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



65 



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PUBLIC DOCUMENT No. 27. 



TWENTY-SEVENTH ANNUAL REPORT 



THE TRUSTEES 



STATE LUNATIC HOSPITAL, 



AT WORCESTER. 



OCTOBER, 1859. 



BOSTON: 

WILLIAM WHITE, PRINTER TO THE STATE. 
1859. 



OFFICERS OF THE HOSPITAL. 



TRUSTEES 

JOSEPH N. BATES, Chairman, 
WILLIAM T. MERRIFIELD, 
CHARLES H. STEDMAN, . 
THOMAS COLT, . 
ROBERT W. HOOPER, 



. Worcester. 

. Worcester. 

. Boston. 

. Pittsfield. 

. Boston. 



TREASURER. 

HENRY WOODWARD, Worcester. 

Office, Mechanics' Bank, Main Street, Worcester. 



RESIDENT OFFICERS. 

MERRICK BEMIS, M. D., Superintendent. 

FRANCE H. RICE, M. D., Assistant-Physician. 

HENRY C. PRENTISS, M. D., . . . . Clerk and Apothecary. 

CAROLINE A. BEMIS, Matron. 



€cmtmontt)ealtl) of Jttas0ad)tt0£tt0. 



TWENTY-SEVENTH ANNUAL REPORT 

OF THE 

TRUSTEES OF THE FIRST HOSPITAL FOR INSANE, 
AT WORCESTER. 



His Excellency the Governor, and the Honorable Council : 

The Trustees of the State Lunatic Hospital at Worcester, in 
compliance with the laws of the Commonwealth, respectfully 
submit this Twenty-Seventh Annual Report. 

It will be seen by reference to the statistics of the Superin- 
tendent, the number of patients in the institution October 1, 
1858, was, males, 141 ; females, 160. Total, 301. 

Admitted during the year 1858-9 — males, 106 ; females, 94. 
Total, 200. 

Whole number under treatment — males, 247 ; females, 254. 
Total, 501. 

Discharged recovered — males, 43 ; females, 46. Total, 89. 

Improved — males, 25 ; females, 27. Total, 52. 

Not improved — males, 7 ; females, 6. Total, 13. 

Died — males, 20 ; females, 10. Total, 30. 

Whole number discharged during the year — males, 95 ; 
females, 89. Total, 184. 

Whole number remaining in the hospital September 30, 
1859— males, 152 ; females, 165. Total, 317. 



6 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Of this number there are — Irish, 75 ; Germans, 4 ; blacks, 
2 ; State paupers, 5. 

SALARIES OF OFFICERS. 

Superintendent, . . ... . . $1,800 00 

Steward and Matron, . . . . 700 00 

Assistant-Physician, . . . 900 00 

Treasurer, 600 00 

The prices of board for patients in the institution, as estab- 
lished by the Trustees for the year ensuing — $3 per week for 
first six months ; $2.75 for remaining six months. 

By the blessing of God, the institution has been preserved 
from prevailing epidemics and diseases. Although our number 
of recoveries is somewhat less than for the past two or three 
years, it will be remembered that the number of patients has 
diminished, and the number of commitments have been less, in 
consequence of the establishment of other like institutions in 
the Commonwealth. We believe, however, that the compara- 
tive number of recoveries, on all the admissions, exhibits nearly 
the same ratio as in previous years. 

The present condition of the hospital and its inmates is most 
satisfactory. The Trustees are gratified to express their con- 
fidence in the untiring industry and devotion of our worthy 
Superintendent, and his efficient corps of assistants, in the pro- 
motion of the welfare of all the inmates of the institution, and 
the progress of all affairs committed to their supervision. 

The improvements and repairs connected with the hospital 
and its surroundings, have been more extensive than any former 
year. The chapel, from its dilapidated and untenantable con- 
dition, requiring many important and expensive repairs, is now, 
in connection with other important improvements, being rebuilt 
and in rapid progress of completion. The erection of suitable 
fences, the relaying of water pipes, and the construction of 
reservoirs on the farm and at the stables, together with the 
general improvements in agricultural affairs, constitute a large 
item in the list of current expenses. 

The more immediate wants of the institution, beyond those 
in progress of completion, are a building and suitable inclos- 
ures for gymnastic exercises for patients and attendants. 



1859.] PUBLIC DOCUMENT— No. 27. 7 

A more substantial supply of water is also much needed in 
the direct vicinity of the hospital buildings, which the Trustees 
believe may be secured by the construction of reservoirs 
sufficiently adequate to supply all necessary demands in the 
event of conflagrations on the premises. 

JOSEPH N. BATES. 
WM. T. MERRIFIELD. 
C. H. STEDMAN. 
THOS. COLT. 
R. W. HOOPER. 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



TREASURER'S REPORT 



The Treasurer respectfully submits his annual report. 



Cash on hand October 1, 1858, . 
Received from the Commonwealth, 
Received from towns and individuals, 
Received interest on railroad bonds, 
Mechanics' Bank, . 



The disbursements have been as follows 
Steward's orders, . . 
Mechanics' Bank, .... 
Town of Quincy, (overcharge on acc't,) 
Expense of sustaining suits, 
Treasurer and expenses, 
Cash on hand, 



8603 


84 


25,818 


54 


88,745 


68 


30 


00 


253 


22 


$60,451 28 


$58,396 99 


793 


97 


62 


18 


290 


00 


676 


88 


231 


26 



,451 28 



H. WOODWARD, Treasurer. 
Worcester, October 14, 1859. 



1859.] 



PUBLIC DOCUMENT— No. 27. 



SUPERINTENDENT'S REPORT 



Tiventy-seventh Annual Report of the Superintendent to the 
Trustees of the State Lunatic Hospital, at Worcester : 

Gentlemen, — The close of another year renders it my duty, 
in compliance with the by-laws of this hospital, to present to yon 
a statement of its general condition ; for which purpose the 
following report, comprising the usual statistical and tabular 
matters, with such brief remarks as they may suggest, is most 
respectfully submitted. 

Table No. 1, 

Showing the General Results of the year. 





Males. 


Females. 


Total. 


Patients in the hospital, Oct. 1, 1858, 


141 


160 


301 


" admitted during the year, . 


106 


94 


200 


Whole number under treatment, . 


247 


254 


501 


Discharged recovered, ..... 


43 


46 


8% 


" improved, ..... 


25 


27 


52 


" not improved, .... 


7 


6 


. 13 


Died, 


20 


10 


30 


Whole number discharged during the year, 


95 


89 


184 


" " remaining Sept. 30, 1859, 


152 


165 


317 



The number of patients in the hospital at the beginning of 
the year was three hundred and one, of whom one hundred 

2 



10 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

and forty-one were males, and one hundred and sixty were 
females. 

The number admitted during the year was two hundred, of 
whom one hundred and six were males and ninety-four were 
females. 

The whole number under treatment during the year was five 
hundred and one, of whom two hundred and forty-seven were 
males, and two hundred and fifty-four were females. 

The whole number discharged during the year was one hun- 
dred and eighty-four, of whom ninety-five were males and 
eighty-nine were females. 

The whole number remaining in the hospital is three hundred 
and seventeen, of whom one hundred and fifty-two are males 
and one hundred and sixty-five are females. 

. Of the one hundred and eighty-four patients discharged, 
eighty-nine had recovered their full measure of mental and 
physical health and have returned to their homes and friends 
clothed in their right minds. 

The recoveries were in the ratio of forty-five per cent, to the 
number admitted, or nearly twenty-six per cent, to the average 
number of patients in the hospital, and seventy-five per cent, to 
the number of those whose insanity had existed less than one 
year. 

The proportion of recoveries has frequently been much 
greater. In 1844 ninety-three per cent, of recent cases recov- 
ered ; and in 1855 ninety-two per cent. I think you will 
perceive, however, that the proportion of recoveries is quite 
satisfactory, and if calculated only upon recent cases, large 
enough to gratify your highest expectations. 

Of the fifty-two discharged as improved, several were suffi- 
ciently restored to return to their homes and resume wholly or 
in part their ordinary labors and duties. Others have become 
so tranquil and so much improved in physical health as to cause 
their friends but little anxiety, and to require from them but 
little care and attention. 

A few, although considerably improved and quite comfort- 
able while under the care and protection of the hospital, are 
demented and hopelessly insane. They have been discharged 
as harmless and incurable and removed to their homes or 
to almshouses, thus diminishing to their friends, or the towns 



1859.] PUBLIC DOCUMENT— No. 27. 11 

in which they have a settlement, or the Commonwealth, the 
expense of their support. 

Of the thirteen who were discharged as not improved, one 
was transferred to another hospital by order of the governor ; 
five returned to their homes, and seven went to almshouses, 
having been discharged as harmless and incurable. 

Five thousand nine hundred and seventy-six patients have 
been admitted into the hospital since it was opened, of whom 
two thousand nine hundred and thirty-three were males, and 
three thousand and forty-three were females. 

Of this number two thousand and forty-seven have recov- 
ered, giving a ratio of nearly forty-six per cent, of recoveries 
on the whole number of patients admitted, or nearly forty-nine 
per cent., deducting the number of those who still remain in 
the hospital. 

Nine hundred and seventy-one patients have been discharged 
" improved," which number added to the number of recoveries, 
makes the number of persons who have received benefit by a 
residence in the hospital, three thousand two hundred and 
fifty-five. 

Table No. 2, 

Showing the Admissions and State of the Hospital, from September 30, 

1858, to September 30, 1859, inclusive. 

Patients in the hospital September 30, 1858, .... 301 

Males, 141 

Females, 160 

Patients admitted in the course of the year, .... 200 

Males, 106 

Females, 94 

Whole number in the hospital in the course of the year, . . 501 

Males, 247 

Females, . . . 254 

Patients remaining in the hospital September 30, 1859, . . 317 

Males, 152 

Females, 165 

Of the admissions, there were cases of less duration than one year, 119 

Males, 59 

Females, 60 

Of the admissions, there were cases of one year or more, . . 81 

Males, 48 

Females, 33 



12 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 2 — Continued. 



Of the admissions, there were cases, the duration of whose insanity 

could not be ascertained, . 

Males, 

Females, ........... 



Patients committed by Courts, 

• Males, 

Females, 

Patients committed by Overseers of the Poor, 

Males, 

Females, ...... 

Patients committed by order of the Governor, 

Males, . * . 

Females, 

Patients on bonds, 

Males, 



69 
65 

16 
4 



21 



Females, 25 

Foreigners and those who have no settlement in this State, 
admitted in the course of the year, . . 

Males, 36 

Females, 35 

Foreigners, and those "who have no settlement in this State, dis- 
charged in the course of the year, 

Males, ' . .36 

Females, 36 

Patients discharged by order of the Governer, .... 

Males, 2 

Females, - 

Foreigners, and those who have no settlement in this State, remain- 
ing in the Hospital September 30, 1859, .... 

Males, 41 

Females, 46 



134 



20 



46 



71 



72 



87 



Foreigners and those who had no settlement in this State, remaining at the 
close of each year, as nearly as can be ascertained : 



1842, 
1843, 
1844, 
1845, 
1846, 
1847, 
1848, 
1849, 
1850, 



34 


1851, 


38 


1852, 


38 


1853, 


57 


1854, 


52 


1855, 


121 


1856, 


150 


1857, 


167 


1858, 


181 


1859, 



208 
241 
216 
151 
115 
155 
119 
86 
87 



1859.] PUBLIC DOCUMENT— No. 27. 13 

The preceding table shows that one hundred and nineteen 
patients were committed to the hospital whose insanity had 
existed less than one year. Other tables will show that for a 
period of twenty-seven years, seventy-five per cent, at least of 
all patients committed to the hospital who had been insane less 
than one year, have recovered their mental health and strength. 
It might also be easily shown that a large majority of those who 
are committed on the first appearance of insanity are restored 
during a period of six months. 

Indeed, it is conceded by all, that the early administration of 
the proper remedies and regimen is of the utmost importance 
in the care and treatment of the insane. When therefore the 
disease has commenced, the patient should at once be confided 
to the care of a hospital designed for the special treatment of 
his malady. 

Dr. Conolly, in an admirable paper on hospitals for the 
insane, remarks, that it seems to have been too much forgotten 
that in every case of insanity, the first object should be as in 
other diseases, the restoration of the patient ; and that this is 
often impossible without a removal of the patient from home. 
All the influences and all the associations of home become per- 
verted in a large majority of cases in this malady ; the alarm, 
and the affections even of surrounding friends, lead to hurtful 
concessions and indulgences, and to the abandonment of whole- 
some control, until the bodily disorder present in the first 
stages of the malady is increased and the mind becomes more 
and more irritated, thus making recovery much more difficult, 
if not altogether impossible. The security of the patient and 
safety of his family then become sufficient reasons for his com- 
mitment to the hospital. 

Reference to the table will also show the manner of commit- 
ting patients to this hospital during the last year. 

A large majority of the one hundred and thirty-four patients 
sent to us by the courts, were committed by the judges of pro- 
bate and insolvency. A few were committed by the police 
courts, and a still smaller number by justices of the peace and 
of the quorum. 

All those patients who are supported by the charity of the 
Commonwealth, are necessarily committed by the courts. 
Many others who possess abundant means for their support but 



14 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

whose friends prefer a strictly legal process of commitment are 
sent to us in the same manner. 

Twenty were committed by the overseers of the poor of the 
towns in which the patients had a settlement. The towns in 
such cases assume all the responsibility and give bonds for the 
support of the patients while in the hospital. Frequently, 
however, persons admitted on bonds from overseers of the poor 
are by no means dependent upon the town for their support. 
This method of commitment is often chosen because it presents 
fewer difficulties than any other. The overseers of the poor 
are, it may be, the patient's neighbors and friends. They know 
his condition, sympathize with his family, and are ready to offer 
any assistance in their power. 

