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Full text of "Annual report of the trustees of the Worcester State Hospital"

Public Document No. 23 



EIGHTY-THIED ANNUAL EEPOET 



THE TRUSTEES 



WORCESTER STATE HOSPITAL 



Year ending November 30, 1915. 




BOSTON: 

WEIGHT & POTTEE FEINTING CO., STATE PEINTEES, 

32 DEENE STEEET. 

1916. 



^A 



Public Document No. 23 



EIGHTY-THIRD ANNUAL EEFORT 



THE TRUSTEES 



WORCESTER STATE HOSPITAL 



• FOR THE 



Year ending November 30, 1915. 




BOSTON : 

WEIGHT & POTTER PRINTING CO., STATE PRINTERS, 

32 DERNE street. 

1916. 



iiA^aU^ .^^f*-^'^''^^^ 



Approved by 
The State Board of Publication. 



3 



CONTENTS. 



PAGE 

Report of the Trustees, 7 

Report of Superintendent, 11 

Laboratory Report, 20 

Valuation, I ... 23 

Report of Treasurer, 24 

Statements of Funds, 30 

Statistics, 33 



Digitized by the Internet Archive 

in 2010 with funding from 

University of IVIassachusetts Amherst 



http://www.archive.org/details/annualreportoftr118worc 



OFFICERS OF THE HOSPITAL. 



TRUSTEES. 

GEORGIE A. BACON, . 
AMOS CHASE, .... 
WILLIAM J. DELAHANTY, M.D., 
TIMOTHY J. FOLEY, M.D., 
DONALD GORDON, ... 
ELLEN A. SHEEHAN, . 



Worcester. 

Lynn. 

Worcester. 

Worcester. 

Boston. 

Worcester. 



RESIDENT 

ERNEST V. SCRIBNER, M.D., 
B. HENRY MASON, M.D., . 
GEORGE A. MacIVER, M.D., 
HAROLD C. AREY, M.D., . 
ROY C. JACKSON, M.D., . 
SIDNEY M. BUNKER, M.D., 
GEORGE E. MOTT, M.D., . 
R. GRANT BARRY, M.D., . 

JENNIE G. Mcintosh, m.d., 

MARIAN K. LIBBY, . 

ELSIE I. Mackenzie, r.n., 

ARTHUR E. GILMAN, . 
BERTHA HARRIS, 
JOSEPH T. REYNOLDS, 



OFFICERS. 

Superintendent. 

Senior Assistant Physician. 

Assistant Physician. 

Assistant Physician. 

Assistant Physician. 

Assistant Physician. 

Assistant Physician. 

Assistant Physician. 

Junior Assistant Physician. 

Director of Industrial Therapeutics. 

Superintendent of Nurses. 

Steward. 

Matron. 

Farmer. 



NONRESIDENT OFFICERS. 



HAROLD 'I. GOSLINE, M.D., 
HOWARD BEAL, M.D., 
WALTER W. CAMPBELL, D.D.S., 
GEORGE E. PARESEAU, 
GEORGE L. CLARK, . 
JESSIE M. D. HAMILTON, . 
JAMES DICKISON, Jr., 



Pathologist. 

Cozisulting Surgeon. 

Dentist. 

Druggist. 

Auditor. 

Clerk. 

Engineer. 



®l}e ^ommontDealtl) of iHaesadiusette. 



TRUSTEES' REPORT. 



To His Excellency the Governor and the Honorable Council. 

The trustees of the Worcester State Hospital herewith re- 
spectfully submit their eighty-third annual report. 

The Legislature of 1914 made no special appropriations for 
the institution as the needs of the State in other directions 
seemed more urgent. 

The most immediate needs of the institution are those which 
follow: — 

First. — The solution of the sewage problem. For more than 
a decade of years the attention of the Legislature has been 
called to this vital issue. At present the sewage is treated by a 
questionable process of filtration. The fact still remains that 
:,he sewage of the institution is not being properly disposed of. 
Some way should be devised to care for it, so that a growing 
community may be protected from a possible menace. Sanita- 
tion seems to be the watchword of the present day. Citizens 
living in the vicinity of these so-called filter beds have, with 
reason, criticized the procrastinating methods adopted by the 
State of solving this problem of sanitation. They cannot and 
do not feel that the State is doing its duty as the guardian of 
the health and comfort of its citizens while it permits such a 
condition to prevail. 

Since the appropriation of $7,500 for a sewer pipe line to 
connect with the Worcester sewerage system, made by the Legis- 
lature of 1913, is unavailable, owing to the terms of the act, we 
urge immediate consideration of this matter. 



8 WORCESTER STATE HOSPITAL. [Dec. 

The disposal of the sewage is a serious concern to the institu- 
tion and its vicinity, and the maintenance of jBlter beds upon 
the grounds prevents, on account of pollution, the development 
of a private water supply which would be of inestimable value 
to the institution, and which would make a saving to the Com- 
monwealth of some thousands of dollars annually. 

Second. — The conditions which exist at this institution make 
it difficult to serve food properly. There are numerous small, 
unattractive dining rooms, many of them distant from the 
kitchen, which means a great loss in efficient service. The 
creation of congregate dining rooms wduld insure more efficient 
and economical service, and would add much to the comfort 
and convenience of inmates, nurses and attendants. The pres- 
ent laundry building could be suitably converted for this pur- 
pose. 

Industrial therapeutics contribute much to the successful 
treatment and management of inmates. At present some of the 
rooms used for industrial occupations are inadequate and un- 
suitable. We, therefore, for the third time, renew our request 
for an appropriation of $100,800 for the construction of a 
laundry and industrial building, and for the conversion of the 
old laundry into congregate dining rooms. 

Third. — The help problem is one which confronts the man- 
agement of every institution, and one which the State can aid 
very materially by providing suitable accommodations for the 
employees, especially those with families. It is the purpose of 
this institution to increase the number of married employees. 
To do this it is necessary that provision be made for their com- 
fort, in order to attract to the service the best class of help ob- 
tainable ; the better the help, the better the service. We, there- 
fore, repeat our request for appropriations of $16,000 and 
$11,400, the former for the construction of two cottages, at 
$8,000 each, to house employees, the latter for two bungalows, 
at $5,700 each, for members of the medical staff and their 
families. 

Fourth. — The installation of a cold-storage plant would per- 
mit the purchasing of supplies in larger quantities and with 
greater economy, and would insure better care of the products 



1915.] PUBLIC DOCUMENT — No. 23. 9 

of the farm and garden. We renew, for the third time, our 
request for an appropriation of $50,400, to be used for the 
construction and equipment of a building for this purpose. 

Fifth. — At present the accommodations for housing men in 
numbers sufficient to work the farm at Hillside are inadequate. 
The trustees feel that if a suitable building could be erected to 
care for 50 male patients capable of doing farm work, much 
good would result to the patients and profit to the institution. 
We, therefore, ask for an appropriation of $20,000 for the con- 
struction of such a building at Hillside Farm. 

Sixth. — Again we ask you to consider the wage question. 
It is our desire to make the officers and employees feel that 
faithful service is appreciated and will be rewarded through in- 
creased pay, — a consideration very vital for the retention of 
efficient help. 

Seventh. — We ask that as liberal a maintenance allowance 
as possible be granted, as there are many improvements neces- 
sary in the institution and the buildings connected with it. 

Accompanying this report are those of the superintendent 
and treasurer, which contain more detailed statements as .to the 
conditions, needs and activities of the institution. 

The problem of caring for defective delinquents is a serious 
one. It is hoped that the solution will render it unnecessary 
to confine them in any institution for the insane. 

During the year a social worker has been added to the staff. 
Through her work the institution has been brought into a 
closer relation with this and other communities, and an increas- 
ing number of patients are returned to their homes, — a much 
desired result. 

Another venture, well under way now, is the co-operation of 
the institution with the school authorities in regard to deter- 
mining the mental age of defective children. 

Thus the institution is reaching out more and more into the 
community, and its motives and work are being better under- 
stood by the people, who can, therefore, appreciate the efforts 
made for their betterment. 

It is with regret that we have to record the death, during the 
year, of Miss Isa M. Richardson, the director of industrial 



10 WORCESTER STATE HOSPITAL. [Dec. 

therapeutics. We wish to express our appreciation of her faith- 
ful, devoted and efficient service during the time in which she 
was connected with the institution. 

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

Respectfully submitted, 

GEORGIE A. BACON. 
AMOS CHASE. 
WILLIAM J. DELEHANTY. 
TIMOTHY J. FOLEY. 
DONALD GORDON. 
ELLEN A. SHEEHAN.- 

Nov. 30, 1915. 



f 



1915.1 PUBLIC DOCUMENT — No. 23. 11 



SUPERINTENDENT'S REPORT. 



