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

.-' ':;:- .:•

-L5£

PUBLIC DOCUMENT.... ....No. 23.

FORTY-FIFTH ANNUAL EEPORT

THE TRUSTEES

OF THE

WORCESTER LUNATIC HOSPITAL

WOECESTEE.

For the Year ending September 30, 1877.

BOSTON:

RAND, AVERY, & CO., PRESTTERS TO THE COMMONWEALTH,

117 Franklin Street.

1878.

Digitized by the Internet Archive

in 2010 with funding from

University of Massachusetts Amherst

http://www.archive.org/details/annualreportoftr43stat

OFFICERS OF THE HOSPITAL.

TRUSTEES.

Prof. JAMES B. THAYER .
EOBERT W. HOOPER, M.D.
Gen. WILLIAM S. LINCOLN
THOMAS H. GAGE, M.D. .
Hon. JOHN D. WASHBURN

Cambridge.

Boston.

Worcester.

Worcester.

Worcester.

RESIDENT OFFICERS.

BARNARD D. EASTMAN, M.D
JOHN G. PARK, M.D. .
HOSEA M. QUINBY, M.D.
W. H, RAYMENTON, M.D.
DANIEL W. BEMIS .
MARIA L. WARREN
CLARENCE BUFELNTON
ALPHEUS YOUNG .
FRED LANE .

Superintendent.

Assistant Superintendent.

Assistant Physician.

Assistant Physician.

Steward.

Matron.

Clerk.

Engineer.

Farmer.

TREASURER.

ALBERT WOOD

Worcester.

tfommimtDealtl) of iilasscul)U0£tt0.

TRUSTEES' REPORT.

To His Excellency the Governor and (lie Honorable Council.

The Trustees of the Worcester Lunatic Hospital respect-
fully submit their Forty-fifth Annual Report.

The reports of the Superintendent and Treasurer are here-
with submitted, and reference is made to them for full infor-
mation as to the transactions of the institution during the
past year. It is believed that an examination of them will
show good results of treatment, and sound financial man-
agement.

The fiscal year closes on September 30, and all accounts
are made up to that date. The statute establishing an
Asylum for the Chronic Insane, and appropriating the build-
ings heretofore used by the Worcester Lunatic Hospital for
that purpose, took effect September 1, 1877; but it was
found impossible to occupy it for that purpose till after the
first of October. No accounts relating to it can therefore be
included in this Report ; but it may be stated that on the
twenty-third day of October it was opened for the uses con-
templated by the statutes, and is now in full and satisfactory
operation, to the great relief of the lunatic hospitals, and
with every prospect of advantage to the Commonwealth.
The Trustees have appointed John G. Park, M.D., heretofore
the efficient and valued Assistant Superintendent of the
Worcester Lunatic Hospital, to be the Superintendent, and
Dr. Enoch Q. Marston, late Assistant Physician at the State

6 LUNATIC HOSPITAL AT WORCESTER. [Oct.

Almshouse at Tewksbury, to be Assistant Physician, of the
Asylum for the Chronic Insane. In their next annual
report, full particulars will be given of the operations of
this institution.

The Trustees have addressed themselves with fidelity, and
with such ability as they possess, to the work of completing
the new hospital, which has been in process of construction,
under their direction and authority, during the past five
years. It was occupied by patients on the twenty-third of
October ; and, though the Trustees claim no credit to them-
selves beyond a faithful devotion to the interests of the Com-
monwealth in all matters relating to the character of the
work, and the economy with which all its details have been
carried out, it is believed it will prove to be one of the
best working institutions in the country for the purposes for
which it was designed.

