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

6 



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University of IVIassachusetts Amherst 



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Public Document No. 23 -^ 



®ljf Olommottturaltli of MuBBUtiinBtttB 



ANNUAL REPORT 



OF 



THE TRUSTEES 



OF THE 



Worcester State Hospital X^,^a.\ 



FOR THE 



YEAR ENDING NOVEMBER 30, 1928 



Department of Mental Diseases 




Publication of this Document approved by the Commission on Adminibtbation and Finance 
500 12-'29. Order 7632. 



"k 






WORCESTER STATE HOSPITAL. 

BOARD OF TRUSTEES. 
Edward F. Fletcher, Chairman, Worcester. 
William J. Delahanty, M.D., Worcester. 
Anna C. Tatman, Secretary, Worcester. 
Howard W. Cowee, Worcester. 
John G. Perman, D.M.D., Worcester. 
Josephine Rose Dresser, Worcester. 
William J. Thayer, Worcester. 

MEDICAL STAFF. 
William A. Bryan, M.D., Superintendent. 
Francis H. Sleeper, M.D., Acting Director Clinical Psychiatry. 
Michael J. O'Meara, M.D., Senior Assistant Physician. 
Clifton T. Perkins, M.D., Senior Assistant Physician. 
S. Spafford Ackerly, M.D., Senior Assistant Physician. 
Jacob Goldwyn, M.D., Senior Assistant Physician. 
Arthur T. Whitney, M.D., Assistant Physician. 
Morris Yorshis, M.D., Assistant Physician. 
Cesareo De Asis, M.D., Assistant Physician. 
Nathan Baratt, M.D., Assistant Physician. 
Lyman Orten, M.D., Assistant Physician. 
Alfred J. Normandin, D.M.D., Dentist. 

VISITING STAFF. 
Ernest L. Hunt, M.D., Surgeon. 
William H. Rose, M.D., Surgeon. 
Benjamin H. Alton, M.D., Surgeon. 
Carleton T. Smith, M.D., Surgeon. 
M. M. Jordan, M.D., Neurologist. 
RoscoE W. Myers, M.D., Ophthalmologist. 
Philip H. Cook, M.D., Roentgenologist. 
Oliver H. Stansfield, M.D., Internal Medicine. 
E. C. Miller, M.D., Internal Medicine. 
Lester M. Felton, Genito-Urinary Surgery. 
Joel M. Melick, M.D., Gynecologist. 
Roy G. Hoskins, M.D., Ph.D., Research. 

HEADS OF DEPARTMENTS. 
Jessie M. D. Hamilton, Treasurer. 
Herbert W. Smith, Steward. 
William P. Boyd, Engineer. 
Anton Svenson, Foremen Mechanic. 
Wallace F. Garrett, Uead Far/ne^. 
Lillian G. Carr, Mairon. 
Anne F. McElholm, R.N., Superintendent of Nurses and 

Principal of Training School. 
Maurice Scannell, Supervisor, Male Department. 



P.D. 23 3 

TRUSTEES' REPORT. 

To His Excellency the Governor, and the Honorable Council: 

The Trustees of the Worcester State Hospital respectfully submit the ninety- 
sixth annual report of the hospital, together with a record of the various depart- 
ments, as given by the Superintendent, Dr. William A. Bryan, and a report of the 
Treasurer, Miss Jessie M. D. Hamilton. 

During the year two new members of the board were appointed. Mr. William 
J. Thayer of Worcester wa"s appointed to fill the vacancy made by the death of 
Mr. Luther Greenleaf, and Mrs. Josephine Rose Dresser was appointed to fill the 
vacancy caused by the resignation of Miss Caroline M. Caswell. 

The board has watched with a great deal of interest the operation of the new 
cafeteria dining room, which was opened in October, 1927. It is with much satis- 
faction that we comment on this marked improvement in the arrangements for 
the service of food. The menus served are varied, the food is well prepared, and 
the patients have almost unanimously registered their commendation of the new 
service. 

There are two features of the medical service of this hospital which deserves 
mention and which the board is heartily in favor of. First, the enlargement of 
the program of teaching, which has been going on for the past two years. We are 
more and more of the opinion that the hospital can be developed into a teaching 
center for groups of individuals, who are in psychiatric work or general medical 
work. The courses being given Affiliating Nurses from General Hospitals, Psy- 
chiatric Social Workers from Smith College, the Occupational Therapists from the 
Boston School of Occupational Therapy, and Theological Students from the various 
seminaries have been productive of great good. The presence of a large number 
of students in the hospital organization has tended to raise the morale of the 
personnel, and we feel that these young men and women leave the hospital and go 
into the community with a better understanding of the work and ideals of a State 
Hospital. 

The second point is the development and elaboration of the work which the 
hospital is doing in the community. The board desires to register satisfaction in 
the development of the Child Guidance Clinic. The clinic is an attempt to prevent 
the onset of mental disease at the time when such effort brings the greatest results. 
It is our recommendation that a further extension of this community work be 
carried out, and that some special appropriation be given for increased personnel 
and organization. 

The policy of the Commonwealth in providing suitable quarters for medical 
officers is in the opinion of the board a proper one, and the two new cottages which 
were granted the hospital last year are rapidly nearing completion. It is recom- 
mended that a continuation of this program be carried out until the medical 
officers have been provided with proper living accommodations. 

Attention is called to the necessity of revising the dining room accommodations 
at the Summer Street Department. A study o f this matter should be made at 
an early date, and the cafeteria service be put into operation in that department. 
The present dining rooms could be abandoned and some additional space thus given 
for patients, and a central cafeteria established in the section of the building under 
the chapel. Some construction work will be necessary before this can be done, 
but it is our belief that the development of the cafeteria system of feeding should 
be continued until all departments of the hospital are using it. 

Attention is again called to the necessity of a study of the storage facilities at 
this hospital. Our basement rooms where our stores are now located are not 
adequate, and a considerable loss is entailed from this source. It would seem that 
a proper store building would be in the interests of economy. 

The board takes this opportunity of extending to the officers and employees 
of the hospital, its hearty thanks for their splendid co-operation and loyalty during 
the year. 

Respectfully submitted, 

Edward F. Fletcher, William J. Delahanty, 

Josephine Rose Dresser, Anna C. Tatman, 

Howard W. Cowee, John G. Perman, 

William J. Thayer, Trustees. 



4 P.D. 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 November 30, 1928, it being the ninety-sixth annual report. 

There remained on the hospital books October 1, 1927, 2,630 patients, 1,323 
men and 1,307 women. Six hundred and fifty-seven patients, 376 men and 281 
women were discharged from the hospital. Of this number 328 patients, 192 men 
and 136 women were discharged; 290 patients, 159 men and 131 women died, and 
39 patients, 25 men and 14 women were transferred, leaving at the end of the 
statistical year, 2,593 patients, 1,290 men and 1,303 women. Two thousand two 
hundred and twenty-two patients, 1,060 men and 1,162 women were actually in 
the institution. Of the patients discharged, 27 were reported as recovered; 185 
as improved; 78 as unimproved; and 38 without psychosis. 

Twenty-four men were transferred by the Department of Mental Diseases to 
the Veterans' Hospitals; 2 women to the Boston State Hospital; 3 women to Med- 
field State hospital; 2 women to Foxboro State Hospital; 2 women to Northampton 
State Hospital; 3 men to the State Infirmary; 1 woman to Westborough State 
Hospital; 1 man and 1 woman to the Gardner State Hospital; 3 women to Herbert 
Hall; and 1 man and 1 woman to Concord. Eleven men and 5 women were re- 
moved from the State, and 2 men and 5 women were deported. 

There remained in the hospital at the end of the statistical year 37 patients less 
than at the beginning. The smallest number under treatment on any one day 
was 2,221 and the largest 2,306. The daily average was 2,248 . 32. 

Principal Causes of Death. 
Twenty-three percent of all deaths were due to arteriosclerosis; 10 percent to 
pulmonary tuberculosis; 9 percent to cardio vascular renal disease, and 8 per- 
cent each to general paralysis and nephritis. 

Ex-Service Men. 
During the year there were 29 ex-service men admitted to the hospital; 1 died; 

5 were discharged; 24 transferred to other institutions, and 14 dimissed, leaving 
at the end of the year 49 ex-service men in the institution. 

To all who have contributed gifts and entertainments for the ex-service men, 
I hereby extend my hearty thanks. 

Staff Changes. 
Resignations. 
Lewis B. Hill resigned to go to the State House, Sept. 3, 1928. 
Henry B. Moyle resigned to go to Hartford May 30, 1928. 
Arthur C. Brassau resigned to go to Memorial Hospital, December 12, 1927. 
Auray Fontaine resigned to go to Delaware Hospital, July 31, 1928. 
Sarah M. J. Ching resigned to go to St. EUzabeth's Hospital, Washington, D. C, 

October 31, 1928. 
Olive N. Ehrenclou resigned to go to Johns Hopkins University, September 29, 1928. 
Reginald P. McKinnon resigned to go into private practice, October 15, 1928. 

Appoint77ients. 
Clifton T. Perkins appointed Senior Physician February 2, 1928. 
Nathan Baratt appointed Assistant Physician June 25, 1928. 
Morris Yorshis appointed Assistant Physician August 1, 1928. 
Lyman Orton appointed Assistant Physician October 1, 1928. 

Internes. 
Bardwell H. Flower appointed Clinical Assistant September 1, 1928. 
William F. Finnegan appointed Clinical Assistant October 1, 1928. 

Report of the Medical Staff — Psychiatric Service. 

In addition to the routine psychiatric work of the hospital which has been 
increased very materially by the greater care with which patients have been studied, 
the plan of carrying on the training of various groups of students during the year 
has been continued. 

The policy of having resident students is one that, in my opinion, is well worth 



P.D. 23 5 

while. These students tend to raise the scientific spirit of the entire institution. 
Their influence reaches into all departments. 

The same plan of organization of the Medical Staff has been continued, namely, 
the separation of the pure medical and surgical work from the psychiatric work; 
the latter being used as an added aid to the psychiatrist. 

The following report of publications will indicate the lines along which our 
psychiatric interests have been developed during the year : 
Dr. Lewis B. Hill — Hospital Social Service, XVHI, 1928, 447 — "The Value 

of Occupational Therapy in Mental Hospitals." 
Miss Theodora Land — Occupational Therapy and Rehabilitation, Vol. VII, 
No. 6, Dec, 1928 — "Psychiatric Social Work." "Psychiatric Social Work 
and the State Hospitals" — Prepared by a committee of which Miss Land is 
chairman. 
Dr. Jacob Goldwyn — Archives of Neurology and Psychiatry, Jan., 1928, Vol. 19 
— "The Erythrocyte Sedimentation Reaction." 

American Journal of Psychiatry, Vol. VIII, No. 1, July, 1928 — "The Sedi- 
mentation Test." 
A. T. BoisEN — Alumni Bulletin of the Union Theological Seminary, Vol. Ill, 
No. 4 — "An Experiment in Theological Education." 
The Chicago Theological Seminary Register, Vol. XVII — "Explorations of 

the Inner World." 
Religious Education, April, 1928 — "The Study of Mental Disorders as a 

Basis for a Program of Moral and Religious Re-education." 
Religious Education, March, 1928 — "The Psychiatric Approach to the Study 

of Religion." 
The American Journal of Sociology, Vol. XXXIII, 1928 — "The Sense of 
Isolation in Mental Disorders: Its Religious Significance." 
D. Shako w and G. H. Kent — Pedagogical Seminary and Journal of Genetic 
Psychology, 1928, 35, 595-618 — "Group Tests for Clinical Studies." 



Report of Medical and Surgical Service 






Movement of Population. 






Female. 


Male. 


Total. 


Patients remaining Dec. 1, 1927 .... 127 


110 


237 


Admitted 440 


506 


946 


Discharged ....... 349 


353 


702 


Deaths 99 


122 


221 


Escapes ........ 


13 


13 


Patients remaining Dec. 1, 1928 . . . .119 


128 


247 



69 more patients were taken care of on the medical wards this year than in the 
preceding year. Also, during the dysentery epidemic, one psychiatric ward. 
Woodward I, was taken over by the medical service and approximately 75 patients 
were cared for on this ward. 

