/ [Document C] BY THE SENATE, February 25th, 1852. Read and ordered to be printed. MEMORIAL OF MISS D. L. DIX, TO THB HONORABLE THE GENERAL ASSEMBLY in behaCWof, the INSANE OF MARYLAND. t I W/vj l?S*A MEMORIAL TO THE Honorable Ibc General Assembly of Maryland. Gentlemen of the Senate and House of Delegates: The subject to which your memorialist solicits your candid at- tention, and on which she urges early and effective legislation, embraces from more than one point of view, the civil and social inleiests of the State of Maryland; reaching through every commu- nity, and penetrating the seclusion of every family. This proposition, facts, not opinions, must demonstrate. Your memorialist presents the claims of that portion of a large, nnd fast increasing class for which appropriate care and protection are not now secured : she asks of Maryland, what has not yet been provided—a State Hospital which shall supply full remedial treat- ment for the Insane. This question, with ever strengthening and uncompromising force, acquires, day by day-, and year by year, weight and urgen- cy, and now presents a phase so strongly denned, that no eye can be blind to the significance of the sign it exhibits, and no sound mind or humane heait, can be at fault in determining the course which a just legislation must pursue, consulting alike the rights and the necessities of individuals, and guarding the financial inter- ests of the State. Gentlemen, your memoiialist is compelled to deal with severe facts, whose sharp outlines may not be softened by the graces of studied phrases and polished periods. With your permission she respectfully, but plainly and earnestly, brings to your knowledge, records gathered through cautious inquiry, and established by patient investigation. She asks your honest and deliberate exami- nation of the statements and tables, which, without an elaborate preamble, are now presented, and urges impartial and fair discus- sion of ihe true merits of the cause she advocates, and which you alone, in your capacity as legislators, have authority to sustain ; nnd she believes, humanity nnd justice to conduct to a successful issue. 4 There are but two institutions in the State of Maryland in which insane patients are brought under curative treatment; and but one, exclusively devoted to the reception of this class. Neither propose to confine their cares to citizens of Maryland ; the one has at the present time, thirty five (35) patients from the District of Colum- bia, sustained by goverment ; thirty-four (34) from the city and county of Baltimore, from the indigent classes; thirty-seven (37) from other counties in the State, leaving twenty-four (24) remain- ing paying patients, from this and other States. Total 130, Jan- ary 1st, 1852. This institution can properly accommodate but 120 patients, but by appropriating two large parlors for lodging- rooms, 15 more can be received; meanwhile this accession of numbers, diminishes the comfort and trenches on the remedial means of the hospital. This institution, the first movement for establishing which was in 1798—was first opened under charge of "an attending physician and other persons," in 1807, under the title of "The Public Hospital, for the relief of Indigent Sick per- sons and the cure of Lunatics;" and, finally, the establishment under vaiious restrictions and conditions at different periods, was leased by the city of Baltimore to private individuals, conditioned on being "exclusively devoted to the treatment of lunatics." A board of visitors was appointed by the legislature in 1828— Dr. Mackenzie retaining the lease from the city, till the first of January, 1834; at which time, by act of the legislature, die hospital was taken possession of by the president and boaid of visitors, in the name of the State ; having at the time 26 inmates. At the present date the resident physician pronounces the institution seri- ously incommoded by receiving a larger number than 120; and positively suffering disadvantages with 135 patients which is the maximum. The message of the Executive for 1849, contains the following paragraph in relation to the wants of the Insane: "Although the Hospital is now filled to its utmost capacity, there are, hundreds of insane persons in the State, one hundred and twenty-three of whom are in the Baltimore Aims-House, and eight in the Penitentiary, without the means of proper treatment for the mitigation or cure of the awful malady with which they are af- flicted. However urgent may be the demands of humanity in behalf of this unfortunate class of persons, and however clear the obligations of society to provide for their wants, in view, never. theless, of the proximity of the Hospital to the city of Bahiinoie, and the limited extent of its grounds, it is questionable whether instead of enlarging the present building, it would not be wiser and better to dispose of the establishment and employ the proceeds with such appropriation as the Legislature may choose to make, in the purchase of a sufficient quantity of land and the erection of an Asylum upon the most modern and approved plan, adapted in all its arrangements for the comfortable accommodation, treatment and cure of insane patients, and of a style and character worthy the munificence of the State." 