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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-THIED AMUAL EEPOET 



THE TBUSTEES 



STATE LUNATIC HOSPITAL 



W^OROESTER. 



October, 1875. 



BOSTON: 

WRIGHT & POTTER, STATE PRINTERS, 

79 Milk Street (corner of Federal). 

1876. 



OFFICEKS OF THE HOSPITAL. 



trustees. 
Hon. HENKY CHAPIN, 
Col. JOHN D. WASHBUEN, 
Prof. JAMES B. THAYER, 
EGBERT W. HOOPER, M. D., 
Gen. WH^LIAM S. LINCOLN, 



Worcester. 

Worcester. 

Cambridge. 

Boston. 

Worcester. 



RESIDENT OFFICERS. 

Superintendent, BARNARD D. EASTMAN, M. D. 

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

Assistant Physician, HOSEA M. QUINBY, M. D. 

Steward, EDWARD C. POLLARD. 

TREASURER. 
ALBERT WOOD, Worcester. 



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€0mmontx)caItl) of i1:Ia05ad)U6ett0. 



TRUSTEES' REPORT. 



To His Excellency the Oovernor and the Honorable Council of the Com- 
monwealth. 

The office of a Trustee of the Worcester Lunatic Hospital, 
who succeeds in doing his duty, is no sinecure. He has the 
double duty of caring for the interests of the Old Hospital 
and its occupants, and acting as a sort of commissioner in the 
construction and arrangement of the New Hospital. The 
members of the Board for the past year have endeavored to 
perform their various duties faithfully, and they briefly submit 
the results of their management. 

It is sometimes a relief to feel that in the expenditure of 
large sums of money the office of a Trustee is without pecun- 
iary compensation, and admits of no perquisites. It presents 
a consoling and assured instance of freedom from temptation. 
It has been the intention and efibrt of the Board that the vic- 
tims of insanity committed to their care should have all the 
humane treatment which their unfortunate condition required, 
and that the interests of the Commonwealth necessarily in- 
volved in the large expenditures for the erection of the New 
Hospital should be carefully protected. 

The whole number of patients in the hospital during the 
past year has been ...... 847 

Number of private patients, . . . .226 
of state patients, .... 201 
of town patients, . . . . 420 



6 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Ill conducting the pecuniary affairs of the Old Hospital, 
the system of approving each bill before payment has been 
continued. All bills are submitted to the Auditor, who is a 
member of the Board. If he approves the bill, it is paid. 
In case he doubts or disapproves any bill, it is not paid with- 
out the approval of the Board. The finances of the hospital 
have generally been well managed, but it is thought that the 
system at present pursued, is more guarded and more effectu- 
ally protects the interests of the State, than any which was 
formerly adopted. It imposes much labor upon the Auditor, 
but the other members of the Board feel bound to say that 
this labor has been cheerfully and conscientiously performed. 

Early in the year, Miss Stinson, one of the Assistant 
Physicians, tendered her resignation, and it was accepted. 
Since her resignation, the immediate charge of the female 
department has been assumed by Dr. Park, the Assistant 
Superintendent. The relations of all connected with the 
management of the hospital are harmonious, and the year 
has been successful in carrying out the purpose for which the 
institution was established. Each one has seemed disposed 
to exemplify the generosity of the State, which has led it to 
do so much for the health and comfort of the insane. Insan- 
ity, in its lighest form, is a sad calamity. When reason is 
once dethroned, no one ought to be surprised at any act which 
may be the result of the misfortune. Courts of law rightly 
treat the insane as irresponsible for their acts, although the 
community is startled by accounts of tragedies which are the 
results of insane impulses for which no party is responsible 
except those who have in their hands the means of preven- 
tion. Filled, as a hospital of this kind is, with a homicidal, 
suicidal, depressed, paralytic and demented population, it 
often seems remarkable that its management is attended with 
a measure of success so satisfactory. 

Every year numerous persons who would, under other cir- 
cumstances, become the hopeless victims of one of the most 
fearful of diseases, are discharged from the hospital clothed 
and in their right mind ; and it is greatly to the credit of our 
State that she was one of the pioneers in America in the 
establishment of hospitals for the care and treatment of the 
insane members of her communit^^ 



1875.] PUBLIC DOCUMENT— No. 23. 7 

It is frequently one of the most trying features of insanity 
that the delusion exists in the mind of the patient that he is 
well, when, to those familiar with the subject, the delusion is 
so fearfully apparent. Friends of freedom and humanity, 
with kind hearts, good motives and mistaken views are often 
filled with needless anxiety in reference to this class of 
patients. This circumstance makes it specially incumbent 
upon those who have to do with the committal or detention of 
patients in the hospital to act with due care and considera- 
tion. The Trustees have endeavored to give such attention 
to their duties in this respect, that they can conscientiously 
assure those interested in the matter that no person has been 
allowed to remain in the hospital against his will an hour, 
unless, after the most careful consideration, the condition of 
the mind of the patient seemed to require it. 

A hospital which has been in operation forty-three years, 
and which was the first state institution of the kind established 
in New England, naturally has many chronic and incurable 
cases. From its location, this hospital has yearly a large 
number of new admissions. From the fact that persons are 
often disposed to keep their friends from hospital treatment 
longer than can justly be considered best, the health of many 
of this class of patients sometimes becomes so much impaired 
that the rate of mortality seems large. These facts may, in 
some years, make the death-rate here seem unusually large 
when compared with that in other hospitals, but an examina- 
tion and careful comparison through a number of years will 
show that the years in which the death-rate has seemed so 
are exceptional, largely dependent upon causes which operate 
at times in every hospital for the insane, and which in 
one year may show results apparently favoring the idea 
of the healthfulness of the patients in one hospital over 
those in another, and in another year show a result entirely 
difierent. 

The management of the hospital during the past year has 
been worthy of its past record, and the Trustees are happy to 
express their continued confidence in the Superintendent and 
those who have been connected with him in the immediate 
management of the afitiirs of the Old Hospital, and their 
appreciation of the care and fidelity with which their delicate 



8 LUNATIC HOSPITAL AT YfORCESTER. [Oct. 

and responsible duties have been performed. The finances of 
the Old Hospital, as shown by the report of the Treasurer, 
are in a satisfactory condition, and the balance of cash, 
including bequests, is $45,562.24. 

At the beginning of the year there was a greater number 
of patients than at the beginning of any year except 1853 
and 1854, being one hundred and twenty (120) more than 
could be conveniently accommodated. 

The current expenses of the Old Hospital during the year 
have been $100,680.39. Annual expense of each patient, 
$206.74. Weekly expense of each patient, $3.98. By refer- 
ence to the table of expenses, it will appear that the expenses 
have been slightly less than during the preceding year. 

The reports of the Superintendent and Treasurer, with the 
tabular statement which is made a part of this Report, show 
the facts so clearly, that the Trustees refer to them for all 
necessary and desirable information. 

New Hospital. 

The construction of the New Hospital buildings is pro- 
gressing speedily and satisfactorily. If the requisite appro- 
priations shall be made by the next legislature, the Trustees 
hope that the buildings will be completed and ready for occu- 
pation as soon as it was originally contemplated that they 
would be. Estimates of the sum necessary to be appro- 
priated will be seasonably presented. 

It is a cause of regret, that the depression which has 
attended nearly all kinds of business, here as well as else- 
where, during the past year, has had a marked effect upon 
the sales of real estate. For the time it has virtually done 
away with any demand for the Old Hospital lands, although 
they have been in charge of a most skilful and faithful agent 
for the purposes of sale. Were this result confined to the 
city of Worcester, we might be somewhat troubled to explain 
the fact, and fear that there is something peculiar to this 
locality in this state of things ; but every one knows that the 
panic, from whatever cause it originated, and from the effects 
of which we have not yet recovered, has not fully exhausted 
itself, but that the causes which produced that result remain, 
to dampen the hopes which once existed, and which will again 



1875.] PUBLIC DOCUMENT— No. 23. 9 

exist, in reference to tlie amount which will be realized from 
sales of the lands and buildings of the Old Hospital. Mean- 
time we cannot fail to congratulate the State upon the admir- 
able location of the New Hospital, with its beautiful surround- 
ings, and to express the hope that no policy will be adopted 
which will prevent the completion of the buildings according 
to the plan which was approved and adopted by the governor 
and council on the last day of the year 1872. 

The Trustees have endeavored faithfully and economically 
to carry out what they understood to be the views and wishes 
of the governor and council, to whom the plans were sub- 
mitted before any contracts were made for the buildings. The 
Trustees can have no other motive than the desire to do what 
they consider best for the State. They know of no contract- 
or who has made unreasonable profits. They believe that, 
generally, the work done and the material furnished have been 
according to the contracts, and they submit the enterprise in 
its present condition with confidence that the State has not 
only received the worth of its money, but that when the work 
shall be completed and the patients removed to their new 
quarters, every man who loves his State will feel an honest 
pride that we have provided for the poor and unfortunate vic- 
tims of one of the saddest diseases which afflict mankind in 
a manner which not only does credit to the humanity of the 
present age, but redounds to the honor and glory of the Com- 
monwealth of Massachusetts. 

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

WM. S. LINCOLN. 

"WoiiCESTER, OctolDer 16, 1875. 
2 



10 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



OFFICEKS AKD THELR SALARIES. 



B. D. Eastman, M. D. (Superintendent), . 
J. G. Park, M. D. (Assistant Superintendent), 
H. M. Quinby, M. D. (Assistant Physician), 
E. C. Pollard (Steward), .... 
Albert Wood (Treasurer), 



^2,500 00 

1,500 00 

1,000 00 

800 00 

500 00 



YALUE OF STOCK AND SUPPLIES, 

September 30, 1875. 



Live-stock, . $6,415 00 

Produce of farm on hand, . . . . . 5,861 75 

Carriages and agricultural implements, . . . 5,135 00 

Machinery and mechanical fixtures, .... 500 00 

Beds and bedding in inmates' department, . . 13,067 00 

Other furniture in inmates' department, . . . 10,360 90 
Personal property of the State in Superintendent's 

department, 11,887 50 

Dry goods, 1,475 18 

Provisions and groceries, ...... 4,121 58 

Drugs and medicines, 475 00 

Fuel, 1,036 00 

Library, 550 00 

Total, $60,884 91 



1875.] 



PUBLIC DOCUMENT— No. 23. 



11 



TREASUKEE'S REPORT. 



To the Trustees of thf Worcester Lunatic HospitaL 

Gentlemen : — I herewith submit my Annual Report on 
the finances of the Worcester Lunatic Hospital for the year 
ending September 30, 1875. 

Receipts. 

