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The eleven last cases were not included in the General Report,

SUPERINTENDENT'S REPORT -- Continued.
Summary. November 30th, 1833.

The whole number of Patients admitted into the Hospital, from January 19th, to November 30th, 1833, .......................153

To wit: January, ...8
February, ....19
March, ....31
April,....27
May, .....13
June,.......9
July, ......10
August, ....5
September, ....4
October, .......8
November, ..... 19-153

Recent cases of 1 year or less, 48
Old cases of 1 year or more, 105-153

Deaths, ...4
Eloped,...1
Discharged,..34
Deduct 39

Remaining in the Hospital of whom 1 is discharged, but not removed,...... 114

Whole number of Males, 96
Females -- Whites, 52 Colored, 5 57-153

Present number of Males, 73
Present number of Females, 41-114
Old cases of Insanity, the period of which has exceeded 1 year, 105

Discharged, cured, .....11
Discharged, much impro'd, 2
Remain, improved,...15
Remain, stationary and not deemed incurable,...18
Idiots or Idiotic,....12
Incurables,.........47-105

Recent cases of Insanity, the period of which has not exceeded 1 year, . 48

Discharged, cured, . 14
Discharged, much imp'd, 5
Remain, improved . 15
Remain, stationary, . 14-48

11 of which have been admitted within the last 4 weeks.
Sent by the Legislature, . 2
Sent by the Courts and from Jails & H. of Cor. 107

By Towns, (Paupers,) ... 11
Private Patients, ... 33-153

State Paupers, ...3
Town Paupers, ...61

Cases induced by intemp, 38
Hereditary Insanity, ....42
Periodical Insanity, ....29

Average number of Patients, for the last six months, ......107 2-6

Foreigners.
Natives of England, 2
" " Scotland, 1
" " Wales, 2
" " Ireland, 19
" " Canada, 1
" " Hayti, 1 26

Natives of other States.
Connecticut,.......1
Rhode Island, ......1
Pennsylvania,.......1
New Hampshire.....3
Virginia, ........1 7

Natives of
The Commonwealth of Massachusetts, 120

Duration of Insanity.
Have been Insane, one year or less,..........48
From 1 to 5 years,......20
From 5 to 10 years.....27
From 10 to 20 years...........31
From 20 to 30 years,..........12
From 30 to 40 years,..........1
Unknown,.........14-153

Under the age of 20 years,..............2
Between the ages of 20 and 30, .......34
Between " " 30 and 40,.........48
Between " " 40 and 50,.............34
Between " " 50 and 60,............14
Between " " 60 and 70,............17
Between " " 70 and 80,..........3
Over 80,............2-153

Applications for admission from without the State, or at a time when we could not receive them, or that have not yet come into the Hospital, .......28

Summary for the month of December, 1833.
Patients admitted,.......10
Recent cases -- Males, 1
Females, 6
7 Old cases -- Males,....3
Females, . 0 3-10

Patients discharged,......11
Recovered,........5
Died,.........1
Improved,........3
Stationary,.........2 -- 11

Whole number admitted, to January 1st, 1834,.....163
Males,.........102
Females,.......61 -- 163
Remain, cured,......2
Remain, improved, . 28

Whole number discharged, .... 50
Recovered, 32, of which discharged, .....29
Died, .......5
Eloped,.......1
Improved,.......11
Stationary,.........4 -50

By a reference to this table, it will be perceived, that an uncommonly large proportion of old cases have been admitted into this Hospital. This was to be expected, as this unfortunate class of individuals had been for years accumulating in the jails, houses of correction, alms-houses and private dungeons. Of the character of the cases, it is sufficient to say, that in little more than ten months, one hundred and seven have been sent to the Hospital, adjudged by the courts "to be so furiously mad, as to be manifestly dangerous to the peace and safety of the community to be at large." A small proportion only of these cases can be expected to recover. To remove them from their abodes of wretchedness and suffering, to a place of comfort and security, was all that was contemplated by the benevolent founders of this institution. For years to come, a large proportion of its wards must be filled with incurables. The proportion of recoveries of recent cases, is doubtless less than may be expected in future years. There are always circumstances attending the infancy of such an institution, unfavorable to its success, and especially one, into which patients have been received as rapidly as into this, the average admission being fifteen a month, or one in two days, during the whole time that it has been open for the reception of patients: add to this, the inexperience of its officers and attendants, and the ignorance in which we are left respecting the character, cause of disease, and propensities of many of the patients, and it will readily be admitted, that thus far the institution has labored under peculiar disadvantages. Before the last three months, that is, previous to the first day of September, there had been received into the Hospital 25 recent cases of insanity, in which the period had not exceeded one year; of these, 12 have been discharged cured, 5 have been discharged improved, some of which were nearly well, and others convalescing, and 6 remain improved, leaving only 2 that exhibit no manifest improvement. Of those old cases, of one or more years' standing, which were considered not incurable, that had been in the Hospital before the last three months, or previous to the first day of September, the whole number is 38 -- of which, 11 have been discharged cured, 2 have been discharged improved, and 12 remain improved -- so that 25 out of 38 cases have exhibited symptoms of amendment. Many recent cases that show no improvement whatever in three months, in six months or a year entirely recover. But three months, and even twelve, are considered too short a period to make a decided impression upon some chronic cases, that, by a persevering application of medical, moral and intellectual means, will ultimately be restored. This will be especially true of chronic cases of many years' standing. "The chaos of illusions" which disturb the imagination in old cases, cannot be "swept at once from the tablet of the mind." Long and persevering efforts are required to break up these illusions, and restore the intellect to soundness, in cases confirmed by years, even where no physical disorganization has taken place. Our hopes, in cases like these, can never be sanguine. But a small proportion of old cases are cured, in any of the best regulated asylums in this country and in Europe. In the far-famed Retreat in Hartford, an institution which stands unrivalled in the proportion of its cares in recent cases, and in the ability and judgment with which all cases have been managed, only 14 per cent. of old cases are reported to have been cured. In the Glasgow Lunatic Hospital, 13 per cent.; in the York Asylum, 12 per cent.; and even in private asylums, in which they have the power to reject forlorn and hopeless cases, after all the trials which time and management can afford, the average will not probably exceed 20 or 25 per cent.

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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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During the past year, the duties of those who have had the immediate management of the Hospital have been peculiarly arduous; such a collection of patients so "furiously mad," and so dangerous to manage, were probably rarely ever brought into any one Hospital, in so short a period. Nearly all the individuals who have had the charge of these patients, were, when they commenced, wholly ignorant of their duty, and had to learn it by experience within its halls. No serious accident has occurred, and the duty, although increasing daily in responsibility, is comparatively less arduous. This enterprise is now fairly begun. It is to be hoped that it has thus far satisfied public expectation. The advantages of this Hospital, although principally prospective, have not been unimportant to its numerous inmates. With the continual care and vigilance of a wise and efficient Board of Trustees, attended by the smiles of a Beneficent Providence, it will doubtless be an extensive blessing to this community, and it is confidently anticipated that it will take high rank amongst the public charities of this Commonwealth.

SAMUEL B. WOODWARD.
November 30th, 1833.