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PUBLIC DOCUMENT No. 23.
THIRTY-SEVENTH ANNUAL REPORT
THE TRUSTEES
STATE LUNATIC HOSPITAL
WORCESTER
October, 1869.
BOSTON:
WRIGHT & POTTER, STATE PRINTERS,
79 Milk Street, (corner of Federal.)
1870.
tHommcmtDMltf) of Jtta0M£t)H0£ii0.
TRUSTEES' REPORT.
To His Excellency the Governor, and the Honorable Council
of the Commonwealth of Massachusetts.
The Trustees of the Worcester Lunatic Hospital respectfully
submit their Thirty-Seventh Annual Report.
The Trustees refer to the reports of the Superintendent and
Treasurer of the hospital for its present condition and prospects.
The finances of the institution have steadily improved since the
close of the war, and are in a satisfactory condition. Prices of
all articles of consumption still remain high, and the cost of
the support of patients cannot reasonably be expected to be
much less than at present, until prices are lower. If the price
of coal had remained the same as it was during the previous
year, and no more had been expended for improvements and
repairs, the weekly cost of each patient would have been $3.67
per week. It has been $4.02 per week. The result of the
financial management for the year is a balance in the treasury
of $13,372.69.
The report of the Superintendent shows that the number of
patients admitted during the year ending October 1, 1869, was
337, and that the number admitted during the year ending
October 1, 1868, was 296. It further shows that the number
of deaths during the past year has been somewhat larger than
usual, although there has been but little sickness in the hospital
during the year. The increase in the number of deaths has been
among those advanced in life, twelve of whom had reached their
seventieth year, and several others had passed their sixty-fifth
year. Among patients who have been insane less than one
year, the proportion of recoveries has been 72 per cent., and
among those who have been insane more than one year it has
been 28 per cent. After deducting the deaths, the proportion
6 LUNATIC HOSPITAL AT WORCESTER. [Oct.
of recoveries has been more than 50 per cent, among the whole
number discharged. The proportion of those discharged during
the past year recovered and improved has been considerably
larger, and the proportion of those discharged unimproved has
been considerably less than during the previous year. These
facts do not prove that the patients have been more skilfully
treated, but they tend very strongly to prove that if a patient
is seasonably brought under treatment at the hospital, his
chance for improvement or recovery is better than in cases
where the opportunity is neglected. In most cases of mental
disturbance it seems to us perfectly clear that a well managed
hospital where the treatment of insanity is made a specialty,
gives to the patient a better opportunity for improvement and
recovery than any other place, and that the mistaken kind-
ness of friends in delaying to give to the patient the benefit of
the hospital treatment too often operates to the disadvantage of
the person whose mind is diseased. In this connection the
Trustees deem it to be their duty to call the attention of the
State government to the matter of a removal of the hospital
buildings from their present location, and the construction of
new buildings substantially in accordance with the views of the
Superintendent in his report herewith presented. The action
of the Superintendent has received the hearty approval of the
Trustees, and they unanimously recommend the purchase of the
beautiful tract of land of which the Superintendent, with the
approval of the Trustees, has obtained the refusal, and the erec-
tion of suitable buildings thereon. The location of the estate is
about two miles distant from Main Street, is easily accessible, is
in a quiet neighborhood, occupied by respectable agriculturists,
with beautiful scenery in every direction, and with every advan-
tage of pure and wholesome air which can be procured in the
county of Worcester. Indeed, it is doubtful whether any part
of the State could furnish a more desirable location for a
lunatic hospital than the one which we have had the good
fortune to secure. Those having the immediate management
of the Worcester Lunatic Hospital have long felt that a more
retired situation than that of the present hospital was very
desirable, and that improvement in hospital buildings, and
in the management of the insane since the time when the
present hospital was located and built, made it their duty to
recommend the erection of new hospital buildings in a more
1869.] PUBLIC DOCUMENT— No. 23. 7
quiet location, and upon an improved plan better fitted for the
various classes of the insane, especially when the property
occupied for the purposes of the present hospital will sell for
money enough to pay for the land and the new buildings. The
Trustees do not advise an immediate sale of the estate, but
sales from time to time as the market shall seem to demand,
and that some person or persons be authorized by the legisla-
ture to sell and convey the present estate, or parts of the same,
whenever it shall be considered advisable to do so. In all
diseases, and especially in diseases of the mind, much depends
upon the surroundings. If the evil spirit was driven out of
Saul by the soothing influence of the harp in the hands of the
sweet singer of Israel, and the demon was cast out of the wild
Gadarene by the Divine power of disinterested love, so will the
surroundings of kindness, suitable restraint, skilful attention,
and an atmosphere of purity and quietness tend to loosen the
power of those mental diseases which take the form of delusion,
and banish them from those secret recesses of the human system,
where they have taken up their abode. The report of the
Superintendent upon the facts relative to the institution are so
full and satisfactory, that it only remains for the Trustees to
express their unanimous approval of its management during the
past year, and to recommend that the legislature take prompt
and efficient action upon the subject of the purchase of
the real estate and the erection of new hospital buildings,
and make such appropriations as will enable those who may
be intrusted with the duties involved in the important changes
suggested, to proceed at once towards accomplishing what in
the opinion of the Trustees is due to the cause of humanity and
to the character of the Commonwealth of Massachusetts.
Very respectfully submitted by the Trustees,
CHARLES MATTOON.
HENRY CHAPIN.
WILLIAM WORKMAN.
S. E. SEWALL.
R. W. HOOPER.
Worcester, October 15, 1869.
LUNATIC HOSPITAL AT WORCESTER. [Oct.
TREASURER'S REPORT.
To the Trustees of the Worcester Lunatic Hospital.
Gentlemen : — I herewith submit my Annual Report on the
finances of the Worcester Lunatic Hospital, for the year ending
Sept. 30, 1869.
Receipts.
Cash on hand September 30, 1868,
received of the Commonwealth for support of patients,
received of cities and towns for support of patients, .
received of individuals for support of patients,
received for sale of farm products, ....
The expenditures of the year have been as follows : —
Provisions, —
Flour, 517 bbls., $5,161 71
Meal for table, 1,022 28
Fresh meats, 4,171 77
Salt meats, 4,037 17
Beans, potatoes and other vegetables, . . 1,894 82
Fish, 973 41
Sugar, 2,340 42
Molasses and syrup, 485 06
Tea, 1,100 48
Coffee and chocolate, 939 13
Bice and crackers, 650 30
Butter, 5,596 03
Vinegar and pickles, 196 35
Cheese, 118 05
Fresh fruit, ....... 282 29
Eggs, salt and other groceries, .... 1,857 84
Total for provisions, $ 30,827 11
Salaries and wages, 20,603 37
Labor, 2,357 76
Provender and bedding for stock, . . . 2,005 82
$4,161 15
19,818 88
30,414 67
40,412 19
2,574 85
$97,381 74
1869.]
PUBLIC DOCUMENT— No. 23.
Furniture, crockery, bedding, &c
•»
$4,727 26
Light,
1,470 03
Soap, .
800 49
Medical supplies,
1,446 67
Live stock, ....
395 00
Improvements and repairs, .
6,129 82
Travelling and transportation,
348 29
Books, papers and stationery,
690 31
Fuel,
6,421 67
Freight and express, .
192 67
Ice,
408 20
Trustees' expenses, .
126 85
Miscellaneous, .
2,396 10
Total current expenses,
$83,347 42
Refunded for overpayment,
207 41
Clothing and materials,
2,776 05
Undertaker's charges, .
895 75
Balance of loan, .
4,500 00
Cash on hand, September 30, 1869,
5,655 11
$97,381 74
Resources.
Due from cities and towns, $9,357 24
Due from individuals, 10,529 41
Cash on hand, and in bank, .... 5,655 11
$25,541 76
Liabilities.
Due for supplies and expenses, .... $7,151 75
Due for salaries and wages, ' .
5,017 32
12,169 07
$13,372 69
2,120 00
$15,492 69
D. W. BEMIS, Treasurer.
Worcester Lunatic Hospital,
Worcester, Oct. 1, 1869.
We have examined the above account, with the vouchers, and find it correct.
William Workman,
Henry Chapin,
Auditing Committee.
Worcester, Oct. 23, 1869.
2
10
LUNATIC HOSPITAL AT WORCESTER. [Oct.
OFFICERS OF THE HOSPITAL.
trustees.
Hon. CHARLES MATTOON, . . . . . Greenfield.
Hon. HENRY CHAPIN, Worcester.
WILLIAM WORKMAN, M. D., Worcester.
Hon. SAMUEL E. SEWALL, Boston.
ROBERT W. HOOPER, M. D., .... Boston.
3ftestiient:=©fitcerg.
SUPERINTENDENT AND PHYSICIAN:
MERRICK BEMIS, M. D.
ASSISTANT-PHYSICIAN — MALE DEPARTMENT :
JOSEPH DRAPER, M. D.
ASSISTANT-PHYSICIAN — FEMALE DEPARTMENT
MARY H. STINSON, M. D.
MATRON :
CAROLINE A. BEMIS.
STEWARD AND TREASURER :
DANIEL W. BEMIS.
Office at the Hospital.
Cfjaplattt :
Rev. GEORGE ALLEN.
1869.] PUBLIC DOCUMENT— No. 23. 11
SUPERINTENDENT'S REPORT
To the Trustees of the Worcester Lunatic Hospital.
Gentlemen: — In obedience to the laws of the Common-
wealth, I have the honor to submit to you the Thirty-Seventh
Annual Report of the Worcester Lunatic Hospital.
The year has been one of comparative comfort and pros-
perity. No severe sickness has visited the inmates. No
calamity has befallen the institution, and nothing has occurred
to mar its general quiet and good order.
Our aim has been to maintain the high character of the
hospital, increase its usefulness, and to multiply its curative
facilities.
Whatever of good we have been able to accomplish must be
attributed mainly to your constant oversight, ready assistance
and wise direction in all the affairs of the institution. From
your frequent visits ' and thorough examinations into all its
departments you have been able to comprehend the difficulties
under which we labor, and have manifested an anxious solici-
tude to promote in every way possible the well-being of the
hospital.
For the general results of the year, and the condition of the
patients in detail, you are respectfully referred to the following
tabular statements, and such explanatory remarks as may
accompany them.
However far short the hospital may have fallen of accom-
plishing all that was desired, it has certainly continued, with a-
tolerable degree of success, the great work of Christian charity,
and the trustees may have satisfaction in reviewing the labors
of the year, and ascribe the praise for the good which has been
accomplished to Him who watches over and directs all things.
12 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 1.
Showing the general results during the year.
Males.
Females.
Total.
Patients in the Hospital, October 1, 1868,
188
194
382
Admitted during the year, ....
171
166
337
Whole number under treatment,
359
360
719
Discharged recovered,
69
80
149
improved,
63
73
136
not improved,
9
2
11
Died,
28
19
47
Whole number discharged,
169
174
343
Kemaining, September 30, 1869,
190
186
376
From this table, it appears that three hundred and thirty-
seven patients were admitted during the year just closed, of
whom one hundred and seventy-one were males and one hun-
dred and sixty-six were females.
At the close of the previous year there were three hundred
and eighty-two patients remaining in the hospital, of whom one
hundred and eighty-eight were males, and one hundred and
ninety-four were females, so that there were seven hundred
and nineteen persons under treatment in the course of the
year, of whom three hundred and fifty-nine were males, and
three hundred and sixty were females ; the daily average was
three hundred and eighty-seven.
The number of patients discharged was three hundred and
forty-three, of whom one hundred and sixty-nine were males,
and one hundred and seventy-four were females.
Of the three hundred and forty-three patients discharged,
one hundred and forty-nine were restored to their usual health
of body and mind, one hundred and thirty-six were improved,
many of them so much so as to be able to return to their ordi-
nary duties, and eleven were discharged as not improved.
Forty-seven patients were removed by death, of whom twenty-
eight were males and nineteen were females. The recoveries
were in the ratio of more than forty-four per cent, to the
number of admissions, or more than forty per cent, to the
average number under treatment ; or twenty-two per cent, to
the whole number in the hospital during the year ; or forty per
1869.] PUBLIC DOCUMENT— No. 23. 13
cent, to the whole number discharged after deducting the num-
ber of those who died. The recoveries were also in the ratio
of seventy-two per cent, to the number of those whose insanity
had existed less than one year, and only twenty-eight per cent,
to the number of those who had been insane more than one
year previous to admission to the hospital.
You will perceive that the percentage of recoveries is some-
what greater than last year, a gratifying result when compared
with similar tables from old and long-established hospitals.
The ratio of deaths to the whole number under treatment
was six and six-tenths per cent, to the average number of
residents.
An examination of the records of the hospital will show that
eight thousand five hundred and thirty-five patients have been
admitted to its wards since it was opened in January, 1833,
four thousand two hundred and sixty-six of whom were males
and four thousand two hundred and sixty-nine were females.
