Annual report of the trustees of the Worcester State Hospital

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Public Document No. 23

SEVENTY-NINTH ANNUAL REPOKT

THE TRUSTEES

Worcester State Hospital,

THIRTY-FOURTH ANNUAL REPORT OF THE TRUSTEES

WORCESTER STATE ASYLUM AT WORCESTER,

Year ending November 30, 1911.

BOSTON:

WEIGHT & POTTER PRINTING CO., STATE PRINTERS,

18 Post Office Square.

1912.

Public Document No. 23

SEVENTY-NINTH ANNUAL EEPOET

THE TRUSTEES

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Worcester State Hospital,

THIRTY-FOURTH ANNUAL REPORT OF THE TRUSTEES

WORCESTER STATE ASYLUM AT WORCESTER,

Year ending November 30, 1911.

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BOSTON,

WEIGHT & POTTER PRINTING CO., STATE PEINTEKS,

18 Post Office Square.

1912.

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VU.JL44

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Approved by
The State Board op Publication.

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CONTENTS

Report of Superintendent,
Laboratory Report,
Report of Treasurer, .
Statistics, ....

PAGE

17

Report of Trustees,

OFFICERS OF THE HOSPITAL.

TRUSTEES.

GEORGIE A. BACON Woecester.

SAMUEL B. WOODWARD Worcester.

GEORGE F. BLAKE, Worcester.

LYMAN A. ELY Worcester.

T. HOVEY GAGE, Worcester.

THOMAS RUSSELL, Boston.

CARRIE B. HARRINGTON, Worcester.

RESIDENT OFFICERS.

HOSEA M. QUINBY, M.D., .

. Superintendent.

THEODORE A. HOCH, M.D.,

. First Assistant Physician.

RAY L. WHITNEY, M.D., .

. Assistant Physician.

CORNELIA B. J. SCHORER, M.D.,

. Assistant Physician.

WILLIAM M. DOBSON, M.D., .

. Assistant Physician.

GEORGE A. McIVER, M.D.,

. Assistant Physician.

PAUL K. SELLEW, M.D., .

. Junior Assistant.

HARRY A. CLARK, M.D., .

. Junior Assistant.

WALTER M. CRANDALL, M.D., .

. Junior Assistant.

IDA A. McNEIL

. Superintendent of Nurses.

MULFORD H. CENTER,

. Steward.

LILA J. GORDON,

. Matron.

JOSEPH T. REYNOLDS,

. Farmer.

NONRESIDENT (

JFFICERS.

SAMUEL T. ORTON, M.D., .

. Pathologist.

GEORGE E. PARESEAU,

. Druggist.

GEORGE L. CLARK, .

. Auditor.

JESSIE M. D. HAMILTON, .

. Clerk.

JAMES DICKISON, Jr.,

. Engineer.

CONSULTING S

URGEON.

HOWARD BEAL, M.D.,

. Worcester

®t]e CommontDealtl} of ittasaactniseite

TRUSTEES' REPORT.

To His Excellency the Governor and the Honorable Council.

In submitting their seventy-ninth annual report, the trustees of
the Worcester State Hospital would respectfully call attention to
the fact, that, while the physical needs of the institution are great,
the most immediate are those which follow : —

First. — The congestion which has existed for some time con-
tinues, and causes conditions which would be deplored did they
affect normal persons, — conditions which, in the case of unfor-
tunate, dependent members of society seem neither humane nor
just.

To meet these conditions the trustees ask for an appropriation
of $86,100 to build and equip a new ward and to provide said ward
with an elevator. This would furnish accommodations for 100
male patients and provide adequate dining facilities for a large
number of both patients and attendants.

In connection with this proposed work, alteration of the Salis-
bury ward is greatly to be desired, and for this the trustees ask
for an additional $10,000.

This last amount was granted by the Legislature of 1911. The
request for this appropriation was based on the supposition that
the work was to be done in connection with that of a new ward.
As the appropriation was too small for the work to be done sepa-
rately, and as the proposed alteration did not seem desirable with-
out the new building, the trustees have not felt warranted in
undertaking the work.

Second. — The arrangement of the roof of the women's ward
which was completed last year has fully justified its expense, in
that it has afforded opportunities for out-of-door exercise for
many patients who otherwise would have received little or none of
the curative properties of fresh air and sunshine.

8 WORCESTER STATE HOSPITAL. [Dec.

These opportunities have been open only to able-bodied patients,
and in order that they may be extended to the weak, the feeble,
and the aged, the trustees ask for the sum of $2,100 for the con-
struction of a passenger elevator for this ward.

The sum of $4,200 was asked for last year so as to provide two
elevators, one for this ward and one for the proposed new ward
for men, and an appropriation not to exceed $2,100 was granted.
As the granting of this appropriation called for the construction
of two elevators, and as the amount appropriated was equal to
one-half of the lowest bid, it could not be used.

Third. — For a number of years the trustees have urged the
purchase of land, known as the Putnam and Curtis tracts, which
adjoins that of the hospital. Within the twelvemonth that is
past, 7 acres of the former have passed into the hands of the city
for hospital purposes. An intermediate strip remains, but, in
view of the fact that the owner has died and the estate is now in
the courts for settlement, no price upon it can be obtained.

The trustees do, however, urge the purchase of the Curtis tract
more strongly than ever. This lot contains 68| acres and is par-
ticularly well adapted for agricultural purposes. By its purchase
the food supply of the institution could be increased, employment
for a large number of patients could be provided, the matter of
sewage disposal could be developed at much less cost, and the
proximity of undesirable neighbors on that side of the hospital
be prevented. To purchase this land the trustees ask for $13,600.

