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



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



SIXTY-FIFTH ANNUAL REPOET 



THE TRUSTEES 



CX^2X->i, , 



Worcester Lunatic Hospital, 



TWENTIETH ANNUAL REPORT OF THE TRUSTEES 



WOECESTi:^ INSANE ASYLUM AT WORCESTER, 



Year ei^ding September 30, 1897. 



BOSTON : 

WRIGHT & POTTER PRINTIN"G CO., STATE PRINTERS, 

18 Post Office Square. 

1898. 



OFFICERS OF TUB HOSPITAL. 



TRUSTEES. 



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



WOIiCESTKK. 

Worcester. 

Worcester. 

South Lancaster, 

worcesteu. 

Boston. 

Whitixsvu.le. 



RESIDENT OFFICERS. 



HOSE A M. QUINBY, M.D., . 
ALFRED I. NOBLE, M.D., . 
ADOLF MEYER, M.D.,. 

EDWIN D. BOYNTON, M.D., 
GEORGE A. TRIPP, M.D., . 
MARGARET A. FLEMING, M.D. 
A. ROSS DEFENDORF, M.D., 
REVERE R. GURLEY, M.D., 
EDWIN LEONARD, Jr., M.D., 
EMMA W. MOOERS, M.D., 
THOMAS T. SCHOULER. 
LILA J. GORDON, 
S. JOSEPHINE BRECK, 
JOSEPH F. REYNOLDS, 



Superintendent. 
Assistant Siqjerintendctit. 
Assistant Physician and 
Director of Laboratory. 
Assistant Pliysician. 
Assistant Physicinn. 
Assistant Physician. 
Junior Assistant. 
Junior Assistant. 
Junior As.^istant. 
Junior Assistant. 
Steward. 
Matron. 
Cterk. 
Farmer. 



NON-RESIDENT OFFICERS, 



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



Treasurer. 

Auditor. 

Engineer. 



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C0mm0iiimaltlj ai ||Iassa:c^usttt^, 



TRUSTEES' REPORT, 



To His Excelleticy the Governor and the Honorable Council. 

The trustees of the Worcester Lunatic Hospital respectfully 
submit their sixty-fifth annual report, together with the reports 
of the superintendent and treasurer, and the statistical tables, 
showing in detail the affairs of the institution. 

Twenty years ago this month these buildings were first 
occupied, it having been thought wise to remove the institu- 
tion from the heart of the city to its present location. The 
buildings were erected to accommodate 650 patients ; from 
time to time additions have been made suitable for nearly 200 
more. The present average is 853, and we have had over 
1,000 patients crowded within our walls. 

At the present time we have (owing to the generosity of the 
last General Court) two hospital wards for the care of the sick, 
in process of construction. These additions, plans for which 
were carefully arranged by the superintendent with the ap- 
proval of the trustees, will be admirably adapted to the pur-^ 
pose for which they are designed. We hope to omit the 
disagreeable iron gratings from the windows, and to make 
these wards in all respects like similar wards in a general 
hospital. 

It is greatly to be regretted that the additional appropria- 
tion asked for, for a new kitchen wing and for the enlargement 



6 WORCESTER LUNATIC HOSPITAL. [Oct. 

of the department occupied by the outside help, was not also 
given us, as our present accommodations are entirely inade- 
quate for the increased numbers in the building. We shall be 
obliged, in consequence, to ask again. 

A home for nurses in connection with a training school will 
also be a necessity when the new wards are completed. 

Dr. Meyer's work in the hospital and laboratory is placing 
us in the front ranks of like institutions in the country. 

The chestnut grove in the rear of the hospital has been cut 
down to make larger yards for the excited patients, and the 
money realized from the sale of the wood is to be used in 
beautifying the grounds, plans for which have been made by a 
landscape gardener, and are to be carried out under the super- 
vision of a committee of the trustees. The plans will be 
carried out gradually, and we hope in time to do as much out- 
side our buildings to cheer and comfort our patients as we do 
inside to cure them. 

Our library is growing yearly. It was established from 
three small funds, altogether about $7,000, left the hospital 
many years ago. The income from these funds enables us to 
buy between two hundred and three hundred books each year. 
These books are carefully selected by one of the trustees, who 
reads each book before placing it upon the shelves. They are 
for the pleasure of the patients and employees. There are in 
all 3,127 books in the library. There are at least 160 volumes 
in the wards all the time ; the average change is between 35 
and 40 books twice a week. The shelves are now crowded, 
and it seems a good time to suggest placing bookcases in all 
the quiet wards, where patients and attendants can have access 
to the books without formality of card or librarian. They 
could be changed from ward to ward with little trouble, and 
would make the wards more cheerful and attractive, and be 
used much more if they could be taken freely. 

A new fire-proof vault for the safe-keeping of our records, 
which (with the new mode of taking) are most valuable and 
important, is in process of construction. 

The plumbing sections are nearly completed. There has 
been vexatious delay in getting material for this work, but 
they will be in use in a few weeks. 



1897.] 



PUBLIC DOCUMENT — No. 23. 



The trustees feel that they cannot too highly commend the 
services of their superintendent, who has been ably seconded 
by officers and employees. 

Respectfully submitted, 

FRANCES M. LINCOLN. 
A. GEORGE BULLOCK. 
THOMAS H. GAGE. 
HENRY S. NOURSE. 
ROCK WOOD HOAR. 
FRANCIS C. LOWELL. 

SARAH E. WHITIN. 

WoECESTEE> Sept. 30, 1897. 



VALUE OF PERSOIN'AL ESTATE. 

Sept. 30, 1897. 



Live stock on the farm, .... 

Produce of the farm on hand, 

Cai'riages and agricultural implements, . 

Machinery and mechanical fixtures, . 

Beds and bedding in inmates' department, 

Other furniture in inmates' department, . 

Personal property of State in superintendent's 

Ready-made clothing. 

Dry goods, . 

Provisions and groceries, 

Drugs and medicine, . 

Fuel, .... 

Library, 

Other supplies undistributed, 

Pipes and radiators, . 



department. 



Total, 



$10,762 00' 

9,972 00' 

6,950 00 

29, .509 33 

29,280 82' 

22,481: 82.- 

26,911 99 

1,690 43 

832 04 

4,343 03 

849 00 

2,775 00 

4,500 00 

5,703 35 

39,700 00 

$196,260 31 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



TREASUKER'S REPORT. 



To the Trustees of the Worcester Lunatic Eosjnlal. 

I herewith submit my annual report on the finances of the 
Worcester Lunatic Hospital for the year ending Sept. 30, 
1897: — 

Receipts. 



Cash on hand Sept. 30, 1896, 

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, 



149,746 


63 


36,678 


70 


84,274 09 


43,634 


39 


6,826 


24 


941 


77 


$222,001 


82 



The expenditures for the year have been as follows : — 



Provisions : — 

Flour, 

Meat, 

Fish, 

Meal for cooking, ... 

Beans, potatoes and other vegetables. 

Sugar, 

Molasses and syrup, ... 

Tea, 

Coffee, . 

Butter, . 

Cheese, 

Fresh fruit, 

Eggs, salt and other groceries. 
Salaries and wagefe, . 
Grain and feed for stock, . 
Hay and pasturage, . 
Furniture, 



,372 75 
,099 14 
,772 12 
456 90 
,463 28 
.549 06 
359 43 
928 12 
,653 41 
,540 14 
576 25 
920 28 
,380 41 
,969 36 
,805 97 
497 82 
,932 98 



Amount carried forward, $111,277 42 



1897.] 



PUBLIC DOCUMENT — No. 23. 



Amoti7il. brought forward, 

Crockery and glassware, 

Tinware, 

Bedding and beds, 

Straw, 

Furnishings, miscelhuK 

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, ordinary. 

Fertilizers, . 

