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Full text of "Report on the chronic insane in certain counties, exempted by the State Board of Charities, from the operation of the Willard Asylum Act"

REPORT 



ONiU INSANE 



RD OF CHARITfES, FROM THE OPERATIC 

OF T"^ ^'' " ■-■■-''-■' ' ■ 



,*^%\Vt'»-# 



REPORT 



CHRONIC INSANE 



IX CERTAIN COUNTIES, EXEMPTED BY THE STATE BOARD 

OF CHARITIES, FROM THE OPERATION OF THE 

WILLARD ASYLUM ACT. 



By 

COMMISSIONERS LETCHWORTH AND CARPENTER. 



TKAXSMITTED TO THE LEGISLATURE JANUARY 18, 18S2. 



ALBANY : 

WEED, PARSONS & CO., PRINTERS. 
1882. 



^ y 



CONTENTS. 



Page. 

Preliminary and General. 

Institutions Visited and Numbers of Inmates 1 

Condition and Habits of the Insane 3 

Violent and Disturbed Cases 4 

Epileptic, Paralytic, Suicidal and Homicidal Cases 5 

Seclusion and Restraint. . 6 

Kind and Extent of Mechanical Restraint 7-8 

Cases Treated in State Asylums 8 

Dietary 9 

Classification 9 

Sane Children 9 

Open Fires and Ventilation 9 

Prescription and Case-Books 9 

Hospital Accommodation 9 

Heating and Temperature 9 

Night Watchmen 9 

Exercise Yards 10 

Recreation Grounds 10 

grames and entertainments . . 10 

Rewards for Labor 10 

Water Supply 10 

Sewerage; H 

Paying Patients 1 1-12 

Cost of Maintenance 13 

Certificates of Commitment 13 

Acute Cases 13 

The Acute Insane of Gtenesee Co 13 

Medical History op Transferred Cases 13 

Unofficial Visitation 13-14 

Curious Strangers 14 

Paid and Pauper Attendants. 14 

Buildings and Construction 14-15 

Notes of Yisitation. 

Broome County 15-10 

Cattaraugus (irUh illustration,^ of Cottage plan) 19-24 

Chautauqua 24-31 

Chenango 32-36 

Cortland 36-42 

Erie (with illustrations of conf/yfi//ate i>lan). 42-48 

Genesee 48-54 

Jefferson 54-58 

Livingston 59-65 

Oneida 65-69 

OnO'SDaga 69-73 

Orange.. 73-78 

Oswego 78-84 

Queens 84-89 

Suffolk 89-94 

Wyoming 94-98 

Conclusions of Commiitee 98-100 



Supplement. I'age. 

Form of Medical History (Chautauqua County) ^^*^~lni 

Rules and Regulations (Erie County) 1|^1 

Rules and Regulations (Oneida County) ^"*^~}^2 

Dietary (Orange County) J"^ 

Dietary (Queens County) lUo- iUJ5 



REPORT. 



To the state Board of Charities : 

At a stated meeting of the Board held at Albany, May 11, 1881 , 
a committee consisting of Commissioners Letchworth, Devereux, 
and Carpenter, was appointed to visit and make report upon the 
condition of the insane department of poor-liouses, in counties ex- 
em^Hed by the Board under chapter 713 of the Laws of 1871, from the 
statute requiring the chronic insane to be transferred to the Willard 
Asylum. Commissioner Devereux gave early notice that he should be 
unable to serve. 

The counties of Cattaraugus and Livingston having applied for 
like exemptions, upon which action of the Board is now pending, the 
committee extended their examination to the insane departments of 
these counties, and the information collected in regard to these insti- 
tutions is included in this report. 

The following table shows the counties visited, the post-office ad- 
dress of the institution, and the date of inspection, with the number 
of inmates. 





I'oBt-ofiQce Address. 


Date of Examination. 


Number of Insane. 




Total. 


M. 


F. 


Broome 

Cattaraugus.. 
Chautauqua. . 
Chenango.. . . 

Cortland 

Erie 


Binghamton . . 

Machias 

Dewittville . . . 

Preston 

Cortland 

Buffalo Plains. 

Linden 

Watertown . . . 

Geneseo 

Rome 


October 13, 1881 
August 12, " 
Sept. 7, " 
Nov. 4, " 
October 4, " 
Sept. 9, " 
Sept. 19, " 
October 13, " 
Sept. 20, " 
Sept. 26, " 
October 5, " 
Sept. 12, " 
October 4, " 
August 3, " 
August 25, " 
Sept. 5, " 


72 
41 

81 
41 
29 

256 
25 
46 
57 

217 

106 
85 
56 

103 
50 
21 


35 
19 
39 
14 
14 
111 
14 
7 
24 
80 
73 
43 
18 
51 
28 
11 


37 
22 

42 

27 

15 

145 


Genesee 

Jefferson 

Livingston . . . 
Oneida 


11 
39 
33 
137 
33 
42 
38 
52 
22 
10 


Onondaga.. . . 

Orange 

Oswego 

Queens 

Suffolk 

Wyoming 


Onondaga Hill 
Orange Farm. 

Mexico 

Mineola 

Yaphank 

Varysburg .... 




1,286 


581 


705 



2 Report on the Chroxjc Insaxe. 

From the foregoing table it will be observed, that the total number of 
insane in the sixteen counties visited at the date of inspection was 
twelve hundred and eighty-six (1,280), of whom live hundred and 
eighty-one (581) were men, and seven hundred and five (705) were 
women. 

Some of the institutions were visited several times, the examination 
occupying one or more days. With a view to ascertaining more satis- 
factorily the ordinary condition and daily routine of an institution, 
no intimation of the intended visit was in any instance given. 

In all places visited by the Commissioners, every facility to complete 
the examination and inspection of institutions was cheerfully extended 
by the oHicials in charge, and it is believed that nothing was withheld 
from observation. 

Where the county physician did not reside at the poor-house, he 
was notified upon the arrival of the Commissioner, and such informa- 
tion was sought from him as related to his particular duties. 

The committee have endeavored to make their inquiries thorough, 
and while availing themselves of such accessory helps as offered, have 
placed main dependence on their own careful personal inspections. 

In all the counties except Queens, the insane department is an in- 
tegral part of the poor-house establishment, embraced in the same 
financial system and under the dii'ect control of the county superin- 
tendents of the poor. In some counties the buildings for the insane 
are separated fr<:>m the poor-house proper ; in others they are connected. 
In Queens county the insane are cared for in an asylum at Mineola, 
under the charge of a resident superintendent, the poor-house being on 
Barnum island, some ten miles distant. 

Such facts as the committee found susceptible of tabulation have 
been so arranged, and are presented in this condensed form to facili- 
tate comparison. 

The following table, framed from the statements of supervising offi- 
cials, shows the condition and habits of the insane at the date of ex- 
amination : 



Report on the Chronic Insane. 









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4 Report ox the Chronic Insane. 

It will be seen that five hundred and sixty-five (565) were classed as 
continuously quiet ; two hundred and thirty-one (231) us beiucj sub- 
ject to paroxysms of excitement ; forty-four (44) as continuously vio- 
lent ; ninety-five (05) asdestructive of their clothing,and one hundred 
and sixty-two (162) as filthy in their habits. The committee, however, 
are not prepared to verify the correctness of the classification as to the 
quiet, excited and violent cases, especially as in some counties, the 
lack of a sufficient number of attendants, prevented the acquirement 
of exact knowledge in regard to the varying conditions of the patients. 

It appears from the examination that the number of continuously, 
violent and disturbed cases is not large. The presence of but a few of 
this class, however, in the small institutions, exerts a disturbing in- 
fluence and creates disorder and confusion in what would otherwise be 
an orderly and pleasing department, while adding largely to the ex- 
pense of administration. 

It is therefore desirable, both in the interest of the insane and from 
an economic view of the subject, that such cases should be removed 
to ap]iropriate State institutions, properly equipped for the special 
care of this difficult class. 

The information in regard to epileptics, paralytics, suicidal and 
homicidal cases, obtained in consultation with the resident officers 
and county physicians is tabulated below. 



Keport on the Chronic Insane. 



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6 liEPOKT OX THE ChRONIC INSANE. 

The foregoing shows that there were in the institutions examined 
seventy-seven (77) with epileptic and twenty-four (24) with paralytic 
complications, fourtt-en (14) suicidal, and thirteen (13) homicidal cases. 

The number found confined by locking in cells or rooms was small 
— in no county exceeding two, even these being excejitional. None 
were found in dungeons or dark rooms. In two of the counties a 
" restraint-book " was kept, in which were recorded the time, kind 
and duration of the restraint enforced. In some of these the entry 
was made wckly, the attendants meanwhile, making memoranda on 
slips of paper carried in their pockets and handed to the head of the 
department at the end of the week. 

The extent to which mechanical restraint is resorted to is shown by 
the following table, as also the number in restraint by mechanical ap- 
pliances on the date of visitation. 



Report on" the Chronic Insane. 





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8 



Report on the Chronic Insane. 



The number of cribs belonging to tliese institutions was thirty-nine 
(39), the number of restraining chairs thirty (3(J), of muffs forty-eight 
(48), of camisoles forty-three (43), of pairs of handcuffs, thirty (30), of 
pairs of shackles, eight (8), and tlie number of wristlet-bands and 
waist-belts, forty-six (46). The committee found that, upon the date 
of visitation but three of the insane, all women, were actually confined 
in cribs during the day, and that the number restrained in chairs, by 
muffs and otherwise, was thirty-four (34), twenty-three ("^3) men and 
eleven (11) women. 

While it appears from the examination that few of the insane were 
under restraint, the presence of so large a number of restraining ap- 
pliances within the institutions, in the absence of strict rules and 
regulations on the subject, may lead to great abuses. Attendants find 
it much easier to manage and control excited and violent patients, for 
the time being, by })hicing them in restraint, rather than by seeking to 
overcome their violence and excitement by personal attention in the 
wards. This mode of dealing with them, is quite likely to be resorted 
to during the night to secure the ease and comfort of the attendant, 
when not under the watchful supervision of the physician or other 
proper officer. It is regarded best, therefore, to discourage the em- 
ployment of mechanical restraint in the care of this class of insane, 
and to suggest that it should only be resorted to by order of the proper 
medical officer, and that a careful record be kept of its kind and dura- 
tion. 

Information as to the number who had received treatment in State 
asylums was sought, and so far as it could be obtained, is set forth in 
the following table. In some cases, however, the figures could only 
be approximatelv reached, owing to defective records ; while in othera, 
no registry whatever of this fact being kept, even approximate esti- 
mates could not bo reported. 



counties. 



Broome 

Cattaraugus. 
Chautauqua. 
Chenango . . 
Cortland.. . . 

Erie 

Genesee. . . . 
Jefferson . . 
Livingston .. 
Oneida. . . . 
Onondaga. . 

Orange 

Oswego .... 

Queens 

Suffolk 

Wyoming. ., 



Number treated In State 
asylums. 



Total. Males. Females. 



60 
37 

54 

"l5 

'"4 

8 

19 

192 

*73 

Go 
42 



17 
27 

io 

'3 
'9 



33 

25 

2 



20 

27 

"5 

1 

8 
10 



32 

17 

6 



Number never treated in State 
asylums. 



Total. 



11 

4 

27 

14 

21 
38 
38 
25 



38 

8 

13 



Males. 



11 

7 
15 



Females. 

3 

2 

15 

io 

-i 

10 « 
31d 
23 

J 

""' '5 
4 



Report on the CnROisric Insane. 9 

With the exception of Queens and Orange counties, the committee 
fonnd no printed dietary. In Queens, the superintendent has in use 
an elaborate and somewhat lengthy schedule, embracing such variety 
of food, as in his opinion, is suffici'ent to secure the best hygienic re- 
sults. — A copy of each dietary will be found appended. As a rule it was 
ascertained that, while the county physician had a general knowledge 
of the kind of food supplied, it was not regulated by him, except in 
one or two instances. The diet for the sick was prescribed by him, 
and this in many instances was supplied from the keeper's table. 

Owing to the limited number of insane in most of the institutions, 
the classification observed in larger establishments is not effected, a,l- 
though carried out generally, so far as practicable, by the officials in 
charge. Idiots are generally separately provided for, but in some 
instances they are placed in the insane department. 

In none of the counties were sane children found with the insane 
adults except Onondaga, where a depraved girl under sixteen years of 
age, was placed in the insane department to prevent her running away. 
At the time of inspection she was in the women's work-room, engaged 
in sewing with the other inmates. 

The committee found no open fires in any of the rooms occupied 
by the sick, except in the small separate hospital, recently erected at 
the Cattaraugus county poor-house, in which it was stated, open fires 
were to be kept in both the men's and women's wards. The desira- 
bility of open fires as a means of ventilation in apartments for the 
sick,"^ cannot be overestimated, and the committee regret to find their 
absence so universal. 

In two of the counties only was it found that a " prescription 
book" was kept in the insane department, and in but two counties a 
"case book" setting forth the condition of the insane from time to 
time. The necessity of preserving a record of all prescriptions given, 
and the importance of keeping a case book as an aid to successors in 
office, and the proper treatment of each patient, are manifest. 

In a few of the counties, there is a hospital ward in the insane de- 
partment, but generally the insane, when sick, are either treated in 
their sleeping-rooms or in the hospital ward of the main poor-house, 
more frequently the former. The presence of the insane in the com- 
mon hospital ward, is always a source of annoyance to other patients, 
hence the necessity of providing hospital-rooms for the separate care 
of the insane when sick. 

In some of the counties, thermometers were found in the several 
wards, but in no instance was a record of the temperature kept. The im- 
perfect plans upon which many of the buildings are constructed, and 
the varied means of heating, make it questionable whether in all cases 
there is a sufficient degree of warmth throughout the buildings, es- 
pecially as the vital forces of the insane are below the normal condi- 
tion, and they therefore require a higher temperature than sane per- 
sons generally. It, therefore, seems desirable that a record of tempera- 
ture should be kept, not only for the satisfaction of friends of patients 
and the information of supervising officials, but as a protection to those 
in immediate charge. 

In several of the larger institutions, a wise precaution is taken in 
the employment of a night-watchman, as a better protection against 



10 Report on the Chronic Insane. 

fire. He is also charged with the duty of arousing attendants in cases 
of emergency. 

In nearly all the counties, there are connected with the insane de- 
partments, separate yards for the men and women, in which they are 
permitted to exercise. The yards are generally quite small. The 
measurements will be found in the notes of visitation embodied herein. 
These yards, however, are surrounded by close board fences from ten to 
fourteen feet high, except in two counties where pickets are used. The 
prospect of the surrounding country, and free air are obstructed, while 
the lieated atmosphere in the summer is quite oppressive. 

The committee found that almost without exception, the doors 
opening into these yards from the wards were unfastened, thus af- 
fording the advantage of free communication. In several institutions 
this freedom was extended to the kitchen, dining, and other depart- 
ments of the house, and in one instance, a low picket fence formed the 
sole barrier to the use of the poor-house grounds. The number even 
thus restricted was comparatively few, while in Cattaraugus county, 
the insane occupy cottages with unlocked doors, and, under the su- 
pervision of attendants, enjoy the full liberty of surrounding grounds, 
the few violent cases being restricted to the main poor-house and 
permitted recreation in its adjacent yard. In Oneida county the in- 
sane are taken to walk upon the roads, and in Suffolk and Orange 
counties, they stroll about the farm arid groves in charge of their attend- 
ants. With these exceptions, there were no grounds aside from the 
yards appropriated for the recreation of the insane. 

Confinement in these small yards must be irksome to patients, and 
tends to increase restiveness and discontent. It having been demon- 
strated in some asylums that these yards are unnecessary, it would seem 
that if the continuously violent and disturbed patients were removed 
to appropriate State asylums, and a reasonable number of paid attend- 
ants employed, that these barriers might be removed altogether. 
Exercise and recreation might be effected in open grounds set apart 
for the purpose, as w'ell as along the country roads and in the neigh- 
boring woods. 

In the way of out-door recreations and amusements. Orange and 
Livingston counties provide swings for both men and women, and in 
the latter count}', quoits are also furnished to the men. Broome and 
Erie counties permit patients to "play ball." With these exceptions, 
no out-door amusements a"e provided for either sex. In the two 
counties first named and in Oneida, entertainments of music and 
dancing are occasionally provided. Reading matter is generally sup- 
plied. In nearly all the counties, means to play checkers, dominoes 
and other games are furnished to the men. 

In a few instances, it was observed that the custom prevailed of 
granting some trivial favor or luxury to the insane, as a reward for 
their labor. The testimony of officers on this point, shows that the 
practice stimulated industrious habits and good behavior. 

In many of the institutions visited, the water supply was found in- 
adequate, not only to meet sanitary needs, but as a protection against 
fire ; especially was this found to be the case in the counties of Erie, 
Livingston and Cattaraugus, Except by those immediately con- 
nected with the institutions, the necessity for copious supplies of pure 
water does not seem, generally, fully to be appreciated. 



Report on the Chronic Insane. 11 

The system of sewerage in several institutions was found defective, 
and the closets, owing either to a lack of water or imperfect construc- 
tion, were frequently offensive. 

in many of the counties, a considerable income is derived from the 
friends or relatives of the insane ; the charges, always moderate, being 
usually regulated according to the ability of the parties to pay. The 
following table exhibits information on this subject, so far as obtain- 
able. 



12 



Report on the Chronic Insane. 



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Eepokt on the CHfioNic Insane. 13 

It is evident that in some counties, the importance of preserving the 
interest of relatives in their insane kindred, by requiring them when 
ible to contribute to their support, does not receive sufficient attention 
it the hands of the officials, and, as a result, the patients suffer from the 
withdrawal of sympathy and the county loses pecuniarily. It may be 
regarded as sound policy to require payment in part at least, in all 
3ases where friends or relatives are able to do so ; but this should not 
be exacted to an extent to endanger the conti'ibu tor's capacity for self- 
upport. Where relatives or friends continue to support insane kin- 
dred, their self-respect is preserved and the family interest maintained. 
Owing to the fact that the accounts of the chronic insane, are mer- 
ged in those for maintenance of ordinary paupers, it was not practica- 
ble to arrive at the cost of their support. In the county of Queens, 
where, as has been stated, the insane department is entirely separate 
from the poor-house administration, the cost is given in round numbers 
as $3.50 per week. This, however, is much reduced by the income 
derived from private patients, many of whom are received from without 
the county. In Erie county during the last year, the accounts for main- 
taining the insane were kept separately, and the cost is reported as $2.58 
per week per capita. In neither of these counties is the investment in 
buildings taken into consideration. 

The examination developed the fact that in some instances, cases of 
acute insanity had been retained in the county establishments contrary 
to law. In several of the cases which were examined into, it appeared 
that the county physician was ignorant of the fact, as Avere also the 
snperintendents of the poor. It frequently happens that the certificates 
af insanity are meagre and vague, and the officers to whose custody 
the patient is committed are unable to determine the duration of in- 
sanity, or to obtain otlier knowledge necessary to a proper disposal or 
treatment of the case. It would seem that the papers committing the 
pauper insane to county poor-houses, should in all cases clearly set forth 
3uch facts as would determine the duration of insanity, and that the 
ounty judge having the evidence before him, should remove any doubt 
upon this point. 

It appears that Genesee county is exempt by law, from the general 
statute requiring.the acute insane to be sent to State hospitals for 
treatment. The examination shows, that this county possesses no con- 
veniences in the way of buildings, attendants, medical.'oversight, and 
3ther essentials for the treatment of this class, above those of poor- 
houses generally ; indeed it is in many respects greatly inferior to the 
average of this class of institutions. It is, therefore, believed that this 
special legislative privilege should be revoked, and the county brought 
under the same obligations and requirements as other counties in re- 
gard to the acute insane. 

In a number of instances the physicians expressed the opinion, that 
as an aid to proper treatment, patients when returned from the State 
asylum, should have forwarded with them a record of their medical 
history, with a statement of the peculiarities of their case while in the 
State institution. 

Most of the county institutions it was found, were occasionally visited 
by public-spirited and influential citizens, and sometimes physicians 
in the county, manifested an interest by calling; but these occasions 
were rare, such visits on the part of medical men being for the most 



14 Report on the Chronic Insane. 

part inspired by an interest in those who had been former patients of 
the visitors. 

It is customary for the board of supervisors during its annual ses- 
sion, to make an inspection of the county poor-house when in its best 
condition. This inspection, generally hurried and superficial, creates 
a favorable opinion of the institution. It is but natural that the 
impression made on the minds of the local representatives of the peo- 
ple, should be reflected in the press of the county. The event of 
the season being over, the institution may lapse into a different routine, 
and the apathy of those who should manifest a continued interest, is 
as discouraging to the officials in charge, as is an appreciative interest, 
stimulating to faithful, vigilant and steady effort. Especially does 
this seem to be the case in remote places. It is therefore evident, that 
unofficial visits from public-spirited citizens and local committees, 
extending through all the seasons of the year, must be attended with 
highly beneficial results. 

In nearlv all the counties complaint was made of annoyance, 
occasioned by visits from pleasure seekers and those who were prompted 
only by motives of idle curiosity. In some of the counties this custom 
had grown to the magnitude of an abuse, through which the quiet of 
the patients and the orderly management of the establishment were 
interrupted. 

While these institutions should at all times be open to inspection, 
thev ought not to be made places of idle resort, and the insane exhibited 
as a siiectacle for the curious. It would seem proper, therefore, that 
the visits of interested persons should be regulated by the physicians 
in charge. 

The number of paid attendants in charge of the insane, as will be 
seen by the notes of visitation, in some counties is greatly deficient. 
This is especially the case in Chautauqua county, where, as an inevitable 
consequence, a deplorable condition exists. The tendency of all insane, 
when without adequate supervision, is to degenerate. If under in- 
telligent management, they may generally be controlled and guided 
into habits of neatness and order and may frequently be trained to 
healthful and productive industry. The efforts to economize by 
placing the insane under paupers, or the failure to provide suitable 
attendants, in the end usually proves expensive, for the reason that, 
from being useful and productive, or even quiet, they become violent 
and destructive and thus expensive. 

A serious disregard of an essential principle of supervision appears 
from the notes of visitation. In two of the counties on arrival at the 
institutions, the insane departments were found locked. Those "in 
charge " were absent and had taken the keys with them, leaving the 
insane without the supervising care of either paid or pauper attendant?. 
Such neglect, inviting the most serious consequences, is inexcusable. 

What information the committee could not readily generalize or 
tabulatCjWill be found in the notes of visitation incorporated herewith, 
embracing the location and sanitary surroundings of the buildings, 
internal subdivision and apportionment of rooms, methods of heating, 
ventilation and lighting, house-keeping and domestic arrangements, 
dormitory and Ijahiing facilities, food, clothing and general care of the 
inmates, etc. 

In but few of the counties, have the plans of the building occupied 



Report on the Chronic Insane. 15 

by the insane, been submitted to experts before erection. Tlic Orange, 
Erie and Cattarangns county buildings are exceptions. The two last 
named are outlined in the accompanying notes of visitation. The 
plans for these three counties were approved by the Board, and the 
buildings afterward constructed, with slight deviations, on the plans 
as approved. As a consequence, there is a marked contrast in the two 
classes of structures. In the first are many serious defects, among 
which may be noted the following: A general prison-like character of 
exterior, which with their strongly barred and grated windows, and 
yards surrounded by high plank fences, betoken to the passing observer 
a jail rather than an asylum for the insane. Their interiors, with 
iron gratings, screened windows, studded doors and heavy bars and 
padlocks, suggest a,t once force dnd resufcuice ; sleeping-rooms some- 
times exceedingly small, absence of light, narrow, steep and crooked 
stairways, dark halls, small and dimly-lighted or even dark rooms for 
storing clothes or linen, imperfect ventilation, improperly constructed 
water-closets, defective sewerage, and a faulty general arrangement, 
obstructing economical administration and complete supervision. 

It is, therefore, evident that economy and more satisfactory results 
every way will be reached, by requiring in the future, that the plans 
of buildings for the care of the chronic insane, be submitted to and 
approved by competent authority, before contracts are made for their 
erection. 

NOTES OF VISITATION. 

Broome County. 

The county of Broome was in 1877 exempted by the State Board of 
Charities from the operation of the Willard Asylum Act, and sub- 
sequently had maintained its chronic insane at the poor-house, which 
is located in the town of Binghamton, upon the county farm of 130 
acres, three miles from the city of Binghamton. 

The department of the poor-house assigned to the insane, is under 
the same supervision and care, as that provided by the county for its 
sane dependents. The persons in charge are the county superintend- 
ent of the poor, the resident keeper and the matron, who have received 
from the superintendent successive annual appointments since 1879, 
and whose joint salaries amounted the past year to $800. 

The county buildings for the various departments of the poor-house, 
are adapted in number to assist in the classification of the inmates, 
and are as varied in size as in their use. They are built in two rows 
upon the opposite sides of.a street or avenue, upon the east of which 
are the principal poor-house buildings for the sane inmates. The 
three north l)uildings upon the west side of the street, are fitted for 
and occupied as the department of the insaije, called the asylum. 

The insane, men and women, each occupy a two story and basement 
wooden building. The basements under each building are used for 
furnace, coal, storage, bathing and washing-rooms, but not for storing 
vegetables. 

The windows in the insane department, have spring fastenings and 
may be lowered from the top. The glass is generally protected by a 
wire netting, placed inside of the locked wooden gratings. 
3 



16 Report on the Chronic Insane. 

The m.ain building, as it is designated, is occupied by men, and has 
two stories, each nine feet in height. The four wards for men have 
thirty-one single rooms, twenty-nine of which are eight by ten feet 
(having a capacity of seven hundred and twenty cubic feet each) 
and two of wliich are ten by twelve feet, and one associate dormitory 
with eight beds. The rooms are separated from the hall (five and a 
half feet in width) by slat partitions and doors. 

The north two story wooden building is occupied by insane women, 
each story being nine and a half feet high. The three wards have 
twenty-one single rooms, eight by ten feet each, and three associate 
dormitories, nineteen by twenty-one feet each, and each with eight 
beds. Each story has a day or work-room twenty feet square. 

The doors to many of the rooms in the insane department are of 
slats, and the partitions and ceilings of narrow matched boards, and 
tinted. Good results have been obtained by tinting the rooms aild 
using colored glass for some of the windows. There are no lathed 
and plastered walls in the; insane department. Duplicate locks can 
be opened by one pass-key. The day or work-room for the women 
upon the first story, is furnished with a rag carpet (made ready for the 
weaver by the patients), a center table with books upon it, engravings 
hanging upon the walls, white window shades, a rocking chair, sewing 
machine and a singing bird, etc. Upon the day of my visit, two 
women were sewing in charge of an attendant, while another in a 
paroxvsm was confined by a muflf. 

The day-room of the same size in the second story, is plainly 
furnished with wooden chairs and benches. The halls are also used 
as sitting-rooms, and many of the rooms have close inner doors for 
day use, thus keeping the air in the rooms fresh for the night. 

The buildings arc warmed by two furnaces in the cellar of the men's 
and three in that of the women's apartments. There are registers in 
the halls, dormitories and day-rooms. Coal is burned except in the 
dining-rooms and kitchen, where wood is used. It is said that in the 
past the heat has been sufficient. Thermometers are placed in the 
hospital and wards. 

Ventilation is secured by flues in the floors, and by pipes to the 
chimney. In the disturbed wards the communication is directly to the 
chimney. Light is obtained by kerosene lamps suspended from the 
hall ceilings. There is no hospital for the insane women. 

South of the main building for the insane men, and annexed to it 
by a hall that serves as the office and dispensary, is the men's hospital. 
It is a one-story building with a basement. The first of the two rooms 
is seventeen feet square,and is used asan attendants' sitting-room, as well 
as a day-room for convalescents. Its five windows, coal stove, carpeted 
floor and house plants, give it a comfortable appearance. The second 
room is the hospital for insane men. It is twenty feet square and nine 
feet high, with three beds. Several chairs, one being a restraining 
chair with liead rest and straps, are in the room. It is warmed by a 
pipe from a stove in the " poor-house jail," in the basement, and by 
warm air from the front room through a slat door. The hospital-room 
has five windows, and is light and well ventilated. It has no open fires. 

The insane are bathed and furnished with clean clothing eacli Sat- 
urday. The bathing arrangements in the basement of the main build- 
ing are in an incomplete state, but are intended to be similar to those 



Eeport On the Chronic Insane. 17 

in use in the women's building, namely, a tank of water and bath tubs. 
Iron sinks with hand basins are provided in the halls for daily use. 

There is no separate laundry for the insane. The washing for the in- 
sane men, is done one day each week in the poor-house laundry. The 
conveniences of tubs, pounding barrels and water are in the basement 
of the women's building, with which a drying yard is connected. 

Water is obtained from two dug wells, two driven wells and a spring, 
from which it is conveyed in iron pipes to the building. The waste 
water runs into a cistern of a capacity of tsvo hundred barrels. There 
is a cistern of one hundred barrels capacity at the men's building, one 
of the same size in the basement of the keeper's residence, and one in 
each of the buildings for the insane. The supply is said to be ample. 
Two hundred feet of hose can be attached to a force pump which, with 
the aid of three men, would be of power sufficient to throw water over 
any part of the buildings in case of lire. The stairways and doors con- 
stitute the fire-escapes. 

The sewerage consists of one main sewer, " to which every thing is 
carried," and which empties into a swamp two hundred feet distant, 
and thence runs into the Chenango river. At the west of each airing 
court is a closet, that is said to be cleaned three or four times during 
a season and each time filled with fresh earth. 

Each disturbed ward has four rooms, two of which were occupied 
upon the day of my visit, by men who were violent and destructive of 
clothing, and were confined to insure the safety of others. One of the 
two, a strong, excited man, was in a restraining chair, and it was said 
would be removed to the Binghamton asylum soon ; these men are said 
to be out daily for air and exercise. 

The day-room for men, is between the disturbed ward and the en- 
trance hall of seventy-eight feet in length. It is about twenty-five feet 
square, is surrounded by benches, and has a door leading from it 
into an exercise yard of one hundred and five by eighty feet. This yard 
is covered with grass and has a shed with benches under it. The 
trees are too small to afi'ord shade. The exercise yard for women has 
a shelter in the center, called a pagoda. 

A paid night-watchman at $15 per month is on duty, from dark 
until relieved in the morning. 

The kitchen is in the basement of the small central two-story brick 
building, midway between the two insane departments. It is sixteen by 
twenty-three feet and has a brick floor, four windows, a stove for cook- 
ing and warmth, a boiling kettle and a sink for washing dishes. 
Water is heated in the stove reservoir. The bread is baked in the brick 
oven of the poor-house. The cook for the insane is paid two dollars 
per week and is assisted by the patients. 

The dining-room for the insane men is twelve by thirty-eight feet 
and opens from the kitchen. When not in use as a dining room, it 
serves for an ironing room. 

At the time of my visit six women were ironing, supervised by an at- 
tendant. The women's dining-room, of the same size, upon the first 
story, is connected by a covered passage with the women's apartments. 
It has green shades at the six windows, each dining-room is furnished 
with pine tables and stools, white table cloths, bowls and plates of 
white earthenware and knives and forks of steel. The bread was good. 
The bill of fare as furnished by the keeper is not printed. The break- 



18 Report ox the Chronic Insane. 

fasts of each day are alike (except that coffee is given three times a 
week) and consf^ts of boiled potatoes, cold meat, bread and butter, 
tea, or milk lor those who prefer it. 

Monday— Dinner, potatoes, fresh beef, bread and butter, oat-meal 
or rice, tea ; supper, bread and butter, sauce, tea. 

Tuesday— Dinner, vegetable and beef soup, rice pudding; supper, 
bread and milk. 

Wednesday — Dinner, boiled dinner and corn bread ; supper, bread 
and butter, sauce, tea, cake. 

Thursday — Dinner, corned beef, vegetables, pie; supper, rice and 
milk. 

Friday — Dinner, tish and vegetables, bread pudding ; supper, bread 
and butter, sauce, tea, cookies. 

Saturday — Dinner, roast beef, vegetables, graham bread; supper, 
mush and milk, ginger cake. 

iSundav — Dinner, beef and vegetables, rice pudding. 

Dr. Richards has for sixteen years had the medical supervision of 
the institution, receiving his appointment from the supervisors, and a 
salary of $350 per year, for which he makes three visits each week, 
and more if cases require his attention. Assistants invited to aid in 
operations and consultations, are paid by the county. To Dr. Richards 
belongs much of the credit of the evident good order and arrangement 
of the insane department. He states that whenever in his judgment, 
any thing has seemed necessary to add to the comfort of his patients, 
his application for it to the supervisors, superintendent or keeper has 
been successful. 

He prescribes the diet and it is prepared. Restraint is reported to 
him by the attendants. 

Each disturbed ward, has a light, well-ventilated strong-room. Of 
the three cribs in the institution, but one is in use. There are no dark 
cells or dungeons. There are four strong arm-restraining chairs, with 
straps and head-rests, three muffs, three pairs of handcuffs, two pairs 
of iron shackles, and three waist straps. 

No restraint book is kept. The attendants place patients in restraint, 
if necessary, during paroxysms, and report to the attending physicians. 
Punishment is not inflicted upon the insane. Prescription and case 
books are not kept in the institution. Certificates of insanity are on 
file, and the insane are registered separately from the sane. 

The medicines are supplied by the county and are dispensed by the 
physician. There are no consulting physicians. 

Members of the medical profession and citizens of the county, " mani- 
fest their interest" in the institution by visits. 

Separate apartments and care are provided for insane men and 
women in the buildings and exercise yards, but elsewhere the separa- 
tion cannot be effe<-ted except by watchful supervision. 

The insane are classified by the pliysician according to their habits 
and condition. Epileptics do not receive special care ; the watchman 
attends to them at night and calls the attendants if necessary. Idiotic 
adults, and idiotic, epileptic or feeble-minded children are cared for in 
other departments of the poor-house. 

Neither in-door nor out-door amusements are provided for either men 
or women regularly, and there are none in which both men and 



Report ox the Chronic Insane. 19 

women join. There is in the summer season an occasional game of 
ball, and dominoes and checkers are provided. 

Four daily and three weekly papers are taken by the keeper, and the 
ladies, and bookstores in Binghamton, furnish reading for the insane. 

The insane men are employed in the cultivation of the farm and 
garden under the supervision of a farmer, but they have no in-door oc- 
cupation. Three of these can perform a fair day's labor and ten a 
partial one. Insane women assist in the cultivation of plants, sew, 
knit, iron, wash and do other housework, nine can perform a partial 
day's work, under the immediate care of attendants. 

All labor is supervised and directed by the keeper, who judges as to 
the amount and kind to be assigned to each patient. 

The labor of the insane is remunerative in so far as it takes the 
place of hired labor. It is considered one of the most beneficial of all 
influences that can be brought to bear upon the minds of the insane. 

The insane are in charge of the keeper, assisted by two farmers at 
$20 per mouth, one at §18, and two female attendants who receive 
respectively §3 and S2.50 per week. 

Paupers do not assist in the care of the insane. The keeper has the 
direction, care and management of the institution and of the eniployees. 

During the past year the cost per capita of the sane, was ninety-six 
cents per week, that of the insane amounted to 81.50 each per week, 
exclusive of the products of the farm ; the vegetables for table use are 
raised upon the farm. 