5 1S52, Jan. 13. The President and Board, in a report to th« General Assembly, declare their opinion, that it is not expedient to enlarge the present Hospital; which, however, they recommend to be preserved as an auxiliary institution. Dr. Fonerden renders testimony in behalf of a new hospital in the report for 1852, from which the following paiagraph is an ex- tract. "It has been mentioned in previous reports, that our accommo- dations are not sufficient to receive all the patients ordered to be sent by the courts and commissioners. Applications from Balti- more city and from the counties are constantly on file for the ad- mission of public patients. When persons are admitted at th« public expense by order of a court, they are retained and provided for during life, if not restored, with scarcely an exception. The rooms set apart for this permanent class are therefore generally oc- cupied. Vacancies take place slowly, and sometimes months elapse without one. Hence new cases cannot be promptly ad- mitted, and some of them while waiting their turn are placed in jails and alms-houses," I ask your attention, in closing the presentation of the above facts, illustrating the inability of the Board of Visitors of the Mary- land Hospital, to afford admission for the fast increasing numbers of applicants, to the Institution at Mount Hope, established and conducted by a band of the Sisters of Charity The ninth Annual Report reaches the public, embodying an earnest claim on Legis- lative interposition, to protect it from encroachments which threaten its very existence. A petition, sustained by such arguments, as aie feelingly and emphatically therein set forth, merits impartial consideration. Mt. Hope,Hospital is not exclusively, nor mainly occupied for the treatment of insanity ;— but according to its report, a majority of the patients are of that class; we make exception to 5G cases during the past twelve momhs, of mania, a potu, a mrlady not comin^ rightly under the statistics of insanity, of the 102 cases admitted during the past year under varying forms of mental dis- ease, 54 were lecorded under the division of mania a potu. Two already were in the Hospital at the commencement of IS52. So that we have before us tlie record 52 discharged recovered, 2 re- maining at the present date, and 2 deceased. In 1850 and '51, TO cases were treated at Mount Hope, for this malady. The whole number of patients of all classes now remaining, is stated to be 115. Thus id shown the insufficient and, sole provision had in Maryland for cuie of the insane. On the fust of January, 1850, according to the most correct tables I possess, we find wiibin the limits of Baltimore city alone, ;JlS insane individuals: this docs not include the insnife in private families, either in the ciiv or county ni large, nor does it include idiots, simpletons, and epileptics,—a l«r-e class to omit. 0 January 1st, 1850, there were— in the Maryland Hospital, - - „ 133 In Mount Hope Hospital, 74 Total, under curative treatment,- - 217 In the Alms House, were r . . 123 In the Penitentiary, - 8 Total, recorded cases in Baltimore city alone, 348 Cases in private families not noted here. I have shown jn part, the insufficiency of the Hospital Institu- tions at Baltimore, for meeting the wants of the citizens of Mary- ,and' m relieving and affording curative treatment for the insane, and that these Hospitals are the sole resource of the citizens with- in their own borders. Briefly, that which is needed, is a new In- stitution capable of receiving two hundred and fifty patients which is the maximum for any first class curative Hospital and xnit should constantly re's id e the medical Superintendent, whose whole tune and care should be devoted to the pursuit of means for seeming thecomfort and recovery of his patiente Well timed' employment alternating with repose, useful labor, and suitable diversions, should be successively provided. What contrasts from iliese appropriate cares are presented in the condition of very many though not the largest portion of this class throughout this State* 1 lie largest part, indeed, wear out life in adverse situations but not ,n extreme* abandonment to misery ; that any abuses'and unnecessary sufferings exist, is a sufficient argument for assuring now at once, such remedies as shall spare the repetition and per- petuation ot these sore distresses. [ Your memorialist knows, and all may know, that confined apart- ments narrow cells, dungeons, and not seldom chains and nLi- cles-botb in private dwellings, in poor-houses, in county iad and ,n he penitentiary, are the miseiable alternatives, (in default of adequate Hospital provision for these unfortunates,) upon wl ch every sentiment of justice and humanity stamps a negative I is naked how I know that any extreme examples of misery exist? I reply, that I have traversed the State with this