Of this number, three thousand nine hundred and seventy-
four have been restored to health, giving a ratio of nearly fifty
per cent, of recoveries after deducting the number of those
who remain under treatment.
One thousand seven hundred and forty-eight have been dis-
charged improved in health of body and mind, very many of
whom have passed a long period of time in great comfort, and
are and have been useful members of the communities in which
they live. The number of those discharged as improved added
to the number of recoveries makes the number of those who
have received benefit by a residence in the institution five thou-
sand seven hundred and twenty-two.
Thus much the hospital has been the means, in some degree
at least, of accomplishing: it has certainly been instrumental in
sending back to the world, in health and happiness, three thou-
sand nine hundred and seventy-four individuals who had been
deprived of their reason.
It has been the means -of restoring to a tolerable degree of
health and comfort one thousand seven hundred and forty-eight
persons who did not fully recover within its wards, but many
of whom were restored to such a measure of health and
strength as to enable them to return to their accustomed occu-
pations and assist in the care of themselves and their families.
U LUNATIC HOSPITAL AT WORCESTER. [Oct.
And more than this, it has afforded peace, comfort and secu-
rity to a large and troubled household during nearly thirty-seven
years.
The hospital has taken from families and friends, from poor-
houses and prisons, from the streets and by-ways the sick and
sorrowing, the violent and dangerous, the suicidal and homi-
cidal, the idiot, the drunkard and debauchee when lost to all
hope and self-respect, and has given back to society, in full
possession of mental and physical health and strength, nearly
one-half of all it has ever received. In addition to this, it has
also relieved and sent back, in comparative comfort, though
not cured, more than one-fifth of the whole number committed
to its care. Besides all this, thousands upon thousands of
relatives and friends have been relieved from dreadful anxiety,
from excessive care and from constant danger by the hospital
thus taking charge of those for whom they could do little or
nothing.
All this and more has been accomplished by the hospital at
the cost of less than two hundred thousand dollars to the State
for buildings, fixtures and land, and to the patients, their
friends and the Commonwealth of not more than an average
expense of one-half year's support for each individual so
returned.
In view of these facts, you may indulge a reasonable degree
of satisfaction and be encouraged to press upon the legislature
such measures as you deem necessary to its future usefulness
and prosperity.
1869.]
PUBLIC DOCUMENT— No. 23.
15
Table No. 2.
Showing the Admissions and State of the Hospital from October 1, 1868, to
September 30, 1869.
Males.
Females.
Total.
Patients in the Hospital, October 1, 1868, .
188
194
382
admitted in the course of the year,
171
166
337
remaining in the Hospital, Sept. 30, 1869, .
190
186
376
Of the admissions there were cases of one year or
less duration, ........
94
108
202
Of the admissions there were cases of more than one
year's duration,
63
54
117
Of the admissions there were cases the duration of
whose insanity could not be ascertained,
14
4
18
Patients committed by Courts,
118
108
226
committed by Overseers of the Poor, .
20
11
31
on bonds, . . . ...
32
46
78
committed by Governor's warrant,
-
-
-
committed by the Board of State Charities, .
1
1
2
committed by Commissioners of Lunacy,
-
-
-
Foreigners and those having no settlement in the
State, committed in course of the year, .
68
69
137
Foreigners and those having no settlement in the
State, discharged in course of the year, .
85
96
181
Foreigners and those having no settlement in the
State, remaining in the Hospital, Sept. 30, 1869, .
30
21
51
Patients in Hospital previously, .....
53
42
95
in other Hospitals in this State previously, .
8
9
.17
in Hospitals of other States previously,
8
6
14
State Paupers remaining in the Hospital at the close of each year as nearly as
can be ascertained.
1842, .
. 34
1852, .
241
1862, .
189
1843, .
. 38
1853, »
216
1863, .
175
1844, .
. 38
1854,
151
1864, .
116
1845, .
. 57
1855,
115
1865, .
91
1846, .
. 52
1856,
155
1866, .
129
1847, .
. 121
1857, .
119
1867, .
101
1848, .
. 150
1858,
121
1868, .
95
1849, .
. 167
1859,
124
1869, .
51
1850, .
. 181
1860,
130
1851, .
. 201
1861, .
156
The foregoing table illustrates the manner of commitment
to the hospital, the duration of insanity previous to commit-
ment, and to some extent the social condition of the patients
16 LUNATIC HOSPITAL AT WORCESTER. [Oct.
before commitment, and also that of those remaining in the
hospital at the close of the year.
It will be seen that seventy-eight patients were admitted on
private bonds, and thirty-one on bonds from overseers of the
poor of towns from which the patients were sent ; the bonds in
all cases being accompanied by certificates from two respectable
physicians that the persons for whom the applications were
made were insane.
Two hundred and twenty-six were committed by the probate
courts of the counties in which the patients resided at the time
of commitment, and two by the Board of State Charities ; these
last being transfers of State paupers from other State institu-
tions. Six have voluntarily sought the benefit of the hospital,
and have had the proper legal papers made after seeking in
their own way to be admitted to the hospital, and these are
tabulated in their proper classes. A few of those who are com-
mitted by the probate courts are persons of sufficient means to
defray their own expenses, and are charged the same prices for
board and attendance as private patients.
Many of the patients supported by the towns are committed
by the judges of probate, the authorities of the towns preferring
this method to that of giving their bonds.
A reference to the table also shows that you have discharged
one hundred and eighty-one persons who had no settlement
in this Commonwealth, and that fifty-one still remain who
are supported by the charity of the State, nearly all whom are
of foreign birth.
The greatest number of patients under treatment at any one
time during the year was four hundred and twelve. The
greatest number of private patients was one hundred and sixty-
four. The greatest number of town patients was one hundred
and seventy-nine, and the greatest number of State patients was
ninety-eight.
The weekly average number of patients was three hundred
and eighty-seven ; the weekly average number of private patients
being one hundred and forty-six, of town patients, one hundred
and sixty-seven, and of State patients seventy-four.
The Board of State Charities have removed to other institu-
tions, and to their homes in other States, one hundred State
patients in the course of the year. This number were all
1869.] PUBLIC DOCUMENT— No. 23. 17
removed after examination by the agent of the Board, and it is
believed that none were removed whose mental and physical
condition did not make such a step seem advisable.
No very feeble person, and no unusually violent, filthy or
destructive patient has been removed. In all cases where State
patients have been removed to other institutions, or to their
homes or friends, previous to recovery, their cases have been
fully investigated, and when relatives or friends have been
known, their wishes have been consulted, and they have always
been fully informed of every change made in regard to the
patients in whom they were interested.
Fifteen State patients have died in the course of the year.
More than the usual number of State patients have been trans-
ferred during the year ; a proceeding made necessary by the
large number of admissions to the hospital.
For a few, situations have been procured where they could
labor and receive wages. Others have been permitted to do such
work in the neighborhood as they could find to do, and have
received all the profits. Four or five male patients have in this
way earned considerable sums of money. Several others have
earned smaller sums varying from twenty to thirty dollars each
in the course of the year.
The steward has paid to patients more than two hundred
and fifty dollars for labor, with the hope of thereby inducing
greater habits of industry among the inmates of the institution.
One patient, a criminal transferred from the State prison,
eloped, and remains away. His insanity was without doubt
feigned.
18
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 3.
Showing the Number Admitted, Restored, Improved, Died, Sfc, in each Month
in the Year.
Admitted.
Removed.
Remaining.
■a
"6
B
-6
MONTHS.
o
o
>
•a
Totals.
1
a
fa
o
E-
M
s
M
o
ft
3
OJ
"3
8
s
fa
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
T.
03
O
October,
23
10
33
7
9
6
4
1
2
16
13
29
195
191
386
November, .
13
11
24
3
6
0
6
1
-
6
-
15
12
27
193
190
383
December, .
12
18
30
3
6
5
4
-
-
2
2
10
12
22
195
196
391
January,
14
9
23
8
6
6
11
2
-
3
3
19
20
39
190
185
375
February, .
8
8
16
2
3
4
3
1
-
3
1
10
7
17
188
186
374
March, . .
11
14
25
2
1
2
3
2
-
-
-
6
4
10
193
196
389
April, . . .
18
23
41
9
11
12
16
-
-
3
1
24
28
52
187
191
378
May, . . .
10
18
28
8
5
3
2
-
-
2
1
13
8
21
184
201
385
June, . . .
17
17
34
7
6
4
2
-
-
2
2
13
10
23
188
208
396
July, . . .
20
11
31
5
12
8
9
-
1
3
2
16
24 40
192
195
387
August, . .
13
14
27
12
9
7
11
-
1
1
1
20
22
42
185
187
372
September, .
12
171
13
166
25
337
3
69
6
80
1
63
2
73
2
9
-
1
6
19
7
169
14
21
190
186
376
Totals, .
2
28
174
343
-
-
-
Table No. 4.
Showing the form of Disease in those Admitted and Discharged during the year.
Admitted.
DlSCHAEGED.
FORM OF DISEASE.
o5
0>
03
s
■3
a>
03
s
0B
"3
a
fa
EH
S
fa
El
Mania,
70
66
136
52
54
106
Mania, Chronic,
32
31
63
45
59
104
Mania, with Epilepsy, .
11
2
13
5
1
6
Mania, with general Paralysis,
5
2
7
-
-
-
Melancholia, ....
8
27
35
4
13
17
Dementia, ....
21
24
45
13
19
32
Dementia, Senile, .
2
6
8
3
4
7
Dementia, with Epilepsy,
4
3
7
7
2
9
Dementia, with gen'l Paralysis,
11
1
12
8
-
8
Monomania of Fear,
2
3
5
1
2
3
Monomania of Suspicion,
5
1
6
3
1
4
Totals, .
171
166
337
141
155
296
1869.]
PUBLIC DOCUMENT— No. 28.
19
Quite a large number of the patients committed in the course
of the year were afflicted with suicidal mania, and several with
both suicidal and homicidal impulses. No suicide or other
calamity has befallen any of the inmates.
An unusual number of the patients were suffering from high
maniacal excitement when admitted, yet the amount of
restraint and seclusion has been very small ; no patient having
been restrained except for the purpose of preventing suicide or
confining clothing upon the person. No one has been in seclu-
sion except such as were strongly homicidal. You have seen
but one nude person in the course of the year, and no more
than two in many years.
Table No. 5.
Showing the Pathological and Pathogenetic Causes of Insanity.
1869.
Previously
Number
Number
Number
Number
CAUSES.
of Cases.
Pre-disposed
of Cases.
Pre-disposed.
Ma.
Fem.
Ma.
Fem.
Males.
Females.
Males.
Females.
Congenital, .
3
1
3
1
20
18
20
18
Hereditary, .
26
34
26
34
488
498
488
498
Periodical,
25
20
25
20
285
392
285
392
Apoplexy,
Paralysis,
2
11
2
1
4
-
4
102
2
46
2
17
1
11
Epilepsy,
Chorea, .
13
6
3
2
211
2
87
5
66
26
1
Phrenitis,
-
-
-
-
9
7
3
5
Neuralgia,
-
1
-
-
5
6
2
2
Neurasthenia,
3
4
-
-
94
119
38
45
Fever, .
2
2
-
-
58
83
28
34
Disease of Heart,
-
-
-
-
-
4
-
-
Anaemia,
2
-
-
-
33
30
10
9
Tuberculosis, .
-
-
-
-
7
13
-
2
Pneumonia, .
-
-
-
-
4
4
1
1
Bronchitis,
-
-
-
-
5
27
5
19
Influenza,
-
-
-
-
2
5
1
3
Asthma, .
-
_
_
_
1
3
1
3
Pertussis,
-
-
_
-
1
1
-
1
Disease of Liver,
-
-
-
-
2
3
-
1
Dyspepsia,
Enterorrhcea,
-
-
-
-
15
9
13
3
6
4
3
3
Exanthemata,
_
_
_
_
10
13
5
6
Eruptions, Suppressed, .
Excretions, Suppressed, .
-
-
-
-
7
15
11
1
4
6
7
1
Renal Affections, .
—
-
—
—
2
1
1
1
20 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 5 — Continued.
1869.
Previously.
Number
Number
Number
Number
CAUSES.
of C
ases.
Pre-disposed
of Cases.
Pre-disposed.
Ma.
Fern.
Ma.
Fem.
Males.
Females.
Males.
Females.
Menstrual Disorder and
Uterine Disease,
_
2
_
_
_
150
_
64
Puerperal,
-
19
-
5
_
326
_
164
Turn of Life,
-
18
-
4
_
212
_
107
Hysteria,
-
1
_
_
_
31
_
15
Puberty,
-
1
-
1
1
9
_
5
Masturbation,
31
11
9
3
467
89
205
36
Excessive Venery, .
1
-
_
_
1
_
1
_
Intemperance,
27
2
9
1
689
101
282
27
Use of Opium,
_
2
_
_
4
17
3
5
Use of Tobacco,
_
_
_
_
3
6
_
4
Domestic Trouble, .