Stationery, 

Postage, 

Transportation, , 

Travelling, 

Trustees' expenses. 

Miscellaneous, . 

Pathological department. 

Labor, 

Clothing and men's furnishings 

Dry goods for women, 

Dry goods for house, . 

Boots and shoes, 

Total current expenses 

Extraordinary expenses, 
Undertaker's charges, 
Money refunded, 
Cash refunded patients, 



• 


• 




$lli;277 42 


.818 18 


. 


250 40 








l,3n7 97 








85 59 








2,816 82 








157 36 








3,705 70 








8,196 02 








5,380 98 








974 34 








1,195 30 








1,686 00 








337 84 








616 16 








492 93 








736 40 








1,137 72 








1,084 28 








935 61 








658 38 








5,572 82 








869 54 








452 35 








316 27 








293 11 








97 80 








39 88 








3,873 35 








2,329 60 








511 16 








4,010 73 








1,429 17 








1,708 80 








1,194 87 


. fl61,456 35 


$15,242 15 


222 00 


37 36 


1,012 06 




Ifi fil?^ F,7 



Cash on hand Sept. 30, 1897, 



$177,969 92 
44,031 90 



^2,001 82 



10 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



Resources. 



Cash on hand, 

Due from the Commonwealth for board, etc., 
from cities and towns for board, etc., 
from individuals for boai'd, etc., 



LlABILITIKS. 

Due for supplies and improvements, . 
for salaries and wages, 
to patients, 



$10,286 73 
5,011 25 
1,917 61 



$44,031 90 

9,975 00 

20,742 39 

10,955 70 

$85,704 99 



Total surplus. 



17,215 59 
f68,489 40 



Respectfully submitted, 



Oct. 1, 1897. 



ALBERT WOOD, 

Treasurer. 



1897.] PUBLIC DOCUMENT— No. 23. 11 



HOSPITAL LIBRARY FUND. 



Lewis Fund. 



Received interest on Springfield bond, . . . $70 00 

170 00 

Expended for books, $39 31 

Rent in State safe deposit vault, .... 5 00 

Deposit in Worcester County Institution for Savings, 20 00 
Cash on hand Sept. 30, 1897, ..... 5 69 

$70 00 



Wheeler Fund. 

Cash on hand Sept. 30, 1896, $33 45 

Received dividends, 212 06 

Expended for books, f 220 78 

Cash on hand Sept. 30, 1897, 24 73 



Lewis Fund Investment. 

Springfield bond, f 1,180 00 

Worcester County Institution for Savings, . . 110 10 



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, 1897, . 



Manson Fund Investment. 

Worcester County Institution for Savings, . .$1,206 17 
Dividends added to principal, . . . . . 48 24 



. $945 


00 


. 870 


00 


. 1,145 


86 


. 1,719 


49 


24 


73 



io 51 



1246 51 



1,290 10 



t,705 08 



$1,254 41 
$7,249 59 



12 WORCESTER LUNATIC HOSPITAL. [Oct. 



LAND ACCOUNT. 



Cash on hand Sept. 30, 1896, . $139 43 

Cash received from sale of land, 517 50 

$656 93 

EXPEKDITURES. 

Commission, ....... 

Surveys, deed, etc., ...... 

Cash on hand Sept. 30, 1897, .... 



$15 


00 


10 


80 


631 


13 



$656 93 



Respectfully submitted. 



ALBERT WOOD, 

Treasurer, 



Oct. 1, 1897. 



■Worcester, Mass., Oct. 25, 1897. 
I hereby certify that I have this day compared the treasurer's statement of disburse- 
ments for the year ending Sept. 30, 1897, with the vouchers on file at the Worcester 
Lunatic Hospital, and find them to agree. I have also inspected the securities repre- 
senting the invested funds of the institution, and find that their marliet value is as stated. 

GEORGE L. CLARK, 

Auditor of Accounts. 



1897.] PUBLIC DOCUMENT — No. 23. 13 



SUPERINTENDENT'S EEPORT. 



To the Trustees of the Worcester Lunatic Hospital. 

I herewith respectfully submit the following report of the 
hospital for the year ending Sept. 30, 1897, it being the sixty- 
fifth annual report. 

There remained at the hospital Oct. 1, 1896, 861 patients, — 
377 men and 484 women. During the year 542 patients 
— 288 men and 254 women — were received ; 453 — 235 men 
and 218 women — were discharged ; and 48 men and 35 women 
died, leaving at the end of the official year 867 patients, — 382 
men and 485 women. Of this number, 274 were supported by 
the State, 444 by cities and towns and 149 by friends. Of the 
453 persons discharged, ^^, including 9 habitual drunkards 
(women), were reported recovered ; 68 as much improved ; 64 
as improved ; and 235, including 1 habitual drunkard (woman), 
not improved ; 1 woman was discharged not insane. Fifteen 
men and 15 women were removed by the overseers of the poor ; 
35 men and 32 women were discharged to the care of the Board 
of Lunacy and Charity, to be removed from the State; 61 men 
and 70 women were transferred to the Medtield Insane Asylum ; 
7 men and 5 women to the Boston Lunatic Hospital ; 1 man and 
1 woman to Westborough ; 3 women to Tewksbury ; 1 man to 
Briclgewater ; 1 man to the Danvers Lunatic Hospital ; 1 girl to 
the School for Feeble-minded ; and 1 woman was boarded out. 
One woman was returned to the Eeformatory Prison for 
Women and one woman to the Worcester jail. Five men 
escaped, and were not returned to the hospital at the end of 
the official year. 

During the year the discharges, including the deaths, have 
very nearly equalled the admissions, so that, at the close, our 
number remained practically the same as at the beginning of 
the year. 



14 WORCESTER LUNATIC HOSPITAL. [Oct. 

Our daily average number has been 853.5, which is about 
our present normal capacity. 

The percentage of recoveries, calculated upon the number 
of discharges and deaths, was 15.85, the same as last year; 
calculated upon the number of admissions, it was 15.68. 

The death rate was 9.72, calculated upon the average num- 
ber of patients; and 5.91, calculated upon the total number 
under treatment. 

There has been no unusual amount of sickness in the house 
during the year. We have, however, had two cases of diph- 
theria, one at the farm-house and one at the hospital, both in 
employees. Happily each of them recovered, and no other 
cases followed. There have been in all 83 deaths, 24 less than 
during the previous year. In 36 of these cases we have been 
enabled, with the permission of the friends, to verify or deter- 
mine the diagnosis by an autopsy. It is to be wished that still 
more of the friends of patients could be induced to overcome 
their prejudices in this direction, as we feel assured they would 
do, did they realize how important, even from a purely human- 
itarian stand-point, an autopsy is. It is certainly from no mere 
curiosity, whether scientific or otherwise, that we urge an ex- 
amination in all instances, but solely on account of the great 
assistance which an accurate knowledge of the condition of the 
brain and the other organs of the body gives us in carrying on 
that exhaustive study of our cases which we have undertaken, 
in order that we may determine, if possible, the exact nature of 
the processes underlying the disease. It is through autopsies 
alone that certain problems in regard to the brain and its dis- 
eases can be solved, — problems which may have an important 
\.^bearing upon the treatment and cure of insanity. 

By a reference to our statistical tables, it will be seen that 
//We have changed somewhat the older classification of insanity 
/ and replaced it by one closely following the principles of 
Kraepelin's psychiatry, as set forth in a review of Kraepelin's 
work, in the "American Journal of Insanity," Vol. LIIL, 
pages 298-302. Here the acute forms of insanity are classified 
according to whether they are processes of deterioration with 
or without remission (katatonia with occasional remissions, or 
dementia precox practically without any remissions) , or whether 



1897.] PUBLIC DOCUMENT — No. 23. 15 

they belong to the group of periodic insanity (mania, with its 
various types, circuhir stupor, melancholia, etc.). The mel- 
ancholia of the pre-senile and climacteric periods have been 
classified apart. The various forms of alcoholic insanity (de- 
lirium tremens, subacute and chronic alcoholic hallucinations, 
etc.) are not specified. 1'he group of constitutional inferiority 
includes a variety of defects, such as moral imbecility, con- 
stitutional neurasthenia, etc., which may be subdivided into 
several types. This, however, will be the task of a special 
comparative study of cases, which necessarily oversteps the 
limitation of mere statistics. 

