LIBRARY OF CONGRESS. (SMITHSONIAN DEPOSIT.) Shelf UNITED STATES OF AMERICA. / MEMOBIAL. mmmtmmmtummt MORTAL ViX SOLICITING A STATE HOSPITAL LOR THE INSANE —■-.-. ...■>• SUBMITTED TO THE LEGISLATURE OF PENNSYLVANIA, i—n^ 0/ leptics, and four very crazy. One insane woman, has for several years occupied a cell in the basement, which measures fifteen feet by six ; it is lighted, and warmed by a stove set in the partition. She has long refused to go abroad. For those of the insane, who are quite enough to be enlarged, chains are employed to restrain them from ramb- ling to a distance. These are as light as is consistent with strength, but yet are a source of great discomfort and evident mortification to the wearers. This class here fall a good deal under the personal direction of the superintendents. The farm consists of two hundred acres, one hundred and forty of which are cultivated ; a grist-mill is on the premises, and is considered a valuable part of the property. The food is ample, and of good quality. The bread, which is of fine wheat flour and mixed with milk, is excellent. The bed-clothing and wearing apparel is comfortable. The children, who are of suitable age, are sent to the district school. Religious services are frequent Medical attendance as often as required. 39 Lebanon County Jail, at Lebanon, is built of stone, and is much on the same plan as other jails constructed thirty or more years since. It was tolerably clean. The only prisoner was a half-crazy imbecile man, who was committed for mischievously *' burning the woods/' He appeared to me incapable of any responsible act. His room was comfortable, and he was well cared for. Lebanon County Poor-house, near the town, is a finely situated and liberally established institution. All the buildings are in repair, and the whole place respect- ably arranged, combining much comfort and convenience. This populous house had many infirm and invalid inmates. Several aged females, almost or quite imbecile, were not in so neat a condition as one would wish, but I learned that it was nearly -impossible to render them more so. The house is very well furnished ; the provision, as usual in the poor-houses, of excellent quality, and amply supplied. Wearing ap- parel also, as usual, good and sufficient. Beds and bed-clothing of excellent quality. This is an excellence which quite distinguishes Pennsylvania alms-houses, especially those of the Germans. There were no cases of violent insanity here in November, but several idiotic and imbecile men and women. Berks County Jail, at Reading, is an old building, constructed with stone, upon an inconvenient plan, and subject to the objections of the common system of indiscri- minate association of prisoners. I understand the plan of a new county prison is under consideration. Several prisoners occupied two of the four jail apartments. Here are no moral or religious influences, and no means for general or special improvement. Idle habits are confirmed, and good habits, if any, weakened or destroyed. Berks County Poor-house, near Beading* is an extensive establishment, providing amply for the necessities and comforts of its numerous inmates. The buildings are large and commodious, constructed of brick, and well finished, and furnished. There were, in the Autumn, two hundred paupers; eight}- of which were sick, infirm, and insane, belonging to the hospital department. Of the insane, there were twenty-two. The salary of the matron of the hospital is insufncent. She is a person of uncom- mon energy and ability for that place. But while every care is taken that a poor-house can give, the insane cannot, for want of the medical and moral treatment which their cases peculiarly require, be often restored. I am satisfied there can be few recoveries here, though the apartments appropriated for this class, are constructed and furnished on the plans most approved in modern hospitals for the insane. I can imagine nothing better. I have seen nothing elsewhere that will compare with the excellence of these arrangements altogether. No cost appears to have been spared to make the inmates comfortable, so far as the buildino- and furnishing are concerned. The deficiencies are want of suitable exercise-grounds, for those who were too much excited to have the range of the premises, and who were incapable of employment ; and the want of competent nurses to aid the matron. The whole place was thoroughly neat. It may be offered as a model to all the counties in the state, for poor-house hospitals for the sick, and incurable insane, epileptics, and idiots. Here they are safe and comfortable, as far as their condition permits. The insane and idiots in the county at large, I heard variously computed at from eighty to one hundred. 40 In the main-building is a school for the children. The supply of well chosen books is altogether deficient. For a time there was very little moral or religious teaching. I understood this was to be resumed at no distant season. In nearly all the poor-houses in Pennsylvania, is found an apartment or chapel, exclusively appropriated to religious services. A knowledge of the language of the people is of course indispensable to useful influence. Few of the inmates understand English, except the most common colloquial phrases, and many of them not even these. Montgomery County Jail, at Norristown, is a large stone building, capable of receiving many prisoners. I saw but one in November. The prisoner was not very clean, but neither was there much neglect. The ventilation was imperfect, and usually the rooms over-heated ; a very common fault in prisons and poor-houses. I under- stood the food was sufficient and suitable in quality. Montgomery County Poor-house is several miles north-west from Norristown, and is a liberally managed establishment, so far as the furnishing of the various buildings and supply of provisions is regarded. There are three large dwelling houses, beside numerous out-buildings, Two of the former have been long built; but one is new, and was designed to increase the accommodations for the sick and the insane. Attached to the poor-house is a large and productive farm, under good management. The new hospital, erected at considerable cost, and I doubt not, in the idea of pro- curing much good for those who should occupy it, is unfortunately not well plaifhed. The principal defects are in the basement, where the insane are placed. The cells for this class in the old building, were condemned by all who saw them, both in their construction, and the wretched condition to which the inmates were abandoned. To remedy some of these acknowledged evils the new cells were made. I confess, except that change of place may have been a benefit, I see nothing gained ; nothing can be more defective than the ventilations and mode of warming the whole range of cells. They are offensive, dreary, and comfortless in the extreme. These miseries are augmented by the entire incapacity of those who have the immediate care of this department; the woman I saw employed there had neither tact nor skill for that most responsible and difficult charge. An assistant, a blind man, could not be supposed to render assistance that would avail much. I do not know that there was a disposition to neglect duty, but, ignorance of how to manage, and to meet the peculiar wants of these maniacs, was obvious at every step. I have found nowhere in Pennsylvania, so bad and hopeless a condition of things for the insane, especially, for the excited and troublesome patients. I am sorry to say this, and especially, because I must believe that the overseers of the poor in the county, had meant to reach some better results. — There is a very small confined yard, enclosed by a lofty wall, in which the insane men and women, for they are brought pretty promiscuously together, when out of the cells, may walk. This place is but a few yards square, and so shut in, as to have little the benefit of pure air; it also prevents a free circulation of air from reaching the cells. This admits remedy by knocking down the wall and