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

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Public Document No. 23 \ ^ '^| 

— ^^.--■, 

i i 



ANNUAL REPORT 



OF 



THE TRUSTEES 



OF THE 



Worcester State Hospital 



/o 



FOR THE 



Year ending November 30, 1924 



Department of Mental Diseases 




Publication of this Document approved by the Commission on Administration and Finance 
600 3-' 26 Order 4440 



OFFICERS OF THE WORCESTER STATE HOSPITAI 

BOARD OF TRUSTEES. 

Caboline M. Caswell, Secretary, Northborough. 

Anna C. Tatman, Worcester. 

William J. Delehanty, M.D., Worcester. 

Edward F. Fletcher, Chairman, Worcester. 

Howard D. Cowee, Worcester. 

John G. Perman, D.M.D., Worcester. 

Luther C. Greenleaf, Boston. 

MEDICAL STAFF. 

William A. Bryan, M.D., Superintendent. 
Lewis B. Hill, M.D., Asst. Superintendent. 

, Director, Clinical Psychiatry. 
Michael J. O'Meara, M.D., Senior Assistant Physician. 
George A. Gaunt, M.D., Senior Assistant Physician. 
Leon E. Duval, M.D., Senior Assistant Physician. 

Donald B. Cheetham, M.D., Senior Assistant Physician. ,, 

Manley B. Root, M.D., Senior Assistant Physician. 
Mervin Fossner, M.D., Assistant Physician. 
John P. Powers, M.D., Assistant Physician. 
Leonard L. Tormey, M.D., Assistant Physician. 
J. Paul Bouthillier, M.D., Assistant Physician. 
Sidney M. Simonds, M.D., Assistant Physician. 
Abraham Wiedman, M.D., Assistant Physician. 
Carl A. Oberg, D.M.D., Dentist. 

VISITING STAFF. 

Ernest L. Hunt, M.D. 

John F. Curran, M.D. 

C. J. Byrne, M.D. [ Surgeons. 

William H. Rose, M.D. 

Benjamin H. Alton, M.D. > 

M. M. Jordan, M.D. K. , . , 

Benjamin T. Burley, M.D. ] Neurologists. 

William F. Holzer, M.D. 1 n i^j, ? ? • , 

Paul G. Haire, M.D. \ Ophthalmologists. 

John W. O'Meara, M.D., Orthopedist. 
Phit.lip it. Cocic, M.D., Roentgenologist. 

HEADS OF DEPARTMENTS. 

Florence M. Wooldridge, R.N., Superintendent of Nurses and Principal of Tra 

ing Schcol. 
MAu:aiCE Sc4NNELL, Super vi $••/,', MaU Department 
Jessie. M. D. Hamilton, Treasurer. 
Herbert W. Smith, Steward. 
Lillian G. Carr, Matron. 
Joseph F. Reynolds, Head Farmer. 
James Dickison, Jr., Chief Engineer. 
Anton Swenson, Foreman Mechanic. 
Edna M. French, Head Occupational Therapist. 




Sljf Olommnnuifaltlj nf MuBBUtl^nBtttB 



TRUSTEES' REPORT. 

To His Excellency the Governor, and the Honorable Council: 

The Trustees of the Worcester State Hospital respectfully submit this, the 
ninety-second annual report of the Hospital, together with the report of the Superin- 
tendent, William A. Bryan, M.D., the report of the Treasurer, Miss Jessie M. D. 
Hamilton, and various statistical and other information. 

In November, 1924, the Trustees elected Hon. Edward F. Fletcher of Worcester 
as Chairman, and Miss Caroline M. Caswell of Northborough as Secretary. 

Progress continues to be made in making the institution less and less an asylum 
for the unfortunate, and more and more a hospital for the mentally sick. 

It is a cause for satisfaction that the antiquated system, or lack of system, of 
toilet and bath facilities in one ell of the women's ward at the Summer Street 
hospital has been remedied during the past year, so that that part of the institution 
is now provided with modern and adequate plumbing and fixtures. 

The plan of serving meals in the cafeteria style to the men patients at the Belmont 
Street hospital, inaugurated during the past year, has been given thorough trial, 
and is heartily approved. Now that the necessary appropriation has been secured 
for a new congregate dining-hall, as before desired, the trustees recommend that 
the same cafeteria system be extended so as to serve all patients, both men and 
women, who are able to go to the dining-hall for meals. The arrangement for the 
cafeteria of the past months was only temporary and experimental. The space 
thereby occupied is needed for other uses as soon as the new dining space is provided. 

The old ice-box refrigerators are in bad repair, and are inefficient and expensive. 
There is very considerable loss in food, both meat and fish, by reason of the impos- 
sibility of keeping the same at proper temperature. Dampness with improper 
temperature causes meat to grow mouldy, so that the spoiled portions must be 
trimmed off and thrown away. Moreover, it is difficult to retain the services of 
meat-cutters, on account of the conditions under which they are forced to work. 
It is the belief of the trustees that these difficulties w^ould be remedied by the instal- 
lation of a modern artificial refrigeration plant, and that actual saving would result. 

The keeping of cattle, and especially of calves and young stock, is a problem which 
ought to be solved at once ; also the handling of feed and milk. Since the tubercular 
'cattle were killed, the entire herd has been quartered at Hillside, a distance of two 
land one-half miles from the hospital, occasioning large expense in transportation of 
iboth supplies and products. The barns are inadequate, and the accommodations 
for young stock are very poor. A new cow barn should be built at the main farm, 
I which should also be provided with suitable quarters for rearing calves. The 
present primitive methods of cooling and handling milk should be altered through 
the installation of modern and efficient appliances and system. 

The problem of the rapidly changing personnel of the employees of the hospital 
lis very serious, especially on the male side. It seems astonishing that during the 
I year 1924 the labor turnover on the male side amounted to 225 per cent. Means 
i should be provided to investigate and study the causes of these changes, in order, 
lif possible, to lessen their frequency, and thereby improve the efficiency of the 
I force, through greater permanency. Very likely similar conditions may exist in 
, other institutions in the Commonwealth. At all events, it seems important that 
I immediate steps be taken to ascertain the causes thereof, in order that the proper 
I remedies may be found to correct these conditions. 



4 P.D. 23. 

The trustees wish to record their satisfaction with the conduct of the Worcester 
State Hospital under the lead of the Superintendent, Dr. Bryan, and his loyal 
assistants. The staff is keenly alive to the needs of the patients for physical and 
mental comfort and improvement. 

Respectfully submitted, 

LUTHER G. GREENLEAF, EDWARD F. FLETCHER. 

CAROLINE M. CASWELL. HOWARD W. COWEE. 

ANNA C. TATMAN. JOHN G. PERMAN. 
WILLIAM J. DELAHANTY. 

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 November 30, 1924, it being the ninety-second annual report. 

There remained on the Hospital books October 1, 1923, 2,579 patients, 1,372 
men and 1,207 women. During the year ending September 30, 1924, there were 
admitted 612 patients — 342 men and 270 women. Six hundred and fifty-four 
patients — 414 men and 240 women, were discharged from the hospital. Of this 
number, 366 patients, 234 men and 132 women — were discharged; 216 patients — 
125 men and 91 women died; and 65 patients — 52 men and 13 women — were trans- 
ferred, leaving at the end of the statistical year 2,536 patients — 1,299 men and 
1,237 women. Two thousand, one hundred and twenty-three patients — 1,035 men 
and 1,088 women — were actually in the institution. Of this 1,924 were supported 
by the State, 87 by friends, and 112 as reimbursing patients. Of the patients 
discharged, 79 were reported as recovered, 175 as improved, and 71 not improved. 
Forty-one patients, — 29 men and 12 women — were discharged as not insane. 
Forty-three men were transferred by the Department of Mental Diseases to the 
United States Veterans' Hospital No. 95 at Northampton; 5 men and 6 women to 
the State Infirmary; 2 men and 5 women to Medford State Hospital; 1 man to 
Dan vers State Hospital; 1 man and 1 woman to the Bridgewater State Hospital; 1 
woman to Westwood Lodge. Ten men and 4 women were removed from the 
State, and 25 men and 7 women were deported. 

There remained in the hospital at the end of the year 43 less patients than at the 
beginning. The smallest number under treatment on any day was 2,114 patients, 
and the largest 2,211. The daily average was 2,142.56. 

The percentage of recoveries, calculated upon the number of discharges and 
deaths, was 13.59, calculated upon the number of admissions 14.28. The death rate 
was 6.76 calculated on the whole number of patients under treatment, and 10.81 
calculated on the daily average number. 

General Health of the Population. 
Generally speaking, the physical health of the patients has been good. I regret, 
however, to report that a male patient, whUe returning from the moving pictures, 
threw himself head first over the railing on third floor and died within half an 
hour. Also a male patient jumped from fourth floor piazza and died ten 
minutes later. A male patient who left the hospital without permission was acci- 
dentally drowned at the lake. 

Principal Causes of Deaths. 
Sixteen per cent of all deaths were due to general paralysis of the insane; 14 
per cent to arteriosclerosis; 13 per cent to cardio-vascular-renal; 10 per cent each 
from pulmonary tuberculosis and bronchopneumonia and 8 per cent from chronic 
myocarditis. 

Staff Changes. 
Resignations. 
Dr. Ransom C. Sartwell, assistant superintendent, resigned August 15, 1924, to 
accept position as superintendent of the State Infirmary at Howard, R. I. 

Dr. Clarence A. Whitcomb, assistant physician and pathologist, resigned May 1, 
1924. 



P.D. 23. 5 

Dr. John Saucier resigned March 8, 1924, to accept a position in a Canadian 
hospital. 

Dr. Henry Weyler resigned May 1, 1924, to enter into general practice. 

Dr. Paul DeCary resigned January 31, 1924, to accept a position on the staff 
of the State Hospital at Howard, R. I. 

Dr. Katherine Hoheb resigned June 13, 1924. 

Dr. Charles E. Futch resigned September 30, 1924, to accept a position at the New 
York Skin and Cancer Hospital. 

Appointments. 

Dr. Katherine Hoheb was appointed assistant physician March 1, 1924. 
Dr. Sidney M. Simons was appointed assistant physician June 16, 1924. 
Dr. Leonard Tormey was appointed assistant physician June 20, 1924. 
Dr. Charles E. Futch was appointed assistant physician July 30, 1924. 
Dr. Arthur Lussier was appointed assistant physician September 5, 1924. 

Student Internes. 
During the summer of 1924, six medical and one dental interne assisted the Staff 
physicians in the usual routine work: — 



Leonard D. Heaton 
Jesse S. Spangler 
Francis A. Scott 
James F. Clancy 
Juanita P. Johns 
Janice Rafuse 
WaUace W. Dietz 



University of Kentucky. 
Johns Hopkins University. 
University of Michigan. 
University of Michigan. 
Boston University. 
Boston University. 
Tufts Dental School. 



Medical Report. 
The medical and surgical facilities of this hospital have been considerably en- 
hanced by the delegation of medical and surgical work strictly to a selected portion 
of the staff, including one senior assistant phj^sician and two junior assistant 
physicians, with a junior physician caring for the laboratory work. The laboratory 
physician is under the supervision of the senior assistant, and has in turn two 
technicians as his assistants. It is felt that by such division of the work, the pa- 
tients receive better care as to their physical well-being, and that some of the more 
obscure physical conditions are more easily recognized. 

Surgery. 

