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

LS43-53 



ARCHIVES 



V 



ELEVENTH 



ANNUAL REPORT OF THE TRUSTEES 



STATE LUNATIC HOSPITAL 



AT WORCESTER. 



iA, 



■irjrtjiJuJZA^ ptbJZ- -H^^AjhJL 



1843. 




S^'gRAft^y./ 



Boston: 

BUTTON AND WENTWORTH, STATE PRINTERS, 
1844. 



Digitized by the Internet Archive 

in 2010 with funding from 

University of Massachusetts Amherst 



http://www.archive.org/details/annualreportoftr09stat 



Z, ZM3 

A 

ELEVENTH ANNUAL REPORT 

OF THE 

TRUSTEES OF THE STATE LUNATIC HOSPITAL 

DECEMBER, 1843. 



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

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

REPORT: 

The experience of the past year has added new and most convincing 
proof of the enlightened wisdom and humanity which has established 
and supported this institution, and which has here erected the noblest 
monument of the public charities of Massachusetts. 

In addition to the liberality of the State, and the assistance and en- 
couragement of benevolent men, this asylum has enjoyed, in an emi- 
nent degree, the smiles and guardianship of that kind Providence with- 
out whose blessing the best directed efforts of the wisest mortals are 
unavailing. From the laying of the foundation stone to this day, 
Heaven seems to have directed the undertaking, and to have crowned 
with its mercies the entire work. Not to see it, we should be blind ; 
not to acknowledge it, we should be most ungrateful. 

Accompanying this are the Reports of the Superintendent and Treas- 
urer. They contain the most full, accurate and satisfactory statements 
of the police and condition of the hospital, and the receipts and expen- 
ses of the treasury. 

The monthly visits, required by law, have been made principally by 
the members of the Board who reside in Worcester, and a very large 
portion of our labors and cares have devolved upon them — labors and 



STATE LUNANIC HOSPITAL. 



able, 



cares which would have been too onerous, had they not been lightened 
and made cheerful and pleasant by the quiet, order, neatness and good 
management, which have uniformly pervaded the whole establishment. 
Eleven years have passed since this hospital was opened for the re- 
ception of patients ; in that time there have been received one thous- 
and seven hundred and seventy-seven patients. 
Committed by the Courts, .... 

" by Overseers of the Poor and friends, 

The number of Discharges is ... 

" " Recoveries is ... . 

During the last year there have been in the hospital, different 
patients, .... 

At the commencement of the year, 
Admitted during the year, 
Now remaining, 
Recovered, 

Died, ... 

Discharged improved, 
Discharged as harmless and incun 

Sent to House of Correction, for want of room, by Trustees, 
Discharged by the Courts, as incurable and dangerous, 
Discharged by Trustees' Private Board, incurable, for want of 
room, ......... 

Average number of patients in the hospital for the year, 

Of those who have recovered, eighty-four were cases of less dura- 
tion than one year, and thirty-two of longer duration. 

Application has been made for one hundred and fifty-seven who were 
not received at the time, and for ninety-eight who have not been receiv- 
ed at any time, for want of room. 

The expenses of the hospital have been $27,914 12, more by $367 25 
than in 1842 ; and the average number of patients has been greater, 
in about the same proportion. 

The books of the State treasury show that the Commonwealth has 
maintained, in other hospitals, one hundred and six State paupers dur- 
ing the past year, at an expense of $9511 42. There have been here 
during the same time, fifty-three State paupers, for the board of whom 
nothing is paid. If the State should allow this hospital one hundred 
dollars per annum, for the board of its patients, a great saving would 
be made in the price of the board of all other patients, and no annual 



1311 

466 

1522 

792 

458 

238 

220 

255 

116 

22 

32 

24 

2 

6 

1 

244J 



STATE LUNATIC HOSPITAL. 5 

appropriation from the public treasury would be necessary. The 
amount that the hospital would have received from the State for State 
paupers the past year, at the rate paid by towns, is about four thousand 
dollars. 

The Legislature, at its last session, passed " An Act to establish an 
aqueduct for the State Lunatic Hospital." The Trustees have not yet 
effected arrangements with all the persons interested in the lands 
through which it is necessary the aqueduct shall pass, but no serious 
difficulty is now apprehended in making equitable arrangements, and 
in securing a plentiful supply of water. The enlargement will make a 
more ample supply necessary, and the Trustees have concluded that it 
will be safer and more conducive to health to use iron conductors. 

George S. Johonnot, of Salem, by his will, which was proved in 
May, 1836, after divers bequests, gave the residue of his property for 
the purpose of purchasing " a piece of land in Salem or the vicinity, 
whereon to erect a stone or brick building, with slated roof, and as 
nearly fire-proof as may be, calculated for a lunatic hospital, for the 
reception of the insane of Essex County, in the first instance ; to be 
extended to other places whenever the funds will admit." By the same 
will Mr. Johonnot authorized his wife Martha to make such different 
disposition of said residue as she might think proper. Mrs. Johonnot, 
thinking that the residue would not be sufficient to build and endow a 
hospital, by her last will, after many bequests and annuities, gave the 
residue in trust to the Trustees of the State Lunatic Hospital, for the 
support and relief of the insane poor, who may from time to time be 
committed to the said hospital from the several towns in the county of 
Essex ; and if, from any cause whatever, this devise cannot take effect 
consistently with the rules of law, she then gave said residue to the 
Trustees of the hospital, to be used and improved for the maintenance 
of insane persons, and for the benefit of said hospital." 

The Legislature of 1841 passed resolves of the following effect: — 
" Whereas said bequests cannot take effect according to existing rules 
of law, therefore the Trustees are authorized and required to receive 
said bequest, and to hold the same in trust for the Commonwealth, to 
be used and improved for the maintenance of insane persons, and for 
the benefit of the hospital. The Trustees were authorized to assume 
the liability of paying the annuities, and required to pay into the treas- 
ury of the Commonwealth, from the income or principal of the Johon- 
not fund, a sum sufficient to enable the treasurer to pay the annuities 
as the same shall fall due. The payments have been regularly made 



6 STATE LUNATIC HOSPITAL. 

by the Trustees and| State Treasurer. When this fund was received 
by the Trustees, it was appraised at about $44,200, and was charged 
with annuities amounting to $2,520. 

The Legislature, at its last session, passed " Resolves for the en- 
largement of the State Lunatic Hospital," of the following tenor : — 
" Resolved, That the Trustees of the State Lunatic Hospital at Worces- 
ter, together with the Superintendent and Treasurer thereof, are hereby 
authorized to erect, in such manner as they shall deem most expedient, 
additional buildings, adjoining or near the existing buildings of said 
hospital, sufficiently large for the accommodation of one hundred and 
fifty insane patients, and to provide all necessary accommodations and 
furniture for the same." 

To defray the expenses of the additional buildings and appurtenan- 
ces, the Trustees are authorized to appropriate and make use of the 
principal of the bequest made by Martha Johonnot, late of Salem, to 
the Trustees of the hospital, " for the maintenance of insane persons, 
and for the benefit of the institution." 

After establishing the price of board of private patients at three dol- 
lars per week, and limiting the amount of expenditure for the enlarge- 
ment to a sum not exceeding the amount of the Johonnot fund, and any 
funds which may be placed in the hands of the Trustees for that pur- 
pose, by individual gift, and providing for the payment of the annuities 
which were chargeable upon the Johonnot legacy by the State treasury, 
it is 

" Resolved, That previous to the execution of these resolves, the 
Governor and Council be requested to obtain the opinion of the Justices 
of the Supreme Judicial Court of the Commonwealth, whether the use 
of the Johonnot fund, as herein contemplated, can be made without a 
forfeiture of said fund to the heirs. at law of the late Martha Johonnot ; 
and if said opinion be adverse, then these resolves shall be of no 
effect." Approved by the Governor, March 24th, 1843. 

In July a communication was received by the Trustees, from the 
Secretary of the Commonwealth, enclosing the opinion of the Justices 
of the Supreme Judicial Court, " that the use of the Johonnot fund, as 
contemplated by the terms of the resolves of March 24th, 1843, can 
be made without a forfeiture of the said fund to the heirs at law of the 
late Martha Johonnot." A meeting of the Trustees and of the Super- 
intendent and Treasurer was held forthwith, at which it was 

" Voted, unanimously, to proceed to the enlargement of the hospital, 
under the resolves of the Legislature and the opinion of the Supreme 
Court thereon." 



STATE LUNATIC HOSPITAL. 7 

At this meeting it was determined to commence the enlargement 
with a view to the accommodation of one hundred and fifty additional 
patients, agreeably to plans submitted, and to erect a building from the 
chapel to meet the central part of the hospital, to furnish additional 
and much needed accommodations ; and Mr. Elias Carter, who was 
favorably known to the Board by the most faithful and able manner in 
which he had executed former contracts for building, was employed to 
superintend the work for a per diem compensation. 

The work has been commenced and prosecuted as far and fast as 
the lateness of the season would permit. Favorable contracts for labor 
and materials have been made ; the excavation has been done princi- 
pally by the labor of the patients, and the Board confidently expect 
that the building will be completed and in readiness to receive patients 
by the first of January, 1845. 

The building connecting the chapel with the central part of the hos- 
pital has been completed ; besides a spacious hall, on the walls of 
which is conspicuously inscribed the name of Martha Johonnot, there 
is a room convenient for the reception of visitors, and for the library, 
and for medicines. 

On the South side of the hospital, the enlargement extends one hun- 
dred feet south, then on a right angle one hundred feet east, both angles 
thirty-six feet wide, leaving an open court sixty-four feet wide between 
the old and new lateral wings. In the basement is a kitchen with appa- 
ratus sufficiently extensive to cook for one hundred persons, and five 
sleeping rooms, and room for two furnaces, wood, and other uses. In 
each of these stories above the basement there are twenty-six sleeping 
apartments, a dining room, bathing rooms, water closet, clothes closet, 
and stairway, with a hall twelve feet wide extending through the whole 
range in the centre, lighted and ventilated at each end. The enlarge- 
ment on the north side corresponds with the southern wing, and when 
completed the hospital will present a front of five hundred and twenty- 
five feet in length, and will afford accommodations for more than four 
hundred patients. 

Thus may we hope that by the favor of Heaven, and the bounty of 
the Commonwealth, the charitable and benevolent purposes of George 
S. Johonnot and Martha Johonnot have been more than accomplished. 
In devoting to so humane a use a portion of their worldly goods, the 
day to them must have appeared very distant when so large a number 
of the unfortunate insane could have been blessed by their bounty. 
The chances that that bounty might be lost, squandered or misapplied, 



8 STATE LUNATIC HOSPITAL. 

were great, but it is now to be invested in a solid masonry of stone and 
brick, which shall stand for generations, a monument of their well ap- 
plied liberality. They have left no children to enjoy their fortune, or 
to perpetuate their name ; but their silver and gold shall provide a 
refuge for the children of misfortune, and the name of Johonnot shall 
be long- associated with the idea of benevolence and humanity. 

Some objections have been urged against the policy of enlarging this 
hospital ; but the benefits and advantages resulting from an enlargement 
are too great and obvious to be overlooked or forgotten. The hospital 
is in the centre of the Commonwealth ; is easy of access by rail-roads ; 
is in a fertile country, with a salubrious air. 

The farm accommodations, stables and out-buildings, are ample and 
convenient. But one Superintendent, one Chaplain, one Steward, and 
one Board of Trustees are necessary. 

In comparing large with moderate sized hospitals, there is a smaller 
number of salaries to be paid, fewer officers and assistants to be em- 
ployed, and fewer subordinates to be maintained and trusted. Large 
quantities of provisions and other supplies can be bought on more favor- 
able terms, and the cost of supporting each patient will be reduced. 
The best services and the undivided attention of the most skilful and 
experienced physicians can be secured, and the advantage of having 
two or more physicians always present for consultation is great. A 
large number of patients affords an opportunity for making a suitable 
classification. Among four hundred patients, many individuals of the 
several trades may be so arranged that they will find exercise and em- 
ployment under the superintendence of trustworthy overseers. 

A systematised, well regulated hospital of four hundred patients may 
well be supposed to be more efficient and less expensive than two hos- 
pitals of two hundred patients each, or four of one hundred. But with 
the friends of suffering humanity, who have been laboring and toiling 
long to procure better accommodations for the insane, the question was 
not whether larger or smaller institutions are preferable, but whether 
any provision shall now be made for the hundreds of unfriended, neg- 
lected, almost forgotten unfortunates, who are pining in want, or raging 
in chains, who are secluded from society and the blessed light and air 
of heaven, in garrets and cellars, in almshouses and prisons. The cry 
of the prisoner has been heard ; his sighs and groans have been re- 
garded ; this hospital is to be enlarged, and much human woe is to be 
alleviated. Many children of sorrow, now moping in darkness and 



STATE LUNATIC HOSPITAL. 9 

nakedness, will be returned to their friends clothed and in their right 
mind ; many who are now the cause of anxiety, grief and terror, will 
be restored to their quiet homes, to usefulness and to society. 

The regulation for fixing the price of board for private patients, 
which was adopted by the last Legislature, and which has been quoted 
in the resolves for enlarging the hospital in a preceding page, has had 
but little practical operation, and that perhaps has not been favorable to 
the poorer classes. When the hospital is enlarged, in the opinion of 
the Trustees, this regulation will he unnecessary. This is the hospital 
for the poor ; if the wealthy have not already sufficient accommoda- 
tions, the very necessity of the case will provide them. It is for the 
poor that the Commonwealth should exercise its benevolence ; not for 
the poor of the almshouse alone, but for the poor of the cottage, and 
of the lowly, humble dwelling. The towns can afford to maintain their 
paupers ; they have been generous, and have seldom complained of the 
burden ; but the public sympathy should be extended to the sorrowing 
father or widowed mother, who, to avoid the stigma of pauperism, 
nerved by an honest pride, stint their own comforts to eke out $2 30 
per week to support in this hospital their unfortunate child. There are 
in Massachusetts many honest parents, and noble spirited sons and 
daughters, who have consumed the midnight oil, and toiled the live-long 
day, to avert from their family the dreaded shame of becoming a town 
charge. There can surely be no good reason why patients of this class 
should be required to pay more than town paupers, or why the already 
too deeply burdened should be taxed for the maintenance of State bene- 
ficiaries. 

The labors of the farm, the garden and the workshops, have been 
productive of the best results, both in the profit derived from them, 
and the great benefit to the health and recovery of the patients. The 
exercises of the chapel have been regularly and constantly attended by 
a very large portion of the household, and the quiet solemnities of these 
well conducted services have had the happiest effects on the minds of 
the patients. These services are of inestimable value, and we have 
great pleasure in bearing testimony to the fidelity, discretion, zeal and 
acceptableness of the worthy Chaplain, Eev. Mr. Allen. 

The Trustees have often witnessed the favorable influence which ex- 
ercise and riding, sports and games, music and dancing have on the 
troubled minds of the patients. Who that has visited these children of 
sorrow, and feels for the bitterness of their lot, would deny them these, 
2 



10 STATE LUNATIC HOSPITAL. 

or any innocent relaxation or amusement ? Who could refuse to shed 
light and joy, if it were but a transient gleam, into those 

" gloomy cells, 

Where ever-boding melancholy dwells." 

The services of the Assistant Physician, Dr. Lee, and of the Stew- 
ard and Matron, Mr. and Mrs. Hitchcock, have been entirely satisfac- 
tory ; and all others employed in the hospital have rendered every rea- 
sonable and desired assistance. 

The Trustees would leave unperformed the most grateful part of 
their duty, if they omitted to record their most full and decided testi- 
mony to the zeal, fidelity and assiduous devotion of the Superintendent. 
His master spirit has pervaded the whole establishment, and he seems 
to have impressed on all laws of kindness and love. By his gentleness 
and courtesy, no less than by his skill and energy, has he given a tone 
and character to this hospital which have made it a model and a praise 
in our own and in foreign lands. Into how many wounded hearts has 
he poured the healing balm ; to how many anxious and sorrowing 
bosoms has he brought consolation and peace ? In this world such 
public benefactors have an ample reward, in the gratitude of those they 
have blessed ; in the coming world, where there are no disturbed fan- 
cies and no clouded vision, they shall have fulness of joy and pleasures 
forevermore. 

Our acknowledgments are also due to the lady of Doctor Woodward, 
and to the other members of his family. Besides the sacrifice of per- 
sonal accommodations and convenience, for the benefit of the patients, 
they have afforded them the soft and gentle answer, and the ready and 
cheerful assistance. Their kindness has been often mentioned by con- 
valescents, and the memory of it will long be cherished. 

In conclusion, we reverently commit this asylum for the unfortunate 
to the watchful providence of a merciful God. May the fulness of his 
benignity rest upon it and bless it. We earnestly commend it to the 
guardian care of a wise and prudent Legislature, and to the favorable 
regard of a paternal government. 

(Signed) DANIEL P. KING. 

HENRY GARDNER. 
EDWIN CONANT. 
H. H. CHILDS. 
Worcester, Dec, 1843. JOSEPH SARGENT. 

A true copy. Attest, JOSEPH SARGENT, 

Secretary of the Board. 



STATE LUNATIC HOSPITAL. 



11 



TREASURER'S REPORT. 



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

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

The Treasurer charges himself from December 1, 1842, to Novem- 
ber 30, 1843, inclusive, as follows : 

For cash on hand, balance of account, Dec. 

1, 1842, ...... $3773 80 

For receipts from cities, towns and individ- 
uals, 26,930 83 

For credits on bills for sundry articles sold, 318 ] 



He credits himself as follows : 
For payments for improvements and repairs, 
" " " salaries, wages and labor, 

" " " furniture and bedding. . 

" " " clothing, linen, &c. 

". " " fuel and lights, 

" " " provisions and groceries, 

" " u medical supplies, . 

« " " hay, $30, straw, $54 06, 

" " " miscellaneous, . , 

Expenses for the year, .... 
Cash on hand, balance to new account, 



$1110 30 


. 7340 


50 


. 1822 


30 


. 1815 


45 


. 3917 


72 


. 9993 34 


. 426 


11 


84 06 


. 1404 34 


$27,914 


12 


3108 


68 



$31,022 80 



$31,022 80 



The Treasurer omits, as unnecessary, a tabular statement of the 
names, occupation, and compensation of those employed at the Hospi- 
tal. The number employed, and the rate of compensation is about the 
same as mentioned in the last report. 



12 



STATE LUNATIC HOSPITAL. 





The item Fuel and Lights includes 




Wood, . 




748 cords, 2 feet 9 inches, . $3375 26 


Charcoal, 




1638 bushels, .... 


156 41 


Anthracite, 




9400 lbs. = 4 tons 1400 lbs. . 


42 34 


Oil, . 




437 gallons, .... 


322 


Candles, . 


. 


69f lbs. 


20 32 


Wicking, 




, 


. 


1 39 


X 


i 


$3917 72 




Provisions and Groceries include 




Fruits, sweet potatoes 


, squashes, &c. 


f 727 04 


Spices and small 


groceries, . 




125 10 


Soap, 




. 




365 30 


Butter, 




10,665| lbs. 




1707 08 


Cheese, 




7706f lbs. 




577 64 


Eggs, 




754J dozen, 




107 21 


Beans, 




30| bushels, 




46 63 


Peas, 




22^ bushels, 




26 88 


Tea, 




635 lbs. 




312 19 


Coffee, 




1285 lbs. 




105 96 


Shells, 




169 lbs. 




20 29 


Brown Sugar, 




12,739 lbs. 




712 93 


White Sugar, 




857 lbs. 




98 71 


Molasses, 




501J gallons, 




125 30 


Honey, 




190-Lf lbs. 




19 70 


Vinegar, 




7 barrels, 




18 92 


Flour, 




255 barrels, 




.1349 85 


Rice, 




2036 lbs. 




. 61 39 


Corn, 




667J bushels, 




. 491 24 


Eye, 




393J bushels, 




. 298 50 


Oats, 




222| bushels, 




. 80 03 


Turnips, 




45 bushels, 


• • \ 


9 50 


Carrots, 




23J bushels, 




5 81 


Potatoes, 




995J bushels, 




. 289 83 


Cabbages, 




182 




. 10 26 


Biscuit, 




. 




. 103 31 


Ham, 




118 lbs. and smoking others, 


. 13 11 


Oysters and Clams, . 




. 


. 14 72 



STATE LUNATIC HOSPITAL. 



13 



Poultry, 


1667 lbs. 


143 46 


Tongues and Sounds 


1 barrel, 


5 00 


Salmon, 


1 barrel and 50 lbs. . 


19 00 


Fresh Fish,. 


