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



I 



^54-&6 



A 



PUBLIC DOCUMENT ......No. 33. 



TWENTY-EIGHTH ANNUAL REPORT 



THE TRUSTEES 



STATE LUNATIC HOSPITAL 



^.T WORCESTER. 



OCTOBER, 1860 



BOSTON: 

WILLIAM WHITE, PKINTER TO THE STATE. 
18 60. 



OFFICERS OF THE HOSPITAL. 



TRUSTEES. 

JOSEPH N. BATES, Chairman, . ... . Worcester. 

WILLIAM T. MERRIFIELD, .... Worcester, 

CHARLES H. STEDMAN, Boston. 

ROBERT W. HOOPER, Boston. 

EDWIN F. JENKS, Adams. 



TREASURER 



HENRY WOODWARD, 

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., . . . . Cleric and Apothecary. 

CAROLINE A. BEMIS, Matron. 



TWENTY-EIGHTH ANNUAL REPORT 

OF THE 

TRUSTEES OF THE STATE LUNATIC HOSPITAL, 
AT WORCESTER. 



To His Excellency, the Governor, and the Honorable Council : 

The Trustees of the Worcester Hospital for the Insane beg 
leave to report the following statistics of the institution for the 
year ending October 1, 1860 : 





Men. 


"Women. 


Total. 


Patients in the house October 1, 1859, 


152 


165 


317 


Admitted during the year, .... 


105 


110 


215 


Under treatment, 


257 


275 


532 


Discharged recovered, 


65 


64 


129 


" improved, 


17 


18 


35 


" not improved, .... 


8 


7 


15 


Died, 


12 


10 


22 


Remaining October 1, 1860, .... 


155 


176 


331 



The health of the patients during the year has been generally 
excellent. In the spring, a few cases of smallpox occurred, in 
nearly every instance of rather a mild form. The deaths that 
have occurred have been mostly among those who were affected 



6 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

with bodily disease on entering the house. Except for a few 
weeks in August, the patients have been unusually quiet. 
Resort has been had to restraint in only a few cases — and that 
the mildest kind of restraint, to prevent accidents arising to the 
individuals themselves from their own violence. The condition 
of the hospital has been much improved during the last few 
years, making it nearly if not quite equal to the hospitals of 
more modern construction. The admirable system of ventila- 
tion and drainage has undoubtedly had a great effect in 
preventing epidemics to which crowded hospitals are liable. 
Until the new hospital at Northampton was finished, that at 
Worcester was unable to furnish beds, other than mattresses 
upon the floors, to more than about three-quarters of the 
inmates. Great judgment had to be used daily in selecting for 
such temporary accommodation those who would bear the 
inconvenience with composure. 

The building is supplied, by a steam-engine, with volumes of 
pure air warmed to any required temperature ; and, by the 
same power, the whole sewerage of the hospital is carried 
through conduits laid under ground, over the whole farm, 
which it serves to fertilize. 

Much pains is taken to give every patient a proper amount 
of exercise out of doors, and to keep them cheerful and happy 
by work and amusement when in the house. The stone cells, 
once considered necessary appendages to a hospital, have been 
entirely abandoned during the last few years, and their places 
occupied by agreeable rooms for music, reading, and billiards. 
Those men who, while in health, had been used to out-of-door 
labor, have had ample opportunity for such work, when dis- 
posed to do it ; thereby improving their own bodily and mental 
condition, and at the same time embellishing and cultivating 
the grounds about the house and farm. The number of days' 
work of men, thus gained, during the year, has been 5,732. 

In addition to exercise and recreation out of doors for the 
women, there has been a large amount of useful labor, not only 
voluntarily, but gladly given by them, in various domestic 
duties, in the laundry and sewing-rooms, amounting during 
the year to 9,552 days' work. 

Some measures are about to be taken to arouse the energies 
of the sluggish and desponding, and to repress the excessive 



I860.] PUBLIC DOCbmrmm at ™ 

activity of others, by giving them an opportunity to engage in 
labor of greater variety and skill, and such as can be carried 
on in the winter and in stormy weather, when out-of-door 
occupations must, in a great measure, be suspended. 

To make these necessary improvements, and place this hos- 
pital in a condition to receive and treat the large number of 
patients sent there, the Trustees have made use of such surplus 
income as they were able by strict economy to save from year 
to year. They had hoped, by a continued system of economy, 
to be able to reduce the price of board, to towns and individ- 
uals, as the next step in the means of contributing to the 
welfare of those under their charge. But the reduction lately 
made in the price allowed for the board of State patients, and 
the provision for the payment of salaries out of the funds of the 
hospital, have made this impossible at present. The argument 
used for reducing the allowance made for the beneficiaries of 
the State, that the buildings were erected by the Common- 
wealth, would apply equally to towns and individuals, who 
primarily furnish the means for all our charitable institutions. 
It is to be hoped that the legislature will so increase the 
amount allowed for the board of State patients, as to make the 
cost to all more nearly equal. 

J. N. BATES. 
WM. T. MERRIFIELD. 
C. H. STEDMAN. 
R. W. HOOPER. 
EDWIN F. JENKS. 

Worcester, October 14, 1860. 



AT WORCESTER. [Oct. 



TREASURER'S REPORT 



The Treasurer respectfully submits the following report. 



Cash on hand September 30, 1859, . $231 26 

Received from the Commonwealth, . 18,192 54 

" " Towns and Individuals, 28,339 62 

" " all other sources, . 12,037 85 

Due Mechanics' Bank, ... 955 74 



,757 01 



The payments have been as follows 
To Steward's orders, 

Salaries, .... 

Mechanics' Bank, 

Collections, Stationery, &c, 

L. Dorman, 

Abby Blan chard, 

Ann Armsby, 

Cash, .... 



$54,562 37 

3,575 26 

1,070 87 

120 31 

48 92 

58 12 

26 33 

294 83 



,757 01 



H. WOODWARD, Treasurer. 



Worcester, October 9, 1860. 



I860.] 



PUBLIC DOCUMENT— No. 33. 



SUPERINTENDENT'S REPORT. 



To the Trustees of the State Lunatic Hospital at Worcester. 

Gentlemen, — In compliance with the by-laws of this hospital, 
and the statute laws of the Commonwealth, I respectfully 
submit the following brief record of the history of those com- 
mitted to my care during the year now closed. 

Table No. 1, 

Showing the general results of the year. 





Males. 


Females. 


Total. 


Patients in the hospital October 1, 1859, . 


152 


165 


317 


" admitted during the year, . 


105 


110 


215 


Whole number under treatment, 


257 


275 


532 


Discharged recovered, 


65 


64 


129 


" improved, 


17 


18 


35 


" not improved, 


8 


7 


15 


Died, 


12 


10 


22 


Whole number discharged during the year, 


102 


99 


201 


" " remaining September 30, 1860, 


155 


176 


331 



By a reference to the foregoing table it will be seen that 
there were in the hospital October 1, 1859, three hundred and 
seventeen patients, one hundred and fifty-two of whom were 
males, and one hundred and sixty-five were females. 

2 



10 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

The number admitted during the year was two hundred and 
fifteen, of whom one hundred and five were males, and one 
hundred and ten were females. 

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

The whole number discharged during the year was two 
hundred and one, of whom one hundred and two were males, 
and ninety-nine were females. 

The whole number remaining in the hospital at the close of 
the year was three hundred and thirty-one, of whom one 
hundred and fifty-five were males, and one hundred and 
seventy-six were females. 

Of the two hundred and one patients discharged during the 
year, one hundred and twenty-nine had so far recovered their 
full measure of mental and physical health that they returned 
to their homes and resumed their ordinary labors. 

Thus it will be seen by a glance at the accompanying tables, 
that the recoveries were in the ratio of fifty-five and one-third 
per cent, to the whole number admitted, or twenty-four and 
one-fourth per cent, to the whole number under treatment, and 
ninety-two per cent, to the number of those whose insanity had 
existed for a period less than one year. 

A larger proportion of recoveries has seldom been reported 
in this hospital ; and the result, so gratifying, is due mainly to 
the fact that a large number of the admissions were recent 
cases of acute mania. Several other cases whose # insanity had 
existed less than one year were suffering from a variety of 
nervous disorders produced by grief, anxiety, or long-continued 
watchfulness, and required only change of scene and hygienic 
treatment, to restore the proper balance of the mind and vigor 
of the bodily powers. 

Of the thirty-five discharged as improved, a few returned to 
their homes in a very comfortable state of health, some were 
sent to almshouses, and others were transferred to other 
hospitals for the insane. Nearly all those discharged as not 
improved were transferred to other hospitals. 

The standard of health, though always low in hospitals for 
the insane, has been, during the year, higher than usual. Late 
in the autumn there were a few cases of pneumonia of a mild 



I860.] PUBLIC DOCUMENT— No. 33. 11 

character ; in the spring there were several cases of varioloid 
and smallpox ; and in the summer three or four cases of 
measles. 

