Annual report of the trustees of the State Lunatic Hospital at Worcester

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PUBLIC DOCUMENT No. 23.

FOETY-FIEST ANNUAL EEPOET

THE TRUSTEES

STATE LUNATIC HOSPITAL

WORCESTER

,

October, 1873

BOSTON:

WEIGHT & POTTER, STATE PRINTERS,
Corner of Milk and Federal Streets.

1874.

OFFICERS OF THE HOSPITAL.

TRUSTEES
ROBERT W. HOOPER, M. D.,
Gen. WILLIAM S. LINCOLN,
Hon. HENEY CHAPLN,
Col. JOHN D. WASHBURN,
JAMES B. THAYER, Esq., .

Boston.

Worcester.

Worcester.

Worcester.

Milton.

RESIDENT OFFICERS.

Superintendent, BARNARD D. EASTMAN, M. D.

Assistant Superintendent, .... JOHN G. PARK, M. D.

Assistant Physician, MARY H. STINSON, M. D.

Assistant Physician, H. M. QUINBY, M. D.

Matron, ELIZA A. TAYLOR.

Steward, SOLON WILDER.

TREASURER.
JOHN D. WASHBURN, Worcester.

Commotuumltl) of itlassacljusette-

TRUSTEES' REPORT.

To His Excellency the Governor, and the Honorable Council.

The Trustees of the Worcester Lunatic Hospital offer their
Forty-First Annual Report.

Among their other duties, the first consideration of the
Trustees has been the interest of the hospital, and the persons
committed to their charge.

The number of patients has been unusually large, and the
character of many of the cases has been pronounced by the
Superintendent as turbulent ; but this may be partially owing
to the exposed situation of the hospital to the noise of a busy
and populous city, which immediately surrounds it.

There has been a more than usual amount of sickness dur-
ing the year among the patients. In June small-pox appeared
in one of the wards, the source of infection being entirely
unknown. By immediately removing those attacked to a
vacant cottage on the new farm, the number of cases was
limited to three, with no fatal result, and no panic was
caused either in the house or in the neighborhood. In August
and September a number of cases of dysentery occurred, and
several who were attacked died. In only one case, however,
could the fatal result be attributed to dysentery alone.

A case occurred about one year ago, which we mention, as
some reflections have been cast on the administration of the
hospital for allowing too much freedom to a person committed

6 LUNATIC HOSPITAL AT WORCESTER. [Oct.

to their charge : a man was sent from the jail of a western
county as insane, who, previous to his insanity, had committed
homicide. His insanity was not considered by the physician,
while here, as of a homicidal character, and he was treated
like other patients, with a view to his recovery, beiug allowed
out-of-door exercise, at first with an attendant, and afterwards
without restraint. On his recovery he was tried and convicted
for the act committed previous to his insanity. As he was
not considered homicidal while under treatment, and the jury
and court convicted him and sentenced him for an act com-
mitted while sane, there was no impropriety in allowing him,
while convalescent, the freedom of any patient whose insanity
was not considered homicidal or dangerous to the community.

Our most painful duty is in listening to the complaints of
patients, well known to be insane, who look upon their com-
mittal and detention as an act of injustice, and incessantly, in
speech and writing, demand release, under threat of the
penalty of the law in this world, and judgment in the next,
upon those who have them in charge. This constant fretting
tends to retard their recovery, and the only remedy, in some
cases, is to transfer them to another hospital.

There is a popular delusion that persons are sometimes
sent to a hospital with the connivance of those in charge of
it. Parents are supposed to be sent by their children to antic-
ipate or preserve their inheritance from waste ; husbands
and wives to pursue or conceal a domestic wrong, or end an
incurable infelicity. This has long been the theme of low
comedy, and of sensational novels; of late it has been the
•subject of popular lectures, and a well-turned epithet of cen-
sure of those in charge of the insane is sure to give delight
to the audience, and bring down the applause of the house.