extending it, so as to enclose at least half an acre, but better one or two. The patients were very indecently exposed, and I left this department of the establishment grieved and astonished. The upper stories 41 of the building were well directed, and comfortable altogether, unless the needed repose of the sick and aged was disturbed by the shrieks and vociferations issuing from the insane cells, below the infirmary. This could hardly fail to be the case. At the Berks County Poor-house Hospital, one felt that the miseries of the insane were miti- gated 5 at the Montgomery County-house Hospital, they seemed perpetuated and aggra- vated. In the one was decency, cleanness, and measured comfort ; in the other naked- ness, exposure, and filth. Bucks County Jail, at Doylestown, is a well built prison, in good order and repair. The apartments being comfortable and decent. I found here four prisoners, two men and two women, committed for immoralities, all occupying one room by day It. would appear that if evil communications are corrupting, they were not likely to leave the prison with amended purposes or repentant minds. The County Poor-house is in Warwick township, three miles from Doylestown. The situation is elevated, pleasant and healthful. The farm is large, productive, and well cultivated. All things pertaining to it, are creditable to the management of the superintendent. The main dwelling was generally neat and comfortable. There were in November one hundred and fifty paupers, twelve of whom were confined in apartments removed from the main building, and in and adjacent to the hospital. The whole condition of, and arrangement for, the insane, especially for the men, was very bad ; very bad, indeed. Eight or nine were crowded into one small over-heated, unventilated room ; the discomforts of which, were intolerable. The attendant, a pauper, appeared to do all in his power to maintain some little cleanness, but want of space, and many other wants, rendered these efforts nearly useless. A small lodging room over the apartment, in which I found most of the men, contains their beds, and miserable enough they were ; yet here eight or nine are crowded each night, and in one bed two are required to lodge. The rattling of the chains and hobbles was the accompanying music, to cries and other most discordant sounds. The history of some of these cases, as rela- ted at the poor-house, and as I learned them elsewhere, are very sad. An epileptic, particularly, moved my sympathies. He was at the time I saw him, tolerably rational, and quite conscious of where he was, and how situated ; but being liable to fits, at almost any hour, he was shut in with the other patients, who embraced the worst cases on the premises. He had a book, and looking up, as I paused beside him, said: "It's a hard place to be in, but I must bear it." It was hard, indeed ; nay, it was more — it was horrible. What an experience of life ; what a living death. The breaking down of the mind, under that terrible disease, was almost too much to be borne J yet how was all this aggravated by such companionship. Such loathsome revolting scenes ! What contrasts does life not afford ! Delaware County Jail, at Chester, is a stone building, old, inconvenient, and very badly planned, but cleanly kept. On my first visit in July, I found three prisoners, two males and a female ; two had severally been committed for vicious conduct. I found all of them together. And to my remark on the impropriety of such mis-arrange- ments, was answered, that it had "always been the custom to keep the prisoners together, and they had not thought much about it !" 42 I re- visited this prison in October, and found ten prisoners ; nine men, and one woman ; the latter at that time employed in the kitchen. The rooms were not very clean ; they were over-heated, the beds as usual on the floor, and the prisoners of all ages and colours, congregated to amuse each other according to their fancy. The allowance of food is one pound of ship-bread to each prisoner, and as much water as they wish. The comity, not the sheriff, is responsible for all defects here. Delaware County Poor-house, several miles from Chester, is a large stone build- ing, clean, well furnished, and well directed. The provisions are good and sufficient, and the food well prepared. Here were eighty -five inmates the third week in October; of these but few are children. From twelve to fifteen are insane and idiotic ; were clean, and comfortable, with the exception perhaps, of wearing chains and hobbles. None were in close confinement; though such cases often occur. A small wooden building, constructed near the main dwelling, contains six cells, cleanly white-washed and scrub- bed, furnished with a small but comfortable bed, but not capable of being warmed at all; accordingly they are disused during the cold season. Each is lighted by a grated window. There are in the basement of the main building four cells, lined with sheet iron, which are used for the violent patients when necessary. There are no recoveries reported in the poor-house through remedial treatment. "The most we expect," said one of the family, "is to do what we can for their comfort; we have no means for curing them. " The entire establishment seemed excellently conducted, and but for the difficulty of managing the insane and idiotic, would afford a quiet home for the aged and infirm. It is estimated that there are in Delaware county about seventy cases of insane and idiotic persons. The poor-house farm is large and productive. Chester County Jail, at West Chester, is built of stone, upon the plan of separate imprisonment. The cells are of good size, perfectly clean, and well aired. The pro- visions supplied, are of excellent quality. The allowance is three meals daily, and as much as satisfies the appetite. There has been but one death, by disease, in four years, and this was by consumption, developed before admission ; and one prisoner was pardoned in consumption, who was also sick when received. I think one man, who was received in a state of intoxication, committed suicide. An accident which has happened to a few lines upon my note-book prevents my stating the whole case. I copy from the warden's report to the board of inspectors, the following facts : We had in prison on the 1st of May, 1843, ------ 32 We received, during the year, white males, - - - - - - 41 " " "*< " females, ------ 3 Coloured males, ----------- 25 44 females, ---_..------ 4 Making in all, - - - 105 In prison on the 1st of May, 1844, --------28 44 The total number sentenced to labor, during four years, since removed from the old prison, is seventy-nine. Of these, forty-seven could read and write; twenty-four 43 could not read nor write j and eight could read only. Thirty-three of these prisoneis were intemperate ; twenty-eight of them temperate, and eighteen were moderate drinkers. 