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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. 



TWENTY-SECOND 

ANNUAL REPORT 



THE TRUSTEES 



STATE LUNATIC HOSPITAL, 

AT WDKCESTER. 



DECEMBER, 1854. 



BOSTON: 

WILLIAM WHITE, PRINTER TO THE STATE. 
1855. 



I 



A 
OFFICERS OF THE HOSPITAL. 



* 



TRUSTEES. 

S. G. HOWE, Chairman, Boston. 

HENRY MORRIS, Secretary, Springfield. 

REJOICE NEWTON, Worcester. 

JAMES B. CONGDON, New Bedford. 

LINUS CHILD, Lowell. 



TREASURER. 
SAMUEL JENNISON, Worcester. 

OFFICE : SAVING'S BANK FOSTER STREET, WORCESTER. 



RESIDENT OFFICERS. 


GEORGE CHANDLER, M. D., 


Superintendent. 


GEORGE ALLEN, 


Chaplain. 


MERRICK BEMIS, M. D., 


Assistant Physician 


EDWARD A. SMITH. M. D., 


u a 


THOMAS HILL, 


Steward. 


ELIZABETH A. REID, 


Matron. 


JOHN T. MIRICK, 


Supervisor. 


PHEBE S. MIRICK, 


u 



TWENTY-SECOND ANNUAL REPORT 

OF THE 

TRUSTEES OF THE STATE LUNATIC HOSPITAL, 

AT WORCESTER, 

1854. 



To His Excellency the Governor and the Honorable Council : — 

In compliance with law and custom, the undersigned, Trus- 
tees of the Massachusetts State Lunatic Hospital at Worcester, 
present their Annual Report of " the condition of the hospital 
and its concerns." 

Under ordinary circumstances, this Report might well be 
very concise, and confined to a summary of the principal 
events of the year. But in the actual state of the case; in 
the present condition of the question concerning the provisions 
to be made for the insane of the Commonwealth ; and in 
the prospect of legislative action upon the whole subject, 
greater diffuseness may be allowed. 

In setting forth the condition of the Hospital, and the 
remedies for its defects, it will be necessary to examine cer- 
tain principles and modes of treatment, which, though familiar 
to professional, are not so to unprofessional readers. Argu- 
ments that would be held superfluous ; considerations that 
would be deemed perfectly trite by a body of physicians, may 
be appropriately addressed to those whose studies and occupa- 
tions have not familiarized them with the subject of insanity, 



6 STATE LUNATIC HOSPITAL. [Jan. 

but who may be called upon to take measures for the cure and 
care of the insane of the State. 

The year has been one of general health and prosperity. 
No epidemic has occasioned unusual mortality in the Hospi- 
tal ; no fatal accident has broken the usual quiet of the house- 
hold ; no manifest abuse of trust has lowered the high character 
of the body of officers and attendants. 

However far short the Institution may have fallen of doing 
the greatest possible good with its means, it certainly has con- 
tinued to carry on, with marked success, the work of Christian 
charity allotted to it by the State ; and another year of good 
deeds may be added to its history of beneficence. That his- 
tory has been glorious in the best sense ; and Massachusetts 
may reflect upon it with as much satisfaction as upon any 
part of her annals. Had she erected at Worcester a Military 
Academy and an Arsenal, from which to draw men and weap- 
ons to conquer in a hundred fields, she could not have won 
such precious laurels as she has earned within these walls. 

Since the opening of this Hospital, four thousand seven 
hundred and fifty-seven insane persons have been received 
within its friendly gates. Of these, two thousand one hundred 
and seventy-two have gone forth again clad in their right 
minds, or have partially recovered. Others, secluded from 
the world, (which to them was one of excitement and suffer- 
ing, while to it they were a terror and a burden,) here pass 
their days peacefully, and receive that respectful attention 
due to every being in human shape, however ruined and de- 
graded he may be ; and those to whom the end comes, have 
their eyes gently closed in death by friendly hands. Nor have 
these only been benefited ; for thousands upon thousands of 
relatives and friends have been relieved from dreadful anxiety, 
by the State thus taking charge of those beloved ones for whom 
they could do nothing. 

Nor yet have benefits and blessings been conferred upon 
these the receivers only, but the giver too has been doubly 
blessed; and Massachusetts has been made richer in the heart's 
treasures for every year in which, from its high pulpit at 
Worcester, the Hospital has preached to all the people its 
daily sermon of Christian love and charity. 

The Trustees have great pleasure in such retrospect ; and 



1855.] SENATE— No. 1. 7 

they heartily ascribe the praise for that portion of the good 
work which has been accomplished during the past year, to 
the Superintendent, his assistants, and the faithful men and 
women in attendance, by whose immediate agency it has been 
effected. 

It is easy and pleasant to render merited praise. It is agree- 
able to indulge in complacent retrospect of past efforts and 
acknowledged excellence. But it is a duty to be mindful of 
faults and shortcomings. It must not be admitted that any 
thing which has been done in the past, or any success which 
has been obtained, can warrant a moment's pause in that long 
career of improvement which is clearly open before this Hos- 
pital. That career, indeed, must be pursued with unwonted zeal 
and energy, if the character which its friends once claimed for 
it, of being a model institution, can be regained and deserved. 

This Hospital was once indeed a model one, in form and 
in administration ; and Commissioners came up hither from 
other States to study it, and went home to copy it. Our State 
felt a reasonable pride in the Institution, and in that remarka- 
ble and eminent man who so long ministered it; and she in- 
dulged in not a little self-gratulation from year to year. It 
seemed to be thought that, as we had begun with the coun- 
try's highest achievement, we had also arrived at the ulti- 
matum of the world's possible progress. But while indulging 
in these pleasant remembrances of the past, and resting on our 
laurels, great improvements were made elsewhere; other hospi- 
tals were built on better models; other and better principles of 
administration were adopted, until now we find ourselves be- 
hind the rest of the world in respect to the facilities and the 
means which we give to those who have the care of our insane. 

It is well known that during the last quarter of a century, 
and especially during the last ten years, close observation and 
study of the phenomena of insanity, in Europe and in this 
country, have thrown fresh light upon its pathology, and caused 
this light to be so widely diffused that changes and im- 
provements, amounting to revolutions, in the mode of treat- 
ing the insane, have been demanded and obtained. These 
changes and improvements have been, as it were, of a moral 
nature ; merely causing the substitution of moral for mate- 
rial agencies, in the administration of hospitals ; yet they 



8 STATE LUNATIC HOSPITAL. [Jan. 

required improved buildings, grounds, and material appliances 
of various kinds. 

The improvements in the art of manufacturing cotton cloth 
have been so great within a quarter of a century, that a factory 
which possessed only the machinery provided for it twenty-five 
years ago, could not be run successfully in competition with new 
ones. No ability or resource of its directors, no skill or zeal 
of its agent, no fidelity or industry of its workmen, could ena- 
ble it to do as much or as good work as its more modern com- 
petitors. Now, a hospital for the insane is an establish- 
ment for repairing health of body, and, through this, health 
of mind. It is a place for repairing disordered men. It should 
possess the best machinery, and the best of officers to work it. 
The principal part of the machinery is the building, and its 
importance is immense. It should not merely serve to house the 
patients and protect them from the weather ; but it should afford 
the greatest possible facility for applying the best mode of 
treatment, by its situation, its construction, its conveniences, its 
furniture, and its various means of occupation and amusement 
within ; and by its gardens, its grounds, and its contrivances 
and allurements to exercise and labor without. Lacking these 
advantages, no ability or resources'of its trustees ; no skill or 
zeal of its superintendent; no fidelity or industry of its attend- 
ants, can ever enable it do so much or so perfect works of cure 
as other institutions that possess them. 

But when, besides the lack of these advantages, a hospital 
is overcrowded with patients; when it is obliged to huddle 
together over five hundred and fifty persons in apartments 
constructed for only three hundred and twenty-seven, and con- 
structed, too, when less space was thought to be requisite than 
is now found to be essential ; when, moreover, the patients, 
instead of being partly drawn according to the original purpose 
from an intelligent and educated yeomanry, are drawn mainly 
from a class which has no refinement, no culture, and not 
much civilization even — that hospital must certainly degenerate. 
Its degeneracy will be the more certain and the more striking if 
a short-sighted economy tempts its managers to adopt the 
readiest, instead of the wisest, methods of treatment, and to 
choose the cheapest, instead of the best system of adminis- 
tration. 



1855.] SENATE— No. 1. 9 

The patients, crowded close together, excite and exasperate 
each other, and confusion becomes worse confounded. The 
crowd must be brought to some kind of order ; and the temp- 
tation is very strong to resort to the old and easy way of doing 
it, — to wit, by main force, — by physical restraint and seclusion. 
Hence, while in some other hospitals the managers are taking 
down gratings, removing iron doors, breaking restraint chains, 
tearing up strait-waistcoats, disusing camisoles and straps, 
in a word, diminishing to nearly nothing the use of physical 
restraint and of seclusion, and substituting therefor increased 
supervision, and a variety of moral means, in that one they are 
building up new cells, and relying upon mechanical contri- 
vances for restraining the patients. Now, however high among 
kindred institutions that hospital may have ranked, however 
excellent it may have been considered at home, it must be 
ranked low by competent and impartial judges. 

Such, in the opinion of the undersigned, by the effect of 
simple causes, and without manifest fault on the part of any 
one, is the case with the Hospital at Worcester; and, such 
being their opinion, they cannot honestly make a report touch- 
ing the condition of the institution and its concerns without 
making it known. 

The Trustees may as well remark here, that, holding these 
opinions, they should probably have exercised the power in- 
trusted to them, and made important changes, both in the 
structural arrangement of the premises, and in the mode of 
administration, had it not been for several considerations, some 
of which it may not be inappropriate to mention here. 

One consideration is, the conservative character wisely given 
by the State to the Board of Trustees, in the manner of its ap- 
pointment. This necessarily makes it slow and cautious about 
adopting any changes of policy. Now, the policy of delegation 
of power to other hands, and of non-interference with the 
immediate management of the Hospital, had been the settled 
policy of this Board long before any of the undersigned be- 
came members of it. 

Another consideration is, the hope entertained by all the 

present members of the Board that the Legislature would take 

early measures for selling the lands belonging to the Hospital, 

and erecting new and suitable buildings upon a site more ap- 

2 



10 STATE LUNATIC HOSPITAL. [Jan, 

propriate and advantageous for the establishment, though of 
far less marketable value. This hope was the result of a belief 
that such a measure was called for by the best interests of the 
State. 

With these remarks, the Trustees proceed to consider, first, 
the 

NUMBER AND CLASSIFICATION OF PATIENTS. 

The number of patients in the Hospital at the beginning of 
the year was five hundred and twenty. 

The number admitted during the year was two hundred and 
ninety-nine. The whole number discharged was four hundred 
and twenty-one, of whom two hundred and ten were trans- 
ferred to the new Hospital at Taunton. 

The average number of patients during the year, and during 
many years, has been enormous. It far exceeds that for 
which the Hospital has accommodations. It constitutes a 
crowd. It embarrasses the administration. It lowers the 
standard of health. It diminishes the comfort and increases 
the excitement of patients, and the perplexities of attend- 
ants. It makes the whole household uneasy. It leads to, 
and perhaps justifies, the resort to objectionable methods of 
government, and to restraints which are injurious. It is a 
prolific source of other evils too numerous to mention. It 
ought to be diminished, and kept down. 

Of the two hundred and ninety-nine patients admitted 
during the year, one hundred and sixteen were foreigners, of 
whom ninety-four were Irish, and all paupers. 

The Trustees would not mention this fact, in the present 
state of the times, or they would mention it only to commend 
the laudable readiness of Massachusetts to care for the 
strangers within her gates, were "it not an important one in 
view of the classification of patients, which they think it' 
essential for every hospital to have the means of making, but 
which ours has not. It has been stated to the Legislature be- 
fore, and it should be repeated, that the Hospital at Worcester 
is fast becoming a Hospital for foreigners, and that its doors 
are becoming practically closed against that class of. persons 
who for many years enjoyed its advantages ; to wit, the mid- 
dling class of native population, — the intelligent yeomanry of 



1855.] SENATE— No. 1. 11 

Massachusetts, who can afford to pay the cost of their board, 
and will not ask for charity. The proportion of Irish patients 
to the whole number was ten per cent, in 1844; but over 
thirty-one per cent, in 1854. 

