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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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The second consideration, connected with the discipline of the institution, respects the regulations by which the insane shall be governed whilst at the Hospital, and the visitatorial power, under which all such regulations shall be administered.


The officers of the institution should be so arranged and of such a number, as to insure the greatest efficacy and economy in the management of its concerns, and a proper responsibility to the public, who are its patrons. A great proportion of the economical regulations of the Hospital must necessarily be of such a nature as cannot properly be reached by enactments of the Legislature, not falling within the usual range of legislation. The same remark may be made of the appointment of nearly all the subordinate officers, and the selection of the domestics of the establishment. The power to frame by-laws, and to appoint the officers referred to, must therefore be placed in the hands of a Board of Visitors, whose duty it shall be to take charge of the general interests of the institution, and to see that its affairs are conducted according to the requirements of the Legislature -- the regulations of its internal police -- and the true intent and object of the institution itself.


The appointment of such a board should obviously proceed from the government. The duties of the Visitors cannot be burdensome, after all the necessary regulations of the institution shall have been made, and the subordinate officers shall have been appointed. To mature and establish such regulations, and to make the necessary appointments, will require much time, careful inquiry, and judicious selection.


The Board of Visitors should be so constituted, as to secure a wholesome responsibility to the public, and at the same time admit of a suitable division of the labor of visitation. To secure these objects, the Commissioners recommend, that provision be made for the appointment, by the Governor and Council, of five Visitors -- a portion of the board to be appointed annually, if the Legislature shall deem it expedient -- that the Visitors thus appointed shall be required to establish, as soon as practicable, all the necessary by-laws and regulations for the government of the institution in all its departments, and to appoint or provide for the appointment of all necessary subordinate officers.


The most important appointment to be made by the Visitors will be that of the Principal or Superintendent. After much consideration, the Commissioners recommend, that the Superintendent be a physician, resident at the Hospital, devoting to its interests all his skill and energies. There is abundant reason to believe, that the apartments of the Hospital will, at all times, be fully occupied by the insane. The care of one hundred and twenty such persons will, therefore, reasonably demand his constant attention and advice. Essential injury might accrue from an occasional absence of the physician; such injury certainly would accrue, if the inmates should be dependent upon one, whose private practice should call him abroad for any considerable portion of his time. The requirement of residence at the Hospital would not, however, preclude the Superintendent from consultations, which might be solicited by his professional brethren.


Periodical and thorough visitations of the Hospital will evidently be indispensable to its success, and to its good name in the community. They should be made as often as once in six weeks by one or more of the Visitors; semi-annually by a majority of them, and annually by the whole board. At each visitation a written account should be drawn up of the state of the institution; and at the annual visitation, which should be a short time before the sitting of the Legislature, a detailed report should be made, to be laid before the Governor and Council, for the use of the government, setting forth very particularly a view of its situation and of all its concerns.


The duty of visitation, as already intimated, will not probably be at all burdensome, after the institution shall have gone into operation. The Visitors will undoubtedly feel themselves amply compensated for their services in the opportunity afforded them to aid the cause of humanity, by a manifestation of the noblest sympathies of the heart. No provision, therefore, need be made for defraying any but the actual expenses of the visitation.


Previously, however, to the complete organization of the establishment, so much of the time of the board will necessarily be occupied, and very laboriously too, that justice would require, that provision be made for compensating them suitably for their services up to that period.


The charge of the treasury of the institution will be an important matter; and the power of appointing the treasurer may, in the opinion of the Commissioners, safely be lodged in the hands of the Board of Visitors, leaving it optional with them to select one of their own number, or some other suitable person, who shall give bonds in such sum as the board shall deem proper. The duties of this office will necessarily demand of the incumbent the devotion of much time and attention; he should, therefore, receive an adequate compensation for his services, to be determined by the Legislature.

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