EIGHTH ANNUAL REPORT, 1871. The Superintendent says, "It appears by the physician's report that a certain percentage of this class has either recovered or improved. It is small, to be sure, but it is constant; and is important as showing the beneficial effect of a change of life and more active out-of-door employment upon those believed to be past all hope of cure." We should be thankful for ever so small a percentage of cure among these unfortunates, and equally thankful for the improved condition of those who are never to be in their right minds. All who know the dreary monotony of life in the lower wards. of a hospital, will understand what relief many patients would feel if they could freely breathe fresh air, even if "employed laying the foundations of a new building," or upon farms, or "performing part of the varied labors of the immense establishment at Tewksbury." The asylum building, although too near the almshouse, is entirely separated from it; and although it sadly lacks some. accommodations which are essential to comfort, to decency, and even to salubrity, is in many respects well adapted to its class of lunatics. The number of patients on September 30, was 295. The Superintendent says: "Of the insane aforesaid, a large majority was transferred from the three lunatic hospitals. This constant draft has so relieved them, that they have been able to meet all demands for admission from within the State, which otherwise would have been utterly impossible. In connection with the labor of the Board of State Charities and its officers, in removing lunatics to their homes without the State, it has prevented thus far the establishment of any new institution of the kind since 1858. The amount of board thus saved already would almost build a new hospital. To give an idea of it, I would state that if our 294 lunatics were now boarding at a hospital, at the weekly rate of $3.50 fixed by the legislature, the annual cost would be exactly $53,655; while here they are maintained for about $27,000, besides performing nearly all the labor of this immense establishment. INSANE CONVICTS. "These facts have become so apparent to the legislature, that an appropriation of $25,000 was made last winter for the enlargement of our present accommodations for this class. The foundation of the extension is now in progress (laid wholly by insane labor, save one hired hand and an officer), and when the latter is completed, it is expected to furnish room for one hundred and fifty additional patients, whose board at the hospital would cost the State over $27,000 per annum, while here it will hardly be half that sum. We shall derive the advantage of additional labor, while many of the patients will enjoy more liberty than is now possible in the hospitals. This action of the legislature will again remove the necessity of erecting at once a fourth lunatic hospital, and the success of the policy may postpone it indefinitely." The most important thing for a lunatic is restoration to reason; but the next is restoration to usefulness, by some employment which gives him comparative happiness. The State hospitals must look to their laurels ! INSANE CONVICTS. Notwithstanding the present satisfactory condition of the State hospitals, they labor under some manifest disadvantages and difficulties, which, unless remedied, will in time become more serious. Of these, the Board will now notice only one; to wit: the necessity of receiving into the hospitals, convicts who have gone mad while under sentence; and lunatics who have committed homicide, or other acts which would be criminal in sane persons. There have been eighty of this class in our State hospitals during the past year. When we consider the structure of the hospital buildings, the condition and wants of the great majority of the patients, and the desirability, on all accounts, of having the least possible restraint, we shall see how much embarrassment to the Superintendents, and how much evil to the other patients, are occasioned by the presence of these doubly unfortunate inmates, who require forcible restraint to prevent escape or violence. A pretty full discussion of the matter is found in the report of the Secretary, which contains the opinions of all the Super h EIGHTH ANNUAL REPORT, 1871. intendents. They all dwell on the disadvantages and injury suffered by innocent insane persons from being associated with criminals. They coincide with eminent authorities abroad as to the desirability of separate provision for this class of patients. All their opinions point toward a separate hospital for criminal and homicidal patients. There are, however, difficulties, both theoretical and practical, in the way of such an establishment. There are not insane convicts enough to call for a special hospital. If one is established nominally for them, but calculated to receive insane homicides, it will inevitably have an odor of infamy about it, and people will object to putting into it persons innocent of criminal intent, but who kill or assail others while under irresistible insane influences. This is not a mere sentimental objection, but a practical one. It is not conceivable that a hospital specially destined for criminal lunatics, men of blood and violence, and for those who in madness assail and slay people, should be so constructed and