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iipiliPitiiilKW'iiiHiiiiit:

SEVENTH ANNUAL REPORT

THE TRUSTEES

tafliw Asflii for tie Clinic Ins

WORCESTER,

For the Year ending September 30, 1884.

BOSTON :

WRIGHT & POTTER PRINTING CO., STATE PRINTERS, 18 Post Office Square.

1885.

OFFICEES OF THE ASYLUM.

TRUSTEES.

A. GEORGE BULLOCK, Worcester.

THOMAS H. GAGE, M.D., Worcester.

WILLIAM DICKINSOX, . . . . . . Worcester.

REV. JOHN F. MOORS, Greenfield.

ROBERT W. HOOPER, M.D., Boston.

ANNA S. FOLSOM Boston.

FRANCES M. LINCOLN, Worcester.

RESIDENT OFFICERS.

HOSEAM. QUINBY, M.D., Superintendent.

ERNEST V. SCRIBNER, M.D., Assistant Physician.

CLARENCE R. MACOMBER, Clerk and Steward.

SOPHIA N. GRAVES, Matron.

WILLIAM SHERMAN, Engineer.

ALBERT WOOD,

TREASURER.

Worcester.

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CommDnujealtl) of iila00acl)U0ett0-

TRUSTEES' REPORT.

To His Excellency the Oovernor and the Honorable Council.

The Trustees respectfully submit this seventh annual re- port of the Asylum for the Chronic Insane.

The income of the institution, derived solely from State, city, and town patients, has been sufficient for the comfort- able maintenance of the patients, and all the usual expenses, and besides this has furnished means for certain necessary repairs and improvements.

It has been the policy of the Trustees since the establish- ment of the institution under the act of the legislature in 1877, to expend from the surplus income such sums in improving the buildings and their appliances as were neces- sary to secure healthful, comfortable and convenient sur- roundings for those entrusted to their charge. In pursuance of this plan the entire surplus revenue of the past year, amounting to about $9,000, has been used in improving the buildings.

This amount has been spent chiefly in new plumbing, put- ting in new heating apparatus, and providing new means of ventilation. Excellent results have been obtained by these outlays, and while we deem it probable that the surplus reve- nue of future years will be expended by our successors in making good the necessary wear and tear, and meeting the requirements suggested by experience, we do not feel that the outlay is unwise or unproductive. The buildings are not new, but they are safe and convenient, their sanitary condition excellent, and we think them well adapted to the

70 ASYLUM FOR CHRONIC INSANE. [Oct.

use they are put to by the State. The lo.w death-rate (about one-half that of last year) certainly shows them to be in healthful condition.

There are certain additions and extensions needed, which are referred to in more detail by the Superintendent in his accompanying report, and which will add much to the efficiency of the institution. The laundry department should be enlarged, a third story added to this part of the building, and one of the wings should be extended for the further ac- commodation of the female patients.

The usual revenue will not be sufficient to cover these im- provements, and we shall probably petition the legislature at its next session to appropriate $10,000 for the purpose, convinced that this sum can be most judiciously spent in the manner indicated.

The net cost, per patient, during the year has been $3.03 a week. The average number of patients has been 390^^^. Employment and out-of-door exercise have been secured for a large portion of this number in work on the garden and land connected with the buildings.

The only change in the medical staff was occasioned by the resignation of the assistant physician, E. Meade Perkins, M.D., and the appointment in his place of E. V. Scribner, M.D.

We feel that the successful administration of all the departments of the Asylum is attained by the wisdom and good judgment of the Superintendent, Dr. Quinby, and of the other resident officers who assist him, and we wish to record here our appreciation of their services.

A. G. BULLOCK. THOMAS H. GAGE. WM. DICKINSON. J. F. MOORS. R. W. HOOPER. ANNA S. FOLSOM. FRANCES M. LINCOLN.

1884.]

PUBLIC DOCUMENT — No. 23.

71

OFFICERS AND THEIR SALARIES.

