Annual report of the trustees of the Worcester State Hospital

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Public Document No. 23

SEVENTY-EIGHTH ANNUAL REPOET

THE TRUSTEES

Worcester State Hospital,

THIKTY-THIRD ANNUAL REPORT OP THE TRUSTEES

WOECESTEE STATE ASYLUM AT WORCESTER,

Year ending November 30, 1910.

BOSTON:

WRIGHT & POTTEE FEINTING CO., STATE PRINTEES,

18 Post Office Square.

1911.

Public Document No. 23

\ c._. . .MTY-EIGHTH 'ANNUAL EEPORT

OF

THE TRUSTEES

OF THE

w Worcester State Hospital,

AND

THIRTY-THIRD ANNUAL REPORT OF THE TRUSTEES

OF THE

WOECESTER state asylum at WORCESTER,

FOR THE

YeAK ending ]S[OVEMBEIi 30, 1910. j

/^.

BOSTON:

WEIGHT & POTTEE FEINTING CO., STATE PEINTEES,

18 Post Office Square.

1911.

^

Approved by
The State Board of Publication

S;

mo -If

CONTENTS

Report of Trustees, 7

Report of Superintendent, 10

Laboratory Report, 17

Report of Treasurer, 28

Statistics, ... 35

OFFICERS OF THE HOSPITAL.

TRUSTEES.

SAMUEL B. WOODWARD -c . . Wobcesteh.

CARRIE B. HARRINGTON Worcester.

FRANCES M. LINCOLN Worcester.

GEORGE F. BLAKE, Worcester.

LYMAN A. ELY, Worcester.

T. HOVEY GAGE, Worcester.

THOMAS RUSSELL, Boston.

RESIDENT OFFICERS.
HOSEA M. QUINBY, M.D.,
THEODORE A. HOCH, M.D., .
RAY L. WHITNEY, M.D., .
CORNELIA B. J. SCHORER, M.D.
WILLIAM M. DOBSON, M.D., .
FRANK L. S. REYNOLDS, M.D.,
FRANK H. MATTHEWS, M.D., .
IDA A. McNEIL,
LILA J. GORDON,
JOSEPH T. REYNOLDS,

Superintendent.
First Assistant
Assistant Physician.
Assistant Physician.
Assistant Physician.
Assistant Physician.
Junior Assistant.
Superintendent of Nurses.
Matron.
Farmer.

ISrONRESIDETyTT OFFICERS.

SAMUEL T. ORTON, M.D.,
GEORGE E. PARESEAU, .
GEORGE L. CLARK, .
JESSIE M. D. HAMILTON,

JAMES DICKISON, Jr.,

Pathologist.

Druggist.

Auditor.

Clerk.

Engineer.

®l)e tfommontoealtl) oi illa00acl)U0ett0,

TRUSTEES' REPORT.

To His Excellency the Governor and the Honorable Council.

The trustees of the Worcester State Hospital respectfully sub-
mit their seventy-eighth annual report.

The reports of the superintendent and treasurer are annexed,
which give in detail the accounts of the management of the
institution.

The trustees wish to call attention to the fact that the matter
of the disposal of the hospital sewage is still unsettled.

The last Legislature passed an act authorizing the hospital
to discharge its sewage into the sewers of the city of Worcester, —
this act to take effect upon its acceptance by the city, on or before
July 1, 1910. The trustees further understand that by the same
act the hospital could not empty its sewage into the Worcester
sewer until the filter beds of the city had been enlarged. As
neither condition has been complied with by the city, it has been
impossible for the hospital to do anything. Moreover, the sum
allowed by the Legislature for the construction of the necessary
work to make the connection between the hospital and the
Worcester sewer is manifestly too small.

Upon the passing of the above act the trustees employed Mr.
C. E. Allen, a consulting engineer of Worcester, to give them an
estimate of what such work would cost. His estimate for the
connecting of the sewers already in use, and the construction of
such new sewers as the changes make necessary, is very nearly
$10,000. In 1905 Mr. Von Volkenburg, a civil engineer of South
Framingham, in a report to a commission authorized by the
Legislature to investigate this same question, allowed $14,000
for the work. As against these two estimates the act of Legis-
lature allows the hospital but $4,000.

8 WORCESTER STATE HOSPITAL. [Dec.

As the Legislature granted no appropriation to the hospital
last year no new work has been undertaken, and in view of the
fact that the institution is still overfilled, the trustees again ask
for a new ward to accommodate 100 male patients. This ward
would not only provide sleeping accommodations for the patients,
but would make possible a congregate dining room for 125 patients
and 80 attendants. The present dining facilities in this part of
the institution are far from adequate, • — half of the patients not
being able to get into the dining rooms, — a condition which is
unfair both to patients and attendants.

The superintendent's report, which is annexed to this, shows
in detail the crowded condition of the hospital, and how this new
ward would relieve the congestion. For building and furnishing
this ward the trustees ask for $84,000.

The trustees ask for a further appropriation of $10,000 for
raising the roof of the Salisbury ward. This will provide beds
for 21 patients, and will make better connections between the
proposed new ward and the old part of the building.

At present there are 131 men sleeping on cots on the floor. If
these two appropriations are granted this condition of affairs
would be remedied, for not only would dormitories be gained
in the new ward, but the small dining rooms in the old Salisbury
ward would be turned into sleeping space for 32 patients, — this
being made possible by the congregate dining room.

In the women's ward, which has lately been completed, an
elevator is needed. This should run to the roof, so that the bed-
ridden and feeble patients could be taken there to get the benefits
of the fresh air. A similar elevator is needed in the proposed
new ward for men. The trustees ask for $4,200 for the two ele-
vators.

We cannot too strongly urge the necessity of purchasing the
two tracts of land known as the Putnam and Curtis tracts. The
Putnam tract joins that portion of the hospital land which is
used as recreation ground for the women. Unless the hospital
can own this land it will soon be cut up into house lots, and when
it is once built upon it will be impossible for the inmates of the
hospital to enjoy the liberty which can now be given them.

The Curtis land is particularly desirable for farm and garden-
ing purposes. As the superintendent's report shows, the hospital

1910.] PUBLIC DOCUMENT — No. 23. 9

lacks sufficient land to provide for its needs, and the addition
of this tract would make possible the raising of many vegetables,
and much hay which now the institution is compelled to pur-
chase. Furthermore, the benefit to the additional number of
patients who would thereby be given wholesome out-of-door
work is incalculable. For these two tracts the trustees ask for
an appropriation of S18,000.

In the resignation of Dr. Albert Wood as treasurer, and Miss
Frances M. Lincoln as a member of the Board of Trustees, the
hospital has lost two people who have proved themselves devoted
to its best interests. Dr. Wood has been treasurer of the hos-
pital for thirty-four years, and has in all that time shown him-
self a faithful and efficient officer. Miss Lincoln has been a
member of the Board of Trustees for twenty-six years. Her
knowledge of the hospital and its needs, her interest and unfail-
ing devotion to it, have made her a most valued member of the
Board.

It is with the truest feeling of loss and regret that the trustees
accept the resignation of Dr. Quinby. For twenty years he has
been superintendent of the hospital, and it is to his untiring
efforts, and the dedication of his time and his energies, that the
hospital has been able to take the high rank which it holds among
other institutions of its kind. He has always shown himself
willing and anxious to help and serve the trustees, and to this
feeling of co-operation is due the fact that their work has always
been to them a genuine pleasure.

To the superintendent, members of the staff and employees
the trustees wish to express their appreciation of the faithful
services rendered.

Respectfully submitted,

CARRIE B. HARRINGTON.
FRANCES M. LINCOLN.
GEORGE F. BLAKE.
LYMAN A. ELY.
T. HOVEY GAGE.
THOMAS RUSSELL.
SAMUEL B. W^OODWARD.

Nov. 30, 1910.

10 WORCESTER STATE HOSPITAL. [Dec.

SUPERINTENDENT'S REPORT.

To the Trustees of the Worcester State Hospital.

I herewith respectfully submit the following report of the hos-
pital for the year ending Nov. 30, 1910, it being the seventy-
eighth annual report.

