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PUBLIC DOCUMENT No. 22.
THIRTY-PIFTH ANNUAL REPORT
THE TRUSTEES
STATE LUMTIC HOSPITAL
^Y O R C E S T E R .
' i-^fcC^ j ,
OCTOBER, 18G7.
BOSTON:
W U I G II T & ? T T IC R , STATE PRINTERS,
No. 4 S I' u I N V, L A N i; ,
18 G8.
A
€ommoimta\l\} of iMa0sac!)ii0e!t0.
TRUSTEES' EETORT.
To His Excellency the Governor and the Honorable Council
of the CommonweaUli of MassacJiusetts.
The Trustees of the "Worcester Lunatic Hospital submit the
following Report, for the year ending September 30, 1867.
The full report made by the Superintendent renders any
statement on our part of statistical details, in regard to the
doings of the past year, unnecessary. The great number of
patients discharged recovered, in proportion to the whole num-
ber that leave our walls, is the best proof of the usefulness and
success of the institution.
The grant of fifteen thousand dollars by the legislature, at
its last session, placed the hospital in a better finaiicial condi-
tion than it had been for some time previously. Unless some
great rise in the prices of the necessaries of life should take
place, without any corresponding increase in the price of board,
(a result we do not anticipate,) we shall have no need of again
calling for legislative aid to pay debts.
Yet we cannot but wish a higher price of l)oard could be paid
by the Couimonwealth and towns. The price of board pdid the
hospital has not, since the beginning of the rebellion, been
increased in nearly so great a proportion as that of provisions
and fuel, or as that of board for persons in health, all over the
country. The consequence is, that though the patients can bo
fed and warmed at the present i)rice, we cannot, with our
limited means, make all the provision for thorn which is desir-
able, both as it regards recreation and employment. A greater
4 LUNATIC HOSPITAL AT WORCESTER. [Oct.
variety in these respects would, no doubt, be highly beneficial
to many within our walls.
A little comparison of the price of board paid by the Common-
wealth to this hospital, with that paid to similar establishments
in other States, for the same class of patients, in places where
the cost of living is as cheap as in Worcester, and even cheaper,
will show that our request for additional compensation is most
reasonable. The price of board paid to this hospital by the
State and towns, is $3.50 a week.
In the New Hampshire Asylum for the Insane at Concord,
the minimum charge for board has been 14.75 the past year.
At the Butler Hospital for the Insane at Providence, R. I.,
the charge for paupers sent by towns is $4.00.
At the Retreat for the Insane in Hartford, Connecticut, the
lowest charge at the present time is $5.50, and that only for
State and other strictly indigent patients.
In the New York State Hospital at Utica, the ordinary charge
for board is $4.00 a week.
In the New Jersey State Asylum at Trenton, the charge for
pauper and indigent patients is $4.00, of which $3.00 is paid by
the counties from which they are sent, and $1.00 by the State
treasury. The salaries of resident officers are also paid by the
State.
In the Pennsylvania State Lunatic Hospital at Harrisburg,
$3.00 a week is charged for patients supported by counties and
towns. This is not, however, because this sum covers the
expenses, but as a matter of policy, for private patients, who
are poor, pay at the same rate, but the legislature always make
an appropriation to cover the deficiency of the receipts. The
prices of the most expensive supplies at this institution are also
far lower than at Worcester. Coal, delivered at the hospital
wharf, was $3.90 a ton (which we suppose was 2,240 pounds.)
The contract for beef, from March 1, 1867, to March 1, 1868,
was nine cents a pound, pork twelve cents, mutton and veal
nine cents.
At the Western Pennsylvania Hospital for the Insane at
Dixmont, near Pittsburg, the price paid for board during the
past year by those sent by order of court, or by directors
of poor, was $8.00 a week. The Superintendent writes :
"The State treasury pays to the institution $15,000, a sum
1867.] PUBLIC DOCUMENT— No. 22. 5
sufficient to pay all salaries and wages, and make up all loss in
keeping public patients, at 13.00 per week."
After reading the preceding statements, any one who knows
the cost of the necessaries of life at Worcester, and considers
how much more expensive it is to support and take charge of
an insane person than a sane one, (a subject fully considered
in the report of the Superintendent,) will see at once that at
least $4.00 a week ought to be paid for the board of patients
supported at the public charge.
We are oblige'd to call attention to the expensive, but abso-
lutely necessary repairs and improvements specified in the
Superintendent's report. The sum total, (112,000,) is large,
but the repairs ought not to be longer delayed, and the gymna-
sium and bowling alleys are so important to the health of the
patients, that we regard them as equally necessary with the
repairs. To say nothing of humanity, it is a wise economy to
employ such agencies to restore men to society. The benefit
of such restoration is double. The productive power of the
community is increased, and, at the same time, its burdens are
diminished.
The systematic gymnastic exercises, which have been intro-
duced among such of the females as could enjoy them, we
believe will be productive of very obvious and beneficial results.
While engaged in these pleasant exercises, with the aid of good
music from a piano, by one of their own number, they lose the
appearance, and, for the time, the reality, of insanity. This
recreation, like all amusements and occupations which draw
the attention of these unfortunates from their own morbid
feelhigs, promotes their recovery.
In our Report for the year 1865, and the report of the
Superintendent for the same year, as well as in his report for
the present year, attention is directed to the importance of
having cottages in connection with the hospital, each under
the care of a man and his wife, accustomed to the treatment
of lunatics, into which some convalescent and other suitable
patients might be admitted. We still regard this plan with,
great interest. We entertain no doubt that a restoration to
family life would have a happy influence on many who would
still need a medical adviser, and a certain degree of restraint
6 LUNATIC HOSPITAL AT WORCESTER. [Oct.
and supervision, without being subjected to constant association
with large numbers of the insane.
Though the treatment of lunatics often requires a separation
from their own families for a longer or shorter period, yet when
such persons are able to enjoy the mode of living to which they
were accustomed before the access of mental disorder, a resto-
ration to it, as far as possible, is a great remedial agent.
The hospital has no funds with which to erect cottages, and
must rely either on the bounty of the State, or the liberality of
individuals, for means of carrying on what we regard as a
measure of the highest importance in improving our institu-
tion. A few thousand dollars would enable us to commence
the work on a moderate scale.
The employment of a well educated female physician in the
female wards, as recommended by the Superintendent, meets
our full approbation. It is very obvious that women usually
understand the characters of each other better than men do,
and that with equal advantages of medical education and expe-
rience, they could judge of the bodily and mental feelings and
wants of their own sex, both healthy and morbid, more readily
than men.
We have, in former Reports, expressed our great confidence
in the Superintendent, Dr. Bemis. The great success of the
hospital, since his connection with it, is due chiefly to his skill,
his sympathy for liis patients, and his devotion to his work.
We recommend most heartily his report to your consideration,
and that of the legislature.
In his labors he is ably seconded by his assistant. Dr. Draper.
We are also happy to state our satisfaction with the conduct
of the financial affairs of the institution by the Treasurer, Mr.
Daniel Bemis.
• Very respectfully submitted by the Trustees.
S. E. SEWALL.
. E. F. JENKS.
• H. CHAPIN.
R. W. HOOPER.
W. WORKMAN.
1867.]
PUBLIC DOCUMEXT— No. 22.
TREASURER'S REPORT.
Receipts.
Cash on hand September 30, 18G6,
received of the Commonwealth, special appropriation,
received of the Commonwealth for support of insane,
received from sale of farm products,
received from loans ^lechanics' National Bank,
received from towns, cities and individuals,
§32 2^
15,000 00
21,203 51
2,572 33
11.600 00
58,231 79
§108,639 90
The expenditure of the year have been as
bllows : —
Prnvinions, —
Flour, §7,366
60
Piice and crackers.
585
58
Rye and corn meal.
589
50
Fish,
988
13
Salt meats, ....
•1.002
82
Fre^h meats.
3,752
12
Fresh fruitf.
314
58
Reans, potatoes and vegetables.
009
87
Butter, ....
4,771
09
Cheese, ' . . . .
220
59
Su^jar, ....
2,081
49
MolasseH, ....
7(J6
59
Tea,
1,017
25
Coffee, ....
955
81
Efrgs, salt and other groceries,
1,137
65
Vinegar and pickles, .
222
65
Ice,
358
27
§29,080 5D
Clnlhinff, —
Boots and shoe.H, §1,815
26
TailorV cloliiinp, ...... 'J,l!)3
96
Hats, rapM, sliirN, drawers, etc., .... 522
17
Clothing material!*, 1,611
19
r..'.72 r.8
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Furniture, —
House furnishing goods and bedding,
Crockery and glass ware, .
Kitchen ware and brooms, .
Pictures and frames, .
Fuel,
LigTii, —
Oil and candles.
Gas, .
Medical supplies,
Undertaker's bills,
Books, stationery and printing, . .
Improvements and Repairs, —
Blacksmithing, ....
Labor,
Lime, sand, plaster and cement, .
Lumber and carpenters' work, .
Hardware and castings.
Steam, gas and water-pipes.
Paints, painting and papering, .
Carriages, wagons and sleighs, etc..
Harnesses, robes, blankets, etc., .
Stone-work, ....
Fencing,
Cordage,
Fertilizers,
Tools and implements for farm, .
Sundries, .....
Live stock,
Provender,
Soap,
Miscellan eo us, —
Interest, i
Express and telegraph.
Revenues and postage stamps.
Travelling and elopement expenses, .
Music and instruction,
W. C. Barbour, examination of accounts.
Patients fare home, ....
Cash to patients on account.
Sundries,
$2,507 25
653 26
427 68
78 75
$3,666
01
• ■ •
7,130
95
$143 85
1,372 29
1,516
14
.
1,179
22
.
977
90
■ . ,
620 75
1231 58
115 25
116 46
1,390 67
868 82
383 15
744 78
533 03
225 67
515 22
591 35
75 78
325 00
99 66
104 03
6,320 45
.
■ 1,719 50
.
2,385 06
•
1,169 25
$1,333 38
44 81
152 59
274 34
185 25
100 00
61 15
379 54
314 10
9 Sd!^ 1 ft
1807.] PUBLIC DOCUMENT— No. 22. 9
Trustees' expenses, . ^207 60
Salaries and wages, • 20,911 93
Freights, '. . . 126 86
Total expenditures for support of patients, .... §86,930 88
Paid loans 19,929 38
Balance cash, September 30, 1SG7, 1,779 64
Total, §108,639 90
Liabilities.
Worcester Co. Institution for Savings, §12,000 00
Accrued interest on same, 365 00
Due for bills of supplies, 7,051 83
for salaries and wages, 4,831 08
$24,247 91
Resources.
Cash on hand, §1,779 64
Due from cities and towns, 7,538 15
from individuals, 8,962 17
from Commonwealth, . ' 6,382 40
§24,662 36
Balance in favor of hospital, 414 45
Invested funds, market value, 1,919 00
Dividciul on hand, 15 00
Balance including fund, . . " ' 2,348 00
We have examined the foregoing accounts for llic year ending September 30,1867, and
find the footings and vouchers all correct.
WM. WORKMAN,
IIKNKY CIIAPIN,
Auditing Committee.
