases, which are not usually in- 
cluded in estimates of recovery, (as such cases have little trial of curative 
means,) and there remains 404 of 465, which is 86| per cent. Twenty-eight 
of those now remaining in the Hospital are mostly convalescing, which be- 
ing deducted, leaves 404 of 437, which is 92^ per cent. 

There have been in the Hospital 1196 patients ; — there have been dis- 
charged recovered 506, which is 42^ per cent. 



DEATHS. 


1834. 


1835. 


1836. 


1837. 


1838. 


1839. 

5^ 


1840. 


Per cent, of deaths of all in the Hospi- 
tal, each year, 


3^ 


3^ 


3i 


3 


4i 


4'- 

31 



Per cent, of whole number of admissions, (90 of 1196,) 



7k 



There are at present in the Hospital, 208 cases of longer duration than 
one year, (208 of 236,) which is 88 per cent. 

There are 28 cases of less duration than one year, which is 12 per cent. 

Per cent, of Recoveries from Insanity arising from certain causes. 
From intemperance, 50 per cent, i Domestic afflictions, - 59 per cent. 
Ill health, - - 63^ per cent, j Religious causes, - 60 per cent. 
Masturbation, - 27 per cent. | 



Hereditary, (336 of 1196,) 
Periodical, (235 of 1196,) 



30i per cent. 
19i per cent. 



Of the 1196 patients who have been in the Hospital, there were. 

Single, including widowers and widows, - 751 62^ per cent. 

Married, . . . - - 445 37^ per cent. 



STATE LUNATIC HOSPITAL. 69 

It will be seen by this table, that the operations of the Hospital have 
been favorable this year. The recoveries of cases of less duration 
than one year, have been ninety-one and one-fourth per cent. Recove- 
ries of cases of longer duration than one year, including all old cases, 
have been during the last year, twenty-two and one half per cent. Of 
all the cases discharged, the per cent, of recoveries has been, the past 
ye?L\-,fifty-thrce. 

The general average of recoveries, of duration less than one year, 
has been eighty-seven and one-fourth per cent. The average of recov- 
eries on all the cases discharged, has been Jifty-ttoo per cent. ; and on 
all the old cases discharged, nineteen and one-third per cent. 

The number of patients who have relapsed so' as to have a return of 
insanity within one year from the previous attack, that have been dis- 
charged recovered, is eighteen, as far as we can collect them from our 
records, and as far as we have been able to learn. Others may have 
relapsed, of which we have no knowledge. 

The above estimates of per cent, are upon the discharged. 

The following are made upon the admitted. Four hundred and 
eighty-eight cases have been admitted into the Hospital, of less dura- 
tion than one year. There have been discharged recovered, of recent 
cases, in the same time, four hundred and four, which is eighty-tioo 
and one half per cent. If we deduct from these, twenty-three deaths, 
of recent cases which have not had trial of remedial means, the per 
cent, will be eighty -six and three-fourths. Twenty -eight of these now 
remain in the Hospital, recently admitted, mostly convalescing, which, 
being deducted, will leave ninety-tico and one half^ex cent, of recent 
cases as recovered or likely to recover. 

There have been in the Hospital, eleven hundred and ninety-six pa- 
tients, of whom, five hundred and six have been discharged recovered, 
which is more Xhzn forty -two per cent. 

The deaths this year have been fifteen, which is three and three-fourths 
per cent, of all the patients in the Hospital, in the course of the year ; 
about the average for each year, since the Hospital was opened. There 
have been eleven hundred and ninety-six patients under our care, of 
whom ninety have died, which is seven and one half ^er cent. 

When a patient enters the Hospital, it is our practice to inquire re- 
lative to hereditary predisposition ; if we learn that parents, or grand- 
parents were insane, or if a number of collateral relatives, as uncles, 
aunts, brothers and sitters, have been aifected with insanity, we record 
the case as hereditary ; of this class of cases, we have three hundred 



70 STATE LUNATIC HOSPITAL. 

and thirty-six, which is something more than thirty per cent, of all that 
have been in the Hospital. 

My views of hereditary insanity have before been fully given, Thdt 
this taint or predisposition never results in alienation of mind without 
the'intervention of an exciting cause, I am free to declare, although 
the strength and activity of the predisposition is very different, in 
different individuals, and very unlike in the members of the same fam- 
ily. In this respect, as before observed, insanity is like other physical 
diseases, and in no respect different. Many cases of this kind have a 
periodical character, for the reason that a slight cause re-excites the 
disease, and a slighter, in proportion to the number of attacks. My 
inquiries into this subjept have satisfied me that, when there is a predis- 
position, the exciting cause is as manifest and apparent as in most other 
cases, but very often that cause is less severe and prominent. The 
production of insanity is not always the sudden and apparent effect of 
one cause, but the result of cause or causes long operating to derange 
the functions of the brain and nervous system, and finally insanity ap- 
pears without any tangible or visible cause at the time, and in many 
cases it is attributed to some circumstance too trivial to produce it, 
because no other is known. Intemperance, ill health, masturbation, 
and often the moral causes of insanity, operate slowly, break down the 
energies of the physical organs, which are the instrumentsof the mind, 
and months, and even years after, the disease appears. With insanity, 
as with many other diseases, a recent or acute attack has a chronic 
cause, if the expression is allowable, and such a case is less likely to 
recover than one of a character in all respects more recent. 

