At the meeting of the State Board of
Health, Lunacy, and Charity, on Saturday, May 5, Mrs. Clara T. Leonard
of Springfield, a member of the board, submitted a written report of her
observations at the Tewksbury Almshouse on Wednesday, Thursday, and
Friday of last week. The report was decidedly in contrast with some of
the testimony put in by the governor before the committee on public
charitable institutions, and it is given below in full:
HON.
THOMAS TALBOT, Chairman.
Sir, — By appointment of the board as a
special committee "to investigate the care of the sick and insane and
other inmates of the State Almshouse at Tewksbury," I have visited that
institution. I arrived there on Wednesday, May 2, at 4.30 P.M., and
remained there until Friday, May 4, at 12. I spent the entire time while
there in a close personal examination of the premises, and in
conversation with inmates of both sexes and all classes.
I found no
material change in any thing since my visits in April, 1882, and April,
1881; both of which visits were made by me without my associates or
previous notice. Now, as then, I found scrupulous neatness everywhere,
in the most remote and little visited parts as well as the more
prominent. It is always my custom to inspect beds, both those unoccupied
and occupied, taking the beds at random, anywhere. I think I examined
more than a hundred beds, including those in remote attic dormitories,
where boys and men sleep, and the beds of the insane. On the night of my
arrival, I took the keys of a matron, and visited a portion of the
insane (fifty-two in all) without her, after they had retired. I found
them in excellent condition, but with no change since the two preceding
visits, when I carefully examined the insane. I found all beds
everywhere in the institution satisfactory. I was assured by inmates of
several years' standing, that the beds had always been changed clean
sheets, etc. whenever a new occupant was received; and all beds were
changed once a week regularly, and oftener when necessary. To this point
I gave much attention, and made inquiry of various inmates, with the
same answer. The bath-tubs were in sufficient number and good order,
just as I have previously found them, with water abundant; except that
some tubs needed painting inside. Many patients were being bathed while
I was there. This process I always find going on in large institutions
much of the time, as different persons bathe on different days, to
accommodate all. There is no common pool nor tank for bathing in the
institution, and has not been for several years. Formerly they were
common in large institutions, but have been given up in Massachusetts
some years ago.
There is no vermin in the institution, except
sometimes stray bugs, liable to be brought in by inmates, as are also
lice of the head and body both. There are cockroaches near the
water-pipes, as I have often seen in hotels and private houses. To keep
out vermin is one of the most difficult tasks in an almshouse, and is
accomplished as well at Tewksbury as could be expected. All my
information in regard to vermin I received from inmates. There are some
rats seen now and then, as might be expected in a large group of
buildings on a farm where they can come in from the fields in search of
food; but, from my inquiries of inmates, I thought no more than I have
seen in almshouses proportionally.
I found the old women's and
old men's wards very cheerful and comfortable, the occupants generally
cheerful and contented, so far as human nature is contented in even more
luxurious surroundings. There are always some children at the almshouse,
a few with their mothers; others sent in from towns in the eastern part
of the State, waiting transportation to Monson; also a number of
children (perhaps twenty) afflicted with loathsome disease, or
hopelessly idiotic. I found the sick children receiving fairly good
care; on the female side, very good care. There are no infants at
Tewksbury without mothers, and, as is well known to the board, no
foundlings since October, 1879; these all being boarded out in private
families, with excellent results. In former times the motherless infants
fared badly here; because they were cared for by pauper women, ignorant
and untrustworthy. In 1879 they ceased to be maintained at the
almshouse. I saw a good many feeble, emaciated infants, born with
nameless diseases, suffering for sins of parents. The men's hospital is
a long brick building, divided by the dispensary into two wards, sick
and convalescent. There are three small rooms off the wards for special
cases, two of which held six beds and one two beds. In eight of these
beds were sick, insane, or idiot men. A small partitioned space off the
long or sick ward is used for cases of delirium tremens. I found seventy
patients in the long ward, thirty-nine of whom were in bed, the rest
able to sit up more or less. None of these are able- bodied. Two paid
male attendants only are in charge of these men, many of whom are
demented. In the short ward were forty-seven feeble men, three of whom
were in bed, with one paid attendant. There has been of late a night
watchman for the two wards, but not always; and the sick must have
suffered when there was not. At present one attendant has just been
dismissed, and his place is unfilled. For these one hundred and
seventeen sick and feeble men, three attendants, with such help as can
be had from patients, do all the work, cleaning the floors, utensils,
etc., bathing the patients, washing and bandaging sores, politicing,
giving medicine, food, etc. Any person accustomed to sick-nursing can
see how inadequate is the number of attendants, and how difficult it
must be to secure proper persons to do so much work for the most
repulsive subjects of disease and dementia.
