\\f~92r
1354 -&6
7
PUBLIC DOCUMENT No. 27.
TWENTY-SIXTH ANNUAL REPORT
THE TRUSTEES
STATE LUNATIC HOSPITAL
AT WORCESTER.
OCTOBER, 1858
BOSTON:
WILLIAM WHITE, PRINTER TO THE STATE.
1858.
Digitized by the Internet Archive
in 2010 with funding from
University of Massachusetts Amherst
http://www.archive.org/details/annualreportoftr24stat
OFFICERS OF THE HOSPITAL,
TRUSTEES.
THOMAS COLT, Esq., Chairman, Pittsfield.
CHARLES H. STEDMAN, M. D., ..... Boston.
JOSEPH N. BATES, M. D., . . . . . . . Worcester.
WILLIAM T. MERRIFIELD, Esq., . . . . . Worcester.
ROBERT W. HOOPER, M. D., . . . . . . Boston.
TREASURE R .
HENRY WOODWARD, Esq., ...... Worcester.
Office — Mechanics' Bank, Main Street, Worcester.
resident officers.
MERRICK BEMIS, M. D., . . . . . . Superintendent.
FRANK H. RICE, M. D., ..... Assistant-Physician.
CAROLINE A. BEMIS, Matron.
HENRY C. PRENTISS, M. D., . . . . Clerk and Apothecary.
GEORGE E. BLAKE, . . . Supervisor of Male Department.
JULIA A. BUXTON, . . . Supervisor of Female Department.
Rev. ISAAC HORSFORD, . Chaplain.
TWENTY-SIXTH ANNUAL REPORT
OF THE
TRUSTEES OF THE STATE LUNATIC HOSPITAL,
AT WORCESTER.
185 8.
To His Excellency the Governor, and the Honorable Council.
The Trustees of the State Lunatic Hospital at Worcester, in
accordance with the requirements of the law, have the honor to
submit this, their Twenty-Sixth Annual Report.
The discrepancy noticed in the last Annual Report of the
Trustees, between the Act of the legislature of 1857, requiring
that the Annual Reports of the various state institutions should
be made up to the thirtieth of September in each year, and the
provisions of the Revised Statutes that the annual meeting of
the Trustees of the Worcester Hospital should be held in the
month of December in each year, has been reconciled by the
passage of an Act of the legislature of 1858 repealing sec-
tion 5, chapter 48, of the Revised Statutes, and requiring the
Trustees of the hospital to hold their annual meetings in
October. The reports of the different officers of the hospital
are accordingly made up to September 30th, 1858, and embrace
a period of only ten months since their last Annual Report.
The Trustees having altered their contracts with the patients
for the payment of board, there will hereafter be no difficulty
in submitting full reports for the year, from the different offi-
cers of the hospital at the time prescribed by the Act of 1857.
6 LUNATIC HOSPITAL AT WORCESTER. [Oct.
In commencing our Report, we desire to express our acknowl-
edgments and thanks to Divine Providence for the continued
goodness and care which during the last year has kept the
hospital from the ravages of unusual disease, has protected it
from any great calamity, and by the prosperity vouchsafed to it
seems to have marked its approval of the efforts that have been
made to alleviate the sufferings of the greatest of human mis-
fortunes.
There has not been a great amount of sickness among the
inmates of the hospital, and the deaths have been almost
wholly confined to worn-out and demented cases of long stand-
ing. No epidemic disease has prevailed, and the general health
of the hospital has been unusually good.
The report of the Superintendent, which is herewith trans-
mitted, exhibits in full the general condition of the hospital
and the results of its operations during the last ten months.
"We have great pleasure in saying that the confidence we had in
Dr. Bemis, and the high expectations we had of his abilities at
the time he was appointed to the responsible position of Super-
intendent of this old and large hospital have in no particular
been disappointed, and we congratulate ourselves and the State
that the institution possesses a man so well adapted to the
position he occupies. The affairs of the hospital have been
managed with prudence and economy, and yet with liberality
towards its inmates in the matters of food, clothing and exer-
cise. An increasing disposition to orderly and quiet behavior
and cheerfulness of intercourse which has been manifest during
the whole year, proves to the Trustees that the true remedial
measures in the treatment of the insane, are those of gentle
kindness, and only by these can be secured the cooperating
efforts of the patient himself, which are so necessary to effect
a permanent cure.
With great gratification we repeat, what was said in our last
Report, that Dr. Bemis has not in a single instance made use
of the so called strong-rooms for the confinement of patients ;
and we are satisfied from past experience, that their use is by
no means necessary in the treatment of even the very worst
cases of insanity. Most of these rooms have been removed
during the last year and their places occupied by rooms for the
exercise and labor of the patients. A few of the rooms have
1858.] PUBLIC DOCUMENT— No. 27. 7
been dismantled and left for the present as a curious relic of
the mistakes and misunderstandings of the past.
The restraint placed upon the patients has been slight, being
simply a confinement to their own bed-room when too noisy
and turbulent, and in a very few (only four) instances of
suicidal mania, the camisole has been used. In most instances
an appeal to the self-respect and sense of propriety of the
patient has been sufficient to insure their good behavior and to
prove that even the most insane do not entirely lose their power
of self-control.
The Superintendent has made efforts during the year to give
employment to the patients, and though he has succeeded in
some measure, we regret it cannot be done to a greater extent.
We deem a light and cheerful occupation of the bodily faculties
an important curative element in the treatment of mental dis-
ease, and this is the most important reason for introducing
manual labor into an insane asylum. As a secondary object, it
might be made a source of revenue to the institution. Most
of the patients are willing and desirous to work. Their labor
should certainly never be compulsory. But we see no reason
why an insane asylum may not be a large industrial establish-
ment, where the cheerfulness and gratification of voluntary and
successful labor shall drive out the despondency of long days of
weary listlessness, and by diverting the mind from the contem-
plation of its own disease help to restore it to its natural health.
During the year, Dr. Frank H. Rice has continued, as
Assistant-Physician, to render valuable aid to the Superintend-
ent, and by his skill as well as interest in all the affairs of the
institution, has earned the approbation of the Trustees and of
Dr. Bemis. His fidelity to his duties make him a valuable
officer of the hospital.
The Trustees have appointed only one Assistant-Physician,
Dr. Bemis having preferred to manage the hospital without
further medical assistance. This arrangement has imposed
greater labor upon himself and Dr. Rice. As long as they find
themselves equal to the task, the Trustees deem it for the best
interests of the hospital that there should be but one Assistant-
Physician.
The duties of Steward have been performed by Mrs. Bemis in
a manner creditable to the hospital and highly acceptable to
the Trustees.
8
LUNATIC HOSPITAL AT WORCESTER.
[Oct.
The Rev. Isaac Horsford has officiated as chaplain during
the year in a manner entirely satisfactory to the Trustees and
Superintendent.
By reference to the report of the Superintendent it will be
seen that, at the close of the last year the number of patients
372
307
in the hospital was ....
.
Males,
. 177
Females,
. 195
Admitted during the last ten months,
.
Males, .' .
. 142
Females,
. 165
Discharged during the same period,
.
Males,
. 180
Females, .......
. 196
376
Whole number of patients who have received the care of the
hospital during the last ten months, 679.
There are in the hospital at the close of this year 301
patients.
Males,
Females,
141
160
127 patients have been discharged from the hospital as
recovered, and many more of those discharged have been very
much improved ; so much improved as to return to their accus-
tomed employments. Of the 376 patients discharged, 149 were
discharged to enter the new lunatic hospital which the State
has erected at Northampton, and the Taunton Hospital. In pre-
vious years, when this lunatic hospital was the only one founded
by the State, there has been crowded into its walls 570 patients
— a number which at once destroyed in a great measure the
objects of the institution and rendered it a place to be carefully
avoided by those who sought the means of curing' an insane
relative or friend. So great an evil as this crowded condition
of the hospital, demanded an immediate remedy which the
State has provided by the erection of two new lunatic hospitals,
one at Taunton and another at Northampton, thus excelling as
she does in all her charities, in the provision she has made for
the most unfortunate of all human beings.