Ill the years 1854 and 1855, plans were made and adopted
for extensive operations and iniprovcnicnts in the buildings for
tlie purpose of ventilation, warming, classification, and new wing
for all domestic purposes to bo carried out and paid for from
surplus funds supposed to be on hand.
The plans were faithfully executed and the expenses ])aid
from the annual income of the hospital. The work extending
quietly through several years, the war of rebellion came on
with high prices, and found the hospital in debt from which it
could not relievo itself.
2
10 LUNATIC HOSPITAL AT WORCESTER. [Oct.
No increase in the price of board was made until July 1865,
consequently the debt increased. In the winter of 1866, an
appropriation was asked of the legislature of 115,000. This
was opposed by members of the board of state charities, on
accounts of certain alleged informalities and discrepancies in the
accounts of former treasurers. No report was made by the
committee on charitable institutions, and the petition was
renewed in 1866, when the same objection was raised. An
investigation was asked for and granted, which resulted in the
following report and the subsequent passage of a Resolve by the
legislature, appropriating the sum of -$15,000 to be applied for
the payment of the debts of the hospital.
D. W. BEMIS,
Treasurer.
Worcester Lunatic Hospital, \
Worcester, Oct. 1, 1867. \
1867.] PUBLIC DOCUMENT— No. 22. 11
REPORT OF ACCOUNTANT
Employed by the Cominiltee on Charitable Institutions.
WoRCESTEE, April 8, 1867.
I hereby certify that I have carefully examined the accounts
of the late Samuel Jennison and those of Henry Woodward,
late treasurers of the State Lunatic Hospital at Worcester, from
September 1, 1853, to October 1, 1866, and find them honestly
and correctly kept and fully vouched.
Mr. Jennison resigned his office August 31, 1857, to Mr.
Woodward, and reported a debt due at the Worcester banks, at
that time, of §8,955.46. The trustees immediately after passed
a vote authorizing Mr. Woodward to borrow of the Mechanics'
Bank =58,000 to pay the debts then outstanding.
From that time to the present, the institution has carried a
debt varying from about •'?9,000 to about -$20,000, on which
they have paid interest amounting to -87,258.82. This debt has
been in notes, and in many cases, aside from these notes, there
has V)ecn a large overdraft at the bank, and the reports made
from time to ^mc showing the amount due at tlic banks do not
show this overdraft.
I liave also examined the books at tlie Mechanics' Bank with
scrutiny, and find every note discounted and paid to corresj)ond
precisely with Mr. Woodward's entries on his book, with the
exception of some slight discrepancies in dates. These note
transactions at the bank up to October 1, 1866, amount in the
gross to -8164,500.
I notice on the books during Mr. Jennison's time, statements
tliat purport to be monthly statements of " hospital funds." I
cannot find any positive funds. On December 1, 1853, the
books show a surplus or balance on hand of -$23,131.85 and on
that very day there were liabilities against this balance to a
large amount, as the vouchers now on file, paid after that date,
prove ; but the amount cannot now be definitely ascertained.
There is, liowcver, no doubt in my mind, but what there was at
that time an actual surplus of several thousand dollars on hand.
12 LUNATIC HOSPITAL AT WORCESTER. [Oct.
At one time, July, 1854, tlie hospital loaned to the Massa-
chusetts Cotton Mills $15,000, and they held a bond of the
Worcester and Nashua Railroad of $500, but even at that time
there were demands against them outstanding. This loan to
the Cotton Mills was repaid in December 1855.
In relation to the " Hospital Fund," to which I have before
referred, I copy from the treasurer's (Mr. Jennison,) books,
December 1, 1854 :—
Amount of funds, including funds invested, . $22,629 97
Charges to the State, . . . $18,611 36
Cities, towns and individuals, . . 19,391 56
Patients for the month of December, 3,603 60
41,606 62
$64,236 49
This statement shows a fund or balance in favor of the hospi-
tal of $64,236.49. This is purely a fictitious statement. The.
charges against the patients for the month is a simple estimate,
undoubtedly somewhere in the neighborhood of correct, but
still not on hand, and not even earned. The charges against
the State, cities, towns and individuals, were, when made, no
doubt supposed to be correct, and to be real assets ; but many
of them were of long standing, some of them in a state of sus-
pense from not being correctly located, others frown other causes,
and all subject to corrections and abatements. They were not
at the time " funds " in any sense, but merely floating assets,
subject not only to corrections and deductions, but to floating
liabilities against them.
After a thorough examination of the vouchers, it appears that
there has been paid by the hospital during this period for per-
manent improvements, or strictly con-
struction account, .... $72,161 01
Land damages, .... 945 00
Real estate, . . . . . 1,275 00
$74,381 01
Under Dr. George Chandler's admin-
istration, $21,706 94
Under Dr. Bemis's administration, . 52,674 07
74,381 01
1867.] PUBLIC DOCUMENT— No. 22. 13
Although the books of the institution have not been kept in
that clear and distinct form showing plainly, at first sight, every
transaction under its proper date, and the true and actual con-
dition of the finances monthly, quarterly or even annually, still
I am positive that tlie accounts are all properly footed and
balanced, and from the evidence of the charges and vouchers
which I have carefully corppared with the books, that the result
now shown is correct. The hospital has carried a large debt
since 1857, and that debt on the first day of April 1867,
amounted to $18,851.13.
Liabilities.
Worcester Co. Institution for Savings, note and
interest, $12,365 00
Mechanics' National Bank, note, . . . 5,500 00
Alfred Wyman, note and interest, . . . 1,377 91
Pay roll, 5,443 55
Sundry bills for supplies, etc., .... 15,343 84
$40,030 30
Resources.
Cash, . ... . . . 8129 12
Due from towns, cities and individuals, 13,390 87
Due from Commonwealth, . . 7,650 18
21,179 17
Balance against the hospital, . . . $18,851 13
Among the items of permanent construction arc
new centre wing, etc., 23,029 00
Apparatus for warming, heating and draining, . 28,000 00
Respectfully submitted.
W. C. BARBOUR.
COMMONWEALTH OP MASSACHUSETTS.
In the Year One Tliousand Eiglit Hundred and Sixty-Seven.
Rksolvk in favor of the Worcester Lunatic Ilospitah
Resolved, That there be allowed and paid to the trustees of the Wor-
cester Lunatic Hospital the sum of fiftefin thousand dollars, to be
applied to the payment of the debts of the hospital.
14 LUNATIC HOSPITAL AT WORCESTER. [Oct.
OFFICERS OF THE HOSPITAL.
TRUSTEES.
HON. SAMUEL E. SEWALL, . . . Boston.
HON. EDWIN F. JENKS, .... Adams.
ROBERT W. HOOPER, M. D., ... Boston.
HON. HENRY CHAPIN, Worcester.
WILLIAM WORKMAN, M. D., . . . Worcester.
RESIDENT OFFICERS.
MERRICK BEMIS, M. D., . . . . Superintendent.
JOSEPH DRAPER, M. D Assistant-Physician.
CAROLINE A. BEMiS, Matron.
DANIEL W. BEMIS, 'Steward.
TREASURER.
DANIEL W. BEMIS, Worcester.
Office at the Hospital.
SALARIED OFFICERS OF THE HOSPITAL.
Superintendent, $1,800 00
Assistant-Physician, 900 00
Malroti, 200 00
Steward and Treasurer, 1,000 00
1867.]
PUBLIC DOCUMENT— No. 22.
15
SUPERINTENDENT'S REPOUT
To the Trustees of the Worcester Lunatic Hospital.
©ENTLEaiEX : — 111 obedience to the laws of the Common-
wealth, I have the honor to submit to you the Thirty-Fifth
Annual Report of the Institution over which you preside.
For the operations and results of the year in detail you are
respectfully referred to the following tabular statements, and
such brief accompanying remarks as may be necessary to
explain them.
Table- No. 1,
Showing the general results during the year.
Males.
Females.
Total.
Patients in the Hospital, October 1, 18C6,
190
191
881
Admitted durin;; the year, ....
154
1:34
288
Whole number under treatment,
341
3J5
OGO
Discharged recovered,
86
72
158
improved.
47
54
101
not improved,
■ 8
4
12
Died,
28
17
43
Whole number disebar;:cd.
167
147
314
Ilemaining, September M, 18G7,
. , 177
1
178
355
At tiic date of the last report there were in the hospital
three hundred and eighty-one patients. Since which time there
have been admitted two hundred and eighty-eight, and three
hundred and fourteen have been discharged or have died,,
leaving three hundred and fifty-five under treatment at the
close of the year.
The total number of patients under treatment during the
year was six hundred and sixty-nine. The highest number at
16 LUNATIC HOSPITAL AT WORCESTER. [Oct.
any one time was four hundred and twenty-seven ; the lowest
was three hundred and fifty-five ; and the average number
under treatment during the year was a fraction more than
three hundred and eighty-nine, or one hundred and ninety-six
and sixty-six one-hundredths males, and one hundred and
ninety-two and forty-two one-hundredths females.
The number of males in the hospital during the year was
three hundred and forty-four, and the number of females was
three hundred and twenty-five. The highest number of males
at any one time was two hundred and nineteen, and the highest
number of females was two hundred and eight.
At the beginning of the year, there were in the liospital one
hundred and ninety males and one hundred and ninety-one
females. At the close of the year there are one hundred and
seventy-seven males and one hundred and seventy-eight females ;
and these are the lowest numbers of each sex in the hospital
at any one time during the year.
The number of males admitted during the year was one
hundred and fifty-four, and the number of females was one
hundred and thirty-four.
The number of patients discharged was one hundred and
seventy-one, of whom one hundred and fifty-eight were restored
to usual health of body and mind, and were discharged as
recovered. The recoveries were in the ratio of a fraction less
than fifty -five per cent, to the number admitted ; or nearly forty-
one per cent, to the average number under treatment ; or
twenty-two and five one-hundredths per cent, to the whole num-
ber in the hospital in the course of the year ; or fifty-four and
five one-hundredths per cent, to the whole number discharged,
after deducting the number of those who died.
The recoveries were also in the ratio of seventy-six and six
one-hundredths per cent, to the number of those whose insanity
had existed one year only, or less, and only about eleven per
cent, to the number of those who had been insane more than
one year previous to their admission to the hospital.
The proportion of recoveries is somewhat less than has been
recorded in some former years, a fact which is explained by
the large number of admissions of chronic cases, several of the
patients admitted having been old, incurable and worn-out
1867.] ^ PUBLIC DOCUMENT— No. 22. 17
inmates of other aud more fortunate institutions for long
periods of years.
The absolute number of recoveries, however — one hundred
and fifty-eight — is creditable to the hospital, and is in no way a
blemish on the history of its life and labor.
Of the patients discharged as recovered, sixty- three had been
under treatment not more than three months ; forty-seven from
three to six months ; twenty-eight from six months to one
year ; and twenty for a longer period than one year. Only
three patients were discharged during the year as recovered
who had been inmates of the hospital for a period of three
years or more, one of whom remained under treatment five
years and another nine years.