Reports of Clinics. 

Ear, nose and throat examinations, 519; eye, 230; gynecological, 360; bloods, 
840; vaccines, 1,334; lumbar punctures, 332; Wassermann, 241; Schick test, 12; 
Bromsulphthalein tests, 29; specific treatments, 1,713; ward dressings, 36,068. 
Total, 41,678. 

In the Eye, Ear, Nose and Throat Clinic, 194 more examinations were made 
than in the preceding year, and 559 fewer inoculations were given than last year. 

Other clinics maintained the average volume of work. 

Malarial Inoculation. 

Number of patients inoculated for first time, 31; number of "takes," 29; number 
of "non-takes," 2. 

Number of patients now on visit, 2; number of relapses after visit of several 
months, 2; number of patients markedly improved but still in hospital, 7; number 
of patients slightly improved, 2; number of patients not improved, 11; number of 
deaths, 9. 

Total number of deaths, 9; number directly attributed to malaria, 5, or 16%; 
number due to suicides, 2, or 6%; number due to pneumonia, 1, or 3%; number 
due to other condition (heart), 1, or 3%. 



6 P.D. 23 

Report of Malarial Therapy. ' 

Another case of rupture of the spleen, spontaneous, occurred during the past year 

which brings the total number of patients presenting this syndrome up to three, 

in a total of 110 patients given the malarial treatment for general paralysis of the 

insane. 

This accident has only been reported in the literature three times, but our 

experience would suggest that the condition is not uncommon. 

SuKGicAL Report. 

Hysterectomy, 9; pan-hysterectomy, 1; hysterectomy and appendectomy, 2 
hemorrhoidectomy, 10; rib resection, 2; dilatation and curettage, 13; hydrocele, 1 
herniorrhaphy, 8; double herniorrhaphy, 1; bilateral inguinal herniorrhaphy, 1 
splenectomy, 1 ; appendectomy, 21 ; salpingectomy, 1 ; circumcision, 5; tonsillectomy 
74 ; breast amputation, 2 ; amputation of hand, 1 ; gastrotomy, 6 ; cholecystectomy, 3 
gastro-enterostomy, 4; P. 0. hemorrhage repair, 2; trachelorrhaphy, 6; trachelor- 
rhaphy, perineorrhaphy and hemorrhoidectomy, 1; perineorrhaphy, 5; partial 
removal of scrotum, 2; exploratory laparotomy, 5; open reduction of humerus, 2; 
removal of ovarian cyst, 1; pylora-plasty, 2; excision of rectal fistula, 1; trachelor- 
rhaphy and perineorrhaphy, 2; ventral suspension, 3; repair of prolapsed rectum, 2; 
removal of bands after open reduction, 1; mastoidectomy, 3; skin graft, 1; vari- 
cotomy, 1; simple enucleation 0. D., 1; incision and drainage of peri-nephritic 
abscess, removal of kidney calculus, incision and drainage of peri-costal abscess 
and curettage of the rib; resection of right and left ovary, 1; sub-mucous re- 
section, 4; incision and drainage of abscess, 12; incision and drainage, 1; excision 
of epithelioma of lip, 1; excision of ingrown toe-nail, 1; excision of carbuncle, 10; 
excision of carcinoma of vulva, 1 ; removal of nasal polypi, 1 ; incision hordeolum, 1 ; 
biopsy, 1; antra drained and irrigated, 4; resuturing abdominal incision, 4; curette- 
ment of incision, 2; incision of tendon sheath infection, 2; cauterization of cervix, 5; 
abdominal paracentesis, 1 ; thoracentesis, 1 ; excision of wen, 2; suturing of tonsil, 1 ; 
multiple puncture of penis, 1; ischio-rectal abscess and fistula in ano, 1; ether 
reduction of fracture and dislocation of shoulder, 1 ; suturing of laceration, 1 ; removal 
of chalazion, 1 ; application of casts, 13; slitting of canaliculus, 1 ; total, 282. 

The total number of operations performed this year was 282 as compared with 
last year's 330 operations. 

Obstetrical Report. 

Number of obstetrical cases, 9; number of babies (two sets of twins), 11; number 
of still births, 1 ; abnormalities, 0; number of deaths of mothers or babies, 0. 

Dental Report. 
Patients, 3,580; cleanings, 1,761; examinations, 1,282; fillings, 1,963; extractions, 
2,495; treatment of pyorrhea, 290; abscess and socket treatment, 290; bridges, 12; 
inlays, 23; crowns, 17; removal of cyst, 1; ectomy alveolar, 73; plates, 42; repairs 
to plates, 58; impactions, 25; set and wire fractured jaw, 2; pressure anesthesia, 15; 
apicoectomy, 1; ether cases, 7; X-ray, 89; treatments, 537; gas-oxygen cases, 1; 
gas-oxygen and other cases, 2; total, 12,566. 



X-Ray Report. 



Ankle 

Chest 

Femur 

Elbow 

G. I. Series 

Mastoids 

Humerus 

Stomach 

Shoulder 

SeUa 

Skull 

Sacro-iliac 

Teeth 



ients. 


Films 


27 


32 


222 


234 


4 


5 


9 


10 


70 


540 


8 


16 


5 


6 


3 


5 


22 


33 


41 


41 


48 


192 


2 


10 


148 


541 



P.D. 23 

Leg . 

Hip . 

Wrist 

Abdomen . 

Fingers 

Hand 

Heart 

Pelvis 

Rib . 

Sinuses 

Appendix . 

Colon enema 

Foot 

Flat abdomen . 

Forearm . 

Gall bladder 

Arm, upper 

Knee 

Lumbar spine 

Kidneys . 

Spine 

Arm 

Mandible . 

Neck 

Nose 

Post-ethmoid sinuses 

Thumb . 

Antra 

Epiphyses 

Spine lumbar and thorax 

Toe . 

Thymus . 

Colon 

Fluoroscopic examination 

Clavicle 

Lateral skull 

Jaw . 

Os calsis . 

Total 

The X-ray work in the past year has more than doubled over that of previous 
years. The quality of the work has been excellent and of inestimable benefit to 
the staff. 

Laboratory Report. 

Alveolar CO, 157; autopsies, 121; bacterial cultures, 134; bacterial smears, 359; 
basal metabolism, 379; blood creatinin, 374; blood N.P.N., 518; blood sugar, 870; 
blood urea, 438; blood uric acid, 421; blood counts (red), 2,161; blood counts 
(white), 2,315; blood counts (differential), 2,315; clotting time, 191; galactose 
tolerance, 391; nitrogen partition, 349; plasmodia malaria, 94; renal function test, 
342; spinal fluid albumin, 5; spinal fluid cell count, 319; spinal gold, 307; spinal 
globulin, 301; sputum, 205; stool, 289; urea curves, 105; urinalysis, 4,567; quanti- 
tative sugar, 39; milk bacteria count, 15; Mosenthal test, 19; haemoglobin, 205; 
animal inoculation, 1; stomach contents, 9; Widal test, 6; milk butter fat (%), 48; 
platelet count, 6; parasites, 4; blood cultures, 19; fragility test, 2; Van den Bergh, 
108; icteric index, 18; vomitus, 2; vital capacity, 146; spinal fluid (sugar), 1; 
occult bloods, 70; agglutinins, 224; liver function test, 26. Total, 18,895. 

The laboratory work for the past year has practically doubled. Most of this 
extra work has occurred as a result of the present routine handling of cases. Also, 
various research projects have increased the volume of work turned out by the 
laboratory. The Memorial Foundation for Neuro-Endocrine Research has 



tients. 


Films. 


11 


11 


25 


28 


8 


8 


8 


10 


15 


15 


19 


21 


24 


24 


6 


6 


17 


23 


64 


131 


1 


1 


4 


4 


12 


19 


1 


1 


6 


6 


21 


115 


1 


2 


23 


42 


2 


2 


6 


10 


12 


16 


3 


3 


3 


4 


1 


1 


2 


3 


2 


2 


9 


9 


2 


4 


1 


1 


1 


1 


1 


1 


4 


6 


9 


24 


16 





2 


2 


1 


2 


5 


7 


1 


2 


959 


2,232 



8 P.D. 23 

loaned a new Benedict Basal Metabolism apparatus, and also a new Bausch and 
Lomb Colorimeter. Thanks are due Dr. A. W. Rowe, Dr. B. S. Walker and Dr. 
R. T. Hunt of the Evans Memorial Hospital for technical advice on several oc- 
casions during this period. 

Physical Examination of Employees. 

On July 1, 1928, a system was established whereby each new employee is given 
a fairly complete physical examination on entry to the hospital service. The 
object of these examinations is twofold. 

First, to eliminate immediately such applicants as are obviously too great 
physical risks in doing the work for which they are hired. As, for example, a farm- 
hand is not a good working risk if he has a hernia, a fireman with hypertension, 
an attendant with marked varicose veins or large cryptic tonsUs, etc. Such 
potential disabilities, though not in themselves serious, might well lead to short 
frequent periods of disability and in the end seriously handicap the service. 

Secondly, to have in the files a record of the general condition of each employee 
to refer to in event of future sickness. This is for the benefit of both the employee 
and the hospital, and in actual practice has been found very useful. We are slowly 
progressing in this system to a point whereby an applicant is accepted on trial, or 
probation for two weeks. During this time he receives his vaccine and physical 
examination. If his examination is satisfactory and his work acceptable, he is 
then considered as an employee. This, we hope, will ultimately lead to a healthier 
group of employees, a more stable population, and better service for the patients. 

From July 1st to December 1st, a total of 136 such examinations were com- 
pleted. It is too early for a statistical survey of any value on these employees. 

Schick and Dick Tests. 

Realizing the inestimable value of preventive medicine, applicable particularly 
to those handling patients in a large institution, we performed the Schick test for 
diphtheria and the Dick test for scarlet fever on 13 senior nurses in October, 1928. 
It is the intention of the medical service, with Co-operation from the Training 
School for Nurses, to Schick and Dick each nurse as she is accepted after the 
probation period, and where the tests indicate the necessity, to immunize them 
against diphtheria and scarlet fever. This will be not only to the benefit of the 
nurses but also to the hospital, in that should there be an outbreak of the above 
diseases at any time, our essential ward force would not be incapacitated. 

All new employees have also had typhoid-para-typhoid inoculations. 

The four o'clock employees' clinic has been continued, and found to be of definite 
value in that the employees do not now stop physicians while carrying out their 
duties, asking for personal medical advice. 

Sick Employees Cared for on Medical Service. 
Total number of employees cared for on ward, 128; total number of days ward 
treatment given: Male, 509 days; female, 351 days. Total, 860. Number of males 
sick, 65; number of females sick, 63. 

Operations Performed on Employees. 
Appendectomy, 2; herniorrhaphy, 1; circumcision, 2; dilatation and curettage, 
1 ; resection of right ovary and left oophorosalpingectomy, 1 ; left salpingectomy, 1 ; 
freeing of volvulus, exploratory laparotomy, 1; hemorrhoidectomy ,_ 1 ; removal 
of gland under right arm, 1 ; biopsy, 1 ; suturing of laceration on lip, 1 ; incision and 
drainage of breast abscess, 1; excision of carbuncle, 2; tonsillectomies, 30. 

Reports of Deaths and Autopsies. 

Number of deaths at Bloomingdale, 234; number of deaths at Summer Street, 58; 
Total, 292. 

Number of autopsies performed: By Worcester State Hospital Staff, 103; by 
State Pathologist, 18. Total number of autopsies, 121 (41.4 of total deaths). 

Number of deaths every week, 5.6; number of autopsies every week, 2.3. 

The total number of autopsies as well as the percentage of permits obtained 
increased over last year. In the coming year, we hope to markedly increase the 
amount of histological work done in the laboratory. 



P.D. 23 9 

Research. 

The hospital is co-operating with the Evans Memorial in a study of certain phases 
of blood chemistry and carbohydrate metabolism in dementia prsecox. 