Upon October 13, 1881, the date of inspection, there were seventy- 
two resident insane, of whom thirty-five males and thirty-seven females 
had accommodations in the asylum department, and nine, for various 
reasons were assigned to places in the poor-house division with the sane. 

Two men were in restraint of tlie halls, and two were confined to 
their rooms. Xone were in dungeons, dark cells or cribs. One 
woman was confined by a mufE, one man in a chair, and one with 
hand-cuffs in the exercise yard. 

AH have been treated in State asylums with the exception of eight 
men and three women, who were chronic cases of insanity when re- 
ceived. Xone were in the hospital for men. 

The bedsteads are all of wood with iron slats, upon which were 
straw beds, sheets, comfortables or quilts, white covers, pillows and 
cases. The whole asylum department was neat and in good order. 

Clothing is provided by the county for all, except pay patients, and 
the greater portion of it is made up in the institution by hired help. 
Coats are purchased in Binghamton. Acute cases of insanity, are only 
allowed to remain while papers are being prepared for their removal 
to State asylums. 

Pay patients are received from Broome and other counties at the 
rate of two dollars per week. 

Visited by Commissioner Carpenter October 13, 1881. 

Cattaraugus County. 
The poor-house of this county is situated on the west side of Lime 
Lake, in the town of Machias, and is accessible by rail over the Buffalo 
New York and Philadelphia line, as well as the Rochester and Pitts- 
burg railroad, by way of Machias station, which is about one mile 
distant from the poor-house. 



20 Report on the Chronic Insane. 

The board of supervisors of this county, in 1877, made an ai)pro- 
priution of !?;l:i,000 to provide requisite buildings for the care of its 
chronic insane. A committee was appointed, consistinji of the superin- 
tendent of the poor, F. Strickland, and supervisors, E/Dusenbury and 
Dr. J. Nichols. This committee applied to the State Board of Chari- 
ties for information and suggestions, and also visited various institu- 
tions for the care of the insane, taking time to perfect their plan, be- 
fore entering into contracts for buildings. 

The dejiartment for the insane is located on the county farm, near 
the poor-house. It forms a group of frame buildings, entirely distinct 
from the poor-house, and surrounded by ample grounds for out-door 
recreation, and for gardening purposes. 

Officiah and employes. — The })oor-house affairs are now directed 
by one superintendent of the poor. His salary is $900 per year. 
The present keeper, "William FoUett, who is appointed by the super- 
intendent, has had supervising charge for the past twenty-two years. 
His compensation is §800 per year. He has a married assistant, 
resident at the poor-house. The male division of the insane depart- 
ment is in charge of an attendant, who receives $13 per month, and 
living. He lodges in a cottage occupied by the male insane. The 
females are in charge of a matron, who receives $2.50 per week with 
board. She sleeps in the cottage with the insane. A woman cook is 
employed at §2 per week, and board. The keeper prescribes the duties 
and regulates the conduct of the attendants. No paupers are employed 
in the care of the insane. 

Medical mqyervision. — The county physicians, Doctors King and 
Ashley, reside within half a mile of the poor-house. They visit the 
asylum when called upon, for which they receive $1 per visit. If 
two patients are prescribed for at any one visit, the charge is $1.50. 
All ordinary medicines are furnished by the physicians. In case of 
injuries^ requiring surgical operations," an extra charge is made. A 
prescription book is kept in the institution, but no case book. 

Buildinfjs. — The group of buildings consists of a cottage, centrally 
located, for the keeper's residence and the office. Directly in rear, in a 
one-story building, connected by an open corridor, is the kitchen with 
separate dining-rooms for men and women. On each side of the last- 
named building are two cottages, connected with the former by open 
corridors. These may be closed in winter by movable shutters. 
Each cottage is two stories in height, and accommodates ai)out thirty 
persons. The low^er floors are used for day-rooms, and the upper for 
sleeping apartments. The windows have two sashes, the frame-work 
being of wood and the interior portions of iron. They are hung with 
cords, pulleys and weights, are painted white, and present the appear- 
ance of the windows of an ordinary dwelling. There are no high fences 
nor walls of any kind about the cottages, which appear like those of 
home-life. The l)uildings are heated by steam, generated from a boiler 
beneath the kitchen, with radiators in the various rooms. A few open- 
grate fires facilitate ventilation. The accompanying diagrams show the 
relation of the buildings to each other, the arrangement of the various 
parts, and their uses. Plate I shows the ground plan. Plate II shows 
the first and second floors of the superintendent's residence. Plate III 
shows the first floor and attic plan of dining-hall. Plate IV the first 
and second floors of the cottages as finally built, and Plate V exhibits 



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Report on the Chronic Insane. 21 

the cottage for patients as originally planned, but subsequently modi- 
led in accordance witii plate IV to meet appropriations. 

The total cost of the whole group of buildings, including boiler and 
aeatiug apparatus, was given as §13,270. 

It is believed that better results would have been attained had the 
xpenditures in some particulars been moderately increased. 

Water supply. — Water is brought in iron pipes from a spring one 
mile and a quarter distant. It flows into a reservoir at the top of the 
poor-house building, and from that point is distributed throughout 
he establishment, and likewise carried to the group of buildings for 
the insane. The supply is insufficient, and eflforts are being made to 
increase it. 

Food. — The keeper says : " The diet varies according to the season, 
ind is regulated by myself. The food for the sick is prescribed by the 
physician. The diet of the insane for breakfast and dinner consists of 
pork and potatoes, bread and butter, tea, and vegetables in their season; 
for supper, corn-pudding and milk, or bread and milk. Once or twice 
a, weet, codfish ; sometimes fresh fish is served at dinner. They have 
milk once a day during about six months of the year. It is customary 
to sweeten coffee and use milk therewith ; some of the old ladies use 
sugar in their tea. In winter the insane have but two meals per day. 
In the garden we raise cabbages, turnips, beets, carrots, spinach, let- 
tuce, onions, tomatoes, beans, peas, and green corn, in all of which the 
insane share. We aim to give the healthy insane, ordinary farmers' 
living." In the dining-room there are in use plain deal-tables, with- 
out cloths, crockery table-v^are, ordinary knives and forks, with round 
top stools for seats. 

Clothing. — In summer it is said the men wear cotton or woolen 
shirts, as directed by the physician; cotton "denim" jackets, cotton or 
woolen socks, ''cottonade" pants, shoes and straw hats. In addition 
thereto are also worn in winter a woolen shirt, or flannel vest and sack 
coat, and boots. Many of the patients wear drawers of canton-flan- 
nel. 

In summer the women wear a calico dress, cotton underclothing, 
stockings and slippers ; in winter similar clothing is worn with the 
addition of canton-flannel drawers and under-wrapper. 

Bedding. — The bedsteads are made of wood, after the Willard Asy- 
lum pattern, having hoop-iron strap bottom. The bed furnishing 
consists of a straw tick, mattress, two sheets, and home-made quilts. 
During the day a counterpane is laid over the bed, which at night is 
replaced by a quilt. It is stated that in winter additional covering is 
added. 

Employment. — At the time of visitation there were forty-one insane, 
nineteen of whom were meu and twenty-two women. The out-door 
labor of the men consists in general farm-work. Some plough, har- 
vest grain, care for the stock, cultivate the gardens, and in the fall 
assist in butchering the hogs. In the winter season some of the men 
are employed in getting out wood from a timber lot belonging to the 
county, two and one-half miles away. There is no in-door employ- 
ment for the men. The women in-doors are engaged in sewing, knit- 
ting, cleaning house, making beds, and sweeping, under the supervis- 
ion of an attendant. Six of the men are said to perform a fair day's 
labor, and four a partial day's work. The keeper said : " Nearly all 



22 Report on the Chronic Insane. I 

the men do something about the farm. Twelve of the women per-| 
form a fair day's labor, and six do a partial day's work. The labor otj 
the men and women is fairly remunerative." The assistant directs the 
labor of tlie men when out of doors, and the matron supervises the'.' 
work of the women within doors. \ 

The influence of labor is regarded by the keeper as highly beneficial.! 
He further said: "It would be difficult to carry on our institution asr 
economically without the labor of the insane. With labor they sleep 
better, and are more quiet. We are very careful to see that they arc ' 
not overworked. If disposed to overwork they are sent in to ■ 
rest. The employment of the insane about the farm and in 
domestic work has resulted in some cures of chronic cases. Ai 
woman who was at Utica six years was returned here at the age or 
forty-five. She remained in the asylum nearly two years, when she waF-- 
discliarged cured. This happened about ten years ago. She has noi"' 
been in an asylum since, and now assists in managing the business of 
her father, who is a widower. A man forty years of age was returnedi 
here from Utica. He claimed that he was the Almighty. I found it 
impossil)le to do any thing with him. At length I told him that we 
needed help to drive the ox-team and thought he could do it. I said, 
if willing he might have charge of the oxen, and explained the farm' 
matters to him, I got him interested. He was with me a year or two,, 
and was discharged cured. This was some fourteen years ago, and he 
has had no relapse since. A female patient from Utica was after a^ 
time discharged, but experienced a relapse and Avas brought back. 
Finally she was discharged as cured. This was four years ago, and tht* 
woman has had no mental trouble since. About five years ago a man. 
was returned from Utica. He was here about six months and then 
discharged. He has not since been returned, and I believe he has had 
no relapse. I have never had any success with cases of self-abuse." 

Amusements, etc. — There are no out-door amusements for the men. 
In-doors, they play checkers and read newspapers, which are sometimes 
supplied. There are no amusements in common for both sexes. 
" Occasionally, " the keeper says, " a brass band comes and gives therai 
music, but not very often. A company of traveling bell ringers came- 
here last fall and played an hour. " 

The interior walls of the cottages are destitute of pictures, andl 
wholly unadorned. 

Restraint. — In the institution are two ordinary cribs, secured by 
padlock. The keeper said: " Three women are put in the cribs, about 
once a week, for a short time. These cribs are seldom used for the- 
men." We have in this department one restraining chair and three; 
muffs. The latter have not been used for a long time and are now only 
brought into requisition when taking violent patients to Utica. Two 
camisoles are used in the women's ward ; also vihen transferring patients 
toUtica. I direct and regulate the restraint through general instructions 
to the attendants. My orders are to be very careful. No restraint book 
is kept. Punishment is inflicted upon the insane solely in self-defense, 
and then only in cases of gi-eat emergency and not as a means of disci- 
pline. For instance, an Italian once raised an ax over my head, in- 
tending to kill me. I was obliged to 'knock him over,' but such cases' 
are very rare. I find women more difficult to manage than men. " 

Farm. — The farm is in excellent condition, being well fenced, sub- 



Eeport on the Chronic Insane. 23 

drained and free from weeds. It is also productive, having long been 
subjected to a thorough system of husbandry. The farm buildings 
which are painted, are commodious, in good condition, and rest on 
solid masonry foundations. The stock yards are supplied with spring 
water. All available pauper labor is utilized on the farm. According 
to the keeper's statement " there is not an able-bodied male pauper in 
the poor-house department." 

General observations. — In the quarters formerly occupied by the in- 
sane in the poor-house building are five patients. One of the men is very 
violent " nearly the whole time ;" another is so "by spells;" and one 
female is said to be continuously violent and disturbed. Two of the 
women are quiet, and are serviceable in doing house work in the poor- 
house department. The wards occupied by the violent and disturbed, 
are particularly described in the report transmitted to the Legislature, 
April 18, 1879, Senate Document No. 50. The idiots are provided for 
in a building situated in a yard in rear of the poor-house. 

The laundry is in a detached building of the poor-house group, 
and in rear of the main building. It is furnished with steam-boiler, 
hot and cold water, and is conveniently arranged with wash-room, 
ironing-roora and drying-room, heated by steam. 

During the past year a small hospital building has been erected, 
about midway between the poor-house and cottage group. It \3 a 
wooden structure, consisting of a main building, with a rear wing. 
It has two wards, one for men and one for women ; a room on each 
side for a male and a female attendant; two bath-rooms, kitchen, etc. 
The building has chimneys at each end, and it is expected that heat- 
ing and ventUating by means of open grate fires will be adopted. The 
structure was in process of completion at the time of my visit. 

A special register of the insane is kept. Certificates of insanity are 
also kept on file in the ofiice. Chronic insane are admitted by order of 
the superintendent of the poor, or overseer of the poor. 

All medicines are dispensed hj the physicians, and in their absence 
by the attendants. 

The medical profession, it is said, do not manifest any special _ in- 
terest in the institution ; neither do the citizens appear to be particu- 
larly interested except through motives of curiosity. In the words of 
the keeper : "We have more visitors during the summer months than 
we think desirable. It has a disturbing influence on the patients. A 
great many pic-nics are held within a few miles of the institution, and 
this brings large numbers here out of curiosity. Upon one occasion 
the visitors numbered over two hundred. Wednesdays and Fridays are 
designated as regular visiting days." 

The acute insane, it was said, are generally transferred to State 
asylums within five days. Certificates of insanity accompany the cases 
sent to Utica. 

Paying patients, residents of the county, are admitted into the insti- 
tution at a per capita charge of 83 per week. The keeper remarked : 
" Their care and treatment are very much the same as in the case of 
the other patients. They are possibly a little favored to meet the 
wishes of friends." 

The visitation was made on August 12, 1881, by Commissioner 
Letchworth, accompanied by Professor A. 0. Wright, Secretary of the 
Wisconsin State Board of Charities, who made an oflficial inspection of 
4 



24 Report on the Chronic Insane. 

the building and plans, with a view to possible utilization of the latter 
by the Wisconsin Board. 

Chautauqua County. 

The Chautauqua county poor-house is located five miles from May- 
ville in a north-easterly direction ; one mile from Point Chautauqua, 
and half a mile north of the hamlet of Dewittville. 

Tiio insane department is situated one hundred feet north of the 
poor-house building. It comprises two brick structures, connected by 
an enclosed corridor, forty feet long and twelve feet wide. 

OfficiaU and employes. — The atfairs of tiie poor-house are con- 
trolled by a board of three superintendents of the poor. 

The keeper of the poor-house is appointed by the board of super- 
intendents. The present incumbent lias tilled this })osition for a period 
of nineteen years; his wife acting a.s matron. Their joint remuner- 
ation is $800 per year, with living. Tiie insane department is under 
the sole charge of another keeper, who is likewise appointed by the 
board of superintendents. His salary, including that of his wife, who 
officiates as matron of this department, is $6oO per year, with living. 
One attendant has charge of the men while they are at work on the 
farm. He sleeps in the asylum and his compensation is 816 per month, 
with board. Aside from the single male attendant referred to, there 
are no paid attendants in this department. A female cook is employed 
for the keeper's family at 83 per week, and a girl for general work in 
the insane department at $2 per week. No paupers were found in 
charge of the insane. 

Medical supervision. — The county physician, T. C.Wilson, M. D., 
resides at Dewittville. He visits the institution once a day, and oftener 
if required. His compensation is $250 per year. All the medicines 
are furnished by the county. They arc dispensed by the physician, 
and in his absence by the keeper. There is no extra charge for surgical 
operations. No prescription, nor "casebook" is kept. The insane 
are registered in the keeper's office at the poor-house, where the cer- 
tificates of insanity are also kept on file. A record book prepared by 
Dr. Wilson, and kept in the insane department, was shown, designed 
to give a complete history of each case. A copy of this will be found 
in the appendix hereto. It should be stated, however, that these 
records fall short of the intention. The physician said : '' Owing to 
the meagre information furnished by the papers accompanying the 
patient, the keeping of this history is incomplete and very unsatis- 
factory. I would recommend that this negligence be remedied by 
statute. There are no consulting physicians. The medical profession 
manifest little interest in the institution." 

Buildiiigs. — The principal building of the insane dei)artment, one 
hundred by thirty-six feet, was erected in 1867 at a cost of about 
$14,000. It is two stories high above a basement, with shingled roof. 
The smaller building in the rear, eighty by forty feet, also two stories 
above basement celhir, with slate roof, was built in 1876 and cost 
about $8,000. 

In the basement of the front building is the asylum kitchen, the 
keeper's kitchen, keeper's dining-room, the laundry, })antry and store- 
room, also two dining-rooms, one for each sex, as well as bath-rooms. 



Report on the Chronic Insane. 25 

At each end is a furnace-room. The basement communicates with the 
upper floors by stairways at each end of the building. 

On the first"^ floor are the office and family rooms of the keeper ; a 
ward for male patients at the left ; and one for females at the right. 

The second floor forms a large ward for men. 

The basement of the rear building contains the steam boiler for 
heating, and is mainly used for storage of coal. The two floors above 
are intersected by a central hall, in each of which, on both floors, are 
wards for men and women. The inmate's kitchen adjoins the two din- 
ing-rooms. It is twenty-four feet by sixteen. The floor is flagged. 
It contains a cooking range, cooking utensils, etc. ; also shelves, upon 
which was folded bed linen. The laundry adjoining is twenty-six by 
sixteen feet. It has a stationary wash-box, with six compartments , 
two of which are used for washing vegetables. These are supplied 
with cold water only. Here also, side by side, are two cauldron stoves, 
one used for boiling' clothes, and the other for food. Old shoes and 
miscellaneous clothing were about the apartment in some confusion. 

On the wall were hung kitchen utensils and men and women's gar- 
ments. Hot-air and smoke pipes pass through the room. 

The two bath-rooms in the basement are seven feet four inches by 
eleven feet. The floors are laid with cement and the windows grated. 
Cold water is supplied in pipes, while hot water is brought in pails. 

A small hospital department for the use of the poor-house inmates 
is situated between the poor-house building and the insane depart- 
ment. It is a two-storied brick building. 

Heating and ventilation. — The old asylum building is heated by 
two coal-burning furnaces, located at each end of the building, in the 
basement cellar, whence the heat is carried by pipes to the first and 
second stories. 

The new building is heated by a boiler in the basement, the steam 
being distributed through the rooms by means of pipes along the 
walls. 

The ventilation is by means of wall flues. In the old building, the 
openings (of which there is one in each room), are only four by six 
inches, and these are covered by plates, leaving only four small spaces 
for the air to pass. 

Window ventilation is mainly relied on. 

The window sashes of the old buildings are of wood — two sashes — 
hung with cords and weights. 

Sewerage. — A main sewer extends from the poor-house building to 
the creek, about eighteen rods distant. It is built of ten-inch socket- 
tile, with cemented joints. From the asylum buildings, an eight-inch 
socket-tile, cemented, is laid to the main sewer. 

These were said to be properly trapped. The water from the roofs 
of the two buildings discharges into the sewers by means of con- 
ductors. 

Water supply. — The source of water supply is from a spring elevated 
one hundred feet, and about three-quarters of a mile distant from 
the building. The water is brought thence through a one-inch iron 
pipe. 

The poor-house and insane department have two hundred feet of 
three-fourth inch hose with a one-fourth inch nozzle, as a protection 
against fire. 



26 Report on the Chronic Insane. 

Diniyig-room and food. — The dining-rooms have each two win- 
dows — double sash, twelve lighted, glass eight by ten, protected 
by horizontal gratings of round iron rods. The floors are flagged with 
stone. These rooms are much below the surface of the ground. 
Three and a half feet above the floor the walls evidenced dampness. 
The plastering is laid directly upon the stone. Each dining-room is 
twenty-eight feet eight inches by fifteen feet six inches, with nine 
feet ten inch ceiling. In each of these rooms were three deal tables 
laid without cloths. Eound top stools are used for seats. The table 
ware was of crockery and tin with ordinary knives and forks. 

The food is regulated by the keeper. lie gave the following as the 
regular diet : " In summer, for breakfast they have bread and butter, 
potatoes, gravy, apple sauce and tea. 

" For dinner, meat, potatoes, bread without buttei', and garden veg- 
etables ; tea is omitted. Pork and beaus are furnished once a week. 
In winter, onions twice a week are added. 

" For supper, mush and milk. 

" The food for the sick is taken from my table. 

" Three meals are supplied the insane throughout the year every 
day, except Sundays, when only two are given." 

Clothing. — The clothing was given as follows : 

" In the summer the men generally wear cotton shirt, linen over- 
shirt, cottonade pants, cotton stockings, shoes, and straw hat. The 
women's dress consists of chemise, blue or butternut colored gown, 
cotton skirt, cotton stockings, shoes, and sun-bonnet. In winter the 
men working out of doors have woolen coat, vest and pants, woolen 
wrapper and drawers, woolen mittens, cap, woolen stockings, and 
boots. 

"Those iu-doors have, in addition to their summer dress, woolen 
underclothing and felt hat. 

" The women are also supplied with canton-flannel wrappers and 
drawers, and woolen stockings." 

Employment. —At the time of visit there were eighty-one patients 
— thirty-nine men and forty-two women. Twenty of the men, 
it was said, were engaged in cutting and drawing wood, pulling beans, 
and attending masons. Seven women were in the kitchen doing 
housework, and eight, it was said, were sewing and mending. Those 
engaged in the latter operations were working under instructions, 
having no attendant with them. Twenty women were in the halls. 
•'' Ten of the men," the keeper said, '' do a fair day's labor, and twenty 
a partial day's work." He estimated that about one-third of the labor 
in both the male and the female departments was remunerative. The 
physician regarded the influence of labor as beneficial, promoting 
sleep and greater quietude. 

There were but two men who were in danger of doing overwork, 
and they were " only sent out for half a day." 

Amusements, etc. — It could not be ascertained that there were in- 
door or out-door amusements of any kind. Seven county papers are 
taken at the poor-house. 

Classification. — The men, it was stated, are classified by putting 
together those whose liabits of life are the same. '• We place some of 
the best of the inmates in every ward — those who have the best judg- 



Eeport on the Chronic Insane. 27 

ment — to look after the others and report ■when the attendant is 
absent." 

No special provision is made for epileptics, except that one occupied 
an open crib at night. 

One of the inmates has proclivities for arson. 

Restraint. — There are in the insane department two cribs with 
covers ; two mnflFs with stra^js and padlocks ; two leather straps and 
wristlets (both in use at the time of the visit); three pairs of hand- 
cuffs, used on the violent or "new cases." The physician said: "If I 
find a patient with handcuffs on, I have him removed and see if he 
cannot be controlled without them." The keeper said: "The daily 
number in restraint for the year averages three. I have not found it 
necessary to confine patients to their rooms, except in one instance 
during the past year. This asylum has no specified mode of punish- 
ment. Sometimes we use handcuffs, restraining their hands behind 
them. I use the handcuffs rather than confine them to their rooms. 
I think it has a better effect to have the other patients see them in re- 
straint." 

No restraint book is kept. 

General ohservatiojis. — In making a general tour of inspection the 
first ward entered was that occupied by men on the first floor, at the 
south side of the old building. Here the central hall is fifteen and a 
half by thirty-eight feet, with a number of small rooms on each side 
for patients. Light is admitted by two windows at the end, which are 
protected by wooden studding. The ceiling is painted and the floor 
laid with boards about twelve inches wide. Stationary seats were 
found arranged along the sides of the hall, divided by iron hand-sup- 
ports, some having one and others five spaces. The papered walla 
at the south end are dark and stained, said to have been "caused by 
leakage from the pipe above." From the ceiling hung two kerosene 
lamps, and two cheap prints were displayed on the walls. The room 
is heated by two registers in the floor, protected by iron straps. One 
of these gratings had been entirely broken out, leaving the hot-air 
flue exposed to the feet. Through the hall, passes the smoke-pipe 
from the furnace, wholly unprotected; and against the wall is the hot- 
air pipe encased in wood, conveying heat to the floor above. 

The water-closet is in the room at the outer corner, as are the closets 
in the other wards. The pipe below w^as said to have a trap. In the 
attic is a tank, which supplies rain water collected from the roof to 
cleanse the basin under the seat. The sujoply of water appeared in- 
suiiicient, and the closets, all similarly arranged, were at the time of 
visit quite offensive. Stored m these closets were brooms, mops, etc. 
In one room, used as a clothes-press, were shoes, boots and clothing 
hung irregularly on cut nails. Some of the clothing belonged to pa- 
tients. The windows of the small rooms have two sashes, with twelve 
panes of glass. They are grated by vertical iron bars. The doors are 
one foot eleven inches wide and paneled. There is an open space 
above the door, in which are three upright studs. All of the single 
rooms in the front side measure four and one-half by eight and one- 
third feet, with ten-foot ceilings, affording only three hundred and 
seventy-five cubic feet of air space. The ventilation is as elsewhere 
described. With one exception, each of these rooms contains one bed. 
The bedsteads, which are narrow, are of iron, with strap iron bottom. 



28 Report on the Chroxic Insane. 

The plastering in most of these rooms was much patched. This was the 
case to a great extent throiigiiout the old building, and in some parts 
it had become detached. Much patching had left small crevices or 
fissures, the margins of which had a peppery appearance, unmistakably 
indicating that bed vermin had gained a strong foothold. The semi- 
annual whitewashing, preceding the fall visitation of the board of 
supervisors, had not yet been made, and the interior was perhaps 
presented in its worst form. 

In several of the rooms tiie presence of bed bugs was more con- 
spicuous from blood smearings on the wall, where patients had crushed 
these insects with their fingers. In some of the rooms in the men's 
ward, the walls were much discolored by tobacco juice expectorated 
by the patients while in bed. The bedticks in many instances in 
this and other jiarts of the old building were deficient in straw and 
had been so long worn as to be unfit for use. The unequal distribu- 
tion of the worn-out straw must have been a source of great discom- 
fort. In some of the beds there was no protection to the person from 
the iron straps beneath. The keeper said : " The straw is unevenly 
spread because the patients make their own beds before retiring 
for the night.'' The pillows were made of feathers but were very 
small ; the bed covering appeared ample for the season. 

The women's ward, at the opposite end of this building, on the same 
floor, has a central hall, fifteen feet six inches by forty-five feet ; with 
nine feet ten inch ceilings, and has small rooms on each side. The 
windows are similar to those in the men's ward. The floor and ceiling 
are painted yellow, the room is heated by two registers in the floor : 
smoke and hot-air pipes pass through the floor above. The walls at 
each end are papered ; the north wall appeared stained and mildewed 
by leakage from above. The room is furnished with one bureau, a 
small wash-stand, looking glass, a few seats with backs, and several 
wall-benches, with iron supporting straps at intervals. The side rooms 
were originally four feet five inches wide by nine feet long, with nine 
feet ten inch ceiling. The partition between a number of these smaller 
rooms has been removed, doubling, and in one case trebling, the size ; 
there are now but six of the small rooms on this floor. One is used as 
a clothes-press. In one of the bed-rooms, without other furniture, a 
woman was sitting on the bed, sewing ; a patch was broken out of the 
ceiling overhead and some dresses were hung on nails against the wall. 
8he had a basket of patch work, also some straw braid and was engaged 
in making straw hats. The work was neatly done ; she was said to be 
a quiet patient. Here was likewise marked evidence of bed vermin. 
The woman said: "The bugs are beginning to crawl." In another 
room beside the usual bed and bedding, was a chair, trunk, old 
fashioned rocking chair, and clothes upon nails in the wall. Another 
had a rag carpet rug on the floor, a shawl in the window for a curtain 
with a couple of books and some specimens of needle work. 

The plastering on the wall was patched, and the ceiling broken. 
There was a manifest lack of attention to details throughout. This 
was further evidenced in the fastening of one of the doors, which was 
secured bv a tow string attached to the knob, with nail driven into 
the door-casing. The lower hinge of the door was broken. 

The men's ward on the upper floor extends throughout the whole 
length of the building. The central hall is eighty feet long and 



. Repoet on- the Chronic Insane. 29 

fifteen and a half feet wide, with windows at each end, having small 
rooms on both sides. 

The floor is of wide boards, unpainted. One of the four registers 
was protected by iron straps ; the perforated plate below was broken. 
The smoke-pipe from the furnace passes into the chimney through a 
partition, over a bed in one of the rooms. It was very much battered, 
and a large hole was visible at one of the joints. The walls of this 
room were cheaply papered, two kerosene lamps hung overhead ; a 
wash sink at one end was supplied with cold water. There were no 
decorations on the walls and no furniture in the room. At each end 
is a water-closet, of the same dimensions and pattern as those of the 
lower wards ; the atmosphere therefrom was offensive. 

The rooms contain one bed ; those on the front side being four feet 
five inches by eight feet eight inches, and those on the opposite side, 
seven and one-half by nine feet. The bed furnishings were of the same 
character as those already described, and seemed in need of attention. 
The walls in the sleeping-rooms were broken and patched ; in one 
room hung several chains, which the keeper said had not lately been 
used. One patient was lying in bed while elsewhere another was on the 
floor. 

The attic of the old building is used mainly for storage and drying 
clothes in bad weather. The windows in the corridor connecting the 
two buildings are of good size, protected on the outside by iron bars 
and on the inside by wire screen work. 

The windows in the new building are of the same kind, having two 
sashes, the outside bars in eight-inch and twelve-inch squares, with 
inside wire screens. 

In the hall on the first floor of the new building is a staircase with 
bluckwaluut hand-rail and balusters. The flooring and wainscoting of 
the hall are of ash, the walls are of brick, whitewashed. 

The first floor on the south side of the hall is used for men. The 
day-room is thirty by eighteen and a half feet, with a height of ten 
feet three inches; adjoining is a one-seated water-closet and a small 
wash-room or lavatory, with galvanized sink and a wash dish. In the 
men's day-room the walls are of brick, whitewashed, as is the case in the 
other rooms throughout the building. Six wooden chairs with bent 
rail were secured to the floor by an iron rod. Nine wooden chairs 
of the same pattern were secured to a plank and bolted to the 
floor. On the walls were a few colored prints. Adjoining this room 
and opening into it are two dormitories, each seventeen by eighteen 
feet six inches. Each has beds on iron bedsteads, two feet eight 
inches in width. The bedding was better than that in the old build- 
ing. Some of the beds lack a sufficiency of straw, although the 
keeper said they "were filled once a week." 

No chairs were in these dormitories. 

The opposite end of the building, across the hall, is occupied by 
women, and is the counterpart of the ward just described. In this 
ward was likewise evidence of a lack of care and supervision. Sitting 
on the floor in the water-closet was a young woman with her limbs in- 
decently exposed. The water-closets in this building are cleansed by 
water taken from the sink in the adjoining room, and ]ioured into the 
chamber beneath the seat. This was manifestly ineffectual and the 
atmosphere in all the closets was highly objectionable. 



30 Report on the Chronic Insane. 

In one of the dormitories adjoining the day-room are six rooms and 
in the other five. One of them contains a crib. 

The floor above is partitioned off as below, into women's wards at 
each end of the building. They are similar in size and description to 
the rooms below. 

In the day-room by a window sat a bare-footed young woman knit- 
ting. Her hair was" combed, her dress neat, and her appearance 
comelv. 

Another patient, an elderly woman, wearing spectacles, her hair 
neatlv combed, was well dressed and wore a ribbon around her neck. 
She was making a bedtick. She had also done some straw-braidiug, 
a sample of which was shown. Upon a small deal table were a number 
of books, some papers and boxes, all in order. The patient last 
referred to, had flowers by her side at the window and had evidently 
seen days of thrift and prosperity. 

In rear of the old building and extending along the sides and ends 
of the new structure are vards, one for men and one for women. Both 
are irregularly shaped. The men's yard is one hundred and twenty- 
five feet in length, with an average' middle width of forty-two feet. 
This is enclosed by a tight, rough board fence, fourteen feet high. 

Absence of supervision was deplorably manifest in the men's yard. 
Here a man neglected in appearance was observed with neither hat, 
coat nor vest, and having his person indecently exposed. He stood 
facing and in full view of the women in the second story of the 
women's ward. Another patient, said to be an idiot, was lying in the 
dirt under the platform of the steps we descended, which were about 
three feet from the ground. He was sparsely clad, while his clothes 
and hair were filled with dust. His person was likewise indecently 
exposed. The yard was thinly covered with grass mingled with short 
weeds, and was* in part rough with small stones or gravel. At one 
end in a pavilion, with seats, were two barefooted men. In one 
corner of the yard, in close proximity to the pavilion is a privy. The 
keeper said " the night-soil which falls upon the ground is removed 
every three weeks." In the privy were two men, both barefooted and 
hatless, one being on the floor. There were in all eight men in the 
yard. Before leaving, women at the windows betrayed some excite- 
ment and attracted attention by violent gesticulation and loud talking. 

The woman's yard on the opposite side, and which by its location 
is overlooked by" the men's large ward in the old building, is about 
one hundred and fifty feet in length, and averages sixty feet in 
width. It is inclosed by a tight, rough board fence, twelve feet 
high. Centrally located in the yard is a pavilion with seats around 
its outer limit.* In place of a door, the large privy has an opening 
eighteen inches wide. The keeper said " the night soil is removed 
from this every two weeks." The center of the yard was thinly 
grassed, but along the fence the sod was worn into a path by the 
tread of feet. In this yard were sixteen women. Four were on 
benches in the pavilion, four were seated on the grass, and others 
were standing or walking, all without bonnets or hoods. The hair of 
some was disheveled. One had a handkerchief over her head, 
another wore a night-cap, while a third wore dried grasses made 
into a sort of bonnet. Nine of the women were dressed in 
blue jean wrappers. The others wore calico dresses. The day was 



Repokt on the Chronic Insane. 31 

oppressively hot. Four of the women were uncomfortably seated on 
the ground in the scorcliing sun. One old woman crouched barefooted 
under the doorway platform, which is but a few feet from tlie ground. 
Her head was wrapped in a piece of cotton quilt, tied with cord or 
small rope. Her gown was turned up about her neck, while her right 
arm was bandaged with ragged-looking cloths. She approached us 
protesting that her right arm was broken. In her hand was a tin cup 
containing bread, of which she was eating. She said : " That woman 
(pointing to another) has broken my arm, and is very ugly." Mean- 
while the woman referred to, advanced toward her accuser in a threat- 
ening manner. The keeper stated that her broken arm was merely a 
delusion. 

In this county, the county judge commits to the poor-house or to 
the State asylum, as the facts of the case may warrant. The physician 
thinks it would be better if all cases of lunacy were first committed to 
the State asylum, and thence, when proper, transferred to the coun- 
ties. 

As to the number of inmates who had sometime been treated in 
State asylums, the keeper said: ^'We have no means of ascertaining 
this, as the commitments or records do not show the fact." 

The price charged for paying patients is $2 per week, and none are 
received from other counties. The number of paying patients in 
the institution at the time of visit was thirteen. The total amount 
received for this class of patients for the year ending June 30, 1881, 
was $562.28. 

The cost of maintaining the insane is not kept separately. 

As bearing upon the existing needs of the asylum the keeper said : 
** Some few things might be furnished that would improve matters, 
but on the whole I think they are pretty well provided for. Most of 
the time we are short of help. We can get along, but it would be 
profitable to have more help." He thouglit in administering the af- 
fairs of the department it was necessary to consult the interests of the 
tax payers. Being a tax payer himself he said he could better realize 
the force of public sentiment in this direction. 

A particular description of the main poor-house was transmitted to 
the Legislature in 1878, Senate Document No. 19. Few changes have 
taken place since, except in the outbuildings. About three years ago 
a large wood-shed was erected near the insane department. During 
the past year a building has been fitted up for a drying-room, etc. In 
this is a large refrigerator, capable of storing beef in carcass. A hog- 
house has also been added, sixty feet by twenty-four feet. An inspec- 
tion was made of the various departments of the main poor-house 
which, as in former visits made since the report alluded to above, 
resulted in the impression that the same cleanliness, order and thrift 
prevailed, which have so long marked the administration of the present 
keeper. 