The amount of the appropriations made by the
Legislature to carcy out the purposes of the
original Acts for the construction of this Hospi-
tal, is $1,167,387 75

And the last Legislature (Resolves of 1877, c. 65)
appropriated $30,000 "to the Trustees of the
Worcester Lunatic Hospital, for the purchase of
such additional furniture as may be required in
consequence of the establishment of the Tempo-
rary Asylum for the Chronic Insane," which
now occupies the old buildings . . . 30,000 00

Making the whole amount appropriated and avail-
able for the building and furnishing of the hos-
pital " . . . 1,197,387 75

Of this amount, as appears by our last annual re-
port, there had been expended at the close of
the fiscal year, ending September 30, 1876 . 879,299 74

During the fiscal year ending September 30, 1877,
there has been expended and charged to the gen-
eral appropriation, the sum of . . . . 174,605 40

And charged to the special appropriation of 1877 17,038 00

Making the total amount expended for construc-
tion and furnishing to September 30, 1877 . 1,070,943 14

Leaving a balance in the hands of the Trustees,
September 30, 1877, from the whole amount ap-
propriated, of . . .... . . 126,444 61

1877.]

PUBLIC DOCUMENT — No. 23.

Under the classification adopted in the last report, the
total amount has been expended as follows : —

Land $112,247 71

Barns and cottages 18,873 74

Grading, excavating, &c 70,435 77

Foundations 35,281 73

Superstructure, masonry ..... 364,551 17

Carpentry 198,192 88

Painting, windows, guards, &c 32,307 28

Water, gas, drainage 55,192 85

Heating and ventilating 56,556 69

Plastering 43,728 89

Architects, engineers, overseers, &c. . . . 28,460 21

Eoad, and grading pertaining thereto . . . 9,589 07

Machinery 10,099 44

Miscellaneous 15,149 42

Expenses laying out old land, and constructing

streets . . . ... . . 3,238 29

Furniture 17,038 00

Total $1,070,943 14

Of the amount which remained unexpended on September
30, 1877, a considerable sum has since been paid out, or will
be required before the close of the year, to meet payments
on existing contracts, or for work already undertaken.
There will remain, however, on the first of January, 1878,
from $50,000 to $60,000 of the appropriation unexpended,
which will, by limitation, lapse into the treasury. This sum
it will, in the judgment of Trustees, be desirable to have re-
appropriated, as an expenditure for out-door work will be
required next season, which could not profitably be under-
taken this year ; especially for airing-courts, completion of
grounds, finishing roads, walls, &c.

It should be observed that the amount charged in the con-
struction account, for " lajdng out old land," is not properly
a part of the cost of the new building and grounds. It
appears in the account for the following reasons.

In accordance with the provisions of an Act of the Legis-
lature, the Governor and Council ordered that the sum of
),000 be credited to the fund for building the new hospital,

8 LUNATIC HOSPITAL AT WORCESTER. [Oct.

as compensation for the site occupied by the State Normal
School, which amount was to include the construction of
" suitable streets to and around said land." The full sum
of $25,000 having been credited to this fund, the expense of
laying out and constructing the streets was, as matter of
book-keeping, charged to the same fund, though forming no
part of the cost of the new hospital.

The legal disability of the holder to receive payment of
the note of $2,500, given by the Trustees, for land pur-
chased of John Bartlett, still continues, and that note there-
fore remains unpaid.

The Hospital continues in charge of Dr. B. D. Eastman as
Superintendent. Dr. H. M. Quinby has been appointed
First Assistant Physician, and Dr. A. R. Moulton is acting,
under the authority of the Trustees, as Second Assistant.

JOHN D. WASHBURN.
R. W. HOOPER.
WM. S. LINCOLN.
THOMAS H. GAGE.
JAMES B. THAYER.

1877.]

PUBLIC DOCUMENT — No. 23.

OFFICERS AND THEIR SALARIES.

B. D. Eastman, M.D. (Superintendent)

J. G. Park, M.D. (Assistant Superintendent)

H. M. Quinby, M.D. (Assistant Physician)

W. H. Raymenton, M.D. (Assistant Physician)

Daniel W. Bemis (Steward)

Maria L. Warren (Matron)

Clarence Buffinton (Clerk)

Alpheus Young (Engineer)

Fred Lane (Farmer) .