2510 lbs. & others, by number, 


84 76 


Salt Fish, ■ 


5724 lbs. 


129 37 


Mackerel, 


3 barrels, 


27 75 


Mutton and Lamb, 


2117| lbs. 


122 37 


Beef, 


24,300 lbs. 


1202 79 


Veal, 


3578J lbs- 


. 204 14 


Pork, 


3257£ lbs. 


. 162 04 


Sausages, 


598 lbs. 


. 57 24 


Tripe, 


139 lbs. 


. 10 99 




$9993 34 



r shoates, 



Miscellaneous includes 

Cash advanced to patients and charged in their accounts or 

paid to them when leaving the Hospital, 
Expenses after elopers and for their return, 
Expenses of sending home patients discharged, 
Funeral expenses, 
Postage, .... 
Books, stationery and printing, 
Expenses of Trustees' visits, 
Four cows, two pairs oxen, one calf, one bull, fou 

two sows, t 

Attorneys fees, 
Analysis of water, 

Pasturing, $24 79, filling ice cellar, $23, 
Sundries, , 



The amount appropriated by Resolve of March 3, 1842, for defray- 
ing the current expenses of the Hospital, remains in the State Treasury 
and no additional appropriation will be required for that purpose the 
ensuing year. 

ALFRED D WIGHT FOSTER, 

Treasurer of the State Lunatic Hospital. 

Worcester, December 25, 1843. 



$205 55 


22 70 


13 


75 


138 


50 


102 48 


165 40 


146 


70 


370 


95 


74 


15 


30 




47 


79 


86 


37 


$1404 


34 



14 



STATE LUNATIC HOSPITAL. 



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28 



STATE LUNATIC HOSPITAL. 



Patients admitted from each of the Counties. 







1843. 


Previously. 


Total. 


Barnstable, . . Males, . 
Females, 




2 
2 


19 
13 


36 


Berkshire, . . Males, . 
Females, 




4 
3 


24 
23 


54 


Bristol, . . . Males, . 
Females, 




7 
6 


53 

37 


103 


Dukes, . . . Males, . 
Females, 








4 
2 


6 


Essex, . . . Males, . 
Females, 




15 
14 


109 
102 


240 


Franklin, . . Males, . 
Females, 




3 

2 


37 
26 


68 


Hampden, . . Males, . 
Females, 




4 
6 


27 
41 


78 


Hampshire, . . Males, . 
Females, 




8 
8 


47 
39 


102 


Middlesex, . • Males, . 
Females, 




14 
11 


87 

77 


189 


Nantucket, . . Males, . 
Females, 




2 




5 
5 


12 


Norfolk, . . . Males, . 
Females, 




15 

10 


89 
59 


173 


Plymouth, . . Males, . 
Females, 




4 
4 


34 
33 


75 


Suffolk, . . . Males, . 
Females, 




11 
12 


90 
73 


186 


Worcester, . . Males, . 
Females, 




22 

30 


189 
208 


449 


Boarders out of the State, Males, . 
Females, 




1 




2 
3 


6 






220 


1557 


1777 



STATE LUNATIC HOSPITAL. 29 

Having completed another year in the State Lunatic Hospital, we 
devoutly tender gratitude and thankfulness to that Almighty Being who 
controls the destinies of man, and whose favor we supplicate in all our 
future operations. 

It is pleasant, now that we have completed the first decade of our 
existence as a Hospital, and entered upon another, to take a retrospec- 
tive view of the past, in which we have labored to accomplish the de- 
signs of the benevolent founders of the institution, so as, in some good 
degree, to satisfy the expectations of the public by the results which 
we exhibit. 

The Hospital was opened in January, 1833, with accommodations 
for 113 patients. It soon became full and crowded, and was enlarged 
so as to accommodate 250. It has again become so crowded that it 
has been thought best still to extend our building, and the foundations 
of 150 apartments are already laid. When these are completed our 
house will afford room for 400 patients, besides officers and assistants, 
which it is hoped will be sufficient for all who may need such an 
asylum. 

By the regulations of the Hospital, established by law, it is made the 
duty of the Superintendent to make a statistical report at the annual 
meeting of the Trustees ; " he shall give a tabular view of the Insti- 
tution deduced from the records of the same," thus wisely providing 
that statistics should be preserved, which at some future time might be 
esteemed valuable to this and other similar charities. 

This Hospital has now been opened nearly eleven years. It has re- 
ceived 1777 patients, discharged 1522, of whom 792 have recovered 
and 136 have died ; the remainder, 594, have been discharged in vari- 
ous conditions, some in a state of convalescence, some greatly im- 
proved, others less improved, and many harmless and incurable or dan- 
gerous and incurable, who were sent away for want of room. 255 
patients remain, who exhibit all the different forms of disease, from 
curable insanity to hopeless idiocy. 

I give the following table to show the number of patients in the Hos- 
pital and the expense of supporting the Institution each year since its 
commencement. 



30 



STATE LUNATIC HOSPITAL. 



The Year. 


No. of Residents. 


Average No. 


No. at the end of each year. 


Expenses. 


1833 


155 


107 


114 


$12,272 91 


1834 


233 


117 


118 


15,840 27 


1835 


241 


120 


119 


16,576 44 


1836 


245 


127 


138 


21,395 28 


1837 


306 


163 


185 


26,027 07 


1838 


362 


211 


218 


28,739 40 


1839 


397 


223 


229 


29,474 41 


1840 


391 


229 


236 


27,844 98 


1841 


399 


233 


232 


28,847 62 


1842 


430 


238 


238 


27,546 87 


1843 


458 


244 


255 


27,914 12 



Since May 19, 1838, salaries have been paid from the State Treas- 
ury. 

I have gathered from the reports of a number of American and 
British Hospitals, the following facts, which I present in this connection. 

American Hospitals. 





Year. 


No. of Residents. 


Average. 


Expense. 


Bloomingdale, 


1842 


219 


120 


#29,319 17 


McLean, 


1842 


271 


. 


26,755 00 


Ohio, 


1842 


207 


145 


15,877 44 


Maine, 


1842 


141 


62£ 


9187 64 


Staunton, Va. 


1842 


152 


115 


21,452 01 


Hartford, Ct. 


1843 


172 


90 


17,569 62£ 


Vermont, 


1843 


224 


abt. 125 


13,050 15 


Trankford, Pa. 


1842 


97 


54 


15,140 20 


New Hampshire, . 


1843 


131 


42£ 


5428 32 







British . 


Hospitals. 








Names. 


Year. 


Residents. 


Average. 


Expenses. 


Expenses. 


Retreat, York, . 


1843 


112 


89£ 


£4924 


3s Sd. 


$23,832 00 


St. Lukes, 


1842 


457 




7518 


6 3 


36,383 84 


York Asylum, . 


1842 




162 


5626 


17 3 


27,233 91 


Cornwall, . 


1842 


189 


... 


2681 


6 9 


12,977 67 


Leicester, . 


1841 


160 


abt. 100 


2601 


3 


12,589 56 


Staffordshire, 


1842 


352 


240 


5691 


15 9 


27,548 25 


Kent, 


1842 


„ 


200 


4439 


7 3 


21,486 50 


Dorset, 


1842 


. 


105 


1998 


16 


9625 79 


Hanwell, . 


1842 


„ 


943 


21,990 


2 1 


106,652 50 


Edinburgh, 


1842 


100 


abt. 60 


1894 


14 7 


9180 63 


Belfast, 


1842 


360 


248 


3762 


4 4 


18,209 13 


Carlow, 


1842 


. 


162 


2532 


15 9 


12,284 02 


Lincoln, . 


1842 


. 


100 


4599 


9 9 


22,307 40 


Lancaster, 


1836 


. 


305 


4492 


5 7 


21,752 63 


Dundee, . 


1836 


167 


129 


2645 


511 


12,803 23 


Glasgow, . 


1842 


369 


196 


5290 


7 


25,656 64 



STATE LUNATIC HOSPITAL. 



31 



It has been supposed that the American Hospitals were supported at 
a much greater expense than those in Europe. This may be true of 
some of them, but others are less expensive according to the number 
of residents. The wages of attendants are probably higher here than 
abroad, but provisions are quite as low here, and in some parts of the 
country even less. The difference against us is not so great, as I had 
supposed. 

In reducing the currency of Great Britian to our currency, I have 
assumed the legal value of the £ sterling to be $4 84 of our currency. 



TABLE 1. 

Showing the Number of Admissions, and the state of the Hospital, from 
Dec. 1st, 1842 to Nov. 30th, 1843. 

Patients in the Hospital in the course of the year, . . . . 458 

235 

-458 



Males, 
Females, 



At the commencement of the year, 
Males, .... 
Females, 

Admitted in the course of the year, 
Males, . . . " . 
Females, 

Remain at the end of the year, . 
Males, .... 
Females, 

Patients admitted, . . 220 

Males, . Ill 

Females, . 109—220 

Cases of duration less 

than one year, . . . 129 

Males, . 59 

Females, . 70—129 

Cases of longer duration 

than one year, ... 91 
Males, . 52 
Females, . 39 91 



Cases committed hy the 
■Courts, . . 152 

By the Overseers, 21 
Private boarders, 47- 



Foreigners now in the 
Hospital, 

Males, . 18 

Females, . 20 38 



-220 

38 



235 
223- 



124 
114- 



111 

109- 



135 
120- 



-238 



-220 



-255 



238 



220 



255 



Patients now in the Hospital, 255 
Males, . .135 

Females, . 120—255 

Cases of duration less than 
one year, .... 
Males, . . 20 
Females, . 25 45 



45 



Cases of longer duration 

than one year, . . 210 

Males, . . 115 
Females, . 95—210 

Foreigners discharged the 

last year, . . . .15 

Males, . . 6 

Females, . 9 15 

Applications not received 

at the time, . . 157 

Not received at all for want 

of room, . . . .98 



32 



STATE LUNATIC HOSPITAL. 



There are in the United States 20 Institutions for the Insane ; in 13 
of these there were admitted in one year 1213 patients. 



Boston, 


62 


Whole Number in th 


3se Institutions 


Bloomindale, 1842, 


86 


in the year : 


Vermont, 1843, . 


111 


Boston, . 


157 


McLean, 1842, . 


129 


Blooming-dale, . 


219 


Ohio, 1843, 


65 


Vermont, 


224 


Maine, 1842, . 


87 


McLean, 


271 


Pennsylvania, 1842, . 


120 


Ohio, 


207 


Staunton, Va., 1842, . 


53 


Maine, . 


141 


Williamsburg, Va., 1842, 


27 


Pennsylvania, . 


238 


Frankford, Pa., 1842, . 


39 


Staunton, Va., . 


152 


Hartford, Ct, 1843, . 


83 


Williamsburg, Va., 


123 


New Hampshire, 1843, 


131 


Frankford, Pa., 


97 


State Lunatic Hospital, Mass 




Hartford, Ct, . 


172 


1843, . 


220 


New Hampshire, 


131 






State Lunatic Hospital, . 458 




1213 




2590 



In making this list, whenever I could find a report for 1843 I have 
made use of it ; when not, I have taken the list from that of 1842. 

It appears by the above table, that the number of individuals resident 
in these institutions annually, is more than twice the number admitted. 
Some of them are not always full and others are crowded. The ac- 
commodations must fall short of the number resident and exceed the 
number admitted. Probably, when quite full, these institutions might 
accommodate 1500 persons. 

No State in the Union has made such ample provision for its insane 
as Massachusetts, having had 458 in its State Hospital, 271 in the 
McLean Asylum, and 157 in the Boston Lunatic Asylum, — in all 886 ; 
and buildings are now being erected for at least 150 more, which will 
give room for 1036. 

The number of patients admitted into this Hospital has been greater 
the past year than in any former year. We have constantly accom- 
modated many more than we have rooms, so that the average number 
has been such as to fill all the apartments, and most of the time the in- 
firmaries designed for the sick. 

The reluctance felt by the Trustees to send away patients who are 
suitable subjects for the Institution, has induced them to keep as many 
as could be lodged and fed, till the ample rooms now being prepared 
can be made ready for occupancy. 

There have been twenty-Jive State paupers in the Hospital the whole 



STATE LUNATIC HOSPITAL. 33 

year, and about the same number have been here part of the time, 
averaging at least half a year. It is right and just that the State should 
pay for these the same as the towns pay for their paupers, and while it 
does not, injustice is done to towns and to a class of persons who are 
hardly able to pay the expense of supporting their friends, even at the 
moderate charge made for their support. Last year the income from 
this source would have more than paid all expenses over what was re- 
ceived from towns and private boarders, and would have enabled them 
to reduce the price of board for these two classes. 

An object so desirable should be attended to, and the minimum price, 
which can be established, be charged in future, especially when the 
new wings are completed, so that the greatest number can be accom- 
modated at the least expense. 



34 



STATE LUNATIC HOSPITAL. 



TABLE 2. 

Showi?i.g the Number of Discharges and Deaths, and the Condition of 
those xoho have left the Hospital, from Dec. 1st, 1842 to Nov. 3Qth, 
1843. 



1 


y. 








_ 














c 










cfi 


M 




X3 S 


O 








O 


| 


o 
p. 


gas 




"S 






a 


a 


- 




» 


a 


E- 


Patients discharged, 203 
















Males, 


100 


53 


19 


13 


7 


8 


100 


Females, 


103 


63 


13 


11 


2 


14 


103 




203 


116 


32 


24 


9 


22 


203 


Patients disch'g'd whose 
















insanity was of less 
















duration than one 
















vear, . . 93 
















Males, 


43 


36 


5 








2 


43 


Females, 


52 


48 











4 


52 




95 


84 


5 








6 


95 


Patients disch'g'd whose 
















insanity was of longer 
















duration than lyr. 108 
















Males, 


57 


17 


14 


13 


7 


6 


57 


Females, 


51 


15 


13 


11 


2 


10 


51 




108 


32 


27 


24 


9 


16 


108 



Facts relating to Discharges. 

Discharged as harmless and incurable, for want of room, in eleven 

years, ........ .... 271 

Sent to the Jails as incurable and dangerous, by the Trustees, . . 39 
Discharged by the Probate Court, ....... 29 

Discharged by the higher Courts — Recovered, . 4 
" " " —Not " . . 5 
Sent to South Boston, 17 



! • 



9 



STATE LUNATIC HOSPITAL. 



35 



la ten American and ten British Asylums, the discharges, deaths, and 
number of residents, have been as follows : 



1842 or 1843. 



1841 or 1842. 



Vermont. 

Discharged, ... 77 

Deaths, . . . 11 83 

Residents — 224. 

Hartford. 

Discharged, ... 74 

Deaths, . . . 9 83 

Residents — 146. 

McLean. 
Discharged, . . 123 

Deaths, . . . 15—138 

Residents — 271. 

Ohio. 

Discharged, ... 55 

Deaths, . . . 4 59 

Residents— 207. 

Maine. 

Discharged, ... 70 

Deaths, . . . 6 76 

Residents — 141. 

Pennsylvania. 

Discharged, . . .108 
Deaths, . . . 12—120 

Residents— 238. 

Staunton, Va. 

Discharged, ... 27 

Deaths, . . . 15 42 

Residents — 1 52. 

Bloomingdale. 
Discharged, . . .102 

Deaths, . . . 7—109 

Residents — 219. 

South Boston. 

Discharged, ... 29 

Deaths, . . . 9 38 

Residents — 157. 

State Lunatic Hospital, Mass. 
Discharged, . . . 181 
Deaths, . . . 22—203 

Residents — 458. 



Staffordshire. 
Discharged, ... 81 
Deaths, . . . 33—114 

Residents — 352. 

Suffolk. 

Discharged, ... 28 

Deaths, . . . 21 49 

Residents — 261. 

West Riding. 
Discharged, . . .71 

Deaths, . . . 57—128 

Residents — 506. 

Dorset. 

Discharged, ... 12 

Deaths, . . . 7 19 

Residents— 128. 

Dundee. 

Discharged, ... 37 

Deaths, . . . 10 — 47 
Residents — 225. 

Montrose. 
Discharged, . . .21 

Deaths, . . . 4 25 

Residents — 107. 

Hanwell. 
Discharged, ... 57 
Deaths, . . . 91—148 

Residents— 1124. 

Dumfries. 

Discharged, ... 24 

Deaths, . . . 8 32 

Residents — 125. 

Carlow. 

Discharged, ... 23 

Deaths, . . . 13 — 36 
Residents — 201. 

Belfast. 

Discharged, ... 83 
Deaths, . . . 27—110 

Residents— 360. 



36 



STATE LUNATIC HOSPITAL. 



I place with the table the statistics of discharge in ten American and 
ten British asylums. The advantage as to deaths is in favor of Amer- 
ican institutions, yet the comparison is not strictly just, as the British 
asylums are not usually full, arid therefore discharge few. The insti- 
tutions that are frequently changing patients have an advantage in this 
particular, the per cent, of deaths is less ; but they have a disadvan- 
tage in another, which is that the per cent, of recoveries of old cases 
is also less. 

The number of deaths, in this Hospital has been large, the present 
year, and yet no great sickness has prevailed, and few cases of acute 
disease have proved fatal. A large share of the deaths with us are 
from cases improperly committed, which would not be received into a 
private asylum in the condition of health in which they are brought to 
this Hospital. The evil is unavoidable, and will always exist in a pub- 
lic institution. 

TABLE 3. 

Showing the Number of Admissions and Discharges, and the average 
Number of Patients each month in the year. 



Monthly Average. 


1 Admissions. 

1 


Discharges. 


December, ..... 234 1-4 


! | 
18 


18 


January, 










235 1-10 


17 


17 


February, 










231 


16 


14 


March, 










233 1-2 


15 


17 


April, . 










237 3-4 


22 


21 


May, . 










240 2-3 


21 


14 


June, . 










249 


22 


13 


July, . 










249 


1 19 


28 


August, 










245 1-4 


! 15 


11 


September, 










253 


19 


18 


October, 










255 1-3 


21 


13 


November, 










259 1-3 


15 


19 


Yearly 


Aver 


age, 






. 244 1-6 


220 

I 


203 



The number of inmates of the Hospital has been constantly increas- 
ing, till the monthly average is 259£. The changes must, of course, 
be great, as 220 were admitted and 203 discharged, a change of 423 
in the course of the year, nearly as many as the whole number of res- 
idents last year, which was 458, a difference of 35 only. 



STATE LUNATIC HOSPITAL. 



37 



The greatest number of admissions was in April and June, 22 each 
month. The greatest number of discharges was in July, 28. 

TABLE 4. 



Ages of Patients in the Hospital, December 


Duration of Insanity with those remaining, 


1st, 1843. 


December 1st, 1843. 




Under 20, .... 9 


Less than 1 year, 


45 


From 20 to 25, 






23 


From 1 to 2 years, 




21 


" 25 to 30, 






36 


" 2 to 5 " 




54 


" 30 to 35, 






38 


" 5 to 10 " 




52 


" 35 to 40, 






30 


" 10 to 15 " 




33 


" 40 to 45, 






33 


" 15 to 20 " 




20 


" 45 to 50, 






27 


" 20 to 25 " 




8 


" 50 to 55, 






20 


" 25 to 30 " 




11 


" 55 to 60, 






14 


Over 30 years, 




. 4 


" 60 to 65, 






8 


Unknown, 




7 


" 65 to 70, 






9 






" 70 to 75, 






6 






" 75 to 80, 






. 1 






Over 80, 






. 1 






255 




255 



The number of patients now in the Hospital between the ages of 25 
and 45 is 137, more than half of the present residents ; a proof that 
insanity is a disease of ripe years, when the energies of mind are 
greatest, when the feelings are most liable to be agitated by great 
causes, when the responsibilities of life are heaviest. 

Peculiar causes operate on different ages. " The secret vice" de- 
stroys the youthful mind, bringing on epilepsy and insanity, while apo- 
plexy and palsy are the diseases of advanced life. 

Of the white population of the State of Massachusetts, which is 
729,030,-252,142 are between the ages of 20 and 40 ; 476,898 are of 
other ages. 



38 



STATE LUNATIC HOSPITAL. 



TABLE 5. 
Statistics of the Hospital from Jan. 1833 to Nov. 30, 1843. 





