"W
953 ?Q.a3
REPORT
aAAX^,: WORCESTER SmiEB HOSPimL CTta^olAajO;
Worcester ls Massachusetts
Fiscal and Record Year Ending June 30, 1953
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APR 12
SiM£ HOUSE. SQS&QM
53
TSBM OF CGHEESTS
Pag©
Board of Trustees .<,..»»<»0»«.. ...... 1
Essid&svfc Soaff ■••••■«•««•••«••>•« X
Chiofs of lursing Staff ..*««.!.. .*••.*» 2
Eaads of Mn&nistrative Daparbssents .•...«•«» 3
C'OBSHlS SET'S »»«eooe<soeooe»«»»»ao« .?
Sij^riatenflsnt ! a Report (,«<.»..*•*«><»». o«o«.«.
PtKTSOESSl 01lSStg©£3 cso.co.o.oaooosso.f'oooo 3.5
F&fGa^nt Of PopOlatiOa ,,ee<»a»e*a»*a»ee IS
Report of the Ollnical Director «,<,.•.«•«.»»<.
©eaupatioaal Therapy Dspartxs=sat 000*«oe«»ec. 3©
Ddpsartiaont of feesiag eo<,o»ao.eo»»««.>«>e 41
Roerestloa BopartJssat »4,.eoa««o«.««eooo 45
Religions Activities s,0«eooo«e*«<.o,l.e« 50
Social Service B@partss®at »<> „«><>«. <,...» o « o
Madieal aad Surgical Department »<,••»•••«•> 57
Physical Therapy Departisssat »»■•«•••••«<>'« 62
X=»Ray Bspartisant (Ba.»««.^*0>.».<.oc,.>oo o3
B@Btal Departsssat ^o^>«®a»«o»«<>e*«>', •«« 64
iiastsoratory »»©•••••••••••••••*•• o»
V
Rssaareh Ssrvio© • • « ..«■.<>•» • ••»«. «.« 71
Psychology BepartEsat »•«»••«•«•«««»•• 74
Publleatioa List soeneeaoesaae®*"**
Moresstes* G^ild Guidance Clinic • »••••>•«<>• ^9
Travelling School Clinic „«e.t>c.e»a«o«o» 97
Steward's Bspsrtiaant • ••••••••*«••*•• 100
Eagiasering Bepartissiit „ . *, „ «,« «c*. «<.*»» 105
Maintenance Bepsrfesrsnt »»O0«c. «»«.»»«• 109
Matron5© Departisent «o.»e»oSa*»ees.<>ee» 113
¥o®3Sss ftuKiliary .••••••••••••••••• 13.5
Financial Report .«e. ••«»••>••••«•• 121
Movsiaeat of Population Chart c«<,oe*«»«««* 124
1.
BOARD OP TRUSTEES
Franklyn Jo Scola, Chairman* Worcester
Mary Vo Campbell, Vioe-Chalrman» Worcester
Daniel F» Murray,, Secretary, Mlllbury
Anna Co Tataan, Worcester
David Go Ljtuagbergs MoD«, Worcester
Michael H« Selzo, Worcester
Carl Go Nordgren, Worcester
RESIDENT STAFF
Bardwell Ho Flower, MoD«, Superintendent
Richard Wo Kelson, MoDo, Assistant Superintendent
David Rothschild, M.Do, Director of Clinical Psychiatry
Bertha So Curtis, MoD«, Senior Physician
Dean Mo Laird, MoDo, Senior Physician
David Mo Moriarlty, MoDo, Senior Physician
Jo Edward Lo Prunier, M.D«, Senior Physician
Joel Ordaz Serratoa, MoDo, Senior Physician
Pierre Bourdon, MoD», Assistant (Junior) Physician
Emanuel Adams Daneman, MoDo, Assistant (Junior) Physician
Urbano K* Guarin, MoDo, Assistant (Junior) Physician
John Hraba, MoD«, Assistant (Junior) Physician
Jacques Brlen, MoDo, Medical Interne (Psychiatric Resident)
James Ao Haycox, MoDo, Medical Interne (Psychiatric Resident)
George Chornesky, MeD», Psychiatric Resident
Paul Eo Phoenix, MoDo, Psychiatric Resident
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Dorothea R« Simmons, M»D«, Psychiatric Resident
Brooks S« White, M*D«, Psychiatric Resident
Miguel A. Mora, M»D», Psychiatric Resident
Sir/ on Go Harootlan, D.M.D., Dentist
Albert Eo Gardner, DoM.D., Dentist
RESEARCH STAFF
Elliot Ro Reiner * M*D», Senior Physician and Acting
Director of Research
Justin M* Hope, H«D*, Senior Psychiatrist (£ time)
Lincoln LeBeaux, M»D«, Senior Physician f| tlsss)
Bernard Cowitz, M»D«9 Assistant Psychiatrist
Leslie Phillips, M»A., Ph.D», Director of Psychological
Research
Marvin Waldman, M«A»9 Head Psychologist
Oscar Ao Parsons, M«A», Research Psychologist
CHIEFS OF KURSIKG SmFF
Kathleen C» Coutu, BoSo, MoEd«, R«JU, Principal of
School of Cursing
Florence Eaton, B<»S«, RoN«, Assistant Principal of
School of Nursing
Lillian Ra Kennedy , B*S«, R»N«, Assistant Principal of
School of Nursing
Eva Tobln, R*B«, Chief Hospital Supervisor, Male Ward
Service, Main Hospital
Mary 0. Santma&j R.N. a Chief Hospital Supervisor, Female
Ward Service, Main Hospital
Gertrude C, Walsh, H.N. f Chief Hospital Supervisor, Hale
Ward Service, Summer Street Department
Margaret M. Diamond, R.N., Chief Hospital Supervisor^
Female Ward Service, Summer Street Department
HEADS OF ADMINISTRATIVE DEPARTMENTS
Joseph P„ Koynahan, Steward
Paul P. Foran, treasurer
W&rren Q. Froetor, Chief Engineer, Main Hospital
Newell A. Gordone Chief Engineer,, Summer Street Department
Anton Svenson, Maintenance Foreman
S. James Mlstark, Head Farmer
Lillian C» Carr9 Matron
Olive 0. Dorraan, Head Social Worker
Evelina Elraadjian, Head Occupational Therapist
Cr&e© L. LaFleur, Principal Clerk, Medical Record Office
George L. Banay, Ph.D.,, Medical Librarian
CONSULTANTS
-irtrnnn^ni iTu ran i wmi i«i i wi m «ii»|i
Franklyn P. Bousquet, M.D., Surgery
Arthur 0. Brase&u, M.D. , Surgery
Percy A. Brooke, M.B., Proctology
Chester W„ Brown, M.D.,, Surgery
John B. Butte, M.D., Surgery
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John ToBo Ganaody^ M0D«„ Neurosurgery
F» Benjamin Carr* MaD*,, Cardiology
David Jo Cavan, M»D0j3 Roentgenology
Louis So Chase9 MoDoj, Psychiatry
George Fo Clancy,, M#D*, Obstetrics and Gynaecology
George Eo Deerings Jr»fi M«D0, Psychiatry
Anthony DiStefanc,, M«Do, Surgery
George A» Diacfi M<Do* Dermatology
Thomas Dwyor*, MD*? Psychiatry
Lester Mo Felfcon* M0DOi( Geni to-Urinary Surgery
Pranklyn So l^ltCj, MoDo, Pathology
Bans Fulder* M«D©.» Internal Medicine
Jacob Goldwynj, M«B&S Neurology
Harry B* Goodspeed^, M*D», Otolaryngology
IS&xsell Gould9 MoDos Anesthesiology
Richard Bn Gubbere D»Po, Podiatry
Walter W* Jettere MoD<,„ Pathology
Robert Mo Johnson, M»Do& Anesthesiology
Charles V« King* M^Do^ Orthopedics
Sidney Kligerman^ M»Dop Psychiatry
Lincoln Lebeauxj, M^D^ Neurology
Sidney Levln„> M^Do* Psychiatry
Donald Ko McCluskeyp M«DQ^ Obstetrics and Gynaecology
Joel Mo Mellck* M«»D»e Obstetrics and Gynaecology
Ervln Co Miller j, MoDo* Internal Medicine
Arnold Ho Modell^ MoDe, Psychiatry
Foscoe Wo Myer3, M«D<»t Ophthalmology
John Wo C'lfeara, MoDo, Orthopedics
Harry Rand* M,D8< Psychiatry
Edwin B« Seelyep U*V*, Surgery
Oliver Bo Stansfleld, M»D»# Internal Medicine
Julius J« Tegelberg, MoDo, Otolaryngology
Anthony Vamvaa, M«D», Anesthesiology
Arthur D, Ward, MoDo, Tuberculosis
MoHo Yudell, MoDop Anesthesiology
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TRUSTEES" REPORT
To His Excellency „ the Governor and to the Honorable Council:
The Trustees of the Worcester State Hospital herewith sub-
mit a report for the 121st flsoal year of the hospital , together
with a report of the Superintendent, Bardwell H. Flower, M.D. , a
report of the Treasurer, Paul P. Foran, and other information,,
The officers of the Board during the early months of the
flsoal year were Michael H. Selso, Chairman; Franklyn «J„ Soola,
Vice-Chairman; Mary 7. Campbell, Secretary, On September 18 B
1952 the following were eleoted and served throughout the re-
mainder of the years Franklyn J. Scola, Chairman; Mary V.
Campbell, Vice-chairman; Daniel Murray, Secretary.
During the year the term of James Mattlmore expired and
Carl CD Nordgren was appointed as his successor.
The Board met in eight regular meetings and called one
special meeting. In addition, Trustees were active in board
committee functions. The hospital was frequently visited by
various members of the Board,
A matter of major concern to the Board of Trustees was suc-
cessfully concluded. This had begun during the previous year
when Mr. Joseph P. Kelly resigned as Institution Treasurer to
accept appointment in the eentral office of the Department of
Mental Health as Administrative Assistant to the Commissioner.
After careful consideration of several candidates, the Board
unanimously appointed Paul P. Foran, of Worcester, as Institu-
tion Treasurer at its regular meeting on November 11, 1952.
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Mr. Foran qualified and officially assumed his duties on Janu-
ary 19, 1953.
The Board maintained an active Interest and participation in
the affairs of the Association of Massachusetts State Hospital
Trustees. The chairman appointed Anna 0. Tatman as its represen-
tative on the Executive Board of that organization »
The members of the Board have been pleased by the further
reduction in the number of patients in residence at the hospital 8
while at the earn® time new admissions have not decreased, All
members of the clinical services who contributed to this happy
accomplishment are to be commended.
The Board wishes to oall to your attention the fact that the
buildings of the Main Hospital are old and not of first oiass con
struotion° It is hoped that the need of renovation of these build-
ing will be recognised and that successive buildings will be worked
on eaoh year until at least all areas of patient habitation and
congregation have been completed,, The Washburn Building, whioh
has previously been renovated, has demonstrated the benefits to
be derived in terms of patient comfort, Improved sanitation and
reduction of fire hazards. In this connection the Board would
stress the need of further alterations and additions necessary to
meet reoognleed standards of public safety. Much has been done in
this regard. Much is being done. Much remains to be done. These
needs should have aetive attention, equal to that given to renova-
tion of ward structures.
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In conclusion^, the Board wishes to remark upon the
loyalty and spirit of helpfulness which pervades the
employee foroe at the hospital «
Respectfully submitted,,
Franklyn J, Scol&, Chairman
Mary V. Campbell, Vice-Chairman Daniel P. Murray, Secretary
David Go LJittigberg, M.D„ Anna 0, Tatman
Carl Co Nordgren Michael H„ Selxo
SUPERINTENDENTS REPORT
To the Truateea of Worcester State Hospital:
The f laoal year of 1953 has been a year of progreea and plana
for the future. The following general thoughts should be kept In
irind aa one reviews the appended reports of department and
division heads.
a Treatment, Eaeh ease admitted. Irrespective of age or
duration of Illness , Is given a thorough ease work-up „ It la our
policy to bring the newly admitted person to a staff meeting within
the first three days In the hospital, where, under the leadership
of the Clinical Director, a preliminary evaluation la carried out
Including recommendations for special tests, studies or Investi-
gations indicated; Immediate treatment procedures necessary and
any other considerations pertinent to the case. Thus, at the
outset our most experienced staff members plan with the residents
the particular needa of the individual patient. After 18-24 day a
in the hospital, each patient Is again brought to staff meeting
for further evaluation, review of treatment if already instituted
and decision regarding subsequent course of action. Thereafter,
the patient is returned for staff review whenever decision is
required on any important phase of the case, such as treatment
modification, or granting of privileges (open ward residence,
temporary or indefinite release from the hospital, etc.).
During the year the hospital balanced the equation of ad-
mission and separation of patients without the protection of a
,a *«» atnoqat 6a&n*
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f ?s »axiwfJ ..BejBf}* adtt o'J £«®n£ir«st*q taoJtftnmftlaaoo tart.
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waiting list. A total of 539 patients were discharged directly
from the hospital and from visit and escape status. At the same
time our pool of patients on visit to the community was main-
tained essentially unchanged. At conclusion of the year our
resident patient population was 86 less than at the beginning
of the year0
B. Teaching. We have maintained teaching programs for
each of the professional disciplines which contribute to our
clinical therapeutic efforts. We have been a teaching center for
4th year students of Tufts College Medical School and have carried
on an active , well rounded training program for peyohiatrlo reel*
dents (physicians )* which is approved by the American Board of
Psychiatry and Neurology, Inc., for a maximum of three years
training. We have furnished opportunities for training in clini-
cal psychology to psychologists seeking advanced degrees in that
field. Eight general hospital schools of nursing have been ac-
tively affiliated throughout the year as a part of their teach-
ing program for undergraduate nurses. We have conducted a train-
ing program for student occupational therapists and for students
from recognized schools of social work,,
Our various teaching programs are based on the assumption
that the majority of persons so trained will not enter the psy-
chiatric field in the strict sense of the word, it is our hope
that these efforts will contribute to the development of the
general community resources for treatment s to the end that emo-
tional and psychological disorders may be better evaluated and
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more often and more adequately treated outside the mental hospital.
It should not be overlooked,, however,, that these teaching pro-
grume have been of definite and appreciated assistance to the
hospital In recruitment of staff appointees in each of the
professional fields.
C° Research The gaps in knowledge and understanding of
psyohlatrlo disorders are still many and large. For this reason
a continuing program of researoh, which is psyehiatrlcally
oriented* is essential . The research efforts at the hospital con-
tinue to be focused principally upon schizophrenia, in which cate-
gory is found the largest percentage of therapeutic failures and
consequent long term hospitalisations.
Our state paid positions are assigned here from the central
Department of Mental Health payroll. They are in many instances
assisted by house staff members and employees. The Worcester
Foundation for Experimental Biology has actively collaborated
and assisted in several projects
D. Medical and Surgical Service. For many decades it has
been a fundamental point in this hospital e program that the
adequate treatment of the patient requires general medical facili-
ties as well as psychiatric. The Medical and Surgical Service
provides an important facet, essentially general practice in
nature. Not only are obstetrical, general surgical, orthopedic
and internal medicine needs mot, but also more obvious assist-
anoe to psyohlatrlo goals is rendered by treatment of the acute
toxic states* severe fulminating excitements, dehydration syn -
dromes, and by opportunity for psychosurgery in selected oases .
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The g&His of th© resident staff are augmented by a large number
of qualified consultants, representing every specialty field,,
E. 8 Continued Treatment " . This term is advisedly chosen
to designate an Important concept of hospital function., It is
selected to replace the tens "chronic custodial9 and stems from
th© philosophy that those ?<rh© do not improve sufficiently to
leave the hospital should be regarded as our therapeutic failures
rather than hopeless cases. Therefore, our attitude is that the
long term patient group should he constantly reviewed from the
standpoint of all therapeutic facilities currently available.
While we have not been able to reconstitute the formal Continued
Treatment Service of prewar daysj, this function has been given
renewed emphasis during the current year, and it is planned to
improve its effectiveness in the cosing year "by the addition
of a social worker*
F° Physical Plant B Mention should be made cf matters which
bear upon the physical implementation of the care and treatment
program for our patients. The buildings of th© Main Hospital are
oldB dating back to the I8?05s and ending In 1913, with the con-
struction of Quimby Building, Our Summer Street Department was
opened in 1833 as the original unit of the Massachusetts State
Hospital system. In process no?? are plans for a new hospital
building, to be constructed on the Main Hospital grounds g which
Dflll permit the discontinuance of Summer Street Department as
an active unit. At the Main Hospital, $sshbu:ra Building has "been
completely renovated, including steel reinforced concrete floors,
13.
radiant heat and entirely reorganised "bathroom facilities «> It
is expected that a similar renovation of Phillips Building will
begin early in the fiscal year 195^. The importance of a con-
tinuing program for the renovation of these old buildings cannot
be emphasised too strongly. Hot only the need for improved living
conditions for patients recommends it,, but also considerations of
safety and fire hazard control as well. In anticipation of the
new building on the main grounds , old needs become laore urgent „
The kitchen, cafeterias and ancillary servioes must be renovated,
rearranged and better equipped if the dietary department is to
adequately serve the integrated hospital which is to corns « The
replacement of the two existing outmoded elevators and the addi-
tion of two sore for Folsom and Thayer Buildings beecaes necessary,
A proper central storehouse and additional day space in the form
of an enclosed porch for Salisbury and Qulmby Buildings should
not be delayed much longer. The construction of a new Male
Bathing Suit® has dragged along throughout the year, fraught with
many technical difficulties and delays* It is not yet completed*
In pleasing contrast to this project, has been the rapidity with
which work has progressed on the renovation of unused portions
of the Farm House, which will make available five apartments fcr
personnel «,
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It appears clearly evident that the old buildings of the
Main Hospital must continue to serve for an indefinite period
in the future „ It then becomes an obligation to integrate th
in function with the nei* building which is being planned,, and to
renovate them and to alter them so that they i*ili conform to
recognised standards for public safety and provide more modern
living conditions for the patient population housed within
theia.
15.
PERSONNEL CHANGES
Ralph A. Luce, M.D., Senior Physician, was granted Kilits
Leave on January 10, 1953. Pasquale Buoniconto, Senior Physician,
resigned January 31? 1953 to become Assistant Superintendent at
the Walter E. Fernald State School. Luis Orlando Mederos, M.D.
resigned June 18, 1953 to accept an appointment at St. Francis
Hospital, Evanston, Illinois.
Two Senior Physicians returned from Military Leave during the
year; David M. Moriarity, M.D., on November 23, 1952 and D. Edward
L. Prunier, M.D. on June 2, 1953« Dean M. Laird, M.D., was promoted
*
from Junior Physician to Senior Physician on January 25, 1953 •
Jose M. Amador, M.D., Junior Physician, was granted Military
Leave May 17» 1953* Werner Jaffe, M.D., Junior Physician, resigned
January 31* 1953 to accept appointment at the King's Park State
Hospital, New York. Bernard Cowitz, M.D., Junior Physician, was
transferred to the Research Service January 1, 1953 • Rafael
Alphonso, M„D., resigned December 31? 1952 to begin a residency at
Worcester City Hospital,
Richard M. Shannon, M.D., was appointed Junior Physician on
February 23, 1953 and resigned April 3, 1953 . Urbano K. Guarin was
appointed Junior Physician April I, 1953. Pierre B. Bourdon, M.D.
was promoted from Psychiatric Resident to Junior Physician on
January 1, 1953 •
Psychiatric Residents appointed during the year were as follows:
Jacques Brien, M.D., July 1, 1952; James A. Haycox, M.D,, July 9,
1952; Brooks White, M.D., July 2, 1952; Paul E. Phoenix, M.D,, July
2, 1952; George Chornesky, M.D., September 1, 1952; and Dorothea
160
Simmons, M.D., August 18, 1952.