1858.] PUBLIC DOCUMENT— No. 27. 9
In the Worcester Hospital there are private sleeping rooms
for 276 patients. By placing several beds in the same room,
the hospital can accommodate 306 patients, without being
obliged, as was the case previous to the opening of the North-
ampton Hospital, to place any patients at night in beds laid
upon the floor. But the rooms in which the associated beds
can be, and are placed, were designed for other uses, such as
the exercise and recreation of the patients and for work rooms
when the patients have employment. To use them for dormi-
tories is a perversion of them from what we deem a very impor-
tant purpose. The hospital is full with 276 patients, but can
accommodate 306 by crowding the beds ; and a larger number
cannot be accommodated without injury to the favorable con-
dition of the patients.
When the hospital is in a crowded condition there is a ten-
dency to discharge patients sooner than it is proper, in order to
give more room to new applicants. A patient who relapses on
account of premature discharge is almost always sure to be
returned to the hospital in a condition greatly worse than at
first, if not entirely incurable. In this way the evil of an
over-crowded state of the hospital, reacts upon itself.
The Trustees have made such alterations in the wards of the
hospital as will increase the entrance of light and air into every
part of the different wards, and give to the patients opportu-
nities of enjoying the beautiful prospect which the elevated
position of the hospital buildings commands. Recesses have
been formed in most of the wards, and furnished in such man-
ner as to give them the appearance of a social sitting-room,
instead of the comfortless look of a hospital hall. Pictures,
and books, and plants, have been placed in the several wards,
and the use and care bestowed upon them by the patients shows
how acceptable they have been.
The Superintendent has given much attention to the classifi-
cation of patients, classifying and separating them according to
their previous social position in life. The Trustees desire to
express their approval of such a classification, and their belief in
its importance in the ultimate cure of the patients. The finer
sensibilities of the insane are by no means lost in their affliction,
and it would be no wonder if the insanity of a highly educated,
intelligent and refined person should be increased rather than
2
10 LUNATIC HOSPITAL AT WORCESTER. [Oct.
cured, if the person is brought into close contact with those
who were always coarse in their habits and tastes, rough in
disposition, and filthy in their dress. We have no doubt that
persons in the better walks of life have often been deprived of
the benefits of a hospital from the dread of the associations they
would be obliged to make within its walls. A classification
into different wards can be made without depriving any class of
patients of its rights and privileges, and we hope such a classi-
fication may be completely carried out. Private lunatic hos-
pitals, as demonstrated in the experience of other countries,
more than our own, are liable to become great evils, and it is
only by affording in public institutions the best medical aid and
the most comfortable accommodations, that irresponsible and
unwatched private hospitals can be rendered harmless.
The Trustees have been highly gratified with the perfect
operation of the heating and ventilating apparatus which has
recently been placed in the hospital. It has answered our expec-
tations in every particular. The accompanying report of the
Superintendent will show how economically it is worked, and
how perfectly it answers its purpose.
During the year many improvements have been made on the
farm. Stone wall has been built, under-drains have been made,
ditches have been dug, water pipes repaired and relaid, buildings
kept in order, and the land and out-buildings of the hospital
carried on to a greater state of improvement. The hospital
now possesses a choice lot of pure blooded animals, obtained,
by careful breeding, at comparatively small cost to the hospital.
Necessary furniture has been purchased for the hospital, so that
the expenses for general improvements and repairs during the
last ten months has been large. These expenses are always
necessary to make and keep the Worcester hospital what it may,
and should be, and what it has heretofore been, — a model insti-
tution, creditable to the State and worthy of the public favor
with which it has always been regarded.
During the last year the Trustees have added to the farm of
the hospital two small pieces of land, one by exchange of a
small piece previously owned by the hospital, and the other by
payment of $1,275. One of these pieces was purchased to
prevent the necessity of opening a street through some portion
of the hospital grounds, and the other piece was deemed a
1858.] PUBLIC DOCUMENT— No. 27. 11
desirable purchase to preserve the proper and convenient shape
of the farm.
The Treasurer's report transmitted herewith, shows a favor-
able pecuniary condition of the hospital.
The Treasurer of the hospital finds some difficulty in the
adjustment of his accounts with the State as settled by the
State auditor. The account of the hospital against the State,
for the support of State paupers for one of the quarters of last
year, was returned to the Treasurer of the hospital with several
deductions made from the balance due the hospital. One
deduction was to the amount of 1622.24, being the amount
already paid to the hospital, by the State, during the last six
years for the support of a patient who, the agent of the Board
of Alien Commissioners now decides, possessed, at the time of
his commitment to the hospital, a legal residence in one of the
towns of this Commonwealth, and consequently that the said
town is liable for his support. In another instance the auditor
has deducted $200 for the amount paid four years ago for the
support of a patient who has not been in the hospital since that
time. No objections were made to these charges, by the State
authorities at the time they were paid, and now so long a
time has elapsed that it is utterly impossible for the officers of
the hospital to procure any legal proof that shall compel the
towns to refund the amount taken by the State from the
balance due the hospital. In some instances, in which the proofs
of residence were deemed by the State auditor sufficient to
warrant the deduction from our account, these proofs have been
submitted to the legal adviser of the hospital, and he has
declined to commence a suit against the towns designated
because he did not consider such proofs strong enough to justify
the risk of the action. It seems proper to the Trustees that if
such deductions are to be made from the hospital accounts,
there should be some limit to the time during which they shall
be liable to such deduction, so that the hospital can find a
remedy against the parties who may be legally liable. But it is
the opinion of the Trustees that in the matter of the support of
State paupers the hospital acts simply as the agent of the State,
and any claims against any town for the support of an insane
pauper, should be prosecuted by the State and in its name, and
that the hospital should be relieved from the burden of prose-
12 LUNATIC HOSPITAL AT WORCESTER. [Oct.
cuting for the board of a patient, whose support in any case,
costs the institution more than it ever receives.
Of all the public charities -which are justly the pride and
boast of this Christian Commonwealth, there are none which
more warmly commend themselves to the sympathies and
watchful care of every citizen than the institutions which she
has erected for the care and cure of the insane. For there is
no inhabitant of the whole State of any age or sex, no person,
however high his social position, however strong his physical
health, or however great and just his pride of intellect that can
feel always sure that he will never call for the experience or
care that can only be obtained from these institutions. While
he feels gratitude that accident or disease has not made him
one of their inmates, he should be eager to alleviate in every
possible way the condition of those upon whom so great a
calamity has fallen.
THOMAS COLT.
C. H. STEDMAN.
J. N. BATES.
WM. T. MERRIPIELD.
R. W. HOOPER.
1858.]
PUBLIC DOCUMENT— No. 27.
13
TREASURER'S REPORT
The Treasurer respectfully submits the following report.
Cash on hand, December 1, 1857,
Received for interest on bonds,
From the Commonwealth for support of patients,
From towns and individuals, for support of patients,
From Mechanics' Bank,
The disbursements have been as follows : —
Steward's orders, .....
Worcester Bank, .....
Mechanics' Bank,
Bills payable. Treasurer's note due Jan. 11
Interest to Worcester and Mechanics' Banks,
Real Estate, ......
Recording Deeds, .....
Printing for Treasurer,
J. M. Barker, examining Treasurer's accounts
Town of Waltham. Expenses of suit,' .
Treasurer's salary, ....
Cash on hand, .....
$132 91
15 00
25,760 31
33,600 23
793 97
$60,302 42
. $38,267 26
8,955 46
8,273
25
1858
, 2,000
00
351
64
1,275
00
1
00
16
25
;s,
5
00
72
79
480
93
603
84
$60,302
42
H. WOODWARD, Treasurer.
Worcester, October 13, 1858.
14 LUNATIC HOSPITAL AT WOKCESTER. [Oct.
SUPERINTENDENT'S REPORT.
Twenty-Sixth Annual Report of the Superintendent to the
Trustees of the State Lunatic Hospital, at Worcester.
Gentlemen, — In obedience to the By-Laws of the State
Lunatic Hospital, the Superintendent presents to its Board of
Trustees the Twenty-Sixth Annual Report.
It is needless to remark that the year has been one of peculiar
trial and severe labor.
In reviewing its history we hope it may be found that our
efforts have been crowned with some degree of success.
Our aim has been to sustain the high character of the
hospital, increase its usefulness, and to extend its curative
facilities.
Whatever of good has been accomplished, must be attributed
to your constant oversight, ready assistance, and wise direction
in all the affairs of the institution.
During the entire year the general health of the patients has
been good, with complete exemption from all epidemic diseases.
For this blessing, we must all feel abundant cause for renewed
thankfulness to God, as well as for the discipline, good order,
and harmony which have always marked our household.