1833 


1834 


1835 


1836 


1837 


1838 


1839 


484C 


1841 


1842 


1843 


Whole No. of Pa- 
tients admitted, - 


153 


119 


113 


125 


168 


177 


178 


162 


163 


198 


220 


Discharged, includ- 
ing deaths and 
elopements, 


39 


115 


112 


106 


121 


144 


168 


155 


167 


191 


203 


Discharged recov'd, 


25 


64 


52 


58 


69 


76 


80 82 


82 


88 


116 


Discharged impro'd, 


7 


22 


23 


17 


23 


24 


29 


j 29 


36 


25 


32 


Discharged not im- 
proved, 


2 


20 


28 


22 


20 


28 


37 


I 29 


37 


66 


33 


Died, - 


4 


8 


8 


8 


9 


16 


22 


15 


12 


12 


22 


Eloped, - 


1 


1 


1 


1 




















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


153 


233 


241 


245 


306 


362 


397 


391 


399 


430 


458 


Patients remaining 
at the end of the 
year. - 


114 


118 


119 


138 


185 


218 


229 


236 


232 


238 


255 


Males admitted, 


96 


68 


51 


66 


94 


96 


80 


75 


73 


107 


111 


Females admitted, - 


57 


51 


62 


59 


74 


81 


99 


87 


90 


91 


109 


Males discharged, - 


19 


58 


57 


56 


65 


74 


66 


59 


71 


96 


92 


Females discharged, 


15 


48 


46 


41 


47 


54 


80 


81 


84 


83 


89 


Males died, - 


3 


5 


4 


6 


6 


10 


14 


9 


7 


3 


8 


Females died, 


1 


3 


4 


2 


3 


6 


8 


6 


5 


9 


14 


Patients sent by 

Courts, 
Private, 


109 
44 


55 

64 


90 
23 


117 

8 


129 
39 


123 
54 


123 
56 


106 
56 


110 
53 


157 
41 


152 

68 


Recoveries : 
Males, - 
Females, 


13 
12 


33 
31 


27 
25 


32 
26 


37 
32 


45 
31 


32 

48 


28 
54 


37 

45 


44 

44 


53 
63 


Average, - - | 


107 


117 


120 


127 


163 


211 


223| 


229 


233 


238 


244 



STATE LUNATIC HOSPITAL. 



39 



Statistics of some other American and British Institutions. 



McLean— 1842. 




York 


Asylum — 1842. 




Whole No. Admitted, 


2142 


Admitted from 1814 to 1842, 


1424 


" Discharged, 


2009 


Discharged 


u a 


1265 


" Recovered, 


957 


Recovered 


a a 


456 


Died, 


186 


Died 


a u 


272 


Ohio— 1843. 




Cornwall — 21 tears — 1842. 


Whole No. Admitted, 


473 


Admitted, 


... 


717 


" Discharged, 


325 


Discharged, 


. . 


577 


" Recovered, 


165 


Recovered, 


• • • 




" Died, 


51 


Died, 


• 


137 


Maine— 1842. 




St. Luke' 


s— 92 tears— 1842. 


Whole No. Admitted, 


222 


Admitted, 


• * ■ 


17,816 


" Discharged, 


157 


Discharged, 


- • • 


17,225 


" Recovered, 


74 


Recovered, 


. . . 


7414 


" Died, . 


12 


Died, 


. 


1684 


Vermont — 1843. 




Leicester — 1841. 




Whole No. Admitted, 


535 


Admitted, 


. 


337 


" Discharged, 


399 


Discharged, 


• • • 


195 


" Recovered, 


230 


Recovered, 


• • 


141 


" Died, 


36 


Died, 




42 


Retreat — Hartford — 


1843. 


Suffolk- 


-14 TEARS— 1842. 


Whole No. Admitted, 


1247 


Admitted, 


. 


1060 


" Discharged, 


1158 


Discharged, 


» • ■ 


843 


" Recovered, 


702 


Recovered, 


. 


435 


« Died, 


83 


Died, 


. 


279 


New Hampshire — 1843. 


Staffordshire — 1841. 




Whole No. Admitted, 


135 


Admitted, 


B 


2685 


" Discharged, 


74 


Discharged, 


• • • 


2447 


" Recovered, 


30 


Recovered, 


. . 


1161 


" Died, 


3 


Died, 


. 


518 


State Lunatic Hospital 


-1843. 


Kent— 


-9 TEARS— 1841. 




Whole No. Admitted, 


1777 


Admitted, 


. 


530 


" Discharged, 


1522 


Discharged, 


... 


282 


" Recovered, 


792 


Recovered, 


. 




" Died, 


136 


Died, 


• . • 


149 


Pennsylvania — 90 trs. to 1841. 


West Riding — Yorkshire— 


-1842. 


Whole No. Admitted, 


4366 


Admitted, 


. 


3006 


" Discharged, 


4257 


Discharged, 


... 


2628 


" Recovered, 


1493 


Recovered, 


... 


1662 


" Died, . 


610 


Died, 


. 


966 



40 



STATE LUNATIC HOSPITAL. 



Statistics — Continued. 



New Pennsyl'a Hosp'l— 


-1841 & '42. 


Belfast 


to 1842. 




Whole No. Admitted, 


299 


Admitted, 


. 


1243 


" Discharged, 


181 


Discharged, 


, 


859 


" Recovered, 


90 


Recovered, 


t # 


608 


" Died, 


21 


Died, 


• 


241 


Friends' Asylum — Frankford, Pa. 


Carlo w in 10 


TEARS 1842 




Whole No. Admitted, 


784 


Admitted, 


9 # 


*499 


" Discharged, 


648 


Discharged, 


. 


331 


" Recovered, 


263 


Recovered, 




226 


" Died, . 


87 


Died, 


• 


66 


BlOOMINGDALE 




Retreat near York. 




Whole No. Admitted, 


2684 


Admitted, 


. 


671 


" Discharged, 


2574 


Discharged, 


, 


577 


" Recovered, 


1195 


Recovered, 


t m 


315 


" Died, 


247 


Died, 


. 


154 



This table has always been valuable, as it shows at a glance the 
whole statistics of the eleven years, during which time these facts have 
been recorded. 

The additional records, taken with care from many reports, it has 
been thought might be interesting to those who like to investigate these 
subjects. 



STATE LUNATIC HOSPITAL. 



41 



TABLE 6. 
Statistics of the Different Seaso?is. 





1833 


1834 


1835 


1836 


1837 


1838 


1839 


1840 


1841 


1842 


1843 


























In Winter, 


27 


26 


24 


23 


26 


46 


39 


32 


31 


50 


51 


In Spring, 


72 


35 


31 


36 


49 


46 


38 


42 


37 


48 


58 


In Summer, 


23 


30 


30 


42 


40 


47 


59 


44 


51 


40 


56 


In Autumn, 


31 


28 


28 


24 


53 


38 


43 


44 


44 


60 


55 


Discharges — 
























In Winter, 





22 


21 


20 


14 


18 


31 


29 


35 


37 


44 


In Spring, 


1 


33 


30 


33 


36 


37 


3S 


38 


33 


46 


49 


In Summer, 


11 


28 


31 


24 


29 


44 


48 


41 


37 


46 


46 


In Autumn, 


23 


24 


22 


21 


33 


29 


29 


32 


50 


50 


42 


Recoveries — 
























In Winter, 





13 


13 


12 


10 


15 


13 


18 


20 


24 


24 


In Spring, 





20 


11 


15 


17 


23 


24 


22 


10 


22 


34 


In Summer, 


9 


16 


16 


12 


15 


18 


23 


20 


22 


23 


29 


In Autumn, 


16 


15 


12 


19 


27 


20 


20 


22 


30 


19 


29 


Deaths — 

In Winter, 





3 


1 





1 


3 


5 


6 


1 


4 


5 


In Spring, 


1 


2 


2 


1 


2 


5 


5 


6 


2 


1 


3 


In Summer, 


3 


3 


2 


4 


] 


5 


7 


1 


5 


3 


6 


In Autumn, 








3 


3 


5 


3 


5 


2 


4 


4 


8 



This table confirms our former experience, that in winter there is 
the least number of admissions, the least discharges, and the least 
deaths. Autumn is generally most favorable for recovery, summer 
has most deaths, but this year is an exception to the rule, as more have 
died in the autumn and more recovered in the spring. The table w ; !!, 
after a time, sustain or contradict the ancient opinion that insanity is 
more prevalent at certain seasons of the year than at others. 



42 



STATE LUNATIC HOSPITAL. 



TABLE 7. 
Classification of Insanity. 



Mania, 
Males, 
Females, 

Melancholia, 
Males, 
Females, 

Dementia, . 
Males, 
Females, 

Idiots, 

Males, 
Females, 



Whole No. No. of each Sex. Curable. Total of Curable. 



878 



610 



205 



11 



471 
407 



279 
331 



128 

77 



10 
1 



304 
276 



150 
211 



580 



361 



Following the old divisions of insanity, I have continued the table ; 
but as formerly, think little of the practical utility of this, or any other 
mode of classification. 

The periodically insane have distinct paroxysms of mania and melan- 
choly following each other, with short intervals, more or less lucid, be- 
tween each. In such cases the severity of one paroxysm is an indica- 
tion of the severity of the other. 

The demented are not always safe to be at large, neither are idiots; 
it is often necessary to confine both. Idiots are excluded from some of 
the institutions, but our experience shows, that they are often violent, 
mischievous and dangerous. There are no institutions in this country 
designed particularly for them, so that if confined at all it is proper that 
it should be in hospitals for the insane. Many persons, who are gener- 
ally esteemed idiots, are congenital insane ; I have seen many who 
have active, but never rational minds. 

In a nomenclature of mental diseases, lately published by Dr. John- 
son, of London, which received the prize offered by the society for the 
improvement of the condition of the insane, idiotism is regarded as 
having no affinity to insanity. 

I have been frequently visited by a class of persons resembling idiots 



STATE LUNATIC HOSPITAL. 43 

in some respects, but differing from them greatly in mental develop- 
ment, who had minds capable of acquiring knowledge to a certain ex- 
tent, whose bodies were active and well formed, which I believe is 
never the case with true idiots, and who were capable of doing many 
things well, but they were usually exceedingly mischievous, often ex- 
tremely passionate, and had the animal feelings and propensities strongly 
developed without the guidance of reason. I have been consulted in 
many such cases, and have had a few under my care in the hospital ; 
they are both troublesome and dangerous. 

Since I have been in this institution, I have had the care of a great 
number of demented patients, recently attacked, who seemed to be at 
once in the very worst condition of this form of disease, and to a stran- 
ger would look as discouraging as the worst old case of dementia. 
Such cases are not placed in this list in this or any former report. 
They often improve very soon, and almost always recover. They are 
extremely liable to forget all that passed while in this torpid state, 
differing in this respect from the violently insane, who generally re- 
member a great portion of their own conduct and their treatment from 
others. 

All writers on insanity in modern times recognize moral insanity, 
and the institutions abound with cases that belong to this class, in which 
estrangement and perversion of the moral feelings constitute the prin- 
cipal feature of the disease. It may not be always easy to distinguish 
between moral insanity and moral turpitude, but it is as easy as to dis- 
tinguish between sincerity and hypocrisy, or between health and the 
first rudiments of disease. If an individual who had always been a quiet 
and orderly citizen, humane and benevolent, of equal temper and mod- 
est demeanor, should become the reverse of this, either gradually or 
suddenly, his feelings and conduct evincing a great change, his whole 
character being transformed, we should in charity be more inclined to 
consider him insane than wicked ; and if we should find that, at the 
time of this change or preceding it, he had had headach and confusion, 
noise in his ears or vertigo, that his sleep had been disturbed, his diges- 
tion bad, that costiveness or other irritations had attended him, or if we 
should discover that a cause, either mental or physical, which might be 
supposed to disturb the functions of the brain, had preceded this change, 
we should be confirmed in the opinion that the alteration of character, 
appearance and conduct was the result of disease. Such a state of the 
system would be sufficient to produce any other form of insanity as 
well as this, the symptoms of which would be wholly unequivocal. 



44 STATE LUNATIC HOSPITAL. 

In all cases of moral insanity there is physical disease, which may- 
be detected by a physician conversant with insanity, its precursors and 
concomitants, though it may not easily be discerned by a court or jury, 
however enlightened in the law. The distinction which I would make 
between moral insanity and moral turpitude, is, that in the former, some 
diseased functions of organs, more or less intimately connected with 
the brain and nerves, has preceded or accompanies it. There is an- 
other fact in this connection worthy of a passing remark. It is, that, in 
cases of insanity in which the intellect is involved so as to make it cer- 
tain that insanity exists, the moral feelings often become first affected ; 
the individual appears strange, is morose when he has been kind, vio- 
lent when he is naturally mild, passionate when he has been calm and 
pleasant, and all this before the intellect becomes disturbed. Nothing 
is more common than for friends to state to us, when they bring pa- 
tients who are violently insane to our care, that, before they became so, 
there was, for weeks or months, a change in their feelings for which 
they were unable to account, but that they did not think them insane 
till they became violent, threatened mischief, or exhibited some delu- 
sion. In all great and sudden excitements of the mind, the feelings are 
disturbed before the understanding is influenced ; under provocation, 
the temper is enraged before the judgment is perverted and volition 
excited ; causes of grief first awaken tender feelings before they influ- 
ence the intellect ; our sympathies are first excited before the mind 
moves to dispense its charities. So in disease — even delirium in fever 
and other acute diseases rarely affects the understanding till it produces 
irritability, impatience, and excitement of the feelings. Is it surprising 
that, in insanity, functions so active should be uncontrollably affected 
alone when they are so frequently, I might say universally, concomi- 
tants of mental derangement ? The subject is one of deep interest, and 
should not be dismissed hastily in the examination of those arraigned 
for crime or suspected of insanity. 

In monomania, it is impossible to say how much the other faculties 
are disturbed besides those which are the subjects of delusion. I have 
long thought that the monomaniac should not be held responsible for 
opinions or acts not apparently connected with his delusion. Where 
monomania is known to exist, and the individual commits some act of 
atrocity for which he is arraigned before a court of justice, the burthen 
of proof ought to be on the prosecution to show that the act is discon- 
nected with the delusion, rather than on the defence to show that it is 
connected with it. I have long held this opinion, because I do not be- 



STATE LUNATIC HOSPITAL. 45 

lieve that an important function of the mind cannot be disturbed, so as 
to produce a delusion, without, in some measure, disturbing the whole 
mind and the feelings in some degree. Our experience confirms this, 
as we see daily in hospitals that monomaniacs are passionate, impulsive, 
and often extremely irritable. A large class of the homicidal insane 
are of this character. We have at this time in the hospital quite a 
number, who are at times the lest and yet often the most dangerous 
persons under our care. I have witnessed many a struggle with the 
insane to control their feelings under irritation, to act and appear like 
other men, but in many cases they succeed but indifferently. As the 
intoxicated man often supposes he walks straighlly when all others see 
him stagger, so the insane man often supposes that he appears quite 
well when all around him discover perversion and waywardness. Dr. 
Johnson remarks on this subject, "In most cases of what has been 
called monomania, the patient's delusion is not confined to one subject, 
or series of subjects, but the insane character of mind is shown in other 
instances, by his conduct and conversation." 

Dr. Copeland says : " Most authors have erred in viewing the more 
partial or slighter forms of insanity as consisting of derangement of 
one or of a few merely of the intellectual or moral manifestations; 
although a single faculty or manifestation may be prominently disor- 
dered, or a single train of ideas be almost exclusively entertained, the 
other mental faculties are never in a healthy state, or very rarely re- 
tain their former energy." 

In the absence of strong motives the insane man acts differently from 
what he does under their influence ; hence, one of the best means of 
relieving the disease is to constantly present motives for self-control. 
Motives also influence them strongly to do acts of violence or mischief 
when counteracting or antagonising influences, being disturbed by dis- 
ease, do not interfere with and prevent them. Under active impulses 
the insane do many things which they cannot account for or prevent, 
and for which they almost immediately feel mortification and regret. 
In such cases the mind acts intently in one direction, while all the usual 
governing influences are excluded, or in a kind of reverie ; he thus 
commits acts of enormity or petty mischief which he immediately re- 
grets, and yet, under the same circumstances, he repeats them and 
again repents and promises amendment. The mind of the monomaniac, 
under such circumstances, is often confused and disjointed ; he cannot 
give a clear account of his conduct, or the motives that led to it. The 
mind is not balanced ; some of its faculties are active and some are 



46 STATE LUNATIC HOSPITAL. 

tardy in their operations. Hence estrangement of feeling and eccen- 
tricity of conduct. 

In the case of Hadfield, for whom Lord Erskine made the celebrated 
defence, which alone would have immortalized his name, right and 
wrong were entirely overlooked ; he had a higher object than any such 
considerations as they appeared to others, or as they really were. It 
was necessary for the good of mankind that he should die, and he 
could not conscientiously take his own life. There was but one alter- 
native ; he must take the life of some one to so exasperate the public 
mind that he would certainly be executed. He knew that he was vio- 
lating the law of the country ; he hoped that in the faithful execution 
of that law he should die and his grand scheme be consummated. He 
was not ignorant of the law, but, on the contrary, he hoped, in the due 
execution of the law, to see accomplished the great object for which he 
conceived he must give up his life. 

If the English law, as laid down by the fifteen judges, had been 
faithfully enforced, Hadfield would have been executed. " In answer 
to the first question," say the judges, " assuming that your lordship's 
enquiries are confined to those persons who labor under such partial 
delusions only, and are not in other respects insane, we are of opinion 
that notwithstanding the party accused did the act complained of with 
a view, under the influence of insane delusion, of redressing or aveng- 
ing some supposed grievance or injury, or of producing some public 
benefit, he is nevertheless punishable, according to the nature of the 
crime committed, if he knew, at the time of committing such crime, 
that he was acting contrary to law, by which expression we understand 
your lordships to mean the law of the land." Did not Hadfield know 
that he was acting contrary to the law of the land, when he shot at the 
king, with a full expectation that the execution of the law would con- 
summate his wishes and designs ? So Hathaway, when he struck 
Richards three blows, one in the name of the Father, one in the name 
of the Son, and one in the name of the Holy Ghost, would not have 
been deterred by any knowledge of the law or its consequences. He 
supposed that it was his duty to obey God rather than man ; he was 
acting by higher authority than that of any earthly tribunal, — it was a 
command from heaven. Hathaway was a monomaniac. So Elmer, 
when he received the command to kill the infant in the cradle, would 
not have been prevented by the fear of any human law, when he had 
received commands from heaven to take the life of the child and to slay 
two others. Davis killed Edwards by command of General Washing- 



STATE LUNATIC HOSPITAL. 47 

ton, whom he saw soaring in the air, and from whom he distinctly 
heard the order. 

In all these cases the mind acts impulsively ; the victim of disease 
does not stop to consider at the time, as the rational mind would, the 
evidence of Divine authority. The mind is unbalanced, and the antag- 
onizing influences are not brought to bear upon it till the deed is done 
and the mischief is accomplished. Then lamentation and sorrow often 
follow, and now, after a lapse of many years, Elmer cries daily, in 
language of deep contrition and supplication, that he may be forgiven 
this great sin. The decision of the judges does not include these cases, 
the most common and aggravated insane homicides. 

The case of McNaugton, who killed Mr. Drummond, mistaking him 
for Sir Robert Peel, whose secretary he was, illustrates another princi- 
ple. It appears to me to be a case that should have been condemned by 
the rule of law established by the English judges. McNaughton supposed 
that Sir Robert Peel was his enemy, trying in every way to do him in- 
jury — even seeking his life. He thought that he should be destroyed if 
Sir Robert Peel was suffered to live ; in self-defence he killed Mr. 
Drummond, mistaking him for Sir Robert. 

We learn by the English periodicals, that the impression is very 
general in Great Britain, that McNaughton knew right from wrong, and 
that he was acting with a full knowledge of the law of the land. 

Mr. Rumbull has published a pamphlet, chiefly devoted to an exami- 
nation of the case of McNaughton. He says there is not a man in the 
country who does not feel that the late decision was a legal, but not an 
equitable one ; that a foul murder has been committed and justice is 
unsatisfied. If, however, McNaughton labored under a delusion re- 
specting the unfavorable feelings of the minister, as he doubtless did, 
and acted in self-defence, he was an insane man. Would British equity 
require such a man to be punished, especially when he was legally ac- 
quitted by the highest tribunal in the land ? 

It has been said that insanity should not be inferred in any case from 
an act which was the first evidence of delusion. This would be erro- 
neous in any other case, and clearly so in insanity where the delusion 
continues. We judge of insanity only by the appearance and conduct 
of the individual. The first act that shows the insanity may be one of 
great atrocity or one of petty mischief, and the mind may have been 
struggling long against the act, which, with the motive before it, could 
no longer be resisted. 

