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PUBLIC DOCUMENT .... .... No. 23.

SEVENTY-FIEST ANNUAL EEPOET

THE TEUSTEES

Worcester Insane Hospital,

TWENTY-SIXTH ANNUAL REPORT OF THE TRUSTEES

WOECESTEE INSANE ASYLUM AT WOECESTEE,

Yeak ending September 30, 1903.

BOSTON :

WKIGHT & POTTER PRINTING CO., STATE PRINTERS,

18 Post Office Square.

1904.

PUBLIC DOCUMENT .... .... No. 23.

SEAnENTY-FIEST ANNUAL EEPORT

THE TRUSTEES

Worcester Insane Hospital,

TWENTY-SIXTH ANNUAL REPORT OF THE TRUSTEES

WOKCESTEE INSANE ASYLUM AT WORCESTEE,

Yeak eistden^g September 30, 1903

7

■ "• ^-^^u . • Yk-^^^^t.d:^,.. ^^r

BOSTON:

WRIGHT & POTTER PRINTING CO., STATE PRINTERS,

18 Post Office Square.

1904.

3«rATE HOU&t, SOSTttI

ApPliOYED BY

The State Board of Publication.

3

COTnTTETsTTS

PAGB

Kkport of Trustees, 7

Report of Superintendent, . 11

Report of Treasurer, . . 23

Statistics, 29

OFFICERS OF THE HOSPITAL.

TRUSTEES.

SARAH E. WHITIN, Whitinsville.

FRANCES M. LINCOLN, . . Worcester.

SAMUEL B. WOODWARD Worcester.

LYMAN A. ELY, Worcester.

PHILIP W. MOEN, Worcester.

ROCKWOOD HOAR, Worcester.

THOMAS RUSSELL, Boston.

RESIDENT HOSEA M. QUINBY, M.D., .. ALFRED I. NOBLE, M.D., . ISADOR H. CORIAT, M.D.. . CORNELIA B. J. SCHORER, M.D HENRY S. CHAFFEE, M.D., CHARLES T. FISHER, M.D., THEODORE A. HOCH, M.D., MELVIN J. ROWE, M.D., . GEORGE H. LYNCH, M.D., . JAMES H. TURNER, M.D., . LINDA RICHARDS, .

HENRY R. CENTER, . LILA J. GORDON, . JOSEPH T. REYNOLDS,

OFFICERS.

Superintende7it.

Assistant Superintendent.

Assistant Physician.

Assistant Physician.

Assistant Physician.

Assistant Physician.

Assistant Physicia7i and Pathologist,.

Junior Assistant.

Junior Assistant.

Junior Assistant.

Superintendent of Nurses.

Steward.

Matron.

Farmer.

NON-RESIDENT OFFICERS. WILLIAM D. SPROAT. . ALBERT WOOD, GEORGE L. CLARK, JESSIE M. D. HAMILTON, . JAMES DICKISON, Jr., .

Druggist. Treasurer- Auditor. Clerk. Etigineer..

Commnixtomlt^ bI ^assarl^xisttts

TRUSTEES' REPORT.

To His Excellency, the Governor and the Honorable Council.

The trustees of the, Worcester Insane Hospital respectfully present their seventy-first annual report, including the reports of the superintendent and treasurer, with the required statistics. In the report of the superintendent will be found in detail the facts concerning the care and management of the institution. The trustees are unanimous in the opinion that the hospital has been most efficiently conducted, and they have only words of the highest respect and commendation for the officers in charge and their admirable services.

For the past year the average number of patients has been 1,125.10, — the largest perhaps in our history. The sixty- first annual report for 1893 gives as the average for that year 878.78, and states that that was the hio;hest number vet reached. Each year now seems to yield an increase upon the average of the year preceding. Therefore the practical pressing problem is, how to expand in order to meet as we should the needs and demands of this rapidly growing family. The new infirmary wards care for about 100 of this increase. ^Nevertheless, as will be readily seen from the figures, we are still overcrowded. The new home for women nurses is nearly readj^ for occupancy, and when the nurses are located there, the rooms now occupied by them in the hospital will be available for patients, thus relieving the congestion in some degree. The home, which accommodates 58 nurses, is finely situated upon high ground. It runs north and south, facing the east with a beautiful outlook upon the lake and surrounding hills, and with the city and

8 WORCESTER INSANE HOSPITAL. [Oct.

sunset view in the rear. This environment makes every room well lighted, cheerful and desirable. This new building .will add much to the comfort and convenience of the nurses, and, with its training school, under the very efficient instruction of Miss Richards, will be of inestimable benefit to all.

It gives the trustees much satisfaction to report a gradually increasing number of patients who are willing to work and who are employed in various ways outside of the wards, especially upon the farm. Patients thus occupied naturally enjoy greater freedom than thoS'e who decline to work, and occasionally one who is restless for change and impatient of all restraint escapes. Thus far, however, those who have escaped were patients well advanced on the road to recovery, harmless to themselves and to others.

The hospital is so open to inspection that all who are inter- ested, whether the general public or the relatives of the patients, can be well informed as to the condition of the inmates, the care and attention they receive and the methods by which the institution is managed. Wednesdays and Fridays, from 10 A.M. to 4 P.M., are visiting days, when the wards are filled with friends of the patients, who have an opportunity to see them in their every-day life and routine. Meetings of the Board of Trustees are held each month, when accounts are audited and financial conditions examined, wards are visited, patients seen and listened to, bedding and clothing are inspected, food sampled and the mode of its preparation noted. Besides this, individual members of the Board make unexpected visits at odd times, both by day and night, when the regular work of the house can be carefullj^ studied. Visits are also made in company with the officers of the hospital as they make the rounds Sunday mornings, when both patients and attendants are expected to present themselves in their best attire. At that time the rooms, the closets, the bedding, and in fact every corner of the house is thrown open for inspection. An intelli- gent interest by the outside public in the delicate and difficult work that is being done in this large and pitiful community would be a positive help and inspiration to those who are devoting themselves to its accomplishment.

