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PUBLIC DOCUMENT .... .... No. 23. 



SIXTY-FOUETH ANiNUAL EEPOET 



THE TRUSTEES 



Worcester Lunatic Hospital, 



NINETEENTH ANNUAL REPORT OF THE TRUSTEES 



WORCESTER INSANE ASYLUM AT WORCESTER, 



Year endixg September 30, 1896. 



BOSTON : 

WRIGHT & POTTER PRINTING CO., STATE PRINTERS, 

18 Post Ofi'-ice Square. 

1897 



OFFICEKS OF THE HOSPITAL. 



TRUSTEES. 



SARAH E WHITIN, . 
FRANCES M. LINCOLN, 
A. GEORGE BULLOCK, 
THOMAS H. GAGE, . 
HENRY S. NOURSE, . 
ROCKWOOD HOAR, . 
FRANCIS C. LOWELL, 



Whitinsville. 

Worcester. 

Worcester, 

Worcester. 
South Lancaster. 
Worcester. 
Boston. 



RESIDENT OFFICERS, 



HOSEA M. QUINBY, IM.D., 
ALFRED I. NOBLE, M D., . 
ADOLF MEYER, M.D., 

APPLETON H. PIERCE, M.D., 
EDWIN D. BOYNTON, M.D., 
MARGARET A. FLEMING, M.D 
THOMAS T. SCHOULER, . 
LILA J. GORDON, 
S. JOSEPHINE BRECK, . 
JOSEPH F. REYNOLDS, . 



Super iyitendent. 
Assistant Superinteiident. 
Assistant Physician and 
Director of Laboratory. 
Assistant Physician. 
Assistant Physician. 
Assistant Physician. 
Steioard. 
Matron. 
Clerk. 
Farmer. 



NON-RESIDENT OFFICERS. 



ALBERT WOOD, . 
GEORGE L. CLARK, 
ALVAN G. LAMB, 



Treasurer. 

Auditor. 

Engineer. 



C0mmoittea;lt^ ci P^assErl^itsrfts. 



TRUSTEES' REPORT. 



To Eis Honor the Lieutenant Governor, Acting Governor, and the Honorable 

Council. 

The trustees of the Worcester Lunatic Hospital respectfully 
subaiit this sixty-fourth annual report, and also the report of 
the superintendent and treasurer, with statistical tables which 
explain in detail the affairs of the institution. 

In our last report mention was made of the fact that plans 
were under consideration for enlarging the scope of the medical 
work of the hospital, in adding a training school for the assist- 
ant physicians and a limited number of internes, — young men 
who might wish to perfect themselves in a knowledge of 
nervous diseases. This was deemed a step in the right direc- 
tion, and was cordially approved by the trustees. These plans 
are now in a large measure perfected, and the new department 
will be opened with the beginning of the official year under the 
especial charge of Dr. Adolf Meyer, who entered upon his 
service at the hospital early in November. During the sum- 
mer Dr. Meyer visited Europe, accomplishing an incredible 
amount of work, and bringing back with him the latest results 
of the progress made by students in the old world. He selected 
much apparatus for the new laboratory, which has been fitted 
up and which w^ill no doubt prove a very useful adjunct in the 
daily work of the hospital. 

For many years the hospital has been so crowded wnth 
patients that the officers have been overwhelmed with routine 
duties. The material wants of the large colony — equal to the 
whole of Massachusetts in early Colonial days — have made it 
impossible to give to individual cases the special care and 
attention which would have been gladly devoted to them. The 
internes will assist in the laboratory and aid in clinical work, 



6 WORCESTER LUNATIC HOSPITAL. [Oct. 

thus relieving the regular staff of physicians from much routine 
labor, and enabling them to devote more time to special cases. 
Increased opportunities bring increased wants, and public 
institutions should keep pace with the march of improvement. 
In order that we may do this, we must solicit aid from our 
guardian, the State. Among so large a number of people, 
either in or out of the hospital, there is always more or less 
acute illness. Insanity often arises from mere physical weak- 
ness. The wards primarily intended for such cases are of 
limited capacity and are now entirely outgrown, so that sick 
persons are found in almost every hall. All such cases need to 
be treated as they are in a general hospital, — with special care, 
special nursing and special diet. It is scarcely possible for an 
attendant to take proper care of a sick person in a ward, where 
the conditions cannot be controlled. Therefore, we must have 
a new infirmary ward. This was referred to in the superintend- 
ent's report for 1894. 

The medical work, as now provided for, requires that all 
cases received into the hospital should be under close observa- 
tion and critical examination, before being assigned to their re- 
spective classes. In the new infirmary this will be provided for. 

As one part of an institution is outgrown, so is another. 
Thus, the kitchen and executive department no longer afford 
necessary facilities. Originally designed for a far smaller 
family, all the space is more than occupied. The time has now 
come when it is absolutely necessary to have more room for 
carrying on the work of this all-important branch of the insti- 
tution in a successful and economical manner. This change 
can be made in connection with the other additions now con- 
templated, and will give ample space for the help employed, and 
give us work rooms for patients. The rooms formerly so used 
have been taken for dormitories, on account of the crowded 
condition of the hospital. 

Appliances for making work attractive to the patients are 
greatly needed. The central thought of the institution is how 
best to treat and cure the demented. The successful solution 
of the question touches a most important problem. Congenial 
work is the basis of contentment. *' Something to do " stimu- 
lates the mind and gives zest to life. If the thoughts of the 
insane can be diverted away from self, and they can become 



1896.] PUBLIC DOCUMENT — No. 23. 7 

occupied in some form of manual labor, a great advance will be 
made towards restoring their mental balance. For many, alas, 
there is no cure ; and for many there can only be unrest and 
discontent until the tired brain ceases to act. Hospital or 
palace, alike, would fail to satisfy them. There are others, 
however, who respond to a proper stimulus, and will gladly 
avail themselves of an opportunity of agreeable employment. 

As to the cost of these desired changes and improvements ; 
the matter has been carefully looked into by the trustees, the 
superintendent and the heads of the various departments, with 
the result of having obtained plans which will meet our needs. 
The expense has been carefully estimated, and we feel certain 
that an outlay of $160,000 will cover the cost of erecting the 
additions and kitchen, besides furnishing them. We therefore 
respectfully ask that the Legislature grant the sum for the 
needed additions, thereby greatly increasing the capacity and 
usefulness of one of its- most vital institutions. 

The hospital has been managed with great efficiency by Dr. 
Quinby and his able corps of assistants. There has been no 
epidemic, and no more sickness than is usually incident to so 
large a community. The perfect neatness, order and cleanli- 
ness of the entire establishment are to be highly commended. 
That, with so changeable and erratic a family, every corner, 
closet and drawer should bear inspection, is a marvel of house- 
keeping which may well be admired. 

Dr. Laure Hulme has resigned, after seven years of faithful 
service, and her place has been filled by Dr. Margaret A. 
Fleming, whose kind and sympathetic influence is felt by the 
patients. 

The year was saddened for us by the loss of our honored and 
lamented governor, who took a personal interest in the pros- 
perity of the hospital and the comfort and welfare of its 
unfortunate inmates. 

SAHAH E. WHITIN. 

FRANCES M. LINCOLN. 

A. GEORGE BULLOCK. 

THOMAS H. GAGE. 

HENRY S. NOURSE. 

ROCKWOOD HOAR. 

FRANCIS C. LOWELL. 
Worcester, Mass., Oct. 1, 1896. 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



VALUE OF PERSOl^TAL ESTATE. 

Sept. 30, 1896, 



department, 



Live stock on the fai'm, . . 

