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

1S43-53 



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SENATE No. 1. 



TWENTY-FIRST 

ANNUAL EEPORT 



THE TRUSTEES 



STATE LUNATIC HOSPITAL, 



AT WORCESTER. 



DECEMBER, 1853. 



BOSTON: 

WILLIAM WHITE, PRINTER TO THE STATE. 

s^ 1854. 



OFFICERS OF THE HOSPITAL. 



TRUSTEES. 
FOSTER HOOPER, President, Fall River. 

S. G. HOWE, - Boston. 

REJOICE NEWTON, Secretary, Worcester. 

JAMES B. CONGDON, New Bedford. 

FRANKLIN RIPLEY, " Greenfield. 



TREASURER. 
SAMUEL JENNISON, Worcester. 

office : SAYINGS BANK, FOSTER STREET, WORCESTER. 



RESIDENT OPFICERS, 



GEORGE CHANDLER, M. D., 


Superintendent. 


GEORGE ALLEN, 


Chaplain. 


MERRICK BEMIS, M. D., 


Assistant PHysiciAN, 


EDWARD A. SMITH, M. D., 


U li 


THOMAS HILL, 


Steward. 


ELIZABETH A. REID, 


Matron. 


JOHN T. MIRICK, 


Supervisor. 


PHEBE S. MIRICK, 


It 



TWENTY-FIRST ANNUAL REPORT 



TRUSTEES OF THE STATE LUNATIC HOSPITAL, 



AT WORCESTER, 
1853. 



To His Excellency the Governor and Honorable Council :■— 

The Trustees of the Massachusetts State Lunatic Hospital, 
at Worcester, have the honor, pursuant to the requirements of 
law, to present their Annual Report " of the Condition of the 
Hospital, and its Concerns." 

In reviewing the history of this institution for the past year, 
the Trustees find abundant cause to acknowledge with gratitude 
the protecting care of. an overruling Providence, and feel to 
congratulate the people of the State, on the hitherto successful 
working of this great charity, when the imperfection, of its 
means is considered. 

The operations of the Hospital have been more extensive 
during the past, than in any preceding year. The number of 
patients within its walls, Dec. 1st, 1852, was 532, and there 
were received, 288, making 820, who were the recipients of its 
care and treatment within the year, and 4,458 since its first 
foundation. 

The number of admissions have been 21 less than in the 
preceding year, while the whole number has been 45, and the 
average 22 more. 



6 ■ STATE LUNATIC HOSPITAL. [Jan 

The admissions have been only from two sources, commit- 
ments by the Com-ts, and commitments by Overseers of the 
Poor. Its doors have been closed to private applications, 
and many who have sought an entrance here, have been turned 
over to neighboring institutions. 

This course was dictated by the crowded condition of the 
Hospital, there having been in it an average of 147 more than 
it was designed to accommodate. 

There were discharged during the year, 300; of whom, 145 
are reported recovered, 36 improved, 41 incurable and harmless, 
37 incurable and dangerous, and 41 to have died. 

Most of the incurable and harmless were sent to their friends, 
and to towns to which they were chargeable ; and the incura- 
ble and dangerous being such as the law authorized to be sent 
to Houses of Correction, were removed thither in accordance 
with the provision of the statute for relieving the crowded con- 
dition of the Hospital. 

In the middle of summer, the unprecedented number of 
567 patients had become residents within its walls. Indica- 
tions of diseases incident to the season began to show them- 
selves, and created a just apprehension, that a fatal epidemic 
was impending over this crowded, but ill-ventilated establish- 
ment. 

In this emergency, the Trustees, in the early part of August, 
decided upon relieving its crowded condition, by sending off 
one hundred of its inmates, and an order was passed for the 
purpose. But so soon as it began to be executed, remon- 
strances and entreaties came back so earnest from the officers 
of the establishments to which they were sent, that the order 
was only partially carried into effect. It was stated by them 
that their respective establishments were already more than 
full, and that those sent to them would be placed in a far worse 
condition than they would be in, were they to remain in the 
Hospital ; in fact, that they could not be received. 

The fears of an epidemic having subsided with the disap- 
pearance of the indications which gave rise to them, and the 
general health of the patients being as good as ordinary, in 
the latter part of August, when the order had been only par- 
tially executed, its further enforcement was suspended. 

A very large and still increasing proportion of the admissions 



1854.] SENATE— No. 1. 7 

is of foreigners. This subject has been repeatedly alluded to 
in former Reports, and needs not to be enlarged upon at 'this 
time. The facts and suggestions in relation to this matter, 
contained in the Report of the Superintendent, are commended 
to the consideration of the government. Unless something is 
done to avert it, the benefits of this institution will soon be 
denied to our native population, except to such as may be 
paupers or criminals. It is fast filling up with a class of incura- 
ble foreign paupers, which circumstance is already seriously 
impairing its usefulness as a curative institution. It is also 
manifest, that further provision must be made for the custody 
and management of the insane. According to the last census, 
the hospital provision for the insane, in the whole country, is 
equal to only about twenty-five per cent, of the whole number. 
In Massachusetts, the provision is in a much greater ratio to 
the whole number, but yet far short of what it should be. 

In New York and Pennsylvania, the residence of the pau- 
pers sent by the counties into their State Hospitals, is limited 
by law to six months, unless, in the opinion of the superin- 
tendents, a longer residence shall be deemed of importance to 
their recovery. At the expiration of the period allowed, they 
are sent back to the county poor-houses. This renders these 
Hospitals essentially curative institutions, by preventing them 
from becoming filled with incurable paupers. 

In this State, if only those who have been sent from this 
Hospital for the want of room, in the last two years, together 
with those who ought now to be sent from it, in order to 
reduce the number of its inmates to 400, — the maximum that 
ought to be retained, — were to be sent to Taunton on the 
opening of that Hospital, they would fill it to its utmost capac- 
ity. But it is known that these constitute but a part of those, 
who are waiting for the opening of that institution to become 
its inmates. 

It is suggested in the Superintendent's Report, that some of 
the incurable and harmless State paupers may be sent to the 
State Almshouses. The suggestion is deserving of a favora-^ 
ble consideration. It may also be thought expedient to con- 
struct apartments in connection with those establishments, for 
the same class of incurable and dangerous patients, and par- 
ticularly for epileptics, who only require safe custody. In tl^is 



8 STATE LUNATIC HOSPITAL. [Jan. 

way, they might be taken care of at a less expense to the 
Commonwealth, and at the same time, be the recipients of all 
the care and attention demanded by the most enlightened 
philanthropy. 

The Hospital at Worcester, needs some extensive repairs 
and improvements to enable it to sustain its former high repu- 
tation, and make it conform to the present advanced state 
of science, as applied to such institutions. At the time this 
Hospital was built, the whole subject of the moral, and we 
may say, the physical treatment of the insane, was compara- 
tively in its infancy. 

It is only a little more than half a century ago, (in 1792,) 
that M. Pinel, of France, first made known the true theory of 
the moral treatment of the insane. Prior to his time. Hospi- 
tals or Asylums existed, in which the insane were lodged, not 
so much generally, for the purposes of treatment and cure, as 
to relieve the public and their friends, from the annoyance and 
danger of their presence. 

These asylums were sometimes monasteries, sometimes pris- 
ons, and generally built on the model of prisons, in which the 
patients were either locked up in cells or dungeons, or chained 
by the neck and limbs to massive stone walls. The treatment 
generally consisted of exorcisms, whippings, and the broth of 
serpents at the full of the moon. No classifications were at- 
tempted; but the violent and the timid were huddled together 
in the same room. Yet, in spite of all this error and absurd- 
ity, some recovered ; for insanity is sometimes paroxysmal and 
self-limited. 

But a brighter day was to dawn on those bereft of their 
reason. Pinel arose and asserted, that the insane were con- 
trollable by moral influences ; that they might be won by 
kindness, and restored to reason by gentleness. 

The advance of his doctrines was slow at first, and they are 
not quite universal at present ; but they early found advocates 
in various countries. 

In England, among the earliest to eriibrace them and en- 
deavor to reduce them to practice were. Dr. Tuke, Superin- 
tendent of the York Retreat, an asylum belonging to the 
Society of Friends, and Dr. Charlesworth," visiting physician 
to the Hospital at Lincoln. Dr. Tuke, being the superintend- 



1854] . SENATE— No. 1. 9 

ent, and possessing the whole control, found but little difficulty 
in testing them in practice at the York Retreat. Dr. Charles- 
worth was only the visiting physician at Lincoln, and every 
step he took in reform, had to receive the sanction of a Board 
of Governors, before it could be taken. This rendered the task 
far more difficult, and the progress less rapid. 

Up to 1819, it appears to have been the practice in the latter 
institution, for the attendants, or keepers as they were called, 
to chain up, or fetter the patients at their discretion. This 
year an order was passed by the Board of Governors, " com- 
manding that the attendants and servants never presume to use 
any degree of restraint or violence, without the consent of the 
directors." 

From this period up to 1835, there was a constant succession 
of orders, improvements in the means of restraint, and altera- 
tions in the construction and arrangements of the establish- 
ment for the purpose of accomplishing an object which is thus 
expressed in the Report of the Board for 1833 : " It is unceas- 
ingly an object in this institution to dispense with, or improve 
as much as possible the instruments of restraint." 

In 1832, Dr. Charlesworth was enabled to report that "the 
register of restraint shows a continual diminution in their num- 
ber." " On the 10th of August, 1834, the House Visitor 
reported that not a single male patient had been under restraint 
since the 16th of July, and not one female patient since the 1st 
of August, and then only for a few hours ; and in 1835, the 
Board took the opportunity of specially recording their sense 
of the merit of Mr. Hadwen, the House Surgeon, by express- 
ing their high approbation of the very small proportion of 
instances of restraint which had occurred under his care." 

This brief history of the progress of change in an institution, 
which may justly be regarded as a bold pioneer in the cause of 
reform, and in introducing a more humane treatment of the 
insane, is related, to indicate by their contrast with those 
attempted to be enforced at Lincoln, what were the prevailing 
sentiments on this subject at the time the Worcester Hospital 
was established. 

