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




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PUBLIC DOCUMENT No. 28. 



THIRTIETH ANNUAL EEPOET 



THE TRUSTEES 



STATE LUNATIC HOSPITAL 



^T W^OROESTEH. 



OCTOBER, 1862 



BOSTON: 

WRIGHT & POTTER, STATE PRINTERS, 

No. 4 Spring Lane. 

18 6 3. 



OFFICERS OF THE HOSPITAL. 



TRUSTEE 

WILLIAM T. MERRIFIELD, Esq., 
ROBERT W. HOOPER, M. D., . 
Hon. EDWIN F. JENKS, . 
EDWARD JARVIS, M. D., . 
WILLIAM WORKMAN, M. D., . 



Worcester. 
Boston. 
Adams. 
Dorchester. 

Worcester. 



TREASURER. 



HENRY WOODWARD, Esq., . 

Office, Mechanics' Bank, Main Street. 



Worcester. 



RESIDENT OFFICERS. 

MERRICK BEMIS, M. D., Superintendent. 

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

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

CAROLINE A. BEMIS, Matron. 



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(Jlommonruealtl) of JMassarljusietts, 



THIRTIETH ANNUAL REPORT 

OF THE 

TRUSTEES OF THE STATE LUNATIC HOSPITAL, 
AT ^V^OROESTER. 



To His Excellency the Governor, and the Honorable Council 
of the Commonwealth of Massachusetts. 

The Trustees of the Worcester Lunatic Hospital beg leave 
to make the following Report of the state of the institution 
under their charge, for the year ending September 30, 1862. 

During the year that has now closed, the hospital has 
enjoyed its usual prosperity, and accomplished a work similar 
to that of previous years. 

Six hundred patients — two hundred and ninety-two males, 
three hundred and eight females — have enjoyed the privileges, 
and been under the care of the institution within the year. 
Of these 



379 


patients- 


-184 males, 


195 females- 


—were here October 1, 1861 ; 


221 


u 


108 


(( 


113 


ii 


were admitted; 


124 


ii 


58 


u 


66 


a 


were discharged recovered ; 


39 


ii 


18 


ii 


21 


ii 


were discharged improved ; 


7 


(( 


5 


ii 


2 


a 


were discharged not improved ; 


34 


a 


11 


a 


23 


a 


died in course of the year, and 


396 


ii 


200 


u 


196 


a 


now remain. 



6 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Some improvements have been made. Another range of 
the stone cells has been removed. They were not merely use- 
less, but offensive and injurious, in reminding the patients of 
the harsher treatment of the insane in olden time. But their 
places are now taken by comfortable rooms that are acceptable 
to the inmates, and important aids in the management and 
treatment of the household. 

Another, and last, range of these cells still remains ; but they 
are never used for the purpose for which they were designed. 
They are kept as curiosities, to show what ideas of insanity 
and its liabilities have prevailed, and what means were sup- 
posed to be necessary for its removal. These cells are now 
sometimes used as places of storage, which, however, could 
better be done elsewhere ; and they will soon give way to 
rooms, which will add to the comfort of the patients, and be 
useful in the administration of the house. 

All the improvements, that have been made within the last 
seven years, are advantageous to the hospital and the patients, 
and increase the facility and success of management. The 
system of warming by steam and of ventilating by the fan was 
admirable in its conception, and is exceedingly comfortable to 
the inmates of the house, as well as economical to the institu- 
tion. This is honorable to the Trustees who, seven years ago, 
conceived the plan, and to those who put it in execution. This 
and other improvements have raised this hospital from its low 
rank in 1855, to a high position among institutions for the 
insane. 

FORMER IDEAS OF INSANITY. 

In the management of insanity there is continual progress. 
The time was, within the memory of some now living, when 
lunatics were considered as doomed to life-long disorder ; at 
the best, they were considered as burdens upon public treas- 
uries or their own estates for their care and support. Some of 
the harmless insane were abroad strolling about the country, 
objects sometimes of pity, often of derision, and occasionally 
of fear. A considerable portion of these patients were dan- 
gerous, or supposed to be so, and society felt it necessary for 
its own security to protect itself from them. They were con- 
fined in prisons, and in strong rooms or cages of poor-houses 
and private dwellings. 



1862.] PUBLIC DOCUMENT— No. 28. 7 

When inquiry was made, in 1829, by order of the legislature 
into the number and condition of the insane in this State, 
many were found who had been thus imprisoned for periods, 
varying from a few weeks to forty-five years. 

The revelation of this state of things, so offensive to hu- 
manity, produced a strong impression on the government and 
the people, and a conviction that something should be done for 
these wretched and neglected sufferers. But it was not pro- 
posed to let them go free, for the safety of the community 
seemed to require that they should be kept from the possibility 
of doing harm. Yet the increasing intelligence and humanity 
of the age demanded that, at least, they should be allowed to 
have a better place of confinement, and it was primarily and 
mainly for this purpose that the hospital was proposed. More 
than one-half of those, who were admitted during the first 
year, came from jails and almshouses, and one-third of the 
whole had been imprisoned from ten to thirty-two years. The 
idea of restoring the insane to health was then recognized, and 
had its weight among the reasons for creating the hospital, but 
it was not the primary and leading one ; and if this motive 
had stood alone, probably the insane would have been obliged 
to wait some years longer for this means and these opportuni- 
ties of restoration. 

In the purposes and the plan of the hospital the legislature 
had principally in view a custodial establishment for the safety 
and convenience of the sane community, and to relieve the 
prisons and the poor-houses of their most undesirable and 
troublesome inmates. The law offered it first to those who 
" were so furiously mad as to be manifestly dangerous for the 
peace and safety of the community to be at large ;" second, to 
the town paupers ; and third, to " any poor persons suffering 
under recent insanity." The last class includes a very small 
proportion of the insane in the general community, but the law 
authorized the Trustees to admit them " for a less sum " than 
the actual cost of support. 

For the first class, the furiously mad and the dangerous, the 
law interposed the courts, sheriffs, and constables, to compel 
them to enter the hospital. The order of commitment was 
mandatory, and could not be resisted by the patient nor diso- 
beyed by the hospital, which was obliged to receive all that were 



8 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

sent in this manner. The reception of the other classes was 
optional ; for the Trustees were permitted, not required, to 
receive them. 

Fortunately for the insane, the courts, by a very liberal 
interpretation of the law, early began to include all the insane 
in the first class ; and still more fortunately for all classes of 
lunatics, the sagacious superintendent and managers of the 
hospital soon saw that its widest and best sphere of usefulness 
was in the cure of the curable cases, and the amelioration of 
those that could not be restored. And thus, while they ful- 
filled the first intention of the law — while they quieted the 
public fear of harm from dangerous and troublesome lunatics, 
and soothed the public conscience, by giving them a better place 
of confinement and softening the hardness of their condition, 
they applied their energies and their skill to the removal of the 
disease from the curable cases, and the improvement of those 
whose maladies had become fixed. The hospital early became 
a curative as well as a custodial institution. From the begin- 
ning, it has been a most valuable and effective agent of 
humanity, and an essential element of the prosperity of the 
Commonwealth. In the relief of suffering, in the restoration 
of useful lives, in adding to the productive power of the people, 
and in diminishing the costs of life-support of the insane, the 
hospital has done a far higher, larger and more profitable work 
than its projectors and fathers dared to hope. 

WHAT THE HOSPITAL HAS DONE. 

During the nearly thirty years of its operation, the hospital 
has received into its wards, and taken the care of, six thousand 
six hundred and sixty-three insane persons. Of these, it has 
given three thousand one hundred and thirty-one back to their 
homes and the world, to usefulness and the common enjoyments 
of their families and society, and to the usual responsibilities' 
of citizenship. 

Of the thirty-five hundred and thirty-two who were not re- 
stored to health, twelve hundred have been improved, their 
violence has been subdued, their excitability calmed, their 
pains assuaged, and their delusions controlled, in such a 
measure, that they could live at their homes, be comfortable in 
their families and neighborhoods, and partake of some, or even 
many, of the blessings of society. 



1862.] PUBLIC DOCUMENT— No. 28. 9 

There remained and still remains another class who have 
never recovered sufficient mental health, or power of self-con- 
trol to go abroad and mingle with the world. These passed or 
are passing the remainder of their days without mitigation of 
their disease. A large proportion of this unimproved class 
have died in the hospital after residing there through periods 
varying from a few hours to almost thirty years. The second 
patient that entered the house, January 22, 1833, died on the 
25th day of July last. Most of these passed calmer and far 
more comfortable lives under the soothing and restraining influ- 
ence of the institution, than they had before they came, or 
probably would if they had remained at their homes or their 
former places of confinement. And few are they who have 
come under tlie care of the hospital, that have been without 
some benefit in various degrees, from the calming of the spirit 
to the complete restoration of health. 

The worth to the State of these blessings of improved and 
established health, in so many of her weakened and disordered 
children, is beyond all calculation. But the financial value of 
the labors and results of the hospital, is a matter of great 
importance to the Commonwealth. It has restored to life, 
health and usefulness, three thousand one hundred and thirty- 
one men and women, who were not only deprived of power to 
sustain themselves and their families, and contribute to the 
support of town and State, and add to the strength of the body 
politic, but were a burden on their own estates or the public 
treasuries, for their sustenance and for the extraordinary care 
which their excited, wayward or depressed condition required. 

Although the hospital has accomplished so much, it will not 
be claimed that none of this restored life and power would have 
been gained without its intervention. Some of these patients 
probably would have recovered by other means, even if the 
hospital had not existed ; yet these would have been few, as, 
according to all observation, most of the insane who are not 
removed from home, or submitted to the appropriate means of 
restoration, remain in their disorder for life ; it is fair to 
presume that most of these would have been insane for life, if 
they had not had some such means and opportunities as they 
have here enjoyed. 
2 



10 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



According to the life-tables, these three thousand one 
hundred and thirty-one men and women lived or will live an 
aggregate of 84,886 years after they regained their health, and 
82,090 of these were working and self sustaining years, before 
they arrived at the period of dependence in old age. Making, 
however, some deduction for those that would have recovered 
by other means if the hospital had not existed, and also for the 
periodical cases whose years of health were cut off by every 
succeeding attack, yet both of these deductions will not very 
materially diminish the total sum of 84,886 years of usefulness 
and enjoyment and the 82,090 years of labor and self-suste- 
nance, that have been given back to these patients, and through 
them to society and to the Commonwealth, by the labors and 
influence of the hospital. 

It must be farther considered, that insanity, if not removed, 
is a life-enduring disease, and although, with its causes and 
conditions, it shortens human life, it does not destroy men at 
once. Mr. Le Cappelain, of London, calculated the value of 
life to the permanently insane at the several ages. Taking his 
tables and the common tables of the expectation of life of the 
sane, it is easy to see the comparative chances of living in 
mental health and mental disorder. 



Expectation or probable duration of Life. 





Sane. 


Insane. 


AGE. 


Males. 


Females. 


Average 
both Sexes. 


20, 

30, 

40, 

50, 

60, 


36.32 
34.54 
30.48 
24.89 
18.77 


21.31 
20.64 
17.65 
13.53 
11.91 


28.66 
26.33 
21.53 
17.67 
12.51 


24.99 
23.46 
19.59 
15.60 
12.21 



At these rates, the three thousand one hundred and thirty-one 
who were restored, would have lived 54,911 years, if their 
malady had not been removed, through all of which the State, 
towns and people must have cared for and supported them. 



1862.] PUBLIC DOCUMENT— No. 28. 11 

The hospital then has done this double work. It has taken 
away a burden and given back a support. It has cut off these 
54,911 years of insanity, which were or would have been a 
heavy tax upon the sympathies and a draft upon the resources 
of the community, and given back, in their stead, as many and 
fifty per cent, more years of aid and labor to the body politic, 
and the cost of this great boon to the Commonwealth has been 
merely the expense of supporting and caring for these three 
thousand one hundred and thirty-one, through an average of 
somewhat less than six months for each one. 

Massachusetts may then take a reasonable satisfaction in this 
great and profitable charity, first established here, and now 
expanded into three institutions for the relief of the children 
of her blood and the children of her adoption. All the money 
the State has expended in the cost and support of these, has 
been judiciously invested. It has brought back a large return 
in the prevention of a great bill of expense for the support of 
life-long lunacy, and it has given to the community a very large 
amount of productive labor, to sustain the families and to aid 
in its due proportion, the public treasury. 

HOSPITALS USED BY FOREIGNERS MORE THAN NATIVES. 

Yet although so much has been done, both in this and in the 
other public hospitals, they have not been enabled to do all that 
was and is desirable for our own people. By a singular, and 
probably undesigned, yet inevitable effect of the course of legis- 
lation in this Commonwealth, the privileges and advantages of 
these public institutions have been diverted, in great measure, 
from the channels in which they should naturally flow, to others 
which should not receive them until the first are filled. These 
hospital privileges and benefits have been and are lavished, and 
even forced upon the State paupers who are strangers, without 
stint and without cost, while they have been sold to our own 
people at a price beyond the cost, and upon the most careful 
exaction of security, and thus the State makes a profit out of the 
sufferings of its own children, and that in their weakest and 
most agonizing hour. 

When the last inquiry was made, in 1854, 93 per cent, or 
nearly all of the foreign lunatics were unable to sustain them- 
selves, nor could their relatives or friends, upon whom they 



12 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

might have a legal claim, support them. Having no estate nor 
resources to fall back upon in their sickness, they were depend- 
ent upon the public treasury for sustenance, and, as very few- 
had paid sufficient tax to gain a legal settlement in any city or 
town, they became the wards of the Commonwealth and were 
State paupers. Their families live in narrow dwellings, with no 
space beyond the necessities or endurance of healthy life, no 
room for the accommodation of an insane member. They have 
neither the courage, nor the patience, nor the power to watch 
over and take care of one who is deranged ; consequently almost 
as soon as one of them becomes insane, the physician is called, 
complaint is made to the court and permission asked for his 
committal to the hospital. The order is issued, and the officer 
directed to take him to the place of healing. Thus nearly all 
the foreign lunatics are sent, and a very large proportion of 
them in the early and curable stage of their disease, to the 
public appropriate institution. In 1854, there were in Massa- 
chusetts only sixteen, or 2^- per cent, of the six hundred and 
twenty-five foreign lunatics, who were not then or had not been 
in some hospital especially provided for the treatment of such 
cases as theirs. 

At the present time there are, in the hospital — 

Independent or pay patients, . , 92, or 23 per cent, of alL 

Town paupers, .... 123, " 31 " 

State paupers, .... 181, " 46 " " 

396 

These proportions vary very widely from the proportions of 
these classes of the insane in the State. At the last enumera- 
tion they were — 

Independent, . . . 1,110, or 42.17 per cent, of all. 

Town paupers, . . . 829, " 31.49 

State paupers, . . . 693, " 26.33 " " 



2,632 



The watchfulness of the alien commissioners, and their energy 
in removing from the State such foreign lunatics as have claims 



1862.] PUBLIC DOCUMENT— No. 28. 13 

for support elsewhere, render it extremely probable that the 
proportion of State paupers among the insane in Massachusetts, 
is less than it was seven years ago. Certainly there is no reason 
to suppose that they are in larger, or that the independent class 
are in smaller proportion now than they were in 1854. Admit- 
ting, however, that these proportions are the same now as they 
were at that time, then, if the State hospitals were equally 
accessible and available to, and used with the same freedom by, 
all classes of patients, each class would constitute the same 
proportion of their inmates as it does of the whole insane 
population of the Commonwealth. 

It is remarkable that the proportions of the town paupers in 
the hospital and in the whole community are almost identical — 
31.06 and 31.49 per cent. But the proportions of the indepen- 
dent and of the State pauper insane, in and out of the hospital, 
are reversed. In this institution there is a very large excess of 
the dependent aliens and a large deficiency of independent 
natives. If these classes of the insane were represented in the 
hospital according to their numbers in the whole State, there 
would be one hundred and sixty-seven instead of ninety-two 
of the native or pay-patients, and one hundred and four instead 
of one hundred and eighty-one foreigners in the institution. 

If the independent class of the insane were represented here 
in as large a proportion as that which is supported by the Com- 
monwealth, they would have two hundred and ninety-one 
instead of ninety-two in the hospital; or, if, on tlie contrary, 
the aliens were represented in as small a proportion as the self- 
sustaining Americans are, there would be only fifty-seven 
instead of one hundred and eighty-one lunatics of foreign birth 
in this establishment. 

The law requires the hospitals to receive, support and treat 
these alien paupers, but limits the payment from the State 
treasury to two dollars and sixty-two cents a week, which is 
less than the actual cost. The hospitals have no property of 
their own, no income, nor resource, except the payments made 
for the board and care of patients. They have no other alter- 
native but to charge upon the other patients the deficiency in 
the payments for the State paupers, or the excess of the cost of 
supporting and treating these over the allowance made by the 
law. 



14 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

During the four years and ten months ending with Septem- 
ber, 1861, the whole cost of supporting the hospital was 
$238,140.88. The average number of patients was 351.7, who 
were supported in the institution in this period, an aggregate of 
88,628 weeks, at an expense of two dollars sixty-eight cents 
and seven mills per week for each. The State paupers consti- 
tuted, in these years, nearly two-fifths, 39.2 per cent, of the 
whole. Previous to May 23, 1857, the Commonwealth paid for 
its wards in the hospital, for those in the institution not over 
thirteen weeks, $2.50, for over thirteen and not exceeding 
twenty-six weeks, $2.25, for over twenty-six and not exceeding 
fifty-two weeks, $2 a week, and for over one year, $100 a year. 
From May 23, 1857, to September 30, 1859, the State paid the 
same as was charged for the board and care of other patients, 
and from September 30, 1859, to May 30, 1862, the State 
paid $2.50 per week for all, and since the latter date $2.62 per 
week for all.* In the first period, the payments by the State 
fell far short of the cost of supporting its wards. In the second 
period there was no loss to the hospital on this account. In 
the third period there was a deficiency of eighteen cents six 
mills per week on each State pauper, and as these averaged 
one hundred and thirty-seven during this time, the loss was 
$25.58 a week, or $1,325 a year. The law of April, 1862, 
increases the price of board and care of the State paupers to 
$2.62 per week, but the great advance in the price of all the 
means of living, especially of dry goods and groceries, increases 
the expense of supporting these patients, so that the deficiency, 
even at $2.62 per week, is now larger than it was before. But 
whatever this deficiency may be, it must be included in the 
expense of supporting the institution, and assessed upon those 
whom the law requires to pay the full costs. 

Thus the great body of the people of Massachusetts, the self- 
sustaining farmers, mechanics, merchants, professional men, 
when they send any of their deranged friends, and the towns? 

*The law of 1837 ordered that "the salaries of the superintendent, assistant 
physician, steward and matron, be paid quarterly out of the treasury of the 
Commonwealth." This law was repealed in 1 859, by an Act which also limited 
the payments of the State for its paupers. These salaries were then charged 
to the towns and families that sent their patients to the hospital, and add 
three thousand and two hundred dollars a year to the cost of their support in 
the institution. 