Fourth. — The question of sewage disposal is a vital issue in the
life of every institution. During the past seven or eight years the
trustees have frequently called attention to the problem as it
relates to the Worcester State Hospital. The constant growth of
the institution, the ever-increasing size of the surrounding com-
munity, the installation of a hydrotherapeutic plant, and the
recent establishment of a congregate bath house have made it
next to impossible to properly care for the consequent drainage.
In the light of present conditions and the fact that the problem
is becoming more serious each succeeding year, the trustees urge
its immediate solution and ask for an appropriation with instruc-
tions regarding its expenditure.

Accompanying this report are those of the superintendent and
treasurer which contain more detailed statements regarding the
condition and needs of the institution

1911.] PUBLIC DOCUMENT — No. 23. 9

While the trustees wish to give expression to their appreciation
of the faithful services of the employees and all persons officially
connected with the hospital, they wish particularly to acknowledge
their gratitude for the generous, willing services and continued
interest of the superintendent who consented to continue in that
capacity pending the appointment of his successor.

Respectfully submitted,

GEORGIE A. BACON.
SAMUEL B. WOODWARD.
GEORGE F. BLAKE.
LYMAN A. ELY.
T. HOVEY GAGE.
THOMAS RUSSELL.
CARRIE B. HARRINGTON.

Nov, 30, 1911.

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, 1911, it being the seventy-ninth
annual report.

There remained at the hospital Oct. 1, 1910, 1,384 patients, —
694 men and 690 women. During the year ending Sept. 30, 1911,
there were admitted 636 patients, — 349 men and 287 women.
Six hundred and seventy-three patients — 369 men and 304
women — were dismissed from the hospital. Of this number 246
patients — 127 men and 119 women — were discharged; 153
patients — 84 men and 69 women — died; 169 patients — 90
men and 79 women — were transferred; and 105 patients — 68
men and 37 women — left on visit or escape, leaving at the end
of the statistical year 1,347 patients, — 674 men and 673 women.
Of this number, 1,096 were supported by the State, 145 by friends,
and 106 as reimbursing patients. Of the 415 patients discharged
and transferred, 76 (including 10 habitual drunkards, women)
were reported recovered, 76 capable of self-support, 27 improved,
and 223 not improved. Two women were discharged as not
insane. Fifty-four men and 54 women were transferred by the
State Board of Insanity to the Worcester State Asylum, 24 men
to the Gardner State colony, 6 men and 3 women to the Monson
State Hospital, 2 men and 2 women to the State Infirmary, Tewks-
bury, 2 women to the Northampton State Hospital, 1 man and 1
woman to the Westborough State Hospital, 1 man and 1 woman
to the Medfield State Asylum, 1 man and 1 woman to the McLean
Hospital, 1 woman to the Wellesley Nervine, 1 man to the Boston
State Hospital, and 1 woman to the Danvers State Hospital.
Thirty-two men and 18 women were removed from the State, and
14 women were boarded out.

There remained at the end of the year 37 patients less than at
the beginning. The smallest number under treatment on any

1911.] PUBLIC DOCUMENT — No. 23. 11

one day was 1,319, and the largest, 1,412. The daily average
number was 1,376.19.

The percentage of recoveries, calculated upon the number of
discharges and deaths, was 13.6; calculated upon the number of
admissions it was 11.9.

The death rate was 7.5 calculated on the whole number of
patients under treatment, and 11.2, calculated on the daily aver-
age number.

Training School for Nurses.

There are 5 nurses in this year's graduating class. While we
have been able to get a satisfactory number of probationers, we
have experienced greater difficulty in obtaining suitable young
women to train, and fewer nurses have been permitted to complete
the course. We have endeavored to maintain a high standard for
our graduates, and almost without exception they have availed
themselves of postgraduate courses in general hospitals in Worces-
ter, Boston, and elsewhere, after which they have established
for themselves good practices in the field of private nursing. A
number of our graduates also have positions of responsibility in
institutions.

During the past year 8 male attendants entered the training
school, but before the end of the year all had dropped out for
some reason. The training is open to all male attendants who
care to avail themselves of the opportunity.

The senior class will be much larger next year than the present
one, and about 65 will be enrolled in the junior class.

During the past year there were no epidemics of contagious
diseases among patients or employees. During the summer
months there were a number of cases of dysentery, confined to a
few wards, but the disease did not take on the epidemic character
of the year before. An important factor in preventing a more
serious epidemic was undoubtedly due to additional screening of
windows, and to the efforts to prevent fly breeding.

Meetings of the staff are held every Tuesday and Thursday at
11 A.M.

Weekly conferences and demonstrations have been given by
the pathologist in the laboratory, consisting of a course in the
anatomy and pathology of the nervous system, with demonstra-

12 WORCESTER STATE HOSPITAL. [Dec.

tions of specimens, both gross and microscopic. At the meetings
the autopsy material is also presented in its final and complete
form, slides are thrown upon a screen and the microscopical sec-
tions are demonstrated. These demonstrations have been attended
by members of the staff, as well as by a number of physicians from
Worcester.

At our clinical staff meetings it has been our custom to
present only special cases of importance or interest; cases with
questionable diagnosis, of unusual symptomatology or unexpected
recovery. At times special groups of cases are taken up for com-
parison and discussion, and again typical cases of mental disease
are shown for purposes of instruction.

Owing to the manner in which our clinical work is conducted,
every case appears for discussion and an interchange of opinions,
as the first assistant physician examines every patient admitted
to the hospital in the presence of the senior and junior physician.
At these times the case is discussed and directions are given for
the proper preparation of the records. The case is again brought
to the first assistant physician when completed, etc., and the
patient is examined by him before final discharge. In this man-
ner, though every patient is not brought before the whole staff,
the diagnosis has been passed upon by at least three of its mem-
bers.

Our system resolves itself practically into a daily bedside clinic,
the first assistant making daily round with various members of
the staff.

