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SENATE No. 1.
TWENTY-FOURTH
ANNUAL REPORT
THE TRUSTEES
STATE LUNATIC HOSPITAL
AT WORCESTER.
DECEMBER, 1856
B OSTON:
WILLIAM WHITE, PRINTER TO THE STATE.
1857.
OFFICERS OF THE HOSPITAL.
TRUSTEES.
WILLIAM T. MERRIFIELD, President,
LINUS CHILD, Secretary,
CHARLES H. STEDMAN,
THOMAS COLT, ....
JOSEPH N. BATES,
Worcester.
Lowell.
Boston.
Pittsfield.
Worcester.
TREASURER.
SAMUEL JENNISON, Esq., .... Worcester,
Office — Savings Bank, Foster Street, Worcester.
RESIDENT OFFICERS,
MERRICK BEMIS, M. D., .
PRANK H. RICE, M. D., .
THOMAS H. GAGE, M. D.,
ELIZABETH REID, .
REV. ISAAC HOSFORD, .
Superintendent.
Assistant-Physician.
Assistant-Physician.
Matron.
Chaplain.
TWENTY-FOURTH ANNUAL REPORT
OF THE
TRUSTEES OF THE STATE LUNATIC HOSPITAL,
AT WORCESTER,
185 6.
To His Excellency Henry J. Gardner, Governor, and the
Honorable Council.
The Trustees of the State Lunatic Hospital at Worcester, in
compliance with the provisions of law, hereby submit their
Twenty-fourth Annual Report.
In reviewing the history of this institution for the past year,
the Trustees find abundant occasion to reiterate an acknowledge-
ment of the superintending care of a merciful Providence, and
to express their convictions that the institution, as heretofore,
has been the means of unspeakable benefit to those unfortunate
beings committed to its care.
For a particular account of the operations of the hospital for
the past year, the number and condition of its patients, and the
success which has attended the efforts of its immediate officers
and managers, the Trustees refer to the full and minute report
of the Superintendent, which is herewith presented.
The financial condition of the hospital will be ascertained
from the report of the Treasurer, which contains a statement
of the receipts and expenditures for the past year.
The last annual report of the Trustees announced the fact
6 STATE LUNATIC HOSPITAL. [Jan.
that Doctor Chandler, who for more than ten years had most
acceptably discharged the duties of Superintendent of the hos-
pital, had resigned his situation, and that Doctor Merrick Bemis
had been appointed as his successor. After the appointment of
Doctor Bemis, the Trustees cheerfully assented to his request
for leave of absence, for the purpose of visiting Europe. He
was absent about six months, having visited the various institu-
tions for the relief of the insane in England and Scotland, and
upon the continent, and having thus acquired much valuable
information which we doubt not will be made available for the
benefit of the institution committed to his care.
Doctor Bemis entered upon the duties of his office at the
hospital, July 16, 1856, Doctor Chandler having kindly con-
sented to retain the charge of the institution up to that time.
During the short period which Doctor Bemis has discharged
the responsible duties of his situation, the Trustees have dis-
covered ample evidence to satisfy them of the wisdom of his
appointment.
During the last year Doctor Frank H. Rice has been appointed
Assistant-Physician at the hospital, and has also performed the
duties of Clerk of the institution. The duties devolving upon
Doctor Rice have been performed to the entire satisfaction of
the Trustees, and we regard him as a most valuable officer.
During the same period, Doctor Thomas H. Gage has been
employed as Assistant-Physician, and has rendered very efficient
aid to the Superintendent. So long as the institution can re-
tain his services, the Trustees will deem themselves fortunate
in securing his valuable aid in the various and difficult duties
devolving upon the Superintendent and Assistant-Physicians.
During the past year the Rev. George Allen, who, for many
years, has discharged the duties of Chaplain, resigned his situ-
ation, and the Trustees have appointed Rev. Isaac Horsford in
his place, and who has entered upon the duties of his appoint-
ment.
The Trustees cannot withhold the expression of their satisfac-
tion at the change of the treatment of the more violent and
furious patients, which has been adopted at the hospital within
the last two years, and which Doctor Bemis, since entering upon
the duties of his office, has carried out more fully than ever
1857.] SENATE— No. 1. 7
before. We allude to the dispensing with the use of the strong
rooms for the confinement of the more violent patients.
Doctor Bemis, since he entered upon his duties, has not, in a
single instance, made any use of the strong rooms for the con-
finement of patients, nor has he as yet found it necessary to
employ any extra attendants in the various wards.
We are not fully prepared to draw any specific conclusions
upon this subject from the experience of the last four months.
We are prepared, however, to state the fact, that during that
period we have found the patients, as a whole, at our monthly
visits, more quiet than during any other four months since our
connection with this institution. Occasions have not been rare
when, out of some 370 patients, not a single one was subjected to
any kind of restraint, other than the care of the attendant within
the ward. It is true that it is frequently necessary to separate
the violent and furious patients from the others. This is done
by confining them for short periods in their sleeping-rooms, and
by this mode of treatment it is found that these violent paroxysms
pass off more readily than by confinement in the strong rooms.
In the last annual report it was stated that of the thirty-six
strong rooms, twenty-four had been removed by order of the
Trustees, and that four large and airy parlors or sitting-rooms
had been substituted in their place.
Of the twelve strong rooms remaining, the six in the female
department have not been used for more than twelve months,
and the six in the male department have not been used for the
last four months, and the Trustees have no doubt that these re-
maining twelve strong rooms may be removed, and the space
occupied by them be appropriated to a much more useful
purpose.
Another change is being introduced by Doctor Bemis, which,
in our judgment, promises highly beneficial results ; we mean
the giving of employment to the patients upon a more sys-
tematic plan than heretofore adopted. As far as the experi-
ment has been tried, it promises the best results, both as a cura-
tive process, and as calculated to arrest that tendency to entire
dementation, which is liable to follow long confinement in the
wards without any employment.
