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

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SENATE - No. 1 



THIRTEENTH 



ANNUAL REPORT OF THE TRUSTEES 



STATE LUNATIC HOSPITAL 



AT WORCESTER. 



DECEMBER, 184^. 



J3 oston : 

BUTTON & WENTWORTH, STATE rillNTEKS 

NO. 37, CONGRESS STREET. 

1846. 



THIRTEENTH ANNUAL REPORT 



TRUSTEES OF THE STATE LUNATIC HOSPITAL. 



D£CE:MB£R, 1845. 



The Trustees most cheerfully perform a duty imposed by the Legis- 
lature, which first established the State Lunatic Hospital, of annually 
submitting a Report of the affairs of the Institution to the Governor 
and Council, and through them to the Legislature, for the information 
of the people of the Commonwealth. 

Accompanying this Report is that of the Treasu-rer of the Board, 
and the Report and Statistical tables of the Superintendent. The de- 
tails exhibited by the statements of these gentlemen will be found 
highly satisfactory, and of deep interest. 

The Trustees are thus precluded the necessity of adverting to many 
particulars, which otherwise they would deem it important to notice, — 
and will only speak generally of the condition of the Hospital. 

Witnessing the evidences of the Christian Philanthropy with which 
Massachusetts is imbued, in the charities of her numerous voluntary 
associations, and the munificent donations of her individual citizens 
for the relief of suffering humanity, and the diffusion of light and life 
far and near, it was natural to expect that the representatives of such 
a constituency, actuated by a similar spirit of benevolence, would 
" devise liberal things" for the alleviation of human woe in its most 
appalling form, and among the dwellers within her own borders. 

From such a people and from such a spirit originated the plan of the 
" State Lunatic Hospital ;" and well has it realized the design of its 
founders. From relatively a small beginning, (possessing only accom- 
modations for 113 patients,) by the generous munificence of the State, 



4 STATE LUNATIC HOSPITAL. [Jan„ 

and the enlightened liberality of individuals, it has increased v.ith the 
increasing wauls of the con nuuiily. 

During ilie year, the attendance of the Trustees has been regular, 
the monthly visits and examinations of the Hospital punctual and 
thorough. The records faithfully exhibit the condition of the Institu- 
tion during the several months, and this has been such as uniformly 
to command their warmest approbation. 

To the gentlemen of the Board residing in the town of Worcester, 
more arduous duties have been assigned on account of their location, 
all of which have been most cheerfully performed. 

A revision of the By-laws has been made for the better organization 
of the Hospital, adapted to its present enlarged state, distinctly de- 
fining the duties of every officer and individual in the employment of 
the Institution. 

The financial affairs of the Hospital are set forth in the detailed re- 
port of the Treasurer. Its resources are from the patients, from the 
products of the farm, and of mechanical labor. 

The current expenses of the past year are greater in proportion to 
the receipts than they will be hereafter ; a considerable outlay being 
required for the enlargement of the Hospital, and the necessary pre- 
parations for a larger number of patients, previous to their reception. 
The ordinary charge for each patient has been $2 25 per week. This 
sum is considered reasonable, and is believed to be generally satisfac- 
tory. The Trustees flatter themselves that by economical management 
the ordinary expenses of the Hospital can be met with its present re- 
sources, — and that no appropriations by the government for current ex- 
penses will be necessary in future. 

The well managed finances of the Institution are the best eulogium 
on the faithfulness and integrity of our Treasurer, the Hon, Alfred D. 
Foster. 

To present a concise view of the results that have attended the oper- 
ations of the Hospital thus far, particularly for the last year, we intro- 
duce the following summary from data furnished by the records : — 

Number of patients admitted since the foundation of the Hospital, 
thirteen years, is . . . . . . 2306 



Number discharged is . 

" now in the Hospital, is 
Recovered of all cases, 
Number of patients admitted the past year. 



1946 
860 

1038 
293 



1846.] SENATE-r-No. 1. 6 

Number of patients discharged at the Hospital, . . 196 

Average numBer in the Hospital, .... 316 

Number now in the Hospital, ..... 360 

Whole number of Officers and Attendants connected with the Hospi- 
tal, including the Superintendent, two Assistant Physicians, Chaplain, 
Steward, Matron, Supervisors and Assistants, is 75. 

Making the whole number of persons in the establishment, 435. 

During the past year, the trustees have seen, with great pleasure, the 
completion of the new buildings designed for the accommodation of an 
increased number of patients, and the other improvements, — which are 
commodious and economical. Accommodations for near four hundred 
patients are now provided by the additions which have been made from 
the Johonnot fund. 

The Bakery and the Laundry, two separate buildings constructed on 
the most approved modern plans, have succeeded to our entire satisfac- 
tion. The same amount of labor in these departments is now per- 
formed by. a less number of persons, and while the expense is thus di- 
minished the work is better done. 

The abundant supply of pure water, brought in iron pipes from an 
elevation which allows of its distribution to every part of the establish- 
ment, is invaluable. 

The farm is an indispensable appendage. Its high cultivation and 
superior stock afford the best evidence of its good management, and it 
is altogether such as the practical farmer would be gratified to inspect. 
The grounds are tastefully laid out and ornamented ; and the gar- 
dens, besides furnishing an abundant supply of vegetables, subserve the 
higher end of affording to the inmates pleasant recreation, and contri- 
bute not a little to their restoration to health. 

The enlargement of the farm, by the purchase of adjoining lands, 
has been made on very advantageous terms. This measure was ren- 
dered indispensable by the enlargement of the Hospital, and preserves 
a desirable and useful symmetry between the two. The number of 
acres in the farm is now 75, and additional lands are engaged by the 
trustees at a very reasonable rate. 

The State Lunatic Hospital has been styled " a model institution," 
and it is only by adopting improvements, which careful observation and 
practical experience have suggested, that it has attained this distinguish- 
ed excellence. One thing more is now most imperiously demanded to 
perfect the noble design of this heavenly charity. We refer to the 
erection of a building separate, and at some little distance from the 



6 STATE LUNATIC HOSPITAL. [Jan. 

Hospital, for the accommodation of the imbecile, the raving, and the 
incurable. The building should consist of solitaries and large rooms 
with suitable conveniences for the comfortable residence of these classes 
of patients. 

The following facts demonstrate the necessity of such an addition, 
and the advantages that would result from it : — 

1st. With our present arrangements we have no suitable places for 
the classes of patients above referred to. The solitaries now used for 
those who require confinement, are not constructed on the most im- 
proved plan as regards ventilation and comfort ; and, indeed, are the 
only unpleasant part of the whole establishment. 

2d. Their proximity to the other apartments disturbs the comfor* 
and quietude of large classes of patients of a different character, — be- 
comes to them a positive injury, — and defeats the important advantages 
of a judicious classification of the patients. 

3d. Many of the harmless and demented do not need separate 
lodges, but may very advantageously occupy large rooms, and of 
course require a less number of attendants ; thus the expense of their 
maintenance may be materially diminished. 

4th. By the proposed arrangement, the Hospital can receive an in- 
creased number of patients. This last consideration derives additional 
force from the fact, that Massachusetts, as yet, provides only for about 
two thirds of her insane poor. 

With the remainder of the Johonnot fund, which will be available 
to this object, an additional sum of not exceeding twelve thousand dol- 
lars will be sufficient to effect the desired object. A favorable location 
has been contemplated at a suitable distance from the Hospital, on a 
beautiful elevation, and peculiarly adapted to this purpose. 

The original buildings of the Hospital, and the large, recent addi- 
tions, were erected by the same architect, Mr. Elias Carter. Though 
built at different times, as the exigencies of the Institution required, 
the whole is commodious and symmetrical. 

With this contemplated improvement, which the Trustees regard as 
most urgent, the State Lunatic Hospital will stand preeminent in its 
wise arrangements and superior advantages. 

In the Report of the Superintendent, much valuable information is 
communicated in relation to the causes and the treatment of insanity. 

The Trustees regard the diffusion of such information as an import- 
ant collateral advantage of the Hospital. 

A knowledge in the community of certain causes that induce insan- 



1846.] SENATE— No. 1. 1 

ity, will tend to their removal ; and as society and the medical profes- 
sion are made better acquainted with the rational treatment of the in- 
sane, many will receive benefit from the institution, who are never 
admitted as patients. The fact that experience declares that kindness 
in the management of the insane is better than severity, would, if uni- 
versally impressed, of itself, do much good. The treatment divides 
itself into medical and moral. The principle is recognized that aberra- 
tions which affect the body only, or the mind only, or involving both, 
are only restored by cooperating with the ever active recuperative 
powers of the system in removing the cause, if curable, or in obviating 
the effects, if palliative only — and to this point, the treatment, both 
moral and medical, is directed. 

And here we would pay that tribute to merit which is so justly due 
to our excellent Superintendent. Well educated in the science of med- 
icine, for more than 20 years devoted to its practice, combining kind- 
ness of heart with decision and energy of character, Dr. Woodward 
was peculiarly qualified to take charge of the Institution ; and now with 
13 years experience in this particular department of medicine, possess- 
ing the entire confidence of all our predecessors, we were prepared to 
expect that the duties of his office would be ably and faithfully per- 
formed, and we have not been disappointed. 

To the Chaplain, the Rev. George Allen, the Assistant Physicians, 
Drs. J. E. Lee and Rufus Woodward — to the Steward and Matron, Mr. 
and Mrs. Hitchcock, and the other officers and attendants, the Trustees 
take pleasure in awarding their highest approbation. 

Notwithstanding the number of insane persons from one cause, in- 
temperance, has greatly diminished, other causes are still in operation, 
which, with an increasing population, produce a proportionate increase 
of subjects for a Lunatic Hospital. 

In the progress of civilization, with all its attendant blessings, we 
have as yet to mourn over the fact, that so far from a diminution of 
insanity, there has been an alarming increase. Insanity is rare in a 
savage state of society. One reason for this disparity undoubtedly, is, 
the substitution of the luxurious and artificial, for the more simple and 
natural modes of life. Another and more important one is, that among 
the ignorant and uncultivated, the mental faculties lie dormant, and 
hence are less liable to derangement. 

But in an age like the present, when mind is aroused, and light is 
dissipating the darkness which has rested like an incubus on the intel- 
lect ; and in a country like our own, where freedom of thought and 



8 STATE LUNATIC HOSPITAL. [Jan. 

action are almost unlimited ; where enterprise is stimulated by the 
bright promises of success ; where novelty and experiments, and wild 
speculation dazzle the imagination and bewilder the judgment, what 
other results can we expect from the extravagance and ultraism of the 
day, than numerous aberrations of mind ? They will occur and must 
be provided for by a wise and humane government. 

And yet we may confidently look forward to a more advanced state 
of improvement, when the evils now attendant on progress will rapidly 
diminish — when body and mind shall be subjected to law, which, while 
they impart vigor and energy, will preserve a healthful and harmonious 
condition of both. 

The State Lunatic Hospital of Massachusetts, the offspring of a be- 
nevolence most honorable to her citizens, has already proved an incal- 
culable blessing to the State. In the distribution of its benefits, the 
preference has always been given to her unfortunate and friendless 
poor. Nor have the advantages of the Hospital been confined to the 
State. The praiseworthy example here set, has exerted an influence 
over the whole country. Since the establishment of this Asylum, 
which was one of the earliest in the United States, similar institutions 
have sprung up in about twenty other States — and soon there will be no 
State where provision is not made for this unfortunate class. And, to 
the honor of Massachusetts be it said, that to her Hospital other States 
have looked as the " Model Institution." 

In conclusion, the Trustees would gratefully recognize the kind Prov- 
idence that directed the attention of the Guardians of the State to the 
relief of a class of their fellow citizens and fellow men, deprived of 
the exercise of those higher faculties which distinguish man from the 
lower orders of creation, and suffering under the heaviest curse to which 
our fallen nature is subject. Through the goodness of the same Prov- 
idence, the measures adopted have been crowned with the most grati- 
fying success. The victims of insanity have been transferred from the 
abodes of filth and wretchedness to those of cleanliness and comfort — 
from chains and dungeons to liberty and the pleasant light of day — the 
broken links in the family circle have been reiinited — the effaced like- 
ness, and the marred image of the Creator restored, and joy and glad- 
ness have been carried to the hearts of thousands of our fellow citi- 
zens. 

In these results the Trustees have found the highest reward of their 
own labor, and are more than repaid for all the sacrifice of time which 
the duties of their office have required. 



1846.] SENATE— No. 1. 9 

We ask for the Institution the fostering care of the government, and 
commend it to the enduring blessing of Heaven. 

H. H. CHILDS, 
JOSEPH SARGENT, 
S. C. PHILLIPS, 
STEPHEN SALISBURY, 
JESSE MURDOCK. 



10 



STATE LUNATIC HOSPITAL. 



[Jan. 



TREASURER'S REPORT. 



To His Excellency George N. Briggs, Governor, and to the Honor- 
able Executive Council of the Commonwealth of Massachusetts : 

The Treasurer of the State Lunatic Hospital respectfully presents 
his Thirteenth Annual Report : 

The Treasurer charges himself from December 1, 1844, to Novem- 
ber 30, 1845, inclusive, as follows ; 
For cash on hand, Dec. 1, 1844, balance of ac- 
count, ---.... $2992 83 
For receipts from the State Treasury for State 
Pauper Lunatics, and from cities, towns, and 

individuals, - 31,885 83 

For credits on bills for sundry articles sold, 6sc., 622 42 
For amount overdrawn at the Worcester Bank, 

carried to next account, - . - . 8387 57 

$43,888 65 

He credits himself as follows : 
For payments for improvements and repairs, 

including 11047 81, paid for land, - - $3255 68 
For payments for salaries, wages and labor, - 10,549 97 
« " " clothing, linen, &c., - - 2332 70 

" " " furniture and bedding, - • 1921 36 

« " " fuel and lights, - - - 6098 28 

" " " provisions and groceries, - 17,132 21 

" " " medical supplies, - - 579 24 

« " " hay, $263 79, straw, $160 25, 424 04 

" " " miscellaneous, - - - 1595 17 



The item fuel and lights includes — 
Wood, 954 cords, 7 feet 2 inches, - - - $4292 35 

Charcoal, 2617 bushels, 235 48 

Anthracite, 121 tons, 1275 lbs., - - - 947 34 

Wick, 6 79 

Oil, 659 gallons, 616 32 



-$43,888 65 



16098 28 



1846.] SENATE— No. 1. 11 

The Treasurer supposes the Institution to be now supplied with the 
officers and attendants thought by the Trustees and Superintendent ne- 
cessary since the enlargement, and he exhibits a tabular statement, 
such as was given in his reports from the second to the tenth inclusive, 
but which was omitted in the two last reports, because thought by him 
to be unnecessary. 



12 



STATE LUNATIC HOSPITAL. 



[Jan. 



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Mary Ann Johnston, 
Eliza E. Morse, 
Sophia N. Fay, 
Hannah Baker, 
Mary Kelley, - 
Martha Fountain, 
Zoa S. Hamlin, 
Benjamin F. Stow, - 
Lozano C. Knowlton, 
John Heywood, 
Ephraim C. Chamber 
Henry S. Snow, 
Willard B. Parks, - 
Junia S. Evans, 
John A. Bruce, 
John Gates, 


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16 



STATE LUNATIC HOSPITAL. 



[Jan. 



Provisions and Groceries include 



Fruits, &c., 


. 


. 




$1409 84 


Salt, spices and small 


groceries. 




- 


232 90 


Soap, 


- 


. 






571 58 


Eggs, 


- 


1050 1-2 dozen, - 






154 67 


Cheese, 


. 


9786 1-2 lbs. 






767 05 


Butter, 


- 


17,142 1-2 lbs. 






2771 08 


Milk, 


- 


, 40 cans. 






42 93 


Peas, dry and green. 


. 


- 




48 61 


Beans, 


- 


47 bushels 1 quart, 






73 10 


Shells, 


- 


30 lbs. 






3 30 


Tea, 


- 


1432 lbs. 






386 52 


Coffee, 


- 


2588 lbs. 






185 57 


Biscuit, 


- 


- 






184 84 


Brown Sugar, 


- 


19,811 1-2 lbs. 






1443 91 


White Sugar, 


- 


1351 lbs. 






167 00 


Molasses, 


- 


866 gallons, - 






295 26 


Honey, 


* 


341 1-4 lbs. 






36 94 


Vinegar, 568 gallons ; 


cider, 3 bbls. and sundry bottles, 




70 34 


Rice, 




2721 lbs. 


#• 




101 76 


Corn, 




1051 bushels. 






775 22 


Oats, 




98 bushels. 






36 75 


Rye, 




492 bushels, 






388 27 


Barley, 




5 bushels. 






3 00 


Flour, 




333 barrels. 






1819 00 


Turnips, 




31 bushels. 






6 20 


Potatoes, 2423 3-8 bushels, and 1-2 acre by the lot 


> 




1031 11 


Poultry, 


- 


1328 3-4 lbs. — 4 doz. pigeons. 




127 76 


Fresh Fish, - 


- 


. 


- 




92 82 


Salt Fish, - 


- 


5446 lbs. 


- 




153 76 


Halibut, 


- 


100 lbs. 


- 




4 00 


Mackerel, - 


- 


3 barrels, - 


- 




35 50 


Oysters, 


- 


23 gallons - 


- 




27 79 


Salmon, 


- 


3 barrels 36 lbs. 


- 




46 40 


Shad, 


- 


2 barrels, - 


- 




16 00 


Ham and dried beef, 


1934 10-16 lbs., and smoking others. 


192 09 


Mutton and lamb, 


- 


2483 lbs. 


