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

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Public Document 



Cl)e Commonwealth of ^ajBiisacfjiisett^ 
ANlSrUAL REPORT 

OF 

THE TRUSTEES 

OP THE 

Worcester State Hospital 

FOR THE 

Year ending November 30, 1921 



Depabtment of Mental Diseases 




BOSTON 

WRIGHT & POTTER PRINTING CO., STATE PRINTERS 

32 DERNE STREET 




Public Document No. 23 



Cf)e CommonitJealtJ) of Qia00aci)U0ettg 



ANNUAL REPOET 



THE TRUSTEES 



.Worcester State Hospital (ju.^ 



FOR THE 



Year ending November 30, 1921 



Department of Mental Diseases 




■/ 



BOSTON 

WRIGHT & POTTER PRINTING CO., STATE PRINTERS 

32 DERNE STREET 



8T11TE LIBRARY or HOStTTS 

JUN16 1922 

ST.ME. HOUSE, BOSTQI^ 



publicatioisr of this document 

approved by the 
Supervisor of Administration. 



•7^ 



CONTENTS 



PAGE 

Report of the Trustees 7 

Report of the Superintendent 11 

Valuation 38 

Report of the Treasurer 39 

Statement of Funds 46 

Statistics 49 



OFFICERS OF THE WORCESTER STATE 
HOSPITAL. 



BOARD OF TRUSTEES 

John E. White 
John G. Perman, D.D.S. 
Ltjther C Geeenleaf . 
Caroline M. Caswell, Secretary 
Mae Carlson Bemis 
William J. Delehantt, M.D. 
Edward F. Fletcher, Chairman 



Worcester. 

Worcester. 

Boston. 

Northborough. 

Worcester. 

Worcester. 

Worcester. 



William A. Bryan, M.D. 
Clarence A. Bonner, M.D. 

Michael J. O'Meaea, M.D. 
Leon E. Duval, M.D. . 



Robert B. Harriman, M.D 
George F. Caldicott, M.D. 
Frankltn p. BoirsQcrET, M.D. 
George A. Gaunt, M.D. 
Harrison M. Stewart, M.D. 

Lloyd E. Byrd, D.D.S. 



MEDICAL STAFF. 

Superintendent. 
Assistant Superintendent. 
Director Clinical Psychiatry. 
Senior Assistant Physician. 
Senior Assistant Physician. 
Senior Assistant Physician. 
Senior Assistant Physician 

(Pathologist) . 
Assistant Physician. 
Assistant Physician. 
Assistant Physician. 
Assistant Physician. 
Assistant Physician. 
Assistant Physician. 
Dentist. 



HEADS OF DEPARTIMENTS 

Elsie I. Richards, R.N. 



Maurice Scannell 
Jessie M. D. Hamilton 
Herbert W. Smith 
Lillian G. Carr . 
Joseph Reynolds 
James Dickison, Jr. 
Anton Swenson . 



Superintendent of Nurses and 
Principal of Training School, 

Supervisor, Male Department. 

Treasurer. 

Steward. 

Matron. 

Head Farmer. 

Chief Engineer. 

Foreman Mechanic. 



Cl)e Commontoealtf) of ^a00acJ)usett0 



TRUSTEES' REPORT. 



To His Excellency the Governor and the Honorable Council. 

The trustees of the Worcester State Hospital respectfully 
submit the eighty-ninth annual report of the hospital, append- 
ing a record of the various departments as reported by the 
superintendent, Dr. William A. Bryan, and by the treasurer, 
Jessie M. D. Hamilton, 

In November, 1920, Mr. Edward F. Fletcher of Worcester 
was duly elected permanent chairman of the Board, and Miss 
Caroline M. Caswell, secretary. 

The trustees assisted in helping to make the American 
Medico-Psychological Association meeting in Boston the suc- 
cess which it was. 

In their corporate capacity the trustees voted to present 
Washington Allston's picture of St. Peter and the Angel in 
Prison, given to the hospital by Dr. R. W. Hooper, to the 
Boston Museum of Fine Arts on condition that the original 
be replaced by a very fine copy. This gift was made after 
careful consideration of the terms of the deed of gift from Dr. 
Hooper, and in view of the fact that the original would be of 
far greater value as an art treasure to the Art Museum than 
to the hospital, w^hile a good copy would give as much pleasure 
to the inmates of the Worcester State Hospital. 

Believing in co-operation the Board voted to place a sign of 
welcome to the city at the junction of Lake Avenue and Bel- 
mont Street, at the request of the Chamber of Commerce, and 
also voted to grant the city of Worcester permission to erect 
a memorial granite shaft for James M. Beatty on the north- 
easterly corner of Beatty Square. 

Still thinking, as outlined in the 1920 report, that there 



8 WORCESTER STATE HOSPITAL. [Dec. 

ought to be something definite for all trustees to do to further 
the work with which they had become associated, they voted 
to give hearty support to the Hospital Trustees Association for 
a year. The association has been invited to hold its spring 
meeting at the hospital. 

One new plan which has worked out very satisfactorily is 
the presenting of a full typewritten report by the superintend- 
ent to the trustees several days before the monthly meetings. 
This report is most comprehensive and gives the trustees time 
to consider the various phases of the work in an intelligent 
manner. 

Repairs on the organ were voted from the private funds held 
by the trustees. 

The details of improvements in the hospital will be noted by 
the superintendent, but the trustees gladly report improved 
conditions and steps in advance everywhere. Buildings 
painted, installation of new toilets on Washburn I and II, 
work begun on the renovation of Lincoln IV and Salisbury III, 
a new system of handling garbage, the purchase of necessary 
home, farm, medical and dental equipment, the grading and 
terracing of the land, and the laying of water pipes at Hillside 
— all these activities pointing to progression. 

Attention is called to the careful analysis made in the sum- 
mary of admissions in the superintendent's report, and to the 
result of treatments which, after all, is the most important 
feature; also to the resident dentist's report of the dental de- 
partment, which shows a very decided increase in work accom- 
plished. The excellent achievements in the pharmacy should 
be especially noted, showing as they do in the pharmacist 
marked thought and interest in the work and capacity for 
service. The social service department is as ever impor- 
tant in its results and in its bearing upon our usefulness in 
the community. An assistant has been at work in this 
branch since September 18. The course of six lectures for 
the social workers of Worcester in psychiatric social service, 
which lectures have been largely attended and thoroughly 
appreciated, is also a forward step in the community's under- 
standing of hospital service, as well as of much educational 
value to the social worker. The out-patient department offers 



1921.] PUBLIC DOCUMENT — No. 23. 9 

many of the advantages of a psychopathic to the people of 
Worcester and vicinity, and will be a most important factor in 
acquainting those outside the hospital \dth its desire for help- 
fulness. The results of this new work have been most encour- 
aging. 

The trustees respectfully submit the fact that there is im- 
perative need of fireproof stairways; that a new storehouse and 
a new system of refrigeration are both very desirable; and that 
a plan for a congregate dining room should be made. The use 
of the Summer Street department for an up-to-date pscyho- 
pathic hospital would greatly increase the value of the Worces- 
ter State Hospital in this section of our State. The trustees 
again urge upon those in power the necessity of increasing 
instead of decreasing salaries and wages for workers in the 
different departments, in order that the best brains and service 
may be obtained for the hospital. 

The trustees can point with no little pride to the advance 
which the hospital has made during the past year under the 
leadership of Dr. Bryan, appointed superintendent in March, 
1921. His keen mentality, united with his love for humanity, 
his common sense backed by willingness to work, his vision and 
command of others, are qualifications which will make the 
Worcester State Hospital most progressive. In all his plans 
he has the endorsement and co-operation of the trustees, and 
the improvements in the hospital in all its departments are 
already perceived. It is most fitting that this, the oldest 
hospital in Massachusetts, know^n in the early days for the 
heartlessness which characterized the care of the insane, should 
now become noted for the incorporation in its remedial work 
of the best and most advanced ideas. The improvements in 
the wards, making them altogether more desirable, the dining 
rooms and sitting rooms planned with a thought of home in 
mind, the admission offices designed to impress the patient 
favorably, the salvage yard arranged to save all left overs and 
to provide proper storage for such goods, the reorganized store 
system, the labor-saving devices, which enable Dr. Bryan to 
know just what each department is doing and just how many 
employees are at their posts — these and various other advanced 
steps point to better service and more satisfactory results. The 



10 WORCESTER STATE HOSPITAL. [Dec. 

clinic at the Summer Street department attended by patients 
recommended by doctors, social workers and the schools, the 
advice tending toward future amelioration of defects thus dis- 
covered, and the schoolroom where those with proper capac- 
ity can be taught and thus increase the possibility of cure, are 
features of the progressive plans now being made and in which 
the trustees rejoice. People and what he can do for them shape 
all Dr. Bryan's plans. The Christmas trees in every ward, 
that those unable to leave the ward should also have some of 
the joys of this glad season, the diversified entertainments, 
the careful plans for every one's happiness, show the heart in the 
work, the desire to help, the hope that good may come to the 
patients, — the patients who are the first and last thought of 
Dr. Bryan and his able assistant, Dr. Clarence A. Bonner, also 
a new appointee at the hospital. 

The trustees would be remiss if in this report they did not 
thank all the employees of the hospital for the admirable way 
in which they have co-operated with Dr. Bryan in the many 
changes he has made, and for the spirit of good fellowship 
which exists. Such co-operation with such an able leader can 
but make for a most successful new year of service. 

Respectfully submitted, 

EDWARD F. FLETCHER. 
JOHN E. WHITE. 
JOHN G. PERMAN. 
LUTHER C. GREENLEAF. 
CAROLINE M. CASWELL. 
MAE CARLSON BEMIS. 
WILLIAM J. DELEHANTY. 



1921.1 PUBLIC DOCUMENT — No. 23. 11 



SUPERINTENDENT'S REPORT. 



To the Trustees of the Wo^rester State Hospital. 

I herewith respectfully submit the following report of the 
hospital for the year ending Nov. 30, 1921, it being the eighty- 
ninth annual report. 

There remained on the hospital books Oct. 1, 1920, 2,271 
patients, — 1,172 men and 1,099 women. During the year 
ending Sept. 30, 1921, there were admitted 616 patients, — 
382 men and 234 women. Five hundred and twenty patients — 
314 men and 260 women — were discharged from the hospital. 
Of this number, 265 patients — 166 men and 99 w^omen — 
Avere discharged; 241 patients — 138 men and 103 women — 
died; and 14 patients — 10 men and 4 women — w^ere trans- 
ferred, leaving at the end of the statistical year 2,367 patients, 
— 1,240 men and 1,127 women. Two thousand and fifty-eight 
patients — 1,048 men and 1,010 women- — were actually in the 
hospital. Of this number, 1,852 were supported by the State, 
102 by friends, and 104 as reimbursing patients. Of the 
patients discharged, 57 were reported as recovered, 157 as im- 
proved, and 33 as not improved. Eighteen patients — 12 men 
and 6 women — were discharged as not insane. Seven men and 
2 women were transferred by the Department of Mental 
Diseases to the State Infirmary; 2 women to Herbert Hall; 
2 men to the Medfield State Hospital; 1 man to the Boston 
State Hospital. Ten men and 4 women were removed from 
the State and 15 men and 3 women were deported. 

There remained in the hospital at the end of the year 95 
more patients than at the beginning. The smallest number 
under treatment on any day was 1,976 patients, and the 
largest 2,084. The daily average was 1,990.62. 

The percentage of recoveries calculated upon the number of 
discharges and deaths was 8.87, calculated upon the number of 
admissions, 10.63. The death rate w^as 11.9, calculated on the 
whole number of patients under treatment, and 8.2 calculated 
on the daily average number. 



12 



WORCESTER STATE HOSPITAL. 



[Dec. 



Admissions classified by Clinical Groups. 

The classification adopted by the American Psychiatric 
Association has been followed, and the following summary of 
admissions, according to clinical diagnosis, with a brief analysis 
of each group, is submitted. 

This summary was prepared by Dr. Clarence A. Bonner, 
assistant superintendent. Dr. Franklin P. Bousquet, assistant 
physician, and Miss Harriet L. Card, superintendent's clerk. 



Traumatic PsycJiosis. 
Number of cases admitted, one. 
Following is a brief abstract of the same: — 

Patient is a white male, age 50, single, and a laborer by occupation. 
Born in Winchendon, Mass. Admitted to this hospital July 13, 1921, 
on regular papers. 

Family History. — Negative. 

Personal History. — Early childhood essentially negative. Attended 
school until he reached the second year of high school, and at sixteen he 
went to work. 

Onset. — Sudden. He thought that women entered his room at night, 
and that they were attempting to persecute him by various methods. 

Physical Examination. — Shows ptosis of right upper lid, pupils slug- 
gish in action. Wrist shows a condition resembling UTist drop. Blood 
pressure, 112 systolic, 70 diastolic. Urinalysis and Wassermann negative. 

The injury to his head is said to have occurred when he fell from a high 
wall while spraying trees ^\dth a chemical. Apparently after this there 
was a progressive weakening of the muscles and the formation of a 
psychosis. 

Senile Dementia. 

Number of cases admitted, 47, — 17 males and 30 females. 
Types. — Simple, 30; presbyophrenic, 1; paranoid, 16; total, 
47. Average age, seventy-two years. 

Results of Treatment. 





Males. 


Females. 


Totals. 


Discharged improved 

Discharged unimproved 

Died 

Remaining in hospital 


17 


30 


47 



1921. 



PUBLIC DOCUMENT — No. 23. 



13 



Cerebral Arteriosclerosis. 
Number of cases admitted, 46, — 31 males and 15 females, — 
equal to 5 per cent of the total admissions; fifth decade, 9; 
sixth decade, 12; seventh decade, 16; eighth decade, 9. 

General Paralysis. 

Number of cases admitted, 34, — males, 27, and females, 7, — 
or 7 per cent of the total admissions. Average age of men on 
admission, fifty years; of women, forty-two. Youngest patient 
in this group is twenty-two years of age, and the oldest was 
sixty-four. 

Twelve patients died, a mortality of 33 per cent. 



Results of Treatment. 



Males. 



Females. 



Totals. 



Discharged improved 
Discharged unimproved 
Died . . . . 
Remaining in hospital . 



Cerebrospifial Syphilis. 
Under this classification we have gathered 8 cases which 
represent an involvement of the nervous system, varying in de- 
gree but exclusive of general paresis. Of these cases 4 have 
left the institution and 2 are remaining in the hospital. Both 
of the females have been permitted to leave. One of the male 
cases responded remarkablj^ well to intensive treatment. This 
patient upon entrance exhibited a paralysis of the right arm 
and an aphonia. At the time of his leaving the institution 
muscular sense was apparently improved to such an extent that 
the patient could readily move his fingers. He also recovered 
his speech to the point where he was able to make himself 
understood. This case is one of the few which stand out as 
convincing evidence of the advisability of intensive treatment 
of neurosyphilitics, including the paretics. 



14 



WORCESTER STATE HOSPITAL. 



[Dec. 



Huntington'' s Chorea. 
During the year 1 case was admitted, 
this case is as follows: — 



A brief abstract on 



The case of A. N., admitted to the hospital May 10, 1921. As usual 
in these cases we have a previous record of an ancestral case. The father 
was a patient in this institution. The patient is fifty-four years of age. 
Received a common school education. Has four children and general 
health has been fairly good. In October, 1921, patient began to show 
unusual signs of nervousness, — ■ became irritable, suspicious, careless in 
her habits, and the tj'pical movements associated with Huntmgton's 
chorea became evident. Neurological findings: vision very much im- 
paired; protrusion of the right eyebaU; general choreic movements, with 
a certain amount of voluntary control. Blood pressure: 200 systolic, 
110 diastolic. The blood serum was negative. 

