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

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4 



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



SIXTY-SIXTH ANNUAL EEPOET 



THE TEUSTEES 



Worcester Lunatic Hospital, 



TWENTY-FIRST ANNUAL REPORT OF THE TRUSTEES 



WOECESTER INSANE ASYLUM AT WORCESTER, 



Year ending September 30, 1898. 



BOSTON : 

WRIGHT & POTTER PRINTING CO., STATE PRINTERS, 

18 Post Office Square. 

1899. 



-r 



OFFICERS OF THE HOSPITAL. 



TRUSTEES. 



A. GEORGE BULLOCK 
THOMAS H. GAGE, 
GEORGE W. WELLS, 
ROCKWOOD HOAR, 
DAVID T. DICKINSON 
SARAH E. WHITIN, 
FRANCES M. LINCOLN, 



worcestek. 

wokcester. 

soijtiibkidge. 

woucestek. 

Cambridge. 

WlIITINSVILLE. 

Worcester. 



RESIDENT 
HOSEA M. QUINBY, M.D., . 
ALFRED L NOBLE, M.D., . 
ADOLF MEYER, M.D., . 

REVERE R. GURLEY, M.D., 
A. ROSS DEFENDORF, M.D., 
MARGARET A. FLEMING, M.D., 
HARRY W. MILLER, M.D., . 
WALTER D. BERRY, M.D., . 
ALBERT E. LOVELAND, M.D., 
ALBERT M. BARRETT, M.D., 
THOMAS T. SCHOULER, . 
LILA J. GORDON, . 
S. JOSEPHINE BRECK, 
JOSEPH F. REYNOLDS, 



OFFICERS. 

Superintendent. 
Assistant Superintendent. 
Assistant Physician and 
Director of Laboratory. 
Assistant Physician. 
Assistant Physician. 
Assistant Physician. 
Junior Assistant. 
Junior Assistant. 
Junior Assistant. 
Junior Assistant. 
Steward. 
Matron. 
Clerk. 
Farmer. 



NON-RESIDENT OFFICERS. 

ALBERT WOOD, Treasurer. 

GEORGE L. CLARK, Auditor. 

ALVAN G. LAMB, Engineer. 



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Cnmmnitixrmltl^ 0f li^assacl^its^tts* 



TEUSTEES' EEPORT. 



To His Excellency the Governor and the Honorable Council. 

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

The Board has visited the hospital once a month as required, 
and its individual members have made frequent and unannounced 
visits at other times. They have examined all parts of the 
house thoroughly, inspected the food as to its quality and 
quantity, and seen the methods used in its preparation and dis- 
tribution ; they have gone through the wards and listened 
patiently to any and all complaints made by patients ; and they 
have carefully examined the accounts and disbursements of 
the institution, and made themselves familiar with the con- 
dition of its finances. They have at all times been impressed 
with the orderliness and cleanliness of the wards, with the in- 
dividual care given the patients, and the constant efibrt that is 
being made to employ and interest them. 

They have noticed with special interest the progressive 
spirit animating the medical department and the high character 
and great value of the work done in the laboratory. 

The infirmary wards, provided for by an appropriation of the 
Legislature of 1896, are practically completed and will soon be 
occupied. The trustees feel that the site for these wards was 
most happil}'' chosen, and that they have been so constructed as 
to in no way detract from the symmetry of the building archi- 
tecturally. Facing the south and open on three sides, they are 
light, airy and full of sun through the day. The general 
arrangement of their interior is certainly pleasing and con- 



6 WORCESTER LUNATIC HOSPITAL. [Oct. 

venient, and they should form a valuable addition to the equip- 
ment of the hospital, and will no doubt be appreciated by the 
patients for whose comfort they were designed. 

During the summer the heating plant of the institution has 
been overhauled and new boilers installed to replace old ones 
that had been in use since the opening of the building. A new 
kitchen has also been completed. All of this work, although 
done rapidly from necessity, is thorough and substantial in 
every respect. Both buildings have been erected within the 
appropriation made by the Legislature for this purpose. The 
extension provided for in the rear of the centre building, for 
the employees and patients' work room, will soon be begun. 
When this is finished and a nurses' home provided for, the in- 
stitution will be well equipped in the way of buildings ; and the 
trustees see no reason why they should be obliged to again call 
upon the State for assistance for many years to come. 

The Board has lost during the year, by resignation, two 
members who have long been actively identified with its inter- 
ests and the interests of the institution under its charge, — 
Francis C. Lowell and Henry C. Nourse. We shall miss their 
valued counsel and assistance, and we regret that the new 
positions of trust to which they have been called made their 
resignation from this Board necessary. 

Respectfully submitted, 

A. GEORGE BULLOCK. 
THOMAS H. GAGE. 
GEORGE W. WELLS. 
ROCKWOOD HOAR. 
DAVID T. DICKINSON. 
SARAH E. WHITIN. 
FRANCES M. LINCOLN. 
WoRCESTEE, Sept. 30, 1898. 



1898.] PUBLIC DOCUMENT — No. 23. 



YALUE OF PERSONAL ESTATE. 

Sept. 30, 1898. 



Live stock on the farm, $9,775 00 

Produce of the farm on hand, 10,000 00 

Carriages and agricultural implements, 6,450 00 

Machinery and mechanical fixtures, 29,509 33 

Beds and bedding in inmates' department, .... 29,280 32 

Other furniture in inmates' department, 22^481 82 

Personal property belonging to the State in superintendent's 

department, 26,922 42 

Ready-made clothing, 1,659 20 

Dry goods, . 792 55 

Provisions and groceries, 3,967 81 

Drugs and medicine, 900 00 

Fuel, 1,406 50 

Library, 4,500 00 

Other supplies undistributed, 5,276 39 

Pipes and radiators, . 39,700 00 

Total, fl92,621 34 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



TREASURER'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, 

1898: — 

Eeceipts. 

Cash on hand Sept. 30, 1897, $44,031 90 

Received of the Commonwealth for support of patients, . . 37,278 75 

of cities and towns for suj^port of patients, . . 86,399 08 

of individuals for support of patients, . . . 43,099 90 

for interest, sale of produce, etc., .... 5,601 63 

belonging to patients, 2,560 66 



$218,971 92 



The expenditures for the year have been as follows : 

Salaries and wages, f 

Provisions and supplies, viz. : — 
Meat of all kinds. 
Fish of all kinds, 
Fruit and vegetables, . 
Flour, .... 
Grain and meal for table. 
Grain and meal for stock, 
Tea, coffee and chocolate. 
Sugar and molasses, . 
Butter and cheese. 
Salt and other groceries. 
All other provisions, . 

Total for provisions and supplies, 



Clothing, .... 

Fuel, 

Lights, .... 

Water, 

Medicine and medical supplies, 
Furniture, beds and bedding. 
Transportation, . 

Amounts carried forward. 



51,585 99 



$13,177 


22 


3,041 


79 


6,502 


62 


6,807 


50 


627 


68 


4,512 


31 


2,052 


68 


4,341 


38 


8,884 


51 


4,484 80 


860 


49 




r\A oqo qa 




0'±,Lij £i VO 


$8,756 


65 


8,077 


53 


4,140 


60 


3,005 


09 


1,575 


96 


4,148 


77 


254 


96 


$29,959 56 $115,878 97 



1898.] 



PUBLIC DOCUMENT — No. 23. 



Amounts brought forward. 

Ordinary repairs, 
Trustees' expenses, 
Pathological department, . 
All other current expenses, 



Total current expenses, .... 

Extraordinary expenses : — 

Water sections, f 8,012 88 

Sewer and water connections to new 

infirmary wards. 
House telephone system, . 
Fire-proof vault, . 

Silo, 

Lawn fund, .... 
Boilers and setting same, , 
Tramway, .... 

Undertaking, 

Cash refvmded, . 

Cash refunded patients (on deposits), 3,272 97 

Total extx'aordinary expenses, . 



8,856 55 


pii-iJjO 


41 84 




1,151 82 




12,833 11 






52,8^ 





,721 85 



. 2,201 


32 


. 2,122 


08 


. 3,769 


19 


. 294 


43 


. 1,500 


00 


. 2,398 


06 


. 1,033 


12 


. $308 


40 


23 


29 



$21,331 08 



3,604 66 



Cash on hand Sept. 30, 1898, 



24,935 74 

$193,657 59 
25,314 33 



$218,971 92 
Resources. 
Cash on hand, $25,314 33 



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



9,176 60 
21,328 98 
13,036 67 



Liabilities. 
Due for supplies and impi'ovements, 
for salaries and wages, 
to patients (on deposits), . 



^8,658 17 
5,277 73 
1,205 69 



^,856 58 



15,141 59 



Respectfully submitted, 



3,714 99 



Oct. 1, 1898. 



ALBERT WOOD, 

Treasurer. 



10 



WORCESTEE LUNATIC HOSPITAL. 



[Oct. 



SPECIAL APPEOPRIATIONS. 



Appropriations. 



Amount 
Expended. 



Balance 
Oct. 1, 1898 



For construction in new infirmary 
wards, 

New boiler house and boilers, 

Construction of new kitchen. 

Total, 



$80,000 00 
11,000 00 
18,000 00 



^57,870 90 

11,000 00 

8,409 91 



$109,000 00 



$77,280 81 



2,129 10 



9,590 09 



$31,719 19 



INCOME OF IJBRAKY FUNDS, Etc. 



Lewis Fund. 

Cash on hand Sept. 30, 1897 $5 69 

Interest on Springfield bond, 70 00 

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

Deposit in Wox'cester County Institution for Savings, 20 00 

Cash on hand Sept. 30, 1898, 50 69 

Wheeler Fund. 

Cash on hand Sept. 30, 1897, $24 73 

Dividends and tax rebate, 210 39 

Expended for books, $175 50 

Cash on hand Sept. 30, 1898, 59 62 



From principal. 
Dividends, . 



Manson Fund. 


. $123 44 
47 00 



$75 69' 
$75 69 

$235 12 
$235 12 

$170 44 



1898.] 



PUBLIC DOCUMENT — No. 23. 



11 



Laavn Fund. 
Principal established March 30, 1898, . . . $1,500 00 

Sale of wood, 164 00 

Dividend, 15 00 



Deposited in Worcester Mechanics Savings Bank, 



$1,669 00 
f 1,669 00 



Library Fund and Lawn Fund. 