There have been under our care, two hundred and thirty-Jive cases 
recorded as "periodical," which is nineteen undone half ^^er cent, of 
all cases that have been in the Hospital. 

By periodical case, is here understood, one that has had more than 
one recurrence of insanity, whether the interval be long or short, that 
is, one year or more than one year. We distinguish those cases in 
which the occurrence of the paroxysms is more frequent, as monthly, 
or once in tico or three months, as paroxysmal, believing that there is 
rarely, in so short a period, a complete lucid interval, although to the 
common observer it may be apparently so. 

Strictly speaking, a periodical case is one that occurs at regular pe- 
riods of one, two, or more years, and cases occurring at periods very 
irregular should not be so denominated. This method of recording 
would materially lessen the number of periodical cases, for probably 



STATE LUNATIC HOSPITAL. 71 

less than one half the number have this regularity. Our recommittals 
. are principally periodical cases and not relapses; many of them occur, 
after awhile, at nearly regular intervals and become habitual ; a very 
slight cause, in such a case, will be sufficient to reproduce the disease, 
and it doubtless may occur merely from habit. 

There is at present in the Hospital, a young female who has had 
four attacks of insanity in about eight years; another middle-aged wo- 
man, has had three attacks in less than four years ; the former has a 
paroxysm of about four weeks, and then becomes as rational as ever ; 
the other is a violent maniac one month, is convalescing a second, then 
is quite well in all respects, till another attack. One of these patients 
is deeply interested in every benevolent movement, gets easily and fre- 
quently excited, is very zealous in promoting whatever cause she es- 
pouses, and exceedingly censorious of all counter movements ; in this 
way, keeping her mind and feelings in a condition to be acted upon by 
any occasional cause of insanity. 

The other is very zealous in the cause of religion, is in constant 
anxiety for her children, that they should walk in the true and only 
way of salvation ; tivice she has become excited by an unusual atten- 
tion to the subject of religion in her neighborhood, and once by the 
sickness of a child, for whose recovery and especially for whose relig- 
ious well-being she was particularly anxious; added to this was watch- 
ing, anxiety, irregularity of life, which, combined, made a strong im- 
pression upon her nervous system, and produced the present severe 
attack of insanity from which she is very favorably convalescing. 

Persons subject to hereditary insanity, and especially those who are 
liable to periodical returns of it, should be extremely careful to aVoid 
every unnecessary excitement of the feelings, and all undue exertion 
of the intellect: they should also be prudent of bodily health and avoid 
every occasional cause of disease. By persevering in this course, they 
may generally avoid insanity in the first instance, and the repetition of 
it afterwards. 

Those first principles of physical education which teach us how to 
avoid disease, are all-important to all liable to insanity from hereditary 
predisposition. The physical health must be attended to, and the 
training of the faculties of the mind be such as to counteract the ac- 
tive propensities of our nature, correct the disposition of the mind to 
wrong currents and too g'-eat activity, by bringing into action the an- 
tagonizing powers, and thus giving a sound body and a well-balanced 
mind. Neglect of this early training entails evils upon the young 
which are felt in all after life. 



72 STATE LUNATIC HOSPITAL. 

The most frequent causes of predisposition to insanity are unre^^ 
strained indulgence of temper, unbridled appetites and desires, perni- 
cious mechanical restraints upon the free movement of organs essential 
to life, improprieties of dress, excessive effeminacy, or ill-directed ed- 
ucation, by which the individual is not prepared to meet the vicissi- 
tudes and trials which must be encountered in the journey of life — and 
particularly from that intensity of the mind and feelings, which is too 
often encouraged, but which over-taxes the young brain and excites it 
to morbid irritation or actual disease. If this is not counteracted, it 
will most assuredly result in that perversion of the faculties which is 
exhibited in mental alienation or in organic lesion which will sooner 
or later prove fatal. 

Let this subject receive the attention it should do, and insanity will 
lose half its victims, and hereditary predisposition be divested of most 
of its terrors. 

Having gone fully into the explanation of the tables, and commented 
freely on many topics more or less intimately connected with them, I 
proceed briefly to notice some subjects of interest before closing the 
report ; and first, 

LABOR AND EMPLOYMENT. 

The labor performed during the year, in all departments of industry, 
at the Hospital, whether we consider its utility to the individuals em- 
ployed or its pecuniary advantages, has never been more successful. 

No class of our patients are so contented and happy as the laborers, 
no other convalescent recovers so rapidly or so favorably. On the 
farm, in the garden, at works of ornament and improvements, we have 
a sufficient number of individuals ready, at all times, to lend a helping 
hand; so also in every department of domestic labor and in the work- 
shops, those of our patients who are versed in these employments, obey 
the summons to labor with cheerfulness and alacrity. 

Jn the winter season we find it difficult to give employment to as 
many as would be benefited by it. The wood-yard, the shoe-shop and 
carpenter's shop, and the various domestic occupations, furnish but a 
moiety of employment for the numerous operatives in the establish- 
ment. In the spring and summer, the garden and the farm open a 
broader field. 

The last season has been very favorable for horticultural and agri- 



STATE LUNATIC HOSPITAL. 



73 



cultural products, and the quantity of valuable articles raised on our 
grounds, is given in a list below, furnished by the steward. 



