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




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PUBLIC DOCUMENT No. 23. 



THIKXY-EIGHTH ANNUAL KEPOKT 



THE TRUSTEES 



STATE LUNATIC HOSPITAL 



WORCESTER 



October, 187 0. 



BOSTON : 

WRIGHT & POTTER, STATE PRINTERS, 
79 Milk Street (corner of Federal). 

1871. 



OFFICERS OF THE HOSPITAL. 



TRUSTEES. 
Hon. HENRY CHAPIN, 
WILLIAM WORKMAN, M. D., . 
Hon. SAMUEL E. SEWALL, . 
ROBERT W. HOOPER, M. D., . 



Worcester. 
Worcester. 
Boston. 
Boston. 



RESIDENT OFFICERS. 
Superintendent and Physician, . . . MERRICK BEMIS, M. D. 
Assistant Physician — Male Department, . H. 0. PALMER, M. D. 
Assistant Physician— Female Department, MARY H. STLNSON, M. D. 
Matron, CAROLINE A. BEMIS. 



Steward and Treasurer, 



DANIEL W. BEMIS, 

Office at the Hospital. 



CHAPLAIN. 
Rev. GEORGE ALLEN. 



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TRUSTEES 9 REPORT. 



To His Excellency the Governor and the Honorable Council 
of the Commonvjealth of Massachusetts. 

The Trustees of the Worcester Lunatic Hospital submit their 
Thirty-Eighth Annual Report. 

The reports of the Superintendent and Treasurer of the 
Hospital, herewith presented, give a full statement of the man- 
agement of its affairs during the past year. Both reports are 
highly satisfactory to the Trustees, and sustain their confidence 
in those who are immediately connected with the daily details 
of the institution. 

Dr. Joseph Draper, Assistant-Physician, having accepted a 
position in another hospital, resigned his office, to take effect on 
the first day of July last. On the 30th day of June last the 
Trustees adopted the following vote : — 

" Voted, That we part with Dr. Draper with great regret, and we 
assure him that his uniform devotion to his duties while in this 
hospital, and his skill and judicious manner of treating the insane, 
and of holding intercourse with them, justify our ojDinion that he is 
well qualified to take charge of any lunatic hospital." 

The vacancy has been acceptably filled by Dr. H. 0. Palmer. 

Time has demonstrated the wisdom and foresight of those 
pioneers in the cause of humanity, who nearly a half century 
ago gave their unselfish exertions to endeavors to produce a cor- 



6 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

rect public sentiment upon the subject of insanity, and labored 
to procure for those unfortunate persons whose reason was de- 
throned, the care and attention which recognized insanity as a 
disease of the brain, subject to medical treatment, and with a 
reasonable prospect, in a great majority of cases, of being cured, 
if treated seasonably and skilfully. The following hospital 
statistics for the year ending September 30, 1870, show among 
other things the importance of early attention to the disease of 
insanity :— 



Males. Females. Total. 



Patients in the Hospital October 1, 1869, 
Admitted during the year, . 
Whole number under treatment, 
Discharged recovered, 

improved, 

not improved, . 
Died, .... 

Whole number discharged, 
Remaining September 30, 1870, 



190 

196 

386 

73 



41 

188 
198 



186 

188 

374 

85 

55 

23 
163 
211 



376 
384 
760 
158 
123 
6 
64 
351 
409 



Of those within the year there were 





Males. 


Females. 


Total. 


Supported by the State, 

by towns and cities, ..... 
by individuals, . . . . 


60 

57 
79 


78 
43 
67 


138 

100 

146 


Totals, 


196 


188 


384 





State. 


Town. 


Private. 


Total. 


Number of different persons admitted, . 
Number remaining September 30, 1870, 


138 
35 


100 
193 


146 

181 


384 

409 



The daily average number of patients was 



396 



1870.] PUBLIC DOCUMENT— No. 23. 7 

The percentage of recoveries to the number discharged is 
forty-one per cent., or about seventy per cent, of those actually 
discharged from hospital treatment. 

The percentage of recoveries to the number of recent cases 
admitted was nearly eighty per cent. 

The percentage of deaths to the whole number was eight and 
four-tenths. 

There exists in the minds of some persons great dread of 
submitting a friend suffering from this disease to hospital treat- 
ment, yet most insane persons can be treated more effectively 
in a quiet, well regulated hospital than in any other place. 
A comparison of the percentage of recoveries in new cases 
treated in the hospital with those which are managed at home 
will convince the mind of any unprejudiced person. It is 
not strange that affection should cling to its object and delay to 
apply the most effective remedies, but the sad sight meets us at 
every visitation, of patients now probably incurable, who might 
have been clothed and in their right minds, if the mistaken 
kindness of family and friends had not delayed too long to 
obtain for them the benefit of treatment in some hospital. 
There have been cases undoubtedly in which persons have been 
confined in hospitals as insane, when alleged insanity has been 
a cover for some unworthy object, but such instances, in public 
hospitals at least, must be exceeding rare. The absence of an 
adequate motive, on the part of merely salaried officers, to be- 
come a party to such iniquity, the monthly and the occasional 
visits of the trustees, the freedom of access to the friends of the 
patients, and especially the pure and elevated character which 
is always sought as an essential prerequisite to the appointment 
of those in the immediate charge of these institutions ought to 
satisfy every reasonable person that the chances for wrongful 
confinement in our hospitals are so remote that there seems to 
be but slight occasion for any anxiety upon this subject. Mis- 
takes are liable to occur in the best regulated establishments, 
but the rule of the Worcester Lunatic Hospital is to carefully 
investigate the cases of the patients, and not to retain a person 
an hour after the cause of restraint has ceased. 

The Trustees take the liberty to suggest whether some change 
is not needed in regard to the admission of patients both to 
public and private lunatic hospitals on the simple certificate of 



8 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

two physicians. In this place it is sufficient to allude to this 
subject without going into an extended discussion of the modi- 
fications which the statute may require. 

An interesting fact in the histories of this hospital and other 
hospitals, is the substantial equality in the number of patients 
of the different sexes. The history of hospitals, and the expe- 
rience of the world, furnish evidence of the same result. In 
this matter, as in innumerable other instances, we are reminded 
of the simple statement of the Book of Genesis," male and female 
created he them," and we learn that they all tend to demonstrate 
the wisdom and justice which are involved in the effort to give 
to each sex equal rights and equal advantages. Having this in 
view, and being impressed with the idea that it is due to the 
delicacy of the feminine nature, that the female patients in the 
hospital should have the benefit of the professional skill and 
attention of one of their own sex, in accordance with the rec- 
ommendation of the Superintendent, the Trustees decided to 
employ a female assistant physician for the female department 
of the hospital. Miss M. H. Stinson, a regularly educated phy- 
sician was employed a number of months ago, and has performed 
her duties to the acceptance of the patients and to the satisfac- 
tion of the Trustees. 

The experience of those having the management of the 
hospital, tends more and more to the conclusion that a 
proper classification of the patients has much to do with suc- 
cess in their management and the hope of their restoration. 
It is very desirable to give to the patients, as far as possible, 
the benefit of a kind of family arrangement, and to secure for 
them the benefit of pleasant and quiet surroundings. It is 
proper to say, that the construction of the present buildings is 
not calculated for convenient classification under the most 
favorable circumstances, and the remarkable growth of the 
city as a manufacturing and mechanical community has so far 
surrounded the present location as to deprive it of the quiet 
which is so essential in the treatment of the insane. Since the 
Worcester Lunatic Hospital was erected, every railroad which 
enters the city has been constructed, every steam-chimney has 
been erected, and the innumerable car-bells and steam-whistles 
have here made the day busy and the night hideous by their 
almost constant exercise. If any one wishes to decide upon 



1870.] PUBLIC DOCUMENT— No. 23. 9 

what would be likely to be the effect of this state of things upon 
the sensitive nerves of an insane patient but recently committed, 
let him spend one night at the hospital in its present location. 

Being fully satisfied that a change was necessary, and that 
the hospital estate, if prudently managed, may be sold for 
sufficient substantially to save the Commonwealth from ulti- 
mate loss, the Trustees petitioned the legislature for the year 
1870 for authority to purchase lands within the city of Wor- 
cester for the location of a new hospital. The legislature 
responded generously to the petition of the Trustees, and 
authorized them to make the purchase. The Trustees have 
purchased a beautiful estate, containing about two hundred and 
seventy acres, for the sum of $110,950 ; and they take the 
liberty to ask the legislature to appropriate the sum of $30,000, 
to enable them to complete the payment of the purchase money 
for the estate and develop the property. They ask further for 
authority to sell or exchange portions of the estate, for the 
purpose of straightening the lines of the estate. The estate 
commences at the causeway at Quinsigamond Lake, bounds 
upon the east about one-third of a mile by the lake, and upon 
the south about one mile by Belmont Street, or the old Boston 
and Worcester turnpike. There are five dwelling-houses upon 
the estate, in which the family system will be commenced and 
tested. The estate is beautifully located upon an eminence, 
with a south and south-easterly exposure. It has an extensive 
and beautiful prospect, made up of land and water, and diver- 
sified by many attractions ; a belt of woodland which breaks 
the force of the cold winds of winter ; Bell Pond reservoir 
so located as to be above the level of the highest buildings 
which will be erected ; the Boston and Albany Railroad passing 
so near that supplies can readily be furnished, and the whole 
estate is so located that although it is convenient of access, there 
is no danger that population or business will be brought so 
near to the proposed location of the buildings that the quiet of 
the establishment will be likely to be disturbed thereby. The 
price of the land seemed to be high, but upon the most careful 
consideration, the Trustees decided that it would be more pru- 
dent to pay the prices established, than to leave the question of 
compensation to arbitrators ; especially when they found that 
His Excellency the governor, and his council, who visited the 

2 



10 LUNATIC EOSPITAL AT WORCESTER. [Oct. 

spot at the special request of the Trustees, were unanimously 
of the opinion that the bargain should be closed ; and good 
judges of real estate in the city of Worcester were of a similar 
opinion. The Trustees are satisfied that no better or more 
desirable estate could be procured, and under the care and 
supervision of our excellent Superintendent and Treasurer, 
they hope and believe that a plan of a lunatic hospital will be 
adopted and carried into operation which will combine the wis- 
dom, skill and enlightened humanity which are the develop- 
ment of the last forty years of faithful and earnest attention on 
the part of those who from time to time have been connected 
with this institution. 

HENRY CHAPIN, 
WILLIAM WORKMAN, 

SAMUEL E. SEWALL, 
ROBERT W. HOOPER, 

Trustees. 



1870.] 



PUBLIC DOCUMENT— No. 23. 



11 



TREASURER'S REPORT. 



To the Trustees of the Worcester Lunatic Hospital. 

I herewith submit my Annual Report on the finances of the 
Worcester Lunatic Hospital, for the year ending September 30, 

1870. 



Keceipts. 

Cash on band September 30, 1869, 

received from the State for support of patients, 
received from cities and towns, . 
received from individuals, .... 
received from sale of farm products, . 



The expenditures of the year have been as follows : 



$5,655 11 

7,580 06 

33,784 00 

41,313 27 

2,095 87 

$90,428 31 



Provisions, — 
Flour, 590 barrels, . 
Meal for cooking, . 
Fresh meats, . 
Salt meats, 
Fresh fruits, . 
Beans and vegetables, 
Sugar, 

Coffee and chocolate, 
Tea, 

Rice and crackers, . 
Butter, . 

Molasses and sirup, 
Vinegar, 
Cheese, . 