Lewis Fund Investment. 

Springfield bond, 

Worcester County Institution for Savings, 
Cash on hand Sept. 30, 1898, .... 

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, 1898, 

Manson Fund Investm,ent 
Worcester County Institution for Savings, 

Total of library funds. 

Lawn Ftmd. 
Worcester Mechanics Savings Bank, 



Land Account. 



Cash on hand Sept. 30, 1897, 

Remitted to State Treasurer, 
Cash on hand Sept. 30, 1898, 



Expenditures. 



fl,140 00 




134 90 




50 69 






$1,325 59 




f840 00 




. 750 00 




1,145 86 




. 1,719 49 




59 62 







4,514 97 




1,130 97 


• 


$6,971 53 


• 


$1,669 00 




$631 la 


$500 00 




131 13 





Respectfully submitted, 



$631 13 



ALBERT WOOD, 

Treasurer. 
Oct. 1, 1898. 

Worcester, Mass., Oct. 24, 1898. 
I hereby certify that I have this day compared the treasurer's statement of disburse- 
ments for the year ending Sept. 30, 1898, with the vouchers on file at the Worcester 
Lunatic Hospital, and find them to agree. I have also inspected the securities represent- 
ing the invested funds of the institution, and find that their market value is as stated. 

GEO. L. CLARK, 

Auditor of Accounts. 



12 WOECESTER LUNATIC HOSPITAL. [Oct. 



SUPERINTENDENT'S REPORT. 



To the Trustees of the Worcester Lunatic Hospital. 

I herewith respectfully submit the following report of the 
hospital for the year ending Sept. 30, 1898, it being the sixty- 
sixth annual report. 

There remained at the hospital Oct. 1, 1897, 867 patients, — 
382 men and 485 women. During the year 488 patients — 
257 men and 231 women — were received; 481 patients — 261 
men and 220 women — were discharged; and 57 men and 44 
women died, leaving at the end of the official year 874 pa- 
tients, — 378 men and 496 women. Of this number, 274 were 
supported by the State, 472 by cities and towns and 160 
by friends. Of the 481 persons discharged, 121, including 2 
habitual drunkards (women), were reported recovered, 56 as 
much improved, 70 as improved and 125 not improved ; 8 
were discharged not insane. Ten men and 16 women were re- 
moved by the overseers of the poor ; 32 men and 24 women 
were discharged to the care of the Board of Lunacy and 
Charity, to be removed from the State ; 17 men and 13 women 
were transferred to the Epileptic Hospital ; 1 5 men to the 
Boston Lunatic Hospital ; 1 man and 30 women to the Med- 
field Asylum ; 15 women to the Worcester Insane Asylum ; 1 
man to Bridgewater, 1 to Taunton and 1 to the McLean Hos- 
pital ; 5 escaped, and were not returned to the hospital or 
accounted for at the end of the official year. Of the 8 persons 
discharged as not insane, 6 of them were cases of simple over- 
indulgence in alcohol, and the 2 others, one of whom was com- 
mitted from the Reformatory for Women and the other from 
the Cambridge jail, were evidently malingers. 

The number of patients remaining in the hospital at the 
close of the official year is practically the same as it was at 



1898.] PUBLIC DOCUMENT — No. 23. 13 

the beginning, while our daily average, 871.4, has been slightly 
higher than last year. 

The percentage of recoveries, calculated upon the number of 
discharges and deaths, was 20.8 ; calculated upon the number 
of admissions, it was 24.78, — a material increase over that 
of last year. 

The death rate was 11.5 calculated upon the average number 
of patients, and 7.4 calculated upon the total number under 
treatment. 

In reviewing the work undertaken in the medical depart- 
ment, we find ourselves already confronted with an embarrass- 
ment of riches. Our cases are so numerous and the means at 
our disposal for their examination so relatively small that we 
have not always been able to work them up as thoroughly as 
is desirable or necessary, if our histories are to be of use for 
future study. Our young men have, I believe, shown all the 
industry and zeal that could reasonably be required in the work 
allotted to them ; but, notwithstanding all this, we find many 
gaps in our cases which remain unfilled simply from a lack of 
time to make the examination necessary, or from a failure to 
make it at the moment when such an examination is alone 
worth making. 

To study insanity successfully, it is not sufficient to study 
simply the condition of the brain and the nervous system ; the 
whole realm of medical knowledge must be brought under con- 
tribution, and every organ of the body questioned. In general 
diseases it is often possible to infer from the symptoms present 
what special organ is at fault, and to limit an examination to 
that ; but no such inference is allowable if one would come at 
the exact cause underlying the disease in a given case of in- 
sanity. To thoroughly examine an insane person requires, 
therefore, not only skill, but time ; and the neglect to get a 
statement, either positive or negative, as to the condition of 
certain organs, may be fatal to the records of the case when 
the time comes for summing them up. We cannot believe, 
therefore, that our work has been laid out upon too broad a 
basis, nor can we bring ourselves to feel that the proper way 
out of this difficulty is to limit our investigations to a certain 
number or class of cases. It might be feasible perhaps to 
limit our admissions and thus relieve us somewhat. It would 



14 WORCESTER LUNATIC HOSPITAL. [Oct. 

be a great relief, certainly, if the transient cases could be 
eliminated, — the cases that have no settlement in Massachu- 
setts, and as a consequence are removed by the State Board 
of Lunacy and Charity, and sent out of the State a few days or 
weeks after they are committed. There were 56 such cases 
this year. Few of them were in the hospital long enough to 
receive any benefit from treatment ; and certainly, from a 
medical stand-point, the time spent in taking their histories 
and in working up their cases was simply thrown away. At 
the time of their admission we have no way of knowing which 
of our patients are likely to come under this head. 

There are many problems in regard to insanity which can 
only be worked out by keeping in touch with a considerable 
number of cases through life, or for a long number of years, 
at least. It is our plan to do this, as far as possible ; and we 
can, of course, best do it when the patients remain in the hos- 
pital for a reasonable length of time, and when they live in the 
neighborhood of the institution and can be followed to their 
homes after their discharge. From this point of view, it would 
undoubtedly be well if the commitments to this hospital could 
be limited to persons from Worcester and Middlesex counties. 

It would also help matters somewhat, I have no doubt, and 
make it easier for all the hospitals, if a change were made in 
the method of disposing of the Boston commitments. Under 
the present arrangement these patients are sent to each hospital 
— with the exception of Northampton — alternately, for a 
month or more. No insane hospital can receive from three to 
five new cases each day for a month — the majority being ex- 
cited cases — without getting swamped in their work. This 
at least is what happens when it comes our turn to receive 
the Suffolk County commitments. Instead of requiring the 
hospitals to receive these commitments, as is now done, it 
would be more satisfactory if they were sent to the various 
hospitals for a week, or at most two weeks, at a time. Perhaps 
the new Board of Insanity may assist us in this direction. 

But, were everything done that has been indicated, or that 
could be done, I fear that we should still be unable to accom- 
plish the work placed before us in as thorough a manner as it 
should be done, with our present help. Aside from our his- 
tories and the matters which pertain directly to the cases in 



1898.] PUBLIC DOCUMENT — No. 23. 16 

hand, we are accumulating a mass of material bearing upon 
the specialty, which would be of great value were it properly 
worked up. This material should be utilized as we go along, 
or much of its value is likely to be lost. While this does not 
belong strictly to the medical work of this institution, it is 
work which it is worth the while of the hospital to do and of 
the State to foster. It can be done nowhere so well as in a 
large hospital, for nowhere else is the material at hand. Here 
we have not only material in abundance, but — and I say it in 
no sense as a mere compliment to the director of our labora- 
tory — talent and ability of the highest order, ready to devote 
itself thereto, were adequate means for doing so at hand. In 
other and neighboring States they do not hesitate to encourage 
such work, and many of them appropriate for this purpose sums 
which are truly vast as compared with the modest outlay we 
anticipate. Such additional assistance as would be required to 
meet our wants could be obtained without difficulty. With our 
present arrangements, our junior assistants leave us at the time 
when they are beginning to be most useful to the institution. 
So far all of them have expressed a desire to remain here a 
second year. Their services could no doubt be secured at but 
slight advance in the way of salary ; and, if one or more of 
them could be retained as second year junior assistants, it 
would be very desirable. The new Board of Insanity may 
think it within their province to advise us here also, and per- 
haps give us countenance and encouragement in extending our 
work in this direction. 

The two infirmary wards, work upon which was begun last 
year, are now practically completed and will soon be ready for 
occupation. They have been substantially built, after plans 
which were described in detail in the report of 1896. In their 
construction they will compare favorably with the original build- 
ings, and in this connection I feel it a duty and a pleasure to 
<;ommend the contractors, Messrs. J. W. Bishop & Co., for 
the good quality of their work and the very satisfactory way in 
which they have carried out their contract. It is certainly to 
their credit and to that of their foreman that the buildings have 
been completed without accident of any kind, and without in- 
convenience to the inmates or disturbance of the ordinary rout- 
ine of the hospital. 



16 WOECESTER LUNATIC HOSPITAL. [Oct. 

In compliance with the request of your Board, the Legis- 
lature of 1897 granted the hospital an appropriation of $69,000 : 
$11,000 for a boiler house and three boilers, $18,000 for a new 
kitchen and $40,000 for an addition to the rear of the executive 
building, to better accommodate the employees and to furnish 
work rooms for patients. Ground was broken for the boiler 
house and kitchen in July, and the work has since been pushed 
as rapidly as possible. The boiler house is now completed, 
and five new boilers, each 72 inches in diameter and 19 feet 6 
inches long, have been installed. The kitchen is also very 
nearly done. 

At the time of making the plans and estimates for the boiler 
house it was thought that two of the old boilers could still be 
used. It was necessary, however, to take them out in order 
to make room for the boiler house, and in doing this it was 
found that they were much worn and that neither of them was 
in a condition to reset. The trustees decided, therefore, to sup- 
ply their places with new ones. These additional boilers and 
the setting and piping of the entire bank have been provided 
for out of the funds of the institution. The contract for the 
boilers was awarded to Stewart & Sons of Worcester. The 
piping, setting, etc., has been done by our own employees, 
under the direction of our mason and engineer. 

