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



SIXTY-EIGHTH ANNUAL EEPOET 



THE TEUSTEES 



Worcester Insane Hospital, 



TWENTY-THIRD ANNUAL REPORT OF THE TRUSTEES 



WOECESTER INSANE ASYLUM AT WORCESTER, 



Year ending September 30, 1900. 



BOSTON : 

WRIGHT & POTTER PRINTING CO., STATE PRINTERS, 

18 Post Office Square. 

1901. 



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



SIXTY-EIGHTH ANNUAL EEPOET 

OP 

THE TRUSTEES 

OF THE 

WoECESTER Insane Hospital, 

AND 

TWENTY-THIRD ANNUAL REPORT OF THE TRUSTEES 

OF THE 

WORCESTER INSANE ASYLUM AT WORCESTER, 

FOR THE 

Year ending September 30, 1900. 



BOSTON : 

WRIGHT «& POTTER PRINTING CO., STATE PRINTERS, 

18 Post Office Square. 

1901. 



■*' * xii'O'- 



STATE HOtfSt, E0STt^4 






OFFICERS OF THE HOSPITAL. 



TRUSTEES. 

GEORGE W. WELLS Sotjthbridge. 

ROCKWOOD HOAR Wokcester. 

THOMAS RUSSELL, Boston. 

SARAH E. WHITIN, Whitinsville. 

FRANCES M. LINCOLN, Worcestee. 

SAMUEL B. WOODWARD, Worcester. 

THOMAS H. GAGE, Worcester. 



RESIDENT 
HOSEA M. QUINBY, M.D., . 
ALFRED I. NOBLE, M.D., . 
REVERE R. GURLEY, M.D., 
FRANK T. BUDD, M.D., . 
MARGARET A. FLEMING, M.D , 
ALBERT C. THOMAS, M.D , . 
GEORGE H. KIRBY, M.D., . 
DOWNEY L. HARRIS, M.D., 
ROSS C. WHITMAN, M.D., . 
CHARLES B. DUNLAP, M.D., 
HENRY R. CENTER, 
LILA J. GORDON, . 
S. JOSEPHINE BRECK, . 
JOSEPH F. REYNOLDS, 



OFFICERS 



Superintendent. 
Assistant Superintendent. 
Assistant Physician. 
Assistant Physician. 
Assistant Physician. 
Junior Assistant. 
Junior Assistant. 
Junior Assistant. 
Junior Assistant. 
Laboratory Assistant. 
Steward. 
Matro7i. 
Clerk. 
Farmer. 



NON-RESIDENT OFFICERS. 

ADOLF MEYER, M.D Director of Clinical Work 

and of Laboratory. 

WILLIAM D. SPROAT, Druggist. 

ALBERT WOOD Treasurer. 

GEORGE L. CLARK Auditor. 

PATRICK W. DAY Engineer. 



C0mm0nixr^a:ltlj of P^assarfjnsrfts- 



TKUSTEES' KEPORT. 



To His Excellency the Oovernor and the Honorable Council. 

The trustees of the Worcester Insane Hospital respectfully 
submit their sixty-eighth annual report, covering the fiscal year 
1899-1900. With this is included the reports made to the 
trustees by the superintendent and the treasurer, and a special 
report of the laboratory director, together with tabulated state- 
ments, setting forth in detail the executive and financial afiairs 
of the institution. 

These reports of each special department seem to show that 
the condition of the hospital is generally satisfactory, and the 
Board, as the result of their monthly inspection, feel that such 
is the fact. 

The year has been a busy and prosperous one in the history 
of the institution, and has been marked by notable advances in 
all of its departments. With the exception of an epidemic of 
diphtheria, which occurred early in the year and which for a 
time caused the medical officers and trustees great anxiety, but 
which happily resulted in no deaths, the health of the patients 
has been good. The number under treatment has been larger 
than during any previous year, and although the wards, es- 
pecially those on the women's side of the house, have been 
crowded, we are pleased to have the assurance of the superin- 
tendent that the increased facilities afl'orded by the infirmary 
wards and the new kitchen have made it possible to care for 
these patients without serious difficulty. 

The chapel wing addition is rapidly approaching completion, 
and it will no doubt be finished early in the coming year. We 
are looking forward to the opening of this buildiog with a great 



6 WORCESTER INSANE HOSPITAL. [Oct. 

deal of interest, as it promises to be such an important factor 
in the industrial work of the hospital. 

We asked last year for an appropriation for a nurses' home, 
but this failed to receive the approval of the Board of Insanity, 
for the reason, as stated by them, that, although they approved 
of suitable provisions for nurses, they believed this work should 
be postponed, on the ground that the chapel wing extension 
was not completed, and that one main project was enough to 
undertake in one year. Now, however, that the addition to 
the chapel wing is practically finished, we would renew our re- 
quest and ask the coming Legislature for an appropriation for 
a building to accommodate sixty nurses, at an estimated cost of 
sixty thousand dollars, this to include heating, ventilation, 
lighting and furnishings. 

A notable feature of the year's work, and one which has 
commended itself especially to the trustees, is the large num- 
ber of the male patients that have been employed upon the 
ground, digging out and breaking up rocks, building roads and 
paths, and cleaning and grading the waste land in the rear of 
the hospital. The trustees have watched this work with great 
interest, and they are glad to be assured by the superintendent 
that its scope is to be enlarged and that it is to be carried on 
systematically in the future. This will not only serve to re- 
duce the great army of the unemployed that one sees on visit- 
ing the wards, which, to the layman at least, is the most 
depressing feature of a hospital for the insane, but will fur- 
nish healthful occupation for the patient, and in time turn the 
seventy-five acres of rocky hillside into a most attractive pleas- 
ure ground for the whole household. 

As a means toward this end, the trustees have appropriated 
five hundred dollars from the lawn fund for the purchase of 
trees and the establishing of a nursery, to be drawn from from 
year to year as this work progresses. 

To fill the vacancy in the position of steward caused by the 
resignation of Mr. Thomas T. Schouler, the trustees secured 
the services of Mr. Henry R. Center, for many years the clerk 
and purchasing agent of the U. S. Fish Commission. Mr. and 
Mrs. Center entered upon their duties in October, and after a 
year's experience of their work we feel that the choice is a 



1900.] PUBLIC DOCUMENT- No. 23. 7 

happy one, and that their services will be of great value to the 
institution. 

There have been no changes in the medical staff of the insti- 
tution during the year. It is with pleasure that the trustees 
can again compliment the superintendent and congratulate the 
State upon the efficient services performed by the superintend- 
ent and his entire staff. 

GEO. W. WELLS, 
ROCKWOOD HOAR, 
THOMAS RUSSELL, 
SARAH E. WHITIN, 
FRANCES M. LINCOLN, 
SAMUEL B. WOODWARD, 
THOMAS H. GAGE, 

Trustees. 
Sept. 30, 1900. 



WORCESTER INSANE HOSPITAL. [Oct. 



YALUE OF PERSONAL ESTATE. 

Sept. 30, 1900. 



Live stock on the farm, $10,667 60 

Produce of the farm on hand, ....... 11,831 00 

Cai'riages and agricultural implements, 6,987 50 

Machinery and mechanical fixtures, 30,080 10 

Beds and bedding in inmates' department, .... 31,993 00 

Other furniture in inmates' department, . . . » . . 24,058 30 

Personal property of State in superintendent's department, . 28,877 73 

Ready-made clothing, 1,439 63 

Dry goods, . 729 36 

Provisions and groceries, 2,605 86 

Drugs and medicines, . . . . . . . . 456 18 

Fuel, 350 00 

Library, 4,988 00 

Other supplies undistributed, 4,426 36 



$159,385 52 



1900.] 