1862.] PUBLIC DOCUMENT— No. 28. 15 

when they commit their insane paupers to the hospitals, are 
virtually compelled to pay not only the actual cost of their 
support, but also a bonus to the State equal to the deficiency 
in its payment, for the privilege of entering the institution, and 
for this, bond and security are required, so that, by no possi- 
bility, the State shall suffer the loss of any part of the cost or 
profits on the healing of its own children's mental maladies. 

Tliere is a large class, in this as in every industrial commu- 
nity, whose daily exertions with their small estates, or whose 
hands and skill alone furnish income sufficient to support 
themselves and their families, both in health and in ordinary 
sickness, but not sufficient to pay the price of board of any 
member in the hospital through three, twelve, or more months 
requisite for his healing or custody. Accustomed to living 
within their own means, to paying for all that they consume or 
use, yet having little or no surplus, they look upon the promise 
and the bond to pay three dollars a week in addition to their 
ordinary and necessary expenses, as a matter extremely hard 
for some and impossible for others. 

In view of the difficulties now presented, the immediate 
necessity of obtaining the requisite bonds, by persons unused to 
asking such aid from others, and of discharging the obligations 
to pay thirty-nine dollars quarterly, through months and per- 
haps years of uncertainty, and especially if the patient be the 
head of the family, and the principal source of income be cut 
off in his sickness, it is natural and inevitable that the friends 
should doubt and hesitate to assume these new burdens so 
apparently and even manifestly beyond their power to bear. 
With income sufficient, but only sufficient, to meet the expenses 
of ordinary life, many of these families postpone,' as long as 
possible, the dreaded day of increasing the drafts upon it; yet 
being accustomed to self-dependence for the supply of all their 
wants, they are unwilling to ask the aid of charity, and their 
natural and habitual self-respect, and perhaps their pride, forbid 
their applying to the town for assistance, and thus make their 
first confession of pauperism. They thus retain their deranged 
relative at home, from week to week, from month to month, 
and some from year to year. 

But at length, after a wearisome period of trial and disap- 
pointment on the part of the family, the patient becomes more 



16 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

violent and difficult to be managed, and the burden of his care 
more oppressive and distressing, or the relatives become 
exhausted with the ceaseless watching and painful anxiety ; 
then for their own relief, rather than with any increased hope 
of restoration, or any new confidence in the hospital, they send 
their friend to it, but not until the chance of recovery is 
lessened, often very materially diminished, and in too many 
cases entirely lost. 

Insanity is one of the most curable of serious diseases, if 
properly treated in its early stages. But it tends to fix itself 
upon the brain, and its chances of cure decrease rapidly with 
delay, and after a variable period in different cases, the malady 
is established for life, and all hope of restoration is gone. The 
records of hospitals show, that about seventy to ninety per cent, 
are restored, if taken within a year after the attack. A second 
year added to the continuance of the disease increases its 
incurableness, and a third and a fourth increase the difficulty 
very greatly, until the fifth- and after, when if any one is 
restored, it is considered rather a happy and unaccountable 
accident, than the result of skill or science that would justify 
the expectation that such may happen again. 

In the twenty-nine and three-quarters years' experience of 
the Worcester hospital, 72.68 per cent, of the recent cases, 
or those of not over a year's standing, and only 25.17 per cent. 
, of those of longer duration were restored. If the comparison 
could be made between those which were sent to the hospital 
within three months of their attack and those which came in 
their second and third and later years, the advantage of early 
treatment would be much more manifest. 

The first effect of delay in sending insane patients to the 
hospital being the diminished proportion of the recoveries, and 
of course the increased proportion of the permanently insane, 
the second effect, the increase of the lunatic population in the 
community necessarily follows. The thirty-four hundred and 
twenty-three who were sent to the Worcester hospital within 
their first year, gave back twenty-four hundred and eighty-eight 
to health and usefulness, and left nine hundred and thirty-five 
in confirmed lunacy. But the twenty-six hundred and forty- 
nine who came, after they had been deranged a year and more, 
returned to health and usefulness only six hundred and sixty- 



1863.] PUBLIC DOCUMENT— No. 28. 17 

seven, and left nineteen hundred and eighty-two to swell the 
ranks of the constant insane population of the State.* 

There is in every country a constant insane population, con- 
sisting in part of those whose disease is recent and curable, but, 
in much greater part, of the old and incurable cases. The 
proportion which these bear to the whole community varies 
widely in different States and Nations, and depends partly on 
the abundance and intensity of the causes that produce mental 
disorder, but much more on the ratio of those patients who are 
not submitted to, nor allowed to have the benefit of, the proper 
remedial measures, in the early stages of their malady, which 
in them is consequently extended from the few months needed 
for the cure to a duration that only ends with life. 

In a perfect state of things, where the best appliances, which 
the science and skill of the age have provided for healing, are 
offered to the lunatics in as early a stage of their malady as 
they are to those who are attacked with fever or dysentery, 
probably eighty and possibly ninety per cent, would be restored, 
and only twenty or perhaps ten per cent, would be left among 
the constant insane population. If this system of prompt and 
proper attention had been pursued in any community, for an 
entire generation, the number of lunatics in that community 
would be represented by eighty or ninety per cent, of the 
numbers annually attacked with mental disease, multiplied by 
one-half, (as it requires about six months on an average to 
effect a cure of the disease,) and ten or twenty per cent, of the 
same number multiplied by the number of years they may be 
expected to live. 

During the seven years, from 1855 to 1861, inclusive, five 
thousand one hundred and seventeen patients, or an annual 
average of seven hundred and thirty-one, were admitted to all 
the lunatic hospitals in Massachusetts. It may be safely 
assumed that as many, and perhaps more, were attacked with 
insanity ; for, although, among these, were many cases which 
had begun in previous years, yet among those attacked in each 
of these years were probably as many who were retained at 
their homes to be sent to the hospitals at a later period, when 
their disorder shall be of one, two, or more years' standing. 

* These numbers do not include those whose previous history was not known. 
3 



18 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

It may, then, be admitted that in each year, from 1855 to 1861, 
at least seven hundred and thirty-one of the people of this State, 
or one in sixteen hundred and sixteen of the total average 
population, became insane. 

The causes of insanity are manifold. They are partly 
organic and inherent, partly connected with personal habits, 
some are due to social customs, and others are accidental. 
Individually they vary from year to year, yet their sum total, 
their aggregate force remains about the same, and they produce 
about the same annual effect, and make about the same number 
of lunatics, in proportion to the population, through successive 
years. As, then, one in sixteen hundred and sixteen of the 
people of Massachusetts has been received into the hospitals, 
and probably as many made insane, in each of the last seven 
years, there is every reason to suppose that as large a propor- 
tion of her population will become insane in the next and each 
of the succeeding years, unless the conditions and habits of the 
people shall be changed and the causes of mental disturbance 
be diminished. 

If from the beginning, our public hospitals had, by favoring 
legislation, been made as accessible and available, and offered 
on as easy terms, to the American as to the Irish insane, and if 
the popular sentiment and general custom had induced the 
native families to send their lunatics to these institutions, in as 
large proportion as the foreign families send theirs, then these 
seven hundred and thirty-one, or that proportion of the people 
annually attacked, would have left but a small number to be 
permanently deranged, and Massachusetts would not have the 
great insane population which, in 1854, was twenty-six hundred 
and thirty-six, and probably is not less now. 

POLICY OP OTHER STATES IN THE MANAGEMENT OF THEIR HOSPITALS. 

Some other States, wisely deeming it to be their highest 
interest and duty to keep their people in the best health and 
efficiency ; to rescue as many as possible from mental destruc- 
tion, and convert them from burdens upon, into supporters of, 
the Commonwealth, have adopted and pursued a policy different 
from that of Massachusetts, in the administration of their 
lunatic hospitals, by opening the doors of these establishments 



1862.] PUBLIC DOCUMENT— No. 28. 19 

more widely for all their citizens, and making the way into 
them more smooth and easy. 

Twenty-four of the States have provided public hospitals for 
the insane, and offer them, on various terms, to their people. 
Ohio, Indiana, Illinois, "Wisconsin, and California assume and 
pay, out of the public treasury, the whole expense of support- 
ing these institutions, and invite all their people of every class — 
the rich and the poor — to send their lunatics, to have board and 
treatment, and be healed, without money and without price. 
The law of Indiana says : " Insane persons residing in this 
State, and having a legal settlement therein, shall be supported 
in the hospital and receive medical treatment at the expense of 
the State." The law of Wisconsin says : " Insane persons 
residing in this State, and domiciled in any county therein, 
shall be supported and receive medical treatment in the hospital 
at the expense of the State." 

New York, New Jersey, Pennsylvania, Michigan, and Georgia 
pay the salaries of the officers out of their public treasuries, 
and no part of this expense is charged upon the estates or friends 
of the independent patients, nor upon the towns and counties 
that send their paupers or pay the cost of patients of narrow 
means. 

Kentucky, Missouri, Louisiana, Tennessee, Mississippi and 
Georgia pay for the support of all their pauper lunatics in their 
hospitals, except that Missouri charges the cost of the clothing 
to the counties. 

In various other ways several States lighten the burden of the 
support of patients in the hospitals, and remove or lessen the 
objections on account of expense that vi^ould prevent the people 
from sending their friends, or counties and towns from sending 
their dependents to these institutions. 

The law of Maine, passed in 1852, says : " Whenever any 
person, unable to pay his or her board and expenses, shall be 
committed to the Maine Insane Hospital, * * * the treasurer 
of the hospital may charge to the State, and the State shall pay 
one dollar per week of said patient's board, and deduct that 
sum weekly from the charge to the patient, city, town, or 
plantation liable for his or her support." 

New Hampshire appropriates three thousand dollars a year 
to pay the whole or a part of the bills of the indigent, and those 



20 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

of limited means who are not paupers, nor ordinarily depend- 
ent, but to whom the cost of supporting a patient in the 
hospital would be inconvenient. 

Pennsylvania " places the rate of board so much below the 
cost, as to prevent any reasonable objection being made by those 
in humble circumstances, who could pay for their friends, or by 
counties and townships which are responsible for their poor, 
to sending them to the institution." The report says this " has 
unquestionably enabled many families in moderate circum- 
stances to partake of the benefits of the hospital who could not 
otherwise have done so." The same report adds : " The 
promptness and liberality with which these appropriations to 
meet the deficiency have been made by successive legislatures 
is the most conclusive proof of their regarding the system as 
subserving the best interests of the whole community without 
being oppressive to any one." 

The law of New York ordains, that " whenever a person in 
indigent circumstances, not a pauper, shall become insane," 
" and his estate is insufficient to support him, and his family, or 
himself if he has no family," then " the first judge of the 
county shall investigate the case," " and he [the patient] shall 
be supported in the hospital, at the expense of the county, until 
he shall be restored to soundness of mind if effected within two 
years, in order," says this humane law, " that he may be 
restored to his family and his estate unimpaired." 

The law of New Jersey orders, " that when a person in 
indigent circumstances, not a pauper, becomes insane and his 
estate is insufficient to support liimself and family, (or if he 
has no family, himself,) under the visitation of insanity," " he 
shall be admitted into the asylum and supported there at the 
expense of the county, until he shall be restored to soundness 
of mind, if effected within three years." 

North Carolina pays the whole bills for the poor in the State 
hospital, and charges eighty per cent, of this cost to the counties, 
and assumes all the responsibility of collecting it. 

Michigan requires that all insane persons, who " have insuffi- 
cient estate to support themselves and their families, under the 
visitation of insanity," shall be admitted to the State hospital 
free of cost as to themselves, but their board is charged to the 
counties. The trustees, in their last report, propose " the 



1862.] 



PUBLIC DOCUMENT— No. 



21 



assumption, on the part of the State, of a portion of the 
expenses of the support of the pauper and indigent insane, to 
the amount perhaps of one or one and a quarter dollars a week," 
in order to lighten the burden on the counties and families of 
limited means, and induce them to send all their patients to the 
hospital. 

In several States, a large proportion of the expense of 
supporting the hospitals is received directly from the public 
treasury, and a small proportion from private or pay patients or 
other sources. From the late annual reports, the facts of the 
following table are derived, showing the amounts and propor- 
tions of income received by the State hospitals from the State 
treasuries and from other sources : 



HOSPITAL. 


Years. 


Amount of 
Monet Eeceived. 


Pkoportion 

PAID BY 




State. 


others. 


State. 


others. 


East Virginia, 


1850-57, 


$245,963 


$30,258 


.89 


.10 


West Virginia, 


1857-59, 


135,000 


49,129 


.73 


.26 


North Carolina, 


1858, '59, 


55,955 


17,867 


.75 


.24 


Georgia, .... 


1857, '58, 


24,412 


7,472 


.76 


.23 


Louisiana, .... 


1859, '60, 


38,750 


10,409 


.78 


.21 


Mississippi, .... 


1858, 


34,000 


4,380 


.88 


.11 


Tennessee, .... 


1855-59, 


167,000 


59,853 


.73 


.26 


West Kentucky, . 


1858 '59, 


52,500 


7,416 


.96 


.03 


Iowa, 


1861, 


16,551 


1,409 


.94 


.05 



South Carolina requires its hospital to receive the pauper 
patients from the several districts, but requires them to pay 
only a part of the cost ; the rest is charged upon the private 
patients, who pay not only for themselves but an excess to aid 
the State or the districts, in the support of their wards. The 
asylum report for 1858 said : " We have now one hundred and 
seven paupers at a cost to the asylum of one hundred and 
sixty-five dollars each, or seventeen thousand six hundred and 



22 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

sixty-five dollars, for which we receive but ten thousand and 
seven hundred dollars. The deficiency amounts to six thousand 
nine hundred and fifty-five dollars, and is made up from the 
profit derived from the paying patients." The grant by the 
legislature was then one hundred dollars a year for each 
pauper. It was then increased to one hundred and thirty-five 
dollars, which is still short of the payment of the cost of the 
advantages which the State receives. The report for 1859 
says : " The average cost of supporting an insane person exceeds 
one hundred and sixty-five dollars per annum." The legisla- 
ture grants one hundred and thirty-five dollars for each of 
the paupers, which still falls thirty dollars short of the amount 
expended by the institution in their behalf. 

The reports do not say whether those States which are quoted 
in the preceding table as paying so large a part of the expense 
of their public hospitals, get any return or profit from the 
board and care of paying patients or other sources, nor whether 
the charge upon the private patients exceeds the actual cost. 
The charge to these varies with the accommodations required 
and attentions given, but there is no evidence that any State, 
except South Carolina and Massachusetts, assesses any part of 
the cost of supporting the paupers upon the others who or 
whose friends pay their bills. 

COMPARATIVE COST OF SANE AND INSANE PAUPERS. 

The cost of the support and care of the insane is every- 
where greater than that of the sane of similar classes. The 
town paupers of Massachusetts in the four years, 1857, 1858, 
1859 and 1861, cost on an average one dollar and fifty cents 
a week. The State paupers in the State almshouses cost one 
dollar and nine cents a week through the four years, 1858 to 
1861. The average cost of supporting and taking care of the 
patients in this hospital was two dollars and seventy-five cents 
a week for the same period. 

There is a still wider difference in the expense of supporting 
the sane and insane paupers in England and Ireland. 

According to the ninth, tenth, eleventh, and twelfth annual 
Reports of the Poor Law Board, and the eleventh, twelfth, 
thirteenth and fourteenth reports of the Commissioners in 
Lunacy, the cost of supporting an annual average of 122,892 



1862.] PUBLIC DOCUMENT— No. 28. 23 

paupers in all the workhouses of England and Wales, was 
sixty-nine cents a week for each, through the four years, 1855 
to 1859 inclusive, while the average cost of supporting the pau- 
per lunatics, in the thirty-eight County and Borough Asylums, 
was two dollars and thirteen cents a week for each, through 
the same period. 

The reports of the Inspectors of Lunatic Asylums and of 
the Commissioners of the Poor in Ireland make similar state- 
ments of the cost of supporting the sane and insane paupers. 
Through the four years 1856 to 1859, the average cost of all 
the indoor paupers in the workhouses, for provisions and 
clothing, was 2s. 2^d., or fifty-three cents a week for each, 
the average expense of supporting the patients in the sixteen 
District Lunatic Asylums was <£20. 5s. lOd., or ninety-seven 
dollars and forty-cents a year, and one dollar and eighty-four 
cents a week for each, through the same period. 

Some allowance must be made in regard to these statements 
of the cost of supporting paupers in the almshouses of the 
State and towns, and in the workhouses of England and Ireland, 
in comparison with the cost of the inmates of hospitals. The 
former include all of every age, nursing infants who cost 
nothing and children who cost very little, as well as adults, 
whereas none but adults are in the institutions for the insane. 

EFFECT OP THE TWO POLICIES ON THE USE OP HOSPITALS AND 
CURE OP PATIENTS. 

The natural effect of the liberal and the economical policies 
of offering the hospitals to the use of the people, is manifest in 
the different ratios of the patients sent, in the early and in the 
later stages of their malady, to the hospitals in Massachusetts, 
Ohio, and Indiana. 

In Ohio 73.7 per cent., in Indiana 70 per cent., in Illinois 
70.5 per cent., and in Massachusetts 64.8 per cent, of the patients 
in their State hospitals were sent in the first year after they 
were attacked. 

As a necessary consequence, those States which sent the 
largest proportion in the early and curable stage, received back 
the largest proportion in health and power of usefulness, and 
had the smallest proportion left in confirmed immovable lunacy 
to be supported for life by their estates or the public treasuries. 



24 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

In the three public hospitals of Ohio, 64.59 per cent, of all 
that were sent to them were restored, and 43.40 per cent, 
remained insane for life. In Massachusetts, 44.05 per cent, 
were restored, and 55.95 per cent, remained a life-burden on 
the people. 

It must be remembered, in this connection, that the reports 
of admission into the hospitals of Massachusetts include both 
the foreign or State paupers, who are admitted free, and the 
American paying patients who are charged more than the cost 
for their support. If distinction were made in the reports, and 
it were shown how many of each of these two classes were sent 
in the several stages of their disorder, it would, without doubt, 
be found that a much larger proportion than 35.2 per cent, of 
the native patients were kept out of the hospital until their 
disease become more difficult and even impossible to be 
removed. 

It is not necessary to go abroad to find the connection between 
the terms of admission and support, and the readiness with 
which people avail themselves of hospital privileges for the cure 
or custody of their insane friends. We have proof of this in 
our own daily experience. Our Irish patients go free and 
stay without cost, and they are sent early and have the best 
opportunities of restoration. The Americans go at their own 
cost, and pay all and more than all of the expense of their 
support, and consequently a large proportion are kept away, 
some for months and years, as long as their friends can endure 
or take care of them, and many for life, because their friends 
lack courage or money to take due advantage of the means of 
restoration so largely provided in the State. In 1859, 97.5 per 
cent, of all the foreign and only 58 per cent, of the native 
lunatics then living in the State had been sent to some hospital. 

The proportion of patients restored,|out of all admitted to 
the hospitals, is twenty-three per cent, greater in Ohio than in 
Massachusetts. Now no one will suppose that the hospitals of 
Ohio are managed with more skill than those of this State. 
But this difference in the results of their labors is due to the 
difference in the proportion of patients sent in the curable 
stage of their disorder. 

