SECRETARY'S REPORT. with contempt upon the poor lunatics, as he styles them; he says that his case is not like theirs, that the hospital is no place for him. And I think he is right. Sane or insane, the confirmed inebriate should have special provision made for him by the laws. Those who are agreed that he should no longer be kept in our present hospitals will differ widely as to what shall be done with him, and it is perhaps hardly my place to discuss it. I only trust that here in Massachusetts, where the Washingtonian Home, with a noble purpose and an unfailing charity, holds out a helping hand to such as have the manhood to help themselves, for that other class who have left no manhood to appeal to, I trust we shall have a practical, not a maudlin philanthropy; that we shall build for them no castle of indolence, or, having built, make it a paradise for loafers; but that labor, subject to the direction and discretion of a well-informed, judicious medical chief, be made compulsory. One great trouble with our present houses of industry for this class is, that the term of sentence is too short for any lasting good. In this future asylum, or refuge, or rest,-call it by what pleasant name you will,-make the sentence long, three years at least; perhaps subject to a reduction for good conduct, at the discretion of its board of directors. Locate such an institution on an island, where nothing intoxicating can be obtained, and the liberty of the grounds can be assured; then we should hear less, it may be, about men of gentlemanly instincts with but a single failing, but we should at least hope to learn of some cases of oinomania permanently cured." The Superintendent's conclusions in this matter will meet with a hearty assent from a large and increasing number of the philanthropic. It may be stated that while this Report is being printed (October, 1871), Dr. D. Dalrymple, who is a member of the British Parliament, in endeavoring to mature for its consideration an improved method for reforming habitual drunkards, is visiting this Commonwealth and other States for the purpose of inspecting institutions which provide for this class, and conferring with their managers. INSTITUTIONS OWNED BY THE STATE. Inmates of the Hospital. The statistics are given as follows: The average number of inmates at this hospital for the past year has been 396.07, an increase of 8 over the previous year. The State patients admitted here have numbered 266; the average number of this class has been 132.78, a decrease for the year of 15. Sixty-nine State patients were removed from the hospital by the Board of State Charities. The Northampton Lunatic Hospital. The number of admissions to this hospital has continued to increase as in former years. Illustrating this fact the Superintendent presents the statistics of the past seven years, covering his administration, by which it appears that the admissions, which for the year 1864-5 were 134, have risen to 211 in the year just closing. Numerous applications for the admission of patients from other.States have been rejected, it having been determined by the Trustees, in January last, to decline to receive such patients henceforth. Various improvements have been made in the appliances conducive to economy of labor and the comfort of the inmates, the enumeration of which is unnecessary in this place. They have been chiefly made by the labor of the workmen ordina SECRETARY'S REPORT. rily employed at the institution. The farm belonging to the hospital has been unusually productive. By consent of the Trustees the Superintendent was enabled to visit Europe during the summer season to recruit his impaired health. During his stay abroad he devoted his time to the examination of the lunatic hospitals of Great Britain and the Continent, and his report upon the present condition of this class of institutions in foreign countries, necessarily brief, is full of interest and valuable suggestions. For various concise descriptions of differences in hospital construction and administration his report should be consulted by those who, at the present time, are endeavoring to determine the best arrangements in the construction of hospitals. Dr. Earle notes the appliances for ventilation and airing in European hospitals, the extent to which mechanical restraints are used, the provisions made for expanding the limits of the hospital and distributing patients in different buildings. He notes also the general tendency to expansion, not merely in hospitals for the insane, but also in institutions for the treatment of other diseases. Upon this point "The principal objection to this expansion is the increased cost, first, probably, in construction; and, secondly, and assuredly, in the current support of the inmates. A hospital so constructed becomes a place of magnificent distances,' and consequently requires more time and labor in executing its daily operations. Both officers and employés must be more numerous than in institutions more compact, and the expense for heating, in a climate so severe as that of Massachusetts, would be very considerably augmented. The advantages to be gained are, first, if the buildings be properly constructed, a somewhat more nearly perfect ventilation, and, if so, a better hygienic condition; and, secondly, a wider separation of the different classes of patients. The classification itself does not necessarily become more complete than in hospitals more compact. But the quiet and the convalescent can be withdrawn more completely from the noisy and the refractory, and, consequently, from the most repulsive features of their surroundings. There are, also, I think, advantages in the separation of the laborors from the other patients. This fact is pretty extensively recognized at the county INSTITUTIONS OWNED BY THE STATE. asylums in England, where, in several places, I found the workers domiciled in special apartments,-sometimes in the main building, sometimes in a building detached. "As the new hospital at Worcester is to be constructed upon these principles there will soon be an opportunity, in Massachusetts, of arriving at a more positive conclusion in regard to their comparative merits, than is possible at present." Dr. Earle does not favor the Gheel or colony system of boarding out patients in private families licensed for the purpose, which has lately been practised in Belgium, and to a limited extent in Scotland. His conclusions upon the relative merits of lunatic hospitals in different countries deserve attention. After giving the general preference to the British hospitals as superior to those of any other country, taking into view their construction, organization and general adaptation to their purpose, as well as their systematic operation, neatness and general comfort, he says: "But making allowance for the differences in national habits and customs, the best hospitals of Great Britain and those of most of the Continental countries, as well as of the United States, are now very nearly upon an equality. If the English hospitals are superior to ours, that superiority lies chiefly in the possession of a more experienced corps of attendants, and a more thoroughly organized system of labor for laboring patients; and in the details of conveniences for the comfort and safety of the patients." Recognizing the fact that "no hospital is perfect in itself, and no general principle or plan for hospitals is perfect, if, in either case the ingenuity or the wisdom of man can devise one that is better," he approves the introduction of new principles and novel plans, in the certainty that either by their success or their failure good will come of them. Of the 211 admissions, 96 were from the general population, and the remaining 115 were transferred from other State institutions. Of the 96 new patients, 62 only had never received hospital treatment before. The average number is reported as 421.9, greater by 8 than in any previous year. Of this number the State patients were 230, a smaller proportion than in 1870. The average number of this class of patients is annually diminishing at this hospital, doubtless through the systematic transfer of all suitable cases to the Tewksbury receptacle. This hospital has generally received a larger proportion than the other State hospitals of patients from other States. The average number of this class for the year has approximated 50, nearly all of them having been admitted prior to the beginning of the current year. The Lunatic Hospitals as a Class. Combining the statistics of the three hospitals these results appear. The whole number of admissions has been 1,061; of discharges 1,033; leaving the number of inmates remaining in the |