In the annual report of 1854, attention was called to the con-
dition of the hospital, and many defects in its accommodation
8 STATE LUNATIC HOSPITAL. [Jan.
pointed out, which, in tho judgment of the Trustees, called
imperatively for a remedy.
The most important of these defects were, 1st, the very im-
perfect ventilation ; 2d, the mode of warming by hot-air furnaces,
placed in the cellars, and so constructed as to create great ex-
posure to fire, and 3d, the condition of the wards as gloomy and
forbidding, having a very insufficient amount of light.
The report of last year stated that the last defect had been
substantially remedied, and that the Trustees were then engaged
in carrying out other changes which promised to remedy sub-
stantially the other two.
The Trustees of 1854 instituted inquiries whether the defec-
tive ventilation, and the dangerous mode of warming the build-
ings, could be obviated within any reasonable expense.
The result of those inquiries were that it would require an
outlay of from sixty to seventy thousand dollars to remove these
defects. This fact induced the Trustees of that year to abandon
the idea of making any extensive improvements in the present
building; and they suggested to the legislature the expediency
of a sale of the present land and buildings, and the purchase
of a new site, and the erection of new buildings upon a more
improved plan.
This subject, thus brought to the attention of the legislature,
resulted in the appointment of a commission, consisting of Hon.
Levi Lincoln, Doctor Edward Jar vis, and Hon. Increase Sumner,
whose report embodied a vast amount of valuable information,
not only upon the number and condition of the insane within
the Commonwealth, but also upon the kind and construction of
building for the reception of this class of persons.
As the report of that commission recommended the continu-
ance of the present hospital building at Worcester, and the
erection of a third hospital for the insane, to be located in the
western part of the Commonwealth, and as the legislature sub-
stantially adopted those recommendations, the Trustees of 1855
again directed their attention to the condition of the hospital at
Worcester, with a view to applying a remedy to defects which
were conceded by all to exist.
The defect in regard to the wards, resulting from a great de-
ficiency of light, was remedied as reported in the annual report
of last year.
1857.] SENATE— No. 1. 9
The great difficulties which seemed almost impossible to re-
move within any reasonable expense, related to the mode of
heating and ventilating the buildings.
The various wards were so low studded, being only about
eight feet in the clear ; the construction of the hot-air furnaces
were such, and the hot-air flues so contracted, and the ducts or
passage ways for conveying away the foul air, were so small,
that to secure an economical and safe mode of meeting with an
efficient ventilation, would, in the opinion of competent judges,
as well as in the opinion of the Trustees, have required an
almost entire change in the internal arrangement of the build-
ing, unless some different mode of warming and ventilation
could be resorted to than that which had been generally in
use in such buildings.
While the Trustees of 1855 were encountering these difficul-
ties, their attention was called to a mode of warming and ven-
tilation, which had been recently adopted at the asylum for the
insane at Utica, in the State of New York.
The Trustees also acknowledge their indebtedness to John
"Wright, Esq., of Lowell, for many valuable suggestions, and
under whose direction and that of one of their own number,
(Mr. W. T. Merrifield,) the work has now been carried to a
successful termination.
After mature consideration of the plan adopted at Utica, and
of the suggestions of Messrs. Wright and Merrifield, the Trus-
tees of 1855 determined to adopt it, and immediately com-
menced the work. This has now been completed, and, in the
opinion of the Trustees, with entire success.
The plan consists in the use of steam for the purpose of heat-
ing. A general description of it may here appropriately be
given, referring, however, to the report of the Superintendent
for a more detailed and minute description of it in its various
parts.
Four large steam boilers are placed outside the main build-
ings, at a distance of about 120 feet. Between the boilers and
the main building is constructed a large air chamber under
ground, which is filled with steam-pipes. From this chamber
proceeds a spacious passage way to the cellar, and through the
cellar under the main building and all its wings. This passage
way is so constructed in the cellar as to embrace within it all
2
10 STATE LUNATIC HOSPITAL. [Jan.
the old flues which conveyed the hot-air from the old furnaces
to the various apartments of the building.
Near the boilers is placed two small steam-engines, only one of
which is to be used at the same time. The steam used for driv-
ing the engine, after it has passed through the same, is conducted
into the steam-pipe in the hot-air chamber, which, with steam
taken directly from the boilers, is used for keeping it at any
desired temperature.
The steam-engine drives a large fan which is fourteen feet in
diameter, by which fresh air is constantly forced into the hot-
air chamber, when it is heated to the necessary temperature,
thence by means of the force furnished by the fan, is forced
through the large passage way under the building and wings,
and through the flues connected therewith into all the apart-
ments of the building. The same force from the fan still
operates upon the air in the various apartments, forcing it out
at the old ventilating ducts, with any rapidity which may be
desired. Thus is secured a constant change of air in all the
apartments of the building. This change may be increased or
retarded at pleasure, by simply increasing or slackening the
speed of the fan.
One of the chief recommendations of this plan, which is
called mechanical ventilation, is that by means of the pressure
upon the air in the various departments secured by the fan, the
foul air can be forced out with great rapidity through much
smaller ducts, than by the ordinary process of ventilation. We
were therefore enabled to use all the old hot-air flues and ducts,
while with the ordinary process of ventilation, they must all
have been taken down and enlarged at very great expense.
With this method of ventilation low studded apartments can
be kept pure with as great facility as those which are more
capacious.
This plan of ventilation will also bo found admirably adapted
for preserving a pure and healthful air in the various apartments
in the warm season of the year. It is expected that the fan
will continue to run in warm as well as in cold weather, and
by it it is estimated that the whole air throughout the whole
building can be changed as often as once in from ten to fifteen
minutes.
As before stated, it is now in successful operation at the Wor-
1857.] SENATE— No. 1. 11
cester Hospital. We are satisfied that by this plan a much
more perfect and economical mode of warming and ventilation
is secured than by any other process. It has been completed
at about half the expense which the plan considered by the
Trustees of 1854 was estimated to cost.