The small plot in front of the premises, with its flowers and shrubs, 
is kept by the matron, Mrs. Wood, with a neatness and care which 
make it one of the pleasing features of the institution. 

The visitation was made by Commissioner Letchworth, September 
7, 1881. 



32 Report ox the Chronic Insane. 

Chenango County. 

The poor-house of this county is situated six miles from the town 
of Norwich, aiul luilf a mile from the hamlet of Preston. It is 
reached by a tedious ride over steej) hills. The site is elevated and 
healtliy, affording a good water supply and quick drainage. The build- 
ing stands about live rods from the road. 

OfflciaU and employes. — The administration of the poor-house 
affairs is intrusted to a board of three su})erintendent8 of the poor, 
each of whom receives $2 per day for actual service, and $3 
per day when transferring the acute insane to Utica. The 
keeper of the poor-house is appointed by the superintendent of the 
poor. His compensation for services of himself and wife is $500 
a year and living, §100 extra being allowed to pay household service. 
A farm-hand is employed at l>17 per month, and a cook at $2 
per week. The department of the insane is under the charge of an 
asylum keeper, who is likewise appointed by the board of superintend- 
ents, and who receives for himself and wife §500 per year and living. 
He is permitted to hire a girl a few weeks during the season of house- 
cleaning in the spring and fall. There are no paid attendants, nor do 
sane paupers assist in this department. 

Medical supervision. — The physician to the poor-house resides at 
Preston. He visits the poor-house weekly, and when called, charging 
for each visit the same as in private practice. He furnishes his own 
medicines, except in cases requiring special prescriptions. The medi- 
cines are usually given to the keeper's wife, sometimes to the keeper, with 
instructions to dispense them. 

A monthly register of the condition of the patients is kept by the 
keeper. Occasionally consulting physicians are called. The medical 
profession in the county manifest some interest, by inquiries about 
former })atients, and sometimes visiting the asylum. 

Buildings, etc. — The main building of the poor-house is a large 
wooden structure, painted white, with shingled roof, in which re- 
side the keeper's family. Here are also the dining-room and kitchen 
for the paupers. On the right is a two-story, L-shaped wing, for the 
women, and on the left is also a two-story, L-shaped wing, with base- 
ment, for men. To the rear of these are the farm buildings with 
convenient access from the men's quarters. 

The asylum department is located about thirty feet from the poor- 
house building. It has a front of seventy-eight by thirty-two feet 
deep; is two stories high, with attic, cellar and basement. The cellar 
is used for the storage of coal, wood, vegetables and farm ])roduct8, 
the basement as a kitchen and wash-room. In rear of this is a 
two-story wing, twenty-nine by thirty-one feet ; at the end of the main 
structure is another wing, sixteen by thirteen feet, one story in height. 
On the first floor, at entrance, are three apartments. The first of these 
is an office, the second, the family room of the asylum kcei)er, and the 
third, his bedroom. Beyond this is a dining-room for inmates; the 
rear end being used for the keeper's kitchen, and several small rooms 
on one side, occupied by patients. Beyond this is a hall, with rooms 
on each side for patients, and in the adjoining building is also a hall, 
with smaller rooms; all rooms below stairs being used for women. 
The second floors are similarly planned and used as wards for patients. 



Report on the Chronic Insane. 33 

In the attic, some small rooms have been recently finished, to accom- 
modate the increasing nnmber ot inmates. Tlie ward occupied by the 
women, off the dining-room, consists of a hall, thirty-two feet long by 
eleven wide, with two large windows at one end. There are three 
rooms on each side of this hall. The windows are furnished with 
white muslin curtains, having scarlet border and fancy bows. The 
floor is of maple; the room was furnislied with table, two strong 
chairs (used as restraining chairs) seA^eral arm chairs, Windsor chairs 
and rocking chairs. The first room on the right measures nine and 
one-half by ten feet. The windows are double sash, twelve lights, 
nine by fourteen, and sash bolts There are no gratings nor bars. The 
window has green outside blinds. The room has a panel door, trian- 
gular transom above it, and bare floor. It is ceiled throughout, was 
occupied by a paying patient, and contained a variety of furniture. 
This description, excepting as regards furniture, answers for the three 
rooms on ihe front side. 

Tlie room adjoining is used for the double purpose of bed-room and 
bath-room. It contained a bath-tub and cold-water pipes, hot water 
being brought in pails. The window was curtained ; a plain rug lay 
on the floor. The next room was used for a clothes-press and store- 
room, in which the clothes were neatly folded and the patients' dresses 
hung on the walls. The rooms on the left averaged in size about 
seven and a half by nine feet. They are ceiled throughout, have win- 
dows, six lights, nine by sixteen, protected by wire screens. The 
doors of these rooms extend from floor to ceiling, and are made of 
frame-work, two by three inch studding; the interior space horizon- 
tally and vertically latticed, with one by three-inch slats. These had 
an opening in the center. The doors were secured by hasp and padlock. 
A water-closet on this floor is provided with two seats and supplied 
with running water. 

The hall. in the lower part of the rear is nine and a half by twenty- 
seven feet, with two windows at one end having wire screen inside. 
Stationary benches are placed against the wall on one side. The stove 
is in the center of the hall ; a sink occupies one end, with pail, basin 
and towels. 

Six women were in this hall ; one was reading a book, two sitting 
in chairs, one- sitting on the floor, others walking or standing. This 
floor is provided with water-closet, and running water; the room doors 
on one side are latticed as described, and the opposite side paneled 
with transoms. The first is secured by hasp and padlock. Some 
rooms are wainscoted about four feet, and plastered above ; others are 
ceiled throughout. The rooms are painted in various colors. 
Windows are protected by wire screen work. These rooms, as was 
generally the case throughout the house, were furnished with bed and 
night vessel. In a few instances other simple articles of furniture 
were included. The ward had several rooms, uniform in character ; 
it was occupied mostly by men. One of the rooms had a stationary 
bunk, occupied, it was said, by a " wild Irishman, afflicted with a pro- 
pensity to kick, tear and thrash around." The windows are protected 
by iron gratings. This ward is likewise provided with a water-closet. 
One of the rooms was occupied by a woman, who was provided with 
straw bed and bedstead, upon which she sat in a crouched position; 
she was said to be very filthy, and destructive of clothing. In the 



34 Report on the Chronic Insane. 

room was a strong cliair in which she was occfisionally fastened. The 
windows are close grated 

In anotlier room was kept a woman wlio at the time of visit was 
working in the kitclien. The kee])er said : '' Once in four or 6ve weeks 
she is subject to paroxysms of excitement, wiiich will last two or three 
weeks, followed by a week's sleep and napiiing, after which she 
becomes useful in the industrial department." Two men were here 
pacing up and down the hall. 

The upper ward, over that first described, contains the same number 
of rooms and is similar in description ; it is a ward for males. Two 
of the rooms, however, are occupied by women, who the keeper said 
*• went to their rooms after the men had gone to bed." 

The ward in the dining-room has rooms on one side and end, eight 
in all, with five grated windows lighting the hall space ; it contained a 
stove and a large spittoon ; the floor was painted. There were eight 
male patients in the hall, one wearing a camisole, another was seen 
fastened in a cliair with belt strap, and further restrained by means of 
a muff and iron shackles — the latter being fastened by a strap passed 
through a staple in tiie floor. Six of the small rooms have paneled 
doors, two are made of strong studs with opening in center, and fast- 
ened with hasp and padlock; tlie windows of the rooms are small and 
all protected by gratings, except one, whicii has a wire screen. One 
of the rooms had a double bedstead, of which there were several in the 
asylum; this was used by two patients, one of them at the time was 
lying in bed, the other was in the hall. 

One of the rooms, the door of which was unfastened, was occupied 
by a strong and healthy woman, said to be about sixty yenrs of age, 
who was lying in bed at the time. 

The reason given for non-observance of strict separation of the 
sexes was: " a preponderance of women,'' and it was added that *' the 
classification as to quiet and disturbed cases was the dominant idea." 
In the attic, over the front building, is a long central hall, extending 
throughout half the building, lighted by a window at the end. On 
the sides of this hall are eleven rooms. The two end rooms have each 
a window. The others are lighted and ventilated by latticed doors. 
They are painted in various colors, and their average size is seven 
feet three inches by eight feet, with average ceilings. The doors are 
secured by hasp and padlock. The rooms, only five qf which were 
occupied, were furnished with bedstead, bed, and night vessel. The 
yard for men and women is inclosed by a white painted picket fence, 
six feet high, about twenty-eight wide and thirty-seven long. 

Heating (uid ventilation, — The buildiug is warmed by stoves, cen- 
trally placed in the various wards. The windows are mainly relied 
upon for ventilation. 

Dijiing-rooni and food. — In the dining-room at time of visit, 
the table was being set and breakfast i)repared by the keeper and his 
wife. Two insane women and a "liiredgirl" assisted. The latter 
had been employed to assist through the fall house-cleaning. The 
windows of the room had tasteful muslin curtains, and on the wall 
hung a small looking glass. At the end. adjoining the keeper's apart- 
ments, was a small cook-stove, sink, and various kitchen utensils. 
Partitioned off the dining-room on one side is a small sleeping-room ; 
also two cells with doors made of three by four-inch framed scantling 



Report on the Chronic Insane. 35 

with a central aperture for passing iu food, secured by hasp and 
padlock. The windows were sixliglit, seven by nine, grated witli rods 
about three and a half inches apart. These have transoms over the 
door about six by twenty-four inches. 

Dishes were placed for thirty-nine persons. Twenty-seven women 
and twelve men were seated at the two long tables. Windsor chairs 
with bent rails were in use. Crockery plates, cups and saucers were 
placed for all, except seven. These had tin basins instead, also spoons. 
The tables were supplied with salt in tea cups ; tin pepper boxes, also 
a large bowl of milk. A^o table cloths were in use. 

The breakfast consisted of fried pork, a slice of which was laid on 
each plate, butter, boiled potatoes, large slice of bread to each, 
nnsweetened tea, with or without milk, as desired. One drank water. 
Two meals are regularly furnished throughout the year, excepting to 
those who work. They are provided with an extra mid-day meal in 
the kitchen. All the bread for the insane is baked in the poor-house. 

Breakfast is served at 9 o'clock, a. m., and dinner at 4 p. m. The 
former is given as follows : Meat, pork or beef, and potatoes, bread and 
butter, unsweetened tea; sometimes codfish picked and cooked in milk 
is supplied, also Mackinaw trout, fried or baked; sometimes are added 
cookies or fried cakes. Four o'clock, dinner. This meal was described 
by the keeper, as in farmer phrase, a " boiled dinner," and consists of 
the following: Corn, beets, turnips, onions, green peas, and other 
vegetables in summer; baked beans and soup occasionally, but no but- 
ter; sometimes pudding, milk and potatoes warmed up. Plain tea is 
allowed at the latter meal, sometimes pickles or pickled beets. 

Clothing. — The summer clothing of the men was said to be a cotton 
shirt, cottonade j^ants and coat, while some wear vests. A portion of 
the inmates have stockings, some shoes or slippers, while those who go 
out to do chores wear boots. In winter woolen clothes are worn, cot- 
ton shirt, no undershirt nor drawers. About one-half wear woolen and 
the other half cotton stockings with slippers, shoes and boots. No 
overcoats, it was said, are required for the men who do chores, as they 
are not exposed. The dress of the women is calico or denim, cotton 
chemise and drawers ; some wear uuder-wrappers and canton-flannel 
or woolen skirts, cotton stockings, shoes or slippers. All wear drawers, 
except one or two. Either hats or hoods are worn. In summer, cotton 
are substituted for woolen skirts' with no under-wrapper. 

Bedding. — The bedsteads in use are mostly of wood, after the Wil- 
lard asylum pattern, with iron-strapped bottom. Tlie bedding con- 
sists of a straw tick, to which, for those who are cleanly in habits, a 
feather bed is added; feather pillows, two sheets, and one or more bed- 
quilts are used, according to the season. 

Em2)loyment. — The total number of inmates in the insane depart- 
ment is forty-one, fourteen of whom are men and twenty-seven 
women. There are but two men who go out of the asylum to work. 
These "do chores," saw wood, and wait on the kitchen. There are 
two of the men who work in-doors, sweeping and assisting in house- 
work. The women, of whom there are five, are employed Avithin 
doors at general housework. 

It is thought that none of the men perform a fair day's labor, and 
the four doing a partial day's work are not worth the services of a paid 
man. The labor of the women is thought to be equal in service to that 



36 Report on the Chronic Insane. 

of a '• hired girl."' The women work under the direction of the 
keeper's wife. None of tlieni are disposed to overwork. Both the 
keei)er and i)liysician think they are better if tliey have something to 
do. In the kitchen, at the time of visit, six women were variously 
em])loyed. One was ])aring potatoes, others washing; one woman was 
sitting, while scrubbing clothes at a wash-tub. She was very stout. 
Her weight hud been ascertained during the year to be three hundred 
and forty-seven pounds. 

Resfraiiif. — The door leading to the yard is generally unlocked, and 
it is said a great portion of the patients have the range of the wards, 
dining-room and kitchen. The quieter cases are permitted to walk in 
the ])our-liouse grounds. U'he keeper said, he aimed at giving them as 
much freedom as possil)le; they had, he said, the same liberty which 
they would enjoy in their own homes. While no attempts at escape 
were made, yet the keeper believes that many might get away if they 
thought it possible. At the time of visit but two persons were 
locked up, one in the hall, and a woman in her own room. Two 
darkened cells or rooms were occupied by two women, but only as 
sleeping-rooms at night. Punishment of the insane is never resorted 
to, the keeper said, " except it be the locking up in rooms for a short 
time." 

Far?}! and garden. — The poor-house farm comprises one hundred 
and seventy acres, on which twenty-three cows are kept, the products 
are consumed on the premises; a good many potatoes are raised, as 
well as some wheat, oats, and a little corn. 

Water supply. — Water is supplied to the institution from a spring, 
distant about one hundred and seventy rods ; it is conducted twenty 
rods of the distance by two-inch pipe, thereafter reduced to one and a 
half inch for some little distance, and the remainder one-inch pipe. 
The supply, it is said, has been sufficient during the past summer, but 
is not in excess of needs. 

Seioerage. — The water-closets are drained, as are likewise the kitchen 
slops, into a stone vault a short distance from the house, and thence 
conducted in a stone drain, rapidly descending to the fields, a goodly 
distance from the buildings. 

Ge7ieral oliservations. — The acute insane are received into the 
institution, but it is said they are promptly transferred to Utica. It 
would a])pear that there is a good deal of visiting by pleasure seekers. 
It is thought that the visits made in summer average forty per week ; 
Some of these are by interested citizens, but most are out of curiosity 
or from pleasure; the physicians think there is too much of this. In 
some of the apartments much confusion was manifest in consequence 
of a vigorous house-cleaning which was going on. A careful examina- 
tion left the impression that cleanliness and good house-keeping pre- 
vailed in the administration of the establishment. 

The visitation was made by Commissioner Letchworth, November 
4, 1881. 

Cortland County. 

The poor-house of Cortland county is about two miles from the vil- 
lage of Homer and two and a half miles from Cortland village, wliich 
is the post office-address. 'It is also within a quarter of a mile of 



Eeport on the Chronic Insane. 37 

Loring, a flag station ou the Ithaca and Elmira raih'oad. It is situ- 
ated in a small valley on the banks of the east branch of the Tiough- 
nioga, a clear, rapid flowing stream. 

Officials and employes. — This county has one superintendent of 
the poor, George Murray, senior, who resides at Homer. His compen- 
sation is S500 per annum. He succeeds, by an appointment of the 
board of supervisors, to the place of Silas Blanchard, who died July 10, 
1881. Mr. Blanchard, by his careful and conscientious administration 
of the poor-house of this county, had won an enviable reputation and 
enjoyed the confidence of both political parties, and the universal re- 
spect of the people of the county. He held the position of superinten- 
dent for eleven years. 

The keeper of the poor-house, Alonzo W. Gates, who has held the 
position for seventeen years, is appointed by the superintendent. His 
salary, including that of his wife, who acts as matron, is $550 per 
year and living. The compensation of the subordinates is fixed by 
the superintendent. A farmer is employed on the farm. The insane 
department is in charge of a sub-keeper and wife, who receive jointly 
1360 per annum and living. Their sleeping apartments are in the 
building with the insane. There are no other paid attendants, nor 
are paupers in care of the insane. "If assistance is wanted," it is said, 
" the farmer is called in." 

Medical supervision. — The physician, S. C. "Webb, M. D., resides 
at Homer village. He is appointed by the superintendent, is required 
to visit every other day, and oftener if occasion demands. His salary 
is 8200 per year. All medicines are supplied by the county. No pay 
is allowed for extra services or surgical operations. Medicines are dis- 
pensed by the physician, or by the keeper of the insane department 
under his direction. 

There are no consulting physicians. In special cases counsel is 
called. The medical profession, the physician says, " visit the insti- 
tution occasionally and enquire after cases with which they are famil- 
iar. A favorable disposition is manifested by physicians throughout 
the county toward the institution." " Citizens frequently inquire and 
make visits to the house ; some of course are mere curiosity seekers, 
others prominent citizens. Supervisors manifest a personal interest 
by occasional visits." 

The insane are registered in the poor-house, A copy of the same is 
filed with the county clerk. The form is that prescribed by the State 
Commissioner in Lunacy. The certificates mostly show whether the 
case is acute or chronic. 

General description. — The jooor-house is a two-story brick structure 
with slate roof. The central portion is used for the keeper's family, 
office, kitchen, etc. The right and left wings are for inmates. The 
basement cellar is used for milk-room, storage, etc. In the rear of the 
poor-house building, twenty eight feet distant, stands the department 
for the insane, in which there were twenty-nine patients. This build- 
ing consists of a central portion of brick, to which is attached a 
wooden building, fifty-one feet long, and thirty-one feet wide, under 
which there is no cellar. In rear are the yards for both sexes of 
the insane. In the central port'on on the first floor are the rooms 
of the keeper and his wife, kitchen and two dining-rooms, one for 
men and one for women. These communicate with the men's ward 



38 Report ox the Chronic Insane. 

on the left and the Women's on the right. Above are dormitories, one 
for men and one for women. In the rear structure the partition ex- 
tends through the center, dividing the men's from the women's wards. 
Througli tlie men's ward on the lower floor is a Inill, ten feet wide, 
twenty-four feet long, with ten foot ceiling. On each side of this are 
small rooms. There are stationary benches on the sides of the room. 
Above the doors of the small rooms are transoms, twelve by twenty- 
six inches, grated. One of the rooms measured was seven feet by five 
feet two, and had ten foot ceiling; another, six feet by seven ; another 
seven feet four by seven feet. The windows have double sash, six 
lights, eight by twelve, outside vertical iron gratings, half-inch rods, 
with three and a half inch spaces. Oneof tlie rooms on the first floor 
in the men's ward is ceiled ; the windows are protected by iron grat- 
ing on the inside and also a wire screen. Tiie room was occupied by 
a suicidal case who had tried to hang himself. The door of this room 
was secured l)y hasp and padlock. The windows in this ward have 
iron guards or gratings outside. Another room on this floor has 
ceiled sides, inside grating, and was said to be used by patients who, 
for a few hours at a "time, were under paroxysms of excitement. The 
ward above is similar to that below, with stationary benches at- 
tached to the side spaces of the hall. A few colored prints were on 
the wall, also a looking glass. Opening out of this ward are six small 
rooms with plastered walls. These average six by seven feet and in- 
clude a clothes-press. One of these rooms was occupied by a patient 
who formerly was an inmate of one of the obsolete dungeons of the 
Onondaga county poor-house. 

The description of the rooms and wards for men will answer for the 
upper and lower wards for women at the opposite end of the building. 
The walls have a few framed pictures and some a looking glass. The 
rooms were generally unfurnished, except as to a bed and night vessel. 
In some was a seat, a small carpet rug, a few trinkets and wall ornaments. 
On the inside casings of one of the rooms, by means of a pin, a patient 
had punctured the wall daily, thereby showing a record of her incar- 
ceration. At one point was noted the number of "days from home," 
another, '• two years in here." Here was also punctured the date of 
her transfer from the Onondaga county poor-house. This room had 
a few cheap prints on the walls (the frames made by the i)atient) some 
dried grasses, a few trinkets and ornaments. Several dresses, tidily 
kept, hung on the wall, the room showing the neatness and taste of 
its occupant. 

On the south and west sides of the women's department were win- 
dow awnings. In the associated dormitory for women, over the 
dining-room, considerable taste was shown in decorating the apart- 
ment, and a preference for bright colors. Kugs were before nearly all 
the beds ; one was a fancy patch-work. All of the beds, excepting 
one, had fancy patcli-work quilts made by the patients. In the room 
were two tasteful crosses, made of green arbor vita^and myrtle, briglit- 
ened with red mountain asli berries, coxcomb and thorn apples. Here 
were also ornamental hanging shelves and evergreen wreaths made by 
one of the patients. There were also framed pictures on the walls and 
stand, on which were sundry trinkets, including a little ])aper cradle. 

The men's dormitory corresponds in size to that of the women's, 
being eleven feet by twenty, with seven feet four inch ceilings. It 



Report o]S! the Chronic Ii^tsane. 39 

contained six beds. The windows are of uniform size, with outside 
gratings. The stairs in this building are so located as to afford ready 
egress in case of fire. In the women's ward was a patient suffering 
from mania caused by religious excitement. She was singing hymns. 

The door opening into the women's yard was unlocked, affording 
free access thereto. It is long and narrow, being twenty-three feet by 
eighty, fenced with rough boards, twelve feet high. In the center 
was a square pavilion, ten by twelve feet, with a double seat extending 
through it. A path was worn in the grass around the borders of the 
yard. The water-closet has a cemented vault, sawdust and ashes be- 
ing used for deodorization. It was said to be ''cleaned twice a year." 

The men's yard is thirty feet wide, of the same length, sanded in- 
stead of grassed, with pavilion and closet as in the women's yard. 

The door to the yard was likewise open ; there were five men in the 
yard and eight in the hall. 

A one and a half story building, twenty-two by fifty feet, stands 
about twenty-five feet from the asylum building and is separated by a 
fence. A central hall and stairway separate the building into two di- 
visions, the right being used for women, the left for men. In the 
male department was an idiot boy of sixteen in care of an adult pau- 
per. In the corner a strong room was partitioned off for turbulent 
cases, said to be seldom used. The room contained four beds. 

In the women's department were several idiot patients in charge of 
two pauper women. The room contained three beds. Both depart- 
ments were well warmed and in apparent good order. There is also a 
strong room in the women's department. A room above was used for 
sleeping, another for storage, another as a drying-room. At each end 
of the building is a small yard eight paces in width by nine in length, 
with water-closet. This building is used to isolate the idiotic and 
filthy cases. 

The house was kept in clean and orderly condition.* 

A. number of the insane men and women were kept in the poor- 
house building with the sane. It was said: " They sleep in associated dor- 
mitories with paupers in the poor-house department, eat at the pau- 
pers' table, have the same care, and share the same freedom as the sane 
paupers. " 

Laundry, — The washing of clothes for the insane is done in the poor- 
house department on a day set apart for the purpose ; the work is 
performed by the patients, under the supervision of the asylum keeper 
or his wife. 

Bathing. — A small hall leading to the yards was likewise used as a 
bath-room and contained a bath-tub, water being supplied from a pump. 
Hot water was brought in pails. 

Heating and ventilation. — The men's ward, lower floor, is heated by a 
coal stove in the hall, protected by iron gratings and secured by pad- 
lock. The hall above has a grated space in the ceiling to the attic for 
the purpose of ventilation. The ceiling of the lower ward has an open- 
ing to warm the ward above. In the walls of the halls are ventilating flues. 
The atmosphere was somewhat impure. The rooms have window ventila- 
tion only. 

The men and women's associate dormitories are ventilated by means 
of a tin tube extending through the roof. 

Dining-room and food. — At the date of visit, dinner was be- 

6 



40 Report on the Chronic Insane. 

ing prepared and the table set by the keeper's wife, aided by four or 
tivc insane women. The tables were covered with enameled cloth. A 
small table was being prepared with food to be carried into the wards for 
two epileptic patients ; one of them a man weighing two hundred and 
twenty-six pounds. The table was laid with crockery plates, bowls 
and pitchers, steel knives and forks, salt cellar and pepper boxes. 
Round top stools were used for seats. The dinner consisted of a meat 
and potato stew, bread, pickled beets, and cabbage with vinegar, and gin- 
ger cookies. Milk was on the table for those who desired it. All who 
preferred tea were served Avith it. The women's dinner and table 
were similar. All were eating at the tables, except three ; one being 
an epileptic, who with two others was served in the wards. One re- 
quired to be fed with a spoon. 

There were a few pictures on the walls in the dining-rooms. The 
doors between the two rooms were open and the keeper and his wife 
served the meal. The keeper gave the dietary as follows : " We always 
have three meals a day. For breakfast : meat and potatoes, either 
boiled or baked — the meat is oftener pork than beef, — bread, tea, 
generally flour gravy, pickles. We always have milk on the table and 
they can help themselves to it. We always have vegetables. For din- 
ner: bread and butter, tea and milk, generally pickles. Have four 
meals of a week, some days fish ; beef served in a variety of ways, 
sometimes in the form of a pot-pie. For supper : bread or biscuit and 
butter, sauce, cake or pie, or pudding of some kind ; also tea and milk. 
In the fruit season we have baked apples, red raspberries, blackber- 
ries and this summer strawberries, tomatoes in their season, occasionally 
grapes, melons and peaches. Once a week we have a meal of mush and 
milk, or johnny-cake and milk, or bread and milk. With this meal is 
furnished butter. We always have butter twice aday and sometimes in 
hot weather three times a day. To avoid waste, bread is sliced from 
the loaf as wanted." It appeared that the food was abundant and of 
great variety. The bread for the asylum is baked in the poor-house 
department. 

Clothing. — The clothing of the men when within doors was given 
as follows : cotton shirt, a few with cotton under-shirt, lined woolen 
pants, woolen coat and vest, cotton and woolen socks, shoes or boots, 
felt hat. In winter those who work outside have thick flannel under- 
shirts, knit woolen drawers, boots, mittens and overcoats. All the 
Avoolen socks used are made from wool of the sheep raised on the farm, 
spun and knitted in the institution. Some fulled cloth is made from 
yarn spun and woven in the house, from which garments are made 
under direction of the keeper's wife, aided by pauper labor. 

The dress for women in winter vvas given as follows: Those less able 
to take care of themselves have woolen dresses of strong home-made 
cloth ; others of calico. All have woolen-flannel under-skirts and canton- 
flannel Avrappers in winter, Avith cotton under-wear and cotton stock- 
ings as well as shoes in summer. 

Bedding. — The bedsteads are of wood, after the style of the Wil- 
lard asylum, iron strap bottom ; the bed consists of a tick filled with 
straw, feather bed, feather pillow, two sheets, quilt. It was said, "all 
have feather beds if neat in their habits." Additional covering is 
used in winter. 

Enwloyment. — In summer some of the men are employed at com- 



Report on the Oheonic Insane. 41 

mon farm work, although this work is not continuous, and there is no 
employment for them in-doors. 

The women do sewing and the housework of the asylum. Nine of 
the men and five women perform a partial day's labor ; of the women 
four perform a fair day's work. There are no special work-rooms for 
the sexes. As to the value of the men's labor, the keeper said: 
*' There are none tliat I would take and pay board for; it is true they 
labor, but it is all that the work is worth to get it. The patients are 
never urged to work beyond their ability, and there is little disposition 
to do so. In one case a female was restricted when disposed to over 
work." 

Restraint. — In the women's upper ward is a crib, made of wooden 
slats, with lid secured by hasp and padlock. At the time of visit, 
none of either sex were locked in their rooms. In the women's de- 
partment was a strong arm chair, varnished, and used for restraining 
chair, though not occupied. There are also two strong arm chairs, 
used as restraining chairs, with strap around waist, as well as wristlets 
and anklets; three muffs, and three pairs of handcuffs. Eestraint 
was said to be used, but only to a small extent. In important cases, 
the keeper is consulted. The attendant exercises his judgment, and 
afterward notifies the keeper. One case, that of a male epileptic, was 
handcuffed constantly, except during night. There is no special pro- 
vision for epileptics. 

Amusemeiits, etc. — Some reading matter is brought by the physician 
every week, consisting of the' ordinary newspaper exchanges. No 
in-door nor out-door amusements are provided. 

Water supply. — The water is brought from a hillside spring," eighty 
or one hundred rods distant, Avith one hundred feet elevation. For a 
few rods from the spring, the water is conveyed in one-inch iron pipe; 
thence to the house in a three-quarter-inch lead pipe. It is said the spring 
never fails, although in dry times the pipes are not entirely filled. 

Wells are " driven" about the premises for drinking water, there 
being four at the poor-house building, three at the asylum, and 
one at the barns. Eain water is not utilized. The stream already 
referred to is about twenty rods from the asylum building. 

A hand force pump, and about one hundred feet of one-inch rub- 
ber hose is provided, as protection against fire. 

Seiuerage. — A main sewer one foot in diameter of round socket-tile, 
cemented, extends from the wash-house and kitchen through the west 
wing, about one hundred feet, where it discharges into a plank-drain, 
eight by twelve inches, which again discharges into the river. The 
fall is from ten to twelve feet. There are no traps nor pipes to carry off 
sewer gas. The conductors from the roof discharge into the sewer. 
The mouth of the sewer a great part of the year is below water in the 
river. A branch of this sewer, made of six-inch socket-tile, cemented, 
extends into the asylum kitchen. 

There are no water-closets within doors. 

Farm and garden. — The farm consists of one hundred and eighty 
acres, eighty or ninety of which are arable. It has a young orchard 
just coming into bearing. One and a quarter acre is devoted to a 
garden, in which are raised vegetables in great variety, including pota- 
toes, beans, peas, beets, turnips and carrots. Some sweet corn and 
vegetables are also raised upon the farm. Thirteen milch cows are 



42 Report on the Chronic Insane. 

kept. The butter used is made on the place. The farm in all its 
appointments is highly creditable. Buildings and fences appeared in 
good order and every thing in its place. The garden was well planted 
and free from weeds. The quantity and quality of out-door products 
indicated a " land of plenty." The grounds in front of the house 
were well kept, showing care and taste, and the whole outward appear- 
ance of the institution and its surroundings was inviting. 

The visitation was made by Commissioner Letch worth, October 4, 
1881. 

Erie County. 

The alms-house of this county is located on Main street, about five 
miles north-easterly from the business center of the city of Buffalo, on 
the old State turnpike road, and about one mile north from the Main 
street station on the New York, Lake Erie and Western railroad. 
Buffalo Plains is the post-office. 

Officials and emjjloyes. — The keeper of the alms-house has also 
supervisory charge of the insane department, and is appointed by the 
board of supervisors at a salary of $1,300 a year, with living tor him- 
self and family. 

The superintendent of the insane department is appointed by the 
keeper of the alms-house. His compensation is $1,200 per year, with 
living. His wife is matron and receives a salary of §416 a year. An 
assistant is also appointed, whose compensation is fixed at $900 a year, 
with living. 

There are six male attendants^mployed at a salary of S30 per month 
each, one hospital steward, six female attendants at $-4 per week, one 
cook for the keeper's family at $5 per week, one dining-room girl at 
$4 per week, one female cook for the insane at ^b per week, one female 
nurse for women's hospital at $2 per week. Employes are ai)pointed 
by the keeper of the alms-house. There are no paupers in the care of 
the insane. 

The keeper of the alms-house prescribes the duties and regulates the 
conduct of the attendants. Printed rules similar to those in use at 
the State asylum are placed in the hands of each attendant. 

Medical supervision. — The resident physician, Charles A. Ring, M. 
D., is alsoai)pointed by the keeper of the alms-house, at a salary of §600 
a year, with board. He and the attendant under his direction dis- 
pense the medicine. 

The dispensary connected with the office of the physician is an at- 
tractive feature of the institution. 

A "case book," but no " prescription book," is kept. 

The insane are registered at the main office and also at the oSice of 
the insane department. 

General description. — The main or administration building of the 
insane department was erected in 1874, from a plan approved by the 
State Board of Charities. This, although carried out generally, was in 
some respects dejjarted from. 

The front part contains the office, reception-room, rooms for the 
asylum superintendent and his family, and apartments for officers 
and employ6s. The rear contains on the first tloor, dining-rooms for 
patients, also asylum kitchen, pantries and store-rooms; on the second 



Report on the Chronic Insane. 43 

floor, two associate dormitories, one having fourteen beds, the other 
eighteen; also, a large room used for sewing. On the third floor are 
two hospital-rooms, one for either sex, and an associate dormitory for 
men, with eleven beds. 

The windows of this building are six feet nine inches by two feet 
six inches, have two sashes suspended by weights, and are protected by 
vertical iron rods, painted white and placed opposite the sash bars. 

In the rear is the boiler-house, between which and the main part it 
is proposed to place the laundry. An old stone building, temporarily 
fitted up, is now used for that purpose. 

ThVough the center of the build'ing extends transversely a hall con- 
necting with the wings on either side and having separate flights of 
stairs at each end. 

The left or south wing for women, one hundred and fifty-six by 
fifty-seven feet, is three stories high, and was erected in 1877. Each 
floor has a central hall with dormitories on either side, also bay win- 
dowo. 

There are eight single rooms for patients, and four associate dormi- 
tories, each of the latter containing eight beds. Each floor has a sepa- 
rate dining-room, also two attendants' rooms, lavatory, bath-room, 
supplied with hot and cold water, and water-closets. A dumb-waiter 
communicates with each floor, also a dust-flue. From the kitchen, 
food is conveyed along a tramway extending through the cellar to the 
north and south wings, thence by means of the waiters it is lifted 
to the several wards. 

On the first floor are the more quiet and epileptic cases ; on the 
second, the better class of inmates who sew and do other work, 
and have more freedom ; on the third, the filthy and more vio- 
lent. 

The right or north wing for men was erected in 1879. It is of the 
same size and general plan as the south wing. The windows have 
iron sashes but no gratings, within or without. 

On the first floor are the men who work the farm ; on the second, 
the more quiet; on the third, the epileptic and filthy cases. The su- 
perintendent determines the classification. 

In the hospital-room for women were five patients, and six in that 
for men. The rooms were clean and cheerful and an attendant was 
present in each. In consequence of the insufiiciency of these apart- 
ments some of the patients are treated in the single rooms of the gen- 
eral wards. 

The following diagram (A) shows the ground plan of the insane 
department, while diagram (B) illustrates one of the wards and the 
uses of its various parts. 

The insane department is designed to accommodate about three hun- 
dred patients. The total expenditure for buildings, steam boiler, 
heating apparatus and prospective laundry building is estimated in 
round figures at 8100,000. The buildings are of stone, quarried on 
the premises, with the aid of the insane. 

Each ward is furnished with several comfortable settees of 
varnished wood, rocking and other chairs, a clock and a table. 
The bay windows are provided with colored shades and were 
at the time of visit brightened by plants. Framed chromos and other 
pictures hung upon the walls. 



44 Report on the Chronic Insane. 

The furnishing of the single rooms consisted of a chair, a wooden 
bedstead, witli strap iron bottom, Willard asylum pattern, a tick filled 
with straw, two sheets, a counterpane, straw pillow and commou husk 
bolster. 

