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

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PUBLIC DOCUMENT No. 22. 



THIRTY-FOURTH ANNUAL REPORT 



THE TRUSTEES 



STATE LUNATIC HOSPITAL 



WOECESTEE. 



OCTOBER, 1866. 



BOSTON: 

WEIGHT & POTTER, STATE PRINTERS, 

No. 4 Spring Lane. 

1867. 



THIRTY-FOURTH ANNUAL REPORT 



TRUSTEES OF THE WORCESTER LUNATIC HOSPITAL. 



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

In submitting their Report for the year ending on the 30th 
of September, 1866, the Trustees desire to express their pro- 
found acknowledgments to God for His providential care over 
the institution during the past year, and for that measure of 
success which He has vouchsafed to the labors of its officers, 
in the restoration of health and joy to many,. and in promoting 
the comfort and safety of all its inmates. 

By the Report of the Superintendent, which is herewith sub- 
mitted, and which gives a full and detailed statement of the 
condition of the hospital during the year, it appears that the 
whole number of patients in the house has been 630. 



There were in the House on the 1st of October, 1865, 
Admitted during the year, 
Discharged recovered, 

improved, 

not improved, . 
Died, .... 
Whole number discharged, 
Remaining Sept. 30, 1866, 



Males. 


Females. 


169 


172 


163 


126 


42 


47 


58 


37 


15 


10 


27 


13 


142 


107 


190 


191 



341 

289 

89 

95 

25 

40 

249 

381 



4 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

It appears by the foregoing table that the mortality of the 
last year has been slightly larger than the average of several 
preceding years. This, however, has not been occasioned by 
the prevalence of any acute disease in the house, but was 
owing to the dropping off of old cases of epileptics, paralytics 
and other chronic diseases, and to the death of several who were 
fatally diseased and died within a few days after admission. 
Not a single death has occurred except from chronic disease ; 
and no sickness from acute disease except very slight cases of 
indisposition for only a day or two of duration. Indeed, we 
may state without exaggeration, that the hospital has rarely 
been invaded by any form of acute disease for the last ten or 
twelve years, or since our very efficient means of ventilation 
were put in operation, by which we are able to convey a con- 
tinual current of fresh air, either warm or cold, to every apart- 
ment occupied by patients or attendants. With an abundant 
supply of pure air and water, wholesome diet, suitable clothing, 
active exercise, and the most rigid, attention to cleanliness, we 
have enjoyed an immunity from acute disease equal to that of 
the most favored class of the community. The internal moral 
administration has been conducted with the usual mild, con- 
ciliatory and. paternal care, giving to all the patients as much 
liberty and indulgence as is consistent with their comfort and 
safety. No harsh personal restraint has been inflicted upon any 
one, and very seldom has any one been deprived of the free 
range of the halls. Frequently all have enjoyed their liberty. 
Occasionally two or three — rarely more than four — have occu- 
pied solitary rooms, and these, with a single exception, only 
for a few days during the paroxysms of furious excitement. 
Our solitary rooms are large, airy, well ventilated and warmed, 
and as cheerful and comfortable as they can be made for the 
mildest form of restraint. 

Among so large a number of insane people there always will 
be some who are periodically noisy, mischievous and filthy. 
And such only are the subjects of restraint in this hospital. 
Full details of the condition of the hospital in all its depart- 
ments are contained in the able and interesting Report of the 
Superintendent, and the Trustees do not deem it necessary 
further to repeat them here. 



1866.] PUBLIC DOCUMENT— No. 22. 5 

"We have had the misfortune to be deprived, a part of the 
year, of the valuable services of our excellent Superintendent, 
who, partly through the fault of the Trustees, and partly from 
his own willingness to assume labors beyond his power of endur- 
ance, became exhausted by over-work, and was thus for a time 
disabled for the performance of the duties of his office. The 
Trustees deemed it advisable that he should be relieved at 
once from his labors, and that he should absent himself from 
these scenes of care and responsibility, and seek restoration to 
health by recreation and travel, and in visiting places and 
friends abroad. Therefore the Trustees promptly gave him 
leave of absence for four months, and we are happy to say that 
at the end of that period his health and strength were suffi- 
ciently restored to enable him to resume the duties of his office, 
which he has since successfully and satisfactorily performed, 
and his health is still becoming more confirmed. 

During the absence of Dr. Bemis the superintendence of the 
hospital was committed to Dr. Joseph Draper, the Assistant- 
Physician, who was favored by the aid of Dr. John R. Lee, 
formerly, for many years, a very competent and faithful 
Assistant-Physician here, and who was providentially here on a 
visit at the time. The affairs of the institution were conducted 
by Dr. Draper to the entire satisfaction of the Trustees, the 
customary good order and discipline being fully maintained. 
Dr. Draper truly merited, as he received, the high appreciation 
of the Trustees for fidelity to his trust. 

The Trustees desire to express their approbation of the plan 
suggested by Dr. Bemis in his Report, for erecting near the 
hospital two or more separate dwellings for the accommodation 
of convalescents, and all these fitted for the enjoyment of the 
quietude t and amenities of the family circle, with apparent 
freedom from all restraint, and apart from the noisy gibberish 
to which they are sometimes exposed in the common halls. 
We refer to his Report without repeating its details. 

The Trustees cannot close their Report without the renewed 
expression of their entire confidence in the skill and judgment 
of Dr. Bemis the Superintendent. 

The financial affairs of the institution have been prudently 
and skilfully managed during the last year by the Treasurer, 
Daniel W. Bemis. All our old outstanding accounts and 



6 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

liabilities, which for some years past have caused some degree 
of apparent though not real confusion in our pecuniary condi- 
tion, have been adjusted, and a clear statement of their exact 
condition is now exhibited in the Report of the Treasurer. 

When the Worcester Hospital was established by the State, 
it was a pioneer institution. There was no model after which 
to pattern, and no experience to guide in its construction, or in 
the relative location of its appurtenances. 

As medical and sanitary science progressed and experience 
was gained, it was discovered that great imperfections existed 
in the original construction and arrangements. The method 
of warming and ventilation was found to be expensive and 
very inefficient, besides being dangerous from exposure to fire. 
The out-buildings, stables and piggery, and the old solitary cells 
for the violent and filthy, were becoming offensive from their 
proximity to the halls — thus endangering the health as well as 
offending the senses of the inmates. After several years of 
deliberation and consideration of many plans for averting these 
evils, the Trustees, in the year 1855, undertook their removal. 
They were authorized, by Acts of the legislature from time to 
time, to make removals, alterations and repairs. The barn 
and piggery were first removed, and placed at a commendable 
distance from the house. The old gloomy and filthy cells were 
demolished ; the old furnaces, and also the kitchens in the 
basements, were removed, and many other improvements made 
in the interior of the main building and in the wings, halls and 
dormitories. The ground having been cleared, a tall steam- 
chimney was erected at a safe distance from the halls ; a steam- 
engine, with four boilers, was purchased, and a.complete appa- 
ratus for warming and ventilating the whole establishment, 
with a capacious conduit, for conveying either warm or cool 
fresh air into every department. A bakery and cooking apart- 
ment, wash-room, and laundry and work-rooms, were included 
in a building contiguous to, but outside, the walls of the hos- 
pital buildings ; also, a neat and commodious chapel, communi- 
cating with the centre building. Many other things were done, 
but it is unnecessary to enumerate further. When the work 
was once begun, there was no stopping point till it was com- 
pleted. These improvements, or rather this reconstruction, — 
for such it was to a great extent, — was made under authority 



1866.] PUBLIC DOCUMENT— No. 22. 7 

of the legislature, to expend money " for permanent repairs or 
improvements, which, in their (Trustees) judgment, will 
promote the interest of said hospital." 

The work of removal and reconstruction was begun, and nearly 
or quite completed in the year 1855, at a cost of $49,362.88. 

By this the hospital was put in a very complete sanitary 
condition ; and the almost perfect immunity from any form of 
acute disease since that date, vindicates the wisdom of the then 
Trustees in making the expenditure. But the cost was to be 
paid from the surplus funds of the hospital. The legislature 
made no appropriation for any part of it. The funds of the 
hospital are derived from two sources only, viz., from dona- 
tions of private individuals, and the profit on the board of pri- 
vate and town patients, — at present only from private patients. 
The surplus money in the treasury not being sufficient to meet 
this large expenditure, a debt was necessarily entailed on the 
hospital. It was contemplated, however, by the Superintend- 
ent and Trustees, that the surplus income of a few years would 
suffice to extinguish this debt, without recourse to the State for 
aid. In ordinary times it would, doubtless, have been cancelled. 

Since the beginning of the war, 1861, and the consequent 
advance in the price of provisions, and of everything pertaining 
to the support of the hospital, we have been unable to more 
than meet the current expenses of living and necessary repairs. 

It became necessary, about two years ago, to rebuild the 
dam from which we obtained our water supply, and to renew 
our aqueduct, the old one being of insufficient capacity and 
much out of repair. A grant of 84,000 was obtained from the 
State ; but the job cost us $6,000, although much of the ordi- 
nary labor was done by our own patients. This, however, was 
paid, without increasing the debt. This debt, varying during 
the last ten years from $20,000 to $15,000, has been carried by 
the hospital by temporary loans. It has not been introduced 
into the annual reports of the Trustees : first, because it was 
considered a renewal or construction debt, and had no particu- 
lar relation to the current expenses of the hospital; and, 
secondly, because it was confidently expected, until some time 
after the beginning of the rebellion, that, in a few years, it 
might be paid by the surplus income of the hospital, without 
making the cost of board burdensome to private patients. 



8 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

In view of the above facts, and seeing no probability of diminu- 
ution of current expenses, at least for some years to come, and in 
consideration of the inadequate allowance by the legislature for 
the support of State patients, constituting nearly one-third of 
our whole number, the allowance being insufficient to pay even 
the actual cost of board, the Trustees respectfully petitioned 
the legislature, at its last session, for an appropriation of the 
sum of $15,000, to enable us to remove this incubus from our 
shoulders, and once more place the hospital in a condition to 
dispense its beneficence to the largest number possible, and at 
the lowest cost possible, consistent with proper care for the 
health, comfort and safety of its patients. 

The Trustees believed the prayer of their petition was both 
reasonable and just. But the petition was never acted upon by 
the legislature. 

In a former report of the Trustees, in which the financial 
balances between the State and the hospital were fully exhib- 
ited, it appears that a large proportion of the expense, not only 
of repairs and improvements, but of the original cost of the estab- 
lishment as it now stands, has been paid by the earnings of the 
hospital itself, together with donations from private individuals.* 

In order to keep pace with the advancement of medical and 
sanitary science, and to furnish the best appliances for the resto- 
ration of physical and mental health to our patients, repairs 
and improvements, in some one or other department, are 
continually needed. These, we shall not be able speedily to 
supply, under the weight of our present burden and prospective 
high cost of materials and labor. 

Having presented this brief statement of facts in relation to 
our pecuniary condition, the Trustees here leave the matter ; 
respectfully commending it to the favor of your Excellency and 
the next legislature. 

Very respectfully submitted by the Trustees. 

WILLIAM WORKMAN. 
S. E. SEWALL. 
R. W. HOOPER. 
E. F. JENKS. 
HENRY CHAPIN. 
Worcester, Oct. 15, 1866. 

* Vide Eeport of the Trustees for October, 1863. 



1866.] 



PUBLIC DOCUMENT— No. 22. 



TREASURER'S REPORT. 



Receipts. 
Cash on hand September 30, 1865, 
received from the Commonwealth, 
received from loans Mechanics' Nat. Bank, 
received from towns and individuals, . 
received for articles sold, . 



$1,040 40 
19,728 25 
32,500 00 
57,537 18 
3,854 09 





$114,659 92 


Expenditures. 




Steward's disbursements, . 


. $69,177 34 


Salaries and wages, . 


19,221 39 


Refunded for over-payment, 


26 69 


Interest on loans, .... 


374 00 


Paid loans at Mechanics' Nat. Bank, . 


25,828 26 


Balance cash September 30, 1866, 


32 24 




$114,659 92 


Liabilities. 




Worcester Co. Institution for Savings, 


. $12,365 00 


Mechanics' Nat. Bank, . 


7,000 00 


Alfred Wyman, note, . 


1,377 91 


Sundry bills for supplies, . . . . 


7,409 23 


Amount due on pay-roll, . 


3,586 96 


Superintendent's salary, in arrears, 


1,150 00 



,889 10 



10 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Resources. 
Due from towns and individuals, $15,421 95 
from the Commonwealth, . 1,207 79 

$16,629 74 



$16,259 36 
DANIEL W. BEMIS, Treasurer. 



Worcester, Oct. 1, 1866. 



We have examined the above account with the vouchers, and find it correct. 

WILLIAM WORKMAN", 
HENRY CHAPIN, 

Auditing Committee. 
Wobcestee, Oct. 15, 1866. 



1866.] 



PUBLIC DOCUMENT— No. 22. 



11 



CLASSIFICATION OE EXPENSES. 



Provisions, — 

Flour, 

Eice and crackers, 
Eye and corn meal, 

Fish, 

Salt meats, .... 

Fresh meats, 

Fresh fruits, 

Beans, potatos and vegetables, 

Butter, 



Cheese, . 
Sugar, . 

Molasses, . 
Tea, . 
Coffee, . 
Small groceries, . 
Vinegar and pickles, . 
Ice, . 

Clothing, — 
Hats, caps, boots and shoes, 
Tailors' clothing, . 
Materials, . 



£7,354 99 
518 39 
464 87 
887 21 

4.950 93 
4,328 81 

577 55 
1,438 54 
5,334 35 

105 04 

1.951 19 
800 58 
865 55 
886 43 
906 10 
242 48 
210 02 



Furniture, — 
House furnishing goods, 
Crockery and glassware, 
Bedding, 

Kitchen-ware and brooms, 
Pictures and frames, . 