Produce of the farm on hand, 

Carriages and agricultural implements, . 

Machinery and mechanical fixtures, . 

Beds and bedding in inmates' department, 

Other furniture in inmates' department, . 

Personal iDropertj^ of State in superintendent's 

Ready-made clothing, . 

Dry goods, .... 

Provisions and gi'oceries, . 

Drugs and medicine, . 

Fuel, 

Library, .... 
Other supplies undistributed, 
Pipes and radiators, . 

Total, 1191,837 87 



$9,479 


00 


8,469 


80 


6,950 


00 


29,525 


86 


29,280 


32 


22,481 


82 


23,385 


80 


1,625 


15 


888 


87 


2,520 


66 


800 


00 


7,425 


00 


4,250 


00 


5,056 


59 


89,700 


00 



1896.] 



PUBLIC DOCUMENT — No. 23. 



TREASUKER'S REPORT. 



To the Trustees of the Worcester Lunatic Hospital. 

I herewith submit my annual report on the finances of the 
Worcester Lunatic Hospital for the year ending Sept. 30, 
1896: — 

Rp:ceipts, • 



Cash on hand Sept. 30, 1895 

Received of the Commonwealth for support of patients, 
of cities and towns for support of patients, 
of individuals for support of patients, 
for interest, sale of produce, etc, 
belonging to patients, 



136,358 51 

44,595 86 

98,421 91 

43,137 03 

4,965 27 

1,815 81 

$229,293 89 



The expenditures for the year have been as follows : — 



Provisions : — 












Flour, . . . . • $4,855 50 


Meats, 










12,495 67 


Fish 










3,263 78 


Meal for cooking, . 


. 








421 86 


Beans, potatoes and other vegetables, 










1,579 01 


Sugar, 










3,469 63 


Molasses and syrup 










353 94 


Tea, ...... 










695 29 


ColTee, ...... 










2,028 01 


Butter, ...... 










9,231 00 


Cheese, 










519 05 


Fresh fruit, 










757 11 


Eggs, salt and other groceries, . 










5,901 16 


Salaries and wages, .... 










57,320 84 


Grain and feed for stock, . 










4,577 70 


Hay and pasturage, .... 










221 81 


Furniture, ...... 










453 53 


Crockery and glass ware, . 








780 98 


Amount carried forward, 


fl08,925 77 



10 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



Amount brought forward, 



Tin wave, . 

Bedding and beds, 

Straw, . 

Furnishings, miscellan 

Tools, . 

Lights, 

Water, . 

Fuel, . 

Soap, . 

Medical supplies. 

Live stock, . 

Carriages, harnesses, etc., 

Blacksmithing, . 

Plants and seeds, 

Hardware, . 

Lumber, 

Paints, oils, etc., . 

Pipe and fittings. 

Lime, cement, etc., 

Repairs, oi'dioary, 

Fertilizers, . 

Stationery, . 

Postage, 

Transportation, . 

Travelling, . 

Trustees' expenses, 

INIiscellaneous, . 

Pathological department, 

Labor, .... 

Clothing and men's furnishi 

Dry goods for women. 

Dry goods for house, . 

Boots and shoes, . 

Total current expenses, 

Extraordinary expenses, 
Undertaker's charges, . 
IMoney refunded, . 
Profit and loss, . 
Cash refunded patients. 



Cash on hand Sept 30, 1896, 



,925 77 







250 05 






1,815 37 






328 54 






2,544 28 






66 53 






8,713 18 






3,201 79 






10,258 88 






773 83 






1,059 73 






3,345 00 






370 67 






378 11 






217 59 






586 48 






1,425 23 






684 60 






1,067 67 






985 71 






7,419 54 






835 61 






227 75 






264 60 






220 98 






100 00 






50 06 






4,388.08 






930 48 






876 49 






4,706 01 






1,927 62 






1,560 57 






1,501 54 


• 


1167,008 34 


9,854 U 




400 00 




20 89 




48 00 




2,21 


5 89 





12,5.38 92 



-179,547 26 
49,746 63 



$229,293 89 



1896.] PUBLIC DOCUMENT — No. 23. 11 



Resources. 

Cash on hand, $49,746 63 

Due from the Commonwealth for board, etc., .... 9,481 90 

from cities and towns for board, etc., .... 21,043 26 

from individuals for board, etc., ..... 11,948 56 



)2,170 35 



Liabilities. 

Due for supplies and improvements, .... $9,060 38 
for salaries and wages, ..... 4,828 51 
to jjatients, 1,987 90 



15,876 79 



Total surplus, 176,293 56 

Kespectfully submitted, 

ALBERT WOOD, 

Treasurer, 
Oct. 1, 1896. 



12 WORCESTER LUNATIC HOSPITAL. [Oct. 



HOSPITAL LIBRAEY FUND. 



Lewis Fund. 

Cash on hand Sept. 30, 1895, $15 00 

Received interest on Springfield bond, . . . 70 00 

Expended for books, ." . . . . . . $60 00 

Rent in State safe deposit vault, .... 6 00 

Deposit in Worcester County Institution for Savings, 20 00 

Wheelee Fund. 



IvI ANSON Fund. 

Worcester County Institution for Savings, . . f 1,149 73 

Dividends added to principal, 46 07 

Balance of " Hooper Yarn Fund," transferred to 

" Manson Fund," 10 37 

Lewis Fund Investment. 

Springfield bond, 11,220 00 

Worcester County Institution for Savings, . . 86 46 

Wheeler Fund Investment. 

Seven shares Central National Bank, 
Six shares Worcester National Bank, 
Worcester County Institution for Savings, 
Worcester Five Cents Savings Bank, . 
Cash on hand Sept. 30, 1896, . 

Manson Fund Investment 
Worcester County Institution for Savings, 



$85 00 



$85 00 



Cash on hand Sept. 80, 1895, . . . . . $&7 34 

Received dividends, 219 20 

1306 54 

Expended for books, . . . . . . . ^273 09 

Cash on hand Sept. 30, 1896 33 45 



54 



1,206 17 



1,306 46 



. §980 00 




. 870 00 




. 1,145 86 




. 1,719 49 




33 45 






4;748 80 


MENT. 




. 


1,206 17 



^261 43 



1896.] PUBLIC DOCUMENT — No. 23. 13 



LAND ACC0U:N^T. 



Cash on hand Sept 30, 1895, $156 93 



Expenditures. 

Surveys, services of civil engineer, . . . . $17 50 

Cash on hand Sept. 30, 1896, 139 43 

$156 93 

Eespectfully submitted, 

ALBERT WOOD, 

Treasurer. 
Oct. 1, 1896. 

Worcester, Mass., Oct. 23, 1896. 
I lierel3y certify that I have this day compared the treasurer's statement of disburse- 
ments for the year ending Oct. 1, 1896, with the vouchers on file at the Worcester 
Lunatic Hospital, and believe it to be correct. 1 have also inspected the securities rep- 
resenting the invested fuuds of the institution, and find that their market value is as 
stated. 

GEORGE L. CLARK, 
Auditor of Accounts. 



14 WORCESTER LUNATIC HOSPITAL. [Oct. 



SUPEKmTENDE^T'S KEPORT. 



To the Trustees of the Worcester Lunatic Hospital. 

I herewith respectfully submit the following report of the 
hospital for the year ending Sept. 30, 1896, it being the sixty- 
fourth annual report. 