Of those discharged as improved, fourteen were under treat-
ment not more tlian one month ; twelve from one to three
months ; seventeen from three to six months ; nineteen from
six months to one year ; and thirty-nine for a longer period
than one year.
Of those discharged and not improved, five were under our
care less than three months ; three from three to six months ;
two from six months to one year ; and two for more tlian one
year.
Of those discharged and recorded as improved, several were
so much improved as to bo able to return to their former occu-
pations and resume tlicir usual and customary responsibilities,
and are now performing their duties in a manner satisfactory
to their friends and to the public.
8
18
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 2,
Showing the Admissions and state of the Hospital from October 1, 1866,
to September 30, 1867.
Males.
Females.
190
191
154
134
177
178
99
81
52
52
3
1
108
91
20
11
24
31
2
1
67
59
71
83
50
51
Totals.
Patients in the Hospital, October 1, 1866, .
admitted in the course of the year,
remaining in the Hospital, Sept. 30, 1867, .
()f the admissions there were cases of one year or less
duration, ........
Of the admissions there were cases of more than
one year's duration, ......
Of the admissions there were cases the duration of
whose insanity could not be ascertained,.
Patients committed by Courts,
committed by Overseers of. the Poor, .
on bonds, .......
committed by Governor's warrant,
committed by the Board of State Charities, .
committed by Commissioners of Lunacy,
Foreigners and those having no settlement in the
State, committed in course of the year, .
Foreigners and those having no settlement in the
State, discharged in course of the year, .
Foreigners and those having no settlement in the
State remaining in the Hospital, Sept. 30, 1867,
381
288
355
ISO
104
4
199
31
55
126
154
101
State Paupers remaining in the Hospital at the close of each year, as
nearly as can he 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
1867,
101
1850,
181
1859, .
124
The preceding table shows that one hundred and eighty
patients were committed to the hospital in the course of the
year whose insanity had existed one year or less previous to
their admission. Other tables in this connection show that for
1867.] PUBLIC DOCUMENT— No. 22. 19
a period of about thirty-five years, seventy-five per cent, at
least of all patients committed to the hospital who had been
insane not more than one year previous to admission, have
recovered their mental health and strength, and have been
restored to their families and friends, and are useful members
of society. Our records also show that a large proportion of
those who are placed under treatment on the first appearance
of mental disease are restored within a period of six months.
It is important, therefore, that the patient should at once be
confided to the care of a hospital designed for the special treat-
ment of his malady.
The table also shows that so large a proportion as one hun-
dred and ninety-nine were committed by the probate courts of
the several counties, thus making the commitment of the
patients a legal, open, fair arrangement in a large majority of
cases. Of tlie eighty-six persons who were admitted on bonds,
proper certificates from physicians accompanied the bonds,
except in a few cases, when the patient voluntarily sought the
care and protection of the hospital. Of the one hundred and
ninety-nine committed by the courts, one hundred and twenty-
six were supported by the charity of the State. Of this class,
one hundred and fifty-four were discharged, leaving one
hundred and one in the hospital at the close of the year.
20
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 3,
Shoiuing the Nmnber Admitted, Restored, Improved, Died, S^^c, in each
Month in the Year.
Table No. 4,
Showing the form of Disease in those Admitted and Discharged during
the year.
Admitted.
DiSCHAKGED.
FOKM OF DISEASE.
"a
s
"o
1^
"3
o
El
Mania,
" Chronic,
" with Epilepsy,
" with general Paralysis,
Melancholia, ....
Dementia, ....
" Senile,
" with Epilepsy, .
" with general Paralysis,
Monomania of Fear,
of Pride, . * .
of Suspicion,
63
13
7
6
19
20
1
4
9
7
5
70
26
4
1
17
9
5
2
133
39
11
7
36
29
1
4
9
12
7
56
30
5
4
19
18
6
10
6
5
5
3
59
37
3
21
14
2
3
1
4
2
1
115
67
8
4
40
32
8
13
7
9
7
4
Totals, . . .
154
134
288
167
147
314
1867.]
PUBLIC DOCUMENT— No. 22.
21
Table No. 5.
Supposed Causes of Insanity of Patients admitted into the Hospital
from January 18, 1833, to September 30, 1866.
186T.
Pkeviouslt.
CAUSES.
Males.
Females.
Males.
Females.
Apoplexy,
_
_
1
2
Asthma, .
—
—
1
—
Bronchitis,
-
-
-
1
Bowels, Disease of, .
-
-
1
-
Cancer, . . .
-
—
—
1
Chorea, ....
-
-
-
3
Constipation, .
-
- 1
-
-
Convulsions, .
- - 1
10
12
Dysentery,
-
-
. 2
2
Dyspepsia,
1 _
-
3
2
Epilepsy,
11
5
177
64
Eruptive Diseases, .
' —
—
3
3
Eyes, Disease of,
-
-
2
-
Eyes, Loss of, .
-
-
1
-
Erysipelas,
-
-
1 ^7
1
Fevers, .
1
-
51
72
Hysteria,
-
-
1 _
1
Ilemorrhoides,
— — 1
1
1
111 Health, .
41
4-1 1
216
900
Influenza,
-
1
3
Insolation,
-
-
19 ;
Idiocy, .
1 _
-
18
10
Laryngitis,
1 _ _ ;
-
_
]Measles, .
-
-
4
6
Nervous Irritation, .
-
-
-
-
Nvmphomania,
-
-
-
4
Oi<l Age, . .
2
3
28
31
Otitis, .
1
-
-
-
Paralysis,
1 ^*
2
77
28
Pneumonia,
1
-
-
—
Rheumatism, .
-
-
5
1
Scrofula,
2
o
2
2
Sea-sicknf's<(, .
-
-
1
1
.Somnambulism,
1
-
-
2
Suppressed Eruptions,
:
-
4
.3
Suppressed Ulcer, .
1
-
1
3
Satyriasis,
1
-
1
-
Tic Douloureux,
-
1
-
1
umor, .
-
-
—
1
Whooping Cough, .
-
-
I
-
Amcnorrliffa, .
-
2
-
21
I^actatioii, Excessive,
-
1
-
3
Menorrhagia, .
-
-
-
10
Menorrhagia, Suppressed,
-
-
-
27
Miscarriage, .
—
1
"
4
22 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 5 — Concluded.
1861.
Pkeviodslx.
CAUSES.
Males.
Females.
Males.
Females.
Pregnancy,
12
Puerperal,
-
8
_
220
Turn of Life, .
-
13
_
77
Amputation of Lej;,
-
-
1
_
Bathing in Cold Water,
1
_
2
_
Drinking Cold Water,
_
_
1
_
Exposure to Cold, .
-
-
11
13
Injuries by Falling, &c.,
1
20
6
Injury of Head,
2
1
60
13
Injury of Spine,
-
1
5
7
Lead, Poison of,
_
_
5
_
Lightning, Stroke of,
-
-
-
1
Labor, Excessive, .
-
-
44
60
Loss of Sleep,
1
-
-
3
Study, Excessive, .
-
-
29
12
Spiritualism, .
o
-
20
24
Criminal Trial,
_
_
_
1
False Accusation, .
_
_
_
1
Imprisonment,
-
_
4
1
Death of Relatives,
1
4
30
86
Domestic Trouble, .
1
3
114
343
Marriage, Unhappy,
- •
-
2
5
Disappointment in Love,
1
2
66
100
Disappointed Ambition,
-
_
9
9
Home Sickness,
_
-
6
18
Fright, .
-
-
21
24
Seduction,
_
_
_
3
Millerism,
_
_
9
G
Political Excitement,
_
-
10
1
Religious Excitement,
2
-
156
177
Pecuniary Trouble,
1
1
144
37
Poverty, .
-
-
1
1
Poverty, Fear of, .
-
-
32
8
Prosecution, .
-
-
1
-
Giving up Business,
-
-
2
-
Change of Business,
1
-
8
-
Violent Temper,
-
2
2
13
Jealousy,
-
-
18
28
Intemperance,
17
3
613
84
Opium, Use of.
-
-
3
9
Tobacco, Use of,
-
-
2
7
Masturbation,
26
3
383
66
Venery, Excess of, .
-
-
1
-
Unknown,
25
31
1,118
1,133
Totals,
154
134
3,783
3,831
18G7.]
PUBLIC DOCUMENT— No. 22.
osi
The foregoing table shows the causes, as assigned by the
friends of the patients, of insanity in the admissions of the
year and of all previous years since the opening of the hospital.
These may all be arranged in two classes, according as their
influence was of a moral or physical nature. The table illus-
trates with sufficient clearness for all practical purposes the
proportions which these classes bear to each other ; and in this
respect the statements made in the table are more reliable
than in any other.
In general, the histories given us of the patients are meagre
and not wholly to be depended upon, so that it is impossible
to give a complete classification of the causes of insanity in
the admissions of one year even, or show very clearly the com-
binations of circumstances influencing the patient previous to
his mental disease. It is hoped that a more satisfactory table
in this department may hereafter be presented, considerable
labor having already been expended in that direction.
Table No. 6,
Shotcing the Ages of Patients Admitted, Discharged Recovered^ not
Recorercd and Died during the Year.
AGES.
Admitted.
DiscnAROED Re-
covered.
DiscnAROED NOT
Recovered.
Died.
SlolCB.
Females.
Males.
Females.
Males.
Females.
Males.
Females.
Less tlian 15,.
1
2
2
_
1
1
1
From 15 to 'JO,
9
9
7
10
4
5
-
1
20 to 30,
37
26
28
14
20
13
4
2
30 to 40,
30
33
15
15
10
13
4
2
40 to 50,
35
27
13
20
10
15
6
3
50 to 60,
19
16
16
7
5
10
4
1
60 to 70,
11
12
3
2
2
2
3
70 to 80,
5
4
1
-
2
-
. 4
2
80 to 90,
1
3
1
-
1
-
1
2
Unknown, . .
-
-
-
-
-
-
-
-
Totals, . .
151
m 1
80
72
55
58
26
17
24
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 7,
Showing the Ages of Patients Admitted, Discharged Recovered, not
Recovered and Died, from January 18, 1833, to September SO, 1866.
Admitted.
DlSCHAEGED RE-
COVERED.
Discharged kot
Recovered,
Died.
AGES.
Males.
Females.
Males.
Females.
Males.
Females.
1
Mal^.
Females.
Less than 15, .
32
25
5
11
20
12
1
1
From 15 to 20,
229
234
123
1^8
67
63
15
15
20 to 30,
1,005
964
491
491
356
372
65
73
30 to 40,
930
1011
452
488
400
370
102
98
40 to 50,
797
830
339
375
289
276
106
97
50 to 60,
421
466
177
219
161
148
75
86
60 to 70,
255
217
90
102
101
69
56
55
70 to 80,
99
71
23
26
25
21
40
23
SO to 90,
14
12
5
2
4
4
5
5
Unknown, . .
1
1
-
-
-
1,335
-
-
Totals, . .
3,783
3,831
1,705
1,852
1,423
465
453
Table No. 8,
Showing the Duration of Insanity hefore Admission of Patients Admitted,
Discharged Recovered, not Recovered, and Died during the year.
Admitted.
Discharged
Recovered.