Fuel, — 
Coal (two years' supply,) 



Light, — 

Gas $1,182 52 

Oil, 242 05 



$918 75 


1,515 55 


2,300 08 


$1,391 75 


459 16 


153 37 


400 00 


208 86 



Medical supplies, 
Undertaker's bills, 
Books, stationery and printing, 
Freights, .... 



$31,823 03 



4,734 38 



2,613 14 
14,003 03 



1,424 57 

1,028 52 

731 60 

946 17 

138 55 



12 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Improvements and Repairs, — 

Blacksmithing, $304 77 

Lime, plaster and cement, 386 87 

Lumber, 632 10 

Hardware and castings, . . . • . . 1,695 93 

Gas and steam-pipe, &c, 288 44 

Paints, oils, and paper-hangings, . . . . 711 87 

Carriages and repairs, 197 95 

Harness and repairs, 159 27 

Stone work, 728 40 

Manure and fertilizers, 746 84 

Tools and implements, 399 26 

Sundries, . 74 92 

$6,326 62 

Live stock, 2,147 00 

Provender, 1,751 66 

Soap, 578 07 



Miscellaneous, 








Horse and carriage hire, .... 


$102 20 




Appraising property, . . 


46 


50 




Travelling expenses, 


56 


58 


i 


Veterinary services, 


73 00 




Tobacco, 


42 


10 




Elopement expenses, . . . 


121 43 




Sundry expenses, . . . 


489 


19 


931 00 
19,221 39 


Salaries and wages, 


. . 


. 


Refunded for over-payment, 






26 69 


Interest paid on loans, .... 


. 


,. 


374 00 


Paid loans at Mechanics' National Bank, 




'- 


25,828 26 




$114,627 68 



1866.] PUBLIC DOCUMENT— No. 22. 13 

THIRD ANNUAL FINANCIAL STATEMENT, 
Made to the Board of State Charities, October 1st, 1866. 



I hereby certify that the following is a correct statement of the condition of 
this institution, and the business transacted here, for the year ending 
September 30, 1866. 

I. Assets. 

[By valuation of D. S. Messinger and E. G. Partridge, on the 1st day of October, 1866.] 

Real Estate, — 
Between eleven and twelve acres of land, known as the Hos- 
pital Grounds, lying between Summer, Mulberry, Fulton, 

and Central Streets, valued at $60,000 00 

The hospital buildings on said tract, 250,000 00 

Four acres of land, and the barns and sheds thereon, . . 25,000 00 
Ten acres of land lying on Mulberry and north-side Central St., 20,000 00 
Eighty-four acres, more or less, comprising the farm, . . 16,800 00 

$371,800 00 
Personal Estate, — 
Neat stock, horses and swine, .... $5,000 00 
Carriages, harnesses, farming tools and implements, 2,000 00 
Hay, grain, root crops, and vegetables, . . 6,103 20 
Fuel, provisions, clothing, and family stores, . 7,948 30 
Kitchen furniture and cooking utensils, &c, . 635 00 

Repair shops, tools, and materials, . . . 1,148 00 
Furniture, pictures, crockery, silver and plated 

ware, . 31,241 50 

54,076 00 

Funds and Investments, — 
1st. A fund of $1,500 given by Abigail Wheeler, and drawing 

interest at 6 per cent., 1,500 00 

2d. A fund of $ given by , 

Total assets, $427,376 00 

II. Receipts. 

Cash on hand at the beginning of the year, .... $1,04040 
Amount of cash received from the annual appropriation for 

186 

Amount of cash from unexpended appropriations of 186 or 

former yearo, 



14 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Amount of cash from appropriations to meet a deficiency, 
Amount of cash from special appropriations, .... 



Total cash received from appropriations, 



Amount received from other sources, viz. : — 

From farm and farm produce, $3,854 09 

From labor, 

From towns and individuals, 57,537 18 

From loans, 32,500 00 

From Commonwealth, for support of paupers, . . . 19,728 25 

Total receipts, $114,659 92 

III. — Expenditures. 
[A.] Current Expenditures. 
1st. Salaries and wages, — 



NAMES. 



Months. 


Days. 


3 


14 


3 


22 


- 


7 


2 


20 


5 


- 


12 


- 


10 


_ 


12 


- 


12 


- 


12 


- 


3 


- 


7 


- 


11 


13 


f 2 


7 


Uj >8 


24 


5 


25 


9 


12 


3 


14 


4 


13 


5 


- 


3 


2 


5 


3 


5 


- 


2 


6 


2 


- 


_ 


25 


12 


- 


5 


23 


2 


— 



Amount. 



Avery, John D., and wife, .... 
Adams, Nelson J., and wife, 

Austin, Frederick H., 

Austin, Carrie, 

Allen, Eev. George, . . . . 
Bemis, Merrick, ) 

Bemis, Caroline A., j 

Boynton, Persis, . . . 
Bacon, Charles L., and wife, 

Bartlett, Albert, 

Bemis, Daniel W., . 

Bickford, William S., . . . . 

Blake, Addie, 

Bliss, Frederick J., 

Brown, Ellen, . J> 

Bolton, Victoria, 

Brown, Lucy E., . 

Childs, E. P., 

Carney, Mary E., 

Cowing, Jennie M., 

Chickering, L. B., 

Coburn, Abbie F., 

Cook, Mary L., 

Campbell, Sarah, 

Castle, Nellie, . . 

Curtis, Minnie, 

Cheney, George, 

Draper, Joseph, and wife, .... 

Darling, Lucie, 

Day, Marion, 



$112 20 

91 18 

5 00 

33 84 

225 00 

1,050 00 

110 00 

400 00 

300 00 

800 00 

75 00 

63 00 

282 20 

33 78 

98 03 

66 99 

232 38 

37 02 

48 91 

146 81 

19 23 
57 97 

27 50 

28 13 
33 33 

20 41 
1,000 00 

81 02 
22 00 



1866.] PUBLIC DOCUMENT— No. 22. 

III. — Expenditures — Continued. 



15 



Months. 


Days. 


1 


9 


5 


29 


1 


10 


2 


•2 


12 


- 


11 


19 


1 


8 


11 


26 


8 


11 


1 


16 


2 


- 


8 


28 


11 


9 


2 


27 


2 


15 


3 


13 


12 


- 


2 


- 


1 


27 


2 


20 


2 


19 


6 


2 


11 


27 


11 


19 


6 


29 


8 


16 


6 


_ 


12 


- 


2 


20 


1 


6 


2 


24 


12 


_ 


8 


16 


- 


26 


1 


10 


12 


- 


12 


- 


11 


6 


- 


26 


11 


18 


_ 


26 


- 


21 


5 


13 


4 


7 


,3 
10 


2 
24 


2 


- 


1 


9 


6 


4 


1 


o 


- 


12 



Day, Emily, 
Demming, John H., . 
Davis, Edward, . 
Drinkwater, Lottie V., 
Evans, M. A., . 
French, Evander, 
Fairbanks, Rosella, 
Flagg, Sabrina, . 
Frost, Mary D., . 
.Frost, Emma, 
Foster, W. H., . 
Francis, Converse, 
Follett, William, . 
Foster, Clara E., 
Fisher, Cornelia, 
Foster, Ira, .... 
Greene, Marshall, 
Garfield, Charlotte A., 
Goldthwaite, A., . 
Gunn, Jessie, 
Gale, Frederick, . 
Holmes, James W., and wife, 
Holden, Myrick, . 
Hapgood, Augustine, . 
Hapgood, Horace A., . 
Howard, Irving M., . 
Holmes, Susan E., 
Johnson, John, . 
Johnson, John, Jr., 
Jordon, George F., . 
Kellogg, Emma, . 
King, George T., 
Keep, Endora, . 
Keep, William E., 
Kinsley, Frederick, 
Lane, Frederick, 
Mellen, Mary E., 
Maynard, Joseph G., . 
Martin, Edgar M., 
Merrick, Charles V., . 
Merriam, W. F., . 
Mellen, J. F., . 
Miles, Antoinette, 
Morrison, Sarah R., . 
Mullett, Henry S., . 
Nourse, John F., 
Newton, Elizabeth, 
Newhall, Albert,. 
Powers, James W, 
Prentiss, Juliette L., . 
Powers, F. F., . 



$16 50 

148 29 

31 25 

21 92 
138 00 
289 22 

16 50 

136 05 

91 42 

18 06 

50 00 

644 25 

339 64 

31 78 
27 89 
85 69 

370 00 

22 00 
46 53 
33 84 
65 87 

227 50 
296 64 
213 09 
169 29 
211 42 
79 00 
900 00 

32 70 

29 15 

30 89 
854 94 

73 07 

21 68 

33 30 

280 00 
165 00 

281 24 

23 83 
298 39 

23 83 
16 12 
65 62 
46 48 
76 94 
271 60 

22 00 
32 22 

141 28 

16 66 

9 96 



16 LUNATIC HOSPITAL AT WORCESTER. 

III. — Expenditures — Concluded. 



[Oct. 



NAMES. 



Months. 


Days. 


5 


13 


11 


13 


6 


- 


12 


- 


5 


13 


1 


3 


- 


18 


12 


- 


12 


- 


10 


17 


3 


23 


4 


24 


3 


28 


6 


- 


1 


28 


- 


13 


- 


13 


3 


- 


1 


- 


10 


22 


1 


19 


- 


24 


4 


4 


12 


_ 


10 


2 


2 


- 


12 


- 


12 


- 


, 12 


- 


12 


- 


11 


10 


8 


3 


4 


26 


2 


5 


1 


15 


- 


- 



Bedhead, Fanny, 
Richardson, I. C., 
Richardson, Fannie, . 
Richardson, Edward E., 
Ranger, Carrie F., 
Roberts, Daniel W., . 
Raymond, Jennie M., . 
Sanderson, Alfred, 
Sherman, William, 
Scripter, Abbie E., 
Sawyer, Mary R., 
Sibley, Sidney, . 
Sibley, George C, 
Sanderson, J. M., 
Smith, Carrie C, 
Scott, Gilman, and wife, 
Stone, Josephine A., . 
Smith, George E., 
Twichell, Daniel E., . 
Tidd, Alice F., . 
Taft, Jessie C, . 
Titcomb, Abner F., . 
Thurston, M. B., 
Vinton, Clarissa F., , 
Williams, Pamelia, 
Walker, Sophronia, . 
Wood, Amos, 
Wood, Thomas, . 
Wright, Jennie W., . 
Woodburn, Nettie, 
Wetherby, Alfred, 
West, Hattie L., . 
Wood, Horace, . 
Wordie, Charles, 
Wetherby, Albert, 



Total, 



$91 12 

210 68 

104 98 

300 00 

77 96 

26 36 

7 70 

336 00 

900 00 

132 16 

43 16" 

129 01 

97 96 

135 00 

24 38 

14 17 

5 50 

50 00 
23 25 

137 64 
40 30 
19 92 

51 47 

138 00 
161 50 

22 00 
600 00 
300 00 
300 00 
150 00 
171 54 

90 14 
121 57 

54 10 

31 91 



$18,168 95 



Salaries and wages, 
Paid for labor, . 



Total for salaries, wages and labor, . 



2d — Provisions and supplies, viz. 
Meats of all kinds, 
Fish of all kinds, . 
Fruit and vegetables, . 
Flour, .... 
Grain and meal for table, 



$18,168 95 
1,052 44 

$19,221 39 



19,279 74 

887 21 

2,016 09 

7,354 99 

464 87 



1866.] 



PUBLIC DOCUMENT— No. 22. 



17 



Grain and meal for stock, 
Tea, coffee and chocolate, 
Sugar and molasses, • 
Milk, butter and cheese, 
Salt and other groceries, 
All other provisions, 



Total for provisions and supplies, 

3d— Clothing, . . ■ . 
4th — Fuel and lights, .... 
5th — Medicine and medical supplies, 
6th — Furniture, Beds and Bedding, 
7th — Transportation and travelling expenses 
8th — Ordinary repairs, .... 
9th — Expenses of the trustees or inspectors 
10th — All other expenses, 

Total current expenditures, 



$1,751 66 
1,751 98 
2,751 77 
5,439 39 
1,148 58 
728 41 



$33,574 69 





4,734 38 




15,427 60 




1,028 52 




2,613 14 




195 13 




4,948 22 




5 66 




5,271 60 




$S7,020 33 



[ B. ] Extraordinary Expenditures. 



1st — Buildings and improvements, . 

Building two bank walls, . . $728 40 

Finishing off reading room, . 150 00 

Alteration of kitchen, . . 250 00 



L,128 40 



2d — Extraordinary repairs, 
Piggery, . 



$250 00 



3d — Miscellaneous expenses, . 

Paid note at Mechanics' National 

Bank, . . '. . . $25,828 26 
Paid for interest on loans, . . 374 00 

Refunded for over-payment, . 26 69 

Total extraordinary expenditures, . 

Total expenditures, .... 



250 00 



26,228 95 



27,607 35 
$114,627 68 



IV . — Liabilities . 

Salaries unpaid, $4,736 96 

Miscellaneous bills, as per vouchers, etc., 7,409 23 

Money borrowed and not repaid, 20,329 38 

Interest due on loans or bills, 413 53 

Total liabilities, $32,889 10 

3 



18 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



V. — Cash Account. 

Dr. 

To cash on hand, October 1, 1865, ' . 

since drawn from the State treasury at sundry times, 

received from sale of produce, 

received from sale of other articles, 

received from loans, 

received from all other sources, . 



Total, 



Cr. 



