COMMENTS 
OF THE OFFICERS OF THE 
Vermont Asylum for the Insane, 
on The 
Report of t he Special Commissioners. 
1878. 
D, LEONARD, STEAM PRINTER, BRATTLEBORO. To the Joint Committee on and 
the Insane JLsylum, of theSe&&te and 
Rouse of Representatives of the Qeneral 
Assembly of Vermont, now in Session : 
Inasmuch as the Report of the Special Commissioners, 
appointed by His Excellency, Governor Fairbanks, “To inquire 
into the Statutes now in force, in relation to the confinement and 
treatment of the insane of our State, and see what changes were 
necessary, if any, in said laws ; also to inquire into the treatment 
of our insane, and determine what, if any, legislation was neces- 
sary,” contains some conclusions from which the officers of the 
Asylum dissent, and some criticisms which they deem unjust; 
they, therefore, respectfully submit the following statement rela- 
tive to the points of disagreement, and request that the same be 
submitted by you, with your report upon that of the said Com- 
missioners, to the General Assembly. 
For the sake of brevity, the officers of the Asylum will confine 
their remarks solely to those points upon which they entertain 
different views from the Commissioners. 
The Chairman of said Commission, who, in the division of 
the labor, assigned to himself the investigation of “ The construc- 
tion of the Asylum, and its fitness for the care of the insane, the 
air space, ventilation, food, washing and administration,” p. 5, 
states that in three things, “ space to live in, pure air to breathe 
and sufficient attendance, the great deficiencies of the Asylum 
consist, and render it unfit for holding so many as it now holds 
and undertakes to care for.” 
The overcrowding to a definite extent being conceded, that is, 
so far as necessity has obliged the duplicating of beds in single 
rooms, still the assertion is made that, “ in the rooms provided, 
even when occupied by the number they were designed for, the 
space and air supply are not sufficient.” P. 5). 
The capacity of the Asylum according to its original design 
is for 400 persons, patients and attendants, allowing in associated 2 
dormitories the average cubic space for each occupant that each 
single room contains. While we can see advantages in larger 
rooms, and would construct them larger if the buildings were to 
be designed anew, we are fully convinced that the health of the 
inmates would never be prejudiced if the capacity of the institu- 
tion upon the basis originally made were not exceeded. Even 
with the overcrowding, which in the past has been greater than 
it is at present, we fail to find evidences of injury to health in 
consequence. 
The mortality, in comparison with the other Asylums of New 
England, has been above three per eent. less than the average in 
the past twelve years. This fact is admitted by Dr. Fassett, who 
says: “The ratio of deaths to the average number of inmates is 
less than in most Asylums in the country, while many show a 
much larger death rate—even double that of the Vermont 
Asylum.” 
In explanation of this favorable record, he suggests that fewer 
“ new cases—many of which are liable to be acute and fatal”— 
are treated, than in some asylums; and that many having 
“ friends and homes, as the end of life approaches, are taken to 
their homes to die among friends.” 
Whatever force there may be in the first assigned cause, there 
is none in the latter ; so rarely is a chronic case removed to die 
at home, that we cannot recall one at the present time. 
But a stranger argument even than the light mortality, in favor 
of the good general hygenic condition of the inmates, not only 
at present but in all the years past, is found in the large number 
of old residents comprising the present household. By reference 
to the tabular statements contained in the Commissioners Report, 
it will be seen that twenty have been thirty or more years in the 
Asylum ; sixty-five between twenty and thirty years, and one 
hundred and eighteen between ten and twenty years. We ven- 
ture the opinion that this state of facts could not exist, had the 
sanitary condition in which they have lived been decidedly bad 
in any essential particular. 
In noting the structural arrangements of asylums, reference is 
made to the openings over the doors of the rooms, and the 
opinion expressed that “ transoms only permit the more ready 
diffusion of gases. They cannot be said to cause or allow venti- 
lation,” (p. 8). Also, “ that in effect the air in asylum corridors 3 
is absolutely still in cold weather, or whenever the windows are 
closed, unless in them the air may be moved by artificial 
means.” (P. 9). 
