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Full text of "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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workshop. 
Construction of iron sta 





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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.; 






i-H «iira 



5:ss 







« BJD 



o s 



II 



38 



WORCESTER STATE HOSPITAL. 



[Dec. 



soob-or 



^1 I OOiOC 



CO I o 



ocnocnoo I oo 
t-h'o 






SS^i 



as 
^1 






■ o ® g^ £ oj -^o a^ 

fe fe fe fe fe S fe 5-g"gft*o og o 5 

^ "5 -3 -3 -5 -5 -3 fcf, c'-S 'S^^ M^ to 
c„.„^u^^^=^g-t5e>ad£eS 
00000005^ -sEsasss 

a s a s fi g a:5'-s -o 0:^0:^ 



a p 



PI 

000 

^as 



m 

c 9 o 



1910. 



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 



(Mi-li-Ht^TtHOOCC^OO 



COCOTtH0005I>OOCOC<l 



o o 

1^ CO 



rSo»^OiOOOOOO r/" 
■doOOOOOOOO^ 
mioO>OOiOOOOO 






44 



WORCESTER STATE HOSPITAL. 



[Dec. 





g 


ra 


CO(Nt>l 1 1 ItO ^^^|r-Hr-(^l ICNI 






1 


lOi-H .-1 




g 


H 






s 


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H 


CD 


CCt-I lllllr-l ll^lll^illl 




1 


1 






^ 


fe 










1 


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0OrHl>l 1 1 1^ ^^cOlrHrHl 1 |(M| 




-1 


TiH ,-1 ,-1 




< 


s 






■f 


-*i r- lo r-H lo 1-1 ao .-H T-H CO T-H M 00 00 CO (M i i-h co 


i 


kI 




.-1 CO CO 


m 


o 






& 


2 


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< 


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a 














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1 


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






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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 




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T^ r-l ^ ^ ^ 














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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 


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§ 


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s 


a 

1 


1 




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


s 


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


^ 


, , , , , ^,^, ,„«CO,^^,.^ .JOCOCOOO ,^, 


s 


1^ 


E-i 


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 11^ 


- 


fe 


1 1 1 1 1 1 1 1 1 1 1 III 


' 


g 


1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 -H 


- 


4 


H 


1 11,1 1 l..,^lo, ,„, IC, IC , , 1 IC,^ 1^1 


s 


f4 


1 l^ici^l . 1 . .-1 ICI , , , ICI^ , 1 , 


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s 




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- 


fa 


1 llll Illl-^IOOII-HIIITX 1 Cq-I 1 1 1 1 ^ 1 1 III 


s 


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


" 


H 5 


H 


, CC , 1 ^ico..^ I2< 1 1 1 1- IC. C.»^, ,1,11, II, 


^ 


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1 ICKlll MlllNlt^llll^l— CQCOMIIIIIII III 


^ 


S 


1 <M||| —ItO-HlMlt-llllllr-. im— lllllll III 


s 


1 


E-i 


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fa' 


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s 


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1 105I10 lllilNI 1 1 N-l 1 1 1 1 1 1 1 -H.-, 1 


^ 


5 


fa 


- iao-» ^coo-2°'S'"-^s '^;^s -^s^s '^-SS'^g ^"^ 


% 


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, ,^«« -c,2-c«-« ,„| ,«« It^CO, 1 l-OO^J. ««- 


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^- 


_, 


lO CO 


■73 








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1 1 1 1 1 lo ,-. 1 




^ 


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c, c.^», ,coco 




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1 1 


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, ■ , , , ,«^t~ 


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1 1 1 , , l« ,^ 


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1 1 1 1 1 J 1 1 1 


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c. 1 1 , 1 1 ICC , 


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1910. 



PUBLIC DOCUMENT — No. 23. 