By cash paid for money borrowed, . 
for interest on bills, 
for salaries, wages and labor, 
for provisions and supplies, . 
for fuel and lights, 
for clothing, furniture and beddin 
for repairs and improvements, 
for all other ordinary expenses, 
for extraordinary expenses, . 
on hand, September 30, 1866, 

Total, 



$1,040 40 


19,728 25 


3,854 09 


32,500 00 


57,537 18 


$114,659 92 


$25,828 26 


374 00 


19,221 39 


33,574 69 


15,427 60 


7,347 52 


4,948 22 


6,500 91 


1,405 09 


32 24 


$114,659 92 



VI. — Summary op the Above. 

Total receipts, $114,659 92 

Total expenditures, • . 114,627 68 

Cash on hand, $32 24 

Total liabilities, $32,889 10 

Total Resources, (including debts due the institution to the 
amount of $0,000.00, and unexpended appropriations to the 
amount of $0,000.00,) 16,629 74 

Balance of liabilities, for or against the institution, . . . $16,259 36 

I consider the current expenses of the institution for the year 1865-6 to have 
been ninety-one thousand four hundred and forty-five dollars and fifty- 
seven cents, as appears by the following statement : — 



Dr. 

To cash on hand, October 1,1865, . 

since drawn from the State treasury, 
received from all other sources, . 

Total, 



$1,040 40 
19,728 25 
93,891 27 



$114,659 92 



1866.] PUBLIC DOCUMENT— No. 22. 19 

Cr. 

By increased cash value of personal assets, .... $1,393 00 

cash on hand, September 30, 1866, 32 21 

paid for all current expenses, 87,020 33 

Total, $91,115 57 

During the year my average number of inmates has been, . 368 
Dividing the current expenses by the average number of inmates 

gives an average annual cost of, $218 09 

And an average weekly cost of, 1 77 



(Signed,) 



MERRICK BEMIS 



Superintendent of Worcester Lunatic Hospital. 



We have examined the above statement and believe it to be correct. 

WILLIAM WORKMAN, 
HENRY CHAPIN, 

Trustees. 



20 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



OFFICERS OF THE HOSPITAL. 



TRUSTEES. 

WILLIAM WORKMAN, M. D., . . . Worcester. 

HON. SAMUEL E. SEW ALL, .... Boston. 

HON. EDWIN F. JENKS, .... Adams. 

ROBERT W. HOOPER, M. D., . ■ . Boston. 

HON. HENRY CHAPIN, Worcester. 



BESIDE NT OFFICERS. 

MERRICK BEMIS, M. D., .... Superintendent. 

JOSEPH DRAPER, M. D., . . . . Assistant-Physician, 

CAROLINE A. BEMIS, Matron. 

DANIEL W. BEMIS, Steward. 



TREASURER. 



DANIEL W. BEMIS, 

Office at the Hospital. 



Worcester. 



SALARIED OFFICERS OF THE HOSPITAL. 



Superintendent, 

Assistant-Physician, 

Matron, . 

Steward and Treasurer, 



$1,800 00 

900 00 

200 00 

1,000 00 



1866.] 



PUBLIC DOCUMENT— No. 22. 



21 



SUPERINTENDENT'S REPORT. 



To the Trustees of the Worcester Lunatic Hospital. 

Gentlemen : — In obedience to the laws of the Commonwealth, 
I submit to you the Thirty-Fourth Annual Report of the Wor- 
cester Lunatic Hospital for the year ending September 30th, 
1866. 

For the operations of the year in detail you are respectfully 
referred to the following tables, and such brief explanations 
and remarks as accompany them. 



Table No. 1. 
Showing the general results during the Year. 





Males. 


Females. 


Total. 


Patients in the Hospital Oct. 1, 1865, 


169 


172 


341 


admitted during the year . 




163 


126 


289 


Whole number under treatment, 




332 


298 


630 


Discharged recovered, 




42 


47 


89 


improved, 




58 


37 


95 


not improved, 




15 


10 


25 


Died, 




27 


13 


40 


Whole number discharged during the year, 


142 


107 


249 


remaining September 30, 1866, 


190 


191 


381 



Thus it will be seen that the number of patients in the hos- 
pital at the beginning of the year was three hundred and forty- 
one, of whom one hundred and sixty-nine were males and one 
hundred and seventy-two were females. 

The number admitted during the year was two hundred and 
eighty-nine, of whom one hundred and sixty-three were males 
and one hundred and twenty-six were females. 



22 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

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

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

The whole number remaining in the hospital is three hun- 
dred and eighty-one, of whom one hundred and ninety are 
males and one hundred and ninety-one are females. 

Of the two hundred and forty-nine patients discharged, 
eighty -nine were discharged as recovered, and have returned 
to their homes and friends, and have resumed the ordinary 
duties and activities of life ; and ninety-five were discharged as 
improved. Many of this class have returned to their former 
occupations, and some of them are filling places of responsi- 
bility and trust, and are performing their duties in a manner 
satisfactory to their friends and employers. Others, though 
not recovered, have become so tranquil and are so much 
improved in health of body and mind as to cause their relatives 
and friends but little anxiety, and to require from them but a 
small amount of care and direction. 

The recoveries were in the ratio of thirty per cent, to the 
whole number admitted ; or a fraction more than twenty-four 
per cent, to the average number under treatment ; or fourteen 
per cent, to the whole number in the hospital during the year ; 
or forty per cent, to the whole number discharged, after 
deducting the number of those who died. The recoveries 
were also in the ratio of sixty-three per cent, to the number of 
those whose insanity had existed less than one year, and only 
ten per cent, to the number of those who had been insane 
more than one year previous to admission to the hospital. 

You will readily see that the percentage of recoveries is 
somewhat less than the average of preceding years, a result 
due in part to the fact that a larger proportion of admissions 
than usual took place toward the end of the year ; and these 
cases are of course still under treatment ; and in part, also, to 
the fact that a large number of the admissions in the early part 
of the year were chronic cases. 

The ratio of deaths to the whole number under treatment was 
six per cent., and ten per cent, the average number of residents. 



1866.] PUBLIC DOCUMENT— No. 22. 23 

In looking over the records of the hospital, we find that 
seven thousand six hundred and fourteen patients — three thou- 
sand seven hundred and eighty-three males, and three thousand 
eight hundred and thirty-one females — have been admitted into 
the hospital since it was opened in January, 1833. Of this 
number three thousand five hundred and sixty-seven have 
recovered, giving a ratio of nearly fifty per cent., after deduct- 
ing the number of those who still remain under treatment. 

One thousand four hundred and nineteen patients have been 
discharged improved in health of body and mind, very many of 
whom have passed a long period of time in great comfort, and 
are, and have been, useful members of the communities in 
which they live. The number of those discharged as improved, 
added to the number of recoveries, makes the number of those 
who have received benefit by a residence in this hospital four 
thousand nine hundred and eighty-six. 

Thus much the hospital has been the means, in some measure 
at least, of accomplishing. It has certainly been instrumental 
in sending back to the world in health and happiness three 
thousand five hundred and sixty-seven individuals. 

It has been the means of giving a tolerable degree of health 
and comfort to one thousand four hundred and nineteen 
patients who did not fully recover within its walls, but many of 
whom were restored to such a measure of health as to enable 
them to return to their accustomed occupation, and to take 
charge of their families. And besides all this, it constantly 
affords security, peace and comfort to a large and troubled 
household. The hospital has taken from families and friends, 
from poor-houses and prisons, from the streets and by-ways, 
the sick and sorrowing, the violent and dangerous, the suicidal 
and homicidal, and has given back to society, in full possession 
of mental and physical health, more than fifty per cent, of all 
it received. It has also relieved and sent back in comparative 
comfort, though not cured, eighteen per cent, more of the 
whole number committed to its care. 

All this, and more, has been accomplished by the hospital, at 
the small cost of not more than one hundred and seventy-five 
thousand dollars to the State for buildings, fixtures and land, and 
to the patients and the Commonwealth not more than an average 
of one-half year's support to each individual so returned. 



24 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



In view of these facts you should enjoy a reasonable degree 
of satisfaction in the success of your institution, and be encour- 
aged to press upon the legislature such measures as you may 
deem necessary for its future usefulness and welfare. 

Table No. 2. 

Showing the Admissio?is and state of the Hospital from October, 1865, 

to September 30, 1866. 



Patients in the Hospital October 1, 1865, .... 

Males, .... 169 Females, 
Patients admitted in the course of the year, .... 

Males, .... 163 Females, 
Patients remaining in the Hospital September 30, 1866, 

Males, . . . .190 Females, 
Of the admissions there were cases of one year or less duration, 

Males, . .. ■ . .110 Females, 

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

duration, . .' 

Males, .... 46 Females, 

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

Males, . . . . 7 Females, 

Patients committed by Courts, . ... 

Males, .... 101 Females, 
Patients committed by Overseers of the Poor, 

Males, .... 10 Females, 

Patients on bonds, . . .... 

Males, . ' . . . 45 Females, 
Patients committed by Governor's Warrant, 

Males, .... Females, 

Patients committed by the Board of State Charities, . 

Males, .... 7 Females, 

Patients committed by Commissioners of Lunacy, 

Males, .... Females, 

Foreigners and those having no settlement in the State, committed 

in course of the year, 

Males, .... 63 Females, 

Foreigners and those having no settlement in the State, discharged 

in course of the year, 

Males, .... 45 Females, 

Foreigners and those having no settlement in the State, remainin 
in the Hospital, September 30, 1866, .... 

Males, .... 54 Females, 



341 



172 



289 



126 



381 



191 



203 



93 



31 



77 



191 



90 



10 



22 



20 



67 



125 



62 



87 



42 



129 



1866.] 



PUBLIC DOCUMENT— No. 22. 



25 



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



1842, 


34 


1851, . 


. 201 


1860, 


. 130 


1843, 


38 


1852, . 


. 241 


1861, 


. 156 


1844, 


38 


1853, . 


. . 216 


1862, 


. 189 


1845, 


57 


1854, . 


. 151 


1863, 


. 175 


1846, 


52 


1855, . 


. 115 


1864, 


. 116 


1847, 


121 


1856, . 


. 155 


1865, 


91 


1848, 


. 150 


1857,' . 


. 119 


1866, 


. 129 


1849, 


. 167 


1858, . 


. 121 






1850, 


. 1S1 


1859, . 


. 124 







The foregoing illustrates the manner of commitment to the 
hospital, the duration of insanity previous to commitment, and 
to some extent the status of patients while in the hospital. It 
appears that there were admitted sixty-seven patients on private 
bonds, and twenty on bonds from towns ; these bonds always 
being accompanied by certificates from two physicians that the 
persons for whom applications were made were insane. 

One hundred and ninety-three were committed by the pro- 
bate court, and eight by the board of state charities. A few 
of those committed by the probate court are persons of prop- 
erty, and are charged at the same rate as private patients. 
And many of the town patients are committed by the court, 
the authorities of the towns preferring this method to giving 
their bonds. 

A reference to the table shows also that you have discharged 
eighty-seven persons who had no settlement in the Common- 
wealth, and that one hundred and twenty-nine still remain who 
are supported by the charity of the State, nearly all of whom 
are of foreign birth. 

The greatest number of patients under treatment at any one 
time during the year was three hundred and ninety-three. The 
greatest number of private patients one hundred and twenty, 
of town patients one hundred and fifty-three, and of State 
patients one hundred and thirty-five. 

The weekly average number of inmates was three hundred 
sixty-eight and six-tenths. The weekly average of private 
4 



26 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

patients was one hundred and twelve and four-tenths ; of town 
patients one hundred and forty-three and eight-tenths ; and of 
State patients it was one hundred and twelve and four-tenths. 

The board of state charities have removed to other institu- 
tions and to their homes twenty-eight State patients in the 
course of the year. This number were all recommended to 
you for discharge previous to their removal, and it is believed 
that none have been discharged whose mental and physical 
condition did not make such a measure advisable. 

No very feeble person has been removed, and no unusually 
violent, filthy or destructive patient has been discharged. In 
all cases where State patients have been removed to other insti- 
tutions, or to their homes or friends previous to recovery, they 
have not only been carefully observed by yourselves, but have 
been visited by the agent of the board of state charities and 
their cases fully investigated before any steps have been taken 
to procure their discharge ; and when relatives or friends have 
been known their wishes have always been consulted. 

Ten State patients have died in the course of the year. 

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

For a few, situations have been procured where they could 
labor and receive wages. Others have been permitted to do 
such work in the neighborhood as they could find to do, and 
have received all the profits. Two men have earned and col- 
lected more than one hundred dollars each during the year. 
Several others have earned smaller sums, varying from twenty 
to fifty dollars each. Two have secured patents on inventions 
of their own, models of which were made here by the patients. 

Three patients eloped in the course of the year, each of 
whom had on previous occasions escaped from the hospital. A 
history of their several escapes would form an interesting nar- 
rative to- all not conversant with hospital life and experience. 
They all returned to their- friends. 



1866.J 



PUBLIC DOCUMENT— No. 22. 



27 



Table No. 3, 

Showing the Number Admitted, Restored, Improved, Died, fyc, in each 

Month in the Year. 





Admitted. 


Removed. 


Remaining. 


MONTHS. 








o 


-a 

> 

p 


■a 

t> 
p 

ft 

S 




















01 


tn 


K 


S 
i— i 


o 
185 


5 




o 
Eh 






« 
































« 


o 


o 


tvt. 


F. 


pvr. 


f. 


M, 


F. 


M 


F. 


M. 


F. 


T. 


3 


s 


o 




S 


fc< 


H 
























r$ 




H 


October, . . 


12 


7 


19 


4 


1 


4 


1 






3 




11 


2 


13 


170 


177 


347 


November, • 


18 


12 


30 


3 


7 


6 


6 


- 


1 


o 


3 


11 


17 


28 


177 


172 


349 


December, . 


10 


15 


25 


5 


4 


6 


1 


- 


1 


3 





14 


8 


22 


173 


179 


352 


January, . . 


13 


10 


23 


2 


1 


4 


- 


1 


1 


- 


- 


7 


2 


9 


179 


187 


• 366 


February, 


17 


6 


23 


3 


8 


- 


1 


1 


2 


1 


- 


5 


11 


16 


191 


182 


373 


March, . . 