Looking upon this matter merely as a question of political 
economy, in its bearing upon the remote as well as present 



1862.] PUBLIC DOCUMENT— No. 28. 25 

means and prosperity of the State, it is plain that there are 
important advantages on the side of the free and open system 
of managing these public charitable institutions. They send 
back to society a larger proportion of workers, producers, self- 
supporters and contributors to the public treasury, and leave 
a smaller proportion of the useless and burdensome class. 
Inasmuch as they have a better or more available material to 
work upon, they produce a more successful result, and convert 
a larger proportion of costly men and women into profitable 
members of the body politic. The Worcester and Taunton 
hospitals have received 8,490 and restored 3,740 to health. 
If these could have been sent at as early a stage of their disease 
and as large a proportion restored as in Ohio, then twenty- 
three per cent, or 860 would have been added to the useful and 
self-sustaining citizens sent back to the world, and as many 
taken from the class that has been or must be supported and 
cared for, through life. 

It must be farther considered that it costs no more to admin- 
ister these institutions on the free principles of Ohio than on 
the economical principles of Massachusetts. Both there and 
here, provisions, groceries, clothing, labor, salaries, would be 
the same under either system. The only difference is in the 
way in which the cost is assessed upon the people. Here it is 
imposed upon those who receive the immediate personal advan- 
tage, many of whom are the least able to bear it, and always 
at a period when they are the weakest and any burden is 
distressing. In the other case, this cost of rescuirig the people 
from permanent insanity, like the cost of schools, roads, 
government, justice and police, is assessed upon the whole com- 
munity, in the proportion that each one is able ]to pay. And in 
both cases, it comes out of the aggregate property and income 
of the Commonwealth. 

The Trustees do not now propose that Massachusetts should 
adopt the plan of Ohio, Indiana, and the other States that sup- 
port their hospitals entirely out of the public treasury, and 
assume the whole burden of these public institutions, but they 
have thought it proper to present to the government and the 
people the various methods adopted by other States for the 
support of their lunatic establishments, and they commend 
these to the careful consideration of the legislature, to see 
4 



26 LUNATIC HOSPITAL AT WOECESTER. [Oct. 

whether, by any different plan, our hospitals may be made 
more available and useful to our own people, and power and 
opportunity given them to diminish this standing army of near 
three thousand lunatics, which has, thus far, been kept full 
and perhaps increased by annual recruits of the neglected and 
uncured patients. 

WORKING CAPITAL. 

The hospital labors under embarrassment from the want of a 
working capital, which would enable it to buy the materials 
needed for use and consumption with cash, and at best advan- 
tage. This necessarily grows out of the credit system, which 
the law and custom have established for its management. The 
law requires the towns and individuals to pay quarterly, and 
now offers the same terms in behalf of the Commonwealth. 
The hospital is therefore obliged to advance the entire cost of 
supporting the institution for three months, before it receives 
any return from any source. It must provide and serve out 
groceries, provisions, and clothing ; it must employ officers, 
attendants, and servants, and for these it must pay in money, 
or obtain credit to the amount of one-quarter of the annual cost 
of supporting the establishment, for the use of its inmates 
and for the benefit of the State, towns and families, that send 
patients to its care, and are responsible for the payment of 
their bills. Now the hospital has no money nor capital applica- 
ble to this purpose. All the property it possesses is invested 
in lands, buildings, furniture, and stock, all of which are 
necessary, in their present form and position for the operations 
of the institution, and cannot be converted into available funds. 
Nor is the hospital in the possession of any legitimate means 
of earning or otherwise creating a working capital. Its only 
sources of income are the receipts for the board and care of 
three classes of patients, on conditions prescribed by the law. 
By the terms of the law, the hospital must board, clothe and 
take the care of the State paupers for two dollars and sixty- 
two cents a week, which is less than the cost, and therefore at 
a loss, and would run the hospital in debt to the extent of the 
deficiency. It must take town paupers " for a sum not exceed- 
ing the cost of their support." It may charge the independent 
patients such a price as the trustees may think proper. The 



1862.] PUBLIC DOCUMENT— No. 28. 27 

first class is taken at a loss ; the second without profit ; and 
the third is left by the law without limit of charge, except that 
they are virtually required to pay not only for themselves as a 
body, but for the deficiency of the State's payment for its 
paupers. Considering that this class of paying patients is a 
small one, not more than 23 per cent, of the whole, and that 
they are already charged for more than they receive, it would 
be invidious and inexpedient to increase their payments for the 
purpose of gaining a surplus. 

As then the hospital has no working capital, nor any means 
of creating it, and yet such is necessary for the operations of 
the establishment ; the only alternative is to use the capital of 
others, either by borrowing money and paying cash for all that 
is bought, or to buy on credit, by inducing the farmers, grocers 
and other dealers, whose provisions and goods are needed for 
consumption, and the persons employed, to allow the institution 
to use their property and services during each quarter in 
advance of payment. 

Following the universally recognized wisdom and economy 
of buying with cash, the hospital has generally borrowed from 
the banks sums of money to enable it to pay in part, at least, 
for the goods, wares, and provisions as they were bought, and 
the services of the attendants, mechanics, and others as they 
were rendered. In either case, whether the hospital buy on 
credit or borrow money and buy with cash, in as far as it gives 
credit it must obtain credit, and be in debt to the extent of the 
cost of whatever material or service is furnished to the patients, 
in the intervals of the quarterly or other payments. 

At the end of the last quarter, September 30, 1862, the 
hospital owed, 

For money borrowed, $4,000 00 

To grocers, traders, farmers, and others for supplies, 8,500 00 
To officers, attendants, and laborers, . . . 2,800 00 



$15,300 00 

There was due to the hospital for board of patients. 

From the State, $13,000 00 

From towns, 5,360 00 

From individuals, 4,232 00 



,592 00 



28 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

The amount of debts due from the hospital is, in fact, the 
working capital, which should be owned by the institution, but 
is really owned by the people who supply the materials or the 
labor for its operations. 

In this respect, the hospital is less favorably situated than 
similar institutions in some other States. The laws of New 
York and of New Jersey expressly order, that their lunatic 
hospitals shall buy with cash and not on credit. And New York 
grants money to the Utica hospital to enable it to do so. The 
laws of some of the States and the regulations of some hospitals 
require, that all payments for the board and care of patients 
shall be made, some quarterly and some half-yearly, in the 
advance. 

The financial relations of the hospital to the Commonwealth 
differ very materially from those of other public charitable insti- 
tutions, which receive support from the public treasury. The 
State makes its payments to the Institution for the Blind, the 
Eye and Ear Infirmary, and the School for Idiots, quarterly in 
the advance, for the support of beneficiaries in those establish- 
ments through the next following term. These grants are of 
specified sums, and, excepting that to the Idiot School, they are 
given only on the general condition, that they shall be applied 
to, and expended for, the benefit of those institutions. The Idiot 
School is required to take a certain number of children recom- 
mended by the governor, in consideration of the money received 
from the State. No bond is exacted from either of these institu- 
tions that the money shall be, nor any account required to show 
that the money has been, expended as directed. But the money 
is paid regularly on the quarter days, in the generous confidence 
that it will be used in accordance with the designs of the 
legislature. 

The State pays the bills of the State almshouses for the sup- 
port of its sane and insane paupers in those establishments 
monthly and promptly, and moreover the law authorizes the 
treasurer to pay to the superintendents five hundred dollars in 
the advance to enable them to make their monthly purchases. 
Thus the State supplies all these institutions with a working 
capital, and they are not obliged to ask credit of banks, mer- 
chants or farmers, who supply their wants. 



1862.] PUBLIC DOCUMENT— No. 28. 29 

Like the State almshouses, the hospitals are not separate 
individualities. They have no independent existence. They are 
simply parts of the Commonwealth. They are owned by the 
State, and the trustees are merely its agents, acting in its name 
and for its advantage ; and, it should be, solely on its responsi- 
bility. For this purpose they hold and use the Commonwealth's 
property which they can neither alienate nor pledge. 

Liasmuch then as no institution can be carried on without a 
working capital which must be either owned or hired, and inas- 
much as capital never works gratuitously for those who do not 
own it, but always exacts payment either in interest on money 
loaned or in the increased charge for goods sold on credit over 
those sold for cash, the more liberal policy practiced by the 
State, in the support of its wards in the institutions for the Blind 
and Idiots, and in the maintenance of its sane and insane paupers 
at the State almshouses, is a wiser and more economical one 
than that which it has adopted for the support of its insane 
paupers in the lunatic hospitals. 

However proper or expedient it may be for the State to allow, 
or, by any legislation, to make it necessary for, its agents to 
borrow money or obtain credit, in order to effect the purposes 
entrusted to them by the law, still considering that the cost or 
rent of the working capital thus obtained, which is six percent, 
if in loans from banks, and as much and probably more if in 
purchases on credit, — must be included in the needful expendi- 
tures for the support of the hospital, and be charged with other 
costs to, and be paid by, the towns and people of the Common- 
wealth, it becomes a questionable economy for the State to 
obtain it at these rates through its agents, the trustees, when it 
can always obtain from the banks, through its own treasurer, 
all that it wants for all its purposes, at five per cent. 

CRIMINAL INSANE. 

The experience of nearly thirty years' operation of this 
hospital, and the careful observation of the successive boards 
of trustees, of the superintendents, and others engaged in the 
management of this institution, all go to establish and to 
strengthen their conviction, that it is impolitic and wrong to 
place insane criminals in the same rooms, wards, or even 



30 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

establishments, with the honest and untainted patients, and 
require them to live together. 

No one will assert that the prison is a proper place for a 
lunatic. And it is equally clear that the hospital created for, 
and occupied by, patients from general society, is not a proper 
place for a criminal. Admitting that the insane convict should 
be removed from the one, it by no means follows that he 
should be carried to the other. Whether viewed in the light 
of humanity, or of economy, it is better that he be detained in 
his prison than be admitted into the hospital; for, at the worst, 
if he be not removed, he may remain insane for life for want 
of the means of healing, while, if he be placed in a ward filled 
with other and respectable patients, he may be an obstacle to 
their restoration, and prevent some, perhaps many, from ever 
regaining their health. The question is not simply whether 
the insane convict shall or shall not have an opportunity of 
being healed, but whether an attempt shall be made to save a 
criminal and a worthless citizen, by the peril, and perhaps the 
sacrifice of the restoration of some, possibly many, honest and 
valuable men who must live and associate with him in the 
hospital. 

Lisanity disturbs the mental health of its victims in various 
ways. Among the most common of these morbid conditions is 
the exaltation of sensibility, which makes the patients timid, 
anxious, suspicious, irritable, and even sometimes quarrelsome. 
Some are depressed in spirit, and almost crushed with a sense 
of imaginary sinfulness, or an intense consciousness of unworthi- 
ness. To meet these morbid conditions of the patient, the 
hospital managers endeavor to bring the most favorable influ- 
ences to act upon him ; they surround him with every thing 
soothing, gentle, and acceptable. They provide every thing to 
cheer, encourage, and elevate him, and inspire him with confi- 
dence that his new position in the hospital is all for his good. 
They arrange all the circumstances, select the associates, and 
control the conversation ; they determine the scenes that may 
be visited, and the ideas that may be presented, according to 
their influence on the over-sensitive and disordered mind. 

It is among the best established principles of the treatment 
of insanity, that a patient should be opposed or interfered with 
as little as possible, consistently with his good ; that his notions 



1862.] PUBLIC DOCUMENT— No. 28. 31 

and arguments should not be disputed, his wishes and incli- 
nations indulged, so far as they can be, safely, his opinions 
and tastes treated with respect, when they are proper, but 
always with tenderness, and that every thing should be done to 
encourage his self-respect. 

Among the patients in the hospital are always the members 
of our own families, our parents, our brothers and sisters, our 
sons and daughters. Prom their childhood they have been 
taught to love virtue and abhor vice, to avoid even the appear- 
ance of wickedness, to associate with good, and shun evil com- 
pany. They have been accustomed to run from the base, the 
degraded and the corrupt. Their sensibilities, their tastes, and 
their consciences, have been cultivated and shaped in accord- 
ance with their education and their habits. They lose none 
of these in their disease. Insanity tends to exalt and intensify 
them. They become morbidly sensitive, and even irritable in 
respect to them. 

To put a convict among such patients as these, to compel 
them to associate with him in the same halls, to eat at the 
same table, to hear his coarse and offensive conversation, his 
vulgar slang, his profanity, his sneers at religion and honesty, 
and religious and honest men, his contemptuous jeers at what 
they have been taught to regard with reverence, his tales of 
cunning and crime, of successful and unsuccessful villany ; all 
this is in contravention of the best principles of managing 
mental disorders, and diminishes, if it does not counteract, the 
influence of the curative measures that may be used. 

It is at least a singular view of governmental responsibility, 
that, looking for the highest good of the community, and the 
moral and spiritual welfare of all its members, educates children 
and youth to walk in the ways of holiness, and encourages all 
of every age to associate only with the pure and the upright, 
when they are well and able to choose for themselves, but gives 
them felons for familiar companions, when they are broken 
down with mental disease, and too weak to choose their company. 

The hospital is provided for all the families of the Common- 
wealth. In the chances of life any one of us may be exposed 
to the accidents or influences that cause insanity, as well as to 
those that cause fever. Any of our children may be afflicted 
with disease of the brain, as well as with disease of the lungs. 



32 LUNATIC HOSPITAL AT WOKCBSTER. [Oct. 

A daughter, the idol of her parents, becomes insane. Her 
anxious and almost agonized friends take her to the hospital, 
and leave her there, in confidence that her intensely sharpened 
sensibilities will be soothed by the gentlest associates, the 
tenderest language, and most refined manners of those that 
surround her ; but she is shocked to find in the same hall with 
her, perhaps sitting next to her at table, a convict from the 
house of correction, a woman that had previously been a keeper 
of a brothel, and still retains her vulgar obscenity, and her 
lascivious ways. Or a son, trained in the same way, may 
become deranged on the subject of religion. Self-chastening 
and downcast, he enters the ward, and finds among the inmates 
a burglar from the State prison, who has been educated and 
practiced in all manner of wickedness, and takes a pleasure in the 
display of his own corruption, and in offending the sensibilities 
of such as he considers to be over-nice and fastidious. 

Among the insane, there are always some whose recovery is 
doubtful, whose chances of mental life or death hang like a 
balance, so evenly adjusted, that the slightest weight will 
turn the scale, the least disturbing cause will decide the issue 
against them. These are watched by the officers and attendants 
in the hospitals, with the tenderest solicitude, and guarded with 
anxious vigilance to protect them from every unfavorable influ- 
ence. To such as these, standing on the verge of mental death, 
the presence and companionship of a felon from the prison may 
be sufficient to overthrow them, and determine the fatal course 
of their disease. 

These are parts of the real and unavoidable life of our public 
hospitals, and of all in every country that admit the two classes 
of honest and criminal patients. These descriptions and com- 
plaints are found scattered through the successive reports of 
such hospitals in America and Great Britain, and the reports 
of the commissioners in lunacy of England, and inspectors of 
hospitals in Ireland. 

In an economical view, the admission of convicts into the 
hospitals is equally objectionable. These men have been and 
are to be prisoners. When they shall be restored to health 
they are not to return to the free world and their homes, but 
to the prison whence they came. They have, therefore, every 
motive to attempt to escape while they are in a weaker place of 



1862.] PUBLIC DOCUMENT— No. 28. 33 

detention. They must then be securely confined, and guarded, 
and watched with extraordinary vigilance, during their whole 
residence in the institution ; for the hospital is made respon- 
sible for them. Their previous life and training, their character 
and habits, render this responsibility exceedingly difficult to be 
borne. They have been used to dissimulation, the practice of 
deceit, and assumption of false appearances in the presence of 
policemen and watchmen. They have studied the ways of 
overcoming obstacles, of picking locks, undoing fastenings, and 
moving bolts ; and with their experience in finding their way 
into forbidden places, they are constantly seeking to find their 
way out through the doors, windows, or walls, that are only 
sufficient to hold the honest and appropriate inmates of the 
house. 

No confidence can be placed in their co-operation with the 
government of the hospital ; no reliance on their apparent con- 
tentment, or professed desire to remain and enjoy the benefits 
of the institution. Wherever they may be, whether in the 
house or abroad, in ward, dining-room, bathing-room, shop, or 
field, no relaxation of the rigid watchfulness can be allowed. 
The greater security of locks and bars and the severer disci- 
pline, which their presence makes necessary in any ward, 
applies to all the inmates, and lessens their freedom and 
increases their discomfort and discontent. The addition of 
a patient of this class increases the cost of managemen,t 
probably two or three times his due proportion. The two 
dollars and sixty-two cents which the State pays for his board 
does not cover half, hardly a third, of the addition which his 
presence makes to the expense of supporting the institution. 

There are now in the hospital ten insane criniinals. Martin 
Bumpus, George Freeman, Edgar Snow, John Connor, John 
Donnegan and Matthew Watson, froni the State prison, and 
Patrick Mulligan, Frank Norton, John Smith and Henry Wil- 
liams, from the houses of correction. In addition to these male 
convicts, several females have been sent from the prisons to the 
hospital. One was from the jail in Worcester, to which she had 
been committed for theft and various misdemeanors. Another 
was from Cambridge jail, to which she was committed for 

5 



34 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

drunkenness. Two others have been, at times within the year, 
confined in the lock-up for street walking.* 

Nearly or quite all of these men have, at some time, escaped 
from the hospital, and have been pursued and retaken. When- 
ever any one of this class of patients escapes from the rooms 
within, or from the attendants abroad, at once the legitimate 
and appointed administration and work of the hospital are 
interrupted, and all are devoted to the one absorbing purpose 
of recovering the fugitive. All the available force of the insti- 
tution, that can be spared, is withdrawn from their appropriate 
work ; the officers forsake all other claims upon their attention, 
the number of attendants is reduced to the lowest limit in the 
wards, and as many as possible sent in pursuit of the prisoner. 
If these means are not sufficient to retake him, then assistance 
is obtained from abroad. Sheriffs are employed, policemen and 
constables are called into requisition, neighbors are asked to 
aid, and advertisements are sent to the papers. 

Beside the loss of the services of the officers, attendants and 
servants of the hospital, who are thus taken from their appointed 
work, and whose salaries and wages must go on while they are 
hunting escaped convicts, as well as when they are taking the 
care of patients, the sheriffs, policemen and runners must be 
paid for the time they give and the service they render for this 
purpose. For this aid from abroad to pursue and retake elopers, 
Donnegan has cost the hospital twenty-five dollars, and Freeman 
about the same. Mulligan has cost about twenty dollars, and 
Norton a smaller sum. Some have been retaken by the efforts 
of the hospital officers, attendants and servants alone, and their 
recovery cost only the time and wages of those engaged and 
sent in pursuit, and no money was specifically paid for this pur- 
pose. All of these expenses of pursuing and retaking escaped 
convicts, have been paid by the hospital, and, of course, charged 
to the other patients, as a part of the cost of supporting the 
establishment. 

Snow has not escaped, nor has he made any serious attempt 
to do so ; but, on other accounts, he is worse than either of the 

* Since this report was written, and before it was printed, two other women 
have been received from the prisons, to which they had been committed for 
street walking. One was from the house of correction at South Boston, and 
the other from the jail in Cambridge. 



