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



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4 



PUBLIC DOCUMENT No. 27. 



THIRTY-FIRST ANNUAL REPORT 



THE TRUSTEES 



STATE LUNATIC HOSPITAL 



A.T WOECESTER, 



OCTOBER, 1863. 



BOSTON: 

WRIGHT & POTTER, STATE PRINTERS, 

No. 4 Spring Lane. 

18 6 4. 



Digitized by the Internet Archive 

in 2010 with funding from 

University of Massachusetts Amherst 



http://www.archive.org/details/annualreportoftr29stat 



€ommonu)ealtl) of JHasaadjusdte. 



THIRTY-FIRST ANNUAL REPORT 

OF THE 

TRUSTEES OF THE STATE LUNATIC HOSPITAL, 

^.T ^W O R C E STER. 



To His Excellency the Governor, and the Honorable Council : 

The Trustees of the Worcester Lunatic Hospital beg leave to 
make the following report of the state of that institution 
during the year ending September 30, 1863. By the blessing 
of that superintending Providence, that ever watches over the 
weak and suffering, the hospital has had another year of pros- 
perity. It has accomplished its usual work, and with the usual 
success. 

At the beginning of the year, October 1, 1862, 

There were in the institution, 
In course of the year there have been admitted, 
Under care during the year, .... 
Discharged, . . . 

Died, 

Leaving in the house, September 30, 1863, 

Of those (104) who were discharged, 51 males, and 53 fe- 
males, have recovered so as to be able to resume their previous 
positions in their families, and their usual responsibilities in 



Males. 


Females. 


Total. 


200 


196 


396 


114 


101 


215 


314 


297 


611 


101 


81 


182 


16 


14 


30 


197 


202 


399 



4 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

society. Sixty-five, (forty-six males and nineteen females,) 
have not recovered to this extent, yet so far as to be able to 
live in their families, and to do some work, and enjoy some of 
the comforts of ordinary life. The cases of twelve others have 
resisted all the powers and influences of the hospital for their 
improvement, and were sent back to their own homes, or to 
those provided for them by their towns or the State, where, 
unless they are more favored than others of their degree of 
disease, they must remain through life as they now are, receiv- 
ing the various degrees of guardianship and care needed to 
keep them in the best condition they are capable of enjoying. 

VARIED CHARACTER OF INSANITY. 

Insanity is a malady of manifold phases, varied almost infi- 
nitely in strength and combination of elements, as well as in 
those of the healthy mind and body. As it is rare that any two 
persons are so nearly alike in form, temperament, and charac- 
ter, or even in countenance, that one cannot be distinguished 
from the other, so it is equally rare, that the mental perver- 
sions, with their complications, are the same in all, or even in 
any two different patients. Of the manifold mental and moral, 
as well as physical elements, that enter into and compose the 
human being, any one, any number, or even all, may be disor- 
dered ; they may be all equally diseased, or in any variety of 
degree or combination ; and to this extent, and in that form 
and manner, the man, the possessor of these elements, is insane ; 
otherwise lie may be sane. 

Some persons think, talk and act calmly, rationally and dis- 
creetly, in connection with' some subjects, but are excited, 
insane, and even wild, in connection with others. Some are 
insane only in certain circumstances, or in certain associations, 
or places, but are elsewhere sane. Many are insane at home, 
but are sound when abroad. Some are insane as to certain 
persons, but not in reference to others. It unfortunately 
happens sometimes, that the closest and dearest natural and 
habitual connections, where, in health, life runs most smoothly 
and joyously, are disturbed and made most wretched, by the 
mental disease of one or the other of the parties. Thus parents 
become insane, suspicious, accusatory, quarrelsome in respect 
to their children, and children 'in respect to their parents. 



1863.] PUBLIC DOCUMENT— No. 27. 5 

Husbands become insane, and morbidly suspicious in reference 
to their wives, and wives in reference to their husbands ; their 
minds are sometimes disordered in relation to certain others, to 
friends, acquaintances, even strangers. 

In regard to those who are the subjects of these diseased sus- 
picions, fears, aversions, or undue confidence, the emotions take 
precedence of observation and reason, and become the founda- 
tion of all other ideas. The lunatic first suspects or confides, 
hates or loves, and then his excited imagination invents, shapes, 
measures, or colors facts to suit and substantiate the precon- 
ceived opinion, and the subordinated reason moulds the whole 
to harmonize with morbid feeling ; while, in regard to other 
persons, these disordered men and women may be entirely sane. 
In the same manner, certain ideas, places, and associations 
disturb and craze some, who, elsewhere, and in other connec 
tions, and with other subjects, are calm, clear-minded, and able 
to direct their moral and mental powers with discipline, to the 
ordinary course of thought, and the usual affairs of life. 

INSANE NEED VAEIED MANAGEMENT. 

In view of these diversities of powers in health and disease, 
and of the manifold varieties of capacities, of thought, labor and 
enjoyment that are left still sound in the insane, and of their 
varied liabilities to suffering or torpor, if misused or neglected, 
it is the first and most important business of the manager of a 
hospital to thoroughly analyze the mental condition of his 
patients, and ascertain wherein, and to what extent, they are 
unsound, what elements are disordered, what ideas, emotions, 
circumstances, or persons, disturb or depress them, what ele- 
ments in them are yet healthy, and what they can do or bear 
without faltering. This is not only the first work of the 
superintendent, but it must be continued and renewed, day by 
day, to meet the patient's varying conditions, and enable him 
so to arrange and measure out his treatment as t» avoid every 
disturbing cause and keep the excited and diseased elements 
dormant, the healthy elements active, and the patient sound 
in as many of his powers, and as large a part of the time as 
possible. 

Some lunatics do this by their own self-analysis and self-dis- 
cipline. They know their own weak points, and carefully avoid 



6 '.' LUNATIC HOSPITAL AT WORCESTER. [Oct. 

those ideas, persons and burdens that create disorder, as a 
cautious, self-denying dyspeptic ascertains what food he can, 
and what he cannot digest, and then refuses all those articles 
that the stomach cannot dissolve, and eats only such as can, 
easily and without pain, be converted into the nutriment of the 
blood. 

Thus the sagacious physician of mental diseases, in a hospital 
and elsewhere, determines and applies his treatment, his guar- 
dianship and his aid, his means and measure of restraint, his 
kind and degree of encouragement and support for each patient, 
according to the peculiarities of his case, and these are varied 
from day to day, to conform to the variations of the disordered 
elements, in improvement or deterioration. This, of course, 
requires an acute power of analysis in the physician, and an 
intense and unremitting habit of observation of the mental 
states of his patients ; but the reward is great in the success of 
his treatment, and the blessing to his patients is rich in the 
amount of comfort and sanity enjoyed during the healing 
process, and the earlier and more frequent returns to health. 

Some patients cannot manage themselves as other men and 
women do at home, yet require only a guardianship to watch 
over them. These can be kept in discreet families, to whom, or 
to whose head, they feel responsible, and who watch over, advise 
and direct them as far as needed. With this amount of 
support, they are sustained in healthy action, and generally in 
tolerably good mental and moral condition ; but, if removed 
from this, they falter, wander, indulge in strange ways, and in 
morbid thoughts, and manifest mental unsoundness. Some 
need a more constant guardianship than can be found in a 
private family, and must be under the government of a hospital 
which exercises a similar, but more effective supervision. 

With this protection and aid, they generally conduct them- 
selves as others do, they engage in employments, use their 
powers, and enjoy life, in various ways and degrees, according 
to the nature and power of their disorder. When some are 
removed and defended from the causes that excited and dis- 
turbed them, when they are protected in those elements which 
are most exposed, and sustained in those which are weak, when 
they are separated from the persons, associations, scenes, cir- 
cumstances, and ideas, in regard to, or in connection with, 



1863.] PUBLIC DOCUMENT— No. 27. 7 

which they are insane, and, as long as this protection and 
support are given them, their sane elements only are brought 
.into action. These absorb their attention, and occupy their 
active powers, and always enure to the patient's comfort and 
advantage, and sometimes to his profit. 

In the management of the patients in this hospital, the 
superintendent has found the practice of these principles both 
profitable and very convenient. Giving every one the largest 
liberty consistent with his disease and liability, he has left each 
to the exercise of his faculties, and the enjoyment of his powers, 
as far as these could be used and enjoyed sanely, and allowed 
and encouraged him to be a law unto himself, so far as that law 
was consistent with reason and common sense. 

There are, and have been connected with this institution, 
patients under every degree of guardianship, from some, who 
were never permitted, to go out of the wards without a watchful 
custodian, to those who only sleep in its rooms, and eat at its 
tables, but go out and come in, and attend to affairs abroad, as 
men do in other positions, except that they thereby acknowledge 
the authority of the officers over them, and govern their 
conduct and conversation in accordance with the opinions and 
wishes of the heads of the establishment. 

One patient, whose disordered or unbalanced mind would not 
allow him to live, nor to conduct himself as other men at home, 
nor enable him to manage his affairs with discretion, was placed 
under the guardianship of the hospital. Dr. Bemis soon saw 
his weakness and his remaining power, and advised him «to 
resume his ordinary business, that of an itinerant pedler in 
Worcester and its vicinity, but to return to the hospital for his 
meals, and at night. By this aid, keeping himself responsible 
to the hospital managers for his propriety of conduct, and 
reporting himself thus frequently, he gained power over himself, 
week by week, and at length recovered, and went to his home, 
and engaged in his accustomed business there. 

Another was a mechanic, with similar disability from mental 
disorder, and in similar need of the hospital influence ; yet, 
with a similar power of self-management, when aided by the 
supervisory watchfulness of the physicians of the institution. 
He went daily abroad, and worked in the shops and among the 
people of the city, but ate and slept in the hospital, and, after 



8 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

months of this limited but effective guardianship, he regained 
his mental health and returned to his home. 

One patient, a male, has daily worked in the neighborhood 
at such employment as he could procure, receiving his wages at 
night, and has placed in one of the savings banks about one 
hundred dollars, the result of his labors. He is still insane, and 
unable to live at home, but with the care and control of the 
hospital, he gets along without trouble. 

Three of the patients, who had been accustomed to light 
labor when in health, have during a part of the year, worked 
in stores in the city, waiting behind the counters, or carrying 
out goods daily and returning to the hospital for their meals, 
and at night to sleep, and only by frequent trials were they able 
to break up their connection with the institution. At first 
taking their meals away, and at last sleeping at home, and 
finally becoming so well as to be discharged from all custody 
and care. 

The foregoing are the extremes of mental power among the 
insane, and they required the lowest degree of guardianship ; 
but there are all grades of liberty and restraint, from these down 
to those who are sometimes temporarily confined to their own 
rooms. Some other patients go out and come in at pleasure. 
Some walk about the town alone ; some visit in the families of 
friends, and some go a shopping. Many do these in company 
with an attendant ; many men work on the farm, in the garden, 
or the grounds about the house, in the shops, some alone, but 
generally under supervision. Many women work in the wash- 
room, the ironing room, the sewing rooms, and perform their 
labors with the same apparent regularity and discipline as other 
people abroad. These at times, and others at any time, read, 
play games, chess$ back-gammon, cards, &c, and some are 
musicians. They talk, they take interest in the affairs of the 
world ; they discuss the war, politics, religion, agriculture, and 
other matters of general or special interest, or indulge in 
pleasant chit-chat, frivolous little talk, as other men and 
women do at their homes. 

Under the direction of the Superintendent, the patients — 
male and female— gather in occasional or weekly parties, which 
are attended by most of the household, by all whose condition 
and health justify it. They look forward to these assemblings 



1863.] PUBLIC DOCUMENT— No. 27. 9 

with manifest satisfaction ; they get themselves in readiness ; 
the gentlemen dress themselves with propriety, and the ladies 
put on such outward adornments as may be there within their 
reach. Then there may be seen a social party of men and 
women, elsewhere and at other times insane, but now and here 
apparently sane, engaged in plays, conversation, and at times 
in dancing, and other means of social enjoyment, as men and 
women are at their gatherings in the outer world. 

About three-fourths of the household meet in the chapel bn 
Sunday, and every evening of the week for religious worship. 
They have also frequent lectures, given by friends of the 
hospital, on such topics as are treated before popular lyceums. 
The patients go gladly to these meetings ; they esteem it a 
privilege to be allowed to be there, and a privation to be kept 
away. The excitable sometimes beg to be permitted to attend, 
and promise to keep quiet if they can be so indulged. It is 
extremely rare that this promise is broken, or that any violation 
of decorum is manifested. The patients listen to the prayers, 
the Scriptures, and the lectures with apparent attention, and 
some of them afterwards talk of what they have heard, and 
discuss the topics that have been presented to them. 

If a person, who is not familiar with mental disorder, were 
to be present at these parties, chapel services or lectures, and 
observe the order, quietness and propriety of manner of these 
patients, or hear their remarks, on the following day, upon 
what they had heard, he would find little reason to suspect that 
he was in a house of lunacy, and among its appropriate 
inmates ; and yet, if he would analyze these men and women, 
and unveil their secret hearts and understandings, he would 
find among them all sorts of insane delusions, and all the 
varieties of perverse and maddening emotions which are 
suppressed and kept dormant by the soothing, cheering, appro- 
priate and healthful influences of the hospital. These diseased 
elements, though sleeping, are yet not dead, but may be quick- 
ened into action, and would be so quickened if they were 
exposed to the ordinary trials and irritations of the world, or 
were engaged in the common business of life, or should attempt 
to bear the usual responsibilities of society. 

Few are insane in all their elements j very few keep their 
insane elements at all times in action, or present or manifest 

2 



10 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

their insanity in all their intercourse with the world. On the 
contrary, most are only partially insane ; they may think and 
talk wildly on some subjects, and in relation to some persons, 
matters, or things, but they think and talk rationally in regard 
to many, perhaps most others. A stranger passing through the 
wards, the shops, or the working rooms, might have no occasion 
or reason to suspect that he was among lunatics, whose mental 
machinery could not run in the world's channel without dis- 
turbance or breaking down, because while there, so far as he 
can see or judge, this machinery seems to run smoothly. 

The visitor might hold occasional conversations with some, 
and even talk frequently and long with others, without discov- 
ering any mental aberration ; yet if he should try them in their 
weak elements, or touch their unsound places, he will find, 
among these persons, that appear to be so calm and rational, 
and are apparently sane', that one believes that he is immeas- 
urably rich, and holds millions in the public funds. Another, 
that he is a pauper, although he really owns farms or stores of 
merchandise, or has money at interest. Some believe that they 
are just on the verge of poverty, although they are among the 
wealthiest ; another imagines himself a king, a prophet, the 
Saviour, even the Divinity. Many imagine that they have been 
guilty of sins impossible to them, and irreconcilable with their 
habits and character. Some think that they have committed 
sins beyond all hope of pardon, and they merit and are to 
receive eternal punishment. Some feel impelled to destroy 
themselves, and are ready to obey the suicidal impulse if oppor- 
tunity offers. One has killed, or attempted to kill his wife, 
child or neighbor, and thought he was ordered by Heaven to do 
so. One imagines his father and mother, or children, hate him 
and cruelly persecute him, and he seems to hate them, and 
endeavors to annoy and persecute them in return. Some others 
believe their husbands or wives guilty of all manner of infideli- 
ties, and are astonished that the world believes them to be 
virtuous. One believes there is a snake or toad in his stomach ; 
another, that the upper and lower halves of the body are 
separated. Some think there is no communication between 
their mouths and their stomachs, or that the stomach is entirely 
and solidly filled, so that nothing more can enter. In obedience 
to their delusion, they refuse all food, and are only fed by the 



1863.] PUBLIC DOCUMENT— No. 27. 11 

stomach pump, by which means, however, they are well nour- 
ished, and otherwise they would perish by starvation, as some- 
times happens in the community abroad, where the friends 
unhappily concur in the belief, and allow the deluded patient 
to waste even unto death for want of food. One imagines 
everybody is looking and laughing at her ; another, that she is 
persecuted by enemies, or haunted by evil spirits, which compel 
her to do what her own spirit .and conscience loathe. These 
delusions are as infinitely various as men's experiences, concep- 
tions and thoughts, and yet the patients may, at most times, 
and to most persons, present as calm an exterior, and talk in as 
sane and rational a manner as others out of the hospital. 

There is a common notion that an insane man is necessarily 
a maniac, noisy, violent, and incoherent, and is at all times 
manifestly crazy, and that he has no rational or consistent 
thoughts. Thus, those who feign insanity are apt to overstep 
their purpose by affecting violence, which is far from the 
common phase of the disease, and they attempt to appear insane 
in all their conversation and manner. They are apparently 
fearful of exhibiting one sane thought, or showing themselves 
as sane in any moment. On the contrary, parties in court 
attempt sometimes to prove sanity, by showing that, at times, 
the suspected person was seen to act or heard to talk rationally, 
as if the absence of manifest insanity, at any moment, hour or 
day, was proof of permanent sanity. It would be as easy to 
prove that some suspected men were not guilty of profanity, or 
others were not intemperate, by witnesses who had seen them 
when they were not drunken, or heard them talk without 
swearing. 

So apparent to strangers and friends is the sanity of some 
patients in lunatic hospitals, that they not infrequently suppose 
that these are needlessly and even improperly restrained, and 
should be sent back to their families and the world. Some- 
times such are taken away ; but a short experiment of home 
and the world, shows that their apparent sanity in the hospital 
was the result of the influences, support and protection which 
there surrounded and sustained them, and without which' their 
minds relapse into mental disorder. 

By all the varied means at the command of the hospital, the 
patients are kept calm, and as far as possible employed, body 



12 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

and mind, in a useful and sane way. The curable are restored 
to health, and returned to their homes and the world, and 
engage again in the ordinary affairs of life. The incurable are 
kept in a comparative or even very comfortable state, and enjoy 
a degree of calmness and mental clearness which could not 
elsewhere be accorded to them. The greatest work of the 
hospital is the restoration of the insane to full mental sound- 
ness, but the work next in importance is their partial restora- 
tion, and their maintenance in that improved condition, where 
they enjoy all that their limited health and power permit, and 
far more than they could at their homes, or elsewhere. 

CRIMINAL LUNATICS. 

Another year's experience has not lessened the importance of 
the views put forth in the last Report, in respect to the impolicy 
of the discriminating payment for the support of the State and 
other patients in the public hospitals ; to the want of working 
# capital, the moral wrong, and financial error of sending the 
insane criminals to live and associate with the honest patients, 
and of requiring these classes of persons, so widely diverse, 
and every where else separated, to associate together in these 
public institutions. 