1
8
1
3
63
219
28
113
Domestic Affliction,
o
5
-.
_
80
249
43
108
Disappointed Affection, .
-
4
-
1
64
102
18
37
Disappointed Ambition, .
-
-
-
-
9
10
8
4
Avarice,
_
_
_
_
8
2
7
2
Pecuniary Trouble,
1
-
-
-
190
41
104
17
Spiritualism, .
-
1
-
1
28
30
12
13
Religious Excitement, .
2
_
_
_
149
183
73
91
Political Excitement,
-
_
-
11
_
5
_
Fright, ....
_
2
_
-
16
25
5
6
Jealousy,
-
-
-
-
19
25
4
8
Seduction,
_
-
-
_
_
4
_
_
Abusive Treatment,
_
_
2
15
1
6
Nostalgia,
1
_
_
_
6
20
_
2
Mesmerism, .
_
_
_
_
3
6
2
4
Criminal Trial,
_
_
_
_
_
1
_
_
False Accusation, .
_
_
_
_
_
1
_
_
Imprisonment,
_
_
_
_
4
_
1
_
Theft, ....
_
_
_
_
_
1
_
_
Novel Reading,
_
_
_
_
_
2
_
_
Sudden Joy, .
_
_
_
_
_
1
_
_
Inhalation of Chloroform,
&c, ....
_
1
_
_
_
1
_
_
Mineral Poisoning,
_
_
_
_
5
_
3
_
Vegetable Poisoning,
_
_
_
_
2
1
2
1
Insolation,
2
_
_
_
23
_
10
_
Injury to Head or Spine,
5
1
_
_
90
25
29
12
Incidental Injuries,
_
_
_
_
15
4
4
_
Srofulosis,
1
1
_
_
6
8
1
2
Cancer, ....
1
_
_
_
_
2
_
1
Venereal Disease, .
-
_
_
_
_
2
_
_
Old Age,
1
3
1
-
49
46
24
23
Unascertained,
8
14
-
-
697
741
-
-
Totals, .
171
166
82
76
4,095
4,103
1,868
1,970
1869.] PUBLIC DOCUMENT— No. 23. 21
The great frequency of relapses, or the predisposition en-
gendered by the disease itself, is shown by the fact that of the
cases included in the foregoing table, forty-five had suffered
from previous attacks of mental disease. A hereditary predis-
position was ascertained in sixty cases, and, I have no doubt,
existed in even a larger number, for this fact like some others,
is often ignored or concealed by the relatives. The most
frequent exciting causes, are, perhaps of a moral kind, proceed-
ing from distress, anxiety, grief, fear and excitement, the
results of domestic affliction, disagreements, disappointments,
reverses of fortune, and sudden and violent shocks to the
mind. That form of insanity which is popularly termed soften-
ing of the brain — general paralysis — is frequently produced by
mental shocks. Of the cases induced by physical causes, eight
were traumatic, two resulting from sunstroke, and six from
direct injuries to the head and spine. The various phases of
ill health of a well-marked character resulted in insanity in
sixty-two cases, and, undoubtedly, in all cases the physical
organs are the first to suffer though the seat of the disease may
be obscure. Twenty-nine cases are tabulated as cases of in-
temperance. It is proper to state in reference to them, that
none of them are cases of mere drunkenness. They are cases
in which an incontrollable craving for stimulants formed one of
the more prominent symptoms of mental disease, or cases in
which habits of intemperance have produced insanity, but they
are all cases in which there were well-marked symptoms of
mental aberration existing at the time of their admission.
I have in some former reports intimated my desire to re-arrange
and classify anew the whole number of cases, and show in a more
acceptable manner the conditions and circumstances influencing
the health of the patients previous to the invasion of mental
disease. Having personally known a large proportion of all
the patients admitted to the hospital, and having carefully
studied the histories of all the others, I expected to be able in
this Report to present a new classification, but other duties pre-
venting, my assistant, Dr. Draper, has taken up the work and
compiled in a careful manner from the records and case books,
and such other sources of information as he could reach, the
foregoing table. The classification is given as indicating quite
clearly the relation of cause and effect in the progress of mental
22
LUNATIC HOSPITAL AT WORCESTER. [Oct.
disease. It illustrates, also, the exciting influences as to
whether they are moral or physical in their nature. It
covers a period of nearly thirty -seven years, and embraces eight
thousand five hundred and thirty-five cases.
Table No. 6.
Showing the Ages of Patients Admitted, Discharged Recovered, not Recovered,
and Died during the Year.
Admitted.
Discharged Re-
covered.
Discharged not
Recovered.
Died.
AGES.
Males.
Females.
Males.
Females.
Males.
Females.
Males.
Females.
Less than 1 5, .
1
1
From 15 to 20,
12
6
3
3
4
3
1
-
20 to 30,
29
46
15
25
20
18
3
2
30 to 40,
57
43
17
18
22
22
7
3
40 to 50,
29
34
12
18
16
14
5
3
50 to 60,
26
18
13
10
7
8
2
1
60 to 70,
8
12
6
3
2
6
4
5
70 to 80,
6
4
1
3
1
2
6
3
80 to 90,
3
2
1
-
-
1
-
2
Unknown, . .
-
1
-
-
-
1
-
-
Totals, . .
171
166
69
80
72
75
28
19
Table No. 7.
Showing the Ages of Patients Admitted, Discharged Recovered, not Recovered,
and Died, from January 18, 1833, to September 30, 1868.
Admitted.
Discharged Re-
covered.
Discharged not
Recovered.
Died.
AGES.
Males.
Females.
Males.
Females.
Males.
Females.
Males.
Females.
Less than 15, .
33
28
7
13
21
13
2
2
From 15 to 20,
346
248
131
150
73
74
15
16
20 to 30,
1,070
1,016
540
516
393
395
71
76
30 to 40,
1,006
1,076
483
512
427
395
107
102
40 to 50,
862
897
360
406
313
309
118
102
50 to 60,
462
493
205
232
175
166
85
90
60 to 70,
272
244
95
114
106
76
59
59
70 to 80,
116
82
26
27
28
23
49
26
80 to 90,
1
16
6
2
5
4
6
9
Unknown,. .
4
3
-
-
1
-
-
-
Totals, . .
4,095
4,103
1,853
1,972
1,542
1,455
512
482
1869.]
PUBLIC DOCUMENT— No. 23.
23
Table No. 8.
Showing the Duration of Insanity before Admission of Patients Admitted, Dis-
charged Recovered, not Recovered, and Died during the year.
Admitted.
Discharged
Recovered.
Disch'dnot
Recovered.
Died.
DURATION OF INSANITY.
oo
«
•
■s
0)
a
S
a
fa
03
s
fa
3
03
&
fa
10
a
e
fa
Insane 1 year or less,
100
104
54
53
16
20
7
More than 1 year and less than
2 years, ....
12
13
9
18
18
19
4
2
More than 2 years and less than
5 years, ....
14
25
4
5
16
23
5
5
More than 5 years and less than
10 years, ....
13
11
2
4
8
4
7
4
More than 10 years and less than
15 years, ....
9
4
-
-
3
5
-
-
More than 15 years and less than
20 years, ....
8
1
-
-
3
-
-
1
More than 20 years and less than
25 years, ....
2
2
-
-
2
1
-
-
More than 25 years and less than
30 years, ....
2
2
—
-
2
—
-
—
Thirty years or more,
3
-
-
-
-
-
2
-
Unknown, ....
8
4
-
-
4
3
-
-
Totals, ....
171
166
69
80
72
75
28
19
2-t
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 9.
Showing the Duration of Insanity before Admission of Patients Admitted, Dis-
charged Recovered, not Recovered and Died, from January 18, 1S33, to Sep-
tember 30, 1868.
Admitted.
Discharged Re-
covered.
Discharged not
Recovered.
Died.
DURATION OF INSANITY.
03
3
"3
1
a
fa
"3
a
a
fa
a
Insane 1 year or less,
2,572
2,753
1,422
1,543
683
656
249
294
More than 1 year and
less than 2 years,
179
144
185
168
136
107
37
19
More than 2 years and
less than 5 years,
565
540
121
139
223
207
102
69
More than 5 years and
less than 10 years,
314
289
48
57
230
218
40
31
More than 10 years and
less than 15 years,
171
175
20
23
115
108
35
27
More than 15 years and
less than 20 years,
78
50
9
9
47
67
20
11
More than 20 years and
less than 25 years,
54
49
7
-
34
37
5
10
More than 25 years and
less than 30 years,
23
19
5
1
12
11
7
6
Thirty years or more,
34
30
2
5
13
13
9
7
Unknown,
105
54
24
21
49
1,542
31
1,455
8
8
Totals, .
4,095
4,103
1,853
1,972
512
482
1869.]
PUBLIC DOCUMENT— No. 23.
25
Table No. 10.
Showing the Civil Condition of Patients Admitted, Discharged Recovered, not
Recovered, and Died during the year.
CIVIL
Admitted.
Discharged Re-
covered.
Discharged not
Recovered.
Died.
CONDITION.
Males.
Females.
Males.
Females.
Males.
Females.
Males.
Females.
Unmarried, .
Married,
Widowers,
Widows,
Unknown,
81
75
14
1
64
70
31
1
33
29
7
33
35
12
41
23
6
2
27
31
16
1
12
12
4
6
7
6
Totals,
171
166
69
80
72
75
28
19
Table No. 11.
Showing the Civil Condition of Patients Admitted, Discharged Recovered, not
Recovered, and Died, from January 18, 1833, to September 30, 1868.
CIVIL
Admitted.
Discharged Re-
covered.
Discharged not
Recovered.
Died.
CONDITION.
Males.
Females.
Males.
Females.
Males.
Females.
Males.
Females.
Unmarried, .
Married,
Widowers,
Widows,
Unknown,
2,147
1,728
195
25
1,736
1,837
509
21
920
854
75
4
782
938
249
3
933
535
60
14
757
532
152
14
192
255
59
6
200
189
91
2
Totals,
4,095
4,103
1,853
1,972
1,542
1,455
512
482
26
LUNATIC HOSPITAL AT WORCESTER.
[Oct.
Table No. 12.
Showing the Occupation of Patients admitted to the Hospital from January 18,
1833, to September 30, 1869.
OCCUPATION OF MALES.
1869.
Previously.
Auctioneers,
2
Armorers,
_
3
Authors, ....
—
3
Blacksmiths and Iron-workers,
2
72
Bakers,
2
14
Butchers, ....
2
7
Book-agents,
-
2
Book-binders, .
-
4
Broom-makers, .
-
2
Book-keepers, .
Britannia-workers, .
-
10
2
Brick-makers, . .
_
6
Bellows-makers,
_
2
Barbers, ....
-
19
Clergymen,
Carvers, ....
3
1
25
3
Carpenters,
Coppersmiths, .
Coopers, ....
Cabinet-makers,
6
1
2
133
9
22
17
Clothiers, ....
_
16
Comb-makers, .
_
4
Confectioners, .
-
3
Card-maker,
-
1
Chair-makers, .
-
3
Cigar-makers, .
-
6
Clerks, ....
7
120
Carpet-weavers,
Caulkers,
—
3
3
Camphene-distillers, .
Dyers, ....
Druggists, . . .
Drovers, ....
1
1
3
3
3
2
Daguerreotypists,
Engineers, ....
1
4
4
Engravers,
-
4
Editors, ....
-
4
Expressmen,
Farmers, ....
18
14
789
Fishermen,
3
35
Gardeners,
1
10
Glass-blowers, .
-
4
Hotel-keepers, .
Hatters, ....
—
14
9
Harness-makers,
-
15
Hackmen and Teamsters,
-
37
Jewellers,
-
24
1869.] PUBLIC DOCUMENT— No. 23.
Table No. 12 — Continued.
27
OCCUPATION OF MALES.
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 Bootmakers,
Sail-makers,
Soap-makers, .
Sash and Blind-makers, .
Sea-captains, .
Sailors, ....
Students, ....
Ship-carpenters,
Shop-keepers, .
Stone-cutters, .
Soldiers, ....
Sexton, ....
Stevedore,
Surveyors,
School-boys,
Tailors, ....
Teachers, ....
Tobacconists, .
Tinners, ....
Tanners, ....
Umbrella-makers,
Wheelwrights, .
No occupation, .
Totals, .
38
2
13
1
13
2
1
1
2
1
2
1
1
11
16
929
33
6
163
36
4
1
3
10
60
7
102
1
53
36
30
7
16
1
4
4
5
3
11
13
326
9
10
3
18
163
60
9
8
13
29
1
1
2
31
29
38
3
8
30
2
18
249
171
4,095
28 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 12 — Concluded.
OCCUPATION OF FEMALES.
I860.
Previously.
Actresses,
2
Cooks,
1
65
Engraver,
-
1
Housekeepers, .