Hospital liistory finds that patient has been very kindly disposed, 
pleasant and tractable; somewhat sensitive, neat in habits and has 
assisted greatly in the care of herself. Mentally she is extremely emo- 
tional — exaggerates her troubles; occasionally makes rather unreason- 
able complaints, but, on the whole, has adopted a rather contented 
manner, and is getting along very comfortably at the present time. 



Psychosis icith Other Brain or Nervous Diseases. 
Four cases were admitted: cerebral embolism, 1; paralysis 
agitans, 1; encephalitis, 2. 



Results of Treatment. 



Females. I Totals. 
I 




Discharged improved 

Died 

Remaining in hospital 



Alcoholic Psychosis. 

Twenty-one cases were admitted, equal to 1 per cent of the 
total admissions. Of the total admissions, 2 were discharged 
recovered, 1 improved, 1 died and 17 remain in the hospital. 

The general run of alcoholic cases shows little change from 



1921. 



PUBLIC DOCUMENT — No. 23. 



15 



that of previous years excepting in numbers. There are 7 
more alcohohc cases this year than last. In detail, there was 

1 case of pathological intoxication, 1 case of delirium tremens, 

2 cases of Korsakoff's psychosis, 10 cases of acute alcoholic 
hallucinosis, 3 cases of chronic hallucinosis, 1 of the chronic 
paranoid t^'pe, and 3 alcoholic deteriorations. 

Psychoses due to Drugs. 
Psychoses due to drugs came under treatment in 2 cases; 
1 was morphine and 1 cocaine. Of this group, 1 escaped from 
the hospital and the other is in the institution. 



Psychosis with Other Somatic Diseases. 

During the year 7 cases were admitted in whom the etio- 
logical factor was some physical condition, ■ — post-infectious 
psychosis, 1 male, 3 females, total, 4; exhaustion delirium, 3 
females. 

These cases are interesting and unusual, for the reason that 
very definite physical disease is allied with the mental con- 
dition. The symptoms are similar to the usual psychoses, but 
the basic cause has been attributed to the physical state. 

Of these cases above mentioned, 2 directly followed partu- 
rition, and 1 followed peritonsillar abscess with resultant ab- 
sorption of toxins. One was associated with pulmonary tuber- 
culosis, 2 followed periods of exhaustion, and 1 followed chronic 
nephritis. 





Results of Treatment. 






Males. 


Females. 


Totals. 


Dicharged recovered 




- 


1 


1 


Discharged improved 




- 


- 


- 


Discharged unimproved 




- 


- 


- 


Died .... 




1 


5 




In hospital 


g 







16 



WORCESTER STATE HOSPITAL. 



[Dec. 



Manic-depressive Psychosis . 
During the year 32 cases were admitted, — 14 men and 18 
women, — equal to 8 per cent of the total admissions for the year. 



SUBCLASSIFICATION. 


Males. 


Females. 


Totals. 


Manic tj'pe . . • . 


3 
10 
1 


14 
3 
1 


17 




13 


Mixed 


2 




Resvlts 


of Treatment. 








Males. 


Females. 


Totals. 


Discharged recovered 

Discharged improved 

Discharged not improved 

Died 


4 

1 

2 

7 


3 

2 
13 


4 
4 

4 


In the hospital 


20 








: ■ — ■ 


14 


18 


32 



Involutional Melancliolia. 
During the year 28 cases were admitted, — 14 men and 14 
women, — comprising 9 per cent of the total admissions. 



Residts of Treatment. 








Males. 


Females. 


Totals. 


Discharged improved 

Discharged recovered 

Remaining in the hospital 


1 

1 

12 


14 


1 

1 
26 




14 


14 


28 



Dementia Pracox. 
Out of 240 cases admitted, 141 were dementia prsecox 



cases. 



There were 97 males and 44 females, comprising 56 per cent 
of the total admissions. 



1921.1 



PUBLIC DOCUMENT — No. 23. 



17 



SUBCLASSIPICATION. 


Males. 


Females. 


Totals. 


Paranoid 


61 


25 


86 


Catatonic 


17 


13 


30 


Hebephrenic 


10 


2 


12 


Simple 


9 


4 


13 




97 


44 


141 





Results of Treatment. 






• 


Males. 


Females. 


Totals. 




7 

1 
2 
87 


2 

2 
40 


9 


Not improved ........ 


1 


Died 


4 


Remaining on books 




127 




97 


44 


141 



Epileptic Psychosis. 
This group is comprised of 4 cases, — 2 men and 2 women, — 
all of whom were placed in a subgrouping of deterioration^ 
The family history could not be obtained in 2 cases. One 
case was positive to insanity, the other case was negative. 



Results of Treatment. 





Males. 


Females. 


Totals. 


Discharged improved 


- 


- 


- 


Discharged not improved 


- 


1 


1 


Died 


1 


- 


1 


Remaining in hospital 


1 


1 


2 




2 


2 


4 



Psychoneuroses and Neuroses. 

The total number of psychoneuroses cases admitted was 
10, — 3 men and 7 women. 

Types. — Hysterical types, 4; psychasthenic, 3; neuro- 
sthenic, 3. 

One was discharged not improved, 3 improved, no deaths^ 
and 6 remain in the hospital. 



18 WORCESTER STATE HOSPITAL. [Dec. 



Psychopathic Personality ivith Psychoses. 

There were 2 cases diagnosed in this group. These were 
both first admissions. One of these was married and the other 
single; one a laborer, and the other's occupation was given as 
civil engineer. One of these cases remained in the hospital but 
a month, when he was permitted to leave on visit. The other 
during his stay showed a gradual increase in psychotic 
symptoms. 

Psychosis ivith Mental Deficiency. 

Of the total admitted there w^ere 21 cases classified in this 
group, — 14 men and 7 women; the average age was forty 
years, the youngest fourteen and the oldest sixty years. Dis- 
charged as improved, none; not improved, 2; remaining in the 
hospital, 19. 

Undiagnosed Psychosis. 

Thirty-six cases were admitted during the past year. These 
included 22 men and 14 women. Four cases were discharged 
as improved, 1 not improved, 3 died, and there are 28 re- 
maining in the hospital. 

This group of cases at the time of staff presentation could 
not be placed in any definite classification according to the 
schedule. In the majority of these cases the history was not of 
any great help. A few of the cases were incomplete because of 
the patient leaving w^ithin a few days after admission, not 
giving opportunity for the proper study and observation. From 
time to time throughout the year it is planned to inspect and 
re-examine cases of this kind, expecting that the symptoma- 
tology will offer evidence of a recognized psychosis. Of these 
36 cases but 4 had a positive Wassermann and but 1 showed 
any symptoms of neurosyphilis. 

Without Psychosis. 
Six cases were admitted wherein no psychosis could be 
found. Of these, 4 were men and 2 women. There was 1 epi- 
leptic, 4 psychopathic personalities, and 1 mentally deficient. 
Of this group 2 men have been discharged and 4 remain in 
the hospital. 



1921. 



PUBLIC DOCUMENT — No. 23. 



19 



At the time these cases were presented at staff meeting 
their conduct and general reactions had given us no clew as 
to the actual type of mental disease. In all the cases there had 
been certain abnormal activities which had served to bring 
them within the view of the authorities. It not infrequently 
happens that patients who have perpetrated conduct disorders 
are of the constitutional inferiority or psychopathic classes, 
who are capable of self-restraint under disciplinary measures, 
but who do not exhibit those gross signs or symptoms which 
enable us to properly diagnose according to the present clas- 
sification. Of this group the psychopathic personalities pre- 
dominated, with 1 case of mental deficiency and 1 of epilepsy 
with infrequent convulsive episodes. 



Ex-Service Men. 

During the past year there were 47 ex-service men admitted 
to this hospital, and 15 of that number remained at the end of 
the year, making a total of 43 soldiers in the institution. Of 
those leaving the hospital 10 are out on a year's trial visit; 
7 left without permission; 1 was transferred to another State 
hospital; 3 were discharged as recovered, 6 as improved, 4 as 
not improved, and 1 as not insane. 

These men have been in charge of a special attendant who 
is himself a veteran, and the results of this plan have been 
most gratifying. 

The following table shows the psychoses of these patients: — 



Dementia prsecox . 

Alcoholic 

Manic-depressive . 

Psychopathic personality 

Mentally deficient 

Psychoneuroses 

Epileptic 

General paralysis . 

Cerebral embolism 

Unclassified . 

Not insane 



26 
5 
3 
3 
2 
1 
1 
1 
1 
2 

9 



20 WORCESTER STATE HOSPITAL. [Dec. 

General Health of the Population. 

The general health of the institution has been good. Among 
the employees 2 nurses suffered from diphtheria and were 
cared for at the Isolation Hospital. One female patient, 
suffering from dementia prsecox, died from fracture of right 
femur, having been pushed by another patient. One woman 
suffering from cerebral arteriosclerosis died from multiple in- 
juries, due to an accidental fall. One woman, also a case of 
cerebral arteriosclerosis, died from asphyxiation, due to food 
in larynx and bronchi. One man, diagnosed general paralysis 
of the insane, died from punctured ribs, due to an accidental 
fall from bed. 

These cases were investigated by the medical examiner, and 
Dr. Myrtelle M. Canavan of the Department of Mental 
Diseases. 

Principal Causes of Deaths. 
Seventeen and one-half per cent of all deaths were due to 
general paralysis of the insane; 15 per cent each to cardio- 
vascular renal disease and pneumonia; 10 per cent to general 
arteriosclerosis; and 7^ per cent to cerebral hemorrhage. 

Staff Changes. 
The follovdng changes have taken place on the medical 
staff of the hospital : — 

Resignations. 

Wilham J. Vivian, M.D., resigned Jan. 21, 1921, to go 
to the United States Public Health Hospital, West Roxbury, 
Mass. 

Donald R. Gilfillan, M.D., resigned to go to the National 
Sanatorium, Marion, Ind., Jan. 27, 1921. 

B. Henry Mason, M.D., acting superintendent, left to 
accept a position at the Psychopathic Hospital, Ann Arbor, 
Mich., April 17, 1921. 

Roy C. Jackson, M.D., resigned July 1, 1921. 

Arthur H. Mountford, M.D., resigned Aug. 31, 1921. 

Ada F. Harris, M.D., resigned Aug. 31, 1921, to be married. 



1921.1 PUBLIC DOCUMENT — No. 23. 21 



A2)pointments . 

William A. Bryan, M.D., was appointed superintendent, and 
assumed charge April 3, 1921. 

George F. Caldicott, M.D., was appointed assistant physician 
June 1, 1921. 

Franklyn P. Bousquet, M.D., was appointed assistant physi- 
cian June 1, 1921. 

George A. Gaunt, M.D., was appointed assistant physician 
Aug. 1, 1921. 

Harrison M. Stewart, M.D., w^as appointed assistant physi- 
cian Oct. 3, 1921. 

Leon E. Duval, M.D., was appointed senior assistant physi- 
cian Jan. 1, 1922. 

Dr. Clarence A. Bonner was made assistant superintendent 
Sept. 13, 1921. 

Dr. Michael J. O'Meara was made senior assistant physician 
Nov. 23, 1921. 

Dr. Lloyd E. Byrd was appointed resident dentist Aug. 15, 
1921. 

Student Internes. 

The staff was materially assisted in the work during the 
summer months by a number of student internes from the 
Women's Medical College, Philadelphia, the University of 
Michigan Medical College, and the Tufts Medical College. 
One dental interne from Harvard Dental School served three 
months in the dental department. These positions are filled 
by second and third year students, and their w^ork consists of 
acting as aids to the medical staff in the examination and 
treatment of patients, and as assistants in the pathological 
laboratory. 

It is our intention to give the students a definite formal 
course of instruction along specialized lines, and such course is 
now being prepared for the next group of internes who come 
to the hospital. 



22 



WORCESTER STATE HOSPITAL. 



[Dec. 



The following students served as internes for periods of two 
to three months: — 

Carl P. Benaglia June 1 to Sept. 1, 1921. 

Fernand M. Riendeau June 9 to Aug. 1, 1921. 

Edward P. A. Vercueil (dental) . . . June 10 to Sept. 10, 1921. 

Henry L. Smith June 22 to Sept. 12, 1921. 

Walter 0. KHngman June 22 to Sept. 10, 1921. 

Mildred Rogers June 30 to Aug. 30, 1921. 

Matilda Maerz July 3 to Sept. 16, 1921. 

Emily Gardner July 3 to Aug. 30, 1921. 



Medical Work. 

The estabhshed routine of immediate preliminary physical 
examination of all newly admitted cases, Wassermann tests, 
typhoid and smallpox vaccines has been followed. Each case 
admitted for ten days' observation is brought to the staff con- 
ference where the question of commitment is decided. Staff 
meetings are held daily at 8 o'clock, each member of the 
staff being assigned a definite day when his cases may be pre- 
sented. No case is presented until history, physical and 
mental examination and all special tests are secured, diagnosis 
made and a course of treatment outlined. 

The general health of the population has been good during 
the year. Two cases of diphtheria have occurred, both of them 
being in the nursing group. They were sent to the City 
Isolation Hospital; both made a good recovery. 

The X-ray department has been in active operation most of 
the year. There has been a total of 55 skiagraphs made from 
September 1 to the close of the year. The pictures taken are 
classified as follows: — 



Hip 2 

Wrist ....... 10 

Foot 1 

Head 3 

Knee 6 



Shoulders . . . . . 4 

Chest 6 

Hand 11 

Ankle 9 

Spine ...... 3 



The following lesions were found in this group of cases: — 

Colle's fracture of wrist. 

Compound fracture of humerus above an old fracture. 

Compound comminuted fracture of right radius and ulnar bones. 



1921.] PUBLIC DOCUMENT — No. 23. 23 

Osteoma pereostitis of left tibia. 
Falling of ant. arch of right foot. 
Fracture of middle third of right humerous. 
Dislocation of acromial end of right clavicle. 
Double fracture of lower one-third of ulnar. 
Three positive cases of tuberculosis. 

We have made increased use of electrotherapeutics in treat- 
ing certain types of psychoses, and the success attending this 
work deserves its further expansion. 



Hydrotherapy. 
A complete reorganization of the hydrotherapy department 
has been brought about in the past year. Considerable new- 
equipment, such as pack beds, has been added. Largely as a 
result of the increased use of this method of treatment, 
restraint and seclusion have been practically eliminated from 
the hospital. 



Calisthenics, Re-educational Work and Habit Training. 

The scope of the re-educational work has been enlarged. 
The sale of articles turned out by this department has been 
abolished, and the products are now used entirely by the 
hospital. This has the eflPect of transferring the interest of the 
instructors to the patient. The therapeutic idea is kept in view, 
and the instructor is interested in the improvement of the 
patient rather than the attempt to turn out beautiful articles 
for display or sale. 

A beginning has been made in grading the classes according 
to the occupation being taught, progressing from the simple to 
the complex, and each type of occupation is in a separate room. 
In this way the progress of the patient can be accurately 
followed. A class of demented patients has been organized 
under a physical culture teacher. Small groups of patients are 
taken to the chapel and an hour spent in playing games, in 
various calisthenic exercises and in marching. We have found 
that this is the longest period of time such work can be prof- 
itably followed for the same patient, and a different group is 



24 WORCESTER STATE HOSPITAL. [Dec. 

treated each hour of the day. In this way one teacher can 
give her attention to a very large group of patients. 

Habit-training classes have been inaugurated on the untidy 
wards, and have done much to raise the morale of the patient 
population on these wards. Three school classes have been 
organized, with patients officiating as teachers, — one class in 
English for young Italian girls, a class in conversational 
French, and a class in the elementary branches. These classes 
have been productive of excellent results, and pupils and 
teachers have shown much improvement as a result of them. 

An occupational therapy department has been started at 
Summer Street, and this work has been enlarged until it is a 
very prominent factor in the work of that department. 

