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PUBLIC DOCUMENT No. 24.
THIRTY-THIRD ANNUAL REPORT
THE TRUSTEES
STATE LUNATIC HOSPITAL,
WORCESTER.
OCTOBER, 1865.
BOSTON:
WRIGHT & POTTER, STATE PRINTERS,
No. 4 Spring Lane.
1866.
^ommonroealtt) of MdBmtl)mtitB.
THIRTY-THIRD ANNUAL REPORT
TRUSTEES OE THE WORCESTER LUNATIC HOSPITAL.
To His Excellency the Governor and the Honorable Council of
the Commonwealth:
Gentlemen, — The Trustees of the Worcester Hospital for the
insane beg leave to Report.
It is nearly one-third of a century since the hospital was
founded, and the Trustees believe it to be in a much better
condition than when placed in their hands.
It has been kept in thorough repair ; a complete system of
warming and ventilation applied ; an abundant supply of water
carried to every part of the house ; a new chapel, kitchen,
laundry, <fec, built, and such other improvements and alterations
made for the proper management and treatment of the insane,
as have been from time to time suggested. Still, much more is
needed to keep up with the requirements of the age.
Progress is continually made in this, as in other branches of
knowledge, and it would be unwise to suppose that perfection
can ever be attained.
To make these improvements, a sufficient surplus of funds
has remained in the hands of the Trustees, from year to year,
until the last three years, when it has ceased, owing to the
enormous rise in the price of all the necessaries of life without
4 LUNATIC HOSPITAL AT WORCESTER. [Oct.
any corresponding increase in the price of board from the
patients.
A few improvements have been made during the year past,
such as a hospital ward in each wing of the building to separate
the sick and feeble from their more active and boisterous com-
panions ; but others have been suggested that our limited
means forbid us to attempt.
We wish to introduce some system of useful labor to keep
the patients occupied with work, that will quiet the restless
energy of some, and stimulate the listless apathy of others.
This is partially done for the women in the laundry and sewing-
rooms, and in a much smaller degree for the men, by employ-
ment in work upon the farm in summer. Some simple but
useful manual labor, suited to the ability and the taste of each
one, that can be had in winter as well as in summer, is much
needed.
In England, as will be seen in a report made by Dr. Jarvis,
in 1863, very favorable results have followed the introduction of
such work, proving useful, not only to the patients themselves,
but a source of considerable revenue to the hospitals.
Another want sadly felt is, some intermediate temporary
residence for patients not fit for discharge, nor proper subjects
for an insane ward ; a place where can be tested their ability to
live free from the actual restraints of the hospital before going
to their homes and into the busy world. As was said in our
last Report, some of our patients are occupied in various
employments in the town, who return to the shelter of the
hospital at night, not having confidence in their ability to leave
its protecting influence altogether.
It is believed that many might be discharged without fear, of
relapse, if some such intermediate step as this could be taken,
instead of ushering them at once into active life.
One or two cottages in the vicinity of the hospital, occupied
by discreet persons now employed there, making a little family
circle by the addition of a few selected patients, would be of
great benefit to the hospital, in relieving its crowded wards,
and to the patients in giving them a chance to show that they
can live without restraint. Many persons when admitted as
patients might with advantage be placed in these cottages.
1865.] PUBLIC DOCUMENT— No. 24. 5
Some suggestion will be offered at a future time for a plan
by which these improvements can be made without involving
much expense.
While no wasteful experiments should be encouraged, the
intelligent Commonwealth of Massachusetts ought to require
that not only every improvement of the age should be intro-
duced into its system for the treatment of the insane, but that
the State should lead in this branch of progress, as it has in so
many others.
The Trustees beg leave to call your attention to the interest-
ing Report of the Superintendent, to whose great skill and
sagacity, with his untiring care and that of his able Assistant,
so much is due for the good condition of the hospital. Also to
the Report of the Treasurer, which, though it does not give a
very flattering account of the financial condition of the hospital
at this moment, gives us the hope that by the end of another
year the expenses may be kept within the receipts and the debt
paid off.
"Very respectfully submitted by the Trustees.
R. W. HOOPER.
E. F. JENKS.
E. JARVIS.
W. WORKMAN.
S. E. SEWALL.
Worcestee, October 13, 1865.
*
LUNATIC HOSPITAL AT WORCESTER. [Oct.
OFFICERS OF THE HOSPITAL.
TRUSTEES.
ROBERT W. HOOPER, M. D.,
HON. EDWIN F. JENKS,
EDWARD JAR VIS, M. D.,
WILLIAM WORKMAN, M. D., .
HON. SAMUEL E. SEWALL, .
RESIDENT OFFICERS
MERRICK BEMIS, M. D., .
JOSEPH DRAPER, M. D., .
CAROLINE A. BEMIS, ....
DANIEL W. BEMIS, . . .
Boston.
Adams.
Dorchester.
Worcester.
Boston.
Superintendent.
Assist.-Physician.
Matron.
Steward.
TREASURER.
MERRICK BEMIS, M. D., .
Office at the Hospital.
Worcester.
SALARIED OFFICERS OF THE HOSPITAL.
Superintendent, $1,800 00
Assistant-Physician, • • • • • 900 00
Matron, 200 00
Steward, 500 00
Treasurer, 400 00
1865.]
PUBLIC DOCUMENT— No. 24.
TREASURER'S REPORT.
RECEIVED.
Cash on hand September 30, 1864,
from H. Woodward,
from Commonwealth, .
from P. B. Aldrich,
from towns and individuals
from articles sold,
$551 84
1,020 79
24,517 23
321 66
47,649 75
4,148 78
*
$78,210 05
PAID.
Steward's orders, . ...
Refunded to towns,
Interest on loans,
Paid Mechanics Bank, (on old debt,)
Balance cash, ....
$73,772 41
35 29
229 18
3,132 78
1,040 39
,210 05
MERRICK BEMIS, Treasurer.
Worcester, October 1, 1865.
We have examined the above Accounts "with the Vouchers, and find the
same correct.
E. F. JENKS,
WILLIAM WORKMAN,
Auditing Committee.
Worcester, November 9, 1865.
LUNATIC HOSPITAL AT WORCESTER. [Oct.
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, for your consideration, my Annual
Report for the year ending September 30, 1865.
For the operations and results of the year in detail, you are
referred to the following tables, and such brief explanations and
suggestions as accompany them.
The uniform nature of the duties and anxieties incident to
life in a lunatic hospital will not allow any great variety in a
faithful record of the results of successive years.. The pleasing
changes wrought in the minds of some of the inmates, the
steady improvement and gradual restoration to health, the
happiness, the joy, and the contentment, which thus takes the
place of distress, despair and dissatisfaction, and the decline of
others through all the stages of the mania and dementia to
utter hopelessness and wretchedness, these conditions make a
large part of the history of every year's proceedings which can-
not be known or appreciated by any except those whose duty it
is to promote the welfare and assist in the recovery of the
insane ; and the influence of these conditions is not confined to
the inmates of the hospital, but extends for good or evil to the
family, the social circle, and the community at large.
The inmates have enjoyed a good degree of health through
the entire year, and disorders incident to the seasons and prev-
alent in the neighborhood have but very lightly visited those
who were attacked by them.
While we have been gratified by the recovery and restoration
of so many, we have to regret that quite a number were
removed by friends, just at that period when the labor and
anxiety of weeks and months were beginning to be seen and felt,
and a few weeks longer were required for complete recovery .1
1865.]
PUBLIC DOCUMENT— No. 24.
Many regained entirely their former healthy condition ; others
so far improved as to be able to return to their families and
friends and resume their former occupations. Others were not
improved or changed by their residence here, but continued in
a hopeless state, wretched in themselves and a source of fear
and anxiety to their friends.
The tables presented are mainly continuations of such as
have been faithfully kept since the establishment of the hos-
pital. They are as correct as the records of the institution
will permit, and certainly embody many useful facts. It has
been deemed unwise to make any deviation from the usual and
established course in regard to them.
. Table No. 1,
Showing the general results of the Year.
Males.
Females.
Total.
Patients in the Hospital, October 1, 1865,
167
177
344
" admitted during the year, .
117
104
221
Whole number under treatment,
284
281
565
Discharged recovered,
51
54r
105
" improved, .....
36
22-
58
" not improved, ....
16
12
28
Died,
12
21
33
Whole number discharged during the year,
115
109
224
" " remaining September 30, 1865,
169
172
341
One hundred and five individuals, or nearly fifty per cent, on
the admissions, have been restored to their friends in possession
of such mental health and the exercise of such a degree of self-
control as admits of their return to society and the full exer-
cise of their civil rights, while fifty-eight have been removed
during treatment, all of whom presented marked features of
amendment, and many of whom had become amenable to the
means of management in the family circle ; and twenty-eight
have been removed, in whom no trace of improvement could
be discerned.