There remained at the hospital Oct. 1, 1909, 1,285 patients, —
658 men and 627 women. During the year ending Sept. 30,
1910, there were admitted 660 patients, — 343 men and 317
women. Five hundred and sixty-one patients — 307 men and
254 women — were dismissed from the hospital. Of this number,
237 patients — 112 men and 125 women — were discharged; 178
patients — 110 men and 68 women — died; 68 patients — 41
men and 27 women — were transferred; and 78 patients — 44
men and 34 women — left on visit or escape, leaving at the end
of the statistical year 1,384 patients, — 694 men and 690 women.
Of this number, 1,132 were supported by the State, 150 by friends
and 102 as reimbursing patients. Of the 305 patients discharged
and transferred, 69 (including 9 habitual drunkards, women) were
reported recovered, 74 capable of self-support, 35 improved and
126 not improved. One was discharged not insane. One woman
and 15 men were transferred by the State Board of Insanity to
the Medfield State Asylum, 15 men to the Gardner State Colony,
3 men and 5 women to the Danvers State Hospital, 1 man and
2 women to the State Infirmary, Tewksbury, 2 women to the
Taunton State Hospital, 2 men to Dr. Coon's Private Hospital,
2 women to the Westborough State Hospital, 1 man and 1 woman
to Herbert Hall Hospital, 1 woman to Dr. Ring's Sanatorium,
1 w^oman to the Monson State Hospital, 1 woman to the New-
ton Nervine, 1 woman to the Boston State Hospital, 1 woman to
the School for the Feeble-minded, and 1 man to the McLean
Hospital. Thirty-five men and 36 women were removed from
the State, and 3 men and 9 women were boarded out.

1910.] PUBLIC DOCUMENT — No. 23. 11

There remained at the end of the year 99 patients more than
at the beginning. The smallest number under treatment on any-
one day was 1,281, and the largest, 1,425. The daily average
number was 1,353.12.

The percentage of recoveries, calculated upon the number of
discharges and deaths, was 16.6; calculated upon the number of
admissions it was 10.4.

The death rate was 9.1 calculated on the whole number of
patients under treatment, and 13.1 calculated on the daily aver-
age number.

Our death rate for the year was about the same as last year.
During the months of June, July and August there was an epi-
demic of dysentery. There were 136 cases, including all the
suspicious cases of diarrhoea. Of this number 22 died, a mortality
of 16.1 per cent. The infection was of a severe type, and all
patients were quarantined as soon as the disease was recognized.
The first case appeared in the male wards, and almost immedi-
ately there was a general epidemic, cases appearing in nearly all
wards without any known source of contagion. The patients in
whom the disease proved fatal were for the most part feeble,
demented and our oldest residents. The disease appeared in
several employees, but without fatality. Ordinary precautions
to prevent the spread of the disease were taken, and, realizing
the importance of the common house fly in spreading contagion,
the wards in which these patients were cared for were carefully
screened.

Aside from the epidemic of dysentery, the general health of
both patients and employees has been good, and there were no
outbreaks of other contagious diseases.

The training school for nurses will begin its winter session with
a class of 75 juniors, the largest in its history, and in December
12 nurses will be graduated. Of last year's graduates, some are
engaged in private nursing, others are taking post-graduate work
in other hospitals, and 1 nurse has returned to us to take charge
of the infirmary wards.

The nurses and attendants are working on a sixty-hour basis, with
one day off in seven. While we have had to increase our nursing
force, we have experienced less trouble in obtaining suitable per-
sons than in other A'ears.

12 WORCESTER STATE HOSPITAL. [Dec.

Our new ward for women is now fully occupied and is proving
itself well adapted to the needs of the class of patients for whom
it was designed, that is, for those of our patients who need more
individual attention, either on account of their disturbed or their
feeble condition, and who cannot be cared for in our infirmary
wards. The continuous baths installed on the lower floor are
in daily use, and have proved very efficient as a means of allay-
ing excitement, both acute and chronic, while the verandas, open
at all times and allowing the patients free access to the open-
air, are much appreciated. The roof of this building is now
enclosed and ready for occupancy, and will prove, I have no doubt,
a very attractive and useful feature of the hospital. To make it
more convenient of access from the other wards, and safer in
case of fire, a second iron stair is being added.

In our last report we asked for an appropriation for a similar
building for men, with certain additions and modifications sug-
gested by the somewhat different conditions which we are here
obliged to meet, and we would again renew this request, and also
ask for an appropriation for raising the roof of the Salisbury
ward, to which this building is to be attached, making it conform
with the other wards of the hospital. As will be seen by referring
to our last year's report, the building provides for a congregate
dining room for 125 patients and a separate dining room for 80
attendants.

Our wards for men are continually overcrowded. x4t present
there are 131 men — mostly of the violent class — sleeping on
the floori To say that we have no more patients than the cubic
contents of the ward allow, and that we are no worse off in the
matter of crowding than the other institutions, does not relieve
us, or qualify the fact that we have for several years been obliged
to provide for from 200 to 300 more patients than we have beds
for, or places outside of the corridors and day spaces in which
to put up beds, and we have, therefore, been obliged to make up
cots for this number every night.

Our dining rooms, with the exception of those on the front
wards, were, as originally constructed, sufficient to accommodate
the minimum number for which the hospital was intended. From
time to time, as our numbers have increased, we have enlarged
these dining rooms. We have now gone, however, as far in this

1910.] PUBLIC DOCUMENT — No. 23. 13

direction as the construction of the house will allow, and still
find ourselves, at meal times, unable to provide for all of our
patients in the dining rooms. In several of the wards, notably
the two excited wards, — each having some 60 odd patients, —
only half of the patients can be fed in the dining room. They
are obliged to eat in their rooms, or in the corridors, wherever
they can find a place. Under these conditions the attendants
cannot possibly give their patients the attention their condition
demands, and wanting this attention the patient easily lapses
into habits that are intolerable.

It is largely to obviate this lack, both in the dining and sleeping
accommodations, that the proposed building was planned. It
provides on its lower story a congregate dining room for 125
patients and a separate dining room for 80 attendants. In the
ward proper there are beds for 100 patients. The congregate
dining room, when completed, will allow the Salisbury dining
rooms to be used as dormitories, thus providing for 32 patients,
and the addition to the Salisbury will provide for 21, making in
all provisions for 153 patients, at an estimated cost, including
furnishings, of $96,100, or $628 per patient, which is certainly
much cheaper than they can be provided for elsewhere, and espe-
cially as the patients to be provided for are of the violent class.

An elevator running to the roof is needed both in the proposed
building and in the one just completed.

A separate dining room for our attendants is an absolute neces-
sity. Now they are obliged to eat with their patients, an arrange-
ment which is perhaps feasible in a small ward, but one which
should not be tolerated in a ward of 60 or more patients. The
attendants cannot get their own meals and at the same tinie give
the patients the attention which they should have. But, aside
from this fact, it is certainly their due that a place be provided
where they can enjoy their meals by themselves, and be relieved
of all duties during the meal hours.

As servants of the State, placed in charge of one of its important
institutions, and bound to look after its interests, both present
and prospective, I feel that we should be lacking in duty did we
not continue to urge the purchase of the Curtis and the Putnam
lands. Now that the Green Hill property has come into the
possession of the city of Worcester, to be used for park purposes,

14 WORCESTER STATE HOSPITAL. [Dec.

these two tracts are the only ones adjoining the hospital property
which are in private hands. They have been surveyed for the
purpose of cutting them up into house lots, and, if not purchased
by the State, will no doubt soon be built upon, and the work of
the hospital thereby seriously interfered with. Their purchase,
on the other hand, would protect the institution on all sides from
future encroachment.

Both tracts are in close proximity to our excited wards. The
Putnam tract joins that portion of the hospital property used"
as recreation grounds for our women, and at its northerly end
extends to within a few hundred feet of our women's excited
wards, which it overlooks. If built upon it would oblige us to
greatly restrict the liberty now enjoyed by this portion of our
inmates, as there is no other portion of our grounds which we
could use for the purpose for which this is now set apart.