Altho we closed the fiscal year with one Senior vacancy and
three Junior Physician vacancies, appointments to these positions
had been consummated for early July, 1953*
On the Research Service several withdrawals occurred.
Nathan S. Kline, M.D. resigned as Research Director on October 18,
1952. Yasuhiko Taketomo, M.D., Assistant Psychiatrist, resigned
September 15, 1952. Edward H. Cranswiek, M.D., Senior Physician,
resigned Cctober 25, 1952. Ash ton M, Tenney, Research Neuro-
physiologist, resigned August 30, 1952.
In ether areas of hospital function, important changes occurred
On September 13, 1952, Far rand H. Van Dyck resigned as Chief Engi-
neer at the Summer Street Department to become Chief Engineer at
Westboro State Hospital. Newell A. Gordon was promoted to succeed
him on September 15, 1952. On January 19, 1953 Mr. Paul P. Foran
of Worcester assumed his duties as Treasurer, replacing Mr. Joseph
P. Kelly who had resigned on January 13, 1952 to become Adminis-
trative Assistant to the Commissioner in the Department of Mental
Health. On December 9, 1952 William W. Stevens from the Metro-
politan State Hospital was appointed Chef, succeeding in this
capacity Fred Somerville who had retired in the previous year on
March 31? 1952 after hO years of excellent service,,
Retirements and Deaths:
Elsie Haglund, Attendant Nurse, retired on August 9? 1952
after 5 years of conscientious service. Ella MaeDonald, Charge
Attendant, with over 20 years of kindly care to patients, re-
tired December 13, 1952. On April 30, 1953, Joseph Quinn, Hospi-
tal Supervisor Attendant, retired . He had rendered over 10 years
17,
of very conscientious service. On October 20, 1952, John C„
Anderson retired, and On April 30, 1953? Henry Gtistafson did like-
vise. The former had been with the hospital 27 years j the latter
21 years. Both were masons who became ill with pulmonary tube
culosis. Sven Nilsscn, machinist, retired after nearly 20 years
of service on June 30, 1953 • He will long be remembered for his
skill. Fred Sprague, Third Class Power Plant Engineer, retired
May 31? 1953 5 after 19 years of dependable duty. On September 30,
1952, Anton Swenson, Maintenance Foreman, retired at conclusion
of m-0 years of service which began September 30, 1912. Ke was
temporarily re-employed in the same capacity on an emergency basis*
On May 8, 1953? Dorothy A. Burnett, Junior Clerk and Stenographer,
retired after many years of work here and at Gardner State Hospi-
tal.
Four employees died during the year. Hazel MacGeoch, Matron
in Hale Nurses' Home, on March 3, 1953? 18 years of service 5
Laura R. Pugh, Dining Boom Attendant, November 17? 1952, 7 years
of service 1 Frank Dixon, Attendant Nurse, February 20, 1953? near-
ly 6 years of service % James Taylor, Charge Attendant, February
26, 1953? nearly k years of service. Each was a reliable and
valued employee.
Employment :
During the year the hospital has experienced relatively full
employment. Out of a total permanent quota of 683 positions we
have carried an average of 30 vacancies 0+,h%). The principal
number of vacancies occurred in Ward Service positions (average 20,
or 2.9$). Head nurses were most difficult to obtain. In this
category we carried an average of 8 75 positions vacant at all times.
MOVEMENT OF gOFUXAlXON
During the year ending June 30 5 1955, Worcester State
Hospital admitted 864 patients, 438 men and 426 wesson* Of these*
629 (72oS^) entered a recognized mental hospital for the first
time a A total of 209 (24 •!$} were classed as readmissions* having
previously ©sperienced psychiatric hospitalization* Twenty-six
(3»1^3 were received by transfer,, coming directly by Commissioner's
order from residence in another psychiatric hospital within the
Commonwealth*
Separations during the same period totaled 939 {480 men and
459 women}* The breakdown of this figure Is Informative* Two
hundred thirty-one (161 men and 70 women) were discharged directly
from hospital residence* Thro© hundred eight (115 men and 193
women) were discharged from visit or escape status* Thus there
was a total of 539 (276 men and 263 women) who were completely
discharged from hospital supervision* The remainder of the
separations is made up of transfers and deaths o A total of 114
(53 men and 56 women) were discharged for transfer to other
mental hospitals while £86 (146 men and 140 women) died« Of
this latter total, three died while on visit in the community* It
ia worthy of note that the transfer total Is abnormally high®
Shis Is occasioned by the fact that during the year 76 patients
(42 men and 34 women) were transferred to the new regional
Tuberculosis Unit at Weatboro Stat® Hospital « She figure for
total deaths (286) represents no significant change and Is in
line with previous experience* Further comment on this may be
19c
found In the section of tills report relating to the Medical and
Surgical Service •
In final analysis, a hospital's function is summarized by a
simple equation* It's bed capacity represents a reservoir* Into
which each year is poured its admission rate and from which is
drawn off its total separations c Applying this concept to the
Movement of Population statistics, it is noted that the hospital
began the year with 2831 patients physically in residence
(1, 316 men and 1,515 women) « It operated without waiting lists,
receiving 864 admissions* It's separations totaled 939* a
favorable balance of 75 over admissions, and at conclusion of the
year, patients actually in residence were 2,745 (1,257 men and
1,488 women) o To be fully realistic, adjustment should be made
for the Westboro transfer of 76 » Such an adjustment reduces
discharges by transfer to 38 and results in approximate equation
of the admission-discharge ratio (864:863)* To round out this
picture, it should be explained that we began the year with 47
patients in Family Care aid 397 on visit or otherwise absents we
ended the year with 54 in Family Care and 401 on visit* etc* !Ihe
residual discharge by transfer figure of 38 Is composed principally
of transfers to V«A» hospitals (14) and return to other hospitals
of women who have been sent here for prenatal and obstetrical
care* It Includes three non-residents who were deported to other
states for further hospitalise tion*
An effort was made to determine to which extent the hospital »s
facilities were used by the various courts during the year«
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Twenty-four Section 100 ooBanitmenta were received (persons under
complaint or indictment) plus one Section 105 commitment (tinder
sentence in a state operated penal institution) and five Section 104
commi brents (under sentence in a county penal Institution) <,
Section 100 commitments to tills hospital generally emanate from
Superior Courts • Many persons under complaint in District Court
are committed to the hospital but these cases are not readily
identifiable in statistics* therefore, a brief review of discharges
was made, since final dispositions were a matter of compiled
recordo It was learned that sixteen Section 100 oases and one
Section 104 case were discharged back to court* In additions
36 cases (29 men and 7 women), who had not been admitted by so-
called criminal commitment* were discharged to the custody of
District Court officials »
Because of the ever-increasing interest in gerontological
matters,, there is appended herewith a chart which reveals that
35<>9# of all first admissions were 65 years of age or older «
Breakdown by sex discloses that the percentage for female first
admissions (39»5#) somewhat exceeds that for males (35/0 » Like-
wise our actual admissions, female, (120) exceeded the males (106)
in this age rangco
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21o
FIRST ADMISSIONS
WORCESTER STATE HOSPITAL
-SEAR ENDING JUNE 30, 1953
Age Group
Bale
Female
Total
65-69
70*74
75-79
80-84
85 and over
29
19
22
25
11
21
30
23
24
22
50
49
45
49
33
Total First Admissions
65 Tears of age and
older
106
120
226
Percentage
35#
39o3#
35o9#
■;
■
22,
I§£23l 2£ SS clinical director
Psychiatric Activities
The primary concerns of a state hospital for mental diseases
should be adequate evaluation of Its patients and adequate care
and treatment for them. The staff of psychiatric physicians is
responsible for these functions. It must possess a thorough
knowledge of modern psychiatry and modern methods of treatment
ranging from the various forms of psychotherapy to the shock
therapies o The physicians should be able to function as thera-
pists themselves and also provide leadership for the therapeutic
team work vhloh can be a highly effective feature of the psy-
chiatric hospital.
The success of the psychiatrists in accomplishing these
aims will depend not only on the quality of their efforts but
also on the quantity, that Is, on the number of physicians avail-
able In this oonneotlon it is well known that there is an
overall shortage of psychiatrists , and at the same time there
has been in recent years a definite movement of psychiatrists
away from hospital work into private practice. As a result of
these trends,, many state hospitals have suffered from serious
shortages of medical personnel. It was our opinion that these
trends might be reversed , at least in part, by improving and
expanding our teaching program, thereby attracting younger men
for training and perhaps inducing some of them to remain in hos-
pital work. To this end we have expended considerable effort in
the past few years, and with some success Judging by the fact
"
tcott
Gf« s<f bJ tforia Gri
« rnmtt
i
I
il ev j
23c
that we have been able to keep our start pretty well at full
strength. In this respect, the formation of the Psychiatric
Training Faculty of Massachusetts and our affiliation with it
have been of definite help to us0
Another consideration in the stress on improving our train-
ing program is the opinion, shared by many others, that an aotive
teaohlng program for physicians not only improves their work: but
also has a beneficial spread to other employees throughout the
hospital. Consequently , the Worcester State Hospital regards its
training program for psychiatric residents as the nucleus for the
efficient functioning of its clinical activities .
Clinical Aof frvltlfff 22& **91Pm 2* fo?*ftPy
Ward conferences . The clinical activities revolve around the
psychiatric work-up of new admissions by the physicians , and dis-
cussion of these oases at ward staff conferences which are held
regularly on the major psychiatric services of the hospital.
These conferences serve two purposes: 1) they bring the patient
and his problems to the attention of the Clinical Director and the
psyehiatrlo service staff, so that the beet thinking of the group
can be utilised in dealing with each patient,, and 2) they are es-
sentially teaohlng ward rounds, serving to supervise and direct
the clinical work of the physicians.
At these conferences, which are held four times weekly, twice
on the acute male psychiatric service and twice on the acute female
service, all new oases are reviewed briefly within a few days of
admission. The problems that they present are discussed and the
lines of investigation and therapy that should be followed are
•••
•au.
i *.
.
-rt& 868.80 H* K»ii
I
24.
suggested. These patients are seen again at the ward conferences
approximately three to four weeks after their admission, at which
time eaoh physician presents a summary of the history , physical
findings and mental status of the patients who had been assigned
to him. After discussion of the slgnifloant factors, decisions
are made as to diagnosis, disposition and therapy.
At the conclusion of these conferences , attention is given to
other patients who may hare been in the hospital for some time and
who come for consideration of changes of management or therapy, In
some eases where good progress is reported, the patients may be
given greater responsibilities within the hospital set-up or plans
may be made for their return to the community. Other patients who
are failing to make satisfactory progress may be brought up to dis-
cuss and to make decisions on modifications of the treatment
program.
The foregoing conferences are attended by representatives of
the Psychology, Social Service , Occupational Therapy and Nursing
Departments, and a free exchange of views is encouraged.
In order to convey an impression of the day to day activities
occurring in the foregoing conferences, it may be useful to present
the following figures, which represent the average number of pa-
tients seen per month during the year July 1, 1952 to June JO 9
1953 for certain specif ic purposes at these ward conferences §
-
I
[
■
■ ■ .
.
25o
New patients 73
Patients for diagnosis, disposition and therapy 68
Special evaluation for:
Visits llfc
Open ward plaoeaent 46
Consideration for Electric Shock Therapy 25
Consideration for Insulin Shook Therapy 3
Consideration for lohotoray
Family Care
i
General staff conferences. Clinical conferences of from one
to one and a half hours duration are held twice weekly, conducted
by the Clinical Director and attended by all members of the psy-
chiatric staff and hy representatives of the ancillary services
of the hospital. Each conference is devoted to detailed discus-
sion of an individual case presented hy a member of the psychiatric
staff. Cases are selected which display problems of special in-
terest from psychodynamiCs psychopathologi©^ therapeutic or diag-
nostic angles.,
Program of therapy «, The hospital utilizes all accepted
methods of treatment. It stresses individual consideration of the
needs of the patient with the following types of therapy in minds
1. Individual pgy oho therapy. Is considered the treatment of
choice in many cases. The type and intensity will depend on the
olinioal indications in each case,, with due regard for the work
load of the physicians, and the need for close supervision of the
psychotherapeutic activities of the younger physicians. This
supervision is provided by regularly scheduled supervisory sessions
by senior members of the staff and teaching consultants. An idea
of the extent of this type of treatment may be given by figures
which indicate that 43 patients were seen for a total of 334
26o
psychotherapeutic sessions (usually of about one hourus duration
each) on an average during eaeh month of the current year0
2. group psychotherapy is being used to an increasing ex-
tent , though still on a rather modest scale. The figures on an
average per month are as follows*.
Number of groups 6
Number of patients 51
Kuraber of sessions 48
Some of the groups consisted of patients who were already
grouped together on the basis that they were receiving insulin
shock therapy. Others were formed on the basis of oertain common
problems, for example, a group of adolescent, delinquent girls,
another group of middle-aged to elderly patients. In general, the
type of group therapy has been non-directive and dynamically
oriented. As in individual psychotherapy, careful control of the
work of the younger psychiatrists is necessary, and for thie pur=
pose one of our teaohing consultants has been holding a two hour
supervisory session weekly.
3. The concept of the therapeutic team is kept in mind in
helping to attain as complete rehabilitation of the patient as
possible. All the facilities of the hospital, if properly util-
ized, may contribute to a successful result. A central foctxs of
this combined therapeutic effort is an active program of occupa-
tional therapy in which the nursing services and the industrial
departments of the hospital are closely integrated. The program
emphasizes the beneficial value of work, if properly prescribed
27.
and adequately supervised, In the various hospital Industries
which provide a relatively normal work environment and a broad
range of graded activities. For the success of this program
there must be close cooperation and a sharing of leadership be-
tween the physicians and occupational therapists in the place-
ment and day to day supervision of the patients. At the same
time8 craft work and recreational and group activities are not
negleoted, and in selected cases there are opportunities for edu-
cational guidance with correspondence courses of a general educa-
tional or vocational nature.
*• 7he Social Service Department plays an important role
in the total therapeutic program by concentrating on planning
for the return of the patients to the community and their social
rehabilitation.
5. Special forms of treatment along physical lines are pre*
scribed for individual patients on the basis of sound clinical
Judgment. These would include electric shock and insulin shock
therapy D prefrontal lobotomy and chemotherapy for neurosyphilis,
sodium amytal interviews, a vitamin regime for alcoholic psychosis
or other special medical measures indicated for toxic or organic
states. In this connection, eleotroencephalographic studies of
selected patients has proved to be a useful diagnostic prooedure„
The shook therapies have been used freely, though not indiscrimi-
nately, and there is no doubt that In our present state of psy
chiatric knowledge they are worth while additions to our thera-
peutic armamentarium . A few details of some of these commonly
used therapies are presented In the following paragraphs.
28.
a» Electric shock therapy., We hare oontinued to
use the standard, form of convulsive treatment. It ie
often the treatment of ohoiee in depressive reactions
of all types and in manic states. However., it is still
felt that eleetrlc shock therapy should not he given
routinely, even in oases of depression (where it may be
especially successful), since some of these oases will
respond well* and with probably better long term results,
to psychotherapy and more conservative measures. In
schizophrenic conditions, electric shock therapy is often
prescribed in acute and stormy cases , but here too each
case should be considered individually. It may be given
to other schisophrenic patients in whom a trial of psycho-
therapy and occupational therapy has failed to produce
good results. It Is also given to selected chronic schiso-
phrenic patients In an attempt to improve their institu-
tional adjustment. In such oases it is usually given on a
maintenance basis, that is, beginning with one treatment
per week and gradually extending the length of time be-
tween treatments to two weeks or a month or even longer,.
Worth while improvement is obtained In a considerable
number of ohronio cases by this method. In the more acute
cases the patients usually reoelve three treatments weekly
for from 10 to 20 treatments „ the exact number depending
on their progress, and towards the end of the course
the treatments may be spread out to a weekly maintenance
basis for a few weeks. The following are a few figures
for the current years
29o
Electric Shook Therapy
Male Female Total
Average monthly number of patients 8? 66 153
Average monthly number of treatments 368 kO? 775
Total patients treated during year 173 189 362
t>« Insulin coma and, subeoma therapy. Insulin eoaa
therapy ie the treatment of ohoioe for a considerable num-
ber of schisophrenic patients , especially for those patients
under kO years of age with illnesses of relatively brief
duration (perhaps up to on© or on© and a half year's length).
It may b© combined with individual or group therapy, or it
may be given after a trial of psychotherapy alone has proved
unsuccessful. The treatments are given five mornings a week
until up to *K> or 50 comas have been obtained. Since this
form of treatment is a distinct stress to the whole
organism., the patients must be in good physical condition
and they must receive very close nursing and medical super-
vision. Insulin subeoma therapy is used on a more limited
scale, for borderline oases of tension or anxiety states.?
including some of -She severer neurotic conditions requir-
ing hospital treatment. It may also be often combined
advantageously with psychotherapy. The figures for the
current year are as follows:
Insulin Coma Therapy
Male Female Total
Average monthly number of patients 9 9 18
Average monthly number of treatments 122 133 255
Total patients treated during year 31 32 63
Male
Female
Total
1.5
1
2.5
19
10
29
6
13
19
30.
Insulin Subcoraa Therapy
Are rage monthly number of patients
Average monthly number of treatments
Total patients treated during year
o. Prefrontal lobptomv. We have continued to use
prefrontal lobotoray in selected oases. It is regarded
as a treatment of last re sort » to be advocated only
after all other methods have been tried thoroughly and
have failed 0 It has been applied chiefly to chronio
schizophrenic patients who continue to show overactive ,
aggressive and tense behavior. A total of 26 patients
reoelved prefrontal lobotomy during th© course of the
year. A modification of th© standard operation in the
form of unilateral lobotomy is being tried in some
cases 9 with the idea that this sore limited procedure
may show less of th® unfavorable blunting effeots of
the standard operation. It is too early to determine
how effective unilateral lobotomy will prove to be.
?aychoaom,atic Ottt~?atjent Clonic. sM geriatric. Cllnj^
As part of the overall treatment program, the hospital conducts
a psychosomatic out-patient olinio at the Worcester Oith Hospital ,
It Is held twice weekly, on one afternoon and on one evening. As
a supplement to this clinic., a geriatric clinic., under the direc-
tion of Dr. Harry Freeman and the Clinical Director, has been
established. It meets bi-weekly. During th© year under review,
31a
the number of patients was as follows %
New Patients Total visits to clinic
Psychosomatic clinic 77 1382
Geriatrie clinio 3 95
These out-patient clinics fulfill an Important community
function^ since they are the only adult psychiatric clinics in
the city of Worcester. They also serve the purpose of providing
the residents with training and experience in out-patient psy-
chiatry. The psychosomatic clinic alms to provide psychotherapy
on a regularly scheduled weekly "basis for patients who are con-
sidered suitable for such treatment. When residents are assigned
to work in the clinic they are supervised by senior members of the
staff who see eaoh resident individually at least one hour a week.