During the months of July and August there was an unusual 
amount of noisy excitement in the house, such as generally 
attends acute mania. The general comfort of the institution 
was much disturbed in this way for a period of several weeks. 

The importance of an early commitment to a hospital cannot 
be too strongly urged on the friends and guardians of those 
afflicted with mental disease, as the only reliable means of 
restoration. There still seems to be a prejudice in the minds 
of people against this early proceeding ; for notwithstanding the 
gratifying results of the year, several cases have been committed 
to our care in such a state of debility and wretchedness, from 
long detention at home as to force upon us the conviction, that 
a commitment to the hospital was considered by the friends as 
little better than consigning their suffering relatives to a living- 
grave. It should not be forgotton that in all hospitals for the 
insane, only those means best calculated to comfort, to improve 
and to restore are ever employed, and that nothing inconsistent 
with the best interests of the patient is ever practiced or 
permitted. 

Table No. 2, 
Showing the Admissions and the state of the Hospital from October 1 
1859, to September 30, 1860. 

Patients in the hospital October 1, 1859, 317 

Males, . 152 

Females, 165 

Patients admitted in the course of the year, 215 

Males, . 105 

Females, 110 

Patients remaining in the hospital September 30, 1860, . . 331 

Males, 155 

Females, . • 176 

Of the admissions there were cases of less duration than one year, 139 

Males, 64 

Females, 75 

Of the admissions there were cases of more than one year's duration, 76 

Males, 41 

Females, 35 



12 LUNATIC HOSPITAL AT WORCESTER. 

Table No. 2 — Continued. 



[Oct. 



Of the admissions there were cases the duration of whose insanity- 
could not be ascertained, - 

Patients committed by Courts, 158 

Males, 77 

Females, 81 

Patients committed by Overseers of the Poor, .... 17 

Males, 13 

Females, 4 

Patients on bonds, 40 

Males, 15 

Females, . 25 

Foreigners, and those having no settlement in this State, admitted 

in the course of the year, 97 

Males, 51 

Females, . . 1 46 

Foreigners, and those having no settlement in this State, discharged 

in the course of the year, 79 

Males, . 42 

Females, 37 

Foreigners, and those having no settlement in this State, remain- 
ing in the hospital September 30, 1860, .' . . . 130 

Males, 62 

Females, 68 



State Paupers remaining in the hospital at the close of each year, as 
nearly as can be ascertained. 



1842, .... 34 


1852, .... 241 


1843, 








38 


1853, 








216 


1844, 








38 


1854, 








151 


1845, 








57 


1855, 








115 


1846, 








52 


1856, 








155 


1847, 








121 


1857, 








119 


1848, 








150 


1858, 








121 


1849, 








167 


1859, 








124 


1850. 








. 181 


1860, 








130 


1851, 








. 208 





The foregoing shows that you have discharged from the care 
and custody of the hospital, in the course of the year, seventy- 
nine patients who have no settlement in this Commonwealth. 
Few, if any, of them have been supported otherwise than by the 



I860.] PUBLIC DOCUMENT— No. 33. 13 

charity of the State. Mostly foreigners, they are very generally 
friendless, homeless and destitute when stricken down by 
disease, and if they so far recover as to come under your con- 
sideration for discharge, they have no places to which they can 
go, and no friends able to assist them. 

It not unfrequently happens that families quite well to do, 
are broken up by the insanity of father or mother. The parent 
is placed in the hospital and the remaining members of the 
family struggle on against poverty and increasing hardship, 
until at length their courage and strength gives out, and they 
are separated. In the economy of charity the younger members 
are sent in one direction and the older ones in another. If in 
the process of time the insane one recovers, or but partially so, 
he sees nothing but ruin to all his social and domestic hopes. 
His family are scattered, and like himself subsisting from day 
to day on the bounty of public charity ; or it may be his chil- 
dren are bound out to service, and thus placed beyond his 
control even after his restoration to health. With his own 
personal prospects of gaining a livelihood it is not much better. 
His occupation is gone, he is destitute of means and of friends, 
and he learns in his first efforts to procure labor that a resi- 
dence in the wards of an insane hospital does not afford him 
the best recommendation. 

Under all these circumstances, the Alien Passenger Commis- 
sioners find it necessary • to place in the State almshouses a 
considerable number. 

Places have been procured for a few others who are now out 
at service and receiving wages. Others have been assisted by 
the Alien Passenger Commissioners with means to reach their 
friends in other parts of the country. 

You will remember that none of these patients have been 
recommended to you for discharge from the hospital, whose 
mental and physical health did not make such a step seem 
advisable. 

Those patients removed from the hospital previous to recov- 
ery have been visited and carefully observed by the Commis- 
sioners or their agent before any steps have been taken to 
procure a discharge, and when relatives or friends have been 
known their pleasure has always been consulted in the matter. 
So that, while the Alien Passenger Commissioners and the 



14 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Board of Trustees have been equally desirous to relieve the 
Commonwealth of any unnecessary expense, the interests of 
the patients have always been as humanely regarded as was 
possible under the circumstances. 

Table No. 3, 

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







Admitted. 


Removed. 


Remaining. 


MONTH. 










■a 


> 

O 


aj 














£ 






> 


P. 

£ 


* 






» 








« 




o 
















£ 


s 


5 


"S 


a 


2 


A 




£ 


g 


« 














o 




o 










a 


ft 


H 


Ph 


t-t 


fc 


O 


H 


&, 


h 


H 


October, . . 


5 


5 


10 


13 






4 


17 


146 


164 


310 


November, 


11 


6 


17 


11 


- 


- 


1 


12 


151 


164 


315 


December, 


6 


7 


13 


7 


1 


1 


2 


11 


155 


162 


317 


January, . . 


9 


5 


14 


7 


1 


- 


3 


11 


158 


162 


320 


February, 




6 


16 


22 


6 


7 


4 


4 


21 


152 


169 


321 


March, . 




8 


9 


17 


9 


1 


- 


1 


11 


155 


172 


327 


April, . 




10 


8 


18 


17 


3 


2 


- 


22 


152 


171 


323 


May, . 




13 


10 


23 


17 


3 


- 


3 


23 


156 


167 


323 


June, . 




11 


13 


24 


16 


- 


- 


- 


16 


158 


173 


331 


July, . 




9 


9 


18 


10 


1 


- 


3 


14 


160 


175 


335 


August, . 




9 


13 


22 


10 


1 


1 


1 


13 


161 


183 


344 


September, . 


8 


9 


17 


14 


9 


7 


- 


30 


155 


176 


331 


Totals, 




105 


110 


215 


137 


27 


15 


22 


201 









I860.] VALUATION COMMITTEE— No. 33. 



15 



Table No. 4, 

Showing the Form of Disease in those Admitted and Discharged during 

the year. 





Admitted. 


Discharged. 


FORM OF DISEASE, 


Males. 


Females. 


Total. 


Males. 


Females. 


Total. 


Mania, 

" Chronic, 
" with Epilepsy, 
" with general Paralysis, . 
Melancholia, .... 
Dementia, .... 
" Senile, 
" with Epilepsy, . 
" with general Paralysis, 
Monomania of Fear, 
" Pride, 
" Suspicion, 
Idiocy, ..... 


39 
4 
3 
4 
18 
14 
2 
5 
3 
3 
2 
8 


42" 

5 

2 

21 
19 

2 

2 

7 
10 


81 
9 
5 
4 

39 

33 
4 
7 
3 

10 
2 

18 


41 

4 

4 

1 

14 

18 

3 
1 
1 

3 


39 
3 
2 

16 
17 

5 

3 
1 
3 


80 

7 

6 

1 

30 

35 

8 
1 
4 
1 
6 


Totals, .... 


105 


110 


215 


90 


89 


179 



Table No. 5. 

Supposed Causes of Insanity of Patients admitted into the Hospital from 
January, 1888, to September 80, 1860. 















I860. 


Pbeviouslt. 


CAUSES. 












Males. 


Females. 


Males. 


Females. 


Apoplexy, 
Asthma, . 






- 






- 


- 


2 
2 


- 


Bronchitis, 












_ 


- 


2 


13 


Chorea, • 












- 


- 


- 


2 


Constipation, 
Convulsions, 












2 


— 


8 


1 
6 


Dysentery, 
Dyspepsia, 
Epilepsy, 
Eruptive Disea 
Eyes, Disease c 
" Loss of, 


ses, 










2 
5 


3 
2 


1 

4 

90 
5 
1 
1 


2 

3 

37 

5 


Fever, 










1 


2 


28 


35 


111 Health, 










25 


34 


166 


529 



16 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 5 — Continued. 









ISO©. 


Previously. 


CATJSE3. 












Males. 


Females. 


Males. 


Females. 


Influenza, ..... 






1 


5 


Insolation, 


i V . 


1 


- 


14 


- 


Laryngitis, 




- 


- 


- 


1 


Nervous Irritation, . 






- 


- 


- 


4 


Nymphomania, 






- 


- 


- 


1 


Old Age, 






o 


1 


10 


4 


Otitis, .... 






