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Public Document
No. 23
Cjbe Commonttiealtl) of ^afimtbii$tm
ANNUAL REPORT
THE TEUSTEES
Worcester State Hospital
Yeae ending November 30, 1922
Department of Mental Diseases
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OFFICERS OF THE WORCESTER STATE
HOSPITAL.
BOARD OP TRUSTEES.
John G. Perman, D.D.S.
Lttther C. Gbeenleaf
Caroline M. Caswell, Secretary
Mae Carlson Bemis .
William J. Delahanty, M.D.
Edward F. Fletcher, Chairman
Howard D. Cowee
f ^^
Worcester.
Boston.
Northborough.
Spencer.
Worcester.
Worcester.
Worcester.
MEDICAL STAFF.
William A. Bryan, M.D.
Michael J. O'Meara, M.D
Leon E. Duval, M.D.
George A. Gaunt, M.D.
Clarence A. Whitcomb, M
Mervin Fossner, M.D.
Manley B. Root, M.D.
John Saucier, M.D.
Henry P. Wbyler, M.D.
John P. Powers, M.D.
Louis Pare, M.D.
Lloyd E. Byrd, D.D.S.
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.
Assistant Physician.
Dentist.
VISITING STAFF.
Ernest L. Hunt, M.D. ]
John F. Curran, M.D. |-
C. J. Byrne, M.D. . J
M. M. Jordan, M.D. .
Benjamin T. Burley, M.D.
William F. Holzer, M.D.
Frank E. Stowell, M.D.
John W. O'Meara, M.D.
Phillip H. Cook, M.D.
Surgeons.
Neurologists.
Ophthalmologist.
Electro-therapist.
Orthopedist.
Roentgenologist.
HEADS OF DEPARTMENTS.
Florence M. Wooldridge, R.N.
Maurice Scannell
Jessie M. D. Hamilton
Herbert W. Smith
Lillian G. Carr
Joseph Reynolds
James Dickison, Jr.
Anton Swenson .
Maude Rose
Superintendent of Nurses and
Principal of Training School.
Supervisor, Male Department.
Treasurer.
Steward.
Matron.
Head Farmer.
Chief Engineer.
Foreman Mechanic.
Head Occupational Therapist,
WORCESTER STATE HOSPITAL. [Dec.
Cfje Commontoealtl) of ^n^smtbn^stm
TRUSTEES' REPORT.
To His Excellency the Governor and the Honorable Council.
The trustees of the Worcester State Hospital respectfully submit the ninetieth
report of the hospital, appending a record of the various departments as reported
by the Superintendent, Dr. William A. Bryan, also by the Treasurer, Miss Jessie
M. D. Hamilton.
During the year the Honorable John E. White resigned from the Board of Trus-
tees and Attorney Howard W. Cowee was appointed to fill the vacancy.
The trustees have studied the needs of both the Belmont and Summer Street
Hospitals and urgently request that additional funds be provided to meet the de-
mands of the State and City inspectors, which requirements are specified in the
superintendent's report.
We feel assured that the past year has shown a greater development in the surgical
and medical departments of both hospitals than was ever developed in any previous
year. The splendid medical and surgical organizations established by Dr. Bryan
is worthy of great consideration. The trustees heartily co-operate with the superin-
tendent in the recommendations embodied in his report, kno^ving that same has
been well thought out.
It is with a source of great pride that we mention the splendid progress made in
the medical field. The organizing of a consulting staff composed of well known
Worcester phj^sicians guiding each specialty, by means of increased facilities for
diagnosis and treatment, the patients at this hospital have been greatly benefited
and physical ailments alleviated. The relief of phj^sical distress aids greatly in
mental recuperation.
Medical Office.
During the last year the medical office has been completely renovated, filing
cabinets have been added and a dictaphone room provided. The comfort and con-
venience plus the pleasant situation of this room greatly aids the phj^sicians in their
daily work.
LiBKARY.
Among the other attractive changes is that of the library, which has been trans-
ferred to a large spacious and sunn}^ room with 1,500 volumes readily accessible.
Adjoining is the medical library where all the new works on medicine are available.
The patients who are unable to attend the library are supplied daily with books on
the ward.
Decorations.
Over 1,000 new pictures have been placed on the wards.
We are of the firm belief that our superintendent. Dr. Bryan, has given his utmost
consideration to every department, working beyond his strength in order to pro-
mote the best welfare of every inmate confined in both institutions.
Respectfully submitted,
EDWARD F. FLETCHER.
HOWARD W. COWEE.
JOHN G. PERMAN.
LUTHER C. GREENLEAF.
CAROLINE M. CASWELL.
WILLIAM J. DELAHANTY.
1
1922.1 PUBLIC DOCUMENT — No. 23.
SUPERINTENDENT'S REPORT.
To the Trustees of the Worcester State Hospital.
I herewith respectfully submit the following report of the Hospital for the year
ending Nov. 30, 1922, it being the ninetieth annual report.
There remained on the Hospital books October 1, 1921, 2,367 patients, 1,240 men,
and 1,127 women. During the j^ear ending Sept. 30, 1921, there were admitted
611 patients — • 347 men and 264 women. Five hundred and sixty-six patients —
326 men and 240 women, were discharged from the hospital. Of this number, 301
patients, 178 men and 123 women — were discharged; 222 patients — 122 men
and 100 women — died; and 43 patients — 26 men and 17 women — were trans-
ferred, leaving at the end of the statistical year 2,451 patients — 1,273 men and
1,178 women. Two thousand and seventeen patients — 1,018 men and 999 women
— were actually in the hospital. Of this number 1,833 were supported by the State,
93 by friends, and 91 as re-imbursing patients. Of the patients discharged, 31 were
reported as recovered, 160 as improved, and 64 not improved. Forty-one patients
— 27 men and 14 women — were discharged as not insane. Twenty men and ten
women were transferred by the Department of Mental Diseases to the Gardner
State Colony; 2 men and 2 women to the State Infirmary; 1 man and 2 women to
the Boston State Hospital; 1 man to Dr. Channing's Sanitarium; 1 man to Her-
bert Hall; 1 man to the Bridgewater State Hospital; 1 woman to Dr. Ring's Sani-
tarium; and 1 woman to the Monson State Hospital. Twenty-two men and 9
women were removed from the State, and 21 men and 14 women were deported.
There remained in the hospital at the end of the year 37 less patients than at the
beginning. The smallest number under treatment on any day was 2,040 patients,
and the largest 2,110. The daily average was 2,029.46.