Over-all supervision of the psychotherapeutic activities of th©
clinic is provided by one of our teaching consultants B Dr. Sidney
Kllgerman* who conducts a weekly two-hour conference for all par-
ticipants in the clinic activities, as well as group supex'vlsory
sessions for second and third year residents.
Training Program. Many of the training activities have
already been described in connection with the work with patients
to which they are geared. Some general features and additional
details may now be mentioned. The hospital is approved for the
three years of residency training required by the American Board
of Psychiatry and Neurology for qualification for certification
as a Diplomats of that Board. The training for first year resi-
dents is designed to provide basic and intensive experience in
32.
the field of the psychoses and the more serious psychiatric con-
ditions requiring care or observation in a mental hospital . They
devote most of their time to admitting new patients and perform-
ing complete psychiatric work-up of assigned oases under the
supervision of the Clinical Director and senior members of the
staff. They take an active part, under supervision* in . 11
forme of treatment „ including psychotherapy and the shook thera-
pies „ and they may help in the teaching of student nurses and
medical students. The second and third year residents are given
increasing responsibilities and opportunities for more indepen-
dent work in fche treatment and management of in-patients and
out-patients $ under supervision, and they participate in the
ollnical and administrative activities involved in ward and
service management.
The demands of modern psychiatric training have necessitated
the increasing use of teaching consultants to supplement and ex-
pand the teaching program. Many state hospitals „ including the
Worcester State Hospital, do not have a sufficient number of
regular staff members adequately trained in dynamically oriented
psyohiatry to supply the needs of modern residency training. It
is hoped that in the future we will be able tokttract to and
keep on our regular staff sufficient well trained men to meet
these needs. The list of our teaching consultants, most of whom
are in the Boston psychoanalytic group, is as follows =
fx
Dr. Lout a 3c Chase
Dr. Thomas Bwyer
Dr. Sidney Kligerraan
Dr. Lincoln Lebeaux
Dr. Sidney Levin
Dr. Arnold Modell
Dr„ Harry Rand
Systematic training in individual and group therapy is pro-
Tided lay the teaching consultants , who conduct a series of regu-
larly scheduled supervisory sessions. Residents are assigned to
the different sessions in accordance vlth the level of skills and
experience that they have reached. In addition to this, first
year residents are supervised in their psychiatric work-up of
their patients by weekly individual conferences with the Clinical
Director or senior members of the staff. Also, a series of weekly
orientation talks extending throughout the year is given to first
year residents by various members of the staff , including the
heads of the Psychology, Social Service, Occupational Therapy and
Nursing Departments. The major portion of this series is devoted
to discussion of psyohopathology, historical aspects of psychiatry,
clinical syndromes and psychodynsmlos.
Neurological conferences are held from four to six times
monthly. They include systematic presentation of neuroanatomies
neurophysiology and neuropathologlo data as well as clinical
examination and discussion of selected neurologic oases.
An orientation in child psychiatry is provided for all mem-
bers of the staff by means of a monthly teaching conference con-
ducted by Dr. J. Welnreb, the Director of the Worcester Youth
Guidance Center, which provides out-patient services in child
t art* ^df J5
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34
psychiatry for the Worcester area. There may he opportunities
for third year residents to do part-time work at this center,
A Journal Club meets bi-weekly during the academic year
and all members of the staff may participate in Its activities .
Medical Students. The hospital is affiliated with the
Tufts College Medical School, which assigns two fourth year
students at a time continuously during the academic year for a
four-week Internship at the hospital. Members of the psychiatric
staff give a review course of talks to the medical students and
supervise their clinical work. The following students interned
at this hospital during the course of the year: David R.
Bassett, Richard E. Barron, Arthur F. Blekf ord, Jr. , Ronald 6.
Gzaja, Charles L. Erlekson, Andrew D. Guthrie, Jr., Alfred L.
Burst, Jr., Bernard Loltman, Albert D. McCarthy, Lawrence M.
MeCartln, Duncan L. MoCollester, Robert W. Monerieff ,
Walter C. Murray, Robert C. Sohoenfeld, Elliott T. Shlnn,
William G„ Shull, Ivan T. Vasey, James A. Whelton.
togffftTgft && T*rt»UofrnoiM* As in the past, this hospital
reoognises the importance of research in psychiatry, and it en-
oourages members of the staff to take part in research projects
with others on the Research Service or to undertake projects of
their own, within the limits of the time available and the
soientlf io capacities of the individuals concerned, In this
connection, the clinical services cooperate closely with the
>1 XK
t m&t& to*
VfcMi d ;.• xnxvoXt A
%tm tta^ii «rf3 to siexfrnea Urn ftn»
« *« »£«©!>,
i & ewts tljB^a
tsorf BXll?
b8 »S frrafoifl- ^^dae^a
.¥£93 . ...lit t?VXU&
■
so en arte o d
■
3 89©
Psychology Department, the Dementia Praecox Research unit of
the Worcester 3tate Hospital and the Worcester Foundation for
Experimental Biology. The Research Service holds seminars for
the psyohiatrlo staff from time to time in order to keep them
oriented on the research activities of the hospital.
The following papers were published by members of the
psychiatric staff during the course of the year;
MS,, Mora (with J.R. Friedman and J. Golombh The hair
whorl sign for handedness, Diseases of the Hervous System,
2JX208-.216, (July) 1952.
S.Lo Sands and D, Rothschild, Soelopsyohiatrle foundations
for a theory of the reactions to aging, J. Nerv, and Mont.
Diseases. 13,6x233-2^1, (Sept.) 19520
J C0 Sabbath and R.A. Luce. Psychosis and bronchial
asthma, Psychiatric Quarterly. 2|>s562-5?6, (Oot.) 19520
E,A. Daneman. Carbon monoxide poisoning, Diseases eg
ana fierjaas £x*£s&, Ifes39-fc8, (Feb. ) 1953*
R.A. Luce and D„ Rothschild. The correlation of EEG and
clinical observations In psychiatric patients orer 65,
£. St SS£ffiSal2Er, lsl67»1729 (April) 1953»
■
-tAnctAnrt?
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36,
OCCUPATIONAL THERAPY DEPARTMENT
Personnel
During this period personnel consisted of Mrs. Evelina Elmad-
jian, OTR, Head O.T., and Mrs. Marjorie E. Valdman, OTR, who re-
signed on January 30, 1953. Mrs. Elsa Fine, O.T. Aide joined the
staff on September 15, 1952, Mr. Robert lienoit, O.T. Aide on Octo-
ber 20, 1952, Mr. Charles Estano, O.T. .aide on December 17, 1952,
and Miss Margaret Plumley, OTR, on March 3, 1952. This personnel
was still employed on June 30, 1953.
Department SsJMev ^nd Program
Our policy remains essentially as outlined in previous re-
ports. The policy of the Industrial Therapy Placement Service
with acute treatment patients is to place the patient in a reality
testing situation, which is selected for him individually and
changed according to this changing needs, and on this level is
aimed at rehabilitation with the final goal of returning to a
work situation in the community. With regard to continued treat-
ment patients the program is aimed at maintaining the patient at
as high a level of mental and physical function as possible, and
to give Mm a normal day of work and social adjustment within the
hospital.
Patients are assigned to work in positions in the hospital
industries by physician's prescription. Each employee who has
one or more patients working with him is called an industrial
therapist. Thus the industrial therapist is responsible for the
.
.
:
. ■
37<
mental and physical well~being and occupational treatment of the
patient during the working period, as well as for the production
of his department. The occupational therapist serves in lie a ion
capacity between the physician and the industry. It is her res-
ponsibility to place all patients personally , to instruct the in-
dustrial therapist regarding treatment alms, to check continually
on the patient" 8 adjustment and progress, and to report the re-
sults of the treatment to the physician. For this purpose two
industrial placement of floes are maintained, with a full time
therapist in charge of each, in whioh the details of such a pro-
gram are handled and records kept. In this manner a dally aver~
age of approximately 800 patients are occupied at the main hospi-
tal in tasks graded to their mental and physical capacities. This
figure is based on patients on psychiatric wards only, and does
not lnolude patients on medical and geriatrics wards.
The two Occupational Therapy Centers have continued the poli-
cy of treating individual patients under the direct supervision of
the physician. Patients are assigned to the centers immediately
upon admission and are graduated from the Center Into Industrial
Placement for treatment as outlined above. The average dally
attendance in the centers is approximately 40 patients and one
therapist is employed full time in each center. In addition to
new admissions, electro- shook and post°*lobotomy patients are
treated. Fine and manual arts are used as treatment media , and
socialising events are held from time to tlme0
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During the report period a Ceramics Shop was set up in con-
junction with the Somen's Center. A kiln is available. This
project was found very beneficial as an outlet for emotional and
creative needs, and functioned daily, with two evening periods a
week under supervision of an O.T. student and two volunteers.
Also during this period three ward projects on the Male Ser-
vice were organized by the O.T. Department and carried on under
the direct supervision of ward personnel. Supplies, instruction
and advice were furnished by this department, and approximately
L, hours per week of O.T. personnel were devoted to these projects.
Supplies were ordered and disbursed by the head O.T.
This department has co-operated with the Women's Auxiliary
of the hospital in their activities in behalf of the patients.
O.T. staff members attend an average of three staff con-
ferences per week for the purpose of reporting on the progress
of patients in Industrial Therapy and centers. An average of 10
personnel hours per week is devoted to this. It is felt to be a
v-tlid contribution to diagnostic procedure and treatment plans for
the patient.
Student Tr.aiQJi.nK
The department is a clinical training center for occupation-
al therapy students. This year 11 students were in affiliation
in three 4 month periods - 10 from Boston School of Occupational
Therapy, and 1 from Richmond Professional Institute, College of
William and Mary. The head O.T. devoted 2 hours lecture and in-
struction to each group of student nurses affiliating at the
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39o
hospital. T;.llcs were given by head O.T. to residents.
Recreational anj. SocjaUzlns AgUvJUe?
Ten monthly dancing prrties with music, decoration, entertain-
ment and refreshments were held during the year. Attendance at
these events was from 500 to 750 patients. A monthly soci'l event
was held for a mixed group of new admission and treatment pstients -
attendance approximately 60 patients. Two mixed group parties were
held for geriatrics patients - attendance approximately 150 each.
This department co-operated with the Women1 s Auxiliary of the hos-
pital in their activities in behalf of the patients. During the
suaier the department co-operated with the Theological Se.iinar
students in outside activities, tennis, etc., and a ward program
of activities.
An all day Memorial Day program was arranged, consisting of
an appropriate memorial day service in the morning, and a concert
and community sing in the afternoon.
On the 4th of July a carnival was held.
On Labor Day an all day progran was arranged.
Seasonal Activities
The purc'iase and handling of hospital gifts to each patient
was done by this department, the supervision of which consumed a
great deal of personnel time from the middle of November until
after the New Year. Approximately 3500 items were packaged in-
dividually and distributed to the wards. Sixteen hundred and
forty (1640) pounds of candy was sorted and boxed and distributed.
(
■
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AOo
A Christians party and Hew Year's ball were given for all patients
able to attend. Decorations vers made and arranged throughout the
hospital. Decorations uere also distributed to the wards. The
staff participated in the annual carol service.
HQSpU^l Mewsoajer
During this year a newspaper was organized, called HEI.S PRESS,
which is a tiierapeutic project directed by the department. It
consists of a 5 page lay-out and has a circulation of 1000 copies.
It has a patient editor and staff.
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DEPARTMENT OF NURSING
Organization
This department has two major goals, Nursing care of patients,
and Education. The Principal of the School of Nursing functions
as a Superintendent of Nurses with supervisory responsibility for
all phases of the department's activity. The Chief Hospital Super-
visors serve as Assistants to the Superintendent of Nurses in Nurs-
ing Administration and Service, thus providing for coordination
and correlation throughout the department. The Assistant Princi-
pals of the School of Nursing serve as Co-directors of Nursing
Education, having direct charge of instruction of Affiliate Nurse
Students.
Administrative Conferences are held each week with the en-
tire Supervisory group including the "Attendant Supervisors".
In this Conference the activities of the week are outlined and
Nursing Service problems are discussed. The Head Nurse group
has two meetings each month. The first meeting is devoted to
Administrative and Service problems, the second meeting centers
around problems of teaching the student Nurses on the wards. The
second monthly meeting of the Head Nurse group is concluded with
a sociable coffee period (expenses borne by a 25 cent assessment
for each member of the group.) In the individual services the
Doctor in charge has regular meetings with the Supervisor, Head
Nurse and Charge Attendants in a group to discuss the problems
of patients and how each one can contribute the best to meet
these individual needs.
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Mwsilnfl 9sn1,ce
This year we set aside ward Washburn 4 as a unit for the care
and rehabilitation of our post-lobotomy patients. Regularly
scheduled activities such as occupational therapy, play and recre-
ational therapy, personal hygiene and grooming, have been given a
new eiphasis by having these patients on a single ward unit. Stu-
dent iJurses under the supervision of a graduate Nurse have been
assigned to the unit and the patients respond well to their program.
Our Hydro cafeteria has been remodeled at this time. During
the remodeling a temporary cafeteria was set up on the Woodward 2
porch. With the renovations completed, the Hydro cafeteria has
become a very pleasant and cheerful spot where our more disturbed
patients can dine in small groups with close supervision.
Fros September to November the entire personnel of the hos-
pital was given the standard Red Cross First Aid Course and each
was granted a certificate. This was accomplished by teaching 3
classes 5 days each week and 2 evening classes each week. These
classes were taught by Nurses from the ward services who had taken
the Instructors Course given by the Red Cross. Doctors Flower
and Kelson helped by giving several hours each.
In June when the Tornado disaster struck Worcester, members
of our personnel, Nurses and Attendants, gave tine to helping
in other area hospitals after completing a tour of duty here.
Several of our Nurses worked at local hospitals on their day or
nights off duty. Many of our people had to do extra duty here
also to help make up for those who had been personally affected
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by the disaster and had to miss work as a consequence.
Personnel
During the year we had 107 appointments to positions; 110
separations from the service of the hospital. We made 13 pro-
motions and 3 transfers from one departma
another. It is our policy in selecting personnel for the Nurs-
ing Service to use the services of a Committee composed of the 2
Chief Supervisors, the Attendant Instructor, and the Principal of
the School of Nursing (Supt. of Nurses).
Nurstag Eduction
We receive Affiliating Students from the following hospitals:
Burbank Hospital, Fitchburg
Faulkner Hospital, Boston
Hahnemann Hospital, Worcester
Milford Hospital, Milford
Mt. Auburn Hospital, Cambridge
St. Vincents Hospital, Worcester
Worcester City Hospital, Worcester
Framingham Union Hospital, Framing ham
We receive students in a staggered rotation system, a group
reporting every 6 weeks for a period of 3 months. We average a
total of 46 students at all times. Each Student spends her first
week in classes (kno^n as a class block) . At the beginning of
the second week she is introduced to the ward situation by spend-
ing her mornings on the ward and her afternoons in classes. At
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the end of her first 6 weeks she spends her entire day in the
ward except for periodically scheduled classes. The Doctors
and Nursing faculty, members from Psychology Department and
Youth Guidance Center, all participate in the teaching program
A total of 255 student Nurses were given instruction in Psychia-
tric IJursing during this year.
As an important part of the overall teaching program we
appointed a full time Nurse to the task of teaching the Atten-
dants. This instruction is centered about their duties on the
job here at this hospital and does not provide for licensure as
a Practical Attendant. We feel that a sound educational program
with stress by example of the therapeutic attitudes is the best
possible method of raising the standards of Nursing care.
We were fortunate in having a graduate Student from i'lcGill
University, .-lontreol, Alss Alberta Hornibrook, R.M., spend a month
with us observing and studying Nursing Administration in Nursing
Service. We had a graduate Student from Panama, dr. iiiguel Tejada,
R.N., who spent 6 months with us taking the basic course in Psychi-
atric Nursing.
Because of the decrease in the number of packs and continu-
ous tubs ordered by the Physicians, it was decided to close the
female hydrotherapy unit and use it as a space for Insulin Therapy
to be given. The hydrotherapy unit on the male side had previous-
ly been closed. We are still equipped to give an occasional pnck
or tub if the need is indicated, but find that the other therapies
appear to be taking its place.
Oil 81*
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45
RECREATION DEPARTMENt
The Recreation Director feels the need of varied activities
and entertainments in a mental hospital and has tried to plar,
for many different types of individuals. For the socially
ellned, dances are given in Sargent Hall, for those who are
interested in games, Whist, Beano and other games are planned,,
As everyone likes plenios and parties, weenie roasts and out-
side picnics are given and ward parties are held. We have b#en
extremely luoky to have the American Legion Auxiliary, the
Veterans of Foreign Wars and Auxiliary, the National Mothers
and the Worcester State Hospital Auxiliary give parties and
danoes for our patients during the year.
There are many patients in the hospital who are musical and
plans are made so they may have practice periods and re-
hearsals. For the men who are interested in sports, ball games
are held, and we feel that our own Worcester State Hospital
"Blue Gaps" team is "tops". In order to make this report brie?
it will be summarised as follows*
TVenty parties were given on wards and in various indus-
tries where patients work At these parties, refreshments &re
served, consisting of cheese cracker sandwiches , cookies, candy .s
punch, ice cream and cigarettes. On many of the wards* pati**-.*>-
will dance, on other wards games will he played with prises of
candy oars or cigarettes. On the wards where older folks re-
side, they seem to enjoy the music of the accordion played by
the Recreation Director.
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us.
In the summer time picnics are held outdoors and on July
Uth and Labor Day, weather permitting, games and carnival ac-
tivities are held In the morning for all patients able to go
outdoors. In the afternoon a dance Is held and patients may
dance on the outdoor danoe space to orchestra music,
Weenie roasts $ birthday parties for elderly people, danoe s
for all holidays p a fashion show, lawn parties given for Jewish
patients by a Jewish organisation, entertainments and dances
given by student nurses for patients and band oonoerts given by
the Norton Band, were all part of the pleasurable events of the
year.
Twenty Beano games were held in Sargent Hall and on wards
for patients who enjoy the game. Prises of candy bars, cigar-
ettes , writing paper, cookies, powder, playing cards, pipes and
tobacco were given to the winners.
Nine Whist parties were given for male and female patients
in Sargent Hall. Cookies and coffee were served at these parties
and prises were given to high and low score winners.
On Memorial Day a program was held in Sargent Hall. Oar
student nurses gave a chorus number and solos were given by
patients An address was given by our chaplain. Even though
this is a solemn oocasion many patients attended and liked the
Service.
Our Christmas Candlelight Service is a tradition and many
patients have spoken of the beauty of the Service. This is given
by the nursing staff and the students.
