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Report Of Commissioners Appointed To Superintend Erection Of A Lunatic Hospital At Worcester

From: Reports And Other Documents Relating To The State Lunatic Hospital At Worcester, Mass.
Creator:  Horace Mann, Bezaleel Taft, Jr., and W.B. Calhoun (authors)
Date: January 4, 1832
Publisher: Dutton and Wentworth, Boston
Source: Available at selected libraries

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It is believed that no further exposition can be necessary to demonstrate the entire unfitness of our jails and houses of correction, as receptacles for the insane. When the Hospital at Worcester shall be completed, all pretence for the necessity, and with it all excuse for the practice, of confining town-pauper lunatics with condemned criminals, will be removed. Such confinement has, in many instances, been effected by private contract between the towns and the keepers, when, for the purpose of saving a few shillings in the support of a lunatic, he has been subjected to the most aggravated sufferings. It is but a short time since, in a neighboring county, a lunatic placed in a house of correction by the overseers of the poor of the town to which he belonged, was so frozen that he died. To prevent renewed instances of this cruel economy, it is suggested, that keepers of jails and houses of correction should be prohibited, under a penalty, from making private contracts for the custody and support of lunatics within the county buildings, without the consent and approbation of the mayor and aldermen of the city of Boston, or of the county commissioners of the respective counties.


As to the other two classes of lunatics, namely, town paupers, and those individuals of whose existence and condition the laws take no special cognizance, the Commissioners take the liberty to suggest, that the Commonwealth ought not, at least for the present, to do any thing more than to proffer them, as far as possible, the benefits of the institution. Over neither of these classes can the State assume an immediate and mandatory control, without a direct, and in some instances a harsh interference with the privileges and supposed rights of corporations or individuals. As to town-pauper lunatics, it is true that their condition, as they are now frequently treated, is one of severe privation and wretchedness; and much, it is foreseen, may be urged in favor of compulsory provisions, having for their object the more humane treatment of this unfortunate portion of our fellow beings. But on the other hand, it should not be forgotten, that hitherto the institution at Charlestown has been the only one of a public character in the State, where the insane have been received and treated according to the principles of mental and medical science; that that institution, although it has been recently enlarged, is still insufficient to accommodate one fourth part of the lunatics in the State, and that the habits of towns were fixed long prior to its existence. Hence, it may be confidently expected, that the course pursued by towns under past circumstances, will prove no indication of their future practice.


But even upon the inadmissible supposition that the inhabitants of our towns could be inaccessible to motives of humanity, still, motives of economy must be decisive in persuading them to place their insane poor within the action of causes, so frequently efficacious in restoring an alienated mind. It seems now to be believed that, if the organ of the brain be not injured, the mind, in every case of alienation, is reclaimable, if suitable means are resorted to on the first access of the disease. But if recovery is expected, assistance must be promptly afforded, for the chances of restoration rapidly diminish with the continuance of neglect. An inconsiderable sum promptly and judiciously expended, will achieve what no amount of labor or cost will be likely to accomplish, after a delay of three or four years. Pecuniary interest, then, becomes the auxiliary of duty; and economy and humanity, for these purposes, are convertible terms.


For many years past, the actual expense of supporting the insane population of the State cannot have been less, on an average, than forty thousand dollars annually. This subject, therefore, assumes an importance as a matter of finance, if not as one of justice, of charity, and of duty.


Some mode, of course, is to be provided by which the expense of supporting the inmates of the institution is to be defrayed. In respect to the expenses incurred by those committed to the Hospital, by virtue of the statutes of 1797, chap. 62, and 1816, chap. 28, as modified by provisions herein previously recommended, no sufficient reason is discovered for any innovation upon former practice. The Board of Visitors ought, therefore, to be invested with the same powers, which the keepers of houses of correction now by law possess against delinquent towns or individuals. As to town-pauper lunatics, and those persons who, by the voluntary agency of their friends, may enjoy the benefits of the institution, it is recommended, that they should be kept for a sum, in no case exceeding the actual expense incurred in their support, without reference to the original outlay of capital. And, perhaps the Visitors should be authorized in their discretion to receive, for a sum something less than the actual cost, patients who have been recently attacked, as a bounty upon humane efforts for their prompt relief. This is a charitable institution, and was especially designed for the necessities of the poorer classes of people. Hitherto no place has existed within the State, where persons possessing something less than an average of property, could, according to commonly received notions of ability to bear expense, afford to send the members of their families, or their friends, when attacked by this malady. The main object of the Legislature in establishing this institution, it is believed, was to supply that deficiency. It was a necessary part of the great circle of duties to be fulfilled by a government constituted for the benefit of the people. Gratuitous education, universally diffused; laws repressing licentiousness, and encouraging industry by securing to every man his honest gains, may be primary duties in the order of performance. But, though secondary in time, it is a duty no less sacred in obligation, to furnish all needful succor to those, whose position has been so assigned them in the great machine of the universe, that they suffer without fault or offence of their own.

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