There reniained at the hospital Oct. 1, 1895, 961 patients, 
— 455 men and 506 women. During the year 281 men and 
295 women were admitted, 303 men and 266 women were dis- 
charged and 56 men and 51 women died, leaving at the end of 
the oflBcial year 861 patients, — 377 men and 484 women. Of 
this number, 133 were supported by the State, 474 by cities 
and towns and 154 by friends. Of the 569 discharged, 107, 
including 9 habitual drunkards (women), were reported re- 
covered; 82 were much improved; 91 improved; and 288, 
including 1 habitual drunkard (woman), not improved; 1 
woman was discharged not insane. Fourteen men and 11 
women were removed by the overseers of the poor ; 38 men 
and 31 women were discharged to the care of the Board of 
Lunacy and Charity, to be removed from the State ; 5 men 
and 37 women were transferred to Tewksbury ; 2 men and 1 
woman to the Boston Lunatic Hospital; 21 men to the State 
Farm; 110 men and 64 women were transferred to the Med- 
field Insane Asylum ; and 1 woman was boarded out. One man 
was discharged by the superior court and 1 woman was re- 
turned to the Reformatory Prison for AVomen. Seven men 
escaped, and were not returned to the hospital at the end of 
the official year. 

There were 64 more admissions than in the previous year 
and 4 less deaths, but owing to the large number of discharges 
there were present at the close 100 less patients than at the 
beginning of the year. 



1896.] PUBLIC DOCUMENT — No. 23. 15 

The daily average number was 956.25. The highest monthly 
average was 1,037.06, and the lowest 840.16. 

The percentage of recoveries, calculated upon the average 
number of the discharges and deaths, was 15.85 ; calculated 
upon the number of admissions, it was 18.58. 

The death rate was 11.19, calculated upon the average num- 
ber of patients; and 6.96, calculate.d upon the total number 
under treatment. 

The number of deaths is slightly less than last year. There 
has been the usual large fatality among those suffering from 
general paralysis, 25 of this class having died from exhaustion 
or from some complicating disease, as lobar or broncho- 
pneumonia, which, separately, were the cause of death in 5 
cases of paresis and in 7 cases of other chronic brain disease. 
Phthisis was the cause of death in 13 cases, the same number 
as last year. One man committed suicide by hanging. This 
patient had been an inmate of the hospital fourteen years, and 
was not considered suicidal. 

At the beginning of the last official year preliminary steps 
were taken towards reorganizino; the entire medical work of 
the hospital. This was to include an exhaustive examination, 
after a uniform method, of each patient upon entrance ; fuller 
and more accurate records ; the more careful observation of 
recent cases ; and the employment of laboratory methods as 
aids in diagnosis and treatment, — methods which have proved 
so useful in general hospitals. 

As there is, at present, no medical school in this country 
which gives its students anything more than the most elemen- 
tary training in nervous and mental diseases, our assistants, 
however well instructed they may be in general medicine, come 
to us with but little knowledge of the principles which underlie 
one of the most complicated of specialties. After coming to 
the hospital, the assistants, in their daily rounds of the wards 
with the superintendent or the junior assistant, gain, it is true, 
much information as to the various forms of insanity, the gen- 
eral management of patients and the discipline and supervision 
of the wards ; but, as these rounds are often hurried and fre- 
quently interrupted, little opportunity is given for more detailed 
instruction, for a minute examination of each case and for the 
weighing of separate symptoms with reference to their bearing 



16 WORCESTER LUNATIC HOSPITAL. [Oct. 

upon the diagnosis. These points they are obliged to work 
out for themselves, and this cannot be done without a great 
deal of study and research on their part ; and later on, when 
they come, as they are sure to do, to find their time more and 
more occupied with routine duties, they are apt to neglect their 
scientific promptings and content themselves with the proper 
performance of their ever-pressing clerical and household 
duties. It seems essential, therefore, to establish, at the out- 
set of our undertaking, a training school for assistants ; and 
the immediate supervision of this work was placed in the hands 
of Dr. Adolf Meyer, who, as mentioned in my last report, en- 
tered upon service at the hospital, as assistant, November 15. 

During the winter a series of lectures upon the nervous sys- 
tem were given to the assistants, and much time was also spent 
in the wards, instructing them as to methods of case taking, 
and in concise and accurate recording at the bedside of the 
results of their observations. They were also instructed in 
methods of preserving and examining the nervous tissues, and 
had the opportunity of being present and assisting at some 
twenty or more autopsies, and of attending a series of nine 
lectures given at the hospital by Dr. Meyer to the students of 
Clark University, in his capacity as docent to that institution. 
Meanwhile, much time was devoted to organizing the labora- 
tory, determining the scope of the work to be undertaken 
therein, and in deciding as to what methods were best suited 
to render it supplementary to the clinical work of the wards. 
Much attention was also given to plans for rearranging the 
duties of the assistant physicians, that they might be relieved, 
either wholly or partially, of certain of their routine duties, — 
such as correspondence with the friends of the patients, keep- 
ing records, etc., — and additional time might thus be gained 
for their more strictly professional work. In pursuance of this 
plan, the old method of keeping the records has been aban- 
doned, as much valuable time was consumed in compiling them, 
they being, after all, of little practical value, except as they 
noted the time of admission and discharge of patients and their 
general condition while at the hospital. Made up, as they 
were, from the assistant's recollection of the case, and written 
out days and sometimes weeks after the occurrence to be noted 
had passed, they failed to give anything like an adequate medi- 



1896.] PUBLIC DOCUxMENT — No. 23. 17 

cal picture of the disease, or to furnish any exact data upon 
"which to found a diagnosis or from which the method or result 
of treatment could be gathered. Hereafter, the record keep- 
ing, so far as the assistant physicians are concerned, will be 
confined largely to notes dictated at the bedside during their 
daily rounds. Arrangements have also been perfected to re- 
duce the labor of correspondence to a minimum. 

Notwithstanding these efforts to economize the time of the 
assistants and to limit their duties, as faras possible, to strictly 
professional work, it has been found that much of the day was 
still of necessity occupied with the discipline and oversight of 
the wards, in devising methods for the employment and recre- 
ation of the patients, in seeing that their material needs were 
provided for and in interviews with friends, — duties which 
neither could be neglected nor (Jelegated to others. The assist- 
ants still lacked time for that minute personal observation of 
their patients, necessary for the careful working out of each 
individual case after the exhaustive plan which we have under- 
taken. It thus became evident that additional help was needed, 
and it was decided that this want would be best satisfied by the 
appointment of a corps of internes, whose duties should be to 
compile and record an exhaustive history of each case upon 
entrance ; accompanying the assistant on his medical rounds ; 
take notes of cases at his dictation ; make urinary analyses, 
bacteriological tests and examinations of the blood and sputa 
when indicated, and assist at autopsies and the general work 
of the laboratory. They should share in the instruction given 
the assistant physicians, and have time and opportunity afibrded 
them to do special laboratory work. Such a plan would no 
doubt prove of great advantage to the institution, as it would 
furnish material from which to select assistant physicians already 
trained for the work. With the approval of your Board, an 
announcement was sent out early in the summer, stating that 
four internes were wanted at the Worcester Lunatic Hospital, 
the same to be selected after a competitive examination. The 
number of letters received (some forty or more) in reply to this 
announcement was satisfactory in the extreme, proving, as it 
did, that there are enough young men anxious to avail them- 
selves of such an opportunity, and that we should have no diffi- 
culty in filling these places. Although many of these would-be 



18 WORCESTER LUNATIC HOSPITAL. [Oct. 

applicants were deterred from appearing at the competitive 
examination by the conditions imposed (that they should have 
had a collegiate and full medical education and a reading knowl- 
edge of French or German, or both, and preferably some general 
hospital experience), we were able to select four men possessing 
the necessary qualifications, and these, after having passed a 
satisfactory examination, received their appointment and began 
work October 1. 