Monomania is insanity ; by it the integrity of the mind is disturbed, 



48 STATE LUNATIC HOSPITAL. 

and, after it is fully established, the mind can no more be considered 
sound, than the body can be considered well when severe local disease 
exists in it. One fact goes far to sustain this view of monomania, 
which is, that under its influence the mind becomes imbecile, and in 
many cases demented. This would hardly be the case if the disease 
did not in a greater or less degree disturb the whole brain. 

Any slight cause of alienation of mind, such as arises from intempe- 
rance, loss of memory, old age, or disease with some degree of mental 
weakness, is considered sufficient to deprive a man of his civil rights, 
and he is placed under guardianship ; but if he does a criminal act, the 
case must be made very clear, or he will be condemned and punished. 
Yet many persons are capable of taking care of property well who 
labor under delusions, but such individuals must be considered insane. 
We should not undertake to divide the mind and say what part is sane 
and what part insane, till we are better able to say what man is insane 
and what one is not. 

While all the mind is more or less disturbed in monomania, some of 
the faculties seem to preserve a good degree of soundness in the worst 
forms of mania and melancholy. 

The homicidal insane in this institution, and we have had many such, 
are nearly all peculiar, and unlike other monomaniacs. Many of them 
have been a long time in confinement, and they are alike irritable, im- 
pulsive, jealous, uneasy, passionate, and often very unreasonable. 

One patient now with us is a good laborer, judicious in his business 
and sensible in his observations and remarks, yet he occasionally sees 
visions and dreams dreams of the strangest character. Not long since 
he saw a most magnificent ball playing upon a hill in the neighborhood 
of the hospital, which appeared to him to be of the purest gold. His 
vision is not generally disturbed, and he is a quiet, religious man, but is 
extremely dangerous when excited, and at such times is always greatly 
confused. 



STATE LUNATIC HOSPITAL. 



49 



TABLE 8. 

Causes of Insanity and circumstances connected with causes and predis- 
position to Insanity. 



Intemperance, . 


239 


Fright 


11 


Ill Health, 


279 


Hereditary, or having insane 




Masturbation, . 


133 


ancestors or kindred, 


503 


Domestic Afflictions, 


179 


Periodical, 


35G 


Religious, 


148 


Homicidal, 


20 


Property, 


98 


Have committed Homicide, . 


15 


Disappointed Affection, 


G4 


Suicidal, .... 


1S8 


Disippoinled Ambition, 


33 


Have committed Suicide, 


8 


Epilepsy, 


45 






Puerperal, 


47 


Have dark hair, eyes and 




Wounds on the Head, 


21 


complexion, 


589 


Abuse of Snuff and Tobac 


co, 8 


Have light hair, eyes and 




Jealousy, . . . 


5 


complexion, 


603 



Arising from physical causes, 
Arising from moral causes, . 

Many not classed. 



722 

538 



The coincidence of this table, with the records of other institutions, 
shows conclusively, that if we have failed in rightly ascertaining 
causes, we have only fallen into a common error. I have looked into 
a great number of reports of other institutions, to ascertain the most 
prominent causes of insanity, and have been struck with the corres- 
pondence, both in this country and in Europe. 

Following out my plan, I give the records of causes, as given in 
some of the reports to which I have alluded. 



50 



STATE LUNATIC HOSPITAL. 



American. 



In the McLean Asylum, 1836, 136 
patients, the cause was 

111 health, in . . 26 



Intemperance, 
Masturbation, 
Disappointment, 
Religious, . 
Puerperal, . 



16 
7 
6 
5 
5 



In the Hartford Retreat, 1247 pa- 
tients : 

Intemperance, . . 103 
111 health, . . . 155 
Religious, . . . 110 
Trouble and disappoint- 
ment, ... 65 
Puerperal, 46 
Masturbation, . . 23 

Ohio Lunatic Asylum. 408 patients : 
111 health, . .57 

Intemperance, . . 32 

Religious, ... 54 
Trouble and disappoint- 
ment, ... 50 
Masturbation, . . 24 

Puerperal, ... 31 

Pennsylvania Hospital, 299 patients, 
1842: 
111 health, ... 46 
20 
23 
20 
15 
9 
3 
2 



British. 



Intemperance, 
Loss of property, 
Loss of friends, 
Religious, . 
Puerperal, . 
Masturbation, 
Tobacco, 



Friends' Asylum, Frankford, 97 pa- 
tients : 

111 health, ... 10 



Intemperance, 
Trouble, 
Religious, . 
Pecuniary, . 
Love, 
Masturbation, 



Hanwell, of 166 cases, 1842 ; 
Intemperance, 
Epilepsy, . 
Poverty, 

Grief and trouble, 
Reverses, . 
Religious, . 
Many not given. 



Edinburgh, of 34 cases, 1842 
Intemperance, 
111 health, . 
Loss of property, 
Loss of friends, . 
Religious, . 
Many not given. 



Belfast, 115 cases, 1842: 
Intemperance, 
111 health, . 
Embarrassment, 
Puerperal, . 
Fright, 
Poverty, 



Dundee, 53 cases, 1842 : 
Intemperance, 
111 health, . 
Ill treatment, 
Fever, 
Poverty, 
Masturbation and Epi 
lepsy, 



Carlow, 492 cases : 

Intemperance and dissi 

pation, 
Grief, 
Fever, 
Trouble, . 
Bodily injury, 
Puerperal, . 
Religious, . 
Jealousy, 



28 
20 
14 
17 
5 
4 



12 
15 

8 
7 
7 
6 



13 
5 
3 
3 
2 



91 
31 
29 
23 
23 
11 
9 
18 



STATE LUNATIC HOSPITAL. 



51 



Staunton, Va., 1842, 127 


cases : 




West Riding, 128 cases: 




111 health, . 




33 


Disappointment, . 


16 


Intemperance, 




20 


Intemperance, 


10 


Religious, . 




14 


Epilepsy and masturba 




Domestic afflictions, 




12 


tion, 


7 


Masturbation, 




5 


Palsy, 


1 


Pecuniary trouble, 




10 


Fright, 

Injury of the brain, 


1 

4 


Williamsburg, Va., 1842, 


75 cases : 


Many not given. 




111 health, . 




11 






Intemperance, 




10 




. 


Trouble, . 




11 






Domestic afflictions, 




9 


Gloucester, 200 cases : 




Religious, . 




8 


Intemperance, 


12 


Love, 




6 


Epilepsy, . 


10 


Tobacco, 




1 


Religious, . 
Puerperal, . 


8 
6 


Bloomingdale, 1842, 179 


cases : 




Love, 


4 


Intemperance, 




19 


Loss of friends, . 


4 


Masturbation, 


. 


15 


Many not given. 




Puerperal, . 


. 


15 






Religious, . 


. 


14 






Love, 


. 


14 






Trouble, . 


• 


13 


Glasgow, 199 cases, 1841 : 
Intemperance, 


46 


South Boston Lunatic Asylum 


, 32 


Poverty, 


17 


cases : 






Religious, . 


10 


Intemperance, 




8 


Love, 


4 


111 health, . 


. 


4 


Epilepsy, . 


3 


Masturbation, 


. 


3 


Masturbation, 


2 


Domestic trouble, 


. 


3 


Many not given. 




Millerism, . 




2 






State Lunatic Hospital, Ms. 1777 ca- 






ses, 1843: 






Lancaster, 1841, of 75 cases, 


known : 


111 health, . 


. 


279 


Intemperance, 2 cornpli 




Intemperance, 


. 


239 


cated, 


12 


Domestic afflictions, 


. 


179 


Religious, . 


8 


Religious, . 


. 


148 


Epilepsy, . 


10 


Masturbation, 


. 


133 


Puerperal, . 


6 


Property, 


• 


90 


Palsy, 


3 



It may not be improper to remark, that in almost all the tables refer- 
red to, a large proportion are stated as cause unknown. 

Intemperance takes a prominent stand in almost every table of Brit- 
ish or American statistics of " cause." It has ever been considered 
as first and foremost of influences which distract and destroy the ner- 
vous system. Delirium tremens arises almost solely from this cause. 
Apoplexy, palsy, epilepsy and other diseases arise from it and termi- 
nate in insanity. These are the physical causes of insanity which arise 
from intemperance, but it is impossible to say how many of the moral 



52 STATE LUNATIC HOSPITAL. 

causes are more or less connected with this great evil, which not only 
produces pecuniary embarrassments, but domestic afflictions, family 
trouble, disappointments of various kinds, and that poverty, which, in 
Europe and in large cities in this country, brings many under the influ- 
ence of this great calamity. 

In my report of the last year, I showed, by dividing the cases arising 
from intemperance into four equal parts, that the first admitted had 81 
from intemperance, and the lost quarter admitted had 38. In all, the 
per cont. was 14£. This year the cases have been 14 of 220, which is 
6f per cent , not half what it was the eleven years previous. One fact 
is to be considered ; the first cases of insanity that came into the hos- 
pital were brought from the jails and other public receptacles of poverty 
and wretchedness, and contained a large proportion of persons who 
were the victims of this habit. 

■^ The number of cases of insanity from religious causes has increased 
the past year in most of the institutions in this country. In this hospi- 
tal, 28 cases of 220 are supposed to have arisen from this cause, 15 of 
which were attributed to the Miller excitement, and much larger pro- 
portions are ascribed to the same cause in some of the New England 
institutions. It is rare that a popular religious error has produced so 
much excitement in the community and rendered so many insane. 
This is not surprising as the subject is momentous, the time fixed for 
the final consummation of all things so near at hand, and the truth of 
all sustained by unerring mathematics. 

The believers in the second advent who have become insane, are 
subjects of the highest excitement; they are full of ecstacy and think 
of nothing but being soon transported to all the enjoyments of heaven. 
But there is another class who have not embraced the doctrine, but who 
have feared it might be true, who have distracted their minds by puz- 
zling over it, thinking about it, and dreading its approach, who have 
sunk into deep and hapless melancholy, which it is a hard task to re- 
move. We find that many of the religious melancholies of the season, 
who have not apparently been made insane by this cause, have been 
more or less disturbed by the contemplation of it. Two patients were 
brought to the hospital in one day, who, laboring under the delusions 
connected with this subject, finally concluded that they were inspired, 
and should hereafter live miraculously, and refused to eat or drink for 
several days. 

Early last winter many cases from this cause came under our care. 
If they were recent, and not greatly exhausted, they recovered favor- 



STATE LUNATIC HOSPITAL. 53 

ably. Two died from exhaustion after the highest excitement, and a 
few have apparently become hopelessly insane. 

The excitement now appears to be gradually subsiding; though its 
influence will be felt some time longer, yet it must finally give way to 
some new, popular belief. It will be fortunate for the community if it 
be less exciting and less prejudicial to the best interests of society. 

The human mind cannot always be contented to pursue the safe and 
beaten track of experience. There are those who are looking for 
" some other way," by which they may arrive at the greatest good. 
As one delusion passes by, another comes, to be seized and made use 
of, by the truly conscientious no less than by the wicked and designing. 

A large proportion of mankind seem not to have learned that religion 
is to be exhibited by the life, by the whole life, and not by feverish 
excitement, ebullitions of distempered fancy, zeal without knowledge, 
and professions without practice. 

We live at a time when the steady principles which have governed 
societ)' seem to be too generally loosened. 

All professions, unless it be the legal, have about an equal share of 
quackery. Mankind generally trust their monied controversies and 
other litigations in the ablest hands, but will jeopardize health and their 
spiritual interests by seeking the counsels of empiricism. 

As ignorance gives place to knowledge, these absurdities will pass 
away ; reason and science will remove the errors which cluster so 
thickly upon these times. It is characteristic of quackery to be always 
changing; to be inventing something new to dupe mankind ; while sci- 
ence and experience make a steady if not uniform progress in improve- 
ment. 

Though we live in times of excitement, and a few are made insane 
by the popular delusions of the day, the great majority of the commu- 
nity pursue the safe road to happiness pointed out in the unerring ora- 
cles of truth. Christianity is a rational system of religion ; it com- 
mends itself to the higher and nobler faculties of man. Whatever of 
animal feeling is exhibited in connection with it, is but the dross which 
is to be separated as useless and debasing. 



54 



STATE LUNATIC HOSPITAL. 



TABLE 9. 
Occupation. 



Farmers, . 


212 


Innkeepers, 


3 


Laborers, . 


147 


Stevedores, 


2 


Shoemakers, 


70 


Stone cutters, 


3 


Seamen, . 


61 


Broom-makers, 


2 


Merchants, 


69 


Coppersmiths, 


2 


Carpenters, 


44 


Watchmen, 


2 


Manufacturers, 


32 


Drovers, . 


2 


Teachers, 


26 


Curriers, . 


2 


Students, . 


24 


Card-makers, 


2 


Blacksmiths, 


18 


Furrier, 




Printers, . 


20 


News Collector, 




Tailors, . . . 


12 


Broker, 




Machinists, 


11 


Engineer, 




Clothiers, . 


7 


Hatter, 




Coopers, . 


9 


Gardener, 




Bricklayers, 


9 


Mat-maker, 




Millers, . 


5 


Stocking-weaver, . 




Cabinet-makers, 


9 


Bellows-maker, 




Clergymen, 


7 


Pump and Block-maker, 




Lawyers, . 


6 


Chair -maker, 




Bakers, 


5 


Tobacconist, 




Musicians, 


4 


Auctioneer, 




Pedlers, 


4 


Miniature painter, 




Painters, . 


6 


Weaver, . 




Rope-makers, 


5 


Wheelwright, 




Paper- makers, 


4 


Barbers, . 




Calico printers, 


3 


Bookbinder, 




Sail-makers, 


5 


Soldier, 




Tanners, . 


3 


Carriage-maker, 




Comb -makers, 


3 


Females not accustomed t< 


) 


Turners, . 


3 


labor, 


164 


Harness-makers, . 


3 


Females accustomed to se 




Physicians, 


5 


dentary employments, 


187 


Coachmen, 


3 


Females accustomed to ac 




Butchers, . 


3 


tive employments, 


278 


Jewellers, 


4 


Many not classed. 





I have found such a coincidence of occupation in several institutions 
for the insane, that I feel that the records of the table arc of increased 
value. I have found all to have the largest number of farmers, and a 
laro-e number from occupations most predominant on our list. 

At the Bloomingdale Asylum, there were, in one year, farmers, 12; 
farmers' wives and daughters, 29 ; merchants, 12 ; seamen, 10 ; law- 
yers, 8 ; physicians, 4 ; clergymen, 2. 



STATE LUNATIC HOSPITAL. 55 

At the Hartford Retreat, farmers and sons, 19 ; farmers' wives and 
daughters, 12 ; merchants and sons, 12 ; students, male and female, 
13 ; shoemakers, 4. 

At the Pennsylvania Hospital, of 91 cases, there were farmers, 16; 
merchants, 9; clerks, 8 ; physicians, 6; seamen, 4; carpenters, 3; 
printers, 3. 

At the McLean Asylum, for twenty years, farmers, 184 ; merchants, 
132 ; mariners, 69 ; carpenters, 53 ; shoemakers, 44 ; students, 42 ; 
physicians, 25 ; lawyers, 16; clergymen, 10. 

At the New Hampshire Asylum, of 39 cases, there were farmers, 
22 ; carpenters, 5 ; merchants, 4 ; shoemakers, 2. 

At Williamsburg, Va , of 52 cases, there were farmers, 19 ; labor- 
ers, 8; shoemakers, 5; carpenters, 3; teachers, 3. 

At the Frankford Asylum, of 200 men, there were farmers, 91 ; 
clerks, 14 ; students, 6 ; tanners and curriers, 7 ; carpenters, 6 ; law- 
yers, 5 ; physicians, 5 ; clergymen, 2. 

At the Friends' Asylum, York, England, of all trades, 48 ; trades- 
men's wives and daughters, 46 ; farmers, 35 ; farmers' wives and 
daughters, 28 ; gentlemen, 7 ; gentlewomen, 31; school teachers and 
governesses, 24 ; manufacturers, 13 ; domestics or laborers, 39. 

It is certainly an interesting inquiry whether one kind of business, 
more than another, predisposes to insanity. The accumulation of facts, 
such as the table records, can only determine the question. Full records 
from all the institutions in our country would, in sufficient time, present 
incontrovertible evidence on the subject, as nothing is more easily as- 
certained than the employments of men. 

A cursory view of the above list would lead the inquirer to believe 
that farmers and their families were more prone to insanity than other 
classes of citizens; but a reference to the census of the United States, 
and to that of this Commonwealth, will show that this is not the case. 
Of 17,062,666, the population of the United States, 3,717,756 are em- 
ployed in agriculture, nearly one quarter of the population; 117,575 
are employed in commerce; 791,545 in trades and manufactures; 
65,236 in the learned professions. 

In Massachusetts, of the 737,699 inhabitants, 87,837 are employed 
in agriculture, 8,063 in commerce, 85,176 in trades and manufactures, 
27,153 seamen, 3,804 in the learned professions. 

In this State, all the trades and manufactures furnish many more pa- 
tients than agriculture, though there are more persons engaged in agri- 
culture than in all these employments. So that this occupation, great 



56 



STATE LUNATIC HOSPITAL. 



as is the list, does not furnish an average number of insane in propor- 
tion to the population. 

212 farmers, of 87,837, the proportion of the farming population of 
the State, is 24-100 per cent. 

321 patients of different trades, of 85,176, the number of those thus 
employed, is 37-100 per cent. 

61 seamen, of 27,153, is 22-100 per cent. 

69 merchants, of 8,063, is 85-100 per cent. 

18 from the learned professions, of 3,804, is 47-100 per cent. 



TABLE 10. 
Diseases which have proved fatal. 



Marasmus, 




30 


Dysenteric Fever, 


2 


Epilepsy, . 




15 


Chronic Dysentery, 


3 


Consumption, 




13 


Lung Fever, 


3 


Apoplexy and Palsy, 




12 


Bronchitis, 


2 


Suicide, 




8 


Old Age, . 


1 


Disease of the Heart, 




10 


Gastric Fever, 


1 


Cholera Morbus, . 




4 


Land Scurvy, , 


1 


Hemorrhage, 




5 


Congestive Fever, 


1 


Inflammation of the Brain 


6 


Erysipelas, 


3 


Inflammation of the Bowels 


4 


Disease of Bladder, 


1 


Mortification of the Limbs 


3 


Concussion of Brain, 


1 


Dropsy, . 




3 






Diarrhoea, 




2 




___ 


Disease of Brain from 


In 








temperance, 




2 


Total, 


136 



Though the number of deaths in the hospital the present year has 
been large, no acute disease has prevailed to any extent. The deaths 
have been from the same causes as heretofore. One case of concussion 
of the brain from a fall, is all the new record of the cause of death in 
the table. 

The causes of death are frequently connected with insanity, but are 
not always so. The insane are particularly predisposed to wasting 
from disease of the digestive organs and the lungs. The heart also 
comes in for a full share of suffering in fatal cases of insanity, as well 
as many that are not fatal. These cases arc mostly chronic. 

In the McLean Asylum, 1836, of 10 deaths, 2 were from marasmus, 
1 from consumption, 2 acute inflammation of the mucus membrane, 1 
dysentery, 1 convulsions, 1 old age, 1 suicide, 1 fracture of neck of 
thigh bone. 



STATE LUNATIC HOSPITAL. 57 

In the Ohio Asylum, of 47 deaths, 11 were from dysentery, 9 from 
marasmus and inanition, 8 from diarrhoea, 3 epilepsy, 3 consumption, 
and 4 from apoplexy and palsy. 

In the South Boston Hospital, 1843, of 9 deaths, 3 were from con- 
sumption, 3 epilepsy, 1 erysipelas, 1 apoplexy, 2 marasmus and general 
debility. 

In the Friends' Asylum, Frankford, Pa., of 10 deaths, 1 was from 
consumption, 1 disease of the heart, 1 epilepsy, 1 inflammation of the 
brain, 1 marasmus, 1 abscess of the brain, 1 old age, 1 dropsy, 2 me- 
ningitis. 

In the West Riding Asylum, Yorkshire, England, of 57 deaths, 10 
were from general debility, (marasmus,) 8 consumption, 11 epilepsy, 
9 old age, 5 palsy and apoplexy. 

In the Dundee Asylum, Scotland, of 10 deaths, 3 were from apo- 
plexy, 2 dropsy of the chest, 2 marasmus and 3 others. 

In the Hanwell Asylum, near London, of 91 deaths, 22 were from 
marasmus or general debility, 18 palsy, 15 consumption, 7 epilepsy, 
5 apoplexy. 

In the Belfast Asylum, Ireland, of 27 deaths, 11 were from maras- 
mus, 6 palsy, 4 consumption, ] epilepsy, 1 apoplexy. 