86
2,205
Housemaids,
25
431
Laundresses,
-
4
Music-teachers,
-
3
Midwives,
-
2
Nurses,
1
15
Operatives in Mills,
17
237
Seamstresses, .
19
769
School-girls,
1
46
Teachers, .
3
84
Type-setters, .
-
3
No occupation, .
13
236
166
4,103
Table No. 18.
Diseases which have proved fatal, from January 18, 1833, to September 30, 1 869."
1869.
Previously.
DISEASES.
Males.
Females.
Males.
Females.
Apoplexia,
Asphyxia,
Asthma, .
2
-
17
2
4
11
1
1
Ascites, .
-
-
5
7
Antochiria,
-
-
17
11
Bronchitis,
-
-
2
-
Carcinoma, .
-
-
2
2
Cardionosus, .
-
1
13
14
Cholera, .
-
-
5
-
Cholera Morbus,
-
-
2
3
Cystitis, .
Dysenteria,
Delirium Tremens,
-
-
1
12
4
1
6
Enteritis,
-
1
6
9
Epilepsia,
Erysipelas,
Hepatitis,
Hydrothorax, .
Hernia, .
3
1
78
9
1
1
1
38
10
2
1
Inanitia, .
-
-
38
59
Mania, Exhaustive,
10
7
17
17
Marasmus,
o
2
73
71
1869.]
PUBLIC DOCUMENT— No. 23.
29
Table No. 13 — Concluded.
1S69.
Previously.
DISEASES.
Males.
Females.
Males.
Females.
Meningitis,
Mortificatio,
Necropneumonia,
Paralysis,
Phthisis Pulmonalis,
Pleuritis, ....
Pneumonia,
Senectus,
Typho-Mania, .
Typhoid Fever,
Variola, ....
8
2
1
28
2
5
19
11
1
64
66
16
29
8
8
1
15
1
2
21
126
2
9
24
11
6
Totals, .
•
512
482
No epidemic prevailed to any extent during the year, and the
health of the household was generally good.
A few cases only of a mild form of diarrhoea, developed by
sudden changes of the weather, and yielding to slight remedial
measures occurred during the summer and early autumn.
During the month of September, three or four cases of a mild
form of typhoid fever appeared among employees who had been
only a short time in service. In general, nothing was ex-
perienced to disturb the sanitary condition of the hospital.
The deaths of forty-seven patients, twenty-eight men and nine-
teen women, was a greater number than during the preceding
year, both absolutely, and when calculated in reference to the
population. An examination of the table will show that the
mortality for the year was less than twelve per cent, of the
average number of residents, and less than seven per cent, of the
whole population of the establishment, while the average mor-
tality, since the opening of the institution, has been no more
than nine per cent, on the average number of patients, and a
fraction more than five per cent, when calculated on the whole
number of residents.
On comparing the mortality of the sexes separately, it will
be found, and has frequently been observed, that any seeming
increase in the death rate is confined almost exclusively to the
male patients. In contemplating the rate of mortality in the
30 LUNATIC HOSPITAL AT WORCESTER. [Oct.
hospital, it must be remembered how large a proportion of the
more feeble inmates are advanced in life.
Twelve of those who died had passed their seventieth year,
nor should it be forgotten that all, or nearly all, are broken in
health of body and mind long before their admission to the
hospital.
On investigating the causes of death, it will be noticed that
the largest proportion, seventeen, occurred from maniacal ex-
haustion, which fact illustrates quite fairly the character of the
admissions during the year. From general paralysis ten,
marasmus four, old age six, epilepsy four, and the remaining
cases embracing a variety of causes, the character of which is
indicated by the table.
As it has happened in other years, so in this, several cases
were brought to the hospital in almost a dying condition, and
ought not to have been removed from their homes at all. Their
journey to the institution probably hastened their death.
Others were apparently sent to us simply because they were
old, feeble and uncleanly in their habits, and required more
attention than relatives and friends were able or willing to
give.
One of the patients who died during the year was eighty-
nine years of age, one was eighty, one was seventy-nine, one
was seventy-six, two were seventy-five each, two were seventy-
four each, one was seventy-two, three were sixty-nine each,
and three were sixty-eight each.
1869.]
PUBLIC DOCUMENT— No. 23.
31
Table No. 14.
Showing the Admissions from each County, from January 18, 1833, to Septem-
ber 30, 1869.
1869.
Previously.
Whole No.
Males.
Females.
Total.
Barnstable,
_
128
128
Berkshire,
-
-
-
190
190
Bristol, .
2
-
2
296
298
Dukes,
-
-
-
20
20
Essex,
27
29
56
1,217
1,273
Franklin,
-
1
1
127
128
Hampden,
1
-
1
377
378
Hampshire,
-
-
-
328
328
Middlesex,
53
65
118
1,478
1,596
Nantucket,
-
-
-
32
32
Norfolk, .
8
7
15
649
664
Plymouth,
-
-
-
238
238
Suffolk, .
12
15
27
758
785
Worcester,
65
47
112
2,416
2,528
Other States,
3
2
5
44
8,198
1
49
Totals,
•
171
166
337
8,535
Table No. 15.
Showing the Whole Number of Patients during the last year, the Average Num-
ber, 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-seven years the Hospital has been in operation.
TEARS.
Whole
Num er.
Average
Number.
No. at end
of each
year.
Current Expen-
ses of each year.
Annual Ex-
pense for each
Patient.
Expense per
week for
each Patient.
1833, . . .
153
107
114
$12,272 91
$114 67
$2 25
1834, .
233
117
118
15,840 97
135 38
2 60
1835, .
241
120
119
16,576 44
137 30
2 64
1836, .
245
127
138
21,395 28
168 44
3 12
1837, .
306
163
185
26,027 07
159 64
3 07
1838, .
362
211
218
28,739 40
136 20
2 62
1839, .
397
223
229
29,474 41
132 16
2 53
1840, .
391
229
236
27,844 98
121 59
2 33
1841, .
399
233
232
28,847 62
123 81
2 38
1842, .
430
238
238
29,546 87
111 12
2 13
1843, .
458
244
255
27,914 12
114 40
2 20
1844, .
491
261
263
29,278 75
112 17
2 15
1845, .
656
316
360
43,888 65
138 88
2 66
1846, .
637
359
367
39,870 37
111 06
2 13
32 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 15 — Concluded.
TEAKS.
Whole
Number.
Average
Number.
No. at end
of each
year.
Current Expen-
ses of each year.
Annual Ex-
pense for each
Patient.
Expense per
week for
each Patient.
1847, . . .
607
377
394
$39,444 47
$104 62
$2 01
1848,
655
404
409
42,860 05
106 09
2 05
1849,
682
420
429
40,870 86
97 31
1 87
1850,
670
440
441
46,776 13
106 40
2 04
1851,
704
462
466
52,485 33
112 61
2 16
1852,
775
515
532
43,878 35
85 20
1 64
1853,
820
537
520
53,606 66
103 14
1 98
1854,
819
430
381
53,221 52
123 77
2 38
1855,
580
349
336
54,895 88
157 29
3 02
1856,
577
357
376
45,631 37
128 64
2 47
1857,
647
387
372
49,004 75
124 04
2 38
1858,
679
372
301
38,267 26
102 86
2 39
1859,
501
309
317
48,363 33
156 51
3 01
1860,
532
324
331
47,757 01
147 39
2 83
1861,
583
369
379
54,748 53
148 37
2 84
1862,
600
401
396
53,043 88
132 18
2 50
1863,
611
398
399
66,082 36
166 03
3 19
1864,
625
366
344
66,612 00
182 00
3 50
1865,
565
350
343
73,772 41
211 37
4 06
1866,
630
368
381
88,398 73
239 28
4 60
1867,
669
389
355
86,930 88
223 47
4 30
1868,
651
370
382
72,054 59
197 60
3 80
1869,
719
387
376
81,440 58
209 04
4 02
It will be seen by the foregoing tables, that the average
weekly expense, per patient, was increased from three dollars
eighty cents to four dollars two cents, a fact which is ex-
plained by the increased cost of coal, and a greater expenditure
in improvements and repairs, than was incurred during the
last year. If the excess of the expenditure for the purchase
of fuel, and for improvements and repairs, be deducted from
the total amount of current expenses, and the average weekly
cost of support be based upon the sum thus given, it will be
found to be only three dollars and sixty-seven cents per week,
making a reduction of thirty-five cents per week from the
actual cost, or thirteen cents per week below the cost of last
year. So that if prices had remained nearly the same, and no
more had been attempted for the comfort of the patients and the
well-being of the institution, the average weekly cost of support
would have been no more than three dollars and sixty-seven cents.
While new outlays have been necessary to preserve and
improve the property of the Commonwealth, and render the
1869.]
PUBLIC DOCUMENT— No. 23.
33
institution more acceptable to its inmates, the treatment of
the patients in a medical, moral and hygienic point of view,
has received its proper share of attention, and the curative
character of the hospital has suffered no depreciation.
In view of these constantly occurring items of expense,
and in consideration also of the fact that the cost of the leading
articles of consumption for the years 1868-9, is nearly one
hundred per cent, in excess of the cost of the same articles
in 1860, it will not be expected that the weekly expense per
patient can at present be reduced much lower.
An examination of the following table of retail prices in
this neighborhood, will show that the average in the price
of the leading articles of consumption, for the years 1868-9,
is somewhat in excess of ninety per cent, over that of 1860 ;
but if the average be proportioned to the relative importance
of the several articles entering into consumption, the advance
will be found to stand at even a higher figure.
Prices.
Increase.
ARTICLES.
I860.
I860.
Per cent.
Flour, per barrel,
$8 00
$14 00
75
Beef, fresh, per pound, .
1»*
28
124
Beef, corned, per pound,
07
17
143
Pork, fresh, per pound, .
09
20
122
Ham, per pound, .
12i
28
124
Butter, per pound, .
25
50
100
Potatoes, per bushel,
70
1 20
71
Rice, per pound,
05
12
140
Beans, per quart, .
10
20
100
Tea, Oolong, per pound,
56
1 40
150
Coffee, Rio, green, per pound
18
30
67
Sugar, brown, per pound,
09
15
67
Molasses, N. 0.,
34
90
164
Coal, per ton, .
6 00
16 00
166
Sheetings, per yard,
10
17
70
Cotton Flannels,
14
30
114
Tickings,
17
33
94
Prints, Merrimac, .
12i
17
36
Thus, while all the articles of general consumption have
increased about ninety per cent, since 1860, the price charged
for board has not increased more than thirty per cent. The
hospital has purchased for cash, at wholesale prices, but the
ratio of increase must be nearly the same.
5
34
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PUBLIC DOCUMENT— No. 23.
35
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LUNATIC HOSPITAL AT WORCESTER. [Oct.
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LUNATIC HOSPITAL AT WORCESTER. [Oct.
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1869.] PUBLIC DOCUMENT— No. 23. 55
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1869.] PUBLIC DOCUMENT— No. 23. 57
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1869.]
PUBLIC DOCUMENT— No. 23.
59
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60 LUNATIC HOSPITAL AT WORCESTER. [Oct.
The usual table, appended, showing the amount of work
executed, will sufficiently testify to the efficiency and faithful-
ness with which that part of the treatment has been carried
out, which consists in the industrial occupation of the patents.
In addition to the usual gardening and farming operations,
the shops, engine and boiler-house, the laundry and kitchen
afford ample employment for considerable numbers of healthy
men and women. Four, and sometimes five, of the male
patients, are employed quite constantly by people in the
neighborhood outside of the hospital.
1869.]
PUBLIC DOCUMENT— No. 23.
61
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62
LUNATIC HOSPITAL AT WORCESTER. [Oct.
Articles Made in the Sewing -Rooms during the Year,
Aprons,
. 44
Collars,
. 15
Bed-spreads,
. 60
Curtains, . . .
. 35
Bed-ticks, .
. 392
Drawers, pairs of,
. 51
Blankets, .
. 21
Dresses,
. 125
Bags, .
. 14
Edging, yards of,
. 45
Carpets,
. 7
Frocks,
. 5
Chemises, .
. 162
Handkerchiefs, .
. 50
Coats,
. 3
Hose and socks, pairs of,
. 30
Jackets,
. 26
Sheets, . .
. 180
Mattress-ticks,
. 250
Shirts,
. 50
Mittens, pairs of,
. 22
Shirt-bosoms,
. 10
Neck-ties, . •
. 15
Skirts and quilts,
. 50
Night-dresses,
. 35
Suspenders, pairs of, .
. 9
Night-caps,
. 14
Table-covers,
. 25
Overalls, pairs of,
. 12
Towels,
. 170
Pants, pairs of, .
. 43
Undershirts,
. 12
Pillow-cases,
. 175
Vests,
. 15
Articles Repaired in the Sewing-Rooms during the Year.
Aprons, 50
Night-dresses, .... 53
Blankets, .