Eggs, salt and groceries, 
Fish, 

Total for provisions, 



$4,571 75 


349 


GO 


4,076 


55 


4,232 


90 


403 


15 


1,786 43 


2,111 


87 


740 96 


962 70 


433 


38 


5,215 93 


619 


51 


150 


34 


120 


26 


1,998 


96 


882 


40 



$28,657 19 



12 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Furniture, crockery, bedding, &c, 

Light, 

Soap, 

Medical supplies, 

Live stock, 

Improvements and repairs, 
Travelling and transportation, 
Books, stationery, printing, &c, 

Fuel, 

Freight and express, 

Ice, 

Trustees' expenses, 
Salaries and wages, 

Labor, 

Provender and bedding for stock, 
Miscellaneous, 

Total current expenses, 
Clothing and materials, . 
Undertaker's charges, 
Supplies to patients, on account, 
Cash on hand September 30, 1870, 



Resources. 
Due from cities and towns, 

from individuals, .... 

from State of Massachusetts, . 
Cash on hand, 



Liabilities. 



Due for supplies and expenses, 
for salaries and wages, 



$3,860 38 

1,855 86 

452 14 

814 77 

2,396 00 

4,637 03 

162 49 

658 97 

3,149 55 

215 78 

366 45 

222 40 

21,607 28 

2,560 50 

2,590 07 

1,508 65 

$75,715 51 
3,973 75 
1,491 05 
1,361 09 
7,886 91 



$11,194 56 

12,349 15 

555 85 

7,886 91 



59,757 55 
5,430 87 



),428 31 



$31,985 97 



15,188 42 

P16,797 55 
2,450 00 



Invested funds, (market value,) 

Total surplus, . $19,247 55 

D. W. BEMIS, Treasurer. 
Worcester Lunatic Hospital, ) 
Worcester, Oct. 1, 1870. J 

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

Henry Chapin, 
William Workman, 

Auditing Committee. 

Worcester, October 1, 1870. 



1870.] 



PUBLIC DOCUMENT— No. 23. 



13 



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-Eighth 
Annual Report of the Worcester Lunatic Hospital. 

For the general results of the year, and the condition of the 
hospital in detail, you are respectfully referred to the following 
tabular statements, and such brief explanatory remarks as may 
accompany them. 

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





Males. 


Females. 


Total. 


Patients in the Hospital, Oct. 1, 1869, 


190 


186 


376 


Admitted during the year, 




196 


188 


384 


Whole number under treatment, 




386 


374 


760 


Discharged recovered, 




73 


85 


158 


improved, 




68 


55 


123 


not improved, 




6 


- 


6 


Died, 




41 


23 


64 


Whole number discharged, 




188 


163 


351 


Kemaining September 30, 1870, 




198 


211 


409 



From this table it appears that three hundred and eighty- 
four patients were admitted during the year, of whom one 
hundred and ninety-six were males, and one hundred and 
eighty-eight were females. 



14 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

At the close of the previous year, there were three hundred 
and seventy-six patients inmates of the hospital, of whom one 
hundred and ninety were males, and one hundred and eighty- 
six were females, so that there were seven hundred and sixty 
persons under treatment in the course of the year, of whom 
three hundred and eighty-six were males, and three hundred 
and seventy-four were females. The daily average number of 
patients in the hospital was three hundred and ninety-six. 

The largest number of inmates during the year was four 
hundred and twenty-seven and the smallest number was three 
hundred and seventy-three. 

The largest number of males at any one time was two hun- 
dred and fifteen and the smallest number was one hundred and 
eighty-four. 

The largest number of females at any one time was two hun- 
dred and thirteen and the smallest number was one hundred 
and eighty-five. 

The number of patients discharged was two hundred and 
eighty-seven ; of whom one hundred and fifty-eight were recov- 
ered, one hundred and twenty-three were improved, six were 
not improved, and sixty-four were removed by death. 

The average number of residents exceeded that of the previ- 
ous year by nine, and there were thirty-three more inmates at 
the close than at the commencement of the year. 

The number of admissions exceeded those of the previous 
year by forty-seven ; the number of those discharged was less 
by nine ; and the number of those who died was greater by 
seventeen than during the previous year. 

The ratio of recoveries is a fraction more than forty-five per 
cent, to the number of those discharged ; or a fraction more 
than fifty-five per cent, after deducting the number of those 
who died. 

At the close of the year there were nine patients in the hos- 
pital who had recovered their usual degree of mental and phys- 
ical health, and were awaiting the convenience of friends for 
their removal. If this number were added to the number of 
those discharged and tabulated, the ratio of recoveries to the 
number discharged, after deducting the number of those who 
died, will be increased from fifty-five per cent, to a fraction 



1870.] PUBLIC DOCUMENT— No. 23. 15 

more than fifty-eight per cent. And if eleven cases of recur- 
rent mania be included in the tabular statement the per cent, 
of recoveries to the number of discharged will be increased 
from fifty-eight to sixty-one per cent. 

Again, if seventy-nine patients who were transferred directly 
to other institutions be deducted from the whole number dis- 
charged the ratio of recoveries to the number discharged will 
be very nearly seventy-six per cent., or eighty per cent, if the 
patients who had recovered and were remaining in the hospi- 
tal, be added to the number of those discharged. 

Of those discharged improved, seven had so far regained 
their habits of self-control as to be able to return cheerfully and 
hopefully to their homes and resume their ordinary occupations 
with profit to themselves and their families. 

Of those discharged not improved, four were confirmed epi- 
leptics, two were cases of chronic disease, long past all hope of 
improvement, and were hopelessly demented. 

The rate of mortality was somewhat greater than during the 
previous year, but may be considered as quite moderate, if we 
regard the condition of many of the patients when admitted. 

The percentage of deaths of the average number of resi- 
dents was sixteen ; but only eight and fonr-tenths per cent, if 
calculated on the whole number under treatment. 

The proper tables of mortality will show that a large propor- 
tion of the deaths occurred to old and feeble persons who had 
long been afflicted with various forms of physical and mental 
disease and to whom death could be considered in no other 
light but that of a happy release. 



16 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 2. 

Shoioing the Admissions and State of the Hospital from October 1,1869, to 
September 30, 1870. 



Males. 


Females. 


190 


186 


196 


188 


198 


211 


119 


129 


76 


59 


1 


_ 


140 


132 


11 


16 


44 


39 


- 


1 


1 


- 


60 


78 


75 


79 


15 


20 


51 


34 


12 


3 


4 


2 



Patients in the Hospital, October 1, 1869, . 
admitted in the course of the year, 
remaining in the Hospital, Sept. 30, 1870, 
Of the admissions there were cases of one year or 

less duration, 

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

Of the admissions there were cases the duration of 

whose insanity could not be ascertained, . 
Patients committed by Courts, .... 

committed by Overseers of the Poor, . 
on bonds, ...... 

committed by Governor's warrant, 
committed by the Board of State Charities, 
committed by Commissioners of Lunacy, 
Foreigners and. those having no settlement in the 

State, committed in course of the year, . 
Foreigners and those having no settlement in the 

State, discharged in course of the year, . 
Foreigners and those having no settlement in the 

State, remaining in the Hospital, Sept. 30, 1870, 
Patients in this Hospital previously, . 

in other Hospitals in this State pi'eviously, 
in Hospitals of other States previously, 



376 
384 
409 

248 

135 

1 

272 

27 

83 

1 

1 



138 
154 

35 

85 

15 

6 



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 


1870, 






35 


1851, . 


. 201 

* 


1861, 


. 156 





The preceding table shows that two hundred and forty-eight 
patients were admitted to the hospital in the course of the year, 
whose insanity had existed one year or less previous to the date 
of their admission. Of this number ninety-two have actually 



1870.] PUBLIC DOCUMENT— No. 23. 17 

recovered their usual health and strength of mind, and have 
been discharged from the hospital and returned to their homes. 
Ninety others have been discharged in the various stages of im- 
provement. Forty-three others who remain are improving in 
such a manner as to give great promise of ultimate recovery. 

Other tables in this Report show that more than seventy-five 
per cent, of all patients admitted to the hospital who had been 
insane not more than one year previous to admission, have 
recovered their mental health and usefulness, and have been 
restored to their families and friends. 

It would not be difficult to show that more than ninety per 
cent, of .uncomplicated cases of mental disease are susceptible 
of recovery if placed under hospital treatment in the earlier 
stages of disease. And it may be shown also that a large pro- 
portion of those who are placed under treatment on the first 
appearance of disease recover their customary health within a 
period of six months. It may not be too much to hope that in 
the future we shall be able to reduce the period necessary for 
recovery to three months in all ordinary cases of mental disease. 

This table also shows that two hundred and seventy-two patients 
were committed by order of the judges of the probate courts of 
the several counties, thus making their admission to the hospital 
an open, fair, legal proceeding of which none can complain. It 
seems to be, however, a measure of doubtful propriety to wait 
for the action of the probate court in all, or in a majority, of 
cases, before gaining an admission to the necessary and proper 
restraints of the institution. One hundred and ten patients 
were admitted without the intervention of the courts. Twenty- 
seven of these were placed in the hospital by the overseers of 
the poor of the towns in which they had settlements ; and 
eighty-three were placed under treatment by their immediate 
friends, or voluntarily sought admission by themselves. In all 
cases the certificates of two physicians, given under oath, have 
accompanied the admission of the patients. One patient has 
been placed under treatment in the hospital by order of the 
judge of the superior court, and one by order of the board of 
state charities. 

Of the three hundred and eighty-four patients admitted in 
the course of the year, two hundred and seventy-eight had 
3 



18 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

been inmates of some hospital for the insane. Eighty-five had, 
at some previous time, been inmates of this hospital. Fifteen 
had been inmates of other hospitals in this State, and six were 
known to have been inmates of hospitals in other States or 
countries. 

Of the three hundred and eighty-four patients admitted in 
the course of the year, one hundred and thirty-eight were sup- 
ported by the charity of the Commonwealth, one hundred were 
supported by towns and cities, and one hundred and forty-six by 
individuals. 

Of the four hundred and nine patients remaining in the hos- 
pital September 30, 1870, thirty-five are supported by .the Com- 
monwealth, one hundred and ninety-three by towns and cities, 
and one hundred and eighty-one by individuals. Of the one 
hundred. and eighty-one patients supported by individuals, only 
six were non-residents of the State at the time of admission, 
and all but two of these were former residents of the State, 
and at the time of becoming insane were only temporarily 
absent from their homes in this Commonwealth. 

The number of patients admitted to the hospital since its 
opening in January, 1833, amounts to eight thousand nine 
hundred and nineteen, of whom four thousand four hundred 
and sixty-two have been males, and four thousand four hundred 
and fifty-seven have been females. 

Of this number four thousand one hundred and thirty-six 
have been restored to health of body and mind, and discharged 
as recovered, one thousand eight hundred and seventy-eight 
have been discharged improved ; the recoveries being in the 
ratio of forty-eight and five-tenths per cent, to the whole num- 
ber. After deducting the number of those who remain under 
treatment, the ratio of those discharged improved is a fraction 
more than twenty-one per cent, to the whole number, after 
deducting the number of those who remain in the hospital. 

The board of state charities have removed to other institu- 
tions, and to their homes in other States, eighty-three State 
patients in the course of the year . This number were all care- 
fully examined by the agent of the board previous to removal, 
and it is believed that none were removed whose mental and 
physical condition did not warrant such a change. 