Major Operations: Gastrotomy, 2; Tonsillectomies, 11; Amputation of Finger, 
2; Appendectomies, 5; Gastro-enterostomies, 1; Double Herniotomy, 1; Chole- 
cystotomy, 1; Unguinal Herniotomies, 5; Amputation of Toes, 1 ; Hysterectomies, 
4; Intestinal Resection, 1; Enucleations of Eye, 2; Dilatation and Curettage, 2; 
Amputation of Right Leg, 1 ; Lipectomy, 1 ; Amputation of Cervix, 1 ; Perineor- 
rhaphy, 1; Vaginal Hysterectomy, 1; Removal of Epithelioma of Lip, 1. Total, 44. 

Minor Operations: Incision and Drainage of Carbuncle, 1 ; Incision and Drain- 
age of Finger, 1; Paracentesis of abdomen, 1; Tendon Suture, 1; Submucous 
Resection, 1; Abscesses Incised and Drained, 22. Total, 27. 

Clinics. 

The clinics are cared for entirely by the Medical Service, and are held at appointed 
hours each week, whenever there are patients who need examination in these clinics. 
At these clinics the Staff physicians receive the benefit of advice and assistance 
from our attending physicians and surgeons, who are at all times on call. 

The attending physician visits the hospital each Tuesday, and examines with 
the members of the Medical Staff such cases as need particular attention. 

The attending ophthalmologist, rhinologist, otologist and laryngologist visits 
the hospital each Wednesday, and examines such cases as are referred to him by the 
Medical Staff. 

There are also on call, and easily accessible, surgeons, both general and ortho- 
pedic; neurologists and other specialists in the various branches, all within ten 
minutes of the hospital. 



6 P.D. 23. 

Gynecological Clinic. 
Patients examined, 54. 
Patients treated (treatments given), 57. 

Neurological Clinic. 
Patients examined, 55. 

Diagnoses. 
General paresis, 47. 
Unclassified, 3. 
Endocrine disturbance, 1. 
Cerebrospinal syphilis, 1. 
Multiple sclerosis, 1. 
Hysteria, 2. 

Amyotrophic lateral sclerosis, 1. 
Encephalitis lethargica. Parkinsonian syndrome, 1. 

Venereal Clinic. 
Salvarsan treatments, 534; Swift-Ellis, 185; Mercury (intramuscular), 19. 
Total treatments, 738. 
Wassermanns : 

Blood . 694 Spinal Fluid . 189 

Eye Clinic. 
Examinations and treatment, 138. 

Laboratory Report. 

Autopsies, 44; Animal Autopsy, 1; Animal Inoculation, 3; Anesthesia, 25; 
Bacterial Cultures, 57; Bacterial Smears, 137; Basal Metabolism Tests, 9; Blood 
Counts— Red, 81; Blood Counts— White, 201; Blood Counts, Differential, 205;' 
Blood Counts, Haemoglobin, 165. Blood Chemistry: Urea Nitrogen, 14; Total 
Nitrogen, 9; Creatin, 7; Creatinine, 14; Sugar, 35; Uric Acid, 5. Dark Field 
Examinations, 2; Feces, 4; Gastric Analysis, 3; Gyn. Clinics, 24; Lectures, 
34; Microscopical Sections, 76; Microscopical Examination of Slides, 56; Milk! 
Counts, 24; Modified Mosenthal, 4; Renal Functions, 29; Sputums, 114. Spinal 
Fluids— Colloidal Golds, 120; Cell Counts, 77; Proteins, 30; Mastics, 33. Swift- 
Ellis Serum, 23; Urinalysis, 1,618; Urine Creatin, 1; Urine Quantitatives, 10; 
Vaccines, 3; Water Counts, 2. 

Dental Report. 

Number Patients, 2,700; Cleanings, 2,377; Fillings, 970; Plates, 64; Treatments, 
255; Extractions, 852; Plates Repaired, 48; X-rays, 163; Bridges, 5; Porcelain 
Jackets, 2, Porcelain Inlays, 2; Gold Inlays, 1; Pivot Teeth, 5. 

Report of the X-Ray Department. 

The report of the Department of Roentgenology for the year ending November 
30, 1924, is herewith submitted. 

Exposures: Ankle, 20; Arm, 11; Chest, 142; Face, 4; Feet, 12; Gastro-Intes- 
tinal, 22; Heart, 12; Hand, 29; Hip, 11; Jaw, 9; Kidney, 2; Knee, 17; Leg, 8; 
Liver, 2; Nose, 15; Neck, 1; Pelvis, 4; Ribs, 4; Sternum, 2; Skull, 55; Spine, 21; 
Shoulder, 8; Thigh, 1; Wrist, 3; Stomach (foreign), 3. 

Fluoroscopic Examination, 36 cases; X-ray Treatment (Epithelioma, 3 cases ;i 
Tubercular Lymphadinitis, 1 case); Dental X-rays, 177 patients; Out-Patient 
Clinics, 10 cases; skull, chest, long bones. 

Social Service Department. 
During the year 439 cases were referred to the Social Service Department. 
Of this number, 112 cases were referred for medical-social histories, 167 for special 
investigation, and 150 for supervision of patients on visit in the community. In 
addition to the cases referred to us this year, 275 visit cases were carried over from 
the previous year. Inasmuch as all (or nearly all) patients leaving the hospital are 
technically "on visit" for a year, their names are automatically placed upon ouxi 
lists and we endeavor to give them supervision according to their needs. We havei 



P.D. 23. 7 

thus carried an average monthly case-load of 260 patients, and it has been literally 
impossible to give adequate follow-up care to so many persons. 

Fourteen cases per month, on the average, have been referred for special investi- 
gation, each investigation requiring interviews with at least four persons and some- 
times ten or twelve persons. About half of the investigations have been made 
primarily for the purpose of obtaining additional data for psychiatric diagnosis, 
and special care has been taken to clear up cases in which conflicting stories are told 
by different relatives, cases in which the patient's conduct in the hospital is mark- 
edly different from that reported by the persons responsible for the commitment, 
and cases of patients sent by court action. A thoroughgoing search for informa- 
tion has occasionally revealed evidence that a patient whose conduct in the hospital 
showed nothing abnormal was suffering from delusions which made him a potential 
menace to public safety; and on the other hand it has occasionally shown that the 
responsibility for the care of a harmless patient was being shifted to the State by a 
family well able to carry the burden. The other half of the investigations have 
been made for the purpose of ascertaining the family situation in the homes of 
patients about to be released on visit, in order to insure conditions that shall be 
conducive to mental health. 

An analysis of the problems of the 439 social service cases shows the following 
results: — In 48 cases there was physical disability in addition to mental illness; 
many of these being cases of venereal disease; 38 cases presented sex problems; 
in 25 cases financial troubles were an added factor; 44 had difficulty regarding 
employment; 45 had marital troubles, and 53 others had friction with members of 
the family or others with whom they were in close contact; 96, including many 
alcoholic cases, were essentially personality problems; and the others presented 
problems for re-education in habits and tastes. 

The great problem for the psychiatric social worker is to help the patient adjust 
himself to the environment to which he goes when he leaves the hospital, and, by 
helping the family to understand the patient's needs, make the environment favor- 
able to further improvement and permanent adjustment. As a contribution toward 
this end, 706 visits have been made to patients or their families, friends, social 
agencies, and others interested in the patients. In 23 cases we have been able to 
arrange for a patient to have medical care after leaving the hospital. In 44 cases 
some modification of the environment has been effected in the interests of the 
patient. The co-operation of various agencies has been helpful in the adjustment 
of 45 patients. We have received aid from Family Welfare agencies, especially in 
teaching a housewife to plan her expenditures economically, and have had the 
co-operation of visiting nurses and out-patient clinics. Child-placing agencies 
have been helpful in arranging for the care of the children of some of our patients, 
and the Boys' Club has been an asset in the training of boys who are brought to our 
out-patient clinic for juvenile delinquency. 

The employment situation has been unfavorable to the placement of such pa- 
tients as are unable to find employment for themselves, because in times of depres- 
sion the mentally handicapped are the last to be accepted. However, 19 of our 
patients have been placed in new positions or returned to positions formerly held, 
some of them being patients who require special understanding and interest to 
keep them out of the hospital. This group, exclusive of those who have had to be 
returned to the hospital, is fully self-supporting and has approximately $500 in 
savings banks. Excellent co-operation has been obtained from St. Anne's Orphan- 
age, which institution has recently begun to take our patients into its employ. 

The number of boarding patients is at present 15. Three new homes were found 
this year. 

We have been particularly fortunate in having the services of Mr. Boisson, the 
chaplain, in investigating and following up all cases in which the religious problem 
is an outstanding feature. Through him also we have obtained closer contact with 
the churches and Y. M. C. A. 

The attendance of a social worker has been required at 81 out-patient clinics, 
and over 100 histories have been taken. In certain cases arrangements have been 
made for follow-up care by other agencies, and the regular weekly conference on 
clinic cases is usually attended by us both. Fifteen schools have been visited in 
order to arrange for the school clinic which the law provides for the examination of 



8 P.D. 23. 

children three years retarded, and the school nurses have been instructed how to 
take the histories. 

During the year three addresses were made by the department and six lectures 
were given to the nurses of the hospital. 

Religious Services. 

• Weekly services have been held both at the Main Department and at Summer 
Street for our Protestant, Catholic and Jewish patients. 

Rev. A. T. Boisson was appointed permanent Protestant chaplain and has 
studied a number of patients whose psychoses have shown a religious coloring. 
It is our intention to carry this work on for some time to come. 

Training School. 

The work of the Training School has been carried on during the year and the 
prescribed curriculum of the State Board of Registration has been carefully fol- 
lowed. 

Eight graduates received their diplomas in June, 1924. The Attendants Course 
for both men and women has been carried on, two complete courses being given. 
This course is compulsory and no attendant is permitted to remain in the service 
without passing it. 

Miss Olive Estey, R.N., assistant superintendent of nurses, resigned in January 
to accept the position of Superintendent of Nurses at the Danvers State Hospital. 
Miss Ethel Oliver, R.N., was appointed to fill the vacancy and remained until 
October when she was compelled to resign on account of ill health. Miss Georgia 
Clarke, R.N., succeeded Miss Oliver. 

The training school for nurses remains a very important phase of the hospital 
activities. Under the leadership of Miss Florence Woolridge, R.N., it has continued 
to improve and our ideal is to offer a course of training for nurses that will be second 
to none. It is by a continuation and extension of our training schools that our 
standard of care for the mentally ill will be raised to the high level it should occupy 
and we propose to further enlarge the activities of the school. 

New diet kitchens have been inaugurated where our pupils receive practical 
instruction in invalid cookery under the guidance of a graduate dietitian. 

Our general medical work has increased to the point where our pupils are receiv- 
ing much practical nursing and our graduates are eminently fitted to carry on 
general nursing with credit to themselves and the school. 

Out-Patient Report. 

Examination of the tables will show that the out-patient service rendered by the 
hospital is increasing. From 41 separate sources, cases were referred, and many 
patients came on their owoi initiative, these being listed in the tables as private 
patients. Cases were seen in 17 different places. The Psychiatrist, Dr. M. B. 
Root, and the Psychologist, Dr. Grace H. Kent, and the Social Workers, Miss 
Theodora Land and Miss Jennie Harrington, remain as last year. 

The most successful clinic has been that held at Memorial Hospital. The Habit 
Clinic, held at the Temporary Home and Day Nursery, we have not held for 
months. We have had comparatively few cases of pre-school children and many of 
these have preferred to come to Memorial Hospital. The adult Psychiatric Clinic 
has been held since April 15, 1925, at the City Hospital Out-Patient Department, 
in conjunction with their Neurological Clinic. This is becoming more and more 
satisfactory. Since May 26, 1924, a weekly clinic at the Lowell Corporation 
Hospital has been held. This was fairly well attended for a time, but attendance 
dropped so that it seemed useless to attend more often than once a month. 
Because of our increasing work in Worcester and the fallacy of traveUing so far for j 
so few cases, I believe that this clinic should be given up for the present. 