The plans for the reorganization of the medical work of the 
hospital, as detailed in my last report, have now been in opera- 
tion a full year. As was perhaps inevitable in such an important 
and wide-reaching an undertaking, we find that we have not ac- 
complished quite all that we had hoped, and that our plans 
have still to be perfected in many of their details; but the re- 
sults already attained have been eminently encouraging, and 
fully warrant all the outlay in the way of time, energy or ex- 
pense which has been found necessary in carrying them out. 
Although our work is greatly increased, no one would now for 
a moment think of returning to the old methods. Besides mak- 
ing an exhaustive study and full record in all recent cases, we 
have, so far as possible, compiled the histories of the older 
patients after the new plan, making them as full and accurate 
as the lapse of time since the inception of the disease would 
allow. We have also taken advantage of the relief given us 
from overcrowding (through the transfer of some two hundred 
chronic cases to the Medfield Asylum) to reclassify our patients, 
grouping together all of the recent cases, and those in which 
the disease is still in a transition state, on the first two floors 
of the hospital, where they can more easily be observed. 

The stafi" of the hospital now consists of the superintendent, 
who is in charge of all the medical and administrative work of 
the hospital ; he is assisted by the assistant superintendent, who 
is at the same time in direct charge of the acute cases of the 
female department ; the second assistant is in charge of the 
acute cases of the male department ; and the third and fourth 
assistants have the wards for the chronic patients. Each assist- 



16 WORCESTER LUNATIC HOSPITAL. [Oct. 

ant physician has a junior assistant to help him. The super- 
vision over the purely medical work of the hospital is put in 
the hands of a physician who is as far as possible free from 
routine and administrative duties, and who is director of the 
clinical and pathological work. 

The division of labor is carried out as follows : the first floors 
are reserved, as has been stated, for the observation cases ; the 
second floors, for observation cases and some private patients ; 
the third and fourth floors are occupied by patients who do not 
need continual clinical observation in the strict sense of the 
word, i.e., chronic cases and patients in stationary phases of 
their disease. Each physician has two floors of the male or 
female side under his charge. 

The patients are given a complete mental and physical ex- 
amination as soon as possible after admission. The examina- 
tion is made by the physician in charge, with the help of the 
junior assistant. The physician on the third and fourth floors 
also takes his share of examinations, since his medical duties 
are considerably less than those of the physician in charge of 
the observation cases. The history is taken by the junior 
assistant, from the patient, from the friends and by correspond- 
ence. As soon as the necessary data are at hand, the physi- 
cian who examined the case reports to the stafi" meeting, makes 
a summary of the available facts and a diagnosis, which is sub- 
mitted for discussion. A provisional prognosis is made, and 
where necessary the treatment is discussed. The further duty 
of the physician is to continue the record of the patient, with 
the help of the junior assistant. Notes are taken in the ward, 
at the medical round, and handed to the stenographer to be 
typewritten. The clinical microscopy and analysis of urine, 
etc., are done by the junior assistant. 

In order to keep up a uniform arrangement and completeness 
of the records, the director of the clinical and pathological work 
outlines the scope and order of the history and the case record. 
He sees the patient with the physician in charge every second 
morning, and is responsible for the accuracy and usefulness of 
the record. 

The staff" meetings take place from 1L30 to 12.30. The 
time is devoted to the report of the cases recently admitted, 



1897.] PUBLIC DOCUMENT — No. 23. 17 

to those ready for discharge, and to matters of importance 
occurring in other patients. The report of deaths and autop- 
sies is also considered. Frequently the patients themselves 
are brought before the staff for clinical demonstration. 

The autopsies are made by the physicians and junior assist- 
ants. The brain is usually examined by the director of the 
pathological work, and the plans for the future microscopical 
examination and the necessary preparatory steps are outlined 
by him. The work is to some extent distributed among the 
junior assistants, according to their interest and ability. 

This general plan has given much satisfaction, and the at- 
tempt made to group the result of the year's observations has 
revealed a steady improvement of the material, and much evi- 
dence of a faithful elaboration of the plan adopted. 

Apart from the work directly referring to the patients, the 
medical spirit of the staff is further cultivated by regular 
weekly journal meetings. The liberal supply of books and 
periodicals allowed by the Board of Trustees makes a division 
of labor necessary. Each physician takes a number of journals 
and reports the contents briefly, frequently in connection with 
a short review of the whole field to which a oriven article 
belongs. 

During the winter months a course on neurology, embracing 
especially the anatomy of the nervous system, was given by 
Dr. Meyer ; also occasional instruction on methods, clinical and 
pathological. Apart from the current work in the laboratory, 
the minute study of special specimens and the preparation of 
material to illustrate the normal histology of the nervous system 
were carried on. Among these studies we mention : (1) a case 
of middle ear disease with acute facial and auditory paralysis 
and typical secondary lesions in the medulla oblongata (to ap- 
pear in the " Journal of Experimental Medicine ") ; (2) a histo- 
logical study of the nervous system of one of Dr. Sanger 
Brown's cases of heredo-ataxia (to appear in "Brain") ; (3) 
the nervous system of an anencephalus, and of normal fetal 
brains (cut in complete series) ; (4) the secondary degenera- 
tions in a case of infantile hemiplegia with sclerosis of the tem- 
poral and parieto-occipital lobe of one hemisphere (also cut in 
complete series) ; (5) normal series of the human brain stem, 



18 WOECESTER LUNATIC HOSPITAL. [Oct. 

etc. ; (6) studies of brain cells in various forms of insanity, 
partly communicated by Dr. Meyer at the meeting of the 
Medico-Psychological Association in Baltimore. 

During the second term (January to March, 1897) a series 
of lectures and clinics to the students in psychology of Clark 
University was given, in which the medical staff of the hospital 
took part. During the summer school a course of ten lectures 
at Clark University and two clinical demonstrations at the 
hospital were arranged. 

This plan may safely be said to have grown, on a natural 
basis, out of the conditions present in the hospital, and to be 
the outcome of the medical needs of the institution. Its aim is 
to do the best that medical science can do for the patients, and 
to gather from the experience, systematically and conscien- 
tiously, all that may benefit the work. Thus it becomes inci- 
dently a plan for research work, in the same way as every 
physician will try to use his experience for the future, — only 
with the advantage that the co-operation of ten physicians, with 
the same methods and the same aim in view, will be likely to 
be more fortunate in the results of research than one physician 
alone can expect to be. " Efficiency of the work on ground of 
well-sifted experience " is its purpose ; it is not put on the 
basis of experimental stations, of which the financial spirit of 
the administration might urge results in the shape of startling 
discoveries or a discontinuance of the financial support. Al- 
though we may confidently expect that, in time, results of 
great scientific value will of necessity come from such a plan, 
its true raison cVetre rests upon the added interest and efficacy 
which it gives to the every-day work of the hospital, to say 
nothing of its direct and immediate efiect upon the patient, in 
that it assures him that he is being treated individually, rather 
than en masse. 

The principal point is that all the physicians are kept in contact 
with the best work that literature gives evidence of, with the 
best methods that we can agree upon, and with a spirit which 
considers guess-work the most dangerous enemy of medical 
practice. With this attitude, every physician is likely to do 
his best work in all his relations to the patient and to the 
administration of the hospital. 