1870.] PUBLIC DOCUMENT— No. 23. 19 

But one really feeble patient, and no unusually violent, filthy 
or destructive person has been removed. I am informed that 
the feeble one who had quite recovered from mental disease has 
improved in physical health since her removal. In all cases 
where patients supported by the State have been removed to 
other institutions, or to their homes or friends, previous to re- 
covery., their cases have been fully investigated, and their 
wishes consulted as far as possible ; and when relatives and 
friends have been known, they have been fully informed of 
every change made in regard to the patients in whom they were 
personally interested. 

Seventeen State patients have died in the course of the year, 
and a larger number than usual were removed by the board of 
state charities ; a work rendered necessary by the largely in- 
creased number of admissions to the hospital during the year. 

The Steward has paid to patients of all classes more than 
three hundred dollars for work done, in the hope of inducing 
thereby greater habits of industry among the inmates, many of 
whom are able to perform considerable labor, and also as a fair 
compensation for labor actually performed. For a few, places 
have been obtained in the neighborhood, where the patients 
could labor and receive wages. Several persons of both sexes 
have in this way earned considerable sums of money. Some 
male patients earned as much as fifteen dollars per week during 
the whole summer. Others earned smaller sums, varying from 
thirty to fifty dollars each. 

Although the results of the year were in general satisfactory, 
they would have been more gratifying but for the removal of a 
number of patients before their entire recovery, or before suffi- 
cient time had been given for a fair trial of remedial treatment. 
Some who did not, would undoubtedly have recovered, if their 
friends had been aware of the chronic character of their malady, 
and of the importance not only of prompt treatment, but also 
of a steady persistence in the use of such means as were adopted 
for their relief after they had been placed in the care of the 
hospital. 



20 



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. 


MONTHS. 








■d 
u 



d 

> 



T3 

« > 
O O 

z s. 


•a 


Totals. 










a 


a 


a 



« 


6 


g 


Q, 




S 


C3 

a 

a 

ft 






M. 


F. 


M. 


F. 


M. 


F. 


M. 


F. 


M. 


F. 


T. 


a 


EH 


October, . . 


20 


8 


28 


5 


3 


3 


3 






2 3 


19 


9 


19 


200 


185 


385 


November, . 


12 


19, 31 


5 


9 


5 


6 


1 


- 


2 1 


13 


16 


29 


199 


189 


388 


December, . 


9 


9! 18 


11 


3 


2 


3 


- 


- 


4J 6 


17 


12 


29 


191 


186 


377 


January, . . 


12 


14' 26 


4 


311 


7 


- - 


4; 4 


19 


14 


33 


184 


186 


370 


February, 


12 


15,. 27, 


1 


2 


1 


2 


- ( - 3 4 


5 


8 


13 


191 


193 


384 


March, . . 


15 


16 31 


4, 6 


12 


9 


- 


- 


2 


- 


18 


15 


33 


188 


194 


382 


April, . . . 


15 


12! 27 j 


5 7 


1 


3 


1 


- 


1 


1 


8 


11 


19 


195 


194 


389 


May, . . . 


10 


17 27 


211 


6 


1 





- 


1 


1 


11 


13 


24 


194 


198 


392 


June, . . . 


27 


22 49; 


610 


6 


8 


- 


- 


5 


2 


17 


20 37 


204 


200| 404 


July, . . . 


20 


22 


42 


3 


6 


4 


8 





- 


3 


1 


12 


15 


27 


212 


207 


419 


August, . . 


20 


14 


34! 


12 


9 


5 


2 


- 


- 


11 


- 


28 


11 


39 


204 


210 


414 


September, . 


24 


20 


44 


15 


16 


12 


3 


- 


- 


3 


- 


30 


19 


49 


198 


211 


409 


Totals, . . 


196 


188 


384 


73 

1 


85 


68 


55 


6 


- 


41 


23'l88 163 

1 1 


351 


- 


- 


- 



Table No. 4. 

Showing the form of Disease in those Admitted and Discharged during the year. 





ADMITTED. 


Discharged. 


FORM OF DISEASE. 


a 

3 


9 

a 

a 


a 


H 


a 


a 
g 

Eh 


a 

Ei 


Mania, 

Mania, Chronic, 
Mania, with Epilepsy, 
Mania, with general Paralysis, 
Melancholia, .... 
Dementia, .... 
Dementia, Senile, . 
Dementia, with Epilepsy, 
Dementia, with gen'l Paralysis, 
Monomania of Fear, 
Monomania of Suspicion, 


82 

42 

18 

14 

10 

12 

7 

4 

3 

2 

2 


95 

43 

11 

2 

10 

14 

5 

6 

1 


177 

85 

29 

16 

20 

26 

12 

10 

3 

3 

3 


70 
38 
7 
2 
1 
8 
3 
9 
7 
1 
1 


83 
35 

4 
6 
4 
5 
1 
1 
1 


153 

73 
7 
2 
5 

14 
7 

14 
8 
2 
2 


Totals, .... 


196 


188 


384 


147 


140 


287 



1870.] PUBLIC DOCUMENT— No. 23. 21 

Table No. 4 shows that fifty-seven per cent, of all the admis- 
sions are of a class usually denominated chronic, and are made 
up largely of epileptics, paralytics and those suffering under 
the various grades of dementia. While many of these may be 
expected to improve, none of them can ever be discharged as 
recovered. Thus the number of recoveries must be drawn from 
the forty-three per cent, of cases suffering from the more acute 
forms of mental disease. 

The large proportion of patients admitted from year to year 
suffering from insanity of an incurable character, must remain 
and accumulate, and eventually call for largely increased ac- 
commodations. If only curable patients were admitted, the 
discharge by recovery, and by death, would very nearly balance 
the number of admissions, and so leave only a small margin of 
incurables at the end of each year. 

If only curable patients, not in an exhausted condition, and 
whose insanity was not complicated with any organic disease, 
were admitted into the hospital, the recoveries should reach 
from eighty to ninety per cent, of the whole number of admis- 
sions ; and about five per cent, would probably sink under the 
force of disease while undergoing treatment ; so that only about 
five per cent, would remain a burthen to the community from 
their insanity becoming chronic and permanent. 

From various causes, it is, however, found that in this and 
in almost all lunatic hospitals in the country, the proportion of 
incurable patients* suffering from the various forms of mental 
disease greatly exceeds the curable. The ratio varies consid- 
erably, and the incurable must necessarily predominate in those 
districts distant from the hospitals where, from ignorance of the 
real character of hospitals, and the condition of their inmates, 
the friends of the insane neglect to provide for them the means 
of relief which might be obtained. Another reason for this 
state of things is found in the fact that the hospitals and asylums 
are already crowded to the utmost limits of their capacity. 
Another reason is the neglect of the State, hitherto, to provide 
such accommodations, and such means for relief, as are de- 
manded by the choice of a large and respectable portion of the 
community. For these and similar reasons admission to a hos- 
pital is not obtained for a large class of cases, while they are 
recent, acute and curable, and only after they have become in- 



22 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

curable and the friends have become weary of the burden of 
supporting them, or they have become troublesome and danger- 
ous, is admission sought and sometimes with difficulty obtained. 

It has always appeared to your Superintendent that while 
every possible facility should be afforded for the care and res- 
toration of the recent and curable, that no means should be 
spared for the comfort and amelioration of the chronic and in- 
curable. The incurable, so-called, sent to your hospital, in 
every particular, require as much care, the same treatment and 
supervision as those who are curable, and generally they do so 
for much longer periods of time before the violence of attack 
yields to the remedial and moral influences of the treatment 
adopted for its relief. 

These incurable patients are as dangerous in their impulses, 
and require the same protection for their safety as the more 
hopeful cases do. They are as dangerous towards the commu- 
nity at large,- and to those attending upon them during the 
periods of their excitement. Their passions are as wild and 
ungovernable ; their despondency and gloom as deep and dark, 
and the perversion of their thoughts, feeling and actions is as 
complete as in those whom we regard susceptible of restoration 
to a sound state of mind. In fact some of the most dangerous 
forms of insanity are those generally regarded as entirely in- 
curable. To these forms belong the epileptics, who suffer from 
paroxysms of blind and furious mania at variable and uncer- 
tain periods. In the same rank may be placed some of those 
who suffer from general paralysis, who, during their attack of 
recurrent mania of an exalted and ambitious nature, are fre- 
quently dangerous to themselves and others. And in almost 
all other forms of chronic insanity there are periods of exacer- 
bation of a more or less violent and persistent character, which 
occur from time to time, and require for their reduction, and 
for the safety of the patient himself and the protection of others, 
that all the resources of a well-ordered hospital or asylum 
should be applied as fully, promptly and persistently as in the 
case of acute and curable patients. 

Now it happens here, as elsewhere, that a majority of the 
patients placed under control and protection are the subjects of 
chronic mental derangement. Those who were responsible for 
the care of these persons, succeeded in retaining them in their 



1870.] 



PUBLIC DOCUMENT— No. 23. 



23 



homes or in almshouses, during the earlier periods of their 
disease ; but from some new source of danger of an unusual 
character making its appearance, or from the great degenera- 
tion of body and mind, and the perversion of all natural habits 
of both, which often follow in the course of mental unsound- 
ness, they have at length been compelled to relinquish their 
charge and consign their friends to the hospital for care and 
protection, after all hope of restoration has departed. 

Would not this class of patients be much more economically 
relieved and cared for by being placed at first in the hospital, 
whereby their recovery would have been promoted and the per- 
sons restored to society, competent to fill their stations in life 
after a much less prolonged course of treatment ? 

Table No. 5. 

Showing the Pathological and Pathogenetic Causes of Insanity. 







18TO. 




Previously. 






Number 


Number 


Number 


Number 


CAUSES. 


of Cases. 


Fre-disposed 


of Cases. 


Pre-disposed. 




Ma. 


Fern. 


Ma. 


Fem. 


Males. 


Females. 


Males. 


Females 


Congenital, . 


2 


1 


2 


1 


23 


19 


23 


19 


Hereditary, . 




26 


23 


26 


23 


514 


532 


514 


532 


Periodical, 




10 


14 


10 


14 


310 


412 


310 


412 


Apoplexy, 
Paralysis, 
Epilepsy, 
Chorea, . 




2 
13 
20 


4 

10 

1 


1 
5 
5 


1 

2 


6 
113 
224 

2 


2 
48 
93 

5 


3 

21 
69 


1 
11 
28 

1 


Phrenitis, 




- 


- 


- 


- 


9 


7 


3 


5 


Neuralgia, 
Neurasthenia, 




6 


3 


3 


1 


5 
97 


7 
123 


2 
38 


2 
45 


Fever, . 




5 


1 


- 


- 


60 


85 


28 


34 


Disease of Heart, 




1 


- 


- 


- 


- 


4 


- 


- 


Anasmia, 




_ 


_ 


- 


- 


35 


30 


10 


9 


Tuberculosis, . 




- 


1 


- 


- 


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, . 




o 


1 


1 


- 


15 
9 


13 
3 


6 
4 


3 
3 


Exanthemata, 




- 


1 


- 


- 


10 


13 


5 


6 


Eruptions, Suppressed, . 
Excretions, Suppressed, . 


- 


5 


: 


- 


7 
15 


11 
1 


4 
6 


7 
1 



24 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 5. — Continued. 





187©. 


Previously. 






Number 


Number 


Number 


Number 


CAUSES. 


of Cases. 


Pre-disposed 


of Cases. 


Pre-disposed. 




Ma. 


Fern. 


Ma. 


Fern. 


Males. 


females. 


1 
Males. 


Females. 


Renal Affections, . 