In April Dr. Meyer went abroad in the interest of the hospi- 
tal. He visited first the most noted Italian hospitals for the 
insane and neurological laboratories ; the clinics of Professor 
Bianchi in Naples ; the large hospital at Reggio-Emilia, under 
the direction of Professor Tamburini ; the clinics of Morselli 
(Genoa) and Lombroso (Turin), and the new asylum at Quarto 
near Genoa ; further, the neurological and physiological labor- 
atories of Professor Mingazzini and Professor Luciani in Rome, 
Professor Fano and Dr. Bottazzi in Florence, Professor Gia- 
comimi and Professor Mosso at Turin, and the pathological 
laboratory of Professor Golgi at Pavi i. Six weeks were spent 
at Heidelberg, at the clinic of Professor Kraepelin and in the 
laboratory of Professor Arnold ; and a visit was paid to the 
new clinics at Giessen (Professor Sommer), Wtlrzburg (Pro- 
fessor Rieger) and Strassburg (Professor Fiirstner). On this 
occasion the laboratories and methods of Professors Goltz and 
Ewald in Strassburg, Professor von Kolliker at WUrzburg and 
Professors Weigert and Edinger at Frankfurt-am-Main were 
studied. During the month of July Dr. Meyer worked in the 
laboratory of Professor von Monakow and the clinic of Profes- 
sor Forel at Zurich. He next visited Professor Dejerine at the 
Salpetriere in Paris, and several of the English and Scotch hos- 
pitals ; Professor Mott's new laboratory for the London County 
Asylums ; Dr. Robertson in Morningside, Dr. Alexander Bruce 
in Edinburgh, Dr. Yellowlee in Glasgow, Dr. Rorie in Dundee 
and Dr. Hyslop at Bethlem Hospital. Owing to the courtesy 
of the men mentioned, a fair picture of the present status of 
methods, etc., was obtained. He returned to the hospital 
early in September, and the time since his return has been 
occupied in arranging the laboratory and further perfecting our 
plans, so that now everything is in order, and we are ready 
with the opening of the official year to begin work after the 
new methods. 



1896.] PUBLIC DOCUMENT — No. 23. 19 

The interest and enthusiasm manifested by every one con- 
cerned argues well for the success of the new enterprise. Five 
rooms have been fitted up in the basement of the executive 
building, near the general office and easily accessible therefrom. 
One of these rooms is to be especially devoted to the use of the 
internes and the medical staff, and will furnish a place where 
they can get away from the bustle and confusion of the general 
office fur the purpose of reading and study. In this will be 
placed the reference library and its accompanying card cata- 
logue. The adjoining room has been fitted up as a general 
microscopical room, and is equipped with necessary micro- 
scopes, the latest and most approved instruments for enlarging 
and drawing microscopical preparations and a complete appa- 
ratus of photo-micrography. A dark room with running water 
and all the necessary appliances for photography connects the 
microscopical room with the general work room, in which are 
the usual freezing apparatus and the necessary microtomes for 
cutting both small and large brain sections. Separated from 
the general work room by a corridor is the chemical room, with 
sterilizing apparatus and appliances for bacteriological and 
chemical investigations. It has been our purpose to exercise 
due economy in fitting up the laboratory, and to buy only such 
instruments as will meet our immediate needs ; but there will 
be added, from time to time, whatever appliances may be found 
necessary or useful for the work in hand. 

The present working plan lays the chief weight on a careful 
study of the symptoms and needs of the patient, and upon the 
laboratory as a help for doing justice to the daily increasing 
complexity of diagnostic and therapeutic problems, without 
which clinical medicine is unable to exist and much less to 
progress. The lines of work in the laboratory must be sug- 
gested by the work in the wards, and, in order to achieve this, 
the idea of having a special pathologist out of contact with 
the clinical work was not deemed to be adequate to the 
needs of the institution. In order to have a uniform and 
methodical working plan, the supervision of the purely medi- 
cal work in the wards and of the laboratory has been united in 
the hands of Dr. Meyer. We have expended in this work, 
including the outlay for the library, some $3,000. The in- 
creased salaries and the necessary running expenses can be 
easily met from the current income of the institution. 



20 WORCESTEK LUNATIC HOSPITAL. [Oct. 

We still hick a training school for nurses, a feature which 
has justly come to be regarded as necessary in every properly 
appointed hospital. That such a school has not already been 
established here is through no lack of appreciation on our part 
of its necessity, but was due partly to the feeling that this 
other work which we have long had in mind and which is now 
so happily inaugurated might justly claim the precedence, and 
partly to the fact that the crowded condition of our house 
for the past four or five years has made it impossible for us to 
find proper room for our attendants or to give them the time 
and quiet necessary for study. Now, however, that the hospital 
is relieved of the pressure of overcrowding, and is likely, as we 
are happy to believe, to remain so for some time to come, we 
shall hope to have such a school in the near future ; the need for 
which will be still more imperative if we add hospital wards to 
our present accommodations, as we hope to do during the coming 
year. I may be allowed in this connection to quote from my re- 
port of 1894, in which I called attention to the fact that: — 

Our wards are so large and our numbers so great that it is difficult 
to secure always the isolation and special care which recent cases 
demand, unless the friends of the patients are able to provide them 
extra attendants and private quarters. Patients are from necessity 
often brought into intimate contact, at the most critical period of 
their disease, wath the turbulent and with those whose minds are full 
of morbid notions in regard to themselves, the hospital and their 
treatment ; and the example and influence to which they are thus 
subjected tend largelj' to counteract the best efforts of the physician 
and attendant, and no doubt frequently retard or even preclude 
recovery. Our present sick ward was planned to meet the wants of 
a limited number of patients, and we have now entirely outgrown its 
capacity, and are obliged to place many of our acute sick on wards 
not arranged for such cases. With our present number of inmates 
we should have a hospital ward distinct from the main building, con- 
ducted upon the lines of a general hospital, with a corps of trained 
nurses and all modern appliances for the treatment of nervous 
diseases. With a view to supplying this want in the near future, 
your Board has authorized me to procure plans for the necessary 
buildings, together with an estimate of the cost of the same. 

Such plans have now been perfected and have met the ap- 
proval of your Board. They provide for two buildings, one 
to be devoted to men and the other to women ; each is four 



1896.] PUBLIC DOCUMENT — No. 23. 21 

stories high, and is to be built in front of, and as an addition 
to, the wards nearest the executive building, but entirely 
separated therefrom. These additions are to be sixty-two feet 
deep, and will conform, as to the exterior, to the present 
architectural features of the building. Each story will contain 
an infirmary ward for ten patients, together with two rooms 
for isolating acute and noisy cases, and the necessary toilet 
rooms. By making slight alterations, that portion of the old 
ward immediately adjacent to the new building can be utilized 
as a part of the latter, and in this will be located the day 
rooms, clothes rooms and service rooms. An easy exit from 
the wards is furnished by an iron staircase, and there is on 
each story a balcony, properly protected, for the use of such 
sick and infirm patients as are unable to otherwise enjoy the 
open air. Each building will accommodate forty-five patients, 
and will cost $40,000. This will include the necessary altera- 
tions in the old ward and the building of an iron staircase in 
place of the present one. 

It is very desirable that the recent cases and all those whose 
condition requires dail^^ or more frequent observation on the 
part of the physicians should be within easy reach of the gen- 
eral office and as little scattered as possible. This requirement 
can be readily provided for in connection with the new in- 
firmary ward. 

