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This is to certify that the foregoing is a true schedule and appraisal of the personal property and real estate at the State Almshouse at Tewksbury, belonging to the State of Massachusetts, September 30, 1876.

The appraisal was made by us, and is correct, according to our best judgment.

(Signed) PEDRICK & CLOSSON,
Appraisers.

Then personally appeared before me Wm. R. Pedrick, and made oath that the foregoing schedule and appraisal is correct, according to his best knowledge and belief.

Essex ss. Before me this second (2d) day of October, 1876.

(Signed) A. W. HARMON,
Justice of the Peace.

SUPERINTENDENT'S REPORT.

To the Inspectors of the State Almshouse at Tewksbury.

Gentlemen: -- In submitting the Twenty-Third Annual Report of this Institution, it is my pleasant duty to congratulate you upon its general condition, and the continued prosperity which has attended it.

As a final retreat for the diseased in mind, whose care, or even relief, has been abandoned by experts, and whose physical state tends only to decay and death, and as the only State Almshouse, which is its true character and designation, for more than a million and a half of people, its population, in ordinary times, must be made up of the infirm, the sick, and defective, of whom many can never be expected to leave its walls.

Under these circumstances, no reasonable person can expect the rate of mortality to be the same as in ordinary communities. Liable, too, as is such a population, to a sudden access of illness, both from within and without, it is not easy to maintain, on every day of the year, and in every variation of the atmosphere, a sanitary condition thoroughly satisfactory to ourselves. But constant effort in this direction has accomplished results which are certainly gratifying to us, and which, perhaps, are the best that can be attained with our present means.

The mortality for 1876 has been 276 out of a total of 3,001 supported, or 9 per cent., while in 1875 it was 325 out of a total of 2,926 supported, or 11 1/10 per cent.

While the presence during the year of an unusual number of able-bodied persons has probably tended to this large decrease of 2 1/10 per cent, in the death-rate, it is in part offset by the inevitable decease of the foundlings, who, I regret to say, have been sent hither in greatly increased numbers. No less than 82 have been admitted during the year, of whom 70 have died; while in 1875, 27 were received, all of whom died.

Exclusive accommodation, and the kindest of nurses, have been provided for these little unfortunates, as in former years, while the care and watchfulness of their medical attendants have been unceasing; but all has been in vain. In view of these facts, I would respectfully recommend such legislation as will require the municipal authorities to commit them to the Massachusetts Infant Asylum, where the State has made ample provision for their support, and which has special facilities for their nurture, both in the institution itself and in private families.

In consequence of the action of the Legislature of 1876, our medical department was reorganized, during the summer, by the appointment of William H. Lathrop, M. D., as resident physician; of Geo. E. Putney, M. D., as first assistant; and Enoch Q. Marston, M. D., as second assistant; and by the employment of nine nurses. This necessarily involves an increase in the amount required for salaries, which fact seems to have been overlooked in making the appropriation for that item.

For the greater comfort of the insane, and for the seclusion of such as desire or need it, forty-nine rooms have been constructed by partitioning off a portion of each hall, three of which are to be used for reception-rooms, and the rest as dormitories. For the condition of the hospital and the insane department, I respectfully refer you to the report of the physician of the Institution. But I must once more call your attention to the pressing need of suitable accommodations for cases of "delirium tremens," which are now sent here in increasing numbers. This is absolutely required for their own safety, and for the comfort of the sick and infirm, who are liable to be seriously disturbed by their outcries.