- 


- 


195 78 



- fl7 11 


- 2286 72 


- 375 51 


- 342 79 


- 50 76 


- 49 44 


- 24 00 


- 87 23 


f 17,132 21 



1846.] SENATE— No. 1. 17 

Tripe, - - 191 1-2 lbs. 

Beef, - - 37,092 1-2 lbs. 

Pork, - - 5740 lbs. 

Veal, - - 5191 1-4 lbs. 

Salt Pork, - - 1 barrel, 422 lbs. 

Salt Beef, - - 961 3-4 lbs. 

Tongue, - - 232 lbs. 

Sausages, - - 901 lbs. 

Amount of provisions and groceries, 



Miscellaneous includes 

Cash advanced to patients and charged in their accounts, or 

paid to them when leaving the Hospital, - 
Expenses after elopers or for their return, - 
Funeral expenses, - - - - - 

Postage, .-.-._ 
Expenses of Trustees' visits, 
Filling ice cellar, 25 50 ; ice, 3 84, 
Pasturing cattle, . - . - - 

Stationery, printing and periodicals. 
Six visits of Steward to Boston to purchase supplies. 
One pair of oxen, two horses, eight cows, one bull, one calf, 

one pig, and exchange of pigs. 
Rent and care of room for Chaplain, 
Sundries, --.-.. 

Amount of Miscellaneous, _ - - 



The preceding account shows a large balance against the Hospital 
on the first of December current. It is partly to be accounted for from 
the fact, that the increased number of patients were all to be supported 
in advance of any thing being paid for them, as the bills did not become 
due till the date to which the account is made up. Including the pur- 
chase of land, there has been much more than usual expended the past 
year, under the item " improvements and repairs." The expenses 
under this head need not be, and probably will not be, continued on 
this enlarged scale — at least that is the Treasurer's opinion. The ag- 
gregate of every other item must, on account of the enlargement of 
3 



- $234 85 


- 51 


14 


- 128 00 


- 107 48 


- 182 


12 


- 29 


34 


- 31 


09 


- 118 


34 


- 27 56 


- 602 


50 


- 43 00 


- 39 


75 


^1595 


17 



18 STATE LUNATIC HOSPITAL. [Jan. 

the institution, be necessarily very much increased in future, compared 
with past years. Should the rigid economy with which the Institution 
has been formerly managed, prevail hereafter, the proportional expense 
will not be greater than it has formerly been. But the tendency in all 
institutions, which depend, in any measure, on the public treasury for 
support, is to increased liberality of expenditure. In the case of this 
Hospital for the insane, who here are, generally, of the poorer classes, 
it is reasonable and fair to presume, that every person who has any 
care in its management will remember it is not the public treasury, 
which bears the larger share of the expense, but the patients them- 
selves, or those liable to support them. This certainly has been re- 
membered, and it ought not to be forgotten. 

Ever since its foundation, the Hospital has been aided in some form 
from the State Treasury. It is right that it should be so, as large num- 
bers of State Pauper Lunatics have always been among its inmates. 
Provision by law now exists, whereby these patients are made chargea- 
ble to the Commonwealth, and the expenses of their support are paid 
from its Treasury. The amount thus received in 1845 was §4,909 70, 
and more than $7,000 is expected on a like account in 1846. It has 
heretofore seemed to the Treasurer that, with the appropriation for 
paying for State Pauper Lunatics, the Hospital need not require further 
aid from the Legislature. It is to be hoped he did not mis-judge ; but 
the present condition of his accounts leads him to fear it may be other- 
wise. 

A larger amount of bills for fuel than usual became due in Novem- 
ber and December of this year; and a less amount of groceries was 
on hand at the close of the year. This has made additional advances 
necessary, and including the balance of account to December first, 
there has been paid out the sum of $10,181 02, which is to be met by 
the receipts subsequent to December first, and the current expenses of 
the Hospital are to be paid from the same source. 

Not including accounts for State Paupers, the balances of 
all accounts accrued to December 1, considered good, 
but not all then due, amount to . . . $18,249 16 

The account for State Paupers, as made up by the Treas- 
urer to December 1, amounts to . . . 7,751 35 

The appropriation for the current expenses of the Hospi- 
tal, made by Resolves of March 3, 1842, and still un- 
paid, is ..... . 2,000 00 



1846.] SENATE— No. 1. 19 

Supposing this all paid within six months, (which cannot 

be expected,) it will be ... . ^28,000 51 

From this deduct, already expended, . . . 10,181 02 

There will remain the sum of . • . . ^17,819 49 

to support the Institution the six months ensuing December first. This, 
it is manifest, is less than half the expenditure of last year, though that 
of the first half of the year was based upon a smaller number of pa- 
tients than are to be calculated for this year. The Treasurer is thus 
brought very reluctantly to the conclusion, that one or all of three 
things must be done — the expenses of the Institution curtailed, the price 
of board materially increased, or an additional appropriation made to 
meet the current expenses of the year. Whether the expenses can be 
diminished, the Superintendent and Trustees are more competent to 
judge than the Treasurer, and to them, not to him, this inquiry belongs. 

The law contemplates that paupers shall be supported at charges not 
exceeding the actual cost of support. The actual cost must be greatly 
controlled by the prices of articles consumed — salaries and wages re- 
maining the same ; and it is apparent that many of those articles are at 
higher market prices than they have been for some time. It is believed 
that the accounts will shew the purchases to have been generally made 
at the lowest market prices. Supposing them to continue to be so 
made, it would seem just and proper for the ensuing year, proportion- 
ally, to enhance the price of board. But this also rests with the Trus- 
tees, who will, doubtless, exercise a sound discretion. And, whether, 
after all, an appropriation will be necessary, is a matter which the 
Treasurer prefers to leave with those to decide, who have the power to 
make it. He has stated the facts on which an opinion is to be formed, 
as well as he can without more detail than is suitable. He will be hap- 
py to open his books and vouchers to any who are authorized to exam- 
ine them, and to make any explanation or give any information in his 
power. 

It may be expected of the Treasurer to state the condition of the 
Johonnot funds. The property in which those funds were invested, 
has all been converted into cash, except 35 shares of the stock of the 
Ipswich Bank, on which the Bank has paid 78 per cent. 

The amount received was .... -$44,318 37 

The amount expended for building and furnishing the Jo- 
honnot wings of the Hospital, was . . . 40,106 84 

Leaving unexpended and in bank, the sum of . . $4,211 53 



20 STATE LUNATIC HOSPITAL. [Jan. 

From the information he had received from the Agent of the Com- 
missioners, the Treasurer was led to suppose the whole would be re- 
quired, and therefore reduced the funds to cash. But, on settlement in 
September last, the gratifying fact appeared, that this large operation 
had been carried on, and every thing satisfactorily done within the esti- 
mates originally furnished — a fact almost without a parallel, either in 
public or private experience. 

It will be the duty of the Treasurer to re-invest the above mentioned 
balance of the Johonnot funds, and to pay the income to the State 
Treasury, as he has hitherto done, unless the Legislature otherwise 
direct. He has not yet done it, because he thought it highly probable 
it would be used, under the authority of the Legislature, for some per- 
manent improvements, or for the purchase of land, and because of his 
over-drafts on the Bank where it is deposited. 

The appropriations, drawn from the Treasury of the Commonwealth, 
for building a barn and shops ; for building a laundry ; for laying an 
aqueduct, and paying for damages for land taken for the aqueduct, and 
for the purchase of land, have severally been exactly expended, and 
the accounts exhibited to the Trustees, and by them approved. 

ALFRED D WIGHT FOSTER, 
Treasurer of the State Lunatic Hospital. 
Worcester, December 22, 1845. 



1846.] SENATE— No. 1. 21 



THE THIRTEENTH REPORT 

OF THE 

SUPERINTENDENT TO THE TRUSTEES 

OF THE 

STATE LUNATIC HOSPITAL, 

WORCESTER, MASS., 

From Dec. 1st, 1844, to Nov. 30th, 1845, inclusive. 



The State Lunatic Hospital, with its enlargements and appendages, 
is now nearly filled with patients. The additions made by the appro- 
priation of the Johonnot fund, were partly finished in February last, 
and entirely completed in the month of July. They are already exten- 
sively occupied, having in them at this time about 70 male patients and 
60 females. In all, we have now 360 patients occupying eighteen gal- 
leries, a few solitary apartments, and male and female dormitories for 
the sick. At the rate of increase since the new apartments were in 
readiness before they shall have been opened a year, every room will 
be occupied. 

With some imperfections, which could be remedied by building a 
large institution at once, instead of many times, this is a noble struct- 
ure, affording comfortable accommodations, well arranged for classifica- 
tion, and well adapted to the wants of the insane. 

When the first Hospital building was erected, a few solitary rooms 
were provided ; and when the first wings were added, some basement 
rooms were finished, in a rough and imperfect manner, for the violent 
and dangerous patients. These rooms are now not only insufficient for 
the present purposes of the institution, but they are also gloomy, un- 
comfortable and badly ventilated apartments. To complete the arrange- 
ments for such a large number of patients, and to make the classifica- 
tion more perfect, so that the noisy and violent patients can be separat- 
ed from the quiet and convalescent, another building is needed, partly 



22 STATE LUNATIC HOSPITAL. [Jan. 

to take the place of the basement rooms, and partly to add some dormi- 
tories for the imbecile and quiet, and increase the number of rooms for 
this class, which, in an institution of this character, may be fairly esti- 
mated at about ten per cent, of the whole. 

So far as I am able to judge, from my own experience and the obser- 
vations of others, in this country ten per cent, of the patients require 
strong or protected rooms, and about the same proportion can be safely 
lodged in dormitories. I am not greatly in favor of dormitories in which 
a large number of patients lodge together ; it is repugnant to all the 
feelings of delicacy belonging to human nature. Nothing could be 
more disagreeable to a person of delicate feelings than to be constrain- 
ed to sleep in a room with a large number of individuals, even for a 
single night ; but to be obliged to lodge in this way from month to 
month, or from year to year, would be exceedingly objectionable. The 
timid often do well to sleep with others in the same apartment, and to a 
suicidal patient it may be some protection to sleep in a room with anoth- 
er patient, or with an attendant ; but where the propensity to sui- 
cide is strong in any case, this protection would be inadequate, and 
could not be relied upon. The patients in our own Hospital are differ- 
ent from those found in many of the large asylums in Europe. An in- 
stinctive love of liberty characterizes the American people, and there 
are few individuals who would be willing to be inmates of any place of 
confinement on account of a daily allowance of abundant food and 
other comforts of life. Our poor have little fear of starvation or other 
suffering from mere poverty ; when they are well, they can provide for 
themselves, and as soon as they recover from insanity or other disease 
in insane or other Hospitals, they yearn for liberty, and desire enlarge- 
ment. Dormitories are not well suited for this class of restless beings, 
though they may do well for paupers who are glad to remain where 
abundance of food is provided, and shelter and lodging secured to 
them. 

In most of the Hospitals in this country now being erected or en- 
larged, the dormitory system, as now extensively in vogue in Europe, 
is not adopted. Probably in no one more than ten per cent, of the pa- 
tients are designed to lodge in this manner. This is well, and shows 
that practical wisdom has prevailed over theories untried in the con- 
struction of our Hospitals. 

I think it not amiss to place a few patients together in dormitories, 
under the care of an attendant ; but I should be particularly careful 
that those affected with periodical excitement, and the impulsive insane 



1846.] SENATE— No. 1. 23 

should not be of the number. Almost every homicide that has been in 
this Hospital, and the number has been unusually great, has been con- 
sidered safe and harmless before he committed the act. Even the dull 
and harmless insane, those that have been for a long time passive and 
stupid, occasionally wake up to a sudden outbreak of violence, do some 
considerable mischief, and again become passive and stupid. 

A few years ago, a man who had been for many years dull and quiet 
in his cage, was let out by his friend as an experiment, thinking he was 
quite harmless. He immediately seized a weapon, pursued an idiot 
brother, and killed him in the presence of his liberator, before they 
could again secure him. He spent the remainder of his days in this 
Hospital, quite docile. 

Another insane man, considered perfectly harmless, in an alms-house 
in this State, was sitting at breakfast with his associates in presence of 
his keepers ; he rose deliberately, seized a billet of wood, and, with a 
well-directed blow upon the head of a poor woman, killed her upon the 
spot, and exhibited no agitation after the deed. For a long time after 
this, he was in our care, was usually quiet and passive, but occasionally 
impulsive. 

An insane man who was usually considered harmless, and who had 
never been separated from his family on account of any violence, 
while sitting in conversation with his wife, rose deliberately, went into 
another room, took up a bludgeon, aimed a deadly blow at the head of 
his wife and killed her. He spent the remainder of the day in la- 
menting the deed. He has been in our care more than twelve years, 
is usually a quiet, conscientious man, but occasionally impulsive and 
passionate. 

A worthy, religious woman, laboring under melancholy, who had 
the care of her family and was left in the house with her two children, 
attempted to destroy them, inflicting dreadful wounds upon them and 
upon a neighbor who came to their rescue. She came to our care and 
recovered. ' While insane, she appeared exceedingly timid and harm- 
less ; no one unacquainted with her previous history would have sus- 
pected her capable of any act of violence. 

A young man, who was insane from love, was left in charge of an 
infant by its mother, while she was engaged abroad ; he cut its throat 
from ear to ear, and the mother on her return found her child dead. 
This man has been with us some years, and, protesting his innocence, 
spends hours every day in prayer that he may be forgiven. He is 
usually quite harmless, but impulsive and excitable. 



24 STATE LUNATIC HOSPITAL. [Jan. 

These cases show that though some insane persons may live together 
in dormitories, the least suspected may become suddenly excited, and, 
before even an attendant could be aroused and come to the rescue, 
might do fatal mischief. I believe those who have the care of the in- 
sane, generally feel safest when they are in separate apartments at 
night. 

Our principal experiment with dormitories last winter, was success- 
ful, and no harm took place ; but we had repeatedly to change some of 
the twenty patients in the course of the season, to bring together such 
as seemed to us perfectly harmless. It is not uncommon in large es- 
tablishments to have sudden outbreaks with those who have been a long 
time quiet. 

This Hospital, having separate rooms for about three hundred and 
sixty patients, and dormitories for twenty or more sick, would be well 
fitted for all classes if it had thirty strong or protected rooms, to take 
the place of some badly constructed ones, and dormitories for thirty 
more. Such apartments can be easily added, and increased accommo- 
dations can hardly fail to be needed. 

The general plan and arrangements of this Hospital are most ap- 
proved for large establishments in this country. It has a tier of rooms 
each side of a spacious corridor, three stories high. Those being 
erected or enlarged at the present time are mostly of the same ar- 
rangement. The H and the L forms present nearly the same advan- 
tages, both ends of the galleries can be open to the light, and a free 
circulation of air, and both forms make a compact building. In such 
a constructed building, as much of the upper story as is desirable can 
be left for day rooms or dormitories, these can afterwards be divided 
into separate apartments if necessary. 

The Star form of building is objectionable inasmuch as one end of 
the corridors must be closed and come in contact with the centre build- 
ing, and as the wings converge the apartments come too near each 
other. 

The Lineal form is good for a small building, but then even I should 
prefer two tiers of rooms, a spacious corridor, and three stories. 

In all the institutions I have visited, the upper story is the pleasantest, 
and is generally occupied by the best class of patients. Three stories 
can be well heated by a furnace of the right construction. A building 
of this description costs less in proportion than any other, can be as 
thoroughly ventilated, and more easily warmed. If the Hospital is to 
contain many more than one hundred patients, the L or H form is pre- 



1846.] SENATE— No. 1. 25 

ferable to the lineal form. If it is to accommodate three or four hun- 
dred, the latter form is quite objectionable, as it will extend too far 
from the centre, where the places of business and domestic labor must 
be located. 

Taking all things into consideration, for such a large establishment 
as this Hospital, designed as a public institution, it is doubtful whether, 
considering comfort, convenience, ease of supervision, warming, ven- 
tilation, and economy of ereclion, there has been a better p'iui devised, 
and the adoption of it by the States of Maine, New Hamjjsliire, New 
York, New Jersey, Ohio and Virginia, which have been moie recently 
erecting similar establishments, is some proof in favor of ibis view of 
the subject. 



26 



STATE LUNATIC HOSPITAL. 



[Jan. 



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38 



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SENATE— No. 1. 



39 



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40 



STATE LUNATIC HOSPITAL. 



[Jan. 



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1846.] 



SENATE— No. L 



41 






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42 



STATE LUNATIC HOSPITAL. 



[Jan, 



TABLE 1. 

Showing the Committals from each County in the State, the present and 

previous years. 



Barnstable, 

Berkshire, 

Bristol, 

Dukes, . 

Essex, 

Franklin, 

Hampden, 

Hampshire, 

Middlesex, 

Nantucket, 

Norfolk, . 

Plymouth, 

Suffolk, . 

Worcester, 

Private boarders. 



Males, 
Females 

Males, 
Females 

Males, 
Females 

Males, 
Females 

Males, 
Females 

Males, 
Females 

Males, 
Females 

Males, 
Females 

Males, 
Females, 

Males, 
Females, 

Males, 
Females, 

Males, 
Females, 

Males, 
Females 

Males, 
Females 



2 

10 

6 
4 

17 

8 




23 

18 

2 



4 
6 

9 
3 

16 
19 

4 
1 

30 
13 

11 
1 

11 
11 

29 
32 



293 



Previously. 



41 
62 

124 
6 

269 
69 
86 

113 

224 
14 

204 
85 

210 

500 

6 

2013 



1846.] 



SENATE— No. L 



TABLE 2. 

Showing the nurnber of Admissions, and the state of the Hospital^ from 
December 1st, 1844, to November 30, 1845. 