The hospital has accommodations for three hundred patients.
Our tables will show that during almost the entire ten months,
the period which this report covers, — we have been greatly
crowded.
By order of his Excellency, Governor Banks, there were
transferred to the hospital for insane at Northampton,
August 16, 1858—
Males, ...... 35
Females, . . . . . 16
— 51
1858.] PUBLIC DOCUMENT— No. 27. 15
September 20, 1858—
Males, . ..... 32
Females, ..... 31
— 63
September 30, 1858—
Males, .00
Females, 28
— 28
Total to Northampton, . . . 142
And to the State Lunatic Hospital at Taunton,
September 2, 1858—
Males, 3
Females, ...... 4
— 7
Whole number transferred, . . . 149
By the same authority we have received from the State
Lunatic Hospital at Taunton,
August 30, 1858—
Males, 17
Females, ...... 26
— 43
September 17, 1858 —
Males, ...... 4
Females, 11
— 15
Total from Taunton, . 58
From the Boston Lunatic Hospital,
September 20, 1858.
Males, > . 12
Females, ...... 19
— 31
Whole number received by transfer, . 89
Thus diminishing the number of patients in this hospital by
the several tranfers —
Males, ...... 37
Females, 23
— 60
16 LUNATIC HOSPITAL AT WORCESTER. [Oct.
On the opening of the " hospital for insane," at North-
ampton, the friends of all patients committed to this hospital
on private bonds from the four western counties of the State,
were at once notified by the undersigned of the occupancy of
the hospital at Northampton, and of their right and privilege to
remove their insane wards from this to that institution.
In preparing the annual reports of hospitals for the insane,
great similarity in general character must occur, and consid-
erable repetition in the details. Each report, however, adds
something to the mass of facts, and the value of these depends
upon their number and the faithfulness and accuracy of those
who observe them.
Reports of hospitals for the insane have undoubtedly done
much in diffusing a knowledge of the condition of the insane,
the character of the disease, the proper method of treatment
and the claims of hospitals upon the community
The whole number of patients in the hospital, December 1st,
1857, was —
Males, . 177
Females, 195
Total, 372
The whole number admitted from December 1, 1857, to Sep-
tember 30, 1858, inclusive, was —
Males, 142
Females, 165
Total, 307
The whole number under treatment, from December 1,1857,
to September 30, 1858, inclusive, was —
Males, . 319
Females, . . . . . .360
Total, . . - . . . .679
1858.]
PUBLIC DOCUMENT— No. 27.
17
The whole number discharged from December 1, 1857, to
September 30, 1858, inclusive, was —
Males, .180
Females,
Total,
As follows : —
196
376
Males.
Females.
Total.
Recovered, ....
55
72
127
Improved,
97
77
174
Not improved, .
10
31
41
Died,
18
16
34
Total,
180
196
376
The whole number remaining in the hospital September 30,
1858, was —
Males,
Females,
Total,
141
160
301
One hundred and twenty-seven patients have been discharged
and have returned to their families and friends in the enjoy-
ment of a degree of mental health and strength equal to that
possessed by them previous to the attack of disease which
placed them under our care.
One hundred and seventy-four have been discharged improved ;
and although not recovered, many of them were sufficiently
well to return to their accustomed occupation, and assist in the
support of themselves and their families. Some of this class
are periodically insane, having intervals of apparent health, of
longer or shorter duration, during which they transact all the
ordinary business of life, and are esteemed valuable members
of society.
It is extremely difficult, in many cases, to decide whether or
not, the patients have recovered. A large class of persons who
3
18 LUNATIC HOSPITAL AT WORCESTER. [Oct.
are brought within the care of hospitals for the insane never
possessed strong and active minds, — could never manage well for
themselves, or control at all the affairs of others. While under
the care and guardianship of friends, they meet well enough
the common events of life. But when oppressed by care and
anxiety, — when afflicted with disease, or when bereaved by the
loss of those upon whom they have leaned for support they
become the ready victims to insanity. After a time they
improve ; but old and familiar faces do not again shine upon the
invalid with their accustomed cheerfulness. Arms once their
willing support are not now outstretched. The charity of the
almshouse is all that is offered them. Under a different state
of things many of this class might be said to have recovered.
There has been during the year the usual amount of sick-
ness ; confined mostly to the habitually feeble, demented, and
long insane patients. During the winter several of the aged
patients suffered from influenza. In the spring there were
several cases of fever. During the summer and autumn there
has been some diarrhoea and dysentery, generally of a mild
character and yielding readily to proper remedies.
The mortality of the patients has been confined almost
entirely to cases of marasmus, consumption, epilepsy and palsy.
It is not to be supposed however, that the inmates of hospi-
tals for the insane are in the possession and enjoyment of robust
health. With few exceptions they are all feeble. The excite-
ment of distempered imaginations may keep up for a time a
state of feverish activity, but it soon subsides and shows too
plainly how sure and fatal have been the approaches of disease.
Table 1,
Showing the Admissions and state of the Hospital, from November 30,
1857, to September 30, 1858, inclusive.
Patients in the Hospital December 1, 1857, 372
Males, 177
Females, 195
Patients admitted in the course of the year, 307
Males, . 142
Females, 165
Whole number in the Hospital in the course of the year, . . 679
Males, 319
Females, 360
1858.] PUBLIC DOCUMENT— No. 27.
Table No. 1 — Continued.
19
Patients remaining in the Hospital September 30, 1858,
Males, 141
Females, 160
301
Of the admissions, there were cases of less duration than one year, 120
Males, 59
Females, 61
Of the admissions, there were cases of one year or more, . . 144
Males, 63
Females, » . 81
Of the admissions, there were cases, the duration of whose insanity
could not be ascertained, 43
Males, . . . 18
Females, 25
Patients committed by Courts, 151
Males, . 79
Females, 72
Patients committed by Overseers of the Poor, .... 22
Males, 10
Females, 12
Patients committed by order of the Governor, .... 88
Males, 32
Females, ' . . . .56
Patients on bonds, 44
Males, . . . • 21
Females, 23
Foreigners, and those who have no settlement in this State,
admitted in the course of the year, 136
Males, 53
Females, 83
Foreigners, and those who have no settlement in this State, dis-
charged in the course of the year, 185
Males, 75
Females, 110
Patients discharged by order of the Governor, .... 149
Males, 70
Females, 79
Foreigners, and those who have no settlement in this State, remain-
ing in the Hospital September 30th, 1858, .... 86
Males, 33
Females, 53
Foreigners and those who had no settlement in this State, remaining at the
close of each year, as nearly as can be ascertained : —
1842,
34
1851,
. 208
1843,
38
1852,
. 241
1844,
38
1853,
. 216
1845,
57
1854,
. 151
1846,
52
1855,
. 115
1847,
121
1856,
. 155
1848,
150
1857,
. 119
1849,
167
1858,
. 86
1850,
181
20 LUNATIC HOSPITAL AT WORCESTER. [Oct.
By the foregoing table it is shown that you have discharged
from this hospital, in the course of ten months, one hundred
and eighty-five patients who had no settlement in this Common-
wealth.
Many of them had recovered and are now supporting them-
selves and families by their own labor. A large proportion of
those not recovered, were able to labor, and at the time of dis-
charge might, with little assistance and direction, procure their
own livelihood.
Nearly all of those having no settlement in this Common-
wealth were foreigners, a large majority of whom were Irish.
This large class of people stand in false relations to nearly
every thing about them. They are strangers in a strange land.
Surrounded by circumstances novel to them, met by customs to
which they cannot adapt themselves, influenced by motives
often extravagant and wild, they must necessarily become
involved in harrassing doubt and perplexity.
They receive in prosperous times high wages, and are able at
the cheapest rates to gratify vicious indulgences. They seek
for labor in the most menial capacity, huddle together in the
most objectionable places, neglect all the rules of health, and
prefer the excitement or solace of rum or tobacco to the quiet,
intelligent influences of well-ordered homes. Under this state
of things it is natural to suppose that a large percentage of
insanity would be found. The table also shows that only eighty-
six patients remain in the hospital who are supposed to have no
settlement in this Commonwealth. A smaller number than has
been in the hospital at any time during the last twelve years.
The number of State paupers has diminished by thirty-three
in the course of ten months.
The number discharged exceeds the number admitted by
forty-nine.
In preparing the preceding table it is shown most conclusively
that those who had no settlement in this Commonwealth have
received the first and best privileges of this hospital.