4 'We have manufactured, during the year 1843-44, fourteen thousand three hundred and 4 ninety-four yards of cotton cloth, four thousand three hundred and fifty-seven yards of carpet, and made bags, four hundred and ninety-four.. These have met a ready market, and afford a fair profit." I visited this prison in July, and saw all the prisoners, of which there were twenty- nine. Twenty of these were convicts, and nine were waiting trial. They were in excellent health, often replying to my inquiry in the words, "I am right hearty." They conversed cheerfully, were clean in their persons and apparel, and presented a remarkable contrast to the sixty-eight prisons I have since visited, always excepting the Moyamensing Prison, and that of Dauphin county. Some of the jails referred to were in Maryland, Virginia, and Ohio. There were two of the prisoners above named, who, though in apparent health, were insane, a German and a Pole ; the insanity of the former was produced by irregular life and intemperance. The case of the latter I did not learn. They both were in comfortable rooms, and were carefully attended. The defects at present in this prison are deficient moral instruction, and the want of a sufficient supply of well chosen books ; these should be furnished without delay. Those who cannot read should be taught, and to this writing and arithmetic might without disadvantage be added. I saw a letter written by a prisoner, who had served out his time, and settled himself to an honest life. It was addressed to the warden, and shows that he was sensible of the kind influences which had been extended to him in prison. "Mr. Robert Irwin: "Sir : — I cannot but think from the gentlemanly manner you treated me while I was with you, you will be glad to hear from me ; and I do assure you, I shall always feel the most sincere gratitude and affection for you, and the other officers connected with the hall. The kind and manly course pursued by you and all in authority, is calculated to reform any one that has the least spark of honesty left in his heart. I have, by sad experience, found that any but an honest and upright course, will lead to wretchedness and misery." Perhaps the writer might have arrived at this conclusion if he had spent his two years in idleness, associated with all the corrupt offenders received during that period, but I hold the faith that he was saved by being withdrawn from evil associates, and evil habits, and subject to discipline through kindness, employment, and the use of books. Chester County Poor-house, near Marshalton^ has been undergoing a steady improvement for some years, in its discipline and domestic arrangements. It is a large, old building, almost surrounded by smaller buildings and out-houses. There is a valuable farm under good cultivation. Early in July, there were one hundred and fifty paupers, from twenty to thirty of which were idiots and insane persons. Forty of the entire number were coloured, (these occupied part of two comfortable houses,) 44 fifty were Irish, and sixty were Americans. About forty-five of the whole number are children. Five of the insane were in close confinement ; ten were often added to this number, but at times were so well as to be allowed at large upon the premises, some- times restrained by irons ; the residue were always at liberty to go about the houses and yards. The health of the place was generally good: very few were seriously ill, but there were a few chronic cases. "About the hardest trial we have here,'' said the kind-hearted superintendent, "is parting with the children." The little creatures clustered around him like a swarm of bees; it was no "make-believe love," between them : the very babies stretched out the little arms to go with him. I spent a long time about the buildings ; and from cellar to attic, and attic to cellar, through the whole, all things were clean and in order. The mistress had inspired the people with an ambition rarely found amongst the inmates of a poor-house : an emula- tion each of the other, in maintaining well-ordered apartments. Not a speck of dirt was to be seen about the wash-boards, the window-sills, or any where ; even the rooms for the craziest men and women, partook the general care. Here one saw that the oldest and least convenient buildings, might be made respectable and healthful, by pro- per attention to cleanliness and ventilation. All the insane were made as comfortable as their condition in a poor-house permitted. But here are no recoveries — here are no means for procuring essential benefits — what can be done is done, and it is a consola- tion amidst such inevitable miseries, to witness efforts for alleviating sufferings and evils which do not admit entire remedy. Curable cases should never be received here. The Philadelphia County Jail, at Philadelphia, situated in the district of Moya- mensing, is a massive stone building, in the Gothic style of architecture. From the rear of the front edifice, the extensive halls run back at right angles 5 these contain three tiers of cells on either side. The two upper tiers being reached by means of railed corridors and galleries, extending the entire length of the blocks, which are ventilated and lighted from the roof. One block is appropriated to prisoners before trial. The other receives convicts who are sentenced, and who are here furnished with employment, and subject to a wholesome, but not rigid discipline. These blocks are exclusively for the male prisoners. The women's prison, divided by a high wall and intervening garden, is a separate building and establishment, disconnected in all domestic arrange- ments, from the men's prison. This department is especially well ordered, clean, com- fortable, and well managed. The prisoners are supplied with suitable work — with books, and have.fthe benefit of moral and religious teaching, (not at the expense of the city or county,) from the moral instructor, who visits the prison at large, and from an association of pious and devoted women, who spare no pains to reclaim the offenders, and restore the outcast. Their benevolent efforts are not confined to the prisoners dur- ing their terms of detention, but they endeavor to extend care and influence beyond the walls of the prison. Their disinterested and faithful exertions, sometimes meet with their highest reward, in the good results which attend upon, and follow these labors. There are many in all prisons, who set at nought counsel, and scorn reproof, but this is no argument whereby a Christian community would find justification in refraining from employing every consistent and reasonable exertion to recover the sin-sick soul — to in- spire virtuous sentiments, to raise the fallen, and to strengthen the weak. The moral 45 teacher in this prison, is a missionary employed by a benevolent society. Would it be more than justice demands, since the courts sentence so many convicts to these prisons, for long terms, for the city to appoint and support a chaplain, at its own cost? The many hundred prisoners in the county jail, though a very unpromising class of pupils, certainly not the less on that account, should be faithfully visited and instructed. Is it not a mistake, however, to sentence to the county prison, offenders, whose crimes make them legitimate subjects for the Eastern Penitentiary ? Sent there, where sufficient and effective arrangements are made for teaching the ignorant* and nourishing the moral nature,, where the regulations are all in all, better adapted for their benefit, than can be those of the county prison ; they would be subject, not to a severer discipline, but would receive a stricter justice, whether we consider their rights as men, or their condemna- tion as criminals. The cells of Moyamensing Prison, are of good and convenient size, well lighted, and ventileied, and in winter, well warmed. They are maintained clean, and well furnished, and are supplied with pure water, by pipes. The food is of good quality, and of suf- ficient quantity. It is well prepared, and usually distributed with care. I have visited all the cells in this extensive prison, and conversed with the prisoners, and having spent the largest part of nine days in a diligent examination of their condition, and of the gene- ral arrangements and the discipline, I do not hesitate to say, it is conducted in a manner highly creditable to the officers, whose duty it is to govern and direct its affairs. There are some defects, but they may be chiefly remedied with due attention. Well chosen additions to the library are much needed, as also care in the distribution of the books. The prisoners were at liberty to communicate to me, their grievances, if they had any, and to represent their condition without restraint. The only grave complaint, and it was t>"ice repeated, was from a prisoner who desired a greater variety of food. Mutton and veal to vary his meals diet, and a larger variety of vegetables ! There were three or four insane men, who had been committed on various petty charges, and were not subjects for this prison, or any other. The Eastern Penitentiary contained in January about three hundred and sixty-two prisoners. Within two years, twenty-seven well attested cases of insanity, have been brought to