In the Lincoln Asylum, of 159 deaths, 3S were from marasmus and 
exhaustion, 13 apoplexy, 12 consumption, 11 epilepsy, 7 suicide, 6 dis- 
ease of the brain, 4 palsy, 7 dropsy, 8 old age. 

These records correspond so nearly with each other and our own, 
that we shall not hesitate to consider them accurate statistics, and sure 
guides to the fatal diseases of the insane. 



58 



STATE LUNATIC HOSPITAL. 



TABLE 11. 



Showing the comparative Expense of supporting old and recent Cases 
of Insanity, from which we learn the economy of placing patients in 
Institutions in the early periods of Disease. 



No. of 
the Old 
Cases. 


Present 
Age. 


Time Insane. 


Totnl Expense 
at $100 a year 
before entering 
tr.e Hospital, & 
$132 a yr. since, 
last year $l'i0. 


No. of the 
recent cases 
discharged. 


Present 
Age. 


Time Insane. 


Co.-tof sup- 
pOitut$2 30 

per week. 


2 


69 


28 years. 


$3212 00 


1622 


30 


7 weeks. 


$16 10 


7 


48 


17 " 


2004 00 


1624 


34 


20 


u 


46 00 


8 


60 


21 " 


2504 00 


1625 


51 


32 


a 


73 60 


12 


47 


25 " 


2894 00 


1635 


23 


28 


a 


64 40 


18 


71 


34 " 


3794 00 


1642 


42 


40 


a 


92 00 


19 


59 


18 " 


2204 00 


1643 


55 


14 


it 


32 20 


21 


39 


16 " 


1993 00 


1645 


63 


36 


(i 


82 80 


27 


47 


16 " 


1994 00 


1649 


22 


40 


it 


92 00 


44 


56 


26 " 


2982 00 


1650 


36 


28 


M 


64 40 


45 


60 


25 '< 


2835 00 


1658 


36 


14 


U 


32 20 


102 


53 


25 " 


2833 00 


1660 


21 


16 


a 


36 80 


133 


44 


13 " 


1431 00 


1661 


19 


27 


it 


62 10 


176 


55 


20 « 


2486 00 


1672 


40 


11 


ti 


25 70 


209 


39 


16 « 


1964 00 


1676 


23 


23 


ti 


52 90 


223 


50 


20 " 


2364 00 


1688 


23 


11 


It 


25 70 


260 


47 


16 " 


2112 00 


1690 


23 


27 


M 


62 10 


278 


49 


10 " 


1424 00 


1691 


37 


20 


It 


46 00 


319 


53 


10 " 


1247 00 


1699 


30 


28 


ti 


64 40 


347 


58 


14 " 


1644 00 


1705 


24 


17 


il 


39 10 


367 


40 


12 " 


1444 00 


1706 


55 


10 


ti 


23 00 


400 


43 


14 " 


1644 00 


1709 


17 


10 


il 


23 00 


425 


48 


13 " 


2112 00 


1715 


19 


40 


U 


92 00 


431 


36 


13 " 


1412 00 


1716 


35 


48 


cc 


110 40 


435 


55 


15 " 


1712 00 


1728 


52 


55 


ti 


126 50 


488 


37 


17 " 


1912 00 


1737 


30 


33 


it 


75 90 




454 years. 


54,157 00 


635 weeks. 


1461 30 


Average expense of o 


,d cases, 


. 


m 




216 


3 20 


Whole expense of 25 


old cases, 


. 


. 


. 


54,15 


7 00 


Average expense of r 


ecent cases, 


. 


. 




. 5 


3 45 


Whole expense of 25 


recent cases 


till recov 


;red, 


• 


146 


1 30 



The results of this table are so striking, and show so conclusively the 
importance of early admission to the insane hospitals, that many other 
institutions have instituted the same inquiry with similar results. 



STATE LUNATIC HOSPITAL. 59 

In the report of 1840, the number of years that the 25 old cases had 
been insane, was 413; the whole expense of their support during that 
time, $47,590 00; the average, $1,903 60. The time that the 25 re- 
cent cases had been confined, was 556 weeks ; the expense, $1,400 00 ; 
the average, $56 00. 

In 1841, whole cost of 25 old cases, - - $49,248 00 

Average, .... 1,969 00 

Whole cost of 25 recent cases, - - 1,330 50 

Average, - - - - 52 22 

In 1842, whole expense of 25 old cases, - - $50,611 00 

Average, .... 2,020 00 

Whole expense of 25 recent cases, - 1,130 00 

Average, - - - « 45 20 

In the Ohio Lunatic Asylum, 1842, twenty old cases cost $28,288 00 

Average, .... 1,414 40 

Twenty recent cases cost, - - - 1,281 00 

Average, - - - - 64 05 

In Maine, 1842, whole expense of 12 old cases, - $25,300 00 

Average, - - - 2,108 33 

Whole expense of 12 recent cases, - 426 00 

Average, - - - - 35 10 

In Staunton, Va., whole expense of 20 old cases, - $41,633 00 

Average, .... 2,082 65 

Whole expense of 20 recent cases, - 1,265 00 

Average, - - - - 63 25 



60 



STATE LUNATIC HOSPITAL. 



TABLE 12. 

Showing the duration of Insanity, the ages arid civil stale of the Pa- 
tients in the Hospital, admitted last year and previous years. 





1833 


18341835 


1836 


1837 


1838 


1839 


1840 


1841 


1842 


1843 


Duration before ad- 


















mission : 
























Less than 1 year, 


41 


56 


48 


54 


72 


82 


84 


75 


81 


106 


129 


From 1 to 5 years, 


27 


29 


37 


37 


58 


5(i 


63 


50 


52 


58 


62 


" 5 to 10 " 


27 


14 


15 


13 


14 


16 


18 


15 


12 


13 


15 


" 10 to 20 " 


31 


6 


5 


11 


14 


& 


10 


10 


10 


5 


7 


" 20 to 30 " 


12 


4 





2 


4 


7 


1 


3 


4 


5 


1 


. " 30 to 40 « 


3 


2 


1 


2 


1 


1 


1 


2 





4 


1 


Unknown, 


12 


8 


7 


6 


5 


13 


2 


1 


4 


7 


5 




153 


119 113 


125 


168 


177 


179 


102 


163 


198 


220 


Duration with those 
























remaining at the 
























end of each year : 
























Less than 1 year, 


26 


22 


21 


11 


29 


28 


34 


28 


32 


40 


45 


From I to 5 3? ears, 


23 


25 


22 


39 


51 


65 


69 


75 


74 


89 


74 


" 5 to 10 " 


20 


24 


34 


35 


38 


44 


44 


52 


53 


38 


55 


" 30 to 20 « 


28 


24 


29 


35 


41 


41 


52 


52 


45 


37 


52 


" 20 to 30 " 


7 


5 


3 


7 


11 


18 


14 


13 


15 


18 


19 


" 30 to 40 " 


2 


2 


4 


2 


2 


3 


4 


5 


4 


6 


4 


Unknown, 


8 


16 


6 


9 


13 


19 


12 


11 


9 


10 


6 




114 


118 


119 


138 


185 


218 


229 


236 


232 


238 


255 


Ages of patients 
























when admitted : 
























Under 20 years, 


2 


12 


4 


11 


13 


17 


10 


10 


7 


14 


15 


From 20 to 30 years, 


34 


31 


23 


29 


58 


47 


47 


46 


50 


55 


48 


" 30 to 40 " 


46 


31 


36 


32 


34 


51 


49 


40 


45 


44 


62 


" 40 to 50 " 


35 


31 


28 


26 


31 


32 


30 


34 


31 


46 


39 


" 50 to oo " 


14 


8 


13 


14 


13 


20 


21 


21 


19 


24 


38 


" CO to 70 " 


17 


5 


6 


13 


12 


8 


14 





9 


12 


11 


" 70 to 80 " 


3 





3 





7 


2 


8 


5 


1 


2 


5 


Over 80 years, 


2 


1 




















1 


■ 1 2 




153 


119 


113 


125 


168 


177 


179 


162 


163 


198 220 


Civil state of patients 
























when admitted : 
























Single, 


92 


71 


52 


68 


94 


101 


80 


.75 


82 


108 


92 


Married, 


38 


40 


46 


49 


61 


05 


75 


71 


63 


76 103 


Widows, 


12 


4 


8 


6 


11 


5 


17 


12 


13 


12 17 


Widowers, 


11 


4 


7 


2 


2 


6 


7 


4 


5 


2 8 


BBSS . 1 , 


153 


111 


113 


125 


168 


177 


179 


162 


163! 198, 220 



STATE LUNATIC HOSPITAL. 61 

The operation, especially as to recoveries and improvements, has 
been particularly favorable the past year, as 129 cases of less duration 
than one year, and 62, less than two years, has afforded a favorable 
class for cure. The recovery of one hundred and sixteen cases is the 
result of these favorable admissions. 

With our present great number of patients, (255,) only 45 cases re- 
main in which insanity was of less duration than one year when admit- 
ted, leaving 210 cases of more than one year's continuance. 

For the first time since the Hopital was opened the number of marri- 
ed persons admitted has exceeded the number of the single, if we ex- 
cept widows and widowers, (103 to 92.) 

In most of the British and American institutions the number of single 
persons admitted exceed the married by a considerable number. Ce- 
libacy unquestionably favors insanity. 



62 



STATE LUNATIC HOSPITAL. 



TABLE 13. 

Shotting the comparative Curability of Insanity treated at different pe- 
riods of Disease. 





Total of Cases 


Total of ea. Sex. 


Cured or Cura 
ble. 


Incurable. 


Of less duration than 1 year, 

Males, --- 
Females, 


878 


395 
432 


349 
387 


47 
45 


From 1 to 2 years, 

Males, --- 
Females, 


310 


153 
157 


85 
99 


68 

58 


From 2 to 5 years, 
Males, - 
Females, 


282 


165 
117 


53 

44 


112 
73 


From 5 to 10 years, - 

Males, - 
Females, 


174 


95 

79 


12 
12 


83 
67 


From 10 to 15 years, - 

Males, - 
Females, 


98 


53 
45 


4 
2 


49 
43 


From 15 to 20 years, - 
Males, - 
Females, 


36 


24 
12 


1 



23 
12 


From 20 to 25 years, - 

Males, - 
Females, 


25 


14 
11 






14 
11 


From 25 to 30 years, - 

Males, - 
Females, 


8 


6 
2 


'0 



6 
2 


Over 30 years, - 
Males, - 
Females, 


11 


5 

6 






5 

6 



Some unknown. 



The number of recoveries given in the table, of that class of patients 
whose insanity is of less duration than one year, continues to be such as 
to inspire a hope that at some future time, if the time has not already 



STATE LUNATIC HOSPITAL. 63 

arrived, insanity will be lessened, and especially that a less number of 
cases will go into a hopeless condition. 

There are not now half a dozen cases in this Hospital, that entered 
it as recent cases, who have failed to recover, and become incurable 
and hopeless ; and most of those which have left us are complicated with 
epilepsy, palsy, or such general prostration of health as to render them 
hopeless independent of their insanity. 

I think it is not too much to assume that insanity, unconnected with 
such complications, is more curable than any other disease of equal se- 
verity ; more likely to be cured than intermittent fever, pneumonia, or 
rheumatism. If this be true, then this department of medical science 
has kept pace with, or overtaken, others which have heretofore been 
considered quite in advance of it. 



64 



STATE LUNATIC HOSPITAL. 



TABLE 14. 

Showing the comparative Curability of Insanity attacking at different 

Ages. 



Under 20, . 
Males, 
Females, 

From 20 to 25, 
Males, 
Females, 

From 25 to 30, 
Males, 
Females, 

From 30 to 35, 
Males, 
Females, 

From 35 to 40, 
Males, 
Females, 

From 40 to 45, 
Males, 
Females, 

From 45 to 50, 
Males, 
Females, 

From 50 to 55, 
Males, 
Ft; males, 

From 55 to GO, 
Males, 
Females, 

From HO to 05, 
Males, 
Females, 

From 05 to 70, 
Males, 
Females, 

From 70 to 75, 
Males, 
Females, 

Over 75, . 
Males, 
Females, 



Total of Cases 



209 

254 

238 

249 

200 

102 

130 

112 

60 

48 

29 

18 

12 



Total of each 
Sex 



10G 
103 

138 
116 

130 

108 

134 
115 

90 
110 

85 
77 

61 
69 

51 
61 

28 
32 

23 
25 

20 
9 

11 

7 

6 

6 



44 
69 

70 

77 

68 
70 

70 
74 

47 
69 

56 

50 

42 
55 

a3 

43 

18 
21 

18 
17 

13 

7 

5 

7 

3 





62 
34 

68 
39 

62 
38 

64 
41 

43 
41 

29 
27 

19 
14 

18 
18 

10 
11 

5 

8 

7 
2 

6 


3 

6 



Of patients under 20 years of age, males do not recover in common 
proportions, but females recover favorably. By the table it appears 



STATE LUNATIC HOSPITAL. 



65 



that more than two-thirds of the females recover. So, also, of females 
between the ages of twenty and twenty-five, nearly two-thirds recover, 
while only about fifty per cent, of the males recover. 

The rate of recovery increases till the ages of 45 and 50, when at 
its maximum both sexes recover in proportion of from 75 to 86 percent. 

These results are inexplicable, and may not hold true elsewhere, but 
have been constantly presented here. 

Of sixty-nine females between the ages of forty-five and fifty, fifty- 
five recovered, and fourteen only failed to recover. 



TABLE 15. 

Showing the relation of Cause to Recovery. 



PHYSICAL CAUSES. 


Whole Number. 


No. of each Sex. 


Curable. 


Incurable. 


Ill health, puerperal, followec 










fever, measles, wounds o 










the heads, &c. 


356 








Males, 




79 


43 


36 


Females, . 




277 


195 


82 


Intemperance, 


239 








Males, 




213 


111 


102 


Females, . 




26 


14 


12 


Masturbation and its results 










debility, weakness, &c. 


133 








Males, 




119 


32 


87 


Females, . 




14 


1 


13 


Epilepsy, . 


45 








Males, 




40 


4 


36 


Females, . 




5 





5 


Palsy, . .. . 


28 








Males, 




19 


4 


15 


Females, . 




9 


1 


8 


MORAL CAUSES. 










Religious, including Mor 










monism, Millerism, Fanat 










icism, Followers of Knapp 


» 








&c. 


151 








Males, 


, . 


78 


54 


24 


Females, . 


, 


73 


48 


25 


Afflictions, trouble, love 


5 








fright, fear of death, fu 










ture punishment, poverty 


J 








&c. 


411 








Males, 


„ . 


164 


95 


69 


Females, . 


• 


247 


149 


98 



Cause unknown in many cases. 



66 



STATE LUNATIC HOSPITAL. 



The forms of insanity arising from ill health, particularly in females, 
are curable in a large proportion, as seen by the table. Even when 
insanity arises from other causes, attention to health and restoration of 
soundness to the bodily powers often removes it. Strict attention should 
he given to the condition of the functions of other organs than the brain, 
for insanity is often secondary from disease of other organs that sym- 
pathize strongly with the brain. 

TABLE 16. 

Showing the Causes of Insanity as affecting persons pursuing different 

Occupations. 











c 






C 




c 


< 




OCCUPATIONS. 


J-H 

c 

s 

£ 


E 


1 


1 
a 

17 


'5 

a 
B 


Farmers, 






146 


49 


10 


20 


Shoemakers, 






51 


8 


4 


22 


4 


t 


Printers, 






14 








11 


1 


( 


Laborers, 






81 


53 


1 


13 


2 


(. 


Seamen, 






45 


25 


1 


4 


2 


5 


Merchants, 






56 


10 


1 


27 


2 




Carpenters, 






37 


14 


5 


6 


1 


3 


Blacksmiths, 






10 


3 


1 


1 





1 


Students, 






23 





2 


17 


1 


r 
A 


Professional men, 




16 


4 





6 


1 


] 


Clergymen, 




6 








4 





] 


Lawyers, 




6 


2 





2 


1 


( 


Physicians, 






4 


2 











t 



< 


s 










■a 
c . 

Is 
5*" 


■3 
PS 

Q 


c. 

E 
u. 


a 
o 

•g-a 


3 

c 


s 

Ml 


3 





6 


1 


2 





1 





1 


1 





1 


1 





1 


























1 














2 











1 











1 





1 








1 


2 























1 











2 

















1 



































1 


















The experience of the past year confirms our former views as veri- 
fied by the table. 

Intemperance is the prolific source of insanity with those pursuing 



STATE LUNATIC HOSPITAL. 



67 



active occupations, and the " secret vice" with the effeminate and those 
who pursue sedentary employments. 

These facts, extensively known, may have some influence in pre- 
venting insanity hy removing causes the most appaling, inasmuch as 
they are voluntary. 

TABLE 17. 

Showing the state of the Moon at the commencement of a paroxysm of 
excitement in 97 cases of Periodical Insanity, amounting in all to 
728 paroxysms. Also the relation of the Moon to the 136 Deaths 
that haoe occurred in the Hospital. 



Number of Paroxysms each Jay. 


Number 


of Death 


s on each day 




Day of the Moon. 


Whole 


Male. 


Fe- 


Day of 


Day of the Moon. 


Whole 


Male 


Fe- 


Pay of 




No. 




male. 


the Qr 




No. 




male. 


the Qr. 


1 


19 


11 


8 


1 


1 


1 


1 





1 


2 


44 


23 


21 


2 


2 


8 


6 


2 


2 


3 


25 


13 


12 


3 


3 





3 


6 


3 


4 


m 


14 


17 


4 


4 


4 


2 


o 


4 


5 


24 


10 


14 


5 


5 


8 


4 


4 


5 


6 


30 


14 


16 


(J 


6 


6 


4 


2 


6 


7 


39 


19 


20 


7 


7 


6 








7 


End of 1st qr. 










End of 1st qr. 










8 


36 


18 


18 


1 


8 


3 


1 


2 


1 


9 


24 


14 


10 


2 


9 


8 


2 


6 


2 


10 


18 


7 


11 


3 


10 


2 


2 





3 


11 


26 


11 


15 


4 


11 


3 


1 


2 


4 


12 


. 23 


13 


10 


5 


12 


4 


2 


2 


5 


13 


26 


14 


12 


6 


13 


8 


(. 


2 


6 


14 


32 


12 


20 


7 


14 


4 


2 


2 


7 


End of 2d qr. 










End of 2d qr. 










15 


29 


14 


15 


1 


15 


3 


3 





1 


1G 


20 


<J 


11 


2 


10 


9 


6 


3 


2 


17 


29 


16 


13 


3 


17 


6 


3 


tfi 


3 


18 


14 


7 


7 


4 


18 








C 


4 


19 


21 


14 


7 


5 


19 


2 


1 


1 


5 


20 


23 


17 


6 


6 


20 


8 


5 


3 


6 


21 


30 


16 


14 


7 


21 


7 


4 


3 


7 


End of 3d qr. 










End of 3d qr. 










22 


27 


12 


15 


1 


22 


2 


1 


1 


1 


23 


32 


12 


20 


2 


23 


2 


1 


1 


2 


2t 


32 


15 


17 


3 


24 


6 


2 


4 


3 


25 


23 


8 


in 


4 


25 


7 


4 


3 


4 


26 


24 


12 


l? 


5 


26 


4 


2 


2 


5 


27 


13 


4 


<j 


6 


27 











6 


28 


14 


7 


7 


7 


28 
Deaths, 


6 
136 


4 


2 


7 


Paroxysms, 


728 





68 STATE LUNATIC HOSPITAL. 

Our moon tables have been referred to in the English periodicals, 
and some importance is attached to the record. I have deemed it wise 
to continue the table as we first commenced it, that facts may be accu- 
mulated for the use of those who may wish to profit by them. 

The number of paroxysms has been increased to 728, adding 52 to 
the record of last year, and five additional cases of this form of insanity. 
Two cases, now in the institution, which had paroxysms every second 
month, have materially improved after great regularity of occurrence 
for nearly twenty years. One passed six monllis without a paroxysm, 
and then they occurred again. The other has been four months free 
from excitement and continues to be so at the present time. 

Dr. Allen, and Dr. Daguire, physician of the Lunatic Hospital at 
Chambery, Savoy, still maintain very strenuously that the moon exer- 
cises a constant and real influence upon insane people. 

The twenty-two deaths that occurred in the Hospital the last year, 
were in the following proportions, arranged according to Dr. Allen's 
theory: 10 occurred at the periods of the new and full moon, and 12 
at the quadratures, the same days being taken that Dr. Allen directs. 
So far as this goes it does not sustain the theory. 