. 170
Overalls, pairs of,
. 35
Bed-spreads, .
150
Pants, pairs of,
1,213
Bed-ticks,
475
Pillows, .
150
Bags,
25
Pillow-cases,
480
Chemises,
3,700
Sheets,
680
Coats,
1,050
Shirts,
4,320
Collars, .
27
Shirt-bosoms, .
78
Curtains, .
55
Skirts,
450
Drawers, pairs of,
375
Stockings, pairs of,
3,115
Dresses, .
805
Table-cloths, .
65
Frocks, .
30
Towels, .
160
Jackets, .
60
Undershirts,
460
Mattresses,
160
Vests,
875
1869,]
PUBLIC DOCUMENT— No. 23.
63
Articles Made in the Shops.
Bee-hives, ....
. 4
Tool-handles,
. 50
Bolts,
50
Patterns, .
6
Boxes, ....
. 30
Writing desk,
1
Small bedsteads, s .
■ 4
Picture frames, .
. 25
Small bureaus, .
6
Iron rods, .
. 20
Boot-jacks, ....
o
Knife-blades,
. 12
Knobs, ....
36
Mattresses, .
20
Chair-rounds,
75
Pillows,
. 30
Curtain sticks, .
50
Rabbit planes, .
4
Screens, ....
15
Roof sashes,
2
Chisels, ....
6
Wardrobes,
6
Coal-sieves,
2
Whiffletrees,
12
Wardrobe-hooks,
12
Barrel-covers,
6
Small tables, .
6
Walking sticks, .
4
Fancy boxes,
6
Buckets,
12
Screw-drivers, .
8
Brackets, .
24
Set of shelves, .
3
Mop-sticks, .
75
Pair of shafts, .
1
Windows glazed,
400
Table legs, sets of,
6
Models,
3
Doors, ....
4
64
LUNATIC HOSPITAL AT WORCESTER. [Oct.
JCLI MVVVS JL\j
jJJU/VI (
;(.«/ ti d oito fo/cu^jo.
Bedsteads,
50
Razors,
20
Brass rings, .
12
Rakes,
39
Boxes,
15
Saws, .
25
Bureaus,
12
Stands,
24
Blinds,
18
Settees,
6
Brooms,
18
Scissors,
12
Chairs,
150
Sofas, .
4
Clocks,
12
Sleigh, . . .
1
Coffee pots, .
8
Sleds, .
o
Chisels,
15
Sashes,
24
Crickets,
4
Chains,
6
Flower stands, .
5
Tubs, .
6
Picture frames, .
50
Tables,
15
Boots ironed, pairs of,
4
Tin pans, .
20
Looking glasses, .
18
Tea-kettle, .
. 1
Horse wagon,
1
Trunks,
. 12
Ox wagons,
2
Umbrellas, .
. "4
Hoes,
12
Window rods,
. 50
Guns,
. 12
Windows, .
. 60
Iron bars, ....
. 6
Wheelbarrows, .
. 6
Knives, ....
. 12
Lock keys, .
. 18
Pen-knives,
. 12
Book-cases,
. 2
Lounges, ....
. 6
Hay-forks, .
. 12
Lanterns, . .
. 12
Hand-cart, .
. 1
Pails,
. 24
Saws filed, .
. 50
Parasols, ....
. 4
Fancy boxes,
. 4
1869.]
PUBLIC DOCUMENT— No. 23.
65
Products of the Farm.
ARTICLES.
Market
Value.
Total Value.
Apples, . . .
18 bbls.,
$5 00
$75 00
Pears, .
20 bush.,
4 00
80 00
Cherries, .
11 u
a2
5 00
7 50
Grapes,
30 "
3 00
90 00
Tomatoes, .
300 "
1 00
300 00
Currants, .
1 "
3 00
3 00
Sweet Corn,
75 "
1 00
75 00
Gooseberries,
1 "
2 00
2 00
Strawberries,
300 boxes,
20
60 00
Beans,
30 bush.,
3 00
90 00
Turnips,
50 "
50
25 00
Beets, .
250 "
50
125 00
Mangel-wurzel,
800 "
40
320 00
Carrots,
800 "
50
400 00
Squashes, .
7 tons,
40 00
280 00
Peppers,
30 bush.,
50
15 00
Cucumbers,
100 "
1 00
100 00
Cabbages, .
3,000 heads,
15
450 00
Cauliflowers,
150 «
20
30 00
Spinnach, .
20 bbls.,
2 00
40 00
Brussells Sprouts,
Kail
Brocoli, &
as., .
.
-
25 00
Lettuce,
2,000 heads,
02
40 00
Celery,
.
-
35 00
Rhubarb, .
3 tons,
40 00
]20 00
Hay, .
130 "
20 00
2,600 00
Corn Fodder,
6 "
10 00
60 00
Milk, .
6,000 quarts,
06
3,600 00
Beef, sold, .
1,297 lbs.,
15
194 55
Pork, sold, .
1,961 "
15
294 15
Other produce sold, .
• •
-
2,304 85
"
$11,841 05
66 LUNATIC HOSPITAL AT WORCESTER. [Oct.
The female patients are sufficiently employed in sewing,
knitting, crocheting, in cooking, washing, ironing, and the
other various household duties incidental to a large hospital.
A few in every ward assist the attendant in the general care
of the ward, and in nursing and watching the more feeble and
insane. Some work regularly for their families at home, in
making and repairing clothing, knitting socks, and such other
labor as can well be performed while in the hospital.
The male patients are not so well provided for in this respect,
nor are so fortunate in being accustomed to light employments,
which can be taken up or laid away at any time without
trouble and inconvenience. Among the male patients there are
not many trained mechanics, and those who do find it nec-
essary to remain with us, and are able to perform labor, are
generally actively employed. A large proportion of those
employed, are engaged in out of door work upon the farm
and gardens. Many of those are, however, incapable, both
physically and mentally, of performing any great amount of
useful labor.
By steady employment in light and cheerful labor, they im-
prove in health of body and mind, their feelings of self-respect
are kept alive, and their habits of usefulness prolonged.
No kind of labor is so beneficial to the patient, or so profitable
to the hospital, as that expended in the cultivation of the farm
and gardens, and the care of the farm-stock. The free and
unrestrained exercise in the open air, the quality of the labor,
calling into play nearly all the muscles of the body, the cheer-
ful influences surrounding the out-of-door laborer, all tend to
improve their condition and promote their recovery.
The products of the farm have been abundant, as the preced-
ing table will show, and have well repaid the labor of growing
and gathering.
The usual amount of labor has been expended in draining,
ditching, blasting and sinking rocks below the surface, in fenc-
ing and in transplanting trees, and in improving in a variety
of ways the value of the estate.
Much more has been done than for several years past
in improving and repairing the buildings, and refurnishing
them. Much more is absolutely necessary, in order to preserve
to the State the value of the property, without serious loss.
,] PUBLIC DOCUMENT— No. 23. 67
Many thousands of dollars must be expended immediately,
if the present occupancy is to be continued. Every part of
the establishment, inside and out, needs painting, as do also
the stables, out-buildings and fences.
The heating and ventilating apparatus, the cooking appa-
ratus, and the washing machinery, all will soon need replacing
at heavy cost. You remember that each of these departments
have been in constant operation twelve years, with little or
no expense of repairs, and are now quite well worn, and must
soon fail. It is believed that no other hospital in the country
has passed so long a period without an entire replacing of
these important fixtures.
All the means formerly in use, and as many more as could
be added, for recreation and amusement, and instruction of
the patients, have been carried out with unabated interest and
activity. The supply of newspapers and periodicals and books
has been considerably increased by judicious purchases, and
many additions have been made to the pictures and objects of
interest and pleasure throughout the house.
The billiard-rooms, reading-rooms, libraries, and music-
room, afford the means of intellectual occupation by the op-
portunities they offer for social contact of persons of similar
tastes and habits, and also by the very generous supply of
books, papers and periodicals, which are found in them.
Many of our patients also visit the public libraries and
reading-rooms of the city, and in our wards may be found at
all times choice books belonging to circulating libraries of the
city.
During the winter a course of lectures, and occasional con-
certs, fill up the time of the long and otherwise monotonous
evenings.
During the summer the picnics, fishing excursions, daily
drives, games of base ball, croquet, and all the other usual
out-of-door amusements, may be mentioned as the principal
source of recreation.
For the assistance rendered by our friends outside of the
hospital, in our endeavors to ameliorate the condition of the
insane, we tender our grateful thanks. To the attendants
and employees generally, great credit is due for the faithfulness
68 LUNATIC HOSPITAL AT WORCESTER. [Oct.
with which they have performed duties always unpleasant,
and sometimes excessive.
It is my duty and pleasure to record my sense of obligation
to the other resident officers and assistants, for the faithful
manner in which they have performed their duties and ad-
vanced the interests of the institution. Dr. Draper continues
to devote his time and skill with unabated interest, for the
welfare of the patients under his charge. Dr. Mary H.
Stinson has, since September 1st, had charge, as Assistant
Physician of the female department. She has so far per-
formed her duties faithfully, scrupulously and well, and I
have no doubt her appointment will prove eminently satisfac-
tory and useful.
The affairs of the Steward and Treasurer sufficiently indicate
the faithful performance of his duties, and the quality of his
success.
Mr. Allen, our Chaplain, has grown old in years in the ser-
vice of the hospital, but is still young, rich and strong, in love,
sympathy and faith, for those who receive the benefit of his
wise counsels and cheerful ministrations.
Gentlemen, thus much in brief, of the labors and successes
of the year just closed. Of its griefs, its disappointments and
trials, who shall tell ? Of hope deferred, of opportunity lost,
of minds wrecked, — hopelessly so, for want of what could have
been done and given, — who shall count the sum of them ?
It is pleasant to indulge a complacent retrospect of past
successes and acknowledged excellence, but it is the part of
wisdom to be mindful of failures and short-comings. If we
would preserve the character of the hospital, if we would hand
down its excellent name and fame to our children, if we would
keep before it its career of usefulness, we must not rest one
moment, or consider anything accomplished, while such a field
of improvement is before us.
During the last few years, such investigations have been
made in the pathology of insanity, and such close observation
of its various phenomona, as to almost revolutionize the modes
of managing and treating the insane. These changes call for
a more liberal and generous expenditure in structural arrange-
ments, in grounds, in administration, and in all the material
appliances of the hospital. It is not enough that we protect
the insane from cold and hunger, from suicide and homicide.
1869.] PUBLIC DOCUMENT— No. 23. 69
We do not perform our whole duty until we afford the
greatest possible facility for bringing into use the best modes
of treatment, by improved buildings, furniture and fixtures
of convenience, by situation, by grounds and contrivances
which will allure to the greatest amount of cheerful exercise
and labor, and by every possible facility for promoting all the^
physical and mental activities, and at the same time of secur-
ing quiet repose and rest to those whose faculties are excited
beyond control, so that they may pass their days in peace, and
receive such attention as is the just due of every human being ;
and of bringing, also, to those who must end their days within
the friendly walls of the hospital, such kindness, care and con-
solation, as shall smooth their passage to the grave, and rob
death of its terrors. Lacking these, no ability or resource
within your power, no amount of skill or faithfulness on the
part of your medical officers, no zeal of your attendants, can
avail anything to those unfortunate men and women under
your charge and trust.
When, in addition to this lack of facilities, the patients are
crowded into small and inconvenient apartments, huddled like
sheep in a fold, made to sleep in temporary beds, in strange
nooks and corners, the quiet and well-behaved convalescents
obliged daily to give way and relinquish their meagre accom-
modations to the incoming excited and furious, and when, in
addition to these difficulties, I remind you that our patients are
now drawn mainly from an intelligent and educated class, and
not, as at first, from poor-houses, receptacles and prisons, we
may well charge ourselves with the failure of fulfilling our
obligations and performing our duties.
It has been too much the custom to consider the Worcester
Hospital complete ; having been constructed and opened to the
public, it was finished — needing no addition or improvement,
no increase of facilities, save what the wit and economy of its
managers might produce — complete in all its appointments to
meet and answer the growing demands of a rich and prosperous
community. But let us see how those best informed upon the
subject have always regarded it.
Since 1856, the extreme limit of accommodation has been
rooms, or their equivalent in space, for three hundred and one
patients. A reference to Table No. 15 will show that the average
70 LUNATIC HOSPITAL AT WORCESTER. [Oct.
number of patients has far exceeded that limit each year, ex-
cept 1859, when it was three hundred and nine, and reaching,
in 1862, four hundred and one, and in 1863, three hundred
and ninety-eight, and during the year just closed three hundred
and eighty-seven.
Five years in succession I have most earnestly recommended
a plan by which a better classification might be obtained, the
evil results of a crowded hospital avoided, the facilities for
treatment multiplied, and all the comforts and privileges of the
establishment increased. These recommendations have been
unheard and unheeded.
In 1854, Dr. Howe urged the establishment of a better sys-
tem, and presented his views in such a manner as to command
a respectful hearing, but to little or no purpose.