The percentage of recoveries, calculated upon the number of discharges and
deaths, was 5.45, calculated upon the number of admissions, 5.07. The death rate
was 7.3, calculated on the whole number of patients under treatment, and 10.9,
calculated on the daily average number,
Ex-Service Men.
During the year, there were 61 ex-service men committed to the hospital, 5 re-
turned from trial visits, and 14 returned from escape. Thirty-three went out on a
year's trial visit, 22 left the hospital without permission, 4 died, 5 were transferred
to other hospitals for the insane, and 13 were discharged. On September 30th
there were 50 ex-service men remaining in the institution.
The American Legion has aided us in making the lot of our ex-service men more
comfortable by entertainments and by the regular visitations of a committee desig-
nated for this duty. Thej^ have further helped to obtain work for several patients
and made it possible for them to return to their homes and once more take up their
usual duties. The Disabled American Veterans have provided entertainments and
have personally escorted large groups of our ex-service men to amusements and
suppers in the city. The Red Cross have cheerfully from time to time rendered
valuable aid.
Grateful acknowledgment is made to the Societies who have contributed gifts
to our ex-service men during the year, and provided splendid entertainments at
frequent intervals.
WORCESTER STATE HOSPITAL. [Dec.
General Health of the Population.
The general health of the institution for the past year has been unusually good.
I would mention, however, the accidental death by burning of a crippled patient
at the Summer Street Department who fell into a bon-fire and who died despite
immediate removal and treatment. Also a female patient at the Summer Street
Department terminated her hfe by suicide. She was found hanged to death, by
the Night Supervisor, in the water section. A male patient, who for years had had
the freedom of the grounds, made his way to the Lake, weighted his pockets with
stones and jumped into the Lake. His body was recovered, and the Medical Ex-
aminer attributed the cause of death to drowning. Two other cases of sudden
death were also reported, and the causative factors determined as self-infhcted.
On September 28th, during fire-drill, an elderly patient fell down stairway and
fractured a cervical vertebra, which caused death. An operative case died from
ether narcosis, following an operation.
There have been no epidemic diseases occurring among the patients or employees.
Principal Causes of Deaths.
Twenty-six per cent of all deaths were due to general arteriosclerosis; 14 per
cent to general paralysis of the insane; 8 per cent due to cardio-vascular-renal
disease, and 5 per cent each to chronic myocarditis, broncho pneumonia and pul-
monary tuberculosis.
Staff Changes.
The following changes have taken place on the medical staff of the hospital: —
Resig7iations.
George F. Caldicott, M.D., resigned February 14, 1922, to accept internship at
Worcester City Hospital.
Franklyn P. Bousquet, M.D., resigned March 15, 1922, to internship at the
Worcester City Hospital.
Harrison M. Stewart, M.D., resigned March 25, 1922, to return to United States
Public Health Service, at Greenville, N. C.
E. Gwynne Merriweather, M.D., resigned May 1, 1922, to accept a position
elsewhere.
Robert B. Harriman, M.D., a physician of very kindly disposition, and extremely
thoughtful of his patients and associates, passed away June 5, 1922.
Claude Girardeau, M.D., resigned June 30, 1922, to accept a position elsewhere.
Clarence A. Bonner, M.D., resigned October 14, 1922, to accept a position as
Assistant to the Commissioner of the Department of Mental Diseases.
Henry J. Emanuel, M.D., resigned October 30, 1922, to accept a position else-
where.
Appointments.
Clarence A. Whitcomb, M.D., v/as appointed Senior Assistant Physician (Path-
ologist) February 2, 1922.
Mervin Fossner, M.D., was appointed Assistant Physician March 16, 1922.
E. Gwjame Merriweather, M.D., was appointed Assistant Physician March 29,
1922.
Claude Girardeau, M.D., was appointed Assistant Physician May 15, 1922.
Manley B. Root, M.D., was appointed Assistant Physician May 23, 1922.
Henry J. Emanuel, M.D., was appointed Assistant Physician June 12, 1922.
John Saucier, M.D., was appointed Assistant Physician August 1, 1922.
Louis Pare, M.D., was appointed Assistant Physician September 1, 1922.
John P. Powers, M.D., was appointed Assistant Physician September 15, 1922.
Henry P. Weyler, M.D., was appointed Assistant Physician November 13, 1922.
1922.]
PUBLIC DOCUMENT — No. 23.
Student Internes.
I am desirous of reporting splendid work done by our internes during the past
summer. Lectures were given by various staff members and each interne prepared
a thesis upon the subject which proved to be the most interesting to him. One of
these has been pubUshed in the Boston Medical and Surgical Journal.
The following students served as internes during the past summer : —
Merrill R. Fox .
Charles E. Futch
A. Dale Kirk
John F. Sander .
Esther Closson .
Helen F. Shrack .
Omins Von Ostrum (Dental)
Johns Hopkins University.
University of Michigan.
University of Michigan.
University of Michigan.
Women's Medical College.
Women's Medical College.
Harvard Dental School.
Medical Routine.
The usual physical examinations, Wassermann tests and the typhoid-prophy-
laxis have been practiced and in addition each new patient and many of the old
patients have had the eyes tested and a complete examination of the nose, throat
and ears, and abnormal conditions found have been treated. The staff meetings
have been held regularly and the staff luncheons continued.
A new system of case work has been inaugurated with an efficient manner ar-
ranged for preparing of notes and general case formation. The medical work has
been increased and enlarged to the point where a full staff is kept fully employed.
The operating room is active daily and consulting specialists in surgery, ophthal-
moscopy, electrotherapy, orthopedics and Roentgenology have been appointed.
This has aided us greatly in a more thorough preparation of cases and has shown a
greatly increased number of physical defects which ordinarily would not have been
noted and which have been studied in relation to the psychoses. The operating
room equipment has been largely increased by the purchase of needed instruments.
A static machine has been installed and has been found useful. The surgical service
has worked out very nicely and each Saturday finds a number of operative cases
ready. The visiting staff is apportioned to certain hours of each week and they
have faithfully co-operated with us and we feel that the medical tone of the institu-
tion has been raised to the point where the patients are now receiving the benefits
of the most modern and progressive methods.
Hydrotherapy. — Hydrotherapy has occupied a very prominent place in our
treatment and records show that the results on the whole from this measure are
very important.