The Trustees desire to bring to the notice of your excellency,
and through you to the attention of the legislature, another
subject, which, in their judgment, is one of considerable impor-
tance. We allude to the laws and regulations now in force in
regard to the amount paid for the support of such patients as
are chargeable to the Commonwealth.
Prior to 1844, the hospital was allowed by the Commonwealth
for the support of its patients, the whole expense of their support.
By certain Resolves passed by the legislature of 1844 and
1845, the compensation for such patients was fixed at the rate
of $2.50 per week, for a term not exceeding thirteen weeks ;
$2.25 per week for a term not exceeding twenty-six weeks, and
$2 per week for a term exceeding twenty-six weeks, and less
than one year, and for one year $100 per year. Other laws in
force require the Trustees, for the foregoing compensation, to
furnish such patients all necessary clothing, and, when they
leave the hospital, to send them away well and comfortably clad.
The hospital is also required to pay the funeral charges of such
as die at the institution. All other patients in addition to the
sum fixed per week for their support, are charged extra for
clothing, funeral charges, and also for damages done by the
patient to the buildings and property of the institution.
The laws further require the Trustees, from year to year, to
fix the price of the support of all other patients, except those
chargeable to the Commonwealth, (which by the foregoing Re-
solves remain at a fixed sum,) at such prices as will cover the
expenses of the institution, except the salaries of such of its
officers as are paid out of the treasury of the Commonwealth.
From 1845 to 1854 the compensation allowed for the Com-
monwealth's patients, at the Worcester Hospital, did not fall so
much below the sum paid by other patients, as has been the
case since that time. Since the present compensation for the
support of State paupers at the lunatic hospitals was fixed by
the Resolves of 1844 and 1845, the cost of sustaining them has
greatly increased. This difference is most perceptible since the
12
STATE LUNATIC HOSPITAL.
[Jan.
close of the year 1853. In 1854 the State Lunatic Hospital at
Taunton was opened for the reception of patients, and the num-
ber at Worcester was consequently greatly reduced. For a few
years prior to 1854, the hospital at Worcester was greatly crowded
with patients. In the summer of 1853, the number reached 567,
and although during that year, and a few years preceding, the
number of patients was far too great to be properly cared for,
yet as one result of the great number, the cost of support per
patient was less than since, or during the earlier history of the
institution.
One fact should here be stated, that the Commonwealth's
patients are usually of a class which remain for a period of at
least one year, so that substantially the Commonwealth pays for
its patients at the rate of $100 a year for support and clothing
and other expenses.
A few statements of the number of State paupers, and of
other patients, and the cost of the support of patients at the
hospital, will place the whole subject in a clear light.
In 1853 the number of State paupers in the 1
" all other patients,
1854, State paupers,
" all others, .
1855, State paupers,
" all others,
1856, State paupers,
" all others,
lospital was
, 216
.
304
. .
151
. .
230
. .
115
. . .
221
. .
141
235
In 1853 the expense of supporting each patient, was . $103 00
1854 " " " " 123 77
1855 " " " " 157 29
1856 " " " " 128 64
It will thus be seen that under the present law the amount
allowed by the Commonwealth for the support of its patients at
the hospital is from thirty to fifty per cent, less than the actual
cost of their support.
During the last year the price charged upon all the patients
per week, except State paupers, was, for the first six months,
$3, and after that $2.75 per week, while the State, for its pa-
1857.] SENATE— No. 1. 13
tients, allowed loss than $2 per week. "With the present cost
of provisions and supplies, the price for the future must of ne-
cessity be as high as during the last year.
The effect of this state of things is practically to impose, as
it were, a tax upon those unfortunate individuals who are com-
mitted to the lunatic hospitals of the State for the benefit of the
State's own lunatic paupers.
The injustice of this state of things will be more strikingly
apparent, when we reflect that this tax is imposed, not upon the
rich and the prosperous, but in most cases upon the poor and
afflicted.
Many instances might be referred to in the Worcester Hospi-
tal, in which a member of a family of limited means becomes
insane. The friends of the patient cannot endure the idea of
making their relative a town charge, and hence they submit to
every privation and self-denial, in order to save enough to sup-
port their afflicted brother or sister at an institution which
promises relief from so great a calamity.
We know of instances in which two sisters have, by the daily
labor of their own hands, supported a third sister at the Wor-
cester Hospital. In another case, a daughter who had no means
but what she earned, supported an aged mother at the same
institution. We cannot but feel that the operation of existing
laws in this respect need only to be stated to the legislature to
secure an immediate remedy.
Indeed, if we rightly interpret a law passed at the last ses-
sion, the legislature has already changed the operation of the
Resolves of 1845, to a limited extent. We allude to the Act
of 1856, chapter 113.
This Act provides that lunatics who have no known residence
in the Commonwealth, may be committed to either of the State
lunatic hospitals, by any two justices of the peace, one of whom
shall be a justice of the quorum, or by any police court.
The fourth section of this Act provides that persons thus
committed " shall be supported at said hospitals at the expense
of the Commonwealth" Our interpretation of this Act is, that
the expression, " shall be supported at the State lunatic hospi-
tals at the expense of the Commonwealth," means that the
Commonwealth is to pay the whole cost of their support, and
not a part of it.
14 STATE LUNATIC HOSPITAL. [Jan.
But this Act has no application to the large number of State
paupers now in the State lunatic hospitals, most of whom have
been committed by the judges of probate.
The judges of probate have now the same authority as here-
tofore, to commit to the State hospitals lunatics who have no
known settlement in the Commonwealth, and will probably
continue to exercise that jurisdiction.
If we are right in our interpretation of the Act in question,
an insane State pauper may be committed to a State lunatic
hospital by a judge of probate, and on the same day another
may be committed by a police judge to the same institution.
