STATE OF NEW YORK. 
STATE BOARD _0F CHARITIES. 
IN THE MATTER OF TIIE INVESTIGATION 
OF THE 
lew York City Asylum for tie Insane. 
REPORT. 
August 12, 1887. TO THE STATE BOARD OF CHARITIES: 
e, tlie members of your Standing Committee on the Insane, 
/ liom was referred tlie letter of the Mayor of the City of Hew 
lork, dated June 17tli, 1887, calling the attention of this board to 
certain complaints made to him “ that the management of the 
Lunatic Asylum on Ward’s Island is not such as to entitle it to 
public confidence,” and preferring the request that the Board would 
“ take prompt steps to make a thorough investigation” of the same, 
subm it the following special report: 
Im pursuance of such reference, you r Committe, including one 
unember for the City of Hew York, have made such investigation 
into the management and affairs of the Hew York City Asylum 
for the Insane on Ward’s Island. 
Our hearings and examinations having been made public, were 
first conducted at the City Hall, Hew York, on the twenty-ninth and 
thirtieth days of June and the first day of July, and were duly ad- 
journed and continued on the sixth, seventh, eighth and ninth days 
of July, at the Asylum, on Ward’s Island. Assistant Corporation 
Counsel Francis L. Wellman, Esq., and W. W. Wheeler, Esq., ap- 
peared at the request of the Mayor, and counsellor Arthur H. Mas- 
ten appeared for the Commissioners of Charities and Correction. 
Hone of the complaints were formulated, and no written specifica- 
tions or charges were submitted to us; but we caused public notice to 
be given at each hearing, inviting all persons to present any griev- 
ances or complaints, orally or in writing, and to produce witnesses 
and to propose interrogatories. Many subpoenas were issued to 
persons whose names had publicly appeared in the newspapers or 
•otherwise, or were privately shown to us, having alleged or sup- 
posed connection with or knowledge of the facts in the cases of 
complaint or matters under examination ; many witnesses were 
examined under oath, and over three thousand folios of testimony 
were taken by our stenographers, all of which reduced by them to 
writing, with the numerous exhibits therein referred to, are here- 
with submitted. Our endeavor was to keep the proceedings within the proper 
limits of time and expense to the State, but within such limits to 
make our examinations as thorough as possible. And now we in- 
dulge the hope that the end of the investigation suggested by the 
Mayor, viz.: “the reformation of abuses and the improvement 
the management of this great charity,” may be attained, not s<3 
much in specific findings of facts relating to particular cases, ■ \n 
conclusions regarding the general causes and conditions whicq 
necessarily have given rise to actual evils and abuses in this Asybjin. 
The institutions for the insane, in common with all the charita- 
ble as well as correctional institutions of the city, are in charge of 
the department of Charities and Correction, under Chapter tlO of 
the Laws of 1882, known as the “ Consolidation Act,” whicli pro- 
vides for the maintenance and government of these institutions 
and specifies the powers and duties of this department. Tbe 
board of three commissioners, which is the head of this depart- 
ment, is given, and is required to “ exercise full and exclusive pow- 
ers for the government, management, maintenance and direction” 
of all said institutions, including the “ Asylum.for the Insane” on 
Ward’s Island, with its branches on Ward’s Island and Randall’s 
Island, all of the patients wherein are men, as well as of the “ Lu- 
natic Asylum” on Blackwell’s Island, with its branches on Black- 
well’s Island and Hart’s Island, all of the patients wherein, ex- 
cepting a few workers on Hart’s Island, are women. (§§ 3d and 385). 
FINANCES. 
These statutory powers and duties of the Commissioners of 
Charities and Correction involve large trusts of a financial char- 
acter. But, as neither formulated charges against their financial 
management, nor expert aids for the'examination of their books, 
accounts and vouchers were furnished: and as such examination 
naturally would involve the affair? of the entire department, and 
necessarily would be prolonged indefinitely at great expense, which 
should devolve upon the local financial officer and be a charge 
against the City and. County rather than the State ; your commit- 
tee confined this blanch of the investigation to certain defects of 
method, and to the supplies delivered at the general storehouse on 
Blackwell’s Island, and thence distributed to the Insane Asylums, as well as Hospitals, Almshouse, Workhouse and Penitentiary, on 
the several islands. 
Section 189 of the Consolidation Act provides, among other 
things, that the Board of Estimate and Apportionment shall an- 
nually, between the first day of August and the first day of No- 
vember, make a provisional estimate of the amounts required to 
pay the expenses of conducting the public business of the City and 
County of New York, in each department and branch thereof, for 
the next ensuing fiscal year ; and that for the purpose thereof the 
heads of departments, at least thirty days before, shall send to the 
Board of Estimate and Apportionment an estimate in writing of 
the amount of expenditure, specifying in detail the objects there- 
of, required in their respective departments. 
Although it is in oral evidence that the Commissioners of Chari- 
ties and Correction have annually complied with the letter of this 
statutory requirement, by giving their departmental estimate to the 
Board of Apportionment; yet it appears that they have received 
the amount fixed for their department in the final estimate of the 
Board of Apportionment, as one gross sum, without crediting to 
the various institutions and branches of their department, the sev- 
eral sums assigned thereto respectively in the provisional estimate ; 
and that from time to time they have augmented or diminished 
these several sums, drawing from one and adding to another as the 
expenses of the institutions and branches of their department 
might seem to demand, and as to them might seem exigent or ex- 
pedient. It is shown also that, while these estimates given to the 
Board of Apportionment have specified in detail the supposed ex- 
penses of each institution of the department for the ensuing year, 
and while such estimates and the items thereof are alleged to be in 
general accordance with the actual expenses of the respective in- 
stitutions for the preceding year, the estimates or items thereof 
for the ensuing year are not transcripts from such actual expenses 
of the preceding year. 
It is thus evident that the Board of Apportionment have no as- 
surance that these annual estimates of the department of Charities 
and Correction, “ specifying in detail the objects thereof,” do not 
specify items and sums for the Asylum for the Insane on Ward’s 
Island, to be used in other charitable institutions or in correc 
tional institutions of the department ; or {vice versa), that there 4 
are resources in tlie estimates made for the other charitable as well 
correctional institutions from which to draw for the expenses of 
this and the other insane asylums. 
There have been for years no accounts of items of actual expen- 
diture of these several institutions, either published or furnished 
to the Board of Estimate and Apportionment. Such items are 
not given in the report of the Comptroller—published in the City 
Record. Though the books, vouchers and accounts of the Board 
of Charities and Correction m ay be open to the examination of 
all persons, including the members of the Board of Estimate and 
Apportionment, it is evident that such busy members of the City 
government as the Mayor, Comptroller, President of the Board 
of Aldermen and President of the Department of Taxes and 
Assessments, constituting the Board of Estimate and Apportion- 
ment, cannot or will not find time to study the accounts of all the 
departments and bureaus filed away in their respective archives. 
This power in the department of Charities and Correction to 
procure a general appropriation for its different bureaus and in- 
stitutions, by unbalanced apportionments, resembling unbalanced 
bids, seems to make it eminently proper that there should be 
annually published or filed with the Board of Estimate and Ap- 
portionment, or one of its officers such as the Mayor or Comp- 
troller, an itemized account of each bureau and institution for 
the preceding year. 
Section 49 of said Act gives the Mayor power to require such 
information as includes the accounting in question. 
We present these views of the financial system, not to reflect 
upon the good faith or intended diligence of the Board of Chari- 
ties and Correction in these respects, but to reveal what appears 
to us to be a fault or defect of the system; and to discover the 
reason, if any, for the failure hereinafter shown to induce the 
Board of Estimate and Apportionment to supply the necessities 
of this asylum for the insane on Ward’s Island. 
ECONOMY. 
The rates for food and for total maintenance are given for the 
twelve years from 1875 to 1887, in the table, Exhibit 16, with the 
following results to-wit: average daily capita during the 
twelve years, for food, less than fifteen cents; and total including 
clothing, care, &c., less than thirty-three cents; and during the 5 
year 1886 for food thirteen cents and eight mills, and total thirty- 
two cents and six mills. 
The foregoing rates cannot he compared with returns from 
Comities exempted by the State Board under the Willard Asylum 
Act, for the reasons that in such returns the cost of treatment, 
care and proper maintenance of the patients in the exempted 
insane asylums is reduced by the products of large farms, and 
covers only chronic cases; and even thus the increase of such cost, 
over the cost of support of the paupers in the poor houses of the 
respective Counties, is not accounted for, but goes into the aggre- 
gates and averages of expenses of these two classes of County 
institutions in one account. But that the average daily cost of 
food and maintenance and treatment per capita during the last 
twelve years, as well as the last year, in the Asylum for the Insane 
on Ward’s Island is extremely low, should go without saying, 
under any just conception of the status of an insane person, as a sick 
patient, and not simply a pauper; and in consideration of the fact 
that among the inmates of this Asylum are the whole number of 
acute cases all requiring good food as well as care and treatment to 
prevent them from becoming chronic, but all in fact reduced with 
the chronic cases not only to one average of expense in account, but 
also to one common level of actual expenditures for food and 
service of attendants, as the evidence before us shows. 
For comparison of the said rates with those of the six State 
Institutions for the Insane, we refer directly to the reports of the 
said several institutions for the last fiscal year. In the report of 
the Committee on audits of the Trustees of the Willard Asylum for 
the Insane, for the year ending September 30, 1886, we find that 
part of the weekly cost per capita, which is made a charge against 
the counties, to be as follows : 
Maintenance—Stores and supplies 851 
Fuel and lights 181 
Farm wrages and expenses .098 
House wages 775 
Furniture and repairs 203 
Miscellaneous 098 
Medicines 029 
Improvements 024 
Clothing 207 
Total $2,466 
Two dollars and forty-six cents and six mills. 6 
But this State Institution is intended for chronic cases only, 
and with a population of about two thousand, has a fertile farm 
of about one thousand acres, and is in great measure self support- 
ing with the products of the farm from the labor of its patients. 