The State should adopt as her children all who congre- 
gate upon her shores. She should make abundant provi- 
sion for all, of whatever nation, kindred, tongue, or color, 
who, having found a home within her borders, do there become 
insane ; but that provision, while as favorable as possible 
to their cure, should be suitable to their condition, their 
wants, and their capacity for enjoyment. It should be made, 
too, in such manner as not to cut oft' any class of her own 
children, who become insane, from sharing her maternal care 
and bounty. 

It is important and pertinent to the present subject, to bear 
in mind, that insanity does not change the nature of men and 
women ; that it does not always blunt their sensibilities, or 
lessen their prejudices, but that, on the contrary, it often inten- 
sifies them. Among the insane of this State are wives and 
daughters, widows and orphans, of farmers, mechanics, minis- 
ters, schoolmasters, and the like. These women were taught 
in our public schools, trained up in our proverbially neat and 
orderly households, and accustomed to cultivated society ; and, 
however ready and willing they might have been, when sane, 
to help the poor, and elevate the humble, of whatever race or 
color, they would have shrunk most sensitively from living 
next door even to a wretched hovel, and from intimate associa- 
tion with those who are accustomed to, and satisfied with 
filthy habitations and filthier habits. Now, they do not lose 
their sensibilities by becoming insane, and they ought not to 
have them wounded by being herded together in the same 
apartment with persons whose language, whose habits, and 
whose manners, offend and shock them. Besides, such asso- 
ciations do not promote the good of any patient, but may 
retard, and perhaps prevent, the cure of some. 

There is yet another class, who have, hitherto, been mingled 
indiscriminately with the inmates of our hospitals, but for some 
at least of whom, the undersigned think that express and sep- 
arate provision should be made, either within or without the 
common edifice ; to wit, criminal lunatics — those who have 



12 STATE LUNATIC HOSPITAL. [Jan. 

committed grave offences, but have been exempted from pun- 
ishment by the courts on the ground of supposed insanity ; 
and those who, becoming insane while undergoing sentence, 
are transferred from the prisons to the hospitals. 

The presence of any of this class is an evil; and if the num- 
ber should be much increased, it would be a very grave one. 
The hospital is a place of refuge for the unfortunate. To make 
it a place of imprisonment for criminals, is to throw painful 
associations about it. Nor is the objection merely a moral 
one. The presence of criminals, who are often desperate men, 
creates the necessity for greater means of restraint and security 
than would be required with ordinary patients, and it converts 
some part at least of the hospital into a prison. The 
criminal should be treated with care and kindness, but not at 
the expense of the well being, or the feelings of the innocent 
insane, or their families. 

Now, the presence of these two classes, in such large and 
increasing numbers, lowers the State hospitals in public 
estimation ; and the consequence is already, that they are less 
used by those who, though they cannot well afford to pay a 
high price, will seek the best accommodations for their insane 
friends. Hence it is, that there begins to be a call for private 
hospitals and asylums. 

The multiplication of these private establishments would be 
a great evil. It is one that may be prevented by making pub- 
lic hospitals unobjectionable residences for patients of any class; 
but it will be difficult of cure, if once it obtains footing. 

If private hospitals should be multiplied in this State, they 
will be established with a view of gain. They may become 
valuable property. It may be impossible to suppress them by 
legal means, and it will be very difficult to bring them under 
such legal supervision as will prevent abuses. 

The history of civilized nations shows that the multiplica- 
tion of private hospitals and asylums for the insane will cer- 
tainly ensue unless public hospitals are of the best kind, and 
present opportunities for what the people deem proper classifi- 
cation of patients ; and it shows, too, that such establishments 
almost necessarily become serious evils. In Great Britain, so 
many of them had become places of abomination, that the 
government had to grapple with the evil, and has lessened and 



1855.] SENATE— No. I. 13 

limited it only by clothing the Lord Chancellor and the Com- 
missioners in Lunacy with inquisitorial and executive powers, 
which, however necessary for the protection of the lunatic, 
would hardly be tolerated in this country. 

It behooves the legislature to attend to this matter in sea- 
son, as well to give to the public Hospitals more means of 
proper classification of patients, as to prevent trouble in 
future. 

HEALTH MORTALITY CURES. 

The number of deaths, and the number discharged as cured 
or otherwise, and similar returns, for the past as well as for 
previous years, will be found stated in the Report of the Su- 
perintendent. Such facts are of value in a statistical point 
of view, when drawn from a long period of time, and from a 
large number of patients, and with a full understanding of all 
the circumstances which may have an influence upon them. 
But as these circumstances can scarcely be alike in different 
hospitals, comparisons between them must be made with 
great caution, else they lead to error. As a picture of the 
Hospital edifice is more or less pleasing according as it is 
taken from one or another point of view, so an account of its 
sanatory condition will be more or less favorable according as 
it may be taken from one or another statistical view. It is 
natural, in both cases, to choose the most favorable stand point* 

The number of deaths during the last year was thirty-four. 
This, compared with the average number of patients during 
the year, gives a mortality which, compared with that of the 
whole population of Massachusetts, is very great, for that is 
only 1.89 hundreths per cent. Compared with the average 
mortality in the State Prison, it is prodigious, for that is only 
three-fourths of one per cent. 

It by no means follows from this, however, that the diet and 
mode of life in the Hospital are less salubrious than in the 
prison. The prisoners are mostly men of vigorous organiza- 
tion, and at a period of life during which mortality is least 
In most of our patients, the original stock of vitality was prob- 
ably small ; in almost all it was sadly impaired before their 
admission. Many brought here a poor nickering flame of life, 
which would have soon been extinguished in the gusty world 



14 STATE LUNATIC HOSPITAL. [Jan. 

without, but which is now carefully tended, and will lick 
up the last drop of the oil of life ere it dies in the socket. 
It is morally certain, however, that the vital energy of the 
patients must have been lessened, and the mortality among 
them increased, by living so much of the time, and in so great 
numbers, in the badly ventilated and poorly lighted wards and 
chambers of this Hospital. The state of the air has been a 
subject of complaint for years. The impression made upon 
visitors during an hour's visit has been disagreeable and hurt- 
ful ; what it must have been upon the patients is manifest in 
their appearance. 

The Trustees are happy to be able to state that the arrange- 
ments just finished in some of the wards, under the direction of 
Mr. Jonathan Preston, have proved of great benefit. They 
remedy the evils so long complained of as much as the struc- 
ture of the building admits. 

There have been no deaths by accident, and but one by sui- 
cide, during the year. Considering the number of patients and 
the fewness of attendants, this speaks well for the watchful- 
ness of the latter. 

GENERAL CONDITION AND TREATMENT OF PATIENTS. 

In the numerous visits which the Trustees have made, either 
as a Board, or individually, — visits often made without previous 
notice, and sometimes by night, they have found evidence 
enough to satisfy them that the Hospital has been kept ha- 
bitually as clean and tidy as circumstances would admit ; and 
that the inmates were well fed, comfortably lodged, and kindly 
treated. They have listened to complaints of patients, but 
found they were all of such stuff as dreams are made of. In 
no instance have friends of patients expressed to the Trustees 
any dissatisfaction. 

Now, when it is considered how completely dependent are 
the patients upon those who have them in charge for comfort, 
for health, and even for life itself; — how liable they are to 
injury by one another, by fire, by accidents of various kinds; 
when it is considered that the attendants may neglect and 
even maltreat them with possible impunity, and moreover how 
liable is the possession of great power to great abuses, there 
certainly is reason for congratulation that in our Hospital, over- 



1855.] SENATE— No. 1. 15 

crowded with patients as it has been, no untoward event has 
disturbed the peaceful current of the year. This is, in a great 
degree, attributable to the influence of the Superintendent, who, 
eminently conscientious, vigilant, and industrious himself, has 
drawn about him a company of assistants who emulate his 
virtues. 

The Trustees think, however, that in several important mat- 
ters of arrangement and of administration the Hospital needs, 
and may have, great improvement. One of these is in respect 
to the 

RECREATION AND AMUSEMENTS OF THE PATIENTS. 

Among the means of treating the insane, those which help 
to divert their thoughts from their unnatural channels, and to 
promote cheerfulness of heart, are very important. Fore- 
most among these are, of course, the associates and attendants 
of the patients, who should be of pleasant temper and cheer- 
ful deportment. But these living agents can be aided greatly 
by mechanical arrangements of apartments and grounds, by 
facilities for games and amusements, and the like. In this 
respect our Hospital is sadly deficient. Most of the wards are 
ill lighted, and the sunbeams never enliven them. The apart- 
ments are of tiresome rectangularity. There are no sunny 
parlors, no cosy nooks, no cheerful bow windows opening on 
green lawns ; no adornment of the halls, no variety of pleasant 
sights for the eye, no variety of pleasant sounds for the ear ; 
but, on the contrary, there is a dull monotony in the structure 
of the rooms, unbroken by diversity of furniture, and an end- 
less extent — square miles, indeed, of walls and ceilings — white- 
washed, whitewashed every where, till the eye, wearied with 
everlasting white, longs even for a stained spot to rest upon. 
All this, of course, helps to give a character to the establish- 
ment, and repels attendants of cheerful tempers, who love to 
live in sunny spots, and amid pleasant scenes, or it dispirits 
them after they come. At any rate, the visitor who compares 
this Hospital with some others, is struck by the grave deport- 
ment, the serious countenances, the almost melancholy aspect 
of attendants and patients. He misses the glad countenance 
which the merry heart maketh. There is a leaden gravity 
which seems to defy relaxation ; and a gloomy air about 



16 STATE LUNATIC HOSPITAL. [Jan. 

the establishment, which must be unfavorable to the cure of 
insane patients. 

This will probably be amended, at least as far as structural 
arrangements go, by letting in more sunlight, breaking up the 
monotony of the wards, providing new parlors, and more fa- 
cilities for amusement and occupations, by other alterations 
which the Board have directed to be made. 

EMPLOYMENT OF THE PATIENTS. 

Another very important instrumentality in the treatment of 
the insane, whether as regards the cure of their malady or 
the melioration of their condition, is the means of controlling 
and directing their minds, through the employment of their 
hands, and the general occupation of their time. These means 
should be varied, in view of the organization, the previous call- 
ing, and the present condition of the patient. The employ- 
ment should be of such nature, and such degree of urgency, 
as will agreeably occupy, without severely taxing, the disor- 
dered faculties. In view of the plurality of the mental 
faculties, the occupation should be varied and adapted as 
much as possible to the disordered faculty, or rather disordered 
combinations of them, which, however, are almost endless. 

A little reflection will show that idleness, so pregnant of 
evil to the sane, may be equally dangerous to the insane; 
and that the best remedy for a disordered current of thoughts 
and feelings is their diversion into other channels by attractive 
occupation. 

In great trouble and in mental anguish, men seek for occu- 
pation of body and of mind, lest they should go mad.; and, 
when they have gone mad, they need it in order to get sane 
again. Even in those cases where excessive occupation, 
where anxiety, or where over-mental action has caused insanity, 
it is not total inaction, but change of action, that is required. 
Indeed, the mind will not rest in recent insanity. It is only 
when serious changes in the brain lead to fatuity, that it be- 
comes quite quiet ; and this condition we wish to prevent, or 
at least postpone, as much as possible. Hence the necessity of 
ample provision in every hospital, of varied material and 
mechanical appliances and contrivances, to aid in the moral 
treatment of the insane. This matter does not seem to have had 



1855.] SENATE— No. 1. 17 

sufficient attention in the organization, or in the administration 
of this establishment. There is lack of variety and abundance 
of means of recreation, and also of industrial occupations. 

The fact that hundreds of tolerably strong and healthy men 
and women are most comfortably fed and lodged in one house, 
at public charge, and yet permitted to pass months and years 
in idleness and sloth, would shock this active and industrious 
community, were it not that custom has made it familiar, and 
seems to warrant it. 

It is true that many patients do recover reason under this 
"let-alone" treatment; but so do men sick with the same 
malady recover health though treated by doctors of different 
schools, and swallowing drugs of opposite character. The 
reputation of doctor and of drug may come from the fact that 
they so often fail to defeat, and do only retard, the natural pro- 
cesses which bring the majority of diseases to a safe issue. In 
order to learn which system is best, we must compare one 
with another working under circumstances as nearly alike as 
possible. 

It is easy to compare our Hospital with others in regard to 
the variety of occupation provided for the patients, the atten- 
tion paid to occupying them with industrial pursuits, and the 
amount of labor they perform. In all these matters many other 
hospitals take precedence of it. In the British hospitals espe- 
cially, great attention is given to the occupation of the patients ; 
and some of them almost deserve the name of industrial estab- 
lishments. Some asylums in Scotland, and some district 
asylums in Ireland, are particularly distinguished in this respect. 