For the support of one the Commonwealth would be chargeable
at the rate of $100 a year for board and clothing, and for the
other at the rate of $145 a year for board, with extra charges
for clothing. This inequality surely ought not to exist. We
also refer to the report of the Superintendent for further state-
ments upon this subject.
The Trustees therefore most respectfully ask the attention of
your excellency, and, through 3^011, the attention of the legislature
to this subject, as one imperatively requiring some modification
of the existing laws.
WILLIAM T. MERRIFIELD,
LINUS CHILD,
CHARLES H. STEDMAN,
THOMAS COLT,
JOSEPH N. BATES,
Trustees.
Worcester, December 27, 1856.
1857.] SENATE— No. 1. 15
TREASURER'S REPORT.
To the Trustees of the State Lunatic Hospital: —
The Treasurer reports : —
That from the 30th day of November, 1855, to the 1st day of
December, 1856, he has received : —
From the Commonwealth, for support of Paupers
committed to said Hospital, ....
and on account of Ellen Hart, heretofore paid by
the State,
Prom cities, towns and individuals, for support of
patients,
Prom the Massachusetts Cotton Mills for balance
of their note, . . . . ■•",■•
For interest on said note. .....
For. interest on Z. Storr's legacy,
For articles sold by the steward,
From the Worcester Bank, overdrawn,
Balance of cash account due the Treasurer,
And that during the year ending November 20, he has paid,
on the Steward's orders : —
$15,681 38
72
11
29,091
74
10,000
00
382
50
30
00
372
00
9,882
86
304
21
$65,796
80
For salaries, wages of attendants, &c,
Improvements and repairs, .
Furniture, .....
Clothing, .....
Flour, 407 barrels,
£9,551 11
4,033 41
1,809 65
1,683 18
3,832 00
16
STATE LUNATIC HOSPITAL.
[Jan.
For Meal, .
.
.
$158 74
Provender, .
.
.
1,669 21
Rice, 2,454 pounds, and biscuit,
.
421 91
Coffee, 2,148 pounds, .
.
.
406 45
Tea, 898 pounds,
.
.
321 39
Sugar, 24,946 pounds,
.
.
2,352 88
Butter, 27,107 pounds,
.
.
5,824 58
Cheese, 2,003 pounds,
.
.
217 83
Fresh meat,- 7,605 pounds
fresh Beef; 5,795
Steak ; 3,507 pounds
soup
meat ; 684
pounds Poultry,
.
.
1,745 14
Salt Beef, 18,419 pounds ;
Earns,
600 pounds,
1,608 64
Fish, 5,000 pounds,
.
.
232 90
Molasses, 477 gallons, .
.
.
209 16
Small groceries, .
.
.
427 95
Fresh fruits,
.
.
920 85
Potatoes, 1,518 bushels,
.
.
891 43
Other vegetables,
.
.
224 92
Vinegar, 306 gallons, .
.
.
33 66
Fuel, 389 cords of Wooc
1, and
32 cords of
Charcoal,
. .
2,658 40
Gas light, 251,000 feet, an
d Oil,
196 gallons,
860 37
Soap, Starch, and Potash,
.
.
105 62
Medical supplies,
.
.
347 55
Books, Stationery, and Printing,
.
204 39
Trustees expenses,
.
.
115 00
Sexton's charges,
.
.
203 25
Live stock purchased, .
.
.
1,184 50
Miscellaneous expenses,
■ •
.
775 30
$45,031 37
And on account of improvements in warming and
ventilation, 17,686 48
Treasurer's salary and expenses,
Balance due as per last report, paid to the Wor-
cester Bank and the Treasurer,
$62,717
85
619
72
2,459
23
,796 80
1857.] SENATE— No. 1. 17
STATE OF THE HOSPITAL FUND.
Amount due for support of patients, December 1,
1856, estimated at ...".. $39,181 03
Bond of Worcester and Nashua Railroad Com-
pany,
Cash in the hands of John Wright,
Cash in the hands of the Steward,
Esq, . .
$9,882 86
304 21
30,134 57
500 00
500 00
140 61
Cash due the Worcester Bank,
Cash due the Treasurer,
Balance, .
$40,321 64
<kACt 391 (Kd.
Respectfully submitted, by
SAMUEL JENNISON, Treasurer.
December, 1856.
Examined and approved by the Auditing Committee.
J. N. BATES.
WM. T. MERRLFIELD.
December 29, 1856.
3
1857.]
SENATE— No. 1.
19
SUPERINTENDENT'S REPORT.
Twenty-fourth Annual Report of the Superintendent, to the
Trustees of the State Lunatic Hospital.
Gentlemen : — At the commencement of the year just closed
there were in the hospital 336 patients, of whom 168 were males,
and 168 females.
There were admitted during the year, 241 patients, of whom
112 were males, and 129 females.
The whole number under treatment was 577, of whom 296
were males, and 281 females. /
Of the patients under treatment, there were discharged
Recovered, 97
Much improved, ...... 20
Improved, ....... 26
Not improved, 23
Died, 35
Total, 201
Remaining under treatment December 1, 1855, 376
Of the patients discharged recovered, 51 were under treat-
ment for a less period than three months ; 17 for a period longer
than three months, and not exceeding six months ; 12 for a pe-
riod longer than six months, and not exceeding one year ; and
17 for more than one year.
Of those discharged much improved, 4 were under treatment
less than six months ; 4 for a longer time than three months,
and not exceeding six months ; 3 for a period longer than six
20 STATE LUNATIC HOSPITAL. [Jan.
months, and not exceeding one year ; and 8 were residents of
the hospital more than one year.
Of those discharged improved, 6 were under our care less
than three months ; 5 more than three months, and less than
six months ; 3 more than six months, and less than one year ;
and 11 were inmates of the institution more than one year.
Of those discharged not improved, 7 were with us less than
three months ; 1 more than three, and less than six months ;
5 for a longer time than six months, and less than one year ;
and 9 were residents in the hospital for more than one year.
