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REPORT
RELATING TO
LUNATIC HOSPITAL.
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ANNUAL REPORT OF THE TRUSTEES
STATE LUNATIC HOSPITAL
AT WORCESTER
DBCBMBKR, 1S4:1.
BUTTON AND WENTWORTH, STATE PRINTERS.
1842.
NINTH ANNUAL REPORT
TRUSTEES OF THE STATE LUNATIC HOSPITAL.
£}E:CKBIBKR, 184rl.
To His Excellency John Davis, Governor, and to the Honorable Ex-
ecutive Council of the Commonwealth of Massachusetts :
The Trustees of the Stale Lunatic Hospital respectfully present their
Ninth Annual
REPORT:
The Trustees acknowledge the favor of a beneficent Providence, con-
tinued to this institution through another year. Since the first con-
ception of its plan, the genuine benevolence of its character and its
freedom from even the appearance of selfishness, has secured the good
will of men and the blessing of God. It is rare for any institution to
be so long, so uniformly and so highly successful in both these re-
spects, and the friends of this establishment should be proportionally
grateful.
The statute requires this report to be " full and detailed." Entirely
to meet this requirement, the Trustees annex the report of the superin-
tendent to them, giving a full and detailed statement of the interior
condition of the hospital. From its numerous facts they select the
following.
In the course of the year there were 399 patients in the hospital ; at
the commencement of the year, 236; admitted in the course of the
year, 163 ; remained at the end of the year, 232. Of the number re-
4 STATE LUNATIC HOSPITAL.
maining at the close of the year, 33 were cases of less duration than
one year, and 199 were of longer duration than one year.
There have been discharged from the hospital during the year, 167.
Of these, 68 were cases of less duration than one year ; 62 recovered,
2 improved, 4 died ; and 99 were of longer duration than one year;
20 recovered, 34 improved, 37 as harmless and for want of room, 8
died.
The treasurer's report will show the details of the fiscal concerns of
the hospital. It appears that the receipts into the treasury, from all
sources, including the balance on hand at the commencement of the
year have been §31,293 73
The expenditures have been 28,847 62
Leaving a balance in the treasury, Dec. 1, 1841, $2,446 11
The expenditures for improvements and repairs have been larger
this year than usual. At the last session of the Legislature, the sum of
Jive hundred dollars was appropriated for the purchase of more land.
The only desirable lot for sale was one of between six and seven acres,
contiguous on two sides to land before owned by the hospital, and, on
a third, bounded by the road. This lot could be purchased for seven
hundred dollars, and no less. Its situation rendered it so much more
useful to the hospital than any other which could be bought, that the
Trustees felt justified in adding the requisite sum, from the general funds,
to the special appropriation, and the land has been paid for and con-
veyed to them.
When the hospital was established in Worcester, the land for a site
was given to the Commonwealth by the town. An expensive bank-
wall was built on the street passing the front of the ground. The
agent of the commissioners for building the hospital had no doubt that
he directed the wall to be, and that it was, built on the line of the land
conveyed. But, about four years ago, the road commissioners of the
town, who acted as surveyors, judged otherwise, and cut down the
street so as to endanger the falling of the wall. The county commis-
sioners determined that the wall encroached upon the street, from a
point to several feet, and established a line according to their decision.
The Board of Trustees demanded a jury, who determined that the line
should remain as the county cominissioneis had established it, but that
three hundred dollars should be paid to the Trustees toward defraying
the expense of removing the wall. This verdict was set aside as ille-
gal, and another jury was ordered upon another petition of the Trustees,
STATE LUNATIC HOSPITAL. 5
The second jury established a new line, different from the supposed
original line, and from the line established by the county commission-
ers. This verdict was sustained by the court of common pleas, and
the county commissioners appealed to the supreme judicial court, be-
fore whom the cause was argued at the law term for the county of
Worcester, in October, 1840, and a decision given in April, 1841,
affirming the judgment rendered by the court of common pleas. See
Metcalfs reports, vol. 1. Trustees of S. L. Hospital vs. the Inhabitants
of the county of Worcester.
The Trustees, supposing there would be no further litigation on the
subject, and a part of the wall having fallen, contracted for the rebuild-
ing of the wall upon the line established by the second jury. The
contract has been completed, the work done in a solid and permanent
manner. An opening has been left in front of the main building of
the hospital, from which steps have been built ascending to the front
door. The work and materials for the wall and steps have cost
^1,C93 52, of which $993 52 have been paid. The necessity for this
change was very much regretted by the Trustees, on account of the ex-
pense, and because it was feared it would destroy the beautiful row of
pine trees, so thriving and so ornamental. If these evergreens should
live in their present situation, the alteration will be an improvement,
but, whatever be the result or the appearance, the change could not be
avoided by the Trustees.
During very cold weather the means of perfectly warming the north
wing were found insufficient, and an additional furnace was built at an
expense of about eighty dollars.
The average cost of board having in past years, upon the principles
adopted in its estimate, been somewhat more than two dollars and fifty
cents per week, the Trustees have decided to continue it at that sum.
The Trustees concur in the opinion of the treasurer, that an appro-
priation of two thousand dollars will be necessary for the current ex-
penses of the hospital the ensuing year.
When the plan of the hospital was first determined upon, it was de-
signed to accommodate only 120 patients. The offices and barn were
designed on a corresponding scale, or rather on a much less scale, as
the utility of farming operations and mechanical employment was not
so highly appreciated in the management of the insane then as now.
■In fact no shops were built, and the barn was only calculated for a
small stock of hay and the shelter of a few animals. Without regard
to the beneficial effect upon the patients from the labor necessary to
6 STATE LUNATIC HOSPITAL.
provide for and take care of cattle, experience has proved, that, where
so much milk is used, it is economy to keep the cows rather than buy
the milk. The statements of the superintendent will show, to some
extent, the present amount of labor and produce of the land owned by
the institution, and the results of the only mechanical labor pursued.
The produce of the land is altogether beyond the means of preserving
it. For two years past, a barn has been rented, but it cannot be good
policy to trust to that mode of securing crops, so liable and so likely to
fail at any time. Considering the productiveness of the land, the num-
ber of animals kept, the present inconveniences, and the probability of
their increase by inability to hire a barn, the Trustees are unanimous in
the opinion that it will be judicious and economical to erect a barn
early the ensuing season. Tn order to procure the best site, the re-
moval of the present shoe-shop and piggery may be desirable, but not
attended with great expense, and the Trustees are of opinion that the
sum of two thousand dollars will be a sufficient appropriation. Should
the Legislature take the same view of the subject which they do, a barn
can be built suitable for the establishment, and the present barn
can be converted into shops for other mechanical pursuits for the ben-
efit of patients, in addition to that of shoe-making, which has been so
successfully conducted. The Trustees are unanimous in respectfully
asking the attention of the Legislature to this subject and the appro-
priation mentioned.
Pursuant to the authority given to the Trustees by the " Resolves,
concerning the will of Martha Johonnot, and the State Lunatic Hospi-
tal," passed at the last session of the Legislature, they employed Pliny
Merrick, Esq., district attorney for the middle district, as counsel, and
through him have received from George Nichols, Esq., executor of
the last will of George S. Johonnot, Esq., deceased, in cash, mortgages
and stocks, property valued at forty-five thousand eight hundred forty-
three dollars and twenty-two cents — the stocks being estimated at the
market value when the transfer was made. There are forty-seven
shares in the bank of the United States, then estimated at S893. Some
of the other stocks are of uncertain worth. The Trustees have as yet
sold none of them. They found it difficult to invest the cash which
they received, according to the requirement of the resolves, and have
made a temporary arrangement which is entirely safe, and will yield six
per cent, per annum. They have received four per cent for the money
deposited in the bank, awaiting investment. This property is charged
with the payment of life annuities to twenty-three individuals, amount-
STATE LUNATIC HOSPITAL. %
ing to twenty-five hundred and twenty dollars per annum, and with the
support of an old horse during his natural life. It is now believed that
the income will be equivalent to the charges upon it ; but it is not cer-
tain that it will be. From this statement, it is evident that the hospital
will derive no advantage from this legacy, until the property ceases to
be encumbered by these annuities, probably many years hence. Nev-
theless, it is believed to have been wise in the Legislature to accept it
in view of the eventual benefit which will accrue. The annuitants will
die, but it may be hoped, while insanity is found, this institution will
never die. The resolves require that the properly, received under this
legacy, shall be converted into cash, and loaned, on notes or bonds se-
cured by mortgages. The Trustees esteem these as the highest class of
securities, always to be preferred to any others when they can be had.
But their experience, during the time since the property came into
their hands, leads them to doubt whether it be wise to require such
investments in all cases.
To secure health and comfort in an Asylum for the Insane, an abun-
dant supply of pure and wholesome water is absolutely essential. This was
understood by the commissioners for erecting this hospital. They made
thorough explorations in all directions, in search of springs, and se-
cured the right, in the first place, of sinking a well, and taking water from
the hill east of the hospital, on land now owned by the institution. But
the summer when the main building was erected, disappointed their
hopes as to the abundance and permanence of that source. They then
dug a well in the yard, back of the building ; but after boring very
deep, the water, when found, was of a mineral quality, unfit for domes-
tic use or for cattle. As a last resource, they obtained permission to
take water from springs on land of F. W. Paine, Esq., and to lay a pipe,
about a mile and a quarter, through the lands of seven or eight proprie*
tors, besides crossing two public roads. The water from this source is
of excellent quality, and abundant in quantity. But the right which
the institution has, either to the water or to enter upon the land
through which the pipe is laid, is one of mere sufferance. It was all
the right, however, which could be obtained, and was accepted from
imperious necessity. It was granted as a boon without compensation ;
nor would it be granted in any other manner than it is for a compensa-
tion. Two of the proprietors, five years ago, insisted upon a memo-
randum in writing, which should prevent any title to cross their lands
being acquired by occupancy. There is probably no reason to appre-
8 STATE LUNATIC HOSPITAL.
hend difficulty from any proprietor with whom this contract of suffer-
ance was originally made, nor from any who have since become pro-
prietors. But it is impossible to foresee into what hands these springs
and lands may fall. Should any person become a proprietor, who
should insist upon exercising his right to stop the aqueduct from run-
ning through his land, he would inflict at once upon the institution an
injury of incalculable magnitude. The present Board of Trustees, hav-
ing their attention called to this subject, have made another effort to
procure a permanent title to this easement ; but with the same success
as their predecessors. Some of the proprietors, for a sufficient con-
sideration, wouldxgive a title — others cannot, and some are not willing
to do it. The Trustees, therefore, submit the subject to the Legisla-
ture. They know that it is invidious to take private property for pub-
lic use, under any circumstances, and should never be done, except for
a fair compensation and from necessity. It would seem that mill-privi-
leges and rail-roads, can have no greater necessity to justify the taking
of private property, than this institution has to secure permanently the
right to this water and the means of using it. The opinion of the Trus-
tees is, that if it can be constitutionally done, all question as to right in
this case, should in some way be put at rest, so that the hospital shall
always have this water.
The monthly visits to the hospital during the past year, have been
regularly made by the Trustees, with the intention of noticing every
thing which pertains to the welfare of the establishment. They cheer-
fully and unanimously bear testimony, as their predecessors have an-
nually done, to the ability, the kindness, the patience, the fidelity, the
perseverance and the skill with which the officers and assistants have
discharged their duty. If now and then the perverseness of insanity
does not appreciate the benevolence and skill which watch over, and
endeavor to cure it ; and the ignorance or misguided views of the
friends of a patient, lead them to distrust the management of a particu-
lar case, or even to speak evil of the good done them, it is of rare
occurrence. A great majority, even in their insanity, appear thankful
for kindness shown them, and those who are discharged cured, almost
invariably carry with them deep and heartfelt gratitude towards those
under whose care they have been, and freely express it wherever they
go. The friends also of patients rejoicing over their restored reason,
or improved physical condition, generally bestow ample praise upon
the medical skill and good management of the officers.
The Trustees regret that in the course of the ensuing year, the in-
STATE LUNATIC HOSPITAL. 9
stitution will lose the very valuable and faithful services of Dr Chand-
ler, the assistant physician. He has been in that office ever since the
first opening of the hospital, and has given entire satisfaction to the
superintendent, and every successive Board of Trustees. If we must
part with him, it is gratifying to know that the insane among our
neighbors of New Hampshire will have the benefit of his skill and ex-
perience at the head of the hospital in that State. Mr and Mrs Ellis,
too, who, as steward and matron, have rendered six years service in
those offices, propose to leave in a kw months. They have discharged
their duties with ability and untiring assiduity, and will carry with
them the respect of those with whom they have been more immediately
associated, as well as of the Trustees.
The contrast is immeasurably great between the condition of the
insane in a well-regulated hospital, or in private families or jails, cages
or dungeons, to which they are often subjected where no hospital exists.
We look upon this institution as an honor to Massachusetts, both for
its direct efforts in the cause of humanity, and for its collateral influ-
ences. It was the misery and wretchedness of the insane in our jails
and houses of correction, which excited some noble-minded philanthro-
pists to procure legislative assistance, and the example of what has
been here done, awakens attention wherever it is known. Those who
are curious in tracing the steps by which great effects proceed from
apparently slight causes, may imagine, not wholly without reason, that
the mud-bird's nest, described in one of the early reports of the Prison
Discipline Society, built on one of the bars of the grated window of
his loathsome apartment in the old Worcester jail, by one of the pre-
sent inmates of this hospital, then in nakedness and filth, now clothed
and comfortable, was the foundation of this noble structure, and that
the effects of that scene may yet be felt on the other side of the globe.
A gentleman who has visited this institution, and is now in Constanti-
nople, writes to have its reports, with an engraved view of the hospital,
sent out to him, that the subject may be discussed in the Armenian
and Greek languages. He says " one of the most painful and disgust-
ing sights which I have witnessed in this country, is the prison of the
insane. They are kept in the same great building with bears and
wolves, but in stronger dungeons, and they are more inhumanly treat-
ed than their brute fellow-prisoners. It is possible that some detail of
the operations in Worcester may lead to efforts for a better system."
Whether such be the effect there or not, it is certain that efforts for a
better system have been made in many States of this Union, since they
2
10 STATE LUNATIC HOSPITAL.
were made here. It is not unreasonable to hope that, by continuing
the course heretofore pursued here, showing the people the effects of
their benevolence, aud that their appropriations are faithfully used, the
Legislature will continue from year to year, their fostering care, and
Heaven to bless their charity.
A. D. FOSTER,
M. L. FISHER,
D. P. KING,
HENRY GARDNER,
ROBERT CAMPBELL.
State Lunatic Hospital,
Worcester, December 1, 1841.
STATE LUNATIC HOSPITAL.
il
TREASURER'S REPORT
To His Excellency John Davis, Governor, and to the Honorable Ex-
ecutive Council^ of the Conimonioealth of Massachusetts,
The Treasurer of the State Lunatic Hospital respectfully presents
his Ninth Annual Report.
The treasurer charges himself, from December 1, 1840, to Novem-
ber 30, 1841, inclusive, as follows :
For cash on hand, balance of last account,
December 1, 1840, ... - $2,201 18
For receipts from cities, towns, and individ-
uals, 24,046 60
For balance of appropriation from the State
treasury, 4,000 00
For credits on sundry bills for shoes, oxen,
cows, pigs, flour barrels, ashes, grease,
old iron, and various other things, - 1,045 95
$31,293 73
He credits himself as follows
For payments for improvements and repairs, 2,268 94
" " " salaries, wages and labor, 7,151 68
" " " furniture and bedding, 1,570 02
" clothing, linen, &c., 2,069 10
" fuel and lights, 3,037 34
" " " provisions and groceries, 10,812 24
" " " medical supplies, 613 68
" straw and hay, (hay |9 91) 89 77
" <' " miscellaneous, 1,234 65
Cash on hand, balance to new account, 2,446 11
Deducting the balance on hand,
The cost of supporting the institution for
the year, appears to be
$31,293 73
2,446 11
$28,347 62
12 STATE LUNATIC HOSPITAL.
The item of improvements and repairs is large when compared with
the same in former years. Of the sum of $2,268 94, the unavoidable
expense of rebuilding the bank-wall in front of the hospital-hill, with
the steps and buttresses of the first rise, amounted to §993 52 ; in the
purchase of land, §200 were added to the special appropriation for
that object ; and about $80 were expended for another furnace in the
north wing, for the more perfect warming of the wards in very coW
weather. These sums amount to §1,273 52, and deducted from the
whole sum, leave §927 66 for the ordinary expenses under this head.