Disch'dTiot
Recovered.
Died.
DURATIOX OF I^"SA^'ITY.
i
1
fa
"3
1
s
fa
1*.
"3
e
a
S
<a
fa
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, . . .
99
18
16
9
4
2
2
1
3
1.54
81
13
14
11
9
3
2
1
78
4
2
1
1
60
6
4
1
1
31
12
5
1
2
2
1
1
55
35
8
6
6
1
1
1
13
4
4
2
1
1
1
11
2
2
1
1
Totals, ....
134
86
72
58
26
17
186T.]
PUBLIC DOCUMENT— No. 22.
25
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, 1866.
Admitted.
Discharged Re-
covered.
Discharged not
Kecovered.
Died.
DUKATIOX OF ISSAXITY.
J,
to
aa
r5
S
1
1
S
s
s
a
Insane one year or less, .
2,387
2,598
1,310
1,445
641
605
231
277
More than one year, and
less than 2 years.
146
117
172
155
110
86
31
17
More than 2 years, and
less than 5 years,
533
507
lie
132
205
185
89
67
More than 5 years, and
less than 10 years,
204
209
47
56)
213
202
36
29
More than 10 years, and
less than 15 years.
154
101
13
22
110
103
31
25
More than 15 years, and
less than 20 years.
71
44
9
9
44
05
19
11
More than 20 years, and
ss than 25 years,
50
42
7
6
32
35
7
More than 25 years, and
less than 30 years.
19
16
5
1
10
10
7
6
Thirty years or more.
32
29
2
5
13
13
8
6
Unknown,
97
48
24
2,705
21
1,852
45
1,423
31
1,335
1
■ 8 8
Totals,
3,783
3,831
465 453
26
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 10,
Showing the Civil Condition of Patients Admitted, Discharged Recovered,
not Recovered, and Died during the year.
CIVIL
Admitted..
Discharged Ke-
COVERED.
Discharged not
Recovered.
Died. <
CONDITIOIf.
Males.
Females.
Males.
Females.
Males.
Females
Males.
Females.
Unmarried, .
Married,
Widowers,
Widows,
Unknown,
81
64
7
2
52
56
26
50
33
3
35
18
19
35
16
4
30 1
20 '
8
6
16
4
7
4
6
Totals,
154
134
86
72
55
58
26
17
Table No. 11,
Shoioing 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.
COiv^DITION.
Males.
Females.
Males.
Females.
Males.
Females.
Males.
Females.
Unmarried, .
Married,
Widowers,
Widows,
Unknown, ' .
1,991
1,597
172
23
1,634
1,722
454
21
840
795
67
3
734
899
216
3
858
501
52
12
702
487
132
14
181
225
53
6
191
178
82
2
Totals,
3,783
3,831
1,705
1,852
1,423
1,335
465
453
1867.]
PUBLIC DOCUMENT— No. 22.
27
Table No. 12,
Showing the Occupation of Patients admitted to the Hospital from
January 18, 1833, to September 30, 1867.
OCCUrATIOX OF MALES.
ISC'?.
rrcviously.
Auctioneers,
2
Armorers,
_
3
Authors, ....
-
3
Blacksmitlis and Iron-workers
4
66
Bakers, ....
-
12
Butchers,
-
5
Book-agents, .
_
2
Book-binders, .
-»
3
Broom-makers,
o
Book-keepers, .
_
10
Brittania-workers, .
_
2
Brick-makers, .
_
6
Bellows-makers,
_
2
Barbers, ....
1 •
15
Clergymen,
_
25
Carvers, ....
-
3
Carpenters,
2
125
Coppersmiths, .
-
9
Coopers,.
-
22
Cabinet-makers,
_
17
Clothiers,
1
15
Comb-makers, .
_
4
Confectioners,.
-
3
Card-makers, .
-
1
Chair-makers, .
-
3
Cigar-makers, .
-
fj
Clerks, ....
9
102
Carpet-weavers,
-
3
Caulkers,
_
3
Camphenc-distillcrs,
-
3
Dyers, ....
-
3
Druggists,
-
3
Drovers, ....
-
2
Daguerreotypeists, .
1
3
Engineers,
—
2
Engravers,
—
4
Editors, ....
-
4
Expressmen, ....
-
14
Farmers, ....
17
746
Fishermen,
2
33
Gardeners,
1
9
Glass-blowers, ....
_
4
Ilotel-kccpcrs,
_
14
Hatters, ....
1
7
Harness-makers,
_
14
Hackmen and Teamsters,
o
35
Jewellers, ....
~
21
28 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 12 — Continued.
OCCUPATION OF MALES.
1 8 6 7 ,
Previously.
Lawyers, . . . .
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 Boot-makers,
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, . . .
1
40
1
1
6
12
2
1
4
4
15
15
850
31
6
155
32
4
1
3
7
49
7
82
1
47
34
24
7
15
1
4
4
5
3
11
. 8
300
9
16
160
58
9
5
10
25
1
1
2
29
27
38
3
8
23
2
18
236
154
3,783
1867.] PUBLIC DOCUMENT— No. 22.
Table No. 12 — Concluded.
29
OCCUPATION OF FEMALES.
1 8 C 7 ..
Freviously.
1
Actresses, ....
_
2
Cooks,
1
63
Engraver, ....
—
1
Housekeepers,
76
2,052
Housemaids, .
17
391
Laundresses, .
-
4
Music teachers.
-
3
Midwives,
-
2
Nurses, ....
-
14
Operatives in Mills,
19
208
Seamstresses, .
12
734
School-girls, .
4
41
Teachers,
o
80
Tvpe-setters, .
-
3
No occupation,
3
233
Totals, . . .
134
3,831
Table No. 13.
Diseases ivhich have p7-oved fafal, from January 18, 1833, to September
30, 18G7.
\
18G7.
I'revlouslj'.
DISEASES.
j Males.
Females.'
Males.
Females.
Apoplexia,
_
_
16
11
Asphyxia,
-
-
-
Asthma, .
-
-
4
1
Ascites, .
-
-
5
7
Autochiria,
-
-
16
11
Bronchitis,
-
-
2
-
Carcinoma,
—
—
2
2
Cardionosus, .
-
2
11
12
Cholera, .
-
-
5
-
Cholera Morbus,
-
-
2
3
Cystitis, .
*
-
-
1
1
Dysentcria,
-
-
12
6
Delirium Tremens,
—
—
4
—
Enteritis,
-
-
6
9
Epilepsia,
3
4
71
33
Erysijjclas,
-
-
9
10
IIef)atitis,
■-
1
-
2
Hydrothorax, .
-
-
1
1
Hernia, .
-
—
1
—
Inanitio, .
2
1
30
57
LUNATIC HOSPITAL AT WORCESTER.
Table No. 13 — Concluded.
[Oct.
1867.
Previously.
DISEASES.
• Males.
Females.
Males.
Females.
Mania, Exhaustive,
2
1
13
14
Marasmus,
4
2
68
68
Meningitis,
2
1
9
14
Mortificatio, .
-
-
-
1
Necropneumonia, .
-
-
1
2
Paralysis,
5
-
50
20
Phthisis Pulmonalis,
5
3
60
121
Pleuritis,
_
_
_
2
Pneumonia,
-
-
15
9
Senectus,
3
2
26
19
Tvpho-Mania, .
-
-
8
11
Typhoid Fever,
-
-
8
6
Variola, .
-
-
1
465
-
Totals, .
26
17
453
Table No. 14, , ^
Showing the Admissions from each Goiinty, from January 18, 1833, to
September 30, 1867.
ise?.
Previously.
C OUNTIES.
Whole No.
Males.
Females.
Totals.
Barnstable,
128
128
Berkshire,
_
1
1
189
190
Bristol,
_
_
-
294
294
Dukes,
_
-
-
19
19
Essex,
32
23
55
1,104
1,159
Franklin, .
-
-
-
126
126
Hampden,
-
-
-
372
372
Hampshire,
-
-
-
225
225
Middlesex,
50
49
• 99
1,287
1,386
Nantucket,
f
-
-
-
32
32
Norfolk, .
3
4
7
630
637
Plymouth,
1
1
• 2
236
238
Sufiblk, .
5
6.
11
731
742
Worcester,
63
50
113
2,199
2,312
Other States,
-
-
-
42
42
Totals,
•
154
134
288
7,614
7,902
1867.]
PUBLIC DOCUMENT— No. 22.
31
Table No. 15,
Showing the Whole Number of Patients during the last year, the Average
Number, the Number at the end of each year, the Expense of each year,
the Annual Expense for each Patient, and the Expense of each Patient
per week for each of the Thirty five Years the Hospital has been in
operation.
YEAES.
Whole
Xumber.
Average
Xumber.
No. at
end of each
Year.
Current
Expenses of each
Year.
Annual
Expense for each
Patient.
Expense per
Week for
each Patient.
1833, .
153
107
114
$12,272 91
$114 67
12 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
4850, .
670
440
441
46,776 13
106 40
2 04
1851, .
704
462
406
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
^6
54,895 88
157 29
3 02
1856, .
577
■357
376
45,631 37
128 04
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, .
000
401
396
53,043 88
132 18
2 50
1863, .
611
398
399
66,082 36
106 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
1867, .
669
389
355
86,930 88
223 47
4 30
It will be seen by the foregoing table, that the number of
patients under treatment during the year was larger than
during the previous year, and the average number was consid-
erably greater. It will also be noticed that while the number
32
LUNATIC HOSPITAL AT WORCESTER. [Oct.
was increased, the aggregate cost of support was somewhat
diminished, thus making the average weekly expense per patient
very considerably less.
While great care has at all times been taken that the expenses
of the institution should be kept as low as possible, it has seemed
to be a wise economy to expend all that was necessary for the
most complete and speedy restoration of all curable patients,
and just and humane to spare no expense in our efforts to
relieve, as far as is possible, the mental condition of those who
do not recover, and render their situation as comfortable as the
nature of their several complaints will permit.
While the cost of support has been somewhat diminished,
the following statement of prices for several years past will
show no great reduction in the cost of any article of consump-
tion, except coal. "Breadstuffs and labor still remain at the
high rates held during the war, with no prospect of immediate
change.
PEICES.
ARTICLES.
ISSl.
1863.
1863. 1864.
1865.
1866.
186'r.
Sugar,. . . .
10 08|
$0 11
-10 141 $0 241 $0 20
$0 14
10 14f
Molasses,
26
46
55
1 00
85
70
65
Tea, .
42
65
75
1 15
1 12
1 10
1 05
Coffee,
16
26
32
•
28
45
40
35
32
Butter,
16
23
55
47
50
30
Rice, .
n
8
8i
14
12
11
11
Codfish,
3
4|
6f
7i
8
7|
7
Beef, .
6i
7
8
15
18
18
16
Flour, of the quality used
at this Hospital,
6 75
7 00
8 75
15 00
11 00
14 00
14 50
Standard Prints for
Dress Goods, .
9
13
25
37
35
25
16
Cottons, 36 inches wide.
H
21
35
. 65
40
32
21
Cottons, 45 inches wide,
121
28
50
75
70
46
33
Blankets,
2 75
3 50
6 50
9 00
9 50
7 50
5 75
Coal, ....