Thirty-five deaths have taken place during the year, 18 of
which have occurred to males, and 17 to females.
Of these deaths, 7 occurred within one month after commit-
ment ; 5 within three months ; 7 within six months ; and 8
within one year.
Eight had been inmates more than one year, 3 of whom had
been with us more than ten years.
Of those admitted, there were 104 whose insanity was of less
duration than three months.
Thirty who had been insane more than three, and less than
six months ; 23 who had suffered more than six months, and
less than one year ; and 84 who had been insane more than one
year.
There were committed by the Courts, 95 males and 98 females.
Total, 193.
Committed by Overseers of the Poor, 18 males and 30 females.
Total, 48.
Of those admitted, there were foreigners and those having no
settlement in the State, 41 males and 47 females. Total, 88.
Of those discharged there were foreigners and .those having
no settlement in the State, 37 males and 39 females. Total, 76.
Foreigners and those having no settlement in the State re-
maining December 1, 1856 ; males, 67 ; females, 74. Total, 141.
185T. SENATE— No. 1. 21
TABLE 1,
Shoiving' the supposed Causes of Insanity of those admitted
during the year.
Ill health, of various kinds, 48
Intemperance, 24
Domestic affliction, 21
Irregular habits of life, . . . . . . . .15
Faulty education, 11
Masturbation, ........... 10
Jealousy, ........... 10
Hard labor, .......... 9
Religious excitement, .9
Palsy,. 7
Puerperal, .......... 5
Turn of life, . . . . . . . . . .5
Epilepsy, . . . . . . ... . . .5
Spiritualism, . . j ....... 5
Loss of property, 4
Old age, 4
Change of business, 3
Nymphomania, .......... 3
Disappointment, ......... 3
Confinement in prison, ........ 3
Gestation, . . . . . . . . . . .2
Injury of head, 2
Injury of spine, 1
Unascertained, .......... 32
Total, 241
Of the above, there were hereditary cases, 36 ; hereditary and
periodical, 25 ; have committed homicide, 2 ; have attempted
suicide, 7.
It has always been difficult to ascertain the causes of insanity
of the patients sent to us. In many cases the friends fail to
give any rational account of the origin and progress of the disease.
Foreigners are generally brought to us by officers who have
never seen the patient previous to having the commitment placed
in his hands.
Ill health, especially with females, is a prominent cause, and
perhaps brings to us more patients than our table shows.
Under the head of domestic affliction, are classed all cases of
insanity arising from loss of property, or loss of friends. Also
22 STATE LUNATIC HOSPITAL. [Jan.
all from neglect, abuse or desertion ; or whatever disturbs the
peace and harmony of the family circle.
It will be sufficiently obvious what cases are placed under
the heads, " Irregular habits of life," " and faulty education."
The popular excitements of the day have not brought to us
so many patients as is generally believed by the community at
large.
No doubt they are a prolific cause of insanity yet in almost
all the cases received here, other causes have been sufficiently
prominent.
TABLE 2,
Diseases which have proved Fatal during the year.
Epilepsy, 5
Exhaustion from maniacal excitement, 5
Consumption, . . . . . . . . . . 4
Palsy, 4
Marasmus, 3
Inanition, 3
Dysentery, .......... 3
Apoplexy, 2
Pneumonia, .......... 2
Chronic Dysentery, 1
Diarrhoea, . . . . . . . . . .1
Old age, 1
Carbuncle, 1
Total, 35
Although the number of deaths have been somewhat larger
than the previous year, yet the general health of the house has
been good. We have suffered but little from acute disease.
Late in the summer there were several cases of dysentery, three
of which proved fatal. And in the autumn there were a few
slight cases of fever. There have been also several protracted
cases of diarrhea. A majority of the deaths occurred to feeble,
worn-out patients.
1857.]
SENATE— No. 1.
23
TABLE 3,
Showing; the number of Admissions and Discharges, the Whole
Number under Treatment, and the Average for each month
in the year.
ADMISSIONS.
DISCHARGES.
Whole
Number.
Average
Males.
Females.
Males.
Females.
December, 1855,
350
335*
8
6
7
9
January, 1856,
349
337
9
6
6
3
February, '
356
343
8
8
5
6
March., '
360
347
6
9
7
4
April, '
374
353
10
15
7
10
May, <
381
359
10
15
9
10
June, '
389
366
14
12
9
12
July, <
392
372
9
14
7
11
August, '
388
366
4
10
15
15
September, '
385
364
11
16
8
8
October, '
392
373
11
12
6
10
November, '
394
377
12
6
11
6
Average
br th
i yea
r>
357
113
129
97
114
TABLE 4,
Showing the Ages of Patients admitted during the year.
Less than 15 years of age, ....... 3
Between 15 and 20, 12
" 20 and 30, 70
" 30 and 40, 63
" 40 and 50, 59
" 50 and 60, 14
" 60 and 70, 13
" 70 and 80, 5
80 years and over, 2
Total, 241
24
STATE LUNATIC HOSPITAL.
[Jan.
TABLE 5,
Ages of Patients remaining November 80, 1856.
Less than 15 years of age, 3
Between 15 and 20, 13
" 20 and 30, 64
« 30 and 40, . . . . - . . . . 110
« 40 and 50, 105
« 50 and 60, 50
» 60 and 70, : 22
« 70 and 80, . ■ 5
80 years of age and over, 4
Total, 376
TABLE 6,
Showing the Duration of Insanity before admission of those
admitted during the year.
Insane less than 1 year, • • • 157
More than 1 and less than 2 years, ....
17
16
5
2 » "5
" « 5 " " 10
« " 10 " " 15
<< a !5 « u 20
a a 20 " " 25
« " 25 " " 30
" " 30 years,
Unascertained, "«
Total,
241
1857.]
SENATE— No. 1.
25
TABLE 7,
Showing the Duration of Insanity of those remaining Novem-
ber 30, 1856.