The cost of a piaDO-forte, §250, is included under the item furni-
ture. The other expenses are those of ordinary occurrence, to keep
the institution properly supplied.
The item of clothing, linen, &c., includes, as usual, the stock of the
shoe-shop purchased within the year. The whole amount is larger
this than some other years, but not larger than it has ever been before.
STATE LUNATIC HOSPITAL.
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STATE LUNATIC HOSPITAL.
Provisions and Groceries include
Fruit, apples,
, pears.
peaches, berries, raisins.
, lemons.
&c.,
f 592 07
Spices, salt, and small groceries.
-
-
-
$160 72
Soap,
-
-
-
-
-
327 09
Vinegar and cider.
11
barrels 25J gallons
>
57 25
Milk,
-
639
quarts,
-
-
25 91
Butter,
-
- 10,20I|
lbs.
-
-
1,751 20
Cheese,
-
- 6,382^ lbs.
-
-
484 16
Eggs,
-
- mil
dozen.
-
-
90 81
Lard,
.-
151
lbs.
-
-
15 52
Beans,
-
33J
bushels.
-
-
64 47
Peas,
-
14
bushels.
-
-
22 79
Tea,
-
- 476J
lbs.
-
-
271 25
Coffee,
-
1,401
lbs.
-
-
167 27
Brown sugar,
-
8,975
lbs.
-
-
730 35
Loaf sugar.
-
707|
lbs.
-
-
84 70
Molasses,
-
495
gallons.
-
-
157 87
Honey,
-
230
lbs.
-
-
19 58
Shells,
-
486
lbs.
-
-
73 56
Corn,
-
725^
bushels.
-
-
639 82
Rye,
-
262^
bushels,
-
-
217 42
Oats,
-
214
bushels,
-
-
97 93
Barley,
-
9
bushels,
-
-
6 30
Rice,
-
1,487
lbs.
-
-
71 00
Biscuit,
-
-
-
-
-
109 77
Flour,
-
231
barrels.
-
1,432 20
Potatoes,
-
1,472
bushels.
-
-
472 39
Poultry,
-
- 1,0041
lbs.
-
-
95 50
Fresh fish.
\^s^
\ lbs. 73 by number, oys
ters and clams.
72 36
Salt fish,
4,875
lbs.
-
-
110 86
Mackerel,
-
3
barrels.
-
-
42 00
Tongues and sounds
3
barrels 248 lbs.
-
26 20
Salmon,
-
1
barrel,
-
-
18 00
Ham, and smoking 1;
lams, 642^ lbs.
-
-
67 39
Mutton and lamb,
- 2,027^
lbs.
-
-
161 95
Beef,
-
- 24,259^
lbs.
-
-
1,482 21
STATE LUNATIC HOSPIl^AL.
17
Pork,
Veal,
Sausages,
Salt beef,
Liver,
Salt pork,
Tripe,
2,978^ lbs.
3,944f lbs.
489J lbs.
191 lbs.
2 barrels,
493 lbs.
Fuel and Lights include
203 07
251 69
49 90
13 38
1 77
32 00
40 56
$10,812 24
Wood,
506 cords, 6 feet, 10 inches,
2,386 67
Charcoal,
2,101 bushels,
207 23
Anthracite,
15 tons— 30,000 lbs. -
155 62
Oil,
246 gallons,
255 20
Candles,
70 lbs.
30 00
Wicking,
-
2 62
$3,037 34
Miscellaneous includes
Cash advanced to patients, and charged in their accounts,
or paid to them when discharged, . - -
Expenses of pursuing and returning elopers.
Expenses of returning patients discharged to the places
whence they were sent to the hospital or to the houses of
correction, . . . - .
Funeral expenses, . - . . -
Postages, ------
Expenses of trustees' visits, - - - -
Books, stationery, periodicals, &c., _ - .
Filling ice-cellar, . . - - -
One horse, two cows, two pairs of oxen, one hog.
Sundries, .--.--
86 15
86 80
58 97
120 25
80 61
90 85
92 95
27 00
460 00
131 07
$1,234 65
The balance of the appropriation made by the Legislature in 1839,
has been drawn from the State treasury and partially expended.
3
18
staTS^ lunatic hospital.
In additiGii to the nic-ney nov/ in his hands, nnd that to be received
for the Bupporl of palierils, the ireasurdr is o!' opinion that an epprc-
prirriion of two thousand dollars vrill be necessury to defray the current
expenses of thocnsuiiig year.
A, D. FOSTER,
Treay.urrr of the Stale Lunatic HospiiaL
STATE LUNATIC HOSPITAL.
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STATE LUNATIC HOSPITAL. 25
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STATE LUNATIC HOSPITAL. 27
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28
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STATE LUNATIC HOSPITAL. 31
The foregoing and following tables are obtained from the record of
the hospital, kept in books in which daily entries are made. In these
registers are to be found the name, age, sex, residence, duration of in-
sanity, time of admission, cause of disease, hereditary predisposition,
occupation, civil state, &c., of each individual that has been in the
hospital.
There is also a record of discharges, deaths, cause of discharge or
death, time of discharge or death, duration, &c.
Besides this register, there are case-books in which some entry is
frequently made of the condition of patients, the medication pursued
and the changes effected ; twelve of these books have already been
filled.
We have, also, a daily entry of the number of patients of each sex
in the hospital ; a record of the monthly visits of the trustees, and by
whom made, and a summary of the operations of the months, by which
is known the number admitted, discharged, died, &c.
From these records we are enabled to obtain the facts and statistics
which we present in our annual reports.
Since the opening of the institution, we have received 1359 patients,
of whom there were from the
County of Barnstable, ----- 29
Males, - - _ 17
Females, 12 ^29
County of Berkshire, ------ 36
Males, 18
Females, 18 36
County of Bristol, 80
Males, 47
Females, 33 80
County of Dukes, ---._. 5
Males, 3
Females, 2 5
County of Essex, ------ 168
Males, - - - 83
Females, 85 168
County of Franklin, 58
Males, 36
Females, 22 58
32 STATE LUNATIC HOSPITAL.
County of Hampden, ----- 60
Males, - - - 25
Females, - - - - ~ . - - - 35 60
County of Hampshire, ------ 77
Males, 44
Females, - - 33 ^77
County of Middlesex, ----- 144
Males, 75
Females, - - 69 144
County of Nantucket, ------ 10
Males, 5
Females, --_--_-. 5 10
County of Norfolk, 125
Males, 75
Females, 50 125
County of Plymouth, - 59
Males, . . - 28
Females, 31 59
County of Suffolk, 148
Males, 81
Females, 67 148
County of Worcester, ----- 355
Males, 169
Females, 186 355
Private boarders from out of the State, - - 5
Males, 2
Females, - - - 3 5
1359
The following tables present the general statistics of the hospital,
for the whole time of its existence, the particular and detailed account
of the operations of the past year, with many interesting facts relating
to insanity and institutions for the insane.
STATE LUNATIC HOSPITAL.
33
TABLE L
Showing the number of Admissions, and the state of the Hospital, from
Decemier 1st, 1840, to November SOth, 184L
Patients in the Hospital in the course
Males,
Females,
At the commencement of the year,
Males,
Females,
Admitted in the course of the year,
Males,
Females,
Old cases,
Recent,
Remain at the end of the year,
Males,
Females,
Patients admitted,
Males,
Females, -
73
90-
163
-163
Cases of less duration than
1 year, ... 84
JMales, - - 35
Females, - - 49 84
Cases of longer duration
than 1 year, ... 79
Males, - - 38
Females, - - 41 79
Cases committed by the
Court, - - - 110
liy the Overseers, - 10
Private boarders, - 43 163
Foreigners in the Hospital
in the course of the year, 47
Males, - - 28
Females, - - 19 47
Of which are natives of oth-
er States, - T - 12
Males, - - 8
Females, - - 4 -12
5
of the year,
195
204—
-399
122
114-
73
90-
79
84-
116
116-
-236
-163
-163
-232
399
236
163
232
Patients now in the Hospital, 232
Males, - - 116
Females, - - 116 232
Cases of less duration than
1 year :
Males, - - 11
Females, - - 22—33
Cases of longer duration
than 1 year:
Males, - - 102
Females, - - 97-199
Applications to the Hospital
not received.
Males, - - 33
Females, - - 58-
-232
91
-91
34 STATE LUNATIC HOSPITAL.
This table contains the facts connected with the admissions of pa-
tients, during the past year. As we commenced the year with a full
house, and closed it with the same, it is obvious that there can be but
little difference in our numbers from year to year.
There has been a greater number of patients in the hospital the last
year than any former year, though the difference is very little the last
three years,— being 397—391—399.
Three hundred and ninety-nine patients have been under our care
during the past year, as is seen by the table, of whom one hundred
and ninety-five were males, and two hundred and four females.
At the commencement of the year there were two hundred and
thirty-six patients, of whom one hundred and twenty-two were males,
and one hundred and fourteen females.
There were admitted in the course of the year one hundred and
sixty-three patients, of whom seventy-three were males and ninety
females.
There remain at the close of the year two hundred and thirty-two
patients, one hundred and sixteen of each sex.
As the accommodations for each sex are about equal in the hospital,
the numbers can never be very different while the institution is full.
For some years, the number of males greatly exceeded the number of
females; for the last two or three years, the number of females admit-
ted has been the greatest, so as, at this time, very nearly to balance
the number of each sex that have resided in the house.
There have been in the hospital, in the course of the year, forty-
sevQn patients who have no residence in this State, and who are a tax
upon its funds ; of these, twenty-eight were males, and nineteen fe-
males. The towns are always ready to send this class of patients to
the hospital, on the slightest indications of insanity ; after they arrive,
those who can be benefited, remain till fully restored ; and others, would
entirely fill our incurable ward, were it not for the salutary provision
made by the government for the discharge of foreigners, other circum-
stances being equal, before residents of the State. Many of these
have no home, and they continue with us, especially in the inclement
seasons, lest they should suffer from cold and neglect after they are
discharged.
Should the towns manifest the same benevolence in regard to their
own paupers, it would indeed be praiseworthy.
We estimate that about one hundred patients are supported by their
friends, one hundred are supported by towns, and the remainder,
STATE LUNATIC HOSPITAL.
35
averaging about thirty, are State paupers. If the expenses of the hos-
pital are $30,000, including the salaries of the officers, and the towns'
pay for one hundred patients, it will make the sum of f 13,260, for the
support of one hundred town paupers, which, divided among the peo-
ple, would be one cent, eight mills and 5-lOths to each individual of
the Commonwealth. In the course of years, this pittance may be very
equally divided throughout the State.
TABLE 2. '
Showing the numher of Discharges and Deaths, and the condition of
those who have left the Hospital, from December \st, 1840, to No-
vember 30th, 1841.
No. of
each sex.
Recov-
ered.
Im-
proved.
Harm-
less.
Died.
Total.
Patients discharged, - 167
Males, - - - -
Females, _ - -
77
90
38
44
15
21
17
20
7
5
167
82
36
37
12
167
Patients discharged whose in-
sanity is of less duration than
one year, - - 68
Males, - - - -
Females, . . -
28
40
26
36
1
1
0
0
1
3
68
62
2
0
4
68
Patients discharged whose in-
sanity is of longer duration
than one year, - 99
Males, - - - -
Females, . _ -
46
53
9
11
15
19
17
20
5
3
99
20
34
37
8
99
This table shows that, in the course of the last year, one hundred
and sixty-seven patients have been discharged from the hospital, of
whom seventy-seven were males, and ninety females; of these, eighty-
two were recovered, thirty-eight males and forty-four females; thirty-
six were improved, fifteen males and twenty-one females; thirty-seven
were not improved, seventeen males and twenty females; and twelve
have died, seven males and five females.
Of the patients discharged, sixty-eight have been insane less than
one year, twenty-eight males and forty females; of this number, sixty-
two have recovered, twenty-six males and thirty-six females ; two were
improved, one male and one female; and four died, one male and
hree females.
36
STATE LUNATIC HOSPITAL.
Of the patients discharged, ninety-nine were insane more than one
year, forty-six males and fifty-three females; of these, twenty recover-
ed, nine males and eleven females ; thirty-four were improved, fifteen
males and nineteen females ; thirty-seven were discharged, as harmless,
for want of room, seventeen males and twenty females; and eight have
died, five males and three females. One female died, very suddenly,
of an attack of inflammation of the bowels, after she had fully recov-
ered from insanity, and was waiting for a place to be prepared for her
reception, her health not being such as to admit of severe labor. This
case is placed with the recovered in the table.
The number of deaths has been less in proportion than any previous
year but one. There was a time, during the latter part of summer,
when bowel complaints were prevalent in the hospital, which proved
fatal to one or two invalids ; the remainder of the season has been
healthy. No epidemic has ever visited the hospital ; and a large pro-
portion of deaths in this, as in former years, have been from chronic
complaints, among a class of patients wholly incurable. Of those who
have died the past year, three only had resided in the hospital, the
others having entered in the course of the year.
TABLE 3.
Showing the number of Admissions
and Discharges
Average of Patients in the Hospital each month of
each month of the year. |
the year.
Admitted.
Discharged.
Monthly Average.
December,
12
13
December,
232i
January,
9
8
January, -
236J
February,
10
15
February,
230
March,
11
10
March, - - -
2325
April,
14
14
April, - - .
234^
May,
12
11
May,
230
June,
13
11
June, ...
231i
July,
19
15
July,
235i
August,
19
16
August, - - -
237d
September,
10
19
September,
237
October,
15
14
October, -
233
November,
19
21
November,
232J
163
167
Annual Average,
233i
STATE LUNATIC HOSPITAL. 37
The table sljows that the received and discharged vary but little;
that the number admitted and discharged the last six months, greatly
exceeds the number during the first part of the year. There were
comparatively few recent cases admitted early in the season, but after
midsummer they became more numerous, and at the close of the year,
an unusual number of recent cases, recovered, were discharged.
The number of apartments occupied in the hospital, does not exceed
two hundred and twenty-five ; it will be seen by the table, that the
average, each month, was much above this number. There is scarcely
a day in the year when every apartment is not occupied ; and much of
the time, we have many more persons in the establishment than we
have rooms for their accommodation, and are obliged to lodge them
in the halls and infirmaries. It is desirable to be full ; but to be over-
run, and then be constantly pressed with new cases, is a subject of
great inconvenience.
Every year, since the hospital was enlarged, we have had applica-
tions enough, that have been rejected for want of room, to fill a good-
sized establishment. While it may be doubtful whether this institution
should be enlarged, it is greatly to be desired that all the insane should
find a retreat in an institution designed for their benefit, and especially
that all recent cases should have the means of cure. Those who are
exempt from this great calamity should see that every comfort is pro-
vided for the victims of this disease, and that no individual who desires
it, or whose friends desire it, should fail of the benefit of curative
means which these institutions afford. The appropriations for the ac-
commodation of such, should be liberal, and the means of support
ample. Humanity, as well as true economy, dictates this. Our good
Commonwealth has exceeded all others in its liberal provision for the
insane; and this hospital will ever stand a monument of its benevolent
and humane spirit.
38
STATE LUNATIC HOSPITAL.
TABLE 4.
Statistics of the Hospital, from January, 1833, to November 30th, 1841.
1S33.
1S34.
1835.
1836.
1337.
1833.
1839.
1840.
1841.
Total.
Whole number of Pa-
tients admitted.
153
119
113
125
168
177
179
162
163
1359
Discharged, — including
deaths and elopements,
39
115
112
106
121
144
168
155
167
1127
Discharged recovered,
25
64
52
58
69
76
80
82
82
588
Discharged improved.
7
22
23
17
23
24
29
29
36
210
Died, ....
4
8
8
8
9
16
22
15
12
102
Eloped,
1
1
1
1
0
0
0
0
0
4
Patients in the Hospital
in the course of the
year,
153
233
241
?45
306
362
397
391
399
1359
Patients remaining at the
end of each year, .
114
118
119
138
185
218
229
236
232
Males admitted, .
Females admitted.
96
57
79
39
51
62
66
59
94
75
96
81
80
99
75
87
73 710
90 649
Males discharged,
Fetnales discharged, .
19
15
58
48
57
46
56
41
65
47
74
54
66
80
68
87
71 534
84 502
Males died,
Females died,
3
1
5
3
4
4
6
2
6
3
10
6
14
8
9
6
7
5
64
38
Patients sent by Courts,
Private,
109
44
55
64
89
21
117
8
129
39
123
54
123
56
105
56
110
53
960
395
Recoveries :
Males,
Females, .