In the past year, a very large amount of work has been done in the study of 
dementia prsecox from several angles. We are in a position to state that several 
of the patients studied definitely have shown failure of certain endocrine glands, 
and some of these patients have responded favorably to indicated medication. 
This work has been done under the supervision of Dr. R. G. Hoskins, consultant 
in Therapeutic Research, and Dr. F. H. Sleeper of the resident staff, and has 
been participated in to some extent by nearly the entire staff. For many years 
exponents of the somatic school of psychiatry have attempted to tie up dementia 
prsecox with various somatic conditions. Cotton, with intestinal pathology; 
McCarthy, with focal infection; Mott, with testicular pathology, and numerous 
others have mentioned the possibility of the glands of internal secretion being at 
fault without, however, producing any convincing proof of their theory. 

Kopeloff and Kirby removed foci of infection from a large group of patients 
and used another group of the same size and same age suffering from the same type 
of psychosis as controls. There was no appreciable difference in the results obtained 
in the two groups. They concluded therefore that focal infection played a very 
small part in the development of the psychosis. 

At the Worcester State Hospital we have removed foci of infection from upwards 
of one hundred prsecox patients in the past year. Several patients seemed to 
improve following surgical removal of these foci. A few became well enough to 
return home. How much foci of infection plays a part in the etiology of the psy- 
chosis I am not prepared to say. The lymphocytosis, bradycardia, diminished 
metabolism and changes in carbohydrate tolerance all seem to offer promising 
endocrine leads. The necessity for research in prsecox is indicated by the fact 
that approximately half of all state hospital beds are filled by this type of patient. 
In terms of money, approximately ten cents of every dollar paid in taxes goes to 
the maintenance and care of patients suffering from this disease. The greater part 
of the research which has been attempted in prsecox has been limited to certain 
phases of the problem. For example, the explanation of the cyanosis which is 
so frequently encountered in the catatonic form of prsecox; likewise frequently 
a series of blood chemistries or nitrogen partitions on the urine will be reported 
as an interesting piece of negative evidence. Research of this sort is not of a great 
deal of value in this particular problem. The individual patient must be studied 
as a whole from all possible angles at the same time and the findings correlated in 
order to obtain the best results. The plan of approach elaborated by Dr. A. W. 
Rowe of the Evans Memorial with certain deletions and additions form the basis 
for the work attempted at Worcester in this field. 

A thorough history is obtained by the social service and by the doctor on the 
patient to be studied. Here is encountered one of our first difficulties. In a very 
large percentage of our patients, subjective evidence cannot be relied upon and it 
becomes necessary for us to depend to a very large extent upon information derived 
from relatives and friends and of course some of this is none too reliable. A 
thorough physical examination is done and here again difficulties are encountered. 
For example, in examining the patient's chest, we request him to breathe deeply 
and he holds his breath. We tell him to do one thing and he does exactly the 
opposite; an example of negativism. It becomes necessary to make repeated 
attempts in order to get satisfactory results. Teeth are thoroughly examined by 
a dentist. Certain X-ray studies are done routinely. The sinuses, sella turcica, 
chest, and gastro-intestinal tract are investigated by means of X-ray. Graham 
tests are performed if indicated. In the laboratory during a week to ten days 
study two phenolsulphophthalain tests are performed, complete blood morphology, 
complete blood chemistry, a nitrogen partition on two twenty-four hour urines 
with complete urinalysis, the urea curve is determined following the ingestion of 
15 grams of urea. The salol test for gastric motility is performed. Urobilinogen 
is determined in the urine. The galactose tolerance test is performed. The Van 
den Bergh test is being performed routinely now as well as the icteric index on each 
patient. The basal metabolism is done, and in this respect it may be noted that 
frequently as many as ten tests are necessary before satisfactory results are obtained. 



10 P.D. 23 

The Wassermann test is performed routinely and the spinal fluid examined for 
globulin, albumin, cell count, colloidal gold and Wassermann if indicated. Any- 
special tests that seem to be indicated are performed. It is possible that tests 
for the autonomic nervous system and studies in colloidal chemistry may likewise 
be included in the routine tests. At the time the physical studies are being carried 
out, a thorough psychiatric status is established. Daily notes by psychiatrist 
showing the mental condition of the patient and the state of the emotions as weU 
as can be determined are recorded. Up to the present time eighty patients have 
been thoroughly studied following out this line of procedure. Each patient's case 
has been thoroughly analyzed by the heads of the research, psychiatric and medical 
services and a joint conclusion arrived at. On this small series of cases, we are 
reluctant to publish any conclusions but we may say that a relatively high per- 
centage of patients have been found to be endocrine. Several of these patients 
have been placed upon appropriate medication and from time to time the complete 
picture will be rechecked from all angles following therapy. 

NuEsiNG Service. 

The training school has been continued as usual and in my opinion is one of the 
most valuable projects in the hospital. 

Miss Florence M. Wooldridge, who has been Superintendent of Nurses at this 
hospital for seven years, resigned during the year and Miss Anne McElholm was 
secured to carry on the work. Miss McElholm was the former Superintendent 
of Nurses at the Westboro State Hospital. 

The probation class carried an enrollment of twelve women and seven men. 
The class of affiliated nurses was carried on during the year, these young ladies 
coming from the general hospitals in this community. The training of these 
nurses is becoming an increasingly important part of our psychiatric activity. 

Religious Work. 

The plan of offering to students of theology opportunity to obtain clinical 
experience in dealing with the maladies of the personality was begun in 1925. 
These students as their practical contribution to the work in the hospital have 
carried on baseball, volley ball, hikes, special case work and the publication of a 
semi-weekly news sheet and a weekly pictorial. For the benefit of this group of 
workers semi-weekly conferences of two hours each are held in which members 
of the medical staff have given generously of their time. 

An important feature of the year's work has been the musical program developed 
under the direction of Rev. Donald Crawford Beatty, a recent graduate of the 
Boston University School of Theology, who came to this hospital as a theological 
student in the summer of 1927 and has remained for two years. Mr. Beatty is 
an exceptionally talented singer and choir director. He has taken an active part 
in the recreational program and has proved himself a most useful addition to the 
corps of workers in the hospital. He is soon to go as chaplain to the Mayview 
Hospital in Pittsburg, Pennsylvania. 

For the most part the students who take advantage of this opportunity go into 
the ordinary pastorate. These men are cautioned against the danger of trying 
to deal unaided with the advanced disorders and they are warned against "religious 
healing." The aim is rather to enable them through the study of the disordered 
conditions to understand better the personal problems of ordinary people in the 
ordinary parish and to kindle their interest in the careful, painstaking, long- 
continued study of personal experience. 

Some of these students, however, have decided to devote themselves to the 
disorders of the personality. In addition to Mr. Beatty, Miss Helen F. Dunbar, 
the first theological student to enlist, is this year finishing a regular course with the 
purpose of giving herself to psychiatry. Rev. Alexander D. Dodd, of the Class 
of 1922 in Union Seminary, who has for two years been doing work in this hospital, 
is now studying for the doctor of philosophy degree in Edinburgh. He is planning 
to take a hospital chaplaincy upon his return. Rev. Austin Philip Guiles, Union 
Seminary, 1925, is staying throughout the year, assisting in the Dementia Prsecox 
research project and trying to lay a scientific basis for the problem of personal 
religious work. 



P.D. 23 11 

In addition to teaching during the summer quarter at the Chicago Theological 
Seminary, the Chaplain, Mr. Boisen, will this year in conjunction with Dr. Lewis 
B. Hill, our former Assistant Superintendent, give a seminar course in psycho- 
pathology at the Boston University School of Theology. During the past year 
he has given six lectures at the Boston University School of Theology, four at the 
Episcopal Theological School in Cambridge, three at a summer conference at the 
Union Theological Seminary in New York. He has also lectured at the Crozer 
Theological Seminary in Chester, Pa., at the Virginia Theological School at Alex- 
andria and has given papers at a church workers' conference at the University of 
Pennsylvania, at the National Conference of the Religious Education Association 
in Philadelphia and at the Research Council of the Religious Education Association 
in Chicago. At the national conference of the American Sociological Society in 
Washington in December, 1927, the experiment with the cUnical year for theo- 
logical students was presented by Dr. Lewis B. Hill. 

Results of research work done in this department have appeared during the year 
in the American Journal of Sociology and in the Journal of Religious Education. 

The religious services have proceeded as usual. All Saints Church in Worcester, 
under the leadership of Rev. Henry W. Hobson, has aided greatly by taking charge 
of the service once each month in both hospitals. In addition they have held a 
special communion service once a month on Wednesday mornings. These services 
have been much appreciated by the Episcopalian patients as well as by many who 
are not Episcopalians. An important part of the religious work is the friendly 
contact with the patients through regular visiting on the wards. 

Our CathoUc Chaplain, Father George Dacey, has been zealous in his work 
with Catholic patients. 

Social Service Department. 

The work of this department has been characterized by a growing breadth of 
scope during the year of 1928. The development of our own work has brought 
to us the opportunity to pass on to others in similar work some of the fruits of our 
experiences here. It has been the growing conviction of the head worker that 
unless the hospital gives back to the community some of its findings as to the causes 
of personality difficulties it is failing in an important function. In the Child 
Guidance Clinic, conducted by the hospital, and in the hospital itself, our workers 
have an unusual opportunity to study some of the roots of personality maladjust- 
ment. We do not say that we have learned what causes mental disease, we do 
say that we are learning more and more from our patients regarding unwhole- 
some mental attitudes and how these warp men's lives. And so we have welcomed 
every opportunity to speak before groups. To this end, twelve addresses were 
given to various community groups, four being in Boston, before groups of social 
workers or those in allied professions. The others were to clubs and church groups 
in Worcester and vicinity. At the hospital three sets of eight lectures were given 
to the three classes of nurses in training. A lecture was given to Occupational 
Therapy Students and one to Theological Students here for summer work. A 
number of addresses have been scheduled for the following year. 

During the year ten visitors from England came to see the hospital. Most of 
them were engaged in some phase of social work or an allied profession and were 
eager to learn of the work of this department. It was a great joy to explain the 
work to such interested and appreciative visitors. 

In the effort to raise the standards of social work a sub-committee was formed 
of the American Association of Psychiatric Social Workers, and as chairman of 
this group, the head worker has been able to draw on her experience here and 
on that of the Massachusetts hospital in analyzing the situation and in working 
out plans for better standards. 

This year we have again co-operated with the Smith College School of Social 
Work in taking their students for training. Our quota of students was raised 
from two to four, and there has been a notable increase in the amount of work 
carried by the department because of the assistance of the students. The number 
of visits to patients "On Visit" from the hospital increased from 415 to 656, and to 
relatives of patients "On Visit" from 312 to 514. Aside from the actual contribu- 
tion in service we feel that the students are pre-eminently worth the time given for 



12 P.D. 23 

teaching them because of the stimulating ideas they bring to us, and because of 
the challenge which always comes with the presence of those eager to learn the ways 
of a new profession. 

This year there were 764 cases referred to the department, about 150 of which 
the social service had previously known. The number of referrals is slightly less 
than last year, although the amount of work done on cases has been much greater; 
141 cases were referred for histories, 164 for special investigations for diagnoses 
and 249 for investigations of the home situation prior to visit. There was an in- 
crease of about 100 in histories and special investigations. The usual number of 
"Visit" cases, about 240, were carried. 

Among the types of problems found we note 96 as against 50 of a year ago in 
which emplojTuent was a serious factor, 49 as against 36 with financial problems, 
31 as against last year's 48 with overt sex problems, 60 as against 64, in which 
friction and quarreling were outstanding, 52 as against 45 in which the marital 
difficulties were important. Alcoholism is still a definite problem here, there 
being 48 cases in which this was a factor, six more than the previous year. 

The Child Guidance Clinic has continued to develop in effectiveness and members. 
The four Smith students divided their 9 months' field training, each having 4^ 
months at clinic work and 4>^ months at hospital work. In September Miss 
Marion Wyman, trained at the N. Y. Institute for Child Guidance, came to take 
charge of the psychiatric social work, her salary being paid by the Welfare Feder- 
ation. She is proving a very capable worker and undoubtedly the clinic will be 
greatly strengthened by the addition of so effective a person. 

The Social Service seminars, under the able leadership of Dr. Lewis Hill, as- 
sistant superintendent, proved most stimulating and were valuable for the students 
as a link between theory and practice. Two hours a week evening sessions were 
held and were regularly attended, although attendance was not required. 