PAYMENT FOR STATE PAUPERS. 

The Commonwealth, from May, 1857, to September, 1859, 
paid the full cost of the support of its paupers in the hospitals. 
From September, 1859, to June, 1862, it paid $2.50 per 
week, which was less than the cost; and from June, 1862, to 
the present moment, it paid $2.62, which still is short of the 
expenditure of the hospital on the account of the State. The 
law of the last session of the legislature again reduced the 
State payments to 82.25 a week for the maintenance of its 
wards, in these public institutions, from October 1 , 1863, which 
will leave a still larger part of the cost of the support of the 
State paupers to be provided for out of other resources of the 
hospital. This is peculiarly unfortunate for the institution, 
inasmuch as the price of provisions, groceries, dry goods, almost 
every thing needed for the use of the patients, has very greatly 
increased within the last year, and adds ver.y largely to the 
deficiency of the State payment for its wards. Unquestionably 



1863.] PUBLIC DOCUMENT— No. 27. 13 

the Commonwealth intends that the hospital shall live out of 
its labors, and that its earnings shall pay its daily and weekly 
cost of support. 

The hospital, having no other means or way of providing for 
these expenditures, must necessarily assess them upon those 
who enjoy its benefits, who occupy its wards, wear its clothing, 
eat its food, and are watched and served by its officers and 
men. If then the State pays less than its proportion of this 
cost, this deficiency must be paid by the others. As in matters 
of trade, every judicious merchant charges the whole cost of 
his business on the whole body of his customers, and if some 
contribute less than their part, others must contribute more, 
and he must assess these burdens on them in unequal propor- 
tions, if he would save himself from ruin ; so, if one class of 
patients pay less than the cost of their maintenance, the 
hospital must charge the deficiency upon the others, in order 
that the sum total of the payments shall be equal to the sum 
total of the expenditures. 

The law which requires that the town pauper " shall be kept 
for a sum not exceeding the actual expense of his support," 
intends that this support shall include more than food, fuel, 
lights, clothing and personal service, — for with all these, the 
patients could not be kept without a house, with all the means, 
rooms and wards fitted for the purpose. House or shelter is 
every where an essential element of life, and its cost is a neces- 
sary part of support, whether in interest on the cost of building 
or in rent, on such conditions as the lessor may grant to the 
lessee. The towns and families that send their patients, having 
no house in which they can be placed, are compelled to hire of 
any one who has a suitable building. The State owns the 
hospitals, and offers them on the conditions implied in the law, 
that those who occupy its wards in company with the State 
paupers, shall pay all the cost of maintaining the whole estab- 
lishment beyond the sum offered by the law for the support of 
beneficiaries of the Commonwealth. The difference between 
the actual cost of supporting each patient and $2.62 a week, 
multiplied by the number of State patients, was the actual rent 
last year ; and that between the actual cost of each and $2.25 
per week, multiplied by the number of State patients, will be 
the rent of next year ; and this has been and must be assumed 



14 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

and paid by the towns and people that send their insane to the 
State hospitals, as a part of the actual expense of supporting 
them. In this connection there are two parties, one the Com- 
monwealth, which owns the hospital, and the other the towns 
and people collectively, who send their patients to it. The 
State is the proprietor, and the towns and people are the tenants 
occupying a little more than half (fifty-five per cent.) of the 
house. 

COST OF CREATING THE HOSPITAL. 

The hospital, with its lands, buildings, aqueduct, furniture, 
apparatus for warming and ventilating, its cattle, and all its 
other materials and property, is the result of the joint contribu- 
tions of the Commonwealth, towns and families, that have 
sent their patients to it, and charitable individuals. The town 
of Worcester, in 1832, bought and paid $ 2,500 for the land on 
which the hospital stands, and gave it to the Commonwealth, 
not for the use of the treasury in general, but for the use of the 
insane. At that time there were comparatively few State 
paupers, still fewer of the State paupers insane, and these 
were hardly taken into the account. But the insane of Massa- 
chusetts, then supported by the towns and their friends, were 
principally natives of this country, and were chiefly in the 
minds of the donors. The great burden of foreign insane 
pauperism has been mostly the growth of later years. Never- 
theless, the land was conveyed to the State, which holds the 
legal ownership. Mr. McCarty gave $500, which was used to 
improve and ornament these grounds, and fit them for their 
intended purpose. The Commonwealth built the original 
hospital in 1832, and added two wings in 1836-7, and paid for 
them out of the public treasury. In 1842-3, the other wings 
were added, and paid for out of the legacy of Mrs. Johonnot, 
which amounted in all to $44,346.17, all of which was expended 
in the buildings and improvements of the hospital ; but the 
State assumed the payment of several annuities which Mrs 
Johonnot had devised, at that time, amounting to $2,520, and 
now to $1,540 a year. 

The hospital was built according to the best ideas of the 
time. Yet, as in all other matters, many improvements have 
been made in the structure of such buildings, and it has been 
found that the insane can be better managed and more easily 



1863.] PUBLIC DOCUMENT— No. 27. 15 

and certainly restored by some different architectural arrange- 
ments. Many changes, therefore, have been made ; all the 
strong rooms have been three times removed, and twice replaced 
with new and improved apartments, and now all of these are 
swept away, and pleasant and comfortable rooms stand in their 
places. 

For the original buildings and the addition in 1843, for the 
aqueduct, barns, strong rooms, and some land, the State at 
various times, from 1830 to 1819, gave $122,900.09 to the 
hospital. Since 1849, all the alterations, additions, improve- 
ments and repairs, and renewals, have been at the cost of the 
hospital, or rather of its tenants. If nothing farther had been 
done besides that which the Commonwealth had done, the 
house and barns would have been useless for the purposes of the 
insane, and untenantable for any purpose. That hospital, with 
its additions, the strong rooms, barns and aqueduct, &c, which 
the State delivered to the trustees in 1832, '37, '43, '44, '47 
and '49, was long ago so decayed, or worn out in some of its 
necessary parts, that it could not be used for the residence and 
treatment of lunatics unless they were repaired or renewed ; 
and even if there had been no decay, the original structure and 
arrangement would have made it unfit to be used for the care 
and custody of the insane, as they are now managed. 

The heating and ventilating apparatus have been more than 
once entirely worn out and renewed. The six kitchens, which 
were all- in operation, at one time, have been swept away, and 
a new one built, which serves the whole establishment with 
greater convenience and economy. In every ward, two of the 
small sleeping chambers have been converted into sitting-rooms 
for the patients, and some others have been converted into 
common dormitories. A new central wing, a new chapel, new 
reading and work rooms, a new laundry, washing and ironing 
rooms, with the suitable apparatus, and a steam-engine, and a 
revolving drying machine have been built. The old barn, 
sheds and infirmary have been taken away, and others, large 
and commodious, have been substituted for them. The roof 
has been from time to time repaired, the rooms and halls 
repeatedly painted and papered, and their walls ornamented 
with pictures, the furniture has been renewed, a new warming 
apparatus has been introduced, by which steam-heated air is 



16 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



driven to all the wards by a fan and a powerful steam-engine, 
and gas introduced through all the house. All these, and all 
the other improvements necessarily arising in so progressive a 
science, as the treatment of insanity, and the adaptation of the 
house and furniture and material to this purpose, all the 
repairs, renewals and alterations required in a house used 
through thirty years, by the wasteful and destructive class 
that occupy a hospital ; all these have been done and 
paid for by the hospital, or the tenants, and not by the legal 
proprietor. 

For these purposes of creating the hospital, and making it 
what it has been and now is, and enabling it to accomplish its 
appointed work, the following sums have been contributed by 
the State, the hospital, and individuals, as nearly as can be 
ascertained. 

State appropriations for the lands, buildings, improvements, fyc., of the 

Worcester Hospital, as found in the several volumes of the Laws and 

Resolves, from 1830 to 1863, inclusive: 

1830. Mar. 10. For erection, a sum not exceeding . . $30,000 00 

1832. Mar. 24. For erection, 20,000 00 

1834. Mar. 9. For building commissioners, balance due, 437 90 

For services and expenses of do : 

Horace Mann, . . $970 86 
Bezaleel Taft, . . . 1,235 78 
William B. Calhoun, . 580 04 2,786 68 

1835. April 7. For enlargement, to be drawn one-half 

in 1835, and one-half in 1836, . . 25,000 00 

1836. Mar. 30. For aqueduct, 3,000 00 

1837. Mar. 29. For completing the enlargement, . •. 10,000 00 

the chapel, . . . ... 3,000 00 

purchase of land, .... 7,000 00 

1838. Feb. 19. For the building commissioners, the 

balance of former appropriations, and . 675 51 

Mar. 3.1. For infirmaries, 2,500 00 

1841. Mar. 17. For purchase of land, .... 500 00 

1842. Mar. 3. For barn and shop, .... 2,000 00 
1844. Mar. 13. For the aqueduct, .... 3,000 00 

the laundry, 2,000 00 

1847. Apr. 14. For apartments for furiously insane, . 6,000 00 

1849. May 1. For apartments for furiously insane, . 5,000 00 



Total direct appropriation, 



$122,900 09 



1863.] PUBLIC DOCUMENT— No. 27. 17 

JOHONNOT LEGACY. 

Beside these direct appropriations, the legislature authorized 
the Trustees to use the Johonnot fund in enlarging the hospital. 

In 1840, George S. Johonnot, and Martha, his wife, of Sa- 
lem, bequeathed, by will, " to the Board of Trustees of the 
State Lunatic Hospital at Worcester, all the residue of ' their 
estate,' to be used and improved for the maintenance of insane 
persons, and for the benefit of the institution." 

This property thus bequeathed, in cash, mortgages, and 
stocks, was valued at 145,843.22, but on settlement, $44,318.17 
was realized, and $28 afterwards received. 

The property was charged with annuities to twenty-three 
persons, and the life support of an old and worthless horse. 
The annual amount of the annuities was then $2,520, and the 
cost of supporting the horse about $75 a year. 

The interest of the property, at six per cent., was $2,659.09. 
The Trustees, in their ninth report, said, " it is now believed the 
income will be equivalent to the charges upon it,' but it is 
feared it will not be." 

By a resolve of the legislature, the Trustees were authorized 
to take charge of and administer this fund, but were required 
to pay the income into the State treasury, which was to assume 
the payment of the annuities. The horse was sent to the 
hospital, and supported at its expense through life. 

In 1843, March 18, by a resolve of the legislature, " the 
Trustees were authorized to erect additional buildings, suffi- 
ciently large for the accommodation of one hundred and fifty 
insane patients, and to provide all necessary accommodations 
and furniture for the same ; " and " to defray the expenses, the 
Trustees were authorized and directed to appropriate and make 
use of the principal of the devise and bequest made by Martha 
Johonnot," "and for this purpose, to sell and convert into 
money the obligations or securities in which the fund of said 
devise or bequest now exists or is invested." 

By this means, the hospital realized, . . . $44,318 17 

Of this sum, the Trustees expended in building 

and furnishing the new wings, $40,106 84 

Dr. Woodward for superintending, . 500 00 40,606 84 



Leaving a balance of, ... . $3,711 
3 



18 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

1847, April 14. The legislature authorized the 
Trustees to expend this balance, together with 
an appropriation of $6,000, herein before men- 
tioned, " for the purpose of providing new 
apartments for the furiously insane patients." 

The Trustees expended the appropriation, and 

of the Jolionnot fund, $3,173 77 



Leaving a balance of .... $537 56 

In 1848, the Trustees, on settlement with the 
Ipswich Bank, received, 28 00 



Making an available unexpended fund of . $565 56 

1849, May 1. The legislature authorized the Trustees to 
expend this residue of the Jolionnot fund, and also $5,000, 
then appropriated as herein before mentioned, " for the pur- 
pose of providing new apartments for the furiously insane 
patients." This was done in that year, and thus the whole of 
this bequest was converted into the buildings and furniture of 
the hospital, and the State then and thereafter paid, and is 
now paying the annuities that were chargeable upon it. 

The Jolionnot bequest was then practically a grant from the 
State, to the extent of the value of the annuities at the time 
the Commonwealth assumed their payment; deducting, how- 
ever, the amount of the income which the treasury received 
from it. 

There is no discoverable record of any calculation or deter- 
mination of the value of these annuities in 1843. In 1841, 
the payments to the twenty-three annuitants were $2,520, which 
nearly absorbed the income, $2,659.09, or the interest, at six 
per cent., on the amount that was realized trom the legacy, 
leaving only $139.09 to meet the chances of depreciation or 
loss. But as these payments were of a decreasing and termi- 
nable nature, and have already diminished to $1,540, and are 
likely to diminish still more rapidly hereafter, while the in- 
come on the property is permanent, it is manifest that these 
annuities could have been purchased for a sum less than the 
amount given by Mr. and Mrs. Jolionnot. 

There were twenty-five annuitants named in the will, of 
whom two died before the testator, and twenty-three survived 



1863.] 



PUBLIC DOCUMENT— No. 27. 



19 



and received the sums specified. These annuities varied from 
sixty to two hundred dollars each. The ages of the annuitants 
varied from seventeen to seventy-nine years ; and the worth of 
these annuities, in 1842, varied in the compound ratio of 
these two classes of facts. But calculated according to the 
expectation of life at these several ages, and money at five per 
cent, interest, their total value, in 1842, was 131,974.96. 

The specific ages of these twenty-three annuitants, the sev- 
eral annuities granted to them, and the value of them, in 1842, 
are as follows : — 







Value in 1842, at 




AGE. 


Annuity. 


5 per cent. 


Remarks. 


17, . . . 


$100 00 


$1,612 10 




19, 








100 00 


1,597 10 


Died June 25, 1852. 


20, 








100 00 


1,589 10 




26, 








100 00 


1,534 10 




27, 








100 00 


1,523 60 




27, 








100 00 


1,523 60 


Died. 


28, 








100 00 


1,512 70 




29, 








100 00 


1,501 40 


Died December 7, 1860. 


30, 








100 00 


1,489 60 




30, 








100 00 


1,489 60 




31, 








100 00 


1,477 40 




35, 








200 00 


2,847 00 




36, 








100 00 


1,408 70 




41, 








100 00 


1,325 20 


Died November 18, 1859. 


47, 








180 00 


2,163 60 




49, 








180 00 


2,081 34 


Died October 22, 1851. 


51, 








100 00 


1,108 50 




52, 








100 00 


1,084 00 




55, 








60 00 


604 62 




63, 








100 00 


790 30 




63, 








100 00 


790 30 


Died May 23, 1855. 


72, 








100 00 


545 70 


Died February 10, 1855. 


79, 








100 00 


375 40 


Died July 29, 1846. 










12,520 00 


$31,974 96 





This value of these annuities in 1842 was a charge upon, 
and should be deducted from the amount of the Johonnot 
legacy. 

The cost of supporting the old horse at the hospital five 
years, at seventy-five dollars a year, in all three hundred and 
seventy-five dollars, must also be deducted from this bequest. 



20 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Then the whole amount realized from this property, #14,346 17 

Less the charges upon it — 

Annuities, $31,974 96 

Support of the horse, . . . 375 00 

32,349 96 



Leaves as the total value of the legacy, when given, $11,996 21 

The Commonwealth, in assuming these annuities in 1842, 
incurred a debt or obligation which could then have been trans- 
ferred to an annuity company for $31,974.96 ; but it received 
and appropriated to its own uses the interest on the Johonnot 
property, until it was expended for the enlargement of the 
hospital. Thus there was paid into the State treasury from 
this source, — 



In 1842, 


. $2,520 00 


In 1845, 


. $961 29 


1843, 


. 2,257 14 


1848, 


361 20 


1844, 


. 2,437 67 







In all, . . $8,537 30 

Deducting from this the interest, at five per cent., on the 
deferred payments, in 1843, 1844, 1845, and 1848, $609.15, 
leaves $7,928.15, as the value of these receipts to the State 
in 1842. 

The amount of the obligation, or value of the 

annuities assumed by the State was, in 1842, . $31,974 96 

Deduct from this the value in 1842, of the interest 

on the Johonnot property then and afterwards, 7,928 15 

Leaves as the amount of gratuitous obliga- 
tion incurred by the Commonwealth, . $24,046 81 

Which must be considered as equivalent to an 
appropriation from the State treasury for the 
enlargement of the hospital, in 1843 and 1844, 
and should therefore be added to the State 
grants before enumerated, .... 122,900 09 

Annuities gratuitously assumed, . . . 24,046 81 

Making total grants for purchase, creation, and 

furniture of the hospital, .... $146,946 90 



1863.] PUBLIC DOCUMENT— No. 27. 21 

• 

Contribution of the Hospital to its own improvement, repair 
and preservation. 
It seems to have been the general policy of the State, that 
the hospital should, out of its own earnings, pay not only for 
keeping itself in repair, and for such improvements as medical 
science might suggest, but also for making such additions, and 
even for the purchase of such lands as might be deemed ne- 
cessary for its prosperity, excepting, however, such as have 
herein before been specified in the account of State appropria- 
tions. This is apparent from the negative, and manifest from 
the positive legislation. 

Repairs, improvements, and. additional furniture have been 
necessary in every year, from the beginning. They have been 
annually made, and purchased and paid for, and their cost an- 
nually reported to the government. The cost of these was 
$1,541 in 1834, the second year of the hospital, and, except 
in a single year, it has never been less, but always more, and 
generally very much more ; and, except as before mentioned, 
the legislatures, who were cognizant of these facts, and whose 
committees, from year to year, visited the hospital, and com- 
mended the care and providence of its managers in thus im- 
proving and preserving the institutions, made no provision to 
meet these expenses. It was well known that the hospital paid 
for these out of its current receipts, which could be no other 
than its charges for the board and care of the patients. The 
absence of any legislation to provide for these inevitable and 
constantly recurring wants, must be taken as at least a legisla- 
tive assent to their payment out of the earnings of the institu- 
tion, and to the corresponding increase of the charge for the 
support and care of the patients. 

Moreover, some of the legislation in respect to the hospital 
gives positive authority to expend a part of its current receipts 
for these purposes. 

By a resolve of the general court in 1855, chapter 96, " The 
Trustees are authorized to appropriate from the unexpended 
balance of funds of the hospital which are applicable to its. 
current expenses whatever sum, in their judgment, the in- 
terests of the hospital may require, for the finishing and fur- 
nishing of the buildings now in process of erection, and also 
for the purchase of a certain lot of land." 