Since that period, the Lincoln Asylum has gone on with its 
changes till it has discarded all mechanical means of restraint, 
and adopted a general mode of treatment quite novel and 
2 



10 STATE LUNATIC HOSPITAL. [Jan, 

peculiar. In the meantime, many of its reforms have been 
copied, and have received the sanction of experience. The 
means of restraint, generally, have been greatly improved, and 
the practice relaxed, or discarded. The brick and mortar cells 
with iron doors, or dungeons, as they may with propriety be 
called, for locking up the violent, noisy, or indecent, are no- 
where to be found in any recent structure, except at Taunton. 
There is not such a cell to be found in either of the public 
establishments of the great States of New York, or Pennsyl- 
vania, nor in the New Jersey State Lunatic Hospital, the de- 
sign of which is quite generally regarded as a model. 

With the view of examining into this subject, and the general 
management of Lunatic Hospitals, together with the best 
modes of warming and ventilating them, — a subject but very 
little understood at the time the one at Worcester was built, 
and quite imperfectly, we fear, comprehended at present, — it 
was deemed expedient that so many of the Trustees, with the 
Superintendent, as should find it convenient, should make a 
tour of observation of the institutions of other States. 

When the time fixed upon for starting arrived. Dr. Chand- 
ler was detained by a summons to court as a witness in 
a capital trial. Dr. Howe was detained by sickness, and Mr. 
Newton declined going. These facts were learned after the 
other members of the Board had arrived in New York. After 
examining the institutions in the city and its vicinity, Mr. Rip- 
ley returned to Massachusetts, the other members of the 
Board continuing on through New Jersey, Pennsylvania and 
Western New York. 

Our thanks are due to the oflicials of the twenty-six institu- 
tions visited by us, for the perfect cordiality with which we 
were everywhere received. Of these institutions, ten of them 
were Lunatic Hospitals. In each and all of them, every facil- 
jty was extended for the most full and thorough observation. 
The Superintendents of the Lunatic Hospitals laid us under 
particular obligations, for their generous courtesy, and .the very 
frank and unreserved manner in which they exhibited their 
respective establishments, together with their methods of man- 
agement and modes of treatment ; pointing out improvements 
and criticizing defects. But one spirit was manifested by 
them, that of doing what they could to impart information 



1854.] SENATE— No. 1. 11 

that might be useful in constructing, improving and managing 
a class of institutions, which, while they are monuments of the 
benevolence of those who erect them, are the last hope on 
earth of a most unfortunate class of our fellow men. 

During this tour no cell was found without a wooden floor, 
a wooden door, and plastered or sealed walls. And the use of 
such as were called strong rooms, was exceedingly limited. 

In the large establishment on Blackwell's Island, containing 
at the time of our visit 574 patients, but two were found locked 
up, and those only temporarily, for a part of the day. The Su- 
perintendent, Dr. Ranny, stated that half a dozen strong rooms 
would be sufficient for that establishment, as not more than 
five or six a day were ever locked up, and those only for a few 
hours at a time. These rooms were furnished with iron bed- 
steads or frames, with sacking bottoms, and beds. They were 
used as sleeping apartments, and did not differ materially in 
size, form or appearance, from the other rooms, occupied by 
patients, except the doors, which were stronger. 

These remarks in relation to the strong rooms on Blackwell's 
Island, are applicable to those in all the other establishments 
visited by us. In nizie hospitals out of New England, con- 
taining about 2,250 patients, the number found under restraint 
by being locked up, was only six. In one instance only had 
that restraint been continued more than two days, and that one 
had not exceeded a week. 

In the State Hospital, at Utica, but one person was found 
under restraint, and that one was confined in what they called 
a chicken-coop bedstead. There, they were in the process of 
demolishing their strong rooms, and removing them out of the 
establishment as useless. Their hospital was built some ten 
years after ours, and their strong rooms were comfortable 
apartments compared with ours, having wooden floors and 
plank doors, and were furnished each with a bedstead and bed. 

Such are the facts as they exist in the institutions of neigh- 
boring States. 

If we extend our examination to the best managed institu- 
tions of Europe, we shall find that a similar state of things 
prevails there. 

In a private x4.sylum at Clermont, in France, subject to gov- 
ernmental supervision, in which there were 1,147 patients in 



12 STATE LUNATIC HOSPITAL. [Jan. 

1851, the same practice obtains. Its Annual Eeport for that 
year, says : " No patient is ever shut up in his cell during the 
day; the strait jacket is never used, except as a means of re- 
pression, or when the patient attennpts to injure himself, or 
others, or to destroy his clothes. It is never kept on long." 

In some of the English hospitals, built pursuant to the law 
of 1845, requiring the counties to make provisions for their 
insane poor in hospitals, " padded I'ooms are fitted up in 
wards, for excited patients." But they are used only for 
temporary confinement. 

~In our Hospital at Worcester, there are forty-eight strong 
rooms or cells. Nearly all of them are constructed of solid 
masonry, with iron doors. A portion of them in the basement 
of the old part, have been condemned by nearly every Board 
of Trustees for the last ten years, as unfit for human occu- 
pancy. But the continually crowded condition of the Hospital 
has rendered it necessary that every part should be occupied. 
It was not till the class of incurable and dangerous had been 
reduced by the partial execution of the order of the 5th of 
August, that the cells in the basement of the old part, appro- 
priated to the females, could be left unoccupied. In Septem- 
ber they were vacated, we trust never to be occupied again by 
human beings. Another portion of the cells, occupied by 
male patients, and opening into the yard, are equally objection- 
able, and ought to be abandoned. They are totally unfit for 
human habitations. How is it possible that the furious, the 
violent, and the indecent, should ever be restored, while occu- 
pying apartments unfit for the abode of dumb beasts ? And 
yet, these cells have been pretty constantly occupied, and in 
some instances, by the same tenants, for very long periods. 

These cells were pointed out as defects, during the superin- 
tendency of Dr. Woodward. The Trustees of 1846, speaking of 
those " who cannot be restrained from keeping themselves in the 
most indecent and disgusting condition," say, "they are obliged 
to occupy apartments tvhere the Trustees never visit them without 
feeling- most sensibly, that they have not been properly cared for^ 
In their recommendation of strong rooms to be built, for sub- 
stitutes for those described, they say, speaking of a separate 
building which they recommend for the purpose, that " it ought 
to be constructed in such a manner that it may be amply ven- 



1854.] SENATE— No. 1. 13 

tilated, and lighted, and warmed. And still further, so ar- 
ranged that the patients, instead of being constantly immured 
in the closest confinement, may be enabled, as far as it can be 
permitted with safety, to go out occasionally, into adjoining 
yards, to see and feel the unobstructed sunshine, to breathe the 
purest atmosphere, and to participate in the benefits and 
pleasures which even such as they may derive from the care of 
t^e Divine Providence." 

The new cells were built, but not in a separate building, and 
the yards were never constructed. The want of these is a great 
defect; and one, which, if properly supplied, would supersede 
the use of the strong rooms to a very great extent. But to 
render the Hospital what it should be, and enable it to retain 
the high reputation which it formerly possessed, and sustain 
that renown which the State acquired, by being the first to 
engage in so humane an enterprise, it is necessary that several 
other important repairs and improvements should be made. 

The question has been raised and considered, whether it 
would be better to endeavor to get along for a few years, 
without attempting any considerable improvements, and then 
build in another location, and sell out the present one ; or to 
effect the necessary improvements in the present institution, to 
bring it up to the requirements of the age, and the present 
state of science as applicable to such hospitals. 

The location is such as no one would select for such an 
object at the present time. The land connected with it, is 
altogether too limited, and is badly situated ; not permitting 
to the patients that freedom and excercise in the open air, 
which is desirable in such an institution. The hospital build- 
ings are almost surrounded by city residences, and are not 
suitable for the uses to which they are put. They are low 
studded, the stories being only eight and a half, and nine feet 
high in the clear. They are warmed by furnaces in their base- 
ments, which are very dangerous, and now nearly worn out. 
They have already been on fire, at least, once from them. 

Their ventilation is so imperfect as not to deserve the name. 
The ventiducts are each but four inches square, opening into 
attics from which the foul air has no means of escape. It 
often ascends through one ventiduct, but to return through 
another. But for the natural ventilation through windows and 



14 STATE LUNATIC HOSPITAL. [Jan. 

doors, the contaminated air would often be intolerable. Its 
evil effects are plainly visible in the appearance of the patients. 
The frequent occurrence of erysipelas in the Hospital, is but 
one of its indices. The tables of mortality show that erysip- 
elas stands at the head of acute diseases in fatality here ; 
while year before last, nineteen cases are reported to have 
occurred from December to June, without fatality, which may 
give some idea of the frequency of the disease. 

There is an entire want of suitable yards connected with 
the buildings. 

There are five separate kitchens, with all the utensils to ren- 
der them severally complete. "* 

The land is of great value, being estimated by competent 
judges to be worth rising two hundred thousand dollars, inde- 
pendent of the buildings, which would purchase land and put 
up another establishment in another place. These are the 
considerations that favor the first alternative of the proposi- 
tion. 

On the other hand, the improvements required are a thorough 
change in the mode of warming and ventilating the Hospital, 
connected with which, would be the reduction of the five 
kitchens into one, the removal of the piggeries, barn, and 
other nuisances from the hospital lot, and the construction of 
yards, properly inclosed, for the unrestricted exercise of the 
patients ; and the construction of sewers for carrying off the 
wash and waste water of the establishment. The land is 
increasing in value, and the buildings are in a condition not 
to require a heavy outlay for repairs for a number of years. 
The pipe, or tubing used for warming, should steam or hot 
water be the agent employed, would not very greatly deterio- 
rate, and could be transferred to any new establishment that 
might be built to take the place of the present one, at some 
future day. The ventilation can be improved, by the intro- 
duction of wooden ventiducts, at a moderate cost. Several 
establishments have had their ventilation improved in this 
way. Among them are the State Lunatic Hospital, at Harris- 
burg, one of the wings of the McLean Asylum, at Somerville, 
and the New Bedford Almshouse. In two of these instances, 
steam is the agent used for warming, and it also furnishes a 
motive power to effect the ventilation. This is essential; for 



1854.] SENATE— No. 1. 15 

no passive ventilation can be relied on. It must be forced to 
be efficient. 