this penitentiary. I do not wish to enter now upon an elaborate discussion of this subject. The gross injustice of sentencing and committing men to prison for erimer: committed while governed by the delusions of insanity, appears so obvious, that no person of the least humanity or intelligence will deny the position. Is it not time hat the penal code of Pennsylvania should be revised ? In this respect especially it demands consideration. The criminal jurisprudence of insanity has engaged much attention during the last thirty or forty years. France has led the way to this just reform, declaring with precision and perspicuity, "that there is no crime nor fault when the party accused was in a state of insanity at the period of the act." The penal code of Louisiana contains an act to the same effect, though less concisely expressed. That of New York lays down the same principle, with distinctness and precision : "No act done by a person in a state of insanity, can be punished as an offence, and no insane perse i can be tried and sentenced to any punishment, or be punished for any crime or offence committed in the state." These decrees, so philosophically just and humane, 46 are Wormy of being copied into every statute book of every nation. Several of the German principalities have long since adopted them. We have been slow in the United States to recognise this duty to a class of sufferers having peculiar and undenia- ble claims on the considerate and merciful care of every people. The English law on this subject is obscure; and successive acts of Parliament are both perplexing and con- tradictory. The high judicial authorities have from time to time declared opinions on these points, which, considering the times in whiph they were expressed, are dis- tinguished only by their errors: and these inexcusable, because, information of undoubted authority, was within reach. The able medical governors of the hospitals and asylums, were both willing and competent to define insanity. A vast many persons honestly believe, that most offenders for whose defence the plea of insanity is urged in courts of justice, are merely feigning a malady in order to escape the punishment consequent on crime. False pretences may be set up, and such have been, but to sustain these with the means of knowledge society now possesses in the experience of intelligent medical men, who have made this branch of their science a study, is not easy. The truth is, insanity is not a malady to be easily coun- terfeited, and those who undertake to simulate this disease, must have a very thorough acquaintance with its manifestations. There is no need to apprehend that in these cases either judge or jury may be imposed upon, if information is sought from those competent to determine this very grave and important question. The insane who have been committed to the Eastern and Western State Penitentia- ries, receive in those prisons such care and humane consideration, as the discipline, and general organization of these places permit. But granting for a moment that the insane do not suffer a great injustice in being committed to the state prisons, they in- evitably, from the plan and arrangement of these institutions, are severe sufferers by such imprisonment; and one finds a sufficient argument for a State Hospital in the unhappy circumstances of the insane patients in the prisons, and jails, and alms-houses of Pennsylvania; without referring even, to another class, numerous and claiming benevolent consideration: I mean those who are not in affluent circumstances, and who borne down by this domestic calamity, are not able to meet the expenses of removal to, and cost of support in those institutions which are already established, and which have proved so great a blessing to large numbers of your citizens. Pennsylvania has the high praise of having established a model prison on the sepa- rate system, which in its whole plan and government is worthy of being copied, wherever civilized life makes the establishment of prisons necessary, for the security of society. I express this opinion in a full confidence, based on extensive knowledge of prisons and prison systems of discipline; and I am satisfied that no unprejudiced, intelligent mind, can examine deliberately and faithfully, the wards of the Eastern Penitentiary, and not arrive at the same conclusion. The best systems, it is acknow- ledged, exhibit defects; and the best systems badly administered may produce the worst consequences ; but in the prison at Cherry Hill, one witnesses both the good system, and the good administration united ; and we wish not to see its harmonious order and just, but mild discipline, disturbed by the strange anomaly of uniting a State 47 Prison and a State Hospital, criminal wards and lunatic wards. We wish not to see misfortune punished as crime, and crime raised to a level with misfortune. I have said that within two years, twenty -seven insane persons have been commit- ted to the Eastern Penitentiary, charged with various crimes. The history of many of these, I have traced. I have resolved that no labor shall be spared on my part, in bringing facts to light. The testimony of intelligent citizens throughout the state, and the opinion of medical men acquainted with these cases, having had them under their care as patjents, settles these points definitively. Men having been known as insane for years, committing recent crimes, still under the influence of insane delusions, are every month tried, and condemned, and sentenced, precisely as if they were in pos- session of a sound mind, and were responsible for their speech and deeds. The fact of their known insanity, is often recorded on the books of the prison, by the officers who convey them there. One often hears the now somewhat trite assertion, "Since we have no State Hospital, they must go to prison, that the lives and property of the public may not be destroyed!" To this custom of sending so large numbers of insane men to the penitentiaries, may be referred many of the aspersions and objections which have been adduced against the 1,4 Separate System." All the Poor-houses in the city and county of Philadelphia, reveal scenes of suffering through defective provision for the insane, and great mistakes in the care and management of them. A majority of the paupers in this county are gathered into the poor-houses, that is, if the city and its districts, the Northern Liberties, Southwark, Kensington, Spring Garden, and Penn township are included. Most of the other townships and villages in the county, I am informed, follow the "old custom" of "letting out the poor," or annually placing them in families, who agree to take them at the lowest rate, as in West Phila- delphia, a part of Blockley township, &c. &c. At Germantowyi is a Poor-house, which I have not visited since June; but I found it at that season, very clean and comfortable. The pleasant weather permitted most of the people to be abroad, including some insane men, who under a degree of restraint, still found pleasure in the air and in exercise. One insane woman remained chiefly in her apartment, which was very comfortable, well situated and neatly arranged. This room she had decorated in a most fantastic manner with flowers, and leaves, and fragments of coloured .cloth; she was tranquil and silent. There are many indigent persons in this township who find aid from the more direct charities of the benevolent citizens, and are with that assistance saved from the entire dependence consequent upon resorting to the poor-house. I think it probable that in winter this establishment must be quite too much crowded for health, or for that degree of comfort and accommodation which should be secured to the aged and infirm inmates. Roxbo rough Poor-house, which also receives some of the poor from Manayunk, I visited three times early in the summer of 1844. I found a remarkably neat, well 48 regulated establishment ; too much crowded indeed, even at that season, and afTbrdino- no suitable provision for the insane of which there were five, and