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Full text of "Annual report of the trustees of the Worcester Insane Asylum at Worcester"

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PUBLIC DOCUMENT. No. 23. 



TENTH ANNUAL EEPOET 



THE TRUSTEES 



WORCESTER INSANE ASYLUM 



WORCESTER, 



Year Ending September 30, 1887. 



BOSTON : 

WRIGHT & POTTER PRINTING CO., STATE PRINTERS, 

18 Post Office Square. 

1888. 



OFFICERS OF THE ASYLUM. 



ROCKWOOD HOAE, . 
FRANCIS C. LOWELL, 
ELLEN S. HALE, 
FRANCES M. LINCOLN, 
A. GEORGE BULLOCK, 
THOMAS H. GAGE, . 
JOHN F. MOORS, . 



. Worcester. 
. Boston. 
. Boston. 
. Worcester. 
. Worcester. 
. Worcester. 
. Greenfield. 



RESIDENT OFFICERS. 

HOSEA M. QUINBY, M. D., ... Superintendent. 
ERNEST V. SCRIBNER, M. D., . . . Assistant Physician. 
CLARENCE R. MACOMBER, .... Clerk and Steward. 
SOPHIA N. GRAVES, Matron. 



WILLIAM SHERMAN, 



Engineer. 



ALBERT WOOD, 



TREASURER. 



Worcester. 



c^.gS) 



TRUSTEES' KEPORT. 



To his Excellency the Governor and the Honorable Council. 

The Trustees in charge of the Worcester Insane Asylum 
respectfully submit their Tenth Annual Report. 

The Superintendent's report and that of the Treasurer, 
appended hereto, state clearly the details of the government 
of the asylum and its financial standing during the current 
year. 

We would call attention especially to the very interesting 
review of the dealing with patients and the improvements in 
the building during the past ten years, and to the valuable 
suggestions as to the care of the chronic insane of the State 
in larger buildings l^uilt and maintained for this class of pa- 
tients. 

The patients of this institution belong to the class of the 
permanently deranged, who, on the average, have suffered a 
long time from their malady before transfer to us, and. are 
often feeble and very listless. It has been of great interest 
to see how many of the inmates have been employed about 
the grounds or on the work on the buildings that has been 
done or is going on. Two patients render valuable service 
in stone cutting, showing little sign of derangement or in- 
efficiency in their steady, interested, and intelligent labor. 

Our Treasurer's report shows a surplus in our treasury. 
The Superintendent's review of the ten years' management 



74 WORCESTER INSANE ASYLUM. [Oct. 

of this institution suggests the propriety of considering the 
reason for the existence of a surplus, the use that will be 
made of it, and the wisdom of so maintaining the price of 
board at a hospital or asylum that the income so derived 
may exceed its ordinary annual expenses. 

It will be observed by inspecting the treasurer's report 
of any of our institutions for the care of the insane, estab- 
lished long enough to be well under way, that a surplus re- 
mains at the end of many of the financial years. 

In our hospitals, where the number of patients and the 
individual patients change frequently, where the forms of 
dementia are many and varied, and a larger force of physi- 
cians and attendants must be employed than in such an 
asylum as ours, the expense of maintenance is great, — con- 
siderably greater than here. The price of board for pauper 
patients, $3.25 per week, is too low, and the annual reports 
would show a steady and considerable deficit if it were not 
that the income derived from the care of private patients is 
sufiicient to turn the balance to the favorable side. In this 
asylum, where we have no private patients, we only are able 
to show an annual surplus by the greatest care and scrutiny, 
and by furnishing a somewhat plainer but yet nutritious and 
wholesome diet. In regard both to the State hospitals and this 
asylum it would be possible, we suppose, to so regulate and 
change, each year, the established price of board, that no 
surplus would remain on balancing the annual accounts. We 
are satisfied, however, and we think any intelligent person 
would be satisfied on examining the history of any such insti- 
tution during a period of years, that such attempt to regulate 
and change the rate so as to render the institution barely 
self-supporting would be unwise and injurious. It is best 
for the State and for the patients themselves that the more 
liberal policy should be upheld. If our institutions were 
barely self-supporting in meeting their ordinary expenses, it 
would be necessary, of course, to resort constantly to the 
Legislature for appropriations for the additions and improve- 
ments which even new buildings require to maintain them in 
good order, and to furnish the new facilities which the genius 
of the age and accumulated experience suggest. 



1887.] PUBLIC DOCUMENT — No. 23. 75 

We all believe that every facility should be ready and at 
hand by which the veil can be lifted from the clouded intel- 
lect, a family thus reunited, a citizen restored to useful and 
honorable service of his country, — or misery, suffering, and 
discomfort alleviated, when, unhappily, the light of reason 
is permanently dimmed. 

If prudent and intelligent managers are selected and ap- 
pointed to the government of insane hospitals they should 
have the money ready to supply these things, — sometimes 
at once, as soon as needed ; often by gradual and careful 
change or addition in building or equipment. It is not 
feasible to explain, nor has the Legislature the time to con- 
sider and investigate each expenditure. 