PUBLIC DOCUMENT — No. 23. 



TREASURER'S REPORT. 



To the Trustees of the Worcester Insane Hospital. 

I herewith submit my annual report on the finances of the 

Worcester Insane Hospital for the year ending Sept. 30, 

1900 : — 

Receipts. 

Cash on hand Sept. 30, 1899, |5,787 19 

Received from Commonwealth for support of patients, . . 44,467 67 

from cities and towns, 94,601 68 

from individuals, 62,959 93 

from soldiers' relief, 381 63 

from farm and farm products, . . . . . 4,628 33 

from labor, 87 75 

from sale of horses and carriages, .... 12400 

from sale of old iron, brass and rags, . . . 369 79 

from sale of grease, tallow and hides, . . . 665 60 

belonging to patients, 1,669 19 

from all other sources except appropriation, . , 1,526 97 

$207,159 63 

from Commonwealth on account of appropriation, . 2,053 63 













1209,213 26 


The expenditures for the year have been as follows : — 


Salaries and wages, 


$67,463 22 


Provisions and supplies, viz. : 


— 




Meat, 


. $15,044 47 




Fish, 








3,171 52 




Fruit and vegetables. 








3,661 48 




Flour, 








6,242 75 




Grain and meal for table, . 








633 13 




Grain and meal for stock, . 








6,321 20 




Tea, coffee and chocolate, . 








2,075 82 




Sugar, syrup and molasses, 








4,337 30 




Butter and cheese. 








8,964 62 




All other groceries, . 








6,976 69 




All other provisions, . 








370 03 




Total for provisions and supplies. 






56,797 91 




Amount carried forward, . 


$124,261 13 



10 



WOKCESTER INSANE HOSPITAL. 



[Oct. 



Amount brought forward. 



Ready-made clothing, 
Dry goods, .... 

Fuel, 

Lights, .... 
Water, .... 
Medicine and medical supplies. 
Pathological department, . 
Furniture, .... 
Beds and bedding. 
Transportation, . 
Expenses of trustees, 
Ordinary repairs. 
All other current expenses. 



$124,261 13 



$7,024 36 

465 13 

11,282 15 

5,598 51 

4,220 94 

1,734 56 

1,108 05 

3,657 68 

1,921 01 

280 51 

33 78 

8,589 72 

15,146 79 



60,963 19 



Total current expenses, $185,224 32 



Extraordinary expenses : — 
On account of appropriation for new building, 
Clothing furnished discharged patients, 
Undertaking, .... 
Returning escaped patients. 
Cash refunded, .... 
Cash refunded to patients, . 

Total extraordinary expenses. 



$3,388 90 

458 45 

232 00 

76 58 

118 23 

1,509 54 



Cash on hand Sept. 30, 1900, 



5,783 70 

$191,008 02 
18,205 24 



Resources. 
Cash on hand Oct. 1, 1900, 
Due from the Commonwealth, . 
from cities and towns, 
from indiyiduals, 
from soldiers' relief, . 
from Commonwealth for bills paid for ma- 
terial and labor on account of new building. 

Liabilities. 

Due belonging to patients, 

maintenance paid in advance, 

salaries, wages and labor, .... 

for all other current expenses, . 



Respectfully submitted, 





$209,213 26 


$18,205 24 




12,478 46 




26,187 19 




14,591 99 




169 92 




1,335 27 


$72,968 07 




$1,768 98 




41 42 




5,649 65 




9,695 32 


$17,155 37 



ALBERT WOOD, 

Treasurer. 



Oct. 1, 1900. 



1900.] 



PUBLIC DOCUMENT — No. 23. 



11 



Special Appropriation. 



Appropriation. 



Balance 
Unexpended 
Oct. 1, 1899. 



Expended. 



Balance 
Oct. 1, 1900. 



Construction of adminis- 
tration building exten- 
sion, . . , . 



$79,998 44 



$35,406 56 



148,931 59 



$31,066 85 



INCOME OF LIBRAKY FUNDS. 



Lewis Fund. 

Cash on hand Sept. 30, 1899, $70 19 

Interest on Springfield bond, , , . . . 70 00 

Deposit in Worcester County Institution for Savings, $20 00 

Expended for books, 59 29 

Expended for rebinding books, , . . . 28 85 

Cash on hand Sept. 30, 1900, 32 05 

Wheeler Fund. 

Cash on hand Sept. 30, 1899 $148 51 

Dividends and tax rebate, 207 33 

Expended for books, $248 93 

Expended for rebinding books, 5 45 

Cash on hand Sept. 30, 1900, 101 46 

Income of Lawn Fund. 
Balance in Mechanics Savings Bank, , , . $1,576 04 

Dividends, 52 11 

Expended for trees, . $433 61 

Expended for freight on trees, 26 79 

Balance in Mechanics Savings Bank, . . . 1,167 85 

Income of Manson Fund. 

Dividends, $45 21 



$140 19 



$140 19 



$355 84 



$355 84 



$1,628 15 



$1,628 15 



$45 21 



12 WORCESTER INSANE HOSPITAL. [Oct. 

Funds. 

Lewis Fund Investment, 

Springfield bond, $1,089 00 

Worcester County Institution for Savings, . . 187 27 
Cash on hand Sept. 30, 1900, 32 06 



|1,308 32 



Wheeler Fund Investment. 
Seven shares Central National Bank, 
Three shares Worcester National Bank, , 
Worcester County Institution for Savings, 
Worcester Five Cents Savings Bank, 
Cash on hand Sept. 30, 1900, 



$875 00 

540 00 

1,445 86 

1,719 47 

101 46 



4,681 79 



Total of library fund, $5,990 11 

Manson Fund. 
Woi'cester County Institution for Savings, . . $1,223 22 

1,223 22 

Laivn Fund. 
Worcester Mechanics Savings Bank, .... $1,167 85 

1,167 85 



$8,381 18 
Land Account. 

Cash on hand Sept. 30, 1900, $58 52 

Respectfully submitted, 

ALBERT WOOD, 

Treasurer. 
Oct. 1, 1900. 

Worcester, Mass., Oct. 29, 1900. 
I hereby certify that I have this day compared the treasurer's statement of disburse- 
ments for the year ending Sept. 30, 1900, with the vouchers on file at the Worcester 
Insane 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. 



1900.] PUBLIC DOCUMENT — No. 23. 13 



SUPERIKTEE^DENT'S REPORT. 



To the, Trustees of the Worcester Insane Hospital, 

I herewith respectfully submit the following report of the 
hospital for the year ending Sept. 30, 1900, it being the sixty- 
eighth annual report. 