We are disposed to accord more practical advantages to the 
transoms as an aid to ventilation than does Dr. Goldsmith. In 
truth, the air in the corridors upon which the rooms of the 
patients open, is never absolutely still. There are ventilating 
flues from these corridors communicating with the chimneys of 
the buildings—thirty-eight in number, amounting to an area of 
about ninety square feet, which, if all concentrated in a single 
shaft, would require one of about nine feet by ten in its diame- 
ters—through which foul air is constantly passing out from the 
building, even without the aid of artificial means. In rooms, 
therefore, not having special flues, the transom affords the sub- 
stitute ; and as there is always an escape of foul air going on 
from the corridors through the flues mentioned, it follows that 
there is an exhaust force acting to draw the air from these apart- 
ments through these transoms or openings above the doors of 
the rooms, which is supplemented and aided by any inlet of air 
from the window, which is opposite the door and transom of 
each room. Even when the window is closed, this amounts to 
considerable, Dr. Goldsmith granting it “ to supplement one- 
fourth of the ventilation required,” (p. r4), but since the introduc- 
tion of the fan, the movement of air throughout the building has 
been so greatly facilitated, its working having even exceeded our 
expectations, that this exhaust force upon the rooms admits of 
easy demonstration. Dr. Goldsmith gives the cubic contents of 
the sleeping apartments at 291,134 feet, which, upon the basis 
of 1,000 feet per person, equals the requirements for 291 indi- 
viduals, and adds that ‘‘502 are made to live in what is the mini- 
mum space for 291.” (P. 14). This is not strictly true. To 
arrive at the total space in which the inmates live, the cubic 
contents of the corridors themselves, in which the patients pass 
fully two-thirds of their time, (assuming they are always indoors), 
must be added to that in which they lodge; but by a singular 
oversight, as it seems to us, the day space in the buildings is 
nowhere taken into account This constant use of the term live 
in, instead of lodge or sleep in, we think, tends to mislead the 
reader. Adding to the cubic contents of the sleeping rooms, 
already given (291,634), the capacity of the corridors (292,464), 4 
we have a total space which, on the basis of 400 inmates, gives 
to each 1,459 cubic feet in which to live, and this, with our 
present means of ventilation, it is possible easily to change once 
an hour, which Dr. Goldsmith himself regards as a sufficiently 
rapid movement. In this computation no account is taken of 
the stairways, bath-rooms, nor dining-rooms, which are used 
some portions of each day by the inmates, to the relief of the 
wards ; nor is the time reckoned which is spent by the patients 
out of doors, still further in favor of the more perfect venti- 
lation of the corridors and sleeping rooms. It should also be 
mentioned that there are many lodging rooms of the class desig- 
nated unventilated, in which the doors are lattice-work, thus 
very largely favoring the air supply. This is the case in some 
of the most crowded of the female halls, where there are two 
beds in single apartments. 
On the occasion of the Commissioners most thorough inspec- 
tion, the ventilation seems to be the point most criticised. “ In 
every room occupied by an inmate who had the door and window 
closed, the air was foul and fetid,” “fearfully bad in rooms of 
filthy patients, etc.,” (p. 16). 
By reference to the testimony it will be seen that we are care- 
ful to select, for the use of persons who are obliged to be con- 
fined to their rooms both day and night, those specially heated 
and ventilated, and we are also careful to prevent, as far as 
possible, the voluntary use of sleeping rooms in the daytime, ex- 
cept with open doors. Practically, the bedrooms are all day 
undergoing an airing for night use, and the occupancy of rooms 
that have become foul and fetid is exceptional. 
As regards the wards and rooms of those cases in which the 
calls of nature are disregarded, and there are quite a percentage 
in every asylum, we do not think it an evidence of defective ven- 
tilating arrangements, if disagreeable odors are perceptible ; we 
have observed it in the most perfectly ventilated buildings we 
have visited. It is the frequent necessary renovation of such 
wards and rooms, on account of the filthy and destructive habits 
of such inmates, that swells the annual account for current re- 
pairs, which, to those unfamiliar with the practical care of such 
institutions, appears disproportionately large. 
In commenting upon the quality of the atmosphere in the 
different apartments, the remark is made that it was found 5 
“ most pure in the double rooms containing only one inmate, 
commonly an attendant.” The impression conveyed by this is 
that the attendants are specially favored in this respect. But the 
use of double rooms by single attendants is not the common ar- 
rangement. It is the case, in fact, only at the Marsh Building, 
and these rooms are also used as visiting rooms by friends of 
patients, therefore not exclusively for the attendant’s use. In all 
cases the rooms for the attendants are selected by the officers, and 
wholly with reference to the best convenience, welfare and over- 
sight of the inmates. 