The library is a constant source of diversion and entertain-

1903.] PUBLIC DOCUMENT — No. 23. 9

ment to many of the inmates. From 150 to 175 books are given out each week. The past year 160 volumes were added to our shelves. These books are selected with care and dis- cretion, many of them only after a personal perusal by a competent judge.

As year by year the hospital grows towards completeness in its appointments and efficiency, the wisdom and foresight of the State in making liberal provisions for the care of the afflicted ones tlirown upon its charity becomes more clear and praiseworthy. We are constantly reminded of the fact that .what we have already makes something more necessary. The hew opportunities make larger demands and require better service. To be just to the past we must be generous each year.

The various recommendations of the superintendent have been carefully considered by the trustees, and are each and all regarded as essential. Estimates of the probable cost of each have been obtained from persons of judgment and experience in such matters, and the amounts called for are believed to be fair and reasonable. The trustees would therefore respectfully ask that the following appropriations be made : —

For a pathological building and morgue,

Additions to laundry building,

New laundry machinery, ....

New piggery, ......

Replumbing and alterations in administration building, Alterations and plumbing in ward dining rooms, Home for 70 male nurses,

All these objects should receive immediate attention, but we mention the pathological building and morgue as requiring your special and prompt action. The trustees have watched with great interest the growth of the medical work of the hospital, and, encouraged by the marked success already obtained, believe that nothing should now be omitted which may promote its further advancement. They are unwilling to see it handicapped as it has been, tlirough lack of facilities to carry on its proper work. The home for the male nurses will offer the same advantages as the home for the female attend- ants, and is greatly to be desired.

	$10,000 00
	3,000	00
	1,500	00
	5,200 00
	6,000	00
	5,000	00
	53,000	00

10 WOECESTER INSANE HOSPITAL. [Oct.

Commending the varied interests of this most important institution to the Legislature, that has never yet failed to make ample provision for its needs, we respectfully submit our report.

SARAH E. WHITIN, FRANCES M. LINCOLN, SAMUEL B. WOODWARD, LYMAN A. ELY, PHILIP W. MOEN, ROCKWOOD HOAR, THOMAS RUSSELL,

Trustees.

1903.] PUBLIC DOCUMENT — No. 23. 11

SUPERINTENDENT'S REPOET.

To the Trustees of the Worcester Insane Hospital.

I herewith respectfull}" submit the following report of the hospital for the year ending Sept. 30, 1903, it being the seventy-first annual report.

There remained at the hospital Oct. 1, 1902, 1,116 patients, — 534 men and 582 women. During the year 624 patients — 357 men and 267 women — were admitted, 439 patients — 244 men and 267 women — were discharged, and 70 men and 47 women died, lea%dng at the end of the official year 1,184 patients, — 577 men and 607 women. Of this number, 375 were supported by the State, 634 by cities and 'towns and 175 by friends. Of the 439 persons discharged, 137, including 17 habitual drunkards, were reported recovered, 75 much im- proved, 57 improved and 165 not improved ; 5 were discharged not insane. Sixty "men and 52 women were transferred by the State Board of Insanity to the Worcester Insane Asylum, 4 men to Foxborough, 2 men to Taunton, 1 man to Medfield and 1 woman each to Tewksbury and Dan vers. Twenty men and 13 women were removed from the State and 10 women boarded out.

There remained at the end of the year 32 more patients than at the beoinnino-. The smallest number under treatment on any one day was 1,068, and the largest 1,212. The daily average number was 1,125.10.

The percentage of recoveries, calculated upon the number of discharges and deaths, was 22.84; calculated upon the number of admissions, it was 20.35.

The death rate was 6.7, calculated on the whole number of patients under treatment; and 10.4, calculated upon the daily average number. Thirty-nine patients died of general paraly- sis and 28 of senile or organic dementia. One woman com- mitted suicide. She had been an inmate of the hospital for

12 WORCESTER INSANE HOSPITAL. [Oct.

several years, and at various times liad parole about the grounds. She appeared uniformly cheerful, and, as far as her delusions would allow, contented ; and there was nothing to indicate a suicidal tendencj^, or to call for anything beyond the usual care and watchfulness in her case.

The general health of the household has been exceptionally good through the year, there having been no case of infectious disease and no acute sickness Avorthy of note either among the patients or employees.

The nurses' home, begun in May, 1902, is now practically completed and will soon be occupied. It is located on the right and in front of the main building, just off the main drive- way. It is built of stone from the hospital quarry, with brick trimmings, to conform architecturally with the other hospi- tal buildings. It is three stories in height, with a high base- ment. It consists of a central building, 40 feet long by 46 feet wide ; and two wings, 48 feet long by 37 feet wide, mak- ino- the entire front 13(3 feet. On the first floor of the centre building, on either side of the main entrance, is the reception room and the office of the superintendent of nurses. Directly over these, on the second floor, is a class room 14 feet wide by 25 feet long ; while in the rear, on each story, across a wide central corridor, are the toilet rooms. Here also is located the main staircase, which is enclosed in brick walls and shut off" on each story by swing doors. Adjoining the staircase and in the same enclosure is an elevator shaft, also of brick. A room is provided in the second story for the cooking school, and one in the third story for the housekeeper. In the two wings, besides a linen closet on each floor and a staircase at either end, there are 53 single rooms, 9 feet 6 inches wide by 14 feet long, and three double rooms, for nurses. The build- ing is to be lighted by electricity and heated by steam from our central heating plant, by the direct, single-pipe system

Although exceedingly plain both in exterior and interior finish, it will be found, I think, well adapted for the purpose for which it was designed, and in every way serviceable. All of the rooms are bright and sunny, and all, both on front and rear, have a delightful outlook over the hospital grounds and the surrounding country.