- 


- 


3 


_ 


Palsy, 






2 


1 


38 


24 


Pneumonia, 






— 


— 


— 


1 


Rheumatism, . 






- 


- 


3 


1 


Scrofula, . 






3 


2 


- 


2 


Sea-sickness, . 






- 


- 


- 


1 


Somnambulism, 






_ 


- 


- 


1 


Suppressed Eruption, 






1 


- 


5 


4 


Suppressed Ulcer, . 






1 


- 


1 


3 


Tic Douloureux, 






- 


- 


- 


1 


Tumor, . 






_ 


- 


- 


1 


Whooping Cough, . 






- 


- 


- 


1 


Amenorrhea, . 






- 


8 


- 


16 


Lactation, Excessive, 






- 


- 


- 


5 


Menorrhagia, . 






- 


2 


- 


3 


Menorrhagia, Suppressed 






- 


5 


- 


5 


Miscarriage, 






— 


1 


— 


1 


Pregnancy, 






- 


1 


- 


4 


Puerperal, 






- 


2 


- 


141 


Turn of Life, . 






— 


7 


— 


32 


Amputation of Leg, 






- 


- 


1 


- 


Bathing in Cold Water, 






- 


2 


2 


- - 


Drinking Cold Water, 






- 


- 


1 


- 


Exposure to Cold, . 






- 


- 


6 


- 


Injury by Falling, &c, 






2 


- 


7 


3 


" of Head, 






2 


- 


45 


8 


" of Spine, 






1 


- 


2 


1 


Lead, Poison of, 






- 


- 


2 


- 


Lightning, Stroke of, 






- 


- 


1 


1 


Labor, Excessive, . 






- 


2 


23 


51 


Loss of Sleep, . 






2 


- 


- 


5 


Study, Excessive, . 






- 


- 


25 


6 


Spiritualism, . 






_ 


- 


11 


14 


Criminal Trial, 






_ 


- 


- 


1 


False Accusation, .' 






_ 


- 


- 


1 


Imprisonment, . 






4 


- 


5 


1 


Death of Relatives, . 






1 


1 


19 


53 


Domestic Trouble, . 






9 


17 


118 


295 


Marriage, Unhappy, 






- 


- 


4 


2 


Disappointment in Love, 






- 


- 


55 


61 


Disappointed Ambition, 






- 


- 


6 


6 


Homesickness, 






2 


3 


1 


5 


Fright, . 






1 


— 


14 


18 



I860.] PUBLIC DOCUMENT— No. 83. 

Table No. 5 — Continued. 



IT 





I860. 


Previously. 


CAUSES. 












Males. 


Females. 


Males. 


Females. 


Seduction, ..... 




1 




1 


Political Excitement, 








_ 


_ 


13 


- 


Religious Excitement, 








1 


2 


130 


166 


Pecuniary Trouble, . 








3 


- 


117 


23 


Poverty, . 








- 


- 


- 


1 


" Fear of, 








3 


1 


30 


11 


Giving up Business, 








- 


- 


3 


- 


Change of Business, 








_ 


_ 


5 


- 


Violent Temper, 








1 


2 


2 


16 


Jealousy, 








2 


4 


17 


23 


Intemperance, . 








17 


4 


139 


55 


Opium, Use of, 








1 


1 


1 


4 


Tobacco, Use of, 








- 


- 


1 


3 


Masturbation, . 








6 


4 


242 


28 


Venery, Excess of, . 








- 


- 


1 


- 


Of the above there were : 










Hereditary Cases, .... 


14 


17 






Periodical " 


7 


19 






Homicidal " 


9 


2 






Suicidal " 


11 


13 







An attempt to set forth with exactness the relative influence 
of the various causes of insanity is extremely difficult. All 
statistical tables are subject to error, and hence great caution is 
necessary in drawing conclusions, even from those prepared by 
the most skilful observers. It often happens that statistical 
statements transmitted with the patients received into the 
hospital, are either carelessly filled up, or the real cause of the 
attack is not given. 

Thus masturbation, intemperance, and other causes disagree- 
able to the patient's friends, but which may have been the most 
influential agents in producing the disease, are in the official 
statement replaced by " unknown," " ill health." An affection- 
ate and well-intended reluctance to publish the moral and 
intellectual infirmities of an afflicted friend may induce those 
relied on for information on the subject to ignore the facts in 
the case, and ascribe the existence of the malady to some trivial 
and inefficient agency. 

Thus it happens that upon the records of the hospital we find 
such causes as " sore finger," " bite of dog." But if all the 

3 



18 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

agencies named in the table were given in good faith, and if 
they really point out conditions predisposing individuals to 
mental disease, we are led to recognize a strong similarity 
between the causes of insanity and of other disorders of the 
nervous system. 

Indeed there is hardly an assigned cause contained in the 
table, moral or physical, which may not induce in other persons 
chorea, epilepsy, convulsions, or paralysis. It is necessary, 
therefore, in attempting to investigate the diversified causes of 
insanity, to divest the mind of any previous ideas which might 
bias the judgment, and attend closely to the facts which have 
been recorded by intelligent observers, and which, if in them- 
selves imperfect, giving only a partial light, are much better 
than any preconceived notions or theoretical speculations. By 
so doing we may hope eventually to arrive at some more satis- 
factory conclusion regarding the nature and cause of mental 
disease, and thus be able to exercise some control over the 
conditions which produce so great an evil. 

Fifty-nine patients have been admitted in the course of the 
year, who for a considerable period of time previous to the 
development of mental disease had been afflicted with ill health 
in some of its many forms. There can be no doubt that in 
nearly every case of insanity the attack is preceded by a bad 
state of the physical health. In short, that insanity is a disease 
of debility, not of strength, and that it generally arises from 
defective nutrition, transmitted weakness, or physical depression 
produced by personal privation or suffering. Insanity is never 
a spiritual malady, a disease of the soul, a sickness of the 
immaterial principle ; but the perverted action of the mind 
resulting from a defect in its material instrument. Whatever 
disturbs the general health, whatever weakens the bodily 
powers, disturbs and deranges the healthy operations of the 
mind. Whatever strengthens the body does much towards 
restoring the integrity of the mental faculties. The mind 
under all conditions partakes of the health of the body, and is 
depressed, irritated, and morose, or calm, clear, and cheerful, 
according as the body is well fed, properly clothed, and 
thoroughly exercised. 

Intemperance was assigned as the cause of insanity in twen- 
ty-one cases admitted in the course of the year, and in nearly 
five hundred cases since the opening of the hospital in 1833. 



I860.] PUBLIC DOCUMENT— No. 33. 19 

Intemperance in the use of intoxicating drinks, disturbs and 
exhaust the brain, and affects its power of correct and ready- 
action ; and hence the mind becomes wayward, its operations 
uncertain, and the individual is unfitted for the highest duties 
of life. Hence follow derangements in the affairs of the world. 
Hence, too, follow ill health, disorders of the nervous system, 
and insanity, which finds so frequent an origin in the exhaust- 
ing effects of intoxicating drinks, especially among the poor. 
Every habit and condition which depreciates the vital force, 
lowers the tone of the muscular system, and diminishes the 
physical energies, lessens thereby the power of labor and of 
production ; in the same manner it also lowers the tone of the 
brain, and the capacity of self-management. In this state the 
mind is over-taxed by the ordinary cares of life. It struggles 
and suffers, and may become permanently deranged. But in- 
temperance has its first depressing effect on the energy of 
physical action and the soundness of the understanding in 
worldly affairs, and secondly on the power and discipline of the 
mental faculties. 

It produces insanity, not so much by excitement, as by reac- 
tion and depression. The intemperate man also refuses his 
food, and in his neglect to supply his body with solid sustenance, 
substitutes a drink that contains but few of the elements of 
nourishment. He thus actually starves his body, while he 
ruins his powers of digestion, and hastens on his insanity, by 
continually taking that which produces fits of unhealthy depres- 
sion of the mental faculties. 

Domestic affliction consigned to the care of the hospital its 
usual proportion of cases. Long protracted grief, from what- 
ever source, by producing watchfulness, or unrefreshing sleep, 
by impairing the appetite and disturbing the process of diges- 
tion is one of the most common causes of nervous disorders 
in general, and is not unfrequently productive of permanent 
disorder of the mental operations. 



20 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 6. 
Diseases ivkich have proved Fatal from Jan. 18, 1833, to Sept. 30, 1860. 











I860. 


Previously. 


DISEASES. 












Males. 


Females. 


Males. 


Females. 


Apoplexy, 

Asthma, .... 






- 


- 


15 
4 


9 
1 


Anaemia, 






- 


- 


1 


1 


Asphyxia, 
Bronchitis, 






— 


— 


1 

2 


- 


Brain Fever, . 






- 


- 


1 


- 


Consumption, . 
Convulsions, . 






1 


2 


34 
3 


53 
1 


Cholera Morbus, 






- 


- 


2 


3 


Cholera, .... 