13
12
33
31
27
25
32
26
37
32
45
31
32
48
28
54
28
44
285
303
25
64
52
58
69
76
80
82
82
588
Average in the Hospital
each year,
107
117
120
127
163
211
223
229
233
STATE LUNATIC HOSPITAL.
39
This table has been prepared with much care, as a summary of all
the statistics from the commencement of operations in the hospital to
the present time. It presents the number of admissions, discharges,
recoveries, deaths, and the number discharged for other reasons, such
as improved and not cured, harmless and incurable, for want of room,
&-C,
The necessity and demand for the hospital cannot be better shown
than by the fact that, in the nine years of its operation, there have
been sent to it, by the various courts, nine hundred and sixty-one
patients, judged to be " so furiously mad as to be manifestly dan-
gerous to go at large," besides many that have been committed by the
overseers of the poor, who are equally furious and unsafe.
The committals from the courts have averaged about one hundred
and six, each year ; and from the overseers, about ten. It is preper,
here, to remark, that the overseers of the poor are frequently the per-
sons who apply to the courts for the admission of dangerous lunatics.
The average number of patients in the hospital has increased every
year, being 107 in 1833, 117 in 1834, 120 in 1835, 127 in 1836, and,
since the enlargement of the building, 163 in 1837, 211 in 1838, 223
in 1839, 229 in 1840, 233 in 1841.
TABLE 5.
Duration of Insanity witli those
remaining
in tiie
Ages of Patients in the Hospital,
December 1st,
Hospital, December 1st,
1841.
841.
Less duration than
one
year,
30
Unde
•20, -
6
From ] to 2 years,
-
-
32
From
20 to 25,
-
-
-
19
" 2 to 5 '>
-
-
52
((
25 to 30,
-
-
-
30
« 5 to 10 "
_
-
44
((
30 to 35,
-
-
-
37
« 10 to 15 «
-
-
33
«
35 to 40,
-
-
-
32
" 15 to 20 "
-
-
16
((
40 to 45,
_
-
-
30
« 20 to 25 «
_
_
10
((
45 to 50,
-
_
-
25
" 25 to 30 "
-
.
4
u
50 to 55,
.
-
_
15
Over 30, -
.
.
4
((
55 to GO,
.
-
-
13
Unknown, -
-
-
7
<c
60 to 65,
-
-
-
11
((
65 to 70,
-
-
.
6
232
((
70 to 75,
-
-
.
3
Unknown, -
-
-
-
5
232
Three only of the old cases, remaining at the close of the last year,
have died in the course of the year, and very kw have been dis-
charged ; of course, a large number of the residents are old incurable
40
STATE LUNATIC HOSPITAL.
cases, and many of them are demented. We usually have about two
hundred of this class; and the remainder, not generally averaging over
thirty at a time, are all the cases that afford any chance of recovery.
It will be seen by the table that we have now but sixty-two cases who
have been insane less than two years, while one hundred and seventy
have been insane from two to thirty years and upv/ards.
The average residence of the curable cases is about four months ;
these must change nearly three times in a year, to enable us to report
our usual number of recoveries. An old case occasionally recovers;
we have had a few interesting cases of this character. Comparatively
few recover who have been constantly insane two years; and, after
five years, a recovery is very rare.
This table shows that fifty-two patients, now in the hospital, have
been insane between two and five years, forty-four between five and
ten years, and seventy-three more than ten years.
By far the greatest number of our patients are between the ages of
twenty-five and forty-five, viz. one hundred and twenty-nine, and the
largest number of any five years, between the ages of thirty and thirty-
five, viz. thirty-seven. These facts would show that insanity is most
common with persons of active life, when the mental and physical
powers are at their acme, and when the responsibilities of life are the
greatest.
TABLE 6.
Classification of Insanity.
Whole Number.
No. of each Sex.
Curable.
Total of Curable.
Mania, _ - - -
Males, ...
Females, - - -
672
353
319
218
220
438
Melancholia, . - -
Males, - - -
Females, - - -
434
204
230
115
138
253
Dementia, . - -
Males, - - -
Females, - - -
179
109
10
4
4
8
Idiots, _ - - -
Males, . - .
Females, - - -
11
10
1
0
0
0
0
The division of insanity into these four classes, is somewhat arbi-
trary. In the strongly marked cases, the distinctions are very plain,
STATE LUNATIC HOSPITAL. 41
no less so by the natural language than by the symptoms of disease ;
as they approximate each other, the difficulty of classification is in-
creased till it is found impossible to decide where the cases shall be
arranged. Many recent cases at first appear demented, but soon come
out of that state, and exhibit excitement and even violence and fury ;
if such cases were classed under dementia, the proportion of recover-
ies would be greatly increased. None are called demented, in the
table, but such as are for a long time torpid and exhibit great imbecility
of mind.
Many writers, who observe the general order of the table, make
another distinction of insanity, viz., monomania. In my opinion, this
does not make the subject any more clear, or remove one objection to
the classification. All the insane are, in a greater or less degree,
monomaniacs. It is very rare that all the faculties of the mind are
alike affected, even in the worst form of mania, or that they are equally
lost in the worst cases of dementia. The maniac will often make cor-
rect observations, and reason well on some subjects, and the melan-
cholic v/ill generally do this to a much greater extent ; yet, u-ith melan-
choly there is, far more frequently, delusion ; but it is usually upon one
subject, though it may influence the whole conduct, — the melancholic
is, therefore, much more distinctly, a monomaniac. What is hardly
less frequent, and certainly very surprising, is that the individual who
is in a state of complete dementia, so far as regards the common opera-
tions of the mind, will have some faculty active, and susceptible of
being awakened, and exhibit intelligence beyond what would be con-
sidered possibl'e.
From the time the institution was opened, till quite recently, we
have had a man with us, whose mind seemed incapable of any rational
action, who was not only demented, but had lo-st the habits of decency
and order, and whose thoughts were at random and chaotic ; yet this
man would play a flute or fife with great accuracy and delicacy, and
would change from tune to tune with the utmost rapidity, striking
twenty airs in as many minutes, if the names of the tunes were men-
tioned. This man was much of the time naked, tearing up all the
clothes and bedding that were given him. At our dancing parties, he
was frequently washed and dressed up, and led into the hall, where he
would sit and play the whole evening, with great accuracy, both as to
time and tune.
6
42
STATE LUNATIC HOSPITAL.
TABLE 7.
Statistics of the different Seasons.
1S33.
1834.
1S35.
IS36.
1S37.
1838.
1839.
1840,
1841.
Total.
Admissions in winter,
27
26
24
23
26
46
39
32
31
274
Admissions in spring,
71
35
31
36
49
46
38
42
37
385
Admissions in summer,
21
30
30
42
40
47
59
44
51
364
Admissions in autumn.
21
28
28
24
53
38
43
44
44
323
Discharges in winter,
0
22
21
20
15
18
36
35
35
202
Discharges in spring,
7
33
30
33
38
37
43
44
35
298
Discharges in summer,
10
28
31
24
30
43
55
42
37
300
Discharges in autumn,
24
24
22
21
38
32
34
34
51
280
Recoveries in winter.
0
12
14
11
10
15
13
18
20
113
Recoveries in spring.
0
20
13
14
17
23
24
22
10
143
Recoveries in summer.
9
16
16
12
15
18
24
20
22
152
Recoveries in autumn,
16
15
12
20
27
20
20
22
30
182
Deaths in winter.
0
3
1
0
1
3
5
6
1
20
Deaths in spring.
2
2
2
1
2
5
5
6
2
27
Deaths in summer.
2
3
2
4
1
5
7
1
5
30
Deaths in autumn.
0
0
3
3
5
3
5
2
4
25
There has ever been an opinion prevalent, that the seasons affect
the insane ; that spring is the season of excitement, that autumn is
the season of gloom and suicide.
The table shows that winter is the most favorable season, whether
it regards attacks, or deaths from insanity. Spring affords the greatest
number of cases, autumn the greatest number of recoveries, and sum-
mer the greatest number of deaths.
Of the suicides that have taken place in this hospital, four have
occurred between the lOth of May and the 3d of August, and only
one in the three autumnal months.
STATE LUNATIC HOSPITAL.
43
TABLE 8.
Causes of Insanity.
Intemperance, — Males,
182
Hereditary, or having insane
Females,
22-
-204
ancestors and kindred,
388
111 health, -
-
208
Periodical, - . - -
251
Masturbation, -
-
]13
Homicidal, - - - -
20
Domestic Affliction, -
-
145
Actual homicides, - - -
15
Religious, -
-
100
Suicidal, - . - .
154
Property, - - -
-
77
Actual suicides, - - -
7
Disappointed affection,
-
58
Disappointed ambition.
-
28
Have dark hair, eyes and com-
Epilepsy, . - -
-
40
plexion, - . - -
399
Puerperal,
-
36
Wounds of the Head,
_
17
Have light hair, eyes and com-
Abuse of snuff, &c.
-
8
plexion, - - . -
389
Arising from physical causes,
Arising from moral causes.
633
408
Many not clnssed.
In the table, intemperance still takes the first rank among the causes
of insanity, and has added nineteen to our list during the last year.
Of" delirium tremens," we have none ; the cases, in the hospital, that
arise from this cause, are far worse than even this frightful disease, and
often follow and are the effect of it.
Intemperance is not only the cause of insanity, but is too frequently
the source of other evils, which are prolific causes of the disease. If
we could ascertain how many of the cases of ill health, of domestic
affliction, of fear of poverty, loss of property, and even religious de-
pression and melancholy, arise from it, the list would be appalling,
and would be nearly or quite double what it now is.
There is one cause that has brought so many individuals to the
hospital, within the last few years, and is so fatal in its tendency, that
I am unwilling to pass it over. In these cases, which, in a short time,
have amounted to fifteen in number, the difficulty has been connected
with intemperance, and, probably, has arisen from it; it seems to me
to be a partial paralysis of the brain. In most of the cases, for some
time before any indications of insanity have existed, there has been
observed a slight unsteadiness in the gait, a little difficulty in the
44 STATE LUNATIC HOSPITAL.
speech, an irregular contraction of the muscles of the face, in speaking
or laughing; sometimes, the senses have been impaired, and the power
of memory lost or diminished. The slightest affection of the limbs,
in walking, resembles the gait of an old man, and this is increased to
the tottering and unsteady walk of the drunkard. The character of
the man changes by degrees ; if he has been prudent and saving, he
suddenly becomes lavish in his expenditures, desires to change his
residence, and is, perhaps, jealous of his neighbors and wishes to leave
them ; this is, probably, the first symptom of disease. When insanity fol-
lows these precursors, no matter how well in health the individual may
be, the seeds of death are sown in his system, the fatal mischief is at
work upon his brain, and he will inevitably die. Ten of the fifteen
cases I have mentioned, have died, and most of them suddenly ; when
I see such a case, I am able to predict the event with the greatest cer-
tainty.
At first, many cases of this character gain strength, flesh, and vigor
of intellect, and, under other circumstances, we should feel encouraged,
but it is all delusive ; a fit of apoplexy, of epilepsy, or other convul-
sions, will inevitably cut off all the prospects of amendment, and often
terminate life very suddenly. In other cases, a fatal marasmus wastes
the powers, and the patient emaciates to a skeleton, and lingers a life
of prolonged misery, with the greatest possible suffering of body and
mind.
Case 1st, An officer of the navy, aged 38, was brought to the hos-
pital, with such symptoms as have been enumerated ; his mind was
greatly demented, and he walked like a man intoxicated. For a time
he gained flesh and seemed better ; he had repeated ill turns, but soon
recovered from them. He was with us some time, rather losing
ground ; but the change was very gradual. He was in the habit of
stooping to pick up pins, straws or threads, that he saw on the floor.
One day, as he was walking, he stooped in front of his door, apparently
for this object ; while in this position, a patient near him called to his
attendant, and said that something ailed him; the attendant hastened
to him, and found him on his hands and knees, apparently dead ; he
laid him on his bed, but he never breathed again.
Case 2d, was a stout, hale man, aged 39, who was brought to the
hospital in the most furious state of mania ; he was very violent, and
apparently unconscious what he did ; he dealt blows and the most
violent abuse, indiscriminately, to all around him. There was evi-
dently a partial palsy, evinced by the loss of sight of one eye, and a
STATE LUNATIC HOSPITAL; 45
very marked unsteadiness in liis gait. His insanity was soon better,
and he was able to labor considerably, but afterwards relapsed and
sank into a complete palsy ; we now despaired of his life ; he lay
nearly four weeks, unconscious and helpless, took nourishment and
cordial medicines. After a time, some amendment was apparent ; he
gained slowly, but, finally, his health appeared to be as good as before
this severe illness. His mind seemed quite rational ; but the unsteady
walk and loss of sight, with evident impairment of the optic nerve,
remained. In this state, he left the hospital and went to his family ; for
sometime, he appeared rational, but suddenly became as insane as ever
and was brought back to our care as furious as at first. He rested
but little the first night, the next day was dull and lethargic, the second
night became completely apoplectic, and died in a few hours.
Case 3d, was a man of slender habit, aged 40 ; he had been insane
but a few months when he came to the hospital. On his first entrance
we observed the unsteadiness of his gait, and his difficulty of utterance.
He considered himself very rich, and had many projects of wealth and
grandeur. At first, he improved slowly, and finally recovered, in a
measure, from his insanity, but, in other respects, remained the same.
His friends took him home, with the hope that his health would there
improve more rapidly, and that he might be able to assist his indigent
family by his labor. He did not remain long, but returned in a worse
condition than before, being greatly demented ; his walk was worse
and his utterance most difficult, For a time, he improved in health
and became quite fleshy ; but his mind and the paralysis were no
better. One morning, we found him in bed looking ill ; soon after
he had an epileptic paroxysm, which was succeeded by one or two
others ; and, in six or eight hours, be expired, without havino- a return
of consciousness after the first attack.
Case 4th. In the summer of 1840, there came to the hospital a
man, aged 47, who was taken violently insane while on a journey to a
neighboring State. While on his way, he lost his money and his bag-
gage, and, in a public-house, claimed a trunk belonging to another
person, for which he was arrested and lodged in jail. His walk was
very infirm, his posture stooping, and his mind exceedingly imbecile.
I learned from his friends that he had formerly followed the business
of teaming, when he used spirits freely, but not intemperately ; he left
this employment for farming, when he nearly or quite abandoned the
use of spirit. For some months before he was decidedly insane he
became unsteady, wished to change his residence and move " west."
46 STATE LUNATIC HOSPITAL.
His wife informed me that, for a long time before he came to the hos-
pital, she had noticed this tottering in his gait, and an occasional fal-
tering in his speech, which alarmed her, and led her to suppose that
he had used intoxicating drinks, especially as he had become some-
what unsteady, and desired a change of residence, which was contrary
to his former disposition and habits. While in the hospital, he was
most extravagant in his notions of wealth and power, and indulged in
many speculations, which were to benefit the world and fill his purse
with gold. For a time, his health improved, and his mind appeared
more composed and rational. Without any apparent cause, he would
suddenly appear worse, and the symptoms of palsy would be increased.
By degrees, he became so much paralysed as to lose the use of his
limbs, though he could move about upon the bed or floor. He now
emaciated rapidly : though he took a full supply of food, he became
more and more palsied ; and in eight months from the time of his ad-
mission, died of marasmus, a complete wreck both of body and mind.
Dr. Connolly, in his very interesting report of the Hanwell institution,
near London, for 1840, notices these cases of paralysis, and speaks of
their fatal nature, whether their appearance be favorable or unfavorable.
The list of periodical cases, in the table, is large, and includes all
that occur at long intervals, and those that occur in paroxysms.
All cases that have had more than one distinct paroxysm of insanity
are denominated periodical, whether these paroxysms are weekly,
monthly, or even occur on alternate days, and if the lucid interval
lasts a year or many years.
Periodicity is one of the most inexplicable circumstances connected
with insanity. Why it is that on one day, or once a week, a patient
should be in the highest state of excitement, and the alternate day or
week, be quiet and rational, is quite unaccountable. There are, at
this time, many cases in the hospital that have these paroxysms, in
which they are, at each time, as violent and furious as a recent case of
insanity ; this excitement is followed by a rational period, or, what is
more common, a period of depression. If this lucid interval is short,
they continue permanent residents; if a year or more in duration, they
leave the hospital, return to their friends, transact business, and are,
in all respects, rational and responsible. The cases with frequent
paroxysms are frequently grievously tormented, during the interval
when the excitement subsides, with neuralgic or rheumatic pains.
