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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. 

FORTY-SECOND ANNUAL REPORT 

OF 

THE TRUSTEES 

OF THE 

STATE LUNATIC HOSPITAL 

AT 

WO H C E S TE R. 



October, 18 74 



BOSTON: 

WRIGHT & POTTER, STATE PRINTERS, 

79 Milk Street (corner of Federal). 

1875. 



OFFICEES OF THE HOSPITAL. 



TRUSTEES. 

Gen. WILLIAM S. LINCOLN, Worcester. 

Hon. HENEY CHAPLN, Worcester. 

Col. JOHN D. WASHBUEN, Worcester. 

Prof. JAMES B. THAYEE, Cambridge. 

EOBEET W. HOOPEE, M. D., 



Superintendent, . 
Assistant Superintendent, 
Assistant Physician, . 
Assistant Physician, . 
Steivard (Acting), 



RESIDENT OFFICERS. 

BABNAED D. EASTMAN, M. D. 
JOHN G. PAEK, M. D. 
MAEY H. STINSON, M. D. 
H. M. QULNBY, M. D. 
E. C. POLLAED. 



TREASURER. 



ALBEET WOOD, 



Worcester. 



CommontDealtt) of itla£0ad)nsctt0- 



TRUSTEES' REPORT, 



To His Excellency the Governor, and the Honorable Council 
of the Commonwealth. 

The Trustees of the Worcester Lunatic Hospital respect- 
fully submit their Forty-Second Annual Eeport. 

It will be seen by the report of the Superintendent, which 
is herewith forwarded, that the number of persons admitted 
to the institution during the year, was 380. The number at 
its commencement was 469, and there are now remaining 
485. The death-rate has been unusually great, seventy-five 
patients having deceased within the same period. Many of 
these were of advanced age, long afflicted with disease ; some 
were feeble and in a low condition at the date of admission 
to the hospital, of whom twenty-three died within a period of 
twenty daj^s subsequent to the date of their admission. 

The finances of the hospital, as shown by the accompany- 
ing report of the Treasurer, are in a sound condition ; the 
balance of cash, with supplies on hand, being $33,211.57, 
including special bequests. 

Satisfactory progress has been made in the work of build- 
ing the new hospital. The walls of one wiug will be covered 
by the close of the season. The excavations and foundations 
for the remaining portions of the building are being carried 
forward with a reasonable degree of energy. An additional 
appropriation will be necessary, if the work is to be prose- 
cuted with proper despatch the coming season. Referring to 
the duty imposed upon the Trustees by the legislature of the 



6 LUNATIC HOSPITAL AT WORCESTER. [,Oct. 

past winter, of making suitable provision in the new hospital 
for the care and custody of such homicidal insane as shall be 
committed to it, the board cannot too strongly urge the im- 
portance of being allowed to erect the building upon the plan 
heretofore recommended to the approval of your honorable 
body. 

No considerable quantity of the land of the old hospital 
has been sold during the year. Up to September 30, 1873, 
the Commonwealth had received from this source, on account 
of sales and interest, $58,488.56. During the current year, 
$4,408.82 has been added to this sum. An additional sale 
has been made, and the net proceeds, amounting to about 
$5,000, will soon be paid over to the Treasurer. The 
Trustees have employed, to aid them in effecting sales of the 
land, agents of acknowledged energy and judgment, but the 
general stagnation of business during the past year has put a 
stop to new enterprises, and under its influence there has 
been almost no demand for land for improvement. With a 
revival of business, the Trustees anticipate a more active 
demand at satisfactory prices. 

Several changes have been made during the year in the 
staff of the institution. Dr. Albert Wood has been appointed 
Treasurer, succeeding Col. J. D. Washburn, one of our 
number, who had temporarily filled that office. Mr. Wilder 
resigned his position as Steward, and Mr. E. C. Pollard is at 
present acting in that capacity. 

To the skill and fidelity of the Superintendent and his 
subordinate officers, the Trustees desire to bear testimony. 

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

Worcester, Oct. 16, 1874. 



1874.] PUBLIC DOCUMENT— No. 23. 



TREASUEEB'S REPORT. 