- 


- 


5 


- 


Cancer, .... 






- 


- 


1 


1 


Congestion of Lungs, 






- 


- 


- 


1 


" of Brain, 






- 


- 


1 


1 


Chronic Dysentery, . 
Chronic Meningitis, 






- 


- 


2 
3 


- 


Dysentery, 

Dropsy, .... 

Delirium Tremens, . 






- 


- 


10 
5 
3 


6 

7 


Disease of Heart, . 






- 


- 


9 


11 


" of Bladder, . 
" of Brain, . 






- 


- 


1 

6 


14 


Diarrhoea, 






- 


- 


13 


8 


Enteritis, 






_ 


_ 


3 


6 


Epilepsy, 
Exhaustion, 






3 
2 


2 

2 


50 
29 


18 
44 


Erysipelas, 
Gangrene of Lungs, 






- 


- 


9 
1 


10 
2 


Hydrothorax, . 






- 


- 


1 


• 1 


Hemorrhage, . 






- 


- 


4 


4 


Hemoptysis, 
Inflammation of Bowels, 






- 


- 


1 
3 


3 


Jaundice, 






_ 


- 


- 


2 


Marasmus, 






1 


2 


47 


49 


Mortification, . 






_ 


- 


- 


1 


Maniacal Exhaustion, 






1 


1 


4 


3 


Malignant Fever, . 






- 


- 


1 


- 


Old Age, 






2 


1 


15 


10 


Palsy, . 
Pneumonia, 








- 


- 


18 
9 


15 
15 


Pleurisy, . 
Rupture, . 
Syncope, . 
Suicide, . 








1 


- 


1 

1 

14 


1 

8 


Smallpox, 
Suppurative P 
Typhoid Fever 
Typho-Mania, 


ilebitis, 






1 


\ 


1 

8 
.7 


6 
5 



I860.] 



PUBLIC DOCUMENT— No. 33. 



21 



Three patients died during the year who were more than 
eighty years of age. Two were between the ages of seventy 
and eighty years, and three were between sixty and seventy 
years of age. 

One of those who died during the year had been an inmate 
of the hospital for a period of more than thirteen years ; one 
had resided here twelve years ; another more than eleven years, 
and three others more than ten years each. 

Two patients who died during the year were brought to the 
hospital in such a feeble state of health that they could not sit 
up at all, and neither of them ever recruited in the least, 
although they lived several weeks. 



Table No. 7, 

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



AGES. 


ADMITTED. 


DISCHARGED RE- 
COVERED. 


DISCHARGED NOT 
RECOVERED. 


DIED. 




Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Less than 15, 


2 


3 














From 15 to 20, 


4 


5 


3 


4 


— 


_ 


_ 


_ 


20 to 30, 


28 


30 


19 


17 


1 


2 


1 


1 


30 to 40, 


36 


41 


25 


24 


6 


4 


1 


2 


40 to 50, 


15 


18 


15 


14 


8 


10 


1 


1 


50 to 60, 


12 


7 


4 


3 


4 


3 


4 


3 


60 to 70, 


5 


3 


3 


4 


1 


2 


2 


2 


70 to 80, 


o 


2 


_ 


2 


1 


_ 


1 




80 to 90, 


1 


1 


- 


- 


- 


- 


o 


1 


Totals, . . 


105 


110 


69 


68 


21 


21 


12 


10 



22 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 8, 

Shoiving the Duration of Insanity before admission of Patients admitted 
from January 18, 1833, to September 30, 1860. 





186©. 


Previously. 


DURATION OF INSANITY. 












Males. 


Females. 


Males. 


Females. 


Insane less than 1 year, .... 


64 


75 


1,465 


1,701 


Insane more than 1 y'r and less than 2 yr's, 


17 


13 


340 


298 


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


13 


11 


442 


383 


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


6 


3 


223 


179 


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


3 


4 


119 


132 


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


2 


1 


37 


37 


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


- 


1 


38 


41 


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


- 


- 


17 


9 


30 y'rs and more, 


- 


- 


24 


24 


Unascertained, 


- 


2 


228 


239 


Totals, ' 


105 


110 


2,933 


3,043 



Table No. 9, 

Showing the Ages of Patients admitted to the Hospital from January 18, 
1833, to September 30, 1860. 





186©. 


Previously. 


AGES. 












Males. 


Females. 


Males. 


Females. 


Less than 1 5 years of age, 


1 




25 


28 


Between 15 and 20 years of age, 


5 


8 


216 


198 


20 and 30 " " 


38 


39 


862 


838 


30 and 40 " " 


25 


29 


754 


840. 


40 and 50 " " 


19 


20 


476 


523 


50 and 60 " " 


7 


5 


337 


381 


60 and 70 " " 


5 


4 


193 


152 


70 and 80 " " 


9 


2 


54 


53 


More than 80 years of age, 


3 


3 


8 


15 


Unascertained, .... 


- 


- 


8 


17 


Totals, 


105 


110 


2,933 


3,043 



I860.] PUBLIC DOCUMENT— No. 33. 23 

Table No. 10, 

Showing the Civil Condition of Patients admitted to the Hospital from 
January 18, 1838, to September 30, 1860. 





I860. 


Previously. 


CIVIL CONDITION. 


Males. 


Females. 


Males. 


Females. 


Unmarried, 

Married, ...... 

Widowers, ..... 

Widows, ...... 

Unascertained, .... 


53 

44 
6 

2 


47 
49 

11 
3 


1,472 . 

1,274 

144 

43 


1,380 
1,257 

369 
37 


Totals, 


• 105 


110 


2,933 


3,043 



Table No. 11, ' 

Showing the Admissions from each County from January 18, 1833, to 
September 30, 1860. 











1S60. 


Previously. 




COUNTIES. 








Whole No. 




Males. 


Females. 


Total. 






Barnstable, 








126 


126 


Berkshire, 








1 


1 


2 


185 


187 


Bristol, 








- 


1 


1 


289 


290 


Dukes, 








- 


- 


- 


19 


19 


Essex, 








17 


20 


37 


815 


852 


Franklin, . 








1 


1 


2 


123 


125 


Hampden, 








- 


1 


1 


351 


352 


Hampshire, 








- 


- 


- 


220 


220 


Middlesex, 








30 


27 


57 


832 


889 


Nantucket, 








_ 


- 


- 


31 


31 


Norfolk, . 











4 


6 


581 


587 


Plymouth, 








- 


- 


- 


233 


233 


Suffolk, . 








10 


9 


19 


637 


656 


Worcester, 








44 


46 


90 


1,517 


1,607 


Other States, 








- 


- 


- 


17 


17 


Totals, 








105 


110 


215 


5,976 


6,191 



24 



LUNATIC HOSPITAL AT WORCESTER. 



[Oct. 



Table No. 12, 

Showing the Occupation of Patients admitted into the Hospital from 
January 18, 1833, to September 30, 1860. 



OCCUPATION OF PATIENTS. 


1SGO. 


Previously. 


MALES. 






Auctioneers, 


- 


3 


Armorers, 










- 


3 


Authors, . 










- 


1 


Blacksmiths, 










- 


34 


Bakers, 










- 


6 


Butchers, . 










_ 


6 


Bookbinders, 










- 


7 


Boot-makers, 










2 


17 


Brokers, . 










- 


3 


Book-keepers, . 
Britannia-workers, . 










2 


6 
2 


Brickmakers, 










- 


5 


Bellows-makers, 










- 


2 


Brewers, . 










_ 


2 


Basket-makers, . 










_ 


- 


Bricklayers, 
Butlers, 










1 


4 
2 


Barbers, . 










2 


3 


Clergymen, 
Carpenters, 
Coppersmiths, . 
Coopers, . 
Cabinet-makers, 










3 
1 


19 

117 

6 

16 

11 


Calico-printers, . 
Clothiers, . 










- 


3 

17 


Comb-makers, . 










- 


4 


Coach-makers, . 










- 


8 


Card-makers, . 










- 


2 


Chair-makers, . 










- 


4 


Cigar-makers, . 










- 


3 


Coachmen, 










- 


16 


Clerks, 










4 


29 


Carpet weavers, 
Curriers, .... 










— 


1 

7 


Cashiers of Banks, . 










- 


4 


Cordwainers, . 










2 


4 


Collectors, 










- 


2 


Caulkers, .... 










- 


4 


Chandlers, 










- 


5 


Camphene distillers, . 
Conductors on Railroads, 










1 


1 

2 


Dyers, .... 
Druggists, .... 










- 


4 
3 


Draymen, .... 
Drovers, .... 










■ _ 


3 
1 



I860.] PUBLIC DOCUMENT— No. 33. 

Table No. 12— Continued. 



25 



OCCUPATION OF PATIENTS. 


I860. 


Previously. 


Dancing masters, 




1 


Daguerreotypists, 












- 


2 


Engravers, 












- 


3 


Editors, 












- 


4 


Express-men, . 












1 


3 


Farmers, . 