22 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

"That the Trustees aforesaid be and they are hereby au- 
thorized to expend annually from the funds aforesaid a sum 
not exceeding five hundred dollars, for the purchase of land 
or other property, or for permanent repairs or improvements, 
which, in their judgment, will promote the interests of said 
hospital." 

In 1849, the legislature extended this authority of the Trus- 
tees, who " are hereby authorized to purchase land," " and that 
the payment for the same be made from the surplus funds now 
in the hands of their treasurer ; provided, the cost of the 
same shall not exceed the sum of three thousand dollars." 
Chapter 101. 

In all these cases, the " funds applicable to current expenses," 
and " surplus funds in the hands of the treasurer," were the 
receipts for board, &c, for the hospital had no other resource, 
and the legislature had these and no other in view, when they 
assented to, and authorized, these expenditures. 

With the implied consent, and under the direct authority of 
the legislature, the Trustees, from time to time, have made 
such repairs and improvements, and such purchases of land 
and other property as in their judgment were needed to promote 
the interests of the hospital. 

The purchases and amounts of these expenditures, as near 
as can be now ascertained, were : 

1836. Moving and altering barn and out-buildings, 
Aqueduct, 

1848. Land, ....... 

1849. Land, 

1850. Gas-fixtures, in a part of the house, 
Damages to W. Hovey, for diversion of water, 
Extension of aqueduct, .... 

1950. Steam fixtures for laundry, .... 

1851. Stone wall on Summer st., front of hospital, . 

1852. Iron fence, in front of hospital, . 

1853. Summer-house, ...... 

1854. Land, 

1855. Steam chimney, in rear of hospital, 
Removing and fitting up barn and out-build- 
ings, 

Apparatus for warming and ventilating, 



8(310 33 


1,067 


33 


500 


00 


2,500 


00 


592 


61 


500 


00 


500 


00 


918 


45 


5,860 


49 


2,321 


75 


555 


00 


175 


00 


1,422 


60 


2,000 


00 


6,000 


00- 



1863.] 



PUBLIC DOCUMENT— No. 27. 



23 



Apparatus for warming, ventilating and draining, 
For barn and sheds, and large cistern in rear for 

safety from fire, 
Dividing Johonnot wards, and fitting up water 

closets and bath rooms, .... 
For six attendants' rooms in Johonnot wards, . 
Water-closets and bath-rooms in centre, 
Four flights of stairs, ..... 
Conveying water from Rattle-Snake hill to stables, 
Dead walls, dividing attics and fencing courts, 
Billiard, reading-rooms and dormitories, in place 

of old cells, . . • . 
For new centre wing, and alterations in old centre 
Fixtures for new kitchen and laundry, 
Rebuilding four rooms in place of old cells, 
For purchase of land, .... 
Four porticoes, over outside doors, 
Opening and fencing drive-way in front, and replac 

ing stone steps, .... 

Ladder house, ..... 
Land, at sundry times, 



$28,000 00 



3,410 61 



500 00 
600 00 
300 00 
250 00 
975 00 
300 00 

1,200 00 

23,029 48 

1,600 00 

600 00 
1,425 00 

400 00 

650 00 

100 00 

4,600 19 



,463 84 



Beside these repairs, improvements, and purchases, that have 
been made at the cost of the hospital, the amount of which has 
been recorded, and is quoted above, there have been a great 
variety and amount of other repairs and improvements done by 
the ordinary force of the hospital, aided by the patients. 

No record was made of them, nor was their cost determined, 
but, nevertheless, they added very greatly to the value of the 
house and other buildings, and the grounds of the institution, 
and to its facility of accomplishing its work. 

In answer to an inquiry made to Dr. Bemis, by the Trustees, 
in respect to these labors of the officers and men and patients, 
he gives, as nearly as can be ascertained and remembered, the 
following statement : 

" Some alterations, made by our own laborers, and for which no price 
can be named, are as follows : 

Cutting out rooms, and making recesses for the purpose of admitting light. 
Constructing several flights of stairs, for safety in case of fire. 



24 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Putting clothes' rooms into many wards. 

Frequent replacing of wornout fixtures for water-closets. 

Frequent putting down of new. drains. 

Replacing the old fence around the hospital gardens, by an expensive 

new one. 
New covering large cistern in the back yard. 
Removing stair-ways in centre wings. 
Removing rooms and arching up recesses to admit light. 
Laying down several hundred feet of brick drain. 
Replacing old water-closets by new. 
Remodelling dining-rooms and attendants' rooms. 
Laying down lead pipes to convey water from Chandler Hill. 
Opening the passage-way through the' basement, and putting in two 

flights of stone steps. 
Laying down new gas main, and relaying old one. 
Building a large brick cistern in rear of stables, for safety in case of fire. 
Removing old buildings, and grading and fencing the grounds. 
Removing partitions, and finishing up small dormitories in various wards. 
Fitting up closets and clothes-presses in many rooms in centre building. 
Fitting up store-rooms in basements. 

Constant repairs of doors and windows, and replacing window screens. 
Cutting away partition walls, and fitting up rooms for bowling-alleys. 
Building grapery, and constructing six work rooms. 
Placing snow rods on the roof of centre building.* 

* Since this Eeport was written, and before going to the press, the dam at 
the reservoir has been built. Only one man, a stone mason, was hired, all of 
the rest of the work was done by the ordinary laborers of the hospital and the 
patients. Sometimes all, and sometimes only a part of the laborers, an aver- 
age of about four and a half were employed, and an average of about eight 
patients worked with them. They did all the work of filling the dam with 
gravel, moving it from the neighboring hill on wheelbarrows. The whole was 
done in 61 working days. 

The patients worked, 467 days. 

sane laborers worked, ...... 273 

stone mason worked, 56i 

Total labor, 796£ days. 

The money expended was, for stone mason, . * . . . . $169 50 
For use of derrick, and tools at the dam, hired, . . ■ . 61 50 

use of derrick at the quarry, hired, 42 00 

powder, 31 52 

steel for drills, 5 13 

plank, ■ , . . . . 49 00 

Total cash cost for the dam, , $358 65 

The whole of which cash, as well as the labor, was contributed by the 
hospital. Mr. Ball, the engineer, estimated the cost at $1,010. 



1863.] PUBLIC DOCUMENT— No. 27. 25 

"The above area few of the many things which it has seemed neces- 
sary to do, and which would be difficult to fix the cost. The work has 
been done by our own laborers, hired for ' the general purposes of the 
hospital, and who, while performing this labor, were attending to many 
other duties." 

OTHER DONATIONS AND GIFTS. 

The town of Worcester, in the beginning, bought the original 
and present site of the hospital, (twelve acres,) and paid 
twenty-five hundred dollars for it. They then conveyed it to 
the State in fee. 

At the same time, Nathaniel McCarty, of Worcester, gave 
five hundred dollars, to be used in preparing and ornamenting 
the grounds. This was expended for these purposes. 

June 2, 1852, Mr. Ziba Storrs, of * gave five hundred 

dollars for the same purpose. 

October 19, 1853, Mr. Enoch Flagg, of Worcester, gave two 
hundred dollars for the use of the hospital. 

1858, George B. Upton, of Boston, gave fifty dollars for the 
same purpose. 

In 1862, Miss Abigail Wheeler, of Barre, by her will, recorded 
November 25, 1862, gave one thousand dollars. The gift is 
simple, direct, and unconditional. 

" Thirdly, I give and bequeath one thousand dollars, I have in bank 
shares, to the Insane Institution at Worcester." 

These shares were worth, at the time of the record, nearly 
eleven hundred dollars. f 

The Trustees considered this gift of charity worthy of 
preservation, as a monument of the kindness of the donor, and 
ought to be used to alleviate the burdens of the weak and the 
suffering. The following extract from their records shows their 
purposes and their doings in respect to this fund: — 

* No record is found of the residence of Mr. Storrs, but he lived, it is 
supposed, in the western part of the State. 

f Miss Abigail Wheelek, a maiden lady, died at about the age of 70. She 
had lived with and taken care of an aged and infirm mother for many years. 
She earned all her little property, about three thousand dollars, with the labor 
of her own hands, as a tailoress. At her death, beside the bequest to the 
the hospital, as our informant, Dr. Whitcomb, of Barre, her family physician, 
understands, she gave one thousand dollars to the Unitarian Church of Barre, 
and her real estate, about a thousand dollars, to her friend and executor. 
4 



26 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

State Lunatic Hospital, Worcester, Mass.,") 
November, 25, 1862. j 

Meeting at the Hospital. Present, Messrs. Wm. T. Merrifield, 
Robert W. Hooper, Edwin F. Jenks, Edward Jarvis, William Work- 
man. The Treasurer being present, reported that Miss Abigail 
Wheeler, late of Barre, had, in her will, gives to the hospital ten 
shares in the banks of Worcester, six in the Central Bank, and four in 
the Worcester Bank. 

On motion of Dr. Hooper — Voted, that the Treasurer be authorized 
to receipt for the legacy of Miss Abigail Wheeler, and that a copy of 
that clause in the will of the donor be entered in the records of the 
Trustees. Voted, that the donation of Miss Wheeler be made a special 
fund, the interest to be applied, by vote of the Trustees, for such objects 
connected with the hospital as they may hereafter determine. 

The gift of Worcester is- in the land. 

The gift of Mr. McCarty was expended in grading the land, 
and became thereby a part of the real estate. 

The gifts of Mr. Storrs and Mr. Flagg were absorbed in the 
current expenditures. 

The gift of Mr. and Mrs. Johonnot was expended in the 
Johonnot wings. 

The gift of Miss Wheeler is reserved as a permanent charitable 
fund. 

The gift of Mr. Upton was used in the purchase of pictures 
to ornament and cheer the wards of the patients. 

LANDS. 

The lands now belonging to the hospital are the result of 
very many purchases, as will be seen by the following analysis 
of all the deeds now on record at the register's office ; and, as 
has already been stated, they were paid for, as the hospital was 
built, by the joint and successive contributions of the Common- 
wealth, the town of Worcester, and the earnings of the insti- 
tution. According to the record — 

The whole cost was . 

Of this the State paid . 
Worcester paid, . 
the hospital paid, 



. 


. 


$16,319 31 


$7,500 


00 




2,500 


00 




6,319 


31 


$16,319 31 



1863.] 



PUBLIC DOCUMENT— No. 27. 



27 





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PLAN OF LAND OF THE STATE LDNATIC HOSPITAL. 



WORCESTER MASS. 



miBWBiMlHXAttUUim 



1863.] PUBLIC DOCUMENT— No. 27. 29 

Tims, so far as can be ascertained from any records at the 
State House, and at Worcester, and from the annual volumes 
of the Laws and Resolves of Massachusetts, the means by 
which the lands were purchased, the buildings erected, the 
furniture, machinery, &c, bought, and the hospital made what 
it has been, and now is, were derived from the joint contribu- 
tions of the State, friends, and the hospital itself. 

State, direct appropriations, . $122,900 04 

State, value of Johonnot annu- 
ities, in 1842, less the interest 
received, .... 24,046 81 



State total, .... $146,946 85 

Johonnot legacy, less the charges 

upon it in 1842, . . . 11,996 21 

Interest on Johonnot legacy, until 

used, value in 1842, . . 7,928 15 

Town of Worcester, . . . 2,500 00 

Nathaniel McCarty, ... 500 00 



Total gifts for lands, buildings,&c. 22,924 30 

Earnings of the hospital, ...... 93,463 84 



Total recorded cost of lands, buildings, and 

improvements, $263,335 05 

The Commonwealth is the largest contributor to this cost, 
having given 55.4 per cent. The hospital gave 35.5 per cent., 
and the friends gave the rest. 

As these gifts were made to the hospital for its sole use, and 
for the benefit of the insane, they may be properly passed to 
the credit of the institution, which, with its friends, contributed 
44.6 per cent, towards it creation. 

If, then, any question should arise between the several classes 
of tenants of the hospital, or their responsible friends, between 
the State, on one part, and the towns and people, on the other 
part, as to the right or propriety of freer occupation of the 
house, and use of its privileges and means, by their patients, or 
of board and care at a lower charge, in consideration of rent 
or interest of money invested in the establishment, it should 



30 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

also be considered, that the State paid 55.4 per cent., and the 
towns and people, in the profits which they paid on the board 
and care of their patients, together with the aid of their friends, 
the donors, paid 44.6 per cent, for this purpose ; and this, in 
equity, should be the basis of settlement of any claims for 
pecuniary favor that should be made on this ground. In this 
view of the matter, neither party should be required to pay any 
more, nor willing to pay any less, than those proportions of that 
part of the cost of support that may be properly charged to 
rent, or to interest on money invested in the purchase and 
construction of the establishment. 

Of more importance than all financial considerations, is the 
fact, that the discrimination of payment for the support of 
patients, made by the law in favor of the State, is necessarily 
against the towns and people, and has its natural and secondary 
effect of diminishing the number of the town and private pa- 
tients, of embarrassing the free use of these public charities by 
our own people, and giving them more into the hands of stran- 
gers. In 1862, the foreigners had a proportion of their insane 
in this hospital, more than three times (|f |) as large as that oi 
the Americans. At the present time the difference of the ratio of 
the insane of each class in Massachusetts, enjoying the benefits 
of this contribution is but slightly less, yet is more than three 
times as large in favor of the stranger, mainly because the alien 
pays nothing for himself, and the native is required to pay not 
only for his own support, but also in part for that of others. 

COMPARATIVE COST OF SANE AND INSANE. 

The management of the insane is necessarily different from, 
and more expensive than, that of the sane. The architectural 
arrangement of the lunatic hospital is very unlike that of a 
common dwelling, or any other public institution, and its walls, 
partitions, windows, and doors, must be much stronger. The 
managers and the guardians, the officers and attendants, must 
be men of great discretion, sagacity and patience, who would 
■earn large wages elsewhere, and can only be obtained and re- 
tained by larger rewards than are paid to those who attend on, 
and do the work of, healthy men and women abroad. 

There is a similar difference in the cost of the food of the 
mentally healthy and disordered. In all the most common 



1863.] PUBLIC DOCUMENT— No. 27. 31 

forms of insanity, mania, melancholia, and dementia, the 
patients need a more digestible and nutritious diet, than men 
and women in health. Their malady, their excitements, and 
their depressions increase the necessity, that they should have 
food that is easily dissolved in the stomach, and converted into 
living flesh, by the nutrient arteries. They need nourishment, 
not only of better quality, but oftentimes more abundant in 
quantity, to meet the excessive and morbid expenditure of force 
by the maniac in his excitements, and to save the melancholic 
and those who are tending to dementia from sinking under their 
depressions into torpidity, and if possible to raise the demented 
out of their sluggishness. Regarding the necessities of luna- 
tics, familiar with their dangers, and desiring to fulfil the 
purposes of a hospital by restoring as many as possible to 
health, and saving as many as possible from sinking into mental 9 
death, the managers of these institutions everywhere feed their 
patients better, and at a greater cost, than sane men and women 
are fed abroad. 

In England, under the supervision of the county and 1 
borough magistrates, and the guardians of the poor, who ad- 
minister the funds intrusted to them with the greatest economy 7 
the average cost of supporting the insane paupers, for food, 
clothing, attendance and management in the public asylum, is 
more than three times as [great as that of supporting the sane 
paupers in the workhouses. In Ireland, the cost of sustaining the 
insane poor in the asylums was almost three and a half times as 
great as that of the sane paupers in the work-houses. A simi- 
lar, though smaller, difference is made here. The average cost 
of the town and city paupers in almshouses, in Massachusetts, 
is about one-half of that of supporting the insane paupers in 
the hospitals ; and the cost of the support of the State paupers 
in the State almshouses is in still smaller proportion. The cost 
of supporting the inmates in the work-house, in the city of New 
York, is less than one-half of that of the inmates of the city 
lunatic asylum. The average cost of the sane paupers in the 
county poor-houses, through the State of New York, was 
eighty-six cents a week, while the cost of the insane paupers in 
the State asylum, was three dollars and forty cents, in the five 
years from 1858 to 1862. Universally, as far as the records 
have been printed and obtained, the managers of the insane 



32 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

have obeyed this pathological law, and yielded to the necessity 
of giving their patients a better, and, 'of course, a more costly 
sustenance and care, than are needed for the support of sane 
men and women, in order to restore them to health, or to save 
them from sinking into dementia and permanent disease, or 
early death. 

In obedience to the same law of the disease which they were 
appointed to treat, and in accordance with the manifest design 
of the Commonwealth, and the calls of humanity, as well as of 
economy, to give every patient the best chance of restoration to 
the enjoyment of life, and the power of self-snstenance, if he or 
she were curable by any human means, to keep the excitable in 
their calmest condition, to rescue those who were in danger of 
or were tending downward to dementia, from that state of 
mental torpidity, and to save the demented from absolute 
mental death, the managers of this hospital have employed 
discreet and intelligent attendants, and provided and prepared 
nutritious and digestible food, which, though somewhat more 
costly than inferior guardians and poorer food would have 
been, have yet been profitable to the patients, and, through 
them, to their families and the State. 

MECHANICAL LABOR. 

The system of mechanical labors for the patients, proposed 
in the Report of last year, has been begun and carried on, as far 
as practicable with the means of the hospital, and, so far, it has 
been satisfactory and justifies the undertaking; more of the 
men have been occupied, and these have been calm and appa- 
rently happy in their work. This experiment encourages the 
continuance and increase of these employments, until all that 
are able shall find some daily and useful occupation for their 
hands. 

The officers and the attendants have all performed their 
parts faithfully and successfully. There have been no remark- 
able events, no accidents, no unusual sickness in the house. 
Dr. Bemis has performed the duties of Steward and Chaplain 
as well as of Superintendent, and by his wisdom, energy, and 
devotion, has accomplished all that was desired in their several 
functions. Dr. Rice, the Assistant-Physician} has been efficient 



1863.] PUBLIC DOCUMENT— No. 27. 33 

and faithful. Mrs. Bernis deserves the meed of high praise 
for her judicious, economical, and graceful management of the 
housekeeper's department. The clerk, supervisors, farmer and 
attendants, all, in their several ways, have done good service 
to the institution and the patients ; and the hospital has 
prospered in their hands. 

WATER. 