Hosea M. Quinby, M D., Superintendent, Ernest V. Scribner, M.D., Assistant Physician, Clarence R. Macomber, Clerli and Steward, Sophia N. Graves, Matron, .... William Sherman, Engineer, Albert Wood, Treasurer, ....

$2,000 00 800 00

1,000 00 325 00

1,000 00 400 00

YALUE OF STOCK AND SUPPLIES.

October 1, 1884.

Live stock,

Carriages and agricultural implements,

Machinery and mechanical fixtures,

Beds and bedding in inmates' department,

Other furniture in inmates' department.

Personal property of State in superintende

Ready-made clothing, .

Dry goods.

Provisions and groceries.

Drugs and medicines, .

Fuel, ....

Library, ....

.	$200 00
	503 65
	7,300 00
.	9,500 00
.	3,200 00
it's deiJartment,	9,200 00
.	721 80
	1,267 43
	3,263 97
	400 00
	2,579 20
	2i 0 00

$38,336 05

72

ASYLUM FOR CHRONIC INSANE.

[Oct.

TKEASUEEE'S KEPOET.

To the Trustees of the Asylum for the Chronic Insane.

Ladies and Gentlemen : — I herewith submit my sev- enth annual report on the finances of the Asylum for the Chronic Insane, for the year ending Sept. 30, 1884 : —

Receipts.

Cash on hand, Sept. 30, 1883 : —

Cash belonging to asylum, ....	18,686 76
Deposits of inmates,	487 12
Amounts received : —
From the Commonwealth for support of
patients,	$17,750 12
cities and towns for support of patients,	53,819 24
other sources,	773 15
patients (on deposit), ....	62 41

The expenditures for the year have been as follows : —

Salaries and wages,

Extra labor (ordinary), ....

Provisions and supplies, viz. : — Meats of all kinds, Fish of all kinds, . Fruit and vegetables, .

Flour,

Grain and meal for table,

Grain,

Tea and coifee, Sugar and molasses. Milk, butter and cheese, Salt and^other groceries. All other provisions.

,173 88

72,404 92 181,578 80

Amoiont carried forward,

$20,420 82 202 42	$20,623 24
$4,355 65 681 04
1,228 38 3,408 81 90 50
15 20
752 69
1,467 79 6,979 63 673 20
1,392 23	21,045 12
. • a	$41,668 36

1884.]

PUBLIC DOCUMENT — No. 23.

73

Amount brought forward. Clothing and material, Fuel, .... Light, .... Medicine and medical supplies, Fm'niture and furnishings, Crockerj^ Beds and bedding, Transportation, Travelling, . Trustees' expenses, Soap and water, . Stationery, . Undertaking, Repairs (ordinary) , All other current expenses.

Total cm-rent expenses, . . . . Repairs and improvements (extraordinary), Refunded inmates from deposits.

$41,668 36

Total amount expended. Cash on hand, Sept. 80, 1884,

Resources.

Cash on hand,

Due from the Commonwealth,

cities and towns, .

other sources.

Liabilities. Due for supplies and expenses, . salaries and wages, inmates (cash on deposit).

13,484 32

6,500 92

1,639 20

580 83

1,077 57

407 27

1,426 21

168 44

34 71

26 48

1,810 76

86 37

272 00

3,000 00

1,649 64

),111 18

50 04

$8,594 50

4,885 68

12,585 65

80 81

$2,758 15 1,660 15 499 49

22,154 72 $63,823 08

9,161 22

$72,984 30 8,594 60

$81,578 80

5,146 64

Total surplus.

4,917 79

$21,228 85

Respectfully submitted.

ALBERT WOOD, Treasurer. ■Worcester, Mass., Oct. 1, 1884.

"Worcester, Mass., Oct. 15, 1884. The undersigned has this day carefully compared the Treasurer's statement of expenditures for the year ending Sept. 30, 1884, with the vouchers which are on file at the Asylum, and found it to be correct.

THOMAS H. GAGE,

Auditor of Accounts.

74 ASYLUM FOE CHRONIC INSANE. [Oct.

SUPERmTElS^DENT'S REPORT.