The whole number of deaths which have occurred in the hospital, 
136, arranged according to this theory of Dr. Allen, present the follow- 
ing results : At the new and full moon, 66 deaths occurred ; at the 
quadratures, 70 deaths occurred, a fraction against the theory, as he 
would have most deaths at the periods of excitement, the new and full 
moon. 

The records of the Retreat, near York, England, for forty years, 
furnish 73 deaths at the new and full moon, and 65 the first and last 
quarter. 



STATE LUNATIC HOSPITAL. 



69 









TABLE 


18. 














Of Per Cent. 




Ave. 


1834 


1835 


183618371838 


1839 


1840 


1841 


1842 


1843 


Recovery of cases 
























of duration less 
























than 1 year, . 


87| 


82 


824 


844 


894 


864 


90 


914 


91 


91 


884 


Per cent, of recove- 
























ries of all dis- 
























charged, . 


513 


531 


464 


53i 57 


524 


47 


53 


m 


46 


57 


Per cent, recovered 






















of old cases, . 


201 


204 


151 


181 254 


154 


164 


224 


20| 


16 


29 


Per cent, of Cases from the most prominent Causes each year. 




1833 


1834 


18351836 


1837 


1838 


1839 


1840 


1841 


1842 


1843 


Ill health, . . . 


8* 


m 


214 224 


214 


28 


261 


25 


214 


17| 


iclO 
lOll 


Religious, . 


84 


6k. 


741 64 


64 


9 


44 


41 


34 


94 


121 


The affections, . 


13| 


114 


174| 16 


16 


141 


25 


161 


121 


141 


9 


Concerni'g property, 


6k 


101 


81! 54 


64 


104 


54 


41 


34 


34 


7 


Intemperance, . 


241 


24 


221 i 144 


104 


161 


74 


124 


12^ 


74 


6* 


Masturbation, . 


5 


51 


\ 7|| 164 


214 


54 


81 


61 


6 


34 


3 



There have been admitted to the Hospital, since it was opened in 1833, 828 
cases, of duration less than one year. 

In the same time there have been discharged, recovered, of recent cases 
619 ; 619 of 828 ; which is a fraction less than 75 per cent. Deduct from this 
number 38 deaths, and 45 recent cases now in the Hospital ; 83 from 828 ; 
and there remains 745, of which 619 is 83 per cent. 

There have been in the Hospital 1777 cases, of which 792 have recovered, 
which is 45 per cent. 





1834 
34 


1835 
34 


1836 


1837 


1838 


1839 


1840 


1841 


1842 


1843 


in the Hospital ea. year, 


3^ 


34 


44 


54 


31 


3 


21 


41 


Per cent, of deaths of the average number of the last year, 22 of 244, is 9 



The average per cent, of recoveries for eleven years, of those dis- 



70 STATE LUNATIC HOSPITAL. 

charged, continues high, and is a very little improved this year. Our 
success with old cases has been unusually good this year. 

Owing to the large number of recent cases admitted, 129, the per 
cent, of recoveries of this class, on the admitted, is somewhat dimin- 
ished ; but the per cent, on all the admitted, of the discharged recov- 
ered, has increased from 43^ to 45 per cent. 

DIET. 

The diet used in the insane hospitals in this country is plain and sub- 
stantial, differing but little in the institutions generally. Some may 
allow more luxuries than others, but it is substantially the same. 

In the British institutions there is a great variation in the diet of the 
different classes. In some of them they make five or six classes, each 
having different food. In this country we make little distinction in the 
ordinary diet, directing from time to time such as particular individuals 
may require. 

Few patients in this hospital complain of the quantity or quality of 
the food. It is never the same two days in succession. The articles 
of food provided are always the best the market affords, and all are 
allowed as much as they desire, or can take with propriety. 

Of the 261 patients now in the hospital, 250 go to the table, drink 
tea and coffee, and take their food with knives and forks from a com- 
mon earthern plate. The few who have their food served in separate 
dishes have equally good diet, but are in apartments having no common 
room for meals, so that they take them alone. Fruits are served plen- 
tifully at the season of them, besides the articles in the prescribed and 
regular diet. About a barrel of apples a day is used in the season of 
them, which is nearly half the year. Berries are used freely when 
plenty, and dry fruits occasionally. 

Diet of the State Lunatic Hospital. 

Sunday. Breakfast : coffee, bread, butter, fish and potatoes, hashed. 
Dinner: water, bread, butter, cheese, crackers. Supper: tea, bread, 
butter, cheese, cake. 

Monday. Breakfast: coffee, bread, butter, cold meat, warm pota- 
toes. Dinner: water, boiled meat, two kinds, vegetables, bread, butter, 
pudding and molasses. Supper : tea, toast or biscuit, bread, butter, 
cheese. 

Tuesday. Breakfast : coffee, bread, butter, meat and potatoes, 



STATE LUNATIC HOSPITAL. 71 

i 

hashed. Dinner : water, roast meat, vegetables, bread, butter. Sup- 
per : tea, bread, butter, cheese, plain cake. 

Wednesday. Breakfast : coffee, bread, butter, meat, warm potatoes, 
sometimes hashed. Dinner: water, stewed beans or peas, meat, bread, 
butter, sometimes fresh fish instead of beans and peas. Supper: tea 
or cocoa, bread, butter, cheese, cake. 

Thursday. Breakfast: coffee, bread, butter, warmed beans or peas, 
warm potatoes, or fish and potatoes, hashed. Dinner: water, soup, 
fresh meat, vegetables, bread, butter. Supper: tea, bread, butter, 
cheese, pie or cake. 

Friday. Breakfast: coffee, bread, butter, hashed fresh meat and 
potatoes. Dinner : water, boiled meat, two kinds, vegetables, bread, 
butter, pudding and molasses. Supper: tea, bread, butter, cheese, 
baked potatoes, cake. 

Saturday. Breakfast: coffee, bread, butter, hashed meat and pota- 
toes. Dinner: water, fish, vegetables, bread, butter, rice and molasses. 
Supper: tea, bread, butter, cheese, sauce or honey. 

Corn and rye bread and wheat bread are both used, as individuals 
prefer. When we speak of " vegetables," besides potatoes, which are 
always on the table at dinner, except Sundays, we have in the season 
of them green peas, beans, corn, squashes, turnips, beets, onions, cab- 
bage, tomatoes, asparagus, &c, most of which we raise in abundance 
in our garden and use freely. Salt, pepper, mustard and vinegar are 
used as condiments. The milk of twelve cows is used in the establish- 
ment. Fruit, bread, or pudding and milk, is sometimes a substitute for 
other meals. 

The next table is the diet table of the New Hampshire Asylum, lately 
established at Concord. Diet of all in the asylum, except in particular 
cases, where another is prescribed. 

Sunday. Breakfast: hashed fish with potatoes, butter. Dinner: 
bread, butter, cheese. Supper: warm baked beans and pork, butter. 

Monday. Breakfast: cold meat, warm potatoes, flapjacks or pan- 
cakes. Dinner: boiled beef and pork, pudding, molasses, butter. 
Supper : nutcakes, cheese, butter. 

Tuesday. Breakfast: warm biscuit, butter, hashed meat and pota- 
toes. Dinner : roast beef or pork, vegetables. Supper : gingerbread, 
butter, cheese, 

Wednesday. Breakfast : cold meat or stewed with potatoes, butter. 



72 STATE LUNATIC HOSPITAL. 

Dinner : meat, soup with potatoes, pie, cheese, or pot pie. Supper : 
baked potatoes or sweet bread, butter. 

Thursday. Breakfast: codfish broiled or stewed, broiled steak, 
potatoes, butter. Dinner: boiled beef and pork, potatoes, rice, mo- 
lasses, butter. Supper: cake, gingerbread, butter. 

Friday. Breakfast : hashed meat and potatoes, toast or warm bis- 
cuit, butter. Dinner : stewed pork and peas, or broiled steak, or fried 
fish, or fried pork and potatoes. Supper: pie, butter, cheese. 

Saturday. Breakfast : fresh meat or ham, potatoes, butter. Din- 
ner : boiled codfish, rice, molasses, butter, potatoes. Supper : butter, 
apple sauce. 

Weak coffee for breakfast, water for dinner, weak tea or shells for 
supper. Corn and rye bread and wheat bread on the table at each 
meal. Milk, when plenty, for one or more of the galleries for supper. 
Fresh meat in cold weather substituted for salt meat. 

The following is the diet of the Boston Hospital, which is purely a 
pauper establishment, and admits no other patients : 

For breakfast, daily, coffee, chocolate or shells, and bread. 

For supper, daily, tea sweetened with sugar, chocolate or shells, 
bread, cheese twice a week, gingerbread or plain cake twice a week. 

For dinner. Sunday : cold corned beef with potatoes. Monday : 
pork and beans, rice pudding. Tuesday : fresh fish and vegetables. 
"Wednesday : roast beef, mutton, lamb or veal, and vegetables. Thurs- 
day : beef soup and rice pudding. Friday : salt fish with vegetables. 
Saturday : same as Wednesday. 

The native fruits of the season. 

Diet of the Pennsylvania Hospital. 

Breakfast : bread, butter, with occasionally fish and potatoes, coffee 
and chocolate, both, to suit different tastes. 

Dinner: boiled or roast beef, veal, mutton or pork, with a variety of 
vegetables, puddings, pies, or the fruits of the season, as apples, 
peaches, melons, &c. for dessert. Bread at pleasure. 

Diet of the Western Virginia Asylum, Staunton. 
" Wheat and corn bread, the various fresh meats with which the 
country abounds, bacon, poultry, butter, molasses, coffee, tea, milk, 
and a great variety of vegetables." 



STATE LUNATIC HOSPITAL. 73 

Diet of the Carlow (Irish) Asylum. 

Breakfast: 1 quart of stirabout, a gruel made of 8 oz. of oatmeal, 
£ of a quart of new milk. 

Dinner : 3£ lbs. of potatoes, 1 pint of mixed milk, (new and sour 
milk mixed,) 8 oz. of beef. Tuesday, 1 pint of soup. 

Supper: half a pound of bread, 1 pint of mixed milk. 

Diet at the Belfast Asylum. 

Breakfast at 9 o'clock, always. For males, 1 quart of stirabout, 1£ 
pints of new or mixed milk. ¥ or females, l£ pints of stirabout, 1 pint 
of new or mixed milk. 

Dinner. Sundays, Tuesdays, Wednesdays, Thursdays : Males, 3 
lbs. of potatoes, 1 quart of soup. Females, 3 lbs. of potatoes, 1£ pints 

of soup. 

Dinner. Monday, Friday, Saturday : Males, 3J lbs. of potatoes, 1 
pint of mixed milk. Females, 3 lbs. of potatoes, 1 pint of mixed milk. 

Supper. Males, 8 oz. of bread, f pint milk. Females, 6 oz. of 
bread, £ pint of milk. 

Convalescents and laborers have 4 oz. of boiled meat every other 
day. 

Diet at the Lancaster Asylum. 

Porridge for breakfast every day ; thick porridge on Wednesday. 

Dinner : scouce, (soup with potatoes and other vegetables) on Sunday ; 
Monday, roast mutton: Tuesday, boiled beef and soup ; Wednesday, 
roast beef; Thursday, scouce; Friday, potatoe pie; Saturday, scouce. 
Females, porridge every day for breakfast ; thick porridge, Saturday ; 
scouce, Sundays, Mondays and Wednesdays; Thursday, roast beef; 
Friday, boiled beef and soup, roast mutton. 

Supper: coffee and cocoa, with bread and butter for males, Sunday ; 
Monday and Thursday, porridge ; Tuesday and Friday, bread, cheese 
and beer; Wednesday and Saturday, tea, bread and butter. Females, 
tea, bread and butter; Sunday and Wednesday, coffee or cocoa and 
bread and butter on the other days of the week. 

Lincoln Asylum, England. 
Males, breakfast, 6 oz. bread, 1 pint boiled milk. Females, break- 
fast, 5 oz. bread ; tea, 1 pint. 

Dinner. Males, bread, 3 oz. ; meat cooked and bones, 4 oz. ; veg- 
etables, 10 oz. Females, same as the males. 

Supper. Males, bread toasted and buttered, 5 oz. ; tea, 1 pint. 
10 



74 STATE LUNATIC HOSPITAL. 

Sunday, roast beef ; Monday, boiled mutton ; Tuesday, boiled beef ; 
Wednesday, boiled beef, or cold meat warmed, with one pint of soup 
for half the patients ; Thursday, boiled mutton ; Friday, boiled beef ; 
Saturday, boiled beef, or cold meat and one pint of soup for half the 
patients. 

I do not quite understand to what class this last allowance is made. 
I copy the report. 

Diet at the Retreat, York, England. 

Breakfast : coffee, bread, butter, toast, &c. Lowest class, bread and 
milk. 

Dinner : roast or boiled joints, potatoes, &c. ; plain fruits or rice pud- 
ding ; fish, game or poultry when in season ; beer or water. The 
lower classes have no game or poultry, but have occasional hashes. 

Supper: tea, bread, butter, toast, or bread and milk, porridge. 

A plain, simple, but substantial diet is generally best for the insane. 
No greater error is committed than drenching the bowels of such pa- 
tients with active or cooling purges, abstracting blood freely, or placing 
them upon a low and insufficient diet. 

In proportion to their number, more of the abstemious become insane 
than of those who live generously, but temperately. 

The strength which the insane sometimes exhibit arises from excite- 
ment and impulse, not from great power. The insane, in general, are 
not as strong or capable of enduring as much as their attendants and 
other laboring men. They have rarely too much blood, but the blood 
is unequally distributed. The brain is irritable, but not inflamed, and 
not often, in mania, congested. The maniac has not a condition of the 
brain that requires depletion, but an irritable one, that needs cool appli- 
cations, and quieting remedies and regimen. Cold water and ice are 
much more likely to remove his excitement than bleeding and starva- 
tion. Narcotics will control him and make him quiet and rational, 
while he would grow worse if treated with severity, and be less likely 
to recover. 

The British physicians have learned not to bleed in mania, but the 
American physicians have not. While I have been writing this sheet a 
patient has been brought to my care, spare, pale and feeble, who has 
been copiously bled four times in ten days, and yet is not the less ex- 
cited. It may be difficult to cure him in his present state, for he is in 
great danger of becoming fatuous, but if he should recover, it will 
probably take a longer time to remove the effects of his remedies than 
to cure his insanity. I have seen many such cases. 



STATE LUNATIC HOSPITAL. 75 

Insanity frequently seems to be produced by insufficient diet. Some 
time since a young man, a student in one of the New England colleges, 
was brought to this hospital apparently in complete dementia. He had 
lost all decency of appearance, was regardless of the calls of nature, 
and was incapable of expressing one idea, or answering a question cor- 
rectly, even in monosyllables. He was poor, and, in order to get 
through college, he took the plainest and cheapest food. For three 
months before he became insane he eat nothing but brown bread and 
molasses, and drank water only. It was observed by his instructors 
that he became a dull scholar, but no one thought him affected by his 
diet till the symptoms of insanity were suddenly developed, and in a 
very few days he was placed in my care. I gave him narcotics and a 
generous diet ; he soon mended, and his appetite became voracious. 
At first, he partook moderately of animal food, but afterwards took it 
freely. When his strength would permit he began to labor. He 
usually took four ox five full meals daily. His recovery was very rapid 
and favorable. He gained forty pounds of flesh in less than three 
months, and was, in a short time, able to resume his studies and finish 
his collegiate course with honor. He is now settled in the ministry, 
enjoys good health and a sound mind, never having failed to pursue his 
generous living. 

Some months ago a lady came under my care, who, by the advice 
of her physician, had lived very sparingly for six months, to remove 
the most deep and settled melancholy. She continued to lose ground 
and became more and more feeble and depressed. She was recom- 
mended by her physician to place herself under my care. When I 
first saw her she was under the greatest apprehensions of evil ; a deep 
gloom had settled upon her mind, which was attended by emaciation 
and total loss of physical energy. I immediately changed her course 
of living, gave her narcotic and tonic remedies, and a generous diet. 
She rode daily, spent her time in cheerful society, and engaged in sports 
and amusements, particularly in dancing, which was apparently very 
beneficial to her. She gained twenty pounds of flesh in forty days, 
had a good appetite, relished her food well, and improved in the most 
favorable manner. After a time she partially relapsed, but has recov- 
ered again, and is now with her friends in a very comfortable state. 

When the health improves and the patient gains flesh, we look for- 
ward to radical improvement of the mind in most recent cases, even if 
no other change is apparent. A case of the kind is now under our care, 
which was so hopeless in its appearance and connected with a cause 



76 STATE LUNATIC HOSPITAL. 

which is so fatal to the intellect, that we nearly despaired of him 
Some time ago his health appeared better, he gained flesh ; his mind 
continued for some time in a bad state, but lately he has become quiet 
and intelligent, and there is now strong hope that he will recover; in- 
deed he may now be considered nearly well. 

THE NEW ENGLAND AND OTHER AMERICAN ASYLUMS. 

In looking over the reports of the institutions for the insane, to obtain 
the statistics here presented, I have been impressed with the excellent 
character of the New England institutions. They admit about 1500 
residents annually ; are all conducted on the most enlightened princi- 
ples, and, having no hobbies, are pursuing their way with unparalleled 
success, under the guidance of men of science, medical experience and 
practical wisdom. They are ornaments to the country and a benefit to 
the human family. Since this hospital went into operation in 1833, 
with two exceptions, they have all been erected. 

The oldest, is the McLean Asylum, which, with a small beginning, 
received its first patient in 1818. Under the care of Dr. Rufus Wy- 
man, its first superintendent, it gained a high reputation, which has 
been more than sustained by his successors, Drs. Lee and Bell, the last 
of whom now manages it with great skill and success. 

The second is the Retreat for the Insane, at Hartford, Ct. The first 
superintendent of this institution was Dr. Todd, a distinguished scholar, 
medical philosopher, and philanthropist. Under his care the Retreat 
gained a name for humanity and success, which was unparalleled in 
the history of similar institutions at that day. Its high reputation has 
since been sustained by Drs. Fuller, Brigham and Butler, the last of 
whom has recently been elected its superintendent. He has carried 
into the Retreat experience, active business ^habits, and medical skill, 
which will insure its prosperity. 

The institutions which have been more recently erected, are the 
Vermont Asylum, at Brattleboro', under the superintendence of the 
indefatigable Dr. Rockwell ; the Maine Hospital, at first under the 
care of Dr. Knapp, now superintended by Dr. Ray, well known as the 
author of an approved work on Jurisprudence of Insanity ; the New 
Hampshire Asylum, now in care of Dr. Chandler, who was my fellow 
laborer for nine years in this hospital, and who carried into that insti- 
tution, not only a great, share of discretion and prudence, but also an 
amount of experience which few men of his age possess ; and the Bos- 



STATE LUNATIC HOSPITAL. 77 

ton Lunatic Hospital, which is strictly a pauper asylum. This hospi- 
tal was first under the care of Dr. Butler, now superintendent of the 
Retreat, Hartford. It is now under the charge of Dr. Stedman, and is 
a well conducted hospital, very creditable to the city of Boston. 

The number of residents in these institutions, as shown by the last 
report of each, is as follows, viz : in the McLean, 271 ; Hartford, 172 ; 
Brattleboro', 224 ; Maine, 141 ; New Hampshire, 135; South Boston, 
157 ; State Lunatic, 458 ; making in all 1558. In my opinion no equal 
number of insane persons have ever, in any place, been managed with 
more skill, humanity, and success. 

The institutions in other states of the union have become numerous ; 
all have fair reputations, and some of them are of equal merit with our 
own New England hospitals. Of these none lias gained greater celeb- 
rity than the Ohio Lunatic Asylum, at Columbus, in that state, which, 
from its beginning, has been superintended by Dr. W. M. Awl. Among 
the many distinguished men connected with asylums in this country 
no one has acquired a higher reputation than this gentleman. With a 
mind of uncommon activity, a benevolence reaching not only to the 
wants of the insane, but to every other class of human sufferers, he has 
gained himself a name for philanthropy, as imperishable as the institu- 
tion which he has fostered and sustained. For his present field of labor 
he is particularly well fitted, and the institution under his care takes 
rank with the best in the country. 

One of the most splendid and extensive establishments for the insane 
in this country is at Utica, N. Y. It has received a large number of 
the unfortunate insane from the common receptacles of the state, as 
well as from among the higher walks of life. It has not yet completed 
the first year of its existence. Under the care of its wise and experi- 
enced superintendent, Dr. Brigham, it will not fail to attain a celebrity 
equal to any other, and must do an immense amount of good in the 
progress of its existence. 