Cash on hand September 30, 1874, .... $15,330 39 
received of the Commonwealth for support of 

patients, 14,871 00 

receivedof cities and towns for support of patients, 51,184 30 

received of individuals for support of patients, . 45,699 56 

received for interest and sale of produce, etc., . 2,717 80 



$129,803 05 



The expenditures for the year have been as follows : — 



Provisions : 
Flour, 732 barrels, at $6.16 per barrel. 
Meat of all kinds. 
Meal for cooking, 
Beans, potatoes and other vegetables, 
Fish, .... 
Sugar, 

Molasses and syrup, . 
Tea, .... 
Coffee and chocolate, . 
Rice and crackers, 
Butter, 

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



$4,508 


69 


10,960 


04 


247 


26 


1,243 


27 


1,093 


62 


2,227 


87 


945 


47 


649 


63 


1,113 


36 


623 


06 


6,884 


88 


112 


47 


177 


66 


169 


08 


2,464 


41 



Total for provisions {^carried forward), 



},420 77 



12 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Amount brought forivard, 
Salaries and wages (14 months), 
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, 
Travelling and transportation, 
Fuel, . 

Freight and express. 
Ice, 

Trustees' expenses, 
Miscellaneous, . 

Total current expenses, 

Clothing and materials. 

Undertaker's charges, . 

Furnished to private patients on account. 

Land, insurance, interest, surveys, etc., 

Total expenditures, 

Cash on hand September 30, 1875, 



$32,420 


77 


40,649 


09 


192 


50 


2,184 


60 


4,113 


30 


1,870 


55 


676 


10 


1,147 


88 


476 


00 


1,779 


26 


3,761 


13 


816 


73 


77 


55 


8,136 


96 


481 


25 


436 


54 


132 


42 


1,327 


76 


$100,680 39 


5,923 


93 


459 


05 


577 


76 


304 


75 



$107,945 88 
21,857 17 



Resources. 






$129,803 05 


Cash on hand, ..... 


, , 


, 


$21,857 17 


Due from the Commonwealth, 


. 


. 


2,623 00 


from cities and towns, . 


, 


, 


13,971 10 


from individuals, .... 






10,822 25 


Liabilities. 


$49,273 52 


Due for supplies and expenses. 


$5,961 88 




for salaries and wages, . 


2,968 


59 


8,930 47 










$40,343 05 


Invested funds, market value. 


• • 


* 


5,219 19 


Total surplus, .... 


$45,562 24 



1875.] PUBLIC DOCUMENT— No. 23. 13 

Salaries and wages were formerly paid once in three months. 
During this year the practice has been adopted of paying 
monthly. The expenditures, therefore, under this head, 
include payments for fourteen months. 

ALBERT WOOD, Treasurer. 
WOECESTEE Lunatic Hospital, October 1, 1875. 



14 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



New Hospital Account. 

The total amount expended on the New Hospital build- 
ings and grounds, at the close of the fiscal year 
ending September 30, 1874, was .... 

The expenditure during the fiscal year ending Septem- 
ber 30, 1875, was 

Total, ........ 

This expenditure is classified as follows : — 



Land, 

Barns and cottages, . 

Grading, excavation, etc., 

Foundations, 

Superstructure, masonry, 

Carpentry, including roofing, 

Painting, windows, guards, etc 

Water, gas, drainage. 

Heating and ventilating, . 

Plastering, 

Architects, engineers, overseers, etc., 

Koads, and grading pertaining thereto. 

Miscellaneous, . . . . . 

Expenses laying out old land, . 



$333,231 92 

256,885 60 



$112,247 71 

18,873 74 

63,802 44 

26,919 14 

215,367 10 

81,933 84 

12,832 13 

9,926 79 

5,485 62 

12,564 46 

15,714 07 

5,454 04 

5,758 15 

3,238 29 



,117 52 



,117 52 



The amount charged to "laying out old land" is not 
properly a part of the cost of the new buildings, but it appears 
in the account for the following reason : — 

In accordance with an Act of the legislature, the governor 
and council ordered $25,000 to be credited to the fund for 
constructing the new buildings, as compensation for the site 
occupied by the normal school, which amount was to include 
the construction of " suitable streets to and around said land." 
The $25,000 having all been carried to this fund, the expense 
of laying out and constructing the streets must obviously be 
charged to the same fund. 



1875.] PUBLIC DOCUMENT— No. 23. 15 

The amount realized for sales of land, and interest, which 
has been passed to the fund for erecting the new buildings, 
according to the statement of the auditor, is $66,897.38. 

A note for $2,500, given by the trustees to Sarah Phillips, 
for land purchased of John Bartlett, is still unpaid, owing to 
a temporary legal disability on the part of the holder to receive 
the payment. 



16 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



SUPERmTE:N^DE]^T'S REPOET. 



To the Board of Trustees of the Worcester Lunatic Hospital. 

Gentlemen : — In accordance with the requirements of the 
by-laws, I herewith submit for your consideration the Forty- 
Third Annual Report of the hospital of which you have con- 
trol. 

The following table shows the movement of population, 
and is an epitome of the year's operations : — 



Table No. 1. 

Showing the General Results during the Year. 





Males. 


Females. 


Total. 


Patients in the hospital, October 1, 1874, 


213 


272 


485 


Admitted during the year, .... 


196 


166 


362 


Whole number under treatment, . 


409 


438 


847 


Discharged recovered, 


65 


35 


90 


improved, 


65 


82 


147 


not improved, .... 


31 


32 


63 


died, 


32 


35 


67 


not insane, ..... 


1 


1 


2 


Whole number dischai'ged, .... 


184 


185 


369 


Remaining September 30, 1875, . 


225 


253 


478 


Largest number on /-Jan. 14 to 17, inclusive, 
any day, . .\ July 29, 


228 


274 >. 
271 / 


502 


231 


Smallest number on any day, Nov. 19, . 


210 


261 


471 


Daily average during the year. 


22402 


262 76 


486.78 


of state patients, . ... 


31.18 


37.28 


68.46 


of town patients, . 


126.15 


137.58 


263.73 


of private patients. 


66.69 


87.90 


154 59 



1875.] PUBLIC DOCUMENT— Xo. 23. 17 

The number of patients at the beginning of the year, four 
hundred and eighty-five (485), was larger than at the begin- 
ning of any previous year, except the two (1853 and 1854) 
which next preceded the opening of the Taunton Lunatic 
Hospital, and was one hundred and twenty (120) in excess 
of the convenient capacity of the house. 

The number of admissions was somewhat less than the 
number that have been received for each of the last five 
years. 

The larijest number in the house durins: the vear was five 
hundred and two (502), being one hundred and thirty-seven 
(137) more than the number for which we have suitable 
accommodation. 

During the last two months the admissions were exceeded 
by the discharges, thereby reducing the number remaining at 
the close of the year to four hundred and seventy-eight 
(478), being seven (7) less than at the beginning. 

The number of patients admitted* is given as three hun- 
dred and sixty -two (302). Four (4) patients originally 
admitted* in previous years as private patients, having be- 
come paupers, were discharged on the records of the hospital, 
and were committed by probate court, that the cost of their 
support could be collected. 

The number of patients actual 1}' received at the hospital 
was, therefore, three hundred and fifty-eight (358). Seven 
persons were each received twice during the year, and it fol- 
lows that the number o^ persons brought to the hospital Avas 
three hundred and fifty-one (351). 

A careful examination of all the admissions shows more 
than one-tJdrd to be incura])le when received. In making 
this estimate, some who lived but a few days have not 
been included, because when admitted it was not certain that 
they were hopeless cases. Those only have been classed as 
incurable whose physical condition rendered death inevitable, 
or whose mental state precluded a restoration to sound mind. 
In some the insanity had existed fifteen, twenty or twenty- 



* Admitted, as used in this Report, lias two meanings : one refers only to the entry 
of a patient on the reeords of the hospital ; the other indicates the method or form 
V)y which the person is placed in the institution. A patient is admitted at the request 
of friends ; he is committed by action of court. Sec Appendix. 
3 



18 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

five years ! Many were affected with such structural brain 
disease as rendered recovery impossible. Several were re- 
ceived in a condition of so great general exhaustion that they 
could live but a few days, or even hours. 

Various opinions have been held regarding the curability 
of insanity. Enthusiastic writers have stated that if the 
insane were early placed under proper treatment, at least 
ninety per cent, will be restored. 

Dr. Thurman succeeded in tracing out the subsequent his- 
tory of every patient who had been under care at the Retreat 
(England) during forty-four years, in whom death had 
occurred either in the institution or after discharge. The 
number of cases thus studied was two hundred and fortj'^-four. 
Of these, one hundred and thirteen died during the first 
attack, and one hundred and thirty-one, about fifty- three per 
cent., recovered. Forty-five of those who recovered re- 
mained well during the remainder of their lives, and eighty- 
six (sixty-six per cent.) had subsequent attacks. He formu- 
lates his conclusion thus : " In round numbers, then, of ten 
persons attacked by insanity five recover, and five die sooner 
or later, during the first attack. Of the five who recover, 
not more than two remain well during the rest of their lives. 
The other three sustain subsequent attacks, during which at 
least two of them die. But, although the picture is thus an 
unfavorable one, it is very far from justifying the popular 
prejudice that insanity is, virtually, an incurable disease ; and 
the view which it presents is much modified by the long inter- 
vals which occur between the attacks, during which intervals 
of mental health (in many cases of from ten to twenty years 
duration), the individual has lived in all the enjoyments of 
social life." 

Bhmford, commenting on these statistics, says: "If we 
could carefully watch every case of insanity from its com- 
mencement, I fear we should see that a less number than 
fifty-three per cent, recover from the first attack, so great is 
the proportion of those who are incurable from the first, or 
who, from the prejudices of friends, are not subjected to treat- 
ment till the chance of cure is gone." 

The statistics of insanity, as found in the annual reports of 
lunatic hospitals, require careful analysis before correct con- 



1875.] PUBLIC DOCUMENT— No. 23. 19 

elusions can be drawn from them. The duplicating of cases 
by the readmission of the same person, — in some instances 
twenty or thirty times, — is one of the most conspicuous 
sources of error. 

An exhaustive analysis of the statistics of the Blooming- 
dale Asylum for the Insane, for the twenty-four years, 1821 
to 1844 inclusive, was published in 1848. The number of 
cases was two thousand three hundred and eight, but the num- 
ber of persons admitted for the first time from the general 
population was one thousand seven hundred and eighty-nine, 
of whom forty-two per cent, recovered their reason. 

A similar analysis of the statistics of the Northampton 
Lunatic Hospital was published in 1872, with the annual 
report of that institution. This analysis shows that two years 
after the close of the period during w4iich one thousand and 
seventy-four persons were, for the first time, admitted to that 
institution from the general population, and by which time 
their curability was essentially ascertained, three hundred and 
thirty-one had recovered, about thirty -one per cent. 