2 


1 


1 


1 


Menstrual Disorder and 


















Uterine Disease, 


- 


8 


- 


3 


- 


152 


- 


64 


Puerperal, 


- 


15 


- 


5 


- 


345 


- 


169 


Turn of Life, 


- 


22 


- 


13 


- 


230 


- 


111 


Hysteria, 


- 


2 


- 


1 


- 


32 


- 


15 


Puberty, 


- 


4 


- 


- 


1 


10 


- 


6 


Masturbation, 


27 


11 


9 


3 


498 


100 


214 ! 


39 


Excessive Venery, 


1 


- 


_ 


- 


2 


- 


1 


- 


Intemperance, 


38 


13 


11 


5 


716 


103 


291 


28 


Use of" Opium, 


- 


1 


- 


- 


4 


19 


3 


5 


Use of Tobacco, 


- 


- 


- 


- 


3 


6 


- 


4 


Domestic Trouble, . 


3 


6 


- 


- 


64 


227 


29 


116 


Domestic Affliction, 


- 


7 


- 


- 


82 


254 


43 


108 


Disappointed Affection, . 


2 


5 


- 


2 


64 


106 


18 


38 


Disappointed Ambition, . 


- 


1 


- 


1 


9 


10 


8 


4 


Avarice, 


- 


- 


- 


- 


8 


2 


7 


2 


Pecuniary Trouble, 


3 


1 


1 


- 


191 


41 


104 


17 


Spiritualism, . 


1 


1 


- 


- 


28 


31 


12 


14 


Religious Excitement, . 


2 


5 


- 


2 


151 


183 


73 


91 


Political Excitement, 


- 


- 


- 


- 


11 


- 


5 


- 


Fright, .... 


- 


1 


- 


- 


16 


27 


5 


6 


Jealousy, . 


- 


2 


- 


- 


19 


25 


4 


8 


Seduction, 


- 


1 


- 


- 


- 


4 


- 


- 


Abusive Treatment, 


1 


1 


- 


- 


2 


15 


1 


6 


Nostalgia, 


2 


1 


- 


- 


7 


20 


- 


2 


Mesmerism, . 


- 


- 


- 


- 


3 


6 


2 


4 


Criminal Trial, 




- 


- 


- 


- 


1 


- 


- 


False Accusation, . 




- 


- 


- 


- 


1 




- 


Imprisonment, 


3 


- 


- 


- 


4 


- 


1 


- 


Theft, . 


1 


- 


- 


- 


- 


1 


- 


— 


Novel Reading, 


- 


- 


- 


- 


- 


2 


- 


- 


Sudden Joy, . 


- 


- 


- 


- 


- 


1 


- 


- 


Inhalation of Chloroform, 


















&c, . . _ . 


- 


- 


- 


- 


- 


2 


- 


- 


Mineral Poisoning, 


- 


- 


- 


- 


5 


- 


3 


- 


Vegetable Poisoning, 


- 


- 


- 


- 


2 


1 


2 


1 


Insolation, 


2 


- 


1 


- 


25 


- 


10 


- 


Injury to Head or Spine, 


4 


- 


1 


- 


95 


26 


29 


12 


Incidental Injuries, 


4 


1 


- 


1 


15 


4 


4 


- 


Scrofulosis, 


1 


- 


- 


- 


7 


9 


1 


2 


Cancer, . 


- 


- 


- 


- 


1 


o 


- 


1 


Venereal Disease, . 


2 


2 


- 


1 


- 


2 


- 


- 


Old Age, . 


5 


6 


2 


- 


50 


49 


25 


23 


Unascertained, 


7 


6 


- 


- 


705 


755 


- 


- 


Totals, . 


196 


188 


78 


79 


4,266 

1 


4,269 


1,950 


2,046 



1870.] 



PUBLIC DOCUMENT— No. 23. 



25 



In Table No. 5 are given the assigned causes of the mental 
disease of the patients admitted during the year. Physical 
causes were supposed to have been concerned in producing the 
mental disturbance for which admission to the hospital was 
sought in three hundred and twelve cases, or about eighty per 
cent, of the admissions. Moral influences were recorded as the 
active agents in fifty-nine cases, or about fifteen per cent, of the 
admissions. 

The prominent physical causes were intemperance ; diseases 
affecting the brain and nervous centres, including those suffer- 
ing from paralysis and epilepsy ; the puerperal state and its 
consequences ; the tendency to a recurrence of insanity derived 
from previous attacks ; various deviations from the normal 
standard of health, as masturbation ; the decay and degenera- 
tion which occur in persons at advanced periods of life ; the 
mental prostration and delirium passing into insanity which 
follow various forms of disease, attended with changes in the 
quality of the blood ; and the abnormal tendencies and defects 
observed in the organs of those born imbecile. 

The chief moral causes are supposed to have been grief, 
anxiety, reverses of fortune, domestic and pecuniary difficulties, 
disappointment, and badly regulated and dissolute modes of 
life. 

Table No. 6. 

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



AGES. 


Admitted. 


Discharged Re- 
covered. 


Discharged not 
Recovered. 


Died. 




Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Less than 15, . 


2 


3 




1 


1 


1 






From 15 to 20, 


12 


10 


1 


5 


6 


2 


- 


1 


20 to 30, 


47 


45 


7 


20 


19 


16 


6 


1 


30 to 40, 


51 


48 


34 


24 


24 


17 


10 


2 


40 to 50, 


38 


43 


16 


22 


14 


15 


9 


4 


50 to 60, 


25 


24 


10 


9 


4 


2 


9 


9 


60 to 70, 


14 


8 


5 


2 


4 


1 


4 


3 


70 to 80, 


6 


6 


- 


2 


2 


- 


1 


3 


80 to 90, 


1 


1 


- 


- 


- 


1 


2 


- 


Unknown, . . 


- 


- 


- 


- 


- 


- 


- 


- 


Totals, . . 


196 


188 


73 


85 


74 


55 


41 


23 



26 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 7. 

Showing the Ages of Patients Admitted, Discharged Recovered, not Recovered, 
and Died, from January 18, 1833, to September 30, 1870. 



AGES. 


Admitted. 


Discharged Re- 
covered. 


Discharged not 
Recovered. 


Died. 




Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Less than 15, . 


34 


28 


8 


13 


21 


13 


2 


2 


From 15 to 20, 


358 


254 


134 


153 


77 


77 


16 


16 


20 to 30, 


1,108 


1,062 


555 


541 


413 


413 


74 


78 


30 to 40, 


1,063 


1,119 


500 


530 


449 


417 


114 


105 


40 to 50, 


891 


931 


372 


424 


329 


323 


123 


105 


50 to 60, 


488 


511 


218 


242 


182 


174 


87 


91 


60 to 70, 


280 


256 


101 


117 


108 


82 


63 


64 


70 to 80, 


122 


86 


27 


30 


29 


25 


55 


29 


80 to 90, 


4 


18 


7 


2 


5 


5 


6 


11 


Unknown, . . 


4 


4 


- 


- 


1 


1 


- 


- 


Totals, . . 


4,181 


4,269 


1,922 


2,052 


1,614 


1,530 


540 


501 



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 


Disch'd not 


Died. 








Recovered. 


Recovered. 






DURATION OF INSANITY. 




a 








"3 








OS 


B 

9 

fa 


"3 


£ 

fa 




a 

fa 




i 


Insane 1 year or less, 


114 


122 


56 


66 


33 


29 


20 


13 


More than l'year and less than 


















2 years, .... 


12 


14 


4 


8 


11 


6 


4 


3 


More than 2 years and less than 


















5 years, .... 


39 


27 


3 


6 


12 


9 


11 


1 


More than 5 years and less than 


















10 years, . . . . 


14 


13 


4 


4 


10 


8 


2 


1 


More than 10 years and less than 


















15 years, .... 


5 


4 


2 


1 


5 


2 


1 


2 


More than 15 years and less than 


















20 years, .... 


5 


1 


1 


- 


2 


- 


2 


- 


More than 20 years and less than 


















25 years, .... 


2 





2 


- 


- 


- 


- 


2 


More than 25 years and less than 


















30 years, .... 


3 


2 


1 


- 


1 


1 


- 


- 


Thirty years or more, 


1 
















Unknown, .... 


1 


- 


- 


- 


74 


55 


1 

41 


1 


Totals, . . ' . 


196 


188 


73 


85 


23 



1870.] 



PUBLIC DOCUMENT— No. 23. 



27 



Table No. 9. 

Showing the Duration of Insanity before Admission of Patients Admitted, 
Discharged Recovered, not Recovered and Died, from January 18, 1833, to 
September 30, 1870. 





Admitted. 


Discharged 


Discharged 


Died. 








Recovered. 


not Recovered. 




DURATION OF INSANITY. 




o 
rt 




"3 




rf 








« 


s 


03 


a 


« 


a 




a 




3 


fa 


» 


fa 


3 


fa 


g 


fa 


Insane 1 year or 'less, 


2,672 


2,857 


1,476 


1,596 


699 


676 


259 


301 


More than 1 year and 


















less than 2 years, 


191 


157 


194 


186 


154 


126 


41 


21 


More than 2 years and 


















less than 5 years, 


579 


565 


125 


144 


239 


230 


107 


74 


More than 5 years and 


















less than 10 years, 


327 


300 


50 


61 


238 


222 


47 


35 


More than 10 years and 


















less than 15 years, 


180 


179 


20 


23 


118 


113 


35 


27 


More than 15 years and 


















less than 20 years, 


86 


51 


9 


9 


50 


67 


20 


12 


More than 20 years and 


















less than 25 years, 


56 


51 


7 


- 


36 


38 


5 


10 


More than 25 years and 


















less than 30 years, 


25 


21 


5 


1 


14 


11 


7 


6 


Thirty years or more, 


37 


30 


2 


5 


13 


13 


11 


7 


Unknown, 


113 


58 


24 
1,912 


21 

2,046 


53 


34 


8 


8 


Totals, . 


4,266 


4,269 


1,614' 1,530 


540 


501 



Table No. 10. 

Showing the Civil Condition of Patients Admitted, Discharged Recovered, not 
Recovered and Died, during the year. 





Admitted. 


DISCHARGED RE- 


DlSCHAEGED NOT 


Died. 


CIVIL 






COVERED. 


Recovered. 






CONDITION. 




















Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Unmarried, . 


94 


84 


30 


29 


41 


29 


13 


6 


Married, 


89 


73 


39 


45 


30 


15 


23 


12 


Widowers, 


13 


- 


4 


- 


3 


- 


5 


- 


Widows, 


- 


31 


- 


11 


- 


11 


- 


5 


Unknown, 


- 


- 


- 


- 


- 


- 


- 


- 


Totals, 


196 


188 


73 


85 


74 


55 


41 


23 



28 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 11. 

Showing the Civil Condition of Patients Admitted, Discharged Recovered, not 
Recovered and Died, from January 18, 1833, to September 30, 1870. 



CIVIL 


Admitted. 


Discharged Re- 
covered. 


Discharged not 
Recovered. 


Died. 


CONDITION. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Unmarried, . 

Married, 

Widowers, 

Widows, 

Unknown, 


2,228 

1,803 

209 

28 


1,800 
1,907 

540 
22 


953 

883 
82 

4 


815 
973 

261 
3 


974 

558 

66 

16 


784 
563 

168 
15 


204 

267 

63 

6 


206 
196 

97 
2 


Totals, 


4,268 


4,269 
1 


1,922 


2,052 


1,614 


1,530 


540 


501 



Table No. 12. 

Showing the Occupation of Patients admitted to the Hospital from January 18, 
1833, to September 30, 1870. 



Occupation op Males. 



Previously. 



Auctioneers, . 

Armorers, 

Authors, . 