In 1833, Horace Mann urged upon the Trustees the necessity
of providing improved accommodations for convalescents, where
they could enjoy a larger and more generous liberty, and pass
from the restraint of the hospital to the freedom of society by
gradual steps. This provision was never made.
If we look at your carefully kept records we shall find such
entries as these in the handwriting and over the names of the
several Trustees.
June 6, 1833. — Measures were adopted by the Trustees for the
removal of all idiots, as not coming within the provision of the
statute, not being furiously insane ; also, new arrangements
deemed requisite for the Africans, who ought not to mingle with
the other female patients. Horace Mann.
W. B. Calhoun.
November 25, 1833. — The solitary cells are all occupied, and
there are five African females in the apartments prepared for that
class. A. D. Foster.
February 24, 1834. — In the institution one hundred and fifteen
patients ; six only of the solitary cells are occupied. In the African
department are five female blacks and one unruly white.
Thomas Kinnicutt.
September 28, 1836. — The Lodge abandoned, and the basement
rooms of the new wing substituted and thought to be a great im-
1869.] PUBLIC DOCUMENT— No. 23. 71
provement for the worst class of patients, bringing them, more
directly under the supervision of the officers, and relieving them of
much anxiety on their account. Thos. Kinnicutt.
February 19, 1838. — Institution crowded, and has been neces-
sary to put patients in rooms not intended for their use.
E. D. Bangs.
October 9, 1845. — One evil only exists in regard to the institu-
tion. The lodges for the confinement of the ungovernable insane
are neither suitable in location or construction, and the Trustees are
unanimously of the opinion that a new building, especially designed
for the imbecile, the raving, and the incurable, is necessary to the
completeness of an institution which reflects so much credit on the
wisdom and liberality of Massachusetts. H. H. Childs.
March 30, 1846. — In the solitaries and basement rooms were
thirteen patients who can wear no clothes, and another in the
galleries who is restrained from tearing off his clothes only by
bracelets. Joseph Sargent.
January 30, 1847. — The solitaries are all occupied, and besides,
the subscriber found more patients under restraint in the galleries
than he has seen before for a long time. There were eight hand-
cuffed, and one other, with no clothing but a torn shirt, came out
from his room in one of the galleries. These facts are mentioned
as presumptive evidence of the need of better accommodation for
patients whose influence upon other patients cannot be good.
Joseph Sargent.
August 31, 1847. — The subscriber found eight men in the lodges
to-day in a state of complete nudity. Joseph Sargent.
March 30, 1849. — The strong rooms recently constructed were
found entirely satisfactory. Levi Lincoln.
June 11, 1851. — The undersigned considers the employment of
men as attendants in the female wards as objectionable ; some of
the women were found to-day in a state of nudity, and some nearly
nude. This is, of course, unavoidable at times ; but the attendance
of men upon these unfortunate creatures (some of whom are still
very young) seems an unnecessary aggravation of the painful fea-
tures of the melancholy spectacle presented in these wards.
S. G. Howe.
72 LUNATIC HOSPITAL AT WORCESTER. [Oct.
October 31, 1853. — The undersigned visited and inspected the
various wards between the hours of seven and nine this morning.
The difference between having a statement of the Hospital in the
daytime in an overcrowded state and seeing the consequences of it
in the evening is the difference between the abstract and the con-
crete. In some of the halls the men were lying upon the floor (not
upon bedsteads,) on each side of the room, so that one had to pick
one's way between them. Some were but half covered up, others
tossing about in vain attempts to get an easy posture upon their
shapeless heaps of bedding. The air, which had been exhausted by
the inmates during the day, and further impaired by gas-light dur-
ing the evening, was almost fetid, so that it was most disagreeable
to breathe. The considerations which, in the daytime, demand the
demolition of the outer strong rooms, demand it still more strongly
by night. If the patients had the sense of the Parisian mob they
would serve them as it did the Bastile. S. G. Howe.
"What are these but the expressions of a want never supplied,
of a suffering never relieved.
It is true that this hospital has been repaired and improved.
It is true that Massachusetts has built and endowed other hos-
pitals, that she cares for and protects more than two thousand of
her children within the wards of lunatic asylums. But the
great and crying evil has not been remedied.
No attempt has been made at any proper classification ; no new
facilities for treatment have been afforded. No opportunities
given for free and unrestrained enjoyment of the higher faculties.
No allurements provided sufficient to induce unwilling men and
women to engage in industrial pursuits ; nothing to reestablish
and keep alive the kindlier feelings of their social natures.
Look again at the condition and prospects of your hospital.
It has two hundred and forty-nine rooms for patients, each of
which is eight feet wide by ten long, and nine feet high. These
rooms are not only the sleeping-rooms of the patients, they are
the dressing-rooms, sitting-rooms, and, to a great extent, the
living-rooms of the patients. They have access to the common
corridor, the dining-room, and the bathing-room. Besides
these two hundred and forty-nine rooms, it has small dormi-
tories equal to thirty-six rooms, making in all two 'hundred and
eighty-five rooms. Into these rooms, destitute of convenience
sufficient to preserve the common decencies of life, have been
1869.] PUBLIC DOCUMENT— No. 23. 73
crowded during the last year a daily average of three hundred
and eighty-seven patients ; and much of the time during the
warm weather there were over four hundred patients. Into
this compact hospital, with no facility for segregation, are
crowded day and night, year in and year out, one hundred
more insane people than it can with any comfort provide for.
This embarrasses the administration. It depreciates the stand-
ard of health ; it diminishes the comfort, and increases the ex-
citement of the patients and adds to the perplexities of the
attendants. It makes the whole household restless and uneasy.
It necessarily leads to the use of objectionable methods of man-
agement, and to unwholesome and injurious restraints. It
annoys and often exasperates the convalescent and brings on a
relapse of his malady. It intensifies the excitement of the
maniacal, and is every way a prolific cause of many other
evils.
I have already stated that our patients are drawn from the
well-to-do families of cultivation and refinement ; among them
are the sons and daughters, wives and widows of farmers, me-
chanics, ministers, lawyers and physicians. These men and
women were trained up in neat and orderly habits, were edu-
cated in New England schools, and are accustomed to good
society, and, however willing and ready they were in health to
help the poor, feed the hungry and clothe the naked, they would
never from choice have chosen habitations with those of low
and degraded propensities and filthy habits. Nor do they when
insane seek such companionship, and they ought not to be so
degraded by being crowded into apartments with persons whose
language, habits and manner offend and shock their sensibili-
ties.
If we continue this method of management we shall degrade
the character of the institution in public estimation, and compel
tliose who desire its aid to seek relief elsewhere. We shall
assist the multiplication of small private asylums where friends
of the insane can procure accommodations for which they are
willing to pay, and we shall be instrumental in bringing upon
society a great evil which it will be quite impossible to control.
In providing for the prospective wants of the insane, two
things are to be kept in mind, — justice and humanity to the
patient, and a regard for the public welfare and safety. The
10
74 . LUNATIC HOSPITAL AT WORCESTER. [Oct.
first will forbid the imposition of any restraint which is not
absolutely necessary, and the second demands certain regula-
tions providing for the safety and security of those who are
unfit to govern and control their own actions, and a wise and
efficient supervision of all persons whose mental disorders make
occasional seclusion and restraint necessary.
Among other evils arising from the existing arrangements for
the management of lunatics are, that they are, and must be, too
much of the time confided to persons who are wholly unac-
quainted with bodily and mental disorders, and who are apt,
from carelessness and inattention, to neglect such methods of
management as might conduce to recovery, and that the con-
stant pains-taking, intelligent supervision which is necessary to
recovery is at present hardly possible.
Sufficient inducements cannot, under existing circumstances,
be offered to individuals with proper physical and mental en-
dowments to undertake for any period of time the care of the
insane ; and the more the insane require trained and skilful
supervision from the violence of their disease, the more difficult
it becomes to obtain such service.
I believe that new arrangements might be made which would
obviate many, if not all, of these difficulties ; but, unfortu-
nately, to effect this, the whole subject requires to be considered
almost without reference to what has been done before.
What is necessary is a healthy public sentiment in regard to
the insane, that they are afflicted with a disease which is cur-
able, and, in the early stages, as much so as any other bodily
ailment ; that when recovered they are as perfectly restored as
persons recovered from any other disease ; that the insane are
not filled with evil spirits to be exorcised or tamed into subjec-
tion only by the mild influences of music and flowers. Nor
does disease endow them with every species of low cunning
and craft which so much gratifies the idle curiosity and so
colors all floating reports concerning them and their manage-
ment.
Such a healthy sentiment as shall regard the most trouble-
some as beloved members of our own families who, by reason
of some disordered action in the nervous system, are suffering,
keenly suffering, from every degree of mental disturbance.
Such a sentiment, too, as shall induce all who feel the ap-
1869.] PUBLIC DOCUMENT— No. 23. 75
proach of mental disease to flee to the asylum for safety and
security, and should assure those who are in a sound state of
mind that, in the event of being afflicted with insanity, they
will be protected ; that their property will be preserved ; their
persons secured from danger or ill-treatment ; that they will
not be excluded from the observation of friends, and of per-
sons desirous of restoring them to society and to usefulness ;
that they will be frequently visited by those who will not allow
them to remain in confinement any longer than is for their
best good, or to be subject to any restraint which the safety or
security of their own persons or property, or the safety and
security of the persons or property of others does not demand.
And that every remedial means, medical, moral and mental,
will be patiently, perseveringly and scientifically employed for
their restoration to health and happiness.
To accomplish these most desirable objects, every lunatic,
wherever he may be, or whatever his condition may be, should
be under the care and control of the State, and should be fre-
quently visited by some State medical officer, and his condition,
care and surroundings carefully and systematically noted and
recorded.
Some sufficient means should be at the command of every
hospital for the insane to instruct nurses and attendants on
probation, and retain their services when desirable.
No person should ever be confined in a lunatic hospital if he
can have proper care and control out of it.
There should be attached to every hospital for the insane a
sufficient number of medical officers, so that one may be ready
all times to attend to insane patients, wherever they may be
cared for, within convenient distance of the hospital.
The patients out of the hospital proper being the majority,
and consisting of all whose circumstances would insure proper
attendance, more complete and perfect arrangements might be
made for the smaller number in the hospital proper than has
been anywhere attempted as yet.
There should be found in the neighborhood of the hospital
a few well-to-do families who would be willing to receive one
or two lunatics, such families being governed, so far as their
lunatic boarders are concerned, by all the rules and regulations
of the hospital. To these such patients should be sent as re-
76 LUNATIC HOSPITAL AT WORCESTER. [Oct.
quire a removal from home, but who hardly need all the re-
straint of a hospital. A few convalescents, and a few mild
chronic cases, might also find more suitable homes in such
accommodations than elsewhere.
Information should be given of all lunatics, harmless or other-
wise, who might be wandering about the country, and liable
to become troublesome and dangerous, and these persons should
be examined and registered by the deputy, and placed under
restraint if necessary. The security and comfort of all these
not necessarily confined in the hospital being provided for, the
hospital would become the most cheerful and comfortable, as well
as the most desirable place for the special treatment of acute
forms of mental disease, and the quiet and repose of such as
need rest and recuperation from exhausting mental disturbance.
Let us consider very briefly what this hospital should be and
of what it should consist.
For the best management and control of persons afflicted
with mental aberration to that degree which requires interfer-
ence and restraint, it is necessary that places be provided where
they can be kept quite separate from relatives and friends, and
all those persons whom in health they have been in the habit of
commanding or controlling, and where they will be removed
from all objects likely to produce the same class of mental
operations which accompanied the invasion of the disease.
The first consideration of importance is the proper location
of the buildings. The site should be elevated, and, if possible,
on a sunny slope, and by no means in a cold or exposed situa-
tion. The soil should be gravel, and there should be such a
supply of pure water as to make the quantity used daily of no
importance.
The estate should be near, but not immediately adjoining, a
large town, having abundant railroad facilities, and should be
thoroughly enclosed by a high and substantial wall, and fur-
nished with a gatekeeper's lodge at the entrance. The surface
of the land should be uneven and broken by groves and scatter-
ing trees of natural growth. The quality of the soil is of but
little consequence in comparison to the quantity, but a heavy
clay sub-soil should be avoided.
The buildings should be mainly of two stories, and should be
constructed in the most substantial manner of brick or stone,
1869.] PUBLIC DOCUMENT— No. 23. 77
and made as cheerful and pleasing in their aspect as a due
regard to a wise economy will permit.
They should consist of, first, a hospital proper, containing
every facility in its construction for classification, seclusion,
and treatment which ingenuity can devise or skill create. This
will be best obtained by erection of separate blocks or wings at
some little distance from each other, connected by light airy
passages or corridors, under which shall be a continuous base-
ment. Each block or wing shall contain within itself every
comfort and every facility for the care of its patients, and shall
be, to all intents and purposes, a separate and detached hospital.