It appears, however, that of these one thousand and sev- 
enty-four persons, four hundred and seventy -seven were 
known to have been insane from one to twenty years, and 
many, having been under unsuccessful treatment at other 
institutions, constituted at the time of their admission to 
Northampton, a part of the grand aggregate of incurables. 
If the full data were at hand, upon which to base a calcula- 
tion of the curability of that portion of the one thousand and 
seventy -four persons admitted, who came under treatment at 
that institution during the early stages of the disorder, or to 
enable us to ascertain the number of cured cases, which 
should properly supplement the chronic ones received, the 
proportion of recoveries Avould be much larger than thirty- 
one per cent., and would represent the true curability of 
insanity as observed at Northampton, 

These careful investigations lead to the conclusion, that of 
the whole number of cases of insanity, less than one-half are 
really cured, many of which relapse ; and it is extremely 
doubtful if, under the most propitious circumstances, any 
possibility exists of increasing the proportion of recoveries 
much above fifty per cent. ! 



20 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

That the proportion of recoveries among the insane is less 
than has sometimes been estimated, is not a good reason for 
delaying treatment ; it is a weighty argument in favor of em- 
ploying, in the early period of the disease, the best remedial 
measures within our knowledge, that as many as possible may 
be restored, and saved from that dark abyss of overthrown 
reason which it is so painful to contemplate. 

No doubt the hospital offers, in a majority of cases, the best 
prospect for recovery, but an occasional one can be better 
managed elsewhere. 

The early period of the disease is the golden time for 
treatment, and not a moment should be lost in obtaining 
competent medical advice, which should be promptly and 
thoroughly followed. 

An ounce of prevention is worth a pound of cure. It is 
to the careful observance of the laws of physical, mental and 
moral hygiene we must look for a diminution of this great 
woe. 

The recoveries of any given year come almost entirely from 
the admissions of that and the preceding year. In view of 
the fact that more than one-third of the admissions of the 
last, and more than one-half of those of the previous year, 
were chronic and hopeless cases, it is not surprising that the 
number of recoveries is small. 

Of some who left the hospital improved, it is known that 
the improvement went on to complete recover}'^ ; but in a 
• statement of their condition when discharged, they cannot 
properly be classed as recovered. Others among the im- 
proved had received all the benefit possible, and they left the 
hospital in suitable condition to live with their friends. 

With the insanity, there existed, in many cases, serious 
complications, which arc noted in the following table : — 



1875.] 



PUBLIC DOCUMENT— No. 23. 



21 



Table No. 2. 
Showing the Complications in the Cases Admitted during the Tear. 



Epileptic, 

Epileptic and homicidal, 

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. 



10 

2 

12 

4 

59 

55 

1 

8 

12 

17 

68 

69 



Table No. 3. 

Shoioing the Relations of the Patients Admitted to Institutions of this 

kind. 





Males. 


Females. 


Totals. 


Never before in any hospital. 

Former inmates of tliis hospital, . 

of other hospitals in this 
State, .... 

of hospitals in other States, 

of this hospital and of other 
hospitals in this State, 

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

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

of this hospital and of hos- 
pitals of other countries, . 


139 

82 

13 
5 

4 

1 

1 
1 


121 

36 

5 
4 


260 
68 

18 
9 

4 

1 

1 
1 


Totals, 


196 


166 


362 



22 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

By the foregoing table, it is seen that about two-thirds of 
the patients admitted have never before been in any hospital. 
To the remaining third the hospital was no new experience. 

There are many persons who suffer repeated attacks of 
insanity. In some of these cases the mind at tirst seems 
entirely sound during the intervals ; but in the course of 
years the attacks come more frequently, the mind clears up 
less perfectly, and at last their reason becomes permanently 
impaired. 

The case of Mrs. S., now an inmate of the hospital, is of 
this character. She was first admitted in 1840, recovered in 
about three months, and remained well for eighteen years. 
She then became insane a second time, recovered in this insti- 
tution in about four months, and continued in sound mental 
health for more than ten years. About a year after this 
second recovery, she was attacked a third time, and the dis- 
ease assumed a more decided recurrent type. For six years 
she spent about half the time in the hospital ; but for the last 
two years she has not been well enough to be discharged. 

One man has been admitted sixteen times in sixteen years, 
spending altogether about three years in the hospital. 

Although these cases are less favorable than those which 
remain well after one attack of mental derangement, they 
require hospital care and treatment none the less. 

Table No. 4 shows whence the patients were received. It 
need only be said that those Avho came from the hospitals in 
Rhode Island and New Hampshire were citizens of Massachu- 
setts. 



1875.] 



PUBLIC DOCUMENT— No. 23. 



23 



Table No. 4. 

Showing the Sources from which the Patients Admitted were directly 

drawn. 



From the general population, 

McLean Asylum for Insane 

Tewksbury Almshouse, 

Ipswich Receptacle, . 

Lancaster Reform School, 

Houses of Correction, . 

State Prison, 

Butler Hospital for Insane (R. I.), 

New Hampshire Hospital for Insane, 
Readmitted without discharge from hospital. 



Total, 



170 
2 
1 
1 

16 
4 
1 
1 

196 



154 

5 

1 

2 



324 
2 
6 
1 
1 

18 
4 
1 
1 
4 

362 



Table No. 5. 

Shoioing by whom the Patients, remaining at the end of the Year, 

are Supported. 



By the State (state patients) , . 

Town (town patients) , . . . 
Friends (private patients) , 


22 

142 

61 


20 

154 

79 


42 
296 
140 


Total, 


225 


253 


478 



Table No. 6. 

Showing the alleged Causes of Insanity in the Number of Cases 
Admitted during the Year. 





NuMBEE OP Cases. 


Number Predisposed. 


CAUSES. 


Males. 


Females. 


Hales. 


Females. 


Business anxiety, .... 
Confinement in prison, . 

Congenital, 

Debility, 


4 
3 
2 

1 


- 


2 

1 


- 



21 LUNATIC HOSPITAL AT WORCESTER. [Oct. 
Table No. G. — Concluclecl. 





Ndmber 


OF Cases. 


Number PitEnisposED. 


CAUSES. 












Males. 


Fema'.es. 


Males. 


Females. 


Disappointed affect 


ion, . 




1 


4 


_ 


2 


Disease of brain, 








2 


1 


- 


- 


Domestic trouble, 








2 


11 


- 


2 


Epilepsy, 








6 


6 


4 


1 


Erotomania, . 








- 


1 


- 


1 


Fear of poverty. 








1 


- 


- 


- 


Grief, . 








5 


7 


1 


3 


General paralysis, 








4 


1 


- 


- 


Hard study, . 








1 


- 


- 


- 


Heart disease, 








- 


1 


- 


1 


Hereditary, 








9 


13 


9 


13 


Ill-health, 








5 


7 


1 


4 


Injury to head. 








7 


3 


2 


2 


Intemperance, 








35 


5 


12 


1 


IMastui-bation, . 








10 


_ 


7 


- 


Nervous debilit}^ 








3 


- 


1 


- 


Nostalgia, 








- 


1 


- 


- 


Old age, . 








2 


- 


1 


- 


Overwork, 








11 


2 


7 


1 


Paralysis, 








8 


- 


- 


- 


Pecuniary trouble, . 








3 


_ 


- 


^ 


Periodical, 








7 


4 


7 


4 


Puerperal, 








- 


20 


- 


8 


Religious excitemei 


It, . 






4 


7 


2 


4 


Sunstroke, 








2 


_ 


_ 


_ 


Typhoid fever. 








- 


1 


- 


1 


Turn of life, . 








- 


13 


_ 


7 


Uterine disease, 








- 


2 


— 


1 


Unascertained, 








G2 


55 


- 


- 


Not insane. 








1 


1 


- 


- 


Total, 


196 


166 


57 


56 



The two entered not insane were jidmitted and discharired 
during the 'year, and consequently appear in several tables. 
One was a convict from the House of Correction, and the 



1875.] PUBLIC DOCUMENT— No. 23. 25 

other a very vicious girl from the State Industrial School, 
neither of whom, after duo observation, were considered 
insane. The former was committed to the care of the general 
agent of the board of state charities for transfer, and the 
latter returned to the school, whence she was sent to Tcwks- 
bury or Bridgewater. 

For the benefit of those who may have confidence in the 
testimony of a superintendent of a lunatic hospital, — than 
whom none can have a keener sense of the great wrong of 
unjustly depriving a person of their liberty, — I desire emphati- 
cally to state, that, in an experience of more than twelve 
years, and a personal knowledge of more than four thousand 
cases, I have never known a single person, who was not 
insane, to be maliciously sent to a lunatic hospital, A few 
cases have occurred under my observation where persons 
have been sent to institutions for the insane, to screen them 
from the consequences of drunkenness or other crime ; or 
where viciousness, or the delirium of acute disease, in a per- 
son whose history was unknown, has been mistaken for 
insanity. I have also seen a few persons, no doubt insane, 
brought to the hospital, whose friends ought to have taken 
care of them, and some, so feeble when received, they should 
have been permitted to die at home. 

The most serious of these mistakes were but errors of judg- 
ment, and I have yet to learn of any department of political 
or social economy wherein mistakes do not occur. 

That it is possible, wilfully and maliciously, to send a sane 
person to a lunatic hospital, is doubtless true. I have been 
credibh^ informed of a very few such cases ; they are exceed- 
ingly rare ; probably no more frequent than the unjust im- 
prisoinnent of guiltless persons in penal institutions, and the 
mistake would be rectified without unnecessary delay. 

The table of alleged causes is, in the main, simply a com- 
pilation of statements made by friends and physicians, as they 
appear on the admission papers. In many respects it is known 
to be imperfect; in some it is probably correct. 

To intemperance is ascril>cd the largest number of cases, 

and it has doubtless been more or less directly instrumental 

in producing many others. I do not believe intemperance to 

be '' the cause of all our woes," but its evils are sufficiently 

4 



26 



LUNATIC HOSPITAL AT WOECESTER. [Oct. 



alarming. More than ten per cent, of all the cases which have 
been admitted to this institution have been directly chargeable 
to intemperance, and I have no doubt, that of those ascribed 
to domestic trouble, business anxiety, etc., at least another 
ten per cent, are very largely due to the same cause. A more 
powerful appeal in behalf of temperance can scarcely be made. 

Twenty-two cases are assigned to hereditary tendencies 
alone, but this influence was more or less operative in many 
others. The few classed as periodical, are those in which the 
original cause is obscure or unknown, and the hisauity has 
assumed a recurrent type. 

Depressing influences, such as nervous debility, ill-health, 
overwork, pecuniary trouble, domestic difficulties, are responsi- 
ble for a large number of cases, and these are often of a 
melancholy and suicidal type. Among females, an unusually 
Jarge number were dependent \upon diseases peculiar to their 
sex. Five cases are said to have been caused by general 
paralysis, but these are instances in which the name of the 
form of insanity with which the patient was afl'ected was 
given as a cause of the malady. Of this most fatal disease, 
thirteen cases — twelve male and one female — have been 
admitted during the year. 



Table No. 7. 

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



AGES. 


Admitted. 


Discharged Ke- 

COVERED. 


Discharged kot 
Recovered. 


Died. 




Blales. 


Females. 


Males. 


Females. 


Males. 


Females. 


Males. 


Females. 