Forty-six patients have been admitted during the year whose 
friends gave bonds for the payment of their expenses. 

There have been committed during the year seventy-one per- 
sons who had no settlement in this Commonwealth, thirty-six 
of whom were males, and thirty-five were females. Seventy- 
two have been discharged, of whom thirty-six were males, and 
thirty-six were females ; leaving eighty-seven now resident in 
the hospital, of whom forty-one are males and forty-six are 
females. 

Thirty-six patients have been admitted during the year who 
were in a state of dementia more or less complete. Some of 
these persons were committed from almshouses, where they had 
become troublesome and required extraordinary attention. 
Others had been taken care of by friends until all hope of 
recovery was past and the patient lost to all ideas of propriety. 

Patients of this class are undoubtedly improved by a resi- 
dence in an asylum. Their minds, enfeebled by long continued 
disease, may be aroused into activity and strengthened to some 
degree by daily exercise, by the presentation of new and varied 
scenes of amusements and instruction, by inspiring hope and 
confidence in the future, and by every means calculated to 
elevate their feelings and affections, and to form anew correct 
habits of life. 

A few of the delusions of the patients admitted during the 
year are sufficiently interesting to be recorded. 

One of our females firmly believes she is the widow of the 
Duke of Wellington, and dislikes to answer to any other name 



1859.] 



PUBLIC DOCUMENT— No. 27. 



15 



or title than that of the Duchess. Another fancies she is filled 
with gunpowder, and is in constant dread of being set on fire 
and blown up. A third, thinks she has some other persons 
head and fears the rightful owner may call for it, while a 
fourth believes she has swallowed the sun. 

One male patient believes he is Napoleon the Great, and is 
often violent if addressed by other patients in his proper name. 
A second, thinks he is a spirit living in the next world, and is 
surrounded by spirits who control his actions, and cause all his 
troubles. A third, is filled with devils, who look out through 
him and who torment him in a great variety of ways, rendering 
his life inexpressibly miserable. A fourth does not labor with 
edged tools for fear that some being will descend upon and 
" cut him up." Another always speaks of himself as the Son 
of God. 

In strong contrast to these and others like them, you have 
often seen two patients, one male and one female, who with 
constant exhibitions of violence, destructiveness and filth, have 
discovered no delusion, but have been clear and coherent amid 
all their noise and madness. 

Table No. 3, 

Showing the number Admitted, Restored, Improved, Died, etc., in each 
month during the year. 







Admissions. 


Removals. 


Remaining. 


MONTH. 










13 


> 
o 

Eh 


6 












1 




o 

H 1 


o 


> 
O 

u 

Pi 

s 


S 
O 


u 

o 


o 

EH 




1 


■a 


October, . . 


8 


6 


1 
14 


3 


3 




6 


12 


143 


160 


303 


November, 


14 


3 


17 


8 


3 


1 


1 


13 


156 


151 


307 


December, 


8 


5 


13 


3 


- 


- 


- 


3 


163 


154 


317 


January, . . 


7 


5 


12 


7 


3 


- 


1 


11 


164 


154 


318 


February, 
March, . 




9 
7 


5 

7 


14 
14 


11 


3 

2 


1 


4 
5 


7 
19 


167 
159 


158 
161 


325 
320 


April, . 




12 


10 


22 


14 


3 


2 


1 


20 


156 


166 


322 


May, . 




6 


11 


17 


6 


7 


1 


- 


14 


154 


171 


325 


June, 




11 


10 


21 


11 


10 


1 


3 


25 


158 


164 


322 


July, . 




13 


10 


23 


11 


4 


- 


3 


18 


164 


163 


327 


August, . 




7 


12 


19 


7 


6 


3 


1 


17 


165 


164 


329 


September, 


4 


10 


14 


8 


8 


4 


5 


25 


152 


165 


317 


Totals, 




106 


94 


200 


89 


52 


13 


30 


184 









16 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 4, 

Showing the Form of Disease in those Admitted and Discharged during 

the year* 





Admitted. 


Discharged. 


FORM OF DISEASE. 










i 






Males. 


Females. 


Total. 


Males. 


Females. 


Total. 


Mania, Acute, 


37 


29 


66 


34 


31 


65 


" Chronic, 


3 


5 


8 


1 


2 


3 


" with Epilepsy, . 
" with general Paralysis, 
Melancholia, .... 


7 

5 

15 


2 
21 


9 

5 

36 


4 
14 


1 
19 


5 
33 


Dementia, .... 


17 


19 


36 


13 


21 


34 


" Senile, . 


2 


- 


2 


2 


- 


2 


" with Epilepsy, 
" with general Paralysis, 
Monomania of Fear, 


3 
2 
5 


1 
7 


4 

2 

12 


2 
1 


1 
2 


3 
3 


" Pride, . 


1 


- 


1 


- 


- 


- 


" Suspicion, 
Idiocy, ..... 


7 
2 


9 
1 


16 
3 


3 
1 


2 


5 

1 


Totals, . 


106 


94 


200 


75 


79 


154 



Sixty-six patients when admitted were suffering from recently 
developed mania in its ordinary form ; characterized by false 
sensations, illusions and hallucinations, vicious and extravagant 
association of ideas, without order or connection ; subject to 
every caprice of passion or volition ; possessed of great excita- 
bility, they are equally diverted and excited by both external 
objects and their own imaginations, and are readily drawn away 
to matters having no relation to themselves, thus making their 
delirium become general, and resulting in a complete overthrow 
of all the faculties of the understanding. 

Five patients had for a long period suffered all the various 
symptoms of mania, and in the table they are set down as cases 
of mania in its chronic form. 

Nine epileptic patients were admitted who are afflicted with 
mania often attended with the most violent fury after each 
attack of epilepsy, and are among our most troublesome patients. 
Their fury is not generally of long duration, frequently only a 
few hours, but is blind and dangerous in the extreme. 

Five male patients were admitted, in whose cases mania was 
complicated with general paralysis. Patients of this class are 



1859.] PUBLIC DOCUMENT— No. 27. IT 

rarely brought to the hospital during the first stage of the dis- 
order. To friends the malady appears inconsiderable, and we 
are assured that the patient is not troublesome, or indeed 
insane ; that he is only pleasantly excited — a little exalted in 
his feelings, and requires only rest and proper treatment to be 
speedily restored to health. 

The progress of the disease is, however, from the period of 
invasion, in which every thing appears bright and hopeful, 
although the patient is often irritable and impatient of control, 
to that of confirmed insanity, resulting in complete and hopeless 
dementia and death. 

Thirty-six patients were admitted whose insanity was of the 
type of melancholia. Perhaps no class of patients suffer so 
keenly as those whose disease is of this form- Their lean, 
slender, stooping persons, pale, sallow features, brown, dry, 
scaly skins, reddened noses, hollow, changeless expression, 
uneasy, suspicious glances, all speak of their gloomy fears and 
forebodings of evil. Fear with ail its terrors hangs over them ; 
one believes that, given up to the power of the devil, he shall be 
led to take the life of his wife or child, and flies from them to 
seek an asylum where he may be controlled and his family 
left in safety. Again he fears he has in some mysterious 
manner committed a heinous crime, and the wrath of God rests 
upon him. 

Another sees all about him persons bent upon his ruin and 
destruction. To-day he is to suffer — his time is come — his 
friends have already been most cruelly treated, and he can look 
for nothing better. 

Another accuses herself of having committed the greatest of 
crimes and justly brought upon her the vengeance of heaven. 
Now she prefers instant death to the agony of uncertainty, and 
again she prays for delay in the execution of a sentence from 
which there is no escape. 

This class of patients know well what is done for them, and 
understand perfectly all that is said ; yet kindness and atten- 
tion, argument and persuasion, always fail to convince them. 
They can reason clearly enough and appreciate whatever is 
brought before them. But they are so changed ; all their 
thoughts, feelings and affections are changed. Their habits 
and mode of life are changed. Their relation to external 

3 



18 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



objects is changed. No feeling of security can triumph over 
their fears. No argument can subdue their prejudices. No 
pleasure can divert their apprehension of evil. 



Table No. 5. 

Supposed Causes of Insanity of Patients admitted to the Hospital from 
January 18, 1833, to September 30, 1859, inclusive. 











1859. 


Previously. 


SUPPOSED CAUSES. 












Males. 


Females. 


Males. 


Females. 


Apoplexy, 


_ 


_ 


2 


— 


Asthma, . 








- 


- 


2 


- 


Bowels, Disease of, . 








- 


2 


1 


- 


Brain, Inflammation 


of, '. 






- 


- 


1 


5 


Bronchitis, 








- 


- 


2 


13 


Chorea, . 








- 


- 


- 


2 


Congenital, 








2 


- 


4 


- 


Constipation, . 








- 


- 


- 


1 


Convulsions, . 








- 


- 


8 


6 


Dysentery, 








- 


- 


1 


2 


Dyspepsia, 








2 


3 


2 


- 


Epilepsy, 








9 


3 


81 


34 


Eruptive Diseases, . 








- 


- 


2 


1 


Eyes, Disease of, 








- 


- 


1 


- 


" Loss of, . 








- 


- 


1 


- 


Fever, 








2 


1 


25 


32 


" Scarlet, 








- 


- 


1 


3 


Hereditary, 








13 


15 


- 


- 


111 Health, 








12 


27 


154 


502 


Influenza, 








- 


- 


1 


5 


Insolation, 








2 


- 


12 


- 


Laryngitis, 








- 


- 


- 


1 


Measles, . 








- 


- 


3 


4 


Nervous Irritation, 








- 


- 


- 


4 


Nymphomania, 








- 


- 


- 


1 


Old Age, . . 








2 


- 


8 


4 


Otitis, 








- 


- 


3 


- 


Palsy, 








- 


1 


38 


23 


Periodical, 








17 


19 


48 


56 


Pneumonia,' 








- 


- 


- 


1 


Rheumatism, . 








- 


- 


3 


1 


Satyriasis, 








- 


- 


1 


- 


Scrofula, . 








- 


- 


- 


2 


Sea-sickness, . 








- 


- 


- 


1 


Somnambulism, 








- 


- 


- 


1 


Sore Finger, . 








- 


- 


- 


1 


Spinal Disease, 








- 


- 


- 


1 


Suppressed Eruptio 


n, 






- 


- 


5 


4 


" Ulcer, 








- 


- 


1 


3 


Tic Doloreux, . 








- 


- 


- 


1 


Tumor, . 












1 



1859.] PUBLIC DOCUMENT— No. 27. 19 

Table No. 5 — Continued. 









1859. 


Previously. 


SUPPOSED CAUSES. 












Males. 


Females. 


Males. 


Females. 


Whooping Cough, .... 




_ 


_ 


1 


Amenorrhcea, . 






- 


2 


- 


14 


Lactation, 






- 


- 


- 


5 


Menorrhagia, . 






- 


1 


- 


2 


Menorrhagia, Suppressed 






- 


4 


- 


1 


Miscarriage, . 






_ 


- 


- 


1 


Pregnancy, . . 






- 


1 


- 


3 


Puerperal, 






- 


- 


- 


141 


Turn of Life, . 






- 


6 


- 


26 


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 


44 


8 


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, 






- 


- 


3 


3 


Study, Excessive, . 






- 


- 


25 


6 


Inventions, 






- 


- 


1 


- 


Excitement, 






- 


- 


2 


4 


Excitement of Politics, 






- 


- 


1 


2 


Anticipation of Marriage, 






- 


2 


- 


1 


Fortune being told, 






- 


- 


- 


1 


Enthusiasm, 






- 


- 


- 


1 


Mesmerism, 






- 


- 


- 


1 


Spiritualism, . 






- 


- 


11 


]4 


Light Reading, Novels, & 


c, 




- 


- 


- 


1 


Anxiety, . 






- 


- 


2 


11 


Criminal Trial, 






- 


- 


o 


- 


False Accusation, . 






- 


- 


- 


1 


Imprisonment, 






4 


1 


1 


- 


Death of Brother, . 






2 


- 


1 


3 


" Children, . 






1 


1 


3 


19 


" Father, 






- 


- 


2 


1 


" Friends, . 






- 


- 


2 


3 


" Husband, . 






- 


2 


— 


19 



20 LUNATIC HOSPITAL AT WORCESTER. -[Oct. 

Table No. 5 — Continued. 











1859. 


Previously. 


SUPPOSED CAUSES. 












Males. 


Females. 


Males. 


Females. 


Death of Mother, .... 






1 


6 


" Niece, 








- 


- 


_ 


1 


" Sister, 








_ 


- 


— 


3 


Wife, 








- 


- 


10 


_ 


Husband, Departure of, 








- 


- 


- 


1 


" Sickness of, 






i 


- 


3 


" Intemperance ( 


)f, 






- 


- 


- 


2 


" Desertion of, 








- 




- 


2 


" Abuse of, 








- 


- 


- 


7 


Abuse of Master, 






! - 


— 


1 


- 


" Parent, 






_ 


_ 


1 


2 


Domestic Trouble, . 






1 3 


2 


59 


136 


" Grief, 






- 


1 


56 


137 


" Cares, 






- 


- 


- 


1 


Marriage, Unfit, 






; _ 


- 


4 


2 


Disappointment, 








- 


- 


4 


7 


Disappointment in Love, 








- 


- 


47 


51 


Disappointed Ambition, 








- 


- 


6 


6 


Homesickness, 








- 


- 


1 


5 


Lost- in Woods, 








_ 


_ 


_ 


1 


Shipwreck, 








- 


- 


1 


- 


Fright, . 








_ 


- 


10 


17 


Fear, 








_ 


_ 


2 


_ • 


" of Death, 








_ 


_ 


1 


1 


" of Insanity, 








- 


- 


1 


- 


Being Witness in Court, 








- 


- 


- 


1 


Seduction, 








_ 


_ 


_ 


1 


Millerism, 








_ 


- 


5 


5 


Religious, 








- 


- 


89 


142 


" Anxiety, . 