Notwithstanding the considerable expense involved, it was 
thought best to take advantage of the opportunity now afibrded 
to remodel our steam plant, it never having been quite satis- 
factory from the first. The returns from many of the radiators^ 
and especially from those in the basement and on the first floor, 
were too nearly on a level with the water line of the boilers. 
To obviate this, the new boilers were depressed twelve feet. 
This has necessitated extensive excavation, and the construction 
of a tunnel sixty feet long, to enable us to discharge the ashes 
from the boilers at grade ; but it has at the same time given us 
a much-needed addition to our coal pocket, and a room over 
this which will be of use as a dynamo room whenever we are 
ready to put in an electric plant. An air-duct, 8 feet wide by 
8 feet high, has been run from the executive building to the 
boiler house and connected with the ducts (of like dimensions) 
running to the male and female wards. The 12-inch steam 
mains have been taken out of the brick trenches in which they 



1898.] PUBLIC DOCUMENT — No. 23. 17 

were formerly run and placed in these ducts, where they can 
more easily be gotten at and protected and repaired ; the steam 
and water connections for the new kitchen run through the same 
ducts. 

When the subject of a kitchen was first considered, it was 
tliought, for many reasons, desirable to place it on the upper 
story of the proposed addition to the executive building, and 
plans were so drawn ; but it was found that this would be an ex- 
pensive building, if constructed with due regard to safety from 
fire, and this plan was, therefore, given up and the present one 
substituted therefor. The kitchen as now located is entirely 
separate from the other buildings. It fills the space at the 
west of the laundry formerly used for a clothes yard, and is 
connected with the main building by a short corridor. It is 
one story high, covers a ground space of 104 by 103 feet, and 
is built of stone from the quarry upon the grounds, and in this 
respect conforms to the rest of the house. It comprises a 
kitchen proper, a scullery, a bakery (with the necessary closets 
and pantries for each), a bread room, a room for storing flour, 
a meat room, and three refrigerators with a combined storage 
capacity of two hundred tons of ice. As in the old kitchen, 
the floor is on a level throughout with the basement floor of 
the main building, making the distribution of food and supplies 
easy. The doors for the reception of supplies and for the re- 
moval of the garbage are located at the rear of the building 
and entirely out of sight from the wards. The change in this 
respect from the conditions about the old kitchen is very 
marked and satisfactory. From the rear of the women's wards 
the outlook is now upon the unbroken front of a building which 
not only hides its own debris but screens the unsightly coal 
sheds as well, and is not itself unpleasing architecturally. 

As the extension of the executive building will occupy the 
site of the old kitchen, nothing can be done towards its erec- 
tion until the new kitchen is finished and occupied. We shall 
then commence excavating for the foundations of this building. 
This work will be carried on through the winter, and will be 
done with the labor of patients, thus giving them employ- 
ment and making a very material saving in the expense of 
construction. 

Heretofore we have had no proper place in which to store 



18 WORCESTER LUNATIC HOSPITAL. [Oct. 

any considerable part of the great number of records and 
valuable papers which have been accumulating from the open- 
ing of the institution in 1834. The records of former patients 
(which have been preserved in an unbroken series), although 
not of much use as medical records, are exceedingly valuable 
in other directions, and, together with the records pertaining 
to the past business transactions of the institution, have to be 
consulted frequently. To provide a safe and convenient place 
for preserving these and the much more valuable histories of 
our patients as now taken, we have built a fire-proof vault, with 
two storage rooms, each 7 by 14 feet. It is entirely outside of 
the building, on the west side of the corridor connecting the 
wards and the chapel wing with the centre, and occupies the 
space heretofore devoted to a piazza. The entrance is from 
the centre building and is convenient to the general office. It 
is built after the manner of a safety deposit vault, the exterior 
structure being of stone, to conform with the original building. 
The cost of the vault was $4,226. 

One of the most valuable and labor-saving improvements 
made during the year has been the introduction of a system of 
telephones, connecting the wards and all departments of the 
hospital with each other. The system was devised and put in by 
Messrs. Plummer, Ham & Richardson of this city. It is auto- 
matic in its action, the various connections being made by simply 
pushing in a button indicating the station wanted. All stations 
are not represented on each box, however, but only such as it is 
desirable to have directly connected, or such as a given station 
has occasion to use most often. To call stations not on one's 
list, a connection must be made through the central office. A 
call bell in each ward and in various parts of the building, with 
a system of signals, makes it easy to call and communicate with 
any of the officers, wherever they may be. The system is sold 
outright. The sixty-one stations, with lead cables to the farm 
and out-buildings cost $2,000. 

Drs. E. D. Boynton and G. A. Tripp left the service of the 
hospital at the beginning of the official year, to enter general 
practice. Drs. R. R. Gurley and A. R. Defendorf were pro- 
moted from junior assistants to assistants, in their place. 

Of the remaining junior assistants for 1896-97, Dr. Emma 
W. Mooers received an appointment as pathologist at North- 



1898.] PUBLIC DOCUMENT — No. 23. 19 

ampton, and Dr. Edwin Leonard, Jr., that of assistant at 
McLean Hospital. 

The junior assistants for this year have been Drs. H. W. 
Miller, W. D. Berry, A. M. Barrett and A. E. Loveland. 

At the close of his service as junior assistant Dr. Berry will 
remain here as assistant, in the place of Dr. Defendorf, who 
has received an appointment as pathologist at Middletown, 
Connecticut, and lecturer on insanity and nervous diseases at 
the Yale Medical School. Dr. Barrett, who came here on a 
year's leave of absence, returns to his old position at the 
Mt. Hope Hospital, Iowa. Drs. Miller and Loveland go to 
McLean. 

The current expenses, less the amount received for articles 
sold, have been $168,721.85 ; dividing this by 871.4, the daily 
average number of patients, gives $188.06 as the annual cost 
of support, which is equivalent to a weekly cost of $3.60. 

H. M. QUINBY, 

Superintendent. 
Worcester Lunatic Hospital, Sept. 30, 1898. 



20 WORCESTER LUNATIC HOSPITAL. [Oct. 



SPECIAL REPORT OP THE MEDICAL 
DEPARTMENT. 



While it seems exceedingly distasteful to fall into the habit of 
describing plans for the future, the execution of which is by no 
means always certain, it is hardly possible to give a correct 
statement of what has been done without outlining briefly the 
guiding principle. After all, this has been our working prin- 
ciple from the first, and, inasmuch as this holds, it may be 
stated without danger of provoking the above criticism. 

The work in a hospital must centre in the duties to the pa- 
tients ; the eflforts of the medical staff must tend towards 
increasing the efficiency of the duties towards the patients 
and their families. This, I think, is the conviction with all 
those seriously interested in hospitals for the insane. 

The ways to achieve this are many. The most prominent 
and most successful one has no doubt been the efibrt towards 
increase of the personal care of patients, the nursing, which 
has been developed so efficiently in many of the American hos- 
pitals. It had its wholesome effect both on the patients and 
on the physicians, although the latter in many places have 
hardly developed beyond what might be called a medically 
trained head nurse. In a few hospitals more purely medical 
work was introduced, in the form of pathological anatomy and 
perhaps bacteriology ; and the examination of urine and sputa 
and lately also of blood has been relegated into the hands of 
a "pathologist." While the immediate and perhaps even the 
remote results of this improvement probably remain behind 
the value of the improvement in the nursing, it has at least 
led many of us to further problems, and especially to the con- 
viction that the nursing of the patient must be supplemented 
by careful clinical observation, and that true medical study 
must begin before the patient is dead. It is really a calamity 



1898.] PUBLIC DOCUMENT — No. 23. 21 

that the word pathology should more and more have singled 
out the study of and interest in a few technical methods largely 
relating to the microscopic examination of dead tissues and 
excreta and of the flora and fauna of human symbiosis, in the 
minds at least of a great part of the medical men, and that the 
larger principles of general pathology seem superfluous, just 
as if the current grasp of the "theory and practice of medi- 
cine " would embrace all that is fit to be known in one's daily 
work as a physician in hospital practice. 

Psychiatry is undoubtedly the one branch of medicine for 
which pathology in the narrow sense of pathological anatomy 
and bacteriology has done very little and promises little. Here 
the pathology of the clinicians, the broad inquiry into disease 
processes, must come to its right first. The close relation of 
neurology and psychiatry has led many to believe that the only 
legitimate research work of the alienist was pathological anat- 
omy of the nervous system ; and, when we look through the 
bulk of valuable contributions from alienists, we see indeed 
that a Meynert, a Westphal, a Hitzig, even a Wernicke, have 
devoted a large share of their work to studies of the nervous 
system, which have nothing to do with psychiatry, not to speak 
of Flechsig, Siemerling, Moeli and others who are professors 
of mental diseases on ground of their neurological work only. 
Psychiatry proper has indeed moved either in syraptomato- 
logical studies or in semi-philosophical considerations, and 
Kahlbaum's eflbrts to replace the metaphysical or roughly 
symptomatic systems by a sound clinical empiricism and gen- 
eral pathological thought came just in the days when the great 
discoveries in cerebral localization overshadowed everything 
else, and attracted the enthusiasm of most young investigators. 
Kraepelin was one of the first who had the courage to build a 
psychiatry on lines foreshadowed by Kahlbaum, and with prin- 
ciples derived from the pure clinical observation and a view of 
psychology of his own. 

The work at our hospital was begun with a desire to do jus- 
tice to the opportunities for an improvement of medical knowl- 
edge necessarily ofi'ered by the large amount of observations 
which could be collected. The experience in Kankakee had 
shown conclusively that pathology begun on the post-mortem 
table failed to make its point almost along the whole line. 



22 WORCESTER LUNATIC HOSPITAL. [Oct. 

Notwithstanding many difficulties, a plan for more clinical in- 
vestigation of the cases was started there, in order to furnish 
the post-mortem anatomy a few data of live pathology at least. 
In the organization of the work in Worcester the greatest 
weight was laid on this point, and an equally great stress on 
the necessity of dropping the distinction between " interesting" 
and "uninteresting" cases. Ever since text-books of mental 
diseases were written, a few impressive types of patients had been 
described to the readers as instances of diseases, and for the 
majority of the patients we are forced to admit that we might 
class them in more than one of the standard groups, but in none 
quite justly. This should be enough evidence that this favor- 
itism in clinical psychiatry has not brought us far. The plan 
is, therefore, to observe all patients with the same accuracy 
and with all those questions in view which seem now to require 
an answer for the purpose of elimination of uncertainties in 
clinical systematization. 