1903.] PUBLIC DOCUMENT — No. 23. 13

The appropriation for erecting and furnishing this building was $45,000, and it has been completed within this sum. All the work has been done in a most thorough manner, and credit is due to Messrs. Fuller and Delano, architects ; Joseph G. Vaudreuil, general contractor ; John P. Rydberg, contractor for the stone work; Bianchi Bros., contractors for the tile and marble work; George E. Brigham, for the electrical wiring; and Simon Norcross, of O. S. Kendall & Son, who planried and supervised the installation of the heating plant, — for the entirely satisfactory way in which they have each carried out their contracts. The excavating, the piping, the plumbing and the painting were done by the regular employees of the hospital, with the assistance of the patients, and all of the beds and bedding and much of the furniture was also made by them. This has materially delaj^ed the completion of the work, but has resulted in the saving of several thousands of dollars to the State.

The addition in the rear of the executive building for our stenographers and typewriters, provision for which was made by the last Legislature, has been completed at something under the sum estimated and appropriated therefor.

The work on our electric light plant is being carried on as rapidly as possible. The addition to our boiler house is well under way, and will be completed before cold weather. Con- tracts for the boilers, engines and dynamos have been awarded, and they will all no doubt be ready for delivery as soon as the boiler house is completed and the necessary alterations made in our dynamo room. Plans for wiring the building are being madei This, however, will be a much less formidable and expensive undertaking than it otherwise would have been, had not provision already been made therefor in all of the more recent additions to the hospital.

I would again call attention to our need of a pathological building and morgue. We are greatly hampered in our work by the lack of such a building. For some years w^e have been trying to bring up the standard of the medical work of the institution and place it upon the same plane as that of the general hospital, and our efforts have, I am pleased to believe, met with no small degree of success. Not so very long ago it

14 WORCESTER INSANE HOSPITAL. [Oct.

was the complaint in regard to our insane hospitals that they were nothing but large boarding houses, and that little if any- thing was done towards the treatment and cure of the inmates. If this was ev.er true of any one of them, which I am unwilling to acknowledge, they can now, I am sure, fairly claim to have gotten beyond the boarding house stage, and to have become in reality hospitals, where each individual has a most thorough and painstaking investigation of his case, followed by such treatment as modern scientiiic methods suggest. As the result of changed methods, the whole medical atmosphere of the insti- tution has changed, and as a consequence we are now able to attract a verj'^ superior class of young physicians as assistants. They no longer, as formerly, seek or hold their positions chiefly for the salary attached, but rather for the experience and train- ing received. Relieved as they now are to a large extent from routine duties, they give, under efficient direction, their time and energy to the study of their patients, and have become very enthusiastic and painstaking in their work. Medical enthusi- asm, however, in an insane hospital, where there is so much to claim a young person's attention in other directions, is a plant difficult to propagate, of slow growth,' and quick to droop un- less persistently and constantly cultivated and encouraged. To secure this result it is necessarj^ that we should keep up with the times, and in order to do this we must have facilities for carrying on certain lines of work recognized as essential in every modern hospital. When our little laboratory was established, the only available place therefor was, unfortu- nately ,,in the administration building, under the general offices and reception rooms. Here the room is not only limited, but on account of location entirely unsuited for the work which it is necessary to carry out. We are obliged, for instance, to forego much in the way of examination of the various excreta, — examinations which are now regarded as absolutely neces- sary for purposes of exact diagnosis, — because of their offen- sive nature. This not only tends to the disadvantage of the patient, but it discourages that thoroughness on the part of the physician which it should be the aim of every one to cultivate. Several of our young men have shown a decided talent for original investigation, and it has been exceedingly unpleasant for the superintendent to say to such that the necessary means

1903.] PUBLIC DOCUMENT — No. 23. 15

for carrying on their investigations could not be furnished, or that they must be discontinued on account of thek^ ofltensive nature. As to the morgue, which would naturally be provided for in the pathological building, I am sure that any one who will take the trouble to make himself familiar with the very disao-reeable conditions under which we now labor in carino* for the bodies of patients after death will readily concede that entirely diiferent provisions must be made before this work can be done in a seemly way, without undue publicity, and without shocking the sensibilities of the living inmates of the house. The estimated cost for a building such as is needed for the above purposes is $10,000.

With the increase in our population, our laundry work has so increased that our present wash room can no longer meet the demands made upon it, and I would recommend that an addition of 20 feet be built thereto, at an estimated cost of $3,000. Two additional washers, a shaker out, a centrifugal wringer, a shirt and a body ironer should be provided.

Our piggery on Plantation Street is becoming more and more a source of complaint from our neighbors. For this reason, if for no other, we shall undoubtedly be forced to dis- continue it in the near future. As there is no place upon the grounds suitable for it, and as it is much out of repair and needs immediate attention, I would recommend that a new piggery be built on our farm in Shrewsbury. The estimated cost of a building similar in size and construction to the present one is $5,206.

The plumbing in the administration building has been in use since the institution was first opened, and is not only anti- quated, worn out and beyond repair, but is not properly arranged for our present needs. It should be entirely renewed, and a toilet room for either sex be provided on each of four floors, and a ventilatino; and lig-ht shaft extended throuo;h the roof. This would necessitate the tearing out of several parti- tions, and would cost in the neighborhood of $6,000.

The plumbing connected with the ward dining rooms should also be renewed, and certain alterations made in the dining rooms themselves. The cost of this work as contemplated would be $5,000.

The completion of the nurses' home for the women only

16 WOECESTEK INSANE HOSPITAL. [Oct.

emphasizes the need of a similar building for the male attend- ants. The necessity is equally as great in one case as in the other. The building should be constructed on much the same lines as the one just completed ; but, in order to provide for the increased number which must soon be provided for, it should be large enough to accommodate 70 attendants, besides the necessary care takers. This would require an appropria- tion of $53,000.

In estimating the cost of such a building, however, it is only proper to take into consideration the fact that for every attendant thus provided for, provision will thereb}^ be made in the hospital for at least an x equal number of patients, and , that this will materially reduce the net cost to the State.

With the completion of our nurses' home a training school will at once be opened. As superintendent of nurses we have been fortunate in securing the services of Miss Linda Richards, whose success in organizing and carrying on such schools is well known to every one at all conversant with hospital work. She entered upon her duties here September 1.