There remained at the hospital Oct. 1, 1899, 968 patients, 
— 413 men and 555 women. During the year 581 patients — 
301 men and 280 women — were admitted ; 353 patients — 159 
men and 194 women — were discharged; and 56 men and 50 
women died, leaving at the end of the official year 1,090 pa- 
tients, — 499 men and 591 women. Of this number, 324 were 
supported by the State, 587 by cities and towns and 179 by 
friends. Of the 353 persons discharged, 93, including 5 habit- 
ual drunkards (women), were reported recovered, 77 much 
improved, 73 improved and 108 not improved ; 2 were dis- 
charged not insane. Fourteen men and 16 women were re- 
moved by the overseers of the poor ; 22 men and 20 women 
were discharged to the care of the Board of Insanity, to be re- 
moved from the State ; 2 women to Tewksbury ; 1 man to Dr. 
Stedman's hospital ; 1 woman to Danvers ; 1 woman to " Her- 
bert Hall " ; 1 man and 50 women to Medfield and 1 man to 
McLean. Three men escaped and were not returned to the 
hospital or accounted for at the end of the official year. 

There remained at the end of the year 122 more patients 
than at the beginning. The smallest number under treatment 
in any one day was 958 and the largest 1,101. The daily 
average number was 1,016.9. 

The percentage of recoveries, calculated upon the number of 
discharges and deaths, was 20.26 ; calculated upon the number 
of admissions, it was 16. 

The death rate was 6.8, calculated on the whole number of 
patients under treatment, and 10.4, calculated upon the daily 



14 WORCESTER INSANE HOSPITAL. [Oct. 

average number, which is practically the same as during the 
previous year. 

After having been exempt for over ten years from a serious 
epidemic of any kind, our institution, like so many others 
throughout the State and country, was called upon during 
the past year to pass through the trying ordeal of an out- 
break of diphtheria. The disease appeared almost simulta- 
neously on the male wards, in the centre building, the female 
wards and at the farm house, and under conditions which 
forced us to conclude that it took its origin from at least two, 
if not from three, independent sources of infection outside of 
the hospital, rather than from any local causes. Of the 27 per- 
sons — 13 men and 14 women — attacked, 2 men and 7 women 
were patients and 11 men and 7 women were officers and em- 
ployees. The first case, that of an attendant on the male 
wards, appeared November 30. The patient was promptly 
removed to the Worcester Isolation Hospital, his room and 
belongings disinfected, and every one with whom he had come 
in contact given immunizing doses of antitoxin. A week after, 
December 6, two of the junior physicians, the wife of the assist- 
ant superintendent and one of the female nurses came down 
with the disease. The latter had in no way come in contact 
with the first case or with any one who had had to do therewith. 
On the following day, December 7, one of the servants at the 
farm house, but forty-eight hours on the place, showed evidence 
of the disease, as well as one of the patients on the female side 
of the house. It was now apparent that we were in the midst of 
an epidemic ; therefore the upper infirmary wards on either 
side of the house were vacated and fitted up as isolating wards, 
the adjacent dormitories being reserved for suspected cases, and 
both proved to be admirably adapted for the purpose. To assist 
the physicians having these wards in charge. Dr. Charles B. 
Stevens, a member of the stafi" of the Isolation Hospital, was 
engaged, and he made visits daily to the hospital. In case of 
the patients the disease was practically confined to the ward 
where it originated and to those first exposed to infection ; but 
among the attendants new cases continued to appear at varied 
intervals until February 1, and it was not until February 21 
that the last patient was discharged and the isolating wards 
closed. The disease ran a rather mild course in the majority 



1900.] PUBLIC DOCUMENT — No. 23. 15 

of the cases, and there were no deaths or unpleasant sequelae 
following. All the cases were treated with antitoxin in doses 
of from 1,500 to 3,000 units, according to the severity of the 
symptoms, and had practically no other medicine. All of the 
attendants and such patients as were exposed to the disease 
were given immunizing doses of from 500 to 800 units of anti- 
toxin. No case was discharged until three successive negative 
cultures had been obtained. This occurred in one case as early 
as the eighteenth day after the attack and in another not until 
the one hundred and nineteenth day. 

In this connection I wish to express my great indebtedness 
to Mr. James C. Coffey, the very efficient officer of the Worces- 
ter Board of Health, for the assistance which he so promptly 
and cheerfully gave us whenever called upon to do so ; to Dr. 
Frederick H. Baker, for his daily bacteriological reports ; and 
to the State Board of Health, for its generous supply of anti- 
toxin. 

The medical work of the year has been in many respects 
highly satisfactory. In making radical changes from old meth- 
ods to new it was not to be expected that an ideal working plan 
would be hit upon at once. We have, therefore, been prepared 
to modify from time to time our original plan, as experience 
and the exigencies of the work seemed to suggest. The object 
of this year's modification has been to enable us to place more 
weight upon the clinical side, and give to each of the assistants, 
both senior and junior, their due share of this work. 

In the laboratory we have had the services, since January 1, 
of Dr. Charles B. Dunlap, a graduate of Harvard in 1889 
and of the Harvard Medical School, and later connected with 
the Boston City and the McLean Hospital. He comes here 
to perfect himself in general pathology and pathological an- 
atomy, and especially in neuropathology. He has had charge 
of the autopsies and the working out of the autopsy material, 
amounting to over sixty cases a year, and many of them 
with complicated lesions of the nervous system. 

At the opening of the year we also secured the services of 
Mr. William D. Sproat, a registered pharmacist of nine years' 
experience in the drug business. Beside his work in com- 
pounding and dispensing medicine, he has rendered valuable 
assistance in the laboratory. 



16 WORCESTER INSANE HOSPITAL. [Oct. 

The work on the chapel wing extension, for the completion 
of which the last Legislature made an additional appropriation ^ 
is progressing satisfactorily, and it is hoped to have the build- 
ing ready for occupancy early in the coming spring. 

In several former reports attention has been called to our 
lack of adequate accommodations for female nurses, and to the 
necessity of a nurses' home for the complete and successful 
carrying out of our plans for reorganizing and improving the 
medical work of the hospital. With our infirmary wards com- 
pleted and occupied, and the new departure in our medical 
work well in hand, the necessity for a training school and a 
more efficient nursing force becomes more and more apparent. 
I would again, therefore, respectfully call your attention to this 
matter, with the hope that, through proper representation to 
the Legislature, means may be provided for the erection, dur- 
ing the coming year, of a building to accommodate sixty nurses. 

During the spring and summer a large number of male 
patients were employed in clearing up the land in the rear of 
the hospital. They were selected from the more demented 
class on the wards, and, although an unpromising lot at first, 
as far as their ability to do intelligent work went, and difficult 
to direct, they built during the season nearly half a mile of 
macadamized road (digging out and breaking up the stone 
therefor) , and cleared and graded some four acres of land. As 
we now have an abundance of such employment available, it is 
our purpose during the coming season to select some competent 
person, and make it his special duty to get out patients from 
the wards, and instruct and direct them in this work. We also 
hope to be able to build in the near future a rough and inex- 
pensive building near our stone quarry, in which the work of 
breaking stone can be carried on through the winter. 

The current expenses, less the amount received from articles 
sold, have been $178,281.39; dividing this by 1,016.9, the 
daily average number of patients, gives $175.31 as the annual 
cost of support, which is equivalent to a weekly cost of $3.37. 

HOSE A M. QUINBY, M.D., 

Superintendent. 

Worcester Insane Hospital, Sept. 30, 1900. 



1900.] PUBLIC DOCUMENT — No. 23. 17 



SPECIAL KEPORT OF MEDICAL WORK. 



Again the duty devolves upon me to give an account of our 
year's doings in the medical work of the hospital. It is in 
many respects a gratifying task. The results of the fourth 
year of systematic medical work as at present arranged have 
proved to be far more encouraging than was anticipated when 
the last report was written. 