The position of the buildings in relation to the points 
of the compass are thus commented upon: “The long axis 
of the group of buildings, constituting the Asylum, trends 
east and west, as will be seen on an inspection of the 
maps. It will also be seen that there are nearly one hun- 
dred rooms that have hardly a ray of sunshine entering them. 
This is always inevitable wherever there are rooms on both sides 
of a corridor, and the building trends east and west. If asylums 
could be built as our military hospitals were, every room 
in them would be flooded with sunshine some time during the 
day.” 
As Dr. Goldsmith intimates, this is a general fault or fact, 
applicable to other institutions as well as the one under consid- 
eration. But there are some considerations that mitigate it, some 
even that favor it. The general non-occupancy of the rooms 
during the day renders it less necessary that all should be 
“ flooded with sunshine,” while in cases of acute maniacal ex- 
citement, it is often the case that sunlight is prejudicial. This 
principle has in some institutions led to the use of close shutters, 
making the rooms dark, for the use of patients in this state. We 
have one case of periodical excitement, now under treatment, 
in which a congested state of the conjunctival mucous membrane 
is an invariable accompaniment, and who for this reason would 
be unable to use a bright sunny room. In another, for the same 
reason, we have used the blue glass window, with advantage to 
the eyes if not to the mind. 
It is not thought that the arrangement of double lines of rooms 
with corridor between, is a disadvantageous one to the general 
welfare of the inmates of institutions of this kind, as there are 
always cases who can occupy the rooms from the sun, if not 6 
with positive advantage, at least without actual detriment. We 
willingly admit that too much sunlight cannot be let into the cor- 
ridors and alcoves appropriated to day use. Another fact should 
be remembered in connection with the use of the rooms upon 
the side opposite to the sunny exposure, such rooms are subject 
to frequent changes of occupants. Many patients are subject to 
paroxysmal excitements and require for a few days or weeks the 
use of the rooms thus situated, but few have constant occupants. 
During the hot season these rooms become the preferable ones by 
reason of their greater comfort, being more exposed to the 
breezes and less to the solar heat. 
We are inclined to the view that the location of asylums 
throughout the country, in respect to the points of compass, has 
been determined by local advantages connected with the 
geography of the site. We are not aware that a special prefer- 
ence in respect to frontage has been found an essential desidera- 
tum. Certainly some of the best asylums have the same general 
trend of buildings as the Vermont Asylum. The McLean, and 
the new Worcester, in Massachusetts, the Butler Hospital at 
Providence, R. I., the Bloomingdale and Utica Asylums, New 
York, and the Morristown and Trenton, New Jersey, are of like 
trend. 
Between the temperature of rooms specially heated and those 
not thus supplied, there is a difference of about 20 degrees as a 
rule ; while the former are kept at 70°, the latter would stand at 
50°. This latter temperature Dr. Goldsmith pronounces “not 
warm enough.” (P. 19). 
For a feeble person, 50° might not be sufficient, but for a 
healthy one it seems to us better than any higher degree. We 
should regard 70° as enervating to a person in ordinary health. 
We believe three-quarters of our household better off to sleep in 
a temperature of 50° than in any higher, and it must be borne in 
mind that these statements of temperature apply to the sleeping 
apartments, not to the corridors. 
“ On the paper which bears the outline of the buildings, sew- 
erage, &c., will be seen a sketch of one ward of the Asylum at 
Concord, N. H.” (P. 20). The reader is left to the inference 
that this sketch is typical of the whole of the wards of that ex- 
cellent institution, but such is not strictly the fact. 
The building from which this plan is made was erected and 7 
opened in 1875. It is their latest improvement, and contains 
rooms for twenty-seven patients. In 1868 the extension, called 
the Kent Building, designed for thirty-three female patients of 
the excited class, was erected. These embrace every modern 
convenience, and the advantage of ample space. The previously 
built portion, which still constitutes the main portion, was built 
substantially upon the same scale as the Vermont Asylum as 
to capacity and size of rooms ; both were essentially modelled 
after the same plan. 