To the Trustees of the Worcester State Hospital. 

I herewith respectfully submit the following report of the 
hospital for the year ending Nov. 30, 1915, it being the eighty- 
third annual report. 

There remained at the hospital Oct. 1, 1914, 1,420 patients, — 
719 men and 701 women. During the year ending Sept. 30, 
1915, there were admitted 731 patients, — 376 men and 355 
women. Six hundred and ninety-two patients — 380 men and 
312 women — were dismissed from the hospital. Of this num- 
ber, 325 patients ■ — ^189 men and 136 women — were dis- 
charged; 132 patients — 76 men and 56 women — died; 91 
patients — 29 men and 62 Avomen — were transferred; and 142 
patients — 85 men and 57 women- — left on visit or escape; 
leaving at the end of the statistical year, 1,459 patients, — 715 
men and 744 women. Of this number, 1,243 were supported 
by the State, 118 by friends, and 98 as reimbursing patients. 
Of the 416 patients discharged and transferred, 54 were re- 
ported recovered, 84 capable of self-support, 80 improved and 
95 not improved. Four men and 8 women (including 3 habit- 
ual drunkards, women) were discharged as not insane. One 
man and 4 women were transferred by the State Board of 
Insanity to the Dan vers State Hospital; 4 men and 4 women 
to the State Infirmary; 1 man and 2 women to the Boston 
State Hospital; 1 woman to the Taunton State Hospital; 2 
women to the jNIedfield State Hospital; 8 women to the West- 
borough State Hospital; 1 woman to the Foxborough State 
Hospital; 19 women to the Gardner State Colony; 1 man to 
the Bridgewater State Hospital; 4 men and 5 women to the 
Monson wState Hospital, and 18 men and 15 women to the 
Grafton State Hospital. Ten men and 6 women were removed 
from the State, and 1 woman was boarded out. 



12 WORCESTER STATE HOSPITAL. [Dec. 

There remained at the end of the year 39 patients more than 
at the beginning. The smallest number under treatment on 
any one day was 1,405, and the largest, 1,493. The daily 
average number was 1,450.14. 

The percentage of recoveries, calculated upon the number of 
discharges and deaths, was 11.8; calculated upon the number of 
admissions it was 7.4. 

The death rate was 6.1, calculated on the whole number of 
patients under treatment, and 9.1, calculated on the daily 
average number. 

Of the cases admitted, by far the greater number suffered 
from dementia prsecox; then come manic-depressive, senile 
dementia, general paralysis and alcoholic psychoses. In con- 
sidering admissions it is of interest to note that the percentage 
of voluntary cases has more than doubled over that of last 
year. Temporary-care cases have increased over 50 per cent. 
The Legislature of last year extended the time that temporary- 
care cases can be detained without commitment from seven to 
ten days. This, perhaps, in some measure accounts for this in- 
crease. This extension of time was a move in the right direc- 
tion, but, in my opinion, if the time were again extended to 
twenty-one days, the results would be even more satisfactory. 
The temporary-care act not only server as a great conven- 
ience, but in many cases obviates entirely the necessity for 
formal commitment. 

The general health of the institution has been good. There 
has been no case of contagious disease of any kind during the 
year among either patients or employees, a fact which is rather 
remarkable when we consider the large numbers of persons who 
are resident here and that new cases are being constantly 
received from the general community. Dysentery, which for 
several years assumed almost an epidemic form, has practically 
ceased to exist. During the year but two cases of this disease 
occurred, both of which recovered. I cannot but attribute 
this excellent result in great measure to the painstaking care 
of the medical staff and the very vigorous and effective general 
sanitary measures which have been enforced. 

A few cases of pellagra have occurred among the patients. 
This is a disease which is more prevalent in the south and west 



1915.] PUBLIC DOCUMENT — No. 23. 13 

than in New England. That pellagra, however, has existed in 
this community in former years is undoubtedly true, and the 
fact of the recognition of more cases now may be partially ac- 
counted for by a greater accuracy in diagnosis. The nature 
and causes of this disease are but poorly understood. It is 
pretty generally accepted, however, that it is due to faulty 
nutrition. Appropriate dietary treatment in many cases affords 
relief, and in some, seems to effect a cure. In one fatal case 
it seemed fair to attribute the mental disease to the influence 
of the pellagra. 

One of the most important changes of the year has been the 
reorganization of the training school for nurses. No other 
agency for their care can ever come into such intimate relation 
with our patients as the nursing staff. How important then 
that we should not only make the best and most careful selec- 
tion of the personnel of the nursing force, but also that having 
secured good material we should so shape and mold it as to 
best adapt it for the accomplishment of our ends, the efficient 
and kindly care of those most unfortunate persons who have 
been committed to our institution. While the training of the 
nurse is primarily that she may better and more intelligently 
care for her patients, it does supplement the too meager wage 
which the financial limitations of the hospital forces it to offer, 
and renders the service more attractive. 

The training course has formerly covered a period of two 
years. The insane hospital, from the nature of its work, has 
hitherto been unable to offer to its pupil nurses that experience 
in certain branches which only a general hospital could offer, 
and with the limited time in the course has compelled its 
graduates to seek by post-graduate work to supplement the 
training which was received here. During the past year the 
training course has been extended to cover a period of three 
years. An arrangement has been entered into with Belle vue 
and the allied hospitals of New York whereby our nurses, at 
some time during the three years' course, preferably during the 
second year, are received there for a ten months' course, and 
on graduation here are given a certificate from Belle vue cover- 
ing the work done there. In changing our course from two 
years to three years an option was given to the senior class to 



14 WORCESTER STATE HOSPITAL. [Dec. 

graduate at two years and receive a diploma accordingly. The 
interest and appreciation of the newly arranged course was 
shown by every member of the class electing to continue on 
the three-year basis. 

The out-patient service, established last year, has been con- 
tinued, and seems to be appreciated by the community. At 
each of the clinics the social worker is present, and follows up 
cases as the needs may indicate. Many former patients and 
those now out on visit report at these times, and thus enable 
the institution to keep in touch with individual cases. 

Early in our out-patient service attention was called to the 
needs of the backward and defective school children, a special 
clinic being arranged for these cases one-half day of each month, 
a representative from the staff of the School for Feeble-minded 
co-operating with the members of our hospital staff. At first 
these clinics were held at the hospital, but the growing at- 
tendance finally led up to a conference with the superintendent 
of schools, resulting in arrangements being made to hold a 
clinic in the school committee room in the City Hall on the 
third Tuesday afternoon of each month. The city has no 
psychologist to examine the children who are unable to keep 
up with the class work in the schools, and so many pupils have 
been presented for examination and so much interest has been 
evinced that now a whole day is given up to this work once 
each month. At this clinic the child's mental age is estab- 
lished, and advice given as to whether commitment to one of 
the schools for feeble-minded is desirable, or whether the child 
may properly continue to be cared for in the community, 
under proper supervision. This latter class is given work in one 
of the ungraded schools, especially along the lines of manual 
training, and in a year is again brought up for examination 
to see if any good has been accomplished. The success of this 
clinic is largely due to the energetic work of Miss Edith M. 
Dixon, who arranges with the parents of a certain number of 
children each month to attend the clinic. 

The growing importance of the social work, which for some 
time was carried on by different members of the medical staff, 
made it necessary early in the year to appoint a regularly 
trained social worker. Miss Marie L. Donohoe was secured for 
this position. She has entered into her work with enthusiasm, 



1915.] PUBLIC DOCUMENT — No. 23. 15 

and is proving a valuable addition to the regular hospital 
staff. Miss Mildred T. Hurley is also kindly doing volunteer 
social service. The volume of the social work is such that both 
these young women are kept pretty constantly and profitably 
employed. 

This whole out-patient and social work is doing something, 
more than attending to the needs of the individuals and fam- 
ilies immediately concerned. It is carrying on a campaign of 
education in the community; it is removing distrust, and 
teaching the community that the hospital influence seeks to be 
kindly, helpful and co-operative; it is teaching the hospital to 
better understand the community view and to cope more in- 
telligently with the problem of securing for its patients as 
early a return to the home as possible. The social worker is 
invaluable in placing out patients in family care and in their 
supervision when so placed. In discharging patients into the 
community, where there is lack of information as to home con- 
ditions, the report of the social worker is of great value in 
determining proper action. If patients have no home or 
friends, employment is sometimes secured, proper boarding 
places found, and assistance given in placing them once more 
in a position to become self-supporting. 