Insane less than 1 year,
34
More than
1 and less than
2
years,
34
"
«
2
5
years,
58
u
It
u
5
10 " "
10
15
«
115
54
Li '
u
15 " "
20
a
32
a
u
20 " "
25*
It
7
u
«
25 " "
30
a
6
a
a
30 years,
8
Unascertained, .
28
Total, .
376
TABLE 8,
Showing Civil Condition of Patients admitted during the year
Unmarried, . . . ... . . . . .85
Married, 131
Widows, 10
Widowers, 7
Unascertained, . . ... . . .* .8
Total, 241
Civil condition of those remaining November 30, 1856 : —
Unmarried, 216
Married, 120
Widows, . 17
Widowers, 17
Unascertained, .......... 6
Total, .... * 376
26
STATE LUNATIC HOSPITAL.
TABLE 9,
[Jan.
Showing the admissions from each County during the last and
previous years.
1856.
—~ 1-
Previously.
Total.
Barnstable, .,
. Males,
. Females,
1
1—
2
121
123
Berkshire, .
. Males,
. Females,
3
4—
7
160 .
167
Bristol,
. Males,
. Females,
0
0—
0
281
281
Dukes,
a
. Males,
. Females,
0
0—
0
19
19
Essex,
. Males,
. Females,
19
14—
33
598
331
Franklin, .
a
■ . Males,
. Females,
3
3—
6
110
116
Hampden, .
. Males,
. Females,
15
13—
28
272
300
Hampshire,
u
. Males,
. Females,
5
3—
8
195
203
Middlesex,
u
. Males,
. Females,
25
33—
58
596
654
Nantucket,
. Males,
. Females,
0
0—
0
31
31
Norfolk,
. Males,
. Females,
1
2
3
559
562
Plymouth, .
u
. Males,
. Females,
1
0—
1
226
227
Suffolk, .
(1
. Males,
. Females,
7
9—
16
539
555
Worcester,
. Males.
. Females,
36
43—
79
1,239
1,318
Other States,
. Males,
. Females,
Totals,
0
0—
0
10
10
241
4,956
5,197
1857.]
SENATE— No. 1.
27
TABLE 10,
*
Showing- the ivhole number of Residents during- the year, the
average number each year, the number at the end of each
year, and the expenses of each of the twenty-four years the
Hospital has been in operation.
Whoie No. of
Average No.
No. at the end
Current expenses
Annual expenses
Year.
residents dur-
ing tUe year.
each year.
of each year.
each year.
per patient.
1333
153
107
114
$12,272 91
$114 67
1834
233
117
118
15,840 97
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
29,546 87
111 12
1843
458
244
255
27,914 12
114 40
1844
491
261
263
29,278 75
112 17
1845
656
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 52
123 77
1855
580
349
336
54,895 88
157 29
1856
577
357
376
45,631 37
128 64
28
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SENATE— No. 1.
29
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46
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1857.] SENATE— No. 1. 47
During the year the largest liberty has been allowed patients,
consistent with public safety.
The old and feeble, and those whose previous habits and con-
dition prevent their laboring in the fields or shops, are at all
times seen in groups about the grounds of the institution.
Some are in the streets who would hardly be taken for the
inmates of an insane asylum.
The women take frequent rides about town, and a few of the
old men ride occasionally, while all take frequent and long
walks.
These people are close observers of all that transpires in the
street, and are amused and relieved of many troubles by the
ever-changing scene before them. They hear the hum of the
busy shops ; witness with interest the tide of business ; watch
with pleasure the blossoming of the trees, the growth and ripen-
ing of the fruit, and gather much of it with their own hands,
for their own gratification.
Few of our patients are, or have been, in restraint during
the year. Since July last, no " strong room " has been oc-
cupied.
Patients often require some seclusion, as one sick of acute
disease requires his bed. But those whose malady has made it
necessary to resort to such means, have been kept in their own
room, the common dormitory of the house. And only in few
cases has the furniture been removed, and fewer still have we
suffered from much destruction of clothing or furniture. We
think that patients who have formerly been exceedingly noisy,
filthy and disgusting during their periods of excitement in the
" strong rooms," have been, to say the least, more easily con-
trolled, and less troublesome during similar excitements, when
not removed from their ordinary rooms.
This does not interfere with a proper classification of patients.
And we have not found that other patients have been much
annoyed by the confusion or excitement thus far.
We do not expect always to succeed. The wisest mistake.
The most patient do not always control themselves. There is
a limit to the forbearance of the most kind and persevering
assistants we can procure.
But we are more and more assured that, with patient and
persevering assistants, fully imbued with the spirit of the enter-
48 STATE LUNATIC HOSPITAL. [Jan.
prise in which they have embarked, it will seldom be necessary
to resort to mechanical restraint.
It is often a sore grief, sufficient to embitter the remainder of
life, for a patient to remember that he has been cast into a room
little better than a criminal's cell, when perhaps a little more
effort would have been successful in assisting the patient to re-
cover himself, and secure again his self-control.
Sometimes, however, the patient desires nothing so much as
to be placed where he can throw off' all the decencies of life,
and descend to every vulgar and debasing habit. The result of
" strong room " treatment in such cases is sufficiently apparent.
Amusements have always entered largely into the plan of
treatment in this institution.
Rides, parties, balls, and games of all kinds are in almost
constant operation. While this is as it should be, much care is
necessary lest those who will not and cannot engage in recrea-
tion without assistance, are forgotten in the more pleasant duty
of associating with those whose minds are but little disturbed.
It seems to be the duty of those engaged in this enterprise —
while not forgetting the more delicate and accomplished patient,
— to direct their energies to that more hopeless and sometimes
neglected class, whose bodies are slowly wasting away, whose
minds are becoming daily more and more vacant, and who are
by certain steps approaching a state of fatuity from which there
is no return. This class may be reformed and re-educated, and
made to assume the decencies and proprieties of life to some
extent.