1862.] PUBLIC DOCUMENT— No. 28. 36 

others, by his persistent attempts to corrupt and disturb the 
other patients in his ward, and diffuse among them a knowledge 
of the ways of crime, by relating tales of his own and others' 
lives of lawlessness and wickedness, and boasting of his daring 
adventures, his cunning tricks, shifts and evasions in the pur- 
suit of his vocation, and escaping from detection. 

Whenever a convict patient has once succeeded in getting 
away from the house or the attendants, altliough retaken and 
brought back, yet he is all the more induced to try liis fortune 
again in the same way. He has tried the house and found its 
weakness and its insufficiency for the confinement of such cun- 
ning and desperate men as himself, and he feels confident that, 
as the house is not, and cannot be made any stronger, he can 
do the same again, and trusts that he shall be more lucky in 
eluding pursuit when he shall be once more abroad. 

Tlie hospital government, conscious of having failed once, 
and fearful of a second failure, find it necessary to increase 
their vigilance and watch with more intensity ; and tlie care 
and attention of the attendants, which are needed and are other- 
wise given to soothe the distresses, calm the excitements, 
restrain the waywardness, and enliven the torpid powers of 
their patients, are necessarily withdrawn, in great measure, 
from these appropriate objects, ami given to the unceasing 
supervision of the convict, and guarding against his second 
escape, which is then and there the most threatening danger. 
Consequently the care of such a patient, which is, at first, much 
more troublesome and expensive than that of the honest inmates, 
becomes still more costly, and his presence is a still greater 
burden on the operations of the institution after he has once 
run away and been brought back.* 

The admission of convicts to the common lunatic hospitals 
is then, in every way, bad. 

* On the evening of the 24th of October, while the attendants of the ward 
were occupied in their usual duties connected with the patients, Bumpus, one 
of the convict patients, went into the bathing-room, to which all the inmates 
have unrestricted access, forced out the grating of the window, jumped to' the 
ground and ran away. Although his escape was soon discovered and the alarm 
given, yet as it was dark, the direction and course of his flight could not be 
traced. The usual means were then taken, the household officers and many of 
the attendants were called from their ordinary work, and gave themselves to 
the business of pursuing the eloper. Sheriffs, policemen, and others were 
employed, and sent on the same errand, and, after a diligent search, in various 



36 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

It is false to humanity to compel the children of virtue to 
live in the same halls with the children of wickedness. It is 
unphilosophical to allow such offensive and disturbing influ- 
ences to reach and act upon the delicate sensibilities and irri- 
table temperaments of the insane. It is bad political economy 
to put to hazard the chance of restoring honest patients and 
increase their danger of permanent insanity. 

After years of complaint from the managers of the Irish 
hospitals, the government was persuaded to build a hospital 
exclusively for the criminal lunatics at Dundrum, near Dublin. 
This has been in successful operation twelve years. 

New York built a similar establishment at Auburn, and 
opened it in 1859. This has been satisfactory. It has done 
much good to its inmates, and given great relief to the State 
hospital at Utica. England has just now built a large asylum 
for her criminal insane. Connecticut prepared a building for 
the same class of patients, at Weathersfield, in connection with 
the State prison, but for some reason not here known it has 
never been used for this purpose. 

Pennsylvania is now taking steps to provide such an estab- 
lishment for her criminal lunatics; and Rhode Island authorizes 
the governor to provide for the proper treatment of such 
patients wherever he may think proper. 

directions, for four days, he was discovered in Wareham, in this State, and 
brought back to the hospital on the evening of the 28th. 

Beside tlie cost of wages and the loss of time, thought and anxiety, of the 
officers and men of the house, the direct cash expense of recovering Bumpus 
was seventy-six dollars and seventy-five cents. 



Paid to one sheriff, for time, travelling expenses and assistance 

employed by him, 

to another officer, for time and travelling expenses, . 
to two other men, for time and travelling expenses, . 
to carpenter, for repairing breach in wall and window, 
to Worcester Spy, for advertising, .... 
to Worcester Transcript, for advertising, . 



|50 00 

10 00 

10 00 

3 00 

1 25 

2 50 

$76 75 



To this should be added the cost of materials, iron grating, lumber, &c., used 
in repair, and also the cost of postage and telegraphing in aid of the search. 
By the law of 1862, the State pays this bill. 

It is plain that it is very expensive to the Commonwealth or its people, to 
thus keep its convicts in a place so unfitting as the lunatic hospitals, for their 
detention. 



• 



1862.] PUBLIC DOCUMENT— No. 28. 37 

The Trustees would now earnestly commend this matter to 
the careful consideration of tlie legislature, and urge them, if 
possible, to relieve the hospitals of this great and costly burden. 
They propose, that the governor and council be authorized to 
make provision for the custody and treatment of the insane 
convicts of Massachusetts, in any suitable place in or out of 
the State ; provided they think it for the interest of the Com- 
monwealth to do so. 

The New York Criminal Lunatic Asylum is sufficiently large 
to accommodate twice as many patients as the State furnishes 
of this class, and many more than the State probably will fur- 
nish for years to come. A larger number would allow a better 
classification, and could be more easily and advantageously 
managed. It has been intimated to this Board, by some person 
having official connection with that asylum, that the managers 
would be glad to negotiate with the authorities of this or any 
other State, to receive and treat patients of this class, on about 
the same terms as are paid for the patients of New York. 

It costs loss to manage this class in an asylum fitted for 
them, like that at Auburn, than it does for the same persons in 
an ordinary hospital, where the deficiency of strength of 
the house must be compensated by the increase of custodians 
and attendants. The last report of the Auburn asylum says, 
that " the average cost of each patient for the year past, in- 
cluding officers' salaries and the patients' clothing, has been 
about $3.45 a week," which is considerably less than the cost 
of supporting the patients at Utica. Add to this some reason- 
able charge on account of the rent, interest on investments, not 
charged to the account of the New York patients. Add, also, 
the cost of transportation, from Massachusetts, and even the 
expense of an occasional visit of the governor, or members of 
the council, or committee of the legislature, still the expense 
of maintaining our criminal lunatics in the asylum at Utica 
would be much less than it really costs the people of this State 
to keep them in the Northampton, Taunton, and Worcester 
hospitals. It would then be an economical as well as a humane 
measure to provide for the care of these patients in the New 
York Criminal Lunatic Asylum, or in any other way different 
from that now adopted in this State. 



38 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

LABOR. 

As in former years, the patients have been employed in as 
many ways and as much of the time, during the last year, as 
the means and opportunities of the hospital allowed. A few 
were employed in all the working days of the year, as other 
men and women are abroad. But most of them worked less 
regularly, through various portions of the hours of the day, 
and various proportions of the days of the week. A record is 
daily made of the number of patients that have worked, and of 
the ways in which they were occupied. Counting all that were 
employed in part or the whole of the time, the number of men 
varied from twenty-five in March, to thirty-seven in February, 
and there was an average of slightly less than thirty (29|) at 
work in some part of each month of the year. This is 14.6 per 
cent, of the average number of males in the house. The number 
of women varied from seventy-one in September, to ninety-four 
in Marcli, and the average for the year was eighty-two and a 
half; which is 41.6 per cent, of the average number of females 
in the house. 

In course of the year, seven thousand five hundred and 
twenty-two and a half days' work were done by the men, and 
thirteen thousand six hundred thirty-nine and three-quarters 
by the women, making twenty-one thousand one hundred and 
sixty-two and a quarter days' labor performed by the patients of 
both sexes in the hospital. Through the three hundred and 
twelve working days of the year, there was a number equal to 
a constant average of three men employed in the kitchen, where 
they did nine hundred and sixty-five and a half days' work ; an 
average of three and two-thirds did eleven hundred and forty- 
two and a half days' work in the bakery ; an average of four 
and a half did fourteen hundred and three and a half days' 
work in the laundry ; an average of nine and a half (9.58) did 
twenty-nine hundred and ninety-one days' work on the farm, in 
the garden, yards, stables, &c. The carpenters worked four 
hundred and eleven days ; the painters two hundred and 
seventeen days ; mattress-makers three hundred days ; and 
men waited on masons twelve days. An average of a little 
more than two female patients did seven hundred and forty- 
eight and a half days' work in the kitchen ; an average of 
slightly more than eleven did three thousand four hundred and 
fifty-nine and three-quarters days' work in the laundry ; a con- 



1862.] PUBLIC DOCUMENT— No. 28. 39 

stant average of fifteen performed four thousand six hundred 
and eighty-four days' work in the sewing rooms, and a some- 
what larger average (15.34) did four thousand seven hundred 
and forty-seven days' work in the halls and in their own rooms, 
sewing, knitting, embroidering, and in manifold other ways 
such as females happily know how to occupy themselves in. 
Comparing these numbers with the average monthly number of 
patients in the hospital, 401, the records of labor show that 
11.8 per cent, of all the week days of the males and 22 per 
cent, of all the week days of the females were occupied in the 
various employments which were provided for them in, or 
connected with, the institution. The proportion of females 
employed was almost twice as great as that of the males. This 
is due, in some measure, to the more ready willingness and 
facility of the women to occupy their hands, but mainly to the 
more abundant means and opportunities of occupation which 
has been offered to them suited to their tastes and habits, and 
accessible and available, at all seasons and in all kinds of 
weather. 

The experience of the labor of the past year was similar to 
that of previous years, and was satisfactory : so many men and 
women were employed comfortably, and generally contentedly, 
and no accident happened, no harm, nor injury given to person 
or property, from the instruments placed in the hands of these 
lunatics. It was not to be expected that these people, of iinbal- 
anced minds and sometimes of confused brains, would never 
make a mistake in the application of their forces, and labor 
always as steadily, skilfully, and successfully, and with as little 
injury to the material on which, or the instruments with which 
they worked, as sane men and women do. But whatever short- 
comings there might have been in the amount and perfection of 
their work, as compared with that done by other laborers else- 
where, it has not been sufficient to throw a doubt on the pro- 
priety and expediency of continuing, and, as far as possible, 
increasing this system of occupying and treating patients. 

Man's faculties and powers of body and mind were given him 
for use. Action for a part of the time is his natural state, and 
unbroken inactivity is his unnatural state. The health of man's 
whole system, and the development and maintenance of all his 
forces in their best condition, require that all his organs should 



40 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

be exercised. This was ordained in the beginning, and has 
been shown to be the inseparable law of our being ever since, 
and those who sustain their health obey it, and generally by 
their own volition. But when men become insane, their 
powers of self-propulsion and of self-direction are impaired in 
various degrees, and in some entirely lost. Some are torpid 
and lead hardly more than a vegetable life, and only want to 
be left alone. From these, upward, through various degrees of 
quiescence and activity, to high excitability, there are all grades 
of patients. They need some encouragement, persuasion, 
urgency, and even authority, certainly some opportunity, to 
induce them to use their powers and to labor, and some 
sympathy and guidance to enable them to apply their powers 
to definite purposes. 

The first idea of a hospital was that of a place of confinement, 
where the lunatics could be safely kept from the chance of 
being injured and the opportunity of doing injury. It held and 
fulfilled simply a negative responsibility, the prevention of 
evil. Under judicious treatment, excitements were generally 
repressed, and the wards were tolerably and sometimes com- 
pletely quiet. This repression extended beyond the morbid 
excitability, and reached even the healthy powers that ought to 
have been in action. There was nothing for the hands to do, 
and little for the brain to act upon. Hence listlessness and 
torpor reigned, and nothing was offered to prevent, but much 
to accelerate, the downward progress of those who were tending 
to dementia. Many of the patients were inclined to sit or lie 
in the halls and on their beds, if permitted ; they loved to 
crouch in dark corners, where no noise would reach, and the 
light would not disturb them. Others walked the halls, some 
amused themselves with scratching the walls, whirling the 
tongs, or in other trivial occupations within their reach. Occa- 
sionally there would be a i-eaction of the morbidly repressed 
nature, and an outbreak of excitement would happen, and 
disturbance produced by one or more of the inmates. 

Here then was and is wanted something to impart life and 
action to these sleeping powers, something to occupy them in 
such sane ways as the patients will consent to be occupied in. 
Amusements, games, bowling alleys, billiard tables, gammon, 
checkers, cards, and other means of light and pleasant occupa- 



1862.] PUBLIC DOCUMENT— No. 28. 41 

tiun have been provided, and used with success so far as they 
go. The patients spend many hours at these games and play 
them properly, and while doing so they keep their faculties in 
sane action. 

But all the amusements that can be brought into the hospital 
fall short of the wants of occupation. They are insufficient to 
occupy all of the patients, or even any of them, through as 
many hours of the day and as many days of the year as they 
are willing to, and can, be employed with advantage to them- 
selves. 

The American and Irish people, especially those classes from 
which our public hospitals receive their patients, are utilitarians. 
They work much and play little. According to their training 
and habits, they busy themselves on farms, in shops, factories, 
and elsewhere, working upon things that require definite and 
successive processes, and have a valuable end and useful pur- 
pose. In these ways, they get their greatest sum of enjoyment. 
Work is their permanent occupation, and amusement is their 
occasional relaxation. They love to spend their few hours a 
month, some more and many less, in bowling and dancing, in 
playing cards, chess, gammon, or in some other amusement, 
and want no more. But they spend their eight, ten, or twelve 
hours a day, from Monday to Saturday, from January to Decem- 
ber, from the beginning to the end of their vigorous lives, in 
cultivating the earth, making shoes, building and repairing 
houses, attending machinery, &c., and ask for no change. 
Amusements serve but to give a cheerful tone to the graver 
business of life, as condiments give a pleasant relish to sub- 
stantial food, but both would be wearisome and offensive if 
used alone. 

Although insanity perverts the mental actions, and often the 
tastes and moral sentiments, yet it does not extinguish them. 
Although it suspends, in various degrees, some of the intellec- 
tual and physical faculties, it seldom suspends all, and rarely 
destroys them. The lunatic retains, partially or entirely, his 
capacity for labor, both with his muscles and with his brain. 

It is the great business of the hospital and the managers of 

the insane, first, to give healthy employment and exercise to all 

the powers and faculties that are not lost, and thus keep them 

alive and give them strength ; second, to give direction to the 

6 



42 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

powers and inclinations that are perverted ; and thirdly, to 
raise into action and give life to those that are dormant or dead. 
On this principle the English, Scotch, and Irish managers of 
the insane have endeavored to occupy their patients in such 
employments as they had been accustomed to, when in health, 
or in such as are found, on trial, to be agreeable to them and 
to which they are willing to give their hands and attention. 
In this the Hospital Superintendents of Great Britain and 
Ireland have been singularly successful. Beside the work on 
the land, which seems to be everywhere adopted, they have 
introduced into their public asylums, a great variety of mechan- 
ical trades, with shops, tools, and machinery, for the use of 
their patients. The plan of every new public asylum includes 
a series of shops with their appropriate accompaniments as 
certainly as it includes lodging and dining rooms. 

The annual British and Irish reports state the number of 
men and women employed and the days' work done in each 
trade, or field of occupation. In the various asylums there 
are male patients daily working as — 

Bakers, Masons, 

Blacksmiths, Mat-makers, 

Bookbinders, Mop-makers, 

Brickmakers, Oakum-pickers, 

Cabinet-makers, Painters, 

Carpenters, Plumbers, 

Coir-pickers, Printers, 

Engineers, Shoemakers, 

Farmers, Tailors, 

Flock-pickers, Tinmen, 

Gardeners, Turners, 

Glaziers, Upholsterers, 

Macliinists, Weavers. 

These are not all in any one, but they are all in the several 
estabhshments of the three kingdoms, and for all of them 
provision is made of rooms, and the usual means and facilities 
of operation, in, or in connection with, the various asylums. 

Beside household work, sewing, knitting, &c., which the 
women do in our hospitals, they are also occupied in bonnet- 
making, hat-making, plating straw, and picking flock. Some 



1862.] PUBLIC DOCUMENT— No. 28. 43 

are sometimes employed abroad, hay-making and in other work 
which females in Europe occasionally perform. 

In these ways, a large part of the patients of both sexes in 
the lunatic asylums of Britain and Ireland are constantly 
occupied, like persons of ordinary and healthy life, through 
eight or ten and some through twelve hours a day. Tiiey go 
to their several places of labor and work steadily through the 
hours appointed for them. 

In the asylums that report these operations minutely, the 
constant average proportion of the male patients at work 
varied, from 37 per cent, in Stafford, and 50 per cent, at 
Colony Hatch, London, to 75 per cent, in Lancaster, and 95 per 
cent, in Edinburgh, and the average of the whole seventeen 
asylums was 67.2 per cent. 

The average proportion of the females employed varied from 
42 per cent, in Essex, and 49 per cent, in Stafford, to 79 per 
cent, in Lancaster and Norfolk, and 80 per cent, in Edinburgh, 
and the average in all these asylums was 69,2 per cent. 

The others remained in their rooms or in the wards, for 
apparently good reasons, which are stated, with the number 
that were kept from labor by each. 

MALES. 

Excited with restraint, Quiet, 

Excited without restraint, Aged and Infirm, 

Excited in seclusion. Too Low-Spirited, 

Excited without seclusion, Too Little Mind, 

Sick, Able but Unwilling. 
Sick in bed, 

The conditions of the unemployed females were — 

Excited, Aged and Infirm, 

Excited in seclusion, Too Low-Spirited, 

Sick, Too Little Mind, 

Sick in bed, Able but Unwilling. 
Quiet, 

All the rest not thus situated went to their several spheres of 
labor, in shop, garden, field, yard or elsewhere. 



U LUNATIC HOSPITAL AT WORCESTER. [Oct. 

In the sixteen public asylums of Ireland the men were 
mostly engaged in cultivating the earth ; but others were 
employed as 

Basket-Makers, Shoemakers, 

Blacksmiths, Tailors, 

Carpenters, Weavers, 
Knitters, 

and in some other occupations not stated. 

During the year 1858, there was a constant average of two 
thousand and seven males and one thousand nine hundred and 
fourteen females in these establishments. Of these one thou- 
sand and seventy-five males, or 53.5 per cent, of all, and one 
thousand and seventy-five females, or 56.1 per cent, of all, were 
constantly employed. 

During the year 1859, there was a constant average of two 
thousand and seventy-nine males and one thousand nine hun- 
dred and eighty females. Of these one thousand and sixty-five 
males, or 51.2 per cent, of all, and one thousand two hundred 
and forty-two females, or 62.7 per cent., were employed. 

The proportion engaged in mechanical labor is less in Ireland 
than in England, probably because a similar disproportion 
exists among the sane population in the two kingdoms. 

There is a smaller proportion of the Irish than of the English 
patients occupied, in any kind of labor, but no reason is given 
in the reports, which would explain the difference. 

In all this employment of insane persons in such a variety of 
ways, only a single accident, involving danger, is known to 
have happened, and that was without bad result. 