Less than 15, 






1 












From 15 to 20, 


13 


10 


3 


2 


6 


6 


1 


- 


20 to 30, 


48 


40 


14 


12 


31 


39 


7 


5 


30 to 40, 


64 


44 


21 


2 


29 


32 


4 


9 


40 to 50, 


31 


34 


7 


8 


13 


15 


9 


9 


60 to 60, 


16 


20 


4 


8 


12 


12 


7 


5 


60 to 70, 


16 


14 


5 


3 


4 


8 


1 


5 


70 to 80, 


6 


3 


- 


- 


- 


2 


3 


2 


80 to 90, 


1 


- 


- 


- 


1 


- 


- 


_ 


Not insane, . 


1 


1 


- 


- 


1 


1 


- 


- 


Total, . 


196 


166 


55 


35 


97 


115 


32 


35 



1875.] 



PUBLIC DOCUMENT— No. 23. 



27 



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. 


DUKATION OF INSANITY. 


1 


"3 
1 


S 


►H 


S 


S 


S 


a 


Insane one year or less, 

More than 1 j^ear and 
less than 2 years, 

More than 2 years and 
less than 5 years, 

More than 5 years and 
less than 10 years, . 

More than 10 years and 
less than 15 years, . 

More than 15 years and 
less than 20 years, . 

More than 20 years and 
less than 25 years, . 

More than 25 years and 
less than 30 years, . 

Thirty years or more, . 

Unknown, . 

Not insane, . 


129 
16 
13 
13 

2 
4 

1 

1 

3 

13 

1 

196 


99 
12 
19 
12 

8 
4 

1 

10 

1 

166 


45 
5 

2 

3 


82 
2 
1 


45 
19 
14 
10 
1 
2 

2 
3 
1 


48 

15 

25 

14 

6 

1 

1 

4 
1 


8 
5 
12 
3 
2 

1 

1 
32 


16 
2 
6 
5 

2 
1 

1 

2 


Total, . 


55 


35 


97 


115 


35 



28 



LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 9. 

Shoioing the Civil Condition of Patients Admitted, Discharged Re- 
covered, not Recovered, and Died during the Year. 



CIVIL 


Admitted. 


DiSCHAKGED EE- 
COVERED. 


Discharged not 
Recovered. 


Died. 


COXDITIOX. 




















Males. 


Females. 


Males 


Females. 


JIales. 


Females. 


Males. 


Females. 


Unmarried, . 


92 


64 


26 


13 


56 


54 


11 


14 


Married, 


8-t 


82 


24 


12 


36 


45. 


18 


14 


Widowers, 


U 


- 


9 


7 


4 


- 


3 


- 


Widows, 


- 


17 


- 


- 


- 


11 


- 


6 


Divorced, 


1 


1 


- 


- 


- 


1 


- 


- 


Unknown, 


4 


1 


3 


3 


- 


3 


- 


1 


Not insane,' . 


1 


1 


- 


- 


1 


1 


— 


— 


Total, . 


196 


166 


55 


35 


97 


115 


32 


35 



Table No. 10. 

Shoioing the Occiqxition of Patients admitted during the Year. 

jMales. 



Bar-tender, .... 1 


Mason, 1 


Barber, . 






1 


Mechanics, 






12 


Blacksmiths, . 






3 


Merchants, 






4 


Book-keepers, . 
Bookbinder, . 






4 
1 


Moulder, . 
Operatives in mills. 






1 
11 


Butcher, . 






1 


Painters, . 






5 


Cashier, . 






1 


Peddlers, . 






3 


City crier, 

Carpenters, 

Clergymen, 






1 

7 

9 


Physicians, 
Plumber, . 
Printer, . 






2 
1 

1 


Clerks, . 






11 


Real estate agent, 






1 


Cook, 






1 


Salesman, 






1 


Coopers, . 
Coal dealers, . 






2 

2 


Seamen, . 
Shoemakers, . 






3 
13 


Curriers, . 






4 


Stone-cutters, . 






3 


Engraver, 






1 


Students, . 






4 


Farmers, . 
Fishermen, 






10 
3 


Speculator, 
Teamster, 






1 
1 


Grocer, . 






1 


Tailor, 






1 


Harness-makers, 






2 


Traders, . 






3 


Junk dealer, . 






1 


No occupation. 






13 


Laborers, 






38 


Unknown, 






3 


Lawyer, . 
Machinists, 






1 

7 


Not insane. 






1 


Manufacturer, . 






1 


Total, 






196 



1875.] 



PUBLIC DOCUMENT— No. 23. 



29 



Table No. 10. — Concluded. 
Females 



Domestics, 


. 37 


No occupation 


Dressmaker, . 


1 


Unknown, 


Housekeepers, 


. 80 


Not insane. 


Operatives in mills, 


. 12 




Seamstresses, . 


7 


Total, 


Teachers, 


2 





24 
2 
1 

166 



Table No. 11. 

Shoicing the Diseases ivhkh have i^roved Fatal during the Year. 



DISEASES. 



Acute mama, . 

Acute melancholia, 

Bright's disease, 

Dysenter}', 

Epilepsy, 

Exhaustion of chronic insanity. 

Exhaustion of chronic insanity w 

tery, . . . 
Exhaustion of chronic insanity w 

elas. 
Exhaustion, , 
General paralysis, . 
Heart disease, 
Hemorrhage of bowels. 
Meningitis, 
Pneumonia, 
Peritonitis, 
Paralysis, 
Phthi'sis, 
Parotid abscess. 
Suicide, 

Serous apoplexy, . 
Sclerosis of cord, . 
Softening of brain, 
Strangulation by food. 

Total, 



th dysen 
th erysip 



1 
1 
2 
2 

3 
1 
1 
1 
1 

31 



10 
1 
1 
1 

5 
4 



1 

1 
10 
2 
1 
1 
1 
1 
4 
9 
1 
5 
1 
1 
1 
1 

67 



30 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

The inimber of deaths is less than in either of the next two 
preceding years, but is somewhat higher than the general 
average since the opening of the hospital. 

Six persons died w^ithin five days of their admission, one 
living only twenty-eight hours. Thirty of those who died 
were admitted within the year, and in fifteen cases there was 
no hope of recovery Avhen they were received. To acute 
insanity is ascribed eleven deaths, and to chronic insanity 
four. 

Epilepsy, heart disease, paralysis and phthisis, hopeless 
organic diseases, constitute nearly a third of the fatal causes. 
Ten deaths were caused by general paralysis, the same num- 
ber as last year. This form of insanity is probably the most 
fatal disease to which we are liable. So surely fatal is it, 
that a late English authority says, " A well authenticated 
case of recovery is, I believe, unknown." Thirteen cases of 
this form of insanity were admitted during the year, four of 
which are already dead, and it is probable the remainder will 
have joined them before the time of making another report. 

The victims of this disease are almost always vigorous 
adult males, full of animal life, who are given to indulgence 
of the appetites, and are subject to great mental strain and 
worry from overwork and anxiety in business. What a 
forcible appeal to be moderate in all things ! 

By a most unfortunate coincidence of circumstances, to 
which all lunatic hospitals are liable, an unusually large num- 
ber of suicides have to be reported. 

Among those who died were the two oldest residents : one, 
a man, had been an inmate of the hospital thirty-three years 
and seven months ; and the other, a woman, thirty-eight years 
and ten months. There are now remaining six patients, each 
of whom have spent in the hospital more than thirty years, 
and eighteen whose term of residence exceeds twenty years. 



1875.] 



PUBLIC DOCUMENT— No. 23. 



31 



Table No. 12. 

Showing the Admissions from each County during the Year. 



COUNTIES. 


Males. 


Females. 


Total. 


Barnstable, 
















- 


1 


1 


Berkshire, 
















1 


- 


1 


Dukes, . 
















- 


1 


1 


Essex, 
















41 


33 


74 


Franklin, 
















- 


1 


1. 


Hampden, 
















2 


2 


4 


Middlesex, 
















67 


59 


116 


Norfolk, . 
















2 


3 


5 


Plymouth, 
















1 


1 


2 


Suffolk, . 
















24 


16 


40 


Worcester, 
















67 


48 


115 


Not insane. 
















1 


1 


2 


Total, 
















196 


166 


362 



32 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



Table No. 13. 

Slioivwg the Whole Number of .Patients during each year^ the Aver- 
age Number^ the Namher at the end of each year, the Expenses of 
each year, the Annual Expense for each Patient, and the Expense 
of each Patient per week for each of the Forty-three Years the 
Hospitcd has been in operation. 



Y E A K S . 


a 

"o 


£1 
s 

0) 

> 


■a 
c .• 

" i 
•S 1 

S V. 

3 O 


Current expenses 
of eacli year. 


Annual expense 
forencl) patient. 


a .a 

'a. <- 
£■2 


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 


859 


367 


39,870 37 


111 06 


2 13 


1847, 








607 


377 


31'4 


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 


63,043 88 


132 IS 


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 


2-23 47 


4 30 


1868, 








651 


370 


382 


72,054 59 


197 60 


3 80 


1869, 








719 


387 


376 


81,410 58 


209 04 


4 02 


1.S70, 








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 


1875, 








847 


487 


478 


100,680 39 


206 74 


3 98 



1875.] PUBLIC DOCUMENT— No. 23. 33 

The current expenses have been a little less than last year, 
and a decrease of a few cents per week in the expense for each 
patient is shown, although, as is stated in the Treasurer's 
report, salaries and wages for fourteen months are included 
in the expenditures of the year. This has not resulted from 
any depreciation of the standard of the hospital service. 
Prices have generally ruled a little lower, and the average 
number of patients has been greater. The current expenses 
are not materially modified by a variation of ten or twenty 
persons in our household, and should the average number of 
patients for the next year be smaller, it is probable the cost 
per week will be increased. 

If the buildings we now occupy were not soon to be vacated, 
it would be necessary, in order to keep the hospital well up to 
the requirements of the times, to expend much larger amounts 
each year in improvements and repairs, than has seemed 
advisable under existing circumstances. The aim has been 
to keep them in a condition that will, as far as possible, 
insure health and comfort to the patients, but not to expend 
money for radical improvements soon to be discarded. 

The farm and garden have been productive, and the house- 
hold well supplied with fruit and vegetables. Farm and 
<2^arden labor is one of the best curative ao^encies in the treat- 
ment of many cases of insanity, and wonderfully tranquillizing 
in many incurable ones. A number of patients have been 
employed in this department during the year, and it is believed 
many more can thus be occupied, and much greater benefit 
received from this source, when we shall occupy the new 
buildings, than is possible under present circumstances. 
Many patients could work on the farm Avho cannot be trusted 
at the cottages. 

The laundry, kitchen and sewing-rooms furnish employ- 
ment for some male and many female patients, and both sexes 
assist in the housework of their respective wards. 

No attempt has been made to keep a record of the number 
of days' work done, or of garments made or mended, or of 
the specific items of lal^or, in any department, performed by 
patients ; but it is a daily study to keep as many as possible 
employed, and a great care to guard against accident from 
this source. 