Staff Luncheons. 
A new feature has been initiated during the past year which 
has been of much interest and benefit to the members of the 
staff. Once in two weeks a staff luncheon is held, at which 
time a specialist is secured in some field of general medicine who 
discusses with the members the particular phase in which he is 
interested. These meetings have been unusually helpful and 
stimulating. We are indebted to the following speakers for 
their helpful talks: — 

Dr. Michael Jordan, "The Relation of the State Hospital to the Neurolo- 
gist." 
Dr. Ernest Hunt, "Surgical Organization." 
Dr. Walter Bieberbach, "Surgery of the Prostate Glands." 
Dr. Thomas F. Kenney, "The Relation of the Board of Health to the 

State Hospital." 
Dr. James Plant, "A Plan for Nurses' Notes." 

On December 7 the fifty-second meeting of the assistant 
physicians of the State hospitals of Massachusetts was held 
here. The program consisted of a ward inspection in the 
morning, luncheon at 1 p.m., physicians' meeting at 2, followed 
by literary papers and discussion, led by Drs. Bonner and 
Gaunt. Calisthenic exercises and occupational activities were 
demonstrated. 



1921.1 PUBLIC DOCUMENT — No. 23. 25 



Laboratory Report. 
The work in the pathological laboratory suffered very 
seriously by the resignation of Dr. Ada Harris. Since that time 
we have had no pathologist in charge, and have only been able 
to do the routine work. A pathologist has been secured and 
will begin his duties on February 1, at which time it is expected 
that a complete reorganization of the pathological work will 
take place and the next year be one of productive activity. 

Dental Department. 
The following report is submitted by Dr. Byrd, the resident 
dentist: — 

I submit herewith the following report of the dental work 
done at the hospital during the year 1921. A full-time dentist 
was appointed in June, 1921, and the report will show the 
increase in the amount of work carried on following this appoint- 
ment. 

For the months of June, July, August, September, October and 
November the least number of patients treated was 193 and the 
greatest number was 267. The least number of prophylactics 
was 87, the highest 161. The least number of fillings was 52 and 
187 the highest. Treatments throughout this period ranged from 
11 per month up to 27. The greatest number of extractions 
were performed in November, there being 462. 

A full equipment for the dental laboratory has been installed 
and four plates have been completed for patients in the hospital. 
The work of Miss Thompson, dental hygienist, has been ex- 
tremely valuable. She has done much prophylactic work, and 
in addition has inaugurated classes in hygiene on the wards. 
Attention should be called to the necessity of the new work 
with accessories for the use of the dental hygienist, and also a 
new dental cabinet and nitrous-oxide machine. The following 
table shows, in detail, the work done in the department: — 



26 



WORCESTER STATE HOSPITAL. 



[Dec. 



Month. 


Num- 
ber of 

Pa- 
tients. 


Clean- 
ing. 


Filling. 


Plates. 


Treat- 
ment. 


Teeth 

ex- 
tracted. 


Im- 
pacted 
Teeth 

ex- 
tracted. 


Plates 

re- 
paired. 


December . 
January 
February . 
March 
April . 
May . 
June . 
July . 
August 
September 
October 
November 








32 
48 
36 
59 
39 
27 
193 
235 
267 
250 
262 
256 


4 

15 

3 

12 

6 

7 

115 

112 

102 

137 

87 

161 


9 
6 
14 

24 
9 
8 
52 
82 
156 
117 
187 
163 


1 
3 


4 
3 
8 
12 
5 
10 
23 
18 
26 
27 
24 
11 


33 

61 

34 

51 

37 

12 

299 

390 

434 

350 

333 

462 


3 
2 
3 
4 


1 


Totals . 


1,704 


761 


837 


4 


171 


2,496 


12 


1 



Report of the Out-patient Department. 
The following report of the work of the out-patient depart- 
ment which was begun at the Summer Street Department in 
June, 1921, is submitted by Dr. George F. Caldicott, who has 
acted as the head of this phase of the work and has also had 
charge of the examination of school children. The personnel 
consisted of Dr. Caldicott and Dr. Michael J. O'Meara, Miss 
Helen A. Martin, psychologist. Miss Mary W. Howgate and 
Miss Jennie A. Harrington, social service workers, Miss 
Margaret Medcalfe and Miss Mary Donohue, nurses. 



I herewith submit the summary of the work done in the out- 
patient department during seven months of the year 1921. 
This department was organized in June, the purpose of the clinic 
being to offer to the people of this section of the State the 
advantages of a psychopathic hospital. At first the idea was 
somewhat new to the public, but the opportunity for help 
offered by the clinic was soon recognized. Before long, not only 
were psychiatric cases presented for diagnosis, treatment and 
advice, but also neurological and syphilogical cases; also cases 
of children who were retarded in school or who were con- 
duct problems. Later the task of examination of school chil- 



1921. 



PUBLIC DOCUMENT — No. 23. 



27 



dren in 58 towns came to be placed under this department. 
The clinic has available physicians, social workers, a psychologist 
and nurses — all training along this line of work. The routine 
of examination consists of searching inquiry along lines of 
physical examination, family history, personal and develop- 
mental history, school progress and tests, practical knowledge, 
economic efficiency, social history and reactions, moral reactions, 
mental and psychological tests; also the routine taking of blood 
for Wassermann tests, together with laboratory examinations, 
as indicated. 

If needed, such facilities as X-ray, electrical apparatus and 
fluroscopes are available for detailed study. From this data a 
complete and composite picture is made from which to draw a 
conclusive diagnosis. A diagnosis being made, advice on the 
disposition of the case is given, and patients who can receive 
treatment at the hospital are given attention free of charge. 

The following table will show the type of cases handled by 
the out-patient department : — 



Diagnosis. 



No. 



Recommendations. 



Disposal. 



/. Psychotic. 

Dementia prsecox . 

Senile dementia . 

Manic-depressive . 

Psj'chosis with cerebral 
embolism. 

Neurosis 

Neurasthenia 

//. Feeble-minded. 
Simple .... 



Delinquent . 

With syphilis 
With epilepsy 



Hospitalization . 
Sanatorium treatment 
Hospitalization . 
Hospitalization . 



Electro and hydrotherapeu- 
tic treatments, with psy- 
choanalysis. 

1, electro and hydrothera- 
peutic treatment. 

2, readmission to hospital . 



1, institutional care . 

5, special class and manual 
training. 

2, corrective supervision (at 
home). 

3, institutional care . 

Institutional care 



Institutional care and syphi- 
litic treatment. 
Institutional care 



Committed to Worcester State 

Hospital. 
Relatives carrying out advice. 

Committed to Worcester State 
Hospital. 

Temporary care at Adams Nerv- 
ine by relatives; later com- 
mitted to Worcester State 
Hospital. Condition unim- 
proved. 

Treatment carried on at 
Worcester State Hospital out- 
patient department. Im- 
provement seen. 

1, carried on at Worcester State 
Hospital out-patient depart- 
ment. 

2, in hospital. Condition im- 
proved. 



Admission pending. 
In hands of relatives. 

Being carried out. 

Advice not followed. 

4, admitted to feeble-minded 

school. 
2, admission pending. 

Patient disappeared. 

1, advice not followed. 

2, patient to report in six months. 

3, admission pending. 



28 



WORCESTER STATE HOSPITAL. 



[Dec. 



Diagnosis. 


No. 


Recommendations. 


Disposal. 


///. Neurological. 








Cerebral irritation asso- 
ciated with tubercu- 
losis. 

Post-cerebral hemor- 
rhage; paralysis. 


1 

1 


Tubercular hygiene sched- 
ule planned for patient 
and family, in care of 
board of health nurse. 

Schedule planned for pa- 
tient. Moderate exercise, 
modified diet, etc. 


Plans being cairied out. 
Plans being carried out. 


IV. Syphilitic. 








Cerebral spinal syphilis 

Secondary syphilis 
Tabo-paresis 
V. Without Psychoses. 


4 

1 
2 


Intensive bi-weekly treat- 
ments. 

Intensive bi-weekly treat- 
ments. 

Intensive treatment and 
hospital care. Out-patient 
department to report. 


3, treatment carried out at 
Worcester State Hospital out- 
patient department. 

1, patient disappeared. 

Treatments carried out at 
Worcester State Hospital out- 
patient department. 

Advice not followed. 


Chorea .... 

Tonsils and adenoids 
plus speech defect. 

Hyperthyroidism (ado- 
lescent). 


1 
1 


Referred to nose and throat 
specialist. 

- 
Removal of tonsils and 

adenoids. 
Quiet mode of living, rest, 

fresh air, good food, as 

scheduled. 


Given treatment at Worcester 
State Hospital out-patient 
department. Condition im- 
proved. 

Tonsilectomy arranged for at 
Memorial Hospital. 

Plans being carried out. Con- 
dition improved. 


Maladjusted : 








(a) School . 

(b) Home . 


1 

3 


Treatment for ears 

Remove patients from pres- 
ent homes. Place in good 


Ad\'ice given to teacher and 
school nurse as to their atti- 
tudes toward patient. Con- 
dition improved. 

Further placement in hands of 
Children's Friend Society. 


(c) Social . 
Conduct problem 


1 
1 


Remove patient from own 
home; attention to recre- 
ation. 

Replacement 


Arrangements pending. 

Patient in hand of Children's 

Friend Society. 
Patient in care of Girl's Welfare 

Society. 


Routine out-patient de- 
partment examination . 


11 


Supervision ; more thorough 
study and investigation. 


VI. Undiagnosed. 








Routine out-patient de- 
partment examina- 
tion. 


1 
5 


Further investigation; pa- 
tient to report to clinic 
again in six months. 

Patients to report in six 
months. 


Patient being cared for by Girls' 
Welfare Society. 

None made. 



TTjpe of Cases seen, School Out-patient Clinic. 


Feeble-minded. 








(a) Simple feeble- 


16 


Special classes, — training 


Arrangements pending for car- 


minded. 




rlong manual lines and 
correction of pathological 
conditions. 


rying out recommendations. 


(b) Feeble-minded re- 


1 


Institutional care. 


- 


quiring institu- 








tional care. 








(c) Feeble-minded po- 


2 


Special classes, — training 


Arrangements pending for car- 


tential psychotics. 




along manual lines. To 
report to Worcester State 
Hospital out-patient de- 
partment every six 
months. 


rying out recommendations. 


Diagnosis deferred 


3 


To report in six months for 








further study. 


- - 


Cases in partial state of 


27 


Pending. 


- - 


completion. 









1921.] PUBLIC DOCUMENT — No. 23. 29 

Community Activities. 
The following lectures have been given by members of the 
staff during the year: — 

Clinic for students of Clark University held at 

Worcester State Hospital Dr. Bryan. 

Lecture on Mental Hygiene before Kosmos Club 

of Wakefield Dr. Bryan. 

Lecture before Psychology Club of Worcester . Dr. Bryan. 
Paper on Mental Hygiene read at meeting of the 

Worcester District Medical Association . . Dr. Bryan. 
Psychology of Insanity, before medical staff of St. 

Vincent's Hospital Dr. O'Meara. 

Anatomy of the Nervous System, before nurses of 

St. Vincent's Hospital Dr. O'Meara. 

Brain and Nervous System, before nurses of 

Worcester City Hospital and Rutland State 

Sanatorium Dr. O'Meara. 

Causes, Classification and Prevention of Mental 

Diseases, before the nurses of Worcester City 

Hospital and Rutland Sanatorium . . . Dr. O'Meara. 
Mental Hygiene, before the nurses of Worcester 

City Hospital and Rutland State Sanatorium Dr. O'Meara. 
Involution Melancholia, given at a meeting of the 

assistant physicians Dr. Gaunt. 

Origin and Scope of the Modern State Hospital, 

given at a meeting of the assistant physicians Dr. Bonner. 
Lecture on Social Service before the Women's Club 

of Marlborough Miss Harrington. 

The following papers have been published or submitted for 
publication during the past year : — 

Paresis — Treatment, Arsphenamine, Mercury and 

Potassium Iodide Dr. Bonner. 

The Origin and Scope of the Modern State Hos- 
pital Dr. Bonner. 

Adrenahn in Terminal Dementia . . . . Dr. Bonner. 

Pathological Changes occurring in Epidemic En- 

cephahtis . . Dr. Ada Harris. 

Acute Encephahtis . Dr. Ada Harris. 

Involution Melanchoha Dr. George Gaunt. 

An Experiment with Simple Tests for the Insane Miss Marjory Bates. 

A course has been inaugurated to which all social workers, 
school nurses and those dealing with the mentally deficient 



30 WORCESTER STATE HOSPITAL. [Dec. 

were invited to attend. The following is the program of 
lectures, the first and second of which have been given at our 
Summer Street Department : — 

Lecture I. Nov. 9, 1921, by Dr. William A. Bryan. 

Introduction, History of Psychiatry. Types of Reaction, Mental 
Mechanisms. 
Lecture II. Dec. 14, 1921, by Dr. Clarence Bonner. 

Methods of Procedure in Caring for Community Patients who need 
Psychiatric Treatment. Subtopics: (a) Symptoms which 
indicate the need of hospital commitment; (6) factors that 
determine the discharge and retention of State hospital 
patients; (c) common forms of diagnosis and their social 
interpretation. Illustrations. 
Lecture III. Jan. 11, 1922, by Dr. Leon Duval. 

Types of Conduct Disorder and Character Changes which indicate 
the Need of Mental Examination and Treatment. Procedure 
— Illustrations. 
Lecture IV. Feb. 8, 1922, by Miss Jennie Harrington. 

The Relation of the State Hospital to the Social Agenc3^ Sub- 
topics: Customs and traditions of the hospital relative to 
giving information to outside agencies; nature of information 
which hospital may contribute to agencies, and nature of 
assistance which hospital may render to such agencies. 
Lecture V. March 8, 1922, by Dr. Michael O'Meara. 

State Hospital Methods of Caring for Mental Patients. Sub- 
topics: Legal relationships; purpose of hospital departments 
and their functions ; treatment of patients, clinics, social serv- 
ice, out-patient service, etc. 
Lecture VI. April 12, 1922, by Dr. William A. Bryan. 
Showing forms of mental diseases. 



REPORT OF THE SOCIAL SERVICE DEPARTMENT. 

To the Superintendent. 

For several years the work of the social service department 
has been conducted by one worker, but since September 18 the 
department has had the services of Miss Mary Wallace Howgate, 
a graduate of Smith College and Smith College Training School 
for Social Work. 

A great deal of the work that a social worker in a State 
hospital is called upon to do is of a miscellaneous character. 
It is the doing of kind little things, both for the patient and 
his family. Looking up patients' clothing, securing his wages, 



1921.] PUBLIC DOCUMENT — No. 23. 31 

referring his family to various agencies for help, and numerous 
other deeds are a part of the work of helping the patient to 
recover by relieving his mind from worry. 

The social worker studies the patient, his family, his job, his 
home surroundings, his recreation, his friends, etc., with a 
view to better adjustments of these relationships, so that a re- 
covery is more possible and a recurrence less likely. Many 
times the irritating influences have been removed by social 
service, and the other factors in the environment have been made 
helpful. The department is an important connecting link be- 
tween the hospital and the community, for many erroneous 
impressions of the hospital have been corrected by the workers. 

The social work of the hospital may be divided into the 
following groups: — 

I. Social Case Work. — A social case is one in which there is social 
problem needing adjustment. 

(o) Environmental and adjustment problems pertaining to home, 
work, friends and recreation. 
II. History Work. — The social worker goes into the community to 
obtain a history in cases where no relatives come to the 
hospital, or where there is some social problem involved. 

(a) Medical history for medical diagnosis. 

(6) Social history for social treatment. 

(c) Medical social history for medical diagnosis and social treat- 
ment. 

III. Investigations. — Made for object of helping patient. 
(a) Court investigation. 

(6) Home investigation. 

(c) Boarding homes investigation. 

(d) Complaint investigations. 

(e) Miscellaneous. 

IV. Supervision. 

(a) Patients on visit. 
(6) Boarding patients, 
(c) Miscellaneous cases. 
V. Community Work. 
(a) Social agencies. 
(6) Linking hospital with community. 
VI. Educational Work. 