Albert Wood (Treasurer) .

$2,500 00

1,500 00

1,000 00

600 00

1,200 00

450 00

400 00

1,200 00

700 00

500 00

VALUE OF LIVE STOCK AND SUPPLIES,

September 30, 1877.

Live stock

Produce of farm on hand .

Carriages and agricultural implements

Beds and bedding in inmates' department

Other furniture in inmates' department

Personal property of the State in Superintendent's

department* .
Dry goods .

Provisions and groceries
Drugs and medicines .
Fuel . . . ' .

Library
Ready-made clothing

Total

$5,195 00

4,235 88

5,118 00

13,192 00

10,239 32

12,300 15

1,170 54

3,910 96

350 00

3,074 00

750 00

338 00

$59,873 85

* Including all personal property not coming under the two previous classes.
2

10 LUNATIC HOSPITAL AT WORCESTER. [Oct.

TREASURER'S REPORT.

To the Trustees of the Worcester Lunatic Hospital.

Gentlemen : — I herewith submit my Annual Report on
the finances of the Worcester Lunatic Hospital for the year
ending September 30, 1877.

Receipts.

Cash on hand September 30, 1876 .... $33,166 49
received of the Commonwealth for support of

patients 10,182 23

received of cities and towns for support of patients 62,450 71

received of individuals for support of patients . 35,587 64

received for interest and sale of produce, etc. . 3,614 30

$145,001 37

The expenditures for the year have been as follows : —

Provisions.
Flour, 619 barrels, at $8.37 per barrel
Meat of all kinds
Meal for cooking
Beans, potatoes, and other vegetables
Fish
Sugar

Molasses and sirup
Tea

Coffee and chocolate
Rice and crackers
Butter

Amount carried forward

$5,186

75

10,743

18

468

13

1,402

96

1,120

76

3,261

48

647

53

1,206

04

712

83

615

88

4,702

94

),068 48

1877.]

PUBLIC DOCUMENT — No. 23.

11

Amount brought forward
Vinegar and pickles .
Cheese

Fresh fruits ....
Eggs, salt, and other groceries .

Total for provisions .

Salaries and wages .

Extra labor ....

Provender and bedding for stock

Furniture, crockery, bedding, etc.

Light .....

Soap .....

Medical supplies

Live-stock ....

Carriages, harness, blacksmithing, etc.

Improvements and repairs

Books, stationery, and printing

Travelling and transportation .

Fuel

Freight and express

Ice .

Trustees' expenses

Miscellaneous .

Clothing and materials
Undertaker's charges
Furnished to patients on account
Interest and money refunded

Cash on hand September 30, 1877

Resources.
Cash on hand .....
Due from the Commonwealth .

from cities and towns

from individuals

$30,068

48

06

56

401

29

349

42

2,754

07

$33,639 82

35,424

20

75

19

1,497

90

2,782

51

2,632

04

957

23

832

36

981

00

1,287

98

3,196

69

775

51

13

35

8,867

37

54

83

555

13

264

36

1,860

22

$95,697 69

5,358

44

491

50

378

58

607

77

$102,533

98

42,467

39

$145,001

37

$42,467

39

2,978

25

17,190

85

8,926

97

Amount carried forward

,563 46

12 LUNATIC HOSPITAL AT WORCESTER. [Oct.

Liabilities.

Amount Drought forward $71,563 46

Due for supplies . . . * . $6,556 56

for salaries and wages . . . 3,288 53

9,845- 09

$61,718 37
Invested funds, market value 5,627 27

17,345 64

Respectfully submitted.

ALBERT WOOD, Treasurer,
Worcester Luxatic Hospital, October 1, 1877.

1877.] PUBLIC DOCUMENT — No. 23. 13

SUPERINTENDENT'S REPORT.

To tlie Board of Trustees of the Worcester Lunatic Hospital.