The general arrangement of the work has been changed in sev- 
eral respects. The daily staff meetings have been abandoned, 
and the time gained has been mainly devoted to a more extended 
observation and examination of the patients on the four services. 
The four floors of the hospital have been divided into two services 
on both the male and female side. The ground floor remains 
the chief admission service ; the second floor becomes a second 
admission service, mainly for the chronic cases. The physician 
in charge of the second admission service is further responsi- 
ble for the third and fourth floors with the asylum cases ; the 
junior assistant of the second admission service taking practi- 
cally the work of the fourth floor, so as to relieve the senior 
somewhat. The four junior assistants gave all their time to 
clinical work, including the clinical laboratory work, which has 
been extended somewhat as compared with previous years. 
They also took their share in the autopsy work, whereas the 
working up of the specimens resulting from the autopsies passed 
into the hands of a special laboratory assistant, appointed Jan. 
1, 1900. This made the laboratory work much more uniform 
and reliable, — far more than in the previous years, when one 
set of inexperienced assistants took their turn of six months of 
laboratory work and then made place for another set of inex- 
perienced men. The appointment of a special laboratory as- 
sistant and of a druggist have done much to make the work 



18 WORCESTEE INSANE HOSPITAL. [Oct. 

smoother, and to bring us nearer the practical balance of means 
and aims asked for in the last report. 

In the course of this year it has become possible to make a 
preliminary grouping of the material collected since October, 
1896, and to take the first steps toward analyzing some of it. 
The result of this beginniDg has led to some changes in the 
current work, especially in the form and method of keeping 
the records, which has rendered them at once more useful clini- 
cally and more satisfactory for the current administrative 
needs. Our chief efforts the coming year will be in the direc- 
tion of a better knowledge of disease forms and prognosis, and 
more definite indications for treatment. 

I need not repeat at length why I regard a consideration of 
both these topics as equally important. We need the greatest 
possible experience as to the course of disorders, if we want to 
have any foundation whatever for a critical attitude as to the 
merits of " treatment." Quackish exuberance of treatment, as 
well as unjustified laisser aller, can be kept out of the medical 
work and teaching only if more unbiassed experience is collec- 
ted with adequate methods. 

During the past year our working plan has received several 
comments which deserve to be alluded to for the sake of en- 
couragement, and in order to bring out some warnings against 
misunderstandings. The effbrts of far-sighted alienists, like 
Dr. Cowles, Dr. Hurd and others, and the less widely known 
but equally meritorious efforts of some of our superintendents 
of hospitals for the insane, have brought forth several note- 
worthy types of progress, — training schools for nurses, patho- 
logical laboratories, and pathologists and efforts along the line 
of clinical research. In this movement we have tried to take 
part. The fundamental principle which underlies our own efforts 
towards the improvement of psychiatry and distinguishes them 
from the methods adopted in practically all the other places is 
this, — that we are not satisfied with a scientific department 
simply, grafted somewhere in the. traditional asylum, but seek 
the growth of the whole hospital idea in conformity with the 
principles of modern medicine. We would stamp all the work 
that pertains to the patients with that conscientiousness and faith- 
fulness and accuracy which alone give a satisfaction greater than 



1900.] PUBLIC DOCUMENT — No. 23. 19 

the salaries which we receive, and make it of value for useful 
deductions in the line of medical experience. Every member of 
the medical staff is given to understand that there is only one 
best way of doing the medical duties, and that the doing one's 
best in that direction is regarded as the only sufficient evidence 
of good will and good ability. We are not satisfied with a 
single ' ' department " encouraged to do its work as it ought to 
be done, while the others lag behind, a continual drawback to 
those who would do better. If the hospital does its work well, 
both the patients and the annals of medical experience get their 
legitimate dues as fruits of its labor ; therefore, I hear only 
with regret comments on the " pathologist's department," where 
the general efficiency of the hospital work should be considered, 
of which that department is only a valuable branch, if the 
work of the hospital generally furnishes the soil and atmosphere 
and needs. This is the key-note of our plan, and in the realiza- 
tion of it lies our chance of success. 

The new distribution of the work among the physicians has 
brought within the reach of possibility a decidedly greater 
efficiency in the year's work ; and when greater economy of 
labor shall be obtained by a more rapid and general acquisition 
of efficient methods and less longing for the extraordinary, we 
can hope to master the great task of dealing with over five 
hundred admissions, a daily population of more than one 
thousand patients, and over sixty autopsies, with a fair degree 
of satisfaction. 

There seems to be a general idea that what is to be demanded 
of the hospitals for the insane is " special investigations." That 
such studies have been made will be seen presently. These 
are partly given as preliminary accounts of experience suffi- 
ciently mature to warrant publication, and are partly of a didactic 
nature. Any one who tries to follow the work of the hospital 
will see, however, that the greatest efibrt goes in the direction 
of laying foundations. There is no branch of medicine so little 
prepared to make use of all the new methods of investigation 
as psychiatry. When bacteriology began to grow, the clinical 
and anatomical knowledge of consumption was ready for the 
tubercle- bacillus, erysipelas for the strepto-coccus, typhoid 
fever for the typhoid bacillus, malaria for the plasmodium, etc. 



20 WORCESTER INSANE HOSPITAL. [Oct. 

But is the hospital for the insane, with its " acute and chronic 
manias and melancholias, " ready for the psychological labora- 
tory ? Here the leap from ordinary hospital habits into scientific 
work is more difficult, because the safe clinical foundation is 
lacking, and, owing to the slow course of the diseases, difficult 
to establish. That short cuts cannot be made in this direction is 
demonstrated over and over again by the failures of all attempts 
which disregard the clinical foundations. These foundations 
are so difficult to attain that the temptation is great to shirk 
the labor ; but if we do not look for those first, we create more 
of that fire work which characterizes much of the literature of 
psychiatry, and which is most remarkable for the small amount 
of ashes and of memories left behind. From year to year these 
foundations of methodical work have been preventing more 
of the insidious leakages of the very important little things 
concerning the patients and the care they get ; and we begin to 
have a sufficient material to bring the problems and methods 
to a test, and to prepare special investigations with the feeling 
that we work with the entire front of facts before us and not 
with impressions. In the mean time the work is not unfruitful 
both for the patients and for those who work to develop ac- 
curate methods. 

The following contributions have come from the hospital this 
year : the articles on mania, melancholia, monomania, moral 
insanity, paranoia, periodicity, psychoses, for Prof. M. Baldwin's 
Dictionary of Psychology (in press). Other studies ready for 
the press are : the report on eight cases who died with a pecu- 
liar symptom-complex and findings in the autopsy which led to 
the establishment of a very interesting pathological complex 
provisionally called " central neuritis" ; further descriptions of 
a tumor of the hypophysis in acromegaly, with new formation 
of ganglion cells ; and of an instance of a metastatic tumor of 
the thyroid and several other observations in the field of 
tumors. A number of other studies have been considerably 
advanced. The collection of serial sections of normal and 
pathological brains and of the results of autopsy studies has 
been increased considerably. 

During the coming year special attention will be devoted to 
the question of the usefulness of various methods of examina- 



1900.] PUBLIC DOCUMENT — No. 23. 21 

tion which have been introduced into general medicine of late 
years ; to the determination of the bearing of studies of the 
blood and the secretions, etc. ; and to a careful investigation of 
the experience obtained by the respective specialists using 
these methods outside of the field of psychiatry. 