The necessity for increased facilities in our general kitchen 
and for more room in the department devoted to outside help 
has been long recognized ; but we have hesitated in taking any 
steps towards remedying this, on account of the material ex- 
pense that it of necessity involved, since no adequate relief 
can be gained except by enlarging and entirely remodelling 
both of these departments. The time has come, however, when 
such a change is imperative. Our ovens and all of our cook- 
ing utensils are now run up to their utmost capacity, and even 
then it is often with the greatest difficulty that we can provide 
sufiicient food for our large family, or distribute it to the 
various wards with that promptness which is necessary to in- 
sure its coming to the table in a hot and palatable condition. 
Run at this high tension, one or more of our ovens or any of 
our cooking utensils is liable to give out at any time, and place 
us in a serious dilemma. 



22 WORCESTER LUNATIC HOSPITAL. [Oct. 

The increase in our medical staff necessitates additional ser- 
vants, but we no longer have any place where we can accom- 
modate them. The dining room is already overcrowded, and 
many of the living rooms are barely tenantable, especially in 
the winter months, on account of dampness caused by the 
steam from the pipe ducts in the basement condensing upon 
the walls. For these and for many other reasons which it is 
unnecessary to enumerate here, we feel that we should be 
doing injustice to the institution and those for whom we have 
undertaken to care if we should allow these defects to go on 
longer without making an effort to remedy them. We have 
therefore drawn up plans of such alterations and additions as 
seem to meet the necessities of the case. This building will 
be 99 by 80 feet, four stories high, and of fireproof construc- 
tion ; and besides the kitchen and bakery, which will occupy 
the whole upper story, there will be additional store-rooms, 
rooms for help, and two large work rooms, 24 by 76 feet, in 
which provision will be made for the employment of patients. 
It is estimated that this addition, including the building of a 
temporary kitchen, will cost $72,000. 

The new farmhouse has been opened and occupied by patients 
nearly a year, and has proved quite as much of a success as was 
anticipated. On account of the absence of locked doors, grated 
windows and the other safeguards usual in hospitals, it was 
feared that it might be found impracticable to here provide for 
all those willing to work upon the farm, and that it would still 
be necessary to lodge some of our farm hands at the hospital, on 
account of their turbulent character and disposition to wander 
away ; but we have thus far found little or no difficulty in either 
of these directions. All the patients seem very much pleased 
with their new quarters, and have caused no disturbance, and 
but two have attempted to escape. 

As regards the income from the farm, no just estimate can be 
formed by comparing this year's report with that of previous 
years, for the reason that the cost of support of the patients 
there employed appears in this year's farm account, as it has 
not done heretofore. Everything bought for the farm or used 
at the farmhouse has been charged to the farm account (except 
the clothing issued to the patients), and everything produced 
thereon has been passed to its credit at a fair market value. 



1896.] PUBLIC DOCUMENT — No. 23. 23 

The expenditures for the past year exceed the receipts by 
$1,468.79; deducting from this the supplies on hand and paid 
for, there remains a net deficit of $1,087.24. The season, 
however, has been an unusually poor one for all farm products, 
and our income has been correspondingly small. Another year 
we can reduce somewhat our running expenses at the farm- 
house, and, with the income which may be relied upon in the 
averasre season, the farm can no doubt bear the charije of the 
support of the patients working thereon, and still show a bal- 
ance on the right side. 

The current expenses for the year, less the amount received 
for articles sold, have been $163,040.43; dividing this by 
956.25, the daily average number of patients, gives $170.50 
as the annual cost of support, which is equivalent to a w^eekly 
cost of $3.27. 

The only change in our medical staff during the year is the 
resignation of Dr. Laure Hulme, who had been seven years in 
the service of the hospital as assistant physician. The vacancy 
thus occasioned was filled by the appointment of Dr. Margaret 
A. Fleming, who entered upon her duties Dec. 11, 1895. 

We are indebted to the publishers of the " Worcester Daily 
Spy," the "Worcester Evening Gazette," the " Fitchburg 
Sentinel," the "Essex County Mercury," the "Lynn Tran- 
script," the " Christian Register," " Zion's Herald " and "White 
Ribbon" for copies of their papers. 

The addition during the year of such a large number to our 
ofiicial family made many changes necessary in our household 
arrangements, but these changes have been for the most part 
cheerfully acquiesced in, and each has shown a disposition to 
concede something for the mutual good. This attitude on the 
part of the assistants, the evident interest with which they 
have entered upon the new work, together with the uniform 
encouragement and support which I have always received from 
your Board, has made my work a pleasure rather than a task. 

H. M. QUINBY, 

Superintendent. 
WoKCESTER Lunatic Hospital, Sept. 30, 1896. 



STATISTICAL TABLES. 



26 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



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1896.] 



PUBLIC DOCUMENT — No. 23. 



27 



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Females. Totals. 


969.02 
984.25 
996.41 


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956.25 


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511.92 
519.96 


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517.49 


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464.45 
472.33 
476.45 


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189.^. 

October, ...... 

November, . . . . 

December, 


















e-. 


Total of cases, 
Total of persons. 
Daily average. 




January, 
February, 
March, . 
April, . 
]\lay, . 
June, . 
July, . 
August, 
September, 



28 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



8. — Received on First and Subsequent Admissions. 









Cases admitted. 


TiMKS FREVIODSLr 
RECOVERED. 


NUMBER OF THE ADMISSION. 
















Males. 


Females. 


Totals. 


Males. 


Females. 


Totals. 


First, 






251 


250 


601 


- 


- 




Second, . 






18 


32 


50 


3 


12 


15 


Third, . 






8 


9 


17 


7 


8 


15 


Fourth, . 






3 


1 


4 


6 


2 


8 


Fifth, . 






- 


2 


2 


- 


7 


7 


Sixth, 






- 


1 


1 


- 


2 


2 


Seventh, . 






1 


- 


1 


1 


- 


1 


Total of eases. 


281 


295 


576 


17 


31 


48 


Total of persons, 






275 


292 


567 


11 


21 


32 



4. — Relation to Hospital of Persons admitted. 



Males. 


Females. 


Totals. 


Never before in any hospital for insane, . 


223 


219 


442 


Former inmates of this hospital only, 


34 


85 


69 


Former inmates of other hospitals only, , 


18 


29 


47 


Former inmates of this and other hospitals : — 








Concord, 


- 






Cook County Hospital for Insane, and 

Westborough. 
Danvers, 


- 






Danvers and Westborough, 


- 






Northampton, 


- 






Russia, 


- 






Taunton, 


- 






Westborough, 


- 


2 


2 


Total of persons, 


275 


292 


567 



1896.] 



PUBLIC DOCUMENT — No. 23. 



29 



5. — Parentage of Persons admitted. 









Males. 


Fkmales. 


Totals. 


PLACES OF NATIVITY. 
















Father. 


Mother. 


Father. 


Mother. 


Father. 


Mother. 


Massachusetts, .... 


36 


39 


35 


33 


71 


72 


Other states : — 














Maine, .... 


8 


8 


6 


11 


14 


19 


New Hampshire, 




10^ 


5 


10 


9 


20 


14 


Vermont, . 




6 


6 


6 


7 


12 


13 


Rhode Island, 




2 


2 


1 


1 


3 


3 


Connecticut, 




2 


1 


- 


1 


2 


2 


New York,. 




5 


6 


2 


2 


7 


8 


New Jersey, 




1 


- 


- 


- 


1 


- 


Pennsylvania 




1 


- 


- 


- 


1 


- 


Maryland, . 




- 


- 


1 


1 


1 


1 


District of Columbia, 




1 


1 


- 


- 


1 


1 


Virginia, 




1 


2 


- 


- 


1 


2 


North Carolina, . 