one idiot ; beside these there were seventeen paupers. One, a young girl, in a state of dementia, was at times subject to violent paroxysms and was exceedingly difficult of control. Another, a German woman of middle age, from Manayunk, was highly excited, and for the safety of others, as also for her own security, was closely confined in the cells in the cellar. Her strength and violence made it necessary for a man to take charge of her, the women of the house fearing and dreading her attacks. The superintendents of this house expressed much dissatisfaction and uneasiness at being obliged to use these under- ground apartments for this purpose. They were damp and in some respeets unsafe. — So far as the habits of the occupants and the situation of the cells would allow, they were made comfortable ; and I think uniformly as the paroxysms subsided the insane were removed for a few hours to the upper part of the dwelling, and in suitable weather, taken into the enclosed yard at one end of the house. There were no means here for any care of the insane, that could conduct to recovery. The exposures of every sort to which they are subject in alms-houses, should be recol- lected by those who have the responsibility and power of determining if these shall last, or if by speedy legislation a fit asylum be opened for those who, in ceasing to exercise the reasoning faculties, cease from self-care, and have no more the capacity for govern- ing their actions. The Philadelphia Alms-house, west of the Schuylkill, is a vast structure built of stone, and capable of receiving above two thousand paupers. The main buildings alone, arranged in a parallelogram, cover and enclose an area of nearly ten acres. The average number of paupers in 1842, was fifteen hundred and forty-six, the inmates dis- persing somewhat in the summer, but thronging again in winter. December 7th, 1844, the number was seventeen hundred, of which six hundred and ninety-nine only, were natives of the United States. This vast establishment is suitably furnished, and kept in remarkably neat order. Ventilation is complete, and every hall and ward exhibited a uniform attention to that promoter of health — thorough cleanliness. I remarked the want of regular employment for a vast number of the inmates, and learned, with no less surprise than regret, that the original judicious plan of providing work for the paupers, according to the measure of their strength and ability, had been superseded ; and further, that the machinery, and other apparatus for carrying out a part of the original system, so necessary to preserve in any degree the morals of the place, was now on sale, I am not ac- quainted with the motives which have led to this determination on the part of the official governors of the alms-house; but it seems, according to all experience in life and civil economy, a great error of judgment to admit such numbers of able-bodied men and women to the benefits of the institution, and to maintain them either in idleness, or with insufficient occupation. The school was not regularly organized when I was there, and I could not learn that the moral training was such as most persons would determine to be sufficient to form the character, to correct ill-habits, and early to deepen impressions of truth, integrity, and good sentiments. There seemed to me too little education of the conscience. I am sensible that many children brought to this house, 49 are already imbued with pernicious ideas ; that their propensities are often vicious, and their habits corrupt and corrupting. All this but strengthens the argument for their more careful education, that so they may, if possible, be saved from successive grades of demoralization, and from the prisons of the land. I do not impute to those who direct these children, any intentional omissions of duty, believing they perform all the guardians require, but I suggest that perhaps the present system will admit of improve- ment and reform. The Blockley Alms-hospital is a very expensive institution, and those aids for sus- taining it at less cost to the city, with equal comforts for the inmates, which are adopted in some large establishments of this sort in other states, are not here resorted to ; for example, the large fruit, vegetable and flower gardens, sometimes cultivated and afford- ing an income of some thousand dollars to the poor-houses, are not here made available, Again, useful employment is afforded, as at the Rochester Alms-house, in New- York, during the season when labor is not practicable on the farm, by cracking stone, for M'Adamizing the streets and roads. Employment in these institutions, even if not made to yield a considerable income, seems of much importance. The virtuous poor are always willing to work according to the measure of their strength ; while the idle vagrant, compelled to labor in the alms- house, will be more ready to seek work abroad, where he can be paid for it. Of that department of the alms-house hospital, which is occupied for the insane, I feel great unwillingness to speak ; but I believe I am not the first to suggest that it has great and fatal defects. Attention has been called to the subject, through the journals of the city, and I trust that there will be no long delay in changing the whole order of this department of the institution. In one respect, and it is no little praise to accord, it was unexceptionable ; it was clean, thoroughly clean. The men's department alone for the insane, received from January 1st, 1843, to January 1st, 1844, three hundred and ninety-five patients; of these, it is painful to record, that two hundred and forty-eight cases were produced by intemperance, and were not strictly hospital patients. The remaining one hundred and forty-seven are recorded under the general head of insanity. Dr. Jarvis, of Louisville, (Ky.) who visited this hospital in 1837, and has since written a treatise on Insanity and Insane Asylums, thus describes the mode of treating excited patients at the Blockley Alms-house ; being a mode of restraint never at any period practised in our best asylums for the insane, and now, with one exception perhaps, disused altogether throughout the country. "A poor female was confined in a 'restraining chair' made of plank ; one strap confined each arm, another the waist, and another passed over the thighs, and held her down to her narrow prison. This girl was in a state of furious excitement; she was using the greatest struggles to extricate herself; she was kicking her feet, endeavoring to strike every one near her ; she was boisterous and spat on any one within reach ; she was the very image of a raging fury ; and we were told that she had been in this excitement for three years, and the same means of straps and chairs had been as long used to calm her." 50 My first visit to this alms-house was in June, 1844. There were many visiters at that time beside myself. I anticipated something like change ; amendment, since 1837. I supposed that in seven years the abominations of the present system, would so have disgusted, not only the official guardians of the house, but the whole public, that with one indignant voice they would have united to demand and enforce a more rational, not to say merciful, organization of the establishment. It was not so. Entering the men's wing, we found the hall and rooms vacant; except three or four, in which Avere several excited patients who were necessarily shut up for a time : for how long a time one could not tell — nor who should determine these questions of restraint; here is no one competent, governing director: " care-takers," are selected from the paupers, and of their qualifications in general for such delicate and very diffi- cult duties, others can judge who know somewhat of the wants and dependence of the insane. The patient's rooms were very clean, and sufficiently furnished. We descended to the exercise-yard, and directly the men were "driven forward by a keeper," into a small grassed area, where they might sit down, or lie down, or do what they listed. Some were