11 


4 


15 


- 


3 


9 


5 


o 


1 


1 


- 


12 


9 


21 


190 


177 


367 


April, . . . 


13 


5 


18 


4 


4 


3 


3 


4 


1 


3 


- 


14 


8 


22 


189 


174 


363 


May, . . . 


15 


10 


25 


5 


4 


2 


6 





- 


3 


- 


12 


10 


22 


192 


174 


366 


June, . . . 


19 


15 


34 


1 


5 


3 


4 


o 


- 


o 


1 


8 


10 


18 


203 


179 


382 


July, . . . 


8 


21 


29 


9 


1 


3 


2 


1 


1 


5 


4 


12 


8 


20 


199 


192 


391 


August, . . 


9 


13 


22 


8 


610 


3 


1 


9 


1 


2 


20 


13 


33 


188 


192 


380 


September, . 


18 
163 


8 
126 


26 
289 


4 

42 


31 8 


5 
37 


1 


- 


3 

27 


1 
13 


16 
142 


9 
107 


25 
249 


190 


191 


381 


Totals, . . 


47 


58 


15 


10 


- 


- 


- 



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

the year. 





Admitted. 


Discharged. 


FORM of disease. 


8 


n 
a 

o 

Eh 


o 

H 


"3 
8 


a 

a 


"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, 


93 

14 

8 

5 

16 

15 

7 

4 

1 


87 
12 
4 
1 
7 
10 
2 
1 

1 

1 


180 

26 

12 

6 

23 

25 

9 

5 

1- 

1 

1 


62 

26 

6 

6 

12 

17 

9 

3 

1 


66 
17 
2 
1 
7 
11 
1 

1 

1 


128 
43 

8 

7 

19 

28 

10 

3 

1 

1 

1 


Totals, .... 


163 


126 


289 


142 


107 


249 



28 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 5. 

Supposed Causes of Insanity of Patients admitted into the Hospital 

from January 18, 1833, to September 30, 1865. 









1866. 


Previously. 


CAUSES. 












Males. 


Females. 


Males. 


Females. 


Apoplexy, 


_ 


_ 


1 


2 


Asthma, .... 






- 


- 


1 


- 


Bronchitis, 






- 


- 


- 


1 


Bowels, Disease of, . 






- 


- 


1 


- 


Cancer, .... 






- 


- 


- 


1 


Chorea, .... 






- 


- 


- 


3 


Constipation, . . . 






- 


- 


- 


- 


Convulsions, . 






- 


- 


10 


12 


Dysentery, 






- 


- 


2 


2 


Dyspepsia, 






1 


1 


2 


1 


Epilepsy, 






10 


5 


167 . 


59 


Eruptive Diseases, . 






- 


- 


3 


3 


Eyes, Disease of, 






- 


- 


o 


- 


Eyes, Loss of, . 






- 


- 


1 


- 


Erysipelas, 






- 


- 


- 


1 


Fevers, .... 






2 


4 


49 


68 


Hysteria, . . . 






- 


- 


- 


1 


Hemorrhoides, 






- 


- 


1 


1 


111 Health, 






32 


42 


184 


858 


Influenza, 






- 


- 


1 


3 


Insolation, 






3 


- 


16 


- 


Idiocy, .... 






3 


1 


15 


9 


Laryngitis, 






- 


- 


- 


- 


Measles, .... 






- 


- 


4 


6 


Nervous Irritation, . 






- 


- 


- 


- 


Nymphomania, 






- 


- 


- 


4 


Old Age, 






5 


2 


23 


29 


Otitis, 






- 


- 


- 


- 


Paralysis, 






11 


1 


66 


27 


Pneumonia, 






- 


- 


- 


- 


Rheumatism, . 






- 


- 


5 


1 


Scrofula, 






1 


- 


1 


2 


Sea-sickness, . 






- 


- 


1 


1 


Somnambulism, 






- 


- 


- 


2 


Suppressed Eruptions, 






- 


- 


4 


3 


Suppressed Ulcer, . 






-. 


- 


1 


3 


Satyriasis, 






- 


- 


1 


- 


Tic Douloureux, 






- 


- 


- 


1 


Tumor, . 






- 


- 


- 


1 


Whooping Cough, . 






- 


- 


1 


- 


Amenorrhea, . 






- 


- 


- 


21 


Lactation, Excessive, 






- 


- 


- 


3 


Menorrhagia, . 






- 


1 


- 


9 


Menorrhagia, Suppressed 






- 


- 


- 


27 


Miscarriage, . 






- 


- 


- 


4 


Pregnancy, 






- 


1 


- 


11 


Puerperal, 






- 


9 


- 


211 


Turn of Life, . 






" 


5 




72 



1866.] PUBLIC DOCUMENT— No. 22. 

Table No. 5— Concluded. 



29 











1866. 


Previously. 


CAUSES. 












Males. 


Females. 


Males. 


Females. 


Amputation of Leg, 


_ 


_ 


1 


_ 


Bathing in Cold Water, 






1 


- 


1 


- 


Drinking Cold Water, 






- 


- 


1 


- 


Exposure to Cold, . 






- 


- 


11 


13 


Injuries by Falling, &c. 






- 


- 


20 


6 


Injury of Head, 






5 


- 


55 


13 


Injury of Spine, 






- 


- 


5 


7 


Lead, Poison of, 






- 


- 


5 


- 


Lightning, Stroke of, 






- 


- 


- 


1 


Labor, Excessive, . 






2 


2 


42 


58 


Loss of Sleep, 






- 


- 


- 


' 3 


Study, Excessive, . 






3 


1 


26 


11 


Spiritualism, . 






- 


- 


20 


24 


Criminal Trial, 






- 


- 


- 


1 


False Accusation, . 






- 


- 


- 


1 


Imprisonment, 






- 


- 


4 


- 


Death of Relatives, 






2 


4 


28 


82 


Domestic Trouble, . 






3 


6 


111 


337 


Marriage, Unhappy, 






- 


- 


2 


5 


Disappointment in Love, 






2 


2 


64 


98 


Disappointed Ambition, 






- 


- 


9 


9 


Home Sickness, 






_• 


- 


6 


18 


Fright, . 






- 


- 


21 


24 


Seduction, 






_ 


_ 


- 


, 3 


Millerism, 






- 


- 


9 


6 


Political Excitement, 






1 


- 


9 


1 


Religious Excitement, 






_ 


- 


156 


177 


Pecuniary Trouble, 






2 


- 


142 


37 


Poverty, . 






- 


- 


1 


1 - 


Poverty, Fear of, . 






1 


- 


31 


8 


Prosecution, . 






- 


- 


1 


- 


Giving up Business, 






- 


- 


2 


- 


Change of Business, 






_ 


- 


8 


- 


Violent Temper, 






- 


- 


2 


13 


Jealousy, 








- 


1 


18 


27 


Intemperance, 








25 


12 


588 


72 


Opium, Use of, 








- 


- 


3 


9 


Tobacco, Use of, 








- 


- 


2 


7 


Masturbation, . 








14 


6 


369 


60 


Venery, Excess of, 








- 


- 


1 


- 


Unknown, 






35 


21 


1,083 


1,112 


Totals, . 






• 


163 


126 


3,620 


3,705 



Of the above there were — 



Hereditary cases, .... 


28 


15 


. 577 


794 


Periodical cases, .... 


24 


19 


599 


635 


Hereditary and Periodical cases, 


8 


3 


382 


414 


Suicidal cases, .... 


13 


16 


101 


246 


Homicidal cases, .... 


10 


3 


149 


46 


Suicidal and Homicidal cases, 


1 


- 


48 


28 



30 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 6, 

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



AGES. 


Admitted. 


Discharged Re- 
covered. 


Discharged not 
Recovered. 


Died. 




Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Less than 15, . 


1 








1 








From 15 to 20, 


8 


9 


- 


2 


4 


3 


- 


1 


20 to 30, 


38 


27 


10 


11 


10 


9 


4 


2 


30 to 40, 


44 


35 


13 


10 


17 


10 


5 


2 


40 to 50, 


32 


26 


8 


9 


13 


10 


4 


3 


50 to 60, 


20 


16 


6 


11 


13 


7 


4 


3 


60 to 70, 


11 


6 


3 


4 


12 


6 


6 


1 


70 to 80, 


7 


5 


1 


- 


2 


2 


4 


1 


80 to 90, 


2 


1 


1 


- 


1 


- 


_ 


- 


Unknown, . . 


- 


1 


- 


- 


- 


- 


- 


- 


Totals, . . 


163 


126 


42 


47 


73 


47 


27 


13 



Table No. 7, 

Showing the Ages of Patients Admitted, Discharged Recovered, not 
Recovered and Died, from January 18, 1833, to September 30, 1865. 









Discharged Re- 


Discharged not 








Admitte 










Died. 








covered. 


Recover] 






AGES. 




















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 



1866.] 



PUBLIC DOCUMENT— No. 22. 



31 



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'd not 
Recovered. 


Died. 


DURATION OF INSANITY. 


Males. 
Females. 


to 

'a 


CO 

i 




03 




"a 

s 

o 


Insane 1 year or less, 

More than 1 year, and less than 
2 .years, 

More than 2 years and less than 
5 years, . . . .• . 

More than 5 years, and less than 
10 years, .... 

More than 10 years, and less 
than 15 years, 

More than 15 years and less 
than 20 years, 

More than 20 years and less 
than 25 years, 

More than 25 years and less 
than 30 years, 

Thirty years or more, 

Unknown, 


110 

12 

19 

9 

5 

1 

1 

6 
163 


93 

4 

15 

7 
4 

3 

126 


37 
2 
1 
2 

42 


40 
3 

4 

47 


19 
36 

7 
6 

o 

3 


8 
12 
11 
9 
5 
2 


14 
8 
3 
2 

27 


9 
1 
3 


Totals, *...'. 


73 


47 


13 



32 



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. 




»5 








03 








C3 
1 


"a 


1 


"3 
8 


"3 

S 
o 


Males. 
Femal 


Insane one year or less, . 


2,277 


2,505 


1,273 


1,405 


622 


597 


217 


268 


More than one 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 


45 


24 


21 


45 


31 


8 


8 


Totals, . 


3,620 


3,704 


1,663 


1,805 


1,350 


1,288 


438 


440 



1866.] 



PUBLIC DOCUMENT— No. 22. 



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 
Recovered. 


Died. 


CONDITION. 


Males. 


Females. 


Males. 


Females 


Males. 


Females. 


Males. 


Females. 


Unmarried, . 

Married, 

Widowers, 

Widows, 

Unknown, 


S2 

68 
13 


52 
49 

24 
1 


19 

19 

4 


15 
25 

7 


43 

26 

4 


21 
21 

5 


9 

13 
5 


4 

7 

2 


Totals, 


163 


126 


42 


47 


73 


47 


27 


13 



Table No. 11, 

Showing the Civil Condition of Patients Admitted, Discharged Recovered, 
not Recovered, and Died, from January 18, 1833, to September 30, 
1866. 



CIVIL 


Admitted. 


Discharged Re- 
covered. 


Discharged not 
Recovered. 


Died. 


CONDITION. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Unmarried, . 

Married, 

Widowers, 

Widows, 

Unknown, 


1,909 

1,529 

159 

23 


1,582 
1,673 

430 
20 


821 

776 

63 

3 


719 

874 

209 
3 


815 
475 

48 

12 


681 
466 

127 
14 


172 
212 

48 

6 


187 
171 

80 
2 


Totals, 


3,620 


3,705 


1,663 


1,805 


1,350 


1,288 


438 


440 



34 



LUNATIC HOSPITAL AT WORCESTER. 



[Oct. 



Table No. 12, 

Showing the Occupation of Patients admitted to the Hospital from 

January 18, 1833, to September 30, 1866. 



OCCUPATION OF MALES. 


1866. 


Previously. 


Auctioneers, . . . . 




2 


Armorers, .... 








- 


3 


Authors, 








- 


3 


Blacksmiths and Iron-workers, . 








5 


61 


Bakers, 








1 


11 


Butchers, 








- 


5 


Book-agents, . . 








- 


2 


Book-binders, .... 








- 


3 


Broom-makers, 








- 


2 


Book-keepers, .... 








1 


9 


Brittania-workers, . 








- 


2 


Brick-makers, .... 








- 


6 


Bellows-makers, 








- 


2 


Barbers, 








2 


13 


Clergymen, .... 








1 


24 


Carvers, 








1 


2 


Carpenters, .... 








7 


118 


Coppersmiths, .... 








- 


9 


Coopers, .... 








- 


22 


Cabinet-makers, 








1 


16 


Clothiers, 








- 


15 


Comb-makers, .... 








- 


4 


Confectioners, . 








- 


3 


Card-makers, . 








- 


1 


Chair-makers, . 








- 


3 


Cigar-makers, . ' . 








1 


5 


Clerks, .... 








11 


91 


Carpet-weavers, 








- 


3 


Caulkers, 








- 


3 


C amphene-distillers, 








- 


3 


Dyers, .... 








- 


3 


Druggists, 








- 


3 


Drovers, .... 








- 


2 


Daguerreotypists, 








- 


3 
2 


Engineers, 








— 


Engravers, 








- 


4 


Editors, .... 








- 


4 


Expressmen, . 








- 


14 


Farmers, .... 








23 


723 


Fishermen, . . . a 








- 


33 


Gardeners, 








- 


9 


Glass-blowers, . 








- 


4 


Hotel-keepers, . 








1 


13 


Hatters, .... 








. 1 


6 


Harness-makers, 








- 


14 


Hackmen and Teamsters, 








2 


33 


Jewellers, 








3 


18 


Lawyers, .... 








3 


12 



1866.] PUBLIC DOCUMENT— No. 22. 

Table No. 12 — Continued. 



35 



OCCUPATION OF MALES. 



Previously. 



Laborers, 

Manufacturers, 

Millers, .... 

Merchants, 

Masons, .... 

Miners, .... 