1897.] PUBLIC DOCUMENT — No. 23. 19 

Plans for the opening of a training school for nurses have 
been under consideration during the year ; and, in fact, what 
may be regarded as a beginning, in a tentative way, has already 
been made, in that our attendants have been brought together 
at various times for purposes of instruction as to their duties. 
That this has not been done regularly and systematically is due 
entirely to a lack of time on the part of the hospital staff, so 
much of their attention having of necessity been required dur- 
ing the year in getting our new medical work fairly under way. 
Many household problems have also come up which it was neces- 
sary to settle before such an important undertaking could be 
successfully inaugurated, involving, as it necessarily does, many 
radical changes in our present nursing force. Now, however, 
our plans are so far perfected that we are in a position to go 
about the formal opening of such a school just as soon as we 
can feel reasonably assured that accommodations will be pro- 
vided for a superintendent of nurses and the additional help 
necessary for our new infirmary wards. 

It may not be out of place in this connection to mention one 
other reason which, hitherto, has held us back somewhat when- 
ever the formal opening of a training school was under consid- 
eration, and that is, a feeling that a lunatic hospital was not in 
a position to offer those facilities for an all-round training which 
the nurse and the general public might reasonably demand 
from an institution which undertook to graduate trained nurses. 
There is now, however, every prospect that this difficulty will 
soon cease to confront us, as negotiations are in progress with 
our city hospital , looking toward an interchange of nurses. This 
will no doubt be of mutual benefit, in that it will enable such 
of our nurses as desire to do so to complete their training at a 
general hospital, and will give those of the latter institution an 
opportunity to become familiar with the care and nursing of 
the insane. 

I would again call attention to the necessity for remodelling 
and enlarging that portion of the hospital in the rear of the 
centre building which is devoted to our outside help, and also 
to the need of increased kitchen facilities. As pointed out at 
length in my last report, this has now become an imperative 
necessity, as we have long since outgrown both of these de- 



20 WORCESTER LUNATIC HOSPITAL. [Oct. 

partments, and must have additional room to properly carry on 
the affairs of the institution. When the hospital was first 
opened the facilities here provided were no doubt ample for the 
400 or 425 patients which the building was intended to accom- 
modate ; but since then the entire fourth story in both wings 
of the hospital has been fitted up and filled with patients ; two 
additional wards have been built, and various rooms in each of 
the wards, originally intended for workrooms or for sitting 
rooms, have from time to time been turned into dormitories, 
until finally our number of patients has more than doubled. 
In the mean time there has been no corresponding growth in 
the department devoted to the help ; and our kitchen facilities 
remain practically such as they were when the hospital was first 
opened. During the past year the needs of the institution 
have caused us to add largely to our medical staff and our cleri- 
cal force ; before the close of the present year two new wards 
will have been added, accommodating 90 more patients, and 
we shall also be called upon to provide for a superintendent of 
the training school, as well as for additional nurses, — all of 
which means additional cooking, additional washing and addi- 
tional service, demands which will fall upon departments which 
are already being run at their highest tension. To the casual 
visitor and even to the general household these departments are 
but little in evidence when everything goes as it should ; but 
about them centre the entire executive work of the institution, 
and any hitch or defect here at once makes itself apparent 
through the entire establishment. 

An appropriation of $80,000 was granted by the last Legis- 
lature for the building of the two infirmary wards. Plans and 
estimates therefor have been completed and approved by the 
governor and council, and a contract entered into with J. W. 
Bishop & Co. of this city to build the same, they being the 
lowest bidders. Ground was broken on September 13, and the 
contractors promise the completion of the work on or before 
August 1 of the coming year. 

When these buildings are completed, it is proposed to em- 
ploy women nurses upon the male infirmary wards and also 
upon the four Appleton wards (male) adjacent thereto. This 
will necessitate the building of a nurses' home, where our 



1897.] PUBLIC DOCUMENT — No. 23. 21 

female employees can be provided for outside of the wards of 
the hospital when not on active duty. The necessity for such 
a home in every well-appointed hospital, whether general or 
insane, can no longer be questioned ; but it is especially neces- 
sary as an adjunct of a training school, and is an important 
part of our plan to provide female nurses for the male wards, — 
a plan which, if carried out, will, we feel assured, greatly im- 
prove the service of the hospital and add vastly to the comfort 
of its patients. 

In order to make room for the additional assistants in the 
medical department, the steward, who with his family has 
hitherto occupied rooms in the centre building, moved early in 
the year to the farm-house, still, however, keeping his office at 
the hospital. This change has proved eminently satisfactory, 
in that it provides a responsible head for what is really a ward 
of the hospital, and at the same time gives the steward more 
comfortable and larger quarters, and a better opportunity for 
keeping a general oversight over the farm and the outside work 
of the institution, while it in no way interferes with his other 
duties. 

A reference to the farm account, which is herewith appended, 
will show that the prediction made in last year's report has 
proved true ; and, while the past year can hardly be regarded 
as an average one, the farm, although charged with the sup- 
port of the patients employed thereon, shows a balance on the 
right side. 

Among the more important repairs and improvements made 
during the year we would mention : the digging up and re- 
covering of our main steam pipes ; the building of a silo, of 
two hundred and fifty tons capacity, at the Hillside farm ; and 
the putting in of the Lynn stall and the construction of an 
annex to our stable, containing a pit for the storage of manure 
and two tanks for liquids, each holding five thousand ^gallons, 
so arranged that they can be easily drawn off and the contents 
applied as a fertilizer. We have been unable, heretofore, to 
use soft coal, on account of the proximity of our main chimney 
to our clothes yard and the consequent soiling of the clothing 
from smoke and soot. To obviate this difficulty we have now 
relocated this yard, building a retaining wall and filling in the 



22 WOECESTER LUNATIC HOSPITAL. [Oct. '97. 

necessary land on the east side of the laundry. This change 
will enable us to greatly decrease the expense of heating the 
buildings. 

The current expenses, less the amount received for articles 
sold, have been $155,708 ; dividing this by 853.5, the daily 
average number of patients, gives $182.43 as the annual cost 
of support, which is equivalent to a weekly cost of $3.50. 
This considerable increase in cost over that of past years is 
due to our greatly decreased number of patients, and to the 
fact that it was impossible to at once diminish our expenditures 
in a like ratio. 

Dr. Appleton H. Pierce resigned his position at the hospital 
in December, to enter general practice, and his place was filled 
by the appointment of Dr. George A. Tripp. 

H. M. QUINBY, 

Sicpermtendent. 
Worcester Lunatic Hospital, Sept. 30, 1897. 



STATISTICAL TABLES. 



24 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



e 

2Q 



g 

« 

Cb 















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t. 1, 189G, . 

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within the yea 


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time of leavin 

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1, ' '. '. 


• 


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ate patients, 
wn patients, 
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sons within th 
sons admitted 
sons recoverec 


f patients : — 
, ■ . • 






in the house Oc 
1 within the yea 
umber of cases 


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as recovered at 
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remaining Sejjt 
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private patients 






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Patien 
Admit 
AVliole 




Deaths 

Patien 

Viz. 

Numb 
Numb 
Numb 
Daily 
Viz, 



1897.] 



PUBLIC DOCUMENT — No. 23. 



25 





H 

Z; 

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853.6 

869.03 

872.41 


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486.66 
482.64 


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382.37 

389.77 


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t-00 

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CO 

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■3 



r-l ^ 

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COiOCO"*CO-^t^cocO 


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10 




CO 


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■3 

a 
fa 


CO ^ (M 
1-1 Cq rH 


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1— tC^I»l-HrHC<lCOCOG^ 


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1 






/3 


1896. 

