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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.  41 


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48 


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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, 
smI  that  considerable  new  furniture  has  been  furnished  and 
mid  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. 


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PUBLIC  DOCUMENT— No.  27. 


67 


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Lightning  in  evening. 

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

Catalpa  blossoms. 
Thunder  storm ;  therm, 
[at  11  A.M.,  91°. 
Fog  A.  M. 
Light  shower  A.  M. 

Drizzling  rain. 

Misty  A.  M. 

Dwarf     Horse-chestnut 

Thunder  storm,     [bloss. 

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LUNATIC  HOSPITAL  AT  WORCESTER. 


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313 

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1859.] 


PUBLIC  DOCUMENT— No.  27. 


77 


GO 

s 

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

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

Drizzling. 

Rain  ;  showery  P.  M. 

Light  rain  ;  double  rain- 
[bow  6  P.  M. 
Frost  A.  M. 
Frost  and  fog  A.  M. 
Drizzling,  variable. 
Rain. 
Fog  A.  M. 
Misty. 
Rain. 
Rain. 
Rain. 

Very  light  shower,  eve- 
Dense  fog  A.  M.    [ning. 
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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