Case 5th. Eight years ago, a respectable farmer was brought to
STATE LUNATIC HOSPITAL. 47
the hospital, at the age of 48. He had been for six years or more
affected with periodical insanity. During the paroxysms he is violent,
almost beyond example ; he breaks and tears every thing that comes
in his way, strips himself of clothing, and, often for days and nights
in succession, screams at the top of his voice. These paroxysms last
him from two to three weeks, and then subside. He soon becomes
quiet, is fond of employment, and will do a great amount of labor for
some days succeeding the paroxysm ; he then enjoys himself well,
feels as if he might be very useful, and resolves, in future, to do better
than he has ever done. After a few days, he becomes gloomy, retires
to his room, avoids company and conversation, and is as wretched and
miserable as he was gay and active before he was depressed. After
two or three weeks of the deepest gloom, he again becomes excited,
more or less suddenly, and thus he spends his life. His paroxysms
average about six annually, and vary in duration and violence. During
the lucid interval, he often suffers much, and is prevented from sleep-
ing by " the gouty pains," as he expresses it, which seem to be true
neuralgia. The most potent remedies have been used in this case,
without, apparently, changing it in the least. This gentleman spends
the lucid interval and period of depression with his family, and often
returns alone to the hospital when indications of excitement return.
Case 6th. At the opening of the institution, in 1833, a female
patient, aged 48, came under our care, who, for seven or eight years,
had been affected with periodical insanity. In her lucid interval, she
has always been modest, respectful and benevolent ; she loves every
body, and has the best feelings of all our household. Her excitements
come on gradually ; the indications are strongly marked in the eye
and general expression of the countenance. Nothing can exceed the
violence and fury of this woman when at the height of her excitement ;
she is noisy, profane, dictatorial and passionate ; rich, to an extent that
enables her to measure her gold and silver by " hogsheads," and her
wealth is lavished on her friends in the most unsparing manner ; for
days and nights she screams, sings and talks incessantly. These
paroxysms are of unequal length, lasting from ten to thirty days.
When she complains of rheumatic pains, it is a sure indication that
the paroxysm will soon be over; and, when it has subsided, she suffers
much from neuralgia, which she calls rheumatism, and she again ex-
hibits the amiable qualities before enumerated. She has from four to
six, and sometimes more paroxysms of this sort, every year.
The fact that so many of these cases are followed by neuralgia, is
48 STATE LUNATIC HOSPITAL.
interesting, as it gives some clue to a correct pathology of this most
interesting but grievous form of insanity.
There have been added to our list, the last year, two actual homi-
cides, increasing the number to fifteen ; the cases in which an attempt
at homicide failed of success, though, in each case, dangerous wounds
were inflicted, have been five ; which, added to the previous number,
makes twenty strong homicidal cases. In this estimate, only those
have been included who have inflicted dangerous wounds. If we in-
cluded men who strike, having threatened to kill, or who threaten
life, and secrete instruments to effect the object, we should double,
and more than double, the number in the table.
Three homicides have been discharged from the hospital by the
highest judicial authority in the State. It is gratifying to learn, from
time to time, that they have continued free from insanity, and are
worthy, valuable citizens. They were all discharged after being fully
satisfied that they had recovered from their insanity. It is to be hoped
that, in all such cases, the fullest evidence will exist that there is a
complete recovery before the patient is discharged.
In the last two cases of homicide, both of which came under our
care the past season, the deed was done from insane impulse. One
killed his wife in a fit of jealousy, fearing that she meditated his de-
struction ; the other attacked a fellow-boarder, and, with a cudgel,
struck her a fatal blow. The former had a trial, and was found not
guilty, by reason of insanity ; the other had no trial, as he was well
known to have been insane many years.
The number of suicidal cases in the table is large, amounting to
one hundred and four, of which number, seven have been actual sui-
cides. For a long time, during the warm months, almost every patient
that was brought to the hospital, was represented by the friends to be
strongly suicidal. Many had attempted to destroy themselves, but
had failed in the attempt; a number made every effort in their power
to obtain the means, but through the vigilance of their friends, had
been unsuccessful. They gave us much trouble and anxiety, but none
of them effected their object. Two of our patients, however, have,
within the past year, succeeded in their attempt : — one, a young lady,
whom we did not suspect ; the other, an aged man, long a resident in
the hospital, who was formerly bent on self-destruction, but who had
outlived the propensity, for years ; during a most terrific thunder-
storm, at which time he was always much afraid, he committed the
act in his nisht-room.
STATE LUNATIC HOSPITAL.
49
Suicide, like homicide, is often the effect of insane impulse ; the
presence of the means, impels to the act ; in a moment, without de-
liberation, the deed is done, and no vigilance of friends or attendants
could prevent it.
TABLE 9.
' Occupation.
Farmers, -
157
Butchers, -
3
Laborers, -
117
Jewellers, -
-
3
Shoemakers,
52
Innkeepers,
-
2
Seamen, -
50
Stevedores,
.
2
Merchants,
45
Stone-cutters,
.
2
Car|»enters,
37
Broom-makers,
-
2
Manufacturers,
29
Coppersmiths,
-
2
Teachers, -
25
Watchmen,
.
2
Students, -
18
Drovers,
-
2
Blacksmiths,
15
Curriers, -
-
2
Printers, -
14
Card-makers,
-
2
Tailors,
11
News Collector,
.
Machinists,
9
Furrier,
.
Clothiers, -
7
Broker,
-
Coopers, -
7
Engineer, -
-
Bricklayers,
5
Hatter,
.
Millers,
5
Gardener, -
.
Cabinet-makers, -
5
Mat- maker,
-
Clergymen,
5
Stocking- weaver,
-
Lawyers, -
4
Bellows-maker,
-
Bakers,
4
Idiots,
-
12
Musicians,
4
Vagrants, -
-
36
Pedlers,
4
Painters, -
4
Females not accustomed to
Rope-makers,
4
labor.
-
127
Paper-makers,
3
Calico Printers,
3
Females accustomed to se-
Sail-makers.
3
dentary employments, -
123
Tanners, -
3
Comb-makers,
3
Females accustomed to ac-
Turners, -
3
tive employments,
192
Harness- makers, -
3
Physicians,
3
Many not classed.
Coachmen,
3
The male patients of the hospital have been previously employed in
fifty-four trades or occupations. The females are from all the em-
ployments pursued by the sex in every department of industry.
Though the number of farmers and laborers on our list is great, it
is confidently believed that sedentary employments tend more directly
to produce insanity than the active ones. We often find that men,
following laborious occupations, have been guilty of excesses, or have
7
50
STATE LUNATIC HOSPITAL.
departed from their regular employment or business before they are
affected with this heavy calamity. Intemperance is one of the most
fruitful causes of insanity with those who pursue labor in the open air;
thus, of one hundred and fourteen farmers, forty-three became insane
by intemperance; of seventy laborers, forty-four became insane by the
same cause ; of thirty-six seamen, twenty-two were intemperate, and
this was the cause of their insanity.
In the production of insanity, more generally depends upon the
temperament than upon the employment. Few are insane who have
good habits, calm and quiet tempers, and thorough discipline of their
feelings.
TABLE 10.
Diseases lohich have proved fatal.
Marasmus, -
24
Brain fever from in
temperance, 2
Epilepsy, , -
-
14
Dysenteric fever,
-
2
Consumption,
-
9
Chronic dysentery.
-
2
Apoplexy, -
-
8
Lung fever, -
-
2
Suicide,
.
7
Old age,
-
1
Disease of the heart,
-
6
Chronic bronchitis.
-
1
Cholera morbus,
-
4
Gastric fever.
-
1
Mortification of the limbs,
_
3
Land scurvy.
_
1
Hemorrhage,
.
3
Congestive fever,
-
1
inflammation of the bo we
Is,
2
Erysipelas, -
-
1
Disease of the brain.
2
Disease of the bladder,
1
Dropsy,
-
3
Diarrhoea, -
-
2
Total, 102
The past year has been peculiarly exempt from mortality, and most
of the deaths that have occurred, have been among those patients who
would never have been better had they lived. Marasmus, epilepsy,
apoplexy, &c. have been the termination of a class of broken-down
cases, past all hope of enjoyment, usefulness, or even comfort, had
life been prolonged. Many cases have incurable disease when they
enter the hospital, and frequently a case is brought to our care, with
delirium of fever, instead of insanity, in which the journey aggravates
every symptom, and death immediately follows.
There is an erythematic inflammation of the brain, attended with a
blood-shot eye, a hot skin, rapid pulse, dry tongue, and muttering
delirium, which is often mistaken for insanity ; a number of such
cases have died in the hospital which should never have been brought
to it. If these improper cases, which terminate fatally, were deducted
from our list of deaths, it would materially lessen our bills of mortality.
STATE LUNATIC HOSPITAL.
51
Of the one hundred and two deaths that have occurred in the hos-
pital, twenty-three took place within twenty days after admission ; ten
of these were recent cases, and thirteen old cases ; thirteen were males,
and ten females. Four of these cases died on the second day, and
many others within a week of their admission.
The following table has been prepared with much care by my
assistant, Dr. Chandler.
TABLE IL
Duration of Insanity with those who have died in the Hospital.
The patients who have died in the hospital, whose
ages and the duration of whose disease have been
ascertained, are in number 99.
The average age when insanity commenced or was
first noticed by friends, is of
Males, . . . . .
Females, . . . .
The mean age of both sexes, . . . .
The average time the insanity had lasted before the
patient was brought to the hospital, is of the
Males, ....
Females,
The mean length of time of both sexes.
The average time of residence in the hospital, is of the
Males, ....
Females,
The mean time of residence in the hospital, of both
sexes, .....
The duration of life, after the individual became in-
sane, is of Males, ....
Females, ...
The mean length of insanity in both sexes, .
The average age at which the ninety-nine have died,
is of the Males, ....
Females,
The mean average age at death of both sexes,
Of fourteen cases of less than three months' stand
ing before coming to the hospital, and who lived
less than three months afterwards, five were males
and nine females.
The average age of the Males is
Females,
The mean age of both sexes, .
The average time insanity had lasted before admis
sion to the hospital, is of Males,
Females, .
The mean time of duration in both sexes,
The average time of residence in the hospital, is of the
Males, ....
Females,
The mean average of residence of both sexes,
Years. Months.
41
42
41
5
3
4
47
45
46
45
49
47
6
3
10
7
8
7
10
7
Days.
15
4
17
15
12
28il
5
19
3
12
4
15^
2
6
12
4
6
15
26
39
32^
34
29
31i
52 STATE LUNATIC HOSPITAL.
This table shows how soon after admission, fourteen recent cases, of
less duration than three months, have died ; the average time of
residence being only thirty-one days ; a proof of the diseased and fatal
condition in which they were when they came under our care.
Of the first hundred patients admitted, eleven died in the hospital,
two of acute diseases, and nine of chronic diseases. Two old men,
one aged eighty, and the other eighty-six, died soon after they came
under our care.
Of the second hundred patients admitted, five died in the hospital;
two of acute diseases, one of whom was an improper subject, and died
in three days.
Of the third hundred cases admitted, two only died in the hospital;
one of fits, in less than twenty days, the other of chronic disease.
Of the fourth hundred patients admitted, eight died in the hospital ;
one of brain fever in three days, an improper subject.
Of the fifth hundred admitted, nine died in the hospital, mostly of
chronic diseases.
Of the sixth hundred admitted, four only died in the hospital, all of
chronic diseases.
Of the seventh hundred, five died in the hospital, all of chronic dis-
eases.
Thus, it will be seen that, of the old cases, comparatively few have'
died while under our care.
STATE LUNATIC HOSPITAL.
53
, TABLE 12.
Showing the comparative Expense of supporting old and recent Cases
of Insanity, from lohich toe learn the economy of placing the insane
in institutions at an early period of disease.
Total expense
at Sloo a year
Cost of
No. of
Present
Time
before entering
No. of the
Present
Time
support
old cases.
age.
Insane.
the Hospital,
and at $13'2
since.
recent cases.
age.
Insane.
at «2 50
a week.
2
67
26 years.
$2960 00
1222
55
15 weeks.
137 50
3
35
12 "
1452 00
1224
20
20 "
50 00
7
46
15 "
1752 00
1227
80
20 "
50 00
8
58
19 "
2252 00
1230
26
18 "
45 00
12
45
23 "
2642 00
1236
39
40 "
100 00
18
69
32 "
3542 00
1245
40
24 "
60 00
19
57
16 "
1952 00
1254
26
15 «
37 50
21
37
14 "
1741 00
1255
27
32 «
80 00
27
45
14 "
1742 00
1260
30
8 "
20 00
44
54
24 "
2730 00
1262
38
16 "
40 00
45
58
23 "
2585 00
1269
24
27 "
67 50
101
49
19 "
2685 00
1269
27
13 «
32 50
102
51
23 "
2581 00
1270
17
21 "
52 50
133
42
11 «
1179 00
1276
21
12 "
30 00
176
53
18 "
2234 00
1291
32
8 "
20 00
190
48
11 "
1185 00
1292
35
35 "
87 50
206
43
14 «
1656 00
1293
72
13 «
32 50
209
37
14 «
1711 00
1296
25
52 "
130 00
223
48
18 "
2112 00
1298
30
18 "
45 00
247
40
16 "
1865 00
1300
45
40 "
100 00
260
45
16 «
1860 00
1302
25
20 «
50 00
274
38
13 "
1557 00
1307
30
11 "
28 00
278
47
8 "
1172 00
1314
50
8 "
20 00
319
51
8 "
995 00
1318
48
38 "
95 00
330
50
9 «
1030 00
1352
47
11 «
28 00
Average expense of old cases, $1969 00
The 25 have cost 49,248 00
Average expense of recent cases, .... 53 22
Whole expense of 25 recent cases till recovered, . 1330 50
The amount of good which institutions for the insane can accom-
plish, cannot be fully known until the public are informed of the bene-
fits they can bestow, both in a pecuniary and medical view, by the
early committal of the afflicted to their wards.
In the table, twenty-five of the early cases now remaining on our
list, are taken to show v/hat it costs to support old incurable cases.
54 STATE LUNATIC HOSPITAL.
The aggregate cost is found to be $49,248, which, being divided by
the number twenty-five, makes $1,969 each. The time that the whole
number have been insane, is 426 years, averaging 17 years each.
These persons are all incurably insane; and many of them, being in
the enjoyment of good bodily health, and not greatly advanced in age,
will probably live along time, so that they may for years be a burden to
their friends or the State. The average age of these persons is some-
thing less than 49; should they average ten years more in the hospital,
the expense yet to come will be $32,000, which, added to $49,248,
will make more than $80,000 for the support of these 25 insane per-
sons during their lives.
If there are seven hundred insane people in this State, and half of
them are incurable, and a burden to their friends or the public, the
annual cost of supporting them will be $35,000, and for ten years
$350,000, at $100 a year.
The last twenty-five recent cases of insanity on our records, which
recovered, are found in the table to have cost, while insane, $1330 50,
which being divided by twenty-five, the number of patients, makes
$53 22 the expense of each individual. The average time each was
insane, is about nineteen weeks.
Nothing can more fully and clearly show the importance of placing
the insane, at an early period, in the way of recovery. At least 90
per cent, will be restored to usefulness ; and, after deducting deaths,
not more than 10 per cent, will remain to add to the list of incurables.
STATE LUNATIC HOSPITAL.
55
TABLE 13.
Showing the duration of Insanity, the ages and civil state of the pa-
tients in the Hosjntal admitted the last year, and- those remaining at
the close of the year.
1833.
1834.
1835.
1836.
1837.
1838.
1839.
1340.
1841.
Total.
Duration before admitted:
Less than 1 year,
41
56
49
54
73
82
84
75
81
595
From 1 to 5 years, .
27
29
37
37
58
50
63
56
52
409
" 5 to 10 " .
27
14
17
13
15
16
18
15
12
147
" 10 to 20 " .
31
8
6
11
15
8
10
10
10
109
" 20 to 30 « .
12
4
1
2
4
7
1
3
4
38
" 30 to 40 " .
3
1
1
2
1
1
1
2
0
12
Unknown,
12
6
7
6
5
13
2
1
4
56
Duration with those re-
maining at the end of
each year :
Less than 1 year,
29
22
21
11
29
28
34
28
32
234
From 1 to 5 years, .
20
25
22
39
51
65
69
75
74
440
" 5 to 10 " .
20
24
34
35
38
44
44
52
53
344
« 10 to 20 « .