Calisthenics. — Occupational Therapy and habit training — The Occupational
Department has been increased by the addition of some very excellent workers
who have established ward classes with the result that wards, especially on the female
side, formerly very noisy, active and destructive, present a changed appearance.
The patients, despite very active mental disturbances, enjoy this teaching. Calis-
thenics and also classes on the male side, have been continued and from time to time,
as circumstances permitted, re-educational classes of the illiterate have been main-
tained.
Medical Report.
Examination of the Blood. — Routine examinations of 279 R. B. C. and Hemo-
\ globin Tests by Dare and Tallquist methods show the average Red Count to be
J 4,471,000 and the average Hemoglobin reading 8L6 per cent. A Red Count should
I be done on all cases where the Hemoglobin is below 81 per cent. The highest cell
I count was 6,350,000 and the lowest 1,500,000.
; Report of the Ophthalmic Service. ■ — In conjunction with the special service re-
\ cently established an Ophthalmic Service has been organized under the direction of
Dr. William F. Holzer. The aim of the service is to examine routinely the eyes of
6
WORCESTER STATE HOSPITAL.
[Dec.
every new patient and to prescribe treatment as indicated. Through the arrange-
ment accurate refraction is done and glasses procured at a minimum cost. A new
electro-ophthalmoscopic and trial case has recently been added to this equipment.
This service has been of great usefulness :
List of Cases treated.
Sebaceous cysts of lid
Inflammation of conjunctiva
Cataract of lens:
Mature
Incipient
Glaucoma :
Chronic
Simple .
Divergence of eyeball
Complete blindness
Optic atrophy
Plastic iritis
Trachoma
Staphyloma of cornea
Paralysis of eye muscles
Districhiasis
Impaired vision, necessitating glasses
Patients examined but not needing glasses
1
7
5
1
2
1
3
1
1
1
1
2
1
1
32
22
X-Ray Examinations of the Teeth. — The following conditions are revealed by
X-ray examinations of the teeth: Frequently roots are entirely covered by gum
tissue and often abscesses are concealed in this way. Cystic areas in bone are shown
and many impacted molars have been revealed. The removal in many cases of this
abnormality has resulted in a great deal of relief from a painful and irritating con-
dition.
The following is the dental record :
Number of patients
Cleaning
Filling
Plates
Treatment .
Teeth extracted
Repair of plates
Impacted teeth removed
3,630 )
3,164
2,043
27
131
2,639
24
37
Report of the X-Ray De/partment. — It is an ob\dous fact that the clinician, and
since the last decade, the alienist, are gradually getting more dependent upon the
X-Ray, and, as a matter of fact, their co-operation has proved to be mostly success-
ful. Let us illustrate with a few examples:
In bone and abdominal surgery I would venture to say that in almost all cases a
skiagraph is indispensable and, in fact, is ordered by the surgeon; on the other hand,
in the presence of an early history of coughing, or slight thoracic pains, at that
stage when both the stethoscope and the laboratory are unable to decipher the
mystery, who is the internist who shall refuse the powerful help of the Roentgen
rays to unravel the intricacies of his problem?
Even in our apparently limited domain of Psychiatry we have understood the
necessity of possessing a department of Roentgenology, because both our surgical
and medical clinics were in need of this valuable element of diagnosis.
The following figures are a demonstration of what we have done last year (No-
vember 30, 1921 to November 30, 1922).
Ankle exposures . .
14
Arm ........
4
Chest
16
Foot
6
Gastro-intestinal ......
7
Hand
. 28
1922.1
PUBLIC DOCUMENT — No. 23.
Hip .
Humerus
Jaw
Knee .
Nose exposiu'es
Leg
Neck .
Pelvis .
Shoulder
Spine
Skull
Wrist
Thigh
Rib
Colon
Clavicle
Total skiagraphs
12
2
7
6
1
9
1
1
9
7
62
7
3
3
2
2
227
Surgical Report, December 1, 1921, to December 1, 1922.
The Hospital is now able to give the best of surgical treatment to patients and
employees. The operating room is fully equipped and is functioning in a very satis-
factory manner. Operations of choice are done Saturday of each week; emergen-
cies are met as they arise. The organization of the surgical department is as fol-
lows :
1. Visiting Staff: Two consulting surgeons and four visiting surgeons.
2. House Staff: One member of the hospital staff. These men serve in rotation,
the service in each case being three months.
3. Nurse in charge of the operating room.
Surgical cases are cared for in the hospital wards and complete clinical records
are kept. All specimens removed at operation are submitted to the laboratory for
examination. Full reports of the operation, cUnical course and pathological reports
are filed in the case records of the patients.
During the fiscal year jfiifty operations have been performed. Cure of the surgical
condition has been secured in thirty-three cases; improvement has been secured
in three cases; no improvement was secured in fourteen cases. No deaths have oc-
curred which can be accounted for in any way in connection with the surgical con-
dition.
Report of Surgical Operations.
Vaginal repair ............. 3
Inguinal herniotomy ............ 10
Gastroenterostomy ............ 1
Circumcision . . . . . . . . . . . . .1
Excision of Sebaceous cyst . . . . . . . . . . .2
Hemorrhoidectomy ............ 3
Ventral Herniotomy ............ 4
Resection of prolapsed rectum .......... 2
! Fixation of uterus . . . . ■ . . . . . . . .2
' Hysterectomy ............. 1
Vaginal hysterectomy ............ 1
Incision of abscess ............ 2
Appendectomy ............. 4
Cholecystectomy ............. 1
Excision of lipoma ............ 2
Incision of carbuncle ............ 1
Lengthening of spermatic cord .......... 1
Excision of fibroma ............ 1
Amputation of leg ............ 1
Gastrotomy ............. 1
Thyroidectomy ............. 1
Ligation of superior thyroid artery ......... 2
Radical cure of hydrocele ........... 1
Dilatation and curettage ........... 1
Salpingectomy ............. 1
WORCESTER STATE HOSPITAL. [Dec.
Report of the Out-Patient Clinics.
There are at present two separate and distinct clinics. One is the neuro-psychi-
atric clinic at the Summer Street Department, and consists largely of consultation
work. The other is the School Clinic, for the examination of retarded school chil-
dren, and is a traveling clinic operating over a fairly large territory.
From December 1, 1921, to November 30th, inclusive, the Summer Street Clinic
examined one hundred and twenty-two cases. No arithmetical or statistical data
will be given, as it is thought that a review of the types of cases seen, sources of
inflow to the cHnic, and results obtained is more in order in this report.