(a) Lectures. 

(b) Advice. 
VII. Out-patient Work. 

(a) Hospital clinics. 
(6) School cUnics. 



32 



WORCESTER STATE HOSPITAL. 



[Dec. 



Table A. — Reason for Consideration. 



Males. 



Females. 



Medical histories 
Medical social histories 
Home investigation 
Special investigation 
Social investigation 
Supervision 
Family assistance . 
Boarding patients . 
Venereal disease clinic 
Miscellaneous 



233 



53 
23 
22 
11 
22 
121 
1 
25 



290 



Table B. — Clinic Work. 





Males. 


Females. 


Totals. 


Patients interviewed at clinics 

Relatives inter\'iewed at clinics 

Social cases selected at clinics 


34 
19 

2 


38 
12 
4 


72 

31 

6 




55 


54 


109 


f . ,., .. ._. . .. i 



Table C. — Service Rendered. 



Males. 



Females. 



Arrangements made for medical care . 

Readjustment in home 

Readjustment in work . . . . . 
Readjustment in recreation . . . . 
Readjustment in church . . . . 
Arrangements for community supervision . 
Referred to relief agencies . . . . 
Referred to special agencies .... 
Referred to venereal disease clinics 
Referred to employment agencies 
Legal aid secured 



3 


16 


6 


13 


2 


8 


4 


5 


1 


- 


15 


5 


4 


2 


15 


11 


1 


4 


5 


3 


3 


4 



1921. 



PUBLIC DOCUMENT — No. 23. 



33 



Table C. — Service Rendered — Concluded. 



Males 



Females 



Totals 



Advice to patient 

Advice to relatives ..... 

Boarding patients visited .... 

Property cared for ...... 

Assisting Red Cross with compensation claims 



418 



It is hoped that with another worker the work of the depart- 
ment may be developed along new lines. More efficient work 
could be accomplished with the use of a department automobile. 

I wish to express my appreciation for the aid and counsel 

given me by Miss Hannah Curtis, the director of social work of 

the Department of Mental Diseases, and for the co-operation 

of the hospital staff and the ready response of help from the 

social agencies. 

Respectfully submitted, 

Jennie A. Harrington, 

Social Worker. 
Nov. 30, 1921. 



TRAINING SCHOOL FOR NURSES. 

I herewith submit the following report on the Training School 
of the Worcester State Hospital for the year 1921: — 

Graduated a class of 14 members, — 13 women and one man. 
Present senior class consists of 13 women; present intermediate 
class, 9 women; first-year students, 22 women. 

Graduation exercises were held September 15. Dr. Myerson 
of Boston addressed the class. Miss Caswell, a member of the 
Board of Trustees, presented the diplomas. After the exercises 
a reception and dance was enjoyed by the graduates and their 
friends. 

On June 25 the Training School had the honor of entertaining 
Miss Linda Richards at an informal tea. She recounted many 
interesting incidents regarding her work here while organizing 
the Training School in 1903. Our graduates now number 209. 

The Alumnse Association has held quarterly meetings at the 
hospital, and after the business meeting a social hour is indulged 



34 WORCESTER STATE HOSPITAL. [Dec. 

in. The Training School has been represented at the various 
State meetings and also at the American Nurses Association 
Meeting held at Concord, N. H. The Worcester branch of the 
Massachusetts State Nurses Association was entertained at the 
hospital. During the evening Dr. Wright of Boston State 
Hospital gave an interesting talk on hydrotherapy. 

The affiliation with Boston City Hospital which had been 
ten months was extended to one year. Interest in the Training 
School has been stimulated by these various activities, and it is 
gratifying to notice an increase in the number of desirable 
applicants during the past few months. 

Merle B. Malsbury, R.N., assistant superintendent of nurses, 
resigned to accept the position of superintendent of nurses at the 
Bangor State Hospital. The vacancy has recently been filled by 
Florence Wooldridge, R.N. 

Elsie I. Richards, 
Superintendent of Nii7-ses. 

Religious Services. 
Religious services have been held regularly each Sunday at 
both the main hospital and the Summer Street Department, a 
Catholic clergyman oflBciating in the forenoon and a Protestant 
clergyman in the afternoon. Response to sick calls and the 
rites of their religion to the dying have been faithfully made by 
members of the clergy. 

Entertainments and Amusements. 

Acknowledgment is made to the following individuals and 
organizations for entertainments given during the year: — 

In February, 1921, an entertainment was provided at the 
Summer Street Department by the Knights of Columbus, in- 
cluding glee club work, solos and instrumental music. 

At the main institution we have been favored, under the 
direction of Mrs. Oscar P. Tabor, with a pageant which was 
very enjoyable to the patients. 

The Auxiliary of the American Legion on two different 
occasions entertained the soldiers in the recreation room with 
instrumental and vocal music. 

One moving-picture entertainment by the Kirk Soap Com- 
pany was provided. 



1921.] PUBLIC DOCUMENT — No. 23. 35 

On November 17, through the courtesy of our storekeeper, 
Mr. WilHam Scott, the Kiltie Clan gave an entertainment at 
the main hospital, and on the 18th a ver\^ enjoyable entertain- 
ment at the Summer Street Department. 

On Thursday, December 29, the American Legion and the 
Women's Auxiliary gave a most enjoyable program, consisting 
of seventeen numbers, for the benefit of the ex-soldiers and 
other patients. 

On December 28 a number of our talented patients, accom- 
panied by several physicians, gave an entertainment to the 
patients at Westborough. 

During the summer months a baseball team played every 
Saturday afternoon and made trips to other hospitals. An 
interhospital league has been suggested and would seem to be 
an excellent idea. 

The weekly moving-picture shows have been productive of 
considerable good, and have contributed materially to the 
recovery of a certain number of patients, as have also the 
weekly dances. 

A hospital orchestra has been organized, and it is our in- 
tention to make music a very important therapeutic measure. 

The various holidays have been observed by special enter- 
tainments. 

New Consteuction. 

General O'perations for the Year. 

Many minor repairs have been made in the building during 
the course of the year. The cattle barns at the main building 
and Hillside have been repainted both inside and out. All the 
porches at the main hospital have been painted, the fence at 
Summer Street, and three cottages for employees, in addition 
to the outside work. Washburn I, which is now used as a 
receiving ward, has been entirely renovated and new clothes 
rooms built, new toilets put in and the entire ward painted. 

The industrial department, under the direction of Mr. 
Corkum, has scraped and refinished over a thousand pieces of 
furniture during the year in addition to rematting and re- 
finishing practically every picture in the hospital. A complete 



36 WORCESTER STATE HOSPITAL. [Dec. 

reclassification of the wards has been made, the first floor on 
each side now being used as a reception service. 

A large salvage yard has been completed where articles no 
longer in use can be taken and either salvaged, stored in a 
proper manner or sold as junk. The utility of this yard has 
been shown since it was built. 

Comprehensive plans have been made and the work begun 
of centralizing the storerooms of the hospital in one corridor. 
The work of renovating the laundry has been completed, and 
the necessity for this renovation is shown by its increased 
efficiency. 

Certain changes have been made in the disposition of garbage 
which have proven to be in the interest of cleanliness. 

All farm implements have been repainted and repaired. 
About 200,000 feet of chestnut lumber was sawed during the 
early part of the year. The trees had begun to decay, and the 
lumber was salvaged before such destruction had progressed 
far enough to destroy them. 

Much work has been done on the boilers, two of them 
having been completely reset. 

Needs. 

Certain special needs for which an appropriation is requested 
are as follows: — 

Refrigeration Plant. — This hospital has no adequate means 
of refrigeration. The antiquated ice boxes now in use are in- 
adequate for our needs, and a great many articles of food are 
rendered useless each year because of our inability to maintain 
a proper temperature. A combined refrigerating plant and 
storehouse, with an ice-making machine of adequate capacity, 
would increase our efficiency a great deal. The present ice 
house is not large enough for our needs, and each year it is 
necessary to go into the market and buy a considerable quan- 
tity of ice to care for our needs during the latter part of the 
year. 

We have sixteen different storerooms, all located in the base- 
ment, and this requires a larger force of storeroom employees 
than would seem to be necessary if a storeroom was all under 
one roof. 



1921.] PUBLIC DOCUMENT — No. 23. 37 

Congregate Dining Room. — The dining-room facilities for pa- 
tients at this hospital are very inadequate, and it is impos- 
sible to give the best service in feeding our patients while 
they are in use. Each ward has a dining room, in all, 42, and 
in no case are these dining rooms equipped for the purpose for 
which they are used. A number of them have no facilities for 
washing dishes. The construction of a congregate dining room 
would enable us to give our patients hot food served in a better 
manner which would contribute a great deal to their comfort. 

Some attention should also be given to the needs of our 
present kitchen. The equipment is almost entirely of wood and 
should be replaced by steel equipment. Our kettles are of the 
old type with no outlet for the purpose of cleaning. These 
should be replaced by modern aluminum kettles. The present 
ventilating system in the kitchen is inadequate and does not 
take care of the various cooking odors. When certain condi- 
tions are present the odor of food can be detected in the 
entrance hall. 

Fireproof Stairways. — We have at the present time seven 
wooden staircases in the main building which make a great fire 
hazard. The shafts in which they are built would cause the 
flames to spread rapidly from one floor to another. These 
wooden staircases should be replaced by iron structures. 

iVutomatic sprinklers are needed in the attic of both the 
main building and the Summer Street Department. The fire 
hazard is very great, and the installation of these would furnish 
a protection that can be secured in no other way. 

In conclusion I wish to express my grateful appreciation to 
the members of the Board of Trustees for their interest and 
helpful suggestions in the work of the hospital. They have 
supported me in all things, and have been untiring in their 
efforts and given freely of their time to assist us in^the care and 
treatment of the patients. 

To the loyal officers and employees who have so splendidly 
co-operated in the work of the year I also wish to express my 
grateful acknowledgment. 



WILLIAM A. BRYAN, 

Sifperintendent. 



Nov. 30, 1921. 



38 



WORCESTER STATE HOSPITAL. 



[Dec. 



VALUATION 

Nov. 30, 1921. 



Real Estate. 



Land (589 acres) 
Buildings . 



$416,357 00 
2,174,812 76 

12,591,169 76 



Personal Property. 



Travel 

Food 

Clothing and materials . 
Furnishings and household supplies 
Medical and general care 
Heat, light and power 

Farm 

Garage, stable and grounds . 
Repairs 



Real estate 
Personal property 



Summary. 



$872 23 
14,936 10 
35,062 58 
182,097 21 
8,869 18 
50,193 84 
50,986 44 
13,238 61 
15,103 50 

$371,359 69 



$2,591,169 76 
371,359 69 

$2,962,529 45 



1921. 



PUBLIC DOCUMENT — No. 23. 



39 



TREASURER'S REPORT. 



To the Department of Mental Diseases. 

I respectfully submit the following report of the finances of 
this institution for the fiscal year ending Nov. 30, 1921: — 



Cash Account. 



Balance Dec. 1, 1920 



$4,092 18 



Receipts. 
Income. 
Board of inmates: 



jTrivate ....... 

Reimbursements, insane 


42,997 


60 


$83,136 84 














Personal services: 












Reimbursement from Board of Retirement 




180 77 






Sales: 












Travel, transportation and office ex- 












penses 


$41 


69 








Food 


1.33 


10 








Clothing and materials .... 


173 


48 








Furnishings and household supplies 


1,289 


11 








Medical and general care 


3 


78 








Heat, light and power .... 


9 


55 








Farm : 












Cows and calves . . $310 97 












Pigs and hogs . . 24 28 












Hides .... 33 81 


369 
71 


06 
95 








Garage, stable and grounds . 








Repairs, ordinary 


656 


29 


2,748 01 






Miscellaneous: 










Interest on bank balances 


$1,096 58 








Rent 


1,239 


62 


2,.336 20 












88,401 


82 






Receipts from Treasury of Commonwealth. 










Maintenance appropriations: 


















$60,043 44 






Advance money (amount on hand November 30) 




48,000 00 






Approved schedules of 1921 . 






608,835 02 


716,878 


46 






Special appropriations .... 








21,058 


69 












Total 


$830,431 


15 



40 



WORCESTER STATE HOSPITAL. 



[Dec. 



Payments. 

To treasury of Commonwealth, institution income .... $88,401 82 

Maintenance appropriations: 

Balance of schedules of previous year . . . $64,135 62 

Eleven months' schedules, 1921 608,835 02 

November advances 26,967 28 

699,937 92 

Special appropriations, approved schedules 21,058 69 

Balance Nov. 30, 1921: 

In bank $20,361 78 

In office 670 94 

21,032 72 

Total $830,431 15 

Maintenance. 

Balance from previous year, brought forward $1,299 65 

Appropriation, current year 740,400 00 

Total $741,699 65 

Expenses (as analj'zed below) 677,769 55 



Balance reverting to treasury of Commonwealth 



$63,930 10 



Analysis of Expenses. 
Personal services: 

B. Henry Mason, acting superintendent . . . $1,061 67 

William A. Bryan, superintendent .... 2,380 00 

Medical 12,624 85 

Administration 20,151 16 

Kitchen and dining-room service .... 12,516 14 

Domestic 30,800 19 

Ward service (male) 65,371 33 

Ward service (female) 60,878 34 

Industrial and educational department . . . 4,185 21 

Engineering department 28,500 84 

Repairs 19,759 20 

Farm 13,265 99 

Stable, garage and grounds 4,469 00 

Religious instruction: 

Catholic $1,200 00 

Hebrew 260 00 

Protestant 375 00 

Travel, transportation and office expenses: 

Advertising $75 43 

Postage 475 90 

Printing and binding 1,276 05 

Printing annual report 257 57 

Amounts camed forward $2,084 95 



$275,963 92 



1,835 00 



$277,798 92 



1921.] PUBLIC DOCUMENT — No. 23. 41 

Amounts hromht forward ,12,084 95 $277,798 92 

Travel, transportation and office expenses — Con. 

Stationery and office supplies 2,764 90 

Telephone and telegraph 2,101 34 

Travel 2,045 47 

8,996 66 



Pood: 

Flour $2.3,199 76 

Cereals, rice, meal, etc 4,865 37 

Bread, crackers, etc 542 54 

Peas and beans (canned and dried) .... 3,142 94 

Macaroni and spaghetti 1,219 87 

Potatoes 4,496 83 

Meat 39,472 94 

Fish (fresh, cured and canned) 7,172 46 

Butter 6,446 05 

Butterine, etc 8,934 97 

Peanut butter 2 70 

Cheese 2,345 31 

Coffee 916 61 

Coffee substitutes . . . ■ 1,021 69 

Tea 547 S8 

Cocoa 105 52 

Whole milk 129 07 

Milk (condensed, evaporated, etc.) .... 1,344 56 

Eggs (fresh) 8,114 04 

Egg powders, etc 1,021 40 

Sugar (cane) 5,807 35 

Fruit (fresh) 1,339 53 

Fruit (dried and preserved) 9,109 34 

Lard and substitutes 1,855 92 

Molasses and syrups 1,189 51 

Vegetables (fresh) 741 09 

Vegetables (canned and dried) 559 81 

Seasonings and condiments 1,575 72 

Yeast, baking powder, etc 466 91 

Sundry foods 731 96 

Clothing and materials: 

Boots, shoes and rubbers $3,614 29 

Clothing (outer) 7,668 96 

Clothing (under) 2,770 19 

Drj- goods for clothing 2,984 53 

Hats and caps 248 64 

Leather and shoe findings 188 61 

Socks and smallwares 1,651 24 

Furnishings and household supplies: 

Beds, bedding, etc $12,006 09 

Carpets, rugs, etc 1,327 78 

Crockery, glassware, cutlery, etc. .... 1,972 90 

Dry goods and smallwares 1,394 52 

Electric lamps 1,439 95 



138,419 65 



19,126 46 



Amounts carried forward $18,141 24 $444,341 69 



42 WORCESTER STATE HOSPITAL. [Dec. 

Aynounts brought forward $18,14124 $444,34169' 

Furnishings and household supplies — Con. 