The dam at the reservoir on Mill Stone Hill became so 
decayed and leaky, that it was necessary to repair or renew it. 
Mr. Ball, a competent engineer, made a very careful survey of 
the locality, and ascertained that the rain annually falling in 
the valley that pours its waters into this reservoir, even in the 
driest year, is sufficient to supply all the possible wants of 
ninety-five hundred persons, which is nineteen times as many 
as are now in the establishment, and many more than probably 
ever will be there. In renewing the dam it is advisable to- 
raise it six feet higher, which will double the capacity of the 
pond, and put the reserved supply of water beyond all possi- 
bility of failure, even in the longest drought. As the banks 
of the pond are somewhat steep, this rise of six feet will cause 
no great increase of fiowage, and but a slight claim of farther 
damages to the land. This can be done under the law of 1848. 
The iron pipe of the aqueduct has become decayed and needs 
some repairs, and will probably need early renewal through its 
whole length. 

FINANCES. 

The accompanying report of the Treasurer shows the 
finances to be in good condition : — 

The total receipts, with the cash on hand, Oc- 
tober 1, 1862, was, $66,082 36 

The total expenditures in the year were, . . 65,946 23 



And there is now in the hands of the Treasurer a 

balance of, $136 13 

The outstanding debts due from the hospital are, $16,237 62. 

5 



34 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

The outstanding claims due to the hospital, supposed to be 
good, are : 

From the Commonwealth, $5,932 43 

Prom Towns, . . . . . . . 6,733 30 

From Individuals, 6,760 88 



Total, 119,426 61 

CHARGE FOR PRIVATE AND TOWN PATIENTS. 

The payments for the support of the hospital, made by the 
steward last year, were on an average 13.19 a week for each 
patient, but this was more than the actual cost for that period, 
for some considerable amount of materials, coal, etc., for two 
years, was bought and paid for within the last year. The 
average payments of the year previous were, for the opposite 
reason, considerably less than the cost. But the average of the 
two years is a fair average of the cost of supporting the insti- 
tution during that period, which was 1149.46 a year, or $2.87.4 
a week, for each patient in the institution. 

This would have been a proper charge for each, if all had 
paid alike. But as the State paid only $2.62 a week, thereby 
eausing a loss of twenty-five cents a week, or thirteen dollars 
a year, on each of the one hundred and eighty-five State 
patients, or $2,405 on the whole. This loss was charged upon 
the two hundred and thirteen town and private patients. 

In the coming year, there is a double reason for increasing 
this charge. The cost of all the materials of life is increased, 
and the State, according to the law of 1863, chapter 241, sec- 
tion 9, will pay only $2.25 per week for its patients, which will 
cause sixty-two cents a week, or thirty-two dollars and twenty- 
four cents a year on each of the State patients, provided the 
average cost of support of the patients is the same in the 
coming year as it has been in the last two years. The loss 
on the whole of the State patients will be five thousand nine 
hundred and sixty-four dollars ($5,964) in the year, provided 
the number is not diminished. The increased cost of the 
materials of life will, in its proportion, increase this loss to the 
hospital. 



1863.] PUBLIC DOCUMENT— No. 27. 35 

This loss of $5,964 or more will necessarily be charged to the 
private and town patients ; and if they continue to be, in the 
coming year, of the same numbers as they were last year, this 
increase of charge will be twenty-eight dollars and one cent 
($28.01) per week, to compensate for the deficiency of payment 
for the State patients. The charge for the town and private 
patients must therefore be higher in the coming than in the 
past year. 

It was to be hoped that some of the items of expense in the 
past years might be omitted in the coming year, especially 
among the repairs and improvements, which last year cost 
$5,206. But beside the usual and ordinary repairs, that inevi- 
tably recur in every year, it will be necessary to replace the 
old and leaky pipe of the aqueduct with a new one. Mr. Ball, 
the engineer, estimates that the cost of this will be $3,879. 
The labor of trenching and filling can be done mostly, if not 
entirely, by the patients and the ordinary laborers of the hos- 
pital ; but the pipe and other materials must be bought at the 
estimated cost of $3,112, which, like the cost of other im- 
provements, renewals, and repairs, must be charged in the 
current expenses, and paid for out of the receipts for the board 
and care of the patients belonging to towns and private 
families. 

The report of the engineer, Mr. Ball, in respect to the water 
and aqueduct is satisfactory to the Trustees, and is herewith 
presented, and commended to the attention of the government. 

The able and minute report of Dr. Bemis, his valuable 
tables, and important observations, are full of interest and 
instruction. They give a good and faithful statistical history 
of the hospital, from its beginning in 1833 to the present time. 
These show that under its three superintendents, Drs. Wood- 
ward, Chandler, and Bemis, this institution has done a great 
and successful work for the State and people. Dr. Bemis has 
revised all the tables, and made some corrections, from infor- 
mation received in respect to patients since the original records 
were made, and the whole presents as complete and accurate an 
account of the condition and progress of the hospital as can be 
obtained from records, inquiry, and correspondence, and is 



36 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

therefore commended to the careful attention and consideration 
of the legislature and the Commonwealth, and of students of 
psychological science. 

Trusting that the same generous Providence that has hitherto 
smiled upon this house of charity, will still watch over it, and 
give it life and energy, wisdom and usefulness, the Trustees 
again commend it to the fostering care of the government, 
and the sympathy and confidence of the people. 

Yery respectfully submitted. 

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

State Lunatic Hospital, Worcester, Mass., ) 

October 1, 1868. J 



1863.] 



PUBLIC DOCUMENT— No. 27. 



37 



OFFICERS OF THE HOSPITAL. 



TRUSTEES 



WILLIAM T. MERRIFIED, 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., .... Worcester. 
Office, Mechanics' Bank, Main Street. 

RESIDENT OFFICERS. 

MERRICK BEMIS, M. D., Superintendent. 

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

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

CAROLINE A. BEMIS, Matron. 



SALARIED OFFICERS OF THE HOSPITAL. 



Superintendent, MERRICK BEMIS, M. D. 
Assistant-Physician, F. H. RICE, M. D., . 
Matron, CAROLINE A. BEMIS, . 



Salary. 

$1,800 00 
900 00 
200 00 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



TREASURER'S REPORT. 



Cash on hand September 30, 1862, 


1153 30 


Received from the Com'mon wealth, 


. 26,989 38 


" " towns, . 


. 19,806 69 


" " individuals, . 


. 12,680 20 


" " all other sources, . 


6,452 79 




866,082 36 


DISBURSEMENTS. 




Paid Steward's orders, 


858,052 68 


Mechanics' Bank, 


. 2,153 76 


Bills payable, 


. 4,500 00 


Interest, .... 


518 72 


T. H. Watson, . 


15 22 


Treasurer, salary and expenses, 


705 85 


Cash on hand, ... 


136 13 




fife 6 6 08° SB 




f 4pvjv_/»Vwj zj\j 


Respectfully, 





H. WOODWARD, Treasurer. 



Worcester, September 30, 1863. 



The undersigned are satisfied, from examination of the Treasurer's books 
and also of the same accounts kept in duplicate at the Hospital by the 
Steward, that the foregoing Report is correct. 

W. T. MERRIFIELD, 
WILLIAM WORKMAN, 

Auditing Committee. 
Worcester, December 9, 1863. 



1863.] PUBLIC DOCUMENT— No. 27. 39 



SUPERINTENDENT'S REPORT. 



To the Trustees of the Worcester Lunatic Hospital : 

Gentlemen, — In compliance with the laws of the Common- 
wealth, I submit to you my annual report of the operations of 
this hospital for the year ending September 30, 1863. 

During no similar period has it enjoyed a higher degree of 
prosperity, been the means of dispensing a greater amount of 
comfort to its inmates, or had more abundant cause for grat- 
itude to the Great Disposer of events for the degree of general 
good health which has prevailed in our large household, and 
for the gratifying results which have attended the labors of 
those concerned in its management and control. 

The year has been one of general prosperity and success. 
No epidemic, or acute disease of any gravity, has afflicted our 
patients. No calamity has interrupted the usual peace, quiet, 
and order of the institution. The call of the country has 
again taken several valuable assistants from the service of the 
hospital to the hardships and dangers of the field, and rendered 
necessary many changes : but no difficulty has been experienced 
in filling their places with reliable and competent persons ; 
and we believe we have been fortunate in securing the services 
of kind, faithful, and efficient individuals to fill the various 
offices of labor and trust throughout the establishment. 

The statistical tables in this report include all the cases 
admitted into the hospital, and it is hoped that enough positive 
benefit is derived from the statistical tables of hospitals for the 
insane to justify the great labor required in their preparation. 
Although mistakes will sometimes be made, and false infer- 
ences will occasionally be drawn from them, still, as the num- 
ber of cases included in them become larger year by year, and 



40 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



the circumstances under which they are made is more fully 
understood and appreciated, practically useful deductions will 
result from them. 

For the results of the year in detail, you are respectfully 
referred to the accompanying tables, and such brief explan- 
atory remarks as they seem to require. 

Table No. 1, 

Showing the general results during the Year. 



■ 


Males. 


Females. 


Total. 


Patients in the Hospital October 1, 1862, . 


200 


196 


396 


" admitted during the year, . 


114 


101 


215 


Whole number under treatment, 


314 


297 


611 


Discharged recovered, ..... 


51 


53 


104 


" improved, ..... 


46 


20 


66 


" not improved, .... 


4 


8 


12 


Died, ........ 


16 


14 


30 


Whole number discharged during the year, 


117 


95 


212 


" " remaining September 30, 1863, 


197 


202 


399 



The foregoing table shows that two hundred and fifteen 
patients have been admitted into the wards of the hospital 
during the year, one hundred and fourteen of whom were 
males, and one hundred and one were females. There have 
been discharged during the year two hundred and twelve 
patients, thirty of whom were removed by death, and one 
hundred and eighty-two were discharged by your order. Of 
this number, one hundred and four had recovered their full 
mental health and strength, and were returned to their homes, 
to take upon themselves again the active and responsible duties 
of life. Sixty-six were discharged as improved. Some of 
these are now known to be occupying places of responsi- 
bility and trust, and are performing their duties acceptably to 
their friends and employers. Others, heads of families, are 
managing their households as skilfully as before the attack of 
mental disease for which they were committed to the care of 
the hospital. They did not recover while in the hospital, and 
are not enumerated in the list of recoveries. Twelve only 
were discharged as not improved. These patients enjoyed a 



1863.] PUBLIC DOCUMENT— No. 27. 41 

good degree of physical health, but had suffered a long time 
from dementia, more or less complete. They were quiet, and 
apparently harmless, and could as well be taken care of out of 
the hospital as any insane persons. A few cases, discharged 
by your order in the course of the year, are periodically insane. 
From some slight derangement of the bodily functions, or 
perhaps from some mental disturbance, they become restless, 
sleepless, and excited. In a few days, they find themselves 
unable to attend to the ordinary duties of life. Their friends 
interfere, and commit them to the hospital. After a period ot 
time, occasionally brief, but sometimes of long duration, their 
excitement passes off, and they are again well. The number 
remaining in the hospital, with which we begin a new year, is 
three hundred and ninety-nine. Of which one hundred and 
ninety-seven are males, and two hundred and two are females. 
Add to this number one who has been supported a part of the 
year, by your permission, without pay, and our numbers are 
four hundred. The average number of patients during the 
year was a fraction less than three hundred and eighty-nine. 
The recoveries were in the ratio of forty-three and seven-tenths 
per cent., to the whole number admitted, or sixteen per cent, 
to the whole number under treatment. The recoveries of 
recent cases, or those who had been insane one year or less 
previous to their commitment to the hospital, were in the ratio 
of seventy-four and four-tenths to the number of such cases. 
And the number of recoveries of those committed within the 
year was fifty-six. 

The ratio of deaths to the whole number admitted was 
thirteen and four-tenths, or four and a small fraction to the 
whole number under treatment, or seven and seven-tenths to 
the average number in the hospital. Four children have been 
born in the course of the year, of mothers who were committed 
to the hospital on account of mania developed during the 
period of gestation. Two infants have been admitted with 
mothers who were suffering from puerperal mania. Two of 
the mothers, and one of the children, still remain with us. 
6 



42 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 2, 

Shoioing the Admissions and state of the Hospital, from October 1, 1862, 
to September 30, 1863. 



Patients in the hospital October 1, 1862, 396 

Males, .... 200 Females, . . .196 

Patients admitted in the course of the year, 215 

Males, . . . 114 Females, . . .101 

Patients remaining in the hospital September 30, 1863, . . 399 

Males, .... 197 Females, . . .202 

Of the admissions there were cases of one year or less duration, . 122 

Males, .... 63 Females, ... 59 

Of the admissions there were cases of more than one year's 
duration, 96 

Males, .... 49 Females, ... 41 

Of the admissions there were cases the duration of whose insanity 

could not be ascertained, 

Males, .... 2 Females, 

Patients committed by Courts, 

Males, .... 72 Females, 

Patients committed by Overseers of the Poor, 

Males, .... 5 Females, 

Patients on bonds, 

Males, .... 32 Females, 

Patient committed by Governor's warrant, .... 
Males, .... Females, ' . 

Patients committed by Alien Commissioners, 

Males, .... 2 Females, 

Patients committed by Commissioners of Lunacy, 
Males, .... 2 Females, 

Foreigners and those having no settlement in the State, committed 
in course of the year, ........ 

Males, .... 41 Females, ... 46 

Foreigners and those having no settlement in the State, discharged 
in course of the year, .....••• 
Males, .... 56 Females, ... 45 

Foreigners and those having no settlement in the State, remaining 

in the hospital September 30, 1863, 

Males, .... 87 Females, ... 88 





3 


1 






135 


63 






10 


5 






61 


29 






1 


1 






5 


3 






3 


1 





87 



101 



175 



1863.] 



PUBLIC DOCUMENT— No. 27. 



43 



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



1842, . 


. 34 


1850, . 


. 181 


1858, . 


. 121 


1843, . 


. 38 


1851, . 


. 201 


1859, . 


. 124 


1844, . 


. 38 


1852, . 


. 241 


1860, . 


. 130 


1845, . 


. 57 


1853, . 


. 216 


1861, . 


. 156 


1846, . 


. 52 


1854, . 


. 151 


1862, . 


. 189 


1847, . 


. 121 


1855, . 


. 115 


1863, . 


. 175 


1848, . 


. 150 


1856, . 


. 155 






1849, . 


. 167 


1857, . 


. 119 







The number of State paupers in the house at the beginning 
of the year, was one hundred and eighty-nine. The number 
of State paupers committed during the year was eighty-seven, 
and the number discharged by your order during the year, and 
removed to their families, or to almshouses, was ninety-two. 
The number of State paupers who died during the year was 
nine, making the whole number of State paupers removed one 
hundred and one, thus diminishing the number of this class of 
patients by fourteen. The number of State paupers at the 
close of the year was one hundred and seventy-five. A few of 
this class of our patients are known to have settlements in this 
Commonwealth, and the above numbers will thereby be 
somewhat reduced. 

The number of patients admitted on private bonds during 
the year was sixty-one, and the number admitted on bonds 
from overseers of the poor was ten. 

The number admitted by the various courts and commis- 
sioners was one hundred and forty-four. Deducting from one 
hundred and forty-four committed by courts, eighty-seven 
State paupers, leaves fifty-seven to be added to the number of 
town patients and private patients, in about the proportion of 
thirty-eight town patients and nineteen private patients. The 
admissions will stand very nearly as follows : 



State patients admitted, . 
Town patients admitted, . 
Private patients admitted, 



87 
48 
80 



215 



u 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



The averages of the different classes will be very nearly as 
follows : 



State patients, 
Town patients, 
Private patients, 



. 185 
. 117 

. 96 

398 



Table No. 3, 

Showing the number Admitted, Restored, Improved, Died, fyc, in each. 
Month during the Tear. 





Admitted. 


KEMOVED. 


Remaining. 


MONTHS. 


3 


• 

a 

Eh 


o 
H 


<6 
? 
o 

P5 


•6 

> 
o 
u 
o. 

a 


•a 

> 
o 
u 
p. 

a 

w 
o 


5 


o 


OS 

3 


0> 

a 

CO 






M. 


v. 


M. 


F. 


M. 


F. 


M. 


F. 


M. 


F. 


"a 
o 


October, . . 


10 


8 


18 


4 


9 


5 


1 


T 


1 


1 


1 


10 


12 


200 


192 


392 


November, . 


8 


5 


13 


5 


2 


4 ! 2 


- 


1 


1 


2 


10 


7 


198 


190 


388 


December, . 


9 


10 


19 


7 


4 






- 


1 


- 


1 


7 


6 


200 


194 


394 


January, . . 


10 


10 


20 


3 


5 


2 












5 


5 


205 


199 


404 


February, . 


5 


5 


10 


2 


2 


3 


1 


- 


1 


- 


- 


5 


4 


205 


200 


405 


March, . . 


8 


8 


16 


4 


4 


1 


1 


- 


1 


1 


1 


6 


7 


207 


201 


408 


April, . . . 


6 


8 


14 


7 


8 


6 


- 


- 


- 


1 


2 


14 


10 


199 


198 


397 


May, . . . 


15 


10 


25 


2 


8 


4 


- 


1 


1 


2 


2 


9 


12 


205 


197 


402 


June, . . . 


11 


11 


22 


6 


4 


3 


6 


- 


2 


1 


- 


10 


12 


206 


196 


402 


July, . . . 


5 


4 


9 


5 


- 


11 


6 


- 


- 


3 


3 


19 


9 


192 


191 


383 


August, . . 


13 


12 


25 


- 


3 


2 


- 


- 


- 


5 


- 


7 


3 


198 


200 


398 


September, . 


14 


10 


24 


6 


4 


5 

46 


2 

19 


3 

4 


- 


1 


2 

14 


15 
117 


8 
95 


197 


202 


399 


•Totals, . . 


114 


101 


215 


51 


53 


8 


16 









1863.] 



PUBLIC DOCUMENT— No. 27. 



45 



Table No. 4, 

Showing the Form of Disease in those Admitted and Discharged during 

the Year. 





Admitted. 


Discharged. 


FORM OF DISEASE. 


"3 


s 


"3 

o 
H 


S 


0> 

"3 

s 

ft 


"3 

o 
H 


Mania, 

" Chronic, 

" with Epilepsy, 

" with general Paralysis, 
Melancholia, . . . 
Dementia, .... 