The hospital receives only those entrusted to its care, in
accordance with a provision of law, and when the cause for
detention ceases, discharges them, it is feared, sometimes,
prematurely. It was once remarked by the late Dr. Luther
Bell, that persons, who, after discharge, indulged in vitupera-
tion of those who had the care of them when ill, showed
evidence of an imperfect recovery.

Some changes have been made in the administration of the
hospital during the year. The former Steward and Treas-

1873.] PUBLIC DOCUMENT— No. 23. 7

urer resigned his office, a new Steward has been appointed,
and one of our Board of Trustees has consented to take tem-
porarily the office of Treasurer, to the great benefit of the
hospital.

He reports the finances in good'coudition, and when the
amounts due are collected, we shall be in a condition to make
purchases* of supplies on more favorable terms, by paying at
once, than by a system of credit.

The work on the new hospital is going on, the grading and
part of the foundation proceeding at the same time.

Sales of land have been made to the amount of nearly sixty
thousand dollars, all of which is paid over to the treasurer of
the Commonwealth, who acts as treasurer of the new hospi-
tal, and every expenditure has the sanction of the governor
and council.

The present financial condition of the country is not favor-
able to the sales of land, but the improvements going on in
the vicinity of the hospital, will probably increase the value
of the land which remains to be sold.

In consideration that the hospital has now, and has had for
years, more patients than the present law permits us to pro-
vide for in the new building, it is desirable that the legislature
should so modify the law of 1870, that authority may be
given to the Trustees to carry out the plans as designed, while
they can be made with more advantage in the arrangement of
the hospital, and economy in its construction.

R. W. HOOPER.
WM. S. LINCOLN.
HENRY CHAPIN.
JOHN D. WASHBURN.
JAMES B. THAYER.

8 LUNATIC HOSPITAL AT WORCESTER. [Oct.

TREASURERS REPORT

To the Trustees of the Worcester Lunatic Hospital.

Gentlemen : — I herewith submit my Annual Report on the
finances of the Worcester Lunatic Hospital, for the year
ending September 30, 1873.

Receipts.
Cash on hand, September 30, 1872,

received of the Commonwealth for sup-
port of patients, ....

received of cities and towns for support
of patients, .....

received of individuals for support of
patients, ......

received for interest and sale of produce,
etc., .......

$8,031 Q6
9,610 05

49,044 33

47,988 98
1,742 06

.16,417 08

The expenditures for the year have been as follows : —
Provisions :

Flour, 573 barrels, at $11. 57.^ per
barrel, ....

Meat of all kinds,

Meal for cooking, .

Beans, potatoes and other vegeta-
bles, ....

Fish,

Sugar, .....

Molasses and syrup,

r

. $5,970

12

. 9,488

77

541

01

. .1,355

50

980

53

. 2,870

29

689

82

Amount carried forward,

11,896 04

1873.] PUBLIC DOCUMENT— No. 23.

Amount brought forward, $21,896 04

Tea,

Coffee and chocolate,
Eice and crackers, .
Butter, .

Vinegar and pickles,
Cheese, .
Fresh fruits, .
Eggs, salt and other groceries,
Total for provisions,

Salaries and wages,

Extra labor, ....

Provender and bedding for stock,

Furniture, crockery, bedding, etc.

Light, . .

Soap, .....

Medical supplies, .

Live stock, ....

Carriages, harness, blacksmithing, etc.,

Improvements and repairs,

Books, stationery and printing,

Fuel,

Freight and express,

Ice, .....

Trustees' expenses,

Miscellaneous,

Total current expenses, .

Clothing and materials, .
Undertakers' charges,
Furnished to private patients on account,
Land, insurance, interest, surveys, etc.,

Total expenditures,
Cash on hand, September 30, 1873,

1,208 93

969 97

651 58

6,368 95

114 10

39 53

60 64

2,391 69

,701 43

32,662

09

53

25

870

99

7,629

65

2,154

02

564

08

958

44

800

00

918

10

4,256

16

620

79

6,257

41

356

19

481

15

219

60

2,693

48

. $95,196 83

5,080

77

700

80

544

59

3,415

96

. $104,938

95

11,478

13

$116,417 08

10 LUNATIC HOSPITAL AT WOECESTEE. [Oct.

Eesources.