30 tons of hay, valued at 
100 bushels of corn, at 75 cents, 
120 " of onions, at 50 cents, 
350 " of potatoes at 25 cents, 
410 " of carrots, at 2s. 
420 " of beets, at 2s. 
210 " of turnips, at 25 cents, 
130 " of parsnips, at 50 cents, 
100 " of ruta baga, at 25 cents, 
1000 " of cabbages, at 5 cents, 
7 loads of pumpkins, at $1 50 
4 " of winter squashes, . 
50 bushels of cucumbers, . 
Green peas, . . . . 
Garden beans, 



Pasturing one pair of oxen and nine cows 26 Weeks, at 3s. 

5,881 lbs. of pork fatted, at 6^ cents, . 

Small pigs sold, . . . . . . * , 

3 cows fatted and sold, ...... 



1300 GO 
75 00 
60 00 
87 50 
136 66 
140 00 
52 50 
65 00 
25 00 
50 00 
10 50 
30 00 
50 00 
40 00 
40 00 



L,162 16 

143 00 

382 27 

83 46 

117 00 



Amount, 1 1,887 89 

Besides the labor on the farm and in the garden, of which the in- 
mates of the Hospital have done a large proportion, many important 
improvements have been made upon the grounds and in the fields ; the 
meadows have been extensively drained and made better, the pastures 
have been cleared of stones and bushes and made more beautiful and 
productive, extensive walls have been made, especially a bank wall 
substantial and handsome, oi forty or fifty rods in length in front of 
a grove which has been much improved, laid out into walks and paths, 
and rendered smooth, and cleared from stone. Whatever has been 
done in this way, is designed to be permanently and thoroughly done, 
having in view both utility and beauty. 

In these various ways, we are enabled to employ a great amount of 
labor, to interest our patients in improvements and productions which 
they, as well as others, see to be valuable and useful to all. We have 
10 



74 STATE LUNATIC HOSPITAL. 

placed upon our premises one hundred thrifty apple trees of the choicest 
varieties of engrafted fruit, many of which begin to bear. We have 
also a great number of English cherry trees, pear trees and peach trees, 
all of which are growing rapidly, and many of them already furnish 
specimens of choice varieties of fruits. Whoever comes after us, will 
discover that, in these particulars, we have labored in prospective, and 
that our object has been to give permanency to the means of enjoy- 
ment, as well as to partake of them ourselves. 

Much yet remains to be done to ornament and improve the Hospital 
grounds, but no small advance has been made in the eight years of our 
residence here. The effect of our labors will be more and more appa- 
rent, as years roll away and leave the bearing fruit tree, the elm, 
the maple, the pine and larch that have been planted by our hands, 
spreading their shades and extending their branches, the monuments of 
our industry and care. 

In the shoe-shop, we have had more or less workmen constantly em- 
ployed, and, in the course of the year, ^cw shoe-makers, who were more 
or less acquainted with the business, have contributed their aid. In no 
department of labor has more good been effected to the laborers them- 
selves, in proportion to the number employed, than in this. Though 
it is no great profit to the establishment, it is a great convenience, as 
we require much mending to be done, which is both troublesome and 
expensive when done abroad. 

The following exhibits made by the steward, from items procured 
from the books of the overseer of this department, will show the result. 

Amount of shoes sold, and work done for patients, . . $437 19 

Shoes sold for stock, ...... 

" sold to family and help, . . . - . 

" 'sold, and work for other persons, 

" made and on hand, . . . ... 

$937 52 



176 27 


264 


06 


30 


00 


30 


00 



EXPENSES. 








Amount of stock used, 


479 97 






Board and wages of overseer, 


325 00 






Fuel and lights. 


12 00 






Binding, .... 


. 30 00 


Profit, 






f 846 97- 


846 97 


' 


$90 55 



STATE LUNATIC HOSPITAL. 75 

It is difficult to find mechanical employments, that can be pursued 
without loss, in such an institution ; the shoe-making is an exception, 
and has always supported itself and afforded a small profit. There are 
always carpenters and cabinet-makers in the Hospilal, and when we 
have mechanical labor of that sort to be done, they unite in it, and are 
auxiliaries on whom we rely for considerable aid. 

It is different in all domestic labor, for in every department we can, 
at a moment's warning, call together whatever help is needed, and in 
the kitchen, laundry and wash-room, are every day found many indi-' 
viduals usefully and pleasantly employed, from whose labor important 
benefit is mutually derived. Of the benefit of labor it is difficult to 
speak definitely ; it is customary for patients who have been brought up 
to labor, as soon as the first excitement is over, to request employment ; 
it is granted and considered by them as a great favor : — they work well 
for weeks or months, till they are nearly or quite recovered, they sleep 
well after the fatigue of the day, always have a good appetite, and are 
cheerful and happy ; the same excitement which, by others, is expended 
in mischief and noise, they expend in useful and agreeable employ- 
ments, and they leave the Hospital better satisfied with its government, 
and with themselves, than those who have been unaccustomed to man- 
ual labor, or who declined to engage in it. 

The following case, from among many, will show the benefit of la- 
bor. A farmer aged about thirty, was brought to the Hospital in Au- 
gust last, so violent as to be attended by Jive stout men ; he had been 
reduced by disease and remedies, but was considered violent and dan- 
gerous. A {ew days after his admission, he requested to go out and 
aid the farmer in his work ; he was permitted to do so ; after he com- 
menced labor, he improved in a very favorable manner, slept well, had 
a good appetite, and gained flesh and strength; at the end of a month, 
he was well, and before the expiration of two months, he returned to 
his home quite recovered. In such a case, it is difficult to conceive 
the effect of confinement ; irritation, anger and violence, requiring re- 
straint, might have followed, which would almost necessarily have 
made a protracted case, and probably an imperfect cure. 