Large sums have been expended within a few years, for im- 
provements and repairs. The amount paid out last year, under 
this head, was six thousand and ten dollars and forty-seven 
cents, mostly for fences, a large part of which were of iron. 
Other improvements must be made, if the present Hospital is 
to be occupied only for a few years, or till another can be built. 
The present furnaces are worn out, and must be replaced, in 
.part at least ; and sewers must be constructed to carry off the 
waste water, which now ponds in the garden, and is complained 
of by the neighbors as a nuisance. 

The present time is favorable to this course of action. 
There is a balance in the treasury of f 23,162 98, which will 
go far towards accomplishing all that is here recommended ; 
and whatever more should be wanted, might be raised on the 
credit of the Hospital, and paid from its future receipts, as 
there is now due from the State, towns, cities and individuals, 
about forty thousand dollars, in addition to the balance on 
hand. 

The second Hospital, at Taunton, will be opened in the 
spring, to receive a portion of its patients, so as to enable the 
work to be done without great inconvenience. 

Steam is the agent recommended for warming, on account 
of the greater facility with which it can be used, and the more 
extensive uses to which it can be applied, as compared with 
warm water, and its greater safety from fire, and the more 
genial warmth it imparts, as compared with hot air furnaces 
The frequency of fires from the latter, in all the large cities and 
towns, shows them to be dangerous, and that they ought never 
to be used in an establishment of the kind, where so many 
persons are locked into their rooms every night; and in case of 
fire, as at Augusta, Maine, many of them must inevitably 
perish. Fears have been entertained by the Board, for the 
safety of this institution, ever since that sad occurrence. This 
consideration, of greater safety from fire, ought alone to be 
sufficient to induce a change. It was the leading motive for 
the change at Utica, the hospital there having been on fire 
several times from its furnaces. 



16 STATE LUNATIC HOSPITAL. [Jan. 

Steam is more generally used for warming large establish- 
ments than water. In addition to hospitals, almshouses and 
prisons, it is quite extensively used in manufacturing establivsh- 
ments. The first cost of an apparatus for using water is some- 
thing less than for using steam, but it is believed that the latter 
possesses advantages over the former, more than sufficient to 
counterbalance the difference in the cost. 

Of the twenty-six public institutions visited by us, but one, 
the Eastern Penitentiary, in Philadelphia, was warmed with 
hot water. There the water was circulated in small tubes, on 
Perkins's plan. It was not giving satisfaction. One wing of 
the Slate Prison at Trenton, New Jersey, had formerly been 
warmed in the same manner, but proving a failure, steam has 
been substituted with entire success. 

In Massachusetts, the General Hospital in Boston, and a 
part of the McLean Asylum at Somerville, are warmed by 
means of water circulated in four-inch copper or cast iron 
tubes. The plan, as adopted in these institutions, gives very 
perfect satisfaction. 

But there are no more perfectly warmed and ventilated es- 
tablishments in the country than the New York Hospital, at 
the city of New York, the Pennsylvania Hospital, in the city 
of Philadelphia, the New Jersey State Lunatic Hospital, at 
Trenton, the State Lunatic Hospital, at Harrisburg, and the 
State Lunatic Hospital, at Utica. Some hospitals have been 
erected within a few years, in several of the Western States, 
perhaps as perfectly warmed and ventilated as these. In all 
these establishments, steam is the agent employed, and it gives 
very perfect satisfaction. It is not only used in them for the 
purpose of warming, but it is also employed in cooking and 
washing, and for effecting a forced ventilation. For these uses 
it is invaluable, as the importance of a forced ventilation can- 
not easily be overestimated. 

The plan of employing it at Utica being the most recent, is 
believed to combine more of modern improvements than any 
other. It is probably the most perfectly arranged plan for 
warming and ventilating, that is to be found, either in this 
country or Europe. It has been introduced the past season, at 
a very heavy expense. Notwithstanding their hospital was 
built more than ten years after ours, and in architectural ar- 



1854] SENATE— No. 1. 17 

rangements is superior, yet the legislature of New York, with 
a liberality that refuses to deny any expenditure that may be 
necessary, to render it more perfect as an instrument for 
accomplishing the benevolent object of its erection, have 
authorized an expenditure of $75,000 the past season. Its 
partitions have been taken down and built up anew, with hot- 
air flues and ventiducts of suitable sizes in them. The amount 
of tubing employed for conveying the steam to warm it, is one 
square foot of superficial surface to every fifty cubic feet of 
space. The proportion employed in the other hospitals men- 
tioned, is from one square foot to fifty, to one square foot to 
seventy-five cubic feet of space. 

The Hospital at Utica, in all its appointments, may justly 
be regarded as a model institution, although its ground plan, 
in our opinion, is inferior to that of Trenton and Harrisburg. 

Our Hospital at Worcester has not only ceased to be re- 
garded as a model institution, but it has fallen into the rear 
rank in the march of improvement. Can the reputation of 
Massachusetts suffer it to remain there ? 

No definite estimates have been made, of the cost of the 
proposed improvements. There are about one million cubic 
feet of space in the whole establishment. In the portion 
occupied by the patients, not including the centre building, 
chapel, kitchens and laundry, according to a computation of 
the Superintendent, there are but six hundred thousand cubic 
feet. One million cubic feet of space, upon the maximum 
calculation, would require twenty thousand square feet surface 
of pipe or tubing. This, at sixty cents per foot, would 
cost $12,000. Boilers, of sufficient size, would cost $5,000 
more. Further than this it would be impossible to make esti- 
mates, until some definite plan shall be determined on. We 
have presented the wants of the institution for the considera- 
tion of the government, and if it shall be determined that those 
wants shall be supplied, there will be no difficulty in obtaining 
plans and estimates. 

But the better course to pursue, in the opinion of a majority 
of the Board, is to make only such repairs as may be necessary 
for occupying it till another institution can be erected to take. 
its place, and that measures be taken immediately, for the pur- 
chase of a suitable site, and the erection thereon of the neces-. 
• 3 



18 STATE LUNATIC HOSPITAL. [Jan, 

sary buildings; and as soon as they can be completed, to 
evacuate the present establishment and sell it. It is believed 
that the hospital property will sell for enough to defray the 
whole expense of a new establishment, comprising all the 
modern improvements, without costing the State one dollar 
from its treasury. 

One of the two schemes should be adopted immediately? 
and unless the legislature shall early decide upon condemning 
the old Hospital and building a new one, the Trustees will 
deem it their duty to enter upon and carry into effect the before- 
mentioned improvements and repairs, the means for doing 
which are already at their command. 

It will be seen by the Treasurer's Report, herewith submit- 
ted, that the receipts during the year, including a balance on 
hand at its commencertient, of |22,780.13, have amounted to 
$76,768.51, and the expenditures to $53,636.66, leaving a bal- 
ance in the treasury, at the close of the year, of $23,131.85. 

Of the receipts, $200 was a donation from an unknown 
friend of the institution, received last October by the hand of 
Major Enoch Flagg, of Chicopee, who stated that the donor 
did not wish to be known. This expression of good will to 
this great and most beneficent charity, is acknowledged with 
gratitude by its Trustees, in behalf of its beneficiaries. 

The expenditures of the last year have exceeded those of 
the preceding, $9,524.87. This has arisen from a variety of 
causes, viz. : the larger number of patients, the enhanced 
prices of most of the supplies, and the larger amount expended 
for repairs and improvements. This item is $6,010.47, being 
$4,168.58 larger than that of the preceding year. 

An iron fence has been placed on the wall in front of the 
Hospital, weighing twenty-four pounds, and costing $1.75 per 
foot, and another by the , steps up to the Hospital, weighing 
thirty-six pounds, and costing $2 per foot The two, exclusive 
of the arch over the entrance, cost $2,321.75. A fence on 
stone posts, with wooden palings, has also been erected around 
the eastern garden. All these fences were determined on, and 
arrangements for their construction made previous to the com- 
mencement of the last year. 

The law provides, that the Trustees shall fix the price of 
board for all but State paupers, at its actual cost. Finding 



1854.] senate—No. i. 19 

that the price established exceeded the cost, as a large surplus 
had accumulated in the treasury, the Trustees, at their first 
meeting in February, 1853, passed the following vote, viz. : — 
Voted^ That patients, the price of whose board the Trustees 
are authorized to establish, after they have been in the Hospital 
one year, shall be charged one dollar and seventy-five cents by 
the week, and no more, from and after the first day of March, 
1853. 

— It now appears, that the reduction is below the actual cost, 
as shown by the Superintendent's statement, which makes it 
$101.37 per year each. If it costs this sum per patient, when 
the Hospital is so crowded, with only about one attendant to ' 
thirty patients, the cost must be very considerably increased 
when the number of patients shall be reduced to the accom- 
modations of the Hospital, or the proportion of attendants to 
patients shall be employed, which was determined on as the 
minimum, by the Association of Medical Superintendents of 
American Institutions for the Insane, at their annual meeting 
in Baltimore, last May. 

They say, in Proposition No.XI. * " In no institution should 
the number of persons in immediate attendance on the patients, 
be in a lower ratio than one attendant for every ten patients ; 
and a much larger proportion of attendants will commonly be 
desirable." 

Other reforms are likewise needed ; such as additional 
means of amusement and occupation, to divert " the mind dis- 
eased" from its vagaries and hallucinations, which, if procured, 
will increase the cost of board. Another consideration should 
not be omitted ; and that is, that the second hospital, when it 
shall be opened, will not be able to board its patients at so low 
a rate. At the New York State Hospital at Utica, the cost 
per patient, in 1852, was $3.18. The counties pay for the 
board of their paupers $2.50 per week, while private boarders 
are charged considerably more, according to circumstances. 

Believing that $2 per week is quite as low as it ought to 
cost under existing circumstances, and less than it will cost 
when the number of patients shall be reduced, and the desired 
improvements made, the Trustees have repealed their vote of 

* See Appendix. 



20 STATE LUNATIC HOSPITAL. [Jan. 

last February, and restored the prices then reduced, to their 
former amount, from and after the first of next March. 