Cash on hand, $11,478 13

Due from the Commonwealth, . . . 2,639 50

from cities and towns, . . . . 12,016 79

from individuals, ..... 11,498 23

$37,632 65

Liabilities.

Due for supplies and expenses, ♦ $12,721 53
salaries and wages, . 8,428 82

21,150 35

$16,482 30
Invested funds, market value, . . . 4,428 53

Total surplus, ..... $20,910 83

JOHN D. WASHBUEN, Treasurer.

Worcester Lx-natic Hospital,
October 1, 1873.

NEW HOSPITAL ACCOUNT.

The total amount expended on account of the new hospital
at the close of the calendar year 1872, as shown by statement
of the treasurer of the Commonwealth, who is, by law,
charged with receiving and disbursiug all moneys on that
account : —

Payments in 1870, $100,000 00

in 1871, . . . . . 29,912 17

in 1872, ..... 8,490 84

Amount carried forward, . . . $138,403 01

1873.] PUBLIC DOCUMENT— No. 23. 11

Amount brought forward, . . . $138,403 01
There has since been expended : —

1873.

Bills Approved.

February.

Voucher No. 1 — Weston

& Rand,

architects, .

$1,500 00

July

2.

Voucher No. 2— E. B.
Walker, grading and

foundations,

1,441 80

July

31.

Voucher No. 3— B. D.

Eastman, sundries,

125 62

July

31.

Voucher No. 4 — But-
trick & Wheeler, engi-

neers' services, .

415 00

July

31.

Voucher No. 5— E. B.
Walker, grading and

foundations,

2,720 70

July

31.

Voucher No. 6 — Weston

& Rand, sundries,

98 00

Aug.

28.

Voucher No. 7— E. B.
Walker, grading and

foundations,

2,189 72

8 4 90 S4

UjTit'V/ u^t

Total to September 30, 1873, . . $146,893 85

The amount realized for sales of land to September 30,
1873, and interest thereon, as by statement of treasurer of
the Commonwealth, is $58,489.37.

A note of twenty-five hundred dollars ($2,500), given by
the Trustees to Sarah Phillips for land purchased of John
Bartlett, is outstanding, owing to a temporary legal disability
on the part of the holder to receive the payment.

12 LUNATIC HOSPITAL AT WORCESTER. [Oct.

SUPERINTENDENT'S REPORT.

To the Board of Trustees of the Worcester Lunatic Hospital.

Gentlemen : — The Forty-First Annual Report of the
operations and condition of the hospital is herewith respect-
fully submitted.

The principal numerical statistics of the year are grouped
in the following tables, to which, with the brief accompany-
ing remarks, I invite your attention.

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

Males.

Females.

Totals.

Patients in the hospital, Oct. 1, 1872,

197

242

439

Admitted during the year,

209

198

407

Whole number under treatment, .

406

440

846

Discharged recovered, .

49

49

98

improved, .

72

76

148

not improved,

41

21

62

Died,

36

33

69

Whole number discharged, .

198

179

377

Remaining, September 30, 1873, .

208

261

469

Largest number present, Aug. 10, 1873,

219

262

481

Smallest number present, Nov. 8, 1872,

189

229

418

Average number present during the year,

208.21

245.17

453.38

The number of patients in the house at the beginning of
the year was greater than at the beginning of any previous

1873.] PUBLIC DOCUMENT— No. 23. 13

year, except the two years immediately preceding the opening
of the Taunton Lunatic Hospital.

The number of admissions is greater than those of any
previous years, except those of 1871 and 1872.

Two patients, originally admitted by private bond, were
discharged on the records of the hospital, to be committed by
the judge of probate, -in order that their expenses could be
charged to the towns legally liable for their support, their
own funds having been exhausted.

The actual number of patients received at the hospital was,
therefore, 405. Inasmuch, however, as ten of the persons
were admitted each twice, and two were admitted each thrice,
during the year the number of persons admitted was 379.