Many of the old residents pursue, from year to year, a regular course 
of employment; they are diligent and faithful, have liberty to go where 
they please about the premises, and accomplish a great amount of val- 
uable service. 



76 STATE LUNATIC HOSPITAL. 



AMUSEMENTS. 

The patients who do not labor, have many regular active amuse- 
ments to furnish them with exercise necessary to health. 

The females ride daily in a carriage kept exclusively for the purpose, 
take long vv^alks vi^hen the vi'eather is pleasant, swing, throw the ring, 
play at battle-door, graces^ &/C. They have their parties every week, or 
every other week, in the matron's room, or, under her direction, in the 
halls or porticoes; these are pleasant seasons, at which, after finishing 
their work, they have fruits and other refreshments. The dancing par- 
ties are held in the female halls, which a large proportion of the quiet 
patients attend, and enjoy the music and the exercise with great de- 
light. 

Many read, and, particularly in winter evenings, play at chess, cards, 
dice, drafts or chequers, backgammon, fcc. All work, more or less, 
with the needle, knit, embroider, or any thing that they choose, which 
would be proper in any female circle. Many of the quiet and conval- 
escent patients walk abroad unattended, mingle with the family, and 
join in conversation and social enjoyments. 

The amusements of the male patients are, in many respects, similar 
to those of the other sex. They ride less and walk more, they have 
more active diversions, as athletic games, nine-pins, &c., and long 
rambles unattended, on a pledge of punctual return. They read much, 
unite in all the games which have been enumerated, sing, play on in- 
struments of music, &c. Many of the laboring patients have their 
pastimes and holidays, and live, from year to year, without a wish for 
home or change. 

Next to manual labor, reading, writing and amusements, are import- 
ant for the insane ; they divert the mind into new and pleasant chan- 
nels of activity, make them forget their troubles and delusions for the 
time, and give vigor and energy to the physical system. Occupations 
of one sort or another should be as constant as possible, and such as 
are congenial to the feelings are always to be preferred. 

HEALTH. 

Diet. The means of promoting and securing the health of pa- 
tients in the Hospital are good, and, in general, we are a healthy com- 
munity. The diet which we use is substantial, but plain and simple. 



STATE LUNATIC HOSPITAL. 77 

We do not weigh or measure our food, but ordinarily allow all to take 
as much as they desire. 

The food is never the same two days in succession. The breakfast 
consists of coffee, bread and butter, and often a hash of meat, or a 
cold cut with warm potatoes ; or milk if it is preferred. 

The dinner consists of animal food, with bread and a profusion of 
garden vegetables. ^ 

The supper is of tea or cocoa, with bread and butter, cheese, often 
plain cake or mush and molasses, or bread and milk. 

On Monday, the dinner is a boiled dish of corned beef or mutton 
and boiled pork, with bread and vegetables in plenty and variety. 

On Tuesday, the dinner is roast meat, with vegetables; bread and 
butter is always on the table at each meal in the better galleries. 

On Wednesday, we have peas or beans, with meat and vegetables. 
Fresh fish is often substituted for these articles; this is particularly the 
case in the summer season, when bowel complaints are prevalent. 

On Thursday, we have soup, with vegetables and meat. 

On Friday, the boiled dish again, the same as on Monday. 

On Saturday, salt fish, vegetables and boiled rice. 

On Sunday, no meat is given. 

Three days in the week, puddings are given with the dinner. When 
a patient prefers it, milk is used, and many take it more or less through 
the season ; during the summer months, some part of our household 
have milk for dinner or supper every day. 

Water is the only drink with dinner. The native fruits are always 
given freely when plenty. Every patient has a supply of apples daily, 
in the fall and winter seasons. 

We have little or no complaint of the quality or quanti<y of food. 
The bread is made of the best flour in the market, of which there is 
used about Jive barrels a week. The common New England brown- 
bread is also used by those who prefer it. 

For the sick, and such persons as require a variation from the stand- 
ard diet of the Hospital, a diet is prescribed daily, or as often as is 
necessary in each case. 

Warmth and Ventilation. The excellent arrangements for 
warmth and ventilation in the Hospital contribute no less to the health 
than the comfort pf its inhabitants. In every attempt at warming an 
institution, or any large public building, both these objects must be 
considered. Purity of air is no Ics essential than warmth of tempera- 
ture. Warmth can be diffused much more readily and effectually in a 



78 STATE LUNATIC HOSPITAL. 

building in which suitable arrangements for ventilation are made. 
The currents in and out of the apartments should be free. Warmth 
by furnaces is not communicated by radiated heat, as from a fire-place 
or stove, but by a supply of air being introduced, raised to a warm 
temperature, to take the place of air that escapes by the ventilating 
passages ; without these passages the air already in the apartments will 
not escape, and consequently a new supply of warm air cannot be in- 
troduced to any desirable extent. 