October, 

November, 

December, 








H 


m 

a 


CD 


"^ 

H 


ho 

03 

ft 




January, . 
February, . 
March, 
April, 
May, . 
June, 
July, 

August, . 
September, 



26 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



3. — Received on First and Subsequent Admissions. 





Cases admitted. 


Times previouslt 
kecovered, 


N0MBEE OF THE ADMISSIOJST. 


Males. 


Females. 


Totals. 


Males. 


Females. 


Totals. 


First, 

Second, .... 

Third, 

Fourth, .... 

Fifth 

Sixth, 


245 

84 

6 

3 


211 

27 
8 
6 
1 
1 


456 
61 

14 
9 

1 
1 


8 
3 

1 


6 

2 
4 
1 
1 


14 
5 

5 
1 

1 


Total of cases, 
Total of persons, . 


288 
284 


264 
251 


542 
535 


12 
11 


14 
13 


26 
24 



4. — Relation to Hospitals of Persons admitted. 



HOSPITAL RELATIONS. 


Males. 


Females. 


Totals. 


Never before in any hospital for insane, . 


225 


204 


429 


Former inmates of this hospital only, 


31 


35 


66 


Former inmates of other hospitals only, . 


20 


7 


27 


Former inmates of this and other hos 


pitals : — 








California, . 






1 


- 


1 


Cranston, . 






- 


1 


1 


Danvers, 






1 


1 


2 


Medfield, . 






1 


1 


2 


McLean, 






2 


- 


2 


Taunton, 






- 


1 


1 


Taunton and Danvers, 






- 


1 


1 


Westborough, 






3 


- 


3 


Total of persons, 


284 


251 


535 



1897.] 



PUBLIC DOCUMENT — No. 23. 



27 



5. — Parentage of Persons admitted. 











Males. 


Females. 


Totals. 


PLACES OF NATIVITY. 
















Father. 


Mother. 


Father. 


Mother. 


Father. 


Mother. 


Massachusetts, .... 


39 


43 


20 


25 


69 


68 


Other States : — 














Maine, .... 


12 


10 


6 


8 


18 


18 


New Hampshire, 




17 


15 


8 


6 


25 


21 


Vermont, . 




4 


4 


2 


_ 


6 


4 


Rhode Island, 






_ 


1 


1 


_ 


1 


1 


Connecticut, 






2 


1 


_ 


1 


2 


2 


New York, . 






4 


4 


1 


2 


5 


6 


New Jersey, 






- 


2 


- 


- 


- 


2 


Virginia, 






1 


2 


_ 


_ 


1 


2 


North Carolina, 






_ 


1 


_ 


_ 


— 


1 


South Carolina, 






1 


- 


- 


1 


1 


1 


Other countries : — 














Canada, .... 


18 


16 


10 


8 


28 


24 


Nova Scotia, 






5 


4 


3 


4 


8 


8 


New Brunswick, 






1 


1 


_ 


1 


1 


2 


Newfoundland, 






1 


_ 


1 


1 


2 


1 


Scotland, . 






7 


4 


4 


4 


11 


8 


England, 








8 


8 


4 


3 


12 


11 


Ireland, 








84 


90 


92 


94 


176 


184 


Wales, 








1 


_ 


1 


_ 


2 


_ 


Norway, 








2 


2 


— 


_ 


2 


2 


Sweden, 








12 


12 


6 


6 


18 


18 


France, 








_ 


_ 


2 


1 


2 


1 


Holland, 








_ 


_ 


1 


1 


1 


1 


Belgium, 








1 


1 


- 


- 


1 


1 


Finland, 








4 


4 


_ 


_ 


4 


4 


Spain, 








_ 


— 


1 


_ 


1 




Portugal, 








1 


1 


_ 


_ 


1 


1 


Germany, 








7 


8 


5 


5 


12 


13 


Russia, 








3 


3 


_ 


_ 


3 


3 


Austria, 








4 


4 


_ 


_ 


4 


4 


Armenia, 








1 


1 


_ 


_ 


1 


1 


Italy, . 








1 


1 


_ 


_ 


1 


1 


Bei'muda, 








1 


1 


_ 


_ 


1 


1 


West Indies, 






2 


1 


- 


- 


2 


1 


Unknown, .... 




40 


39 


83 


80 


123 


119 


Total of per 


sons, 


• 


284 


284 


251 


251 


535 


535 



28 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



6. — Birthplace of Persons admitted. 



PLACES OF BIETH. 


Males. 


Females. 


Totals. 


Massachusetts, ....... 


99 


77 


176 


Other States : — 








Maine, 


10 


10 


20 


New Hampshire, 










12 


8 


20 


Vermont, . 










7 


2 


9 


Rhode Island, 












3 


3 


6 


Connecticut, 












4 


1 


5 


New York, . 












9 


7 


16 


New Jersey, 












1 


- 


1 


Pennsylvania, 












2 


3 


5 


Washington, D. ( 


~< 










- 


2 


2 


Virginia, 












1 


- 


1 


West Virginia, . 
Ohio, . 












- 


1 

1 


1 
1 


Michigan, . 












_ 


2 


2 


Arkansas, . 












1 


- 


1 


Texas, 












1 


- 


1 


Other countries : — 








Canada, 


12 


12 


24 


Nova Scotia, 










7 


8 


15 


New Brunswick, 










3 


3 


6 


Prince Edward Island 


5 








_ 


3 


3 


Newfoundland, . 










2 


2 


4 


Scotland, 












2 


1 


3 


England, . 
Ireland, 












9 

50 


8 
68 


17 

118 


Norway, 
Sweden, 












8 
11 


10 


3 
21 


France, 












— 


1 


1 


Finland, 












4 


- 


4 


Holland, . 












- 


2 


2 


Belgium, 












1 


- 


1 


Germany, . 
Russia, 












7 
3 


4 
3 


11 

6 


Austria, 












3 


- 


3 


Armenia, 












1 


- 


1 


Italy, . 
Azores, 












1 
1 


2 


3 

1 


Bermuda, . 












1 


- 


1 


West Indies, 












2 


_ 


2 


Unknown, . 












11 


7 


18 


Totals, 


• 


• 


• 


• 


• 


284 


251 


535 



1897.] 



PUBLIC DOCUMENT — No. 23. 



29 



7. — Residence of Persons admitted. 



PLACES. 


Males. 


Females. 


Totals. 


Massachusetts (by counties) : — 








Essex, 


- 


1 


1 


Hampshire, 


1 


- 


1 


Middlesex, 


93 


70 


163 


Norfolk, 


6 


4 


10 


Plymouth, ....... 


- 


1 


1 


Suffolk, 


57 


75 


132 


Worcester, 


127 


100 


227 


Totals, 


284 


251 


535 


Cities or towns, ...... 


284 


251 


535 


Country districts, 


- 


- 


- 



30 



WOECESTER LUNATIC HOSPITAL. 



[Oct. 






o 



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First, 

Second, .... 
Third, .... 
Fourth, .... 
Fifth, .... 
Sixth, .... 


o 



1897.] 



PUBLIC DOCUMENT — No. 23. 



31 



9. — Occupations of Persons admitted. 



FEMALES. 



Clerk 


1 


Stenographer, ... 1 


Cook, .... 


1 


Shirtmaker, . 






1 


Cotton picker. 


1 


Shoestitcher, . 






1 


Dressmakers, . 


4 


Student, 






1 


Domestics, 


43 


Teachers, 






6 


Housekeepei's, 


39 


Type-setter, . 






1 


Housewives, . 


61 


Waitress, 






1 


Laundresses, . 


2 


Washerwomen, 






3 


Lodging-house keeper, . 


1 


Weaver, 






1 


Milliner, 


1 


Unknown, 






16 


Operatives, 


10 


No occupation, 






49 


Straw worker. 


1 





Seamstresses, , 


5 


Total, . . . .251 



Artist painter. 