chained, and others muffled, that they might not do mischief. As if their own collective vociferations were not productive of sufficient discord, a fiddler from the other department was brought to increase the confusion. The worst feature here to my thought, was the indiscriminate association of all these insane men, without the smallest regard to the degree of insanity, or to the different physical and mental states they might exhibit; those who were conscious of their own malady, who were conscious where they were, "in the alms-house crazy-ward," those who did not comprehend this, or comprehending, did not care; the drooping melancholic, the noisy maniac, the drivelling idiot, and the spasm-shaken epileptic, all were here together. From this scene revealing so little of appropriate and remedial care, we turned away, and followed our conductor to the women's department. Here, save a few, who were in their rooms, in states of vehement excitement, we found the patients collected into one large room — the hideous tumult of which beggars description. The recent and the established cases ; the tranquil and the excited ; the conscious and the unconscious; were herein one "great, monstrous, horrid company," to adopt the expressive de- scription of one of them ; crying, shouting, laughing, screaming, moaning, complaining, rolling on the floor, moping in the corners, assuming all attitudes, and rousing each other to higher and higher exasperation ; here they were, and here too, was sent the pauper musician, with the sharp, shrill, dissonant fiddle, adding discord to discord, and com- mingling the war of words, with the war of sounds, in rivalry of Babel I But this does not complete the picture. In a remote part of this large room, in a " tranquilizing chair," that monstrous invention, which merits a place with the instruments of inquisi- torial torment, or the machines of rack and torture employed in the middle ages, by regal despotism, in a tranquilizing chain was fastened a young and beautiful girl, in the highest state of frenzy, yet, now and then, becoming, for a few moments, tranquil. She smiled sweetly, in her woe, and uttered half sentences, that moved many to tears. It was a sad and pitiable sight. Closely bound, hands, feet, and waist, she could only move the head and neck a little. Her beautiful hair fell in waves upon her neck, and 51 there was a charm in her appearance, notwithstanding the wildness of the eye, that at- tracted all strangers. The "board of guardians," not less than the more infrequent visi- ters, drew towards her. I asked who she was, and whence she came. No one could tell. She had been found wandering in the outskirts of the city, and was brought there a few days before, raving mad ! I saw her once again, some weeks later ; she was still highly excited, and more unmanageable than before. 1 was consoled, to learn, subsequently, that her friends had traced her from the upper part of the county, above Frankford, and had removed her home. A merciful change, but how much more merciful, if she could have had the benefit of skilfully directed hospital care. My second visit to the alms-house, produced new distrusts of the management of the lunatic department, and confirmed first opinions. I found in the men's ward, a poor man in a "tranquilizing chair," whose countenance wore an expression of agonized suffering I can never forget. His limbs were tightly bound, his legs, body, arms, shoulders, all were closely confined, and his head also. Feeble efforts to move were broken down by this inexorable machine. Upon the head, sustained by the apparatus, which confined the movements of the neck, was a quantity of broken ice. This, as it gradually melted, flowed over his person, which however, was in some degree protected from the wet by a stiff cape, either of canvass or leather. It was a very hot day, but he was deadly cold, and oh, how suffering! To suffer would have been his lot, perhaps, under any circumstances; but this treatment, " employed to keep him still," was a fearful aggravation of inconceivable misery. I asked how long he had been under this restraint. "Four days !" What, day and night? "No, at night we take him off and strap him upon the bed." How long will you keep hirnso? "Till he is quiet." How long have you ever kept the patients in this condition? "Nine days, 1 believe, is the longest. ' It does not require much knowledge of the human frame, and of its capabilities to endure suffering, and resist destructive and injurious influences, to know whether such a mode of treating insane persons is remedial and restoring in its effects, or whether it does not seriously endanger life, and lay the foundation of various fatal ailments, in addition to the malady under which they are suffering. I am sure the intelligent and skilful medical men in Philadelphia, will concur in the opinion, that this department of the alms-house calls for speedy and entire reconstruction. This can be accomplished with but little difficulty, and at small additional expense. To doubt the willingness of the citizens of Philadelphia to promote this much needed change, would be to distrust that humanity and liberality which has never been found deficient, when benevolent objects have been presented for their consideration and support. Why the alms-house alone, of the numerous public charities of Philadelphia, should show a condition so adverse to the objects it proposes to accomplish, is a problem I cannot resolve. If idleness is the nurse of vice and crime, it would seem consistent with the purest political economy, to provide employment for all who are able to labor in the alms- house. If education is important to the youthful mind, especially moral culture, then a more careful attention to the school would be a public as well as individual good. If benevolent institutions for the protection of the friendless, and the recovery of the sick and disabled, to health and usefulness, are recognized as important and necessary in 52 crowded cities, and a densely inhabited country, then it is well that these should be so established as to procure for the recipients of charity, all the benefits which they can be made capable of securing. The exciting causes of insanity in large cities, are numerous. The poor and indi- gent are also numerous. If an extensive alms-house is necessary to receive the crowds, the thousands of sane paupers, surely a hospital, on a curative foundation, is also necessary, and to be preferred to a mere receptacle. In the one case, the maniac may be restored to reason and usefulness ; in the other, there is a possibility, but it rests upon slight probability. It may be argued by some, that many who are sent to this hospital, are the victims of their own vices and indiscretions, and are undeserving the special care solicited. Many of them are unworthy; in all probability the majority may have abused their privileges, wasted property, and impaired their health by indul- gences and excesses,, which must be condemned. But shall not these find mercy, and pity, and succour? You do not abandon the criminal in the jail; the juvenile offender tinds a "Refuge;" and the halls of your penitentiary echo to the voices of those who, by earnest counsels and instruction, strive to reclaim the convict from perverse and criminal habits, to rectitude and duty. Let not the erring, perhaps once vicious insane, alone be abandoned. One of your own citizens has not long since said publicly, what none have attempted to disprove: "That unless means are taken to discover the real condition of the insane in the alms-house hospital, the people of this community will justly incur the infamy of sustaining a moral nuisance, an establishment disgraceful to humanity, and a libel upon the present state of our knowledge of the proper treatment of mental disease." The city and county of Philadelphia needs its own hospital and asylum for the treatment and protection of the insane ; as the cities of New York and Boston, sensible of the necessity of such provision for this class of their poor, have theirs. All