Christmas carols were sung on male and female wards by pa-
tient carolers who marched through the wards. All patients
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enjoy this and many patients show their appreciation by encoring
when the carolers leave the wardo
Church Services
PIT ty- three Protestant Services were held during the year
at Worcester State Hospital and Summer Street Department* Organ
music was played at Worcester State Hospital and piano music at
Summer Street Department., At the Protestant Services 556 male
and female patients joined in choir work and many enjoy singing
solos and duetse
Thirty-five Jewish Services were held at Worcester State
Hospital o Organ music was played for the Services o
Twelve Episcopal Services were held at Worcester State
Hospital o
Prac tice Periods
One hundred fifty-four practice periods were allowed in
studio for patients interested in piano, violin and guitar and
voice o
Rehearsals
One hundred t^ent,/- three rehearsals with violinist? ladles
choral group, student nurses for Candlelight Service* soloists
and student nurse chorus for Memorial Day number »
Music
Choir numbers » duets and solos given at Protestant Church
Services by members of patient choir,, every Sunday morning °
Violin and organ prelude and postlude solos given at
Protestant Sunday Services twenty-one Sundays during the year*
(Patient violinist) »
ASo
Record music played lot studio by patientao
Piano music played in studio «
Violin and accordion music played on wards for patients
enjoyment o
Violin and accordion music played on lawns when patients were
out in afternoon*
Records borrowed by student nurses for music on wards «
Games
One hundred sixty-four games of Hearts, Whist, Pachesi, War*
Cribbage, Casino and Rummy with groups*
Soft Ball Games
Our soft ball team bad 51 games at home field with patient vs<
employee teams » One game was at Grafton State Hospital with
Grafton State Hospital team and two games were with Hood's Mlk Co
vso Worcester State Hospital Blue Caps*
In the miscellaneous activity field were requisitions for
party supplies > planning with ward nurses and department employees
for par ties > monthly reports made out, choir robes and surplices
to Chapel for use at Protestant Services* plans made with
Entertainment Chairman of various organisations for parties to
be given in Sargent Hall for patients, thank you letters to
organisations for parties given patients. Whist tallies made out
for Whist parties, 36 pianos tuned by State Division of the Blind,
interviews with the Occupational therapy Department, Chaplin,
Doctors, Steward, inventoxy sad beano cards put in order for
beano games* Two pianos donated to hospital a New Cross and
surf -a a
•^knJa at. be-. .'jtetfist oivnl^
no be rroilfy xV
e netf' saw ©ins^ an olqaw
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49o
candlesticks given to Summer Street Department for Protestant
Services • Cards , games and recreation equipment given to wards
for patients use* Interview with school girl about Musical Therapy 0
New amplifying system installed in Sargent Bail,, June 16 9 1953 *
Chairs back in Sargent Ball after 19 dances given.. Male patient
helpers* One patient assigned to department to assist Recreation
Director.
Radio
From our centralized radio control room* music and news is
sent to wards by rebroadcast of outside radio programs , local
programs from studio given by patient talent and recordings from
control room of radio department with patient assistant acting as
"disc dockeytt»
A new microphone was installed in the studio, June, 1953 o
Radio programs were typed daily*
Twenty** throe radio programs were given over Worcester State
Hospital radio station by patient talent - piano recitals and
violin recitals*
Thirty-four replacements in radio speakers on wards, June, 1953..
New relay system was installed in radio department -
Electric rectifier for relay system (paging) June, 1953*
Radio music, record music, and news sent to wards, five days
of week from 1:00 - 4:00 and from 6:00 - 9:00 P«M»
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The hospital is served hy Chaplains representing each of
the three major faiths, Catholic, Protostasit and Je^lsho
The CoEralseion on Administration and Flneao© has estab-
lished rates for remuneration of full time accredited ®h&p~
laina. The Oatholio chaplain has been appointed, "by the Bishop
of the Worcester dl©«a©s® and sssrrog full time. The Protestant
chaplain nas appointed 9 on a frail tia®. basis, fey the Superin-
tendent after he bad been approved for such assignment hy the
Committee on Institutional Ministry of the Massachusetts
Coonell of Churches. Si® Jewish chaplain still serves usadar
th® older authorisation of f isced rate p®r religious ssrvio©
h®Xd„ The rea@oiii fer this is that no generally accepted,
ageney for the accreditation of rabbis existed, The United
RabMni© Chaplaincy Commission ha® been formed and r@ cog-
nised as the ©artlfying body. Based on Jewish in-patient popu-
lation, the GoBiHsisslon on Administration and Finance has ap~
proved one-third time for the Jewish chaplain at %h® hospital ,
Sine© tills will require considerable readjustment of Jewish
chaplain9® time allotment, appointment binder the new plan has
not as yet been accomplished,,
The senior chaplain from the standpoint of length of ser-
vie© is B&bfei Savid Alp©rt, ©f Brockllae, who has occupied
tale position for c^er tisenty years. H&bfei Alpert Is keenly
interested In his work. He hag regularly conducted services
each ■areek; he h&w, been of assistance in problem® which have
51,
arisen in the eases of individual patients and he has main-
tained a close relationship with the families of patients.
If, as seems lifc®lye th© new pattern of chaplain function will
require that Babtol Alpert devotes his time t© institutions in
the Boston area, h© trill la© missed by many friends at
Worcester.
Hext in service seniority is Rev. John X, Smith9 the
Protestant Chaplain^ who lias been with us sine© 19^8. His pro«
gram is principally eonposefi of few functions s 1.) Beiigleas
Services, flies© are conducted each Sunday ,> both at th© Main
Hospital and at Suismer Street Department. Special services are
held on Christmas morning and daring Lent. A patients5 ehoir
presides special msaaio. 2.) Visitation of patient®. An ef-
fort is made to see each newly admitted Protestant patient
during th© first wees: of hospital stay. In many instances,
this leads to subsequent interview* Contact is also made with
the families of some patients "by sailff "by telephone or by per-
sonal visits. 3.5 Teaching and Training Activities, ^he
Protestant 8haplain served as one of the faculty for a six
we©& suiter school. of Clinical Pastoral f raining for clergy-
men s sponsored "by th® Institute of Pastoral Oar®, of Boston „
Fifteen students participated t representing seven denominations,
eight seminaries and three countries. Also during the year the
hospital provided a seminar meeting for institutional chaplains
within th© state. ^* ) Public Relations, lis® Protestant Chap-
lain serves in th© Bep&rteent of Religion and Health ©f the
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Sreater Worcester Area Council of Churches; on the Board of
Directors of th© Central Massachusetts League of Hurses; on
th® Advisory Committee to the hospital "s School of Parsing,
and on the Board of Directors of the Worcester Committee on
Alcoholism. H® has given many talk® regarding the. hospital to
church groups and ©oimunity organisations.
The Oatholio Chaplain is Rev,, Henry F. Murphy, vhose ser-
vice vith us began in April, 1952. He celebrates Mass for the
Catholic patients at the Main Hospital and at Sumner Street De-
partment on each Sunday, Holy Day and HFirst Friday." The
attendance at Sunday Mass averages 350 at the Main Hospital and
at Summer Street Department, about 150. Schedules for Con-
fessions are posted before these services, and the chaplain is
available in his office during the day to patients who may
visit hira there. Likewise, he administers the "Last Sacra*.
meats" to all who are in danger of death. For this service
Father Murphy is available at all hours for immediate call. In
his absenos a substitute priest is provided. Father Murphy
offers a Mass of Requiem and reads the committal service for all
Catholic patients interred in Hillside Cemetery, ©sraed by the
hospital in Shrewsbury.
Tim chaplain endeavors to see each nearly admitted patient
who Is of Catholic faith. E@ spends a great deal of time on the
wards and counsels many patients in his office. On Saturday and
Sunday afternoons he is available in his office for interviews
with relatives and friends of patients.
.
ANNUAL REPORT OF THE SOCIAL SERVICE DEPARTMENT
For year ending June 30, 1953*
Olive E. Dorraan
Head Social Worker
Several years ago, the Social Service Department was forced
to face reality, and to make rather radical changes in its program 3
With the number of admissions steadily increasing, a nd the depart-
ment having only four social workers at the time to take all the
histories in addition to many other duties, we were expected to
perform, we developed a feeling of frustration* As a result of
many conferences with the Psychiatric Staff, the Clinical Director
and the Superintendent, it was agreed that we would do no medical
social histories, (which on six to seven hundred admissions were
so time consuming), but that we should devote our time to getting
patients out of the hospital, and keeping them out* It was further
agreed that all patients who were ready to leave the hospital by
Discharge from Observation, by short or long visits, whould be re~
f erred to Social Service for plans to be made with and for them, a
that all patients out on indefinite visit should be the responsi-;: \
of Social Service for supervision during the year's visit period.
Therefore, the Junior Psychiatrists and the Residents take the h: !
tories on most of the admissions, except those who come in unc r
ciai Court Commitment such as Section 100, and those patients
n whose history there appears to be a need for an outside ii li-
gation to be done, these are referred to Social Service,, Carefu
53,
prepared questionaires which are sent to the families of all pa-
tients, upon admission, are often painstakingly made out by the
relatives, and these serve quite well in many cases*
Our first contact with patients is either on admission, if
relatives accompany them, and seem confused over the proceedure
etc., or within three days, when as a member of the therapeutic
team, the Social Worker attends the new case conference on the
admission ward. There any assistance needed from the Social Ser-
vice Department is suggested by the Staff Psychiatrists.
On the first visiting day after the patient's admission rel-
atives are encouraged to come to the office, for there are two
Social Workers on duty every day in the year. We plant in the
minds of the relatives that before too long their patient may
conditions
be able to leave the hospital, and/in the home which may have con-
tributed to the illness thus may be talked out early in the hosp-
italization* Anxieties, hostilities, plus limitations which the
relatives, as well as the patient must recognize and sometimes
accept, and the sharing of time and knowledge by the Social Worker
with the relatives, makes for better adjustment when the patient
actually leaves the hospital*
Many so-called "Personal Services" are done for the patient
on admission, which will ease his anxiety over bits of business
which his admission Interrupted* Clothes at the cleaners, bag-
gage at the R.R. station lockers, a dental appointment, a car left
on the street, insurance or income tax due, rings or a watch at a
loan company, pets in the attic or cellar when a patient is brought
-
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OV* 91fi ©19 3 9fltt OJ 9000
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54*
in, children to be cared for when the mother leaves them, are only
a few of the services which, instead of being "errand girl" type
of things, affords the Social Worker an opportunity of making a
worthwhile contact with and for the patient.
We have attended all staff meetings and have participated in
all plans for the patient to leave, even if it be only for two
hours on the grounds. In making plans for, and with patients, we
know as far as possible, who will take him, what home conditions
are, work plans, as well as church attendance and recreation. If
the patient cannot go home, we make other placement plans, which
are mutually agreeable to the family and the patient. We keep in
touch with a patient after he leaves the hospital on visit for one
•" year, and assist him in every possible way. This has paid off in
lowered readmission rates*
For the year ending June 30, 195**-, we have been able to assist
the other departments to more than balance our admissions and sep~
am t ions. We had 11, 3l6 interviews, divided as follows*
With patients in the hospital 5,0*f2
With patients outside the hospital 812
With relatives in the Social Service Office *f,022
With relatives in their homes 310
With Social Agencies 700
With patients in the Psychosomatic Clinic 110
With clergymen, lawyers, doctors, police
officers and others 320
Two of our workers left during the year, one to study in
Europe, and the other .to take a position in her home town. One
of these workers has been replaced. The Head Social Worker
served on a committee to write and publish "A Manual for Family
Care." Several speaking engagements have been filled, and a paper
3 "
. sq sveri fcnc agnize s«
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art* fin-1- ^lim/st s
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BfcffiOfi sis
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55v
on "Foster Home Placement for Mental Hospital Patients" was pre-
sented before the State Conference of Social Work- Lectures have
been given to the residents and the student nurses and group meet-
ings have been held with attendants on the Male Service to acquaint
them with the services the Social Worker had to offer patients, and
how we could work together*
Mr. Lawrence Etter has been with us for the student year of
nine months. Because of lowered registration in the Schools of
Social Work for the past two years, we had only one student this
year, but we feel it worth v/hlle to train even one, since we have
three students become staff members as they finished their train-
ing period with us, and received their masters degrees in Psychiatric
Social Work. Mr, Etter came to us from the Simmons College School of
Social Work.
Our Family Care Department had a total number of W7 patients in
homes on July 1, 1952, and on June 30, 1953 » the number has increased
to 5^o We investigated ten Family Care applications from people in-
terested in taking patients and accpeted seven. Two of our homes
were closed because of Illness in the caretaker's family and the
ten patients moved from these homes were absorbed in other Family
Care homes without the necessity of returning them to the hospital •
Nine patients were placed on visit status during the year, who had
previously been in Family Care.
Among our aims and ambitions for the year ahead, are these:
A. To carry cji £££££ therapy wJJ&s
1 - The pregnant patients who come to us from our other
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56o
State Hospitals for delivery, to allay their anxiety
about having their babies born in a state hospital
and their worry over the problem of possible heredi-
tary factors.
2 -Parents of young schizophrenic patients, that we nay
better understand the setting in which the psychosis
has developed as veil as interpreting to parents what
this hospital can do for their children during hospit-
alization and on release*
3 -A small group cf discharged patients, that we may assist
them in their adjustment outside the hospital, after
other contacts with the hospital have ceased*
h -The new patients, for orientation purposes*
B. Tj> hftvp a larger rmmbar of Social Workers.
If we had more workers, we believe that we could increase
the number of patients released for community residence
as more effectively assist them in making adequate ad-
justment in community living*
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57,
MEDICAL AND SURGICAL DEPARTMENT
The hospital continues to operate a distinct Medical and
Surgical Unit consisting of five wards for men and five wards for
women» These wards provide 174 beds for women and 145 beds for
men, totaling 319» It is our basic policy that any patient
requiring bed care shall be admitted to this Service 0 Doe to the
steady pressure of cases needing such care, the bed capacity has
gradually been increased over tfce years « The present situation
in this regard is illustrated by the following chart*
MEDICAL AND SURGICAL HARDS
BCD CAPACITY'
Actual
Thayer 1 (male)
Thayer 2 (male)
Thayer 5 (male)
Thayer 4 (male)
Quimby Annex (male)
Total, male
Folsom 1 (female)
Folsom 2 (female)
Folsom S (female)
Folsom 4 (female)
Woodward 3 (female)
Total, female
Grand Total, male and female
Excess of beds over rated
capacity
DoHoBo
Bed
Rated
Capacity
Capacity
6/30/53
27
30
24
25
26
34
21
26
27
30
226
145
27
35
24
33
27
27
17
26
S7
53
132
174
257
24fa
319
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In general* the Medical and Surgical Department furnishes
General Hospital services to our patient population* It's chief
is a Senior Physician, assisted at present by too Junior Physicians
and by active consultants from practically every specialty field,,
In addition to the usual conditions requiring general hospital
care (such as surgical cases, internal medical problems, ortho-
pedic emergencies* prenatal and natal oases, etc*) this service
furnishes therapeutic facilities for acute toxic states (notably
delirium tremens), acute fulminating excitements with electrolyte
Imbalance, hypohydration states secondary to Improper food and
fluid Intake, etc* We are licensed to maintain 6 bassinets ,
and pregnant women from the majority of the state hospitals are
referred here for delivery*
During the year, 912 patients were admitted (501 men and
411 women)* Discharges from the Service are detailed in the
succeeding chart,. ?he totals for the "Not Improved" group are
abnormally high by virtue of the fact that 42 men and 34 women
suffering from active pulmonary tuberculosis were discharged for
transfer to Westboro State Hospital * Ihe two wards thus vacated
were cleaned and renovated and occupied by other patients who
would benefit from closer medical attention*
DISCHARGES, EXCLUSIVE OF DEATHS.
MEDICAL AND SURGICAL SERVICE
TEAR ENDING JUNE 30, 1954
Recovered and Improved
Not Improved
For Study Only
Stotol
Hale
Female
Hbtal
393
59
10
229
44
22
622
103
32
402
295
757
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drfJhs •dacMsad £*««» &iJttatt!&l
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59*
There have been 283 deaths (144 men and 139 women) plus
two men and one woman who died while on visit to the community
The principal causes of death are summarised as follows?
Cardiovascular 184
Infectious Disease 6?
Neoplastic Lesions 15
Renal Disease 9
Gastrointestinal Disorders 3
Drowned 1
Extensive Second and Third Degree Burns 1
Insulin Coma 1
Miscellaneous _5
286
One open-ward patient, resident at Hillside Annex, collapsed
beside a water tub for livestock and fell in, drowning himself »
One patient was severely burned in a bath tub when the mixer
valve failed* One patient died of causes referable to Insulin
coma therapy*
The principal causes of death were cardiovascular in nature,
as might be expected from an average age at time of death of
72*3 years o The category heading* "infectious disease11, is
largely made up of terminal bronchopneumonia but also includes
deaths due to pulmonary tuberculosis o
There were 80 autopsies performed representing 29#* Lacking
a resident pathologist* these were done by a consultant pathologist*
Twenty-five deaths were classified as medicolegal, juris-
diction having been accepted by the Medical Examiner a
Twenty-eight deceased patients were buried at state expense «
Seven more were referred to medical schools for teaching purposes «
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60
Consultations
Regular x-ray clinics were held once weekly (total 51) by
David J. Cavan M*D» for interpretation and report on all x-ray
plates » Be also did 8V flourosoopiea related to 0*1* Series
examine tions •
Dr« Roscoe W* Myers held 27 eye clinics, seeing a total of
109 patients* He is available both Tor refraction and for patho-
logical conditions of the eyes*
Other consultants were called a total 109 times, exclusive
of surgery, for a variety of problems arising within •our patient
population*
In addition, a consultant anesthetist was used on a total
of 122 cases*
Ma .lor Surgical Procedures
There were 115 major surgical procedures* Of these, 25
were prefrontal lobotomies, performed by Br* John T„ B* Carmody
end 17 were uncomplicated vaginal deliveries carried out by the
resident staff* The remaining surgical procedures included hip-
nailing, open reduction of fracture, suprapubic cystotomy, hysterec-
tomy, bowel resection, herniorrhapy and amputation of extremity*
Seventeen babies, (11 males; six females) were born at the
hospital* There was no infant or maternal death*
There were 303 minor surgical procedures performed* These
included incision and drainage, suturing of lacerations, closed
reduction of fractures and application of casts, debridement of
wounds, evulsion of detached nails, cauterizations, biopsies
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and massive wound dressings for ambulatory patients. In addition
there were 140 removals or foreign objects and 99 lumbar puncture*
with pressure readings*
Five days per week* Monday through *Viday, en ambulatory
patient's clinic is held for examination, and treatment if indi-
cated, of a variety of conditions such as early localised Infection
pre-E*S„T* and insulin checkup, follow-up of minor lacerations
and fractures, etc* An approximate average of 15 patients per
day are so seen., A total of 35, 614 dressings were done at this
clinic and on the wards • Once weekly, a gynaecological clinic is
held for new female patients « three hundred sixty-four were given
such examinations in this clinic* At the hernia and rectal clinic »
held once weekly, 285 males were examined* Significant patho-
logical cases discovered at these clinics were subsequently seen
by appropriate consultant specialists.
One thousand eighty-four typhoid and paratyphoid innocul«ition»
were given patients and employees* Small pox vaccina tione totaled
494* Blood specimens for Binton Examination were taken in 848
cases * Only 12 new cases of lues were discovered during the
year; each of these received an intensive three-day course of
penecillln therapy*
A regular employees' clinic is conducted five days per week.