We stand now before questions such as our forefathers met 
in the "continued fevers." Internal medicine has learned to 
divide them into miliary tuberculosis, typhoid fever, protracted 
forms of pneumonia, malaria, " status gastricus febrilis," fever 
of anemia, of hysteria, — more or less distinct pathological and 
nosological entities ; the " transition forms" are plainly shown 
to become rarer and prove to be at best mixed forms; i. e., 
patients with two disease processes, or insufficiently observed 
cases. We must make use of this experience in psychiatry ; 
search for distinctive features of disease processes, and distrust 
any system which leaves out the majority of patients as now 
classified, or classifies only by main force. 

Physicians trained in our bacteriological era are prone to 
think that most of the above divisions of "continued fever" 
are a product of the last decades, and that only the latest re- 
sults of what I called above the study of the flora and fauna of 
man have settled these problems. They certainly have fur- 
nished the most decisive and obvious demonstrations ; but to 
deny the older clinicians the ability of having clearly foreseen 
most of these divisions and of having been able to act accord- 
ingly, would be a grave injustice and ingratitude towards those 
who have ably prepared the ground for pathological research 
in the restricted sense of the word by putting forth clinical 



1898.] PUBLIC DOCUMENT — No. 23. 23 

problems as guides of research. This should be remembered 
before we deny psychiatry the right of a hopeful existence, al- 
though a pathological anatomy and bacteriology of the brain 
have furnished but few data, and physiological chemistry is too 
much in its infancy to give us the much-needed help in an ac- 
cessible form. 

All these points were carefully weighed when our work was 
organized, and our plan took the following form : — 

To the greatest extent possible the work is to be limited to 
what is essential for the care of the patients, the training for 
greatest efficiency of the medical work and the promotion of 
promising and important general questions, such as the de- 
velopment of a real record of the experience of the hospital, 
which would form a natural array of facts, preferable to text- 
book traditions. 

In analogy with the proverb, "Noblesse oblige," we may 
well say that opportunities create obligations. Hospitals ofl'er 
opportunities which a private practice can never afford, and 
the public who support a hospital should be trained to demand 
a use of the opportunities, returns from the experience to the 
benefit of those physicians who cannot avail themselves directly 
of the advantages of hospital work. Such returns are being 
furnished from most general hospitals ; the State hospitals for 
the insane have often enousfh been taken to task for not doing 
the same, and desperately unconvincing replies have frequently 
been the echo of such criticism. It is true that a few of the 
enumerated difficulties cannot be ignored, and corroborate the 
conviction that the work in State hospitals must gravitate to 
the best possible care of the patients, and that every other effort 
must bear as directly as possible on the efficiency of the med- 
ical work. The accumulation of scientific knowledge cannot 
be the uppermost aim, but it finds its place naturally enough 
in a careful arrangement of the work which must be done. 
Careful histories must be taken, accurate methods of examina- 
tion of patients must be used, prognoses must be given the 
friends, and indications for treatment must be formulated. 
And, when autopsies are made, they must be fit to give an 
answer to the most important questions, — not merely to the 
point interesting a coroner, the " cause of death," but to ever 
so many essential problems of etiology and differential diag- 



24 WORCESTER LUNATIC HOSPITAL. [Oct. 

noses of pathological anatomy. It is the fatal division of 
practical and theoretical, of routine and research work, which 
furnishes so many excuses to those who would like to separate 
reason and sense from the mere comfort of their daily duties. 

Apart from the conviction that the odd and " uninteresting" 
cases were to be given due attention as well as the " pets" of 
literature and tradition, the necessity of considering the entire 
course of diseases and their influence on the later life of the 
patient has received much consideration. For this very essen- 
tial, though much-neglected, part of psychiatry, a shifting pop- 
ulation presents many diflSculties. Many hospitals in which 
patients had been before have very generously given us ab- 
stract of records, and, with some help from the authorities who 
attend to the transportation of many of our patients into the 
hands of foreign authorities, it would become possible to sup- 
plement our forecast by statements of the actual fate of those 
made the object of our study and treatment. Without such an 
effort we would always grope in the uncertain light of our 
more or less optimistic imagination, and never be able to say 
what the hospital really achieves and what would be the most 
advisable steps in the great social problem. 

The enormous number of "interesting data" one meets in 
observation of about five hundred admissions a year makes a 
great restriction in the work necessary. Instead of striving 
for endless biographies of patients, we must learn to give con- 
cise statements with answers to all the important questions on 
which we are really working, and without waste in useless di- 
rections, or on topics for which we have not a strong enough 
working force in our present stafi". For this reason we did not 
take part in that wave which passes over the country in the 
form of routine examination of the blood, but restricted it to 
special indications ; nor have we entered on complicated psy- 
chological experiments. A great deal of the work of the past 
two years has indeed been devoted to the decision of what 
could be done most profitably and what should be the indica- 
tions for our efibrts in every special direction. A certain 
amount of blind, purposeless work is unavoidable ; but the main 
lines must be chosen judiciously on ground of sound working 
hypotheses. They must answer distinctly felt needs. 

From this point of view disease concepts become more than 



1898.] PUBLIC DOCUMENT — No. 23. 25 

'mere names. It is quite a different question whether a person 
will suffer from periodic attacks of mental diseases with perfectly 
clear intervals of usefulness or from a steady and lasting de- 
terioration. This can be seen by a glance at the table of statis- 
tics, which contains, as it were, a curve of recoverability in the 
following groups : the periodic psychosis with no, or but little, 
deterioration after an attack, the catatonia with occasional re- 
coveries, dementia prsecox with lasting defect, and paranoic 
conditions and paranoia practically never curable. It goes 
without saying that the last word is not spoken concerning a 
i;ruly medical classification of mental diseases ; but in a measure, 
as we learn to make distinctions of practical and essential 
value, we shall gladly relegate the meaningless terms, mania, 
melancholia, etc., of our former statistics to the vocabulary of 
mere symptomatology. 

A strong stimulus for accuracy is received by the careful 
autopsies which are made whenever permission is obtained. 
With about an equal number of deaths, 68 autopsies were per- 
mitted, against 36 last year. This is due to the greater interest 
taken by the physicians in the opportunity of controlling and 
enlarging their observations, and perhaps to the greater confi- 
dence of the friends of patients in purposes of such examinations. 

The result of this work is manifold. It affords training in 
accurate thought and methods which the medical college can 
rarely give in an equally forcible manner to the student who is 
overburdened with cramming ; and invaluable material and 
experience are accumulated for the time when a monographic 
treatment of the disease forms observed in our hospital can be 
thought of. It has also yielded a number of findings which can 
be added as valuable material to the slowly growing knowl- 
edge of the architecture of the brain. Further, it begins to 
constitute a collection of great value to those who wish to study 
the nervous system and not merely the books on the same. 

On the whole, though, we had to lay on our work many re- 
strictions which are a cause of frequent disappointment. Con- 
sidering the amount of work which must be done conscientiously 
and without the inaccuracy of haste, many very essential points 
could not be settled in certain cases because the working; force 
was taxed to the utmost. Part of this may be better in the 
course of time through the development of time-saving methods. 



26 WORCESTER LUNATIC HOSPITAL. [Oct. 

but not all. This question deserves serious consideration. 
There is nothing more demoralizing than the feeling that, even 
with the strongest effort, that which seems a reasonable scope 
of the task is beyond one's working capacity. I lay to this 
fact the discouragement and lack of medical interest of the 
physicians in most hospitals for the insane ; they stand before 
an unmanageable task, and no effort is made to limit it to well- 
defined problems and to furnish an estimate of what working 
force is really needed for a true minimum eflSciency of medical 
work proper. Under those conditions the authorities cannot 
be blamed for not providing more help, because they see no end 
of possible needs. It is therefore one of the tasks in the man- 
agement of an attempt conscientiously to do justice to the 
medical duties in such a large hospital, to be fully aware of the- 
minimum scope of a profitable working plan and of the propor- 
tion between the working force needed and the working power 
available, so that the demoralizing feeling of impossibilities 
does not get the upper hand, both on the side of the medical 
staff and on the side of the authorities who are responsible for 
the hospital. 

I cannot leave this remai:k without expressing my recognition 
of, and gratitude for, the untiring efforts of my colleagues, who 
never shirked any pains, even to the extent of overtaxing their 
working power, in the common effort to do justice to the task 
before us. 

The general arrangement of the work, as outlined by Dr. 
Quinby in the report of 1897, is still maintained. Apart from 
the daily report of cases and discussions on the topics brought 
out by them, a number of conferences were devoted to a con- 
sideration of literature on various clinical topics, and a com- 
plete course on the anatomy of the nervous system on ground 
of demonstrations and practical exercises was carried out. 
The study of serial sections in a number of interesting brain 
lesions was carried further, and is maturing for publication. 
Clinical questions, too, are being submitted to more careful 
studies ; but it lies in the nature of the subject — the necessity 
of watching the outcome for a number of years at least after a 
*'cure" — that it would be injudicious to rush to print with 
what has been done. 



1898.] PUBLIC DOCUMENT — No. 23. 27 

Since Oct. 1, 1897, the followiDg publications have come 
forth from our hospital : — 

" Various Types of Changes in the Giant Cells of the Para- 
central Lobule," "American Journal of Insanity," October, 
1897 ; <' Anatomical Findings in a Case of Facial Paralysis of 
Ten Days' Duration," "Journal of Experimental Medicine,'* 
Vol. IL, No. 6, 1897; "The Morbid Anatomy of a Case of 
Hereditary Ataxia," " Brain," Vol. XX, p. 276. 

The following articles are in press : " Critical Digest of the 
Present Concepts of the Nervous System ; " '< Critical Keview 
of Modern Presentations of Neurology." 

Respectfully, 

ADOLF MEYER. 



28 WORCESTER LUNATIC HOSPITAL. [Oct. '98. 



LIBRARY REPORT. 



The library contains 3,254 volumes. One hundred and 
twenty-seven volumes have been added during the past year, 
5 volumes have been destroyed, while 6 volumes have been 
found, during renovation of shelves, to be useless, making a 
total of 11 volumes. One hundred and twenty-four volumes 
have been sent to the bindery to be repaired. 