5 



34 LUNATIC HOSPITAL AT WORCESTER. [Oct. '75. 

To the many kind friends who by gifts of books, pictures, 
flowers and other uscfid and ornamental articles, or by read- 
ings, concerts and entertainments, have contributed to the 
welfare of our household, our cordial thanks are due. 

To the clergymen who have so kindly continued to lead our 
religious services, we are under renewed obligations. The 
plan of having difierent pastors oflnciate is a very successful 
one, and we hope to continue it. 

I desire to express my appreciation of the skilful and 
efficient service rendered the hospital and patients by the 
assistant officers, and by the various employes, who have 
been zealous and faithful in their trying duties. 

And now we leave the past, and turn to the future. Ardu- 
ous, complicated and perplexing duties are before us. When 
we have done our best, we may not escape censure. With 
compassion for the poor ones under our care ; with sympathy 
for those who are bound to them by ties of kinship and love ; 
with a determination to spare no effort to alleviate in every 
possible Avay the sufferings and sorrows of patients and their 
friends ; and with a firm dependence upon Him who careth 
for us all, let us bend our energies anew to the task. 

B. D. EASTMAN, 

Siij)erintendent. 
Worcester Lunatic Hospital, 

WORCESTEU, Oct. 16, 1875. 



APPENDIX. 



[For the information of the general public, and more particularly that 
portion who may be called upon, either in a friendly or official capacity, 
to act in tlie matter of sending persons to the hospital, the following 
Suggestions to Friends, Forms of Admission, and Collection of Laws, 
have been made ] 

Worcester, Oct. 16, 1875. 



SUGGESTIONS TO THE FRIENDS OF PATIENTS. 



Persons should never be brought to the hospital except in strict 
compliance with the requirements of the law. Blank forms of ad- 
mission, and all necessary" information, will be furnished upon appli- 
cation to the Superintendent. 

No deception should ever be used in conveying a patient to the 
hospital. Let all arrangements be properly made, and with suffi- 
cient assistance to control excitement, should an}' arise. Let the 
person be plainly, but kindly, told they are to go the hospital. No 
continued resistance will ordinarily be made ; but, if it become 
necessary, better use force than fraud. Do not call upon an officer 
for assistance, if it can be avoided. 

If possible, some person should come with the patient who can 
give a correct historj^ of the case. Effort should be made to incul- 
cate the idea that the officers and employes of the hospital will be 
kind and friendlj', and endeavor to promote the best interests of 
those under their charge. 

An abundance of underclothing should be brought with every 
patient, especially' if they are at all disposed to derange their dress, 
together with suitable outer-garments for ordinary wear and for 
attending lectures and religious services, if their condition will 
admit. Jewelr}-, superfluous articles of dress, knives, etc., should 
not be brought, as they are liable to be lost, and the hospital will 
not be responsible for them. All practicable care will be taken to 
avoid loss or destruction of clothing, etc. ; but it cannot be entirely 
avoided. 

All packages sent by express to patients should be paid through, 
and plainl}' directed to the person for whom they are intended, care 
of Worcester Lunatic Hospital, Worcester, Mass. 

All letters for patients should be placed in an unsealed envelop, 
directed to the patient, and the whole placed in another envelop 
addressed to the Superintendent. Neither money nor postal- 
stamps should be sent directly to patients, but may be sent to the 
Superintendent for their benefit. 



38 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

In all cases which have been at the hospital but a short time, or 
are subject to periodical attacks of excitement, friends should ascer- 
tain their condition, and the propriety of visiting them, before 
coming to see them. No objection will be made to a reasonable 
amount of visiting to such patients as will not be injuriously affected 
thereby. 

No letters written about persons while at the hospital should be 
shown them after their discharge. 

B. D. EASTMAN, M. D., 

Superintendent. 
WoECESTER Lunatic Hospital, ? 
WoRCESTEE, Mass. ) 



1875.] PUBLIC DOCUMENT— No. 23. 39 



CONCERNING ADMISSION TO THE HOSPITAL. 



The laws of the Commonwealth prescribe three methods by which 
a person may be placed in the hospital, — 

First. By Ordee of Court. 

Second. By Fhiends. 

Third. By Overseers of the Poor. 

First. By Order of Court. 

Anj" of the judges of the supreme judicial, superior and probate 
courts, and any trial justice of juvenile offenders of Suffolk Count}*, 
may commit a person to the hospital. 

Commitments are usually made by the judges of probate court, 
the form of application, with the necessary accompanying certifi- 
cates being as follows : — 

[The applicant must answer in writing the printed interrogatories accompanying this blank.] 
To the Honorable Judge of the Probate Court in and for the County of 

of on oath, complains that of 

in said county of , is an insane person, and a proper sixbject for 

the treatment and custody of the Worcester Lunatic Hospital. 

Wherefore h prays that said may be committed to the said 

Worcester Lunatic Hosiiital, according to law. 

SS. A. D. 187 . 

Then the above-named made oath that the above complaint, 

by h subscribed, is true. 
Before me, 

Justice of the Peace. 

I, the subscriber, one of the selectmen of mayor of the city of 

, w'liere said resides, hereby acknowledge that notice 

in writing has been given to me of the intention to present the foregoing 
complaint and application, 

A. 1>. 187 . 



40 LUNATIC HOSPITAL AT WOKCESTEE. [Oct. 

To the Monordble Judfje of the Prolate Court in and for the County of - . 

The subscriber, liaviug made application to your lionor for the commit- 
ment of to the Worcester Lunatic Hospital as a lunatic, now 
presents the following statement, in answer to interrogatories :— 

What is the age of the lunatic ? Ans. 

Birthplace ? Ans. 

Mai-ried or single ? Ans. 

Occupation ? Ans. 

Supposed cause of disease ? Ans. 

Duration? Ans. 

Character, — whether mild, violent, or dangerous ? Ans. 

Homicidal, or suicidal? Ans. 

Paralj'tic, or epileptic ? Ans. 

Previous existence of insanity in the lunatic ? Ans. 

Previous or present insanity in any of the family ? Ans. 

Habits in regard to temperance ? Ans. 

Whether he has been in any lunatic hospital ; if so, what one, when, and 
how long ? Ans. 
(If a woman.) 

Has she ever borne any children ? Ans. 

How long since the birth of her last child ? Ans. 

Name and post-office address of some one of the nearest relatives or 
friends ? Ans. 

What facts show whether h has or has not a settlement, and where, if 
anywhere, in this State ? Ans. 

[For the law relating to settlements, see Gen. Stat., chap. 69. 
Supplement to Gen. Stat., 186S, chap. 32S. 
" " 1870, " 392. 

" " 1871, " 379. 

•' " 1874, " 274.] 

Applicant. 

Physicians' Certificate. 

The subscribers, physicians of in the county of 

having made due inquiry and personal examination of named in 

the foregoing application, within one week prior to the date hereof, certify 
the said is insane, and a proper subject for the treatment and 

custody of the Worcester Lunatic Hospital. 

ss. A. D. 187 . 

Then the above-named and made oath that the 

above certificate is true. 

Justice of the Peace. 

Commonwealth of MAssAcnrsETTS. 

SS. 

At in said county, on the day of A. D. 187 . 

On the application of for the commitment of of 

in said county, to the Worcester Lunatic Hospital, ; 



1875.] PUBLIC DOCUMENT— No. 23. 41 

notice iu vrritiug having heen given by said applicant to one of the selectmen 
of ^vhere said resides, of h intention 

to make said application, and said having received all necessary 

notice of the time and place appointed for hearing, it appears upon a fall 
hearing that said is an insane person, and a projjer subject for the 

treatment and custody of the Worcester Lunatic Hospital. 

Therefore it is ordered that said be committed to the said 

Worcester Lunatic Hospital. 

Judge of the Probate Court. 

Second. By Feiends — Private Patients. 

For the admission of private patients, application must be made 
by relative, guardian or friend, and certificate of insanit}', acknowl- 
edgment of notice to selectmen or ma^-or, and satisfactory bond for 
support must be given according to the following form : — 

COMMOXAVEALTH OF MaSSACHL'SETTS. 
[STATE SEAL.] 

The Worcester Lunatic Mospital. 

In consideration of the admission of of in the county 

of as a patient at the Worcester Lunatic Hospital, at Worcester, 

we, the undersigned, promise to pay to the treasurer of said hospital the rate 
of board which may from time to time be determined by the trustees of said 
hospital, for said patient, so long as he shall continue a boarder in said 
hospital, Avith such extra charges as may be occasioned by the necessity of 
giving h more than ordinary care or attention ; to provide or pay for all 
clothing or other things necessary or proper for h health and comfort ; to 
pay for all damages which he may do to furniture or other property of 
said hospital ; to pay for reasonable charges in case of elopement, and funeral 
expenses in case of death ; and to remove h from the hospital whenever 
the room occupied by h shall be required for a class of patients having 
preference by law, or Avho, in the opinion of the superintendent, should be 
received. We also promise that if, against the advice of the superintendent, 
he be removed, either by lis or by any of h friends, before the expiration 
of three calendar months, we Avill jiay board for thirteen Aveeks. 

Payments to be made quarterly, and at the time of removal, with interest 
on each bill from and after the time at Avhich it becomes due. 

Witness our hands, this day of A. D. 18 . 

Attest : PrincipaJ. 

[Post-office address.] 

Surety. 

[Post-office address.] 

If it becomes necessary to communicate with any friend of the patient, 
address, — 



42 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Statement of an applicant for ike admission of , an 

insane person, io the Worcester Lunatic Hospital : — 

Age of the insane person, Occupation, 

Birtliplace, Eesidence, 

Civil condition (single, married, widowed or divorced), 

Is this the iirst attack of insanity? Other attacks, and when. 

Supposed cause of insanity, 

Duration of this attack. 

Character of insanity, — Avhether mild, violent, or dangerous, • 
Homicidal or suicidal, 
Paralytic or epileptic, 
Having delusions or hallucinations, 

Habits in regard to ardent spirits, opium and tobacco. 

Natural eccentricities of temper, thought, or action, 

Any serious disease or bodily injury heretofore. 

Previous or present insanity in relatives, 

If ever in any institution for insane, when, where, and how long, 

If a woman, she has borne children ; the last years ago. 

Facts showing whether he has or has not a settlement, and, if any, 
where, 

Name and post-office address of some nearest relative or friends over eigh- 
teen years of age, 

Father, Mother, 

Children, Brothers, 

Sisters, Husband, 

Wife, 

If the applicant is unable to state any of the foregoing particulars, he shall 
state his inability to do so. 

Application. 

I request that the above-named may be admitted as a patient 

at the Worcester Lunatic Hospital. 

Applicant. 

A. D. 18 . 

[Post-office address.] 

Physicians' Certificate. 

