We have upon our table, the reports for the year 1848-9 of the Pennsylvania Hospital for the Insane, (the eighth,) of the Massachusetts State Lunatic Asylum, (the sixteenth,) of the New York State Lunatic Asylum, (the sixth,) of the Physician and Superintendent of the M’Lean Asylum for the Insane at Somerville, Massachusetts, (the thirty-first,) and of the New Jersey State Lunatic Asylum, (the second.) The first and fourth are on private, and the other three on a public foundation.
1. We suppose the first in our list combines as many of the substantial advantages for the treatment of patients of this class, as any institution in the world, and we are happy to know, that the prominent principles which have been recognized in its structure and economy, have been adopted in asylums of the latest date. The hospital has been quite full during the whole year, and yet the health of the patients has been remarkably good. The present arrangements are fitted to accommodate 200 patients, and provision will soon be made for receiving 20 more. It is certainly desirable to extend the benefits of such an institution to as large a number as can divide without diminishing the aggregate of good, but we quite concur with Dr. Kirkbride in the opinion, that a larger number than 220 could not be well received in one building, nor receive due attention from one medical officer—“a daily visit to all the wards, and a daily supervision of all the departments by its official head, being exceedingly desirable in every institution for the insane.” Seven of the seventeen deaths during the year, “occurred within a fortnight after the patients’ admission,” and only one had been more than a year in the asylum.
Of 1391 patients admitted to this hospital, 725 were under middle age, (35 years,) and 666 over. Of 773 male patients, the leading occupations were as follows:—farmers, 115; merchants, 66; laborers, 62; clerks, 50; carpenters, 30; shoemakers, 22; physicians, 19; seamen and watermen, 19; teachers, 17; tailors, 15; students, 15; NO OCCUPATION, 108.
Of 618 females, 66 were seamstresses or mantua-makers, and 64 domestics; store-keepers and attendants in stores, 12, and teachers, 9. Of single females, not pursuing a regular employment, 29 were daughters of farmers, and 29 daughters of merchants. Of the married, 57 were wives of farmers; 39 of laborers; 35 of merchants; 23 of clerks. Of the 618, 244 were single, 286 married and 88 widows. And of the 1391, 773 were natives of Pennsylvania; 91 of New Jersey; 197 from other of the United States; 340 from foreign parts, of whom 189 were from Ireland!
The most productive cause of insanity, as shown by the returns, is intemperance, 84; the next is mental anxiety, 69; grief for loss of friends, &c., 69; then comes the loss of property, 67; religious excitement, 56; domestic difficulties, 45, and unascertained, 563! In 907 of the cases, insanity appeared before middle age, leaving 384 only developed after that period.
The plan of detached cottages for a particular class of patients, continues to be an approved feature of the arrangements; and among the valuable improvements of the last year is the erection of a museum and reading-room on an eligible site. The building is 46 feet by 24, with a piazza, and the interior is furnished with interesting and valuable cabinets in natural science, as well as with newspapers, maps, periodicals, pamphlets, &c. On the interesting topics of society, instruction, and moral treatment, and the arrangements for heating and ventilation, much valuable information is furnished. The annual receipts and expenses are balanced with the sum of twenty-six cents, and the cost of each patient per week, including every thing, is $3 88. The amount expended on free patients during the year is $7,666 88. This is unalloyed charity.
2. The State Hospital at Worcester, (Massachusetts,) under the care of Dr. Chandler, was overflowing with patients, though fifteen new rooms were added during the year. The average number for the year was 404, and the number of dormitories 360 only. The number of foreigners in the hospital at the close of 1842 was 34, at the close of 1847 it was 121, and at the close of 1848 it was 150!
Dr. Chandler is of opinion, that it would not be judicious to enlarge the present hospital, but he would rather erect a new one, and separate the sexes. He thinks three small hospitals, in different sections of the State, would have some advantage over a large one.
The whole number of patients admitted from January 1833, to November 30, 1848, is 3084, of whom 1433 were discharged cured, 416 improved, and 272 died. Of the patients admitted last year, 154 were under middle age, and 255 above, showing a very different result from that which we have stated above at the Pennsylvania hospital. Of the whole number received at Worcester, the cause of insanity in 322 cases is supposed to have been intemperance; in 266 domestic affliction; in 233 religious views, and in 161 self-abuse. Hereditary tendencies to insanity were traced in 691 cases. Fifteen hundred and sixty-one were single, one thousand two hundred and thirty-two married, one hundred and ninety-nine widows, and eighty-six widowers. Dr. C. thinks it very clear that the sympathies and motives to action, which the domestic relations supply, are all but indispensable to keep the whole system of mind and body in a healthful state. If we understand the report of the trustees, the cost to the State of each patient is $2 33⅓.
3. The report of the New York State Lunatic Asylum established at Utica, was made to the Legislature, February 1, 1849. During the six years since it was opened, it has had an annual average of 335 patients. The whole number under care during 1848, was 877, of whom 495 were removed at the end of the year. Judges of county courts have authority to send to the asylum any person who becomes insane and whose estate is insufficient for the support of himself and family; and the county is chargeable with the expenses of his restoration, if it is effected within the space of two years. Six hundred and twenty-nine of this class have been received into the institution since it was opened, and have thus been partakers of the most seasonable and appropriate charity which the public can bestow. These have been among the most hopeful subjects of hospital treatment, and would have suffered most for want of it.