To the Trustees of the Worcester Lunatic Hospital. 

Gentlemen : — I herewith submit my Annual Report on 
the finances of the Worcester Lunatic Hospital, for the year 
ending September 30, 1874. 

Receipts. 
Cash on hand September 30, 1873, . . . $11,478 13 

received of the Commonwealth for sup- 
port of patients, .... 10,241 80 

received of cities and towns for support 

of patients, 50,580 17 

received of individuals for support of 

patients, .... . 49,298 35 

received for interest and sale of produce, 

etc., 3,578 99 



$125,177 44 



The expenditures for the year have been as follows : — 
Provisions : 
Flour, 819 barrels, at $8.38| per 

barrel, . . . ." . $6,867 98 
Meat of all kinds, . . . 10,788 57 
Meal for cooking, . . . 1,236 32 
Beans, potatoes and other vege- 
tables 1,121 70 

Fish, 1,780 56 

Sugar, . . . . . 3,091 89 



Amount carried forward, .$24,887 02 



LUNATIC HOSPITAL AT WORCESTER, [Oct. 



Amount brought forward 


. $24,887 02 


Molasses and syrup, 


757 75 


Tea, . . " . 




. 1,256 96 


Coffee and chocolate, 




. 1,376 71 


Rice and crackers, 




588 14 


Butter, 




. 6,328 33 


Vinegar and pickles, 




147 87 


Cheese, 




185 08 


Fresh fruits, 




276 98 


Eggs, salt and other groceries 


3, . 2,229 14 


Total for provisions 


3, 


. $38,033 98 



Salaries and wages, 

Provender and bedding for stock, 

Furniture, crockery, bedding, etc 

Light, 

Soap, ..... 

Medical supplies, . 

Live stock, .... 

Carriages, harness, blacksniithing, etc. 

Improvements and repairs, 

Books, stationery and printing, 

Travelling and transportation, 

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, 1874, 



34,363 


40 


1,044 


91 


3,663 


72 


2,142 


91 


1,021 


00 


1,035 


53 


1,780 00 


1,869 


69 


1,716 


61 


1,191 


75 


234 


87 


9,400 


28 


483 


95 


443 


29 


251 


03 


2,786 


76 


. $101,463 68 


6,070 36 


1,026 


25 


638 


86 


647 


90 


. $109,847 05 


15,330 39 



$125,177 44 • 



1874.] 



PUBLIC DOCUMENT— No. 23. 



Eesources 
Cash on hand, 
Due from the Comonwealth, . 

from cities and towns, 

from individuals, . 



$15,330 39 

4,514 75 

11,773 93 

12,521 31 

$44,140 38 



Liabilities. 

Due for supplies and expenses, . $6,848 24 
for salaries and wages, . . 8,774 65 



Invested funds, market value 
Total surplus, 



15,622 89 



$28,517 49 
4,694 08 



. $33,211 57 
ALBERT WOOD, Treasurer. 



Worcester Lunatic Hospital, 
Oct. 1, 1874. 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



New Hospital Account. 

The total amount expended on account of the 
New Hospital Buildings and Grounds at the 
close of the hospital fiscal year, Sept. 30, 
1873. (corrected from report of 1873), was $138,403 01 

The expenditures during the fiscal year ending 

Sept. 30, 1874, was . . . . . 194,828 91 



Total, .... 


• 




$333,231 92 


This expenditure is classified for 








convenience, as follows : — 








Land, ..... 


$112,247 


71 




Erecting barns and repairs on cot- 






, 


tages, . .... 


18,873 


74 




Grading, excavating, etc., . 


44,113 


84 




Laying out and selling old land, 








including building streets, 


3,238 


29 




Foundations, .... 


13,509 


32 




Superstructure of stone and brick, 


94,110 


82 




Carpenter work of superstruc- 








ture, including roofing, . 


26,099 


25 




Water-pipe, drainage, etc., 


7,502 


93 




Heating and ventilating, 


1,436 


11 




Engineers, architects, overseers, 








etc., ..... 


6,784 


33 




Roads and grading pertaining 








thereto, .... 


3,819 


04 




Miscellaneous, .... 