The State Board of Insanity has removed from the institu- 
tion practically all of its epileptics and the women inebriates 
and victims of drug habits, concentrating these cases in certain 
specified institutions. This practice has certainly assisted in 
the better classification of the other patients here and should 
result in good to the classes in question, as they will now be 
concentrated where more intensive methods of study and 
treatment can be applied. It is now to be hoped that at some 
early date the problem of the defective delinquent will be as 
effectually solved. 

During the year Miss Isa M. Richardson, our director of 
industrial therapeutics, died after a sudden and brief illness. 
Miss Richardson was an earnest, conscientious and capable 
young woman, who was carrying on a very useful and success- 
ful work here. She was well liked by her associates and her 
untimely death was a great shock to us all. Miss Marian K. 
Libby has been appointed to carry on this work. 

Interest in the therapeutic industries continues unabated. 



16 WORCESTER STATE HOSPITAL. [Dec. 

Much work is accomplished on the wards and in the special 
industrial rooms for the men and women. This industrial 
work has great value in the treatment of certain forms of men- 
tal disease, to combat dementing tendencies. 

The work of the dentist has been somewhat amplified, and 
in addition to his regular work three weeks of intensive ap- 
plication have been devoted to the treatment of cases of Rigg's 
disease, an affection of the gums. In the course of this work 
an examination was made of the teeth of every patient in the 
house. Satisfactory results were obtained in the majority of 
cases. 

The Legislature of last year failed to authorize measures 
which would solve the question of the disposal of the sewage 
from this institution. I feel that I should do less than my duty 
if I should fail to present this subject for the consideration of 
your Board. The present method of sewage disposal is entirely 
inadequate, and is a source of serious offence to the neighbors 
and the passers-by. I would again recommend that your Board 
ask for some measure of relief. I believe that the only solution 
of the matter that would be in any degree permanently satis- 
factory is the connection of our sewer with the system of the 
city of Worcester. The estimate for the accomplishment of this 
work is $7,500. If this sum can be granted under such condi- 
tions as it is possible to comply with, it will provide a solution 
of our long-standing difficulties. 

Last year your Board made several requests for special ap- 
propriations covering work which it seemed highly desirable 
should be entered into to develop the institution more fully and 
to increase its efficiency. The desirability of accomplishing 
these undertakings has been recognized by the State Board of 
Insanity to the extent that, under its authority, plans and 
specifications covering this work have been prepared. The 
urgent necessities of the State expenditures prevented the 
granting of our special appropriations last year. I recommend 
that your Board again bring forward these requests that they 
may again be considered and, if found possible, granted. 

I believe that a better and more economical service of food 
could be obtained if for many of our small dining rooms 
one large central room could be provided, located near the 



1915.] PUBLIC DOCUMENT — No. 23. 17 

kitchen and to which the majority of our patients could come. 
The building now occupied by the laundry, carpenter shop, 
and some of our other industries, could well be converted into 
a large congregate dining room. This would necessitate the 
erection of a new building for the accommodation of those 
activities. Such a building, constructed of brick, two stories 
and basement, could well provide for the laundry in the base- 
ment and first story, leaving the upper story for the various 
industrial operations. All these changes are considered to- 
gether because they are interdependent. It is estimated that 
to carry out these plans will cost $100,800. 

It would seem to be a rather self-evident fact that to secure 
and retain in the service competent and desirable persons not 
only should a reasonable wage be paid but also that the con- 
ditions of living should be made as attractive as possible. 
With this end in view I recommend that permission be sought 
for the erection of two more houses for employees, to accom- 
modate 10 employees on the upper floor, the lower providing a 
home for a man and his family. To erect and furnish such 
buildings will need the sum of $16,000. 

Greater opportunities for independent family life should also 
be provided for certain of our officers. I recommend that 
authority be sought for the erection and furnishing of two 
bungalows for this purpose. To accomplish this will require 
the expenditure of $11,400. 

I believe that it would increase the efiiciency of the steward's 
department if it were possible to house our supplies in one 
building, which should be equipped with refrigerating apparatus 
providing cold storage for such articles as needed this special 
provision. For the erection of this building as planned the 
sum of $50,400 will be needed. 

Milk has been one of the most important products of the 
farm. This institution, by the farmer's careful management, 
had bred up one of the finest herds of Holstein cattle that 
existed in this part of the country. I regret to state that, 
despite very careful and persistent quarantine, the hoof-and- 
mouth disease found entrance and soon infected the entire 
herd which was maintained at the home farm, necessitating 
the slaughter of every animal there. 



18 WORCESTER STATE HOSPITAL. [Dec. 

Fortunately, the institution did not have all of its cows in 
one place. At the Hillside Farm in Shrewsbury, another herd 
was maintained, which did not become infected, and can serve 
as the nucleus from which to breed back and* replenish our 
stock. 

At the Hillside Farm the housing accommodation is not 
sufficient to provide for as many workers as it would seem 
desirable to maintain there. While the farm there has been 
conducted at a profit, a greater efficiency in operation could be 
secured if a greater number of our able-bodied male patients 
could be permanently housed there. I agree with the proposi- 
tion of the State Board of Insanity to erect a new building 
there to accommodate 50 male patients. Such a building as 
would be suitable for this purpose could probably be erected 
and furnished for about $20,000 if patient labor could be used 
as far as possible in its erection. 

Early in the year Dr. Mary E. Morse resigned her position 
as assistant pathologist to accept an appointment at the Boston 
State Hospital. A little delay was experienced in securing a 
successor. Dr. Harold I. Gosline has now been appointed to 
the position of pathologist. He has had experience at the 
Danvers State Hospital and the Boston Psychopathic Hospital. 
He comes well recommended and equipped, and is taking up 
the laboratory work with every promise of success. 

It gives me great pleasure to commend the work of the med- 
ical staff. Every member has done conscientious and efficient 
work. The large numbers of patients received and the special 
activities and innovations have made new and imperative 
demands upon the staff. In every instance these demands 
have been met in an efficient and cheerful manner. Consider- 
able active work has been done in hydrotherapy with the acute 
cases. A few properly applied treatments have in many in- 
stances seemed useful in breaking up mental torpidity and 
stimulating an interest in surroundings. Treatment with elec- 
tricity has also in some instances seemed to exert a favorable 
influence on paralytic conditions. 

I wish to acknowledge my indebtedness to all of the officers 
and employees who have, in the main, rendered faithful service, 
and have assisted in bringing about any measure of success 
which may have been attained. 



1915.] PUBLIC DOCUMENT — No. 23. 19 

Religious services have been held regularly in the chapel. 

The usual round of chapel entertainments has served to in- 
terest and amuse our patients. 

Thanks are again due to the publishers of the "Fitchburg 

Sentinel" and the "Worcester Evening Gazette" for copies of 

their papers, and to the Worcester Employment Society for 

assistance in sewing. 

E. V. SCRIBNER, 

Superintendent. 
Nov. 30, 1915. 



20 



WORCESTER STATE HOSPITAL. 



[Dec. 



LABORATORY REPORT. 



To the Superintendent of the Worcester State Hospital. 

The report of the laboratory for the past year is herewith 
respectfully submitted. 

The following routine work has been done : — 



Urinalyses, 

Bacteriological examinations (exclusive of throat cultures), 

Throat cultures, 

Sputum examinations, 

Blood examinations. 

Cerebrospinal fluid examinations, 

Vaginal smears, ... 

Stomach contents, . 

Fecal examinations, . 

Surgical specimens, . 

Pus from ear, .... 

Clot from uterus. 

Culture from eye. 

Smear from abscess, 

Cervical smear, 



760 
65 

61 
47 
36 
25 
25 
10 



Total, 



1,046 



Forty-two autopsies were performed during the year, repre- 
senting 31 per cent, of the deaths during this period. 
The psychiatric diagnoses in the cases were as follows : — 

Senile psychoses, 13 

Organic dementia, 10 

General paralysis, 7 

Dementia prsecox, 6 

Alcoholic psychoses, • 3 

Imbecility, 1 

Manic-depressive insanity, 1 

Paranoid condition, 1 

Total, 42 



1915.] PUBLIC DOCUMENT — No. 23. 21 

The major anatomical diagnoses were: — 

Pulmonary tuberculosis, 5 

General paralysis, 5 

Broncho-pneumonia, 5 

Arteriosclerosis, .....'. 5 

Brain tumor, 3 

Lobar pneumonia, 3 

Myocarditis, . . . . . . 2 

Intestinal tuberculosis, . . . . . . . . . . 2 

Pellagra, 2 

Chronic ulcerative colitis, . . 

Acute cardiac dilatation, 

Chronic bronchitis with hydrothorax, 

Pulmonary gangrene, . . . . . . . 