The ideals of our out-patient work remain the same. We have attempted to 
make well-rounded studies of the children and the adults examined. During July 
and August, 1924, the Psychiatrist and Psychologist were present at the sessions 
of the Juvenile Court. We examined children at the court and made reports to 
aid the Judge in his decisions. The weekly conferences are still held at the public 
library. At these conferences practically all the clinic cases are discussed. Fol- j 



P.D. 23. 9 

lowing this discussion a letter of summary and recommendations is sent. We 
have perfected a system for keeping in touch with our cases and we expect this 
follow-up work will be valuable. 

During the summer an attempt was made to see regularly, at the Summer Street 
department, patients on visit from the hospital. Very few patients came in re- 
sponse to the letters, so that this was discontinued. We are at present working 
over plans for seeing these patients regularly. 

Table I — Cases Enumerated by Agencies. — Private Patients, 60; Central District 
Court, 38; Children's Friend Society, 22; Girls' Welfare Society, 21; Worcester 
State Hospital, 12; Temporary Home and Day Nursery, 9; Associated Charities, 
6; City Hospital, 0. P.D. , 6; St. Anne's Orphanage, 6; Lancaster Industrial School 
for Girls, 6; Lowell Schools, 6; Northboro Society for District Nursing, 5 ; Memo- 
rial Hospital, O.P.D., 5; City Hospital, 5; Lowell Policewomen, 5; Worcester 
Schools, 4; Shirley Industrial School for Boys, 4; Worcester Society for District 
Nursing, 3; Society for Prevention of Cruelty to Children, 3; Physicians, 3; Board 
of Health, 3; Shrewsbury Schools, 3; State Division of Child Guardianship, 3 
Rutland Prison, 2; United Jewish Charities, 2; North American Civic League, 2 
Jewish Home for Aged and Orphans, 2; Southbridge District Nursing Society, 2 
Superior Criminal Court, 2; County Jail, 2; Lowell Social Service League, 2 
Lowell Corporation Hospital, O.P.D., 2; St. Agnes Guild, 1; Rutland State Sani- 
torium, 1 ; West Warren School, 1 ; Fitchburg Society for Prevention of Cruelty 
to Children, 1; West Boylston School, 1; Leominster School, 1; Probate Court, 
1; Northampton State Hospital, 1; Lowell District Court, 1; Lowell Minister, 1; 
Total New Cases, 266. Return Visits, 148. Total Visits, 414. 

Table II — Cases Enumerated by Age. — _ 

Age. 

1. Babies up to age 6 . 

2. Children 6 to 21 

3. Adults over 21 

4. Lowell (irrespective of age) 

Totals 

Table III — Cases Enumerated by Places of Visits {including first and return visits) . 
Memorial, P.D., 136; Lowell Corporation Hospital, 59; City Hospital, O.P.D., 53; 
Worcester State Hospital, 33; Temporary Home and Day Nursery, 31; Central 
District Court, 31; Girls' Welfare Society, 26; Lancaster Industrial Schools for 
Gu-ls, 13; Worcester County Jail, 6; St. Anne's Orphanage, 6; Patients' Own 
Home, 5; City Hospital, 4 ; St. Agnes Guild, 4; Shirley Industrial School for Boys, 
3; Rutland Prison, 2; Rutland State Sanitorium, 1; Summer Street Department, 
1. Total, 414. 

Table IV — Enumeration of School Clinics. — West Boylston, 31; Shrewsbury, 115; 
Oxford, 21; West Warren, 32. Total, 119. 

Table V — Hospital Patients on Visit — 20. 

Table VI — Hospital Patients Studied — 12. 

Table VII— Totals.— Out-Fatient Cases, 414; School Clinics, 199; Patients on 
Visit, 20; Hospital Cases, 12; Grand Total, 645. 

Table Vlll—Out-Patient Schedule.— 



New 


Return 


Tota 


Cases. 


Visits. 




24 


12 


12 


178 


85 


85 


32 


22 


22 


32 


29 


29 



266 



148 



414 



Monday 
Tuesdaj'' 

Wednesday 

Thursday 
Friday 

Saturday 



School Clinics, P.M. 

City Hospital, A.M. 

Memorial Hospital, P.M. 

Girls' Welfare Society, A.M. 

Temporary Home and Day Nursery, P.M. 

Lowell Clinic. 

City Hospital, A.M. 

Conferences Public Library, P.M. 

Patients seen in homes and at hospitals by appointment. 



10 



P.D. 23. 





Important Condition — Diagnosis. 










Mental Disease — Alcoholic ........ 


2 


Involution Melancholia 










6 


Undiagnosed 
D. Praecox . 












19 
13 


Manic Depressive 
Organic Brain Disease 












3 
13 


Senile 












1 


Epilepsy . 
General Paresis . 












16 
3 


Psychosis with Somatic 


! Disease 










4 


Total Mental Disease . 








80 


133^% 


Mental Deficiency 












177 


30M% 


Psychoneurosis . 












37 




Unmarried Mothers 












99 


17% 


Conduct Disorder 












114 


193/2% 


Neurological Disease 












1 




Cerebral Syphilis . 
Chorea 












6 
6 




Dystrophy . 
Tabes 












1 
1 




Speech Defect 
Hyper-Thyroidism 
Routine Examination 












3 

2 

30 




Pre-psychotic 
Nervous Child 












5 

18 




Head Injury 














3 





Total number of cases . 



583 



Occupational Therapy. 

In September, 1923, we inaugurated a school for the training of Occupational 
Therapists and in September, 1924, three pupils were graduated and given certifi- 
cates. The present class consists of five young women who will receive their 
certificates in September, 1925. 

The Occupational Therapy Department is a very important part of the hospital. 
An average of 400 patients are treated each day in our classes and they contribute 
in no small degree to the improvement and recovery of our patients. All articles 
made in this department are utUized by the hospital, no sale being permitted. 

General Maintenance of the Hospital. 

The ordinary repairs of buildings and grounds have been kept up. No new con- 
struction of buildmgs has been carried on but a number of large projects have been 
completed during the year. The water sections in the Lincoln wards have been 
completely renovated and new plumbing has been installed. A similar project 
has been carried on at the Summer Street department but has not yet been com- 
pleted. 

Perhaps the most radical change made during the year is in the method of feeding 
our patients. This hospital has had no central dining-room but each ward has had 
its own dining-room. The inability to supervise the distribution of food, the 
difficulty of transportation and the lack of facilities for keeping food warm, made 
this a very unsatisfactory way of handling the problem. A system of feeding 
patients by means of a cafeteria was inaugurated and this has been so successful 
that it is our purpose to open other cafeterias where patients will receive their food 
hot and in proper quantities. 

In conclusion, I wish to thank the Board of Trustees for the support and encour- 
agement given me. I also wish to thank the officers and employees of the hospital 
for their loyalty and labor. Without their assistance and their constant endeavor 
to improve the service rendered by the hospital, nothing could be accomplished. 

WILLIAM A. BRYAN, Superintendent. 
November 30, 1924. 



P.D. 23. 



11 



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, 1924. 



supplies 



Income. 
Board of Inmates: 

Private ...... 

Reimbursements, insane . 

Personal services: 

Reimbursement from Board of Retirement 
Sales: 

Travel, transportation and office expenses 

Food 

Clothing and materials 

Furnishings and household ; 

Medical and general care 

Heat, light and power 

Farm: 

Cows and calves . 

Hides . 

Hay . 

Garage, stable and grounds 
Repairs, ordinary 



Total sales . 
Miscellaneous: 

Interest on bank balances 
Rent . . . ■ . 



Cash Account. 
Receipts. 



$235 00 
51 92 
17 50 



$33,838 03 
87,231 00 



$18 42 

883 27 

133 88 

84 03 

99 82 

70 00 



304 42 

53 99 

252 04 



$1,022 67 
1,435 00 



Total income 



Maintenance. 



Balance from previous year, brought forward 
Appropriation, current year ..... 

Total 

Expenses (as analyzed below) . . 

Balance reverting to Treasury of Commonwealth 



department 



Personal Services: 

Dr. William A. Bryan, Superintendent 

Medical . 

Administration 

Kitchen and dining-room service 

Domestic 

Ward service (male) 

Ward service (female) 

Industrial and educational 

Engineering department 

Repairs . 

Farm 

Stable, garage and grounds 

Religious Instruction: 

CathoUc ...... 

Hebrew ...... 

Protestant ..... 

Travel, transportation and office expenses 
Advertising 

Postage .... 
Printing and binding 
Printing annual report 
Stationery and office supplies 
Telephone and telegraph . 
Travel .... 
Official bond . 

Food: 

Flour 

Cereals, rice, meal, etc. 
Bread, crackers, etc. 
Peas and beans (canned and dried) 
Macaroni and spaghetti 
Potatoes .... 

Meat ..... 
Fish (fresh, cured and canned) . 
Butter ..... 



Analysis of Expenses. 



$121,069 03 
237 37 



1,899 87 



2,457 67 



$125,663 94 



$12,695 85 
765,172 77 



$777,868 62 
740,761 33 



$37,107 29 



$4,350 00 
21,306 85 
25,177 18 
20,919 07 
34,860 35 
85,812 16 
92,779 84 

5,586 74 
34,345 13 
20,615 29 
15,718 59 

5,229 64 



$366,700 84 



$1,200 00 
240 00 
555 00 



$76 79 

748 00 

202 93 

254 30 

2,023 04 

2,340 16 

1,803 54 

52 00 



$16,413 35 
4,965 39 
531 80 
5,861 86 
1,317 18 
5,295 05 
38,366 81 
7,145 65 
6,084 17 



1,995 00 



7,500 76 



Amount carried forward . . . . . . . . . ... . 8376,196 60 



12 



Amount brought forward 



P.D. 23. 

$376,196 60 



Food — Continued 
Butterine, etc. 
Peanut butter, etc. 
Cheese . 
Coffee . 
Tea 
Cocoa 
Whole milk 
Milk (condensed, evaporated, etc.) 
Eggs (fresh) 
Egg powders, etc. 
Sugar (cane) . 
Fruit (fresh) . 
Fruit (dried and preserved) 
Lard and substitutes 
Molasses and syrups 
Vegetables (fresh) 
Vegetables (canned and dried) 
Seasonings and condiments 
Yeast, baking powder, etc. 



Clothing and materials: 
Boots, shoes and rubbers 
Clothing (outer) 
Clothing (under) 
Dry goods for clothing 
Hats and caps 
Leather and shoe findings 
Machinery for manufactiiring 
Socks and smallwares 



Furnishings and household supplies: 
Beds, bedding, etc. . 
Carpets, rugs, etc. 
Crockery, glassware, cutlers, etc. 
Dry goods and smallwares 
Electric lamps 
Fire hose and extinguishers 
Furniture, upholstery, etc. 
Kitchen and household wares 
Laundry supplies and materials 
Lavatory supplies and disinfectants 
Machinery for manufacturing . 
Table linen, paper napkins, towels, etc. 

Medical and general care: 

Books, periodicals, games, etc. . 
Entertainments . " . 

Funeral e.xpenses 
Ice and refrigeration 
Laboratory supplies and apparatus 
Manual training supplies . 
Medicines (supplies and apparatus) 
Medical attendance (e.xtra) 
Patients boarded out 
Return of runaways 
School books and supplies 
Tobacco, pipes, matches . 
Toilet and other persona! articles 
Water ..... 
Sewerage .... 