Here are seen and treated the minor ailments which may be dealt
with on an ambulatory basis and as an emergency measure.. Industrial
injuries are examined at this clinic whenever possible, although
in many instances t&ese cases are seen at irregular times* Bight
hundred elghty~six employees were seen during the year.-.
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2
PHYSICAL THERAPY DEPARTMENT
Mrs. Florence Boucher served as Physical Therapist
through the year.
Classification of treatments and tests are:
Ultraviolet, air cooled 101
Eaklng **?1
Passage 240
Diathermy 9^0
Kusele Reeducation 319
Total Treatments and Tests 2,091
Total Number of Patients Treated 317
In November, 1952, a new eight-channel electroencephalo-
graph was Installed in the operating room suite « Two hundred
sixty-six tracings were taken,,
>10
63,
X-RAY DEPARTMENT
i
Mrs.> Mary C« Ryder served as X-ray Technician* Re new
equipment was added during the year<» A tabulation of the work
of the department follows:
Parts
Patients
Films;
Abdomen
50
90
Ankle
71
76
Barium Enema
9
29
Cervical Spine
17
42
Chest
845
850
Clavicle
3
6
Coccyx
2
5
Dorsal Spine
123
187
Elbow
23
24
Encephalogram
1
8
Esophagus
2
9
Foot
57
63
Gall Bladder Series
14
64
C«I« Series
26
161
Hand
123
132
Hip
99
237
Jaw
12
30
Knee
50
83
Leg
42
42
Lumbar Spine
100
179
Mastoids
2
14
Nose
42
81
Pelvis
102
113
Pelvimetry
6
12
Ribs
48
124
Shoulder
69
139
Skull
133
388
Sinuses
10
28
Wrist
82
83
Zygoma
9
21
Others
22
81
Fingerprints
5
13 sets
•total
2199
-3S573 «//*/■
I
64.
DEIiTAL DEPARTMENT
Daily dental clinics in operative and surgical dentistry
have reduced the incidence of caries and diseased teeth, in the
hospital's patient population as indicated by the submitted year-
ly report.
During the Summer months, two dental student internes have
been instructed in oral diagnosis, oral hygiene, and surgery,
operative, prosthetic dentistry, and Dental roentgenology. Empha-
sis has been made in correlating oral manifestations with possible
systemic or mental disturbances.
Since oral hygiene is an important health measure in an in-
stitutional community, a weekly check of 25c/° of the wards, or
monthly 100^ cheek of the wards, has maintained the oral hygiene
standard of our mental patients.
Aii effort is made to examine every patient, edentulous or
not, at least once a year to check on any defects or growths
that may have occurred since the last examination.
(See chart to follow)
DENTAL DiiP_-Ra_.EMT
(Summer Street Included)
EXAMINATIONS:
Number of Patients
Number of Examinations
Microscopic Examinations
X-ray and Diagnosis _____
TOTAI
_______
JM3.
16S
_!___-
Q
TREATMENTS:
Extractions _________
Surgical Extractions
Fillings
Prophylaxis __
Repair of Dentures ___________
Dentures Constructed
Dentures Numbered for Identification
Ligatures Applied and Removed ________
Sutures Applied and Removed _._,
Fracture Immobilized .. ,
Alveoectomy __ . . . __
Anesthesia _
Miscellaneous Treatment
Excision of Hypertrophied Tissue
Others
Jacket Crovn
TOTAL __ __
Case Records Dictated
Case Records Taken
TOTAL,
_____
6
__l
_""
_i
120
231
jo
82
2
12.
___4&
6
_j
-j_59I6 /-^//>
8_v3
_____
1516
GRAND TOTAL
_______r^>^3
66.
Walter Lechovicz and David L. Young, both from Tufts College
Dental School, finished their Summer intemeship on September 12,
1952.
Edward G. Zapski and William F. Brady began their interne-
ships on June 8, 1953.
LABORATORY REPORT
The Laboratory has functioned under the immediate leadership
of Fred Elmadjian, Phd. and Edwin Lain son. It's major research
undertakings are detailed in the section of this report dealing
with the Research Service. The total number of tests and deter-
minations for the year totals 38., 384- The more important pro-
cedures are detailed below.
Animal Bioassays Total Research Medical
Rabbits (Asheim Zondek
Test) 15 ~ 1 14
Rat Blood Pressure 25 ■ — 25 0
Rats, operated (endocrine)
1402 1402 — 0
Rats^ Colon Assay 259 259 — — — — 0
Rats, Uterine Assay 152 — 152 0
Endocrine Procedures
Guard Separation Procedure
373 _ 373 0
Basal Metabolic Rates — 56 — 0 56
Ketosteroid Extractions- 208 — 208 0
Digitonen Separation
Procedure 92 • 92 0
Oolorimetric Determinations
2757 — 2757 0
Hydrolysates 135 135 — 0
Chromatography 46I — 461 0
Autopsies • 26 0 — ■ 26
His to pathology. Post
Morte.q Sections, — ~ 27 — 0 27
Blood rlorobology
Hemoglobin 3362 2 ——-—3360
Red Counts 2799 — 2 2797
White Counts 3772 — S3 3689
Differential 5298 — — 377 4921
Shillirgram 666 639 27
Eosinophil Count — 559 - — — 553 6
Platelet Count 9 — — 0 9
68c
Blood Morphology (Continued)
Total Research Medical.
Reticulocyte Count — - 3 0 — 3
bleeding Time 127 0 127
Clotting Time 127 0 127
Prothrombin Time 153 0 153
Hematocrit 307 0 307
Sedimentation Rate - 215 0 — 215
Blood Typing 298 ■ - — 0 — 298
Rh Typing ~ 303 — 0 303
Cross Matching — 80 ~.- Q 80
Spinal Fluids
Clorides 5 »- 0 5
Protein 100 — 0 100
Gold Sol 100 0 — 100
Sugar > 5 — ■■ • 0
Bacterjology
Agglutinations — 157 0 — — 157
Bacterial Counts
(Milk; utensils)— 269 • 0 269
Cultures
Blood 33 — 0 33
Fungi — 1 ■ 0 1
Nose & throat - 64 — 0 64
Stools — 496 0 — 496
Spinal Fluids - 92 — 0 — 92
T. B. 26 ■ — 0 — — — 26
Others — 7 0 — 7
Occult Blood — 28 0 28
Ova & Parasites 15 — 0 15
Smears 175 — — 0 175
Smears for T.B. 396 0 — — — 396
Concentrations
for T.B. 147 0 147
Tissue Chemistry
Cholesterol ■ 93 — - 93 0
Extractions for Assay
— -630 — 630 0
Blood Chemistry Tptal Research Hgdlsai
Albumin 151 — --— — 0 151
Amylase 33 0 38
Ascorbic Acid 20 — 0 20
Bilirubin 91 0 91
Bromide 70 0 70
Calcium 11 0 11
Cephalin Flocculation 126 0 126
C02 — 6 ■ 0 — 6
Cholesterol 1013 ~ 724- 239
Globulin ■ 160 -~~ 0 160
Icteric Index 131 0 131
K.P.H. 3164'-—— 0 3164
Phosphorus — 14- 6
Phosphotase 14 Q 14
Sugar — 1337 ■ 13 1324
Thymol Turbidity — 49 0 : 49
Total Protein 205 — — 0 205
Urea — 36 0 36
Uric Acid 55 — 8 47
Drug , Presumptive 10 — — 0 10
Extraction for Assay- 146 146 0
Chloride 13 0 13
Urines, Qualitative
Routine 3699 — 7 3692
Bile — 18 ■ 0 13
Urobilin 6 0 ■ 6
Urobilinogen ■■ 6 0 6
Occult Blood 11 0 11
Drug, Presumptive 5 — 0 ■ — 5
Sugar only 63 63 0
Sodium — — 70 — 70 — 0
Potassium 70 70 0
Creatinine 185 — — 185 — 0
Phosphates 151 — 151 ■ — 0
PH — 7 7 0
Uric Acid 254 — 254 — 0
Extractions for Assay 41 — 41 *— °
70,
PODIATRY
During the year, the Consulting Podiatrist -was ill for a
tlsie and finally resigned. Richard E. Gubber began Ms services
in June 1953. A total of 94 Podiatry Clinics vere held.
During the year there were several changes in the Service,,
Nathan S. Kline 4 M6D. resigned as Director of Research on Octo-
ber 18* 1952. E&imrd H. Oranawlekj, 35. D, , Senior Physician^
resigned October 25 ^ 1952. Xasuhiko TaketosaOp M0D0, Assistant;
Psychiatrist resigned September 15, 1952» and Asfeton M. Tennej,
M.A. a Bessareh Neurophysiologist resigned August 30, 1952c
Before the year eloeed a new Director of Research, Harry
Freeman 8 M,B0i, had been . selected but had not yet reported for
duty. Bp„ Freeaan has had a previous long association with re-
search activities here. We are confident that ha will provide
sound leadership and isproved coordination of research
activities.
fh& y®ar5g activities plus plans for the future are oat-
lined DSXOVp
Projects of the psvehistrle deimrtBeBt
1„ Dr» Bolner is working on the problem of psychotherapy
of the pay ©hoses. Approaches to this nave developed partly fros
observations on patient® during ingulin coma therapy vhsre con-
sistent fantasy experiences are expressed. Observations of Him
fantasy productions have led to a plan ©f study of "both the con-
tent and formal ^sharacterigtlcs of dreams of psychctlsa. $he.
disclosure and understanding of this saaterial requires intensive
Sososrledga of the motional life of the patients under study each
as results from long, continuous association tilth the patient*
It Is further planned for resident physicians to collabo-
rate in an intensive therapeutic study of a few patients for
;■;..
the purpoee of working out these objectives as well as new
therapeutic techniques » One lead that appears particularly
promising is the use of dual or even several psychotherapists
working separately with the patient out in a coordinated effort.
Under tails proposed plan of collaborative work with other phy-
sicians goals of objeetiveness and improved control would be
accomplished. Progress , then, would have been made toward
greater understanding of the psychotherapeutic problems of
schizophrenia.
A report is being prepared at the present time of the
effect* if any, of the recent tornado disaster on out-patients
who, in course of psy oho therapy, were directly involved in the
tornado.
In the last year Dr. Reiner has written sis papers on vari-
ous phases of insulin therapy.
2. Brs. Hope and Labeaus are continuing their studies of
the two adrenaleetomised patients under conditions of various
medications. To date the psychiatric status of these patients is
not significantly changed. They have, however, contributed val-
uable data in the field of adrenal regulation by varying the type
and dosage of the medicaments, which Include Cemp, S. , Comp* F. ,
Comp. B and licorice extract.
The possible therapeutic effect of adrenalectomy in schizo-
phrenia cannot, however, be evaluated in terms of such patients
as these. There are too many extraneous complications of ageing
and chronic physical illness.
.
.:.
The psychiatric effects of various steroids (Corap. S and F)
and lioorie© extract have also been investigated on schizophrenia
patients and normal subjects. Ho definite effects have been
noted.
They have also made a comparative analysis of the psychi
atrlo rating scale on schizophrenic and arteriosclerotic sub-
jects (30) to determine whether the same type of scale is applic-
able to the older subjects <,
Research don© outside of the Kejsearoji Service fcjr Jjha Hoj^iSal
""Tersonneir"
Since July, 1952 Bre. Daneman, Chomesky and Eayeox have
been engaged in studies designed to throw some light on the rela-
tionship of arteriosclerosis and psychosis, various drags have
been used in an attempt to ameliorate the symptoms of the arterio-
sclerotic patient, SSicotinie acid was initially used as a
cerebral vasodilator &n& failed completely to produce any efaanget;.
Recently carbon dioxide (10$) and cortisone (100 mg0 daily for
k days) have been used. The criteria of response have h&&n im~
provement in memory and diminution in the slow waves commonly
found In the EEG'e of older people. For controls they have tested
20 elderly men at the Masonic Home in Charlton, snder similar con-
ditions. The data are not as yet completely analyzed, but they
have found a correlation of „9 between the frequency of the brain
waves and memory function. In this program the Worcester Foun-
dation for Experimental Biology participated, furnishing trans-
portation of the normal control subjects, paying them a fee for
participation in the studies , and supplying the cortisone .
■ 'V a
Report of the ]tMM2£iz£M, i^3£^SM§Sll
Service Activities, , During the year the number ©f contacts
Tilth patients and other® examined and studied fcy rasmhers ©f the
department are presented in the following table:
*r of Huaher of
Hospital Patients,.. Procedures
House patients S3 206
11 31
Extra Mural
Court 2 &
School Clinic 58 109
1 2
Roxgfil Saojeetg
Normal controls 73 ^®
Total tests and patients 228 *
seen.
Individual Therapy
Grand total of procedures
Daring the yesar 1952-1953* the Psychology Department under-
tool: research studies in certain phases of the psyehopathology
of eehisophrsnie patients* Although it is a *&Fell-lsnwn fact
that the schisophrenic patient is inadequate in a wide variety
of 'beharicrs fl interpretations of these inadequacies haw been
ambiguous and conflicting,, This appears partly due to the fact
that relatively little Is Smarm as to whether such reported in-
adequacies are unique to the schizophrenic group or whether they
nay also he characteristic of other sooially Inadequate groups .
The effort spent in experimentation with schisophrenic groups
in controlling for such factors as age, education, intellectual
leTela degree of cooperation, ete«, attest to the importance of
this problem. One set of variables , however, has not received
such careful attention in this regard.. This its the factor of
the premorbid social inadequacy of the schisophrenic as contrasted
to the social adequacy of the usual normal control populations
employed o
In reviewing clinical and case history studies of schizo-
phrenics It has been noted that such individuals typically show
low social attainment, e.g., they tend not to marry and show low
occupational accomplishment. It would thus appear that the
typical schisophrenic has been a chronic failure in his adapta-
tion to society before the onset of psychosis. It was inferred,
therefore, that many experimentally observed inadequacies of the
schisophrenic could be associated with a failure of adaptation
existing premorbid!? (as well as at the time of testing) rather
than with the psychotic condition itself. If this were the case
then the uncontrolled factor of social inadequacy would have far-
reaching implications; the inadequacy of the schisophrenic8 e
performance under experimental conditions might be held in common
with any Inadequately adaptive individual and might not be unique
to the schisophrenic
Such a hypothesis hae been subject to test within the past
year p one method being by the technique of experimental stress «
For experimental stress situations, the hypothesis would Imply
that the presence of the psychosis Is Irrelevant to the observed
Inadequacy of the schisophrenic under conditions of experimental
stress. He performs inadequately because he is a member of a
larger class of individuals who show poor adaptation*
It should follow 9 therefore, that social attainment,
(adequacy of performance in real life) is positively related to
the ability to perform adequately under conditions of experi-
mental stress. Accordingly, the hypothesis wag tested that in a
normal population those individuals of higher social attainment
(as measured by the Worcester Scale of 3oolal Attainment) would
perform more adequately on psychomotor tasks under conditions of
experimental stress than those individuals of lower social attain-
ment. The hypothesis was confirmed under two different stress
conditions.
Theso results supported the formulation that social attain-
ment is related to an ability to cope with stressful situations.
This has permitted us to infer with greater assurance, from the
characteristically low social attainment of th@ schiaophrenlcs
that the observed inadequacy of the schisophrenic under experi-
mental stress is associated with a chronic failure of adaptation
already in existence in the premorbid period rather than with the
psychosis itself .
Further experimentation has been directed to the question of
whether areas of inadequacy other than performance under
eacpe risen fcal stress ar-e assooiatad with poor adaptation rather
than with the schisophrenic oonditionpper sj»* To this end, it
was fourof. that in a group of normal subjects, social effectiveness
was also related to scoring on a scale of maladjustment. Similar
to the inference drawn from the experimental stress study, it was
concluded that a high degree of maladjustment „ as measured toy the
maladjustment scale , was not unique to schizophrenia bat rather
characteristic of a broader class of inadequately adaptive in-
dividuals {. of which the schizophrenic is a member,, This infer-
ence was tested more directly by the comparison of maladjustment
scores of a schizophrenic group to that of another inadequately
adaptive, yet non-psychotic group a assaultive criminals « Ho sig~
nifloant difference was found in scoring on the maladjustment
scale between these groups.
Two major implications follow from the above findings*
(1) there appears to be a general factor of adaptation to stress-
ful situations that is reflected in both social adequacy and per-
formance under conditions of diverse forms of experimental stress;
(2) characteristics assigned to schisophrenics moy be attributed
to a larger population of inadequate individuals s of which the
schisophrenic population is a sub-group.
The nature of this general factor of adaptation lias been in-
vestigated with the framework of a developmental approach by the
utilisation of certain measures of Rorschach performance vhich
have been found to be developmental in nature. The goal has
been to delineate those processes that are unique to the schiso-
phrenic condition from those processes specific to other inade-
quately adaptive behavioral types*
78.
A second amid i^elated approach to this goal has been an
analysis within a patient population of the manner in which
symptoms tend to cluster and the finding that there appears to
be three modal syndrome groups. This is the first step in in-
vestigating within a generally inadequate group (in this case
psychopathologlcal groups) those processes associated with
specific forms of symptom ohoic®.
There are in press, or in the process of publication, about
18 papers on this general topic.
Projects at the laboratory
lo Under Dr. Elraadjian. This work is under the auspices
of the Worcester Foundation for Experimental Biology. It is a
resumption of investigations in the field of the autonomic ner-
vous system which hare previously indicated a deficient response
in the schisophrenic patient. With further enlightenment in this
field by the work on adreno-ecrtieal functions and the relation-
ship between the pituitary-aAreno-oortieal axis and the adreno-
medullary -hypothalamic system, further research studies are in
order which may throw new light on this phase of autonomic
reactivity.
Br. ElmadJlan is perfecting techniques by which he can
measure noradrenaline and adrenaline in the blood of humans.
The test is of a bio»assay type* the plasma being extracted and
titrated for its oontent of thece substances against rat colon or
uterus. He is at present analysing the amounts of these sub-
stances in rat adrenals and brains. Initially, he is investigat-
ing the effects of hypophysectomy; of stress such as insulin..
■
9-
cold or traum&j of th® administration of steroids to normal
and hypophysectcmij&ed animals.
Preliminary work has been going on in a few human normal
subjects, arthritic subjects and schisophrenic patients.
The projected program, when the techniques are perfected, is
to study the levels of adrenaline and nor-adrenallne in normal,
psychotic and neurotic subjects and to determine whether there
are any differences in stress situations.
Detailed studies have also been made of the two adrenaleo~
tomlsed patients, their course having been followed closely by
determinations of sodium and potassium. Various medicaments
have been used in maintaining these patients, Compounds B, F, B
and licorice extract, singly or in combination. These studies
have been valuable in contributing to our knowledge of adreno-
cortical physiology o
2. Under Kr. Lameon. This work is under the auspices of
the Worcester State Hospital. Techniques are being studied on
two fields of investigation: (1) ketosteroids in blood, and
(2) the endrogeneous synthesis of cholesterol; (3) the Korea
project.