Gentlemen: — The expiration of another hospital year
calls for the Forty-Fifth Annual Report, which is respectfully
submitted.

During the last few months, the work of preparing the
new building for occupation has been pushed as vigorously
as possible, and it was first occupied on the 8th of October
by your Superintendent and a few assistants. The first
patients were removed from the old building on the 16th of
October, and the transfer completed, without any accident,
October 23 ; four hundred and thirty patients having been
removed to the new building and one hundred left as a
nucleus for the Asylum for Chronic Insane, which occupies
the old building, in accordance with the provisions of an Act
passed by the last Legislature.

This extra labor, coming at the time when the Annual
Report should be prepared, must be my excuse for the brev-
ity of this document, and the unusual delay in presenting it
to your Board.

14 LUNATIC HOSPITAL AT WORCESTER. [Oct.

Table No. 1.

Showing the General Results during the Year.

Males.

Females.

Total.

Patients in the hospital, October 1, 1876

249

238

487

Admitted during the year * .

177

177

354

Whole number under treatment

426

415

841

Discharged recovei'ed .

38

34

72

improved .

58

39

97

not improved

31

43

74

died .

43

26

69

not insane .

-

1

1

Whole number discharged f

170

143

313

Remaining September 30, 1877

256

272

528

Largest number on any day, June 13

255

278

533

Smallest number on ( Nov. 30, 7 . , .

i < -rw n r inclusive
any day . . ( Dec. o, >

242

241

483

Daily average during the year

247.09

259.37

506.46

of State patients .

26.97

26.57

53.54

of town patients

168.11

161.55

329.66

of private patients .

52.01

71.25

123.26

* Including three re-admissions within the year, and eight nominal admissions of patients
discharged to be committed.
t Including two by elopement.

Table No. 2.
Shoiving the Complications in the Cases admitted during the Year

Epileptic .......

4

7

11

Epileptic and homicidal

5

-

5

Paralytic

8

■ 7

15

Paralytic and homicidal

o

-

o

Suicidal

16

28

44

Homicidal .

32

12

44

Suicidal and paralytic .

-

1

1

Suicidal and homicidal

5

4

9

Total number of cases epileptic

9

7

16

Total number of cases paralytic

10

8

18

Total number of cases suicidal

21

33

54

Total number of cases homicidal

44

16

60

1877.]

PUBLIC DOCUMENT — No.

15

Table No. 3.

Showing the Relations of the Patients admitted, to Institutions

of this Kind.

Males.

Females.

Total.

Never before in any hospital

123

138

261

Former inmates of this hospital .

39

31

70

of other hospitals in this
State ....

7

6

13

of this hospital and of other
hospitals in this State

6

_

6

of other hospitals in this
State and hospitals in
other States

2

1

3

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

-

1

1

Totals

177

177

351

Table No. 4.

/Showing the Sources from which the Patients admitted were
directly drawn.

From the general population

McLean Asylum for the Insane .

Ipswich Receptacle ....

Houses of Correction ....

State Prison .....
Re-admitted without discharge from hospital,

158
1
1
14
2
1

168
1

1

7

326
2
1
15
2
8

Totals

177

177

351

Table No. 5.

Showing by whom the Patients, remaining at the End of the
Year, are supported.

By the State (State patients)
Town (town patients)
Friends (private patients)

28

176

52

23
179

70

51
355
122

Total

256

272

528

16 LUNATIC HOSPITAL AT WORCESTER. [Oct.

Table No. 6.

Showing the Alleged Causes of Insanity in the Number of Cases
admitted during the Tear.

NUMBER OF CASES.

NUMBER PREDISPOSED.

CAUSES.

Males.

Females.

Males.

Females.

Abortion .....

-

1

-

_

Army life

1

-

-

-

Apoplexy

-

1

-

-

Business anxiety .

5

-

2

-

Confinement in prison .

1

-

1

-

Congenital .

1

-

-

-

Disappointed affection .