As elsewhere stated, the Vermont Asylum has a total space, 
in the opinion of Dr. Goldsmith, for only 291 inmates. He, 
however, states that “it may be so altered, in his judgment, as to 
have space and ventilation ample for 325 or perhaps 350.” At 
present, however, in his opinion, “ it has ventilation enough for 
only 149.” (P. 20). 
In the testimony taken last June, we stated that the system of 
ventilation, as designed by us, then lacked the motive power to 
make it complete and effective. This has been supplied and put 
in use since the final visit of the Commissioners. We are 
convinced that the practical working of this fan will be to supply 
the needed changes of atmosphere for the fullest requirements 
of the number for which there is space. 
Dr. Fassett, to whom was assigned the investigation of 
“ That which relates to the medical or other treatment of 
the insane,” discusses at the outset the questions of se- 
clusion and restraint, and quotes from Dr. Folsom, the able 
secretary of the Massachusetts Board of Health, “ The Criminal 
Lunatic Asylum, at Broadmoor, England, which held, in 1875, 
a daily average number of 503 inmates, of whom 204 had been 
sent there for murder and no for attempt at murder, maim, etc., 
and yet no form of mechanical restraint was used in any part of 
the asylum during the year.” And “ with all this, there were no 
instances of the commission of premeditated acts of violence, no 
attempt to escape was even partially successful, and there was no 
accident which could have been prevented by the use of mechan- 
ical restraint.” 
In referring to the Reports of the English Commissioners in 
Lunacy, we find the explanation of this remarkable disuse of 
mechanical restraint. In Report of 1874, page 299, note the fol- 
lowing: “Mechanical restraint has not been employed, but 8 
during the last 13 months 67 men and 12 women have been se- 
cluded, on account of violence, dangerous propensities, or for 
safe custody, the former altogether upon 2,768 occasions, the lat- 
ter upon 63 occasions.” This was upwards of 15 per cent, of 
the average resident number (508). “ Besides the above, 54 men 
and 22 women have been secluded from time to time, owing to 
maniacal excitement, to epilepsy, or with a view to medical treat- 
ment, &c.” This made 15 per cent, additional, or upwards of 
30 per cent, that were subjected to more or less seclusion. 
In explanation of this large percentage of seclusion, the Com- 
missioners say it is explained by the Medical Superintendent “to 
be due to the necessity which arose in the early months of the 
year for taking extra precautions for the safety of patients and 
attendants, owing to the violence and misconduct of a few of the 
most troublesome patients of the convict class ; but chiefly in the 
latter months of the year, in consequence of the escape of two 
patients, necessitating stricter measures generally, in order to 
insure safe custody.” 
In England seclusion is preferred to mechanical restraint. In 
this country it is the opinion that the interests of the insane are 
best served by the avoidance of seclusion, even if restraint must 
be a condition of its avoidance. There are now some indica- 
tions of a common practice being ultimately reached. Even the 
English Commissioners, in their report of 1872, p. 266, thus 
speak: “It is our opinion, many times strongly expressed in 
these reports, that all the bad qualities of such inmates are ex- 
aggerated by excessive seclusion.” In the light of the present, 
therefore, we believe we are best serving the cause in discarding 
neither, but in reducing both to the minimum as far as practicable. 
Under the head of “ Employment,” Dr. Fassett considers all 
outdoor privileges, and comments unfavorably upon the airing 
courts for the disturbed and demented classes, which he considers 
too small. This, he says, “ seems to us the most inexcusable of 
any of the faults of the institution.” (p. 51). We do not think 
the purpose of these airing courts was fully taken into account 
by the commissioners. 
They are designed for the use of but a limited number at most. 
The larger proportion of the inmates enjoy the use of the unen- 
closed grounds in front of the buildings, and are taken out in 
groups for exercise and diversion regularly each half day by their 9 
attendants, and when the winter doses in, the new gymnasium, 
with sleigh riding, etc., will afford the like opportunities 
for healthful recreation. The airing courts are immediately 
connected with the buildings or wings occupied by the excited 
or demented classes, and are provided exclusively for these 
classes, in recognition of the necessity of open air for all, yet 
recognizing, also, that such are to be protected from public 
observation and remark, while laboring under demonstrative in- 
sanity, or having reached a helpless state of fatuity. 