administered as to give as good a chance for the recovery of patients as one destined for innocent persons. We must go back to the old prison structures, and introduce the odious features of prison discipline. A man of good heart and blameless life may, in his madness, slay wife or child. That man, however, has a clear right to the very best remedial treatment, and to the greatest degree of freedom consistent with safety to himself and to others; in short, to every possible chance of recovery from the dominion of the demon which sometimes possesses him. A trifle may turn the scale for or against him. That trifle may be his being put in a hospital constructed and administered for the confinement and treatment of criminals, instead of being in one for innocent persons; and it may doom him to lifelong madness. On the other hand, to a convicted and sentenced murderer, insanity comes as a temporary pardon. It would be inhuman to punish a lunatic. He is the State's ward and patient. He must be treated as though he were innocent, and given the best chance of cure. As soon as he is cured he reverts to the status of a convict. He merits penal discipline. But PAUPERISM AND RELIEF OF PAUPERS. liability to recurrence is one of the painful features of insanity; and if the sufferer is remanded to prison, the severity of discipline may upset his scarcely re-established reason. Then there is the difficulty of deciding at what point impulses cease to be sane, and to become insane; and the greater difficulty of drawing the line between innocent and criminal actions. Other considerations might be against a separate hospital; but it is not worth while to decide now whether they outweigh those strong ones in favor of such an establishment, while the number of actually criminal lunatics remains as small as it is. Besides the State will be better able to decide this question after the result of the experiments on trial at Worcester, is known. If successful, the treatment of criminal lunatics will be much less difficult than in hospitals as now constructed. PAUPERS AND PAUPER ESTABLISHMENTS. The diffusion of knowledge by common schools, by the press, the pulpit, and other means, is slowly dissipating that ignorance which is a fruitful source of pauperism. State and towns are making direct efforts to relieve existing paupers by measures which shall not tend to multiply the evil, as most public measures have been wont to do. The Secretary's report contains an important mass of testimony and of evidence respecting the comparative merits and demerits of the method of supporting the dependent in almshouses, and the method giving them relief at their homes. It is made up mainly of answers to questions addressed by him to overseers of the poor in our own and some other States. It forms a very valuable contribution to that wide knowledge necessary for the proper solution of that vexed question. To us, at least, it is more useful and reliable even than the immense mass of evidence to be found in the English Blue Books. It contains the opinions of many of our shrewd, practical men, derived from their actual experience in matters which concern them as citizens and tax-payers. The people of New England generally select overseers of the poor with more regard to their common sense, prudence and honesty, than EIGHTH ANNUAL REPORT, 1871. Most of the answers to the they select other functionaries. questions put to them by the qualities. The Secretary adds to the value of this mass of evidence and testimony, by a judicious analysis of it, and by his own cautious inferences. The prevailing sense of their various opinions is that a proper pauper system for a State like ours, should be based upon outdoor relief, strictly supervised and carefully administered, with the almshouse as a necessary adjunct. The chief features of such a system are, first, temporary relief, to prevent breaking up families by tiding them over uncommon difficulties, to keep their children and youth from becoming paupers. Next, discrimination between those who are being swept towards pauperism by accidental forces and those who tend towards it by hereditary qualities, or by lack of the degree of bodily and mental power absolutely necessary for self-support clear through old age. The first must, if possible, be put in the way of taking care of themselves. The latter must be supported through life in such manner as will give them all the enjoyment to which they are justly entitled, and hold them to such duties as they can perform. The stream of social life must have its dregs. In the present state of things no better disposition of them is to be expected than consignment to a well regulated almshouse; and no better models for the proper care and employment of paupers can be found than in the country poors' farms of New England. THE SANE STATE PAUPERS Of Massachusetts are now provided for by a joint method of out-door relief and of almshouse support. The first is given through the Visiting Agency for the State sick poor; the second is given mainly at the Tewksbury Almshouse, which is the great pauper receptacle of the State. OUT-DOOR RELIEF.-LOCAL RELIEF. Formerly there were but few dependent persons in our borders who, having no settlement in any town, and therefore no claim upon the local authorities, sought it at the hands of the |