Heat, light and power: 
Coal (bituminous) . 

Freight and cartage 
Coal (screenings) 
Coal (anthracite) 

Freight and cartage 
Wood 
Electricity 
Gas 

Oil . 

Operating supplies for boiler and engines 



Farm: 

Bedding materials . 
Blacksmithing and supplies 
Carriages, wagons and repairs 
Dairy equipment and supplies 
Fencing materials 
Fertilizers 
Grain, etc. 

Hay . . . . 

Harnesses and repairs 
Horses .... 
Cows .... 
Other live stock 



58,719 68 

2,022 29 

1,683 83 

3,332 43 

1,329 47 

40 51 

77 79 

958 92 

7,371 60 

2,319 56 

8,473 77 

1,850 42 

8,135 89 

2,319 42 

1,034 00 

3,450 68 

1,307 29 

1,481 51 

2,381 10 



52,985 31 

6,076 93 

1,195 38 

4,862 26 

197 90 

700 82 

171 75 

1,461 61 



S10,366 54 

681 35 

2,913 84 

981 87 

1,021 26 

282 30 

3,431 32 

7,769 37 

3,392 47 

1,181 60 

440 20 

2,707 87 



$802 
1,061 

711 
1,551 

633 

115 
6,221 

340 
2,066 
89 
6 
4,114 
1,702 
8,087 
3,100 



$15,092 64 

26,456 79 

3,090 39 

3,414 37 

2,189 22 

6 17 

361 47 

1,277 77 

558 33 

1,300 50 



$1,377 42 

270 02 

294 75 

289 34 

73 21 

2,200 18 

11,094 65 

5,725 58 

150 20 

735 00 

6,.392 34 

35 00 



144,271 42 



17,651 96 



35,169 99 



30,602 97 



53,747 65 



Amount carried forward 



$657,640 59 



P.D. 23. 

Amount brought forward . 

Farm — Continued 

Rent . . . . . 

Spraying materials .... 

Stable and barn supplies . 

Tools, implements, machines, etc. 

Trees, vines, seeds, etc. 

Truck and tractor repairs and supplies 

Veterinary services, supplies, etc. 

Molasses ..... 

liime 

Beet pulp ..... 

Garage, stable and grounds: 
Motor vehicles 

Automobile repairs and supplies 
Fertilizers .... 
Road work and materials . 
Spraying materials . 
Tools, implements, machines, etc. 
Trees, vines, seeds, etc. 



Repairs, ordinary: 
Brick . . 

Cement, lime, crushed stone, etc 
Electrical work and supplies 
Hardware, iron, steel, etc. 
Labor (not on pay roll) 
Lumber, etc. (including finished 
Paint, oil, glass, etc. 
Plumbing and supplies 
Steam fittings and supplies 
Tools, machines, etc. 
Boilers, repairs 
Dynamos, repairs 
Engines, repairs 



13 

$657,640 59 



products) 



Repairs and renewals: 
Retubing boiler 
Co 2 recorders . 
Plumbing L-1-2-3-4 
Plumbing S-1-2-3-4 
Screens, main hospital 
Relay floor, H-1-2-3-4 
Relay floor, A-1-2-3-4 
Relay floor, 2d floor, laundry 
Repairs to roof, main hospital 
Repairs to porch, main hospital 
Blacksmith shop 
Unit drive for drying tumbler 
Roto flue cleaner, boiler room 
Press, laundry 
Trucks .... 
Pipe threading machine . 
Master key system . 
Screens, Summer Street 
Repairs to roof. Summer Street 
Fence, Summer Street 
Food carts. Summer Street 
Hand stoker . 



$437 70 

43 83 

115 83 

572 22 

1,224 66 
312 53 
589 16 
342 90 
221 00 
720 00 



$1,394 64 

2,487 92 

9 21 

214 03 

4 51 

357 76 

248 67 



$217 30 

423 10 

1,025 77 

1,703 61 

119 88 

2,778 98 

6,895 75 

2,463 46 

1,235 67 

490 15 

800 00 

62 18 

458 62 



$522 46 

645 00 
3,875 19 
3,875 94 

490 00 
539 00 
402 86 
294 00 
4,601 32 
1,465 34 
481 26 
857 50 
107 80 
406 70 
269 71 
684 18 

646 90 
365 94 

1,494 23 
745 09 
786 99 

2,956 80 



33,217 52 



4,716 74 



18,674 47 



26,512 01 
Total expenses for maintenance . . . . . . . . . . $740,761 33 



Special Appropriations. 



Balance December 1, 1923 . 

Appropriations for current year .... 

Total 

Expended during the year (see statement below) 
Reverting to Treasury of Commonwealth 

Balance November 30, 1924, carried to next year 



$470 00 
35 



$470 35 
8,000 00 

$8,470 35 

470 35 

$8,000 00 



Object. 



Act or 
Resolve. 



Whole 
Amount. 



Expended 
during 
Fiscal 
Year. 



Total 
expended 
to Date. 



Balance 

at end of 

Year. 



Remodeling heating system 
Additional fire protection 



Chap. 126, Acts 1922 
Chap. 510, Acts 1924 



5,114 24 
?,000 00 



$470 00 



11,114 24 



$470 00 



B,113 89 



$0 35* 
8,000 00 



$3,113 89 



$8,000 35 



* Balance reverting to treasury of the Commonwealth 
Balance carried to next year .... 

Total as above ...... 



$0 35 
8,000 00 



$8,000 35 



14 



P.D. 23. 



Per Capita. 
During the year the average number of inmates has been 2,160.30. 
Total cost for maintenance, $740,761.33. 
Equal to a weekly per capita cost of $6.5941. 
Receipt from sales, $1,899.87. 
Equal to a weelily per capita of $.0169. 
All other institution receipts, $123,764.07. 
Equal to a weekly per capita of $1.1017. 
Net weekly per capita, $5.4755. 

Respectfully submitted, 

JESSIE M. D. HAMILTON, Treasurer. 



VALUATION. 

November 30, 1924. 
Real Estate. 



Land (589 acres) 
Buildings . 



Personal Property. 



$416,357 00 
2,185,674 26 

$2,602,031 26 



Travel, transportation and office supplies 

Food .... 

Clothing and materials 

Furnishings and household suppl 

Medical and general care . 

Heat, light and power 

Farm .... 

Garage, stable and grounds 

Repairs .... 



Real estate 
Personal property 



Summary. 



$8,137 


19 


20,845 


37 


18,906 


31 


254,379 


58 


21,081 


93 


37,324 


37 


29,464 


87 


10,118 


17 


33,959 


86 


$434,217 65 



STATEMENT OF FUNDS. 



Patient's Fund. 



$2,602,031 26 
434,217 65 



$3,036,248 91 



Balance on hand November 30, 1923 ....... 

Receipts ........... 

Interest ............ 


$12,434 12 

10,545 57 

467 62 


$23,447 31 
12,065 68 


Refunded ........... 

Interest paid to State treasury ........ 


. $11,598 06 
467 62 




$2,000 00 
2,000 00 
2.000 00 
2,000 00 
3,167 37 
214 26 


Investment. 
Worcester County Institution for Savings . . . . 

Worcester Five Cents Savings Bank ....... 

Worcester Mechanics Savings Bank ....... 

People's Savings Bank ......... 

Balance Worcester Bank and Trust Company . . . . . 

Cash on hand December 1, 1924 ....... 


$11,381 63 

$11,381 63 

$1,658 93 
66 75 


Lewis Fund. 
Balance on hand November 30, 1923 ....... 

Income ............ 


$1,593 43 
65 50 


Expended for entertainments, etc. ....... 


$926 36 

600 00 

65 82 


Investment. 
American Telephone and Telegraph Company collateral trust 4% bond . 
Fourth Liberty Loan Bonds ........ 

Balance Worcester Bank and Trust Company ..... 


$1,592 18 
$1,592 18 

$6,653 25 
394 35 


Wheeler Fund. 
Balance on hand November 30, 1923 ....... 

Income ............ 


$6,387 99 
265 26 


Jlxpended for entertainments, etc. ....... 






$6,258 90 



$712 50 

4,000 00 

1,300 00 

246 40 


$6,258 90 

$1,196 00 
35 00 


$1,149 25 
46 75 




$1,100 00 
61 00 


$1,161 00 
$1,161 00 



P.D. 23. 15 

Investment. 
American Telephone and Telegraph Company collateral trust 4% bond 
Second Liberty Loan Converted Bonds ...... 

Fourth Liberty Loan Bonds . . . . . 

Balance Worcester Bank and Trust Company ..... 

Manson Fund. 
Balance on hand November 30, 1923 . . . . . ■ . 

Income ............ 

Expended for entertainments ........ 

Investment. 
Fourth Liberty Loan Bonds ........ 

Balance Worcester Bank and Trust Company 

Respectfully submitted 

JESSIE M. D. HAMILTON, Treasurer. 

Nov. 30, 1924. 

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



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 $2,602,031 26 

Personal property ........... 434,217 65 

Total $3,036,248 91 

Total acreage of hospital property, 589.16. 

Acreage under cultivation during previous year, 149.50. 

4. Medical service: ^"" •"• 
Superintendent ......... 1 - 1 

Assistant physicians ........ 12 - 12 

Medical internes ......... - - - 

Dentist 1 - 1 

Total physicians ........ 14 - 14 



5. Employees on pay roll (not including physicians) : 



M. F. T. 



Graduate nurses ......... 1 30 31 

Other nurses and attendants 108 82 190 

All other employees ........ 95 81 176 

Total employees . 204 193 397 

6. Patients employed in industrial classes or in general hospital work "^- * • 

on date of report 660 741 1,401 

7. Patients in institution on date of report (excluding paroles) . . 1,018 1,095 2,113 

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



16 



P.D. 23. 





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18 P.D. 23. 

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











Parents of I 


PAKENTe 






Patients 




Male 




OF Female 










Patients 


. 


Patients 


. 


Nativity. 


















M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


United States .... 


108 


80 


188 


50 


47 


97 


34 


35 


69 


Albania . . . . ■ 


1 


_ 


1 


1 


1 


2 


- 


- 


- 


Armenia 










3 


- 


3 


3 


3 


6 


— 


- 


— 


At sea . 










1 


- 


1 


— 


- 


- 


- 


- 


— 


Azores 










2 


- 


2 


2 


2 


4 


- 


- 


— 


Austria 










1 


1 


2 


— 


— 


— 


1 


1 


2 


Canada 










28 


25 


53 


42 


45 


87 


30 


32 


62 


Denmark 










3 


- 


3 


3 


3 


6 


- 


- 


- 


England 










4 


2 


6 


8 


7 


15 


7 


5 


12 


Finland 










2 


4 


6 


3 


3 


6 


5 


5 


10 


France 










1 


- 


1 


— 


- 


— 


- 


- 


- 


Germany 










3 


- 


3 


4 


3 


7 


3 


3 


6 


Greece 










3 


2 


5 


3 


3 


6 


1 


1 


2 


Ireland 










23 


30 


53 


39 


38 


77 


46 


48 


94 


Italy 










13 


2 


15 


13 


13 


26 


3 


3 


6 


Judea 










1 


— 


1 


1 


1 


2 


- 


- 


— 


Mexico 










1 


— 


1 


1 


1 


2 


- 


- 


- 


Norway 










1 


2 


3 


1 


1 


2 


2 


2 


4 


Philippine 


sland 


s 






- 


- 


- 


1 


1 


2 


- 


- 


— 


Poland 










11 


3 


14 


13 


13 


26 


3 


3 


6 


Portugal 










- 


- 


- 


- 


- 


- 


2 


2 


4 


Roumania 










1 


- 


1 


1 


1 


2 


- 


— 


- 


Russia 










9 


2 


11 


12 


12 


24 


4 


4 


8 


Scotland 










1 


- 


1 


3 


1 


4 


- 


— 


- 


Spain 










2 


— 


2 


2 


2 


4 


— 


- 


— 


Sweden 










3 


4 


7 


7 


7 


14 


5 


5 


10 


Turkey in Europe 






— 


- 


- 


— 


— 


- 


1 


1 


2 


West Indies 






2 


- 


2 


2 


2 


4 


- 


- 


- 


Total foreign born 


120 


77 


197 


165 


163 


328 


113 


115 


228 


Unascertained 




1 


1 


2 


14 


19 


33 


11 


8 


19 


Grand 


totals 








229 


158 


389 


229 


229 


458 


158 


158 


316 



Table 5. — Citizenship of First Admissions. 