30
24
29
35
41
41
52
52
45
349
" 20 to 30 " .
9
5
3
7
1]
18
14
13
15
95
Over 30, .
3
2
4
2
2
3
4
5
4
29
Unknown, .
8
16
6
9
13
19
12
11
9
103
Ages of patients when
admitted :
Under 20 years,
2
6
3
11
13
17
10
10
7
79
From 20 to 30 years,
34
23
22
29
58
47
47
46
50
356
" 30 to 40 « .
48
44
42
30
34
51
49
40
45
383
" 40 to 50 " .
34
28
30
25
31
32
30
34
31
275
« 50 to 60 " .
14
9
11
16
13
20
21
21
19
144
« 60 to 70 " .
17
6
6
10
12
8
14
6
9
88
« 70 to 80 " .
5
2
5
0
7
2
8
5
1
35
Over 80, .
0
0
0
0
0
0
0
0
1
1
Civil state of patients
admitted :
Single,
92
71
32
68
94
101
80
75
82
715
Married, .
38
40
46
49
61
65
75
71
63
508
Widows, .
12
4
8
6
11
5
17
12
13
88
Widowei-s,
11
4
7
2
2
6
7
4
5
48
As comparatively few patients enter the hospital who are under
twenty, the age of celibacy, and, as a large proportion of the individuals
in society above that age, are married, it is obvious that seven hundred
and fifteen single, to five hundred and eight married persons, gives a
56
STATE LUNATIC HOSPITAL.
far greater proportion of single than of married persons, as insane.
There can be but little doubt that these facts will hold true, not only
as respects insanity, but in other diseases, and also in crimes.
Three hundred and eighty-three patient^ have been admitted who
were between the ages of thirty and forty, which is the greatest num-
ber of any ten years. The number between sixty and seventy, is
eighty-eight, while the number under twenty, is but seventy-nine. If
the season of youth is the time for the foundation of this disease, it is
not the time for its development. This table will not show the true
state of the case, as a considerable number of the cases admitted at a
later period of life, may have become insane at an early age.
TABLE 14.
Showing the comparative Curability of Insanity treated at different pe-
riods of disease.
Of less duration than
Males,
Females,
From 1 to 2 years,
Males,
Females,
From 2 to 5 years.
Males, • .
Females,
From 5 to 10 years,
Males, ' .
Females,
From 10 to 15 years,
Males,
Females,
From 15 to 20 years,
Males,
Females,
From 20 to 25 years,
Males,
Females,
From 25 to 30 years,
Males,
Females,
Over 30 years, .
Males,
Females,
Total of Cases.
Total of each
sex.
Cured or Cura-
ble.
Incurable.
1 year,
575
.
281
250
31
. 1
294
268
26
222
106
56
50
116
74
42
218
128
44
84
90
38
52
\ U7
76
10
66
71
10
61
87
48
4
44
39
2
37
31
19
1
18
12
0
12
24
14
0
14
10
0
10
7
5
0
5
2
0
2
6
3
0
3
3
0
3
STATE LUNATIC HOSPITAL. 57
The figures in the table show, most conclusively, the importance of
placing patients in an institution in the early periods of disease.
Of five hundred and seventy-five cases that have been insane less
than one year, five hundred ^nd eighteen have recovered, or are con-
sidered curable ; fifty-seven have not recovered or are considered in-
curable ; of these, twenty-eight have died ; leaving, of those living, but
twenty-nine who have not recovered ; some of these even may have
been subsequently cured. Among the incurables, are the epileptic,
paralytic, those who become insane in the progress of other dis-
eases, and the cases that have been mistaken for insanitv. How small
is the number left, after these shall have been deducted !
We can never expect one hundred per cent, of cures in recent cases.
The circumstances above-named, together with the liability of being
misinformed as to the duration of insanity, and the certainty that, in
some cases, organic disease commenoes with the first development of
mental alienation, will always make a small deduction of cures from
this class.
More than half the males, and nearly two thirds of the females,
named in the table as having been insane from one to two years, have
recovered, and one third of those in whom insanity has existed from
two to five years.
There have been in the hospital three hundred and two cases, of
duration from five to thirty years and upwards, of which number only
twenty-seven have recovered, or are supposed to be curable.
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, . . . .
161
Males,
82
33
49
Females,
79
53
26
From 20 to 25, .
i 200
Males,
1
107
54
53
Females,
93
57
36
From 25 lo 30,
188
Males,
102
52
50
Females,
86
56
30
From 30 to 35,
186
Males,
106
50
56
Females,
'
80
48
32
From 35 to 40,
161
Males,
I
71
37
34
Females,
90
54
36
From 40 to 45,
110
Males,
59
39
20
Females,
51
37
14
From 45 to 50,
97
ftlales.
■
43
30
13
Females,
54
44
10
From 50 to 55,
81
Males,
37
25
12
Females,
44
32
12
From 55 lo GO,
47
Males,
21
15
6
Females,
26
16
10
From 60 to 65,
! 35
Males,
19
16
3
Females,
16
13
3
From 65 to 70,
24
Males,
16
10
6
Females,
8
6
2
From 70 to 75,
12
Males,
8
4
4
Females,
4
4
0
Over 75, .
10
Males,
6
3
3
Females,
.
4
0
4
By the table it will be seen that males under twenty are far less
likely to recover than females ; the cause of this difference has fre-
quently been alluded to in former reports.
STATE LUNATIC HOSPITAL.
59
Of eighty-two males, under twenty years of age, thirty-three only
have recovered or are considered curable, while of seventy-nine females,
fifty-three have recovered. Of the former, the recoveries are thirty-
eight per cent., of the latter, sixty-six per cent.
Of the cases attacked between the ages of twenty and twenty-five,
there is also considerable disparity as to recoveries, quite in favor of
the female sex.
It still continues to be an interesting fact deducible from our rec-
ords, that persons attacked with insanity after forty years of age, re-
cover in much greater proportion than those attacked before that age.
TABLE 16.
Shoiving the relation of Cause to Recovery.
Intemperance,
Males,
Females,
Domestic nfflictions, trouble, love,
fear of death, poverty, &c. .
Males, ....
Females, ....
Ill health, puerperal, wounds, &c.
Males,
Females, .
Religious,
Males,
Females, .
, Masturbation, .
Males,
Females, .
Epilepsy,
Males,
Females, .
Palsy, . .
Alales,
Females, .
210
330
278
101
118
38
20
No. of each
Sex.
186
24
129
201
62
216
49
52
105
13
34
4
15
5
95
13
79
121
32
150
30
34
31
1
91
11
50
8J
30
66
19
18
74
12
30
4
13
4
From the table, we learn that there is a diflerence in the per cent, of
recoveries of insanity, from the different causes.
From intemperance there is a fair average of recoveries, amounting
to more than fifty per cent.
60
STATE LUNATIC HOSPITAL.
From mental suffering, arising from domestic afflictions, disappointed
affection, fe.ir of death, fear of poverty, loss of property, &c., there is
a more favorable record of recoveries; with males in the proportion
of seventy-nine of one hundred and tvi^enty-niiie, and with females in
the proportion of one hundred and twenty-one of two hundred and one.
The cases arising from ill health among the males, afford about the
common success, or fifty per cent, of recoveries. In females, it is
much better, as there have been one hundred and fifty recoveries of
two hundred and sixteen.
The favorable report of recoveries of this class, shows the benefit of
medication, in cases of insanity having any connection with ill health,
for all these patients that recover pursue a regular course of medicine,
and many continue it for a long time.
The cases arising from moral causes, are frequently connected with
ill health, and also require the use of remedies.
Ill health greatly increases the predisposition to insanity, and all
causes operate with much more certainty in such cases. All moral
and religious causes have a direct influence upon the health, and in
this way, by acting upon the brain, the organ of the mind, impair its
functions and bring on disease.
The two worst forms of ill health, epilepsy and palsy, have a distinct
place in the table. Recoveries from these are very rare, amounting
to seven only of thirty-eight.
TABLE 17.
Showing the per cent, of cases from the most jiTominent causes each year.
1833.
1831.
1835.
1836. 1837.
1838.
1839 1840 1 1841.
Intemperate drinking, .
245
24
22-1
14.i lOd
1G|
7h n\
121
Ill health, ....
8.^
175
n%
22i
m.
28
261 25
2U
The affections,
131
11.^
17.i
16
16
143
25 161
12$
Concerning property, .
Cd
10^^
85
5.1
Qh
lOi
5h 4.1
3i
Religious, ....
8i
^^.
7.i
til
6d
9
4^ 41
3i
Masturbation,
5
5^
7|
16.i
2U
5^1 81 61 6
In the course of the first three years after the hospital was opened,
a large number were committed who were intemperate, amounting to
from twenty-two to twenty-five per cent. The next three years, the
number of committals from this cause was considerably lessened, being
but thirteen and one third per cent. For the last three years, the
number is still less, average but ten and one third per cent. If this is
STATE LUNATIC HOSPITAL.
61
any indication of the diminution of the victims of intemperance and
the lessening of the evii, it is gratifying to know it.
The per cent, of ail missions from other causes, has not essentially
varied from the last year.
TABLE 18.
Showing the state of the Moon at the commencement of a paroxysm of
excitement hi 70 cases of Periodical Insanity, amounting in all to
592 paroxysms. Also the relation of the Moon to the 102 deaths
that have occurred in the Hospital.
Number of Paroxysms ea
ch day
Number of Deaths
on each day.
Day of the Moon.
Whole
Male.
Fe-
Day of
Day of the Moon.
Whole
Male.
Fe-
Day of
No.
male
the ar-
No
male
the Qr.
1
12
6
6
1
1
1
1
0
1
2
34
19
15
2
2
7
5
2
2
8
22
11
11
3
1 3
7
3
4
3
4
25
11
14
4
4
3
2
1
4
5
21
10
11
5
5
4
2
2
5
6
21
10
11
6
6
5
3
2
6
7
30
14
16
7
7
4
0
4
7
End of 1st qr.
End of 1st qr.
8
31
15
16
1
8
1
1
0
1
9
20
11
9
2
9
5
1
4
2
10
14
5
9
3
10
2
2
0
3
11
22
10
12
4
11
2
1
1
4
12
21
11
10
5
12
1
1
0
5
13
21
12
9
6
13
8
6
2
6
14
25
11
14
7
14
2
2
0
7
End of 2d qr.
End of 2d qr.
J5
22
10
12
1
15
3
3
0
1
16
15
7
8
2
16
7
5
2
2
17
26
14
12
3
17
3
2
i
3
18
14
7
7
4
18
0
0
0
4
19
]3
9
4
5
19
2
1
1
5
20
20
14
6
6
20
7
5
2
6
21
24
12
12
7
21
6
4
2
7
End of 3d qr.
End of 3d qr.
22
24
12
12
1
22
2
1
1
1
23
27
9
18
2
23
1
0
1
2
24
27
14
13
3
24
6
2
4
3
25
21
8
13
4
25
6
3
3
4
26
20
10
10
5
26
3
2
1
5
27
8
3
5
6
27
0
0
0
6
28
13
6
7
7
28
4
2
2
7
Paroxysms,
592
Deaths,
102
62 STATE LUNATIC HOSPITAL.
At the suggestion of one of the most scientific men in New Eng-
land, we commenced a table of observations on the influence of the
moon upon the paroxysms and deaths of the insane.
Dr. Allen, author of a work on atmospheric and lunar influence,
published in London, in 1831, insists very strenuously on the influence
of the changes of the moon on the insane.
The table records the paroxysms of seventy cases of periodical in-
sanity, amounting, in the whole, to 592 paroxysms, and the day of the
moon on which they occurred.
On the second day of the moon, which is the second day of the first
quarter, there have occurred the greatest number of paroxysms, viz.
thirty-four.
On the eighth day of the moon, which is the first day of the second
quarter, there occurred the second greatest number of paroxysms, viz.
thirty-one .
On the seventh day of the moon, which is the last day of the first
quarter, the third greatest number of paroxysms occurred, viz. thirty.
On the twenty-third and twenty-fourth days of the moon, which are
the second and third days of the last quarter, the next greatest number
of paroxysms occurred, viz. twenty-seven.
On the seventeenth day of the moon, twenty-six paroxysms occurred ;
on the fourth and fourteenth days, twenty-five paroxysms occurred ;
and on the twenty-first and twenty-second days, twenty-four paroxysms
occurred.
The least number of paroxysms have, each year, occurred on the
twenty-seventh day of the moon, which is the last day but one of the
last quarter.
On the first day of the moon, twelve paroxysms occurred ; on the
nineteenth and twentieth days, thirteen paroxysms occurred, and on
the tenth and eighteenth days, fourteen paroxysms occurred.
The same days, to the number of three, have the precedence of
numbers this year as last. Last year, the greatest number of paroxysms
occurred on the eighth day ; this year on the second.
For three successive years, the fewest paroxysms have occurred on
three successive days, viz. on the twenty-seventh, twenty-eighth, and
first days of the moon.
The greatest number of deaths that occurred on any one day, was
on the thirteenth day of the moon, which is the sixth day of the second
quarter, viz. eight.
STATE LUNATIC HOSPITAL. 63
On the second, third, sixteenth and twentieth days of the moon,
seven deaths occurred.
On the twenty-first, twenty-fourth and twenty-fifth days of the moon,
six deaths have occurred, and on the sixth and ninth days, five
deaths occurred.
On the eighteenth and twenty-seventh days of the moon, no deaths
occurred ; and on the first, eighth, twelfth and twenty-third days, one
death only occurred on each.
On the six days on which the greatest number of deaths have hereto-
fore occurred, the greatest number have still occurred, and on the
two days on which there has been no deaths in previous years, no
deaths have occurred the past year.
These facts and coincidences we leave for the present, with the
single remark, that no theory seems to be supported by them which
has existed either among the ignorant or the wise men who have been
believers in the influence of the moon upon the insane.
From facts collected with equal care, other observers come to differ-
ent conclusions.
Dr. Allen, before-mentioned, who had devoted much time and at-
tention to the moon, and its influence on the insane, comes to the
conclusion that its modifying influence can be clearly ascertained.
His theory is founded "on the supposition of an increase of excite-
ment occurring at the new and full moons, and a diminution at the
quadratures." Hence, we shall have cases o{ excitement more liable to
die, on an average, at the new and full moons, and cases of exhaustion
at the quadratures; and, in cases of periodical excitement with inter-
missions, the excitement will be more liable to occur during the ex-
citing phases of the moon.
The following observations and table are made, according to his
theory, upon the five hundred and ninety-two distinct paroxysms of ex-
citement, in seventy periodical cases of insanity, and upon the one
hundred and two deaths that have occurred in this hospital, extending
through a period of nine years, and one hundred and sixteen moons.
According to Dr. Allen's theory, the exciting days of the moon are
the days of the new and full moon, the first and fifteenth, including the
three days before and after each. The exhausting periods are the first
days of the second and fourth quarters, the eighth and twenty-second
days, with the three days before and after each.
The followincp table was prepared by Dr. Chandler. \
64
STATE LUNATIC HOSPITAL.
TABLE 19.
The following Tahle shows hoiv Dr. Allen's theory applies to the cases
of excitement and the deaths., as they have occurred in this Hospital.
COMMENCEMENT OF EXCITEMENT.
DEATHS.
Age of the
Moon.
Males on day of
Females on day
of
Males on days of
Females on days of
o
1
^
Excit-
ing.
Ex-
haust-
ing.
Ex-
cite-
ment.
Ex-
haust-
ion.
Ex-
cite-
ment
Ex-
haust-
ion.
Exci'e-
ment.
Exhaust
Ion.
Excite-
ment.
[ Exhaust-
I ion.
1
.
12
6
_
6
_
1
1
0
.
2
-
34
19
-
15
-
7
5
.
2
«
3
-
22
11
-
11
-
7
3
-
4
_
4
-
25
11
_
14
-
3
2
_
1
_
5
21
-
10
-
11
4
-
2
-
2
_
6
21
-
10
-
11
5
-
3
-
2
-
7
30
-
14
-
16
4
_
0
-
4
_
8
31
-
15
-
16
1
-
1
.
0
.
9
20
-
11
_
9
5
_
1
_
4
_
10
14
5
-
9
2
■
2
-
0
.
11
22
-
10
-
12
2
1
-
1
12
-
21
U
-
10
-
1
1
-
0
-
13
-
21
12
-
9
-
8
6
-
2
.
14 -
25
11
-
14
-
2
2
-
0
_
15 1 -
22
10
-
12
-
3
3
-
0
-
16
.