The average number of books issued weekly from the main 
library has been 66. During the year six ward libraries have 
been established, containing 942 volumes. The weekly reports 
of books issued to patients from these libraries give an average 
of 42. Of these, the Appleton 1 library has the poorest record, 
5^ ; while Howe 3 has the best, 8f . 

Six books have been sent to nine different halls each week, 
to lie on the centre table, where all patients could have free 
access to them. 

Total average number of books issued weekly to patients has 
been 162 (less than 80 last year). 

The card catalogue of the library has been improved by 
adding, to the already existing title catalogue, an author's cat- 
jilogue. This work is not yet completed. 



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32 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 





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1898.] 



PUBLIC DOCUMENT — No. 23. 



33 



3. — Received on First and Subsequent Admissions. 





Cases admitted. 


TlMKS PREVIOUSLY 
RECOVERED. 


NUJIBER OF THE ADMISSION. 
















Males. 


Females. 


Totals. 


Males. 


Females. 


Totals. 


First, ..... 


219 


198 


417 


_ 


_ 


_ 


Second, 


28 


25 


53 


8 


3 


11 


Third, ..... 


6 


4 


10 


- 


2 


2 


Fourth, 


- 


2 


2 


- 


- 


- 


Fifth, 


3 


- 


3 


2 


- 


2 


Sixth, 


- 


1 


1 


- 


1 


1 


Seventh, 


- 


1 


1 


- 


1 


1 


Eighth, ..... 


1 


- 


1 


1 


- 


1 


Total of cases, 


257 


231 


488 


11 


7 


18 


Total of persons. 


253 


230 


483 


9 


7 


16 



4. — Relation to Hospital of Persons admitted. 






Males. 


Females. 


Totals. 


Never before in any hospital for insane, . 


196 


165 


361 


Former inmates of this hospital only, 


34 


80 


64 


Former inmates of other hospitals only, . 


20 


29 


49 


Former inmates of this and other hospitals : — 








Butler 


- 


1 


1 


Danvers, 


1 


- 


1 


McLean, ....... 


1 


1 


2 


Kortharapton, 


- 


2 


2 


Pierce Farm, 


1 


- 


1 


Danvers, Taunton, South Boston and 
Westborough, 


_ 


1 


1 


Stockton, Cal., 


- 


1 


1 


Total of persons, 


253 


230 


483 



34 



WOECESTER LUNATIC HOSPITAL. 



[Oct. 



5.- 


- Parentage of Persons admitted. 








Malbs. 


Females. 


Totals. 


PLACES OF NATIVITY. 
















Father. 


Mother. 


Father. 


Mother. 


Father. 


Mother. 


Massachusetts, .... 


43 


42 


31 


29 


74 


71 


Other States : — 














Maine, .... 


11 


7 


10 


12 


21 


19 


New Hampshire, 
Vermont, . 




7 
3 


9 
3 


3 

6 


5 
2 


10 

8 


14 
5 


Rhode Island, 






- 


- 


1 


3 


1 


3 


Connecticut, 






1 


3 


1 


1 


2 


4 


New York, . 






2 


2 


2 


3 


4 


5 


New Jersey, 






2 


1 


- 


_ 


2 


1 


Maryland, . 
Virginia, 






1 


1 


3 


3 


1 

3 


1 
3 


North Carolina, 






- 


1 


_ 


_ 


_ 


1 


South Carolina, 






1 


1 


- 


1 


1 


2 


Georgia, 






- 


1 


- 


- 


- 


1 


Louisiana, . 






1 


- 


- 


_ 


1 


- 


Nebraska, . 






_ 


1 


_ 


_ 


- 


1 


California, . 






1 


- 


- 


- 


1 


- 


Other countries : — 














Canada, .... 


13 


14 


9 


8 


22 


22 


Nova Scotia, 




6 


5 


7 


9 


13 


14 


Prince Edward Islanc 


, '. 


1 


1 


- 


_ 


1 


1 


New Brunswick, 




4 


4 


2 


4 


6 


8 


Newfoundland, . 




- 


1 


2 


1 


2 


2 


Scotland, . 






1 


1 


6 


6 


7 


7 


England, 






10 


9 


7 


6 


17 


15 


Ireland, 






97 


99 


73 


73 


170 


172 


Wales, 






1 


1 


_ 


1 


1 


2 


Norway, 
Svveden, 






5 


1 
6 


1 
10 


1 

10 


1 
15 


2 
15 


Finland, 






1 


1 


_ 


- 


1 


1 


Holland, 






1 


1 


_ 


- 


1 


1 


France, 






3 


2 


1 


1 


4 


3 


Germany, . 






6 


6 


4 


3 


10 


8 


Poland, 






2 


1 


_ 


_ 


2 


1 


Russia, 






1 


2 


1 


1 


2 


3 


Spain, . 
Italy, . . 
West Indies, 






2 


1 
2 


1 


1 


2 

1 


1 
2 
1 


China,. 






1 


1 


- 


- 


1 


1 


Unknown, . 




25 


24 


50 


46 


75 


70 


Total of persons 


' 


253 


253 


230 


230 


483 


483 



1898.] 



PUBLIC DOCUMENT — No. 23. 



35 



6. — Birthplace of Persons admitted. 



PLACES OF BIRTH. 


Males. 


Females. 


Totals. 


Massachusetts, 


95 


79 


174 


Other States: — 








Maine, 


8 


10 


18 


New Hampshire, 












12 


6 


18 


Vermont, 












3 


3 


6 


Rhode Island, 












2 


3 


5 


Connecticut, 












2 


1 


3 


New York, . 












2 


6 


8 


New Jei-sey, 












- 


1 


1 


Pennsylvania, 
Virginia, 












1 


1 

2 


1 
3 


North Carolina, . 












1 


- 


1 


Florida, 












- 


1 


1 


Louisiana, . 












1 


- 


1 


Illinois, 












1 


2 


3 


Other countries : — 








Canada, . 


13 


10 


23 


Nova Scotia, 


, 








8 


10 


18 


Prince Edward Island 












2 


3 


5 


New Brunswick, 












9 


7 


16 


Newfoundland, . 












- 


2 


2 


Scotland, 












1 


2 


3 


England, 
Ireland, 












11 
51 


10 
45 


21 

96 


Norway, 
Sweden, 












6 


1 

10 


1 
16 


Finland, 












1 


_ 


1 


Holland, . 












1 


- 


1 


France, 












1 


1 


2 


Germany, 
Poland, 












6 
1 


1 

1 


7 
2 


Russia, 












3 


2 


5 


Austria, 












- 


1 


1 


Italy, , 
Arabia, 












2 


2 
1 


4 
1 


China, . 












1 


_ 


1 


West Indies, 












- 


1 


1 


Unknown, , 












8 


5 


13 


Totals, 


253 


230 


483 



I 



36 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



7. — Residence of Persons admitted. 



PLACES. 


Males. 


Femalea. 


Totals. 


Massachusetts (by counties) : — 








Berkshire, . 




1 


- 


1 


Essex, . 




- 


1 


1 


Middlesex, . 




88 


87 


175 


Morfolk, 




3 


4 


7 


Suflfolk, 




67 


43 


100 


Worcester, . 




104 


95 


199 


Totals, . 


253 


230 


483 


Cities or towns, . 




253 


230 


483 


Country districts, 




- 


- 


- 



1898.] 



PUBLIC DOCUMENT — No. 23. 



37 



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cc" 

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38 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



9. — Occvpation of Persons admitted. 



Book-keepers, , 


2 


Shoe-shop employee, 




1 


Cooks, 


2 


Student, . 




1 


Dressmakers, . 


4 


Teachers, . 






3 


Domestics, 


. 22 


Tailoress, . 






1 


Housewives, 


71 


Typesetter, 






1 


Housekeepers, . 


. 37 


Waitress, . 






1 


Laundresses, . 


2 


Weavers, . 






2 


Librarian, 


1 


Unknown, 






. 11 


Mill operatives, 


. 15 


No occupation, 






50 


Kurse, 


1 




Night walker, . 


1 


Total, . . . .230 


Seamstress, 


1 





Barbers, 3 


Dyer and color mixer, 




Blacksmiths, . 






4 


Engineer, . 






Brakemen, 






2 


Farmers, . 






9 


Brick masons, . 






2 


Freight handler. 








Book-keeper, . 






1 


Fireman, . 








Book folder, 






1 


Foremen, . 








Bobbin maker, . 






1 


Grocer, 








Carpenters, 






6 


Hostler, . 








Canvassers, 






2 


Iron founder, . 








Carriage trimmer. 






1 


Ice dealer, 








Clerks, 






7 


Laborers, . 






56 


Cook, 






1 


Laundry man, . 








Coopers, . 






3 


Letter carrier, . 








Comb maker, . 






1 


Lumber dealer. 








Coachman, 






1 


Machinists, 






12 


Druggists, 






2 


Merchants, 






4 



1898.] 



PUBLIC DOCUMENT— No. 23. 



39 



9. — Occupation of Persons admitted — Concluded. 



MALES — Concluded. 



Mill superintendent, 


1 


Ship calkei% . . , . 


1 


Motorman, 


1 


Shirt cutter. 


1 


Moulders, . 


4 


Stone masons, . 


2 


Musician, . 


1 


Stone cutters, . 


2 


Operatives, 


. 15 


Students, .... 


3 


Printers, . 


2 


Tailors, .... 


5 


Painters, . 


6 


Teamsters, 


5 


Paper hanger, . 


1 


Tinsmith, .... 


1 


Piano finisher, . 


1 


Undertaker, 


1 


Photographer, . 


1 


Waiter, .... 


1 


Pliysicians, 


2 


Watchman, 


1 


Plumbers, 


2 


Weaver, .... 


1 


Reporter, . 


1 


Window cleaner, 


1 


Rubber factory employ 


ee, . 1 


Wire workers, . 


2 


Shoemakers, 


7 


Wood carver, . 


1 


Salesmen, 


4 


Unknown, 


6 


Seamen, . 


3 


No occupation. 


31 


Steam fitter. 


1 






Ship carpenters. 


2 


Total, 


263 



40 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



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PUBLIC DOCUMENT — No. 23. 