6 50
6 75
10 50
16 50
15 00
12 50
8 00
1867.] PUBLIC DOCUMENT— No. 22. S3
A considerable expense must be made in the course of the
ensuing year, for paints and oils, and the necessary labor of
painting, papering and general repairing, which has been neg-
lected during the period of high prices, and which cannot
longer be left undone without great detriment to the property
of the Commonwealth. The annual repairs of an establish-
ment subjected to the hard uses of hospitals for the insane,
must always be considerable.
Twenty-six males and seventeen females have died during
the year. Of these deaths, three resulted from the complica-
tions incident to mania in its acute stage, three from organic
disease of the brain, eight from phthisis, two from disease of
heart, seven from epilepsy, five from general paralysis, six from
marasmus, five from the diseases incident to old age, and four from
the gradual exhaustion of chronic mania. Three of the deaths
occurred suddenly, two of which were almost instantaneous.
Of the patients who died in the course of the year, four were
admitted while suffering from mania in its acute stage, thirteen
while suffering from chronic mania, nine from melancholia,
and seventeen from dementia.
Of those who died, three did not live more than one week
after being placed in the hospital, five others died within two
weeks after admission, and four more died before the expiration
of one month ; six died between one and three months, one
between three and six months, and three between six months
and one year after admission, and twenty-one were residents of
the hospital for longer periods than one year.
The records of the hospital sliow in each year how dangerous
a disease insanity really is ; and although a favorable termina-
tion may generally be expected after safely passing through the
acute stage, yet so large a proportion as thirty-nine out of forty-
three deaths occurred to patients wlio had been admitted to the
hospital after tlie acute stage of disease had passed, and recov-
ery had become well-nigh hopeless. It is safe to suppose, that
had these persons been earlier committed to some hospital for
>curative treatment, the recoveries and not the deaths, of some
of them at least, might have been reported.
It has happened, in several instances in the course of the
year, that patients have been brought to the hospital who were
too ill and feeble to bear the excitement and fatigue of the
5
34 LUNATIC HOSPITAL AT WORCESTER. [Oct.
journey, and a permanent injury had resulted to the persons
thus committed. In some of these cases death has speedily
followed the admission of the patient.
While it is highly important that prompt measures be resorted
to in the treatment of insanity, the most scrupulous care should
be taken that the patient be not subjected to the exposure and
fatigue attendant upon removal in a feeble and exhausted state
of health.
As usual, quite a number of very aged persons have been
committed to our care in the course of the year. Four per-
sons have been committed to the hospital, who were each more
than eighty years of age, and one of whom was more than
eighty-five. Five have been committed who were between
seventy-five and eighty, and five who were between seventy and
seventy-five. The hospital is not a proper place for these per-
sons. They can receive no benefit by a residence in it. They
should be cared for by their families and friends, and failing in
that, there should be some retreat, some home, where these
feeble, aged persons could quietly spend the remainder of their
days, under the care of kind, faithful, judicious nurses, and
peacefully pass from this to the world to come. You will
remember that this subject has been often reported to you, and
you will also remember with what feelings of sadness you have,
in your visits, contemplated the condition of these poor old
men and women, sent away from home, family and friends, at
that period of life, and in that condition of mental and bodily
infirmity, when the kind attentions of relatives and friends, the
comforts and pleasures of home, are most needed, and for the
hope of which, all the energies of youth and manhood have
been exhausted. Let me most earnestly recommend the estab-
lishment of a home and family for this most helpless class of
your patients, and let us hope that the recommendation may be
most speedily acted upon, so that we may be able to give these
persons committed to our care the comfort and protection they
so much need.
Among the old and feeble patients in the hospital, there has
been more than the usual amount of bodily illness of a some-
what mild character, caused in part by the enfeebled condition
of many when admitted, and in part by the long-continued
1867.] PUBLIC DOCUMENT— No. 22. 35
cool, wet, changeable weather of the spring, summer and earlj
autumn.
The following tables will illustrate some of the results of labor
performed by the inmates of the hospital. The greatest and
best of all results, however, the increased health, vigor and
activity, both mental and physical, of the patients, cannot be
shown in any table, and can hardly be estimated.
About sixty per cent, of the patients perform some labor,
directed and assisted by their attendants, and about twenty per
cent, labor to advantage, under the direction of their attendants,
without assistance. A very large proportion of the females are
employed during some part of each day, at labor of some descrip-
tion. The males suffer from the want of those light employ-
ments which are so convenient and useful to females, and bavins:
been bred only to labor of a rougher character, are, when insane,
little inclined to form any new habits useful to themselves or
others.
All labor done by the iilmates of the hospital is of an unsteady,
unreliable nature, requires constant oversight, direction and
assistance, and is of a quality which few employers would be
willing to purchase at any price.
Our patients, perhaps, receive the most direct advantage of
labor from the licalthy, pleasant occupation the farm and
gardens afford to such as engage iu that kind of work. Our
tables show that the products of the farm have been abundant,
and have well repaid the labor devoted to their cultivation and
growth.
A very considerable amount of labor has been expended
in fencing, ditching, under-draining and improving the value
of the land belonging to the hospital. The gardens have
been materially improved, the lawns enlarged, new walks and
driveways laid out, and many trees removed, and others
transplanted.
36
LUNATIC HOSPITAL AT WORCESTER. [Oct.
w
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1867.]
PUBLIC DOCUMENT— No. 22.
37
Articles made in the Sewing-Rooms during the Year.
Aprons, 51
Mattress Ticks, . .
270
Bed-Spreads, .
137
Mittens, pairs of, .
18
Bed-Ticks, .
106
Neck-ties, . . .
29
Blankets,
29
Night-Dresses,
21
Bags, .
19
Night-Caps, .
23
Carpets, .
11
Overalls, pairs of, .
17
Chemises,
183
Pants, pairs of,
44
Coats,
5
Pillow-Cases, .
311
Collars, .
41
Sheets, ....
194
Curtains,
53
Shirts, ....
. 211
Drawers, pairs of,
64
Shirt-Bosoms, .
26
Dresses, .
. 181
Skirts and Quilts, .
78
Edging, yards of,
38
Suspenders, pairs of,
22
Frocks, .
3
Table-Covers,
21
Handkerchiefs,
31
Towels, ....
. 211
Hose and Socks, pairs of.
52
Undershirts, .
11
Jackets, ....
19
Vests, ....
17
Articles repaired in the Seiving-Rooms during the Year.
Aprons, Ill
Night-Dresses, . . . 98
Blankets,
117
Overalls,, pairs of, .
63
Bed-Spreads, .
121
Pants, pairs of.
1,089
Bed-Ticks, .
641
Pillows, .
87
Bags, .
19
Pillow-Cases, .
483
Chemises,
3,621
Sheets, .
931
Coats,
429
Shirts, .
4,327
Collars, .
47
Shirt-Bosoms, .
34
Curtains,
73
Skirts, .
. 198
Drawers, pairs of.
672
Stockings, pairs of,
4,962
Dresses, .
. 849
Table-Cloths, .
49
Frocks, .
31
Towels, .
218
Jackets, .
82
Undershirts, .
. 124
Mattresses,
97
Vests,
. 171
38
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Articles made in the Shops.
BeeMves,
7
Set of Shelves,
3
Bolts, .
63
Pair of Shafts,
1
Boxes, .
34
Table-Legs, . . .
. 110
Bedsteads,
13
Tool-Handles,
50
Bureaus,
2
Watch-Chains,
2
Boot-Jacks,
3
Patterns,
12
Knobs, .
45
Writing Desks,
4
Chair-Kounds,
150
Picture-Frames,
30
Ox-Sleds,
2
Gimlets, .
3
Tent-Frame, .
1
Stone-Boats, .
2
Truck, .
1
Iron Rods,
30
Dog-House, .
1
Knife-Blades, .
. 20
Curtain-Sticks,
60
Mattresses,
. 270
Screens, .
3
Pillows, ...
. 311
Chisels, .
13
Rabbit Planes,
6
Coal Sieves, .
4
Turning Lathe,
1
Wardrobe Hooks,
12
Roof Sashes, .
4
Settees, .
a
Wardrobes, .
2
Small Tables, .
29
Whiffletrees, .
4
Wash-Stands, .
7
Barrel-Covers,
6
Flower-Stands,
4
Walking-Sticks,
6
Tool-Chests, .
6
Buckets,
12
Work-Boxes, .
8
Brackets,
12
Screw-Drivers,
7
Mop- Sticks, .
. . '74
Models, .
4
Windows glazed, .
. 600
1867.]
PUBLIC DOCUMENT— No. 22.
39
Ull lOUlC
> / CJJUOI
Kti Vlt IIIV ^JIIUJJSm
Bedsteads,
27
Razors, .
30
Brass Eings, .
18
Rakes, .
36
Boots, pairs of.
13
Saws,
40
Boxes, ....
21
Shaft-Wheel, •
1
Bureaus,
16
Stands, .
24
Blinds, ....
. 21
Settees, .
50
Brooms, ....
7
Scissors, .
18
Chairs, ....
. 127
Sofas,
4
Clocks, ....
4
Sleigh, .
1
Coffee-Pots, .
12
Chains, .
4
Chisels, ....
21
Sleds, .
2
Crickets,
6
Sashes, .
12
Flower-Stands,
4
Tubs, .
8
Flat-Irons,
6
Tables, .
12
Frames,
21
Tin Pans,
24
Boots Ironed, pairs of .
9
Tea Kettle, .
1
Looking-GIasses, .
24
Trunks, .
8
Horse Wagons,
2
Umbrellas,
4
Ox Wagons, . . . .
2
Window-Rods,
50
Hoes,
18
Windows,
74
Iron Bars, . . . .
2
Wheelbarrows,
6
Knives,
24
Lock Keys, .
.24
Pen-Knives, . . . .
12
Book-Cases, .
4
Lounges, . . . .
8
Hay-Forks,
2
Lanterns, . . . .
4
Hand-Carts, .
2
Pails,
27
Saws filed,
50
Parasols, . . . .
2
40
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Products of the Farm.
AETICLES.
Market
Value.
Total Value.
Apples, 40 bbls.,
$4 50
1180 00
Pears,
35 bush.,
4 00
140 00
Cherries, .
2 "
5 GO
10 00
Grapes,
25 "
2 00
50 00
Tomatoes, .
300 "
75
225 00
Currants, .
10 "
3 00
30 00
Sweet Corn,
75 "
1 00
75 "00
Gooseberries, .
2 "
2 00
4 00
Beans,
30 "
3 00
90 00
Parsneps, .
100 "
50
50 00
Turnips, .
250 "
30
75 00
Potatoes, .
600 "
1 00
600 00
Beets,
250 "
30
75 00
Manjiel-wurzel,
1,200 "
30
360 00
Carrots, .
1,200 "
35
420 00
Squashes, .
3 tons.
60 00
180 00
Peppers, .
25 bush.,
50
12 50
Cucumbers,
75 "
75
55 25
Cabbages, .
. 2,500 heads,
10
250 00
Ehubarb, .
2,500 lbs..