To the Trustees of the Asylum for the Chronic Insane.

Ladies and Gentlemen : — There remained in the asy- lum at the close of the last official year 392 patients, — 198 males and 194 females.

During the year 37 males and 10 females were admitted, 4 males and 7 females were discharged, and 22 males and 20 females died ; leaving at the end of the year 386 patients, — 209 males and 177 females.

Of the number discharged, one male and three females were tal^en home by friends, one male and one female were removed to poor-houses, and two males and three females eloped.

One among those discharged is reported cured. This patient, a female, was committed to the Taunton Hospital in April, 18 7 (J, at the age of 34, and, when transferred to the asylum, was suffering from chronic mania, was violent, destructive, noisy and completely demented. After remain- ing in this condition nearly three years, she began to show signs of improvement, became industrious, and, as a con- sequence, less noisy and destructive. Her violence continued to be a prominent symptom for several years, mingled with many delusions as regards the identity of former friends and of the persons about her. After a time these delusions ceased to trouble her, she regained entire self-control, her mind gradually cleared up, and, in November, 1883, after having been six years and seven months insane, she left the asylum apparently free from any evidence of mental disease, and has continued well up to the present time.

There still remain at the asylum several patients for whose ultimate recovery there is every reason to hope. " Chronic" and "incurable" are by no means synonymous terms as

1884.] PUBLIC DOCUMENT — No. 23. 75

applied to the insane. Recoveries, however rare, are still sufficiently frequent in the history of the asylum to call our attention to the necessity of providing for each and every insane person careful daily oversight in institutions estab- lished upon a strictly medical basis, if we would neglect nothing which may contribute to a possible cure ; for, as the above history shows, a cure does now and then take place in cases apparently the most hopeless.

Although the mental condition of a majority of the in- mates of the asylum deteriorates, or at best remains sta- tionary, it is not safe to assume that this will bj the fact in any given case, as not a few insane persons first show sio^ns of improvement after years of mental alienation. These signs are often faint at first and may easily be overlooked, but when recognized and encouraged sometimes lead to most happy and unexpected results. The process of improve- merit may extend over months and even years before it is complete. It may, and in the majority of cases does, only reach a certain stage, where it stops, but even when this process stops far short of cure, it is no less anxiously to be set in motion and encouraged, for it is by such means that the chronic dement becomes transformed from a listless drone into an industrious and useful member of the com- munity ; the violent become quiet and capable of enjoyino' more or less freedom of action, and the victim of delusions learns to divert his thoughts into other channels ; while not a few of the disorderly, turbulent and untidy become quiet, orderly and happy members of the household, still capable of appreciating and enjoying, in their own persons, many of the comforts of life, and of contributing no little to the well- being of those about them, more unfortunate, perhaps, than themselves.

. There is left, therefore, much for the asylum to do above and beyond the simple duty of furnishing a safe and com- fortable retreat for the patient. It can and should do much towards mitigating the pains and penalties of disease, and as chronic insanity is precisely the same malady in its nature and manifestations as recent insanity, and demands the same methods for its treatment, the asylum no less than the hospital should be under competent medical supervision, and

76 ASYLUM FOR CHRONIC INSANE. [Oct.

should be furnished with every appliance for the study, investigation and treatment of disease.

Five patients are reported eloped and still at large. With the opportunities for escape furnished by unlocked wards and extended personal freedom about the grounds of the asylum, more or less elopements will of necessity take place without in any way subjecting those who have the immediate care of the patient to a charge of negligence.

In chronic as well as in recent insanity, an undefined restlessness is frequently a characteristic of the disease. The patient runs away actuated by the same motive that prompts him to assault an associate, tear his clothing, or commit fany of the thousand and one acts peculiar to the insane.

In not a few cases he returns of his own accord, after a longer or shorter absence, only to again elope when oppor- tunity offers.

A very insane person may show great cunning in planning and executing an escape, and often succeeds in eluding every effort to trace him, and especially when he, like the majority of the inmates of the asylum, has neither home nor friends to whom he would naturally turn.