Community Work. 
Table of Cases Treated: 
Summer Street Out-Patient Clinic for Patients on visit, 228. 
Adult Guidance Clinic, 61. 

Traveling School Clinic for Retarded Children, 256. 
Worcester Child Guidance Clinic, 251. 
Total number of children and adults treated, 796. 
Total number of visitations, approximately, 1,250. 

The work of the Summer Street Clinic for patients out on visit from the hospital 
was carried on as usual, on the afternoon and evening of the second Monday in 
each month. While there seems to be an attitude on the part of many, that the 
Out-Patient Physician's request to interview them was for the sole purpose of 
sending them back to the hospital, others considered it an opportunity to talk over 
their troubles and to obtain advice offered to meet certain difficult situations. 
Oftentimes relatives came along to seek advice. 

Allied to this work is that done at the Adult Guidance Clinic. Regular hours 
on Tuesday and Thursday were set aside for interviews at the Memorial Hospital. 
Sixty-one visits were made, including twenty-seven young unmarried mothers, 
referred by the Girls' Welfare Society. Because of the pressure of the juvenile 
work, these Clinic hours at Memorial Hospital had to be given, over to the Child 
Guidance Work. Appointment for Adult consultation, however, went on just 
the same, only the hours were held in the evening to fit in with the physician's 
time. This is an important branch of the Out-Patient activities, and the Clinic 
with regular hours will be resumed, it is hoped, next spring. 

Perhaps the most significant department of the outside activities of this hospital 
is that devoted to the mental, emotional, and physical welfare of the child in the 
community. During the past year 507 children were examined and treated in our 
two clinics, namely, the Worcester Child Guidance Clinic, and the Traveling School 
Clinic. Approximately forty percent were referred from the school, and the rest 
from parents, physicians, the court, and the welfare agencies. There has been a 
marked increase in the number of children handled by the Clinic this year. More 
and more school children are being referred directly by the school teacher through 



P.D. 23 13 

their principal, and several of the teachers and principals attend this hour of clinic 
conferences during the year. 

A trained psychiatric social worker, Miss Marion Wyman, M.A., has been ap- 
pointed. Miss Wyman is a graduate of the Smith College for Psychiatric Social 
Workers, having had her classical training at the Institute for Child Guidance in 
New York City. Her coming in September has enabled us to increase the number 
of Youth cases and also to extend the follow-up work which is so important. She 
has also strengthened our contact with the schools and agencies by frequent visit- 
ation. Her personality, training, and experience make her a valuable asset to 
the Clinic. Following Miss Leahey's resignation to assume new duties as psychol- 
ogist at the newest Guidance Clinic, came a reorganization of the Psychological 
Department under Mr. David Shakow who with two student psychologists guaran- 
teed us adequate efficietit psychological service. 

In November the Worcester Welfare Federation voted us an increase of fifteen 
hundred dollars, expenses of a stenographer and supplies. New equipment in 
the form of testing apparatus and material has been secured for the Clinic, for the 
use of the psychologist. A library of books bearing on our work has been loaned 
by the City Library for circulation among parents and otheVs interested. At- 
tractive desk, chairs, steel filing cabinets with book cases to match have been 
purchased for the Clinic. Near the end of the year the Worcester State Hospital 
Nurses Alumnae Association conducted a bazaar and presented to the Child 
Guidance Clinic the sum of two hundred dollars. This growing interest on the 
part of the nurses in their hospital is indeed a gratifying endorsement of our work. 

On one or two days of each week of the School year the Out-Patient Physician 
with two Psychologists and a Social Worker conducted School Clinics on retarded 
children in neighboring towns. Physical, psychometric and psychiatric exami- 
nations were made on each child recommended by the Principal of the school, 
reports made on these cases, and recommendation to the school regarding each 
pupil. There were 256 children examined in the following towns: Marlborough, 
Uxbridge, East Douglas, Millbury, Westford, Shrewsbury, Hopkinton, Ashland, 
West Boylston, and Grafton. The results of these clinics are noticeable in placing 
children in their proper group and in facilitating the establishment of special classes. 

During the past year as in former years the Out-Patient Department has been 
committed to the program of educating the community in matters of mental 
hygiene. Dr. Alfred Adler of Vienna spoke on Child Psychology at the High School 
under the auspices of the Child Guidance Clinic. The University Extension courses 
in mental hygiene in Fitchburg and Lowell were also conducted. These together 
with College Club courses on child psychology, Y.M.C.A. group on questional 
adjustment problems and miscellaneous lectures constituted avenues through 
which knowledge of mental health can be offered to the community. 

General Repair Work. 

The regular repair work of the hospital has been kept up throughout the year, 
and the institution is in fairly good condition. Most of the wards in the hospital 
have been repaired during the year, and much general work has been done. The 
building for the cafeteria was completed in October, 1927, and the cafeteria for 
the patients and employees have been kept. We are now feeding approximately 
1,200 patients out of the 1,600 in the main group at the cafeteria, and it is our 
opinion that this method of service is by far the best way of handling the food 
situation with large groups of patients. By this method of service, we are able 
to give patients much better food, and greater variety and with a choice, something 
which would be possible in no other method. We have been able to do this, and 
in addition have cut down the waste to an almost unbelievable point. 

Recommendations: I am again recommending the establishment of a new farm 
unit, and a main hospital group. This recommendation has been made in previous 
reports, but the need is still urgent and should be taken care of at a very early 
date. Transportation is costly and difficult, particularly in the winter time, and 
the dairy equipment we have at the Hillside Farm is very poor and inefficient. 
I would again call attention to the necessity for the elimination of the remaining 
stairways of wooden construction. These stairs are a decided fire menace, and 
should be replaced by metal stairways. 



14 



P.D. 23 



We received in the early part of tlais year an appropriation of two officers' cottages, 
and these have been in the course of construction during tlie year. The work 
has proceeded rather slowly because we have built them entirely with our own 
mechanics, and at the same time have had to keep up the repair work of the hospital. 
This program should be continued until we have at least eight cottages along the 
avenue, housing members of the medical staff, and I will recommend that two more 
cottages be added to this group as early as possible. 

I wish to express my sincere appreciation for the work of the visiting staff of the 
hospital. This visiting staff is made up of busy practitioners in the community, 
who have given freely of their time and knowledge in carrying on the work of the 
hospital. I also ^vish to commend the loyalty and general efficiency of the officers 
and employees of the hospital. No success in anj^ organization is possible without 
such loyalty and I desire to express my appreciation to every officer and employee 
for their co-operation during the year. I also wish to thank the board of trustees 
for the support and encouragement which has been given me at all times. 

VALUATION. 

November 30, 1928. 
Real Estate. 



Land, 589 acres 
Buildings 



Travel, transportation and office expenses 

Food 

Clothing and materials 
Furnishings and household supplies 
Medical and general care 
Heat, light and power 
Farm .... 
Garage, stables and grounds 
Repairs .... 



Real estate 
Personal property 



Personal Property. 



Summary. 



.1438,200.00 
2,201,283.33 

$2,639,483.33 

$7,984 . 14 
13,906.36 
34,940.08 
274,278.89 
22,553.91 
18,691.28 
41,004.39 
13,780.87 
22,549.26 

$449,689.18 

$2,639,483.33 
449,689.18 



$3,089,172.51 

FINANCIAL REPORT. 

To the Deipartment of Mental Diseases: 

I respectfully submit the following report of the finances of this institution for 
the fiscal year ending November 30, 1928. 



Cash Account. 






Receipts. 






Board of Patients ........ 


. $112,603.54 


$112,603.54 


Personal Services: 




Reimbursement from Board of Retirement 




262.81 


Sales: 






Food 


$8.54.29 




Clothing and materials ...... 


76.92 




Furnishings and household supplies .... 


61.44 




Medical and general care ...... 


27.52 




Heat, light and power ...... 


40.50 




Farm: 






Cows and calves ....... 


343.43 




Pigs and hogs ....... 


17.34 




Hides 


203.74 




Vegetables ........ 


113.05 




Use of teams ....... 






Empties ........ 


. '. '. 2.15 




Garage, stable and grounds ..... 


8.80 




Repairs, ordinary ....... 


214.31 




Total sales ....... 




$1,963.49 


Miscellaneous: 






Interest on bank balances ..... 


$1,714.00 




Rent 


928.. 50 


2,643.10 






Total income ....... 


$117,472.94 



P.D. 23 

Maintenance. 
Balance from previous year, brought forward 

Appropriations, current year ...... 

Total 

Expenses (as analyzed below) ...... 

Balance reverting to Treasury of Commonwealth 

Analysis of Expenses. 
Pe rsonal 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 ..... 

Balance December 1, 1927 . 

Appropriations for current year .... 

Total 

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

Balance November 30, 1928, carried to next year 



Special Appropriations 



$24,392.43 
14.50 



15 

$13,983.94 

825,120.00 

$839,103.94 
820,840.26 

$18,263.68 

$411,877.26 

2,665.00 

9,872.76 

161,993.82 

18,786.39 

38,450.96 

41,705.39 

65.838.81 

30,314.88 

5,426.31 

21,322.07 

12,586.61 

$820,840.26 

$26,801.39 
12,000.00 

$38,801 39 

24,406.93 
$14,394 46 



Object. 


Act 

or 

Resolve. 


Whole 
Amount. 


Expended 

During 

Fiscal Year. 


Total 
Expended 
to Date. 


Balance 
at End 
of Year. 


Automatic Refrigeration . 
Equipment for Dining Room 
Boilers ..... 
Water Supply, Hillside Colony . 
Officers' Cottages 


1926-79 

1926-79 

1927-138 

1927-138 

1928-127 


$7,000.00 
5,000.00 

42,000.00 
4,500.00 

12,000.00 


$115.58 

112.70 

17,570.46 

6,593.69 


$6,988.22 

4,997.28 

37,511.85 

6,593.69 


$11.78* 
2.72* 
4,488.15 
4,500.00 
5,406.31 






$70,500.00 


$24,392.43 


$56,091.04 


$14,408.96 



Balance reverting to Treasury of the Commonwealth during year (mark item with*) 
Balance carried to next year .......... 

Total as above ............ 

Per Capita. 
During the year the average number of inmates has been 2,248.32. 
Total cost for maintenance, $820,840.26. 

Equal to a weekly per capita cost of $6.9825 (52 weeks to year). 
Receipt from sales, $1,963.49. 
Equal to a weekly per capita of $.0167. 
All other institution receipts, $115,509.45. 
Equal to a weekl per capita of $.9822. 
Net weekly per capita, $5.9836. 



$14.50 
14,394.46 



$14,408.96 



Respectfully submitted, 

JESSIE M. D. HAMILTON, Treasurer. 



STATEMENT OF FUNDS. 

Patient's Fund. 



Balance on hand November 30, 1927 
Receipts ..... 

Interest ..... 



Refunded .... 
Interest paid to State Treasurer 



Worcester County Institution for Savings 

Worcester Five Cents Savings Bank 

Worcester Mechanics Savings Bank 

Peoples Savings Bank 

Bay State Savings Bank 

Balance Worcester Bank and Trust Company 

Cash on hand December 1, 1928 



Inveslvnent. 



$15,889.06 

23,168.90 

764.51 



$19,719.83 
764.51 



$2,000.00 
2,000.00 
2,000.00 
3,000.00 
3,000.00 
7,206.80 
131.33 



$39,822 . 47 



20,484.34 
$19,338.13 



$19,338.13 



16 P.D. 23 

Lewis Fund. 
Balance on hand November 30, 1927 ....... $1,607.40 

Income 63.78 

$1,671.18 
Expended for entertainments, etc. .......... 108.19 

$1,562.99 
Investment. 
American Telephone and Telegraph Company collateral trust 4% bond . $926.36 

Millbury Savings Bank 634 . 26 

Balance Worcester Bank and Trust Company . . . . . . 2 . 37 

$1,562.99 

Wheeler Fund. 