1 


1 


1 


4 


" Excitement, 








- 


- 


13 


8 


" Fanaticism, 








_ 


- 


13 


7 


" Perplexity, 








- 


- 


9 


3 


Pathetism, 








_ 


_ 


_ 


1 


Infidelity, 








- 


- 


1 


- 


Mo i monism, . 








- 


- 


1 


- 


Pecuniary Anxiety, 








- 


- 


18 


5 


Difficulty, 








- 


- 


55 


8 


" Loss, 








4 


1 


43 


10 


Strike for Wages, . 








_ 


- 


1 


_ 


California Excitement, 








_ 


_ 


2 


- 


Poverty, . 








- 


- 


- 


1 


Poverty, Fear of, 








2 


- 


28 


11 


Giving up Business, 








— 


— 


1 


— 


Change of Business, 








_ 


- 


1 


_ 


Indulgence of Parents, 








_ 


- 


3 


1 


Jealousy, 








- 


- 


17 


23 


Passion uncontrolled, 








_ 


_ 


_ 


1 


Violent Temper, 








- 


- 


1 


14 



1859.-] PUBLIC DOCUMENT— No. 27. 

Table No. 5 — Continued. 



21 











1859. 


Previously. 


SUPPOSED CAUSES. 


Males. 


Females. 


Males. 


Females. 


Anger, . 

Great Indignation, . 
Intemperance, . 
Opium, use of, 
Tobacco, use of, 
Masturbation, . 
Venery, Excess of, . 








15 

7 


7 
3 


1 

424 
1 
1 

235 

1 


1 

48 
4 
3 

25 



From the foregoing table it will be seen that hereditary 
predisposition was admitted in twenty-eight cases. It is quite 
probable that predisposition to the disease by hereditary taint 
existed in a much larger number of cases, as the fact is often 
ignored by friends, especially when some immediate exciting 
cause is well known and acknowledged. 

The records of the hospital show that fourteen hundred and 
forty-eight persons have been admitted since its opening, in 
whom hereditary taint was known and acknowledged to exist. 

The hereditary cases, it will thus be seen, are in the ratio of 
twenty-four per cent, to the whole number admitted. There 
can be no doubt, however, that a strict investigation would show 
a larger proportion. 

Forty persons admitted during the year were known to have 
suffered from previous attacks of mental disease, and therefore 
labored under predisposition to insanity. Many of these cases 
were also strongly hereditary. 

Thirteen females and seven males admitted during the year 
suffered from suicidal mania, and, as' usual in such cases, gave 
us much care and anxiety. 

Three females and four males admitted in the course of the 
year, were afflicted with homicidal insanity, of a marked 
character. 

Intemperance was the ascribed cause in twenty-two cases, 
fifteen of which were males, and seven were females. This is 
in the ratio of eleven per cent, to the admissions, which is a 
larger proportion than that of several years preceding. In 1833 
the ratio of cases caused by intemperance to the whole number 



22 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



of admissions, was twenty-five per cent. ; in 1834, twenty-four 
per cent. ; in 1835, twenty-three per cent. ; in 1836, fifteen per 
cent. ; in 1838, sixteen per cent. ; in 1840 and 1841, twelve 
per cent., while in 1848, 1851, 1853, 1854, it was only two per 
cent., and in 1855 one per cent. 

Ill health, as usual, is the ascribed cause in the largest num- 
ber of cases. Thirty-nine persons admitted during the year 
were suffering from ill health, previous to the development of 
insanity. 

Since the opening of the hospital six hundred and ninety-five 
patients have been admitted, whose insanity was caused by a 
bad state of health, five hundred and twenty-nine of whom were 
females, and one hundred and sixty-six were males. 

By a calculation based upon the foregoing table, it will be 
seen that seven hundred and thirty-three women, and four 
hundred and sixty-six men, making in all eleven hundred and 
ninety-nine persons, have become insane from the influence of 
fear, grief, disappointment, trouble, affliction and other depress- 
ing emotions, giving a ratio of more than twenty per cent, to 
the whole number of admissions. 



Table No. 6. 

Diseases which have proved Fatal, from January 18, 1833, to September 

30, 1859- 













1859. 


Previously. 


DISEASES. 












Males. 


Females. 


Males. 


Females. 


Apoplexy, 
Asthma, . 










1 

1 


- 


14 
3 


9 

1 


Anasmia, . 










- 


- 


1 


1 


Asphyxia, 
Bronchitis, 










- 


— 


1 
2 


- 


Brain Fever, . 










- 


- 


1 


- 


Consumption, . 










3 


2 


31 


51 


Convulsions, . 










- 


- 


3 


1 


Cholera Morbus, 










- 


- 


2 


3 


Cholera, . 










- 


- 


5 


- 


Cancer, . 










- 


- 


1 


1 


Congestion of Lungs, 








- 


- 


- 


1 


" Brain, 








- 


- 


1 


1 


Chronic Dysentery, 
" Menengitis, 








- 


- 


2 
3 


- 



1859.] PUBLIC DOCUMENT— No. 27. 23 

Table No. 6 — Continued. 











1859. 


Previously. 


DISEASES. 










Males. 


Females. 


Males. Females. 


Dysentery, 


_ 




10 


6 


Dropsy, .... 
Delirium Tremens, . 






- 


- 


5 
3 


7 


Disease of Heart, 






- 


- 


9 


11 


" Bladder, . 






- 


- 


1 


- 


" Brain, 






- 


- 


6 


14 


Diarrhoea, 






- 


- 


13 


8 


Enteritis, 






- 


- 


3 


6 


Epilepsy, 
Exhaustion, 






5 
2 


1 
1 


45 

27 


17 
43 


Erysipelas, 






- 


- 


9 


10 


Gangrene of Lungs, 






- 


1 


1 


1 


Hydro-thorax, 






- 


- 


1 


1 


Hemorrhage, . 






- 


- 


4 


4 


Hemoptysis, 






- 


- 


1 


- 


Inflammation of Bowels, 






- 


- 


3 


3 


Jaundice, 






- 


- 


- 


2 


Marasmus, 






2 


2 


45 


47 


Mortification, . 






- 


- 


- 


1 


Maniacal Exhaustion, 






- 


1 


4 2 


Malignant Fever, 






- 


- 


1 


- 


Old Age, ' . 






2 


- 


13 


10 


Palsy, . 
Pneumonia, 








3 


1 


15 

9 


14 
15 


Pleurisy, . 








- 


- 


- 


1 


Rupture, 


. 






- 


- 


1 


- 


Syncope, . 
Suicide, . 


• 






1 


: 


1 
13 


8 


Suppurative Phlebitis, 
Typhoid Fever, 
Typho Mania, 






- 


i 


1 
8 

7 


6 

4 


Totals, 








329 


310 



The foregoing table shows that two patients only have died 
during the year of any form of acute disease. They were 
females, and suffering from recent attacks of mania. Both 
were brought to the hospital in an exhausted condition, and 
died in two weeks after admission. 

One male committed suicide after a residence in the hospital 
of five vjeeks. 

Two males and one female died of exhaustion. They were 
old and feeble, and had long been insane. Their decay was so 
gradual that we could perceive little change from day to day, 
or week to week. They suffered no apparent pain or distress. 



24 



LUNATIC HOSPITAL AT WORCESTER. 



[Oct. 



Five males and one female died of epilepsy. They were all 
cases of long standing, and had become quite demented, and 
had for months been in feeble health. 

Three males and two females died of consumption. The 
development of tubercles doubtless had some influence as an 
immediate and exciting cause of their mental disorder. 

One female died of gangrene of the lungs. She was ill when 
brought to the hospital. 

Two males and two females who had previously been inmates 
of several charitable institutions, died of marasmus. 

Three males and one female died of palsy, and two males 
died who were each more than seventy-five years of age. 

It is proper to remark in passing, that some of the above 
named patients should have been cared for by friends. They 
were old and feeble when brought to the hospital. They 
were not violent or destructive. Age and dementia had done 
its work, and made them somewhat repulsive in their habits. 
They required care and attention ; but their struggle for life 
was almost at an end. The objects of their labor had been 
attained or lost ; their parts acted in the great drama ; and all 
the kind attention of love and affection, all the endearments of 
home should have been lavished on the closing scene. 



Table No. 7, 

Showing the Ages of Patients Admitted, Discharged, Recovered, not 
Recovered, and Died during the year. 





ADMITTED. 


DISCHARGED RE- 
COVERED. 


DISCHARGED NOT 
RECOVERED. 


DIED. 


AGE. 
















Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Less than 15, . 


5 


2 




1 


1 


1 


1 




From 15 to 20, 


10 


4 


2 


1 


1 


2 


- 


- 


20 to 30, 


33 


32 


9 


9 


5 


3 


1 


- 


30 to 40, 


23 


27 


17 


18 


9 


8 


3 


2 


40 to 50, 


17 


20 


9 


10 


11 


14 


4 


3 


50 to 60, 


9 


5 


2 


3 


3 


3 


5 


2 


60 to 70, 


6 


4 


3 


4 


2 


2 


3 


3 


70 to 80, 


3 


- 


1 


_ 


- 


- 


3 


- 


80 to 90, 


- 


- 


- 


- 


- 


- 


- 


- 


Totals, . . 


106 


94 


43 


46 


32 


33 


20 


10 



1859.] 



PUBLIC DOCUMENT— No. 27. 



25 



Table No. 8, 

Showing the Duration of Insanity before admission of Patients admitted 
from January 18, 1833, to September 30, 1859. 





1859. 


Previously. 


DURATION OF INSANITY. 












Males. 


Females. 


Males. 


Females. 


Insane less than 1 year, .... 


59 


60 


1,406 


1,641 


Insane more than 1 y'r and less than 2 y'rs, 


14 


11 


326 


287 


2 y'rs and less than 5 y'rs, 


15 


10 


427 


373 


5 y'rs and less than 10 y'rs, 


7 


3 


216 


176 


10 y'rs and less than 15 y'rs, 


4 


5 


115 


127 


15 y'rs and less than 20 y'rs, 


2 


1 


35 


36 


20 y'rs and less than 25 y'rs, 


1 


2 


37 


39 


25 y'rs and less than 30 y'rs, 


1 


- 


16 


9 


30 years, .... 


- 


- 


24 


24 


Unascertained, . . ' . 


3 


2 


225 


237 


Total, 


106 


94 


2,827 


2,949 



Table No. 9, 

Showing the Ages of Patients admitted to the Hospital from January 18, 
1833, to September 30, 1859. 





1859. 


Previously. 


AGES. 












Males. 


Females. 


Males. 


Females. 


Less than 15 years of age, 


5 


2 


20 


26 


Between 15 and 20 years of age, 


10 


4 


206 


194 


20 and 30 " 


33 


32 


829 


806 


30 and 40 " 


23 


27 


731 


813 


40 and 50 " 


17 


22 


459 


501 


50 and 60 " " 


9 


5 


328 


376 


60 and 70 " 


6 


4 


187 


148 


70 and 80 " 


3 


- 


51 


53 


More than 80 years of age, 


- 


- 


8 


15 


Unascertained, .... 


- 


- 


8 


17 


Totals, 


106 


94 


2,827 


2,949 



26 



LUNATIC HOSPITAL AT WORCESTER. 



[Oct. 



Table No. 10, 

Showing the Civil Condition of Patients admitted to the Hospital from 
January 18, 1833, to September 30, 1859. 





1859. 


Previously. 


CIVIL CONDITION. 


Males. 


Females. 


Males. 


Females. 


Unmarried, ..... 
Married, 

Widowers, . . . 

Widows, 

Unascertained, . . . 


55 

48 

3 


40 
42 

12 


1,417 

1,226 

141 

43 


1,340 
1,215 

357 
37 


Totals, 


106 


94 


2,827 


2,949 



Table No. 11, 

Showing the Admissions from each County from January 18, 1833, to 
September 30, 1859. 









1859. 


Previously. 




COUNTIES. 








Whole No. 




Males. 


Females. 


Total. 






Barnstable, 








126 


126 


Berkshire, 






- 


1 


1 


184 


185 


Bristol, 






- 


2 


2 


287 


289 


Dukes, 






- 


- 


- 


19 


19 


Essex, 






22 


20 


42 


773 


815 


Franklin, 






- 


- 


- 


123 


123 


Hampden, 

Hampshire, 

Middlesex, 






31 


23 


54 


351 

220 

778 


351 

220 
832 


Nantucket, 






- 


- 


- 


31 


31 


Norfolk, . 






5 


6 


11 


570 


581 


Plymouth, 
Suffolk, . 






2 
11 


12 


2 
23 


231 

614 


233 
637 


Worcester, 






35 


30 


65 


1,452 


1,517 


Other States, 






- 


- 


- 


17 


17 


Totals, 






106 


94 


200 


5,776 


5,976 



1859.] 



PUBLIC DOCUMENT— No. 27. 



27 



Table No. 12, 

Showing the Occupation of Patients admitted into the Hospital from 



January 18, 1833, 


to September 30, 1859, inclusive. 


OCCUPATION OF PATIENTS. 


1859. 


Previously. 


MALES. 






Auctioneers, ....... 


- 


3 


Armorers, 










- 


3 


Author, 










- 


1 


Blacksmiths, 










- 


34 


Bakers, . 










- 


6 


Butchers, . 










1 


5 


Bookbinders, . 










- 


7 


Boot-makers, 










2 


15 


Brokers, . 










1 


2 


Bookkeepers, . 










1 


5 


Britannia-workers, . 










- 


2 


Brickmakers, . 










- 


5 


Bellows-makers, 










- 


2 


Brewers, . 