Patients in the Hospital in the course of the year, .... 556 

Males, 292 

Females, 264 556 

At the commencement of the year, . . • 263 

Males, 128 

Females, 135 263 

Admitted in the course of the year, > . . 293 

Males, , . 164 

Females, 129 293 

Remain at the end of the year, 360 

Males, 192 

Females, 168 360 



Patients admitted. 




293 


Patients now in the Hospital, 


360 


Males, . . 164 






Males, . . 192 




Females, . 129- 


-293 




Females, . 168—360 




Cases of duration less 










than one year, . 


, 


156 


Cases of duration less 




Males, . . 81 






than one year, . 


63 


Females, . 75- 


-156 




Males, . . 33 
Females, . 30 63 




Cases of longer duration 










than one year, . 


. 


137 






Males, . . 83 






Cases of longer duration 




Females, . 54- 


-137 




than one year, . 
Males, . . 159 


297 


Cases committed by the 






Females, . 138—297 




Courts, 


167 








By the Overseers, . 


21 








Private boarders, . 


105—293 


Foreigners discharged 










the last year, . 


18 


Foreigners now in the 






Males, . . 13 




Hospital, . 




57 


Females, . 5 18 




Males, . . 24 










Females, . 33- 


—57 









Since the completion of our new apartments, the number of patients 
has greatly increased. The number of residents is greater by 65, than 
it was last year, and nearly 100 greater than it was the year before. 
The number admitted has been very great. The number of discharges 



44 



STATE LUNATIC HOSPITAL. 



[Jan. 



has been less than last year. Having had an abundance of room, we 
have not been obliged to send away harmless and incurable or danger- 
ous patients to jails and houses of correction, to make room for such as 
are sent by a legal process. For the same reason, we have kept no 
account of applications for admission ; all proper subjects who have 
applied for admission have been received. There have been numerous 
applications from abroad that have not been received, being prohibited 
by the regulation which rejects all who have not a residence in this 
Commonwealth. 

The statistical year closed in 1844, with more than thirty patients 
beyond the extent of our accommodations. When the new apartments 
were finished, these patients were here to fill them, and it was not till 
mid-summer when all the new apartments were in readiness that we 
could say we were not full. Mid-summer again will hardly fail to find 
us again full, and we fear under the necessity of rejecting applications 
or sending the incurable insane into receptacles unfit for their residence, 
and which will be more disagreeable from the contrast with the better 
quarters here provided. 

TABLE 3. 

Showing the numier of Discharges and Deaths, and the condition of 
those who have left the Hospital, from Dec. Ist, 1844, Zo Nov. 1st, 1845. 





a 

1- 


1 


■a 

i 

p. 

g 


II 


►So 


5 


o 


Patients discharged, . 196 
















Males, 


100 


64 


11 


5 


5 


15 


100 


Females, 


96 


58 


14 


15 





9 
24 


96 




196 


122 


25 


20 


5 


196 


Patients discharjred whose 
















insanity was of less du- 
















ration than one year, 104 
















Males, 


57 


49 


1 





1 


6 


57 


Females, 


47 
104 


44 


1 






1 


2 

8 


47 




93 


2 





104 


Patients discharged whose 
















insanity was of longer 
















duration than one year, 92 
















Males, 


43 


15 


10 


5 


4 


9 


43 


Females, 


49 


14 


13 


15 





7 


49 




92 


29 


23 


20 


4 


16 


92 



1846.] SENATE— No. 1, 45 

The number of patients discharged the past year, has been less 
than usual. This has arisen from the fact, that after February the new 
wino-swere so far completed as to receive all patients whom the friends 
wished to remain, which prevented the necessity of discharging, as in 
former years. It has been as gratifying as desirable, to be able to find 
accommodations in the Hospital for all the proper subjects of it who 
desired a residence here. This can hardly be expected another year, 
if the proportion of admissions of old and incurable cases be as great 
as formerly. 

The State of Massachusetts should not be satisfied till her citizens be 
fully provided with accommodations for the insane. It is not sufficient 
that the poor be provided for. The day is probably past when private 
charity will be extensively relied upon to erect Hospitals. The Com- 
monwealth has taken the business into her own hands, and should not 
be satisfied till suitable provision shall be made for all who may need a 
Hospital for the cure of insanity, or an Asylum for custody and com- 
fort. The middle and poorer classes of society need this aid from the 
government, and when one of their number is attacked with this dis- 
ease, they look to a public institution for relief, where the necessary 
aid can be found at a moderate price. Such institutions should be 
found in this State, and they should never be so crowded that any indi- 
vidual need be rejected for want of room. 

There is in this State a large class of very worthy citizens, who, by 
industry and frugality, are enabled to live comfortably while their fam- 
lies are in health, and who spurn the idea of becoming a public charge ; 
but when one of their number becomes insane, and requires the care 
of others, thus suspending the efforts by which they earn their daily 
bread, they almost immediately require aid, and hail with gladness such 
arrangements in a Hospital as will afford the best possible care of their 
friends at a moderate charge, thus enabling them to earn instead of 
expending, and saving them the mortification of applying for public 
assistance. Much as the insane poor need the establishment of institu- 
tions of benevolence to aid them in their suffering, this much larger 
class have the strongest claim upon the public. It is more desirable to 
prevent than to relieve pauperism ; and aid afforded to such individuals 
in this indirect way, does not subject them to the feeling or the impu- 
tation of paupers ; they pay a moderate weekly charge for the support 
of their friends, and feel grateful to the Commonwealth for the liberal 
provision made to their benefit. 

Insane Hospitals should be considered charities, and should be made 



STATE LUNATIC HOSPITAL, 



[Jan. 



such, or the benefit to be derived from them must be limited in extent 
and not reach a large majority of the community who most need the 
aid which they afford. The wealthy can always be provided for ; mon- 
ey will command all the appliances within the reach of the sufferer, 
but those in moderate circumstances gladly avail themsetves of these 
public charities. 

TABLE 4. 

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



Monthly Average. 


Admissions. 


Discliarges. 


December, 270 1-2 


27 


16 


January, 










276 1-3 


19 


13 


February, 










279 1-2 


15 


15 


March, . 










289 2-3 


25 


6 


April, . 










305 


27 


11 


May, . 










319 1-2 


28 


19 


June^ 










327 


23 


16 


July, 










337 


25 


17 


August, 


^ 








337 


20 


20 


September, 










340 


25 


21 


October, 










350 2-3 


30 


19 


November, 










355 2-3 


29 


23 


Yearly av 


erage, 








316 


293 


196 



During the last sixty days, there have been admitted to the Hospital, 
fifty-nine patients, and, for the last year, the average has been nearly 
one for every business day in the year. The condition of a Hospital 
that has so many changes, is almost necessarily less quiet than one that 
has a great number of stationary residents. This difficulty is nearly 
counterbalanced, however, by the advantages of classification. The 
statistical year of the Hospital closes with 97 more patients than last 
year. 



1846.] 



SENATE— No. L 



47 



TABLE 5. 

Showing the number of Residents^ the average number of Patients, the 
number at the end of each year, and the Expense of each year ^ for 
the thirteen years the Hospital has been in operation. 



The Year. 


No. of Residents. 


Average No. 


No. at the end of each year. 


Annual Expense. 


1833 


153 


107 


114 


^] 2,272 91 


3834 


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 


1844 


491 


261 


263 


29,278 75 


1845 


556 


316 


360 





The expense of supporting a patient at the Hospital has varied, ac- 
cording to the value of the necessaries of life, from $112 17 to $168 
42, averaging $130 62. The average for the five years preceding the 
present year, is $117. For the whole time of thirteen years, the aver- 
age charge for board has been at the rate of $2 50 per week, and for 
the five years preceding the present year, the average expense has 
been $2 25 for each patient. The expenses of the past year have been 
greater than the previous years, because new apartments have been 
opened, requiring additional assistants, greater in proportion to the num- 
ber of patients actually in their care, and because the price of provis- 
ions has gradually risen during the last quarter, from 15 to 30 percent. 
above what it was last year, or the first two quarters of the present year. 
The present high price of provisions will necessarily increase the ex- 
penditure of the present quarter considerably. The price of labor in 
the Hospital has been nearly the same for ten years. It is difficult to 
diminish the expense so as to materially lessen the price of board. The 
wages are not too high for the services rendered, and the fare is simple 
and substantial, not embracing many luxuries. 



48 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 6. 
Statistics of the Hospital, from January, 1833, to Nov. 30th, 1845. 





1833. 


1834. 


1835. 


1836. 


1837. 


1838. 


1839. 


1840. 


1841.1842 


1843. 


1844. 


1845. 


Whole No. of patients 
admitted, 


153 


119 


113 


125 


168 


177 


179 


162 


163 198 


220 


236 


293 


Discharged, including 
deaths and elopements, 


39 


115 


112 


106 


121 


144 


168 


155 


167 


191 


203 


228 


196 


Discharged recovered, . 


25 


64 


52 


58 


69 


76 


80 


82 


82 


88 


116 


124 


122 


Discharged improved, . 


7 


22 


23 


17 


23 


24 


S9 


27 


36 


25 


32 


40 


25 


Discharged not improved. 


2 


20 


28 


22 


20 


28 


37 


29 


37 


66 


33 


49 


25 


Died, .• . 


4 


8 


8 


8 


9 


16 


22 


15 


12 


12 


22 


15 


24 


Eloped, .... 


1 


1 


1 


1 





























Patients in the Hospital 
in the course of the year, 


153 


233 


241 


245 


306 


362 


397 


391 


399 


430 


458 


491 


556 


Patients remaining at the 
end of the year, . 


114 


118 


119 


138 


185 


218 


229 


236 


232 


238 


255 


263 


360 


Males admitted. 


9G 


C8 


51 


66 


94 


96 


80 


75 


73 107 


HI 


109 


164 


Females admitted, . 


57 


51 


62 


59 


74 


81 


99 


87 


90 


91 


109 


127 


129 


Males discharged, . 


19 


58 


57 


56 


65 


74 


66 


59 


7] 


96 


92 


108 


100 


Females discharged. 


15 


48 


46 


41 


47 


54 


30 


81 


84 


83 


89 


105 


96 


Males died, . 


3 


5 


4 


6 


6 


10 


14 


9 


7 


3 


8 


9 


15 


Females died, 


1 


3 


4 


2 


3 


6 


& 


6 


5 


9 


14 


6 


9 


Patients sent by Courts, . 


109 


55 


90 


117 


129 


123 


123 


106 


110 


157 


152 


158 


167 


Private, .... 


44 


64 


23 


8 


39 


54 


56 


50 


53 


41 


68 


78 


126 


Recoveries : 
Males, 
Females, 


13 
12 


33 
31 


27 
25 


32 

20 


37 
32 


45 
31 


32 

48 


28 
54 


37 

45 


44 
44 


53 
63 


56 

68 


64 

58 


Average, 


107 


117 


120 


127 


163 


211 


223 


229 


233 


238 


244 


261 


316 



1846.] 



SENATE— No. 1. 



49 



TABLE 7. 
Statistics of the different Seasons. 





1833. 


1 

1834. 


1835. 


1 

IS36.'lS37. 


1838. 


1S39. 


1S40. 


1841. 


1842.1843. 


1844. 


1845. 


Admissions — 




















1 






In Winter, 


27 


26 


24 


23 


26 


46 


39 


32 


31 


50, 51 


51 


61 


In Spring, 


72 


35 


31 


36 


49 


46 


38 


42 


37 


48' 58 


60 


80 


In Summer, 


23 


30 


30 


42 


40 


47 


59 


44 


51 


40 


56 


71 


68 


In Aatumn, 


31 


28 


28 


24 


53 


36 


43 


44 


44 


60 


55 


54 


84 


Discharses — 




























In Winter, 





22 


21 


20 


14 


18 


31 


29 


35 


37 


44 


48 


40 


In Spring, 


1 


33 


30 


33 


36 


37 


3» 


38 


33 


46 


49 


GO 


34 


In Summer, 


11 


2b 


31 


24 


29 


44 


48 


41 


37 


46 


46 


65 


40 


In Autumn, 


23 


24 


22 


21 


33 


29 


29 


32 


50 


50 


42 


55 


52 


Recoveries — 




























In Winter, 





13 


13 


12 


10 


15 


13 


18 


20 


24 


24 


31 


25 


In Spring, 





20 


11 


15 


17 


23 


24 


22 


10 


22 


34 


33 


29 


In Summer, 


9 


16 


10 


12 


15 


18 


23 


20 


22 


25 


29 


23 


28 


In Autumn, 


16 


15 


12 


19 


27 


20 


20 


22 


30 


19 


29 


37 


40 


Deaths — 




























In Winter, 





3 


1 


0' 1 


3 


5 


6 


1 


4 


5 


2 


4 


In Spring, 


1 


2 


2 


ll 2 


5 


5 


6 


2 


1 


3 


3 


2 


In Summer, 


3 


3 


2 


4' 1 


5 


7 


1 


5 


3 


6 


6 


7 


In Autumn, 








3 


3| 5 


3 


5 


2 


4 


4i 8 


4 


11 



TABLE 8. 



Ages of Patients in the Hospital, 


Duration of Insanity with those remaining, 


December 1st, 1845. 


December 1st, I8it 


( 


Under 20, . . . . 13 


Less tJian 1 year 




63 


From 20 to 25, 






45 


From 1 to 2 years. 


69 


" 25 to 30, 






50 


" 2 to 5 




59 


" 30 to 35, 






44 


" 5 to 10 




63 


« 35 to 40, 






42 


« 10 to 15 




40 


" 40to 45, 






32 


« 15 to 20 




26 


« 45 to 50, 






34 


" 20 to 25 




11 


" 50 to 55, 






39 


" 25 to 30 




7 


" 55 to 60, 






18 


Over 30 years, 




7 


" 60 to 65, 






19 


Unknown, . 




15 


« 65 to 70, 






8 








" 70 to 75, 






12 








" 75 to 80, 






2 








Over 80, 






2 








360 


- 




360 



50 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 9. 
Classification of Insanity. 



Mania, 

Males, . 
Females, 

Melancholia, 
Males, . 
Females, 

Dementia, . 

Males, . 
Females, 

Idiots, 

Males, . 
Females, 



Whole No. No. of each Sex. 



1130 



796 



242 



12 



624 
506 



352 

444 



149 
93 



10 
2 



415 
361 



194 

287 



Total of Curable. 



776 



481 



Many not classed. 



The classification of patients in a Hospital is one of the most im- 
portant matters connected with institutions for the insane. It is far 
from being a correct view of the subject to throw those together, exclu- 
sively, whose diseases most resemble each other. The excited placed 
with the quiet, and the quiet with the excited, often has a favorable 
efTect reciprocally. The convalescent should not usually be annoyed 
by such as are disagreeable to them, but a case of pleasurable excite- 
ment is often agreeably associated with those recovering, and is fre- 
quently rather beneficial than injurious. 

In former reports, I have spoken of the difficulty of classifying the 
forms of disease for any practical purpose. The maniac becomes 
melancholic, and the melancholic a maniac by turns. Periodical cases 
generally pass more or less directly from one form to the other, and 
when passive and quiescent often appear rational, though they may not 
be free from delusion or false judgment. 

False judgment and a false estimate of things constitute, in a large 
proportion of cases, the main feature of the disease ; there is no very 
obvious delusion of any other character. In many cases of what has 
been termed moral insanity, this false judgment may be found to exist 
in a greater or less degree. The individual whose temper and pas- 



1846.] SENATE— No. 1. 51 

sions are easily disturbed, may greatly misjudge of the provocation 
which excites him, and over estimate the causes which disturb and es- 
trange his feelings. The state of the nervous system has much influ- 
ence on his temper and disposition. Improper education increases sus- 
ceptibilities, fosters appetites and propensities and gives them that pre- 
ponderance in the character which a good education would repress, di- 
rect, and regulate. 

The hallucinations of the insane are entirely visionary, disconnect- 
ed wholly with disease of the senses; false perceptions, creations of the 
fancy, or irregular combinations of received impressions, such as with 
the rational mind occur in dreams. Many insane persons mistake 
dreams for realities, and contend stoutly that they have seen or beard 
what they only imagined or falsely perceived. Others seem to have 
waking dreams ; the mind, inattentive to surrounding objects, is occu- 
pied by reveries which are mistaken for actual existences. 

A man recently in the Hospital, who had had great pecuniary trou- 
ble, imagined that two sheriffs came to his door, which was locked, 
opened it, which he distinctly heard, and entered the room. He saw 
them distinctly, heard them read the instruments of attachment of his 
person, and saw them retire. Though he is now calm and self pos- 
sessed, he cannot be persuaded that this vision was not a reality, 

A young man now favorably convalescing, told me that when he 
was first attacked with insanity, he saw beautiful visions in the room 
over his head, ships, fishes, steam-boats, and all sorts of water craft, 
heard heavenly music, saw immense crowds of people come to pay 
him homage, among whom he recognized uncles, aunts, cousins and 
other friends. These he now admits were fancies, not realities ; but 
when he was on his way to the Hospital, he saw immense trains of 
rail-road cars transporting slaves to the Pacific Ocean, passing by with 
great rapidity, fully loaded with colored persons. " This," says he, 
" 1 think was a reality." 

This condition of the mind is essentially different from that which 
leads an insane man to suppose himself wicked, poor or despised. 
In these cases, the judgment is principally in fault, in thefother, the per- 
ceptions are vivid, the imagination active and unrestrained, while the 
qualifying or correcting influences are inactive or deficient. 

Many insane persons dismiss their delusions with reluctance, even 
when far advanced towards recovery ; they are cautious in admitting 
the evidence which establishes their fallacy and removes from their 
minds impressions which heive afforded them pleasure. 