As a part of our laboratory work through the year, inter- esting studies upon the chemistry of nerve degeneration in general paralysis and other mental disorders have been made by Dr. I. H. Coriat, and published in the "American Journal of Insanity," Vol. 59, No. 3, 1903. Other contributions will soon be ready for publication. This is a line of investigation in which but little has thus far been done, and one which promises valuable results in determining the causes underlying disorders of the brain.

For the first time in the long history of the hospital it be- comes the sad duty of the superintendent to record the death of a medical officer of the institution. William Emmett Kornegay, M.D., junior assistant physician, died Sept. 18, 1903, from general septicsemia, following a slight surgical operation upon the nose.

The deceased was born near Goldsboro, in North Carolina, in 1877. He gained his primary education in the schools of that State, and entered the University of North Carolina, where he remained two years, when he entered the medical depart- ment of the University of Maryland, and graduated therefrom

1903.] PUBLIC DOCUMENT — No. 23. 17

in 1901. His work at the latter institution was of such character that at the end of his medical course he received the appointment of resident pathologist to the University Hospital, which he held for one year. Dr. Kornegay came to this hos- pital June 18, 1902. During his year and a quarter of service here he endeared himself to all by his cheerfulness and modesty, his uniform courtesy and his conscientious devotion to duty, while his attainments, his interest and enthusiasm in his work and his marked industry gave promise of a successful profes- sional career, and emphasize the great loss which the hospital sustained in his death.

Dr. Henry A. Cotton, who served the hospital loyally and well one year as junior and over two years as senior assistant physician, resigned June 1, 1903, to accept a position at the Dan vers Insane Hospital.

Dr. Theodore A. Hoch, who has been connected with the hospital since Oct. 1, 1900, first as junior and then as senior assistant, was appointed as pathologist and director of the laboratory June 1, 1903.

Dr. Henry S. Chaifee and Dr. Charles T. Fisher, having served one year or more as junior assistants, were promoted to senior assistant physicians in April and June respectively.

Dr. H. Walton "Wood very satisfactorily completed his junior year in the service and resigned July 25, 1903, to re- ceive an appointment at the Taunton Insane Hospital.

The current expenses, less the amount received from articles sold, have been $227,751.16; dividing this by 1,125.1, the daily average number of patients, gives $202.43 as the annual cost of support, which is equivalent to a weekly cost of $3.89.

With 625 admissions during the yea-r, many of them in the acute stage of insanity, the calls upon all departments of the hospital have often been exacting ; but I am happy to report that with but few exceptions all the employees have proved equal to the task imposed upon them, and have shown a com- mendable zeal and devotion to their work, and to all such I am certainly much indebted.

H. M. QUINBY,

Sujjerinlendent. Worcester, Sept. 30, 1903.

18

WOECESTER INSANE HOSPITAL.

PKODUCTS OF THE FAKM

On Hand Oct. 1, 1903, and not delivered at the Hospital.

Apples, barrels, .	1,000	Ensilage, tons, .
Barley and oat fodder, tons	60	Hay, tons, . . . .
Beans, Lima, bushels,	100	Hay, swale, tons,
Beets, bushels, .	800	Lettuce, plants, .
Cabbage, heads, . , .	32,500	Onions, bushels, .
Carrots, bushels,	800	Parsnips, bushels,
Cauliflower, heads,	400	Rowen, tons.
Celery, heads.	10,000	Squash, winter, pounds.
Cider, gallons, .	4,000	Straw, rye, tons, .
Corn, sweet, dozen.	1,200	Tomatoes, bushels.
Egg plants,	200	Turnips, bushels,

FARM ACC0U:N^T.

Dr.

Blacksmith,

Bread, .

Butter,

Current expenses

Fertilizer, .

Fish, .

Fuel, .

Furniture, ,

Grain, .

Groceries, etc.,

Harness, repairs.

Ice,

Lights,

Live stock : —

Cows, .

Horses,

Pigs, .

etc..

Amount carried forward, $19,394 67

1903.] PUBLIC DOCUMENT — No. 23. 19

Amount brought forward, $19,394 67

Meats, 1,882 48

Milk, 554 80

Repairs, 1,904 13

Seeds, 253 09

Sugar, 328 03

Tools, machines, etc., 378 24

Wages, 7,988 31

Wagons, repairs, 508 85

Water, 251 98

$33,444 53 Cr.

Apples, No. 1, 301 barrels, $45150

Apples, No. 2, 266 barrels, 31125

Apples, crab, 3^ bushels, 3 60

Asparagus, 174 bunches, 22 78

Beans, Lima, 60 bushels, . 65 44

Beans, shell, 78 bushels, 117 00

Beans, string, 168 bushels, 181 31

Beets, 278 bushels, 184 38

Beef, 19,668 pounds, 1,619 12

Bones sold, 3,860 pounds, 19 30

Cabbage, 30,500 pounds, 347 40

Carrots, 43 bushels, 23 65

Cauliflower, 379 heads, 25 34

Celery, 3,468 heads, 294 50

Cider, 4,9 14 gallons, 589 68

Corn, sweet, 1,971 dozen, 295 65

Cucumbers, 5,610, . . ^ 164 67

Cucumber pickles, 6,625, . 23 18

Currants, 316 quarts, 33 28

Drawing coal, . . 363 72

Eggs, 67J dozen, 16 87

Egg plants, 250, ' . . . ^ . v . 16 60

Feed, ground, 2,610 pounds, 30 47

Fertilizer, 100 loads, 100 00

Gravel sold, load, 50 70

Gravel, load, . 349 00

Greens, 39 bushels, 19 00

Hay, 19,970 pounds, 199 70

Hides sold, 2,796 pounds, 179 00

Ice, 1,102 tons, 881 28

Ice sold, 304 tons, 89 40

Iron, junk, sold, 6 73

Lettuce, 234 80

Amount carried forward, $7,309 10

20

WOECESTEE INSANE HOSPITAL.