If a single year of a hospital be taken and isolated a some- 
what large surplus may appear. If a period of years be 
taken the surplus of single years will be found to merge and 
be absorbed in the necessary and proper expenditures of 
wise administration, and this both to the present advantage 
of the patients and to the actual saving and gain of the State. 

We have two institutions under our care. This year, at 
the hospital which is under our charge, we have built and 
equipped two new buildings, or wards, for the care of the 
suicidal insane, without resorting to a special legislative ap- 
propriation. During the past ten years at this asylum we 
have changed an old and somewhat dilapidated building into 
a cheerful, well-equipped, and well-constructed establishment, 
without appeal to other aid than our own income. If the 
suras charged to private patients have helped us to do this 
at the hospital, then the private patients of to-day and the 
years to come are benefited. If the State and the towns 
have helped us at the asylum, it is to the gain of the State 
and towns henceforth, and the surplus of a single year has but 
been a part of the wise, necessary and economical expendi- 
ture of the decade. The history of the financial management 
of our two institutions will be found but a repetition of that 
of the other establishments of the State. We are convinced, 
therefore, that not a narrow but a liberal and comprehensive 
policy should be sustained, and that a desire to save upon a 
year's cost of supporting the insane should not be allowed to 



76 WORCESTER INSANE ASYLUM. [Oct. 

cause a greater ultimate loss and injury, both to the State 
and to the unfortunate beings who are its wards. 

We would express our thorough satisfaction with the 
ability and untiring devotion of our Superintendent, Dr. 
Quinby, and with the excellent services of his staif, and of 
the attendants. 

ROCKWOOD HOAR. 

FRANCIS C. LOWELL. 

ELLEN S. HALE. 

FRANCES M. LINCOLN. 

A. G. BULLOCK. 

THOMAS H. GAGE. 

J. F. MOORS. 

Worcester, Sept. 30, 1887. 



1887.] 



PUBLIC DOCUMENT — No. 23. 



77 



OFFICERS AND THEIR SALARIES. 



Hosea M. Qiiinby, M. D., SuiJeriiitendent, 
Ernest V. Scribuer, M. D., Assistant Physician, 
Clarence E,. Macomber, Clerk and Steward, . 
Sophia N. Graves, Matron, .... 
William Sherman, Engineer, .... 
Albert Wood, Treasurer, .... 



$2,500 00 

1,000 00 

1,000 00 

325 00 

1,000 00 

400 00 



VALUE OF STOCK AKD SUPPLIES, 

October 1, 1887. 



Live stock, 


$425 00 


Carriages and agricultural implements, 


650 00 


Machinery and mechanical fixtures, .... 


9,000 00 


Beds and bedding in inmates' department, 


9,457 60 


Other furniture in inmates' department. 


3,000 00 


Personal property of State in superintendent's department, 


9,500 00 


Ready-made clothing, ....... 


1,146 08 


Dry goods, 


1,997 58 


Provisions and groceries, ...... 


2,168 15 


Drugs and medicines, ....... 


300 00 


Fuel, 


1,080 00 


Library, 


325 00 


Other supplies, 


2,346 89 




$41,396 30 



78 



WORCESTER INSANE ASYLUM. 



[Oct. 



TREASURER'S REPORT. 



To the Trustees of the Worcester Insane Asylum. 

Ladies and Gentlemen: — I herewith submit my Tenth 
Annual Report on the finances of the Worcester Insane 
Asyhmi for the year ending Sept. 30, 1887. 



Receipts. 



Cash on hand Sept. 30, 188G : 
Cash belonging to asylmn, 
Deposits of inmates, . 



),472 55 
794 50 



Amounts received : — 
From the Commonwealth for support of patients, $17,460 51 
cities and towns for support of patients, 55,359 04 

other sources, 866 69 

patients (on deposit), .... 63 03 



§10,267 05 







' 


The expenditures for the year have been as follows : — 


$84,016 32 


Salaries and wages, $20,973 77 




Extra labor (ordinary), .... 
Provisions and supplies, viz. : — 


15 00 


$20,988 77 




Meats of all kinds, 13,823 27 




Fish of all kinds. 






690 42 




Fruit and vegetables. 






1,695 94 




Flour, 






3,103 66 




Meal for table, .... 






85 40 




Grain and hay, .... 






207 21 




Tea and coffee, .... 






747 01 




Siigar and molasses, 






1,213 75 




Milk, butter and cheese, . 






6,359 43 




Salt and other groceries, . 






921 93 




All otlier provisions. 






1,629 66 


$20,477 68 


Clothing and other material, . 


$5,224 09 


Fuel, 






5,154 99 




Light, 






1,399 05 




Amounts carried forward. 


$11,778 13 


$41,466 45 



1887.] 



PUBLIC DOCUMENT — No. 23. 