52 STATE LUNATIC HOSPITAL. [Jan. 

I once knew a clergyman who was somewhat embarrassed by the 
expenses of his education, who, while in the delirium of fever, receiv- 
ed the impression that he had been presented with a purse of gold suf- 
ficient to cancel all his debts. This impression did not leave him 
when his disease was removed, and he was surprised, when quite re- 
covered, to find that the whole was a delusion. 

It is not always easy to determine whether cases of this description 
are illusions or hallucinations. 

A patient now with us hears a clock tick over his head at night, which, 
he says, keeps him awake ; he also smells many disagreeable odors 
which come into his room through the cracks and ventilating openings, 
and these he stops up with rags. In this case, both hearing and smell- 
ing are affected with disease. The senses in this case are probably 
diseased, as the man is kept awake by the noise. 

A patient now recovered saw, when he was first insane, ranges of 
little fellows on the side of his room, rising in regular gradations from 
one to three feet high. These phantoms visited him every night and 
kept him from sleep. 

Another patient was, when most insane, visited at night by naked 
skeletons, who made lewd motions before him ; he also smelled poison 
in his room and tasted it in his food. This man would imagine that 
he was on the confines of the bottomless pit without the hope of es- 
cape, and so riveted was his mind to this delusion that he would become 
excessively agitated and distressed, and sob and weep bitterly at his 
impending fate. He had one or two of these paroxysms during reli- 
gious worship on the Sabbath. He at last recovered favorably. 

A person now with us is surrounded day and night by persons who 
shoot at him Avith white powder which makes no noise. He makes 
holes through his clothes, and exhibits them as the marks of the silver 
bullets which are fired at him. He does not hear the report of the 
muskets, but sees the persons shoot at him and feels the wounds which 
are made in his flesh. Before he came to the Hospital, he loaded his 
gun with black powder to revenge upon the persons who thus annoyed 
him ; this caused his arrest and confinement. 

Another man came directly from one of our seminaries to this insti- 
tution. He sees persons at his window resembling the professors whom 
he has been accustomed to hear, and converses with them. He has 
seen lightning and flame flashing through his room and about the hou- 
ses in town. 

One man stands at his window and gives orders to the rail-road depot, 



1846. SENATE— No. 1. 53 

half a mile distant, respecting the movements of the cars. He sees his 
wife at the window in the night, who directs him not to take his medi- 
cine. 

Another man sees angels and cherubs at his window in the night, 
and holds conversations with them. They tell him that Tuesday is the 
proper Sabbath, and he observes that day instead of Sunday. 

Another sees vermin, particularly spiders, crawling over his person 
and about his room. 

One, a bachelor, sees the devil in his room, who tells him all his 
thoughts. He feels sensible effects upon his body, which are the result 
of these interviews. He can drive him away at any time by promising 
to get married. 

An old gentleman is visited at night by the corpse of his friend, 
which brings him raisins, tobacco, &c. Sometimes he gets into bed 
with him, he finds he is cold, very soft, and offensive to the smell. 

A deaf and dumb patient feels himself drawn to the earth and to 
substances about him,. and says the earth is like onions applied to his 
feet. 

A recent case of insanity, now in our care, is annoyed by gas thrown 
at him, which dazzles and disturbs him so that he is unable to know 
what he is about. 

One patient, who has been long with us, is excessively annoyed by 
what he calls " plaster of Paris women," v^'ho blow his hair off with 
their " chemistry winds." He is quite bald, covers his head with a 
handkerchief, and rubs it constantly. 

A woman, now in the Hospital, is greatly disturbed by an old wo- 
man, who visits her at night and commands her to do things which she 
afterwards knows are wrong, but which, at the time, she feels obliged 
to perform. She often obliges her to get out of bed in the night and 
lie on the floor ; of this she complains bitterly, but dare not disobey. 

A very intelligent patient came into the hall one day when I was in, 
and said that an angel came into her room,- and seeing a book upon the 
table, took it and disappeared. She was greatly agitated and alarmed, 
and walked briskly through the hall, exclaiming, " an angel has been 
in my room and took away my book. I saw the little hand, and the 
book is gone — the book is gone !" She knew the angel, it was her own 
daughter who had died some time before. As she was so much dis- 
turbed, search was made for the book, and it was found in the hands of 
an excited patient, who acknowledged that she went into the room and 
took it. The lady remained greatly disturbed for a long time. 



54 STATE LUNATIC HOSPITAL. [Jan. 

The cases enumeraled are a few among the many in which the 
mind is deranged through false impressions received by the senses, or 
false perceptions in the brain, independent of the senses. 

A case has been in our care the past year, which is so exceedingly 
interesting, that I consider it worthy of minute detail. 

E. A. M., an orphan girl, aged 15 years, was admitted to the Hospi- 
tal Dec, 1844. She had had chorea, and had been for some time 
melancholy, and affected with headache and great distress in the eyes, 
which, at such times, appeared prominent and distorted. When the 
paroxysms of headache were over, the eye assumed nearly a natural 
appearance. For some time she apparently improved, the paroxysms 
were less severe, and her general health rather better. At this time 
she began to occupy herself in active domestic employments, she was 
most of the time cheerful, and we had strong hope of a radical amend- 
ment. 

These paroxysms did not wholly subside, and when they did occur, 
she was a great sufferer, and felt gloomy and desponding. She had 
amenorrhoea, and was inclined to constipation, had bad appetite and 
sleepless nights. In the intervals of these paroxysms, she was cheer- 
ful and active, but would usually say her head ached, if she was ques- 
tioned as to her health. 

Some time in March, the disease manifestly increased, the paroxysms 
became more severe and protracted, and the gloom and despondency 
increased. In the latter part of April, her symptoms were greatly ag- 
gravated, the suffering in her head became agonizing, and her sight 
was greatly impaired. She took no notice of those about her unless 
touched by them, when she seemed much frightened, but did not speak. 
During the month of May, she was extremely ill, confined most of the 
time to her bed. She had severe spasms and excessive headache, 'aid 
nearly senseless, moaning and suffering extremely, often tearing her 
hair and beating her head with great violence. With the exception of 
moving her hands, she seemed entirely paralyzed. In this state she 
continued some weeks, apparently near dissolution. She took very 
little food and emaciated rapidly. Early in June she recovered her 
speech, and we then ascertained that she was entirely blind and deaf 
and had lost the senses of smell and taste. She was entirely unconscious 
that she was at the Hospital, talked to her brothers and sister as if they 
were present, and complained in the bitterest terms that they would not 
answer her questions, or in any way communicate with her. She had 
no idea that she was deaf, and it was truly heart-rending to hear her 



1846.] SENATE— No. 1. 55 

exclaim, " why will you not talk to me — all is silent as the grave — 
what have I done that you will not speak to me .-*" For hours together 
she would address her friends in the most plaintive and imploring lan- 
guage, begging for one word, even if it was that of unkindness. At 
times she imagined she was a captive among some barbarous people 
who could not understand her language, and frequently asked if there 
were no missionaries among them who could serve as interpreters. 

While in this condition, after trying various remedies, it was thought 
advisable to try tho effect of galvanism. The battery was got ready 
and the fluid applied gently to her hands, when she became agitated in 
the most extraordinary degree, her countenance flushed, her eyes 
glared open, her expression the wildest conceivable, while she continu- 
ally screamed, " don't bury me alive — don't bury me alive, — I am not 
dead — I am not dead !" Never did I witness such a scene — every 
avenue of communication with her was cut off, and for twelve hours 
she screamed without intermission, declaring that she was not dead and 
begging most imploringly that we would not bury her alive. Too late 
we found that we had excited a storm which we could not calm ; there 
was no way in which we could soothe or pacify her in the least de- 
gree. When completely exhausted, she became quiet and slept. For 
some days she would start, and appear frightened by the slightest 
touch. She gradually got better of this excitement and appeared much 
as she had done for some weeks previous. During all this time, she 
did not recollect any thing of the Hospital or its inmates. She called 
those about her by the names of her absent friends, myself and my 
assistant she recognized as physicians who had attended her some years 
previous ; her nurse she called by the name of her sister. When I 

visited her, she would say, " Dr. ■, why do you not speak to me, 

you used to be so kind and pleasant and now you are as silent as the 
rest ; do Dr. speak one word to me." 

She improved slowly and favorably till about the middle of June, 
had taken morphine, sub-muriate of mercury, the arsenical solution 
and some laxative medicines, had also had blisters on her temples. 
Much of the time she swallowed with difficulty, so that food and medi- 
cine were given irregularly. On the 17th of June, she again lost her 
speech, but communicated in a very limited manner by general signs. 
If thirsty, she would place her finger on her lips ; if she wanted air, she 
would make the motion of the fan. With this increase of symptoms, 
she had frequent pulse, dry skin, dry tongue, soreness of the throat, 
and great difiiculty of swallowing. On the 20th of June, for the first 



56 STATE LUNATIC HOSPITAL. [Jan. 

time during this long illness, she seemed to have some idea of the Hos- 
pital, and those who resided here, and by some external mark or pecu- 
liarity of dress, recognized a few individuals with whom she had pre- 
viously been intimately acquainted. 

When she first came to the Hospital, sad and unhappy, she and an- 
other young lady who was equally melancholy, were in the practice of 
sitting together in their rooms and weeping as they rehearsed their 
grief. Ascertaining this to be case, I directed their attendants to pre- 
vent such interviews alone, and seperate them if thus found talking to- 
gether. To avoid scrutiny, they learned the manual alphabet and com- 
municated with each other on their fingers quite freely. This was un- 
known to me at the time, but now it was thought of by the young lady, 
who was nearly recovered, and she made an attempt to communicate 
with her upon her fingers. After a time, the experiment succeeded, 
and she learned for the first time that she was deprived of her ex- 
ternal senses ! She thought she had been for a long time in a dark, 
dismal place, where the people did not talk, and where they drank but 
did not eat. 

Early in July she again lost her speech for forty-eight hours, and 
during the time was exceedingly sensitive and easily agitated. The 
slightest touch would alarm her, and bring on trembling ; fanning 
agitated her, and the least motion of the bed-clothes would excite and 
disturb her. 

Till the sixth of July, the senses remained lost. Various experi- 
ments were tried with her to satisfy us that they were entirely gone. 
She drank vinegar as water, took a tea -spoonful of Cayenne pepper 
as she would take so much bread, without noticing it in the least. 
On the 7th of July, the sense of smell was suddenly restored and she 
enjoyed the fragrance of flowers and other perfumes. This was the 
first restoration of any of the external senses, and it remained but a 
short time. For some days she had been very comfortable and seem- 
ed to be improving favorably. On the night of the I2th, the nurses 
were awakened by her groans, and found her in a state of great trep- 
idation and alarm, which was only increased by every attempt to quiet 
her. When any one touched her, she would spring away in great fear, 
her eyes staring, and her whole frame trembling with agitation. In 
the afternoon of the next day, she became more composed and was 
able to recognize a few friends, but had entirely lost her speech. 
When she recognized any one, she would seize hold of them with a con- 
vulsive grasp, and by familiar signs of recognition, and great anima= 



1846.] senate—No. i. 57 

tion of countenance, would show the joy and satisfaction she experi- 
enced in meeting them. When these paroxysms have left her, she 
has usually supposed that she has been away to some dismal place, 
" down, down, down." When she meets her friends after the illness has 
passed, she says with great animation and expressions of delight, " got 
back, got back." At this time, she communicated readily with her fin- 
gers, and many of her friends learned her language. Her sense of touch 
was very acute, she read with ease the lettering on books, and the books 
for the blind. Her mind was very active, and her memory retentive. 
She walked about with some assistance, and gains strength and health 

between these paroxysms. She talked much with her friend J , 

who had recovered, and was employed to converse with, and take 
charge of her. 

When she is in one of her paroxysms she is dull, understands but 
little, and often loses her memory of every thing. 

Her smell repeatedly returned for a short period, but was soon gone 
again, — so far as we have been able to discover, she has been totally 
blind from the first, and deaf since the first loss of hearing. She has re- 
peatedly come out of these paroxysms with some delusion upon her mind. 
Once she supposed that her mother had visited her and brought her 
ornaments, which had been lent her ; these she afterwards claimed 
as her own. For a long time, this impression remained, though her 
mother died when she was two years old. In the intervals of these 
paroxysms, she is sensible and rational, very quick in her discernment, 
and greatly disposed to mirthfulness. 

Early in August, when she was in this comfortable state, she was 
frightened by some one coming to her room and taking hold of her. 
She was so much agitated by this, that the slightest touch, for a number 
of days, would alarm her. Her trepidation on this occasion was so 
great that she could hardly be persuaded to take her food or drinks, 
every communication frightened her so much. She again recovered 
from this fear and was cheerful and happy. She took much pleasure 
in knitting and was very industrious. 

On the 12th of August, her friend J. left her. She had been most 
kind and faithful to her, and her departure was a cause of great grief ; 
they were mutually attached, and both felt sad at the separation. Her 
attachment to J. was very strong, and whenever her name was com- 
municated to her, her countenance brightened and she was full of an- 
imation and joy. Soon after this good friend left her, our patient was 
removed to the family apartments, where she has since remained. 



68 STATE LUNATIC HOSPITAL. [Jan. 

On the 14th of August, she had another paroxysm, which is thus 
described by one who was with her. " Her face assumed a singular 
expression, her eyes rolled wildly, and when I attempted to speak with 
her, I found she did not notice at all. She kept my hand, but would suf- 
fer no other hand to touch her without an expression of horror. She 
trembled constantly, started frequently, and seemed to be in the great- 
est fear. In about an hour she became more calm and slept. It was 
thought' best to place her in bed as she was not in a comfortable posi- 
tion. When touched for this purpose, she manifested the greatest agi- 
tation, and screamed in the most frightful manner, resisting with all her 
power. When finally placed in bed, she crouched close to the wall, 
trembled so as to shake the bed, and with every breath, continued those 
dreadful screams. After an hour she became more quiet, and slept 
again. When she waked she felt about to ascertain where she was, 
examined the hands of her watch to tell the time, and recognized the 
friend who was with her. She moved her hands about in an awkward 
manner, as if she had some idea of having communicated with them. 
When we attempted to talk to her in the usual manner, we ascertained 
that she had forgotten her alphabet ; she had also forgotten how to 
knit, though she was knitting when the paroxysm came on. After a 
few attempts she succeeded in writing her wants on the slate, and in the 
course of the day learned her alphabet again and was able to knit." 
As usual she supposed that she had been away during this paroxysm, 
said she was " so glad to get back," and would never go away again. 
She did not inquire for any one, and was much afraid of being touch- 
ed. She had been intimately acquainted with many persons in the 
house, but now seemed to have forgotten them all, and for a considera- 
ble time could not be made to understand who they were. After a few 
days she recollected that there were three physicians here, and gradu- 
ally regained her knowledge of other friends. 

For many days, in the latter part of August, she was quite ill, suffer- 
ed from palpitation, headache, and severe neuralgia. After these 
symptoms had continued some days, she began to lose the use of her 
lower limbs ; they were very painful, and when she attempted to walk, 
tottered, and repeatedly fell. Early in September, she lost the use of 
them entirely, and all sensibility in them. For a time they were per- 
fectly cold and white as if dead, and pins or needles thrust into 
them produced no impression. They have since appeared more nat- 
ural, but are yet insensible. At this time she very suddenly regain- 
ed her senses of smell and taste, and was made very happy by it ; 



1846.] SENATE— No. 1. 59 

thought her other senses would soon be restored, and indulged in many 
pleasant anticipations. Soon after this, she began to articulate a few 
words, though in an imperfect manner ; she was not conscious of it, 
and when told that she had really spoken, her delight was unbounded ; 
she repeated the words continually and daily added to their number. 

She was now very happy ; could taste, smell, and talk considerably. 
Her feeling was also very acute, so that she could not only read the 
books for the blind, which she did readily, but coins, seals, and engrav- 
ed visiting cards. She was very industrious, and employed herself in 
knitting purses, making worsted mats, and sewing. The articles thus 
made she sold to visiters, and took great pleasure in counting her money 
and shewing it to her friends. She prepared some articles to be ex- 
hibited at the Fair in October, and was much delighted when she learned 
that she had obtained a premium for them. She was much interested 
in all accounts of the fair, and the descriptions of the articles there ex- 
hibited. 

The evening after the fair she attended a dancing-party, which was 
got up for the patients, and though she could neither see the dancing 
nor hear the music, she enjoyed it greatly. She could feel the motion 
of the floor and took the hands of the dancers as they passed her, ex- 
amined their dresses, inquired of all her associates who they had for 
partners, and seemed quite the happiest person in the room. 

At this time she wrote to her brother that she was " as happy as the 
day is long." She remained in this state of enjoyment and good health 
till the 20th of October, when she again became ill, and for several 
days was in intense pain. She had severe palpitation, and the pain 
about the heart was very violent ; her eyes were much swollen and in- 
flamed, and the distress in her head very great. Much of her pain 
seemed neuralgic, and she suffered apparently beyond human endu- 
rance. Large doses of morphine only afforded relief, and these often 
repeated. For many days her life was in jeopardy, audit seemed hard- 
ly desirable that she should again recover. Her distress gradually 
subsided, but we found that she had again lost her speech, and with it, 
all feeling in her hands ; they were entirely useless. 

Her situation was now more deplorable and hopeless than ever. The 
only medium by which she had been able to communicate with those 
around her was now withdrawn, and existence was a burden. She 
could not speak as in her first attack, for she was now dumb ; she could 
not recognize her friends by the sense of touch, for her hands were 
paralyzed. She could see no one, hear no one, feel no one, and she 



60 



STATE LUNATIC HOSPITAL. 