The associate dormitories were similarly furnished, one chair being 
allowed to each bed. A few of the single rooms contained articles of 
luxury and taste, brought by friends of the patients, and one dormi- 
tory was decorated with a number of paper birds, crosses and flowers 
made by an inmate. 

An effort was apparently made to keep the wards clean, but there 
was not the perfect order observable that would indicate efficient ad- 
ministration. A number of attendants were absent from their 
posts of duty, and the separateness and independence of the functions 
of the physician from those of the superintendent, did not seem to be 
clearly defined. While there was no actual conflict, there appeared to 
be, on the part of the latter,an assumption of power and responsibility 
properly belonging to the physician. 

The dining-rooms were provided with deal tables, Windsor chairs, 
having bent rail ; the table furniture consisting of crockery ware, ordi- 
nary knives and forks, except in the case of disturbed patients, where 
tinware is substituted and knives and forks are not used. 

In the laundry are fourteen stationary and eight ordinary tubs, 
together with the usual laundry appliances, also separate rooms for 
ironing and drying clothes. 

The yard for women, one hundred and eighty-five by one hundred 
and fifty feet, recently planted with trees, has several settees and 
benches, also a central pavilion, twenty-four feet square, provided 
with seats. 

Heating and ventilation. — The main building is warmed by stoves ; 
the wings by steam. Radiators are placed in the halls and in each 
dormitory. Heat is admitted to the single rooms through a perforated 
plate at the bottom of the doors and through the transoms. 

Ventilation is effected by means of a lai-ge air shaft, in which is 
the iron smoke-stack from the boilers. The system at present ex- 
tends only to the north wing, but it is intended to include also the 
south wing, the connections being already prepared within the build- 

The present ventilation in this latter wing is somewhat defective. 

Dietary. — The following is given as the dietary: "For breakfast, 
coffee, bread and molasses, with hash three times a week." 

For dinner the range of articles from which to select includes 
" vegetable soup, rice soup, corned beef, and stewed fresh beef, potatoes, 
beans, cabbage, beets, carrots and other vegetables ; codfish on Fri- 
days." 

For supper, ''corn meal mush, bread, molasses, tea or coffee; some- 
times cold meat and fried potatoes." 

The laboring men have beefsteak or sausage for breakfast, and the 
women who work in laundry, tea for dinner. Sugar and milk are 
used in both tea and coffee. All the inmates have more or less fruit 
when in season. 

The diet of the hospital comprises eggs and milk, and sometimes 
dishes are brought from the superintendent's table. 

The physician prescribes the diet. 



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Clothing. — For men in summer blue denim overshirt and pants; 
white shirts, cotton socks, straw hat, shoes or boots. Those who are 
in-doors wear slippers. In winter woolen under-clothing is worn, and 
those who work out of doors have woolen pants, woolen knitted jackets 
with caps and mittens. For women, in summer, cotton underwear, 
with skirt, blue dress, stockings and straw hats. In winter, an addi- 
tional skirt and woolen hoods are provided. 

Employment. — Some of the men are employed at farm labor, 
plowing, hoeing, jilanting, mowing, reaping, cutting wood, etc., 
others work in the garden. 

A few mechanics work at their trades. Several work about the 
house, making beds, scrubbing floors, washing windows, and assist- 
ing in the dining-rooms. 

The women knit, sew, wash, iron, and do general housework. 

The superintendent says, ''' Twenty of the men perform a fair day's 
labor; the others don't do much. They accomplish about half as 
much as sane laborers." 

The farm contains one hundred and fifty-four acres of land of 
average quality and moderately productive. 

Restraint. — In one of the dormitories on the women's side was 
an open crib, having wooden slats, with straw tick, and ordinary 
bedding ; four restraining chairs, two with and two without padlocks, 
one muff, with belt and wristlets, were in another apartment. 

In one of the single rooms on the lower floor was a restraining chair 
with arms and back of square studding and a thick plank seat. Here 
was secured a woman, by an adjustable plank in front rounded to fit 
the person, and further restrained by a muff with Avristlets. In the 
same room was another restraining chair not in use at the time of 
visit. 

Another room contained a crib three feet eleven inches long, two 
feet eight inches wide, and two feet four in height, with a cover of 
slats secured by hasp and padlock. In this room was also a restrain- 
ing chair. 

In the upper ward of the male department were two patients, 
strapped without muff, and four with muff and wristlets. There 
were also three restraining chairs, two with open seats, and one crib 
without cover. 

One of the dormitories contained four cribs with covers, said to be 
used only at night for beds. In this ward were also three restraining 
chairs with straps, and one pair of handcuffs, two cribs with and two 
without covers ; several of the restraining chairs have open seats and 
stocks for feet. 

The superintendent said '' camisoles are not used." In the ward 
below was one crib with cover, one restraining chair, one pair mana- 
cles, one muff with strap. There are no secure rooms for the con- 
finement and isolation of the insane. 

The institution contained in all sixteen cribs, of which eight are 
open and eight closed ; twelve restraining chairs, four having open 
seats and stocks for the feet, and three restraining straps. There are 
nine muffs with belts and twelve waist straps ; of camisoles there are 
fifteen, and two pairs of handcuffs. The superintendent said, " these 
comprise all the modes of restraint in use." 

The rule is that the attendant report to the physician, and the physi- 



46 Report on the Chbonic Insane. 

cian shall regnlate the restraint. This it was said was not observed; 
frequently the restraints are not reported till the following day. There 
are no dark rooms nor cells, and punishment, it was said, is not in- 
flicted. 

Water supply. — The e.xamination of the water supply confirmed 
previous conclusions, that it was greatly deficient, and the health of 
the inmates was suffering in consequence. This was so manifest 
that a communication on the subject was addressed to the board of 
supervisors of Erie county, and presented at the opening 6f its ses- 
sion October 11, 18S1, of' which the following is a copy. 

Buffalo, Oct. 10, 1881. 

To the Hoyiorable the Board of Supervisors of Erie county, N. Y.: 

Gentlemen — In making an examination of the water snpply at 
the Erie county alms-house on the 8th and 9th days of September 
last, it was found that the wells, of which there are several, were 
virtually dry, and that the rain water in the capacious cisterns of the 
establishment had been exhausted. In this extremity recourse was 
had to a distant well, from which water was being hauled by teams 
for drinking and for cooking purposes. To meet other deniands, 
leather hose^'was laid to a pond about fourteen hundred feet distant 
from the alms-house, through which water was forced by means of a 
hand lever pump to cisterns, in which it underwent a process of filtra- 
tion before being used. But little water was found in the pond. This 
was tinged green and yellow and gave evidence of great impurity. An 
examination of this water after being filtered showed it to be of a pale 
amber hue and containing floating particles. The water of this stag- 
nant pond, divested of its surrounding contaminations, is deemed un- 
suitable for domestic use. There is a well upon the grounds, said to 
have been bored two hundred and eighty-two feet, from wiiich it was 
contemplated to pump water by means of a wind-mill. This has 
practically proved a failure. The water from this source is not 
adapted to the uses of the house, unless subjected to a chemical pro- 
cess which would be expensive. 

In the insane asylum the water-closets at times cannot be used as 
originally intended, for lack of water, and in consequence a highly 
objectional condition of the atmosphere is frequently the result. 

At times it has been necessary for a succession of weeks to melt 
snow, to meet the general needs of the house. 

On the days of visitation there were nearly seven hundred inmates, 
and at times this number is largely increased. The minimum amount 
of water requisite for all the purposes of such an institution, accord- 
ing to the best authorities, is forty gallons per inmate; the maximum, 
sixty gallons. At the minimum rate this would require twenty-eight 
thousand gallons daily. 

In providing a supply it would be wise perhaps to estimate, not 
only for an increased number of inmates, but also for any future en- 
largement of the institution. The supply of water at the alms-house 
has always been greatly deficient, either to meet its sanitary require- 
ments, or for protection against fire, from which it has largely suffered 
by the destruction of its buildings. 

Under existing conditions, I feel justified in earnestly entreating 



Report on the Chronic Insane. 47 

you to give early consideration to this important subject, that such 
action may be taken by your honorable body as shall provide for the 
alms-house an abundantsupply of pure and wholesome water. 

Very respectfully, 

WM. P. LETCH WORTH, 
Commissioner of the State Board of Charities, Eighth Judicial District. 

Setoerage. — Several eight-inch cemented socket-tile sewers extend 
from the asylum building to a twelve-inch tile sewer, which discharges 
into a walled drain about two feet square near the poor-house build- 
ing. This extends one hundred and sixty-seven yards and then dis- 
charges into an open ditch fifty-five yards from the highway. The 
system of sewerage is defective. 

General observations. — Regarding out-door amusements for men the 
superintendent says : " We "have ball playing. The balls are made of 
soft rags covered with leather. In-doors the men play checkers." 

There are no out-door nor in-door amusements in common for both 
sexes. 

Papers are occasionally supplied by benevolent societies and indi- 
viduals. 

There is a contribution box in the institution for visitors; the pro- 
ceeds are devoted to the purchase of books and papers for the inmates. 

It is matter for regret that expenditures have been made in connec- 
tion with this asylum not in accordance with the original plan, ap- 
proved by the State Board of Charities, nor in keeping with true 
economy. A small old stone building, cheaply constructed and badly 
planned, which stood in the rear of the men's wing, was to have been 
taken down and its material used in constructing (as already shown 
in diagram A) a wash-house in rear of the administrative depart- 
ment and between the kitchen and the boiler-house. A considerable 
sum has been expended in reshaping and refitting this building for 
temporary occupancy as a laundry, and in constructing a subterranean 
passage to it from the kitchen, with stairs at either end. The conse- 
quence is that the plan of the asylum is incomplete, and one of its pri- 
mary aims defeated. The building, being occupied by women and be- 
ing on the men's side, is in violation of one the first principles of proper 
classification, viz. : the separation of the sexes. The building and its 
surrounding yard are now overlooked from the men's wards, and the 
men by this arrangement are deprived of a yard in proper location. 
It has become necessary to make a long narrow inclosure for them 
some distance beyond, which again encroaches upon the women's de- 
partment in the poor-house. i3ut for this, with a sufBcient supply of 
water and some change in sewerage, the provision liere made for the 
chronic insane would reflect credit upon the county. And, indeed, the 
liberal spirit manifested by the people in this direction is worthy of 
note. 

As the rules of the State Board of Charities require that a resident 
physician should be employed in places where there are over one hun- 
dred insane, the attention of the keeper of the alms-house was directed 
to this point and a request made, through the Secretary of the Board, 
that a resident medical superintendent be placed in charge of the 
asylum department. The request has been complied with, so far as 
regards the employment of a physician, but he is made subordinate 
7 



48 Report on the Chronic Insane. 

to a superinteiideut and assistant superintendent, and his sphere of 
usefulness thereby circumscribed. There is no doubt but that a resi- 
dent medical superintendent, with a competent matron and a well-se- 
lected corps of attendants, could properly administer the atfuirs of the 
insane department, disi)ensing with a general superintendent and an 
assistant superintendent, and thus effect a saving of several thousand 
dollars yearly in salaries. It is believed that not only greater economy 
but better administration would in this way be attained. 

The inspection was made by Commissioner Letch worth, September 9, 
1881. 

Genesee County. 

This county claims the right under a special statute to receive and 
treat not only chronic, but acute cases of insanity. 

The poor-house is located in the town of Bethany, distant one and 
a half mile from Linden station, on the New York, Lake Erie and 
Western railroad, and nine miles from Batavia. 

The site of the building is elevated and commands an extensive 
prospect. The ground in front of the main building has recently been 
planted with flowers, and the fence removed. The farm contains one 
hundred and eighty acres of land, besides a timbered lot of fifty acres 
one and a half mile distant. A fruit-bearing orchard of eight acres, 
furnishes plenty of apples for the inmates. 

Officers and emploi/es. — The poor-house institution is under the con- 
trol of three superintendents of the poor, who are elected by the peo- 
ple, and hold office for three years. The keeper resides in the building 
and receives an annual compensation of §700, and living for himself 
and wife, she acting as matron. A female assistant receives 12.50 per 
week. A man is employed for work upon the farm. 

In the insane department are two paid attendants ; a man at 120 
per month and board, and a woman at ^3 per week and board. 

The keeper prescribes the duties and regulates the conduct of the 
attendants under direction of the physician. 

Afedical supervision. — The visiting physician resides one and a half 
mile distant, at the village of Bethany. He visits the poor-house every 
other day, and oftencr if required. His compensation is $175 per 
year, which includes medicines, with the exception of such supplies as 
are kept in the house. No extra allowance is made for surgical opera- 
tions. The medicines are dispensed by the attendants under direction 
of the physician. At present, the sick are treated in their rooms. 
There is no consulting physician. The doctor said : " No acute cases 
have been received here within a year ; they may be received, however, 
if brought." 

General description. — The main poor-house structure, built over fifty 
years ago, is of brick, two stories high and thirty by forty feet. It is 
occupied as the keeper's residence, office, etc. 

Situated in the rear of the main structure is a largo two-storied 
wooden building. The lower story is used for kitchen and dining 
purposes, and the upper story for sleeping apartments. 

Some delay occurred in beginning the tour of inspection, in conse- 
quence of the absence of the male attendant in charge of the insane 
men. He was temporarily absent on the farm and had with him the 



Report on the Chronic Insane. 49 

keys of the men's ward, which was locked. The general exterior of 
the building for the insane resembles that of a county jail. 

The department for the insane is situated north of the main build- 
ing. It is twenty-six by thirty feet, built of cobble-stone with cut 
stone corners. The walls are somewhat dilapidated, the corners of the 
building especially showing signs of weakness. The Avindows are pro- 
tected on the outside by strong liorizontal iron bars, bolted to the 
frame. 

Connecting the main building to the insane asylum is a i)uild- 
ing forty by fourteen feet — the lower story of cobble-stone and the 
second story of wood. 

The rooms are ranged on one side of a hall. They are ceiled and 
painted throughout and have ceilings eight feet four inches high. 
They were unoccupied on the day of visitation. 

The doors are constructed of double boards laid transversely, each 
having an opening five by eleven inches. They are covered by an iron 
grating and secured by heavy iron bolts and padlock. 

The windows are suspended at the top by hinges and secured by 
lock. They are protected by a frame-work of slats one by two and a 
half inches, having half-inch openings for admission of light and air. 

The hall on the first floor of the main building is ceiled and painted. 
Light is admitted by two windows having inside iron gratings of hori- 
zontal rods, two inclies apart. Two benches with backs, a heavy deal 
table, and a pair of manacles comprised its only furniture. A rusty 
stove-pipe passes from the furnace in the cellar, through the floor to 
the ceiling above. The joint next the floor was much battered. A 
register in the floor admits heat direct from the furnace. 

In the hall were two patients, one of whom it was alleged had been 
in the institution for years. His dress was of heavy gray cottonade. 
He wore no shirt, and was bare-footed. His hair was cut close. He 
was said to be filthy at times. The other was dressed in ordinary citi- 
zen's clothing with felt hat. 

Opening out of this hall are four bed-rooms. One of these is much 
defaced, and in a corner was observed a funnel-shaped box twelve 
inches square used as a night-vessel, the excrement falling into a pail 
placed on a shelf in the cellar below. The sides of the box were in a 
filthy condition, and the ventilation being inadequate the air was ex- 
tremely offensive. The same arrangement and uncleanliness were ob- 
served in adjoining rooms. All the doors on this floor have bolts 
additionally secured by chain and padlock. 

Communicating with the yard in the south-east corner of the build- 
ing is a small hall provided with bath-tub and roller-towel. Cold 
water is supplied from a rain-water tank in the attic, hot water being 
brought in pails. The hall is painted and evidenced cleanliness. 

The women's department is upon the second floor and is reached 
from the hall by a narrow flight of steps. In the connecting building 
the hall and rooms are ceiled and painted throughout. The doors are 
of double-inch bo;irds matched. Some have open gratings and all are 
provided with iron bolts and locka. The windows are without grat- 
ings and are formed of two wooden sashes fastened with bolts. 
They measure two feet eight inches by four feet. The furniture of the 
rooms consisted of wooden bedsteads and bedding. The floors were 
bare and muslin shades screened the windows. The hall windows also 
had muslin shades. 



50 Report on the Chronic Insane. 

One of these rooms was occupied by a male paying patient. His 
apartment contained patent iron bedstead, with wire bottom, straw 
tick, two sheets, one quilt, colored counterpane, straw bolster, feather 
pillow, carpet rug, small cushioned rocker, painted deal table, upon 
which was noticed a comb and brush. A scriptural motto was upon the 
wall, and clean-looking clothing and comfortable morning-gown hung 
upon the side of the room. 

The ante-room leading to the main hall serves as a bed-room for a 
pauper, and a dining-room for three female i)atients. The furniture 
consisted of a patent bedstead, chair, rocking-chair, table with oil- 
cloth cover, wash-stand, pail and basin. The door entering the main 
hall is grated. 

In this hall was a paying patient, dressed in calico and wearing a 
sun-bonnet of the same material ; also a pauper patient said to be de- 
structive of her clothing, and an idiot attired in a long gingham gown, 
without belt or collar. The hair of the latter was cut close and her 
feet were bare. 

The main ward measures thirteen by fifteen feet, and its ceilings are 
seven feet high. It contains five rooms; its windows, four feet six 
inches by two feet three inches, are grated with horizontal iron rods 
set in frames secured by padlock. The doors in construction and in 
respect to gratings, bolts and outer locks are similar to those just 
described. The entire ward and its rooms are ceiled with wood, 
painted, and at the time of inspection were commendably clean and 
in order. 

In the hall was a Avoodeu settee and chair, a deal table with oil- 
cloth cover, a cup-bourd for dishes, secured by hasp and padlock. 
The floor was painted and the walls bare. The smoke-pipe from the 
furnace below passes vertically through to the attic above, protected, 
however, by a grated box. 

The rooms contained bedding as before described. One bedstead 
was of iron, the others wooden, of the Willard asylum pattern. One 
room occupied by a pauper patient had the additional furnishing of a 
featherbed, flag-bottomed chair and painted foot-stool. The south- 
east room upon this floor, with the usual bed-room furniture, has also 
an iron bath-tub, supplied with cold water from a tank in the attic. 

Nine women occupy the rooms on this floor, two of whom are quiet 
patients, who were working in the poor-house building at the time of 
our visit. 

In the unfinished attic, under the bare rafters, were hung the winter 
dresses of the patients, the under-clothing being arranged over a line. 
Through tlie roof and its sides were crevices affording here and there 
a glimpse of the sky. The dila^ndation of this building at the time of 
inspection amounted almost to insecurity. 

The yard for men, seventy by thirty feet, is in view of the women's 
department. It is inclosed by a tight planed board fence, eleven feet 
high, and is provided with out-door conveniences on the plan of an 
earth-box, which can readily be drawn out and cleaned. This it was 
said is done once in three mouths. The grass is short and partially 
worn into paths. 

The yard for women is on the east side of the building, fifty by 
sixty-six feet, and surrounded by a tight board fence eleven feet high, 
planed and painted. Out-door conveniences are provided similar to 



Report on the Chronic Insane. 51 

those already described. In the center of the yard a large post was 
noticed, to which it was said a violent patient, since transferred _ to 
the Willard asylum, was formerly chained, " to prevent his hurting 
other patients." The yard was sparsely sodded and in many places the 
frrass was worn entirely away by the continued tread of patierts. 

Here were women, two of whom were paying patients. These latter 
were better dressed and wore sun-bonnets. The retrospective fatuity in a 
patient was here somewhat touchingly revealed. One woman, whose 
hair was cut close, with much earnestness related her troubles and 
among other things bewailed the loss of hair. '• I suppose," she said, 
" you have come to see the crazy people. Well, we are not much more 
crazy than the people who keep us here. Wiien I was a child I visited 
the Rochester Insane Asylum with my parents and my little brother. 
I recollect we gave the crazy people some pennies and it pleased them ; 
now I am confined here with the insane and my hair is cut off. I 
want to get out and go home." 

Another whose lower limb was exposed, badly swollen, livid in color, 
and presenting a raw and fearful sore, was said to occupy a room in the 
poor-house department. 

In the rear and beyond the yards is a wooden building, one and a 
half story, and eighteen by forty-two feet, called the " old school- 
house." Here were four insane and two idiot women under the charge 
of a female also of unsound mind, who had formerly been a pauper. 

In the front part of the building is the attendants' room, plainly 
furnished, warmed by a box-stove, the pipe from which passes through 
the adjoining ceiling. In the rear is an apartment for inmates eleven 
by twenty- four feet ; the door leading to it is grated with vertical 
iron rods. This room is furnished with three wooden benches, and a 
low-deal dining-table, the food being brought from the poor-house 
department. The ceiling is seven feet four inches high. Small 
rooms open from this on the left, and all are ceiled throughout. On 
the floor in one corner of the mainroom sat an old woman said to 
have been in the institution thirty years. She wore an old hood and 
a butternut-colored gown. Her feet were wrapped in cloths tied by 
strings, with which her hands were constantly occupied. She was in 
a violent and excited state, her speech loud and profane. An idiotic 
female, twenty-two years old, whom it was necessary to feed, was 
crouched on a bench, her feet under her, with one hand partially 
stuffed in her mouth. She appeared to suffer painfully from the flies 
which had collected in the creases about her mouth and eyes. She 
had not the sense to drive them away. She was dressed in_ a loose 
gown and was bare-footed, as were all the inmates of this building._ 

Off this hall is a room thirteen feet six inches by seven feet, occupied 
by an idiot, who sleeps in a wooden bunk. The bedding here was in 
order, but the air was impure. Here also was a wooden bedstead with 
counterpane and straw pillow. Another room seven feet square, with 
ceiling eight feet high, was occupied by the woman first described. 
It contained no bedstead nor bedding of any kind, the occupant sleep- 
ing on the floor and using a blanket. " At'times," said the attendant, 
"it becomes necessary to use the hand-cuffs upon her." These hiing 
on a nail in the hall. The air in this room was very offensive. Night 
buckets were used in these rooms as well as in the main building. A 
stairway leads from the attendants' room to the attic. At the north 



52 Report on the Chroxic Insane. 

end is a room in which are two wooden bunks. One of these was used 
at night by an inmate. The bedding consisted of a straw tick, cover- 
let and blanket. The ventihiting flue from below opens into this 
room. The plastering of the ceiling was nearly off, some of the laths 
broken, evidences of leakage a]ii)arent, the open sky visible in 
several places through the roof. The central room was unfurnished. 
In the t^TO south rooms the i)lastering had mostly fallen. They were 
at the time of visit unoccupied. The attendant said : " They are used 
at times as a temporary expedient to relieve an over-crowded condition." 

A small yard twonty-six by forty-two feet adjoins this building, 
inclosed by a tight board fence seven feet high. This yard is designed 
for the use of the inmates, and communicates with the ward within 
by a door which is kept unlocked. It is shaded by a tree with seats 
around the base. A closet with box beneath occupies one corner. 

In a building situated in the rear of the portion called the "jail 
house," at the south-east corner, is a small room, eight by nine feet six 
inches and ceiling eight feet high. It is occupied by a quiet, paj'ing 
patient. The small window is crossed with iron bars. A stained 
wood bedstead of French pattern, good bed and bedding, painted 
chair and stand, looking glass and framed picture on the wall, com- 
prise the furniture. Clothing hung on the wall, and on the stand was 
a Bible and two other books of a religious character, all belonging to 
the patient. 

On the third floor of the old poor-house building is a room ten by 
twenty-six feet, with ceiling eight feet four inches at one angle, and 
three feet from floor at the otlier, where sleep six of the insane who 
work on the farm. The room is lighted by a window two feet by one 
foot six inches, and another three feet by twenty-one inches. A third 
window of similar size was temporarily boarded up. This room con- 
tained three iron bedsteads, strap iron bottoms, straw ticks, sheets, 
pillows, quilts and blanket. One stool was in the room, and nails 
were driven in the wall upon which to hang clothing. 

A room adjoining, twelve by sixteen feet, with ceiling eight feet 
six inches high, and plastered walls, contained three bedsteads with 
bedding similar to that just described, also a stool. Clothes were hang- 
ing from nails in the wall. It was well lighted, and separated from 
the male dormitory in the poor-house department by a door with open 
grating, over which was hinged a close blind. 

Heating and ventilation. — In the basement under the main asylum 
building is a hard coal-heating-furnace, put in several years since, 
from which heating-pipes pass to the rooms above. The furnace sys- 
tem is supplemented by stoves when needed. 

The ventilation is mainly accomplished by means of the windows, 
and is insuflicient. Circular openings about six inches in diameter 
are cut in the ceilings of some of the upper rooms to facilitate ventila- 
tion. 

No thermometers are used. 

Dietary. — We were informed that the insane women all eat in their 
wards. The insane farm hands eat with the paupers in the poor-house, 
and the others in the men's ward of the asylum, the food being sup- 
plied from the poor-house kitchen. 

There is no diet table. The keeper prescribes the diet, supervised 
by the physician. 



Report on the Chroxic Insane. 53 

The table-ware is of tin, as are also the spoons. The insane at the 
pauper table use crockery-ware witli ordinary knives and forks. 

The food in summer for breakfast was said to be meat, potatoes, 
bread and tea. Dinner includes the foregoing, with vegetables in their 
season, twice a week, comprising onions, beets, cabbage, beans, etc. 
Supper consists of bread and milk or mush and milk. In winter the 
diet is said to be the same. 

There is no special diet for the sick. 

Clothing. — In summer, the men wear denim shirts, satinet pants 
and vest, denim overfrock, blue or brown, wool or straw hat, cotton 
socks, and boots ; winter, denim shirts, woolen coat, vest and pants, 
woolen socks, and boots. Those who work in the woods wear drawers 
and wrappers. 

The women wear in summer, calico dress, cotton underwear, cotton 
skirt, cotton stockings and shoes, and in winter, the same, with more 
under-clothes. 

Bedding. — The bedsteads throughout are mainly of flat iron, with 
hoop iron slat bottoms, upon each of which was a straw tick, two sheets, 
feather pillow, tufted quilt, and a counterpane, removed at night. 
In the men's department are three wooden bedsteads of the Willard 
asylum pattern, and the usual bedding. 

Employment. — Some of the men are employed in farm work, such 
as plowing, mowing, harvesting, gardening, etc. Cutting wood is all 
done by the insane. The keeper said : " The best seed sower on the 
farm is one of tlie insane." They are not employed in-doors. The 
women do housework; three work in the kitchen. Four of the men 
do a fair day's work, and seven a partial day's labor. Two of the 
women do a fair day's labor, and one a partial day's work. 

The keeper said: "Four men do three-fourths of a day's work each, 
and the others not over one-fourth. Two of the men last winter 
chopped ten cords of wood in one day. Two women do three-fourths 
of a day's work, and the rest about one-fourth." Nothing is done to 
prevent the insane from overworking. 

The keeper said : " The influence of labor is highly beneficial. They 
are more quiet, and sleep and rest better. One man, if he lays still 
for three days, will be raving." 

Restraint. — The restraining appliances consist, it is said, of "one 
muff, two pairs of handcuffs, and one pair of leg-irons, worn by a patient 
to prevent him from running away." The keeper prescribes the 
restraint; confinement in dungeons, or dark cells, is not resorted to. 
" If patients are unmanageable," said the keeper, " we shut them in 
their rooms as the only means of punishment." 

Water supply. — The poor-house and insane asylum are supplied 
with water from two wells at the house, one being located five feet 
east of the asylum, and about ten feet north of the poor-house build- 
ing. There are also two wells at the barns. The keeper said : " Two 
of the wells are inexhaustible, and two have sometimes failed." 
There are three underground cisterns for rain water. There is also a 
zinc-lined oblong tank in the attic for receiving the water from the 
roof of the asylum building. The bath is supplied with cold water 
by means of pipes and faucets. No special provision is made against 
fire. 
Sewerage. — One of the sewers starts ten feet from the poor-house 



54 Repobt on the Chronic Insane. 

well. It is a wooden box laid underground for a distance of eight 
or nine rods, and discharging into an open ditch in the garden. One 
from the east end of tlie poor-house, near the paupers' kitchen, dis- 
charges into tlie same ditch. One from the wash-house is made of plain 
brick tile, six inches in diameter, and discharges into an adjoining pas- 
ture. None of tliese sewers have traps. 

Oeneral observations. — The sexes are separated whilst in-doors, also 
when out. Tiiere is no special chissilication, except to keep some of 
the violent and excited by themselves. There is no special provision 
for ci)ile])tics or idiotic. There are no insane epileptics. Idiots are not 
sepai-ated from the insane. 

No in-door nor out-door amusements are provided, except checkers. 

The clotliing of the insane is washed separately from that of the 
sane paupers, and the men and women's clothing are kept separate. 
It is all washed at the wash-house. 

There are six paying patients residents of tlie county — three men 
and three women. The price charged for maintenance is from $2 to 
$3 per week. A soldier pays $72 per year. One patient from outside the 
county pays $3 per week. Those paying over $3 per week board 
from the keeper's table, and those at %'i from the poor-house table. 

During the past year a frame wing, sixty by twenty-eight feet, has 
been built in connection with the main i)Oor-house building at the 
left. It is two stories high with shingled roof. In this addition are 
two rooms to be used for the sick — one for the men eighteen by 
twenty feet, and one the same size for women — and in these rooms it 
is proposed to treat tlie insane when sick. On the upper floor is a 
large room intended for chapel purposes. Under the chapel is an oflice 
for the superintendents, a kitchen, buttery, and wood-shed. 

The inspection of the institution was made by Commissioner Letch- 
worth September 7, 1881. 

Jefferson County. 

The poor-house of this county is situated on the rocky banks of the 
Black river, a mile and a half from Watertown, with which place it is 
in telephonic communication. The building faces the east, and stands 
a little distance from the highway, with an intervening shaded park of 
several acres. In front of tlie house is a small flower-garden inclosed 
by a picket-fence, while the river flows close by the rear. 

The main building of the poor-house is brick, two stories high, with 
dormer windows and basement, the floor of the latter being about one 
foot below grade in front and above grade in rear. It forms the 
residence of the superintendent, oflicers, etc. 

The left wing, two stories high, about eighty-five feet long, and 
a foot and a half below grade in front, is occupied by sane paupers. 
The right wing, two stories high, with basement, is allotted to the 
insane. The basement floor is above grade in the rear. 

The roof of each wing is of sheet iron, painted. The front and 
rear windows, including the front basement, have outside iron 
guards. 

Officials and employes. — This county has one superintendent of 
the poor, who is also keeper. The present incumbent has held the posi- 
tion five years. The compensation allowed for himself and wife is $800 



Report on the Chronic Insane. 55 

per yem' aud living. A man to work on the farm at $24 a month, and a 
wornan, once an inmate, at 11,50 per week are employed. A woman 
has also been usually employed at ^2 per week to take charge of the 
bakery. This place was vacant, however, at the time of the visit. 

Tiie insane department is under the charge of a keeper, whose wife 
acts as matron. The , compensation of both is $450 per year and liv- 
ing. He has held the situation eight and a half years. A female at- 
tendant is also employed at $3 per week. No pauper labor is used in 
the insane department. 

Medical supervision. — The county physician resides at Watertown. 
He is appointed by the board of supervisors and is required to visit 
the asylum once a day, and oftener, if necessary. His compensation 
is $350 per annum, for which he is expected to furnish all needed 
medicines. 

General description.— The wing building for the insane is of brick 
one hundred and five by thirty-eight feet. The basement contains 
the kitchen, and dining-room for each sex, bath-room, clothes-press, 
bake-room, laundry and family kitchen. The sitting room and dor- 
mitories are on the two upper floors. There are two flights of stair- 
ways in the building. 

In the basement hall the windows contained painted boxes filled 
with flowers. The first room at the right, a long apartment, was used 
as a store-room, and also for drying clothes in stormy weather. It was 
filled with clean clothing, neatly folded or hung. Clothes were being 
dried there at the time of visit. The air was damp aud disagreeable. 
Adjoining this was the bake-room. The next was used as a bath- 
room. Further on was the laundry, next to which were the dining- 
rooms. The tables in the latter were laid for supper, with tea, bread 
and butter. Later ^qyq seen twenty-nine women at the supper table. 
Their dresses were clean and hair neatly combed. None had their 
hair cut close. In the male dining-room were seven men partaking 
of bread and butter with tea. A paid assistant was present. In both 
dining-rooms, were stained and varnished deal-tables and benches, 
crockery plates and steel knives and folks. Beyond these rooms, was 
the asylum kitchen, which in its appointments and orderly arrange- 
ment, indicated good housekeeping. 

On the second floor, adjoining 'the apartments for attendants, is a 
goodly-sized room, formerly called the "fool's room," but now known 
as the ''second department." At the time of inspection it was occu- 
pied by four insane women and one idiot. On entering this apartment 
the first object that met the eye was the white and rounded form of a 
woman entirely nude. She was sitting in a square painted box that 
came to her armpits. The box was enlarged in front to allow suffi- 
cient space for her knees in the sitting posture, and also lowered in front 
to a shelf on which she received her food. Her face was pale, hair 
short, eyelids red and eyes sunken. The apartment seemed cold. The 
keeper, In explanation, stated that she was an idiot ; that clothing 
seemed to torture her and cause her to scream, so that it was found 
impossible to keep her properly clad. She was designated the "idiot 
girl," although her age was given as between forty and fifty years. It 
was further' stated that she was brought to the asylum about a year 
ago, in a box similar to that in which she is now confined. 

Of the other women in the room, one was sitting on the floor, eating 
8 



oG Report on the Chronic Insane. 

ht'i* supptT; luiother was restrained by a muff, and a third was iu an 
exciit'd condition. 

Adjoinin;f this department is thi- mule ward, which contains seven 
rooms. All have paneled doors, excepting one which has npright 
slats. Over the doors were good-sized transoms with horizontal rods. 
The ceilings are ten feet high. The rooms are furnished simply with 
bedstead, bedding, and night bucket. 

The sitting-room has two windows with mnslin shades, and was 

furnished with comfortal)le chairs. .Some pictures hung upon the wall. 

The sitting-room of the womeii's ward was larger and was provided 

with window curtains, rocking and other chairs, also several pictures. 

The bed-rooms adjoining contained clean and comfortable beds. 

On the third floor was a large sitting-room for female patients, hav- 
ing pictures on the walls, muslin window curtains, rocking-chairs, 
and a goodly number of otiier chairs. In an associate dormitory were 
ten beds. 

The women's wards were supplied with upholstered lounges or 
settees. 

The women's yard, connected witli the wards by an unlocked door, 
is L shaped, one hundred and four by altout one hundred feet, and 
surroun<led by a close matched board fence ten feet high, with serrated 
top. A small portion was grassed, the remainder planted with maples, 
over thirty in number, aflbrding a dense shade. It- is provided with 
seats and closets. Several women were in the yard. 

With free communication to the malj ward is a yardaboutthe same 
length as the other and forty-six feet wide. It also is grassed and 
shaded with maples and pines. Only two men were in this yard ; one 
wearing shoes and the other barefooted. 

Heating (171(1 ventilafi(m. — The building is heated by steam, with di- 
rect radiation. Ventilating flues from the various wards and rooms 
open into the attic, to which air is admitted under the eaves. 

Bathing arrangements and laundry. — The patients are bathed, it 
was said, once a week, and oftener if necessary. For this purpose com- 
mon wash-tubs are placed in a room adjoining the laundry in the 
basement. 