1,496 


54 


$333,231 92 



The amount charged to " laying out and selling old land, 
including building streets," is not properly a part of the cost 
of the New Hospital, but it appears in the account from the 
following reasons :-r— 

In accordance with an Act of the legislature, the governor 
and council ordered that $25,000 be credited to the fund for 



1874.] PUBLIC DOCUMENT— No. 23. 11 

constructing the New Hospital, as compensation for the site 
occupied by the Normal School, which amount was to include 
the construction of " suitable streets to and around the said 
land." The $25,000 having all been credited to this fund, the 
expense of laying out and constructing streets must obviously 
be charged % to the same fund, leaving a balance of $21,761.71 
to be applied to the erection of the new buildings. 

The amount realized for sales of lands and in- 
terest to Sept. 30, 1873, as by statement of 
the Treasurer of the Commonwealth, was . $58,488 56 

Amount added from sales and interest during 

year ending Sept. 30, 1874, . . . 4,408 82 

Amount realized on sales made in September, 
but not passed into the Treasurer's hands 
during that month, ' 5,000 00 



Total sales, $67,897 38 

A note of twenty-five hundred dollars, given by the Trus- 
tees to Sarah Phillips for land purchased of John Bartlett, is 
still outstanding, owing to a temporary legal disability on the 
part of the holder to receive the payment. 



12 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



SUPEBISTTENDESTT'S BEPORT. 



To the Board of Trustees of the Worcester Lunatic Hospital : 

Gentlemen: — The Forty-Second 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 : — 



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





Males. 


Females. 


Totals. 


Patients in the hospital Oct. 1, 1873, 




208 


261 


469 


Admitted during the year, 




202 


198 


400 


Whole number under treatment, . 




410 


459 


869 


Discharged recovered, . 




42 


29 


71 


improved, . 




67 


70 


137 


not improved, 




51 


50 


101 


Died, ...... 




37 


38 


75 


Whole number discharged, . 




197 


187 


384 


Remaining Sept. 30, 1874, 




213 


272 


485 


Largest number on any day, Aug. 1, 1874, . 


223 


276 


499 


Smallest number on any day, Nov. 5, 1873, . 


203 


250^1 


453 


12, 1873, . 


208 


245 J 


Daily average number during the year, 


212.5 


263.6 


476.1 


of state patients, 


26.7 


36.1 


62.8 


of town patients, 


114.5 


130.7 


245.2 


of private patients, . 


71.3 


96.8 


168.1 



1874.] PUBLIC DOCUMENT— No. 23. 13 

The number of patients in the house at the beginning of the 
year was thirty more than at the beginning of the previous 
year. 

The admissions during the year were seven less, and the 
discharges, including deaths, seven more, than during the 
previous year, leaving, at the close, an increase of sixteen. 

Four patients, originally admitted upon 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 
collected either from the State or the towns legally liable for 
their support, the bonds proving worthless. 

The number of patients actually received at the hospital 
was, therefore, three hundred and ninety-six. Fourteen per- 
sons were received, each twice, and one person thrice, during 
the year; therefore, the number of persons received during 
the year was three hundred and eighty. 

AH applications for admission from without the State have 
been refused. 

The number discharged as recovered, is a smaller per cent, 
of the whole number discharged than has usually been reported 
from the institution. A large number of patients have been 
transferred to other state institutions, or discharged to the 
care of their friends or to town authorities, who could only 
be classed as improved or unimproved. Of the improved, 
many, doubtless, might, by a sufficient stretch of the imagina- 
tion, have been classed as recovered. To me, however, it 
seems proper to class as recovered only those who appear to 
have been restored to their own normal condition. 

Many of those discharged improved, seemed on a fair road 
to recovery, and, in some cases, it is known that the recovery 
was completed after the patient left the hospital. The degree 
of success of an institution for the insane is not to be measured 
by the tabulated recoveries alone, but it should receive credit 
for the benefits that accrue to many a benighted mind that 
cannot sustain itself among the troubles and trials incident to 
ordinary life, as well as for the safety its custodial function 
insures to society. 