[Jan. 



constantly suffered the most agonizing pain. Her friend watched her 
with increasing vigilance and solicitude, and as she was relieved from 
suffering she commenced teaching her an alphabet on her face. By un- 
tiring perseverance, she succeeded in communicating to her simple 
ideas in this novel manner. While this experiment was going on suc- 
cessfully, the sensibility of her hands was at once partially restored, 
and she was again able to converse in her usual manner. 

From this severe illness she gradually recovered to her former con- 
dition, except that the acute sense of feeling which she had long had in 
her fingers, did not return, and she has since been unable to read even 
the raised letters of the blind. 

During the month of November, she has been very comfortable most 
of the time ; has had considerable headache, and gets easily fatigued, 
yet she is ever cheerful and happy. For some days previous to the 
annual Thanksgiving, she was anticipating the pleasures and festivities 
of that occasion, and when the day arrived she was full of enjoyment. 
She dined with her friends, and in the evening enjoyed the dance as 
much as before. She now spends her time in knitting, sewing, writing 
and playing games. In her chair on castors, she moves about from one 
apartment to another, enjoying the salutations which she everywhere 
meets, and though quite blind, deaf and dumb, and unable to walk or 
read, she has much real pleasure, is ever patient, cheerful and thankful 
to those friends who meet her with affectionate kindness and sympathy, 
and grateful to her Heavenly Father for so many favors and blessings 
in the midst of all her privations and sufferings. 

TABLE 10. 

Showing the Causes of Insanity, and circumstances connected with 
causes and predisposition to Insanity. 



Intemperance, . 


278 


Jealousy, 


11 


Ill Health, 


318 


Fright 


14 


Masturbation, . 


145 


Palsy, .... 


19 


Domestic Afflictions, 


219 


Hereditary, or having insane 




Religion, 


191 


ancestors or kindred. 


565 


Property, 


131 


Periodical, 


450 


Disappointed Affection, 


68 


Homicidal, 


23 


Disappointed Ambition, 


33 


Have conmitted Homicide, 


16 


Epilepsy, 


56 


Suicidal, 


239 


Puerperal, 


67 


Have committed Suicide. . 


11 


Wounds of the Head, 


26 


Arising from physical causes, 


918 


Abuse of Snuff and Tobacc 


0, 9 


Arising from moral causes. 


667 



Many not classed. 



1846.] SENATE— No. 1. 61 

Intemperance continues to be one of the most prominent causes of 
insanity, notwithstanding the great change in the habits of the commu- 
nity. Probably three-fourths of the quantity of alcoholic drinks, in 
proportion to the number of individuals in New England, is abandoned, 
— yet there is enough still in use to send to this Hospital a large num- 
ber of cases, annually, from this cause. Those persons who are not 
reached and influenced by the many appliances now bearing upon this 
habit, have strong appetites or weak principles, and are likely to use 
this poison so imprudently, as finally to feel its influence on physical 
health, and especially on the brain and nervous system in the production 
of palsy, epilepsy, apoplexy, insanity, and other kindred diseases. It 
is not surprising that a brain that has been subjected to such a powerful 
narcotic as alcohol, that has been almost daily pressed with blood till it 
produces vertigo and stupor, should be so disturbed in its functions as to 
exhibit alarming disease and finally organic changes, which produce 
incurable chronic maladies that make life miserable and death prema- 
turely certain. The brain is often affected in this way directly, and 
fatal mischief comes from the influence of this narcotic upon the organ 
itself. But it as frequently produces disease of other organs in the 
first instance, as the stomach, the liver, and the nervous ganglions ; 
with these organs the brain has direct and powerful sympathy, and in- 
sanity is produced indirectly when the brain itself is not primarily af- 
fected. 

It is a wonderful provision of the animal economy, that so great and 
frequent transgressions of the laws of life do not more suddenly and 
certainly prove fatal. We can eat excessively, and use improper arti- 
cles freely, and for a long time, without any apparent evil ; but the 
penalty will come — transgressions of these laws will be followed by 
summary punishment, as surely as violations of the moral law. 

The condition of the brain is rendered such by the intemperate use 
of alcoholic drinks, that even a suspension of their use will not always 
prevent the occurrence of insanity. With great opportunities for ob- 
servation, I do not now recollect a single case of delirium tremens 
arising from the abandonment of intoxicating drinks. I know that many 
preventives have been prescribed, and that a cautious withdrawal has 
been recommended to prevent this calamity — yet, in my experience of 
six years as physician of a prison, and thirteen as Superintendent of this 
Hospital, I have seen many individuals who were broken off abruptly 
from all stimulating drinks, yet I do not think a single case of this dis- 
ease has occurred. The reformation of intemperate persons by the 



62 STATE LUNATIC HOSPITAL. [Jan. 

modern temperance reform, sustains this view of the subject, so con- 
trary to former theories of this disease. The work of disease has so 
far advanced in some individuals who have recently reformed, or have 
pretended to reform, from the use of intoxicating drinks, that ordinary 
insanity has occurred without the apparent intervention of other causes, 
— even in these cases, the withdrawal of the stimulus cannot be reason- 
ably supposed to have had any agency in producing the insanity. 

A brain that has been long involved in the fumes of alcohol, that has 
circulated through it for years a contaminated vital fluid from which it 
must receive its nutrition, cannot be supposed to be in a condition to 
perform healthy functions. Such must be the condition of the brain in 
the case of many drunkards, and the results which we constantly wit- 
ness, are proof of the correctness of this pathology. 

In my experience, the senses, especially the sense of hearing, has 
been affected in cases of insanity arising from intemperance. 

Twelve years ago, there was an insane man in the Hospital, who 
seemed to anticipate the magnetic telegraph. He conceived the idea 
of so managing electricity, as to communicate intelligence from one 
end of the Union to the other " as quick as lightning." He also sup- 
posed that he could instantly send intelligence to Europe whenever he 
desired. He went to Washington to obtain a patent for his discovery. 
When with us, he would spend the whole day passing from door to 
door of his gallery, striking his key upon the locks, at the same time 
uttering words unintelligible to us, and listening to the reply. In this 
way he communicated with his friends in Europe, where he was born 
and educated. He believed he was arrested and confined in the Hos- 
pital by false friends, who were desirous of taking advantage of his 
discoveries, — thought they had got possession of his apparatus, and tan- 
talized him by giving him frequent shocks of electricity. These shocks 
exasperated him exceedingly and kept him constantly distui'bed. They 
conveyed sounds to him as well as other impressions, calling him hard 
names, which kept him angry and violent much of the time. He was 
intemperate, and had had delirium tremens. 

A man aflfected with insanity from the same cause, had an impres- 
sion that he had a dictator in his head, whose mandate he dared not 
disobey. If he told him to do mischief, he did it, and laid the whole 
blame to his director. He had not a very good opinion of the power 
that directed him — often got angry with him, called him a " fellow," 
and a " mean fellow," and said that he was " ugly " and made him 



1846.] SENATE— No. L 63 

so. This man was usually quiet and well-disposed, but was much of 
the time miserable and unhappy, because he must obey such a bad 
director. 

Another man who has twice been in the Hospital, and whose insan- 
ity was produced by intemperance, was greatly excited and rendered 
quarrelsome by false hearing. His neighbors and children were taught 
to utter disrespectful language to him, and of him, and even perform 
music set to words reproachful and derogatory to his good name — peo- 
ple rapped at his door and left improper messages ; indeed, he was 
kept in a state of perpetual excitement and anger. When he under- 
took to avenge his imaginary wrongs, he was arrested and brought to 
the Hospital. This man is now much better, and able to live peacea- 
bly, in the world, whh habits greatly improved, if not wholly cured. 

A musician in our care would sing tunes, and then listen to hear the 
sounds go around the globe and return to him in full harmony some 
minutes after. His insanity was from the same cause. 

Many of the insane from intemperance have false vision. One man 
who was with us, was visited by bears and tigers in his room, and he 
would fight them manfully, always overcoming them at last. 

Another had snakes in his bed at night, with which he would con- 
tend, and which he would destroy. While at labor in the field, he 
would stop frequently and stamp them to death. 

An old man who had been long intemperate, was visited by devils in 
the form of serpents, whom he could charm or frighten at pleasure. 
He dared not leave his room long at a time, fearing they would gain 
possession. 

Alcohol is not the only narcotic which thus affects the brain and ner- 
vous system. Opium produces delirium tremens and probably insan- 
ity. Toiacco is a powerful narcotic agent, and its use is very deleteri- 
ous to the nervous system, producing tremors, vertigo, faintness, palpi- 
tation of the heart, and other serious diseases. That tobacco certainly 
produces insanity, I am not able positively to observe ; but that it pro- 
duces a predisposition to it, I am fully confident. Its influence upon 
the brain and nervous system generally, is hardly less obvious than that 
of alcohol, and if used excessively is equally injurious. The young 
are particularly susceptible to the influence of these narcotics. If a 
young man becomes intemperate before he is twenty years of age, he 
rarely lives to thirty. If a young man uses tobacco while the system 
is greatly susceptible to its influence, he will not be likely to escape in- 



64 STATE LUNATIC HOSPITAL. fJan 

jurious effects that will be developed sooner or later, and both diminish 
the enjoyments of life and shorten its period. 

The very general use of tobacco among young men at the present 
day, is alarming, and shows the ignorance and devotion of the devotees 
of this dangerous practice to one of the most virulent poisons of the 
vegetable world. The testimony of medical men, of the most respec- 
table character, could be quoted to any extent to sustain these views of 
the deleterious influence of this dangerous narcotic. 

Dr. Rush says of tobacco — " It impairs appetite, produces dyspepsia, 
tremors, vertigo, headache, and epilepsy. It injures the voice, destroys 
the teeth, and imparts to the complexion a disagreeable, dusky brown." 

Dr. Boerhaave says that " since the use of tobacco has been so gen- 
eral in Europe, the number of hypochondriacal and consumptive com- 
plaints has increased by its use." 

Dr. CuUen says : " I have known a small quantity snuffed up the 
nose to produce giddiness, stupor and vomiting. There are many in- 
stances of its more violent effects, even of its proving a mortal poison." 

Dr. Darwin says, " it produces disease of the salivary glands and the 
pancreas, and injures the power of digestion by occasioning the person 
to spit off the saliva which he ought to swallow." 

Dr. Tissott once saw the smoking of it prove fatal. 

Dr. Pilcher details the particulars of a case of a medical student 
whom he had been requested to see. " This gentleman suffered under 
all the symptoms of phthisis. There was muco-purulent expectoration, 
night sweats, &c. The mucous membrane of the throat, epiglottis, 
and the neighboring parts, was coated with a brown fur. The patient 
had been an immoderate snuff-taker ; he was told to discontinue the 
snuff; he did so, and recovered." 

Dr. Chapman says : " By a member of Congress from the West, in 
the meridian of life, and of a very stout frame, I was some time since 
consulted ; he told me that, from having been one of the most healthy 
and fearless of men, he had become ' sick all over, and timid as a girl.' 
He could not even present a petition to Congress, much less say a word 
concerning it, though he had long been a practising lawyer, and served 
much in legislative bodies. By any ordinary noise he was startled or 
thrown into tremulousness, and afraid to be alone at night. His appe- 
tite and digestion were gone, he had painful sensations at the pit of his 
stomach, and unrelenting constipated bowels. During the narrative of 
his suffering, his aspect approached the haggard wildness of mental 
distemperature. On inquiry, I found that his consumption of tobacco 



1846 ] SENATE— No. I. 65 

was almost incredible, by chewing, snuffing and smoking. Being sat- 
isfied tliat all his misery arose from this poisonous weed, its use was 
discontinued, and in a few weeks he entirely recovered. 

Distressing as was this case, I have seen others, from the same cause, 
even more deplorable. Two young men were in succession brought to 
me for advice, whom I found in a state of insanity, very much resemb- 
ling delirium tremens. Each had chewed and smoked tobacco to ex- 
cess, though perfectly temperate as regarded drink. The further ac- 
count given me was, " that in early life, adopting this bad practice, it 
grew with their growth. Dyspepsia soon occurred, attended by great 
derangement of the nervous system, and ultimately the mania I have 
mentioned. But I have also seen the same condition very speedily in- 
duced." 

Dr. Franklin says he never used it, and never met with a man who 
did use it that advised him to follow his example. 

The venerable John Quincy Adams, in a recent letter on the subject, 
says that in early life he used tobacco, but for more than thirty years he 
had discontinued the practice. " I have often wished," says he, " that 
every individual of the human race, affected with this artificial passion, 
would prevail upon himself to try, but for three months, the experiment 
which 1 have made, and am sure it would turn every acre of tobacco 
land into a wheat field, and add Jioe years to the average of human life." 

Some cases have come under my observation which show the injuri- 
ous effects of tobacco where no evil was suspected. 

A respectable merchant, who abstained wholly from ardent spirits, 
applied to me for advice. He complained of great weakness, tremor 
of the limbs and joints, with lassitude, general prostration of health, 
and depression of spirits. Knowing that he used tobacco freely, I ad- 
vised him to discontinue it entirely ; he soon became better, and after a 
time was wholly relieved from these disagreeable symptoms. 

A distinguished clergyman informed me that he had been an extrav- 
agant snuff-taker ; that for years he had had a disagreeable affection of 
the head, and his health was not good. lie did not attribute either to 
his use of snuff, but thinking it a filthy habit and a growing evil, he re- 
solved to leave it off. He was surprised to find the difficulty in his 
head almost immediately left him, and his general health became quite 
good. 

A gentleman of athletic frame, and about twenty-four years of age, 
applied to me for advice. He complained of insufferable faintness and 

9 



66 STATE XUNATIC HOSPITAL. [Jan. 

distress of stomach, morning sickness, vomiting, trembling and prostra- 
tion of strength. He diminished his tobacco considerably, and was im- 
mediately better, but had not resolution to abandon the pernicious prac- 
tice. 

In our experience in the Hospital, tobacco in all its forms is injuri- 
ous to the insane. It increases excitement of the nervous system in 
many cases, deranges the stomach, and produces vertigo, tremors, and 
stupor in others. It is difficult to control its use with the insane, and 
though considerable suffering comes from its entire abandonment, it 
cannot be generally allowed with safety. 

One patient, while at labor, found a quantity of tobacco, and hid it in 
his bed. He used it freely, became sick, lost his appetite, and confined 
himself to his bed completely intoxicated. After some days, diligent 
search was made, and a store of tobacco was found in his straw bed ; 
when this was removed he almost immediately recovered, and in a few 
days was well as before. 

A patient who came into the Hospital a furious maniac, soon became 
ealm and improved favorably. He labored in the field with propriety, 
and exhibited every indication of a favorable convalescence. Suddenly, 
without any apparent cause, he again became very violent and insane. 
It was soon discovered that he had in some way obtained tobacco. Af- 
ter he ceased to use it, he again became calm and convalescent. 

An aged lady was brought to us very insane. The practice of her 
friends for some time had been to give her ardent spirits to intoxicate 
her at night, and tobacco and snuff, in unlimited quantity, for the day. 
All these were withdrawn at once ; her sufferings for some days were 
great ; but after a time she became calm, and got better as soon as the 
influence of this excitement was over. 

I have already exceeded my intended limits in the detail of cases. 

It is very natural to suppose that an article possessing the active prop- 
erties of this fascinating narcotic, should produce most deleterious 
effects upon health— particularly upon the brain and nervous system. 

The uninitiated cannot smoke a cigar, or use tobacco in any form, 
without unpleasant effects, — how then can it be possible that a poison 
so active can be used with impunity ? The stomach and brain, subject- 
ed to such influences, will become diseased, and show their effects as 
certainly as if alcohol were used. If asked my medical opinion, which 
was safest, four glasses of wine or four quids of tobacco, daily, I 
should say unhesitatingly the wine. Of the two evils, this would, in my 



1846.] SENATE— No. 1. 67 

opinion, be the least. Tobacco is the strongest, most dangerous nar- 
cotic — the habit of its use is the strongest and most difficult to over- 
come, and the influence felt from it most baneful and destructive to 
health. 

The causes of insanity may be divided into voluntary and involuntary. 
Of the former, the principal are intemperance and the secret vice, other 
causes may be of this class, such as hazardous speculation, many re- 
ligious vagaries, imprudent exposures, and irregularities. None are so 
prominent as the two first named, and none so fully stain the character 
with guilt, which even the occurrence of hopeless disease can hardly 
wipe away. Intemperance disorders the senses, and induces apoplexy, 
epilepsy and palsy. The cases from this cause are about as favorable 
for recovery as the majority of others, but are most sure to return if 
the habit of intemperance recurs. The secret vice produces the very 
worst form of insanity, because it is so difficult to avoid the continu- 
ance of the cause, and because the energies of the system are more 
prostrated by it than by almost any other cause. Such patients become 
degraded animals, so entirely abandoned to the habit, that hopeless de- 
mentia and drivelling idiocy generally follow. A k\v can be influenced 
to abandon the practice, and a few others can be cured in spile of it ; 
but in almost all cases the disease will become worse, and these dread- 
ful consequences will ensue. 

The secret vice, though doubtless a frequent cause of insanity, and 
of other severe and fatal diseases, far more than is generally supposed, 
is most operative in preventing recovery from insanity, arising from 
this and other causes. It is extensively and alarmingly the result of an 
active propensity excited by disease and unrestrained by reason, moral 
influences or self-respect. Many cases of a favorable character pro- 
gress towards recovery till this practice is commenced, then the patient 
becomes listless, is inclined to lie down or sit in a bent position, walks 
moderately, looks feeble and feels weak and miserable. His mind 
loses its energies, its scope is circumscribed, more and more, till this 
beastly indulgence occupies all his thoughts, and the remnant of all the 
physical powers are concentrated to this single effort of gross and de- 
based animal nature. Thus the grovelling sensualist lives often a long 
life a degraded sutFerer, whhout a manly thought or a moral feeling 
worthy of his nature or his destiny, and finally leaves the world without 
the regret of his friends, a useless, burthensome, loathsome object of 
abhorrence and disgust. 