Cardiovascular renal disease, 

Internal hemorrhagic pachymeningitis, . . . . . 

Subdural hemorrhage, 

Cerebral embolism, • . . . 

Myocarditis with fatty degeneration, . , 

Pulmonary infarct, 

Cerebral hemorrhage, 

Chronic interstitial nephritis, 

Hypostatic pneumonia, 

Septicaemia, 



Total, 46 

Counted twice, 4 



42 

The delay incident to the change in the laboratory staff has 
been fully made up, and we are in good running condition 
again. 

During the incumbency of the present pathologist the inter- 
nal arrangement of the laboratory has been modified to enable 
it to turn out the greatest amount of work with the working 
force available. 

A different method has been devised for the storing of brains 
than the one formerly used here. 

The autopsied cases from the beginning of the laboratory 
have been numbered in such a way as to make available at a 
moment's notice the total number of autopsies done since the 
beginning of the laboratory and the total number done in any 
given year. 



22 WORCESTER STATE HOSPITAL. [Dec. 

A catalogue of the literature in the library has been started. 
This will cut down the time for looking up references from 
several days to a few moments, when completed. 

An index of the clinical symptoms in autopsied cases is 
about 20 per cent, completed. Such an index will make possible 
scientific studies, which have been impossible in the past owing 
to the time required to get out the facts. 

One study has been completed, entitled "Th^ Conduct of 
the Insane: a Contribution to the Psychopathological Theory," 
presented at the twentieth anniversary of the founding of the 
Danvers State Hospital laboratory Nov. 19, 1915. 

Meetings have been held in the laboratory at frequent in- 
tervals, at which topics of current interest have been presented 
before the staff. 

H. I. GOSLINE, M.D., 

Pathologist. 

Nov. 30, 1915. 



1915.1 PUBLIC DOCUMENT — No. 23. 23 



VALUATION OF PERSONAL PROPERTY. 



Food, $8,825 00 

Clothing, 11,452 00 

Furnishings, 81,676 00 

Heat, light and power, 10,066 00 

Repairs and improvements, . . . . . . . 4,210 00 

Farm, stable and grounds, 38,749 00 

Miscellaneous, 17,256 00 

Industries, 2,251 00 

Total, $174,485 00 



24 



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, 1915: — 



Balance Dec. 1, 1914, 



Cash Account. 



$12,777 04 



Receipts. 



Institution Receipts. 






Board of inmates: — 






Private, 


$34,579 52 




Reimbursements, insane. 


16,211 77 


$50,791 29 


Sales: — 




Food 


$515 47 




Clothing and materials, . 


353 15 




Furnishings, . 


66 44 




Repairs and improvements, 


9 89 




Miscellaneous, 


53 57 





Farm, stable and grounds: — 
Cows and calves, $92 00 
Hides, . . 48 87 

Sundries, . . 53 17 



Miscellaneous receipts: — 
Interest on bank balances, 
Rent, .... 
Sundries, 



Sales, account of industries fund, 



194 04 



$668 45 

42 00 

476 17 



1,192 56 



1,186 62 



53,170 47 
193 10 



Receipts from Treasury of Commonwealth. 
Maintenance appropriations: — 
Balance of 1914, . 

Advance money (amount on hand November 30) , 
Approved schedules of 1915, . $337,121 58 

Less returned, ... 41 33 



Special appropriations, 
Industries fund, 

Total, 



$495 28 
25,000 00 



337,080 25 



362,575 53 

285 00 

188 12 

$429,189 26 



1915. 



PUBLIC DOCUMENT — No. 23. 



25 



Payments. 



To treasurj of Commonwealth : — 

Institution receipts. 

Industries fund. 
Maintenance appropriations: — 

Balance November schedule, 1914, 

Eleven months' schedules, 1915, 

November advances, 

Special appropriations: — 
Approved schedules, 





$53,170 47 




193 10 


$13,272 32 




337,080 25 




13,741 79 






364.094 36 



285 00 



Industries fund: — 
Approved schedules, 



188 12 



Balance Nov. 30, 1915: 
In bank. 
In office, 



Total, 



Maintenance. 
Appropriation (allowance for coal, $534.30), . 
Expenses las analyzed below), .... 

Balance reverting to treasury of Commonwealth, 



$10,510 65 
747 56 


11,258 21 






$429,189 26 

$372,784 30 
372,576 99 



$207 31 



Analysis of Expenses 
Salaries, wages and labor: — 

Dr. Ernest V. Scribner, superintendent, 

General administration, . 

Medical service, 

Ward service (male), 

Ward ser-vdce (female), 

Repairs and improvements. 

Farm, stable and grounds. 



Wages refunded, account of 1914 expenses, 



Food: — 
Butter, . 
Butterine, 
Beans, . 

Bread and crackers. 
Cereals, rice, meal, etc.. 
Cheese, . . . 

Eggs, . 
Flour, . 
Fish, . 

Fruit (dried and fresh). 
Lard, 
Meats, . 

Amounts carried forward, 



$3,000 00 
37,722 90 
14,897 95 
30,001 79 
33,237 51 
18,588 05 
13,730 55 

$151,178 75 
41 33 



$7,078 24 
4,944 11 
1,112 09 
435 38 
2,769 13 
704 81 
5,590 33 

11,013 25 
3,194 27 
3,811 38 
1,659 24 

24,742 76 



$151,137 42 



r,054 99 $151,137 42 



26 



. WORCESTER STATE HOSPITAL. 



[Dec. 



Amounts brought forward. 



$67,054 99 $151,137 42 



Food — Con. 

Milk, .... 
Molasses and syrup, 
Spices, seasonings, salt, etc., 
Sugar, .... 
Tea, coffee, broma and cocoa. 
Vegetables, 

Yeast, .... 
Sundries, 



Clothing and materials: — 
Boots, shoes and rubbers. 
Clothing, ..... 
Dry goods for clothing and small wares, 
Furnishing goods, .... 
Hats and caps, .... 
Leather and shoe findings. 

Furnishings: — 

Beds, bedding, table linen, etc., 

Brushes, brooms, .... 

Carpets, rugs, etc.. 

Crockery, glassware, cutlery, etc.. 

Furniture and upholstery. 

Kitchen furnishings, 

Materials and machinery for manuf acturin. 

Wooden ware, buckets, paUs, etc., 

Sundries, ..... 



Heat, light and power: — 
Coal, . 
Wood, . 
Gas, 
Oil, 
Sundries, 



Repairs and improvements: — 
Brick, .... 
Cement, lime and plaster. 
Doors, sashes, etc.. 
Electrical work and supplies. 
Hardware, 
Lumber, 

Machines (detached). 
Paints, oil, glass, etc., 
Plumbing, steam fitting and supplies 
Roofing and materials, 
Sundries, 

Farm, stable and grounds: — 
Automobiles and supplies. 
Automobile repairs. 
Blacksmith and supplies, 

Amounts carried forward, 



13,070 42 




307 


17 




403 45 




7,040 


99 




1,967 


20 




5,483 


26 




177 


85 




317 


14 


95,822 47 






$1,143 


94 




3,436 


69 




2,143 


41 




283 


15 




70 


82 




130 


32 


7,208 33 






$9,275 08 




530 


37 




649 


11 




2,247 


33 




2,274 


01 




943 


06 




159 


79 




761 


38 




51 


07 


16,891 20 






$35,620 74 




5 


50 




449 


69 




252 


81 




167 


71 


36,496 45 






$145 


60 




326 


77 




48 


14 




1,240 


29 




3,457 


66 




4,013 


27 




424 


38 




2,072 


36 




6,480 


22 




1,499 


10 




477 


12 


20,184 91 






$1,902 71 




268 


55 




511 


17 




$2,682 43 


$327,740 78 



1915. 



PUBLIC DOCUMENT — No. 23. 



27 



Amounts brought forward, 



$2,682 43 $327,740 78 



Farm, stable and grounds — Con. 








Carriages, wagons, etc., and repairs, 


395 


99 




Fertilizers, vines, seeds, etc., . . . . 


841 


76 




Hay, grain, etc., ..... 


8,452 


67 




Harnesses and repairs, . . . . 


353 


60 




Other live stock, . . . ... 


49 


00 




Tools, farm machines, etc., 


739 


79 




Sundries, ...... 


1,005 


19 


14,520 43 








Religious services, ..... 




• 


1,232 35 


Miscellaneous: — 








Books, periodicals, etc., .... 


$439 03 




Cuspidor supplies, ..... 


37 


90 




Entertainments, ..... 


508 25 




Freight, expressage and transportation, 


1,287 


31 




Funeral expenses, ..... 