17 


459 


Fishermen, 












1 


15 


Fruiterers, 












- 


4 


Gunsmiths, 












- 


3 


Gardeners, 












_ 


10 


Grocers, . 












- 


3 


Glass-blowers, . 












_ 


3 


Gilders, . 












- 


2 


Hotel-keepers, . 












- 


16 


Hatters, . 












- 


3 


Hostlers, . 












1 


10 


Housewrights, . 












_ 


7 


Harn ess-makers, 












- 


7 


Ironmongers, 












_ 


3 


Jewellers, . 












_ 


12 


Lawyers, . 












- 


12 


Laborers, . 












29 


350 


Last-makers, 












_ 


1 


Manufacturers, . 












1 


33 


Millers, . 












_ 


16 


Merchants, 












1 


113 


Masons, . 












_ 


17 


Miners, 












_ 


5 


Mat-makers, 












_ 


3 


Miniature painters, 












- 


1 


Musicians, 












— 


7 


Machinists, 












2 


33 


Messengers, 












_ 


2 


Moulders, . 












_ 


6 


Millwrights, 












_ 


1 


Nailers, 












_ 


1 


Newsmen, 












_ 


3 


Optician, . 












- 


1 


Operatives in Mill, 












4 


54 


Oystermen, 












- 


4 


Painters, . 












1 


30 


Printers, . 












- 


29 


Physicians, 












- 


11 


Paper-makers, . 












. - 


4 


Peddlers, . 












_ 


18 


Pilots, 












_ 


1 


Potters, 












_ 


3 


Porters, . 












_ 


9 


Pump and Block-makers, 










- 


3 


Pattern-makers, 










— 


5 



26 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 12 — Continued. 



OCCUPATION OF PATIENTS. 




Previously. 



Police officers, . 
Rope-makers, . 
Riggers, . 
Restaurators, 
Shoemakers, 
Sail-makers, 
Soap-makers, . 
Sash and blind-makers, 
Stage drivers, . 
Sea captains, 
Sailoi's, 
Saddlers, . 
Silversmiths, 
Students, . . 
Stock-maker, . 
Silk-weavers, . 
Ship carpenters, 
Ship brokers, . 
Shopkeepers, . 
Stonecutters, 
Soldiers, . 
Spinners, . 
Sheriffs, . 
Shoe dealers, . 
Stable keepers, . 
Shoe binders, . 
Tailors, 
Teachers, . 
Tobacconists, . 
Teamsters, 
Tinners, . 
Umbrella-makers, 
Victuallers, 
Wheelwrights, . 
Watchmakers, . 
Wood-turners, . 
Watchman, 
Whip-maker, . 
Weavers, . 
No occupation, . 



19 



FEMALES. 



Carpet-weavers, 
Cooks, 

Chamber maids, 
Dress-makers, 
Engravers, 
Housekeepers, 
House maids, 
Laundresses, 



4 
5 

7 

41 
8 
9. 



4 
9 
3 
7 
208 
9 
4 
2 
5 

15 

101 

9 

19 

49 
1 
2 

17 
2 
5 

14 
5 

13 
3 
5 
2 
7 

15 

52 
3 

12 
2 
4 
3 

14 
4 
3 
1 
1 

18 
3 



2 

58 

36 

53 

1 

1,001 

138 

53 



I860.] PUBLIC DOCUMENT— No. 33. 

Table 12 — Continued. 



27 



OCCUPATION OF PATIENTS. 


I860. 


Previously. 


Milliners, 


3 


27 


Mantuamakers, . 












- 


6 


Midwife, . 












- 


1 


Nurses, 












1 


14 


Nurserymaids, . 
Operatives in mill, 
Seamstresses, . 












11 
13 


21 
133 
317 


Straw-sewers, . 












- 


10 


Shoe-binders, . 












2 


17 


Students, . 












- 


4 


School girls, 












3 


44 


Teachers, . 












- 


61 


Tailoresses, 












- 


38 


Type-setters, 
Wool stapler, . 
Weavers, . 












2 


2 
1 

18 


No occupation, . 












8 


6 






28 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 13, 

Shoioing 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-eight 
years the Hospital has been in operation. 



Tear. 


Whole No. 


Average No. 


No. at end of 
each year. 


Current expenses of 
each year. 


Annual expense 
for each patient. 


1833, . 


153 


107 


114 


112,272 91 


$114 67 


1834, . 


233 


117 


118 


15,840 97 


135 38 


1835, . 


241 


120 


119 


16,576 44 


137 30 


1836, . 


245 


127 


138 


21,395 28 


168 44 


1837, . 


306 


163 


185 


26,027 07 


159 64 


1838, . 


362 


211 


218 


28,739 40 


136 20 


1839, . 


397 


223 


229 


29,474 41 


132 16 


1840, . 


391 


229 


236 ' 


27,844 98 


121 59 


1841, . 


399 


233 


232 


28,847 62 


123 81 


1842, . 


430 


238 


238 


29,546 87 


111 12 


1843, . 


458 


244 


255 


27,914 12 


114 40 


1844, . 


491 


261 


263 


29,278 75 


112 17 


1845, . 


656 


316 


360 


43,888 65 


138 88 


1846, . 


637 


359 


367 


39,870 37 


111 06 


1847, . 


607 


377 


394 


39,444 47 


104 62 


1848, . 


655 


404 


409 


42,860 05 


108 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 


1860, . 


532 


324 


331 


47,757 01 


147 39 



I860.] 



PUBLIC DOCUMENT— No. 33. 



29 



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36 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



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Hereditary and Suicidal. 

Suicidal. 

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I860.] PUBLIC DOCUMENT— No. 33. 37 

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38 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 





"3 « 
1 ■« 

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3 ® 


Pauper from Ireland, 
do do 

Periodical. 

Pauper from Germany. 
Hereditary. Periodical. 

Hereditary. 

Pauper from Germany. 


Hereditary. 

Pauper from England. 

Pauper from Ireland. 
Paup. from Eng. Period. 




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do 
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Recovered 
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do 




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do 
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do 
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do 

do 
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do 
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Remains 
Discharged 
Remains 
Discharged 
Remains 

do 
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Discharged 
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1 yr 11 mths 
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1 yr 3 mths 
1 yr 11 mths 
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11 months 

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1 year 

1 yr 9 mths 
4 months 
1 yr 9 mths 
1 yr 9 mths 
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9 months 
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. 1 year 
. 3 years 
. 1 year 
. 15 years 
. 3 months 
. 6 do 
. 2 years 

years 
. 2 do 

years 
. 3 do 
. 10 weeks 






. 3 mon 
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. 3 year; 
. 1 mon 
. 6 mori 
. 3 do 
. 10 year 
.40 do 
. 4 do 
. 1 weel 
. 6 year 
. Few da 
. 6 weel 
. 7 year 
. 8 days 
. Unkno 




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Congenital, . 
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Intemperance, 
Epilepsy, 
Intemperance, 
Unknown, . 
Sun stroke, . 
Intemperance, 

do 






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Masturbation 
Hard study, . 
Unknown, . 

do 
Death of hus 1 
Loss of prope 
Fever, . 
Unknown, , 

do 
Fever, . 
Ill health, . 
Unknown, . 
Epilepsy, 
Unknown, , 
Epilepsy, 
Childbirth, 








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do 
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do 

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do 
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2 weeks 
Unknown 

3 years 

6 months 
Unknown 

6 months 
3 years 

7 weeks 


years 
1 year 
3 days 

1 year 
15 years 

2 months 

3 years 
3 do 

3 do 
6 do 

2 months 
6 do 

4 do 

6 weeks 
Unknown 

3 years 

7 do 
Unknown 

1 week 

6 weeks 

1 month 

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1 month 
Unknown 

4 months 

3 vears 
3" do 

Unknown 

4 weeks 
10 years 

2 weeks 

4 months 




Unknown, . 

do 

do 

do 

do 
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Religious, 
Nervousness, 
Unknown, . 
Old age, 
Unknown, . 

do 

do 
111 health, . 
Masturbation, 
Unknown, . 


ooo 


Opium eating, 
Unknown, . 
Pecuniary, . 
Unknown, 
Disappointment, 
III health, . 
Unknown, . 
Epilepsy, 
Unknown, 
Intemperance, 
Unknown, . 

do 

do 
Intemperance, 

do 
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Unknown, 
Miscarriage, 
Unknown, . 
Intemperance, 
Unknown, 


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44 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 





■a a 

1 1 

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Hereditary, 
do 

Suicidal. 

Hereditary andPeriodical. 

Suicidal. 

do 
do 

do do 

do 

do 

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do do 
do 

do 




03 


Improved 
Not improved 
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do 
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do 

do 
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do 

do 

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do 

do 
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do 
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Duration 

before 
admission. 