The output of 17-ketosteroide is a measure of adrenc-gonadal
activity. The usual procedure at present is to measure It in the
urine, a method which Involves a great deal of tiae and effort in
collecting the urine and which also brings in a factor of delay in
time between the output of urine in the kidney and its ultimate
excretion through the urethra. Blood determinations would avoid
both these factors. As a method of measurement it requires as yet
a good deal of investigation but holds definite promise.*
■
■
-
■
80 ,
The study of cholesterol synthesis arose from the findings
of Dr. Shwehk at the Foundation that blood synthesizes choles-
terol from acetate. This study was done with isotope-tagged
material. Studies are going on at the hospital as to what frsc
tlon of the blood contains the cholesterol;, plasma, red cells or
white cells . Separation of these components must be made under
cold conditions because otherwise there is a rapid deteriora-
tion of the material., particularly the white cells. It Is for
this reason that a refrigerated material is needed. Eventually*,
when the techniques have been perfected* studies on cholesterol
synthesis will be made in various conditions, schizophrenia,,
arteriosclerosis and others.
In the research project in Korea, the relationship between
battle stress and adrenocortical activity was under intensive
study. One phase of this was under the supervision of Dr.
Elmadjian. The urines are now feeing processed at the hospital
laboratory and the ketosteroids are being measured. The results
should give extensile information as to the effects of an actual
and extreme stress and throw light upon cur data which have been
derived from experimental stress situations only.
Studies under consideration
1. Cooperative project between the Worcester State Hospital
and the Worcester Foundation for Experimental Biology.
Objective
Since schizophrenic patients are known to exhibit certain
abnormalities in urinary steroid excretion and adrenal
.
responsiveness and in view of the fact that a new method has
been developed for the quantitative analysis of the individual
urinary 17-lcetosteroid8j and since by use of this new method an
approximation can be made of the endogenously produced steroid
hormones , it is suggested that a project be started to more olosely
define the abnormalities in steroid metabolism that schizophrenic
patients exhibit „
Procedure
Two projects will be undertaken. One is designed to study
the metabolism of specific exogenously administered steroids, and
the second project will be concerned with the type of steroids
produced by adrenal stimulation as well as their quantitative
assessment as a result of ACTH treatment.
We have previously studied the metabolism of specific types
of steroid hormones such as A «»androstene&iones adrenosterone 8
17-hydro&yprog®gterones 17-hydroxy-ll-desoxycortieosterone, corti-
sone „ and hydrocortisone in rheumatoid arthritic patients, These
studies have yielded definitive information as to the pathways of
metabolism of these important adreno-oortieal steroids. We have
learned the relationship between these adrenocortical hormones
and their urinary metabolites from these in vivo metabolism studies „
We propose now to administer these compounds, which are known to
be non-toxic, to schizophrenic patients and study the metabolism
of these compounds as compared to what occurs in normal controls,
The procedure would involve the oral administration of specific
compounds over a 3-day period. The various analyses of the urine
would be performed Just prior to, during, and after the hormone
administration.
■
'
82«
The second project would be concerned with the responsive-
ness of the adrenal cortex of both schisophrenic and suitable
normal control patients to two dosage levels of ACTH. These
dosages would be first, a minimum effect Ire dose of ACTH re-
quired to increase the 17-ketosteroid excretion in the urine,
and second, a somewhat larger dose. By our newly developed
methods we could study in detail the responsiveness of the
adrenals which, in earlier work, has indicated that the adrenals
of schisophrenic patients are relatively nonresponsive, as well
as indicate the qualitative differences In hormonal production by
varying doses of ACTH. This study would involve careful collec-
tions of urine just prior to, during, and Just after ACTH ad-
ministration. The dosage 8 of ACTH that we Intend to employ would
be in the low range for human subjects.
Anticipated results
These studies have been designed to yield the maximum informa-
tion concerning the details of steroid metabolism. It is quite
possible that these studies will elucidate some of the primary
differences that exist between schisophrenic and normal patients^
2. Noradrenaline and adrenaline studies in schisophrenic
subjects under basal and stress conditions. The background for
this study has already been described.
3. Investigative studies with drugs. There are two drugs
which hold promise of quieting excited states in patients:
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(a) Rauwolfia serpentina - an anti-hypertensive substance
which apparently diminishes autonomic activity.
(b) Chloropromazine - a substance tested in Europe and re-
cently described at the International Physiological Congress at
Montreal (September, 1953), which potentiates the action of drugs
which aot upon the autonomic and central nervous system. It
diminishes excitement and is of value In the therapy of acute
psychotic states.
A third drug3 lysergic acid, has been already studied. It
has the property of producing acute echlaiophrenie-like states in
normal subjects and of exaggerating the abnormal responses of
apathetic patients, The particular aspect under consideration Is
whether this drug, by reactivating the acute aspects of the psy-
chosis, can, in combination with shock therapy s result in an
Improvement in such patients who did not respond to shock therapy
alone*
ka Further studies of factors of social inadequacy as ra»
latsd to stress reactivity as described In the work of the
psychology department. It is hoped to verify this hypothesis
more fully by studying eehisophrenic patients from groups with a
higher economic level,, such as possibly McLean Hospital^ or from
areas such as Sewtan or Wellegley, who are committed to state
hospitals o
5. Dr. Reiner3 s project on psychotherapeutic studies done
by several psychiatrists on the same patients. At the minimuss
this will be of value as a training procedure,,
60 Therapeutic studies in ageing. This project has to do with
ageing, "but la a development of hormonal studies in schizophrenia.
It is Itnown that the excretion of 17-&etosteroide is diminished in
age, an indication of diminished metabolic activity. It is pro-
poses, to treat a small group of normal old men (70 years plus)
with a mixture of steroids by mouth, over a 6-8 month period, de-
signed to raise the level of the excretory hormonal productivity
to that of young individuals « Tests will he made of effects on
blood chemistry, memory, psychological response to psychomotor
stress situations* and muscular strength. If improvement re-
sults, the techniques can be applied to our aged psychotic
population who form so large a proportion of our hospital
clientele.
The Worcester Foundation for Experimental Biology will
supply the major part of the personnel and costs „ The hospital
will contribute some services in the way of psychological tests.
Further attempts will be made to obtain a few schizophrenic
patients with metastatic lesions to determine the effect of
adrenalectomy upon the psychotic state.
85=
LIBRARY REPORT
1» Medical Library
The Medical Library la constantly expanding with an average
yearly accession of 300 bound volumes of periodicals and 100
medical monographs and textbooks purchased from current funds*
Aleq w© receive donations from the Medical Library Association
Exchange and from members of the staff » At the present ©very
available shelfplace is used to the limit and many little-used
periodicals as well as older books had to be moved to the base~
ment stockroom to accommodate the newly acquired material • After
many years of struggle with the unbound periodicals, neglected
during lite war years., we practically caught up with the bindings.
It is done by the Industrial Department of the Northampton State
Hospital, all in one color8 and rather crudely, but at least we
do not have to worry for losing many single issues as used to be
the case previouslye With this great influx of bound periodicals
the two basesnent stockrooms are very crowded also and we are glad
to hear that ground is supposed to be broken soon for the new
Clinical Building where the Medical Library will be conveniently
located on the 1&ird floor*
The Library continued its services to the staff and with a
large number of students (especially affiliate nurses), good use
is made of our facilities* Although our book fund is rather
limited we try to keep up with the new reference material coming
off the press in a flood tide*
To show the scope of our varied activities^ the following
statistics are quoted;
Periodicals received regularly 120
Hew books purchased 90
Items received from Medical Library
Association Exchange 39
Periodicals bound 520
Interllbrary loans received 111
Interllbrary loans sent 47
Circulation figures 978
Number of volumes in the library 12,325
2* General Library
The wide variation in i&e education of our patient-body
necessitates a careful selection of new books & In addition to
books of current interest, a solid foundation ia "laid for & good
permanent library* Biographies, the Glassies, poetry, plays,
short stories j, humor, art - in short* a book for ©very taste is
provided in the library for our readers* The yearly appropria-
tion, drawn from the Canteen Pundg is not large but it is enough
to purchase the most premising books » As in the Medical Library
the Geaeral Library shelves are just as crowded,, although the
wear and tear is much greater here* Additional shelf place in
a new location would constitute a welcome change for this library
also a
The library continued to be under the charge of Mas SfeOurren
who maintained the regular services, including the trips with the
book truck to the closed wards* The library is well patronized
by patients and saiployees* Statistics t
Sew books added to the library 290
fikgazines received regularly 42
Technicals periodicals sent to ikm deparuaents 17
Magazines sent to Summer Street Department 11
Circulation 7,592
Number of volumes in the library 2,952
HTBLICATTQ*! LIST
1952 - 1953
NoSo Kline, Synopsis of E» Bleuler's Dementia praecax, International
Univ. Pr«, N»Y«, 1952
g»Sg Kline,, Some hazards in group psycho therapy 5 International
jrl of. group Psycho thero 2:11-115, 1952
J»H» Friedman, Jo Golomb & N« Mora, The hair whorl sign for
handedness, Dlsa Bervs System,, 13: 208-216, 1952
J«H« Blair , R»Co Sniff en* E.E» Cranawicky W» Jaffe & H.S» Kline*
Tho question of hlstopathol. changes in the testes of
schizophrenics, Jrl of Mental Science » 98:464-465, 1952
AaBa Sheflen & W»W0 Jetter3 Delayed pathologic ssanifestatlons of
hypoglycemic comae Jrl of ffeuropathol* & E&pev* neurology,
11:317-323, 1952
Sol* Sands & D* Rothschilds Sociopsychiatric foundations for a
theory of the reactions to aging, Jrl of lferva & lento
Disease,, 116:233-241, 1952
J»C* Sabbath & B»A» Luce, Psychosis and bronchial asthma,
1~Psychiatr« Quarterly,, 26:562-576, 1952
DaLo Gerard & L»G» Houston^ Family setting and the social ecology
of schizophrenia, Psychiatry Quarterly, 27s 90-101, 1953
NoS» Kline & al»a Patterns of biochemical organisation related
to morphology, Amsr* Jrl of Psychiatry^ 1095605-611* 1953
SaAa Danemang Carbon monoxide poisoning, Diseases of the I?ervB
^~System7 14:39-48, 1953
EJfU Reiner & A»E« Sheflen, The vital signs of insulin ccma
therapy * A statistical ©valuation, Jrl of Clin* & Eacpero
Psychopa tholegy , 13:139-151, 1952
DoL» Gerard & L» Phillips, Relation of social attainment to
psychological and adreno- cortical reactions to stress.
Archives of Xieurol* & Ps^hiatrya 69:350-364, 1953
E» Eoagland & Go Pincua* Study of adrenocortical, physiology in
normal and schisophrenic men, Archives of p enrol* &
Psychiatry^ 69:470-485, 1953
88.
J» Welnrebs, Report or an experience in the application of dynamic
psychiatry in education, Mental Hygiene „ 571233-295, 1953
A<»E,> Sheflen & EgR» Reiner,, Sensitivity in insulin coma therapy,
Jrl of Clln» & Eacpero Psychopathole*>y. 13:225-236, 1952
La Phillips & J»Qo Smith 0 Rorschach interpretation* Advanced
technique* Grune & Stratton, 1UY*, 1955
RoAa Luce & Da Rothschilds, The correlation of EEG and clinical
observations in psychiatric patients over 6BS Jrl of
Gerontology fi 8x167-172, 1953
AoBe Sheflen, B»R» Reiner & B? Ocwita, therapeutic response in
insulin coma therapy* A study of vital signs and sensitivity
Jrl of Clin* & Expert Psyehopathol* 14:57-67, 1953
EsRo Reiner a Fantasies in insulin coma therapy* Some psychosomatic
considerations with a case report, Jrl of Clin* & Beeper*
Psychopa thologyB 14:84-94, 1953
Lo Phillips 8 Case history data and prognosis in schizophrenia,
Jrl of $erv* & Mento Disease & 117:515-525, 1953
Lo Phillips & Jo La FremOs Developmental theory applied to normal
and psychopa thological perception, Jrl of Personality
22:464-474, 1954 ~~~ **
9
£Vv
WORCESTER CHILD GUIDANCE CLBTIC
This clinic began In the early 1920* s as an integral part
of the out-patient activity of the Worcester State Hospitalo It
has over the years grown into a separate State Clinic, liberally
aided by the Community Chest of the City of Worcester and known
locally as the Youth Guidance Center.. It is located in downtown
Worcester at 2 State Street* Ihe State funds allocated to the
Clinic are administered by the Commissioner of the Department of
Mental Health, Jack R* Ewalt, BUD, Ihe Community Chest funds
are the responsibility of the Child Guidance Association of
Worcester* of which Abbe© W* Bal&mo Is president* On the
Association^ Executive Committee, the Superintendent of the
Worcester State Hospital and the Chief of the Psychology Depart-
ment serve, ©x officio* Thus the Commonwealth is represented
in all phases of Clinic activity and a bond of professional
relationship Is maintained with the hospital,
There Is appended herewith a portion of the annual report
of the Center *s Director, Joseph Weinreb, M»D. to the annual
meeting of the Association*
Report of fee Director
1953 - 1953
RX am happy to report that the Youth Guidance Center has
continued Its growth and development in ©very direction during
the past year*
I would like to restate the main functions of the Clinic
90,
and report the accomplishments la each area during this year* 2hs
functions of the Youth Guidance Center are classified as follows:
1„ Diagnostic Service
2* Consultation Service
3» treatment Service
4* Professional Training in Child Psychiatry
a. Psychiatrists
b* Psychologis ts
Co Psychiatric Social Workers
5« Contribution in training other professions in
Mental Health
a* Uurses
bo Teachers
c» Ministers
6» Public Education in Mental Health
7. Child Psychiatric Consultation to other agencies
8» Child Psychiatric Consultation Services to schools
9» Research in Child Psychiatry
Kiere has been an increase in service in all of the first
eight categories* 2her© has been a slight increase in the amount
of diagnostic* and treatment services* We have been and are
increasing consultation services as a matter of policy as this
represents an opportunity for a broader base of service to a
larger miaber of children in the community » This consultation
service is becoming more active not only to th© public at large v
but to other agencies and schools as well*
Professional training has been increased in child psychiatry
particularly when funds were made available to us by the National
Institute for Mental Health for a fellowship In child psychiatry-
We have also undertaken a program with fee Division of Cental
Hygiene of the State Department of Mental Health in ^ich we are
91.
supervising and training personnel to staff new clinics to be and
already established in neighboring coramunitles* 2his is a very
important contribution to the welfare of our Coameawealth, and
marks a turning point in the policy of the Commonwealth in placing
more effort towards preserving mental health rather than building
bigger hospitals*
In the field of psychology the lack of funds for trainee
stipends has hampered us in enticing interns in that field* We
are* however, training two of our own and three other junior staff
members in addition to our cooperation with the Department of
Psychology of Clark University.
At title present time we are training psychiatric Social Workers
from Boston University, Boston College and Simmons College* The
Supervisor of the Student Training Program has been appointed to the
faculty of Boston Universityo
We have continued our program of contributing to the training
program for student nurses at the Worcester State Hospital and
Bfemori&l Hospital as we have for the past four years* In addition
we have placed with us for training a graduate nurse from the John
Hopkins University School of Public Health* We are also parti-
cipating in a small measure in the training program of the Worcester
District Hursing Society*
Our work with ministers this year consists primarily of the
inclusion of five interested ministers in a group conducted by
the director*
There have "bsen 536 lectures, discussions and group meetings
with public groups during this past year*.
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W© are pleased to report that increasing number of social
agencies have found us to be useful to tham and we were consulted
during this past year by the following agencies s Family Service
Organization, Jewish Social Service Agency, Worcester District
Nursing Society, Division of Child Guardianship, Massachusetts
Society for Prevention of Cruelty to Children,, Children's Friend
Society, Community Chest, Worcester Department of Public Welfare,
Young Womens Christian Association, Bay State Society for Cripple!
and Handicapped, Ine», and Cerebral Palsy Clinic
We were again able to operate the School Consultation Service
in cooperation with the Worcester State Hospital and will continue
this very promising service insofar as we can the ensuing year*
'ihe one area in which we have not done sufficiently is in
the area of Research.. It is an accepted medical principle that
every clinical facility has as one of its obligations tc help in
the increase of medical knowledge through research* We have ample
opportunity for research at our Center, but due to pressure of
other work no time has been left for lt« We are badly in need of
funds for additional personnel that can carry on such a program«
In the past three years since we have been at 2 State Street*
I have bragged about the ample housing available in our nice well-
located quarters* I regret or maybe I should be happy to report
that we have outgrown our space and are on the brink of using bath
rooms for working space* Hhere are, unfortunately, no spare bath
rooms in our present building c We should be looking further into
the possibility of increasing our spaceo
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The Youth Guidance Center has by now received every possible
approval f.faat a Child Guidance Clinic can possibly receiver, Each
and every one of them are hard earned*
lo Membership in the American Association for Psychiatric
Clinics for Children*
2s Approval for training in child psychiatry by the
American Board of Psychiatry and Neurology.
3o Approval for training in child psychiatry by the
SSassachusetts Faculty in Psychiatry* Ine*
4o Approval for training in child psychiatry by tfae
American Association for Psychiatric Clinics for
Children »
5« Approval for training In clinical psychology by the
American Psychological Association*
6 • Approval for fellowship In child psychiatry by
National Institute for Mental Health of the U.S»
Public Health Service*
7« draining in Social Work by Boston University*
8* Training in Social Work by Boston College-
9o "Training in Social Work by Simmons Collegeo
10o Training in Mental Health Nursing by John Hopkins
University °
It might also interest you to know that each of the above
organizations has and exercises their right to fully inspect our
clinic and our work without reservation^
These honors are not empty ones, for they are of great
importance in our work and moat important of all these inspections
and approvals are the most effective means of checking up on the
work of the staff of the Clinic*1
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DEPARTMENT OF SJEN'BAL HEALTH
DIVISION OP MENTAL HYGIENE
ANNUAL SERVICE REPORT
Worcester Child Guidance Clinic
la QliPlc Service
No» of clinic sessions (£ day) 510
No > of visits to clinic by children 5543
Average no« of visits per session 11
2« Case Load
Carried over from previous year 340
New cases accepted 245
Reopened from previous years 23
Total no<, of cases served
5o Co-seo Closed and Condition on Closing
Diagnostic service rendered 67
Treatment given 53
Unasslgned 40
Total no. of cases closed
4C Cases Carried Over to Next Year
No* of cases
5* Ages of New Cases
Ages 0X234^
508
HKT/&C)
'2W
6 7 8 9 10 11 12 13 14 Others
No* of
Boys 8 8 1 5 3 6 14 11 21 20 10 15 12 11 12 13
Ho» of
Oirls
3 3 0 2 3 3 10 4
3
6
6
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clntlO at
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6o Sources of Referral of law Cases
Children* s Agency 5S
Clinic Staff
Coamiunity Education X
Court S
Family Agency 1
Former Client
Friend or Relative 49
Be<h Agency &
Physician go
School 118
Others 1
7» Inter^ietys with or isSxyut Patients or Prospective Patients
% Psychiatrist 1485
By Psychologist 3B5S
% Social Worker (Clinic* Ccasauaity Office) 2S10
3y Occupational SSisraplst
% Remedial Reading 'Sator
By Sp$oeh Instructor
By Others
3* Conference gdLtfe or gbgut Patients
Within &gency (Consultation t^ith Staff) 235
Outside Agency (Group Conference on Cae© or Prohleia) 100
9« List of Clinic Personnel
Position
Joseph Welnreb* M*1>4 Xttreo-ten*
Willis Ploo£, H*D* Psychiatrist
Pa-eld Moriarty* M*l>* Psychiatrist
Polly Bssrees© Social Worker
Emily Faueetfc Social Worker
Maj02?i© Eayden Social Worker
Catherine Arlauskas Social Worker
fitonroe . Oreea Social Worker
Bearh&s©. WMzsllp Ph*X>*
&lic© Sastentjauia Psychologist
Lsmranc© Bskin Psychologist
S tanley ISsuger Psyefeologis t
IScaa Jacelsson Receptionist
Spirma Pespas 3rB Cleric & Stenographs;?