14 LUNATIC HOSPITAL AT WOECESTEE. [Oct. 



Table No. 2. — Showing the complications in the cases admitted 
during the year. 



Epileptic, 

Epileptic and homicidal, 
Epileptic and suicidal, 
Paralytic, . 
Paralytic and homicidal, 
Paralytic, homicidal and suicidal, 

Suicidal, 

Homicidal, ..... 
Suicidal and homicidal, 
Total number of cases epileptic, 
Total number of cases paralytic, 
Total number of cases suicidal, . 
Total number of cases homicidal, 



1874.] 



PUBLIC DOCUMENT— No.. 23. 



Table No. 3. — Showing the relations of the patients admitted to 
institutions of this kind. 





Males. 


Females. 


Totals. 


Never before in any hospital, 


121 


147 


268 


Former inmates of this hospital, . 


52 


35 


87 


of other hospitals in this 
State, .... 


10 


4 


14 


of hospitals in other States, 


5 


3 


8 


of this hospital and of other 
hospitals in this State, 


7 


6 


13 


of this hospital and of hos- 
pitals in other States, 


1 


2 


3 


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


3 


. 


3 


of this hospital, of other hos- 
pitals in this State, and of 
hospitals in other States, . 


1 


_ 


1 


of hospitals of other coun- 
tries, 


2 


1 


3 


Totals, 


202 


198 


400 



16 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 4. — , 



le sources from which the patients ad- 
mitted were directly drawn. 





Males. 


Females. 


Total. 


From the general population, 


187 


188 


375 


McLean Asylum for Insane, 


4 


2 


6 


Houses of Correction, . . . « . 


6 


4 


10 


State Prison, 


2 


- 


2 


State Almshouse, Tewksbury, . 


2 


1 


3 


Readmitted without discharge from hospital, 


1 


3 


4 


Totals, 


202 


198 


400 



Table No. 5. — Showing by whom the patients, remaining at the 
end of the year, are supported. 



By the State (state patients), 

Towns (town patients) , . 
Friends (private patients), 
Total 



82 
244 
159 



485 



1874.] 



PUBLIC DOCUMENT— No. 23. 



17 



Table No. 6. — Showing the alleged Causes of Insanity in the num- 
ber of cases admitted during the year. 









Number op Cases. 


Number Predisposed. 


CAUSES. 












Males. 


Females. 


Males. 


Females. 


Depression, 






2 


- 


1 


- 


Domestic Trouble, . 






3 


11 


- 


3 


Debility, . . . . 






1 


1 


1 


- 


Diabetes, 






1 


" 


1 


- 


Disappointed affection, 






1 


1 


" 


- 


Disease of brain, . 






2 


1 


- 


1 


Epilepsy, 






10 


3 


4 


1 


Excessive lactation, 






- 


2 


- 


1 


Excessive venery, . 




' • 


1 


- 


- 


- 


Embolism, 






- 


1 


- 


- 


Fever, 






4 


1 


2 


- 


Fright, . . . 






- 


1 


- 


1 


Grief, . 






- 


5 


- 


1 


General paralysis, . 






3 


1 


1 


- 


Hard study, . 






2 


1 


- 


- 


Hereditary, 






15 


23 


15 


23 


Intemperance, 






28 


9 


14 


3 


Injury to head, 






5 


- 


1 


- 


111 health, 






2 


12 


- 


5 


Masturbation, . 






10 


- 


7 


- 


Neurasthenia, . 






- 


4 


- 


- 


Old age, . 






3 


1 


- 


- 


Overwork, 






7 


3 


3 


1 


Periodical, 






11 


13 


11 


13 


Paralysis, 






3 


1 


1 


1 



18 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 6. — Concluc 









Number 


of Cases. 


Number Predisposed. 


CAUSES. 












Males. 


Females. 


Males. 


Females. 


Puerperal, 






- 


8 


- 


4 


Pecuniary trouble, . 






10 


- 


4 


" 


Religious excitement, 






8 


9 


3 


4 


Spiritualism, . 






1 


1 


1 


- 


Sunstroke, 






6 


1 


- 


- 


Syphilis, . . 






- 


1 


- 


- 


Turn of life, . 