We, the subscribers, respectable physicians in in the county of 

, having made due inquiry and personal examination of , 

named in the foregoing application, within one iveek prior to the date hereof, 
certify that he is insane, and a proper subject for custody and remedial 
treatment in the Worcester Lunatic Hospital. Audi, , further 

certify that I am the family physician of the said 

M. D. 

M. D. 

A. D. 18 . 



1875.] PUBLIC DOCUMENT— No. 23. 43 

Acknowledgment of Notice. 

I, tlie subscriber, one of the selectmen, or mayor, of , where said 

resides, hereby acknowledge that notice in writing has been 
given to me of the intention to present the foregoing application. 
A. D. 18 . 

[See Acts of 1S62, chap. 223, sects. 4, 5, 8, 13. Acts of 1865, chap. 268.] 

TJiird. By Overseers of the Poor. 

An}' insane person supported as a pauper by any cit}' or town, 
may be placed by the overseer of the poor thereof in the hospital, 
with the consent of the trustees, upon compliance with the following 
form : — 

Commonwealth of Massachusetts. 

[state seal.] 

The Worcester Lunatic Hospital, 

In consideration of the admission of < of in the county 

of as a patient at the Worcester Lunatic Hospital, at Worcester, 

we, the undersigned, being a majority of the overseers of the poor of the 
town of • in the county of for and in behalf of the 

inhabitants of said town, promise to iiay to the treasurer of said hospital the 
rate of board which may from time to time be determined by the trustees ot 
said hospital, for said patient, so long as he shall continue a boarder in 
said hosi>ital, with such extra charges as may be occasioned by the necessity 
of giving h more than ordinary care or attention ; to provide or pay for 
all clothing or other things necessary or proper for h health and comfort ; 
to pay for all damages which he may do to furniture or other property of 
said hospital ; to pay for reasonable charges in case of elopement, and funeral 
expenses in case of death; and to remove h from the hospital whenever 
the room occupied by h shall be required for a class of patients having 
preference by law, or who, in the opinion of the superintendent, should be 
received. We also promise that if, against the advice of the superintendent, 
he be removed, either by us or any of h friends, before the expiration 
of three calendar months, we will pay board for thirteen weeks. 

Payments to be made quarterly, and at the time of removal, with interest 
on each bill from and after the time at which it becomes due. 

Witness our hands, this day of A. D. 18 . 

Attest : 



Overseers of the Poor of the Town of 

If it becomes necessary to communicate with any friend of the patient, 
address, — 



44 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

Statement of an applicant for the admission of , an 

insane person, to the Worcester Lunatic Hospital : — 

Age of the insane person, Occupation, 

Birthplace, Eesidence, 

Civil condition (single, married, widowed or divorced). 

Is this the first attack of insanity? Other attacks, and when. 

Supposed cause of insanity. 

Duration of this attack, ^ 

Character of insanity, — whether mild, violent, or dangerous, 
Homicidal or suicidal. 
Paralytic or epileptic, 
Having delusions or hallucinations. 

Habits in regard to ardent spirits, opium and tobacco, 

Natural eccentricities of temper, thought, or action. 

Any serious disease or bodily injury heretofore. 

Previous or present insanity in relatives. 

If ever in any institution for insane, when, where, and how long. 

If a woman, she has borne children ; the last years ago. 

Facts showing whether he has or has not a settlement, and if any, 
where, 

Name and post-office address of some of nearest relatives or friends over 
eighteen years of age, 
Father, Mother, 

Children, Brothers, 

Sisters, Husband, 

Wife, 

If the applicant is unable to state any of the foregoing particulars, he shall 
state his inability to do so. 

Application. 

I request that the above-named may be admitted as a patient 

at the Worcester Lunatic Hospital. 



A. D. 18 . 

[Post-office address.] 



Applicant. 



Physicians' Certificate. 

We, the subscribers, respectable physicians in in the county of 

, having made due inquiry and personal examination of , 

hamed in the foregoing application, within one iveeJc prior to the date hereof, 
certify that he is insane, and a proper subject for custody and remedial 
treatment in the Worcester Lunatic Hospital. And I, , further 

certify that I am the family physician of the said 

M. D. 

M. D. 

A. I). 18 . 



1875.] PUBLIC DOCUMENT— No. 23. 45 

ACKXOWXEDGMENT OF NOTICE. 

I, tlie subscriber, one of the selectmen, or the mayor, of , where 

said resides, hereby acknowledge that notice in writing has been 

given to me of the intention to present the foregoing apxilication. 

A. D. 18 . 

[See Acts of 1862, chap. 223, sects. 4, 5, 8, 13. Acts of 1865, chap. 268.] 



46 LUNATIC HOSPITAL AT WORCESTER. [Oct. 



LAWS NOW IN EORCE 

EEGULATING THE GENEEAL MANAGEMENT OF THE STATE 
LUNATIC HOSPITALS, 

AND THE RECEPTION AND REMOVAL OF PATIENTS. 



[General Statutes, Chapter 5.] 
Section 11. The trustees or inspectors of each state lunatic hos- 
pital, state almshouse, the hospital at Rainsford Island, reform 
school for bo3"s, and industrial school for girls, shall annually on the 
thirtieth day of September, cause to be made an accurate inventory 
of the stock and supplies on hand, and the value and amount there- 
of, at such institution, under the following heads : Live-stock on 
the farm ; produce of the farm on hand ; carriages and agricultural 
implements ; machinery and mechanical fixtures ; beds and bedding 
in the inmates' department ; other furniture in the inmates' depart- 
ment ; personal property of the state in the superintendent's depart- 
ment ; ready-made clothing ; dr}^ goods ; provisions and groceries ; 
drugs and medicines ; fuel ; library. 

[General Statutes, Chapter 71.] 
Section 7. The inmates of a state almshouse, state lunatic hos- 
pital, or the hospital at Rainsford Island, ma}' be transferred from 
one iustitutiou to another, or sent to any state or place where they 
belong, by the board [^alien commissioners, now board of state cJiari- 
ties'], or their order, when the public interest or the necessities of 
the inmates require such transfer ; but no patient shall be transferred 
or discharged from a state lunatic hospital without the concurrence 
of the trustees thereof. 

[General Statutes, Chapter 73.] 
Of the State Lunatic Hospitals. 
Section 1. The government of each of the state lunatic hospi- 
tals at Worcester, Taunton, and Northampton shall be vested in a 
board of five trustees, appointed and commissioned by the governor 
with the advice and consent of the council, subject to removal only 
for sufficient cause. The trustees now in office shall continue to 



1875.] PUBLIC DOCUMENT— Xo. 23. 47 

hold their offices until the terms thereof expire according to the 
provisions of this section. On the first Wednesday of February in 
each 3-ear the term of office of the senior member in each board, as 
the}' stand arranged on the list of their appointments, shall termi- 
nate, and the name of the person appointed to fill the vacanc}' shall 
be placed at the bottom of the list, and other vacancies may at 
any time be filled, and the names of the persons appointed substi- 
tuted in the list for the remainder of the vacant terms. 

Section 2. The trustees of each hospital shall be a corporation 
for the purpose of taking and holding, to them and their successors, 
intrust for the commonwealth, any grant or devise of. lands, and 
any donation or bequest of money, or other personal property, made 
for the use of the institution of which they are trustees, and for the 
purpose of preserving and investing the proceeds thei'eof in notes 
or bonds secured bj' good and sufficient mortgages or other securi- 
ties, with all the powers necessar}- to carry said purposes into effect. 

Section 3. The}' shall take charge of the general interests of 
the institution and see that its affairs are conducted according to 
the requirements of the legislature and the b^'-laws and regulations 
which the board shall establish for the internal government and 
economj' thereof; and they shall be reimbursed all expenses incurred 
in the discharge of their official duties. 

Section 4. They shall establish by-laws and regulations, with 
suitable penalties, for the internal government and economj- of the 
institution ; shall appoint a superintendent who shall be a physician 
and constantl}^ reside at the hospital ; and a treasurer who shall 
give bonds for the faithful discharge of his duties ; and shall ap- 
point, or make provision in the by-laws for appointing, such officers 
as in their opinion may be necessary for conducting efficiently and 
economically the business of the institution ; and shall determine, 
subject to the approval of the governor and council, the salaries of 
all the officers. All their appointments shall be made in such man- 
ner, with such restrictions and for such terms of time as the b}'- 
laws may prescribe. 

Section 5. The salaries of the superintendents, assistant ph3'si- 
cians, stewards and matrons of the state lunatic hospitals shall be 
paid quarterly' from the current receipts of the several hospitals. 

Section G. There shall be thorough monthly visitations of each 
hospital by two of the trustees thereof, and quarterly by a majority 
of them, and semi-annually by the whole board, at each of which a 
written account of the state of the institution shall be drawn up, 
which shall be presented at the annual meeting to be held between 
the first and fifteenth days of October. At the annual meeting a 
full and detailed report shall be made, exhibiting a particular state- 



48 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

meut of the condition of the hospital and all its concerns, with a 
list of the salaried officers and their salaries, and in a tabular form, 
under the heads specified in section eleven of chapter five, the value 
of the stock and supplies, to be laid before the governor and council 
on or before the fifteenth day of October, for the use of the govern- 
ment ; and at the same meeting the treasurer shall present to the 
trustees his annual report on the finances of the institution ; both 
of which reports shall be made up to the thirtieth da}' of Septem- 
ber inclusive. The trustees shall audit the report of the treasurer, 
and transmit it with their annual report to the governor and 
council. 

Section 7. The accounts and books of the treasurer shall at all 
times be open to the inspection of the trustees. 

Section 12. The jurors shall be selected in equal numbers from 
the place in which the trial is had, and one or two adjoining places, 
as the judge shall direct ; and the same proceedings shall be had in 
selecting and empanelling the jury as are prescribed in chapter forty- 
three : provided^ that in the counties of Suifolk and Nantucket all 
the jurors may be taken from the same place. 

Section 13. The judge shall preside at such trial, and administer to 
the jury an oath faithfully and impartially to tiy the issue, and the 
verdict of the juiy shall be final on the complaint. 

Section 14. If, hy reason of challenges or otherwise there is 
not a full ]w'y of the persons summoned, the judge shall cause the 
officer who served the summons, or in his absence the officer 
attending the jury, to return suitable persons to suppl}' the defi- 
ciency' ; and shall have the same authority as the supi'eme judicial 
court to enforce the attendance of jurors and witnesses, and inflict 
fines for non-attendance. 

Section 15. The officer who summons and attends the jury shall 
receive therefor four cents a mile for all necessaiy travel, and one 
dollar and fifty cents for each day that he attends upon them ; and 
the jurors and witnesses shall be entitled to such compensation as 
is prescribed for jurors and witnesses in the supreme judicial court. 

Section 16. The expenses of the trial, including the fees of all 
necessary witnesses, shall be allowed and certified by the judge, and 
paid out of the county treasur}'. 