Moreover the salaries of its physicians and other items, being paid 
by the State, are not included in said rates. The compensation 
for the present fiscal year has been fixed by the Millard Asylum at 
two dollars and twenty-five cents per week for each patient, as the 
county charge. By law the sum fixed by this asylum is the maxi- 
mum limit of the county rates at the other State Asylum for the 
Chronic Insane at Binghamton, which also has a large and produc- 
tive farm cultivated by the labor of its able bodied patients. These 
two State Institutions are in a fair way to solve the problem to what 
extent, given the requisite quantity and quality of land, Asylums 
for the Chronic Insane may in time become practically self sus- 
taining, as to current expenses, with great benefit to the patients 
who perform the labor under watchful medical supervision. 
Comparing the daily cost per capita for the last fiscal year, we 
have at Willard Asylum, with its chronic cases largely self sup- 
porting, and exclusive of acute cases, and exclusive of large items 
paid by the State, the county charge over thirty-five cents; but at 
ATard’s Island with its acute as well as chronic patients, dependent 
almost entirely on high priced markets and without large resources 
from its land or labor, the total charge, including salaries of phy- 
sicians and all items of expenditure, less than thirty-three cents. 
Taking now the Hudson River State Hospital, as representative 
of the four State Hospitals for the acute insane, and selecting it 
on account of the clear financial statements, in its report for the 
year 1886, we find that its average of 400 patients cost per capita 
per week ($5.1327), five dollars thirteen cents two and seven 
tenths mills, of which the practical expense for board was 
($4.1539), four dollars fifteen cents and three and nine-tenth mills, 
or about four times that of the Xew York City Asylum for the 
Insane on Ward’s Island with its acute cases, which the evidence 
on estimates according to the test of two years, applicable to the 
State Institutions, show to be at least one fourth of its census in 
all its different branches, of nearly 2,000 patients. 
The average cost per capita in the two City Asylums on Ward’s 
and Blackwell’s Islands, for men and women respectively, is nearly the same if we exclude items for wages; and less than in the 
Kings County Asylum at Flatbush. A comparison of the statis- 
tics of expenses in these three City and County Institutions, with 
the six state institutions for acute and chronic insane, made in the 
17th annual report of the State board, transmitted to the Legisla- 
ture January 24, 1881, for the year 1883, is here cited, because it 
is in published and convenient form for reference, and is indica- 
tive of former interest in the subject. The result of this com- 
parison appearing on pages 12 to 24 of the said report, makes 
the yearly cost of the 3525 patients in the Kew York City Asylums 
$384,891, gud of the 1236 patients in the Kings County Asylum 
$154,500; or in aggregate $539,391 for 4761 patients, acute and 
chronic cases ; while the cost of the patients in the four State Hos- 
pitals for the acute insane, with an average population of 1424, 
and in the two State Asylums for the chronic Insane, with an 
average population of about 2260, making the less number in total 
census of 3684 patients, was the much larger sum of $777,144. 
FOOD. 
This undue ecomony of expenditure for the two City Asylums, 
which owes its continuance to defective financial methods already 
mentioned, and to the imperfect correspondence between the 
Board of Estimate and Apportionment and the Board of Chari- 
ties and Correction, is intimately related to questions respecting 
the character of the food supplied to this particular Asylum for 
Insane men on Ward’s Island. Our inquiry is whether such food 
has been as good as required by 
(1) The market and the purchase prices, and 
(2) The needs of the patients. 
It is in evidence, and is undisputed, that the department of 
Charities and Correction has complied with section 64 of the Con- 
solidation Act, by making contracts with the lowest bidders, on 
advertisements and sealed proposals, for all foods and other sup- 
plies, wherever the several parts of any supply together involved 
the expenditure of more than one thousand dollars; excepting cer- 
tain teas and other groceries purchased at private sales, which, though 
prohibited by the statute, appear on the testimony of the Inspector 
appointed by the Comptroller, to have been recommended or ap- 
proved by said Inspector as of general merit and for the interest 
of the Cit}7. 8 
It is shown also that in cases of contracts on sealed proposals, the- 
proposals and contracts have been made on samples, called exhib- 
its, and preserved in the office of the department; that all foods- 
and supplies purchased under sealed proposals or otherwise, for 
the various institutions on the several islands, excepting meat, fish 
and milk, have been delivered at the general store house on Black- 
well’s Island, and thence distributed to the several institutions, on 
written requisitions of the respective superintendents or superior 
officers thereof ; that on such general delivery at the store house, 
and before distribution or acceptance, the goods delivered have 
been examined there, by comparing samples thereof with the re- 
spective exhibits; that such examinations cover- about $30,000 
worth of goods every fortnight, and have been made daily by the 
General Store house clerk of the department, and since April 1st, 
1885, also to some extent by the Inspector appointed by the Comp- 
troller. 
It appears that the examinations by the Inspector are not checks 
upon the department, except in so far as they furnish expert know- 
ledge ; for he attends only live days in the week, and arrives late 
in the afternoon, after the largest deliveries have been made, and 
takes his samples of such deliveries from the hands of the Store 
house clerk. 
The testimony of Mr. Corwin, the Inspector, Mr. Cleary, the Gen- 
eral Store house clerk, and the Commissioners of the department, 
shows that there has been no use or acceptance of goods rejected 
by the Inspector, except in the case of ten thousand pounds of 
coffee, which about three months ago was condemned by the In- 
spector on the ground that it was burned in the roasting. On the 
merits of this exceptional transaction we make no findings, inas- 
much as the quality of the coffee is claimed by the Commission- 
ers on representations made to them by experts, to be good and in 
accordance with the exhibit, and is now the subject of litigation in 
a pending action between the city and the merchant who supplied 
the goods. 
The Inspector testified that in three cases where goods delivered 
had been rejected by him, there were no subsequent deliveries of 
goods in accordance with the respective exhibits. This was, how- 
ever, explained by the testimony of the Commissioners,'showing 
that in each of these three cases, the total purchase was under 9 
$1,000, and therefore not required by the Statute to be by written 
contract; but that in excess of the statutory requirements, they 
had called for sealed proposals by exhibits and awarded the pur- 
chase to the lowest bidder, though without written contract which 
could be enforced. 
The Inspector further testified as a matter, not of fact but of 
opinion, that there was in the general Store house, a lot of tea re- 
jected by him more than one year ago; and that parts of the rejected 
tea had been distributed and used. And he produced Mr. James- 
H. Davies, an expert, who testified that he had examined two 
samples of tea furnished by the Inspector, one of which lie found 
to be good, and the other of which he found to be bad and such 
as would injure the health of any consumer. But the Inspector 
subsequently testified that he did not know that this bad tea had 
been used or accepted by the department, and did not know of 
any circumstance showing such acceptance or use. In the even- 
ing of the day on which this testimony was given, and on the 
return trip from Ward’s Island, your Committee caused the boat 
to stop at Blackwell’s Island, and requested Mr. Davies to exam- 
ine samples of all the teas in the general Store house. This wit- 
ness subsequently testified that he had done so, and that he found 
the articles to be’good Oolong teas, unmixed, wholesome and worth 
in the market several cents per pound more than the contract and 
purchase prices. 
The inspection of meat, fish and milk is made on the Dock at 
the foot of East 26th Street by the Dockmaster, Bernard Gormly. 
From an examination of the appliances there in use, as well as 
from the testimony of the Dockmaster, we are left with serious 
doubts as to whether the examinations are sufficiently thorough, 
and the means, time, skill and care employed are such as to prevent 
the acceptance of unhealthy or inferior articles for consumption. 
It is just, however, to say, that complaints against the meat were with 
few exceptions confined to the cuts, which could not be better for 
the prices, and the cooking which is referred to hereinafter, thus 
implying and sometimes expressly admitting that the meat was 
wholesome. The complaints against articles as stale included vege- 
tables with fish, but the Inspector, Mr. Corwin, as well as other 
witnesses, testified that the vegetables accepted had been good. 
The proofs show that the purchase and contract prices have 10 
been within the market prices of the character and quality of food 
supplied to this institution. 
The contentions over points of good faith and diligence on the 
part of the Board of Charities and Correction, in their business of 
purchasing and distributing supplies in their department, concern- 
ing which considerable evidence was produced before us, in rela- 
tion to the Asylum for the Insane on Ward’s Island, have called 
for the foregoing statement respecting the prices and qualities of 
such supplies. These points are important as they affect the char- 
acter of said Board, but. are of more immediate consequence in 
their bearing upon the future attitude and action of the Board of 
Estimate and Apportionment, responsive to the demands for relief 
to this Asylum, which, though apportioned by the one, must ne- 
cessarily be administered by the other Board. It is eminently 
proper, therefore, that we should give our opinions on these ques- 
tions of fact, and that, subject to these opinions already given, we 
should report our general conclusion as follows, namely : that from 
all the proofs before us, we fail to find on the whole, any deficiency 
in the quality of the food supplied to this Asylum, as compared 
with either the purchase or the market prices thereof; or bad 
faith or gross negligence on the part of the Board of Charities 
and Correction, whose business it is to furnish such supplies. 
(2) The second branch of our inquiry relating to food, is deter- 
mined by the needs of the patients in the Asylum in question, and 
neither involves the sifting of evidence nor admits of doubt. The 
testimony is undisputed and cumulative, coming from discharged 
patients, attendants, assistant physicians, Medical Superintendent, 
General Superintendent, and each of the three Commissioners of 
the Department, and proving conclusively that the dietary is in- 
sufficient in variety and nutritious qualities. We find also that the 
food with one exception is not properly prepared. The bread is 
good, made as it is from mixed flours of fair quality, and baked at 
the general bakery on Blackwell’s Island. But the cooking in 
other respects is shown to be bad in fact, and made necessarily so 
by the inadequate appliances in a kitchen intended for five hundred 
inmates, and made to pass through its processes called cookery, 
food for over 1,700 patients besides attendants. 