M. 


F. 


T. 


Citizens by birth ......... 

Citizens by naturalization . . 

Aliens ........... 

Citizenship unascertained ........ 


108 
30 

84 

7 


80 
19 
42 
17 


188 
49 

126 
24 


Totals 


229 


158 


387 



P.D. 23. 



19 



Table 6. — Psychoses of First Admissions. 



Psychoses. 


M. 


F. 


T. 


M. 


F. 


T. 


1. 


Traumatic, total . . . . . . . 1 


_ 


_ 


- 


_ 


_ 


_ 


2. 


Senile, total 








- 


- 


- 


11 


8 


19 




Simple deterioration . 








9 


2 


11 


- 


- 


- 




Paranoid types 








1 


6 


7 


- 


- 


- 




Pre-senile type . 








1 


- 


1 


— 


- 


- 


3. 


With cerebral arteriosclerosis 








- 


- 


- 


26 


23 


49 


4. 


General paralysis 








— 


- 


- 


28 


9 


37 


5. 


With cerebral syphilis . 








— 


- 


- 


1 


- 


1 


6. 


With Huntington's chorea 








— 


- 


— 


- 


- 


- 


7. 


With brain tumor 








- 


- 


- 


- 


- 


- 


8. 


With other brain or nervous ( 


liseases, total 






- 


- 


- 


5 


- 


5 




Multiple sclerosis 








3 


- 


3 


- 


- 


- 




Encephalitis lethargica 








2 


- 


2 


- 


- 


- 


9, 


Alcoholic, total 








- 


- 


- 


24 


2 


26 




Pathological intoxication 








2 


2 


4 


- 


- 


- 




Delirium tremens 








3 


- 


3 


- 


— 


— 




Acute hallucinosis 








11 


- 


11 


- 


— 


- 




Acute paranoid type 








4 


- 


4 


- 


- 


- 




Chronic paranoid type 








2 


- 


2 


— 


- 


— 




Alcoholic deterioration 








2 


— 


2 


— 


- 


- 


10. 


Due to drugs and other exogenous toxins, total 
Opium (and derivatives), cocaine, bromides, chlora 


1, 


- 


~ 


~ 


1 


~ 


1 




etc., alone or combined .... 




1 


- 


1 


— 


- 


- 


11. 


With pellagra ..... 






- 


- 


- 


— 


- 


— 


12. 


With other somatic diseases, total . 






- 


- 


- 


4 


6 


10 




Exhaustion dehrium .... 






4 


5 


9 


- 


- 


- 




Cardio-renal disease .... 






— 


1 


1 


- 


- 


— 


13. 


Manic-depressive, total 






- 


— 


- 


12 


18 


30 




Manic type ..... 






6 


8 


14 


- 


- 


- 




Depressed type .... 






6 


8 


14 


- 


- 


- 




Mixed type ..... 






- 


2 


2 


- 


— 


- 


14. 


Involution melancholia 






— 


— 


- 


5 


10 


15 


15. 


Dementia prsecox, total 






- 


— 


- 


40 


28 


68 




Paranoid type ..... 






12 


14 


26 


- 


- 


- 




Katatonic type .... 






8 


6 


14 


- 


— 


- 




Hebephrenic type .... 






15 


7 


22 


- 


— 


- 




Simple type ..... 






5 


r 


6 


- 


- 


— 


16. 


Paranoia and paranoid conditions 






- 


- 


- 


2 


8 


10 


17. 


Epileptic, total ..... 






- 


- 


- 


1 


- 


1 




Epileptic, clouded states . 






1 


- 


1 


- 


- 


- 


18. 


Psychoneuroses anu neuroses, total 






- 


- 


- 


1 


1 


2 




Hysterical type .... 






1 


- 


1 


- 


- 


- 




Anxiety neuroses .... 






- 


1 


1 


- 


- 


- 


19. 


With psychopathic personality 






- 


- 


- 


1 


2 


3 


20. 


With mental deficiency 






- 


- 


- 


2 


7 


9 


21. 


Undiagnosed ..... 






- 


- 


- 


51 


27 


78 


22. 


Without psychosis, total . . 






- 


- 


- 


14 


9 


23 




Alcoholism ..... 






1 


- 


1 


— 


- 


— 




Psychopathic personality . 






5 


2 


7 


- 


- 


- 




Mental deficiency .... 






6 


6 


12 


- 


- 


— 




Others, Encephalitis lethargica . 






2 


- 


2 


- 


- 


- 


Totals . 














229 


158 


387 



20 P.D. 23. 

Table 7. — Race of First Admisnons classified with Reference to Principal Psychoses. 



Race. 






Total. 


Senile. 


With 
Cerebral 
Arterio- 
sclerosis. 


General 
Paealysis. 


With 
Cerebral 
Syphilis. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


African (black) 

Armenian . 

English 

Finnish 

French 

German . 

Greek 

Hebrew 

Irish . 

Italian 

Lithuanian 

Mexican . 

Portuguese 

Scandinavian 

Scotch 

Slavonic 

Spanish 

West Indian 

Mixed 

Race unascertain 

Totals 


ed 




4 
3 

18 
3 

26 
4 
4 
6 

39 

13 
7 
1 
2 

11 
2 

14 
2 
2 

62 
6 

229 


12 
5 

24 
3 
2 

47 
3 
2 

2 

7 

6 

40 
5 

158 


4 
3 

30 
8 

50 
7 
6 
6 

86 

16 
9 
1 
4 

18 
2 

20 

2 

2 

102 

11 

387 


5 
1 
1 

4 
11 


1 

2 

3 

2 

8 


6 

2 

1 

4 

6 
19 


1 

3 
2 

3 
2 

1 

13 

1 

26 


3 
2 

6 

10 
2 

23 


4 

5 

2 

9 
2 

1 

23 
3 

49 


1 

6 

1 
3 
2 
1 
1 
1 
2 
1 
1 
1 
1 
6 

28 


1 

1 

1 

3 

1 

2 
9 


1 

1 

7 

1 

1 
6 
2 

1 
1 
1 
3 
1 
1 
1 
1 
8 

37 


1 

1 


- 


I 

1 



Table 7. — Race of First Admissions classified with Reference to Principal 

Psychoses — Continued . 



Race. 






With Other 
Brain or 

Nervous 
Diseases. 


Alcoholic. 


Due to 

Drugs 

AND Other 

Exogenous 

. Toxins. 


With 

Other 

Somatic 

Diseases. 


Manic- 
Depbessive. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


African (black) 

Arinenian . 

English 

Finnish 

French 

German 

Greek 

Hebrew 

Irish 

Italian 

Lithuanian 

Mexican . 

Portugese . 

Scandinavian 

Scotch 

Slavonic . 

Spanish 

West Indian 

Mixed 

Race unascertain 

Totals 


ed 




2 

1 

1 
1 
5 


- 


2 
1 

1 
1 
5 


1 

1 
1 

8 
3 

1 

1 
5 

1 

2 
24 


1 
1 

2 


1 
1 
1 

9 
4 

1 
1 
5 
1 

2 
26 


1 
1 


- 


1 
1 


1 
1 

1 
1 

4 


1 

1 

1 

1 
2 
6 


1 

1 

2 
1 

1 

3 

1 

10 


1 
3 
1 

3 

4 
12 


3 
3 
1 
3 

2 
2 

2 
2 

18 


4 
6 
2 
3 

5 
2 

6 
2 

30 



P.D. 23. 

Table 7. 



21 



-Race of First Admissions classified with Reference to Principal 
Psychoses — Continued. 



Race. 






Involution 
Melan- 
cholia. 


Dementia 
Precox. 


Paranoia 

AND 

Paranoid 
Conditions. 


Epileptic. 


PSYCHO- 

NEUBOSEa 

AND 

Neuroses. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


African (black) 

Armenian . 

EngUsh 

Finnish 

French 

German 

Greek 

Hebrew 

Irish 

Italian 

Lithuanian 

Mexican . 

Portuguese 

Scandinavian 

Scotch 

Slavonic . 

Spanish 

West Indian 

Mixed 

Race unascertain 

Totals 


ed 




2 

1 

2 
5 


1 
2 
2 

3 

1 
1 

10 


1 
2 
2 

5 

1 

1 
1 

2 

15 


1 

6 
1 
3 

1 
3 
7 
3 

1 

2 
1 

10 

1 

40 


1 
5 

11 

1 

2 

1 

1 

6 

28 


1 

6 
2 

8 

1 
3 
18 
4 
1 

2 
3 

2 

16 
1 

68 


2 
2 


1 

1 
2 

3 

1 
8 


1 
1 
4 

3 

1 

10 


1 
1 


- 


1 
1 


1 


1 
1 


1 

1 
2 



Table 7. — Race of First Admissions classified with Reference to Principal 
Psychoses — Concluded. 



Race. 






With 
Psychopathic 
Personality. 


With Mental 
Deficiency. 


UNDIAQNOaED. 


Not Insane. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


African (bis 

Armenian 

English 

Finnish 

French 

German 

Greek 

Hebrew 

Irish 

ItaUan 

Lithuanian 

Mexican 

Portuguese 

Scandinavi 

Scotch 

Slavonic 

Spanish 

West India 

Mixed 

Race unasc 


ick) . 

an 

n 
ertain 


ed 




1 


1 

1 


1 

1 
1 


1 

1 


1 
2 

1 

2 
1 


1 
3 

2 

2 
1 


1 

1 

4 
1 
1 
2 
10 
4 

1 

1 

6 

1 

13 

2 


1 
3 
1 

1 

11 
1 

2 
1 

6 


3 
1 
1 

1 
7 
2 
2 
2 
21 
5 

1 
3 

7 

1 

19 

2 


1 
1 
2 

2 
1 
2 

4 
1 


1 

1 

1 
6 


2 

1 
3 

2 
2 
2 

10 

1 


Totals 








1 


2 


3 


2 


7 


9 


51 


27 


78 


14 


9 


23 



22 P.D. 23. 

Table 8. — Age of First Admissions classified with Reference to Principal Psychoses. 



Psychoses. 




Total. 


Under 15 
Years. 


15-20 

Years. 


20-25 

Years. 


25-30 

Years. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


1. Traumatic .... 

2. Senile .... 

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 disease 

9. Alcoholic .... 

10. Due to drugs or other exogenou 

toxins .... 