The desideratum on this subject is, to admit free currents of air, 
warmed to a suitable but not high temperature, and always to have 
ventilating passages, so as to allow free currents of air to escape. 
Witliout this latter provision satisfactory results will not be had from 
hot air-furnaces; with this arrangement in due proportion, the apart- 
ments will be easily warmed, readily ventilated, and made pure and 
wholesome. Another consideration must not be overlooked. The air 
admitted must be taken from out of doors; no suitable supply can be 
obtained elsewhere, and the ventilating openings should go up in the 
centre wall of the building and terminate in the attic, and not open 
out of the building. Stoves, steam and hot water are all objectionable 
as modes of warming public buildings, in which a large number of in- 
dividuals congregate, and much more reside; they do not aid ventila- 
tion, and ventilation cannot be thorough and perfect by any other 
mode whatever than by hot air-furnaces, which continually force in 
liberal currents of warm, pure air. 

It is surprising how little this subject is understood, and how badly 
the principle, simple as it is, is usually applied. In this Hospital one 
experiment upon another has developed the true method, and our ap- 
paratus for this purpose is as perfect as we can expect or desire. 

The furnace which is most approved is manufactured by our in- 
genious townsman, Wm. A. Wheeler, Esq., from a model of his own 
invention, which, with comparatively little fuel, heats a great current 
of air, sufficient, in ordinary weather, to warm a building one hundred 
feet long by thirty-Jive wide, and three stories high. One of these fur- 
naces is placed in each of the four wings of the Hospital. The fuel 
which they all consume, during the season when fires are necessary, 
varies little from one cord of wood a day. Two or three small fur- 
naces, in addition, are used a few days in the year, when the weather 
is extremely cold. 

The temperature of the Hospital is agreeable and uniform, not vary- 
ing as much in all the cold season as it does in the month of July. 



STATE LUNATIC HOSPITAL. 79 

Fires are kept burning in the night when the thermometer is down to 
ten or twelve, and the degree of warmth is regulated at all times by the 
thermometer. Health generally prevails in winter and there is no 
suffering at any time from cold. 

Baths. The importance of the warm and cold bath is properly 
appreciated in all institutions for the insane. In this Hospital we have 
conveniences for both, well adapted and simple. In each of the galle- 
ries of the centre wings is an arrangement for warm bathing; there are 
also in the establishment six shower-baths, besides which there is a 
bathing room for common resort. Baths are frequently used for clean- 
liness, and are often prescribed as a remedy for disease. It is a com- 
mon error to disregard the most obvious means of health by neglecting 
the state of the skin. This is the more singular as the means of pro- 
moting it are so pleasant and so easily found. 

For the insane, baths are peculiarly desirable, as the secretions of 
the skin are often offensive and unhealthy ; in many cases they make 
impressions on the nervous system which are extremely favorable. 
As remedial agents we have not found baths to supersede the necessity 
of other remedies, but have often found them useful auxiliaries. 



DISCIPLINE. 



"^ ^ri'i''^'*-^-^"^ 'M'4^'-^-- 



Restraints. The British institutions are at present making an 
effort to surpass each other in the success of managing the insane 
without restraints. Some of them have abolished them almost entirely, 
while others have noted the hours, in the course of the year, that they 
have applied them. The restraints here considered are the strait 
waistcoat, muffs, mittens, and confining Q^iasB»^, solitary rooms are not 
included. 

In this Hospital strait waistcoats and muffs are never used, and con- 
fining G^aaais but rarely. Mittens and wristbands are all the restraints 
which are here applied, and those only when absolutely necessary to 
the comfort of the individual, or the safety of the patients who occupy 
the same apartment. These restraints are made use of for' two pur- 
poses for the individuals themselves, viz. to keep clothes upon them 
when they are disposed to take them off, and as a safeguard in case of 
suicidal propensity. For the more violent, such as strike, tear clothes 
and bedding, break furniture, &c. they are sometimes applied for a 
short period, but never continued for a great length of time. 

While restraints should be applied as rarely as possible, and never 



80 STATE LUNATIC HOSPITAL. 

for the benefit of the attendant, but only for the good of the patient or 
the safety of those with whom he associates, yet I cannot but consider 
them as important auxiliaries in the treatment of the insane. It is un- 
doubtedly true, that, with corporeal restraints judiciously applied, pa- 
tients will sooner be made tranquil than by the presence of one or more 
attendants, who they know will watch all their movements and interfere 
with their mischievous designs. Their presence will often be a source 
of irritation which will serve to keep up the excitement, and, in most 
cases, restraints that are not painful are far less disagreeable to both 
the furious and suicidal patients, than that unceasing surveillance 
which is necessary as a substitute. 

Whenever a patient is under restraint, we frequently propose a re- 
lease, on condition of a pledge to avoid the irregular conduct for which 
it was imposed ; these pledges we require to be given in a solemn 
manner, stating to the patient the condition he will be in, if, by a for- 
feiture of his word, it should be necessary to re-apply them ; both his 
self-respect and desire of liberty are here called in requisition, to pre- 
vent him from further violation of decorum, and afterwards, in many 
cases, restraints cease to be necessary. 

Pledges. We think much of pledges with the insane, and often 
avoid restraints, by taking the word of a violent patient to be quiet and 
peaceable. Even the suicidal, who have been detected in making pre- 
paration for self-destruction, or in secreting instruments for future use, 
will generally, and, with me, have never failed to adhere strictly to a 
pledge given in good faith, with feelings of solemnity. 

With most patients, ever so violent, there are times when they will 
make promises, which will have no inconsiderable influence. Those 
who are desirous to labor, are easily induced to give a pledge to be 
orderly and industrious, and make no eflTort to escape. 