[Oct.

Amount brought forward,

Live stock sold : —

Calves (38),.

Hogs (39), . Milk, 403,713 quarts, Oats, 684 bushels. Onions, 660 bushels, Parsley,

Parsnips, 332 bushels. Pears, 33 bushels. Peas, 120 bushels, Peppers, 384, Plants sold, . Pork, 6,871 pounds. Pork sold, 40,639 pounds. Radishes, 1,276 dozen, Raspberries, red, 66 quarts, Rhubarb, 11,116 pounds. Scullions, 10 bushels, . Spinach, 77 bushels, . Squash, summer, 1,119 pounds. Squash, winter, 60,900 pounds. Strawberries, 1,809 quarts. Straw, rye, 5,841 pounds, . Tomatoes, 86 bushels, . Tomatoes, green, 36 bushels, Turnips, 298 bushels, . Vegetables sold, squash, 150 pounds. Deficit against farm, ,

1903.]

PUBLIC DOCUMENT — No. 23.

21

LIST OF PERSONS

Employed in the Worcester Insane Hospital, Sept. 30, 1903.

Superintendent, per year, .

Assistant superintendent, per year,

Assistant physician, per year,

Assistant physician, per year.

Assistant physicians (two), each, per year,

Junior assistant physicians (four), each, per year.

Pathologist, per year, .

Druggist, per week, . ...

Assistant in laboratory, per month.

Steward, per year.

Matron, per year,

Clerk, per month.

Treasurer, per year, .

Auditor, per year.

Stenographer (two), per week, .

Stenographer (one) , per month,

Superintendent of nurses, per year.

Supervisors (three men), each, per month.

Supervisors (four women), each, "

Marker of clothing, etc., "

Seamstresses (four), "

Attendants (fifty-three men), "

Attendants (sixty -four women), "

Night attendants (eight men), "

Night attendants (twelve women), per month, ,

Baker,

Assistant baker,

Steward's assistant.

Kitchen men (three),

Cooks (two),

Laundrymen (two).

Laundress,

Laundry girls (seven),

Kitchen girls (five).

House girls, each,

OflSce girl.

Carpenters (five), per day,

Painters (two), " "

$3,000 00

2,000 00

1,000 00

900 00

800 00

400 00

1,000 00

20 00

25 00

1,200 00

600 00

60 00

500 00

75 00

10 00

80 00

900 00

to 45 00

30 00

20 00

18 00

28 00

20 00

28 00

20 00

60 00

30 00

30 00

$25 00 to 45 00

28 00 and 30 00

25 00 and 35 00

20 00

fl4 00 to 18 00

14 00 to 18 00

14 00 to 16 00

18 00

|2 50 to 3 00

2 50

$40 00 25 00

$23 00 14 00 25 00 18 00

to

to to to to

22

WORCESTEE INSANE HOSPITAL.

[Oct.

Masons (three), per day, .

Mason's helper, " "

Plumber, per month, .

Engineer, per day,

Firemen (two), per month.

Farmers (two), each, per month,

Housekeepers (two), each, per month.

Farm laborers (fourteen) , each, per month,

Farm help (five women), " " "

Florist, per month,

Coachman, per month,

Expressman, per month, .

Basement and yard man, per month.

Butcher, per month, .

|3 25

2 25 75 00

3 00 40 00

$45 00 and 75 00 18 00 and 20 00 25 00 to 35 00 14 00 to 22 00 45 00 28 00 25 00 28 00 25 00

YALUATIOIS^ OF PERSONAL ESTATE.

Sept. 30, 1903.

Provisions and groceries,

Ready-made clothing,

Dry goods : —

For clothing,

For bedding, etc.,

Furnishings : —

Beds and bedding in inmates' department,

Other furnishings in inmates' department, .

Personal property of State in superintendent' ment,

All other property. Heat, light and power : —

Fuel,

Repairs and improvements : —

Machinery and mechanical fixtures. Farm, stable and grounds : —

Live stock on farm,

Produce of farm on hand, .

Carriages and agricultural implements. Miscellaneous : —

Drugs and medicines, ....

Tobacco, • .

Library

Other supplies undistributed.

's depart

$4,015 45
3,480 40
745	85
880	71
32,454	00
24,053	30
18,029	93
17,496	27
7,550 00
35,456	05
14,530	50,
20,450 48
7,431	90
389	04
23 59
5,653	28
6,889	18
fl99,529	93

1903.]

PUBLIC DOCUMENT — No. 23.

23

TREASUEER'S REPORT.

To the Trustees of the Worcester Insane Hospital.

I hereby submit my annual report on the finances of the Worcester Insane Hospital for the year ending Sept. 30, 1903.

Receipts.

Cash on hand Sept. 30, 1902, . . . . Received from cities and towns for support of patients,

from individuals for support of patients, .

from soldiers' relief for support of patients,

from interest on bank balance,

from farm and farm products,

from sale of rags and rubber,

from sale of ice, .

from sale of old brass and iron,

from sale of barrels, .

from sale of sundries, .

from sales from store,

from Commonwealth for current expenses,

fi'om Commonwealth from special appropriations.

Total receipts,

$5,394 41
* 114,879	82
51,343 43
2,609	27
349	42
4,378 57
264 90
89	40
75	89
170	15
1,230	14
717	94
234,773 77
30,955	37
1447,132 48

Expenditures. Pay roll, . . . $79,821 82

Food : — Butter, Beans, .

Bread and crackers, Cereals, rice, meal, etc. Cheese, Eggs, . Flour, . Fish, . Fruit, . Meats, . Molasses, etc.,

Amounts carried forward.,

$9,185 62
628 75
414 72
1,688 39
790 67
5,725 78
4,790 55
3,310 57
3,542 31
15,320 74
647 14
$46,045 24 $79,821 82

24

WORCESTER INSANE HOSPITAL.

[Oct.