The Curtis tract adjoins the land now used by the hospital
for garden and farming purposes, and should be secured, not
only to protect the hospital property, but more especially to
enable us to extend our farm and garden work. The entire tract
could be put to immediate use and would add decidedly to the
income of the hospital, and return to the State every year a fair
interest on the cost of both the tracts it is proposed to purchase.
We are now obliged to buy many of our vegetables and most
of our hay and grain, all of which could be raised by the insti-
tution at much less expense, as we have on our wards ample
help now idle, and only waiting to be employed. No work is so
well adapted for employing all classes of the insane as farm work,
and none so helpful to the person employed. That this kind of
work can be made remunerative for the institution, as well as
useful to its inmates, will appear, I think, from our garden account,
which has been carefully kept for the past three years. In this
account we have charged to the garden all fertilizers, seeds, tools,
horse labor, all wages of hired help with their board, together
with the board of patients, — employees, — and credited it with
the articles raised, at a valuation fixed for farm products by the
Board of Insanity and uniform for all institutions.

In 1908 19 acres were under cultivation. The receipts were
$8,099, and the expenses, $5,286. In 1909, with the same acreage,
the receipts were S8,024, and the expenses $5,241, — a profit in
the one case of $148 and in the other of $146 per acre.

1910.] PUBLIC DOCUMENT — No. 23. 15

Our account for this year is not as yet closed, but I have no
doubt that it will be equally as favorable, if not more favorable,
for the institution.

The following changes occurred on the staff during the past
year.

Resignations. — March 31, 1910, Dr. John R. Ross, to go to
King's Park State Hospital, New York; May 20, 1910, Dr. Flor-
ence H. Abbot, to accept a position at the Newton Nervine;
July 15, 1910, Dr. Nelson G. Trueman; Oct. 7, 1910, Dr. John G.
Striegel, after completing a service of three months; Nov. 5, 1910,
Dr. George A. Mclver.

Appointments. — Dr. Samuel T. Orton was appointed pathol-
ogist Jan. 1, 1910. Dr. Cornelia B. J. Schorer was appointed
senior assistant physician Aug. 5, 1910, to fill the vacancy caused
by the resignation of Dr. Abbot. Dr. Frank H. Matthews was
appointed junior assistant physician May 23, 1910. On April 1,
1910, Dr. Frank L. S. Reynolds was promoted from junior assistant
physician to senior assistant physician. Mr. Mulford H. Center
was appointed steward Feb. 15, 1910.

We msh to thank the proprietors of the " Worcester Evening
Gazette" and the "Fitchburg Sentinel" for copies of their papers,
and the Worcester Employment Society for their valuable assist-
ance in sewing.

The closing year marks my thirty-eighth year of service in the
two institutions under the charge of your Board and my twentieth
year as superintendent of this hospital, and I feel that the time
has come when I ought, in justice to the hospital, and to myself,
to give over the work into other hands, and I would, therefore,
respectfully request that your Board accept my resignation, to
take effect on April 1 next.

These years have certainly been years of material growth in the
history of the institution. The number of its patients has in-
creased from 300 to 1,400, and many additions have been made to
the hospital buildings to provide for this increase, as well as to
improve its service. During this time there has been a marked
advance in the knowledge of psychiatry and in the methods for
caring for the insane, and it has been my constant effort to keep
pace with this advance, and to place the Worcester hospital in
the front rank as regards the character and quality of its medical

16 WORCESTER STATE HOSPITAL. [Dec.

work. How far I have succeeded in carrying out my purpose you
can best decide.

To lay down, before one is compelled to do so, a work which
for so many years has been to him a labor of love and seldom a
burden, is no easy thing to do, but it becomes less difficult when
one is assured that the work he has had so much at heart ^dll still
go on, and undoubtedly in a better way.

To your Board, who have rendered me such hearty and unfail-
ing support, and have given me so much of your time, and have
assisted me so materially with your counsel, I feel myself deeply
indebted.

I believe that the institution is in a thoroughly sound condition,
both financially and otherwise, and that it was never better
equipped than at present for doing the work demanded of it,
and although ceasing to be its superintendent, I shall not cease
to have a lively interest in its success.

HOSEA M. QUINBY,

Superijitendent.
Nov. 30, 1910.

1910.] PUBLIC DOCUMENT — No. 23. 17

LABORATORY REPORT.

During the year a number of important additions have been
made in the laboratory equipment. The bacteriological outfit
has been made complete by the addition to the former apparatus
of an autoclav, hot-air sterilizer and a stock of test tubes, flasks
and other glassware, so that special bacteriologic investigations
are now within reach of our facilities. A large electric centrifuge
has been installed, which is capable of modification to qieet the
requirements of clinical examinations, milk analysis and many
special investigations.

A new Minot automatic precision microtome has been pur-
chased for the more accurate sectioning of pieces of cerebral
cortex, required in the type of investigations under way and in
view.

A considerable addition has been made in the way of new
shelving, both in the laboratory stock room and in two of the
upstairs workrooms, for the purpose of storing glassware, chemi-
cals and specimens in a more orderly method.

That part of the medical library pertaining most directly to
the laboratory phase of the hospital's work, including texts,
charts, atlases and bound volumes of periodicals, has been moved
from its former quarters to the laboratory, and provided with new
bookcases for its care.

The apparatus for lantern slide projection and microphotog-
raphy, with its accompanying screen, has been moved to the
laboratory and placed in position, where it is hoped it will prove
useful for both photographic purposes and for demonstration to
the staff of lesions of interest occurring in the routine and special
examinations undertaken.

A considerable part of the current year has been spent in devis-
ing and executing methods designed for the more economical and
convenient storage of the large, and, from the laboratory stand-

18 WORCESTER STATE HOSPITAL. [Dec.

point, invaluable collection of slides and specimens which have
accrued during the fifteen years of the laboratory's activity. The
microscopic slides have been removed from the ordinary slide
boxes and filed in order in drawers fitted with cleats for their
reception, and the whole brains preserved from former autopsies
have been taken from their individual jars, wrapped in cheese
cloth, tagged, and preserved in a barrel of formalin solution.
These two methods have resulted in a very considerable saving
in storage space, and have yielded a supply of boxes and jars
which will be sufficient to care for all future slides and specimens
until they, too, have accumulated in sufficient quantity to be
similarly stored.

The card index of autopsied cases, arranged by chnical and an-
atomical diagnoses, has been brought up to date, and alphabetical
and numerical indices covering all autopsies of the fifteen-year
period have been completed.

The laboratory's share of the medical library has been cross-
indexed by the card system by title and author, and each book
marked with a serial library number.

During that part of the hospital year covered by this report,
i.e., Jan. 1 to Oct. 1, 1910, a total of 70 autopsies have been per-
formed. These cases represent 52+ per cent, of the total number
of deaths in the hospital during that period. This proportion of
autopsies to deaths, while a good one, has been exceeded in other
years, and it is hoped that it may be increased in the future.

The autopsied cases classified by clinical diagnoses were as
follows : —

General paralysis, 26

Senile psychoses, 14

Organic dementia, 10

Dementia prsecox, 5

Epileptic insanity, 4

Alcoholic psychoses, 3

Manic-depressive ii^ sanity, 2

Paranoid condition, 2

Acute delirium, 1

Involution melancholia, ■ . 1

Imbecility, 1

Morphinism, 1

1910.] PUBLIC DOCUMENT — No. 23. 19

The autopsied cases classified by the major anatomical diag-
noses were as follows : —

Acute colitis (bacillary dj^sentery), . . . . . . .11

Exhaustion, . . . ' 5

Carcinoma, 4

Cardiorenal, 4

Cellulitis, V 4

Chronic nephritis, 4

Pulmonary tuberculosis, 2

Pulmonary abscess, 3

Valvular heart disease, 3

Edema of lungs, 2

Lobar pneumonia, 3

Thrombosis, 2

Pyelonephritis, 2

Hypostatic pneumonia 2

Hemorrhagic pachymeningitis,

Arteriosclerosis,

Cerebral hemorrhage,

Cerebral softening,

Sarcomatosis,

Pulmonary infarct,

Ruptured heart,

Facial erysipelas,

General peritonitis,

Acute pleurisy,

Mastoiditis,

Strangulation by food,

Gummatous meningitis,

Decubitis,

Rupture of aneurysm,

Septicaemia,

Hemorrhagic ileocolitis,

Chronic colitis, •

Gangrene of intestines,

In all cases a complete microscopic examination of the trunk
organs is made. The brains were treated by two different meth-
ods. Those showing organic changes fitting them for examina-
tion by the total section process, and those warranting exhaustive
special study, were preserved in Mo in formalin. The remainder
were examined by a routine procedure which embraces the micro-
scopic study of sections from seventeen different areas, each in

20 WORCESTER STATE HOSPITAL. [Dec.

three different fixatives, for the display, respectively, of the cells,
fibers and neuroglia.