This condition of things is wrong and shameful; especially does 11 
it appear so in view of the fact that the patients compelled to eat 
the mixtures set before them, are not ordinary paupers, but insane 
persons, that is to say, sick persons, and many of them acute cases 
requiring for their recovery as well as comfort, wholesome, digesti- 
ble and nutritious food. 
BUILDINGS. 
The unwise economy which is evident in the food supplied to 
this institution, is exhibited in its buildings. 
The Asylum Building proper has a capacity of one thousand 
(1,000) patients. But the population of the Asylum at the time 
of our investigation was nearly two thousand patients, inade- 
quately accommodated as follows, to wit.: 
In the said building 1,326 
In the “ annex” leased to the department by the Commis- 
sioners of Emigration 339 
Emigration Asylum 60 
“ Branch” on Randall’s Island.... 131 
In the Hart’s Island “ Branch” of the Lunatic Asylum . . 60 
Making the total number of patients 1,916 
or almost twice the capacity of the only proper building. The 
“Annex” on Ward’s Island and the “Branch” on Rand- 
alls Island should be condemned as uninhabitable. The new 
lease of the Insane Asylum from the Commissioners of Emigra- 
tion is intended by the department of Charities and Correction for 
the temporary and provisional accommodation of some of this out- 
lying population. But inasmuch as the more quiet patients are 
placed in the Annex and the different Branches, we may eleminate 
their number from the total census in considering the immediate 
problems of this extremely crowded building. Taking the mini- 
mum number 1,326, we have 326 not properly provided for in this 
building; and the placing of them therein means great discom- 
fort and injury not only for the 326, but for every one of the en- 
tire number of 1,326 patients, with disgusting and dreadful crowd- 
ing of the filthy and violent wards. 
ATTENDANTS. 
The crowding of the building is not of recent occurrence, but 
has been continued and carried to the utmost extent for many 12 
years, causing innumerable injuries to the patients, including those- 
direct and others which, if not so immediate or apparent, are no- 
less real or decisive against any good management or results.. 
Among these indirect but determinate evils produced by this one 
common cause, has been the inevitable degradation of the char- 
acter and service of attendants on the wards. It is not difficult to 
imagine the general condition, with patients huddled together, 
many of them without sufficient airspace, in associate dormitories, 
and most of them deprived of day rooms, which have been filled 
with beds, and confined to long wards as cheerless and comfortless 
as are these miserable masses of humanity which crowd them. 
The day attendants, compelled to pass fifteen working hours in 
these repulsive places, and in the arduous duties of restraining and 
quieting the excitements which are responsive to such environ- 
ments, are at night compelled to sleep two or three, and six or 
seven, in small and uncomfortable rooms. In this condition vio- 
lent wards must become more disturbed, and filthy wards more 
disgusting, and the entire asylum well-nigh demoralized, even 
with the best material for educated attendants. But the worst ef- 
fect is that while the salaries of these officers are not relatively 
low, the general situation repels not only the best, but even ordi- 
narily good men, who would otherwise become applicants for their 
position, and attracts such as have no due appreciation, and perhaps 
not even a dull apprehension, of the depressing and disturbing in- 
fluences to be overcome. 
This conclusion we should have no difficulty in finding from the 
circumstances, without direct evidence on the subject. It must 
be true in the nature of things. But it is established by the sworn 
statements of many witnesses, including not only the testimony of 
the Commisioners and Medical Officers having to do with the gov- 
ernment of the asylum, but also the cross-examination of most of 
the attendants who appeared before us. Such cross-examination 
generally discovered antecedents not creditable for the nurses and 
guardians of persons who by natural law have been deprived of 
their reason, and by civil law of their liberty, and left helpless and 
remediless against any sort of trespass, be it injury or indignity. 
The avocation of many of these sworn attendants had been that 
of barkeeper. An examination is made of all ward attendants on 
their return to the asylum after their day out every fortnight. 13 
But sucli is the tendency to intoxication among them that many 
are discharged for this reason. 
How it is unjust as well as uncharitable to say that every bar- 
tender is a thoroughly depraved or untrustworthy man, without 
taking into account his nativity and training. It is also untrue 
that all the attendants in this asylum are in the general category 
which we have given. We believe there are good men among 
them. But it is safe to say that the fair presumption is against the 
moral or personal fitness of bartenders to fill the responsible office 
-of Attendants of the Insane; and that the proofs show that the 
majority who fill this responsible office are not only of questiona- 
ble antecedents and character, but that many of them are decidedly 
rough and coarse or untrustworthy, if not positively bad. 
The following statistics of discharges and vacancies further il- 
lustrate the position. It is in evidence before us that in the year 
1886 about eighty attendants were dismissed for cause, exclu- 
sive of those resigned or honorably discharged, and inclusive 
of twenty-three dismissed for intoxication, including three in- 
toxicated while on duty on the ward, and five for striking patients. 
These dishonorable discharges for one year embraced about one 
half of the staff of attendants. At the time of our examination 
it was shown that there were, and long had been, many vacancies 
in this staff which the asylum authorities were unable to fill. 
The General Superintendent seems to have little responsibility for 
the selections of attendants, and to be responsible only for their 
dismissal, the examinations for appointments being regulated by 
the civil service rules. 
The testimony of Mr. Lee Phillips, the Secretary and Execu- 
tive Officer of the City Civil Service, is instructive on this point, 
and is further illustrative of the entire position respecting the 
character and qualifications of these most important officers on the 
wards of the asylum. ILis statements under oath before us, 
among others, are as follows : “ Applicants for positions as atten- 
dants for Ward’s Island come under my charge. * * They 
“ apply to us and we examine them. I have occupied this position 
“ for the year past, since last June, and I have noticed that the 
“ character of the applicants as spoken of for the position of atten- 
“ dant, has been very low as a general thing. They have been, so 
“ far as the men were concerned, a good many that were appar- 14 
“ ently drinking men, arid half way tramps you may say, that would 
“ be out of a place, and they would come along and apply for this, 
“ because the examination was very simple; and it seemed to me 
“ from my observation, that the better class, or the more desirable 
“ class, were kept from applying for those places on account of 
“ the inadequacy of the compensation and the hard work. * * * 
“ As a general thing the female attendants have been of a better 
“ class. * * * We have no technical examination to test them, 
a * * * I judge that if we were to get down the examination too 
“ close in the matter of experience and ability, and the knowledge 
“of the duties they have to perform, we would sift out a great 
“ many and have very few people. We are unable to supply 
“ them as fast as they need them now, although we are holding 
“ weekly examinations.” 
We think the system of examinations of the City Civil Service 
for applicants for attendants in the City Insane Asylums, calling 
for such examinations before the nominations by the Superintend- 
ent, is less effective than the system obtaining in the State Asy- 
lums for the Insane, where such examinations are made after such 
nominations. In the City Civil Service, if there are sufficient 
applications, the effect is to crowd the calendar for such nomina- 
tions, perhaps when less needed, leaving the surplus to wander 
away before vacancies occur; and whenever there is a pressing 
demand the effect is to retard the supply : and in all cases, the gen- 
eral result is to present many applicants unworthy, or unqualified 
for the appointment. 
Your committee find that the grievous evils connected with the 
staff of attendants in this Asylum are due directly and indirectly 
to the extreme crowding of its building and undue economy, which 
have been continued systematically and persistently for many years. 
APPOINTMENTS. 
There is no inducement for the exercise of political influence 
to fill the neglected and degraded office of attendant in this 
asylum. The assistant physicians have been examined by a medi- 
cal board composed of eminent members of the profession in prac- 
tice in New York City. 
It appears from the testimony of each of the Commissioners of 
Charities and Correction, and the General Superintendent of the 15 
Insane and such of the Assistant Physicians and Ward Attendants 
who appeared as witnesses before us, that the appointments of 
Assistant Physicians and Ward Attendants in this Asylum were 
as a rule for some time prior to the civil service examinations, as 
they have been since, made by the Commissioners on the nomina- 
tions of the General Superintendent, and in the order of his nom- 
inations, and without political influence. 
ABUSES. 
Your committee received all evidence offered to sustain allega- 
tions of injuries or indignities suffered by patients on wards or 
grounds of this Asylum, except in the matters known as the Far- 
risli case and the Roth case, the merits of which it was not proper 
to publicly investigate outside the proceedings therefor then pend- 
ing in the common law tribunals. But the case of Henry Mendel- 
sohn, a paretic patient whose death on the ninth day of December 
last had been made the subject of investigation before coroner 
John R. ISTugent, resulting in a verdict of a coroner’s jury exoner- 
ating the authorities of the asylum, we did not exclude from our 
examination. On the coroner’s record and other evidence before 
us, we are not satisfied that the death of Mendelsohn was hastened 
by injuries received by him at the hands of attendants as alleged, 
or that any violence or injury was inflicted upon him by any 
attendant. 
Conflict in the evidence is invariable and almost inevitable, in 
cases of alleged abuse of patients in any insane asylum. On one 
hand we have the testimony of patients who may be in the asylum, 
or if out of it, discharged perhaps not as cured but on bond or con- 
tract of indemnity or guaranty against consequences, and who may 
be subject to delusions formed in the first histories of their 
respective cases. On the other hand we are quite certain to have 
the statements of attendants, strongly interested to deny or sup- 
press the truth in all cases where they have trespassed upon the 
rights of patients, or where they have witnessed such trespass by 
their associates, which, in violation of the rules, they have con- 
cealed from or failed to report to the medical officers. 
In all the matters brought before us, the complaints were met 
by denials, where the accused persons were in the asylum. In 
support of the complaints we departed from the legal rule requir- 16 
ing the best evidence, and admitted hearsay testimony, not to 
establish the truth of the charge, but to furnish the means of 
obtaining further proofs. The evidence adduced in support of the 
denials consisted of sworn testimony of Attendants, and in some 
cases the statements of patients who were not put under oath. 