The male attendants
were spoken well of by some patients, by some of long term in hospital
with praise. Two men, apparently credible persons, gave me instances of
attendants striking and roughly using sick men. One of these patients
said that attendants had a hard time sometimes with delirium-tremens
patients, who were very dangerous and difficult to handle. In my opinion
these two wards cannot have proper care without six paid attendants,
four for day and two for night; nor would any of our good hospitals
probably get along with even that number of nurses. First-class men
cannot be had for this position, even at twenty-five or twenty-six
dollars per month, which is what they are paid. No attendant should ever
be permitted to be unkind to a patient, much less to strike or abuse
one, which is horrible to contemplate. But when cheap and insufficient
attendants
are demanded, we must put up with what we can get, as
housekeepers sometimes must with faulty domestics. The surest way to
prevent abuse is to have competent men in charge, and enough of them.
The appropriation does not permit this.
The women nurses and
attendants are respectable and intelligent. They belong to the class of
women who earn their living at about the same rate in other avocations;
could earn as much, easily, elsewhere and more agreeably, I should
think. The women are in three old wooden hospital-buildings and one new
brick one, all on the opposite side of the quadrangle from the men's
hospital.
Most of the hospital rooms are large wards. Dr. Anna
Wilkin has been in charge of these since Feb. 6, 1882; and to her I am
indebted for much valuable and trust-worthy information in regard to the
institution. Miss Wilkin is faithfully devoting her time and skill to
the alleviation of suffering.
I found her hospital in as good
condition as the structure of the buildings will permit. They are old
and cheap, with the exception of the brick one, but not uncomfortable,
and are very clean. In the women's hospital and the maternity, ward, I
found ninety- four women, fourteen sick infants, twelve new-born
infants, and fourteen children between two and three years old, most of
whom had mothers in the almshouse.
For these one hundred and
thirty-four patients, I found one head nurse, a graduate of the Boston
training-school; three assistants, one of whom is night nurse; and a
single matron for the lying-in and children's building, forty-four
inmates. These matrons not only have the personal care of these one
hundred and thirty-four persons, but cut and make nearly all their
clothing, with what help they can get from such persons. The sick
include thirteen sick, insane, and idiotic women, and some terrible
cases of loathsome disease, sores, ulcers, humors, etc., requiring
excessive care and much intelligence. Nearly all the pauper helpers are
either infirm, know very little, or cannot be trusted. By day there are
only four nurses to one hundred and thirty-four patients, certainly a
very small number. I made many inquiries of the women in hospital as to
their treatment. Without exception, all who had mind enough to tell any
thing said they had kind care; some even with emotion spoke of Dr.
Wilkins's and the nurses' goodness.
All my conversation with
patients and inmates was held in such a way that the attendants and
physicians could not hear what was said of their treatment, and I
encouraged inmates to tell me fully all about themselves. Many
complained of food, that it was not good, nor to their taste.
The food which I examined seemed of fair quality : the bread not
so good as at Monson, but tolerably good, certainly not sour or heavy;
milk, excellent; good gruel made with milk; tea reminded me of that in
railroad stations, not the best quality. Butter is served twice a day to
the sick, and toast for a good many, and crackers; beans once a week,
for dinner; roast beef twice a week, salt fish once, fresh fish once,
corned beef once, soup once, oatmeal, etc. A few sick get beefsteak,
eggs, etc., when ordered by the physician. No one complained that they
had not plenty to eat : all said they had. This diet is the same for
sick and well, except the few extras butter, gruel, milk, etc. for sick.
Some who were feeble said they longed for little dainties. I have found
free patients in the Massachusetts General Hospital, whom I have visited
there, getting roast chicken, beefsteak, cranberry-sauce, puddings,
jelly, egg-nog, etc.At that hospital, however, the average cost of a
patient is ten dollars and fifty-nine cents per week; at the Boston City
Hospital, eight dollars and seventy-four cents per week. So, for two
dollars and nine cents per week, little luxury can be expected. I will
discuss the subject of cost more fully hereafter. I think that curable
patients would recover better at Tewksbury if they had richer and more
tempting fare. A large proportion of all the sick suffer from chronic
disease : of these the poor, failing consumptives, those suffering from
ulcers, etc., would enjoy fruit and other delicacies which they rarely
have; and I felt in talking with them how hard it was that their few
remaining days should not have such comfort.