No feature of an asylum is, in our view, more benificent in its 
practical working than this. The size of these courts has been 
determined by the surroundings. They could not be materially 
larger without exposing to public view their occupants. This 
is the point which, it did not seem to us, the Commissioners fully 
comprehended. 
In considering the sanitary condition of the Asylum, Dr. Fas- 
sett states, “they have estimated the lack of ventilation, not only 
by their own senses, but by the effect upon the health of the in- 
mates,” and that “ the effect upon the health was painfully 
evident in the pale, mottled faces, the cold, clammy hands, the 
feeble circulation, the lack of vitality.” (P. 53). 
With such a state of health, we would naturally expect that 
the death record would show a large mortality from tuberculosis 
and acute affections, which would be quickly fatal under such 
conditions. But the record for the past two years shows but five 
cases from acute diseases all told, and but three from consump- 
tion out of a total of sixty-four, and this latter is a malady that 
would be specially fostered, as is well known, by living in 
impure air. We have taken pains to ascertain the death rate 
in all the State Asylums of New England for the 12 years last 
past, and find the mean average to be 10.38 per cent, on the 
average population of each institution each year. 
The mean average of the Vermont Asylum for the same 
period upon its average population, has been but 6.95 per cent. 
We have also ascertained the percentage of recoveries in the same 
institutions for the same period of time upon those admitted, 
which we find to be 31 1-2 per cent., and in this respect the Ver- 
mont Asylum does not fall below the others ; there is scarcely a 
fractional difference. 
With this state of facts, the remarks made by Dr. Fassett rela- 10 
tive to the sanitary condition'of the inmates, in the last quotation, 
seem contradictory. ‘‘ The pale, mottled faces, the cold, clammy 
hands, the feeble circulation, the lack of vitality,” are, however, 
attributable, we believe, to another cause, and that incident to 
the malady under which all the inmates labor. That cause is 
exhausted innervation. Such patients are not in a condition of 
impoverishment of blood, but there is a want of tone by reason 
of deficient nerve force. In such cases there is always a weak 
capillary circulation which gives rise to the apparent paleness 
and lack of vitality. Yet such cases do not die; they often live 
on for years in just the condition described, and at last drop off 
from sheer nervous exhaustion, without any acute disease what- 
ever, simply because the nerve force runs at last to so low an ebb 
that the vital processes can n« longer be sustained. In contrast 
to these cases, Dr. Fassett comments upon the “ ruddy faces and 
more animated manner of the classes regularly employed,” draw- 
ing the inference that this better grade of cases illustrate simply 
the difference between indoor and outdoor advantages. But here 
again we think he is largely in error. Those whom it is prac- 
ticable to employ out of doors in a regular way, are those who 
are yet a long way from that condition of advanced dementia 
which is coincident with the degree of enervation, which is 
characteristic of the class he so graphically describes. The lat- 
ter, by outdoor exposure, might indeed lose some of the paleness 
incident to indoor life,—become browned by the sun,—but no 
amount of sunlight and forced labor, for it could not be other in 
cases of advanced dementia, would infuse into them the ruddy 
glow of health and the animated manner that belongs to the 
earlier stages of mental disorder. 
In reference to the medical treatment of the patients, we think 
an erroneous impression was given in the statement that “ each 
(medical assistant) testified that he has charge of one side of this 
large hospital, with the aid of Dr. Draper, when needing advice.” 
(P- 45)- 
The duties of the Superintendent are much more individual 
than would be inferred from the above quotation. Under the 
By-Laws the duties of the Superintendent are clearly defined in 
this respect, as follows : 
Art. VIII, Sec. 2. “ In the discharge of his duties, his first 
care shall be for the welfare of the patients committed to the charge of the institution, and this care must be so far personal 
that he shall be at all times conversant with the actual condition 
of each individual case ; and he must be responsible for the 
classification of the inmates and the general course of treatment 
pursued.” 
In the testimony of the Superintendent before the Commission- 
ers appended to the Report, occurs this question, by Dr. Fassett, 
and answer: 
Shies.—Do you personally superintend the treatment of every 
individual in the Asylum, or do you only see them as you are 
called in consultation? 
Ans.—“ For the general direction of everything I am respon- 
sible, but the carrying of it out in detail is intrusted to my 
assistants. My custom is to visit one department of the institu- 
tion each day with the assistant of that department. The 
assistants are required to make two regular visitations each day, 
but each one of us is subject to the nurses’ call at any time.” 
