“The provision for the care of the insane poor in the county of Cortland is shockingly bad. Of eighty-eight paupers, thirty-one are insane; being more than one-third the whole number. Eighteen are males and thirteen are females. About twenty-four of this number are of American birth. Not a single case has ever been treated in an asylum, although several have been admitted for fifteen or twenty years; fifteen cases are mild, nine are violent, and twelve are excitable. Eleven are filthy, several are not only insane but have become idiotic. None of the males perform any amount of labor, six females perform some indoor labor. There is no system of amusement or light occupation to divert the mind of any. Ten are destructive, nine require occasional restraint; the violent are controlled by close cells and straight-jackets. The house has not a full supply of water. The insane are not all required to wash hands and face daily! The arrangement for cleanliness and ventilation is imperfect; several are confined in cells without the privilege of coming daily to the open air!! The building is a story and a-half wood structure, ill adapted to the purpose for which it is used; the ceilings are low, the bedsteads are wood, and usually two sleep in one bed; in one bed three sleep; in some instances a sane and an insane sleep together. Such as are able, come to a common table, the others have food carried to them; the diet is such as a farmer’s table affords, plain but ample. The rooms are heated in winter with wood and coal stoves, with stove pipes running through the rooms, without attention to uniformity of heat. There is no accommodation for the various grades of insane; but the violent cases are kept in cells in a building off from the main building. In one ward ten are constantly confined. The sexes are not kept entirely separated, and male attendants are employed to care for female insane. The atmosphere in the rooms is generally unwholesome. At this institution recent cases are received! Two cases were received in 1864. Ultimate recovery by management or treatment is not held in view. Dr. H.O. Jewett, who visited this house says, “the edifice is a badly constructed affair. It was originally a farm house, additions having been made to it; the cells are seventeen in number, 5 1/2 x 6 1/2 feet, ten feet ceiling in front, the wall above being finished upon the rafters; there is one window of eight lights to each cell. There are really no means except accidental ones, for ventilating the various rooms; and with the present arrangement of the house uniform or appropriate warmth in winter season is out of the question; neither is there sufficient help employed in the establishment to ensure anything like proper cleanliness of the apartments or persons of the inmates. The common claims of humanity would seem to demand some regulations which will secure more attention to the physical comfort and moral training of each individual, and the special medical treatment of the insane.” What language can be more explicit or more earnest? Is it any wonder that in such want of care the insane become idiotic or demented, and the mild cases incurable?”