Section 17. There shall be allowed to each judge of the probate 
court, for receiving, hearing, and determining, every application 
made to him for the commitment of a lunatic, a fee of two dollars, 
to be paid out of the county treasury. The judges shall present 
their accounts for such fees as often as once in each year, to the 
county commissioners, who shall audit and allow them if found 
correct. There shall be allowed to the judge of the probate court 



1875.] PUBLIC DOCUMENT— No. 23. 49 

for receiving, hearing, and determining, an application for the dis- 
charge of a lunatic from either hospital, two dollars, to be paid by 
the party making the application. 

SECTioisr 18. The superior court maj^ allow to any sheriff, con- 
stable, or other person to whom a precept is directed by name, who 
may commit any person to either hospital, the same fees as are 
allowed to officers upon the commitment of persons to prison, and 
such further sums for expenses incurred in said commitments as to 
the court may seem reasonable ; and the sums so allowed shall be 
made up in the general bill of costs for the term of the court at 
which the allowance is made. 

Section 25. Ever}' city and town pajing expenses for the sup- 
port or removal of a lunatic committed to either hospital, shall have 
like rights and remedies to recover the full amount thereof, with 
interest and cost, of the place of his settlement, as if such expenses 
had been incurred in the ordinarj- support of the lunatic ; and the 
lunatic, if of sufficient ability to pay the same, and any kindred 
obligated b}^ law to maintain him, shall be liable for all such 
expenses paid b}' any city or town in either case. 

Section 26. The governor may at any time cause to be removed 
from one of said hospitals to either of the others, such of the 
inmates thereof as circumstances or the necessities of the case may 
in his judgment require. 

Section 30. Any justice of the supreme judicial court or supe- 
rior court, at any term held within and for the county in which 
either hospital is located, or the judge of the probate court of such 
county, ma}' on application in writing for the discharge from such 
hospital of any lunatic who has remained there a sufficient time to 
make it appear that he is incurable, cause him to be delivered to the 
agents of any place in which he has his legal settlement, or to his 
friends when it appears that it would not be to his injury, and that 
he would be comfortably and safely provided for by any parent, 
kindred, friend, master, or guardian, or by the place of his legal set- 
tlement. When request for the purpose is made in writing by any 
person interested in such discharge, the judge before whom the trial 
is to be held shall issue a warrant to the sheriff" of the county or 
his deputy, directing him to summon a jury of six lawful men to 
hear and determine the question whether such lunatic is incurable, 
and ma}' be comfortably and safely provided for, according to the 
terms of this section ; the proceedings shall be the same in selecting 
the jurors, conducting the trial, and allowing the costs, as are pro- 
vided in sections twelve, thirteen, fourteen, fifteen, and sixteen. 

Section 31. If, after tlie discharge of an incurable lunatic under 
the preceding section, it is made to appear on complaint by any 
7 



50 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

person under oath to the judge of the probate court for the county 
in which the lunatic has his legal settlement or is placed, that he is 
not comfortably supported, or that the public safety is endangered 
by him, said judge shall order his recommitment to said hospital. 
And the same proceedings may be had in determining these ques- 
tions by a jury, upon the request of any person interested therein 
made in writing to said judge, as are provided in the preceding 
section. 

Section 32. No pauper shall be discharged from either hospital 
■without suitable clothing ; and the trustees may furnish the same at 
their discretion, together with such sum of money, not exceeding 
twenty dollars, as they may deem necessary. 

[General Statutes, Chapter 172.] 
Section 14. When a person indicted is at the time appointed 
for the trial found to the satisfaction of the court to be insane, the 
court may cause him to be removed to one of the state lunatic hos- 
pitals for such a term and under such limitations as they may 
direct. 

[General Statutes, Chapter 180.] 
Lunatics in the State Prison. 

Section 1. The physician of the state prison as chairman, with 
the superintendents of the state lunatic hospitals, shall constitute a 
commission for the examination of convicts in said prison alleged 
to be insane. Each commissioner shall receive for his services in 
such capacity his travelling expenses and three dollars a day for 
each day lie is so employed, which shall be charged to the prison. 
[By Acts of 1862, chapter 8, this commission was made to consist of 
the physician of the state prison as chairman, the superintendents 
of the state lunatic hospitals at Worcester and Taunton, together 
with the superintendents of the McLean Asylum at Somerville and 
the Boston Lunatic Hospital.] 

Section 2. When a convict in the prison appears to be insane, 
the warden or inspectors shall give notice thereof to the chairman 
of said commission, who shall forthwith notify the members thereof 
to meet at the prison. 

Section 3. The commission shall investigate the case, and if, in 
the opinion of a majority of them, the convict has become insane, 
and his removal would be expedient, they shall so report, with their 
reasons, to a judge of the superior court, who shall forthwith issue 
his warrant under the seal of that court, directed to the warden, 
authorizing him to remove the convict to one of the state lunatic 
hospitals, there to be kept till, in the opinion of the superintendent 



1875.] PUBLIC DOCUMENT— No. 23. 51 

and trustees thereof, he may be recommitted consistently with his 
health. The superintendent when so satisfied shall certify the fact 
of such restoration upon the warrant, and give notice to the war- 
den, who shall thereupon cause the convict to be reconveyed to the 
prison, there to remain pursuant to his original sentence, comput- 
ing the time of his confinement in the hospital as part of the term 
of his imprisonment. 

Lunatics in other Prisons. 

Section 4. When a convict in a prison other than the state 
prison, or in the house of correction, appears to be insane, the phy- 
sician attending the prison or house of correction shall make a 
report thereof to the jailer or master, who shall transmit the same 
in the county of SuflTolk to a judge of the superior court, and in 
any other county to the judge of the probate court. The judge 
shall make inquirj- into the facts therein stated, and if satisfied that 
such convict is insane, he ma}^ at an}' time he deems necessary, 
cause such prisoner" to be removed to one of the state lunatic hos- 
pitals. 

Section 5. If a person so removed is restored to sanity before 
the expiration of his sentence, he shall be forthwith returned to the 
prison or house of correction from which he was removed, there to 
remain pursuant to his original sentence, computing the time of his 
confinement in the hospital as part of the term of his imprisonment. 

■ [Chapter 223, Acts of 1862.] 
An Act concerning State Lunatic Hospitals and Insane and Idiotic Persons. 

Section 1. The titles of the state lunatic hospitals shall be sev- 
erally. The Worcester Lunatic Hospital, The Taunton Lunatic Hos- 
pital, and The Northampton Lunatic Hospital. 

Section 2. The lands now holden, and which may hereafter be 
holden, by the trustees of any state lunatic hospital, in trust for the 
commonwealth, for the use of the institution of which they are 
trustees, shall not be taken for an}- street, highwa}^ or railroad, 
without leave of the legislature specially obtained. 

Section 3. Any of the judges of the supreme judicial, superior, 
and probate courts, and, in the city of Boston, of the police court, 
ma}- commit to either of the state lunatic hospitals any insane per- 
son who, in their opinion, is a proper subject for its treatment or 
custody. But in all cases, the evidence and certificate of at least 
two respectable physicians shall be required to establish the fact of 
insanity. In all cases the judge shall certify in what place the luna- 
tic resided at the time of his commitment ; or if ordered to be 
confined by any court, the judge shall certify in what place the luna- 



52 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

tic resided at the time of tlie ari-est in pursuance of which he was 
held to answer before such court ; and such certificate shall, for the 
purposes of this act, be conclusive evidence of his residence. 

Section 4. Any person applying for the commitment or for the 
admission of a lunatic to a state lunatic hospital, under the provisions 
this act, shall first give notice in writing to the mayor, or one or 
more of the selectmen, of the place where the lunatic resides, of his 
intention to make such application ; and satisfactory evidence that 
such notice has been given shall be produced to the judge in cases 
of commitment, and to the trustees upon applications for admission. 

Section 5. Upon eveiy application for the commitment or ad- 
mission of an insane person to an}^ hospital o-r asylum for the 
insane, there shall be filed with the application, or within ten daj^s 
after the commitment or admission, a statement in respect to such 
person, showing, as nearly as can be ascertained his age, birth- 
place, civil condition, and occupation ; the supposed cause and the 
duration and character of his disease, whether mild, violent, dan- 
gerous, homicidal, suicidal, paralytic, or epileptic ; the previous or 
present existence of insanity in the person or his family ; his habits 
in regard to temperance ; whether he has been in an}^ lunatic hos- 
pital, and, if so, what one, when, and how long ; and, if the patient 
is a woman, whether she has borne children, and, if so, what time has 
elapsed since the birth of the youngest ; the name and address of 
some one or more of his nearest relatives or friends, together with 
any facts, showing whether he has or has not a settlement, and if 
he has a settlement, in what place ; and if the applicant is unable 
to state any of the above particulars, he shall state his inability to 
do so. The statement, or a copy thereof, shall be transmitted to 
the superintendent of the hospital or asylum, to be filed with the 
order of commitment, or the application for admission. 

Section 6. The judge ma}^ hear and determine such applications, 
in respect to persons alleged to be insane, at such times and places 
as he may appoint ; and the presence of the alleged lunatic at the 
hearing may be required or dispensed with, in the discretion of the 
judge ; and the court may, in its discretion, issue a warrant to the 
sheriff, or his deputy, directing him to summon a jury of six lawful 
men, to hear and determine whether the alleged lunatic is insane. 
Whenever a jury is summoned, pursuant to the provisions of this 
section, the same proceedings shall be had and the same fees and 
expenses paid as are provided by the General Statutes, chapter 
seventy-three, sections twelve, thirteen, fourteen, fifteen, and six- 
teen. 

Section 7. Whenever application shall be made to any judge of 
[the] probate [court] for the commitment of an insane person 



1875.] PUBLIC DOCUMENT— No. 23. 53 

under the provisions of this act, he may allow to the sheriff, depui}^ 
sheriff, or constable, or other person to whom a precept is directed 
b}^ name, who may serve the same, the same fees as are allowed to 
officers upon the commitment of persons to prison, and such further 
sum for expenses incurred in said commitments, or in bringing such 
lunatic before the judge, as to him may seem reasonable ; and the 
sums so allowed shall be certified and paid, as provided in the Gen- 
eral Statutes, chapter seventy-three, section sixteen. 

Section 8. Upon every application for the admission of an 
insane person to the several state lunatic hospitals, or to an}' as}-- 
lum or private house for the reception of the insane, the applicant 
shall file with his application a certificate, signed by two respectable 
physicians, one of whom, when practicable, shall be the famil}' ph}'- 
sician of the patient, certifying after due inquiry or personal exam- 
ination [due inquiry and personal examination. Acts of 1865, chap- 
ter 268, section 1] of the patient hy them, within one week prior to 
the date of the certificate, to the insanit}^ of the person in whose 
behalf admission is sought, and that such person is a fit subject for 
remedial treatment at such hospital, asylum, or private house. 

Section 9. Any insane person who is supported by an}' place as 
a pauper, may be committed, b}' the overseers of the poor thereof, 
to either of the state lunatic hospitals, with the consent of the 
trustees, and shall be kept for a sum not exceeding the actual 
expense of his support. And the trustees shall receive into the 
hospital an}' other insane person having a settlement or residence 
in this commonwealth, for such compensation as they may deter- 
mine. 