" Senile, 

" with Epilepsy, 

" with general Paralysis, 
Monomania of Fear, 

" of Pride, . 
" of Suspicion, 


41 
16 
13 

7 
14 
13 

5 



1 

2 


39 

19 

3 

18 

16 

2 

1 

2 
1 


80 
35 
16 

7 
32 
29 

7 

3 
3 
3 


44 
17 
2 
6 
12 
32 

3 
1 


49 

19 

2 

8 

14 

2 

1 


93 

35 

4 

6 

20 

46 

2 

3 

2 


Totals, .... 


114 


101 


215 


117 


95 


211 



The following tables have been carefully made up from the 
original records. Some slight errors in the division of the 
classes and sexes have been corrected. The records also have 
been rendered more complete by filling blanks from information 
'received in answer to inquiries made about individual cases. 



Table No. 5. 



Supposed Causes of Insanity of Patients admitted into the Hospital from 
January 18, 1833, to September 30, 1863. 





1 8 <S 3 . 


Previously. 


CAUSES. 


Males. 


Females. 


Males. 


Females. 


Apoplexy, 

Asthma, ...... 

Bronchitis, ..... 

Bowels, Disease of, . 

Cancer, ...... 




- 


1 
1 

1 


2 
1 

1 



46 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 5 — Continued. 









1863. . 


Previously. 


CAUSES. 












Males. 


Females. 


Males. 


Females. 


Chorea, ....*.. 


_ 






3 


Constipation, . 






- 


- 


- 


- 


Convulsions, 






- 


- 


10 


12 


Dysentery, 






- 


- 


2 


2 


Dyspepsia, 






- 


- 


2 


- 


Epilepsy, 






13 


3 


132 


48 


Eruptive Diseases, . 






- 


- 


3 


3 


Eyes, Disease of, 






- 


- 


1 


- 


Eyes, Loss of, . 






- 


- 


1 


- 


Erysipelas, 






- 


- 


- 


1 


Fevers, . 






- 


1 


46 


64 


Hysteria, 






- 


- 


- 


1 


Hemorrhades, . 






- 


- 


1 


1 


Ill Health, 






23 


23' 


311 


770 


Influenza, 






- 


- 


1 


3 


Insolation, 






- 


- 


16 


- 


Idiocy, 






- 


1 


15 


8 


Laryngitis, 






- 


- 


- 


- 


Measles, . 






- 


- 


4 


6 


Nervous Irritation, . 






- 


- 


- 


- 


Nymphomania, 






- 


- 


- 


4 


Old Age, . 






- 


2 


20 


24 


Otitis, . 






- 


- 


- 


- 


Paralysis, 






7 


- 


48 


26 


Pneumonia, 






— 


— 


— 


- 


Rheumatism, . 






- 


- 


5 


1 


Scrofula, . . . . 






- 


- 


1 


2 


Sea-sickness, . 






- 


- 


1 


1 


Somnambulism, 






- 


- 


- 


2 


Suppressed Eruptions, 






- 


- 


4 


3 


Suppressed Ulcer, . 






- 


- 


1 


3 


Satyriasis, 






- 


- 


1 


- 


Tic Douloureux, 






- 


- 


- 


1 


Tumor, . 






- 


- 


- 


1 


Whooping Cough, . 






- 


- 


1 


- 


Amenorrhea, 






- 


- 


- 


20 


Lactation, Excessive, 






- 


- 


- 


3 


Menorrhagia, . 






- 


- 


- 


8 


Menorrhagia, Suppressed 






- 


- 


- 


23 


Miscarriage, 






- 


- 


- 


4 


Pregnancy, 






- 


4 


- 


6 


Puerperal, 






- 


3 


- 


196 


Turn of Life, . 






- 


3 


- 


55 


Amputation of Leg, 






- 


- 


1 


- 


Bathing in Cold Water, 






- 


- 


1 


- 


Drinking Cold Water, 






- 


- 


1 


- 


Exposure to Cold, . 






- 


- 


11 


13 


Injuries by Falling, &c, 






- 


- 


20 


6 • 


Injury of Head, 






- 


1 


53 


10 


Injury of Spine, 






— 


— 


2 


6 



1888.] 



PUBLIC DOCUMENT— No. 27. 
Table No. 5 — Continued. 



47 











1863. 


Previously. 


CAUSES. 












Males. 


Females. 


Males. 


Females. 


Lead, Poison of, ... 




_ 


4 




Lightning, Stroke of, 






- 


- 


- 


1 


Labor, Excessive, . 






3 


- 


37 


57 


Loss of Sleep, . 








- 


- 


- 


3 


Study, Excessive, 








1 


- 


24 


9 


Spiritualism, . 








- 


- 


17 


24 


Criminal Trial, 








- 


- 


- 


1 


False Accusation, 








- 


- 


- 


1 


Imprisonment, 








- 


- 


4 


- 


Death of Relatives, 








- 


- 


28 


69 


Domestic Trouble, 






* 


'4 


8 


106 


328 


Marriage, Unhappy, 






- 


- 


o 


5 


Disappointment in Love, 






2 


6 


62 


89 


Disappointed Ambition, 






- 


- 


9 


9 


Home Sickness, 






- 


- 


6 


17 


Fright, . 






1 


- 


19 


24 


Seduction, 






- 


• - 


- 


3 


Millerism, 






- 


- 


9 


6 


Political Excitement, 






- 


- 


9 


1 


Religious Excitement, 






- 


- 


156 


176 


Pecuniary Trouble, . 






2 


- 


140 


37 


Poverty, . 






- 


- 


1 


1 


Poverty, Fear of, 






- 


- 


30 


8 


Prosecution, . * . 






- 


- 


1 


- 


Giving up Business, 






- 


- 


1 


- 


Change of Business, 






- 


- 


8 


- 


Violent Temper, 






- 


- 


2 


13 


Jealousy, 








- 


-■ 


18 


27 


Intemperance, 








20 


4 


520 


58 


Opium, Use of, 








- 


- 


3 


9 


Tobacco, Use of, 








- 


- 


2 


7 


Masturbation, . 








9 


2 


338 


53 


Venery, Excess of, 








- 


- 


1 


- 


Unknown, 








29 
114 


40 
101 


988 


1019 


Total, 








3264 


3399 



Of the above there were — 



Hereditary cases, .... 


16 


13 


519 


753 


Periodical cases, .... 


22 


20 


536 


573 


Hereditary and Periodical cases, 


8 


6 


357 


402 


Suicidal cases, ..... 


15 


13 


162 


203 


Homicidal cases, .... 


7 


4 


114 


33 


Suicidal and Homicidal cases, . 


3 


4 


32 


19 



48 



LUNATIC HOSPITAL AT WORCESTER. [Set. 



The foregoing table shows the assigned causes of insanity in 
the admissions of the year, and of all the previous years since 
the opening of the hospital, as nearly as could be ascertained. 
These may be arranged into two Classes, according as their in- 
fluence was of a moral or physical character. A glance at the 
table will indicate with sufficient clearness for all practical pur- 
poses the proportions which these classes bear to each other. 
In general the histories given us of the patients are so meagre 
and unreliable that it is impossible to give a classification of 
the causes of insanity of much value, or show even the combi- 
nations of circumstances influencing the individual previous to 
his attack of mental disease. 



Table No. 6, 

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





Admitted. 


Discharged Re- 
covered. 


Discharged not 
Eecovered. 


Died. 


AGES. 














Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Less than 15, 


O 


5 




1 


1 


1 


1 


From 15 to 20, 


9 


5 


1 


6 


3 


1 


- 


20 to 30, 


17 


24 


10 


10 


11 


8 


2 2 


30 to 40, 


36 


26 


21 


17 


19 


6 


3 


1 


40 to 50, 


22 


23 


9 


9 


10 


9 


5 


- 


50 to 60, 


12 


10 


3 


8 


3 


2 


2 


3 


60 to 70, 


6 


6 


o 


1 


3 


1 


3 


3 


70 to 80, 


10 


- 


4 


1 


- 


- 


1 


3 


80 to 90, 


- 


2 


1 


- 


- 


- 


- 


1 


Unknown, 


- 


- 


- 


- 


- 


- 


- 


- 


Totals, . . 


114 


101 


51 


53 


50 


28 


16 


14 



1863.] 



PUBLIC DOCUMENT— No. 27. 



49 



Table No. 7, 

Showing the Ages of Patients Admitted, Discharged Recovered, not Re- 
covered, and Died, from January 18, 1833, to September 30, 1863. 









Discharged Ke- 


Discharged not 








Admitte 










Died. 








COVERE] 


Recovered. 






AGES. 




















Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Less than 15, 


26 


25 


5 


10 


16 


12 


1 


1 


From 15 to 20, 


206 


208 


120 


129 


61 


60 


14 


13 


20 to 30, 


912 


891 


448 


451 


323 


343 


56 


64 


30 to 40, 


835 


925 


397 


440 


343 


335 


90 


88 


40 to 50, 


720 


767 


308 


351 


250 


242 


95 


88 


50 to 60, 


372 


417 


161 


193 


135 


131 


66 


76 


60 to 70, 


213 


198 


78 


91 


79 


60 


48 


49 


70 to 80, 


85 


60 


21 


24 


21 


17 


34 


21 


80 to 90, 


9 


9 


4 


2 


2 


4 


5 


3 


Unknown, . . 


- 


- 


- 


- 




- 


- 


- 


Totals, . . 


3,378 


3,500 


1,542 


1,691 


1,230 


1,204 


409 


403 



The foregoing table shows the ages of the patients at the 
time of their commitment to the hospital, without reference to 
the age at which the disease made its first appearance. Few 
patients are received into the institution less than fifteen years 
of age. From fifteen years of age the number of admissions 
increases rapidly, until fifty years have elapsed, when the num- 
ber steadily diminishes until eighty-five to ninety. A few only 
are committed above eighty years of age. One, however, was 
during the last year admitted who was more than eighty-eight 
years of age. 



50 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 8, 

Showing the Duration of Insanity before Admission of Patients Admitted, 
Discharged Recovered, not Recovered, and Died during the Tear. 





Admitted. 


Discharged 
Recovered. 


Discharged 

not 
Recovered. 


Died. 


DURATION OF INSANITY. 






















"3 

a 

o 

ft 


"3 


1 


"3 


a 

ft 


"a 

8 


to 

"3 

a 

ft 


Insane 1 year or less, . 


57 


58 


37 


38 


9 


6 


3 


5 


More than 1 year and less than 2 


















years, 


12 


8 


9 


6 


1 


2 


1 


3 


More than 2 years and less than 


















5 years, 

More than 5 years and less than 


17 


18 


4 


6 


11 


6 


3 


3 


10 years, .... 
More than 10 years and less than 


9 


11 


1 


3 


17 


8 


2 


- 


15 years, .... 
More than 15 years and less than 


8 


4 


- 


- 


7 


5 


5 


1 


20 years, .... 
More than 20 years and less than 


6 


2 


- 


- 


3 


1 


2 


- 


25 years, .... 
More than 25 years and less than 


3 


— 


— 


— 


2 


- 


- 


— 


















2 


Thirty years or more, . 


2 
















Unknown, ... 


- 


- 


- 


- 


50 


28 


- 


- 


Totals, . . . . 


114 


101 


51 


53 


16 


14 



1863.] 



PUBLIC DOCUMENT— No. 27. 



51 



Table No. 9, 



Showing the Duration of Insanity before Admission of Patients Admitted, 
Discharged Recovered, not Recovered, and Died, from January 18, 
1833, to September 30, 1863. 







Discharged He- 


Dischar 


ged not 


Died. 








covered. 


Recovered. 




DURATION OF INSANITY. 




















to 

"3 


"3 
S 




E 




6 


"3 


i 




3 


fa 


§ 


fa 


a 


fa 


3 


fa 


Insane 1 year or less, 


2,131 


2,390 


1,199 


1,326 


604 


582 


211 


256 


More than 1 year and less 


















than 2 years, 


116 


101 


144 


133 


57 


57 


20 


13 


More than 2 years and less 


















than 5 years, 


492 


467 


100 


121 


178 


158 


78 


56 


More than 5 years and less 


















than 10 years, 


263 


240 


40 


49 


172 


174 


30 


23 


More than 10 years and 


















less than 15 years, 


138 


148 


12 


20 


92 


90 


28 


23 


More than 15 years and 


















less than 20 years, 


65 


38 


9 


9 


36 


57 


17 


7 


More than 20 years and 


















less than 25 years, 


44 


32 


7 


6 


28 


34 


4 


7 


More than 25 years and 


















less than 30 years, 


18 


15 





1 


9 


10 


5 


4 


Thirty years or more, 


29 


26 


2 


5 


11 


13 


8 


6 


Unknown, 


82 


43 


24 


21 


43 


29 


8 
409 


8 


Totals, .... 


3,378 


3,500 


1,542 


1,691 


1,230 


1,204 


403 


Totals, .... 


6,878 


3,2 


33 


2,434 


812 



52 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 10, 

Showing the Civil Condition of Patients Admitted, Discharged Recovered, 
not Recovered, and Died, during the Year. 




Table No. 11, 

Showing the Civil Condition of Patients Admitted, Discharged Recovered, 
not Recovered, and Died, from January 18, 1833, to September 30, 
1863. 



CIVIL 


Admitted. . 


Discharged Re- 
covered. 


Discharged not 
Recovered. 


Died. 




Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Unmarried, . 

Married, 

Widowers, 

Widows, 

Unknown, 


1,783 
1,424 

148 

23 


1,505 

1,568 

407 
20 


764 

719 

56 

3 


671 
823 

195 
2 


751 

426 

41 

12 


648 
421 

122 
13 


160 

199 

44 

6 


168 
159 

74 

2 


Totals, 


3,378 


3,500 


1,542 


1,691 


1,230 


12,04 


409 


403 



1863.] 



PUBLIC DOCUMENT— No. 27. 



53 



Table No. 12, 



Showing the Occupation of Patients admitted to the Hospital from 
January 18, 1833, to September 30, 1863. 



OCCUPATION OF MALES. 


1863. 


Previously. 


Auctioneers, . ^^^^^^^^^^^H 




2 


Armorers, 










- 


2 


Authors, . 










- 


3 . 


Blacksmiths and Iroi 


l-workers, 








3 


54 


Bakers, . 










- 


10 


Butchers, . 










- 


5 


Book-agents, 










- 


2 


Book-binders, . 










1 


2 


Broom-makers, 










- 


2 


Book-keepers, . 










- 


8 


Britannia-workers, 










- 


2 


Brick-makers, . 










- 


5 


Bellows-makers, 










- 


2 


Barbers, . 










- 


12 


Clergymen, 










- 


23 


Carvers, . 










— 


2 


Carpenters, 










2 


114 


Coppersmiths, . 










1 


8 


Coopers, . 










1 


21 


Cabinet-makers, 










- 


16 


Clothiers, . 










- 


15 


Comb-makers, . 










- 


4 


Confectioners, . 










- 


3 


Card-makers, . 










- 


1 


Chair-makers, . 










_ 


3 


Cigar-makers, . 










- 


4 


Clerks, 










7 


72 


Carpet-weavers, 










- 


2 


Caulkers, . 










- 


2 


Camphene-distillers, 










- 


3 


Dyers, 










- 


3 


Druggists, 










1 


2 


Drovers, . 










- 


2 


Daguerreotypists, 










- 


3 


Engineers, 










- 


2 


Engravers, 










- 


4 


Editors, . 










- 


4 


Expressmen, . 










- 


14 


Farmers, 










20 


664 


Fishermen, 










1 


29 


Gardeners, 










_ 


9 


Glass-blowers, . 










- 


4 


Hotel-keepers, . 










1 


12 


Hatters, . 










- 


5. 


Harness-makers, 










_ 


14 


Hackmen and Teamsters, 








_ 


28 


Jewellers, 








- 


18 



54 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 12 — Continued. 



OCCUPATION OF MALES. 


1863. 


Previously. 


Lawyers, 




12 


Laborers, 








24 


740 


Manufacturers, 








1 


28 


Millers, .... 








- 


6 


Merchants, 








- 


142 


Masons, .... 








1 


28 


Miners, 








- 


4 


Miniature-painter, . 








- 


1 


Mat-makers, 








— 


2 


Musicians, 








- 


7 


Machinists, 








- 


40 


Moulders, 








- 


7 


Operatives in Mills, 








9 


61 


Palmleaf-splitter, 








- 


1 


Painters, .... 








3 


39 


Printers, .... 








- 


30 


Physicians, 








1 


14 


Paper-makers, 








- 


'7 


Peddlers, 








1 


12 


Potter, .... 








• - 


1 


Pump and Block-makers, 








- 


4 


Pattern-makers, 








- 


4 


Plumbers, 








- 


4 


Police officers, . 








- 


3 


Rope-makers, . 








- 


10 


Restaurators, . 








1 


7 


Shoemakers and Bootmakers, 








13 


255 


Sailmakers, 








- 


9 


Soap-makers, . 








1 


6 


Sash and blind-makers, 








- 


3 


Sea-captains, . 








- 


16 


Sailors, .... 








4 


148 


Students, .... 








- 


56 


Ship-carpenters, 








- 


8 


Shop-keepers, . , 








- 


3 


Stone-cutters, . 








— 


9 


Soldiers, .... 








- 


10 


Sexton, .... 








- 


1 


Stevedore, .... 








- 


1 


Surveyors, 








- 


2 


School-boys, 








3 


20 


Tailors, .... 








- 


20 


Teachers, 








1 


30 


Tobacconists, . 








- 


3 


Tinners, .... 








1 


6 


Tanners, .... 








- 


17 


Umbrella-makers, 








- 


2 


Wheelwrights, . 








1 


16 


No occupation, 








11 


194 










114 


3,264 



1863.] PUBLIC DOCUMENT— No. 27. 

Table No. 12 — Concluded. 



55 



OCCUPATION OF FEMALES. 



Previously. 




Actress, . 

Cooks, 

Engraver, 

Housekeepers, . 

Housemaids, 

Laundresses, 

Music Teachers, 

Midwife, . 

Nurses, 

Operatives in Mills, 

Seamstresses, . 