- 


2 


Basket-makers, 










- 


- 


Bricklayers, 










1 


3 


Butlers, . 










- 


2 


Barbers, . 










- 


3 


Clergymen, 










1 


18 


Carpenters, 










2 


115 


Coppersmiths, . 










- 


6 


Coopers, . 










- 


16 


Cabinet-makers, 










2 


9 


Calico-printers, 










- 


3 


Clothiers, . 










- 


17 


Comb-makers, . 










- 


4 


Coach-makers, . 










1 


7 


Card-makers, . 










- 


2 


Chair-makers, . 










1 


3 


Cigar-makers, . 










- 


3 


Coachmen, 




■ 






- 


16 


Clerks, 










3 


26 


Carpet weaver, 










- 


1 


Curriers, . 










- 


7 


Cashiers of Banks, . 










- 


4 


Cordwainers, . 










- 


4 


Collectors, 










- 


2 


Caulkers, 










- 


4 


Chandlers, 










- 


5 


Camphene distiller, . 










- 


1 


Conductors on railroads, . 










- 


2 


Dyers, .... 










- 


4 


Druggists, 










- 


3 


Draymen, 










- 


3 


Drover, ........ 


" 


1 



28 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 12 — Continued. 



OCCUPATION OF PATIENTS. 



Dancing master, 

Daguerreotypist, 

Engravers, 

Editors, . 

Express-men, 

Farmers, . 

Fishermen, 

Fruiterers, 

Gunsmiths, 

Gardeners, 

Grocers, . 

Glass-blowers, 

Gilders, . 

Hotel-keepers, 

Hatters, . 

Hostlers, . 

Housewrights, 

Harness-makers, 

Ironmongers, 

Jewellers, 

Lawyers, . 

Laborers, . 

Last-makers, 

Manufacturers, 

Millers, . 

Merchants, 

Masons, . 

Miners, 

Mat-makers, 

Miniature painter, 

Musicians, 

Machinists, 

Messengers, 

Moulders, 

Millwright, 

Millers, . 

Nailer, 

Newsmen, 

Optician, . 

Operatives in mill, 

Oystermen, 

Painters, . 

Printers, . 

Physicians, 

Paper-makers, 

Peddlers, . 

Pilot, 

Potters, . 

Porters, . 

Pump and blockmakers, 



1859. 



1 

1 

1 

28 
2 
o 



Previously. 



1 
1 

3 

4 

3 

450 

13 
4 
3 
9 
3 
3 
2 

15 
3 
9 
7 
7 
3 

11 

12 

322 

1 

31 

6 

111 

17 
5 
3 
1 
7 

30 
2 

6 

1 

4 

1 

3 

1 

49 

4 

28 

29 

11 

4 

17 

1 

3 

9 

3 



1859.] PUBLIC DOCUMENT— No. 27. 29 

Table No. 12 — Continued. 



OCCUPATION OF PATIENTS. 


1859. 


Previously. 


Pattern-makers, 




5 


Police officers, . 










- 


4 


Rope-makers, . 










- 


9 


Riggers, . 










- 


3 


Restaurators, . 










— 


7 


Shoemakers, 










13 


195 


Sail-makers, 










_ 


9 


Soap-makers, . 










- 


4 


Sash and blind-makers, 










- 


2 


Stage drivers, . 










1 


4 


Sea captains, 










- 


15 


Sailors, 










4 


97 


Saddlers, . 










- 


9 


Silversmiths, 










_ 


19 


Students, . 










-■ 


49 


Stock-maker, . 










- 


1 


Silk-weavers, . 










- 


2 


Ship carpenters, 










- 


17 


Ship brokers, . 










- 


2 


Shopkeepers, . 










2 


3 


Stonecutters, 










- 


14 


Soldiers, . 










- 


5 


Spinners, . 










- 


13 


Sheriffs, . 










_ 


3 


Shoe dealers, . 










2 


3 


Stable keepers, 










- 


2 


Shoe binders, . 










- 


7 


Tailors, . 










1 


14 


Teachers, . 










2 


50 


Tobacconists, . 










_ 


3 


Teamsters, 










_ 


12 


Tinmen, . 










_ 


2 


Umbrella-makers, 










_ 


4 


Victuallers, 










_ 


3 


Wheelwrights, . 










1 


13 


Watchmakers, . 










_ 


4 


Wood-turners, . 










_ 


3 


Watchman, 










_ 


1 


Whip-maker, . 










_ 


1 


Weavers, . 










1 


17 


No occupation, 










3 


- 


FEMALES. 






Carpet weavers, 


_ 


2 


Cooks, 










3 


55 


Chamber maids, 










3 


33 


Dress-makers, . 










2 


51 


Engraver, 










_ 


1 


Housekeepers, . 










7 


994 


House maids, . 










3 


135 



30 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 12 — Continued. 



OCCUPATION OF PATIENTS. 



Previously. 




Laundresses, 
Milliners, 
Mantuamakers, 
Midwife, . 
Nurses, 

Nurserymaids, . 
Operatives in mill, 
Seamstresses, . 
Straw-sewers, . 
Shoe-binders, . 
Students, . 
School girls, 
Teachers, . 
Tailoresses, 
Type-setters, . 
Wool stapler, . 
Weavers, . 
No occupation, . 



1859.] 



PUBLIC DOCUMENT— No. 27. 



31 



Table No. 13, 

Showing the whole number of Patients during the last year, 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-seven 
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 

1 


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 


53,606 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 


1859, . 


501 


309 


317 


48,363 33 


156 51 



32 



LUNATIC HOSPITAL AT WORCESTER. 



[Oct. 



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1859.] 



PUBLIC DOCUMENT— No. 27. 



33 



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46 



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1859.] PUBLIC DOCUMENT— No. 27. 49 



Every year's experience gives us additional proof that kind- 
ness and occupation are the most reliable resources in the care 
and restoration of the insane. 

The insane always appreciate that kindness of heart and that 
benevolence of feeling which will interest itself in their unreal 
and extravagant miseries, and is ever solicitous to relieve their 
suffering. They are keenly alive to that benevolence which 
will take them by the hand and lift them up, and be to them a 
friend and a companion. They always look for one in whom 
are the qualities of mutual forbearance and fellow-feeling. 

It is true that kindness of heart may do harm by giving way 
to unreasonable demands and indulging vicious propensities. 
It may even become so passive as to strengthen the delusions 
which are characteristic of the disease. But when mingled 
with a pure devotion to duty and a keen perception of right, it 
becomes the most powerful means in the care and treatment of 
the insane. 

In the application of labor as a remedy in the treatment of 
the insane, there are several important considerations. It is 
not enough that the lunatic simply performs a task. He should 
not be required to wear out his muscular energy in order to 
procure tranquillity only ; if possible, there should be a hearty 
and intelligent participation on the part of the patient, and so 
much of pleasure associated with the labor that fatigue may 
not follow. The occupation should be simple and plain in 
description, but useful and elevating in its character. Its 
utility should be perfectly apparent. Labor so selected and ap- 
plied gives regularity to all the mental operations. It create 
and imposes the necessity of self-control. It gives tone and 
vigor to the body, and brings about a new series of mental 
impressions. 

The ordinary labor of the farm and garden is undoubtedly 
best suited to the wants and condition of the insane. It secures 
the benefit of out of door exercise as well as mental concentra- 
tion, and more than any other description of labor promotes 
the restoration of those engaged in it. But in our climate, 
and, indeed, in any, the application of farm labor must be par- 



50 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

tial, and confined in a great degree to a part of the year ; 
neither can it include a large proportion of our inmates. 

What is wanting is some occupation which shall at all times 
be accessible and in constant operation. There seems to be 
no way of accomplishing this but to have all descriptions of em- 
ployment and occupation at hand, and the implements or means 
by which it is carried on possessed by the hospital, and every 
reasonable provision should be made for engaging those of every 
trade found in the institution. 

There can be no question as to its practicability. Young 
men are committed to the hospital whose friends inform us 
that they have been some one or two years growing strange ; 
they have now lost the power of self-control and are unable to 
attend to any business. Placed in one of our wards under 
ordinary circumstances they droop, become demented, and sink 
into hopeless fatuity. 

On the arrival of one of this class of patients at the hospital, 
he will tell you that he is an outcast from society — the object 
of scorn and derision, — that ruin stares him in the face, and 
that, forsaken of friends, of hope, and of Heaven, he desires 
not longer to live. If we can induce this man to labor, he must 
of course give his whole attention to the task and exercise con- 
siderable ingenuity to accomplish his object. While his mind 
is thus occupied it is necessarily diverted from the dominion of 
his disease, and in proportion as cheerful labor is continued will 
be the freedom from diseased fancies and restoration to mental 
health. 

In giving occupation to the insane we hope also to act upon 
the healthy powers of the mind, and thus afford rest and tran- 
quillity to those that are diseased. It has already been hinted 
that in the selection of employment for the insane, choice 
should be made of such as will combine with it mental occupa- 
tion ; but this is not sufficient. In the care and treatment of 
the insane nothing should be omitted which will have a ten- 
dency to bring back the powers of the mind to their best estate. 
There is no way by which this can be accomplished but by 
operating upon the healthy channels of the mind, thus avoiding 
irritation and excitement. It is not enough that we have books 
and pictures, newspapers and maps ; patients should be induced 



1859.] • PUBLIC DOCUMENT— No. 27. 51 

to read and examine — to have some daily mental exercise suited 
to their capacity and their normal taste. This will require 
much care and study on the part of those who control the 
matter. The surgeon does not prescribe exercise for the recently 
fractured limb, and the brain when diseased requires no less 
care and attention than the wounded limb. But, after all, the 
great evil in this, as in many similar institutions, is idleness. 

Patients are too often suffered to lounge about the wards, 
gradually losing both bodily and mental tone and vigor, and 
becoming daily more and more indifferent to all about them, 
except, perhaps, the quantity and quality of their food. The 
poor lunatic may be disinclined to labor from the fact that his 
mind is pre-occupied by diseased fancies. Still he is, in some 
degree, alive to the stimulus of emulation, rewards and punish- 
ments, and any inducement to regular employment in the 
shape of harmless luxuries or indulgencies are always proper by 
encouraging regular labor and voluntary control of the mental 
faculties, which become habitual, and therefore salutary. 

For this purpose places of amusement, workshops, green- 
houses, gardens, and the like, should be supplied in all their 
variety. Nothing should be omitted which ingenuity can de- 
vise or labor accomplish. 

Acting upon such considerations, you have humanely and 
wisely directed that more extensive means be employed for the 
accomplishment of so desirable an end. More extensive farm- 
ing operations than have hitherto been carried on will present, 
in a greater variety and abundance, opportunity and induce- 
ment to engage in that best of all occupations. Increased 
facilities for various kinds of labor in the workshops will also 
afford to many agreeable employment, and occupy and 
strengthen their mental faculties without irritation or fatigue. 

The reading and billiard-rooms, suggested in the report of 
last year, are now completed and furnished on both sides of the 
house. The billiard-room, twenty-four feet square, occupying 
a retired yet convenient locality in the second story of the south 
wing of the house, has been fitted up with considerable taste ; 
the walls decorated and all the work handsomely finished and 
painted. It is supplied with a good table, settees and matting, 
and is warmed by steam and lighted by gas. 



52 LUNATIC HOSPITAL AT WORCESTER: [Oct. 

The reading-room is in the third story, directly above the 
billiard-room, and is of the same size, and has been fitted up with 
equal care and taste. It is supplied with books, papers, maga- 
zines, and the like, and is at all times accessible to patients. 
On the female side, there has been constructed in the second 
story of the north wing, a room fifteen by twenty-four feet, and 
handsomely finished and decorated, and occupied as a bagatelle 
room. Directly over this, and communicating with it, is a 
room of the same size and style, now occupied as a music-room 
and reading-room. These rooms are also warmed by steam 
and lighted by gas. They are all attractive places of resort, 
and have beguiled our inmates of many a weary hour. 

We need, and hope soon to have in operation, bowling alleys, 
where in cold or rainy weather, and indeed at all times, the 
patients, both male and female, can exercise in that healthy 
and unexceptionable game. 

We may mention, in this connection, the long felt necessity 
of pleasant and attractive yards or airy courts, to which the 
feeble and demented patients can have free access, going out 
and returning at will. 

But we may not be content with airy courts simply. Unless 
they are planted with trees and shrubbery, possess a fountain, 
a rustic arbor, a mound so high as to give wide prospect, and 
are stocked with pet animals, they must be of questionable 
utility. Properly constructed they would, in some degree, 
restore the patient to the pleasures of society and the world, 
while affording all the benefit of seclusion and restraint. 

This leads us to speak of another want. Nothing would be 
of greater benefit to a large number of our inmates than a well 
ordered gymnasium. Conveniently located and properly fur- 
nished, it would become a place of resort to all that class of 
persons who, from social position, extravagance of delusion, or 
physical disability, cannot be induced to engage in any regular 
employment. They would thus receive new and pleasing, yet 
unexciting, impressions, opening to their minds new trains of 
thought, and furnishing material for study and reflection. 

This change would be brought about without much expense, 
and with great moral and practical benefit to the patients. 



1859.] PUBLIC DOCUMENT— No. 27. 53 

A building now on the premises, convenient in size and loca- 
tion, might easily be remodeled by the patients, and converted 
into a light, comfortable, cheerful gymnasium. 

It is proper again to record in this report the various sources 
of amusement and recreation afforded to the inmates as a 
means of relief and restoration. 

All the amusements and pastimes of former years have been 
engaged in, and every healthy out-of-door exercise or harmless 
in-door game that could be thought of has been put in requisi- 
tion. 