express objec to ...cue my search I do not propose ,0 detain you^poIde ailed history of the pnsons and poor-houses of Maryland nor .0 break down the screen which shuts out from gene, d,n pec, ou and curious gaze the troubles and sufferings of many respectable but mdigent families, who hide their insane in thei^o v7 dwell »ngs-for_what remedy have they? Noihing, save extreme* nerJ." P..yf and that only as a ten,por/ry expedient, c?n j ^ & car,erat,on of the msane m jails. In poor-houses/ he lections hough diffeung are equally urgent. The trustees and medio" attendants, uniting w„h successive superintendents, in he BaltJ more Alms-House, have, for years, earnestly and auhfull! ore' M..toJ in their Annual Reports, the inhumanity nnd mci £/e 7 suiting to all parties from this association of the demented, and the raving maniac, with the aged and the infirm; the feeble and the sick; the young and the helpless ; your memoralist can but add another voice of remonstrance against the perpetuation of this great abuse. I have said that the sufferings of the insane, expos- ed in unfit situations are great ;—language, however strong, is feeble to describe them,—but I would not be understood to cast blame on superintendents of poor-houses, and keepers of jails: either they have not the means, or they have not the knowledge to conduct rightly, one may almost say decently, the cares required by the unfortunate maniac; they abide a necessity of which they do not know how to rid themselves; and become hardened to sufferings which since they cannot remedy, they strive to forget, These men who govern poor-houses and prisons, are not. cruel and brutal,—but they are wrongly/orcerf to a work which every hour sears the better feelings, and which almost converts them to the rude, hard guardiansj which they sometimes, by the hasty ob- server, are charged with being. The establishment of a Slate Hospital would put an end to the continual repetition of scenes and conditions of existence which should not be suffered for a day to blemish the history of any community, nor any civilized and christian people. That this condition of things is not confined to one, three, six, or any dozen of the States, nay, that it is found now at this day, in every one of these United States, is no excuse for its toleration in any of them. Much has been done for the relief of the insane, and for lessening, by contrast, what is of minor consideration, the cost of their support to the public;—but much more remains to be ac- complished. It is a fact known to all experience, that the longer a necessary work is delayed, the greater the trouble and expense in effecting it. In this case, it is beyond estimate; for who can show how many of the unhappy Insane are now but commencing an existence, in which the reason is merged in delusions and vehement ravings, and for how many dreary years life may be protracted ; and, for what purposes, it becomes those who enjoy health and reason to inquire :—"Perhaps," as long since wrote a deep thinker and close observer of the course of human affairs, 11 these poor maniacs are a particular rent—charge on the great family of mankind ;—left by the Maker of us all, like younger children, who though the estate be given from them, yet the Father expected that the heir should take care of them." The insane cannot be left in charge of their families, nor to the ordinary charities which flourish more or less freely in all commu- nities; they require arrangements specially adapted to their special necessities. No domestic cares, no common modes of treating the sick ; no accustomed practice of accomplished medical advisers reaches their necessities. In what these necessities consist, none can understand, except they have paused to search out the stales of suffering, the entire disqualification for self-care whidi il»ic 8 malady often creates and perpetuates in the management of the unskilful and uninformed. No helpless infant can be more help- less, no wild animal of the desert more uncontrollable, than are many of these unfortunates, in different states and stages of the disease. Yet this malady, the result, in almost all instances of physical ailments, and so distressing in its effects upon the sufferer, and all with whom he is connected, is less hopeless than two-thirds of the same diseases which attack mankind. The tabular returns of.all well conducted Hospitals of these times; and the whole expe- rience of society establishes my position. Referring to the United States Census for 1840, we find the insane and idiot population of Maryland, recorded as 550, the entire number of citizens being 470,019. An interval of ten years has closed, and in 1S50 we derive from the United States Census the following record:—Insane, 916, (it is not shown what proportion of these are a private charge,) total population 583,- 035 ; showing an increase, supposing the lelurns approximate to accuracy, of 406, a ratio far exceeding the increase of the whole population, and offering the most persuasive argument for early and effectual care of recent cases; but even