The entries in the case hooks, containing the histories of the 
patients, by or in behalf of whom the complaints were made, were 
also received in evidence. 
We can select few if any one of these charges, the direct evidence 
on which, when taken separately, does not admit of either serious 
doubts or a finding against its truth. But while on the one hand 
we cannot combine the positive evidence in all the cases to estab- 
lish the objective truth in any individual case ; on the other hand, 
we cannot resist the moral conviction that some of these charges 
are true. This conviction or subjective belief is forced upon us 
by the general trend of the positive and direct testimony taken 
alone, so far as we are conscious that we can separate it from the 
general situation and circumstances also in evidence before us. 
This circumstantantial evidence, however, removes all doubts of 
the objective facts, that there are numerous and continued injuries 
and indignities inflicted upon the patients by the attendants in 
this asylum. In the first place, the general situation naturally and 
almost necessarily gives rise to such abuses. The conditions of 
extreme crowding and of degradation of the service have, since the 
first day of January, 1883, been attended with the complete 
abolition of seclusion or mechanical or chemical restraint, and of 
all appliances therefor; which to be successful requires moral 
restraints of a higher order, instead of the demoralizing influences 
which have continued on the wards of this asylum. Over-worked, 
irritable and ignorant attendants, who need the constant direction 
and discipline of persons other than themselves, and whose ante- 
cedent experiences have never resulted in self-restraint, practiced 
by their own wills on their own nervous organisms, are placed in 
positions of absolute and exclusive control of badly crowded and 
excited patients, without appeal or remedy except on unverified 
reports to absent medical authorities. The presumption that 
offenses are continually practiced by such attendants upon patients 
in such conditions, is of the highest degree of probability. 
This moral certainty of abuses abounding on the wards of this 17 
•asylum, is, if possible, further established by evidence amounting 
almost to mathematical demonstration. Each of the medical 
officers, who was examined, testified to several acts of violence by 
attendants upon patients, which had been witnessed by himself. 
But though the attendants, who were sworn, were greater in num- 
ber than the medical witnesses, and each attendant had of course 
spent a much larger portion of each day upon his ward than any 
medical officer upon all the wards, not one of these lay witnesses 
<;ould remember a single instance of such violence. 
Again, the violent acts observed by the physicians having been 
immediately followed by the discharge of the respective attendants 
guilty of the same, as shown by the testimony, there was thus 
given one term for a comparison between the number of discharges 
for such acts, committed in the presence and within the personal 
knowledge of some medical officer, and the number of discharges 
for such acts committed during the absence of all medical officers, 
and established only on information and evidence. Given thus 
the one term for such an instructive comparison, we sought 
the other term in the further examination of the assistant 
physicians, only to find that some of them could not recollect any 
such discharges based on such evidence, and none of them could 
remember that the number of such acts of personal violence 
reported and established by proofs, was more than a small portion 
of the number of such acts witnessed by the medical officers. In 
extenuation of this evidence it was suggested by the General 
Superintendent, that the occurrences coming within the personal 
notice of the physicians, would naturally leave a more durable im- 
pression upon their minds, than would similar occurrences reported 
to them. Accordingly the records were received as the best 
evidence, and a transcript of the same marked Exhibit 17, July 9, 
was filed with the proofs. This transcript being from the time of 
an official visit of two of the members of your committee to this 
asylum and its branches, October 13, 14 and 16, 1883, covers the 
period from October 15, 1883, to June 27th, 1887, and embraces 
31 cases of actual violence committed by attendants upon patients; 
including such violent acts as kicking, striking and slapping; one 
being for slapping one patient by two attendants at one time, 
witnessed by an assistant physician; another case being for 
undue violence in handling a patient, witnessed by two assistant 18 
physicians ; and another case being for both kicking and striking 
one patient bv three attendants at one time witnessed by two 
assistant physicians. Of the 31 cases 15 are for such acts of 
personal violence, witnessed by one or more members of the 
medical staff; 8 are for such acts none of which were committed 
within the observation or knowledge of any member of said staff; 
and 8 are cases concerning which no entries or data respecting 
these points are given. 
Now this comparison shows that only a small proportion of such 
acts of personal violence committed by attendants on patients, 
which are not witnessed by any member of the medical staff, are 
ever reported and proved to -the satisfaction of the medical authori- 
ties. For the medical officers are not on any one ward to exceed 
two hours each day, and their presence must be generally known 
to the attendants. Assuming for argument’s sake, that these two 
hours are only one-sixth of the time spent by patients in the wards 
used as day rooms, and that attendants wrnuld be as much inclined 
to interfere with the rights of patients in the presence as during the 
absence of their superior officers, which are extremely favorable 
assumptions for the asylum, being unwarranted by the facts; 
and using the data left after making these liberal concessions, we 
find as follows: that for this one-sixth of the time there being 
fifteen cases, there should for the whole time be at least ninety 
cases, of which only 31 cases are given. The conclusion is that, 
for two out of every three of such cases of personal violence by 
attendants on the wards, there are no remedies for the patients in 
this asylum. 
We do not believe that these numerous trespasses upon the 
patients are generally of a serious nature, so far as physical injury 
is concerned. But they are all infractions of the rules of the 
asylum, and violations of the dignity and rights of the patients. 
There are other and still more numerous abuses resulting from 
the crowded condition of the asylum, which could not be pre- 
vented by the best attendants. A visitor on a violent ward for 
the insane anywhere is apt to discover recent marks of injuries on 
the patients, and especially on the more disturbed cases ; but an 
investigation on the spot most generally reveals the fact that such 
injuries have been received from fellow-patients. It does not 
need to be stated that such evils must be indefinitely multiplied by 19 
the conditions which obtain in this asylum, nor that the systematic 
and persistent subjecting of patients to such enormously increased 
risks at the hands of each other, as well as at the hands of their 
attendants, is the great abuse calling for reform on Ward’s Island. 
On the examination of Dr. Trautman, the Medical Superin- 
tendent of this Asylum, his testimony as given includes among 
other things, the following questions and answers, to wit: 
“ Q. I would like to ask one question of you, doctor, as an ex- 
“ pert and as Superintendent of this asylum : whether in your 
“ opinion the treatment of the chronic and acute insane, as they 
“ are treated in this Asylum, does not tend to lower the whole 
“ service and treatment to that which is proper only for the 
“ chronic insane ? 
“ A. I should say not, because we have on the acute service the 
“ officers that are best acquainted with the treatment. Only the 
“ oldest officers and those best experienced have charge of the 
“ acute insane. 
“ Q. Do you have a better dietary for the acute insane? 
“ A. iso; we have to shift them whenever it is necessary to 
“ shift them” [to the hospital.] 
“ Q. You should have ? 
“A. We should have. Yes, sir. 
“ Q. Do you have a better class of attendants—more expert ? 
“ A. We have not. 
“ Q. Do you have more attendants in proportion ? 
“ A. We have attempted to remedy this, but in reality we have 
not. 
“ Q. Then in view of these three instances, do you not say that 
“ in this case at least, the attempt of the authorities to house and 
“ to treat both the acute and the chronic insane in the same insti- 
“ tution, has not only tended to, but has effected, the degrading of 
“ the whole service from that which is proper for the acute in- 
“ sane, to that which is adapted, if to any, to only the chronic 
“ insane ? 
“ A. To some degree undoubtedly. The great number that ag- 
u gregates here makes it impossible for the men that are at the 
“ head, for the Superintendent, to look close enough after the 
“ acute insane.’'’ 
TREATMENT. 20 
Dr. Macdonald, the General Superintendent of both Asylums, 
on his examination, somewhat qualified the foregoing testimony of 
Dr. Trautman, but was none the less emphatic in affirming the 
substance of the same, namely: that proper distinction had not 
and could not be made in favor of the treatment of the acute in- 
sane, and that not even proper care and attention had been or 
could be given to the chronic insane in this asylum. 
In the words of Dr. Macdonald, uttered by him as medical su- 
perintendent in the year 1874, which there seems to be no reason 
to qualify at this time, we “ fully believe that there are many men 
“ within these walls now, incurable cases, who with more generous 
“ diet and more generous provision generally, at the accession of 
“ their disease, would have long since gone forth clothed and in 
“their right minds.” (.Medical Superintendents Report for 
187 %p. 12.) 
We find that the experiments in the mixed asylums of New 
York City, and particularly in this Asylum for men on Ward’s 
Island, have resulted, not in raising the care of the chronic insane, 
but in degrading the treatment of the acute insane far below the 
normal standard for the chronic insane. 
RESPONSIBILITY. 
That tlie abuses in the City Insane Asylum on Wards Island are 
the results of accumulations of experience, arid the continued 
effects of long standing causes suffered to remain against warnings, 
entreaties and expostulations, is shown by references to former years, 
with citations which we make at length, as the responsibility for 
the present situation can be seen only in its relations to the past. 
The evils resulting from inadequate accommodations and provis- 
ions for the insane in both City Asylums, have been brought to 
the notice of the proper authorities of the City and of the State, 
in many ways and for many years. 
The State Board of Charities has not failed to call attention to 
these grievances, in its annual reports to the Legislature of the 
State, as well as in various communications to the Board of 
Charities and Correction, the Board of Estimate and Apportion- 
ment, and the Mayor of the City. Its second animal report, 
transmitted in the year 1869, for the year 1868, states “that the 21 
“ provision for lunatics is extremely inadequate and discreditable 
“to the City” (page lxxi.), and gives the number and condition of 
the Insane of the City and description of the Lunatic Asylum on 
Blackwell’s Island, which was then with its branches, the “ Retreat,” 
the “ Lodge,” etc., the only public asylum of the city (pp. 200- 
203). In its fourth annual report allusion is made to the necessity 
for and the origin of the Asylum for the Insane on Ward’s Island 
(pp. 90, 91). Its sixth annual report presents the evils of bad 
crowding in both these asylums, and the inability of the Commis- 
sioners of Public Charities and Correction to provide remedies 
with the means at their disposal. 