All those who have watched, directed or immediately super- 
intended this system of labor in lunatic hospitals — the Com- 
missioners in Lunacy for England, and the Inspectors of 
Asylums for Ireland, and the Superintendents of Asylums, all 
speak with satisfaction of its working and its results, and of its 
effect on the management of the institutions and on the patients. 
The Irish Inspectors, in their seventh report, say : " The system 
of providing, for the inmates of the District Asylums, occupa- 
tion suitable to their condition is carried out on an extensive 
scale, with the best results." Dr. Cleaton, Superintendent of 



1862.] PUBLIC DOCUMENT— No. 28. 45 

the Rainhill, England, Asylum, says : " I am fully persuaded 
that, next to the disuse of mechanical restraint, the most 
important of recent improvements in the treatment of the 
insane, is the extent to which occupation is adopted as an 
auxiliary to the pharmaceutical remedies," 

The advantage is two-fold. First, in the small profit derived 
from the labor of the patients, and second, and of far greater 
value, the increased facility of managing the household, and 
thirdly, and of more importance than all, is its power as a 
remedial measure. 

In several of the English asylums the insane mechanics keep 
the buildings and furniture and agricultural tools in repair, 
and even make new furniture and tools when needed ; they 
make shoes, clothing, &c., and also some articles for sale. 
Two-thirds of the furniture of the Prestwich Asylum was made 
by the patients. Other reports speak of ploughs, wheelbarrows, 
harrows, tables, chairs, bedsteads, &c., being made by their 
men. In the School for Idiots at Redhill all the furniture was 
made for a new hospital in the neighborhood. The pupils of 
the Massachusetts School for Idiots make shoes, mats and 
brooms, which are sold in the market at remunerating prices. 

In view of all these facts, seeing that the experience here on 
a small scale, and in Great Britain and Ireland on a large scale, 
of employing patients in mechanical trades and thus giving 
them more general and constant occupation at all seasons, has 
been satisfactory and encouraging to farther extension of the 
same, the Trustees after mature and careful consideration, and 
full consultation with the Superintendent, have determined at 
once to introduce the same system into the Worcester hospital. 
They will begin moderately and proceed cautiously with such 
means as are now in their hands. 

The old building in the rear of the male wings of the hospital 
which has been used for a wash house and laundry is about to 
be vacated, by the removal of those operations to the new and 
better house prepared for them. This old building is of brick, 
two stories high, and has a large attic. It is fifty feet long and 
forty feet wide. Here will be room which will accommodate 
many shoemakers, tailors and other mechanics, and will meet 
all the present wants and be sufficient for the trial of the 
experiment. 



46 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

The Trustees are aware that this will impose a new care and 
responsibility on the Superintendent, and other officers, on the 
attendants and all connected with the movements of the hospi- 
tal, at least, until the new system gets into full operation. It 
will require the most untiring supervision, and the most careful 
thought to discriminate among the patients who shall be 
employed, and how much and in what way. The daily and 
hourly effect of labor on each one's condition must be watched, 
so that none should suffer evil rather than gain good, and the 
whole must be arranged, shaped, and daily directed for the 
advantage of the patients. 

But the Trustees are confident, that what has been done here 
with a few may be done also with many ; that what is done in 
England with so much ease and success, and what is accom- 
plished in Ireland with patients of the same race as constitute 
a large part of the household at Worcester, may also be done 
in this institution. Our people, both native and foreign, are 
as much accustomed to labor and as little used to idleness in 
their days of health, as the people of England and Ireland. 
Our officers are men of as much wisdom and tact, as much 
energy and industry, they are as much devoted to their work 
and wield as much influence over the wills and the movements 
of the patients under their care as those of European hospitals. 
There is no advantage or facility or means for this purpose, on 
the other side of the ocean, that we have not, except the simple 
fact, that their system is established and in successful, undis- 
turbed operation, and all new comers to the asylums fall into it 
as a matter of course, and work with the others, while ours is 
yet to be begun, and our patients to be put on a new course, 
with no multitude of workers already in shop and field inviting 
the new patients to follow or accompany them. But the English 
began this system within a very few years. Their asylums 
began not all at once, but one after another, and their annual 
reports, which told of their beginnings and progress, made no 
especial complaint of difficulties in getting the new system into 
operation and effecting so great a change in the habits of their 
patients. 

And now the Trustees think, the time has come for this 
hospital to follow the examples so largely and so long set before 
them. They think they would do wrong to the patients and to 
the Commonwealth to postpone it ; and having a Superintendent 



1862.] PUBLIC DOCUMENT— No. 28. 47 

of great sagacity and energy, of great business talent as well 
as scientific skill, assisted by a competent corps of officers and 
attendants, and all, from the head to the servant, devoted 
exclusively to the work of the hospital, with no interest, no 
business, nor responsibility beyond the institution, all ready to 
give their whole thoughts and all their anxieties to the great 
work they have undertaken of managing these four hundred 
lunatics, and of curing as many as possible and ameliorating all 
the others — with such aids as these, the Trustees commence 
this new purpose with confidence that the hospital will prosper 
with this, as it has in every new advancement, and accomplish 
more effectually the object of its creation. 

The report of the Superintendent which accompanies this, 
contains a full account of the condition and operations of the 
hospital during the past year, and a general history of its 
progress from its beginning in 1833. This will show how 
large a work has been done, and how important the institutions 
for the insane are to the happiness of the people and the 
prosperity of the Commonwealth. 

Looking into the future with the light of the past, considering 
that what has been will be again, that there will be as many made 
insane and as many patients sent to the hospitals in the coming 
as in the last year, the Trustees of this institution look for as 
great a responsibility to be thrown upon its managers and as 
large a work to be required of them in 1863 as in 1862, and 
these they are prepared to fulfil and perform. 

In view of the intimate connection of the hospital with the 
State, its towns, and families, and of its importance as an agent 
of humanity and of public economy, it is again commended to 
the generous confidence of the people and the just support of 
the legislature. 

Yery respectfully submitted, by the Trustees. 

WILLIAM T. MERRIFIELD. 
ROBERT W. HOOPER. 
EDWIN F. JENKS. 
EDWARD JARVIS. 
WILLIAM WORKMAN. 

Worcester, October 1, 1862. 



48 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



TEEASURER'S REPORT. 



To the Trustees 



The Treasurer submits the following report. 



Cash on hand September 30, 1861, 
Received from the Commonwealth, 
" " towns and individuals, 

" " all other sources, . 

Due Mechanics' Bank, 



DISBURSEMENTS. 

Steward's order. 

Salaries, ..... 
Mechanics' Bank, (interest,) 
Cost in suit, Treas. vs. Springfield, 
Collection, stationery, &c., . 
Cash, ..... 



1220 73 

19,343 34 

30,426 36 

899 69 

2,153 76 



I. 

. $48,482 49 


3,464 


51 


684 


50 


171 


11 


87 


97 


153 


30 



,043 88 



153,043 88 



H. WOODWARD, Treasurer. 



Worcester, October 1, 1862. 



1862.] 



PUBLIC DOCUMENT— No. 28. 



49 



SUPEEINTENDENT'S REPORT. 



To the Trustees of the State Lunatic Hospital, at Worcester : 

Gentlemen, — I am again called upon in obedience to the 
laws of the Commonwealth, to report to you the operations and 
results of the year ending September 30, 1862. 

I trust that the retrospect about to be made will show that 
the year past has been one of progress and some degree of 
success. 

It has been a year of general health and prosperity. No 
serious calamity has befallen the institution or its inmates. 
Nothing occurred to mar the general good order and comfort of 
the house until late in the year, when a large number of our 
male attendants enlisted in the service of their country, making 
it necessary to employ an equally large number of men, and 
strange hands in their places. This has been the cause of con- 
siderable uneasiness and excitement in the male wards, and it 
will probably require several months of hard labor to bring 
back the usual comfortable state of things. 

Table No. 1, 

Showing the general results of the Year. 





Males. 


Females. 


Total. 


Patients in the Hospital October 1, 1861, 


184 


195 


379 


" admitted during the year, . 


108 


113 


221 


Whole number under treatment. 


292 


308 


600 


Discharged recovered, 


58 


66 


124 


" improved, 


18 


21 


39 


" not improved, .... 


. ^ 


2 


r 


Died, 


11 


23 


34 


Whole number discharged during the year, 


92 


112 


204 


" " remaining September 30, 1862, 


200 


196 


396- 



50 LUNATIC HOSPITAL AT WOECESTER. [Oct. 

The foregoing table shows that one hundred and twenty-four 
patients have been discharged from the hospital as recovered. 
In all these cases the cause of commitment had ceased to exist, 
and they were, by your order, discharged from the care and 
custody of the hospital, and returned to their homes and friends, 
restored to a good degree of mental and physical health. 

Thirty-nine have been discharged from tlie hospital improved. 
Several of these were so much improved that it was difficult to 
decide to which class they should be assigned, and they are now 
regarded by their friends as having recovered their full measure 
of mental health. 

A few only of those discharged during the year are periodi- 
cally insane, and have long intervals of apparent health, during 
which they perform all the ordinary duties of life. These are 
reported as improved. 

The number of deaths among the females has been large, and 
will be spoken of under its proper head. 

The whole number admitted during the year was two hundred 
and twenty-one, of whom one hundred and eight were males, 
and one hundred and thirteen were females. A number some- 
what less than the number of admissions of last year. 

The diminution in the number of admissions was confined 
mostly to the months of August and September. 

The whole number under treatment was six hundred, of 
whom two hundred and ninety-two were males, and three 
hundred and eight were females. 

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

The whole number remaining in the hospital at the close of 
the year, was three hundred and ninety-six, of whom two hun- 
dred were males, and one hundred and ninety-six were females. 

It will be seen at a glance, that the recoveries were in the 
ratio of fifty-six and one-tenth per cent, to the whole number 
admitted, or twenty and two-thirds per cent, to the whole 
number under treatment. 

• Of those who were admitted during the year, eighty-seven 
have been discharged recovered — forty-nine males, and thirty - 
.eight females. 



1862.] PUBLIC DOCUMENT— No. 28. 51 

There has been, during the year, the usual amount of sick- 
ness, confined almost entirely to the habitually feeble, the 
demented, the epileptic, and the palsied patients. 

Table No. 2, 

Showing the Admissions and state of the Hospital, from October 1, 1861 

to September 30, 1862. 

Patients in the hospital October 1, 1861, 379 

Males, . . 184 

Females, . . . . . 195 

Patients admitted in the course of the year, 221 

Males, 108 

Females, 113 

Patients remaining in the hospital September 30, 1862, . . 396 

Males, . 200 

Females, 196 

Of the admissions there were cases of less duration than one year, 117 

Males, 57 

Females, 60 

Of the admissions there were cases of one year or more, . . 83 

Males, 41 

Females, 42 

Of the admissions there were cases the duration of whose insanity 

could not be ascertained, 21 

Males, 10 

Females, 11 

Patients committed by Courts, 148 

Males, 71 

Females, 77 

Patients committed by Overseers of Poor, . ... . . 21 

Males, 9 

Females, 12 

Patients on bonds, 52 

Males, 28 

Females, 24 

Foreigners and those having no settlement in the State, admitted 

in course of the year, ........ 81 

Males, 40 

Females, 41 

Foreigners and those having no settlement in the State, discharged 

in course of year, ......... 76 

Males, 37 

Females, 39 



52 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Foreigners and those having no settlement in this State, remaining 

in the hospital September 30, 1862, 157 

Males, . . . .83 

Females, 77 



State Paupers remaining in the Hospital at the close of euch Year, as 
nearly as can he ascertained. 



1842, 34 


1853, 216 


1843, 








38 


1854, 








. 151 


1844, 








38' 


1855, 








. 115 


1845, 








57 


1856, 








. 155 


1846, 








52 


1857, 








.119 


1847, 








121 


1858, 








. 121 


1848, 








150 


1859, 








. 124 


1849, . 








167 


1860, 








. 130 


1850, 








181 


1861, 








. 156 


1851, 








201 


1862, 








. 157 


1852, 








241 





The foregoing table shows that you have discharged from the 
hospital in the course of the year seventy-six patients who were 
supposed to have no settlement in this Commonwealth, and of 
the three hundred and ninety-six patients remaining in the 
hospital at the close of the year one hundred and fifty-seven 
are supposed to have no settlement in this Commonwealth, 
nearly all of whom are of foreign birth. 

A smaller number of patients than usual have been removed 
to almshouses during the year, and but very few have been 
discharged except to the care of friends and relatives. 

Situations have been procured for a few where they could 
labor and receive wages, and a few others have been enabled 
to reach their friends in other parts of the country. 

In all cases where patients dependent upon the charity of the 
Commonwealth have been removed from the hospital previous 
to recovery, they have been carefully observed by the alien 
commissioners or their agent before any steps have been taken 
to procure their discharge, and when the existence of relatives 
or friends has been known, their pleasure has always been 
consulted in the disposition of the patient. 



1862.] 



PUBLIC DOCUMENT— No. 28. 



53 



Table No. 3, 

Showing the number Admitted, Restored, Improved, Died, ^c, in each 
Month during the Year. 





Admitted. 


Removed. 


Kemaining. 


MONTHS. 




a 


o 


•3 
1 


> 

e 


■d 
S, 

s 

o 

!2i 


•d 


o 


« 

s 


S 






M. 


F. 


M. 


F. 


M. 


F. 


M. 


F. 


M. 


F. 


"3 

o 


October, . . 


12 


16 


28 


4 


7 


2 


- 


- 


- 


1 


2 


7 


9 


189 


202 


391 


November, . 


14 


8 


22 


- 


6 




2 


1 


- 


2 


1 


3 


9 


200 


201 


401 


December, . 


8 


8 


16 


3 


4 


1 


1 


- 


1 


1 


4 


5 


10 


203 


199 


402 


January, 


9 


7 


16 


3 


5 


2 


1 


- 


- 




3 


5 


9 


207 


197 


404 


February, 


9 


7 


16 


2 


4 


1 


2 




- 


1 


- 


4 


6 


212 


198 


410 


March, . . 


14 


8 


22 


6 


6 


1 


- 


- 


- 


1 


1 


8 


7 


218 


199 


417 


April, . . . 


6 


13 


19 


13 


9 


1 


3 


- 


- 


2 


4 


16 


16 


208 


196 


404 


May, . . . 


9 


6 


15 


7 


10 


3 


3 


3 


- 


- 


3 


13 


16 


204 


186 


390 


June, . . . 


4 


18 


22 


6 


1 


2 


1 


- 


1 


- 


3 


8 


6 


200 


198 


398 


July, . . . 


7 


14 


21 


4 


5 


2 


4 


- 


- 


1 


- 


7 


9 


200 


203 


403 


August, . . 


6 


5 


11 


8 


4 


1 


2 


1 


- 


- 


1 


10 


7 


196 


201 


397 


September, . 


10 


3 


13 


2 


5 


2 


2 


- 


- 


2, 1 


6 


8 


200 


196 


396 


Totals, . . 


108 


113 


221 


58 


66 


18 


21 


5 


? 


1123 


92 


112 








Til- ._ X? . 






T 




•1 




1 






; 




j^i - 


1 


' L ^ 


1 





Few patients are ordinarily admitted to the hospital during 
the winter months. 

On the approach of winter, however, when it becomes appar-* 
ent that the suiFerers cannot be cared for during the cold and 
stormy season in their own homes, the friends provide for their 
safety and comfort in a hospital. 

On the opening of spring the causes of mental derangement 
increase and multiply as the season advances, causing a large 
number of admissions during the warmer season of the year. 



64 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



As has been elsewhere mentioned, this table indicates a con- 
siderable diminution in the number of admissions during the 
months of August and September. 

This must be owing partly to the depressed condition of the 
times, and the uncertain state of all industrial pursuits, reducing 
in a great degree the ability of families and the willingness of 
towns to place their insane under the care and treatment of 
a hospital. 

Something must also be due to the fact of the absence of so 
large a proportion of the male population in the service of their 
country. 

Table No. 4, 
Showing the Form of Disease in those Admitted and Discharged during 

the Year. 





Admitted. 


Discharged. 


FORM OF DISEASE. 


■3 
3 


a 


o 




1 


t 



Mania, 

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


41 

15 

5 

2 

17 
14 
4 
3 
5 
2 


39 

13 

4 

24 

19 

3 

3 

2 

4 
2 


80 

28 

9 

2 

41 

33 

7 

6 

7 

6 

2 


46 
7 
3 

14 

13 

6 

2 
2 


53 

7 
2 

24 

17 

3 

1 

4 

1 


99 

14 

5 

38 
30 
8 
3 
6 
1 


Totals, .... 


108 


113 


221 


92 


112 


204 



Eighty persons, forty-one males and thirty-nine females, when 
admitted, were suffering from recently developed mania in its 
'ordinary form. 

Twenty-eight, fifteen males and thirteen females, had for a 
considerably long period of time suffered all the symptoms of 
mania and are classed in the above table as cases of chronic 
mania. 

Fifteen of those admitted during the year were epileptic, and 
nine were afflicted with general paralysis. 



1862.] 



PUBLIC DOCUMENT— No. 28. 



65 



No attempt is made in tlie foregoing table to give a classifica- 
tion of the various phases of insanity ; but to present in a 
convenient manner the prominent manifestations as observed 
in this hospital. 

Table No. 5. 

Supposed causes of Insanity of Patients admitted into the Hospital from 
January 1833, to September 30, 1862. 









1863. 


Previously. 


CAUSES. 












Hales. 


Females. 


Males. 


Females. 


Apoplexy, 
Asthma, . 






- 


- 


2 
2 


1 


Bronchitis, 






- 


- 


2 


13 


Chorea, . . . 






- 


- 


- 


2 


Constipation, . 
Convulsions, . 






- 


- 


2 

8 


1 
6 


Dysentery, . . . 


■■ 




- 


- 


1 


2 


Dyspepsia, 

Epilepsy, 

Eruptive Diseases, . 






9 


5 


7 ' 
108 
5 


6 

33 

5 


Eyes, Disease of, 






~ 


- 


1 


- 


" Loss of, . . _ . 






1 


- 


1 


- 


Fever, .... 






2 


3 


34 


39 


Ill Health, 






22 


34 


219 


602 


Influenza, 






- 


- 


1 


5 


Insolution, 






- 


- 


14 


- 


Laryngitis, 
Nervous Irritation, . 






— 


— 


~ 


1 

6 


Nymphomania, 
Old Age, 









1 


15 


1 
8 


Otitis^ 
Palsy, . 
Pneumonia, 






7 


2 


3 

42 


2.5 

1 


Rheumatism, . 






- 


- 


3 


1 


Scrofula, . 






- 


- 


3 


4 


Sea-sickness, . 






- 


- 


- 


1 


Somnambulism, 






- 


- 


- 


1 


Suppressed Eruption, 
Suppressed Ulcer, . 
Tic Douloureux, 






- 


- 


6 
2 


4 
3 

1 


Tumor, . 






- 


- 


- 


1 


Whooping Cough, . 
Amenorrhcea, . 






- 


- 


: 


1 

20 


Lactation, Excessive, 






- 


- 


- 


5 


Menorrhagia, . . . 






- 


1 


- 


7 


Menorrhagia, Suppressed 
Miscarriage, 






- 


4 

2 


— 


11 
4 


Pregnancy, 
Puerperal, 
Turn of Life, . 






- 


2 

10 
3 


- 


5 

148 

44 



56 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 5 — Concluded. 









1863. 


Previously. 


CAUSES. 












Males. 


Females. 


Males. 


Females. 