In closing, allow me to express my feeling of obligations for 
the continued furtherance of our work. 

Yours respectfully, 

ADOLF MEYER. 



STATISTICAL TABLES. 






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f leavin 

tients, 
tients, 
patients 
s within 
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5 recove 


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». +3 


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in the the house Oct. 1 
d within tlie year, 
lumber of cases within 


.2 








ischarged within the year 
iz. : as recovered at time 

as much improved, 

as improved, 

as not improved, . 

as not insane, 
eaths, .... 
atients remaining Sept. 30 
iz. : supported as State pa 
as town pa 
as private ] 
umber of different person 
umber of different person 
year, .... 
umber of diffei-ent persons 
year, .... 


aily average number of p; 

iz. : State patients, 
town patients, 
private patients, . 








atients 
dmitte 
''hole r 








o^<^ 


Q> Qp.!> ^;zi ^ 


Qt> 1 



26 



WORCESTER INSANE HOSPITAL. 



[Oct. 



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COCO'— I'— i<M«O?O00C51 

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1900.] 



PUBLIC DOCUMENT — No. 23. 



27 



5. — Received on First and Subsequent Admissions. 











Cases admitted. 


Times previodslt 
recovbked, 


NUMBEK OF THE ADMISSION. 


Males. 


Females. 


Totals. 


Males. 


Females. 


Totals. 


First, . 
Second, 
Third, . 
Fourth, 
Fifth, . 
Sixth, . 
Seventh, 
Eighth, 








268 

25 

4 

1 

1 
1 

1 


218 
45 
9 
2 
3 
1 

2 


486 

70 
13 
3 
4 
2 
1 
2 


8 
3 

1 


11 

2 
2 
2 

1 

2 


19 
5 
2 
3 

1 

2 


Total of 
Total of 


case 
pers 


ons, 


301 
299 


280 
277 


581 
567 


12 
12 


20 
20 


32 
32 



4. — Relation to Hospital of Persons admitted. 



Males. 


Females. 


252 


193 


27 


53 


16 


25 


_ 


1 


- 


1 


1 


1 


- 


1 


- 


1 


1 


_ 


1 


- 


2 


- 


- 


1 


- 


2 


1 


1 


301 


280 



Never before in any hospital for insane, . 
Former inmates of this hospital only. 
Former inmates of other hospitals only, . . 
Former inmates of this and other hospitals : — 

Butler, R I., 

Butler and McLean, .... 

Danvers, 

Danvers and Medfield, 

Danvers, Boston, Taunton and West- 
borough, 

Danvers, Taunton, Teveksbury and West- 
borough, 



Fort Steilacoom, Wash., . 

McLean, .... 

McLean and Westborough, 

Northampton, 

Taunton, .... 

Total of persons, 



445 
80 
41 

1 

1 

2 
1 



1 
1 
2 
1 
2 
2 

681 



28 



WORCESTER INSANE HOSPITAL. 



[Oct. 



5. — Parentage of Persons admitted. 









Males. 


Females. 


Totals. 


PLACES OF NATIVITY. 
















Father. 


Mother. 


Father. 


Mother. 


Father. 


Mother. 


Massachusetts, .... 


40 


36 


22 


29 


62 


65 


Other States : — 














Maine 


11 


10 


7 


4 


18 


14 


New Hampshire, 




5 


5 


8 


6 


13 


11 


Vermont, . 




8 


7 


3 


4 


11 


11 


Ehdde Island, 




1 


1 


1 


2 


2 


3 


Connecticut, 




2 


6 


1 


1 


3 


7 


New York, . 




3 


2 


2 


4 


5 


6 


Penns\ Ivania, . 




- 


- 


1 


- 




- 


Maryland, . 




2 


2 


- 


- 




2 


District of Columbia, 




1 


1 


- 


— 




1 


Virginia, 




2 


2 


- 


1 




3 


North ( arolina, . 




- 


- 


1 


1 




1 


South Carolina, . 




- 


- 


1 


- 




- 


Georgia, 




1 


- 


- 


- 




- 


Missouri, . 




- 


- 


1 


1 




1 


Minnesota, . 




- 


- 


1 


- 




- 


California, . 




- 


- 


1 


1 




1 


Other countries : — 














Canada, . . . . 


19 


18 


19 


20 


38 


38 


Nova Scotia, 




7 


8 


2 


3 


9 


11 


Prince Kdward Islanc 


, 


1 


1 


2 


1 


3 


2 


New Brunswick, 




2 


2 


2 


1 


4 


3 


Newfoundland, . 




4 


4 


1 


1 


5 


5 


Scotland, . 






8 


3 


7 


5 


10 


8 


England, . 






16 


15 


9 


6 


25 


21 


Ireland, 






96 


101 


99 


102 


195 


203 


Norway, 






1 


1 


2 


2 


3 


3 


Sweden, 






1(1 


11 


5 


5 


15 


16 


France, 






1 


- 


- 


1 


1 


1 


Denmark, . 






1 


- 


1 


1 


2 


1 


Holland, 






1 


1 


- 


- 


1 


1 


Finland, 






2 


2 


- 


- 


2 


2 


Poland. 






4 


4 


- 


- 


4 


4 


Germany, . 






12 


12 


3 


1 


15 


13 


Russia, 






4 


4 


4 


4 


8 


8 


Italy. . 






2 


2 


- 


- 


2 


2 


Greece, 






1 


1 


- 


- 


1 


1 


Turkey, 






1 


1 


- 


- 


1 


1 


Unknow^n, . 




35 


36 


71 


70 


106 


106 


Total of persons 




299 


299 


277 


277 


576 


576 



1900.] 



PUBLIC DOCUMENT — No. 23. 



29 



6. — Birthpl 


ace 


f Persons admitted. 






PLACES OF BIRTH. 


Males. 


Females. 


Totals. 


Massachusetts, 


95 


75 


170 


Other States : — 








Maine, ........ 


9 


9 


18 


New Hampshire, 
Vermont, 










7 
8 


6 

7 


13 
15 


Rhode Island, 










2 


5 


7 


Connecticut, 










3 


3 


6 


New York, . 










8 


8 


16 


Pennsylvania, 
Maryland, . 
District of Columbia, 










1 

1 


2 


2 


Virginia, 










3 


1 




West Virginia, . 










1 


- 




North Carolina, . 










- 






South Carolina, . 










- 






Ohio, .... 










1 






Iowa, . 










- 






Wisconsin, . 










- 






Missouri, 










- 
















- 






Kansas, 










- 






California, . 










- 






Other countries : — 








Canada, 


15 


15 


30 


Nova Scotia, 










6 


9 


15 


Prince Edward Island 










1 


2 


3 


New Brunswick,. 










4 


6 


10 


Newfoundland, . 










3 


2 


5 


Scotland, 










1 


4 


5 


England, 










14 


7 


21 


Ireland, 










53 


75 


128 


Wales, 










1 


- 


1 


Norway, 
Sweden, 










1 
11 


2 
6 


3 
17 


France, 










2 


_ 


2 


Denmark, , 










_ 


2 


2 


Finland, 










1 


- 


1 


Poland, 










3 


- 


3 


Germany, . 
Austria, 










7 
1 


2 


9 
1 


Hungary, . 
Russia, 










1 

6 


3 


1 

9 


Italy, . 
Greece, 










1 
2 


1 


2 
2 


Turkey, 










1 


- 


1 


Unknown, . 