79 



Amounts brought forward^ 
Medicine and medical supplies, 
Furniture and furnishings, 
Crocker}^ , 
Beds and bedding, 
Transportation, 
Travelling, 
Trustees' expenses. 
Soap and water. 
Stationery, 
Undertaking, 
Repairs (ordinary) , 
All other current expenses. 



Total current expenses, 
Repairs and improyements (extraoi'dinary), 
Refunded inmates from deposits, 



111,778 i;3 


$41,466 45 


235 61^ 




1,462 05 




569 84 




1,190 22 




265 27 




60 00 




35 77 




1,045 69 




174 16 




221 00 




3,000 00 




1,833 82 






$21,871 56' 






$63,338 01 


$9,488 50 




7 00 


<aQ A(\!^ ^n 



Total amount expended. 
Cash on hand, Sept. 30, 1887, 



$72,833 51 
11,182 81 



Resources. 




$84,016 32. 


Cash on hand, ...... 


. $11,182 81 




Due from the Commonwealth, 


4,152 46 




cities and towns. 


. 13,896 31 




other sources, .... 


221 05 


$29,452 63 


Liabilities. 




Due for supplies and expenses. 


. $5,817 28 




salaries and wages. 


1,807 15 




Due inmates (cash on deposit) , 


850 53 


8,474 96 






Total surplus, 


$20,977 67 



Respectfully submitted, 



Worcester, Mass., Oct. 1, 1887. 



ALBERT WOOD, 

Treasurer. 



Worcester, Mass., Oct. 29, 1887. 
The undersigned has this day carefully compared the Treasurer's statement of 
expenditures for the year ending Sept. 30, 1887, with the vouchers \YhichL are on file- 
at the asylum, and found it to be correct. 

THOMAS H. GAGE^ 

Auditor of Accoimts. 



80 WORCESTER INSANE ASYLUM. [Oct. 



SUPERINTENDENT'S REPORT. 



To the Trustees of the Worcester Insane Asyhim. 

Ladies and Gentlemen : — I herewith submit for your 
consideration the Tenth Annual Report of the Superintend- 
ent of the Worcester Insane Asylum. 

There remained in the asylum at the close of the last offi- 
cial year 398 patients, — 192 males and 206 females. Twenty- 
one males and 25 females have since been admitted, 10 
males and 4 females have been discharged, and 21 males and 
17 females have died, leaving in the asylum, Sept. 30, 
1887, 392 patients, — 182 males and 210 females. 

The whole number of patients under treatment during the 
year has been 444, — 213 males and 231 females, while the 
daily average has been 393.52. 

Of the 46 patients admitted, 2 males and 6 females were 
transferred from the Tewksbury Almshouse, 10 females from 
the Worcester Lunatic Hospital, 9 males and 11 females 
from Taunton, and 10 males from Northampton. 

Of the 14 patients discharged, 10 males were transferred 
to Bridgewater, 1 female to the Worcester Lunatic Hospital, 

I female was sent to Ireland, and 2 females returned to their 
homes. 

Two patients are reported recovered, — 1 from puerperal 
mania, of two years and two months' duration, the other from 
alcoholic mania, after a four years' residence in the asylum. 

Of the 38 deaths, 13 were due to phthisis, 5 to epilepsy, 

II to exhaustion of chronic mania, 4 to paresis, and 1 each 
to senility, paralysis, Bright's disease, chronic diarrhoea and 
cerebral effusion. 



1887.] 



PUBLIC DOCUMENT — No. 23. 



81 



Ratio of Deaths from the Opeyiing of the Asylum to Oct. i, 7'9<§/ 





t 


1 o 


Deaths 


. 


1 =li 


§S ° . 




'^ 1 


Daily Ave 
number 
Patients 








Per cent. 
Whole 
of" I'atie 
treated. 




OFFICIAL YEAR. 


'a 
3 


1 
fa 


o 


S -a a &H 


1877-78, . 


429 


382.98 


18 


8 


26 


6.05 


6.78 


1878-79, 








422 


367.41 


22 


11 


33 


7.82 


8.98 


1879-80, 








413 


363.15 


15 


8 


23 


5.56 


6.33 


1880-81, 








401 


362.09 


18 


6 


24 


5.98 


6.62 


1881-82, 








439 


375.59 


21 


11 


32 


7.28 


8.51 


1882-83, 








461 


384.33 


37 


24 


61 


13.23 


15.84 


1883-84, 








438 


390.69 


22 


20 


42 


9.58 


10.75 


1884-85, 








448 


391.12 


20 


14 


34 


7.58 


8.69 


1885-86, 








476 


400.28 


23 


15 


38 


7.98 


9.49 


1886-87, 








444 


393.52 


21 


17 


38 


8.55 


9.65 



The general health of our inmates has been good ; cases 
of acute sickness having, as in the preceding year, been few. 
Very little restraint has been used, and the liberty of the pa- 
tients, within the grounds, has been greatly enlarged, and 
yet in no case has any serious accident resulted therefrom. 
Four patients have abused the privilege granted them and 
escaped, but this proportion is no greater than might be 
expected under any system. 