The exercise of the mental faculties of our patients has 
been stimulated in some degree, and much recreation has been 
afforded by lectures, concerts of sacred music, tableaux vivants, 
historical tableaux, with reading and magic lantern scenes. 
Daily walks and drives, social parties, and, during the winter, 
skating and coasting parties, have been as usual carried on 
with great animation. 

The patients' library continues to increase, partly by dona- 
tions from friends, but mostly by purchase, and the supply of 
newspapers and periodicals has been abundant. 

By a unanimous vote of your Board, the office of Resident 
Chaplain was abolished on and after the first day of March, 
1859 ; and the Superintendent was directed to supply daily 
evening religious services in the chapel, and at least one 
service on the Sabbath. Iff! 

In compliance with the above vote, the services of the Rev. 
Samuel R. Souther were secured for one year. Mr. Souther 
has performed the ordinary duties of chaplain by preaching to 
the patients on the Sabbath since March first in a highly 
acceptable and satisfactory manner. His services^are always 
judicious and solemn. Sincere and earnest in his efforts to do 
good, he has succeeded well in winning the love and securing 
the confidence of his hearers. We consider ourselves fortunate 
in having obtained the services of a chaplain of such experi- 
ence, good sense and practical wisdom. 

We have every reason to believe that our patients are not 
only comforted, but improved, by the exposition of divine 
truth, when it is laid before their minds in a quiet, cheerful 



54 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

and hopeful manner. The fact is, a large majority of insane 
persons are rational on religious subjects. Our tables show a 
small number of patients who have been insane on religious 
matters only, and even if persons are insane on these matters, 
plain and practical illustrations of divine truth make an im- 
pression upon the feelings through the healthy channels of the 
mind, affording instruction and strength to proceed in the way 
of truth and righteousness. 

The means employed for warming and ventilating the hos- 
pital continue in active operation, and are believed to be quite 
perfect. No alteration or repairs of any magnitude have been 
required, and the whole apparatus is simple, compact and 
economical. 

When the plan was first put in operation it was estimated 
that three tons of anthracite coal per day would be required 
from November to April, and one ton per day from April to 
November. Our tables have shown each year that the amount 
actually consumed has been considerably less than the above 
estimate. 

The various parts of the house are always comfortably 
warmed during the cold weather by a free circulation of fresh 
warm air, and made cool and comfortable in the heat of 
summer by forcing in through all the registers a constant 
breeze of pure air from without. 

The wards are also well ventilated. Seldom indeed is there 
now any offensive odor, even in apartments assigned to the 
most violent and filthy patients. 

In a hygienic point of view, the results of our system of ven- 
tilation cannot be overstated. Patients who formerly were 
violent, filthy and disgusting, are now tranquil and tidy. 
Those who were uniformly pale, feeble and sickly, are now im- 
proved in health and appearance. The standard of general 
health has been greatly elevated since the introduction of the 
present plan of warming and ventilating the house. 

The following table shows the exact amount of coal con- 
sumed from October 1, 1858, to October 1, 1859 : 



1859.] 



PUBLIC DOCUMENT— No. 27. 



57 



Amount for each 



Daily aver. 



Brabor 



October, 1858, 
November, " 
December, " 
January, 1859, 
February, " 
March, " 












lbs. 

66,000 
109,200 
154,000 
167,000 
169,000 
136,000 


lbs. 

2,129 

3,640 ^0 

4,967 

5,367 

6,039 

4,387 


April, " 
May, " 












75,500 
41,500 


2,516 
1,338 


June, " 
July, 

August, " 
September, " 












31,500 
27,000 
23,750 

24,750 


1,050 
870 
776 
825 


Total, 












1,025,200 oi 


', 512| tons. 



In the early part of the year you erected a barn one hundred 
feet in length by forty feet in width, a tool and cart house 
forty-sis feet in length by twenty-six in width, and a shed one 
hundred feet in length by eighteen feet in width. 

These buildings are all complete, and the arrangements and 
accommodations have been found every way commodious and 
satisfactory. In connection with the barn is a most perfect 
piggery, one hundred feet in length by thirty feet in width. 
There are in this department facilities for steaming food and 
heating water, by steam generated in the boiler-house, five 
hundred feet distant. 

There are in the new barn two apartments fitted up in a 
comfortable manner and warmed by steam, one of which is 
used as a work-room in rainy and stormy weather. Here all 
the repairs of harnesses and the like are made. The other 
apartment is the sleeping-room of the person who takes care of 
the stables, and is responsible for the condition of the stock and 
other property of this department belonging to the Common- 
wealth. 

The farm and gardens have as usual been in a great measure 
cultivated by the patients, and a considerable amount of grad- 
ing, fencing and trenching has also been carried on. A large 
number of fruit and forest trees have been transplanted, and 
are now growing well. 



54 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



and he-Treasurer's report will show that a good deal of atten- 
pe'wi lias bean paid to the subject of improvements and repairs, 
sm I that considerable new furniture has been furnished and 
m id for. Many of the wards have been in part refurnished, 
u,nd are now beginning to look more cheerful and home-like 
than they did with the old furniture, much of which was quite 
worthless. We have found that it is necessary to continue 
from time to time the purchase of books and pictures, which 
add so much to the cheerfulness of our wards. 

Under active and judicious management, an increasing 
number of the female patients are occupied in the domestic 
labors of the kitchen, laundry, bakery, and wards, and in 
needle-work. Quite a number of the married females purchase 
materials and make the clothing for their children at home, 
while regaining their health at the hospital. 

All the bed and house linen, all the clothing for female 
patients, and a large part of the clothing for male patients, has 
been made by the assistance of a single seamstress. 

A great part of the washing and ironing, and all the mend- 
ing for the household, is also done by the female patients. 

The following table shows the labor performed in the sewing- 
room by female patients : 



Bed Spreads, 


31 


Frocks, 


48 


Bed Ticks, 


144 


Trousers, pairs of, 


76 


Sheets, 


262 


Overalls, pairs of, 


48 


Pillow Cases, 


273 


Yests, 


21 


Pillows, 


19 


Hose, pairs of, 


33 


Shirts, 


226 


Mittens, pairs of, 


50 


Chemises, . 


167 


Knit Edging, yards, 


250 


Drawers, pairs of 


63 


Carpets, 


5 


Night Dresses, 


53 


Table Covers, 


23 


Night Caps, 


13 


Window Curtains, 


153 


Skirts, 


51 


Napkins, 


56 


" embroidered, 


18 


Towels, 


273 


Dresses, 


153 







1859.] 



PUBLIC DOCUMENT— No. 27. 



57 



The following table shows some of the results of the labor 
performed on the farm and in the garden : 



Apples, . 






40 barrels, 


at |2 00- 


- $80 00 


Pears, 






10 bushels 


at 2 00 


20 00 


Cherries, 






15 « 


at 2 00 


30 00 


Grapes, . 






3 " 


at 2 00 


6 00 


Tomatoes, 






75 " 


at 75 


56 25 


Corn, sweet, 






75 " 


at 1 00 


75 00 


Beans, 






20 " 


at 2 00 


40 00 


Peas, 






18 " 


at 2 00 


36 00 


Parsnips, 






50 " 


at 50 


25 00 


Turnips, 






. 500 " 


at 20 


100 00 


Potatoes, 






900 " 


at 50 


450 00 


Beets, 






590 " 


at 20 


118 00 


Carrots, 






1,200 " 


at 20 


240 00 


Barley, 






. 158 " 


at 1 00 


153 00 


Cabbages, 






500 heads, 


at 4 


20 00 


Squashes, 






4 tons, 


at 20 00 


80 00 


Hay, 






80 " 


at 10 00 


800 00 


Rowen, . 






5 " 


at 8 00 


40 00 


Corn Fodder, 






30 " 


at 4 00 


120 00 


Straw, 






10 " 


at 6 00 


60 00 


Milk, 






40,000 quarts 


at 4 


1,600 00 


Beef, 






11,000 pounds. 


at 8 


880 00 


Pork, 






7,256 " 


at 10 


725 60 



15,754 85 

The labor performed by the inmates is not a source of direct 
revenue to the hospital. It is mostly expended in improving 
the value of the estate belonging to the Commonwealth, — in 
beautifying the grounds, and in procuring comforts and 
pleasures for the patients which the institution could not well 
afford to purchase. 



Our thanks are due to Miss Dix for many kind attentions in 
behalf of the patients. 



58 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

From the publishers of the Palladium, Spy, Transcript, and 
Bay State, we receive the daily and weekly issues, and large 
and well selected bundles of exchanges, giving a supply of the 
last newspapers from all parts of the country. 

From the periodical office of S. Thompson & Co., we receive 
liberal donations of illustrated papers and magazines. 

We are also under obligations to the publishers of the 
Boston Advertiser, Salem Register, Zion's Herald and Wes- 
leyan Journal, Puritan Recorder, Springfield Republican, 
Religious Magazine, Bunker Hill Aurora and Charlestown 
Mirror, Youth's Companion, Gospel Messenger, Old Colony 
Memorial, Essex County Mercury, and many other papers and 
periodicals, all of which are very gratefully received. 

We desire also to express our sense of obligation to the many 
friends who have contributed to the welfare of our patients 
during the year, among whom are Messrs. A. S. and B. D. 
Allen, Mrs. A. S. Allen, Mr. and Mrs. William Sumner, and 
Mr. and Mrs. A. W. Sawyer, of Worcester, who have given 
concerts in sacred music ; Dr. J. R. Nichols, of Boston, who 
gave us a lecture on the chemistry of fire and water ; Henry 
Woodward, Esq., of Worcester, for contributions of pictures ; 
David Scott, Esq., of Worcester, Mrs. Prince, of Worcester, 
Dr. Jarvis, of Dorchester, and Dr. Clapp, of Pawtucket, for 
donations of books ; and to Hon. Oliver Warner for maps. 

It is my duty also to record my personal obligations to the 
other resident officers and assistants, who have faithfully car- 
ried out all my plans and devoted themselves wholly to the 
interests of the institution. 

In looking back over the events of the year, we feel that we 
have been most signally blest in all our endeavors to promote 
the welfare of those placed under our charge. 

The year has been one of health and prosperity. We are 
confident that much comfort and happiness has been conferred 
upon many sufferers, and a fair proportion have been restored 
to health, to themselves, and to society. 



1859.] PUBLIC DOCUMENT— No. 27. 59 

With confidence in the strength of Him who has sustained 
us amid the labors and trials of the past, we cheerfully com- 
mence the duties of another year, trusting that by His guid- 
ance we may perform them well. 



MERRICK BEMIS. 



State Lunatic Hospital, Worcester, 
October 1, 1859. 



60 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



TERMS AND FORMS OF ADMISSION, &c. 



ADMISSION OF PATIENTS. 

Inquiries are often made by letter and otherwise in reference to the 
course, to be pursued in order to obtain admission for the insane to the 
hospital, and what are the expenses of support, &c. 

When patients are committed to the hospital by order of any court, 
the county in which that court is held pays the expense of carrying the 
patient to the hospital. 

To entitle insane persons to the care of the hospital it is necessary 
that they be committed by order of the court of probate and insolvency, 
or by any other court having jurisdiction in the town or county in which 
the insane person resides, or by two justices of the peace, one of which 
shall be a justice of the quorum. 

Patients may also be sent to us by the friends if satisfactory bonds 
are given for their support while in the hospital. 

Overseers of the poor may also commit the insane poor of the town 
in which they have jurisdiction by giving bonds in behalf of the town 
for the support of the patient while in the hospital. 

When it is desirable that an insane person should be committed by 
the court of probate and insolvency, any one interested may make 
petition to the judge of probate and insolvency, for the removal of the 
lunatic to the hospital. 

An acknowledgment of notice of the petition from one of the select- 
men of the town in which the lunatic resides must also be presented 
with the petition. 



1859.] PUBLIC DOCUMENT— No. 27. 61 



PETITION. 

Commonwealth of Massachusetts. 

To the Honorable , Judge of Probate and 

Insolvency, for the county of 

Kespectfully represents , of , 

in the county of , that of , 

in the county of , is a lunatic, and so furiously mad as 

to render it dangerous to the peace and safety of the community that 

he should be at large. 

Wherefore, your petitioner prays, that the said 

, may be committed to the State Lunatic Hospital at 
"Worcester. 

Dated* at , this day of 

A. D. 18 



ACKNOWLEDGMENT OF NOTICE. 

, A. D. 18 . — The subscriber, one of 
the Selectmen of the town of , aforesaid, hereby 

acknowledges due notice of the foregoing petition. 



FORM OF PRIVATE BOND. 

State Lunatic Hospital at Worcester. 
Whereas, , of , in the county 

of , has been admitted a boarder in the State Lunatic 

Hospital at Worcester, we in the 

county of , as Principal and 

of , in the county of , as Surety, 

do hereby jointly and severally promise , 

Treasurer of said hospital, to pay him or his successor in said office, the 
sum of dollars and cents per week for the 

board of said , so long as he shall continue a 

boarder in said hospital, with such extra charges as may be occasioned 
by requiring more than ordinary care and attention ; to provide 

for suitable clothing, and to pay for all such necessary articles 

of clothing as shall be procured for by the Steward of the 

hospital, and to remove from said hospital whenever the room 

occupied by shall be required for a class of patients having 

preference by law, or in the opinion of the Superintendent, to be received 
into said hospital. Also to pay, not exceeding fifty dollars, for all 



62 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

damages lie may do to the furniture and other property of said hospital, 
and for reasonable charges in case of elopement, and funeral charges in 
case of death. Payment to be made quarterly and at the time of 
removal, with interest on each bill from and after the time it becomes 
due. 

"Witness our hands this day of , A. D. 18 

Attest. (Signed,) 

, Principal. 
, Surety. 



FORM OF OVERSEERS' BOND. 