Sources of inflow were Courts (particularly juvenile), welfare organizations,
(Girls' Welfare Society, Children's Friendly Society, Jewish Welfare Society), other
hospitals and their dispensaries, private physicians, interested relatives and indi-
viduals who come on their own initiative. District and School Nurses also sent many
cases. The largest number of cases from any one source were those of the Girls'
Welfare, who send all of their cases routinely, and studies of the subsequent liis-
tories of these girls have shown that the Clinic has helped materially in understand-
ing their difficulties and helping them in making their readjustments.
Types of cases were many and varied. Two cases are cited as follows:
1. Adolescent boy, brought by court officer. Charged with indecent exposure.
Found to be case of adolescent maladjustment. Recommend removal from school
and hard physical labor. One year later, no repetition of offence, adjusting well.
2. Girl, 18, brought by sister. Hebephrenic Dementia PriECox. Committed to
State Hospital.
These cases could be multiplied indefinitely, but space forbids. We will pass on
to the School Clinic work, carried on at the request of and in co-operation with the
State Department of Education. Two hundred and seventy children were exam-
ined between December 1, 1921, and November 30, 1922, inclusive. The work
began in the early part of November, 1921, and approximately three hundred chil-
dren have been studied to date. One full day per week, during the school year, is
given to this work, which is carried on by one physician, one psychologist, and two
social workers, together with assistance from school and district nurses, in the va-
rious locaUties where the clinics were held. An average of ten to twelve cases were
examined each clinic day. The clinics are a part of a Statewide survey of backward
school children, and the examinations are required by a recently-enacted State law.
The children range from six to sixteen years of age chronologically, and we have
found a range of mental ages from two and a half or three years up to normal. Some
of the "retarded" children are found to be cases of maladjustment, due to physical
disease, unwholesome environment, language difficulties (in foreigners) etc. In one
town, out of twenty-one children selected as being backward in school, eighteen
were found to have almost no knowledge of the English language. Physical disease
as a basis for retardation was commonly found, and endocrine disease has been
found in a number of well-marked cases.
REPORT OF THE SOCIAL SERVICE DEPARTMENT.
To the Superintendent.
The report of the Social Service Department for the year ending November 30, 1922,
is herewith submitted. During the year there has been no change in the Social Service
staff, which consists of two workers.
Some of the functions of the department are to contribute data relative to the cases
of patients, to the physician, which may aid in their diagnostic work, to study outside
conditions which will help in the placing of patients in the community, to visit patients
who have left the hospital and aid them, if necessary, in securing financial help or em-
ployment and making known to them the educational and recreational opportunities
of the commimity. Encouraging, helping, adjusting and advising constitute the four-
fold work in the homes of the patients. We aim to bring the hospital and commimity
into closer relationship for the benefit of the patients.
1922.1
PUBLIC DOCUMENT — No. 23.
Table A. — Sources of New Cases.
Males.
Females.
Totals.
Referred by physicians
Referred by agencies or hospitals
Referred by friends of patient
Referred by initiative of patient
Selected by social worker
121
60
3
2
15
136
13
4
3
22
. 257
73
7
5
37
201
178
379
One hundred and eighty-four visits were made to patients who are on visit from the
hospital and 178 to relatives during the year. There were at the beginning of the year
25 patients boarded by the hospital in families and at the close of the year 23 were in
family care. The visits paid to this group of patients during the year was 110. 11
boarding homes were investigated, 7 proved satisfactory and 2 were unsuitable. 226
interviews were held for some definite purpose with patients on the ward.
In April, 1922, in an effort to do some constructive work with the younger girls on
the wards, a Camp Fire group was started with Mrs. Mary Howgate Caldicott as guar-
dian and Miss Maude H. Rose, Occupational Therapist, as assistant. The National or-
ganization authorized and chartered a group of 12 — giving the guardian the privilege
of having a list of prospective members from whom they could draw when the mental
condition of a regular member did not warrant her participation in the group activities.
Due to the constant shifting it has been impossible to build up the correct esprit de
corps but it is hoped that this lack will become less of an obstacle in time. For group
activities, the greatest amount of time has been given to out of door work. During the
winter group attention will be focussed on music and handicraft. It is our aim to make
the organization a more valuable therapeutic agent for patients eligible for membership.
Often through the efforts of the Social Workers there is a changed attitude of the
community towards the hospital and a better understanding of hospital methods and
purposes. By invitation, we have spoken at the meetings of three organizations explain-
ing our work. The senior worker has given a series of four lectures in Social Work to the
seniors in the Nurses Training School.
In closing the report the department wishes to thank the outside agencies for their
aid in supervising patients on visit and their help in various ways. We are also glad
for the spirit of co-operation given us by other departments of the hospital and we are
grateful to the physicians for their advice and interest in our work.
Respectfully submitted,
Jennie A. Harrington,
Social Worker.
Report of Laboratory Work during the Year 1922.
During the year 1922 the Laboratory has co-operated in a more intensive study of
the physical conditions of the individual patient rather than the study of any par-
ticular disease process. This has included routine examination of all cases ad-
mitted to the Hospital. The counting of red blood corpuscles and hemoglobin
determination have, during the past nine months, been routine on all admissions,
j During the earlier part of the year a large portion of the time was consumed in
I the process of rehabilitation which has included the re-organization and increase
I of the Laboratory staff and in the purchase of new equipment resulting in a sub-
) stantial increase in the scope of the Laboratory work.
j During the summer a Benedict metabolism apparatus was purchased by the Hos-
I pital and this method of study is now available to the clinical staff. Trouble has
been experienced in obtaining sufficient co-operation on the part of the patient to
ensure correct determinations.
, Bacteriological examination of the granulomata attached to the roots of extracted
i teeth has been made in all suitable cases. In the majority of these no growth on
10
WORCESTER STATE HOSPITAL.
[Dec.
culture media has been obtained but saprophytic bacteria has been found. In cases
shomng pathogenic bacteria vaccines have been made.
Supphes are now at hand and preparatory work is in progress for a quantitative
chemical determination of the more important constituents of the blood. This
form of examination will be available for the use of the clinical staff in the near
future.
The Laboratory is also being equipped to do Wassermann examination of the
blood for the detection of syphilis and other serological procedures.