2 months 
1 year 

3 months 

6 weeks 

8 years 

4 days 
1 year 

4 weeks 

1 week 

7 weeks 

9 months 

2 months 
Unknown 

7 weeks 

8 do 

1 year 
10 years 

2 months 
Unknown 

5 years 
2 do 

Unknown 

18 months 

4 weeks 

years 

6 weeks 
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2 years 

3 do 

2 weeks 
6 months 
6 do 
6 do 




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Measles, 
Unknown, . 
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Unknown, . 
Injury of head, 
Unknown, 

do 
Rheumatic fever, 
Unknown, 
Masturbation, 
Religious, 
Pecuniary, . 
Turn of life, . 
Illegitimate child 
Unknown, . 

do 

do 
Over excitement, 
Unknown, 

do 

do 
Drugged liquors, 
Unknown, . 
Epilepsy, 
Unknown, . 

do 

do 
111 health, . 
Unknown,' . 

do 
Domestic trouble, 




d 
rt o 

o 
o 


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do 
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Single 
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Single 
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do 
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do 

do 
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do 
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I860.] PUBLIC DOCUMENT— No. 33. 45 



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46 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



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I860.] 



PUBLIC DOCUMENT— No. 33. 



47 



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48 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

In conducting the affairs of the Hospital during the year, 
every effort has been made to provide labor for such of the pa- 
tients as could be induced to engage in it. By an accurate 
account kept of every day's labor performed by the inmates of 
the hospital it has been found that five thousand seven hundred 
and thirty-two days' work have been done by males, and nine 
thousand five hundred and fifty-two by females. These are full 
day's work performed by the patients in the various depart- 
ments of labor connected with the establishment. Beside this, 
there is a great amount of light labor performed by patients in 
and about the wards, dormitories, and dining-rooms, which can- 
not be taken into the account, because it is engaged in only at 
short intervals. Many of the females make and repair their 
own clothing, and also a part of the clothing worn by their 
children at home. 

In this connection it may be proper to add, that by some 
alterations now going on in the buildings of the hospital, we hope 
soon to open three large, light and cheerful rooms, as work 
rooms for females, and by changing the occupation of a de- 
tached building, to fit up for the males, in addition to our 
present carpenter's and joiner's shop two large and convenient 
rooms, in which the various kinds of labor suited to the capa- 
city of the patients may be performed. 

There will of course be difficulty in procuring labor to any 
very great extent in a hospital for the insane. Every facility, 
however, should be afforded, every advantage taken of any 
desire to engage in active employment, and every inducement 
offered to enlist a heartyfcco-operation on the part of the insane. 

But all labor should be made cheerful and pleasant. The over- 
burdened and weakened should not be taxed by long-continued 
attention. Neither should an individual be compelled to work on 
the farm who can find no amusement or comfort even, except in 
some mechanical pursuit. Every kind of work should be so 
divided that it maybe easily and well done : and every task should 
be so allotted that it may gratify the tastes of every individual. 

Thus all might be employed, and all governed by one common 
impulse of activity and enjoyment. Thus might be seen in opera- 
tion every trade, and every species of labor. There might also 
be every grade of employment ; reading, music, embroidery ; 
displays of taste and skill in ornamental productions ; walking, 



I860.] 



PUBLIC DOCUMENT— No. 33. 



49 



riding and driving ; all the games which ingenuity could devise 
and every kind of pastime which an eager desire for the welfare 
of the insane could dictate ; the varied pursuits of horticulture 
and agriculture, the unceasing sound of domestic labors, — 
every department filled with busy workers, without compulsion, 
and without remuneration other than that of escaping the pains 
of idleness and disease. / 

The following tables show some of the results of labor per- 
formed by patients. 

Articles made in the sewing-room in the course of the year : 



Bed Spreads, . 


. 134 


Frocks, . 


34 


Bed Ticks, . 


225 


Trousers, pairs of, . 


98 


Sheets, . 


489 


Overalls, pairs of, . 


51 


Pillow Cases, 


419 


Vests, . 


47 


Pillows, 


41 


Hose, pairs of, 


53 


Shirts, . 


334 


Mittens, pairs of, . 


63 


Chemises, 


351 


Knit Edging, yards of, 


. 340 


Drawers, pairs of, . 


54 


Carpets, 


4 


Night Dresses, 


34 


Table Covers, 


17 


Night Caps, . 


16 


Window Curtains, . 


. 105 


Skirts, . 


235 


Napkins, 


72 


Skirts embroidered, 


13 


Towels, . 


378 


Dresses, 


217 


Coats, . 


27 


Comforters, . 


18 


Jackets, 


14 


Valances, 


19 


Aprons, 


27 



Articles repaired in the sewing-room, in the course of the 
year : 



Shirts, . 


. 1,792 


Skirts, . 


. 137 


Trousers, 


. 1,704 


Hose, pairs of, 


. 712 


Coats, . 


. 312 


Dresses, 


. 1,631 


Vests, . 


. 428 


Chemises, 


. 1,720 


Bed Ticks, . 


. 492 


Overalls, 


. 33 


Bed Spreads, 


. 308 


Jackets, 


. 17 


Sheets, . • . 


. 713 


Frocks, . 


. 19 



50 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Products of the Farm. 



Apples, . 

Pears, 

Cherries, . 

Grapes, . 

Tomatoes, 

Sweet Corn, 

Beans, 

Peas, 

Parsnips, . 

Turnips, . 

Potatoes, 

Beets, 

Carrots, . 

Cabbages, 

Squashes, 

Peppers, . 

Cucumbers, 

Rhubarb, 

Hay, 

Rowen, . 

Corn Fodder. 

Milk, 

Beef, 

Pork, 



100 barrels, 


at $1 50- 


- $150 00 


30 bushels 


at 


2 


00 


60 00 


20 


u 


at 


2 


00 


40 00 


4 


u 


at 


3 


00 


12 00 


100 


a 


at 




75 


75 00 


50 


u 


at 


1 


00 


50 00 


50 


a 


at 


2 


00 


100 00 


40 


a 


at 


2 


00 


80 00 


150 


a 


at 




50 


75 00 


500 


a 


at 




20 


100 00 


700 


a 


at 




50 


350 00 


600 


u 


at 




20 


120 00 


1,150 


u 


at 




20 


230 00 


300 heads, 


at 




06 


18 00 


8 tons, 


at 30 


00 


240 00 


20 bushels 


, at 




20 


4 00 


40 


a 


at 




20 


8 00 


2,500 


aounds, 


at 




02 


50 00 


80 tons, 


at 15 


00 


1,200 00 


10 


a 


at 15 


00 


150 00 


30 


a 


at 


4 


00 


120 00 


40,000 


quarts, 


at 




04 


1,600 00 


8,000 


pounds, 


at 




08 


640 00 


7,500 


u 


at 




10 


750 00 



,072 00 



Amusement is closely allied to labor, and forms an important, 
and by no means an easy part of the general care and treat- 
ment of the insane. Especially is this the case in a hospital 
open to all classes of society, and admitting patients afflicted 
with every grade of mental disease. Nearly all the males can 
take part in, and enjoy out-of-door games and gymnastic exer- 
cises. But the mental difference produced by education, social 
position, habits of life, and by the grade and severity of disease, 
form the patients in every hospital for the insane into widely 
separated and strongly marked classes, each following its own 
peculiar inclinations, and becoming interested, only in its 



I860.] PUBLIC DOCUMENT— No. 33 . 51 

appropriate objects. To many, an allowance of tobacco will 
impart the highest enjoyment and procure unremitting labor. 
Others will be sufficiently gratified by a book, a picture, an 
occasional game and the family newspaper. "While to those of 
more highly cultivated minds, lectures, recitations, readings, 
concerts, tableaux vivants, excursions to remarkable places, the 
pursuit of some department of natural history will afford the 
greatest amount of recreation, and best relieve the monotony 
of a long-continued residence in a hospital. In the arrange- 
ment and management of amusements, great care should be 
taken that excitement does not result therefrom. The mind when 
recovering from disease should be kept in a calm and cheerful 
state, free from every cause of dissipation and excitement. 

It may not be out of place to say a word in relation to the 
food and appetite of the insane. The powers of life must be 
supported mainly through the stomach. Hence it is necessary 
to bestow some thought upon diet. Constitutional vigor is 
generally much impaired among the insane. They require the 
sustaining influence of food, in quantity and quality generous 
and highly nutritious ; not only is a liberal supply of animal 
food requisite, but stimulating drinks must sometimes form a 
part of ordinary diet. The appetite rendered feeble and capri- 
cious by weakness, must be recovered by food that imparts 
strength. When solid food cannot be taken liquid food may be 
made sufficiently nourishing. Milk, when it can be borne, 
cream, broth, soup, beef-tea, may all be brought into use. 
Some require frequent support of sustenance, and others bear 
longer intervals. But in all cases the enfeebled powers of life 
must be strengthened by a liberal supply of highly nutritious 
food. Much may be accomplished by making every thing 
about the dining-rooms and tables as attractive as possible, by 
disposing of the viands in such a manner as to provoke an 
appetite, by engaging in a lively conversation, and by spending 
as much time at the table as can be spared from other duties. 
In this manner patients will often be diverted from their insane 
fancies, and be betrayed into taking a generous meal. 