this large increase we knew, falls within the actual amount. The supposition, that this increase, so disproportionate, may be explained by the influx of emigrants, is unsubstantial. Of the 946 which are contained in the tables of the seventh census, 63 only are foreigners by birth. And, again, 104 only are free negroes, and 96 slaves, so that we have still in Maryland 683 Anglo Americans disqualified for all the offices of civil and social obligation, by reason of mental dis- ease;—or a total of 746 whites. The statistics of all the States exhibit rapid and fearful increase of this terrible malady. The entire number in the United States, according to the census of 1840, was 17,457, to a population of 17,069,453. The census of 1850 gives, in a total population of 23,267,498 an insane population of above 27,000. Nofe only is this great in- crease of insanity an alarming fact, but tracing the tabular state- ments, sent abroad annually, from all hospitals for the reception and treatment of insanity in the United States, we note year by year, the increase, if not predominance of insanity in the youthful classes of society. Medical men of sound minds and rare skill urge vainly on the dull ear of society, that prevention is in its power to a vast extent, and of infinite worth before cure, or, alas, the hazard of no cure—but the timely warnings are unheeded' and individuals, as communities, rashly multiply exciting causes, and too late deplore tho inevitable results consequent on transgression of the physical laws of health and life. I offer two tables, the first borrowed from Dr. Stokes' last Re- port; that which follows is taken from the last Annual Report of the Western Hospital, at Staunton, Virginia, and prepared by Dr. Stribling. 1 only add, that the records of other institutions ex- hibit large numbers of patients comparatively youthful, or in the very prime of life. 9 TABLE Shotting tho Ages of Insane Patients,from January 1st 1851, to January 1 st, 1852: Males. Females. ... .i Total. Between 10 and 15, 2 1 3 " 15 20,- 0 13 13 " 20 30,- 30 32 62 " 30 40,- 26 3f 57 " 40 50,- 7 16 23 " 50 60, - 4 8 12 " 60 70,- 1 4 5 " 70 80,- 2 3 5 " 80 90,- 1 ] 2 73 109 182 This table furnishes a view of the ages of all the insane patients treated in the course of the year. No one can pass through this institution without being forcibly struck with the large number of young females, and young men, evidently belonging to the mid- dle and higher walks of life, who are here the subjects of insanity. The question at once presents itself to every reflecting mind,whence comes it, that so many at the tender ages of fifteen to twenty five are stricken with this heavy calamity ? Shews the Age at ivhich Insanity is supposed to have commenced with Patients who have been in the Asylum during tht year: Males. Females. Total. Of those under 15 years, 10 7 17 between 15 and 20 years, - 23 24 47 20 and 25 u 35 28 63 25 and 30 (( 38 28 66 30 and 35 (< 26 20 46 35 and 40 u 14 12 26 40 and 45 u 23 16 39 45 and 50 cc 4 9 13 50 and 60 a 7 9 16 CO and 70 " 2 2 4 over 80 years, - 1 0 1 Unascertained, 45 23 68 228 17S 406 Dr. Ray states in the Repott of the Butler Hospital, for 1851, "that the, increasing prevalence of insanity cannot be denied;"— 10 "of the causes which appear, in answer to our earnest inqui- ries, we cannot speak in detail, but there is much in our politi- cal, religious, and social usage?,—calculated to distuib the bal- ance of the mental powers, and prepare the way for unequivocal insanity ;—also the eagerness, the hurry, the vehemence which constitute such prominent traits in our national character, produce a morbid irritability of the biain, but a single remove from overt disease." " The gross neglect of correct family education and discipline, and the neglect of the moral powers—'those which guide the passions and de:ermine the motives, is the crowning defect of the education of our times, ruinous in its consequences to the health both of the body and of the mind." I am compelled to omit the pages which follow these remarks; rich and strong in wisdom and truth; they are, so to say, a code of sound instruc- tions which all need to study with care and reflection. In advertinir to one very fruitful cause of cerebral disease, I find no little difficulty, but shall adduce one example, which I might follow with a thousand, to show the wickedness and ill-conse- quences of the intermarriage of blood-relations. In a commu- nity composed of 300 families, 34 heads of families were known to be nearly allied by the ties of consanguinity. T'here were born to these parents ninety-five children, of whom 44 were idiotic, 12 scrofulous, 1 wrxsdeaf, and 1 was n. dwarf. In one family.of 8 children, 5 were idiots. Not one of the 95 could be called per- fectly sound in body and mind. Increase of Insanity amongst the younger classes of society, furnishes another argument for early treatment of the malady, be- fore disease has fastened for life, on its victim. The public safety, equity, economy and lastly humanity, require adequate, appro- priate