Since my last report the repairs in our cooking depart- 
ment have been completed, our kitchens connected by a 
hydraulic elevator and refurnished with an entire new set of 
cooking apparatus, consisting of an eight-foot range, with 
broiler and griddle attached, four forty-gallon jacket kettles, 
three steam kettles, a Whitely meat-roaster, and a hot 
closet. 

We have also thrown out bays at the end of our South 
Johonnot wards, and begun alterations which will result 
eventually in the complete renovation of our extreme male 
wings. 

During the winter the dam at the Hermitage Pond, so- 
called, from which the asylum obtains its water supply, be- 
gan to leak and to show such other signs of weakness that it 
was deemed prudent to draw off the water. On account of the 
condition of the ground it was impossible to determine what 
the exact trouble was, or to take any effectual steps towards 



82 WORCESTER INSANE ASYLUM. [Oct. 

its repair until late in the spring. It was then found that 
the spiling back of the wall had entirely rotted away, and 
that the dam, as originally constructed, was so defective that 
very extensive repairs, if not an entire rebuilding, would be 
necessary to insure its safety. By the direction of the Trus- 
tees, Messrs. Knowles and Allen were employed to carry 
out these repairs, under the supervision of Mr. Charles A. 
Allen, city engineer, and according to plans made by him. 
The work is now completed and has been done in the most 
substantial and satisfactory manner. 

With the close of the present official year the asylum ends 
its first decade. It may be well, therefore, to look back and 
see what it has accomplished during this time, and note how 
it has administered the trust placed in its hands. The new 
Worcester Lunatic Hospital was opened Oct. 23, 1877, 
and on the same day the old buildings, occupied from 1833, 
were turned over to the asylum and at once filled with the 
chronic, indigent insane, transferred from the other State 
hospitals. Although these buildings had for many years 
proved inadequate to meet the wants of the hospital, they 
were still substantial, convenient, homelike, and in the main, 
well adapted to the new purpose to which they were to be 
devoted. They were, however, extremely faulty in the mat- 
ter of lioht and ventilation, and needed radical alterations to 
correct these faults and to introduce pure air and sunshine 
into the wards, recognized by modern sanitary science as one 
of the first requisites of a properly constructed hospital. 
Extensive repairs were also necessary to make good the 
wear and tear of over forty years' use, and more especially 
since no outlay, save what was absolutely demanded, had 
been made upon the buildings for several years, or from the 
time that it was decided to build a new hospital and abandon 
the old. 

Beginning its career without any resources of its own, 
■ and having to depend entirely upon the income to be derived 
from its patients, as fixed by the laws of the State, it was 
obliged to borrow funds to meet its current expenses. It 
had, therefore, no means at its disposal to make the various 
alterations and repairs which the condition of the buildings 
demanded. In consideration, however, of the fact that its 



1887.] PUBLIC DOCUMENT — No. 23. 83 

former tenants had allowed the buildings unduly to deterio- 
rate, the sum of ten thousand dollars was appropriated from 
the surplus funds of the Worcester Lunatic Hos})ital, and 
used by the asylum in building a new laundry, relaying 
floors and carrying out such other repairs as were absolutely 
demanded. 

Under the wise organization and skilful management of 
Dr. Park, its first superintendent, the financial success of 
the asylum was at once assured, and in its subsequent man- 
agement it has only been necessary to follow out the methods 
devised and adopted by him to realize like results. After 
refunding its loans and meeting all of its other liabilities, 
the asylum had, at the end of the first year, a considerable 
balance in its favor, and this has continued to be the case 
during each subsequent year. 

Reserving in its treasury a sufBcient fund to meet its quar- 
terly bills, and to anticipate any emergency that might arise 
during the year, the asylum has devoted the balance of its 
income to necessary repairs and improvements. With the 
earnings of the past ten years it has renewed the inside 
finish in six of its eighteen wards, relaid all of its drains, 
put in new plumbing over the greater portion of the 
house, renewed its entire heating apparatus, enlarged the 
laundry and equipped it with new machinery, repaired, 
enlarged and refurnished the kitchen, and thrown out bay 
windows at the ends of several of the wards. Plans have 
been adopted involving radical changes in the system of ven- 
tilation, and in so far as these plans have been carried out 
they have proved eminently successful. In the meantime 
the entire house has been repainted, the general repairs kept 
up, and a great deal of work done about the grounds, — 
grading, cutting and setting curbstones, paving and laying 
sidewalks, etc. 

Patients' labor has been largely utilized and has been an 
important factor in reducing the cost of these repairs. It 
has enabled us to carry out many improvements which 
without an appropriation from the State would have been 
impossible in the absence of such help. 