It is true that the circumstances are not the same in the 
two countries. There is greater development of individuality 
here ; more of self-guidance, and more of voluntary labor. There 
is less disposition to submit to the direction of others ; and, as 
people do not lose their ordinary characteristics in their insane 
state, it may be more difficult to keep lunatics busily employed 
in this country than it is in Great Britain. But one-third of 
our patients are Irish ; the most of whom, if at home, and in 
some of the district asylums, would surely be kept at work. 
With regard to the Americans, they are quite as active and 
industrious as any people ; only they are more fond of con- 
sidering their labor to be voluntary and self-directed ; and it 
3 



18 STATE LUNATIC HOSPITAL. [Jan, 

would seem that advantage might be taken of their general 
peculiarities, so that they would be induced to join in some 
industrial occupation. 

Many, if not most, of our patients are regaled daily at table 
with what would have been rare, and perhaps unknown luxu- 
ries in their former homes. These cannot be needful for their 
cure ; and the enjoyment of them might perhaps be made con- 
ditional upon their doing a certain amount of work. Few 
lose the sensitiveness of the " pocket nerve ;" and this, if not 
already morbidly active, might be quickened by prospect of 
immediate gain. It certainly would be better for the Hospital 
and for the State, to have all the inmates who are in ordinary 
bodily health busily engaged in light work, even by paying for 
every hour's time, than to have hundreds lounging idly about 
the wards, gradually losing the tone and vigor of their bodies ? 
and indifferent to every thing except the quantity and quality 
of the next meal. 

Of course the disinclination to steady occupation is seldom 
to be regarded as laziness, or as in any way culpable, but 
rather as one of the results of insanity, which deranges the 
distribution of the nervous energy, and sometimes lessens the 
amount of it. But though punishment, even by deprivation 
of comfort, may not be just, yet inducements to regular 
employment, in shape of wages or of little luxuries, may be 
both just and proper, by encouraging regular exercise of body 
and voluntary direction of the mental faculties, which become 
habitual, and therefore pleasant and salutary. 

It cannot be too often repeated that Nature, pitched out 
even by so rude a fork as insanity, constantly tends to return - 
and her plain indications may be often relied upon by the 
uninitiated, though they contravene doctrines announced as axi- 
omatic by the " professors." All agree that it is not right to 
thwart directly the inclinations of the insane, or to' force 
them to action when disposed to inaction; but still the prin- 
ciple holds, that efforts at self-control are exercises which tend 
to strengthen the enfeebled mind, and that patients should be 
encouraged to make them. 

It is true that, generally, we have rather to deal with deranged 
than with diminished mental energy, in cases of recent insanity. 
There is undue, involuntary, perhaps violent action of cer- 



1855.] SENATE— No. 1. 19 

tain faculties which disturbs the mental balance, and oversets 
reason. There is danger that, by mere force of habit, this 
undue action may become permanent, while by the same 
cause the inaction of other faculties may be confirmed ; and 
this is to be counteracted, while yet manageable, by strength- 
ening the weakened faculties, and reestablishing the balance. 
Constant and urgent inducement to action may therefore 
be usefully presented to the mental faculties and disposi- 
tions which are in abeyance, and new channels opened for 
the thoughts and affections. In a word, deranged habits of 
mind should not be left to grow worse by neglect; the 
patient should not be abandoned to blind chance, but roused to 
effort, and encouraged to sane mental exercise by succession of 
pleasant objects, and by agreeable pursuits, which occupy the 
mind without taxing or worrying it. 

For this purpose, places of recreation, games, workshops, 
gardens and the like, are to be provided in abundance and in 
variety. But especially should there be opportunity and induce- 
ments to engage in those tranquil and salubrious pursuits 
which a large and well-managed farm presents in greater 
variety and abundance than can be found elsewhere. 

There are facts in abundance to show that these things are 
most desirable and most useful in the cure and care of the 
insane. 

The value of the work done by the patients in the Worcester 
Hospital in 1853, when there was over 500 of them, was only 
$2,000, as estimated by the Superintendent. Only about one 
in five there does a moderate day's work. In summer time 
about one-quarter of the patients are said to do a moderate 
day's work ; in winter only about one-fifth. The Superintend- 
ent estimates that only $300 a year is saved to the Hospital 
by the aid which the men render, and only $700 by that of 
the women. 

The Reports of some of the British Hospitals furnish a 
striking contrast to this. In them, three-quarters of the patients 
are industriously and usefully occupied. Some of the details 
of their industrial pursuits show a striking contrast with ours, 
and are, moreover, interesting in a moral point of view. 

The Report of the Wilts County Asylum for 1852 says : — 
" The employment of the patients is an object of primary 



20 STATE LUNATIC HOSPITAL. [Jan. 

consideration. A large proportion of the men are engaged in 
agricultural pursuits." 

" Under the active and judicious superintendence of the 
matron, an increasing- majority of the female patients are occu- 
pied in the domestic labors of the kitchen, laundry and wards, 
and in needlework. The greater part of the bed and house 
linen has been, and is in process of being, made by the assist- 
ance of a single seamstress." 

The Report for 1852 says : " The original outfit of clothing 
was supplied by the Asylum for the North and East Ridings 
of Yorkshire, an institution in which the industrial system has 
been developed to the fullest extent, and where it was made 
entirely by the patients. This is probably the first instance of 
an asylum entering into a contract of such a kind. Great 
interest was excited among the patients, who were made aware 
that they were preparing clothing for another asylum ; and quite 
a sensation was manifested when two carts, laden with heavy 
bales of woollen clothes and shoes, shirts, and dresses for the 
women, left the rooms of North and East Ridings Asylum." 

Again: "during the year, all the clothing required for the in- 
creasing number of inmates has been made by the patients. 
In the tailors' and shoemakers' shops much work has been 
done, the amount of which will be seen in the tables appended 
to this Report. The female patients continue to be extensively 
engaged, under the direction of the matron, in the various 
services of the kitchen, the laundry, and the wards, and a large 
stock of clothing and bed linen has been made by them, 
assisted only by their ordinary attendants ; it not having been 
thought necessary to fill the place of the seamstress, who left 
her situation at midsummer. A further reduction in the staff 
of servants of the establishment has been effected by the dis- 
continuance of a second laundry-maid ; and, after some months' 
trial, the success of this plan may be considered as proved." 
Now, the Wilts County Asylum is not particularly distin- 
guished for industrial activity among English Hospitals. If 
the contract were made with some others, the inactivity which 
characterizes ours would be more striking. There employment 
is the rule, idleness the exception ; here it is the contrary. 
There activity well directed, begets salutary industry; here 
idleness undisturbed, becomes enervating sloth. It does not 



1855.] SENATE— No. 1. 21 

appear that the occupation of the patient retards cure ; but, on 
the contrary, the evidence of its good effects, in a salutary and 
curative point of view, is most abundant and convincing. 

The Trustees think that the Worcester Hospital may be 
greatly improved by more ample provision of means of indus- 
trial occupation in workshops and upon the farm, and that the 
present relief from the crowd (whose pressure has acted so un- 
favorably to all improvement) furnishes a good opportunity for 
introducing a better system of internal administration with this 
view. The Trustees would not have the Hospital converted 
into a workhouse. They would not enforce labor, or require it 
with any view to immediate pecuniary gain ; but they believe 
that the majority of the patients may be induced to do a con- 
siderable amount of useful work, and, at the same time, pro- 
mote their own health and happiness. 



HABITS OF THE PATIENTS. 

Following after this evil of inactivity, and probably aggra- 
vated by it, is the great prevalence of morbid appetites and 
filthy habits among the patients. This, too, is a matter re- 
specting which it is difficult to make comparisons with other 
hospitals ; but from all that can be learned by the Trustees, the 
proportion of what may be called morbidly filthy cases is 
uncommonly great in the Hospital at Worcester. Before the 
exodus to Taunton, nearly half the whole number were of 
this description, and the proportion is fearfully great even now. 
This is a delicate matter to touch upon in a public report ; 
nevertheless, it is an important one. It regards the comfort 
and well being of the patients ; it is an indication of the hy- 
gienic condition of the household, and of the degree of medical 
care bestowed upon it ; and to avoid mention of it on proper 
occasion would be squeamishness. 

By filthy patients is meant those who, if not watched and 
prevented, will besmear their persons with, and even swallow, 
substances the most disgusting to the natural taste. 

Now, all morbid appetites and unnatural habits are conse- 
quent upon, or certainly connected with, some derangement of 
the bodily functions ; and though the derangement may be of 
special or minute parts of the nervous system, or even of 



22 STATE LUNATIC HOSPITAL. [Jan. 

intangible, and as yet obscure magnetic agencies, si ill, beyond 
a peradventure, it must be increased or diminished by the 
varying conditions of the great organs whose functions seem 
to be more under our cognizance and control. A lunatic may 
tell a hawk from a handsaw after supping on dry toast, but be 
perplexed by their resemblance after minced pie. A suicidal 
patient may be content to live through the night if he has 
eaten the one, but be looking after razors and ropes if he has 
swallowed the other. In the same manner, the distortion of 
tastes, which makes things seem comely and desirable that 
are usually offensive and repulsive ; the inversion of natural 
tendencies which makes filth pleasanter than cleanliness ; and 
the perversion of appetite that renders substances palatable 
which are usually disgusting — these must be more or less 
salient, according to the condition of the bodily health of the 
sufferer. In all these matters there is great room for improve- 
ment ; and the relief given by the reduction of the number of 
patients, by improved ventilation, and by the greater amount 
of medical and moral care which can be given by the Super- 
intendent to each case, will probably bring it about. This 
naturally leads to notice of the 

DUTIES AND CARES OF THE SUPERINTENDENT. 

It seems to the Trustees that too much labor and responsi- 
bility, aside from his medical duties, have devolved upon the 
Superintendent of this Hospital. Eight hours a day of such 
close study as a careful physician ought to bestow upon the 
malady of his patients, is surely as much as a man of ordinary 
powers can bear, and wear well. But eight hours divided among 
the patients of this Hospital, when it is crowded, would give 
but about three-quarters of a minute to each, supposing not a 
second to be lost in passing from one to the other ; and it would 
give only about a minute and a quarter to the present number. 
But, in reality, with all possible diligence, not one minute 
could be given to each case. 

It is commonly thought, that since most of the patients in a 
public hospital are chronically insane, and since their condition 
does not vary from day to day, all that the physician has to do 
is, to assure himself of their presence and safety by a glance at 



1955.] SENATE— No. 1. 23 

them as he walks through the wards. But every day effects 
changes, more or less considerable, r in every organized body 
and there are exceptional cases in which, by some extraordi- 
nary revolution in the system, reason is restored in the most 
unexpected manner. These changes may come at any time ; 
and they should be watched for, in order that the curative 
tendency may be favored. It should be assumed that they 
may happen to each and every patient, however old and 
desperate his malady. As the anxious parent clings to hope 
so long as there is a spark of life in a child's body, so the 
physician of a hospital for the insane should hold that there 
is a hope, because a possibility, of each patient's restoration 
to reason. He should bear in mind that each one is some- 
body's beloved child, or parent, or relation ; or, if not, then 
that he is doubly unfortunate, and should, therefore, be doubly 
interesting to him. 

Besides, there are many patients who will not speak of any 
pain or suffering which they may be undergoing ; and some 
who cunningly conceal it. Certainly, therefore, the physician 
should make frequent personal observation of each, and es- 
pecially of those cases where the patients are too much 
demented to seek relief of their own accord, even when suffer- 
ing ever so much. But if we allow that five minutes should 
be given to each case, the physician would have to labor ten 
hours daily in order to attend to each patient three times a 
week. It is true, he has his assistants ; but his ablest and 
most trusty assistants are his own senses, and upon them he 
must mainly rely. 

Such calculations of the division of time cannot, indeed, 
be very accurate or valuable; for some physicians have a natu- 
ral quickness of perception, so sharpened through practice, that 
a patient's condition is seen at a glance, as by a flash of rev- 
elation. They have the intuition of genius. But surely, after 
making every allowance, it must be admitted that the proper 
medical care of the individual patients, — the regulation of their 
diet and regimen, — the contrivance of their amusements and 
occupations, and the general oversight of the moral condition 
of the great household — these things are enough to occupy 
fully and worthily the time and the energies of one man. 