Thirty-three have died, two in a few days and three in a few
weeks after admission, two suddenly, two of old age, and the
remainder of protracted and exhausting ailments peculiar to
10 LUNATIC HOSPITAL AT WORCESTER. [Oct.
affections of the nervous system. The mortality is consid-
erable. But if it be recollected that every patient admitted
labors under some constitutional disease ; that some are sent in
extreme old age, in the last stages of decay ; that many when
admitted are exhausted by long duration of their malady ; that
all are liable to the diseases of the community in general, besides
the maladies and accidents peculiar to their own situation, the
number of deaths will not appear large. It must be remem-
bered also that the general health of the inmates has been good,
and that the cases of disease have been less troublesome than
formerly. A large majority of the deaths are referable to affec-
tions of the lungs and the brain. Some are sent to the hos-
pital to die, that due care and attention may be bestowed upon
the last days of exhausted life, and that friends who have
watched over and sympathized with the sufferer while any ray
of reason remained may now be relieved of so unwelcome a
burden.
This class of patients demands all the care, anxiety and watch-
fulness extended to the dying. But while they incommode the
general order, and give by their decay and death a melancholy
character to the department to which they belong, they are
doubtless proper subjects for the care and concern of the
hospital.
The death of those who die in the hospital is rarely attended
with any apparent suffering or distress, and still more rarely is
there any return of reason, bringing with it aspirations after a
new mode of living, nor is there any appearance of agony or
anxiety.
The delusions of life often extend to its termination. Two
of those who died during the year could not believe they were
born to die. Death to them was not a reality. The belief in
the immortality of their bodies was to them the only reality.
In one the dread of death was more terrible than death itself,
and having lived for years in the torment of insane fear, died
at last in perfect quiet, unaffected and unappalled. Two died
so suddenly that pain could hardly have been experienced, or
the nature of the change appreciated. Four sank in thecoma
which succeeds epilepsy. In one, a morose and repulsive dis-
position was softened at the approach of death, and in another
habitual acrimony and discontent were aggravated. One who
1865.] PUBLIC DOCUMENT— No. 24. 11
had for weeks resisted every attempt at alleviation, was at last
most distressingly eager for medical aid. One quite accurately
foretold his death when its approach was not apparent.
By reference to the table it will be seen that four patients
died of epilepsy, six of paralysis, and thirteen of phthisis. The
number of deaths in the hospital is pretty nearly determined by
the number of epileptic, paralytic, and consumptive patients
admitted.
The recent laws regarding the signing of certificates of lunacy
by physicians, have operated in an unfavorable manner upon
the admission of a few patients into the hospital, and must
prevent the early admission of patients afflicted with certain
forms of mental disease.
The necessity for two physicians to testify to some definite
fact which is of itself sufficient to prove insanity, is easily ful-
filled in cases of acute mania, where the mind of the patient is
completely absorbed in his present feelings and impulses, and
has neither power nor inclination to exercise caution.
In other forms of insanity, however equally destructive in the
end to all the reasoning and controlling powers of the mind,
proof is not so readily obtained ; the evidence is cumulative,
and the patient retains much of his capacity for concealing
symptoms and eluding the inquiries of his physician, and often
refuses altogether to see a medical man. In this manner the
patient escapes the treatment calculated to remove his disease
until it has become incurable.
Sometimes a well meant but mistaken friendship takes such
a direction and exercises such an influence as to prevent the
admission of the patient ; or if it does not prevent admission,
so disturbs the relations existing between patient and the
hospital as to retard recovery and promote disorder and
dissatisfaction.
This difficulty is the source of great suffering to many fami-
lies in this Commonwealth, who are obliged to bear the burden
and anxiety consequent upon the care of some insane member,
until the disease becomes continuous and incurable.
Hospitals were undoubtedly created and endowed for the
public good, and to answer a want felt by the community. Let
the laws controlling admission to their wards be so humanely
framed as to open their doors to any diseased member of society,
12 LUNATIC HOSPITAL AT WORCESTER. [Oct.
and let the benefits, if any, be conferred alike upon every grade
of mental suffering. Establish commissions for investigation if
necessary ; guard them with the most jealous care ; but while
they are hospitals, make them also asylums, to which every
sufferer may flee for comfort and help. Do not longer enact
laws which attach to the character and conduct of a residence
in a hospital for the insane, the stigma of prison life and disci-
pline. Surround them with the most generous safeguards.
Endow them with every facility for treatment and every comfort
and convenience for their inmates. And by giving a generous
impulse to public opinion, already favorable, assist in their
elevation.
Insanity is said to be on the increase in this country. All
classes in society, the rich as well as the poor, the learned as
well as the ignorant, are its victims. The hospital may
become the temporary residence of the most successful merchant
or the most refined scholar in the Commonwealth. It may
become the permanent home of both.
The legislator who enacts laws relative to the control of the
institution may be interfering with the future welfare of a loved
wife, son or daughter, and while voting supplies may be
increasing or diminishing the comfort and the prospect of
their recovery.
Several applications have been made for the admission of
patients living in other States. These have been refused on
the ground that the laws regulating admission to the hospital
gave to the Trustees no right to admit patients who belong out
of this Commonwealth. State paupers, and those liable to
become a public charge wherever they may belong, may, on
becoming insane, be committed by the courts having jurisdiction
in such cases. But responsible parties, living in other States,
seeking the benefit of remedial treatment for an insane friend
or relative, are shut out from this hospital, the Trustees having
no choice in the matter.
It seems a small matter to refuse admission to an insane
person who has no legal claim upon the institution, but the
refusal may involve the life of the individual, the welfare of the
sufferer's family, and the safety of the community.
The patient himself may select some particular hospital or
desire some particular district of country. Economy may
1865.]
PUBLIC DOCUMENT— No. 24.
13
decide the choice of the friends, or the facility of access may,
and does often, determine the residence of the insane. There
are, doubtless, many reasons which render such a refusal a great
misfortune.
Table No. 2,
Showing the Admissions and state of the Hospital, from October 1, 1864,
to September 30, 1865.
Patients in the Hospital, October 1, 1865, .
Males, .... 167 Females,
Patients admitted in tbe course of the year,
Males, . . . .117 Females,.
Patients remaining in the Hospital, September 30, 1865
Males, .... 169 Females,
Of the admissions, there were cases of one year or less
Males, .... 65 Females,
duration,
one year'
Of the admissions, there were cases of more than
duration, .... ...
Males, .... 50 Females,
Of the admissions, there were cases the duration of whose insanity
could not be ascertained,
Males, .... 2 Female,
Patients committed by Courts,
Males, ....
66 Females,
Patients committed by Overseers of the Poor,
Males, .... 15 Females,
Patients on bonds, . . .
Males, .... 32 Females,
Patients committed by Governor's Warrant,
Patients committed by the Board of State Charities,
Males, .... 6 Females,
Patients committed by Commissioners of Lunacy,
Foreigners and those having no settlement in the State
in course of the year, .....
Males, . . . . 40 . Females,
Foreigners and those having no settlement in the State,
in course of the year, .....
Males, .... 57 Females,
Foreigners and those having no settlement in the State
in the Hospital, September 30, 1865,
Males, .... 36 Females,
committed
discharged
remaining
344
177
221
172
341
172
137
72
31
81
123
57
17
26
32
58
38
46
78
103
91
55
14
LUNATIC HOSPITAL AT WORCESTER. [Oct.
State Paupers remaining in the Hospital at. the close of each year, as
nearly as can he 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
1864,
116
1849,
167
1857,
119
1865,
91
Table No. 3,
Showing the Number Admitted, Restored, Improved, Died, fyc, in each
Month during the Tear.
Admitted.
Removed.
Remaining.
•a
13
a
S '9
MONTHS.
o
o
o
T3
Totals.
to
0)
s
SI
■3
O
B
M
O P>
3
"a
5
■3
a
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
T.
o
October,
11
10
21
1
3
3
3
1
3
_
2
5
12
17
173
175
348
November, .
6
8
14
4
5
3
2
1
-
-
-
8
7
15
171
176
347
December, .
9
12
21
4
2
2
2
-
-
2
-
8
4
12
172
184
356
January,
7
5
12
7
8
1
1
3
-
2
8
11
19
171
178
349
February, .
5
8
13
3
3
-
-
-
-
1
2
4
5
9
172
181
353
March, . .
11
9
30
4
4
3
1
1
-
-
4
7
9
16
176
181
357
April, . .
10
12
22
5
8
2
1
5
-
2
2
14
11
25
172
182
354
May,. . .
14
7
21
7
5
5
2
3
4
2
1
17
12
29
169
177
346
June, . .
10
9
19
o
5
3
3
-
-
2
4
7
12
19
172
174
346
July, . . .
12
6
18
6
1
2
2
1
-
1
3
9
6
15
175
174
349
August, . .
12
8
20
4
2
6
3
2
o
-
1
12
8
20
175
174
349
September, .
10
117
10
104
20
221
4
51
8
54
6
36
2
22
4
-
2
2
16
115
12
109
28
224
169
172
341
Totals, .
16
12
12
21
1865.]
PUBLIC DOCUMENT— No. 24.
15
Table No. 4,
Showing the Form of Disease in those Admitted and Discharged during
the Year.
Admitted.
Discharged.
FORM OF DISEASE.
9
to
§
"3
O
H
3
a
a
fa
"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,
42
17
10
3
16
19
1
2
5
2
42
28
3
12
17
1
1
84
45
13
3
28
36
2
3
5
2
39
18
5
o
21
24
2
4
38
19
2
11
36
2
1
77
37
7
2
32
60
2
3
4
Totals, ....