Early in the year we opened a tailor shop in one of the new
work rooms adjacent to the laundry, and several of our male
patients have been regularly employed, under the instruction and
oversight of a journeyman tailor, in repairing and pressing men's
suits as they come from the wash. We hope soon to be able to
extend this work and eventually to cut and make all of the outside
clothing used by our men.

The exterior woodwork of all the hospital buildings has been
repainted during the year, together with the walls in many of the
wards. The ceilings in the Lincoln and Appleton wards have
been removed and replaced. The work of enlarging the dining
rooms in the Lincoln wards, laying terrazzo floors, and putting
in a new food lift, with drying closets, etc., has been completed.

1911.] PUBLIC DOCUMENT — No. 23. 13

A granolithic walk has been laid from the main entrance of the
hospital grounds to the center building.

At the farm the old farmhouse which for several years had been
used as a storehouse for garden tools has been enlarged and the
exterior painted. The interior is now being rearranged to adapt
it for the use of our farmer and those of our farmhands, who are
now obliged to find lodgings off the grounds. The rough and
unsightly bank in the rear, heretofore used as a dumping place for
the refuse of the hospital, has been cleaned up and a retaining
wall built. Back of this cellars have been constructed for the
storage of vegetables, and the whole has been covered with an
enclosed shed 90 feet long for the housing of our farm tools.

In our reports of 1909 and 1910 certain plans were presented for
obviating the crowded condition of the hospital, and for furnish-
ing better dining-room facilities for our patients and attendants.
These plans provided for the building of a ward adjoining the
Salisbury ward, and for the raising of the Salisbury roof in order
to make this new building more accessible. Two elevators were
also asked for, one for the new ward, and one for the women's
ward then just completed. The Legislature of 1910 appropriated
$10,000 for altering the Salisbury wards, and $2,100 "for the con-
struction of two passenger elevators."

By thus selecting for approval a part of our plan, and rejecting
the remainder, the Legislature has placed us in something of a
dilemma, as no alteration in the Salisbury wards is desirable
except as a part of the entire plan proposed, and if desirable could
not be made separately, for the sum appropriated.

The amount appropriated for elevators is also inadequate,
being only one-half of their estimated cost.

For the above reasons it seemed best not to attempt work in
either of these directions this year, or until the whole matter could
be referred back to the Legislature for further consideration, and
I would, therefore, respectfully advise that our great need be
again called to the attention of the Legislature, with the request
that we be allowed to carry out the improvements outlined in
reports of 1909-10, and that the necessary appropriation be made
therefor. I would also renew the request for an appropriation for
the purchase of the Curtis land.

14 WORCESTER STATE HOSPITAL. [Dec.

The matter of the disposal of the hospital sewage is still in
abeyance, and should be settled at once.

The following changes occurred on the medical staff during the
year: —

Resignations.
Dr. Frank L. S. Reynolds, Jan. 31, 1911.
Dr. Frank H. Matthews, Feb. 23, 1911.
Dr. John Striegel, Oct. 7, 1910.
Dr. James H. Cook, June 6, 1911.
Dr. Harry Hagerty, Sept. 1, 1911.

Appointments.
Dr. George A. Mclver, senior assistant physician, Feb. 1, 1911.
Dr. Harry Hagerty, junior assistant physician, Jan. 2, 1911.
Dr. Paul K. Sellew, junior assistant physician, Oct. 18, 1911.
Dr. Harry A. Clark, junior assistant physician, Nov. 13, 1911.
Dr. Walter M. Crandall, junior assistant physician, Nov. 20, 1911.

We wish 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.

HOSEA M. QUINBY,

Superintendent.
Nov. 30, 1911.

1911.] PUBLIC DOCUMENT — No. 23. 15

LABORATORY REPORT.

To the Superintendent of the Worcester State Hospital.

The laboratory work for the current year, Oct. 1, 1910, to Oct.
1, 1911, has been carried on according to the plan outlined in the
last report.

The routine examination of all cases except those reserved for
more complete study has embraced the gross and microscopic
examination of all of the trunk organs, a bacteriological examina-
tion of material from three or four organs and an examination of
the brain by three methods for the display respectively of the
nerve cells, nerve fibers and neuroglia from six areas of each hemi-
sphere; one of the cerebellum, one of the medulla and three levels
of the cord, thus offering as comprehensive a review of the patho-
logical conditions as seems feasible for routine examination of all
cases.

An efficient addition to the laboratory equipment has been
made in the form of specially designed porcelain baskets for
embedding sections which have proven of value in the routine
and special work. A mercury vapor lamp giving a constant light
factor has been installed for use in gross photographs.

A photographic study of facial asymmetry in a variety of psy-
choses has been begun. One evening of each week has been
assigned to a laboratory staff meeting at which points of interest
occurring in the course of routine microscopic examinations are
demonstrated by means of lantern slides and micro-projection.
At first this work undertook only the demonstration of specimens
as they occurred in the regular autopsy series, but in order to
render the points illustrated more readily appreciable the routine
demonstrations have been supplanted for the time by a course
of lectures and demonstrations on the gross anatomy, histology
and histopathology of the central nervous system.

16 WORCESTER STATE HOSPITAL. [Dec.

At the completion of this course the routine autopsy examina-
tions will again be taken up for consideration, but it is planned to
offer these only on alternate weekly meetings, while the inter-
vening hours will be filled with lectures on general pathology in
order to render the lesions encountered in the trunk organs more
easy of interpretation.

A meeting of the pathologists of the various State hospitals
was held in this laboratory in April of this year and an organiza-
tion formed to further a co-operative interchange of material and
ideas.