Balance on hand November 30, 1927 $6,197.01 

Income 241.53 

$6,438 . 54 

Expended for entertainments, etc. .......... 348.20 

$6,090.34 
ItivestTnent. 
American Telephone and Telegraph Company collateral trust 4% bond . $712.50 

Grafton Savings Bank 4,000.00 

Millbury Savings Bank 1,374.22 

Balance Worcester Bank and Trust Company . . . . . . 3 . 62 

$6,090.34 

Manson Fund. 

Balance on hand November 30, 1927 $1,171.53 

Income . 43.60 $1,215.13 

Expended for entertainments, etc. .......... 45 . 00 

$1,170.13 

Investment. 

Millbury Savings Bank $1,162.80 

Balance Worcester Bank and Trust Company . . . 7.33 

$1,170.13 

Respectfully submitted, 

JESSIE M. D. HAMILTON, Treasurer. 

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

November 30, 1928. 

STATISTICAL TABLES. 
As Adopted by the American Psychiatric Association. 
Prescribed by the Massachusetts Department of Mental Diseases. 
Table 1. General Information. 

Data correct at end of hospital year, November 30, 1928. 

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

2. Type of irtstitution: State. 

3. Hospital plant: 

Value of hospital property: 

Real estate, including buildings . $2,639,483 . 33 

Personal property 449,689 . 18 

Total $3,089,172.51 

Total acreage of hospital, 589 . 16. acres 

Acreage under cultivation during previous year, 175.00 acres. 

4. Medical service: 

Men. Women. Totals. 
Superintendent ..........1 - 1 

Assistant Physicians ......... 10 - 10 

Medical internes .......... 2 - 2 

Dentist ............1 - 1 

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

5. Employees on payroll (not including physicians): 

Men. Women. Totals. 

Graduate nurses .......... 1 33 34 

Other nurses and attendants ........ 101 129 230 

All other employees 103 75 178 

Total employees 205 237 442 

6. Patients employed in industrial classes or in general hospital work on date of 

report 703 917 1,620 

7. Patients in institution on date of report (excluding paroles) . . 1,075 1,153 2,228 



P.D. 23 

Note: — The following items, 8-13, inclusive, are for the year ended September 30, 1928. 



17 



Census of patient population at end of year: 

Actually in Hospital. 



White: 
Insane 
Epileptics 
Mental defectives . 
Alcoholics 
All other cases 


M. 

. 1,015 

'. '. 13 
1 
5 


F. 

1,099 

3 

26 

1 

3 


T. 

2,114 

3 

39 

2 

8 


Total . 


. 1,034 


1,132 


2,166 


Other races: 
Insane 
Mental defectives . 


26 


29 
1 


55 

1 


Total . 

Grand Total 


26 
. 1,060 


30 
1,162 


56 
2,222 



Absent from Hospital but 
Still on Books. 
M. F. T. 



225 
1 



138 



363 
1 



138 



364 



9. Patients under treatment in occupational-therapy classes, including phys- 
ical training, on date of report ....... 

10. Other patients employed in general work of hospital on date of report 

11. Average daily number of all patients actually in ho-spital during year 

12. Voluntary patients admitted during year . . . 

3. Persons given advice or treatment in out-patient clinics during year 



4 
230 


3 
141 


7 
371 


Males. 


Females. 


Total. 


78 
610 


301 
619 


379 
1,229 



1,094.59 1,150.53 2,245.12 
4 8 12 



408 



796 



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



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fl 


Tl 


r/5 


I-H 


d 


o5 


n 


O 




-^ 




(.<J 


a 


.fcl 


P^ 




<i 





aw 
rrt 



o 05 a 



to 



O T3 

w 02 ,— I 

"2 5r< 03 

S? =« S 

3^ t^ '^ 



, 02 g 

? o=i2 

•?5 o ^ 



ft 



O 



o 






<D 



Oj 



O 
P O 



tS-O 



bC 



O O • jri ^ 



a ^13 



bc'ft 
.5 o 



.r^ 



EC CQ 02 ^ 



03 - 

l>i OJ >H 03 - 

. . bC 03 -4^ -g u 

'd :3 0? o_2 ft 



*^ o 



1— I O 



o 
H 



P.D. 23 19 

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











Parents of M 


ALE 


Pakents of Fe 


.male 


Nativity. 


P 


\TIENTS 






Patents. 






Patients 
























M. 


F. 


T. 


Fathers 


Mothers. 


Both 

Parents. 


Fathers 


Mothers. 


Both. 
Parents. 


United States 


124 


109 


233 


57 


66 


52 


55 


62 


47 


Africa 




1 


— 


1 


1 


1 


1 


1 


- 


- 


Australia . 






- 


2 


2 


- 


1 


- 


2 


2 


2 


Canada i . 






24 


IS 


42 


34 


32 


29 


2 , 


24 


18 


China 






1 


- 


1 


1 


1 


1 


- 


- 


— 


Czechoslovakia 






1 


- 


1 


1 




1 


— 


— 


— 


Denmark . 






- 


- 


- 


1 


1 


1 


- 


— 


— 


England . 






4 


2 


6 


9 


6 


5 


2 


2 


1 


Finland 






1 


1 


2 


1 


1 


1 


2 


2 


2 


France 






2 


- 


2 


1 


2 


1 


1 


1 


T 


Germany . 






3 


- 


3 


4 


3 


3 




1 


1 


Greece 






2 


1 


3 


2 


4 


2 


1 


1 


1 


Holland . 






1 


- 


1 


2 


- 


1 




- 


- 


Hungary . 






- 


- 


- 


- 


1 


- 




- 


- 


Ireland 






15 


22 


37 


38 


36 


33 


40 


39 


35 


Italy 






6 


7 


13 


9 


9 


9 


11 


11 


11 


Norway 






- 


2 


2 


- 


- 


- 


2 


2 


2 


Poland 






8 


6 


14 


11 


11 


11 


6 


6 


6 


Portugal . 






1 


1 


2 


1 


1 


1 


1 


1 


1 


Russia 






2 


2 


4 


5 


3 


3 


3 


3 


3 


Scotland . 






1 


a 


4 


1 


3 


1 


5 


4 


4 


Spain 






_ 


1 


1 


- 




- 


1 


1 


1 


Sweden 






9 


4 


13 


12 


11 


11 


6 


6 


6 


Turkey in Euroi. 


e 




1 


- 


1 


1 


1 


1 


- 


- 


- 


Wales 






- 


1 


1 


- 


- 


- 


1 


1 


— 


West Indies 2 






_ 


1 


1 


- 


- 


- 


_ 


1 


1 


Other countries 






5 


4 


9 


6 


6 


6 


6 


6 


6 


Unascertained 






2 


1 


3 


16 


13 


14 


13 


12 


9 


Total 






214 


188 


402 


214 


214 


188 


188 


188 


158 



1 Includes Newfoundland. 



2 Except Cuba and Porto Rico. 



20 



P.D. 23 









H 


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




















•^ 2 G 


fe' 


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








a g-g 












^ 3-^ 


s 


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


















ll 


H 


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










g-d 














S.S 


6h" 


1 1 1 1 1 t 1 1 1 1 1 J 1 1 




CO 






a c3 








-« 






p"" 


S 


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




"e 














-40 








H 


1 rt t^o-«iHC<imo3500MC<ico 1 


o 




z 


m b 


-< rtcq rtrtrtrt(M 


M< 






O 

s 




fa 


1 »-Hcc^^uDoo«05coi:^ooas 1 


s 


S 
tD 

S 






■^ C3 


S 


1 1 ■* O CO t~ i» CD I-- Tfi ;0 -* ■* 1 






o 














H 


] 1 1 ^cq iM 1 1 1 1 1 1 1 


t- 


H^ 




a 


"* m 








g 




n 


31 


fa 


1 ] li-l.-lrtlM| 1 1 1 1 1 1 


lO 


•'S> 


g; 


H 


-^ ;»> 










« 
o 

pa 


1 




s 


1 1 1 1 -^"^ 1 1 1 1 1 1 1 1 


c^ 










^ 




Q 

m 

Eh 




H 


1 1 1 r-lCq 1 OJ 1 1 1 1 1 1 1 


>o 


•r^ 


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CO 
■to 


a 
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03 E 


fa 


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


CO 


0^ 


P<H 


z 


>, 








^ 




a 




s 


1 1 i 1 rt 1 « 1 1 1 1 1 1 1 


IM 


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■:§ 




H 




H 


1 M 1 COCCt-HCO<M I 1 — 1 1 c^ 1 


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1^ 






fe £ 








S 






"o S 


fa' 


IC^IC^C^JI 1 I 1 1 1 li-Hl 


t^ 


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t5^ 






k:^ 




















S 


1 1 IrtrtrtTOIMI l-H|^l 


o 
























e 






H 


1 COt^irt-^ifflO— icOO-WI>l>ffl 1 


s 


■^ 




























fa" 


1 eoMoowso-^rocacot^ooo i 


r^ 












5^ 






s 


1 ( -^ t^ CD Oi 05 00 t^ •<*' t^ ■<*' iC 1 


§ 






!-• • 


H 


|«rt|i-i«C<lc<l| ICMrtCOl 


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■» ,- 
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fa 


l^i-ll,-l|C<)i-ll |<M1C<II 


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i 1 1 1 l-Hlrtl 1 lrt-.J<l 


t^ 


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H 


»-< CO CD W3 -^ Oi <M -* CO C<1 CS r-i -^ 1 


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fa 


ICMCOIlMt^C^COM—iC^ll 1 1 








H 


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cq 






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£ 






cq 


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g 
g 














H 


i-H »0 cq t^ w CD T-H W3 -^ -^ rr CO lO I 


CO 


CO 


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p 








CO 

e 




Ph 


's' 


fa 


I utlCI^^CO-^^'-'tMr-.c-IC-liJ* i 


go 


CO 






1 


S 


1-1 1 OCOOOtN 1 -cfC^COCqrt-H 1 


o 












.o 








H 


rt t^ l:^ t^ CO 00 t^ 00 00 QO -W CD in 1 


05 


CO 






.£ 

;! 












fa" 


1 CO lO Ol i-H •«< ■0' C^ ■* CO rt CO <M 1 

«-*<MiOOJi*COCD-a<C-JCOCOCO 1 


Ml 


^ 










o 


"^ 




H 


CO 03 CO 02 05 -* Cq OS W ■* O) -H O ] 


u 


5- 


























-il 


fa" 


1 ^ rH CO t>. lO 05 t^ 00 00 t^ W3 00 1 


Oi 






O 




o 


«*--. 




H 








5^ 














s 


CO 00 W5 CD c-q en CO oj t- CO m CO Cd i 


Ml 


"» 










Os 


__ 








I— ' 


-^ 






H 


CO C<1 CO -* O en C<1 O — 1 ->J< CO CO >o 1 


c^ 








CNOOCOCOCO^COCOC-JC^CSCO 


o 






■s 












S, 








■< 




QC 


fa" 


I -^ Ml ^cq — ^ oor^-^ -^ cooo t 


QO 






b 




00 


rt< 


















H 




•< 


S 


COOO OJCOOOOOC^OMJOO^Ot^ 1 


-* 










►J 






















< 




H 




o 




m > 






i °-g 










s^ggggggggggg-gS 


1 










<J 




fccnM*O5-Mi05-^O5TPOi-*cn ^ S 
<-c— icqcqcocoM'M'uawscDcD t»ic5 

PrMCCie^COC0-0<-<J'«O«OSO<Ot^P 


H 








1 







P.D. 23 



21 



Table 5. Citizenship of First Admissions. 



Citizens by birth 
Citizens by naturalization 
Aliens . . . . 

Citizenship unascertained 

Total 



Males. Females. Total. 

124 109 233 

26 28 64 

52 36 88 

12 15 27 



214 



188 



402 



Table 6. Psychoses of First Admissions. 



Psychoses. 



T. 



M. 



1. Traumatic psychoses .... 

2. Senile psychoses ..... 

3. Psychoses with cerebral arteriosclerosis . 

4. General paralysis .... 

5. Psychoses with cerebral syphilis 

6. Psychoses with Huntington's chorea 

7. Psychoses with brain tumor . 

8. Psychoses with other brain or nervous diseases, total 

Other diseases ..... 