The average weekly cost of support per patient for the ten 
years has been $2.98. Their diet has been plain but gener- 



84 WOKCESTER INSANE ASYLUM. [Oct. 

ous, their clothing abundant, their attendance ample, and 
nothing has consciously been neglected that is essential to 
the health, happiness or well-being of the patients. A med- 
ical officer has been upon the grounds and within call at all 
times. Each patient has been visited twice daily, and more 
frequently in cases of sickness or unusual excitement. 
Regular service has been held in our chapel on Sundays, 
and at least one entertainment has been given during the 
week, while many of the patients, either alone or in com- 
pany with an attendant, have been allowed to attend religious 
services and various entertainments in the city. The amount 
of restraint employed has become less and less each year, and 
the greater part of that now used would be discontinued were 
it not for the fact that the crowded condition of the female 
wards makes it necessary to associate dangerous patients at 
night, either on the corridors or in dormitories. Leaving 
these cases, some half a dozen in number, out of the account, 
an average of three female patients have worn restraint dur 
ing the past year, while but one male has been thus confined, 
and for a few days only. That restraint could be entirely 
abolished from the asylum I have no doubt, but I by no 
means feel assured that this would be for the best interest of 
the patients. Although free to acknowledge that restraint 
has been used heretofore with too little discrimination, I feel 
that its entire abolition would be unwise, and that it would 
take from our hands a valuable means of curbing certain 
propensities of the insane and of accomplishing results which 
could not be so well accomplished by any other method. 

Recoofnizing the fact that labor is one of the most useful 
agencies for diverting the minds of the insane, and improv- 
ing both their bodily and mental strength, much time and 
thought have been given to devising methods for employing 
the greatest possible number of our inmates, and to inventing 
some means whereby special cases, able, but disinclined to 
work, on account of delusions or indolence, might have their 
interest awakenecL and be led to occupy their time in 
useful labor, instead of spending it listlessly upon the wards. 
It has not been deemed advisable to attempt to introduce 
any special branch of industry at the asylum, as, up to the 
present time at least, ample facilities have been offered in 



1887.] PUBLIC DOCUMENT — No. 23. 85 

the improvements and alterations which have been carried 
on for the employment of all of our inmates who have shown 
any inclination to work. The more simple the work the 
greater the number of patients that can prolital)ly be em- 
ployed therein. The amount and value of the labor that is 
performed each day by any one of a majority of our inmates 
is very little, but where no extra supervision is required, 
when time is no object, and where there is little or no mate- 
rial that can be destroyed, the aggregate value of the labor 
derived from patients is considerable. We now and then 
find an inmate who, having learned a trade prior to his sick- 
ness, retains his capacity for skilful la1)or, but the number 
of such patients is small, much smaller, in fact, than is 
generally supposed. 

The average yearly death rate for the past ten years, 
reckoned upon the daily average number of inmates, has 
been 9.16 per cent., — not a high average if we take into con- 
sideration the class of patients under treatment, the feeble 
condition of a majority of them, and the number of years 
they have suffered from mental disease. Tliat v/holesome 
diet, regular habits and proper sanitary surroundings tend to 
lengthen life is nowhere more plainly shown than in the wards 
of an asylum for the chronic insane, where may be seen patient 
after patient living on, year by year, although seemingly in 
the last stage of consumption or of other wasting disease. 

The average duration of insanity at the time of admission, 
in the patients transferred to the asylum, was 5.41 years. 
A knowledge of this fact would suggest that few, if any, 
cures could be looked for from among its inmates, since 
in insanity, as in other diseases, the number of cures bears 
a direct ratio to the duration of the disease ; and yet 
nine of the patients have returned to their homes, having 
made good recoveries. It is not, however, to the cures 
alone that we should look when attempting to estimate the 
success of this, or of any hospital for the insane. A great 
deal is done by every hospital to better the condition of its 
patients which cannot be made to appear in any report or 
table of statistics. Experience proves that cases, seemingly 
the most hopeless and forlorn, are susceptible of no little 
improvement if the efibrts toward this end be persistent and 



SQ WOECESTER INSANE ASYLUM. [Oct. 

well directed. It is for this reason that labor among the 
chronic insane is by no means a thankless task, or one which 
may not call forth the highest talents and the best endeavors 
of anyone who seeks to better the condition of his fellow-men. 