Amputation of Leg, 


_ 


_ 


1 


_ 


Bathing in Cold Water, 






1 


— 


2 


2 


Drinking CoM Water, 






- 


- 


1 


- 


Exposure to Cold, . 






- 


- 


6 


- 


Injuries by Falling, &c., 






- 


- 


9 


3 


Injury of Head, 






1 


- 


47 


8 


Injury of Spine, 






2 


- 


4 


2 


Lead, Poison of. 






— 


— 


2 


- 


Lightning, Stroke of, 






- 


- 


1 


1 


Labor, Excessive, . 






3 


1 


30 


54 


Loss of Sleep, . 






- 


- 


2 


5 


Study, Excessive, . 






- 


- 


25 


6 


Spiritualism. . 






- 


- 


13 


14 


Criminal Trial, 






- 


- 


- 


1 


False Accusation, . 






- 


- 


- 


1 


Imprisonment, . 






1 


- 


17 


2 


Death of R<-latives, . 






2 


2 


20 


61 


Domestic Trouble, . 






1 


1 


128 


319 


Marriage, Unhappy, 






- 


- 


4 


2 


Disappointment in Love, 






- 


2 


55 


63 


Dissappointed Ambition, 






- 


2 


6 


6 


Home Sickness, . . 






- 


- 


7 


10 


Fright, . 






- 


- 


16 


19 


Seduction, 






- 





- 


2 


Political Excitement, 






1 


- 


16 


- 


Religious Excitement, 






- 


5 


136 


172 


Pecuniary Trouble, . 






4 


- 


123 


23 


Poverty, . 






- 


- 


- 


1 


" Fear of, . 






2 


- 


33 


12 


Giving up Business, 






— 


- 


3 


— 


Change of Business, 






- 


- 


7 


-' 


Violent Temper, 






- 


1 


3 


18 


Jealousy, . 






- 


1 


19 


27 


Intemperance, . 






19 


2 


186 


68 


Opium, Use of, 






1 


2 


2 


5 


Tobacco, Use of. 






- 


- 


1 


3 


Masturbation, . 






15 


12 


256 


37 


Venery, Excess of, . 






~ 




1 


" 



Of the above there were during the year- 



Hereditary Cases, 
Periodical " 
Homicidal " 
Suicidal " 



17 


26 


11 


17 


9 


3 


13 


15 



1862.] 



PUBLIC DOCUMENT— No. 28. 



57 



111 health is as usual the most prominent cause of insanity, 
as classed in the foregoing table, which is made up from the 
representations and descriptions of those who bring the patients 
to the hospital. 

Ill health arising from its many sources, is undoubtedly the 
most fruitful cause of insanity. 

But there are generally if not always several circumstances, 
all of which unite to bring on that state of brain and nervous 
system which results in mental derangement. The one that 
seems most prominent to those best acquainted with the case is 
the one recorded here. 

It is difficult and often impossible to ascertain the true and 
relative bearings of the various circumstances around us, upon 
our own minds ; and how much more difficult is it to ascertain 
the precise cause that suggests to the insane mind each suc- 
cessive link in the chain of its delusion. 

Fully believing however, that the statistics of insanity are of 
as much worth as any vital statistics the table is presented with 
the hope that it may be extended and perfected till it shall be 
found entirely correct and thoroughly reliable. 



Table No. 6. 
Diseases loMch have proved Fatal from Jan. 1833, to Sept. 30, 1862. 











186S. 


Pkeviouslt. 


DISEASES. 










Males. Females. 


Males. 


Females. 


Apoplexy, 
Asthma, . 








- 


- 


15 
4 


9 

1 


Anaemia, . 








_ 


_ 


1 


1 


Asphyxia, 
Bronchitis, 








- 


- 


1 
2 


- 


Brain Fever, . 








_ 


- 


1 


- 


Consumption, . 
Convulsions, 








2 


8 


37 
3 


60 

1 


Cholera Morbus, 








_ 


- 


2 


3 


Cholera, . 








- 


- 


5 


- 


Cancer, . 








_ 


- 


1 


1 


Congestion of Lungs, 






- 


- 


- 


1 


" " Brain, 






1 


- 


1 


1 


Chronic Dysentery, . 

" Meningitis, . 






- 


- 


2 
3 


-r 


Dysentery, 
Dropsy, . 






- 


- 


10 
5 


6 

7 



58 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 6 — Concluded. 









186S. 


PREVIOnSLT. 


DISEASES. 












Males. 


Females. 


Males. 


Females. 


Delirium Tremens, .... 






3 




Disease of Heart, 






- 


- 


9 


11 


" " Bladder, . 






- 


- 


1 


- 


" " Brain, . 






- 


- 


6 


14 


Diarrhoea, 






- 


- 


13 


8 


Enteritis, . 






- 


- 


3 


6 


Epilepsy, . 
Exhaustion, 






— 


2 

2 


. 57 
32 


23 

47 


Erysipelas, 
Gangrene of Lungs, 
Hydrothorax, . 
Hemorrhage, . 






- 


- 


9 
1 

1 
4 


10 

2 
1 
4 


Hemoptysis, 






- 


- 


1 


- 


Inflammation of Bowels, 






- 


- 


3 


3 


Jaundice, 








- 


- 


2 


Marasmus, 






1 


2 


49 


53 


Mortification, . 






- 


- 


- 


1 


Maniacal Exhaustion, 






- 


- 


5 


6 


Malignant Fever, . 






- 


- 


1 


- 


Old Age, 






5 


- 


19 


13 


Palsy, 
Pneumonia, 






2 


3 


22 
15 


16 
9 


Pleurisy, . 
Rupture, . 

Syncope, ... 
Suicide, . 






- 


1 


1 

1 
15 


1 

8 


Smallpox, 

Suppurative Phlebitis, 
Typhoid Fever, 
Typho Mania, . 






- 


5 


1 

8 

7 


1 
6 
5 



Of the eleven males who died during the year, five died of 
old age without any apparent disease. They were all more 
than seventy years of age and three of them were each more 
than eighty years of age. Two^ died of long continued palsy; 
and two of phthisis ; and one of marasmus. One of those who 
died of old age had been an inmate of the institution nearly 
thirty years, his name being the second one on the records of 
the hospital. 

A larger than usual number of females have died during the 
year. A reference to the table will sufficiently explain the 
causes. 

Eight died of phthisis a,nd five of typhomania. These last 
died immediately after being brought to the institution. Three 



1862.] 



PUBLIC DOCUMENT— No. 28. 



59 



died of paralysis, two of marasmus, two of epilepsy, and two of 
exhaustion. 

Two of those who died of paralysis were each more thau 
seventy years of age. 

Table No. 7, 

Showing the Ages of Patients Admitted, Discharged Recovered, not Re- 
covered, and Died during the Year. 





Admitted. 


Discharged Ke- 


Discharged not 


Died. 








COVERED. 


Kecoveked. 






AGES. 
















Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Less than 15, 


3 








1 








Froml5 to20. 


2 


1 


- 


1 


1 


1 


- 


2 


20 to 30, 


27 


24 


13 


18 


3 


5 


- 


6 


30 to 40, 


34 


23 


24 


19 


7 


4 


3 


4 


40 to 50, 


26 


41 


15 


17 


6 


8 


- 


4 


50 to 60, 


6 


12 


4 


6 


2 


3 


1 


3 


60 to 70, 


7 


8 


1 


4 


2 


1 


- 


2 


70 to 80, 


3 


4 


1 


1 


1 


1 


3 


1 


80 to 90, 


- 


- 


- 


- 


- 


- 


4 


1 


Totals, . . 


108 


113 


58 


66 


23 


23 


11 


23 



Table No. 8, 

Showing the Duration of Insanity before Admission of Patients admitted 
from January 1833, to September 30, 1862. 





186S. 


Pkeviodslt. 


DURATION OF INSANITY. 


Males. 


Females. 


Males. 


Females. 


Insane less than 1 year, 

Insane more than 1 y'r and less than 2 yr's, 
2 yr's and less than 5 yr's, 
5 yr's and less than 10 yr's, 
10 yr's and less than 15 yr's, 
15 yr's and less than 20 yr's, 
20 yr's and less than 25 yr's, 
25 yr's and less than 30 yr's, 
30 yr's, . . . . 

Unascertained, 


57 ■ 

25 

14 

8 

2 

1 

1 


60 
23 
17 
9 
2 
1 
1 


1,587 

382 

475 

239 

124 

42 

38 

17 

24 

237 


1,797 

367 

412 

193 

139 

. 40 

43 

9 

24 

253 


Totals, 


108 


113 


3,165 


3,277 



60 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 9, 

Showing the Ages of Patients admitted into the Hospital from January 
1833 to September 30, 1862. 







1863. 


Pebviouslt. 


AGES. 














Males. 


Females. 


Males. 


Females. 


Less than 15 years, . 


. 


3 


- 


26 


28 


4 

Between 15 and 20 years of 


age, . 


2 


1 


226 


210 


20 and 30 " 


(( 


27 


24 


932 


903 


30 and 40 " 


« 


•34 


23 


817 


897 


40 and 50 " 


(( 


26 


41 


524 


585 


50 and 60 « 


(( 


6 


12 


349 


396 


60 and 70 " 


u 


7 


8 


209 


164 


70 and 80 " 


(1 


3 


4 


61 


59 


More than 80 years of age, 


• 


- 


- 


11 


18 


Unascertained, 


• 


- 


- 


8 


17 


Totals, . 


108 


113 


3,165 


3,277 



Table No. 10, 

Showing the Civil Condition of Patients admitted into the Hospital from 
January 1833 to September 30, 1862. 





1S6». 


Pkbviodslt. 


CIVIL CONDITION. 


Males. 


Females. 


Males. 


Females. 


Unmarried, 

Jklarried, 

"Widowers, . . . , . 

Widows, 

Unascertained, . . . 


49 

53 

5 

1 ' 


53 
45 

15 


1,591 

1,376 

153 

45 


1,473 
1,365 

397 
42 


Totals, 


108 


113 


3,165 


3,277 



1862.] 



PUBLIC DOCUMENT— No. 28. 



61 



Table No. 11, 

Showing the Admissions from each County from Jan. 1833 to Sept. 30, 

1862. 













1S63. 




Previously. 




COUNTIES. 








Whole No. 




Males. 


Females. 


Total. 






Barnstable, .... 








126 


126 


Berkshire, 








- 


- 


_ 


187 


187 


Bristol, . 








- 


_ 


_ 


290 


290 


Dukes, . 








.:. 


_ 


— 


19 


19 


Essex, . 








24 


20 


44 


893 


937 


Franklin, 








_ 


— 


_ 


126 


126 


Hampden, 








- 


- 


- 


352 


352 


Hampshire, 








- 


1 


1 • 


221 


222 


Middlesex, 








31 


30 


61 


952 


1,013 


Nantucket, 








_ 


_ 


— 


31 


31 


Norfolk, . 








4 


- 


4 


593 


•597 


Plymouth, 








- 


- 


- 


233 


233 


Suffolk, . 








6 


6 


12 


676 


688 


Worcester, 








43 


56 


99 


1,726 


1,825 


Other States, 








- 


- 


- 


17 


17 


Totals, . . . . 


108 


113 


221 


6,442 


6,663 



Table No. 12, 

Showing the Occupation of Patients admitted to the Hospital from 
January 1833 to September 30, 1862. 



O C CXJP ATION. 




Previously. 



. MALES. 

Auctioneers, 

Armorers, 

Authors, .... 

Blacksmiths, 

Bakers, .... 

Butchers, .... 

Bookbinders, 

Boot-makers, 

Brokers, . 

Book-keepers, . 

Britannia-workers, . 

Brickmakers, 

Bellows-makers, . 

Brewers, .... 



3 
3 

2 
37 
6 
7 
7 
19 
3 
8 
2 
5 
2 
2 



62 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 12 — Continued. 



OCCUPATION. 


186S. 


Previously. 


Basket-makers, 


_ 


5 


Bricklayers, 






• • 




- 


2 


Butlers, .... 










- 


7 


Barbers, .... 










- 


19 


Clergymen, 










- 


125 


Carpenters, 










3 


6 


Coppersmiths, . 










1 


16 


Coopers, .... 










- 


12 


Cabinet-makers, 










1 


3 


Calico-printers, . 










- 


17 


Clothiers, .... 










- 


4 


Comb-makers, . 










- 


8 


Coach-makers, . . ^ 










- 


2 


Card-makers, . 










- 


4 


Chair-makers, . 










- 


4 


Cigar-makers, . 










1 


3 


Coachmen, 










- 


16 


Clerks, 










3 


38 


Carpet-weaver, . 










- 


1 


Carriers, . 










— 


8 


Cashiers of Banks, . 










- 


4 


Cordwainers, 










- 


6 


Collectors, 










- 


2 


Caulkers, . 










- 


4 


Chandlers, 










- 


5 


Camphene-distiller, . 










- 


1 


Conductors on Railroads, 










- 


3 


Dyers, 










- 


4 


Druggists, . . . 










— 


3 


Draymen, . 










- 


3 


Drover, 










— 


1 


Dancing master. 










- 


1 


Engineers, 










— 


3 


Editors, . 










- 


4 


Express-men, . 
Farmers, . 










24 


4 

505 


Fishermen, 










3 


20 


Fruiterers, 










- 


4 


Gunsmiths, 










- 


3 


Gardeners, 










- 


10 


Grocers, . 










- 


3 


Glass-blowers, . 










- 


3 


Gilders, 










- 


2 


Hotel-keepers, . 










- 


16 


Hatters, 










- 


3 


Hostlers, . 










2 


11 


House-wrights, . 










- 


17 


Harness-makers, 










1 


7 


Ironmongers, . 










- 


3 


Jewellers, . 










- 


12 


Lawyers, . 










" 


13 



1862.] 



PUBLIC DOCUMENT— No. 28. 

Table No. 12 — Continued, 



63 



OCCUPATION. 




Previously. 



Laborers, . 

Last-maker, 

Manufacturers, . 

Millers, 

Merchants, 

Masons, 

Miners, 

Mat-makers, 

Miniature-painter, 

Musicians, 

Machinists, 

Messengers, 

Moulders, . 

Mill-wright, 

Nailer, ... 

Newsmen, 

Optician, . 

Operatives in Mills, . 

Oyster-men, 

Painters, . 

Printers, . 

Physicians, 

Paper-makers, . 

Peddlers, . 

Pilot, 

Potters, 

Porters, 

Pump and Block-makers, 

Pattern-makers, 

Plumbers, . 

Police officers, . 

Rope-makers, . 

Riggers, 

Restaurators, 

Shoemakers, 

Sail-makers, 

Soap-makers, 

Sash and blind-makers. 

Stage drivers, . 

Sea captains, . 

Sailors, 

Saddlers, . 

Silversmiths, 

Students, . 

Stock-maker, 

Silk-weavers, 

Ship carpenters. 

Ship brokers, . 

Shop-keepers, . 

Stone-cutters, . 

Soldiers, . 



21 
1 
3 



408 

1 

35 

16 

117 

17 

5 

3 

1 

7 

39 

2 

8 

1 

1 

3 

1 

66 

4 

34 

29 

12 

4 

19 

1 

3 

9 

3 

5 

8 

4 

9 

3 

7 

229 

9 

4 

2 

5 

16 

104 

9 

19 

53 

1 

2 

18 

2 

10 

14 

9 



64 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 12 — Concluded. 



OCCUPATION, 


XS&2. 


Previously. 


Spinners, 


_ 


13 


Sheriffs, .... 










- 


3 


Shoe dealers, . 










- 


5 


Stable-keepers, . 










- 


2 


Shoe-binders, . 










— 


7 


Tailors, 










1 


17 


Teachers, . . . . • 










- 


52 


Tobacconists, . 










- 


o 
O 


Teamsters, 










2 


U 


Tinners, . . f 










— 


2 


Umbrella-makers, 










- 


4 


Victuallers, 










- 


3 


Wheelwrights, . - . 








~ 


1 


14 


Watchmakers, . 










- 


5 


Wood-turners, . 










1 


3 


Watchman, 










- 


1 


Whip-maker, . 










- 


1 


Weavers, . 










- 


20 


No occupation, . 


. 


3 


— 


. Females. 






Carpet weavers, 


- 


2 


Cooks, . . 










- 


63 


Chambermaids, . 










- 


42 


Dress-makers, . 










2 


61 


Engraver, 










— 


1 


House-keepers, . 
House maids, . 










65 

27 


1,119 
170 


Laundresses, 










2 


56 


Milliners, . 










- 


31 


Mantua-makers, 










- 


6 


Midwife, . 










- 


1 


Nurses, 










- 


15 


Nursery maids, . 










- 


21 


Operatives in mills, . 










7 


148 


Seamstresses, . 










4 


332 


Straw-sewers, . 










- 


10 


Shoe-binders, . 










- 


19 


Students, . 










- 


4 


School girls, 










3 


51 


Teachers, . 










2 


64 


Tailoresses, . . . 




, 






- 


39 


Type-settgrs, 










- 


2 


Wool stapler, . 










- 


1 


Weavers, . 










- 


20 


No occupation, . • 










1 





1862.] 



PUBLIC DOCUMENT— No. 28. 



65 



Table No. 13, 

Showing the Whole Number of Patients during the last year, the Average 
Number, the number at the end of each year, the Expense of each year, the 
Annual Expense for each Patient, and the expense of each patient per 
week for each of the Thirty Years the Hospital has been in operation. 



TEAK. 


Wliole 


Average 


No. at end 
of eacli 


Current expenses 


Annual expense 


Expense per 
week for 




Number. 


Number. 


year. 


of eacli year. 


for eacli patient. 


each patient. 


1833, . 


153 


107 


114 


$12,272 91 


$114 67 


$2 25 


1834, . 


233 


117 


118 


15,840 97 


135 38 


2 60 


1835, . 


241 


120 


119 


16,576 44 


137 30 


2 64 


1836, . 


245 


127 


138 


21,395 28 


168 44 


3 12 


1887, . 


306 


163 


185 


26,027 07 


159 64 


3 07 


1838, . 


362 


211 


218 


28,739 40 


136 20 


2 62 


1839, . 


397 


223 


229 


29,474 41 


132 16 


2 58 


1840, . 


391 


229 


236 


27,844 98 


121 59 


2 88 


1841, . 


399 


233 


232 


28,847 62 


123 81 


2 38 


1842, . 


430 


238 


238 


29,546 87 


111 12 


2 18 


1843, . 


458 


244 


255 


27,914 12 


114 40 


2 20 


1844, . 


491 


261 


263 


29,278 75 


112 17 


2 15 


1845, . 


656 


316 


360 


43,888 65 


138 88 


2 66 


1846, . 


637 


359 


367 


39,870 37 


111 06 


2 13 


1817, . 


607 


377 


394 


39,444 47 


104 62 


2 01 


1848, . 


655 


404 


409 


42,860 05 


106 09 


2 04 


1849* . 


682 


420 


429 


40,870 86 


97 31 


1 87 


1850, . 


670 


440 


441 


46,776 13 


106 40 


2 04 


1851, . 


704 


462 


466 


52,485 33 


112 61 


2 16 


1852, . 


775 


515 


532 


43,878 35 


85 20 


1 64 


1853, . 