The laundry is supplied with hot and cold water. Washing is done 
by hand. In summer the clothes are dried in the yard, and within 
doors during winter. 

Dietary. — The institution has no printed dietary. The food sup- 
plied was said by the keeper to be as follows : Breakfast, potatoes, 
beef, generally boiled, unsweetened tea, without milk, hop-yeast bread, 
and butter, when no meat is used ; dinner, the same, except that cof- 
fee is supplied with sugar and milk, twice a week, in place of tea, pork 
and beans once a week, fried pork once a week, and tlsh on Fridays ; 
supper, in summer, bread and butter twice a week, with clear tea. 
bread and apple-sauce with tea, and bread and milk twice a week with- 
out tea. Only two meals are served on Sundays, and also in winter 
from the 20th of October to the 20th of April. These two meals are 
similar to breakfast and dinner, except that more vegetables are 
added for dinner and frequently for breakfasr. Quite often pickled 
beets are added for l)reakfast with turnips and cabbage, besides potatoes 
for dinner. Green corn, peas, and string beans are served in their 
season for dinner. Fresh fruit is given as a treat occasionally, but 
not regularly. 



Report on the Chronic Insank. 57 

Clothing. — The following was given as the clothing provided for 
patients: In summer, for men, a white cotton shirt, cottonade pants, 
vests and frock coats, straw hats, slioes and cotton socks ; many go 
barefooted. *'It is almost impossible," the keeper remarked, "with 
one or two exceptions, to keep any thing on tlieir feet." In the winter 
the clothing is the same, except that heavier cottonade goods are worn, 
and boots in place of shoes, with woolen socks and heavy clotli caps. 

The women in summer are provided with cotton underwear, cotton 
under-skirt, and calico dress. We use heavy striped goods for some; 
those who work wear drawers, but a great many will not wear these. 
Shoes and stockings are supplied to those who will use them, also a 
calico sun-bonnet. In winter an nnder-waist is furnished, also a 
quilted skirt. Nearly all are then compelled to wear shoes and stock- 
ings. Those patients who will not wear them are kept in the house. 

Bedding. — Wooden bedsteads are in use, of the Willard asylum pat- 
tern, having iron-strap bottoms. The bed consists of straw tick, with 
feather pillow, two sheets, one bed-quilt in summer; and in winter, it 
was said, two or more are used, if necessary. About one-fourth of the 
beds are double. 

Employment. — There is no employment for the men in-doors. 
There are nine who perform a partial day's labor. One works outside 
about the stables, and on the farm. The keeper thinks the labor of 
this man worth SlOO a year to the institution. He works without 
supervision, and can bo sent anywhere. 

The women are engaged under the direction of the attendant, mostly 
at housework or sewing. It was said that ten of them perform a fair 
day's labor. The keeper thinks three hired women would do the work 
of these twenty. Two men disposed to overwork are required to be 
guarded in this respect. The keeper thinks when insane men want 
to work, labor is benelicial, but he does not favor compulsion. 

Restraint. — Two muffs, two pairs of hand-cuffs, and one pair of 
shackles were said to be the restraining appliances in use. These 
are preferred by the keeper, but disapproved of by the physician. 
The doctor thinks a couple of restraining chairs and a few cribs are 
needful, also that the number of attendants is insufficient. At the 
time of visit only one person was found restrained by hand-cuffs. 
Ordinary rooms are used for the seclusion of patients, the doors of 
which they sometimes break down. The restraint is said to be regu- 
lated by the physician, and but little practiced. 

There are no dark rooms nor cells in the institution. The keeper 
says •'punishment is not inflicted upon the insane under any circum- 
stances. I do not think there is any sense in punishing an insane per- 
son. The former custom of punishing is now abolished. It is in- 
tended to keep only the mild cases here, and send the troublesome to 
Willard asylum." 

Water supply. — By means of a steam pump the water is forced 
through a one and a quarter inch pipe into a reservoir on the third 
floor, having a capacity of a hundred barrels. 

The keeper said : " Last winter the water in the river was two 
degrees below fret-zing point, and we could not pump it, and had to 
carry it in pails from the river. This happened but once in the three 
years the pipes have been in use. The pumps are run with only 
twelve pounds pressure of steam." 



58 Keport on the Chronic Insane. 

The sewers of Watertown empty into the river one and a half mile 
above the poor-house. 

The river water is used for cooking and general purposes. The 
water for drinking is supplied from a flowing well of five-inch bore 
drilled fifty-five feet in the solid rock. The nearest closet is distant 
one hundred and fifty feet. The nearest sewer is seventy-one feet dis- 
tant, and is made of six-inch ghized socket-tile with cemented joints. 

Seiuerage. — Slops are emptied into iron sinks witii traps, connecting 
with a six-incli socket drain, with cemented joints. The glazed tile 
extends but a short distance in rear of the building, and tlien dis- 
charges into an open sewer. In ordinary seasons this is covered a 
portion of the time with water ; when otherwise it must be offensive. 
In tiie yards are common privies with wooden vaults, said to be 
cleaned once a month, or every six weeks, as required. 

Farm and f/arden. — The poor-house farm comprises one hundred 
and seventy-six acres ; about forty-five acres are meadow land, one hun- 
dred acres pasture, fifteen or twenty acres waste land. There is no 
woodland. The live stock consists of fourteen milch cows and three 
horses; none of the milk is sold. Some butter was made in the 
month of June. A small crop of oats, a little corn, and about five 
acres of potatoes were planted ; about two acres are appropriated as a 
garden, for the raising of vegetables for the inmates. The farm has 
a small orchard of apples. 

General observations. — Practically, there is no classification, except 
as to the separation of a few of the more disturbed from the rest. The 
sexes are separated while in and out of doors. There is no special 
provision for epileptics. 

The insane are registered in the poor-house office, separately from the 
other inmates. Certificates of insanity are there filed. Some of those 
examined did not show whether the cases were acute or chronic. The 
physician thinks that many of the certificates arc filled up very im- 
perfectly, and that they should be more full, embracing a previous 
medical history of the case. He stated that one of the reasons given 
in a certificate for the patient being insane was, that he " was a rav- 
ing maniac." He thought the medical profession of the county 
" manifested no particular interest in the institution." Many visitors 
came from motives of curiosity. 

The county journals, as well as illustrated papers, and other read- 
ing matter .are supplied. Visitors engaged in missionary work in the 
poor-house furnish some books to the inmates. At the time of inspec- 
tion, a reverend gentleman from Watertown, and two ladies were for 
several hours engaged in this work. They had })reviously, on different 
occasions, distributed newspapers, as well as some forty or fifty Bibles 
and prayerbooks. 

Paying patients are not now received. There were, however, one 
man and two women for whom the county received $1 per week each. 
Two, it was said, were sent to Rome, for whom their friends were able 
to pay. The amount received from paving patients for the year wai 
$374. 

The examination of this institution was made by Commissioner 
Letch worth, October 13, 1881. 



Repokt on the Chronic Insane. 59 

Livingston County. 

The Livingston county poor-house is located about one mile east- 
ward from the village of Geneseo, and two miles from the station on 
the Corning branch of the New York, Lake Erie and Western rail- 
road . 

The site is somewhat retired, standing about eighty rods back from 
the roadway. Directly in front of the buildings is an inclosurc about 
fifty feet in width, phmted with flowers and shrubbery. Between this 
and the highway is a meadow, with a cornOeld at the left. 

The poor-house farm comprises one hundred and fifty-one acres of 
land, of fair quality, comparing favorably with other farms in the 
vicinity. 

Officials and employes. — The insane department is directed by the 
superintendent of the poor, who also acts as keeper of the poor-house 
proper, and whose compensation is fixed by the board of supervisors 
at 81,000 per annum. He is required to live at the poor-house. His 
wife acts as matron, and is paid at the rate of $6 per week, while his 
son discharges the duties of book-keeper and general assistant for a 
remuneration of 825 per month, including board and lodging. 

Two men, one on each floor, are employed in the male department, 
each sleeping in his own ward at night. One of these is required to 
be in the asylum at all times, the other goes out with the field hands. 
The compensation of these assistants is 825 and 830 a month, respect- 
ively, with board. 

In the female department there are also two attendants, one on each 
floor, who sleep in the wards. They each receive 84 per week, with 
board. Female cooks are employed in the kitchens of each depart- 
ment, one being paid 84 per week and the other 83. In reference to 
compensation the supei'intendent said: " We pay good wages and re- 
quire good service." 

Medical S'i/pervisio}i. — The l)oard of sujjervisors appoint the physi- 
cian of the asylum. The present incumbent resides at Geneseo. His 
compensation is 8250 per year, the stipulation being that he furnish 
the medicines. He visits the institution two or three times a week, 
and oftener if required. No extra allowance is made for services in 
special cases. 

The physician, who has an office and a small dispensary in the poor- 
house, prescribes the medicines when called upon. The matron also 
occasionally prescribes for patients. 

The sick are treated in their rooms. There is no consulting {jhysi- 
cian, but if needed, one is called. The medical profession, it was 
stated, "take no special interest in the poor-house. Occasionally a 
physician will make an inquiry concerning some patient formerly un- 
der his charge." 

General description.— The department for the insane, sixty-five feet 
west from the poor-house, consists of two brick l)uildings. The first, a 
two-story and basement, was built in 1869, and has a large brick ad- 
dition, built in 1873. Further west some forty-five feet is another 
brick building, two stories in height, with basement, built in 1879, 
at a cost of about 814,000, including furniture and heating apparatus. 

The basement in the old part, used as a general kitchen for the 
men's department, measures seventeen feet by forty-six, and is eight feet 



60 Report on the Chronic Insane. 

high. It has a brick floor. Here was found the usual furniture, also 
a hvrgc kitchen range burning hard coal, and a cauldron stove used on 
wash (lays for boiling clothes. Adjoining the kitchen is a scullery and 
a room for the temporary keeping of soiled garments. 

In rear of the kitchen is the dining-room for men, twelve feet by 
fifty feet. It is lighted by two windows having iron gratings. In 
one corner of the floor of this room is a sink with perforated plate. 
A large store-room connects this dining-room and that of the attend- 
ants with the kitchen. 

In the north end of the building is a hall measuring eight feet by 
twenty-six feet, and eight feet high. The floor is brick laid through- 
out. A sink in this floor, having perforated plate with bell-trap is 
connected with the sewer. 

The cells, Seven in number, open into this hall — three on one side, 
and four on the other, averaging nine feet ten inches by five feet nine 
inches in size. The doors of these cells are two feet four inches wide, 
and arc constructed of vertical iron rod.s, set in an iron frame two 
inches apart. Tiiey are secured when closed by a heavy padlock. 
Each cell has one window twenty-two by forty-two inches, protected 
by iron grating of flat bars. 

The furniture consists of an iron bedstead, a straw tick, a feather 
pillow, sheets, two blankets and a counterpane for day use, also a 
night-bucket. 

In one of the cells was a restraining-chair, with open seat, stocks for 
the legs, and body-sti'aps, also muffs, waist-belt and wristlet bauds. In 
another hanging on the door was a pair of manacles. The keeper 
said, " These rooms are used only for restraint. " 

Upon the first floor above the dining-room is a hall used on Sundays 
for religious services, and occasionally in the winter for dancing. 
The keeper said, "We have a good fiddler in the asylum, and fre- 
quently have dances with the attendants and insane men and women 
together. " 

The windows in this hall are grated. Benches are provided for one 
side as well as for the end, while on the other side is a wooden settee. 
The walls are relieved i)y four framed prints. The hall is heated by a 
register placed in the floor, and the heat for the upper story is carried 
by pipes through this hall. 

Several small rooms, occupied by the cooks and other domestics, 
open into tliis hall. The windows in them are narrow, containing but 
four panes of gla.ss,one al)ove the other, each measuring four and one- 
fourth by sixteen inches. Each room has a circular opening for ventila- 
tion over the window live inches in diameter. On the north side of the 
hall are three small rooms of equal size. One is used for storing men's 
clothing ; the others are occupied by two women patients of the quiet 
class, wlio assist in the kitchen. 

A hall twelve feet four inches by thirty-four feet three inches leads 
northward. It is divided on the east by two rooms, now u«ed by the 
attendants and hired man. and a hall stairway. The furniture of this 
hall consists of a wooden chair, a round stand, a spittoon, and an orna- 
mental advertising card on the wall. Between the doors of the rooms 
were placed wall seats. The heat is supplied through a register from 
the flue below. Six rooms originally occupied the west side of the 
hall. These the present keeper converted into three. Each room as 



Report on the Cheonic Insane. 61 

now arranged has two windows five feet seven inches by twenty-one 
inches, with outside wooden sash provided with bolts. 

The doors are provided with grated transoms. One of these rooms 
was occupied by a male patient. Its furniture consisted of an iron 
bedstead, a straw tick, two sheets, two featlier pillows, and a counter- 
pane, a deal table, a Bible, and some illustrated papers. A spray of 
flowers in water was also observed. There was no chair. The patient's 
clothing hung, some from cords and some from hooks. 'J'he bed was 
clean and well made, the window clean and room in order. The 
other two rooms had no furniture except beds of a similar pattern to 
the above. 

At the east end of the old building, on the tirst floor, is a large hall 
with room adjoining, whicii has been converted into a hosi)itai ward 
for both sane and insane. It was formerly one of the cell wards of the 
insane department. The attendant here was an insane pauper. A 
dark flight of steep, narrow stairs leads to the floor above. 

On the second floor of the west wing is a hall with two windows at 
the end, heated by a register. Five small rooms and one double 
room open into this hall. The small rooms are four feet eight inches 
by eight feet two inches, windows narrow and ventilation through the 
ceiling. The doors are double, secured by a bolt, and furnished with 
diamond-shaped apertures, four inches in diameter. Above the door 
and of the same width is an opening secured by three wooden bars. 

The ceiling is ten feet two inches high. The rooms on the oppo- 
site side of the hall are six feet four inches and eight feet two inches. 
They have the same arrangement of windows and ventilation. The 
hall proper was furnished with wall benches, a stand upon which 
illustrated and other papers were noted, three wooden chairs, a deal 
table and spittoon. 

In the north hall also changes have been made. Six rooms opening 
into this hall now occupy the space formerly divided into ten cells. 
These rooms are used as sleeping apartments,iour being double and two 
single. The beds and bedding are similar to those already described. 
One of the rooms had a rug which was the gift of friends. The hall 
itself was without chaiis, and its walls were bare. 

The ne20 building. — This is occupied by women. It is connected 
with the old building by a covered porch two stories high, latticed 
above and closed below. 

On the first floor a long hall extends the entire length of the build- 
ing, and is intersected in the center by another. The windows which 
are located in the west end are of double sash, each containino- 
twelve panes of glass six by eighteen. The frame is of wood, with 
iron divisions and suspending weights. Large chromos were 
noticed on the walls. The floors were bare and the furniture con- 
sisted of oak settees and a plaster vase with flowers. Six steam radi- 
ators placed in different parts of the building supplied heat. 

The occupied rooms were furnished with iron bedsteads and beds 
similar to those already described, also rocking chairs. The 
furnishing in some instances was brightened with articles suggestive 
of home life. 

The bath-room, supplied with hot and cold water, contained wash- 
stand with stationary bowls and water-closet conveniences. 

A^ store-room, south of the hall, is shelved on two sides, one for 



62 Report os the Chronic Insane. 

clothing, the other for medicines and articles sent by friends. Dresses 
of i)atieiits hung from wardrobe hooks in the wall. 

The attendants' room is on the south-east. It is comfortably fur- 
nished. 

The second floor is a counteii^art of the first in dimensions, arrange- 
ments and furnishing. It contained fourteen i)atiL'nts. 

In the attic on the north side are two rooms recently finished with 
dormer windows. Tiiey are reserved for filthy patients. One of these 
apartments was occupied by a blind insane woman. It was furnished 
with a bedstead, bedding, rng, chair and stand. The door was bat- 
tened. There was a fan-light above but no ventilation. 

The basement, in the south-east corner, comprises a good sized 
kitchen provided with necessary kitchen appurtenances, including a 
large range. A pantry adjoins on the west and is supplied with 
crockery and other table ware. 

At the west end of the building was found a shoemaker's bench and 
"kit." 'J'he shoemaker is a pauper, and besides working at his craft 
attends to the steam boiler. 

The coal for the boiler is conveniently stored near the shoemaker's 
shop. 

In this part of the building is a pump for supplying water to the 
steam boiler and also for forcing it up to the tanks in the attic. 

The bath-rooms in the building are of an improved pattern, and 
are supplied with hot and cold water. 

The water-closets have automatic seats. 

There are no special work-rooms in the asylum. The women work 
in the several wards. 

Directly in the rear of the insane asylum are the yards. That of 
the men's department is one hundred and eight feet by one hundred 
and sixty-five feet, surrounded by a tight board fence, twelve feet high, 
with small iron spikes on top. Two pavilions, twelve by twenty 
feet, were noticed in one of the yards, one having a rope swing. 
Seats were arranged on two sides. Horse-shoes, used for quoits, were 
found lying on the ground. On the north side of the yard are two 
privies, with a tight box beneath. The soil is used for fertilizing 
purposes. 

The women's yard adjoins ihe men's and measures eighty-thrt-e by 
fifty-four paces. " It has quite a number of shade-trees and has out-door 
conveniences. It is inclosed by a planed and pointed close board fence, 
ten feet high. The grass was well-worn in both yards. 

Heativg and ventilation. — Two furnaces burning hard coal are in 
the basement of the old building. In the north-west basetnent is an- 
other furnace. All are of the portable pattern. Hot-air pipes are 
carried from them throughout the building. 

Ventilation is effected by means of circular openings over the win- 
dows in each room, which lead to the attic. The system, however, is 
imperfect, and the atmosphere at the time of visitation was perceptibly 

bad. 

The new building has a large steam boiler in the basement and a ra- 
diator in each hall. Ventilating flues are placed in the wall, extend- 
ing through each floor and through the roof. The water-closets are 
ventilated in the same way. 

Dining-rooms a7idfood'—ln the dining-room for men, tweuty-three 



Report on the Oheonic Insane. 63 

inmates were at supper at the time of visit, seated at a long table 
covered with enamoled cloth, and furnished with crockery phites, 
bowls, cups, saacers, etc. They were in charge of a paid attendant. 
Soup, bread, apple-sauce, tomatoes, boiled rice, sweetened tea and 
milk constituted the evening meal. 

The dining-room for women is in the basement of the new building. 
It is a pleasant apartment having five windows provided with shades. 
Here were found three tables covered with enameled cloth, and set 
with crockery plates and cups, steel knives and forks. Windsor 
chairs having bent rails were used for seats. The dietary was given 
by the superintendent as follows: "For breakfast, we have bread, 
meat, potatoes, coffee or tea with milk and sugar according to taste; 
butter is allowed twice a week according to the supply. For dinner, 
we have bread, meat, potatoes, squash, onions, soup, once or twice a 
week, and all kinds of vegetables in their season, for we have plenty of 
them. We use tomatoes quite freely. For supper, mush and milk, 
bread, molasses, cake or pie twice a week. We also have twice a week 
baked pork and beans, and on Fridays, codfish for breakfast and dinner. 
This we cook, picked up and stewed with milk. We use beef in pref- 
erence to pork. We serve one and a quarter pound daily to each 
inmate. We use fresh meat almost exclusively." In regard to the 
diet the physician said : " I have examined the diet for the insane sev- 
eral times and have approved of it." 

Clothing. — The dress of the men in summer was said to be " cotton- 
ade pants, denim overalls, light jumpers or frocks, cotton socks, shoes 
or boots, and straw hats. Some go barefooted in summer, from 
choice. In winter, black felt hats or caps, cardigan jackets, cotton 
drawers and wrappers, heavy cotton and wool socks, and shoes, also 
heavy cottonade pants and boots for those who are exposed." 

The women in summer wear in addition to the usual under-clothing 
** a calico dress, a skirt, cotton stockings, shoes, and sun-bonnet. In 
winter their dress is similar, with the addition of wrappers, woolen 
stockings, shoes or gaiters." 

Bedding. — The bedsteads are made from gas-pipe, and have strap- 
iron bottoms. The bedding consists of a straw tick, a feather pillow, 
two sheets, two blankets and a counterpane ; the latter being removed 
at night. 

Employment. — The men are employed " in all branches of farming 
and gardening." On the day of inspection it was said "twelve 
men are out in charge of an attendant cutting up corn." This force 
included " all capable of working much." There is no in-door em- 
ployment for the men, and no out-door employment for the women. 
The latter do housework, plain sewing and repairing of clothes, besides 
helping in the laundry. None of the men do a full day's work. The 
keeper says, " We only work them six hours a day." He instructs his 
attendants to restrain them from doing more. One-fourth of them, 
he said, "could do a full day's work if required; but three farm 
hands could do as much as the twelve." The keeper gave it as his 
opinion " that labor is highly beneficial to the insane ; that in sum- 
mer they are not so nervous as in winter, and sleep better at night 
when working daily." The doctor said, that in winter when shut up, 
more complain of Illness than in summer, when they are working 
out. 

9 



64 Report on the Chronic Insane. 

The total mimbcr of insane September 20, 1881, was fifty-seven; 
twenty-four men and thirty-three women. 

Reslrabit. — This is directed by the keeper. No restraint book is 
kept; patients are sometimes liandcuffed and put in cells. In the 
attic was found a restraining chair, said to be unused. There were 
also found two restraining chairs in the men's ward, said to be rarely 
used. 

In the new building was a muff, and a i>air of leather mittens said 
to be out of use, and in the male department, two pairs of mittens, 
and one muff with fastenings. Tiie kcejjer said, " My theory is to 
have as little restraint as possilde, and to give them as much liberty 
as is consistent with safety. 1 sometimes refuse them tobacco. When 
I came here I found cribs in use ; I have never resorted to them, but 
on the contrary, have had them taken apart and stored in the attic." 
Water t^uppli/. — In the attic there is a heavy oblong tank, lined 
with galvanized iron for receiving rain water; it holds thirty barrels. 
The overflow is conveyed to a cistern in the basement. A force pump 
also forces water from a cistern into this tank, whence the build- 
ing is supplied. There are also two cisterns at the old building, and 
four at the poor-house, all of which are of sufficient capacity. There 
are five wells on the ])i-emises, one in front of the insane department, 
one on the farm, two behind the buildings, and one at the road fifty 
rods distant. At the time of visitation but little water was in the 
cisterns, and well water was being hauled by teams a distance of three- 
fourths of a mile. The keeper said he had drawn water nearly all 
summer from the distant well at the road. It is contemplated to 
bring water from springs one and three-fourth miles distant toward 
the south and east, when an elevation of one hundred and fifty feet 
can be secured. 

Estimates for this work have been prepared, and an appropriation 
made. There are no special provisions made against fire. The keeper 
said, " If fire should break out, we could only sit down and see it 
burn. We have no water even if we had engines. I think with any 
kind of energy we could get the inmates out." 

Seiverage. — The sewer from the old building passes out from the 
men's yard for a distance of one hundred and fifty feet, and discharges 
into an open ditch. From the new building is laid a ten-inch glazed 
socket-tile sewer, extending from about two hundred feet to a point 
two rods beyond the women's yard, where it also empties into an open 
ditch. The slops from the kitchen are emptied into the sewer outside 
the building. The sewer also connects with the laundry and water- 
closets of the new building. One of the wells is only about fifty feet 
from the sewer. From these facts the defects of the system will be 
apparent. 

Paying patients. — Patients, residents of the county, are received in 
the institution at 13 per week. The number at the time of examina- 
tion consisted of nine men and ten women. Some derived a small 
income from personal property, but not enough to pay the regular 
price. They were received, however, and their income applied toward 
maintenance. There were no paying patients from other counties in 
the institution. 

The total receipts from paying patients for the year ending June 30, 
1881, were $i,04;i.30. 



Keport on the Chronic Insane. 65 

Amuseyyients, etc. — Papers and magazines are frequently sent from the 
village reading-room. The superintendent takes one daily and two 
weekly papers, which are placed at the disposal of the inmates. The 
men play checkers with the attendants, and ont of doors pitch quoits. 
In the women's yard there is a swing. 

General observations. — The keeper said: "Prominent men of the 
county sometimes visit the institution to satisfy themselves how it is 
kept, bnt the majority of visitors come from curiosity. We have 
sometimes as many as forty a day. No particular day is set apart for 
visitors." 

The examination of this institution was made by Commissioner 
Letchworth September 20, 1881. Since then it is stated that the 
county authorities liave directed that wells be bored for water, instead 
of seeking a supply from springs as above mentioned. Until a good 
supply of water is provided, and the serious defects in sewerage, 
already reported upon by Commissioner Craig, are remedied, it would 
seem proper that the exemption of this county be deferred, and the 
committee so recommend. 

Oneida County. 

The chronic insane of Oneida county are maintained in the insane 
or asylum department of the county poor-house, which is located upon 
the county farm of two hundred acres, distant two miles from the 
city of Rome, with which it has telephonic communication. 

The poor-house consists of several brick buildings so constructed 
and joined together as to present the appearance of one lai-ge symmet- 
rical institution. 

The main two-story center or administrative building, erected in 
1860, separates the sane from the insane department, and is the resi- 
dence of the county superintendent of the poor, who has supervision 
of the institution. In 1877 a large three-story addition was erected 
for the use of insane women. 

Under the whole structure is a basement, of which the jiart belong- 
ing to the insane department serves for storage purposes, dining-rooms, 
a work-room for the insane women, and contains four sleeping-rooms 
occupied by insane men. Each of the rooms is eighteen feet square 
and eight feet high, with windows two and a half by four feet above 
the ground, and doors opening into a long hall eight feet wide, there 
being an open space of two inches above and below each door for 
ventilation. The windows may be raised or lowered, and have spring 
fastenings. 

All windows throughout tlie insane department are grated, and 
all above the basement are adjusted with weights and pulleys. The 
two strong rooms upon each floor have inside gratings to the large 
windows. 

The communication between the sane and the insane departments is 
through a grated door in the basement hall, which is locked except 
when necessary for the passage of the car that conveys the food'pre- 
pared in the kitchen of the poor-house, to the dining-rooms for the 
insane. It is said that while the number of women as paupers is about 
half that of men, the case is reversed in the department for the insane, 
where the number of women is usually double that of men. There 



66 Report on the Chronic Insane. 

are nine wards for the insane, five of which are for females. The four 
wards for men have forty-five rooms, of which twenty-seven are single 
rooms, nine by five feet and ten feet iiigii, with a capacity of four 
hundred and fifty cubic feet. Sixteen are associate dormitories, nine 
by eight feet and ten feet high, with u capacity of three hundred and 
sixty cubic feet of air per inmate. Each story is ten feet high. The 
five wards for women contain sixty-four rooms, of which nunil)er 
tliirty-three are single rooms, fourteen by eighteen feet, with a capacity 
of one thousand one hundred and twenty cubic feet of air. The 
twenty-eight associate dormitories for women have each four beds. 
The dormitories are each fourteen by seventeen, having a capacity of 
two thousand three hundred and eighty cubic feet of air or five hun- 
dred and ninety-five cubic feet of air per inmate. 

Tiiere are no work or day-rooms for the insane men otlier than 
their ward halls. 

The basement of the asylum is occupied in part by a sewing or 
work-room, the width of the building. This room is somewhat circu- 
lar in form, and lias seven windows. Opening from the sewing-room 
is a store-room for materials and newly-made clothing and bedding. 
Sixteen of the })atients are said to sew regularly, and do the sewing for 
the inmates of both departments of the institution. 

In addition to the sewing, three hundred pairs of stockings were 
knitted duiing the past year. Ail completed articles are marked with 
the asylum mark. Care is taken that clothing is kept exclusively for 
the individual use of the one to whom it is assigned. 

Two wards for insane women in the old building are occupied by 
the aged. The halls are long with double windows at the end. The 
rooms are carpeted and the windows curtained. A recess serves as 
a day-room in each. The halls have a comfortable, cheerful air, each 
has couches and chairs, and one contains a piano. The old ladies 
appeared to have outlived the disturbed period of insanity. 

The institution is lighted by kerosene lamps suspended in the halls. 

Each of the three female wards in the easterly or new building has 
a day-room corresponding in size, appearance and exposure to the 
sewing-room in the basement. Strong chairs are fixed to the floor, 
and where the insanity of the patients in the wards permits, movable 
chairs and couches are added. 

The engine is in the basement and has three boilers, two of which 
are used for heating purposes during the winter, and the third or 
smaller one is used through the year for cooking, heating water and 
forcing water to the top of the building. Tlie^nstitution is said to 
have been sufficiently warmed by steam, the ward halls having heaters 
or radiators. No open fire-])]aces are in use. 

Thermometers are supplied in the wards during the winter. 

The ventilation is by flues in tlie walls to the top of the building, 
opening into each room and hall of the new wards, and into the halls 
of the old division. 

There is no hospital department. 

The bath-rooms in each ward are supplied with bath-tubs, hot and 
cold water, sinks, towels and looking-glass. 

A few feet soutii of the building is a two-story brick laundry in two 
divisions, one of which is the poor-house laundry, the other that of the 
insane. 



Report on the Chronic Insane. 67 

The two are entirely distinct and have stationary wash-tubs, with 
steam heat. Soft soap made from cotton seed oil, said to be a nice 
article, is made and used, the soap grease being sold for about what 
the oil costs. The drying-rooms are upon the second floor. The work 
in the laundry for the insane is done by insane women. 

The institution is supplied with water from the Mohawk river by 
the Rome water-works. The water is said to be of good quality and 
i sufficient in quantity. No means are taken to ascertain by measiire- 
I ment the amount delivered, either in bulk or per inmate. The pres- 
sure is not sufficient to raise water into the third story during the 
early morning, and hence it is conveyed into large cisterns, from which 
a steam pump forces it over the building. Later in the day power from 
tlie w^ater- works raises the water. Rain water is conducted by leaders 
into the sewers where it materially assists in cleansing. 

The sewers are said to be properly trapped and to empty into ponds 
one-half mile distant. Closets open from each hall and are twelve in 
number, including, one for the sewing-room and two in the basement. 

The two exercise yards are about one acre in extent each, with a 
few small trees. The ground is well covered with grass. Two small 
pavilions with benches are in that for the females, while a covered 
shed is provided for the men. 

On September 26, 1881, nearly all of the insane men were in their 
exercise yard. There is a smaller yard of about one-quarter of an acre 
for the use of the women who work in the laundry. Outside of these 
yards there is no ground appropriated to the exercise and recreation 
of the insane. 

There is a night-watchman. 

Upon each floor hose is arranged for use, which can be connected 
with a powerful steam-pump in case of fire. Fire-escapes are provided 
in each hall. An attendant occu])ies a room in each hall. All cook- 
ing is done by steam in the kitchen of the institution, except for the 
sick, whose food is furnished as is prescribed. 

The basement dining-rooms for both men and women are lighted 
by windows and are distinct from each other. The one for women is 
one hundred and fifteen by thirty-five feet, and is provided with chairs, 
while tliat for the men is thirty-five feet square, and is provided with 
stools. Each has long table with top painted white, and is fur- 
nished with stone- ware plates and bowls, steel knives and forks, and 
some tin basins for the use of the men. 

The diet is prescribed by the superintendent. Breakfast consists of 
coffee, bread and butter, meat and potatoes. Dinner, Monday, Thurs- 
day and Saturday, meat, potatoes, tea and bread. Tuesday, beans. 
Friday, fish. Wednesday, soup, potatoes and tea. Sunday, meat. 
The vegetables are varied from day to day, and are such :as are raised 
upon the farm. Meat consists of pork, beef or mutton. Beef is 
smoked in the fall and packed for use. Corn bread is given once each 
week. The bread is daily baked in brick ovens for the whole institu- 
tion. Supper is of bread and milk, and mush with milk or molasses. 
The sick have food from the superintendent's kitchen, as is prescribed 
by the physician or matron, it being such as beef tea, mutton broth, 
rice and other suitable articles of diet for invalids. 

The medical supervision consists of the daily visits of Dr. West, who 
receives his appointment from the superintendent of poor, with the 



68 Repobt on the Cheokic Insane. 

approval of the commissioner of the district. His annual salary is 
|i800, for which sum he gives medical aud surgical attendance to both 
sane and insane, and provides assistants in operations and consulta- 
tions without additional expense to the county. Medicines are 
furnished by the county and dispensed by Ur. West. 

A prescription book is kept, but no case book. 

The insane are registered in the general or county register and in a 
separate record book for the insane department. Certificates of in- 
sanity are on file in the office. 

Citizens of tlie county, as well as the medical profession, prove their 
tn'eat interest in the inmates and the care bestowed upon them, by 
frequent visitations. 

Three male attendants, at %30 per month each, have charge of the in- 
sane men, with whom one attendant goes out daily. Eight female attend- 
ants, at 13 per week each, care for the insane women. The matron has 
supervision of the asylum, and has thus far served without salary. 
Paupers are not employed in the care of the insane. Two strong 
rooms for the confinement of the insane are upon each floor. The 
rooms, it is said, have not been used for three years previous to the 
last month. 

There are in the institution six cribs, four muffs and two camisoles. 
Strong chairs are fastened to the floor in wards or day-rooms, aud can 
be used with simple straps, if necessary, as restraining chairs. 

There are no iron manacles, fetters or shackles in use, although 
there are some belonging to the institution stored in the attic. No 
other restraint is allowed. The attendants administer restraint, and 
are said to report immediately to the matron and superintendent. 

The superintendent keeps a restraint book, containing a record of 
the number of such cases aud the mode of restraint, whether by 
waist-belt, wristlets, etc. On the day of my visit two women were con- 
fined to their chairs by waist-belts, and a girl of twelve was con- 
fined by wristlets. ' 

Confinement in dungeons or dark cells is not resorted to. Attend- 
ants, it is declared, are not allowed to inflict punishment upon the in- 
sane. 

Separation of men and women is said to be maintained both in and 
out of the institution. 

The men are classified according to their habits, and the women by 
their habits and degree of insanity, this being arranged by the matron 
and superintendent from time to time. 

Idiots are retained in the same department. 

There is no provision for epileptics, nor care bestowed upon them be- 
yond that provided for the insane. 

Amusements are not provided in or out of the building for men or 
women, and none are in common for both. Female patients are taken 
to walk in the roads three times each week by attendants. 

Games are not supplied. Patients whose condition permits, attend 
services in the chapel and through the week with two attendants. 

The rooms for the insane women are pleasant, neat, and cheerful, 
but are neither ornamented nor decorated. The apartments for the 
insane men are very inferior in plan, appearance, comfort and repairs, 
to those occupied by insane women, and if not improved others should 
be provided. 



Kepokt on the Chronic Insane. 69 

Flowers are cultivated in the grounds in front of the institution, 
and it is said are gathered frequently for the pleasure of the insane, 
who do not, however, assist in their cultivation. A small conservatory 
is supplied with plants by ladies in Rome. 

A visiting committee furnish papers, magazines, and other reading 
matter. Each division of the poor-house has a case of books that may 
be used by the insane. 

Upon the farm and near the asylum is a cemetery where the 
unclaimed dead are buried and their graves marked, a record being 
kept in the oflBce to assist friends in their removal. About half who 
die are said to be claimed by friends. Burial services are held at each 
interment. 

Insane men are employed in the cultivation of the farm and garden, 
under the supervision of four farmers. In the l)uilding they are 
emploved at whatever they can do, as taking care of the wards, paint- 
ing, etc. The women have no out-door employment, but are engaged 
in housework, sewing, aud knitting. About twenty men can perform 
a fair day's work, and fifteen a partial one. The insane are not forced 
to work.' None of the earnings are set apart for the insane. 