1858.]
PUBLIC DOCUMENT— No. 27.
21
Table No. 2.
Supposed Causes of Insanity of Patients admitted to the Hospital from
January 18, 1833, to September 30, 1858, inclusive.
1858.
Previously.
SUPPOSED CAUSES.
Males.
Females.
Males.
Females.
Apoplexy,
Asthma, .
-
-
2
o
-
Bowels, Disease of, .
-
-
1
-
Brain, Inflammation of,
-
-
1
5
Bronchitis,
-
-
2
13
Chorea, .
-
-
-
2
Congenital,
-
-
4
-
Constipation,
Convulsions,
—
-
8
1
6
Dysentery,
Dyspepsia,
Epilepsy,
Eruptive Disea
ses, .
8
4
1
2
73
2
2
30
1
Eyes, Disease of,
loss of, .
Fever,
-
-
1
1
25
32
Scarlet,
-
-
1
3
Ill-health,
19
35
135
467
Influenza,
-
-
1
5
Insolation,
-
-
12
-
Laryngitis,
Measles, .
-
-
3
1
4
Nervous Irritation, .
_
-
-
4
Nymphomania,
Old Age,
1
1
7
1
3
Otitis,
_
_
3
-
Palsy, _ .
Periodical,
4
2
34
48
21
56
Pneumonia,
_
-
_
1
Rheumatism,
-
-
3
1
Satyriasis,
Scrofula, .
-
-
1
2
Sea-sickness,
_
_
_
1
Somnambulism,
_
_
_
1
Sore Finger, .
_
-
_
1
Spinal Disease,
Suppressed Eruption,
Ulcer, .
-
-
5
1
1
4
3
Tic Doloureux,
_
_
_
1
Tumor, .
-
-
-
1
22 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 2 — Continued.
1858.
Previously.
SUPPOSED CAUSES.
Males.
Females.
Males.
Females.
Whooping Cough, ....
_
_
_
1
Amenorrhea, .
-
-
-
14
Lactation,
-
-
-
5
Menorrhagia, .
-
-
-
2
Menorrhagia, suppressed,
-
-
-
1
Miscarriage,
-
-
-
1
Pregnancy,
-
-
-
3
Puerperal,
-
5
-
136
Turn of Life, .
-
5
-
21
Amputation of Leg,
-
-
1
-
Bathing in cold water,
-
-
2
-
Cut Foot,
-
-
1
1
Dog Bite,
-
-
1
-
Drinking cold water,
-
-
1
-
Dye-house, fumes of,
-
-
1
-
Exposure to cold, .
-
-
6
-
Fall,
-
-
-
4
Fracture of Arm, .
-
-
-
1
Injury, .
-
-
4
3
Injury of Head,
1
1
43
7
Kick of Horse,
-
-
1
-
Lead, poison of,
-
-
2
-
Lightning,
-
-
1
1
Loss of Blood,
-
-
1
-
Malformation of Head,
-
-
1
-
Poison, .
-
-
1
-
Spinal Injury, .
-
-
1
1
Excess of Labor,
-
-
28
51
Loss of Sleep, .
-
-
-
3
Fatigue and Exposure,
2
1
1
2
Study, excessive,
-
-
25
6
Inventions,
-
-
1
—
Excitement, .
-
-
2
4
Excitement of Politics,
-
-
1
2
Anticipation of Marriage,
-
-
-
1
Fortune being told, .
-
-
-
1
Enthusiasm,
-
-
-
1
Mesmerism,
-
-
-
1
Spiritualism, .
1
1
10
13
Light reading, Novels, &c
■)
-
-
-
1
Anxiety, .
-
-
2
11
Criminal Trial,
-
-
2
-
False Accusation, .
-
-
-
1
Imprisonment,
.-
-
1
-
Death of Brother, .
-
-
1
3
Children, .
-
-
3
19
Father,
-
-
2
1
Friends, .
_
_
2
3
Husband, .
—
—
-
19
1858.] PUBLIC DOCUMENT— No. 27.
Table No. 2 — Continued.
23
1858.
Previously.
SUPPOSED CAUSES.
Males.
Females.
Males.
Females.
Death of Mother, .
1
6
Niece,
-
-
-
1
Sister,
-
-
-
3
Wife,
-
-
10
-
Husband, departure of,
-
-
-
1
sickness of,
-
-
-
3
intemperance c
>,
-
-
-
2
desertion of,
-
-
-
2
abuse of, .
-
-
-
7
Abuse of master,
-
-
1
-
parent,
-
-
1
2
Domestic trouble,
2
9
57
127
grief,
-
-
56
137
cares,
—
—
-
1
Marriage, unfit,
-
-
4
2
Disappointment,
-
-
4
7
in Love,
-
-
47
51
Disappointed ambition,
1
1
5
5
Homesickness,
-
-
1
5
Lost in woods,
-
-
-
1
Shipwreck,
-
-
1
-
Fright, .
-
2
10
15
Fear,
_
-
2
_
of Death,
-
1
1
-
of Insanity,
-
-
1
-
Being witness in Court,
-
-
-
1
Seduction,
-
-
-
1
Millerism,
-
-
5
5
Religious,
-
-
89
142
Religious anxiety, .
-
-
1
4
excitement,
-
—
13
8
fanaticism,
-
-
13
7
perplexity,
-
-
9
3
Pathetism,
—
-
—
1
Infidelity,
-
-
1
-
Mormonism,
-
-
1
-
Pecuniary anxiety, .
-
-
18
5
difficulty,
-
-
55
8
loss,
—
-
43
10
Strike for Wages, .
-
-
1
_
California Excitement,
-
-
2
_
Poverty, .
-
-
-
1
Fear of Poverty,
3
-
25
11
Giving up Business,
-
-
1
-
Change of Business,
_
-
1
_
Indulgence of Parents,
-
-
3
1
Jealousy,
1
3
16
20
Passion uncontrolled,
-
-
-
1
Violent Temper,
—
—
1
14
24 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 2 — Continued.
1858.
Previously.
SUPPOSED CAUSES.
Males.
Eemales.
Males.
Females.
Anger, .
Great Indignation, .
Intemperance,
Opium, use of,
Tobacco, use of,
Masturbation, .
Venery, excess of, .
11
3
2
1
1
1
413
1
232
1
1
46
3
3
24
Little is known respecting the causes of insanity. They may
be remote and only slightly predisposing to the influence of the
disease, or they may be immediate and exciting to a greater or
less degree.
Among the remote causes are constitutional predisposition,
hereditary or otherwise. The influence of education, moral
and physical, the peculiarities of organization, and previous
attacks of disease seriously disturbing the action of the brain.
Some of the immediate and exciting causes are domestic
affliction, reverses of fortune, disappointments, jealousy, and
unrestrained anger. The exciting causes may also be physical,
as irregular menstruation, consequence of parturition, apo-
plexy, blows on the head and abuse of strong drink.
It has been supposed that some peculiarity, mental or
physical, is necessary to the development of insanity ; without
the existence of which, causes capable of producing the disease
will not affect the individual, or they will put in motion some
other train of morbid phenomena.
Habitual intoxication does not always produce insanity.
Some are afflicted with paralysis, some with apoplexy, others
with disease of the liver or lungs.
Again, it is supposed that there is something in the state or
condition of society which promotes a peculiar susceptibility to
mental diseases. It is well known that a false system of edu-
cation increases the susceptibility to mental disease.
By lack of moral discipline and by capricious indulgence,
the passions acquire a controlling power, and thus form a char-
acter subject to violent emotions. An overstrained and prema-
1858.] PUBLIC DOCUMENT— No. 27. 25
ture exercise of the intellectual powers is equally destructive
to mental health. During the early years of existence the
brain is inadequate to perform the task of reflection to any
great extent, or to accomplish any purely intellectual labor.
The artificial forcing of young minds is utterly destructive to
sound health of body or mind. Parents and teachers ambitious
for the intellectual prowess of their children and pupils destroy
their own hopes and lay the foundation for early bodily disease
and mental decay.
Notwithstanding the extensive religious awakening and excite-
ment during the early part of the year the insanity of few if
any of the patients admitted during the ten months had any
connection with the doubts, fears, and anxieties respecting a
future state of existence.
