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First Report Of The Superintendent Of The Lunatic Hospital At Worcester, Mass.

From: Reports And Other Documents Relating To The State Lunatic Hospital At Worcester, Mass.
Creator: Samuel B. Worcester (author)
Date: November 30, 1833
Publisher: Dutton and Wentworth, Boston
Source: Available at selected libraries

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In this institution, it is conceived that no such trial has been had, and no such opportunity has been afforded. We have witnessed with sincere gratification the effect of the kindness and indulgence, moral discipline, and medical treatment, in calming the ravings of the violent -- in soothing the agitated passions of the furious -- in awakening the hopes, and removing the despondency of the melancholic -- as well as in establishing habits of order, cleanliness, and civility, in those whose minds are still warped by all the delusions of insanity. In many we have witnessed the embers of apparently expiring reason rekindle, and these delusions vanish by slow and almost imperceptible movements, till the intellect emerged from its cloud, and the light of reason was restored to the mind. With respect to fatality, it is to be expected that it will be greater in this Hospital, than in most institutions of the kind, having no power to reject any individual, however forlorn the case, if sent by the courts; it will be liable to have those, whose bodily powers cannot long be sustained under the weight of mental and physical disease which for years may have been preying upon their energies. Four deaths only have occurred; two of the subjects were over 80 years of age -- one died in sixteen days after he entered the Hospital, having contracted the disease on his way hither from his solitary abode of thirty years, which so soon terminated his existence -- the other was in a state of most hopeless dementia, came into the Hospital feeble and decrepit, after a residence of twenty-eight years in one prison. The other two were middle aged -- one died of marasmus, the other of dysentery. The inmates have been remarkably exempt from acute disease. During the summer, bowel complaints were common for a season, but they were usually mild, and managed without difficulty. The deaths in the Hartford Retreat, average 1 of 24 1-2; in Bloomingdale, 1 of 17 1-2; Pennsylvania Hospital, 1 of 6 1-2; Glasgow Asylum, 1 of 10; Wakefield, 1 of 4; Lancaster, 1 of 4; York, 1 of 5; Cork, 1 of 3.


A large proportion of the patients now in this institution have heretofore been in a state of extreme wretchedness. The jails, penitentiaries and alms-houses have been their miserable abodes; -- from thence they have been transmitted to the Hospital. If by the means here adopted they are restored to their reason, what is their prospect for the future? That world only is before them in which they have suffered every indignity, every privation and cruelty. As they go away, if they fail to receive the protection and aid of friends, they will hardly fail to fall into the same unhappy condition, and again relapse into insanity. To this they will be more liable than patients in easy circumstances in life.


The Hospital building is found upon trial to be well adapted to the purpose for which it was designed. The arrangement combines the advantages of simplicity and convenience, and affords to its inmates a safe and comfortable retreat. It is unfortunate for the institution, that the excess of males over females, makes it necessary to occupy four of the galleries with men, leaving two only for females. This does not afford for the latter sufficient classification; in consequence of which furious and noisy patients are, from necessity, inmates of the same hall or gallery, with the quiet and convalescing. A separate dwelling for convalescents, and a quiet and orderly class of patients, is extremely desirable. They would then avoid all those disagreeable scenes, and be out of the noise and the confusion which they now witness, and from which they constantly suffer. This would be a most important auxiliary in the cure of insanity. Something answering with this purpose, is connected with every other Hospital in the country. The centre building, if not occupied by those who had the immediate management of the Hospital, might be in part appropriated to this purpose; with the present arrangement this cannot be. In addition to this important object, such a building would add to the accommodations which the present crowded state of the Hospital very greatly require. Doctor Spurzheim, than whom, no man has attended more carefully to the intellectual operations of man, both in health and disease, speaking of Hospitals for the cure of insanity, has the following language: "Convalescents ought to be separated from patients under curative treatment; their habitation requires less care as to division, and the internal arrangement may be more general." "They ought to form a large family, and not one ought to be idle. The house for convalescents may be in the neighborhood of the division for harmless patients," &c. If to this could be added, a cheap building, as a retreat for incurables, (of which this institution will always have a large share,) this establishment would combine all the advantages which could be derived in a Hospital for the insane -- a quiet and undisturbed asylum for incurables; lodges for the violent and noisy; the great Hospital for the recovery of curable cases, old and recent; and a peaceful and pleasant abode for convalescents. By this arrangement, the expenses would not be enhanced, excepting so far as would be necessary to erect the buildings themselves, as a much larger class of private patients might then be accommodated, the same superintendent and steward might attend to the whole establishment, and from one hundred and fifty to two hundred apartments would thus be afforded at a less expenditure, by more than one half, than has been furnished by any State of the Union, for the same object. Already, patients of a quiet character, able and willing to pay any reasonable expense, have been offered to this institution, in numbers sufficient to authorize the erection of such a house. With such convalescents as would from time to time become its inmates, it would doubtless furnish all the patients with suitable accommodations. If erected as a simple boarding house only, it might be so arranged as that wings might afterwards be attached, if thought expedient. These inmates would require but little restraint, might ride or range the grounds at pleasure, living together in one family, and uniting in amusements or labor, as would be most beneficial and agreeable. One hundred and ten patients are all that this institution can accommodate, without occupying the lodges for the violent. One hundred and fourteen is the present number. If the courts should send in at the same ratio, for three months to come, as for the last month, not a solitary ward will be unoccupied. Something therefore must be done. Either the law must be modified, or other accommodations must be provided.

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