In the year 1877 the abuses and evils in this Asylum for men 
on Ward’s Island, as well as in other institutions of the city, had 
become so great, that the State Board in its eleventh annual report, 
transmitted January 17, 1878, called the attention of the Legisla- 
ture to the special communications which the three members of the 
said Board for the City of Yew York had made, one to the Mayor, 
and two to the Board of Estimate and Apportionment (p. 31). In 
the said communication to the Mayor, dated October 20th, 1877, 
signed by Theodore Roosevelt, Josephine Shaw Lowell and 
Edward C. Donnelly, the said three Commissioners of the State 
Board of Charities, and published at pages 207 to 225 of said report, 
to the Legislature, the entire subject is opened with the following 
sentences at page 207, to wit: 
“ To the Honorable Smith Ely, Jr., Mayor of New York: 
“Sir.—We feel that it is our duty to protest against the esti- 
“ mate of expenses of the department of Public Charities and Cor- 
“ rection for the year 1878. 
“We have frequently pressed upon the attention of the Com- 
“ missioners the dangerously over-crowded condition of the Lunatic 
“ Asylum on Blackwell’s Island, and had anticipated from them a 
“ request to the Board of Apportionment for an appropriation to 
“ buy a farm, upon which inexpensive buildings for the chronic 
“ insane could be erected, but of this no mention is made in their 
“ estimate.” 
The communication continues on pages 217, 218 and 219, refer- 
ring to reports of Dr. Macdonald, the Medical Superintendent, who 
is at present the General Superintendent of both City Asylums, 
as follows: “ This institution, intended exclusively for men, contained, 
“according to the official census in January, 1877, seven hundred 
“ and sixty-tliree inmates. 
“Nothing beyond extracts from the reports of the Medical 
“ Superintendent is required in regard to this asylum. 
“ From annual report of Medical Superintendent, January 1, 
“ 1876 : 
“ ‘ In my last annual report I referred, at some length, to the 
“ ‘ difficulties under which we labored from the want of a satisfac- 
“ ‘ tory corps of attendants. These difficulties have met no abate- 
“ ‘ ment during the year that has elapsed since that report was 
“ ‘ presented. Of the importance to the well being and success of 
“ ‘ an institution of a well organized and trained staff of attend- 
“ ‘ ants, there can be no question. 
££ Insane Asylum, Ward’s Island. 
“ ‘ Next to the mental and bodily qualideations which lit a man 
“ ‘ for the post, the essential requisite for a thoroughly reliable and 
“ £ competent attendant is, perhaps, length of service. Attendance 
“ £ upon the insane—proper attendance—is a duty which cannot be 
££ £ taken up at a moment’s notice by men who have spent their 
“ £ lives in other pursuits. It is a delicate and difficult task, apti- 
“ ‘ tude for which is found only in the few, and proficiency in 
££ £ which can come to none save after prolonged and faithful prac- 
“ £ tice. Attendants are not keepers, whose duty is only to guard 
u £ their patients, but nurses, who have to do with those suffering 
£: £ from disease. Hence an attendant can approach a fair degree of 
“ £ usefulness only after a lengthened service, after he has learned 
“ £ not only all the details of his office in relation to the care of the 
££ £ insane generally, but also the names and the peculiarities of the 
“ £ special patients in his ward. In this respect, our staff of attend- 
££ £ ants fails at once and conspicuously, for there are in the asylum 
££ £ now but two attendants whose appointments antedate the com- 
,££ £ mencement of the year. There is constant changing, enough in 
£££ itself to create confusion and seriously to embarrass the working 
££ £ of the institution. During the year that has just closed there 
££ £ have been sixty changes in the list of attendants and the con- 
££ £ fusion and embarrassment will be further accounted for when 
££ £ we examine the causes leading to these changes. Of the sixty '“ ‘ attendants who retired from the institution, twenty-one did so 
“ ‘ through resignation, and thirty-eight by dismissal. * * * 
■“ ‘ Regarding the latter I may here say that sixteen were dismissed 
“ ‘ for intoxication, or bringing liquor into the building, five for 
“ ‘striking patients, and the remainder for various infringements 
'“ ‘ of rules.’ 
“From report of Medical Superintendent, January 1, 1877. 
“ ‘ There has been some progress made during the year in 
“ ‘ increasing the efficiency of the corps of attendants. It has been 
“ £ enlarged by the appointment of eight men over the quota of a 
“ ‘ year since, so that we have now one attendant to seventeen 
“ ‘ patients; and of late there has been some little improvement 
“ ‘ in the class of men seeking and procuring appointments. But, 
“ ‘ with all this, there is still much to be desired. In the first 
“ £ place, despite the increase alluded to, the force must still be 
“ £ considered inadequate. Nominally we have, as I have said, one 
“ £ attendant to every seventeen patients, but practically the pro- 
“£ portion is much less, for every day, upon an average, four 
*£ £ attendants are not available for duty, through absence upon 
£ leave or sickness, or some such cause ; and despite the improve- 
<£ £ ment in their qharaeter which I have acknowledged, there is still 
“ £ much to be desired in that regard also. A glance at the records 
“ £ of dismissals of attendants during the year, with the causes there- 
“ £ for, will show at once that there has been something lacking. 
“‘Apart from twenty-two who have resigned their positions 
“ ‘ thirty-six have been dismissed for cause. The number of 
“ ‘ changes thus entailed in a single year, would of itself be enough 
“ ‘ to seriously embarrass the discipline and order of an institution; 
“ ‘ and it will he readily imagined that further embarrassment must 
“ ‘ arise from the influence of causes leading to their dismissal. 
■“ ‘ The offense of thirteen of the attendants dismissed was intoxi- 
“ ‘ cation ; of six, ill usage of patients, and of the remaining seven- 
“ ‘ teen various other infractions of rules. In one instance the 
“ ‘ dismissal of an attendant for striking a patient was followed by 
“ ‘ his arrest, and subsequent sentence to an imprisonment in the 
“ ‘ penitentiary for three months.’ ” 
The said first communication to the Board of Estimate and 
Apportionment, dated December 24, 1877, signed by State Com- 
missioners Lowell and Donnelly, and published in said report to tlie Legislature, at pages 229, 230 and 231, among other import- 
ant contents, lias tlie following : 
“ To tlie Board of Estimate and Apportionment, City of New 
York: 
“ Gentlemen.—Before you decide finally upon the amount of 
“ the appropriation for the maintenance of the department of 
“ Public Charities and Correction for the year 1878, we wish to 
“ make one more appeal to you in behalf of the most unfortunate 
“ of the city’s poor, the insane men and women crowTded into the 
“ asylums on Ward’s and Blackwell’s Islands, and beg you not 
“ only to grant the full amount asked for in the estimate of the 
“ Commissioners, for these institutions, but even to make a larger 
“ appropriation for salaries than they have suggested. 
“ Ignoring for the present the general deficiencies of these 
“ asylums, we ask you to consider only the sufferings to which 
“ the patients must be subjected owing to the small number of 
“ attendants who are placed in charge of them. 
“ The attendants themselves must be constantly overworked, 
“ and consequently liable to become irritable and to maltreat the- 
“ patients.” 
To which should be added excerpts from the said second ap- 
pended communication to the same Board, by State Commission- 
ers Theodore Boosevelt and Josephine Shaw and Lowell, as follows: 
“ To tlie Board of Estimate and Apportionment, City of New 
York : 
“ Gentlemen.—In a communication which we had the honor 
“ to lay before you some few months since in reference to the 
“ institutions under the charge of the Department of Public 
“ Charities and Correction of this city, we stated that, in our 
“ opinion, it was necessary to establish a new asylum for the 
“ chronic insane, and suggested the purchase of land for this pur- 
“ pose. A special act of the Legislature being required to enable 
“ the city to acquire real estate, we now address you again to 
“ request that you will at once take steps to secure the passage of 
“ such an act. 
“ There is, indeed, the most urgent need of classification through- 
“ out the whole department, but no step forward is possible while 
“ the excessive number of insane patients keeps so large a propor- 25 
“ tion of all the buildings overcrowded. The moment this pres- 
u sure is removed great improvements would be possible. 
“ We therefore again urge you to ask at once for a law author- 
izing the city of New York to buy land for the purpose of 
“ establishing an insane asylum outside of the city.” 
Reference is made to the twelfth annual report of the State 
Board (pages 237 to 256), showing that “ the Asylum is badly 
“ overcrowded ” (page 250); and to the next succeeding annual 
report for the year 1879, transmitted February 5, 1880, which 
includes the report of Commissioner Lowell on the Public Chari- 
ties of New York City (pp. 137 to 169), and from which we quote- 
the following : 
“ New York City Asylum it>R Insane. 
“ Census, December 31, 1879. 
“ Paid officers and employees 101 
“Patients, main building 783 
“ Patients,, emigration annex 31L 
“Work-house help, males 6L 
“Work-house help, females 33 
Total 1300 
“ This asylum still continues in the same condition as when re- 
“ ported upon last year, but still more over-crowded, having 1097 
“patients in buildings intended for about 700. It is well man- 
“ aged so far as it can be under the conditions, and I believe all is 
“ done that the superintendent finds possible to counteract the 
“ effects of the want of sufficient room and of the poor arrange- 
“ ment of the building. 
“ The annex continues to be a most objectionable feature of the 
“ asylum, and is an absolutely unfit building for insane.” 
“ The number of employees dismissed (twenty-five) shows that 
“ the character of the appointments is not what it should be, and 
“ points to the great importance of making the superintendent 
“ absolutely responsible by giving him the power to appoint and 26 
“ remove all his subordinates. Yotliing short of this change can 
<£ render it possible to fix the responsibility for sliort-comings.” 