1 


Druggists, .... 2 


Barbers, .... 


5 


Farmers, 






19 


Blacksmiths, . 


2 


Firemen, 






2 


Book-keepers, 


3 


Fish dealer, . 






1 


Bookbinder, . 


1 


Gardeners, 






2 


Butcher, 


1 


Iron worker, . 






1 


Butter and egg dealer, . 


1 


Insurance clerk, 






1 


Canvassers, 


2 


Jeweller, 






1 


Cabinet makers. 


3 


Laborers, 






55 


Carpenters, . 


7 


Lather, . 






1 


Carriage washer, . 


1 


Lumber dealer. 






1 


Carders in mill. 


2 


Machinists, 






10 


Clerks, .... 


12 


Masons, . 






4 


Cigar maker, . 


1 


Mechanics, 






2 


Coachman, 


1 


Messenger boy. 






1 


Comb maker. 


1 


Moulder, 






1 


Cook, .... 


1 


Motorman, 






1 


Confectioner, 


1 


Operatives, 






21 


Conductor, 


1 


Painters, . 






8 


Dentist, .... 


1 


Pailmaker, 






1 



32 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



9. — Occupations of Persons admitted — Concluded. 



MALES — Concluded. 



Peddler, 1 


Students, .... 2 


Printers, . 




4 


Tailors, . 






2 


Professor of music, 




1 


Teacher, . 






1 


Photographers, 




2 


Teamsters, 






7 


Plumbers, 




2 


Telephone lineman 






1 


Railroad employees, 




3 


Tinsmith, 






1 


Religious editor. 






Tool sharpener. 






1 


Restaurant keeper. 






Upholsterer, . 






1 


Rigger, . 






Violin maker. 






1 


Rubber worker. 






Waiter, . 






1 


Sailor and cook. 






Watchmen, 






2 


Stable keeper, 






Weavers, 






6 


Sewing machine agent. 






Wire agent, . 






1 


Steamfitter, . 






Wire worker, . 






1 


Shirt cutter, . 






Unknown, 






13 


Shoemakers, . 






No occupation, 






28 


Shoe dealer, . 








Stone cutter, . 






Total, .... 284 


Storeroom keeper. 









1897.] 



PUBLIC DOCUMENT — No. 23. 



33 



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a 








V 


e, 

e (infanti 

seraiice, 

is, . 

tulion, 
mperance 

onia, 
erance, 

jrance, 


1. Physical : — 

Cerebral hemorrhag 
Cerebral hemorrhag 
Epilepsy and intern; 
Epilepsy, . 
Phthisis, . 
Phthisis and nephrit 
Typhoid fever. 
La grippe. 
Puerperal infection, 
Puerpetium, . 
Pregnancy, 
Pregnancy and desti 
Menopause, 
Menopause and inte 
Plumbisra, 
Morphinism, . 
Digitalis, . 
Syphilis, . 
Syphilis and pneum 
Syphilis and intemp 
Senility and syphili 
Senility, . 
Senility and intempe 
Intemperance, . 
Potts' disease, . 
Ill health, . 
Gastritis, . 
Nephritis, 
Heat exhaustion, 
Sunstroke, 
Privation, . 
Sexual excess, . 



34 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



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02 




. . 




Nostalgia, 

Disappointment iu love, 

Family trouble, 

Bereavement, ...... 

Worry, 

Mental worry and bereavement, . 

Financial trouble, 

Unknown, 

3. — Not insane 

Totals 




1. — Physical — Concluded. 

Masiurbation 

Masturbation and intemperance, . 
Maaturbalion and injury to head, . 
Injury to leg and amputation. 
Fracture of thigh and intemperance, 
Injury to head, .... 
Fracture of ribs, .... 
Gunshot wound (cranial), 

Ovariotomy 

Overwork, 

2. — Mental : — 

Heredity, 

Overetudy, 

Religious excitement, 

" Christian science," 

Frieht 



1897.] 



PUBLIC DOCUMENT — No. 23. 



35 



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36 



WOECESTER LUNATIC HOSPITAL. [Oct. 



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







Persons First Admitted 
TO ANT Hospital. 




Persons 


Died. 


AGEB. 


AT 


WHEN 




AT 


1 


AT TIME 


FIRST ATTACK. 


ADMITTED. 


FIRST ATTACK. 


OF 


DEATH. 




Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Congenital, . 




1 


5 


6 


- 


- 


- 


1 


- 


1 


- 


- 


- 


15 years and less, 




4 


3 


7 


1 


2 


3 


- 


- 


- 


- 


- 


- 


From 15 to 20 years, 




11 


12 


23 


8 


10 


18 


- 


- 


- 


1 


- 


1 


20 to 25 years, 




25 


19 


44 


25 


27 


52 


- 


2 


2 


1 


2 


3 


25 to 30 years, 




26 


21 


47 


31 


23 


54 


- 


1 


1 


- 


2 


2 


30 to 35 years, 




12 


21 


33 


19 


24 


43 


1 


2 


3 


1 


3 


4 


35 to 40 years, 




22 


21 


43 


19 


23 


42 


5 


3 


8 


2 


- 


2 


40 to 50 years, 




31 


31 


62 


46 


35 


81 


4 


6 


10 


9 


7 


16 


50 to 60 years. 




26 


23 


49 


32 


33 


65 


12 


7 


19 


8 


4 


12 


60 to 70 years. 




17 


8 


25 


19 


9 


28 


8 


7 


15 


13 


7 


20 


70 to 80 years, 




9 


5 


14 


15 


11 


26 


3 


3 


6 


6 


6 


12 


Over 80 years, . 




5 


2 


7 


5 


4 


9 


3 


1 


4 


3 


3 


6 


Unknown, . 




36 


33 


69 


5 


3 


8 


11 


3 


14 


4 


1 


5 


Total of persons. 




225 


204 


429 


225 


204 


429 


48 


35 


83 


48 


35 


83 


Mean ages in years, 


38.11 


37.24 


37.67 


42.38 


40.57 


41.47 


55.02 


44.11 


48.56 


52.83 


53.54 


53.18 



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, 






1 5 


6 


- 


2 


2 


1 


7 


8 


Under 1 month. 






44 


44 


88 


16 


3 


19 


60 


47 


107 


From 1 to 3 months. 






32 


33 


65 


3 


1 


4 


35 


34 


69 


3 to 6 months. 






17 


12 


29 


2 


4 


6 


19 


16 


35 


6 to 12 months. 






23 


19 


42 


5 


4 


9 


28 


23 


51 


1 to 2 years, . 






21 


9 


30 


4 


1 


5 


25 


10 


35 


2 to 5 years, . 






30 


26 


56 


10 


12 


22 


40 


38 


78 


5 to 10 years, . 






14 


12 


26 


7 


10 


17 


21 


22 


43 


10 to 20 years, . 






3 


4 


7 


5 


5 


10 


8 


9 


17 


Over 20 years, . 






3 


4 


7 


2 


3 


5 


5 


7 


12 


Unknown, . 






37 


36 


73 


9 


5 


14 


' 46 


41 


87 


Total of cases, . 


225 


204 


429 


63 


50 


113 


288 


254 


542 


Total of persons, 






225 


204 


429 


59 


47 


106 


284 


251 


535 


Average in years. 






1.76 


2.54 


2.15 


3.78 


7.03 


5.40 


2.77 


4.78 


3.77 



1897.] 



PUBLIC DOCUMENT — No. 23. 



37 



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^ .3 
- 3 


a 
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Dementia prajcox. 
General paralysis. 
Locomotor ataxia. 
Hysterical insanity 
Epileptic insanity. 
Organic dementia, 
Secondary dementi 
Melancholia (involi 
Senile dementia, 
Imbecility, . 
Idiocy, 


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1897.] 



PUBLIC DOCUMENT — No. 23. 



