SPECIAL DUTIES ASSIGNED TO THE BOARD. The above-named amounts, including both that paid by cities and towns and by individuals, was received for support in the following-named establishments: : The collection of this large amount in a single year was in consequence partly of the decision of the Supreme Court in the suit between Cambridge and Boston, mentioned in the Report of last year. The consequence of this decision was to remove from the State list of patients many persons who had been in the hospitals and asylums more than a year, and for whose support arrears of board were collected. The expenses of the Board and its departments during the year ending Oct. 1, 1881, and for the calendar year 1881, will be given in connection with the estimates for the year 1882, and will also be found in detail at the end of the Appendix. SPECIAL DUTIES ASSIGNED TO THE BOARD. Besides the duties imposed upon the Board by the general statute above cited, the Legislature has required the performance of certain special duties during the past year. These relate chiefly to matters of health in connection with the important question of the water-supply and drainage of cities. By a Resolve of 1881, chap. 33, the Board was charged with the preparation of a plan for separating the criminal insane from other insane persons in the public asylums. Reserving for the present the recommendations of the Board in regard to these important subjects, which have all been SPECIAL DUTIES ASSIGNED TO THE BOARD. fully considered since the 1st of June, we may here present those general considerations, with respect to the subjectmatter of the last-named Resolve, which must precede and explain the recommendations the Board will make to the Legislature. CLASSIFICATION OF THE INSANE. SPECIAL REPORT UNDER THE RESOLVE, The Classification of the Insane. - The Criminal and Dangerous Insane. The general condition of the public health and of the charities, both of the State and of the cities and towns, has not materially changed within the last year. But one great class of persons namely, the insane, who, whether poor or rich, must depend upon the public for care and oversight - has been steadily increasing in Massachusetts for many years, and apparently must continue to increase. This is not due, according to the best authorities, to any extraordinary development of insanity as a disease, but it is rather an accumulation of persons suffering from insanity in its chronic stage. There has been no sudden increase in new cases of insanity, but a constant addition to the number of those who, having been attacked in years past, have not been removed from the list by recovery, death, or departure from the State. It is held by many that insanity is less curable than formerly; and it is no doubt true that many persons are now reckoned insane who, a generation ago, would not have been included in that class. Whatever may be the reasons for the present state of things, it has long existed, and has led to the building of large and costly insane hospitals, which, again, are now nearly full, and, from present appearances, will be completely filled, perhaps crowded, before the close of the year 1882. It therefore seems wise to consider in advance, whether some policy cannot be adopted to classify the insane, especially those reckoned incurable, so that suitable provision may be made for them as they accumulate without renewing that extravagance in hospital building which has become the subject of public complaint in this and other States. The first and most important feature in such a classification would be that the criminal and dangerous insane men be removed from the present hospitals and asylums to a sepa CLASSIFICATION OF THE INSANE. rate asylum, intermediate between a prison and a hospital, in which they can be held and treated as their condition requires, without coming in contact with patients whose insanity is not dangerous to life, nor complicated with crime, nor manifestly the result of a vicious life. The number of these criminal and dangerous insane is not very large, but grows greater from year to year; and more than a hundred men could now be removed from the existing hospitals and asylums to such a special asylum, if it were in existence. The necessity for an asylum of this kind was considered by the last Legislature, on the recommendation of his Excellency the Governor; and the following resolve was passed: [Chap. 33, Resolves of 1881.] Resolved, That so much of the Governor's message as recommends that separate provision be made for the criminal insane be referred to the State Board of Health, Lunacy, and Charity, with instructions to consider the same, and report a plan by which it may be carried into effect to the next Legislature. Acting under this Resolve, the Board referred its subjectmatter to the Committee on Lunacy, whose chairman, Dr. Hitchcock, while visiting England during the past summer, made a special effort, at the request of the Board, to ascertain what has been done, and what experience has been gained, by the British Home Government in regard to the insane criminals of England, Ireland, and Scotland. Dr. Hitchcock had the pleasure of an interview with the Earl of Shaftesbury, Chairman of the English Commission of Lunacy, and with Dr. Arthur Mitchell, Chairman of the Lunacy Board of Scotland; and he spent a day with Dr. Orange, Superintendent of the Criminal Insane Asylum at Bracknell, known as the Broadmoor Asylum. From the notes of Dr. Hitchcock, written out since his return to America, the following extract is made : "I learned that England, Scotland, and Ireland have each an institution, at Bracknell, Perth, and Dundrum, respectively, in which are confined many of the criminal lunatics of the United Kingdom; by criminal lunatics being meant those persons who either were convicted of crime |