Miniature-painter, . 

Mat-makers, 

Musicians, 

Machinists, 

Moulders, 

Operatives in Mills, . 

Palm leaf splitter, 

Painters, . . 

Printers, .... 

Physicians, 

Paper-makers, . 

Peddlers, .... 

Potter, .... 

Pump and Block-makers, 

Pattern-makers, 

Plumbers, 

Police Officers, 

Rope-makers, . 

Restaurators, . 

Shoemakers and Bootmakers, 

Sail-makers, 

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, .... 



33 



1 

14 



817 

31 

6 

149 

30 
4 
1 
3 
7 

43 
7 

82 
1 

46 

32 

20 
7 

13 
1 
4 
4 
5 
3 

10 
8 
286 
9 
8 
3 

16 
158 

56 
8 
3 
9 

22 
1 
1 
2 

27 

26 

33 
3 
7 

19 
2 

18 
232 



163 



3,620 



36 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 12 — Concluded. 



OCCUPATION OF FEMALES. 



Previously. 




Actresses, 
Cooks, 
Engraver, 
Housekeepers, . 
Housemaids, 
Laundresses. . 
Music Teachers, 
Midwives, 
Nurses, . 
Operatives in Mills, 
Seamstresses, . 
School-girls, 
Teachers, 
Type-setters, . 
No occupation, 

Totals, . 



Table No. 13. 
Diseases which have proved fatal, from January 18, 1833, to September 

30, 1866. 











1806. 


Previously. 


DISEASES. 












Males. 


Females. 


Males. 


Females. 


Apoplexia, 


1 


1 


15 


10 


Asphyxia, 








- 


- 


2 


- 


Asthma, . 








— 


— 


4 


1 


Ascites, . 








- 


- 


5 


7 


Autochiria, 








1 


- 


15 


11 


Bronchitis, 








- 


- 


2 


- 


Carcinoma, 








- 


- 


2 


2 


Cardionosus, . 








2 


1 


9 


11 


Cholera, . 








- 


- 


5 


- 


Cholera Morbus, 








- 


- 


2 


3 


Cystitis, . 








- 


- 


1 


1 


Dysenteria, 








- 


- 


12 


6 


Delirium Tremens, 








- 


- 


4 


- 


Enteritis, 








_ 


- 


6 


9 


Epilepsia, 








1 


1 


70 


32 


Erysipelas, 








- 


- 


9 


10 


Hepatitis, 








- 


- 


- 


2 


Hydrothorax, . 








- 


- 


1 


1 


Hernia, . 








- 


- 


1 


- 


Inanitio, . 








2 


2 


34 


55 



1866.] PUBLIC DOCUMENT— No. 22. 

Table No. 13 — Concluded. 



37 









1866. 


Previously. 


DISEASES. 












Hales. 


Females. 


Males. 


Females. 


Mania, Exhaustive, 


3 


3 


10 


11 


Marasmus, . . • 






3 


1 


65 


67 


Meningitis, 






- 


- 


9 


14 


Mortificatio, . 






- 


- 


- 


1 


Necropneumonia, . 






- 


- 


1 


2 


Paralysis, 






7 


1 


43 


19 


Phthisis Pulmonalis, 






4 


2 


56 


119 


Pleuritis, 






- 


- 


- 


2 


Pneumonia, 






- 


- 


15 


9 


Senectus, 






2 


- 


24 


19 


Typho-Mania, 






1 


1 


7 


10 


Typhoid Fever, 






- 


- 


8 


6 


Variola, . 






- 


- 


1 


- 


Totals, . 




• 


27 


13 


438 


440 



Table No. 14, 

Showing the Admissions from each County, from January 18, 1833, to 

September 30, 1866. 









1866. 


Previously. 




COUNTIES. 








Whole No. 




Males. 


Females. 


Totals. 






Barnstable, 






_ 


128 


128 


Berkshire, 






- 


- 


- 


189 


189 


Bristol, 






- 


- 


- 


294 


294 


Dukes, 






- 


- 


- 


19 


19 


Essex, 






20 


28 


48 


1,056 


1,104 


Franklin, . 






- 


- 


- 


126 


126 


Hampden, 






3 


1 


4 


168 


172 


Hampshire, 






- 


- 


- 


225 


225 


Middlesex, 






53 


38 


91 


1,196 


1,287 


Nantucket, 






- 


- 


- 


32 


32 


Norfolk, . 






7 


5 


12 


618 


630 


Plymouth, 






1 


- 


1 


235 


236 


Suffolk, . 






10 


7 


17 


714 


731 


Worcester, 






66 


46 


112 


2,087 


2,209 


Other States, 






3 


1 


4 


38 


42 


Totals, . 




• 


163 


126 


289 


7,225 


7,514 



38 



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 iveek for each of the Thirty-three Years the Hospital has been in 
operation. 









No. at end 






Expense per 


TEAK. 


Whole 


Average 


of each 


Current expenses 


Annual Expense 


Week for 




Number. 


Jf umber. 


Year. 


of each Year. 


for each Patient. 


each Patient. 


1833, . 


153 


107 


114 


$12,272 91 


$114 67 


§2 25 


1834, . 


233 


117 


118 


15,840 97 


135 38 


2 60 


1835, . 


241 


120 


119 


16,576 44 


137 30 


2 64 


1836, . 


245 


127 


138 


21,395 28 


168 44 


3 12 


1837, . 


306 


163 


185 


26,027 07 


159 64 


3 07 


1838, . 


362 


211 


218 


28,739 40 


136 20 


2 62 


1839, . 


397 


223 


229 


29,474 41 


132 16 


2 53 


1840, . 


391 


229 


236 


27,844 98 


121 59 


2 33 


1841, . 


399 


233 


232 


28,847 62 


123 81 


2 38 


1842, . 


430 


238 


238 


29,546 87 


111 12 


2 13 


1843, . 


458 


244 


255 


27,914 12 


114 40 


2 20 


1844, . 


491 


261 


263 


29,278 75 


112 17 


2 15 


1845, . 


656 


316 


360 


43,888 65 


138 88 


2 66 


1846, . 


637 


359 


367 


39,870 37 


111 06 


2 13 


1847, . 


607 


377 


394 


39,444 47 


104 62 


2 01 


1848, . 


655 


404 


409 


42,860 05 


106 09 


2 04 


1849, . 


682 


420 


429 


40,870 86 


97 31 


1 87 


1850, . 


670 


440 


441 


46,776 13 


106 40 


2 04 


1851, . 


704 


462 


466 


52,485 33 


112 61 


2 16 


1852, . 


775 


515 


532 


43,878 35 


85 20 


1 64 


1853, . 


820 


537 


520 


53,606 66 


103 14 


1 98 


1854, . 


819 


430 


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 


1866, . 


630 


368 


381 


88,398 73 


239 28 


4 60 



The cost of support during the last year, as will be seen by 
the table, has been very great, but in reality not increased above 
that of the year preceding. Several of the former years' bills 
were paid during the year now closed ; thus making the cost 
apparently greater than it really was. There was no essential 
difference between the years 1865 and 1866 in cost of support. 



1866.] 



PUBLIC DOCUMENT— No. 22. 



39 



There is also an apparent discrepancy between the statement 
in the table and that in the financial statement made to the board 
of state charities : the latter appearing considerably greater by 
adding to the expenses the increased amount of assets. 

It has been supposed that the debt, for the removal of which 
you asked legislative assistance last year, accrued from the 
increased cost of supplies, and that a judicious rise in the price 
of board would have prevented the evil. 

The legislature establishes the price for a large class of our 
patients, and indirectly governs the price of another large class ; 
and it was thought unwise and unjust to make the remaining 
class support themselves and assist largely in the support of 
the others. 

But the debt was not created in this manner. 

During the last ten or twelve years, more than sixty thousand 
dollars have been expended in permanent improvements, which 
the hospital has paid for, and which should properly be charged 
to construction. While this work was going on, our income was 
diminished by an Act of the legislature reducing the price paid 
for board of State paupers, and also by making the hospital pay 
the salaries of its officers. And it was again diminished before 
the completion of the work by the breaking out of the rebel- 
lion. The following statement will illustrate our relation to 
the Worcester banks by showing the amount due from the 
hospital at the end of each year. If, however, any note was 
lying overdue at the end of the year, it cannot be shown ; and 
thus, in one or two years, the statement may not be exact. It 
is within the truth. 



Nov. 30, 1856. 


Due 


Worcester 


Bank, 


$9,882 86 


1857. 


Due 


do. 


do. 


8,955 46 


1857. 


Due 


Mechanics' 


Bank, 


9,553 25 


1858. 


Due 


do. 


do. 


2,000 00 


1859. 


Due 


do. 


do. 


- 


Sept. 30, 1860. 


Due 


do. 


do. 


. 10,930 74 


1861. 


Due 


do. 


do. 


10,472 79 


1862. 


Due 


do. 


do. 


. 13,153 70 


1863. 


Due 


do. 


do. 


13,737 62 


1864. 


Due 


do. 


do. 


12,604 48 


1865. 


Due 


do. 


do. 


10,082 17 



40 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



The following table of prices of the more important articles 
of consumption for the last sis years, will show whether we are 
likely to do more the coming year than to furnish needful 
supplies, and keep the buildings in good repair : — 





PRICES. 


ABTICLES. 
















1861. 


1863. 


1863. 


1864. 


1865. 


1866. 


Sugar, .... 


$0 081 


$0 11 


150 14^ 


$0 241 


$0 20 


$0 14 


Molasses, 


26 


46 


55 


1 00 


85 


70 


Tea, .... 


42 


65 


75 


1 15 


1 12 


1 10 


Coffee, .... 


16 


26 


32 


45 


40 


35 


Butter, .... 


16 


23 


28 


55 


47 


50 


Rice, .... 


71 


8 


«t 


14 


12 


11 


Codfish, .... 


3 


4| 


6| 


71 


8 


73 


Beef, .... 


£ 


7 


8 


15 


18 


18 


Flour, of the quality used 
at this Hospital, . 


6f 


7 


8f 


15 


11 


14 


Standard Prints for Dress 
Goods, 


9 


13 


25 


37 


35 


25 


Cottons, 36 inches wide, . 


9* 


21 


35 


65 


40 


32 


Cottons, 45 inches wide, . 


m 


28 


50 


75 


70 


46 


Blankets, 


2 75 


3 50 


6 50 


9 00 


9 50 


7 50 


Coal, .... 


6 50 


6 75 


10 50 


16 50 


15 00 


12 50 



1866.] 



PUBLIC DOCUMENT— No. 22. 



41 



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42 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



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1866.] 



PUBLIC DOCUMENT— No. 22. 



43 



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LUNATIC HOSPITAL AT WORCESTER. 



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1866.] PUBLIC DOCUMENT— No. 22. 47 





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1866.] PUBLIC DOCUMENT— No. 22. 53 



Homicidal. 
Hereditary, 
do 
do 

do 

do do 

Periodical. 

do Sui. do 

Homicidal. 
Suicidal. Periodical. 

Hereditary. do 


do 

Suicidal. 

do 

Hereditary. 


Not improved 

do 
Improved 
Not improved 

do 
Improved 
Not improved 

do 
Improved 

do 
Not improved 
Recovered 
Improved 

do 

do 

do 

do 
Recovered 

do 

do 
Improved 

do 


Recovered 
Improved 
Not improved 

do 
Improved 

do 

do 
Not improved 
Improved 

do 

do 

do 
Recovered 
Improved 

do 


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do 
Remains 

do 

do 

do 
Discharged 

do 
Remains 
Discharged 
Remains 
Discharged 
Remains 
Discharged 

do 
Remains 


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to r-ICO -3 £ £,a rB£ 


5 mths 22 dys 
1 yr 5 mths 
1 yr 5 mths 
1 yr 5 mths 
1 yr 4 mths 
5 mths 22 dys 
1 yr 3 mths 
1 yr 4 mths 
1 yr 1 mth 
1 yr 4 mths 
4 mths 16 dys 
1 yr 4 mths 
11 mths 19 dys 
4 mths 14 dys 
1 yr 3 mths 


Probate Court 

do 

do 

do 

do 

do 

do 

do 

do 
Private Bond 

do 

do 

do 
Probate Court 

do 
The Overseers 
Probate Court 
Private Bond 

do 

do 
Probate Court 
The Overseers 

do 


Probate Court 

do 
The Overseers 
Probate Court 
Private Bond 

do 
Probate Court 
The Overseers 
Probate Court 

do 

do 

do 

do 

do 

do 


CO cocacQ CO GO CO CO CO CO 

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- 


111 health, 
Unknown, 

do 
Epilepsy, 
Unknown, 
111 health, 
Unknown, 
111 health, 
Masturbation 
Epilepsy, 
111 health, 

do 
Epilepsy, 
Unknown, 

do 
111 health, 
Brain fever, 
Unknown, 
111 health, 
Unknown, 

do 
Epilepsy, 
Unknown, 


do 
Epilepsy, 
Intemperanct 
Puerperal, . 
Unknown, 
Death of son 
Masturbation 

do 
111 health, . 
Intemperancf 
Epilepsy, 
111 health, 
Puerperal, 
111 health, 

do 


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54 



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58 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



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1866.] PUBLIC DOCUMENT— No. 22. 59 



Hereditary. 

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64 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



The table of causes gives various particulars regarding the 
oodily and mental condition and health of the patients at the 
time of their admission to the hospital. Very few were in 
general good health and fair bodily condition when committed 
to our care. In eighty-six cases their health was injured and 
their condition reduced, and in a large majority of the remain- 
ing cases, their health indifferent and their general condition 
indicative of danger to life. And in all these cases, their 
mental condition was aggravating their bodily lesions. In 
some, this alone was connected with the derangement of there 
general health ; but there were various other diseases compli- 
cating many of the cases, as epilepsy, paralysis, hysteria, anae- 
mia, cerebral and spinal congestion and irritation, dyspepsia, 
uterine diseases, and diseases of the heart, and disordered 
conditions of the liver. 