We believe that the number of persons made insane by the
influence of religious hopes and fears has been greatly over-
stated. The insane mind is frequently occupied by delusions
of a religious nature when it is well known that the cause of its
derangement has no connection with feelings or impressions
relating to a future state of existence. No richer or wider
field than the invisible world, can be offered to the gloomy mis-
anthrope whose mind is already diseased, none his imagina-
tion will be more apt to choose to wander in and dwell on,
when the whole origin of his derangement may have been
nothing more than the influence of dyspepsia or some trivial
reverse of fortune.
Ill health in its various forms, as usual, stands at the head of
our table, sending us twice the number of females that it does
of males.
Intemperance sends us thirteen, and domestic affliction fre-
quently caused by intemperance, eleven.
26
LUNATIC HOSPITAL AT WORCESTER.
[Oct.
Table No. 3.
Diseases which have proved Fatal, from January 18, 1833, to September
30, 1858.
1858.
Previously.
Males.
Females.
Males.
Females.
Apoplexy,
_
_
14
9
Asthma, .
1
—
2
1
Anasmia, .
-
-
1
1
Asphyxia,
-
-
1
-
Bronchitis,
-
-
2
-
Brain Fever, .
-
-
1
-
Consumption, .
2
4
29
47
Convulsions, .
-
-
3
1
Cholera Morbus,
-
-
2
3
•Cholera, .
-
-
5
—
Cancer, .
-
-
1
1
Congestion of Lungs,
-
-
-
1
Brain,
-
-
1
1
Chronic Dysentery,
-
-
2
-
Meningitis,
2
-
1
-
Dysentery,
-
-
10
6
Dropsy, .
-
-
5
7
Delirium Tremens, .
-
-
3
-
Disease of Heart, .
-
-
9
11
of Bladder,
-
-
1
_
of Brain, .
-
-
6
14
Diarrhoea,
-
-
13
8
Enteritis,
-
_
3
6
Epilepsy,
4
2
41
15
Exhaustion,
-
-
27
43
Erysipelas,
-
-
9
10
Gangrene of Lungs,
-
-
1
1
Hydro-thorax,
-
-
1
1
Hemorrhage, .
-
-
4
4
Hemoptysis,
-
-
1
-
Inflammation of Bowels,
-
-
3
3
Jaundice,
_
-
-
2
Marasmus,
1
4
44
43
Mortification, .
_
_
_
1
Maniacal Exhaustion,
_
-
4
2
Malignant Fever, .
_
-
1
-
Old Age,
2
1
11
9
Palsy,
4
2
11
12
Pneumonia,
-
1
9
14
Pleurisy,
-
-
-
1
Kupture,
-
-
1
-
Syncope,
-
-
1
-
Suicide, .
_
_
13
8
Suppurative Phlebitis,
-
-
1
-
Typhoid Eever,
-
1
8
5
Typho Mania, ....
2
1
5
3
Total,
18
16
311
294
1858.]
PUBLIC DOCUMENT— No. 27.
27
TABLE 4.--S/ig
■ the Post Mortem Appearances of all Cases examined from November 30, 1857, to September 30, 1858.
Mental Disease.
Date of
Post Mortem
Exatui nation.
One year,
Four mouth;),
ExhallStiOD,
Fourteen hours,
Chronic and Paroxys-
Melancholia,
Melancholia ami Palsy,
Thirty-two hours,
Paralysie Generale,
Paroxysmal Mania and
Paralysie Generale,
Acute Mania.
Paroxysmal Mania,
Twelve months,
Twenty-four hrs.
General Appearance of Body.
Well formed, not much wasted,
but rather thin ; enmplcMoii
light, but slightly Sallow,
Great emaciation ; lividity of de-
pending portions; rigor mortis
strongly marked; complexion
'ull ; well formed when admitted :
complexion sallow; much ema-
ciated; sedemn of tinkles,
; rigor mortis
Somewhat emaciated: ci.i j.K-\i< -u
Strong, and well formed ; com-
plexion light ; abundance of
cutaneous fat: rigor mortis
strongly marked,
larked ; ,-li^ht lividity of de-
pending portions,
marked . depending portion
livid . feet ami ;i nk !. - swollen,
Strong, and well formed; much Very thin ; Strongly adherent
emaciated at tin I ' <!•■ ith : com- to Cranium, an "
plexion dusky and sallow, but little blood
Thin, a
Uttle blood,'
Thick, and much congested,
Thin and bloodless ; strongly
adherent to Cranium,
Thin, ami adherent
ruled from I'niiiiuiii,
Scalp thick, and congested
with venous blood, easily
separated ; ecchymozedfrom
heating bis head against the
and contained
Head quite thin and large,
am well formed,
Normal,
Head large ; Cranium
Head small and narrow, par-
ticularly in front; Cranium
thin J osseous, tissue dense;
Diplce almost absent.
Of moderate thk
Cerebri! Substance.
of the membranes,
■ -mail whitish opaque bodice
imbedded in the substance of the Pia Mater,
t the top and side of brain,
Nothing unusual in appearance nf membrane,'
it. There was a moderate effusion in the cavity of the Arach-
noid, and considerable vascular congestion. The membranes
were perfectly healthy,
din.'il Si nil v tie.ir the I leeijiit..-!':iHetal -iltnrei, w.i- mi ., I he-i, ,i ,
of this membrane to the Arachnoid, and a bony deposit contain-
ing spirilla1 of hone three-fourths of an inch in length. The
sides of the Brain, containing
1 in each Ride of the Brain, li :
were small deposits of false :
ditiou, containing small bony deposits. Tin- '
No adhesion of Dura Mater to Cranium o
serum elTused in the Arachnoid cavit
and opacity of that membrane,
Dan Mater Df usual thickness, and not adherent to Cranium or
Ar.iel 1 I Lin -li.-ht eltu-iou ,.,f -iTuiii in An-linoid I'avity ;
Pia Mater very v.tscular; Cliiudula? Pacchioni small,
r three pia. e-. and containing bony Cerebrum of
ttealthy to appearance.
E 0 change io substance or vessels of Brain.
the ventricles
> Pleura on both -ide-, and also to Mediastinum.
J Air-cells and small bronchial tubes were much dilated, and
I plugs of viscid mucous completely filled them. The capillary
- emptied and nearly obliterated by <
ray matter natural in appearance and color: general con sis t-
enee firm ; no congestion of vessels of Brain. The Vertebral
and Basilar arteries were much thickened, and contained por-
tions i,| bum ami ealear is matter; portions of the Internal
Carotid and Cerebral arteries were completely ossified. The
Choroid Plexus congested, and occupied with cysts, but a
small quantity of si
in the Cerebral subs
Iubstance of Brain apparently healthy; the ventricles were
distended with serum, the Lateral containing one ounce each.
The Basilar and Vertebral arteries were thickened and spotted
1 with an atheromatous deposit of a calcareous nature.
Nothing unusual in the appej
e substance or vessels
. and to appearance
Cerebellum softened, the
arteries much thickened, ami *
. and apparently healthy,
1 in:; 1 lb and
t the si/i* of n large pea. imbedded mi the substance
Apparently healthy,
morbidly adherent to Cranium;
No change in substance of Brain
1858.] PUBLIC DOCUMENT— No. 27. 29
Three persons died, within the ten months which this report
embraces, who were more than eighty years of age.
Four were between the ages of seventy and eighty years, and
six were between the ages of sixty-five and seventy years.
Making thirteen of those the cause of whose death is stated in
the table of mortality upwards of sixty-five years of age each.
Of the patients who died, seven were admitted since Decem-
ber 1, 1857. Two had been inmates of the hospital more than
fifteen years, and two more than ten years each.
Two patients died within thirty-six hours after admission ;
three within one week after admission, and two within two
weeks after admission.
Table No. 5,
Showing the Ages of Patients admitted from November 30, 1857, to
September 30, 1858.
Less than 15 years of age, - . 3
Between 15 and 20, 18
20 and 30, 63
30 and 40, 93
40 and 50, 78
50 and 60, 35
60 and 70, 12
70 and 80, 3
More than 80 years of age, 2
Total, 307
Table No. 6,
Showing the Ages of Patients remaining in the Hospital, September 30,
1858.
Less than 15 years of age, 1
Between 15 and 20, 9
20 and 30, 52
30 and 40, 128
40 and 50, 84
50 and 60, 40
60 and 70, 15
70 and 80, 8
More than 80 years of age, 4
Total, 301
30
LUNATIC HOSPITAL AT WORCESTER.
[Oct.