11. With pellagra 

12. With other somatic diseases . 

13. Manic-depressive . 

14. Involution melancholia 

15. Dementia prB3cox 

16. Paranoia or paranoid condition 

17. Epileptic .... 

18. Psychoneuroses and neuroses 

19. With psychopathic personality 

20. With mental deficiency 

21. Undiagnosed. 

22. Without psychoses 

Totals .... 


s 

3 


11 
26 

28 
1 

5 

24 

1 

4 

12 

5 

40 

2 

1 

1 

1 

2 

51 

14 

229 


8 

23 

9 

2 

6 
18 
10 

28 
8 

1 
2 
7 
27 
9 

158 


19 
49 
37 

1 

5 
26 

1 

10 

30 

15 

68 

10 

1 

2 

3 

9 

78 

23 

387 


- 


1 
1 


1 
1 


1 
3 

1 
1 
6 

12 


2 
1 

3 


1 
5 

1 
1 
1 
6 

15 


1 

4 

7 

1 

3 

2 

18 


1 
3 

2 
2 
3 

11 


1 

5 
10 

1 

2 
5 
5 

29 


3 
1 

2 

2 
14 

13 
2 

37 


2 
3 

6 

1 
5 
2 

19 


3 
1 

2 

2 
5 

20 

1 

18 

4 

56 



Table 8. — Age of First Admissions classified with Reference to Principal 
Psychoses — Continued . 



Psychoses. 




30-35 

Years. 


35-40 

Years. 


40-45 

Years. 


45-50 

Years. 


50-55 

Years. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


1. Traumatic .... 

2. Senile 

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 disease 

9. AlcohoUc .... 

10. Due to drugs or other exogenou 

toxins .... 

11. With pellagra 

12. With other somatic diseases . 

13. Manic-depressive . 

14. Involution melancholia . 

15. Dementia prtecox . 

16. Paranoia or paranoid condition 

17. Epileptic .... 

18. Psychoneuroses and neuroses . 

19. With psychopathic personality 

20. With mental deficiency . 

21. Undiagnosed 

22. Without psychoses 

Totals .... 


3 
3 


2 
5 

6 

1 

3 
1 

18 


1 
2 

1 

4 
2 

1 
2 
1 

14 


3 

7 

1 

10 
3 

1 
5 
2 

32 


3 

4 

2 

1 

4 

6 

1 

21 


1 

1 

4 

1 
1 

1 
1 
2 
2 

14 


4 

4 

3 
5 

5 
1 

1 
1 

8 
3 

35 


9 

2 
5 

2 

4 
1 

9 
32 


2 
2 
4 
2 

6 
1 

17 


9 

_ 

2 
5 

4 
2 
8 
3 

15 
1 

49 


1 
4 

1 

1 

1 
2 

1 
1 
1 
4 
2 

19 


2 

4 
1 
3 

1 

5 

16 


1 
6 

1 
1 

4 
2 
5 

2 
1 

1 
9 
2 

35 


5 

1 
2 

1 

1 
1 

1 

3 
15 


2 
2 

3 
2 

1 
1 

1 

12 


2 

7 

1 
2 

1 

1 
4 
3 
1 
1 

1 
3 

27 



P.D. 23. 23 

Table 8. — Age of First Admissions classified with Reference to Principal 
Psychoses — Concluded . 



Psychoses. 




55-60 

Years. 


60-65 

Years. 


65-70 

Years. 


70-75 

Years. 


75-80 

Years. 


Over 80 
Years. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


1. Traumatic 

2. Senile 

3. With cerebral arterio 

sclerosis 

4. General paralysis 

5. With cerebral syphilis 

6. With Huntington' 

chorea . 

7. With brain tumor 

8. With other brain o 

nervous diseases 

9. Alcoholic . 

10. Due to drugs or othe 

exogenous toxins 

11. With pellagra 

12. With other somati 

diseases . 

13. Manic-depressive 

14. Involution melancholii 

15. Dementia praecox 

16. Paranoia or paranoic 

condition 

17. Epileptic . 

18. Psychoneuroses anc 

neuroses 

19. With psychopathic per 

sonaMty . 

20. With mental deficiencj 

21. Undiagnosed 

22. Without psychoses 

Totals . 




2 

1 
4 

1 

3 
11 


1 

1 

5 
3 

1 
1 

12 


3 
1 

1 
4 

6 
3 

1 
4 

23 


6 

1 

1 

1 
1 

2 
12 


1 
2 

1 

1 
1 

6 


7 
3 

1 

2 

1 
1 

1 

2 
18 


1 
6 

1 
1 

3 
12 


3 

1 
1 

2 

7 


1 
9 

1 

1 
1 

1 

5 
19 


1 

7 

8 


4 

8 

1 
13 


5 
15 

1 
21 


5 
3 

1 
9 


1 
3 

1 
5 


6 
6 

1 

1 
14 


3 

2 

5 


3 

5 

8 


6 

7 

13 



24 



P.D. 23. 





to Z 


H 


1 M>OTt< 1 1 1 1 IN 1 1 1 (M^ 1 1 1 1 1 N-Hrt 


CO 




f^; 


l-H(Nllllllll|C<|i-i||ll|>-iiCl 


IN 




s 


1 INTO-* 1 1 1 1 (^] 1 1 1 1 1 1 1 1 1 1 ,-lco.- 


Oi 










o 


H 


1 1 "-^CO 1 1 1 1 1 1 1 1 1 1 Tf< 1 1 1 1 1 rt 1 


O: 




fe 


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


1 


CO 


s 


1 1 '-<« 1 1 1 1 1 1 1 1 1 1 ■* 1 1 1 1 1 rt 1 


O: 


Oh 


2 o 


H 


|i-it^-*l 1 l-H>o| |(NU3mt>l-<|r-i|,-iTt< 


IN 


fe 


1 ^CO 1 1 1 1 1 1 1 1 .-HINrtM 1 1 1 r-l 1 iO(M 


Oi 




S 


1 I'^Tt'l i Irtioi ii-ic<5iM-*l>-i| 1 lOO) 


CO 

CO 


S 
K 


s w 

O o 


H 


C> rt Ol rsi CO "-1 


2 




fe 


rt rt iM 1-1 


s 




S 




§ 








Q 


H 


l-*00<Oi-H| IrHiol |i-<(NCOO»CI 1 l-HtDCJ 


00 


6C 


fe 


iTfCOi-il 1 1 1 i 1 1 liMiOCC-*! 1 I.-ICO-H 


I^ 
N 


CO 

s 

o 

'<^ 

CO 
CO 


§ 


1 1 lOlO^ 1 1 -HIO 1 1 rH 1 ,-lt^,-l 1 1 1 1 CCrt 


"»< 


iJ 


H 


1 C^CO-* 1 1 1 1 lO 1 1 1 1 1-1 TjH 1 1 1 1 (NQOlN 


CO 




(ii 


1 .-IM^ 1 1 1 1 rt 1 1 1 1 -H 1 1 1 1 1 (N(Mi-i 


:=! 


1 


§ 


1 .-Hrtro 1 1 1 1 TjH 1 1 1 1 1 ■* 1 1 1 1 1 0.-H 


o 

IN 




s 


H 


1 a>at^<-i 1 1 lOco-H 1 ooicoooi-<(Ncoo5ooc<5 

»-"}<CO a .-HCOrHCDrt t^lM 


00 

CO 




t^ 


1 OOCOO 1 1 1 1 (M : 1 OOOOOOOO 1 -HiNt^l^O! 
<N -^--H IN IN 


00 

in 


o 


§ 


1 rtCOOOrH 1 1 lC-*-H 1 ^INmOlNr-lrti-<(N-HTtl 

-HiNOl IN rt -<(( lOrt 


IN 


l*J 


oi 
H 
no 
O 
H 
o 
1- 












^ 

Q 






T 


.5 

1 -3 

•.■■■■I- I-.I--- 

. -S • .S .o .£.§.. .§ .^1 . . 
o :=•§ c 5 13 "o :2 Tjag 

"S fe- fe,2 g5 = '«'a35'V-r'^--S c ^S c g 
e„2g£ffi^oooa-gJ;Sgc-jae^g 


"3 
o 
H 




rtC<IM'<J'in(Ot^OClOO-iiNM'*iOtDt^OOOO-<IN 
rt^_i^Mrtrt,-irtrtlNlNCM 





P.D. 23. 

Table 10. — Environment of First Admissions classified with Reference tc 
Princiipal Psychoses. 




25 


Psychoses. 


Total. 


Urban. 


Rural. 


Unascer- 
tained. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M 


F. 


T. 


1. Traumatic ..... 

2. Senile 

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 

9. Alcoholic ..... 

10. Due to drugs and other exogenous 

toxins ..... 

11. With pellagra .... 

12. With other somatic diseases . 

13. Manic-depressive 

14. Involution melancholia 

15. Dementia prsecox 

16. Paranoia or paranoid condition 

17. Epileptic ..... 

18. Psychoneuroses and neuroses 

19. With psychopathic personality 

20. With mental deficiency 

21. Undiagnosed .... 

22. Not insane .... 

Totals 


11 
26 

28 

1 

5 
24 

1 

4 

12 

5 

40 

2 

1 

1 

1 

2 

51 

14 

229 


8 

23 

9 

2 

6 
18 
10 

28 
8 

1 
2 

7 

27 

9 

158 


19 

49 

37 

1 

5 
26 

1 

iO 

30 

15 

68 

10 

1 

2 

3 

9 

78 

23 

387 


10 
22 
23 

1 

5 
21 

1 

2 
11 

3 
36 

1 

1 

2 

42 
10 

191 


8 
19 
9 

2 

4 
15 

9 
23 

8 

1 
1 
5 
23 
6 

133 


18 

41 

32 

1 

5 
23 

1 

6 
26 
12 

59 
9 
1 
1 
1 
7 
65 
16 

324 


1 
4 
5 

3 

2 
1 
2 
4 
1 

1 

1 

9 
4 

38 


4 

2 
3 

1 
5 

1 
2 
4 
3 

25 


1 
8 
5 

3 

4 
4 
3 
9 
1 

1 
2 
2 
13 
7 

63 


- 


- 


- 


Table 11. — Economic Condition of First Admissions classified with Reference 
to Principal Psychoses. 


Psychoses. 


Total. 


Depen- 
dent. 


Margi- 
nal. 


Comfort- 
able. 


Unascer- 
tained. 


M. 


F. 


T. 


M. F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


1. Traumatic ..... 

2. Senile 

3. With arteriosclerosis 

4. General paralysis .... 

5. With cerebral syphilis . 

6. With Huntington's chorea 

7. With brain tumor .... 

8. With other brain or nervous diseases 

9. Alcoholic ..... 

10. Due to drugs and other exogenous 

toxins ..... 

11. With pellagra .... 

12. With other somatic diseases . 

13. Manic-depressive .... 

14. Involution melancholia . 

15. Dementia prsecox .... 

16. Paranoia or paranoid condition 

17. Epileptic ..... 
IS. Psychoneuroses and neuroses . 

19. With psychopathic personality 

20. With mental deficiency . 

21. Undiagnosed .... 

22. Not insane ..... 

Totals ..... 


