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In 1836, a raving maniac was conveyed to the State Hospital; he refused to be clothed, committed every sort of extravagance, and months passed before he was sufficiently composed to address himself to any useful employment. Gradually, however, he resorted to the carpenter's shop, amused himself with the tools, but finally applied to useful work, and, with few intervals, has since been able to accomplish a large amount of productive labor.

Another patient, who was confined nearly four years in a county prison, had several violent paroxysms: his mind is never entirely free from delusions: he speaks of his excitements -- knows he is insane, and unsafe to be at large: is now ordinarily quiet, pleasant, and good-tempered. He is an ingenious mechanic; makes correct observations on common things, but exhibits strange fancies and delusions upon all spiritual concerns. He labors diligently and profitably most of the time.

I do not recollect a more satisfactory illustration of hospital care upon large numbers of incurable patients, brought under improving influences at one and the same time, than is afforded in the first opening of the hospital for the insane poor at South Boston. Prior to 1839, the insane poor of Suffolk county were confined in a receptacle in rear of the almshouse; or rather all those of this class who were furiously mad, and considered dangerous to be abroad upon the farm grounds. This receptacle revealed scenes of horror and utter abomination such as language is powerless to represent. These wretched creatures, both men and women, exhibited cases of long standing, regarded past recovery, their malady being confirmed by the grossest mismanagement.

The citizens were at length roused to a sense of the enormity and extent of these abuses, matched only, it is believed, (except in individual cases,) by the vile condition of the English private madhouses, as thrown open to the inspection of parliamentary commissioners, within the last thirty years. The monstrous injustice and cruelty of herding these maniacs in a hall filled with cages, behind the bars of which, all loaithsome and offensive, they howled, and gibbered, and shrieked, and moaned, day and night, like infuriated wild beasts, moved the kindling sensibilities of those heretofore ignorant or indifferent. The most sanguine friends of the hospital plan expected no more for these wretched beings than to procure for them greater decency and comfort; recovery of the mental faculties, for such as these, was not anticipated.

The new buildings were completed, opened, and a system of discipline adopted by Dr. Butler, the results of which I witnessed with profound interest and surprise. The insane were removed, disencumbered of their chains, freed from the remnants of foul garments, bathed, clothed, fed decently, and placed by kind nurses in comfortable apartments. Remedial means, medical and moral, were judiciously applied. Behold the result of a few months' care, in their recovered physical health, order, general quiet, and well-directed employments. Now, and since, visit the hospital when you may, at neither set time nor season, you will find this class of incurable patients exercising in companies or singly, reading the papers of the day, or books loaned from the library; some busy in the vegetable, some in the flower gardens, while some are found occupied in the washing and ironing-rooms, in the kitchen and in the sewing-rooms. Less than one-sixth of those who were removed from the almshouse recovered their reason; but, with the exception of three or four individuals, they regained the decent habits of respectable life, and a capacity to be useful, to labor, and to enjoy occupation.

No hospital in the United States but affords abundant evidence of the capacity of the insane to work under direction of suitable attendants, and of recovery from utter helplessness to a considerable degree of activity and capacity for various employments.

I have seen the patient attendants, in many institutions, persevere day by day in endeavors to rouse, and interest, and instruct the demented in healthful occupations; and these efforts after a time have found reward in the gradual improvement of the objects of their care, and their acquisition of power to attend to stated healthful labors.

While the interests of humanity, those first great obligations, are consulted by the establishment of well regulated hospitals for the insane, political economy and the public safety are not less insured. The following tables exhibit the advantage of largely extended and seasonable hospital care for the insane. I am indebted chiefly to the reports of Drs. Woodward and Awl for these carefully prepared records.

TABLE

Showing the comparative expense of supporting old and recent cases of insanity, from which we learn the economy of placing patients in institutions in the early periods of the disease; from the report of the Massachusetts State Hospital, for 1843. By Dr.Woodward.