68 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE n. 
Occupation. 



Farmers, 


272 


Stone-cutters, 


3 


Laborers, 


178 


Soap-makers, 


3 


Merchants, . 


98 


Stevedores, . 


2 


Shoemakers, 


89 


Broom-makers, 


2 


Seamen, 


80 


Copper-smiths, 


2 


Carpenters, . 


57 


Watchmen, . 


2 


Manufacturers, 


35 


Drovers, 


2 


Teachers, 


31 


Card-makers, 


2 


Students, 


31 


Glass -makers. 


2 


Blacksmiths, 


22 


Engineers, . 


2 


Printers, 


20 


Tobacconists, 


2 


Tailors, 


14 


Weavers, 


2 


Coopers, 


14 


Soldiers, 


2 


Machinists, . 


13 


Pump-makers, 


2 


Clergymen, ' . 


12 


Umbrella-makers, 


6 


Painters, 


]2 


Snath-maker, 




Cabinet-makers, 


11 


Gilder, 




Bricklayers, . 


10 


Sheriff, 




Cluthiers, 


8 


Constable, 




Rope-makers, 


7 


I^urrier, 




Jewellers, 


7 


News-collector, 




Lawyers, 


6 


Broker, 




Physicians, . 


6 


Hatter, 




Sail-makers, . 


6 


Mat- maker, . 




Millers, 


5 


Stocking-weaver, 




Bakers, 


5 


Bellows-maker, 




Musicians, . 


5 


Chair-maker, 




Paper-makers, 


5 


Auctioneer, . 




Coachmen, . 


5 


Miniature-painter, 




Innkeepers, . 


5 


Bookbinder, . 




Pedlers, 


4 


Fisherman, . 




Harness -makers, 


4 


Dyer, . 




Barbers, 


4 


Shipwright, . 




Tanners, 


4 


Truckman, . 




Book-keepers, 


4 


Britannia-ware-maker, 




Curriers, 


4 


Cashier, 




Gardeners, . 


4 


Females not accustomed tc 




Wheelwrights, 


4 


labor, 


177 


Carriage-makers, 


4 


Females accustomed to seden 




Turners, 


4 


tary employments, . 


240 


Calico-printers, 


3 


Females accustomed to active 




Comb-makers, 


3 


employments. 


432 


Butchers, 


3 


Many not classed. 





1846.] 



SENATE~No. 1. 



69 



TABLE 12. 
Diseases which have proved fatal. 



Marasmus, . 


37 


Diarrhosa, 


3 


Apoplexy and Palsy, 


20 


Chronic Dysentery, . 


3 


Epilepsy, 


17 


Erysipelas, . 


3 


Consumption, 


16 


Disease of the Brain from In 




Disease of the Heart, 


13 


temperance. 


2 


Suicide, 


11 


Bronchitis, . 


2 


Disease of the Brain, 


7 


Old Age, 




Typhus Fever, 


6 


Gastric Fever, 




Hemorrhage, 


5 


Land Scurvy, 




Lung Fever, 


5 


Congestive Fever, 




Cholera Morbus, 


4 


Concussion of the Brain, . 




Inflammation of the Bowels, 


4 


Disease of the Bladder, 




Dysenteric Fever, 


. 4 


Fright, 




Mortification of the Limbs, 


. 3 






Dropsy, 


3 


Total, . 


175 



Though the number of deaths has been large this year, (24,) it is not 
greater in proportion to the number in the Hospital than it has been 
several previous. There has been an uncommon number of persons 
affected with general palsy in our care the present season. Seven have 
died suddenly, five with symptoms of apoplexy, and two with epilepsy. 
Many such cases remain whose hold on life is very precarious and un- 
certain. 

A large number of deaths every year are from old, demented, incur- 
able cases, who have little mind left, and no hope of future usefulness. 

Deaths from acute diseases, affecting persons recently insane, are 
exceedingly rare with us ; but we have to lament a few every year 
that have fatal lesion of the brain, or some severe febrile or inflamma- 
tory disease which proves fatal. 

An insane person laboring under acute disease, has much less pros- 
pect of recovery than one who has the possession of his mind, or even 
one who has delirium, incident to these forms of disease He cannot be 
as well nursed, as well prescribed for, or judged of, as one whose rea- 
son is undisturbed ; and insanity itself often arises from causes, or pro- 
duces effects, which coincide whh the symptoms of acute disease, and 
render it more likely to be fatal. It is not uncommon for insane per= 
sons, when sick with fever or acute inflammation, to keep about, and 



70 STATE LUNATIC HOSPITAL. [Jan. 

sometimes take substantial food till within a short time of death. The 
maniacal excitement, proving a substitute for muscular strength, gives 
way suddenly, and the patient dies at once. Some patients who have 
been greatly excited for many days together, seem to die of exhaustion 
only. With this there is often combined a fright or alarm that agitates 
the patient, but which admits of no explanation, the mind being in a 
condition which precludes understanding ; such cases often fail rapidly, 
and die suddenly. 

It is not uncommon that the friends, or their physician, mistake other 
diseases for insanity, especially an erythematic inflammation of the 
membranes of the brain, which might generally be fatal if undisturbed, 
but which is not unfrequently rendered so by a long journey, severe re- 
straints or opposition, and often probably by improper treatment. 

The present autumn a case was brought to our care of this descrip- 
tion — there had been neither a passage of urine or from the bowels for 
some days previous. She had dry tongue, rapid pulse, hot skin, and 
symptoms of great exhaustion. She took a laxative medicine which 
moved moderately, but she failed rapidly, and in spite of every effort, 
sunk down and died in forty-eight hours after her admission, and about 
the end of the second week of her illness. 

No epidemic has ever visited this Hospital to any great extent. This 
year a disease has existed in our neighborhood, affecting many individ- 
uals, but two cases only occurred among our patients, one of these very 
slight, and the other unattended by severe or dangerous symptoms. The 
deaths that occur are more frequently from newly admitted patients, 
than from old residents, showing conclusively that the elements of dis- 
ease and death are generated elsewhere, and not in the Hospital. 

Of the twenty-four deaths that have occurred the present year, eigh- 
teen were from the 293 patients admitted in the course of the year, and 
six only from the 263 that remained at the end of the last year. 



1846.] 



SENATE— No. 1. 



71 



TABLE 13. 

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. 


Cost of support 

at $100 per 

year. 


No. of the 
recent cases 
discharged. 


Present 

Age. 


Time Insane. 


Cost of 

support at 

$2 25 per 

week. 


2 


71 


30 


years. 


$3000 00 


2077 


25 


9 -weeks, 


$20 25 


7 


50 


19 


(( 


1900 00 


2080 


30 


17 " 


38 25 


8 


62 


23 


(I 


2300 00 


2087 


44 


11 " 


24 75 


12 


49 


27 


a 


2700 00 


2102 


40 


11 " 


24 75 


18 


73 


35 


(( 


3500 00 


2109 


56 


20 " 


45 00 


19 


61 


20 


a 


2000 00 


2110 • 


24 


28 " 


63 00 


21 


41 


18 


« 


1800 00 


2117 


29 


28 « 


63 00 


27 


49 


18 


(1 


1800 00 


2123 


23 


28 " 


63 00 


44 


58 


27 


ii 


2700 00 


2128 


45 


21 " 


47 25 


45 


62 


27 


(C 


2700 00 


2130 


37 


15 " 


33 75 


102 


55 


27 


li 


2700 00 


2133 


33 


20 " 


45 00 


133 


46 


15 


u 


1500 00 


2135 


48 


29 " 


65 25 


209 


41 


18 


ti 


1800 00 


2146 


27 


9 " 


20 25 


260 


49 


18 


li 


1800 00 


2153 


22 


9 " 


20 25 


278 


51 


12 


il 


1200 00 


2156 


51 


32 " 


72 00 


319 


55 


11 


« 


1100 00 


2167 


27 


26 « 


58 50 


347 


60 


16 


(1 


1600 00 


2171 


30 


26 « 


58 50 


376 


42 


14 


li 


1400 00 


2178 


76 


22 " 


49 50 


425 


50 


15 


(1 


1500 00 


2186 


45 


20 " 


45 00 


431 


38 


15 


(( 


1500 00 


2188 


25 


28 " 


63 ! • 


435 


57 


17 


11 


1700 00 


2198 


36 


8 " 


18 OU 


451 


50 


11 


11 


1100 00 


2204 


57 


12 " 


27 00 


488 


38 


19 


(( 


1900 00 


2219 


14 


6 " 


13 5'' 


532 


71 


15 


(( 


1500 00 


2230 


57 


8 " 


18 LJ 






467 


years. 


$46,700 00 






443 weeks. 


#996 75 



Whole expense of 24 old cases, at $100, 
Average expense of 24 old cases. 
Whole expense of 24 recent cases, 
Average expense of 24 recent cases, . 



#46,700 00 

1,945 83 

996 75 

41 53 



72 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 14. 

Showing the Duration of Insanity , the Ages and Civil State of Patients 
in the Hospital, admitted last year and previous years. 



' 


IfiSS. 


1S34. 


1885. 


ISSS. 


1837. 


1838. 


1839. 


1840.1841. 


1842 


1843. 


1844. 


1843. 


Duration before admis- 


















1 






sion : 
Less than 1 year, 


41 


56 


48 


54 


72 


82 


84 


75! 81 


106 129 


127 


156 


From 1 to 5 years, 


27 


29 


37 


37 


58 


50 


63 


56 52 


58, 62 


68 


89 


" 5 to JO " 


27 


14 


15 


13 


14 


16 


18 


15 12 


13 


15 


12 


15 


" ]0 to 20 « 


31 


6 


5 


11 


14 


8 


10 


10 10 


5 


7 


10 


19 


» 20 to 30 " 


12 


^ 4 





2 


4 


7 


1 


3 


4 


5 


1 


5 


5 


" 30 to 40 " 


3 


2 


1 


2 


1 


1 


1 


2 





4 


1 


3 





Unknown, . 


12 


8 


7 


6 


5 


13 


2 


1 


4 


7 


5 


11 


9 




153 


119 


113 


125 


168 


177 


179 


162 163 


198 


220 


236 


293 


Duration with those re- 


























maining at the end of 


























each year: 




























Less than 1 year. 


26 


22 


21 


11 


29 


28 


34 


28 


32 


40 


45 


51 


63 


From 1 to 5 years. 


23 


25 


22 


39 


51 


65 


69 


75 


74 


89 


74 


84 


128 


" 5 to 10 " 


20 


24 


34 


35 


38 


44 


44 


52 


53 


38 


55 


45 


63 


" 10 to 20 " 


28 


24 


29 


35 


41 


41 


52 


52 


45 


37 


52 


49 


66 


" 20 to 30 " 


7 


5 


3 


7 


11 


18 


14 


13 


15 


18 


19 


14 


18 


« 30 to 40 " 


2 


2 


4 


2 


2 


3 


4 


5 


4 


6 


4 


7 


7 


Unknown, . 


8 


16 


6 


9 


13 


19 


12 


11 


9 


10 


6 


13 


15 




114 


118 


119 


138 


185 


218 


229 


236232 


238 


255 


263 


360 


Ages of patients when 




























admitted : 




























Under 20 years, . 


2 


12 


4 


11 


13 


17 


10 


10 


7 


14 


15 


16 


20 


From 20 to 30 years, . 


34 


31 


23 


29 


58 


47 


47 


46 


50 


55 


48 


64 


92 


" 30 to 40 " 


46 


31 


36 


32 


34 


51 


49 


40 


45 


44 


62 


(55 


63 


" 40 to 50 " 


35 


31 


28 


26 


31 


32 


30 


34 


31 


46 


39 


43 


42 


« 50 to 60 « 


14 


8 


13 


14 


13 


20 


21 


21 


19 


24 


38 


26 


49 


« 60 to 70 " 


17 


5 


6 


13 


12 


8 


14 


6 


I) 


12 


11 


17 


18 


" 70 to 80 " 


3 





3 





7 


2 


8 


5 


1 


2 


5 


3 


8 


Over 80 years. 


2 


1 




















1 


1 


2 


2 


1 




153 


119 


113 


125 


168 


177 


179 162 


163 


198 


220 


236 


293 


Civil state of patients 


. 
























when admitted : 


























Single, 


92 


71 


52 


68 


94 


101 


80 75 


82 


108 


92 


114 


165 


Married, 


38 


40 


46 


49 


61 


65 


75 71 


63 


7() 


103 


102 


105 


Widows, 


12 


4 


8 


6 


'11 


5 


17 12 


13 


12 


17 


17 


16 


Widowers, . 


11 


4 


7 


2 


2 


6 


7, 4 


5 


2 


8 


3 


7 




153 


119 


113 


125 


168 


177 


179 162 


163198 


220 


236 


293 



1846.] 



SENATE— No, 1. 



73 



TABLE 15. 

Showing the Comparative Curaliliiy of Insanity^ treated at different 
periods of Disease. 



Total of Cases. 



Of less duration than 1 year, 
Males, 
Females, 

From 1 to 2 years, 

Males, 
Females, 

From 2 to 5 years, 
Males, 
Females, 

From 5 to 10 years, 
Males, 
Females, 

From 10 to 15 years. 
Males, 
Females, 

From 15 to 20 years. 

Males, 
Females, 

From 20 to 25 years. 

Males, 
Females, 

From 25 to 30 years. 
Males, 
Females, 

Over 30 years. 
Males, 
Females, 



Total of each Sex. 



1115 



387 



360 



202 



121 



42 



32 



10 



13 



Cured or Curable. 



529 

586 



196 
191 



209 
151 



115 

87 



60 
61 



29 
13 



18 
14 



466 
527 



105 
117 



65 
57 



14 
12 



Incurable. 



63 
59 



91 
74 



144 
94 



101 
75 



55 
57 



28 
13 



18 
14 



Some unknown. 



10 



74 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 16. 

Showing the Comparative Curability of Insanity attacking at different 







Total of Cases. 


Total of each Sex. 


Curable. 


Incurable. 


Under 20, . 


270 








Males, 






135 


58 


78 


Females, 






135 


38 


47 


From 20 to 25, 




335 








Males, 




.- 


187 


101 


86 


Females, 






148 


100 


48 


From 25 to 30, 




3i8 








Males, 




. 


169 


85 


84 


Females, 




. 


149 


99 


50 


From 30 to 35, 




302 








Males, 




. 


159 


87 


72 


Females, 




. 


143 


93 


50 


From 35 to 40, 




261 








Males, 




. 


123 


68 


55 


Females, 




. 


138 


92 


46 


From 40 to 45, 




195 








Males, 






108 


72 


36 


Females, 




. 


97 


63 


34 


From 45 to 50, 




163 








Males, 






78 


50 


28 


Females, 






. 85 


64 


21 


From 50 to 55, 




155 








Males, 




. 


73 


48 


25 


Females, 






82 


59 


23 


From 55 to 60, 




78 








Males, 






39 


26 


13 


Females, 






39 


24 


15 


From 60 to 65, 




71 








Males, 




. 


32 


21 


11 


Females, 






39 


27 


12 


From 65 to 70, 




34 








Males, 






22 


14 


8 


Females, 






12 


8 


4 


From 70 to 75, 




23 








Males, 






13 


6 


7 


Females, 






10 


9 


1 


Over 75, 




17 








Males, 






6 


3 


3 


Females, 




. 


11 


5 


6 



Some unknown. 



1846.] 



SENATE— No. 1. 



75 



TABLE 17. 

-Showing the relation of Cause to Recovery. 



PHYSICAL CAUSES. 

Ill-health, puerperal, follow- 
ed fever, measles, wounds, 
&c., 

Males, 

Females, 

Intemperance, 

Males, 
Females, 

Masturbation and its results, 
debility, weakness, &c., 
Males, 
Females, 

Epilepsy, . 
Males, 
Females, 



Palsy, 



Males, 
Females, 



MORAL CAUSES. 

Religious, including Mor- 
monism Millerism, Fanat- 
icism, &c., 

Males, 
Females, 

Afflictions, trouble, love, 
fright, fear of death, fu- 
ture punishment, &c., 
Males, 
Females, 

Anxiety about property, fear 
of poverty, &c., . 
Males, 
Females, 



443 



587 



158 



56 



44 



196 



397 



129 



355 



259 

28 



143 
15 



47 
9 



32 
12 



102 
94 



117 

280 



103 
26 



50 
259 



141 
15 



39 
1 



74 

m 



71 
171 



60 
16 



38 
96 



118 
13 



104 
14 



40 
9 



27 
10 



28 
28 



46 
109 



43 
10 



76 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 18. 

Showing the causes of Insanity as affecting persons pursuing different 

Occupations. 

















i 


a 
.S 




■a 
















3 






1 


E 




w 
















u 






<! 


<^ 




.a 










S 




a 


^ 






•a 


T! 












OCCUPATIONS. 


s 




o 


-tl 






S 


S 




s 












S 


■3 





i 


>• 





■3 


& 





>• 








E 


"3 

t— 1 


3 
1 


1 

Q 




Tn 


S 

a 

£ 


p. 

1 

(5 


5 




1 


3 



■3 

1-5 


1 





Farmers, 


60 


10 


24 


20 


24 


26 


3 





8 


1 


3 





179 


Shoemakers, 






9 


5 


24 


4 


10 


5 


2 





1 


1 





1 


62 


Laborers, . 






67 


3 


15 


4 


8 


6 








3 





1 


2 


109 


Seamen, 






31 


1 


6 


3 


6 


6 














3 





56 


Merchants, . 






11 


2 


32 


2 


4 


15 








2 








1 


69 


Carpenters, . 