02
50 00
Hay,. .
. 100 tons.
20 00
3,000 00
Corn fodder,
15 "
10 00
150 00
Milk,
.55,000 qts..
06
3,300 00
Beef, sold,
.10,919 lbs..
14
1,528 66
Pork, sold,
. 5,242 "
15
786 30
Other produce sold,
.
-
257 37
Total,
^11,954 08
1867.]
PUBLIC DOCUMENT— No. 22.
41
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42
LUNATIC HOSPITAL AT WORCESTER. [Oct.
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1867.] PUBLIC DOCUMENT— No. 22. 65
With feelings of gratitude we are able to report that there
has been no attack of epidemic disease in the hospital during
the year, and there has been also almost entire absence of acute
disease of any form.
The hospital was opened for the reception of patients on the
18th of January, 1833, since wliich time seven thousand nine
hundred and two insane persons have received the benefit of
its care and custody. Of this number, three thousand seven
hundred and fifteen have been discharged recovered, and
restored to their families and friends. One thousand five hun-
dred and twenty have been discharged improved ; one thousand
three hundred and fifty-four have been removed by their
friends or guardians, or were transferred to other institutions
without material change, and nine hundred and sixty-one
have died.
It is my duty to complain of the manner of cammitment in
many instances of patients to the hospital. Some oflficers and
guardians undertake to mislead and deceive tlie patients when
intrusted with the duty and responsibility of commitment, by
promises of journeys, or visits to places of entertainment,
or by making the patient believe the hospital a hotel, and
on entering by giving such orders as are usual at such places.
The officers of the hospital have never been guilty of promothig
any such practice, but have, on all occasions, said and done
what they could to correct the evil.
Feelings of kindness undoubtedly prompt many individuals
to adopt some plan of deception when about to place their
insane relations in a public hospital ; but such plans are always
destructive to the welfare of the patient and the interests of
the institution. They tend to invest the disease with horror
and disgust. They multiply and strengthen the delusions of
the patient with regard to the hospital, and by a certain reac-
tion, they diminish the public confidence in the care and treat-
ment of the insane. It is acknowledged by all who have had
much to do with persons suffering from mental disease, that
next to kindness, perfect candor is most likely to calm the
excited passions, and reassure tlie disturbed confidence of the
deranged mind.
A large majority of patients, if candidly told they were about
to be removed from home and placed in a hospital, would cheer-
9
66 LUNATIC HOSPITAL AT WORCESTER. [Oct.
fully acquiesce in the arrangement ; and if persuasion should
fail to remove them quietly, it would be infinitely better that
necessary force should be used by friends and relatives, than
that deception should be resorted to, and thus destroy the
confidence of the patient, and force upon his diseased mind
the conviction that the officers of the hospital were concerned
in a plot to deprive him of his liberty.
Having personally observed the conduct of nearly five thou-
sand patients on their admission to the hospital, I do not hes-
itate to declare the extreme rarity of any exhibition of violence
or anger caused by their commitment, in an open and legal
manner, to the care and custody of a public institution. On
the contrary, many who had been very troublesome, violent
and dangerous, become immediately quiet and comparatively
calm when they are placed in the wards of the hospital, and
commence at once to exercise all the powers of self-control
they possess.
It is only when fraud and deception has been resorted to,
that t^lie patient becomes suspicious, restless, turbulent and
violent. When honestly and openly committed, and on their
admission treated with candor and kindness, they recognize the
fact that they are among friends whose care it is to soothe and
protect them.
Mistakes like these must be borne until the community shall
be made to regard insanity as a disease, and not a vice ; until
they shall be able to look upon those suffering from mental
disease as they look upon other sick people afflicted with a
malady no more horrible, and as curable in its early stages, as
any other ; and until they can be made to believe that when
cured they are fully and completely restored, and as deserving
of confidence and trust as they ever were.
Seclusion has been resorted to during short intervals, gen-
erally for a few hours only at a time, quite frequently ; its
employment being confined to a very few individuals in the
excitable wards, whose violent and destructive propensities
during their paroxysmal attacks, render it necessary that at
such periods they should be separated from their companions.
The ordinary sleeping-rooms of the ward are always used
for this purpose. Rarely has any one been placed under so
called physical restraint.
1867.] PUBLIC DOCUMENT— No. 22. 67
One patient has been in seclusion a small portion of every-
day, and when not in seclusion wears loosely fitting leather
bands upon her wrists, so loosely however that she is able to
sew and knit with ease and comfort while thus confined. The
destructive tendencies of this patient have been for a long
period of time quite extraordinary ; when placed by the side of
other patients, her efforts to assault, worry and to tease are
incessant. When alone her excess of vitality is generally
expended upon her clothing and furniture. All the usual
devices for safety and protection have been thus far quite
useless.
Another female patient has been permitted to remain in her
room a large part of the time for about two-thirds of the year.
When thus secluded she is generally quiet, comfortable and
happy ; but when with others she is always abusive and violent ;
she cannot even suffer the ordinary change of cleansing her
room and making her toilette in the morning without an
exhibition of the most violent temper and vulgar abuse.
One male patient, who has in other institutions made several
homicidal attacks, wears on his wrists leather bands so loosely
fitted that he assists readily and easily in sweeping and
scrubbing.
And one other male patient has during a small portion of
the year been kept constantly in his room on account of long
continued violent maniacal excitement, from which he is now
happily recovering.
Tlie absolute amount of seclusion and restraint will be
better understood by you when I state what the official records
will prove, namely, that the whole time spent in seclusion and
restraint directed or permitted by the management of the
hospital bears the proportion of only twenty-eight one thou-
sandths of one per cent, to the whole time passed by the
average number of patients in the hospital during the year.
This state of things ought certainly, to be highly satisfactory
to you when it is remembered that patients are often brought
to the hospital in irons and strait jackets ; and when it is no
uncommon thing that from notions of prudence and safety the
patient is accompanied to the hospital by two or three stalwart
men, who not unfrequently relate with evident satisfaction the
story of their skill in betraying the confidence of the poor
68 LUNATIC HOSPITAL AT WORCESTER. [Oct.
insane person until he is fairly witliin the walls of the
institution.
Early admission to a hospital cannot be too strongly or too
frequently urged upon the friends of the insane. Almost every
hospital report most earnestly recommends the removal of the
patient to an institution during the first stages of mental
disease. So common has this become that no new argument
can be presented on the subject. It is true, as all statistics
show, that a very large proportion of cases recover if treated in
the commencement of the disease, but if left without treatment
for the space of a year or more there is little if any hope of
recovery or improvement even.
Some few do certainly recover, but they are exceptional cases,
occurring under the most favorable circumstances. Our
own records show how few recoveries may be expected from
this class of patients.
When we consider that these patients with such slight pros-
pect of restoration must remain during the remainder of their
lives ; objects of constant care to their friends and tlie commu-
nity, and the subjects of the deepest mental misery and distress ;
and of a misfortune so great that it separates them from all
their former social ties, pleasures and responsibilities, fills their
minds with terror, gloom, suspicion and delusion ; and which
more or less completely destroys all the mental faculties and
renders them helpless, hopeless and idiotic ; surely every con-
sideration of humanity should impress upon us the necessity
and responsibility of an early attention to the first symptoms of
insanity ; and every one in any way connected with such a
case should lose no time in placing the sufferer under special
treatment and thus facilitate the removal of this terrible malady.
When the disease is for a time unattended or unchecked
and receives no proper treatment, it generally assumes a
graver character and the sufferer either becomes hopelessly
demented or the subject of wild and unnatural ideas which
render him a pest and a danger to society. He may be
neglected until he fires a dwelling or commits a homicide and
is tried by the laws of the land as a criminal for acts which are
but the manifestations of mental disease.
It is true that a large number of the eases are of a milder
type, and pass quietly through the stage of chronic insanity to
1867.] PUBLIC DOCUMENT— No. 22. 69
that of dementia. But the care of these cases of chronic
insanity is attended with long-continued expense, and at best
only affords slight relief, when, if earlier placed under treat-
ment, a small expense for a short period would, in a large pro-
portion of cases, end in the restoration of the afflicted patient
to sound mental health.
In close connection with this subject, that of premature
removals deserves your attention. There can be no doubt that
the results of treatment tabulated in this Report, would have
been materially different, had not many patients been removed
before sufficient time had elapsed to afford any plan of treat-
ment a fair trial. Some who did not recover would undoubt-
edly have been restored if they had been suffered to remain,
and persevere in the use of remedies after they had been placed
in the hospital, while others who were reported improved, were
so fortunate as to continue improving after their return to their
homes, until perfect recovery had taken place. A few others,
reported not improved, would have received benefit if their
friends had understood the chronic character of their cases, and
the importance of a steady persistence in the use of remedial
measures.
Little, if anything, need be said on the treatment of insanity,
beyond a brief statement of the plan followed in this hospital.
In all institutions established for the treatment of mental dis-
ease, the various measures suggested as likely to promote recov-
ery, are usually divided and considered under two separate
heads.
The medical treatment of insanity includes the use of such
remedies as will act upon the body in such a manner as to
assist in the removal of the derangement of such functions as
are believed to be the cause of the disease of the mind.
The moral treatment of insanity comprehends all tlie means
and agencies which are supposed to exert immediately on the
mind such an influence as will tend to restore its hcaltliy and
natural operations.
In order to fulfil the indications of the medical treatment of
the insane, all known remedies are faithfully prescribed and
administered, consistent with the pathological conditions of the
patient.
70 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Mental health has a much closer relation to physical infirmity
than we are willing to admit ; and the extent to which human
happiness depends upon the integrity of the physical organs,
and the perfection of their functions, cannot be estimated.
Some unhealthy condition of the' nervous system, without
producing any well-marked bodily symptoms, may so control
all the operations of the mind, as to diminish every capacity
for enjoyment, paralyze every susceptibility for pleasure, and
completely overwhelm the sufferer with fear, suspicion and
gloom.
The mind and the body, of a necessity, participate in the
health and disease of each other; and the particular condition
of the one may, to a certain extent, be determined by that of
the other. Thus indigestion may be the cause or the result
of an irritable, unhappy disposition of mind ; and ascerbity of
temper may be the occasion or consequence of an acid state of
the stomach.
The relation in which complaints of the alimentary canal
stand to disease of the brain and nervous system, is not always
clear ; in some it is the relation of cause ; in others it may be
that of effect. But even then there is a reaction of the second-
ary upon the primary complaint, and the first is aggravated by
the complication.
Among the many physical conditions of mental disease, per-
haps no one requires more frequent attention, or is oftener
overlooked, than that disordered state of the stomach and
bowels, which so often gives rise to constipation ; sometimes
alternating with diarrhoea, and accompanied with indigestion,
flatulence and eructations, anorexia and nausea, transient pains
in the hypochondria, livid and yellow suffusions of the skin,
viscid secretions of the mouth, and offensive breath ; — that
condition of the alimentary canal which, by sympathy, influ-
ences the brain, and gives rise to that general uneasiness and
dissatisfaction which troubles so many persons so often ; that
state of the mind in which nothing in the affairs of life gives
pleasure or hope ; that quality of the affections wliich rejects
all the attentions of friendship, all the kind offices of love,
and produces also that depi-essing effect which diminishes the
strength of the memory, blunts the imagination, and destroys
the power of concentration.