In order to procure more intellectual amusement, and make
it the means of instruction, a plan is in operation to establish a
system of daily intellectual entertainments.
Historical readings, with familiar explanations, courses of
lectures and school exercises. Thus beginning what we hope
may prove a source of pleasure and profit at least, a part of the
year.
Our patients are well supplied with newspapers ; so that al-
most any patient can have the paper he has been accustomed to
read at his own fireside. For this we are indebted to the many
publishers who send their papers to us free of charge.
Some of our best galleries are supplied with libraries, and all
patients have free access to the books.
1857.] SENATE— No. 1. 49
So far as we have been able, we beautify the walls of the gal-
leries with pictures which give the appearance of life and gaiety,
and relieve the wards of that cheerless, sober look, so often ob-
served in similar institutions. We expect to be able to extend
this pleasure to all parts of our house.
We have been trying of late to introduce a system of labor
among our patients. So far as we have been able to succeed,
the result has been gratifying. There seems to be no .reason
why strong healthy men or women should not perform some
labor at an institution of this kind. It should not be compul-
sory. If it can be made pleasant and attractive, so that a con-
siderable number will engage in it, I have no doubt that it will
be found greatly useful as a remedial measure.
Patients who come to us slightly excited, so uneasy and res-
tive that they cannot be controlled at home, need only that their
activity be directed in proper channels, to become soon able to
manage their own affairs with safety and propriety.
Others, again, more excited ; impatient of all control and
direction, constantly busy in destroying, defacing and defiling
every thing in their reach, can, by a constant effort, be so di-
rected as to spend their strength and activity in performing
some labor, and thus work off their excess of vitality, and
become quiet and correct.
Those too, who are passing into imbecility, may, by easy and
pleasant tasks of labor, be amused, aroused and strengthened,
to some extent. If so, they will become more decent and cor-
rect in their deportment, and though they never recover, they
will experience some of the pleasures of life, and relieve their
friends of much anxiety for them.
/ There are in the hospital 141 patients having no settlement
in" the State, nearly all of whom are Irish. For the support of
these patients we receive from the State Treasury " two dollars
and fifty cents per week each for a term less than thirteen
weeks ; two dollars and twenty-five cents per week for any term
exceeding thirteen weeks, and not less than twenty-six weeks ;
two dollars per week for any term exceeding twenty-six weeks,
and less than one year, and for one year the sum of one Jmndred
dollars."
This 141 patients have been supported during the past year,
7
50 STATE LUNATIC HOSPITAL. [Jan.
at an expense of one hundred and twenty-eight dollars and
sixty-four cents.
November 30, 1855, there were 115 State paupers remaining,
supported, during the year ending at that date, at an expense
of one hundred and fifty-seven dollars and twenty-nine cents.
November 30, 1854, there were 151 of this class remaining,
supported, during the year ending at that time, at an expense
of one # hundred and twenty-three dollars and seventy-seven
cents. It will be easy to see that there has been a loss in the
last three years of more than $14,000. But this is not lost to
the hospital.
The Trustees, at their annual meeting, are obliged to estab-
lish the price of board for the ensuing year. And if in 1855
there was a loss of $6,588.35, the Trustees were obliged, in
order to meet the wants of the house, to raise the price of board
on all patients sent by their friends, or by the towns. The cost
of support being raised, the towns remove their more comfortable
insane. Farmers and mechanics, desirous to pay their own
bills, and hardly able at the lowest rates, can but poorly bear
a heavier burden. And they are obliged often to remove their
afflicted ones to their homes, or to the poor-house.
Another reason why a larger sum should be paid for the sup-
port of State paupers, is found in the fact that all comfortable
State paupers have been and are being removed, when able to
labor, to the State almshouses, leaving only the violent, destruc-
tive and dangerous, the cost of whose support is much greater
than the quiet, demented, and easily controlled.
The buildings and apparatus for heating and ventilating by
steam, commenced more than a year ago, are now quite com-
plete, and so far as we are able to judge, will answer our warmest
anticipations.
These buildings and fixtures are as follows : —
First. Directly under the road is a coal cellar, 45 feet square,
and 12 feet deep ; the roof being supported by groined arches
and pillars of solid brick masonry, laid in cement. In these
arches are coal drops from the road above through the roof to
the cellar below.
Next north, and adjoining, is the boiler room, 25 feet by 45,
and arched overhead. In this room ere placed four flue boilers,
each 30 feet long, and 42 inches in diameter. From this leads
1857.] SENATE— No. 1. 51-
an arched passage 80 feet long, for containing and conducting
an iron smoke flue to the chimney, which is 12 feet square at the
bottom, 100 feet high above ground, and 12 below the surface.
In this chimney are carried up, besides the smoke flue, warm
air ducts and ventilating ducts, for future use.
Next adjoining these subterranean rooms is a building 48
feet by 24 feet, two stories high. The lower story being divided
into two equal parts, one of which is occupied by two steam-
engines, of each 15 horse power. The other half is the fan
room, in which is a fan of 14 feet diameter by 8 feet in width ;
it has 12 floats or wings, and revolves in a brick box 40 times
per minute, and is capable of conveying into the air chamber,
and thence to the wards, 75,Q00 cubic feet of fresh air each
minute.
The large story above the fan and engine rooms, is to be
occupied as a shop in which any little mechanical apparatus,
requiring power, may be placed for the occupation and amuse-
ment of patients.
Adjoining the fan room, and between it and the main build-
ing, is an air-chamber, 120 feet long by 22 feet in width, and
15 feet in depth, reaching to and under the main building of
the hospital. In this chamber are placed 45,000 feet of wrought
iron 3-1 inch steam pipe, and 500 feet cast iron pipe, varying
in calibre from 2 to 6 inches. This steam pipe is arranged in
double rows, on standards reaching from floor to ceiling, 8 feet
apart the whole extent of this room.