Table No. 7,
Showing the Duration of Insanity before admission, of those admitted
from November 30, 1857, to September 30, 1858.
Insane less than 1 year, 135
more than 1 and less than 2 years,
52
2 and less than 5 years,
40
5 and less than 10 years,
23
10 and less than 15 years,
19
15 and less than 20 years,
12
20 and less than 25 years,
8
25 and less than 30 years,
1
30 years,
2
Unascertained,
15
Total, 307
Table No. 8,
Slowing the Duration of Insanity of those remaining, September 30,
1858.
Insane less than 1 year, .
more than 1 and less than 2 years,
33
2 and less than 5 years,
52
5 and less than 10 years,
95
10 and less than 15 years,
30
15 and less than 20 years,
15
20 and less than 25 years,
9
25 and less than 30 years,
11
30 years,
3
Unascertained,
12
Total, 301
Table No. 9,
Slioioing the Civil Condition of Patients admitted from November 30,
1857, to September 30, 1858.
Unmarried, 158
Married, 122
Widows, 14
Widowers, ...... r ... 6
Unascertained, 7
Total, 307
1858.]
PUBLIC DOCUMENT— No. 27.
31
Table No. 10,
Showing the Civil Condition of Patients remaining September 80, 1858.
Unmarried, . 165
Married, 84
Widows, 23
Widowers, .......... 8
Unascertained, . .21
Total, 301
Table No. 11,
Shovjing the Occupation of Patients admitted into the Hospital from
January 18, 1833, to September 30, 1858, inclusive.
OCCUPATION OF PATIENTS.
1858.
Previously.
MALES.
Auctioneers, .......
-
3
Armorers,
-
3
Author,
1
-
Blacksmiths,
2
32
Bakers,
-
6
Butchers, .
-
5
Bookkeepers, .
Book-binders, .
1
5
6
Boot-makers,
-
15
Brokers, .
-
2
Britannia-workers,
-
o
Brickmakers, .
-
5
Bellows-makers,
-
2
Brewers, .
-
2
Basket-makers,
-
-
Bricklayers,
Butlers,
-
3
2
Barbers, .
-
3
Clergymen,
Carpenters,
Coppersmiths, .
2
8
16
107
6
Coopers, .
Cabinet-makers,
1
15
9
Calico-printers,
-
3
Clothiers,
-
17
Comb-makers, .
-
4
Coach-makers, .
-
7
Card-makers, .
1
1
Chair-makers, .
—
3
32 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 11 — Continued.
OCCUPATION OF PATIENTS.
1858.
Previously.
Cigar makers,
3
Coachmen,
-
16
Clerks,
2
24
Carpet weaver,
-
1
Curriers, .
-
7
Cashiers of Banks, .
-
4
Cordwainers, .
-
4
Collectors,
-
2
Caulkers,
-
4
Chandlers,
-
5
Camphene distiller, .
Conductor on railroad,
1
1
1
Dyers,
Druggists,
_
4
3
Draymen,
Drover, .
—
3
1
Dancing master,
-
1
Daguerreotypist,
Engravers,
1
1
2
Editors, .
-
4
Express-men, .
Farmers, .
30
3
420
Fishermen,
1
12
Fruiterers,
-
4
Gunsmiths,
-
3
Gardeners,
-
9
Grocers, .
-
3
Glass-blowers, .
-
3
Gilders, .
-
2
Hotel-keepers, .
Hatters, .
—
15
3
Hostlers, .
-
9
Housewrights, .
-
7
Harness-makers,
-
7
Ironmongers, .
-
3
Jewellers,
-
11
Lawyers, . * .
Laborers,
32
12
290
Last-maker,
-
1
Manufacturers,
-
31
Millers, .
-
6
Merchants,
4
107
Masons, .
-
17
Miners,
-
5
Mat-makers,
-
3
Miniature painter, .
Musicians,
—
1
7
Machinists,
1
29
Messengers, . .
-
2
Moulders,
-
6
Millwright,
-
1
Millers," •
1
3
1858.] PUBLIC DOCUMENT— No. 27.
Table No. 11 — Continued.
33
OCCUPATION OF PATIENTS.
1858.
Previously.
Nail r,
1
New men,
-
3
Optiscian,
-
1
Operatives in mill, .
2
47
Oystermen,
-
4
Painters, .
1
27
Printers, .
-
29
P hysicians,
-
11
Paper-makers,
-
4
Peddlers, .
-
17
Plot,
-
1
Potters,
-
3
Porters, .
-
9
Pump and Block-makers,
-
3
Pattern-makers,
1
4
Police officers, .
1
3
Rope-makers, .
-
9
Riggers, .
-
3
Restaurators, .
-
7
Shoemakers,
12
183
Sail-makers,
-
9
Soap-makers, .
-
4
Sash and Blind makers,
-
2
Stage drivers, .
-
4
Sea Captains, .
1
14
Sailors,
3
94
Saddlers, .
-
9
Silversmiths,
-
19
Students, .
-
49
Stock-maker, .
-
1
Silk-weavers, .
-
2
Ship Carpenters,
-
17
Ship Brokers, .
-
2
Shop keepers, .
-
3
Stone cutters, .
2
12
Soldiers, .
-
5
Spinners, .
-
13
Sheriffs, .
-
3
Shoe dealers, .
-
3
Stable keepers,
-
2
Shoe binders, .
-
7
Tailors, .
1
13
Teachers,
1
49
Tobacconists, .
_
3
Teamsters,
1
11
Tinmen, .
_
2
Umbrella-makers,
-
4
Victuallers,
_
3
Wheelwrights, .
-
13
Watch makers,
-
4
Wood-turners, .
_
3
Watchman,
_
1
Whip-maker, .
_
1
Weavers,
•
-
17
34 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table 11 — Continued.
OCCUPATION OF PATIENTS.
185S.
Previously.
FEMALES.
Carpet weavers,
-
2
Cooks,
-
55
Chamber maids,
-
33
Dress makers, .
4
47
Engraver, . •
-
1
Housekeepers, .
67
927
House maids
23
112
Laundresses,
8
44
Milliners, .
4
22
Mantua-makers,
-
6
Midwife,
1
-
Nurses,
1
12
Nursery-maids,
-
18
Operatives in mill,
Seamstresses, .
8
7
116
305
Straw-sewers,
3
7
Shoe-binders,
-
16
Students, .
-
4
School girls,
5
36
Teachers,
2
56
Tailoresses,
3
33
Type-setter,
Wool stapler,
Weavers, .
-
1
1
17
Table No. 12,
Showing the Duration of Insanity before admission, of Patients admitted
from January 18, 1833, to September 30, 1858.
Males.
Insane less than 1 year, 1,606
more than 1 year and less than 2 years,
326
2 years and less than 5 "
427
5 years and less than 10 "
233
10 years and less than 15 "
115
15 years and less than 20 "
35
20 vears and less than 25 "
37
25 years and less than 30 "
16
30 years, ....
24
Unascertained,
225
Total, 3,044
1858.] PUBLIC DOCUMENT— No. 27.
Table No. 12 — Continued.
35
Females.
more than 1 year and less than 2 years,
287
2 years and less than 5 "
373
5 years and less than 10 "
202
10 years and less than 15 "
127
15 yeai's and less than 20 "
36
20 years and less than 25 "
39
25 years and less than 30 "
9
30 years, .
24
237
Total, 2,975
Table No. 13,
Showing the Ages of Patients admitted to the Hospital from January 18,
1833, to September 30, 1858.
Males.
Females.
Less than 15 years of age,
19
24
Between 15 and 20 years of age,
199
183
20 and 30 "
799
773
30 and 40 "
689
762
40 and 50 "
583
606
50 and 60 "
310
359
60 and 70 "
180
143
70 and 80 "
50
51
More than 80 years of age,
7
14
Unascertained, . . . .
8
17
Totals, ....
2,844
2,932
Table No. 14,
Showing the Civil Condition of Patients admitted to the Hospital from
January 18, 1833, to September 30, 1858.
Civil condition.
Males.
Females.
Unmarried,
Married,
Widowers, . . . . .
Widows,
Unascertained,
1,520
1,170
135
38
2,863
1,262
1,250
343
35
2,890
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 15,
Showing the Number of Admissions and Discharges, and the Whole
Number under Treatment for each of ten months.
Admitted.
Discharged.
Whole
Number.
Males.
Females.
Males.
Females.