School-girls, 

Teachers, 

Typesetters, 

No occupation, 

Totals, 



The foregoing tables show that no age or condition of life is 
exempt from insanity more than from other diseases with which 
mankind is afflicted. No trade or profession affords any great 
security from its ravages. It is a mistake, however, to suppose 
that the relative frequency of the disease in persons employed 
in the various pursuits of life, is exactly indicated by the num- 
bers recorded in the tables. For example, a considerable 
number of patients committed to this hospital, both male and 
female, for a considerable period of time previous to commit- 
ment, followed no trade or profession, and had little or no oc- 
cupation of any kind ; but the prevailing occupation of the 
life of the individual was the one enumerated in the tables. 
Again, a large proportion of our people are engaged in some 
way or other in agricultural pursuits, either as farmers, farm 
laborers, or the sons or daughters of farmers, and the number 
given in the tables for these classes is sufficiently large to dis- 
turb our belief in the healthfulness of a country life and agri- 
cultural pursuits. But if we compare the relative numbers 
engaged in each occupation in the whole community, we shall 
find that the common opinion respecting the general healthful- 
ness of agricultural labors is correct. 



56 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



The tables show that there were admitted during the year, 
twenty farmers and twenty-four farm or out of door laborers. 
Thirteen boot and shoemakers. Nine operatives in mills, and 
seven clerks. Of the admissions of females, there were forty- 
six house-keepers. Twenty-two seamstresses, and thirteen 
house-maids. 



Table No. 13. 

Diseases which have proved Fatal from January 18, 1863, to September 

30, 1863. 













1863. 


Previously. 


DISEASES. 












Males. 


Females. 


Males. 


Females. 


Apoplexia, 


_ 


_ 


15 


9 


Asphyxia, 










- 


- 


2 


- 


Asthma, . 










- 


- 


4 


1 


Ascites, . 










- 


- 


5 


7 


Antochinia, 










- 


1 


15 


9 


Bronchitis, 










- 


- 


2 


- 


Carcinoma, 










1 


- 


1 


1 


Carditis, . 










- 


- 


9 


11 


Cholera, . 










- 


- 


5 


- 


Cholera Morbus, 










- 


- 


2 


3 


Cystitis, . 










- 


- 


1 


- 


Dysenteria, 










- 


- 


12 


6 


Delirium Tremens, 










1 


- 


3 


- 


Enteritis, 










- 


- 


6 


9 


Epilepsia, 










4 


2 


60 


26 


Erysipelas, 










- 


- 


9 


10 


Hepatitis, 










- 


- 


- 


2 


Hydro thorax, . 










- 


- 


1 


1 


Hernia, . 










— 


— 


1 


- 


Inanitio, . 










- 


2 


33 


50 


Mania Exhaustive, 










2 


- 


8 


7 


Marasmus, 










- 


- 


63 


63 


Meningitis, 










- 


- 


9 


14 


Mortificatio, . 










- 


- 


- 


1 


Necropneumonia, . 










- 


- 


1 


2 


Paralysis, 










6 


- 


24 


19 


Phthisis Pulmonalis, 










2 


7 


47 


98 


Pleuritis, 










_ 


- 


- 


2 


Pneumonia, 










- 


- 


15 


9 


Senectus, 










- 


2 


24 


13 


Typho-Mania, 










- 


•- 


7 


10 


Typhoid Fever, 










- 


- 


8 


> 6 


Variola, . 








- 


- 


1 


- 












16 


14 


393 


389 



1863.] PUBLIC DOCUMENT— No. 27. 57 

It would appear from the foregoing table, that disease of the 
ordinary character was the cause of death in nearly all the 
cases enumerated, and that those only are special which are 
ascribed to the exhaustion consequent upon maniacal excite- 
ment. But such a statement would not be strictly true, for in 
many of them the fatal termination was the result of habits 
and conduct incidental to their insanity; but, in making up 
the tables, the name of the disease which proved fatal is given 
as the cause, leaving out of the account any notice of the 
causes or conditions which may have induced such disease. 
Among the insane, the depraved appetite of some, the abste- 
miousness or voracity of others, the degradation of habits, 
the occasional infliction of injuries on their own persons, the 
excitement and constant activity of many, the exhaustion of 
their nervous energy, the want of sleep, the disinclination and 
inability to lie in bed, the depressing effects of long-continued 
mental disease, and the concomitant physical debility are 
frequent exciting causes of their diseases. Nearly or quite all 
of the deaths which have occurred during the year, have taken 
place in the progress of those forms of physical disease, in one 
stage or another, with which the mental malady has been com- 
plicated, and for which the patients were committed to our care. 
Insanity is to a greater or less degree a disease of debility, and 
the standard of vitality among the insane is low. The more 
feeble, from long-continued mental disease, are prepared to 
sink at any time under slight derangement of any physical 
function. There is often great difficulty in learning from many 
of them any thing of their symptoms or sufferings, and which 
are frequently masked to a great extent till their diseases have 
assumed a degree of intensity incapable of relief, which might, 
in the first instance, have been afforded them. All these vari- 
ous conditions concur in rendering the diseases of the insane 
and their treatment peculiar, and different from that which 
prevails in any sane community. 

Of the deaths which occurred during the year, six were from 
general paralysis, nine from consumption, six from epilepsy, 
two from exhaustion, consequent upon maniacal excitement, 
and two from general decay of the vital powers, and a prema- 
ture old age, and two others, females, died without any apparent 
disease. They were each nearly ninety years of age. One of 



58 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



them had been for many years an inmate of the institution, and 
the other but a few weeks. 



Table No. 14, 

Shoioing the Admissions from each County, from January 18, 1833, to 
September 30, 1863. 











1863. 


Previously. 




COUNTIES. 








Whole Ho. 




Males. 


Females. 


Total. 






Barnstable, .... 


1 




1 


126 


127 


Berkshire, 








o 


- 


2 


187 


189 


Bristol, . 








o 


1 


3 


290 


293 


Dukes, . 








- 


- 


- 


19 


19 


Essex, . 








23 


20 


43 


937 


980 


Franklin, 




i 




- 


- 


- 


126 


126 


Hampden, 








1 


1 


2 


352 


354 


Hampshire, .. 








1 


1 


2 


222 


224 


Middlesex, . 








23 


32 


55 


1,013 


1,068 


Nantucket, . 








- 


- 


- 


31 


31 


Norfolk, 








1 


2 


3 


597 


600 


Plymouth, 








1 


- 


1 


233 


234 


Suffolk, ' . 








5 


4 


9 


688 


697 


Worcester, . 






50 


38 


88 


1,825 


1,913 


Other States, 






4 


2 


6 


17 


23 


Totals, . 








114 


101 


215 


6,663 


6,878 



The following table does not very accurately show the ex- 
pense for any one year. The expenses of one year will overlap 
those of the next, and in greatly varying proportions from one 
year to another. For example, during the last year it happened 
that we paid for a large part of the coal for two years. This 
makes the cost of support, as shown by the table, very high 
The actual expense, however, for each patient was something 
less than three dollars per week. 



1863.] 



PUBLIC DOCUMENT— No. 27. 



59 



Table No. 15, 

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-one Tears the Hospital has been in 
operation. 









No. at end 




i 


Expense per 


YEAR. 


Whole 


Average 


of each 


Current expenses 


Annual expense 


week for 




Number. 


Number. 


year. 


of each year. 


for each patient, 


each patient. 


1833, . 


153 


107 


114 


$12,272 91 


§114 67 


m 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 


1837, . 


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 53 


1840, . 


391 


229 


236 


27,844 98 


121 59 


2 33 


1841, . 


399 


233 


232 


28,847 62 


123 81 


2 38 


1842, . 


430 


238 


238 


29,546 87 


111 12 


2 13 


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 


1847, . 


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 


38L 


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 83 


1861, . 


583 


369 


379 


54,748 53 


148 37 


2 84 


1862, . 


600 


401 


396 


53,043 88 


132 18 


2 50 


1863, . 


611 


398 


399 


66,082 36 


166 03 


3 19 



60 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



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PUBLIC DOCUMENT— No. 27. 



61 



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LUNATIC HOSPITAL AT WORCESTER. [Oct. 



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1863.] 



PUBLIC DOCUMENT— No. 27. 



63 



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1863.] 



PUBLIC DOCUMENT — No. 27. 



65 































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Periodical. 
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do 

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Recovered 
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Not improved 

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Improved 

Recovered 

Improved 

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Recovered 

Improved 

Recovered 

Improved 

Not improved 

Recovered 

Not improved 

Improved 


Discharged 

Died 

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PUBLIC DOCUMENT— No. 27. 



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82 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Classification of Expenses as per Treasurer's Report. 



PROVISIONS. 

Breadstuff's— Flour, $3,308 79 

Crackers, . . . . . . 185 72 

Rye, Corn Meal and Hominy, . . 400 00 

Fish, 698 94 

Meats . 3,890 37 

Fruits— Apples, 414 14 

Other Fruits, 123 54 

Vegetables— Potatoes, &c, 1,021 70 

Beans, . . . . . . . 360 27 

Butter, ' . . 3,681 57 

.... 839 09 

809 89 

. . . . 385 65 

. 368 04 

364 81 

528 87 

153 31 



Sugar, 

Coffee, 

Tea, . 

Molasses, . 

Eggs, 

Small Groceries, 

Ice, . 



CLOTHING. 



Boots and Shoes, and Caps, 
Fulled Cloth and Garments, 



FURNITURE 

House furnishing goods, 

Paper Hangings, . 

Bedding — Mattresses, Blankets, &c, 

Crockery and* Glass Ware, 

Dry Goods — Sheetings, Prints, &c, 

Pictures and Frames, 



$722 


02 


1,038 


98 


$617 14 


68 42 


756 


48 


440 


10 


2,177 


14 


98 


20 



$17,534 70 



1,761 00 



1,157 48 



Wood, (2 years' supply,) 
Coal, 



15 



7,741 



3,047 81 



LIGHT 



Gas, . 

Oil — Whale and Kerosene, 



$1,094 10 
114 00 



L,208 10 



1863.] PUBLIC DOCUMENT— No. 27. 

MEDICAL SUPPLIES. 

Medicines, &c, 

l 

AGRICULTURAL DEPARTMENT. 

Implements, $145 51 

Live Stock, . 222 00 

Fertilizers, Seeds, &c, Ill 23 

Rent of Land, two years, 255 00 

Trees, Shrubs, &c, 195 00 

Provender — Corn, Oats, &c, 1,071 96 

Labor, and supervision of labor of male patients, . 2,468 37 



IMPROVEMENTS AND 


R E PAIR s. 


Laundry Fixtures, purchased last year, 


$500 00 


Steam and Gas Pipe, and Plumbing, . 






189 16 


Window Sash, .... 








17 50 


Lumber, ..... 








377 55 


Hardware, .... 








629 36 


Blacksmithing, .... 








593 75 


Bricks, 








44 55 


Sand, Lime, Cement, &c, . 








160 10 


Paints and Oils, 








379 99 


Labor, 








2,314 54 


SALARIES, WAGES 


, &c. 




. $3,235 00 


Domestic Department, .... 


. 2,183 51 


Supervision and care of patients, . . . 


. 5,448 78 


Engineers and Watch Department, . 








1,856 25 



83 



$552 59 



,802 07 



3,206 50 



$12,723 54 



MISCELLANEOUS. 

Books, Newspapers, and Lectures, .... $352 96 

Stationery 122 55 

Postage, ......... 100 63 

Undertakers' bills, . 326 75 

Soap, (2 years,) 410 93 

Freight, 106 35 

Carriage Hire, 30 75 

Watering Streets, (two years,) 100 00 

Trustees' Expenses, . . ... . . . 106 84 

Elopement Expenses, 136 90 

Petty Cash Expenses, fares home and cash supplied 

to patients, &c, . 264 23 

$2,058 89 

Total, $58,052 68 



84 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



The following table will show the rise in the prices of some 
of the leading articles of consumption in three years : 



Sugar, 

Molasses, 

Tea, 

Coffee, 

■Butter, ....... 

Rice, 

Codfish, 

Beef, 

Flour, of the quality used at this hospital, 
Standard Prints, for dress goods, 
Cottons, 36 inches wide, . 
Cottons, 45 inches wide, . . . . 

Blankets, 

Coal, 



26 
42 
16 
16 

3 



9 

m 

2 75 
6 50 



W 11 
46 
65 
26 
23 
8 

7 

7 

13 

21 

28 

3 50 

6 75 



55 

75 
32 

28 

6* 



25 
35 

50 
50 
50 



The above table shows the cash prices for the best quality of 
supplies in this market. The prices of many articles of daily 
consumption are steadily increasing, viz., coal, flour, meats, 
cotton goods of all kinds, and blankets, and the prospect is that 
the prices of all supplies will increase steadily through the 
ensuing year. 

Much attention has been paid to the employment of the 
patients, and the system of labor has been improved and more 
fully carried out than before, although our tables do not show 
a larger amount than for the preceding year. Six good work- 
rooms have been constructed in the old laundry building, and 
are growing into daily use. The employment of the inmates 
has, in many instances, been instrumental in their recovery, 
and productive of great benefits in those cases where recovery 
has not yet taken place ; it has contributed to the general health, 
happiness, and tranquillity of our inmates, and has procured 
for them comforts and pleasures which could not otherwise 



1863.] PUBLIC DOCUMENT— No. 27. 85 

have been afforded. In the choice of occupations, and the 
times and occasions when the patients may be occupied with 
safety and propriety, much care and considerable discrimination 
is necessary. Agricultural labor is best suited to a large class, 
and perhaps best agrees with all. Some are more willing to 
attend to their own trades, and others are only suited when 
assisting at one which they have never followed, and which 
they know nothing of. There are many, however, independent 
of the sick and infirm, who cannot be safely engaged in any 
occupation. In an old institution, this number is necessarily 
large and increasing. 

Some few have a strong dislike to work of any kind ; others 
are so nervous and irritable, that they become violent if they 
are interfered with sufficiently to place them in any position 
of labor. Many suffer from epilepsy, and are wholly unfit for 
labor of any kind, although apparently robust enough to 
engage in any ordinary employment. A large number are 
more or less completely demented, and cannot be made to 
attend to labor of the simplest description. About twenty per 
cent, of our inmates perform labor to advantage, when under 
constant direction and assistance, and about sixty per cent, 
perform some labor every day. The larger number of males 
are employed in cultivating the farm and gardens ; in looking 
after the stock of cattle, horses and pigs ; and in care of the 
stables and out-houses, yards and drive-ways. A few assist as 
masons, carpenters, blacksmiths, painters, glaziers, and uphol- 
sterers in the general repairs of the establishment. Some 
assist the engineer in the boiler-house and engine-room, in 
attending to the fires of the apparatus for warming, ventilat- 
ing, cooking and pumping. Some assist the baker in the bake- 
room, and others work in the kitchen. Many are daily 
employed in the wards, assisting the attendants in the various 
household duties incident to that station. Most of the healthy 
females are employed in household work in the several wards 
of the female department, or in the laundry, kitchen and 
sewing-rooms. Others knit, sew, and assist in repairs of 
clothing and bedding, in their own rooms in the wards. Some 
have, and many might have, sewing and knitting from their 
own homes. All the work performed by the patients, however, 
is of an unsteady character, requires constant assistance and 



86 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

oversight, and is of a quality that no manufacturer or em- 
ployer would be willing to purchase at any price. 

The following tables show some of the results of labor. 
The best results, those which the patients themselves realize, 
cannot be shown in any tables. It is fair to state in this 
connection, that some crops have been grown and gathered 
on land not belonging to the institution. And no mention 
is made of the products of such labor in the tables ; the work 
has been done mainly for the sake of procuring for the patients 
more labor than they otherwise could have enjoyed. There 
was neither profit nor loss to the institution on account of 
labor on land not belonging to it. And the only benefit to 
any one arising from it, was to the patients who cultivated 
the land and gathered in the crops. 



1863.] 



PUBLIC DOCUMENT— No. 27. 



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88 



LUNATIC HOSPITAL AT WORCESTER. 



[Oct. 



Articles made in the Sewing-Rooms during the Year. 


Aprons, 


160 


Jackets, .... 


Bed Spreads, 


122 


Mattresses, 




Bed Ticks, . . ' 


274 


Mittens, pairs of 




Bosoms, 


14 


Neck Ties, 




Bureau Spreads, 


25 


Night Dresses, . 




Carpets, 


2 


Night Caps, 




Chemises, 


170 


Overalls, pairs of 




Clothes Bags, . 


10 


Pants, pairs of, . 




Coats, 


37 


Pillow Cases, 




Collars, 


28 


Sacques, . 




Comforters, 


45 


Sheets, 




Curtains, . 


142 


Shirts, 




Drawers, pairs of, 


122 


Skirts and Quilts, 




Dresses, .... 


237 


Suspenders, pairs of, 




Edging, yards of, 


115 


Table Cloths, . 




Frocks, .... 


13 


Towels, 




Hats, braided, . 


22 


Under Shirts, 




Handkerchiefs, . 


112 


Vests, 




Hose and Socks, pairs of, . 


129 


Waists, 




Articles Repaired in 


the Sewing-Rooms during the Year. 


Aprons, 


. 748 


Meal Bags, 


Blankets, . 


. 124 


Night Dresses, . 




Bed Spreads, 


. 182 


Overalls, pairs of, 




Bed Ticks, 


. 621 


Pants, pairs of, . 




Bosoms, . 


40 


Pillows, 




Chemises, . 


3,626 


Pillow Cases, . 




Clothes Bags, . 


36 


Sheets, . . ■ 




Coats, 


680 


Shirts, 




Collars, 


33 


Skirts, . . . 




Curtains, . 


10 


Stockings, pairs of, 




Drawers, pairs of. 


330 


Table Cloths, . 




Dresses, . 


281 


Towels, 




Erocks, 


86 


Tunics, 




Jackets, 


170 


Under Shirts, 




Mattresses, 


72 


Vests, 





1863.] 



PUBLIC DOCUMENT— No. 27. 



89 



Apples, 

Pears, 

Grapes, 

Tomatoes, 

Sweet Corn, 

Beans, . 

Parsnips, 

Turnips, 

Potatoes, 

Beets, 

Carrots, 

Squashes, 

Peppers, 

Cucumbers, 

Cabbages, 

Rhubarb, 

Hay, 

Rowen, 

Corn Fodder, 

Lucern, 

Milk, . 

Beef, . 

Pork, . 



Products of the Farm. 