A more quiet and regular class of patients, of which we always have 
more or less, are -permitted to go abroad unattended, on a pledge to 
return with punctuality, and few indeed ever forfeit it. 

Advancement to a better gallery, permission to ride or walk, admis- 
sion to the matron's parties, liberty to attend chapel on the Sabbath, 
are obtained on a pledge given or implied and well understood, that 
every propriety suitable to be observed in the place, is absolutely bind- 
ing on them. It is sufficient in most cases, for patients to know, that 
privation of privileges will follow violation of a pledge, to induce them 
strictly and punctually to adhere to whatever is expected of them. 

Having adopted this course with respect to pledges, and the inculca- 



STATE LUNATIC HOSPITAL. 81 

tion of self-respect and self-control, we have very little need of personal 
restraints; and while this sheet is being written, but one individual in 
the Hospital has any restraint upon his person, and this only to prevent 
his destroying his clothes and bed; he is quiet and entirely harmless. 

Courts or Yards. By relying upon the pledges of our patients 
and inculcating self-respect, we have been able to dispense with the use 
of courts. They have a prison-like appearance, and while in them, our 
patients were constantly rolling in the dirt, or sleeping upon the ground, 
thus soiling their clothes and becoming sun-burnt. We find that one 
attendant can take charge of the same number of patients while walk- 
ing or at labor, as he could formerly in the courts, and they are more 
pleasantly and usefully employed. Escapes were more common while 
these were used, for, the wall being considered a protection, less vigi- 
lance was used by the attendants. We now di.'^pense with them en- 
tirely^ and find that not only the personal appearance of our patients is 
improved, but they are also more quiet and have more self-respect. 

MEDICATION. 

In some European institutions, reliance is placed only upon moral 
means and corporeal restraints, in I he treatment of insanity. It is very 
obvious, however, to all who have witnessed the efficacy of medicine 
in removing maniacal excitement, that, in many cases, much suffering 
is permitted by such a course, which would soon be removed by the 
judicious administration of suitable remedies. 

Many cases of insanity arise from disease of other parts of the sys- 
tem, which sympathize strongly with the brain ; neither moral influ- 
■ence nor restraints, can reach the cause in such a case. In all cases 
in which the health is not good, remedies should be prescribed to im- 
prove it, and with the restoration of health thus effected, the mind gen- 
erally becomes calm, and finally, rational. 

In almost every case of melancholy, whether arising from moral or 
physical causes, the health is not good, the digestive apparatus is dis- 
ordered, the secretions are bad, and the functions of organs important 
to health, are suspended or performed in an imperfect or unnatural 
manner; these are all proper subjects for medical treatment, and the 
neglect of it may leave the case to become chronic and incurable, 
while, with a different course, it would recover. 

But there is a condition of the brain itself in insanity, which requires 
11 



82 STATE LUNATIC HOSPITAL. 

the application of remedies, and which is as certainly relieved by them 
as any other severe disease by its appropriate means of cure. 

Many of the insane do not sleep. Disease of the brain, in such cases, 
is a substitute for sleep. The use of sleep is to renovate the powers of 
life ; but disease, vi'ith the maniac, keeps up the production of this prin- 
ciple, and perpetual activity is necessary for its expenditure. The maniac, 
like the child, must be active, because, in one way or another, he must 
expend the too abundant supply of the principle of activity produced by 
his diseased brain; he must work, or he must do mischief; he may 
bear cold and fatigue, and make efforts, bodily and mental, of which 
he was entirely incapable in health, because his muscles and his mind 
feci the influence of this accumulation of sensoreal power, and their 
activity does not expend it faster than it is produced. It is in this con- 
dition of the brain, that remedies operate like a charm ; they remove 
the irritation upon which the excitement depends, compose the agitated 
state of the nervous system, and bring about quiet and repose. In this 
way, a healthy condition of the brain is produced, and the disease is 
cured. As soon as such a patient is brought, by the use of remedies, 
within the range of moral influence, these should be exerted to prevent 
the violence and mischief, to which the excited state of the brain con- 
stantly impels him. 



LIBRARY AND PERIODICALS. 

Reading and writing are among the most interesting employments 
in the Hospital. 

, The library, which has been considerably enlarged the past year, 
contains many valuable books, which are sought with much interest by 
all who are fond of reading. The tastes are as different in the Hospi- 
tal, as abroad. The bible, however, is desired by all ; few read any 
thincr who do not read the bible more or less; no evil arises from it in 
any case that we can discover, but much would arise from withholding 
it. It is a means of self-control to many who have believed in its pre- 
cepts, and who feel that they must not depart from its instructions. 

Newspapers are freely circulated in the Hospital. Many read the 
religious papers, of which we have a good selection, with great inter- 
est and satisfaction ; they are sought for, and carried from gallery to 
gallery, and from patient to patient, till they are worn out. 

Another class of patients seek for the political papers, another for 



STATE LUNATIC HOSPITAL. 83 

the news and miscellaneous reading ; all papers are extensively read, 
and we have many every day in the Hospital. 