But, besides these duties, many others are imposed upon the 



24 STATE LUNATIC HOSPITAL. [Jan. 

Superintendent by the statutes, or have devolved upon him by 
the common law of custom. He has to carry on the extensive 
correspondence of the Hospital ; and much of this he cannot 
do by deputy. He", virtually appoints, and is responsible for, 
the Assistant Physicians, Steward and Matron. He directly 
appoints, and is responsible for, the Clerk, Apothecary, Super- 
visors of Departments, Overseers of the Wings, Overseers of the 
Laundry, Bakery and Workhouse, Watchman, Farmer, and all 
necessary Attendants in the galleries, laundry, bakery, kitchen, 
workshops, and on the farm. He must " see, constantly, that 
all persons thus appointed by him, and also all subordinate 
officers appointed by the Board, perform, faithfully, the duties 
required of them ; and from time to time he shall give them 
such instructions as he may deem necessary to secure the 
exact and thorough performance of their respective duties." 

But, besides all this, the physician is, virtually, head of the 
Steward's Department, and does a great deal of duty in other 
departments which require much thought, and of course, divert 
much of his power from his more legitimate field of action. 

Now, much of this labor and responsibility ought to be, and 
may be, spared to the Superintendent, and still a great deal 
will remain. The " one-man power " must be maintained in 
such an establishment. The Superintendent must be the real 
head of the household, and have patriarchal power ; hence the 
obvious necessity of so restricting the number of patients that 
he can have daily and intimate knowledge of their individual 
condition, and time and strength left to make all the necessary 
provisions for their safety, comfort and cure. To gather into 
this Hospital, therefore, more than twice as many patients as 
can be thus carefully, properly and faithfully treated, is justifi- 
able on no ground but that of stern necessity, which the State 
cannot plead. To gather into it any more is unwise. It is 
not even justifiable on the ground of economy ; for in this mat- 
ter of care and cure of the insane, as in other matters, the best 
way is the cheapest. It is the way that the men of Massa- 
chusetts manage their individual business. In their banks, 
manufactories, and workshops, they do not burden their cash- 
iers, agents and overseers, with such a load of business that 
some part of it must be slighted, some neglected, and all of it 
done hurriedly ; and they should not so burden the Superin- 



1855.] SENATE— No. 1. 25 

tendents of their Hospitals. To attend to two hundred patients 
faithfully and efficiently is good work for a good man ; to 
attend to two hundred and fifty will tax the energies of the 
best one to the uttermost. More than this one man cannot do, 
and do well ; and let not Massachusetts require him to make 
the vain attempt. 

MECHANICAL RESTRAINT AND SECLUSION OF PATIENTS. 

The sight of scores of men and women confined in cells, 
dignified by the name of strong rooms, or restrained in the use 
of their limbs by mechanical contrivances, has long constituted 
the most melancholy feature of this Hospital. In the mind of 
the visitor who doubted the necessity of this rude method of 
treatment, and who suspected that its adoption was the result 
of a parsimonious selection of the cheapest rather than the 
best method, the melancholy was not unmingled with sterner 
feeling. 

There is about the insane a helpless dependence that is 
more touching even than that of woman ; so that the unneces- 
sary abridgment of their personal freedom, or the needless 
diminution of their remaining means of enjoyment, is a wrong 
which, if done with intent, or through unworthy motives 
should meet with indignant reprobation. It has been done in 
this Hospital partly through a supposed necessity, and partly 
in consequence of the crowd of patients forced into it. It is 
still done in other public institutions where the insane are con- 
fined, and the matter therefore, should, in every possible way, 
be brought before the public ; and appeals should be made to 
the intellect and the conscience of the people, until the wrong 
ceases. 

The assertion, that public opinion in New England is less 
enlightened than that of Old England with regard to the 
treatment of the insane, may seem strange, but nevertheless it 
is true. It is true, moreover, that here, in Massachusetts, prac- 
tices are tolerated in some institutions* where the insane are 
kept, which would there be indictable at common law, as will 
be shown presently. 

There are in the Worcester Hospital forty-eight " strong 

* There are 23 insane persons confined in prisons in Massachusetts, and 152 under 
charge of jailers. 

4 



26 STATE LUNATIC HOSPITAL. [Jan. 

rooms," or rather cells. They are built of stone or brick, pre- 
cisely like prison cells, with grated doors and windows, aper- 
tures for putting in food, taking out vessels, &c. They are 
so contrived that they can be easily warmed and cleansed 
from filth that offends the eye, but in all other respects they 
are unfit abodes for human beings. The older ones are per- 
fectly detestable. Opened to the more enlightened moral sense 
of this day, they seem like the relics of a comparatively barba- 
rous age. Well might the Trustees, in the Report of last year, 
ask, " How is it possible that the furious, the violent, the inde- 
cent should ever be restored while occupying apartments unfit 
for the abodes of dumb beasts ? " They might have added, 
that any sane man, unless an eminent non-resistant, would 
become " furious and violent " by being placed therein. 

Even those cells constructed at so great cost within a few 
years, are not fit habitations for the worst maniac, because 
they needlessly aggravate his malady and his misery. They, 
too, are stone cells, with iron doors and grated windows. 

These cells have been almost continually in use since they 
were built ; and when the Hospital was as crowded, as it some- 
times has been, their use has doubtless seemed absolutely 
necessary. 

So many unfortunate men and women have been shut up 
in them year after year, and so many others have been restrained 
by mechanical contrivances, that such imprisonment and re- 
straint have come to be considered as matters of course in 
the treatment of the insane by official and unofficial visitors, 
by legislative committees, and, to a certain extent, by the pub- 
lic at large. 

Now, it can be shown that neither "seclusion" nor "re- 
straint " of insane persons is necessary, saving in rare and 
exceptional cases, and then only for short periods of time 
and in ordinary rooms ; first, by general reasoning ; second, 
by experience in other places ; third, by experience here at 
home within the last year. 

First, as to the general reasoning. " Seclusion " of an insane 
person is a dainty word for expressing his imprisonment in a 
cell. Restraint is a dainty substitute for fettering his hands 
or feet, or both, the fetters being of leather instead of iron. 

Insanity, as was remarked before, deranges, but does not 



1855.] SENATE— No. 1. 27 

alter, the nature of men. It often merely intensifies certain 
modes of mental action. It is especially apt to intensify the 
lower and peculiarly selfish propensities. In dealing with 
insane emotions and passions, we have often to deal with sane 
ones merely raised to a higher power. 

Human nature continues to pervade the motives, though the 
actions be ever so extravagant ; as gravity pervades particles of 
matter that may be forced upwards or sideways by disturbing 
forces. We are to consider that opposition provokes to attger, 
and that the soft answer turns away the wrath of insane as 
well as of sane men. We are to consider the principle, that 
whatever directly represses the individuality ; whatever restrains 
the personal liberty; especially whatever restrains the freedom 
of motion and locomotion, instantly excite opposition, temper 
and rebellion. This is a sort of oppression of individual right 
and freedom, which the most dull or deranged intellect can 
feel, and which every one instinctively resists. 

It is amazing how contentedly and unconsciously men bear 
oppression, if their arms, legs and tongues are free. A man 
who was sitting contentedly in a room immediately desires to 
go out if any one locks the door. A man who never cared to 
leave his quarter of the town, if put under arrest, at once wants 
to break the jail limits, though they are as extensive as the 
whole county. If the Legislature should enact that no inhab- 
itant of Massachusetts should leave the State under heavy 
penalties, there would be a rush of men, women and children 
towards the borders. 

The more directly restraint affects the person, the more 
feeling and opposition it excites. A man who would only be 
indignant if confined in a room, is furious if his hands are tied, 
A woman who would only scold and fret at the imprisonment, 
would scratch and bite at the bonds. An angry man whose 
doubled fist would be dashed into any face that wore a look of 
defiance, is soon calmed by a placid smile. 

Now, the natural supposition is that people are not utterly 
changed in these respects by insanity. So long as the senses, 
are unimpaired, and the perceptive faculties, or any of them, 
are active ; so long as any reason remains, (and its light is sel-. 
dom entirely quenched,) so long must men be more or less 
subject to the ordinary laws of humanity. 



28 STATE LUNATIC HOSPITAL. [Jan. 

Secondly. Abundant recent experience confirms the infer- 
ence that would be drawn from a priori reasoning, and proves 
that forcible restraint of insane persons usually does more harm 
than good, and is very seldom necessary. Indeed, the great 
modern reformation in the treatment of the insane is founded 
upon this idea. The heroic Pinel confided in it. Having with 
difficulty got permission from the timid authorities, who proph- 
esied all sorts of evil, he first made what was deemed the peril- 
ous experiment. He went to the cells of the great Parisian 
madhouse, where furious men were struggling with their 
chains, striking at whoever approached the gratings, spitting 
at them, and yelling themselves hoarse with curses and impre- 
cations. He boldly entered, and having charmed and calmed 
the maniacs by his gentle but firm bearing, he struck off 
their fetters. The prisoners were amazed at the sudden recov- 
ery of freedom, and at the unexpected fact that no one would 
fight or oppose them, and they soon became appeased and 
quiet. They did not abuse, nor even care to exercise their 
freedom, but soon yielded to that common instinct of human- 
ity which is seldom lost, even through insanity, — the instinct 
which leads us in childhood, in sickness, in prostration, when- 
ever, in short, we are conscious of inability to guide ourselves, 
then to seek the guidance of others, and, if the guidance can- 
not be found in men, to seek it of God. 

A reform was commenced at once ; and though it has been 
obstructed, and occasionally retarded, as all reforms are sure to 
be by timid conservatism, it has been carried on with the most 
blessed results. In all civilized countries the reformation was 
hailed with pleasure, and in all its principles were admitted to 
a certain extent ; though practiced upon far more heartily and 
fully in some than in others. 

In some British hospitals the reform became a complete 
revolution, and all forcible mechanical restraint of patients 
and all seclusion were completely discarded. Their example 
has been virtually followed by some hospitals in this country. 
In others the principle of the reform was not admitted with 
full faith, and there the old usages were clung to, or given up 
grudgingly and by halves. The old cages were improved a 
little, and called " strong rooms ;" and the iron chains were re- 
placed by leathern straps. 



1855.] SENATE— No. 1. 29 

There was a conflict of opinion and of words. The force 
of reasoning and the weight of evidence soon seemed in 
favor of an almost complete reliance upon moral means, 
and an almost complete abandonment of forcible restraint 
and seclusion, in the treatment of the insane. Still, how- 
ever, this " almost " left a wide margin for variety of prac- 
tice in different hospitals, and for honest differences of opinion 
as to the degree in which the principle of non-restraint, as it 
was called, could be safely acted upon. In this, as in all 
similar matters, men's judgments were unconsciously affected 
by their character. Bold and hopeful reformers went forward ; 
cautious and doubting conservatives held back. 

The British Commissioners in Lunacy, conscious of the 
vital importance of this matter, issued circulars to the Super- 
intendents of public and private hospitals in the kingdom, 
asking for the result of their experience in regard to it. The 
answers are from one hundred and eighty-one institutions, and 
embody a vast amount of interesting and important informa- 
tion. In June, 1854, the Commissioners made their Report, 
which concludes thus : — 

" As the general result which may be fairly deduced from a careful examination 
and review of the whole body of information thus collected, we feel ourselves fully 
warranted in stating, that the disuse of instrumental restraint, as unnecessary and 
injurious to the patients, is practically the rule in nearly all the public institutions 
in the kingdom, and generally also in the best conducted private asylums, /even 
those where the ' non-restraint system,' as an abstract principle, admitting of no 
deviation or exception, has not, in terms, been adopted. 

" For ourselves we have long been convinced, and have steadily acted on the 
conviction, that the possibility of dispensing with mechanical coersion, in the man- 
agement of the insane, is, in a vast majority of cases, a mere question of qxpense, 
and that its continued or systematic use, in the asylums and licensed houses where 
it still prevails, must, in a great measure, be ascribed to their want of suitable space 
and accommodations, their defective structural arrangements, or their not possessing 
an adequate staff of properly qualified attendants, and frequently to all these causes 
combined. j 

" As respects the question of seclusion, it will be seen, upon a pertisal of the 
statements in Appendix (G,) that its occasional use for short periods, chfcfly during 
paroxysms of epilepsy or violent mania, is generally considered beneficed. 