In the lower story there should be the dining-rooms, sculleries,
lavatories, water-closets, sitting-rooms, billiard-rooms, reading-
rooms, and an occasional room for temporary seclusion of ex-
cited patients. The lower story should be connected with the
upper story by a wide, light, and easy stairway, and this story
should contain the sleeping apartments, bathing-rooms, water-
closets, wardrobes, and dressing-rooms, and rooms for seclusion
when necessary, and also semi-secluded rooms for the sick, and
proper chambers and offices for the nurses.
The rooms should all be lighted by large and pleasant
windows, commanding the most pleasing views the situation
will permit. The rooms on the lower floor should be large,
cheerful, and airy, well warmed at all times, and thoroughly
ventilated. The rooms of the upper story should be of con-
venient size, and have every comfort and convenience of sleep-
ing-rooms and sick-rooms. The bathing-rooms, water-closets
and lavatories should be large, light, airy, and of materials
which do not absorb moisture. Each room should be thoroughly
ventilated by separate flues carried to the main ventilating shaft
or duct. The kitchen and domestic offices should be at or near
and in the rear of the centre of this proposed group of separate
and detached wings or blocks. The public offices, medical
offices and business offices, should be at. or near and in front
of the centre. The corridor basement should connect each
wing or block, as well as the corridor above, with the central
offices and with each other, and in the basement will be placed
facilities for conveying all supplies from the kitchen and stores
to the wings or blocks. The males should occupy apartments
on one side of the central offices and the females on the other,
78 LUNATIC HOSPITAL AT WORCESTER. [Oct.
and all the accommodations should be separate and distinct from
each other.
This centre group of blocks or wings should be of sufficient
capacity to accommodate, in the best possible manner, about one-
third of the whole number of patients destined to be managed
and controlled in the whole establishment. The remaining
two-thirds should be accommodated in structures of a different
character, but should be subject to the same management and
control. So far as the hospital proper is concerned, the objects
sought are, a more perfect and complete ventilation, so that the
atmosphere of one ward should not diffuse itself through any
other ward, but should escape at once into the open air, while
its place is supplied as speedily by the purest air obtainable
from the common supply of the whole atmosphere outside ; a
more complete separation of those cases requiring special treat-
ment, and needing rest and seclusion, a more sunny and cheer-
ful aspect to various wards, and less interference and discom-
fort from the general conduct of a large hospital.
The question of the plan would simply be, first, what is the
structure most conducive to health; second, what is the most
convenient and economical. That is, how can we best secure
perfect ventilation, plenty of sunlight on all sides, pleasing
views from all look-outs, and easy and convenient means of
communication.
In order to realize all these advantages the wings or blocks
may be arranged in any way in reference to each other, but it
will generally be found best if placed in a line, or side by side,
thus diminishing the distance to be traversed in going from
wing to wing, and facilitating the administration of affairs.
This allows covered passage-ways between all parts of the
hospital without interfering with light or ventilation, and will
afford the means for cozy, vine-covered walks and protected
flower gardens for the exercising grounds of this class of
patients. The remaining two-thirds of the whole number of
patients destined to be cared for in the establishment should be
accommodated in houses of smaller capacity, built for the pur-
pose on the grounds of the institution and within its enclosures.
These houses should be of sufficient capacity to accommodate
twelve to fifteen persons each, and should be of two stories in
height, having all day accommodations in the first story, and
1869.] PUBLIC DOCUMENT— No. 23. 79
all sleeping, and bathing, and dressing accommodations in the
second story. The store-rooms should be placed in the basement,
which should be high and dry. These houses should be plainly
and substantially built of brick or stone, plainly furnished, and
should be models of neatness and convenience. The cooking
apparatus of each of these houses should be worthy of Yankee
ingenuity and skill, and should be made to warm and ventilate
all the rooms of the houses during the cold season of the year,
as well as to warm all the water for the bathing purposes of the
family. These houses may be placed at such distances from
each other as the extent of the estate will permit, care being
taken only to select sunny and cheerful spots in protected
situations. Those occupied by the males should be at a little
distance, and somewhat different in character and convenience
from those occupied by females, and should be separated from
them by a drive-way and such other distinction as may be con-
venient. There should be no interior divisions of the estate
except at the hospital proper, and such as are needed for the
protection of growing crops.
Each house should have its garden for fruits, flowers, and
vegetables, and should be cultivated by members of the family.
Each garden should have its own walks, which should unite and
harmonize with the general walk and drive through the whole
grounds.
Naturally enough the houses on the side near the farm-
house and stables should be occupied by the farm laborers.
Those near the shops and engine-house would best accomo-
date the mechanics, gardeners and chore-men.
On the other side the houses near the laundry and bakery
will accommodate the laboring women, housekeepers, seam-
stresses, &c. At a little distance from these the houses will be
occupied by women — wives and daughters not accustomed to
labor, who will pass their time in light employments, and in
the gardens and grounds of the institution.
And still further remote, almost outside the gates, should be
one for each sex, of still better character, partially secluded
from all others, which should be furnished for, and occupied
by, convalescents during the few weeks or months just pre-
vious to leaving the control of the institution for the duties of
active life.
80 LUNATIC HOSPITAL AT WORCESTER. [Oct.
At or near the central group, or hospital proper, should be
placed the steam-works for heating and ventilating, pumping,
&g. The laundry, bakery, a model bathing-house, and the
general store-house from which all supplies should be issued by
an order from the proper office, and a strict account kept with
every family receiving such supplies.
Here, too, should be the gymnasium, recreation-rooms,
lecture-rooms, general library and chapel.
Here also should be a system of experimental shops for such
persons as cannot be expected to engage in useful labor, but
who would while away much of their time in rational activity
and thus promote a speedy restoration to sound health of body
and mind.
Could this plan be adopted and carried out a wide step would
be taken in advance of any existing arrangement for the care
and recovery of the insane. In doing so a departure would,
of course, be made from the general style and character of
hospital buildings.
Instead of the long, inconvenient, rectangular groups, copied
with but slight alterations from old monastic institutions, there
would be the central edifice, the hospital proper, in which would
be placed all cases of acute mania, the violent and dangerous,
the suicidal and troublesome, having every arrangement for
classification, and every facility for the care and treatment of
the inmates. There would be on one hand a few cottages,
plain, neat and substantial, for the quiet, harmless and in-
dustrious chronic cases, with gardens and work-rooms where
they could follow such industrial pursuits as could be made
available without special oversight. On the other hand, there
would be the more spacious residences of others who would
devote their time to the cultivation of flowers, to reading, walk-
ing and riding, and such other light occupations as they were
accustomed to follow when in health. One great benefit to
accrue from this is a near approach to the family system, and
the kindly influences of home treatment, the pleasures of a
family circle, homely surroundings, and many of the social
comforts which make life desirable. The insane would nec-
essarily enjoy a more free and generous style of amusement
and exercise, and would more frequently, and with less re-
straint, mingle in the society of friends and relatives ; in a word,
1869.] PUBLIC DOCUMENT— No. 23. 81
all the enjoyment of life would be multiplied, and all the social
endearments to a great extent preserved, without diminishing
in any degree the prospect of recovery, or increasing in any way
the labors of the institution.
The convalescent would be peculiarly benefited by this plan.
As the excitement of disease wears away, and the mind, regain-
ing its powers, becomes capable of rational reflection, comforts
of social life are first dwelt upon, relief from the irksomeness
of confinement is now sought and demanded by every considera-
tion of justice and humanity, and it is best found in the well-
ordered family. Thus the patient is again brought within the
sphere of his healthful and accustomed mental activities, old
associations return, former healthy trains of thought are ex-
cited and reestablished, one illusion after another being dis-
pelled, they yield at last to reality, and thus renew in the mind
those healthy actions which completely restore the empire of
reason.
At present the convalescent returns to the duties and respon-
sibilities of active life at once, with no kind assistance and no
protecting care. The beneficial influences of the hospital close
upon him, and he returns to the world where his misfortune
often operates strongly against his success. Make the arrange-
ment suggested in this paper, and the restored would pass from
the hospital to the world at large by gradual steps, and recover
one by one his customary duties and responsibilities.
Equally unjust and arbitrary are the present regulations to
another class of sufferers, viz. : those who are not insane and
yet require the seclusion and restraint of an asylum. The
moment a man is placed in the wards of an hospital he is con-
sidered insane, and is in the eye of the law insane, no matter
what his condition may be, or what may be the type of his
disease. He may have voluntarily sought the quiet of the
hospital as a place of rest from over-burdening cares, or as a
place of restraint from the dominion of some overpowering habit;
still all the civil difficulties of a case of insanity attach to him
and do not readily leave him.
The adoption of this plan would bring blessings to the aged
insane ; those who are consigned to the tender mercies of an
insane hospital in the last stages of declining health, when the
years have come in which they have no pleasure, worn out by
li
8£ LUNATIC HOSPITAL AT WORCESTER. [Oct.
the cares and trials of a long life ; and it may be by its sorrows
and sufferings. The new and strange surroundings, the ab-
sence of familiar faces, the loss of homely comforts, the well-
worn easy chair, the old cozy room and bed and fireside, the
accustomed food, and all the kindly offices of the faithful
family physician, surely ought to be replaced by some sort of
apology for a family circle. Kindness, sympathy, humanity,
dictate that their wandering existence should be made cheer-
ful and attractive by all the delicate attentions of home, family
and friends.
Children, also, upon whom rests the blight of permanent
mental disease, instead of the example and surroundings of a
ward in a lunatic hospital should receive all the guardianship,
care and protection which a Christian family and home, with
the absence of maternal love, can bestow.
Another, and, perhaps, the greatest of all advantages likely
to result from this, or some similar plan, is the employment
of a higher and more skilful class of nurses and attendants.
No plan can succeed in the management of the insane with-
out the aid of well-trained, competent and thoroughly devoted
assistants in every department, who will religiously fulfil
every obligation, and give certainty and efficiency to all the
operations of the institutions ; who will respect the rights, an-
ticipate the wants, and obey the calls of the weakest and feeblest,
as well as the most cheerful and companionable of those under
their charge ; who will, by patient attention, win the love of
the most wayward ; by kind and approving demeanor give
courage and strength to the faltering, and who will, by perse-
verance, so cheerfully and kindly restrain the vicious, that
restraint will be deprived of its horror and abuse.
At present, attendants upon the insane are mostly quite
young persons, seeking what will pay best, and having no
settled ideas as to their future course, but are ready to adopt
any mode of life, or to engage in any business that will offer the
surest road to a position, character, and respectability. They
enter upon full work and full pay at once, and expect little, if
anything more, as a reward for long and faithful service. The
system of management forbids, the necessities of the institution
forbid any attention to the future condition of the attendant.
1869.] PUBLIC DOCUMENT— No. 23. 83
The merchant, the manufacturer, the master mechanic, can,
and does increase the pay and exalt the condition of such
assistants as are most useful to him. But not so here. Young
men and women who devote themselves to the care of the in-
sane are called upon to perform duties to which few are equal,
and for which all are poorly paid. No system of rewards. No
prospect of comfort in the future. No convenience for the ties
of affection and family. No recognition of higher and holier
duties, which can induce attendants upon the insane to retain
their places after having become competent to perform their
labors. The few who are worthy and do remain, do so at a
loss of comfort and competency.
All alienists are agreed upon the necessity of classification ;
of separating such as are liable to injure themselves or others
in any way, and of permitting those to associate together who
may contribute in some degree to each others restoration.
How can this well be 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 are more
or less detached from each other ? How can the old and feeble
be separated from the violent and noisy, so as not to be dis-
turbed by them ? How can the convalescent be placed beyond
the constant annoyance of those of depraved habits, obscene
language and disgusting manners ? And how can those unfor-
tunate 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 tender, and
whose sense of propriety remains active. How can all these be
properly directed and controlled under any existing hospital
arrangements.
These various classes of the insane require for their restora-
tion to health and soundness of mind a wider separation from
others than is at present possible. Not isolation, but segrega-
tion, which shall divide them into groups possessing nearly
the same characteristics, mental and physical, and give to each
a house, a home within the hospital precincts. A house con-
veniently and tastily arranged, having a garden and lawn, and
such other appointments as would be desirable for a family of
well-to-do people. How can these most desirable objects be
obtained ? Simply by asking permission of the legislature to
84 LUNATIC EOSPITAL AT WORCESTER. [Oct.
purchase, occupy, and improve, a suitable tract of land, and on
it quietly and energetically commence building, according to
the proposed plans, and eventually, as opportunity occurs, put
the lands at present owned by the hospital into the market,
occupying the same until the new structures are erected, the
legislature in the meantime giving to the Trustees, with suit-
able checks and guarantees, the credit of the State to some
specified extent.
If we consider carefully the matter we shall find that the lot
upon which the hospital now stands contains twelve and six-
tenths acres, and at thirty cents per foot will amount to
$164,656.80.