391 


00 




Gratuities, ...... 


57 


65 




Hose, etc., ...... 


77 


12 




Ice, ....... 


209 


96 




Medicines and hospital supplies, 


3,855 


87 




Medical attendance, nurses, etc. (extra), . 


84 


00 




Patients' board out, .... 


5,703 


82 




Postage, ...... 


761 


80 




Printing and printing supplies. 


861 


58 




Printing annual report, .... 


178 


75 




Return of runaways, .... 


134 


07 




Soap and laundry supplies, 


3,218 


13 




Stationery and office supplies, . 


1,186 


98 




Travel and expenses (officials). 


1,093 


92 




Telephone and telegraph, 


708 


72 




Tobacco, ...... 


1,326 


33 




Water, .......' 


6,082 


34 




Sundries, ...... 


878 90 










29,083 43 


• 




- 


Total expenses for maintenance, . 


$372,576 99 



Special Appropriations. 

Balance Dec. 1, 1914, 

Expended during the year (see statement annexed) , 
Reverting to treasury of Commonwealth, 



$285 00 
627 21 



$912 21 



$912 21 



Resources and Liabilities. 

Resources. 

Cash on hand $11,258 21 

November cash vouchers (paid from advance 

money), account of maintenance, . . . 13,741 79 

Due from treasury of Commonwealth, account 

of November, 1915, schedule, .... 10,496 74 



Liabilities. 



Schedule of November bills. 



$35,496 74 
$35,496 74 



28 



WORCESTER STATE HOSPITAL. 



[Dec. 



Per Capita. 
During the year the average number of inmates has been 1,463.09. 
Total cost for maintenance, $372,576.99. 
Equal to a weekly per capita cost of $4,897. 
Receipt from sales, $1,192.56. 
Equal to a weekly per capita of $0,156. 
All other institution receipts, $51,977.91. ■ 
Equal to a weekly per capita of $0,685. 



Industries Fund. 



Balance Dec. 1, 1914, 
Receipts credited, 



Expenditures, approved schedules (see statement below), 
Balance Nov. 30, 1915, 



Industries. 
Expenditures. 



Tools and machinery: 
Tooling irons. 
Labor, . 



$18 83 


193 


10 


$211 


93 


$188 


12 


23 


81 



$2 50 
92 75 



Materials: — 




Clay 


$21 23 


Leather, .... 


... 2 99 


Linen, etc., .... 


41 10 


Notions, .... 


11 40 


Painting supplies, . 


1 27 


SUls, . . . ... 


14 88 



$211 93 



$95 25 



92 87 



$188 12 



1915. 



PUBLIC DOCUMENT — No. 23. 



29 



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o 



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30 WORCESTER STATE HOSPITAL. [Dec. 



STATEMENT OF FUNDS. 



Patients' Fund. 
Balance on hand Nov. 30, 1914, .... $4,088 16 

Receipts, 3,632 61 

Interest, 160 40 

$7,881 17 

Interest paid to State Treasurer, . . . . $160 40 

Refunded, . . ■ 3,091 97 

■ 3,252 37 



$4,628 80 
Investment. 
Worcester County Institution for Savings, . . $2,000 00 
Worcester Five Cents Savings Bank, . . . 1,000 00 
Balance Worcester National Bank, . . . 1,235 28 
Cash on hand Dec. 1, 1915, 393 52 

$4,628 80 

Lewis Fund. 
Balance on hand Nov. 30, 1914, .... $1,562 60 
Income, 58 71 

$1,621 31 

Expended for books, etc., 101 68 



$1,519 63 
Investment. 
American Telephone and Telegraph Company- 
bond, $926 36 

Worcester County Institution for Savings, . . 349 44 

Balance Worcester National Bank, . . . 243 83 

$1,519 63 

Wheeler Fund. 
Balance on hand Nov. 30, 1914, .... $5,561 33 
Income, 273 37 

$5,834 70 

Expended for books, etc., 261 31 

$5,573 39 



1915. 



PUBLIC DOCUMENT — No. 23. 



31 



Investment. 
6 shares Worcester National Bank, . . . $1,002 00 
American Telephone and Telegraph Company- 
bond, 712 50 

Worcester County Institution for Savings, . . 1,632 00 

Worcester Five Cents Savings Bank, . . . 1,753 85 

Mechanics Savings Bank, 187 86 

Balance Worcester National Bank, . . . 285 18 



Lawn Fund. 
Balance on hand Nov. 30, 1914, .... $157 34 

Income, 6 30 



Expended for plants, etc., 



$5,573 39 

$163 64 
$163 64 



M ANSON Fund. 
Balance on hand Nov. 30, 1914, . 
Income, 

Investment. 
Worcester County Institution for Savings, . 



[,356 92 
54 80 



$1,411 72 
$1,411 72 



Respectfully submitted, 



E. V. SCRIBNER, 

Treasurer of the Corporation. 



Nov. 30, 1915. 



Worcester, Mass., Dec. 8, 1915. 

I hereby certify that I have this day compaFed the treasurer's statement of 
funds for the year ending Nov. 30, 1915, 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. 

GEORGE L. CLARK, 

Auditor of Accounts. 



STATISTICAL TABLES 



[Form prescribed by State Board of Insanity.] 





[0 
EH 

H 
K 

o 

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1,420 
1,420 

1,414 


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Patients under care Sept. 30, 1914 
In hospital. 
In family care, . 
Viz.: regularly committed. 


emergency, 
voluntary, . 
temporary care, . 
Admitted within the year, . 
Viz.: by regular commitment, 


emergency, 
voluntary, . 
temporary care, 
viz.: observation, . 
others, . 
by transfer, 
from visit, . 
from escape. 
Nominal admission for discharge. 
Viz.: from visit, ' 
from escape. 
Nominally admitted from escape 

visit 

Whole number of cases within the 
Dismissed within the year, . 
Viz.: discharged, 

as recovered, 

as capable of self-suppor 

as improved, . 

as not improved, . 

as not insane, . 

died 

transferred, 
escaped, . 
on visit Oct. 1, 1915, . 



36 



WORCESTER STATE HOSPITAL. 



[Dec. 



1=1 
o 
O 



C3 



C^ 



n 
o 


1 


1,459 

1,412 

47 

1,453 


8 

6 

1,243 

98 

118 

1,979 

566 

494 
529 

439 
54 

84 

1,419.35 

30.79 

1,450.14 

1,227.63 

98.19 

124.32 

18 

5.63 

82 

3.49 




t^ CO c^ 


7 

1 

601 

68 

75 

994 

297 

240 
255 

194 

22 

34 

700.56 

28.03 

728.59 

584.70 

65.26 

78.63 

9 

4.46 

27 

.63 




lOCOCilO 


1 

5 

642 

30 

43 

985 

269 

254 
274 

245 

32 

50 

718.79 

2.76 

721.55 

642.93 

32.93 

45.69 

9 

1.17 

55 

2.86 






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497 

413 

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1,414.37 

30.79 

1,445.16 

1,222.65 

98.19 

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COOOU5 CO 
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7 

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75 

977 

286 

229 
240 

185 

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699.30 

28.03 

727.33 

583.44 

65.26 

78.63 




OOOCIO 

^H O ^H 


1 

637 
30 
43 
963 
250 

235 
257 

228 

25 

46 

715.07 

2.7,6 

717.83 

639.21 

32.93 

45.69 




V 


- 1 


5 year,' 
from the 

the com- 

elf-suppor 

tients, 
Dts, . 
e patients 




Patients under care Sept. 30, 1915, 
In hospital. 
In family care, . 
Viz.: regularly committed. 


emergency, 
voluntary, . 
temporary care, 
supported as State patient 
as reimbursing 
as private patie 
Number of different persons with 
Number of different persons admi 
Number of different persons adm 

community. 
Number of different persons dism 
Number of different persons dismif 

munity, .... 
Number of different persons recov 
Number of different persons capab! 
Daily average number in hospital 
Daily average number in family c 
Daily average number under care 
Viz.: State patients, . 

private patients. 
Whole number of voluntary admis 
Daily average number of voluntai 
Whole number of temporary-care 
Daily average number of temporar 



1915. 



PUBLIC DOCUMENT — No. 23. 



37 



2. — Family-Care Department. 



Males. 



Females. 



Totals. 



Remaining Sept. 30, 1914 

Admitted within the year, .... 
Whole number of cases within the year, 
Dismissed within the year, . . . ■ . 

Viz.: returned to institutions, . 

discharged, 

died 

escaped, 

Remaining Sept. 30, 1915, .... 

Supported by the State, .... 