41 



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42 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



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2. »* - 


1. Physical — Concluded. 

lujury and grippe, . 

lujury and domestic trouble, . 

Trauma and worry. 

Overwork, . . . . 

Overwork and worry, 

111 health, .... 

Ill health and domestic troubl 

Insolation, 

Hasmaturia, 

Gastric psychosis and flnancla 

Gastric disorder. 

Grippe, overwork and worry. 

Grippe and home training, 

Anoemia and indigestion, 

AnEemia, .... 

Coal-gas poisoning and nephr 

Pelvic abscess 

Pneumonia 

Typhoid fever and bereaveme 

2. Mental: — 

Heredity, .... 

Worry, 

Shock 

Worry and spiritualism. 
Bereavement, . 
Fright, .... 
Bereavement and spiritualism 
Disappointment in love, . 
Mental overstrain, . 
Religious excitement. 
Domestic trouble, . 
Insomnia, .... 

Unknown, 

3. Not insane, .... 


C 

E- 



1898.] 



PUBLIC DOCUMENT — No. 23. 



43 



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44 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



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







Peesons First admitted 
TO Ant Hospital. 


Persons died. 


AGES. 


AT 
riKST ATTACK. 


■WHEN 
ADMITTED. 


AT 
FIRST ATTACK. 


TIME 


AT 
OP DEATH. 




Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Congenital, 




2 


2 


4 


- 


- 


- 


- 


- 


- 


- 


- 


- 


15 years and less, 




4 


6 


9 


3 


1 


4 


2 


- 


2 


- 


- 


- 


From 15 to 20 years. 




11 


9 


20 


14 


8 


22 


2 


- 


2 


1 


- 


1 


20 to 25 years. 




13 


23 


36 


19 


24 


43 


- 


4 


4 


3 


3 


6 


25 to 30 years. 




19 


19 


38 


28 


21 


49 


5 


- 


5 


3 


1 


4 


30 to 35 years, 




23 


22 


45 


23 


26 


49 


3 


1 


4 


5 


1 


6 


35 to 40 years, 




22 


16 


38 


26 


16 


42 


10 


4 


14 


4 


1 


6 


40 to 50 years, 




27 


20 


47 


34 


28 


62 


10 


7 


17 


12 


8 


20 


50 to 60 years. 




16 


17 


33 


19 


25 


44 


9 


7 


16 


10 


5 


15 


60 to 70 years. 




16 


6 


22 


21 


9 


30 


8 


5 


13 


11 


6 


17 


70 to 80 years. 




4 


3 


7 


8 


6 


14 


5 


7 


12 


5 


10 


15 


Over 80 years, . 




- 


1 


1 


- 


1 


1 


- 


4 


4 


- 


8 


8 


Unknown, . 




39 


22 


61 


1 


- 


1 


3 


5 


8 


3 


1 


4 


Total of persona 




196 


165 


361 


196 


165 


361 


57 


44 


101 


57 


44 


101 


Mean ages in years, . 


39.86 


37.29 


38.58 


,40.69 


39.04 


39.81 


45.13 


49.07 


47.1 


48.54 


58.77 


53.65 



13. — Reported Duration of Disease before Last Admission. 



PREVIOCS DURATION. 




First Admission 
TO Ant Hospital. 


All Other 
Admissions. 


Totals. 




Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Congenital, 








2 


2 


4 


- 


1 


1 


2 


3 


5 


Under 1 month. 








47 


40 


87 


6 


10 


16 


53 


50 


103 


From 1 to 3 months. 








22 


21 


43 


4 


9 


13 


26 


30 


58 


3 to 6 months. 








12 


15 


27 


2 


3 


6 


14 


18 


32 


6 to 12 months, 








25 


16 


41 


6 


4 


10 


31 


20 


51 


1 to 2 years, . 








11 


10 


21 


6 


2 


8 


17 


12 


29 


2 to 5 years, . 








28 


23 


51 


10 


5 


15 


38 


28 


66 


5 to 10 years, . 








12 


12 


24 


5 


9 


14 


17 


21 


38 


10 to 20 years, . 








3 


7 


10 


11 


11 


22 


14 


18 


32 


Over 20 years, . 








2 


2 


4 


2 


2 


4 


4 


4 


8 


Unknown, . 








.S2 


17 


49 


9 


10 


19 


41 


27 


68 


Total of cases, . 


196 


165 


361 


61 


66 


127 


257 


231 


488 


Total of persons. 








196 


165 


361 


57 


65 


122 


253 


230 


483 


Average in years. 








1.54 


2.15 


1.84 


6.11 


4.79 


5.45 


3.83 


3.47 


3.65 



1898.] 



PUBLIC DOCUMENT — No. 23. 



45 



PS 

< 
a 
o 
tn 

ft 

H 
<1 


P4 

Eh 

o 
o 


•SIBIOX 


■* « gj r-l ■* Cq ITJ M to lO CO eO 1 i-l-!jl5qrH 1 .H to t* tJ( M | 1 


■eaiBraa^ 


(MiOOlr-l'* II >C O CO (M (M 1 r-H CO i-H i-l 1 1-( <N tT CO (M 1 1 


•Ba[Bpj 


IMCOCOIICMC^ t- rl <N i-l ,-( | |r1i-'ll|.«t<lr->lHII 

CO T—l 


CO 

n 

E- 


•BIBJOX 


^llllll r-( 1 1 1 1 1 llllllrHrHllil 


•sa[Btna^ 


XSIIIIII I-l 1 1 1 1 1 lllllllrHIIII 


•saiBfj 


1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 i 1 1 1 r4 1 1 1 1 1 


<! 

l-f 

!2i 


■BIB^OX 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Ill 


•s9|Bnia^ 


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


•saiBjM 


1 1 r 1 1 1 t 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


ft 

> 
O 
« 

a 

o 

15 


•9IB50X 


i-iggii-ill th I CT 1 1 1 ililiii-iif-ii-iii 

CO r-t 


•saiBtua^ 


'S'" '^ • ' ^ ' -- ^.^^11 


•sajBj^ 


i-HtOiO 1 1 1 1 1 1 rH 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


ft 

O 
« 


•BIBJOJ, 


rlQOOOlT-lll rH 1 rH 1 1 1 |r-ll||||(Mrtlll 


•8a[8tna^ r-lieOlrlll n l i-l l l l lr-llllli;q-H||| 


■BaiBj^ 


1 com 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 




A. 
g 

W 

o 
D 


•SIBJOX 


IN-*lMr1lll IM CO 1 rl 1 I Ir-mlliHIrlrHrtll 


•saiBcaa^g; 


i-lliMrtlll rH IM^I 1 t 1 IrHlllrHlrHrHllI 


•BaiBH 


rHTtirHIIII rH rH I rH 1 1 llrHllllllrHII 


ft 

O 
O 


•BIBIOX 


IrilMlcqiNlN t- CO (M <N CO 1 rHC^rHrHll^tHlrHrHII 


saiBina^ 


IrHIIIMII rH CO rH (M IM 1 rHrHrHrHllrHllrHII 


•B3IBH 


II(MI|IMIM to 1 rH 1 rH 1 IrHIIIICOIrHIII 


ft 


•SIB^OX 


00COCOrHTt<MCO Oi t- lO \a r^ l-i rHT^iOtlMrHaJt-CO^IMrH 


•sa^Btua^ 


COCOTtrH"* II 05 ■* CO (N 1 rH rH CO •* 1 rH rH C- O CO CO rH 1 


•saiBut 


■OjraalllMCO 1 CO IM CO rn | lrHrHlrHI(M<NlrHrHi-l 






f4 

< 
m 

s 

O 
O 


A. — Insane : — 

Imbecility 

Epileptic insanity, 

Constitutional inferiority, .... 

Hystero epilepsy, 

Hysterical insanity 

Impulsive insanity, 

Sexual neurasthenia 

Periodic insanity — 

Manic, delirious and mixed forms (1st 

attack), 

Manic, delirious and mixed forms (2d 

attack), 

Manic, delirious and mixed forms (3d 

attack) 

Manic, delirious and mixed forms (4th 

attack) 

Manic, delirious and mixed forms (5th 

attack), 

Manic, delirious and mixed forms (8th 

attack), 

Manic, delirious and mixed forms (18th 

attack), 

Circular forms (1st attack), . 
Circular forms (2d attack). 
Circular forms (4th attack), . 
Circular forms (9th attack), . 
Circular forms (Tith attack), . 
Depressed forms (Ist attack), 
Depressed forms (2d attack), . 

Depressed forms (4th attack), 
Depressed forms (6th attack), 
Depressed forms (9th attack), 



46 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



'2 

IS 
a 
o 






6 






'S 



o 






cS 






^ 



1^ 









Tt to 1 1 to lO t- (M CO to 1 l(MTl<r-li-l 1 iH rH rH IN w CO <N SO 00 


,_, 


00 




H 


•9IB10X 




'^ 


TH 




-=) 












« 


•saiBina^ 


OOI ITfKKN^OOOl li-IIMi-(l IrHI IrHt-tN^-CO-* 
T-^ ,-H CO " CJ (M 


o 


o 
















-<1 


•saiBj^ 


^tDI l<MS^>naOOiOI ll-l<MlrH| IrHi-Hi-l-^rHtHlTjl 
r-( CO CO to l-l 


to 


00 




•eiBjoj, 


lOtOI ltOC0rtrHl~cq| 1 |rtrHr-(l 1 1 leqt-Ncoi 1 








w 
























•sajBoiaj 


-*<M 1 1 1-1(M rH r-< to iH 1 1 | li-l 1 1 1 1 1 r-H CO i-H 0> 1 1 


«# 

'rr 


Til 
















•satBji 


r-l-*! I.Ot-11 |i-<i-I1 I IrllrHI | 1 IrHTjiiHCftl 1 


5 


ira 


w 


•SlBJOi 


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 «> 


00 


ao 




<1 

O 










R 


•aaiBtaa^ 


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 


•S3[BJ^ 


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 ^ 


H* 


1* 


n 


•Bwox 


dtOI liOr-lt-O'^'C^I 1 1 1 1 1 1 1 1 1 r(NIC0l 1 

CO tH 


•M 


^ 


m 


>■ 






'-* 


<"• 


o 


o 


















< 




•saiBtaa^ 


l-l"*l| IO>rMO-*(MOI 1 1 1 1 1 1 1 1 1 IIMIIMl 1 


g 


§ 


a 


P. 






