There has been but one change in the official household, 
during the past year. Dr. Lee, the first Assistant Physician, 
left on the first of last October. He has been for a long period 
connected with the Hospital, and has uniformly given the high- 
est satisfaction. It was with regret that the Trustees learned 
his determination to leave. He has gone on a tour of obser- 
vation to Europe and Asia. He carries with him the highest 
confidence of those Trustees who have been officially connect- 
ed with him, in his integrity, ability and skill, and their best 
wishes for his safe return and future success. 

The State still retains the valuable services of the other 
officials, by whose assiduous care and attentive zeal, under 
Providence, this blessed charity has gone on for a series of 
years, fulfilling its mission of beneficence, restoring the lost to 
themselves, and gladdening the hearts of thousands. 

For a more full and particular account of the affairs and 
condition of the Hospital, we refer to the interesting and able 
Report of Dr. Chandler, the Superintendent, which is herewith 
transmitted as a part of this Report. 

FOSTER HOOPER. 
SAMUEL G. HOWE. 
REJOICE NEWTON. 
FRANKLIN RIPLEY. 
JAMES B, CONGDON, 

Worcester, Dec. 26thj 1853. 



1854.] 



senate—No, i. 



/■>« 



TREASURER'S REPORT. 



To the Trustees of the State Lunatic Hospital: 

The Treasurer respectfully reports : — 

That the balance in his hands at the close of the 
year ending Nov. 30, 1852, was, 

Since which time he has received — 

From the Commonwealth for support of Lunatic 
State Paupers, 

From cities, towns, and individuals, 

From the Steward, for articles sold, 

Interest on legacy of Ziba Storrs, 

A donation from an unknown " Friend of the In- 
stitution," 

Deduct excess of credit in report of 1852, 



$22,780 13 



22,658 65 

30,957 53 

154 61 

30 00 



200 00 

$76,780 92 
12 41 

$76,768 51 



Tire Expenditures of the year have been a§ follows : — 



For wages and labor, . 
Salary of Treasurer, 
Improvements and repairs, 
Furniture, 
Clothing, 

Flour, 680 barrels. 
Meal of Rye and Corn, 
Biscuit, $227.33 ; Farina, $12.96, 
Coffee, 3,758 pounds, . 
Tea, 2,016 " 

Sugar, 30,615 " 



$11,560 83 

400 00 

6,010 47 

1,661 58 

1,716 77 

4,519 19 

1,087 70 

240 29 

431 59 

491 60 

2,018 30 



L: 



STATE LUNATIC HOSPITAL. 



[Jan. 



For Rice, 3,798 pounds, . . . 


$195 56 


Molasses, 1,408 gallons, . . 


394 10 


Syrup, 134 « . . . . 


38 02 


Beef and Pork, 76,579 pounds, 


5,186 59 


Fish— salt, 11,500 « . . . 


417 91 


» fresh, 1,414 « . . . 


76 37 


Mackerel, 


130 75 


Poultry, 2,900 pounds, 


299 80 


Bacon, 3,235 « . . . \ . 


349 16 


Beans, $92.50 ; Peas, $6.50, 


99 00 


Potatoes, 1,688 bushels, . . . . 


1,079 18 


Butter, 32,775 pounds, . . . 


6,337 94 


Cheese, 2,347 « 


205 52 


Apples, $401.15 ; Fresh Fruits, $436.92, . 


838 07 


Squashes, ....... 


75 00 


Cassia, $26.28; Mustard, $27; other small 


I 


groceries, $122.94, 


176 22 


Vinegar, $98.17; Honey, &c., $15.63, 


113 80 


Lard, 1,318 pounds, . . . . 


156 60 


Salt, $44.63 ; Saleratus, $29.86, . 


74 49 


Wood, 265 cords, 


1,323 37 


Charcoal, 5,621 bushels, . . . . 


551 27 


Hard Coal, 638,935 pounds, . 


. 1,960 '03 


Two pair Oxen, $233 ; Nine Cows, $251, 


484 00 


Pasturing, $30.87 ; Shorts, $42, . 


72 87 


Straw, 34,000 pounds, . . . . . 


187 98 


Whale Oil, $213.86; Lime and Cement, 




$32.45, ........ 


246 31 


Soap, $75.40; Potashes, $70.25; Starch 




$13.74, 


159 39 


Gas Light and repairs, . . 


578 67 


Medical Supplies, ..... 


238 50 


Books, Stationery, and Printing, $109.91 




Postage, $30.19, .... 


140 10 


Music and Teaching, .... 


67 00 


Removal of Patients, . . • • • 


81 50 


Expense charged to Patients, 


36 29 


Recovery of Elopers, .... 


45 85 


Freight, by railroad and express, . 


258 79 


Trustees' expenses, 


383 55 



1854.] SENATE— No. 1. 23 

For Sexton's bills, |219 50 

Miscellaneous expenses, not otherwise speci- 
fied, 219 89 



$53,686 66 
Balance, November 30, . . . . 23,131 85 



$76,768 51 
SAMUEL JENNISON, Treasurer. 

Worcester, December 8, 1853. 



Worcester, Jan. 23, 1854. 

The undersigned, a Committee of the Trustees of the State 
Lunatic Hospital, have examined the accounts of Samuel 
Jennison, Esq., Treasurer of the institution, and have, in a satis- 
factory manner verified all its items, except that which consists 
of the receipts from " Cities, Towns, and Individuals," which 
item must be left for further examination, in order that there 
may be no unseasonable delay in printing the Annual Report. 

JAMES B. CONGDON. 
S. G. HOWE. 



1854.] SENATE— No. 1. 25 



SUPERINTENDENT'S EEPORT. 



Twenty-first Annual Report of the Superintendent, to the Trus- 
tees of the State Lunatic Hospital. 

Gentlemen : — Although the year that has just passed, went 
by without many remarkable events to mark its progress, every- 
day brought with it some incidents of interest to this large 
family. The almost daily arrival of the insane to become 
members of it, and the departure of those who have, for a 
time, sojourned with us, — the change going on in the mental 
condition of its individual members, — the breaking away of 
the cloud that obscured the mental vision of some, and the 
darkness settling upon the minds of others, — the wild extrava- 
gance of the conduct of some, and the melancholy repose of 
others, — the bold obtrusion of some, and the hesitating diffi- 
dence of others, — and that moral perversity of the feelings that 
causes some to lift their hands against themselves or others, — 
all these are incidents of daily occurrence, and they occasion 
much anxiety on the part of those who have the care of the 
different departments, and demand unceasing activity and 
watchfulness. The institution has been so much crowded 
during the whole year, that the wisest direction and most 
wakeful vigilance could hardly be expected to have preserved 
us so safely as we have been. We are, therefore, ever ready 
to acknowledge the guiding hand of Providence in all its vast 
concerns. 

The hospital has had its usual success in restoring to health 
and to their friends, a large share of those committed to its 
care, in ameliorating the condition of others, and in making 
comparatively comfortable, a large share of all within its bor- 
ders. 

The following annexed Tables exhibit, with the accompany- 
ing remarks, more particularly the past and present conditiou 
of the institution. 
4 



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34 



STATE LUNATIC HOSPITAL. 



fJan. 



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1854. 



SP.NATE—No. 1. 



35 



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36 



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1854.1 SENATE— No. 1. 37 



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38 



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1854.1 SENATE— No. 1. 39 



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1854.] 



SENATE— No. 1. 45 



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STATE LUNATIC HOSPITAL. 



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1854.] 



SENATE— No. 1. 47 



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48 



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1854,] 



senate—No. i. 



49 



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2 do The Overseers 

3 years Probate Court 
Unkn'wn do 

2 m'nths do 

3 do do 

2 years Munici'l Court 
Unkn'wn Probate Court 

2 weeks do 

6 years do 

2 weeks do 
15 years do 

6 weeks do 

2 m'nths do 
Unkn'wn The Overseers 

4 m'nths Probate Court 
2 years do 

12 do The Overseers 

5 m'nths Munici'l Court 
8 do Probate Court 
5 do do 

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13 m'nths The Overseers 
2 weeks Probate Court 
2 m'nths do 

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8 years do 
2 do do 
10 do The Overseers 


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do . . . 

do . . . 
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do . . . 
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do . . . 

do . . . 

do . . . 
Masturbation, 
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do . . . 

do . . , 
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do . . . 

do . . . 

do . . . 




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do 

do 

do 
Male 
Female 

do 

do 

do 
Male 

do 
Female 
Male 
Female 

do 
Male 

do 

do 




r-li-H(M(M(M0qcO r-IM(NNC^(M(M(MIM(M(M(MCO 

> 
OOOOOOOOOOOOOOOOOOOOOOOOOOOOO 


C'-^(MCO^iCc01~00050'-i'>JC»3-*lO«OI-^0005'~>--i<M;0^ifiOt^CO 



50 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 1, 

Showing the Admissions from each Comnty the last and previous 

years. 





. Males, 
. Females, . 


4 
2— 


1853. 


Previously. 


Total. 


Barnstable, , 


6 


109 


115 


Berkshire, 


. Blales, 
, Females, . 


5 
5— 


10 


134 


144 


Bristol, 


. Males, 
o Females, . 


11 

6— 


17 


258 


275^ 


Dukes, 


, Males, 
. Females, . 


1 
0— 


1 


16 


17 


Essex, 


, Males, 
. Females, . 


8 
13— 


21 


514 


535 


Franklin, 


. Males, 
. Females, . 


2 

0— 


2 


100 


102 


Hampden, 


. Males, 
. Females, . 


10 
15— 


21 


211 


236 


Hampshire, . 


„ Males, 
. Females, . 


4 
3— 


7 


174 


181 


Middlesex, . 


. Males, 
. Females, 


7 
15— 


22 


502 


524 


Nantucket, . 