9. Alcoholic psychoses, total 

Delirium tremens .... 
Korsakow's psychosis 
Other types, acute or chronic 

10. Psychoses due to drugs and other exogenous toxins, total 

11. Psychoses with pellagral 

12. Psychoses with other somatic diseases, total 
Exhaustion delirium .... 
Cardio-renal diseases .... 
Other diseases or conditions 

13. Manic-depressive psychoses, total . 
Manic type ..... 
Depressive type .... 
Other types ..... 

14. Involution melancholia 

15. Dementia prsecox (schizophrenia) . 

16. Paranoia and paranoid condition . 

17. Epileptic psychoses .... 

18. Psychoneuroses and neuroses, total 
Hysterical type ..... 
Other types ..... 

19. Psychoses with psychopathic personality 

20. Psychoses with mental deficiency . 

21. Undiagnosed psychoses 

22. Without psychosis, total 
Epilepsy without psychosis 
Psychopathic personality without psychosis 
Mental deficiency without psychosis 
Others ...... 

Total 



2 
20 
15 
19 

1 



2 
52 
1 
4 
1 



1 
27 

7 
5 



11 

30 

5 

1 



3 

47 

22 

24 

1 



5 

29 



14 17 



13 

82 



■57 

7 6 13 

49 56 105 

3 6 9 



214 188 402 



22 

Table 


7. Race 


P.D. 23 

of First Admissions Classified with Reference to Principal 
Psychoses. 


Race. 


Total. 


Traumatic. 


Senile. 


With 
cerebral 
arterio- 
sclerosis. 


General 

paralysis. 


With cerebral 
syphilis. 


African (black) 

American Indian 

Armenian . 

Chinese 

Dutch and Flemisl 

English 

Finnish 

French 

German 

Greek . 

Hebrew 

Irish 

Italian i 

Lithuanian . 

Portuguese . 

Scandinavian 2 

Scotch 

Slavonic ^ . 

Syrian 

West Indian * 


1 


M. 

1 

4 

1 
1 

8 

1 

26 
4 
3 
2 

41 
9 
2 
1 

17 
4 

10 

2 

68 

9 


F. 

4 
1 

7 
3 

20 
1 
2 
1 
41 
11 
4 
2 
8 
4 
8 
2 
1 

63 
4 


T. 

5 
1 
5 
1 
1 

15 
4 

46 
5 
5 
3 

82 

20 
6 
3 

25 
8 

18 

2 

1 

2 

131 

13 


M. F. T. 


M. F. T. 

1 - 1 
- 1 1 


M. F. T. 


M. F. T. 
1 - 1 


M. F. T. 
















2 1 3 


2-2 


- 






- - - 


2 1 3 


2 1 3 


3 1 4 


- - - 


- - - 


- - - 


- - - 


1 - 1 


- - - 


1 - 1 


4 12 16 
- 1 1 


4 1 5 
- 1 1 


1 1 2 

2 2 


_ _ _ 








1 - 1 
1 - 1 


1 - 1 


1 - 1 


1 1 

- 1 1 

- 1 1 


2-2 
1 - 1 




























Mixed 

Race unascertained 


- 1 1 


13 9 22 


3 2 5 
1 - 1 


7 3 10 


- - - 






Total .... 


214 


188 


402 


2 1 3 


20 27 47 


15 7 22 


19 5 24 


1 - 1 


' Includes "North" and "South." j 

2 Norwegians, Danes and Swedes. 1 

3 Includes Bohemian, Bosnian, Croatian, Dalmatian, Herzegovinian, Montenegrin, Moravian, Polish, Russian, Ruthe-i 
nian, Servian, Slovak, Slovenian. * Except Cuban. 1 

Table 7. Race of First Admissions Classified with Reference to Principal 
Psychoses — Continued. 


Race. 


With 

Huntington's 

chorea. 


With brain 
tumor. 


With other 
brain or 
nervous, 
diseases. 


Alcoholic. 


Due to drugs 

and other 

exogenous 

toxins. 


With 
pellagra. 


African (black) . 
American Indian 
Armenian .... 
Chinese .... 
Dutch and Flemish 
English .... 
Finnish .... 
French .... 
German .... 
Greek .... 
Hebrew .... 

Irish 

Italian! .... 

Lithuanian .... 

Portuguese .... 

Scandinavian ^ . 

Scotch .... 

Slavonic ' . 

Syrian .... 

West Indian «... 

Other specific races 

Mixed .... 

Race unascertained 




M. F. T. 


M. F. T. 


M. F. T. 

1 - 1 

1 - 1 
1 - 1 

2-2 


M. F. T. 

1 - 1 
4-4 
1 - 1 
1 - 1 

5 3 8 

2-2 
- 2 2 

3 - 3 

1 1 2 

3 1 4 
1 - 1 


M. F. T. 


M. F. T. 


: : : 


: : : 


- - - 


- - - 


_ _ _ 


: : : 


- - - 


- - - 


Total 


- - - 


- - - 


5-5 


22 7 29 










1 Includes "N 

* Norwegians 

s Includes Bo 

nian, Servian, Slo 


orth" and ' 
Danes and 
hemian, Bo£ 

vak, Sloveni 


South 
Swede 
nian, ( 
an. 


s. 
I!roatiai 


, Daln 

i 


latian, Herzeg 
Except Cuban 


ovinian, Mont 


snegrin, Mora\ 


ian, Polish, R 


ussian, Ruthe- 

i 
1 



P.D. 23 

Table 



23 



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



Race. 


With other 
somatic 
diseases. 


Manic- 
depressive. 


Involution 
melan- 
cholia. 


Dementia 
praecox. 


Paranoia 

and 
paranoid 
conditions. 


Epileptic 
psychoses. 




M. F. T. 


M. F. T. 


M. F. T. 


M. F. T. 


M. F. T. 


M. F. T. 


American Indian 

Armenian . 

Chinese 

Dutch and Flemish 

English 

Finnish 

French 

German 

Greek 

Hebrew 

Irish . 

Italian ^ 

Lithuanian . 

Portuguese . 

Scandinavian 2 . 

Scotch 

Slavonic ' . 

Syrian 

West Indian * 

Other specific races 

Mixed 

Race unascertained 


















: : : 


: : : 




2-2 

1 - 1 

2 1 3 


1 - 1 


: : : 












2 1 3 
1 - 1 


- 1 1 

- 1 1 


- 2 2 
1 - 1 


1 6 7 
1 - 1 
















2 1 3 
12 4 16 

3 1 4 
1 - 1 






- 2 2 


2-2 

- 2 2 

- 1 1 

- 1 1 


- 3 3 


- 1 1 


1 - 1 


- 1 1 


5 2 7 










_ _ _ 


- 1 1 




3 3 6 










2 2 4 
1 - 1 


- 1 1 

1 6 7 










1 3 4 


2 - 2 
16 8 24 
1 - 1 


- 4 4 


2-2 
- 1 1 


Total . 






6 5 11 


3 14 17 


2 11 13 


52 30 82 


1 5 6 


4 1 5 



» Includes "North" and "South." 
2 Norwegians, Danes and Swedes. 

s Includes Bohemian, Bosnian, Croatian, Dalamatian, Herzegovinian, Montenegrin, Moravian, Polish, Russian, Ruthe- 
nian, Servian, Slovak, Slovenian. * Except Cuban. 

Table 7. Race of First Admissions Classified ivith Reference to Principal 
Psychoses — Concluded. 



Rack. 


Psycho- 
neuroses 

and 
neuroses. 


With 
psycho- 
pathic 
personality. 


With 

mental 

deficiency. 


Un- 
diagnosed 
psychoses. 


Without 
psychosis. 




M. F. T. 


M. F. T. 


M. F. 


T. 


M. F. T. 


M. F. T. 


African (black) 


_ _ _ 


_ _ 


_ 


_ 


2 2 


_ _ _ 


American Indian 










_ _ _ 


- 


- 


_ _ _ 


_ _ _ 


Armenian 










_ _ _ 


1 


1 


1 - 1 


_ _ - 


Chinese . 








_ _ _ 


_ _ _ 


- 


- 


_ _ _ 


_ _ _ 


Dutch and Flemish 








_ _ _ 


_ _ _ 


- 


_ 


_ _ _ 


_ _ _ 


English . 








_ _ _ 


_ _ _ 


- 


- 


2 4 6 


_ _ _ 


Finnish . 






_ _ _ 


_ _ _ 


- 


- 


_ _ _ 


2 2 


French . 






2 2 


_ _ _ 


2 


2 


9 5 14 


1 - 1 


German . 






_ _ _ 


_ _ _ 


- 


- 


1 1 


_ _ _ 


Greek . 








_ _ _ 




_ 


_ 


1 1 


_ _ _ 


Hebrew . . ■ 








_ _ _ 




- 


- 


_ _ _ 


_ _ _ 


Irish 








_ _ _ 


1 1 


2 


2 


10 11 21 


1 1 


Italian 1 . 








_ _ _ 


_ _ _ 


1 


1 


2 4 6 


_ _ _ 


Lithuanian 








_ _ _ 


_ _ _ 


_ 


_ 


2 2 


1 - 1 


Portuguese 








_ _ _ 


_ _ _ 


- 


- 


_ _ _ 


_ _ - 


Scandinavian - 








_ _ _ 


_ _ _ 


- 


- 


3 3 6 


1 - 1 


Scotch 








1 - 1 


_ _ _ 


_ 


_ 


- 2 2 


_ _ _ 


Slavonic ^ 








_ _ _ 


_ _ _ 


1 


1 


5 1 6 


1 1 


Syrian . 








- - - 


_ _ _ 


- 


- 


1 1 


_ _ _ 


West Indian * . 








- - - 


_ _ _ 


- 


- 


_ _ _ 


_ _ _ 


Other specific races 








_ _ _ 


_ _ _ 


- 


- 


_ _ _ 


_ _ _ 


Mixed 








_ _ _ 


2 3 5 


2 2 


4 


14 17 31 


2 2 


Race unascertained 








- - - 


1 1 


2 


2 


3 2 5 


- - - 


Total 








1 2 3 


2 5 7 


7 6 


13 


49 56 105 


3 6 9 



1 Includes "North" and "South." 

2 Norwegians, Danes and Swedes. 

s Includes Bohemian, Bosnian, Croatian, Dalmatian, Herzegovinian, Montenegrin, Moravian, Polish, Russian, Ruthe- 
nian, Servian, Slovak, Slovenian. * Except Cuban. 



24 



P.D. 23 

Table 8. Age of First Admissions Classified with Reference to Principal 

Psychoses. 



PSTCHOSES. 




Total , 




Under 




15-19 






20-24 






25-29 










15 


years. 




years 






vears 






Shears. 




M. 


F. 


T. 


M. 


F. T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. T. 


1. Traumatic 


2 


1 


3 


_ 


_ 


_ 


_ 


_ 


1 


1 


2 


1 


- 1 


2. Senile 


20 


27 


47 


- 


_ 


_ 


_ 


- 


_ 


_ 


_ 


- 


_ 


3. With cerebral arteriosclerosis 


15 


7 


22 


- 


- 


- 


- 


- 


- 


- 


- 


_ 


_ 


4. General paralysis .... 


19 


5 


24 


- 


- 


- 


- 


- 


- 


- 


- 


2 


- 2 


5. With cerebral syphilis .... 


1 


- 


1 


- 


- - 


- 


- 


- 


- 


- 


- 


- 


- 


6. With Huntington's chorea . 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


7. With brain tumor .... 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


8. With other brain or nervous diseases 


5 


- 


5 


1 


- 1 


1 


- 


1 


1 


- 


1 


1 


- 1 


9. Alcoholic 


22 


7 


29 


- 


- 


_ 


_ 


_ 


1 


- 


1 


_ 


1 1 


10. Due to drugs and other exogenous toxins 


- 




- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


11. With pellagra 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- - 


12. With other somatic diseases . 


H 


5 


n 


- 


- 


- 


- 


- 


- 


- 


- 


- 


1 1 


13. Manic-depressive .... 


3 


14 


17 


- 


- 


1 


1 


2 


_ 


3 


3 


1 


1 2 


14. Involution melancholia 


2 


11 


13 


- 


- - 


- 


- 


- 


- 


- 


- 


- 


- 


15. Dementia praecox .... 


52 


30 


82 


- 


- 


2 


5 


7 


11 


2 


13 


11 


3 14 


16. Paranoia and paranoid conditions . 


1 


5 


6 


- 


- 


- 


- 


- 


- 


- 


- 


- 


1 1 


17. Epileptic psychoses .... 


4 


1 


5 


- 


- 


1 


- 


1 


1 


1 


2 


- 


- 




1 


2 


3 


- 


- - 


- 


- 


- 


- 


1 


1 


1 


- 1 


19. With psychopathic personality 


2 


5 


7 


- 


- 


- 


- 


- 


1 


- 


1 


- 


1 1 


20. With mental deficiency 


V 


« 


13 


1 


- 1 


1 


- 


1 


- 


1 


1 


3 


- 3 


21. Undiagnosed psychoses 


49 


6B 


105 


1 


- 1 


2 


7 


9 


3 


3 


(5 


3 


3 6 


22. Without psychosis .... 


3 
214 


6 
188 


9 
402 


- 


- - 


- 


1 


1 


1 


2 


3 


- 


- - 


Total 


3 


- 3 


8 


14 


22 


19 


14 


33 


23 


11 34 



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



Psychoses. 