This amount of routine technique in addition to the record
keeping entails a large amount of technical and clerical work.
The laboratory enjoys the services of a clerical assistant who
takes care of the stenographic and some of the technical work.
The hospital pharmacist, who is a skilled microtomist, is at work
during the afternoons at the laboratory. The members of the
staff take part in the performance of the autopsies, both in the
actual sections and in the record taking.

The laboratory facilities are at all times at the disposal of the
staff for any special lines of investigation or study which they
may wish to undertake. The amount of material which would
repay intensive study is large, and much must be granted only a
cursory or routine examination on account of the restrictions of
time and opportunity, so that volunteer investigations are always
welcome.

During the year a number of especial investigations have been
undertaken and reports thereof will be published later.

During the summer months the hospital was visited by an
epidemic of dysentery, and an investigation was begun by the
pathologist, with the assistance of Mr. W. L. Dodd, a student of
the Massachusetts College of Pharmacy, who was at work in the
laboratory during August and September as a volunteer, through
the courtesy of the superintendent.

The investigation revealed that the epidemic was a dysentery
of bacillary origin, — due to the Bacillus dysenterice, Shiga type, —
and further experiments were undertaken to yield evidence, if
possible, of the method of transference of the infection from case
to case. The house fly has been held accountable for much such
transmission, and naturally was under suspicion here. To obtain
definite experimental data concerning the transportation of
bacteria by flies, a culture was obtained of a harmless organism
which is not native here, but which, bj^ means of its pigment
production, is easily recognizable on cultivation, — B. prodi-
giosus. Broth cultures of this bacillus were exposed in a part of
the hospital which was thickly infested with flies, and sterile wire
traps, baited with sterile sugar syrup, were set in five ward dining
rooms and in the scullery room of the kitchen. The flies caught

1910.] PUBLIC DOCUMENT — No. 23. 21

in the traps were taken to the laboratory daily and allowed access
to a plate of solid culture medium which was examined after
twenty-four and forty-eight hours for colonies of B. prodigiosus.

Within the six days of the experiment the test organism was
recovered from flies caught in every one of the six places where
traps were set, in spite of the fact that five of them were in ward
dining rooms which are completely screened.

These results serve to indicate the enormous activity of flies
in carrying organisms where the supply of flies is abundant and
the organisms available in quantities, and also suggest the in-
efficiency of screens as a means of defense.

The hospital is so situated in its grounds and with reference
to the surrounding community as to make it probable that the
majority, at least, of the swarms of flies about the buildings in
season is home grown. With this idea in view a survey of the
grounds revealed a number of badly infested breeding places for
flies, and it is anticipated that care of these plague spots through-
out another season will result in at least a very marked diminution
of the numbers of the flies, and consequently in the danger of other
similiar epidemic outbreaks.

The laboratory aims at two apparently diverse but ultimately
convergent ideals: (1) the solution of concrete clinico-pathologic
questions, such as those of epidemiologic origin and those of
diagnosis by means of histologic and bacteriologic methods as
applied both to the living cases and at necropsy; (2) research
problems. These studies are abstract, and at the time are often
devoid of practical application or even of promise of practical
value. The very intimate association of the accepted methods
of clinical microscopy of today, however, with the abstract re-
search problems of yesterday indicates their value.

Dr. E. E. Southard, the pathologist to the State Board of In-
sanity, has issued a circular letter to those State hospitals which
support laboratories aiming at a co-operative interchange of
material. Thus, if the pathologist of one hospital is making inten-
sive studies of one type of psychosis he can put material from such
a case to better use than would be afforded in another laboratory
where the pathologist is busy mth material of another class. A
movement is now under consideration looking toward an occasional
meeting of the pathologists from all the State hospitals for the

22 WORCESTER STATE HOSPITAL. [Dec.

purpose of discussing their various lines of work and better cor-
relating their endeavors. This laboratory is in entire accord with
Dr. Southard's suggestion, and is ready to turn over material of
value for special study to those laboratories enabled to make use
of it.

The pathologist here is preparing for an intensive study from
the stratigraphic aspect of the brains of imbeciles and defectives
and for purposes of control of the brains of normal children and
foetuses, and would, therefore, probably cover more thoroughly the
brains of such cases than would be done in the routine examina-
tion in the laboratory of a sister institution, where the more com-
plete examinations may be, for instance, reserved for cases of
epilepsy; and so would be glad to turn over material of the latter
sort to an investigator who would find it of more value than would
obtain here. This laboratory is also anxious to obtain the brains
from cases of long-standing amputation of a limb or loss of an eye,
etc., for the study of cortical cell changes by the serial method.

SAMUEL T. ORTON,

Patliologist.
Nov. 30, 1910.

1910.

PUBLIC DOCUMENT — No. 23.

23

PRODUCTS OF THE FARM

On Hand Dec. 1, 1910, and not delivered at the Hospital.

Apples, barrels,

. 355

Mangel-wurzels, bushels,

1,200

Beets, bushels,

. 400

Onions, bushels,

250

Cabbage, tons,

. 22.5

Parsnips, bushels, .

350

Carrots, bushels, .

. 350

Squash, winter, tons, .

15

Celery, boxes.

. 100

Turnips, bushels .

450

FARM ACCOUNT.

Dr.

Bread, $400 31

Butter, 1,207 76

Blacksmith and supplies, 472 69

Carriage and wagon repairs, 613 80

Current expenses, 1,317 78

Fertilizer, 671 00

Fish, 245 77

Fuel, 1,213 12

Furnishings, 108 54

Groceries, etc., 3,122 44

Harness and repairs, 45 21

Hay, grain, etc., 12,460 95

Ice, 186 00

Live stock : —

Cows, 130 00

Pigs, 45 00

Horses, 743 50

Meats, 2,261 24

Milk, 1,131 48

Repairs, 293 71

Seeds, .■ . 244 78

Sugar, 461 96

Tools, 304 54

Wages, \ 13,883 19

Water, 258 06

Net gain for year ending Nov. 30, 1910, ..... 9,805 70

$51,628 53

24 WORCESTER STATE HOSPITAL. [Dec.

Cr.