provision for the insane before the malady assumes a chronic character, and the hapless being becomes a life-care to his friends, or a heavy burthen upon the public. Every man and woman possessed of sound health is wealth to the State; every individual diseased and disabled is a draft, both directly and indirectly, on its riches and prosperity. It is cheaper to cure than it is to support, even at the very lowest rates. I ask to show you, by positive esti- mate, results reached by examining, collating, and contrasting accounts gathered with careful labor. In ihe Hospital at Staunton, Va., in 1842, twenty old cases had cosf> $41,633 00 Aveiage expense of old cases, 2 081 65 Whole expense of curing twenty recent cases, 1^265 00 Average expense of curing these cases, 63 25 In the Ohio State Hospital, in 1S42, the whole expense of twen- ty-five old cases had been $50,611 00 Average do., 2'o20 00 W hole expense of twenty five recent cases cured, 1,130 00 Avei age of twenty-five cured, ' 45 20 In (he Massachusetts State Hospital, in 1843, there remained twenty-five old cases, the peiiods of whose, insanity had varied, n and all in sufficiently rigorous physical health to authorise the expectation of their living many years longer, and the'cost of whose support to the public had already reached the sum of , $54,157 00 Average expense of do., 2,1(56 20 The whole expense of twenty-five cases of indigent patients recovered, was 1,461 30 Average, 58 45 Thus it is seen that while the interests of humanity, those first great obligations, are consulted by the establishment of well regu- lated hospitals for the insane, political economy and the public safety are not, less insured. Dr. Trezevant, (Report of the South Carolina Lunatic Asylum for 1842 and '45',) observes, "Many sunk from chronic diseases of the lungs and bowels, engendered by exposure during their wan- derings, or the want of attention, when confined in the jails or work houses." He complains of their being kept five or six months under care of the family physician, and asks, "Is it light that the patient should be placed under the care of those, who are unac- customed to the care of Lunatics ) How often is the case aggravat- ed either by tin? foolish indulgence of fiiends, the restraints of gross ignoiance, or the injudicious treatment of the medical advisers?" Dr. Ray (Medical Jurisprudence of Insanity) argues thus, "In case of homicide and other acts of violence, if the subject be insant, it is an act of humanity to afford him the refuge. If he be crimi- nal and pleads insanity as a means to elude the law, then the re- straint of the Asylum, guards the community from the further commission of crime." Dr. Allen, of the Kentucky State Hospital, makes in a late re- port the following practical remarks : "Cases of recent occurrence, which have been treated this year, have, as usual, very generally recovered. "After several years constant and close observation of insanity, in its various forms and indications, I am more and more confirm- ed in the opinion, that the only grounds upon which a cure can be, with any degree of confidence expected, is a prompt applica- tion of proper treatment in the early stages of the disorder. True some recover from the chronic forms of the malady ; but I must own, that were it has occurred, I claim little credit for the science of medicine. Nature, by some evolution in the system, effecting it, aided, no doubt, to some extent, by the wholesome discipline of the Institution. , ."There is no affection so little understood by the community, and I may say, perhaps by medical men generally, as insaniiy cases of years duration are often biought here by friends, unde. medical advice, who ask and expect us to 'feel the pulse and tell them when a cure may be effected.' " The following tables exhibit the advantage of largely extended nnd seasonable rnspilal care for the insane. 1 am indebted chiefly to the reports of Drs. Woodwaid and Awl for these carefully pre- pared records: 13 TABLE Showing the comparative expense of supporting old and recont cases of insanity, from which we learn the economy of placing patients in Institutions in the early periods of disease: «._ .. 03 - rt '- 1 » ~~T~ ... .m 8 $- 4*3 i & m i V ■a o o 4> u 3 5 ail's -oCg- ■S£° -O w o M a B It .3 i zt 6 «, £ o £-3 OJ a O JG £ S b '< 30 7 U 2 69 : 28 $3,212 00 1,622 ft 16 10 7 4S 17 2,004 00 1,624 34 20 46 00 8 60 21 ' 2,501 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 SO 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,S35 00 1,658 36 14 32 20 102 53 25 2,833 00 1,660 21 16 36 SO 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 1,599 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 j ^54,157 00 635 $ 1,461 30 When it is remembered, in addition to these facts, that there are very few acute diseases from which so large a proportion of persons attacked, fully recover, as from insanity, brought under early and appropriate hospital treatment, the positive obligation to meet fully this great want throughout the United States, as well as in Maryland, is too plain to admit a question. Entire and early cure of cases which are functional, not organic; early cared for, and not protracted, n the ride ; duration of the disease, the exception. Recovery, implies a complete restoration of the men- tal powers. IS TABLE Showing the eompardtiva eurability of a given number of eases healed at different periods of insanity, as introduced to hos- pital care: 1' ■ .