On September 26, the day of my visit, two hundred and seventeen 
insane persons were inmates of the institution, of whom eighty were 
men and one hundred and thirty-seven women. Although they were 
very quiet and orderly for insane persons, it was stated that none could 
be called continuously quiet and orderly. 

None were in restraint of the halls or confined in their rooms. Two 
women and one man were in "restraint of chairs." One man's hands 
were in a muff, one man in a camisole, and two with hands confined 
by straps. None were in cribs, dungeons, or cells. 
" Ninety of the whole number of the insane have employment. 

All have been to the Utica State asylum with the exception of about 
twenty-five, who were chronic cases at the time uf their admission. 

The wooden bedsteads in the five wards for women were new, heavy, 
and strong. The straw beds had sheets and pillows with cases upon 
them. Comfortables are generally provided. Blankets are being 
introduced. All except the men's wards have white counterpanes. 

The sewing-women make the clothing for the women, as well as the 
men's shirts and overalls. The remainder of the clothing for the men 
is purchased ready-made. 

Pay-patients are received at the rate of 82 per week each, and 
receive the same care and treatment as other patients. 

Of the fifty pay-patients in the institution September 26, seventeen 
were resident and thirty-three non-resident of the county of Oneida; 
twenty-eight were' State paupers. 

Visited by Commissioner Carpenter September 26, 1881. 

Onondaga County. 

The poor-house of the above county is located at Onondaga Hill, four 
and a half miles from the city of Syracuse. 

A full description of this building was made in 1879, by a joint com- 
mittee of this Board and the board of supervisors of Onondaga county. 
Acting upon the report of this committee, important changes were 
made, embracing a system of steam-heating for the .whole establish- 



70 Report on the Cheonic Insane. 

ment ; the removal of the stone dungeons in the basement ; providing 
pleasant sitting and work-rooms, as well as associate dormitories, in 
the old asylum" building ; also, some changes in the system of sewer- 
age; the appointment of a resident medical superintendent; the sub- 
stitution of responsible paid attendants for pauper help; and the trans- 
fer of the more violent and disturbed cases to the Willard asylum. 

This committee concur in the opinion then expressed by the joint 
committee referred to, that the present building is not properly de- 
signed for the care of the chronic insane, and that, in view of tlie large 
number to be provided for in the poor-house, its close connection 
therewith, the insufficient supply of water, the small size of the poor- 
house farm, the inferior quality of its land, etc., the public inter- 
est will require other provision for the chronic insane of this county. 

At the time of visitation there were one hundred and six patients; 
seventy-three males and thirty-three females. 

QlJicinls and employes. — This county has but one superintendent 
of the poor, who resides at Syracuse. 

The keeper, who resides in the poor-house, is appointed- by the su- 
perintendent. The joint salary fur himself and his wife, who officiates 
as matron, is §800 a year and living. 

In the insane department are four female attendants, whose wages are 
$15 per month each; also, two male attendants, at §25 per month. A 
baker is employed in the poor-house department, at $8 per week. He 
has also charge of the general kitchen. 

An assistant keeper is engaged in charge of the insane when they 
work out of doors. There are also two *' hired girls" in the poor-house 
department. The paid force for the insane department numbers 
thirteen persons. No paupers are employed on this staff. 

Medical supervisio?i. — Tiie superintendent appoints the physician, 
who also acts as superintendent of the asylum with subordinates, ap- 
pointed subject to his approval. His salary 'is §600 a year, and he 
resides at the poor-house. 

The insane are registered separately at the office of the poor-house 
department. The certificates of insanity do not show whether the 
case is acute or chronic. 

The consulting physician resides half a mile from the poor-house. 
Ho visits regularly once a week, and oftener if necessary. His com- 
pensation is §100 a year. It was said: " The medical profession of the 
county are not particularly interested in the institution, unless to visit 
some patients whom they have previously had under their care." 

There are no hospital-rooms specially provided for the insane. The 
sick are treated in tiieir rooms. Medicines are furnished by the county 
and dispensed by the medical superintendent. 

Epileptics are provided with low beds, elevated but a. few inches 
from the floor. 

Dietary. — The following was given as the dietary : " For break- 
fast, as a general thing, potatoes and meat, either corned beef or 
pork, bread and butter, sweetened coffee with milk. Dinner, pretty 
much the same, except on Friday, when there is fish. Cold water is 
served at dinner. No butter is supplied except to the boarders, who 
also have tea and coffee. Once a week there is fresh meat stew ; 
sometimes bean soup and beef soup ; sometimes we give beets or onions. 
Supper consists of bread and butter, with tea, and in the fruit season 



Repoet on the Chronic Insane. 71 

sometimes fruit. If we have no frnit, giiigerbrearl, and some kind of 
sauce are supplied. Sometimes we give green corn for supper, also 
tomatoes and green peas. Last year about two hundred bushels of 
apples were baked in the poor-house for the whole establishment." _ 

The general diet is prescribed by the keeper, and that for the sick 
by the medical superintendent. 

Crockerv-ware is used on the tables, and ordinary knives, forks and 
spoons. Table cloths are not used. The women have chairs with 
backs ; the men have stools. 

Clothing. — The men in summer are supplied with shirt, vest, nn- 
lined pants, frock or sack coat, all of cotton goods, cotton stockings, 
shoes and straw hats'; in winter, flannel undershirts and drawers, 
lined pants, vest and frock or sack coat, all of satinet, woolen stock- 
ings, shoes and felt hats. The workers out of doors wear boots ; sev- 
eral have overcoats. 

The women in summer are furnished with cotton undergarments 
and gingham dresses, also calico sun-bonnets. In winter those who 
workln the wash-house have canton flannel underwear, quilted skirt 
and woolen stockings. 

Paving patients generally furnish their own stockings. 

Bedding. — This consists of a tick filled with straw, two sheets, a 
pillow, and a quilted comfortable. In winter, it was said, "one or 
more blankets are added." 

Employment. — On the day of visitation twelve women were engaged 
ironing, six in the dining-room washing dishes, four regulating the 
sleepiug-rooms, six cleaning floors halls, and stairways, and seventeen 
were sewing and knitting. 

In the afternoon the work-room contained about twenty women, 
employed mostly with sewing and knitting, under the supervision of 
an attendant. The matron was also present, part of the force assist- 
ing her in making bed-quilts. 

The apartment was clean and well lighted, the walls papered and 
wainscoted and the Avood-work grained. The furniture consisted of 
tables, comfortable rocking and other chairs, while plants and flowers 
added an air of cheerfulness to the windows, and pictures hung npon 
the walls. 

It was thought that ten of the women in the insane department 
performed a fair day's labor. It was estimated that one hired woman 
could do as much as two or three of the women patients. 

On the same day five of the men were busy sweeping and house - 
cleaning; five were at work on the farm. 

None of the men performed a fair day's labor, and but twelve a par- 
tial one, the labor of three of the men being only equal, it Avas es- 
timated, to that of one paid laborer. 

The influence of labor, however, upon the inmates was regarded as 
highly beneficial. 

Restraint. — In answer to the question as to what number of patients 
had proclivities for escaping, the superintendent said : " It is difficult 
to answer that question, as nearly all would like to get away and go 
home if they could." 

In the female department, only one patient, a woman, exceedingly 
profane in speech, was confined to her room at the time of visit. The 
10 



72 Report on the Chronic Insane. 

day being cold none were in the yard. Twenty-seven were in the halls 
and sittiiior-rooms, or in their own rooms with unlocked doors. 

In the men's yard were two male patients and twenty in the halls 
or o])en rooms. 
The yards are in free communication with the respective halls. 
None of the patients were restrained at the time of the visit, in 
chairs, cribs or muffs. 

Tiiere were on the premises three cribs and three muffs with belts 
and wristlets ; also three restraining chairs, but one of which, it was 
said, was used. Patients are sometimes restrained in a common chair 
by fastening tliem there. Two pairs of manacles were in the asylum, 
but the medical superintendent said, "they have not been used dur- 
ing my administration, and I think they were not for some time pre- 
vious." 

The matron, who takes a watchful interest in the women's depart- 
ment, thinks it very wrong to deceive the insane under any circum- 
stances. She said: " One patient brought here fifteen years ago was de- 
ceived by being told, when discharged from the State asylum, that she 
was going home, and she has never forgotten the deceit." 

No restraint book is kept, but each attendant keeps an account on 
a slip of paper and returns this once a month to the medical superin- 
tendent. "Patients are sometimes put in a room or fastened in a 
chair for various offenses." Discipline is enforced for slight misde- 
meanor by the attendants, while all grave cases are reported to the 
physicians. In the women's work-room is a crib made of black wal- 
nut, and all the wood-work has rounded corners. The lid is hinged 
and secured by a covered lock. It is twenty-seven inches wide, five 
feet seven inches long and nineteen inches deep,and contains a straw bed, 
two sheets, quilt and counterpane. 

General ohservations. — During the last summer a building twenty- 
eight by seventy feet has been erected for a tobacco shed and work- 
shop for repairing tools and breakiniJ stone. 

What is designated as the old school-house building has been en- 
larged and repaired, and is now used in part for idiots, also for shoe- 
shops and dormitories. 

There is still some evidence of dampness in the upper part of the 
main building caused by the water settling back under the slate of 
the roof. 

Thermometers were placed in every ward in the insane department, 
but no record of temperature is kept. 

The farm, at last report, contained but thirty-six acres of land; 
about sixteen are rough, rocky soil and devoted to pasture; three and 
a half acres are appropriated to the garden and the buildings; while the 
yards occupy about two acres more. The remainder is cultivated and 
in fair condition. Twenty-one acres of land are rented by the county 
and have been cultivated for corn, beets, oats and tobacco. The work 
is done by pauper labor. The farm is mainly inclosed by stone walls. 
Last winter there was purchased, for $3,000, twenty-one acres adjoining 
the leased portion. 

The water sujiply is insufficient. A small reserve is held in the 
reservoir for supplying the water-closets, but it would be inadequate 
in case of fire. At the time of visit, water had been drawn by teams 
for several weeks. 



Keport on the Chronic Insane. 73 

A patent fire extinguisher is in the insane department. There are 
three hydrants in different parts of the asylum and three hundred feet 
of two-inch hose. 

It was thought that adequate means of escape from the dormitories 
in case of fire was not provided. 

The water-closet for men is within the building, giving rise to an 
offensive odor. 

Paying patients receive about the same treatment as paupers. They 
are supplied with tea and coffee and some extra articles of food. A 
uniform rate of 82 per week is charged. 

The total receipts from this source for the year ending June 30, 
1881, was $1,768. 

It is said that a number of papers and magazines are supplied to 
the asyl«m, and that the menin-doors amuse themselves with games 
of checkers and cards. 

The only form of out-door recreation provided for the women was 
a swing in their yard. 

Religious services with singing are held every alternate Sunday, The 
Rev. Mr. Huntington, a member of the local visiting committee, was 
said to manifest a special interest in this work. It was further stated 
that "a few prominent citizens evidenced interest in the institution by 
visiting it, as do also the committee of the State Board of Charities; at 
the same time many persons come here purely from curiosity." 

The institution was found clean, and order prevailed in its various 
departments. 

The visitation was made by Commissioner Letchworth October 5, 
1881. 

Orange County. 

The building for the insane of the county of Orange was erected in 
1875 upon the county farm, four miles from the village of Goshen, and 
near the Orange Farm railroad station and post-otfice. It is con- 
structed of brick with gray-stone window sills, and stands at right 
angles with the poor-house, which it joins, and of which it is a depart- 
ment, and communicates with it by doors upon the south. It is said 
to be fire-proof, and is eighty feet in length by forty in width, having 
three stories and an attic, with a basement the full size of the build- 
ing. There is no cellar. From its construction a fire must burn 
through eight inches of brick before communicating with the story 
above or below. 

The divisions and partition walls extend from the foundation to the 
top of the building, and consequently the rooms in the basement and 
the three stories above, comprising the four wards, correspond in size, 
number, and in their use. A main hall fourteen feet in width extends 
from north to south of each ward, upon each side of which the rooms 
are situated. 

The first ward, or basement, has nine rooms for patients. These 
rooms upon the day of inspection were occupied by eighteen men of 
the milder forms of insanity. The east windows are two sash and 
of half the usual size, above the ground, while those upon the 
west are of the full-size, entirely above ground. 

The windows throughout the second, third and fourth wards are 



74 Report on the Chronic Insane. 

five feet by two feet eight inches, double sash, adjusted with weights 
and pulleys. All have inside gratings on hinges, held in position by 
a bolt and brass lock, opening like a door when needed for cleaning 
purposes. At the north of each ward hall, are triple windows of usual 
size, arranged to appear as one. 

The three stories are each nine feet high. The first and fourth 
wards are occupied by men, and have eighteen rooms seven by nine 
feet, and one associate dormitory seventeen by ten, with four inmates. 
The second and third wards are occupied by women, and have 
eighteen rooms seven by nine feet, and one associate dormitory seven- 
teen by ten with four inmates. 

The wards are heated by steam from the same source as the poor- 
house, and are said to have been sutiiciently warm in the past winters. 
The engines and boilers are situated in the poor-house building; reg- 
isters are in each hall and room. 

Upon the day of inspection the air was pure and the wards well 
ventilated. In the brick walls are ventilating flues extending to the 
top of the building, with registers in each room and hall, each ward 
hall having in addition four open fire-places. Each sleeping-room 
has an outside window and a transom over each door. 

The sick have no apartments other than their ordinary rooms. 

The north-east corner room in each ward serves as a bathing-room, 
and contains a bath-tub, chairs, stationary wash-basin, a glass, and 
water that can be heated to any degree l»y the turning on of steam. 

The ward halls constitute the day-rooms for men and women. The 
men have no work-rooms. 

The wash-room or laundry is in an extension south of the asylum, 
under the old ladies' department of the poor-house, and is separate 
from that of the poor-house. It is furnished with stationary tubs, 
hot and cold water, and opens into a drying yard. The ironing stove 
is in the asylum kitchen. 

In the attic are two tanks of a capacity of one thousand five hun- 
dred and twenty-seven gallons each, into which leaders conduct rain 
water from the roof. The principal supply of water comes from two 
springs, the larger of which is six hundred feet distant, and the other 
one hundred feet soutli of the closet in the men's airing court ; both 
being on higher ground. 

A steam pump in the engine and boiler-room of the poor-house 
forces water daily into and fills the tanks, from whieh it is distributed 
by pi])es through the building. There is no means of ascertaining 
the quantity of water used daily by each patient. There is in addi- 
tion a well in the front yard. 

The sewage is conducted by an eight-inch tile drain into an open 
ditch five hundred and fifty feet from the insane department ; and is 
washed away by a stream of running water. The ditch drains the 
drowned lands that extend into !New Jersey, and is said to have cost 
the State $G0,000. There is a closet in the south-west corner room of 
each ward, and at the extreme west of each yard. An exercise yard, 
one hundred and forty-eight feet by eighty feet wide, is provided for 
the use of insane women ; while that for the men is one hundred and 
forty-eight feet by forty-six feet wide, having a shed in the center, 
with benches underneath ; each yard is turfed, and has one small tree. 

The exercise grounds outside of these yards consist of an acre of 



Eeport on the Chronic Insane. 75 

land east of the asylum, upon which its main entrance opens, and 
contains two large shade trees with a swing. In addition to the en- 
joyment of these grounds, the insane rove over the farm in company 
with their attendants, and a path leads to the wood, where the women 
sit in the shade. 

In each ward hall there is a hose connected with the steam pump 
in the engine-room, of sufficient length to force water over the ward, 
that is said to be at all times in readiness for use. An attendant sleeps 
in each ward. There is no paid watchman. In case of fire the means 
of escape are the stairs at the north of each hall, doors upon the south 
opening into the poor-house, and outside entrances. 

Much of the basement of the old ladies' department of the poor- 
house is devoted to the use of the insane ; in it is the dining table for 
the insane men of the first ward, and the kitchen where, by a paid 
cook, assisted by two sane paupers, the cooking is done upon a double 
range, and two steam kettles. The baker of the institution makes 
bread for the inmates of all the departments. 

The diet is prescribed by the superintendent, from whose table the 
sick are supplied with food. A copy of the printed dietary will be 
found in the appendix. 

The dining-rooms are in the south-east part of each ward. That 
of the first ward opens from tlie kitchen, and is more of a hall-way 
than a room, having an uncovered table at which the insane men 
dine, with chairs, and a table service like that of the poor-house. 

The dining-rooms of the three remaining wards are uniform in size 
and -arrangement, each having chairs, a table covered with light 
enameled cloth, a dumb waiter communicating from the kitchen, a 
sink for washing dishes, and a closet with neatly-covered and orna- 
mented shelves, upon which are attractively arranged table service of 
glass, white granite ware, silver plated knives, forks, spoons and cas- 
tors. Each of the second, third and fourth ward dining tables had, 
upon the date of inspection, a center bouquet of flowers, and colored 
napkins, both for use and ornament. Each dining-room is cared for 
by two patients under the supervision of an attendant. 

There is no resident physician; Dr. A. P. Ferries visits the institution, 
including the poor-house, three days each week, for which he receives 
an annual salary of 6200. The medicines are furnished by the county, 
and dispensed by the physician, who furnishes his own surgical instru- 
ments. In cases of amputation and of necessity, different physicians 
are called in whose bills are paid by the superintendent. There is a 
dispensary. Surgical operations are not an additional charge, unless 
they involve extra visits and assistants. 

There are neither prescription nor case books in the institution. 

The poor-house register is in common for both sane and insane. All 
are registered as paupers. 

The certificates of insanity are on file in the institution. Citizens 
of the county visit frequently. 

A cook at $15 per month, and a laundress at $1 per day, three or 
four days a week, are exclusively employed for the insane. 

Each ward is in .charge of one paid attendant, who receives $15 
per month. Paupers do not assist in the care of the insane. The 
superintendent -'regulates the duties and conduct of the attendants." 

There are no padded rooms, nor rooms for the confinement or isola- 



76 Report on the Chronic Insane. 

tion of the insane, other than their sleeping-rooms. Two of the six 
cribs are said to be used with open lids, because of the need of beds; 
the third is required and occupied regularly at night. 

The county has provided one restraining-chair with straps, six 
muffs, six camisoles, one pair of iron shackles, said to have been used 
once for two hours within the past year; one pair iron handcuffs, 
tw^elve leather straps, and six pairs leather wristlets. There are no 
other means of restraint in use in the institution. It was stated, " that if 
too noisy, destructive, violent, pugilistic or quarrelsome, the lunatic is 
put in his room or chair till he cools down," and that restraint is be- 
coming less used or necessary. It is regulated by the attendants upon 
each ward, wlio do not keep restraint books. 

The sui)erintendent states that he does not allow the insane to be 
punished, and there are no dungeons nor dark cells for their confine- 
ment. 

The insane are classified by the superintendent according to their de- 
gree of insanity. 

Epileptics have no separate care, but are said to be more closely 
watched than other inmates. There is no night-watchman. 

The men and women have separate dining-rooms, wards, yards, 
and exercise-grounds, and do not see each other, except that all attend 
Sabbath services, and are seated in difftn-ent portions of the second 
ward hall, into which the organ is brought for the occasion. At other 
times the organ is in the reception or entrance-hall. The organ was 
purchased in 1880, at a cost of $70, of which sum $20 
is said to have been subscribed in the institution, the remain- 
der by Goshen churches ; at the same time 16, the amount 
contributed above the cost of the organ, was expended for singing- 
books. 

Religious services are held in the ward-hall by different ministers 
from the county, who receive a compensation of $2, each Sabbath. 

The reception-room is seventeen by ten feet, and contains a black- 
walnut bookcase made by a former inmate. It is six by seven feet in 
size, is neatly carved, and has six shelves, with a few books upon them, 
'J'he room is also furnished with comfortable chairs and a sofa. 

The idiotic adults are not classed with the insane, but are given a 
place in the department for the sane. There are no feeble-minded nor 
idiotic children among the insane. 

The men exercise in the open air, and have a swing. In-doors they 
have cards, dominoes and other games. The women exercise in the 
open air, and have a hammock and swings. In-doors, games are pro- 
vided, but it is said that the majority do not care for them. There is 
at times dancing, music, and reading aloud by the attendants. Neither 
out nor in-door amusements are in common to all. 

The county supplies the county papers, and each editor donates a 
copy to the insane. 

The wards for the women are prettily ornamented with autumn 
leaves, wreaths, engravings, and window draperies, tastefully arranged 
by the attendants. The piano in the third ward, as well as many 
pieces of ornament and furniture, is said to be the property of the at- 
tendant. 

All the wards are furnislied with chairs, sofas, tables, etc. There is 
cool drinking-water in each ward hall. The wards are lighted by 



Report on the Chronic Insane. 77 

kerosene lamps. The associate dormitories are very neatly furnished. 
All the Avindows have green shades. The third ward is provided with 
mosquito nets. 

The insane at times assist in the care of a flower-garden, forty feet 
square, overlooked by the hall windows. The men are employed upon 
the farm, but labor principally in the garden, and liave no in-door oc- 
cupation. The women assist in the house-work, and have no out- 
door employment. 

About half of the men and women can work a portion of the time, 
but none are to be relied upon from day to day, and no attempt is 
made to furnish continuous work. 

Labor is performed under the immediate supervision of attendants, 
by direction of the superintendent and matron. 

Wliile labor is considered one of the greatest benefits to the insane, 
it is valuable also in so far as it does away with hired laborers. 

Twelve of the insane are generally in the sane department of the 
poor-house. All, with one exception, work, unless prevented by 
paroxysms, when they are removed to the asylum. 

The number of the insane September first, the day of inspection, 
was eighty-five ; males, forty-three ; females, forty-two. Of the 
whole number, all were said to be quiet and orderly, except "by 
spells." 

Four men and one woman were in restraint of the halls, one man in 
restraint of a chair, two men in muffs, and it is said that it has been 
necessary to confine the hands of one woman in a muff nine months of 
the year. One woman sleeps in a crib. 

But one inmate of the third ward can be trusted without an attend- 
ant. All who have been received during the past twelve years have 
been treated in State asylums. About twelve insane were inmates of 
the poor house previous to that time, concerning whom little is known 
by the present officials. 

' There is no separate hospital department. The bedsteads through- 
out the institution are of iron, and except in the associate dormitories 
are of large size, and are occupied by one or two persons according 
to the number in the institution and the character and degree of in- 
sanity. The straw beds are boxed to appear like mattresses, and the 
straw changed quarterly, unless required more frequently. Each bed 
Has one pair of sheets, husk bolster and feather pillows. The beds 
were all clean and neatly made and each was provided with a com- 
fortable or rose blanket and white counterpane. 

The walls are whitewashed once in six weeks. Tar is burned to 
purify the air. The halls, rooms and furniture are said to be washed 
each week with a solution of carbolic acid. 

Ready-made clothing for the men is purchased in New York, except 
shirts and overalls which are made in the house. The clothing for the 
women is made by both the sane and the insane women in the insti- 
tution. Flannel is furnished if it is needed throughout the year. 

The acute insane do not remain in the institution, but are removed 
by the superintendent to State asylums. 

Pay patients would be received if there were room. A special law 
permits the reception of patients from Orange, Rockland and Ulster 
counties. Upon September 1, one pay patient was resident at 15 per 
week, who received the same care as the public patients. 



78 Report on the Chronic Insane. 

Omnge county has thirty-seven insane at Middletown, of whom 
twenty are considered chronic cases ; but the present limited accom- 
modations for the insane u])on Orange Farm do not permit their re- 
turn to county care. 

Visited by Commissioner Carpenter, September 1, 1881. 

Oswego Cocnty. 

The poor-house of this county is situated on a slight elevation, 
eighty feet from the highway, distant about a mile and a half from 
the village of Mexico, its post-office and railroad station. 

The ground in front is planted with trees and flowers, and inclosed 
by a neat fence. The building, two brick stories above a stone bivse- 
nlent, consists of a central section surmounted by a tower, and two 
L-shaped wings. 

The central section has a tin roof. On the main floor of this division 
are a parlor and office, with sleeping apartments above. This portion 
of the building is occupied by the keeper of the insane department, 
and the right wing is used for the insane. The left wing is occupied 
by the officials and inmates of the poor-house proper; the general 
office of the institution being also here. 

Officials and employes. — This county has but one superintendent 
of the poor, who resides in the jioor-house. His compensation is $2 
per day, with living for family. His wife acts as matron of the poor- 
house department at a remuneration of $4 per week. 

The poor-house is in charge of a keeper, who also lives in the 
poor-house, and is paid for the services of himself and wife $450 per 
year and living. A female assistant receives $2 per week ; and a man 
is employed for farm work at $30 per month. The latter has charge 
of the insane when employed out of doors. 

The insane department is in charge of a keeper, who with his wife 
and daughter reside in the building. He is paid for himself and wife 
$400 a year and living. The daughter acts as an assistant, and re- 
ceives ^'l per week. 

All subordinate officers are appointed by the superintendent. There 
are no paid attendants in the insane department. The keeper says, 
" We do our own work with the help of the insane, including wash- 
ing; besides helping on the poor-house farm." 

Medical, supervision. — The county physician resides at Mexico. 
He is required to visit the institution daily. His compensation is $1 
per day ; receiving no pay for extra services. 

Medicines are supplied by the county, and are dispensed, it was 
said, by the keeper according to instructions from the physician. The 
latter informed the Commissioner that the consulting physician 
generally visited the institution with him once a month, adding that 
there was not mucii interest evinced by a majority of the physicians in 
the county ; but three or four visited it occasionally. 

General description. — Some little delay occurred in beginning the 
inspection of the institution, from the fact that on the arrival of the 
Commissioner, the keeper was absent in the flelds, and had the keys 
with him. 

As there were no attendants in the asylum, access to the wards of 
the insane department could not be had until his return. His wife 



Keport on the Chronic Insane. 79 

also being absent on account of the death of a relative, no one was in 
charge, but the daughter, a young miss of eighteen years. 

The building or wing for "the insane is a rambling structure, the 
interior having irregular halls and rooms, and some crooked stairways. 
The windows having outside iron gratings, each contain twenty-four 
panes of glass, six by nine inches. 

One of the rooms on the.first floor, nineteen by twenty-two feet, and 
eleven feet high, is used as a sitting-room ; the floor is painted, and 
the windows provided with muslin curtains. The furniture consisted 
of arm chair, stationary wall-benches, a round table and a looking 
glass. 1'he walls were bare. 

In consequence of the over-crowded condition of the asylum, two 
beds were placed on each side of this room. Three patients were 
quietlv sitting here at the time of inspection. 

In rear of this room, and separated from it by upright hard- 
wood studding, placed three inches apart, is a range of cells each five 
by seven feet, and eleven feet high. In the studding was an opening, 
five by nine inches, through which food might be passed. The cells 
have hard- wood doors, secured by two heavy bar-latches at the top and 
bottom. The keeper said, "The doors are left open at night, unless the 
patients choose to close them." The furniture comprised bedstead, bed- 
ding, and night conveniences. Nails were /Iriven in the wall on one 
side' for hanging clothes. In each cell is a window containing four 
panes of glass, each six by nine inches. 

Adjoining the sitting-room is a good-sized apartment, used as a 
hospital for women. It contained a patient eighty-six years old, 
who had been an inmate about eighteen years. 

The bedsteads in use were of the French pattern and there was a 
comfortable supply of bedding. A flower-stand filled with boxes of 
plants was in one corner. The painted floor was clean, and the room 
orderly. Adjoining the hospital is a ward with cells for women cor- 
responding to the male ward on the same floor. It was furnished with 
Four flag-bottomed chairs, three rockers, an arm-chair on rollers, a 
table wFth enameled cloth cover, on which were a few newspapers, a 
small stand, a sewing-machine, green paper shades, a small looking 
^lass, a few wall ornaments and a kerosene bracket-lamp. Here were 
five inmates; two were reading, one knitting, two were sitting list- 
lessly, another was somewhat^excited. All were cleanly dressed and 
hair tidily arranged. 

Opening into this ward is a cell termed " the dark hall." Here was 
a restraining-chair said to be used only as a commode for a cripple. 

Here likewise from overcrowding was a bed. Opening into this 
room is a long, dark clothes-press. 

The women's ward for disturbed cases, in the rear building, com- 
prises a central hall, lighted by two windows at the farther end, and 
twelve cells, seven on one side and five on the other. One is used as a 
oath-room and is supplied with hot and cold water. Patients are re- 
][uired to bathe once a week, the filthy cases oftener. 

The cells here correspond with those already described. The hall 
svas furnished with eight strong but comfortable chairs, recommended 
by the comm.issioner of the district. These were arranged along the 

de of the hall and were secured to the flooi-. 

Fourteen patients were here at the time of visit ; one afflicted 
11 



31 



80 Rkpokt ox tuk Chkonic Insane. 

with canctT occupiea one of ilie cells, the door of which was unlocked ; 
another hiid goitre ; ii third was restrained by wristlet and waist- 
6tra|)8. The keeper said, "She is sometimes seized with an impulse 
to strike, aiid at one time injured mv wife by hittinj: lier in the 
mouth. One of the patients in the asvhim had formerly wore straps 
for several vears. " I tc.ok the responsibility of removing them when 
I came, four years ago, and have not put them on since, except in a 
few instances, and then they were worn but a few hours at a time. 
Tliree of the women were barefooted, and about one-half had their 
hair shortened, "some," according to the statement of the keeper, 
" from choice." One of the patients here was understood to have 
charge of the restt. All were ouiet. 

Tlie cells were furnished with beds only. The walls were without 

ornament. . , jj j n 

A similar ward for men was on the floor below, having studded cells 
or rooms on the sides. One of these contained four beds. It was 
large, four cells having, by the removal of ])artitions, been connected 
into one. In the ward were seven strong, comfortable chairs, like those 
in the women's ward ; two wooden settees, one with three, the other 
with six seats. Three men were quietly sitting in this hall, the un- 
fastened door of which communicated with the yard. 

On the thinl floor are live associate dormitories, three having four 
beds each, one six, and one three beds. There are also two single 
rooms, each containing a bed, in all, twenty-three beds. A daugh- 
ter of the keeper, a girl eighteen years of age, sleeps in a room 
on this floor. The ceiling of this floor is twelve feet high, the floor 
painted, and some of the walls papered. The beds were well made 
and the rooms cleanly kept. The dormitories on this floor are used 
only at night, unless " at times in a few exceptional cases." 

Stairwa'\-s extend through each end of the main wing, and in tlie 
rear projection, at its junction with the building. 

In the WHsh-room, which is located in the basement near the dining- 
rooms, six women were engaged in washing, round tubs being in 
general use. The room was supplied with hot and cold water ; had a 
small cauldron for boiling clothes, and other requisite appliances. A 
male patient was using a patent wringer for wringing clothes. One 
of the women likewise had charge of this work, and was very active. 
The keeper said, that at times it was necessary to restrict her to pre- 
vent overwork. It was necessary to watch another patient in this 
respect. 

Yards. — The men's yard is inclosed by a tight board fence, planed 
and painted, twelve feet in height. In the short turf were numerous 
paths well worn. On one side was a pavilion six by twenty-four feet, 
in which were sitting two patients just in from work on the farm, 
and awaiting dinner. There were no shade trees ; the water-closet 
was constructed with a box underneath for the utilization of night 
soil. The keeper of the poor-house said : '* These as well as all others 



are cleaned every two weeks, and supplied with dry muck every three 
or four days." 

In the yard were eight men, all of whom were quiet. One was a 
lawver, and a former graduate of Hamilton College. 

The women's yard adjoins that of the men, is fifty by one hundred 
feet, of similar description, has pavilion of the same size, and water-. 



Report on the Chronic Insane, 81 

closet. This yard is shaded by a few apple trees. Throe or four 
patients were here engaged in hanging clothes upon a line. Under the 
pavilion was a discarded crib without a lid. 

Heating and ventilation. — The insane department is heated by a 
tubular steam boiler, three by seven feet, located in the basement; 
pipes lead to radiators placed in various parts of the building. The 
smoke-stack is carried ujjward through a large wooden Hue, designed 
to exhaust the foul air by flues therefrom, connecting with the several 
rooms. 

The physician thought the ventilation was not entirely effectual. 
Thermometers are hung in the wards, halls and sitting-rooms, but 
no daily record is made of the temperature. The keeper said, " In 
cold weather we run as near sixty-tive degrees as we can." 

Food. — In the men and women's dining-rooms and kitchen were 
five women patients engaged in cooking and preparing the table for 
dinner ; one having sjiecial charge of tlie dining-room, another the 
kitchen. Uncovered deal tables, white crockery plates, bowls, tea- 
cups and saucers, steel knives and forks, tinned iron spoons, glass salt 
cellars and tin pepper boxes were in use. Round top stools were 
placed for eighteen inmates. In the women's dining-room was a cup- 
board for dishes, and two clothes-racks hung witli clothes. The table 
was set for thirty-two women. Food was carried to the remaining 
patients in the ward, except to two paying patients. Later the patients 
were seen at dinner, to which they were summoned by an ordinary 
dinner bell, rung by the keeper, in a way that betokened somewhat 
of family life. The keeper, assisted by his daughter, was present and 
served the food. The dinner consisted of a piece of boiled pork, 
which the keeper said was their "' staple meat," placed on each plate, 
a piece of butter, and unpeeled boiled potatoes, milk, and gravy; also 
unsweetened tea with milk. 

The keeper gave the regular dietary as follows: "For breakfast, 
unsweetened coffee with milk, hop-yeast bread, and pickled codfish, 
cooked in milk, or boiled pork or beef. For dinner, beef or pork, and 
occasionally fresh fish, the pork being boiled and the beef in the form 
of a stew, pickled beets, lettuce, and such food as make up a farmer's 
diet ; sometimes tomatoes or boiled cabbage are supplied. Supper is 
a light meal, and consists of bread or mush and milk. This is pretty 
nearly the average diet; we cannot confine ourselves to any particular 
thing ; we have more beef in winter than in summer." 

Clothing. — The dress of the inmates was stated to be as follows : 
" In summer the men wear a white or colored shirt, cottonade pants, 
or similar goods, vest and frock coat. In extremely hot weather some 
have linen coats. Cotton socks are worn by the men the year round, 
except those who work out of doors. Some of these wear woolen 
socks, some wear slippers, and some boots or shoes. In winter some 
wear cotton and others woolen shirts. All who will wear them are 
supplied with knitted woolen drawers and shirts. Pants are lined 
and furnished of cotton and woolen mixed goods. The vest and coat 
are of the same material, while the cost is from *8 to $10 per suit. 
Two or three who assist in doing chores in winter have overcoats." 

" The dress of the women in summer consists generally of a cotton 
chemise, a few of the feebler wearing canton flannel under-clothing, 
cotton skirt and gingham dress, cotton stockings, and shoes or slip- 



82 Report on the Chronic Insane. 

pers. Those who want them hiive gingliam sun-bonnets. Two are 
always kept hanging at the door at the exit to the yard, and some 
have their own. A great many will not wear them. In the winter 
woolen stockings are furnished; a good many have quilted skirts and 
under-waist. The dresses are of various colors." 