A great want for
the sick at Tewksbury is a sick-kitchen for each of the two hospitals,
male and female, such as is in use at the-Sherborn Prison and at Monson,
with a special cook, where food is prepared more suitable than in the
great common kitchen. But the appropriation is too scanty to admit 'of
this. It is evident that one hundred dollars and sixty-eight cents per
annum is a small sum for the support of an able-bodied man or woman.
It will provide bare necessaries of life, food, clothing,
warmth, and shelter. Yet this is .what was the cost per capita at
Tewksbury last year. But these people are not able-bodied :
three-fourths are sick or insane, or little children in arms, or old,
feeble, or crippled. They must not only be warmed, fed, and clothed, but
have bodily care, be washed, dressed, fed, and, many of them, have
medical attendance, nursing, medicine. It is only in large aggregates
that the expense can be brought so low.
Where shall we cut it
down ? In attendance, when there are only nine nurses to two hundred and
eleven adults, and forty infants under three years, or one nurse to
twenty-eight persons? Shall we give them less food? Cheaper it can
hardly be, unless we cut off milk and butter and tea. I cannot see where
to reduce expenses, but I can see very plainly where they ought to be
increased very materially.
The clothing of all in the hospital
is of very cheap material, but decent and sufficient, except for
children and infants. The excessive economy practiced does not allow as
much soft flannel as these should have, nor proper outside garments for
these little ones to get full benefit of the fresh air in cool weather.
The insane-asylum contains two hundred and thirty-five patients,
all women; sixteen more insane women sick in hospital are counted as
there in this report. For these are employed four female and three male
attendants, or seven attendants to one hundred and fifty-one patients
when all are in the asylum. To-day there is one attendant to every
thirty-three and four-sevenths patients. These patients are in large
wards. It will easily be seen, that seven attendants cannot distribute
themselves among sixteen wards on four floors, so they get on as they
can. The insane patients are most of them very demented, all chronic
cases, capable of little work; yet they, with the female attendants,
make all their clothing and clean their apartments. Every thing is
beautifully neat, and is exactly as it was in 1881 and 1882, when I
visited them; the persons, hair, and clothing of the insane are in
excellent order, as I have always found them. Now, the very small number
of attendants necessitates a great evil, the care in part by men of
these insane women. Because the insane women are too strong when
refractory, as they often are, for women to manage them, unless a
greater number of women were employed, men are absolutely necessary.
Some violations of decency occur, of which I have had ocular
demonstration; women exposing themselves in a shocking manner before
men. Twelve women attendants would be a small force for these wards, and
at least that number should be employed. Men should never have the
personal care of women; of course; yet these women in charge could never
deal with their patients unless four or five attendants were available
in a ward, to aid each other in case of a struggle.
There are
to-day forty-four paid employees in the institution for eight hundred
and ninety-eight persons on May 1. This was the full number by
inventory. I counted persons in different wards as I went, with the help
of matrons. Those in both hospitals and insane buildings are exactly
correct; the others nearly so. Population there varies from day to day,
and is now about nine hundred. There are one hundred and forty-three
women and children not sick, with two attendants, one a night watch, one
for day, in the wards in the main building, and two hundred and
thirty-three men and boys in the opposite wing, with two attendants. The
employees are as follows, in full :
Superintendent, head matron,
assistant superintendent, clerk, three physicians, one engineer, one
baker, seven attendants for insane, two attendants for old men (not
sick) and boys (two hundred and thirty-three persons), three cooks for
nine hundred inmates, two employees in charge of laundry, five female
and three male sick-nurses, two matrons for one hundred and forty-three
women, and about forty babies who are not sick, one watchman, one
gatekeeper, one teamster, one gardener, six farm-laborers, one
carpenter, forty-four employees.
This is about the usual number.
As in private families, days' work are done during the year by
masons or other workmen on repairs. The names of such employees even for
a day appear in annual reports. So when a nurse or a doctor leaves, and
is replaced by another, both names appear on the lists. It would be
equally true to say that a private family kept five servants, when they
never kept more than one, if, as it sometimes unfortunately happens to
be the case, that number of changes occurred during the year, as to say
that the State almshouse had sixty-four employees last year; forty-four
or forty-five was the actual number. No person of adequate experience or
judgment would see any place to reduce this force. True humanity and
regard for the interests of the poor at Tewksbury would add seven or
eight good attendants, and this I hope to see done. Every inmate I have
talked with speaks of Capt. Marsh favorably, some with great affection.
Not one admits to me that they ever knew him or Dr. Lathrop to do an
unkind thing; though, as I have said, there is some complaint of
occasional harshness by male attendants.