-------------------------------------------------------------------------------------------------- i* "o a o to S a ^ © r gallon, 108 00 151 00 36 00 211 00 45 00 47 50 21 50 57 00 40 00 5 00 12 75 17 00 20 00 6 00 14 00 „ 25 25 52 75 49 m 20 00 972 ~i*i *5 In addition to the above, the hands employed on the garden" have taken rare of a gieen house containing a large number of plant?, have attended to the transplanting of trees and shrubbery, and bestowed much labor in other ways of which no note hat been taken. The products of the farm, including carpenters^ work done by the farmer and those patients entrusted to his care, were as fol- lows : 500 bushels corn, at 50 cents per bushel, . 240 bushels potatoes, at 50 cents pel bushel, 103 bushels buckwheat, at 50 cents per bushel, 9 loads fodder, * 126 loads wood, at $1 75 pel load, • 300 dozen sheaf oate, at 25 cents per dozen, 8,000 lbs. potk,at $4 50 per hundred (,266.lbs. veal, at 6 cents per lb., - 3 calfskins, at $1 each, 6,570 gallons milk, at 20 cents per gallon, 37 head of stock hogs, at $2 each, 5 head young cattle, at $;10 each, Making 115 panels plank fence, at 30 cents each, Making and hanging 3 large gates, at £7 each, ,' j Remodeling horse stable, - Erecting a building 80 feet long by 26 feet wide, for barn, corn crib, flour house, cow stable. &c. &c, The farmer and bis; assistants have done much that was useful and necessary, such as clearing woodland, hauling stone, &c. &c, not included in this statement. The female patients have in their appropriate sphere been no less industrious, and their labor attended with proportionate pronf, as the following statement will shew : 277 men's coats, made at &1 each, - - 277 00' 310 " pantaloons, made at 50 cents each, 155 00 257 " vests, made at 50 cents each, - 128 50" 25 " drawers, made at 25 cents each, - 6 25 216 " shirts, made at 37-J-cents each, - 81 00 77 " roundabouts, made at 75 Cents each, 3S 60 192 female's dresses, made at 37^ cents each, - 72 00 212 " under dresses, made at 25 cents each, 58 00' ]54 <■• aprons, made at 12?, cents each, - 19 25 71 " caps, made at 17 cents each, - G 83- SS " collars, made at 12-i cents each, ., 1100 32 " nicht gowns, made at 25 cents each,. 8. QO 601 pair stockings, knit at 37£ cents each, -' 22 56* Carried forward, $S78 8£ 250 00 120 00 51 50 20 00 220 50 75 00 360 00 10 64 3 00 1,314 00 74 00 50 00 34 50 21 00 50 00 276 50 <2,930 64 16 Brought forward, $878 83 300 pair socks, knit at 25 cents each, - 90 00 98 pair socks, footed at 18| cents each, - 18 37^ 408 hankerehiefs and towels, hemmed at 6|- cents each, 25 50* 11 mattress ticks, made at 75 cents each, - 8 25 68 mattress slips, made at 25 cents each, . 17 00 142 pillow ticks and cases, made at 12^ cents each, 17 75 4 bed ticks, made at 37^ cents each, - - 1 50 84 bolster ticks and cases, made at 12^ cents each, 10 50 213 sheets and bed spreads, made at 25 cents each, 63 25 25 comforts, made at $L each, - - - 25 00 8 bed quills, pieced and quilted, at $3 each, 24 00 94 curtains for windows, made at 25 cents each, 23 50 7 carpets, made up at $1 50 cents each, - 10 50 2,974 pieces of clothing, mended at 3 cents each, 89 22 Amount of fancy woik, made and sold, proceeds to be applied to completing chapel, ... 77 00 Total, - - - . $1,370 07^ SHOE SHOP. The new work and rrtending done amounts to $1,021 73 Contra. The cost of material used, - $414 21 The wages of foreman 12 months, - - 252 00 The dieting of do. do. at $8 per mo., 96 00 ------• 762 21 Profit, - - - $259 52 This statement cannot exhibit the saving to the institution, as from the convenience of having such a shop, shoes are often mend- ed so soon as they need it; whereas, if they had to be sent else- where it would be deferred, notwithstanding the admonition of Dr. Franklin, that "a stitch in time saves nine," until the expense of repairing would be greatly iucreased or the shoe be rendered useless. Our patients, both male and female, have uniformly been well supplied with shoes. The servants, numbering about thirty, get, under a rule of the institution, two pair each per an- num ; and the whole cost for the year of having supplied the wants in this respect of more than four hundred patients ar.d thirty servants, has only been seven hundred and sixty-two dollars and fifty-two cents. HAT SHOP. The hats for patients who are supplied by the State, and fortius servants, are made by one of the attendants, with such aid as his patients can afford him. Not les3 than two hundred and fifty 17 patients and thirty servants have been provided for during the year, at a cost to the institution of not more than one bundled and thirty-five dollars. The hats are made of coney