Notwithstanding the fact that a new hospital has been 
opened at West'oorough within the year, the State of Massa- 
chusetts will undoubtedly be called upon in the near future to 
provide additional accommodations for her insane. Her four 
State hospitals are favorably located and have ample accom- 
modations for all of the acute cases that will be likely to be 
sent to them for many jears to come, could they be relieved 
from time to time of the accumulation of chronic cases. Such 
relief could, without doubt, be properly provided in build- 
ings specially designed for this class of cases upon the 
grounds of the present hospitals and under the management 
of their officers. The majority of our hospitals, however, 
are already of such a size as to make it questionable whether 
their superintendents should have any additional responsi- 
bilities thrust upon them, and especially if there is to be 
any material increase in the number of acute cases that they 
are called upon to treat. Northampton, perhaps, might in 
this way provide for all of the insane in the western part of 
the State for some years to come ; but the most feasible 
plan for giving relief to the other hospitals would seem to 
be to establish another asylum for chronic cases in some 
central location, on a plan that would admit of enlargement 
from time to time as necessity seemed to demand. In such 
an institution a thousand patients might safely be brought 
under one manao-ement. With a central structure suffi- 
ciently large for the purposes of administration, and for the 
care of all of the more disturbed cases, the remaining build- 
ings need not be either elaborate in design or costly in 
structure, and could, therefore, be built promptly, as re- 
quired. 

A large and fertile farm is, without question, one of the 
most essential adjuncts of such an institution ; and although 
it has been found impossible, under any scheme that human 
ingenuity has yet been able to devise, to make an asylum 
for the insane self-supporting, it is only through the facili- 
ties which a lar^e farm affords that the insane can be em- 



1887.] PUBLIC DOCUMENT — No. 23. 87 

ployed to the best advantage, -and their labor made the most 
beneficial to themselves and remunerative to the institution. 

In compliance with the request made in our last report 
the Legislature of 1887 changed the name of this institution 
to Worcester Insane Asylum. 

The weekly cost of support per patient during the past 
year has been $3.09, 

The asylum is still indebted to the proprietors of the 
' ' Worcester Evening Gazette " for a copy of their paper ; 
to Miss Anna S. Folsom for magazines ; to the Hospital 
Newspaper Company for books, papers, and Christmas 
cards ; and to Mr. A. S. Lowell for miscellaneous reading 
matter. 

H. M. QUINBY, 

Superintendent. 

September 30, 1887. 



STATISTICAL TABLES. 



TABLES FOE UNIFOEM STATISTICS 

IN THE 

MASSACHUSETTS HOSPITALS AND ASYLUMS 

FOR THE INSANE. 

(Approved by the Board of Health, Lunacy and Charity, April 3, 1880.) 



By the act of the Legislature establishing an Asylum for 
the Chronic Insane, it was provided, " That the inmates 
thereof shall consist only of such chronic insane as may be 
transferred thereto by the Board of State Charities in the 
manner provided in section four, chapter two hundred and 
forty, of the acts of the year eighteen hundred and sixty- 
three." (Statutes, 1877, chap. 227.) 

All the patients of the asylum, therefore, have been 
former inmates of one or more hospitals in the State ; and 
whenever in these tables they appear as " first admissions," 
they are only to be regarded as first admissions to this 
asjdum. 



92 



WORCESTER INSANE ASYLUM. 



[Oct. 



1. General Statistics of the Year. 





Males. 


Kemales. 


Totals. 


Patients in asylum Oct. 1, 1886, . 
Admissions within the year, 


192 
21 


206 
25 


398 
46 


Whole number of cases within the year. 
Discharges within the year, .... 
Viz.: as recovered, 

much improved, 

improved, 

unimproved, 

Deaths, 


213 

10 
21 


231 

2 

1 

1 
17 


444 

2 

1 
11 
38 


Patients remaining Sept. 30, 1887, 
Viz. : supported as State patients, 
town iiatients, 
private patients, . 
Xumber of different persons within the year, 

admitted, 

recovered, ..... 
Daily average number of patients. 


182 

55 

127 

213 
21 

186.47 


210 

38 

172 

231 
25 

2 
207.05 


392 

93 

299 

444 
46 

2 

393.5*2 




1887.] 



PUBLIC DOCUMENT — No. 23. 



93 



3. Received on First and Subsequent Admissions. 





Cases Admitted. 


Times P. eviously Ke- 

COVEEED. 


>UM15ER OF THE ADMISSION. 


Males. 


Females. 


Totals. 


Males. 


Females. 


Totals. 


First, . . 

Second, 

Etc., 


21 


25 


46 


~ 


— 


— 


Total of cases. 
Total of persons, . 


21 
21 


25 
25 


46 
46 


- 


- 


- 



4. Ages of Persons Admitted for the First Time. 



Fifteen years and less 
From 15 to 20 years, 
20 to 25 years, 
25 to 30 j^ears, 
30 to 85 years, 
35 to 40 years, 
40 to 50 years, 
50 to 60 years, 
60 to 70 years, 
70 to 80 years, 
Over 80 years, 
Unknown, 
Totals, . 



At Fikst Attack of 
Insanity. 



Males. Females. 



21 



25 



11 



46 



When Admitted. 



Males. 



21 



25 



1 
3 

7 
5 
11 
8 
5 
4 



46 



94 



WORCESTER INSANE ASYLUM. 



[Oct. 



5. Parentage of Persons Admitted. 





Males. 


Females. 


Totals. 


PLACES. 
















Father. 


Mother. 


Father. 


Mother. 


Father. 


Mother. 


Vermont, .... 