In many such cases, when insanity is dependent on organic 
disease, we can expect to do but little more than palliate the 
symptoms. There is no hope of recovery. Appropriate treat- 
ment may, and often does, retard the progress of disease, both 
mental and bodily, and the patients may even enjoy sufficient 
tranquillity of mind to enable them to arrange their affairs, and 
give such advice and direction as they would before their illness 
have wished. 

There is also a class of cases depending on shocks to the 
nervous system, which are productive of insanity, and in which 
there are attendant bodily derangements which require the aid 
of the physician to promote removal. 

Another class of patients, with broken constitutions and with 
various chronic 'degenerations, whose mental faculties are com- 
pletely destroyed, are often sent to end their days in the 
hospital ; namely, those incapacitated by old age — the time of 
life at which this occurs varying with each individual. Others 
are sent who have inherited a low mental organization, and 
they, at an early period of life, break down and become help- 
less, and dependent on others for the performance of every 
office of daily life. 

Another large class are those who are the subjects of epilepsy, 
which, in its progress, induces complete prostration of the 
mental faculties with some, and with others a great irritability 



1866.] PUBLIC DOCUMENT— No. 22. 65 

of the passions and excitement of the mind, which run into an 
attack of mania, attended with violent mental disturbance, the 
presence of delusions and hallucinations which render the 
patient often furious and dangerous, and very difficult of 
control and management. 

Many cases, which have suffered from slight apoplexy and 
paralysis, terminate in mental aberration and impairment of the 
mind, and live for years in the hospital a dreamy kind of 
existence, incapable of any mental effort, and unable to manage 
themselves or their affairs. 

It is quite common to have patients brought to the hospital 
suffering from an attack of acute mania, in whom the lungs 
are in a state of active disease. You will remember some such 
cases when the patients died soon after admission. 

Others have been sent, in whom a typhoid condition has been 
developed by long continued violent excitement, attended with 
general functional derangement of all the organs essential to 
health and life. 

Defective nutrition and various dyspeptic conditions are 
observed in many of those admitted, which probably induced 
insanity by interfering with healthy nutrition. 

Little more need be said in the Annual Report, of treatment, 
medical or moral ; bnt a few words may not be amiss. Moral 
treatment of the insane consists in occupation, recreation, 
education and amusement ; but, in order to secure these, great 
difficulty is often, nay, always experienced. It is difficult to 
secure sufficient novelty and variety ; it is also difficult to 
present matters to the insane mind in a manner which will be 
pleasing and instructive, and it is difficult to fasten .the atten- 
tion so as to interest the patient. Hence it is necessary to 
vary constantly the means of instruction and amusement. 
What we succeed in to-day, fails to-morrow. Last winter we 
had courses of lectures illustrated by experiment, alternated 
with music and magic-lantern scenes. Then, in the spring, 
social reunions, and in summer, concerts, picnic parties, &c. 
This coming winter we propose to have historical and geo- 
graphical lectures illustrated by the stereoscopticon, alternated 
with views of picture galleries and works of art found in the old 
world. Add to this the frequent familiar conversation clubs, 
the chapel exercise, and an idea is given of moral treatment. 
9 



66 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Of the medical treatment we have still less to say, except 
that occasional cathartic tonics and a moderate supply of 
stimulants constitute the bulk of our materia medica. Drugs 
are comparatively little used, and yet, whenever any pathologi- 
cal reason exists for the administration of any medicine, it is of 
course freely used. Cathartics and tonics are perhaps more 
frequently used than all other medicines. A generous supply 
of nourishing food and a discreet use of tonics and stimulants 
seems to be imperatively demanded by all the feeble patients 
and nearly all chronic cases. Declining health and strength 
must be sustained ; the feeble powers of digestion and assimila- 
tion must be provoked and supplied. 

But cathartics always enter somewhat largely into the medi- 
cal treatment of the insane. Perhaps we do not fully under- 
stand the close relation existing between the brain and stomach. 
No doubt, much of the uneasiness and morbid sensibility from 
which so many of our patients suffer — that condition of mind 
which cannot be cheered by hope or diverted by pleasure — is 
frequently nothing more than the natural result of the sym- 
pathy existing between the morbid condition of the alimentary 
canal and the brain. 

Humiliating it is, and must be, to admit the frailty of man 
to such a degree that a slightly overtasked stomach or a torpid 
condition of the bowels will cloud all his worldly prospects, 
render him dissatisfied with life and all its blessings, make him 
suspicious of his friends and jealous of his own household ; 
but it cannot be denied ; and the care of that disordered state 
of the imagination, so often observed in this class of our 
patients, and their restoration to the best state of manhood, 
may often be brought about by the means directed to relieve 
the diseased state of the stomach and bowels, particularly 
if coupled with cheerful out-of-door exercise and pleasant 
companionship. 

The process may be slow, but if perseveringly followed will 
generally be crowned with success. 

The mortality of the year, as is elsewhere shown, was at the 
rate of ten per cent, on the average number of patients in the 
hospital during the year ; and calculated on the total number 
under treatment, six per cent. For the male patients, as fre- 
quently happens, the rate was considerably higher ; the 



1866.] PUBLIC DOCUMENT— No. 22. 67 

difference of the ratios probably depending on the greater 
immunity from diseases of the brain and nervous system which 
the females enjoyed. Two patients at the time of their death 
were more than eighty years of age, two others were more than 
seventy, and six were between sixty and seventy. 

Five patients died within three weeks of the time of their 
admission, and seven others within two months of their admis- 
sion. Twenty-five of the patients admitted during the year 
have already died. Six died quite suddenly : two while asleep, 
and two others so suddenly that no change could have been 
anticipated, and no suffering, mental or physical, experienced. 

Thirteen of the deaths were ascribed to the various diseases 
of the cerebro-spinal system : as paralysis, or epilepsy and 
apoplexy. Nine were ascribed to diseases affecting the organs 
of circulation and respiration ; eight to diseases affecting the 
organs of assimilation. Two were the result of old age, and 
eight were the result of influences which insanity directly 
exercised over their bodily health, and terminated in exhaus- 
tion, with little, if any, secondary disease. 

Notwithstanding the very considerable bill of mortality, the 
general health of the patients has been good throughout the 
entire year, and no disease of an epidemic character has been 
observed in the hospital. 

Diseases of the brain and other parts of the nervous system 
which have been present, existed in connection with insanity. 
Under these a large number of patients labored at the time of 
their admission, their lives being sustained and prolonged by 
great care and attention during a progressive decline of bodily 
and mental health. A large number of such patients are still 
under treatment, of whose recovery not the slightest hope can 
be entertained. Could such cases, as well as all others, be sent 
to the hospital in the early stage of their disease, it is probable 
that judicious treatment might relieve a much larger propor- 
tion than can otherwise be expected. Early and efficient 
treatment, when the disease of the brain and cerebro-spinal 
system is in its first stages, and unattended with change of 
structure in these nervous centres, is the all-important 
consideration. 

Your attention has often been called to a class of patients 
committed to our care as being apparently improper subjects 



68 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



for hospital treatment — allusion is now made to the feeble and 
aged — those who suffer from no undue excitement, who are 
neither homicidal nor suicidal, and who do not require any 
extraordinary plans for safety and security. 

There have been committed during the year nine persons 
each more than seventy years of age, and two of whom were 
more than eighty years old, and three others between sixty- 
three and seventy years of age. In some of these cases the 
friends and guardians readily admitted that the patients were 
brought here to spend the remnant of their days. Of course 
no treatment can be of much service to such patients. Proper 
attention to hygienic rules is all that can be suggested. They 
come to us in the last stages of declining health, " when the 
years have come in which they have no pleasure." Worn out 
by the cares and trials of a long life, and it may be by sorrow 
and suffering, they are objects of incessant care and anxiety, 
and become burdens to their families and friends. When at 
last they are brought to the hospital, the fatigue of the journey 
frequently destroys their little remaining strength, and they 
sink and die at once. If not, the new and strange surround- 
ings, the absence of familiar faces, the loss of comforts, the 
well-known easy chair, the old cozy room and bed, the accus- 
tomed food, and above all the kind offices of the faithful family 
physician, give such a shock to their sensibilities as to render 
them objects of the utmost pity. There is great impropriety in 
committing this class to our care. They cannot recover under 
any circumstances, and but seldom improve. Kindness, sym- 
pathy, humanity, dictate that their waning existence should be 
made cheerful and attractive by all the delicate attentions of 
home, family and friends. 

Articles made in the Sewing-Rooms during the Year. 



Aprons, 


63 


Collars, 


. 


36 


Bed-Spreads, 


41 


Curtains, . 


. 


51 


Bed-Ticks, 


. Ill 


Drawers, pairs of, 


. 


72 


Blankets, . 


15 


Dresses, . 


. 


180 


Bags, 


21 


Edging, yards of, 


. 


50 


Carpets, . 


4 


Frocks, 


. 


4 


Chemises, . 


. 170 


Handkerchiefs, . 


. 


25 


Coats, 


7 


Hose and Socks, pairs 


of, . 


40 



1866.] PUBLIC DOCUMENT— No. 22. 

Articles made in the Sewing-Rooms — Concluded. 



69 



Jackets, 

Mattress Ticks, . 
Mittens, pairs of, 
Neckties, . 
Night-Dresses, . 
Night-Caps, 
Overalls, pairs of, 
Pants, pairs of, . 
Pillow-Cases, . 



21 
44 
20 
30 
15 
35 
15 
75 
155 



Sheets, 
Shirts, 

Shirt-Bosoms, . 
Skirts and Quilts, 
Suspenders, pairs of, 
Table-Covers, . 
Towels, 
Undershirts, 
Vests, 



Articles repaired in the Sewing-Rooms during the Year, 



Aprons, 

Blankets, . 

Bed-Spreads, 

Bed-Ticks, 

Bags, 

Chemises, . 

Coats, 

Collars, 

Curtains, . 

Drawers, pairs of, 

Dresses, . 

Frocks, 

Jackets, 

Mattresses, 



125 

150 

128 

450 

28 

3,930 

560 

51 

65 

781 

945 

57 

89 

76 



Night-Dresses, . 

Overalls, pairs of, 

Pants, pairs of, . 

Pillows, 

Pillow-Cases, 

Sheets, 

Shirts, 

Shirt-Bosoms, . 

Skirts, 

Stockings, pairs of, 

Table-Cloths, . 

Towels, 

Undershirts, 

Vests, 







Articles made 


in the Shops. 




Beehives, .... 4 


Curtain-Sticks, . 


50 


Bolts, . , 






30 


Screens, . 


2 


Boxes, 






12 


Chisels, 


6 


Bedsteads, 






18 


Coal Sieves, 


2 


Bureau, 






1 


Wardrobe Hooks, 


18 


Boot-Jacks, 






2 


Settees, 


4 


Knob?, 






36 


Small Tables, . 


6 


Chair-Rounds, 






75 


Wash-Stands, . 


4 



70 LUNATIC HOSPITAL AT WORCESTER. 

Articles made in the Shops — Concluded. 



[Oct. 



Screw-Drivers, 
Set of Shelves, 
Pair of Shafts, 
Table-Legs, 
Tool Handles, 
Watch-Chains, 
Patterns, 
Writing-Desks, 
Picture-Frames, 
Gimlets, . 
Horse Wagon, 
Stone Boats, 
Hand Carts, 
Iron Rods, 
Knife-Blades, 



6 

2 
1 
4 

30 
4 

10 
2 

25 
2 
1 
1 
2 

20 

18 



Mattresses, 
Pillows, . - 
Rabbit Planes, 
Turning Lathe, 
Roof Sashes, 
Wardrobes, 
Whiffletrees, 
Barrel-Covers, 
Walking-Sticks, 
Buckets, . 
Brackets, . 
Mop-Sticks, 
Windows glazed, 
Models, . 



30 

35 

4 

1 

6 

2 

6 

4 

18 

16 

12 

72 

400 

2 



Articles repaired in the Shops. 



Bedsteads, ... 25 


Iron Bars, ... 4 


Brass Rings, 






12 


Knives, 






6 


Boots, pairs of, . 






12 


Pen-Knives, 






24 


Boxes, 






12 


Lounges, . 






4 


Bureaus, . 






18 


Lanterns, . 






6 


Blinds, 






24 


Pails, 






25 


Brooms, . 






6 


Parasols, . 






4 


Chairs, 






130 


Razors, 






24 


Clocks, 






6 


Rakes, 






36 


Coffee-Pots, 






18 


Saws, 






24 


Chisels, 






12 


Shaft-Wheel, 






1 


Crickets, . 






3 


Stands, 






18 


Flower-Stands, 






3 


Settees, 






8 


Flat-Irons, 






2 


Scissors, . 






18 


Frames, . 






20 


Sofas, 






2 


Boots Ironed, pairs of 




6 


Sleigh, 






1 


Looking-Glasses, 




12 


Sleds, 






2 


Horse Wagon, . 




1 


Sashes, 






12 


Ox Wagons, 




2 


Tubs, 






6 


Hoes, 






12 


Tables, . 






20 



1866.] PUBLIC DOCUMENT— No. 22. 71 

Articles repaired in the Shops — Concluded. 



Tin Pans, 


25 


Lock Keys, 


18 


Tea Kettle, 


1 


Book-Cases, 


2 


Trunks, 


6 


Hay-Forks, 


12 


Umbrellas, 


2 


Hand-Cart, 


1 


Window-Rods, . 


50 


Saws filed, 


60 


Windows, . . . 


82 


Chains, 


6 


Wheelbarrows, . 


6 







72 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 






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1866.] public document—No. 22. 

Products of the Farm. 



73 



Apples, 

Pears, . 

Cherries, 

Grapes, 

Tomatos, 

Currants, 

Sweet Corn, 

Gooseberries, 

Beans, 

Parsnips, 

Turnips, 

Potatos, 

Beets, . 