117
104
221
115
109
224
Table No. 5.
Supposed Causes of Insanity of Patients admitted into the Hospital from
January 18, 1833, to September 30, 1865.
1865.
Previously.
CAUSES.
Males.
Females.
Males.
Females.
Apoplexy,
mm
_
1
2
Asthma,
—
_
1
_
Bronchitis,
_
_
_
1
Bowels, Disease of,
-
-
1
Cancer, .
_
_
_
1
Chorea, .
_
-
_
3
Constipation, .
-
-
_
_
Convulsions, .
-
_
10
12
Dysentery,
-
-
2
2
Dyspepsia,
-
-
2
1
Epilepsy,
11
3
156
56
Eruptive Diseases,
-
_
3
3
Eyes, Disease of,
"■
—
2
—
16 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 5 — Continued.
1865.
Previously.
CAUSES.
Males.
Females.
Males.
Females.
Eyes, Loss of,
_
1
Erysipelas,
-
-
-
1
Fevers, ....
3
3
46
65
Hysteria,
-
-
-
1
Hemorrhoides,
-
-
1
1
111 Health,
24
30
160
828
Influenza,
_
-
1
3
Insolation,
_
-
16
_
Idiocy, ....
-
-
15
9
Laryngitis,
-
-
-
-
Measles,
-
-
4
6
Nervous Irritation, .
_
-
-
-
Nymphomania,
-
-
-
4
Old Age, . ...
1
1
22
28
Otitis, ....
-
_
-
-
Paralysis,
8
•
58
27
Pneumonia,
-
-
-
-
Rheumatism .
-
-
5
1
Scrofula, . . .
-
-
1
2
Sea-sickness, .
-
-
1
1
Somnambulism,
-
-
-
2
Suppressed Eruptions,
-
-
4
3
Suppressed Ulcer, .
-
-
u
3
Satyriasis,
-
-
1
-
Tic Douloureux,
-
-
-
1
Tumor, ....
-
-
-
1
Whooping Cough, .
-
-
1
-
Amenorrhcea,
-
-
. -
21
Lactation, Excessive,
_
_
-
3
Menorrhagia,
-
-.
-
9
Menorrhagia, Suppressec
,
-
2
-
25
Miscarriage, .
-
-
-
4
Pregnancy,
-
-1
-
10
Puerperal,
-
10
-
201
Turn of Life,
_
7
-
65
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
1
54
12
Injury of Spine,
1
-
4
7
Lead, Poison of,
1
-
4
-
Lightning, Stroke of
_
-
-
1
Labor, Excessive, .
1
-
41
58
Loss of Sleep,
_
-
-
3
Study, Excessive, .
-
1
26
10
Spiritualism, .
—
-
20
24
Criminal Trial,
_
-
-
1
False Accusation, .
-
—
—
1
1865.] public document—No. 24.
Table No. 5 — Concluded.
17
1865.
Previously.
CAUSES.
Males.
Females.
Males.
Females
Imprisonment, ....
1
4
Death of Relatives,
-
6
28
76
Domestic Trouble, .
_
1
111
336
Marriage, Unhappy,
-
-
2
5
Disappointment in Love,
-
1
64
97
Disappointed Ambition,
-
-
9
9
Home Sickness,
_
_
6
18
Fright, .
_
_
21
24
Seduction,
_
■ _
_
3
Millerism,
_»
_
9
6
Political Excitement,
_
_
9
1
Religious Excitement,
—
_
156
177
Pecuniary Trouble,
-
-
142
37
Poverty, .
-
-
1
1
Poverty, Fear of, .
1
-
30
8
Prosecution, .
-
-
1
-,
Giving up Business,
-
-
2
_
Change of Business,
_
_
8
_
Violent Temper,
-
-
2
13
Jealousy,
-
-
18
27
Intemperance,
25
5
563
67
Opium, Use of,
-
-
3
9
Tobacco, Use of
-
-
2
7
Masturbation,
6
3
363
57
Venery, Excess of,
-
-
1
-
Unknown,
34
29
1,049
1,083
Totals, .
117
104:
3,503
3,601
Of the above there were —
Hereditary cases, ....
12
13
565
781
Periodical cases, ....
15
16
584
619
Hereditary and Periodical cases,
9
6
373
408
Suicidal cases, ....
3
11
198
235
Homicidal eases, ....
9
3
140
43
Suicidal and Homicidal cases, .
6
3
42
25
18
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 6,
Showing the Ages of Patients Admitted, Discharged Recovered, not
Recovered, and Died during the year.
Discharged Re-
Discharged not
Died.
covered.
Recovered.
AGES.
Males.
Females.
Males.
Females.
Males.
Females.
! Males.
Females.
Less than 15, .
1
1
_
„
_
From 15 to 20,
10
8
, 1
5
-
-
1
1
20 to 30,
27
25
14
14
8
3
3
4
30 to 40,
18
25
16
17
14
10
2
4
40 to 50,
23
19
8
3
10
11
3
6
50 to 60,
13
18
6
10
8
7
2
2
60 to 70,
19
7
6
4
9
2
-
3
70 to 80,
2
2
-
1
2
1
1
-
80 to 90,
3
-
-
-
-
-
-
1
Unknown, . .
1
-
-
-
-
-
-
-
Totals, . .
117
104
51
54
52
34
12
21
Table No. 7,
Showing the Ages of Patients Admitted, Discharged Recovered, not
Recovered, and Died, from January 18, 1833, to September 30, 1865.
Admitted.
Discharged Re-
covered.
Discharged not
Recovered.
Died.
AGE S.
Males.
Females.
Males.
Females.
Males.
Females.
Males.
Females.
Less than 15, .
31
25
5
11
19
12
1
1
From 15 to 20,
221
225
123
136
63
60
15
14
20 to 30,
967
937
481
480
346
363
61
71
30 to 40,
886
976
439
478
383
360
97
96
40 to 50,
765
804
331
366
276
266
102
94
50 to 60,
401 >
450
171
208
148
141
71
83
60 to 70,
244
211
87
98
89
63
50
54
70 to 80,
92
66
22
26
23
19
36
22
80 to 90,
12
11
4
2
3
4
5
5
Unknown, . .
1
-
-
-
-
-
-
-
Totals, . .
3,620
3,705
1,663
1,805
1,350
1,288
438
440
1865.]
PUBLIC DOCUMENT— No. 24.
19
Table No. 8,
Showing the Duration of Insanity before Admission of Patients Admitted,
Discharged Recovered, not Recovered, and Died during the year.
Admitted.
Discharged
Recovered.
Disch'dnot
Recovered.
Died.
DURATION OF INSANITY.
A
.
CD
3
.8
s
a
3
03
a
"3
3
a
Em
Insane 1 year or less, .
67
59
31
33
' 7
6
5
10
More than 1 year and less than 2
years,
13
7
13
12
14
12
-
-
More than 2 years and less than
5 years,
10
12
3
4
7
5
4
5
More than 5 years and less than
10 years, ....
8
7
3
3
10
4
2
2
More than 10 years and less than
15 years, ....
7
5
1
2
5
2
-
2
More than 15 years and less than
20 years, ....
4
2
-
-
-
2
-
1
More than 20 years and less than
25 years, ....
4
9
-
-
4
1
1
-
More than 25 years and less than
30 years, ....
-
1
-
-
1
-
-
1
Thirty years or more,
2
-
-
-
2
-
-
-
Unknown,
2
1
-
-
2
2
-
-
Totals, ....
117
103
51
H
52
34
12
'21
20
LUNATIC HOSPITAL AT WORCESTER. [Oct.
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, 1865.
Admitted.
Discharged Re-
covered.
Discharged not
Recovered.
Died.
DURATION OF INSANITY.
"3
S
0)
fa
OS
1
fa
8
"3
s
fa
3
s
o
fa
Insane one year or less, .
2,277
2,505
1,273
1,405
622
597
217
268
More than 1 year and less
than 2 years,
134
113
170
152
74
74
23
16
More than 2 years and less
than 5 years,
514
492
115
128
198
174
86
64
More than 5 years and less
than 10 years,
285
262
45
56
207
193
34
29
More than 10 years and
less than 15 years,
149
157
13
22
108
98
31
25
More than 15 years and
less than 20 years,
70
44
9
9
41
63
19
11
More than 20 years and
less than 25 years,
50
42
7
6
32
35
5
7
More than 25 years and
less than 30 years,
18
16
5
1
10
10
7
6
Thirty years or more,
32
29
2
5
13
13
8
6
Unknown, ...
91
44
24
21*
45
31
8 8
Totals, .
3,620
3,704
1,663
1,805
1,350
1,288
438 440
1865.]
PUBLIC DOCUMENT— No. 24.
21
Table No. 10,
Showing the Civil Condition of Patients Admitted, Discharged Recovered,
not Recovered, and Died, during the year.
CIVIL
Admitted.
Discharged Re-
covered.
Discharged not
Eecovered.
Died.
CONDITION.
Males.
Females.
Males.
Females.
Males.