large cities, as witness those just referred to, and not less Philadelphia and Baltimore, need for their own dependent citizens, a well established hospital. It is but few years since the Alms-house of Suffolk county, Boston, revealed scenes of horror and abomination rarely exhibited, and such as we trust are now, in the mass at least, no where to be found in the United States. These mad-men and mad-women were the most hopeless cases, of long standing, and their malady was confirmed by the grossest mismanagement. The citizens at length were roused to the enormity of these abuses ; to the monstrous injustice of herding these maniacs in a building filled with cages, behind the bars of which, all loathsome and utterly offensive, they howled, and gibbered, and shrieked day and night, like wild beasts raving in their dens. They knew neither decency nor quiet, nor uttered any thing but blasphemous imprecations, foul language, and heart- piercing groans. The most sanguine friends of the hospital plan, hoped no more for these wretched beings than to procure for them greater decency and comfort ; recovery of the mental faculties for these was not expected. The new establishment was opened, and organized as a curative hospital. The insane were gradually removed, disen- 53 cumbered of their chains, and freed from the foul remnants of garments that failed to se- cure decent covering. They were bathed, clothed, and placed in comfortable apartments, under the management of Dr. Butler, now superintendent of the Retreat, at Hartford. In a few months behold the result : recovering health, order, general quiet, and measured employment. Visit the hospital when you please, at u no set time or season," but at any hour of any day, you will find these patients decently clothed, comfortably lodged, and carefully attended. They exercise in companies or singly, in the spacious halls : they may be seen assembled reading the papers of the day ; or books loaned from the library ; some labor in the yards and about the grounds ; some busy themselves in the vegetable, and some in the flower-garden ; some are employed within doors, in the laundry, in the kitchen, in the ironing-room, in the sewing-room. In every part of the house a portion of the patients find happiness and physical health, by well-chosen, well- directed employment. Care is had that this does not fatigue, that it is not mistimed : and the visiter sees, amidst this company of busy ones, some of the incurables who so long inhabited the cages, and wore away life for years in anguish, encompassed by indescribable horrors. And though, of this once most miserable company, less than one- sixth were restored to the right, use of their reasoning faculties, with but few excep- tions, they are capable of receiving pleasure, of engaging in some sort of employment, and of being taken to the chapel for religious services, where they are orderly and seri- ous. Such, to the insane paupers of Suffolk county, Boston, have been, and continue to be, the benefits of the hospital treatment. Than theirs, no condition could be worse before removal from the old building; now none can be better for creatures of broken health and impaired faculties, incompetent to guide and govern themselves, but yielding to gentle influences and watchful care. Gentlemen, I have endeavored to show you in the preceding pages, — First, that the provision for the poor and indigent insane of your state, is inappropriate, insufficient, and unworthy of a civilized and christian people : Second, that it is unjust and unjusti- fiable to convict as criminals and incarcerate those in prisons, who, bereft of reason, are incapable of that self-direction and aetion, by which a man is made responsible for the deeds he may commit : Third, I have, in the description of your alms-houses, adding the opinion of the most intelligent men of your state, shown that these are, in all essential respects, unfit for the insane : and that while they may, with uncommon care and devotedness on the part of the superintendents, and other official persons, be made decent receptacles, they cannot be made curative hospitals nor asylums, for affording adequate protection for the insane : Fourth, still less can these ends be accomplished in private families, even where pecuniary prosperity affords the means of supplying many wants. But in those where this calamitous malady is united with poverty and pinching want, it is barely within the bounds of probability that the patient should recover. There is then but one alternative — condemn your needy citizens to become the life-long victims of a terrible disease, or provide remedial care in a State Hospital. Let this be established on a comfortable, but strictly economical foundation. Expend not one dollar on tasteful architectural decorations. In this establishment, let nothing be for ornament, but every thing for use. Choose your location where the most good can be accomplished effectually, at the least cost. Let economy only not degenerate into meanness. Every dollar indiscreetly applied, is a robbery of the poor 54 and needy, and adds a darker shade to the vice of extravagance, in misappropriation of the public funds. Choose a healthful situation where you can command at least one hundred acres, and better if a larger tract, of productive land, mostly capable of cultivation. Let the supply and access to pure water, be ample and convenient : also consider the cost of fuel, which is a large item in the annual expenses. Furnish your establishment by means chiefly of convict labor, from your two state penitentiaries, with mattresses, bed-clothing, chairs, &c. &c. You thus secure a sale for their work, and get good articles at reasonable cost for your own use. You will recollect that at some future time other hospitals will be needed and demanded, but let the location of the Jirst have reference to sparing as far as possible to the poor at large, the heavy charge of travelling expenses. A substantial brick, or unhewn stone building, not more than three-stories high with the basement, to save labor, and the consequent multiplying of attendants, having the officers' apartments in the centre, and those of the male and female patients in the two wings respectively, will be found most commodious. Numerous minor considerations will, at a suitable time, receive a share of attention. But one thing should not be overlooked in a hospital designed to benefit the people at large. In this state it must be recollected that the medical superintendent, the governing, resident physician, who alone can be head of such an institution, and also his assistant, must have practical acquaintance with both the German and English languages, which are spoken in this commonwealth. Nearly half the insane of the lower classes, east of the mountains, are Germans, and cannot, in general, utter a sentence of English; and the medical adviser would find no little embarrassment in directing the moral training and treatment of his patients, except he could speak their language fluently, and was familiar, by residence and practice, with some of their peculiarities and local customs. I have perceived the importance and value of this, from being frequently accompanied to the poor-house hospitals by the attending physicians ; and as they have mixed with the inmates, addressing one in one language, one in another, I have seen that in a State Hospital for the Insane in Pennsylvania, it is absolutely necessary to pos- sess these qualifications in order to be really successful. If the mere outward manifestations of disease were to be studied, and decided on, if no other influence were to reach the patient than a medical prescription for a symp- tom which could not be mistaken, it would be of little consequence in what language the physician conversed, or whether he possessed at all the gift of speech ; but as much beside is to be embraced in intelligent, skilful hospital practice, your physician for the State Asylum must speak readily the two languages of the country, at least. The medical superintendent