No patient has been admitted who was not a resident of the
State, although many applications for such admissions ' have
been received.

The number discharged as recovered constitutes a smaller
per cent, of the whole number discharged than has been ex-
hibited in former years. All thus classed were believed to
have reached their normal condition, which must, of course,
be the standard for comparison.

Several were cases of dipsomania, in which recovery is
considered to mean nothing more than recovery from the
immediate effects of debauch. Indeed, it has not been the
policy of the institution to retain this class of cases in the
forlorn hope of working permanent reformation.

Among those classed as improved are several who appeared
to be nearly well when discharged, and whose recovery was
afterwards completed.

The number of deaths is numerically larger than in any
previous year, but is not so large a per cent, upon the average
number of inmates as had been previously reached.

The number of patients remaining at the close of the pres-
ent year is greater than remained at the close of any previous
year in the history of the hospital, except the two years next
preceding the opening of the Taunton Hospital.

It has been with considerable difficulty that the number of
inmates has been prevented from reaching a higher figure.
The General Agent of the Board of State Charities has relieved
us by the removal from time to time of such State patients as

14 LUNATIC HOSPITAL AT WORCESTER. [Oct.

it was proper to transfer to other institutions or to the places
legally liable for their support. The discharge of such
chronic, quiet town patients as could be suitably provided
for by the towns wherein they had settlements has also
afforded some relief, and the friends of a number of patients
whose condition warranted it have been allowed and encour-
aged to remove them to their homes.

In consequence of the removal of so many quiet patients,
and the admission of so large a number of cases of a very
demonstrative type the population of the hospital during the
year has, on the whole, been of a turbulent and noisy charac-
ter, and this has added to the cares and anxieties of the offi-
cers and employes.

In a large number of the cases admitted, there coexisted
with the insanity serious complications. Some of the more
prominent ones are noted in the following table : —

Table No. 2. — Showing the complications in the cases ad-
mitted during the year.

Epileptic,

Epileptic and homicidal,

Epileptic, homicidal and suicidal,

Epileptic and paralytic,

Paralytic, .....

Paralytic and homicidal,

Suicidal,

Homicidal,

Suicidal and paralytic, . .,

Suicidal and homicidal,

Total number of cases epileptic,

Total number of cases paralytic,

»
Total number of cases suicidal, .

Total number of cases homicidal.

17

6

1

1

7

3

64

30

1

6

25

12

72

46

1873.]

PUBLIC DOCUMENT— No. 23.

15

Table No. 3. — Showing the relations of the patients admit-
ted to institutions of this kind.

Males.

Females.

Never before in any hospital,

143

149

Former inmates of this hospital,

40

34

of other hospitals in this State, .

11

6

of hospitals in other States,

7

2

of this hospital and of other hospitals
in this State,

3

5

of this hospital and of hospitals in
other States,

1

-

of other hospitals in this State and
hospitals in other States,

-

1

of this hospital, of other hospitals in
this State, and of hospitals in other

4

of hospitals of other countries, .

-

1

Totals,

209 •

198

Table No. 4. — Showing the sources from which the patients
admitted were directly drawn.

Males.

From the general population,

Taunton Lunatic Hospital,

McLean Asylum for Insane,

House of Correction, .

State Prison,
Readmitted without discharge from hospital,

Totals, . . ' .

193
3
4
7
1
1

209

190
1

2
4

198

16 LUNATIC HOSPITAL AT WORCESTER. [Oct.

The number of State patients remaining at the close of the
fiscal year ending Sept. 30, 1866, was 129, since which there
has been a yearly reduction until but 25 remained Sept. 30,
1872. During the past year, however, there has been an
increase in the number of this class of patients.

The following table gives the classification in reference to
the support of; the number remaining : —

Table No. 5.

State patients,
Town patients,
Private patients,
Totals,

48
244
177

469

Table; No. 6. — Shoiving the Causes of Insanity as ivell as
could be ascertained, in the number of cases admitted dur-
ing the year 1873.

Number

df Cases.

Number Predisposed.

CAUSES.

Males.

Females.

Males.

Females.