"At the same time, we would observe, that the facilities which seclusion holds 
out to harsh or indolent attendants, for getting rid of and neglecting 'xoublesome 
patients under violent attacks of mania, instead of taking pains to soothe their 
irritated feelings, and work off their excitement by exercise and chmge of scene, 
render it liable to considerable abuse ; and that, as a practice, it is oppn, though in 
a minor degree, to nearly the same objections which apply to the ijtore stringent 



30 STATE LUNATIC HOSPITAL. [Jan. 

forms of mechanical restraint. We are, therefore, strongly of opinion, that, when- 
ever seclusion is resorted to as a means of tranquillizing the patient, it should only 
be employed with the knowledge and direct sanction of the medical officers, and 
even then be of very limited duration. 

" Further experience, we think, has shown that, except for the reception of epi- 
leptic patients during the continuance of their paroxyms, and, in a few cases, where 
there is a determined propensity to suicide, the utility of padded rooms is not so 
great as was at one time supposed, and that, for cases of ordinary maniacal excite- 
ment, seclusion in a common day- room or sleeping-room of moderate size, from 
which all articles that might furnish instruments of violence or destruction have 
been removed, and v/hich is capable of being readily darkened, when required, by 
a locked shutter, will, in general, be found to answer every useful piirpose." 



In many American hospitals the principle of " non-restraint " 
has been acted upon wisely, though without that attachment 
to a theory which leads some to forbid a resort to any mechan- 
ical restraint or forcible seclusion, even in those rare but not 
unknown cases which are manifestly benefited by their prudent 
use. 

The Trustees have long regretted that circumstances did 
not permit the adoption of this reform as fully at Worcester as 
in other 'American hospitals. 

A Corhmittee of the Board last year visited nine hospitals 
or : of Nkw England, and there found that, taking the whole 
number f patients, only one in three hundred was confined in 
a sfccong room, while at Worcester more than ten times that 
pre portion of patients were so confined. There were less than 
six : undre.'l patients ; and yet the forty-eight strong rooms were 
■ almost continually used for the forcible seclusion of men and 
womm, many of whom were raving, and whose wretchedness 
was toubtJess increased by their imprisonment and restraint. 

Thi records of the Trustees will show how often and how 
strong y they have denounced these rooms as unfit places of 
habitation. But there was always a crowd of patients within 
the Ho jpitai , and more pressing for admission. Those in charge 
deemed it n. ;ssary to use these rooms. Still, therefore, men 
and w >rien were thrust into them, and made more furious by 
the cos nement; and still many others were restrained by 
straps a vl various mechanical contrivances, who might have 
had'- fret " ! m: < motion, and the use of their limbs, if sufficient 
space a, ' suiij lent means of medical and moral treatment 
had been -,\t command, and if there had been fuller faith in 




1855.] SENATE— No. 1. 31 

the efficacy of milder measures. The principal evil, and that 
which seemed to justify the use of so much seclusion and re- 
straint, was the crowd of patients. Of this evil, the Trustees 
and the Superintendent have complained, as often and as 
loudly as seemed becoming and proper to do. 

In 1853, the crowd was so great, and the danger of an epi- 
demic so imminent, that a vigorous effort was made by the 
Trustees to lessen the number, by summarily discharging one 
hundred patients, and throwing them back upon the town 
authorities. This, however, caused so much opposition, so 
much complaint, and so much real distress, that it was not 
persevered in long. 

Thirdly. An opportunity has been furnished during-^he last* 
year of showing here at home, by actual experiment, and 
beyond all possibility of doubt or cavil, that the imprisonment 
and restraint of insane persons, as practised at Worcester for 
so many years, was not necessary for their proper care and. safe-_ 
keeping. During the months of January, February and March, 
there had been sixty-six patients confined in the " strongrooms," 
twenty-one of them during the whole time, thirty-three nearly 
half the time, the others during various periods from a day to 
a month. 

In April, two hundred and ten patients were removed to the 
new hospital at Taunton. The patients selected were those 
whose homes were in the neighborhood of Taunton, and not 
those who were most troublesome. By reason of qne of those 
curious circumstances which, if unnoticed, defeat statistical 
calculations, it so happened that only a few of them were 
of that violent class whom it had been deemed necessary 
to confine at Worcester. Still, however, the change in their 
condition, and consequently in their conduct, after arriving at 
Taunton, and enjoying the superior advantages of the new 
hospital, was most striking and most gratifying. Two hun- 
dred and two out of the two hundred and ten patients enjoyed 
the full liberty of the hospital, and the free use of their limb" 
from the moment of their arrival. Not a single one was 
fined in a " strong room." Nine were occasionally restrain 
by being shut up in their ordinary chambers, 6r wore the 
isole, or leathern straps, a few days at a time. One unfortu-^J 
woman only had to have her hands confined most of the til 



32 STATE LUNATIC HOSPITAL. [Jan. 

though even she is now free. Among the patients transferred 
were three who had been confined in strong rooms during the 
whole of the three last months passed in Worcester, and six 
who had been confined a third of the time. Now, every one 
of these men were left perfectly free, and have remained so, 
and have done no harm to themselves or others. 

These facts, added to that of the confinement in prisons of 
so many lunatics innocent of crime, prove the truth of what 
was said above, that Massachusetts has been and is treating 
lunatics in a manner that would be indictable at common law 
in England. 

In 1853, a man named William Robert was tried at the 
Carnarvonshire Summer Assizes for having kept his brother, 
a lunatic, needlessly confined with a chain in a room about 
the dimensions of our strong rooms at Worcester. There was 
no cruel intent proved or even alleged ; there was no stint of 
food ; the man was in good health, and fat ; he was kept as 
well, perhaps, as his relatives knew how to keep him ; and yet 
Robert was found guilty of " unlawfully confining and 
imprisoning his brother in an improper, excessive and cruel 
manner," and he was himself condemned to one month's 
imprisonment. 

Lord Chief Justice Campbell, in his charge to the jury, dis- 
tinctly stated the principle, that the use of restraint greater in 
degree, more severe in character, or longer in duration, than is 
necessary for the security and care of a lunatic, is an offence 
at common law, and indictable as such. 

Massachusetts is a sovereign State, and will not answer 
the summons of any earthly court. She cannot be mulcted in 
damages ; and there is no prison large or strong enough to hold 
her. But there is a higher court before which she is arraigned 
continually ; whose sentence she cannot escape ; but which she 
must execute upon herself. The plea, that she had no cruel 
intent, will avail but little, and that of ignorance can no longer 
be made. If, in her hospitals, jails, houses of correction, and 
almshouses, the helpless insane continue to be subjected to 
greater privation of freedom and to greater suffering, than are 
absolutely necessary for their care and safekeeping, she will 
be continuing in wrong doing, and must suffer the heavy pen- 



1855.] SENATE— No. 1. 33 

alty of a condemning conscience, or the heavier penalty of 
lack of conscience to condemn. 

The Trustees, anxious to prevent any relapse into the old 
system, under any pressure of a crowd, or under any supposed 
necessity, and aware, moreover, of the temptation which the 
existence of " strong rooms " offers to attendants to get rid of 
the trouble of watching patients, by confining them under bar 
and bolt, have directed the demolition of most of these offen- 
sive cells, and the construction of comfortable sitting rooms in 
their place. They trust that their successors will persevere in 
the work, and that, in future, no seclusion and no mechanical 
restraint will be used here, for the treatment of the insane, 
except in those rare cases where solitude is required, or where 
the patient must be restrained, either by men's hands or by 
instruments, and in which the latter is the least objectionable. 

REMEDY FOR DEFECTS. IMPROVEMENTS, ETC. 

The Trustees having thus commented upon several imper- 
fections of the Hospital, without, however, exhausting the 
subject, may, of course, be expected to propose some effectual 
remedy therefor. This they did in a memorial to the legisla- 
ture at its last session. To this memorial they now refer, with 
the remark, that additional experience, observation and reflec- 
tion, have confirmed them in the opinions there set forth; 

They showed that there are many important defects in the 
establishment, which are radical and irremediable, and which 
must embarrass those who administer its affairs, and prevent 
them from doing so much for the cure and care of the insane 
as they might otherwise do. 

First. That the site of the building has become a very un- 
favorable one, owing mainly to the rapid growth of the neigh- 
borhood. The once quiet village of "Worcester has become a 
busy manufacturing city, and is rapidly encompassing the 
Hospital. Roads, streets, and rail-tracks run in front and rear, 
and across the premises, so that the patients cannot go to walk, 
or ramble in the fields and woods,without crossing some of them. 
They cannot even stroll quietly in their own grounds and gar- 
dens with any privacy and quiet. They are subject to the 
observation of the curious, and the rudeness of the indiscreet 

Now, the noise and din, the hurry and bustle, of an enter- 
5 



34 STATE LUNATIC HOSPITAL. [Jaii. 

prising manufacturing town, the busy streets, the swift succes- 
sion of passers by, the rush of cars, and the shriek of steam 
whistles, may be pleasant and useful to certain patients ; they 
may furnish a desirable excitement ; but the Hospital should be 
so placed that such patients can have access to them, without 
being so placed that none can escape from them. 

Second. The memorial showed that the sewerage is very 
imperfect, and that, owing to the situation of the land, no fea- 
sible method had been found for carrying off the waste water 
from the building. This is received into the gardens ; and 
there some of it is absorbed, and some is evaporated, while 
some remains stagnant at certain seasons, so that the air must 
be more or less vitiated. 

Third. That the structure of the main building is, for this 
age, very bad. It has five kitchens, instead of one central one. 
It is inconvenient in many respects. It lacks the many con- 
veniences and appliances which experience has shown to be 
important in the administration of such establishments, and 
conducive to the comfort and well being of the patients. 
Owing to the want of height between the floors, and to other 
radical defects, it cannot be so modified as to meet the ad- 
vanced requirements of the times. 

Fourth. That the arrangements for ventilation were never 
sufficient, and that, owing to structural defects in the building, 
they can never be made so. There is not sufficient volume 
of air in the wards ; and it cannot be kept pure without 
changing it so rapidly as to create almost a gale of wind. 
The evil has been much lessened by arrangements adopted 
this season, but it cannot be completely abated. 

Fifth. That the arrangements for warming the building are 
imperfect and insecure. The building has already been on 
fire several times ! TJie risk of fire is still greater than pru- 
dent persons ought, unnecessarily, to run. It is greater than 
careful men of business would run in a manufactory filled 
with valuable merchandise. 

These reasons were deemed sufficient to warrant a recom* 
mendation to the legislature that the grounds and buildings 
should be sold, and a new building erected upon a suitable site 
in the immediate neighborhood. This recommendation the 
Trustees distinctly made, and they endeavored to enforce it by 
other considerations, such as that— "v 



1855.] SENATE— No. 1. 35 

First. If the old building is to be continued in use, the State 
is bound, by considerations of safety of the patients, to intro- 
duce a secure and efficient apparatus for warming. The best 
one yet tried, and which would be applicable to the building, 
is a steam apparatus, and this would cost from sixty to seventy- 
five thousand dollars. 

Second. The real estate of the present Hospital would sell 
for at least one hundred thousand dollars more than the cost 
of a suitable site for a building and a good farm in the neigh- 
borhood. There would be a saving of one hundred and sev- 
enty-five thousand dollars, so that there could be no weighty 
objection on the lower considerations of economy, to what 
is called for by higher considerations of humanity ; to wit, the 
erection of a new hospital in all respects Avorthy of the State. 

The Trustees might further enforce this recommendation by 
many considerations, the result of the last year's experience 
and observation, but they will close by quoting, from a high 
authority, a passage very much to the point. 

The Commissioners in Lunacy, in their last Report to the 
British Parliament, July, 1854, after speaking of their endeav- 
ors to improve the condition of hospitals, conclude thus : — 

" We regret to say that our endeavors in this respect are, in several of these in- 
stitutions, opposed by great difficulties, some arising from defects in the original 
construction of the buildings, and others from an adherence to certain errors in 
management and treatment, which, in the best conducted establishments for the 
insane, are condemned, and have now become obsolete. 

" Indeed, so formidable are the difficulties in the way of advancement, in old 
and badly situated hospitals, that, in those instances where improvements have been 
attempted, large sums of money have sometimes been spent without adequate results. 
In such cases, th& only effectual mode of overcoming all obstacles to improvement 
appears to be, to abandon the old buildings, and erect new 'buildings on eligible 
sites ; a course which has already been taken at Manchester and Stafford, and about 
to be adopted at Nottingham." : jfl 

In consequence of the memorial' of the Trustees, the legisla- 
ture, at its last session, arj^ointed a. Commission to consider the 
matter, and also to ascertain the number, condition and 
wants of the insane in the Commonwealth, and to report upon 
the subject generally. 