We acknowledge with gratitude, contributions of money, books and 
periodicals for our library, from the following gentlemen. From Isaac 
P. Davis, Esq., of Boston, ten volumes of valuable miscellaneous books ; 
from Hon. Bezaleel Taft, of Uxbridge, contributions of money and 
means of procuring valuable works ; from Dr. McDonald, of New York, 
a bundle of Foreign Reports, and an interesting account, from his own 
pen, of the Blooiningdale Asylum; from the Hon. Samuel Hoar, of 
Concord, a handsome sum of money for this object; from the Ilev. T. 
F. Norris, of Boston, valuable contributions of books and papers; 
from the venerable Noah Webster, LL. D , of New Haven, an ingeni- 
ous pamphlet on the English language; from Julius W. Adams, of 
Westfield,^^ifee?i vols, of valuable miscellaneous books; from Henry 
Hill, Esq., of Boston, the History of Missions, f/trce volumes of the 
Missionary Herald, and various pamphlets and newspapers ; from Dr. 
Pliny Earle, of the Friend's Asylum, Frankford, Penn., a bundle of 
reports of foreign institutions and copies of reports of the Asylum, with 
which he connected. 

The following journals and periodicals have come to hand more or less 
regularly from the editors or unknown friends. The Springfield Repub- 
lican, from Mr. Bolles, its editor and publisher; the Boston Recorder 
and Youth's Companion : the Gospel Messenger, Utica, N. Y. ; the 
Utica Observer ; the New York Baptist Register, Utica; the Oneida 
Whig ; the Utica Democrat, and many favors of the same kind from 
our friend Dr. Batchelder, who has kindly forwarded the Journal of 
Commerce, and the New York Evangelist, and who has otherwise ta- 
ken a deep interest in the welfare of this institution. We receive reg- 
ularly, the Greenfield Mercury and Gazette; the Taunton Whig; the 
Phrenological Journal ; the Sabbath School Visitor ; the New Hamp- 
shire Sentinel, Keene; the Temperance Union, N. Y. ; the Haverhill 
Republican ; the New Hampshire Patriot ; the Botanical Medical Re- 
^/^rder, from A. Curtiss, M. D., editor; the Olive Branch, Boston ; the 
Hampshire Gazette, Northampton ; the Boston Temperance Journal; 
the Albany Evening Journal ; the Old Colony Memorial ; the Barn- 
stable Patriot; many numbers of the New York Observer, from David 
Hitchcock, Esq., Sturbridge, Ms,; and many other occasional contri- 
butions. 

If the individuals who have favored us with this amount of interest- 
ing and valuable reading could justly appreciate the pleasure they have 



84 STATK LUNATIC HOSPITAL. 

given our numerous family, I am quite sure they would feel themselves 
fully rewarded for the trouble these contributions have occasioned 
them. We are happy to acknowledge our obligations for all favors 
received in this way. 

FIRE DEPARTMENT. 

The vole of the trustees to procure a fire engine has been carried 
into effect in a very satisfactory manner, and an engine has been pro- 
cured at a reasonable price, which has sufficient power to throw water 
on any part of the Hospital building. 

After the engine was procured, no time was lost in organizing the 
men employed in the estalilishmcnt, with sucli quiet and active patients 
as were disposed to unite under the direction of the steward and as- 
sistant physician, into a fire company. This company assemble on 
Monday of each week, at the ringing of a fire bell, and exercise the 
engine by throwing water upon the building, washing the windows, 
and, in various ways, giving exercise to all who may be disposed to 
unite in the sport 

This organization was formed that we might be in readiness, in case 
of fire about the premises, to act with concert and efficiency in its ex- 
tinguishment. 

Buckets have also been procured to hang by the water-tanks in the 
attic story, and in the hall of the centre building, that they may be in 
readiness, if needed. 

Every man in the Hospital knows where he is to be found should an 
alarm of fire be given, and every precaution is used to prevent fires by 
attending to stoves, pipes and open fires in the building, and by strict 
injunction that no lamps or candles shall be carried about the building 
at any time except in lanterns. 

The reservoir of water, which is always nearly or quite full, has been 
a great source of relief in contemplating the subject of fires and the diffi- 
culties that previously existed of procuring water in case of necessity. 
This reservoir contains nearly twenty thousand gallons, and was not 
frozen over last winter. 

The subject of fire has always occasioned us great anxiety. The 
present arrangements, with the employment of a watchman, afford 
much relief We hope to escape a calamity great, in any case, but 
most dreadful in a hospital for the insane. 



STATE LUNATIC HOSPITAL. 85 

CHAPEL AND RELIGIOUS SERVICES. 

The Rev. Julius A. Reed officiated as chaplain of the Hospital for 
one year ending the first of October. His services vi^ere well appreci- 
ated, and he left us with the good wishes of all our family. He is a 
plain, practical preacher, sincere and honest in his efforts to do good, 
and succeeded well in winning the affections and securing the confi- 
dence of his hearers. His services were always judicious and solemn, 
well attended to, and influential on the conduct of his audience. No 
disturbance ever took place in the chapel during his ministrations, and 
universal regret was felt in our household at his departure. 

After Tilr. Reed dec ded to leave his charge, immediate application 
was made to the Rev. George Allen to supply the vacancy. He re- 
ceived the appointment of chaplain and commenced the duties of his 
office on the first of October. From our knowledge of Mr. Allen we 
were led to suppose that his good sense, experience and practical wis- 
dom would qualify him for the station. In this we have not been dis- 
appointed. We consider ourselves fortunate in having obtained a 
chaplain of such talents and varied attainments, and have strong con- 
fidence that, under his auspices, increasing good will result from our 
chapel services. 