15
7
-
8
-
7
5
-
2
-
17
26
14
-
12
-
3
2
-
1
.
18
14
7
"
7
_
0
0
-
0
.
_
19
13
_
9
-
4
2
-
1
-
1
_
20
20
_
14
-
6
7
-
5
-
2
_
21
24
-
12
-
12
6
-
4
-
2
_
22
24
-
12
-
12
2
-
1
-
1
_
23
27
-
9
-
18
1
-
0
-
1
_
24
27
-
14
-
13
6
-
2
-
4
_
25
21
_
8
-
13
6
-
3
_
3
26
_
20
10
.
10
_
3
2
-
1
-
27
_
8
3
-
5
-
0
0
-
N 0
-
28
13
6
-
7
-
4
2
-
2
-
593
138
153
140
162
102
34
26
15
27
Of the five hundred and ninety-three excitements named in the table,
two hundred and ninety-one occurred among the male patients, and
three hundred and two among the females.
Of the two hundred and ninety-one among the males, one hundred
and thirty-eight occurred when the moon is supposed to exert its
greatest disturbing force, and one hundred and fifty-three on days when
its influence is least.
STATE LUNATIC HOSPITAL. 65
Of the three hundred and two cases of excitement among the females,
one hundred and forty commenced on the exciting days, and one hun-
dred and sixty-two on the exhausting days.
With some individuals, these excitements last from three to six
days, with others three or four weeks ; in some, the periods observe
great regularity in their recurrence, and in others, as great irregularity.
Of the one hundred and two deaths, sixty were of males, and forty-
two females.
Of the males, thirty-four died on exciting days of the moon, and
twenty-six on exhausting days.
Of the females, fifteen died on exciting, and twenty-seven on ex-
hausting days.
On examining the tables, and noting the sex, age, time of death,,
cause of death, in each case, and the state of disease under which the
patient suffered and died, and comparing it with the exciting and ex-
hausting phases of the moon at the time of the one hundred and two
deaths, we find that twenty occurred in males laboring under an active
and exciting state of disease, of which fourteen took place during the
exciting phases of the moon, and eighteen during the exhausting phasis,
which is twenty-three to eighteen against the doctor's theory.
We find fourteen deaths among females laboring under diseases of
excitement, of which seven occurred during each aspect of the moon,
which, of course, neither sustains nor contradicts the theory. We find,
also, twenty-seven deaths of females who were laboring under exhaust-
ing diseases; of these, ten took place when the moon was exerting the
most disturbing influence, and seventeen when she had, according to
the doctor's theory, withdrawn as much as possible her sway over
lunatics.
The result is, that fifty-six deaths occurred when the phasis of the
moon corresponded with the condition of the patients, and forty-six
when in the opposite state.
Doctor Allen's table of thirty deaths, shows that the condition of
the patients corresponded with the phasis of the moon in twenty-six
cases, and was opposed to it in four only, a very different result.
If Dr. Allen's theory v;as true, in application to our records, the ex-
citements of disease in periodical cases, should commence in the ex-
citing phasis of the moon ; but the table shows that a majority of the
excitements in our cases, commenced when the moon had its most de-
pressing influence, in the ratio of 153 to 138 in males, and of 162 to
140 in females.
9
66
STATE LUNATIC HOSPITAL.
Thus, after this careful examination of the influence of the moon on
the condition of the insane, we find that our records do not sustain
the views of the learned author, to whose test we have brought our
experience and recorded observations.
TABLE 20.
Showing the causes of Insanity as affecting individuals of different
occupations.
OCCUPATION OR BUSINESS.
§
1
a
S
■g
'clc
1
p.
s
0
s
f
'0
C3"_C
5"
OTHER CAUSES.
Farmers,
114
43
18
15
13
10
0
2
C Palsy, . 1
< Epilepsy, 4
Shoemakers,
44
8
21
4
3
3
4
1
( Jealousy, 1
Epilepsy, 1
Printers,
10
0
9
0
0
0
0
1
Laborers,
70
44
13
5
2
4
0
2
Seamen,
36
22
3
3
1
5
1
0
Jealousy, 1
Merchants, .
45
9
22
0
2
10
1
0
Epilepsy, 1
Carpenters, .
30
12
6
1
1
4
4
1
do. 1
Blacksmiths,
7
2
1
0
0
2
0
2
Students,
21
0
16
1
1
0
2
0
Poor diet, 1
Professional men,
13
3
5
1
1
0
0
2
Unknown, I
Clergymen, .
6
0
3
1
0
0
0
1
do. 1
Lawyers,
4
1
2
0
1
0
0
0
Physicians, .
8
2
0
0
0
0
0
1
From the table, it will be seen that, of two hundred and sixty-one
who pursue active employments in the open air, one hundred and
twenty-three became insane by intemperance, which is more than
forty-seven per cent.
Of the one hundred and thirty-three who pursue sedentary employ-
ments within doors, twenty-one, only, are from intemperance, which
is less than sixteen per cent.
STATE LUNATIC HOSPITAL.
67
Intemperance is by far the most prominent cause of insanity among
farmers, seamen, carpenters, and all those who pursue active employ-
ments in the open air.
Of those who pursue sedentary employments, as appears in the table,
only sixteen per cent, are caused by intemperance, while fifty-five per
cent, are caused by the " secret vice," showing clearly what are the
tendencies of those different kinds of employments in producing the
causes of insanity.
TABLE 91.
Of Per Cent.
Recovered of cases of du-
ration less than ] year, .
Per cent, of recoveries of
all discharged,
Per cent, recovered of old
cases, ....
20^
82
531
204
82.i
46i
844
531
151 i 181
894
57
254
864
524
154
90 +
47
164
914 91 +
53 49^
224 201
There have been admitted, since the hospital was opened, 556 cases of
duration less than one year.
In the same time there have been discharged, recovered, of recent cases 466;
466 of 556 ; which is 83| per cent. Deduct from these 28 deaths of recent '
cases, and there remains 466 of 528, which is 86| per cent. Deduct 32 re-
cent cases now in the liospital, most of which are recovering, and it will be
466 of 496, or 93 + per cent.
There have been in the hospital 1359 cases, of which 588 have been dis-
charged recovered, which is 43^ per cent.
DEATHS.
1334.
1S35.
1S36.
1337.
1333.
1339.
isjo.
1841.
Per cent, of death of all in the
hospital each year,
34
34
3i
3
44
54
31
3
Per cent, of deaths of the whole number, 102 of 1359, is 74.
Per cent, of deaths of the average number in the hospital, 12 of 232, is 5.
There are, at this time, in the hospital, 200 old cases and 32 recent cases.
Per cent, of old cases,
Per cent, of recent cases,
86 +
13 +
Of the 1359 patients that have been in the hospital, there were
Single,
715
which
is
53 per cent.
Married, .
508
(.i
a
374 "
Widows, .
88
ii
li
64 "
Widowers,
48
it
ii
34 "
68 STATE LUNATIC HOSPITAL.
The table shows that the operations of the hospital, this year, are as
favorable as usual.
The average of recoveries of cases of less duration than one year, is
now 88 per cent, for the whole time, and is as great as can ever be ex-
pected. There will always be circumstances, as has been before remark-
ed, which will prevent a greater proportion of recoveries of cases of this
character.
Twenty-five or thirty individuals have been insane more than once,
but have so entirely recovered, and have such a long and favorable
interval, in which they transact business and perform public and
private duties as well as other men, that we discharge them as recov-
ered, and do not consider the return of insanity a relapse, but a new
attack of disease.
Some patients have a renewed attack from a repetition of the cause
that produced the first, or some other cause, and, after a time, return
to our care. The causes most likely to renew the attack are intem-
perance, among the physical causes, and family troubles, pecuniary
embarrassment, «Sic., among the moral causes. If the interval is a
year or more, we call this a new attack.
When these two sets of cases are deducted, the number of relapses,
or cases in which insanity returns, is very small, not amounting, an-
nually, to more than two per cent. Almost all such cases are correct-
ed on our records before the report is made, so that very few have re-
lapsed, in any way, that have been reported as recovered.
We have rarely reported a periodical case as recovered twice, in
two successive years. Many that come to the hospital, and get to be
very comfortable, are reported improved ; and those that remain, have
never been reported recovered, if they have any repetition of the
paroxysms while they continue with us, even if the interval is of con-
siderable length.
In the infancy of an institution, the records of recoveries, based
upon the admissions, must always be disadvantageous, but this disad-
vantage is always diminishing as years are added to its duration.
The per cent, of all the recovered, on all the admissions in this hos-
pital, is now forty-three and one third, and the per cent, of discharges,
recovered, on the admissions this year, is fifty and one third, a differ-
ence of seven per cent.
I present the estimates of per cent, of deaths on all the residents in
the hospital, since it was opened, which is seven and a half per cent.,
on the average number in the hospital for the last year, which is five
per cent., and on all that have been with us the last year, which is
three per cent.
STATE LUNATIC HOSPITAL. 69
Having completed another year in the State Lunatic Hospital, and
made out our ninth annual, tabular report, we cannot too strongly ex-
press our gratitude to our Heavenly Father that we are able to record
so much success and so little calamity.
It has truly been a season of prosperity, affordinglthe highest aver-
age of recoveries, and the greatest exemption from mortality. No
epidemic has visited us, and no accident has occurred to disturb the
tranquillity of our household.
During the nine years now terminated, there have been admitted to
the hospital thirteen hundred and fifty-nine patients. There have
been five hundred and eighty-eight recoveries, and one hundred and
two deaths.
The condition of the present residents in the hospital is comforta-
ble, and a large proportion of them are contented and happy.
With few exceptions, the incurable and permanent residents are
made better, are more quiet and pleasant in their feelings, and better
appreciate the comforts and benefits of their home.
Here are congregated more than two hundred and thirty inmates,
who form a quiet and happy family, enjoying social intercourse, en-
gaging in interesting and profitable employments, in reading, writing,
and amusements, walking and riding in suitable weather, and assem-
bling in social worship in their own little chapel, on the Sabbath. Yet
all of these persons are more or less insane, some with delusions, some
with perverted senses, and others with estranged moral feelings, but
all appearing quite harmless and rational, when undisturbed, and each
pursuing some suitable avocation with apparent pleasure and delight.
Fifty years ago, when Finel made his first experiment of divesting
the maniac of his chains and improving the comforts of his dreary
abode, he took six stout men with him to seize and confine any
who should attempt to do violence, and injure himself or his asso-
ciates !
With what amazement would this enlightened philanthropist have
contemplated our social circles, useful occupations, and the numerous
enjoyments of the insane in modern institutions.
Pinel and Rush, on the two continents, were the pioneers in this
benevolent enterprize, and, like most pioneers, little thought to what
results their efforts would ultimately lead, what a glorious superstruc-
ture would be erected on the foundations they had laid.
Pinel thought it prudent to take a body-guard to secure himself
from danger in his first interview with the liberated maniac; now, we
70 STATE LUNATIC HOSPITAL.
take the child into his presence, in every apartment of the insane, only
to be caressed and delighted.
Pinel immortalized his name by the correctness of his views, the
benevolence of liis heart, and the boldness of his efforts in breaking
the chains of the maniac and increasing his liberty and enjoyment.
Oar distintTuished countryman had views equally correct, a spirit as
truly philanthropic, and as much firmness of purpose in his intercourse
with the insane.
One knocked off their chains and changed public sentiment in
France, the other left an influence equally salutary on the public mind
in this country.
The writings of Dr. Hush were antecedent to those of the immortal
Frenchman, and breathe as pure a spirit and equal intelligence.
Rush's able •'' Essay on the influence of physical causes upon the
moral faculty," was read before the American Philosophical Society,
in August, 1786. The work of Pinel in liberating the maniac from
his chains, was in 1792, and his published writings, which gave im-
mortality to his name, appeared some time after.
In the days of these great and good men, the insane were still found
in their strong rooms and gloomy dungeons, living in solitude ; in
many cases, they had only put off the chain and manacles to put on the
strait waistcoat, and to suffer the torments of a rotary swing or a tran-
quillizing chair.
The hospitals of that day were cold, damp, cheerless, solitary, ill-
ventilated abodes; their attendants were prison-keepers; how could
their inmates be other than terrific beings, safe only in close and rigid
confinement 1
In our day, the maniac is disarmed of his fury in the asylums, made
calm by the plastic power of Christian kindness; he feels the benign
influence of sympathy and compassion, and becomes a quiet, peace-
able, intelligent and reasonable being.
This law of kindness does not stop here ; it finds in the maniac the
same desire to be active that is found in other men, and this principle
is improved for his benefit. He goes to the workshop, the garden,
and the field of labor, to the delightful oflice of improvement ; here, he
finds happiness and contentment in these new sources of health and
enjoyment. His mind, intent on his labor, runs into healthy channels
of thought, he acts and thinks as he has been accustomed to do, in the
same circumstances, when sane. These manual employments bring
STATE LUNATIC HOSPITAL. 71
the mind into its natural state, the delusions and estrangements give
way to healthy feelings, desires and movements ; calmly, quietly and
rationally he applies himself to business, he feels happy that he is able
to accomplish his accustomed labor ; his self-respect is elevated, and
if his delusions return, their I'orce and tenacity is diminished, they
finally yield by degrees and diiappear entirely, and often forever.
If there is any thing in which the institutions of the present day
surpass all others, it is in employment and occupation of one kind or
another, and those of our own country are not surpassed by any others,
in this respect.
With all that has been done in Europe, and particularly in Great
Britain, during the last few years, to abolish restraints and introduce
labor, they have hardly come up to the standard of the New England
asylums, in either of these particulars.
The progress of improvement in this country, for the last ten years,
has been great. Our institutions are better and more thoroughly un-
derstood, public sentiment has changed and is changing in their favor,
the institutions around us have received a nev/ impulse, and are
adopting all the improvements of the present day. New asylums are
being erected in every direction, and it is truly gratifying to contem-
plate the spirit that is abroad, and the interest that is felt for the un-
fortunate.
The insane are no longer approached with dread and abandoned in
despair ; the darkness which for centuries hung over them, is dispelled,
and they are feeling the influence of the light of science and the
warmth of Christian charity beaming upon them, to revive, to renovate
and to save them.
Every citizen of this Commonwealth should be proud of the elevated
stand which she has taken in this glorious cause of humanity ; that
her provisions are more ample than those of any other State for
the accommodation and recovery of the insane.
LABOR.
The subject of labor becomes more and more interesting, each year.
Its pecuniary value is annually increasing, and may be extended far
beyond what it now is.
In the season of farming and gardening, we employ a large number
of men on the land, to good profit. The shoe-shop, always well sup-
72 STATE LUNATIC HOSPITAL.
plied with workmen, has been a source of benefit to them, of profit to
the State, and great convenience to the whole establishment.
More shops are needed, and more branches of mechanical labor
could be pursued with profit and benefit. Cabinet-making, basket-
making, mattress and harness-making, could all be pursued to advan-
tage, if we had shops to work in. If a new barn is built, the present
one, at comparatively little expense, could be converted into very good
shops, and furnish additional store-rooms.
The business of mattress-making is now carried on with profit to
the establishment ; all the mattresses used in the establishment are
made here ; we have never purchased any since the house was opened.
Basket-making is also a good business for our people ; it is easily
learned, and can be pursued with profit.
Clothing, to the value of twelve or fifteen hundred dollars, is annu-
ally made in the establishment, and this department of business may
be greatly extended. All the bedding, and much under-clothing of
the patients is made by the females ; the quantity of yarn which they
knit, costs from one hundred and fifty to two hundred dollars a year.
The socks and stockings knit by the patients, and sold, are of con-
siderable value, and procure the means of purchasing for them many
necessaries and comforts.
Agricultural and horticultural employments are most valuable in
their season, and most congenial to the tastes and habits of our people.
Our regular laborers are never sick ; not one has died since the hos-
pital was opened. We are never in want of sufficient help for any
purpose suitable for their employment.
Our gardens and grounds are becoming more valuable and produc-
tive, from year to year. Much labor has this year been expended on
improvements.
The benefit of labor to our patients is more and more apparent
every year.
Some of our best laborers are from a class of patients that were, at
first, obstinate, ill-natured and mischievous, and who entirely refused
to work ; old cases, that had been treated unkindly, and who had no
good feelings or human sympathies, when they first came to us, are
now interested in labor, are confidential, kind in their feelings and
civil in their deportment.
In the domestic departments, in cooking, washing, ironing, and in
the sewing-room, the inmates of the house, in large numbers, are daily
employed. At one time, not long before the close of the year, there
STATE LUNATIC HOSPITAL.