This Commission has performed its arduous task with re- 
markable skiU and success. There has, probably, never been 
collected, in any large community, such a mass of minute, 






36 STATE LUNATIC HOSPITAL, [Jan, 

thorough, and reliable information, concerning the number and 
condition of the insane, as has been gathered by this Commis- 
sion, excepting, perhaps, that gathered by the eminent Q,uete» 
let in Belgium. 

They have ascertained the names, age, sex and condition of 
over twenty-four hundred insane persons, and of more than 
one thousand idiotic persons. 

This information will soon be spread before the legislature? 
and will show the pressing necessity of further and immediate 
provision for the insane of the Commonwealth. 

The Trustees have had several interviews with the Commis* 
sioners, and, after earnest consideration of the subject, have 
coincided with them in the following conclusions :-— 

That there is urgent need of more accommodations for the 
insane, and that, therefore, a new Hospital should be erected 
immediately in the western part of the State. 

That the new Hospital should be constructed for no more 
than two hundred and fifty patients. 

That final action upon the question of the disposition to be 
made of the property at Worcester, and the erection of a 
new building in that neighborhood, (though the questions de- 
serve serious attention,) should be deferred until after the 
Western Hospital is completed. 

That further alterations and improvements shall be made in 
the old building, by means of funds now in the hands of the 
Trustees, and the inconveniences and evils be borne as they 
best can be, in view of their effectual remedy within a few 
years. 

It is partly in consequence of having come to these conclu- 
sions that the Trustees have directed several alterations and 
improvements in the old building and grounds. 

Respectfully submitted by 

S. G. nOWB, 
REJOICE NEWTON, 
JAMES B. CONGDON, 
LINUS CHILD, 
HENRY MORRIS, 

I Trustees. 
Worcester, December, 1854, 



1855.1 



SENATE— No. 1. 



37 



TREASURER'S REPORT. 



To the Trustees of the State Lunatic Hospital : — - 

The Treasurer respectfully reports : — 

That the balance of cash in his hands on the 
30th November, 1853, was 

Since which time to the 30th of November, 
1854, he has received 

From the Commonwealth, for the support of 

Lunatic Paupers, the sum of 
From cities, towns, and individuals, 
From the Steward of the Hospital, for articles 

sold, 

For interest on Worcester and Nashua Railroad 

Bond, a legacy of Ziba Storrs, ♦ 



$23,131 85 



19,108 84 

32,736 52 

344 27 

30 00 

$75,351 48 



The Expenditures of the year have been as 

For Wages and Labor, . 

Improvements and Repairs, 

Furniture, 

Clothing, 

Flour, 457 barrels, 

Rye and Corn Meal, 

Biscuit, 

Coffee, 3,691 pounds, 

Tea, 1,158 

Sugar, 25,549 » 

Rice, 2,701 

Molasses, 1,149 gallons, 

J3eef and Pork, 62,414 pounds, 



follows : — 




$11,543 


98 


3,645 44 


1,333 82 


1,626 


90 


4,820 12 


1,586 78 


236 


99 


494 


09 


387 


28 


1,760 


10 


139 


73 


351 


81 


4,845 98 



38 



STATE LUNATIC HOSPITAL. 



[Jan. 



For Fish, salt, 11,000 pounds, 
" fresh, 3,865 " 
Poultry, 670 pounds, 



Bacon, 5,470 " 

Potatoes, 1,885 bushels, 

Beans and Peas, 

Butter, 26,138 pounds, 

Cheese, 1,631 " 

Apples, 1,670 bushels, 

Dried Apples, 

Fresh Fruits, 

Small Groceries, Spices, &c, 

Vinegar and Cider, 

Lard, 1,329 pounds, 

Salt, $49.22 ; Saleratus, $37.21 

Wood, 278 cords, . 

Charcoal, 2,692 bushels, . 

Hard Coal, 1,577,420 pounds, 

Straw, .... 

Whale Oil, 

Lime and Cement, $73.57 ; Potash, $118.70, 

Starch, $29.20 ; Hops, $39.10 ; Soap, $42.63, 

Gas Light and Kepairs, .... 

Medical supplies, 

Postage, $40.26; Freight, $78.25, . 
Books, Stationery and Blank Books, 
Trustees' expenses, . . . 

Expenses charged to Patients, 
Expenses on account of Elopers, 
Sexton's bills, ...... 

Expense of removals to Taunton Hospital, 
2 Cows, $75 ; 3 pair Oxen, $430 ; pasturing, $25, 530 00 
Land purchased of Samuel Putnam, . 175 00 

Miscellaneous items, .... 125 61 



$402 49 

204 81 

73 70 

531 04 

1,273 99 

41 13 

4,958 58 

175 76 

836 13 

73 51 

211 36 

•108 54 

68 82 

155 89 

86 43 

1,982 50 

335 59 

5,544 65 

254 30 

151 91 

192 27 
110 93 
667 90 

193 46 
118 51 
181 46 
299 00 

72 47 

76 89 

170 15 

63 71 



Balance of Funds, 

Consisting of a note of the Mas- 
sachusetts Cotton Mills, dated 
July 11, 1854, , , , $15,000 00 



$53,221 51 
22,129 97 



1855.] SENATE— No. 1. 33 

Cash deposited in Worcester B'nk, $4,879 03 
Cash deposited in Central Bank, 2,002 02 
Cash in the Treasurer's hands, . 248 92 

$22,129 97 

In addition to which the Treasurer holds a bond 

of the Worcester and Nashua Railroad Co., . 500 00 



$22,629 97 

SAMUEL JENNISON, Treasurer. 
Worcester, December 20, 1854. 



Examined and found correct. 

JAMES B. CONGDON, Auditing- Committee. 
January 15, 1855. 



1855.] SENATE— No. 1. 41 



SUPERINTENDENT'S REPORT. 



Twenty-second Annual Report of the Superintendent to the 
Trustees of the State Lunatic Hospital. 

Gentlemen: — The interesting facts and e*vents that have 
occurred in this institution the past year are herewith presented. 
The health of the inmates generally has, perhaps, never been 
better. There has been but very little acute disease, and noth- 
ing like an epidemic, among our household. By the timely 
transfer, to the kindred institution in this State, of two hun- 
dred and ten patients, the remainder were saved from the 
contaminating influence of an excessively crowded house 
during the warm weather. By order of the governor, we con- 
veyed to the Second Hospital for the Insane in Taunton, on 
Friday, the 7th of April, and on each of the five succeeding 
Fridays, a car load of patients. By an arrangement of the 
railroads, an extra engine took a car filled with some thirty-five 
patients, and from two to five attendants, and ran to meet the 
connecting train. There was no accident, and, indeed, no dif- 
ficulty, in the transfer. The patients were mostly of a very 
orderly class, and they were gratified with the ride. The pa- 
tients selected by the Governor were those from that section 
of the State, and from the counties of Norfolk, Suffolk, and 
Middlesex — being one hundred and five of each sex. During 
this time, our number of patients was reduced from five hun- 
dred and fifty-nine to three hundred and forty-three. This 
reduction took off no more than the overplus, and left this 
Hospital quite full, but not crowded. The relief thus afforded 
us was seized upon to paint and fit up several of our wards. 
But more desirable to us than for any thing else, it gave us a 
possible chance to abandon nine strong rooms that had been 
daily used, ever since the institution was opened, for the vio- 
lent and filthy males, and also to disuse, forever I trust for that 
purpose, eight rooms in the basement of the north old wing, 
6 



42 STATE LUNATIC HOSPITAL. [Jan. 

for the same class of females. These seventeen rooms have 
not been occupied at all, for seven months past, by patients, 
but they have been converted to other uses. They were never 
proper for the purposes they were designed and put to ; and, 
of late years, they were used only from what we thought abso- 
lute necessity. 

Abandoning these ill-contrived rooms, and reducing the 
number of our patients to about the capacity of the institu- 
tion, has lessened our cares and responsibilities, while we have 
been enabled thereby to improve very materially the general 
appearance of the institution and condition of its inmates. 

The improvement in the ventilation, which, under the direc- 
tion of the Hon. Jonathan Preston, has, in part, been effected, 
and which will soon be finished, will render our wards still 
more healthful and pleasant. We know that one fruitful 
source of the just odium this Hospital has received the last 
year or two arose, in a great degree, from its crowded wards, 
another from its defective ventilation. The atmosphere of 
apartments occupied by the healthy, we all know, becomes 
vitiated soon, unless frequently changed. The air of the wards 
of hospitals becomes vitiated, not only by respiration, but by 
diseased secretions of the sick. At this Hospital, the same 
room that is used as the sitting-room by day is made the dor- 
mitory at night. The means of ventilating the sleeping apart- 
ments in this Hospital are undoubtedly much more ample 
than they are in the greater part of the private dwellings in 
this State. But still, for a hospital, the means here are de- 
ficient. Besides the window in each room, these means of 
ventilation consist of an opening over the door, about eight 
inches by thirty, into the gallery, into which the warm air of 
the furnaces is diffused. Leading from each room, ventiducts, 
opening in the attics, are constructed in the partition walls. 
These ducts are about four inches square. In most of the 
rooms there are two of these ducts — one from near the bottom, 
and one from near the top. In those rooms that have but one 
duct, that one is about four inches and a half square. This 
improvement consists in continuing these ventiducts as they 
come up to the attic, each story by itself, in wooden boxes, 
into a main shaft near the chimney, into an enlargement of 
which, recently altered for that purpose, this main shaft enters, 



1855.] SENATE— No. 1. 43 

and there the foul air from the rooms below comes in contact 
with the nine-inch cast-iron smoke-pipe of the furnace in the 
basement. Where it was not convenient to collect these ducts 
into a brick chimney, Collins's Ventilators, thirty inches in 
diameter, have been placed on the roof for that purpose. Here- 
tofore, the foul air that came up through these ducts into the 
attic diffused itself through the whole attic, seeking an open 
window to escape, or to find another duct in which the current 
was reversed by some means. It has been not at all uncom- 
mon to find the current up in one duct, and down another, in 
the same wing of the Hospital at the same time. When the 
wind is strong against one side of the Hospital, and windows 
open on the opposite side, it is not unfrequent that the air 
rushed up the windward ducts, and down the leeward ones. 
In ducts in the outer walls of brick buildings, the current of 
air in winter is often down, and in summer up ; because, in 
winter, the walls and ducts are colder than the air inside, and 
in the summer the duct is often warmed by the direct rays of 
the sun on the outside, and the air in the duct is rarefied and 
raised. The internal partitions, when of brick, become colder 
in summer than the surrounding atmosphere, and condense 
it, and the current in flues in them is often down. The 
smell of soot, from chimneys unused in summer, is from the 
same cause. It is supposed that this change in the mode of 
ventilation will increase the quantity of foul air that will pass 
off, by increasing the currents, and render less liable the foul 
air to return to the wards again after it has been carried to the 
attics, by conveying it more directly to the Collins's Ventilators 
or to the tops of the chimneys. The foul air, after it gets into 
the chimneys, comes in immediate contact with the cast-iron 
smoke-pipe, which, by its heat of the furnace for six months or 
more in the year, will keep up a constant current upwards in 
the ducts below. The external winds, the harder they strike 
upon the Collins's Ventilators, will so much the more increase 
the currents in those ducts that are collected in them. The 
fixtures described above refer to the ducts that start from the 
bottom of each room. The flues that start from the top of 
the rooms open into the attic yet, and in extreme cold weather 
will be closed, to enable us to warm the wards sufficiently. 
All the water closets recently renewed are ventilated down- 



44 STATE LUNATIC HOSPITAL. [Jan. 

wards, which is also a decided improvement upon the old 
movable pan. One new sewer has been laid down, and an- 
other has been covered over a hundred feet farther from the 
building. Other of the drains need covering, which can be 
done early in the ensuing spring ; when, also, the piggery should 
be removed, from the place it has occupied for twenty -two 
years, to one more remote from the buildings. When the wind 
is easterly, these pens have been offensive from their proximity. 



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56 



STATE LUNATIC HOSPITAL. 



[Jan. 



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68 



STATE LUNATIC HOSPITAL. 



[Jan. 



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1855.1 SENATE— No. 1. 69 



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70 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 1, 

Showing the Admissions from each County the last and previous 
i years. 





1834. 


Previously. 


Total. 


Barnstable,. 


. Males, 
. Females, 


. 3 

. 2— 


5 


115 


120 


Berkshire, . 
it 


. Males, 
. Females, 


. 7 
. 2— 


9 


144 


153 


Bristol, 


. Males, 
. Females, 


. 2 
. 3— 


5 


275 


280 


Dukes, 


. Males, 
. Females, 


. 1 
. 1— 


. 2 


17 


19 


Essex, 


. Males, 
. Females, 


. 12 
. 22— 


34 


535 


569 


Franklin, . 