State Lunatic Hospital at Worcester. 
"Whereas of , in the county 

of , has been admitted a boarder in the State Lunatic 

Hospital at Worcester, we 

, a majority of the Overseers of the Poor of the 
town of , in the county of , in behalf 

of the inhabitants of said town, do hereby promise 

Treasurer of said hospital, to pay him or his suc- 
cessor in said office, the sum of dollar and 
cents per week for the board of said 

so long as he shall continue a boarder in said 
hospital, with such extra charges as may be occasioned by 
requiring more than ordinary care and attention, to provide for 
suitable clothing, and to pay for all such necessary articles 
of clothing as shall be procured for by the Steward of the 

hospital, and to remove from said hospital whenever the i*oom 

occupied by shall be required for a class of patients having 

preference by law, or in the opinion of the Superintendent, to be received 
into said hospital ; and if he should be removed at the request of 

before the expiration of six calendar months after 
reception, to pay board for twenty-six weeks, unless he should be 
sooner cured. Also to pay, not exceeding fifty dollars, for all damages 
he may do to the furniture, and other property of said hospital, and . 
for reasonable charges in case of elopement, and funeral charges in case 
of death. Payment to be made quarterly and at the time of removal, 
with interest on each bill from and after the time it becomes due. 

Witness our hands this day of 

A. D. 18 

Attest. (Signed,) 

Overseers of the Poor 

of the 
town of 



1859.] PUBLIC DOCUMENT— No. 27. 63 



In conformity" to the laws of the Commonwealth the Trustees are 
required at their annual meeting to establish the price of board. The 
expense for the ensuing year will be at the rate of three dollars per 
week for the first six months after the commitment of a patient, and two 
dollars and seventy-five cents per week after the expiration of six 
months. All necessary clothing must be supplied by the friends of the 
patient. 

Clothing will be supplied a*t the hospital if desirable and charged in 
the bills at cost. 

Damages clone to furniture and other property to the amount of fifty 
dollars may also be charged. 

Reasonable charges will be made in case of elopement, and funeral 
charges in case of death. 

All bills are collected by the Treasurer quarterly, or interest charged 
on the same after becoming due. 

Bills become due on the first of January, April, July, and October, 
and when the patient leaves the hospital. 



64 



LUNATIC HOSPITAL AT WORCESTER. 



[Oct. 



AN INVENTORY 

Of Amounts in value of the Stock and Supplies on hand at the 
State Lunatic Hospital. 











$3,285 00 


Produce of the farm on hand, . 






1,858 25 


Carriages and agricultural implements, 






906 29 


Machinery and mechanical fixtures, . 






5,858 33£ 


Beds and bedding in the inmates' department, 






3,728 43 


Other furniture in the inmates' department, 






3,227 31 


Superintendent's department, . 






371 66 


Housekeeping department, 








786 26 


Ready made clothing, 








264 79 


Dry goods, . . 








918 93 


Provisions and groceries, 








1,423 09 










158 00 


Fuel, 








3,300 00 










295 75 



METEOROLOGICAL OBSERVATIONS 



THE STATE LUNATIC HOSPITAL, WORCESTER, MASS., 



185 8-9 



Latitude, 42° 16' 17" N. ; Longitude, 71° 48' 13" W. 
Elevation, 536 feet. 



Explanation. — The force of the wind is estimated upon a scale of 10 and indicated by figures 
affixed to the letters denoting the direction. - When no number is affixed, 1 is meant. 



66 



LUNATIC HOSPITAL AT WORCESTER. 



[Oct. 



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1859.] 



PUBLIC DOCUMENT— No. 27. 



67 





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PUBLIC DOCUMENT— No. 27. 



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Fog A.M. ; Privet bloss. 
Lightning in evening. 

Very light shower P.M. 
Very light shower A.M. 

Catalpa blossoms. 
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[at 11 A.M., 91°. 
Fog A. M. 
Light shower A. M. 

Drizzling rain. 

Misty A. M. 

Dwarf Horse-chestnut 

Thunder storm, [bloss. 

Variable rain. 
Thunder storm ; rainbow 
[6 P. M. 

Solar eclipse P. M., par- 
tial. 








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1859.] 



PUBLIC DOCUMENT— No. 27. 



77 





GO 

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Brilliant aurora A. M. & 
[P.M. 
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Very light showers. 

Light fog A. M. 
Light fog A. M. 

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Misty. 
Rain. 
Rain. 
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Foggy A. M. 
Aurora faint 7 P.M. & 
Showery. [seq. 
Light shower A. M. 
Foggy in valleys. 




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1859.] PUBLIC DOCUMENT— No. 27. 83 



BY-LAWS 

ESTABLISHED BY THE TRUSTEES OF THE STATE LUNATIC 
HOSPITAL IN WORCESTER. 



CHAPTER I. 

Organization and Meetings of the Board of Trustees. 

Section 1. The Board of Trustees shall be organized as soon as 
may be, after the annual appointment of the members, at a meeting to 
be called by the Trustee who is first named in the commission of the 
Governor, at which meeting one of the Trustees shall be appointed 
Chairman, and another Secretary of the Board. In case of the death 
sickness, or absence of the Chairman, such other Trustee as may be first 
named in the commission of the Governor, shall perform the duties of 
Chairman until the Board, at its next following meeting, shall make an 
appointment. 

Sect. 2. The Chairman shall call meetings of the Board as often as 
he may deem the same expedient, or whenever he shall be requested to 
do so by any two Trustees. He shall preside at all meetings, shall pre- 
pare the annual report required to be laid before the Governor and 
Council, and shall be the organ of the Board in receiving and preparing 
all official communications in relation to its concerns. 

Sect. 3. The Secretary shall keep a record of the proceedings of 
the Board, and shall prepare, or cause to be prepared, all documents, 
statements, and notices, which may be directed by the Board or by the 
Chairman. Whenever directed by the Board or Chairman, he shall 
give notice, in writing, to each Trustee, of the time and place appointed 
for a proposed meeting of the Board. He shall promptly communicate 
to the Treasurer all the proceedings of the Board in relation to the 
settlement of accounts with patients, and the financial concerns of the 
institution. To assist him in the performance of his duties, he shall be 
authorized to employ the clerk residing at the hospital. 

Sect. 4. The monthly, semi-annual, and annual visitations of the 
hospital shall be made, so far as may be, in connection with the meetings 
of the Board ; and, otherwise, in conformity to such arrangement as the 
Board may, from time to time, adopt. 



84 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Sect. 5. The annual meeting of the Board shall always be held 
between the first and fifteenth of October, for the purpose of receiving 
and auditing the annual report of the Treasurer, and of considering and 
adopting the annual report of the Board, as prepared by the Chairman, 
in order that the same may be seasonably forwarded to the office of the 
Secretary of the Commonwealth. 

Sect. 6. The Treasurer's report shall contain a statement of all 
receipts and expenditures for the year ending the last day of September 
in each year ; and all bills for board and expenses of patients shall be 
payable to the Treasurer on the first days of January, April, July, and 
October, in each year. 

Sect. 7. The Trustees shall at their annual meeting in each and 
every year, fix and establish the price to be charged for the board of 
patients at the hospital, according to the provisions of law in that behalf* 
made and provided. 

CHAPTER II. 

Officers of the Hospital, Tenure of Office, and Salaries. 

Section 1. For conducting efficiently and economically the business 
of the institution, the following officers shall be appointed by the Trus- 
tees, viz. : a Superintendent, a Treasurer, one Assistant-Physician, a 
Steward, and a Matron. 

Sect. 2. The several officers appointed by the Board shall hold 
their offices during the pleasure of the Board, and shall not resign their 
offices without giving to the Board at least six months' notice of their 
intention so to do. 

Sect. 3. The salaries of the officers shall be established as follows, 
viz. : — 

The Superintendent shall receive the sum of eighteen hundred dollars 
per annum, and shall be provided with furnished apartments, and also 
board and fuel for himself and family ; together with the services of 
one female domestic, and horse-keeping for one horse. 

The Treasurer shall receive the sum of six hundred dollars per 
annum. 

The Assistant-Physician shall receive the sum of five hundred dollars 
for the first year, six hundred dollars for the second year, seven hundred 
dollars for the third year, and nine hundred dollars for the fourth and 
each succeeding year, together with board and fuel, and the use of a 
furnished apartment. 

The Steward and Matron shall receive jointly the sum of seven 
hundred dollars per annum, together with board and fuel, and the use 
of furnished apartments. 



1859.] PUBLIC DOCUMENT— No. 27. 85 

CHAPTER III. 

Duty of Superintendent. 

Section 1. The Superintendent shall be a physician, and shall con- 
stantly reside at the hospital. 

Sect. 2. He shall have the superintendence of the hospital, and of 
all the buildings and grounds connected therewith, the oversight and 
charge of the patients, and the general direction of all the concerns of 
the institution, subject to such regulations as may be from time to time 
established by the Trustees. 

Sect. 3. He shall visit all the patients personally, or learn their 
condition daily, and as much oftener as may be necessary, and shall 
direct such medical, moral and physical treatment as may be best adapted 
to their relief, giving the fairest trial to kind and moral management. 

Sect. 4. He shall cause to be kept a record showing the name, age 
and residence of each patient, the time when received and removed, 
whether cured or relieved, whether eloped or dead, and if dead, from 
what cause. 

Sect. 5. He shall receive and answer all communications relating 
to the concerns of the institution, and shall cause a record of his 
correspondence to be regularly kept. 

Sect. 6. Under the general direction of the Trustees, he shall, from 
time to time, appoint such persons as he may deem qualified to perform 
the duties of clerk and apothecary, supervisors of departments, overseers 
of the laundry, bakery and workshops, watchmen, farmer, and also all 
necessary attendants, in the galleries, laundry, bakery, kitchen, work- 
shops, and on the farm, and shall contract with them to perform the 
services required of them by the by-laws, on such conditions and at such 
rate of weekly or monthly wages as he shall deem expedient. 

He shall see constantly that all persons thus employed by him, and 
also all subordinate officers appointed by the Board, perform faithfully 
the duties required of them, and from time to time he shall give them 
such instructions as he may deem necessary to secure the exact and 
thorough performance of their respective duties. 

He shall be authorized to discharge from service any of the persons 
thus appointed by him, upon their request, or whenever he shall cease 
to be satisfied in respect to the performance of their duties. 

Sect. 7. At each monthly visit of the Trustees he shall exhibit all 
the records, and in a verbal or written report shall make known the state 
of the institution, specifying the cases of patients received or removed 
during the month, and accompanying the same with such suggestions 
and remarks as he may deem useful. 



86 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Sect. 8. At the annual meeting of the Trustees he shall submit a 
report in writing, upon such topics as may have been suggested by the 
progress of the institution and the experience of the year, including 
therein a tabular statement comprising all important particulars from 
the records. 

CHAPTER IV. 

Duty of Treasurer. 

Section 1. The Treasurer shall give bonds for the faithful per- 
formance of his duties, in the sum of fifteen thousand dollars, with such 
sureties as shall be approved by the Trustees. 

Sect. 2. He shall receive, hold and disburse all the moneys which 
may be granted by the legislature or obtained from other sources for the 
use of the Hospital ; and once in each year, and oftener if required by 
the Trustees, he shall exhibit an account of his receipts and expendi- 
tures, with all the vouchers therefor, for the examination of the Board. 

CHAPTER V. 

Duty of the Assistant-Physician. 

Section 1. The Assistant-Physician shall always be a physician, 
and shall constantly reside at the hospital. He shall exercise a general 
supervision of all the patients, under the direction of the Superintendent. 

Sect. 2. The Assistant Physician shall visit all the patients in his 
department daily, and oftener if necessary ; carefully observe their con- 
dition, wants and treatment, and see that they have food, medicine, 
exercise, amusements, clothing and bedding suitable for them ; exert 
what moral influence he can with them, and endeavor in every way to 
promote their comfort and recovery. 

Sect. 3. He shall see that the subordinate officers and attendants 
are faithful and kind, attentive to the wants of the patients, and vigilant 
in the discharge of all their duties, and he shall enter in a book kept for 
the purpose all instances of neglect of duty observed by him, or of which 
he may receive information, which shall be immediately reported to the 
Superintendent. 

Sect. 4. For the due performance of the duties enjoined in the 
foregoing sections he shall spend much time in his department, shall be 
in constant communication with the supervisors, overseers and attend- 
ants, and shall carry out the plans and instructions of the Superintendent 
in the best manner he is able. 

Sect. 5. He shall report to the Superintendent daily the general 
condition of his department, and the particular state of such patients as 
may be sick or greatly excited, requiring restraint or seclusion. 



1859.] PUBLIC DOCUMENT— No. 27. 87 

Sect. 6. He shall attend to the warmth, cleanliness, ventilation, 
and good order of his department, and superintend the use of the bath. 

Sect. 7. He shall keep records of the cases of all the patients, 
describing the symptoms, the changes' that may occur from time to time, 
the mode of treatment and all the peculiar circumstances connected 
therewith. 

Sect. 8. He shall attend to visitors when necessary, and shall 
always be ready to perform whatever services may be required of him 
by the Superintendent. 

CHAPTER VI. 

Duty of Steward. 

Section 1. The Steward, under the direction of the Superintendent, 
shall purchase furniture, fuel, stores, stock for the workshops, implements 
and cattle for the farm, and all other necessary articles, and shall be 
responsible for the economical use of the same. 

Sect. 2. He shall keep clear and methodical and exact accounts 
of all receipts and expenditures, and of charges against patients, and 
shall submit the same, together with proper vouchers therefor, to the 
Treasurer, at least once in three months, and as much oftener as the 
Treasurer shall require. 

Sect. 3. Under the direction of the Superintendent, he shall attend 
to engaging and discharging the subordinate officers and attendants, and 
to the settlement of their wages, for which latter purpose he shall keep 
regular accounts with them. 