- 


2 


- 


- 


- 


2 


Georgia, 




- 


1 


- 


- 


- 


1 


Louisiana, . 




_ 


_ 


- 


1 


- 


1 


Illinois, 




1 


1 


- 


- 


1 


1 


Iowa, .... 




- 


- 


1 


- 


1 


- 


Other countries : — 














Canada, .... 


12 


11 


8 


9 


20 


20 


Nova Scotia, 




4 


5 


4 


4 


8 


9 


Prince Edward Island, 




- 


- 


1 


1 


1 


1 


New Brunswick, 




3 


1 


7 


6 


10 


7 


Newfoundland, . 




1 


1 


1 


2 


2 


3 


Scotland, . 






8 


9 


11 


10 


19 


19 


England, 






10 


6 


13 


11 


23 


17 


Ireland, 






92 


91 


107 


105 


199 


196 


Germany, . 






7 


5 


2 


2 


9 


7 


France, 






_ 


- 


2 


2 


2 


2 


Norway, 






1 


2 


2 


2 


3 


4 


Sweden, 






9 


9 


8 


8 


17 


17 


Holland, . 






- 


- 


1 


1 


1 


1 


Finland, 






2 


2 


1 


1 


3 


3 


Poland, 






- 


_ 


1 


1 


1 


1 


Switzerland, 






_ 


_ 


1 


- 


1 


- 


Russia, 






1 


1 


5 


5 


6 


6 


Italy, . _ . 






3 


3 


_ 


- 


3 


3 


V\ est Indies, 






2 


2 


- 


- 


2 


2 


Mexico, 






1 


1 


- 


- 


1 


1 


China, 






1 


1 


- 


- 


1 


1 


Unknown, .... 




44 


51 


55 


66 


99 


107 


Total of persons, 




275 


275 


292 


292 


667 


667 



30 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



6. —Birthplace of Persons admitted. 



PLACES OF BIRTH. 



Females. Totals 



Massachusetts, . 

Other States : — 
Maine,. 

New Hampshire, 
Vermont, 
Rhode Island, 
Connecticut 
New York, 
New Jersey 
Maryland, 
Virginia, 
North Carolina, 
South Carolina, 
Ohio, . 
Illinois, 
Michigan, . 
Oregon, 

Other countries : — 
Canada, 
Nova Scotia, 
New Brunswick, 
Prince Edward Island, 
Newfoundland, . 
England, 
Scotland, 



112 


93 


13 


9 


7 


6 


10 


5 


2 


2 


2 


- 


9 


3 


1 


- 


1 


1 


1 


- 


- 


2 


1 


- 


- 


1 


1 


- 


1 


- 


1 


- 


13 


12 


6 


7 


2 


6 


- 


5 


1 


6 


16 


9 


3 


8 



1896.] 



PUBLIC DOCUMENT — No. 23. 



31 



6. — Birthplace of Persons admitted — Conchided. 



PLACES OF BIRTH. 


-Males. 


Females. 


Totals. 


Other countries — concluded. 








Ireland, 












42 


87 


129 


France, 


. 










- 


2 


2 


Italy, . 












8 


- 


3 


Germany, . 












5 


3 


8 


Isorway, 












1 


2 


3 


Sweden, 












7 


9 


16 


Poland, 












1 


1 


2 


Russia, 












1 


6 


6 


Finland, 












3 


1 


4 


West Indies, 












2 


- 


2 


Mexico, 












1 


- 


1 


China, . 












1 


- 


1 


Unknown, . 












5 


7 


12 


Total, . 


275 


292 


667 



32 



WORCESTER LUNATIC HOSPITAL. [Oct. 



7. — Residence of Persons admitted. 



PLACES. 


Males. 


Females. 


Totals. 


Massachusetts (by counties) : — 








Berkshire, 


1 


1 


2 


Bristol, 


- 


1 


1 


Middlesex, 


Ill 


102 


213 


Norfolk, ...... 


4 


6 


10 


Plymouth, 


1 


1 


2 


Suffolk 


59 


86 


145 


Worcester, 


99 


95 


194 


Totals, 


275 


292 


567 


Cities or towns, 


273 


288 


561 


Country districts, 


2 


4 


6 



1896.] 



PUBLIC DOCUMENT — No. 23. 






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34 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



9. — Occupations of Persons admitted. 



Carpet weaver, ... 1 


Seamsti-ess, . 


1 


Clerks, . 




2 


Stenogi-apher, 


1 


Cooks, . 






2 


Students, 


2 


Domestics, 






44 


Tailoress, 


1 


Dressmakers, 






4 


Teachers, 


4 


Gardener, 






1 


Vest maker, . 


1 


Housekeepers 






19 


Washerwoman, 


1 


Housewives, 






121 


Unknown, 


12 


Laundresses, 






3 


No occupation, 


53 


Nightwalker, 






1 






Operatives, 






17 


Total, 


. 292 


Peddler, . 






1 







Author, 1 


Cooper, 1 


Bai'ber, . 






1 


Currier, . 








Basket maker. 






1 


Cutter, . 








Blacksmiths, . 






2 


Draughtsman, 








Bookbinder, . 






1 


Druggist, 








Book-keepers, 






3 


Dyer, . 








Bricklayer, 






1 


Engineer, 








Carpenters, 






3 


Farmers, 






14 


Cape maker, . 






1 


Fortune teller, 








Card grinder,. 






1 


Gardeners, 








Car conductor, 






1 


Glass blower. 








Chairmakers, . 






3 


Harness makers. 








Clerks, . 






10 


Hostler, . 








Chemist, 






1 


Hull corn dealer. 








Cigar makers. 






2 


Iron moulder, . 








Clothes cleaner. 






1 


Iron worker, . 








Cook, 






1 


Janitor, . 








Combmaker, . 






1 


Lawyer, . 








Coal dealer, . 






1 


Laundr3-man, . 








Collector and canvasser, 


1 


Laborers, 






55 


Confectioner, . 


1 


Lather, . 






1 



1896.] 



PUBLIC DOCUMENT — No. 23. 



35 



9. — Occu^jations of Persons admitted — Concluded. 



MALES — Concluded. 



Letter carrier, 


1 


Seamen, .... 


2 


Locksmiths, . 


2 


Shoemakers, . 


6 


Machinists, 


12 


Sign painter, . 


1 


Masons, .... 


3 


Students, 


2 


Mill employees, 


2 


Superintendent of mill, . 




Motorman, ... 


1 


Switchman, . 




Mule spinner, . . 


1 


Tailors, .... 




Operatives, 


7 


Tanner, .... 




Organ maker and tuner, 


1 


Teacher, .... 




Plasterer, 


1 


Teamster, 




Painters, 


5 


Telegraph operator, 




Peddlers, 


7 


Tinsmith, 




Printers, .... 


3 


Upholsterer, . 




Poi'ter, .... 


1 


United States soldier, . 




Plumbers, 


2 


Varnisher, 




Produce dealer, 


1 


Watchman, 




Railroad employees, 


2 


Weavers, 


5 


Restaurant keeper. 


1 


Wire workers, 


5 


Rope maker, . 


1 


Wool merchant. 


1 


Rubber merchant, . 


1 


Unknown, 


14 


Rubber boot maker. 


1 


No occupation, 


30 


Stable keeper. 


1 






Sail maker, 


1 


Total, . . 


275 


Salesmen, 


7 







36 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 






'^ 



S 

a 






1 

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a 
a 
a 
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,-1 T-l i-l T-H CO 


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lOCOrH|CNt>.^|i-l| 1 1 1 1^CO|t-I.-(^| 
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1. — Physical : — 

Apoplexy, . 

Epilepsy, 

Meningitis, . 

