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During the year ending April 1, 1884, the whole number of inmates in the 230 city and town almshouses of Massachusetts was a little more than 7,000; while the average number was less than two-thirds as many, -- namely, 3,920. This would give an average number in each almshouse of 17 persons. Of the whole average number (3,920), less than 620 were insane; although among the whole number of different persons during the year (7,000) there may have been 700 insane persons, or one-tenth of the whole almshouse population. During the same year, the number of insane persons in the hospitals and asylums of Massachusetts was nearly 5,000; so that not more than a seventh part of the insane persons under public supervision in Massachusetts have been in the smaller almshouses during the past year. If to these were added the insane population of the Tewksbury asylum (connected with the State Almshouse, but under medical management), the number of insane persons even nominally in almshouses would be less than a fourth part of the whole number under public supervision. This is much less than the usual proportion. In the State of New Hampshire, for instance, there were in 1883 354 insane persons in the ten county almshouses; while the State Asylum at Concord contained only 300 insane persons at that time. As there were undoubtedly some insane persons in the still existing town almshouses of New Hampshire, it would appear that more than half the New Hampshire insane are in almshouses, probably three-fifths. In Vermont, the proportion must be nearly as great. In Connecticut, it is much less, because the rapid enlargement of the State Asylum at Middletown has withdrawn many of the insane from the town poorhouses, so that the number now remaining in the 101 poorhouses of Connecticut does not probably exceed 150, while the number in insane asylums was upwards of 1,100 during the year 1883. In Rhode Island, the proportion of the insane in town almshouses seems to be even less than in Connecticut; but the statistics are not at hand. Taking New England as a whole, it is safe to say that less than a fifth part of all the insane under public supervision are in the almshouses (estimated at 600) in the six States.

The county almshouses of New Hampshire, which have grown up within the last twenty years, were never reported upon as a whole by the State authorities until 1883, when a special commission on the condition of the insane published a valuable report. This showed that the ten almshouse farms contained about 4,000 acres of land, ranging in size from the Grafton County almshouse with 650 acres to the Cheshire almshouse with 230 acres. The ten county almshouses contained during the year a population something less than 2,000, and an average population of about 1,030, rising in the winter to about 1,250. The average weekly cost for all the inmates was about $1.50, which is about 35 cents less than the average weekly cost at the single State Almshouse of Massachusetts, containing in 1883 an average population of 1,000, or nearly as many as in all the county almshouses of New Hampshire. Between a third and a half of these almshouse inmates in New Hampshire were insane or idiotic, and something more than a third part might properly be called insane. The State Commission, from whose report these facts are drawn, report strongly against retaining so many of the insane in these almshouses, and say that nearly a fourth part of them were confined in strong rooms in February, 1883. The general management of these New Hampshire almshouses, however, judging by the two largest, which I have visited, and from the statements made to me by a member of the State Commission, is kindly and frugal, without being specially censurable, except that the insane ought to be under better medical supervision and to have more and better attendance. This is the general criticism to be made on the treatment of the insane in almshouses, even when they are under a State supervision as vigilant and enlightened as that in Wisconsin appears to be.

The State Almshouse of Massachusetts at Tewksbury, which was last year the subject of so much criticism, was at that time in better condition than any large almshouse which I have ever visited, and is now slightly improved. About ten years ago there were serious neglects and some abuses in this almshouse, chiefly in the care of the insane; but these had been corrected for years. The almshouse and insane asylum at Tewksbury are now under medical management. This change, which had been long contemplated, secures the better care and greater skill that generally accompany the management of the insane by a resident physician, so that it is now safe to say that the Tewksbury almshouse is in better condition than any such establishment in New England. In consequence of the burning of the Bridgewater State Workhouse in 1883, the Tewksbury almshouse has had a larger population in the year which ended October 1 than ever before, the whole number of different persons residing there for longer or shorter periods during the year having been nearly 3,800. The average number was almost exactly 1,000, the net cost about $93,500, and the average weekly cost, therefore, $1.80. This weekly cost, though larger than in the county almshouses of New Hampshire, is considerably less than the average cost in the 230 city and town almshouses of Massachusetts, which was nearly $2.50 a week during the same year. Some of these small almshouses, and occasionally a large one, show an average cost of $4 or $5 a week, -- generally, in consequence of a small number of inmates in an almshouse calculated for a much larger population.