The fly problem has received more attention during the sum-
mer and the results seem to justify the hope that the pest may be
practically eradicated next year. The pigpens have been removed
and the cleaning up of the refuse has excluded one of the most
active sources of fly production. Attention to the prompt spread-
ing of barley malt and other fertilizers has also aided in reducing
the available breeding places. Two places remain, however, and
toward one of these attention has been chiefly directed this sum-
mer. This is the pit at the stable. This is a masonry pit with
a wooden floor, and during the summer of 1910 was found to be
only a limited producer on account of its comparative fly tight
construction. During the early part of the summer of 1911 there
were very few flies about the stable, but in July they began to be
noticeable, and examination showed that the year's wear has
resulted in the appearance of a number of cracks in the floor allow-
ing the flies easy access to the manure. These were stopped up
and a specially constructed fly trap erected and emptied daily
and counts made of the catch, in the hope that rendering the pit
tight would reduce or abate the breeding. It was soon found,
however, that unless the manure was removed from the stalls
into the bin as soon as it was dropped the flies had sufficient access
to thoroughly impregnate it with eggs, so that the pile in the
bin was receiving a daily seeding, while the opening of the trap-
doors gave opportunity for the escape of many of the new genera-
tion. For this reason a trap was constructed to be mounted on
the door of the bin in such a way that it admitted a broad band
of light to attract the flies and yet trapped them and held them to
die by starvation. This trap has a large capacity and the advan-
tage that it requires no care except an occasional emptying, and

1911.] PUBLIC DOCUMENT — No 23. 17

yet in an otherwise light-tight bin serves as an ample attraction
without baiting. Between August 1 and October 5 this trap,
with no attention, caught and killed over a gallon of flies. This
experiment was so successful that its enlargement to meet the
conditions at the farm barn was attempted. The farm barn
offered the only remaining breeding place, and toward the end
of the summer was producing flies at a tremendous rate. Eight
large traps were constructed and the doors to the manure cellar
closed and made tight. The result of this closing of the doors,
however, was to give origin to so much steaming of the manure
piles as to necessitate their reopening for ventilation. This con-
dition might probably be remedied by the installation of a system
of drains to withdraw the excess of water and leave the piles dry.
Tight closure of the cellar would then in all probability serve to
greatly reduce the number of flies, while properly distributed traps
would effect the destruction of the reduced brood.

In spite of the noticeable reduction of the total number of flies
about the institution in the early months of the summer, the total
number of cases of bacillary dysentery was large. In the investi-
gation of 1910 the fly was believed to be the chief factor (though
not necessarily the only one) in the distribution of this infection.
If these conclusions be correct the cases of this summer suggest
that while the pest was reduced it was still present in numbers
sufficient to distribute the contagion. In 1910 there were 136
cases and 22 deaths. The statistics for 1911 cover a slightly
longer period and show 99 cases with 14 deaths. This yields a
morbidity percentage, calculated against the daily average popu-
lation, of 9.9+ for 1910, and 7.2+ for 1911 and a mortality per-
centage, calculated against the number of cases of dysentery, of
16.1+ for 1910 and 14.1+ for 1911.

The lack of a more serious outbreak this summer when repaint-
ing required the removal of all the ward screens for some time
argues well for the efforts at fly eradication and promises a great
reduction when this line of attack is prosecuted as far as possible.

The proportion of autopsy permissions to total deaths for the
past year has been discouraging. In 1910, with 176 deaths, the
number of autopsies was 85, or 48+ per cent.; in 1911, with 153
deaths, 47 or 30 + per cent. This reduction parallels the experi-
ence of many laboratories in this part of the country.

18 WORCESTER STATE HOSPITAL. [Dec.

The psychiatric diagnoses of autopsied cases were : —

General paralysis, ~ 13

Senile psychoses, 11

Organic dementia, 5

Alcoholic psychoses, 4

Dementia praecox, 4

Involution melancholia, 3

Epileptic insanity, 2

Manic-depressive insanity, 2

Paranoid condition, 2

Acute delirium, 1

The major anatomical diagnoses were : —

Cardiorenal, 6

Lobar pneumonia, 4

Broncho-pneumonia, 4

Cerebral softening, 3

Acute colitis, 3

Valvular heart disease, 3

Pulmonary tuberculosis, 2

Pulmonary embolism, 2

Cerebral hemorrhage, 2

Tumor of brain, 2

Carcinoma, 2

Acute pyelonephritis,

Acute nephritis,

Subdural hemorrhage,

Chronic internal hemorrhagic pachymeningitis,

Cholecystitis,

Lesions of tj^phoid fever,

Empyema,

Multiple fractures,

Gangrene of leg,

Cellulitis of leg,

Exhaustion of general paralysis, ........

Osteitis deformans,

Acute hemorrhagic encephalitis,

Septicaemia from fractured ribs,

SAMUEL T. ORTON,

Pathologist.
Nov. 30, 1911.

1911.

PUBLIC DOCUMENT — No. 23.

19

PRODUCTS OF THE FARM

On Hand Dec. 1, 1911, and not deliveked at the Hospital.

Apples, barrels,

858

Mangel-wurzels, bushel

3, . 1,600

Beets, bushels,

620

Onions, bushels, .

. 320

Cabbage, tons, . . .

19

Parsley, bushels, .

4

Carrots, bushels, .

450

Parsnips, bushels, .

. 325

Celery, boxes,

200

Squash, winter, tons,

. 11.5

Cucumbers, pickle, pecks,

584

Turnips, barrels, .

. 303

Cauliflower, boxes,

12

FA

RM ACCOUNT.

Dr.

Bread, $366 47

Butter, 1,027 60

Blacksmith and supplies, 560 57

Carriage and wagon repairs, 98 73

Current expenses, 1,275 14

Fertilizer, 386 59

Fish, 231 71

Fuel, • . 1,013 65

Furnishings, 826 03

Groceries, etc., . 3,021 42

Harness and repairs, 51 30

Hay, grain, etc., 9,019 98

Ice, 255 60

Live stock: —

Bulls, 78 00

Horses, 650 00

Pigs, 35 00

Meats, 2,175 79

Milk, 1,543 68

Repairs, 531 26

Seeds, 216 42

Sugar, 498 90

Tools, 125 36

Wages, 14,929 86

Water, 315 74

Net gain for year ending Nov. 30, 1911, 11,556 73

$50,791 53

20 WORCESTER STATE HOSPITAL. [Dec.

Cr.