Agents, .... 

Blacksmiths and Iron-workers, 

Bakers, .... 

Butchers, . 

Book-agents, ... 

Book-binders, . 

Broom-makers, 

Book-keepers, 

Britannia-workers, . 

Brick-makers, . 

Bellows-makers, 

Basket-makers, . . 

Barbers, . . . . 

Boot-makers, . 

Clergymen, . 

Carvers, .... 

Carpenters, . 

Coppersmiths, 

Coopers, 

Cabinet-makers, 
Clothiers, . 

Comb-makers, 
Confectioners, 
Card-makers, . . "'. 



2 
3 
3 

74 
16 
9 
2 
4 
2 
10 
2 
6 
2 

19 

337 

28 

4 

139 

9 

23 

19 

16 

4 

3 

1 



1870.] PUBLIC DOCUMENT— No. 23. 

Table No. 12. — Continued. 



29 



Occupation of 


Males 








1ST©. 


Previously. 


Chair-makers, 




3 


Cigar-makers, . 












_ 


6 


Clerks, . 












10 


127 


Carpet-weavers, 












» _ 


3 


Caulkers, 












- 


3 


Cam phene-distillers , 












- 


3 


Dyers, 












- 


3 


Druggists, 












- 


4 


Drovers, . 












- 


3 


Daguerreotypists, . 












- 


5 


Dentist, . 












1 


- 


Engineers, 












- 


4 


Engravers, 












- 


4 


Editors, . 












_ 


4 


Expressmen, . 












- 


14 


Farmers, 












22 


807 


Fishermen, 












2 


38 


Gardeners, 












_ 


11 


Glass-blowers, 












_ 


4 


Hotel-keepers, 












1 


14 


Hatters, . 












- 


9 


Harness-makers, 










_ 


15 


Hackmen and Teamsters, 










_ 


37 


Jewellers, 










_ 


24 


Lawyers, 












- 


16 


Laborers, 












33 


967 


Leather-cutters, 












2 


- 


Manufacturers, 












2 


33 


Millers, . 












1 


6 


Merchants, 












5 


171 


Masons, . 












2 


37 


Miners, . 












- 


4 


Miniature-painter, . 












- 


1 


Mat-makers, 












_ 


3 


Musicians, 












4 


12 


Machinists, 












10 


73 


Moulders, 












1 


S 


Mechanics, 












3 


- 


Mariners, 












2 


163 


Mail-agent, 












1 


- 


Operatives in Mills, 












11 


115 


Palm-leaf Splitter, . 












- 


1 


Painters, 












3 


55 


Printers, 












2 


37 


Physicians, . . . 












3 


31 


Paper-makers, 












- 


7 


Peddlers, 












- 


18 


Potters, .... 












1 


2 


Pump and Blockmakers, . 












1 


•± 


Pattern-makers, 












- 


6 


Plumbers, 












— 


6 



30 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Table No. 12.— Concluded. 



Occupation of Males. 



IS?©. 



Previously. 



Police Officers, .... 
Paper Hanger, .... 

Rope-makers, 

Restaurators, 

Shoe-makers, 

SaiJ-makers, 

Soap-makers, 

Sash and Blind-makers, . 

Sea-captains, 

Students, 

Ship-carpenters, .... 

Shop-keepers, 

Stone-cutters, ..... 

Soldiers, 

Sexton, ...... 

Stevedore, 

Surveyors, ..... 

School-boys, 

Traders, 

Tailors, . . . . . 
Teachers, . . . 

Tobacconists, . . 

Tinners, 

Tanners, 

Teamster, ..... 
Umbrella-makers, .... 

Vagrant, 

Wheelwrights, .... 

Watchman, 

Wire-drawer, 

No occupation, . 

Totals, 

Occupation op Females. 

Actresses, 

Cooks, 

Engraver, ...... 

Housekeepers, .... 

Housemaids, . . ... 

Laundresses, 

Music-teachers, . 
Midwives, . 

Nurses, 

Operatives in Mills, 

Seamstresses, 

School-girls, 

Teachers, 

Type-setters, 

Tailoress, 

Vagrant, ..... 

No occupations, . 

Totals, 



2 
15 



7 
4 
4 
2 

1 

1 

1 

1 

1 

11 



196 



12 
13 



10 

3 

18 

61 

9 

8 

16 

31 

1 

1 

2 

35 

30 

39 

3 

10 
30 



18 



257 



4,279 



97 
24 



23 
24 

5 
4 

1 
1 
9 



188 



2 

66 

1 

2,291 

456 

4 

3 

2 

16 

254 

788 

47 

87 

3 



249 



4,269 



1870.] 



PUBLIC DOCUMENT— No. 23. 



31 



Table No. 13. 

Diseases which have proved fatal, from January 18, 1833, to September 30, 1870. 











18TO. 


Previously. 


Diseases. 














Males. 


Females. 


Males. 


Females. 


Totals. 


Cerebro- Spinal Apparatus, — 












Apoplexy, 


4 


- 


23 


10 


33 


Palsy, 


2 


3 


61 


24 


85 


General Paresis, .... 


5 


1 


22 


2 


34 


Rantollissenient ; Organic Dis. of 












Brain, ..... 


— 


- 


— 


2 


2 


Epilepsy, _ 


10 


5 


68 


29 


97 


Typhomania, 


2 


1 


13 


13 


26 


Mania a potu, .... 


- 


- 


6 


- 


6 


Meningitis, . 


- 


- 


2 


1 


3 


Maniacal Exhaustion, . 


3 


2 


92 


107 


199 


Cerebral Congestion, 


1 


- 


4 


1 


5 


Circulatory Apparatus, — 












Organic Disease of Heart, 


2 


- 


7 


20 


27 


Angina Pectoris, .... 


- 


- 


1 


- 


1 


Respiratory Apparatus,— 












Tubercular Phthisis, 


3 


4 


56 


80 


136 


Pneumonia, . 






_ 


_ 


15 


12 


27 


Bronchitis, 






- 


_ 


2 


1 


3 


Laryngitis, 






- 


- 


1 


- 


1 


Pleurisy, 






- 


- 


- 


1 


1 


Pulmonary Gangrene, 






- 


- 


1 


1 


2 


Pulmonary Congestion, 






1 


- 


- 


3 


3 


Asthma, 






- 


- 


4 


- 


4 


Hydrothorax, 






- 


- 


3 


2 


5 


Hoemoptysis, . 






- 


- 


1 


1 


2 


Digestive Apparatus, — 












Jaundice, 


- 


- 


1 


4 


5 


Hepatitis, 








- 


- 


1 


- 


1 


Enteritis, 








- 


- 


3 


6 


9 


Pentonitis, 








- 


_ 


- 


1 


1 


Dysentery, 








- 


- 


13 


9 


22 


Cholera, 








_ 


- 


4 


- 


4 


Cholera Morbus, 








_ 


_ 


4 


3 


7 


Marasmus, 








4 


3 


53 


86 


939 


Inanition, 








- 


- 


1 


2 


3 


Genito- Urinary Apparatus, — 












Cystitis, . . . . . . 


- 


- 


1 


- 


1 


Menorrhagia, . . . . 


- 


- 


- 


2 


2 


Ovarian Disease, . . . . 


- 


- 




1 


1 


General Diseases §' Cachexias, — 












Fever, Typhoid or Continued, 


- 


- 


6 


13 


19 


Variola, 


_ 


_ 


2 


- 


2 


Erysipelas, 


— 


— 


8 


16 


24 



32 



LUNATIC HOSPITAL AT WORCESTER. 

Table No. 13. — Continued. 



[Oct. 





1810. 


Previously. 


Diseases. 


Males. 


Females. 


Males. 


Females. 


Totals. 


Dropsy, General, .... 

Cancer, 

Carbuncle, ..... 
Elephantiasis, .... 
Anaemia, 

Old age, 

Accident, ..... 
Suicide, ..... 


4 


1 

3 


3 

2 

26 

3 

19 


6 
4 
1 

1 

1 

27 
18 


9 
6 
1 
1 

1 

1 

53 

3 

37 


Totals, 


41 


23 


542 


511 


1,053 



Table No. 14. 

Showing the Admissions from each County, from January 18, 1833, to Septem- 
ber 30, 1870. 









1870. 


Previously. 












Whole No. 




Males. 


Females. 


Totals. 






Barnstable, 








128 


128 


Berkshire, 






_ 


- 


- 


190 


190 


Bristol, 






2 


- 


2 


298 


300 


Dukes, 






_ 


- 


- 


20 


20 


Essex, 






30 


26 


56 


1,273 


1,329 


Franklin, . 






1 


1 


o 


128 


130 


Hampden, 






- 


- 


- 


378 


378 


Hampshire, 






- 


- 


- 


328 


328 


Middlesex, 






66 


66 


132 


1,596 


1,738 


Nantucket, 






_ 


- 


- 


32 


32 


Norfolk, . 






6 


9 


15 


664 


679 


Plymouth, 






1 


1 


2 


238 


240 


Suffolk, . 






9 


9 


18 


785 


803 


Worcester, 






81 


76 


157 


2,428 


2,585 


Other States, 






- 


- 


- 


49 


49 


Totals, 






196 


188 


384 


8,535 


8,919 



1870.] 



PUBLIC DOCUMENT— No. 23. 



33 



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-eight years the Hospital has been in operation. 









No. at end 




Annual Ex- 


Expense per 




Whole 


Average 




Current Expen- 






TEAKS. 


Number. 


Number. 


of each 
year. 


ses of each year. 


pense for each 
Patient. 


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 32 


1841, . 


399 


233 


232 


28,847 62 


123 81 


2 38 


1842, . 


430 


238 


238 


29,546 87 


111 12 


2 13 


1843, . 


458 


244 


255 


27,914 12 


114 40 


2 20 


1844, . 


491 


261 


263 


29,278 75 


112 17 


2 15 


1845, . 


656 


316 


360 


43,888 65 


138 88 


2 66 


1846, . 


637 


359 


367 


39,870 37 


111 06 


2 13 


1847, . 


607 


377 


394 


39,440 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 


1870, . 


760 


396 


409 


75,715 51 


101 20 


3 68 



84 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



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1870.] 



PUBLIC DOCUMENT— No. 23. 



35 



ffi O (O H CI a ^ I I CI S rH «D r-l ■<# O H a lO N 6D 

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54 



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1870.] PUBLIC DOCUMENT— No. 23. 55 



Suicidal. 
Heredit. and Homi. 
do 

do and Suicidal. 

do 
Hereditary. 

Periodical. 

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Hered., Period. & Horn. 

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1870.] PUBLIC DOCUMENT— No. 23. 59 



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1870.] PUBLIC DOCUMENT— No. 23. 61 



There died during the year sixty-four patients, of whom 
forty-one were males and twenty-three were females. The rate 
of mortality on the average number of residents was sixteen 
per cent. The mortality calculated on the whole population of 
the hospital was eight and four-tenths per cent. During several 
years past the death-rate has been considerably increased among 
the male inmates of the hospital. In thirteen cases seven males 
and five females, the age at the time of death was over sixty 
years. In seven it varied from sixty-five to seventy years. In 
three from seventy to eighty years, and two males were each 
more than eighty years of age. 

In thirty-one cases which proved fatal, namely, twenty-two 
males and nine females, cerebral disease, paralysis or epilepsy 
was present, and with various secondary complications con- 
tributed to this result. 

The large preponderance of males involved in these sections 
of the table of mortality abundantly accounts for the varying 
ratio of mortality in the two sexes which have been alluded to. 
The deaths from the several forms of cerebral disease reached 
nearly fifty per cent, of the whole mortality of the year. 