and cotton—are neat, durable, and comfoitable—superior greatly in all respects to the wool hat, which, if purchased at wholesale, would cost con- siderably more than is expended under our present arrangement. It is not occupation alone, but useful employment, that so emi- nently assists other remedial moral means for the restoration of the patient. Hence the value of a productive farm or plantation, on which those who are able, and whose early habits permit, may find in labor, not the curse, but the inestimable blessing of well- directed toil; due exercise of the physical powers, and occupied attention, recalling the disturbed and distracted mind to the integ- rity of sound health. I have endeavored to prove the advantages to be possessed by hospital treatment for the insane. I have tried to illustrate the disadvantages of domestic care and prescription for this suffering class of otir fellow-beings. I have glanced at the inefficiency and cruelly of a poor-house and prison residence for the epileptic and the maniac. In imagination for a short time, place yourselves in their stead. Enter the horrid noisome cell; invest yourselves with the foul tattered garments which scantily serve the purposes of decent covering; cast yourself upon the loathsome pile of filthy straw, find companionship in your own cries and groans, or in the waitings and gibberings of wretches miserable like yourselves; call for help and release, for blessed words of soothing, and kind offices of care till the dull walls weary in sending back the echo of your moans; then, if your self-possession is not overwhelmed under the imagined miseries of what are the actual distresses of the insane, return to the consciousness of your sound intellectual health, and answer if you will longer refuse or delay to make adequate appropriation for the establishment of a hospital for the care and cure of those who are deprived of the use of their reason- ing faculties, and who aie incapable of exercising a rational judgment. Of all men, they are to be ancounled most miserable, who are reduced to mere animal existence. In asking for the establishment of a Srate Hospital for the Insane in Marvland, located to assure, through salubrity of air, abun- dance of pure water, a productive farm, and open access, by far reaching lines of travel, the largest good to the largest numbers, vour memorialist is sustained by the opinions of all the citizens of the Stale who have had time and opportunity of studying the subject fully, and of examining its claims. By none is ibis more earnestly desiied than by the Physician of the Maryland Hospital, and by the President of that Institution, ihat good man and good < iiizpn, who for 24 years, without reward or lecompeose, " hoping all rhino's, and seeking not his own," has spared neither time, nor labor, nor that which most men yive least icadily ana Liu-st, large 3 18 pecuniary aid to keep in existence and useful operation the oldest charitable and humane institution in the State of Maryland. Non immemor tanti beneficii ! It is not improbable, that some members of your Honorable Body, men, too, of good hearts and liberal minds, will hesitate, if not seriously demur to a measure they will admit to be impor- tant, and opening strong claims on theii ■efficient support and offi- cial action, but who will urge the large indebtedness of the State as an argument against new plans for the application of the public funds. I respect their cautiousness and hesitation. The mone- tary obligations of the State are heavy; taxation is already one- rous; but will these be lessened by the omission to provide by crea- ting a State Hospital for the Insane of the State, for those who must be supported in some way during the period of their natural lives. In hundreds of cases? if not thousands, it rests on your decision, Legislators of Maryland, whether this shall be accom- plished at heavy or light cost, to the State. The time-worn adage, —"Honesty is the best policy," Maryland has engraven on her shield, and the citizens stand fitm, as honest men, on the strong rock of Integrity, honored and honorable, each lends his strength to redeem the State from the heavy burthens of her debt. And is the rich man less affluent, or the poor man the poorer, for coming up boldly to this work ? No, no, they have struck the vein of the pure gold of virtue, and are enriched by treasures thafmoth and rust do not corrupt." And does the legislator argue that being true to the principles of honesty, he may stand acquitted of othe° obligations? No, there is another law to which he will pay tri- bute ;—in "doing justice," he will " remember mercy.'''' And, again, he will not consent that Sister States, younger and feebler' by reason of earlier years, should take precedence of his maternal Maryland. See Alabama—honest and resolved, she provides for full payment of her monetary obligations, and at the same time assumes cheerfully the debt she owes humanity. Owning the ward- ship of her insane children,—she appropriates $100,000.00 for a State Hospital, and is earnest only to advance to completion the work so well and wisely commenced. Look at Indiana__noble clear-sighted Indiana,—honest and true; liberal and wise!