“ The increase during the year has been 107, with no increase 
“ of accommodation. The purchase of a large farm by the city 
“ would provide a place for an asylum for chronic insane patients, 
££ both men and women, and it is very desirable that before real 
<£ estate increases in price, the city should buy land enough to 
“ meet her probable needs for twenty years to come, since on all 
<£ the islands the buildings are becoming far too crowded, and at 
“ some not very distant date more room will certainly have to be 
“ provided in some way. 
“ The superintendent reports: 
“ £ There has been no death due to accident or injury during the 
<£ £ year, nor has there been an}7 suicide; indeed, it is now two years 
“ £ and nine months since we have had a suicide.’ ” 
££ Such a record, in so overcrowded an asylum, shows that the 
<£ patients must have been very well cared for by officers and 
<£ attendants.” 
The same State Commissioner for New York City in her report 
upon the condition and needs of the insane of New York City, 
which was transmitted to the Legislature with the fourteenth 
annual report of the State Board (page 192), again shows that 
<£ the buildings and land (about 160 acres in all) are still very in- 
<c sufficient for the number of the insane in this asylum,” which 
was again followed in the text of the sixteenth annual report 
of the State Board, transmitted to the Legislature, January 17, 
1883, with the following warning and recommendation, at page 
20, to wit: 
££ Insane of New York City. 
££ The condition of the insane of New York city has been care- 
<£ fully examined during the year by the New York commissioners, 
“ a committee of the Board appointed for the purpose. It was 
<£ found that the accommodations for this class, especially in the 
<£ men’s department, were greatly crowded, and that they could 
<£ not be well extended in the locality upon the islands, owing to 
“ the lack of sufficient lands. The committee recommend the 
<£ purchase of a farm outside of the city, and the erection of plain “ and inexpensive detached cottage buildings upon it, with the 
“ view of the removal of a part of the chronic insane men to them. 
“ The matter was brought to the notice of the board of estimate 
“ and apportionment, who thereupon made an appropriation to 
“ carry out these objects. This will give facilities for the out-door 
“ employment of the insane men, and at the same time relieve the 
“ crowded condition of the present accommodations. The report 
“ of the committee upon the subject is hereto appended, to which 
“ we invite attention.” 
The report of said committee appended at pages 151 to 163, 
shows that there was a surplus of 340 patients, unprovided for on 
Ward’s Island, and that “the very great need of more land for 
<£ the insane of the city, was brought to the attention of the Board 
“ of Estimate and Apportionment by the New York Conimission- 
“ ers of the State Board, and that the Board of Commissioners of 
“ Public Charities and Correction supported the request for an 
“ appropriation for the purchase of a farm” (page 153); and 
embraces a copy of a written communication to said Board of 
Estimate and Apportionment dated December 14, 1882, and 
signed by resident State Commissioners William B. Stewart and 
Josephine Shaw Lowell, from which we take the following 
excerpt: 
“ New York, December 14, 1882. 
“ To the Board of Estimate and Apportionment, New York 
City: 
“ Gentlemen.—On April 8,1882, a letter was presented to you, 
“ signed by the New York City commissioners of the State Board 
“ of Charities, and by the late Dr. James R. Wood, then chairman 
“ of the Advisory Board of the Insane and Lunatic asylums of 
“ this city, asking that you would make an especial appropriation 
“ for the salaries of physicians in these two asylums, and stating 
“ that it was impossible to secure and retain the services of com- 
“ petent physicians, without adequate payment. 
“ We would now renew this request with increased emphasis. 
“ The asylums have suffered very much owing to the loss of 
“ physicians, who, having become valuable by experience gained 
“ in the asylums, are forced to leave to take paid positions else- 
“ where. 
“ During the year 1882 the lunatic asylum lost five physicians 28 
“ from tliis cause, and Dr. McDonald, superintendent of the insane 
“ asylum writes: 
“ ‘ During the current year six (6) assistant physicians have re- 
“ 4 signed in order to accept salaried positions in other asylums.*** 
“ ‘ The senior in point of time of service at present in the asylum, 
“‘ Dr. Harrison, has been here only since April of this year, and 
“ ‘ lie has an offer from a State asylum at $1,000 a year.’ ’’ 
In its seventeenth annual report, transmitted to the legislature 
January 24th, 1884, the State Board of Charities, after stating the 
facts showing undue economy in the management of the two Hew 
York City Insane Asylums, and the King’s County Lunatic 
Asylum, and showing “such insufficient supervision as can be 
“ given them in conjunction with the paupers and criminals of 
‘‘those cities,” advises as follows: “In view of these facts, the 
“Board recommends that the care of the insane in Hew York and 
“ King’s Counties be placed in each county under a separate 
“ department, entirely independent of the respective departments- 
“ of public charities and correction.” (p. 23.) 
The beginnings of promised efforts by the local authorities to- 
provide remedies in pursuance of the warnings of the State Board, 
were appropriately recognized in its next annual report, trans- 
mitted January 27, 1885, as follows: 
“ In the last annual report of the Board, attention was called to 
“ the overcrowding of the insane in these Asylums, and although 
“ no further accommodation has been so far provided, yet the 
“ authorities of Hew York city and Kings county have taken very 
“ important steps, which will eventually lead, it is to be hoped, to 
“ an entire change in the manner of caring for the insane of these 
“ counties. 
“ The Hew York city authorities, early in the year, entered into 
“negotiations, for the purchase of 1,000 acres of uncleared land 
“ on Long Island, with the intention of making a settlement for 
“ the chronic insane, but unhappily it was found that no title to 
“ the land could be obtained. 
“ The Kings county authorities, under chapter 230, Laws of 
“ 1884, have bought 1,000 acres of land on Long Island, and 
“ intend to proceed with the erection of buildings as soon as 
possible.” 
In addition to the special communications to the various city authorities by the State Board, referred to in its annual reports to 
the legislature, we mention the following among others, to wit: A 
special meeting of the State Board having been held March 16, 
1882, in New York city, for the purpose of considering matters 
relating to the insane; the following resolutions were adopted by 
it at its stated meeting October 10, 11 and 12, 1882, to wit: 
“ Whet 'eas, The provision for the care of the insane in the county 
“ of New York is wholly inadequate, owing to want of sufficient 
“ land belonging to the city, upon which to erect the requisite 
“ buildings for their accommodation and : 
“ Whereas, The overcrowding and other evils consequent on this 
“ state of things, entails great additional expense on the city of 
“New York by preventing the cure of cases which might other- 
“ wise be discharged from the asylum, therefore 
“Resolved, That the attention of the Board of Estimate and 
“ Apportionment of New York city be called to these facts by the 
“New York Commissioners of the Board.” 
That the State Commissioners for New York city did act in 
pursuance of these resolutions appears from their report at the 
meeting of their Board, in January, 1883, and from the printed 
minutes of the Board of Estimate and Apportionment for the year 
1882, pages 451 and 470 in evidence. 
At the adjourned stated meeting of the State Board, held in New 
York December 11, 12 and 13, 1883, the following resolutions, 
offered by Commissioner Lowell, were adopted, to wit: 
“Resolved, That the New York Commissioners be requested to 
“ go before the Board of Estimate and Apportionment of the city 
“ of New York and draw their attention to the fact that 3,000 
“ acres of land in Suffolk county, suitable for a farm for the chronic 
“ insane of the city, are now for sale at $50,000, and to recom- 
“ mend that an examination of the land be made with a view of 
“ purchasing it for the purpose above named. 
“Resolved, That the State Commissioner in Lunacy be requested 
“to join the New York City Commissioners in going before the 
“ Board of Estimate and Apportionment.” 
And by resolution of the State Board, adopted April 13, 1886, 
its officers were directed to aid in securing the passage of 
Assembly Bill 384, entitled, “An Act to authorize and empower 
“ the Board of Commissioners of Emigration to lease certain lands 
f 30 
“ and buildings on Ward’s Island in the city of Yew York,” being 
the same just leased to the Board of Charities and Correction. 
At the adjourned stated meeting of the State Board, held 
March 7, 1887, the chairman of the Standing Committee on the 
Insane offered the following resolutions, which were adopted, to 
wit: 
“ Whet -eas, There are under the care of the Department of 
“ Public Charities and Correction of the City of Yew York 1,828 
“ insane men and 2,399 insane women (4,222), of whom 1,368 (823 
“ men and 545 women) are without proper accommodation, as 
“ appears by reports made to this Board, and 
“ Whereas, The City of Yew York purchased two years ago a 
“ large tract of land on Long Island for the purpose of providing 
“ adequately for its dependent insane, which land is at present of 
“ no use for the purpose, owing to the want of buildings, therefore, 
“Resolved, That the Yew York City Commissioners of the 
“ Board be and are hereby requested to present to the Board of 
“ Estimate and Apportionment of the City of Yew York, the 
“ urgent necessity of providing adequate buildings for the shelter 
“ of the dependent insane of the city, and the desirability of using 
“ the land already owned by tbe city and held for this very 
“ purpose.” 
The resolutions in each of the two foregoing cases were duly pre- 
sented to the Board of Estimate and Apportionment. 
The published minutes of the Board of Estimate and Appor- 
tionment in evidence before us, show various appearances before 
said Board by members of the State Board of Charities during the 
last few years. Members of the Board of Charities and Correc- 
tion were generally present also at these times. On each of these 
occasions, as is shown by the said minutes, representations were 
made showing the necessity of enlarged general appropriations for 
the City Insane Asylums and of special appropriations for the pur- 
chase of a farm and the erection of buildings thereon. Reference 
is made particularly to said minutes for the year 1882, pages 451 
to 457, 470 to 484; for the year 1883, pages 434 to 436, and 445 
to 448; for the year 1885, pages 198, 221 to 225, 245 and 246; 
and for the year 1887, pages 201 to 205. 