25 


16 


41 


Totals, 


299 


277 


5:6 



30 



WORCESTER INSANE HOSPITAL. 



[Oct. 



7. — Residence of Persons admitted. 



Massachusetts (by counties) : ■ 

Bristol, 

Hampden, . 

Middlesex, . 

Norfolk, 

Suffolk, . 

Worcester, ... 
Totals, . 
Cities or towns, 
Country districts. 



1 


1 


2 


1 


1 


2 


96 


100 


196 


6 


8 


13 


46 


51 


97 


150 


116 


266 


299 


277 


576 


299 


277 


576 



PUBLIC DOCUMENT — No. 23. 



31 





1 

o 


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00 CO T-l 


CO 




■S9iBtna^ 


QO CM Oi <N CO 1-* 1 (M 

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<N 




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CO '^ -<* i-H i-H i-H 1 1 

CO (M 

CM 


C5 
CN 




is 

o 
a 


■SIBJOl 


lO i-H T-t 1 1 1 1 1 

CO 


CO 




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I— 1 




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o 


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O 


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CO 


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< 


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CO CO "O rH C^ 1 1 1-1 -- 
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uO CO 1-1 1 1 1 1 1 C5 

O 1-1 —1 
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m 
a 
a 

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o 




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ii o '^ -^ e -B ^ ^ 


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H 



32 



WORCESTER INSANE HOSPITAL. 



[Oct. 



9. — Occupation of Persons admitted. 
Females. 



Attendant, 


1 


Operatives, .... 16 


Actress, .... 


1 


Stenographer, 






1 


Boarding-house keeper, 


1 


Seamstress, . 






1 


Clerks, .... 


2 


Stitcher, 






1 


Cook, .... 


1 


Tailoresses, . 






2 


Copyists, 


2 


Teachers, 






2 


Dressmakers, 


2 


Washerwoman, 






1 


Domestics, 


56 


Waitress, 






1 


Housewives, . 


64 


Unknown, 






11 


Housekeepers, 


46 


No occupation, 






. 63 


Music teacher. 

Nurse, .... 


1 
1 


Total, . 






. 277 



Males. 



Agent, .... 


1 


Curriers, .... 2 


Architect, 






1 


Dentist, 








Actor, . 






1 


Decorator, 








Blacksmiths, . 






4 


Designer, 








Bartenders, . 






2 


Druggist, 








Ball player, . 






1 


Electrician, . 








Barber, . 






1 


Electric lineman. 








Boiler maker, 






1 


Engineer, 








Broker, . 






1 


Farmers, 






12 


Bookbinder, . 






1 


Fresco painter, 








Book-keepers, 






2 


File maker, . 








Butchers, 






2 


Fireman, 








Carpenters, . 






7 


Foreman, 








Cabinet makers. 






2 


Furrier, . 








Chair makers. 






2 


Fruit dealer, . 








Car cleaner, . 






1 


Grocers, 








Carriage maker. 






1 


Harness maker. 








Clerks, . 






7 


Herdic driver, 








Constable, 






1 


Hotel clerk, . 








Coachman, 






1 


Hostlers, 






3 


Comb maker. 






1 


Jewellei", 






1 



1900.] 



PUBLIC DOCUMENT — No. 23. 



33 



9. — Occupation of Persons admitted — Concluded. 
Males — Concluded. 



Journalist, .... 1 


Proofreader, . 


i 


Laborers, 






55 


Pool-room keeper. 


1 


Letter carriers, 






2 


Plumbers, 


2 


Literature, 






1 


Physician, 


1 


Lineman, 






1 


Quarryman, . 


1 


Locksmith, 






1 


Railroad employee. 


1 


Longshoreman, 






1 


Reporter, 


1 


Lumber surveyor, 






1 


Retired, .... 


1 


Lumber dealer, 






1 


Sailors, .... 


3 


Marketmen, . 






2 


Stone cutter, . 


1 


Masons, . 






4 


Shoemakers, . 


9 


Machinists, . 






17 


Student, .... 


1 


Manufacturer, 






1 


Superintendent of mill, 


1 


Merchants, 






2 


Tailors, .... 


2 


Moulders, 






4 


Tradesman, . 


1 


Motormen, 






2 


Teamsters, 


4 


Musicians, 






2 


Tinsmiths, 


2 


Music teacher. 






1 


Trunk maker. 


1 


Operatives, . 






17 


Waiter, .... 


1 


Organ pipe voicer. 






1 


Watchman, . 


1 


Painters, 






7 


Wire worker. 


1 


Plasterer, 






1 


Unknown, 


19 


Peddlers, 






3 


No occupation. 


34 


Printers, 
Porter, . 






3 
1 


Total, . 


299 



34 



WOECESTEE INSANE HOSPITAL. 



[Oct. 



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s 






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03 


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




o 

Eh 


(M ' 1 1 1 1 1 1 1 1 1 1 1 r 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 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


< 

m 

M 




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Alcohol 

Alcohol and morphine, . 

Alcohol and febrile disorder, . 

Alcohol and trauma. 

Alcohol and ill health, 

Alcohol and constitutional inferiority. 

Alcohol and epilepsy. 

Alcohol and senility. 

Alcohol and mastiirbation. 

Alcohol and sexual excesses, . 

Alcohol and lactation, 

Alcohol, worry and family trouble. 

Abscesses, 

Apoplexy 

Arterio-sclerosis, .... 

Bereavement, 

Bereavement and spiritualism, . 
Business trouble, .... 

Chorea 

Constitutional inferiority, 
Cerebro-spinal meningitis, 
Disappointment in love, . 

Epilepsy 

Epilepsy and ill health, . 

Family trouble 

Grippe 

Heredity, 

Immorality, 

Lactation, 

Lead poisoning-, .... 



1900.] PUBLIC DOCUMENT — No. 23. 



35 



I I I I I I I I I I r I I I I I I I I I t I I I I I 



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1900.] 



PUBLIC DOCUMENT — No. 23. 



37 



12. — Ages 


of Insane at First Attack, Admission and Dec 


ith. 






Peksons First admitted 
TO Ant Hospital. 


Persons died. 


AGES. 


AT 
riBST ATTACK. 


WHEN 
ADMITTED. 


AT 
FIRST ATTACK. 


AT 
TIME OF DEATH. 




Ma. 


Fe. 


Tot. 


Ma. 1 Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Congenital, 




2 


4 


6 


- 


- 




- 


- 


- 


- 


- 


- 


15 years and less, 




2 


2 


4 


1 


1 


2 


- 


1 


1 


- 


- 


- 


From 15 to 20 years, 




13 


7 


20 


11 


5 


16 


- 


2 


2 


- 


- 


- 


20 to 25 years, 




25 


20 


45 


27 


18 


45 


2 


1 


3 


- 


- 


- 


25 to 30 years, 




20 


21 


41 


30 


31 


61 


- 


3 


3 


1 


3 


4 


30 to 35 years. 




24 


15 


39 


30 


20 


50 


6 


3 


9 


3 


9 


12 


35 to 40 years. 




20 


19 


39 


26 


24 


50 


5 


4 


9 


5 


3 


8 


40 to 50 years. 




30 


32 


62 


50 


35 


85 


10 


7 


17 


14 


4 


18 


50 to 60 years , 




21 


21 


42 


29 


28 


57 


8 


11 


19 


11 


6 


17 


60 to 70 years, 




12 


11 


23 


15 


20 


35 


5 


9 


14 


5 


13 


18 


70 to 80 years, 




10 


6 


16 


18 


5 


23 


4 


5 


9 


8 


8 


16 


Over 80 years, . 