Sect. 4. He shall constantly observe the conduct of the subordinate 
officers and attendants, and see that in all respects they do their duty, 
and forthwith report to the Superintendent any instance of misconduct 
or negligence on their part which he may observe or of which he may 
be informed. 

Sect. 5. He shall attend particularly to the business of the laundry, 
bakery, workshops and farm ; shall see to the cleansing of the sewers 
as often as may be necessary, and that the grounds, yards and roads, 
the aqueduct, laundry, bakery, workshops, barns, and other out-buildings 
are always kept in order in conformity to such directions as he may 
receive from the Superintendent. 

Sect. 6. He shall pei^form all services that may be required of him 
in maintaining the police of the establishment ; shall see to the opening 
and closing of the house, and that the attendants rise and commence 
business immediately after the ringing of the bell, and that they retire 
in proper season at night ; that the bell is rung at proper times, and that 
the fires are regularly kindled and extinguished. He shall go in search 
of elopers ; shall observe the conduct of inmates at the religious and 



88 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

other meetings ; and when in the wings, shall exert all the good influ- 
ences he can to promote the comfort and recovery of the patients. 

Sect. 7. He shall receive visitors, give them all suitable informa- 
tion, and accompany them personally to such parts of the buildings 
and grounds as, by the permission of the Superintendent, are open for 
examination. 

Sect. 8. He shall be at all times ready to perform whatever extra- 
ordinary services shall be required of him by the Superintendent. 



CHAPTER VII. 

Duty of Matron. 

Section 1. The Matron shall have the general direction of the 
domestic concerns of the hospital. 

Sect. 2. She shall attend to the cleanliness and good order of the 
apartments, have care of the cooking, sewing, clothing and bedding, 
' and in connection with the Steward, shall take the general direction of 
the washing, ironing and baking. 

Sect. 3. She shall see that all the female attendants are faithful and 
diligent in the discharge of their duties, kind and pleasant to patients 
wherever they meet them, discreet and regular in their deportment, and 
that they observe all the regulations of the hospital. 

Sect. 4. She shall be in the way of seeing the patients frequently, 
and shall be careful always to exert a good moral influence on them and 
the attendants, and shall spare no effort to promote the comfort and 
good order of the household. 

Sect. 5. She shall be at all times ready to perform whatever extra- 
ordinary services shall be required of her by the Superintendent. 

CHAPTER VIII. 

Duty of Clerk and Apothecary. 

Section 1. The Clerk and Apothecary shall keep the records of 
the hospital, under the direction of the Superintendent ; he shall copy, 
seal and direct letters, make copies of all documents and other papers, 
post the books of the Steward, keep the weather table, and perform all 
other clerical services which may be required by the Superintendent or 
by the Secretary of the Board of Trustees. 

Sect. 2. He shall also prepare and put up the medicines prescribed 
by the Superintendent and Assistant-Physician. 

Sect. 3. He shall keep the office in order, wait upon visitors, and 
perform what other services shall be required of him by the Superin- 
tendent. 



1859.] PUBLIC DOCUMENT— No. 27. 89 



CHAPTER IX. 

Duties of the Supervisors. 

Section 1. The Supervisors of the respective departments are 
responsible in a great measure for the order and discipline of the insti- 
tution. It is their duty to see that the rules of the hospital are carried 
out in every particular, and that every patient is treated with uniform 
kindness and attention. 

Sect. 2. They will administer all medicines prescribed by the 
Superintendent or Assistant-Physician, and see that their orders are 
most strictly observed. 

Sect. 3. They will pass all their time in the wards of their 
respective departments, and assist their attendants in their efforts to 
amuse, interest and employ the patients under their care. 

Sect. 4. They must prevent, in every possible way, any disturbance, 
noise or confusion among the patients. 

Sect. 5. They must report at once all irregularities in the conduct 
of the attendants, or neglect in the performance of duties that may come 
under their notice. 

Sect. 6. They will act as mediums or messengers between the 
attendants and office, receiving and transmitting all messages and 
requests between the same. 

Sect. 7. They should report to the Superintendent each day, before 
the regular visit of the Superintendent and Assistant-Physician, the 
general condition of the patients. 

Sect. 8. They must have the general charge and supervision of the 
clothing of patients, and of the beds and furniture in the wards. 

Sect. 9. They shall have the general charge and direction of the 
sick, and must know that orders of the Superintendent and Assistant- 
Physician are faithfully executed. 

Sect. 10. They shall in every possible way promote the general 
interests of the Hospital, and be at all times in readiness to perform 
any service required by the Superintendent. 

CHAPTER X. 

Duty of Attendants. 

Section 1. Treatment of Patients. — In all their intercourse with 
the patients, the Attendants shall treat them with marked respect and 
civility. They shall be kind and gentle in their manner, and avoid 
violence of every kind. They must answer, as well as they can, every 
civil question, and attend at once to every reasonable request. They 
12 



90 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

must be quiet and calm under every provocation, and never scold, 
threaten or recriminate ; and whenever they desire any thing done by a 
patient, they must request it in a respectful and becoming manner. 

Sect. 2. In the care of the insane, sympathy, tact and kindness 
should always take the place of force and authority. But if unfortu- 
nately force must at any time be resorted to, the manner of its employ- 
ment should take away its offensiveness. 

Sect. 3. A cheerful look, a kind manner, a respectful demeanor, 
and sympathizing language, will do much towards quieting the most 
excited patient. 

Sect. 4. The opposition patients make often arises from delusions 
that lead them to believe they are to be injured in person, property or 
character, so that every attempt to control them, to administer food, 
medicine or baths, or to do any thing for them, should be done in the most 
quiet and kind manner. 

Sect. 5. Angry looks, cross words, violent actions, will destroy the 
patient's confidence, and, if he is subjected to such treatment in the com- 
mencement of his disease, will destroy all hope of recovery and cause 
years of suffering to him and anxiety to his friends. 

Sect. 6. Morning Duties. — The Attendants shall rise in the morn- 
ing at the ringing of the bell, and at once commence the labors of the 
day. On opening the doors of the patients' sleeping rooms, they shall 
greet the patients with expressions of kindness, see that they arise from 
bed, are neatly dressed, properly washed, and have their hair and 
clothes well brushed in time for breakfast at the prescribed hour. 

Sect. 7. Immediately after the patients have arisen from bed the 
Attendants shall remove the chamber vessels, spread open the beds for 
airing, see that the soiled beds and bedding are removed, and put the 
beds in good order. 

Sect. 8. The Attendants shall keep the patients' rooms and every 
part of the wards perfectly neat and clean at all times. " Nothing is 
clean enough if it can be made cleaner." This rule must be most 
scrupulously observed. 

Sect. 9. Whenever any unpleasant odor is discovered, the cause is 
to be ascertained and removed at all times, day or night. 

Sect. 10. Whenever any room, or any part of the wards, or any 
furniture is soiled, it must be cleaned immediately. 

Sect. 11. Whenever any bed, or furniture has been disarranged 
it must be put in order promptly and cheerfully. 

Sect. 12. The halls, sleeping-rooms, parlors, staircases and closets 
must be swept and brushed as many times each day as may be neces- 
sary to keep them perfectly clean. 



1859.] PUBLIC DOCUMENT— No. 27. 91 

Sect. 13. The windows, doors and standing work of the halls must 
be scrubbed as often as may be required. 

Sect. 14. The urinals and water-closets must be thoroughly 
watched and frequently rinsed with hot water. 

Sect. 15. Bedding, if wet only, must be cleansed by pouring hot 
water through the soiled part, and carefully dried before using. 

Sect. 16. Clean linen must be put on each bed once in every week, 
and oftener if necessary. Spreads are to be sent to the laundry when 
soiled. 

Sect. 17. If old or feeble patients wish to lie down during the day, 
they will go to their own room for that purpose, and the Attendant must 
assist them if necessary. When they leave their beds the Attendants 
will see that the beds are put in order, and, if soiled, that they are 
cleansed and dried. 

Sect. 18. Meals. — The Attendants shall cause the tables to be 
properly laid. They shall see that the furniture of the tables is always 
neat and clean. And so far as they can shall make the table appear 
cheerful and inviting. The Attendants must always be present at the 
tables to prepare and distribute food to such patients as are not able to 
do it for themselves, and shall see that each one is well served. They 
shall be careful that no knife, fork, or other article is taken from the 
tables and carried from the dining-rooms by any patient. 

Sect. 19. Patients who take their meals in their own rooms, or at 
a table in the ward, must be carefully served, and the Attendants must see 
that their food is brought to them warm and in good order. If necessary 
one Attendant must remain by them while they are eating. 

Sect. 20. Patients are never to be forced to take food but by the 
express order and in the presence of the Superintendent or Assistant- 
Physician. 

Sect. 21. The conduct of the table shall always be decorous. And 
for any deviation from the rules of propriety the Attendant in charge 
must be mainly responsible. 

Sect. 22. Baths. — Every patient must take a warm bath once in a 
week, unless otherwise directed by the Superintendent or Assistant- 
Physician. 

Sect. 23. The temperature of the bath may be such as is most 
agreeable to the patient. 

Sect. 24. Those who desire to bathe daily must be gratified in this 
respect and assisted by the Attendants. 

Sect. 25. All hot baths, foot baths, sponge baths and shower baths, 
directed by the Superintendent or Assistant-Physician, must be scrupu- 
lously administered by the Attendant in charge. 



92 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Sect. 26. In the bathing of patients the rules of delicacy must be 
most strictly observed in all cases. 

Sect. 27. Shaving. — The shaving of patients must be done by the 
Attendant in each ward at regular intervals, and patients who desire to 
be shaved more frequently must be gratified. 

Sect. 28. Great care must be taken that no injury is done at the 
time of shaving. No patient must be allowed to use a razor unless 
permission has been given by the Superintendent. 

Sect. 29. When such permission has been granted, an Attendant 
must always be present. 

Sect. 30. When an Attendant is engaged in shaving a patient, no 
other patient should be near. 

Sect. 31. The shaving must always be neatly and quickly per- 
formed. The patient must not be sent from the chair until his face is 
smooth, clean and dry, and his hair and whiskers properly trimmed and 
brushed. 

Sect. 32. Patients at work on the Farm. — Whenever it is thought 
advisable for patients to work on the farm or in the gardens, some gen- 
eral order to that effect will be given to the Farmer or some other 
responsible person, and no patient is ever to be taken from the wards 
and put to labor, unless some such order respecting the patient has been 
given. 

Sect. 33. The Farmer or Attendant at work with such patients 
will be held strictly responsible for their safe keeping until they are 
returned to the proper ward. 

Sect. 34. All farmers, mechanics and attendants are expected to 
work with the patients, and when thus employed will avoid every 
appearance of driving or superintending, instead of working with and 
assisting them. 

Sect. 35. Retiring at Night. — Patients must not retire for the 
night before 8 o'clock, P. M., without permission from the Assistant- 
Physician, except in cases of sickness and fatigue. 

Sect. 36. All those who do not attend chapel service at 8-^ o'clock 
must retire at that time, unless special permission has been given to 
the contrary. 

Sect. 37. After returning from the chapel, patients may retire in 
every part of the house. 

Sect. 38. At 9^ o'clock all patients, attendants, and other persons 
employed must be in their rooms, and no light is to be kept burning 
unless in case of sickness, always excepting the one light in each ward, 
to be in readiness in case of accident. 

Sect. 39. Before closing the door for the night, the Attendant should 
cheerfully bid the patient a " good night," and be sure the patient is 
comfortable in bed. The door then is to be carefully locked. 



1859.] PUBLIC DOCUMENT— No. 27. 93 

Sect. 40. No patient's door is ever to be left unlocked without 
permission from the Superintendent or Assistant-Physician. 

Sect. 41. Discipline. — No patient is ever to be placed in his room 
in the day time until he is actually unsafe, and after all other means of 
control have failed. If placed in his room his case is to be reported at 
once. Under no circumstances whatever must it be done rashly or 
inconsiderately. When secluded in their own rooms they must be 
frequently observed, and reported if occupied in defacing the walls, 
injuring furniture, destroying clothing, or any unseemly act. 

Sect. 42. No means of restraint is ever to be placed on a patient, 
except by the express order of the Superintendent and in his presence. 

Sect. 43. Escapes. — Whenever a patient is missing he is to be 
reported at once, and all proper means taken to recover him under the 
direction of the Superintendent or Assistant-Physician. 

Sect. 44. Prohibited Articles. — Patients are not to have possession 
of any knife, razor, or any other dangerous weapon, and whenever one 
is suspected of having any thing of the kind, a careful search is to be 
made for it until it is discovered. 

Sect. 45. Patients are not to be supplied with tobacco, cigars, or 
any stimulating beverage. 

Sect. 46. All letters, packages, &c, must pass through the office, 
and be inspected by the Superintendent or Assistant-Physician. 

CHAPTER XL 

Duties of House Clerk. 
, Section 1. It shall be the duty of the House Clerk to receive and 
mark neatly and legibly all clothing brought with patients when they 
enter the hospital. She shall enter in a book kept for the purpose the 
name and number of every article, and also take charge of any jewelry, 
knives, scissors, razors, &c, and all moneys and papers, and be respon- 
sible for their safe keeping until permission is given by the Superin- 
tendent for their delivery to the patient. 

Sect. 2. She shall also mark and register all clothing provided for 
patients during their stay in the hospital. 

Sect. 3. She shall at all times be ready to assist the female patients 
in altering and repairing any article of clothing, and in every way make 
herself generally useful. 

Sect. 4. She shall observe all the regulations of the hospital, and 
be ready at all times to perform any service required by the Superin- 
tendent. 



94 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

CHAPTER XII. 

Duty of the Baker. 

Section 1. The Baker, under the direction of the Steward and 
Matron, shall prepare bread, pastry, and other articles pertaining to his 
department of cooking, and shall supply the kitchen with such quantity 
as may be required. 