-

3

-

-

Domestic trouble .

2

4

-

-

Epilepsy . . .

8

4

2

3

Excitement .

1

-

-

-

Grief ....

2

5

-

-

General paralysis .

4

-

-

-

Hereditary .

9

21

9 '

21

Ill health

8

10

5

3

Injury to head

2

1

-

1

Intemperance

23

4

8

1

Masturbation

8

1

-

-

Nervous debility .

1

4

-

-

Old age

-

2

-

-

Overwork

7

5

1

3

Paralysis

1

4

-

-

Puerperal

-

10

-

2

Religious excitement

5

7

4

3

Sunstroke

2

-

-

-

Syphilis

'■

1

-

-

-

Tobacco

1

-

-

-

Turn of life .

-

7

-

-

Uterine disease

1

3

-

-

Unascertained

84

80

-

-

Total .

177

177

32

37

1877.]

PUBLIC DOCUMENT — No. 23.

17

Table No. 7.

Showing the Ages of Patients admitted, discharged recovered, not
recovered, and died during the Year.

AGES.

Admitted.

Discharged re-
covered.

Discharged not
recovered.

Died.

Males.

Females.

Males.

Females.

Males.

Females.

Males.

Females.

From 15 to 20

9

16

3

3

5

5

-

2

20 to 30

50

47

13

11

26

17

7

-

30 to 40

52

29

14

8

21

23

6

5

40 to 50

36

46

5

6

20

22

11

7

50 to 60

19

17

2

2

11

10

11

2

60 to 70

5

14

-

4

5

3

5

4

70 to 80

4

4

1

-

1

3

1

3

80 to 90

2

4

-

-

-

-

2

3

Total

177

177

38

34

89

83

43

26

Table No. 8.

Showing the Duration of Insanity before Admission of Patients,
admitted, discharged recovered, not recovered, and died during
the Year.

Admitted.

Discharged re-
covered.

Discharged not
recovered.

Died.

DURATION OF INSANITY.

"Hi

at

1

a>
Em

a>
3

s

jo3

el

1

09

ID

'a

a

Em

Insane one year or less,

100

100

23

25

41

29

11

3

More than 1 year and

less than 2 years

13

27

8

5

11

16

10

4

More than 2 years and

less than 5 years

17

21

3

2

17

20

11

9

More than 5 years and

less than 10 years .

7

9

3

—

3

7

2

2

18 LUNATIC HOSPITAL AT WORCESTER. [Oct.
Table No. 8. — Concluded.

Admitted.

DISCHARGED RE-
COVERED.

Discharged not
recovered.

Died.

DURATION OF INSANITY.

CD '

<D

"3
1

1

e3

1

3

tS

a

Pa

More than 10 years and

less than 15 years .

5

7

-

-

2

6

2

2

More than 15 years and

less than 20 years

3

5

1

1

4

2

4

o

More than 20 years and

less than 25 years

2

1

-

-

3

1

2

2

More than 25 years and

less than 30 years .

-

-

-

-

-

-

-

1

Thirty years or more .

1

1

-

1

-

-

-

1

Unknown .

29

6

-

-

8

2

1

-

Total .

177

177

38

31

89

83

43

26

Table No. 9.

Showing the Civil Condition of Patients admitted, discharged
recovered, not recovered, and died during the Year.

CIVIL
CONDITION.

Admitted.

Discharged re-
covered.

Discharged not
recovered.

Died.

Males.

Females.

Males.

Females.

Males.

Females.

Males.

Females.

Unmarried

Married

Widowers

Widows

Divorced

Unknown

73

86

7

1
10

82
64

29
1
1

22

12

4

12

19

3

44

42

2

1

32
35

16

11

26
6

8

11

5

2

Total .

177

177

38

34

89

83

43

26

1877.]

PUBLIC DOCUMENT — No. 23.

19

Table No. 10.

Showing the Occupation of Patients admitted during the Year.

Males.