Fire hose and extinguishers 477 27 

Furniture, upholstery, etc 3,865 33 

Kitchen and household wares 6,118 10 

Laundry supplies and materials 3,225 77 

Lavatory supplies and disinfectants .... 2,075 30 

Machinery for manufacturing 50 21 

Table linen, paper napkins, towels, etc. . . . 2,191 14 

36,144 3& 

Medical and general care: 

Books, periodicals, etc $585 70 

Entertainments, games, etc. 2,059 40 

Funeral expenses 958 00 

Gratuities 17 00 

Ice and refrigeration 1,472 99 

Laboratory supplies and apparatus .... 274 46 

Manual training supplies 113 82 

Medicines (supplies and apparatus) . . 5,781 88 

Medical attendance (extra) 895 72 

Patients boarded out 2,623 22 

Return of runawaj^s 151 66 

Tobacco, pipes, matches 2,657 46 

Water 8,309 26 

Sewerage (chapter 165, Special Acts of 1919) . . 2,400 00 

28,300 57 

Heat, light and power: 

Coal (bituminous) i $39,692 14 

Freight and cartage 36,681 46 

Coal (screenings) 11,811 79 

Coal (anthracite) 6,057 33 

Freight and cartage 2,322 65 

Electricity 263 90 

Gas 1,373 65 

Oil 556 81 

Operating supplies for boilers and engines . . 346 36 

Sundries 20 00 

99,126 09' 

Farm : 

Bedding materials $500 24 

Blacksmithing and supplies 510 81 

Carriages, wagons and repairs 469 50 

Dairy equipment and supplies 389 91 

Fencing materials 7 56 

Fertilizers 995 79 

Grain, etc 11,508 77 

Hay 8,161 78 

Harnesses and repairs 210 04 

Cows 83 96 

Other live stock . . 725 00 



Amounts carried forward $23,563 36 $607,912 71 

1 Includes refund of S454.71 on coal which came through care of medical department and did 
not go through institution cash. 



1921.] PUBLIC DOCUMENT — No. 23. 43 

Amounts brought forward $23,563 36 $607,912 71 

Farm — Coti. 

Labor (not, on pay roll) 66 73 

Rent 250 00 

Spraying materials 200 65 

Stable and barn supplies 98 00 

Tools, implements, machines, etc 1,175 23 

Trees, vines, seeds, etc 711 58 

Veterinary services, supplies, etc. .... 659 81 

■ Lime 236 12 

.26,961 48 



Garage, stable and grounds: 

Motor vehicles $1,805 77 

Automobile repairs and supplies 5,072 42 

Blacksmithing and supplies 105 12 

Carriages, wagons and repairs 13 15 

Hay 351 99 

Harnesses and repairs ....... 4 10 

Road work and materials 250 00 

Stable supplies 25 08 

Tools, implements, machines, etc 246 01 

Trees, vines, seeds, etc. 64 42 

Veterinary 5 50 



Repairs, ordinary: 

Cement, lime, crushed stone, etc. .... $1,192 58 

Electrical work and supplies 879 04 

Hardware, iron, steel, etc 2,999 68 

Lumber, etc. (including finished products) . . 3,347 23 

Paint, oil, glass, etc. ........ 6,655 69 

Plumbing and supplies 2,658 36 

Roofing and materials 2,209 96 

Steam fittings and supplies 981 09 

Tools, machines, etc 572 66 

Boilers, repairs 1,902 84 

Dynamos, repairs 32 98 

Engines, repairs 428 39 

Repairs and renewals: 

Hand stoker type for two boilers .... $848 10 

Corn-shelling machine 264 72 

Laundry machinery 8,365 00 

Telephone line 449 70 

Woodward porches 1,163 78 



7,943 56 



23,860 50 



11,091 30 



Total expenses for maintenance $677,769 55 



44 



WORCESTER STATE HOSPITAL. 



[Dec. 



Special Appropriations. 

Balance Dec. 1, 1920 . $24,874 43 

Appropriations for current year 16,000 00 

Total $40,874 43 

Expended during the year (see statement below) . $21,577 61 

Reverting to treasury of Commonwealth ... 5 22 

— — — • 21,582 83 

Balance Nov. 30, 1921, carried to next year $19,291 60 



Object. 


Act or Resolve. 


Whole 
Amount. 


Expended 
during 
Fiscal 
Year. 


Total 

e.xpended to 

Date. 


Balance 

at End of 

Year. 












Water supply 


Chap. 95, Res. 
1917. 


$11,385 00 


S6,580 75 


SI 1,207 64 


$177 36 


Renovating the plumbing . 


Chap. 153. Sp. 
Acts 1919. 


5,500 00 


361 53 


5,498 46 


1 54* 


Alterations of buildings. 


Chap. 153, Sp. 


5,500 00 


103 49 


5,497 89 


2 11* 


Hillside Farm. 


Acts 1919. 










Worcester department, heat- 


Chap. 123, Res. 


3,758 72 


498 67 


644 48 


3,114 24 


ing system. 1 


1917. 










Alterations to laundry 


Chap. 225, Acts 
1920. 


21,000 00 


3,220 36 


20,998 43 


1 57* 


Water supply for fire protec- 


Chap. 225, Acts 


17,000 00 


10,812 81 


17,000 00 


- 


tion. 


1920. 










Alterations in heating shaft 


Chap. 203, Acts 
1921. 


16,000 00 


~ 


"" 


16,000 00 




?80,143 72 


S21,577 61 


$60,846 90 


$19,296 82 



Balance reverting to the treasury of the Commonwealth . . $5 2.^ 

Balance carried to next year 19,291 60 



Total as above 



$19,296 82 



Resources and Liabilities. 

Resources. 

Cash on hand $21,032 72 

November cash vouchers (paid from advance money), 

accoimt of maintenance 26,967 28 

Due from treasurj^ of Commonwealth from available appropriation, 

account of November, 1921, schedule 

Special appropriations 

Liabilities. 
Outstanding schedules of current year: 

Schedule of November bills 

Special appropriations 



$48,000 00 

21,389 24 
518 92 

$69,908 16 



$69,389 24 
518 92 

$69,908 16 



1 Transferred from Grafton State Hospital Dec. 1, 1919. 



1921.1 PUBLIC DOCUMENT — No. 23. 45 



Per Capita. 
During the year the average number of inmates has been 2,027.65. 
Total cost for maintenance, $677,769.55. 
Equal to a weekly per capita cost of $6.4281. 
Receipt from sales, $2,748.01. 
Equal to a weekly per capita of $0.0260. 
All other institution receipts, $85,653.81 . 
Equal to a weekly per capita of $0.812.3. 
Net weekly per capita cost, $5.5898. 



Respectfully submitted, 



JESSIE M. D. HAMILTON, 

Treasurer. 



Examined and found correct as compared with the records in the office of the 
Auditor of the Commonwealth. 

ALONZO B. COOK, 

Auditor. 



46 WORCESTER STATE HOSPITAL. [Dec. 



STATEMENT OF FUNDS. 



Patients' Funt). 

Balance on hand Nov. 30, 1920 . . . $9,340 57 

Receipts . . 10,115 09 

Interest 329 21 

Refunded $8,191 09 

Interest paid to State Treasurer . . . 329 21 



Inveslment. 
Worcester County Institution for Savings 
Worcester Five Cents Savings Bank 
Worcester Mechanics Savings Bank . 

Peoples Savings Bank 

Balance Worcester Bank and Trust Company 
Cash on hand Dec. 1, 1921 .... 



LE"w^s Fui\T). 
Balance on hand Nov. 30, 1920 . . . $1,754 32 
Income 67 85 



$2,000 00 


2,000 00 


2,000 00 


2,000 00 


2,996 72 


267 85 



$19,784 87 

8,520 30 
$11,264 57 



[1,264 57 



$1,822 17 

Expended for pictures, books, etc 179 38 



L,642 79 



Investment. 
American Telephone and Telegraph Company 

collateral trust 4 per cent bond . . . $926 36 

Fourth Liberty Loan bonds .... 600 00 

Balance Worcester Bank and Trust Company 116 43 



L,642 79 



1921.1 PUBLIC DOCUMENT — No. 23. 47 



Wheeler Fund. 
Balance on hand Nov. 30, 1920 . . . $6,539 00 
Income 308 82 

$6,847 82 

Expended for entertainments, magazines, etc. . . . 475 OS 

S6,372 74 

Investment. 
American Telephone and Telegraph Company 

collateral trust 4 per cent bond . . . $712 50 

Third Liberty Loan bonds 4,000 00 

Fourth Liberty Loan bonds .... 1,300 00 

Balance Worcester Bank and Trust Company 360 24 

$6,372 74 



Manson Fund. 
Balance on hand Nov. 30, 1920 . . . $1,347 98 
Income 50 98 

$1,398 96 

Expended for entertainments 120 27 

$1,278 69 

Investment. 
Fourth Liberty Loan bonds . . . . $1,100 00 
Balance Worcester Bank and Trust Company 178 69 

$1,278 69 

Respectfully submitted, 

JESSIE M. D. HAMILTON, 

Treasurer. 
Nov. 30, 1921. 

N. B. — The values assigned to the above securities are their 
respective purchase prices. 



STATISTICAL TABLES 

AS ADOPTED BY AMERICAN PSYCHIATRIC ASSOCIATION 



Prescribed by Massachusetts Department of Mental Diseases 



STATISTICAL TABLES. 



Table 1. — General Information. 

1. Date of opening as an institution for the insane: Jan. 18, 1833. 

2. Type of institution : State. 

3. Hospital plant: 

Value of hospital property: 

Real estate, including buildings .... $2,591,169 76 
Personal property 371,359 69 



Total 



2,962,529 45 



Total acreage of hospital property, 589.16. 

Acreage under cultivation during previous year, 263.75. 



4. Medical service: 

Superintendent 

Assistant physicians 

Medical internes 

Dentist 

Total physicians 

5. Employees on pay roll (not including physicians) 

Graduate nurses 

Other nurses and attendants 

All other employees 

Total employees 

6. Patients employed in industrial classes or in 

general hospital work on date of report 

7. Patients in institution on date of report (ex- 

cluding paroles) 



Men. Women. Totals. 
1 - 1 

7-7 



1 



1 



Men. Women. Totals. 

1 16 17 

112 100 212 

78 77 155 



191 193 384 

Men. Women. Totals. 

543 401 944 

1,051 1,042 2,093 



Table 2. — ■ Financial Statement. 
See treasurer's report for data requested under this table. 



52 



WORCESTER STATE HOSPITAL. 



[Dec. 






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1921. 



PUBLIC DOCUMENT — No. 23. 



53 



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54 



WORCESTER STATE HOSPITAL. 



[Dec. 



Table 4. — Nativity of First Admissions and of Parents of First Admissions. 











Parents 


OF 


Parents 




Patients. I 


Male 




or Female 










Patients. 


Patients. 


Nativity. 






















ro 




m 


IC 


_o 


M 


m 


£ 


m 




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S 


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O 


"3 


a 


O 


"S 


a 


o 




s 


fe 


tn 


S 


fe 


h 


S 


P4 


H 


United States 


131 


71 


202 


62 


57 


119 


26 


29 


55 


Albania 


4 


_ 


4 


4 


4 


8 


_ 


_ 


_ 


Armenia 


3 


3 


6 


3 


3 


6 


3 


3 


6 


Austria 


2 


3 


5 


3 


3 


6 


3 


3 


6 


Belgium 


- 


- 


- 


1 


- 


1 


- 


- 


- 


Canada 


25 


31 


56 


39 


44 


83 


30 


29 


59 


Central America .... 


1 


- 


1 


- 


- 


- 


- 


- 


- 


China 


2 


- 


2 


3 


3 


6 


- 


- 


- 


Denmark 


1 


- 


1 


1 


1 


2 


- 


- 


- 


England 


5 


3 


8 


7 


5 


12 


11 


7 


18 


Finland 


4 


4 


8 


4 


4 


8 


4 


4 


8 


France 


3 


- 


3 


5 


4 


9 


1 


- 


1 


Germany 


6 


2 


8 


10 


10 


20 


3 


3 


6 


Greece 


8 


3 


11 


8 


8 


16 


3 


3 


6 


Ireland 


20 


24 


44 


39 


39 


78 


38 


39 


77 


Italy 


12 


9 


21 


12 


12 


24 


10 


10 


20 


Norway 


3 


- 


3 


3 


3 


6 


- 


- 


- 


Poland 


8 


2 


10 


11 


11 


22 


2 


2 


4 


Portugal 


4 


- 


4 


4 


4 


8 


- 


- 


- 


Russia 


8 


7 


15 


9 


9 


18 


12 


12 


24 


Scotland 


5 


4 


9 


5 


6 


11 


6 


8 


14 


Spain 


2 


1 


3 


2 


2 


4 


1 


1 


2 


Sweden 


6 


4 


10 


6 


6 


12 


4 


4 


8 


Switzerland 


1 


- 


1 


1 


1 


2 


- 


- 


- 


Syria 


- 


1 


1 


- 


- 


- 


1 


1 


2 


Turkey in Asia .... 


1 


- 


1 


1 


1 


2 


- 


- 


- 


West Indies 


2 


- 


2 


2 


2 


4 


- 


- 


~ 


Total foreign born 


136 


101 


237 


183 


185 


368 


132 


129 


261 


Unascertained 


5 


2 


7 


27 


30 


57 


16 


16 


32 


Grand totals .... 


272 


174 


446 


272 


272 


544 


174 


174 


348 



Table 5. 


— Citizenship of First Admissions. 






Males. 


Females. 


Totals. 


Citizens by birth 

Citizens by naturalization 


131 

17 

119 

5 


71 
12 
89 
2 


202 

29 

208 


Citizenship unascertained 




7 


Totals .... 


272 


174 


446 


r . . — 





1921. 



PUBLIC DOCUMENT — No. 23. 



55 



Table 6. — Psychoses of First Admissions. 



Psychoses. 



1. Traumatic, total ....... 

(o) Traumatic delirium _ 

(6) Traumatic constitution ..... 

(c) Post-traumatic mental enfeeblement (de- 

mentia) ........ 

(d) Other types 

2. Senile, total . 

(o) Simple deterioration ..... 
(6) Presbyophrenic type 

(c) Delirious and confused types .... 

(d) Depressed and agitated types .... 

(e) Paranoid types ...... 

(f) Pre-senile type 

(g) Other types . ._ 

3. With cerebral arteriosclerosis ..... 

4. General paralysis ....... 

5. With cerebral syphilis ...... 

6. With Huntington's chorea ..... 

7. With brain tumor ....... 

8. With other brain or nervous diseases, total 

(a) Cerebral embolism 

(b) Paralysis agitans ...... 

(c) Meningitis, tubercular or other forms (to be 

specified) ....... 

(d) Multiple sclerosis ...... 

(e) Tabes dorsalis 

(/) Acute chorea ....... 

(fir) Other diseases (encephalitis) .... 

9. Alcoholic, total 

(a) Pathological intoxication 

(6) Delerium tremens ...... 

(c) Korsakow's psychosis ..... 

id) Acute hallucinosis _ 

(e) Chronic hallucinosis ..... 

(/) Acute paranoid type ..... 

(g) Chronic paranoid type ..... 
(h) Alcoholic deterioration . . 

(i) Other types, acute or chronic .... 

10. Due to drugs and other exogenous toxins, total 

(o) Opium (and derivatives), cocaine, bromides, 
chloral, etc., alone or combined (to be speci- 
fied) 

(b) Metals, as lead, arsenic, etc. (to be specified) 
ic) Gases (to be specified) . . . . . 
id) Other exogenous toxins (to be specified) 

11. With pellagra 

12. With other somatic diseases, total .... 

(a) Delirium with infectious diseases . 

(b) Post-infectious psychoses .... 