The professional duty of the Superintendent, it will be seen by 
the above showing, is really something more than that of coun- 
selling physician in cases of special difficulty ; it embraces pri- 
marily the determination of the general course of treatment of 
the patients individually ; and the professional responsibility of 
the assistant physicians will be best understood by reference to 
the By-Laws, Art. IX, Sec. 4, which reads as follows: 
“ They will daily, and as much oftener as may be necessary, 
report to the Superintendent upon the cases under treatment, 
relative to the progress made, and concerning any occurrence of 
an unusual or unexpected character, and consult with him in 
reference to any changes in classification or treatment that may 
be indicated.” 
Of the value of professional experience no one can be more 
sensible than ourselves, and in this respect it does not seem to 11s 
that we are open to much criticism. The senior medical assist- 
ant has had full six years’ experience in the specialty and entered 
it after one year’s service in the Hartford City General Hospital. 
The second has now had about one year’s experience in his 
present position. We know of no school but this practical one, 
where the experience desired can be obtained, and neither cer- 
tainly at present can be regarded as inexperienced. 
We gladly bear witness to the careful and thorough investiga- 
11 12 
tions of the Commissioners, both in reference to the fitness of the 
Asylum for its purposes, and in reference to the actual treatment 
of the inmates ; yet, with all due respect, cannot but believe that 
a personal, practical experience of their own in the care of the in- 
sane, would have modified more or less their conclusions and 
recommendatious. 
In the Report of Mr. Walker upon the legal relations of the 
Asylum to the State, he remarks that “ the Trustees have always 
sought the patronage of the State and been willing, so far as 
the Commissioners have been able to learn, to receive the State 
beneficiaries at the prices fixed by the Legislature.” (P. 59). 
How far this statement holds, does not require very extended 
research to show. This is the third time that the Legislature has 
respectfully been asked to raise the price of caring for the insane, 
to a figure that would cover the actual cost, and that the Trus- 
tees have publicly and emphatically expressed their unwilling- 
ness to care for these classes at the expense of others, as the re- 
fusal of the request has obliged them partially to do. 
In respect to the admission to, and discharge of, patients from 
the Asylum, the Commissioners are of the opinion that the laws 
are defective, and “ recommend the enactment of such laws as 
will tend more effectually to prevent the wrongful detention of 
persons, claimed to be insane, in any asylum in the State.” 
(P. 61). 
The manner in which the insane poor may be wrongfully 
detained is dwelt upon, and the statement made that “ the Com- 
missioners fear there may be one or more such cases now 
confined at Brattleboro who ought to be discharged.” (P. 62). 
In replying to this, we deem it sufficient to say that, in our 
judgment, no person of sufficiently sane mind to be safely at 
large and capable of caring for himself or herself is there de- 
tained. 
It is stated that “the Commissioners have learned that for- 
merly it was the custom of the Superintendent to allow patients 
to execute deeds of real estate ; but that they have not learned 
whether this practice is still continued or not.” (P. 65). 
The present Superintendent has no recollection of any occasion 
for such a transaction during the time he has been in charge, 
and is not cognizant of any such at any former period. 
On the question of the supervision of the correspondence of 13 
the patients, the views of the Superintendent are given in the 
printed testimony, and need not be here repeated. We would only 
say that in this matter we have pursued the universal course, 
which the past experience of those qualified to judge, has shown 
to be for the best interest of the inmates, who, from the nature of 
the malady they labor under, are irresponsible and require guar- 
dianship and oversight to shield them from the indiscretions 
incident to their insanity. As a matter of fact, much of the cor- 
respondence of the patients passes unread and even unopened, 
the supervision being only that of a general knowledge of the 
channels in which it drifts. 
Though the statement is made in a general way that “ some 
insane asylums” adopt the unrestricted course, of exercising no 
oversight of the patients in this respect, it is not supported by 
citing any institution in which this practice prevails, and we 
know of none. In addition to the reasons given in the testi- 
mony of the Superintendent referred to, (p. 46), there is one 
which is not there noted, but which seems to us worthy of men- 
tion, as showing it to be an advantage for the physician having 
charge of the patient, to have also the supervision of his corre- 
spondence. It is that the letters or writings of the patient are 
the best key to his mental state. In conversation the patient may 
be reticent or suspicious of all inquiries made of him, or he may 
dissemble and endeavor to appear better than he is, in the hope 
of an early release from confinement; but in the absence of an 
interrogator and uninfluenced by the presence of any one to 
check or turn the current of his thought, by writing he expresses 
more the genuineness of his ideas and the delusions that possess 
him. It is in this way that the first evidences of convalescence 
and coherence may often be detected, and the understanding of 
individual cases be materially aided. 