Dr. Wilkin thinks Capt.
Marsh one of the best and kindest men she ever knew. I believe that he
has been maligned, and feel great sympathy for him. This venerable and
still active man of seventy-eight years would inspire respect in any one
who met him now, having had no previous account of him. He belongs to a
past generation, and there are modern ideas and improvements which could
be better carried out by a younger man. It would be an advantage to have
a professional man of the organizing talent of Dr. Quimby of the
Worcester asylum in charge of the State almshouse. While I have
confidence in the medical management of Dr. Wilkin, I cannot say the
same of the other physicians. There is a slipshod condition of things in
the men's hospital which even the small appropriation does not excuse.
Dr. Lathrop, though a man of polite manners, and spoken of by all as
amiable and gentle, seems to me to lack force and energy, and is by no
means thorough in his work; nor is his male assistant wholly
satisfactory, so far as I can judge. I recommend a change in both those
officers, and if possible, would endeavor to retain Dr. Wilkin, who is,
I think, just such a woman as is needed. I examined the hospital bills,
and find the apparently large sum of $1,439 for medicines last year.
This includes trusses and supporters, infants' food, and flaxseed for
poultices, bought in large quantities by the barrel, making up large
items, and incorrectly charged as "medicines," because purchased from a
druggist.
I made inquiry about the care of the dead (of male
inmates of long standing), two or three of whom gave full accounts, not
varying. I also asked Dr. Wilkin about this. I asked no other persons.
Male patients die and are "laid out " on the beds in open ward, as there
are no private rooms for the purpose. Females are, when liable to die,
placed in a private room, as the new hospital has separate rooms. They
are then placed in a coffin, and taken to the chapel until buried : all
seems to be done decently. The men who told me were not likely to state
things too favorably, judging from some other things they said. Every
dead body is viewed by a physician before being taken out of the bed.
Further than this, I know nothing about the subject. It has been my
desire to make a most thorough and careful examination of this
institution, to satisfy my own mind and other people of
the real
condition.
To this end I have talked most freely with, and
cross-questioned, various inmates, and have given out in the wards, in
advance of my coming, that I wished to hear the truth. One nice old
Irishwoman said she had been here, "off and on," for twenty or more
years. "No, dear," she said, " I never was ill-used, nor see nobody
ill-used; but you know there's quare people here, and many things they
say." Another woman, smart and intelligent, but a victim of
intemperance, said she had been "in and out for eight years;" and Capt.
Marsh "has been a father to me, and I was always well used." I heard no
complaints from women, except some trivial ones, such as are common in
the world, not one of abuse. I have investigated drawers, cupboards,
closets, baggage-rooms, etc. All are in first-rate order, trunks marked;
few paupers bring trunks or have good clothes, but wear State clothes.
Their few effects are done up in bags, ticketed and numbered, and kept
on shelves in good order to return to them. Some of the insane women
wear their own clothes, nicely marked and of good quality: one had her
own sheets and pillow-cases. She has had her own things every time I
have been there; in fact, I see no changes, no "fixing up."
In
carefully considering the expense of the institution, I am at a loss to
know, in reducing it by cutting down the number of attendants, who it is
proposed to dispense with. Shall it be the engineer, or the baker, the
three cooks, or the teamster? Are there too many personal attendants to
take care of the food and clothing and other property of the State
distributed among these irresponsible inmates ? Nineteen of these for
eight hundred or nine hundred sick or idiot or infirm or aged or insane
or infants, or so intemperate, vicious, or broken down that they cannot
live in the outside world; and every one except a few temporary boys,
about twelve or fourteen in number, belong to one of these classes. The
wages paid these attendants and officers are moderate. That some kind of
persons could be found to take their places, there is no doubt. But
thirty dollars a month for a training school nurse or male attendant is
moderate. So is twenty-five dollars per month for a female attendant to
insane, when we consider the excessive number in charge of each
attendant. An ignorant, unskilled female servant-girl gets half that
sum, and is worth about one-sixth as much for service. Shall we cease to
cultivate the farm or garden? Shall we give up repairs? The law of the
State allows three dollars and twenty-five cents per week per capita for
care of the insane in our State asylums, but there is not much
sick-nursing needed for those. The Tewksbury paupers need full as much
expense as the insane, and the institution is in fact a great hospital.