Our accounts show that much attention has been paid to the 
clothing of the patients. The insane suffer much from feeble- 
ness of circulation and consequent coldness of the extremities. 



52 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

On this account it is desirable that the clothing should be 
always of thick and -warm material. It should likewise be 
perfectly neat and tidy. Indifferently clad patients very soon 
lose their ideas of propriety, and that self-respect, without 
which they can rarely recover. The supply of clothing should 
be so abundant that frequent changes of all the apparel worn by 
each individual, may be made without hesitation or difficulty. 

The air respired by the insane should be perfectly pure, and 
moderately warmed, never oppressively hot, nor below sixty- 
five or sixty-eight degrees, Fahrenheit. The insane are rarely 
satisfied with a temperature below seventy degrees Fahrenheit, 
unless they are accustomed to much out-of-door exercise, and 
even then considerable fault will be found with the thermometer 
indicating a temperature of sixty-five degrees Fahrenheit. 

Personal cleanliness demands strict attention, both as a means 
of preserving physical health, and as an important moral agen- 
cy. Exhalations from the bodies of the insane are often 
strongly marked, and a large class of patients are liable to 
become careless and filthy in their habits. In addition to the 
regular use of the tepid bath for purposes of cleanliness, it 
is necessary to exercise great care, in order to insure a proper 
observance by the patient of this great essential of health and 
comfort. • 

Among the many physical causes of mental disease, perhaps 
none is more frequent and certainly none oftener overlooked 
than a disordered state of the stomach and bowels. It is that 
condition of the alimentary canal which gives rise to constipa- 
tion, sometimes alternating with diarrhoea, and accompanied 
with indigestion, flatulence and eructations, anorexia and nau- 
sia, transient pains in the hypochondria, livid and yellow suffu- 
sions of the skin, viscid secretions of the mouth and extremely 
offensive breath. This condition of the alimentary canal which 
so often lays the foundation for mental disorders is the result 
of a great variety of causes. Perhaps the most frequent is ex- 
cess in the use of indigestible food. Too great indulgence of 
the appetite on the one hand, scanty and unwholesome diet on 
the other, produce nearly the same train of symptoms, and 



I860.] PUBLIC DOCUMENT— No. 33. 55 

indicate a very common condition in those cases in whi brute 
orders of the mind follow affections of the stomach and bov con " 

The relation in which complaints of the alimentary cana*P, 
stand to the disease of the brain may sometimes be doubtful ; 
in some it is the relation of cause, in others it may be that of 
effect. But even then there is a reaction of the secondary upon 
the primary disease, and the original is aggravated by the 
complication. 

All must understand how readily the brain is influenced by 
every condition of the alimentary canal. That general uneasi- 
ness and dissatisfaction which troubles so many persons so often ; 
that state of the mind in which nothing in the affairs of life 
gives pleasure, or hope ; that quality of the affections which 
rejects all the attentions of friendship, all the kind offices of 
love, — is frequently nothing more than the result of sympathy 
between the brain and a constipated state of the bowels. It is 
humiliating to admit that cheerfulness, good humor, and large 
anticipations of future welfare, may be wholly destroyed by a 
fit of indigestion : that -the strength of the memory may be 
diminished, the imagination blunted, the power of concentra- 
tion impaired, by a neglected state of the alimentary canal. 

No class of patients suffer more seriously than those who are 
afflicted with this general disorder of the digestive organs. 
The deranged state of the thinking faculties, the sense of weari- 
ness and oppression, at first slight and irregular, and hardly 
noticed, becomes daily more severe and oppressive, until the 
power of self-control is lost, and by the influence of disease, or 
it may be by accident, some one sensation or emotion becomes 
exalted, and the judgment impaired ; a general and constant 
irritability of the mind succeeds, which disturbs and deranges 
all the mental operations. It is hardly to be supposed that 
any one cause of insanity is more common than this neglected 
condition of the stomach and bowels. Its effects are so slight 
and irregular at first as not to arrest the attention of the 
patient, and thus known to the physician only in the advanced 
stages of the disorder when the prospect of recovery has become 
slight, and palliative treatment only can be attempted. 

Our tables show that in more than twenty percent, of all the 
admissions to the hospital, insanity was produced by some one 
or more of the depressing emotions. 



52 LP UNATIO HOSPITAL AT WORCESTER. [Oct. 

On tlnV an< ^ anx i e ty> grief, distrust, domestic affliction, poverty, 
j ^reverses of fortune, are by far the most prominent moral 

^ctuses of insanity. They produce disease by a slow and con- 
stant operation, and in an advanced state of civilization are 
continual in their influence. 

In high states of civilization, when the relations of men are 
intimate and their interests suffer by contact ; when their nervous 
susceptibilities have become unduly exalted, and their minds 
rendered irritable, the influence of the passions in the produc- 
tion of mental disease can hardly be overestimated. But it 
should be borne in mind that, not only do the passions and 
emotions exercise a great influence upon the health of the 
physical organs, but that the condition of the physical organs 
controls in an equal degree the operations of the mental facul- 
ties. The mind and body of necessity participate in the health 
and disease of each other, and the particular condition of the 
one may to a certain extent, be determined by that of the other. 
Thus indigestion may be the cause or the result of an irritable, 
unhappy disposition of mind. And ascerbity of temper may 
be the occasion or the consequence of an acid state of the 
stomach. 

Thus we can very easily see how real to the sufferers are 
many of the miseries of the poor victims to nervous disease and 
insanity. While surrounded by "all the blessings of existence 
which men so covet, they are more really miserable than the 
most homeless, friendless beings that beg a scanty subsistence 
from door to door. 

Some unhealthy condition of their nervous systems, without 
producing any well-marked bodily symptoms, may so control 
all the operations of the mental faculties, as to diminish- every 
capacity for enjoyment, paralyze every susceptibility of pleas- 
ure, and completely overwhelm the mind in fear, suspicion, 
and gloom. 

Mental health has a much closer relation to physical infirmity 
than we are willing to admit, and the extent, also, to which 
human happiness depends upon the integrity of the physical 
organs and the perfection of their functions, we cannot com- 
pute. 

How important, then, in a hygienic point of view, are the 
advantages of a judicious system of physical education, not 



I860.] PUBLIC DOCUMENT— No. 33. 55 

merely that development of muscle and perfection of brute 
force, so much sought in gymnasiums, but a special and con- 
stant attention to physical development by free exercise in the 
open air. Wherever pure air and free, joyous exercise are 
withheld from any individual, the consequences are evil. The 
want of pure air and wholesome exercise degrades the vital 
energies in the same manner as does meagre or scanty food, by 
destroying the balance between the functions of supply and 
demand which, in a healthy condition, preserves every organ 
in a state adequate to the perfect performance of its offices. 
The muscles grow paler and weaker, and the ability to perform 
labor is diminished. The brain, by the impoverished condition 
of blood, undergoes the same process of change, and the capac- 
ity of self-management is impaired. In conducting the ordi- 
nary affairs of life, an individual so situated must make 
extraordinary efforts, which the enfeebled state of his brain 
will poorly enable him to do. After struggling for awhile, his 
strength is overcome, his courage gives out, his self-respect fails, 
his mental operations become clouded, and his power of self- 
control is lost. 

Every condition and circumstance in life which has a ten- 
dency to diminish vital force, degrades the standard of general 
health, and thus in a peculiar and certain manner promotes the 
development of insanity, by producing that unhappy condition 
of the mental faculties which does not understand the true 
nature and relation of things, and cannot, in the management 
of common worldly affairs, rightly use proper means for the 
accomplishment of desired purposes. Individuals suffering 
from this latent form of disease, are compelled to make extraor- 
dinary efforts at self-management, and if not able to persevere 
with an uncommon exaltation of will, at length become loose 
and wayward in their habits of thought and action, and unable 
to grasp complicated designs, hence in the affairs of the world, 
though they struggle manfully for a time, too often falter and 
fail. Their minds, more irregular and more easily disturbed 
than at first, now become a ready prey to the ravages of 
disease. 

About a year ago you directed such improvements and 
repairs as made it necessary to remove the old chapel and 



56 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



office, and rebuild in their place a new wing one hundred and 
twenty feet long, thirty feet wide, and three stories high. This 
building is now nearly completed and is occupied in all its 
parts. The basement contains sufficient store-room, refrigera- 
tor and wash-room. In the first story above the basement are 
situated the kitchen, domestics' dining-room, bakery and iron- 
ing-room, with all necessary store-rooms and closets. In the 
west end of the second and third stories, and contiguous to the 
old centre building is the chapel and lecture-room. And in 
the east end are work rooms for patients and sleeping rooms 
for domestics. The kitchen is furnished with the most approved 
apparatus for working by steam, which has been found satisfac- 
tory in every particular. A railroad extending from the base- 
ment of the new wing under the entire length of the old build- 
ing affords a ready means of access to the patients' dining-rooms 
in all parts of the hospital. 