Repairs and improvements : —

Bricks,

Cement, lime, etc.. Doors, sashes, etc, Electrical work and supplies,

Hardware,

Lumber,

Machinery, etc., .... Paints, oils, glass, etc., Plumbing, steamfitting and supplies, Roofing and materials, Sundries,

Farm, stable and grounds : — Blacksmith and supplies, . Carriages, wagons and repairs, .

Amounts carried forward, .

Amounts brought forward.

Sugar,

Tea, coffee, etc., . Vegetables, ...

Sundries, ....

Clothing and clothing material Boots, shoes, etc., Clothing,

Dry goods for clothing, etc Furnishing goods, Hats and caps, . Leather and shoe findings, Sundries,

Furnishings : — Beds, bedding, table linen, etc., . Brushes, brooms, etc., Carpets, rugs, etc.. Crockery, glassware, cutlery, etc., Furniture and upholstery, . Kitchen furnishings, . Woodenware, etc., . . Sundries, ■

Heat, light and power : — Coal, ......

Gas,

Oil,

Sundries,

16,045 24 $79,821 82

4,417 44 1,931 80

4,877 84 3,303 69 60,576 51

f 1,347 47

5,207 36

1,899 17

1,486 37

198 75

70 19

25 94

J5,445 45

387 43

266 01

1,236 65

391 82

470 25

87 63

487 57

22,815 51

6,237 54

142 12

58 48

$332 38

569 19

59 65

621 58

662 91

3,063 35

687 34

■ 1,532 93

2,740 41 230 26

1,215 03

|578 95 921 70

10,235 25

8,772 81

29,253 65

11,715 03

1,500 65 f 200,374 07

1903.] PUBLIC DOCUMENT -	-No. 23.	25
Amounts brought forward, .	•	.	f 1,500 65	jf200,374 07
Fertilizers, seeds, etc.,			977 02
Hay, grain, etc., ....			9,669 06
Harness and repairs, .			683 07
Horses, . .			1,287 50
Cows,			2,436 00
Other live stock, .			161 00
Tools, farm machines, etc..			483 49
Sundries,			1,318 74
		18,516 53
Miscellaneous : —
Books, periodicals, etc., f 516 30
Chapel services, ....			611 85
Freight, expressage, etc., .			268 84
Funeral expenses.			280 06
Gratuities,			27 47
Hose, etc., . . . . .			108 35
Labor (not on pay roll), .			8 00
Medicines and hospital supplies,			2,101 97
Medical attendance, .			207 51
Postage,			381 28
Printing and printing supplies, .			277 47
Return of runaways, .			115 14
Soap and laundry supplies,			2,569 44
Stationery and office supplies, .			428 59
Travel and expenses (officials),			164 68
Telephone and telegraph, ,			189 68
Tobacco, . .			982 00
Water,			5,058 96
Sundries,			1,490 46
		15,787 65

Total,

Paid out of special appropriations, Receipts paid to State Treasurer,

Total expenditures. Cash on hand Sept. 30, 1903, .

Resources Cash on hand Oct. 1, 1903, . Bills due from cities and towns. Bills due from individuals, Bills due from soldiers' relief, . Unexpended special appropriations,

$234,678 15

30,955 37 179,131 55

$444,765 07 2,367 41

$447,132 48

$2,367 41

30,037 09

12,082 54

425 25

59,711 78

$104,624 07

26

WORCESTER INSANE HOSPITAL.

[Oct.

Liabilities.

Due for maintenance paid in advance, . . $152 22

for salaries, wages and labor, . . . 7,443 74

for all other current expenses, . . . 17,536 21

Special Appropriations.

),132 17

OBJECT.	Resolves.	Whole Amount.	Expended in 1902.	Expended in 1903.	Balance Oct. 1, 1903.
Nurses' home, . Electric lighting, Electric lighting,	1901, chap. 471, 1902, chap. 118, 1903, chap. 414,	$45,000 00 16,000 00 45,000 00	$14,767 85 565 00	$27,531 08 3,239 29 185 00	$2,701 07 12,195 71 44,815 00

Patients' Funds. Balance on hand Sept. 30, 1902, . . . .

Receipts during year,

Interest on bank balance,

Expenditures during year,

Balance on hand Sept. 30, 1903, . . . .

$2,157 75
3,449 13
47 45
	$5,654 33
.	2,832 04

?,822 29

Respectfully submitted,

ALBERT WOOD,

Treasurer,

Oct. 1, 1903.

1903.] PUBLIC DOCUMENT — No. 23. 27

STATEMENT OF FUNDS.

Lewis Fund.

Balance on hand Sept. 30, 1902,

Collected Springfield bond.

Dividends,

Safe Deposit Vault rent,

Depreciation Springfield bond, .... Chicago, Burlington & Quincy Railroad bond, . Deposit Worcester County Institution for Sav- ings,

Investment. Chicago, Burlington &'Quincy Railroad bond, Worcester County Institution for Savings, Cash on hand Sept. 30, 1903,

Wheeler Fund.

Balance on hand Sept. 30, 1902,

Dividends,

Central National Bank, first payment in liquida- tion 700 00

Central National Bank, second payment in liquidation, . . . . . ...

Advance in Worcester National Bank shares, .

Expended for books, . . . ' .

Five shares Boston & Philadelphia Steamship Company,

Deposit Worcester County Institution for Sav- ings,

$1,254 60
1,000 00
100 15
	$2,354 75
15 00
10 00
926 36
73 64
	1,015 00
$1,339 75
$926 36
342 60
70 79
	$1,339 75
$4,648 22
175 56

I

175 00
16 00
	$5,713 78
$251 84
712 50
57 50
	1,021 84

$4,691 94

28 WOECESTER INSANE HOSPITAL. [Oct. 1903.

Investment. Three shares Worcester National Bank, . . |570 00

Five shares Boston & Philadelphia Steamship

Company,

Worcester County Institution for Savings,

Worcester Five Cents Savings Bank,

Cash on hand Sept. 30, 1903, ....