11 
26 

28 
1 

5 
24 

1 

4 

12 

5 

40 

2 

1 

1 

1 

2 

61 

14 

229 


8 

23 

9 

2 

6 

18 
10 

28 
8 

1 
2 
7 
27 
9 

158^ 


19 

49 

37 

1 

5 
26 

1 

10 

30 

15 

68 

10 

1 

2 

3 

9 

78 

23 

!87 


- 1 

- 1 
1 - 

1 - 

- 1 

- 1 

1 1 
1 - 

4 5 


1 
1 
1 

1 

1 

1 

2 
1 

9 


7 
16 
14 

1 

5 
19 

3 
6 
3 

27 
2 
1 

1 

2 
31 
10 

148 1 


6 
18 

7 

2 

2 

12 

9 

18 
5 

1 

4 

17 

6 

07 


13 

34 

21 

1 

5 
21 

5 
18 
12 
45 

7 
1 

2 

6 

48 

16 

255 


4 
10 
13 

4 

1 

1 
6 
2 
13 

1 

18 
3 

76 


1 
4 
2 

4 
6 
1 
9 
3 

1 

3 
9 
3 

46 


5 
14 

15 

4 

1 

5 
12 

3 
22 

3 

2 

3 

27 
6 

122 


1 
1 


- 


1 
1 

































26 P.D. 23. 

Table 12. — Use of Alcohol by First Admissions classified with Reference to 
Principal Psychoses. 



Psychoses. 




Total. 


Absti- 
nent. 


Temper- 
ate. 


Intem- 
perate. 


Unascer- 
tained. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


1. Traumatic .... 

2. Senile 

3. With arteriosclerosis 

4. General paralysis . 

5. With cerebral syphilis . 

6. With Huntington's chorea 

7. With brain tumor . 

8. With other brain or nervous disease 

9. Alcoholic .... 

10. Due to drugs and other exogenous 

toxins .... 

11. With pellagra 

12. With other somatic diseases . 

13. Manic-depressive . 

14. Involution melancholia . 

15. Dementia prsecox . 

16. Paranoia or paranoid condition 

17. Epileptic .... 

18. Psychoneuroses and neuroses . 

19. With psychopathic personality 

20. With mental deficiency . 

21. Undiagnosed 

22. Without psychosis 

Totals .... 


s 


11 
26 

28 
1 

5 
24 

1 

4 

12 

5 

40 

2 

1 

1 

1 

2 

51 

14 

229 


8 

23 

9 

2 

6 

18 
10 

28 
8 

1 
2 
7 
27 
9 

158 


19 

49 

37 

1 

5 
26 

1 

10 

30 

15 

68 

10 

1 

2 

3 

9 

78 

23 

387 


2 
4 

7 

1 

3 

1 

2 
4 
1 
8 
2 

1 

9 

7 

52 


2 
9 
2 

2 
6 
2 
7 
4 

1 

2 
7 
1 

45 


4 

13 

9 

1 

3 

1 

4 
10 

3 
15 

6 

1 

3 
16 

8 

97 


6 
16 
12 

2 

1 
6 
3 
19 

1 

1 

22 

3 

92 


4 

11 

5 

3 

5 
7 

18 
3 

2 

3 

13 

8 

82 


10 
27 
17 

2 

4 
11 
10 
37 

3 

1 

2 

4 

35 

11 

174 


3 

6 

7 

24 

1 
2 
1 
9 

1 

16 
4 

74 


1 

2 

2 

2 
1 

3 
11 


4 
6 
7 

26 

1 
4 
1 
11 
1 

1 

19 

4 

85 


2 

4 

1 

4 
11 


1 
3 
2 

1 
5 
1 

1 

2 
4 

20 


1 
3 
4 

1 
5 
1 
5 

1 

2 

8 

31 



27 



Q^ 



S 



ii 
si 


H 


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


' 


(xi 


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


1 


S 


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


1 




Q 

m 
o 
a 



> 
Q 


H 


1 1 ^'^ 1 1 1 l-Hl |rt| lOJI 1 l-li rt,H 


05 


fa 


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


W 


^ 


lllrHllll^ll-^lllMlllll -H-H 


r^ 




a 
m 

02 


H 


1 1 1 -1 1 1 1 1 ^ 1 1 1 1 1 1 1 1 1 1 1 1 1 


ct 


fa 


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


1 


S" 


1 1 1 ^ 1 1 1 1 rt 1 1 1 1 1 1 1 1 1 1 1 1 1 


IN 






H 




s 


fa 


1 l>t^lM 1 1 1 1 1 1 1 ^ •* <N -I" e^ 1 1 1 rtCO-H 


.* 
.>1< 


§ 


1 «ot^co 1 1 1 1 M-H 1 1 1 1 1 1 1 1 1 1 c^iN 


CO 




S 


H 


1-H (N f-l f-t CC fH 


•O 


fa 


1 1 ^lO 1 1 1 1 i-i 1 1 M03100CO 1 ^ 1 i-f*W 




i 


liOOiOl 1 l-^OOl IC^'*-*OOI l>-l| It^rt 


«5 
05 





g 


H 




00 


fa 


1-H fH 


5 


§ 


rt CO CC 


o 




g 


H 


1 0>a>tr^'-i 1 1 lOcO-H 1 OOiOQOO— ilNMOSOOCO 
1— Ttico (N .-HOT>-KOt-i t~<N 


CO 


fa 


1 OOMOi 1 1 1 1 <N 1 1 tOOOOOOOO 1 rt (N t^ t^ O 


00 


S 




iM 
IM 




» 
OD 


a 

o 

Ph 














G 

1 .2 

-a .§ -^ • ^ • • • 

i ;S'§ « 5 ^ ^ o «£S 

■|rtli.ii1>l§ lili 

t-(.Hr^rtl-lr-lr-li-li-(r-(IN(M(M 


"(3 
o 



28 



P.D. 23. 



Table 14. — Psychoses of Readmissions. 



Psychoses. 


M. 


F. 


T. 


M. 


F. 


T. 


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














2. Senile, total 








- 


- 


- 


- 


4 


4 


Simple deterioration . 








- 


3 


3 


- 


- 


- 


Pre-senile type .... 








- 


1 


1 


— 


- 


- 


3. With cerebral arteriosclerosis . 








- 


- 


- 


1 


- 


1 


4. General paralysis .... 








— 


- 


— 


1 


- 


1 


5. With cerebral syphilis 








- 


- 


— 


2 


- 


2 


6. With Huntington's chorea 








- 


- 


— 


— 


- 


— 


7. With brain tumor .... 








- 


- 


— 


- 


- 


- 


8. With other brain or nervous diseases, tota 


1 






- 


- 


— 


- 


- 


- 


9. Alcoholic, total .... 








- 


- 


— 


6 


- 


6 


Acute hallucinosis 








3 


- 


3 


_ 


_ 


- 


Chronic paranoid type 








1 


- 


1 


— 


- 


- 


Alcoholic deterioration 








2 


- 


2 


— 


- 


- 


10. Due to drugs and other exogenous toxine, 


total 






- 


- 


- 


- 


- 


- 


11. With pellagra .... 








- 


- 


— 


— 


- 


- 


12. With other somatic diseases, total . 








- 


— 


— 


- 


- 


- 


13. Manic-depressive, total . 








- 


- 


- 


7 


12 


19 


Manic type 










6 


5 


11 


— 


— 


— 


Depressed type . 










1 


4 


5 


— 


- 


- 


Mixed type 










- 


3 


3 


- 


- 


- 


14. Involution melancholia 










- 


- 


- 


- 


1 


1 


15. Dementia prsecox total 










- 


- 


_ 


22 


9 


31 


Paranoid type 










5 


4 


9 


- 


- 


- 


Katatonic type . 










4 


2 


6 


- 


- 


— 


Hebephrenic type 










8 


2 


10 


- 


- 


— 


Senile type 










5 


1 


6 


- 


- 


— 


16. Paranoia or paranoid condition 








- 


- 


- 


3 


3 


6 


17. Epileptic, total .... 








- 


- 


- 


- 


1 


1 


Epileptic, clouded states 








- 


1 


1 


- 


- 


— 


18. Psychoneuroses and neuroses, total . 








- 


— 


- 


— 


- 


— 


19. With phychopathic personaUty 








- 


- 


- 


2 


1 


3 


20. With mental deficiency . 








- 


- 


- 


- 


2 


2 


21. Undiagnosed .... 








- 


- 


- 


6 


7 


13 


22. Without psychosis, total 








- 


— 


- 


1 


3 


4 


Psychopathic personality 








- 


1 


1 


- 


— 


— 


Mental deficiency 








1 


2 


3 


- 


- 


- 


Totals 










- 


- 


- 


51 


43 


94 



Table 15. — Discharges of Patients classified with Reference to Principal Psijchoses 
and Condition on Discharge. 


Psychoses. 


Total. 


Re- 

COVEBED. 


Im- 
proved. 


Unim- 
proved. 


Not 
Insane. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


1. Traumatic .... 

2. Senile 

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 disease 

9. Alcoholic .... 

10. Due to drugs and other exogenou 

toxins .... 

11. With pellagra 

12. With other somatic diseases . 

13. Manic-depressive . 

14. Involution melancholia . 

15. Dementia praecox . 

16. Paranoia or paranoid condition 

17. Epileptic .... 

18. Psychoneuroses and neuroses . 

19. With psychopathic personality 

20. With mental deficiency . 

21. Undiagnosed 

22. Not insane .... 

Totals .... 


3 

3 


1 
3 
8 
4 
3 

1 
36 

1 

1 
16 

3 
50 

3 

2 

7 

9 

29 

13 

190 


7 
4 
3 

3 

1 

3 
36 

3 
35 

5 

1 
4 
1 

8 
4 

118 


1 

10 

12 

7 

3 

1 
39 

2 

4 

52 

6 

85 
8 

3 
11 
10 
37 
17 

308 


19 

1 
1 

7 
2 

7 
37 


2 

18 

_ 

2 
22 


21 

1 

1 

25 

2 

9 
59 


1 
1 
7 
1 
1 

1 

17 

8 

30 
2 

2 

5 

4 

15 

95 


5 
2 

2 

1 

1 

3 
16 
3 

27 
5 

1 

4 
1 

6 

_ 

77 


1 
6 
9 
3 
1 

1 

18 

1 

3 

24 

3 

57 

7 

3 

9 

5 

21 

172 


2 
1 

3 

2 

1 

1 

20 

1 

2 
5 

7 

45 


2 
2 

1 

2 

8 

15 


4 
3 

4 
2 

3 
1 

28 
1 

2 
5 

7 

60 


13 
13 


4 
4 


17 
17 





































29 



m 
w o « 

g§l 


H 


1 1 1 1 1 ^ 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 <-< 1 1 1 


fe 


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


s 


1 1 1 1 1 ^ 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ^111 


O 

§ 


H 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 '^ -'^ 1 1 1 1 1 1 1 rt 


f-ii 


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 rt rt^ 1 1 1 1 111^ 


With Other 
Brain or 

Neuroses 
Diseases. 


H 


lllllllll -HllrHll ^ll^ll ^111 


fe 


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


^ 


lllllllll lll-^ll rtll'Hil rHill 


K w w 


H 


lllllllll 1 (M^ III 1 1 1 1 1 1 1 1 1 1 


fe 


lllllllll 1 1 ^ 1 1 1 1 1 1 1 1 1 1 1 1 1 


§ 


lllllllll 1 <N 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


►3 a 

W J 

z -<: 


H 


i-Hrt lllllll IIMIIII lll^ll Wll^ 

CO 


P^ 


lllllllll It^llil llllll ^111 


§ 


I.HII1IIII IU5IIII Ill-Ill (NII-1 


« R 2 

Ec] ^ Ph 
U H H 


H 


lllllllll •llllll 0)iM 1 O-^ 1 "5'-l 1 1 


f^ 


lllllllll c^iiiiii mioiTiii — ii-(|i 


^ 


III!— illll Olllll ■*t^l'*"-i| -^lll 


s 

CO 


H 


1 1 1 1 1 1 1 1 (M llllll fJCO 1 IN 1 1 M^ 1 ^ 


E^ 


1 1 1 1 1 1 1 1 IN llllll ^Oi 1 1-- 1 1 CO 1 1 1 


S 


lllllllll llllll "-I-* 1 'H 1 1 1 —1 1 rH 


s 
p 
-< 

« 


H 


lllllllll llllll -llllll 1 1 1 1 


fe 


lllllllll llllll llllll 1 1 1 1 


S 


lllllllll llllll ^4 1 1 1 1 1 1 1 1 1 


•< 


H 


n NM -1 IN IN 


fe 


iNl^llliN^iN -^r-rHiii ttia>'-^n i to inin^io 


§ 


rt— l|-l-(rt||l Mt^lrH^rt CO(NM-*MI 2^'^ 


Causes of Death. 