Apples, 673 barrels, . $1,682 50

Asparagus, 21 boxes, 73 50

Beans, Lima, improved, 69.5 bushels, Ill 20

Beans, string wax, 48 bushels, 38 40

Beans, string green, 47 bushels, 42 30

Beef, 6 sides, 1,944 pounds, 116 64

Beets, 433.25 bushels, 259 95

Blackberries, 284 quarts, 39 76

Bran, 100 pounds, 1 50

Cabbage, 24.9205 tons, 623 01

Carrots, 286.25 bushels, 214 69

Cauliflower, 62.5 boxes, 78 12

Celery, 354.25 boxes, 318 83

Cider, 3,066 gaUons, 306 60

Citron, 112 pounds, 112

Corn, green, 875 bushels, 875 00

Cucumbers, table, 122.5 boxes, 91 88

Cucumbers, pickle, 584 pecks, 175 20

Currants, 194 quarts, 21 34

Grain bags, 1,585, 31 70

Hay, 4.5 tons, 94 50

Hides, 270 pounds, 28 01

Ice, 1,200 tons, 3,600 00

Lettuce, 438.83 boxes, 219 42

Live stock: —

Bulls, 3, 310 00

Calves, 56, 721 00

Cows, 7, 370 00

Horses, 2, 200 00

Pigs, 161, 872 52

Manure, 30 cords, 180 00

Milk, 393,746 quarts, 23,624 76

Muskmelons, 19 crates, 33 25

Oats, 630 bushels, 283 50

Onions, 381.25 bushels, 419 38

Parsley, 9.25 bushels, 4 62

Parsnips, 385.5 bushels, 28 91

Peas, green, 115 bushels, 230 00

Peppers, 1.5 bushels, 11 25

Plants, celery and tomato, 4,027, 35 27

Pork. 39,156 pounds, 3,414 22

Potatoes, 96 bushels, 86 40

Radishes, 154 dozen bunches, 46 20

Amount carried forward, $39,916 45

1911.] PUBLIC DOCUMENT — No. 23. 21

Amount brought forward, 139,916 45

Rhubarb, 10,730 pounds, 214 60

Sand, 311 yards, 370 00

Skins, calf, 3, ...._..... 4 90

Squash, winter, 16.91 tons, 591 85

Squash, summer, 48.83 barrels, . . . . . . . 48 83

Spinach, 164 bushels, 65 60

Straw, 1,500 pounds, 7 50

Strawberries, 5,050 quarts, 606 00

Tomatoes, ripe, 427 bushels, 320 25

Tomatoes, green, 24 bushels, 12 00

Turnips, 165.36 barrels, 181 90

Veal, 215 pounds, 23 65

Labor of patients, 2,552 days, 2,552 00

Labor of farm attendants, 1,600 days, 2,400 00

Teaming, 869 days, 3,476 00

$50,791 53

22 WORCESTER STATE HOSPITAL. [Dec.

VALUATION OF PERSONAL ESTATE.

Nov. 30, 1911.

Provisions and groceries, $4,659 32

Clothing and clothing material, 17,160 87

Furnishing, 111.624 24

Heat, light and power: —

Fuel, 4,408 72

All other property, 1,381 98

Repairs and improvements: —

Machinery and mechanical fixtures, 3,803 88

All other property, . . 4,080 04

Farm, stable and grounds: —

Live stock on the farm, 25,914 50

Produce of the farm on hand, 5,433 25

Carriages and agricultural implements, . . . . 11,172 55

All other property, 9,549 55

Miscellaneous, 18,795 25

$217,984 15

1911.

PUBLIC DOCUMENT — No. 23.

23

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, 1911: —

Cash Account.

Balance Dec. 1, 1910,

Receipts.

$7,628 22

Institution Receipts.

Board of inmates: —

Private,

$43,937 30

Reimbursements, insane,

18,001 36

Cities and towns,

120 71

$62,059 37

Ssles: —

Food,

$1,910 87

Clothing and materials,

482 91

Furnishings,

12 17

Heat, light and power,

35 75

Repairs and improvements,

258 84

Miscellaneous,

274 32

Farm, stable and grounds: —

Cows and calves,

1,353 50

Pigs and hogs,

922 52

Hides,

29 81

Sundries,

294 49

5,575 IS

Miscellaneous receipts: —

Interest on bank balances,

$544 04

Rent,

420 00

964 04

Receipts from Treasury of Commonwealth.
Maintenance appropriations: —

Balance of 1910, . . . .

Advance money (amount on hand November

30)

Approved schedules of 1911, $276,918 00

Less returned, ... 58 81

$24,935 48
12,000 00

276,859 19

68,598 59

Total, $390,021 48

24

WORCESTER STATE HOSPITAL.

[Dec.

Payments.
To treasury of Commonwealth, institution receipts,
Maintenance appropriations: —

Balance November schedule, 1910,

Eleven months schedules, 1911,

November advances, .....

$32,563 70
276,859 19

3,489 14

$68,598 59

312,912 03

Balance Nov. 30, 1911: —

In bank $8,035 66

In office, 475 20

8,510 86

Total, . $390,021 48

Maintenance.