Lawn Fund. Balance in Mechanics Savings Bank, Sept. 30,

1902,

Sale of trees,

Dividends,

712	50
1,608	36
1,719	47
81	61	$4,691 94
fl,210	28
30	00
43	66	$1,283 94
•	-	371 86
•	$912 08

Expenditures during year, .... Balance in bank Sept. 30, 1903, .

Manson Fund. Balance in Worcester County Institution for

Savings Sept. 30, 1902,

Dividends,

Land Account. Balance on hand Sept. 30, 1903,

Respectfully submitted,

ALBERT WOOD,

Treasurer of Corporation. Oct. 1, 1903.

WoECESTEE, Mass., Oct. 26, 1903. I hereby certify that I have this day compared the treasurer's statement of disburse- ments for the year ending Sept. 30, 1903, with the vouchers on file at the Worcester Insane Hospital, and find them to agree. I have also inspected the securities repre- senting the invested funds of the institution, and find that their market value is as stated.

GEO. L. CLARK,

Auditor of Accounts:

$1,323 02 52 92	$1,375 94
.	$58 52

STATISTICAL TABLES.

[Form prescribed by State Board of Insanity.]

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32

WORCESTER INSANE HOSPITAL.

[Oct.

cq

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1903. J

PUBLIC DOCUMENT — No. 23.

33

3. — Received on First and Subsequent Admissions.
NUMBER OF THE ADMISSION.	Cases admitted.	Times pkeviouslt recovered. '
		Males.	Females.	Totals.	Males.	Females.	Totals.
First,			299	216	615	-	-	-
Second, .			41	39	80	13	9	22
Third, .			6	6	12	7		8
Fourth, .			6	1	7	3		4
Fifth, .			2	2	4	2		3
Sixth,			1	1	2	-
Seventh, .			-	1	1	-
Eighth, .			2	-	2	1	-
Ninth,			-	1	1	-	1
Total of cases,		357	267	,624	26	15	41
Total of persons,		353	267	620	22	14	36

34

WORCESTER INSANE HOSPITAL.

[Oct.

4. — Relation to Hospital of Pei	^sons admitted.	\
	Males.	Females.	Totals.
Never before in any hospital for insane, .	272	201	473
Former inmates of this hospital only,	51	40	91
Former inmates of other hospitals only, .	27	15	42
Former inmates of this and other hospitals : —
Danvers, Massachusetts Hospital for Epi- leptics,	-	1	1
Danvei's, Westborough, Taunton, Foxbor- ough,	1	-	1
Elwyn's Hospital, Pennsylvania,	-		1
Herbert Hall,	-		1
McLean,	2		3
Medfield,	2		3
Newton Nervine, McLean, . .	1		1
Northampton,	-		1
Palmer, .......	-		1
Taunton,	-		1
Taunton, Herbert Hall, . . .	-		1
Tewksbury, , . . . .	1		1
Westborough,	-		1
Westborough, Taunton, Tewksbury,	-		1
Total of cases,	357	267	624

1903.]

PUBLIC DOCUMENT — No. 23.

35

5. — Parentage of Persons admitted.

				Males.	Females.	TOTALSi
PLACES OF NATIVITY.
	Father.	Mother.	Father.	Mother.	Father.	Mother.
Massachusetts, ....	52	46	28	29	80	75
Other States : —
Maine, ....	11	12	9	10	20	22
New Hampshire,			5	6	6	7	■11	13
Vermont			7	4	5	5	12	9
Rhode Island,			1	2	2	1	3	3
Connecticut,			1	1	2	1	3	2
New York, .			5	7	2	2	7	9
Pennsylvania,			1	1	1	-	2	1
Maryland, .			-	-	-	/ 1	-	1
District of Columbia,			1	1	-	_	1	1
Virginia,			-	-	2	1	2	1
North Carolina,			1	1	1	1	2	2
Alabama, .			1	1	-	-	1	1
Other countries : —
Canada, ....	22	28	9	8	31	36
Nova Scotia,			14	17	1	1	15	18
New Brunswick,			4	2	4	4	8	6
Newfoundland, .•			2	2	2	2	4	4
■ Prince p]dward Island	,		2	1	2	2	4	3
"West Indies,			1	1	1	1	2	2
Scotland, .			5	7	11	10	16	17
England,				15	15	16	14	31	29
Ireland,				109	105	75	78	184	183
Norway,				1	1	1	1	2	2
Sweden,				10	10	3	3	13	13
Denmark,				1	1	-	-	1	1
Holland,				-	-	2	2	2	2
France,				-	_	1	1	1	1
Germany,				7	7	3	3	10	10
Austria,				1	1	-	1	1	2
Italy, .				5	5	2	2	7	7
Armenia,				2	2	—		2	2
Hungary,				-	-	2	1	2	1
Finland,				6	6	1	_	7	6
Poland,				2	2	2	2	4	4
Russia,				6	6	2	2	8	8
Assyria,				1	1	-	-	1	1
China,				1	1	-	-	1	1
The Azores,			-	-	1	1	1	1
Unknown,			54	54	68	70	122	124
Totals,		357	357	267	267	624	624

36

WOECESTER INSANE HOSPITAL.

[Oct.

	6.-	— Residence of Persons admitted.
PLACES.	Males.	Females.	Totals.
Massachusetts, (by counties) : —
Berkshire,							1	-	1
Bristol,							1	-	1
Essex, .							-	1	1
Franklin,							1	-	1
Hampden,							-	1	1
Middlesex,							93	86	178
Norfolk,							'7	10	17
Plymouth,							1	-	1
Suffolk,							70	68	128
Worcester,			\				183	112	295
Totals,	367	267	624
Cities or towns,							357	267	624

PUBLIC DOCUMENT — No. 23.

37

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38

W0RCE8TEE INSANE HOSPITAL.

8. — Occupation of Persons admitted.