30 barrels, at $2 50 


$75 00 






20 bushels, at 3 00 


60 00 






2 " at 2 00 


4 00 






100 " at 50 


50 00 






50 " at 1 50 


75 00 






60 " at 2 50 


150 00 






350 " at 50 


175 00 






450 " at 20 


90 00 






. 1,300 « at 50 


650 00 






. 500 « at 20 


100 00 






. 900 " at 20 


180 00 






91 tons, at 20 00 


190 00 






3 bushels, at 50 


1 50 






50 " at 50 


25 00 






900 heads, at 05 


45 00 






. 2,000 pounds, at 02£ 


50 00 






60 tons, at 20 00 


1,200 00 






30 " at 15 00 


450 00 






10 « at 4 00 


40 00 






2 " at 10 00 


20 00 






45,000 quarts, at 04 


1,800 00 






7,030 pounds, at 08 


562 40 






9,050 " at 06 


543 00 



,985 90 



As will be seen by the foregoing table, the products of the 
farm have been abundant, and have well repaid the labor 
devoted to their cultivation and growth. The fruit and vege- 
tables which the farm supplies, could not at all times be 
procured in the market, nor could the hospital afford to pur- 
chase. The very generous supply of milk which the patients 
enjoy the year round, is another prominent advantage derived 
from the farm. But perhaps the greatest advantage our 
patients receive from the farm is the pleasant and healthy 
occupation it gives to a large number who cannot engage in 
any other occupation. Considerable progress has been made 
during the year in laying out the grounds and the transplant- 
ing of trees. More than twenty-three hundred trees and 
shrubs have been transplanted during the year ; under-drains 
have been laid ; gravel walks have been made ; flower gardens 

12 



90 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

have been laid out for the female patients ; the yards in the 
rear of the building have been levelled and covered with turf, 
and the drive-ways have been paved or gravelled. All these 
small things, which may not seem to be required, are necessary 
in promoting the general objects of the hospital ; and we can 
only regret that we have not been able to devote more time 
and money to so desirable an end. 

The supply of water has been a subject of great anxiety and 
inconvenience for some years. The two-inch iron pipes which 
convey the water from Paine's spring, at the Hermitage, so- 
called, were laid down seventeen or eighteen years since, and 
have become so filled up with oxide of iron and other matter, 
that they have not for several years given us an abundant sup- 
ply. They have required constant repairs, and various attempts 
have been made to clean them, and to keep them clean, at an 
expense of from two to four hundred dollars a year. Still, the 
supply had steadily failed until the last summer, when you 
directed me, by your vote, to rebuild the dam, which was also 
much out of repair, and make arrangements to put down new 
pipes. The accompanying report of Mr. Ball, the engineer 
employed by me to make the necessary surveys and estimates 
of cost, shows that a suitable and permanent dam will cost 
about one thousand dollars. And the laying down of five 
thousand nine hundred feet (the distance from the spring to 
the hospital) of four-inch hydraulic cement pipe, with such 
gates and other fixtures as are necessary, will cost nearly four 
thousand dollars. The work on the dam was commenced about 
the middle of September, and will be completed in the month 
of October. It is highly desirable to lay down the pipes early 
next summer. 

Among other needs, it may be proper to state, that owing to 
the high prices which almost every thing commands, we have 
not been able to lay down our bowling alleys, or fit up our 
gymnasiums, rooms for which have been in readiness nearly 
two years. We also need sun shades in our yards, with cosy 
seats and benches, for the comfort and convenience of our 
patients. Every dollar thus invested is sure to yield large 
returns in future years, in promoting the comfort, health, and 
general welfare of the inmates of the institution. 

We ought to have an ice-house, which can be cheaply con- 
structed by our own laborers. The old ice-house is of insuffi- 



1863.] 



PUBLIC DOCUMENT— No. 27. 



91 



cient capacity, does not preserve the ice, and is needed for 
other purposes. We want also, for our evening entertainments, 
a stereopticon, with a sufficient number of slides and perma- 
nent fixtures. And we hope to be able to purchase one in a 
few weeks, for use the coming winter. It is hardly possible for 
us to realize these needed improvements and additions, without 
aid from other sources than the ordinary income. In the com- 
ing year, as in the past, the hospital will do well to meet its 
legitimate expenses with its yearly earnings. 

For several years, this hospital has made no expression of 
any want, and it has paid from its own earnings, for perma- 
nent improvements, repairs, and buildings, large sums of 
money, which has greatly increased the value of the property 
of the Commonwealth. Since the connection of the under- 
signed with the institution in his present capacity, it has 
paid for 



Apparatus for warming, ventilating, and draining, . 
For barn and sheds, and large cistern in rear, for safety 

from fire, ......... 

Dividing Johonnot wards, and fitting up water-closets 

and bath-rooms for same, ..... 

For six attendants' rooms in Johonnot wards, . 

Water-closets and bath-rooms in centre, 

Four flights of stairs, . . . . . . 

Conveying water from Rattlesnake Hill to stables, . 

Dead walls dividing attics and fencing courts, 

Billiard and reading rooms and dormitories in place of 

old cells, ........ 

For new centre wing, and alterations in old centre, . 
Fixtures for new kitchen and laundry, . 
Rebuilding four rooms in place of old cells, 
For purchase of land, ...... 

Four porticoes over outside doors, 

Opening and fencing drive-way in front, and replacing 

stone steps, ....... 

Ladder house, ....... 



$28,000 00 


3,410 


01 


500 


00 


600 


00 


300 


00 


250 


00 


975 


00 


300 


00 


1,200 


00 


23,029 


48 


1,600 


00 


600 


00 


1,425 


00 


400 


00 


650 


00 


100 


00 


$63,339 


49 



Besides these permanent alterations and improvements, the 
whole establishment has been kept in ordinary repair. Worn- 
out fixtures have been replaced, small embellishments of the 



92 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

house and grounds have yearly been made, parts of the house 
have been refurnished, and every thing necessary for the 
comfort of the patients has received proper attention. 

The plan of treatment pursued during the year has not dif- 
fered materially from that followed in previous years. The 
use of the warm bath, an occasional purgative and sedative, 
have been of service in producing quiet and repose in the early 
stages of acute mania, and in the paroxysms of periodical 
mania; while cold sponge baths, tonics, stimulants, and above 
all good diet, and active out-of-door exercise, have been found 
to give great relief to patients suffering from chronic mania. 
Cod liver oil and stimulants have, in some cases, raised the 
standard of health in demented patients of feeble constitutions, 
where there was sluggishness of circulation, coldness of the 
extremities, and lividity of the surface. Constant attention 
has been given to the diet, clothing, and exercise of the 
patients, and a close investigation of the habits of each case, 
which has been productive of good results in the course of 
both mental and bodily disease. 

The same effort has been made during the year past as 
before, to amuse, instruct, and entertain our patients in an 
intellectual manner, by lectures and concerts, and by social 
parties, at frequent intervals. During the winter season, we 
had a series of about twenty lectures, several concerts of sacred 
music, and weekly parties for social entertainment, at which 
both sexes mingled freely with their attendants in games and 
in conversation, until nine o'clock in the evening, when they 
retired to their several wards. The amount of discipline and 
self-control which these various reunions exercise on our 
patients, is productive of the best results, and they have in 
some degree dispelled the gloom and cheered the hearts of 
many a miserable sufferer ; and not a few under the influence 
of deep melancholy, who can take no active part in the scenes, 
look with pleasure and delight on the games and plays which 
their minds are too dull to fully appreciate. One hundred and 
fifty newspapers are received by the patients every week. The 
wards and reading-rooms are well supplied with maps, and the 
patients' libraries contain more than one thousand volumes of 
recently published books. There are hanging on the walls of 
the several wards nearly six hundred pictures, many of which 



1863.] PUBLIC DOCUMENT— No. 27. 93 

are oil paintings, engravings, water colors, and photographs, of 
considerable value. On Sundays, they continue to listen to a 
sermon from Rev. Samuel Souther, who discharges his duty 
with singular discretion and faithfulness ; and on every eve- 
ning, at eight and a half o'clock, they assemble in the chapel 
for devotional exercises conducted by the undersigned. 

I am under great obligations to Doctors Rice and Prentiss 
for the manner in which they perform their duties, and for 
their thorough devotion to the best interests of those com- 
mitted to our care. My assistants have generally performed 
their duties in a manner highly acceptable to the patients, and 
entirely satisfactory to myself. 

We are under renewed obligations to the many kind friends 
in the city and in the neighborhood, who have so generously 
assisted us in our lectures, concerts, and social entertainments, 
which have contributed so largely to the comfort and happiness 
of our patients. 

It is with great satisfaction that I acknowledge a legacy of 
one thousand dollars — ten shares of bank stock, bequeathed to 
the hospital by Miss Abigail Wheeler, late of Barre. And it 
must be gratifying to all the surviving friends of Miss Wheeler, 
and to every true friend of the hospital, that you have, by your 
vote, given such a charitable direction to the income of this 
legacy. 

Her name is placed on the Benefactors' Tablet in the Chapel, 
and will be held in grateful remembrance. 

To the publishers and proprietors of newspapers and periodi- 
cals throughout the Commonwealth, who have sent to us their 
daily, weekly, and monthly issues, we are greatly indebted. 

For the personal kindness, the cordial support and counsel I 
have at all times enjoyed from each individual member of the 
Board of Trustees, in the discharge of my duties, permit me 
to renew the expression of my deep sense of obligation. 

We now commence the labors of another year with an hum- 
ble trust and confidence that He who watches over all will 
regard this institution, and all its interests, with his special 
favor. 

MERRICK BEMIS. 
Worcester Lunatic Hospital, Worcester, Mass., > 

October 1, 1863. J 



94 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



AN INVENTORY 



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 grocerie 

Drugs and medicines, 

Fuel, . 

Library, 

Pictures, 

Billiards .and bagatelle tables, 

Pianos, .... 



$3,750 00 


3,500 


00 


850 


00 


5,500 


00 


4,500 


00 


3,500 


00 


350 


00 


1,200 


00 


250 


00 


150 


00 


500 


00 


100 


00 


6,000 


00 


500 


00 


1,250 


00 


500 


00 


300 


00 



$32,700 00 




MAP 

4 OF THE 

GREEN BROOK 

WATER SHED. 



SCALE ONE INCH-48 RODS. 
'VTO.U1\«. P.3A.LL. C.E. 



B 

J 

OF 

PROPOSED AQUEDUCT 

FOR THE 

STATE LUNATIC HOSPITAL 



WORCESTER MASS. 



SCALE ONE INCH 




1863.] PUBLIC DOCUMENT— No. 27. 101 



ENGINEER'S REPORT. 



Merrick Bemis, M. D., Superintendent State Lunatic Hospital, Worcester : 

Dear Sir, — Having been requested by yourself to make some surveys 
and estimates, to ascertain the feasibility of permanently supplying your 
institution with water from the source from which water is now conveyed 
thereto ; and having made such surveys and estimates, I present the following 
Report : 

The plans herewith presented, marked A, B, and C, represent, first : A, the 
basin of the Green Brook, so called, above your present reservoir. Second : 
B, plan of the route over which the pipe will have to be laid in passing from 
the reservoir to your institution. Third : plan C, represents the dam and 
fixtures that is proposed to be erected at the reservoir. 

The first question to be answered is, what amount of water will be required 
to supply the largest want of the institution. Taking thirty-five gallons per day 
for each patient and attendant, as the necessary amount as stated by yourself, 
and the largest number of persons in the institution as five hundred, this 
would require seventeen thousand five hundred gallons per day, or six million 
three hundred and eighty-seven thousand five hundred gallons per year of 
three hundred and sixty-five days. 

Now can the resources of the present source of supply, namely, the Green 
Brook as drawn from on the land of Mr. Fred. W. Paine, be so improved and 
controlled as to be enabled to furnish this amount constantly ? 

The amount of water shed of this brook which drains through the point of 
the present dam on the brook, is found by measurement to be two hundred 
acres. The practice of supplying artificially, by means of aqueducts, cities 
and towns, with water, has led to very extensive experiments and investiga- 
tions to ascertain the amount of water which certain definite areas may be 
relied upon to yield annually. These investigations have proved beyond a 
doubt that the amount of water furnished by any certain area, is directly 
proportional to the amount of rain annually falling upon such area, influenced 
by all the varying circumstances of soil and evenness, or unevenness of surface. 

Observers who have given the most careful attention to this subject, and 
made the most accurate measurements, have shown that certain areas yield from 
forty to seventy-five per cent, of water falling upon their surface annually, 
which amount is drained therefrom by the rivulets, brooks, and rivers leading 
thereto. An area covered by extensive level sandy plains, yielding the least 
amount, and an uneven clayey soil the most. The water shed of the Green 
Brook consists of a single basin, of small extent, surrounded by steep hills. 
Those on the west and north being composed of a stiff, impervious, clayey 
subsoil, and •those on the east form the ledges of Millstone Hill, so-called. 

Considering the nature and character of this water shed, fifty per cent, of 
the annual amount of rain falling upon its area, is considered a low estimate of 



102 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

the amount of water which will pass out of this valley annually, past the 
point where your present dam is situated. The average amount of rain 
falling in this vicinity as registered at your institution for the last twenty 
years, has been 46.92 inches, fifty per cent, of which is 23.46 inches. This 
gives the annual amount of water which is drained from this area by the 
Green Brook, as 121,859,000 gallons or 333,800 gallons per day through the 
year; an amount sufficient to supply nineteen such institutions as yours with 
1 7,500 gallons per day. 

In addition to the above estimate, recourse has been had to the measure- 
ment of the present quantity of water flowing in the brook, by such means as 
have been at command in the limited time given to the surveys. 

On April 23d, the water flowing was measured, and found to be 345,000 
gallons per day of twenty-four hours ; an amount slightly over the average 
annual flow. 

On April 25th, at 1 o'clock, P. M., after the storm which commenced about 
2 o'clock, P. M., April 24th, had raised the stream very considerably, a measure- 
ment was again made of the water flowing in the same, and found to be at the 
rate of 1,648,000 gallons per twenty-four hours. As most of this amount of 
water is drained off during the wet months of the year, the next question to 
be considered is that of storage in the wet months for use in the dry months, 
when little or no water flows in the brook. 

Your present reservoir on the land of Mr. Paine, is adjudged to contain 
about 375,000 gallons. This can be raised six feet, which is substantially the 
height of the first dam built on the brook by the hospital, and then will flow 
water on to the land of Mr. Green, a distance of thirty feet. When this is 
raised, the reservoir will store 1,500,000 gallons. The area of the reservoir 
when raised six feet above its present level, is 34,500 square feet, and could it 
be raised eight feet instead of six, the reservoir would then hold 2,150,000 
gallons. The first amount is sufficient to supply the institution for eighty-four 
days, and the last, one hundred and "twenty days, or the additional two feet 
will supply the institution for thirty-four days. There is no objection to rais- 
ing the dam eight feet above its present level, more than six feet, save a 
slight increased expense in land damage on the farm of Mr. Green. 

Could the Green Meadow, as it is called, be used as a reservoir ? Then 
your supply might be considered inexhaustible. This meadow lies only some 
eighty rods above your reservoir, and when flowed by a dam twelve feet in 
height, as has been contemplated, by Andrew H. Green, Esq., the proprietor 
of the pond, will contain about thirty-six acres. The average depth of the 
water upon this surface is adjudged to be seven feet. This would make the 
quantity of water in the reservoir when filled, eighty-two millions of gallons, 
an amount of water sufficient to supply your institution with seventeen 
thousand five hundred gallons per day for between twelve and thirteen years, 
Therefore, so far as your institution is interested, the supply of water for it 
from this source, appears to be inexhaustible. The present dam at the 
reservoir needs to be entirely rebuilt in a more permanent and thorough 
manner. The location is good, and need not be changed. The expense of 
rebuilding; the same is estimated as follows : — 



1863.] 



PUBLIC DOCUMENT— No. 27. 



103 



320 perch retaining wall, at $1.30 per perch, 
Spiling, . 

500 yards filling, at 23 cents per yard, 
Waste way, ..... 

Filter, 

Cement work extra, to protect pipes, 
Gate box, ..... 
Waste gate and pipe, . 
Clearing; basin, .... 



$416 


00 


70 


00 


115 


00 


35 


00 


55 


00 


10 


00 


43 


00 


191 


00 


75 


00 



$1,010 00 

From an examination of the routes over which the pipe can be laid from 
the reservoir, the following at present is deemed best, to wit : commencing at 
the dam and following substantially the present location of the pipe, avoiding 
the brook, and keeping on slightly higher ground until you reach Belmont 
Street ; thence by Belmont, Liberty, Arch, Hanover and Prospect Streets to 
the county lands, and thence crossing these and Central Street to your own 
grounds at a point near which your present pipe lies. Or if it be deemed 
objectionable to cross the county lands, the pipe may be laid from Hanover 
Street through Laurel, Summer and Central Streets to the point on your own 
premises above indicated. The distance from the reservoir to the centre 
wing of the hospital by the first route named, is about five thousand nine 
hundred feet, and if the streets be entirely followed, thus avoiding the county 
land, the distance will be increased about four hundred feet. The head from 
the outlet pipe at the reservoir to the top of the cisterns in the centre build- 
ings will be about forty-eight feet. The Patent Water Pipe, made by the 
New Jersey Water and Gas Pipe Company, is recommended as best suited to 
your purpose. This pipe is made of sheet iron, riveted together, of such 
thickness as will be sufficient to sustain the given pressure, coated inside and 
out with a layer of best hydraulic cement. This coating preserves the iron 
from corrosion, and hence prevents vitiation of the water by the presence of 
any of the usual salts or oxide of iron, so common with cast-iron pipe. 



Estimate of the Cost of the Pipe. 
5,900 feet 4-inch pipe, at 51 cents per foot, . 
Trenching and filling, 13 cents, . 
6-inch gate at reservoir, ...... 

Extra 6-inch pipe, ....... 



Amount, 



$3,009 00 

767 00 

48 00 

35 00 

$3,859 00 



Add cost of dam, 1,010 00 

Total cost of aqueduct, $4,869 00 

Yours, very truly, 



PHINEHAS BALL, 

Civil Engineer. 



Worcester, April 27, 1863. 



METEOROLOGICAL OBSERVATIONS 

MADE AT 

THE STATE LUNATIC HOSPITAL, WORCESTER, MASS., 

1862-3. 

Latitude, 42° 16' 17" K; Longitude, 71° 48' 13" W. 
Elevation, 528 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. 



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109 





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1863.] 



PUBLIC DOCUMENT— No. 27. 