The staff of the Laboratory has also assisted in the clinical examination and
treatment of cases. This work has included ear, nose, throat and ophthalmoscopic
examination and the treatment of patients infected vnth sj^phiUs.
The following report shows the number of Laboratory examinations made during
the year 1922.
Autopsies
Blood counts, red
Hemoglobin determinations
Blood cultures
Blood groupings
Bacteriological cultures
Bacteriological smears .
Gastric analysis
Determination of metabolic rate
Renal functions (phenolphthalein)
Sputums ....
Spinal fluid examinations
Lange colloidal gold examinations (sp. Fl.)
Shick tests .
Vaccines
Urinalysis
Widal . . .
Microscopic sections
48
396
396
6
8
54
75
5
68
86
43
88
76
3
15
694
2
157
Religious Services.
Religious services have been held regularlj' each Sunday at both the main hos-
pital and the Summer Street Department for our Catholic, Protestant and Jewish
patients. Response to sick calls and the rites of their religion to the djdng have
been faithfully made by members of the clergy.
Requirements.
The hospital refrigerator is not satisfactory, and because of the antiquated ice
box method of storage there is a loss in food stuffs. This could be eliminated by an
up-to-date refrigerating plant. I would caU attention to the advisability of a con-
gregate dining room in which food could be served much more efficiently and in a
more pleasing manner to the patients.
The recent fire in the Manhattan State Hospital causes us to mention with em-
phasis the necessity of altering our seven wooden staircases, which increase the
danger greatly in the event of fire ; also the need of a sprinkler system both in the
main building and at Summer Street and certain new fire escapes.
A general store house to care for the large purchase receipts is quite necessary
since the establishment of the new purchasing department and should be given
careful consideration. Last year the hospital avenue was made very satisfactory
by special preparation, but the hard winter mil necessitate further work on this
roadway.
Again more attention will have to be given the trees on the grounds which were
injured so badlj'- in the ice storm of 192L
On the Phillips Wards of the female side new plumbing is needed to replace the
old and antiquated style now in use. New plumbing and reconstruction is needed
at the Summer Street Department to properly prepare the hydrotherapy depart-
ment for the proposed new function of this institution. New regulators to control
the inflow of hot water in the hydrotherapeutic department is recommended.
1922.
PUBLIC DOCUMENT — No. 23.
11
Projects completed.
Apart from the minor repairs, alterations and usual new constructions, the fol-
lowing projects have been completed:
The basement on the female side has been cemented, a new cement floor made
in the garage. The store rooms have been rebuilt and a new system inaugurated.
Many of the wards have been renovated and painted. Development of the land at
the lake corner has begun and a new stone wall started. The main building has
been partly rescreened. At the Summer Street Department much repairing and
ward renovating has been carried out, also new plumbing and floor relaying has
been done.
Thanks are due to the following physicians for their aid in preparing the special
parts of this report: Drs. Duval, Gaunt, AVhitcomb, Fossner, Root, Saucier and
Weyler, and to Miss Harrington for the Social Service Report.
I desire to express my gratitude to the Board of Trustees for the splendid co-op-
eration and support given me during the year. They have at all times been ready
and willing to render valuable advice and assistance and have given freely of their
time and counsel. In addition I take this opportunitj^ of making public acknowledg-
ment of the interest and excellent support given me by the officers and employees
of the hospital.
WILLIAM A. BRYAN,
Superinte7ident.
Nov. 30, 1922.
VALUATION
Nov. 30, 1922.
Real Estate.
Land (589 acres)
Buildings
$41 6,-357 00
2,170,623 53
82,586,980 53
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.
$8,472 09
12,999 66
32,924 58
235,902 92
21,864 55
26,166 31
25,910 60
12,420 79
16,107 67
8392,769 17
,586,980 53
392,769 17
,979,749 70
12
WORCESTER STATE HOSPITAL.
[Dec.
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 November 30, 1922: —
Cash Account.
Balance December 1, 1921
Income.
Board of inmates :
Private
Reimbursements, insane
Receipts.
$39,418 52
46,075 97
Personal services:
Reimbursement from Board of Retirement .
Sales :
Travel, transportation and office expenses .
Food ...
Clothing and materials
Furnishings and household supplies . . .
Medical and general care
Heat, light and power
Farm:
Cows and calves . . . . $110 00
Hides 46 33
Sundries 11 57
,494 49
183 29
Garage, stable and grounds
Repairs, ordinary
$0 10
163 68
131 59
187 74
5 53
86 00
167 90
60 96
247 20
Miscellaneous:
Interest on bank balances
Rent
,201 54
724 20
1,050 70
1,925 74
Receipts from Treasury of Commonwealth.
Maintenance appropriations:
Balance of 1921
Advance money (amount on hand November 30)
Approved schedules of 1922
Special appropriations :
Balance of 1921
Approved schedules of 1922
$21,389 24
96,000 00
558,453 23
$518 92
5,739 89
Total
To treasury of Commonwealth:
Institution income ....
Maintenance appropriations:
Ba,lance of schedules of previous year
Approved schedules of 1922 .
November advances
Advanced on October schedule
Payments.
$42,421 96
558,453 23
18,502 26
50,736 52
$21,032 72
Amount carried forward
?,654 22
675,842 47
6,258 81
$791,788 22
$88,654 22
670,113 97
$758,768 19
1922.1
PUBLIC DOCUMENT — No. 23.
13
Amount brought forward
Special appropriations:
Balance of schedules of previous year
Approved schedules of 1922
November advances ....
Advanced on October schedule
Balance, November 30, 1922:
In bank ....
In office ....
$518 92
5,739 89
3 98
237 92
126,302 86
216 46
Total
$758,768 19
6,500 71
26,519 32
$791,788 22
Maintenance.
Balance from previous year, brought forward
Appropriation, current year
Total
Expenses (as analyzed below)
Balance reverting to treasury of Commonwealth
$226 36
692,285 00
2,511 36
661,191 87
$31,319 49
Analysis of Expenses.
Personal services
Religious instruction .
Travel, transportation and office expenses
Food
Clothing and materials . . . . ' .
Furnishings and household supplies
Medical and general care
Heat, light and power
Farm
Garage, stable and grounds
Repairs, ordinary
Repairs and renewals
Total expenses for maintenance
$299,161 98
1,825 00
8,783 97
129,423 04
16,879 17
36,457 21
28,380 41
61,712 40
28,447 26
7,694 82
27,962 46
14,464 15
$661,191 87
Special Approphiations.
Balance December 1, 1921 .