39 



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40 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 






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llll 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


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1 1 i 1 1 1 1 1 1 1 1 1 1 1 <-l 1 1 1 


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2 


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llll 1 1 1 -H 1 1 1 1 1 1 1 1 1 1 


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P rt t> CD'S g2 c c S S «^ j- o -^ 1^1^ S S a; 
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1897.] 



PUBLIC DOCUMENT — No. 23. 



41 



1 , 1 1 1 1 1 1 - I 1 1 


'^i^ 


1 1 1 1 1 1 1 1 i-l 1 1 1 1 <M 


1 1 1 1 1 1 1 1 1 1 1 1 1 <M 


1 1 1 ' 1 1 - 


1 1 1 1 1 1 1 1 1 1 1 1 1—1 


1 
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1 1 1 1 1 1 1 1 1 1 1 1 i—^ 






1 
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1 1 1 1 1 1 1 1 1 1 1 1 1 <:o 


1 


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1 

1 1 1 1 1 1 1 1 1 1 1 1 1 (M 




CO 

CO 




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CO 


1-1 1 l-H^|,-ll |,-l| 


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eneral: — 

Nephritis, interstitial, 
Pyelo-nephritis and cystitis^ 
General tuberculosis, . 
Sarcomata, ..... 
Prostatic hypertrophy and cystitis, 
Anasmia, pernicious, . 
Epithelioma, labialis, 
Senile gangrene. 
Enteritis, acute, .... 
Enteritis chronic. 

Peritonitis, 

Septicemia, .... 


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42 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



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1897.] 



PUBLIC DOCUMENT — No. 23. 



43 



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 


T— 1 


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


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I— 1 


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T— 1 


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n 


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1 1^1 1 |l-H| |r-l,-l| 


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1 1 1 1 T-l ^ 1 1 t 1 1 1 


I— 1 










General : — 

Nephritis, interstitial, 
Pyelo-nephritis and cystitis. 
General tuberculosis, . 

Sarcomata, 

Prostatic hypertrophy and cystitis, 

Antemia, pernicious, . 

Epithelioma, labialis, . 

Senile g-anffrene. 

Enteritis, acute, .... 

Enteritis, chronic. 

Peritonitis, 

Septicemia, 


o 



44 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 







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nsane: 
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1897.] 



PUBLIC DOCUMENT — No. 23. 



45 



^ 
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H 


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ii 


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1— 1 T— 1 1— C tH I— 1 


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CO 
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1—1 


CO 


00 
00 

CO 
CO 


•saiBjvi 


1— ICOCN-*ICOC<1COG<1(MCO 


CO 


GO 


M 
o 
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H 
H 
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■< 


la M 
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CO 
CO 


CM 

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o 

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CO -* lO '-I 00 -* G^ CO ^ 1 
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t^ -^ 1 to CO C^ 1 T-l CM 1 


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Average of known eases (in months), 




._._...... 


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, . 



46 



WOECESTER LUNATIC HOSPITAL, 



[Oct. 



'« 
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1 1 1 . . 1 . . 1 . . 1 . 1 1 1 1 . . 1 . 1 . . 1 1 . 


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1 . 1 . 1 1 r . 1 . 1 . . 1 1 . . . . . 1 1 . 1 1 1 . 


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1 . 1 1 1 1 . 1 1 1 1 1 1 1 . 1 1 . 1 . 1 . 


s 
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»r5t^(Mr'CO-^Clcqt^t-COOOOJiOu:!COOCOOiOf-HOOOO--ira 

(Mr-icno«inc0'!i'i-i-*t-a>0>i-it-rH0J0>03 — — '^-3't-o-j'Oira 

i-lrH i-(rHrHr-l>-li-lr-i,-l-Hi-(IMi-(C^i-lrHi-llM(M<M>-Hi-'i-HCN--l 


•BaiBuia^ 




•saiBj^ 


i-HtO — COCOCOIM-KCO!0050IMOOC<lCDCOt-—'t-'nOCOCn-Hg 
OOtOiO^t-COeO^Ot'OiOiOOQOr-iOlOOOOiCOCOt'CO'MCO 


1— 1 














1833 
1834, 
1835, 
1836 
1837 
1838 
1839, 
1840 
1841 
1842 
1843 
1844 
1845 
1846 
1847 
1848 
1849 
1850 
1851 
1852 
1853 
1854 
1855 
1856 
1857 
1858 
1859 



1897.] PUBLIC DOCUMENT — No. 23. 47 



I I I IrHI I I I I I I I I I I Ir-ir I I I li-lliHrHlr-ll li-IC5|tDi-lCO<3iOO 



|||lllllllllllll|i-llllllll|r-((|l|i-(i-HIC-J.Ot-(rt 



|||lrHIIIIIIIIIIIIIIIIII'-(lr-llir-llllr-ll-*tOlM00 .O 



I I I I I I I I I J I I I 1-1 I I I 1-1 I I I I I I I I I I T-( 1-1 i-ito o cj CO -* CO (^^ 



iliiiiiiiiiiii-iiiiiiiiriiiiiirii-iTtoatoiocococi 



|||||||l|lllllllli-i|llllllll|r-li-l|(M>OC000r-<iOO 



llllllllllllllllllllr-lllllllllrHlrHrHlr-ICOCOtD l- 



iiiiiiiiitlliirili<-iiiiiiiiiiiiTHiir-(oocoa> 



lilliliiiiiiiiilliiiiiiiltilit-iii-iiit-((N'na> 



||lllllllllllllllllllllllllllllliHli-('^-;l<^ 



|||lllllllllllltlllllllllllllllllHli-<iaO(M 



I I I I I I I I I I I I I I I I I I I I I I I I I I I i I I I I I I I -^tooi Ol 



I I I I I r I I I I I r I I I I I I I I I I I I I I I I I I I I i>-i(Ma>-« 



I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I li-K-HOIr- a> 



I I I I I I I I I I I I I r I I I I I I I I I I I I I I I I I I I I I r-( 00 >- CO 



C0'^t^t-0i'MC0^ra-^t-f-H00^1CDC0t'O'MO00i0C0i£^Ti<00OC0t-CD0iO'^-*C000Q0i-(O 00 
(000-*'»i*COO(MOOCOOO(M000100CDCO-tiO>000^«-'0«ra»0»OCOrHeOCO»niir30COOO CO 
1-li-lrHrHr-(r-tc^C<l(M<MC^COCOCO(MW(N0>1'M i-iCl'MC^C^<M!M(MC0C0C0-«JliO'^«O'^»OrJ< l(M 



»O0^U5if5c001O00(M--C0'^O'H''— 'OOeOOOirHOOCOOJi— ICOOOCOO^OOCOOO-*(MOrH ( ■* 

t^OSt-t-iOt— 00>01Cl"^»i^<Mu^tOCO^iCOCO*^OOOOriOf— (^r-(U^^00ir50-*0'ra»i t- 

r~, ^ ,_, ^ ,_, rH r-H rH f-t ni i-H !-♦ rH r-i n i-H rH rH r-l r-t i-l (M C^ (>» 01 Ol IM C^ IcO 



OOCl'MC^COCOCOt'C<ICOCOTl<^C<liOt'OCOOOSTl<000^0101C001COOO-*000'^<D^iO Tt< 
OOOt-t-OOt-C^O'— "'HCOt^OOvn-^OinNi— i-^OOfM-^fOOSCO^ICOOOt— rHCOO>»OCOCOif5-^ at 



<(N«C^<>»M<MtNIM 



O ^ C-1 CO tC V 



lOO^'MCO'^'i^cOt^OOOJO — C-loO'^iTicot-OOCiO — 'NCO-TiOCOt 



COCOCOCOCDCOCDCDcOCDl^t-r— I^t^t— t~t^t— l^C/^COC 
3 00 CO CO 00 C ~ -^ — - 



; 00 00 CO cc cc c 



30>0;01^Cri0^010i 



48 



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1897,] PUBLIC DOCUMENT — No. 23. 