Females.
Males.
Females.
Unmarried, .
58
38
22
24
25
6
6
12
Married, . .
51
57
27
24
26
23
5
7
Widowers, . .
8
-
2
-
1
-
1
-
Widows, . .
-
9
-
5
-
4
-
Unknown, . .
-
-
-
1
-
1
-
-
Totals, . .
117
104
51
54
52
34
12
21
Table No. 11,
Showing the Civil Condition of Patients Admitted, Discharged Recovered,
not Recovered, and Died, from January 18, 1833, to September 30,
1865.
22
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 12,
Showing the Occupation of Patients admitted to the Hospital from
January 18, 1833, to September 30, 1865.
OCCUPATION OF MALES.
18 6 5.
Previously.
Auctioneers,
2
Armorers, ....
1
2
Authors,
-
3
Blacksmiths and Iron-workers,
2
59
Bakers, .....
-
11
Butchers,
-
5
Book-agents,
-
2
Book-binders, .
-
3
Broom-makers, . .
-
2
Book-keepers, . .
-
9
Brittania-workers, .
-
2
Brick-makers, ....
-
6
Bellows-makers,
-
2
Barbers,
1
12
Clergymen, ....
-
24
Carvers, . .
,
—
2
Carpenters, ....
1
117
Coppersmiths, .
-
9
Coopers, ....
-
22
Cabinet-makers,
-
16
Clothiers,
-
15
Comb-makers, ....
-
4
Confectioners, .
-
3
Card-makers, ....
-
1
Chair-makers, .
-
3
Cigar-makers^ .
1
4
Clerks, ....
5
86
Carpet-weavers,
-
3
Caulkers, ....
-
3
Camphene-distillers, .
'-
3
Dyers, ....
-
3
Druggists,
-
3
Drovers, ....
-
2
Daguerreotypists,
-
3
Engineers,
-
2
Engravers, ,
—
4
Editors, ....
-
4
Expressmen, .
-
14
Farmers, ....
16
707
Fishermen,
1
32
Gardeners, . .
-
9
Glass-blowers, .
-
4
Hotel-keepers, .
-
13
Hatters, ....
-
6
Harness-makers,
-
14
Hack men and Teamsters,
1
32
Jewellers,
—
18
1865.] PUBLIC DOCUMENT— No. 24.
Table No. 12 — Continued.
23
OCCUPATION OF MALES.
Lawyers, ....
Laborers, .
Manufacturers,
Millers, ....
Merchants,
Masons, ....
Miners, ....
Miniature-painter, .
Mat-makers, ...
Musicians,
Machinists, . ...
Moulders,
Operatives in Mills, .
Paluileaf-splitter,
Painters, ....
Printers, ....
Physicians, . . .
Paper-makers, .
Peddlers, ....
Potter, .
Pump and Block-makers, .
Pattern-makers,
Plumbers,
Police officers, .
Rope-makers, .
Restaurators, .
Shoemakers and Bootmakers,
Sailmakers,
Soap-makers, .
Sash and Blind-makers, .
Sea-captains, .
Sailors, ....
Students, ....
Ship-carpenters,
Shop-keepers, .
Stone-cutters, .
Soldiers, ....
Sexton, ....
Stevedore,
Surveyors,
School-boys, . . .
Tailors, ....
Teachers,
Tobacconists, .
Tinners, . .
Tanners, ....
Umbrella-makers, .
Wheelwrights, .
No occupation,
Totals, ....
27
2
3
1
11
1
10
115
24
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 12 — Concluded.
OCCUPATION OF FEMALES.
1865.
Previously.
Actresses, . . . ...
_
2
Cooks,
63
Engraver,
—
1
Housekeepers, .
64
1,919
Housemaids,
-
14
356
Laundresses,
-
2
Music Teachers,
1
2
Midwives,
-
2
Nurses,
1 ■
13
Operatives in Mills,
7
187
Seamstresses, .
15
706
School-girls,
2
34
Teachers,
2
77
Typesetters,
-
3
No occupation, ......
2
234
Totals, .
108
3,601
Table No. 13.
'
Diseases which have proved Fatal from January 18, 1833, to September
30, 1865.
i860.
Pkeviouslt.
DISEASES.
Males.
Females.
Males.
Females.
Apoplexia,
_
_
15
10
Asphyxia,
-
-
2
-
Asthma, .
-
-
4
1
Ascites, .
-
-
5
7
Antochinia,
-
-
15
11
Bronchitis,
-
-
2
-
Carcinoma,
-
-
2
2
Carditis, .
-
-
9
11
Cholera, .
-
-
5
-
Cholera Morbus,
_
• -
2
3
Cystitis, .
-
-
1
1
Dvsenteria,
-
-
12
6
Delirium Tremens,
-
-
4
-
Enteritis.
_
-
6
9
Epilepsia,
2
2
68
30
Erysipelas,
-
-
9
10
Hepatitis,
-
-
-
2
Hydrothorax, .
—
1
1
1865.]
PUBLIC DOCUMENT— No. 24.
Table No. 13 — Concluded.
25
1865.
Previously.
DISEASES.
Males.
Females.
Males.
Females.
Hernia, ......
1
_
Inanitio, .
1
3
33
52
Mania, Exhaustive,
-
2
10
9
Marasmus,
-
2
65
65
Meningitis,
-
-
9
14
Mortificatio,
-
-
-
1
Necropneumonia,
-
-
1
2
Paralysis,
6
-
37
19
Phthisis Pulmonalis,
3
10
53
109
Pleuritis,
-
-
-
2
Pneumonia,
-
-
15
9
Senectus,
-
2
24
17
Typho-Mania,
-
-
7
10
Typhoid Fever,
-
-
8
6
Variola, .
-
-
1
—
Totals, .
12
21
426
419
Table No. 14,
Showing the Admission from each County, from January 18, 1833, to
' September 30, 1865. •
1865.
Previously.
Whole
C OUNTIES.
Males.
Females.
Total.
Barnstable,
128
128
Berkshire,
-
-
-
189
189
Bristol,
-
-
-
294
294
Dukes,
-
-
-
19
19
Essex,
22
25
47
1,009
1,056
Franklin, .
-
-
-
126
126
Hampden,
2
2
4
364
168
Hampshire,
-
'-
-
225
225
Middlesex,
37
22
59
1,137
1,196
Nantucket,
-
-
-
32
32
Norfolk, .
6
4
10
608
618
Plymouth,
-
-
-
235
235
Suffolk, .
5
4
9
705 .
714
Worcester,
43
42
85
2,002
2,087
Other States,
2
5
7
31
38
Total,
117
104
221
7,104
7,225
26
LUNATIC HOSPITAL AT WORCESTER. [Oct.
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-three Tears the Hospital has been in
operation.
TEAK.
Whole
Number.
Average
Number.
No. at end
of each
Year.
Current expenses
of each Year.
Annual Expense
for each Patient.
Expense per
Week for
each Patient.
1833, .
153
107
114
$12,272 91
1114 67
$2 25
1834, .
233
117
118
15,840 97
135 38
2 60
1835, .
241
120
119
16,576 44
137 30
2 64
1836, .
245
127
138
21,395 28
168 44
3 12
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 68
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
381
53,221 52
123 77
2 38
1855, .
580
349
336
54,895 88
157 29
3 02
1856, .
577
357
376
45,631 37
128 64
2 47
1857, .
647
387
372
49,004 75
124 04
2 38
1858, .
679
372
301
38,267 26
102 86
2 39
1859, .
501
309
317
48,363 33
156 51
3 01
1860, .
532
324
331
47,757 01
147 39
2 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
1864, .
625
366
344
66,612 00
182 00
3 50
1865, .
565
350
343
73,772 41
211 37
4 06
1865.]
PUBLIC DOCUMENT— No. 24.
27
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PUBLIC DOCUMENT— No. 24.
47
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48
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Articles made '
'n the Sewing-Rooms during the T(
jar.
Aprons, 97
Mattress Ticks, ... 60
Bed Spreads, .
57
Mittens, pairs of,
30
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81
Neck Ties, . .
21
Blankets, . -
28
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22
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17
Night Caps, .
11
Carpets, .
7
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14
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150
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75
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20
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237
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54
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261
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73
Shirts, .
206
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91
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. 22
Dresses, .
196
Skirts and Quilts,
142
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75
Suspenders, pairs ol
24
Frocks, .
12
Table Covers, .
70
Handkerchiefs,
78
Towels, .
. 222
Hose and Socks, pairs of,
68
Under Shirts, .
17
Jackets, ....
45
Vests,
65
Articles repaired in the Sewing-Rooms during the Tear,
Aprons, 153
Night Dresses, . . . 123
Blankets,
171
Overalls, pairs of,
114
Bed Spreads, .
186
Pants, pairs of,
1,256
Bed Ticks, .
443
Pillows, .
117
Bags,
39
Pillow-Cases, .
237
Chemises,
4,252
Sheets, .
664
Coats,
730
Shirts,
5,242
Collars, .
%
37
Shirt Bosoms, .
37
Curtains,
75
Skirts, .
138
Drawers, pairs of,
. 698
Stockings, pairs of,
6,977
Dresses, .