Hereditary,

21

34

21

34

Periodical,

18

11

18

11

Paralysis,

3

1

1

-

Epilepsy, . .

8

2

1

-

Neurasthenia, .

-

6

-

-

Fever, . .

4

1

-

-

Uterine disease,

-

8

-

2

Puerperal,

-

10

-

2

Excessive lactation,

-

1

-

-

Turn of life, .

-

8

-

2

Masturbation,

14

2

5

-

1873.] PUBLIC DOCUMENT— No. 23.

Table No. 6 — Concluded.

17

Number

3P Cases.

Number Predisposed.

CAUSES.

Males.

Females.

Males.

Females.

Intemperance,

38

6

6

-

Use of tobacco,

1

-

1

-

Domestic trouble, .

3

19

1

5

Disappointed affection,

3

-

-

-

Pecuniary trouble, .

3

-

-

-

Spiritualism, .

-

2

-

-

Religious excitement,

4

11

-

2

Fright, .

1

1

-

-

Injury to head,

1

1

-

-

Incidental injuries, .

5

1

1

1

Disease of brain,

3

2

3

1

Old age, .

1

3

-

-

Opium eating,

-

1

-

1

Excessive venery, .

1

-

-

-

Sunstroke,

5

-

1

-

111 health,

11

5

4

3

Overwork,

4

6

2

3

Hard study, .

2

-

-

-

Mental excitement,

3

3

-

-

Lead poisoning,

1

-

1

-

Debility, . .

-

3

-

2

Homesickness,

-

2

-

-

Unascertained,

50

48

-

-

Not insane,

1

-

-

-

Totals, .

209

198

66

69

The foregoing table gives the alleged causes of insanity in

the cases admitted.

3

18 LUNATIC HOSPITAL AT WORCESTER. [Oct.

Tables of this character are very unsatisfactory. The
friends of patients from whom the statement of causes
usually comes, sometimes, purposely practice deception and
often display great ignorance by assigning as a cause, some
comparatively trivial circumstance attendant upon the begin-
ning of insanity or some symptom of the already fixed malady.

It is often very difficult, even impossible, to assign the
cause of mental derangement. Insanity is often the result of
a concatenation of causes. A child inherits a nervous organ-
ization prone to departure from the normal state. Judicious
training and cultivation might develop a strong mind and a
well balanced character. Subjected, however, from . his
earliest infancy to injudicious training and unfavorable sur-
roundings ; never learning, either from precept or example
the paramount importance of self-control, he reaches manhood
with his physical, mental and moral powers in an unhealthy
and unstable state, — the sport of conceit and prejudice, — the
victim of passion and appetite. As a legitimate result of
such conditions, reason becomes dethroned, — too often, alas,
never to be restored.

In the case entered " not insane " the man was found to be
affected with typhoid fever. He is now nearly well.

Table No. 7. — Showing the Ages of Patients Admitted, Dis-
charged Recovered, not Recovered, and Died during Year.

AGE S.

AD5IITTED.

Discharged Re-
covered.

Discharged not
Recovered.

Died.

Males.

Females.

Males.

Females.

Males.

Females.

Males.

Females.

Less than 15,

3

1

From 15 to 20,

11

7

3

2

8

5

-

-

20 to 30,

55

35

14

10

35

17

6

1

30 to 40,

54

45

11

13

28

22

5

6

1 40 to 50,-

39

52

11

12

22

29

5

7

50 to 60,

21

40

4

7

12

15

4

7

60 to 70,

19

13

5

5

6

6

8

4

70 to 80,

6

6

1

-

-

2

6

4

80 to 90,

1

-

-

-

1

-

2

'3

Over 90,

-

-

-

-

-

-

-

1

Unknown,

-

-

-

-

-

1

-

-

Totals, .

209

198

49

49

113

97

36

33

1873.]

PUBLIC DOCUMENT— No. 23.

19

Table No. 8. — Showing the duration of Insanity before
Admission of Patients Admitted, Discharged Recovered,
not Recovered, and Died during the Year.

Admitted.

Discharged Re-
covered.