Appropriation, $303,000 00

Expenses (as analyzed below), ....... 302,932 94

Balance reverting to treasury of Commonwealth,

$67 06

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

Food:

Butter,

Beans,

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, .....
Dry goods for clothing and small wares,

Amounts carried forward,

$28,775 16

13,645 09

24,178 39

24,163 41

20,409 02

17,091 94

$128,263 01

$14,543 81

968 09

433 41

1,440 72

775 30

5,551 15

8,458 10

4,269 67

2,723 81

20,369 27

486 00

498 84

6,147 83

1,949 49

4,191 85

2,088 62

74,895 96

$2,248 84

3,480 45

2,366 12

$8,095 41

$203,158 97

1911.

PUBLIC DOCUMENT

Amounts brought forward,

Clothing and materials — Con.
Furnishing goods,
Hats and caps, .
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
Roofing and materials,
Sundries, .

supplies,

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,
Funeral expenses, . . .

No. 23. 25

$8,095 41 $203,158 97

383 83
172 51
48 51

$6,051

55

586 40

357 82

559

02

736 63

444

82

59 44

1,055

62

9,851 30

$24,661

65

328

17

240

20

294

26

25,524 28

$278 85

1,266

08

633

54

1,651

22

1,549

8b

2,992

72

65

30

6,523

54

1,834

94

58

00

4,189

35

21,043 40

$820

65

841

90

901

21

9,772

28

165

13

650

00

78

00

35 00

288

91

298 03

2,255

86

16,106 97

$582

35

706

20

616

77

554

00

Amounts carried forward,

$2,459 32 $284,385 18

26

WORCESTER STATE HOSPITAL.

[Dec.

Amounts brought forward,

Miscellaneous — Con.
Gratuities, .
Hose, etc., .

$2,459 32 $284,385 18

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, .....

Total expenses for maintenance,

50 60

11 00

306 00

2,762 07

86 97

414 40

34S 11

175 20

119 00

2,932 80

646 41

128 52

219 67

354 06

1,262 35

5,184 82

1,086 46

18,547 76

$302,932 94

Special Appropriations.
Appropriations for fiscal year, ....... $12,100 00

Balance November 30, 1911 $12,100 00

Resources and Liabilities.
Resources.

Cash on hand, $8,510 86

November cash vouchers (paid from advance money) , 3 ,489 14
Due from treasury of Commonwealth account

November, 1911, schedule 14,073 75

Liabilities.

Schedule of November bills,

$26,073 75

$26,073 75

Per Capita.
During the year the average number of inmates has been 1,370.55.
Total cost for maintenance, $302,932.94.
Equal to a weekly per capita cost of $4.24.
Receipts from sales, $5,575.18.
Equal to a weekly per capita of $0.0780.
All other institution receipts, $63,023.41.
Equal to a weekly per capita of $0.8819.

1911.1

PUBLIC DOCUMENT — No. 23.

27

a
n

$10,000 00
2,100 00

o
o

o
o

Is
8*

' '

l

-a!

i i

1

a

I

$10,000 00
2,100 00

o

o

o
o

1
s

M

0

o

«!

Res. 1911, chap. 510
Res. 1911, chap. 510

1
eg
O

Altering and repairing Salisbury ward, .

Two passenger elevators,

>H

8

PQ

,*

^

£

bs

^

I— i

|

P

C

4 e

a

'*

w

1.1

a

J

<5 -^

3

£

w

J2?

d

ti
ti

3

S

-sj

4)

o

«

28 WORCESTER STATE HOSPITAL. [Dec.

STATEMENT OF FUNDS.

Patients' Fund.
Balance on hand Nov. 30, 1910, . . . . $4,460 77

Receipts, 3,066 50

Interest on bank balance, 165 69

$7,692 96

Interest paid to State Treasurer, . . . $165 69

Refunded, 2,523 76

2,689 45

$5,003 51

Investment. ~~

Worcester County Institution for Savings, . $2,000 00
Worcester Five Cents Savings Bank, . . . 1,000 00
Balance Worcester National Bank, . . . 1,838 22
Cash on hand Dec. 1, 1911, 165 29

$5,003 51

Lewis Fund. =

Balance on hand Nov. 30, 1910, .... $1,384 11
Income, 103 20

$1,487 31

Expended vault rent, 6 00

$1,481 31
Investment. —

American Telephone and Telegraph Company

bond, $926 36

Worcester County Institution for Savings, . 342 60

Balance Worcester National Bank, . . . 212 35

$1,481 31

Wheelee Fund.
Balance on hand Nov. 30, 1910, .... $5,151 37
Income, 239 10

$5,390 47

Expended for books, 103 20

$5,287 27

1911.] PUBLIC DOCUMENT — No. 23. 29

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,

712 50

1,600 00

1,719 47

160 40

524 90

$5,287 27

Lawn Fund.
Balance Mechanics Savings Bank, Nov. 30, 1910, $552 17

Income, 19 56

$571 73

Expended for plants, etc., 136 59

$435 14

Investment.
Mechanics Savings Bank, $435 14

Manson Fund.
Balance Worcester County Institution for Sav-
ings, Nov. 30, 1910, . " $1,504 19

Income, 60 46

$1,564 65

Investment.
Worcester County Institution for Savings, .... $1,564 65

Respectfully submitted,

H. M. QUINBY,

Treasurer of the Corporation.

Nov. 30, 1911.

Worcester, Mass., Dec. 7, 1911. '
I hereby certify that I have this day compared the treasurer's statement of
funds for the year ending Nov. 30, 1911, with the books kept at the Worcester
State Hospital, and find it correct. I have also inspected the securities represent-
ing the investments and find their value is as stated.

GEO. L. CLARK,

Auditor of Accounts.

STATISTICAL TABLES

[FOHM PRESCRIBED BY STATE BOARD OF INSANITY.