^ s 1 • • • • 

is ^ §, 

fe .2 a CO . 

-^ Si c " ->. 

i 1 ^ i ?s 1 

M 2 . . . s ..S ■ ■ . . 2.2 „ • • • <3 • • ^ 

1. .11 .Miii...|ii|.|,ii 11 

•1^^- lull ^llllll ililjil ii|| 



30 





M « H 
B B m 
O ** < 
w o °° 


H 




w 




f^ 




1 




% 




<N 




o 

3 

o 

§ 
o 

< 


H 


1 1^1 1 1 1- 111 -H^ 1 1 1 


00 




?=; 




1 


§ 


1 1- 1 1 1 I.H III ^^111 


X 


o 


w o 5 H 


H 




Ifl 


Y 


fe 




-^ 


O 


§ 




■* 




<2 

" H W 
^ « & 


H 


-1 1 1 1 1 1 1 111 1 1 1 1 1 


•* 




(ii 


^1111111 111 11111 


M 


i 




IN 


:3S 

•< to 


y 




CO 


_o 


fe 


1 1 1 1 1 1 1 1 111 1 1 1 1 1 a> 


1 


^ 




g 


^62 

w S « 


H 


1^ 1 1 1 1 1 1 111 1 1 1 1 1 


s 


f^ 




lO 


5J 


i 


1 1-1 1 1 1 1 1 1 III 1 1 1 1 1 '4< 


H 

s 

CO 


H 


' " ' " ' " ' 


IM 


'tS 


(i; 


' ' ' ' ' ' ' ' 


o» 




^ 




00 


Oh 


H 

<; 
S 
P 


H 




- 




P^ 




1 


§ 




'^ 




H 




n 

<N 


CO 


fc; 


rM 1 1 1 1 ^rHrt 1 rtrt 1 1 1 1 rt 


o> 


s 


1 rtM^-H 1 1 -( rt 1 1 rt-Hrt^ 1 


(N 
M 


CO 

T— 1 

P5 
< 


m 
Q 


P 

<; 
O 




s i'"' 1 % 

•St S ^ .2 

«-i--g" |-" |■l"■■ 
^1 Sb^^.-J 1 ii sg§ -1:5 


"3 
o 



31 



►2 < 



I I I 1 I I 'H 



2g 



•J 2 
ta ■< S5 

" H H 

p 



^§ 



<! O 15 

352 
!5 K £: 



■M.-^ I I I 



■* ■* iM (M tH ifl Tjl^l-HOO 



i-HTt<i-l I I lO COi-lT-li-l 



a w 

P a < 
J ■? ■? 



Is 



o a 03 -9,-s 2 2 

a, o o g*s-5 a ■-« 

Sad 2 « sis^S « 

C?63 o! OS'S O-S-^ o 



•2 °.^ 03 03 

fe £ S M 0.O, 



■5 o: 

i--s'i • • • 

s^ « p 1^ en C 

la '-' o cnT3 C 1l 
2^ "^ tH fli S^ .— M 



> 






I s fil' 



^ M S3 * S m " 
''-3 c3 o.iS >- 

.2S£c.«-a 
•a Si © o5 1- 
i-i a ti t< h ■« 

C3 Qi « J3 oi:^ 



S3 
"e.2 S " 

° 3 e S 
3 fS -.5 



O 0.3 § 

o t- t^ 2 
"III 

b o 3 3 



32 



P.D. 23. 











•* 






c^ 




S 




IN 






H 


1 1 1 1 1 t i 1 <-( 1 1 1 1 t *-H 1 


ifS 


nS 


fe 




® 




§ 


1 1 1 1 1 1 1 1 ^11 1 1 1^ 1 


» 


o 




H 




C<3 


1 


&; 




1 


1 

Si 


s 




CO 


o 


H 




- 




&; 




1 




§ 




-^ 


;5 "3 
o 


H 







o 


fe 




■* 




§ 




-^ 






H 




CO 


fe 


1 1 1 1 1 l-H^ l^-H 1 1 1 1 1 


CO 
IN 




^ 


' "— ^' ' --' ' 


g 


H O ^ 

P 15 ;< 
►J •< 3 
J "^ 

►2S 


H 


1 1 1 1 1 1 1 1 1 - 


t^ 


^ 
'w 


pci 


1 1 1 1 1 1 1 1 III 1 i 1 1^ 


t^ 




S 




1 


s 


Q 


E-i 


11111-11 111 11111 





P^ 


1 1 1 1 1- 1 ' 


CO 




S 


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


t^ 


00 
CO 

H 

n 
< 


Q 

b 
O 

P 




• • • g ■ • 4 

1 S... Q 

1 • - .§ • • ■ 1 -^ • • • 

|..i..g.. 1... i.i... 

-.2 -I -^^ • ■ ^ • ■ • § .2 ■ • •■ 

•-.tlo«o3o3o3_t3 00J03 SosSuS 






33 



^1 


H 


1 1 1 OO-H 1 1 OqiN 1 1 1 1 (Nrfi 1 rt 1 1 1 m-H 




fa 


lllcoiilll iiiiiMm:illi.-Hi 


o> 


§ 


: 1 1 lO-H 1 1 <N(M 1 1 1 1 1 -H 1 ^ i 1 1 iMrH 


lO 






H 


1 1 1 CO 1 1 1 1 1 II ^^ 1 -* 1 1 1 1 1 1 1 


(N 


fa 


1 1 1 ^ 1 1 1 1 1 1 1 1 1 1 Cs| 1 1 1 1 1 1 1 


CO 


§ 


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P.D. 23. 

Table 18. — Total Duration of Hospital Life of Patients dying in Hospital 
classified according to Psychoses. 



35 



Psychoses. 


Total. 


Less than 
1 Month. 


1-3 

Months. 


4-7 

Months. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


1. Traumatic ..... 

2. Senile 

3. With cerebral arteriosclerosia 

4. General paralysis 

5. With cerebral syphilis . 

6. With Huntington's chorea 

7. With brain tumor 

8. With other brain or nervous diseases 

9. Alcoholic ..... 

10. Due to drugs and other exogenous 

toxins ..... 

11. With pellagra .... 

12. With other somatic diseases . 

13. Manic depressive 

14. Involution melancholia 

15. Dementia prsecox 

16. Paranoia or paranoid condition 

17. Epileptic ..... 

18. Psychoneuroses and neuroses 

19. With psychopathic personality 

20. With mental deficiency 

21. Undiagnosed .... 

22. Not insane ..... 

Totals . . 


1 

8 

24 

30 

2 

4 
8 

2 

7 

20 

1 
1 

3 
9 
2 

122 


19 

15 

9 

2 

1 

3 

7 

23 

4 

6 
2 

91 


1 
27 
39 
39 

4 

5 

8 

2 
10 

7 

43 

5 

1 

3 
15 
4 

213 


6 
4 

1 

2 
1 

1 

3 
18 


3 

1 

1 
5 


9 

4 

1 

2 
1 
1 
1 

4 
23 


2 

2 
4 
1 

1 

2 
1 

1 
14 


2 
3 
2 

2 
2 

11 


4 
5 
6 

1 

1 

4 
2 
1 

1 
25 


2 
4 
3 

1 

2 

1 

1 

14 


5 
3 

1 

2 
11 


7 
7 
4 

1 

2 

1 
3 

25 



Table 18. — Total Duration of Hospital Life of Patients dying in Hospital 
classified according to Psychoses — Continued. 



Psychoses. 


8-12 

Months. 


1-2 

Years. 


3-4 

Years. 


5-10 

Years. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


1. Traumatic ..... 

2. Senile 

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 

9. Alcoholic ..... 

10. Due to drugs and other exogenous 

toxins ..... 

11. With pellagra .... 

12. With other somatic diseases . 

13. Manic depressive 

14. Involution melancholia 

15. Dementia prsecox 

16. Paranoia or paranoid condition 

17. Epileptic ..... 

18. Psychoneuroses and neuroses 

19. With psychopathic personality 

20. With mental deficiency 

21. Undiagnosed .... 

22. Not insane ..... 

Totals 


2 
1 

1 
4 


3 

2 
2 

1 

- 
1 

9 


3 

4 
3 

1 

1 
1 

13 


2 
4 
9 

1 

1 

2 
1 

1 
3 

24 


6 
3 
3 

3 

_ 

15 


8 

7 

12 

1 

1 

5 
1 

1 
3 

39 


1 

4 
3 

2 

1 

1 
7 
1 

1 
3 

1 

23 


2 
1 
1 

2 
2 

1 

1 

1 

11 


3 
5 
4 

2 
1 

1 
2 
9 
1 
1 

1 

1 
2 

34 


1 
1 

5 

1 
1 

1 
3 

2 
1 

14 


1 
1 

5 

1 
9 


1 

1 

5 

1 

2 
1 

1 

8 

1 
2 

23 



36 P.D 

Table 18. — Total Duration of Hospital Life of Patients dying in Hospital 
classified according to Psychoses — Concluded. 


. 33. 


Psychoses. 


10-15 

Yeahs. 


15-20 

Yeaks. 


20 Years 
AND Over. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


1. Traumatic ..... 

2. Senile 

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 

9. Alcoholic ..... 

10. Due to drugs and other exogenous toxins 

11. With pellagra .. .' . 

12. With other somatic diseases . 

13. Manic-depressive 

14. Involution melancholia 

15. Dementia praecox 

16. Paranoia or paranoid condition 

17. Epileptic ..... 

18. Psychoneuroses and neuroses 

19. With psychopathic personality 

20. With mental deficiency 

21. Undiagnosed .... 

22. Not insane ..... 




1 

1 

1 


1 

5 
1 

1 


1 

1 

5 
1 

1 


1 
3 


1 

1 
1 

2 
2 


1 

1 

1 
1 
5 
2 


3 


6 


9 


Totals 


4 


7 


11 


4 


7 


11 


3 


6 


9 

























Table 19. — Family Care Department. 








M. 


F. 


T. 


Remaining Sept. 30, 1923 . 




_ 


19 


19 


Admitted within the year . 










— 


8 


8 


Nominally returned from visit for disc 


large 








— 


4 


4 


Whole number ot cases within the yea 










— 


27 


27 


Dismissed within the year . 










— 


10 


10 


Returned to the institution 












- 


9 


9 


Discharged . 












- 


- 


- . 


Died .... 












— 


- 


— 


Visit .... 












- 


1 


1 


Escaped 












- 


- 


- 


Remaining Sept. 30, 1924 . 












— 


17 


17 


Supported by State 












- 


9 


9 


Private 












— 


5 


5 


Self-supporting 












- 


3 


3 


Number of different persons within th 


3 year 








— 


26 


26 


Number of different persons admitted 










— 


7 


7 


Number of different persons dismissed 










— 


8 


8 


Daily average number 










— 


19.95 


19.95 


State 










— 


11.08 


11.08 


Private .... 










- 


5.28 


5.28 


Self-supporting 










- 


3.59 


3.59