Bookkeepers, . . . 2	Rubber worker, . . . 1
Clerks, .			4	Saleswomen, .			3
Cook, .			1	Seamstresses,			3
Domestics,			51	Servants,			2
Dressmakers,			6	Student, . ,			1
Housekeepers,			39	Tailoress,			1
Housemaids, .			2	Typewriters, .			2
Housewives, .			65	Washerwoman,			1
Laundresses, .			3	Weavers,			2
Matron,			1	Unknown,			7
Milliner,			1	No occupation,			57
Music teachers,			2
Nurses, .			2	Total, . . . .267
Operatives, .			19

Actor, 1	Color mixer, . . . . 1
Baggage master.			1	Comb maker,			1
Bakers, .			3	Contractors, .			2
Barbers,			2	Cook,
Bartenders, ,			4	Cooper, .				, 1
Blacksmith, .			1	Currier, .
Bookkeepers,			2	Driver, .
Bottler, .			1	Electrician,
Bricklayer, .			1	Engineers,				6
Cabinet maker,			1	Expressmen,				2
Carpentei-s, .			5	Farmers,				18
Carriage maker.			1	Farm hand,				1
Chair makers,			4	Felt shearer, .				1
Cigar makers.			2	Finisher,				1
Cigar store, .			1	Firemen,				2
Civil engineer.			1	Foreman,				1
Clerks, .			11	Gardener,				1
Coachmen,			2	Gate tender.				1

1903.]

PUBLIC DOCUMENT— No. 23.

39

8. — Occupation of Persons admitted — Concluded.

MALES — Concluded.
Hack driver, . . . . 1	Real estate, .... 1
Harness maker,			1	Reed worker.			1
Hatter, .			1	Restaurant keepers	) •		2
Hostlers,			2	Retired, .			1
Hotel keeper,			1	Rope maker, .			1
Insurance,			1	Rubber workers, .			2
Iron workers,			2	Salesmen,			9
Janitor, .			1	Shearer, .			1
Laborers,			75	Shoe cutter, .			1
Leather finisher, .			1	Shoe dealer, .			2
Liveryman, .			1	Shoemakers, .			7
Lumber dealers, .			2	Soap maker, .			1
Lunch room, .			1	Spectacle maker,			1
Machinists, .			9	Stableman, .			1
Manufacturer,			1	Stationery enginee	f,		1
Masons, .			4	Steamfitter, .			1
Mason tender.			1	Stone cutters.			2
Mechanics,			3	Student, .			1
Milk business.			1	Tailoi-s, .			4
Moulders,			3	Teamsters,			7
Nurse, .			1	Tinsmith,			1
Operatives, .			15	Upholsterer, .			1
Organ pipe voicer,			1	Varnisher,			1
Painters,			7	Waiters,			3
Paper maker,			1	Weavers,			8
Peddler,			1	Wheelwright,			1
Physician,			1	Wood chopper.			1
Plumbers,			2	Wood workers,			3
Polisher,			1	Unknown,			. 17
Postmaster, .			1	No occupation.			. 42
Printer, .			1
Provision dealer,			1	Total, .■			. 357

40

WORCESTER INSANE HOSPITAL.

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1903.]

PUBLIC DOCUMENT — No. 23.

43

11. — Ages of Insane at First Attack^ ArJmission and Death.

'	Persons first admitted TO ANT Hospital.	Persons died.
AGES.		AT	WHEN		AT			AT
	j-iRST attack	ADMITTED.	FIRST ATTACK.	TIME OP DEATH.
	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.
Congenital,	5	2	7	-	-	-	-	-	-	-	-	-
15 years and less,	5	3	8	1	3	4	1	-	1	-	-	-
From 15 to 20 years, .	9	5	14	8	4	12	-	-	-	-	-	-
20 to 25 years, .	21	15	36	30	23	53	3	4	7	1	3	4
26 to 30 years, .	29	17	46	39	22	61	6	4	10	2	1	3
30 to 35 years, .	26	23	49	38	23	61	2	3	5	4	4	8
35 to 40 years, .	20	18	38	31	20	51	8	2	10	6	3	9
40 to 50 years, .	36	29	65	48	39	87	15	6	21	16	3	19
50 to 60 years, .	30	20	50	37	23	60	10	11	21	15	7	22
60 to 70 years, .	11	11	22	13	19	32	12	10	22	14	12	26
70 to 80 years, .	11	12	23	11	16	27	9	7	16	8	10	18
Over 80 years, .	5	3	8	9	4	13	3	-	3	4	4	8
Unknown, ....	64	43	107	7	5	12	1	-	1	-	-	-
Total of persons.	272	201	473	272	201	473	70	47	117	70	47	117
Mean ages in years, .	39.3	40.7	40.0	40.5	42.7	41.6	50.1	51.0	50.5	54.1	58.4	56.2

12, — Reported Duration of Disease before Last Admission.

PREVIOUS DURATION.		First .Admission TO ANY Hospital.	All Other Admissions.	Totals.
	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.	Ma.	Fe.	Tot.
Congenital,				5	2	7	1	-	1	6	2	8
Under 1 month.				73	35	108	22	12	34	95	47	142
From 1 to 3 months.				32	29	61	10	6	16	42	35	77
3 to 6 months,				20	11	31	3	4	7	23	15	38
6 to 12 months.				24	8	32	4	1	5	28	9	37
1 to 2 years, .				30	18	48	5	4	9	35	22	57
2 to 5 years, .				18	28	46	13	12	25	31	40	71
5 to 10 years, .				14	16	30	8	6	13	22	21	43
10 to 20 years, .				1	9	10	2	4	6	3	13	16
Over 20 years, .				1	3	4	-	4	4	1	7	8
Unknown,				64	42	96	17	14	31	71	56	127
Total of cases, .	272	201	473	85	66	151	357	267	624
Total of persons,				272	201	473	81	68	147	353	267	620
Average in years,				1.18	2.60	1.89	1.91	5.04	3.47	3.09	7.64	5.38

44

WORCESTEE INSANE HOSPITAL.

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1903.]

PUBLIC DOCUMENT — No. 23.

45

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1903.]

PUBLIC DOCUMENT— No. 23.

47

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48

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1903.] PUBLIC DOCUMENT — No. 23.

49

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