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

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REPORT 



RELATING TO 



LUNATIC HOSPITAL. 



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Digitized by tine Internet Archive 

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MWTH 

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. 


- 


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$160 72 


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- 


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- 


327 09 


Vinegar and cider. 


11 


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57 25 


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639 


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25 91 


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- 


- 10,20I| 


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- 


- 


1,751 20 


Cheese, 


- 


- 6,382^ lbs. 


- 


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484 16 


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- 


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- 


- 


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. 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 






1 
3 






68 


62 


2 





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 

















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 











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, 





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. 





12 


14 


11 


10 


15 


13 


18 


20 


113 


Recoveries in spring. 





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. 





3 


1 





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. 








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 





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 





7 


2 


8 


5 


1 


35 


Over 80, . 


























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 





12 






24 














14 





14 








10 





10 






7 














5 





5 








2 





2 






6 














3 





3 








3 





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 





Over 75, . 




10 








Males, 






6 


3 


3 


Females, 


. 




4 





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 





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 





4 


7 


End of 1st qr. 










End of 1st qr. 










8 


31 


15 


16 


1 


8 


1 


1 





1 


9 


20 


11 


9 


2 


9 


5 


1 


4 


2 


10 


14 


5 


9 


3 


10 


2 


2 





3 


11 


22 


10 


12 


4 


11 


2 


1 


1 


4 


12 


21 


11 


10 


5 


12 


1 


1 





5 


13 


21 


12 


9 


6 


13 


8 


6 


2 


6 


14 


25 


11 


14 


7 


14 


2 


2 





7 


End of 2d qr. 










End of 2d qr. 










J5 


22 


10 


12 


1 


15 


3 


3 





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 











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 





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 











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 







. 


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 


_ 





- 


4 


_ 


8 


31 


- 


15 


- 


16 


1 


- 


1 


. 





. 


9 


20 


- 


11 


_ 


9 


5 


_ 


1 


_ 


4 


_ 


10 


14 




5 


- 


9 


2 


■ 


2 


- 





. 


11 


22 


- 


10 


- 


12 


2 




1 


- 


1 


12 


- 


21 


U 


- 


10 


- 


1 


1 


- 





- 


13 


- 


21 


12 


- 


9 


- 


8 


6 


- 


2 


. 


14 - 


25 


11 


- 


14 


- 


2 


2 


- 





_ 


15 1 - 


22 


10 


- 


12 


- 


3 


3 


- 





- 


16 


. 


15 


7 


- 


8 


- 


7 


5 


- 


2 


- 


17 




26 


14 


- 


12 


- 


3 


2 


- 


1 


. 


18 




14 


7 


" 


7 


_ 








- 





. 


_ 


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 


- 





- 


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 


- 








- 


N 


- 


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 






s 


f 

'0 

C3"_C 

5" 


OTHER CAUSES. 


Farmers, 


114 


43 


18 


15 


13 


10 





2 


C Palsy, . 1 
< Epilepsy, 4 


Shoemakers, 


44 


8 


21 


4 


3 


3 


4 


1 


( Jealousy, 1 
Epilepsy, 1 


Printers, 


10 





9 














1 




Laborers, 


70 


44 


13 


5 


2 


4 





2 




Seamen, 


36 


22 


3 


3 


1 


5 


1 





Jealousy, 1 


Merchants, . 


45 


9 


22 





2 


10 


1 





Epilepsy, 1 


Carpenters, . 


30 


12 


6 


1 


1 


4 


4 


1 


do. 1 


Blacksmiths, 


7 


2 


1 








2 





2 




Students, 


21 





16 


1 


1 





2 





Poor diet, 1 


Professional men, 


13 


3 


5 


1 


1 








2 


Unknown, I 


Clergymen, . 


6 





3 


1 











1 


do. 1 


Lawyers, 


4 


1 


2 





1 













Physicians, . 


8 


2 

















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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