BediliiKj. — The bedsteads mostly used are of the "Willard asylum 
pattern, with hoop iron bottom. The bedding, with a few exceptions, 
consists of two straw ticks, generally a straw pillow, two sheets, a 
tufted comfortable and white counterpane, removed at night. It was 
said ''two or mure comfortables are used, in cold weather. A few of 
the beds had feather pillows, furnished by friends." 

Emi>l(njment. — The total number of the insane here is fifty-six, of 
whom eighteen are men and thirty-eight are women. 

Aside from the work done by the women in the laundry, kitchen, 
dining-room and dormitories, the insane assist in making the clothing 
and bedding for the inmates. The keeper stated that "all the pa- 
tients' dresses and underwear were made by his wife, assisted by the 
women ; and all the men's shirts, as also the bedding for the whole 
establishment." 

The men who work out of doors do most kinds of farm labor, tak- 
ing care of the stock, milking, mowing, cradling and hoeing, but none 
are allowed to drive a team. In winter the men must remain abso- 
lutely idle, as no in-door employment can be furnished. One of the 
men brings in the wood and coal and helps in the laundry. 

Only one of the men performs a fair day's labor and two a partial 
day's work. Of the women, five perform a fair day's labor and seven 
a partial day's work. The keeper thinks that the whole labor of all 
the men is equal to that of two hired men and of the woiuen to tliat of 
four hired servants, except that on washing days, it would require six 
to perform the same amount of work. The keeper said " the more the 
men labor the better it is for them, unless they are overworked." 

It was stated that "one of the insane in each department had charge 
over the rest about them." One of the men the keeper styled his 
deputy. The keeper said "he thought he got along better than if he 
had more paid attendants." 

Restraint. — At the time of visit none were restrained in their 
rooms or cells. The halls, dining-rooms and kitchen, the hospital- 
room, laundry-room and yard were in free communication, except as 
to the separation of the sexes. All of the inmates were in the build- 
ing or yards, except five who were at work on the farm, under charge 
of the " hired man." None were in mechanical restraint, except the 
one already mentioned. There are no restraining chairs in the insti- 
tution, nor camisoles; there is one muflF, two pairs of hand-cuffs and 
one pair of shackles. The keeper said, "I have used these very sel- 
dom, and have never used but a single pair at any one time ; have 
never used them in taking patients to Utica, although some were ex- 
tremely violent. I sometimes order patients to remain a few minutes. 
In this I am governed by circumstances; punishment is never in- 
flicted; excited patients are secluded in their rooms until the spasm 
is over. I never show temper or anger under any circumstances." 

In the baseiuent is a room thirteen feet long by twelve feet wide 
with seven and a half feet coiling, in which two cells, six by six and a 
half feet, are set off by upright studding. This is used for refractory 



Eepoiit on the Chronic Insane. 83 

cases. One of the doors has two heavy bars extending from top to 
bottom with a strong, heavy bar and staple across the center. This 
room has two outside windows. In one of the cells was a board at the 
height of a bed, with straw tick, straw pillow and blankets. In the 
other was a bunk, with straw tick and other bedding. Secured to the 
wall was a sliort chain, about one foot long, with ring attached. The 
cells were warmed by steam pipes. 

Wafer siqjpli/. — Water is supplied from a spring half a mile distant ; 
a windmill forces it into two reservoirs, one hundred and twenty-five 
feet above the spring, from whence it is distributed by gravitation. 
These reservoirs contain sixty barrels each; the/pipe from the spring 
is one and one-half inch ; there are six faucets in the insane depart- 
ment, to which in case of tire, three-fourths-inch rubber hose may be 
attached, of which there is about one hundred feet. The bnildiugs are 
insured. The water supply was brought into use in August last ; 
previous to which water was drawn by teams. 

tSeweroge. — A tile drain extends under and into the asylum build- 
ing to the laundry; this also receives the discharge of two water- 
closets within the building. A four-inch drain tile extends outward 
from the furnace-room to carry off surface water; which in the spring- 
time had caused serious inconvenience. This drain also receives the 
slo))s outside the building. Another drain, near the kitchen door, dis- 
charges into one of the main drains. The surplus water from the 
reservoir discliarges into the sewer system. The first named sewer 
empties into a ditch, six or eight rods distant from the building. 
Other sewers discharge at the same distance from the building, on a 
flat piece of ground. The keeper of the poor-house said, " Great 
pains are taken to purify the open sewer." The water-closets in the 
wards are not self-flushing, and one of them was quite offensive for 
this reason. 

General ohservatmis. — The farm connected with the house is small, 
comprising only seventy-five acres. There are a few old apple trees of 
but little account. A small orchard, containing fifty trees of grafted 
fruit, was planted a year ago. Eight cows are kept, the milk from 
which is principally used by the inmates. It was said, that " a ton of 
butter was made and used in the house." About two and a half acres 
are approjjriated to a vegetable garden, principally planted with beets 
and cabbage for winter use. Here also are raised a variety of garden 
products, including sweet corn, peas, beans, carrots, tomatoes, cucum- 
bers, etc. 

Paying patients are received at the uniform rate of §2 per week. 
There are only three at present, two women and one man ; these are 
quiet cases; two of these eat at the keeper's table, and receive extra 
care and attention to their clothing. 

The amount received during the fiscal year from paying patients 
was 14(31-30. 

Abundant reading matter is supplied by people of the county, part 
of this literature finding its way into the insane department. Means 
of playing checkers, backgammon and dominoes are furnished to the 
men. 

No special provision is made for epileptics. 

The idiotic class, of which there are but few, are cared for in award 
in the pauper department which, with the remaining establishment. 



84 Report on the Chronic Insane. 

was also visited. One of the idiots here is a girl nine years old, unable 
to talk or feed herself, destructive of clothing, and a source of much 
trouble. She was in charge of a pauper woman. Her hair was 
combed, her person clean, and she appeared to be well cared for. 
Another idiot, u young man, twenty-twn years old, required to be fed; 
his hands were distorted, and he hiid no use of his lower limbs; he 
was restrained in a rocking chair. A blind woman in this ward, over 
ninety vears of age, required constant care ; her clothes had been 
changed three times on the day of visit. Other inmates in this ward 
require constant attention. Cleanliness and neatness were manifest 
throughout the department. The keeperof tlie poor-house said : '"Our 
motto is 'cleanliness,' and we think we have pretty well carried it 
out. " 

The visitation was made by Commissioner Letchworth, October 14, 
1881. 

Queens County. 

The county asylum for the insane is located in the town of North 
Hempstead, ten miles from the county poor-house, and one and a 
half miles from the Mineola post-office and railroad station. 

The wooden structure erected in 1791 as a county court-house and 
occupied as such, was remodeled in 1876 for a county insane asylum, 
at an expense of over $7,000, including all improvements made to 
the present time. 

The main building is sixty feet front by forty in depth, with exten- 
sions to the north and west of two and a half stories; has no basement. 
It is surmounted by a cupola that materially assists in its ventilation. 

A cellar twenty-five feet square, which is used for milk, bread, fish 
and some vegetables, is under the superintendent's reception-room at 
the south-wcst corner of the building. During the winter season tur- 
nips and cabbages are buried outside in the ground. 

The rooms upon the three stories vary in height according to date 
of construction, and the objects and use for which they were originally 
designed. The first story averages nine feet in height, while a portion 
of the second is eleven and one-half, the remainder from eight to 
eleven and one-half, and the third, which was unoccupied space until 
utilized for present purposes, is, in its highest part, nine feet, sloping 
to four and one-half feet. 

The superintendent's reception and family apartments occupy the 
front of the main building upon each side of the entrance hall. North 
of these and at the left is the dining-room for the women, and an ex- 
tension of two stories, the first being used for a kitchen and bake-room. 
'J'he kitchen is twenty-two feet by twenty-one, having outside windows 
upon two sides. It is provided with a range of suflicient size to meet 
the requirements of the institution. Forty loaves of bread can be 
baked at one time. Upon the front is a sink, and a pump that 
supi)lies water for culinary purposes from a cistern, is situated a few 
feet outside of the building. When this supply is exhausted water is 
forced into the cistern from a well near by. The bakery opens from 
the kitchen. The newly-made bread was tasted and found good. 

The building is warmed by heaters u])on the first fioor, that furnish 
hot air to the second and third stories, and by two Baltimore heaters 



Eeport on the Chronic Insane. 85 

that deliver heat into the third story hall. The rooms are said to 
have been at all times sufficiently warm. The degree of heat is not 
regulated by thermometers in tlie wards. 

All the windows are adjusted with weights and pulleys. 

There are two wards, one for men and one for women. The ward 
for men consists of ten rooms located in the three stories. The rooms 
vary in size and in the numbci" of their occupants. There are no sin- 
gle rooms. The two rooms on the lirst floor are each eleven feet by 
eight and one-half, and eight feet high, with a capacity of seven hun- 
dred and forty-eight cubic feet of air each, and one hundred and eighty- 
seven feet per inmate. The room upon the second floor is twenty-six 
by twenty-three and one-half feet, and eight and one -half feet high, 
with nine inmates. At the east are two large windows, near the door 
is a sink with three faucets for toilet purposes, and one reclining chair. 
The entrance door opens into a small hall, from which stairs lead to 
the floors above and below ; and a door opens upon a tin roof from 
which a lower roof may be reached, and thence the ground, thus form- 
ing a fire-escape that has been proved to be perfectly safe by two or 
three patients who have had an opportunity to use it. The third 
story has a central hall tifty-eight feet long and fourteen high, that is 
well furnished with wooden settees, chairs, tables, rocker, and a lamp 
suspended from the ceiling. Large windows are at each end of the 
hall, and a cooler containing ice-water is upon one side. The rooms 
opening upon either side have ceilings of nine feet at the highest 
point, and slope from about half way to four and one-half feet. Tran- 
soms are over each door. All are warmed by hall registers from heat- 
ers on the first floor. Six of the eight rooms on this hall have small 
windows. No. 1 Is an attendant's room ; No. 2 is fourteen feet by 
eleven feet eight inches, with five beds ; No. 3, of the same size, has 
four beds ; No. 4, fourteen feet by seventeen feet six inches, has six 
beds and a large window; No. 5, fourteen by sixteen feet eio-ht 
inches, has six beds; No. 6, fourteen feet by" fifteen, has six beds; 
No. ? is an inclosed passage from which tiiere is a stairway to the cu- 
pola above, that is arranged to form a fire-escape into the hall below 
by raising the lower steps; No. 8 is fourteen feet by seventeen feet 
nine inches, with six beds. 

The ward for women is in the second story, and consists of thirteen 
rooms and halls of irregular sizes and shapes. The hall upon the 
second floor is fourteen by eleven feet, less a stairway taken from the 
south and west, that forms a part of the fire-escape from the third 
story. The various halls in the female ward are furnished with wooden 
settees, chairs, tables and clocks. Upon the left is an irregular-shaped 
room sixteen by twentj^-three feet, eleven and one-half feet high, a 
stairway having been taken from it. It has seven beds, a register and 
a window opposite the door. The south-east corner room upon the 
same hall has large south and east windows, an unused fire-place in a 
chimney and a register ; it is twenty by sixteen feet, and eleven and 
one-half feet high. At right angles with this hall is one opening from 
it having three rooms, two of which are occupied by attendants ; the 
third is thirteen by fourteen feet, eleven and one-half high ; this in 
addition to the usual furniture has a i-ag carpet upon the floor. Upon 
the opposite side of the hall is an associate dormitory fourteen and 
one-half by twenty-nine feet with twelve beds, and two large grated 



86 Report on the Chronic Insane. 

west windows separated by a chimney. Upon the right are two closets 
for clothing and bedding, one for the use of the inmates, the otlier 
opens into the entrance hall. Upon tiie north is a hall, seven and one- 
half feet in width, with an outside window. Here are three rooms, 
each ten and one-half by nineteen and one-half feet, and nine feet iiigh, 
each containing si.\ beds. On a continuation of this hall in the exten- 
sion is a room fourteen by fifteen feet, Ijy eight and one-half in height, 
\»ith four beds and one window, anotlier si.\ and one-half by fourteen 
feet (and uthcns). At the extreme end of this hall is a wash-room for 
the insane women, in which is a sink with two faucets. This communi- 
cates by a door with an outside closet and a narrow stairway to the 
ground. Tiiis stairway has been condemned, and it is to be replaced. 
Changes are contemplated in this part of the building, in order to 
increase the accommodations and to add to the safety of the inmates. 

South of the kitchen, and twenty feet from it, in an inclosed yard 
formerly the exercise yard for insane women, is a one-story wooden 
building, one-half of which is the store-room for blankets, clothing, 
etc., while the other half is for the storage of groceries. The build- 
ings are not fire-proof. .\11 are of wood with partitions lathed and 
plastered. 

Contributions of papers and other reading matter are received from 
the local committee, and friends of the institution, in quantities to 
meet the demand. 

Ventilation is secured by open doors and windows and transoms 
over each door. The third floor has a grated ventilator through the 
ceiling into the cupola above. Upon the days of visitation the air was 
generally fresh and pure. 

There are no rooms designed particularly for occupation by the sick, 
they being cared for in their usual rooms. 

The bath-room, eleven by eleven and a half feet, is situated upon 
the first floor, with doors opening into it from both ironing-room and 
hall, and has one bath-tub in which patients take their weekly baths. 
Saturday being appropriated to the men, and Monday to the women. 
Frequent baths are prescribed at other times by Dr. Rogers, who has 
faitli in the soothing and medicinal effects of cold water, and who 
states that in place of medicine, baths are at times given at midnight, 
and that they have seldom failed in producing the desired effect by 
bringing to the patient the relief of sleep. 

The laundry, twenty-eight by eighteen feet, with a ceiling of eight 
feet, is situated at the north-east corner of the building, and opens 
from the ironing-room. It is supplied with stationary wash-tubs and 
pounding-barrels. At the time of my inspection eight men were at the 
pounding-barrels, two at each; one was softly humming a tune to 
which all kept time with their pounders. Two women were washing 
in the tubs. This department was supervised by a laundress and two 
attendants. 

The insane are said to work as directed and according to their 
strength, and all are said to be frequently relieved. 

There is no method of ascertaining the whole (piantity of water sup- 
plied for each day's use, or that of each patient. Water is supjdied by 
three cisterns, into which rain-water is received. Two wells with 
pumps in each, and three rubber hose for use in case of fire, also con- 
vey the water forced from the wells to fill the cisterns if required. 



Keport on- the Chronic Insane. 87 

A.t both the south-east and south-west corners of the building are wells, 
3ftv-four feet deep each, and about fifty feet from vaults. There are 
nclosed vaults in each airing court, and at the south-west corner of 
the building. 

The system of sewerage consists in the conveying of water from the 
sinks and tubs to cess-pools, so arranged that water can be drawn from 
Due to the otlier, bv which process, and a frequent removal of the sed- 
iment, it is said thiit a iiealthful and satisfactory sewerage is secured. 

Patients have no work-rooms or places of resort when the weather 
Joes Qot permit their being in the exercise yards. Of these yards 
there are two, one hundred by one hundred and twenty-five feet each. 
The one for the women is entirely separate from that of the men. 
There is a large shed with benches underneath in the center of each. 
Ice-water, to which all have access, is in each yard. 

Outside of the exercise yards there is no ground for the recreation 
3r amusement of either men or women. 

Protection from fire consists of vigilance upon the part of the 
officers, a paid night-watchman, three hose for conducting water as 
pumped from the wells, and two Halloway's fire extinguishers, with 
3xtra charges for each, two fire-escapes, and the usual doors and stair- 
ways. 

The dining-room for the men is in a one-story extension, north of 
the main half, twenty feet by twenty-nine, height, nine feet. That 
for the women is nineteen and a half feet by twenty-six and a half 
feet, and joins the kitchen. Each has pine tables, chairs, and white 
stoneware, knives and forks of steel, and spoons of galvanized iron. 
Pay patients, served after others have eaten, are furnished with_ a 
greater variety of food, and have their tables covered with white 
cloths. 

The superintendent states that he "adheres to the printed dietary 
scale as nearly as possible." (See Appendix.) 

The medical supervision is that of the superintendent and of Dr. 
Phillip M. Wood, who is and has been the visiting physician since 
the asylum was organized, and who is paid by the visit. The sum 
paid in the year 188U amounted to $375, for medicines and medi- 
cal attendance as physician and surgeon. His visits are made each 
alternate day, and mo)-e frequently if necessary. 

There is no allowance for surgical cases. The county has furnished 
instruments for surgical and accident cases. 

Prescription and case books are not kept in the institution. Cer- 
tificates of insanity are on file, and a registry of names, age and res- 
idence made as patients come in, remains in the office. Dr. Wood's 
private prescription and case books are in his own office. There are 
no consulting physicians. The medical society of the county, con- 
sisting of ninety members, has an active interest in the institution, and 
regularly appoint a committee to inspect and report at its annual 
meetings. 

The citizens of the county manifest their interest by visits. The in- 
stitution is in charge of Dr. David S. Rogers, the superintendent, who 
has received successive annual appointments from the supervisors 
since the opening, with a salary at present of $1,200 per year. The 
assistant keeper receives $40 per month ; the baker, $18; the laundry 
man, $17, and the laundry woman, $15 per month. 
12 



88 Report on the Chronic Insane. 

The three male aud throe female attendants are in three grades, 
the first grade receiving $19 per month, the second $17, and the third 
$15 per month, making in all a paid force of fourteen, whose united 
salaries amount to $3,200 per annum. The duties of each are assigned 
by the supt.'rintcndt*nt, and are performed under his direction. Paupers 
do not as.sist in the care of the insane. 

There are neither cribs, restraining chairs, nor manacles nor cells 
and dungeons of any description in whicli to confine the insane. In 
and belonging to the institution are two pairs of muffs, six camisoles 
and some leather straps. It is said that the superintendent supervises 
all restraint, and that none is allowed except upon application to him 
and by his approval. There is no restraint book kept. Upon August 
3, one woman paced the exercise yard in a camisole dress and it is said 
to be also necessary to confine her to her bed with straps at nigiit. 
Also in the men's "yard sitting upon a bench was a man who was con- 
fined by a waist strap to a post. His feet having been frozen and par- 
tially amputated, his constant efforts to escape prevent their healing, 
and hence his confinement. 

The building is so constructed that while admitting of the separa- 
tion of men and women in rooms, wards, halls, dining-rooms and 
exercise yards, there is no separation while at their work in the 
kitchen and laundry. A constant supervision is said to be maintained 
over these departments. 

Space is too limited to admit of thorough classification of either the 
men or the women. There is no apartment set apart for epileptic or 
idiotic patients. 

The idiotic are retained at the county poor-house. 

Classification is determined by the superintendent. 

Out-door amusements are not provided for either men or women. 
In the asylum, cards, dominoes, and checkers are supplied. It is said 
that the insane men care more for games than the women, the latter 
seldom engaging in them. 

There are no amusements in or out of the institution that are par- 
ticipated in by both men and women. 

Neither wards, rooms, nor grounds are ornamented or adorned. 

Insane men are employed in gardening, in the care of the grounds 
and in stable work. In-doors they do whatever they are able to do. 
Women have no out-door employment but assist in housework. 

No patient is able to perform a fair day's labor, but many work for 
short periods. It is said that continuous work would be unsafe. 
Nearly all can work a portion of each day. Forty-four women 
patients can each perform a partial day's work. 

The work of the men is remunerative in that vegetables are raised 
and supplied for the entire family. It is said that there, are resident 
twenty men and women, the value of whose labor would average $10 
per month each, and in addition transient labor is performed by the 
insane, to such an extent as to obviate the necessity of a greater paid 
force than at present employed. The superintendent directs the kind 
of labor each is to perform and its duration. Labor as before stated 
is regarded as a great curative agency. 

Earnings are not set apart for the insane. Labor is provided as a 
medical remedy but it is too fitfully performed and too irregular and 
unreliable to receive a reward. 



Keport on the Chronic Insane. 89 

Upon August 3, I visited the institution as one of a committee of 
the State Board of Charities, consisting also of Commissioner Smith 
and the Secretary. 

Of one hundred and three inmates fifty-one were men and fifty-two 
women, and twenty were not residents of the county. One woman 
and one man were in restraint, one woman destructive of clothing. 
The youngest was a boy of 17. Sixty-five have at some time been 
treated in State asylums and thirty-eight have not. 

The apartments are furnished with single iron bedsteads, wooden 
chairs, are warmed by registers or from the hall, and lighted by kero- 
sene lamps in which 150 test oil is burned. 

The bedding consists of straw beds, one pair of sheets, one pillow 
and case, rose blankets, varying in number as required, and white 
counterpanes. 

The clothing varies with the season, and is not of any fixed or dis- 
tinctive character; flannel is provided for all in winter, but not in 
the summer season. 

It is stated that the insane are received, being committed in the 
usual wav, by the county Judge, upon certificates from two examining 
phvscians. If classed by the superintendent as acute, friends are com- 
municated with, and it is said that such a course has often resulted in 
clianging their condition to that of private patients. 

Upon Augnst 3, twenty of the inmates, eight women and twelve men, 
were pay patients ; of these two women and three men were residents 
of the county, and six women and nine men were non-residents, pay- 
ing from ^3 to S8 per week. These boarders are said to receive the 
same treatment as the public patients, with the exception of a separate 
table, better food and Ireedom to work as they will. 

Visited by Commissioner Carpenter August 3, 1881. 

Note.— The contemplated changes have been made. 

Suffolk County. 

The institution consisting of the Suffolk county poor-house and its 
department for the insane is located upon the county farm, near the 
railroad station at Yaphank. The two are so closely associated, 
both by the construction of the building and by the government, as 
to render it impossible to report either separately, for combined as they 
are under one roof and one management they are one institution. 

The main building or poor-house erected in 1870 was enlarged in 
1877 by the addition of a wing, intended for the use of insane women. 
The same year Suffolk county was exempted by the State Board of Char- 
ities from the operation of the Willard Asylum act of 1871. 

The insane men have accommodations in the main or poor-house 
building, in which one-hall," the old hall" is also set apart for insane 
women. Insane men have no separate paid male attendant, nor care 
other than that shared by the sane. They dine at the same table, are 
provided with the same food, exercise in one yard, labor in one field, 
and are under one keeper. Necessarily the statement of facts in rela- 
tion to provision and care of the insane must include to a great degree 
that of the sane. 

The whole structure is of wood. The central or main building above 
the basement consists of three stories and a garret, together with wings 



90 Report on the Cheonic Insa.ne. 

of two stories and a garret. A basement appropriated to the various 
uses of storao:e, work, silting-rooms and rooms for insane men extends 
under the whole structure. The portion under the wing for insane 
women may properly be called a cellar, with small windows. It is of 
the size of the addition, and includes the milk cellar, furnace, space 
for a few vegetables, and storage. 

The windows throughout the institution have upper and lower sashes, 
with twelve panes of glass each, eleven by fifteen inches, and are 
adjusted with weights ami pulleys. The building is not tire-proof. 

The three ap:irtments for insane men are unlike each other, and are 
located upon different floors and divisions of the poor-house. The first 
is upon the third floor and was fitted up for the use of insane men 
December, 1880, in compliance with a resolution of the board of super- 
visors, dated 1879, for the object of providing rooms to be used in 
place of the basement cells. It is ninety feet in length and nine and 
one-half feet high, having windows at each end of a central hall 
twelve feet wide, from which fourteen single rooms o})en, each six by 
fourteen feet and nine and one-half feet high, with capacity of seven 
hundred and ninety-eight cubic feet of air each ; and one associate 
dormitory, ten by fourteen feet and nine and one-half feet high, with 
capacity "of one thousand three hundred and thirty cubic feet of air, 
and a bath-room the same size. The hall window opens upon a fire- 
escape ; each room has an outside window, and over each door is an 
open grated transom. 

The second is upon the second story of the poor-house department 
and is fifteen by twenty- nine feet, and ten feet in height, with three 
windows five feet by three upon the south side ; upon the day of in- 
spection it was occupied by six insane men who were able to perform 
daily work. This number is at times increased to twelve. Its capac- 
ity for air is four thousand three hundred and fifty cubic feet, being 
seven hundred and twenty-five per inmate. It is supervised by the 
engineer, who also has charge of the engine-room and the men's division 
of the poor-house. 

The third apartment for men is in the basement of the poor-house, 
and consists of eight cells or rooms, the use of which was intended to 
be abandoned upon the completion of the new hall. This ward was occu- 
pied upon the day of inspection by eleven insane and four feeble- 
minded or demented men. Each room is eight and one-half by fourteen 
feet, and eight feet high, having one window three feet square above 
and on a level with the ground, adjusted with weights and pulleys. 
The floors are of brick and the partitions are plastered upon brick. A 
slat door opens from each room into a hall seven and one-half feet wide 
by sevunty-five feet, communicating at each end with large rooms, one 
of which is used as a sitting-room by men and has a door opening from 
it into the men's exercise yard. The eight rooms are occupied by one 
or two men according to the judgment of the keeper, and all are oc- 
cupied by violent or filthy cases. 

Three halls are occupied by insane women, one of which, the old 
hall as it is styled, is in the poor-house department. It has six single 
rooms, six by fourteen feet, with capacity of eight hundred and forty 
cubic feet each, two single rooms, nine by fourteen feet, with capacity 
of one thousand two hundred and sixty cubic feet, and two associate 
dormitories, fourteen by seventeen feet, with capacity of two thousand 



Eepokt on the Chronic Insane. 91 

;hree hundred and eighty cubic feet of air, each occupied by two or 
three inmates, as is necessary. The hall is sixty by ten feet and the 
aath-room twelve by fourteen. The insane of this ward are violent, 
?xcitable and filthy cases, in charge of one paid attendant. 

The ward in the new wing has sixteen single rooms, each six by 
eleven feet, and ten feet high, with capacity of six hundred and sixty- 
cubic feet of air. and eight associate dormitories each eleven by eleven 
feet, with a capacity of six hundred and live cubic feet of air per in- 
mate; each room has a window and a transom over the door. Both 
halls of the ward are in charge of the first attendant, assisted by the 
nurse. 

There are no day or work-rooms for either men or women, who pass 
the time in the exercise yards and their own rooms or ward halls. 
The insane men may if they.please occupy the brick lloor sitting-room 
in the basement, midway between the cells and shops, that being for 
the use of both sane and insane. 

The whole institution with the exception of the new wing which 
is warmed by a furnace in the cellar, is heated by steam from one en- 
gine and boiler. Kegisters are in the halls and it is said that all apart- 
ments have been sufficiently warm. Thermometers are in use during 
the winter season. 

The ventilation is from the doors and windows. Upon August 24 
and 25, the air was generally good. 

There is no hospital department. 

Tiie bathing arrangements consist of bath-rooms in the apartments 
for women, and in the new hall for insane men, in which are stationary 
bath-tubs, with hot and cold water. Sinks are in the halls, in which 
are hand basins and water faucets. 

The laundry is in common with that of the poor-house department. 
The clothes are boiled by steam, and there is an in-door drying-room 
for the winter season. 

Water is supplied from a " spring well " in the engine-room near 
the boiler. From it water is forced into the three tanks, each with a 
capacity of three thousand gallons, from which it is distributed over 
the institution. About one tank is daily filled. The water is said to 
be pure and good. There is also a well at each barn, in the kitchen, 
and one is placed one hundred feet from the front of the poor-house. 
Cisterns are not used. 

The sewerage or drainage consists of drain pipes to an open pool 
sixteen hundred feet distant, said to be properly tapped. Inclosed 
closets are at the extreme of each airing court, that are said to be daily 
cleansed, and the sewage conducted by pipes to the pool. 

The exercise yards are inclosed spaces without trees and covered 
with grass. The one for sane and insane men is one hundred and 
thirty by sixty-five feet, having sheds and benches underneath, while 
one sixty-five feet by eighty, with a shed and benches, is provided for 
insane women. 

The groves near by are frequented by the insane. A shaded avenue, 
two miles in length, surrounds the farm and is used by the patients in 
taking exercise, as well as an orchard of three acres in which the fruit 
is eaten as gathered. These grounds are said to be open to all, but it 
is understood that men and women must occupy them at different 
hours. 



92 Report on the Chronic Iksane. 

There is no paid watchman. 

The means of escape in the event of a fire are the three iron fire- 
escapes provided the past year, and the nsual modes of egress by stair- 
ways and doors. The keeper overlooks the place at night and the at- 
tendants sleep upon the halls. Ten hose are in order in the institu- 
tion and two Babcock's fire extinguishers have been provided. 

There is no se])arate kitchen for the insane, whose food is prepared 
in that of the institution. 

The dining-room for sane and insane men, fourteen by sixty feet 
and eleven feet high, is upon the first floor. It is distinct from that 
upon the opposite side of the kitchen, fourteen by thirty feet, which 
latter is the dining-room for the pauper women and the insane wo- 
men of the "old hall." 

The tables are of uncovered pine. Stools are provided. The plates 
are of white-ware and the knives and forks are of steel. Tin cups are 
furnished for the men and white bowls for the women. The ward 
dining-room has a table covered with enameled cloth and is provided 
with chairs. The table is furnished with white-ware. 

The diet is prescribed by the keeper and is but little varied for the 
insane men, who dine at the same table with the sane inmates of the 
poor-house. Bill of fare : Monday, dinner, boiled beef, potatoes, tur- 
nips in their season, bread and tea. Tuesday, beef stew with tea and 
bread. Wednesday, beef and beef soup, bread and tea. Thursday, 
beef stews. Friday, fish and potatoes. Saturday, pork, beans and 
potatoes. Sunday, baked beans and roast beef, bread and potatoes. 
The daily breakfast consists of coffee with sugar and milk, meat, 
hominy and molasses or milk, bread and butter. For supper each 
day, tea, bread and butter, molasses cake, stewed fruit or some sauce. 

There is no separate diet table for the sick. The care of the sick 
is regulated in diet, by direction of the physician and the keeper. The 
sick are given all the milk and cream they can use, and a woman is 
assigned to cook for them. 

The medical supervision is that of Dr. James B. Baker, who for ten 
years has been the visiting physician of the institution, and is paid by 
the visit. He visits alternate days and daily if necessary. Should 
consulting physicians or surgeons be called, bills for their services are 
presented to the superintendents of the poor. Medicines are furnished 
by the county and are given out by Dr. Baker. There is no extra 
allowance "for services rendered in case of accident requiring surgical 
operations." 

The institution has no prescription or case books. The insane are 
registered as paupers in the same book as the sane and are distin- 
guished by the descriptive word "insane" annexed. 

Certificates of insanity are on file in the institution. 

There are no appointed consulting physicians. The interest of the 
medical profession in the county has been manifested from time to 
time. The medical society have held one meeting at the poor-house 

The citizens of the county visit frequently. Wednesday and Thurs- 
day of each week are visiting days. At times the number of visitors 
is very large and the interest is said to continue throughout the year. 

The employees for the insane department cannot be entirely sepa- 
rated from those for the sane. 

The keeper at $7oO salary, an assistant keeper at $550, a matron at 



Report on the Chronic Insane. 93 

$250, nurse at $150, and seamstress at $180 per year, all have their 
time partially occupied in the performance of duties which extend 
over the whole institution. In addition to these there is a farmer at 
$350 per year, an engineer at $300, and a cook at $180, whose services 
are for all the inmates, while two female attendants are the only 
paid employees whose work is confined exclusively to the care of the 
insane. Two of the assistant cooks are inmates and three pauper 
men and three pauper women are detailed to assist in the care of the 
insane, and one woman takes charge of the table for the insane women. 

All employees and attendants are under the supervision of the keeper 
who regulates the conduct and prescribes the duties of each. 

There are no secure rooms for the confinement of the insane, other 
than their sleeping-rooms. There are no cribs. Two wooden restrain- 
ing chairs with leather straps are screwed to the floor. The two pairs 
of muffs were upon the date of inspection out of order. Six camisoles 
are said to be occasionally used two or three hours at a time. Of the 
four pairs of wrist manacles in tlie institution two were in use. Be- 
sides these means of restraint the county owns about twenty leather 
straps. There is no restraint book. The two dark cells have not 
it is said been used during the term of the present keeper, who states 
that no punishment is allowed save that of confinement in rooms. 

Separation is secured in-doorsand out. Classification is determined 
by the keeper as sane or insane according to habits of cleanliness, de- 
gree of insanity, imbecility and violence, and is regulated and re- 
arranged by him whenever it becomes necessary from the changed con- 
dition of the patients. The idiotic and epileptic have no separate care, 
having at night the same attention as other inmates. 

Idiotic, epileptic, and feeble-minded children are assigned rooms 
jn the insane department. Upon the date of inspection a girl about 
fourteen years of age, an epileptic, idiotic mute was with the in- 
sane and a boy of seven years of age was in the charge of an insane 
woman. 

The out-door amusements for men consist of exercise in the open 
air, and work. Both men and women have the liberty of the ground 
at separate hours. Women are at times taken to drive and to walk by 
the attendants. 

Games and other in-door amusements are not provided for either 
men or women or for both in common. 

All who wish to read are allowed to do so. Illustrated and county 
papers are taken and distributed by the keeper. Papers and magazines 
are contributed by the friends of the institution. 

The rooms and wards are not decorated or adorned, and grounds are 
not set apart for decoration or ornamental purposes. There are a few 
plants or shrubs by the rnaiu entrance. 

The insane men are employed in farming, stable work and garden- 
ing, and in shoe, carpenter and other shops. It is stated that vege- 
tables are raised upon the farm sufficient in variety and quantity for 
table use. The women are employed in housework and sewing. Upon 
the day of my visit ten men were able to do a fair day's work atid ten 
a partial day's work. Eight or ten women could do a fair day's work 
and nearly all of the women or twenty-five could do a partial day's 
work. 

It is stated ''the labor of the men cannot be said to be remunerative. 



94 Report on the Chroxic Insane. 

not more than their board, it may save $1,000 ; they work upon the 
farm upon wliich vegetables are raised." The women are said to make 
all of the clothes of both men and women, assist in the housework 
and perhaps save §i500 or 1600 a year. "All the men labor under the 
direction of the keeper or his assistant, the women under that of the 
matron, wiiose supervision prevents their over-work." The authorities 
regard the influence of labor upon the insane as being the most effi- 
cient of all curative measures in operation for their benefit and as one 
that meets their great special need. 

Upon August 24, 1881, fifty insane were resident, of whom twenty- 
eight were men and twenty-two women. 

Eight women who are limited to the halls when in-doors are allowed 
to go into the exercise yard. One man and one woman were confined 
to their rooms. None were in restraint of chairs, seats or muffs. The 
paroxysms of two meu made handcuffs necessary. Since August 24, 
three men who were in restraint have been taken to the asylum at 
Binghamton. 

Except in the basement cells the bedsteads are of iron, upon which 
are well-filled straw ticks or mattresses, sheets, pillow and case, 
blankets, and white or bine plaid cover. In some instances the beds 
placed in the rooms at night are destroyed before morning. 

Acute cases of insanity are removed to State asylums immediately 
after examination. 

Upon August 24, one woman and one man were pay patients at the 
rate of $2.50 per week each, whose treatment was said to be the same 
as that of the other insane. 

Non-residents of Suffolk county are not admitted. 

The county of Suffolk elects three superintendents of the poor, by 
whom the keeper is appointed. 

Visited by Commissioner Carpenter August 24, 1881. 

Wyoming County. 

This county poor-house is located in the town of Orangeville, one 
mile from Varysburg station, on the Tonawanda Valley railroad, and 
half a mile from the small village bearing the same name. The site 
of the building is somewhat elevated, affording good drainage, and the 
district is healthful. 