1

1

s

0

a
PS

<

1

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Patients in the hospital Sept. 30, 1910,
Viz.: regularly committed,
emergency,
voluntary,
temporary care,
Admitted within the year,
Viz.: by regular commitment, .
emergency,
temporary care,
viz.: observation, .
others, .
by transfer,
from visit,
from escape,
Nominal admission for discharge,
Viz.: from visit, .
from escape,
Whole number of cases within the year
Dismissed within the year, .
Viz.: discharged,

as recovered,

as capable of self support,
as improved,
as not improved, .
as not insane,
died, ....
transferred,

escaped, ....
on visit Oct. 1, 1911,
Nominal dismissals for commitment,

34

WORCESTER STATE HOSPITAL.

[Dec.

DJ

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persons withi
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voluntary,
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supported

r of differen
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1911.

PUBLIC DOCUMENT — No. 23.

35

2. — 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

Sixth to this hospital,

Eleventh to this hospital,

260
22

1

202
11

7

1

462
33

8

1

Total cases,

Total persons

Never before in any hospital for the insane,

288

222
227
190

505
515
429

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

Males.

Females.

Totals.

PLACES OF NATIVITY.

fl

■g

^

^

.2
1

1

1

.2
I

&

o

.2

o

Massachusetts, ....

87

24

27

51

26

28

138

50

55

Other New England States, .

22

17

21

19

17

17

41

34

38

Other States

13

, 7

8

8

7

8

21

14

16

Total native, . .

122

48

56

78

50

53

200

98

109

Other countries: —

Armenia,

2

2

2

-

-

-

2

2

2

Austria

1

-

-

3

3

3

4

3

3

Azore Islands

1

»

3

1

1

2

4

4

Canada

14

20

17

15

17

17

29

37

34

Denmark,

_

-

-

1

1

1

1

1

East Indies

1

-

-

-

-

1

-

-

England

5

6

8

14

12

14

20

20

Finland,

4

4

4

2

2

6

6

6

France,

_

2

2

-

Germany,

3

5

4

1

1

4

6

5

Greece,

1

1

1

1

1

2

2

2

Holland,

1

1

1

1

-

2

2

Ireland

38

87

85

43

61

58

81

148

143

Italy

8

7

7

4

4

12

11

11

New Brunswick, ....

7

5

7

2

2

13

7

9

-

-

-

-

1

1

-

1

Norway,

Nova Scotia,

_

1

_

1

1

1

2

1

4

2

1

5

6

7

9

8

8

Prince Edward Island, .

3

2

2

_

-

1

3

2

3

Poland

4

3

3

1

1

1

5

4

4

Russia

10

10

10

8

7

7

18

17

17

Scotland,

2

8

5

3

5

3

5

13

8

Sweden,

5

6

6

5

6

6

10

12

12

Turkey,

2

2

2

-

-

-

2

2

2

Total foreign

115

177

168

110

134

130

225

311

297

Unknown,

2

14

15

2

6

7

4

20

22

Totals

239

239

239

190

190

190

429

429

429

36

WORCESTER STATE HOSPITAL.

[Dec.

If.. — Residence of Insane Pe

rsons

admitted j

rom the Community.

First admitted

to Any

Hospital.

Other
Admissio

NS.

Totals.

PLACES.

1

1

1

1

"3

s

1

s

"3

£

o

Massachusetts (by counties) : —

Berkshire,

-

1

i

-

-

-

-

1

1

Bristol, .

1

-

i

-

-

-

1

-

1

Hampden,

-

"

-

1

-

1

1

"

1

Middlesex,

85

66

151

17

13

30

102

79

181

Norfolk, .

4

3

7

2

1

3

6

4

10

Suffolk, .

49

37

86

8

6

14

57

43

100

Worcester,

100

83

183

21

17

38

121

100

221

Totals,

239

190

429

49

37

86

288

227

515

Cities or large towns (10,000 or over),

197

167

364

43

32

75

240

199

439

County district

s (un

der 1

0,000), .

42

23

65

6

. 5

11

48

28

76

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

Males.

Females.

Totals.

Unmarried

121

73

194

Married,

91

77

168

Widowed

24

37

61

Divorced,

1

3

4

Totals

237

190

427

Unknown,

2

-

2

Totals

239

190

429

1911.] PUBLIC DOCUMENT — No. 23. 37

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

Candy maker, 1

Seamstresses,

. . 2

Clerk,

1

Stenographer,

. . . 1

Companion,

1

Student, .

. . . 1

Copyist, .

1

Tailoresses,

. . . 3

Domestics,

32

Teacher, .

1

Housekeepers,

13

No occupation,

. 44

Housewives,

73

Laundresses,

4

Total,

. . . 190

Milliner, .

1

Unknown,

0

Nurses,

2

Operatives,

9

Total,

. . . 190

Males.

Acrobat, ....

1

Florist, 1

Barbers, ....

2

Gardener, .

1

Blacksmiths, .

4

Glass worker, .

1

Butchers, ....

2

Grocer,

1

Carpenters,

16

Harness maker,

1

Chauffeur,

1

Hostler,

1

Chair worker, .

1

Janitor,

1

Chemist, ....

1

Junk collectors,

2

Christian Science healer,

1

Laborers, .

50

Clerks, ....

14

Laundryman, .

1

Coachmen,

2

Machinists,

4

Comb makers, .

2

Managers,

3

Cook, ....

1

Mechanic,

1

Cooper, ....

1

Merchants,

2

Dentist, ....

1

Moulders,

3

Druggist, ....

1

Operatives,

27

Electricians,

2

Painter,

1

Engineers,

3

Paper boy,

1

Errand boy,

1

Pedler,

1

Farmers, ....

11

Piano workers,

2

Fireman, ....

1

Piano tuner,

1

Fisherman,

1

Plumber,

1

38

WORCESTER STATE HOSPITAL.

[Dec.

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

Males — Concluded.

Printers, .

3

Umbrella maker,

1

Rabbi,

Waiter,

1

Railroad conductor,

Watchmen,

. . 2

Sea captain,

Wire workers, .

2

Stenographer, .

No occupation,

. . 25

Student, .