- 


9 


- 


6 


Uterine disease, 






- 


5 


- 


2 


Use of tobacco, 






2 


- 


2 


-' 


Unascertained, 






61 


69 


- 


- 


Totals, . 


202 


198 


92 


70 



Table No. 7. — Showing the Ages of Patients Admitted, Discharged 
Recovered, not Recovered, and Died during the Tear. 



ages; 


Admitted. 


Discharged Re- 
covered. 


Discharged not 
Recovered. 


Died. 




Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Less than 15, 


1 




1 




2 








From 15 to 20, 


7 


5 


- 


_ 


4 


3 


1 


1 


20 to 30, 


40 


42 


6 


4 


31 


27 


2 


5 


30 to 40, 


61 


53 


13 


7 


38 


32 


10 


6 


40 to 50, 


42 


51 


13 


9 


19 


28 


A. 


9 


50 to 60, 


19 


25 


6 


6 


10 


18 


7 


8 


60 to 70, 


15 


16 


3 


2 


5 


9 


8 


4 


70 to 80, 


10 


3 


- 


1 


5 


3 


4 


4 


80 to 90, 


o 


2 


- 


- 


1 


2 


1 


1 


Unknown, 


4 


1 


- 


- 


1 


- 


- 


- 


Total, . 


202 


198 


42 


29 


116 


122 


37 


38 



1874.] 



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. 







Discharged Re- 


Discharged not 










covered. 


Reco 1 


fERED. 






DURATION OF INSANITY. 


S 


| 


1 


1 


"3 


■a 

1 


1 


"3 

a 


Insane one year or less, 


70 


95 


31 


21 


28 


37 


6 


17 


More than 1 year and 


















less than 2 years, 


29 


24 


2 


5 


15 


18 


4 


4 


More than 2 years and 


















less than 5 years, 


28 


29 


1 


2 


20 


24 


9 


8 


More than 5 years and 


















less than 10 years, . 


24 


19 


- 


- 


20 


21 


7 


2 


More than 10 years and 


















less than 15 years, . 


9 


6 


4 


- 


10 


9 


4 


3 


More than 15 years and 


















less than 20 years, . 


6 


4 


1 


- 


6 


3 


1 


2 


More than 20 years and 


















less than 25 years, . 


4 


6 


- 


1 


3 


3 


- 


- 


More than 25 years and 


















less than 30 years, . 


3 


4 


- 


- 


- 


- 


1 


2 


Thirty years or more, . 


5 


- 


- 


- 


3 


2 


5 


- 


Unknown, . 


24 
202 


11 

198 


3 


- 


13 


3 


- 


- 


Total, . 


42 


21 


118 


120 


37 


38 



20 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Six cases in the foregoiug table are reported as recovered 
after being insane five years or more. These were all period- 
ical cases and are to be considered as having recovered from 
the attack for. which they were sent to the hospital. On the 
papers by which they were admitted, the duration was 
reckoned from the beginning of the first attack. With these 
exceptions, all the recoveries occurred within two years of 
the beginning of the insanity. 

This is a strong argument in favor of the early treatment 
of the disease ; but we must not shut our eyes to the fact, 
that a large proportion of cases of insanity are incurable from 
the first. Nevertheless, as it cannot always, at the outset, 
be determined to which division a given case belongs, all in 
which there is even a chance for the benefit of a doubt, should 
be early subjected to proper treatment. 



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



CIVIL 


Admitted. 


Discharged Re- 
covered. 


Discharged not 
Recovered. 


Died. 


CONDITION. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


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


92 

94 

9 

7 


74 
84 

39 
1 


16 
23 

2 


8 
13 

9 


62 

49 

5 

3 


56 
45 

18 


16 

16 

5 


10 

18 

10 


Total, 


202 


198 


41 


30 


119 


119 


37 


38 



1874.] 



PUBLIC DOCUMENT— No/ 23. 



21 



Table No. 10. — Showing the Occupation of Patients admitted dur- 
ing the Tear. 



MALES. 



Agent, 1 


Machinists, . . . . 8 


Artists, . 








3 


Moulders, 






2 


Baker, 








1 


Mechanics, 






3 


Blacksmith, 








1 


Mariner, . 