The lot on which the barns are located contains four and
twenty-five-tenths acres, and at thirty cents per foot will amount
to $55,539.
Ten aeres bordering upon Mulberry and Central Streets, at
20 cents per foot, will amount to $87,120.
Ten acres bordering upon a continuation of Laurel and Wil-
mot Streets, at ten cents per foot will amount to $43,560.
Ten acres on Rattlesnake Hill, so called, at five cents per
foot, will amount to $21,780.
Forty acres on Chandler Hill, between Belmont Street and a
continuation of Laurel Street, should be offered to the city of
Worcester for the purpose of a park, and at two thousand
dollars per acre will amount to $80,000.
The remaining seventeen acres lying between Shrewsbury
Street and the continuation of Laurel Street, at one thousand
dollars per acre, will amount to $17,000, making a total of
$469,655.80.
You will notice that this calculation is based upon a value
per foot considerably less than the several lots are appraised by
competent judges.
You must remember that the value of land in this vicinity is
constantly increasing, and by the time new structures shall be
completed will be very considerably augmented.
You will remember also that it leaves upon the estate all the
buildings and fixtures which may be removed to the new loca-
tion or their value appropriated to the same purpose.
Can the Trustees dispose of the present property and give a
clear title for the same ? A careful examination has been made
1869.] PUBLIC DOCUMENT— No. 23. 85
of all the deeds conveying the property owned by the hospital,
and no one of them contains a restricting clause or condition of
any importance. Eminent legal counsel inform me that the
Trustees have full power to give clear titles to any and all lands
now owned and occupied by the hospital.
Has the city of Worcester any claim for damages if the
hospital is removed to some other location within the city
limits, and the lands disposed of by sale ?
The records of the town have been searched by the city clerk,
and no action of the town is recorded upon their books which
could in any way involve a claim for damages in case of
removal.
You perceive there is no obstacle or hindrance requiring
legislation, or raising any question of right or damage in the
matter of disposing of the present property and using the pro-
ceeds for the general purposes of a new establishment.
Believing that the legislature would regard with favor the
plan recommended in this Report, and grant your petition, a tract
of land, comprising about one hundred and seventy-five acres,
has been bonded with right to purchase of the several owners,
and a map of the same is herewith presented.
The land lies in the most easterly part of the city, and is
about two and a quarter miles distant from the court house.
The land is of excellent quality, mostly of a gravelly subsoil,
well situated, easy of access, and commands an extensive and
beautiful prospect. It is well wooded for the purpose, but
nearly all improved land, and is well watered, one spring upon
it, undeveloped, affording about fifteen thousand gallons of
pure water per day. There are other permanent springs and
rivulets upon the place.
The neighborhood is unsurpassed, the land is all highly cul-
tivated, there is no bog, or meadow, or unimproved land in the
vicinity, and is all owned and occupied by a class of wealthy,
intelligent farmers and retired men of business.
Objection may be made that the land is held at high prices,
but I need only to remind you that one acre and a half, or two
acres near to the present buildings, will more than pay for the
whole estate ; or that the increase in value of land purchased by
myself for the hospital, and paid for out of its yearly earnings,
will, probably, nearly, if not quite, make the purchase.
86 LUNATIC HOSPITAL AT WORCESTER. [Oct.
If we compare present with former prices you may be sur-
prised to learn the slight difference which there really is.
The land "on which the hospital now stands was purchased in
1830, and was practically as far outside of the then village of
Worcester, which competent judges declared had reached its
utmost limit of growth, as the Bancroft estate outside of the
city of Worcester of to-day.
More than two hundred dollars per acre was paid in 1830 for
the lot, destitute of buildings or improvements, on which the
hospital now stands.
Three hundred dollars per acre is the price asked by Mr.
Bancroft for his highly cultivated farm of about sixty-seven
acres, with its groves, orchards, and gardens, and its substantial
mansion house, and other farm buildings, in good repair, suit-
able for the occupancy of the Steward and Treasurer, and a
half dozen convalescent gentlemen boarders.
In 1837, land was purchased of Abijah Bigelow, on which the
stables now stand, and which was then unimproved and un-
occupied, for about five hundred and seventy-five dollars per
acre.
In 1869, Walter Bigelow demands for a portion of his rich
and valuable land, on which are highly cultivated fields and
orchards, and a large supply of pure spring water, two hundred
and fifty dollars per acre
In 1838, land was purchased of Abijiah Bigelow, on Mulberry
and Central Streets, for two hundred and twenty-two dollars
and twenty-two cents.
In 1869, Messrs. Bond, Duncan, and Rice, will sell to the
hospital such improved lands as you desire, for prices varying
from one hundred and fifty dollars to two hundred dollars per
acre.
Bear in mind, that in these purchases, with the exception of
Mr. Bancroft's estate, you run the lines at your will and
pleasure through these gentlemen's farms, taking all you want,
and leaving what you do not want, and giving to you a tract of
land fulfilling all the indications suggested as desirable in this
Report, and affording a site equal to, if not superior, to any
other hospital site in this country.
The cost of the whole establishment in complete working
1869.] PUBLIC DOCUMENT— No. 23. 87
order, with all the lands mentioned in these remarks, will not be
more than five hundred thousand dollars.
A careful and judicious management of the present estate
will, undoubtedly, realise that sum within the time necessary
for the perfecting and carrying out the plans indicated in this
Report. If the site selected offers insuperable objections, it is
hoped that another may be presented to your notice which will
afford such attractions as to satisfy all minds, and it gives me
pleasure to state that a tract of land has been offered, contain-
ing about two hundred acres, and midway between the city and
the lake, in a retired situation, yet easy of access, being near to
the railroad, and having unlimited facilities for procuring water,
and being less exposed to bleak winds than the site first men-
tioned.
In view of the constantly increasing demands for accommoda-
tions for the insane, it is most earnestly desired and recom-
mended, that some measures be taken to put in operation the
plan recommended by these remarks.
Thus is briefly and faintly sketched the plan and its promise.
Will you adopt the plan and demand its execution ?
MERRICK BEMIS.
Worcester Lunatic Hospital,
Worcester, Mass., October
'ITAL, )
1, 1869. j
METEOROLOGICAL OBSERVATIONS
THE STATE LUNATIC HOSPITAL, WORCESTER, MASS.,
1868-9.
Latitude, 42° 16' 17" N. ; Longitude 71° 48' 13" W.
Elevation, 528 feet.
Explanation. — The force of the wind is estimated upon a scale of 10, and indicated hy figure
affixed to the letters denoting the direction. When no number is affixed, 1 is meant.
12
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PUBLIC DOCUMENT— No. 23.
107
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108 LUNATIC HOSPITAL AT WORCESTER. [Oct.
APPENDIX.
FORMS CONCERNING ADMISSION TO THE HOSPITAL.
PETITION.
[The applicant must answer in writing the printed interrogations accompanying this
blank.]
To the Honorable the Judge of the Probate Court, in and for the County
of
of on oath complains
that of , in said county
of , is an insane person, and a proper subject for the treatment
and custody of the Worcester Lunatic Hospital.
Wherefore, h prays that said
may be committed to the said Worcester Lunatic Hospital according to law.
, ss. A. D. 186 .
Then the above named made oath that
the above complaint, by h subscribed, is true.
Before me, Justice of the Peace.
I, the subscriber, one of the selectmen of
where said resides, hereby acknowledge
that notice has been given to me of the intention to present the foregoing
complaint and application.
To the Honorable the Judge of the Probate Court, in and for the County
of :
The subscriber, having made application to your honor for the commitment
of to the Worcester Lunatic Hospital, as a lunatic,
now presents the following statement in answer to interrogatories : —
What is the age of the lunatic ? Ans.
Birthplace ? Ans.
Civil condition of lunatic ? Ans.
Occupation ? Ans.
Supposed cause of disease ? Ans.
Duration V Ans.
Character — whether mild, violent or dangerous ? Ans.
1869.] PUBLIC DOCUMENT— No. 23. 109
Homicidal or suicidal ? Ans.
Paralytic or epileptic ? Ans.
Previous existence of insanity in the lunatic ? Ans.
Previous or present insanity in any of the family ? Ans.
Habits in regard to temperance ? Ans.
Whether he has been in any lunatic hospital ; if so, what one, when, and
how long ? Ans.
(If a woman.) Has she ever borne any children ? Ans.
(If a woman.) How long since the birth of her last child ? Ans.
Name and post-office address of some of the nearest relatives or friends ?
Ans.
What facts show whether h has or has not a settlement, and where, if
anywhere, in this State ? Ans.
[For the law relating to settlement, see Gen. Stat., chap. 69.]
Applicant.
PHYSICIANS' CERTIFICATE.
The subscribers, respectable physicians of in the
county of , having made due inquiry and personal
examination of named in the foregoing
application, within one week prior to the date hereof, certify that the said
is insane, and a proper subject for
the treatment and custody of the Worcester Lunatic Hosjjital.
A. D. 186 .
, ss. A. D. 186 .
Then the above named
made oath that the above certificate is true.
Justice of the Peace.
Commonwealth of Massachusetts.
ss. At , in said county on the
day of A. D. 186 .
On the application of for the commitment
of of in said county, to the Worcester
Lunatic Hospital, ; notice in writing having been
given by said applicant to one of the selectmen of
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 appeai-s, 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.
110 LUNATIC HOSPITAL AT WORCESTER. [Oct.
FORM OF OVERSEERS' BOND.
Worcester Lunatic Hospital.
Whereas, of , in the county of
, has been admitted a boarder in the Worcester Lunatic
Hospital, , a majority
of the Overseers of the Poor of the town of , in the county of
, in behalf of the inhabitants of said town, do hereby promise
Treasurer of said Hospital, to pay
him, or his successor in said office, the rate of board which may, from time to
time, be determined by the Trustees of said hospital, for said patient, so long
as h shall continue a boarder in said hospital, with such extra charges as
may be occasioned by h requiring more than ordinary care and attention, to
provide for h suitable clothing, and to pay for all such necessary articles
of clothing as shall be procured for h by the Steward of the hospital,
and to remove h from said hospital whenever the room occupied by
h shall be required for a class of patients having preference by law, or
in the opinion of the Superintendent, to be received into said hospital : Also
to pay not exceeding fifty dollars for all damages h may do to the
furniture and other property of said hospital, and for reasonable charges in
case of elopement, and funeral charges in case of death. Payment' to be
made quarterly, and at the time of removal, with interest on each bill from
and after the time it becomes due.
Witness our hands this day of
Attest. (Signed,)
Overseers of the Poor
of the
Town of
FORM OF PRIVATE BOND.
Worcester Lunatic Hospital.
Whereas, , of , in the county of
, as Principal, and
of , in the county of , as surety, do hereby
jointly and severally promise Treasurer of
said hospital, to pay him or his successor in said office, the rate of board which
may, from time to time, be determined by the Trustees of said hospital, for
said patient, so long as h shall continue a boarder in said hospital, with such
extra charges as may be occasioned by h requiring more than ordinary
care and attention ; to provide for h suitable clothing, and to pay for all
such necessary articles of clothing as shall be procured for h by the
Steward of the hospital, and to remove h from said hospital whenever
the room occupied by h shall be required for a class of patients having
preference by law, or in the opinion of the Superintendent, to be received
into said hospital. Also to pay, not exceeding fifty dollars, for all damages
h may do the furniture and other property of said hospital, and for reason-
1869.] PUBLIC DOCUMENT— No. 23. Ill
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. 1SG .
, Principal.
, Surely.
Patients will be received into the hospital at any time, if the following
conditions are complied with :
If the patient is in indigent circumstances, and has no settlement in any
town in the Commonwealth, the Probate Court, or if in the city of Boston,
the Superior Court, will issue a warrant for the commitment of the patient
to the hospital. The State will then pay the cost of support, and the county
from which the patient is sent will pay the expenses of the commitment.
If the patient is in indigent circumstances, and has a settlement in any
town in the Commonwealth, the Overseers of the Poor of that town may give
a bond for the support of the patient. Or, when this is inconvenient, an
application may be made to the Probate Court of the county where the
patient resides, and a warrant will be issued for the commitment of the patient
to the hospital, and the town will be held responsible for the support of the
patient.
In all other cases a bond from responsible persons, as principal and surety,
will be required for the expenses of the patient while in the hospital.
In all cases, before admission to the hospital, two physicians, one of whom
shall be the family physician, must certify that the patient is insane.
All necessary clothing must be supplied by the friends of the patients.
Clothing will be supplied at the hospital, if desirable, and charged in the
bills at cost.
Damages done to the furniture and other property to the amount of fifty
dollars may also be charged.
Reasonable charges will be made in case of elopement, and funeral charge
in case of death.
All bills are collected by the Treasurer quarterly, or interest charged on
the same after becoming due.
Bills become due on the first of January, April, July and October, and
when the patient leaves the hospital.
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