. Males, 
. Females, 


1 
0— 


1 


29 


30 


Norfolk, 


, . . Males, 

. Females, 


15 

18— 


33 


508 


541 


Plymouth, 


, Males, 
. Females, 


12 

. 7— 


19 


198 


217 


Suffolk, 


. Males, 
. Females, 


. 19 
. 36— 


55 


409 


464 


Worcester, 


. Males, 
. Females, 


. 37 
. 32— 


69 


998 


1,067 


Other States, 


. Males, 
. Females, 


. 
. 0— 





10 


10 




288 


4,170 


4,458 



1854.] SENATE— No. 1. 5i1 

When the Second Hospital for the Insane, at Taunton, shall 
be opened for the reception of patients, we expect to be re- 
lieved of some of our surplus population. There are, in this 
hospital, about one hundred for whose support towns and indi- 
viduals are liable, from the Cape counties including Norfolk 
and Suffolk. If they should be removed, and all commitments 
from that section of the State, be diverted from this hospital 
to that, this institution would probably be relieved of its 
crowded state for a few years. One hundred and thirty-two 
patients were sent to us, from those counties, the past year. 
We suppose we can, with propriety, send back to towns a few 
who could be made comfortable and taken proper care of ini 
the new State Almshouses, when they shall be finished, and 
thereby be relieved of some of the more harmless and incu= 
rable State paupers^, 



52 



STATE LUNATIC HOSPITAL, 



[Jan. 



TABLE 2, 

lowing the Admissions and State of the Hospital, from Dec. 
1st, 1852, to Nov. 20th, 1853. 



Patients in the Hospital, December 
1st, 1852, . . . . 532 
Males, . . 264 
Females, . , 268 

Patients admitted in the course of 

the year, 288 

Males, . . 136 
Females, . . 152 

Whole number in the Hospital in 
the course of the year, . . 820 
Males, , . 400 
Females, , . 420 

Patients remaining in the Hospi- 
tel, November 30th, 1853, . 520 
Males, . . 266 
Females, , . 254 



f the admissions, there were 
cases of less duration than one 



132 



Males, 
Females, . 



55 
77 



tf the admissions, there were 
cases of one year or more, , 60 
Males, . . 35 

Females, . . 25 



Cases the duration of whose in- 
sanity before admission not as- 
certained, . . . . 
Males, . . 46 

Females, , . 50 



Patients committed by Courts, 
Males, . . 113 
Females, . . 128 



96 



241 



Committed by Overseers of the 

Poor, 47 

Males, . . 23 

Females, . . 24 



Private Boarders on bonds, 
Males, 
J'emales, . 







Foreigners and those who have no 
legal residence in this State, 
admitted during the year. 
Males, . . 37 

Females, . . 69 



105 



Foreigners discharged during the 
year, . . . « . 117 
Males, . . 39 

Females, , . 78 

Foreigners remaining in the Hos- 
pital at the end of the year, . 216 
Males, . . 104 
Females, . . 122 



State Paupers remaining in the Hospi- 
tal at the end of each year, as near 
as they can be ascertained : — 

No. 



1843, 


38 


1844, 


38 


1845, 


57 


1846, 


52 


1847, 


121 


1848, 


150 


1849, 


167 


1850, 


181 


1851, 


208 


1852, 


241 


1853, 


216 



The number of admissions is much less than it would have 
been, had we not declined all except those ordered here by the 



1854] SENATE— No. 1. 53 

courts, and sent to us by the Overseers of the Poor of towns. 
We have advised several applicants to seek admittance to 
institutions in neighboring States. 

--Foreigners admitted, were one hundred and six, and dis- 
charged, one hundred and seventeen. They would have accu- 
mulated here, had you not removed thirty-one to make more 
room for those patients that remained. 

By a continuation of this table, which was suggested by 
one extensively engaged in statistics, we see that the Irish 
part of the foreigners have accumulated one hundred and 
fifteen in the last eight years, which is as far back as they 
could, with certainty, be traced. Most of the foreigners are 
Irish ; the others are from the other States of this Union, the 
British Provinces and several of the European countries. The 
Irish are almost invariably State paupers. Only three instances 
have come to my knowledge, of their bills, or any part of their 
bills, having been paid by themselves or by their friends. 

There remains in the hospital, Irish males, ... 61 
« " « « females,. . . 79 

Total, . . 140 



54 



STATE LUNATIC HOSPITAL. 



[Jan. 



Continuation of Table 2. 
Irish. 





1846. 


1847. 


1848. 


1849. 


1850. 


1851. 


1852. 


1853. 






a 

a 


o 
H 


Si 


o 




o 


i 


o 


i 




a 


o 


o 
OS 

w 


"5 




"3 

O 

H 


Total 


Amissions : — 

Recent cases, . . . 

Males, 

Females, .... 

Chronic cases, . . . 

Males, 

Females, .... 

Duration of insanity : 

Unknc^wn, 

Males, 

Females, .... 


6 

7 

1 



7 
4 


13 

1 

11 
25 


2 

6 

6 
9 

9 
6 


8 
15 

15 

38 


7 
9 

3 
2 

6 
5 


16 
5 

11 
32 


12 
12 

4 

8 

5 
5 


24 
12 

10 

46 


7 
11 

2 

9 

14 
5 


18 
11 

19 

48 


5 
11 

I 

9 
10 


16 
14 

19 
49 


6 
24 

8 
9 

10 
12 


30 
17 

22 

69 


8 
26 

3 
14 

6 
14 


34 
17 

20 
71 


159 
92 

127 

378 


Discharged : — 

Recovered, .... 

Males, 

Females, .... 

Died, 

Males, ..... 
Females, .... 

Otherwise, 

Males, 

Females, .... 

Increase in 


3 
3 

2 

2 

1 
1 

eij 


6 
4 
2 

12 

?ht 


9 
4 


2 


2 

ye 


13 
2 
2 

17 

ars 


9 
4 

1 
4 

1 
2 


13 
5 
3 

21 


10 
6 

1 
3 

4 
5 


16 
4 

9 

29 


9 
12 

5 
6 


3 


21 

11 

3 

35 


3 
14 

2 
2 

5 
1 


17 
4 
6 

27 


6 
13 

5 

7 

9 
16 


19 
12 
25 
56 


10 
22 

3 
9 

2 

20 


32 
12 
22 

m 


137 

54 
72 

263 
115 



1854.] 



SENATE— No. 1. 



55 



TABLE 3. 

Showing the Number of Discharges and Deaths, and the Con- 
dition of those who left the Hospital, from December \st, 1853, 
to November 20th, 1853. 



Kecov- 
ered. 



Improved 



and 
harmless 



and dan- 
gerous. 



Patients discharged, . . 
Males. . . . . . 

Females, . . . . 

Recent cases — less than 
one year — discharged, 

Males, 

Females, . . . . 

Chronic cases — one year 
or more — discharged, 

Males, 

Females, . . . . 

Patients discharged, the 
duration of whose in- 
sanity not ascertained, 

Males, 

Females, . . . . 



133 
167 



5 

32 

3U0 



300 



121 



142 



37 



8 

7| 

145' 



145 



101 



34 



10 



36 



28 



41 



37 



29 



33 



13 



21 



16 



41 



26 



133 
167 



57 
64 



71 
71 



5 
32 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 4. 

Shotai7ig the Number of Admissions and Discharges, and the 
Average Number in the Hospital each month in the year. 





Monthly Av- 


AdmiSBions. 


Discharges. 




erage. 






December, 1859, 


525 


23 


29 


January, 1853, 










525 


20 


17 


February, " 










531 


24 


22 


March, " 










539 


29 


18 


April, « 










545 


30 


20 


May, « 










556 


29 


20 


June, " 










561 


30 


35 


July, " . 










554 


20 


25 


August, " 










540 


18 


43 


September, " 










524 


25 


30 


October, " 










524 


18 


20 


November, " 










520 


22 


23 


Average number for the year, 




537 







Our average number, and our crowded state, has been great- 
er the past year than ever before. This state of things was 
suffered to be so only because there was no provision at all 
suitable for them anywhere else. But when our number 
arose up to five hundred and sixty-seven, you felt compelled to 
order back a few to what seemed the only places they could 
go ; and, from every place any were sent to, you are aware 
that remonstrance, strong and beseeching, came back to us to 
send them no more, and of their inability to take proper care 
of them in their unsuitable accommodations. 

As soon as provision elsewhere can be made, the number 
here should be reduced to four hundred or less. The accom- 
modations here were not designed for so large a number as 
four hundred. There are many objections to crowding an 
ir^stitution of this kind. It diminishes its remedial power ; it 
adds greatly to the difficulty of conducting it, and increases 
vastly its liability to accidents, which are avoided in the best 
ordered establishments only by unceasing vigilance. Crowd- 
ing together the violent insane is only provoking constant war- 
fare between them. Few, I apprehend, would be found wil- 
ling to be responsible for such a state of things long, or indeed 
be able to endure it. 



1854.1 



SENATE— No. 1. 



57 



CQ 



lO 1^ 

pq ^ 






i 


fer9S9Si2 92°o^w coxir^io Oi(?J-H05 

CDOOCCCO «ClOOi> rf<C«COC0 i-lrH 


1 


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i>COOt^ CO-^O^-i r-(CV?COCO rHOJrH 


1 


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CO CO i> O -*int>.lO CJCOCOW i-h rn 


1 


t«.Cv?l>-lO CTWC^O COQOCiW OOOl> 
'^COt^lO rPCOlOt^ C^OJCT'^ r=iOert 


i 


r^ ifc SS ii T*< t>. r*< CO ifi'-^^CO J>C5C0G0 
mcCOOCO 'srcOGOO CVCO'^CO i— 1 


i 


SS'^^iv; JSiS^P inoiOico ciioGOQo 

COiOOOlO COCOt1<1>. COCOi-H'^ 


s 


mCOi— 100 COOOrtiCO mmi^CO COOOOr-l 
rflOCOi-^ rr-^lOCO riOiOJCO rH 


i 


CTp^ff'-l JNCOTOl^ QO!>OiO OC^OOGO 
COJ>l>J> Tj<J^GOCO OiTf^CO'* r-l r-i 




rHoco^ o^coo? inoiooo -^oji^i-i 

COQOCOGO TT-COrJHWD C* C^ OJ Tt* rH 


i 


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•^ 


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iffii J. II if iflfi ilii 

o^a2CiQ<5 So>MM<l -C^^^^KKl l>OQ!»<! 

1 J s ■ g 
< fi p^ ft 



68 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 6. 

Showing tli6 whole number of Residents during the year, the 
average number each year, the number at the end of each year, 
and the expense of each of the twenty-one years the Hospital 
has been in operation. 



The Year. 