1 


Broker, . 








1 


Milkman, 






1 


Butchers, . 








5 


Operatives in mills, 






13 


Book-keepers, 








4 


Organ-maker, . 






1 


Clergymen, 








3 


Painters, . 






6 


Carpenters, 








7 


Peddlers, . 




^ 


2 


Cabinet-maker 


5, 






3 


Physicians, 






2 


Cashier, . 








1 


Printers, . 






3 


Clerks, . 








8 


Shoemakers, . 






10 


Currier, . 








1 


Stone-cutter, . 






1 


Coppersmith, 








1 


Sail-maker, 






1 


Carver, . 








1 


Salesmen, 






9 


Contractor, 








1 


Stable-keeper, . 






1 


Detective, 








1 


Students, . 






4 


Farmers, . 








. 28 


Tailors, . 






2 


Fishermen, 








2 


Teachers, 






2 


Grocer, . 








1 


Watchman, 






1 


Laborers, . 








. 28 


No occupation, 






18 


Liquor dealers 








2 


Unknown, 






6 


Merchants, 








4 





Masons, . 








4 


Total, .... 202 



FEMALES. 



Dressmakers, . 


3 


Seamstresses, . 


8 


Domestics, 


. 47 


Teachers, . 


3 


Housekeepers, . 


. 80 


No occupation, 


. 33 


Nurse, .... 


1 


Unknown, 


1 


Operatives in mills, 


. 21 







Student, .... 


1 


Total, 


. 198 



22 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 11. — Showing the Diseases which have proved fatal 
during the Year. 



DISEASES. 



Acute mania, .... 
Acute mania with laryngitis, . 
Acute melancholia, 
Aneurism of aorta, 
Apoplexy, .... 
Congestion of lungs, 
Diabetes, 

Delirium tremens, . 
Epilepsy, . . . . 

Erysipelas, .... 
Embolism from erysipelas, . 
Exhaustion of chronic insanity, 
Exhaustion of chronic insanity w 

tery, 

Gastritis, 

General paralysis, . 
Heart disease, 
Ovarian tumor, 
Paralysis, .... 
Pneumonia, .... 
Phthisis, ..... 
Senile bronchitis, . 
Self-inflicted injury, 
Softening of brain, . 
Tubercular peritonitis, . 



ith dysen 



Total, 



37 



38 



75 



The number of deaths exceeds the number in any previous 
year, and is a larger per cent, of the average population. 
This large mortality is not due to the prevalence of any ep- 
idemic, nor can it be attributed to defects in the general san- 
itary condition of the hospital. It is principally owing to the 
hopelessly diseased condition of many of the patients on 
admission. 

Forty-six of those who died were admitted either within the 
year or near the close of the preceding year. Of these there 
were not more than ten, of whom there was, at the time of 
their admission, any reason to hope that they would survive 
more than a few days or weeks, and several ought not to 
have been brought to the hospital. One was moribund when 
admitted, and died the next day, and in all, twenty-three 



1874.] 



"PUBLIC DOCUMENT— No. 23. 



23 



died within twenty days after their admission. Five of the 
number were old residents, having been in the institution 
from fifteen to thirty-one years. 

Twelve deaths are ascribed to the exhaustion of chronic 
insanity, and three, to the same cause, with dysentery, no 
attempt having been made to classify their insanity under 
special heads. 

The case of gastritis was the result of corrosive poison 
taken with suicidal intent before admission. 



Table No. 1 2. — Showing the Admissions from each County during 
the Tear. 



COUNTIES. 


Males. 


Females. 


Total. 


Bristol, . 














1 


- 


1 


Berkshire, 














1 


- 


1 


Essex, 














30 


30 


60 


Hampden, 














1 


1 


2 


Middlesex, 














85 


67 


152 


Norfolk, . 
Plymouth, 














4 


4 
2 


8 
2 


Suffolk, . 
Worcester, 














18 
62 


23 
71 


41 
133 


Totals, 


202 


198 


400 



24 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 13. — Shoiving 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-two, Years the Hospital has been in operation. 