820 


537 


520 


53,606 66 


103 14 


1 98 


1854, . 


819 


430 


381 


53,221 52 


123 77 


2 38 


1855, . 


580 


349 


336 


54,895 88 


157 29 


3 02 


1856, . 


577 


357 


376 


45,631 37 


128 64 


_ 2 47 


1857, . 


647 


387 


372 


49,004 75 


124 04 


2 38 


1858, . 


679 


372 


301 


38,267 26 


102 86 


2 39 


1859, . 


501 


309 


317 


48,363 33 


156 51 


3 01 


1860, . 


532 


324 


331 


47,757 01 


147 39 


2 88 


1861, . 


583 


369 


379 


54,748 53 


148 37 


2 84 


1862, . 


600 


401 


396 


53,043 88 


132 18 


2 50 



66 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



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1862.] 



PUBLIC DOCUMENT— No. 28. 



67 



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80 



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1862.] PUBLIC DOCUMENT— No. 28. 81 



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1862.] PUBLIC DOCUMENT— No. 28. 83 



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84 



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1862.] 



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t— CO C5 o >— I (M'co -^'ip o i^^a; ci c — r^i : 

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CPCDCDCDCOCPCOCOCDCPCOCPCOCOCOCOCOCDCPCPCOCOCD 



86 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 





■3 -i 

S 1 

o o 

& 

03 S 


* 

Periodical. 
Hereditary. 

do 
do 

do 

do 




c3 

03 
,£3 

a 

M 


Not improved 

do 
Recovered 
Not improved 
Improved 
Recovered 
Improved 

do 
Not improved 
Improved 
Recovered 
Not improved 
Recovered 
Improved 
Not improved 
Improved 

do 
Not improved 

do 

do 
Improved 

do 
Not improved 
Recovered 
Not improved 

do 
Recovered 
Improved 
Not improved 
Improved 

do 

do 
Not improved 




Si .S 

« O C3 

s s 


'Ti Ti Ti n^ "^ "^ 
ootiOratiDwtiDKiJDm 60mt>D« 
■So=«-So<3o-9o3o-Sc3-Sooooooooots-5o!S--oooo_o 

S'TS'g 3T3JSrc3 gr^^T3 d^ g t3 t3 r^ r^ t3 T3 T3 -XS '« -g 2 ^S -g | 'O TS -CU ^3 

i .2 1 .a § .2 §.S § .2 S .53 S 

P5 op^ n p^ p rtQp^ pp^ fii^ 




13 r-; 


0502 C003 03030203 020302 (n02a3a3O3O3a)ma3a3Maia3S..» 
tSlS TJ'TS 'C'd'TS'? TS-CTJ r-j rjj r^ t3 t3 ra r^S Tj^a TS TS T3 'T3 TS 

05 05 ■* .-H IM to lO O C5 0> C<J CO <M C5 05 ■* ■* <M CC Oi C5 t^ CO <M 1-H 

i-Hrt^rHrt <M (M (N (M -1 ^ rH ^ ,-H (M 

K3O3r3O!o303a3O3O3a!o3«!oi02a!a3oia!03aio3»im[omco mmmwmco 

sa^sagsaassaalssssssasassa saaaaa 

COCOC^COCOC<3(MCOCO(MC<ICO(MOOCOCOroOOCOC<I<M<M<N<N<N(M IM(M(MMlMlM 




il 

Is 

P5§ 


Probate Court 
Private Bond 
Probate Court 

do 

do 
Private Bond 

do 
Probate Court 
Alien Comm. 
Private Bond 
Overseers 
Private Bond 

do 

do 
Probate Court 

do 

do 

do 
Private Bond 

do 
Probate Court 
Private Bond 
Overseers 
Probate Court 
Private Bond 
Probate Court 

do 

do 

do 

do 

do 

do 

do 




s c 
.2 ®.2 


3 weeks 
10 days 

6 months 
1 year 

3 months 
1 month 

4 do 
3 do 

7 years 
3 do 

3 weeks 

6 months 
1 month 
1 year 

1 do 

2 do 

2 weeks 
2 months 
10 years 
2 do 
2 weeks 

4 months 
6 months 

2 months 
years 

Unknown 

3 months 
3 years 

years 
6 months 

1 year 

2 months 

5 weeks 




1 

o 

o 

o. 
a, 

m 


Unknown, . 

do , . . 
Typhoid fever, 
Epilepsy, 

Menstrual trouble, 
111 health, . 
Masturbation, 
Rel gious. 
Unknown, . 
Masturbation, 
111 health, . 
Bilious fever, 
Domestic affliction, 
111 health, . 
Epilepsy, 
Unknown, . 
Religious, 
Masturbation, 
Old age, 
Paralysis, 
Unknown, 
Old age. 

Domestic affliction. 
Puerperal, . 
Ill health, . 
Unknown, . 
Ill health, . 

do . . . 
Epilepsy, 
Puerperal, . 
Ill health, . 

do 
Masturbation, 




_ s 

o 


rdnj 'Ti ^ Ti -a '^ 'S'S 
■% 'fcC'S 'B 'baZ 'bi'S % ^ 'S M-g "bCrS 'S-d'fcbSTs'bifcl'a'a'^'bcg'M^^'^ns M 




02 


ajoj (u to <u <o a> ^ ^ '^ 
1^1 o oo.2|oii1^|oij|ooiJo|oooo.2ogiig^1o 




Age 

admit- 
ted. 


t^c;ic<ioioocoj^o<r>-*c<i02 0t^^ooot^ooNoto«2ioioojooc2^eo 

lCC<lTOOTOSc<)C<lrhC^MC<|e05D(N'0>0C0t^l0<Nt^eDC<l-*KlC0-*C0e0-*C^cq 




S3 
^1 


^ _l —1 -H rt ^ ,-1 (M IM <M (N (N (N CO tN ^ ^ _( ^ ^ rt C<HN <M IM BO CO 
S^OOOOCOOOCOOOO'— oooooooooooooooooo 




d 
'A 


cocb':ocr^^O':oocoQ20cocooco^c^coco':occoO':ococ:^soocDOOO':o 
CDO'X>cocO':oyD<;DO^QO;ocooocci(:ocooco«o^coos0^cocococo^^<o 



1862.] 



PUBLIC DOCUMENT— No. 28. 



8T 



Hereditary. 

Hereditary and Period, 
do • 


.3 ^ g ^ U > > 
g'gS'^Tie 'S'S 2 -g 2 'g 2-^2 -c 

S53cgf>5'oS!*oooo^o^og'ot>og->g-o> 

0>e!>on^p>OTS'T3'di3ST30'T3a'Oo'T3tloCI^O 

CU O +^ S 0.4J o Ck ^ d, +j P^ 4j (l,-t-> ft 

b-^ojOQino <pfl o a o a oeo a 


ra r^ ITS 

ecto bCm Mm 

cs.S«.Soots.9oooodoooooooooooo 


com viKtixnmvi^mvi^ tri^nmaiwvjtDaixwwm 
■* G2 00 ^ Tt( o >-l 00 CO 05 >0 CO lO CO ,— 1 ^ CO ,— 1 00 00 00 J-- ■* 

(NtN „ (N IM O) rH <M .-1 r-( N C^ (M (M r- rt r-l 

m 

sissa Issass 

CN<MrJ,-H,-l i-l I-H r-l i-H i-l .^ 


Probate Court 
Private Bond 
Probate Court 

do 
Private Bond 
Probate Court 

do 

do 

do 

do 

do 

do 

do 

do 

do 

do 

do 
Overseers 
Probate Court 
Private Bond 
Probate Court 

do 

do 

do 

do 

do 


4 weeks 
3 months 

3 years 
Unknown 

9 years 
2 months 
2 do 

Few days 
do 

Unknown 

10 months 
2 months 
9 weeks 

1 do 

4 years 
4 weeks 
4 days 

1 week 

2 years 

11 do 

6 weeks 

1 year 

3 months 
6 years 

3 do 

2 weeks 




Unknown, . 
Gestation, 
111 health, . 
Unknown, 
111 health, . 
Unknown, . 

do 
Intemperance, 
Misfortune, . 
Intemperance, 
Unknown, 
Seduction, . 
Turn of life, . 
Intemperance, 
Study, . 

Improper bathing 
Political, 
Unknown, 
Kleptomania, 
Epilepsy, 
Spinal injury, 
Unknown, . 
Ill health, . 
Paralysis, 

do 
Intemperance, 


'C t3 rd nd tS 'd 

kS .S'^.S'* CrtC oSC=s C 


Female 

do 
Male 

do 
Female 

do 

do 
Male 

do 

do 

do 
Female 

do 
Male 

do 

do 

do 

do . 
Famale 
Male 

do 

do 
Female 
Male 
Female 
Male 


C2;JOCOOCOlOOO'OC005C300-+n=«^-HClOCOI^THiOOCD 
COCOiO>0-*0<ICOCO^CO-*--l^COCOr-ilMCO<N!MCOCO'*i<>jTt(C\I 


.— «.— (1— iTtl-^COaOGO-— -^C^COI^T-HCOCCOOOl^GOOOOCOCO^t^ 
CO . 

S'-o5PooooooooooCuooooocoooooo 

P-Cr^-CT3'a'Ci'T3'Cl'CT3't3'C OJTSTj'O'C'a'd'TS'CTS'd'dTa 


CO C3 O' — c-1 CO •* lo o 1^ CO Ci o — c-1 CO -t< lo CO I- 00 ':r; c r-j (M CO 

CO CO -t^ '^^ -H -^ -« -f — ^ -^ -f -h .c >C 'O lO 'O «0 'O »0 ^C «C CO CO CO CD 

COCOCOCDCOCDCCCOCOCOCOCOIOCOCOCOCDCDCOCDCOCOCDCOCDCO 
COCOCOCOCOCOCOCOCOOCDCOCOCOCOCOCCCDCOCOCDCOCOCDCOCO 



88 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



During the year past much attention has been paid to the 
subject of labor. Strict and methodical accounts have been 
kept of the number of patients employed, and the time of 
service. More than twenty-one thousand days' work has been 
performed, a great variety and amount of labor having been 
accomplished. Strictly as our account has been kept, however, 
we shall be misled if we rely too much upon it. We must 
remember that for every four or five patients engaged in ordi- 
nary labor, a competent person must be paid whose time is 
necessarily spent in directing and assisting the insane at their 
work, and who often accomplishes with his four or five patients 
less labor, and of an inferior quality, than he would have 
performed alone. Then there is the loss of time and expe^ise 
attending the more frequent elopements. Then, too, there is 
the great liability to accident from the use of tools among the 
insane, and the increased danger from fire, when so large a 
number of patients are permitted the privileges necessary to 
induce them to labor. 

Besides these considerations, the introduction of labor as a 
system requires other outlays. As the system progresses, shops 
must be erected, tools and machinery must be purchased, and a 
large force of assistants must be employed. 

We should anticipate, also, the annoying question of compen- 
sation for labor actually performed, for it will be difficult to 
make the patient believe the work he has done was of primary 
importance to him in the progress of his recovery, and of little 
or no value to the institution. 

We are thoroughly satisfied, however, that occupation of 
some kind has a curative influence of the highest importance, 
and in order to realize the full benefit of it we have taken 
unwearied pains in this direction. 

. The following tables will show some of the results of labor 
during the year. 

At all times the character of the labor has been regulated 
with due regard to the patient's feelings, and so far as possible, 
in accordance with his previous occupation, and as great a 
variety of labor has been provided as our limited means would 
justify. 



1862.] 



PUBLIC DOCUMENT— No. 28. 



89 



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12 



90 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Articles Made in the Sewing-Rooms, 








Aprons, . . . .21 


Mats, 13 


Blankets, . 




7 


Mattress Ticks, 






73 


Bed Spreads, 




24 


Mittens, pairs of, 






89 


Bed Ticks, . 




109 


Napkins, . 






82 


Bureau Spreads, 




12 


Neck Ties, . 






79 


Chemises, . 




142 


Night Dresses, 






9 


Coats, 




2 


Night Caps, 






10 


Collars, 




7 


Overalls, pairs of, 






30 


Comforters, 




37 


Pants, pairs of. 






90 


Curtains, . 




19 


Pillows, 






30 


Drawers, pairs of. 




42 


Pillow Cases, 






426 


Dresses, 




154 


Pillow Ticks, 






37 


Edging, yards of. 




41 


Sheets, 






488 


Embroidery, yards of. 




7 


Shirts, . ^ 






277 


Frocks, 




18 


Skirts, 






51 


Hankerchiefs, 




25 


Suspenders, pairs 


of, 




163 


Hose and Socks, pairs of, 


166 


Towels, 






268 


Jackets, . * . 


13 


Vests, 






. 42 


Articles Repaired in the Sewing-Rooms. 


Aprons, . . . .17 


Overalls, pairs of, . . 381 


Bags, Meal and Clothes, 


97 


Pants, 




. 1,325 


Blankets, . 


29 


Pillows, 






6 


Bed Spreads, 




. 89 


Pillow Cases, 






77 


Bed Ticks, . 




. 373 


Sheets, 






. 105 


Caps, . 




7 


Shirts, 






. 4,615 


Chemises, . 




7 


Shirt Bosoms, 






. 39 


Coats, 




. 776 


Skirts, 






. 42 


Collars, 




. 115 


Socks, pairs of, 






. 17 


Curtains, . 




18 


Table Cloths, 






. 23 


Drawers, pairs of, 




. 308 


Towels, 






. 10 


Dresses, 




68 


Tunics, 






4 


Frocks, 




. 219 


Undershirts, 






. 294 


Jackets, 




. 84 


Vests, 






. 414 


Mattress Ticks, . 




. 83 











In the following table may be found some of the results of 
the labor performed upon the farm; and besides this some 
crops have been cultivated and gathered from land not belonging 
to the institution, and of which no mention has been made, the 
object simply being to procure more labor for the inmates than 



1862.] 



PUBLIC DOCUMENT— No. 28. 



91 



could otherwise be had. In the table the quantities are 
nearly all true weights and measures, and the prices generally 
those of the market. In addition to this, as usual there has 
been an amount of other labor, such as underdraining, fencing, 
improving the grounds and reclaiming land, much of which 
has been performed by inmates of the hospital under proper 
direction and assistance. 

The patients labor only about six or eight hours each day as 
a general rule. Some few, however, labor through the entire 
day. In procuring this amount of labor our aim is only the 
comfort and restoration of the patient. No question of 
economy or profit is permitted to interfere with this object. 



Apples, . 
Pears, . 
Grapes, . 
Tomatoes, 
Sweet Corn, 
Beans, . 
Parsnips, 
Turnips, 
Potatoes, 
Beets, . 
Carrots, . 
Squashes, 
Peppers, 
Cucumbers, 
Rhubarb, 
Hay, . 
Rowen, . 
Corn Fodder, 
Milk, . 
Beef, . 
Pork, . 



Products of the Farm. 






25 barrels, 


at $2 25 


$56 25 






25 bushels 


,at 2 00 


50 00 






2 


at 2 00 


4 00 






150 « 


at 50 


75 00 






50 


at 1 00 


50 00 






75 " 


at 2 00 


150 00 






. 300 


at 50 


150 00 






400 « 


at 20 


80 00 






1,200 


at 50 


600 00 






600 « 


at 20 


120 00 






800 


at 20 


160 00 






7 tons 


at 25 00 


175 00 






20 bushels, 


at 20 


4 00 






75 " 


at 50 


37 50 






. 2,500 pounds. 


at 02 


50 00 






80 tons, 


at 15 00 


1,200 00 






7 " 


at 15 00 


105 00 






10 " 


at 4 00 


40 00 






50,000 quarts, 


at 04 


2,000 00 






81,050 pounds 


at 08 


648 40 






95,036 « 


at 06 


580 21 



5,325 36 



I am unable to give my usual table for the daily and monthly 
consumption of coal, but have no doubt that it has been some- 
what greater during the year past, than for several years pre- 
ceding. This is owing partly perhaps to the kind and quality 



92 LUNATIC HOSPITAL AT WOBpCESTER. [Oct. 

of coal used, partly to the condition of the apparatus and 
partly to change of firemen, one having died and another having 
enlisted in the army. 

The apparatus for warming and ventilating, however, con- 
tinues to give as good results as ever, and has not yet required 
any extensive repairs. 

It gives us pleasure to be able to report a good degree of 
success in our efforts to amuse, instruct and gratify in our 
patients a wholesome love of variety, and to introduce to them 
many new subjects of thought, by lectures, readings, social 
entertainments of various kinds, by books, pictures and maps, 
and by every means which our limited income would allow. 
Our lecture season continued with some interruptions through 
the entire year. Concerts of sacred music have also frequently 
been given by friends from the city. Sociables are often held 
during the long winter evenings, at which both sexes join in 
all the games common on such occasions. In all our labors 
every effort has been made to keep alive the mental faculties of 
the patients by introducing to them such subjects of thought 
as require only simple and easy mental action, hoping thereby, 
if possible, to assist in arresting the progress of disease and to 
prevent the remaining faculties from being involved in that 
general ruin which is sure to overtake the minds of those who 
cannot be interested in any thing beyond the sphere of their 
own personality. 

The Sunday services in the chapel are still performed in a 
most satisfactory manner by Rev. Samuel Souther, and there is 
great reason to believe that the patients receive a large share 
of comfort from his ministrations. 

Drs. Rice and Prentiss continue to perform the duties of 
Assistant-Physicians in the most acceptable manner to the 
patients, and with a zeal for the welfare of the institution 
worthy of all praise. 

My assistants are almost without exception thoroughly 
devoted to the best interests of those consigned to our care. 

We are under obligations to many friends for books, pictures, 
newspapers, and assistance in our social entertainments, which 
have contributed largely to the comfort and happiness of the 
inmates. 



1862.] PUBLIC DOCUMENT— No. 28. 93 

As we now close the labors of the past and commence the 
duties of another year, we may well invoke the blessing of 
Him without whose aid all our labors are vain. 

By His blessing the closing year has been one of success. 
May we hope that the same degree of prosperity will crown the 
labors of the one now opening. 



MER^CK BEMIS. 



State Lunatic Hospital, Worcester, 
October 1, 1862. 



94 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



AN INVENTOEY 



Of amounts in value of the Stock and Supplies on hand. 



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 inmates' department, 

Superintendent's department. 

Housekeeping department. 

Ready-made clothing. 

Dry goods. 

Provisions and groceries, 

Drugs and medicines. 

Fuel, 

Library, . 







$3,250 00 






2,500 00 






^ 750 00 






5,500 00 






. 4,000 00 






3,500 00 






. 350 00 






1,200 00 






100 00 






. 250 00 






1,500 00 






100 00 






. 1,500 00 






300 00 



1862.] PUBLIC DOCUMENT— No. 28. 95 



LAWS EELATING TO TERMS AND FORMS OF ADMIS- 
SION. 



[Chapter 223 Acts of 1862.] 

An Act concerning state lunatic hospitals and insane and 

idiotic persons. 
Be it enacted, §"0., as follows : 

Section 1. The titles of the state lunatic hospitals shall be severally, 
The Worcester Lunatic Hospital, The Taunton Lunatic Hospital, and 
The Northampton Lunatic Hospital. 