-. Males, 
. Females, 


. 1 
. 5— 


6 


102 


108 


Hampden, . 
u 


. Males, 
. Females, 


. 7 
. 9— 


16 


236 


252 


Hampshire, 

u 


. Males, 
. Females, 


. 4 
. 3— 


7 


181 


188 


Middlesex, . 

u 


. Males, 
. Females, 


. 24 
. 14— 


38 


524 


562 


Nantucket, . 


. Males, 
. Females, 


. 1 

. 0— 


1 


30 


31 


Norfolk, > . 
\ « 


. Males, 
. Females, 


. 7 
. 9— 


16 


541 


557 


Plymouth, . 


. Males, 
. Females, 


. 2 
. 3— 


5 


217 


222 


Suffolk, . 

u 


. Males, 
. Females, 


. 18 
. 45— 


63 


464 


527 


Worcester, 
u 


. Males, 
. Females, 


. 35 
. 57— 


92 


1,067 


1,159 


Other States, 


. Males, 
. Females, 


. 
0- 


- 


10 


10 




299 

i 


4,458 


4,757 



1855.] SENATE— No. 1. 71 

More than one-third of this year had passed before any of 
the commitments were diverted from this hospital to the new- 
hospital in Taunton ; hence our books show some admis- 
sions from the counties in that section of the Commonwealth. 
It is probable that hereafter there will be but few, if any, sent 
here from that part of the State, although there is nothing in 
the laws, I believe, by which judges are required to commit 
.the insane to that hospital rather than this. That point was 
undoubtedly left unsettled purposely, that the friends of the 
patient might make their election between the two institutions. 
The laws give the governor authority, from time to time, to 
equalize, if need be, the relative numbers in the two hospitals, 
by transferring such patients from one to the other as he shall 
see fit. 



72 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 2, 

Showing the Admissions and State of the Hospital from Dec. 
1, 1853, to Nov. 30, lj354. 



Patients in the Hospital December 
1, 1853, . . .520 

Males, . . 266 

Females, . . 254 

Patients admitted in the course of 
the year, . . . 299 

Males, . .125 

Females, . . 174 

Whole number in the Hospital in 
the course of the year, . 819 
Males, . . 391 

Females, . . 428 

Patients remaining in the Hospi- 
tal November 30, 1854, . 381 
Males, . . 193 
Females, . . 188 



Of the admissions, there were 
cases of less duration than one 
year, . . . 140 

Males, . . 55 

Females, . . 85 

Of the admissions, there were 
cases of one year or more, . 114 
Males, . . 50 

Females, . . 64 

Cases the duration of whose in- 
sanity before admission not as- 
certained, . . .45 
Males, . . 17 

Females, . ., ' 28 



Patients committed by the Courts,'230 
Males, . . 87 

Females, . . 143 



Committed by the 
the Poor, 
Males, » 
Females, . 



Overseers of 

34 
23 



57 



Committed on the warrant of the 
Governor, 

Males, . . 4 

Females, . . 8 



12 



Foreigners, and those who have 
no legal settlement in this 
State, admitted during 
year, 

Males, 

Females, . 



the 

41 

84 



Foreigners and those having no 
legal settlement in the State 
discharged during the year, 
Males, . . 67 

Females, . . 113 

Those having no legal settlement 
in this State, remaining in the 
Hospital November 30, 1854, 
Males, . . 67 

Females, . . 84 



125 



180 



151 



State Paupers remaining in the Hos- 
pital at the end 1 of each year, as 
near as they can be ascertained : — 



1842, 


34 


1843, 


38 


1844, 


38 


1845, 


57 


1846, 


52 


1847, 


121 


1848, 


150 


1849, 


, 167 


1850, 


181 


1851, 


208 


1852, 


241 


1853, 


216 


1854, 


151 



1855.1 



SENATE— No. 1. 



73 



Continuation of TABLE 2. 
Irish. 





1846. 


1847. 


1848. 


1849. 


1850. 


1851. 


1852. 


1853. 


1854. 






K 




0) 




to 








OJ 




& 




M 




M 




M 




Total. 




1 


o 

Eh 




03 

O 


a 


o 
H 


A 


o 


a 
o 
03 


03 

o 


A 
o 

03 


03 

O 

H 




03 

o 
Eh 


a 


o 
H 


Si 


o 
Eh 




Admissions : — 






































Recent cases, 


- 


13 


- 


8 


- 


16 


- 


24 


- 


18 




16 


_ 


30 


_ 


34 


_ 


46 215 


Males, . 


6 


- 


2 


- 


7 


- 


12 


- 


7 


- 


5 




6 


_ 


8 


_ 


10 


I 


Females, 


7 


- 


6 


-» 


9 


- 


12 


- 


11 


- 


11 


- 


24 


- 


26 


- 


36 






Chronic cases, 


_ 


1 


_ 


15 


_ 


5 


_ 


12 


_ 


11 


_ 


14 


_ 


17 


_ 


17 


_ 


26 


118 


Males, . 


1 


- 


6 


- 


3 


- 


4 


- 


2 


- 


6 


- 


8 


_ 


3 


_ 


7 






Females, 


- 


- 


9 


- 


2 


_ 


8 


_ 


9 


- 


8 


_ 


9 


_ 


14 


_ 


19 






Duration of Insan- 








































ity Unknown, 


- 


11 


- 


15 


- 


11 


_ 


10 


- 


19 


- 


19 


_ 


22 


_ 


20 


_ 


24 


151 


Males, . 


7 


- 


9 


- 


6 


_ 


5 


- 


14 


- 


9 


_ 


10 


_ 


6 - 


6 






Females, 


4 


- 


6 


- 


5 


- 


5 


- 


5 


- 


10 


- 


12 


- 


14 


- 


18 






Totals, . 




25 




38 




32 




46 




48 




49 




69 




71 




96 


484 


Discharged: — 


1 


1 




































Recovered, 


- 


6 


- 


13 


- 


13 


- 


16 


- 


21 


- 


17 


- 


19 


_ 


32 


_ 


33 


170 


Males, . 


3 


■- 


9 


- 


9 


- 


10 


- 


9 


- 


3 


- 


6 


_ 


10 


_ 


10 




Females, 


3 


- 


4 


- 


4 


- 


6 


- 


12 


- 


14 


- 


13 


- 


22 


- 


23 




Died, 


_ 


4 


_ 


2 


_ 


5 


_ 


4 


_ 


11 


_ 


4 


_ 


12 


_ 


12 


_ 


9 


63 


Males, . 


2 


- 


- 


- 


1 


- 


1 


- 


5 


_ 


2 


— 


5 


_ 


3 


_ 


4 






Females, 


2 


- 


2 


- 


4 


- 


3 


- 


6 


- 


2 


- 


7 


- 


9 


- 


5 






Otherwise, 


_ 


2 


_ 


2 




3 


_ 


9 


_ 


3 


_ 


6 


_ 


25 


_ 


22 


_ 


83 


155 


Males, . 


1 


■- 


- 


- 


1 


- 


4 


- 


- 


- 


5 


_ 


9 


_ 


2 




32 






Females, 


1 


- 


2 


- 


3 


- 


5 


- 


3 


- 


1 


- 


16 


- 


20 




51 






Totals, . 




12 




17 




21 




29 




35 




27 




56 




66 




25 


388 


Increa 


se 


in i 


iin 


e y 


ear 


s, 






• 










• 






• 


96 



10 



74 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 3, 

Showing the number of Discharges and Deaths, and the con- 
dition of those who left the Hospital, from December 1, 1853, 
to November 30, 1854. 















Incurable 


Incurable 
















Improved 


and 


and dan- 


Deaths. 






o 
d 

o 
"A 












harmless. 


gerous. 














M 




s-i 




M 












o 


13 


fl 


■3 


,C 


■3 


A 




A 




£. 


«" 


































£ 




a 




a 






o 




o 










H 


W 


H 


W 


H 


W 


H 


w 


H 


W 


H 


H 


Patients discharged, 




438 




122 




53 




90 




139 




34 




Males, 


198 


- 


45 


_ 


21 


_ 


48 


- 


69 


- 


15 


_ 


198 


Females, . 


240 


1 


77 


- 


32 


- 


42 


- 


70 


- 


19 


- 


240 


Recent cases — less than 




























one yr. — discharged, 


- 


128 


_ 


85 


_ 


18 


_ 


5 


_ 


12 


_ 


8 




Males, 


56 


- 


36 


_ 


6 


_ 


2 


_ 


9 


_ 


3 


_ 


56 


Females, . 


72 


J 


49 


- 


12 


- 


3 


- 


3 


- 


5 


- 


72 


Chronic cases — one yr. 




























or more — discharged. 


- 


220 


_ 


30 


- 


26 


- 


58 


- 


83 


- 


23 




Males, 


105 


_ 


8 


_ 


8 


_ 


32 


- 


45 


_ 


12 


_ 


105 


Females, . 


115 


- 


22 


- 


18 


- 


26 


- 


38 


- 


11 


- 


115 


Patients discharged, the 




























duration of whose in- 




























sanity not ascertained, 


- 


90 


- 


7 


_ 


9 


- 


27 


- 


44 


- 


3 




Males, 


37 


J 


1 


_ 


7 


_ 


14 


_ 


15 


_ 


_ 


_ 


37 


Females, . v . 


53 


- 


6 


- 


2 


- 


13 


- 


29 


- 


3 


- 


53 


Totals, . 


438 




122 




53 




90 




139 




34 







The results of the year have been favorable in a curative 
point of view. One hundred and twenty-two have recovered 
so as to return to their families and business. Others have 
left us improved or otherwise, who, had they remained longer, 
would have increased the number of cures. Some of those 
transferred by the Governor had been with us only a few days. 

Among the " harmless and incurable " are included a few 
State paupers that the Overseers of the Poor took directly to 
the State Almshouses, from one of which we have received 
others in return. Those we received from the State Alms- 



1855.1 



SENATE— No. 1. 



75 



house have appeared about as harmless as any patients we 
have. This has deterred me from advising and recommending 
others to you to be sent back to the towns as fit subjects for 
those institutions. 



TABLE 4, 

Showing' the number of Admissions and Discharges and the 
average number in the Hospital each month in the year. 





Monthly Av- 








erage. 


Admission. 


Discharges. 


December, 1853, 


529 


23 


10 


January, 1854, 








541 


25 


13 


February, " 








548 


18 


16 


March, " 








548 


30 


19 


April, " 








496 


34 


163 


May, " 








365 


22 


103 


June, " 








350 


39 


31 


July, 








357 


18 


17 


August, " 








354 


17 


21 


September, " 








368 


30 


13 


October, " 








374 


22 


15 


November, 








377 


21 


17 


Average number for the year, 






430 







76 



STATE LUNATIC HOSPITAL. 



[Jan. 



TABLE 5, 

Showing- the 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-two years the Hospital 
has been in operation. 





Whole No. of 


Average No. 


No. at the 


Current Expenses 


Annual Expense 


The year. 


residents dur- 


each ; year. 


end of each 


each year. 


per patient. 




ing the year. 




year. 






1833 


153 


107 


114 


$12,272 91 


$114 67 


1834 


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 


1848 


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 


1854 


819 


430 


381 


53,221 51 


123 77 



1855.1 



senate—No. i. 



77 



TABLE 6, 

Shoiving- the causes of Insanity, and the circumstances connected 
with the causes and predisposition to Insanity the last and pre- 
vious years, as reported to us by their friends. 





1854. 


Previously 


Ill health, ....... 


26 


579 


Intemperance, 












12 


376 


Domestic affliction, . 












19 


353 


Religion, 












8 


277 


Masturbation, 












11 


208 


Property, 












6 


192 


Disappointed affection, 












7 


109 


Disappointed ambition, 












- 


39 


Epilepsy, 












8 


119 


Puerperal, . 












10 


137 


Wounds on the head, 












1 


51 


Hard labor, . 