of a hospital for the insane, needs not only a quick perceptive faculty in detecting the characterizing symptoms of the various forms of this malady, but adding to this an acquaintance with the social habits of both the German and English classes, he should possess energy, promptness of action, and ready determina- tion ; he should have active business habits, and devotion to his profession. The very onerous duties which devolve on him will not nourish self-indulgence, or allow leisure for various pursuits: he must consecrate himself to the work, and he must concentrate all his energies, physical and mental, to promote the success and prosperity of the 55 institution; making it so far as human means are concerned, an asylum where the curable may find health, and the incurable alleviation and solace for their sufferings. Gentlemen, of the Legislature of Pennsylvania, I appeal to your hearts and your understanding; to your moral and to your intellectual perceptions; I appeal to you as legislators and as citizens ; I appeal to you as men, and as fathers, sons, and brothers ; spare, I pray you, by wise and merciful legislation now, those many, who if you deny the means of curative treatment and recovery to health, will by your decisions, and on your responsibility, be condemned to irrecoverable, irremediable insanity : to worse than uselessness and grinding dependence; to pain and misery, and abject, brutalizing conditions, too terrible to contemplate ; too horrible to relate ! Grant to the exceeding urgency of their case, what you would rightly refuse to expediency alone. Benevolent citizens of your commonwealth were the first of civil- ized people to establish a society for alleviating the miseries of prisons ; shall Penn- sylvanians be last and least in manifesting sensibility to the wants of the poverty- stricken maniac ? Is the claim of the Lunatic less than that of the Criminal ? Are the spiritual and physical wants of the guilty to be more humanely ministered to, than the bodily and mental necessities of the insane ? You pause long, and hesitate to con- demn to death the blood-stained murderer ; will you less relentingly condemn to a living-death, the unoffending victims of a dreadful malady? The wise and illustrious Founder of Pennsylvania, laid broad the basis of her gov- ernment in justice and integrity: now — while her sons with recovering strength, are replacing the shaken Keystone of the Arch, may they, as in the beginning, find their Salvation, — Truth, and their Palladium, — Righteousness ! Respectfully submitted, D. L. DIX. Harrisburg, February 3, 1845. APPENDIX. Table showing the comparative expense of supporting old and recent cases of in- sanity, from which we learn the economy of placing patients in institutions in the early periods of disease; from the report of the Massachusetts State Hospital. p c •-•3 o CB Efi CD en -i CD 02 CD 3 Ch CD CD Time insane, in years. Total expense, at $100 a year, be- fore entering the hospital, & $132 a year since ; last year $120. « ? a c en 3 CD 3 co a" 'a . cd 3" *"» —l CD to 2 CD CD CU 3 ►i CD 02 CD P orq CD CD 3 SL cd 02 ^. " 3 02 S3 3 CD V. 3' Cost of support, at $2.30 per week. 2 69 28 $3,212 00 1,622 30 7 $16 10 7 48 17 2,004 00 1,624 34 20 46 00 8 60 21 2,504 00 1,625 51 32 73 60 12 47 25 2,894 00 1,635 23 28 64 40 18 71 34 3,794 00 1,642 42 40 92 00 19 59 18 2,204 00 1,643 55 14 32 20 21 39 16 1,993 00 1,645 63 36 82 80 27 47 16 1,994 00 1,649 22 40 92 00 44 56 26 2,982 00 1,650 36 28 64 40 45 60 25 2,835 00 1,658 36 14 32 20 102 53 25 2,833 00 1,660 21 16 36 80 133 44 13 1,431 00 1,661 19 27 62 10 176 55 20 2,486 00 1,672 40 11 25 70 209 39 16 1,964 00 1,676 23 23 52 90 223 50 20 2,364 00 1,688 23 11 25 70 260 47 16 2,112 00 1,690 23 27 62 10 278 49 10 1,424 00 1,691 37 20 46 00 319 53 10 1,247 00 1,699 30 28 64 40 347 58 14 1,644 00 1,705 24 17 39 10 367 40 12 1,444 00 1,706 55 10 23 00 400 43 14 1,644 00 1,709 17 10 23 00 425 48 13 2,112 00 1,715 19 40 92 00 431 36 13 1,412 00 1,716 35 48 110 40 435 55 15 1,712 00 1,728 52 55 126 50 488 37 17 1,912 00 1,737 30 33 75 90 454 $54,157 00 635 $1,461 30 Average expense of old cases, ... Whole expense of twenty-five old cases, Average expense of recent cases, - Whole expense of twenty-five recent cases till recovered, $2,166 20 54,157 00 58 45 1,461 30 5S From Dr. Awl's reports of the Ohio Institution, we extract the following tables : In the report of 1840, the number of years that the twenty-five old cases had been insane, was 413 ; the whole expense of their support during that time, $47,590 ; the average, $1,903 60. The time that the twenty-five recent cases had been confined, was 556 weeks ; the expense, $1,400 ; the average $56. In 1841, whole cost of twenty-five old cases, - - - $49,248 00 Average, -------- 1,969 00 Whole cost of twenty-five recent cases, - 1,330 50 Average, - •♦ - - - - - - 52 22 In 1842, whole expense of twenty-five old cases, - $50,611 00 Average, -------- 2.020 00 Whole expense of twenty-five recent cases, - - - - 1,130 00 Average, - - - - - - - - 45 20 In this institution, in 1843, twenty old cases had cost, - - $44,782 00 Average cost of old cases, .. - 2,239 10 Whole expense of twenty recent cases, till recovered, - - 1,308 30 Average cost of recent cases, - • - - - 65 41 In the Massachusetts State Lunatic Asylum, in 1843, twenty-five old cases had cost, ------- $54,157 00 Average expense of old cases, - - - - - 2,166 20 Whole expense of twenty-five recent cases, till recovered, - - 1,461 30 Average expense of recent cases, - - - - - 58 45 In the Ohio Lunatic Asylum, in 1844, twenty-five old cases had cost, $35,464 00 Average expense of old cases, ----- 1,418 56 Whole expense of twenty-five recent cases, - - - 1,608 00 Average expense of recent cases, - ~ - - - 64 32 In the Maine Lunatic Hospital, in 1842, twelve old cases had cost, •■ $25,300 00 Average expense of old cases, - - - - - 2, 108 33 Whole expense of twelve recent cases, - 426 00 Average expense of recent cases, - - - - - 35 50 In the Hospital at Staunton, Va., twenty old cases had cost, - $41,633 00 Average expense of old cases, - - - - - 2,081 65 Whole expense of twenty recent cases, - 1,265 00 Average expense of recent cases, - - - - r 63 25 The results of this table are so striking, and show so conclusively the importance of early admission to the insane hospitals, that many other institutions have instituted the same inquiry with similar results. 59 Table (from Dr. JlwVs sixth report for 1844, of the Stale Hospital, at Columbus, Ohio,) showing the comparative expense of supporting old and recent cases of in- sanity. 3 p o Present a Duration, of insa fore ad Cost of before ad at $2 pe Number ( cases. > P Duration sanity b( mission. Time, in spent in lum. Cost of cure, at $3 per week. fD as OS •Saw. ^ CO ■£< pr 2 o w >i in o CD 3 P £. Zt 3 I I 1 2 * 1 P O) 1 «■ 1 42 18 $1,872 00 1 29 1 month. j 20 $60 00 2 45 11 1,144 00 2 22 6 " 18 54 00 3 35 13 1,352 00 3 35 5 " 15 45 00 4 40 12 1,248 00 4 26 4 " 9 27 00 5 38 15 1,560 00 5 41 8 " 43 129 00 6 38 10 1,040 00 6 37 5 " 16 48 00 7 42 10 1,040 00 7 27 7 " 59 177 00 8 40 15 1,560 00 8 34 4 " 15 45 00 9 40 20 2,080 00 9 31 1 " | 18 54 00 10 40 9 936 00 10 22 9 " 13 39 00 11 50 10 1,040 00 11 18 1 week. 11 33 00 12 48 11 1,144 00 12 29 2 months. 52 156 00 13 45 9 936 00 13 23 5 " 25 75 00 14 35 10 1,040 00 14 24 8 " I 5 15 00 15 57 27 2,808 00 15 28 2 " ; 13 39 00 16 57 10 1,040 00 16 45 4 '* 14 42 00 17 28 13 1,352 00 17 28 4 " 26 78 00 18 49 21 2,184 00 18 41 1 " 23 69 00 19 j 43 15 1,560 00 19 24 3 " 15 45 00 20 45 10 1,040 00; 20 32 2 " 15 45 00 21 29 14 1,456 00! 21 20 5 " 33 ( 99 00 22 33 10 1,040 00 22 20 8 " 29 ! 87 00 23 40 28 2,912 OOi 23 21 5 " 8 24 00 24 | 39 10 1,040 00 24 31 5 days. 16 48 00 25 1 40 ! 10 1,040 00 25 25 10 months. 25 75 00 $35,464 00 $1,608 00 Average number of years for each case before admission into the asylum, 13|. Average number of weeks spent in the asylum, 2I3. Average cost of each case before admission into the asylum, $1,418 56. Average cost of each recovery in the asylum, $64 32.