In this as in former years the asylum has been free from epidemic. There have been 42 deaths ; 10 from phthisis, 6 from epilepsy, 13 from exhaustion of chronic mania, 4 from heart disease, 2 each from paresis, senility and paralysis, and 1 each from pneumonia, Bright's disease and strangu- lation by food.

The small death-rate of the present year as compared with the last, — 9.5 against 13.2 per cent., — confirms the observation of a former report, that the asylum death-rate is likely to vary greatly from year to year.

In the present instance this variation is in a great measure due to the large death-rate of last year, to the small number of transfers to the asylum, and to the unusually good phy- sical condition of those transferred.

We still continue the plan, adopted several years ago, of employing one attendant for the especial purpose of getting out those of our male patients who are physically able but are disinclined to work. This plan has been upon the whole

1884.] PUBLIC DOCUMENT — No. 23. 77

successful, notwithstanding the fact that a very large propor- tion of our patients still remain unemployed, either from bodily or mental incapacity.

Twenty or more persons, who otherwise would have re- mained idle, have thus been occupied out of doors, daily. The work performed has been of the roughest character and of little or no pecuniary benefit to the asylum, but the effect has been most salutary, not only upon the patient himself, but indirectly upon the whole house, in the increased quiet and good order of the wards. In not a few patients thus employed the intelligence has been awaked and habits of industry formed which are likely to prove permanent, and eventually to restore the person to the ranks of voluntary and useful workers.

Nothing of this kind has, as yet, been attempted among the females, for the reason that it is more difficult in their case than in that of the males to find work adapted to feeble in- tellects, and secondly, because we have no work-room which could be used for this purpose. I regard it, however, as even more important in the case of the females than of the males that the idle, listless and unwilling should be employed, and should the alterations proposed in another part of this report be carried out, it is the intention to provide a room therein for the especial use of this class of our female patients.

During the year the outside wood-work of the asylum has been repainted, and repairs and improvements continued in the wards as rapidly as the force and means at our command would warrant. All work, except plumbing, has been done by our own mechanics, with the assistance of patients ; and while repairs can be done in no other way with so much economy, it is not possible to push them with any degree of rapidity, or to accomplish much toward the completion of the whole in any one year. In fact it will be several years before we can hope to do all that remains to be done to put the building in proper repair. In the wards, four tiers of bath-rooms are yet to be torn out and rebuilt, ventilating flues are to be added to many rooms and corridors, and most of the ceilings and many of the floors to be renewed.

Our engines — put in second-hand twenty-five years ago

78 ASYLUM FOR CHRONIC INSANE. [Oct. '84.

— should be replaced upon the score of economy, if for no other reason ; and our kitchen and kitchen furniture demands immediate, thorough overhauling. We hope and expect to be able to accomplish all of this work in due time from our own income.

But besides these general repairs there are certain altera- tions in the original plan of our buildings which should be made to adapt them to the present necessities of the asylum, and to secure greater efficiency in administration.

The first alteration contemplates extending the extreme Johonnot ward, on the female side of the house, twenty feet, making it uniform with the male side, giving room for from twenty-five to thirty additional patients, — for a large dor- mitory for patients requiring the care of a night attendant, and for inside rooms for the noisy, where they will attract less attention from the street and give less annoyance to our neighbors. It is estimated that this addition can be built for five thousand dollars, or about two hundred dollars per patient.

The second alteration contemplates the enlargement of the laundry and the addition of a third story thereto, to be oc- cupied by our female help and by the work-room alluded to above.

Our present laundry is much too small to accommodate the number of patients necessary to do the work of the institution, and the apartments for help in the chapel wing are cramped, inconvenient and not sufficient in number. The estimated cost of this alteration is $5,000.

I am sure that it would be greatly to the advantage of the asylum if both these alterations could ,be made during the coming spring and summer, and I would therefore respect- fully recommend that the Trustees petition the legislature for the sum necessary for the completion of this work.

In behalf of the patients of the asylum I thankfully acknowledge the receipt from the publishers of a copy of the Worcester Daily Gazette, and of books, periodicals, illus- trated papers and Christmas cards from the Hospital News- paper Society of Boston.