Private 

SeK-supporting, 

Number of difierent persons within the year, 
Number of different persons admitted, 
Nimiber of different persons dismissed, 
DaUy average number, 

State, 

Private, 

Self-supporting 



7 

7 

6 

2.76 

2.76 



1 

45 

40 

3 

2 

55 

55 

12 

28.03 

24.98 

1.79 

1.26 



64 
64 
17 
14 
1 

2 

47 

42 

3 

2 

62 

62 

17 

30.79 

27.74 

1.79 

1.26 



3. — Insane received on First and Subsequent Commitment. 



NUMBER OF THE COMMITMENT. 


Cases committed. 










Males. 


Females. 


Totals. 


First to this hospital, 


206 


198 


404 


Second to this hospital, 


25 


18 


43 


Third to this hospital 


4 


8 


12 


Fourth to this hospital, 


- 


2 


2 


Filth to this hospital, 


1 


3 


4 


Fourteenth to this hospital 


- 


1 


1 


Total cases, ........ 


236 


230 


466 


Total persons 


235 


229 


464 


Never before in any hospital for the insane. 


194 


174 


368 



38 



WORCESTER STATE HOSPITAL. 



[Dec. 



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









Males. 


Females. 


Totals. 


PLACES OF NATIVITY. 


§ 


1 


o 


1 


1 


o 


-(.9 

a 
.S 

Pi 




S3 

1 


Massachusetts, . . . . 


69 


32 


31 


58 


20 


20 


127 


52 


51 


Other New England States, 




18 


19 


13 


18 


15 


15 


36 


34 


28 


Other States, . 




6 


3 


5 


10 


8 


11 


16 


11 


16 


Total native, 




93 


54 


49 


86 


43 


46 


179 


97 


95 


Other countries: — 
























Austria, . 






. 2 


2 


2 


4 


5 


5 


6 


7 


7 


Azores, 






1 


1 


1 


- 


- 


- 


1 


1 


1 


Canada, . 






19 


24 


23 


17 


26 


26 


36 


50 


49 


England, . 






6 


8 


7 


6 


9 


10 


12 


17 


17 


Finland, . 






5 


6 


6 


4 


4 


4 


9 


10 


10 


France, 






- 


1 


1 


- 


- 


- 


- 


1 


1 


Germany, 






'' 1 


1 


2 


2 


3 


2 


3 


4 


4 


Greece, 






3 


2 


2 




- 


- 


3 


2 


2 


Ireland, . 






19 


35 


40 


31 


51 


46 


50 


86 


86 


Italy, 






9 


8 


8 


1 


1 


1 


10 


9 


9 


Lithuania, 






1 


1 


1 


- 


- 


- 


1 


1 


1 


Madeira Islands, 






- 


- 


- 


1 


1 


1 


1 


1 


1 


New Brunswick, 






1 


2 


1 


- 


- 


- 


1 


2 


1 


Newfoundland, 






- 


- 


- 


1 


1 


1 


1 


1 


1 


Norway, . 






2 


2 


2 


- 


- 


- 


2 


2 


2 


Nova Scotia, . 






3 


4 


5 


5 


5 


5 


8 


9 


10 


Poland, . 






3 


3 


3 


- 


- 


- 


3 


3 


3 


Portugal, . 






i 1 


1 


1 


1 


1 


1 


2 


2 


2 


Prince Edward Island, 






- 


2 


1 


2 


1 


2 


2 


3 


3 


Russia, 






12 


12 


12 


6 


6 


6 


18 


18 


18 


Scotland, . 






- 


- 


1 


1 


3 


5 


1 


3 


6 


Sweden, . 






5 


8 


7 


4 


4 


4 


9 


12 


11 


Syria, 






2 


2 


2 


- 


- 


- 


2 


2 


2 


Turkey, . 






2 


2 


2 


- 


- 


- 


2 


2 


2 


Wales, 






- 


- 


1 


- 


- 


_ 


- 


- 


1 


West Indies, 






1 


- 


- 


1 


1 


1 


2 


1 


1 


Total foreign, . 


98 


127 


131 


87 


122 


120 


185 


249 


251 


Unknown, 






3 


13 


14 


1 


9 


8 


4 


22 


22 


Totals, 


194 


194 


194 


174 


174 


174 


368 


368 


368 



1915.] 



PUBLIC DOCUMENT — No. 23. 



39 



5. — Residence of Insane Persons admitted from the Community. 



PLACES. 



Massachusetts (by counties) : — 

Middlesex, 

Norfolk, . . . 

Suffolk 

Worcester, 

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



First admitted 
TO Any 

HoSPITAIi. 



64 

4 

2 

124 



194 
138 
66 



64 

2' 

7 

101 



174 
144 
30 



12S 
6 



368 
282 



Other 
Admissions. 



Totals. 



77 



4 
148 



235 

170 

65 



6 

14 
123 



229 
190 
39 



163 
12 
18 

271 



464 
360 
104 



6. — Civil Condition of Insane Persons fit 


^st admitted to Any Hospital. 




Males. 


Females. 


Totals. 


Unmarried 

Married, 

Widowed, . . . 

Divorced 


94 
76 
15 
4 


64 

65 

41 

3 


158 
141 
56 

7 


Totals, . 

Unknown, . . . 


189 
5 


173 
1 


362 
6 


Totals 


194 


174 


368 



40 



WORCESTER STATE HOSPITAL. 



[Dec. 



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



Females. 



Booklceeper, . . . ' . 1 


Reader, . 


1 


Cashier, . 






1 


Seamstresses, . 


3 


Clerks, . 






3 


Stenographers, 


2 


Cooks, 






2 


Tailoress, 


1 


Domestics, 






36 


Teacher, . 


1 


Dressmakers, . 






2 


"Waitress, 


1 


Housekeepers, 






8 


No occupation. 


37 


Housewives, . 

Inspector, 

Laundress, 






51 

1 
1 


Total, . 
Unknown, 


170 

4 


Nurses, . 






3 


Total, 


174 


Operatives, 






15 







Males. 



Baker, 1 


Engineers, .... 2 


Barber, . 






1 


Farmers, 








10 


Blacksmith, 






1 


Firemen, 








4 


Bookbinder, . 






1 


Furrier, . 








1 


Brakeman, 






1 


Gardener, 








1 


Cabinet makers, 






2 


Janitor, . 








1 


Carpenters, . 






9 


Laborers, 








50 


Carriage maker, 






1 


Locksmith, 








1 


Chauffeur, 






1 


Liunberman, 








1 


Clerks, . 






8 


Machinists, 








8 


Coachman, 






1 


Masons, . 








2 


Comb maker. 






1 


Mechanics, 








1 


Contractor, 






1 


Merchant, 








1; 


Cook, 






1 


Motorman, 








1 



1915.] 



PUBLIC DOCUMENT — No. 23. 



41 



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



Males — 


Concluded. 








Musicians, '. 


2 


Tailors, 2 


Newspaperman, . 


1 


Teacher, . 






1 


Operatives, 


25 


Teamsters, 






2 


Painters, 


2 


Timekeeper, . 






1 


Pattern makers, . 


2 


Upholsterer, . 






1 


Piano action maker, 


1 


Waiters, . 






5 


Plumber, 


1 


Watchman, 






1 


Printers, .... 


2 


Watch repairer. 






1 


Real estate dealer. 


1 


No occupation, 






14 


Shipper, .... 
Soldiers, .... 
Storekeeper, . 


1 
2 

1 


Total, .... 187 
Unknown, .... 7 


Students, 


2 


Total, . 






194 



42 



WORCESTER STATE HOSPITAL. 



[Dec. 