(c) Exhaustion delirium ..... 

(d) Delirium of unknown origin .... 

(e) Cardiorenal disease ..... 
(/) Diseases of the ductless glands 

(g) Other diseases or conditions (to be specified) . 

13. Manic-depressive, total 

(a) Manic type ....... 

(b) Depressive type ...... 

(c) Stupurous type ...... 

(d) Mixed type ....... 

(e) Circular type 

(/) Other types 

14. Involution melancholia ...... 

15. Dementia prjecox, total . . . . 

(a) Paranoid type ....... 

(b) Catatonic type ...... 

(c) Hebephrenic type ...... 

(d) Simple type 

(e) Other types ....... 

16. Paranoia or paranoid conditions . . . . 



27 



42 



28 
141 



56 



WORCESTER STATE HOSPITAL. 



[Dec. 



Table 6. — Psychoses of First Admissions — • Concluded. 



Psychoses. 



17. Epileptic, total 

ia) Epileptic deterioration 

(6) Epileptic clouded states . 

(c) Other epileptic types (to be specified) 

18. Psychoneuroses and neuroses, total . 

(a) Hysterical type .... 
(6) Psychasthenic type .... 
(c) Neurasthenic type .... 
id) Anxiety neuroses .... 
^ ie) Other types 

19. With psychopathic personality 

20. With mental deficiency .... 

21. Undiagnosed ...... 

22. Without psychoses, total .... 

(a) Epilepsy ...... 

(6) Alcoholism 

<c) Drug addiction .... 
<d) Psychopathic personality 
ie) Mental deficiency .... 
if) Others 



Totals 



272 174 446 



PUBLIC DOCUMENT — No. 23. 



57 



aj 

H 
m 
O 

a 


DUE TO 
DRUGS AND 
OTHER EX- 
OGENOUS 
TOXINS. 


■s^^ox 


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


.. 


"saiBuia^ 


1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 


1 


•sapH 


1 1 1 1 1 1 'H 1 1 1 1 M 1 1 1 1 1 1 1 1 1 1 


CM 


O 

w 
o 


■sp^ox 


- , 1 ,« ,o,^, ,o^ , , ,^^ , , ,^^ 


^ 


•saiBinajj 


Illloqi-HIIIMIIII-Hllllll 




■sa(T3It 


- 1 1 1 1 1 ^_ 1 1 t^-H 1 1 1 .-^ 1 1 1 -H^ 




WITH OTHER 

BRAIN 

OR NERVOUS 

DISEASES. 


■sib:jox 


1 1 1 1 1 1 r-. 1 1 1 Mrt 1 1 1 1 1 1 111-^ 


^ 


•sajBuiajf 


1 1 1 1 1 1 --I 1 1 1 1 —1 1 1 1 1 1 i 1 1 1 1 


« 


■sai^iv: 


1 1 1 1 1 1 1 1 1 1 <-l 1 1 1 1 1 1 1 1 1 1 -H 


^ 


WITH 

hunting- 
ton's 

CHOREA. 


•SJB^OX 


1 1 1 1 1 1 1 1 1 1 <-! 1 1 1 1 1 1 1 1 1 1 1 


- 


•saiT3raa^ 


1 1 1 1 1 1 1 1 ' 1 -- 1 1 1 1 1 1 


-^ 


■sajBj^i 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


1 


n s w 
^ « & 


•sib;ox 


1 1 1 1 1 1 rt 1 1 -H 1 1 1 1 ,-i-H 1 _( 1 1 _(cq 


OO 


•sajBxuaj 


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


t-q 


■saiBM 


IIIIII'-HIIIIIIII'HI'-III rt(M 


o 


si 


•si'b:>ox 


.-( 1 T-l 1 CC I CD ^ 1 1 CO CM 1 1 COCM<-H 1 1 1 OOCO 


CO 


•sajBuia^ 


■-HI 1 |rt| 1 1 1 |T-lrt| 1 |rt| 1 IICMI 


t^ 


■sa|Bj\[ 


1 lT-(|(M|Ort| |CNr-l| ICOt-c-hi 1 ICOCO 


CM 


WITH 
CEREBRAL 
ARTERIO- 
SCLEROSIS. 


•SIB'^OX 


"-HI 1 iTfl'*! 1 lOI 1 1 «■-< 1 1 1 1 0050 


CO 


•sa(Binaj[ 


—"IIICMI-HllllOlllrtllllliol 


lO 


•saiBi^ 


llll<MICOIII>OIII -Hrt 1 1 1 1 too 


s 


J 

M 
Z 

to 


•SIBJOX 


1 1 1 1 cq i tocM 1 1 ^ 1 1 1 1 -* 1 1 1 1 ooo 


CM 


•sai3niaj[ 




I^ 


•sajBj^ 


llllllC0^1IC<llllllllll-#ira 


■o 


Eh 

s 

<! 

PS 


■SfBiOX 


1 1 1 1 1 1 I 1 1 1 'H 1 1 1 1 J 1 1 1 1 1 1 


- 


•sa[Buiaj[ 


I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


1 


•sapjn 


1 1 1 1 1 1 1 1 1 1 •-< 1 1 1 1 1 I 1 1 1 1 1 


- 


►J 

H 
O 


•s|b:>ox 


.-HCOt^COOOOOCCCO^HCMOOCMCOtOO-^OOCO^Hi-HCOOO 
.-H CM lO-H^H-Ht^CM ^H ^ CM OCM 




•sajBuia^ 


■<*< 1 CO 1 t^-^OCOCOOi-HOCM 1 C^IOiOO^H^H 1 ooco 
.— t 1— 1 ^ .— 1 CO 


-* 


•saj^iv 


lr~ CO Tjl CO ^ ■* t^ O 00 CO t^ CM -< CO QO >0 O CM 1 — ' g >« 


C^ 


Race. 














-a 

o 

c 




African (black) 

Albanian . 

Armenian 

Chinese . 

English . 

Finnish 

French 

German . 

Greek 

Hebrew . 

Irish . 

Italian 

Lithuanian 

Portuguese 

Scandinavian 

Scotch 

Slavonic . 

Spanish . 

Syrian 

Turkish . 

Mixed 

Race unascerta 


13 



58 



WORCESTER STATE HOSPITAL. 



[Dec. 



o 
O 



fi^ 



^*=^ 












to 
» 

o 
a 

o 
to 


to 
Z 

g 


•sib;ox 


1 1 1 1 1 1 F 1 -^ 1 ^ 1 1 1 1 1 1 1 J 1 Mi-^ 


to r 


saiBuia^ 


1 1 1 1 1 1 1 1 1 1 -H 1 1 1 1 1 i 1 1 1 1 rt 


Cq 


•saiBi\[ 


1 1 1 I 1 J 1 1 'H 1 1 1 1 1 1 1 1 1 1 1 CO 1 


•* 


Q 
H 

< 
S 


■siB^ox 


1 1 rHrtCq 1 m 1 CO 1 I>-^ 1 —1 1 -Hrtrt^ 1 00<M 


to 

CO 


■saiBuiaj 


1 1 1 1 rt 1 rt 1 rt 1 ^CT 1 1 1 rt 1 >-lrt 1 CO 1 


-* 


•sai'Bj\[ 


1 1 — 1— 1-H 1 cq 1 (M 1 COC^ 1 — 1 1 1 —1 1 1 1 CDCq 


s 


S < a 


•SIB^Oi 


^ , , ,^,c.o, , 1^^ , , , IC. , , lOC 1 


oq 


■sajBuiaj 


lllllllllico— illllTiiiic^i 


l:~ 


•saiBjj 


■-HI 1 I^IMC^I l-HI 1 1 1 l-HI 1 |tO| 


■* 


WITH PSY- 
CHOPATHIC 

PER- 
SONALITY. 


•siB^ox 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 J 1 1 1 1 1 <M 1 


(M 


•eajBuia^ 


1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 


1 


•sajBj^ 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 <M 1 


cq 


PSYCHO- 
NEUROSES 

AND 
NEUROSES. 


•siB^ox 


— illlllrtlicoicqiiiliiiicol 


o 


•sajBrnajj 


llllllllicoir^lllllllimi 


t>- 


•saiBK 


-H|||l|rt||||«|||||l|||| 


CO 


6 

►J 


■si^^ox 


1 1 ^ 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 I 1 CO 1 


■* 


■sajBuiaj 


II 1 1 1 1 1 1 1 1 1 cq 1 


C<l 


•saj-Bj^ 


1 1 -H 1 1 1 1 1 1 1 1 1 1 1 1 1 J 1 1 1 -^ 1 


oq 


go 

Is 


■siB^ox 


to CO CO ci) to to Qo CO to lo 00 1- rt cq -* e<) CO rt 1 ^ooco 


3 


•sa[Buiaj[ 


Cq|C-Jli«(Nir3w^CMt^<Ml 1 l<M-*l 1 IOO--H 


•^ 
•* 


■sai^BK 


■*co-HC<irt.*cocMifflco-H>ra-HN-* 1 cq^ 1 — loiM 


Oi 


2 
2 « 

H 1 J 
f F^ O 
►J ^ M 
o S o 

> z 
z < 


•siB^ox 


1 1 1 ico-Hrdcairt^i 1 1 1 i-*i 1 iQOrt 


00 


•sai^maj^ 


1 1 1 1 IM—KM 1 1 -HIM 1 1 1 1 1 rt 1 1 1 m 1 


■* 


■saj^j^ 


1 1 1 1 « 1 oqcM 1 1 cq 1 1 1 1 1 CO 1 1 1 co -h 


•* 


si 

2 a. 

a 

Q 


•sjT3;ox 


1 1.-II-*— i-*cqr-i|co-HNi 1— icol 1 It^cq 


s 


■sajBuiaj^ 


1 i-^icq-Hcvjrtrti^ic^ii 1 IMI 1 l>oi 


s 


•saiBj^ 


1 1 1 icqicq-^l icM-HI 1 irtrti 1 iMcq 


■^ 


S oto 

«i <! 
K S W 

E o 2 
^="5 


•sii3:>ox 


1 1 1 1 — 1 1 1 1 1 cq c-1 cq 1 1 1 1 1 1 1 1 1 1 


r- 


•saiBiuaj 


lllllllll(NC^C^IIIIIIIIII 


to 


■sa]'Bj\[ 


1 1 1 1 '-^ 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 


-' 




















African (black) 

Albanian . 

Armenian 

Chinese . 

English . 

Finnish . 

French 

German . 

Greek 

Hebrew . 

Irish . 

Italian 

Lithuanian 

Portuguese 

Scandinavian 

Scotch 

Slavonic . 

Spanish . 

Syrian 

Turkish . 

Mixed 

Race unascerta 


"3 
o 
E-i 



1921. 



PUBLIC DOCUMENT — No. 23. 



59 



05 

< 


3 


•SIBIOX 


1 1 l>0-<l INO— llrtrtCOOOl I'HI'J'T)*! 


O 


•saiBmaj 


1 1 1 -< 1 1 1 iNco 1 1 -• 1 ■*-! 1 1 1 1 csicq 1 JO 


•saiBi\[ 


1 1 l-*-^l 1 ICO-HI 1— KMt^l I^ICdC^ll .* 


o 

CO 


•siB^ox 




■o 


■sa[Buiajj 


IIIIIIIIIIIICOI— ilrtrtllMI 


03 


■sajBi^ 


1 1 looiMI 1 iTjti 1 i(NiMol 1 |rt(^^c-q| 


CO 




•SIBJOX 


1 1 1— 1 1 |rt-H| lc<ia5leol INI— ■t^— . 


'i' 


•saj'sraaj 


1 1 1 -H 1 1 1 1 1 1 1 Nrti 1 ^ 1 1 1 1 rtrt 1 


2 


■saiBi\[ 


I 1 1 1 1 1 1 -H-H 1 i 1 (M 1 0= 1 INI 1 tOrt 


(M 


g 
^ 


•spiox 


1 1 1 1 1 1 1 1— (-HiNt^it^i |«"CqNr^ 




•sajBuia^ 


lllllllllll<MTf<IQOIICOII— 1" 


s 


"sa[Bi\[ 


1 1 1 1 1 1 I 1 -l-< 1 1 CO 1 05 1 1 1 rtCMrt 1 


00 


in 

2 


•siB^ox 


1 1 1— ■'Hi 1 1 1 1 1— i.*|Ni— 1| immrH 


f; 


•saiT3uiaj; 


lll-Hlllllll— iNlt^lllIrt-^l 


2 


■8a|i3j^ 


1 1 1 l-HI 1 1 1 1 1 IMI>oi-H| loq^rt 


'^ 


O 


■sit!;ox 










•sapuia^ 


'I'I'I' -INIi« IN 


00 


•sa|i3i^ 


IlllllllllllllOllllcoIrt 


s 


lO 

Q 
Z 


■spiox 


lllllllllllllllllll^lrtN 


•sajBraaj; 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 


1 


•sal's i\[ 


lllllllllllllllllll^l— 1 N 


s 


■siT3;ox 


^N«O.^00^H 1 T*^-HCq 1 t^NOO^ 1 .<JH^<M^HCOCO 


to 
■* 


•sacemajj 


It^iOf^N— i|e-J«5l lfflOOTt<Ttl|C<lt^lt~'*N 


^ 


•sapK 


^40— Ht^:0 I 1 C<l»ON 1 -MTt^Tft^ 1 NC^N-^N.^ I N 
r.HCCN ^ ^H— ^05 — <(MI^ 

1 N 1 


Psychoses. 


Traumatic 

Senile 

General paralysis 

With Huntington's chorea 

With brain tumor ........ 

With other brain or nervous diseases .... 

Due to drugs and other exogenous toxins 

With pellagra 

With other somatic diseases 

Manic-depressive 

Involution melancholia 

Paranoia or paranoid condition 

Epileptic 

Psychoneuroses and neuroses 

With mental deficiency 

Undiagnosed 

Without psychosis 


1 

o 


^HNCO-^iCSOt^OOCSO — NC0*^>O:Ot^000iO — N 





60 



WORCESTER STATE HOSPITAL. 



[Dec. 



o 






ft^ 






-^ 



►J 
< 



to 

< 
m 


o 

« 
> 




■sib:>ox 


1 CO C2 r 1 1 1 1 1 1 I 1 1 1 1 1 1 I 1 1 1 1 


cq 




•sajBuiaj 


1 oo-H 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 =n 




•saiBi\[ 


1 in oo r 1 1 1 I 1 1 1 1 I 1 1 1 1 1 1 1 1 1 


S 






•SIB^OX 


1 >Ct^ 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 I ] —1 1 


CO 




•sajBraa^j 


1 eocs 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


l« 




•sajBH 


l<MifflllllllllIIIII[lll-<l 


00 




s 
g 


•SJB^OX 


l^Oilllllllllll-Hlllllrtl 


i^ 




•sapraajj 


1 o.* 1 I 1 1 1 1 1 1 1 1 1 rt 1 r 1 1 1 -H 1 


s 




•saii3i\[ 


1 >nm 1 1 1 1 1 1 I I 1 1 I 1 1 1 1 I 1 1 1 


o 




to 


•siB^ox 


1 OOO 1 1 1 1 1 CO 1 1 1 1 1 rt 1 1 1 1 1 1 1 


N 




•saiBmaj 


1 QOC<l 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


o 




"sai^pi 


1 (MO 1 1 I 1 1 CO 1 I 1 1 1 .-( 1 1 1 1 1 1 1 


2 




s 


•sjB^ox 


|IMt(<IM^I Irtl 1 1 1 1 iThl 1 1 1-^1 1 


s 




sajBmajj 


1 ^^ 1 1 1 1 1 1 1 1 1 1 I 1 1 1 I I 1 1 1 


<M 




•sajBiv 


l«COIMrt| Irtl 1 1 1 1 1^1 1 1 IrtI 1 


2 




e 


•sp^ox 


IrHQOffll 1 1 ICOl 1 l(MC<liOIC<ll |rtTj<| 


CO 




•sajBuiaj 


I'-lrti-ll 1 1 Irtl 1 1 l—icqlrtl |_rt| 


25 




"saiB]^ 


1 1 Tt<.* 1 1 1 1 IM 1 1 1 cq^co 1-^1 1 1 CO 1 


§ 




e 


•si^^ox 


rt 1 rtT}.i-irt 1 1 1 1 1 rtT»iu5in 1 1 1 1 1 ^ 1 


<M 

CO 




•sei-eniaj^ 


1 1 rt.^ 1 rt 1 1 1 1 1 1 CO.*C<l 1 1 1 1 1 rt 1 




•sai^j^ 


1-1 { leO-^l 1 1 1 1 |r-lrt(MCO| I 1 1 Icol 


■" 




e> 


■smox 


1 1 1 OOIM 1 1 1 CO 1 1 1 IM-HOO 1 1 CJ 1 -HM< 1 


-^ 




•sa|i3nia^ 


1 1 1 Ncq 1 1 1 <M 1 1 1 -Hirato 1 1 cq 1 1 cq 1 


IM 




•sa[i3i\[ 


1 1 lOl 1 1 l^-ll 1 IMCOCMI 1 1 1— c(M| 


s 




to 
m 

i 


Traumatic 

Senile . . . . _ 

General paralysis 

With Huntington's chorea 

With brain tumor 

With other brain or nervous diseases .... 