In hospitals for the insane, it is always to be anticipated that 
a large proportion of the yearly mortality will, in the absence 
of any epidemic or special disease, be attributable to diseases 
affecting the brain and nervous centres. 

In eight cases, five males and three females, death resulted 
from exhaustion consequent on high maniacal excitement. 

In ten cases, six males and four females, death resulted from 
diseases affecting the lungs and heart ; and nine persons, four 
males and five females, died apparently from the gradual decay 
and wearing out of the system consequent on old age. 

The health of the patients at the time of their admission was 
almost invariably in a very unsatisfactory state. Only a small 
number could have been tabulated as possessing good bodily 
health and condition. In a large proportion of the patients, 
their health was indifferent and their bodily condition reduced, 
and in many their health was bad and their condition so pros- 
trate that considerable danger to life was apprehended. 

Various functional derangements of organs were present in 
a large number of the second class, a state of debility or anasmia 



62 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

was frequently observed, and in chronic forms of disease, im- 
plicating the organs of the chest and abdomen, as well as those 
more intimately connected with the operations of the mind. 
Many of these were incurable in their nature, but had not yet 
reached that stage which would immediately compromise the 
life of the patients. Of this character were many cases of 
epilepsy, paralysis, diseases of the lungs and liver, which would 
only admit, at first, of a period of relief, and ultimately pass 
into a more dangerous and fatal stage. 

The third class included only three cases which from vari- 
ous causes could be considered as immediately dangerous to 
life. In many of them the time for treatment had long passed 
before they were sent to the hospital, and upon admission they 
were found to be sinking from disease, or from exhaustion con- 
sequent upon the unchecked violence of their mental disturb- 
ance. In many, bodily disease of a grave type was combined 
with mental disease of an acute character, which had rendered 
their removal to the hospital indispensable. 

Throwing out of the calculation the patients resident in the 
hospital, who are known to be suffering from various forms of 
disease, and who are generally numerous enough to fill both 
sick wards to their full extent, it is satisfactory to be able to 
state that the general health of a majority of the patients was 
good throughout the year, and that no epidemic or other 
troublesome disease prevailed during the year. 

This was more remarkably so in the female side of the hos- 
pital. At different seasons there were the usual affections ob- 
served in the ordinary community outside of the hospital, as 
bronchitic attacks, catarrhs, affections of the throat and slight 
diarrhoea. 

In the male side of the hospital, occasionally, patients sinking 
under disease were, just before death, attacked with diarrhoea 
in a more marked and severe manner than among the females, 
and pulmonary congestions were also more frequently observed 
in the last stages of life in the male sex. 

The medical and moral treatment of the patients has been 
conducted on the same great principles as have been hitherto in 
use and described in former reports. Such changes and devia- 
tions as time and experience have shown to be desirable and 
necessary have been adopted. 



1870.] PUBLIC DOCUMENT— No. 23. 63 

In my annual report for the year ending September 30, 1867, 
I recommended the employment of a thoroughly educated, re- 
fined Christian woman, as an assistant-physician, on the female 
side of the house, in the hope of supplying a want long felt and 
often timidly expressed. In July, 1869, Mary H. Stinson, M.D., 
was invited to visit the hospital and remain, with a view of 
testing the propriety of appointing her assistant-physician in 
the female department of the hospital. 

Thus began the experiment of employing female physicians 
in public hospitals. Dr. Stinson's success has been such as to 
warrant the employment of female physicians in the female 
wards of the lunatic hospitals, and I believe the continued suc- 
cess of the plan thus adopted will be the means of introducing 
an important aid to the treatment of the mental maladies of 
females. 

The employment of the patients continues to be maintained 
with as much vigor as possible. Although no tabulated state- 
ment of the amount of work done during the year can be made 
in this Report, as much has been accomplished as in any pre- 
vious year. The men are as usual employed out of doors on 
the farm and in the gardens, or in-doors in the laundry, bakery, 
kitchens, and other work-rooms, where the heavier work of the 
establishment is performed. Considerable work is also done by 
the patients in the carpenter's shop, the mattress shop and the 
blacksmith shop. 

The women are employed in the greatest number at needle- 
work, but many of them assist in the laundry, kitchen and 
wards of the hospital. More than sixty per cent, of the women 
are actually employed in some useful labor. 

The quantity of land available for the requirements of the 
hospital, and the profitable employment of the patients, has 
long been too limited. The purchase of land for the purpose 
of rebuilding will add to our means of usefulness in respect to 
the employment of male patients, and not only be of advantage 
as a direct curative agent, but it is hoped that it will tend to 
keep down, if not lessen, the average weekly cost of all the 
patients maintained here. 

In a neighborhood so largely agricultural, there is certainly 
no other employment to be compared in efficacy with that which 
can be carried on in connection with a farm. 



64 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

It is satisfactory to be able to report that the average weekly 
cost per patient has been reduced from four dollars and two 
cents to three dollars and sixty-eight cents, and that there 
remains in the treasury a very fair cash balance in favor of the 
hospital. 

I ought to allude to the fact that patients are often brought 
to the hospital in mechanical restraint, or by false pretences. 
Many placed in the hospital during the year had on hand-cuffs 
when they arrived ; some were secured by ropes, and very 
many were entirely deceived in regard to their admission to the 
institution. 

It is not easy to estimate the wrong done to patients who are 
taken from their homes and placed in a hospital by brute force 
or by misrepresentation. It destroys their confidence in the 
medical officers and their friends ; it weakens all the efforts 
made for their recovery or even for their comfort. There are 
patients now in the hospital who have been inmates for years, 
and who persistently refuse every kindness, neglect all advice, 
repudiate every attempt to gain their confidence because they 
were deceived, or were entrapped, and they regard the officers 
of the hospital as parties to the plot to deprive them unjustly 
of their liberties. 

I think there has been for some years past a decided increase 
of severe physical disease of a chronic nature attending the 
mental derangement of the patients admitted to the hospital, 
and many cases of this character are now running their slow 
but sure course . 

There is, however, among the patients at large a great amount 
of active life, and matters of general interest are pursued with 
pleasure and profit. Though subject to many interruptions 
from varying moods, a large amount of intellectual enjoyment 
marks the daily life of a lunatic hospital. Some of the patients 
devote themselves especially to certain branches of study or in- 
vestigation. For instance, the study of music has been fol- 
lowed with some success. Natural history and botany have been 
taken up for a time with much enthusiasm. A large number 
of select weekly and monthly periodicals, beside the daily 
papers, is supplied by the institution, and books of a solid char- 
acter are from time to time added to the libraries. Several of 



1870.] PUBLIC DOCUMENT— No. 23. 65 

the city libraries also contribute to the literary employment of 
patients. 

Other patients, like the generality of persons whose minds 
have acquired no decided bent, range without much selection 
over the lighter works and periodicals at their disposal. 

Out of door life has been encouraged in all, by the practice 
of taking long rides and rambles in the country, and much de- 
light and freshness of feeling, with intellectual reinforcement 
has been thus acquired. The winter evenings have been en- 
livened by social parties, lectures, concerts, and entertain- 
ments of different kinds. Music, perhaps, takes the highest 
rank in these amusements, in its power to please the greatest 
number of patients. We have to thank various friends of the 
institution for their estimable contributions to our winter eve- 
ning entertainments. They have assisted us out of good will 
and sympathy, with that which money could not purchase. I 
take this occasion to thank them, one and all, for their great 
kindness in this respect. 

The ordinary methods of removing dulness by excursions, 
sight-seeing, attending lectures in the city, and meetings of a 
benevolent or religious character, with absences of a longer 
duration, in many instances, have been freely used. 

It gives me satisfaction to acknowledge in behalf of the pa- 
tients, special acts of kindness from Miss Dix, Dr. Hooper, 
Wm. Knowlton, Esq., and Hon. Henry Chapin and others. In 
the consciousness of pleasure bestowed and sorrow lightened be 
their reward. 

Since my last report Dr. Draper has accepted the position of 
assistant-physician to the female department of the New Jer- 
sey State Lunatic Asylum at Trenton, and Dr. H. 0. Palmer 
has very acceptably filled the office of assistant-physician to the 
male department of this hospital since Dr. Draper's resignation. 

The staff of officers has in other respects remained unchanged 
during the year, and each in their several departments have ac- 
tively contributed to the success and good working of the insti- 
tution for which my acknowledgment of such faithful service 
should now be made to you. 

There have been several changes, however, among the attend- 
ants and supervisors, both male and female. In the case of super- 
visors of both sexes, some have left to settle more permanently 

9 



6Q LUNATIC HOSPITAL AT WORCESTER. [Oct. 

in life. Attendants have left because the change in supervisors 
has given them an opportunity to change more readily than 
otherwise would have been offered. The whole body, however, 
of employees have with few exceptions, and those not of a grave 
nature, conducted themselves in a highly satisfactory manner, 
and have earned my good opinion from the earnestness with 
which they have devoted themselves to their duties, and for the 
uniformly good treatment and management of those directly 
under their care and control. 

On the evening of every day, and on the afternoon of Sun- 
days, religious services have been held in the chapel by the 
Rev. George Allen, who for more than twenty years has so 
faithfully performed the duties of chaplain. Two afternoons 
of each week have also been spent by him in visiting the wards 
of the hospital and conversing with such patients as desired 
religious instruction and comfort. 

For whatever of success may have attended our labors, I am 
largely indebted to the kind, faithful and intelligent coopera- 
tion of my assistants and associates in office. And it gives me 
great satisfaction to recognize in this public manner the value 
of the faithful and self-denying services of many of those who 
fill subordinate places of trust and responsibility. In no walk 
of life is a true Christian spirit of forbearance more called for 
than in the position of an attendant in a hospital for the insane ; 
exposed to constant taunts, to irritation, and even to personal 
abuse, they must never retaliate. On them in a great measure, 
depends the successful treatment of the patients. While pre- 
serving strict discipline, and checking every wayward act, they 
must also encourage the timid, cheer the sorrowful, and forgive 
and forget all irritability and petulance. The manner in which 
attendants in this hospital have discharged their trying duties 
during the 'past year shows they have generally borne this in 
mind, and that they have been actuated in the care of their 
unfortunate charge by a higher motive than that of mere pecu- 
niary remuneration. 

It will not, I trust, be considered beyond my province to take 
this opportunity of recording the loss which this hospital has 
sustained in the death of one who was its warm, faithful friend, 
wise counsellor and devoted trustee, Hon. Charles Mattoon. His 
peculiar business aptitude, punctuality and clearness of com- 



1870.] PUBLIC DOCUMENT— No. 23. 67 

prehension, and mastery of all the details of the institution, 
rendered him a valuable and trustworthy adviser. All resi- 
dent in the hospital felt that they had lost a kind, faithful, sym- 
pathizing friend when he passed away. 

"With the support of your generous sympathy, and prudent 
counsel in every emergency, which I have so long and so uni- 
formly enjoyed, I look forward with hope, confident of success, 
in our difficult and responsible labors. 

MERRICK BEMIS. 



Worcester Lunatic Hospital, Worcester, Mass., 

October 1, 1870. 



APPENDIX 



70 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



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, he prays that said 
may be committed to the said Worcester Lunatic Hospital according to law. 

, ss. A. D. 187 . 

Then the above named made oath that 

the above complaint, by h subscribed, is true. 

Before me, , Justice of the Peace. 

I, the subscriber, one of the selectmen of 
where said resides, hereby acknowledge 

that notice has been given to me of the intention to present the foregoing 
complaint and application. 