The fan forces the air into this chamber, over the heated
pipes, and into the large air duct under the house, formed by
cutting out the partition walls supporting the floors of the
rooms on one side of each wing, thus making a continuous pas-
sage under the whole house, the partition walls and floors being
now supported by arches. This was lathed and plastered above,
and double brick walls built in front and rear, the interspace of
four inches being filled with non-conducting substance. From
this air duct the warm air passes to the rooms by the flues used
in the old arrangement. In the construction of all these air
chambers, double arches and double walls are everywhere made
with an interspace of four inches. And in their construction
more than 800,000 bricks have been used, and 500 perches of
stone.
52
STATE LUNATIC HOSPITAL.
[Jan.
From each patient's room there is carried up in the inner
wall ventilating flues, and these are gathered in the attic into
large ducts, and carried out at the chimneys.
The expenses have been about as follows : —
Excavating,
Brick and stone work, .
Four boilers, smoke pipe, &c,
Steam engines and force pumps,
Steam pipe and fittings,
Shafting and pulleys and belting,
Fan,
Total,
$2,500 00
12,500 00
4,500 00
1,850 00
6,500 00
500 00
500 00
$28,850 00
Much inconvenience has been felt for want of a proper drain-
age. Arrangements have been made to drain all the cess pools
of the establishment by means of a force pump on the hill in
the rear of the buildings, and thus make it useful as a means of
enriching the soil of the farm. These arrangements are a large
brick tank, 36 feet by 24 feet, divided in two equal parts, each
covered in by groined arches. Into one of these all sewerage
passes by proper channels, which, becoming full, the solids settle,
the fluid passes over into the other, from which it is pumped by a
force pump, through an iron pipe of four inch calibre, to any
distance required, and distributed by means of a flexible hose.
This, we hope, will be beneficial to us, and lessen the annoy-
ance we have made our neighbors.
On the farm of one hundred acres, there has usually been
kept four horses, one yoke of oxen, about twenty cows, and
from fifty to one hundred swine.
Of late, but one horse has been kept on the place, and during
the last year but sixteen cows. Some new stock has been pur-
chased, and perhaps it may be necessary to purchase more as
the old become fit for the butcher.
Some of the products of the farm has been as follows : —
Apples, . 40 barrels, at $2 50, .
Cherries, . 15 bushels, at 2 00, .
$100 00
30 00
1857.]
SENATE— K
Grapes,
2 bushels at $4 00,
Tomatoes,
. 100
" at 0 40,
Cucumbers
, 75
" at 0 50,
Beans,
. 30
at 2 00,
Peas, .
. 20
" at 1 00,
Cabbages,
2,000
heads, at 0 05,
Beats,
. 75 bushels, at 0 25,
Onions,
. 100
" at 0 50,
Turnips,
20
" at 0 25,
Parsnips,
100
" at 0 50,
Potatoes, .
50
" at 0 75,
Hay, .
75
tons, at 10 00,
ixowen,
Corn fodde]
j
Carrots,
1,000 bushels, at 0 25,
Beef,
7,666
pounds, at 0 08-^-
Pork,
8,224
" at 0 lO,'
Total.
53
$8 00
40 00
37 50
60 00
20 00
100 00
18 75
50 00
5 00
50 00
37 50
750 00
50 00
50 00
250 00
650 61
822 40
,279 76
Much of the labor necessary in producing the above results,
has been performed by patients.
A few .men who go out and in without restriction, except
proper hours, have taken nearly the whole care of the vegetable
gardens, and have thus procured a quiet, happy state of mind,
and good health.
• Doctor Frank H. Rice has performed the duties of assistant
physician, and also of clerk. He has been active and devoted
to his duties, and has rendered me very valuable service.
Since July, Dr. Thomas H. Gage has also performed the
duties of assistant, to whom I am under obligations for the
performance of many duties.
Rev. Isaac Hosford conducts with much labor and good will
the chapel exercises, in which our patients are all interested.
In looking over the events of the past year, we cannot but
feel grateful to the Giver of all good, for the results which have
crowned our labors. No calamity has befallen us. We have
suffered but little from acute disease.
Our bill of mortality is not large. Comfort and quiet has
54 STATE LUNATIC HOSPITAL. [Jan.
been the rule Of our house. The changes it has been necessary
to make have all been productive of good. Humbly hoping
that this state of things may continue, and that our institution
may be more and more useful each successive year,
I am, gentlemen,
Your obedient servant,
MERRICK BEMIS.
State Lunatic Hospital, Worcester,
December 1, 1856.
METEOROLOGICAL OBSERVATIONS
MADE AT THE
STATE LUNATIC HOSPITAL, WORCESTER, MASS.
Lat. 42° 16' 17", Long. 17° 48' 13".— Elevation, 53Qfeet.
56
STATE LUNATIC HOSPITAL.
[Jan.
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1857.]
SENATE— No. 1.
57
•2
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Snow.
Rain, slight.
Snow.
Snow, 11^ inches.
Snow, 1^ inch.
Snow.
Snow, 10^ inches
Snow, slight.
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Snow, ^ inch.
Lunar halo.
Lunar halo.
Snow, slight.
Snow, 3£ inchs.
Snow, slight.
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STATE LUNATIC HOSPITAL.
[Jan.
Rain. Fog. p. M.
Rain, interrupted. Spar-
[rows appeared.
Crocus in blossom.
Hazy, 2 p. M.
Puss willow in blossom.
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Daphne Mez. in blossom.
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61
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Rain. Dandelion andRed
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Rain, slight.
Hail.
Rain. Cherry in blossom.
Rain continued.
Rain continued.
Pyrus Japonica. [Cherry.
Rain, slight. Teach, W.
Rain, slight.
[in blossom.
Rain, slight. Shad bush
do Apple in bios. Lu-
Narcissus. [nar halos.
Rain. Tulip. Fog 7 a.m.
Rain. Calicanthus.
Flowering Almond.
[Lilac. Horse Chestnut.
Thunder shower. Hail.
Shower. '"Tart. Honey-
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Rain.
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