721
Table-Cloths, .
56
Frocks, .
194
Towels, .
229
Jackets, .
. 138
Under Shirts, .
221
Mattresses,
61
Vests,
. 486
1865.]
PUBLIC DOCUMENT— No. 24.
49
Articles repaired in the Shops.
Bedsteads,
•22
Parasol, .
1
Brass Rings, .
12
Razors, .
20
Boots, pairs of,
23
Rakes, .
24
Boxes, ....
3
Saws, .
34
Bureaus, ....
15
Shaft Wheel, .
1
Blinds, ....
38
Stands, .
5
Brooms, ....
4
Settees, .
4
Chairs, ....
. 219
Scissors, .
16
Clocks, ....
12
Sofas, .
4
Coffee-Pots, .
8
Sleighs, .
2
Chisels, ....
3
Sleds, .
2
Crickets, ....
2
Sashes, ......
6
Flower-Stands,
12
Tubs
2
Flat-Irons,
7
Tables, .
. 165
Frames, ....
50
Tin Pans,
9
Boots Ironed, pairs of,
13
Tea-Kettle, .
1
Looking Glasses,
24
Trunks, .
2
Horse Wagons, . . .
2
Umbrellas, . . .
«
Ox Wagons, .
6
Window Rods,
10
Hoes, .
31
Windows,
74
Iron Bars,
23
Wheelbarrows,
2
Knives, ....
6
Lock Keys,
15
Pen-Knives, .
16
Book Case,
1
Lounges,
7
Hay Forks,
6
Lanterns,
18
Handcart,
1
Pails, ....
16
Saws filed,
80
Paint Mill,
1
Chains, . . . .
7
Articles made in the Shops.
Beehives,
16
Writing-Desk, •
1
Bolts, ....
28
Picture Frames,
. 103
Boxes, ....
22
Gimlets, ....
12
Bedsteads,
15
Horse Wagon,
1
Bureaus, ....
11
Stone Boats, . .
2
Boot-Jacks, ..
4
Horse Cart, .
1
Knobs, ....
78
Ox Wagon, .
1
Chair Rounds,
68
Iron Rods,
12
Curtain Sticks,
54
Knife-Blades, .
. 12
Screens, ....
4
Mattresses, .
63
Chisels, ....
6
Machine for picking hair,
1
Coal Sieve,
1
Pillows, ....
24
Wardrobe Hooks, .
12
Rabbit Planes,
2
50
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Articles made in the Shops — Concluded.
Koof Sashes, .
16
Wardrobe, .
1
Round Table, . .
1
Whiffletrees, .
12
Lounges,
2
Barrel Covers,
15
Small Tables, .
13
Blinds, ....
3
Wash-Stands, .
5
Walking-Sticks,
18
Snow Shovel, .
1
Library Steps, pairs of, .
2
Snow Scraper,
1
Dry Sinks,
4
Screw-Drivers,
10
Buckets, ....
6
Set of Shelves,
1
Brackets,
24
Pair of Shafts,
1
Mop Sticks, .
36
Table Legs, .
22
Glazing Windows, .
510
Tool Handles,
19
Paper Weights,
2
Watch Chains,
16
Sofa, . ' .
1
Products of the Farm.
Apples,
Pears,
Cherries, .
Grapes,
Tomatoes,
Currants, .
Sweet Corn,
Gooseberries,
Beans,
Parsnips, .
Turnips, .
Potatoes, .
Beets,
Carrots, .
Squashes, .
Peppers, .
Cucumbers,
Cabbages, .
Rhubarb, .
Hay,
Rowen,
Corn-Fodder,
Milk,
Beef,
Pork,
Mutton, .
15 bbls.
at $5 00
$75 00
25 bush, at
4 00
100 00
4
u
at
2 00
8 00
10
a
at
2 00
20 00
100
u
at
75
75 00
10
a
at
2 00
20 00
50
u
at
1 50
75 00
3
u
at
2 50
7 50
30
u
at
3 00
90 00
300
u
at
50
150 00
300
u
at
20
60 00
700
u
at
80
560 00
500
u
at
20
100 00
700
a
at
20
140 00
H
tons
at 25 00
137 50
10 bush, at
50
5 00
35
u
at
50
17 50
1,000 heads at
12
120 00
3,000
lbs.
at
2
60 00
70
tons
at
35 00
2,450 00
3
«
at 20 00
60 00
2
((
at 10 00
20 00
45,000 <
juarts at
6
2,750 00
6,846
lbs.
at
15
966 90
5,124
a
at
18
922 32
500
n
at
10
50 00
,039 72
1865.]
PUBLIC DOCUMENT— No. 24.
51
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52
LUNATIC HOSPITAL AT WORCESTER. [Oct.
P EI CES.
ARTI CLES.
1861.
1863.
1863.
1864.
1865.
Sugar, ....
$0 081
$0 11
$0 141
90 24
m 20
Molasses, ....
26
46
55
1 00
85
Tea, .....
42
65
75
1 15
1 12
Coffee, ....
• 16
26
32
45
40
Butter, ....
16
23
28
55
47
Rice,
n
8
H
14
12
Codfish, . . • .
3
4.8
6|
74
' 2
8
Beef,
H
7
8
15,
18
Flour, of the quality used at
this Hospital, .
6|
7
8|
15
11
Standard Prints, for dress
goods, ....
9
13
25
37 ,
35
Cottons, 36 inches wide,
H
21
35
65
40
Cottons, 45 inches wide,
12i
28
50
75
70
Blankets, ....
2 75
3 50
6 50
9 00
9 50
Coal, . ...
6 50
6 75
10 50
16 50
15 00
Some of the cases discharged as recovered, and others per-
mitted to leave. previous to recovery, were, when admitted,
attended with very destructive, violent and filthy habits, and
seemed to be quite incurable, and the improvement manifested
was obtained at considerable expense in extra attendance.
Whenever it has seemed to promise a more speedy recovery,
patients have received all the attention of a separate attendant,
regardless of any expense to the institution.
In all chronic cases tending to dementia, there is a propensity
to careless, slovenly and dirty habits. The surest way of per-
petuating these is to leave the patient to himself; and the surest
and speediest way to reform, and recovery of habits of decency
and propriety, is to place the patient in the care of an intelligent
and judicious attendant. This involves an expense of ten or
1865.] PUBLIC DOCUMENT— No. 24. 53
twelve dollars per week, while very few patients pay more than
three dollars and fifty cents, and a majority only pay three
dollars and twenty-five cents per week.
The necessity and importance of employing special attend-
ants for many of our patients, even when no remuneration is
received, will be seen and felt when it is remembered that to
the care of one individual are committed from twelve to sixteen
patients ; that he is their companion, servant and nurse ; that
he is also their governor and teacher, even though they may be,
and often are, with their impaired minds, his superior in talent,
education and social position ; that he must bear the constant
exhibitions of their sufferings, their suspicions and their
caprices; that he is often subject to flattery and deception;
that he is expected to be always patient, kind, persevering and
successful ; that he must protect one from suicidal impulse,
another from troublesome and disgusting habits, which aggra-
vate his disease, and another so far as possible from the torment
of troublesome delusions. These are some of the labors of an
attendant upon the insane. The faithful discharge of such a
variety of duties is certainly enough to tax severely the patience
and forbearance of the strongest and wisest person. The
attendants do and must suffer under such burdens, and some-
times lose equanimity and self-control. If at the best they
succeed in preserving their temper and vigilance, those confided
to their care can receive but little personal attention. w „
Considerations of this nature have led to the employment of
special attendants for the care and control of those whose
peculiarities indicated any particular mode of management.
In many recent cases this provision has been of great service,
both as the means of learning the real condition of the patient,
and of guarding against difficulties and dangers which so often
present themselves during this stage of the disease, and which
seclusion or mechanical restraint may aggravate.
Determined suicides are thus saved until the suicidal impulse
has passed away. Abstainers from food are preserved by a
careful husbanding of strength, by promoting general comfort,
and by a quiet and persevering administration of proper reme-
dies, until their places are again filled at the table.
Destroyers of clothing are prevented from doing mischief,
and a successful check placed upon the wayward and restless.
54 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Every superintendent of a hospital for the insane urges the
necessity of an early admission in a large majority of the cases
brought under his notice. The dangers of delay are repeated
in almost every hospital report. But every year's history shows
that patients are retained among their relatives so long as they
are manageable ; so long as they appear to be robust and healthy.
Whenever afflicted with bodily infirmity, when the light of
reason is entirely shut out, then they are sent to the hospital to
die. The record of every year's admissions shows that in
many cases abstinence and emaciation were permitted to reach
the last stage where death seemed to be inevitable before any
steps were taken to provide for their care in the hospital. In
others, convulsions and paralysis to the degree of utter help-
lessness first suggested the necessity of any new arrangements.
Hospitals for the insane are intended for the relief of the
various diseases incident to the nervous system. They are, or
should be, places from which the hurtful influences of every day
life are excluded ; where all the relatives connected with the
development of insanity are sought to be broken up; where the
misanthropic is drawn into social life, and the restless, excitable
man, encumbered and checked by the ordinary restraints of
hospital life ; where the individuality of each is sought to be
preserved and modified, and elevated by a discipline common
to the whole. In a word, the hospital is intended to be a place
where all that can be done for the relief of mental disease and
suffering is done, and done in the best possible manner.