6 


2 


8 


9 


3 


12 


2 


1 


3 


3 


3 


6 


Unknown, . 




67 
252 


33 

193 


100 

445 


6 

252 


3 
193 


9 

445 


14 
56 


3 


17 
106 


6 


1 


7 


Total of persons, 


60 


56 


50 


106 


Mean ages in years, . 


44.7 


39.2 


41.9 


41.6 


41.6 


41.6 


48.6 


54.9 


51.7 


55.7 


55.0 


55.3 



13. — Reported Duration 


3/ Disease 


before Last Admission. 




PREVIOUS DURATION. 


First Admission 
TO Ant Hospital 


All Other 
Admissions. 


Totals. 




Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Congenital, 






1 


5 


6 


1 


1 


2 


2 


6 


8 


Under 1 month, 






61 


46 


107 


12 


23 


35 


73 


69 


142 


From 1 to 3 months, 






30 


20 


50 


- 


15 


15 


30 


35 


65 


3 to 6 months, 






21 


14 


35 


2 


11 


13 


23 


25 


48 


6 to 12 months, 






16 


16 


32 


2 


2 


4 


18 


18 


36 


1 to 2 years, . 






18 


15 


33 


4 


3 


7 


22 


18 


40 


2 to 5 years, . 






25 


23 


48 


7 


4 


11 


32 


27 


59 


5 to 10 years, . 






8 


10 


18 


3 


3 


6 


11 


13 


24 


10 to 20 years, . 






5 


6 


11 


2 


4 


6 


7 


10 


17 


Over 20 years, . 






2 


- 


2 


1 


1 


2 


3 


1 


4 


Unknown, . 






65 


38 


103 


15 


20 


35 


80 


58 


138 


Total of cases, . 


252 


193 


445 


49 


87 


136 


301 


280 


581 


Total of persons, 






252 


193 


445 


47 


84 


131 


299 


277 


.576 


Average in years, 






1.74 


1.94 


1.84 


3.3 


2.27 


2.78 


2.52 


2.1 


;2.3l 



38 



WORCESTER INSANE HOSPITAL. 



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EH H 



PUBLIC DOCUMENT — No. 23. 



39 



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WORCESTER INSANE HOSPITAL. 



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0HiJijeaP5WPHCLiH<I^W<llzilzi<1aH 



1900.] 



PUBLIC DOCUMENT — No. 23. 



41 



1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 i-i 1 1 1 cq 


' • ' ' 1 . i 1 


1 1 1 1 1 1 1 1 1 1 1 1 t 1 1 1 t rH 1 1 1 1 <M 


llli-lllllHIIIIIIIIIIIIlIcO 


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r 1 1 . . . r. . i« 


1 1 1 t 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 CO 


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


• ' 1 . . 1 1 . 1 . 1 1 jco 


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llllllllllrHllllrHfllll-^ 


, ^ .,,,,...,.......,., |o 


'■''''-'''''' 1 1 1 j W 


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COIrHl 1 1 I 1 1 lT-li-(r-ieOI IrHI 1 | ll-' 

1 " 


rHI 1 1 1 1 1 1 1 (—1. .iHI .rHI 1 1 '(2 


(Ml^l 1 I 1 1 1 . li-li-H<NI . r 1 . . '12 


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1 1 r I lr-lr-ie»'-lrHI 1 1 IrH. 1 IrHI IIN 




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Cerebral hemorrhage. 

Fracture of skull, . 

Cerebral concussion, 

Cerebro-spinal meningi- 
tis. 
Post-epileptic coma, 

Convulsions, 

Pyelitis 

Peritonitis, 

Peri-rectal abscess, . 

Ileo-colitis, 

Chronic diarrhcea, , 

G-astritis, .... 

Enteritis 

Exhaustion, 

Inanition, .... 

Carcinoma of breast. 

Uterine carcinoma, . 

Cancer of sigmoid flex- 
ure. 
Bepticsemia, 

Suicide by strangulation. 

Asphyxia by food, . 

Totals, 



42 



WORCESTER INSANE HOSPITAL. 






o 






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•SIBJOi 


CO OS to O O C<1 1 1 1 1 


GO ■* COi-H 1 I-H 1 1 

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05 




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CO 


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A. — Insane : — 

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 to years, . 

10 to 20 years,. 
Over 20 years, . 
Unknown, 


Totals, 
Average of known cases (in mo 

B. — Habitual drunkards : — 
From 1 to 3 months, 
3 to 6 months, 
6 to 12 months, 
1 to 2 years, . 
5 to 10 years, . 
Unknown, 

Totals, 
Average of known cases (in mo 



PUBLIC DOCUMENT — No. 23. 



43 







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44 



WORCESTER INSANE HOSPITAL. 



[Oct. 






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1 1 I 1 1 I 1 1 1 t [ 1 1 1 1 1 t 1 1 1 1 1 1 1 1 1 1 1 1 


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1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 r 1 1 




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1 1 1 1 1 1 1 1 1 1 1 r 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 r 


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a 


1 1 1 1 [ 1 1 1 1 1 1 1 1 I I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


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1 1 r 1 1 1 1 1 1 I I 1 1 1 t 1 1 1 1 1 1 1 r 1 1 r 1 1 1 




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00<0'OiCt'OD«OCOOt-05a>OOOOi-i0500iOOiC30CDt'00(MC00003 
















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 
1860 
1861 



1900.] PUBLIC DOCUMENT — No. 23. 45 



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


1-1 




1 r 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


. 




1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 f 1 1 1 1 1 1 1 1 1 1 1 1 l-H 


"^ 




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'■''''' 1 1 1 . . . , 1 . . , 1 1 . . . .^ ,^^^^^^ 


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1 1 1 1 1 1 1 1 1 1 I 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 iHrH 1 I 1 IH I-t (N O tC rH 05 


s 








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en 




1 1 1 1 . 1 1 1 IrH . , , , , , , , , , .« , . , , , ,N , ,^ ,«^^0«t; 


« 




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to 




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1862 
1863 
1864 
1865 
1866 
1867 
1868 
1869 
1870 
1871 
1872 
1873 
1874 
1875 
1876 
1877 
1878 
1879 
1880 
1881 
1882 
1883 
1884 
1885 
1886 
1887 
1888 
1889 
1890 
1891, 
1892 
1893 
1894 
1895 
1898, 
1897, 
1898 
1899, 
1900, 





46 



WOECESTER INSANE HOSPITAL. 



[Oct. 



a 
o 
O 






Remaining 

OF Each Ybab's 

Admissions 

Sept. 30, 1900. 


o 

E-< 


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




1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 i-H 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 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 




n 

H 

M 

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1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 I 1 1 1 1 1 1 1 1 1 




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


53 


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


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TEARS 
ENDIN& 
8EPT. 30. 






cococococceoco-^rf*'ri<-.i<-^'^Ti<^^»r3»nvo»£5»Oini20i2»2SO 

00 00 00 00 OO 00 00 00 00 OOOO 00 00 00 00 QO 00 00 00 CO 00 CO 00 0000 OO 00 OO 00 



1900.] PUBLIC DOCUMENT — No. 23. 47 



r-l 1 1 i-l r 1 iH trHeOrH(MM 1 rH OS t- <* ■* OJ «S 00 r-l O tH 05 O (N I- JJ ^ » iO O M ;* M » j-l 


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fin 
5 


III 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 [ rH 


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1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 I 1 1 1 1 1 1 1 1 1 1 1 1 < 1 1 > 


1 


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CO 


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1 1 r 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 lrH-4<Tt< 


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1 i 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 |T]IC~ 


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1 1 1 1 t 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 i l(N^ 


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1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 IN CO 


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48 



WORCESTER INSANE HOSPITAL. 



