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December 5, 1966

The State and the Mentally III: A History of Worcester State Hospital in Massachusetts, 1830-1920

JAMA. 1966;198(10):1133. doi:10.1001/jama.1966.03110230149054

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Now is a good time, when large state mental hospitals are being widely attacked, to study how they developed their present form. The Worcester (Mass) State Hospital is one of the oldest and most outstanding. Its history, although in many respects unique, demonstrates the problems and vicissitudes characteristic of these institutions.

In the 1820's, the humane and optimistic ideas of Pinel, Tuke, and Rush were replacing old theories about mental illness. At the same time, population growth and urbanization were increasing the number of mentally ill and the difficulties in their care. In these circumstances the Massachusetts legislature, persuaded by reformers like Horace Mann, authorized the erection of a lunatic asylum for 120 patients. The hospital opened in 1833 and under Superintendent Woodward soon became a model. Moral and medical treatment were carried out eagerly, and there was determined effort to cure and discharge patients. Between 1833 and 1846, 2,583