Apples, 739 barrels, . $2,217 00

Artichokes, 30 pounds, 60

Asparagus, 11.89 boxes, 53 51

Beans, Lima, improved, 65.75 bushels, 98 63

Beans, string, 76.5 bushels, 57 38

Beef, 2 sides, 565 pounds, 39 55

Beets, 345.75 bushels, 207 45

Blackberries, 727 quarts, 72 70

Cabbage, 21.1325 tons, 211 33

Carrots, 71.5 bushels, 42 90

Cauliflower, 50.83 boxes, 50 83

Celery, 558.16 boxes, 558 16

Cider, 2,691 gaUons, 269 10

Corn, green, 643 bushels, 482 25

Crab apples, 1 barrel, 3 00

Cucumbers, table, 53.5 boxes, 80 25

Cucumbers, pickle, 372 pecks, ■ . . 279 00

Currants, 530 quarts, 58 30

Egg plant, 8.23 barrels, 20 57

Hay, 5 tons, 105 00

Horse radish, 195 pounds, 9 75

Ice, 1,285 tons, 3,855 00

Lettuce, 487.83 boxes, 365 87

Leeks, 32 bushels, 16 00

Manure, 30 cords, 150 00

Milk, 361,871 quarts, 21,712 26

Onions, 447 bushels, 379 95

Parsley, 5.98 bushels, 2 99

Parsnips, 312 bushels, 312 00

Pears, 4 barrels, 7 00

Peas, green, 158 bushels, 158 00

Peppers, .5 bushels, 38

Pork, 40,484 pounds, 4,157 03

Radishes, 178.83 dozen bunches, 44 71

Raspberries, 86 quarts, 17 20

Rhubarb, 10,740 pounds, 214 80

Squash, winter, 18.22 tons, 546 60

Squash, summer, 20.5 barrels, 20 50

Spinach, 128 bushels, 51 20

Strawberries, 5,966 quarts, 596 60

Tomatoes, 532.5 bushels, 399 38

Tomatoes, green, 36 bushels, 18 00

Turnips, 202.5 barrels, 253 13

Amount carried forward, $38,195 86

1910.] PUBLIC DOCUMENT — No. 23. 25

Amount brought forward, $38,195 86

Bones, 4,000 pounds, 24 00

Grain bags, 2,050, 45 00

Hides, 65 pounds, ..." . 7 48

Livestock: — fei

Calves, 59, 576 00

Cows, 30, .... V 1,363 00

Pigs, 48, 810 84

Oats, 815 bushels, 448 25

Plants, tomato, 3,000, 37 10

Sand, 256 yards, 320 00

Swill, 2 lots, 24 00

Teaming, 990.5 days, 3,962 00

Labor of patients, 3,046 days, 3,046 00

Labor of farm attendants, 1,846 days, 2,769 00

$51,628 53

26 WORCESTER STATE HOSPITAL. [Dec.

OFFICERS AND THEIR SALARIES.

Residents.

Superintendent (per annum), $3,000 00

First assistant physician (per annum), 1,500 00

Assistant physician (per annum), 3, at 1,000 00

Assistant physician (per annum), 1, at 800 00

Assistant physician (per annum), 4, at 400 00

Superintendent of nurses (per annum), 900 00

Steward (per annum), 1.200 00

Matron (per annum), 800 00

Farmer (per month), 75 00

Nonresidents.

Pathologist (per annum), $2,000 00

Druggist (per week), 16 00

Auditor (per annum), . . . . ' 75 00

Clerk (per month), 75 00

Engineer (per week), 25 00

1910.1 PUBLIC DOCUMENT — No. 23. 27

VALUATION OF PERSONAL ESTATE.

Nov. 30, 1910.

Provisions and groceries, $13,115 48

Clothing and clothing material, 18,480 29

Furnishings, 114,050 61

Heat, light and power: —

Fuel, 2,042 00

All other property, 674 94

Repairs and improvements: —

Machinery and mechanical fixtures, 3,074 62

All other property, 4,580 04

Farm, stable and grounds: —

Live stock on the farm, 26,600 00

Produce of the farm on hand, 3,486 50

Carriages and agricultural implements, .... 11,530 85

All other property, 6,827 10

Miscellaneous, 15,947 91

$220,410 34

28

WORCESTER STATE HOSPITAL.

[Dec.

TREASURER'S REPORT.

To the Trustees of the Worcester State Hospital.

I respectfully submit the following report of the finances of
this institution for the fiscal year ending Nov. 30, 1910 : —

Balance Dec. 1, 1909,

Cash Account.

$8,596 28

Institution
Board of inmates: —
Private,
Reimbursements,

Salaries, wages and labor:
Wages not called for,

Receipts.

$45,203 51
20,387 12

$65,590 63
43 51

Food,

Clothing and materials.

Furnishings,

Repairs and improvements,

Miscellaneous,

Farm, stable and grounds: —
Cows and calves.
Pigs and hogs.
Hides,
Sundries,

Miscellaneous receipts: —

Interest on bank balances.

Rent,

Sundries,

$1,527 09

565 74

50 03

124 32

358 12

$1,939 00

1,986 63

7 48

320 75

$450 19
420 00
103 70

from Treasury of Commonwealth. •
Maintenance appropriations: —

Balance of 1909,

Advance money (amount on hand Novem-
ber 30)

Approved schedules of 1910, $261,675 33

Less returned, . . 237 90

2,625 30

4,253 86

973

$17,816 12

12,000 00

261,437 43

73,487 19

Special appropriations.

291,253 55
2,114 90

Total,

$375,451 92

1910.

PUBLIC DOCUMENT — No. 23.

29

Payments.

To treasury of Commonwealth, institution receipts, $73,487 19

Maintenance appropriations: —

Balance November schedule, 1909, . . 26,412 40

Eleven months' schedules, 191-0, . . . 261,437 43

November advances, ..... 4,371 78

Special appropriations : —

Approved schedules (less advances of November, 1909),

$365,708 80
2,114 90

Balance Nov. 30, 1910: —

In bank, $7,168 53

In office, 459 69

7,628 22

Total, $375,451 92

Maintenance.

Appropriation $316,300 00

(as analyzed below), 298,372 91

Balance reverting to treasury of Commonwealth,

$17,927 09

Analysis of Expenses
Salaries, wages and labor: —
General administration,
Medical service, .
Ward service (male), .
Ward service (female).
Repairs and improvements.
Farm, stable and grounds.

$26,965 97
13,144 54
20,642 78
19,666 28
14,541 78
15,581 23

$110,542 58

Butter,

Bread and crackers.

Cereals, rice, meal, etc..

Cheese,

Eggs,

Flour,

Fish, .

Fruit (dried and fresh),

Meats,

Milk,

Molasses and syrup.

Sugar,

Tea, coffee, broma and

Vegetables,

Sundries,

Clothing and materials : —
Boots, shoes and rubbers.
Clothing,

$1,808 36
8,006 06

80,012 90

Amounts carried forward,

$9,814 42 $190,555 48

30

WORCESTER STATE HOSPITAL.

[Dec.

Amounts brought forward,

$9,814 42 $190,555 48

Clothing and materials — Con.

Dry goods for clothing and small wares,

Furnishing goods,

Hats and caps, ....

Leather and shoe findings,

Sundries, .....

Furnishings : —

Beds, bedding, table linen, etc.,

Brushes, brooms.

Carpets, rugs, etc..

Crockery, glassware, cutlery, etc.,

Furniture and upholstery,

Kitchen furnishings.

Wooden ware, buckets, pails, etc.,

Sundries, ....

Heat, light and power: —

Coal, ....

Gas, .....

Oil

Sundries, . . - .

Repairs and improvements : —

Brick,

Cement, lime and plaster,

Doors, sashes, etc.,

Electrical work and supplies.

Hardware, .....

Lumber, .....

Machinery, etc., ....

Paints, oil, glass, etc., .

Plumbing, steam fitting and supplies.

Roofing and materials.

Sundries, .....

Farm, stable and grounds: —
Blacksmith and supplies.
Carriages, wagons, etc., and repairs,
Fertilizers, vines, seeds, etc.,
Hay, grain, etc., .
Harnesses and repairs,
Horses,
Cows,

Other live stock.
Rent,

Tools, farm machines, etc..
Sundries,

Miscellaneous: — •

Books, periodicals, etc..

Chapel services and entertainments.

Freight, expressage and transportation.

Amounts carried forward,

2,154 11

624 92

112 47

11 15

135 17

12,852 24

$8,421 11

670 08

773 52

1,512 34

1,278 22

536 83

72 20

1,130 35

14,394 65

$19,364 50

310 56

313 67

156 13

20,144 86

$1,239 81

1,156 55

349 98

2,162 52

982 23

4,288 31

806 12

1,871 97

1,966 90

717 30

2,936 04

18,477 73

$801 28

2,365 89

1,017 91

14,229 98

222 83

803 50

130 00

45 00

317 10

370 47

1,229 50

21,533 46

$1,003 17

521 00

892 90

$2,417 07

$277,958 42

1910.

PUBLIC DOCUMENT — No. 23.

31

Amounts brought forward,

$2,417 07 $277,958 42

Miscellaneous — Con.

Funeral expenses, . . .

Gratuities, .....
Hose, etc., .....
Ice, . . . . .' .