Mangel-wurzel, 

Carrots, 

Squashes, 

Peppers, 

Cucumbers, . 

Cabbages, . 

Rhubarb, 

Hay, . 

Corn fodder, 

Milk, . 

Beef, . 

Pork, . 



20 bbls. at $6 00 


$120 00 


20 bush 


at 


4 


00 


80 00 


4 


u 


at 


2 


00 


8 00 


25 


a 


at 


2 


00 


50 00 


200 


a 


at 




75 


150 00 


10 


u 


at 


2 


00 


20 00 


75 


a 


at 


1 


50 


112 50 


5 


a 


at 


2 


50 


12 50 


30 


a 


at 


3 


00 


90 00 


300 


a 


at 




50 


150 00 


300 


d 


at 




20 


60 00 


3,800 


it 


at 




75 


2,850 00 


200 


a 


at 




30 


60 00 


1,300 


u 


at 




30 


390 00 


1,500 


a 


at 




35 


525 00 


5 tons 


at 30 


00 


150 00 


20 bush 


.at 




50 


10 00 


15 bbls 


at 


4 00 


60 00 


1,000 heads at 




12 


120 00 


3,000 


lbs. 


at 




91 


75 00 


80 


tons 


at 30 


00 


2,400 00 


3 


u 


at 15 


00 


45 00 


50,000 


qts. 


at 




7 


3,500 00 


11,987 


lbs. 


at 




14 


1,678 18 


2,229 


« 


at 




18 


411 22 




$13,127 40 



The products of the farm have been more abundant than 
ever before, and the crops were grown without any additional 
expense in paid labor. The usual amount of labor has been 
expended in reclaiming lands, in draining, blasting and sinking 
rocks, in fencing and transplanting trees, and in improving, in 
a variety of ways, the value of the estate. Much yet remains 
to be done to ornament and improve the grounds, and make 
them pleasant and attractive. The old drive-way in front 
should be speedily abandoned, and the space graded and planted 
out with shrubbery, thus widening the lawn to Summer Street. 
The employment of patients has, as in former years, received 

10 



74 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

considerable attention, and but few of those able to labor and 
safe to be trusted with tools are found unwilling to engage in 
some sort of occupation. Many of those employed, however, 
are both physically and mentally incapable of any great exer- 
tion. The little they do is for their own good and not for the 
benefit of the hospital. By steady employment in light and 
cheerful labor they are prevented from sinking lower in health 
of body and mind, their feelings of self-respect are kept alive 
and active, and their habits of usefulness prolonged. 

Among our patients there are comparatively few mechanics, 
and the several shops and work-rooms, when used at all, are 
occupied mostly by persons not trained to any trade or calling 
which can at present be pursued here without adding very con- 
siderably to the current expenses of the institution. It is to be 
hoped that the time is not far distant when tradesmen can be 
employed for the care and instruction of certain classes of male 
patients, and they be trained to some degree of skill in the var- 
ious mechanical callings. Such an enterprise would involve the 
expense of two or three additional men of tact and skill to 
manage and carry on whatever work was begun. 

No kind of labor, however, is so beneficial to the male patients, 
in a great majority of cases, or so useful to the hospital, as the 
cultivation of the farm and the care of the farm stock. The 
exercise in the open air, the apparent freedom enjoyed, the 
kind of labor, calling into play nearly all the muscles of the 
body, imperceptibly improves their condition and promotes 
their recovery. Then, too, the deep interest some take in the 
progress of the operations in which they are engaged, and the 
great pleasure others enjoy in caring for the various animals 
kept upon the farm, aid very much in restoring their minds to 
a normal condition. 

The female patients are perhaps sufficiently employed in sew- 
ing, cooking, washing, and the various household duties inci- 
dent to a large and crowded hospital, and their labor is reduced 
to something like system. 

The sewing-rooms have each their cheerful company of sew- 
ers. The ironing-room always presents a scene of activity, and 
is daily filled with nearly the same group, except as now and 
then one recovers her health and leaves for home. The laun- 
dry and kitchens have their own assistants from the wards, upon 



1866.] PUBLIC DOCUMENT— No. 22. 75 

which they depend, and without which they could not well 
succeed. 

That labor of course is most useful to the hospital which it 
needs for its own assistance and support. How much is accom- 
plished in this direction will be best illustrated by a reference 
to the accompanying tables. But the cultivation of a few acres 
of land, the growing of some small crops, the making or repair- 
ing of a few useful articles, is the least of all possible benefits 
to the insane. In another point of view, however, these little 
matters assume a large importance. Cheerful labor, especially 
in the open air, does much towards restoring the insane to 
health. It banishes harassing doubts and perplexities, dissi- 
pates distressing delusions and brings quiet to the troubled 
mind and sleep to wakeful eyes. In providing occupation foF 
the insane, the healthy powers of the mind are brought into 
activity, and thus the diseased faculties are afforded tranquillity 
and repose. It is not enough, however, to provide the means 
for labor alone, nor is it sufficient to combine intellectual and 
manual labor. In the care and treatment of the insane nothing 
should be omitted, no means should be withheld which will 
have the slightest tendency to draw back the intellectual facul- 
ties to their best estate. The only way in which this can be 
accomplished is by operating upon the healthy faculties, and 
thus avoid irritation and excitement. It is not enough that we 
buy books and newspapers, pictures and maps ; patients must 
be induced to read and examine. It is not sufficient that you 
open music rooms and billiard rooms ; patients must play regu- 
larly and systematically. They must have not only work and 
play, but they must also have some daily mental exercise suited 
to their capacity and their normal taste. Patients must not be 
suffered to lounge about the wards, gradually losing both bod- 
ily and mental tone and vigor, and becoming daily more and 
more indifferent to all about them save, perhaps, the quality 
and quantity of their food. The poor lunatic is disinclined to 
mental or manual labor because his mind is pre-occupied by 
diseased fancies ; still he is alive to the stimulus of emulation, 
rewards and punishments, and can be acted upon through the 
remaining healthy faculties. But how ? By increased facilities 
for various kinds of labor in workshops, with skilful trades- 
men ; by more extensive farming operations, and by a greater 



76 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

variety and abundance of opportunities to engage in that best 
of all occupations ; by giving out small parcels of ground to 
such as desire it, for their own special cultivation and manage- 
ment, and thus securing to that class the boon of occupation 
without irritation or fatigue ; by lectures, by reading and con- 
versation clubs ; by cheerful, well-furnished apartments ; by 
greenhouses and conservatories ; and by all the means of plea- 
sure and profit which ingenuity can devise and labor accom- 
plish ; but, above all, by well-trained, competent and thoroughly 
devoted assistants in every department, who will religiously 
fulfil every obligation, and give certainty and efficiency to all 
the operations of the institution ; who will respect the rights, 
anticipate the wants and obey the calls of the weakest and 
feeblest as well as the most cheerful and companionable of those 
under their charge ; who will, by patient attention, win the 
love of the most wayward, by kind and approving demeanor 
give courage and strength to the faltering ; and who will, by 
perseverance, so cheerfully and kindly restrain the vicious, that 
restraint will be deprived of its horror and abuse. 

It will be remembered that I have expressed in former reports 
my hopes and fears upon this subject. During the last summer 
a plan has been put in operation by which some effort will be 
made to give to the attendants some special information upon 
the peculiar duties and responsibilities of their position. It is 
to be hoped, if health and strength does not fail, that we shall 
be able, by lectures and familiar conversation upon special 
topics, to explain the nature of their duties and obligations, 
and assist in raising them to an appreciation of their responsi- 
bility, and to a capacity to discharge with fidelity and discretion 
the duties imposed on them. In their familiar conversations 
the various phases of insanity have been spoken of, and the 
relations of the insane to the community, to the family and 
friends, and to the hospital and to the attendants, were spoken 
of so far as could be of use to the hearers. Moral treatment, 
so far as it is dependent upon impressions received from nurses 
and attendants, the influence of pleasing sights, of kind words, 
of gentle manners, of forgiving dispositions, has been also 
discussed with much freedom. 

The great object being to impress the understanding and 
awaken the sympathies and affections by showing that insanity 



1866.] PUBLIC DOCUMENT— No. 22. 77 

was a disease, a misery, the greatest of all misfortunes, which 
was to be relieved and made endurable so far as kindness, for- 
bearance and consoling words have power to mitigate human 
suffering. That mental disease was not a violent passion to be 
resisted, a perversity of the will to be opposed, or evil spirit to 
be subjugated, but the most dreadful of all maladies that can 
afflict the human race. And further to show, if possible, 
various personal peculiarities, so that patients might be aided in 
the right direction to recover their self-control, to show what 
might be hoped and what feared in each individual case, and 
what permitted and guarded against. But, above all, to prove 
in every possible manner, by illustration and by example, that 
every attendant with whom the patient comes in contact must 
and does increase or diminish that patient's comfort and happi- 
ness, and that it is especially important that first impressions 
should be agreeable and hopeful, not clouded by fear, or dis- 
tressed by undue severity ; that the first greetings should 
always be warm, cordial and cheerful, let the recipient be what 
he may. Thus much and more has been attempted, and is still 
being pursued. But how far short of our aims we have fallen, 
let our oft expressed hopes and fears testify. Our corps of 
attendants and assistants, drawn from the middle ranks of 
society, sons and daughters of well-to-do families, many of them 
having been country school teachers, seeking for the time being 
what will pay best, having as yet no settled ideas as to their 
future course in life, but ready to adopt any mode of life or to 
engage in any business that will offer the surest road to a posi- 
tion, character and respectability, cannot at present be expected 
to remain permanently with us, however useful they may prove 
to be. The merchant, the manufacturer, the master mechanic, 
can and does increase the pay and exalt the condition of such 
assistants as are most useful to him. But not so here. Let it 
be said with shame, young men and women who devote them- 
selves to the care of the insane perform duties to which few are 
equal, and are but poorly paid. No system of rewards, no 
prospect of comfort in the future, — what can induce attendants 
upon the insane to retain their places after having become com- 
petent to perform their duties ? The few who are worthy and 
do remain, do so at the loss of comfort, competency and posi- 
tion. This leads me to the consideration of another question 



78 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

at which I have hinted in many former annual reports, and 
that is, new and improved accommodations for the insane, in 
which they can be comfortably cared for and successfully 
treated. 

It will be remembered that mention was made of a plan which 
seemed desirable, and which it is believed the trustees of this 
hospital could carry out without difficulty and without involving 
the State in any great expense. It does not seem proper to 
make any undue haste in the matter, and it is hardly desirable 
to take steps at present beyond a fair consideration of the ques- 
tion. The plan is simply this : to put into the market at some 
future time certain lands belonging to the hospital and where 
the buildings now stand, occupying the same until rebuilt in 
some more, desirable locality upon an improved plan. These 
lots, about twenty-five acres, have been appraised for three years 
in succession for about one hundred thousand dollars, leaving 
the buildings and eighty-five acres of most desirable land still 
belonging to the hospital. 

If we look carefully at the matter, we shall find that the lot 
upon which the hospital stands contains twelve acres, which at 
twenty-five cents per foot, would amount to the sum of one 
hundred and thirty thousand six hundred and eighty dollars. 
The lot upon which the stables stand contains four acres, which 
at fifteen cents per foot, would amount to the sum of twenty- 
six thousand one hundred and thirty-six dollars. Other lots, 
adjacent to Mulberry and and Pine Streets, containing ten acres, 
at ten cents per foot, would amount to the sum of forty-three 
thousand five hundred and sixty dollars, making a total of two 
hundred thousand three hundred and seventy-six dollars, leav- 
ing all the building material, fixtures, furniture, stock and tools, 
with eighty-five acres of land in one lot nearly square, upon 
which is a pond of pure water and a well-grown grove of trees, 
the only objection being that it is high and difficult of access. 
It is within the mile circle of the city and three different routes 
can be shown to the highest point, which are not so steep or 
rugged as to be difficult. 

It is believed that within ten years from the present time the 
whole thing may be accomplished without asking for one dollar 
from the State treasury. 



1866.] PUBLIC DOCUMENT— No. 22. 79 

The age demands, the wants of the insane demand, your 
patrons demand, more extensive comforts, a better class of accom- 
modations, an improved style of architecture, greater facilities 
for classification, treatment, recreation and amusement. 

Could some plan like this be adopted a very great advance 
might be made upon any existing arrangements for the care and 
recovery of the insane. Will not Massachusetts, the State which 
is foremost in so many matters of public interest, consider the 
necessity and propriety of making, at so little cost, some new and 
improved arrangement for her most unfortunate children ? 
Will she not be willing to create for the insane a model 
institution, when it can be done almost without cost ? 

In view of what the hospital has done, and may do with 
increased facilities, will she not, at some not far distant day, 
make the experiment ? Is she willing to condemn the insane 
to small, inconvenient and crowded apartments, simply 
because, in such, life can be sustained at a less expense ? 

We hope to see, and believe the time will come, when we shall 
have in the heart of the Commonwealth a hospital for the 
insane, constructed upon the best plan for classification and 
treatment of the various mental disorders which affect the 
human race. When we shall have the centre building the 
hospital proper, with every facility for treating all cases of acute 
mania, and for all violent and dangerous, euicidal and trouble- 
some cases, having every arrangement and convenience which 
skill and ingenuity can devise — large, airy sleeping and day 
rooms, improved facilities for bathing, perfect ventilation, cozy 
libraries, spacious parlors, convenient billiard and play rooms ; 
and near by, a few plain, neat and substantial cottages, capable 
of accommodating a family of eight or ten quiet, harmless, 
industrious persons ; and not far remote, two or three houses 
of more style and pretension, for a class of people found in 
every hospital, where they could live in a quiet family, devoting 
themselves to reading, writing, and the cultivation of gardens 
and such light occupations as their health would allow. All 
these houses would be under the charge of old and well trained 
attendants, who would there find inducements to remain and 
make the care of the insane a life business. 