The Bloomingdale Asylum, near New York, under the care of Dr. 
Wilson ; the Pennsylvania Hospital, Philadelphia, superintended by Dr. 
Kirkbride ; the Frankford Asylum, near that city, under the care of 
the Friends ; the Virginia Institutions, at Staunton and Williamsburg, 
under the supervision of Drs. Stribling and Gait ; and the Maryland 
Hospital, in the care of Dr. Fisher, have all a high reputation, and are 
doing much for the comfort and cure of the insane of the several states 
in which they are located. 

There are also institutions for the insane in Kentucky, Georgia, Ten- 



78 STATE LUNATIC HOSPITAL. 

nessee, and South Carolina, but their reports have not reached me, and 
I am not able to give their statistics or name their superintendents. 

All the American hospitals for the insane must be able to accommo- 
date from three to four thousand patients. They must relieve a vast 
amount of suffering of patients and anxiety of friends. They are prob- 
ably not surpassed for custodial care, or remedial treatment, by any in- 
stitutions in the world. 

Eleven years ago all the institutions in the United States did not 
admit annually as many patients as have been resident in this hospital 
the past year ; and their condition, with a few exceptions, was far from 
being good. There were not then more than 100 patients in the New 
England institutions in a year, while now, as we have seen, there are 
more than 1500. 

All the institutions in the United States, except this hospital, are in the 
care of comparatively young men, all of whom have assumed their 
stations since I occupied this place. I know them all personally, that 
I have named, some more and some less intimately. They have all 
high claims to public confidence, have good talents, and sterling merits 
as men and as physicians. Long may they occupy the stations which 
they now fill, and live, as I have done, to see these charities multiply 
in a ten-fold ratio around them, till they are commensurate with the 
wants of the community. 

A great revolution has been made in Europe within a few years in 
discarding personal restraints. For this improvement the old world is 
indebted to Dr. Charlesworth of Lincoln, Dr. Conolly of Hanwell, Dr. 
Brown of the Crichton Asylum, Dumfries, assisted by other kindred 
spirits in Great Britain, by which they have greatly ameliorated the 
condition of the insane in the institutions which they superintend, and 
awakened a spirit of improvement which has pervaded the whole 
kingdom. 

Restraints were never common in this country as in Europe, and 
though not wholly abandoned, are rarely used to any great extent. 

I have been more or less intimately connected with institutions of this 
character for the last twenty years, and have had the care of nearly 
eighteen hundred patients within the last eleven years, yet I never saw 
a leg-lock, a tranquilizing chair, or a muffled hand garment ; neither 
have I seen a strait waistcoat for ten years, nor any other instrument of 
severe restraint. 



STATE LUNATIC HOSPITAL. 79 



IMPROVEMENTS AND AMUSEMENTS. 

In the course of the antumn a building has been erected between the 
centre building of the hospital and the chapel, which is seventy-six feet 
long and twenty-five feet wide, in which have been fitted up a commo- 
dious office tioenty-four feet square, two small sleeping apartments, and 
a hall forty feet by twenty-four, which is admirably adapted to the 
wants of the establishment. This hall opens directly into the chapel by 
folding-doors seventeen feet wide, and will furnish accommodations for 
150 or 200 more worshippers, when the enlargement of the hospital, 
which is now in progress, shall be completed and ready for occupants. 
In this room the matron now holds her parties twice a month, at which 
times from 75 to 100 females assemble and unite in labor and enjoy 
social intercourse. These parties, in this commodious room, have be- 
come more than usually interesting and advantageous. The work, at 
these parties., is done wholly for the institution ; any individual would 
be frowned upon who should exhibit her own work on these occasions. 
Many beautiful articles are here manufactured and kept for sale to in- 
crease the library. Such persons as prefer to do it make garments 
and bedding for the household. The matron presideSj assisted by the 
members of the family, who always attend with the supervisor, and as 
many attendants and assistants as can be spared from other important 
duties. 

The hall is large, high, well lighted and easily ventilated, and forms 
a fine room for these assemblages, which have heretofore been pleasant 
but limited for want of an apartment to admit all who would be profited 
by meeting on these and similar occasions. 

In the same hall we now hold our dancing parties, twice a month. 
These parties have never before been so well conducted, or afforded so 
much real enjoyment. From 75 to 100 individuals, of both sexes, 
assemble here to spend a few hours socially, to enjoy a season of relax- 
ation from the tedium of confinement, to dance, and to witness the 
amusement, which seems to be as much enjoyed by the spectators as 
by those who partake of the sport of the evening. These parties are 
always conducted by the assistant physician, and the utmost order and 
decorum prevails at them as well as at those under the supervision of 
the matron. 

Every Saturday evening a religious meeting is held in this hall, 
which continues one hour. The meeting is conducted by the chaplain, 



80 STATE LUNATIC HOSPITAL. 

who explains, in a familiar way, some portion of scripture ; prayers are 
offered, and sacred music increases the interest of the season. 

Thus, in this room, appropriately named Martha Johonnot, in 
honor of the noble spirited woman who gave a munificent legacy to add 
to the accommodations and increase the benefits of this establishment, 
those assemble who like to enjoy the social hour, and engage in benev- 
olent labor at the matron's parties, those who are fond of music and 
the dance, and those who like to devote an hour, on the approach of 
the Sabbath, to solemn thoughts and contemplations which are fitted to 
prepare for the duties of the succeeding day. 

In this hall, in the chapel on the sabbath, and at the singing parties, 
the sexes come together, but at no other time in any considerable num- 
ber in the hospital. 

The learned Jacobi has lately questioned whether, in institutions for 
the insane, the sexes should not be in separate establishments, having 
no intercourse or communication with each other, and especially when 
in the same institution, they should not be wholly separated, even in 
the church in which they assemble for religious worship, having a high 
partition raised above their heads between them, so that no opportunity 
should be had of seeing each other. 

From this opinion I entirely dissent. The intercourse of the sexes 
in institutions of this kind is as favorable as elsewhere. The influence 
they have upon each other every where else, in schools, churches, and 
the social circle, when judiciously admitted, is equally favorable here. I 
would increase rather than diminish it, and in the hospital would en- 
courage walks, games, and especially dances, in which the intelligent 
and convalescent patients should be brought together, under the guid- 
ance of their attendants, and hold free and pleasant intercourse. Es- 
pecially would I have them assemble together for religious worship on 
the Sabbath, at singing parties, and other seasons of social enjoyment. 

The influence of the sexes is reciprocal every where, and, when 
properly directed, has a favorable effect on both. 

We have been too much disposed to consider the insane as making 
an exception to all the rules of intercourse so useful in civilized society, 
but they apply in full force to them when not excited, and especially 
when convalescent. Indeed there can be no question but that the best 
way to treat the insane is to do to them and by them as to other indi- 
viduals, keeping out of sight as far as practicable their peculiarities, 
never speaking of them unless to admonish them to avoid the excesses 
that grow out of them, to encourage self-respect and rational conduct, 



STATE LUNATIC HOSPITAL. 81 

get them into habits of order and accustomed channels of duty and em- 
ployment, and, as disease wears away, they will discover no peculiarity 
or difference arising from estrangement of conduct while insane. 

The intercourse of the sexes in the social circle, and in religious 
duty, will greatly aid this important work, and should always be en- 
couraged in such cases as are admissible. 

If a patient, when he has recovered, goes out of his ward as the pris- 
oner goes out of his cell, every thing for a season will appear singular 
to him, and it will be very strange if he does not appear eccentric and 
unnatural, and even give his friends the impression that he has not re- 
covered. But let him be accustomed to society before he leaves the 
hospital, and he will feel right and appear well. 

We find our new hall in constant requisition for the games and active 
sports which convalescent patients enjoy, and from which they receive 
much benefit. 

The amusements out of doors continue to be walking, riding, &c. 
One carriage is constantly employed, and two others are more or less 
used. The good old Johonnot horse, now supposed to be 37 years old, 
contributes his full share to these amusements, and bears his labors and 
his age admirably. The usual house games are continued, with the 
addition of such new ones as we are able to procure. 

LABOR. 

Our estimation of the value of labor has not diminished by the experi- 
ence of the past year. The farm and garden have been thoroughly 
attended to, and the quality and quantity of the articles raised have ex- 
ceeded the usual production. 

The laborers are the happiest and most healthy class of patients in 
the hospital ; many convalescents would be completely miserable with- 
out labor, and their recovery would be retarded, if not prevented, if 
they were deprived of it. 

When the excitement of a violent patient has so far subsided as to 
enable him, with great effort, to exercise self control, he then calls for 
labor, and will expend the excitement in this way, advantageously to 
himself and the institution, which without it he would find it necessary 
to expend in noise, violence, and mischief. This holds equally true 
with both sexes. Labor under such circumstances is not only a safety 
valve to expend diseased excitement, but it puts the patient into accus- 
11 



82 STATE LUNATIC HOSPITAL. 

tomed channels of thought and action, and the mind performs rationally 
at labor, if insane every where else. 

Convalescents are not the only persons benefited by useful employ- 
ment ; a large class of the incurable insane are rendered healthy and 
happy by it. What there is of mind remaining is kept bright and pre- 
vented from sinking into dementia by labor. No persons about the 
hospital are more gratified to witness production, profit and improve- 
ment than the laboring insane. They take delight in viewing the lux- 
uriant crops in the fields and gardens, and feeling that they have con- 
tributed their share to what goes for the general good. 

The melancholy patients are benefited no less than the maniacal, by 
labor. They need the exercise, and particularly require the mind to 
be diverted from gloomy contemplations, and to be made active in some 
way that will interest and excite them. 

The agricultural and horticultural operations at the hospital materi- 
ally lessen the expenses of the establishment. The profits of the farm 
and garden last year were nearly ten per cent, of the cost of the whole ; 
this ten per cent, would make nearly 25 cents per week on the price of 
board and other expenses ; this reduces the price of board 13 dollars a 
year for each patient. It would be well if our farm and garden could 
be extended, even doubled. The Commonwealth would save money 
by the investment. The cost of our present farm was not more than 
six thousand dollars. The avails of it are nearly three thousand, and 
very little more help is required to manage while at work than with- 
out it. 

The labor done by the patients in other departments, aside from ag- 
riculture and horticulture, is as much or probably more than all the 
hired help do in these departments, so that it may be assumed that the 
patients of the hospital do as much labor as to do the whole work on 
the land, the avails of which is from two to three thousand dollars. If 
the farm could be doubled, another 25 cents could be deducted from 
the price of board by the profits which would accrue from it. The ex- 
pense of supporting the hospital this year was a little less than $28,000, 
if we had raised nothing it would have been $30,000. With present 
numbers and plenty of land it might easily be reduced two or three 
thousand dollars more. 

The excavation of the cellars for the new wings, an extent of 375 
feet in length by 38 feet in width, was done principally by patients, 
which probably saved to the fund, which is to erect our additional 
building, not less than three hundred dollars. 



STATE LUNATIC HOSPITAL. 



83 



Valuable improvements have been made on the land by ditching, 
walling, road-making, &c, which occupied much time, and made val- 
uable improvements on the premises. 



The quantity of the 


Product 


s of 


the I 


''arm and G> 


arden 


, as given in the 


following table 


, with their t 


>alue as estimated 


by the Steward. 


Hay, 40 tons, at $12 00, and 10 tons at $10 00, 


- 


- 


$580 00 


Onions, 95 bushels, 


at 


67 cents, 


- 


- 


63 65 


Tomatoes, 30 


u 


at 


50 


<t 


- 


• 


15 00 


Green peas, 40 


ci 


at 


100 


u 


- 


- 


40 00 


Potatoes, 150 


<« 


at 


25 


u 


- 


- 


37 50 


Corn, 225 


tc 


at 


70 


It 


. 


- 


157 50 


Soft corn, 30 


u 


at 


35 


tt 


- 


- 


10 50 


Cabbages, 200 




at 


6 


tt 


- 


- 


12 00 


Beets, 365 


a 


at 


25 


11 


.. 


- 


91 25 


Ruta Baga, 185 


u 


at 


25 


a 


- 


- 


46 25 


Parsnips, 80 


u 


at 


50 


tt 


- 


- 


40 00 


Carrots, 1040 


it 


at 


25 


tt 


- 


- 


260 00 


Broom corn, 342 lbs 




at 


6 


tt 


- 


- 


20 52 


Broom corn seed, 30 bushels. 


at 


30 


tt 


- 


- 


9 00 


Oats and straw, 


- 




- 


- 


- 


- 


20 00 


Winter squashes and pumpk 


ins, 


1000 lbs. at 1£ cents, 


- 


15 00 


Garden vegetables, 


- 




- 


■ - 


- 


- 


100 00 


Corn fodder, 


- 




- 


- 


- 


- 


40 00 


Poultry, 150 lbs. - 


- 




- 


- 


- 


- 


15 00 


Pasturing 12 cows, 


- 




- 


- 


- 


- 


150 00 


Milk, 35,040 quarts, 


at 4 cents, 


- 


- 


- 


- 


1401 60 


Pork, 6,308 lbs. 


at 6 ' 


;« 


- 


- 


- 


- 


378 48 


Beef, 5,867 lbs. 


at 5 ' 




- 


- 


- 


- 


293 35 


Pigs sold, - 


- 




- 




- 


- 


103 50 



$3900 10 

The stock has been fed from the produce of the farm and garden ; a 
number of tons of last year's hay lay over, to be used this year. 
Stock on hand, 4 oxen, 13 cows, 4 horses, 34 swine. 



The following statement of the labor and expenses of the shoe shop 
is given by the overseer. I have before said, and now repeat, that no 
department of labor is more beneficial to those employed, or more 
convenient and useful to the establishment, than shoemaking. 



84 



STATE LUNATIC HOSPITAL. 



Amount of work done for officers and 


assistants, 


- $358 00 


cc ct u 

Custom work, 


patients, 


- 


- 


- 496 74 

- 290 79 


Shoes now on hand, 


- 


. 


- 


60 00 


Stock on hand, 


tools, 


- 


$622 07 
230 00 


30 00 


Expended in stock and 
Wages of overseer, 


$1235 53 


Board of overseer, 


- 


- 


100 00 




Binding, 


- 


- 


40 00 




Fuel and lights, 


- 


- 


20 00 




Stock and shoes on hand at the beginning of 






the year, 


■ 


- 


155 00 


1167 07 









Balance, 



$68 46 



It has been our intention to place the value of shoes so as to cover 
expenses. This has been done so as to make the small balance of 

$68 48. 

In the cabinet shop much useful and profitable labor has been done, 
and many patients have here worked off" their excitement and favored 
convalescence by daily employment of the customary implements of 
labor. 

In the matress shop a large amount of labor has been done, profit- 
able to the hospital and to those employed. All the matresses for the 
establishment are made there ; none have been bought for many years. 

The amount of labor done by the females in the hospital is com- 
mendable. They assist in washing, ironing, preparing vegetables for 
cooking, scrubbing and domestic labor, besides the needle work, knit- 
ting, straw braiding, &c. More than 100 females are daily employed 
in these various departments of useful and profitable labor. One woman 
has bound 871 pairs of shoes, besides making many garments, in the 
course of the past year. 

From three to four individuals have gone to the wash room daily, and 
as many to the ironing room, besides casual labor in both these depart 
ments. 



• STATE LUNATIC HOSPITAL. 85 

LIBRARY. 

The Hospital Library has increased from year to year till it has now 
become quite valuable. The books purchased are select, consisting of 
the most approved popular works, papers and periodicals. For this 
purpose not one dollar is taken from the funds of the hospital. The 
Jobonnot Sewing Circle is constantly engaged in adding valuable arti- 
cles to the stock, from which enough is sold to supply all the books 
necessary to make the library valuable and useful. From this stock 
more than $120 worth of articles were sold last year, which were 
wholly manufactured in the hospital, and a handsome supply remains 
for future disposal. 

A great number of our patients read, some to little advantage, others 
to as much benefit as the rest of mankind. For some, one book an- 
swers a long time. One day, recently, as I passed through ihe hall, an 
excited patient was lamenting that he had lost his sermon. The next 
day he was happy, he had found it ; he said he had nearly read it 
through before my visit, and had only failed to do so the day before, 
when it was lost, for a long time previous. He said it was a good ser- 
mon, and he intended to read it through every day. 

We have received, from many benevolent individuals, donations to 
our library, which we are always gratified to acknowledge. From 
Hon. Samuel Merrill, of Andover; Samuel AVells, Esq. of Northamp- 
ton ; William Nichols, Esq. and Joseph Balch, Esq. of Boston ; Dr. 
Batchelder, Utica, N. Y. ; John Tappan, Esq., Boston ; Rev. Thomas 
Norris, Boston ; Rev. Dr. Woods, Andover, and other individuals, not to 
be named, we have received valuable additions to our stock of reading. 

The following newspapers have come regularly to us, free of ex- 
pense : The Boston Recorder, Old Colony Memorial, Youth's Com- 
panion, Library of Health, Springfield Republican, Springfield Gazette, 
Hampshire Gazette, Gospel Messenger, Utica, N. Y., New Hampshire 
Sentinel, Haverhill Republican, New Hampshire Patriot, Olive Branch, 
Mother's Magazine, Boston Atlas, Christian Watchman, Barnstable 
Patriot, Worcester Cataract, Social Monitor, and Phrenological Journal. 

The Salem Gazette, New York Evening Post, Boston Times, and 
the Albany Evening Journal, come to us occasionally. A bundle of 
the Temperance Journal and the Cold Water Army come regularly. 
The Rev. Mr. Norris, of the Olive Branch, favors us with a bundle of 
papers repeatedly, evincing his continued interest in our happiness. 

We feel grateful for all these favors, and shall make the customary 
slight return of one of our Annual Reports. 



86 STATE LUNATIC HOSPITAL. 



CHAPEL AND RELIGIOUS WORSHIP. 

Our confidence in the benefits which result from religious worship 
for the insane, increases from year to year. 

A greater number of patients have attended religious exercises the 
past year than in any previous year. A very large proportion of the 
patients desire and expect to be present every Sabbath, and no ordinary 
circumstances would keep them away. From 150 to 180 attend each 
Sabbath, and are apparently as attentive as other congregations to the 
instructions there given. 

Of the 458 patients who have been residents of the hospital the past 
year, 420 have attended chapel exercises more or less, and about two- 
thirds attend each Sabbath. Of the 38 who have not attended, eight or 
ten are recent cases, who will probably be well enough to do so after a 
few weeks residence, and most of the remainder are the same indi- 
viduals from year to year, who are too insane to control themselves, or 
too much demented to have sufficient regard to personal appearance 
and propriety of conduct to be admitted. 

Our choir of music is very creditable to the performers, and would 
do honor to any congregation. It consists of from twenty to thirty in- 
dividuals, members of our household, one half or one third of whom 
are generally patients, with from two to four musical instruments, some 
of which are also played by patients. 

For more than three years the Rev. George Allen has officiated as 
chaplain to the hospital. His performances are judicious, and very ac- 
ceptable to our congregation ; they are always interesting, and often 
eloquent and forcible expositions of religious truth. His views of all 
subjects are given with great freedom, and yet with such propriety and 
delicacy as to offend none and satisfy all. 

I am happy to append to this report of our chapel exercises the views 
of our chaplain as given in the following letter 

Doct. Samuel B. Woodward, 

Superintendent of the State Lunatic Hospital. 
Dear Sir, — An intimation, from a source entitled to the highest con- 
sideration, having been made, that my views would not be unacceptable 
to the public, respecting the tendency and effect of stated religious wor- 
ship and instruction, on the patients in the hospital under your care, I 



STATE LUNATIC HOSPITAL. 87 

cheerfully yield to the suggestion, at least with no other distrust than 
that of my ability to do justice to a subject having in itself so many 
points of interest that have not been much contemplated by the public 
mind. I trust, sir, you will excuse me, if, following the before mention- 
ed intimation, I take the liberty of addressing this communication to 
yourself, freely leaving it to your own discretion, whether it shall re- 
main in your hands, or pass from them into those of the public. 

While, therefore, I frankly lay before you my views respecting pub- 
lic religious service at the hospital, I am persuaded they are not neces- 
sary to aid or alter your own conviction of its true tendency and effect. 
Could I suspect your mind of doubts on this subject, I should pause, for 
no inconsiderable time, before venturing to attempt to remove them by 
any opinions which I might otherwise confidently express. Your theo- 
retical consideration of the subject before the erection of the chapel, 
seven years ago, had been determined on, naturally conducted you to a 
safe general conclusion, and your practical opportunities and use of 
them since that experiment was made, must, 1 think, have settled in 
your mind at least all which your theory comprehended. If, at that 
period, any of the friends and official patrons of the hospital wavered 
or were incredulous, it was natural that the cautious and the responsible 
should not be over sanguine of success in venturing on an experiment 
which had in it so much of novelty, and which was new only because 
former general views had been adverse to the belief of its advantage or 
practicability. 