Medicines and hospital supplies, .
Medical attendance, nurses, etc. (extra),
Postage, .....
Printing and printing supplies,
Printing annual report.
Return of runaways, .
Soap and laundry supplies, .
Stationery and office supplies.
School books and school supplies, .
Travel and expenses (officials),
Telephone and telegraph,
Tobacco, .....

Water,

Sundries, .....

522 23

59 15

11 00

254 00

2,551 98
213 70
559 80
316 49
276 83
136 94

3,691 01
676 37
321 49
224 69
313 72
903 29

5,944 49

1,020 24

20,414 49

Total expenses for maintenance, ..... $298,372 91

Special Apphopkiations.

Balance Dec. 1, 1909,

$2,114 90

Total,

Expended during the year (see statement annexed) ,

$2,114 90
$2,114 90

Resotjeces and Liabilities.
Resources.

Cash on hand, $7,628 22

November cash vouchers (paid from advance money) , 4,371 78

Due from treasury of Commonwealth, account

November, 1910, schedule 24,935 48

Liabilities.

Schedule of November bUls,

$36,935 48
$36,935 48

32

WORCESTER STATE HOSPITAL.

[Dec.

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1910.1 PUBLIC DOCUMENT — No. 23. 33

STATEMENT OF FUNDS.

Patients' Fund.
Balance on hand Nov. 30, 1909, .... $4,063 22

Receipts, 2,113 80

Interest on bank balance, . . . . . 139 73

$6,316 75

Interest paid to State Treasurer, . . . 139 73

Refunded, 1,716 25

1,855 98

$4,460 77
Investment. ^^

Worcester County Institution for Savings, . $2,000 00
Worcester Five Cents Savings Bank, . . . 1,000 00
Balance Worcester National Bank, . . . 1,258 69
Cash on hand Dec. 1, 1910, . . . . . 202 08

$4,460 77

Lewis Fund.
Balance on hand Nov. 30, 1909, .... $1,334 41
Income, 55 70

$1,390 11

Expended vault rent, 6 00

$1,384 11
Investment. —

Chicago, Burlington & Quincy Railroad bond, $926 36

Worcester County Institution for Savings, . '342 60

Balance Worcester National Bank, . . . ': | 115 15

$1,384 11

Wheelek Fund.
Balance on hand Nov. 30, 1909, .... $5,035 55
Income, |,i 222 22

— $5,257 77

Expended for books, 106 40

$5,151 37

34 WORCESTER STATE HOSPITAL. [Dec. 1910.

Investment.
3 shares Worcester National Bank, . . . $570 00

American Telephone and Telegraph Company

bond,

Worcester County Institution for Savings,
Worcester Five Cents Savings Bank, .
Mechanics Savings Bank, ....
Balance Worcester National Bank,

Lawn Fund.
Balance Mechanics Savings Bank, Nov. 30, 1909,
Income,

Expended for plants, etc.,

712 50

1,600 00

1,719 47

154 18

395 22

S5,151 37

S635 18
25 64

$660 82
108 65

S552 17

Investment.
Mechanics Savings Bank, $552 17

M ANSON Fund,
Balance in Worcester County Institution for

Savings, Nov. 30, 1909, $1,445 81

Income, 58 38

$1,504 19

Investment.
Worcester County Institution for Savings, .... $1,504 19

Respectfully submitted.

H. M. QUINBY,

Treasurer of the Corporation.

Nov. 30, 1910.

Worcester, Mass., Dec. 9, 1910.

I hereby certify that I have this day compared the treasurer's statement of
funds for the year ending Nov. 30, 1910, with the books kept at the Worcester
State Hospital, and find it correct. I have also inspected the securities repre-
senting the investments and find their value is as stated.

GEO. L. CLARK,

Auditor of Accounts.

STATISTICAL TABLES

[Form pbescbibed by State Boakd of Insanity.;

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38

WORCESTER STATE HOSPITAL.

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PUBLIC DOCUMENT — No. 23.

39

Insane received on First and Subsequent Commitment.

Cases committed.

NUMBER OF THE COMMITMENT.

Males.

Females.

Totals.

First to this hospital,

Second to this hospital,

Third to this hospital,

Fourth to this hospital,

Fifth to this hospital,

Sixth to this hospital,

Eighth to this hospital

Tenth to this hospital,

277
20

I

240
12
5

2
1
1

1

517

32
10

4
2

1

1

Total cases,

304

264

568

Total persons,

303

264

567

Never before in any hospital for the insane, ....

245

217

462

Nativity and Parentage of Insane Persons first admitted to Any
Hospital.

PLACES OF NATIVITY.

Massachusetts,

Other New England States,

Other States, .

Total native.
Other countries: •
Armenia, .
Austria, .
Azore Islands,
Canada, .
Cape Breton,
China,
Denmark,
England, .
Finland, .
France,
Germany,
Greece,
Ireland, .
Italy,
New Brunswick,
Newfoundland,
Norway, .
Nova Scotia,
Prince Edward '.
Poland, .
Portugal, .
Russia,
Scotland, .
Sicily,
Society Islands,
Spain,
Sweden, .
Switzerland,
Syria,
West Indies,

Total foreign,
Unknown,

40

WORCESTER STATE HOSPITAL.

[Dec.

Residence of Insane Persons admitted from the Community.

Massachusetts (by counties) : —

Essex,

Hampden

Middlesex,

Norfolk,

Suffolk

Worcester,

Totals,

Cities or large towns (10,000 or over).
Country districts (under 10,000), .

First Admitted
TO Any Hospital.

47

Other
Admissions.

Two patients committed as insane found to be sane.

5. — Civil Condition of Insane Persons first admitted to Any Hospital.

Males.

Females.

Totals.

Unmarried,

108

98

206

Married, .

105

77

182

Widowed,

24

40

64

Divorced,

4

2

6

Totals,

241

217

458

Unknown

*

-

4

Totals

245

217

462

1910.

PUBLIC DOCUiVIENT — No. 23.

41

6. — Occupation of Insane Persons first admitted to Any Hospital.

Candy maker, .... 1

Saleswomen, .

. . 4

Cigar maker,

1

School teachers,

2

Cook,

1

Stenographer, .

. . 1

Domestics,

37

Storekeeper,

. . 1

Dressmakers,

5

Tailoress, .

1

Hair worker,

1

Vocalist, .

1

Housekeepers,

15

Waitresses,

. . 2

Housewives,

67

No occupation.

. . 52

Matron,

1

Milliners, .

3

Total,

. 216

Nurse,

1

Unknown,

. . 1

Operatives,

18

Peddler, .

1

Total,

. 217

Barbers, 3

Express agent, ... 1

Bartender,

Farmers, .

9

Bellboy, .

Fireman, .

1

Blacksmiths, .

Florists, .

2

Bookbinder,

Gardener, .

1

Bookkeeper,

I

Hostlers, .

3

Butcher, .

i-

Inventor, .

1

Cabinet makers,

Janitor,

1

Candy maker, .

Laborers, .

55

Canvasser,

Laundrymen,

2

Carpenters,

Lawyer. .

1

Carriage dealer.

Letter carrier.

1

Carriage maker.

Machinists,

9

Circulation manager

,

Mechanics,

5

Clerks, . .

Motorman,

1

Cooks,

Operatives,

37

Draughtsman, .

Painters, .

6

Electricians,

Pattern maker.

1

Elevator boy, .

Peddler, . ,

1

Engineers,

2

Plumbers, .

2

42

WORCESTER STATE HOSPITAL.

[Dec.

6. — Occupation of Insane Persons first admitted to Any Hospital — Con-
cluded.

iiALES — Concluded.

Porter, 1

Storekeepers,

. . . 2

Railroad brakeman,

Students, .

2

Railroad conductor,

Tailors, .

... 4

Real estate broker, .

Teamsters,

. . . 5

Registrar of deeds.

Waiters, .

. . . 3

Reporter, .

No occupation,

. 22

Salesmen, .

Ship builder,

Total,

. 234

Stable keeper, .

Unknown,

11

Stenographer, .

Stone masons, .

3

Total,

. 245

1910.]

PUBLIC DOCU]\iENT — No. 23.