December, 1857,
395
12
11
11
9
January, 1858,
393
9
7
5
15
February, "
393
10
8
8
7
March, "
397
11
8
9
10
April, "
401
11
12
13
12
May,
404
16
12
14
16
June, "
397
11
12
8
10
July, "
402
12
11
15
8
August, "
443
24
40
46
28
September, "
434
26
43
51
81
Totals, .
142
165
180
196
Table No. 16,
Showing the Admissions from each County during the last and previous
years.
1858.
Total.
Previous^'.
Whole No.
Males.
Females.
Barnstable,
126
126
Berkshire,
5
2
7
177
184
Bristol,
21
37
58
281
239
Dukes,
_
-
-
19
19
Essex,
22
18
40
392
432
Franklin,
1
1
2
121
123
Hampden,
10
7
17
334
351
Hampshire,
2
4
6
214
220
Middlesex,
20
30
50
718
768
Nantucket,
-
-
-
31
31
Norfolk, .
3
2
5
565
570
Plymouth,
-
2
2
229
231
Suffolk, .
17
29
46
568
614
Worcester,
38
31
69
1,383
1,452
Other States,
3
2
5
12
17
Totals,
142
165
307
5,468
5,775
1858.]
PUBLIC DOCUMENT— No. 27.
37
Table No. 17,
Showing the whole number of Patients during the ten months, the average
number, the number at the end of each year, the expense of each year,
and the annual expense for each patient for each of the twenty-six years
the Hospital has been in operation.
Year.
Whole No.
Average No.
No. at end of
each year.
Current expenses of
each year.
Annual expense
for each patient.
1833, .
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
1857, .
647
387
372
49,004 75
124 04
1858, .
679
372
301
38,267 26
102 86
38
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PUBLIC DOCUMENT— No. 27.
59
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60 LUNATIC HOSPITAL AT WORCESTER. [Oct.
It will be seen that nearly all the foregoing tables date from
the opening of the hospital. They thus embrace a period of
twenty-six years, and cover nearly six thousand cases, contain-
ing all that has been known and recorded concerning the
patients.
The tables are as nearly correct as can be made from the
records of the hospital, and may be relied upon as affording
statistics relative to the peculiar features and conditions of
insanity as observed in this hospital.
While it is a popular belief, that insanity is a disease of
growing frequency in this community, it seems to be proper to
afford all the information possible as to the mode and success
of its treatment, the character and condition of the hospital,
and its fitness for the care and recovery of those who may be
placed within its wards.
No hospital for the insane within our acquaintance, possesses
such complete accommodations for the classification of the
several grades of patients and the various phases and con-
ditions of disease. There are comfortable, cheerful, home-like
wards for twelve classes of each sex, each ward having by
itself all its appointments and arrangements complete, as to
dining rooms, water closets, bath rooms and lavatories, ward
robes, attendants' rooms and suicidal rooms. There are con-
venient sick rooms, patients' visiting rooms and recreation
rooms, in close proximity to each ward.
During the last year a complete separation has been main-
tained between the foreign and native patients, much to their
mutual satisfaction and benefit. The foreign patients have
the same comforts and accommodations, the same grade of
attendants, and receive the same care and attention that native
patients do. But looking at the welfare of the patients, there
seemed to be good and sufficient reasons for a separation.
When in health they separate themselves. They do not occupy
the same house or live in the same neighborhood, except in
widely different capacities. They have but few feelings in
common with each other. Opposite in religion and all the
notions of social life, it would not be well to class the two races
in the same wards, where each must bear from the other what
was considered troublesome and offensive while in health.
1858.] PUBLIC DOCUMENT— No. 27. 61
But while an effort has constantly been made to keep up a
style of life in the hospital which should not so widely differ
from that to which our patients have been accustomed in their
homes as to disturb their natural feelings or offend their tastes,
the result has been greatly to elevate the condition of the
foreign patients while in the hospital. So that the separation
has not been brought about by any considerations of economy,
such as plainer and cheaper accommodations, or a smaller
allowance for the daily sustenance and care of the poor insane
immigrant.
The subject of labor becomes of more importance each year.
Its pecuniary value cannot be estimated. But aside from its
cheering and healthy influences it procures for the patients
many small comforts which could hardly be afforded otherwise.
We must again add our testimony to the value of agricultural
and horticultural employment in the cure and recovery of the
insane. It has of late been well established that a farm and
gardens are very important parts in a system of the treatment
of the insane, and we hope their utility may never be ques-
tioned. They are valuable by affording employment, and thus
contributing to the comfort, happiness and recovery of a large
class of patients, as well as for the pleasure and luxury
resulting from an abundant supply of fruits and vegetables
obtained from them.
In making up the table of the products of the farm and
gardens, we regard a few bushels of roots or a few barrels of
fruit, more or less, as of little value in themselves. But in
another view of the case, these little matters are of great
importance. The pleasure of watching their growth and assist-
ing in their cultivation has helped restore the insane to health.
It has banished harrassing doubts and perplexities, dissipated
distressing delusions, brought quiet and repose to excited
mind, and sleep to wakeful eyes.
The farm and gardens belonging to the hospital were never
more productive, and their results in all respects never more
satisfactory than at present. The garden devoted to the raising
of kitchen vegetables, has been, as usual, almost entirely
managed by patients. We hope, in addition to this, to have
a green-house for the cultivation of grapes.
62
LUNATIC HOSPITAL AT WORCESTER. [Oct.
In making up the table the present year before the harvest,
will materially lessen the amount of the products of the farm,
leaving, as it does, some of the crops on the ground.
Apples, .
50 bushels.
at $0 50-
- $25 00
Cherries, .
10
it
at
2
00
20 00
Plums,
1
a
at
2
00
2 00
Grapes, .
5
u
at
2
00
10 00
Corn, sweet,
150
a
at
50
75 00
Beans,
30
a
at
2
00
60 00
Peas,
60
a
at
1
00
60 00
Beets,
75
a
at
50
37 50
Cucumbers,
. 125
a
at
50
62 50
Tomatoes,
. 150
a
at
75
112 50
Squashes,
3,000
pounds,
at
01
30 00
Cabbages,
1,000 heads,
at
05
50 00
Milk, .
25,000
quarts,
at
05
1,250 00
Hay, .
75 tons,
at 12
00
800 00
Rowen, .
15 tons,
at 10
00
150 00
Corn Fodder, .
25
tons,
at
2
00
50 00
Potatoes,
100 bushels.
at
50
50 00
12,844 50
The carrots, beets, and potatoes for winter use are not
included. Beef and pork fattened on the place during the year
is not yet slaughtered.
There are kept on the farm for the use of the hospital three
horses, four oxen, one bull, and sixteen cows. There are
growing up six yearling heifers, three yearling bulls, and four
calves, and fifty swine.
In the. course of the year there have been built about two
hundred and fifty rods of heavy stone wall, and about the same
number of rods of large, capacious stone under-drains have been
laid. Rocks have been blasted and removed from the fields,
water pipes have been repaired, land reclaimed, and ditches
made. A portion of all this labor has been performed by
patients.
The labor of the female patients is no less important. They
assist in the kitchen and wash room, and perform nearly all
the ironing for the whole establishment. They work in the
1858.]
PUBLIC DOCUMENT— No. 27.
63
sewing room, and do much of the mending for the inmates.
They make all the bedding, towels, napkins, table spreads, and
window curtains. They also make the chemises, dresses, shirts,
and some of the trousers and vests worn by the patients.
Some of them assist the attendants in the care of the dining
rooms, and many of them prefer to take care of their own rooms
and furniture.
The following table will show the number of articles made
by the female patients, from November 30, 1857, to September
30, 1858.
Bed Ticks, .
26
Sheets,
383
Chemises, .
300
Shirts,
278
Coats, .
8
Skirts,
60
Dresses,
175
Skirts, embroidered,
18
Frocks,
19
Suspenders, pairs of,
160
Hose, pairs of,
32
Spreads,
45
Mattress Ticks, .
117
Table Covers,
20
Napkins,
75
Towels,
235
Pillows,
105
Trowsers, pairs of,
84
Pillow Cases,
400
Window Curtains,
. 150
Overalls, pairs of, .
14
Vests, .
. 23
Our mattresses have all been made over, and some fifty new
ones manufactured by male patients.
Nothing contributes more to the happiness of the household
than the round of amusement afforded them. Biding, walk-
ing, reading, games of all kinds, cultivation of flowers, care of
pets, birds, &c, the Matron's parties, dancing, singing, magic
lantern scenes, maps and pictures, break up the monotony
which must otherwise be dull and irksome.