Sect. 2. He shall take care of all supplies furnished him for use, 
and shall be held responsible for the judicious and economical use of 
them. 

Sect. 3. He shall take charge of the bakery and furniture, and 
always see personally to the fire and lights, and to the opening and 
closing of his department. 

Sect. 4. He shall observe all the regulations of the hospital, and 
see that they are observed by all persons employed in the bakery, and 
shall immediately report every instance of remissness or neglect of duty 
to the Steward. 

Sect. 5. He shall be ready at all times to perform any service 
which may be required by the Superintendent. 

CHAPTER XIII. 

Duty of Farmer. 

Section 1. The Farmer, under the direction of the Steward, shall 
take care of the stock, barn, stables, and piggeries, shall see to the care- 
ful use and safe keeping of all implements of labor, and to the feeding 
and proper treatment of all the animals, and he shall have charge of 
the teams and of all the work done upon the farm. 

Sect. 2. He shall be ready at all times to perform any service 
which may be required of him by the Superintendent. 

CHAPTER XIV. 

Duty of the Engineer and Fireman. 

Section 1. It shall be the duty of the Engineer and Fireman to 
attend to and take care of the steam apparatus for warming and ven- 
tilating the hospital. He will also supply steam for cooking, bathing 
and laundry purposes, and also for the stables whenever needed. 

Sect. 2. He must attend to the force pumps, and see that they are 
kept in working order, and shall keep them in action so much of the 
time as may be necessary. 

Sect. 8. He must attend to the generation of steam so carefully as 
to be able to adapt it to all the variations of the temperature. 



1859.] PUBLIC DOCUMENT— No. 27. 95 

Sect. 4. He must keep his department in a perfectly neat and 
orderly manner. 

Sect. 5. He will not permit any company or visitor in his depart- 
ment without permission from the Superintendent. 

CHAPTER XV. 

Duty of the Overseer of the Kitchen. 

Section 1. The Overseer of the Kitchen shall have the general 
charge of all the cooking, under the direction of the Steward and 
Matron. He shall take care of supplies for the kitchen, and prepare 
food for the household as may be directed. 

Sect. 2. He shall see to the proper distribution and delivery of food 
to the various wards, and shall be responsible for the cooking of the 
same. 

Sect. 3. He shall personally take care of the fires and lights, and 
see that his department is properly closed for the night. 

Sect. 4. He shall be mainly responsible for the conduct of such 
help as he may require in the performance of his duties. 

Sect. 5. He shall at all times be ready to perform any service 
required of him by the Supermtendent. 

CHAPTER XVI. 

Duty of the Laundress. 

Section 1. The Laundress, under the direction of the Steward and 
Matron, shall have the general charge of the laundry. She shall on 
specified days collect the clothes and soiled linen from the place of their 
deposit, and cause them to be properly washed and ironed, and returned 
to the wards to which they belong. 

Sect. 2. The soiled clothes and bed linen belonging in the centre 
building shall, on specified days, be taken from the rooms to which they 
belong, and after washing and ironing in a neat manner, shall be returned 
to the rooms from which they were taken. 

Sect. 3. She shall take care of the laundry and its fixtures, keep 
them in good order, attend personally to the fires and lights, and secure 
the apartments at night. 

Sect. 4. She shall observe all the regulations of the hospital, and 
see that they are observed by those employed in the laundry. 

Sect. 5. She will not permit any visitor or company in the laundry, 
without permission from the Superintendent, Steward or Matron. 



96 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

CHAPTER XVII. 

Duties of the Watch. 

Section 1. The Watchman will visit the office at half-past nine 
o'clock in the evening, to receive his instructions for" the night, and im- 
mediately commence his duties. 

Sect. 2. He shall be constantly awake, faithful and vigilant. He 
shall visit each wax'd in the male department at least every hour during 
the night. He must avoid noise, never converse in a loud tone with any 
one, and open and shut all doors as quietly as possible. 

Sect. 3. In the treatment of patients he must observe the same 
rules as the Attendants. 

Sect. 4. He must always attend to any want expressed by a patient. 

Sect. 5. He must notice any unusual noise in a patient's room, and 
ascertain the cause, and if necessary give notice to the Attendant. 

Sect. 6. He must give especial attention to the sick, and faithfully 
execute any order respecting them. 

Sect. 7. He must be scrupulously watchful in regard to fire, and if 
one occurs must at once give notice to the Superintendent, but in no case 
make an alarm. 

Sect. 8. He must be on service twelve hours of each day. 

Sect. 9. He will at all times be in readiness to perform any service 
required by the Superintendent. 

CHAPTER XVIII. 

Duties of the Watchwoman. 
Section 1. The Watchwoman will have charge of the female 
wards during the night, and be governed by the rules laid down for the 
Watchman. 

CHAPTER XIX. 

Duty of Overseers of Workshops. 

Section 1. The Overseers of Workshops, under the direction of 
the Steward, shall take care of all stock supplied to them, and see that 
it is economically used and properly manufactured by the patients under 
their charge ; and they shall keep regular accounts of all stock received 
and all articles manufactured, sold, or otherwise disposed of. 

Sect. 2. They shall exercise a judicious and prudent oversight of 
all patients under their charge, and shall see them returned to the 
wards, or placed in the care of their respective attendants, when their 
labor is done. 



1859.] PUBLIC DOCUMENT— No. 27. 97 

Sect. 3. They shall take care of the apartments, and of all stock, 
tools, and fire therein ; shall see to the fires and lights, and that the 
workshops are properly closed at night. 

Sect. 4. They shall be ready at all times to perform any service 
which may be required of them by the Superintendent. 

CHAPTER XX. 

Attendance upon Religious Service. 

Section 1. All persons employed in the hospital who are well, 
and can be spared from their duties in the house or in the wards, shall 
attend evening prayers, and the religious services on the Sabbath, both 
morning and evening, unless leave of absence be specially granted. 

Sect. 2. Officers and Attendants shall take especial care that their 
demeanor during the services shall be strictly becoming and worthy of 
imitation ; and it shall be considered a noticeable breach of duty, for 
any one to sleep habitually while present in the chapel. 

Sect. 3. The attendance of patients in the chapel shall be under 
the direction of the Superintendent ; and all the arrangements which he 
may direct concerning them shall be faithfully carried into effect by the 
other Officers and the Attendants. 

CHAPTER XXI. 

Duty of the Yard Attendant. 

Section 1. Under the direction of the Steward, he shall take care 
of the yards and cellars. He shall keep all the walks, avenues and 
courts perfectly clean and neat. He shall remove all rubbish and filth, 
collect and take off whatever may be thrown from the windows of the 
wards. 

Sect. 2. He shall keep the cellars and attics well swept and white- 
washed, and shall remove the dust from the dust holes as often as may 
be necessary. 

Sect. 3. He shall remove all the soiled straw beds, and at the 
request of the Supervisors shall return fresh and clean ones. 

Sect. 4. He shall see that the doors and gates of his department 
are secured for the night, and shall be ready at all times to perform any 
service required by the Superintendent. 

CHAPTER XXII. 

Duties of Coachman. 
Section 1. He shall take care of all carriages, horses and har- 
nesses, &c, and see that they are at all times in good order and ready 
for use. 

13 



98 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Sect. 2. He shall drive out with the patients at such times as may 
be directed by the Superintendent, and shall be careful that no accident 
occurs, and shall also see that the patients conduct themselves in a 
becoming manner. 

Sect. 3. He shall never stop at any house, shop or store, or do any 
errands, or carry any messages or packages, without express direction 
from the Superintendent. 

Sect. 4. He will at once report any impropriety that occurs during 
the ride. 

Sect. 5. He will hold himself in readiness to perform any service 
required by the Superintendent. 

CHAPTER XXIII. 

Miscellaneous Regulations. 

Section 1. No Officer or Attendant, while connected with the 
hospital, shall at any time make use of distilled spirits or intoxicating 
liquor of any kind, at home or abroad ; nor shall any one make use of 
tobacco, or smoke a cigar or pipe about the premises. 

Sect. 2. No company shall be admitted into the wards occupied by 
the patients, except by express permission from the Superintendent. 
All other parts of the hospital may be exhibited by the Assistant- 
Physician, and the Steward or Matron, at such times and under such 
restrictions as the Superintendent shall direct. 

Sect. 3. The Attendants shall always keep themselves well dressed 
in neat and clean apparel. 

Sect. 4. All persons employed at the hospital shall avoid the use 
of profane, obscene or vulgar language, treat each other with uniform 
civility, never indulge in loud talking or laughing, nor play at any game 
together without the permission of the Superintendent. In all respects 
they shall exhibit a good example to the patients, and shall be held 
strictly responsible for the bad influence of their conduct. 

Sect. 5. All persons employed at the hospital shall accustom 
themselves to speak respectfully of the officers and the institution, and 
shall inculcate these sentiments in their intercourse with the patients 
and they shall sustain and carry into operation all directions and pre- 
scriptions for the patients in the most ready and faithful manner. 

Sect. 6. All persons who have duty to perform at the hospital 
shall rise in the morning at the ringing of the bell. 

Sect. 7. Leave of absence will be granted to all persons employed 
in the various wards by the Superintendent, and in his absence by the 
Assistant-Physician. 



1859.] PUBLIC DOCUMENT— No. 27. 99 

Sect. 8. Leave of absence will be granted to all persons employed 
in the kitchen, laundry, bakery and serving rooms by the Superintendent, 
and in his absence by the Matron. 

Sect. 9. Leave of absence will be granted to all persons employed 
on the farm and in the various workshops by the Superintendent, and in 
his absence by the Steward. 

Sect. 10. All persons who shall agree to perform service at the 
hospital shall be considered as engaged for one year, unless a special 
contract shall be made for a longer or shorter term ; and no person 
employed at the hospital shall discontinue service at or after the expira- 
tion of the year or term agreed for, without giving to the Steward at 
least thirty days' notice of an intention so to do. 

Sect. 11. It is expected that the Attendants will devote their whole 
time to the interests of the hospital. 

Sect. 12. They will never leave their duties without permission, 
and whenever leave of absence is given they will always leave their 
keys at the office until they return. 

Sect. 13. When they go out they will never carry bundles, letters, 
or any thing for patients, or do any errand for them without permission 
from the Superintendent. 

Sect. 14. The Attendants must on no account take any friend or 
visitor into any of the wards, without permission from the Superin- 
tendent. 



100 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



DIET TABLE 

FOB THE STATE LUNATIC HOSPITAL 



SUNDAY. 

Breakfast — Coffee, bread and butter, hash of fish and potatoes. 
Dinner — Bread and butter, cheese, crackers and pie. 
Supper — Tea or cocoa, bread and butter, cold meat and warm 
potatoes. 

MONDAY. 

Breakfast — Coffee, bread and butter, boiled eggs and warm potatoes. 
Dinner — Boiled dish, vegetables, hasty pudding, and bread and 
butter. 

Supper — Tea or cocoa, warm biscuit and butter, and cheese. 

TUESDAY. 

Breakfast — Coffee, bread and butter, hash of meat and potatoes. 
Dinner — Roast meat, vegetables, and bread and butter. 
Supper — Tea or cocoa, bread and butter, cheese and plain cake. 

WEDNESDAY. 

Breakfast — Coffee, warm biscuit and butter, cold roast meat and 
potatoes. 

Dinner — Stewed or baked beans or stewed peas, vegetables, boiled 
rice and bread and butter. 

Supper — Tea or cocoa, bread and butter, cheese and gingerbread. 

THURSDAY. 

Breakfast — Coffee, bread and butter, hash of fish and potatoes. 
Dinner — Soup with meat, vegetables, pudding and bread and butter. 
Supper — Tea or cocoa, bread and butter and sugar gingerbread. 

FRIDAY. 

Breakfast — Coffee, bread and butter, cold meat, warm baked or 
stewed beans or peas, and warm potatoes. 

Dinner — Boiled dish, vegetables, pudding and bread and butter. 
Supper — Tea or cocoa, warm biscuit and butter and cheese. 



1859.] PUBLIC DOCUMENT— No. 27. 101 



SATURDAY. 

Breakfast — Coffee, bread and butter, hash of meat and potatoes. 
Dinner — Salt or fresh fish, vegetables, boiled rice, and bread and 
butter. 

Supper — Tea or cocoa, bread and butter, and tea cake. 

The condiments provided, are salt, pepper, mustard, and vinegar. 
Toast, griddle cakes, fried pudding or cakes, to be used twice a week. 
Milk is used freely. Apples in the season of them are served every 
day at dinner, other fruits occasionally. The sick have a prescribed 
diet. 



102 LUNATIC HOSPITAL AT WORCESTER. [Oct. '59. 



Time of Bell Ringing and Meals. 





Bell rings. 


Breakfast. 


Supper. 


March 1 to 15, . 






5£ A. 


M., 4^ P.M., . 


7 


6i 


" 15 to 81, . 






H ' 


< H " • 


8f 


H 


April 1 to 15, . 






5 


' 5 


H 


5| 


" 15 to 30, . 






4f ' 


' 51 " . 


H 


6 


May 1 to Sept. 1, 






H 4 


' 5* « . 


6 


6 


Sept. 1 to 15, . 






4| < 


' h " • 


6i 


6 


" 15 to 30, . 






5 


' 5 


H 


H 


Oct. 1 to 15, . 






5* < 


' 4| « . 


6f 


H 


" 15 to 31, . 






H ' 


' 4* " • 


7 


H 


Nov. 1 to March 1, 




5f ' 


< H " • 


7 


5 



Bell rings week days at 12 M. 

" " every evening at 8^. 

" " Sundays at 2\ P. M. 

Dinner, week days at Vl\ P. M. 

" Sundays at . 12 M. 

Supper, Sundays, half an hour earlier than on week days. 



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