43

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CO (N 00 '^ C^ CO lO O t^ lO 00 CQ CO (M CO CO (M 1> CO

3

to 1—1 7-i 1—1 CO '^ T-l 1— 1 1— 1 1—1

^
^

H

s

COi-l li-i(MC0t^05 1 CO >Ci cq CO O CO CO 1 (M (N

1-1 ^ rH CO 1-1 1-1

<

fe

1

COi— lOOCOl loot- l>(MCO|COCOCOI<MtOi-<

T^ r-l ^ ^ ^

«

^

^3 ^
O g

■ ...•••■I i

0) ^

p

sical.

uses, .

)ther caus

causes,

position,
sposition

auses,

sauses,

causes,
ses, .

and othe

Phy

ther cai

is,

is and c

d other

1 predis
1 predi

other c

other c

d other
,her cau
disease
disease

H

Alcohol, .
Alcohol and o
Arterioscleros
Arterioscleros
Childbirth,
Childbirth an
Congenital,
Constitutiona
Constitutiona
causes.

Heredity and
111 health,
111 health and
Involution,
Involution an
Opium and ot
Organic brain
Organic brain

1910.

PUBLIC DOCUMENT — No. 23.

45

(M (M 00 I I 1 ^

I I I (M (NOO I I 1 -^

(N (M i-H CO !>. 00 rH I I (N

<M T-H '^l (N I ,-( I I I

CI lOOO I I I (M

T-l I I I rH

(M I <M (N (M I I I 1

cq T-i T-H 00 CO

C0'*rH^iO(N(M7-li-lCq

CO 00 CO I— I 1 I CO

(M I I I iM

CO 00 '

(M T-H

S 1^

r^-^ C

o o g >; >..2 .2 ^ g

>; ^ 'H S q; >, >>,a^ « tH
OOP-icct/^ccasHHE-i

m ...

I . . . .

o

f-l

"^ .. .. .

t3 oT ^ oT 03

3 feJD 3^

>1 >.

S fij 6 ^ ^

PI o

46

WORCESTER STATE HOSPITAL.

[Dec.

9. — Probate Duration

of Mental Disease before Admission.

First admitted to Ant Hospital.

PREVIOUS DURATION.

Males.

Females.

Totals.

Congenital, .

11

15

26

Under 1 month, .

44

32

76

From 1 to 3 months.

42

32

74

3 to 6 months.

15

20

35

6 to 12 months.

24

18

42

1 to 2 years.

21

20

41

2 to 5 years.

36

29

65

5 to 10 years,

19

19

38

10 to 20 years,

7

13

20

Over 20 years, .

3

3

6

Totals, .

222

201

423

Unknown, .

22

15

37

Not insane, .

1

1

[2

Totals, .

245

217

462

Average kno-WTi duration (in years).

3.6

4.8

4.2

1910.

PUBLIC DOCUMENT — No. 23.

47

S^p

H

^ .,«..o o.,c=-o.-«oco^^c.^co «o>S-''S»"^ -"-

s

fe

s

. ,.,. co,«,ooo,coc.,..o. «.=„., ,«.o,2 . . .

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s

a

1

1

, >,ll ^ ,^ H ICOt-O 1^^ ICO |0.,^,,^<OC« 1^1

s

, , , , , , , ■ , ,c«, ,^, , ,^ ,^,^, ,«co,^ , , ,

^

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s

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-

fe

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'

g

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-

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s

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-

fa

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s

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^

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^

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s

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^

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fa

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i

K
m
<

m

P

O

A. — First admitted to any hospital: —

Acute hallucinosis

Alcoholic insanity, acute: —

Alcoholic depression,

Alcoholic hallucinosis,

Alcoholic katatonia

Delirium tremens

Alcoholic insanity, chronic: —

Alcoholic deterioration

Alcoholic hallucinosis,

Alcoholic paranoic condition, ....

Polyneuritic psychosis,

Constitutional inferiority

Delirium, acute

Dementia prsecox,

Epileptic insanity,

Exhaustion psychosis

General paralysis of the insane

Huntington's chorea,

Hysterical insanity

Imbecility

Involution psychosis

Manic-depressive insanity: —

Circular form

Depressed form

Manic form

Mixed form

Melancholia, involution

Melancholia, senile

Organic dementia,

Paranoic condition

Paranoic condition, senile

Senile dementia,

Toxic insanity, acute: —

Delirium,

Traumatic insanity

Not insane

1

48

WORCESTER STATE HOSPITAL.

[Dec.

T3

D

05 e<l-(CD 1 1 t^Mt^

1 ^t--e^'^30co^-

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1910.

PUBLIC DOCUMENT — No. 23.

49

1

i

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JO ^ t. O ^ ^ <M
CO

lis

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>

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liillll

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ill.
H t-i ^ g

50

WORCESTER STATE HOSPITAL.

[Dec.

a

•sFlox

i-Hiiiii-Hi "iiiii 1 1 iiii iiir

•saiBcaa^

1 '-I 1 IIII 1 1 1 1

•S8IBK

1 1 1 1 1 1 1 -H 1 ,M 1 1 1 1 1 1 1 IIII IIII

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1 1 1 1 1 1 1 1 1 llllll 1 1 ,111 IIII

II

■BiBiox

l,ll-H|,|| 1,1111 1 rt l|!M| ,111

•saiBraaj[

,111,1111 11,111 1 IIII

•sai^K

llllT^IIII llllll 1 -H |,<M| IIII

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•saiBpi

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53

•ei^^ox

-H , ,«^ 1 1 , 1 1 1 1 1^-, 1 ^ ,- 1 . - 1 1 1

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<1°

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1910.

PUBLIC DOCUMENT — No. 23.

51

" ' ' ' '^ '''"'"' -■'■-'"" - ' " ' "

to

CO

,,,,,,, ,, ■,,■,, , , . ■ ,^, , , , , , , . . , , ,

«

^

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o

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^

' "^" '^ .., 1 ,., 1...

1 ,-H, , , , , , , , , , , IC ^^, , ,^, ,^^ , , , . , , ,

-

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^

, 1 1 1 1 1 1 , 1 1- 1 1 1 . 1 1 , 1 1 IC, 1 1 , ,11, , , ,

^

II,,,,, , 1,1,,,,, ,,11111111 , , , 1 1 1 ,

'

,,,,,,, , 1 1 -> 1 1 1 , 1 , , , , , <N , , 1 , ,1,1 1 II

1 1 , l^-H 1 ^ 1 , ICOl 1 , 1 1 1 1 1 ,«, , , , , ,^1 , , ,

s

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w

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tl

^,^ ,«^ , c. , ,-^ , ,-, , ,-l IC. , 1 1 1 ,^ ,- , -■

oa

1 , , 1 — — 1 — 1 , -H-H I,— , |,«|,^|||, ,,1— , -H,

^

— 1— ,-4H,l — ,,,co,,,l ,,111—,,,, ,Cil,, 1 ,1

?3

, rt , .^— II ^ 1 — 1 M^^Mrt , , , , 1 t- , — , 1 — — II — 1 1

S

1 1 , , 1 1 , — ,,,,— , — — 11111—1,11 — ,,, , ll|05

1 — , — — , , CO , — , (M , — (^^ , ,,,,,=oi— 1, ,— ,, — 'M^S

— «-o.c.- o — C.C. — =o>o ., eg -^—

S

ll.,_ . -,-„-,.„ .— ,. , -i|.

0-, CO ,— c-^o, ,i,,„2'-i' '^'' - '-|2

Arteriosclerosis and septic arm from abra-
sion,

Endocarditis and lobar pneumonia, .

Ruptured heart,

Ruptured aneurysm of abdominal aorta, .

Valvular heart disease

Valvular heart disease and nephritis.
Venous thrombosis

IV. Diseases of the respiratory system: —

Broncho pneumonia, .....
Broncho pneumonia and cerebral hemor-
rhage

Broncho pneumonia and pulmonary abscess.
Hypostatic pneumonia, ....

Lobar pneumonia,

Pleurisy and influenza, ....

Pulmonary abscess

Pulmonary oedema,

Pulmonary tuberculosis

V. Diseases of the digestive system: —

Acute enteritis,

Chronic enteritis

Chronic enteritis and arteriosclerosis,
Carcinoma of stomach, ....