Appropriations for current year
Total
Expended during the year (see statement below)
Reverting to treasury of Commonwealth
Balance November 30, 1922, carried to next year
5,982 94
647 71
$19,291 60
$19,291 60
6,630 65
$12,660 95
Object.
Act or Resolve.
Whole
Amount.
Expended
during
Fiscal
Year.
Total
expended to
Date.
Balance
at End of
Year.
Water supply ....
Worcester department, heating
system 1 . . .
Alterations in heating shaft .
Chap 95, Res. 1919 .
Chap. 123, Res. 1917 .
Chap. 203, Acts 1921 .
$11,385 00
3,758 72
16,000 00
$2,643 89
3,339 05
$11,207 64
3,288 37
3,339 05
$177 36*
470 35*
12,660 95
$31,143 72
$5,982 94
$17,835 06
$13,308 66
Balance reverting to treasury of the Commonwealth ...... $347 71
Balance carried to next year 12,660 95
Total as above $13,308 66
1 Transferred from Grafton State Hospital Dec. 1, 1919.
14 WORCESTER STATE HOSPITAL. [Dec.
Resoubces and Liabilities.
Resources.
Cash on hand $26,519 32
November cash vouchers (paid from advance money) :
Account of maintenance . _ $18,502 26
Account of special appropriations . . . . 241 90
Account of October schedule 50,736 52
69,480 68
$96,000 00
October schedule 4,736 52
Due from treasury of Commonwealth from available appropriation account
November, 1922, schedule 2,002 12
Special appropriation 243 05
$102,981 69
Liabilities.
Outstanding schedules of current year:
Schedule of November bills $52,002 12
Schedule of October bills 50,736 52
$102,738 64
Special appropriation:
November $3 98
October bills 239 07
243 05
$102,981 69
Per Capita.
During the year the average number of inmates has been 2,049.01.
Total cost for maintenance, $661,191.87.
Equal to a weekly per capita cost of $6.2055.
Receipt from sales, $1,050.70.
Equal to a weekly per capita of $0.0098.
All other institution receipts, $87,603.52.
Equal to a weekly per capita of $0.8221.
Net weekly per capita $5.3736.
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.
1922.
PUBLIC DOCUMENT — No. 23.
15
STATEMENT OF FUNDS.
Balance on hand November 30, 1921
Receipts ....
Interest ....
Refunded
Interest paid to State treasiu-y
Patients' Fund.
Investment.
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 December 1, 1922
Balance on hand November 30, 1921
Income .....
Expended for entertainments, etc.
Lewis Fund.
Investment.
American Telephone and Telegraph Company collateral trust
4 per cent bond ........
Fourth Liberty Loan bonds ......
Balance Worcester Bank and Trust Company
Wheeler Fund.
Balance on hand November 30, 1921 .
Income ..........
Expended for entertainments and magazines
Invest7nent.
American Telephone and Telegraph Company collateral trust
4 per cent bond ........
Third Liberty Loan bonds .......
Fourth Liberty Loan bonds ......
Balance Worcester Bank and Trust Company
Manson Fund.
Balance on hand November 30, 1921 .....
Income ..........
Expended for entertainments ......
Investment.
Fourth Liberty Loan bonds ......
Balance Worcester Bank and Trust Company
$11,264 57
14,508 62
373 01
$16,588 57
373 01
$2,000 00
2,000 00
2,000 00
2,000 00
776 70
407 92
L,642 79
65 54
$926 36
600 00
37 57
3,372 74
265 35
$712 50
4,000 00
1,300 00
115 25
L,278 69
46 81
$1,100 00
27 50
$26,146 20
16,961 58
$9,184 62
$9,184 62
$1,708 33
144 40
$1,563 93
$1,563 93
3,638 09
510 34
5,127 75
5,127 75
L,325 50
198 00
1,127 50
1,127 50
Respectfully submitted,
Nov. 30, 1922.
JESSIE M. D. HAMILTON,
Treasurer.
N. B. — The values assigned to the above securities are their respective purchase
prices.
16
WORCESTER STATE HOSPITAL.
[Dec.
STATISTICAL TABLES.
as adopted by american psychiatric association.
Prescribed by Massachusetts Department of Mental Diseases.
Table 1. — General Infonnation.
1. Date of opening as an institution for the insane: Jan. 18, 1S33.
2. Type of institution: State.
3. Hospital plant:
Value of hospital property:
Real estate, including buUdings .....
Personal property ........
Total
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. Entiployees 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 (excluding paroles)
. S2,586,980 53
392,769 17
. $2,979,749 70
Men. Women. Totals.
1-1
11 - 11
1
-
1
13
-
13
Men.
Women.
Totals.
1
100
98
17
82
79
18
182
177
199
178
377
Men.
Women.
Totals.
577
1,009
631
1,015
1,208
2,024
Table 2. — Financial Statement.
See treasurer's report for data requested under this table.
PUBLIC DOCUMENT — No. 23.
17
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18
WORCESTER STATE HOSPITAL.
[Dec.
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PUBLIC DOCUMENT — No. 23.
19
Table 4. — Nativity of First Admissions and of Parents of First Admissions.
Nativity.
United States
Albania
Armenia
Austria
Belgium
Canada
Denmark
England
Finland
France
Germany
Greece
Ireland
Italy .
Japan
New Zealand
Poland
Roumania .
Russia
Scotland
South America
Spain .
Sweden
Switzerland
Syria .
Turkey in Asia
West Indies
Total foreign born
Unascertained
Grand totals
Patients.
124
1
6
125
1
250
219
1
6
1
217
2
438
Parents of
Male
Patients.
178
30
250
171
33
250
1
59
3
15
8
1
5
10
108
20
27
349
63
Parents
OF Female
Patients.
128
17
130
15
258
32
376
Table 5. — Citizenship of First Admissions.
Males.
Females.
Totals.
Citizens by birth
Citizens by naturalization
Aliens . . . .
Citizenship unascertained
Totals . . . .
124
26
20
250
188
219
44
147
28
20
WORCESTER STATE HOSPITAL.
Dec.
Table 6. — Psychoses of First Admissions.
1. Traumatic, total ..........
(o) Traumatic delirium ........
(6) Traumatic constitution .......
(c) Post traumatic mental enfeeblement (dementia)
(d) Other types
2. Senile, total
{a) Simple deterioration ........
(6) Presbyophrenic type
(c) Delirious and confused types ......