Barber ..... 1

Moulders .... 2

Blacksmith .

1

Musician

1

Book-keeper .

1

Operatives in

milk

8

Broker .

1

Painters

6

Butchers

3

Peddlers

1

Carpenters .

6

Pilots .

2

Carriage-maker

1

Porter .

1

Clergyman .

1

Printers

4

Clerks .

7

Sail'maker

1

Confectioner

1

Salesmen

2

Cooper .

1

Shoemakers

16

Curriers

5

Stonecutter

2

Dentist .

1

Student

1

Engraver

1

Tailors

3

•Farmers

12

Teacher

1

Fishermen

5

Turner .

1

Grocer .

1

Weavers

9

Harness-maker

1

Wheelwright

1

Laborers

26

No occupation

11

Machinists

6

Unknown

6

Masons

4

Mechanics

6

Total . . . .177

Merchants

6

Females.

Book-keeper .

1

Students

3

Clerk ....

1

Teachers

3

Domestics

35

Telegrapher .

1

Dressmakers

2

No occupation

. 37

Housekeepers

70

Unknown

1

Operatives in mills

15

Proof-reader

1

Total .

. 177

Seamstresses

7

20

LUNATIC HOSPITAL AT WORCESTER. [Oct.

Table No. 11.

Showing the Diseases which have proved Fatal during the Year.

DISEASES.

Acute mania ........

Acute melancholia .......

Apoplexy . . . . . .

Cancer . . .

Chronic bronchitis .......

Epilepsy

Exhaustion of chronic insanity . . . ,
Erysipelas ........

General paralysis .......

Gunshot wound of head, inflicted before admission.

Heart disease

Paralysis

Pneumonia ........

Phthisis ..........

Pleurisy . .

Typhoid fever .......

Senility .........

Total

4
1
1

1
2
6
1
14
1
1

3
3
1
1
3

43

7
1
2
1
1
5

10
1

17
1
1
3
4
4
1
4
6

26

69

Table No. 12.

Showing the Admissions from each County during the Year.

COUNTIES.

Males.

Females.

Total.

41

38

79

-

1

1

65

68

133

Norfolk

2

4

6

-

2

2

Suffolk

7

5

12

62

59

121

Total

177

177

354

1877.]

PUBLIC DOCUMENT — No. 23.

21

Table No. 13.

Showing the Whole Number of Patients during each Year, the
Average Number, the Number at the End of each Year, the Ex-
penses of each Year, the Annual Expense of each Patient, and
the Expense of each Patient per Week for each of the Forty-Jive
Years the Hospital has been in Operation.

TEAKS.

o

■Q

a

a

a

0>

to

cj
a>
>
<

a .

*> u

s <*
a o

(V

§ 1

a g

a o
o

a "S
m S

a g
a a

H 5

1833 .