49 



1 

i 


•siB^ox 


JO ^ t. O ^ ^ <M 
CO 


lis 


•sai^raa^ 


g5 t^ O T^l >-l T-H (M 


GO 00 CO 


•saiBH 


1 - '" ^ ' ' ' 


IIS 




•si^^oi 


1 2 CO ^ 1 1 1 


g g g 


•sajBuia^ 


CO O (M rH 1 1 1 


g s ^ 


•saiBM 


g O -. , 1 1 1 


o o ^ 


% 


•si^^oi 


^ 1 1 1 I 1 1 


^ ^ ^ 


■S8iBraaj[ 


1 1 1 1 1 1 1 


, , , 


•S9IBM 


-H 1 1 1 1 1 1 


^ ^ 


d 

1 


■siB:toi 


g CO 1 1 1 1 1 


(M (M CO 


•saiBin9^ 


O 1 1 1 1 1 1 

CO 


M ° ^ 


•S9IBIV 


o CO , • , 1 1 1 


Tt< T^ CO 


H 
> 


•siB^ox 


O C, , ^ , , 1 


05 as ^ 


•saiBina^ 


Oi ^ 1 ^ 1 1 1 


1-1 1-1 00 


•S9IBIV 


ir- T-H 1 1 1 1 1 


00 00 O 


-1 


•SITS^JOi 


lO t^ (N 1-1 1 1 T-H 


§ § ^ 


•S9IBra9^ 


t^ CC (N 1 1 1 ^ 


?? ?? ^ 


•saiBH 


00 O , ,-. , 1 , 


^ ^ ^ 


> 


■sF^ox 


'^l O (M (M 1-1 1-H 1-1 


CO XO CO 


•saiBoia^ 


rH lO <N (M 1-1 rH 1-1 


?? ^ 2 


•S9IBM 


CO '^ 1 1 1 1 1 


S^ S5 s:^ 


Si 

W 


1 


„ ^^ _- -^ 3 -i -- 

& ^ 1 ^ ^ ^ 1 
"III '^ 1 ^ 

liillll 

1 1 g 1 1 a 1 


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 


O -.J 

2 <! 


•SIB^OX 


icqii-^llll llllll 1 lllll IIMII 


•saiBinaj 


Icqil-Hliii llllll 1 1 IIII l-ill 


•saFM 


1 1 1 1 1 1 1 1 1 IIII 1 T^ 1 1 


IS 


•SFiox 


1-lll-Hll, II1-.II 1 1 IIII IIII 


•sai^raa^ 


,- 1 1 1- 1 1 , 1 , l-H, 1 , , 1,11 1,1, 


•sai^pi 


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 


'4 


•s^ox 


1-1,1111 1 rtT-<|lT-l I'JHIrt 


•saiBoia^ 


1^ II llllll 1 -1 IIII I-HII 


■S3IBK 


lllllllll llllll 1 1 -H|:^ leOlr-l 


li 

Q 


•sp^ox 


1 MrH |||.^|rt I-Hllll rH rH IIII 1 =0 rH rl 


•eaiBraa^ 


1 MrH llllll llllll 1 1 IIII 1 CO 1 rt 


•saiBpi 


llllll-Hl-H 1^1,11 rt rt IIII 1 Ci'* 1 


53 


•ei^^ox 


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


•saiBuiaj 


1 1 1 (M-1 IIII llllll 1 1 IIII IIII 


•S3IBH 


•H 1 1 ^ 1 1 1 1 1 IIII -H-H 1 U5 1 -H 1 , rt 1 1 , 


<1° 


•eiBcjox 


— ^" - -^^^ =^3^" 


■saiBuia^ 




•saiBjM 


^,,„^,^, , , o --C.^ ^CO-H^ 




Eh 

H 
P 


1 f -f , 

ii11ils!PJii.i:W Ml 

llllll iilMliaiMl i^Jlill lllll 

a p p 

M KB 



1910. 



PUBLIC DOCUMENT — No. 23. 



51 



" ' ' ' '^ '''"'"' -■'■-'"" - ' " ' " 


to 






CO 




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


« 






^ 




''■'''' - ' ' '- ,,,,.,,,. , 


o 




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


- 




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 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 




,111-11 - ,,11,1,1 ,,,,,-,,,, II-. 1 , , 


w 




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


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 


•saiBH 


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 


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abra- 
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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. 



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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 



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