15 


5 


7 


2 


8 


6 


3 





2 








1 


49 


Blacksmiths, 






4 


1 


1 





1 


4 


2 

















13 


Students, . 









2 


18 


2 


2 











1 











25 


Clergymen, 












4 





1 


1 


1 

















7 


Lawyers, 






2 





2 


1 





1 




















6 


Physicians, . 






2 














1 


1 

















4 


Painters, 












11 


1 








1 





1 











14 


Manufacturers, 






9 





3 





4 


3 


1 


1 





1 








22 


Barbers, 









1 








1 




















2 



y 



When there is a strong constitutional tendency to insanity, it is a 
question of serious magnitude to decide what course to pursue with off- 
spring toward off the danger and protect the system from its accession. 
All that can be said of hereditary predisposition is, that it increases the 
liability to disease ; it is never, strictly speaking, a cause. Some other 
influence must be brought to bear upon the individual before he will 
have gout, consumption, scrofula, epilepsy, insanity, or any other hered- 
itary disease. The course adopted by parents and teachers in this 
matter, is often a mist.^ken one. Strong propensities should generally 
be checked, not encouraged. The student should be taught to be ac- 
tive, and the active be restrained and made to study. If the nervous 
system is exceedingly susceptible, the muscular and circulating systems 
should be encouraged to activity so as to balance this unequal tendency. 
If the child is disposed to be rough, passionate, and quai'relsome, he 
should be subjected to gentle influences, mild diet, and female society 



1846.] SENATE— No. 1. 77 

and instruction. Obedience to well directed authority is essential to 
any suitable control and salutary management. Unrestrained passion, 
ungoverned appetite and unlimited indulgence, are probably more fre- 
quently the causes of insanity, diseases of the heart, and other severe 
nervous affections, than hereditary predisposition ; they establish a pre- 
disposition where none existed, and may also prove an exciting cause of 
disease in the very cases in which they have given the tendency. 

There are many cases of children where the mind is too active for 
the body ; intense application wears upon the physical powers and in- 
duces disease. In others, all the energies of the system are devoted to 
gratify animal wants and the lower propensities. Of all things, pre- 
cocity should be discouraged ; the very indication of it is a proof of in- 
cipient disease of the brain, which, if encouraged, will inevitably re- 
sult in concentrating the elements of death upon the brain or some vi- 
tal Organ. The common impression that the young must be permitted 
to pursue their own inclinations in the business of life, is not always 
sound discretion. The character should be moulded by training, and 
the inclinations be changed when they tend to develop the causes of 
disease which hereditary propensity or acquired tendency has establish- 
ed. This can always be done by suitable training, and this is the great 
business of education. It is not so much to store the mind with know- 
ledge as to train the faculties, lop off excrescences, and cultivate what 
is feeble and improperly developed, thus making a well balanced mind, 
fortified to meet the evils of life, to overcome difficulties and to bear 
with good spirit the unavoidable calamities that will meet us. Enow- 
ledge can be acquired at any age, but the foundation of a useful and 
happy life must be laid by correct discipline in youth, when the suscep- 
tibilities are tender and the confidence in parents and teachers, leadino- 
to no suspicions of error, is paramount and abiding. Many of the evils 
of life, the imperfections of character, the sufferings to which after- 
life is incident, and many of the failures of youth to accomplish antic- 
ipated results, arise from education founded on incorrect principles, and 
pursued to the accomplishment of undesirable ends. Such are also the 
foundations of disease, and especially insanity. When we Vv'itness the 
great number of cases of insanity arising from improper influences, 
education, habits, unrestrained desires and propensities, we have little 
cause to seek for natural tendencies, but great reason to lament over 
evils now established in the character and the life, which an early, cor- 
rect discipline, would have averted. 



78 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 19. 

Showing the state of the Moon at the commencement of a paroxysm of 
excitement in 125 cases of Periodical Insanity, amounting in all to 
875 paroxysms. Also, the relation of the Moon to the 175 Deaths 
which have occurred in the Hospital. 



Number of 


Paroxysms each D 


iY. 


Number of Deaths each Day. 


Day of the Moon. 


Wliole 
No. 


Male. 


Fe- 
male. 


Day 
of the 
Gtiiart'er. 


Day of the Moon. 


Whole 
No. 


Male. 


Fe- 
male. 


Day 
of the 
Quarter. 


1 


25 


17 


8 


1 


1 


4 


2 


2 


1 


2 


51 


28 


23 


2 


2 


9 


6 


3 


2 


3 


32 


17 


15 


3 


3 


11 


5 


6 


3 


4 


34 


16 


18 


4 


4 


6 


3 


3 


4 


5 


27 


12 


15 


5 


5 


9 


4 


5 


5 


6 


34 


16 


18 


6 


6 


9 


5 


4 


6 


7 


44 


22 


22 


7 


7 


8 


1 


7 


7 


End of 1st qr. 










End of 1st qr. 










8 


39 


21 


18 


1 


8 


7 


4 


3 


1 


9 


27 


16 


11 


2 


9 


9 


3 


6 


2 


10 


20 


9 


11 


3 


10 


3 


3 





3 


11 


30 


13 


17 


4 


11 


3 


1 


2 


4 


12 


29 


17 


12 


5 


12 


6 


3 


3 


5 


13 


28 


15 


13 


6 


13 


8 


6 


2 


6 


14 


39 


18 


21 


7 


14 


6 


4 


2 


7 


End of 2d qr. 










End of 2d qr. 










15 


39 


23 


16 


1 


15 


4 


3 


1 


1 


16 


22 


11 


11 


2 


16 


10 


6 


4 


2 


17 


36 


22 


14 


3 


17 


6 


3 


3 


3 


18 


18 


9 


9 


4 


18 


2 


2 





4 


19 


26 


17 


9 


5 


19 


3 


2 


1 


5 


20 


37 


21 


16 


6 


20 


8 


5 


3 


6 


21 


32 


18 


14 


7 


21 


7 


4 


3 


7 


End of 3d qr. 










End of 3d qr. 










22 


31 


16 


15 


1 


22 


4 


3 


1 


1 


23 


34 


13 


21 


2 


23 


5 


2 


3 


2 


24 


39 


21 


18 


3 


24 


7 


3 


4 


3 


25 


29 


13 


16 


4 


25 


7 


4 


3 


4 


26 


26 


12 


14 


5 


26 


7 


4 


3 


5 


27 


19 


9 


10 


6 


27 











6 


28 


28 


17 


11 


7 


28 
Deaths, 


7 


5 


2 


7 


Paroxysms, 


875 


175 





1846.] SENATE— No. 1. 79 

There have been added to this table, on the moon, 19 new cases 
of periodical insanity, making 125 cases, and 86 new paroxysms of 
excitement, making, in all, 875 paroxysms, also 24 deaths, which 
makes in the whole 175 deaths in 13 years, which is an average of 13J 
annually. 

The results of this year are more favorable to the theories which 
have been promulgated on the subject of lunar influence, but lead to no 
results, as a whole, to sustain the theory. 

Of the cases of excitement recorded, 51 of the 86 occurred at the 
new and full moon, and 35 at the quadratures ; this is considerably 
in favor of the popular theory. Of the 24 deaths, 11 occurred at the 
period of excitement, and 13 at the period of collapse ; a trifle against 
the theory. Of the 24 deaths, 11 occurred at the period of excite- 
ment, at the new and full moon. Of these deaths, one was from dis- 
ease of the brain, two from disease of the heart, one from lung 
fevei', two from epilepsy, one from fright, one typhus fever, one 
marasmus, one dysentery, and one consumption. 13 deaths occurred 
at the quadratures or periods of collapse, two from typhus fever, 
three from apoplexy, one suicide, two from palsy, two from maras- 
mus, one from consumption, one dysentery, and one from disease of 
the heart. The deaths of five cases of acute disease were in the 
period of excitement. One of acute disease of the brain, one of 
acute epilepsy, one of lung fever, one of dysentery, and one of ty- 
phus fever. 

Though I have not been able to discover any direct influence of 
the moon in the production of insanity, or in the occurrence of the 
paroxysms in periodical cases, it cannot be denied that there is such 
a thing as regular periodicity with regard to the functions of the 
animal economy, and to certain diseases affecting the system. The 
menstrual period is a lunar period ; almost all fevers have weekly or 
semi-monthly tendencies to crisis. The most acute often terminate 
at the end o"f the first week, and the more protracted at the end of 
the second, third, or fourth week. Epilepsy often occurs at nearly 
regular lunar periods, and many of the friends of patients say that 
this disease and the excitements of insanity occur most frequently 
at the new and full moon. If these coincidences were observed only 
by the ignorant and superstitious, they might pass unnoticed as too 
intimately connected with preconceived notions and partial examina- 
tions of occurrences to establish and sustain what tradition has handed 
down as true ; but men of the greatest science and closest observa- 



80 



STATE LUNATIC HOSPITAL. 



[Jan. 



tion, such as Mead, Sydenham, Balfour, Orton, Allen, and Morrison, 
recognize such influence. It is at this time a subject of close phi- 
losophical investigation, which should be encouraged and examined, 
rather than ridiculed and rejected. 



TABLE 20. 
Of Per Cent, 



Recovery of cases of less 

than one year, 
Recoveries of all discharged, 
Recoveries of old cases, 



1834. 


1835. 


1836. 


1637. 


1838. 


1839. 


1840. 


1841. 


1842. 


1843. 


1844. 


82 


82 


84 


89 


86 


90 


91 


91 


91 


88 


93 


54 


46 


53 


57 


52 


47 


53 


49 


46 


59 


54 


20 


16 


19 


25 


16 


17 


22 


21 


16 


29 


24 



89^ 
62^ 
3U 



Per Cent, of cases 


from the most 


prominent 


Causes each year. 






1833. 


1834. 


1835. 


1836. 


1837. 


1838. 


1839. 


1840. 


1841. 


1842. 


1843. 


1844. 


1845. 


Ill-health, . 


8 


18 


21 


22 


21 


28 


27 


25 


23 


18 


16 


15 


13 


Religious, . 


9 


6 


7 


7 


6 


9 


5 


4 


4 


9 


13 


9 


7 


The Affections, . 


14 


12 


17 


16 


16 


15 


25 


17 


13 


15 


9 


10 


14 


Property, . 


7 


11 


9 


6 


6 


10 


6 


5 


4 


5 


7 


3 


9 


Intemperance, 


25 


24 


23 


15 


10 


16 


8 


12 


12 


8 


6 


8 


10 


Masturbation, 


5 


6 


7 


16 


21 


6 


8 


7 


6 


4 


3 


2 


6 



Per Cent, of Deaths of all in the Hospital each year. 



1833 



2^ 



1834 1835 



3ii 3i 



1836 



3i 



1837 



3^ 



1838 



4i 



1839 



5h 



1840 



m 



1841 



1842 



25- 



1843 



41 



1844 



1845 



Per cent, of deaths of the whole number, 175 of 2306, . . . 7i 
Per cent, of deaths of the average number the last year, 24 of 316, . 7^ 



Per Cent, of the Recoveries compared with the admitted. 

There have been in the Hospital 2306 patients, of whom 1038 have recovered, 
which is ........ . 44^ per cent. 

There have been admitted to the Hospital the last year, 293 patients, and 
there have recovered 122, Avhich is ... . 42 per cent. 

There have been admitted 156 cases of duration less than one year ; of these, 
93 have recovered, which is ..... 62 per cent. 

Many others are convalescent. 



1846.] SENATE— No. 1. 81 

Labor. The labor of the Hospital, whether considered as econom- 
ical, pecuniary, or remedial, is becoming more important every year. 
It may now be divided into domestic, mechanical, horticultura!, and 
farming. 

Domestic labor divides into a number of branches and departments. 
The sawing of wood, supplying the fires, procuring vegetables, and 
assisting in preparing them for cooking, the feeding of stock, milking 
cows, &c., daily employ many individuals, and furnish them agreeable 
and healthy exercise. 

Many women and a few men assist in cooking, both in the kitchens 
and bakery, making themselves useful, and spending their time agree- 
ably. Since our last report, an excellent bakery has been erected, and 
has been in operation nearly a year. All the bread, pastry, &:c., con- 
sumed in the establishment, are here prepared. This is considered not 
only convenient but truly economical. Two persons, a man and wo- 
man, do all the baking for the family, which consists of between four 
and five hundred persons. The bread, throughout the establishment, is 
uniform, and is used when in the most palatable and healthy condition. 

One patient, a young man, is constantly employed in the bakery, and 
is making good progress in learning the trade. 

At the close of the last year, our new laundry went into successful 
operation. In this departmiCnt of domestic labor, more female patients 
are constantly employed than in any other. Two male patients are 
constantly employed here, and occasionally more ; one turns the man- 
gle, the other plies the washing-machine. The washing is mostly done 
by steam, and the building warmed conveniently and cheaply by steam 
pipes. Ten or twelve women daily spend five or six hours in this de- 
partment, assisting in the wasiiing, ironing and mending the garments. 
The rooms for labor are pleasant and the patients usually volunteer to 
do this labor. 

In winter and bad weather, the large attic of this building is used for 
drying, and artificial heat is applied. In summer and pleasant weather, 
the drying is done in the open air. A convenient airing room, contig- 
uous to the ironing room, is used for hanging clothes in a high temper- 
ature, thus securing perfect dryness when used. The overseer of the 
laundry collects the clothes from the different apartments, taking a list 
of the articles, and on certain days of the week sees that they are 
washed, ironed, and mended, and returns them to their places, being 
responsible for their safe return, as well as for the proper operation of 
his department, in every respect. 

11 



82 STATE LUNATIC HOSPITAL. [Jan. 

These two new buildings, the bakery and laundry, situated some- 
what remote from the house, are a great acquisition to the Hospital. 
Washing should never be performed in the basement rooms of a Hos- 
pital. The steam, and particularly the effluvia arising from soiled 
clothes, is always offensive in the apartments above. Basement rooms 
are rarely pleasant, and often unhealthy from dampness and coldness. 

If it is an object to secure respectable help in these departments, 
and to employ a large number of patients, it is desirable that the apart- 
ments should be commodious, well lighted and pleasant. 

The preparation and packing of fuel for the fires in the house, fur- 
nish much labor for a class of patients who are employed in the garden 
and on the farm in summer. This furnishes healthy employment for 
them, and is sought by many more than can be engaged in it. This 
labor is almost exclusively performed by patients. 

The care of stock and poultry is the favorite labor of some patients. 
One man devotes himself to the horses, others to the oxen, djc., taking 
the best care of them. 

Mechanical Labor. In the mattress shop much labor has been 
performed the past year. All the mattresses for the new wings were 
made here, and many others have been made over. This shop has 
been profitable to the institution, and is a convenience that could not 
well be dispensed with. One patient makes most of the mattresses, 
others assist him in untwisting the rope, picking the hair, and other 
minor duties connected with the employment. 

The Shoe Shop is another valuable department of Hospital labor, 
The profit in this shop is small, as the principal object of engaging in 
the business was to furnish employment to shoemakers, who abound in 
the Hospital, to make better and cheaper work than we could have 
made for us elsewhere, and to do our own mending, which is a consider- 
ation of some magnitude, employing at least one hand constantly. 
The results of this department of labor have always been satisfactory, 
and still continue to be so. 

The following is a statement of the labor and expenses of this shop, 
furnished by the overseer : — 

Amount of work done for Officers,, Overseers, and Assistants, $450 59 
For Patients, . . . . . . 630 96 

Shoes on hand, . . . . . 85 00 



1846.] SENATE— No. 1. 


83 


Stock on hand, . . - . . 


. $35 00 


Expended in stock, . . . . . $591 01 
Wages of Overseer, . . . . 233 67 


$1,201 55 


Board of " . . . . 101 53 




Binding, . . . , . 35 00 




Fuel, . . . . . 20 00 




Stock on hand at the commencement of the year, 90 GO 


§1,071 21 





Balance, 



$130 34 



One female patient has bound 1050 pairs of shoes the past year ; 
666 pairs for this shop and 384 pairs for another, besides a considera- 
able amount of other needle work. Others are equally industrious as 
seamstresses, laundresses, &c. 

Many patients have been employed in the carpenter's shop the past 
year. Most of the bedsteads and tables for the new wings, have been 
made here. There is no want of employment for a good mechanic in 
this shop and about the premises, or for as many patients as can be 
furnished with benches and tools. In such a large establishment, re- 
pairs and improvements are daily called for, and as much benefit in pro- 
portion to their numbers, is derived from the active labor of these arti- 
sans during convalescence, as from any other laborers, not even except- 
ing farmers and gardeners. 

One patient, after getting over his excitement, continued his labor till 
he paid all his own bills for board at the Hospital, and had more than 
enough money remaining to bear his expenses home. Another paid a 
large share of his expenses while here, and recovered from deep mel- 
ancholy, which had continued many months. He returned home cheer- 
ful and happy. 

A man, now favorably convalescing, thinks he shall not be able to re- 
turn home next month, as he has engaged to make so many hand-sleds 
for coasting and labor. 

The seamstresses' room is the next important department of labor at 
the Hospital. This is a new and well adapted apartment, over the 
bakery. In this, two tailoresses and a dress-maker find constant em- 
ployment in making and mending garments, in which they are assisted 
by many female patients. This assistance is not only very important 
to the institution, but very useful to the patients themselves. A larger 



8 A. STATE LUNATIC HOSPITAL. [Jan 

proportion of the women are regularly and constantly employed than 
of the men ; sewing, knitting, and embroidery occupy the time of a 
large number who do not seek more active employments. 