3 


60 


Jealousy, . . • 












1 


18 


Fright, 












2 


30 


Palsy, _ 












1 


36 


Periodical cases, 












26 


886 


Homicidal cases, 












29 


183 


Have committed homicide, 












2 


25 


Hereditary cases, 












29 


1,002 


Suicidal cases, 












25 


436 


Have committed suicide, 












1 


19 


Cases arising from physical causes, 










86 


1,575 


Cases arising from moral causes, 










51 


1,072 



Probably in no part of the world are the causes of insanity 
more numerous and more active than among the population 
of Massachusetts. Here the mind, and body too, are often 
worked to the extreme point of endurance. Here wealth and 
station are the results of well-directed efforts ; and the general 
diffusion of intelligence among the whole people stimulates a 
vast many of them to compete successfully for these prizes. 
But in the contest, where so many strive, not a few break down. 
The results on their minds may not, perhaps, be any less dis- 
astrous, whether wealth and station are obtained or not. The 
true balance of the mind is disturbed by prosperity as well as 



78 



STATE LUNATIC HOSPITAL. 



[Jan. 



adversity. It is only in a sound body that the manifestations 
of the mind are sane and entirely healthy. As a people^we 
cannot boast of the highest standard of physical health, al- 
though we may of general intelligence, enterprise and hard 
work. 



TABLE 7. 



Duration of insanity before admission: — 
Less than one year insane, 
More than 1 and less than 2 years insane, 



" " 2 ' 


i it 


5 


a 


It 


» " 5 ' 


< a 


10 


a 


U 


u a 10 t 


I u 


15 


M 


u 


u u 15 t 


i a 


20 


U 


a 


" " 20 ' 


i a 


25 


li 


u 


" " 25 ' 


I a 


30 


« 


a 


Over 30 years, 


. 




. 


. 


Unknown, 











133 

27 

33 

14 

7 

2 

1 

1 

4 

77 

299 



Duration of insanity with those remaining in the Hospital at the end of the year: 

36 
39 
66 
52 
44 
24 
12 
9 
9 
90 

381 



Less than one year, 
1 year and less than 2, 



2 years 
5 " 


<C (t 

u u 


5, 
10, 


10 " 


a a 


15, 


15 " 


u a 


20, 


20 " 


it (( 


25, 


25 " 


« if 


30, 


30 years and upwards, 
Unknown, 



Ages of Patients when admitted: — 
Under 15 years, 



15 years and less tl 

20 

30 

40 

50 

60 

70 

80 years and more, 



an 20, . 

30, . 

40, . 

50, . 

60, . 

70, . 

80, . 



1 

20 
94 
67 
72 
27 
13 
4 
1 



299 



1855.] SENATE— No. 1. 


79 


TABLE 7— Continued. 




Ages of Patients in the Hospital December 1, 1854: — 




Less than 15 years, ..... 


- 


15 years and less than 20, .... 


12 


20 » " " 30, . 


78 


30 " " " 40, . 


106 


40 " " " 50, . 


101 


50 " " " 60, . 


42 


60 " " " 70, . 


25 


70 " " " 80, . 


15 


80 years and more, ..... 


2 




381 


Civil state of Patients when admitted: — 




Single, ...... 


153 


Married, ...... 


112 


Widows, ...... 


16 


Widowers, ...... 


4 


Unknown, ...... 


14 




299 



80 



STATE LUNATIC HOSPITAL. 



[Jan. 



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1 

1 


Whole No. admitted, . 
Whole No. discharged, . 
Discharged recovered, . 
Discharged improved, . 
Discharged not improved, 
Died, . 
Eloped, . 
Whole No. in Hospital 

in course of the year, . 
No. remaining at the end 

of each year, . 
Males admitted, . 
Females admitted, 
Males discharged, 
Females discharged, 
Males died, 
Females died, . 
Sent in by courts, 
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overseers, 
Sent in on warrant of Gov'r, 
Males recovered, 
Females recovered, 
Average No. in Hospital, 



1855.1 



SENATE— No. 1. 



81 



TABLE 9. 

Diseases that have proved fatal. 





1854. 


Previously. 


Marasmus, . 


5 


78 


Apoplexy and Palsy, 










3 


53 


Consumption, 










4 


58 


Epilepsy, 










2 


45 


Disease of the Heart, 










- 


20 


Suicide, 










1 


19 


Disease of the Brain, 


« . 








- 


20 


Typhus Fever, . 










- 


11 


Lung Fever, 










4 


18 


Hemorrhage, 










- 


6 


Dysenteric Fever, 










- 


9 


Cholera Morbus, 










- 


4 


Inflammation of the Bowels, 








- 


8 


Mortification of the Limbs, 








- 


3 


Dropsy, ..... 








1 


8 


Chronic Dysentery, 








1 


4 


Erysipelas, 








2 


15 


Diarrhoea, .... 








1 


18 


Disease of the Brain from Intemperance 








- 


3 


Bronchitis, 








- 


3 


Old Age, 








- 


13 


Gastric Fever, . 








- 


5 


Land Scurvy, 








- 


1 


Congestive Fever, 








1 


2 


Concussion of the Brain, 








- 


1 


Disease of the Bladder, 








- 


1 


Fright, .... 








- 


1 


Rupture, 










- 


1 


Maniacal Exhaustion, 










7 


49 


Convulsions, 










- 


2 


Cholera, . 










- 


4 


Asthma, . 










1 


1 


Hydrothorax, 










- 


3 


Cancer, . 










- 


1 


Pleurisy, 












1 


Jaundice, 










1 


1 


Chorea, . 










- 


1 












34 


491 



11 



82 



STATE LUNATIC HOSPITAL. 



[Jan. 



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1855.] SENATE— No. 1. 83 

In this table, the two hundred and ten that werejransf erred 
were not taken into the count, Had they been reckoned, the 
per cent, would have been different. For recent cases recov- 
ered, it would have been 66; for all discharged, 28; and for 
old cases, 12. The per cent, of deaths of all in the Hospital 
would have been 4.15 ; and of the average number, 7.9. 

By the persevering efforts of the Assistant Physicians, Drs. 
Bemis and Smith, the patients have this year enjoyed, in walks, 
in amusements and freedom on their parole of honor out of 
doors, greater indulgence than ever before. They have been 
enabled to do so, in part, because the grounds this year about 
the building have been protected by fences for the first time. 
Intruders have been kept off, and our quiet people could sit 
and stroll about this hill pleasant days unmolested. Far less 
mechanical restraint has been used than was formerly deemed 
absolutely necessary. Amusements of various kinds, as 
walking, riding, working, reading, writing, music and games, 
have been put in requisition to arouse the listless minds of 
the inactive, and to bring into a healthy channel the wander- 
ing thoughts of the deluded. 

We are under great obligation to the proprietors for the 
following periodicals, for which we can make them in return 
only this acknowledgment, and express the gratitude of our 
patients who are made happy in their perusal : The Daily 
Advertiser, Evening Gazette, Olive Branch, Puritan Recorder, 
Christian Witness, Church Advocate, Youth's Companion, 
Monthly Religious Magazine, Zion's Herald, New England 
Farmer, Prisoner's Friend, from Boston ; Register, Essex 
County Gazette and Advertiser, from Salem ; Old Colony 
Memorial, Plymouth ; Lynn News, Lynn ; Assistant of the 
Ministry at Large, Roxbury ; Gospel Messenger, Utica, N. Y. ; 
Democrat, Taunton ; iEgis, Spy, Palladium and Journal, Wor- 
cester ; Courant, Clinton ; and some papers and books from 
several friends of the Hospital. 

The stated daily and weekly religious services here have 
been continued by the able Chaplain who has so long been 
with us. These services, besides promoting something of re- 
ligious growth in the hearts of all, are among the moral means 
by which the insane as well as the sane become habituated to 



84 



STATE LUNATIC HOSPITAL. 



[Jan. 



the rules of order and decorum. Former associations are 
awakened in their minds, which 'allay the restless feelings of 
the insane, and help them to keep in subjection their wandering 
thoughts. They are the occasion of some happiness and 
activity on the Sabbath, and they mark the hour of repose at 
night. 

The patients assist in the various departments of the Hos- 
pital, and their services are valuable for what they perform, 
and still more valuable in its effects upon their own health. 
Some thirty have regular daily duties assigned them out of 
the wards; and, when there is any extra job on hand, as many 
more are often taken out into the fields and shops by the sev- 
eral assistants. The attendants are assisted in the wards, in 
the care of them, in sewing and knitting, by a hundred or 
more of the patients. But still there is a great want here of 
some kind of mechanical labor, at which considerable numbers 
could be engaged without danger to themselves, that would be 
both healthful and pleasant in its performance. 

The farm and garden have yielded full returns for the labor 
bestowed, as the following estimate of the crops by the Stew- 
ard will show : — 



Apples, 95 bushels at 40c, 
Cherries, 20 bushels at $2.00, 
Com, sweet, in ears, 80 bushels at 50c. 
Beans, 7 bushels at $2.00, . 
Beets, 162 bushels, 
Cabbage heads, 1,800 at 5 cents each, 
Cucumbers, 85 bushels at 50c, 
Turnips, 105 bushels at 25c, 
Tomatoes, 50 bushels at 40c, 
Onions, 145 bushels at 50c, . 
Squashes, 3,583 lbs. at 2c, . 
Peas, 30 bushels at $1.00, 
Milk, 41,050 quarts at 3lc, . 
Beef, 8,434 lbs. at 7c, . 
Pork, 14,578 lbs. at 8c, . 
Poultry, 150 lbs. at 10c, 







$38 00 






40 00 


) 




40 00 






14 00 






40 50 






90 00 






42 50 






26 25 






20 00 






72 50 






71 66 






30 00 






. 1,436 75 






590 38 






. 1,166 24 






15 00 



5,733 78 



1855.] SENATE— No. 1. 85 

And for wintering or fattening the stock on hand, of 4 horses, 
2 oxen, 24 cows and 122 swine : — 

Hay, 44 tons at $20.00, $880 00 

Rowen, 4 tons at $15.00, 60 00 

Corn fodder, 15 00 

Carrots, 1,600 bushels at 25c, .... 400 00 



$1,355 00 

I cheerfully acknowledge the ready cooperation of the sev- 
eral persons employed in this institution in carrying forward 
the great purpose of this charity. The duties of those in the 
immediate attendance on the insane are perplexing, and often 
arduous, and, when faithfully discharged, can be fully remu- 
nerated only by an approving conscience. We have been for- 
tunate in acquiring and sustaining a high tone of moral and 
intellectual excellence in the attendants and assistants. 

Persons devoted exclusively to the care and attendance 
on the insane are : — 

Males, 13 

Females, . . 18 — 31 

Persons employed in the various departments to work 
with and give exercise to the insane are :— 

Males, 17 

Females, . . . . . . . . * 18—35 

66 

The term of their services varies from several causes. About 
one-third leave yearly. Some, from the length of time and 
their devotion to it, become identified with its reputation. 
Those best adapted to their stations generally remain longest. 

To each of the members of your Board, who have been ever 
ready to advise and assist me, and who have been active and 
zealous in promoting the best interests of the insane, I am 
glad of this opportunity to express my obligations and my 
gratitude. The services of your Board have been rendered 



86 STATE LUNATIC HOSPITAL. [Jan. 

without pecuniary compensation, and visits of business to, and 
inspection of, the Hospital, by some or all of its members, 
have been frequent. The book of Monthly Visits shows that 
no month since the institution was opened has passed without 
a record of such a visit having been made. Thirty-seven times 
have you been at this Hospital the past year, besides your 
meetings of business elsewhere. 

Most respectfully, 

Your obedient servant, 

GEORGE CHANDLER. 



State Lunatic Hospital, Worcester, 
Mass., December 1, 1854. 



1855.] 



SENATE— No. 1. 



87 



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SENATE— No. 1. 



91 





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SENATE— No. 1. 



99 





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Extremes of Thermometer. 
January 29, . . . . — 6 . 
July 4, .... 93°.5. 








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14 



OFFICERS 

OP THE 

STATE LUNATIC HOSPITAL 

AT WORCESTER, 
1.855. 



TRUSTEES 



REJOICE NEWTON, President, 
WILLIAM T. MERRIFIELD, 
LINUS CHILD, . 
HENRY MORRIS, Secretary, 
CHARLES II . STEDMAN, 



Worcester. 

Worcester. 

Lowell. 

Springfield. 

Boston. 



TREASURER 



-SAMUEL JENNISON, . ... . Worcester. 
Office— Savings Bank, Foster Street. 



RESIDENT OFFICERS 



GEORGE CHANDLER, M. D. 
GEORGE ALLEN, . 
MERRICK BEMIS, M. D„ 

EDWARD A. SMITH, M. D., 

ELIZABETH A. REID, . 
JOHN T. MIRICK, . 
PHEBE S. MIRICK, . 



Superintendent. 

Chaplain. 

Assistant Physician. 

Assistant. Physician 
and Steward. 

Matron. 

Supervisor . 



$>8 25^W.PX