There would be, of course, the chapel and lecture-room in 
common. The laundry and bakery, the warming apparatus, 



80 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

the engine house, the stables and farm buildings, all in com- 
mon for the whole. The great benefit, it seems to us, to be 
derived from so wide a departure from all accustomed rules, is 
a near approach to the family system, and the kindly influences 
of home treatment. Could this system, or some similar one, 
be 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 enjoyments, homely sur- 
roundings, and the enjoyment of many of the social comforts 
which make life pleasant. They would have also the advantage 
of well trained, educated nurses and attendants, whose busi- 
ness for life it would be to care for and sympathize with them. 
They would enjoy a more free and generous style of amuse- 
ment, recreation 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 very great extent preserved 
without diminishing in any way the prospect of recovery or 
increasing the labors of the institution. 

All the plans for the amelioration of suffering described in 
former reports have been employed with vigor during the past 
year, and an increased effort has been made to carry all such 
measures to a greater extent, and multiply all facilities for 
similar purposes. « 

In this recapitulation of certain statements made in my last 
annual report to your board, I desire only to present a few of 
the most prominent reasons in favor of adopting, at some 
future day, a new and improved plan for the care, custody and 
treatment of the insane of all classes, and I hope hereafter to 
be able to present the subject in such a manner as to claim 
attention. 

The usual recreations and amusements have all been con- 
ducted with unabated interest and vigor. The billiard rooms, 
reading rooms, libraries, and music room, afford the means of 
intellectual culture and occupation by the very generous supply 
of books, papers and periodicals which are to be found in them. 
Some slight additions have been made to the library, and some 
one hundred and fifty newspapers find their way weekly into 
the wards and reading rooms. 



1866.] PUBLIC DOCUMENT— No. 22. 81 

A course of about thirty lectures was delivered during 
the winter and spring, which were listened to with great 
interest by about two hundred and fifty of the patients and 
their attendants, and during the spring and summer several 
concerts were enjoyed by the inmates. 

All our accustomed means of occupation, amusement and 
healthy recreation have been pursued with vigor and advan- 
tage. The record of work done in and about the house, 
gardens, shops and on the farm, and the quantity of produce 
from the farm will testify to the amount of profitable work 
done. 

The picnic parties, fishing excursions, daily drives, games of 
base-ball, croquet, and all the other usual out-of-door and 
in-door games and amusements, may be mentioned as our 
principal sources of recreation. 

Our heartfelt thanks are due to Miss Dix for many kind 
attentions in behalf of our patients. 

From the publishers of the " Massachusetts Spy," " Palla- 
dium," and the " Worcester Evening Gazette," we receive the 
daily and weekly issues, and large bundles of well selected 
exchanges, giving a full supply of late papers from all parts of 
the country. 

From the periodical office of S. Thompson & Co., we also 
receive liberal donations of illustrated papers and magazines. 

For many years we have been under obligation to the pub- 
lishers of the " Boston Advertiser," " Salem Register," " Zion's 
Herald," " Religious Magazine," '■ Youth's Companion," " Gos- 
pel Messenger," " Essex County Mercury," and " Old Colony 
Memorial," and many other papers and periodicals, all of which 
are gratefully received. 

We desire also to express our sense ' of obligation to the 
many friends who have contributed to the welfare of our 
patients during the year, among whom may be specially men- 
tioned Mrs. Sumner, who has so kindly taken charge of our 
choir, and given beside several concerts in sacred music ; Miss 
Souther, who has also assisted us with her musical talent ; to 
Dr. J. R. Lee, for valuable and interesting lectures on the Holy 
Land ; Professor James Bushee, for his course of illustrated 
lectures on chemistry and kindred subjects ; and to Rev. George 

11 



82 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Allen, for his timely and judicious assistance, and supplying 
the chapel desk for a large part of the year. 

It is my duty as well as pleasure to record my sense of per- 
sonal obligation to the other resident officers and assistants who 
have faithfully carried out all my plans, and devoted them- 
selves wholly to the interest of the institution ; but especially 
am I indebted to the Steward and Treasurer, D. W. Bemis ; to 
my assistants, Joseph Draper, M. D., and John R. Lee, M. D. ; 
and my Supervisors, Marshall S. Greene and Miss Pamelia 
Williams, for their kindness and perseverence, and thorough 
devotion to the interests of the hospital during my illness and 
absence. 

For the kindness, assistance, forbearance, cordial council 
and support I have at all times received from each individual 
member of your boardj allow me to renew the expression of 
my deep sense of gratitude. 

I beg to congratulate you on the retrospect of the year. It 
has been one of prosperity, and, we fondly hope, of progress, 
during which great good has been accomplished, much suffer- 
ing alleviated, and many happy recoveries effected. 

With renewed confidence in the strength of Him who has 
sustained us amid the labors of the past, we cheerfully com- 
mence the duties of another year, trusting that by his guidance 
we may perform them well. 



MERRICK BEMIS. 



Worcester Lunatic Hospital, 
Worcester, Oct. 1, 1866. 



METEOROLOGICAL OBSERVATIONS 



THE STATE LUNATIC HOSPITAL, WORCESTER, MASS.. 

1865-6. 

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



Explanation .—The force of the wind is estimated upon a scale of 10 and indicated by figure 
affixed to the letters denoting the direction. When no number is affixed, 1 is meant. 



84 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



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1866.] 



PUBLIC DOCUMENT— No. 22. 



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PUBLIC DOCUMENT— No. 22. 



91 





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Rain ; shadbush in bios. 

Cloudy A. M. ; fair P. M. 

Fair weather. 

Fair weather. 

Fair weat'r; p. jap. in bl. 

Fair weather. 

Fair weather. 

Cloudy ; white frost. 

Cloudy ; showers. 

Fair weather; apple in bl. 

Fair weather; al'ndin bl. 

Fair weather; aurora b's. 

Cloudy; lilac in blossom. 

Fair weather. 

Fair weather. 

Cloudy ; rain ; horse ch't 

Cloudy ; rain, [in bios. 

Drizzling rain. 

Cloudy A. M. ; fair P. M. 

Fair weather. 

Rain; honeysuckle in bl. 

Rain. 

Fair weather. 

Fair weather ; frost. 

Cloudy. 

Fair weather. 

Rain. 

Slight showers. 

Cloudy. 

Cloudy; Scotch rose in bl. 

Rain; Persian lilac in bl. 




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1866.] 



PUBLIC DOCUMENT— No. 22. 



93 





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1866.] 



PUBLIC DOCUMENT— No. 22. 



95 







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Jbair weather. 

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Fair weather. 

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Cloudy. 

Fair weather. 

Cloudy and rainy. 

Fair weather. 

Fair weather. 

Clear. 

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Fair weather. 

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Fair weather. 

Fair weather. 

Fair weather. 

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Cloudy and rainy. 

Cloudy and rainy. 

Cloudy and rainy. 

Fair weather. 

Fair weather. 

Slight frost in low lands. 

Cloudy and rainy. 

Cloudy and rainy. 

Fair weather. 

Fair weather. 

Fair weather; cloudy. 

Fair weather. 






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1866.] 



PUBLIC DOCUMENT- No. 22. 



101 



LIST OF TRUSTEES, 

From the commencement of the Hospital. The first three were Commis- 
sioners for building, and as such were appointed in 1830. 



NAMES. 


Residence. 


When 
appoint- 
ed. 


When 

services 
ended. 


In what way services 
ended. 


Horace Mann, . . . 


Dedham, . . 


1832, 


1834, 


Commis'n expired. 


Bazaleel Taft, Jr., . . 


Uxbridge, . . 


1832, 


1834, 


« it 


William B. Calhoun, . 


Springfield, . . 


1832, 


1835, 


it u 


Alfred D. Foster, . . 


Worcester, . . 


1832, 


1836, 


U U 


Francis C. Gray, . . 


Boston, . . . 


1832, 


1836, 


it t. 


Thomas A. Green, . . 


New Bedford, . 


1834, 


1837, 


it ti 


Thomas Kinnicutt, . . 


Worcester, . . 


1834, 


1838, 


it u 


Horace Mann, . . . 


Boston, . . . 


1835, 


1839, 


a a 


Emory Washburn, 


Worcester, . . 


1836, 


1837, 


Resigned. 


Abra'm R. Thompson, 


Charlestown, . 


1836, 


1841, 


Commis'n expired. 


Myron Lawrence, . . 


Belchertown, . 


1837, 


1840, 


it a 


Stephen Salisbury, 


Worcester, . . 


1837, 


1840, 


it a 


Edward D. Bangs, . . 


Worcester, . . 


1838, 


1838, 


Deceased. 


William Lincoln, . . 


Worcester, . . 


1838, 


1840, 


Commis'n expired. 


Daniel P. King, . . . 


Danvers, . . 


1S39, 


1844, 


it u 


Alfred D. Foster, . . 


Worcester, . . 


1840, 


1842, 


a it 


Maturin L. Fisher, 


Worcester, . . 


1840, 


1843, 


it it 


Henry Gardner, . . 


Boston, . . . 


1840, 


1845, 


(( a 


Robert Campbell, . . 


Pittsfield, . . 


1841, 


1843, 


Resigned. 


Edwin Conant, . . . 


Worcester, . . 


1842, 


1844, 


« 


H. H. Childs, . . . 


Pittsfield, . . 


1843, 


1846, 


Commis'n expired. 


Joseph Sargent, . . 


Worcester, . . 


1843, 


1848, 


(( K 


Stephen Salisbury, 


Worcester, . . 


1844, 


1S50, 


it a 


Stephen C. Phillips, . 


Salem, . . . 


1844, 


1851, 


tt tt 



102 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

List of Trustees — Concluded. 



NAMES. 


Residence. 


When 
appoint- 
ed. 


When 
services 
ended. 


In what way services 
ended. 


Jesse Murdock, . . . 


Carver, . . . 


1845, 


1847, 


Commis'n expired. 


Thomas F. Plunkett, . 


Pittsfield, . . 


1846, 


1849, 


u u 


Thomas French, . . 


Canton, . . . 


1847, 


1848, 


Resigned. 


Isaac Davis, .... 


Worcester, . . 


1848, 


1849, 


u 


William Appleton, . . 


Boston, . . . 


1849, 


1851, 


Declined. 


Levi Lincoln, . . . 


Worcester, . . 


1849, 


1852, 


Commis'n expired. 


Ensign H. Kellogg, 


Pittsfield, . . 


1849, 


1853, 


(t « 


John S. C. Knowlton, 


Worcester, . . 


1850, 


1853, 


Declined. 


Foster Hooper, . . . 


Fall River, . . 


1851, 


1854, 


Commis'n expired. 


Samuel G. Howe, . . 


Boston, . . . 


1851, 


1855, 


(C (C 


Rejoice Newton, . . 


Worcester, . . 


1852, 


1856, 


a a 


Franklin Ripley, . . 


Greenfield, . . 


1853, 


1854, 


U (( 


James B. Congdon, . 


New Bedford, . 


1853, 


1855, 


Resigned. 


Linus Child, .... 


Lowell, . . . 


1854, 


1858, 


Commis'n expired. 


Henry Morris, . . . 


Springfield, . . 


1854, 


1855, 


Resigned. 


Charles H. Stedman, . 


Boston, . . . 


1855, 


1861, 


Commis'n expired. 


William T. Merrifield, 


Worcester, . . 


1855, 


1863, 


« « 


Thomas Colt, . . . 


Pittsfield, . . 


1855, 


1860, 


U cc 


Joseph N. Bates, . . 


Worcester, . . 


1856, 


1861, 


it it 


Robert W. Hooper, . 


Boston, . . . 


1858, 


- 


i Commis'n expired 
\ and reappointed. 


Edwin F. Jenks, . . 


Adams, . . . 


1859, 


- 


- 


Edward Jarvis, . . . 


Dorchester, . . 


1861, 


-. 


Commis'n expired. 


William Workman, . 


Worcester, . . 


1862, 


- 


- 


Samuel E. Sewall, . . 


Boston, . . . 


1863, 


- 


- 


Henry Chapin, . . . 


Worcester, . . 


1866, 


- 


- 



1866.] PUBLIC DOCUMENT— No. 22. 103 



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. 

Birthplace ? Ans. 

Civil condition of lunatic ? Ans. 

Occupation ? Ans. 

Supposed cause of disease ? Ans. 

Duration ? Ans. 

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



104 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

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 and 

made oath that the above certificate is true. 

Justice of the Peace. 



Commonwealth of Massachusetts. 

, ss. At , in said county on the 

day of A. D. 186 . 

On the application of for the commitment 

of of in said county,to the Worcester 

Lunatic Hospital, ; notice in writing having been 

given by said apphcant to one of the selectmen of 

where said resides, of h intention to make said 

application, and said having been duly notified of 

the time and place appointed for hearing, it appears, upon a full hearing, 
that said is an insane person, and a proper subject for 

the treatment and custody of the Worcester Lunatic Hospital. 

Wherefore it is ordered that said be committed 

to the said Worcester Lunatic Hospital. 

Judge of Probate Court. 



1866.] PUBLIC DOCUMENT— No. 22. 105 

FORM OF OVERSEERS' BOND. 

Worcester Lunatic Hospital. 
Whereas, of , in the county of 

, has been admitted a boarder in the Worcester Lunatic 
Hospital, , a majority 

of the Overseers of the Poor of the town of , in the county of 

, in behalf of the inhabitants of said town, do hereby promise 
Treasurer of said Hospital, to pay 
him, or his successor in said office, the rate of board which may, from time to 
time, be determined by the Trustees of said hospital, for said patient, so long 
as h 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 
jr of the 

) Town of 



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 h 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 the furniture and other property of said hospital, and for reason- 



106 LUNATIC HOSPITAL AT WORCESTER. [Oct. '66. 

able 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. 

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 
when the patient leaves the hospital. 



APR ZSWKIX