In my last report, I gave briefly the history of the case of a girl twelve 
years old, who had been insane from infancy. She has recently come 
under my care, and is now in the Hospital. No change had taken 
place in her mind when she came to us, nor had her friends been able 
to teach her. She apparently failed to learn for want of the power of 
attention. When she first came under my care she seemed incapable 
of doing any thing requested of her regularly. Her habits were, in 
many respects, bad, and her passions were frequently excited by an at- 
tempt to teach her. Our first effort was to correct some of her disa- 
greeable habits, one of which was a continued spitting upon herself and 
the floor. This habit was entirely controlled in a few weeks. She was 
next made t'o take an interest in piling blocks, which were daily brought 
to her. When she got out of patience with these, she repeatedly threw 
them out of the window, and would neither go for them nor put them 
away. Afier a time, she became interested in them, amused herself 
very much with them, and will now pack them nicely in the box when 
she has done with them, and go for them when she desires to renew the 
amusement. After this she took a fancy to dolls, in which she became 
greatly interested ; she will now dress them and amuse herself with 
these, and other toys familiar to children. She has recently assisted in 
setting the table, goes to the fountain, procures water, and fills the cups 
for the boarders in the wards, and does such errands for the attendants 
as they can make her understand. The greatest advance that has been 
made in the improvement of her mind and power of attention, is in 
teaching her to sew. For a long time all the efforts to accomplish this 
seemed unavailing. Her attendant would place the needle in her hand, 
pass it through the cloth, and assist to draw it through, and finish the 
stitch, but the child failed to accomplish the whole, and it seemed doubt- 
ful whether she would be able to do it. Her faithful attendants perse- 
vered, and, finding an increased interest in the employment, were en- 
couraged to continue their efforts, and she is now able to sew a very- 
decent seam, and improves rapidly in this new and advanced depart- 
ment of knowledge. The success of these efforts encourages us to 
persevere. It is easier to advance in improvement than to begin it, 
and we are not without hope that this interesting being will not only be 
able to take care of herself, but in some degree, to be useful to her 
friends, and perhaps gain knowledge which shall show her her own re- 



1846.] 



SENATE— No. 1. 



85 



sponsibilities, moral duties and obligations. It is no small achievement 
in any case to make a responsible agent out of an irresponsible one, but 
to make an intelligent woman of an insane infant, who has grown to 
womanhood without developments of mind or morals, is an attempt 
worthy of patient trial. 

Farm and Garden. Since the report of last year, about ten acres 
of land has been added to the farm. Most of this was unreclaimed 
meadow land, capable of being made very valuable. Besides this, the 
Hon. Stephen Salisbury has purchased a farm of twenty-seven acres, 
contiguous to our own, for the benefit of the Hospital. We can have 
the use of this by paying annually the interest of its cost, and the fee 
of the land when the principal shall be paid. It is a very desirable 
and necessary addition to our domain, and the price is very reasonable. 

No department of labor is more profitable to the Hospital or benefi- 
cial to the individuals employed, than these out-door labors, and more 
persons labor regularly in them than in all other business, at the seasons 
when they can be pursued. The same class of patients do much at 
improvements. They have this year dug the stone and laid sixty rods 
of heavy, substantial wall, cleared six acres of land of a great quantity 
of stone and stumps, made a good road in front of the Hospital, graded 
the land where the old road was, made hedges and banks, and trans- 
planted trees and shrubbery. 

The quantity of the products of the farm and garden, is given in the 
following statement, with the value as estimated by the Steward : — 



30 tons of 


hay, at $17 00 per ton, 


. 


$510 00 


145 bushels of onions, at 


67 cents. 


97 15 


30 




" tomatoes, at 


. 50 


a 


15 00 


30 




" green peas, at 


$1 GO 


(( 


30 00 


50 




" early potatoes. 


at 75 


<( 


37 50 


60 




" late potatoes, at 


40 




24 00 


200 




" corn, at 


$1 00 




200 00 


20 




" soft corn, at 


. 50 




10 00 


200 




" beets, at 


. 50 


(( 


100 00 


60 




" parsnips, at 


. 75 




45 00 


1134 




" carrots, at 


. 30 




340 00 


2000 cabbag( 


3S, at 4 cents, 


. 




80 00 


400 lbs 


. of broom corn. 


. 




26 00 



86 



STATE LUNATIC HOSPITAL. 



[Jan. 



$6 00 


45 


00 


4 00 


25 00 


. 100 00 


60 00 


. 250 


00 


. 1,520 


00 


. 479 


12^ 


. 418 


60 


55 


00 



20 bushels broom corn seed, 
3000 winter squashes, 

3 loads of pumpkins, . 
Corn fodder. 
Garden vegetables, 
Poultry, 600 lbs., 
Pasturing 15 cows. 
Milk, 38,000 quarts, at 4 cents, 
Pork, 7,666 lbs., at 6^ " 
Beef, 8372 lbs., at 5 " 
Pigs sold, . 



The season was dry, and the hay fields, pastures and gardens suffer- 
ed much from the drought. The stock has been fed from the farm and 
gardens. Stock on hand, 4 oxen, 17 cows, 6 horses, 1 bull, and 41 
swine. 

It is very desirable that the farm purchased by the gentleman for our 
benefit should be secured to the Hospital. It is good land, lying con- 
tiguous to our present farm, is fitted for any culture, and is daily be- 
coming more valuable. Much of it is well fitted for hay and pastures, 
and the labor bestowed upon it the present year has enhanced its value 
since the purchase. 

The high price of provisions the present year may so exhaust the 
resources of the Hospital, that there may be no money to pay for land, 
but the government, looking well to the interests of the Commonwealth, 
will not fail to secure such a valuable possession to the insthution. 



LiBKARY. Next to labor, I consider reading and writing the most 
valuable employments for the insane. One of the most troublesonie 
circumstances connected with an insane mind, is the loss or diminution 
of the power of attention ; and one of the most unfavorable circum- 
stances attending its recovery, is, that this power cannot be regained or 
sufficiently excited, so that the mind can concentrate its energies upon 
one thing, to the degree necessary to accomplish any useful design. 
Labor often assists greatly in fixing the attention to a single object or 
operation, so that the individual can accomplish it. By this, an impor- 
tant point is gained. The mind is made to act in its accustomed healthy 
channels, the disorder of the mental machinery is for the time removed, 
and its natural action adjusted. Even if this is temporary, it is well, 
for if one operation of the mind is right and rational, others may be- 



1846.] SENATE— No. 1. 87 

come so by association, and the healthy balance be finally restored. 
Reading has a tendency to bring about this favorable result. If the 
subject is interesting, it excites attention. It often produces healthy in- 
fluences and impressions ; these dispel delusions and false judgments, 
and leave the mind in a more healthy state. A person may labor at 
simple employment to which he has been accustomed, without giving 
much attention to his work, so also an individual may read without 
thought, and with little benefit. This forms no argument against the 
principle above advanced, but is an exception to it. 

Writing often forms a better test of the state of the mind and the 
power of attention. No insane person, whose faculties are all af- 
fected, can write a well connected letter or other composition. Atten- 
tion must be given to the form and manner of writing, no less than to 
the ideas expressed, or it will result in an unintelligible scribble. Many 
monomaniacs write well upon subjects disconnected with their delu- 
sions, and the extent of these delusions is often more fully learned by 
their writing upon the subject than in any other way. 

We are greatly indebted to many long-continued friends for frequent 
contributions to our stock of reading. Newspapers and periodicals 
come to us gratis, not only from every part of this Commonwealth, but 
from the neighboring States. From year to year, these weekly messen- 
gers have reached us, and are sought for with avidity, and read with 
pleasure. 

I acknowledge with gratitude, the receipt of books and periodicals 
for our library from Rev. Dr. Pavkman, Rev. Louis Dwight, and Rev. 
Thos. F. Norris, of Boston ; Henry K. Newcomb, Esq., S. F. Haven, 
Esq., Clarendon Harris, Esq., J. W. Goodrich, Esq., J. S. C. Know;- 
ton, Esq., Rev. Mr. Hubbard, Thompson's express, and Leonard's ex- 
press, Worcester ; Mr. and Mrs. Josiah Hay ward, Sturbridge ; Miss 
E. P. Woodberry, Beverly ; Rev. C. Simmons, Dr. Batchelder, Ulica, 
N. York. 

It gives me great pleasure to say that we regularly receive from the 
editors the following newspapers, for which we return our warmest 
thanks, and a copy of this Report : — The Boston Recorder, Olive 
Branch, Youth's Companion, Christian Watchman, Christian Witness, 
Zion's Herald, Springfield Republican, Springfield Gazette, Hampshire 
Gazette, Greenfield Mercury, New Bedford Mercury, Fall River Moni- 
tor, Old Colony Memorial, Keene Sentinel, New Hampshire Patriot, 
Haverhill Democrat, Gospel Messenger, Advocate of Peace, Harbinger, 
Temperance Stafldard, Congregational Visiter, Christian Citizen, Wor- 



88 STATE LUNATIC HOSPITAL. [Jan. 

cester Cataract, National iEgis, State Sentinel, Worcester Transcript. 
Besides these, large bundles of exchange papers are frequently sent 
to us from printing offices in Worcester and Boston. 

The ladies of our family have received $125 from the sale of arti- 
cles made in their sewing society, which has been appropriated for the 
benefit of the library. -i 

Religious Sekvices. Twice on each Sabbath our family assemble for 
worship in the Chapel, and hear interesting and instructive lessons of relig- 
ious truth. These services are always appropriate, solemn and impres- 
sive. The Rev, George Allen continues to be our chaplain, and with rare 
judgment and skill selects subjects unobjectionable to any, and presents 
them in a manner calculated to do much good. His evening prayers 
and reading of the Scriptures are well approved by all who hear him, 
and always exceedingly appropriate and interesting. The music at 
these daily services is always good, often excellent, and we are under 
great obligations to our spirited choir of singers for their valuable aid 
in chapel and devotional exercises. 

Our Chapel, 80 feet long by 30 feet wide, is well filled on the Sab- 
bath with worshippers from our family. About 300 are usually pres- 
ent, and their quiet and orderly demeanor has ever excited the admira- 
tion of strangers, and won the confidence and approval of the officers, 
who, with their families, are invariably present. 

The regular evening prayers have now been continued nearly two 
years, with most satisfactory results. 

The subject of religious worship for the insane, is no longer a prob- 
lem with us. We consider it no less important, and hardly less influ- 
ential with the insane than with the rational mind. If, as is said by a 
modern author, the moral character is let loose, and the moral sense 
blunted by insanity, it forms no argument unfavorable to religious 
teaching. The frequent impressions of religious truth cannot fail to 
have a salutary influence on such minds, and I have the fullest confi- 
dence that impressions are left on the insane which have a most bene- 
ficial effect on future conduct and character. 

Tha Bible is pui m'o the hands of all the insane with almost univer- 
sal h^.r:<?rit. We occasionally find patients turning over its pages to 
discover confirmation of their own impressions of personal wickedness 
— others to seek denuiiciations of characters, such as they suppose 
themselves to possess. The^e cases are few, while the many read it 



1846.] SENATE— No. 1. 89 

for instruction, direction, consolation and support, indeed with the same 
intention with which it is read by mankind abroad. 

Religion should be the basis of government, and the bible is the basis 
of true religion. Without the bible or its influence in education, man, 
even in this day, is a semi-barbarian. Whether he is abroad or in se- 
clusion, the oracles of truth influence his character, chasten his feel- 
ings, and make him better. The insane man who reverences religion 
and consults his bible, has more self-respect, more control over his 
feelings, more love of order and truth, and is a better patient than he 
who is ignorant of the law of love given in those sacred pages, or who 
has been educated to disregard the institutions and duties of religion. 

A violent maniac in the periods of his excitement and passion will 
break over all the boundaries of propriety in his language and conduct, 
but when his excitement begins to subside, the benign precepts of his 
religion again have influence over him, and aid him to enforce self- 
government, and gain the mastery over his feelings. 

Ten yeai's ago it was the general impression that religious influence 
was of doubtful utility to the insane. Not an institution in this coun- 
try had devotional exercises or stated religious worship on the Sabbath. 
When the Chapel, in connexion with the Hospital, was in contempla- 
tion, the Commissioners, appointed by the government, made a contract 
to erect a building to accommodate about one hundred persons. One 
distinguished member of that board was absent on public business 
when this contract was made. After his return, a meeting was called 
to sanction what his associates had done. At that m.eeting I presented 
every consideration in my power to induce them to enlarge the plan. 
It was considered perfectly absurd by most individuals in that commis- 
sion, to think of ever gathering one hundred patients in a Chapel. My 
friend joined with me, and insisted that he would not consent to the 
construction of any Chapel that did not accord with my wishes. In 
consequence of this decision, the contract was broken up, and the pres- 
ent Chapel, for 250 patients, was erected. On the day of dedication, 
more than 120 patients were present. This was the first religious 
meeting that had ever been held here. Since that time the Chapel 
has been enlarged, and will now accommodate from 3 to 400 persons. 
It is generally well filled every Sabbath. 

Conclusion. It is with sincere pleasure that I bear testimony to the 
faithfulness and devotion of the Steward and Matron, Mr. and Mrs. 
Hitchcock, and of the Assistant Physicians — Doctors, John R. Lee and 
12 



90 STATE LUNATIC HOSPITAL. [Jan. 

Rufus Woodward, all of whom have labored assiduously to promote 
the comfort of the patients and the welfare of the Hospital. I should 
do great injustice to my own feelings, to omit, on this occasion, to ac- 
knowledge my obligations to the Supervisors, Mr. and Mrs. Mirick, to the 
Overseers of the Departments, and all persons employed in the Hospi- 
tal. I have always been fortunate in collecting around me faithful, 
competent and discreet men and women, who have felt that they had 
duties to perform, responsible, self-sacrificing and difficult. The per- 
sons employed here are respectable and well educated, belonging to the 
substantial yeomanry of the Commonwealth, not menials, not servants ; 
all have duties assigned to them for the fulfilment of which, they are 
responsible. No individual who uses intoxicating drink is employed, 
and those who do not use tobacco are preferred. 

All the improvements projected by the Trustees and approved by the 
government in connexion with this great establishment, are now com- 
pleted. Every department is in the care of faithful and experienced 
officers, and the system of management seems well adapted to promote 
its best interests. 

I am admonished by the lapse of thirteen years, since I assumed the 
management of this institution, that I should resign the charge into 
other hands, before age shall compel me to relinquish it, or the time 
shall arrive when I may not be able to judge of my own qualifications 
for the trust. I was here at the opening of the institution, received the 
first patient, and have since received more than twenty-three hundred, 
a greater number than were ever in the care of one man in this coun- 
try. I am now the senior Superintendent, both by age, and duration of 
office. 

I have enjoyed much in my intercourse with this unfortunate class of 
individuals. I have witnessed, with much satisfaction, the gleaming of 
intellect, which bad been long shrouded by insanity ; have seen hopes 
revive, delusions vanish, false judgments give way to returning reason, 
and the mind and moral sensibilities restored, and established in health 
and vigor. There are pleasures to be derived from rendering good 
custodial care to the insane who have been neglected, abused, and sub- 
jected to various sufferings ; but to be instrumental in the recovery of 
the insane, affords higher enjoyment, and is an abundant reward for all 
needed sacrifices and efforts. In Hospitals for the insane, there are 
many trials, and I have had my share. In my intercourse with patients, 
however, where few have repelled me, hundreds have greeted me cor- 



1846.] SENATE— No. 1. 91 

dially and affectionately, and after recovery, have left me with grateful 
hearts and kind benedictions. 

During my residence here, I have received from the Trustees all the 
assistance I could ask or desire. They have sustained me under all 
circumstances, encouraged me in all difficulties, and have afforded me 
every necessary facility in my labors. We have met as strangers, and 
parted friends. 

The duties of this station are not likely to lessen. They require en- 
ergy, firmness, and unceasing vigilance. This Hospital cannot stand 
still while others are progressing. Nothing should be spared to make 
it perfect. Massachusetts will not be out done in her care and provis- 
ion for the insane. Improvements will, from time to time, require ex- 
penditures. If they are met with the same libei'al spirit as heretofore, 
and the institution be as well sustained, she will ever have reason to be 
proud of her State Lunatic Hospital. 

Commending it to the scrutiny and guardian care of the government, 
and the protection of a wise and beneficent Providence, I close, and 
respectfully submit this report. 

SAMUEL B. WOODWARD. 



State Lttnatic Hospital, 
Worcester, Mass., Nov. 30th, 1845. 



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1846.] 



SENATE— No. 1. 



95 



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1846,] 



SENATE— No. 1. 



97 



CO 


Slight shower at 2, P. M. 

[at 2, P. M. 

Thunder in morning. Thermometer 90° 
Thermometer 92° at 2|, P. M. 

Thunder shower in the night. 

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Showers in the night with lightning. High 
Halo around the moon. 

Halo around the moon. 
Shower at 10, A. M. 

Very sl'ght shower at sunrise. 
Fine showers in the afternoon. 
Aurora Borealis. 


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1846.] 



SENATE— No. 1. 



99 



8 


Rain in the morning and at night. 

Fine showers in the afternoon. 
Aurora Borealis. 


Inches 

of 
Rain. 


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101 



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104 



STATE LUNATIC HOSPITAL. 



[Jan. 



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Fair days, .... 248 
Cloudy days, - - - - 117 

DAYS ON WHICH 

Rain fell, - - - - 93 
Snow fell, .... 29 
Halos of tlie moon were seen, - 8 
Aurorse Boieales, ... 8 


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Crocus, - 
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Trailing: Arbutus, 
Fever Bush, 
Missouri Currant, 
Peach Tree, 
Wild Cherry, 
Cohush, - 
Apple Tree, 
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licanthus, 

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phne, - 

rus Japonica, - 

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isamine, 

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14 



STATE LUNATIC HOSPITAL. 



[Jan. 1846.] 



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