—But few years since, Indiana made provision for the gradual payment of nearly twelve millions of dollars of her public debt, and bein°- instructed in the necessity of timely provision for the insane, the deaf mutes, and the blind within her borders,—she adopted a wisd and noble policy, equally prudent and humane; and levied a spe- cial tax for the ereciion of edifices for the insane,for the deaf mute and the blind, at a cost of more than $200,000, an 1 provided for the ample support of all these;—and a section in the new Consti- tution lays down a principle, and establishes a law for the perpetual support of these three charities by the State. There, in the young State of Indiana, almost within the shadow of her Capitol ai Indianapolis, stand these monu- ments of a christian and enlightened age, recording a fore- \ 19 \ thought and munificence, which, under ihe circumstances has no parallel, though Illinois, ranging side by side geographically, almost completes a corresponding page in her history. Shall Maryland falter,solicited by more urgent incentives todetermine her decisions and to quicken her energies?—Surely she will not! No truth in ethics is more surely established than this;—not one human being, whether of high or low degree, strong or weak, learned or unlearned, conspicuous or humble, old or young, in the full fresh vigor of health, or feeble through weakness, but is vulner- able to the attacks of maniacal insanity. The man of most mighty intellect, the woman endowed with rarest viitues, may in an hour become the beneficiary of humanity;—the hapless ward of heart stricken kindred, helpless alike to restore and cherish. The precious home no longer offers health giving influences; the cares and caresses of dearest friends but enhance the miseries of this terrible malady. "Lover and friend it puts far away, and acquain- tances into darkness." The well-organized, well-sustained Hos- pital alone opens its portals for shelter and relief. The skill which directs appropriate care, here«disstpates the delusions which dis- tinct; and heals the sicknesses which other direction could not arrest. Legislators of Maryland, importunity urged by thesacied voice of unerring Duty, presses this cause upon your notice;—you who fill places of authoiity,—forget not, amidst the heal of debate, the clash of opinions, and the sometime strife for political distinctions, foiget not the majesty of your station, the dignity*and sccredness of that trust confided to you by your constituents; forget not that you have the right and the means of exercising the ennobling offi- cesof justice, humanity,and civil obligation. Becoming through your station as legislators, benefactors of the needy, whose mental darkness, through your action, may be dispersed, how many prayers and blessings from grateful hearts will enrich you ! As your work on earth shall be measured, and your last hours shall be slowly numbered; when the review of life's deeds becomi s more and more searching, amidst the flashes of uncompromising memories, how consoling will be the remembrance that of many transactions— often controlling, transient and outward affairs,—frequently con- ducting to disquieting results,—possibly sometimes to those of doubtful good, you have accomplished a work whose results of widelv diffused benefits, create a light brightening your path through " the dark valley," and leading to those ''gates of eternal life" which open upon "the blessed mansions" in which the finite faculties are beyond the reach of blight, and advance con- tinually in knowledge, to perfection ! Respectfully submitted, D. L. DIX. Annapolis. February 24th, 1852. APPENDIX. Report of the Pennsylvania. Institution, from 1751 to 1841: 1811—Admitted 4,358: Restored to family perfectly cured 1,493. Discharged improved, 913. 1843—Admitted, 258: Cured, 68. In three years, admitted, males, 288 ; females, 181—439 : Cured, males, 97; females, 61—158. 1844—Admitted, 285: Cured' 75. 1850—Admitted, 228: Cured, 106.—[Sundry Reports by Dr. Kirkbride. TABLE (from Dr. .Iwl's sixth report for 1844, of the State Hospital, at Columbus, Ohio,) showing the comjmrdtive expense of supporting old and recent cases of insanity: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16|57 1728 18149 1943 20 45 2129 22 33 23 40 2439 25 40 42 45 35 40 38 38 42 40 40 40| 50 48 45 35 57 « u 3 <2 ^ _c ►> a o c. r. t - g Q o a 42 - I.I.M £.2 • ^ OS <° ° 0> * 18 11 13 12 15 10 10 15 20 9 10 11 9 10 27 10 13 21 15 10 14 10 28 10 10 $1,872 00 1,144 00 1,352 00 1,248 00 1,560 00 1,040 00 1,040 00 1,560 00 2,080 00 936 00 1,040 00 1,144 00 936 00 1,040 00 2,808 00 1,040 00 1,352 00 2,184 00 1,560 00 1,040 00 1,456 00 1,040 00 2,912 00 1,040 00 1,040 00 $35,464 00 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 29 22 35 26 41 37 27 34 31 22 18 29 23 24 28 45 28 41 24 32 20 20 21 31 25 '^3 < 2 d 4 ii 4 ii 1 ii 3 ■ « 2 i< - 5 ii 8 u 5 ii 5 days 10 months M 91 l> d m . 09 •3 •5.2