We have now had regular religious worship on the sabbath for more 
than three years. In the course of that time nearly six hundred pa- 
tients have attended meetings more or less, and less than ninety have 
been in the Hospital who have failed to attend. 

Our expectations of benefit from the chapel have been more than 
realized. From one hundred and tioenty to one hundred and fifty pa- 
tients assemble on each sabbath, and no congregation is more orderly 
and attentive. There is a solemnity visible in the countenances of 
those present which clearly indicates that tliey know for what purpose 
they have come together ; and even those who are at first disposed to 
be restless and disorderly catch the influence which is every where 
prevalent around them, and become calm and sober themselves. 

The instances of self-control manifested in the chapel, by those who 
are often greatly excited, restless and noisy in the halls, are truly re- 
markable. 

The sabbath previous to the day on which this sheet was written, a 
woman, who had been greatly excited, very profane and noisy, request- 
ed to attend chapel. A 1 eflTorts at self-control while in the halls were 
unavailing, except for w I'VA' mci'/enls at a time ; she would promise to 



86 STATE LUNATIC HOSPITAL. 

be quiet, but, in a moment, be as noisy and talkative as before. Know- 
ing, however, her reverence for the sabbath, ii>: the strength and sin- 
cerity of her resolutions to be quiet, she was permitted to attend. The 
most careful observer would not have been able to detect any thing in 
her appearance and conduct that would distinguish wci from the most 
dignified and rational person in the house. 

During the evening previous to the same sabbath, a patient, furiously 
mad, was brought to the Hospital in the care of a sheriff. He had 
been considered quite dangerous, and the sheriff hesitated whether it 
would be safe to come with him unless he was confined in irons. He 
appeared calm on the following morning, and it was proposed that he 
should attend chapel ; he seemed pleased with the privilege, attended 
the service all day, and conducted with the utmost propriety. The.se 
occurrences, which were of yesterday, are happening almost every sab- 
bath, and show most clearly the propriety and importance of religious 
worship to the insane. 

The truth is, that many insane persons are rational on religious sub- 
jects, and a few are insane on these subjects only. Both classes are 
often benefited by religious instruction. 

It is through the healthy avenues of the mind that religious truth is 
received and makes its impression upon the feelings. On most sub- 
jects the insane can reason and feel the force of reasoning as well as 
others, and, even if insane on religious subjects, plain and forcible il- 
lustrations of truth may weaken their confidence in insane impressions 
and throw light where darkness only has been prevalent. 

The habits of New England people require order and decorum in 
the place and time of religious worship. The insane feel the force of 
this habit equally strong ; they frown upon those who work or trifle 
upon the sabbath, and are particularly indignant to those who are dis- 
posed to disturb the quiet of our religious assemblies. There is a 
feeling of pride extending over our whole household in the quiet and 
orderly observance of the sabbath in the Hospital. The good counsels 
of the chaplain are treasured up and often repeated in the week time, 
as motives of self-control to themselves and as admonitions toothers. 

When patients have recovered and are about to return to their 
friends, they often speak of their enjoyment of chapel exercises, express 
their regret at leaving those interesting services, and implore the bless- 
ing of heaven upon future ministrations. 

An excellent woman who recovered from dreadful melancholy at the 
Hospital, a year or two since, writes in substance thus, after inquiring 
after the general welfare of the family : — " How do you get along in 



STATE LUNATIC HOSPITAL. 87 

your beautiful little chapel 1 I shall ever feel deeply interested in your 
religious meetings, as I feel sensible that one of the first rays of light 
that entered into my benighted mind was in the solemn worship of that 
house," 

CONCLUSION. 

I cannot close this report of the Hospital without expressing my 
gratitude to all who have aided me in the administration of its affairs. 
I have ever found the trustees ready to assist me in my labors and 
counsel me in my difficulties. The duty is more arduous upon them, 
particularly upon those who are in our immediate vicinity, than the 
public are generally aware. Their advice is sought, or they are called 
upon for some information concerning the institution, almost daily, 
which must be a heavy tax both upon their time and patience. 

The services of Dr. Chandler, the assistant physician, are identified 
with the institution and indispensable to its prosperity. We have now 
been associated nearly eight years in the arduous duties of the place. 
We have met and surmounted many difficulties together. On his good 
judgment and sound discretion I have ever relied with confidence and 
safety. 

To Mr. and Mrs. Ellis, the steward and matron of the Hospital, we 
are indebted for most valuable services. They have carried into every 
duty a zeal and ability worthy of all praise, and are ever ready, with a 
cheerful spirit, to anticipate the wants and to contribute to the happi- 
ness of all associated with them, or who rely upon them for aid and 
counsel. 

All persons employed in the Hospital have seemed desirous to pro- 
mote its interests as far as practicable. 

For whatever of prosperity or success has attended our efflDrts in the 
management of the Hospital during the past year, we are greatly in- 
debted to the industry, vigilance, faithfulness and devotion of those 
who have labored in subordinate stations. 

Surrounded by such faithful auxiliaries the duties of superintendent 
are rendered pleasant and comparatively easy. If zeal in the cause of 
the institution and devotion to its interests will secure future success, 
relying on Divine aid for a blessing we pledge to it our best efforts for 
its continued prosperity. 

SAMUEL B. WOODWARD. 
State Lunatic Hospital, 



Worcester, Nov. 80th, 1840 



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STATE LUNATIC HOSPITAL. 



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Mountain Ash in bios. Tto west across the heavens at 

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