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



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PUBLIC DOCUMENT No. 22. 



THIRTY-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 






^ 


M 


^ 




i. 


pq 


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"W 




K 


H 


C 






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05 I— 00 t~ 



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•sai'Bniaa 



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03 


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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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LUNATIC HOSPITAL AT WORCESTER. [Oct. 



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1867.] 



PUBLIC DOCUMENT— No. 22. 



43 



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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. 



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PUBLIC DOCUMENT— No. 22. 



83 





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F.air weather. • 
Fair weather. 
P'air weather. 
Fair weather. 
Fair weather. 
Fair weather. 
Fair weather. 
Fair weather. 
Fair weather. 
Cloudv. 

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A number of shooting 
Fair weather. [stars. 
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Rainy. 

Fair weather. 
Fair weather. 
Cloudy and rainy. 
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Fair weather. 
Cloudv ; first snow. 
Cloudy. 
Fair weather. 
Fair weather. 
Fair weather- 
Fair weather. 
Cloudy. 
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Rainy A. M. ; fair P. M. 




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PUBLIC DOCUMENT— No. 22. 



85 





50 




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1867.] 



PUBLIC DOCUMENT— No. 22. 



89 







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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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r weather, 
r weather. 
r weather. 

r A.M.; shower P.M. 
r weather, 
r weather. 

r A.M.; shower P.M. 
r weather, 
ar. 

r A.M. ; cloudy P.M. 
avy rain all day. 
avy rain all day. 
avy rain all day. 
avy rain all'day. 
r weather. 

r weather ; rainbow, 
r weather, 
r weather, 
udy A.M.; rain P.M. 
my all day. 
r A.M.; shower P.M. 
ar. 

r weather, 
ir weather. 
r weather, 
udy and rainy, 
r weather, 
r weather. 










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Rain & 
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Snow. 


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L867.] 



PUBLIC DOCUMENT— No. 22. 



93 





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Slight rain. 
Slight rain. 

Drizzly. 

Lightning in the eve. 

Lightning and thunder. 
Aurora Borealis, 9 P.M. 
Aurora Borealis. 

Aurora Borealis. 

Sliight frost ; hazy. 

Hail. 

Aurora Borealis, 10 P.M. 

Cloudy. 

Slight flurry of snow. 


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PUBLIC DOCUMENT— No. 22. 



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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.?!.