H. M. QUINBY,

Superintendent September 30, 1884.

STATISTICAL TABLES.

TABLES FOR UOTFORM STATISTICS

MASSACHUSETTS HOSPITALS AND ASYLUMS FOR

THE INSANE.

(Approved by the Board of Health, Lunacy and Charity, April 3, 1880.)

By the act of the legislature establishing an Asylum for the Chronic Insane, it was provided, " That the inmates thereof shall consist only of such chronic insane as may be transferred thereto by the Board of State Charities in the manner provided in section four, chapter two hundred and forty, of the acts of the year eighteen hundred and sixty- three." (Statutes, 1877, chap. 227.)

All the patients of the Asylum, therefore, have been former inmates of one or more hospitals in the State ; and whenever in these tables they appear as *' first admissions," they are only to be regarded as first admissions to this Asylum.

82

ASYLUM FOR CHRONIC INSANE.

[Oct.

General Statistics of the Year.

	Males.	Females.	Total.
Patients in asylum Oct. 1, 1883, .	198	194	392
Admissions within the year,	37	10	47
Whole number of cases within the year, .	235	204	438
Discharges within the year, ....	-	-	-
Viz.: as recovered, .....	-	1	1
much improved,	-	-	-
improved,	-	-	-
unimproved,	4*	6*	10
Deaths,	22	20	42
Patients remaining Sept. 30, 1884,	209	177	386
Viz. : supported as State patients.	81	32	113
town patients,	128	145	273
private patients, .	-	-	-
Number of different persons within the year,	235	204	439
admitted,	37	10	47
recovered,	-	1	1
Daily average number of patients.	20106	189.63	390.69

* 5 Eloped, — [2 males, 3 females.

2. Monthly Admissions, Discharges, and Averages.

			1	1 Discharges. 1	Daily Aveeagb of
	A: )MISSIONS. 1
				(Including Deaths.)	Patients in the	EOTTSB.
MONTHS.
	Ma.	Fe.	Tot.	Ma,	Fe.	Tot.	Ma.	Fe.	Tot.
1883.
October,	2	7	9	3	2	5	196.19	199.87	396.06
November,	-	-	-	2	4	6	196.70	197.63	394.33
December,	2	-	2	4	1	5	193.80	194.71	388 51
1884.
January,	-	-	-	3	-	3	191.87	194.	385.87
February,	14	-	14	-	2	2	200.61	192.89	393.50
March, .	-	-	-	4	-	4	201.64	192.	393.64
April, ,	-	-	-	1	2	3	199.13	191.70	390.83
May, .	-	2	2	4	5	9	198.51	185.84	384.35
June, .	19	1	20	1	2	3	204.20	184.57	388.77
July, .	-	-	-	1	1	2	211.13	183.22	394.35
August, .	-	-	-	1	4	5	209.71	181.26	390.97
September,	-	-	-	2 26	4 27	6 53	209.23	177.87	387.10
Total of cases	>, 37	10	47	_	_	_
Total of per	-
sons, .	. 37	10	47	26	27	53	—	—	—

1884.] PUBLIC DOCUMENT — No. 23.

83

3. Received on First and Subsequent Admissions.

	Cases Admitted.	Times Previously
				Recovered.
NUMBER OF THE ADMISSION.
Males.	Females.	Total.	Males.	Females.	Total.
First,	37	10	47
Second,	-	_	_	_	_	_
Etc., . . " .	-	-	-	-	-	-
Total of cases,	37	10	47	_	_	_
Total of persons, .	37	10	48	-	-	-

4. Ages of Persons Admitted for the First Time.

	1 At First Attack of I
				When Admitted.
		[NSANITT.
	Males.	Females.	Total.	Males.	Females.	Total.
Fifteen years and less, .	1		1	1		1
From 15 to 20 years,			-	1	1	1	-	1
20 to 25 years,			5	2	7	6	2	8
25 to 30 years.			8	1	9	7	2	9
30 to 35 years,			3	1	4	0	2	. 7
35 to 40 years.			3	1	4	4	2	6
40 to 50 years,			3	1	4	3	2	5
50 to 60 years.			4	■ -	3	2	-	2
60 to 70 years.			2	-	9	4	-	4
70 to 80 years.			-	-	-	-	-	-
Over 80 years.			-	-	-	-	-	-
Unknown,			9	3	12	4	-	4
Totals, .			37	10	47	37	10	47

84

ASYLUM FOR CHRONIC INSANE.