Discharged not
Recovered.

Died.

DURATION OF INSANITY.

"3
3

a

■3

"3

a

0

OS

a

"3

a

ft

Insane one year or less,

106

111

37

43

55

44

17

17

More than 1 year and
less than 2 years,

8

7

1

1

4

3

2

1

More than 2 years aud
less than 5 years,

28

28

2

-

14

17

8

6

More than 5 years and
less than 10 years, .

15

17

3

1

7

11

2

4

More than 10 years and
less than 15' years, .

6

5

-

-

3

1

3

1

More than 15 years and
less than 20 years, .

6

4

-

-

4

1

1

-

More than 20 years and
less than 25 years, .

3

1

-

-

2

2

-

-

More than 25 years and
less than 30 years, .

2

1

-

-

2

1

-

1

Thirty years or more, .

5

5

-

1

1

9

1

1

Unknown, .

30
209

19
198

6

3

21

15

2
36

2

Totals,

49

49

113

97

33

The case reported as recovered after having been insane
thirty years is that of a woman who had been addicted to
opium-eating during that period. At the time of her admis-
sion she was taking very large quantities of opium, which
had produced very serious physical and mental derangement.
She had been bed-ridden for months, and was very suicidal.
After the first few days at the hospital she took no opium.
When discharged she was in pretty good physical health, able
to walk and to care for herself, and with her mind entirely

20

LUNATIC HOSPITAL AT WORCESTER. [Oct.

clear. It seemed proper that she should fairly be classed as
recovered, although, of course, no one would doubt a repe-
tition of the symptoms if she again became addicted to taking
opium.

Table No. 9. — Showing the Civil Condition of Patients
Admitted, Discharged Recovered, not Recovered, and Died
during the Year.

CIVIL CONDI-

Admitted.

Discharged Re-
covered.

Discharged not
Recovered.

Died.

TION.

Males.

Females.

Males.

Females.

Males.

Females.

Males.

Females.

Unmarried, .
Married,
Widowers, .
Widows,
Unknown,

106
88
13

2

67
96

34
1

20

26

3

16

25

8

71

38

3

1

38
43

15
1

8

23
5

5

17

11

Totals, .

209

198

49

49

113

97

36

33

1873.]

PUBLIC DOCUMENT— No. 23.

21

Table No. 10. — Showing the Occupation of Patients Ad-
mitted during the Year.

MALES.

Agents, .

2

Baker,

1

Blacksmiths, .

4

Butchers, .

2

Book-keepers, .
Barber, .

2
1

Clergyman,
Carpenters,
Cabinet-makers,

1
5
3

Cooper, .
Clerks,

1
11

Curriers, .

2

Coppersmiths, .
Dentists, .

2
2

Engineer,

1

Farmers, .

14

Glass-blower, .

1

Grocers, .

5

Harness-makers,

2

Junk dealer, .

1

Laborers,

32

Manufacturer, .

1

Merchants.

5

Mason,

1

Machinists,

Moulders,

Mechanics,

Mariners,

Operatives in

Painters, .

Physicians,

Milkman,

Polisher, .

Postmaster,

Shoemakers,

Stone-cutter,

Saloon keepers

Store keepers,

Salesmen,

Silversmiths,

Surveyor,

Tailor, .

Teachers,

Teamsters,

No occupation

Unknown,

Total,

mills,

10
3
3

4
9
3
4
1
1
1

24
1
2
2
3
2
1
1
2
4

20
6

209

FEMALES.

Agent,

1

Seamstresses, .

8

Housekeepers, .

. 103

Teachers,

2

Domestics,

. 41

Type-setter,

1

Music teacher,

1

No occupation,

. 21

Nurses, .

3

Operatives in mills,

. 16

Total,

. 198

Saleswoman, .

1

22

LUNATIC HOSPITAL AT WORCESTER. [Oct.

Table No. 11

-Showing the Diseases which have proved
fatal during the Year.

DISEASES.

Males.

Females.

Total.

Apoplexy,
Bright's disease, .