73
were not a dozen of the one hundred and fifteen women in the estab-
lishment that were not more or less employed every day. We are in-
deed an industrious household, all busy, all have something to do,
and all feel that we are adding to the general stock of good.
The quantity and value of the produce of our farm and garden, are
given in the following table furnished by the steward.
430
do.
70
do.
23
do.
60
do.
70
do.
15
do.
Produce of the Farm.
20 tons of hay, at $15,00, . _ .
155 bushels of corn, at $1 00,
240 bushels of potatoes, at 30 cents, -
500 do. of carrots, at 25 cents,
of beets, at 25 cents,
of parsnips, at 2.'?.
of oats, at 55 cents,
of onions, at 50 cents, - - -
of English turnips, at 25 cents,
of ruta baga, at 25 cents,
11 loads of pumpkins, at §1,50,
20 cwt. of winter squashes, at $1,50,
540 cabbages, at 5 cents, - - . -
1 load of melons, - . . . .
5 barrels of pickles, - - - .
Garden vegetables for a family of 300 persons.
Corn fodder and straw, - - - .
Pasturing 8 cows 26 weeks, - - - >
Pasturing 2 oxen 26 weeks, . . .
Milk from the cows, — 26,330 quarts, at 4 J cents,
6,198 lbs. of pork, at 6 cents.
Small pigs sold, .--..-
Beef sold, -..-----
250 lbs, of poultry raised, - . . .
$390 00
. 155 00
72 00
- 125 00
107 50
- 23 33
12 65
30 00
15 50
3 75
16 50
30 00
27 00
10 00
15 00
150 00
15 00
102 00
32 50
1,184 85
371 88
37 50
339 50
25 00
J,291 46
Stock on hand, 4 horses, 2 oxen, 8 cows, 44 swine.
The cows are all well kept, and average about 9 quarts of milk a day
through the year. The cost of keeping through the year, is estimated
10
74 STATE LUNATIC HOSPITAL.
at $75,00 each, which, for the S cows, is $600 00 ; this sum deducted
from the milk, as it costs us if purchased, $GUO 00 from 1 1,184 85,
leaves us a profit on the cows f 584 85.
In the shoe-shop, we have done more labor to better profit than
heretofore. From three to five patients have usually worked at this
employment at a time, and ten or twelve in the course of the year.
Shoes made and sold amount to $1,108 00
Shoes made by patients for themselves and friends, . 42 00
$1,150 00
Cost of stock, 1491 00
Fuel, lights and binding, . . . . 45 00
Wages and board of overseer, . . :W0 00 896 00
Net profit, $254 00
The advantages of labor to the individuals employed is no where
more apparent than in this shop. The curable patients who under-
stand the trade, are always glad to find employment here, and seek the
privilege before they are sufficiently restored to control themselves in
the house, and labor before they can sleep quietly at night.
Case 1st. A respectable tradesman, aged 50, had been eccentric,
and considered a little insane, for about three years. Last spring, he
was suddenly attacked with violent mania and brought to the hospital.
He was excessively furious and excited, for a long time ; after awhile
he improved, and was quiet in the day-time, but extremely disturbed
and noisy at night. It was proposed to him to work at his trade, as
he was a shoemaker; he consented, and performed his labor very well.
For a time, his nights were bad, but gradually improved and he slept
well. He is now gaining in the iriost favorable manner, is more fleshy
than he has ever been, works well and sleeps quietly. For a time
after he began to improve, he was out of the shop for a season, in con-
sequence of the absence of the overseer ; he became nervous and ex-
ceedingly impatient for his return; fearing that, if not employed, he
should relapse and be as bad as ever.
The incurable cases that labor in the field or in the work-shop, im-
prove iu all their habits, in intelligence and self-respect, till they ap-
pear like rational men, though their delusions still remain and insanity
is not cured.
STATE LUNATIC HOSPITAL. 75
Case 2©, came to the hospital in February, 1833. For some lime
he appeared ferocious and obstinate, and was watched very narrowly.
He had been in close confinement six years, for a distressing homi-
cide, by which he had, in a temporary paroxysm of jealousy, killed his
wife.
As months passed by, he became less jealous, more docile, and
finally became a suitable person for employment under vigilant sur-
veillance. The first year, we did not trust him ; the second, we gave
him more latitude ; and the third, he secured our confidence. He is al-
ways employed about the hos])ital, takes an interest in its concerns,
and renders himself useful and happy. He keeps a book in v/hich he
charges his services, and has already a long account against us. He
calls for no settlement, because his wants are all supplied, and a hand-
some sum, coming at once, will be belter than driblets. Few men en-
joy themselves better than this man; he is kind in his feelings, indus-
trious, temperate in his habits, and has all the liberty for which he
asks. He makes baskets and whips, helps to lake care of the stock
and cultivate the garden, and kills rats. He never asks permission to
leave the hospital grounds, and never does leave them except to go on
errands, which he always performs well.
Once, when asked if he would not like to go to his old employment
in a manufactory, at high wages, he replied that he did not charge
quite so much for his labor at the hospital, but the State was safe, and
he understood that the manufactories about were failing, and he might
not be better oflf in the end than to remain where he was.
This man is still insane, his delusion still remains, but he says noth-
ing about it unless it is mentioned to him.
Case 3d, came to the hospital, in February, 1833, at the age of 37.
He was feeble and emaciated, quite unfit for labor. For six months,
he was not well enough to do any thing, but gradually regained his
health and grew fleshy and well. He met the proposal to labor with a
prompt refusal. The steward was directed to take him out to the
wood-yard, and see that he was employed in piling wood; while on his
way, he made a desperate attack upon the steward and was with diffi-
culty overcome. In the course of the day, he made a second attack
upon his keeper with a stick of wood. He was, after a time, willing
to pursue his employment, and worked some in the garden and about
the grounds. From year to year, he improved, till he has become a
kind and faithful man, spends his time with the help in the kitchen,
76 STATE LUNATIC HOSPITAL.
doing whatever they request of him, is pleasant, docile and harmless,
is quite a favorite in the house, and is suffered to go about the premises,
when and where he pleases.
There is no change in his delusions, he is rich and powerful, has
houses, lands and servants all over the country.
AMUSEMENTS.
Nothing contributes more to the happiness of our family than the
round of amusements they are permitted to enjoy. Riding, reading,
games, walks, cultivation of flowers, in their rooms or on the grounds,
the matron's parties, dancing, &c., occupy the time and fill the inter-
vals of labor with great satisfaction and real benefit.
Riding is the most useful amusement for the female patients, as it
combines recreation with real utility, as a remedy for ill health.
The carriage devoted to this exercise, travels about twenty miles a
day, carries, on an average, six patients at a time, who ride about four
miles; the excursion occupies about an hour, and five parties usually
go every pleasant day, averaging from 25 to 30 a day.
In the month of June, the driver estimated that he drove the car-
riage full 110 times, carrying in all, 543 patients ; that he drove on 23
days, and about 460 miles.
In the month of July, he drove the carriage 25 days, rode 96 times,
carried 5S2 patients, and drove 475 miles.
It will be seen by this statement that the business of riding is thor-
oughly attended to, and it is no less agreeable than useful.
In addition to riding, the females walk in pleasant weather about the
grounds or in the grove, in parties, with or without an attendant, and
spend much time in the open air about the grounds, attending to the
flowers and the gardens.
In the hall, they swing, play ball, battledoor, graces, nine-pins, and
occasionally, blind-man's-buff". Many play the more silent games,
cards, back-gammon, draughts, chess, dice, solitaire, &lc.
The men take long walks, spending an hour or two at a time,
going in parties of a dozen or more ; play ball, nine-pins, chess, and all
the different games of cards, draughts, &c.
Dancing is a favorite amusement with both sexes. Formerly, our
dancing parties have been held on the evenings of Thanksgiving, Christ-
mas, the 8th of January, "22d of February, and 4th of March. The
STATE LUNATIC HOSPITAL. 77
present year, these parties have been more desired by our patients, and
recently we have permitted them to dance once a week. These par-
ties are always quiet and pleasant, they continue two or three hours,
and always close before 9 o'clock. The music is, at present, very
good; the violin, the clarionet and bass-viol, all played by patients.
From 50 to 100 patients attend these parties, some to join in the dance,
and others to witness it.
Singing is an amusement very agreeable to our patients. In all the
female halls there are good singers, and the winter evening rarely
passes without much good music in some of them.
The men read and talk politics more, and sing less.
DIET.
The food used in the hospital is of the best quality, simple and
plain, but substantial and good, with kw delicacies. Coffee in the
morning, and tea in the evening, are furnished to all. Animal food is
used once a day, and sometimes twice, and vegetables in perfection
and variety, after the custom of New England families. The articles
of food are the best the market affords, and are prepared with skill
and care for the table. Very little complaint is made of the food,
and the variety is sufficient for health. Water, with coffee, tea and
milk, constitutes the drink of the whole family, officers, attendants, and
patients. Neither beer, cider, nor any other article that can intoxi-
cate, is admitted in the establishment. We are all pledged to ab-
stinence principles.
Milk is the diet of such patients as prefer it, and is extensively used
in the family every day, the quantity used being from fifteen to twenty
gallons a day. Invalids often use milk, and preparations of milk, as a
large part of their food.
Our laboring people eat heartily and have no dyspepsia. Most of
the insane have good appetites and eat well ; some are in feeble health,
and have a prescribed diet every day.
The native fruits are given freely in the season of them ; apples are
dealt out plentifully in winter, and candy-making and corn-parching
are among the winter amusements.
A few individuals are difficult about their food, and, for months to-
gether, take none without being fed.
A lady came to the hospital about a year ago, who declined taking
her food ; she was emaciated to a skeleton, and for some days had en-
78 STATE LUNATIC HOSPITAL.
tirely refused to eat. After every effort to induce her to take food had
failed, the stomach-pump was resorted to ; for ten weeks she did not
swallow a particle, but daily took from two to three pints of milk, in
this way. In this course, she improved a little; at the end of the ten
weeks, she could be fed, and, after a long time, took her food volun-
tarily. She recovered very favorably at the end of nine months, and
is now well.
WARMTH AND VENTILATION.
The process of warming and ventilating the hospital, is more perfect
than any other I have known. In all our apartments the air is pure,
the temperature equal, and the warmth well diffused. The thermome-
ter hardly varies twenty degrees during the winter months. There is
constantly a large column of pure air from out of doois, warmed, and
poured into our halls in a rapid current, so as to pervade every part of
the building, and drive the contaminated air through the ventilating
passages to the attic story, where it escapes by sky-lights, and side and
end windows when necessary. In no part of this extensive building
is there frost in winter ; even in the attic story, where the water is brought
directly from out of doors and accumulates in tanks, ice is never
formed.
Our experience with our furnaces, has increased our knowledge of
their usefulness by converting them into air-tight stoves. In this man-
ner considerable fuel may be saved. After the fire burns well, every
draft of air is stopped, except the crevices in the stove or furnace,
which are found to be sufficient to keep up slow combustion, and the
fuel lasts much longer, making a great savmg of fuel and labor. Small
fires are kept burning during the night, to keep up the circulation of
ji lie air in the apartments, and to keep the temperature mild and com-
fortable.
In cold weather there is no economy in letting the fires go down at
night, as much more fuel is needed in the morning to bring up the
proper temperature.
MEDICATION.
Nothing can more clearly show the importance of suitable medical
treatment in insanity, than the success which attends the means em-
ployed to restore the large class of patients who come under our care
with ill health.
STATE LUNATIC HOSPITAL. 79
When a patient comes to the hospital, the first object is to learn ev-
ery circumstance connected with the health. If the brain itsdf is af-
fected with disease, to ascertain its nature and the most sure mode of
affording relief.
Insanity is a physical disease, and as susceptible of cure, by reme-
dies which make impressions upon the system, as any other disease of
equal severity. Like other diseased organs, the brain often suffers by
sympathy with other parts diseased, and the cure of the primary affec-
tion relieves the secondary in the usual way.
The influence of Dr Rush's notion of the utility of liberal bleeding
in insanity, still clings to the physicians in the country generally, and
wc rarely have a patient committed to our care who has not been copi-
ously bled. The physicians in the charge of the institutions, both in
this country and in Europe, have long since abandoned this practice as
rarely beneficial and often hazardous. It is a frequent remark that it
is often more difficult to cure the evil that arises from the loss of too
much blood, than to remove the insanity in violent cases of recent at-
tack.
The condition in which the patient is found in violent mania, when
the physician visits him, is not always duly considered. The o-reat
excitement of the pulse, the distension of the blood-vessels, the heat and
redness of the skin, and the amazing muscular power which they some-
times exert, only show what he has done rather than the condition in
which he is ; they are the effects of his amazing excitement, and not
the symptoms of his disease. A little cold water or ice applied to his
head, will afford him greater and more immediate relief than the loss
of a pound of blood.
Under the influence of this mistaken view, I once bled a stout ship-
master, who was in most violent mania, twenty-eight pounds in thirty
days, used Cox's circular swing almost daily, till it produced sickness
and vomiting, — and \et, at the end of the month, found my patient lit-
tle or no better. I then resorted to remedies less hazardous and more
composing, and produced a sudden amendment, and speedy recovery.
In a case of genuine mania, there is usually no inflammation of the
brain or its appendages, the excitement is much moie frequently of a
nervous character, and will yield more readily under a mild and safej*
treatment. Local bleeding, cupping, ice to the head, mild cathartics
and narcotics, succeed far better and are less hazardous. Many cases
yield like a charm to narcotics, if the system is prepared for their use,
80 STATE LUNATIC HOSPITAL.
and they are prescribed in a proper manner and with discrimination.
Bark and iron combined with narcotics, do well when excitement has
abated and the strength requires to be restored.
In chronic cases of insanity, tonics, narcotics, baths, laxatives, and
remedies that tend to remove local disease, if it exists, are often found
beneficial. In certain torpid cases the cold bath, with stimulants and
acrjds, is a valuable auxiliary in the cure.
It is only my intention to glance at the course of medical tre<itment
suitable in insanity. Each case requires its own appropriate remedies
of cure, and experience is the best guide to this in every case of dis-
ease.
One thing is well established, that the insane cannot be as well
treated at home as with strangers, nor as well in a private family as in
an institution. Few physicians can give to them the attention which
they require, or persevere a sufficient time with such remedies as they
need, or with sufficient regularity.
The insane man is the only one who discards the kind offices of
his friends at the time when he most needs their aid and solace, and
throws himself upon strangers.
In chronic cases, much benefit arises from a perseverance with rem-
edies for a much longer period than most physicians would prescribe
them, or most patients pursue them.
Two cases, recovered, left the hospital the past season, who had
been a long time insane, and whose friends had despaired of their
recovery.
One of these cases was briefly this. A man, aged about 40, who
had been four years insane, and much of the time in the hospital, was
at periods very violent, breaking and tearing whatever came in his
way. When he took narcotic medicines, he would sleep better and be
able to perform some labor, without them he was incapable of restraint
abroad, and would frequently tear up his garments and appear violent
and naked in his room. A year since this was his condition most of
the winter ; he then took no medicine. Early in the spring we again
commenced a course of medicine ; in a week or two he was calm and
" in his right mind," at least sufficiently so to work. As soon as the
spring work commenced, he began to labor with the farmer. His
medicine was continued six months, the doses being gradually lessened
after two or three months, and, towards the close of summer it was
entirely withdrawn.
STATE LUNATIC HOSPITAL. 81
No man could do better than he did ; he was calm, respectful, pur-
sued his business with judgment, slept well at night, eat and worked
well during the day.
On the first of October, the steward hired him for a month, with the
understanding that, if as well at the end of that time, he should be
discharged. During the month he worked well, took charge of other
patients at labor with him, and at the time agreed, left the hospital.
We have heard from him often, — he continues well and is very steady
and industrious.
PHYSICAL AND MORAL MANAGEMENT.
When a patient comes into the hospital, we immediately look to his
condition ; if he is filthy, we have him thoroughly washed and bathed ;
his clothes changed and a decent suit put on, if the one he wears is not
so. We examine the state of his health, and obtain from himself and
his friends all the information that we can concerning his condition be-
fore his admission. If he is in a situation to converse, we spend some
time with him, and ascertain what may be necessary in his case; some-
times we defer this examination a day or two till he becomes acquaint-
ed with his attendant and associates in the gallery. He is invited to
take his meals at the table, and to unite in amusements if he is in a
situation to do so. We do not allude to his mental delusions, or any
circumstances that induced his friends to place him in the hospital.