Until such views obtain in the community, and are operative
in the commitment of patients to the hospital, no real proof
can exist of the true value of medical treatment in mental
disease. The recovery of sound health of body and mind is
the thing to be sought, not as is too often the case, the conven-
• ience of relatives and friends, by the removal of the patient
because he has become an unwelcome burden to the family
circle.
In this connection it should be remembered that as there is
delay in admission, there is also haste in removal of those who
are in the way of recovery. During convalescence there is
always danger of relapse. After the excitement has entirely
passed away, and the ordinary current of thought has become
reestablished, there often remains a susceptibility to impres-
1865.] PUBLIC DOCUMENT— No. 24. 55
sions of an unhealthy character, and an inability for continuous
mental activity which renders the discharge of many who have
apparently recovered their mental strength, attended with great
danger. To pass suddenly from the seclusion and restraint of
hospital life, to unrestrained activity, is, at best, hazardous.
The weakened powers of the mind shrink before the burdens
imposed upon them by a return to the labors of active life.
The endearments of home, even, are fraught with danger ; the
anxiety of the family circle for the success of the convalescent
is frequently taken as an evidence of distrust. To make the
return to home and friends safe, trial visits are recommended,
and the transition is thus rendered gradual. But to make an
arrangement entirely satisfactory, there should be some inter-
mediate place between the hospital and the world at large ; some
resting-place on the borders of society, beyond the restraints of
the hospital and yet within its influence ; some house emanci-
pated from the daily routine of hospital life, affording all the
comforts of a home, the usages of a family, and the society of
healthy minds, beyond the limits of the hospital proper, but
recognized by law, and within the authority of its directors and
managers. Such an establishment would give courage and
confidence to the convalescent, revive more speedily his former
habits, and prepare the way for a more satisfactory and
successful return to the duties and responsibilities of active
life.
One great want felt by all institutions devoted to the care of
the insane, is a full corps of reliable, well educated and
thoroughly trained assistants in each department. In the out-
of-door departments, in the engine and boiler-rooms, the
carpenters' shop, the stables and on the farm, the places are
usually satisfactorily aud quite permanently filled ; but in the
laundry, the work-rooms, the kitchen, and more particularly in
the wards, great difficulty is experienced in procuring and
retaining such assistants as are thoroughly devoted to the
interests of the institution and the welfare of its inmates. In
the female department it is usual to have a much higher class
of attendants, and those who remain longer in service than in
the male department ; but until the duties of the position are
made less burdensome, the opportunities for progress and
improvement multiplied, and the chances for future comfort
56 LUNATIC HOSPITAL AT WORCESTER. [Oct.
increased, we must be content with a second rate service-
Young women, school teachers and others, who do not seek
ordinary places of labor, become attendants in a hospital for
the insane, preferring some duty rather than idleness. The
hospital does not in any way stimulate improvement, and the
attendant makes no profession of entering the service for a life
labor ; on the contrary, she leaves on the first opportunity for a
more permanent and satisfactory settlement.
The young man generally comes to us from the farm, and is
wholly untrained, except such training as he has received in
the common school and a well ordered New England family
circle. He may have no higher qualification than physical
health and strength, has hardly ever seen an insane person, and
perhaps regards every manifestation of insanity as an exhibition
of perversity or malice. He remains during the whole period
of his service in utter ignorance of the true character of the
insane, and equal ignorance of his real duties, except such
information as he may draw from occasional words of encour-
agement or reprimand from the superintendent.
We profess to have diminished, in a great degree, the amount
of physical restraint. We have made an effort to introduce
various kinds of labor among our patients. Considerable
attention has been paid to the subject of amusement and
education as means of relief; and yet to minds wholly untrained
in the way of their special duties is committed the control and
management of the insane. Upon them rests the great respon-
sibility of instructing, amusing, protecting and nursing them.
They must execute all plans, follow all rules, grant or withhold
favors, and by their very presence cheer or annoy those under
their care. They are the companions, and are expected to be
the friends of the patients. Are they generally able to perform
their duties ? Can they do it well ? The farmer demands of
those who take care of his oxen and horses a certain amount
of skill ; the master mechanic that his journeymen shall have
learned the trade ; but the attendant receives no instruction
and has no probation, and enters almost at once upon full pay
and full duty.
How can these difficulties be met and overcome ? First,
perhaps, by offering a larger salary, so as to bring applications
of a higher order, and an annual increase to those whom it is
1865.] PUBLIC DOCUMENT— No. 24. 57
found desirable to retain. Second, by promoting social inter-
course by special privileges and otherwise, and by so far securing
the comfort of the attendant as to prolong his term of service.
Third, by some arrangement which will allow discreet and
devoted attendants to remain in service after marriage. And
above all, if possible, requiring of each applicant some term of
probation, during which he shall be instructed, and at the end
of which he shall be employed or discharged, as the promise
of his usefulness may dictate. It certainly is not advisable that
the Commonwealth or the institution should have a long list of
pensioners, but so much depends upon the discretion and
faithfulness of the attendant in the management of a hospital
for the insane, that it seems to me of the first importance that
good, judicious, faithful attendants be secured and retained at
almost any cost. On them depends, in no small degree, the
successful working of the institution. When it is remembered
how much of firmness and forbearance, how much care and
anxiety, is necessary to a faithful and satisfactory performance
of their duties ; when it is remembered, too, how many
perplexities surround their situation, how many obstacles they
must meet and overcome, how many provocations they must
endure, we shall have some idea of the worth of skilful
attendants on the insane. We shall not be satisfied with those
who control by force, or who manifest a dictatorial spirit ; we
shall expect tact which can lead and direct, kindness which can
soothe and sympathize, and skill which can promote occupation,
amusement and instruction.
In general little is to be feared from cruelty and neglect.
Ignorance of the real character of their duties, a low estimate
upon the necessity and value of their own services, and a
want of appreciation of the character of the insane are more
frequently the causes of their errors and offences.
When this most desirable stage of improvement is reached,
the position of attendant would not be looked upon as in any
way inferior to the most honorable place in society. They
would be sought to care for and control patients at their homes
in cases where relatives object to sending the patient to the
hospital, and in many cases would doubtless prevent the neces-
sity of consigning the insane to the care of a public institution.
You suggest that these things have already been accomplished
58 LUNATIC HOSPITAL AT WORCESTER. [Oct.
in this hospital. It is true that there have been many excep-
tions to the general rule ; but while a few have been uniformly
faithful, kind and discreet/ have been so persevering and sym-
pathizing as to almost elevate their labors to the dignity of a
mission, many, very many, have disappointed our hopes and
disturbed every effort to ameliorate the condition of those
under their charge.
During the past two or three years there has' been a steadily
increasing demand for larger and more commodious rooms and
a higher style of accommodations than we can at present offer.
For many years better accommodations have been needed for
certain classes of patients admitted to this institution. The
institution presents to all the same unvaried rule, the same
unyielding routine. No matter what a person's previous habits
and associations have been, when disease comes upon him and
he is obliged to seek refuge in an asylum, he must take his place
in a common ward, occupy a room eight feet wide by ten in
length, and scarcely eight feet in height.
If he has any society it must be the society of those assigned
to his ward.
The accommodations and conveniences of the ward at the very
best are hardly sufficient to preserve the decencies of domestic
life.
There is a class of patients in every hospital who require
little or no restraint or seclusion. They cannot live at home
or with friends ; they need the assistance, guidance and support
of a hospital or asylum ; their friends are able- and willing to
pay for it ; they are proper subjects for the guardianship and
treatment of the hospital, and yet the hospital affords them no
adequate accommodation or convenience.
There is that wayward, suspicious, troublesome class, many
of whom belong to the higher ranks of society ; they are
querulous, critical and censorious ; they cannot conform to the
usages of any family circle ; they disturb the peace of society ;
and at length are consigned to the custody and care of the
hospital ; but the hospital with its present arrangements cannot
detain them with peace to its managers, or comfort to its other
inmates.
Then there is a large class of quiet, apparently harmless and
industrious persons who need just that amount of guidance and
1865.] PUBLIC DOCUMENT— No. 24. 59
direction dispensed in a well ordered hospital, but who do not
require the existing arrangements for strength and security,
and who would be further improved by some new arrangement,
some modification of restraint, impossible at present. This
large class, generally considered incurable, must continue to be
subject to the care and control of the hospital, and might at a
less expense be comfortably provided for in some other institu-
tion, where to custody, useful occupation, and medical care
and control, might be added some of the comforts and pleas-
ures of the family and home.
Convalescents too, those whose minds are so fully restored as
to render a further companionship with the insane irksome and
injurious, but who are not sufficiently strong to return to their
homes and resume the active duties of life without great dan-
ger of a relapse, should have some intermediate place between
the necessary restraint of the hospital, and the danger of a
too sudden return to excitements incident to active life. Some
resting place which shall make the passage of the convalescent
from the confinement of the hospital to the freedom of society
gradual and safe, and so afford time and opportunity for the
weakened powers of the mind to become strong enough for the
daily conflict of life, is one of the great and growing wants of
this institution.