.[

1

2

1

3
1

Cancer of liver,

-

1

1

Congestion of lungs,

1

1

2

Disease of the heart,

2

1

3

Dropsy, ....
Dysentery, . , .
Epilepsy.
Exhaustion of acute ma

nia,

3
1

2

2

3

5

2
3

4

7

Exhaustion of acute mania, with dysentery,

1

-

1

Exhaustion of chronic mania,

2

1

3

Exhaustion of chronic mania,with dysentery,

-

1

1

Exhaustion of chronic mania, with amp utat'n,

-

1

1

Exhaustion of chronic melancholia,

-

1

1

Exhaustion of acute melancholia,

1

2

3

General paralysis, .....
General paralysis, with dysentery,
Old age, ....

5
1
1

2

5
1
3

Phthisis,

.

1

1

2

Phlebitis,

.

1

-

I

Pneumonia,

.

2

-

2

Paralysis,

.

8

7

15

Suicide, .

.

1

1

2

Septicaemia,
Typhomania,

.

1

1

-

1
1

Totals,

36

33

69

The number of deaths during the year exceeds the number
in any previous year, but does not constitute so large a per
cent, of the average number of residents as was the case in
1870.

About one-fourth of the cases which died, were admitted
during the year or near the close of the previous year, in
such a condition of organic disease, that it was obvious from
the first, that all we could do for them, was simply to nurse
them during the few days or weeks they had to live.

One woman was moribund when admitted, and her friends
who were intending to return by a railroad train which left
about half an hour after their arrival, were astounded when
informed of her condition and requested to remain. She lived
about four and one-half hours.

1873.]

PUBLIC DOCUMENT— No. 23.

23

Had it by any possibility happened that this patient's
friends had left the eity, as they intended, before it was appar-
ent that she was so ill, and her death occurred within a few
hours thereafter, it would in all probability have been a fruit-
less task to attempt to dissuade them from the belief that the
hospital management was blameworthy.

Of those who died, sixteen were over seventy years of age,
and twelve between sixty and seventy.

During August and September a number of cases of dysen-
tery occurred, and altogether six patients died who were
affected with it. Of these, one was a case of general paral-
ysis, and two were cases of maniacal exhaustion, with dysen-
tery. Of the remaining three, two had not the stamina to
withstand an attack of any acute disease.

The case of mania, with amputation, was that of a woman
who had been insane twenty-three years, and bed-ridden
several years, in which the femur was found to have been
fractured without any known cause. The condition of the
limb became such, that upon consultation, it was deemed best
to amputate, when it was shown that the fracture was origi-
nally dependent upon disease of the bone.

Table No. 12. — iShoioing the Admissions from each County
during the Year.

COUNTIES.

Males.

Females.

Totals.

Bristol, .

2

-

2

Essex,

29

33

62

Hampden,

1

1

2

Middlesex,

78

82

160

Norfolk, .

6

5

ii :

Suffolk, .

18

13

31

Worcester,

75

63

138

Franklin,

-

1

1

Totals, .

209

198

407

24

LUNATIC HOSPITAL AT WOKCESTER. [Oct.

Table No. 13. — Showing the Whole Number of Patients
during each year, the Average Number, the Number at the
end of each year, the Expense of each year, the Annual
Expense for each Patient, and the Expense of each Patient
per week for each of the Forty-one Years the Hospital has
been in operation.

Number at

Current Expen-

Annual Ex-

Expense per

YEARS.

Whole

Average

end of

ses of each

pense for each

week for

Number.

Number.

each year.

year.

Patient.

each Patient.

1833,

153

107

114

$12,272 91

$114 67

$2 25

1834,

233

117

118

15,840 97

136 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 62

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

86,980 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

408

75,715 51

191 20

3 68

1871,

879

439

421

96,455 69

219 27

4 22

1872,

864

450

439

92,533 93

205 63

3 95

1873,

846

453

469

96,196 83

210 14

4 04

1873.] PUBLIC DOCUMENT— No. 23. 25

The foregoing table shows the expense for each patient per
week to have been $4.04, which is very near the average for
the last nine years. The rate per week as given in this table
differs somewhat from that given in the return to the Board of
State Charities ($4.25), on account of the different methods
by which they are computed.