[Oct.

5. Percentage of Persons Admitted.

			Maxes.	Females.	Totals.
PLACES.
	Father.	Mother.	Father.	Mother.	Father.	Mother.
Massachusetts, .	11	11	1	1	12	12
New Hampshire, Nova Scotia,			1 1	1 1	:	:	1 1	1 1
Portugal, England, Ireland,			1 2 20	1 2 20	8	8	1 2 28	1 2 28
Italv, .			-	-	1	1	1	1
Germany, .			1	1	-	-	1	1
Totals, .			37	37	10	10	47	47

6. Residence of Persons Admitted.

PLACES.	Males.	Females.	Totals.
Massachusetts, viz. : Suffolk County, . . . . Middlesex County, .... Hampden County, .... Essex County, Worcester County, .... Unknown, ......	24 3 2 5 3	4 3 2 1	28 6 2 3 5 3
Total, Cities or large towns,	37 37	10 10	47 47

7. Civil Condition of Persons Admitted.

	Unmakried.	Maemed.	Widowed.	Unknown.
NUMBER OF
THE ADMISSION.
	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.
First,	20	5	25	9	4	13	1		1	7	1	8
Total, .	20	5	25	9	4	13	1	-	1	7	1	8

1884.]

PUBLIC DOCUMENT — No. 23.

85

8. Occupations of Persons Admitted.

OCCUPATIONS.	Males.	Females.	Total.
Laborers,	10		10
Domestics,							-	4
Dressmakers, •							-	1
No occupation.								-
Wives, .							-	2
Carpenters,									-
Operatives,									2
Painters,									_	1
Tinsmith,									-
Glassmaker,									-
Currier,									-
Printer,									-
Moulder,									-
Farmer,									-
Agent,									-
Engineer,									—
Unknown,								13	1	14
Total, . . . ....	37	10	47

9. Form of Disease in the Cases Admitted.

FORM OF DISEASE.	Males.	Females.	Total.
Mania, chronic, Epilepsy, . . . . . Dementia, chronic, ..... Melancholia, " Paresis, ....... Total of cases, Total of persons,	18 4 11 3 1 37 37	9 1 10 10	27 11 3 1 47 47

86

ASYLUM FOR CHRONIC INSANE.

[Oct.

10. Reported Duration of Insanity before Last Admission.

	First Admission TO THIS Hospital.	All Other Admissions.	Totals.
PREVIOUS DURATION.	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.
Congenital, Under 1 month, . From 1 to 3 months, . 3 to 6 months, . 6 to 12 months, . 1 to 2 years, 2 to 5 years, 5 to 10 years, 10 to 20 years, , Over 20 years, Unknown, .	2 1 7 10 4 2 1 10 37 37 5.22	3 2 5	2 1 10 12 4 2 15	-	-	-	-
Total of cases, Total of persons, . Av'ge of known cases,	10 10 1.88	47 47 3.55	-

11. Probable Causes of Insanity in Persons admitted.

CAUSES.	Males.	Females.	Total.
Intemperance,	5		5
Epilepsy,					3	-	3
Masturbation,					2	_	2
Heredity,					2	_	2
Typhoid fever,					1	_	1
Sunstroke,					2	_	2
Grief, .					1	_	1
Business troubles, .					1	_	1
Religious excitement.					1	_	1
Overwork, .					1	1	2
Ill-health, .						1	1
Family troubles, .,					1		1
Over-heat,					1	_	1
Unknown,					16	8	24
Totals,	37	10	47

18^4.]