Section 2. The lands now holden and which may hereafter be 
holden, by the trustees of any state lunatic hospital, in trust for the Com- 
monwealth, for the use of the institution of which they are trustees, shall 
not be taken for any street, highway or railroad, without leave of the 
legislature specially obtained. 

Section 3. Any of the judges of the supreme judicial, superior, and 
probate courts, and, in the city of Boston, of the police court, may commit 
to either of the state lunatic hospitals, any insane person who, in their 
opinion, is a proper subject for its treatment or custody. But in all 
cases, the evidence and certificate of at least two respectable physicians, 
shall be required to establish the fact of insanity. In all cases the judge 
shall certify in what place the lunatic resided at the time of his commit- 
ment ; or if ordered to be confined by any court, the judge shall certify 
in what place the lunatic resided, at the time of the arrest in pursuance 
of which he was held to answer before such court ; and such certificate 
shall, for the purposes of this act, be conclusive evidence of his residence. 

Section 4. Any person applying for the commitment or for the 
admission of a lunatic to a state lunatic hospital, under the provisions of 
this act, shall first give notice in writing to the mayor, or one or more of 
the selectmen, of the place where the lunatic resides, of his intention to 
make such application ; and satisfactory evidence that such notice has 
been given shall be produced to the judge in cases of commitment, and to 
the trustees upon applications for admission. 

Section 5. Upon every application for the commitment or admis- 
sion of an insane person to any hospital or asylum for the insane, there 
shall be filed with the application or within ten days after the commit- 
ment or admission, a statement in respect to such person, showing as 
nearly as can be ascertained his age, birthplace, civil condition, and 



96 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

occupation ; the supposed cause and the duration and character of his 
disease, whether mild, violent, dangerous, homicidal, suicidal, paralytic or 
epileptic ; the previous or present existence of insanity in the person or his 
family ; his habits in regard to temperance ; whether he has been in any 
lunatic hospital, and if so what one, when, and how long ; and, if the 
patient is a woman, whether she has borne children, and, if so, what time 
has elapsed since the birth of the youngest t the name and address of 
some one or more of his nearest relations or friends, together with any 
facts showing whether he has or has not a settlement, and if he has a settle- 
ment, in what place ; and if the applicant is unable to state any of the 
above particulars, he shall state his inability to do so. The statement or 
a copy thereof shall be transmitted to the superintendent of the hospital 
or asylum, to be filed with the order of commitment, or the application 
for admission. 

Section 6. The judge may hear and determine such applications, in 
respect to persons alleged to be insane, at such times and places as he 
may appoint ; and the presence of the alleged lunatic at the hearing may 
be required or dispensed with, in the discretion of the judge ; and the 
court may in its discretion, issue a warrant to the sheriflp, or his deputy, 
directing him to summon a jury of six lawful men, to hear and determine 
whether the alleged lunatic is insane. Whenever a jury is summoned, 
pursuant to the provisions of this section, the same proceedings shall be 
had and the same fees and expenses paid as are provided by the General 
Statutes, chapter seventy-three, sections twelve, thirteen, fourteen, fifteen 
and sixteen. 

Section 7. Whenever application shall be made to any judge of 
probate for the commitment of an insane person under the provisions of 
this act, he may allow to the sherifi", deputy-sherifi" or constable, or other 
person to whom a precept is directed by name, who may serve the same, 
the same fees as are allowed to officers upon the commitment of persons to 
prison, and such further sum for expenses incurred in said commitments, 
or in bringing such lunatic before the judge, as to him may seem reason- 
able ; and the sums so allowed shall be certified and paid, as provided in 
the General Statutes, cha,pter seventy-three, section sixteen. 

Section 8. Upon every application for the admission of an insane 
person to the several State lunatic hospitals, or to any asylum or private 
house for the reception of the insane, the applicant shall file with his appli- 
cation a certificate, signed by two respectable physicians, one of whom, 
when practicable, shall be the family physician of the patient, certifying 
after due inquiry, and personal examination of the patient by them, within 
one week prior to the date of the certificate, to the insanity of the person in 
whose behalf admission is sought, and that such person is a fit subject for 
remedial treatment at such hospital, asylum, or private house. 



1862.] PUBLIC DOCUMENT— No. 28. 97 

Section 9. Any insane person who is supported by any place as a 
pauper, may be committed by the overseers of the poor thereof, to either 
of the state lunatic hospitals, with the consent of the trustees, and shall 
be kept for a sum not exceeding the actual expense of his support. And 
the trustees shall receive into the hospital, any other insane person having 
a settlement or residence in this Commonwealth, for such compensation 
as they may determine. 

Section 10. The expenses of the state lunatic hospitals for the 
support of lunatics having known settlements in this state, shall be paid 
quarterly, either by the persons obligated to pay, or by the place in which 
such lunatics had thieir residence, at the time of their commitment, unless 
other sufficient security is taken to the satisfaction of the trustees, for 
such support. If any place or person refuses to pay whatever sum may 
be charged and due according to the by-laws of the hospital, on account 
of the support of such patient therein, or for the removal of any patient 
whom the trustees are authorized by law to remove, for thirty days after 
the same has been demanded by the treasurer, in writing, of the mayor 
and aldermen of the city, or of the selectmen of the town, or of the person 
liable therefor, the same, with interest from the time of such demand, 
may be recovered for the use of the hospital in an action to be instituted 
by the district-attorneys, or other prosecuting officers, in the name of the 
treasurer, against such delinquent city, town or person. 

Section 11. The expenses of the hospitals for the support of lunatics 
not having known settlements in this state, committed thereto, shall be 
paid quarterly by the Commonwealth at the same rates charged for city 
and town pauper lunatics therein, but not to exceed the sum of two 
dollars and sixty-two cents per week ; and the same may afterwards be 
recovered, by the treasurer of the Commonwealth, of the lunatics them- 
selves, if of sufficient ability to pay the same, or of any person or kindred 
obligated by law to maintain them, or of the place of their settlement if 
any such is ascertained ; and the district-attorneys, or other prosecuting 
officers, shall institute suits therefor when requested. 

Section 12. It shall be the official duty of the attorney-genei*al and 
district-attorneys to advise and consult with the trustees and treasurers of 
the several state lunatic hospitals, when requested by them, on all ques- 
tions of law relating to their official business. 

Section 13. If at any time, all the state lunatic hospitals shall be so 
full that the inmates cannot all be suitably accommodated therein, and in 
the opinion of the trustees of either hospital it is proper that some should 
be removed, the trustees may remove to their respective homes, or to the 
places of their legal settlement, or of their residence, so many as may be 
necessary to affi)rd suitable accommodation for the remainder ; but only 
such patients shall be selected for removal as, in the opinion of the 
13 



98 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

trustees and superintendent, are not susceptible of improvement and can 
be suitably managed at their homes or in the places to which they may 
be sent. 

Section 14. Any judge of the supreme judicial or superior court, at 
any term held within and for the county in which either hospital is 
located, or the judge of the probate court of such county, or the trustees 
of such hospital may, on application in writing for the discharge from 
such hospital of any insane person who has remained there a sufficient 
time to make it appear that he is incurable and not dangerous to the 
peace arid safety of the community, cause him to be delivered to the 
agents of any place in which he has a legal settlement or on which he 
has a legal claim for support, or to his friends, when it appears that it 
would not be to his injury, and that he would be comfortably and safely 
provided for by any parent, kindred, friend, master or guardian, place or 
institution. When application has been made to any judge for the dis- 
charge of any insane person, any person interested in said discharge may 
request a trial upon said application by a jury, and the judge before 
whom the trial is to be held shall issue a warrant to the sheriff of the 
county, or his deputy, directing him to summon a jury of six lawful men, 
to hear and determine whether such insane person is incurable, and may 
be comfortably and safely provided for according to the terms of this 
section. The proceedings shall be the same in selecting jurors, conduct- 
ing the trial and allowing the costs, as are provided in sections twelve, 
thirteen, fourteen, fifteen and sixteen of chapter seventy-three of the 
General Statutes. 

Section 15. The several judges of probate in the counties where 
the state lunatic hospitals are located, shall have the same authority at 
any time to discharge from confinement lunatics committed to the hospi- 
tals, as is conferred upon the trustees and the justices of the supreme 
judicial and superior courts by the twenty-ninth section of chapter 
seventy-three of the General Statutes. 

Section 16. The money and cost of clothing which the trustees of 
any state lunatic hospital may by law furnish to discharged pauper 
lunatics, the expense of pursuing such as elope therefrom, and of burial 
of pauper lunatics dying in the hospitals, shall be reimbursed to the 
trustees by the places of legal settlement of city and town paupers, and 
by the Commonwealth in the case of state paupers. 

Section 17. When a person held in prison on a charge of having 
committed an indictable offence is not indicted by the grand jury, or, on 
trial is acquitted by the jury by reason of insanity, the jury in either case 
shall certify that fact to the court, and thereupon if the court is satisfied 
that he is insane, they may order him to be committed to one of the state 
lunatic hospitals, under such limitations as they may direct. 



1862.] PUBLIC DOCUMENT— No. 28. 99 

Section 18. The eighth, ninth, tenth, eleventh, nineteenth, twen- 
tieth, twenty-tirst, twenty-second, twenty-third,'^ twenty-fourth, twenty- 
seventh, twenty-eighth and thirtieth sections of the seventy-third, and 
the fifteenth section of the one hundred and seventy-first, and the 
seventeenth section of the one hundred and seventy-second chapters of 
the General Statutes, are hereby I'epealed. 



PETITION 



[The applicant must answer in writing the printed interrogations accompanying 
this blank.] 

To the HonoraUe the Judge of the Probate Court, in and for the County 

of 

of 

on oath complains that 

of , in said county of , is an insane 

person, and a proper subject for the treatment and custody of the 
"Worcester Lunatic Hospital. 

Wherefore h prays that said 
may be committed to the said Worcester Lunatic Hospital, according to 
law 



, ss. A. D. 186 

Then the above named 
made oath that the above complaint, by subscribed, is true. 

Before me. 

Justice of the Peace. 



I, the subscriber, one of the selectmen of 

where said 
resides, hereby acknowledge that notice in writing has been given to me 
of the intention to present the foregoing complaint and application. 

A. D. 186 



100 LUNATIC HOSPITAL AT WORCESTEE. [Oct. 

To the Honorable the Judge of the Prolate Court, in and for the County 

of 

The subscriber, having made application to your Honor for the 

commitment of 

to the Worcester^ Lunatic Hospital, as a lunatic, now presents the 

following statement, in answer to interrogatories : — 

What is the age of the lunatic ? Ans. 

Birthplace ? Ans. 

Civil condition of lunatic ? Ans. 

Occupation ? Ans. 

Supposed cause of disease ? Ans. 

Duration ? Ans. 

Character — whether mild, violent, or dangerous ? Ans. 

Homicidal or suicidal ? Ans. 

Paralytic, or epileptic ? Ans. 

Previous existence of insanity in the lunatic ? Ans. 

Previous or present insanity in any of the family ? Ans. 

Habits in regard to temperance ? Ans. 

Whether he has been in any lunatic hospital ; if so, what one, when, 
and how long. Ans. 

(If a woman.) Has she ever borne any children? Ans. 

(If a woman.) How long since the birth of her last child ? Ans. 

Name and post-office address of some one of the nearest relatives or 
friends ? Ans. 

What facts show whether h has or has not a settlement, and 
where, if anywhere, in this State. Ans. 

[For the law relating to settlement, see Gen. Stat. chap. 69.] 

Applicant. 



physicians' certificate. 
The subscribers, respectable physicians of 
in the county of , having made due inquiry and 

personal examination of • named 

in the foregoing application, within one week prior to the date hereof, 
certify that the said is insane, 

and a proper subject for the treatment and custody of the Worcester 

Lunatic Hospital. 

A. D. 186 

, ss. A. D. 186 

Then the above named ^nd 

made oath that the above certificate is true. 
Justice of the Peace. 



1862.] PUBLIC DOCUMENT— No. 28. 101 

Gommonioealth of Massachusetts. 
, ss. 
At , in said county, on the 

day of A. D. 186 . 

On the application of 
for the commitment of 

of in said county, to the Worcester 

Lunatic Hospital, ; notice 

in writing having been given by said applicant to one of the selectmen 

of where said 

resides, of h intention to make said application, and said 

having been duly notified of the time and place appointed 
for hearing, it appears upon a full hearing that said 
is an insane person, and a proper subject for the treatment and custody 
of the Worcester Lunatic Hospital. 

Therefore it is ordered that said 
be committed to the said Worcester Lunatic Hospital. 

Judge of Probate Court. 



FOKM 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 
successor 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 



102 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

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 



FORM OF PRIVATE BOND. 

State Lunatic Hospital at Worcester. 
Whereas , of , 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 occas-ioned 
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 
damages he may do 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. 



1862.] PUBLIC DOCUMENT— No. 28. 103 



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 
patients. 

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. 

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

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

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



METEOROLOGICAL OBSERVATIONS 

MADE AT 

THE STATE LUNATIC HOSPITAL, WORCESTER, MASS., 

1861-2. 

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. 



14 



106 



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108 LUNATIC HOSPITAL AT WORCESTER. [Oct. 





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•PUBLIC DOCUMENT— No. 28. 



121 





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122 LUNATIC HOSPITAL AT WORCESTER. 



[Oct. 



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INDEX. 



Page. 

Accounts, 27 

Admissions, 1861-2, 5, 49, 50, 51 

from various causes, 55 

in thirty years, 8, 55, 60 

monthly, 53 

of foreigners, 51 

on bonds, 51 

yearly, 66 

Ages, 59, 60 

Almshouses, State, money advanced to by State, 28 

State, paid monthly by State, 28 

Amusements, 40 

insufficient for occupation, 41 

Average number in Hospital, 65, 66 

Blind Institution, money paid to in advance, 28 

California Asylum, free, 19 

Causes of insanity, 17, 18, 55 

permanent, . . . . ' 18 

Cells removed, 6 

Classes to whom hospital was offered, 7 

Constant insane population in State, .16 

may be diminished, 18 

Convict, insane, 29, 33 

Counties from which patients are sent, 61 

Courts, patients committed by, 51, 66 

Credit, Hospital buys on and gives, 26 

New Jersey and New York Asylums not allowed to buy on, . . . 28 

Criminal insane, 29 

cost of, 37 

escapes of, 32 

injurious to other patients, 31 

increase cost of hospital, 34 

provision for in Pennsylvania and Rhode Island, 36 

require greater watchfulness, 33 

should not be in hospital, 30 

Criminal Lunatic Asylums in New York, England and Ireland, .... 36 

I 

Deaths, 49,66 

causes of, 57 

ratio of, 68 



124 INDEX. 

Page. 

Debts due to and from hospital, .... 27 

Discharges, 1861-2, 49 

foreigners, 51 

monthly, 53 

yearly, 66 

Early notions of insanity, 6, 7, 40 

Economical and liberal policies, effect of, . 23 

English Asylums, cost of paupers in, . ' . . 22 

criminals in, . 36 

mechanical trades in, 42 

Escapes of criminal patients, . 32 

cost of, . . . . . . ' . . 34 

effect of on hospital, ; . 34 

Expense of hospital, each patient in, 14, 65 

in several States, 21 

same under different policies, 25 

sane and insane paupers, . 22 

Eye and Ear Infirmary, paid by State, in advance, 28 

Farm, products of, 91 

Financial value of hospital labors, 8 

Flowering season for twenty-four years, 21 

Foreigners admitted, 51 

at end of year, . 52 

deficiency of paj'ment for paid by natives, 14 

and natives, ratio of in hospital, .12 

use hospital in undue proportion, 11,24 

Forms of admission, • . 99 

of disease of mind, 54 

Health, years of, enjoyed by recovered patients, 10 

Hospital, borrows money and buys on credit, . 26 

credit given by, on all bills, 27 

curative, 8 

custodial originally, 7 

enjoyed by foreigners more than natives, . . . . . . . 11 

financial worth of its labors, 9 

free in California, Illinois, Indiana, Ohio, Wisconsin, 19 

improvements in, 6 

income, sources of, . . • . . . 26 

labors, results of, 8 

loses by State paupers, 14 

number and proportion of patients restored in, 8, 10 

object of to employ powers sanely, 41 

original object of, 7, 40 

Idiot School, paid by State, in advance, 28 

Illinois Hospital, free, 19 

Improvements, 6 

Indiana Hospital, free, !19 

Insanefconstant number of in Massachusetts, 16 

maj' be diminished, 18 

how treated by managers of hospitals, £0 

mental and moral condition of, ... 30 



INDEX. 125 

Page. 

Insane, number made yearlj', 17 

old and recent cases received and cured, 16 

state of, thirty years ago, 7 

Insanity, curable in early stages, 16 

duration of, in curable, 17 

duration of, in incurable, 10 

years of, removed by hospital, . . . ' 11 

Kentucky pays for paupers, . ; 19 

Labor and amusements, comparative desirableness of, 41 

needed by all, 39, 40 

performed last year, 38, 89 

Laws concerning insanity in Massachusetts, 95 

Life tables, of sane and insane, 10 

Maine pays part of cost of patients not rich, . 19 

Married and single, 60 

Mechanical trades, effect of, 44 

in British asylums, 42 

in Irish asylums, 44 

safety of, in hospitals, 44 

to be introduced at Worcester, 45 

Meteorology, 105 

summary of, 119 

Michigan, counties pay for patients not rich, 20 

Native patients, kept out of hospital by expense, ....... 15 

pay for deficiency of foreigners, 14 

New Hampshire pays part of cost of patients not rich, . . . . . . 19 

New York, Criminal Lunatic Asylum, 36 

hospital not allowed to buy on credit, 28 

pays salaries, . 19 

provides for support of patients not rich, 20 

New Jersej', hospital not allowed to buy on credit, 28 

pays salaries, 19 

provides for support of patients not rich, 20 

North Carolina pays part of paupers' support, 20 

Officers, 3 

Occupations of patients, 61 

Ohio Hospitals, free, 28 

Overseers of poor, patients committed by, 51 

Patients, descriptive list of, 70 

Paupers, sane and insane, comparative cost of, 22 

Payment by State, in advance, to Blind Institution, &c., 28 

monthly, to State Almshouses, 28 

to hospitals, deficiency of paid by independent patients, . . . . 21 

history of, 14 

less than cost in Massachusetts, 13 

less than cost in South Carolina, 21 

Pennsylvania pays part of cost of patients not rich, 20 

Policies of different States in support of hospitals, . 18 

effect of on recovery of patients, 25 



126 INDEX. 

Page. 

Rain and snow, twenty-one years, 120 

Recoveries, 1861-2, 49 

in each year, 66 

in thirty years, 8 

per cent., 68 

ratio of, in Massachusetts and Ohio, 24 

Salaries, how paid, 14 

paid by State, in Georgia, Michigan, New Jersey, New York, and Pennsyl- 
vania, 19 

Snow and rain, 120 

South Carolina makes independent patients help support poor, .... 21 

State paupers at end of each year, 52 

Treasurer's Report, 48 

Trustees, . ' ■ • 3 

Weather and wind, 118 

Wisconsin Hospital, free, 19 

Working capital, 26 

borrowed, 29 

at cost of independent patients, • . . . . 29 



iiPR E5'S3W.PJL