30-34 






35-36 






40-44 






45-49 




50-54 




years 






years 






years 






years 




years. 




M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. 


F. 


T. 


M. F. T. 


1. Traumatic 


_ 


_ 


_ 


_ 


_ 




_ 


_ 


_ 


_ 


_ 


_ 


_ _ _ 


2. Senile 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


1 - 1 


3. With cerebral arteriosclerosis 


_ 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


_ _ _ 


4. General paralysis 


1 


- 


1 


3 


1 


4 


3 


2 


5 


6 


- 


6 


3 1 4 


5. With cerebral syphilis .... 


- 


- 


- 


- 


- 


- 


- 


- 


- 


1 


- 


1 


_ _ _ 


6. With Himtington's chorea .... 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


_ _ _ 


7. With brain tumor 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


_ _ _ 


8. With other brain or nervous diseases . 


- 


- 


- 


- 


- 


- 


2 


- 


2 


- 


- 


- 


_ _ _ 


9. Alcoholic 


3 


- 


3 


2 


1 


3 


3 


1 


4 


3 


1 


4 


5 1 6 


10. Due to drugs and other exogenous toxins 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


_ _ _ 


11. With pellagra 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- - - 


12. With other somatic diseases 


- 


1 


1 


- 


- 


- 


_ 


- 


- 


2 


- 


2 


- 1 1 


13. Manic-depressive 


1 


4 


5 


- 


2 


2 




- 


- 


- 


- 


- 


- 1 1 


14. Involution melancholia .... 


- 


- 


- 


- 


1 


1 




2 


9 


- 


4 


4 


- 2 2 


15. Dementia prsecox 


8 


3 


11 


10 


4 


14 


5 


4 


9 


2 


3 


5 


1 3 4 


16. Paranoia and paranoid conditions 


- 


- 


- 


- 


- 


- 


- 


2 


2 


- 


- 


- 


_ _ _ 


17. Epileptic psychoses 


- 


- 


- 


- 


- 


- 


1 


- 


1 


- 


- 


- 


1 - 1 


18. Psychoneuroses and neuroses 


- 


1 


1 


- 


- 


- 


- 


- 


- 


- 


- 


- 


_ _ _ 


19. With psychopathic personaUty 


- 


- 


- 


- 


1 


1 


- 


2 


2 


- 


1 


1 


_ _ _ 


20. With mental deficiency .... 


2 


- 


2 




2 


2 


- 


2 


2 


- 


- 


- 


- 1 1 


21. Undiagnosed psychoses .... 


3 


3 


6 


3 


8 


11 


8 


3 


11 


ti 


1 


V 


2 8 10 


22. Without psychosis 


- 


- 


- 




1 


1 


- 


2 


2 


- 


- 


- 


1 - 1 


Total 


18 


12 


30 


18 


21 


39 


22 


20 


42 


20 


10 


30 


14 18 32 



P.D. 23 

Table 8. 



25 



Age of First Admissions Classified with Reference to Principal 
Psychoses — Concluded. 



Psychoses. 


55-59 
years. 


60-64 
years. 


65-69 
years. 


70 years 
and over. 


Unascer- 
tained. 




M. F. T. 


M. F. T. 


M. F. T. 


M. F. T. 


M. F. T. 


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 peUagra 

12. With other somatic diseases 

13. Manic-depressive .... 

14. Involution melancholia 

15. Dementia praecox .... 

16. Paranoia and paranoid conditions 

17. Epileptic psychoses .... 

18. PsychoneuToses and neuroses 

19. With psychopathic personality 

20. With mental deficiency 

21. Undiagnosed psychoses 

22. Without psychosis .... 




- 1 1 
1 1 2 
1 - 1 


2 4 6 

3 1 4 
- 1 1 


4 5 9 
3 3 6 


13 17 30 
8 2 10 


- - - 






































3-3 


1 2 3 


1 - 1 




















2 1 3 

- 1 1 
1 1 2 

- 3 3 

- 1 1 


1 - 1 

1 - 1 
1 - 1 


- 1 1 
1 1 2 
1 - 1 


1 1 2 


- - - 










- 1 1 


- - - 












- - - 


- - - 


- - - 


1 - 1 


- - - 


2 4 6 


3 6 9 


1 3 4 


12 7 19 
1 - 1 


_ - _ 


Total 




10 13 23 


12 14 26 


11 13 24 


36 28 64 


- - - 



26 









1 N (M T-H 1 I 1 1 CM 1 1 1 1 ; N CI 1 1 >-i W O 1 


-ti 






H 




CM 




u ■ 












b 


1 -H-H 1 1 1 1 1 'H 1 : 1 1 1 1 -I 1 1 —— lo 1 


CM 




13 ei 










&■*' 


s 


irt^^i 1 1 1— 1 1 1 1 ifj^i 1 i-^-*i 


C^l 








Ire! 1 1 1 1 l^^l I It-h^^oO'-'I I'-i|>-C[ 


_i 






H 




CO 




6 












fa 


iroi 1 1 1 1 1 1 1 1 i-H|(M^l |t-(|mi 


o 














O 








03 


O 








<» 




^ 


1 1 1 1 1 1 1 1 ^ 1 1 1 1 T-KO i 1 1 1 1 ^5 1 


—1 


6 




^ 






-g 










^ 










S" 






rHO|-*l| 1 1 1 1 i 1— KrOTftCO-^l icolcol 


CM 


cc 




f-i 




LO 


Ds 














fa 


.-col 1 1 1 1 1 1 1 l-^(NMtO— 1| IOJIG5I 


1^ 

CI 




Oi 








^ 






1 M 1 Tf 1 1 1 1 1 1 1 1 ^-^.^ 1 1 1 -H 1 Tf 1 


lO 


W 




s 




CM 


a^ 










o 




H 


C-li-5— <rTI 1 IfO'*'! lOOOOOCOIMTt'COINiOM'b- 


2 






N-^-H rt T-H Tt< IC 




<» 


a . 






CM 


o 


°'7i 








s 


li 




|r-<— iTfl 1 1 ICOl ICO00000OlN<-llM'-H!Mt^-*l 


IC 


£ 


fa 


rt rH Ol 


05 


-§> 


i3«2 














(M-fCCll 1 IM.-HI IO(NIO o^-^-^nt-n 


■# 




S 


rH^ ^ CO (M 


CM 


,sj 










'i 




H 


ICOCOCOl 1 l>-lt>.| 11^— IlLOIrll IrtOl-H 


O 


1^ 


ro S 










c3 n 


fa 


lOqCO-Hl 1 1 IMI |,Hr-l|COl 1 1 1 lOrH 


Ol 


CO 


^^ 








§ 


'0 

a 


^ 


1 -ICO (N 1 1 1 -HlO 1 1 -H 1 1 (M 1 -H 1 1 -^TtH 


CM 


o 


03 


<5 




00 










s 




H 


lOOCOCO'-'l It-ioI 1 I(N|C0I 1 1 l'0»t<'^ 


<o 


o 






•.# 


*c^ 










=c 


aj 








CO 










•<Si 


2 


fa 


1 t^!M 1 1 1 1 1 1-1 1 1 1 CM 1 (M 1 1 1 1 COI>'-< 


CM 


'^ 


^ 








^ 


" 


13 


I^^COWI |-lTt<l 1 1 1 l-ll 1 1 IC^It^I 


CM 


oc 










J. 










•c* 










fc, 




H 


cow^^-t<rtl |iomi i— t^cocMOi-ocot^co'O . 


CM 




TTC-IM CM n-— 1— ICC i-iO 


o 


'^ 


■« 




'^ 


■* 


g 


fa 


— il^OiOl 1 1 It^l IiOtJi-mO — IC^IOCDOO 


00 


.O 




!» ^ rH CO 1.0 


00 




o 








1 


H 


















2 


CMOmOarHl |0!N1 iOCOCMC^l— iT«iT-iCMt^05C0 


■* 




CM^^ CM lO T)< 


c^ 


Eq 
^ 




















«i 










<» 










^ 
» 














a ' 




Q 






IB O 
CI . *» 










« 2 

•si § . 

-S . g -5 . >> . . . 




n 
< 






1 .. § i i 1 il 




H 


C 
K 
p 




.2 |-§ « 5 ^ '-B -3 «asi 










1 r|l-i|.sl||||.|^s|||o^- 

S „ " 2 "^-° ° °2 ^° i:3 g § a^ »S ^S 


"3 
o 




>-HeMCO'<j;io«t>."o6oiO'^CMCOT(<iOOh-'o6o>0'^C^i 








rtrH.-lT-(rH.-lr-li-lrt,-<CMCMCM 





Ti ^ 



P.D. 23 

Table 10. Enviromnenl of First Admissiojis 
Principal Psychoses. 


27 

Classified with Reference to 


PSTCHOSES. 


Total. 


Urban. 


Rural. 


Unascer- 
tained. 




M. 

2 
20 
15 
19 

1 

5 
22 

6 
3 
2 

52 
1 
4 
1 
2 
7 

49 
3 


F. 

1 

27 
7 
5 

7 

5 

14 

11 

30 

5 

1 

2 

5 

6 

56 

6 


T. 

3 
47 

22 
24 

1 

5 

29 

11 
17 
13 
82 
6 
5 
3 
7 
13 
105 
9 


M. F. T. 

2 1 3 
19 25 44 
13 7 20 

19 5 24 

1 - 1 

_ _ _ 

4-4 

20 7 27 

4 5 9 

2 13 15 

2 11 13 
50 27 77 

1 5 6 

3 1 4 

1 2 3 

2 4 6 
6 6 12 

40 54 94 
2 6 8 


M. F. T. 


M. F. T. 


2. Senile 

3. With cerebral arteriosclerosis 

4. General paralysis . 

5. With cerebral syphilis 

6. With Huntington' chorea 

7. With brain tumor .... 

8. With other brain or nervous diseases . 

9. Alcoholic 

10. Due to druRS and other exogenous toxins 

11. With pellagra 

12. With other somatic diseases 

13. Manic-depressive .... 

14. Involution melancholia 

15. Dementia praecox . . 

16. Paranoia and paranoid conditions 

17. Epileptic psychoses .... 

18. Psychoneuroses and neuroses 

19. With psychopathic personality 

20. With mental deficiency . . 

21. Undiagnosed psychoses 

22. Without psychosis .... 




1 2 3 

2-2 


- - - 






1 - 1 

2-2 

2-2 
- 1 1 


1 - 1 


1 3 4 


1 - 1 


1 - 1 


- - - 


- 1 1 
1 - 1 
6 2 8 
1 - 1 


3-3 


Total 


214 


188 


402 


191 179 370 


18 9 27 


5-5 


Table 11. Economic Condition of First Admissio7is Classified with 
Reference to Principal Psychoses. 




Total. 


Dependent. 


Marginal. 


Com- 
fortable. 


Unascer- 
tained. 


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 e.togcnous 

toxins 

11. With pellagra .... 

12. With other somatic diseases 

13. Manic-depressive .... 

14. Involution melancholia 

15. Dementia prscox .... 

16. Paranoia and paranoid conditions 

17. Epileptic psychoses 

18. Psychoneuroses and neuroses 

19. With psychopathic personality 

20. With mental deficiency . 

21. Undiagnosed psychoses . 

22. Without psychosis .... 

Total 


M. 