49 



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1897.] PUBLIC DOCUMENT — No. 23. 



51 



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1889, 
1890, 
1891, 
1892, 
1893, 
1894, 
1895, 
1896, 
1897, 


E-i 



52 



WOECESTER LUNATIC HOSPITAL. 



[Oct. 



LIST OF PERSONS 

EilPLOTED IN THE WORCESTER LUNATIC HOSPITAL, SePT. 30, 1897. 



Superintendent and physician, per y 


ear, 






$3,000 00 


Assistant superintendent and physician, per year, 




1,500 00 


Assistant physician, 


■' 






1,200 00 


Assistant physicians (two). 








800 00 


Assistant physician, 


" 






400 00 


Junior assistant physicians (four), 








400 00 


Steward, 


" 






1,200 00 


Treasurer, 


" 






500 00 


Auditor, 


" " 






75 00 


Matron, 


" 






600 00 


Clerk, 


" » 






720 00 


Stenographers (two), 


per month 


1, 


40 00 


Supervisor (man), 


U It 




45 00 


Supervisor (woman), 


" 




30 00 


Assistant supervisors (men, two), each, " " 




35 00 


Assistant supervisors (women, two), 


each, " " 




25 00 


Marker of clothing, etc.. 


" 




20 00 


Seamstresses (two), each. 


11 a 




IS 00 


Attendants (men, thirty-seven), per 


month, 


. $23 00 to 25 00 


Attendants (women, forty-one), " 


- 




. U 00 to 18 00 


Night attendants (men, five). 






. 25 00 to 23 00 


Night attendants (women, five), " 


" 




18 00 


Baker, " 


'( 






50 00 


Assistant baker, " 


ii 






25 00 


Steward's assistant, " 


a 






30 00 


Office girl. " 


^i 






16 00 


Kitchen men (two), " 


" 




f 26 00 and 35 00 


Cooks (two), " 


Cl 




25 00 and 28 00 


Laundry man, " 


u 




30 00 


Laundress, " 


u 




, 


20 00 



1897.] 



PUBLIC DOCUMENT — No. 23. 



53 



Assistant laundry man, per month. 












$27 00 


Laundi-y girls (seven), " " 










$14 00 to 18 00 


Kitchen girls (four) " " 










14 00 to 16 00 


House girls (nine), each, " " 










14 00 


Carpenters (three) , per day. 










$2 50 and 3 00 


Painters (four), " " 










2 60 and 2 75 


Mason, " " 










. 3 00 


Helper, " " 












. 2 25 


Plumber, per year. 












900 00 


Engineer, » « _ _ 












1,000 00 


Firemen (two), " month, . 












40 00 


Farmer, " " , . 












60 00 


Housekeeper, " " . . 












20 00 


Farm laborers (thirteen), per month. 










$23 00 to 30 00 


Farm help (women, five), " " 










. 14 00 to 18 00 


Florist, 










45 00 


Coachinan, " " 










27 00 


Expressman, " " 










25 00 


Basement and yard man, " " 












25 00 



54 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



PKODUCTS OF THE FARM 



On Hand Oct. 1, 1897, and not delivered at the Hospital. 



Apples, . 

Beans, shell, lima. 

Beets, 

Brussels sprouts, 

Cabbage, . 

Cauliflower, 

Celery, 

Corn fodder, . 

Egg plant. 

Ensilage, . 

Hay, 

Hay, swale, 

Mangolds, 

Oat fodder. 

Onions, 

Parsley, 

Parsnips, 

Pears, 

Rye, . 

Sage, 

Spinach, 

Squash, . 

Straw, rye. 

Turnips, . 

Tomatoes, 



40 barrels, 
18 bushels. 
200 bushels. 
5 bushels. 
7,500 heads. 
1,200 pounds. 
6,000 heads, 
10 tons. 
50 

400 tons. 
350 tons. 
17 tons. 
50 tons. 
20 tons. 
500 bushels. 
5 bushels. 
200 bushels. 
20 bushels. 
20 bushels. 

5 bushels. 
100 bushels. 

18,000 pounds. 

6 tons. 
200 bushels. 

28 bushels. 



1897.] 



PUBLIC DOCUMENT — No. 23. 



55 



SUMMARY OF FARM ACCOUIS^T. 



Dr. 



Blacksmithing $291 

Bread 200 

Butter 519 

Current expenses, .... 10 

Fertilizers 869 

Fuel, 138 

Furnishings 4 

Furniture 31 

Grain and meal, .... 3,122 

Groceries, etc., .... 1,528 

Hay, 50 

Lights 183 

Live stock 1,686 

•Meat 1,719 

Pasturage, 120 



Amount carried foricard. 


$10,475 01 


845 barrels apples, . 


$845 00 


302 bunches asparagus, . 


30 20 


84 bushels lima beans, . 


11 50 


35^ bushels string beans. 


35 50 


25 bushels carrots, . 


12 50 


235 bushels beets, . 


133 65 


302 barrels cabbage. 


385 25 


1,084 bunches celery. 


106 72 


2,229 cucumbers, . 


60 23 


20,836 cucumbers (pickle), . 


41 67 


lOi bushels cauliflower, . 


17 25 


1,121 boxes currants. 


112 10 


2,431 dozen corn, . 


243 65 


130^ pounds chickens, . 


26 10 


1,560 gallons cider, . 


124 80 


1745 bushels dandelions. 


119 25 


457 dozen eggs 


106 50 


23,470 pounds hay, . 


234 70 


125 pounds horseradish. 


10 00 


357 dozen lettuce, . 


214 20 


Live stock sold. 


970 75 


289,474 quarts milk. 


11,578 96 


72 melons 


9 25 


56J bushels onions, . 


56 50 


376 bushels oats, 


116 56 


114^ bushels peas, . 


142 76 


10 bushels pears, 


10 00 


140 bushels parsnips, 


75 00 


25,434 pounds pork. 


1,253 56 


2 bushels parsley, . 


2 00 


Plants, 


11 00 



Amount brought forward. 



$10,475 01 



Repairs, 160 14 

Salt 25 27 

Seeds 148 88 

Sugar, 343 02 

Tools 25 73 

Wages 5,825 07 

Water 194 41 

$17,197 53 
Net gain for year ending Sept. 

30, 1897 $3,783 46 



Cb. 



Amount carried forvmrd, 



17,097 11 



Amount brought forward, 

8,572 pounds rhubarb, 
68^ boxes raspberries, 
15,330 radishes, 

4 bushels Swiss chard, 
60 bushels squash (summer), 
12 tons squash (winter), 
1,495 boxes strawberries, 
841 bushels spinach, 
4161 bushels turnips, 
274^ bushels tomatoes, 
2 cords wood, . 
Standing wood on lot, 
3,220 pounds bones, 
1,118 loads gravel, . 
200 posts, . 

2 tons straw, . 
30 bushel-boxes, 
Cash for making cider, 
Cash for corn and tomatoes. 
Cash for drawing wood, 

5 dozen egg plants, 
5 bushel peppers, . 

3 bushels rye, . 
3 telegraph poles, . 
2 hides. 

Ice, .... 
97 pounds popcorn, 

Sod 

835 railroad ties, 



$20,980 99 



$17,097 11 

204 01 
13 70 
117 60 

2 00 
60 30 

240 00 
179 40 

42 25 

166 85 

257 25 

7 25 

2,000 00 

16 10 
111 80 

30 00 

26 00 

3 00 

1 35 
116 82 

9 60 

5 00 

50 

3 00 
5 00 

4 35 

3 00 

4 85 

2 40 
250 50 

$20,980 99