1867.] PUBLIC DOCUMENT— No. 22. 71
No class of patients suffer more seriously, and in the treat-
ment of mental disease none are more likely to be neglected,
than those who are afflicted with this general disorder of the
digestive organs.
The deranged state of the thinking faculties, the sense of
weariness and oppression, at first slight and irregular, and
hardly noticed, becomes daily more severe and oppressive, until
the power of self-control is lost, and by the influence of disease,
or it may be by accident, some one sensation or emotion becomes
exalted, and the judgment impaired ; a general and constant
irritability of mind succeeds, which disturbs and deranges all
the mental operations.
Constitutional vigor is generally much impaired among the
insane ; hence the necessity of the sustaining influence of food,
in quantity and quality, generous and nutritious ; not only is
a liberal supply of animal food requisite, but stimulating drinks
must sometimes form a part of the ordinary diet. The appe-
tite, rendered feeble and capricious by weakness, must be
recovered by food that imparts strength. When solid food is
refused or rejected, milk, cream, broths, soups, and beef-tea
may all be brought into use. Much may be accomplished by
making everything about the dining-rooms and tables as
attractive as possible, by disposing of the viands in such a man-
ner as to provoke an appetite, by engaging in lively conver-
sation, and by spending as much time at the table as can be
spared from other duties ; remembering at all times that the
powers of life must be supported mainly through the stomach,
and that by the administration of a liberal supply of nutri-
tious food.
In the treatment of mental disease, next in importance to
nutritious food, is an abundant supply of fresh, pure, moder-
ately warmed air. Great care should be taken that the air
is not over-heated or scorched. The insane are rarely satisfied
in an atmosphere of a temperature below seventy degrees
Fahrenheit, unless they are accustomed to much out-door
exercise ; and even tlien fault will be found when the ther-
mometer indicates a temperature of sixty-five degrees.
Exercise is of the greatest importance among the means of
restoring both the pliysical and mental health of lunatics in all
curable cases. Walking or riding in the open air, during as
72 LUNATIC HOSPITAL AT WORCESTER. [Oct.
great a portion of the day as the strength of the patient will
permit, is often of great service. Long walks in the fields and
woods, in company with a suitable attendant, have, in many
instances, been the principal means in the restoration to sound-
ness of mind and health of the insane. It is necessary that
the attendant or guardian be intelligent, cheerful, and of a
kind and forbearing disposition, otherwise he is worse than
useless.
All establishments for the insane ought to be provided with
the means of aifording regular and systematic labor, chiefly in
in the open air, to as many of the patients as can be induced
to undertake it. Gardening, and the various agricultural
works, should, as much as is possible, employ their time at
regular and stated periods of the day, and by a system of judi-
cious management, many of the inmates, even cases of demen-
tia, may be brought into the habit of devoting themselves to
useful occupation.
The insane suffer much from feebleness of circulation, and
consequent coldness of extremities. It is desirable, therefore,
that their clothing should be always of thick and warm
material, and perfectly neat, clean and tidy.
Indifferently clad patients very soon lose their ideas of pro-
priety, and that self-respect without which they can rarely
recover. The supply of clothing should be so abundant, that
frequent changes of all the apparel worn by each individual,
may be made without difficulty or delay.
Personal cleanliness demands and should always receive the
strictest attention, both as a means of preserving the physical
health, and as an important moral agency. Exhalations from
the bodies of the insane are often strongly marked, and a large
class of patients are liable to become careless and filthy in their
habits. In addition to the regular use of the tepid bath for
purposes of cleanliness, it is necessary to exercise great care,
in order to insure a proper observance by the patient, of this
great essential of health and comfort.
Care, anxiety, grief, distrust, domestic affliction, poverty,
and reverses of fortune are among the most prominent moral
causes of insanity. In high states of civilization, when the
relations of men are intimate and likely to suffer by contact,
when their nervous susceptibilities are unduly exalted, and
1867.] PUBLIC DOCUMENT— No. 22.1 73
their minds become irritable by a social friction, the influence
of the passions and emotions in the production of mental dis-
ease, cannot be overestimated ; and it should be borne in mind
also, that not only do the passions and emotions exercise a
great influence upon the body, but that the condition of the
body controls, in ^n equal degree, the operations of the mind.
How important then, in a hygienic point, it is. that those
who have become diseased and seek the benefit of treatment,
are not only able to be removed from the excitements instru-
mental in the development of their malady, but that they are
provided with every facility for treatment which skill and
experience can suggest or invent, or capital procure. The
most strict personal attention of the officers of the establish-
ment should be given to their diet and regimen. Their rooms
should be large, light, airy and well furnished ; with a pleas-
ing degree of warmth in cold weather, and perfect ventilation
at all times. The appointments for bathing should be conven-
ient and extensive. Their food should be nutritious, whole-
some, and spread before them in the most inviting manner ;
music, books, pictures, and games should always be at hand ;
raised walks, covered galleries for stormy weather, bowling
alleys, swings, gymnasiums, croquet grounds and skating
rinks, are all highly serviceable in the mitigation of disease,
and tend strongly to promote recovery.
In the moral treatment of insanity, all these means prove
useless, unless assisted and directed by kind, faithful, intelli-
gent attendants. No others can carry out your plans, no
others are willing to devote themselves wholly and entirely to
the work.
Patient, intelligent perseverance in kindness, with some
indulgence as a reward for good conduct, and an honest firmness
in the application of proper measures, will often secure great
quiet and comfort among the most miserable and wretched
sufferers from nervous disease, and restore habits of order and
self control to those persons of peculiarly perverse intellect
and faulty education, who have never learned the hiabits and
principles of self-goverjimcnt ; kind and judicious conversation
is with very many a powerful moral means of restoration to
reason. Even when it seems to be listened to with indiffer-
ence, it is often attended to and carefully reflected upon. The
10
74 LUNATIC HOSPITAL AT WORCESTER. [Oct.
mere habit of pondering over it and thinking upon it, diverts
the mind and gives rest to the diseased feelings, and the patient
seems at once to make an advance towards recovery.
These brief remarks indicate very feebly something of the
plan of treatment most faithfully and hopefully followed in
your institution. Whatever of success it has attained, is due
mainly to those young men and women who have so scrupu-
lously and perfectly carried out our plans ; who have so wisely
assisted in all the details of trial and labor, without any
ulterior design or selfish motive ; with no thought of reward
save that of an approving conscience. Some such there are,
and in your service, who have by their intelligent, persevering
kindness, by their untiring energy and devotion to the wants
of the insane, exalted the performance of the most menial
duties to the character and dignity of a mission. By the
assistance of such, and only such, can we hope to make our
hospital all it should be.
In the appointments of this hospital a want has long been
felt, of a limited number of attendants of a higher order than
any yet found in hospitals for the insane. Men and women
possessed of true Christian feelings, elevated in character,
courteous in manner, cultivated and intelligent in mind, and
having that peculiar tact and nicety of feeling, which will
enable them to move and act among the various grades of
patients and employees, without friction or distrust, would
supply a want frequently felt and and often expressed by both
patients and officers. They should not be confined to the
ordinary duties of the ward, but should act as teachers, guides
and companions to such as need their assistance. To some
they would be of great benefit as instructors, to some as
readers, to many others as guides and companions.
Another want frequently felt, is the presence, in the male
wards, and particularly in the wards for the old and feeble
men, of one or two women of middle age, of strong Christian
feelings and elevated characters, who shall act as nurses and
companions to those who so much need them. These old and
sick men, who have but just left their own houses, their wives
and their daughters, placed among entire strangers, and often
necessarily under the care of young men, who have no tact or
experience in the performance of their duties, and but little
1867.] PUBLIC DOCUMEXT— No. 22. 75
true feeling in regard to them, must suffer most keenly the
loss of such attentions as woman only can bestow.
The presence in our male wards of one or two women well
acquainted with the whole subject, of refined manner, Chris-
tianly patient, so intelligent as to be a guides, friends and coun-
sellors to all who would need their services, would be making
a great advance toward perfecting our plan of treatment.
Another want which has long been felt, and often most
timidly expressed, is that of a thoroughly educated, refined,
Christian woman, as an assistant-physician, on the female side
of the house.
I know perfectly well the cost of any such recommendation ;
but my interest in the welfare of the insane, and my long
experience in the details of hospital life, enable me to speak
with some degree of confidence in reference to this matter, and
I express my earnest conviction, in desiring that some well
educated young woman, commencing as an attendant, shall
pass through a regular course of instruction, become duly
qualified, and at some future day act as medical assistant in
the female department of this hospital.
On the evening of every day, and on the afternoon of
Sundays, religious services have been held in the chapel by the
Rev. George Allen, who for more than eighteen years has so
faitlifully and acceptably performed the duties of Chaplain.
One afternoon of each week has also been spent by the Chap-
lain in wards of the hospital, in visiting and conversing with
such patients as desired religious instruction and comfort.
And from my personal knowledge, I venture to say, that great
benefit has resulted from these interviews. The promises of
the gospel, rather than the terrors of the law, have been wisely
presented, with such cheering and hopeful words, and in such
a quiet and modest manner, that not only have the depressed
been consoled, the old and feeble comforted and strengthened,
but the convalescent have also received salutary lessons, the
benefit of which they retain after they return to their homes.
All the usual amusements, recreations and entertainments
have been pursued with vigor during the year. Lectures, con-
certs, social parties, dancing parties, readings and recitations
during the winter season ; long walks, rides, croquet parties
and impromptu picnics during the summer, are among the more
76 LUNATIC HOSPITAL AT WORCESTER. [Oct.
common means used for breaking the otherwise dull and
tedious monotony of the time.
A class in light gymnastics was during the winter organized
among the female patients, and regular lessons have been given
twice in each week. The interest excited at the first continues
unabated, and much good is expected to result from this
enterprise.
An attempt has been made to extend our facilities for
gymnastic exercises for both sexes by putting up such fixtures
on the lawns as seemed most desirable in carrying forward this
part of our work.
The amount of discipline and self-control which all our
attempts of this character exercise on the patients, is produc-
tive of great good in dispelling gloomy forebodings and in
cheering the hearts of the depressed. Even those under the
influence of deep melancholy, who can take no active part in
the scenes themselves, and who seem to have little or no inter-
est in them, do often look with pleasure and delight on the
games and plays which their minds are too dull and vacant to
fully appreciate.
A large number of newspapers and periodicals and illus-
trated papers are received by the patients every week. Not a
few receive direct from the publishers their accustomed paper
or magazine. The reading rooms and libraries are well sup-
plied with books, maps and periodicals. More than one thou-
sand pictures, of various kinds, hang on the walls of the
several wards.
In making up the annual reports of this hospital, it has not
been the custom, for many years past, to express any want or
ask for any assistance ; but as appearances now indicate that
high prices will continue to rule, and that it will be considered
uncharitable and unwise to raise the price of board to a cor-
responding rate of increase, it may be well to consider the
propriety of asking legislative appropriations for such objects
as are deemed of vital importance.