PUBLIC DOCUMENT — No. 23.

87

12. Relation to Hospitals of Persons Admitted.

HOSPITAL KELATIONS.	Males.	Females.	Total.
First admission to any hospital for insane, Former inmates of the hospital, .... of Danvers Lunatic Hospital, of Tevvksbury Almshouse, . of Northampton Lunatic Hospital, of State Workhouse, Westborough,	32 1 4	5 3 2	37 4 2 4
Totals,	37	10	47

13. How Supported.

	Patients Admitted.	Average of the	Year.
SUPPORTED AS	Male.	Female.	Total.	, Male.	Female.	Total.
State patients, . Town patients, .	23 14	5 5	28 19	73.85 127.21	32.67 156.96	106.52 284.17
Totals, .	37	10	47	201.06	189.63	390 69

14. Discharges, Classified by Admission and Result.

	Improved.	Unimproved.	Died.	i Total.
ADMISSION.	Ma.	Fe.	Tot	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.
First, ....		1 1 1	1 1 1	4 4 4	6 6 6	10 10 10	22 22 22	20 20 20	42 42 42	26	27 27 27	63
Totals, Persons,	26 26	53 53

88

ASYLUM FOR CHRONIC INSANE.

[Oct.

(^

6

	a X H s O Ph I i « O s	1 o	\ 1 1 1 1 lO 0 CO t^ 05 »o	42 104.82
	I	1 1 1 1 1 1 '^ 00 lO --H CM	20 141.89
	10	1 1 1 1 1 "O -.0 0 CM 1-1 CO	22 67.76
	m w Q < c X	■3 0	1 1 .-1 (M C5 lO 00 t^ 1 1 1	42 44.59
	"2 a En	1 1 1 — 1 >-l '^ CO rH 1 1 1	0
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	O		. ^ .
		Total, . Average of known cases (in months), ,
	Congenita], . Under 1 month. From 1 to 3 months, 3 to 6 months, 6 to 12 months, 1 to 2 years, 2 to 5 years, 5 to 10 3'ears, 10 to 20 years, Over 20 years, Unknown,

1884.]

PUBLIC DOCUMENT — No. 23.

89

16. Cases Discharged by Recovery or Death.

	Rbcovekies.	Deaths.
	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.
Mania, chronic, . .		1	1	13	8	21
Epilepsy, ....	-	-	-	3	2	5
Dementia, chronic,	-	-	-	4	9	13
Paresis, ....	-	-	-	2	-	2
Melancholia,	-	-	~	-	1	1
Total of cases,	_	1	1	22	20	42
Total of persons, ,	—	—	—	22	20	42

	17.	Causes	of Death.
CAUSES.	Males.	Females.	Total.
Phthisis,	6	4	10
Epilepsy, Senility, Exhaustion, .					3 6	3 2 7	6 2 13
Paresis, .					2	-	2
Paralysis, Pneumonia, .					-	• 2 1	2 1
Heart disease,					3	1	4
Bright's disease, .					1	-	1
Strangulation from food,				1	-	1
Totals, .					22	20	42

90

ASYLUM FOR CHRONIC INSANE.

[Oct.

18. Ages of those who Died.

	At Time	OF First Attack.	At Time of Death.
AGES.
	Males.	Females.	Total.	Males.	Females.	Total.
Fifteen years and less, .		1	1
From 15 to 20 vears, .	1	1	2	1	-	1
20 to 25 years, .	2	1	3	1	1	2
25 to 30 years, .	1	4	5	1	1	2
30 to 35 years, .	2	6	8	2	-	2
35 to 40 years,	1	1	2	3	5	8
40 to 50 years, .	5	1	6	5	5	10
60 to 60 years, .	3	1	4	4	2	6
50 to 70 years, .	1	2	3	3	3	6
70 to 80 years, .	-	1	1	1	2	3
Over 80 years.	-	-	-	-	1	1
Unknown, ....	6	1	7	1	-	1
Totals, ....	22	20	42	22	20	42

1884.]

PUBLIC DOCUMENT— No. 23.

91

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