{d) 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 ....
(a) Cerebral embolism
(6) Paralysis agitans . . • . . ■ • _ •
(c) Meningitis tubercular, or other forms (to be specified)
id) Multiple sclerosis .
ie) Tabes dorsalis
(j) Acute chorea .........
ig) Other diseases
9. Alcoholic, total . . _
(a) Pathological intoxication .......
(6) Delirium 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 ....
(a) Opium (and derivatives) cocaine, bromides, chloral, etc.,
alone or combined (to be specified) ....
(b) Metals, as lead, arsenic, etc. (to be specified)
(c) Gases (to be specified) .......
(i) Other exogenous toxins (to be specified) ....
11. With pellagra ..........
12. With other somatic diseases, total
(a) Delirium with infectious diseases .....
(6) Post-infectious psychoses . . . . . _ .
(c) Exhaustion delirium ........
(d) Delirium of unknown origin ......
(e) Cardiorenal disease ........
(/) Diseases of the ductless glands ......
ig) Other diseases or conditions (to be specified )
13. Manic-depressive, total
(a) Manic type,
(6) Depressed type
(c) Stuporous type .........
id) Mixed type .
(e) Circular type .........
(j) Other types
14. Involution melancholia ........
15. Dementia Prfficox, total ........
(a) Paranoid type .........
(b) Catatonic type .........
(c) Hebephrenic type ........
(d) Simple type
(e) Other types
16. Paranoia or paranoid conditions .......
17. Epileptic, total
ia) Epileptic deterioration ........
(b) Epileptic clouded states
(c) Other epileptic types (to be specified) ....
32
7
4
28
45
30
1922.]
PUBLIC DOCUMENT — No. 23.
21
Table 6. — Psychoses of First Admissions — Concluded.
18. Psychoneurosis and neuroses, total
(a) Hysterical type .
(&) Psychasthenic type
(c) Neurasthenic type
(d) Anxiety neuroses
(e) Other types ....
19. With psychopathic personality
20. With mental deficiency
21. Undiagnosed ....
22. Without psychosis, total
(a) Epilepsy ....
(b) Alcoholism ....
(c) Drug addiction .
(d) Psychopathic personality .
(e) Mental deficiency
(/) Others
Totals
1
20
104
12
438
22
WORCESTER STATE HOSPITAL.
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1922.
PUBLIC DOCUMENT — No. 23.
27
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PUBLIC DOCUMENT — No. 23.
29
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Undiagnosed
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1922.
PUBLIC DOCUMENT — No. 23.
31
Table 14. — Psychoses of Readmissions.
Psychoses.
1. Traumatic, total .........
(a) Traumatic delirium .......
(6) Traumatic constitution
(c) Post-traumatic mental enfeeblement (dementia)
id) Other types
2. Senile, total .
(a) Simple deterioration .......
(6) Presbyophrenic type .......
(c) Delirious and confused types
(d) 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
(o) Cerebral embolism .......
(6) Paralysis agitans
(c) Meningitis tubercular or other forms (to be specified)
(<f) Multiple sclerosis ........
(e) Tabes dorsalis
(/) Acute chorea ........
ig) Other diseases
9. Alcoholic, total .
(a) Pathological intoxication ......
(6) Delirium tremens
(c) Korsakow's psychosis
id) Acute hallucinosis .......
(e) Chronic hallucinosis .......
if) Acute paranoid type
ig) Chronic paranoid type ......
ih) 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 specified) ....
(6) Metals, as lead, arsenic, etc. (to be specified)
ic) Gases (to be specified)
id) Other exogenous toxins ......
11. With pellagra .........
12. With other somatic diseases, total .....
(a) Delirium with infectious diseases ....
(6) Post-infectious psychoses ......
ic) Exhaustion delirium .......
id) Delirium of unknown origin .....
(e) Cardiorenal disease
(/) Diseases of the ductless glands .....
ig) Other diseases or conditions (to be specified)
13. Manic-depressive, total .......
(a) Manic type .........
(6) Depressed type
ic) Stuporous type ........
id) Mixed type
ie) Circular type ........
(/) Other types
14. Involution melancholia .......
15. Dementia precox, total
(a) Paranoid type .........
(6) Catatonic type .........
(c) Hebephrenic type ........
id) Simple type
ie) Other types
16. Paranoia or paranoid condition
17. Epileptic, total
(a) Epileptic deterioration .......
(6) Epileptic clouded states .......
(c) Other epileptic types (to be specified) . . . ,
31
32
WORCESTER STATE HOSPITAL.
[Dec.
Table 14. — Psychoses of Readmissions — Concluded.
Psychoses.
18. Psychoneuroses and neuroses, total
(a) Hysterical type .
(6) Psychasthenic type
(c) Neurasthenic type
(d) Anxiety neuroses .
(e) Other types ....
19. With psychopathic personality .
20. With mental deficiency
21. Undiagnosed ....
22. Without psychosis, total
(o) Epilepsy ....
(6) Alcoholism ....
(c) Drug addiction .
id) Psychopathic personality .
(e) Mental deficiency
(/) Others
Totals
57
PUBLIC DOCUMENT — No. 23.
33
1^
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1 1 1 1 1 1 1 1 1 1 1 1 J 1 1 1 1 1 1 1 1 o
o
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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
Manic-depressive ....
Involution melancholia .
Dementia precox ....
Paranoia or paranoid condition
Epileptic
Psychoneuroses and neuroses .
With psychopathic personality
With mental deficiency .
Undiagnosed
Not insane
^^CSOO-^W^COt^OOOiO^-HMCO-^iO^Dt^OOOSO^Cl
34
WORCESTER STATE HOSPITAL.
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to
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WITH OTHER
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OR NERVOUS
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o
General Diseases.
Facial erysipelas
Gangrene of foot
Pernicious anaemia ....
Inguinal hernia . . . . . ■
Exhaustion due to Manic-depressive
psychosis
Carcinoma of intestines
Carcinoma of head of pancreas .
Diseases of the Nervoiis System.
Cerebral hemorrhage . .
General paralysis of the insane .
Cerebral spinal syphilis
Diseases of the Circulatory System.
Cardio-vascular renal disease
Arteriosclerosis
Cerebro arteriosclerosis
Chronic endocarditis ....
Acute myocarditis ....
Chronic myocarditis ....
Fatty degeneration of the heart .
Aortic regurgitation ....
Diseases of the Respiratory System.