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 


86,930 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 


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 


95,196 83 


210 14 


4 04 


1874, 






869 


476 


485 


101,463 68 


213 16 


4 10 



1874.] PUBLIC DOCUMENT— No. 23. 25 

The expense per week for each patient, as shown in the 
foregoing table, is not materially higher than it was during 
the previous year, although some substantial improvements 
in the general diet of the house have been made. In fact, if, 
from the "total current expenses," there be subtracted the 
excess of value of general supplies now on hand over the 
amount on hand one year ago, it would be shown that the ex- 
pense per week per patient was really a trifle less than last 
year. 

Your attention. is again respectfully called to the fact that 
additional legislation is needed to enable you to satisfactorily 
complete the building already begun. 

The last legislature passed an Act (Acts of 1874, ch. 370), 
as follows : — 

Be it enacted &c, as follows: 

Sect. 1. The commissioners having in charge the construction 
of the state prison at Concord shall make provision- therein for 
insane criminals. 

Sect. 2. The "commissioners having in charge the construction 
of the lunatic asylums at Worcester and at Danvers shall make 
provision therein for the safe custody and treatment of the homicidal 
insane not included in the first section of this act. 

Sect. 3 This act shall take effect upon its passage. [Approved 
26, 1874. 



\ 

\ 



This Act settles the question so long and so urgently brought 
before successive committees on public charitable institutions, 
as to what shall be done with the insane criminals or, properly, 
insane convicts, for which we should be truly thankful. It 
throws upon your institution the burden of making especial 
provision for the homicidal insane. That portion of the orig- 
inal plan for the construction of which provision is yet to be 
made, is that in which the class of homicidal insane would 
naturally be placed. In working out the original plan, suit- 
able accommodations for this class can be provided. 

With the progress of the new building you yourselves are 
sufficiently familiar. For the benefit of the general reader, 
however, it may be well to submit a brief statement. 

Since the last report was made, the minutiae of the details of 

4 



26 LUNATIC HOSPITAL AT WORCESTER, [Oct. 

the structure have been perfected, contracts made, and one 
wing, that is, the wards for one sex, will be under roof this 
fall. 

The main body of the work is of stone from the hospital 
quarry, the plinth, water-table, sills and caps, corbels, angle 
quoins etc., of New Hampshire granite ; the whole relieved by 
the use of brick about the doors, windows, gables, and cor- 
nices. This gives warmth and tone to the design, and will, it 
is thought, when finished, have a very pleasing effect. 

The main work of grading is finished. Considerable ex- 
cavating to bring the surface to proper slopes and levels 
around the building, still remains to be done. As the work 
progresses, and the original design of this portion of the plan 
nears completion, its success begins to be apparent to the eye, 
although only the coarser work has yet been attempted. 

During last fall and winter, a substantial, well drained 
stone and gravel road was built from Shrewsbury Street to 
near the new building. This will be the principal avenue of 
approach "when the building is occupied, and will require, 
before it is finally finished, some additional work, such as 
gutters, grading at sides, etc. 

An eight-inch water-main has been laid to the building from 
Bell Pond, and the hospital has the prospect of an abundant 
supply of good water. 

The farm and garden have yielded bountifully of their 
respective products. One of the most valuable products of 
the farm is milk. In a family so large as ours, with so many 
aged persons and invalids, milk becomes a very important 
commodity. No attempt has been made to keep an exact 
account of the number of gallons, but the supply has been 
kept well up to the demand. All the usual farm and garden 
vegetables have been supplied in liberal quantities. 

Our thanks are again due to those who have in different ways 
contributed to the happiness and well-being of our inmates, to 
those who have aided in the social and religious gatherings of 
our large family, as well as to those whose fidelity and. effi- 
ciency have rendered their services valuable. 

In conclusion, gentlemen, allow me to congratulate you that 
so large a measure of success has attended the administration 



1874.] PUBLIC DOCUMENT— No. 23. 27 

of the hospital affairs, and to express the hope that the year 
upon which we have just entered, may even more abundantly 
fulfil our mutual aspirations. 

B. D. EASTMAN, 
• Superintendent. 

Worcester, October 14, 1874. 



m*^*****