A. D. 187 . 



To the Honorable the Judge of the Probate Court, in and for the County 

of 

The subscriber, having made application to your Honor for the commitment 
of to the Worcester Lunatic Hospital, as a lunatic, 

now presents the following statement, in answer to interrogatories : — 

What is the age of the lunatic ? Ans. 

Birthplace ? Ans. 

Civil condition of lunatic ? Ans. 

Occupation ? Ans. 

Supposed cause of disease ? Ans. 

Duration ? Ans. 

Character — whether mild, violent or dangerous ? Ans. 

Homicidal or suicidal ? Ans. 

Paralytic or epileptic ? Ans. ' 



1870.] PUBLIC DOCUMENT— No. 23. 71 

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 he 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 Hospital. 

A. D. 187 . 

, ss. A. D. 187 . 

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. 187 . 

On the application of for the commitment 

of of in said county, to the. Worcester 

Lunatic Hospital, ; notice in writing having been 

given by said applicant to one of the selectmen of 

where said resides, of h intention to make said 

application, and said having been duly notified of 

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

the treatment and custody of the Worcester Lunatic Hospital. 

Wherefore it is ordered that said be committed 

to the said Worcester Lunatic Hospital. 

, Judge of Probate Court. 



72 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 Woi*cester 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 Avhich 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 re- 
quired for a class of patients having preference by law, or in the opinion of 
the Superintendent, to be received into said hospital : Also to pay not 
exceeding fifty dollars for all damages he may do 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 he shall continue a boarder in said hospital, with 
such extra charges as may be occasioned by h requiring more than ordinary 
care and attention ; to provide for h suitable clothing, and to pay for all 
such necessary articles of clothing as shall be procured for h by the 
Steward of the hospital, and to remove h from said hospital whenever 
the room occupied by h shall be required for a class of patients having 
preference by law, or in the opinion of the Superintendent, to be received 
into said hospital. Also to pay not exceeding fifty dollars, for all damages 
he may do the furniture and other property of said hospital, and for reason- 



1870.] PUBLIC DOCUMENT— No. 23. 73 

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. 187 . 

Principal. 
Surety. 



Patients will be received into the hospital at any time, if the following 
conditions are complied with : 

If the patient is in indigent circumstances, and has no settlement in any 
town in the Commonwealth, the Probate Court, or, if in the city of Boston 
the Superior Court, will issue a warrant for the commitment of the patient to 
the hospital. The State will then pay the cost of support, and the county 
from which the patient is sent will pay the expenses of the commitment. 

If the patient is in indigent circumstances, and has a settlement in any 
town in the Commonwealth, the Overseers of the Poor of that town may 
give a bond for the support of the patient. Or, when this is inconvenient, an 
application may be made to the Probate Court of the county where the 
patient resides, and a warrant will be issued for the commitment of the pa- 
tient to the hospital, and the town will be held responsible for the support of 
the patient. 

la 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 of 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. 

10 



74 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



List of Trustees from the Commencement of the Hospital: 



NAMES. 


Residence. 


When 
appointed. 


When 
services 
ended. 


In what way services 
ended. 


Horace Mann, 


Dedham, . 


1832, 


1834, 


Commission expired. 


Bazaleel Taft, Jr., . 


TJxbridge, 


1832, 


1834, 


u ti 


William B. Calhoun, 


Springfield, 


1832, 


1835, 


it tt 


Alfred D. Foster, . 


Worcester, 


1832, 


1836, 


u tt 


Francis C. Gray, . 


Boston, 


1832, 


1836, 


tt it 


Thomas A. Green, . 


New Bedford, . 


1834, 


1837, 


U 11 


Thomas Kinnicutt, 


Worcester, 


1834, 


1838, 


It 11 


Horace Mann, 


Boston, 


1835, 


1839, 


It It 


Emory Washburn, . 


Worcester, 


1836, 


1837, 


Resigned. 


Abraham R. Thompson, 


Charlestown, 


1836, 


1841, 


Commission expired. 


Myron Lawrence, . 


Belchertown, . 


1837, 


1840, 


tt ti 


Stephen Salisbury, 


Worcester, 


1837, 


1840, 


ii u 


Edward D. Bangs, . 


Worcester, 


1838, 


1838, 


Deceased. 


William Lincoln, . 


Worcester, 


1838, 


1840, 


Commission expired. 


Daniel P. King, 


Danvers, . 


1839, 


1844, 


it ii 


Alfred D. Foster, . 


Worcester, 


1840, 


1842, 


tt tt 


Matarin L. Fisher, . 


Worcester, 


1840, 


1843, 


it it 


Henry Gardner, 


Boston, 


1840, 


1845, 


tt it 


Robert Campbell, . 


Pittsfield, . 


1841, 


1843, 


Resigned. 


Edwin Conant, 


Worcester, 


1842, 


1844, 


it 


H. H. Childs, . 


Pittsfield, . 


1843, 


1846, 


Commission expired. 


Joseph Sargent, 


Worcester, 


1843, 


1848, 


it u 


Stephen Salisbury, 


Worcester, 


1844, 


1850, 


tt tt 


Stephen C. Phillips, 


Salem, 


1844, 


1851, 


tt it 


Jesse Murdoch, 


Carver, 


1845, 


1847, 


tt tt 


Thomas F. Plunkett, . 


Pittsfield, . 


1846, 


1849, 


it it 


Thomas French, 


Canton, 


1847, 


1848, 


Resigned. 


Isaac Davis, . 


Worcester, 


1848, 


1849, 


tt 


William Appleton, . 


Boston, 


1849, 


1851, 


Declined. 



* The first three were Commissioners for building, and as juch were appointed in '. 



1870.] 



PUBLIC DOCUMENT— No. 23. 



75 



List of Trustees — Continued. 



NAMES. 


Residence. 


When 

appointed. 


"When 
services 
ended. 


In what way services 
ended. 


Levi Lincoln, . 


Worcester, 


1849, 


1852, 


Commission expired. 


Ensign H. Kellogg, 


Pittsfield, . 


1849, 


1853, 


u u 


John S. C. Knowlton, . 


Worcester, 


1850, 


1853, 


Declined. 


Foster Hooper, 


Fall River, 


1851, 


1854, 


Commission expired. 


Samuel G. Howe, . 


Boston, 


1851, 


1855, 


It ti 


Rejoice Newton, 


Worcester, 


1852, 


1856, 


(I << 


Franklin Ripley, . 


Greenfield, 


1853, 


1854, 


(I II 


James B. Congdon, 


New Bedford, . 


1853, 


1855, 


Resigned. 


Linus Child, . 


Lowell, 


1854, 


1858, 


Commission expired. 


Henry Morris, 


Springfield, 


1854, 


1855, 


Resigned. 


Charles H. Stedman, 


Boston, 


■ 1855, 


1861, 


Commission expired. 


William T. Merrifield, . 


Worcester, 


1855, 


1863, 


it u 


Thomas Colt, . 


Pittsfield, . 


1855, 


1860, 


" 


Joseph N. Bates, . 


Worcester, 


1856, 


1861, 


ii it 


Robert W. Hooper, 


Boston, 


1858, 


- 


( Commission expired, 
| and re-appointed. 


Edwin F. Jenks, . 


Adams, 


1859, 


- 


Deceased. 


Edward Jarvis, 


Dorchester, 


1861, 


- 


Commission expired. 


William Workman, 
Samuel E. Sewall, . 


Worcester, 
Boston, 


1862, 
1863, 


_ 


1 Commission expired, 
j and re-appointed. 
( Commission expired, 
\ and re-appointed. 


Henry Chapin, 
Charles Mattoon, . 


Worcester, 
Greenfield, 


1866, 
1866, 


1870, 


( Commission expired, 
< and re-appointed. 
(. Deceased. 



METEOROLOGICAL OBSERVATIONS 



THE STATE LUNATIC HOSPITAL, WORCESTER, MASS., 

1869-70. 

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 by figure 
affixed to the letters denoting the direction. When no number is affixed, 1 is meant. 



78 



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LUNATIC HOSPITAL AT WORCESTER. 



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a. 

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Fair weather. 

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Fair weather. 

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Fair weather. [& light. 

Fair weather. 

Fair weather. 

Fair weather. 

Fair weather. 

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Fair weather. 

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PUBLIC DOCUMENT— No. 23. 



89 





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Fair weather. 

Fair weather. 

Rain p. m. and evening. 

Slight shower ; th'der & 

Fair. [light. 7 p.m. 

Fair weather. 

Fair weather. 

Fair weather. 

Fair weather. 

Fair weather. 

Fair weather. 

Slight frost in a. m. 

Fair weather. 

Fair weather. 

Fair weather. 

Fair weather. 

Slight rain a.m. and p m. 

Fair weather. [Cloudy. 

Fair weather. 

Fair weather. 

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Slight rain 3 p. m. ; aur. 

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Fair weather. 

Cloudy. 

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PUBLIC DOCUMENT— No. 23. 



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APPENDIX TO SUPERINTENDENT'S REPORT. 



The Superintendent's report for the year ending September 80, 
1865, contained suggestions and recommendations which were en 
dorsed by the Trustees in their report for the same year in the 
following words : — 

" Another want sadly felt is some intermediate temporary residence for pa- 
tients not fit for discharge, nor proper subjects for an insane ward : a place 
where can be tested their ability to live free from the actual restraints of the 
hospital before going to their homes and into the busy world. As was said in 
our last report, some of our patients are occupied in various employments in 
the town who return to the shelter of the hospital at night, not having confi- 
dence in their ability to leave its protecting influence altogether. 

" It is believed that many might be discharged without fear of relapse, if some 
such intermediate step as this could be taken, instead of ushering them at once 
into active life. 

" One or two cottages in the vicinity of the hospital, occupied by discreet 
persons now employed there, making a little family circle by the addition of 
a few selected patients, would be of great benefit to the hospital, in relieving 
its crowded wards, and to the patients in giving them a chance to show that 
they can live without restraint. Many persons when admitted as patients 
might with advantage be placed in these cottages. 

" Some suggestion will be offered at a future time for a plan by which 
these improvements can be made without involving much expense. 

" While no wasteful experiments should be encouraged, the intelligent 
Commonwealth of Massachusetts ought to require that not only every improve- 
ment of the age should be introduced into its system for the treatment of the 
insane, but that the State should lead in this branch of progress as it has in 
so many others." 

The same suggestions were pressed in 1866, '67 and '68, and in 
1869 they were again presented with a more complete plan for car- 
rying out the wishes of the Trustees, and a more definite statement 
of their views in regard to the management of the insane. The 
result of all this was an attempt in the spring of 1869 to bond the 
right of purchase of certain lands in the easterly part of Worcester 



98 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

bordering upon Lake Quinsigamond, owned by Charles Bowen, 
Mrs. Lucy A. Watson, Henry Prentice, and Robert Taft. After 
considerable time had been spent the effort was abandoned, and the 
right to purchase certain lands in the north-easterly part of the city 
was bonded of Walter Bigelow, Timothy Bancroft and others. 
On the 30th of September, 1869, the Trustees— 

Voted, That it was expedient to erect new hospital buildings on the land 
for which Dr. Bemis has procured bonds ; and also, 

Voted, That Dr. Bemis be Authorized to secure by bonds a right to pur- 
chase such adjacent lands as he thinks expedient ; also, 

Voted, That Hon. Samuel E. Sewall be directed to prepare a petition to 
the legislature for leave to purchase land and erect a new hospital, said pe- 
tition to be presented and examined at the next meeting of the Board. 