n 


O 


•saiBj^ 


iHni |tOIINi-(C^t~l I 1 1 1 1 1 1 1 1 1 1 ll-ll 1 


■^ 


^ 


H 


« 






















n 


•818J0X 


COCOI l-*i-(vOiO-<*00l 1 r 1 1 1 Irll 1 fr-llrHI 1 


O 


o 


o 


w 
























o 

P>< 


■saiBcna^ 


eOtll ICOICOl ItCI 1 1 1 t 1 Ir-cl 1 IrHI 1 | | 


IM 


(M 














s 


•saiEH 


IrHI li-.i-IC^O->ll-*| 1. 1 1 1 1 1 1 1 1 1 1 l>HI 1 




IM 

Tj< 


p 




C0>OI lOl^rHCOtOl 1 1 1 1 1 1 1 li-<|i-l| IrHI 


to 


to 




•siBjox 




UJ 






> 












O 

g 














rHnlli-Hleaillllllllllllil-lllrHI 


Ol 


O) 




•saiBcaaj 








MCOIIOIi-lrHrOtOlllllllllrHIIIIII 


,^ 


C; 




u 


■saiBH 










s 












•siBjox 


f-ctOI IrHI 1 1 It-I ICleOI 1 1 IrHI 1 IrHIC^I 


(N 


Oi 




•saiBraa^ 


rH 1 1 1 1 1 1 1 1 O 1 1 rH« 1 1 1 1 1 1 1 1 rH 1 IM 1 


Til 




•saiBW 


ItOllrHllllt-llrHrHllllrHIIIIIII 


to 


-* 


a: 
< 


P 

Eh 


•BIBIOX 


ai^r-^f-<>^ 1 OS 05 CO CO f-H rH 1 CO rH rH rH rH rH CO C^ »0 CO »0 CO ■* 
COt-r-rHTTOO rHCO 


00 
00 


CO 

Tl< 


•sa[Bnia^ 


l-iO 1 lO IIMCOOU^ IrH llliH 1 IrH 1 |rHinrH-*COCq 
rH T r-i rH rH C^ i-H 


CO 
IM 


IM 


C 












< 


•BaiBp^ 


ffltOrHrHU? It-tOeOOOrH 1 IN IrHrH IrHCOrHOC^ri IN 
r- CO COO 1-1 N 


xO 


(M 








fcT 












.V 












m > 












" 0) 

.^ (*H 










M 


V-73 










QQ 


a i '3 










<1 










H 


.S 2 ... .2 a- 










m 


Concluded. 
teric melanchol 
Qia (1st attack) 
Qia (2d attack), 
Dia (4th attack; 
tia pr;ecox, 
ary dementia, 
c condition, 
ia, 

1 paralysis, 
lie insanity, 
sm, . 

sm and alcohol 
nism, 
nsanlty, 
delirium, . 
m of inanition, 
m following pe 
lia following ty 
psychosis, 
atic insanity, 
gton's chorea, 
c dementia, 
le delirium, 
dementia, . 
drunkards, 
ane, . 










« 
fa 

o 
o 


C3 


a 
o 






fa 


go«M^a£j:;«o<;5c;>SEHfafiflfio&HSoii^3j-Sa 
5 a 
1 1 


^ 










O 


o 








a 
o 


a 
o 














<i ri 







1898.] 



PUBLIC DOCUMENT — No. 23. 



47 















< 

H 

O 


•sisjox 


00 CO CO IT) CO rH i-H 
<0 IC 1-H 


CO t^ 


•saiBraa^ 


Ol t^ !» ,-1 ,-1 1-1 T-H 

C2 1-1 

1—1 


O C5 
G-J r-l 
IM (M 


•saiBH 


CO «0 «0 i-l (M 1 1 

tH CO 

00 


^ CO 
(M (M 


a 
< 

O 


•SIBJOI 


>o CO 1 1 1 1 1 


00 00 


•saiBraaj: 


CO .-I 1 1 1 1 1 


Tj< -* 


•S91BM 


C^ C<> 1 1 1 1 1 


rjH T)< 




•st8?ox 


»0 »0 t-" 1 1 1 1 

05 


1— ( 1— ( 

o o 


•saiBraaj 


CO 1 1-1 1 1 1 1 




•sai^I^ 


CM >Ci 1 1 1 1 1 




a 

H 

o 

>— 1 

H 
O 

!zi 


•BIBJOX 


■^ «o ■* 1 1 1 1 


(M CM 


•sai^raa^ 


CO O CM 1 1 1 1 

to 1-t 


O Oi 
GO t^ 


•S3IBI? 


CO o (N 1 1 II 

CO 




d 

H 

O 
K 


•SIBJOI 


t^ o cq 1 »-( 1 1 

iO ,-1 


o o 


•S3iBraaj[ 


r- ^ 1 1 1 1 1 

(M 


00 00 

(M (M 


•saiBK 


O 05 <N 1 tH 1 1 

CO 


CM CM 


ft 

O 
K 

»— ( 

u 

D 


•sib;ox 


CO t^ Th 1-1 1 1 1-1 




•S3lfltn3j[ 


^ 1-1 CO 1 J 1 rH 


Oi CI 
1— 1 1— ( 


■saiBi? 


Ci «0 1—1 T-l 1 1 1 


t^ CO 

CO CO 


> 

8 

a 


•siBjox 


CM CO (M »-l <M .-1 1 

O 1— < 


1-1 OS 
(M 1—1 

I— 1 I— 1 


•sajBraaj 


t-- -^ i-( tH 1-1 1— 1 1 

CO 




•B91BH 


UO C5 1-1 1 rH 1 1 

«5 


CO -* 


O 

a5 

§ 
Q 

S 

O 

6J 

a 

s 

Zi 






1 i 1 1 1 1 i 

fsi CO H fs< fe oj OJ 


m O 

=4-1 =4-1 
O O 

o o 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



6 



'^ 



R z 


•SJB^OX 


II 1 1 1 1 i 1 t ,H 1 1 1 


saiBraa^ 


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


•sa[Bj^ 


II 1 1 1 1 1 1 1 1 1 1 1 




•BIB^OX 


rHI rlllllllr-llll 


•saiBcaa^ 


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


•gaiBj^ 


,H 1 1 , 1 1 1 ^ 1 1 1 


i 


•918501, 


,-HI COIIi-llllllll 


•saiBtua^ 


II rt 1 1 1 1 1 1 1 1 1 1 


•S31BK 


rHI iMIIr^lllllll 


O -4 

s s 


•BiBjoj;, 


rHI rHIIIIlTHIIII 


•saiBoiaj; 


II rH 1 1 1 1 1 rt 1 1 1 1 


•saiBj^ 


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


Periodic 
Insanity, De- 
pressed Form, 
2d Attack. 


•BIB^OJ, 


II 1 1 1 1 1 1 1 1 1 1 1 


•saiBma^ 


II 1 1 1 1 1 1 1 1 1 1 1 


•8a{Bj^ 


II 1 1 1 1 1 1 1 1 1 1 1 


Periodic 
Insanity, De- 
pressed Form, 
1st Attack. 


•B18}0X 


rH 1 1 1 1 1 1 1 1 1 1 1 1 


•BaiBOiaj 


11 1 1 1 1 1 1 


•83[BK 


rH 1 1 1 1 1 1 1 1 1 1 1 1 


Periodic In- 
sanity, 
Manic Form, 
1st attack. 


•B[B10X 


II 1 1 1 1 1 r-l 1 (M 1 1 1 


•BaiBina^ 


II 1 1 IM 1 1 1 


•saiBji 


II 1 1 1 1 1 rH 1 1 1 1 1 


Epileptic 
Insanity. 


•SIBJOJ, 


II 1 1 1 1 1 1 IM IM 1 1 1 


•aaietna^ 


II 1 1 1 1 1 1 1 1 1 1 1 


•B3|BH 


II 1 1 1 1 1 1 IM IM 1 1 1 


o 

o 
< 


•818)0X 


rHrH (MrHrHrHlMrHOlONIMrH 


•aaiBoia^ 


iMI COrHrHlllrHCONII 


•eaiBH 


OrH OJIIrHlMrHOOt-IIMrH 


a 

<1 
fi 

O 

02 
P 

<1 


a 

"a 
o 


Nervous system : — 
Exhaustion, . . . . 
Paralysis 

Respiratory system : — 
Phthisis puhnonalis, 
Phthisis and broncho-pneum 
Pulmonary hemorrhage. 
Gangrene of lungs, 
Oedema of lungs, . 
Pneumothorax, 
Broncho-pneumonia, . 
Lobar pneumonia, 
Hj postatlc-pneumonia, 
Acute bronchitis, . 
Pleurisy, 



1898.] 



PUBLIC DOCUMENT — No. 23. 



49 



■ <H rH 1 1 1 1 1 1 1 1 1 1 1 1 1 


CO 11 


1 1 iH 1 1 1 1 1 1 1 1 1 1 1 1 1 <M 


1 r- 1 1 1 1 1 1 1 1 1 1 1 1 1 1 tH 


(N 1 1 1 1 1 1 1 i 1 1 I 1 1 1 1 O 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 iH 


IM 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 -4- 


llrlll llirilltlrHl- 


1 1 rH 1 1 1 1 1 1 1 1 1 1 1 1 1 C^ 


' ' « ' ' ' ' 1 rH 


\a 


llllrl liHIIIIIIIIIO 


1 
llllrH lrtllllllllpi< 


jr. 


t t . 1 1 1 . . 1 1 1 . . >-< . iH 


I . • > . 1 ....... rH . rH 


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


i" 


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


. . 1 . . 1 . 1 1 1 i . . 1 1 




... 1 1 1 ..... 1 . 1 . CO 


1 1 1 . 1 1 1 1 1 1 . . 1 t . 1 <M 


i" 


1 1 t 1 1 rH 1 ... 1 .... 1 to 


r 


. 1 1 1 . ^ ......... jo 


OSrH-^e^rH NCOrH«rHrHrHMrHrHrH 

1 


■^ICOrHrH .COrHrHlrllrH. '2 


USrHrHrH. eq| .rHrHlrHrHlHrnlbj 




Circulatory system ; — 
Cerebral hemorrhage, . 
Acute dilatation of heart, . 
Endocarditis,. 
Heart failure, . . . 
Sinus thrombosis, . 