Whole No. of 
Residents dur- 


Average No. 


No. at the end 


Current Expenses 


Annual Expense 




ing the year. 


each year. 


of each year. 


each year. 


per Patient. 


1833 


153 


107 


114 


812,272 91 


$114 67 


]834 


233 


117 


118 


15,840 27 


135 38 


1835 


241 


120 


119 


16,576 44 


137 30 


1836 


245 


127 


138 


21,395 28 


168 44 


1837 


306 


163 


185 


26,027 07 


159 64 


1838 


362 


211 


218 


28,739 40 


136 20 


1839 


397 


223 


229 


29,474 41 


132 16 


1840 


391 


229 


236 


27,844 98 


121 59 


1841 


399 


233 


232 


28,847 62 


123 81 


1842 


430 


238 


238 


27,546 87 


111 12 


1843 


458 


244 


255 


27,914 12 


114 40 


1844 


491 


261 


263 


29,278 75 


112 17 


1845 


556 


316 


360 


43,888 65 


138 88 


1846 


637 


359 


367 


39.870 37 


111 06 


1847 


607 


377 


394 


39,444 47 


104 62 


l,-:48 


655 


404 


409 


42,860 05 


106 09 


1849 


682 


420 


429 


40,870 86 


97 31 


1850 


670 


440 


441 


46,776 13 


106 40 • 


1851 


704 


462 


466 


52,485 33 


112 61 


1852 


775 


515 


532 


43,878 35 


85 20 


1853 


820 


537 


520 


53,636 66 


103 14 



The annual expenses of the hospital are materially affected 
by expenditures for extraordinary improvements, and by the 
rise or fall of supplies. Much has been done, the past year, 
to put in good condition the buildings and the fences. The 
centre building — the north wing — the south wing and the south 
Johonnots, have been painted on the outside. The south Jo- 
honnot, the south centre and the upper story of the south L, 
have been painted on the inside. Zinc was used instead of 
lead for all inside work, and for outside of the Johonnot wing, 
the roof of office, laundry, the wood and iron fences. 

The iron fence erected on the bank wall, in front of the hos- 
pital, is of cast iron pales three and a half feet long, passing 
through wrought iron bars seven-eighths of an inch thick, and 



1854.] SENATE— No. 1. 59 

two inches wide, and weighs twenty-four pounds to the foot. 
It is fastened to the wall on cast iron saddles, two and a half 
inches high, and braced on the back side, to the wall, with 
wrought iron rods. This fence cost $1.75 per foot. It is 899 
feet long. 

The fence each side of the steps running up to the hospital, 
is similar. It is 360 feet long. It stands on stone posts, and 
weighs 36 pounds to the foot. It cost $2 per foot. The four 
large cast iron posts in this fence cost |6 each, and the eight 
small ones |4.50 each. The whole expense was $2,321.75, not 
including the arch over the steps. It is painted dark green. 

The fence around the east garden is about finished. It is 
1,784 feet long. It stands on 223 stone posts. They are 8 
feet long, 9 inches square, and set 4 feet in the ground, and 8 
feet apart. Two rails 2 by 8 inches, of the best Canada pine, 
held by iron bolts to the posts, sustain the pickets, which are 
6 feet long, 2 inches wide by 1|- inches thick. The pickets 
are nailed on to the rails half an inch apart, with four nails 
each. The wood-work was all painted before being put to- 
gether. The posts cost set, ironed for the rails, $2 each. The 
whole fence would have cost, per foot, about $1, had not three 
of our patients mostly prepared the wood part of it and put it 
together. Mr. Ball, the surveyor, fixed the grade on Central 
and Mulberry Streets, and on the adjoining owners. It stands 
wholly on the hospital land, because one of the adjoining 
owners, Mr. Joel Fletcher, forbid the erection between his land 
and the State's, of a fence in uniformity in height with all the 
rest around the garden. He consented that we might build 
the fence on the line, 6 feet high, on the grade that it now 
stands, by his house, about half way across his lot, and then 
he required that it be at least half of a foot less in height. 
This fence stands wholly on the hospital land. We were care- 
ful that neither the superstructure nor the substructure of it, 
should encroach upon the land of any highway or neighbor. 

The gravel for grading up for this fence, besides the old 
stone wall which was buried, and the gravel for filling Mul- 
berry Street, was taken from the knoll in the south garden. 
About 2,500 cart loads of it was moved for these purposes. 

A very handsome summer house or arbor was erected in 
front of the north portico, 18 feet in diameter and 33 feet high, 
after a design of E. Boyden, Esq. It cost $555. 



60 



STATE LUNATIC HOSPITAL. 



[Jan. 



A flagging of Bolton stone from Connecticut, 7 feet wide 
and 28|^ long, has been placed by the front door. 

Besides the above, about the usual amount has been ex- 
pended for the ordinary improvements and repairs. From 
present indications it is presumed, that the current expenses of 
the present year will be greatly enhanced by the great rise in 
most kinds of provisions, and by the increase of wages of those 
employed. It can hardly be expected that the income will be 
equal to the necessary expenditures ; for, while the price of 
board of patients is very low, and while the number of patients 
is probably to be lessened, by being transferred to Taunton, 
the price of supplies has not been so high for many years. 

TABLE 7. 

Showing the Causes of Insanity as affecting persons pursuing 
different occupations. 











i 






<A 










i 




c 


B 






C3 

■a 
















03 

-C o 


a 


tj 




m" 


m 






P. 

a 

a 

C 
w 


"3 
fi 


1 

OS 


a 

o 




u 

a> 
P. 
2 


n, 

5 


P. 

'c 


a 

Is 


"3 

o 


Farmers, 


75 


24 


34 


30 


31 


31 


6 


11 


3 


255 


Laborers, 








95 


15 


20 


9 


12 


9 


5 


12 


2 


179 


Seamen, 








34 


9 


9 


3 


8 


7 


1 


1 


3 


75 


Merchants, 








15 


6 


32 


5 


5 


23 


1 


3 


- 


90 


Carpenters, 








20 


8 


10 


4 


11 


8 


4 


2 


- 


67 


Shoemakers, 








13 


14 


39 


9 


11 


9 


2 


] 


— 


98 


Blacksmiths, 








4 


1 


2 


1 


2 


4 


3 


1 


- 


18 


Students, 








- 


4 


24 


2 


3 


- 


- 


2 


- 


35 


Clergymen, 








1 


2 


4 


- 


1 


1 


1 


- 


- 


10 


Lawyers, 








2 


- 


2 


1 


- 


1 


- 


- 


- 


6 


Physicians, 








2 


- 


- 


- 


- 


1 


1 


- 


- 


4 


Painters, 








2 


1 


11 


2 


1 


1 


1 


1 


- 


20 


Manufacturers, 






10 


3 


5 


2 


7 


5 


2 






34 



1854. 



SENATE— No. 1. 



61 



TABLE 8. 

Shoiving the Causes of Insanity, and the circumstances connected 
with the causes and predisposition to insanity the last and pre- 
vious years. 




Previously. 



Ill health, 

Intemperance, .... 

Domestic affliction, 

Religion, ..... 

Masturbation 

Property, . ' . 
Disappointed affection. 
Disappointed ambition, 

Epilepsy, 

Puerperal, ..... 
Wounds on the head, . 
Hard labor, .... 

Jealousy, . . . . . 

Fright, 

Palsy, 

Periodical cases. 

Hereditary cases, 

Homicidal cases, 

Have committed homicide, . 

Suicidal cases, .... 

Have committed suicide. 

Cases arising from physical causes. 

Cases arising from moral causes. 



21 
6 
9 
13 
11 
5 
5 



2 
1 
51 
41 
29 
2 
49 

59 
42 



5.58 

370 

344 

264 

197 

187 

104 

39 

113 

129 

51 

56 

18 

28 

35 

835 

961 

154 

23 

387 

19 

1,516 

1,030 



62 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 9. 

Previous Occupation of Patients, where it was known. 




Previously . 



Farmers, 

Laborers, 

Merchants, 

Shoemakers, . . . 

Seamen, ....... 

Carpenters, ... 

Manufacturers, 

Teachers, 

Students, 

Blacksmiths, 

Machinists, 

Painters, 

Tailors, 

Clergymen, 

Lawyers, 

Physicians, 

Females accustomed to active employment. 
Females accustomed to sedentary employment, 



18 
14 
1 
15 
7 
3 
9 
1 
1 
2 
1 
1 



1 

23 

7 



421 

331 

130 

147 

122 

109 

80 

53 

48 

32 

6 

29 

19 

19 

8 

9 

835 

293 



1854.] 



SENATE— No. 1. 



63 



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Duration of Insanity before ad- 
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Less than 1 year, .... 
From 1 to less than 5 years, 
" 5 " 10 " 
" 10 " 20 " 
" 20 " 30 " 
" 30 and upwards, . . . 
Unknown, 


Duration of Insanity with those 
remaining in the Hospital at 
the end of each year : — 
Less than 1 year, .... 
From 1 to less than 5 years, 
" 5 " 10 " 
« 10 " 20 " 
« 20 " 30 " 
" 30 and upwards, . . . 
Unknown, 





64 



STATE LUNATIC HOSPITAL. 



[Jan. 





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Ages of patients when admitted: 
Under 20 years, .... 
From 20 to less than 30 years, 
« 30 « 40 " 
" 40 " 50 " 
« 50 " 60 " 
" 60 " 70 " 
« 70 « 80 « 
" 80 and upwards, . . 


Civil state of patients when ad- 
mitted : — 

Single, 

Married, 

Widows, 

Widowers, 

Unknown, 





1854. 



SENATE— No. 1. 



TABLE 11. 



Ages of Patients in the Hospital, Dec. 1, 1853. 



Duration of Insanitv with those remaining in 
the Hospital, Dec. 1st, 1853. 



Under 10 years old, 
From 10 to 15 years, 
» 15 " 20 



(( 


20 


11 


25 


(C 


25 


n 


30 


(( 


30 


(( 


35 


(( 


35 


a 


40 


« 


40 


u 


45 


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45 


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50 


It 


50 


u 


55 


(( 


55 


ii 


60 


(( 


60 


a 


65 


u 


65 


(( 


70 


tl 


70 


K 


75 


it 


75 


(( 


80 


Over 80, 




. 