1 


1 


- 


- 


1 


1 


Massachusetts, 


4 


4 


9 


9 


13 


13 


New Hampshire, . 


1 


1 


1 


1 


2 


2 


New York, .... 


1 


1 


- 


- 


1 


1 


Nova Scotia, 


_ 


- 


1 


1 


1 


1 


Prince Edward Island, 


1 


1 


- 


- 


1 


1 


Cape Breton, 


1 


1 


- 


- 


1 


1 


England, .... 


3 


3 


1 


1 


4 


4 


Ireland, .... 


4 


4 


8 


8 


12 


12 


Sweden, .... 


1 


1 


1 


1 


2 


2 


Italy, 


1 


1 


- 


- 


1 


1 


Germany, .... 


- 


- 


1 2 


2 


2 


2 


Portugal, .... 


1 


1 


- 


- 


1 


1 


Unknown, .... 


2 


2 


2 


2 


4 


4 


Totals, .... 


21 


21 


:, 25 


25 


46 


46 



6. Residence of Persons Admitted. 



PLACES. 


Males. 


Females. 


Totals. 


Massachusetts, viz. : — 

Bristol County, . . . . 

Suflfolk County, 

Middlesex County, .... 
Norfolk County, .... 
Plymouth County, . 
Worcester County, .... 
Unknown, 


4 

9 

■ 1 
2 
2 
3 


3 

13 
2 
1 

4 

2 


7 
22 
2 
2 
2 
6 
5 


Totals, 

Cities or large towns, 


21 
21 


25 
25 


46 
46 



1887.] PUBLIC DOCUMENT — No. 23. 



95 



7. Civil Condition of Persons Admitted. 



NUMBEK 


Unmakried. 


Markied. 


Widowed. 


Unknown. 


OF THK 

ADMISSION. 


1 


a 

a) 

fa 


O 


"3 


a 


o 




I 


■3 



S 

S 


s 
a 

fa 



B 


First, 
Second, 


8 


8 


16 


3 


11 


14 


3 


3 


6 


7 


3 


10 


Totals, 


8 


8 


16 


3 


11 


14 


3 


3 


6 


7 


3 


10 



8. 


Occupat 


ions 


of Persons 


' Admitted. 




OCCUPATIONS. 


Males. 


Females. 


Totals. 


Housekeepers, 
Laborers, 














1 


5 


5 
1 


Domestics, 














2 


2 


Fish packer, . 
Machinist, 














1 
1 


— 




Waiter, . 














1 


- • 




Sailor, . 














1 


- 




Cook, . 














- 


1 




Trader, . 














1 


- 




Gas-fitter, 














1 


- 


1 


Milkman, 














1. 


- 




Teacher, 














- 


1 




Teamster, 














1 


- 




Printer, . 














1 


- 




Operatives, . 
Tailor, . 














3 
1 


— 




Laundress, 














- 


1 




No occupation. 
Unknown, 














4 
3 


2 
13 


6 
16 


Totals, . 














21 


25 


46 



96 



WORCESTER INSANE ASYLUM. 



[Oct. 



9. Fu'nn of Disease in the Cases Admitted. 



I'ORM OF IiISEASE. 


Males. 


Fcmaks. 


Totals. 


Mania, chronic, 

recurrent, ...... 

Epilepsy, 

Dementia, chronic, 

Paresis, 


13 
1 

2 
5 


17 

2 

1 

3 

2 


30 

3 
3 

8 
2 


Total of cases, 

Total of persons, 


21 
21 


25 
25 


46 
46 



10. Reported Duration of Insanity before Last Admission. 





First Admission 
TO THIS Hospital. 


All other 

Admissiuns. 


Totals. 


PREVIOL-.S DURATION. 




„. 






<n 






m 








a 


"3 
o 




i 

fa 


"3 
1 


*« 


"3 

S 
fa 


o 


Congenital, . 


2 


- 


2 


- 


- 




2 


- 


2 


Under 1 month, 


- 


- 


- 


- 


- 


- 




- 


- 


From 1 to 3 months, . 


- 


- 


- 


- 


- 


- 




- 


- 


3 to 6 months, . 




- 


- 


- 


- 


- 


- 


- 


- 


6 to 12 months, . 




- 


- 


- 


- 


- 


- 


- 


- 


1 to 2 years. 


- 


1 


1 


- 


- 


- 


- 


1 


1 


2 to 6 years, 


1 


3 


4 


- 


- 


- 


1 


3 


4 


5 to 10 years, 


2 


10 


12 


- 


- 


- 


2 


10 


12 


10 to 20 years. 


7 


3 


10 


- 


- 


- 


7 


3 


10 


Over 20 years. 


2 


- 


2 


~ 


- 


- 


2 


- 


2 


Unknown, 


6 


7 


13 


1 


1 


2 


7 


8 


15 


Total of cases, 


20 


24 


44 


1 


1 


2 


21 


25 


46 


Total of persons, . 