This hospital necessarily applies the same arbitrary rule to
all classes of patients, and to every grade of disease ; the same
unsatisfactory relations exist for those who require all the tact,
skill and strength of the institution, and those who only require
the comfort, rest and peace of an asylum ; its operation is that
of a machine, bearing with equal, unyielding severity upon the
mild and harmless, and the violent and dangerous, affording
the same amusements and pleasures to the incurable and
demented as to the most intelligent convalescent.
For nearly one-third of a century this institution has to a
great degree answered the wants of this community, and
fulfilled its duties the community know how well. Shall it be
made to answer the growing demands of another generation of
men ?
If so, it seems necessary at once to extend our plans, multi-
ply our facilities, and improve our system, so as to afford to all
60 LUNATIC HOSPITAL AT WORCESTER. [Oct.
the greatest possible chances for recovering, and the greatest
amount of comfort to such as may not recover.
Let us, if possible, establish a family circle for a few of the
convalescent of both sexes, by opening a house and placing it
under the care of a married couple of well tried, faithful, skil-
ful attendants. Let us attempt the same for a class of harm-
less, industrious incurables, and also one for two or three of
the more difficult, whose friends are able and willing to pay
generously. Let us inaugurate some such plan, and quietly and
steadily persevere in it until it shall prove a success. If need
be, let us as,k legislative assistance and direction, and thus
commence under sanction of the law.
If you ask how this can be accomplished ? how, even the
work may be commenced? several methods may be suggested.
First. There are in the immediate vicinage of the hospital,
adjoining its grounds, several well constructed cottages now
offered for sale, and some of which could doubtless be rented for
a term of years, if thought more advisable to so timidly
begin the work.
Second. The whole hospital property could be put into the
market, and still occupied for the present, until a sum was
realized, which would nearly pay for an estate, with new and
appropriate buildings, perfectly adapted to the wants of the
insane.
Third. Twenty-five acres of the grounds and gardens
adjacent to the buildings, were last year appraised at one
hundred thousand dollars ; a sum which would go far towards
the erection of new hospital buildings, and leave in a compact
area of eighty-five acres of the most desirable land belonging
to the estate, on which jsucli buildings might be placed. The
site would be pleasant and healthy ; overlooking the city and
surrounding country, and affording a prospect of great beauty
and activity ; removed a little distance from the city, but
easy of access.
There are doubtless many other desirable localities. The
hospital already owns this, and can spare the twenty-five acres
for a capital upon which to work. On no condition, how-
ever, should any land be disposed of in any other arrangement
for the prosecution of the plan.
1865.] PUBLIC DOCUMENT— No. 24. 61
I would recommend then, something like this : that the
Trustees have power to put into the market, certain lands
belonging to the hospital, and that they proceed quietly to
remove the material in the present buildings, one wing at a
time, to Chandler Hill, and there use it in the construction of
new buildings, so far as it can be made available. The pro-
ceeds from the sale of lands, and such assistance as the legisla-
ture may grant, to be expended in carrying out the design.
Let it not be understood that the site spoken of, is the only
desirable one, or that there is none better. Within the limits
of Worcester, and near to the town, there are others every
way desirable, and one of which could have been purchased a
few years since at a reasonable rate.
Could this, or any similar plan, be adopted and carried out, a
wide step would be taken in advance of any existing arrange-
ments for the care and recovery of the insane. Will not Mas-
sachusetts take this occasion to consider the necessity and
propriety of making such an arrangement for her most unfor-
tunate children ?
In the carrying out of this or any similar plan suggested by
the foregoing remarks, a departure would of course be made
from the general style and character of hospital buildings.
There would be the central edifice ; the hospital proper, in
which would be placed all the cases of acute mania, the violent
and dangerous, the suicidal and troublesome ; having every
arrangement for classification, and every convenience for the
treatment of insanity ; with large and airy sleeping rooms, and
day rooms, and with improved facilities for bathing, and a
more reasonable arrangement for water-closets.
There would be, on one hand, a few cottages, plain, neat and
convenient, for the quiet, harmless and industrious of both
sexes ; with workshops, where they could follow such indus-
trial pursuits as could be made available, with the laundry and
bakery for the whole.
On the other hand, there would be the residences of others,
who would devote their time to the cultivation of gardens, in
music, reading and writing, walking and riding, and such
other light occupations and amusements as they were accus-
tomed to follow when in health.
62 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Then, there would be the chapel and lecture room, in which
there would be, at regular intervals, divine service and frequent
lectures, sociables and reading clubs.
One great benefit to accrue from all this, is a near approach
to the family system, and the kindly influences of home treat-
ment. Could this system be adopted and carried into operation,
the insane would have all the benefits they now have, with the
added advantage of the family circle, to such as could be
admitted to its privileges ; homely surroundings, and the
enjoyment of many of the social comforts which make life
pleasant. They would have, also, the advantage of well trained
nurses and attendants, whose business for life it would be to
care for and sympathize with them. They would enjoy a
more free and generous style of amusement and exercise, and
more frequently, and with less restraint mingle in the society
of friends and relatives — in a word, all the enjoyments of life
would be multiplied, and all the social endearments, to a great
extent, preserved, without diminishing in any degree the pros-
pect of recovery, or increasing in any way the labors of the
institution.
"We know that there are difficulties in the way of any scheme
which anticipates change. There can be no doubt, that in a
large hospital, the arrangements could be perfected with much
less labor; we know how difficult even to start the experiment,
unless it can be shown that it will be the cheapest method of
supporting the life of patients, as well as most promising in
regard to their recovery of mental health.
But pity will it be if the Commonwealth refuse to depart
from her beaten track in the care and custody of the insane,
and allows the opportunity to pass without an effort.
If the obstacles to a radical movement seem insurmountable,
there can be no question as to propriety of leasing, with a view
to purchase, two or more cottages in which to make the experi-
ment in a small but safe way. Success in the undertaking-
seems to be perfectly sure, and there is no danger of encum-
bering the institution with any new burdens in assuming the
responsibilities of the enterprise ; on the contrary, we shall
lighten existing ones.
At present, the rules and regulations relating to the hospital
are, to a certain extent, arbitrary and unjust. The moment a
1865.] PUBLIC DOCUMENT— No. ,24. G3
man is placed in the wards of the hospital he is considered
insane, and is, in the eye of the law, insane, no matter what is
his real condition, or what the grade of his disease.- All the
civil difficulties of a case of insanity attach to him, and do not
readily leave him. The moment he is thought to be well
enough to return to his family, and receive the care and atten-
tion of his relatives and friends, he is said to be sane, to have
recovered. He returns to the duties and responsibilities of
active life at once, with no kind assistance and with no protect-
ing care. The beneficial influences of the hospital close, and
he returns to the world, where his misfortune often operates
strongly against him.
Make the arrangement suggested, even by a small beginning,
and some of the difficulties will be removed. Patients would
have all the real benefits of home treatment, all the pleasures
of the family circle, with suitable occupation, recreation and
amusement, and much more open air exercise than can now be
enjoyed. They would have the society and companionship of
friends and relatives, with much more comfort, and would enjoy
all the social ties in a more reasonable and generous manner.
Above all, the restored would pass from the hospital to the
world at large by gradual steps, and recover, one by one, his
customary duties and responsibilities.
Of the general principles of treatment little can be said here,
nor is it necessary to recount the various and growing means
by which the patients have been supplied with employment,
amusement, recreation and wholesome variety in their daily
life. These have been repeated over and over again in former
Reports.
All the plans for effecting these most desirable objects, which
have been described in former Reports, have been employed
during the past year, and an increased effort has been made to
carry all such measures to a greater extent, and multiply all
the facilities for similar purposes.
Few changes have been made among the officers and assist-
ants during the year. Dr. Rice, who had so long and faithfully
performed the duties of Assistant-Physician, resigned his office
in May, and his place has been filled by Dr. Joseph Draper,
who brings to the office a large experience, thorough knowledge
64 LUNATIC HOSPITAL AT WORCESTER. [Oct.
of the insane, and a love for the peculiar duties of the spe-
cialty.
The supervisors of the female department, Misses Piatt and
Lummis, both left in course of the year — one to engage in
other duties, and the other to recover, if- possible, her health,
now declining. It will be long before their places can be well
filled.
So large a number of assistants as are employed in this hos-
pital must necessarily witness several changes in the course of
the year. Generally, these changes have been at the desire of
those employed. Instances of misconduct have been infrequent,
and discharge on that account still more so. The comfort and
well-being of the hospital depend in so great a degree on the
good character and conduct of the attendants, and the success
of the treatment is so much under their control, that a large
amount of labor and care are expended to secure the highest
class of attendants.
With my highest regard for' your constant kindness and for-
bearance, for your ready sympathy and assistance, and with a
firm trust that He who rules over all will safely guide us
through another year, I close this brief record of the past.
MERRICK BEMIS.
State Lunatic Asylum, Worcester,
October 2, 1865.
METEOROLOGICAL OBSERVATIONS
MADE AT
THE STATE LUNATIC HOSPITAL, WORCESTER, MASS.,
1864-5.