The Treasurer's report to the Trustees does not, in making
up the current expenses, include some items furnished patients
for which the hospital is to be reimbursed, neither does it
include increase or decrease in personal property or "funds."
Indeed, it hardly seems proper to include increase of " funds"
from legacies, which are not applied to the ordinary expenses
of the institution in estimating the cost of carrying on the
hospital. If, for instance, the hospital should be so fortunate
as to receive a legacy of one hundred thousand dollars, it
would appear, by this mode of computation, that it cost noth-
ing to carry on the hospital during the year in which the gift
was received.

We have, however, in this table a comparative exhibit of
the financial condition of the hospital during a series of years,
while the form adopted by the Board of State Charities is
convenient for comparing the results at the different institu-
tions.

Since the last annual report was submitted, the plans for
the new hospital buildings have been approved by the Gov-
ernor and Council, as required by the Resolves of 1872.

The action of the legislature authorizing the erection of the
new hospital buildings, limited the number of inmates, for
which accommodation was to be provided to four hundred.
There are, however, nearly five hundred now in the hospital,
and the pressure upon us for an increase of that number is
very great. Even the additional accommodations soon to be
provided in other parts of the State will be inadequate to the
demands that will have arisen before they are completed. In
view of these considerations, the plans as approved by the
Governor and Council were so arranged as to admit of exten-
sions, that will give, altogether, accommodations for five hun-
dred inmates ; the whole to constitute an harmonious and
complete scheme of classification. It is respectfully suggested

26 LUNATIC HOSPITAL AT WORCESTER. [Oct.

that it will be expedient to ask the legislature to confer upon
the Trustees the requisite authority to carry out the design.

It is gratifying to know that the plans for the new buildings
have received the endorsement of some or the most experi-
enced superintendents of institutions for the insane in the
country.

The selection of the particular location or site upon which
the new edifice should be erected was a somewhat difficult
problem, and received very careful attention. The advice of
several gentlemen of experience in such matters was asked,
and the conclusion which they reached was unanimous. Pro-
posals for the grading, excavations; and foundations, were re-
ceived, and the contract for the same completed in May, at
advantageous prices. The work has been prosecuted with a
reasonable degree of vigor, and nearly one-fourth of the foun-
dation will have been laid before the advent of frost, and work
will be resumed early in the spring.

Stone of a quality suitable for foundations, is found on the
hospital property near the site of the buildings, and a quarry
has been opened. The use of this stone will materially
lessen the cost of the work.

To the many kind friends who have contributed to the
pleasure of our unfortunate inmates, by presents of flowers,
plants, books, papers, etc., and to those who have given
dramatic entertainments, readings, concerts, exhibitions, etc.,
we owe a debt of gratitude. Not only do such entertainments
afford amusement, but they exert a beneficial and often cura-
tive influence by affording subjects for thought and conversa-
tion, and helping to break the monotony of hospital life.
The providing such diversions is a necessity in any well
ordered hospital for the insane, and all assistance in the work
is thankfully received and thoroughly appreciated.

We are also greatly indebted to the several clergymen of
the city, who have, during the past year, kindly consented to
alternately conduct religious services on the Sabbath, and also
to the choir who assist so acceptably.

This arrangement has given very great satisfaction, and we
hope to be able to continue it.

To each and all connected with the hospital, officers or

1873.] PUBLIC DOCUMENT— No. 23. 27

employes, who have conscientiously and earnestly endeavored
to aid in carrying on the work, I beg to express my acknowl-
edgment of their labors.

Allow me, gentlemen, in closing, to return my sincere
thanks for the kindness and consideration shown me, and for
the deep interest and hearty cooperation you have taken in
the daily labors of the hospital and in the endeavors to make
it worthy the confidence of its patrons.

B. D. EASTMAN,

Superintendent.

Worcester Lunatic Hospital, Worcester, Mass., October 15, 1873.

^25^*^