[Oct. 



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PUBLIC DOCUMENT — No. 23. 



49 



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50 



WORCESTER INSANE HOSPITAL. 



[Oct. 



LIST OF PERSOI^S 

Employed in the Worcester Insane Hospital, Sept. 30, 1900. 



Superintendent and physician, per year. 

Assistant superintendent and physician, per year. 

Assistant physician, per year (non-resident), 

Assistant physician, per year, .... 

Assistant physicians (two), each, per year, 

Junior assistant physicians (four) , each, per year. 

Steward, per year, 

Matron, per year, . 

Clerk, per year, . 

Treasurer, per year, 

Auditor, per year, 

Stenographer and typewriters (three), per month. 

Supervisor (man), per month, .... 

Assistant supervisors (two men), each, per month. 

Supervisors (three women), each, per month, . 

Marker of clothing, etc., per month, . 

Seamstresses (two) , each, per month. 

Attendants (men, forty-seven), per month. 

Attendants (women, fifty-five), per month, 

Night attendants (men, seven), per month. 

Night attendants (women, eight), per month, . 

Baker, per month, 

Assistant baker, per month, , 

Steward's assistant, per month, . 

OfB.ce girl, per month, . 

Kitchen men (three), per month, 

Cooks (two), per month. 

Laundry man, per month, 

Laundress, per month, . 

Assistant laundry man, per month. 

Laundry girls (seven), per month, 



$3,000 00 

1,500 00 

2,000 00 

1,200 00 

1,000 00 

400 00 

1,000 00 

600 00 

720 00 

500 00 

75 00 

$60 00 and 30 00 

45 00 

40 00 

25 00 

20 00 

18 00 

to 28 00 

to 20 00 

to 28 00 

18 00 

50 00 

27 00 

27 00 

16 00 

to 46 00 

and 28 00 

30 00 

20 00 

25 00 

14 00 to 18 00 



23 00 
14 00 

25 00 



16 00 
25 00 



1900.] 



PUBLIC DOCUMENT — No. 23. 



51 



Kitchen girls (five), per month, 

House girls (eight), per month. 

Carpenters (two), per day. 

Painter, per day, . 

Mason, per day, . 

Mason's helper, per day. 

Plumber, per month, . 

Engineer, per day. 

Firemen (two), per month. 

Farmer, per month. 

Housekeeper, per month, 

Farm laborers (fifteen), per month, 

Farm help (five women), per month. 

Florist, per month. 

Coachman, per month, . 

Expressman, per month. 

Butcher, per month. 

Basement and yard man, per month. 



$14 00 to $18 00 

14 00 

2 60 and 3 00 

2 50 

3 25 
2 25 

75 00 
2 50 
40 00 
60 00 
18 00 
20 00 to 30 00 
14 00 to 20 00 
45 00 
23 00 
25 00 
23 00 
25 00 



52 



WORCESTER INSANE HOSPITAL. 



[Oct. 



PRODUCTS OF THE FARM 



On Hand Oct. 1, 1900, and not delivered at the Hospital. 



Apples, . 

Barley fodder, 

Beets, 

Cabbages, 

Carrots, . 

Celery, . 

Corn fodder, 

Ensilage, 

Hay, 

Hay, swale, 

Mangolds, 

Oat fodder, 

Onions, . 

Parsnips, 

Rowen, . 

Rye, 

Squash, . 

Straw, rye. 

Turnips, 



590 barrels. 

15 tons. 
500 bushels. 
20,000 heads. 

800 bushels. 
5,000 heads. 
25 tons. 
600 tons. . 
250 tons. 
8 tons. 
400 bushels. 

22 tons. 
400 bushels. 
200 bushels. 
33 tons. 
40 bushels. 
36,000 pounds. 
12 tons. 
200 bushels. 



1900.] 



PUBLIC DOCUMENT — No. 23. 



53 



FAEM ACCOUNT. 



Dr. 

Bread, . 

Butter, 

Groceries, etc.. 

Meat, . 

Fish, . 

Sugar, . 

Current expenses, 

Wages, 

Fuel, . 

Lights, 

Grain and meal, 

Live stock, . 

Furniture, . 

Repairs, 

Water, 

Fertilizer, . 

Seeds, . 

Net gain for year ending Sept. 30, 1900, 



Cr. 



Apples, 693 barrels, . 
Asparagus, 32i dozen bunches, 
Beets, 207f bushels, . 
Beans, lima, 43 bushels. 
Beans, string, 50i bushels. 
Beef, 10,085 pounds, . 
Bones sold, 3,630 pounds. 
Cabbage, 247| barrels. 
Celery, 53^ dozen bunches, 
Carrots, 112=j^o bushels, 
Cauliflower, 44 heads. 
Currants, 806 quarts, . 
Cucumbers, 617, . 
Corn, 2,779 dozen. 

Amount carried forward. 



$290 92 


539 


43 


1,576 


37 


1,690 


38 


169 


66 


397 


60 


2,092 35 


6,125 


02 


312 


79 


221 


63 


6,864 


60 


2,380 00 


279 


41 


320 98 


172 


37 


536 


59 


111 


93 


900 


18 


$23,982 16 


$1,312 


50 


41 


00 


120 


94 


49 


75 


87 


88 


840 


91 


75 


69 


338 


32 


73 


21 


81 


44 


2 


20 


62 


84 


66 


67 


222 


32 



,325 67 



54 



WORCESTER INSANE HOSPITAL. 



Amount brought forward. 

Crab apples, 6 bushels, 

Chickens, 

Cider, 1,147 gallons, . 

Dandelions, 74 bushels. 

Egg plant, 97, . 

Eggs, 117 dozen, 

Grapes, 3 bushels. 

Hay, 41,350 pounds, . 

Hides sold, 14, . 

Honey, 19 pounds. 

Ice cut, 861 tons, 

Kale, 13 bushels. 

Live stock sold, . 

Loads of wood, three, 

Milk, 327,292 quarts, . 

Lettuce, 421 dozen. 

Musk melons, 80, 

Oat straw, 89 tons. 

Onions, 615i bushels, . 

Oats, 8061 bushels, . 

Old iron sold, 

Potatoes, 45 bushels, . 

Parsnips, 87 1 bushels. 

Pease, 1081 bushels, . 

Peppers, one half bushel, 

Parsley, 114 pints, 

Pears, 16 bushels, 

Pork sold, 40,455 pounds. 

Radishes, 1,192| dozen, 

Rhubarb, 

Rye straw, 11,560 pounds. 

Rye, 5 bushels, . 

Spinach, 172 bushels, . 

Squash, 124 1 dozen (summer). 

Squash, winter, 27 barrels, 

Strawberries, 108 quarts. 

Scullions, 2>l\ bushels. 

Tomatoes, 274| bushels. 

Tomatoes, green, 16 bushels. 

Turnips, 637 bushels, 

Vegetables sold, . 

Water melons, 62, 

Wagon sold. 

Drawing coal, 







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