P 


a 

u, 
o 

H 
g 
B 
Eh 


1 


1 1 1 |i-H'<^ocoo^cc>io 

(M (M CO (M 1-1 


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CO 

1— t 


132 
61.09 


S 


1 1 1 li-l|COi-l>OOCOCO 
1—1 1—1 I— 1 rH 


CO 1 1 

to 


CO 00 
to tm 


.2 
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1 1 1 1 |Ttico»o>o-^(ro(N 

I— 1 1— 1 (N 1— 1 


CD 1 1 


CD OS 

i> to 

06 

to 


M 
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1 

M 


in 

1 


CO 1 1 (N T^l OS Ca '^ (N i-H <N »o 

<M (M CO cq 


1—1 1—1 1 

CO 
1—1 


(N CO 

CO to 

T— 1 

to 
10 


1 

S 


tH 1 1 i-H CO '^ -^ O TfH 1-1 rJH T^i 
1—1 1—1 1—1 


CO 1 1 

to 


CD to 
to CO 

CD 

to 




(M 1 1 1-1 1-H to to '^ 00 O 00 1-1 
1-1 1-1 <M 


to tH 1 


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i 
s 

o 

1« 

13 
<J 

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«■ 

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a 

-"J 

1 


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<! 
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1 


1 |«OOOil>.COCOi-ICOi— IrH 
i-lCOCOCOCOt^TtHTtiCOi-l 


CO T— 1 1— 1 

CD 
CO 


00 TtH 
CO CO 


-a 

a 


1 1 l> (N O OOO O T-l CO>OI> 
1— li— IC<lT-lTt<<MC<l'-< 


CO 1 T-i 

I— 1 


'tH OS 

1—1 

CO 




1 1 OS --^ OSl> 00 CO OOO TtH 
(M(Nr-Hi-ICO(N(Ml-l 


CO 1-1 1 

OS 

1—1 


OS 'Jt" 
(M 




1 


lO 1 t^ CO i-< CO 00 O OS t^ CO CO 
(N tH CO 'dH CO (N CO CO CO (M 


to <N 1-1 
^ (N 

CO 


00 00 

CO 

CO 

<N 


a 

"3 


C<J 1 00 CO t> to to 1-1 O ^ •'+1 -* 
1—1 1— li— li— li— iCOC^i— li— 1 


CO rH 
CO 1— 1 
1— 1 


■^ 1-1 
t^ 00 

1—1 


CO 1 OS O^ 00 CO OS OS CO <M (M 
1-H <M (M 1— 1 1— 1 (M 1— 1 CQ T-i 


00 1—1 

1—1 


OS 'vtl 

1— ( 

7—1 




OQ 

o 




oT crT err 02" cq" oT oT oT oT 
^o3c3c3c3c3c3o3^ 

•r^OtOOiOOOOOO aT 
rj-jCMCMCOCO'^tOCOt^OO ^ 

^"flOOOOOOOOO^ 

."S oatOOtOOtOOOOO^ 
fl ^i-((M(MCOCO'*tOCOI:^g 

CiO ^ i^" 


Totals, 

Unknown, . ....'. . . '. 
Not insane, . . . . . 


Totals, 

Mean known ages (in years). 



1915.1 



PUBLIC DOCUMENT — No. 23. 



43 



^i-llOCOl^l I |IMI05t-H|t-H(NI I |r-ll 



T-H^COlT-Hlllll^^lllllll 



'^l^l ICOl I |(M!OCI lrH<M| I |r-l| 



00 T-H'lO I— I I-^ |rHi-(O:(MO0(Mi— I lO |i— I |0 I 
(M r-( ,-1 



-^r-<C^r-<|C<»l I |i-(|^|i-l|05| I iOI 



^icoi icq|7-i.-Hoocc^(Ml ii>|t-i| I I 



l>Cq| I I I 1 1 IrHrHOr-ll |OI |i-Ht^ 
1—1 CO 



^1-1 I I I I I I 



lO I 1 I CO I I r-l t^ 



COrHl II I I I |,-(,-ltO>-l| I'^lj I I I 



LOiOiOCO'— It^i— I-^(NCOCOiOCO<Mt- IOTt<C0'— liOi— I 
1— I (N I—I 1— I LO CO Cfl 



COC^rt^COi-lOTI I ji-llt^i-ltMICOT-lli-lCOl 
C<1 T-H (N 



OCO'-< I lOOi— I'^IMNCOOOC^I |i— l-<*IC0CO l<M'-l 
(M 1-1 (N 1-* 




44 



WORCESTER STATE HOSPITAL. 



[Dec. 







•— 3 


1 1 I CO 1 1 1 Tt< 1 (N 


1 1 1 (N 


■^ 1 t 


^ 




1 


1 

Eh 






CO 


CD 




g 














m 












H 


(U 


1 1 1 1 1 1 1 --H 1 1 


■ III 


(N 1 i 


<M 




H 


"3 






1— 1 


1—1 




O 


a 




























* 






EC 


o 

o 


i 


1 1 1 CO 1 1 1 CO 1 c« 


1 1 1 (N 


(N 1 • 1 

to 






m 


1 1 .-1 lO lO i— 1 tH CO 1 T-( 


1-1 1 1 rH 


IOCS 1 


'^l 




|m' 


"3 






rH 


(N 


P 


o 


o 






1—1 


1—1 


-<i 


^ 


H 










D 


H 
Q 























Izi 

M 


2 
fq 


S 


1 1 i-H IM ^ ^ ,-lCq 1 1 


^111 


t^t^ 1 


tH 


B 


"3 






»o 


CO 


!» 




a 










O 


o 










a 


s 


fa 










Q 


« 












^ 


P 


^ 


1 1 1 CO.-I 1 1 O 1 i-H 


1 1 1 1-1 


00 (M 1 


o 


^ 


13 


© 






lO 


CO 


(U 


a 


1 












m 


1 1 1— 1 1 1— 1 I— 1 1-H rH 1 1 


1 1 1 1 


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lO 




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CO 


CO 




z; 


O 














H 












2 


■ 














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1 1 ^ 1 ^ ^ ^ 1 1 1 


1 1 1 1 


00 1 1 


00 












CO 


CO 




< 


fa 
























S 


1 1 1 1 1 1 1 T-4 1 1 


1 1 1 1 


t^ 1 1 


b- 




K 


O 






(N 


(N 




m 


"cS 












a 


g 














m 


COi-iCOt^Oi-Hi-iTiHT-iiO 


<N (N 1-1 >0 


OI>T-| 


92 






3 


(NCq (N 




1-1 lO 


CO 






o 






CO 


CO 




i 


H 










• 












A 


a) 


1— 1 1 CO 00 O 1— 1 .— 1 lO 1 1 


(M(N 1 1 


OCO 1-1 


-* 




"s 


1—1 1—1 




'^ CO 


t^ 




i 


s 






1—1 


T—i 




a 


fa 
























ID 


(N i-H 1 OS O 1 1 05 i-tiO 


1 1 1-1 lO 


o^ i 


^ 






O 


1—1 T— 1 




t^ (M 


o 






la 






1—1 


1— t 


— 




S 








: 




m 










■ 




^ 




d . . . . ^ 










GC 




■ O CQ 










< 




? 'o i 


^ 








O 




.... g ... g . 


^ ■ +3~ - • 








O 




1-Sh 3 


S ^ 










hysical 
worry, 

teriosc 
tis, 

;her ca 


S Si -t-T 








k 




Ds -^3 • • ^'bCM • O • 


- >.-S • 








w 




Overwork, 
Overwork an 
Puerperium, 
Senility, . 
SeniUty and i 
Spinal menin 
Surgical shoe 
Syphilis, 
Syphilis and 
Trauma, 


-e pi « 












d QJ X 


-s .N 


^ 








Bereaveme 
Change of 
Religious e 
Worry, . 


02 ^ <D 

'S d fH 


Is 








Tot 

Unknow 
Not insa 





1915. 



PUBLIC DOCUMENT — No. 23. 



45 



10. — Probable Duration of Mental Disease before Admission. 



PREVIOUS DURATION. 


First admitted to Any Hospital. 










Males. 


Females. 


Totals. 


Congenital, 


13 


12 


25 


Under 1 month, 


35 


12 


47 


[From 1 to 3 months, .... 


29 


25 


54 


3 to 6 months, .... 


23 


16 


39 


6 to 12 months, .... 


20 


16 


36 


1 to 2 years, .... 


20 


7 


27 


2 to 5 years, .... 


25 


35 


60 


5 to 10 years, .... 


4 


20 


24 


10 to 20 years, .... 


'7 


16 


23 


Over 20 years, 


5 


4 


9 


Totals, 


181 


163 


344 


Unknown, 


13 


10 


23 


Not insane, 


~" 


1 


1 


Totals, 


194 


174 


368 


Average known duration (in years), . 


4.50 


5.60 


5.04 



46 



WORCESTER STATE HOSPITAL. 