The means employed for warming and ventilating the various 
parts of the institution continue to give satisfactory results. 
No important alteration or repairs have yet been necessary. 
The following table shows the exact amount of coal consumed 
from October 1, 1859, to October 1, 1860 :— 







Amount for each 
month. 


Daily average. 






lbs. 


lbs. 


October, 1859, ....... 


68,000 


2,193 


November, 


u 










111,000 


3,700 


December, 


a 










154,300 


4,977 


January, 1860, 










169,000 


5,451 


February, 


a 










170,000 


5,862 


March, 


u 










134,300 


4,332 


April, 


u 










76,500 


2,550 


May, 


u 










42,250 


1,363 


June, 


u 










30,200 


1,006 


July, 


u 










26,000 


835 


Auoust, 


a 










22,750 


734 


September, 


a 










23,750 


792 


Total, 












1,028,050* 


- 



*Or, 514i-tons. 



The usual amount of labor upon the farm, aside from sowing 
seed and gathering in of the crops, has been performed. Worn 
out lands have been reclaimed, rocks have been removed, walls 



I860.] PUBLIC DOCUMENT— No. 33. 57 

made, ditches dug, cisterns built, water pipes repaired and 
under-drains laid, thus at all times furnishing employment to 
a large number of male patients. Fruit trees and forest trees 
have been transplanted and hedges started with a view to 
improve the estate and beautify the pleasure grounds connected 
with the buildings. 

In behalf of the patients I desire to tender my grateful 
acknowledgments to the many kind friends who have assisted 
us during the year in our lectures and concerts and other 
entertainments designed to amuse and instruct those placed 
under our care. 

I desire also to express my sense of obligation to those who 
have so generously made donations of books, maps and pictures, 
thus contributing much to the welfare of the inmates. 

We are under renewed obligations to the publishers of news- 
papers in various parts of the Commonwealth for their daily 
and weekly issues, and to those in this city also for large and 
well-selected bundles of exchanges, giving us a liberal supply 
of newspapers from all parts of the country. 

It is my duty to record my personal obligations to my assist- 
ants Drs. Rice and Prentiss for their untiring devotion to the 
interests of the hospital and the cheerfulness in which they 
have assisted me in all my duties. 

The employees of the institution almost without exception, 
have faithfully and earnestly carried out all my plans and devoted 
their whole time and strength to the welfare of the patients. 

In looking back over the events of the year, we acknowledge 
with deep gratitude the blessing which has attended all our 
efforts to promote the welfare of those placed under our care. 

And with renewed confidence that He who upholds and 
sustains all, will impart to us strength for future labor, we 
cheerfully commence the duties of another year, hoping and 
trusting that by His direction we may perform them faithfully 
and well. 

MERRICK BEM1S. 

State Lunatic Hospital, Worcester, 
October 1, 1860. 



58 



LUNATIC HOSPITAL AT WORCESTER. 



[Oct. 



AN INVENTORY 



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

Live stock on the farm, .... 

Produce of the farm on hand, . 

Carriages and agricultural implements, 

Machinery and mechanical fixtures, . 

Beds and bedding in the inmates' department, 

Other furniture in the inmates' department, 

Superintendent's department, 

Housekeeping department, 

Ready-made clothing, 

Dry goods, 

Provisions and groceries, 

Drugs and medicines, 

Fuel, 

Library, . 



on 


hand at the 


. $3,380 00 




2,260 00 




875 00 




5,500 00 




3,850 00 




3,225 00 




350 00 




1,000 00 




150 00 




350 00 




1,575 00 




150 00 




2,200 00 




300 00 



I860.] PUBLIC DOCUMENT— No. 33. 59 



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 committed 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. 



60 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



PETITION. 

Commonwealth of Massachusetts. 

To the Honorable , Judge of Probate and 

Insolvency, for the county of 

Respectfully represents , of f 

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 



1680.] PUBLIC DOCUMENT— No. 33. 61 

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,) 

, 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 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 ; 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 



62 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

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 at the hospital if desirable and charged in 
the bills at cost. 

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

Eeasonable 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. 



METEOROLOGICAL OBSERVATIONS 

MADE AT 

THE STATE LUNATIC HOSPITAL, WORCESTER, MASS., 
1859-60. 

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. 



64 



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[snow-fall. 
Very brief and light 
Snowscuds 11 A.M.&seq. 
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High winds. 

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Snow scuds 11 A. M. to 
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[to N. E. ; hail accom- 
Aurora. [panying P. M. 
Light fog A.M. ; rain int. 
Dense fog A. M. ; shower 
[P. M. 

Light fog early A. M. 
Misty P. M. ; driz. r. eve. 




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I860.] 



PUBLIC DOCUMENT— Xo. 



69 





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Drizzly rain continues. 

Snow followed by rain & 
Snow succeeds. [fog. 
Snow squalls 7 P. M. 
Snow squalls. 

Robins appear; rain fol- 
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[P. M. 
Light fog A. M. ; aurora 
Dense fog; aurora P. M. 
Light fog ; aurora P. M. 
Fog deepening into driz- 
[zly rain. 
Light snow. 

Snow squalls. 
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Aurora P. M. very bril- 
Aurora 12 P. M. [liant. 
Hazy A. M. ; light rain 
[P. M. 
Very hazy nil day. 
Very hazy all day. 






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LUNATIC HOSPITAL AT WORCESTER. 



[Oct. 





03 

M 




Mount. Ash bios.; fog fol- 
Drizzle. [lowed by rain. 

Hazy A. M. 
Intermittent rain. 
Steady rain. 
Peony blossoms. 
Syringa bloss.; shower. 
Showery P. M. 
Gusty all day. 

[num bloss. 
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Th. St.; solar halos A.M. 
Showery, with thunder. 
Thunder shower. 
Continued rain. 
Lightning 10 P. M. 
Showers; rainbow 5 A.M. 
Shooting star 9 P. M. 

[storm 4 P. M. 
Misty A. M. ; thunder 
Foggy ; Locust bloss. 
Light fog A. M. 
Comet visible. 

[rainbow 7.15 P. M. 
Thunder and lightning; 
Showery all day. 
Faint aurora. 






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80 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 





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B Y-LAW S • 



STATE LUNATIC HOSPITAL 



AT WORCESTER. 



BOSTON: 

WILLIAM WHITE, PRINTER TO THE STATE. 
1860. 



BY-LAWS 



A A 



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. 



4 LUNATIC HOSPITAL AT WORCESTER. 

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 pleasm-e 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. 



BY-LAWS. 5 

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. 



6 LUNATIC HOSPITAL AT WORCESTER. 

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. 



BY-LAWS. 7 

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 oh 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 perform 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 



8 LUNATIC HOSPITAL AT WORCESTER. 

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 VH. 

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 
aj>artments, 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 VIH. 

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. 



BY-LAWS. 



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 
2 



10 LUNATIC HOSPITAL AT WORCESTER. 

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. 



BY-LAWS. 11 

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. 



12 LUNATIC HOSPITAL AT WORCESTER. 

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 9J o'clock all patients, attendants, and other persons 
employed must be in their rooms, and no light is tb 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. 



BY-LAWS. 13 

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 XI. 

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. 



14 LUNATIC HOSPITAL AT WORCESTER. 

CHAPTER Xn. 

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 XHI. 

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



BY-LAWS. 15 

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 Superintendent. 

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 fights, 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. 



16 LUNATIC HOSPITAL AT WORCESTER. 

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 ward 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. 



BY-LAWS. 17 

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 Supeiintendent ; 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. 

3 



18 LUNATIC HOSPITAL AT WORCESTER. 

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 hi 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. 



BY-LAWS. 19 

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. 



20 LUNATIC HOSPITAL AT WORCESTER. 



DIET TABLE 

FOE THE STATE LUNATIC HOSPITAL 



SUNDAY. 
Breakfast — Coffee, bread and butter, bash 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. 



BY-LAWS. 21 



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. 



22 



LUNATIC HOSPITAL AT WORCESTER. 



Time of Bell Ringing and Meals. 





Bell rings. 


Breakfast. 


Supper. 


March 1 to 15, . 


5£A, 


M., 4^P. M., . 


7 


f.i 


" 15 to 31, . 


H ' 


< - H " • 


6f 


H 


April 1 to 15, . 


5 


' 5 


6i 


5f 


" 15 to 30, . 


4| < 


' 61 " . 


«i 


6 


May 1 to Sept. 1, . 


H ' 


' H " • 


6 


6 


Sept. 1 to 15, . 


4| , 


' 51 " . 


6} 


6 


" 15 to 30, . 


5 


' 5 


H 


H 


Oct. 1 to 15, . 


H ' 


< H " • 


6f 


H 


" 15 to 31, . 


H ' 


' H " • 


7 


H 


Nov. 1 to March 1, . 


5f < 


< 4i « . 


7 


5 



Bell rings week days at . 

" " every evening at . 

" " Sundays at 
Dinner, week days at 
" Sundays at 

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



12 M. 



1\ P. M. 
121 p. M. 



12 M. 



m Z5S9W.PX