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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. 



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 





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^*^