Officials and employes. — The administration of public relief in this 
county is controlled by a board of three superintendents of the poor. 
The keeper of the poor-house is appointed by the board of sui)erin- 
tendents. He receives 8700 a year and living. He has general charge 
of the establishment, including the insane. A farm hand is employed 
at $20 per month, also a woman at 82.50 per week, who has charge of 
the pauper kitchen and dining-rooms. 

T'he insane department is under the immediate charge of a matron, 
who receives 84 per week, and occupies rooms in the building. She 
has one female assistant who is paid $2 per week and has also rooms 
in the asylum. Both eat at the keeper's table. There is an additional 
attendant, a pauper, said to be "simple-minded, but useful under di- 
rection." The farm hand attends to the men in the keeper's absence, 
and has charge of them when at work, but does not occupy rooms in 
the asylum building. 



Report on the Chronic Insane. 95 

Medical supervision.— The county physician is apjininted by the 
board of superintendents, and is required to visit the poor-house 
twice a week, or oftener if necessary, and to furnish such medicines free 
of charge as are not kept in stock at the county-house. His salary is 
$100 per year. Medicines are dispensed by the matron, according to 
the physician's orders. Neither prescription l)ook nor '' case book " is 
kept. There are no consulting physicians, and it was thought that 
the medical profession evinced no particular interest in the institution. 

General description. — T\\q, department for the insane is a two-story 
frame building, thirty feet by sixty ft-et, standing forty feet west of the 
poor-house. In 1880 it was enlarged to its present size by an addition 
of twenty-four feet. A cellar in which the furnace is located extends 
nnder the whole structure. Here also coal is stored, and in winter 
or rainy weather clothes are hung to dry. A covered porch for each 
story extends the entire width of the buildingat its rear, overlooking 
the yards. 

The first story, occupied by male patients, is entered by an ante- 
room, separated from the ward l)y a partition of vertical iron rods in 
which is a grated door. A hall fourteen feet wide extends through 
the center, into which open twelve rooms, six on each side. Tliese 
rooms vary in size, averaging seven and a half feet square, and to- 
gether with the hall are ceiled throughout with matched boards and 
painted. The window-sashes in the older portion are of wood, pro- 
tected on the inside by a frame of vertical iron rods, secured by a pad- 
lock, while in the new part both upper and lower sashes are secured 
by locks. The doors in the old part are of triple thickness, with 
grated openings in the center ; in the new, they are paneled and have 
transoms, six by thirty-two inches. 

The hall was furnished with a pine table, plain wooden chairs, and 
an arm-chair. The walls were bare. 

The second story, reached by a staircase from the ante-room on the 
first floor, is allotted to the female patients. A broad hall, similar to 
that on the floor below, extends through the center, with rooms on 
each side. At the front end is a sitting-room, with an adjoining sleep- 
ing apartment for the matron. The hall is furnished with cane-seat 
chairs and a long pine table, while hanging-baskets suspend from the 
windows. The floor is bare, as are also the walls, with exception of 
two large oil-portraits, which were left by a former patient. The 
sleeping-rooms on this floor are about the same size as those below. 
They have iron bedsteads and simple furniture. Some were provided 
with cushioned rocking-chairs, a piece of rag-carpet on the floor, and a 
few trinkets. Dresses hung upon the walls and occasionally flowers 
were seen, transplanted in tea-cups or old bottles. One of these rooms 
was remarkably neat, and contained a number of objects illustrating 
the brighter side of home life. The floor was covered with rag-carpet, 
and the walls adorned with cheap pictures in improvised frames, fancy 
slippers containing dried grasses, and a variety of other ornaments. 
Upon a small table with snow-white cotton-spread, lay a variety of 
illustrated papers. Several dolls, neatly dressed, a work-box, a well- 
worn Bible, a copy of the Pilgrim's Progress and a book of sacred 
songs were among the other articles observed here. A cane-seat 
rocking-chair, and a trunk full of clothing gave further hints of com- 
fort. 

13 



96 Report on the Chronic Insane. 

About sixty feet to the right of the insane department is a one- 
story frame structure, twenty-four by thirty-six feet, for the care of 
idiotic females. The sitting-room in front and two small rooms ad- 
joining, are occupied by two pauper attendants. The ward for the 
idiotic is separated from this portion of the building by a grated par- 
tition, witii grated door. A heating-pipe from a cook-stove in the 
sitting-room passes through the ward to a chimney in the farther 
end. It was stated that in winter a large box-stove is substituted for 
the cook-stove. The ward is twenty feet by ten feet, ceiled and painted. 
On each side are small rooms seven by seven and a half feet, and ten 
feet high also ceiled and painted. The windows are grated and 
measure two feet three inches by twelve inches. The doors are of 
triple thickness of boards, with openings seven by fourteen inches. 
They are secured by hasp and padlock. Underneath the doors is a 
space of two inches, and above are transoms six by thirty-six inches. 
A circular aperture, seven inches in diameter, overhead in each room, 
opens into an attic, for ventilation. The rooms are fitted up with 
wooden bunks, and provided with straw-beds and necessary bedding. 

In the rear is a yard sixty-three by ninety-seven feet, inclosed by a 
board fence, nine feet high. In the center is a pavilion with seats. 
The yard is grassed and has graveled walks around the sides. 

The yard for female inmates, of similar size, is inclosed on the south 
and west sides by a tight board fence, and on the north side by a fence 
pailiug nine feet in height. In the center is a pavilion with vines 
growing about it. Flower-beds were also noticed. The walks are 
graveled. 

The yard, for the insane men, ninety-seven by fifty feet, is situated 
between those for the insane women and the idiotic females. A 
tight board fence, nine feet high, incloses it, and a pavilion occupies 
the center. 

Heating and ventilation. — The building is heated by a furnace. Ther- 
mometers are kept in the wards, but no daily record of temperature is 
taken or recorded. 

Dietary. — The food for the insane, cooked in the keeper's family 
kitchen and served in the wards, was described as consisting of beef, 
pork, potatoes, white and brown bread with butter, for breakfast and 
dinner ; bread, corn mush and milk and sauce for supper. Beef soup is 
served twice a week ; pork and beans, once a week ; fried cakes, cookies, 
and pie, once a day; tea and coffee, if desired ; beets, turnips, cabbage, 
carrots, and occasionally tomatoes. In the winter, apples are furnished 
according to the supply. The diet for the sick is regulated by the 
physician. Crockery, pressed tin basins, ordinary knives and forks 
comprise the table ware. The tables are laid without cloths. Wood 
chairs are used for seats. 

Clothing. — The keeper gave the clothing as follows: "The men in 
summer wear check shirt, cottonade pants and vest, denim frock, cot- 
ton socks, boots or shoes. Those not working wear slippers. In win- 
ter, woolen sack coat, lined pants, vest, check shirt, woolen wrapper, 
socks, boots and lined leather mittens. The women, in summer, wear 
a calico dress, cotton underwear, cotton stockings, shoes or slippers, 
and in winter, calico dress, woolen under skirts, cotton flannel wrap- 
pers and drawers, woolen stockings and shoes. It is sought to have 
variety rather than uniformity in dress. Some of the men wear woolen 



Report on the Chronic Insane. 97 

clothing all the year round." The ftttire of the patients appeared 
in good order and cleanly. 

Bedding. — The bedsteads tliroiighout the building are of iron. 
The bedding comprised a tick filled with straw, thin mattress, sheets, 
pillow and case, coverlet, over which is a counterpane for day use 
only. In the winter, it was said, "additional covering is used, as neces- 
sity requires." 

Employment— T\\Q men are employed in general labor upon the 
farm, as hoeing, haying, harvesting, milking, picking up stones, etc., 
but none are permitted to use the teams in plowing. 

The keeper said none of "the men perform a fair day's labor, and 
but five can do a partial day's work. The labor of the men altogether 
would not equal that of one able-bodied man, while that of the women 
is only equal to about one hired servant. The hired man personally 
directs the labor of the men. The poor-house farm comprises two hun- 
dred and eighty acres of rolling table-land lying at the junction of 
Tonawanda and Stony creeks. The women work under the direction 
of the matron, or her assistant. Their work consists principally of 
ironing. If a tendency to overwork is exhibited, it is checked, and 
watch is kept for that purpose. Labor is thought to be highly bene- 
ficial ; the inmates are better when at work than when idlej! if not 
overworked." 

Restraint. — Jfo" special restraint" it was said is used. But one 
woman was secluded in her room at the time of the visit. There were 
in the insane department one crib, one muff, a restraining appliance 
of iron and leather, a chain with ring at each end, and straps to buckle 
around the ankles. The keeper said : " We have three or four pairs 
of handcuffs, which have not been used in a year." He further stated, 
that he directed the restraint, and in case of disobedience, he some- 
times punished the offender by showering him with a hose from the 
water-works. This was used by the keeper alone. His metbod, 
he said, was to " strip the patient bare, and shower him until he gave 
up;" but he said '' This punishment is rarely used." Sometimes the 
muS" is used, as circumstances require. 

Water supply. — The water supply derived from springs consists in 
part of the gravity system, with reservoir of six hundred barrels capac- 
ity, and twenty feet head. The water is carried to the building in 
one and a half-inch iron pipes, and the supply was said to be fully 
adequate. There are also two wells, one six feet from the wash-house, 
and another between the horse and stock barns. Twenty barrels daily 
are required for the use of the institution. Eain water is utilized by 
means of cisterns. The poor-house and insane departments have three 
hundred feet of three-fourth-inch rubber hose, for use in case of fire. 
The elevation of the reservoir being only twenty feet, it is deemed of 
little service for such an emergency. 

Sewerage. — A large sewer extends from the wash-house a distance 
of fifty rods. To this the slops from the kitchen are carried in pails 
and emptied. The contents of the night vessels are utilized upon a 
compost heap. 

General ohservations. — The total number of insane in the poor- 
house at the time of examination was twenty-one ; of these, eleven 
were men and ten women. 



98 Report on the Chroxic Insane. 

A separation of the sexes is maintained. No amusements sepa- 
rately or in common are provided for either sex. 

Tlie clothes of the insane are washed at the wash-house pf the poor- 
house department. 

No bath-tubs nor bathing-rooms are provided. The able-bodied pa- 
tients bathe in tubs at the wash-house ; the others in their rooms. 

Paying patients, residents of the county, are received, paying an 
average rate of §2 per week, according to the ability of the patient, 
or the circumstances of friends. They are treated precisely like the 
other patients, though extras may be furnished, if paid for. 

Paying patients from other counties are taken, who are charged 
$2.50 per week for board, with clothing extra. At the time of our 
visit, there were four paying patients, all men, from this county, and 
three paying patients from Genesee county. The total amount received 
from paying patients during the year ending June 30. 1881, was 
$703. 

The insane are registered in the keeper's office at the poor-house. 
The certificates of insanity are on file in the office. 'The physician 
said: "We have no acute insane." The certificates do not always 
show whether a case is acute or chronic. For the past year the 
county judge has approved the physician's certificates, and sent them 
to the poor-house, instead of elsewhere, as heretofore. Under this 
method it is possible for acute cases to be retained in the insane 
department, contrary to statute. 

In fact, the local visiting committee did report to the Board that a 
case of acute insanity was retained, and that it appeared to be one 
that might be benefited, if transferred to a State asylum. A letter 
of inquiry was at once addressed to the county physician, who was 
ignorant of any infraction of the statute. "Further investigation 
substantiated the fact, that a patient had been admitted to the insane 
department of the poor-house, October 19, 1880; and after remaining 
eleven months, was transferred to the insane asylum at Buffalo, 
August 11, 1881. Injustice to the superintendents of the poor, it 
should be stated that the committal and physician's certificate did 
not set forth whether the case was acute or chronic. 

The local visiting committee of the State Board of Charities visit 
the poor-house occasionally ; they also send papers and periodicals for 
the use of the inmates. 

The visitation was made by Commissioner Letchworth, September 
5, 1881. 

CONCLUSIONS. 

A retrospective glance over the whole examination shows that, with 
few exceptions, the care of the chronic insane in the counties does not 
attain to a just and proper standard. In some counties the deficiency 
is lamentable. It should be kept in mind, however, that many of the 
counties applied to the Board for exemption from the operation of the 
Willard Asylum Act as a temjjoranj measure, intending to provide 
for their chronic insane at the poor-house until such time only as the 
State should receive them under its care. It would, therefore, per- 
haps be unjust to exact as large an expenditure on buildings under 
such circumstances, as would have been proper had permanent pro- 



Report ox the CnRON'ic Insane. ^ 99 

vision been contemplated. It must also be remembered, that at no 
time since the Board was empowered to grant the.se exemptions, has 
the State been able to accommodate the insane of the exempted coun- 
ties in its institutions. The Board, therefore, has not been able to 
present to the county authorities the alternative of adopting such a 
standard of care as it might deem satisfactory, or to order the removal 
of the chronic insane to the State institution. 

Unsatisfactory as are the results of the examination, as a whole, 
your committee would not advocate the suspension or revokement of 
the licenses already granted. To do so would leave the insane of such 
counties in one sense beyond the protection of the Board, and its op- 
portunities for frequent conference and consultation with the local 
authorities would be interrupted. The history of the care of the 
chronic insane will show that, with hardly an exception, there has 
been a steady improvement in every county exempted by the Board. 
The committee would, therefore, recommend that legislative action 
should be sought to enable the Board to remove existing evils, and, till 
that time, to continue its protests and appeals to the local authorities 
to elevate their standard of care for the chronic insane. 

The examination has led the committee to the conclusion that both 
on humane and economic grounds the insane cannot, as a class, be 
treated under a uniform system adapted to sane paupers, and that it is 
desirable to separate them from the poor-house system for the follow- 
ing reasons: 

First. The brief term for which superintendents of the poor are 
elected to oflBce, and the frequent changes occurring in poor-house 
officials and employees. 

Second. The tendency to distribute patronage in the employment 
of officers and attendants, and in the purchase of supplies, as rewards 
for political services and for strengthening partisan influence. 

Tliird. The lowering of a proper standard of care for the insane to 
that suitable for sane paupers would obviously be unjustifiable ; while, 
on the other hand, abnormally raising the standard of the sane to that 
of the insane, would be unnecessarily expensive. 

Fourth. The necessity for special care and treatment of the insane 
directed by medical authority. 

The committee further conclude, that the welfare of the chronic 
insane and the interests of the pul)lic will be promoted, by the adop- 
tion of the following principles as a basis of action, in the future care 
of this class of dependents. 

First. The enlargement of State provision by means of plain, 
inexpensive buildings, with good sanitary surroundings and located 
upon tracts of good arable land should be sufficient for the accommo- 
dation of all counties desiring to place their chronic insane under State 
care. 

Second. That the chronic insane should not be retained by coun- 
ties in groups numbering less than two hundred and fifty (250), 
thereby admitting of better classification, a better systemization of 
labor with industrial employment adapted to winter as well as sum- 
mer, resulting in larger products, also, securing an economic ad- 
vantage, by inviting competition in the purchase of supplies in large 
quantities, together with the greater per capita saving, always attain 
able in providing for a considerable number instead ol for a few. 



100 Report on the Chronic Insane. 

Third. That counties having a smaller number of chronic insane, 
desiring to provide other tluin State care, should be permitted to unite 
and form a district asylum. 

Fourth. That the control and management of all county and dis- 
trict asylums sliould be placed under a smull board of uncompensated 
managers, either elected by the peojjle and non-partisan, or, appointed 
by a full bench of one of the branches of the judiciary, or, appointed 
by the Governor — in any case the term of oHice to be long; the 
asylums so controlled and directed to be subject to the same rules and 
regulations as the State institutions for the chronic insane. 

Fifth. That in all cases the chronic insane should be placed under 
the immediate charge of a resident medical superintendent, having 
the api)ointment and entire control of the subordinate force. 

Sixth. That violent and disturbed cases should be provided for in 
appropriate State asylums, having special provision for their care, 
their presence in county institutions interrupting orderly administra- 
tion, and defeating the ends of economy. 

Seventh. That all county asylums should not only have a separate 
board of management from the poor-house establisliment, but that their 
financial system should also be separate, and that all asylum buildings 
hereafter erected should be elscwliere located than upon the poor-house 
farm. 

Respectfully submitted, 

WM. P. LETCHWORTH, 
SARAH M. CARPENTER, 
CoDwiittee. 

Albany, Decemler 5, 1881. 



SUPPLEMENT TO REPORT ON THE CHRONIC INSANE 
IN COUNTIES EXEMPTED FROM THE WILLARD ASYLUM 
ACT. 

Form of ''Medical History" of Insane Patients Prepared for 
THE Chautauqua County Poor-house. 

By Charles T. Wilson, M. D. County Physician. 

Medical History of 

Date, Age, Color, Born in 

Residence, . . . Occupation, Married . ... No. of Children,. . . 

Date of last confinement. ..Height. .Weight. ..Color of Hair. ..Eyes. . 

Date of Commitment, By whom 

Drs and 

History Antecedent To Present Disease. 

General Health, Hereditary Predisposition, 

Previous Disease Injuries, 

Habits Mode of Life 

Hygienic Influences to which exposed 



Report on the Chronic Insane. 101 



History of Present Disease. 

Supposed Exciting Cause 

Date of Seizure 

Mode of Invasion 

Subsequent Symptoms in order of occurreuce 



Previous Treatment. 



Present Condition — General Symptoms. 

) Out of Bed 

Position, >■ 

) In Bed 

) Of Countenance 

Aspect. >■ 

) Of Body 

Skin Pulse 

Tongue 

Respirations 

^ Appetite 

General State of )■ Thirst 

Digestion J Bowels 

General State Urinary Secretion 

Sensations of Patient 

Examinations of Special Regions or Functions, commencing with one 
presumably most affected 

Diagnosis, 
treatment. 

Remarks — [''These should include previous history of friends re- 
ferring to tendency of patients."] 

Rules and Regulations of the "Erie County Insane Asylum" 
FOR Attendants and Assistants. Their Duty to the Insti- 
tution. 

1. All persons employed in the asylum are expected to do all they 
can to promote the welfare of the insLitution : treat the officers on all 
occasions with respect and politeness, and do readily and cheerfully 
any duty required of them. 

2. All must expect an unceasing observation of the manner of per- 
forming their duties; and suggestions, by an officer, of deficiencies or 
improvement therein are to be taken kindly and without offense, and 
efforts made to improve. 

3. In the first place self-respect is enjoined on all. Each one shall 
be responsible in his or her department and should be ambitious to do 
the duties of it to entire acceptance. Let your dress always be neat 
and clean. 

4. Avoid all ungentlemanly habits, such as wearing hats within 
doors, going in shirt slevees, etc. Never indulge in loud talking or 
laughing ; use no profane, obscene or vulgar language. Treat each 
other with politeness ; be civil, cordial and frank. Cherish a high 



102 Report os the Chronic Insai^e. 

sense of moral obligations ; cultivate a humble, self-denying spirit ; seek 
to be useful and maintain at all hazards your purity, truth, sobriety, 
economy, faithfulness and honesty. Patients look to attendants for 
good example ; let the attendants be careful in nothing to set a bad 
one. 

5. The attendants are to treat the inmates with respect and atten- 
tion ; greet them cheerfully with "good morning, " or " good evening," 
and show tliem such other mark of good-will and kindness as evince 
interest and sympathy. Under all circumstances be kind and consid- 
erate ;'speak in a mild and persuasive tone of voice; never address a 
patient rudely. A patient is ever to be soothed and calmed when 
irritated; encouraged and cheered when melancholy or depressed. 
They must never be pushed, collared or rudely handled. 

6. If the attendant receives insults and abusive language, he must 
keep cool, forbear to recriminate, to scold or dictate in the language 
of authority. Violent hands are never to be laid on a patient, under 
any provocation. A blow is never to be returned, nor any other insult. 
Sufficient force to prevent patients injuring themselves, or others, is 
always to be applied gently ; all struggling with patients should, if 
possible, be avoided, by calling additional assistance, when a patient is 
highly excited or disposed to violate, before entering his room or at 
tempting to dress or control him. 

7. On rising in the morning it is the duty of attendants to see that 
each patient confided to his or her care is thoroughly washed, hair 
combed, clothes cleaned, and in fact that the whole dress be neat and in 
good repair. The patients' beds are then to be made, and the wards, 
bathing-rooms, closets, passages and stairs to be swejot, and the whole 
premises to be put in complete order, as soon as it can be done. No 
part of the asylum shall be considered clean if it can be made cleaner. 

8. One attendant must always be in each ward with the patients, 
and must not leave under any circumstance until relieved. The at- 
tendants must not retire to tlieir rooms while the patients are in their 
wards, only long enough to adjust their own dress. All the hours, 
with this sole exception, should be devoted to the patients to keep 
them tidy and comfortable, to prevent improper conduct, such as 
lying on the floor or ground ; to interest and amuse them by reading or 
talking to them and the like. They are responsible for the safe-keep- 
ing of the patients, and must not leave them except in care of some 
responsible person. 

9. Visitors will not be admitted on Sundays or legal holidays. The 
keeper, or such persons as he will designate, will show visitors through 
the asylum. Under no circumstances will the attendants be allowed 
to receive or entertain company in the asylum, except in the adminis- 
tration building. Male attendants will not enter the female depart- 
ment, except on duty, or with permission from the keeper, or physi- 
cian. Persons wisliing to see patients, or learn their condition, will in- 
quire for the keeper, physician or matron, and information concerning 
patients will not bo given except to relatives or family friends and pub- 
lic officers, and such information will be given only by the keeper or 
physician. 

10. The physician will tend to the patients that are in the hospital, 
and he will also visit the wards twice each day, and oftener if neces- 
sary. The attendants will each day report to him all manners of 



Report on the Chronic Insane. 103 

restraint and name of each person so restrained. They will notice the 
habits and conduct of patients, and inform the physician, at his dailv 
visits, of all circumstances requiring attention, such as loss of appetite", 
or any indisposition, etc., etc., 

11. At meals the attendants must always be present to see that every 
one has a proper supply. They must see that no patient carries away 
a knife, fork or any other article from the table. An attendant must 
never place in the hands of a patient, or leave where a patient can get, 
any penknife, rope, cord, razor, medicine, matches, or any dangerous 
weapon, or article. A constant watch of patients is to be kept in 
these respects. An attendant must never deliver a letter from or to a 
patient without permission from the keeper, nor ever to retain in his 
or her possession, without permission, any writing of a patient. 

12. No attendant or employee of the asylum must absent themselves 
without permission from the keeper, or his assistant. Application 
for leave of absence should be made several hours before leaving ; if 
such permission be granted, they must leave their keys in the office 
until their return. This rule applies to all employees in the asylum. 

13. The engineer shall have charge of the boiler-house, boilers, and 
general charge and oversight of all machinery in the wash-house and 
ironing room, the apparatus for extinguishing fires, for warming and 
ventilation, of pipe-fittings, sewers ana water supply. He shall also 
be subject to the same rules as other attendants and' employees. 

14. It shall be the duties of the cooks, of both keeper's and inmates' 
kitchen, to see to the safe-keeping and economical use of all the sup- 
plies furnished them, that the food is well cooked and nothing wasted. 
They shall take no victuals into the wards or other places in the asy- 
lum, or allow to be taken, unless so ordered by superintendent, matron 
or physician. They must see that their kitchen, store-room, cellar, 
pantry, and such other places which are under their charge, are kept 
clean. They are subject to the same rules as other attendants or em- 
ployees, and shall obey orders, which may be given to them from time 
to time, by the keeper, matron or physician. 

15. It shall be the duty of the attendant that has charge of the wash- 
house to see that all the clothes are properly washed, ironed and sent 
to the store-room. Those that need mending to be sent to the sewing- 
room, and see that no inmate escape while under his or her charge ; 
and is subject to the same rules as other attendants or employees. 

EuLEs AND Regulations of the " Oneida County Insane Asylum," 

No. 1. The morning bell shall be rung at five o'clock. Breakfast 
will be served at six o'clock, dinner twelve m. , tea at six p. m., the year 
round. 

No. 2. The asylum is to be closed at ten o'clock every night, at 
which time the attendants and assistants must all retire to their apart- 
ments. 

No. 3 . Sunday the buildings and grounds are not to be exhibited 
to visitors; nor shall any visitor be admitted into the wards or rooms 
of patients or attendants, except in cases of serious illness and by 
special permission of the superintendent. 

No. 4. The person or persons directed to accompany visitors through 
the wards will not be permitted to point out or mention the names or 
14 



104 Beport on the Chronic Insane. 

peculiarities or conduct of patients. The history, conduct and con- 
versation ot patients must never be spoken of to visitors, nor reported 
by attendants when abroad. 

No. 5. An attendant or assistant must not receive a present or 
gratuity from any patient in the asylum or the friend of a patient, or 
a visitor ; or sell to or buy any thing from a patient, or receive any per- 
quisite of any kind whatever. 

No. 6. The whole time of attendants and assistants belongs to the 
asylum. This does not prohibit each one from attending to his or 
her own clothing. 

No. 7. No company shall be admitted into the rooms or wards oc- 
cupied by tiic patients at any time, except by the express permission 
of the superintendent or matron. All persons employed by the insti- 
tution are expected to show marked respect and attention to strangers 
and visitors. 

No. 8. The attendants and assistants must never leave the asylum 
without permission of the superintendent or matron. Attendants 
when thus leaving must deposit the keys of the ward in the ofiBce as 
directed, until their return. 

No. 9. Attendants will notice the habits and conduct of patients, 
and inform the physician at his daily visit of all circumstances re- 
quiring attention ; such as loss of appetite or any indisposition. 

No. 10. Food is not to be carried to the rooms of patients ; nor is 
any one to be absent from the regular meals, excepting in cases of 
sickness or high excitement, without permission. 

No. 11. The attendants shall never apply any restraining apparatus 
without giving immediate notice to superintendent or matron. 

No. 12. An attendant must never place in the hands of a patient, 
or leave where a patient can get, any razor, penknife, rope, cord, 
medicines, matches, or any dangerous wea])on or article. A constant 
watch of patients is to be kept in these respects, their beds frequently 
searched for such articles, and the knives and forks counted after each 
meal. An attendant must never deliver any letter or writing from or 
to a patient without permission of the superintendent; nor ever retain 
in his or her possession, without such permission any writing of a 
patient. 

No. 13. One attendant must always be on the seventh and ninth 
wards with the patients, and must not leave under any circumstances 
until relieved. 

No. 14. The dress of attendants should always be neat and clean. 
Never indulge in loud talking or laughing; use no profane, obscene or 
vulgar language. Never play at any games with one another nor with 
patients. 

No. 15. If the attendant receives insult and abusive language, he 
must keep cool and not scold or threaten. Violent hands are never 
to be laid on a patient under any provocation. A blow is never to be 
returned, nor any other insults. Sufficient force to prevent the patient 
injuring himself or others is always to be applied gently, and all 
struggling with a patient should, if possible, be avoided by calling ad- 
ditional assistance. 

No. 16. Male attendants and employees are not allowed to visit the 
women's wards except on order of superintendent or matron. 

No. 17. The night watchman shall visit all the wards every hour 



Kepokt on the Chronic Insane. 105 

and report any sick or noisy patients to the ward attendant. It shall 
be his duty to report any violation of the rules, during the night, to 
the superintendent. 

Dietary at the Orange County Insane Asylum from Novem- 
ber 1 TO March 1. 

Monday. 

Breakfast : Bread and butter, tea and coffee, oat meal. 
Dinner : Bread and meat, rice pudding and tea, raw onions. 
Supper : Mush and milk. 

Tuesday. 

Breakfast : Bread and butter, tea and coffee, apple sauce. 

Dinner : Pork and baked beans, boiled mush or rice, bread and tea. 

Supper : Eice and milk, molasses cake. 

Wednesday. 

Breakfast : Bread and butter, tea and coffee, oat meal. 
Dinner : Hash meat, bread, boiled onions, pickled beets, tea. 
Supjier : Bread and milk. 

TJiursday. 

Breakfast: Bread and butter, tea and coffee, apple sauce. 
Dinner: Pork or beef stew, tea and boiled rice, bread. 
Supper : Mush and milk, ginger snaps. 

Friday. 

Breakfast : Bread and butter, tea and coffee, oat meal. 
Dinner: Fish, potatoes, rice pudding, bread and tea. 
Supper : Kice and milk. 

Saturday. 

Breakfast : Bread and butter, tea and coffee, apple sauce. 
Dinner : Fresh beef soup, bread and tea, raw onions. 
Supper : Mush and milk, cake. 

Stmday. 

Breakfast : Bread and butter, tea and coffee, oat meal. 
Dinner : Cold meat, molasses cake, apple sauce, tea and bread. 
Supper : Bread and milk. 

Dietary at the Queens County Insane Asylum. 

Sunday. 

Breakfast : Coffee, three-eighths of an ounce ; chicory, three-sixty- 
fourths ounce; condensed milk, one-half ounce; sugar, one-half 
ounce ; water, one pint; mush, two ounces; molasses, one ounce; 
bread — butter, one-half ounce. 



106 Report on the Chronic Insane4 

Dinner : Pea soup, one pint ; peas, one and one-half ounces ; beef, 
slightly corned, twelve ounces: potatoes, eight ounces; vegetables, 
four ounces; rice pudding, rice, two ounces ; milk, eight ounces; 
sugar, one ounce. 

Supper : Tea, one-eighth ounce ; condensed milk, one-half ounce ; 
sugar, one-half ounce, domestic cake, one ounce; bread — butter, one- 
half ounce. 

Monday. 

Breakfast : Coffee, one pint ; hash, beef, two ounces ; potatoes 
four ounces; bread — butter, one-half ounce. 

Dinner: Irish stew, beef, twelve ounces; potatoes, eight ounces 
vegetables, four ounces. 

Supper: Tea, one pint; dried fruit, stewed, one ounce ; or, apple 
butter, two ounces; bread — butter, one-half ounce. 

TiLesday. 

Breakfast: Coffee, one pint; hominy, two ounces; milk, eight 
ounces; bread — butter, one-half ounce. 

Dinner: Meat pie, beef, twelve ounces; potatoes, eight ounces; 
vegetables, four ounces. 

Supper: Tea, one pint; cheese, one ounce; brown bread; butter, 
one-half ounce. 

Wednesday. 

Breakfast : Coffee, one pint; wheaten grits, two ounces ; molasses, 
one ounce; bread — butter, one-half ounce. 

Dinner: Vegetable soup, one pint; roast beef, twelve ounces; pota- 
toes, eight ounces; vegetables, four ounces. 

Supper: Tea, one pint; pickles, one ounce; bread — butter, one- 
half ounce. 

Thursday. 

Breakfiist : Coffee, one pint ; hash, beef, two ounces ; potatoes, four 
ounces ; bread — butter, one-half ounce. 

Dinner: Mutton stew, mutton, twelve ounces; potatoes, eight 
ounces ; vegetables, four ounces. 

Supper: Tea, one pint; head cheese, one ounce; brown bread; 
butter, one-half ounce. 

Friday. 

Breakfast: Coffee, one pint ; mush, two ounces ; syrup, one ounce ; 
bread — butter, one-half ounce. 

Dinner: Salt codfish; five ounces; potatoes, eight ounces; vege- 
tables, four ounces ; bread pudding, four ounces : hard sauce, butter, 
one-half ounce ; sugar, one-half ounce. 

Supper: Tea, one pint; molasses cake, one (unce; bread — butter, 
one- half ounce. 



Report on the Chrokic Insane. 107 

Saturday. 

Breakfast : Coffee, one pint : rice, two ounces ; milk, eiglit ounces ; 
bread — butter, one-half ounce. 

Dinner: Beef soup, one pint; roast beef, twelve ounces; potatoes 
eight ounces ; vegetables, four ounces. 

Supper: Tea, one pint; dried fruit, stewed, one ounce; or, apple 
butter, two ounces; bread — butter, one-half ounce. 

Sunday. 

Breakfast : Coffee, one pint ; oatmeal, two ounces ; molasses, one 
ounce ; bread — butter, one-half ounce. 

Dinner : Bean soup, beans, one ounce ; beef, slightly corned, twelve 
ounces; potatoes, eight ounces; vegetables, four ounces. 

Supper : Tea, one pint; smoked iish, one ounce; rye bread; butter 
one-half ounce. 

Monday. 

Breakfast : Coffee, one pint ; hash, beef, two ounces ; potatoes, four 
ounces; bread — butter, one-half ounce. 

Dinner : Roast mutton, twelve ounces ; potatoes, eight ounces ; 
vegetables, four ounces. 

Supper : Tea, one pint; domestic cake, one ounce ; bread — butter, 
one-half ounce. 

Tuesday. 

Breakfast: Coffee, one pint; mush, two ounces; milk, eight ounces; 
bread — butter, one-half ounce. 

Dinner: Beef stew, beef, twelve ounces; potatoes, eight ounces; 
vegetables, four ounces. 

Supper ; Tea, one pint ; cheese one ounce ; brown bread ; butter, 
one-half ounce. 

Wednesday. 

Breakfast: Coffee, one pint; hash, beef, two ounces; potatoes, four 
ounces ; bread — batter, one-half ounce. 

Dinner: Barley soup, barley, one ounce; baked pork, four ounces; 
beans, three ounces ; beets, pickled, four ounces ; vegetables, four 
ounces ; hominy, two ounces; molasses, one-half ounce. 

Supper: Tea, one pint; pickles, one ounce; bread — butter, one- 
half ounce. 

Thursday. 

Breakfast: Coffee, one pint; rice, two ounces; sugar sauce, sugar, 
one-half ounce; bread — butter, one-half ounce. 

Dinner : Macaroni soup, macaroni, one-eighth ounce ; roast beef, 
twelve ounces ; potatoes, eight ounces ; vegetables, four ounces. 

Supper : Tea, one pint; dried fruit, stewed, one ounce; or, apple 
butter, two ounces ; brown bread ; butter, one-half ounce. 



108 Report on the Chronic Insane. 

Friday. 

Breakfast: Coffee, one pint; hominy, two ounces; syrup, one 
ounce; bread — butter, one-half ounce. 

Dinner: Fresh fish, eight ounces; potatoes, eight ounces; vege- 
tables, four ounces; bread pudding, four ounces; hard sauce, butter, 
one-half ounce ; sugar, one-half ounce. 

Supper: Tea, one pint; molasses cake, one ounce ; bread — butter, 
oue-half ounce. 

Sat^irday. 

Breakfast: Coffee, one pint; oatmeal, two ounces; milk, eight 
ounces; bread — butter, one-half ounce. 

Dinner : Mutton pot pie, mutton, twelve ounces; potatoes, eight 
ounces ; vegetables, four ounces. 

Supper: Tea, one pint; head cheese, one ounce; rye bread ; butter, 
one-half ounce. 

First. Bread is allowed ad libitum. Second. The bone is included 
in the meat ration of twelve ounces. Third. Cabbage, carrots, pars- 
nips, leeks, onions, tomatoes, beets, etc., are furnished as vegetables. 
Fourth. Diet for the sick : milk, beef, tea, eggs, cocoa, sago, farina, 
rice, chickens and oysters are furnished for the sick on the order of 
the medical superintendent. Fifth. Sauce for the fish ; flour, fifteen 
pounds; condensed milk, three quarts; butter, six pounds (this 
quantity is for one thousand persons). The dietary scale covers a 
period of two weeks for the purpose of affording greater variety than 
a weekly scale. 



/ 



r'r*»-^»'^'^