General : — 
Peritonitis, .... 
Acute enteritis, . . 
Strangulated hernia, . 

Septicsemia 

Parenchymatous nephritis, . 
Interstitial nephritis, . 
Chronic nephritis, 
Nephropyosis, 
Carcenoma, .... 
Asphyxia (suicide), 


"3 
o 
El 



50 



WORCESTER LUNATIC HOSPITAL. 



[Oct. 



T3 

E3 
I— < 
O 

a 
o 
o 






s 






^ 



to 





•BIBJOX 


Tj(| r-lliri|rHr-l«l-l| 


•8aiBtnaj[ 


II rflllllOIC^II 


•saiBj^ 


^1 IIIIIIWrHlrll 


o;^ 


•S[B10i 


llH ItlilllMlllHI 




•saiBtnaa 


II 1 1 1 1 1 r TH 1 1 1 1 


•saiBj^ 


llH llllllrHllr-ll 


» . 

go 


•siBjox 


II 1 1 1 1 IH 1 1 l-l 1 1 1 


•e9[Btnaj 


II 1 1 1 1 1 1 1 rH 1 1 1 


•eaiBK 


II 1 1 1 1 ^ 1 1 1 1 1 1 


o o 


•BIBJOX 


IH 1 1 1 1 1 1 1 1 1 1 1 1 


a ifa ti 
3°S 


•saiBtna^ 


II 1 1 1 1 1 1 1 1 t 1 1 


S a 


■sajBH 


11 1 1 1 1 1 1 1 1 1 1 1 1 


si 


•9IBJ0X 


II 1 1 1 1 1 1 t iH 1 1 1 


•BaiBina^ 


II 1 1 1 1 1 1 1 r-< 1 1 t 


•saiBH 


II 1 1 1 1 1 1 1 1 1 1 1 




•8io»ox 


II 1 1 1 1 1 1 1 1 1 1 1 


•saiBcua^ 


II 1 1 1 1 1 1 1 1 1 1 1 


•88(8J^ 


' • ' 




•SIBJOJ, 


1 , 1 . . 1 . ^ 1 . ^ 


•saiBtna^ 


II 1 1 1 1 1 1 1 IH 1 1 1 


•B9IBH 


II 1 1 1 1 1 1 1 1 1 1 l-l 


►J 2 

w « 
Ph 


•BIBIJOi 


Nl tOi-l.-(lrHIC)mill 


•saiBcna^ 


1-(| I<-I|H|II|INIII 


•saiBji 


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1898.] 



PUBLIC DOCUMENT— No. 23. 



51 



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1898.] 



PUBLIC DOCUMENT — No. 23. 



53 






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1898.] PUBLIC DOCUMENT — No. 23. 



55 



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1898.] PUBLIC DOCUMENT — No. 23. 57 



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1898.] 



PUBLIC DOCUMENT — No. 23. 



59 



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Totals, 



60 



WORCESTEE LUNATIC HOSPITAL. 



[Oct. 



LIST OF PERSONS 

Employed m the Worcester Lunatic Hospital, Sept. 30, 1898. 



Superintendent and physician, per 


year. 




. 13,000 00 


Assistant superintendent and physician, 


per year. 


. 1,500 00 


Assistant physician. 




(( n 


1,500 00 


Assistant physician. 




11 (( 


1,000 00 


Assistant physicians (two), 




" " 


900 00 


Junior assistant physicians (four) 


> 


« cc 


400 00 


Steward, 




" » 


1,200 00 


Treasurer, 




cc (1 


600 00 


Auditor, 




H (( 


75 00 


Matron, 




« » 


600 00 


Clerk, 




(( C( 


720 00 


Stenographers (three). 




per month 


$30 00 and 60 00 


Supervisor (man). 




It t( 


45 00 


Supervisor (woman). 




" 


30 00 


Assistant supervisors (men, two) 


each, 


u 


35 00 


Assistant supervisors (women, two) each, " " 


25 00 


Marker of clothing, etc., 




" 


20 00 


Seamstresses (two) each. 




tl t( 


18 00 


Attendants (men, forty-three) , 




t< (C 


$23 00 to 28 00 


Attendants (women, forty-five). 




II II 


14 00 to 20 00 


Night attendants (men, five). 




II II 


25 00 to 28 00 


Night attendants (women, six), 




II II 


18 00 


Baker, 




II 


.50 00 


Assistant baker. 




II 


27 00 


Steward's assistant. 




It II 


80 00 


Ofl&ce girl. 




11 i( 


16 00 



1898.] 



PUBLIC DOCUMENT — No. 23. 



61 



Kitchen men, per month, 








$25 00 and 


$35 00 


Cooks (two), « « . . 








25 00 and 


28 00 


Laundry man, " " . . 










30 00 


Laundress, » « . . 








. 


20 00 


Assistant laundry man, per month. 








■ 


27 00 


Laundry girls (eight) , " " 








$14 00 to 


18 00 


Kitchen girls (four), " " 








14 00 to 


16 00 


House girls (nine) each, " " 










14 00 


Carpenters (four), per day. 








f 2 50 and 


3 00 


Painters (three), " " 








2 50 and 


2 75 


Mason, " " 










3 00 


Helper, " " 










2 25 


Plumber, per year. 










900 00 


Engineer, u u _ ^ 








1,000 00 


Firemen (two), " month, . 










40 00 


Farmer, " " . . 










60 00 


Housekeeper, " " . . 










20 00 


Farm laborers (fourteen), per month, 








$2S 00 to 


30 00 


Farm help (women, four), " " 








14 00 to 


18 00 


Florist, 








. 


45 00 


Coachman, " " 








. 


25 00 


Expressman, " " 








. 


25 GO 


Basement and yard man, " " 








. 


25 00 



62 WOKCESTER LUNATIC HOSPITAL. [Oct. 



PRODUCTS OF THE FARM 

On Hand Oct. 1, 1898, and not delivered at the Hospital. 



Apples, 105 barrels. 

Beans, shell, Lima, 25 bushels. 

Beets, 250 bushels. 

Brussels sprouts, 25 bushels. 

Cabbage, 15,000 heads. 

Celery, 5,500 heads. 

Eggplant, 200 

Ensilage, 500 tons. 

Hay, 425 tons. 

Hay, swale, 30 tons. 

Mangolds, 25 tons. 

Oat fodder, 30 tons. 

Onions, 476 bushels. 

Parsley, 5 bushels. 

Rye, 20 bushels. 

Sage, 5 bushels. 

Spinach, 100 bushels. 

Squash, 48,800 pounds. 

Straw rye, 6 tons. 

Turnips, 2,400 bushels. 

Tomatoes, 30 bushels. 

Pop corn, 20 bushels. 



1898.] 



PUBLIC DOCUMENT — No. 23. 



63 



FAKM ACCOUNT. 



Dr. 

Bread, $200 00 

Butter, 680 54 

Blacksmithing, 214 10 

Groceries, etc., 1,570 74 

Meats, 1,711 51 

Sugar, 336 59 

Wages, 5,800 24 

Live stock, 1,840 50 

Grain and meal, 4,512 31 

Light, 192 28 

Fuel, 440 27 

Water, . 126 62 

Pasturage, 120 00 

Seeds 53 95 

Repairs 144 88 

Fertilizer, 370 00 

Other current expenses, 730 39 

$19,044 92 

Net gain for year ending Sept. 30, 1898, .... 1,599 17 



$20,644 09 



Cr 



Apples, 35 barrels, . 
Asparagus, Bih dozen bunches. 
Bones, .... 
Brussels sprouts, 6 bushels, 
Beans, string, 92 bushels, 
Beans, Lima, 24 bushels. 
Beans, shell, 51 bushels, 
Beets, 240 bushels, . 
Corn, 138 barrels, . 
Currants, 428 boxes, 
Cabbage, 203 barrels. 
Cash for live stock sold, 

Amount carried forward. 



$79 50 


34 50 


51 00 


14 00 


69 00 


29 38 


51 00 


128 75 


207 00 


42 80 


233 25 


929 59 


. $1,869 77 



64 WORCESTER LUNATIC HOSPITAL. [Oct. '98, 



Amount brought Jorward, 

Celery, 169 dozen bunches, 

Cauliflower, 636 heads. 

Chicken, 101 pounds, 

Cider, 4 gallons. 

Dandelions, 2-11 bushels, 

Eggs, 453 dozen, . 

Egg plant, 18 bushels. 

Fowl, 91 jDOunds, . 

Gravel, 177 loads, . 

Hay, 3 tons, . 

Horse-radish, 10 pounds 

Honey, 8 pounds, . 

Hides, 2, . 

Kale, 69 bushels, . 

Lettuce, 413 dozen, 

Melons, 152^ bushels, 

Milk, 309,666 quarts, 

Oats, 694 bushels, . 

Pickle cucumber, 167 bushels 

Peas, 106 bushels, . 

Parsley, 5 bushels, . 

Pork, 30,295 pounds, 

Pears, 20 bushels, . 

Plants, celery, cabbage and tomato. 

Parsnips, 69 bushels, 

Onions, 616 bushels. 

Raspberries, 46 quarts, 

Radish, 4,055 bunches. 

Rhubarb, 3,450 pounds, 

Squash, 22,930 pounds, 

Sled, ox and manure spreader 

Squash, summer, 136 bushels, 

Swiss chard, 167 bushels, 

Strawberi-ies, 983 boxes. 

Spinach, 148 bushels, 

Tomatoes, 207 bushels, . 

Tomatoes, green, 46 bushels 

Turnips, 107 bushels. 

Wood, 11 cords, 

Wood, standing, 



$1,869 77 



293 26 


63 60 


20 10 


60 


120 60 


92 08 


36 26 


13 58 


17 70 


60 00 


80 


1 60 


6 00 


34 60 


193 00 


112 76 


12,386 64 


211 29 


166 39 


149 00 


4 60 


1,592 93 


20 00 


13 60 


88 50 


624 90 


9 00 


143 25 


61 36 


501 42 


45 00 


40 78 


78 26 


100 62 


102 30 


194 24 


26 40 


51 25 


53 60 


1,164 00 


$20,644 09