It is not necessary to go into the history of the enabling act, of 
the negotiation for the purchase of a farm of one thousand and 31 
sixty-seven acres, situated on the Long- Island Railroad, between 
the town of Farmingdale and Deer Park Station, which resulted 
in failure on account of defect of title; or of the final purchase 
of the farm of nine hundred acres and upward on the line of said 
railroad, near Central Islip Station. The deed of said farm hav- 
ing been delivered in the fall of 1885, thereupon the following 
preamble and resolution were passed by the Board of Charities 
and Correction, and communicated to the Board of Estimate and 
Apportionment, as shown by their respective minutes, to wit: 
“ Whereas, the Board of Estimate and Apportionment having con- 
“ sented to the purchase of a suitable tract of land on Long Island 
“ for the purpose of carrying into effect Chapter 428, Laws of 
“ 1883, the overcrowded Insane Asylum on Ward’s Island calling 
“ for immediate attention: 
“ Resolved, that the aforesaid Board of Estimate and Appor- 
“ tionment be and they hereby are respectfully requested to trans- 
“ fer the sum of $60,000 appropriated for Two Stories Pavilion 
“on Ward’s Island, 1883, where the same will not be needed, to 
“ an appropriation of 1885, for construction of suitable buildings 
“on the land at Central Islip, Long Island, for the accommodation 
“ of those persons in charge of the department, whom the Board 
“ deem it expedient to send there to work the farm thereon, as 
“ contemplated in this plan for relieving the overcrowded institu- 
“ tions of this department.” 
Subsequently, to wit: in September, 1886, the Board of Chari- 
ties and Correction asked the Board of Estimate and Apportion- 
ment for an additional appropriation of fifty thousand dollars, for 
buildings and improvements upon the said farm, which was de- 
nied. Ho favorable action was taken by the Board of Estimate 
and Apportionment on either of these two applications, amounting 
in the aggregate to $110,000, until June 15th, 1887, when, after a 
renewed request by the State Board, a transfer of $10,000 was 
made from said fund of $60,000. 
Ho subpoena was issued by your Committee for any member of 
the Board of Estimate and Apportionment, and no appearance was 
made by anyone of or for said Board, though repeated invitations 
were extended to the members thereof through the office of the 
Corporation Counsel. 
We find from the evidence that the Board of Charities and Cor- 32 
rection did not accompany tlieir applications for such special ap- 
propriation and transfer with any plans or specifications for the im- 
provement of said farm. But President Letchworth of the State 
Board of Charities, together with its three members for the city, 
recommended to the Commissioners of Charities and Correction 
while in conference with them in February, 1886, that they should 
erect inexpensive buildings on the Cottage plan, none to exceed 
•over two stories in height, and at the same time furnished a plan 
with written and oral explanations of the Alt Sclierbitz Asylum 
in Saxony, as illustrating the principles they there recommended. 
Ground plan drawings of this Asylum were soon afterwards pre- 
pared by president Letchworth, from notes and drawings made 
during a personal examination by him of said asylum. These were 
sent to the Commissioners of Charities and Correction, with a letter 
•committing said oral suggestions and recommendations to writing, 
which was signed by the said four State Commissioners. 
We call attention to the approval by the State Commissioner 
in Lunacy of the project for the farm, and his hearty concurrence 
in the efforts of the State Board to secure the same; and to his 
frequent conferences with its members and with the Commis- 
sioners of Charities and Correction in the interest of the Insane on 
the Islands. 
In conclusion we cite the reports of Dr. Macdonald, former 
Medical Superintendent on Ward’s Island, now General Superin- 
tendent of both the asylums. Quotations have already been made 
from his two reports, dated the first day of January, 1875 and 
1876, respectively, as given in the report of the three State Com- 
missioners for Hew York City, transmitted to the legislature 
January 17, 1878. We find instructive warnings in all the annual 
reports of the Superintendent; and we refer to his published re- 
ports by years and pages, as follows : for the year 1871 at pages 
12 to 21; for 1875, pp. 19-21; for 1876, pp. 192-6; for 1877, 
pp. 13-15 ; for 1878, p. 11, and for 1882, p. 1; and we cite his un- 
published reports in evidence, for the years 1881, 1885 and 1886, 
particularly the last, which quotes his first report for the year 1871, 
reciting the evils of crowded patients and demoralized attendants, 
and certifies that the recital is as applicable now as then. 
The reports of the Superintendent and other proofs show that 
the early attitude of the Board of Charities and Correction, being 33 
one of opposition to a farm for the overflow of the insane, was 
followed successively by indifference and acquiescence. That 
Board has failed to file plans and specifications with its applications 
for special appropriations for the improvement of said farm; or 
to apply for limited appropriations for barracks, or tents, or other 
temporary accommodations for the surplus of this asylum, except 
on the occasion of the transfer of said ten thousand dollars, June 15, 
1887, when the Board of Estimate and Apportionment was given to 
understand that part of said transfer should be used in immediate- 
ly providing some such temporary accommodations; but it does 
not appear that anything has been done to make that understand- 
ing good. 
It is evident that the failure to provide needed remedies and re- 
forms in this asylum, is nothing more nor less than the failure to 
provide the requisite funds for sufficient buildings and current ex- 
penses. But where does the responsibility for this failure rest ? 
Evidently between the Board of Charities and Correction and the 
Board of Estimate and Apportionment, or upon one of them. It 
is not for your Committee to censure or reflect upon the Board last 
named. If any criticisms are called for, it is for the public to 
make them upon the facts which are presented. But, in justice, 
we state that the applications of the Board of Charities and 
Correction for transfer of the special fund of $60,000, and for 
further special appropriation of $50,000 for the farm, should have 
been accompanied by written plans and specifications for buildings 
and improvements; and that all estimates for general appropria- 
tions over those granted, should have been accompanied by some 
assurances that such increase would be expended on the institution 
for which it was asked, and the whole fund therefor kept intact, 
sacred to the use thereof and that alone, together with the publi- 
cation or filing of accounts as suggested hereinbefore under the 
head of “Finances.” 
We find that within the past few years great reforms and im- 
provements have been made in this, as in the other, city asylum 
for the insane; that among such reforms and improvements, are 
the entire abolition of discipline by seclusion or by mechanical or 
chemical restraint; the institution of more perfect night service 
of physician and watchmen, and the larger employment of pa- 
tients in labor alike benefical to the patients and productive to the 
institution. 3 We find that neither the General Superintendent nor the Medi- 
cal Superintendent, nor the Commissioners of Charities and Cor- 
rection can be held, on the evidence, directly responsible for the 
evils in the present condition of the Insane Asylum on Ward’s 
Island; hut that the said Commissioners are, in some measure, re- 
sponsible indirectly through defaults and delays in measures for 
relief, to wit: in neglecting to present increased estimates for the 
insane asylums from year to year, notwithstanding the aggregates 
of their estimates were annually reduced by the Board of Estimate 
and Apportionment, and in omitting to publish or file with the 
said Board, copies of their annual accounts, as assurances against 
abuses of the system of their unbalanced estimates, and in 
delaying to file with said Board plans and specifications on 
applications for special appropriations for buildings and im- 
provements. The system under which this great charity is main- 
tained, is, at the same time, accountable for these evils. This 
system, as we have found on the topic of finances, is one of unbal- 
anced estimates between and among different institutions and 
bureaus in the same department, and of divided responsibility 
between two departments. 
Respecting the said Commissioners, we further find that Mr. 
Brennan and Mr. Porter give their whole time to their duties in 
their department, and that Dr. Simmons gives several hours each 
day being all his time not occupied in the practice of his profession ; 
that the duties in the business of the office and upon the islands, 
and in the general government of the institutions of the depart- 
ment, including with the insane asylums, all the hospitals, the 
almshouse, institutions for children, the workhouse, the several city 
prisons and the penetentiary, and embracing a population of over 
fourteen thousand, require the undivided time of each Commis- 
sioner ; but that even then their multiplied official engagements 
admit too few opportunities for personal visits upon the wards of 
this-Asylum, and absorb in general business the energy and enthu- 
siasm needed to push reforms and remedies such as a governing 
board of this Insane Asylum should be able to effect. 
PAUPERS. 
The moral obligation of the authorities and of the people of 
New York City to press forward immediately the needed reforms 35 
and remedies in their Insane Asylum on Ward’s Island, cannot 
abate by showing that the patients therein are paupers. Public 
outdoor relief in our cities often produces malingering and the 
practising of idleness and vice in the summer, depending upon 
winter relief, and the perpetrating of all sorts of personal and 
political frauds. But it is no crime to be really poor and sick in 
body and mind. In our industrial civilization, some of the in- 
dividuals are constantly falling away from normal relations in soci- 
ety, because they have not sufficient nervous force to keep their 
places. Such cases require the application of the principle, that 
the strong shall help the weak. The insane man beyond all other 
men appeals for sympathy and protection whatever may be the 
cause of his malady, whether due to his personal transgressions 
or by heredity to violations of law in former generations. 
But there seems to be a popular misapprehension as to the pres- 
ent proportion of paupers in public institutions for the insane. 
Patients having property or friends able and obliged to take 
care of them, are properly excluded from Ward’s Island, if when 
committed to the Insane Pavilion of Bellevue Hospital, the Su- 
perintendent of the out-door poor diligently investigates the case 
with a view to determine whether it is a proper charge upon the 
city ; and if improperly committed to the Asylum any subse- 
quent discovery of facts showing the same, is presumed to be 
communicated to said Superintendent. But it does not follow by 
any means that the whole or even the majority of the population 
of the Asylum, were public charges prior to becoming Insane. 
The probability is altogether the other way. The testimony and 
exhibits before us show, as a mixed matter of fact and opinion, 
that rather more than two-thirds of the male patients of the New 
York City Asylums are a public charge only on account of their 
insanity, having been working men, and so self-supporting up to 
the time of their becoming insane. 
ALIENS. 
The foreign born population is shown to be about two thirds of 
the whole census of the city asylum for the insane on Ward’s Is- 
land. The large majority of the subjects of this asylum thus re- 
semble in one respect those of the State asylum for insane immi- 
grants situated on the same island. But, in other respects, the 
differences are noteworthy. In the State asylum the patients may be presumed to liave been insane on their arrival in this country. 