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1863.] PUBLIC DOCUMENT— No. 27. 123 



APPENDIX. 



FORMS CONCERNING ADMISSION TO THE HOSPITAL. 



PETITION. 

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

To the Honorable 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 h 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 



To the Honorable the Judge of the Probate 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. 



124 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

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 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 and 

made oath that the above certificate is true. 

Justice of the Peace. 



Commonwealth 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 



1863.] PUBLIC DOCUMENT— No. 27. 125 

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. 

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

Judge of Probate Court. 



FORM OF OVERSEERS' BOND. 

Worcester Lunatic Hospital. 

Whereas, of , in the county of 

, has been admitted a boarder in the Worcester Lunatic 

Hospital , 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 rate of board which may, from time to 

time, be determined by the Trustees of said hospital, for said patient, so long 

as he shall continue a boarder in said hospital, with such extra charges as may 

be occasioned by h requiring more than ordinary care and attention, to 

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

of clothing as shall be procured for h by the Steward of the hospital, 

and to remove h from said hospital whenever the room occupied by 

h 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 h 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 

Attest. (Signed,) 

Overseers of the Poor 

of the 
Town of 



126 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

FORM OF PRIVATE BOND. 

Worcester Lunatic Hospital. 

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 rate of board which 
may, from time to time, be determined by the Trustees of said hospital, for 
said patient, so long as he shall continue a boarder in said hospital, with 
such extra charges as may be occasioned by h requiring more than 
ordinary care and attention ; to provide for h suitable clothing, and to 
pay for all such necessary articles of clothing as shall be procured for h 
by the Steward of the hospital, and to remove h from said hospital 
whenever the room occupied by h 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. 

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. 



1863.] PUBLIC DOCUMENT— No. 27. 127 

LAWS RELATING TO TERMS AND FORMS OF 
ADMISSION. 



[Chapter 223, Acts of 1862.] 
An Act concerning state lunatic hospitals and insane and 

idiotic persons. 
Be it enacted, 8fc, 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 Commonwealth, 
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 commitment ; 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 conclu- 
sive 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 admission 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 commitment or admission, a 
statement in respect to such persons, showing as nearly as can be ascertained, 
his age, birthplace, civil condition, and 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 ; the name 
and address of some one or more of his nearest relatives or friends, together 



128 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

with any facts showing whether he has or has not a settlement, and if he has 
a settlement, 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 sheriff, 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 sheriff, deputy-sheriff 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 reasonable ; and the sums so allowed 
shall be certified and paid, as provided in the General Statutes, chapter 
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 application a certifi- 
cate, signed by two respectable physicians, one of whom, when practicable, 
shall be the family physician of the patient, certifying, after due inquiry or 
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. 

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 their 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 



1863.] PUBLIC DOCUMENT— No. 27. 129 

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 bj r the district-attorneys, or 
other prosecuting officers, in the name of the treasurer, against such delin- 
quent 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 themselves, 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-general and 
district-attorneys to advise and consult with the trustees and treasurers of the 
several state lunatic hospitals, when requested by them, on all questions 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 afford suitable accommodation for the remainder ; but only such patients 
shall be selected for removal as, in the opinion of the trustees and super- 
intendent, 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 and 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 discharge 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 

* By Ch. 240, § 9, Acts of 1863, reduced to " twenty-five " cents. 
17 



130 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

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, conducting 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 hospitals, as is con- 
ferred 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 luna- 
tics 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 1 7. When a person held in prison on a charge of having com- 
mitted 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. 

Section 18. The eighth, ninth, tenth, eleventh, nineteenth, twentieth, 
twenty-first, 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 
repealed. 

[Act of 1863, Chapter 240.] 

Ax Act in relation to state charitable and correctional 

institutions. 

[Section 4.] The board of state charities shall have full power to transfer 
pauper inmates from one charitable institution or lunatic hospital to another, 
and for- this purpose to grant admittances and discharges to such pauper 
inmates, but shall have no power to make purchases for the various institutions. 

Section 9. The expenses of the lunatic hospitals for the support of 
lunatics not having known settlements in this state, committed thereto, shall 
be paid by the Commonwealth, at the same rates charged for other lunatics 
residing therein, not exceeding two dollars and twenty-five cents a week for 
each lunatic. 



1863.] PUBLIC DOCUMENT— No. 27. 131 

GENERAL LAWS FOR THE GOVERNMENT OF THE 
STATE LUNATIC HOSPITALS. 

[General Statutes, Chapter 73.] 

Section 1. The government of each of the state lunatic hospitals at 
Worcester, Taunton, and Northampton, shall be vested in a board of five 
trustees, appointed and commissioned by the governor with the advice and 
consent of the council, subject to removal only for sufficient cause. The trustees 
now in office shall continue to hold their offices until the terms thereof expire, 
according to the provisions of this section. On the first Wednesday of Feb- 
ruary in each year, the term of office of the senior member in each board, 
as they stand arranged on the list of their apjDointnients, shall terminate, and 
the name of the person appointed to fill the vacancy shall be placed at the 
bottom of the list, and other vacancies may at any time be filled, and the 
names of the persons appointed substituted in the list for the remainder of the 
vacant terms. 

Section 2. The trustees of each hospital shall be a corporation for the 
purpose of taking and holding to them and their successors, in trust for the 
Commonwealth, any grant or devise of lands, and any donation or bequest of 
money, or other personal property, made for the use of the institution of 
which they are trustees, and for the purpose of preserving and investing the 
proceeds thereof in notes or bonds secured by good and sufficient mortgages, 
or other securities, with all the powers necessary to carry said purposes into 
effect. 

Section 3. They shall take charge of the general interests of the institu- 
tion, and see that its affairs are conducted according to the requirements of 
the legislature, and the by-laws and regulations which the board shall estab- 
lish for the internal government and economy thereof; and they shall be 
reimbursed all expenses incurred in the dischai'ge of their official duties. 

Section 4. They shall establish by-laws and regulations, with suitable 
penalties, for the internal government and economy of the institution ; shall 
appoint a superintendent, who shall be a physician, and constantly reside at 
the hospital ; and a treasurer, who shall give bonds for the faithful discharge 
of his duties ; and shall appoint, or make provision in the by-laws for appoint- 
ing, such officers as in their opinion may be necessary for conducting efficiently 
and economically the business of the institution ; and shall determine, subject 
to the approval of the governor and council, the salaries of all the officers. 
All their appointments shall be made in such manner, with such restrictions, 
and for such terms of time, as the by-laws may prescribe. 

Section 5. The salaries of the superintendents, assistants, physicians, 
stewards, and matrons of the state lunatic hospitals shall be paid quarterly 
from the current receipts of the several hospitals. 

Section 6. There shall be thorough monthly visitations of each hospital, 
by two of the trustees thereof, and quarterly by a majority of them, and 
semi-annually by the whole board, at each of which a written account of the 
state of the institution shall be drawn up, which shall be presented at the 
annual meeting to be held between the first and fifteenth days of October. 



132 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

At the annual meeting, a full and detailed report shall be made, exhibiting a 
particular statement of the condition of the hospital and all its concerns, with 
a list of the salaried officers and their salaries, and in a tabular form, under 
the heads specified in section eleven of chapter five, the value of the stock 
and supplies, to be laid before the governor and council on or before the 
fifteenth day of October, for the use of the government ; and at the same meet- 
ing the treasurer shall present to the trustees his annual report on the finances 
of the institution ; both of which reports shall be made up to the thirtieth day 
of September inclusive. The trustees shall audit the report of the treasurer, 
and transmit it with their annual report to the governor and council. 

Section 7. The accounts and books of the treasurer shall at all times be 
open to the inspection of the trustees. 

[Resolve of 1844, Chapter 78.] 
Resolved, That the price to be charged for the board of patients at the 
state lunatic hospital, who are not state paupers, shall in all cases be fixed by 
the trustees of said hospital : provided, that the charge for town paupers 
shall not exceed the estimated average cost of supporting patients in said 
hospital. 

[General Statutes, Chapter 73 continued.] 

Section 12. The jurors shall be selected in equal numbers from the place 
n which the trial is had, and one or two adjoining places, as the judge shall 
direct ; and the same proceedings shall be had in selecting and impanelling 
the jury as are prescribed in chapter forty-three; provided, that in the 
counties of Suffolk and Nantucket all the jurors may be taken from the same 
place. 

Section 13. The judge shall preside at such trial and administer to the 
jury an oath faithfully and impartially to try the issue, and the verdict of the 
jury shall be final on the complaint. 

Section 14. If by reason of challenges or otherwise, there is not a full 
jury of the persons summoned, the judge shall cause the officer who served 
the summons, or in his absence the officer attending the jury, to return 
suitable persons to supply the deficiency ; and shall have the same authority 
as the supreme judicial court to enforce the attendance of jurors and witnesses, 
and inflict fines for non-attendance. 

Section 15. The officer who summons and attends the jury shall receive 
therefor four cents a mile for all necessary travel, and one dollar and fifty 
cents for each day that he attends upon them ; and the jurors and witnesses 
shall be entitled to such compensation as is prescribed for jurors and witnesses 
in the supreme judicial court. 

Section 16. The expenses of the trial, including the fees of all necessary 
witnesses, shall be allowed and certified by the judge, and paid out of the 
county treasury. 

Section 17. There shall be allowed to each judge of the probate court, 
for receiving, hearing, and determining every application made to him for the 
commitment of a lunatic, a fee of two dollars, to be paid out of the county 
treasury. The judges shall present their accounts for such fees as often as 



1863.] TUBLIC DOCUMENT— No. 27. 133 

once in each, year, to the county commissioners, who shall audit and allow 
them if found correct. There shall be allowed to the judge of the probate 
court for receiving, hearing, and determining, an application for the discharge 
of a lunatic from either hospital, two dollars, to be paid by the party making 
the application. 

Section IS. The superior court may allow to any sheriff, constable, or 
other person to whom a precept is directed by name, who may commit any 
person to either hospital, the same fees as are allowed to officers upon the 
commitment of persons to prison, and such further sums for expenses incurred 
in said commitments as to the court may seem reasonable ; and the sums so 
allowed shall be made up in the general bill of costs for the term of the court 
at which the allowance is made. 

Section 25. Every city and town paying expenses for the support or 
removal of a lunatic committed to either hospital, shall have like rights and 
remedies to recover the full amount thereof, with interest and cost, of the 
place of his settlement, as if such exjjenses had been incurred in the ordinary 
support of the lunatic ; and the lunatic, if of sufficient ability to pay the same 
and any kindred obligated by law to maintain him, shall be liable for all such 
expenses paid by any city or town in either case. 

Section 2G. The governor may at any time, cause to be removed from 
one of said hospitals to either of the others, such of the inmates thereof as 
circumstances or the necessities of the case may in his judgment require. 

Section 29. Any two trustees of either hospital, or either of the justices 
of the supreme judicial court or superior court, at any term held within and 
for the county in which the hospital is located, may on application in writing 
for that purpose, discharge from confinement, after the cause of such confine- 
ment has ceased, any lunatic committed thereto. The trustees may also 
remove any idiot or other patient to the place where the judge or court com- 
mitting him shall certify that he resided, when, in their opinion he ceases to 
be dangerous and is not susceptible of mental improvement by remedial treat- 
ment at the hospital, if such place shall not remove him after reasonable 
notice in writing from the trustees. 

Section 31. If after the discharge of an incurable lunatic, under the 
preceding section, it is made to appear on complaint by any person under 
oath to the judge of the probate court for the county in which the lunatic has 
his legal settlement or is placed, that he is not comfortably supported, or that 
the public safety is endangered by him, said judge shall order his recommit- 
ment to said hospital. And the same proceedings may be had in determining 
these questions by a jury, upon the request of any person interested therein, 
made in writing to said judge, as are provided in the preceding section. 

Section 32. No pauper shall be discharged from either hospital without 
suitable clothing ; and the trustees may furnish the same at their discretion, 
together with such sum of money, not exceeding twenty dollars, as they may 
deem necessary. 



INDEX. 



Page . 

Acknowledgments, ... . ... 93 

Additions to Hospital at its own cost, 15 

Admissions and numbers, ............ 3 

Admissions, discharges, and number remaining each month, 44 

Admitted, by what authority, 42 

Ages of patients, 48 

Amount of water required, 101 

Amount of water falling from given water-shed, ....... 101 

Amount of water capable of being stored from given water-shed, .... 101 

Annual expense of each patient, 59 

Annuitants, 19 

Annuities, Johonnot, 14 

assured by the State, ..." 14 

Application for the admission of patients, form of, 123 

Aqueduct and dam, report of engineer on, 101 

Architecture of hospitals improved, . 15 

Articles made and repaired, 88 

Auditing Committee's Report, 38 

Average number of each class, ...... .... 44 

Buildings and guardianship for sane and insane, 30 

Capacity of reservoir, 102 

Causes of insanity as reported by friends, 45 

Charge to town and private patients, 34 

Civil condition of patients, 52 

Classification of expenses, . 82 

Comparative cost of sane and insane, England, 31 

Ireland, 31 

Massachusetts, 31 

New York, 31 

Contributions by Hospital, • 21 

specified, 22 

unspecified, 23 

Contributions by State, 21 

Cost of aqueduct estimated, • 103 

Cost of dam estimated, 103 

Cost of Hospital, 14 

Cost of Hospital, total, 29 

Counties from which patients were admitted, 58 

Criminal lunatics, 12 

Current expenses of each year, 5 



136 INDEX. 

Page. 

Dam and Aqueduct, report of engineer on, 101 

Dam and reservoir, 29 

Debts due from Hospital, 33 

Debts due to Hospital, 34 

Delusions often concealed, . 10 

Delusions various, 4 

Diseases which have proved fatal, 50 

Donations and gifts, Flagg, 25 

Johonnot, 25 

Maccarty, 25 

Storrs, 25 

Upton, ' 25 

Wheeler, 25 

Worcester, 25 

Donations and Gifts, how disposed of and used, ....... 26 

Duration of insanity, 50 

before admission, • 51 

Erroneous notions of insanity, 11 

Engineer's report on aqueduct and dam, 101 

Expenditures, 22 

Expense of support includes losses and rent, 13 

Farm, § 9 

Feigners of insanity err, 11 

Finances, .33 

Flowering season on Hospital Hill for twenty-five years, 121 

Food of sane and insane, 30 

and attendants for insane in hospital, 30 

Foreign and native patients, ratio of in Hospital, 30 

Foreigners admitted, 42 

discharged, *2 

remaining, , 42 

Form of bonds, 125 

Form of disease of those admitted and those discharged, 45 

Form of warrant for commitment, 124 

General remarks on some of the assigned causes, 57 

General results, 40 

Gift of Worcester, 14-25 

Gift of Maccarty, 14-25 

' Gift of Johonnot, 14, 17, 25 

Grants by State, 15 

Hereditary cases, 47 

High cost diminishes pay patients, 30 

Homicidal cases, .47 

Hospital, changes and repairs in, at its own cost, 15 

cost of, . 14 

supported by its inmates, 12 

total cost of, and how paid, 29 

architecture, improvement in, 15 

Insane have varied power of self-control, &c, $ 

Insane and sane, comparative cost of, 30 



INDEX. 137 

Page. 

Insanity, erroneous notions of, 11 

Insanity, effect of treatment of, . . . 12 

Insanity suppressed or kept out of sight, 9 

Insanity, varied forms and character of, 4 

Inventory of Hospital property, 94 

Johonnot annuities, 14 

Johonnot horse, cost of support, 20 

Johonnot legacy, how used, 17 

Hospital allowed by State to use it, 17 

grant from State to extent of annuities, ........ 20 

Labor in Hospital, 32 

Lands, cost of, 26 

Lands, description of, 27 

plan of, 28 

Laws relating to the Hospital, 127 

Lectures and other amusements, 92 

List of prices, 84 

Losses and deficiency in payments, charged to expense, 13 

Loss on State patients, 13 

paid by town and private patients, . . 13 

Lunatics not always insane, 10 

Lunatics not insane in all their elements, ... 10 

Manifest and apparent insanity suppressed, . . . . . . . . 9 

Map of water-shed, 95 

Map of aqueduct, 97 

Measurement of water in the Green Brook, 102 

Meteorological observations, 105 

Xumber at the end of each year, 59 

Occupation of patients before admission, 53- 

Officers, 32 

Patients supported by town, 43 

Percentage of admissions caused by ill health, 63 

Percentage of admissions caused by religious excitement, ... .63 

Percentage of admissions caused by disease of the affections, 63 

Percentage of admissions caused by pecuniary trouble, 63 

Percentage of admissions caused by intemperance, 63 

Percentage of admissions caused by masturbation, 63 

Percentage of deaths of all in the Hospital each year, 63 

Percentage of deaths of the average number of patients each year, ... 63 

Percentage of recovery of recent cases, 63 

Percentage of recovery of all discharged, 63 

Percentage of recovery of chronic cases, 63 

Periodical cases, 47 

Petition for the admission of patients, form of, 123 

Physician's certificate, 124 

Plan of dam and filter, 99 

Private patients admitted, 43 

Private and town patients pay losses on State patients, . . . . . . 13 

Products of farm, . 89 

18 



138 INDEX. 



Rain and snow for twenty-two years, 120 

Ratio of native and foreign patients in Hospital, 30 

Recapitulation of statistics, 60 

Receipts, 33 

Removal of insane from causes, 7 

Removal of insane from causes often sufficient for cure, 7 

Rent a part of support, 13 

Rent, claims of State for, 29 

Repairs intended by Legislature to be made by Hospital, 21 

Repairs ordered by sundry laws to be made by Hospital, 22 

Restraint and guardianship limited to necessity, 6 

Starvation of self under delusion, 10 

State contribution to Hospital, 16 

State paupers, payment for, 12 

Suicidal cases, 47 

Summary of meteorological observations, 119 

Superintendent's Report, 39 

Supply of water abundant, 102 

Tabular view of each patient under treatment during the year, .... 64 

The average number under treatment during each j-ear, 59 

Town and private patients pay all the rent, . 13 

Treasurer's Report, .... 38 

Treatment of insanity, effect of, 12 

Trustees' Report, 3 

Varied management needed, ' 5 

Varied management practiced, 6 

Wants of the Hospital, 90 

Water-shed, number of acres of, 102 

Weather and wind, 118 

Weekly expenses of each patient, 59 

Whole number of patients under treatment during each year, . ... 59 



APR 25^3W.P.A,