153

107

114

$12,272 91

$114 67

$2 25

1834

233

117

118

15

840 97

136 38

2 60

1835

241

120

119

16

576 44

137 30

2 64

1836

245

127

138

21

395 28

168 44

3 12

1837

306

163

185

26

027 07

159 64

3 07

1838

362

211

218

28

739 40

136 20

2 62

1839

397

223

229

29

474 41

132 16

2 53

1840

391

229

236

27

844 98

121 59

2 32

1841

399

233

232

28

847 62

123 81

2 38

1842

430

238

238

29

546 87

111 12

2 13

1843-

458

244

255

27

914 12

114 40

2 20

1844

491

261

263

29

278 75

112 17

2 15

1845

656

316

360

43

888 65

138 88

2 66

1846

637

359

367

39

870 37

111 06

2 13

1847

606

377

394

39

440 47

104 62

2 01

1848

655

404

409

42

860 05

106 09

2 05

1849

682

420

429

40

870 86

97 31

1 87

1850

670

440

441

46

776 13

106 40

2 04

1851

704

462

466

52

485 33

112 61

2 16

1852

775

515

532

43

878 35

85 20

1 62

1853

820

537

520

53

606 66

103 14

1 98

1854

819

430

381

53

221 52

123 77

2 38

1855

580

349

336

54

895 88

157 29

3 02

1856

577

357

376

45

631 37

128 64

2 47

1857

647

387

372

49

004 75

124 04

2 38

1858

679

372

301

38

267 26

102 86

2 39

1859

501

309

317

48

363 33

156 51

3 01

1860

532

324

331

47

757 01

147 39

2 83

1861

583

369

379

54

748 53

148 37

2 84

1862

600

401

396

53

043 88

132 18

2 50

1863

611

398

399

66

082 36

166 03

3 19

1864

625

366

344

66

612 00

182 00

3 50

1865

565

350

343

73

772 41

211 37

4 06

1866

630

368

381

88

398 73

239 28

4 60

1867

669

389

355

86

930 88

223 47

4 30

1868

651

370

382

72

054 59

197 60

3 80

1869

719

387

376

81

440 58

209 04

4 02

1870

760

396

408

75

715 51

191 20

3 68

1871

879

439

421

96

455 69

219 27

4 22

1872

864

450

439

92

533 93

205 63

3 95

1873

846

-453

469

95

196 83

210 14

4 04

1874

869

476

485

101

463 68

213 16

4 10

1875

847

487

478

100

680 39

206 74

3 98

1876

829

500

487

94

446 59

188 89

3 64

1877

841

506

528

95

697 69

189 12

3 64

22 LUNATIC HOSPITAL AT WORCESTER. [Oct.

The foregoing table shows the average weekly expendi-
ture per patient to be the same as last year. In fact, the
minimum, compatible with due regard to the welfare of our
patients, under the circumstances in which we have been
placed, had been reached. It should not be forgotten, that
at the old building, with an average of about four hundred
and seventy-five inmates (not including those at the cottages),
there were almost fifty per cent more patients than the house
could properly accommodate ; or, in other words, the space,
and heat, and light, and service, &c, that belonged to two
patients were given to three. In our present quarters, under
circumstances more favorable for the physical and mental
comfort of our inmates, increased expenditure must be
expected ; but the aim must be to keep it within reasonable
limits.

At this writing we have occupied our new building, with
all our family, but a week. Many months will elapse before
all the multifarious details of such an establishment are
fully adjusted, and the wheels move with only the usual
friction. In looking back upon the work of planning,
erecting, furnishing, and occupying new buildings, it is a
source of congratulation that the work has been carried on
so successfully and satisfactorily. The success of the whole
project is yet to be demonstrated, and to that end we now
devote our energies.

B. D. EASTMAN,

Superintendent.

Worcester Lunatic Hospital, ^
Worcester, October 30, 1877. J

1877.] PUBLIC DOCUMENT — No. 23. 23

SUGGESTIONS TO FKIENDS OF PATIENTS.

Persons should never be brought to the hospital except in strict
compliance with the requirements of the law. Blank forms of
admission, and all necessary information, will be furnished upon
application to the Superintendent.

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

If possible, some person should come with the patient who can
give a correct histoiy of the case. Efforts should be made to
inculcate the idea that the officers and employes of the hospital
will be kind and friendby, and endeavor to promote the best inter-
ests 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 condi-
tion will admit, Jewelr}*, superfluous articles of dress, knives,
&c, 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, &c. ; but it
cannot be entirely avoided.

All packages sent by express to patients should be paid through,
and plainly 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 envelope,
directed to the patient, and the whole placed in another envelope
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.

In all cases which have been at the hospital but a short time, or

24 LUNATIC HOSPITAL AT WORCESTER. [Oct.

are subject to periodical attacks of excitement, friends should
ascertain 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.

The Worcester Lunatic Hospital, which has been in existence
forty-five years, has removed to its new buildings, near Lake
Quinsigamond, about one and one-half miles from the Union
Passenger Station, and is prepared to offer special accommodations
to those who desire them.