On the subject now before me, if I mistake not, the nature of 
man, which is often so little infringed by insanity, is not a blind guide 
to one who is observant of her ever faithful indications. I need not 
suggest to you, sir, that a want of due observation here has led to errors 
in the moral as well as in the physical treatment of the insane. All 
grades of disease have been thought of, by the popular mind, as having 
nearly the same level ; and by many, the worst forms of insanity, being 
too exclusively considered, have been used as a standard for all others, 
and this view of the mass has of course led to unjust conclusions re- 
specting the moral and physical treatment of all. The man has been 
too much overlooked even in the maniac, and by far too little consider- 
ed, in the fainter exhibitions of a disordered mind. The feelings and 
actions of the insane, though hopelessly deranged, are, in a true sense, 
subject to the same general laws which are recognized in the rest of 
our species. His constitutional principles, if disturbed, are not destroy- 



88 STATE LUNATIC HOSPITAL. 

ed. They only act, with increased or diminished force, to such ends 
as delusion suggests. Permanent in their existence, their vigor is often 
witnessed through all the stages of his disease, and in none more dis- 
tinctly than in those who are deluded by the wildest and most monstrous 
fancies. His conduct is the child of motive, of some sort or other, 
however sudden, violent or transient the supposed invo]untary impulse 
that controls him. He is influenced by hope and fear as are other 
men — by his instantaneous, fitful or fixed conviction, however absurd, 
of good or evil, physical or moral. If his particular joys and sorrows 
are the effect of a delusion peculiar to himself, we may well inquire, 
who, among those not suspected of mental disease, is wholly exempt, 
at all times, if ever, from some delusion which awakens a false hope or 
a fallacious fear, an imaginary grief or an irrational joy ? Are there 
not cases, not a few, where it is impossible to tell how far these minor 
delusions may proceed, before awakening, in the most sagacious ob- 
server, any suspicion of a disordered mind ? Is it not, sometimes, the 
direction or the steadiness of a delusion, rather than its degree, which 
removes doubt, and establishes the conviction of insanity ? Is it not, 
in many cases, the growth of a delusion, instead of a change of its 
character, which makes dangerous today what yesterday was harm- 
less? Is not the difference in degree, so far as can be detected, 
sometimes slight, even when the course of treatment must be greatly 
changed, and restraint take the place of freedom ? In such cases, as well 
as in many others, how much that is rational often remains. How dis- 
tinctly visible the man. How quick and just is the moral sense. How 
strong the sympathies of humanity. Even where the delusion is pro- 
gressive, incurable, and violently mischievous, not seldom is the sub- 
ject of it intelligent, social, kind, and conscientious. Except in the 
line of his delusion, he is apt to be what he has been, and to find his 
hopes and fears, his joys and sorrows, just where other men find theirs, 
and where he himself has been accustomed to find them, whether in 
the present world, or in the world to come. 

The habits of men are, proverbially, powerful on all, especially when 
those habits were early begun, have often been repeated, and have long 
been continued. When their authority is thus established, not to prac- 
tice them is violence to self. When such habits are wrong, to suspend 
them is deemed a commendable effort ; to abandon them, a glorious 
triumph. The power of habits on the insane, it is superfluous to say, 
is, every day before you ; sometimes for good, and sometimes for evil, 



STATE LUNATIC HOSPITAL. 89 

according to the character of those habits, and the condition of their 
owner. The principles, the feelings, the hopes, and the restraints of 
religion, are often among the earliest, strongest, and most enduring 
habits of the mind. A considerate view of the subject would lead one 
to presume that much of the influence of such habits would continue 
with the insane, at least in many cases, where the mind is not greatly- 
obliterated. In those cases of derangement, of which there are many, 
where the intellectual powers are become stronger and more acute by dis- 
ease, and where the sensibility to natural and moral qualities and relations 
is quickened by such malady, the power of past habits, as well religious 
as others, often bears an unresisted sway, and the wants which such 
habits induce should, with discretion, be accommodated, and not re- 
sisted, if the habits themselves are in their nature useful or innocent. 

The community of patients in the hospital is, to a great extent, a 
New England community. Their cherished principles and most pow- 
erful habits of thought, feeling, and outward expression, are, in many 
respects, such as constitute and exhibit the specific character of a New 
England population. Of those whose birth and education were else- 
where, whether in other parts of the United States, in C4reat Britain, 
Ireland, or on the continent of Europe, a large part were educated with 
a reverence for the character, stated worship, and word of God. To 
them the sabbath has not been, nor yet is it, as the other days of the 
week. To some, it is sacred ; by others, it is valued for its uses ; by 
most, there is felt for it that which induces towards it, in various de- 
grees, a decent outward respect ; while, by nearly all, would be missed, 
not without something like regret, the notice of a day, which, having a 
character of its own, has given a character to society, — a day which 
comes to their thoughts, even in the reckoning of time, not without the 
suggestion of solemn truth. The recognition, the restraints, and the 
hopes of religion, are, in their minds, as in others, intimately associated 
with the day. 

That the salutary influence of public worship and religious instruction 
may be expected to be felt by all in the hospital, whose intellectual and 
moral faculties are adequate to receive benefit from them, is very much 
more than can be affirmed. In this, at least as great diversity might 
be expected among the inmates of that institution, as exists out of it, 
among those who, more favored by the providence of God, are yet, in 
many cases, less rational in their sense and use of the Divine bounty. 
I take it, however, that the true question is not whether all the patients 
are likely to receive, or are susceptible of, benefit from the truths and 
12 



90 STATE LUNATIC HOSPITAL. 

institutions of religion, or even whether most may derive benefit from 
this source of good, any more than whether one medicine, of a more 
material form, can be administered, with the same salutary effect, to 
all or most of the patients who need medical treatment. A discreet 
moral regimen was enjoined by the Great Physician, whose own pre- 
scriptions, if sometimes bold, were always dictated according to the 
cases for which he administered. That a moral regimen, in one form 
or another, is an indispensable part of the curative and mitigating sys- 
tem of practice in a hospital for the insane, is, I believe, universally 
admitted. That it is so by yourself, is evident from the constant use of 
i t which you make, adapting its character and degree to the condition 
and capacity of the patient in whose case you employ it. Nor is this 
moral regimen peculiar to the practice of a hospital for the insane. It 
is only applying, in an appropriate way, to a specific case, a general 
law of our nature, which a skilful physician makes advantageous use of 
in the common walks of his profession. But what regimen, when ju- 
diciously employed, is, in its nature, more fit to quiet the disturbed, to 
balance the unequal, and direct the misguided functions of the mind, 
than the principles, precepts and hopes of Christianity ? Its errand was 
to enlighten, warn, and encourage ; to bind up the broken-hearted, and 
to cast out evil spirits — a work which, though not without Divine power, 
it has often wrought without a miracle. 

Religious truth — its principles, precepts and sanctions — is, confess- 
edly, of no small force, not only on individual character and condition, 
but, also, in the due regulation of social life. It is felt in the family 
and in the neighborhood, and it extends its broad shield over the widest 
circle of human relations. It is given to superintend all the interests of 
man in this life, as well as lead to, and fit for, a better. Is its influence, 
so needful elsewhere, not wanted in the hospital to regulate its social 
intercourse ? — to keep alive those principles which, always and every 
where, pine and perish when not fed ? — to maintain, in commanding 
and winning force, the due sense of right and wrong? — and to create 
and nourish those social affections which are the joy of their possessor, 
which communicate happiness to others, and which, besides aiding so- 
cial comfort, tend to the permanent restoration of those whose maladies 
are not incurable ? 

Hospitals for the insane are, even now, too much looked upon through 
the medium of traditionary and irresponsible facts. Past impressions, 
that they are gloomy prison-houses, where wild and furious monsters 
are chained in solitary exile, have not yet wholly faded from the public 



STATE LUNATIC HOSPITAL. 91 

mind. Such impressions, always wrong in a degree, were never so 
wrong as now. Professional science and Christian love, uniting in the 
enterprise of humanity, have entered the doors so long kept shut by 
the jealous hand of ignorance and barbarity, and have thrown a broader, 
and brighter light into windows where privation and sorrow had far too 
little to relieve and cheer them. The hospital which here claims 
special consideration, has not only its cells, but its apartments and halls 
of social, every-day intercourse, conducted with great freedom, among 
numerous individuals of character and manners diversified by nature, 
by education, and by disease. Social life to them is necessary from 
constitution and habit. Sometimes it is needful to keep the mind from 
wasting its energies by the undiverted excitement of its own delusion, 
and, at other times, to rouse it from the depression or torpor which would 
weigh upon it in monotonous solitude. In many cases the reasons are 
various and obvious which demand for the patient the influences of social 
life. To make it useful it must be regulated less by arbitrary restraint 
or the vigilant oversight of a guardian, than by that voluntary and 
almost unconscious submission to the proprieties of life, which is often 
best secured by the authority of good principles. These principles are 
not self-existent or self-sustained any where, and, of course not, in a 
hospital for the insane. They have need to be infused and cherished, 
both by the power of ordinary circumstances and the instruction of 
religious duty and hopes. Whatever is to inform and regulate mind in 
a hospital, must act upon it there, as it acts upon it elsewhere, in other 
conditions of life. 

Is not the proximate cause of insanity frequently found, both where 
there is, and where there is not, a hereditary predisposition to that dis- 
ease, in a course of thought and life which has not been shaped by just 
principles? In how many instances has the patient reached the sad 
result without a suspicion of the end to which his course was leading ? 
In cases of recovery, partial or entire, from the pernicious effect of 
insubordination to just moral sentiments, having their foundation in the 
nature and relations of man, what shall prevent a relapse into, and a 
confirmation of, his malady, but a better knowledge of the moral regi- 
men which the Maker of man has prescribed for the preservation and 
happiness of his creatures ? And where shall the recovering patient 
find, and be persuaded to use, in due season, this prophylactic knowl- 
edge, with so much advantage, as in the very place where he becomes 
conscious of his renovated condition ? 

They, too, who come to the hospital for relief, are of various grades 



92 STATE LUNATIC HOSPITAL. 

of character, intellectual and moral. If there are some of a dark shade, 
there are others, not a few, of clear and transparent light. The unfor- 
tunate are, by no means, always the unwise. The same adverse event 
is, often, irrespective of previous virtue or discretion. Accordingly it 
is not rare to find, in the hospital, such as have been well educated, in 
whose minds and hearts religious truth early found a place, and where 
its beneficent power has long been, not obscurely, prevalent. Its sincere 
and unaffected character is marked by its practical consistency. Such 
feel the value and the necessity of those religious means which have 
done so much to form and preserve their Christian character, and to 
cheer them so much by the light of Christian hope. 

If it is a principle, in the wise management of a hospital for the in- 
sane, to keep from it, as much as possible, a forbidding aspect, and to 
make it, as much as possible, comport with the ordinary arrangements 
and associations of life, then the due observance of the sabbath, the 
decent preparation for its services, the united worship of God, in a 
place set apart for that purpose, and the stated public ministration of 
divine truth, may well be supposed to aid in removing the unfavorable 
impression of ignominious confinement, to which unjust impression the 
patient is always sufficiently liable, and in promoting the just view and 
corresponding feeling, that the hospital is not erected as a receptacle 
for the vicious, but as a place of relief and restoration to those who 
have been overtaken by a misfortune from which the best of our race 
has no pledge of exemption.. 

Who, Sir, better than yourself can bear witness, that insanity is not, 
of course, ingratitude ? Of the patients under your care, is not the 
proportion large who are often not insensible to the evidence of kindness 
in its various manifestations? Is not the gratitude of some most exem- 
plary, and the most gratifying reward of your efforts to promote their 
comfort? Do not the chapel, its worship, and its teaching of grace' 
and truth, indicate a friendly concern for their welfare, not unmindful 
of their highest and permanent good ? Do not many of them appre- 
ciate that evidence of kind regard ? Would not still more miss the 
benefit with regret, if deprived of it? 

Though the language just used has the form of inquiry, it will cer- 
tainly not be taken by yourself, for the language of doubt. Distrust 
has given place to assurance. It is not extravagant to say, that convic- 
tions can hardly be dissimilar in the minds of those who have been 
familiar with the experiment in the hospital over which you are placed. 
Successive years have united their testimony to the importance of social 



STATE LUNATIC HOSPITAL. 93 

worship and religious instruction within its limits. They have given 
their deliberate and irreversible tribute of respect to the foresight and 
decision of those, who, against general, and, as was supposed, well set- 
tled, public sentiment, determined to erect, within the precincts of the 
hospital, a chapel for the worship of God, and thus did honor 1o that 
religion which had done so much to relieve the sufferings and raise the 
hopes of man. Having myself witnessed, for the last three years, the 
exemplary order, the marked decorum, and the interested expression 
of so many patients who have attended stated worship in the chapel, I 
should deem it unjust to them, as well as to the power of religious truth, 
to withhold my ready testimony to the proprieties which have marked 
divine service there. In the congregation of patients gathered from 
sabbath to sabbath, in the chapel, and composed of various and remote 
grades of the insane, rare and but momentary interruptions of the re- 
ligious services have taken place. When they have occurred, from 
whatever cause, the restoration to a settled general calm has imme- 
diately followed the transient disturbance. When any one has, by the 
sudden impulse of some new or recurring delusion, or by the restless- 
ness which is induced by some forms of disease, violated the proprieties 
of divine service, it has, so far as is known, been followed by his re- 
gret, in which the congregation have taken at least a reasonable share. 
Besides the general demeanor, so appropriate and so constant, of the 
congregation gathered in the chapel, there are other and yet more sig- 
nificant proofs of the value, to the patients, of the ordinary means of 
religious improvement, in its broad and most generous sense. If their 
subsequent rational conversation respecting what has been listened to 
in the chapel — if their accurate memory and just statement of what 
they have there heard — if the spontaneous and reverent but cheerful 
hymns of worship, trust and praise, by groups gathered in different 
apartments of the hospital — if their frequent reading of the scriptures 
and clear sense of what they read — if their often-expressed conviction 
of the importance of religious instruction — if resolutions, framed or re- 
newed by the fresh presentation of truth, to maintain a religious life — 
if mutual counsel and encouragement to make good those resolutions — 
if a course of conduct, which, in a good degree, comports with the 
directions of divine truth — if a manifest desire that others should walk in 
its light — if conscientious struggles to forego the temptations which most 
importunately solicit them to do wrong — if the presence of a cherished 
Christian hope, and the frequent prevalence of its power over worldly 
care and sorrow — if any and all of these things are significant of the 



94 STATE LUNATIC HOSPITAL. 

value and need of stated public worship and the regular ministration of 
divine truth, then there can be no reasonable doubt of their power and 
importance in the hospital, where, by your suggestion and influence, 
they were introduced, and where they have been, for so many years, 
steadily and orderly maintained. 

In conclusion, permit me, sir, to express the persuasion, that the re- 
cent progress in that department of humanity with which it is your lot 
to be officially connected, is a clear indication that still further advance 
will be made in the same great cause which has already gained so 
much of public confidence and good will. What has been already 
done, it is presumed, will encourage and effectively aid the future, call- 
ing forth new individual skill and enterprize, and, from our beloved 
Commonwealth, that enlarged and generous provision for the unfortu- 
nate, which is the State's wise economy and its certain revenue of 
honor. It may and must be true, that, here, as elsewhere, progress 
has its limit. Where that boundary is will not be learned by rash ex- 
periment or blind penurious distrust. Wherever it may be, it may be 
presumed to be yet distant. If it took so long to find out, that men, 
whose nature was not vacated by partial malady of the mind, might 
profit by that which is divinely adapted to their nature — if professional 
intelligence has been so slow to disengage itself from the adhesion of 
indurated errors, and so long in reaching the near conclusion, that 
men, whose temporary, intermittent, or fixed delusions, do not unfit 
them, in many cases, for the manual and intellectual occupation to 
which they have been addicted — that persons who can calmly and skil- 
fully ply the needle and other implements of housewifery, or perform 
the labors of the workshop and the field — that men who can amuse 
themselves with games of mingled chance and skill — who can patiently 
conduct the complicated strategy of the chess-boai'd — who can derive 
pleasure and profit from the perusal of books of literature and science — 
who can take part in various colloquy with such coherence and precis- 
sion that an intelligent stranger would have no suspicion of a derange- 
ment which is often most evident to others — who are eager for informa- 
tion respecting the condition and prospect of state and national affairs — 
who can discourse, with scarcely, if at all, unimpaired ability, of public 
men and measures — who can perform, and exact the performance of, 
such duties as compose the civilities and ordinary morality of life ; — if, 
I repeat it, professional wisdom was so dilatory in coming to the belief, 
that men thus capable could also, with propriety and advantage, engage 
in social worship, and receive religious instruction in the house of God, 



STATE LUNATIC HOSPITAL. 95 

is there not wide room for confidence, that humanity and skill will be 
still further gratified, by the success of their united persevering en- 
deavors to relieve the sufferings of the unfortunate, and to soften to- 
wards them the aspect of their fellow men 1 

With the hope, dear sir, that the best blessings of Divine Providence 
may rest on you, and your family, and on the hospital committed to 
your superintendence, 

I subscribe myself, 

Very respectfully, Yours, 

Geo. Allen. 
Worcester, Nov. 16, 1843. 

In the course of the past year Mrs. Cornelia Hitchcock, the wife of 
our respected steward, Charles P. Hitchcock, Esq., has been appointed 
matron of the hospital. Both these officers are admirably qualified for 
their stations, and have performed their duties in an acceptable manner. 

Doct. John R. Lee continues to be the assistant physician, and is a 
faithful and intelligent officer, well esteemed by the whole household. 

Mrs. Sarah Hay ward, still the devoted supervisor, spends her whole 
time for the benefit of the patients. 

We have a most respectable family of attendants and assistants, who 
are experienced, intelligent, kind, and faithful. To them the hospital 
is greatly indebted for prosperity and usefulness. 

Under the direction of the present respectable and efficient board of 
trustees, if my health, now recovered, shall be continued to me, I shall, 
as far as I am able, perform the duties of my station. 

Again commending the hospital to the scrutiny and protection of the 
government, and to the guidance of a wise and beneficent Providence, 
1 respectfully submit this report. 



SAMUEL B. WOODWARD. 



State Lunatic Hospital, 
Worcester, Ms., Nov. 30, 1843. 



STATE LUNATIC HOSPITAL. 



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Snow commenced at 10 A. M. — 4 inches snow. 
Thermometer 8° at 12 o'clock. 
Snow squall in the night. 

Snow commenced at 10 A. M. 

Eighteen inches of snow. 

Thermometer 7° at 8 o'clock. Circle around the 

Circle around the moon. [moon 

Thermometer 2° above at 6 A. M. 

Thermometer 7° below at 6 A. M. 

Snow squalls. 

Snow commenced at 8 A. M. 

Six inches snow and hail. 

Thermometer 8° below at 5£ A. M. 
Thermometer at at 5£ A. M. 
Snow in the night. 
Rain and hail in the night. 

Snow commenced at 2. P. M.— 2 inches snow. 




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STATE LUNATIC HOSPITAL. 



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Cold and blustering weather. 

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102 



STATE LUNATIC HOSPITAL. 



REMARKS. 


Frost in the low grounds. 
Severe frost. 

Fine showers. 

Thunder storms in the night at 10 and 12. 

[and lightning. 
Heavy storms in the evening and niglit. Thunder 
At 9 A. M. wind changed to N.E. and storm 
commenced. 

Rain at 3£ P. M. 

Rain commenced at 8£ A. M. 

High wind and rain at 5 P. M. Rainbow. 
Showers in the morning. 


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STATE LUNATIC HOSPITAL. 



103 



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Rain at 7 A. M. 

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Shower at 1 P. M. Thunder and lightning. 

Rain in the night. 

Rain commenced at 1\ A. M. 


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Snow commenced at 10 A. M. 

Snow squall in the afternoon. 

Snow commenced at 12 at night; 8 in. of snow. 

Zodiac light. 
Thermometer 6° at 6 A. M. 

Snow commenced at 2 A. M. ; 2 in. of snow. 

Rain commenced at 3 P. M. 
Snow commenced at 6 P. M. 

Snow, 13 inches. 


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