Carcinoma of tongue

Dysentery

Duodenal ulcer with hemorrhage.
Gangrene of intestines, ....
General peritonitis and tonsillitis,
Obstructive jaundice with oedema of lungs,

VI. Diseases of the genito-urinary system : —

Acute nephritis,

Chronic nephritis,

Chronic nephritis and broncho pneumonia,
Pyelonephritis

VII. Violence: -

Asphyxiation from food in larynx, .
Concussion of brain and scalp wound from

fall out of bed

Found dead (natural causes), ;

1

52

u

WORCESTER STATE HOSPITAL. [Dec

■BlB^ox i II Ill 1 1 1 1 1 r rill

•sajBraa^

•eaiBM

S

•SIB^Oi

•saiBma^

•saiBH

25

•SIB^Oi

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - 1 1 1 1 1- 1 1

•BajBraa^

1 1 ' 1 1 1 ' 1 II 1 1 'III 1- ' 1

•saiBM

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - 1

E-i'-'

•SIB'^OX

111,11111 I 1 1 1 1 1 , -H ,11, , , , ,

•BajBuiaj

' ' ' ' ' ' ' ' ' ' ' ' ' ' '

•saiBH 1 1 1 1 1 1 1 1 1 1 1 1 i 1 1 1 - .111 III,

•siB^ox

,11.1,111 >,,,,, 1 , 1,11 lO, 1 1

•saiBuia^

,1,11,1,1 ,1,1,1 1 , < r , , , -. , ,

■saiBH

,1,1,,,,, 1,1111 1 1 1 1 1 1 1 -< 1 1

Ml

•SIB^OX

1 1 1 1 1 1 1 , 1 , I- i 1 1 1 1 1 1 1 1 1 1 1 1

•saiBraa^

'''''''' ' 1 1 1 1 - 1 1 1 III

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1 1 1 1 1 1 1 1 1 11-111 1 1 1 1 1 1 1 1 1 1

a .

Z a ^

1 Q*-^

•siB^ox

,..,,,,11, ,,1111 1 « 1,1, -II,

•gaiBma^

l« 1 1 , , , , 1 1 1 1 1 1 1 1 1 1,11 - . 1 .

■saiBH

1,11111,1 I , , 1 , 1 1 - , , , , , , , ,

Eh

Q

o

p

I. General diseases: —

Cellulitis of leg from decubitus, .

Exhaustion

Exhaustion and arteriosclerosis, .
Exhaustion from general paralysis.

Facial erysipelas

Sarcoma (axillary), . . .

Sarcoma (.jaw),

Sarcomatosis (primary in kidney),

Septic arm from abntsion, ....

Septic arm from wound and broncho

pneumonia,

General septicaemia from decubitus, .
Septicaemia (unknown origin), . . .
Septicaemia from cellulitis of ankle, .
Septicffimia from cellulitis of back, .
Septicaemia from septic leg,
Septica>mia from leg ulcer and broncho

pneumonia, ......

II. Diseases of the nervous system: —

Cerebral hemorrhage,

Chronic internal hemorrhagic pachymen-
ingitis,

Gummatous meningitis

Status epilepticus,

Sub-dural hemorrhage,

III. Diseases of the circulatory system : —

Acute dilatation of heart, ....

Arteriosclerosis

Arteriosclerosis and acute endocarditis.
Arteriosclerosis and pulmonary oedema,

1910.1

PUBLIC DOCUMENT — No. 23.

53

1 1 1 1 1 1 1 1 > 1 , 1 1 1 1 , , 1 , 1 , -H , , , , , , 1 1 1 " 1 ,

-

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 .1 II

'

-

1 1 1 "-' 1 1 1 1 >■ 1 1 1 1 1 1 1 1 1 1 1 ^

c

1

i 1 1 1 1 1 1 1 1 1 1 ^ 1 1 1 1 1 1 1 1 1 o 1 1 1 1 1 1 1 1 1 II

05

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ^ 1 1 1 1 1 1 j 1 I II >n

1 1 1 1 1 1 1 1 1 1 1 ^ 1 1 1 1 1 1 1 1 1 CC 1 1 1 . 1 1 1 1 1 II

^

''''''' ' 1 1 ' 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

--

' ' ' 1 1 , 1 1 1 1 1 1 . f 1 1 1 1 1 1 , II

'

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 .

^

.111111 ^ , , ,^ , ,^ , , 1 i« 1 1 1 , , 1 ,1,1 , II

as

1 1 1 1 1 1 1 1 1 1 1- 1 1 1 1 1 1 1 -< 1 1 1 1 1 1 1 1 1 1 . II

1

- - h

' ' - 1 , . 1 , I-, 1 1 , , l-r. 1 , 1 1 1 . 1 1 1 1 ,

«

' ' ' 1 1 1 ., 1 1 1 1 1 1 1 11 11 1 ■ ,1

'

1 1 1 1 1 1 1 - 1 1 1 1 1 1 - 1 1 1 1 1 1 C. 1 1 , , 1,1, , , ,

lO

1 1 1 1 - 1 1 1^111,111 , 1 1 1 I-- 1 1 1 1 1 1 1 1 11

w

^

_

abra-
ta,

mor-

mgs,
onia
fron

Arteriosclerosis and septic arm from

sion,

Endocarditis and lobar pneumonia.
Ruptured heart, . . . • .
Ruptured aneurysm of abdominal aor
Valvular heart disease.
Valvular heart disease and nephritis.
Venous thrombosis,

IV. Diseases of the respiratory system: —
Broncho pneumonia, .
Broncho pneumonia and cerebral ht

rhage

Broncho pneumonia and pulmonary ab

Hypostatic pneumonia.

Lobar pneumon,ia.

Pleurisy and influenza.

Pulmonary abscess.

Pulmonary oedema.

Pulmonary tuberculosis,

V. Diseases of the digestive system: —
Acute enteritis, ....
Chronic enteritis.

Chronic enteritis and arteriosclerosis.
Carcinoma of stomach,
Carcinoma of tongue, .

Dysentery

Duodenal ulcer with hemorrhage.
Gangrene of intestines.
General peritonitis and tonsillitis, ^
Obstructive jaundice with oedema of _h

VI. Diseases of the genito- urinary system: -

Acute nephritis

Chronic nephritis.

Chronic nephritis and broncho pneum

Pyelonephritis

VII. Violence :-

Asphyxiation from food in larynx.
Concussion of brain and scalp wound

fall out of bed, .
Found dead (natural causes),

.3
1

54

WORCESTER STATE HOSPITAL.

[Dec.

i

o

s

<

K
H

<

W o

•sjinox

1 CO i-ICQ 05 CO CO 1 1

s-

?^i

•S8IBm9j[

1 1 1 cqtr^coco 1 1

>o I

lOCO

•ssi^H

1 COt-h 1 <N 1 1 I 1

CO 1

CO'*
00

0

0 13

•BlB^Oi

1 ,-1 CO cq CD t^ i-H T-H 1

<M

^i

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lO 1

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CO

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1 ^CO-H^ 1 1 1 1

O 1

, coco

CD

i

<;

o
i*
a

1

1

K
P
Q

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r-H CO C5 <:C> 00 T— 1 rH | |

O 1

CO

OiOO
^00

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1 COCOCOIO 1 ^ 1 1

00 1

00^

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^ '

,-1 CD

0

i

t

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§

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1-1 ^ 00 lO CO 1-1 1 1 I

Oi 1

CO

C5CO

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1 t--^^(MT-. 1 1 1

CO 1

00 lO

■sapK

^^-*l r-H r-l 1 1 1 1

^ 1

^s

K

2S

H a

(S
0

•siB(jox

t^ 1-1 lO CO i-i(M 1 1 1

^ '

OiO

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GO 1

00 o

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tO^ (M (M 1 T-( 1 1 1

C^

^^

0

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s

1

1

A. — Recovered: —

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, .

4^

S 2

1910.1

PUBLIC DOCUMENT — No. 23.

55

rH(M^coco^a5co(M

00 1

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