In the meantime many of those who were interested in the project 
had visited the proposed site and expressed themselves strongly in 
favor of the first named location, the effort to bond which was 
now renewed and carried to a successful termination. 

The legislature, in answer to the prayer of the Trustees' petition, 
granted, in. the form of a loan to be paid for from the proceeds of 
the sale of the lands now occupied by the hospital within the limits 
of the city, one hundred thousand dollars, to be applied to the 
purchase of the new site. About three hundred and seventy-five 
acres of land have been purchased of Henry Prentice, Lucy Ann 
Watson, Robert Taft and Charles Bowen, at a cost of about one 
hundred and ten thousand dollars. It is desirable to purchase, for 
the purpose of straightening lines and rendering the estate more 
compact, several small lots numbered 1, 2, 3, 4, 5, on the plan. 
Nos. 1 and 2 are very small lots, and there is upon each a small 
house. That upon No. 1 is entirely worthless, except to the present 
occujDant. No. 3 is the most valuable lot and contains about eight 
acres. Its purchase is important as, in its present condition, it 
makes an awkward projection of another man's estate into and near 
the middle of the north side of the hospital estate. No. 5 is impor- 
tant only as straightening the boundary line. No. 4 contains about 
fourteen acres, and is important both from its position as straighten- 
ing the boundary line, and also as containing valuable springs. 

For similar reasons it will be desirable to dispose of the lot 
marked (B) in the plan. This lot is now covered with wood, which 
may be cleared off and then the land disposed of, thus realizing a 
sum, sufficient perhaps to pay for the lots which we desire to pur- 
chase. The lot marked (A), containing about three and a half acres, 



1870.] PUBLIC DOCUMENT— No. 23. 99 

may very properly be offered for sale in the future as not being 
necessary to the hospital, after the estate has become somewhat de- 
veloped. This lot, however, should not be disposed of until the 
hospital has secured its approaches both from the city and from the 
railroad, which passes very near to this point. [See plan of lands, 
p. 100.] 

This estate is situated in the easterly part of the city, near the 
Boston and Albany Railroad, about one mile from the present hos- 
pital buildings, and about the same distance from the Central Rail- 
road Station. The old "Worcester turnpike forms the southern 
boundary line of all the estate except the lot marked (A) on the 
plan. Lake Quinsigamond is on the eastern border, and Mill Stone 
Hill, so called, divides and separates the western border from the 
city. It is crossed but by one thoroughfare, a town road, known as 
Love Lane. 

The estate has generally an eastern and south-eastern slope, 
though a portion of it has a full southern slope. It is well sheltered, 
warm, and vegetation starts upon it early in the spring. 

The eastern and western borders are very finely skirted with 
wood. The soil is, much of it, a gravelly loam, though the highest * 
land upon the estate is clay. The rocky ledge of Mill Stone Hill 
breaks out on the western border where it is covered with a fine 
growth of wood. The rock does not extend sufficiently far into the 
estate to interfere with any development necessary for hospital pur- 
poses. Nor does it extend far enough to make any additional drain- 
age necessary for hygienic reasons. 

On the estate there are five good, substantial dwelling-houses, sur- 
rounded with gardens and orchards, such as are found on well-to-do 
country farms. These will in the spring be occupied by thirty or 
forty patients and their attendants. Although built without any 
reference to such uses, they will be occupied without alteration or 
special preparation for at least one year, in order to test the ques- 
tion whether, on an estate set apart for the purpose, with skilful 
attendants, under proper medical and supervisory care, a fair pro- 
portion of insane persons such as are ordinarily found in lunatic 
hospitals, cannot be better cared for than in any at present existing 
accommodations. 

The failures and successes, the disappointments and difficulties of 
this plan, will be fully and honestly presented in my next annual 
report. 

If the plan meets with any success, I shall also present a topo- 
graphical map of the estate, with plans for such new structures as 
seem to me to be desirable for the proper accommodation, care and 
restoration of the insane. 



100 LUNATIC HOSPITAL AT WORCESTER. [Oct. 




IPtoa mM ffe© Wn^mM&» 



1870.] PUBLIC DOCUMENT— No. 23. 101 

The prominent features of the plan have been very briefly men- 
tioned in several of my annual reports, and may be here anticipated 
by repeating a few general statements made in my report of last 
year. 

For the best management and control of persons afflicted with 
mental aberration to that degree which requires interference 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 situation. 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 en- 
closed by a high and substantial wall and furnished with a gate- 
keeper's lodge at the entrance. The surface of the land should be 
uneven and broken by groves and scattering 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 and 
made as cheerful and pleasing in then' 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 ob- 
tained by the erection of separate blocks or wings at some little dis- 
tance from each other, connected by light, airy passages or corridors, 
under which shall be a continuous basement. 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 sepa- 
rate 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 excited patients. The lower story should be con- 
nected with the upper story by a wide, light and easy stairway, and 
this story should contain the sleeping apartments, bathing-rooms, 
14 



102 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

water-closets, wardrobe and dressing-rooms, and rooms for seclu- 
sion, 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 convenient size and have every com- 
fort and convenience of sleeping-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 this basement will be placed facilities for conveying all sup- 
plies 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, and all the accommodations 
should be separate and distinct from each other. 

This centre group of blocks or wings should be of sufficient capac- 
ity 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 treatment and needing rest and seclusion ; 
and a more sunny and cheerful aspect to the various wards ; and less 
interference and discomfort from the general conduct of a large hos- 
pital. 

The question of the plan would simply be, first, "What is the struc- 
ture most conducive to health ? second, What is the most convenient 
and economical ? That is, How can we best secure perfect ventila- 



1870.] PUBLIC DOCUMENT— No. 23. 103 

tion, 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 gen- 
erally be found best if placed in a line or side by side, thus dimin- 
ishing 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 hospi- 
tal 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 des- 
tined to be cared for in the establishment, should be accommodated 
in houses of smaller capacity built for the purpose 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 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 dis- 
tinctions as may be convenient. There should be no interior divis- 
ions 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 vegeta- 
bles, which should be cultivated by members of the family. Each 
garden should have its own walks, which should unite and harmon- 
ize 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. 



104 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Those near the shops and engine-house would best accommodate 
the mechanics, gardeners and chore-men. 

On the other side the houses near the laundry and bakery will 
accommodate the laboring women, housekeepers, seamstresses, &c. 

At a little distance from these the houses will be occupied "by 
women, wives and daughters not accustomed to severe 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 fm*nished for and occupied by convalescents 
during the few weeks or months just previous to leaving the control 
of the institution for the duties of active life. 

At or near the central group, or hospital proper, should be placed 
the steam-works for heating and ventilating, pumping, &c. ; 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 per- 
sons 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. 

The question may be fairly asked, How can these results be at- 
tained ? The legislature has granted permission to purchase, occu- 
py and improve a suitable tract of land, and on it quietly and ener- 
getically 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 suitable checks and guarantees, the credit of the 
State to the extent of one hundred thousand dollars. 

My estimate of the value of the lands was one year ago as follows : 
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- 



1870.] PUBLIC DOCUMENT— No. 23. 105 

five-hundredths acres, and at thirty cents per foot will amount to 
$55,539. 

Ten acres bordering upon Mulberry and Central Streets, at twenty 
cents per foot, will amount to $87,120. 

Ten acres bordering upon a continuation of Laurel and Wilmot 
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 con- 
tinuation of Laurel Street, should be offered to the city of Worces- 
ter 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 com- 
petent judges. 

You must remember that the value of land in this vicinity is con- 
stantly increasing, and by the time new structures shall be completed 
will be very considerably. augmented. [See plan of lands, p. 106.] 

The legislative Committee on Charitable Institutions not being 
satisfied with this appraisal, requested Mr. Ely, a real estate agent of 
Worcester, to make an appraisal and report to them, which he did, 
as follows : — 

Worcester, Mass., January 25, 1870. 
Committee on Charitable Institutions. 

Gentlemen, — Agreeably to request I herewith submit to you my estimate 
of the value of land now occupied by the State Lunatic Hospital in this city, 
or what I think can be realized for the same, within three years, by proper 
management in the sale thereof: — 



Hospital lot, . 




12.6 acres 


at 60 cents per foot, 


$329,303 60 


Barn lot, 




4.5 " 


" 40 " " 


78,408 00 


Mulberry & Central St. lots, 


10 " 


« 25 " " 


108,900 00 


Laurel & Wilmot St. 


lots, 


10 " 


" 15 " " 


65,340 00 


Rattlesnake Hill, 




10 " 


u 5 u << 


21,780 00 


Chandler Hill, 




40 " 


" $2,000 per acre, 


80,000 00 


Shrewsbury Street, . 




17 " 


" 1,000 " " 


17,000 00 




$700,731 60 






Respectfully, 


L. A. Ely. 



This appraisal being higher than was anticipated, some members 
of the Finance Committee of the legislature desired another esti- 



106 LUNATIC HOSPITAL AT WORCESTER. [Oct. 




IPtaa @1 iS® EmmMm® 



1870.] PUBLIC DOCUMENT— No. 23. 107 

mate made by two or more persons. The services of Messrs. Emory- 
Banister and David S. Messenger, well known public appraisers, 
and old residents of Worcester, were obtained, and the following is 
their statement : — 

Gentlemen, — The following is the result of the appraisal made by Emory- 
Banister and David S. Messenger of the property of the Worcester Lunatic 
Hospital, February 22, 1870 :— 

Hospital lot, . . 548,656 feet at 30 cents per foot, $164,656 80 

Barn lot, . . . 185,130 " " 25 " " 46,282 50 

Mulberry St. lots, . 185,130 « " 25 " " 46,282 50 

E. Central St. lot, . 592,417 " " 25 " " 47,393 36 

Lot No. 6, 12£ acres, 12,250 00 

Lot No. 7, 12£ " 6,250 00 

Lot No. 8, Chandler Hill, 36^ acres, 36,600 00 

Lot No. 9, Belmont St., 11J " 22,500 00 



$382,215 16 
All other property (not personal), 50,500 00 



Total, $432,715 16 

(Signed,) Emory Banister. 

D. S. Messenger. 

From these several appraisals it will be seen that with judicious 
management a sum not much short of $500,000 may be realized 
from the sale of the present site. It is to be hoped that the new 
hospital, when complete, with accommodations for four hundred and 
fifty patients, will not have cost much more than that sum. Indeed, 
it is fairly believed that, with prudent use of the means within 
the control of the Trustees, the whole may be accomplished with- 
out involving the Commonwealth in any expense beyond the use 
of certain sums of money until a portion of the lands have been dis- 
posed of. 

As no lots have yet been sold, and as the $100,000, so generously 
loaned by the legislature, have been expended in the purchase of 
the new site, and your Board have assumed a debt of about $10,000 
in order to complete the purchase, giving your notes for the same, 
and as at present we have no means for the development of the 
newly purchased site, it is earnestly desired that the legislature 
would grant a further loan of about $30,000, with which to cancel 
your obligations to the former owners of the lands, and also to com- 
mence the work of grading and building farm buildings, so that the 
estate may be fully and usefully occupied. 



108 LUNATIC HOSPITAL AT WORCESTER. [Oct.'70. 

It is fairly believed that no further loan from the State will be 
needed, as in all probability certain portions of the land now occu- 
pied will be disposed of in the course of the present year, affording 
at least sufficient means for the prosecution of the work. 

With such assistance as is now asked, the work will be faithfully 
and scrupulously pursued, and every honest effort will be made to 
insure its ultimate success. 



MERRICK BEMIS. 



Worcester Lunatic Hospital, Worcester, Mass., 

October 1, 1870. 



11*2 5*9*^