Tailor,

Total, . •.

. 229

Teamsters,

8

Unknown,

. . 10

Tinsmith, .

1

Traders, .

3

Total,

. . 239

1911.

PUBLIC DOCUMENT — No. 23.

39

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—H «-+J-^-+J-(J-p>-|J-^-+^-^ O

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o2£

0Z

40

WORCESTER STATE HOSPITAL.

[Dec.

lOiOHcqio

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1911.

PUBLIC DOCUMENT — No. 23.

41

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42

WORCESTER STATE HOSPITAL.

[Dec.

9. — Probable Duration of Mental Disease before Admission.

PREVIOUS DURATION.

Congenital,
Under 1 month, .
From 1 to 3 months,

3 to 6 months,

6 to 12 months,

1 to 2 years,

2 to 5 years,
5 to 10 years,

10 to 20 years,
Over 20 years,

Totals, .
Unknown,
Not insane, .

Totals, .
Average known duration (in years).

First admitted to Ant Hospital.

12
49
43
32
17
20
25
14
3

215
23
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239
3.13

16

43

27

7

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13

28

16

5

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181

190
4.52

28
92
70
49
30
33
53
30

396

32

1

429

3.79

1911.

PUBLIC DOCUMENT — No. 23.

43

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A. — First admitted to any hospital: —

Acute hallucinosis,

Alcoholic insanity, acute: —

Alcoholic delirium, ......

Alcoholic depression,

Alcoholic hallucinosis

Delirium tremens, ......

Alcoholic insanity, chronic: —

Alcoholic deterioration,

Alcoholic hallucinosis,

Alcoholic paranoic condition, ....

Polyneuritic psychosis,

Constitutional depression,

Constitutional inferiority

Delirium, acute,

Dementia praecox,

Epileptic insanity

Exhaustion psychosis,

General paralysis of the insane,

Hysterical insanity,

Imbecility,

Involution psychosis

Manic-depressive insanity: —

Circular form,

Depressed form,

Manic form

Manic-delirious form,

Mixed form,

Melancholia, senile,

Organic dementia,

Paranoic condition,

Paranoic condition, senile, .

Senile dementia,

Toxic insanity, acute: —

Delirium, ........

Hallucinosis

Traumatic insanity,

Not insane

|

44

WORCESTER STATE HOSPITAL.

[Dec.

! *b.

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B. — Other admissions: —

Alcoholic insanity, acute: —

Alcoholic depression,

Alcoholic hallucinosis,

Delirium tremens

Alcoholic insanity, chronic: —

Alcoholic deterioration,

Alcoholic paranoic condition, ....

Constitutional inferiority

Dementia precox,

Epileptic insanity, ......

General paralysis of the insane, ....

Hysterical insanity,

Imbecility,

Manic-depressive insanity: —

Circular form,

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Melancholia, senile,

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Paranoic condition

Senile dementia,

Totals

Aggregate cases,

1911.

PUBLIC DOCUMENT — No. 23.

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PUBLIC DOCUMENT — No. 23.

47

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Pulmonary tuberculosis

V. Diseases of the digestive system: —

Carcinoma (stomach), ....
Cholangitis and cholelithiasis, .

Acute enteritis,

Dysentery, .

Ulcerative enteritis

Colitis,

Entero-colitis, . . .

Acute hemorrhagic ileo-colitis,

Intestinal obstruction, ....

VI. Diseases of the genito-urinary system: —

Acute cystitis,

Chronic interstitial nephritis,

Chronic nephritis and valvular heart dis-

Chronic nephritis and other causes, .
Parenchymatous nephritis, . . - .

VII. Violence: —

Asphyxia from food

Burns of both feet, and shock, .
Multiple injuries and shock,

4

48

WORCESTER STATE HOSPITAL.

[Dec.

1

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I. General diseases: —

Carcinoma (breast),

Convulsions of general paralysis,

Diabetes

Diabetic gangrene of foot, ....
Exhaustion from general paralysis,
Exhaustion from heat, ....
Infection from fractured rib,
Osteitis deformans and broncho-pneumonia,

Sarcoma (jaw),

Septicaemia from abrasion of hand,
Septicaemia from gangrenous decubitus,
Septicaemia from septic leg,

II. Diseases of the nervous system : —
Acute hemorrhagic encephalitis,

Brain tumor,

Cerebral hemorrliage

Exhaustion from organic dementia, .
Sub-dural hemorrhage, ....
Tabes dorsalis,

III. Diseases of the circulatory system: —

Arteriosclerosis

Arteriosclerosis and other causes,

Myocarditis, . •

Septic thrombosis and gangrene of the leg, .
Valvular heart disease, ....
Vegetative endocarditis, ....

IV. Diseases of the respiratory system : —

Broncho-pneumonia

Broncho-pneumonia and facial erysipelas, .

1911.1

PUBLIC DOCUMENT — No. 23.

Ill- 1 t 1

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Empyema,

Pulmonary infract

Pulmonary tuberculosis, ....

V. Diseases of the digestive system: —

Carcinoma (stomach),

Cholangitis and cholelithiasis,

Acute enteritis

JJysentery

Colitis

Entero-colitis

Acute hemorrhagic ileo-colitis, .

VI. Diseases of the genito-urinary system: —
Acute cystitis, . .
Chronic interstitial nephritis,
Chronic nephritis and valvular heart dis-
ease,

Chronic nephritis and other causes, .
Parenchymatous nephritis

VII. Violence: —

Asphyxia from food,

Burns of both feet, and shock, .
Multiple injuries and shock,

50

WORCESTER STATE HOSPITAL.

[Dec.

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5 to 10 years,

10 to 20 years, .
Over 20 years,

!§ o
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Totals, ....

Average of known cases (in

months,

1911.

PUBLIC DOCUMENT — No. 23.

51

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