20 


24 


44 


1 


1 


2 


21 


25 


46 


Av'ge of known cases, . 


13.56 


7.87 


10.71 


- 


- 


- 


13.56 


7.87 


10.71 



1887.] 



PUBLIC DOCUMENT — No. 23. 



97 



11. Probable Causes of Insanity in Persons Admitted. 



CAUSES. 


Males. 


Females. 


Totals. 


Intemperance, 

Epilepsy, 

Syphilis, 

Heredity, 

Menopause, . 

Senility, 

Religious excitement. 










1 
3 

1 


2 

1 
6 

1 
1 
1 


2 


Overwork, 










- 


1 




Congenital, . 










1 


- 




Business troubles. 










1 


- 




Puerperal, 










- 


1 




Sickness, 










2 


- 


2 


Unknown, 










12 


11 


2;3 



Totals, 



21 



25 



46 



12. Relations to Hosjyitals of Persons 


Ad^ 


n 


'tied. 






HOSPITAL RELATIONS. 


Ma. 


Fe. 


Tot. 


First admission to any hospital for insane, 






- 


- 


- 


Former inmates of the asylum, .... 






1 


1 


2 


of Danvers Lunatic Hospital, . 






1 


8 


9 


of Tewksbury Almshouse, 






2 


4 


6 


of Boston Lunatic Hospital, . 






1 


1 


2 


of Worcester Lunatic Hospital, 






2 


11 


13 


of Northampton Lunatic Hospital, 






10 


- 


10 


of Taunton Lunatic Hospital, . 






28 


13 


41 


of Butler Hospital, R. I., 






- 


1 


1 


of State Workhouse, 






1 


- 


1 


Total of cases, 


46 


39 


85 


Total of persons, . . . . 






21 


25 


46 



98 



WOKCESTER INSANE ASYLUM. 



[Oct. 









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First, .... 
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Totals, 
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1887.] 



PUBLIC DOCUMENT — No. 23. 



99 



ft^ 



6 








H 

s 

a 

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C 
m 

o 

X 


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s 


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21 
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m 




Congenital, . 

Under 1 month. 

From 1 to 3 months, 
3 to 6 months, 
6 to 12 months, 

1 to 2 years, 

2 to 5 years, 
5 to 10 years, 

10 to 20 years. 
Over 20 years. 
Unknown, 


Totals, . 

Average of known cas 
months), . 



100 



WOECESTER INSANE ASYLUM. [Oct. 



16. Cases Discharged by Recovery or Death. 





llECOVEKIES. 


Dkaths. 


F0E3I OF INSANITY. 


3 


1 


o 




1 


o 


Mania, chronic, 
Epilepsy, .... 
Dementia, chronic, 
Melancholia, chronic, . 

Paresis, 

Puerperal mania, . 
Alcoholic mania, . 




1 
1 


1 

1 


13 
4 
1 

3 


13 
1 

2 

1 


26 
5 
1 
2 
4 


Total of cases. 
Total of jDcrsons, . 


- 


2 
2 


2 

2 


21 
21 


17 
17 


38 
38 



17. Causes of Death. 



CAUSES. 


Males. 


Females. 


Totals. 


Phthisis, 










5 


8 


13 


Epilepsy, 










4 


1 


5 


Senility, 










- 


1 


1 


Exhaustion, . 










7 


4 


11 


Paresis, . 










3 


1 


4 


Chronic diarrhcea, 










1 


- 


1 


Paralysis, 










- 


1 


1 


Bright's disease, . 










1 


- 


1 


Cerebral effusion, . 










- 


1 


1 


Totals, . 


21 


17 


38 



1887.] 



PUBLIC DOCUMENT — No. 23. 



101 



18 


. Ages of those tvho Died 










A T Time of First Attack. 


At Time of Death. 


AGES. 
















Males. 


Females. 


Totals. 


Males. 


Females. 


Totals. 


Fifteen years and less, 






1 


- 


1 


- 


- 


- 


From 15 to 20 years, 






2 


3 


5 


- 


- 


- 


20 to 25 years, 






3 


- 


3 


2 


- 


2 


25 to 30 years, 






3 


2 


5 


5 


2 


7 


30 to 35 years, 






1 


2 


3 


2 


3 


5 


35 to 40 years, 






3 


3 


6 


3 


3 


6 


•iO to 50 years. 






4 


3 


7 


7 


4 


11 


50 to 60 years, 






1 


- 


1 


1 


1 i 2 


60 to 70 years. 






- 


1 


1 


1 


3 


4 


70 to 80 years. 






- 


- 


- 


- 


1 


1 


Over 80 years. 






- 


- 


- 


- 


- 


- 


Unknown, 






3 


3 


6 


- 


- 


- 


Totals, . 


21 


17 


38 


21 


17 


38 



102 



WOECESTER INSANE ASYLUM. [Oct. 



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PUBLIC DOCUMENT — No. 23. 



103 



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