[Dec. 






o 



C3 



o 









1 

<; H 


•sit3:}ox 


r-<rt^Cv) t~C0CT.(rq|tO|g|O|-*INM^ (MO 


•sajBuia^ 


1 ICOl (Ml 1— (|-*|iO|u5|-a(|,-icvlrt ao-* 


•sapH 


«rtrt(M >nc00i-<|IM|t^|u5|O|i-IOI -^O 


a 
m 
a 
a 

< 

s 
& 


<: 




•SIB^OX 


llll 1— IIMIIIICC|-*|-*IICCI COrt 


"saiBma^j 


(III IllllllOSIIICCIIrtI C<3-H 


•saiBi\[ 


llll l-^C-JIIII-JllTtllrtllMI II 


o < 


■si'B^ox 


llll 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 II 


•saiuniajj 


llll 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 II 


•saiBM 


llll 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 II 


c 

m 

O O 
^ « 


■si^'tox 


1 |rt| C<5rt(M| lOIOSICCI^IrtlOl Cql 

CO 


•saiBraa^ 


llll IIIIICMI— •INIrtlrtll ^1 


•saiBjij 


1 1— ll CO-HCql ItJIIOOItHIMI IOI rnl 



H 
l> 
O 
« 
P. 

s 


•siBiox 


1 t-l(M 1 MIC-51 ICOImlCOICOl INI lO-* 


•saxBuiaj 


llll lllll-^|CO|COIII|-H| ^1 


•sai^H 


I^MI (MIC^I IC^IIt^l 1 ICCl |,-Hl ^^-"i* 


1^ i 

< tp 
Si li 

m 


•sre^oX 


1 1 cq 1 (Ml co(M lt~|t-.| 1 leol Icji o -h 


•saiBuia^ 


ll-HI (MII^I-IIOllllllll tOrt 


•saiBj^ 


ll-Hl IIM— IICOIOOIIICCIIMI II 


Q 

> 


o 


•sl■B:^ox 


«IC5(M l»-l|lllllllll|.^lrt OrJ> 


•saiBtna^ 


IIIMI lllllllllllllll— 1 ■«(M 


•sa['Bj\[ 


T^It^lM l^lllllllllll^ll <MC-J 


B 

s 

O 

U 


•si'b:joX 


1 1 iJO (M t-t Cq CC (M (M r^ •«»< O T-H -^ .-H t^ ^^ cq (M 1 -^ 00 
,-H .-H ^ M ^H C^ 


•saiEmaj[ 


1 ICOl INI-H-He<l-Hrt|rt-<lOI(MlOI <ot^ 


•sapi^ 


1 ICOM rt|«'-<rta>(?5l3>rtC<3IC0rt|t^l (X;-< 
-H «S (M 






m 
< 
H 

CO 

hH 
P 

fa 

o 

% 

o 
fa 


A. — First admitted to any hospital: — • 
Alcoholic insanity, acute: — 

Alcoholic delirium, 

Alcoholic depression, 

Alcoholic hallucinosis 

Delirium tremens, ...... 

Alcoholic insanity, chronic: — 

Alcoholic deterioration 

Alcoholic hallucinosis, 

Alcoholic paranoid condition, .... 

Korsakow's psychosis, 

Cerebrospinal syphilis, ..... 

Constitutional inferiority 

Defective delinquent 

Dementia pracox, 

Epileptic equivalent 

Epileptic insanity, 

Exhaustion psychosis, 

General paresis, 

Huntington's chorea 

Hysterical insanity, 

Imbecility, 

Katatonia, 

Manic-depressive insanity: — 

Depressed form, 

Manic form, 



1915.1 



PUBLIC DOCUMENT — No. 23. 



47 





CO -<Ir^ rf-HT(<COOrtw(M —t^rtw-HTtlCO-Hrt-^ 


«^00|»0|00 c^i^ic^^^ 


c< i-H iicococqiii o;o«-H— ic^iiii 


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


g rttO — rtCO-Ht~-H — CO CO-H 1 1 1 -* 1 — i-H-l 


llOOICOIt^ lllllll 05 II III rt(0 |«| l|rt||cOIII-< 


llt^lCMI^ llllllljo II llll«llll llrHlllllll 


llj^l^lM lllllll g II lll-Hrt|rt| IIIIICOIII^ 


lllllll 1 1 1 1 1 1 '-H 1 ^ II 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


lllllll 1 1 1 1 1 1 ^ 1 ^ 11 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


lllllll lllllll 1 II 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


1-H-H«||-* llrtllrHl to II llCOlCOIIrt M|||||rtrtT-<| 


I'-H— lll<M ll-Hiii||m II iieji-olii ^lllllrtlll 


lll-H||« I1IIIT-.IC5 II II-^IMII-H |||||||_lrt| 

1 "^ 


-HlllCOl-* (Mlll^lll,^ -HM ^|_..H001ll (Mllllrt-Hlll 


-HlllMIM -HlllrtllM II liirt— clll COIIIIIrtlll 


IIIIII<M —lllllllloO ,-lrt rtlrtlt^lll lllllr-lllll 
1 " 


lllllll lllll— llltO ICO |-H|-HOlT^|-H -^Mlli-Hlllll 


lllllll lllll-il CO l-H III rt^3 1 1 1 COM 1 1 -H 1 1 1 1 1 
CO 


lllllll lllllll -* ICO l-HII 50rt \ T-, M 1 1 1 1 1 1 1 1 1 
CO 


CO 1 1 1 1 1 1 — irt iin<iijco Ico lillllll T)fl^ 1 -H 1 1 1 1 1 1 


eill.ili -Hill— II CO II lillllll cocoi-Hiiiiii 


lllllll l-<IICOIllo ICO lillllll — -Hllllllll 


-<u5cn|io-Hco lOlcoco-Hirt oo jcq -hico-*— i-jiuseo oios — — -neoi 1 Icq 


-H«OOICOrtCO i-<IICOI|.-lNl< II lllCO-*COrt| toco-Hrtrt— .III— 1 


licnieoic:^ .a<lc-jrt— I|1t(> ico rHico«i>.— i^co cocoiii—lllrt 

-H eq 05 ,-H 


Manic-depressive insanity, allied to, . 

Moron 

Organic dementia, 

Paranoid condition, senile, .... 

Paraphrenia, 

Senile dementia, 

Toxic insanity, acute: — 

Delirium 

Hallucinosis 

Traumatic insanity, 

Unclassified depression, . . 
Unclassified paranoid condition, . . 
Not insane, ........ 


Totals, 

B. — • Other admissions: — 

Alcoholic insanity, acute: — 

Alcoholic depression, 

Alcoholic hallucinosis, 

Alcoholic insanity, chronic: — 

Alcoholic deterioration, 

Alcoholic hallucinosis, 

Alcoholic paranoid condition, .... 

Constitutional inferiority 

Dementia priecox, 

Epileptic insanity, 

General paresis 

Imbecility, 

Manic-depressive insanity: — 

Depressed form, 

Manic form 

Mi.xed form, 

Manic-depressive insanity, allied to, . 

Moron 

Organic dementia, 

Paranoid condition 

Paranoid condition, senile, .... 
Psychopathic personality 



48 



WORCESTER STATE HOSPITAL. 



[Dec. 






O 



C) 



o 












1 






i ^ r-H 


^, 




oo 


1 « s . 


•smox 




GO 




■^ 


1 Q^K 




































•saiBra3j[ 




CO 






•saiBj^ 


1 -H 1 


-* 
^ 


'i" 


00 






•si'b:>ox 


1 1 1 


« 


(M 


CO 




ffi 














!ii 
















•satBrae^ 


1 1 1 


CO 


U5 




















n 


■S3J'BJ\i; 




^ 


CD 


CO 




•SITS^Oi 




1 


- 


- 


























1 


o <■ 


•sajBuiaj 






















I 




•saiBi\[ 


1 1 1 










•si'B^jox 


1- 1 


LO 


02 


o 














O O 
g 


•saiBina^ 


1 1 1 




^ 


-* 




•sai^jij 


1 - 1 


00 


>o 


ta 

















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^lultiplo cerebral abscesses. 
Organic brain disease, . 

III. Diseases of the circulatory sy.stem : — 

Acute cardiac dilatation. 
Arteriosclerosis, .... 
Arteriosclerosis and other causes. 
Aortic and mitral regurgitation, . 
Cardiovascular-renal disease, 
Clironic endocarditis, . 
Valvular heart disease, 

IV. Diseases of the respiratory system : — 

Chronic bronchitis 'with hydrothora^ 

oedema of brain, 
Pneumonia, broncho, . 
Pneumonia, hypostatic. 
Pneumonia, lobar. 
Pneumonia, lobar and empyema, 
Pneumonia, traumatic lobar. 
Pulmonary abscess. 
Pulmonary gangrene, double, 
Pulmonary tuberculosis, 

V. Diseases of the genito-urinary system : - 

Chronic interstitial nephritis. 
Chronic parenchymatous nephritis, 

VI. Accidents and violence: — 

Accidental burns of feet, myocarditis 
fatty degeneration, infective throm 
right femoral artery. 
Asphyxia during epileptic seizure. 
Fracture of skull, hemorrhage of brair 
Multiple injuries, fractured spine and 


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53 



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1915.] PUBLIC DOCUMENT — No. 23. 



55 





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