At night he is shown to his neat bed-room, and advised to keep his
bed and take good care of his room. He is treated with marked at-
tention and civility, and his wishes are gratified as far as practicable.
If he is in a situation to labor, he is invited to go to the wood-yard or
garden and work a little. If medicine is to be given to him, he is in-
formed of it, and the reason explained to him.
If he is very violent, he at first takes a strong room ; and if noisy
and boisterous at night only, he spends his days in company with other
patients, and takes his strong room at night.
He is placed in no restraint till some act of violence renders it de-
sirable, which is comparatively rare. No harsh measures are allowed,
but we expect acquiescence in all our rules. If medicine is thought
necessary, it is always administered in the easiest way possible.
In our intercourse with the insane, we design to be cinidid and ad-
mit of no deception. Uniform kindness and respect, every attention,
11
\
82 STATE LUNATIC HOSPITAL.
even in small things, that will interest and encourage them, is bestow-
ed Indiilo-ence is not always best, and decision and firmness, tern-
pared with mildness, are always more or less necessary. Self-respect
is encouraged, and every one is required to be a,s much like a rational
person as is in his power.
Motives are always presented to induce quiet and adherence to
rules, and rewards are often bestowed, but punishments, as such, are
never inflicted ; yet the breaking of rules, disturbance and mischief
are rebuked, and often some privation follows.
Pledges are to be considered most sacred, and the violation of them
is followed by a cessation of indulgences, and sometimes by temporary
restraints and privations.
The good of the whole is always considered paramount to the com-
fort of one, and no partiality is extended to any one, or neglect of
another on account of external circumstances ; good conduct entitles
all to every privilege and respect which is bestowed on any one.
Reasoning with the insane, is often of little benefit; but when their
faith in their delusions begins to waver, and when they have, in a meas-
ure, the government of themselves, reasoning often dispels delusion and
strengthens the power of self-control ; confidence, friendship, and an
interest in their welfare will secure their respect, and often establish
permanent friendship and lasting gratitude.
FEIGNED INSANITY AND FEIGNED SYMPTOMS WITH
THE INSANE.
There is far less motive for feigned insanity in this country than in
Europe, where the means of subsistence are scanty and cannot always
be obtained by diligence in business and frugality in saving. In
this country, no one wishes to stay in confinement, even where food
is abundant and of the best quality. The love of liberty is universal.
In the penitentiaries, there is sometimes feigned insanity in order to
avoid labor and gain indulgences. Such cases came repeatedly un-
der my observation while I was physician to the State prison in my
native State.
I have no doubt that in some instances, the insane are found dis-
playing themselves in caricature, and many times feign suffering which
they do not feel. I have recently had a case of this description.
A young Irish girl came into the hospital very insane. For a time
STATE LUNATIC HOSPITAL. 83
she was very noisy, mischievous and troublesome. The attendants, in
whose care she was, frequently spoke of her having slight fits ; and
after a time she would have one at each of my visits. From the first, I
thought they were feigned. One day, while in chapel, she had a bad
one, and struggled violently as she was carried out ; but immediately
came out of it and ran off, when the attendant proposed to sprinkle
cold water in her face.
The next day I told her that these fits were very unpleasant, and it
was desirable, if possible, to be cured of them, and proposed using the
shower-bath two or three times a day till she was well. After the first
bath, the fits ceased, and she had no more for a week ; on the recur-
rence of the fits the bath was again prescribed, since which the fits
have disappeared. The girl is still insane, though much improved and
very pleasant, and happy. She thinks very favorably of the sliower-
bath for fits, and often recommends it for others who are her associates,
when they are somewhat wayward.
During the past year, a young man was brought to the hospital in a
state of the highest possible excitement. Before he reached the door,
his noise disturbed the whole establishment, and after he entered he
raved and stamped in the most terrific manner.
His attendants were two stout, intelligent men, who gave the follow-
ing history of his case.
He was arrested for stealing a horse, and confined in one of the jails
of the Commonwealth. iNothing singular appeared about the man till,
after a k\v weeks, he broke jail and escaped ; he was pursued and over-
taken, and then was a violent maniac. He was placed in another jail,
of which one of his attendants to the hospital was keeper, and there
awaited his trial. During this time, which was but a few weeks, he
was noisy, violent and furious, broke and tore whatever came in his
way.
At his trial, the evidence of insanity was so strong that he was sent
to the hospital as a furious maniac.
When his keeper related this story to me, taken in connection with
his outrageous conduct on entering the house, I was strongly impressed
with the belief, that it was a case of feigned insanity. I called on him
before he retired, and advised him to be quiet, and told him we should
give him a good room and comfortable bed, if he was civil and quiet ;
but if not, his accommodations would be of a different kind. He made
no disturbance in the night; but was noisy and talkative in the morn-
incr. He knew not where he was, where he had been, or what he had
84 STATE LUNATIC HOSPITAL.
done. The second day after he was admitted, he read hymns and sang
witli his attendant, when, suddenly, he came to himself, found he was
in Worcester where he had lived for some time, knew the officers of
the hospital and most of the people in the village. He had a distinct
recollection of every thiug previous to the April preceding, — the time
he took the horse; but remembered nothing after that till that day.
From that time he worked well at his trade, till he became apprehen-
sive that he should be arrested after he left the hospital and tried and
punished for his offence. He mentioned his fears to some of his friends,
and was not a little uneasy about it. One day while his overseer was
a little remiss, he escaped, and we have not heard of him since.
LIBRARY AND PERIODICALS.
The library belonging to the hospital has increased from year to year,
till it is now quite valuable.
Reading is one of the most interesting and beneficial employments
of the patients. All the new and popular publications of the day are
looked for with interest, and perused with pleasure by the members of
the family.
The bible or new testament is in the hands of every patient who
desires it. Religious newspapers are also circulated freely, and are
always read with interest by many of the patients.
By the kindness of the editors of newspapers and other periodicals,
this kind of reading is abundantly furnished, and the papers are sought
with great eagerness by those patients who have resided in the neigh-
borhood where they are published.
Early in the year we received donations of money for our library
from the following individuals. Hon. Samuel Hoar, $5; Mrs Edward
D. Bangs, $5; Robert Lash, Esq., $10; Joseph Adshead, Esq., Man-
chester, England, $5 ; in the whole $25. Instead of spending it di-
rectly for books, it was proposed by our family that it should be ex-
pended for articles to be manufactured, that the value might be in-
creased. The interest in this enterprize extended through the family;
the labor commenced with spirit in the spring, and continues unabated
at this time. The amount from the articles sold is nearly three times
that of the first investment, and the stock on hand is worth nearly or
quite the sum with which we commenced. In this way, twenty-five
dollars have been made nearly one hundred in eight months, and a
STATE LUNATIC HOSPITAL. 85
sum of money is always on hand to purchase new books as they come
from the press.
From two gentlemen in this town, whose names we are not permit-
ted to mention, and from the Rev. Luzerne Ray, our former chaplain,
we have received eighty volumes of valuable books, and from another
gentleman a large number of papers and periodicals, which have fur-
nished much valuable reading.
From Hon. Bezaliel Taft, Hon. Emory Washburn, Henry Hill, Esq.,
Boston, Mrs. John Kimball, Westborough, Rev. George Allen, chap-
lain of the hospital, Joseph Adshead, Esq., H. Byington, Esq.,
Stockbridge, Mrs. Charles Sedgwick, Lenox, and Mrs. Eastman of
Roxbury, we have received donations of books. Froin Dr. Batchel-
der, ofUtica, and the Rev. Thomas F. Norris, of Boston, we have re-
ceived papers, periodicals, and other documents of great value and
interest. We desire to express our gratitude to all the above-named
persons for their kindness, and the gratification they have furnished
our family.
The following papers and periodicals have been received quite reg-
ularly, and have always been read with pleasure and interest.
The Boston Recorder, the Gospel Messenger and New York Bap-
tist Register, Utica, N. Y. ; the Christian Register, Boston ; the
Youth's Companion, Zion's Herald, the Olive Branch, Boston; the
Springfield Republican, the Springfield Gazette, the Hampshire Ga-
zette, the Greenfield Mercury, the Albany Evening Journal, the Old
Colony Memorial, the Barnstable Patriot, the Keene Sentinel, the
New Hampshire Patriot, the Sabbath School Visiter, the Utica Demo-
crat, the Haverhill Republican, the Phrenological Journal, the Library
of Health, the Mother's Assistant, the Lynn Record, the Taunton
Whig, the Claremont Eagle, and perhaps some others that may have
been overlooked.
The editors and proprietors of these papers are assured that their
favors are gratefully and thankfully received. I send to each of them
the annual report of the hospital as a slight return for the favors re-
ceived from their hands.
CHAPEL AND RELIGIOUS SERVICES.
In November, 1837, ihe hospital chapel was dedicated for religious
worship. Since that time there have been in the hospital eight hun-
dred and forty-five patients, of whom seven hundred and ninety-seven
86 STATE LUNATIC HOSPITAL.
have attended religious worship on the Sabbath, more or less, and
forty-eight have failed to attend.
Of the three hundred and ninety-nine patients who have been in the
hospital the past year, three hundred and seventy-three have attended
these exercises, and twenty-six have not attended.
Of the two hundred and thirty-two patients that are now in the hos-
pital, two hundred and fourteen have attended the religious services,
and eighteen have not attended ; in this number are included six re-
cent cases, that will probably all attend when they shall be able to ex-
ercise sufficient self-control, leaving but twelve old cases that are not
in a condition to attend the chapel. Some of these remain in the house
in consequence of their liability to epilepsy, sonae from continued ex-
citement, and some from habits of negligence and want of regard to
personal decency.
There have been regular services in the chapel every Sabbath of the
past year, and all parts of the service have been performed which are
customary in the New England churches.
A respectable choir of singers has always been in attendance, con-
sisting of persons employed in the institution and patients, accompan-
ied by from two to four musical instruments; their performance has
been good at all times, and has never been interrupted by disturbance
or discord. Much credit is due to those members of tlie family who
have assisted in this pleasant and very desirable part of religious wor-
ship-
Sacred music is one of the safest and most salutary exercises for the
insane. Its influence on the feelings is soothing, it awakens attention,
diverts the mind from its reveries, and prepares for the accompanying
duties of the place.
During the last year, the Rev. George Allen has officiated as chap-
lain of the hospital. The services of the house have always been con-
ducted by him with solemnity and discretion, and the influence of re-
lin-ious teaching has never been better. He is judicious in the selec-
tion of bis subjects, and appropriate and solemn in the application of
religious truth, and has never failed to interest his hearers while he has
been sufficiently guarded not to offend them.
His mode of preaching has shown that any topic, discussed with
prudence, is as suitable for our congregation as for others, and that tne
insane bear instruction and reproof as well as other religious assemblies.
With few exceptions, they are attentive listeners, always wide awake,
STATE LUNATIC HOSPITAL. 87
and they carry much of the influence of the Sabbath into the enduing
week. Tliey often recollect the texts of both services, and will
repeat many of the leading thoughts of the sermon many days after.
On the day following the last Sabbath, as an experiment, I inquired
the place of the text, chapter, verse, «S;.c., of eight or ten patients, soiPiC
of whom are generally so much excited, and others so much abstracted,
that I would not have believed that they gave the least attention to the
services ; yet, to my surprise, all knew the place of the texts and the
subjects of the discourses. One woman who had recently come into
the hospital, had not only recollected the place of the text, but after her
return to her room, had surrounded with the mark of a pen, the portion
of the verses principally used in the discourse; another had turned
down the leaf of her bible to the text.
The good order and solemnity of our chapel exercises, have been the
subjects of frequent remark and commendation by strangers and visit-
ers, and all who witness them cannot fail to be impressed with the pro-
priety and peculiar fitness and value of religious services for the insane.
These exercises are very acceptable to a large proportion of the in-
mates of the hospital ; they generally attend voluntarily, and those who
are required to attend, are of that class who are equally opposed to any
thing else that requires an effort.
The preparation for attendance in the chapel, the assembling to-
gether, the music before service, the solemn exercises of the place, and
the topics of conversation to which all these operations lead, with the
variety they afford and the pleasure they give, make the Sabbath, to
many, the most interesting day of the week. Instead of the dread with
which its dull monotony was formerly contemplated, it is hailed as a
day of gratification and delight by many members of our family.
Besides the religious services of the Sabbath, there is a prayer-meet-
ing on Saturday evening, and a bible-class on the Sabbath, which
many of the patients attend.
The change of public sentiment with regard to religious instruction
for the insane, has been great for the last few years ; when this hospi-
tal was erected, it was not contemplated, and no provision was made
for assembling together for this purpose. This is the only institution
of the kind in the country, so fiir as my knowledge extends, which has
a chapel set apart for religious worship.
In many of the institutions, religious meetings are regularly held on
the Sabbath, and this practice is being extended through most of the
asylums in the country.
88 STATE LUNATIC HOSPITAL.
For four years we have tried this experiment fairly, admitting to the
exercise all patients who were in a situation to attend. Here are col-
lected the excited maniac, the gloomy melancholic, the anxious inquir-
er after truth, those who imagine themselves guilty of the unpardona-
ble sin, the gods, saviors and prophets, the infidel, the scoffer, — and
yet we have found no injury arise from such attendance, and no dispo-
sition to disturb the quiet and solemnity of the place.
By our whole moral treatment, as well as by our religious services,
we inculcate all the habits and obligations of rational society. We
think the insane should never be deceived ; all their delusions and false
impressions of character should be discouraged by removing, in the kind-
est manner, every badge of honor and distinction which they are dis-
posed to assume, and by directing their attention to other subjects of
interest. They may be held responsible for their conduct so far as
they are capable of regulating it. By encouraging self-control and re-
spect for themselves and others, we make them better men, more or-
derly and reasonable, before any impression is made upon their delu-
sions. To aid this, it is easy to see how useful must be that religious
instruction which points out their duty to themselves and to their fel-
low-men, and their responsibility to God.
The evils that we at first anticipated do not accompany these saluta-
ry influences. There is certainly a choice of subjects for their consid-
eration, but the range is much wider than we at first supposed ; and,
whatever is the topic of discourse, the service is seldom objectionable
to any one, and usually acceptable to all.
CONCLUSION.
Before the close of another year, it is probable that my faithful
friend and fellow-laborer. Dr. Chandler, will be transferred from the
station which he has so long occupied with honor to himself and ben-
efit to the hospital, to another and more elevated sphere of duty, where
his usefulness will be increased, and other hundreds and thousands will
bless his labors.
Desirable as his continuance with us would be, we ought not to wish
it when he is called to apply his knowledge and ample experience in
the same field of duty and benevolent labor, — but I shall deeply feel
his loss. If, in his successor, I can find the firm friend, the faithful
assistant, the discreet counsellor, that I have found in him, I shall be
most fortunate. For nine years have we gone hand in hand in ardu-
ous duty, without a jar or discord, without a word of difference or a
feeling of unkindness.
STATE LUNATIC HOSPITAL. 89
Mr. and Mrs. Ellis, our steward and matron, also leave us the com-
ng spring.
To say that they have done their duty would be no common praise
in a place requiring so much care and vigilance, but they have done
more ; they have sought to lighten the burdens of their associates, and
sustain them in all their trials and difficulties. It is with deep regret
that I anticipate their departure.
My best wishes attend them all ; they have won the affections- of
those with whom they have been so long associated, and the hundreds,
who have been under their care will " rise up and call them blessed."
In looking forward to the duties of this great institution, deprived of
my tried and faithful associates, I should tremble at the prospect did I
not know that I am under the guardianship, and sustained by the wis-
dom of a board of trustees, who have cheerfully aided me in all times
of difficulty and trial, and who will advise me whenever I need their
counsel : and that I am surrounded by good and faithful aids, in those
who fill subordinate stations, whose industry, vigilance and devotion to
duty, demand my warmest gratitude.
During another year, if life and health are spared me, I shall be
ready to perform the duties of the place, which new relations must
make more difficult ; and, after having devoted ten years, the best of
my life, to this institution, I shall be ready to retire and make room
for some one in the vigor of manhood, who can bring to the service
the high intelligence and enlarged benevolence fitted for the station.
Commending the hospital to the scrutiny and fostering care of the
government, to the confidence of an intelligent public, and the protec-
tion and smiles of Divine Providence, I respectfully submit this report.
SAMUEL B. WOODWARD.
State Lunatic Hospital, )
Worcester, Ms., Nov. 30, 184L )
12
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