2 

20 
15 
19 

1 

5 

22 

6 
3 
2 
52 
1 
4 
1 
2 

7 
49 
3 


F. 

1 

27 
7 
5 

7 

5 
14 
11 
30 
5 
1 
2 
5 
6 
56 
6 


T. 

3 

47 

22 

24 

1 

5 

29 

11 
17 
13 
82 
6 
5 
3 
7 
13 
105 

g 


M. F. T. 
- 1 1 


M. F. T. 

2 1 3 
20 27 47 
15 7 22 
19 5 24 

1 - 1 

5-5 

22 7 29 

5 5 10 

3 14 17 

2 11 13 
52 29 81 

1 5 6 

4 1 5 

1 2 3 

2 5 7 
7 6 13 

48 55 103 

3 6 9 


M. F. T. 


M. F. T. 














: : : 


: : : 


1 - 1 


- - - 






























1 - 1 


- 1 1 






214 


188 


402 


- 1 1 


212 186 398 


2-2 


- 1 1 



28 P.D. 2c 

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



PSTCHOSBS. 



Total. 



Abstinent. 



Temperate. 



Intem- 
perate. 



Unascer- 
tained. 



Traumatic 

Senile 

With cerebral arteriosclerosis . 
General paralysis . 
With cerebral syphilis 
With Huntington's chorea 
With brain tumor ... 
With other brain or nervous diseases 
Alcoholic 

Due to drugs and other exogenous 
toxins 



With pellagra 

With other somatic diseases 
Manic-depressive . 
Involution melancholia . 
Dementia pracox . 
Paranoia and paranoid conditions 
Epileptic psychoses 
Psychoneuroses and neuroses . 
With psychopathic personalitj- 
With mental deficiency . 
Undiagnosed psychoses . 
Without psychosis . 

Total 



F. T. 



M. F. T. M. F. T 



402 



61 135 196 



M. F. T. 



M. F. T. 



2 12 



3 2 

2 - 

3 1 



2 - 
- 1 



2-2 
21 6 27 



1 8 

- 1 

- 1 



59 15 74 



12 5 17 
2-2 



61 17 78 



- 2 2 

1 1 2 

13 12 25 



33 21 54 



29 





H 


1 1 rw 1 1 1 1 1 ,H 1 


1 1 t 1 1 1 1 1 1 1 -H 1 


CO 


■u-d 










t> £ 




I 1 1 1 1 t I t 1 1 


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




§.s 


[^ 








a c3 










t)^ 


§ 


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


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


ra 




H 


1 1 1 1 1 1 1 1 ^ 1 


1 li-llMI 1 1 1 ICOl 


t^ 


■a 










01 










o 

o 


fe 


1 1 1 1 1 1 1 1 -H 1 


1 1 -H 1 1 1 1 i 1 1 C-J 1 


Tf 


!> 




















Q 


^ 


1 1 1 1 1 1 1 1 1 1 


1 1 1 1 I>J 1 ,1 1 1 1 -< 1 


CO 






1 1 1 i 1 1 1 1 1 1 


1 1 1 1 r-l 1 1 1 1 1 1 1-1 


(M 




H 








13 










« 












Pq 


1 1 1 1 1 1 1 1 1 1 


1 1 1 1 -< 1 1 1 1 1 1 1 


^ 


c« 










D. 




















m 


i 


1 1 1 1 1 1 1 1 1 1 


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






H 


1 OiI> CO 1 1 1 1 1 1 


|t-l|.-liOrH| 1 1 l-Hl 


00 






N 


lO 


13 










& 


li; 


1 ■*< ^ 1 1 1 1 1 1 


1 1 1 T-HCO^ 1 1 1 1 IM 1 


o 


o 






CO 


-o 










'^ 










§ 


1 lococ) 1 1 1 1 1 


l-Hl IC^JI 1 1 1 I05I 


IM 




H 


1 Tj< o lO T-H 1 1 IM CO 1 


1 CO a- 1> LO c-i oq CO CO N ■* !N 


>.o 






.-1 CO 


rf 












^ 










.^ 


[i. 


1 TtH^Tfl 1 1 1 1 lO 1 


1 coooiocr. cqr-KMc-jrtffii-i 


I> 


^^ 






CO 












S 


1 OCft'-l'-l 1 1 IM.-I 1 


1 lOi-KNO 1 l-(r-l,-l,-imrt 


00 








t^ 




H 


COrJCTtiO 1 1 1 CO^ 1 


1 INI>iO02C0C0 1 rt<.-<COO 


t^ 






lO rHTtl 


00 












_aj 


P^ 


-^C)<N 1 1 1 1 1 .-1 1 


iMi-oioixrql icooMio 


03 


60 




rt (N 


t^ 










w 














(NiCiMXi 1 1 1 COO 1 


1 INIC-J^COI^CO-*'-! 


00 




§ 




Tt< M 


o 




H 


cot^ ^^1 1 lOo; 1 


1 rtt^coNO'Ocot^comoi 


IN 




■*IN(M (M 


r-< T-H .-1 OJ --HO 


o 








'"' 


-* 










"3 


fe 


^t^t^iO 1 1 1 1 t- 1 


1 lOTf'-HOiO'-iCMiOilOtOO 


x 




cq 


>-i,-iCO "O 


00 


o 










H 










^ 


(N o lO (35 "-I 1 1 iC C^l 1 


i OC0<M(M'HTti.-i(Mt>aiC0 


-* 




!M i-H —1 (M 


'O Tt< 


(N 






» 

a 




















^ 










m O 










m O 

...... .=3 .g 






a 

I .^>> . . . 






•B 2 ?? 


CO T3 Qj"-^ 




05 




2 ca o « 


i § si 




m 




S . . £ > ^ 




c 

n 
o 




'3 o fe S; 


•2 .2 .-H § S & S 






§ .2-g a M 




IB 




• • 2 S 2.3-^-^ ■ M 

2 a.-s g.-s.-s.ti.-s 8 § 


• •" o c3 » a.S'So 2 
(HiB(iiHt,^g?oor3T3>> 


"3 
o 


■-icicoTtiiodt^oooJo 


rH<NCo'-*>0«5l>o6o50'-5c^ 








rHrtrti-(i-l7-lrtrtr-IC<l<NN 





0^ 



CO 
CO 



g 



O 



30 



P.D. 23 



Table 14. Psychoses of Readmissions. 



Psychoses. 

1. Traumatic psychoses ..... 

2. Senile psychoses ..... 

3. Psychoses with cerebral arteriosclerosis 

4. General paralysis ..... 

5. Psychoses with cerebral syphilis . 

6. Psychoses with Huntington's chorea 

7. Psychoses with brain tumor 

8. Psychoses with other brain or nervous diseases 

9. Alcoholic psychoses ..... 

10. Psychoses due to drugs and other exogenous toxins 

11. Psychoses with pellagra .... 

12. Psychoses with other somatic diseases . 

13. Manic-depressive psychoses. '. 

14. Involution melancholia .... 

15. Dementia praecox ..... 

16. Paranoia and paranoid conditions 

17. Epileptic psychoses ..... 

18. Psychoneuroses and neuroses 

19. Psychoses with psychopathic personality 

20. Psychoses with mental deficiency 

21. Undiagnosed psychoses .... 

22. Without psychosis ..... 



Total 

Table 15. 



Males. Females. 
2 
3 2 



Total. 
2 
5 

1 



1 


1 


2 


2 


1 


:•( 


- 


1 


1 


_ 


3 


3 


1 


1 


2 


13 


- 


13 


- 


17 


17 


1 


- 


1 


_ 


1 


1 


4 


1 


5 


7 


8 


15 


2 


- 


2 



36 



37 



73 



Discharges of Patients Classified ivith Reference to Principal Psychoses 
and Condition on Discharge. 



Psychoses. 




Total. 




Recovered. 


Improved. 


Unimproved. 




M. 


F. 


T. 


M. F 


. T. 


M. 


F. 


T. 


M. 


F. T. 


1. Traumatic 


3 


_ 


3 


_ 


_ 


3 


_ 


3 


_ 


_ 


2. Senile 


2 


2 


4 


- 


- 


1 


1 


2 


1 


1 2 


3. With cerebral arteriosclerosis .... 


1 


2 


3 


_ 


_ 


1 


2 


3 


- 


.. 


4. General paralysis 


9 


4 


13 


- 


- 


8 


2 


10 


1 


2 3 


5. With cerebral syphilis 


- 


2 


2 


- 


- 


- 


2 


2 


- 


- 


6. With Huntington's chorea .... 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


7. With brain tumor 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


8. With other brain or nervous diseases 


1 


1 


2 


_ 


_ 


_ 


- 


- 


1 


1 2 


0. Alcoholic 


19 


3 


22 


1 


1 2 


11 


1 


12 


7 


1 8 


10. Due to drugs and other exogenous toxins . 


- 


1 


1 


- 


- 


- 


1 


1 


- 


- 


11. With pellagra 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


12. With other somatic diseases .... 


3 


(i 


9 


- 


- 


2 


4 


6 


1 


2 3 


13. Manic-depressive 


11 


22 


33 


- 


- 


8 


20 


28 


3 


2 5 


14. Involution melancholia 


- 


5 


5 


- 


- 


- 


3 


3 


- 


2 2 


15. Dementia praecox 


48 


33 


81 


2 


9 


26 


21 


47 


20 


12 32 


16. Paranoia and paranoid conditions . 


3 


5 


8 


_ 


- 


3 


4 


7 




1 1 


17. Epileptic psychoses 


9 


1 


3 


- 


- 


2 


1 


3 


- 


- 


18. Psychoneuroses and neuroses .... 


9 


3 


5 


- 


- 


1 


2 


3 


1 


1 2 


19. With psychopathic personality 


5 


5 


10 


- 


- 


4 


4 


8 


1 


1 2 


20. With mental deficiency 


3 


3 


6 


- 


- 


3 


2 


5 


- 


1 1 


21. Undiagnosed psychoses 


10 


12 


22 


- 


I 1 


7 


8 


15 


3 


3 6 


22. Without psychosis 


3 


3 


(J 


- 


- - 


- 


- 


- 


- 


- 


Total 


125 


113 


238 


3 


2 5 


80 


78 


158 


39 


30 69 



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70 years Unascer- 
and over. tained. 


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W 

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W 

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Traumatic ..... 

Senile ...... 

With cerebral arteriosclerosis 

General paralysis .... 

With cerebral syphilis 

With Huntington's chorea 

With brain tumor .... 

With other brain or nervous diseases . 
Alcoholic ..... 

Due to drugs and other exogenous toxins 
With pellagra ..... 

With other somatic diseases 
Manic-depressive .... 

Involution melancholia 
Dementia prsecox . . . 
Paranoia and paranoid ctnditions 
Epileptic psychoses .... 

Psychoneuroses and neuroses 

With psychopathic personality . 

With mental deficiency 

Undiagnosed psychoses 

Without psychosis .... 


"3 


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00 


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a 


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38 



P.D. 23 



2^: 

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05 

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P.D. 23 



3g 



Table 19. Family Care Department. 



Remaining in Family Care Oct. 1, 1927 
On visit from Family Care Oct. 1, 1927 
Admitted during the year 
Whole number of cases within the year 
Dismissed within the year 

Returned to institution 

Discharged . 

On visit 
Remaining in Family Care Sept. 30, 1928 

Supported by State 

Private 

Self-supporting 
Number of different persons within the year 
Number of different persons admitted 
Number of different persons dismissed 
Average daily number in Family Care during the 

Supported by State 

Private 

Self-supporting 



[ale 


Female. 


Total. 


1 


13 


14 


_ 


3 


3 


1 


16 


17 


_ 


4 


4 


- 


2 


2 


_ 


2 


2 


1 


12 


13 


— 


8 


8 


— 


3 


3 


1 


1 


2 


1 


12 


13 


— 


3 


3 


— 


4 


4 


— 


— 


13.50 


— 


— 


8 


— 


— 


3 


- 


- 


2