In order to avoid confusion in correspondence, care should be
taken to give the proper address.

B. D. EASTMAN,

Superintendent.

Worcester Lunatic Hospital, ^

Worcester, Mass. )

1877.] PUBLIC DOCUMENT — No. 23. 25

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 Order of Court.

Second. By Friends.

Tliird. By Overseers of the Poor.

First. By Order of Court.

Any of the judges of the supreme judicial, superior, and probate
courts, and any trial justice of juvenile offenders of Suffolk County,
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 subject for

the treatment and custody of the Worcester Lunatic Hospital.

Wherefore h prays that said may be committed to the said

Worcester Lunatic Hospital, according to law.

ss. A.D. 187 .

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

by h subscribed, is true.
Before me,

Justice of the Peace.

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

, where said resides, hereby acknowledge that notice

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

A.D. 187 .

26 LUNATIC HOSPITAL AT WORCESTER. [Oct.

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

The subscriber, having made application to your honor 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.

Married, or single ? Ans.

Occupation ? Ans.

Supposed cause of disease ? Ans.

Duration ? Ans.

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

Homicidal, or suicidal ? Ans.

Paralytic, or epileptic ? Ans.

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., 1868, chap. 328.

" " 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 Massachusetts.

ss.

At m said county, on the day of A.D. 1S7 .

On the application of for the commitment of of

in said county, to the Worcester Lunatic Hospital, ;

1877.] PUBLIC DOCUMENT— No. 23. 27

notice in writing having been given by said applicant to one of the selectmen
of where said resides, of h intention

to make said application, and said having received all necessary

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

treatment and custody of the Worcester Lunatic Hospital.

Therefore, it is ordered that said be committed to the said

Worcester Lunatic Hospital.

Judge of the Probate Court.

Second. By Friends — Private Patients.

For the admission of private patients, application must be made
by relative, guardian, or friend, and certificate of insanity, acknowl-
edgment of notice to selectmen or rnayor, and satisfactory bond
for support, must be given according to 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, 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, with such extra charges as may be occasioned by the necessity of
giving h more than ordinary care or attention ; to provide to 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 by 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. 1S7 .

Attest: Principal.

[Post-office address.]

[Post-office address.]

Surety.

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

28 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, Kesidence,

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-ofBce address of some nearest relative 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.

Applicant.
A.D. 187 .

[Post-office address.]

Physicians' Certificate.

We, tbe subscribers, respectable physicians in 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 tbat he is insane, and a proper subject for custody and remedial
treatment in the Worcester Lunatic Hospital. And I, , further

certify that I am tbe family physician of tbe said

M.D.
M.D.

A.D. 187 .

1877.] PUBLIC DOCUMENT — No. 23. 29

ACKNOAVLEDGMENT OF NOTICE.

I, tlie subscriber, one of tbe 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.o. 18 .

[See Acts of 1862, chap. 223, sects. 4, 5, 8, 13. Acts of 18C5, chap. 2G8.]

Third. By Overseers of the Poor.

Any insane person supported as a pauper by any city or town,
may be placed by the overseers of the poor thereof in the hospital,
with the consent of the trustees, upon compliance with the follow-
ing 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 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, 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.r>. 187 .

Attest:

Overseers of the Poor of the Town of

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

30 LUNATIC HOSPITAL AT WOECESTER. [Oct.

Statement of an applicant for the admission of , an

insane person, to the Worcester Lunatic Hospital : —

Age of the insane person, Occupation,

Birthplace, Eesicience,

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,

H 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. 187 .

[Post-office address.]

Physicians' Ceetificate.

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 week 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.D. 187 .

1877.] PUBLIC DOCUMENT — No. 23. 31

Acknowledgment of Notice.

I, the 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 application.

A.D. 187 .
[See Acta of 1862, chap. 223, sects. 4, 5, 8, 13. Acts of 1865, chap. 268.]

jl, 8 5 ■»***.