The large proportion of the patients of this State, who are 
supported or aided by the State, and the small number who are 
supported by private means, is commented upon by Mr. Walker, 
who remarks, this fact “ suggests wrong somewhere.” 
In explanation of this, his first inquiry is: “Do the citizens 
of the State who are able to pay for the support of their insane, 
send them out of the State, and avoid the Vermont Asylum be- 
cause other States have superior hospitals, where the patients are 
better cared for and treated?” 14 
On this point we have the testimony of Dr. Fassett in reply. 
We were assured by him on the occasion of his last visit at Brat- 
tleboro, that in his visits to other asylums he had made investi- 
gation upon this point, but failed to find this to be the case to 
any extent. In the Concord Institution, the nearest and most 
available to Vermont, he found but one. The question is there- 
fore unanswered by this inquiry. Again he essays a possible 
solution of the distasteful fact: “ Can it be possible that the State 
is being defrauded by individuals and officers of the Asylum 
combining to have private patients classed as State beneficiaries?” 
On the page immediately preceding this inquiry, Mr. Walker 
observes, “ Men and corporations are unfortunately greatly in- 
fluenced and moved by money considerations. Such influences 
are potent; they permeate almost every measure. Benevolent 
and philanthropic measures and institutions do not always escape 
them.” That the key note were here struck, might indeed be 
imagined, if by this arrangement the Asylum would receive a 
higher rate per week ; but the facts are, that while no private 
patient is received for less than $3.50 per week, besides clothing, 
beneficiaries are received at $3.00, and the Asylum has the 
privilege of clothing them at its own expense ! This second 
query, therefore, fails to give a satisfactory answer, and Mr. 
Walker propounds no further. The facts, whatever their signifi- 
cance may be, are as follows : 
The whole number of patients belonging to Vermont in the 
Asylum August 1st, 1878, at date of last Report, was 326, 
instead of 364 as stated by Mr. Walker, no doubt by error. Of 
this number 31 were supported wholly by private means, but 21 
of these paid but $3.50 per week besides clothing; 127 were 
whollv supported by the State at $3.00 per week inclusive of 
clothing; 168 were beneficiaries, i. e., received 75 cents per 
week from State in aid of their support. Of these 142 were 
supported by towns, and 26 only were aided by the State, oh the 
certificates of the Selectmen of the towns where they reside, that 
they were proper subjects to receive such aid, under the pro- 
visions of the Statutes for the Relief of the Insane poor. The 
friends instead of towns, make up the balance of support in the 
latter cases. 
It is in respect to this latter class that Mr. Walker “Appre- 
hends there may have been some who have received the State 15 
aid of 75 cents per week improperly.” This is a matter for 
which the Selectmen of the towns where such patients reside 
are wholly responsible, and if any are thus improperly aided, it 
is doubtless due ‘to a misapprehension of the strict meaning of 
the Statutes, by which indigent, though not absolutely destitute 
and dependent persons, are made beneficiaries. This is not a 
matter in which the officers of the Asylum can be in any manner 
an interested party. 
The recommendations of Mr. Walker claim careful consider- 
ation. It matters not to the Asylum whether the supervision of 
the insane be committed to a board, or assigned to a commis- 
sioner as under the existing law. The proposition, however, to 
delegate to a supervisory board the arbitrary power of discharging 
patients, that have been placed by their friends or the public 
authorities in the care of the officers of the Asylum, in compli- 
ance with every legal requirement, will in our opinion be liable 
to lead to conflicts of authority, culminating in acts in which the 
rights of committing parties, and the professional judgment of 
the medical officers will be set aside. The value of special 
experience in dealing with and judging of the insane, the 
Commissioners who make this report particularly dwell upon 
as essential; and the question naturally presents itself, will the 
qualifications of such a board as it is proposed to create be likely 
to be adequate to the responsibility it is proposed to shoulder 
upon it? 