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.
GQ
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!/3
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Slight shower y r. M.
Aur. 9 P. M.; daph. mez.
Dandelion in bios. [bl.
Lunar halo.
Misty all day.
Squally and rainy. .
Interrupted rain.
Leatherwood in blossom.
Leatherwood in blossom.
Hyacinth in blossom.
Shower 8 P. M.
Liverwort in blossom.
Wind flower in blossom.
Slight shower 2 P. M.
Fever bush in blossom.
Interrupted rain.
Moderate rain continu'd.
Rain ended 10 A. M.
Blue violet in blossom.
Bloodrootinbl. [ryinbl.
Smoky early A.M.; cher-
Cherry in bl. and shad bu.
Pyrus jap'ainbl.: th.and
Miss. cur. in bl. [light'g.
Rain.
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PUBLIC DOCUMENT— No. 24.
73
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Ram ; wild cherry in bl.
Peach in blossom.
Lunar halo; almond bl.
Hazy 9 P. M.; lun. halo.
Rain 3 P. M.
Rain; apple bios.
Hazy 9 P. M.; lun. halo.
Hazy 9 P. M.; rain 11.
Rain ; mountain ash.
Hazy 9 P.M.; r'n 11 P.M.
Sh'y ; th.& light'g; Sc. r. bl.
Showery; narcissus bl.
Light frost A. M.; au. 9.
Hazy 9 P. M.
Cloudy ; lilac in bios.
Hazy 2 P. M. [calac's in bl.
Sh'y; th.& light'g; r. rose &
Rain 11 P.M.; ger. mac'm
Clou'y; horse ches't. [bl.
Cloudy ; tart, honeysu'l.
Cloudy ; Persian lilac.
Cloudy A. M. with rain.
Cloudy A. M.
Fair weather.
Fair weather.
Fair weather.
Cloudy; rain 3 P. M.
Cloudy.
Showery P. M.
Fair weather.
Fair weather.
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LUNATIC HOSPITAL AT WORCESTER.
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Fair weather.
Fair weather.
Hazy 9 A.M. and 2 P.M.
Hazy 9 A. M.
"Very sli't showers A. M.
Cloudy with no rain.
Cloudy with no rain.
Cloudy with no rain.
Rain P. M.
Rain A. M.
Rainy.
Fair weather.
Fair weather.
Somewhat cloudy.
Somewhat cloudy.
Cloudy; rain; th. & light.
Cloudy A.M.; fair P.M.
Fair weather.
Cloudy.
Cloudy. [bow 6.
Somewhat cloudy ; rain-
Rainbow 7 P. M.
Fair weather.
Fair weather.
Fair weather.
Showery.
Fair weather.
Fair weather ; fr. breeze.
Fair weather; fresh br'ze.
Fair weather; sul'y P. M.
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PUBLIC DOCUMENT— No. 24.
81
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LUNATIC HOSPITAL AT WORCESTER. [Oct.
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Cherry,
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Crocus,
Currant, Missour
Dandelion, .
Daphne Mezereoi
Fever Bush,
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Honeysuckle, Ta
Horse-Chestnut,
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1865.] PUBLIC DOCUMENT— No. 24. 83
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 Prolate 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.
84 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.
PHYSICIAN'S 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 anc *
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
1865.] PUBLIC DOCUMENT— No. 24. 85
■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 *he county of
, in behalf of the inhabitants of said toAvn, 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
86 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. 186 .
Attest'. (Signed,)
, Principal.
, Surety.
Patients will be received into the hospital at any time, if the following
conditions are complied with :
If the patient is in indigent circumstances, and has no settlement in any
town in the Commonwealth, the Probate Court, or if in the city of Boston,
the Superior Court,, will issue a warrant for the commitment of the patient to
the hospital. The State will then pay the cost of support, and the county
from which the patient is sent will pay the expenses of the commitment.
If the patient is in indigent circumstances, and has a settlement in any
town in the Commonwealth, the Overseers of the Poor of that town may give
a bond for the support of the patient. Or, when this is inconvenient, an
application may be made to the Probate Court of the county where the
patient resides, and a warrant will be issued for the commitment of the patient
to the hospital, and the town will be held responsible for the support of the
patient.
In all other cases a bond from responsible persons, as principal and surety,
will be required for the expenses of the patient while in the hospital.
In all cases, before admission to the hospital, two physicians, one of whom
shall be the family physician, must certify that the patient is insane.
1865.] PUBLIC DOCUMENT— No. 24. 87
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 charge
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
wien the patient leaves the hospital.
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, Sfc, 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
conclusive evidence of his residence.
Section 4. Any person applying for the commitment or for the admission
of a lunatic to a state lunatic hospital, under the provisions of this act, shall
first give notice in writing to the mayor, or one or more of the selectmen, of
88 LUNATIC HOSPITAL AT WORCESTER. [Oct.
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 application 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 fired
-with the application, or within ten days after the commitment or admission, a
statement in respect to such person, showing as nearly as can be ascertained,
his a^e, 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 Ion" - . 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
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
reauired 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
1865.] PUBLIC DOCUMENT— No. 24. 89
date of the certificate, to the insanity of the person in whose behalf admission
is sought, and that such person is a fit subjecl 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 deter-
mine.
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, accord-
ing to the by-laws of the hospital, on account of the support of such patient
therein, or for the removal of any patient whom the trustees are authorized
by law to remove, for thirty days after the same has been demanded by the
treasurer in writing, of the mayor and aldermen of the city, or of the select-
men of the town, or of the person liable therefor, the same, with interest from
the time of such demand, may be recovered for the use of the hospital in an
action to be instituted by the district-attorneys, or other prosecuting officers
in the name of the treasurer, against such delinquent city, town or person.
Section 11. The expenses of the hospitals for the support of lunatics
not having 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 cfny such is ascertained ; and the dis-
trict-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 superin-
* By ch. 240, § 9, Acts of 18G3, reduced to " twenty-five " cents.
12
90 LUNATIC HOSPITAL AT WORCESTER. [Oct.
tendent, 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 hear and deter-
mine, whether such insane person is incurable, and ihay 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 lunatics
dying in the hospitals shall be reimbursed to the trustees by the places of legal
settlement of city and town paupers, and by the Commonwealth in the case
of state paupers.
Section 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.
1865.]
PUBLIC DOCUMENT— No. 24.
91
[Acts of 1863, Chapter 240.]
An Act in relation to state charitable and correctional
t
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.
GENEEAL 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 trus-
tees, appointed and commissiond 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, accord-
ing to the provisions of this section. On the first Wednesday of February in
each year the term of office of the senior member in each board, as they stand
arranged on the list of their appointments, 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 establish
for the internal government and economy thereof; and they shall be reimbursed
all expenses incurred in the discharge 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
92 LUNATIC HOSPITAL AT WORCESTER. [Oct.
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 preserved at the
annual meeting to be held between the first and fifteenth days of October.
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 Ust 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
meeting 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.
, [Eesolve 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
in 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.
1865.] PUBLIC DOCUMENT— No. 24. 93
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
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 18. 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 expenses 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 26. 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
94 LUNATIC HOSPITAL AT WORCESTER. [Oct.
be dangerous, and is not susceptible of mental improvement by remedial
treatment 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.
LAWS ENACTED IN 1865.
[Chapter 268, of Acts.]
An Act amending the Act concerning state lunatic hospitals
and insane and idiotic persons.
Be it enacted, 8fc, as follows ;
Section 1. The eighth section of the two hundred and twenty-third
chapter of the acts of the year eighteen hundred and sixty-two, is hereby
so amended that the certificate signed by two respectable physicians, and
required by said section, shall be made according to the provisions of said
section, after due inquiry and personal examination of the patient by them.
Section 2. Upon application for the admission of an insane person to any
state lunatic hospital, or to any asylum or private house for the reception of
the insane, the applicant shall file with his application a statement containing
the names and address of such insane person's father, mother, children,
brothers, sisters, or others next of kin not exceeding ten in number, and over
eighteen years of age, when the names and address of such relatives are
known by the person or persons making such application, and such statement
shall be filed with the order of commitment or application for admission. And
the superintendent, or person in charge of such asylum or house for the
reception of the insane shall, within two days from the time of the admission
or commitment of any insane person send, or cause to be sent, a notice of said
commitment in writing by mail, postage prepaid, to each of said relatives, and
to any other two pessons whom the person committed shall designate.
[Approved May 16, 1865.
1865.] PUBLIC DOCUMENT— No. 24. 95
[Chapter 16, of Eesolves.]
KESOI/VE IK RELATION TO THE PRICE OF BOARD IN STATE LUNATIC
HOSPITALS.
Resolved, That there be allowed and paid to the treasurers of the several
lunatic hospitals, a sum sufficient to make the rate of board for the past year
three dollars per week for each insane state pauper therein supported, the
same to be paid from the surplus of the appropriation for lunatic hospitals, for
the year eighteen hundred and sixty-four ; and that there shall be allowed
and paid for the board of insane state paupers for the current year, a sum
not exceeding three dollars and twenty-five cents per week. [Approved
March 22, 1865.
APR 25^W.PX
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