Due to drugs and other exogenous toxins 

With pellagra 

With other somatic diseases 

Manic-depressive 

Involution melancholia 

Paranoia or paranoid condition 

Epileptic 

Psychoneuroses and neuroses 

With mental deficiency 

Undiagnosed 

Without psychosis 


"3 
o 




T-ICsICO-^iOCOI>-OOa!O^HC<)CO^»^CDt^OD050^C^l 





1921. 



PUBLIC DOCUMENT — No. 23. 



61 





•s^ox 


[ ^(^n 1 1 1 Irtl JrtMMiOl 1 1 \ ^<CH-I 


CD 
CD 


•sai^niej 


1 2'^'^ 1 1 1 1 1 1 1 rt-H 1 lo 1 1 J r 1 COr^ 


s 


•saiBpi 


lTtflOOC<Illl|rt|liC<llMOIlll-<COl CO 

« 'J* 1 

1 


o 

:^ 

o 
O 


■si-B^ox 


ll-Hlllllllll-^l-Hllrtllrtl 


« 


•S3{Bra9j^ 


Illlllllllll-Hlrtllrtllll 


CO 


■S9IBJ^ 


1 1 --H 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 rt 1 


c. 


o 


■SF^Oi 


1 1 I l-Hl 1 1 1 1 1 l(^ql^Jcol imi-hc<ii 


t^ 


•sajBuiej 


llllll]lllllC<lCJ>OII03llrt| 


2 


•seiBj^ 


1 1 1 1 -H 1 1 1 1 1 1 1 1 1 M 1 1 1 1 rtrf 1 


'* 




■si^iox 


1 Z^c^"^^'"' ' Tt^coC-i 1 TtH^-<**iO 1 CO-*.-iC^00-^ 


i 


•sajBuia^ 


1 --HC<l:OC<I^ ! c^l-^ 1 1 coocqo 1 (Mcq I xP^O^H 


o 


■sal's i\[ 


lOtOro^l IC<IOIMIr-l«c-1C5|^cq«00C^M 


s 


o 

to H 


■siis^ox 


rtiCOOOrtI 1 lull |rt-*|051 |C<1^TJ<CD-^ 




•sajBuia^ 


iTjtrtI 1 1 1 Irtl IrtMIOI Irtl^c^l 


Oi 


■sa|i3j\[ 


rt^t^Ortl 1 l-rfil 1 1— i|Tt<l li-HrtTO^rt 




< 
(S 

a 

H 


•eitj^ox 


1 W^ 1 1 1 1 1 (N 1 i rt^ 1 U5 1 ,-, 1 1 coco 1 


s 


•sajBiuaj^ 


l<^^-^l 1 1 1 IrtI IrtrtlCKil 1 1 icqc-JI 


■M 


•sa[Bj^ 


liiliiri«iiiiicoirtii rtrt 1 


t- 


H 

O 

H 


•SITS^OX 


tUtJicO C-J C0C<I^ rt CMCO 


to 


•sa^Buiaj 




■sa|i3i^ 


"Scocq^ ' ' "^S"^ ' '^rtrt'^ ' =^"'=^'*<^'^ 


CM 


a 

IS 


8 '-S 

J i §■■.■■■ 

. . "3 . . . . ^ . b« . . :s g.- 

'1 t III i il"" 
g ;S^ « :S ^ ^ o ^as 

■'#l||ililil1ii" 

■^ •£^||2|:2^ = |^.o.|g.2§|g§i 

g ^ o g gW^ OOOaoi3g'o-g,Op,SMg 


o 
Eh 


.-iirqco-*iotdt-^oo'cBO-HMcoT)<'iocdi>;odo30rtc-j 





62 



WORCESTER STATE HOSPITAL. 



[Dec. 



0^ 



^ 






•SIB^OJ, 



•sa]Btn8j 



•sai'Bj^ 



J I I I I I I 1 I I 1 I 1 I -^ 1 1 I I -^ 1 I 



I I I I I I I I I I I I I J I I I I I I I I 



1 I 1 I I I I 1 I I I I I I —1 I I I I -^ 1 1 



•SJB^OX 



•sa|Bnia^ 



•sai^j^ 



ooo-H I I I ,-Hrt I I I Cdcoo I .-1,-H I -Hcq I 



ICOl 1 1 I 1 I I 1 I IMCO— 1"-H|«| I 



imto.-il I irtrti 1 I I io>i 1 I 1 icqi 



■sib:»ox 



■Sa|BUI9J^ 



•sajBjv; 



^H -^i^ o CO 00 ^H [ ccocq I t^oioo i noic^ias^^^o 



I •nm^r-M—i I C^O I I CCnrtCO I T-iO l tOM<C<l 



T-H (M (M ^H ^,-^00 »-< W 



■si^iox 



•saiBuiaj; 



•sajBi^ 



H(M«5-^Q0^H I -^J^ ^ !M it^C<JOO^ I -* O CM -^ SO =0 
■^ -"^ CO C^l CO OJ -^ ^^ C<I CO 



I I^lOt^CQr^ I N «0 I I CDOO-^-^ I C<I I>. I t^-Tj^CM 






6^ 



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3 2 d g 



OJ S 



p. u 



P 0-313 









1— lCSCOTt<lOCOI>-OOOOi— '(MCO-^»OCC>I>.OOOiO'-HC<l 



PUBLIC DOCUMENT — No. 23. 



63 












O 



fe^ 






Q 


•SIB^OX 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 J r 1 1 1 «-H 1 


■M 


W 








Z 














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f 1 1 1 1 1 1 1 r 1 1 J 1 1 1 1 1 1 1 1 1 1 


1 


m 








o 
















< 








t) 


■sai^jv^ 


1 1 1 1 1 1 1 1 1 1 1 J 1 1 1 1 1 1 1 —< M 1 


C<1 




■siB^ox 


OTCCCO « (M(MO cq 


t^ 


H 






CO 


a 






















s 


•sajBuia^ 


<M rt rt rt CC rt 




o 








(a 








s 














o 








O 


"saiBjv; 


f OOOtJ^-'f 1 1 »-icOC<l 1 1 ^ C^ lO I .^(NrHt^ooc^ 


oq 




•siB^ox 


f-Ht^lr^TtiiM 1 1 rt-* 1 ; (Nt^M-co 1 «M-Hooo>-i 


o 


2; 














•sajBuiaj 


r-*T).NI 1 1 l(MI l-H-*COOI 1 1 iTfTOrt 


■^ 


« 








<! 

s 
















"sajBjv; 


-HCCC<3C<1<MI I-«C<11 l-HTOrtt^l««-<M<MI 


CO 




•siT3^ox 


1 Tl< 1 1 1 1 1 1 1 1 1 1 1 -<tO 1 J 1 1 ■* 1 (>J 


.^ 


fH 
















» 








z 


•sa(Bma^ 


ICqlllllllllllli-Hlllloqll 


lO 


F4 








Q 








•sajB]^ 


1 cq i 1 1 1 1 1 1 J 1 1 1 -iio 1 1 1 1 oq 1 <M 


(M 




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rtOJO-*00>-c 1 ■*-HOJ 1 t^iMOOrt 1 •♦OCKl-HCOSO 










J 






■* 








-» 

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lt^lOt^(M-H INO 1 I^OO^J'*' lIMr^ II^TfiN 


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H 








•sajB]^ 




cq 








cq 






c 
















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to ■ O 
















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o 

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T-Hc^co^iocot^ooa50'-Hcqco^>o=or-.oooio^Hc^i 






rtrt— i-H— irtrtr-i— irtcMoqcq 





64 



WORCESTER STATE HOSPITAL. 



[Dec. 



a. 



S. 






fen 



;:d 



o 

g 
< 

O 
< 


■SITS^JOX 


lcoooo-s<l 1 1 1 1 l<Mo:-*>nl 1 1 lt~cnl 


s 


■sajBxnaj 


ij^cMrtrtl 1 1 1 1 r-Hcoioi 1 1 i«iol 


t^ 


■sa{Bi\f 


1 ooo^-ro 1 1 1 1 1 1 -HO^o i i i i o-*i 1 




% 

K 
H 
P- 

s 


•siB^ox 


1 It-HIO— (1 1 IrtrHl 1 I lOI 1 1 iNrfrt 


-* 


•sajBras^ 


IIIIIIIIOIIIIICQIIII— il^ 


o 


•saiBi^i 


1 1 rtUSrt 1 1 1 lOrt 1 1 1 1 t- 1 1 1 1 rtrt 1 05 




B 
H 
[1. 

H 


•sib:>ox 


—ICOI^racC— 1 1 <M 1 rH 1 C<HOifflO 1 T-ITfl(N00CO(M 


Oi 


•sajBraaj 


1 tOCOiCrt— 1 1 1 1 1 1 C^OOCD^ 1 1 rt 1 TOOO 1 


t^ 


■satBK 




■o 




■siB^ox 


|tOOOC-ll 1 llMI 1 IC^OOC3I^|CCO|T}<COCO 


oo 


•saj'Bmaj[ 


iTjtt^rti 1 ic^jl 1 rMt>ooiolcq.:oiiMM— . 


o 


■sajB]^ 


1 <M^-^ 1 1 1 1 1 1 1 1 rtMCJ 1 rt 1 1 cq(M!N 


in 


o 


•S[b;ox 




CO 


•sajBuia^ij 


|I^>or~lMrt|MOI ltO0OTj<-»i|c<Hr~|t^Tt<CKl 


-* 


•saiBH 


"!2eSc5"' ' ' "^'S*^ ' "Sl^m ' =^"<^"^<mt»< 


s 




H 
O 

a 


Traumatic 

Senile . . . 

General paralysis 

With cerebral syphilis 

With Huntington's chorea 

With brain tumor 

With other brain or nervous diseases 

Alcoholic 

Due to drugs and other exogenous toxins 

With pellagra 

With other somatic diseases 

Manic-depressive ....... 

Involution melancholia 

Dementia precox 

Paranoia or paranoid condition .... 

Epileptic 

Psychoneuroses and neuroses 

With psychopathic personality .... 

With mental deficiency 

Undiagnosed 

Without psychosis 


"3 


»-IC^C0'^iCC0t^000i(3'-HCqc0-^iOCOt^0005O^HC^ 



1921. 



is 


PUBLIC 

•sp^ox 


DOCUMENT — No. 23. 

1 1 1 1 1 1 1 1 1 1 1 1 1 1 CO 1 1 1 1 1 ^ 1 


CO 


•saiBraa^ 


1 1 1 1 1 1 1 J 1 1 1 1 1 1 J 1 1 1 1 1 1 1 


1 


•sajBK 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 C<1 1 1 1 1 1 rH 1 


CO 


Q 

m 

o 
> 

Q 


•siBpx 


I'-lllllll-HIIIIMTOl— llllll 


00 


•s8{Braaj[ 


1 ^ 1 I 1 1 1 1 1 1 1 1 1 J 1 J ^ 1 1 1 1 1 


C<I 


•sapii;; 


IIIIIIII-HllllcqcolllIili 


o 


Q 


"SIT310X 


1 1 1 1 1 1 1 1 -H 1 1 1 r 1 1 ] 1 1 1 1 1 ^ 


M 


•sajBTna^ 


1 1 1 1 1 1 1 1 ^ 1 1 1 1 r 1 1 J 1 J 1 1 ^ 


M 


•S9IBI\[ 


1 1 1 I 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


1 


o' 

o 

Q 


■siB^ox 




to 


•sajBuiaj^ 


loo^~rt| 1 1 IrHi i«rtc<i!Mi 1 1 1 icq| 


>o 


•sapj^ 


lt^(M<MI 1 1— icol 1 r i |-*l 1 1 1 |(M| 


^ 


O 

5 


•s^B^ox 


laiC0Ci»O^^I(M03I |-<}^:OCO001 IC<Ji-l(M»OC^ 


CD 


•sajBraaj 


1 cot^io-<-H 1 cqTji 1 i Mrtoo 1 1 rt 1 cqt^ | 


cq 


•sa|'Bi\[ 


ltoco-*(-tti| 1 ioi i-iust^Mi irtT-iiooe<i 


(M 


o 


■si^^ox 


1-i t* "<JH CI CO 1 I ^^zac<i 1 c^ioooco i cooo^Cicoco 


cq 


■S9|BUI8^ 


lO-H'-l-Hl 1 1 1 1 |C^OCOO|r-lO|lO>0— 1 


s 


■saiBiM 


-<c<ieo--^c<il i-HtONi ioiO'-3|c<ic<iT-i-*— icq 


o 


hi 

■< 
H 
O 


•SITJ^OX 




CO 

>*< 


•sajBraaj 


IW>01^(Mrt|cqcOI ICOOOTliTHIMt^lll^TttH 


s 


•saiBi\[ 




C] 


aj 

H 
CO 
O 
« 
o 

>^ 


'S 

i ° 

c! . 2 . m 

Jo § 

-Bo S ^ 

' "i ' 'g 1 'i'i '" 1 11 ■■ ■ 

^■1^1 1 1 1ll pa ^ll 1 

1 .-g^lllJolilllilollli! 


o 


-HC<IC<3^100t^OOOO— ■C^JCO-!t<>OCOI-~OOCJO— 'C^l 





65 



66 



WORCESTER STATE HOSPITAL. 



[Dec. 



Table 14. — Psychoses of Readmissions. 



Psychoses. 



1. Traumatic, total 

(a) Traumatic delirium 

(6) Traumatic constitution 

(c) Post-traumatic mental enfeeblement (de- 
mentia) ........ 

id) Other types 

2. Senile, total . 

(a) Simple deterioration 

(h) Presbyophrenic type 

(c) Delirious and confused types .... 
id) Depressed and agitated types . . . ' . 

(e) Paranoid types 

(/) Pre-senile type 

Ig) Other types . ._ 

3. With cerebral arteriosclerosis 

4. General paralysis _ 

5. With cerebral syphilis 

6. With Huntington's chorea 

7. With brain tumor 

8. With other brain or nervous diseases, total 

9. Alcoholic, total 

(o) Pathological intoxication 

(6) Delirium tremens _ 

(c) Korsakow's psychosis . . . . . 

id) Acute hallucinosis _ 

(e) Chronic hallucinosis 

(/) Acute paranoid type 

ig) Chronic paranoid type 

(h) Alcoholic deterioration . . . . 

(i) Other types, acute or chronic .... 

10. Due to drugs and other exogenous toxins, total 

(o) Opium (and derivatives), cocaine, bromides, 
chloral, etc., alone or combined (to be speci- 
fied) 

(6) Metals, as lead, arsenic, etc. (to be specified) . 

(c) Gases (to be specified) . . . 