The carriage is mostly devoted to females and feeble old men.
The males who do not labor much on the farm take frequent
and long walks with an attendant. They also engage in games
of base ball, cricket and quoits, and spend much of the time
in the open air.
In addition to riding, the females walk in pleasant weather
about the grounds in parties, or sit with their needle work or
books in the grove within the inclosure and amuse themselves
by watching the business of the street. In the house they play
64 LUNATIC HOSPITAL AT WORCESTER. [Oct.
all the various games of cards, draughts, dominoes, graces,
battledoor, &c.
The males also, while in the house, engage in all the games
that ingenuity can devise to occupy time.
It is to be hoped and expected that we may hereafter be able
to have for the benefit of the patients, a reading-room and
museum for each sex.
It is designed to fit up an apartment in a cheerful and attract-
manner, in which the convalescent and the cultivated patients,
who desire some place of resort, may quietly read and study,
or amuse themselves with such objects of interest as we may
be able to collect. If we are successful in making the arrange-
ment, a want will be supplied which has long been felt by
patients of refined feelings and cultivated minds ; especially
while convalescing, and still so feeble as to be constantly
annoyed by the many unpleasant associations of a hospital
ward. We hope it will be in our power to place in these rooms,
beside books, papers and periodicals, specimens of natural
history, birds, minerals, shells, &c, pictures, charts, maps,
globes, portraits, busts, &c. A multiplication of such objects
cannot fail to render a residence in the hospital less irksome
than it would otherwise be.
Although there must be restraint and privation connected
with a residence in a hospital for the insane, we desire to sur-
round the patients with so much that is cheerful and attractive,
and such a variety of the means of occupation and amuse-
ment, as to dispel many unpleasant associations and hasten
a restoration to health and usefulness.
In view of these things, we have also in contemplation the
furnishing of a billiard room for males, and a sort of calisthe-
neum for females.
The process of warming and ventilating the hospital is quite
perfect, and has been found to be satisfactory, by all who have
examined it. Every apartment in the house is not only warmed,
but thoroughly ventilated. The temperature is equal ; the
warmth well diffused, and the air so constantly renewed by the
operation of the fan, as to be always fresh and pure in every
part of the house. The fan is in constant operation during
summer and winter, affording the patients as much comfort in
1858.]
PUBLIC DOCUMENT— No. 27.
65
the warm weather by its supply of cool, fresh air, as in the
winter by its constant breeze of warm air.
The following table will show the exact amount of coal con-
sumed from November 30, 1857, to September 30, 1858.
Amount for
each Month.
lbs.
Daily Average,
lbs.
December, 1857,
January, 1858,
February, "
March, "
April, "
May, "
June, "
July,
August, "
September, "
Total, .
152,000
144,000
167,000
126,000
71,700
47,400
38,100
32,400
35,500
38,100
4,903
4,645
5,964
4,064
2,585
1,529
1,270
1,045
1,146
1,270
852,200 or, 426^ tons.
Little can be said in an annual report of a hospital for the
insane respecting the treatment of insanity. But it may be
necessary in passing to remark that all our patients are under
treatment.
None are left without some effort being made to restore to
them that degree of mental health which will enable them to
return to their families and assume their ordinary business.
All occupation suited to their physical condition, all amuse-
ment congenial to their tastes, all seclusion and restraint neces-
sary for the safety of the patient, belong to the domains of
medicine and might very properly be classed under the heads,
hygienic and moral. Nothing can be of greater importance to
the insane than a system of judicious moral treatment.
In fact the whole discipline of an asylum may be termed its
system of moral treatment, inasmuch as its tendency is to
66 LUNATIC HOSPITAL AT WORCESTER. [Oct.
bring about a new class of mental impressions and direct the
operations of the mind into healthy channels. The means in
use in hospitals for the insane often seem to be slight and
feeble, and to the inexperienced utterly inadequate to meet and
overcome the passion, violence, and fury which has so often
been observed in attacks of insanity.
But it must be borne in mind that the patients are under
constant care and surveillance, and that wide departure from
good order and correct discipline cannot be unobserved.
Kind, firm, persevering watchfulness takes the place of seclu-
sion and mechanical restraint, and vastly diminishes the neces-
sity of severe and repressive measures.
Thus it happens that patients who, while with their friends,
surrounded with all the comforts of home, were furious, abu-
sive, and uncontrollable, become harmless and obedient when
they find themselves belonging to a community controlled and
directed in all its movements, watched and restrained in all its
manifestations of violence, and cheered and sustained by kind-
ness and sympathy amid all its gloom and melancholy.
But every physician will understand how utterly useless is
purely moral treatment in the case of those whose insanity
depends upon a change in the pathological condition of the
brain or any other organ. Here recourse must be had to
medicines. And in order to fulfil the indications of treatment
and meet the symptoms of disease as observed here, cathartics,
emetics, and emetico-cathartics, warm baths, and warm baths
with the application of cold to the head, are employed to a con-
siderable extent. In many cases however stimulants and tonics
are freely administered and are generally admissible in the
later stages of mania when the system is much enfeebled by
the process of disease and other sources of exhaustion to which
neglected cases are sometimes exposed.
Still we must often be content with removing all causes of
excitement and enforcing only hygienic rules. The dismissal
of intimate friends, the removal of familiar objects of occupa-
tion and amusement, the absence of noise and confusion, the
suppression as far as possible of mental activity, the establish-
ment of regular habits as to sleep, diet, and exercise, are all
that can or need be done for the restoration of the patient to
sound mental health. These are the influences which attend
1858.] PUBLIC DOCUMENT— No. 27. 67
a residence in a hospital for the insane, and which often restore
health to the patient without the administration of medicine.
Looking over the events of the year now closed, we cannot
too strongly express our gratitude to our Heavenly Father that
we are able to record so much success and prosperity.
The number of patients who have been restored to usefulness
and happiness has been large. There has not been an unusual
amount of sickness and mortality. The condition of those who
remain under our care is comfortable, and a large majority of
them are contented and happy.
We desire in behalf of the patients to express our gratitude
to Hon. George B. Upton, for a donation of fifty dollars for the
purchase of engravings for one of the male wards ; to Samuel
Jennison, Esq., for the purchase of statuary for one of the
female wards ; to Messrs. Earle and Drew, publishers of the
Massachusetts Spy ; to William R. Hooper, Esq., publisher of
the Worcester Transcript ; Hon. J. S. C. Knowlton, publisher
of the Worcester Palladium; and T. W. Caldwell, Esq., pub-
lisher of the Bay State, for large and weekly packages of their
best exchanges, as well as for their weekly and daily issues.
Also to S. Thomson, Esq., for liberal supplies of illustrated
papers ; to Nathan Hale, Esq., for the Boston Daily Advertiser
since the opening of the hospital in 1833 ; to the publishers of
the Salem Register, the Salem Gazette, the Andover Adver-
tiser, the Bunker Hill Aurora, the Cambridge Chronicle, the
New England Farmer, the Statesman, the Youth's Companion,
Zion's Herald, Gospel Messenger, and to unknown friends for
other weekly papers received by mail.
We are aso indebted to Hon. Charles Sumner for Public
Documents, to Hon. Charles Mason for Patent Office Reports,
and to Professor Henry for publications from the Smithsonian
Institute, to Mr. Chamberlain of Boston for an interesting
microscopical exhibition, and to Edwin Bynner, Esq., for a
valuable watch dog.
I must express my sense of obligation to the other resident
officers of the hospital for the persevering manner in which they
have performed all their duties, and their untiring devotion to
the interests of the institution.
To my assistant, Dr. F. H. Rice, I am under special obliga-
tions for the fidelity and efficiency with which he carries out
9
68 LUNATIC HOSPITAL AT WORCESTER. [Oct.
all my plans and labors to promote the welfare of all the inmates
of the hospital.
While we acknowledge with devout gratitude the many bles-
sings vouchsafed to this institution during its whole history, let
us hope that the same Good Providence will still watch over
and protect it, and assist all who may be connected with it to
elevate its character and increase its usefulness.
MERRICK BEMIS.
State Lunatic Hospital, Worcester, \
October 1, 1588. j
METEOROLOGICAL OBSERVATIONS
THE STATE LUNATIC HOSPITAL, WORCESTER, MASS.,
1857-8.
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