3 

9 

37 

75 

96 

73 

64 

51 

37 

28 

16 

14 

7 

9 

1 

520 



Less than 1 year insane, 
From 1 to 2 years insane, 



2 

5 " 
10 " 
15 ' 
20 " 
25 " 
Over 30, 
Unknown, 



5 

10 
15 
20 
25 
30 



51 

53 

100 

99 

57 

27 

12 

7 

8 

106 

520 



66 



STATE LUNATIC HOSPITAL. 



[Jan. 



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1854.] 



SENATE— No. 1. 



67 



TABLE 13. 

Diseases that have proved Fatal. 




Previously. 



Marasmus, 

Apoplexy and Palsy, .... 
Consumption, ..... 

Epilepsy, 

Disease of the Heart, .... 

Suicide, 

Disease of the Brain, .... 

Typhus Fever, 

Lung Fever, 

Hemorrhage, 

Dysenteric Fever, .... 

Cholera Morbus, .... 

Inflammation of the Bowels, 
Mortification of the Limbs, . 
Dropsy, . . . . . 

Chronic Dysentery, .... 

Erysipelas, ...... 

Diarrhoea, ...... 

Disease of the Brain from Intemperance, 

Bronchtis, 

Old Age, 

Gastric Fever, ... 

Land Scurvy, 

Congestive Fever, .... 
Concussion of the Brain, 
Disease of the Bladder, 

Fright, 

Rupture, 

Maniacal Exhaustion, .... 

Convulsions, 

Cholera, 

Asthma, . . . ^ . . 

Hydrothorax, 

Cancer, ...... 

Pleurisy, .... . . 

Jaundice, 

Chorea, 



14 



71 

52 

50 

45 

19 

19 

20 

11 

14 

6 

9 

,4 

8 

3 

7 

4 

15 

17 

3 

3 

12 

5 

1 

2 

1 

1 

1 

1 

35 

2 

4 

1 

1 

1 

1 

1 



41 



450 



There has been but very little of acute disease of any form, 
in this hospital the past year. From bowel complaints, which 
so often prevail in hospitals in the warm season, we have been 



68 STATE LUNATIC HOSPITAL. [Jan. 

remarkably exempt. Notwithstanding our great freedom from 
acute disease, we are often reminded that we are mortal. In- 
sanity is, not unfrequently, only one of the symptoms of the 
breaking down of the constitution — one symptom of a fatal 
disease. It is an accompaniment of the last stages of con- 
sumption, of marasmus, of palsy and of epilepsy — all of them 
almost necessarily lead to a fatal termination. But few of the 
patients are blessed with the robust health of the laboring 
parts of the community. Most of them are suffering from dis- 
ease of some organ of the body or part of the system. Ill 
health is indeed one of the most prolific sources of insanity ; 
and, in many, traces of it are distinctly visible while the mind 
is insane, even unto the end of life. Diseases of the digestive 
organs, and of the nervous system, afflict many, and yet a ma- 
jority of the patients enjoy very comfortable physical existence. 
They eat fully and sleep soundly. 

As usual, there have been several deaths from consumption 
and marasmus. Cases of this kind are usually brought to the 
hospital with the fatal disease upon them. The most we can 
do for such, is to relieve them of a part of their burdens, and 
smooth their downward path to the grave. 

There have been fourteen deaths from maniacal exhaustion 
— a disease peculiar to insanity. Great and long continued 
muscular effort, accompanied with high mental excitement or 
delirium, and the want of sleep, characterize this form of dis- 
ease. Unless the patient can be induced to take nourishment 
somewhat in proportion to efforts made, exhaustion soon 
supervenes. There is often an aversion to, and a loathing of 
food in these cases. We have to deplore the loss, the past 
year, of valuable members of society from this cause. Some 
chronic cases, that are periodically excited, wear themselves 
out in a paroxysm of violence. 

Three men of three score years and ten, died of dropsy of 
the chest, complicated with other diseases; one of whom was 
Ezra Holmes, after a residence in this hospital of more than 
twenty years. He was a homicide, and his wife, whom he 
always said was kind and affectionate to him, fell by his hand, 
just after he had drank a glass of wine she had given, with the 
blessing, " Come, let us drink and forget our sorrow, and re- 
member our poverty no more !" " In a moment, the idea," as 



1854. 



SENATE— No. 1. 



.69 



he afterwards feelingly related, " of Sampson and the weaver's 
beam," rushed into his mind, and he seized a weapon and gave 
her a fatal blow. He had been insane some years previous, 
with a species of religious.fanaticism. 



TABLE 14 

Showing- the Average Ag-e at which patients luere taken de- 
ranged, the average time of their derangement before and 
after coming to this Hospital, and their average age at the 
time of their death in this Hospital. 





Years. 


Months. 


Days. 


The average age at which 201 males were taken 








deranged, 


42 


8 


10 


The average age at which 205 females were 








taken deranged, 


39 


1 


10 


The average age at which the 406 of both sexes 








were taken deranged, ..... 


40 


11 


1 


The average time Ihe 201 males were insane 








before coming to the Hospital, 


4 


2 


9 


The average time they lived afterwards, . 


1 


9 


24 




6 





3 


The average time the 205 females were insane 








before coming to the Hospital, 


3 


3 


6 


The average time they lived afterwards, . 


1 


7 


29 




4 


11 


5 


The average age the 201 males were when they 








died, 


48 


8 


13 


The average age the 205 females were when 








they died, 


44 





15 


The duration of life of the 406 of both sexes 








after becoming insane, 


5 


5 


20 



From this collection of fatal cases, we see the prospects of 
a continuance of life are in favor of the male over the female, 
both in escaping this fearful malady to a later day, and in re- 
sisting its fatal inroads upon life after its attack. While the 
male arrives at nearly the age of 43 years, the female is over- 



70 STATE LUNATIC HOSPITAL. [Jan. 

taken soon after she passes the age of 39 ; and, while the male 
is able to resist its ravages over six years, the female succumbs 
in less than five years. The average age of the 201 males 
embraced in this table, when they died, was 48 years, 8 months 
and 13 days, while that. of the 205 females was 44 years and 
15 days. 

The chance of life, for persons in health at corresponding 
periods, as calculated and acted upon by life insurance compa- 
nies, is four times greater than is here exhibited, for the male^ 
and more than five times greater for the female. This shows^ 
pretty conclusively, that insanity, when not recovered from^ 
tends to shorten life. 



1854] 



senate—No. i. 



71 






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72 STATE LUNATIC HOSPITAL. [Jan. 

The general law, ihat action is necessary for the healthy 
condition of the mental and physical functions of the body, 
applies with equal force to the great majority of the insane as 
well as to the sane. For the growth and full development of 
any of these functions, well-directed exercise and efforts are 
essential, and constant use of them is absolutely necessary to 
prevent their premature decay. For the insane, after the acute 
stage of their disease has passed, labor or amusement greatly 
■promotes their recovery and happiness too. When not too 
violent, it promotes the health of the body by increasing the 
appetite and the powers of digestion ; it relieves the nervous 
t^ystera of its irritability, prepares the body for quiet repose at 
night, and furnishes objects for the mind to dwell upon away 
from its peculiar delusions. He who works or plays must pay 
tsome attention to his occupation, and in so doing, his thoughts 
ure, for the time, diverted from the disordered channel. 

Amusements, of various kinds, have been introduced, and 
are ih constant requisition among our patients. But still, the 
great want of stimulus to action is a serious evil, and one not 
easily remedied. Many of the insane are inclined to stand or 
bit about our wards, listlessly dreaming over their insane fan- 
cies. We encourage and urge, their engaging in some kind of 
employment, whether of profit or not. Such amusements as 
require of those that engage in them, action of the body and 
limbs, are better than the sedentary ones, for they directly pro- 
mote the health of the body as well as the health of the mind. 
But chess, cards, and the magic lantern are better than noth- 
ing. Our library shows much hard use, and is daily resorted 
to by many who read with interest and intelligence. About 
t.eventy-five dollars are annually expended, to replenish it with 
miscellaneous books. 

It is our rule to get out daily, all whose state of mind does 
iiot forbid it, into the open air. The males walk out in parties 
with their attendants, over the hills. The feeble men are car- 
ried to ride. The females have a carriage devoted to their 
entire use, and they also walk out in parties with their nurses. 
Some walk the streets unrestrained, except by their word of 
honor. The music, dancing and working parties are continued, 
as they have been for years. 

Many newspapers are daily placed in the hands of our pa- 



1854.] SENATE— No. 1. 73 

tients, but not as many as would be useful, or as is desirable. 
There is hardly a paper or periodical published in this State, 
but what would find in our family, more than one reader local- 
ly interested in its perusal. The following are sent to the 
hospital by their publishers, gratuitously, for which they have 
the thanks of our great family : — The Daily Advertiser, Eve- 
ning Gazette, Olive Branch, Puritan Recorder, Christian Wit- 
ness and Church Advocate, Christian Watchman and Reflect- 
or, Youth's Companion, Monthly Religious Magazine, Zion's 
Herald, New England Farmer, The American Patriot, and 
Observer, from Boston ; Register, Essex County Gazette, and 
Advertiser, from Salem; Lynn News, from Lynn ; Old Colony 
Memorial, from Plymouth ; Assistant of the Ministry at Large, 
from Roxbury ; Gospel Messenger, from Utica, N. Y. ; Cour- 
ant, from Clinton; ^gis, Spy,']Palladium, and Transcript, from 
Worcester ; Democrat, from Taunton; Chronicle, from Cam- 
bridge. 

We have received, for the use of the inmates, from Hon. 
Charles Allen — Annual Message and accompanying Docu- 
ments, 1851-2. Part 3d. Patent Office Report, 1851, Ag- 
ricultural. Abstract of the Seventh Census. Congressional 
Globe, Vol. 24. Part 1, 2, and 3, First Session 32d Con- 
gress. Appendix to Congressional Globe, Vol. 25. 

From the Hon. John Davis — The Annual Message and ac- 
companying Documents, 1852-3. Part 2d. Patent Office 
Report, 1851-2, Mechanical. Annual Message and accom- 
panying Documents — 1852-3. Part 1st. 