Phthisis, 

Typhoid fever. 

La grippe, . 

Syphilis, 

l^ocomotor ataxia. 

Malaria, 

Measles, 

Uteiine, 

Menstruation, 

Puerperal, . 

Menopause, . 

Senility, 

111 health, . 

Privation, 

Masturbation, 

Dissipation, , 

Intemperance, 

Opium habit, 



1896.] 



PUBLIC DOCUMENT — No. 23. 



37 



1 1 1 1 1 1 1 1 1 1 1 t I ! 1 1 1 1 1 1 1 1 1 1 


iM 


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


(M 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 i 1 1 1 1 1 1 1 1 1 


1 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 i 1 1 t 1 1 1 


•^ 


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


^ 


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


1 


ll|rH||||COt-(Ti< r^CCG^IICOCMCOrHllCN I CM 

CO o 

1— ( 


II It-Ill 1 II |!M '-ii-iCMIlCOi-liOT-illlM 1 


05 


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CO 


ICOIrHI 1 li-Hi-IC^llO '^IiOCOt-HI li-HuOCOl lOfl 1 


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to 


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1 


tH'Xii-IOt-Ii— l(MT-l-:tlCMCi t^COCMi-Hi— lOOCOOiOiOC^li— 1 i-H 
l-H l-l(MCO^r-l i-H T-< 

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Lead poisoning, . 
Nervous prostration, 
Sickness in infancy. 
Injury to head, 
Fracture of femur. 
Fall, . 

Surgical operation. 
Bite of dog, . 
Sunstroke, . 
Overwork, . 
Unknown, 

2. — Mental: — 

Hereditary, . 
Congenital, . 
Worry, ... 
Fright, . 
Nostalgia, 
Family troubles, . 
Business troubles, 
Bereavement, 
Excessive mental laboi 
Disappointment in love 
Continement in prison, 
Religious excitement, . 

3. — Not insane, 


O 

H 



38 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



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1896.] 



PUBLIC DOCUMENT — No. 23. 



39 



12. — Ages of Insane at First Attack, Admission and Death. 




13. — Reported Duration of Disease before Last Admission. 



PREVIOUS DURATION. 


First Admission 
TO Ant Hospital. 


All Other 
Admissions. 


Total. 




Ma. 


Fe. 


Tot. 


Ma. 


Fe. Tot. 


Ma. 


Fe. 


Tot. 


Congenital, 






4 


7 


11 


4 


1 


5 


8 


8 


16 


Under 1 month, 






60 


43 


103 


6 


13 


19 


66 


56 


122 


From 1 to 3 months, 






26 


29 


55 


7 


7 


14 


33 


36 


69 


3 to 6 months. 






22 


27 


49 


1 


6 


7 


23 


33 


56 


6 to 12 months, 






20 


20 


40 


7 


2 


9 


27 


22 


49 


1 to 2 years, . 






22 


14 


36 


11 


5 


16 


33 


19 


52 


2 to 5 years, . 






36 


32 


68 


11 


16 


27 


47 


48 


95 


5 to 10 years, . 






12 


13 


25 


5 


12 


17 


17 


25 


42 


10 to 20 years, 






10 


8 


18 


1 


9 


10 


11 


17 


28 


Over 20 years, . 






4 


5 


9 


4 


2 


6 


8 


7 


15 


Unknown, . 






7 


21 


28 


1 


3 


4 


8 


24 


32 


Total of cases, . 


223 


219 


442 


58 


76 


134 


281 


295 


576 


Total of persons. 






223 


219 


442 


52 


73 


125 


275 


292 


567 


Average in years. 






1.75 


2.15 


1.85 


3.48 


4.05 


3.76 


2.61 


2.95 


2.78 



40 



WOKCESTER LUNATIC HOSPITAL. [Oct. 



5 

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to 

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A. — Insane : — 

Mania, acute, 

chronic, . 
recurrent, 
puerperal, 
Melancholia, acuie, 

chronic, . 
recurrent, 
Dementia, primary, 

secondary, . 
senile, . 
organic. 
General paralysis of the insane. 
Adolescent insanity, . 
Epileptic insanity, 
Alcoholic insanity, 
Hysterical insanity. 
Congenital mental deficiency, 
TTehephrenia, 

Taranoia 

Polyneuritic delirium, . 
Idiocy, 

B. — Habitual drunkards, 

Not insane 


o 
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o 


m 

a 
o 
£ 
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Eh 



1896.] 



PUBLIC DOCUMENT— No. 23. 



41 



'8 



ca 



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O 


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05 lO rt 


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CO CO 


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r^ CO 

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CM CO as 1 T-H T-l 

CO 


CO CO 


a" 

CO 

Z 

O 


•sitnoi 


tH 1 1 1 1 1 


T-l 1—1 


•saiBtnajj 


T-l 1 1 1 1 1 


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1 1 1 I 1 1 


1 1 


a 


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> 

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00 CO 
00 00 


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-H kO I T-H <M 1 

Ci T-H 


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1—1 1—1 


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-H r^ -^ 1 T-l 1 

lO 1-1 


CO -* 


Q 

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>o ^ C<l 1 1 1 

00 




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(M CO 1 1 1 1 


Id no 


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CO 1-1 (?^ 1 1 1 


CO lO 

-:(< -*l 


> 
O 
« 

a 

a 
g 


•SIBJOX 


-* >* CO T-l 1 1 


(M T-l 

00 00 


•saiBinaj 


O CO T-l T-l 1 1 




•S3IBIM 


'+I th (Tq 1 1 1 

CO 


1^ CO 

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a 

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■siBiox 


T-l CO CO T-l CS T-l 

05 


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o o 


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CO (M 

CO CO 


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T-l C<« 1 1 1 T-l 




NUMBER OF THE ADMISSION. 






fe c» H fij fii c/2 


CO 

a 

Ui o 

=4-1 SJH 

o o 

-1-1 -►J 
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42 



WORCESTER LUNATIC HOSPITAL. [Oct. 






to 



C 



'^ 






^G<>i-(C<IC<l'-ieO<MrjHr-<,-l-<^r-l 



|rH|i-l|TjHSOG<>(MI |CCr-l 



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Lobar 
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Heart 



P5 



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1896.] 



PUBLIC DOCUMENT — No. 23. 



43 



I 1—1 T-l 



I ^ rH I ,-1 I I 



|T-l|T-(r-li-(|G<lr-<l I IrH 



r-l 


1 1 T-H 1 i-( rl r-l 




1— l|r-li— 1| |i— (| |i— 1,— lT-H|,— 1 












to" 

o 
H 










Heart failure, 

Rupture of heart, .... 
Rupture of aneurism in cii'cle of Willis, 
Thrombosis with septica3mia, . 
Sinus thrombosis, .... 
Cerebral embolism, .... 
Intestinal hemorrhage, 












a; 

,c 

o 
a> 

OQ 

cS 

<D 

> 


Peritonitis, . 
Enteritis, . 
Intestinal obstruction. 
Cancer of stomach, . 
Perforation of stomach. 
Carcinoma of liver, . 
Acute nephritis, . 
Cancer of uterus. 
Miliary tuberculosis, . 
Erysipelas of leg. 
Heat prostration. 
Suicide by hanging, . 
Gangrene of foot. 
Pyaemia, 



44 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



o 
O 






a 



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^ 



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1 1 1 1 I 1 1 1 1 1 1 1 1 (Mill II 




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J < 


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Nervous system : — 
Exhaustion from mania, acute, . 
chronic, 
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chronic, 
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senile, 
organic, . 
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General paralysis, .... 
Cerebral meningitis, . . •. . •. 
Internal hemorrhagic pachymeningitis. 
Convulsions, ..... 
Locomotor ataxia, .... 