In the city asylum, on the contrary, the foreign born population is 
composed mainly of men who first became insane after they landed 
on our shores. This is proved first by the opinion of Dr. Mac- 
donald given on his examination before us as an expert and as the 
General Superintendent; and, second, by the records, a transcript 
from which certified by medical officer Dr. Douglas, is in evi- 
dence before us, and marked Ex. 8, July 4. By this transcript it 
appears that for the year, from January 20, 1884, to January 20, 
1885, the admissions of patients in this city asylum included 319 
foreigners, whose respective periods of residence in this country 
are therein given in written answers to questions, as follows: less 
than one year 10 ; more than one year and less than five years 71, 
over five years 223, and unknown 15. The transcript covers the 
subsequent time nearly two years and six months from January 20, 
1885, to July 4, 1887, and including 939 admissions of foreign- 
ers, gives in similar form the respective periods of the residence 
of these patients in this country as follows : less than one year 17; 
more than one year and less than five years 198 ; more than five years 
647, and unknown 77. It thus appears that the change in the 
practice of receiving patients in the city asylums from the state 
asylum under the control of the Commissioners of Emigration, 
through commitment instead of direct transfer as prior to such 
change, has had little appreciable effect in the statistics; but that for 
the year prior to January 20, 1885, the date of such change of 
practice, as well as for all the time subsequent, the number of ad- 
missions in the Asylum on Ward’s Island of patients who have 
been in the country over five years, are to the whole number of 
admissions therein of all the foreign born, in about the same ratio, 
to wit, about two thirds. 
The result so far as it may be relied upon, establishes the ratio of 
immigrants who have been in this country less than five years and 
have been admitted to this city asylum for insane men, to be about 
one third of the population of foreign birth therein, or about two 
ninths of the whole census thereof. It would be a violent pre- 
sumption that should hold the whole number of this two ninths to 
be immigrants who were insane on their arrival in this country : 
and we may therefore safely assume that not more than two ninths 
of the entire census of this asylum have been deported by govern- 37 
merits, societies, and families abroad, and illegally landed in Ameri- 
can ports. And this ratio, though not exact and perhaps not very 
nearly approximate as to insane arrivals, is, as we show herein- 
after, the utmost undue proportion of foreign horn in this asylum. 
This maximum is too great, of course, hut it is less than the ratio 
sometimes assumed in discussions on this subject. 
That there should not he any residue of immigrants who are 
insane on their arrival, suffered to land or remain so as to become 
public charges upon City or State, goes without saying. Space 
will not admit any historical review of the general subject related 
to this matter, either before the decision of the Supreme Court of 
the United States declaring the law of the State of New York im- 
posing thq per capita tax upon immigrants to be unconstitutional; 
or afterwards and subsequent to the Federal Act of August 3, 
1882. 
This act provides that of foreign passengers to this country 
“any convict, lunatic, idiot, or any person unable to take care of 
“himself or herself without becoming a public charge, * * * 
“shall not be permitted to land” (U. S. Statutes at Large, vol. 22, 
page 214, § 2). Under a Contract with the Secretary of the Treas- 
ury, this law has been, and is now administered by the State Com- 
missioners of Emigration at the Port of New York. Upon their 
vigilance and upon the rigid execution of the provisions of the 
act, in the fullest scope of intention as well as terms, rests the re- 
sponsibility of effectually cutting off, through earnest endeavours 
to the utmost extent possible at the source, such illegitimate and 
illegal additions to the dependent populations of the public insane 
asylums of the City and of the State. 
The question will arise how can this residue of immigrants in- 
sane on their arrival in this country ever reach this asylum, if the 
federal law to prevent their landing is properly enforced. 
The effects of all deportations by foreign local authorities, charita- 
ble societies, families and individuals, of alien criminals, lu- 
natics and paupers, upon the City of New York as the port of 
entry, are both direct and indirect, and thus doubly disastrous. 
Those who stay become charges upon the city. Those who go to 
other states may be assisted by the authorities of such states to 
return to New York City, as was often done in former years. 
Such breaches of interstate comity by Massachusetts resulted in 38 
the conference between the Commissioners of Health, Lunacy and 
Charity of that State and our State Board of Charities, held in 
the City of New York, November 12, 1879. 
Among the points brought out by this conference, are the fol- 
following: 
(1st.) Massachusetts had deported by state authority, exclusive 
of those sent out by its towns and cities, during the period from 
1870 to 1878, seven thousand and five paupers to the State, and 
mainly to the City of New York. 
(2d.) Massachusetts held New York responsible for the support 
of persons who have become dependent in that State, but had no 
settlement in New York, and had never been in New York, except 
as passengers in transit for Massachusetts. 
(Thirteenth annual report of the State Board of Charities, pp. 
213 to 280). 
It is difficult to say how far benefit has resulted from that con- 
ference; but if Massachusetts still continues such deportations to 
any great extent, they are secret and indirect, through other door- 
ways into the State, though the intended and ultimate destination 
of such assisted foreign paupers may be the City of New York, 
as the original port of entry. 
The State Board of Charities has from the first contributed to 
abate these evils of foreign and other deportations, by such con- 
ferences and correspondence with the authorities of other States 
and the State Department at Washington and Members of Con- 
gress, as well as in its annual reports. 
It is in evidence that of such cases of illegal importation as have 
escaped the federal law, all which appear to come within State 
legislation, either the Alien Pauper law or the State Pauper law, 
are reported on information of the Superintendent of the asylum, 
by the Commissioners of Charities and Correction to the Secretary 
of the State Board of Charities; and thus to a great extent, and 
in the degree that the proofs will allow, this illegitimate residue 
illegally left under Federal legislation becomes a burden for removal 
by the State and ceases to be a charge on the City. So that in order 
to keep this residue within the least possible limits, duties unper- 
formed under the federal law, devolve unjust burdens upon the 
State of New York; and in order to take care of this net and 
final residue left upon our hands, still more unjust burdens are 
cast upon the City of New York. 39 
It is evident tliat to guard against these accumulated evils, in 
the City of Hew York, both direct and indirect, the Federal law 
must he enforced as it never has been enforced; and further legis- 
lation by Congress may be demanded. 
The question, however, though important in its bearings on the 
future, has little immediate or practical relation to the remedies now 
demanded in this asylum on Ward’s Island: for, as we have seen, the 
immigrants who form this undue residue of the foreign popula- 
tion of this asylum number less than two ninths of its-entire cen- 
sus ; wdiile nearly one half of this census are without proper 
accommodation within the walls of the asylum building, which is 
nevertheless crowded by over thirty per cent in excess of its capa- 
city, making the whole number of its wretched inmates, inclusive 
of acute cases, suffer the long train of evils consequent thereon. 
But what shall we say of the four ninths which, with said two 
ninths, have been taken by us as composing the aggregate foreign 
born population, which is two thirds of the total census of this 
asylum? The ratio of these immigrants who were more than five 
years residents of this country, before they became inmates of this 
asylum, being about four ninths of the entire census thereof, is in 
proportion to the ratio of the foreign born population of the City 
of New York to its entire population, according to the last federal 
census of 1880, as follows : the said ratio in the asylum being 
about four ninths, and the said ratio in the city being about four 
tenths, the proportion is as ten to nine. 
This is a favorable showing for our substantial and worthy citi- 
zens of foreign birth, the old fashioned immigrants, who are as 
much interested as are native born citizens in preventing the 
deportation to our shores of criminals, lunatics, and paupers of 
every sort. The proportion of the foreign born may 1 >e legitimately 
somewhat larger in this City Asylum than in the City at large ; 
for the reason that, given the whole number of persons of neurotic 
temperament or tendency in any country, those who are strangers 
in the land will to the greatest extent through home sickness, 
unaccustomed business pursuits or social frictions or other unwont- 
ed experiences, as exciting causes, naturally develop any predis- 
position to insanity. 
We find therefore on this subject that, while the situation on 
Ward’s Island, as on all the islands under the government of the 40 
Commissioners of Charities an 1 Correction, is suggestive of the 
physical and moral corruption which illegal deportations have 
been casting upon American shores; the correction of these evils 
of illicit immigration would not be the correction jpro tanto of the 
present evils in this Asylum, but rather the prevention of future 
evils, of the same species, though of greater magnitude, which 
present indications prophecy. 
RELIEF. 
The facts proved show that the’ abuses which have continued, 
and against' perpetual protests endured, in the New York City Asy- 
lum for the Insane, are effects of persistent causes. The difficulties 
which hitherto have resisted all efforts for the removal of these 
causes will not yield to attempts at reform on the surface of 
the affairs or administration of this asylum. For these causes are, 
as we have seen, general and inherent in the Department of Char- 
ities and Correction or in the Department of Estimate and Appor- 
tionment, or are resultants of lines of error in the relations of the 
two departments. Although remedial legislation for the govern- 
ment of these departments, as well as of all other departments of the 
city, should he largely determined in its principles and methods, 
by the people of the locality ; yet the facts are so pregnant with 
considerations respecting the same, that your committee make the 
the following suggestions in the premises. 
The remedies to be effectual must be as radical as are the evils 
to be removed, and should reform from the foundation, and cut 
out these general and persistent causes of long continued abuses, 
root and branch. All such remedies and reforms, without losing 
anything radical or decisive in their nature, may be classed respec- 
tively under the two species of relief, viz: 
A. Provisional Relief. 
B. Permanent Relief. 
A.—For provisional relief, the immediate remedies demanded 
are proposed as follows : 
(1.) The Board of Charities and Correction to give to the Board 
of Estimate and Apportionment, plans and specifications for all 
buildings and improvements, in respect of which special appro- 
priations are asked or needed: and also annual accounts and re- 
ports and all necessary information for the general appropriations, Pages 41- end missing