“In a population of sixty-three in the poor-house of Richmond county eleven are insane. They have all been admitted since 1853, and two of them have received treatment in an asylum. Six are males, five are females, three of the cases are mild, eight are excitable, and six are violent. Two are filthy in their habits, and three require mechanical restraint. Two males are capable of out-of-door labor, for the rest neither occupation nor amusement is afforded. The building which is of stone, two stories high, is supplied with water, though no bath tub has yet been introduced. The patients are required to wash daily. One case, on account of its violence, is confined in a basement cell, and as he is a cripple he cannot get out of it; but attention is paid to the ventilation of the room. The other rooms are variously 9 x 9, 13 x 7, 13 x 16, 9 x 10, &c., each lighted by twelve lights of 8 x 10 glass. Two rooms in the attic do not open out of doors; they are used for confining female patients when violent. The bedsteads are of iron, only one in each room, and one only sleeps on each. There are none who sleep on straw alone. Those who are confined to their rooms are served with their meals by attendants; the others go to a general table which is abundantly supplied—the vegetables coming directly from the farm. The building is heated by furnaces, though no attention is paid to the uniformity of heat by a thermometer. The attendants for the insane are paupers. Their garments are changed every week. The insane are visited by the physician of the establishment as occasion requires.
The building was never constructed with reference to the accommodation of the insane, but in a wing of the building occupied for the purpose they are made as comfortable as in any institution of this class. All have shoes, and none were without them during the winter. The appearance of the rooms is clean and tidy. The restraint used is by hand-cuffs, gloves and belt, confining to the bed and confining to the room.”