I never expected to be ashamed of Massachusetts, but I am now
ashamed. This rich and prosperous State, year after year, cries out,
"Cut down pauper expense;" and persons are found who point to some of
the poorest-kept almshouses in the State as a model for Tewksbury. The
taxes are paid in chief by the rich. The poorer class do not pay in
taxes even the proportionate cost of the protection by police of their
persons and property. For the purpose apparently of justifying this
parsimony, gross misstatements are spread upon the columns of every
paper in the land; and the proud old Commonwealth receives insult and
cries of shame from States like New York and Ohio, when I read in their
own recent reports of insane in county almshouses chained naked in
outhouses, wallowing in their own excrement, sexes mingling and bearing
fruits of shame and neglect time and again.
Most of all, Irish
citizens of Massachusetts, legislators and voters, grudge to their own
countrymen, and nearly every inmate of Tewksbury is of foreign birth or
parentage, largely Irish,—grudge to these, I say, the poor sum of one
hundred and nine dollars per annum per capita when sick or crippled or
feeble or infant or insane.
Political feeling should never enter
into questions of charity; but if one party asks for a just and fair
expenditure, and another calls for meager and inadequate one, in a
spirit of niggardly and selfish greed, the God who hears the cry of the
poor shall avenge their cause as he did the wrongs of the slave, and the
party who goes for the wrong shall surely fall. This report has been
written entirely since four P.M. of Friday. No person has previously
seen it, or had any knowledge of what I have written; nor has any
suggestion been made to me in regard to it. Such as it is, it is all my
own. The short time I have had, and my inability to confer with any one
about it, writing it alone at my room in a hotel, makes it more
imperfect than I could wish. I would have been glad of a week of time at
least to write and revise at leisure. It is my wish that my statements
should be given to the Legislature as well as to this board; therefore I
have given facts known to most of my associates. The attempt to cut
clown the appropriation for the State Primary School at Monson fills me
with great alarm. I am very familiar with the interior work of that
institution, and know that it would be wrong to reduce expense there. If
it is ever done, the children would have poor food and clothing, and
unsuitable persons in charge. Very cheap service and overworked
employees mean always inferior work done. There is much hope for the
young, therefore more harm can be done by parsimony at Monson than at
Tewksbury. Here, again, we find Irishmen in the Legislature oppressing
their own people, and unwilling to spend a fair sum in their care. If
the administration of public charity falls into the hands of a governor,
there is a danger of office in charitable institutions being made a
reward for political service. We have only to turn our eyes to other
States to see this actually in practice. The care of the insane and
other dependents has been shockingly mismanaged, because committed to
politicians.
Massachusetts has steadily progressed in the
contrary direction, giving the charge of the poor into boards holding
long terms of service, and intrusting a portion of the work to women,
who have no part in politics, and who work without compensation and from
benevolent motives.
It is easy, when it is sought to produce a
certain impression rather than to know the truth, to take exceptional
instances as general conditions, to show all the evils and none of the
good, to base falsehoods upon a slender foundation of truth. This is the
most dangerous form of slander, and this is what has been done at
Tewksbury. And probably many good people to-day believe that people with
foul diseases bathe in the same water as others, which is utterly false;
that nurses beat and ill- treat sick women; that people have short
allowance of bad food, when food is abundant and good, though too coarse
for the sick and feeble, for the most part. Tender hearts ache to think
of the suffering there, when in their own towns the paupers never were
half so comfortable or well cared for as people have been for the past
few years at the State almshouse. The poor of Springfield cost in the
almshouse two dollars and forty-eight cents per week each; yet all the
seriously sick poor are sent to the City Hospital, at a cost of about
twelve dollars per week each, and all children are boarded out in
families as the law requires. This law is disobeyed in Lowell and other
cities; and children are kept with adult paupers, many of whom are
persons of the same character found in our prisons.
With the
management of my own city almshouse, I have been familiar for some
years, since the Union Relief Society and Children's Aid Society also
work in common with the overseers of the poor; by which co-operation the
standard of poor relief has been much raised, the people of the city
being willing to pay for what is reasonably comfortable and for
competent attendance. Great care should be exercised to prevent
pauperism from being made too attractive by undue expense. To attain the
just medium is our duty, and should be our desire. In conclusion, I
would say, that most of the abuses at Tewksbury belong to past years,
and have been gradually reformed. I speak of it as I have known it since
my first visit there, April 15, 1881. We deal with things as they are.
Like all human institutions, I think it can be improved, but gradually
and by temperate and well-considered action. All of which is
respectfully submitted to my associates, asking that it may be presented
to the Legislature.
Signed -Clara T. LEONARD.
Transcribed by Candi Horton, 2007 ©
Genealogy Trails History
Group