The water closets and bathing rooms in the centre wards are
so worn out by long continued use, that they must be replaced
immediately, and will cost one thousand dollars. The water
closets in the return wings need extensive repairs, and will
require an outlay of five hundred dollars.
1867.] PUBLIC DOCUMENT— No. 22. 77
The bowling alleys taken up in making alterations some
years ago should be replaced, and will cost five hundred
dollars.
The verandas on each side of the house should be enlarged,
and brought forward with new fronts, giving space for parlors,
or day rooms for the centre and Johonnot wards, — a work
which would require an outlay of about five thousand dollars.
Then a building for the purposes of a gymnasium is much
needed, and would cost about five thousand dollars ; making,
for permanent improvements and construction, the sum of
twelve thousand dollars.
It is believed that no one who will investigate the subject
would doubt the propriety or utility of these improvements, or
regard the sum stated more than sufficient to do the work in a
plain and substantial manner.
I beg to remind you tliat the boilers and pipes for warming
the establishntent have been in constant use, with only very
slight repairs, eleven years, and will not probably stand many
years longer; indeed, it is supposed that the steam apparatus
has already operated longer, as well as more satisfactorily, than
that of almost any otlicr similar establishment in the country.
I trust you will bear with me wliilc I once more, very briefly,
call your attention to the subject of improved arrangements for
the care and control of certain classes of the insane. All
Alienists are agreed upon the necessity of classification ; of
separating such as arc liable to injure themselves or others in
any way ; and permitting those to associate together who may
contribute in some degree to each others' restoration. How
can this be well done under existing circumstances? How can
it be done at all, unless the establishment is both a hospital and
an asylum, so constructed that its several parts arc more or
less detached from each other? How can the old and feeble
1)0 separated from the violent and noisy, so as not to be dis-
turbed l)y them ? IIow can the convalescents be placed beyond
the constant annoyance of those who have depraved habits,
obscene latiguage and disgusting manners ? And how can
those unfortunate persons be made comfortable and happy who
only suffer from some disturbance or obliquity of the reflective
faculties ; whose perceptions are keen, whose feelings are
78 LUNATIC HOSPITAL AT WORCESTER. [Oct.
tender, and whose sense of propriety remains active ; how
can they be properly directed and controlled in any existing
hospital arrangement ?
These various classes of patients require for their restoration
to health and soundness of mind a wider separation from others
than is at present possible. Not isolation, but segregation,
which shall divide them into groups, possessing nearly the
same characteristics, mental and physical, and give to each a
house within the hospital precincts. The house should be con-
venient, tastily arranged, and have a garden, lawn, and such
other appointments as would be desirable for a family of well-
to-do people.
In view of the constantly increasing demands for accommo-
dations for the insane, it is most earnestly desired and recom-
mended, that some measures be taken to put in operation, in a
small, safe and inexpensive way at first, the plan indicated by
these remarks. '
If need be, appoint a committee of your board to present
the subject to the legislature for authority and assistance.
It cannot be that Massachusetts, with her five large hospi-
tals, her three large pauper establishments, her numerous
smaller asylums, receptacles and almshouses, is so well satisfied
with her existing arrangements that she is unwilling to take
advantage of some occasion to try other methods of caring for
and restoring this unfortunate class of her children. If so,
why do her citizens so often seek for their insane relatives
accommodations which the Commonwealth does not afford to
any, even the most affluent ? This question is rapidly becom-
ing one of the great problems of social science. To meet it
fairly and honestly, and to assist, wisely and faithfully, in its
solution, is our duty and privilege.
I am especially grateful to Miss Dix for many favors. To
Dr. R. W. Hooper and William Emerson Baker, Esq., for val-
uable and rare photographs ; and particularly to two friends of
the original and of the Worcester hospital, for a very fine and
life-like portrait of Miss Dix, painted by Waugh, of Philadel-
phia, and sent to us as a Christmas gift. It now graces the
walls of the trustees' room in the hospital.
I am also under obligations of respect and gratitude to my
assistants in the various departments of official labor. They
1867.] PUBLIC DOCUMENT— No. 22. 79
have performed their duties cheerfully and faithfully, and
rendered all necessary assistance in the management of the
institution. These duties are arduous, and often peculiarly
trying ; yet no word of complaint or murmur of dissatisfaction
is ever heard.
The employees have generally performed all their duties in a
highly satisfactory manner.
With great pleasure I acknowledge from several members of
Congress and heads of departments valuable public documents,
which annually increase the library of the patients. The pub-
lishers of many newspapers have also sent to us their regular
issues, without cost. Hon. J. D. Baldwin, Hon. J. S. C.
Knowlton, Dr. Bartholomew, publishers, of this city, and S. S.
Thompson, Esq*, continue as heretofore to send us large pack-
ages of exchanges, besides the daily and weekly issues of their
own publications. Dr. Hooper sends us valuable magazines.
Mr. and Mrs. Munroe, Mr. Hill, Miss Hill, Mr. Jordan and Mr.
Rice, of tlie Old South Church choir ; Mrs. Doane and Mr.
Allen, of the Central Church choir ; Mr. Chandler and Mrs.
Sumner, with their class ; Miss Nellie Fiske and Mrs. Denny,
of Union Church choir ; Mr. D. .H. O'Neil and choir of St.
John's Church ; Miss Annie Sargent, Mr. Burt, Mr. Zittertart,
Mr. S. R. Leland, and many others, gave us concerts of sacred
music during the long evenings of winter and spring. My
acknowledgments arc also due to Miss Eliza Lamb, who has so
kindly assisted us in our liglit gymnastic class, and to William
Knowlton, Esq., for many favors.
The year just closed has been one of unusual anxiety and
interest, but we have been met by no insurmountable difficul-
ties, nor alarmed by impending dangers. The number of
patients wlio have received the benefits of the hospital lias been
large, and the general history of the year is one of prosperity.
By the act of a wise and generous legislature, the hospital
has Ijcen relieved of its financial difficulty, and it has now bet-
ter facilities for carrying on its great work than it ever before
possessed. I desire to express my thanks for the encourage-
ment thus afforded me amid the labors and anxieties of my
position.
To you, gentlemen, and each of you, I desire to express my
grateful sense of obligation for the many kindnesses shown me,
80 LUNATIC HOSPITAL AT WORCESTER. [Oct.
and for the ready counsel and assistance always afforded me in
conducting the affairs of this institution, and promoting in
every way the comfort and welfare of its inmates.
We close the labors of the old year, and commence those of
the new, with unfaltering trust and confidence in the strength
of Him who has upheld us in the past, hoping and believing
that in the future our labors may be crowned with success.
MERRICK BEMIS.
^Worcester Lunatic Hospital,
Worcester, Oct. 1, 1867.
METEOROLOGICAL OBSERVATIONS
JIADE AT
THE STATE LUNATIC HOSPITAL, WORCESTER, MASS.,
1866-T.
Lalilude, 42° 16' 17" N. ; Longitude 71° 48' 13" W.
Elevation, 528 feet.
Explanation. — The force of the wind is estimated upon a scnle of 10 and indicated by figure
affixed to the letters denoting the direction. When no number is affixed, 1 is meant.
11
82
LUNATIC HOSPITAL AT WORCESTER.
[Oct.
1
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85
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1867.]
PUBLIC DOCUMENT— No. 22.
89
'A
Cloudy and rainy.
Fair weather ; tulips and
Fair weather, [dan. in bl.
Fairweat'r; aurora 9p.m.
Fair weather.
Cloudy.
Cloudy.
Rainy.
Rainy.
Fair weat'r ; violet in bl.
Fair weather.
Fair w'r; sh. b. & fever b.
Fair wea'r ; peach, wild
Rainy weather. [cherr3'.
Fair weather.
Fair weather. -
Cloudy and rainy.
Fair wea'r ; Miss, curr't
Fair weather. [in bl.
Rain ; cherry in bloss.
Cloudy.
Cloudy and rainy.
Fair weat'r; p. jap. in bl.
Fair weather.
Fair w'r;fl'g, alm'd and
Rainy weat'r. [app. in bl.
Fair weather.
Fair; leathcrwood inbl.
Rainy.
Cloudy ; jessami in bios.
Cl'dy ; fair p.m. au.9 p.m.
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PUBLIC DOCUMENT— No. 22.
91
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PUBLIC DOCUMENT— No. 22.
93
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Aurora Borealis.
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Almond, Floweri
Apple,
Arbutus, Trailing
Ash, Mountain,
Bloodroot, .
Calicanthus,
Cherry,
" Wild,
Crocus,
Currant, Missour
Dandelion, .
Daphne Mezereo
Fever Bush,
Geranium Macule
Honeysuckle, Ta
Horse-Chestnut,
Hyacinth, .
Leatherwood,
Lilac, . . .
" Persian,
Liverwort, ,
Maple, Red,
Narcissus, .
Peach,
Pyrus Japonica,
Rose, Russian,
" Scotch,
Shad Bush,
Violet, Blue,
Wind Flower,
1867.] PUBLIC DOCUMENT— No. 22. 99
APPENDIX.
FORMS CONCERNING ADMISSION TO THE HOSPITAL.
PETITION.
[The applicant must answer in writing the printed interrogations accompanying this
blank.]
To the IlonoraUe the Judge of the Prolate Court, in and for the County
of
of on oath complaina
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.
, S3. 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 has been given to me of the Intention to present the foregoing
complaint and application.
A. D. 18G .
To the Honorable the Judge of the Probate Court, in and for the County
«/ _ _ : .
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.
100 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.
PHYSICIANS' CERTIFICATE.
The subscribers, respectable physicians of in the
county of , having made due inquiry and personal
examination of named in the foregoing
application, Avithin 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.
Commonioealili of Massaclmsetts.
ss. At , in said county on the
day of A. D. 186 .
On the application of for the commitment
of of in said county, to the Worcester
Lunatic Hospital, ; notice in writing having been
given by said applicant to one of the selectmen of
where said resides, of h Intention to make said
application, and said having been duly notified of
the time and place appointed for hearing, It appears, upon a full hearing,
that said Is an insane person, and a proper subject for
the treatment and custody of the Worcester Lunatic Hospital.
Wherefore it is ordered that said be committed
to the said Worcester Lunatic Hospital.
Judge of Probate Court.
1867.] • PUBLIC DOCUMENT— No. 22. 101
FOEM OF OVER SEEKS' BOND.
Worcester Lunatic Hospital.
Whereas, of , in tlie county of
, lias 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 rpquiring 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 Sujieriutendent, 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 tinie it becomes due.
Witness our hands this day of
Attest. (Signed,)
( UL'e.rseers of the Poor
■} of 'the
I Toivn of
FOEM OF PEIVATE 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 boai'd which
may, from time to time, be detei-mined 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 tlie opinion of the Superintendent, to be received
into said hospital. Also to paj^, not exceeding fifty dollars, for all damages
h may do the furniture and other property of said hospital, and for reason-
102 LUNATIC HOSPITAL AT WORCESTER.' [Oct. '67.
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 Bostonj
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 hosjjital.
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 fiiends 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.
At^RSS'^al.?!.
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