Hilda Bssry 32?4 ftLesfe & Stenographer
©ane^ietr© Cfeegory Eyp&st
«T©an Eierstoad Typist
Joan Scott Receptionist
96.
Staff In. Training Position
Hose Segur Social Worker
Roalyn Ashman Social Worker
Daniel Lynch Social Worker
Bertoert Strean Social Worker
Genevieve Madison Social Worker
Dorothy Collard Nurse in Training
97«
TRAVELING SCHOOL CLIEt'C
The Worcester Traveling School Clinic composed of psychiatrist*
psychologists, and social worker functioned for the year ending
June 30, 1953, under the direction of Willis ELoof, M„D„ and the
general supervision of Joseph Weinreo, MoDo Later in the year
two additional psychiatrists were utilised* The personnel was
supplied jointly be the Worcester State Hospital and the Worcester
Youth Guidance Center*.
Service was given to 16 towns in our area as listed in the
following table:
School Clinic Cases for Year Ending June 1953
Town Total Huraber of Cases
Berlin 3
Boylston 14
Charlton 3
Clinton 2
Bolden 94
Jefferson 2
Horthboro X
Oacford 1
Paxton 3
Rutland 3
Southbrldge 2
Southboro x
Speneer 13
Sterling 1
Webster 4
West Brookfield X
It was decided to concentrate our efforts in several given
communities and to give emergency service where needed» This was
made necessary because our staff could only devote two days a
week to this particular work and the area to be covered was large »
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Our plan of procedure was as follows; Prior to going to a
given community the superintendent of schools of tfaat area was
contacted and a time set for an interview^ At this time the type
of service which we could give and its limitations were fully
discussed » The super in tendant in conjunction wish the teachers
and school nurse then arranged a schedule of interviews for the
period we were there* All cases were treated in the same manner
as a diagnostic study is handled at the Worcester Youth Guidance
Center, except that the teachers were usually consulted before
any child was seen* The psychiatrist, and when necessary the
psychologist, saw the child while the social worker usually saw
the parents* When all information was obtained from these sources,
the team then held a conference of its own during which time the
evaluation and recommendations were discussed* There then
followed a second conference with the teacher and key people in
the school at which time information was given to them which we
felt would have a positive effect on the over-all teacher-pupil
problems* The emphasis was in a sense upon consultation to the
school© However., when we felt that the problems were such that
outside help was necessary the parents were again seen and were
referred to other agencies* On occasion when it was felt that a
second or 1&ird contact with a child would be therapeutic this
was also arranged*
Xn general the discussions with the teachers centered around
the positive influence they could have on children with emotional
problems and the ways in which this might be facilitated* In
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99,
this regard we c&n honestly say that we often jue&rned as much,
if not more* than we taught* There waa also sorae emphasis placed
upon the use of ancillary ccaaraunity resources such as the Boy
Scouts, YoWoCoiUj Y^-McCiAsp camps „ etc Some of the dynamic
aspects of learning problems were clarified and through our
diagnostic study we were able to differentiate for them the truly
mentally deficient from those latoo had the capacity to learn, but
were greatly inhibited by their emotional problems *
The direct help to the children waa usually effected through
favorably inf licencing poor environmental situations,, by giving
needed information (with the permission of the parents) and by
correcting mislnformationo Some children were referred for
psycho therapy*
Finally and most Important of all, we hope that the schools
came to look upon us, not as interferring^ critical "Know-it-alls"
but as sincere interested friends*
'She books jpco? the fiscal year 2,953 were closed in good order
witfa low imrentoi»l«s and the appropriation balancee which were
reverted were ©^eedingly sassXU A few Tears back the Catcptrcllsr's
Beparteaent of £he Cesssx&nwealt&i iiss tailed a Badgefcary Control
Systosa* OSiia system is adequate and to fanctleaing satlafac torily*
Xteing the current year a systssa wa© devised in which all
institutions within the department of Elantal Bsalth would sulsaifc
requisitions covering 1&eir needs to the Purchasing Bureau
periodically « Also, under the supervision of the Purchasing Bare&u,
patttsnta* clothing was displaced for several days at: the State
Souse » Prior to this display, institutions had noted their needs
on questionnaires supplied by i&© Purchasing Bissau* Vendors 8i3b~
jaitt@d ffiorchsodise along the linos requested in this questionnaire*
During the period this clothing was on display, Slotting Sapsspviaers*
Hursing Supervisors, Stsfflwdat, Housekeepers, end other Interested
personnel of the institution visited the Stat© Bouse and noted
their choice on forms supplied by tno Ps^chaslng Bureau* Fmx»tem®n
were ssade as reeegsraanded on these fortas* What appealed to msay
•was that they saw the- actual clothing on display^ that the
Purchasing Bsre&u was vitally interested in supplying the needs
of the institution, and the price Was only one facta?, and not the
das&natiag am in amking the choice « Shis mantae of pugcSiasiBg
clothing.* together wii&i periodic requisitions^ wag a vast improve*-
ment oyer the xaenner in which goods were jroeured previously*
For a f tm years the Department of Sbntel Health has been
,
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101.
experimenting with a Master Meixuo One could say that during this
fiscal year this Master Menu had worked with extreme satisfaction*
It is the consensus that this experiment gave greater variety of
food,, to the patients, at a lower cos to Of course* the psycho-
logical effect on the patients that the entire hospital staff was
eating the seme food* cooked in the same manner as the patients
should not he overlooked* Satisfactory recipes which are the
basis of this Master Menu have been the means of improving the
food* She Master Menu also has been the real basis of the budgetary
request* In other words, the daily cost per eater was established,,
and this cost projected to the number of eaters* and funds for
the food account wars appropriated on this basis * It has now been
definitely established that budgetary requests in the Clothing (06) *
Furnishings (06)* Travel and Transportation (10), Repairs* Altera-
tions and Additions (12) are based on formulae established by the
Department* The funds received under this set-up have been
adequate* In fact with proper control at the institution level*
there should be adequate clothing and an adequate amount of all
types of supplies*
Since 1958* each report has discussed the Storeroom situation*
This essential department's quarters are a series of basement roomsp
which are entirely inadequate* end expensive to operate* She time
allotted to control supplies is considerably greater than needed*
if quarters were adequate*
The Laundry during this current period has functioned very
satisfactorily* The same may be said of the Dry Cleaning Plant*
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Duping 1Mb etg3?©XEfr fiscal 3©as», t?e has© don© the dry ©leaning tor
this institution* Grafton State aaspitale Wesfchor© Stats© Hospital,
scsae dry ©leaning fop TSaafield State Hospital, and a consides'&'ble
aiaoaat for Waiter B« F©3?»a2d Spools and Efr3.es Standia&»
I& the mSxt Cafeteria we have a quota of nineteen (19} dining
room attendants* tFnfortunately, we have espexi^aiced the aess©
coalition this seas* as 2a preTions years* D«s?ing this eurreafc
fiscal year., sSxtscaa (3.6) dinlEsg rocsx attendants fcessain&ted their
services* ITils is a tswsaeafiotja tus%«<oqr@r» and it is extremaly
difficult to fe?ala gersonael sender this conditions Xt is fait
that the reason for this ton*-©*©* is that t&e salary is i&adeq.nafee,
and the w$Vk rather hard and dlf fieult, and lastly* that the «ard
attendants recei^r© a higher salary $&&& a dining roeaa attendant.
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103.
FARM REPORT
The operation of an Institution farm is a challenging under-
taking with many real problems a Management of 400 - 500 aero a
of land requires a great deal of skill end know-how* plus equip-
ment and labor* The growing of vegetables demands many weeders
and long hours of work. Our patients perform much of the manual
labor, which is considered good therapy* However, baseball,
athletics and special projects continue to drain the work forces <,
The vegetable program fits in well with our other projeetso
Crops should be rotated every three or four years* By turning
under our forage crop sods and alternating with vege tables , we
not only obtain higher yields but also maintain sound conservation
practice « Rainfall is always a controlling factor in vegetable
production and this year gave us below average rainfall during
July and August* Some surplus vegetables were sold to other
institutions 9 while surplus beans, cucumbers and tomatoes were
sent to the Institution cannery « a total of 180,341 lbs* of farm
products were canned,.
The production of cattle forage requires good weather , equip-
ment and labor* Quality forage is a must in the maintenance of
good health and high production of our herd of 70 miiying cows
and 50 replacement young stock* With the life expectancy of a
cow approximately three lactations, it becomes worthwhile to
work towards a wen-fed and healthy herdo This has been a good
milk production year with the cows hitting a new high record of
15500 lbso of milk per animal and a butterfat of 581 lbs* The
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real problem is to plan a program which keeps the cows calving out
on the average of 12-14 months, thus Insuring an even flow of
milk throughout the year*
Growing hogs has been a profitable venture on this farm*
Plenty of garbage, plus grain for the finishing stages, gives us
about 50,000 lbs* of pork available for Institution consumption*
Our sows have averaged 7-8 pigs per litter, nearly double the
national average o
Ihe orchard does its bit towards our institution diets o Al-
though our 18-year old orchard is considered young, over 50,000
lbs* of fruits were harvested* Weather again is a determining
factor with heavy rainfalls early in the spring necessitating
10*15 spray applications » Ihe crop this year was outstanding from
a fancy viewpoint* We were presented a 90% fancy apple certificate
from the Massachusetts Apple Grower Institute for qualifying under
their strict rules »
Maintaining the grounds requires constant supervisiono During
the winter months, much sanding was done on roads and walks and
considerable snow plowed to keep the roads open* Summer care of
lawns and flower gardens is classified a major project*
Six acres of usable land was carved out of the Hillside Pine
Meadows swamp, and approximately the same acreage was sold to the
DoPoWo to establish a building and storage yard* The main hospital
avenue was re-surfaced with bituminous concrete type I, which ahov-ld
make repairs unnecessary for a period of twenty years* Considerable
tractor and manpower was provided for the new main hospital front
parking area* Production statistics for the year 1952
Milk 1056341 lbs*
Pork 50650 lbs.
Vegetables 646857 lbs»
**uit 52248 lbs*
•
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105 .
ENGINEER'S KEPARQMEHT
Ac Main Hospital
1* Personnel? Warren Go Proctor served as Chief Power
Plant Engineer throughout the year© Sven Wilsson, Machinist,
retired after 20 years of service*
2« Fuel Consumption
Bituminous Coal 171*5 tons
Anthracite Coal 80»25 tons
Bunker C Oil 1,310*945 gals*
Ko« 2 Fuel OH 47,306 gals
Electric Power Generator 1,544,900 E«W«H«
Water Used 18,500,000 ego
5o Electrical Works o The electricians serviced all
electrical apparatus throughout the hospital regularly* Over 250
motors were oiled and cleaned* A new electric motor (10 B*P*)
and hayloading apparatus were installed at the Bay Barn* They
removed old light fixtures from several offices and a few
selected wards and replaced them with fluorescent lights, sub-
stantially reducing the amount of electric current used and
Improving illumination* AH fire alarm batteries were checked
weekly and fire alarm gongs twice monthly*
4» Steamflttera and Plumbers* The old steam return lias
between the Avenue Cottages and Bale Nurses Borne was renewed*
About 120 feet of old water pipe beneath Quimby building was re-
placed with copper tubing* All sprinkler systems were inspected
twice weekly o Compressors and refrigeration units were inspected
twice weekly and serviced when necessary* Many items of broken
machinery and piping were welded* Pipe tables and stands were
3
';. -"■;
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i-: ...
106,
made for ward use© A new boiler was installed at Prospect Cottage*
Cast Iron soil pipe under the Tin Room in Kitchen was
replaced and vented« A new dental chair was installed and the
old dental chair relocated* Sinks were put in at Wheeler Cottage
and in two apartments at the Farm Bouse* The water main beneath
the Farm House was replaced* The Hydro Cafeteria dishwasher was
overhauled and renovated*
Emergency service was maintained for plugged toilets, wash
bowls 9 floor drains , etc* Two areas of sewer line were freed of
obstructions*
5° Machinist* The machinist serviced machinery throughout
the Main Hospital including sewing room, mending room, laundry,
kitchen, bakery, and three elevators* Likewise , oil burners were
maintained In working order*
€» Bagtoe and Boiler Room Repairs* The Ames Engine was
overhauled and repaired* Number 2 and number S boiler feed pumps
were overhauled as was number 1 vacuum pumpa Four boilers in the
lain power plant, one boiler at the Farm House, one at the Dairy
Building and t&o at Hillside Annex were prepared for inspection
by representatives of the Department of Public Safety. Six air
tanks were also prepared for such Inspection* All boiler and
pump appliances were checked and repaired if indicated*
7«» ffS-g® Protection* Weekly fire drills, attended by patients
and employees, were held* Weekly fire inspections of tine hospital
were made by the Engineer's Department and frequent inspection
visits were made by Worcester firemen*
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107,
All fire extinguishers were recharged or checked as to t&eir
condition* A new rubber-lined fire hose was purchased for
Hillside and over-age hose was replaced at the hospitals
Sprinkler systems were checked twice weekly* Ward personnel
were questioned regarding knowledge of fire rules and precaution *
Registers and ventilators were checked regularly to prevent
collection of combustible material*
B* Summer Street Eepartment
•MWMMMMM* ■lyiHXimi Will *«D»irtM«>MNM«MIM«lHW
lo Personnel* As stated elsewhere in this report, Parrand
H* Van Dyck resigned as Chief Engineer on September 15, 1952
and Howell H« Gordon was promoted to succeed him on September 15,
1954 c
2* Fuel Consumption
Coal9 Bituminous 1,18905 tons
Coal, Screenings 50 « 5 tons
Gas 541,900 c«c»f»
Electric Power Purchased 252^400 K»W.H«
Water Seed 5,368,700 c»f .
3* Electrical Work* Kine electric fly catchers and an
electric clock were installed in the kitchen* The R*C«A. radio
speaker was repaired on three occasions* A new electric line was
Installed for the coffee vending machine in the Center Buildings
She wiring and light fixtures in the holler room were renewed as
was all wiring to irons in the laundry* Service was maintained
to all light fixtures, switches, outlets, and hand iron cords
for the laundry building*
4* Plumbing; and Steamfittlng* A new sink and garbage table
were installed in the female cafeteria* Hew double faucets were
■
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put In tfe© fcitch&m« Sorvio© was gi^n to t&essaos&afclc -©©.top
control ifeXv&q^ wat©s» fauceta* water oloaetfla sliowox>ss *mt©s»
linois., etesm lio©39 seadlatoa?©, ate* 2k© thy©© Ineft iron pip©
cold tmfeer supply Has tto th© fcollox* tooo ©mi teofc mfcoa* boat©*
me x?©p2»©©& wltfe tee© lnoh eopp&y tufcii*g» FertgHfive f ©et of
tb© higfc pressure stoam Xlae to th© kitchen wae *©plac©d with
*wo lno& l3Poa pip©* cuvS repaid wcstSc wag doae or oish&2» parts of
t^se line* Baspgeasy g©s«vlce was jpossdos'ed for plugged toilets »
waeb "bowleg fl©03? draiasj, st»»
5* fffefrfrfftfoft* 33.fc&0a» laussfiry, and «9*ing ipooia zaae&ii»3*y
«ras oorviired woofely and rap&lffed ttber© necessary* Boilers wor©
eleaneda vasbed* and laspco ted» Hew food pip© busblag and pipe
fos* '*&© ntattfe&r 2 "ooiley -sras in© tailed. Food pipe 1» ntsnb©2» 3
bollea? t?a& s*opairod«
s* I&tift ££B£8SiS&fiS+ ^^ &**!i© involving eatlpo patient-
eBrp3L®33B^ population t^s>© JssM ©aoh ¥©eko FItb Inepoetlooe of tfca
hospital wor© made toy s^presenfcatlves of tbe Wosrosstesr Fisn»
S^pa5?*taa©nt» 2&© spslnlelos? oysteai and fir© alawa oystaax wore
t©st©d st weejcly int©3?wals* &XL f 1p© ©aEta&gu£sh©2*a ©eye 2»©©faeok@d
and Soda &eld -ejitiBgixishovs were refilled*
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109,
MAINTENANCE DEPARTMENT
The ordinary maintenance and repair work has been carried
on as usual during the past year* plus many other projects »
Renovation of the following has been completed by our own
personnel:
Washburn Building 2 and 3» Repaired windows and frames; puttied
and painted »
Salisbury 1 and 3* Washed ceilings and walls; repaired all broken
plaster, window frames and sash* doors and door jambs Q Ceilings
whitened; wall and woodwork painted two eoatso Aluminumed all
radiators and pipes »
Folsom Porch 1 and 2« Washed end cleaned both porches and nece-
ssary repairs made* Calsomined ceilings* Walls given two coats
of paint .,
Hydro Cafeteria* Washed ceilings; repairs made and celling
calsomined • Dining room, kitchen and two halls completely reno-
vated and given two coats of painto This represented the final
work on this cafeteria which had previously been enlarged and
rearranged by contract project*
Thayer Diet Kitchen*, Ceilings and walls washed, repaired and
given two coats of painto Floor cleaned and shellacked.
Dairy Group, which consists of Cow Barn, Ray Barn, Bull Pen and
manure Pit,. Necessary repairs made to all wood work; sanded bad
spots; puttied and caulked all holes « Buildings given two coats
of paint, including screens o Broken glass re«»set*
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scf XX« ftwiir -*I;£i3tr baa .
tct»t ■toofc f>aa o*xoo£> t£f«Ai Em
.a 6«Bt«iliac.-'>A ..aifraoo ow* betf/tlao.
:^s a«d 1 dtfod fitutae;:
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lie.