(d) Other exogenous toxins (to be specified) 

11. With pellagra 

12. With other somatic diseases, total . . . . 

(o) Delirium with infectious diseases . 

(h) Post-infectious psychosis . . . . 

(c) Exhaustion delirium 

(d) Delirium of unli:nown origin . . . . 

(e) Cardiorenal disease ...... 

(/) Diseases of the ductless glands 

(g) Other diseases or conditions (to be specified) . 

13. Manic-depressive, total ...... 

(a) Manic type 

(6) Depressive type 

(c) Stuporous type 

(d) Mixed type 

ie) Circular type 

(/) Other types 

14. Involution melancholia 

15. Dementia pra-cox, total ...... 

(o) Paranoid type 

(6) Catatonic type 

(c) Hebephrenic type 

Id) Senile type 

(e) Other types _ . . _ 

16. Paranoia or paranoid conditions . . . . 

17. Epileptic, total 

(a) Epileptic deterioration . . . . . 

(6) Epileptic clouded states 

(c) Other epileptic types (to be specified) . 



24 



1921. 



PUBLIC DOCUMENT — No. 23. 



67 



Table 14. — Psychoses of Readmissions — Concluded. 



Psychoses. 



18. Psychoneuroses and neuroses, total 

(a) Hysterical type 

(b) Psychasthenic type . 

(c) Neurasthenic type . 
id) Anxiety neuroses 

(e) Other types 

19. With psychopathic personality 

20. With mental deficiency 

21. Undiagnosed .... 

22. Without psychosis, total . 

(a) Epilepsy . 
(6) Alcoholism 

(c) Drug addiction 

(d) Psychopathic personality 

(e) Mental deficiency 

(/) Others .... 



Totals 



WORCESTER STATE HOSPITAL. 



[Dec. 







■si^iox 


1 1 1 1 t 1 1 1 1 1 1 1 t 1 1 1 1 1 1 1 t t^ 


t^ 




» 










2 










<! 










!5 


•sajBraaj 


1 1 1 1 1 1 r 1 1 1 t 1 1 1 1 1 t 1 1 1 1 CO 


CO 




C 








■S8tBI\[ 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 t •« 


■* 


"S 


















5 




•sjb:>ox 


1 IrtMrHI IrtlMI 1 IN— IOI-HMIC<IMI 


C-J 


r^ 


d 








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> 

o 

K 










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1 1 rtOa 1 1 1 1 1 1 1 1 rt-Hrt 1 -H 1 1 1 1 1 


t--. 


is 










'"^ 








o 


t) 


•saiBH 


1 1 1 1-HI Irtcql 1 Irtlrol IC<1|(MMI 


o 


r^ 










■^^ 










« 




•si^ioi 


1 -Ht>.co 1 1 1 1 -H,-i 1 1 in^co 1 ecootooo 1 

r-< 00 tH 


•"if 












CO 










Ql) 










CO 








O 


> 
o 


•sajBraaj^ 


1 J 1 1 I 1 1 1 1 1 1 1 cono 1 —1003 1 lo 1 


o 


^ 


C3 








;^ 










'•O 


B 








* "^ 








Cs 














•SSI'S J^ 


\ T^t-'O 1 1 1 1— i-Hi ic<i— icoicqeccctoiO'l 


(3 


"e 






























S 










•S 




■sib;ox 


1 1 1 1 1 1 1 1 ■* 1 1 TiH«co r 1 1 — 1 1 <-i 1 1 


o 


1^ 










_o 








«i 


1^ 
> 
O 


•saiBuiaj 


1 1 1 1 1 J 1 1 CO 1 1 ^r-io 1 1 1 rt 1 ,H 1 1 


CO 




Pi 








•saiBM 


1 1 1 1 1 1 1 1 rt 1 1 1 iraco 1 1 1 1 1 1 1 1 


a 


5J 










c^ 










J 


■s^ox 


|rtcooot-i| irtt^— iiTjimrocDiTitrttoocoir^ 


i 


■^ 








t;j 

^ 




•sajBuiaj 


1 1 rtM 1 1 1 1 CO 1 1 -*— to— 1 N to CO i-H >o CO 
Cl CO 


C5 




C 








CO 
CO 


H 








_e 








"o 




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1 — It^co—t 1 1 r^^T-t I 1 00-<tti0 r C^ lO CO 00 !>• -^ 


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33 


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5=5 






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52 w 


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CO 






m ■ O 


H 




m 
H 

c 

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o 


.■3 . 3 g .g .g ..g .8 S2>, 

• • S m-C S \iS :a S _ C ffl ci • • 
o;scj R^-TS o-a^ftrt 

■g ^-""t^o - -H -S 'g c«-s CO 

■ ■^•i^lil ■§ mi i' Hi 1 ■ 

3^-= c-^'5-^-^'o M-5'3 o c g:S ^-5^-5 '^ 




















HM^O&g:^&<lQ^^S»5Qf2K(S^^U)& 






i-Ht— li— t.— It— li— 11— 1.— li— ItHC^CQC^I 


1 



1921. 



PUBLIC DOCUMENT — No. 23. 



69 



a 

31 

o 
K 
o 

(H 

to 
fin 


G o m 

O "! < 
K S W 
H o 2 

^"=2 


■S[B}0X 


1 1 1 1 1 1 1 II 1 1 1 1 1 1 1 1 


•sa[Bniaj 


1 1 1 1 1 1 1 II 1 1 1 1 1 1 1 1 


•sajBiv^ 


1 1 1 1 1 1 1 II 1 1 1 1 1 1 1 1 


6 
o 

K 

§ 

< 


•siB^ox 


'■-'■' c , , , , , 


•s8[Buia^ 


1 1 1 1 1 1 1 II 1 1 1 1 1 1 1 1 


■saiBj^ 


1 1 'H 1 1 1 1 II 1 1 C<l 1 1 1 1 1 


WITH OTHER 

BRAIN 

OR NERVOUS 

DISEASES. 


■S[B^0X 


lllllll II .-Hr-iiiioqii 


•saiBoia^j 


1 1 1 1 1 1 1 II —l'^ 1 1 1 N 1 1 


■sajtiK 


lllllll II 1 1 1 1 1 1 1 1 


WITH 

hunting- 
ton's 

CHOREA. 


•siB^ox 


1 1 1 1- 1 1 II 1 1 1 1 I 1 1 1 


■saiBoia^ 


1 1 1 1 "-' 1 1 II 1 I 1 1 1 1 1 1 


•sa[Bjv; 


lllllll II 1 1 1 1 1 1 1 1 


^2 


•spiox 


lllllll II III -H(N 1 1 1 


•sapniaj 


lllllll II 1 1 1 1 .^ 1 1 1 


•sajBj^^ 


lllllll II 1 1 1 -H-, 1 1 1 


►J 2 

«2 


•sib;ox 


-.JH 


•sajBina^ 


lllllll II 1 1 1 t^ 1 1 1 1 


■S^II3I^r 


lllllll II II --l^M 1 1 1 


B K C 
B W « 


•SIt3C(0X 


>C 1 1 1 1 1 1 II 1 1 OO 1 1 1 1 1 


•sai^uia^ 


lllllll II 1 1 cq 1 1 1 1 1 


•saiBjv 


o 1 1 1 1 1 1 .1 1 lO 1 1 1 . 1 




"smox 


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


•saiBuiaj 


1 1 1 - ' 1 1 11 1 1 - 


•sa[Bjv 


"H 1 1 1 1 1 1 II 1 1 — 1 1 1 1 1 


J 
% 


•si^iox 




■saiBoiaj 


|-H|rt« — « c-l-H .-.-iiolr-— .C^It-i 


•sapi^ 


Ol-Hllll II IIOTiOO)l-1l 




E 

a 
Q 

o 




General Diseases. 

Influenza 

Multiple abdominal abscesses . 
Arthritis deformans .... 

Purpura hemorrhagica .... 

Pernicious anemia 

Septicemia following infection of left leg 
Exhaustion due to manic-depressive in- 
sanity 

Carcinoma of breast 

Diseases of the Nervo^is System. 

Encephalitis 

Epidemic encephalitis .... 
Cerebral hemorrhage 
General paralysis of the insane 
Cerebrospinal syphilis .... 

Tabes dorsalis 

Status epilepticus 



70 



WORCESTER STATE HOSPITAL. 



[Dec. 



o 



fi. 



0^ 



<3 






H 

m 

e5 



H 

O 
M 
o 


K 

& t< g 
O <! ^ 

K S a 

H o 2 


•SJB^OX 


1 1 1 1 1 1 r 1 1 « 1 -H 1 1 1 1 1 1 1 1 


•sajBraa^ 


1 1 1 i i 1 1 1 1 -H 1 -H 1 J 1 1 1 r 1 1 


■sa[Bi\r 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


!3 

o 
a 




•siB^ox 


0-. 1 1 l« 1 1 1 1 , ,11,,,^ 


"sajBuiaj 


1 1 1 1 1 <M 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


•saiBj^i 


O^ 1 1 1 rt 1 1 1 •^■•^ II 1 1 1 1 1 1 1-1 


WITH OTHER 

BRAIN 

OR NERVOUS 

DISEASES. 


•si^^ox 
•saiBuia^ 


1 1 1 1 1 ^ 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


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


•saiBj^ 


Ill 1 1 1 1 1 1 1 1 1 1 1 1 


WITH 

hunting- 
ton's 

CHOREA. 


•sib:>ox 


1 1 1 1 1 1 1 1 1 1 1 1 1 II 


•saiBuia^ 


1 1 1 1 1 1 r 1 1 1 1 1 1 1 1 1 1 1 1 1 


•gajBj\[ 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


< £ 

r H a 
3 to 


•sjB^ox 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


•sajBraa^ 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


•saiBH 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


►J 2 

< 02 

K >* 

■z < 

H K 


•spJiox 


i 1 1 1 1 1 1 1 1 «rt II 1 1 1 1 1 1 1 


•sajBcnaj 


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


■saiT3i\[ 


1 1 1 1 i 1 1 1 1 '-^ 1 1 1 1 1 1 1 1 1 1 


§2l 

C3 K O 
W IB « 
K H H 
a W J 


•si^j^ox 


=°S^^' i«i i^^i , «,,,,, 1 


•sajBraaj 


I OO— < 1 J 1 rt 1 1 CO— 1 II —1 1 1 1 1 1 1 


•saiBi\[ 


0(^JCC^IIII 1— III! — illllll 


.J 

s 

a 
to 


•S|T!?0X 


t^t^i-H 1 1 m 1 1 «iot~ II 1 1 rt 1 — IN— 1 


■saiBuiaj 


^CqrH 1 1 CO 1 1 — ICOt- II 1 1 rt 1 1 «— . 


■sajBi\[ 


con 1 1 1 1 1 1 1 N 1 1 1 1 1 1 1 -H-i 1 


J 
< 

H 

o 


•sjBiox 


to .a< 1^ — 1 — < O (M -H NO'*— Irt CO ■-< rt —1 —1 (M CO 


•sajBraaj 


OOOJtXI— ION— 1 (MOCv)— ICO — 1— 1— ,1 |rt<M 


■sal's j/\r 


OOCOCO-H 1 -H 1 1 1 -.IM 1 lO Nil ««rt.^ 




M 
<) 

a 
Q 
fe, 



a 

to 




Diseases of the Circulatory System. 
Cardiovascular-renal disease 
Arteriosclerosis ...... 

Cerebro arteriosclerosis .... 

Acute vegetative endocarditis . 
Chronic endocarditis .... 

Chronic myocarditis .... 

Chronic valvular heart disease 

Femoral thrombosis 

Diseases of the Respiratory System. 
Hypostatic pneumonia .... 

Broncho-pneumonia 

Lobar pneumonia 

Pulmonary thrombosis .... 
Pulmonary tuberculosis .... 

Diseases of the Digestive System. 

Acute enteritis 

Chronic gastroenteritis .... 
Chronic enterocolitis .... 

Bacillary dysentery 

Carcinoma of intestines .... 
Carcinoma of pylorus .... 
Carcinoma of stomach .... 



1921. 



PUBLIC DOCUMENT — No. 23. 



71 





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Intestinal obstruction .... 

Cirrhosis of liver 

Exhaustion (persistent vomiting due to 
adhesion of bile duct) .... 

Diseases of the Genitourinary System. 

Chronic cystitis 

Pyelo nephritis 

Chronic parenchymatous nephritis . 
Carcinoma of bladder .... 
Carcinoma of uterus .... 

Accidents, Violence and S^ldden Deaths. 
Fracture of right femur (pushed by another 

patient) 

Multiple injuries (accidental fall) 
Asphyxiation (due to food in larynx and 

bronchi) 

Accidental fall from bed (punctured rib) 
Dementia pra;cox (sudden death) 


m 

o 
Eh 



72 



WORCESTER STATE HOSPITAL. 



[Dec. 



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1921. 



PUBLIC DOCUMENT — No. 23. 



73 



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74 



WORCESTER STATE HOSPITAL. 



[Dec. 


















ID 

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Psychoses. 


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Senile . . . 

General paralysis 

With cerebral syphilis 

With Huntington's chorea 

With brain tumor 

With other brain or nervous diseases . . . 

Alcoholic 

Due to drugs and other exogenous toxins 

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With other somatic diseases . . . . . 

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Undiagnosed 

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1921.1 



PUBLIC DOCUMENT — No. 23. 



75 



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o 


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76 



WORCESTER STATE HOSPITAL. 



[Dec. 



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to 


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i 

o 

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o 
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Traumatic 

Senile . . . . 

General paralysis 

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With pellagra 

With other somatic diseases .... 

Manic-depressive 

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Dementia prsecox . 

Paranoia or paranoid condition .... 

Epileptic 

Psychoneuroses and neurones .... 

With mental deficiency 

Undiagnosed 

Without psychosis 


"c; 

1 


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1921. 



PUBLIC DOCUMENT — No. 23. 



77 



< 


« 


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lO 


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c^ 


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^ 


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1 1 -H 1 1 1 1 1 1 1 1 1 1 1 — 1 1 1 1 1 1 1 


^1 


•saiBui 


1 1 1 1 1 1 1 1 1 " 1 -1 1 1 1 1 1 


" 




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1 " 


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■ 
O 

w 

o 










Traumatic 

Senile ...... 

With cerebral arteriosclerosis 
General paralysis .... 

With cerebral syphilis 
With Huntington's chorea . 
With brain tumor . . _ . 
With other brain or nervous diseases 

Alcoholic _ 

Due to drugs and other exogenous toxins 

With pellagra 

With other somatic diseases 
Manic-depressive 
Involution melancholia 
Dementia prsecox . . . 
Paranoia or paranoid condition . 

Epileptic 

Psychonouroses and neuroses 

With mental deficiency 

Undiagnosed 

Without psychosis .... 


1 




i-'C^CO-^lCOt^OOOO'-HiMCO^i.OtDt^ooc^O'-HC^j 

1 _ ^ „ „ „ rt „ „ „ ^ ei c-j C-] 





78 



WORCESTER STATE HOSPITAL. [Dec. 1921. 



Table 19. — Family-care Department. 



Males. 



Females. 



Totals 



Remaining Sept. 30, 1920 .... 
Admitted within the year .... 
Nominally returned from visit for discharge 
Whole number of cases within the year 
Dismissed within the year .... 

Returned to the institution 

Discharged 

Died 

Visit 

Escaped 

Remaining Sept. 30, 1921 .... 

Supported by State 

Private 

Self-supporting 

Number of different persons within the year 
Number of different persons admitted 
Number of different persons dismissed 
Daily average number 

State 

Private 

Self-supporting 



25 
10 
1 
36 
14 
10 

2 
2 

22 

13 

5 

4 

31 

6 

12 

24.11 

15.36 

4.75 

4.00 



25 
10 
1 
36 
14 
10 

2 
2 

22 

13 

5 

4 

31 

6 

12 

24.11 

15.36 

4.75 

4.00