Section 10. The expenses for the state lunatic hospitals for the 
support of lunatics having known settlements in this state, shall be 
paid quarterly, either by the persons obligated to pay, or by the 
place in which such lunatics had their residence at the time of their 
commitment, unless other sufficient security is taken to the satisfac- 
tion of the trustees, for such support. If any place or person 
refuses to pay whatever sum may be charged and due according to 
the by-laws of the hospital, on account of the support of such 
patient therein, or for the removal of any patient whom the trustees 
are authorized by law to remove, for thirty days after the same has 
been demanded by the treasurer in writing, of tlie mayor and ah:ler- 
men of the city, or of the selectmen of the town, or of the person 
liable therefor, the same, with interest from the time of such 
demand, may be recovered for the use of the hospital, in an action 
to be instituted by the district-attorneys, or other prosecuting offi- 
cers, in the name of the treasurer, against such delinquent city, 
town, or person. 



54 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

[Chapter 105, Acts of 1870.] . 
An Act relating to the Price to be Paid for the Board of Insane State Paupers in 

Lunatic Hospitals. 

Section 1. The expenses of the state lunatic hospitals for the 
support of lunatics not having known settlements in this state, com- 
mitted thereto, shall be paid quarterly by the commonwealth, at the 
same rate charged for city and town pauper lunatics therein, but not 
to exceed the sum of three dollars and fifty cents for each person 
per week ; and the same may afterwards be recovered, by the 
treasurer of the commonwealth, of the lunatics themselves, if of 
sufficient abilitj^ to paj^ the same, or of any person of kindred 
obligated by law to maintain them, or of the place of their settle- 
ment, if an}' such is ascertained. 

[Chapter 223, Acts of 1862.] 

Section 12. It shall be the official duty of the attorney-general 
and district- attornej's to advise and consult with the trustees and 
treasurers of the several state lunatic hospitals, when requested by 
them, on all questions of law relating to their official business. 

Section 13. If at an}- time, all the state lunatic hospitals shall 
be so full that the inmates cannot all be suitably accommodated 
therein, and in the opinion of the trustees of either hospital it is 
proper that some should be removed, the trustees ma}' remove to 
their respective homes, or to the places of their legal settlement, or 
of their residence, so many as may be necessary to afford suitable 
accommodation for the remainder ; but onh' such patients shall be 
selected for removal as, in the opinion of the trustees and superin- 
tendent, are not susceptible of Improvement, and can be suitably 
managed at their homes or in the places to which they ma}' be sent. 

Section 1G. The money and cost of clothing which the trustees 
of any state lunatic hospital may by law furnish to discharged 
pauper lunatics, the expense of pursuing such as elope therefrom, 
and of burial of pauper lunatics dying in the hospitals, shall be 
reimbursed to the trustees by the places of legal settlement of city 
and town paupers, and by the commonwealth in the case of state 
paupers. 

Section 17. When a person held in prison on a charge of having 
committed an indictable offence is not indicted by the grand jury, 
or on trial is acquitted by the jury by reason of insanity, the jury 
in either case shall certify that fact to the court, and thereupon, if 
the court is satisfied that he is insane, they may order him to be 
committed to one of the state lunatic hospitals under such limita- 
tions as they may direct. 



1875.] PUBLIC DOCUMENT— No. 23. 55 

[Chapter 240, Acts of 1863.] 
An Act in relation to State Charitable and State Correctional Institutions. 
Section 4, They [the board of state charities] shall have full 
power to transfer pauper inmates from one charitable institution or 
lunatic hospital to another, and for this purpose to grant admit- 
tances and discharges to such pauper inmates, but shall have no 
power to make purchases for the various institutions. They shall 
receive no compensation for their services except their actual travel- 
ling expenses, which shall be allowed and paid. 

[Chapter 288, Acts of 1864.] 
An Act relating to Insane Persons and Lunatic Hospitals. 

Section 6. It shall be the duty of the overseers of the poor of 
any cit}^ or town, except the city of Boston, to commit to one of the 
state lunatic hospitals, or the Boston Lunatic Hospital, with the 
consent of the trustees thereof, an}' person supported by such cit}' or 
town who is suffering under recent insanity, and is a fit subject for 
remedial treatment. 

Section 7. Whenever the board of state charities shall have 
reason to believe that any insane person, not incurable, is deprived 
of proper remedial treatment, and is confined in any almshouse or 
other place, whether such insane person is a public charge or other- 
wise, it shall be. the duty of said board to cause application to be 
made to one of the judges of the supreme judicial, superior, or pro- 
bate courts, for the commitment of such person to a hospital in the 
manner prescribed by law. 

Section 8. The governor and council may license an}^ suitable 
person to establish and keep an as3'lum or private house for the 
reception and treatment of insane persons, and may at any time 
revoke such license. And such asylum or private house shall be 
subject to visitation bj' the governor and council, or any committee 
thereof, and by the judge of the probate court of the county wherein 
the same is situated. 

Section 9. Whoever establishes or keeps such an asylum or 
private house, without a license unless otherwise authorized by law, 
shall forfeit a sum not exceeding five hundred dollars. 

[Chapter 268, Acts of 1865.] 
An Act amending the Act concerning State Lunatic Hospitals and Insane and 

Idiotic Persons. 

Section 1. The eighth section of the two hundred and twenly- 
third chapter of the acts of the year eighteen hundred and sixty-two 
is hereb}' so amended that the certificate signed by two respectable 
physicians and required by said section shall be made according to 



56 LUNATIC HOSPITAL AT WORCESTER. [Oct. 

the provisions of said section, after clue inquiry and personal examin- 
ation of the patient b}' them. 

Section 2. Upon application for the admission of an insane per- 
son to an}' state lunatic hospital, or to any asylum or private house 
for the reception of the insane, the applicant shall file with his 
application, a statement containing the names of such insane per- 
son's father, mother, children, brothers, sisters, or other next of kin, 
not exceeding ten in number, and over eighteen years of age, when 
the names and address of such relatives are known by the person or 
persons making such application, and such statement shall be filed 
with the order for commitment or application for admission. And 
the superintendent, or person in charge of such asylum or house for 
the reception of the insane, shall, within two daj's from the time of 
the admission or commitment of any insane person, send, or cause 
to be sent, notice of said commitment in writing, by mail, postage 
prepaid, to each of said relatives, and to any other two persons whom 
the person committed shall designate. 

[Chapter 321, Acts of 1871.] 
Ax Act in relation to the Discharge of Persons Confined as Insane. 

Section 1. Any two of the trustees of either of the state lunatic 
hospitals, on application in writing, or of their own motion, or any 
judge of the supreme judicial court at an}^ time and in any county, 
or the judge of the probate court for the county in which the hospital 
is located or of the count}' in which the patient had his residence at 
the time of his commitment or admission, on such application, after 
such notice, as the said trustees or judge ma}' deem reasonable and 
proper, may discharge any person confined therein if it appears that 
such person is not insane, or, if insane, will be sufficiently provided 
for by himself, his guardian, his relatives, his friends, or the city or 
town liable for his support, or that his confinement therein is not 
longer necessary for the safety of the public nor his own welfare. 

Section 2. Any two of the trustees may remove any person 
confined therein to the city or town in which the judge or court 
committing him certified that he resided at the time of the confine- 
ment, or to the place of his known lawful settlement, when in their 
opinion he ceases to be dangerous and is not susceptible of mental 
improvement at the hospital, if such city or town does not remove 
him after reasonable notice in writing. 

Section 3. Any person may, in writing, make application to a 
judge of the supreme judicial court at any time and in any county, 
setting forth that he believes or has reason to believe that a person 
therein named is confined as an insane person in a lunatic hospital 
or other place, whether public or private, and ought not longer to 



1875.] PUBLIC DOCUMENT— No. 23. 57 

be so confined, stating also the names of all persons supposed to 
be interested in keeping Mm in confinement, and requesting his 
discharge. 

Section 4. The judge shall, upon reasonable cause being shown 
for a hearing, order notice of the time and place of hearing on said 
application to be given to the superintendent in charge of the hos- 
pital, or place of confinement, and to such other persons as he deems 
proper, and such hearing when ordered shall be had as speedily as 
conveniently may be before the same or any other judge of the 
supreme judicial court in any county. The alleged insane person 
may be brought before the judge, at the hearing, upon a writ of 
habeas corpus, if any party so requests and the judge deems it 
proper, and an issue or issues may be framed and submitted to a 
jury by direction of the judge or on the request of any person who 
appears in the case. The jurors may be those in attendance on 
said court, if in session at the time of the hearing, or may be sum- 
moned for the especial purpose on venires issued by the clerk of 
said court upon the order of the judge substantially in accordance 
with the provisions of chapter one hundred and thirty-two of the 
General Statutes. 

Section 5. If it appears upon the verdict of the juiy, or in the 
opinion of the judge, if not submitted to a jury, that the person so 
confined is not insane, he shall be discharged from such confine- 
ment. 

Section 6. Upon complaint of any person confined in any lunatic 
hospital or other place for the treatment or custody of insane per- 
sons, public or private, or of any other person in his behalf, to the 
general agent of the board of state charities, that such person 
ought not longer to be so confined, the agent shall have power to 
investigate the case, make report thereof to said board, and if they 
so direct, shall make application for the discharge of the person so 
confined to a judge of the supreme judicial court, as provided in 
section three of this act ; and the proceedings upon such applica- 
tion shall be as ordered in sections four and five of this act. And 
any district-attorney, upon request of the agent, shall aid him and 
conduct the proceedings in his behalf. 

[Chapter 275, Acts of 1873.] 
An Act giving Trial Justices of Juvenile Offenders Jurisdiction in Matters relating 

to Insane Persons. 

Any trial justice of juvenile offenders of SuflTolk County shall have 

the same jurisdiction as the judges of probate in all matters relating 

to the commitment of insane persons, and may commit to either of 

the state lunatic hospitals, or to the Boston Lunatic Hospital, any 

8 



58 LUNATIC HOSPITAL AT WORCESTER. [Oct.'75. 

insane person, who in his opinion is a proper subject for treatment 
or custody in such hospitals, in accordance with the laws now or 
hereafter in force in relation to lunatic hospitals and insane persons. 
Said trial justice shall receive the same fees and compensation as 
now provided by law for judges of probate in like cases, to be paid 
by the county of Suffolk. 

[Chapter 363, Acts of 1874.] 
An Act relating to the Correspondence of Insane Persons, etc. 

Section 1. All persons confined as patients in the several lunatie 
asylums in this state, shall be allowed to write monthly to the super- 
intendent of the as^'lum in which they are confined, also to the board 
of state charities. ... 

Section 2. All patients in such asylums shall be furnished by 
the several superintendents with all materials necessary for such 
correspondence. And a locked box shall be placed in each ward in 
which each writer may deposit his or her communication, said boxes 
to be opened and letters to be distributed monthly by some member 
of the board of state charities.