Respiratory system : — 
Phthisis, . . _ . 
Broncho-pneumonia, .... 
Lobar pneumonia, .... 
Pleurisy, 

Circulatory system : — 
Cerebral hemorrhage, 
Heart disease, 



1896.] 



PUBLIC DOCUMENT— No. 23. 



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1896.] PUBLIC DOCUMENT— No. 23. 49 



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1896.] PUBLIC DOCUMENT — No. 23. 51 



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1869 
1872 
1873 
1874 
1876 
1877 
1878 
1879 
1880 
1881 
1882 
1883 
1884 
1885 
1886 
1887 
1888 
1889 
1890 
1891 
1892 
1893 
1894 
1895 
1896, 





1896.] 



PUBLIC DOCUMENT — No. 23. 



53 



LIST OF PERSONS 



Employed in the Worcester Lunatic Hospital, Sept. 30, 1896. 



Superintendent and physician, per year, 

Assistant superintendent and physician, per yeai', 

Assistant physician, " " 

Assistant physician, " " 

Assistant physician, " " 

Assistant physician, " " 

Steward, " " 

Treasurer, " " 

Matron, " " 

Clerk, " " 

Supervisor (man), per month. 

Supervisor (woman). 

Assistant supervisors (men, two) each. 

Assistant supervisors (women, two), each. 

Marker of clothing, .... 

Seamstresses (two), each, 

Attendants (men, thirty-six) $23.00 to $25.00 per month. 

Attendants (women, forty-four), $14.00 to 1 18.00 per month. 

Night attendants (men, five), $25.00 to $28.00 per month. 

Night attendants (women, five), per month. 

Baker, " 

Assistant baker, " 

Steward's assistant, " 

Office girl, " 

Kitchen men (two), $25.00 to $35.00 per month. 

Cooks (two), $22.00 and $25.00 per month. 

Laundry man, per month, .... 

Laundress, u u .... 

Assistant laundry man, per month. 

Laundry girls (seven), $14.00 to $18.00 per month. 



$3,000 00 

1,500 00 

1,200 00 

800 00 

800 00 

800 00 

1,200 00 

500 00 

600 00 

720 00 

. 45 00 

30 00 

35 00 

25 00 

18 00 

18 00 



18 00 
50 00 
25 00 
30 00 
16 00 



30 00 
20 00 

27 00 



54 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



Kitchen girls (four), $14.00 to $16.00 per month. 

House girls (eight), each, per month, . 

Carpenters (three), f 2.50 and $3.00 per day. 

Painters (four), $2.50 and $2.75 per day. 

Mason, $3.00 per day. 

Helper, $2.25 per day. 

Plumber, per year, 

Engineer, j)er year. 

Firemen (two), per month. 

Farmer, per year. 

Housekeeper, per year. 

Farm laborers (13), $23.00 to 30.00 per month. 

Farm help (women, five), $14.00 to $18.00 per month 

Florist, per month, ... 

Coachman, <■<. u ... 

Expressman, u c( ... 

Basement and yard man, " « ... 



$14 00 



900 00 


1,000 


00 


40 


00 


600 


00 


240 


00 


45 


00 


27 


00 


25 


00 


25 


00 



1896.] 



PUBLIC DOCUMENT — No. 23. 



55 



SUMMARY OF FARM ACCOUNT. 



Dr. 



Blacksmithing, 

Bread, 

Butter, 

Current expenses, 

Fertilizers, 

Fuel, . 

Furnishings, 

Furniture, . 

Grain and meal, 

Groceries, . 

Hardware, . 

Lights, 

Live stock, 



Amount carried fortvard, 



$193 19 
200 GO 
445 46 
129 52 
605 04 
631 62 
331 23 
112 11 

4,277 71 

1,323 81 

23 01 

194 31 

2,895 00 

11,362 01 



Amoxint hroi. 



Meat, . 

Pasturage, 

Repairs, 

Salt, . 

Seeds, 

Straw, 

Sugar, 

Tools, 

Wages, 

Water, 



\ghtfonoard, $11,362 01 

1,830 27 
120 00 
232 92 
14 12 
166 59 
164 95 
291 04 
22 10 

5,558 90 
162 20 



$19,925 10 



Cr. 



261 barrels apples, 

37 dozen bunches asparagus, 

26 bushels Lima beans, 

116 bushels string beans. 

20 bushels shell beans, 

8,700 pounds bones, . 

110 bushels beets, 

183 barrels cabbage, . 

330 bunches celery, . 

73 bushels cucumbers, 

40 dozen cucumbers, . 

250 pounds cauliflower, 

940 boxes currants, . 

163 barrels corn, 

31^ pounds chicken, . 

500 gallons cider, 

206 bushels dandelions, 

253| dozen eggs, 

Gravel, 

12 tons hay, 

25 pounds horse-radish, 

434 dozen lettuce, 

Live stock sold, . 

277,832 quarts milk, . 

108 melons, 

228 bushels onions, . 

88 bushels peas. 

Amount carried forward, 



$515 


00 1 


54 60 


26 00 


116 


00 


20 00 


43 


20 


55 00 


256 00 


33 


00 


79 00 


13 


00 


5 


00 


94 


00 


163 


00 


4 


85 


40 


00 


206 


00 1 


66 27 ] 


26 


35 


240 


00 


2 


00 


224 50 


1,609 


19 


11,113 


28 


13 


50 


228 00 


152 


00 


$15,398 74 



Amount brought foricard, $15,398 74 



2^ bushels pears, 
51 barrels parsnips, 
25,570 pounds pork 
Plants, 
553 posts, . 
Pasturage, . 
63 boxes raspberries, 
8 bushels radish, 
1,096 pounds rye meal, 
8,669 pounds rhubarl), 
14 bushels salsify, 
35,000 pounds fquash, 
241 dozen summer squash 
1,712 l)oxes strawberries, 
31 bushels spinach, . 
Sod, .... 
3,351 pounds straw, . 
120 barrels tm-nips, . 
152 bushels tomatoes, 
14^ cords wood, . 



Deficiency in receipts to bal- 
ance, .... 



2 50 


97 00 


1,466 06 


6 00 


82 95 


8 80 


12 60 


16 00 


14 25 


225 20 


42 00 


350 00 


120 50 


171 20 


31 00 


1 50 


33 51 


150 00 


154 00 


72 50 


$18,456 31 


1,468 79 


$19,925 10 



56 



WORCESTER LUNATIC HOSPITAL. [Oct.'96. 



PRODUCTS OF THE FARM 



On Hand Oct. 1, 1896, and not delivered at the Hospital. 



Apples, . 

Apples, cider, 

Beans, shell. 

Beets, 

Brussels sprouts. 

Cabbage, . 

Cauliflower, 

Celery, 

Cora fodder. 

Corn, shelled for seed, 

Carrots, . 

Ensilage, . 

Hay, 

Hay, swale, 

Mangolds, 

Oat fodder, 

Parsley, 

Parsnips, 

Rye, . 
Sage, 
Salsify, 
Squash, 
Straw, rye. 
Turnips, . 



575 barrels. 

350 bushels. 

12 bushels. 

600 bushels. 

5 bushels. 

7,000 heads. 

900 pounds. 
3,000 heads. 
40 tons. 
10 bushels. 
200 bushels 
200 tons. 
220 tons. 
15 tons. 
40 tons. 
20 tons. 
5 bushels. 
200 bushels. 
10 bushels. 
10 bushels. 
5 bushels. 
35,060 pounds. 
1 ton. 
1,000 bushels.