Vegetable Barn* Replaced all broken and split clapboards* Sanded
and puttied and painted entire building two coats *
Maple Cottage o necessary repairs made to all woodwork and shingles
In preparation for staining; trim and porches all given two coats*
Farm Cottage* Broken clapboards replaced 5 new bulkhead o Renovated
part of front porch.; caulked and puttied holes* Entire building
given two coats of palnto
Farm Garages* Seven stalls* Doors repaired; brol-en glass replaced
and two coats of paint applied*
Elm Cottage. Outside completely renovated and two coats of paint
applied* Elm Cottage B* Apartment* Ceiling and walls In kitchen
and bathroom washed. Ceiling calsomiaed® Walls and woodwork
given two coats of paint* All floors cleaned and shellacked*
Wheeler Cottage* Necessary repairs to clapboards and trim made*
Sanded and scraped loose paint* Puttied and caulked all holes*
Entire building given two coats of paint*
Avenue Cottage 1-2-3-4 « Outside repairing of all woodwork*
Caulked and puttied all holes« Two coats of paint applied*
Quonset Huts* The last two huts were erected with concrete floors
and double doors front and rear* The completed unit now consists
of four huts* All were completely painted with two coats to metal
and woodwork a Work was begun on a long, truck tail-board level
loading platform at the rear of these huts which are located he-
hind the Straw Barn*
Two Stall Garage* Erected to house new farm truck and bus* This
consisted of a brick addition, wiifc, roof and overhead doors* to
the open stalls adjacent to the Main Garage*
^ofcte bem >fctov CXa otf afi
sod orti awX-Q XlB aario*s«K| ba-
anJtbXXwd e*Itfi aelorf baitowq
'SJtqet aaal-
newfctflal xil eXXav . ifl gnXXJU
,-.&«aIa®XJ> '^©eaeu I XXA
«a»Xod XXa 5rta fi
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Summer Street Department. Third floor-Center, complete renovation*
Floors sanded and refinished; ceilings washed and whitened; walls
papered* Kitchen remodeled; new cabinets installed, inlaid
linoleum laid on floor* Engineer's office - ceilings and walla
washed and calsomined* Walls and woodwork given two coats of paint »
lard S and Ward 11 were completely renovated; regular main-
tenance to the buildings Included windows, glass, plastering and
painting*
Sargent Building. Rooms 29-42 * Ceilings and walls washed*
Ceilings calsomined* Walls and woodwork given too coats of paint
E*B* 4 and 5* Ten rooms renovated* Ceilings washed and calsomined*
Walls and woodwork given two coats of pninto Floors cleaned and
shellacked*
Radio Room Area. Rooms and stairway renovated*. Woodwork and
plaster repairs made* Celling whitened* Walls and woodwork given
two coats of paint*
A large amount of repair work was done to the slate roofs,
both at the Main Hospital and Summer Street Department*
The window screen repair work has continued to be a large
project* Approximately 600 new screens were made*
The usual carpenter repair work has been done on all windows ,
such as new box casings* new parting beads and window cords* This
work is necessary to all windows throughout the hospital*
The patching and plastering of walls and ceilings in wards
and cottages is a continuous necessity for proper upkeep*
The replacing of window glass is again tremendous* Over 3800
panes of glass, 5000 feet of window cord and 1300 2bs« of putty used.
vvoaet adaX
el Jew ^fceaatflrfw J&cy9 fcertesw age
fol-alni Bi eufa/iJttfas
ellaw ftrtB sgniX Goi^c e'aoar
bad salwJu&i t£g ^awobal
oftadtamr • asaJbll
i*X*j lo atfaoo £3 a&fc"
JtaaJtafOfeXaa fuxa &edtL.w eaaltJtoO efied
Iwsa il«x©«£>o tart ova
•
^a^oot efrs oS aaob aaw A
aortal* b aflii
i arses? aaea^
48WoftnX,tf Xia ao as* >b aaatf
aftaM cti ayx-'l-rja Ana bXI -. - ' ~ 2-»-.iX*£»tfB iX?x -■— S' -''-' ; &-;-:
008S «xovO a
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A continuous amount of lock repairing, such as resetting,
ins telling and losy making, was carried on throughout the year*
The following major projects were carried on by contracts
Farm Bouse* Work was begun on March 9, 1963* by I» Tapper & Son
on a project to renovate and remodel two floors of this building,
providing us with five apartments for personnel* The project was
well advanced as the year closed*
Kitchen Area* Kiesseli and librae Co* completed a tiling project*
One side walls and floor of the Tin Washing Boom were tiled* The
floor of the Ice Cream Making Hoom was Idled* The area leading
from the Kitchen, to the Scullery bad its side walls and floor
tiled *
New Male Bathing Unit* Peabody Construction Company » This new
unit Is located against Apple ton and Lincoln buntings* and
incorporated into the basement of those buildings* Work was be-
gun in the previous year on January 90, 19SS, and dragged on
during the current year without completion*
Executive Building* A* Belanger and Sons* Repolntlng of masonry
and caulking of window frames was done on the east side of this
building*
Cannery Roof * This was covered with asbestos shingles by outside
labor* supervised by the l&lntenance Department* Three metal
roof ventilators were installed*
■ ■ ■ ■
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•eJtei* 1c •
-
Jjatfea
U3o
MATRON '.£ nftV>AT.'i*TEi.TT
Hits department has functioned well under tie le i
of Lillian Q. Carr.
The Sewing Boon fabric:, cod over 39,000 now articles. These
included sheets, pillow slips, patient's hospital johnnd , 11
types of towels, "strong blankets", curtains, soft s.. , n»s
shirts, bathrobes, "strong dresses", etc.
Hie Mending Room hrs serviced clothing and linen n< or
repair of hone fabric ted articles, purchased goods vnO
clothing worn by patients hero. Over 61,000 items we: e .
this year.
The Marking Roon applied identifying nark or stemped
to nearly 18,000 articles. Tliis figure votild be nuclj greater,
v.'c e it not for the fact that nuch of the marking is uo::e on t ?
in t .e clothing offices aid linen rooms which s rve as control
centers.
The natron's Department served as a distributing and control
center for household supplies issued to some 29 units t rou ..hoi t
the hospital
The Industrial Therapy Shops, heado ' by 7ran:: R. Proctor,
p-.ive occupation to an average of 45 patients daily .iuri.v the ye
and performed a variety of cervices useful to tie hocpit; 1
t lese the more numerous iters were:
Mimeograph co ies i-.ic.Cg ...... 186,910
Men's outer clothing repaired
..a! pressed „ r'.l
U4.
Articles of furniture repaired 1,014
Chair seats repaired 98
Furniture reu;hol stored 26
Window shades made . 259
New pillows made 136
Hew mattresses made 183
Bed frames repaired and painted. .... 322
Bed springs repaired 133
Shoes half-soled and healed (prs.) . . . 659
Hew Men*s coats made 4.07
New lien's pants made 297
Ediphone cylinders shaved 2,0A6
Eg.2 rugs made. . . 281
Toweling woven (y&s.) 1,559
215«
WOUfoN'S ATOCELXAgy
The Woman* s Auxiliary* which began as a group of staff wives
In 1930 j> has expanded and is now a large enthusiastic organization
composed of both women from the general community and of hospital
employee's wives* Xt holds regular aionthly meetings from October
through June each year and has been of significant assistance
to the therapeutic efforts of the hospital*
Perhaps one can best sense the spirit of tfals group by
inclusion of a portion of the report submitted by the president,
Urso Clayton X>« Jenks, to its annual meeting in June* 1953*
"Sfeaabers of the Auxiliary and Guests:
Our Constitution states that the object of the Woman1 s
Auxiliary to the Worcester State Hospital shall be to aid the
Board of Trustees and the Superintendent of the hospital in
carrying out the purpose and functions of the hospital* These
are primarily:
A* To interpret the hospital to the community*
B» To help support financially, and otherwise, the
preventive work carried on by the hospital*
Wo have made a conscious effort to interpret the hospital
to lhe community o To this end* each month* invitations were
sent to each member of one of the large women's college clubs of
Worcester to be our guests at our regular monthly meeting* Thus,
we invited the member's of th© Smith,, Vassar, ffit* Hblyoke and
Simmons College Clubs and the members of the Clark University
Ffe.cu2.fey Woman's Club* Each time a dozen, more or less, accepted
and came to our meeting* It was satisfying to know that these
■ ■ ' ' *
■ ■ •
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college women had been personally told that there was a Woman's
Auxiliary at the Worcester State Hospital* and that our members
were earnestly striving to learn the fundamentals regarding
emotional problems and mental healtho
Also* our superintendent's wife* Mrs« Bardwell 1» Flower »
as well as your president^ has addressed during the year several
church groups and Women's Clubs telling them aomefchizig s
hospital and the patients and especially about the work or the
Woman's Auxiliary.*
Before the Fashion Show which we gave for the patients^
Lyda Flanders gave me ten minutes of radio time on her fifteen
minute program* The Sfodern Kitchen • I thus had time not only
to ask for donations of good used clothing suitable for a Fashion
Show but also to explain that the patients were people with the
same feelings of pride , pleasure and discontent that we feel»
Immediately after the broadcast p people began to leave bundles of
clothing at Mrs* Flanders5 of flee* I wish there were time to
repeat here the messages they left with their bundles * Several
said they were happy to give clothes they would have continued to
wear* if in so doing8 they could make the sick people happy at
Worcester State > On© woman wept as she brought in a carload of
beautiful clothes g explaining that they belonged to her recently
deceased sister who had been a patient at Worcester State,, dis-
charged quite well and normal , had married and had had many happy
years as a wife and mother* Her gratitude to Worcester State
could hardly be repaid by these clothes, she wept&
117,
All of thla shows that the public Is not indifferent and
will become interested and anxious to help If the Auxiliary will
but point the way*
Otoe Fashion Show itself was wonderful* If fine feathers make
fine birds, certainly the transformation was spectacular* Depressed
and rather bedraggled women in their cotton dresses were trans-
formed into radiant fashion plates* After each had had her hair
dressed^ make-up applied* and gotten into her beautiful outfit
complete with nylon stockings, hat, bag and other accessories,,
she certainly looked like a million dollars * Saey gased at them-
selves in f&e mirror* and said incredulously, "Is that ME?" It
Is a pleasure to recall the poise and confidence with which each
walked alone across the stage to music pivoting slowly as the
commentator described her costume* Since each kept her outfit,
the stimulus lasted, and the next day, the ^models" staged an •
impromptu fashion parade of their own throughout the hospital-*
The Open HOuse definitely comes under the heading of inter-
preting the hospital to tgie community* We mailed 800 invitations
and secured newspaper and radio publicity* We served a delightful
tea to our guests in B»Ba 2« At the ceremony In Sargent Hall,
we were happy to assist the hospital by furnishing the awards to
the tsro rusmera-up in the Attendant-of-the~Y©ar con tea t» We gave
Mr« l&unberg from the male side and Mrs* Rennault from the female
side identical mahogany self-winding electric clooks with
illuminated face a
Just & brief summary of the work that we did for the patients <s
■
..
u*.
At Christmas as a result of our efforts j> many hundreds of glf ts
were donated for Christmas gifts to the patients* Again*
Mrs a Flanders permitted m© to make a radio appeal for gifts, and
again, as they were brought into her office , the donors would
say that it had never occurred to them that they could help the
patients at Worcester State* It was only a small group of us,
at this busy time of year who spent several wearisome days
Chris tma s wrapping these articles » A gift card attached to each
present displayed the patient's name and each patient received a
different and a personal gifts
Also on the Sunday evening before Ghristraas^ we sponsored
our usual carol sing throughout the lain hospital o 3his project
has grown each year* Four years ago,, when I was program chairman,
I asked the Pilgrim Fellowship (young peoples group} of the
Boylston Congregational Church if they would like to sing Christmas
carols at the Belmont and. Summer Street hospitals * A small group
responded eagerly , and so great was their enthusiasm that the
young minister who accompanied them discarded his prepared sermon
for Christmas Sunday, and told in a simple, moving and human
manner the experiences of his young people and their sincere
desire to bring joy and brightness of Christmas to the State
Hospital™ She next Chris teas (three years ago) most of the youth
of Boylston were waiting on -fee church steps at 6 PoM<» for the
chartered bus which would take them to the hospital* The next
Christmas {two years ago) the First Baptist Church heard of this
enterprise and asked if their young people could join in the carol
119,
singing o This worked out very well, on© group talcing the female
side and one the male side,, and then crossing over to the other
sideo Thus each ward had two different waves of youthful singers
pass through which made It more of a party evening for each ward*
This Christmas, X received a letter from Mr» Hickman* director of
music at Central Congregational Church, asking if a group of their
young people might sing carols through the hospital corridors or
wherever directed*
Just what to do witii all this wealth of material was a hit
of a problem* but w© gratefully told them all to come and had
three groups maabering in all some 200 who trouped all over the
hospital in and out of wards from Ohs first floor to the sicker
wards on the third floor o It was in on© of these third floor wards
that Bro Nelson who was conducting the tour pointed out to me a
woman patient sitting up in bed singing lustily with the carollerso
"That is the first time she has spoken since entering the hospital,*
he said* Apparently some repression had been broken down by the
familiar carols and the whole-hearted enthusiasm of the boys and
girls a
Although these young people wanted no reward* the Auxiliary
felt that it might be wise to make their final impression not a
hospital ward but a social party, so in E»B*2 we regaled them with
punch, sandwiches, cakes and cookies o
We also helped a man patient who was leaving the hospital to
reestablish and furnish his home, giving living room furniture and
sheets, pillow cases and towels «. We paid for a specially built-up
120o
shoe ordered by Sfes* 01i\>e Soman,, head social worker s for a lame
woman patient who could not walk without the special shoeo
Ohese are a few of the high lights of the year* We could
have done better and we will in time a However # we bar© had a
busyff interesting and rewarding winter.. Each of us felt we were
doing some thing worth while »n
•
121.
FINANCIAL REPORT
Worcester State Hospital
1953
To the Department of Mental Health:
I respectfully submit the following report of the finances of this institu-
tion for the fiscal year ending June 30 , 1953 ,
STATEMENT OF EARNINGS
Board of Patients;
Private ...... . . $ 182,687o06
Cities and Towns, o o o * . . ..«...«.
Department of Mental Health 40,333.11
$ 223,020<,17
Per§2SSl Service^:
Labor of Employees .0.0.0.00. ..
Reimbursements from Board of Retirement . »
Sales and Rent?:
. OOs* o oooo«e»*oeoo • • • » o o 5VU>5 -t 9
Clothing and Materials «, .......... 1.00
Housekeeping Supplies • •«...... .
Laboratory and Medical. <> ........ . 22.69
Heat and other Plant Operations ••«... 24.57
Farm and Grounds. ..... ... 6,267*59
Automotive.
Advertising and Printing.
itopoxrs .. .......O.C..OO.O. ^^w?.oo
Special Supplies o ........ ...... 2*25
Office and Administrative
Equipment
Special Outlay.
Furnishings ..«.•«••«•*•«.».. 37.00
Rents - Employees ...... ... 27,290.36
Rents Others. .........•••*. .. 497.88
Meals Employees I6,25lo00
Total Sales and Rents 5l,310„15
Miscellaneous:
Interest on bank balances .........
OliJjLXry ......aou..o..«.a.i> lj /Olg77
Total Miscellaneous 1,781.99
• o»*e-a«e #•••»«**
£»e*««»o**eoo
'e«oQo*#o««oa»oov
122.
Total Gash Receipts reverting and
transferred to State Treasurer ♦..«,» 276,H2,>31
Total Earnings for year (page 9»Xnst« Income) 276,. .''.91* /.ft
Accounts Receivable outstanding July 1, 1952 143 .69
Accounts Receivable outstanding June 30, 1953 226o94
Accounts Receivable increased ...... . 83*25
MAINTENANCE APKiOPRIATIOB
Appropriation, current year 3»008j,711.41
Total 3,008,71JL41
Expenditures as Follows?
01. Salaries, Bermanent 1,97a ,940*73
02. Salaries, Other 38,833.02
03o Services - Son-employees 23,700.00
04. Food for Persons 415,751*64
05. Clothing 59,013,83.
06. Housekeeping Supplies and Expenses 71,726.19
07. Laboratory, Jfedical and General Care 47,947.79
03* Heat and Other Plant Operation 136,331.75
09* Farm and Grounds 42,319.2$
10. Travel and Automotive Expenses 5 , 286*39
Ho Advertising and Printing 375*22
12. Repairs, Alterations and Additions 62^615.78
13. Special Supplies and Expenses 61.68
14. Office and Administrative Expenses 11,231.01
15. Equipment 22,688.51
16. Rentals 487.50
18. Special Outlay
Total Maintenance Expenditures 2,911,298*30
Balance of Maintenance Appropriation, June 30s, 1953 97, 413 .11
SPECIAL APPROPRIATIONS AND SPECIAL OUTLAY
123.
Balance July 1, 1952, brought forward
Appropriations for current year
Total
Expended during the year
Revarting te Treasury of Commonwealth
Balance June 30, l95->-> esreffed to next year
None
Rose
Hone
None
Bo-do
PER CAPITA
1. During the year the average number of patients has been
20 ^otal cost of maintenance
3. Equal to a weekly per capita cost
of (52 weeks to year)
Un Total receipts for the year
5o Equal to a weekly per capita of
6. Total net cost of Maintenance for year
(Total Maintenance less total receipts)
7o Net weekly per capita
2,911,298.30
20,03
276,212.31
1.90
18. IS
Respectfully submitted,
A/
FINANCIAL STATEMENT VERIFIED
(Under Requirements of C. 7, S 19 QL)
Date: October 29, 1953
By_r . _/ra/n_ J^sepfr A. Frenaey
For the Comptroller
Approved for Publishing
2788
2,635,185.99
Paul P,> Foran,
Treasurer
/e/ Ralnh E, Houston
Acting Comptroller
'
lSgS£ 22 POHJIATIQg? 12Uo
July 1, 1952 to Juno 30, 1953,
■
1 Total M& ISB32&
&ti§ntg On Booki At Bgginning Of ££§£
lo In Hospital <> • ••••••••••••••••••••«• 2831 1316 1515
2. In Family Car© (Public Hospitals Only) .........<> 47 9 38
3. On Visit Or Otherwise Absent But Still Carried On Boobs . • 357 158 239
4* Total On Books At Beginning Of Year (Sum Items 1,2,3) . « « 3275 1483 1792
Admissions During Year (Exelusiv© Of Those Returned From Visit,
Escape, etc.)
5o First Admissions ,«•••••••«••••<>«••••• 629 324 305
6e Readmissions ««••••••••••••••••••••• 209 M)3 I **
7. Transfers Prom Other Hospitals For Jfental Disease Within State 26 XI 15
8. Total Admissions • •••••••••••■•••••••• 438
9. Sum of Items 4 and 8 (For checking) ••••*••••*•• 4139 1921 2218
Separations During Year
10o Discharges D?-4,ect From Hospital . ......<> o 231 161
llo Discharges WMle On Visit, Escape, Etc. • •••••••■» 308 113 193
12o Total Discharges .........«......•••* « 539 276 263
13. Transfers To Other Hospitals For Mantal Disease Within State 114 58
H/irt Deaths In Hospital •••••«•••«»••.••••«•• 283 144 139
15. Deaths Of Patients On Visit Or Otherwise Absent From Hospital 3 2
16* Total Separations {S«u Items 12,13,14,15) 939 480 459
Patients On Books At End Of Yg_ag
17c Resident In Hospital At End Of Year ............. 2745 1257 1488
18. In Family Care «••••••••••••«•••••••• 54 10 M
19* On Visit Or Otherwise Absent But Still CfcVrled On Books . « 401 174 227
20* Total On Books At End Of Year (Sum Items 17,18,19). . . • . 3200 1441 1759
21. Sua of Items 16 and 20 (Should Equal Item 9 if all entries
are correct) ........... 4139 1921 2218
22 o Average Daily Patient Population In Hospital During Year . 2777.42 1287.67 1489*75
23. Rated Capacity Of Hospital. • . ..... 2356
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