Broncho-pneumonia ....
Lobar pneumonia ....
Pulmonary gangrene ....
Chronic bronchitis ....
Pulmonary tuberculosis
Acute miliary tuberculosis .
1922.1
PUBLIC DOCUMENT — No. 23.
35
1 1 1 1 1 1 1 1 1 1 111
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1 1 1 1 1 1 1 1 1 1 III
■"
1 1 1 1 1 1 1 1 1 1 III 1
1 1 1 1 1 1 1 '-< 1 1 III
2
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oo
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in
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o
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^ 1 „^ ^ „ 1 rt«^ ^ 1 ^
-
2
Diseases of the Digestive System.
Acute enteritis
Gastro enteritis
Diarrhoea and enteritis
Dysentery
Diseases of the Genito-urinary System.
Chronic intestinal nephritis
Multiple burns of nearly entire body .
Fracture of cervical vertebrae
Intra capsular fracture of r. femur
Fracture of 1. hip and clavicle
Cardiac failure
Self inflicted injury of upper respira-
tory tract
Suicide by hanging ....
Suicide by drowning ....
36
WORCESTER STATE HOSPITAL.
[Dec.
m
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to
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General Diseases.
Facial erysipelas
Gangrene of foot
Pernicious antemia ....
Inguinal hernia
Exhaustion due to Manic-depressive
psychosis
Carcinoma of intestines
Carcinoma of head of pancreas .
Diseases of the Nervous System,.
Cerebral hemorrhage ....
General paralysis of the insane .
Cerebral spinal syphilis
Diseases of the Circulatory System.
Cardio-vascular renal disease
Arteriosclerosis
Cerebro arteriosclerosis
Chronic endocarditis ....
Acute myocarditis ....
Chronic myocarditis ....
Fatty degeneration of the heart .
Aortic regurgitation ....
Diseases of the Respiratory System.
Broncho-pneumonia ....
Lobar pneumonia ....
Pulmonary gangrene ....
Chronic bronchitis ....
Pulmonary tuberculosis
Acute miliary tuberculosis .
PUBLIC DOCUMENT — No. 23.
37
1 1 1 I 1 1 1 I 1 J III
'^
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 —1
II-- - 1 1 , -H 1 1 - ■
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-^
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OO
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^
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;=;
llll 1 lllll III
o
Diseases of the Digestive System.
Acute enteritis
Gastro enteritis .....
Diarrhoea and enteritis
Dysentery
Diseases of the Genito-urinary System.
Chronic intestinal nephritis
Multiple burns of nearly entire body .
Fracture of cervical vertebrae
Intra capsular fracture of r. femur
Fracture of 1. hip and clavicle
Cardiac failure
Self inflicted injury of upper respira-
tory tract
Suicide by hanging ....
Suicide by drowning ....
1
WORCESTER STATE HOSPITAL.
[Dec.
!S
Q
CO
<
1
■S[T3^0X
1 1 rtO 1 1 1 1 -H 1 1 1 rtrHN 1 ^ 1 1 1 1 1
2
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to '
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i
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a
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 conditions
Epileptic
Psychoneuroses and neuroses
With mental deficiency
Undiagnosed
Without psychosis
"3
rtC<lCC-^iOCOI>.OOOiO^COCO-*»OCOt^OOOSO^C^
PUBLIC DOCUMENT — No. 23.
39
<
K
>
O
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IC^ICOIIIIIIIIINI-*— 'IIIICOI
^
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t--
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loausl 1 1 1 IIMI 1 liOIOJI 1 i IrtCOl
S
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t^
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f
33
A
m
0
a
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 other somatic diseases
Manic-depressive
Involution melancholia
Paranoia or paranoid conditions
Epileptic
Psychoneuroses and neuroses ......
With mental deficiency
Undiagnosed
Without psychosis
1
o
'HMCOTHinOt-OOCnO— i'MTO')>lOtOIr^OOOO'-i(rg
40
WORCESTER STATE HOSPITAL.
[Dec.
tl5
CO
«
H
•SIB^OX
1 rortTH 1 1 1 1 rt I 1 1 1 1 CO 1 1 1 1 1 1 1
s
•sa[Braaj
1 o 1 1 1 1 1 1 1 1 1 1 1 1 <^ 1 1 1 1 1 1 1
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i
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t^
■sajBiuajj;
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-
■saiBi\[
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o
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00
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s
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^
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r.
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cr
c
s
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i5
1. Traumatic
2. Senile
4. General paralysis
6. With Huntington's chorea
7. With brain tumor
8. With other brain or nervous diseases
10. Due to drugs and other exogenous toxins
11. With pellagra
12. With other somatic diseases
13. Manic-depressive
14. Involution melancholia
16. Paranoia or paranoid condition ....
17. Epileptic
18. Psychoneuroses and neuroses
20. With mental deficiency
21. Undiagnosed
22. Without psychosis
"3
PUBLIC DOCUMENT — No. 23.
41
<
o
2
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If-IIIIIIlllllllCOllll-Hll
ira
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1 1 I 1 1 1 1 1 1 1 1 1 1 1 'Hrt 1 1 1 1 1 1 =^5
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3
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II1>-I||IC<1IIICCII'-I|IIIII w
•sapuiaj;
IIIIIIIIIIIIC^II-HIIIIIICO
1
•saitjpjr
'lll-^'ll^l''-^''!'
'^
•SITJ^OX
l-!i<Tt(Mrti 1— icol 1 lira— lOoi-Hi 1 1 1 1
OO
■ sal's uia^
ICOrtI— II 1 1— ll 1 lTt<— ■001 1 1 1 1 1 1
05
•sa[Bi^
1 r-icoM 1 1 1 rtcq 111.^111.^11111 C|1
Psychoses.
Traumatic
Senile
General paralysis
With Huntington's chorea
With brain tumor
With other brain or nervous diseases
Alcohohc
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 mental deficiency
Undiagnosed
Without psychosis
1
— icacc-*iraot^ooo30^c<ieo-^tC!Ot^oooso^H(M
42
WORCESTER STATE HOSPITAL.
[Dec. 1922.
Table 19. — Family-care Department.
Males.
Females.
Totals.
Remaining Sept. 30, 1921 .
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
23
23
13
13
5
5
5
5
41
41
26
26
22
22
19.55
19.55
10.88
10.88
4.74
4.74
4.93
4.93
Publication of this Document
approved by the
Commission on Administration and Finance.
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