Inhibatory legislation must be very guarded not to defeat by 
reaction the real interests of the class of persons whose welfare 
is at stake, and the officers of the Asylum recognize in the 
propositions urged a tendency to antagonistic, rather than co- 
ordinate working, in a cause having but the single ultimate object 
for all engaged, namely, the welfare of the insane. 
Concerning the correspondence of the inmates, the officers of 
the Asylum desire that every needed privilege should be secured to 
them, but are convinced that the recommendations of Mr. Walker 
go a step farther than is practicable, necessary or wise. After 
specifying the privileges in this respect in detail which should 
be inviolable, (p. 66), all the rest of the correspondence, Mr. 
Walker suggests, “ Should be sent unread by the officers of the 
Asylum to the guardian or some one of the next of kin, or 16 
other suitable person, to be disposed of as he deems best for 
all concerned.” 
First, this is not practicable, for the reason that but few 
patients comparatively are under guardianship, and many have 
no near kin. In the absence of guardians or near kin, Mr. 
Walker does not indicate who would be a “suitable person.” 
But evidently he does not consider the value of this surplus 
correspondence much, as he is willing to leave it to any body 
but the'officers of the Asylum, (to whom it might possibly be a 
benefit, as affording a clue to some of the obscurities of the 
patients’ mental disorder,) “to be disposed of as seemed best for 
all concerned !” 
We regret to feel obliged to criticise with apparent severity 
these recommendations, but the tendency of them seems to be to 
create antagonisms of authority, and to place those in charge of 
Asylums in a false attitude toward the inmates. There is at 
least an implied reflection upon their honesty. 
We respectfully submit that in all this matter somebody must 
be trusted. 
The penalties suggested for the imaginary infractions of the 
proposed laws are severe, and we think without precedent; and 
so long as but one Asylum exists in the State, its officers cannot 
but understand that in all this proposed stringent legislation, 
they alone are meant. 
In all the recommendations made we note no suggestion that 
the insane of the State, not in the Asylum, should be looked 
after! although this was a point pressed by Commissioner 
Calderwood in his report for the two years past, who states that 
“ there are scattered throughout the State not less than 180, of 
whom 60 are cared for by towns, either boarded out in families, 
or kept in poor houses,” which latter places Dr. Fassett states, 
“ none claim to furnish any proper treatment.” 
The supervision proposed therefore embraces but a moiety of the 
insane of the State in its provisions, and that portion, too, the one 
already under a chartered, permanent official oversight. It seems 
rather the Asylum and its officers, than the insane, for whom 
legislation is proposed ! To those in other States where a broad 
and comprehensive system of supervising public charities exists, 
embracing not alone the Asylums and the insane, but the prisons 
and the reformatories, and their inmates, all classes of depend- 17 
ents ; such partial and special legislation cannot but be regarded 
as narrow, rather than wise, liberal and broadly philanthropic. 
To the concluding recommendations of the Commissioners, 
the officers of the Asylum have little to say. The meaning of 
the clause immediately preceding the recommendation for a new 
Asylum, viz. : “ Considering the condition in which we found 
the pauper insane in the Asylum at Brattleboro,” is somewhat 
vague, but seems rather to reflect upon those having them in 
charge. If this be so, we would respectfully ask, does the cause 
for blame lie with the officers of the Asylum, or with the State? 
Mr. Walker reluctantly concedes, (p. 67), that the present 
rate leaves the Asylum in debt, even after throwing out of 
account all expenditures of a permanent character, and the item 
of interest on the debt incurred for improving the accommoda- 
tions for the insane, in the five years past. 
Dr. Fassett affirms that “There is no similar institution in 
New England where the cost is not more than that allowed the 
Vermont Asylum,” and further says, the policy of the State in 
reference to the care of the insane reminds him of an old history, 
“For there shall no straw be given you, yet shall you deliver 
the tale of bricks.” (Pp. 44, 45). 
Dr. Goldsmith virtually admits the necessity for more liberal 
support, by recommending S3.50 per week for the inmates of the 
embryo Asylum. (P.70) 
The Vermont Asylum asks it, that it may receive the actual 
cost of caring for those at present in its keeping. 
J. DRAPER, 
Secretary of Board of Trustees and Superintendent. 
Vermont Asylum for the Insane, Brattleboro, Nov. n, 1878.