From Hon. I. McNaer — Espy's Report on Meteorology. 

From Rev. S. C. Jackson — General Laws and Resolves of 
Massachusetts. Documents and Pamphlets. 

From Miss Dix — A large roll of prints. 

From one who has sent us many favors — The Proceedings 
of the Constitutional Convention, 1853, of Massachusetts. 

From Signor Blitz — An hour and a half of most acceptible 
entertainment in our Chapel, in his peculiar and inimitable 
style, at which some three hundred of our patients were pres- 
ent. 

The daily labor performed about this establishment, by the 
patients, amounts to very considerable. They mix with the 
attendants and assistants, in all the departments of business, 
10 



74 



STATE LUNATIC HOSPITAL. [March, 



and render essential service. The fields, the gardens, the 
workshops, the kitchens, the laundry, and the wards, give em- 
ployment to many. The results of their labor, in part, is 
added, as estimated by the steward. Most of the crops of the 
farm and gardens were abundant and profitable for the labor 
bestowed. 



Apples, 


40 barrels. 


at 


81.75, . 


$70 00 


Beans, dry. 


41 


bushel 


3" 


1.75, . 


7 87 


Beets, 


156 


(( 


u 


25, . 


39 00 


Cabbage heads, 


2,100 


u 


u 


5, . 


105 00 


Corn, sweet in ears, 60 


(( 


u 


50, . 


30 00 


Cherries, 


20 


u 


u 


2.00, . 


40 00 


Cucumbers, 


175 


u 


a 


50, . 


87 50 


Turnips, 


285 


u 


u 


25, . 


71 25 


Parsnips, 


75 


u 


a 


50, . 


37 50 


Onions, 


75 


u 


u 


50, . 


37 50 


Milk, 


43,750 quarts 


u 


^, ' 


1,531 25 


Beef, 10 beeves. 


7,667 pounds. 


a 


7, . 


536 69 


Pork, 24 hogs. 


7,244 


u 


u 


8, . 


579 52 


Poultry, 


180 


a 


(( 


10, . 


18 00 



$3,191 08 

And for wintering the present stock of four horses, one yoke 
of oxen, twenty-five cows, one heifer and one calf, there was 
cut on the farm : — 



Hay, 48 tons, at $15.00, 

Rowen, 5 " « 12.00, 

Corn-fodder, .... 



$720 00 
60 00 
30 00 

$810 00 



And raised in the garden :• — 
Carrots, 1,845 bushels, at 30 cents, 

Total, 



556 00 



. $1,366 50 



1854.] SENATE— No. 1. 75 

The religious services have been ably conducted by the Rev. 
Mr. Allen, who has, for more than thirteen years, sustained the 
relation of chaplain to this hospital. He has a very constant 
audience of about 350, with their attendants, and, usually, a 
few strangers, who make up the congregation on the Sabbath. 
But few worshippers demean themselves with more propriety 
and decorum than our patients. They listen, with much ap- 
parent satisfaction and interest, to the expounded word. The 
chaplain has been singularly judicious in conducting these exer- 
cises, and made them appropriate to the place and to his hear- 
ers. While he has been acceptable to most, if not all, he has 
offended none. He has been kind, courteous and urbane to all. 

On the first of October last. Dr. John R. Lee, who has, for 
more than eleven years, performed the duties of Assistant Phy- 
sician, resigned his office, and started on a tour of Europe and 
Asia. He was a skilful physician, a pleasant associate, and 
conscientious in the discharge of every duty. He endeared 
himself to the patients under his immediate charge, and, as a 
testimony of their regard for him, raised money and procured 
a likeness of him to hang in one of their wards. 

To my associates in the various departments of this hospi- 
tal I feel under great obligations, for the prompt and faithful 
manner in which they have discharged their several responsible, 
and often arduous, duties. 

Most respectfully, 

Your obedient servant, 

GEORGE CHANDLER. 

State Lunatic Hospital, \ 
' Worcester, Dec. 2, 1853. ( 



76 



STATE LUNATIC HOSPITAL. 



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Mist. Hail, 5 p.m. 


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SENATE— No. 1. 



77 









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Snow. 

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Snow and Rain. 
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snow. 
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[striated. 
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78 



STATE LUNATIC HOSPITAL. 



[Jan. 











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SENATE— No. 1. 



79 





03 




R. 3 in. Snow. 

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1854. 



SENATE— No. 1. 



81 





s 




Strawberry. Colum. 
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Plum-tree, [stria. 
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Fog. Rain. 
Rain continued. 

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Apple-tree. 

Tulip. 

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Peony. [comel. 
Mountain Ash. G. 
Iris. Sh. [Maculat. 
Showers. 
Showers. 
Thunder. 
Shower. 
Star Grass. 

Shower. 
Shower. 


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STATE LUNATIC HOSPITAL. 



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85 





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SENATE— No. 1. 



87 





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(Jan. 





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Extremes of Thermometer. 
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Coldest day, Feb. 15 — Warmest, 








Total Days, - - - - 208 
- - - 129 

""---- 284 


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1854. 



SENATE~No. 1. 



89 



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1854.1 SENATE— No. 1. 91 



APPENDIX. 



[From the American Journal of Insanity, No. 1, Vol. x. page 67.] 

ARTICLE III. 

Report " On the Organization of Hospitals for the Insane" 
made hy the Standing Committee of the Association of Medical 
Superintendents of American Institutions for the Insane, at its 
Meeting in Baltimore, May IQth, 1853. 

The proposistion, relative to the " Construction of Hospitals," 
having met with so universal an approval, from all connected 
with, or interested in, the subject, and a want, seeming to the 
association still to remain unsatisfied, a committee was ap- 
pointed at the meeting, held in New York, last year, to draw 
up a series of propositions, that should, in like manner, embody 
the well-ascertained views of its members, in reference to the 
" Organization of Hospitals for the Insane," in regard to 
which there was no difference of opinion. As is stated in our 
report of the meeting at Baltimore, postea, " each proposition 
was taken up in detail, and minutely and fairly discussed, be- 
fore it was finally accepted." As now laid before our readers, 
the propositions may be received as the authorized exponents 
of the views of the above association, " On the organization 
of Hospitals for the Insane." 

1st. The general controlling power should be invested in the 
board of trustees or managers, if, of a State institution, selected 
in such manner as will be likely most effectually to protect it 
from all influences connected with political measures or politi- 
cal changes; if, of a private corporation, by those properly 
authorized to vote. 



92 STATE LUNATIC HOSPITAL. [Jan. 

2d. The board of trustees should not exceed twelve in num- 
ber, and be composed of individuals possessing the public con- 
fidence, distinguished for lib-erality, intelligence and active 
benevolence ; above all political influence, and able and willing 
faithfully to attend to the duties of their station. Their tenure 
of office should be so arranged, that where changes are deemed 
desirable, the terms of not more than one-third of the whole 
number should expire in any one year. 

3d. The board of trustees should appoint the physician, 
and, on his nomination, and not otherwise, the assistant phy- 
sician, steward, and matron. They should, as a board, or by 
committee, visit and examine every part of the institution, at 
frequent stated intervals, not less than semi-monthly, and at 
such other times as they may deem expedient, and exercise so 
careful a supervision over the expenditures and general opera- 
tions of the hospital, as to give to the community a proper 
degree of confidence in the correctness of its management. 

4th. The physician should be the superintendent and chief 
executive officer of the establishment. Besides beinsf a well 
educated physician, he should possess the mental, physical and 
social qualities, to fit him for the post. He should serve during 
good behavior, reside on, or very near the premises, and his 
compensation should be so liberal, as to enable him to devote 
his whole time and energies to the welfare of the hospital. 
He should nominate to the board suitable persons to act as 
assistant physician, steward, and matron ; he should have the 
entire control of the medical, moral and dietetic treatment of the 
patients, the unrestricted power of appointment and discharge 
of all persons engaged in the care, and should exercise a gene- 
ral supervision and direction of every department of the insti- 
tution. 

5th. The assistant physician, or assistant physicians, where 
more than one are required, should be graduates of medicine, 
of such character and qualifications as to be able to represent 
and to perform the ordinary duties of the physician, during his 
absence. 

6th. The steward, under the direction of the superintending 
physician, and by his order, should make all purchases for the 
institution, keep the accounts, make engagements with, pay 
and discharge those employed about the establishment ; have 



1854.] SENATE— No. 1. 93 

a supervision of the farm, garden and grounds, and perform 
such other duties as may be assigned him. 

7th. The matron, under the direction of the superintendent, 
should have a general supervision of the domestic arrange- 
ments of the house, and, under the same direction, do what 
she can to promote the comfort and restoration of the patients. 

8th. In institutions containing more than 200 patients, a 
second assistant physician, and an apothecary, should be em- 
ployed, to the latter of whom, other duties, in the male wards, 
may be conveniently assigned. 

9th. If a chaplain is deemed desirable, as a permanent offi- 
cer, he should be selected by the superintendent, and, like all 
others engaged in the care of the patients, should be entirely 
under his direction. 

- 10th. In every hospital for the insane, there should be one 
supervisor for each sex, exercising a general oversight of all 
the attendants and patients, and forming a medium of com- 
munication between them and the officers. 

11th. In no institution should the number of persons in imme- 
diate attendance on the patients, be in a lower ratio than one 
attendant for every ten patients, and a much larger proportion 
of attendants will commonly be desirable. 

12th. The fullest authority should be given to the superin- 
tendent, to take every precaution that can guard against fire 
or accident, within an institution, and to secure this, an effi- 
cient night-watch should always be provided. 

13th. The situation and circumstances of different institu- 
tions, may require a considerable number of persons to be 
employed in various other positions; but, in every hospital, at 
least all those that have been referred to, are deemed not only 
desirable, but absolutely necessary, to give all the advantages 
that may be hoped for, from a liberal and enlightened treat- 
ment of the insane. 

14th. All persons employed in the care of the insane, should 
be active, vigilant, cheerful, and in good health. They should 
be of a kind and benevolent disposition, be educated, and, in 
all respects, trustworthy, and their compensation should be 
sufficiently liberal to secure the services of individuals of this 
description. 



ftPR2 5'39W.P,A.