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

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

SIXTY-NINTH ANNUAL EEPOET 

01" 

THE TRUSTEES 

OF THE 

WoRCESTEE Insane Hospital, 

AND 

TWENTY-FOURTH ANNUAL REPORT OF THE TRUSTEES 

01" THE 

WOROESTEE INSANE ASYLUM AT WOECESTER, 

FOR THE 

Year ENDi^a September 30, 1901. 




BOSTON : 

WRIGHT & POTTER PRINTING CO., STATE PRINTERS, 

18 Post Office Square. 

1902. 



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



SIXTY-NINTH ANNUAL EEPORT 



THE TRUSTEES 



Worcester Insane Hospital, 



TWENTY-FOURTH ANNUAL REPORT OF THE -TRUSTEES 



WORCESTEE INSANE ASYLUM AT WOECESTEE, 



Yeak ending September 30, 1901. 



,^k>^^C<L:-! ^^i.-. , .4-.--'/"- , 




f^ BOSTON: 

WRIGHT & POTTER rPlJSTTTN'J CO., STATE PRiN'f^ERS, 
18 Post Office Square. 
1902. 



Ua-^l^c-^ £^^^i^c<u<^C c^ 



£^'^^l^CA..4i^i 



OFFICERS OF THE HOSPITAL. 



TRUSTEES. 

ROCKWOOD HOAR, Worcester. 

THOMAS RUSSELL Boston. 

SARAH E. WHITIN Whitinsville. 

FRANCES M. LINCOLN, Worcester. 

SAMUEL B. WOODWARD Worcester. 

THOMAS H. GAGE, Worcester. 

GEORGE W. WELLS Southbridge . 



RESIDENT OFFICERS. 

HOSE A M. QUINBY, M.D Superintendent. 

ALFRED I. NOBLE, M.D., Assistant Superintendent. 

REVERE R. GURLEY, M.D., Assistant Physician. 

GEORGE H. KIRBY, M.D , Assistant Physician. 

CORNELIA B. J. SCHORER, M.D. Assistant Physician. 

HARRY A. COTTON, M.D., Junior Assistant. 

ISADOR H. CORIAT, . Junior Assistant. 

WILLIAM H. NEWCOMB, M.D. , , . . . . Junior Assistant. 

THEODORE A. HOCH, M.D Junior Assistant. 

CHARLES B. DUNLAP, M D . Laboratory Assistant. 

HENRY R. CENTER, Steward. 

LILA J. GORDON . . . Matron. 

S. JOSEPHINE BRECK, Clerk. 

JOSEPH T. REYNOLDS, 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. 



Cnmmnnixrealtlj 0f P^asBarfriiBrfts. 



TRUSTEES' REPORT. 



To His Excellency the Governor and the Honorable Council. 

The trustees of the Worcester Insane Hospital would re- 
spectfully submit their annual report, together with the reports 
of the administrative and financial officers. 

The importance and detail of the great and varied responsi- 
bilities of the superintendent and the interesting duties of the 
pathologist can be appreciated only by careful reading of their 
several reports. 

The work in erecting and furnishing the addition to the 
chapel wing of the building is nearly completed. The hospital 
is now in large degree well equipped. It needs at once a new 
mortuary and a method of lighting by electricity. We ask for 
an appropriation for these purposes. It was found that the 
appropriation of $45,000 for the building, equipping and fur- 
nishing a nurses' home would prove inadequate. The Board 
had prepared careful plans and estimates, but found that the 
work could not be done for the sum appropriated, and, there- 
fore, has not begun upon it. We ask for an increase in the 
appropriation, to fully cover the necessary expenditure. 

We would express our high approval of the work of the 
permanent officers of the institution, and of their intelligent, 
efficient and economical service. They are not content with a 
perfunctory ^performance of routine duties, but are inspired 



6 WORCESTER mSANE HOSPITAL. [Oct. 

with a zeal to deal more skilfully and successfully with each 
case submitted to them, and to advance the already high repu- 
tation of this, the oldest institution in the State. 

Respectfully submitted, 

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

GEORGE W. WELLS, 

Trustees. 



I 



1901.] PUBLIC DOCUMENT — No. 23. 



YALUE OF PERSONAL ESTATE 

Sept. 30, 1901. 



Live stock on the farm, $11,367 00 

Produce of the farm on hand, 17,946 25 

Carriages and agricultural implements, 7,517 50 

Machinery and mechanical fixtures, . . . . . . 82,538 85 

Beds and bedding in inmates' department, .... 31,99300 

Other furniture in inmates' department, 24,053 30 

Personal property of State in superintendent's department, . 30,095 67 

Ready-made clothing, 1,854 31 

Dry goods, 1,626 13 

Provisions and groceries, 3,527 53 

Drugs and medicines, 436 86 

Fuel, 1,336 35 

Library, 5,238 00 

Other supplies undistributed, 6,623 70 

$176,154 45 



WOECESTER IJSTSAlSrE HOSPITAL. 



[Oct. 



TREASURER'S REPORT. 



To the Trustees of the Worcester Insa7ie Hospital. 

I herewith submit my annual report on the finances of the 

Worcester Insane Hospital for the year ending Sept. 30, 
1901. 

Receipts, 

Cash on hand Sept. 30, 1900, ....... $18,206 24 

Received fi-om Commonwealth for support of patients, . 50,143 81 

from cities and towns, 102,852 59 

from individuals, . 62,807 72 

from soldiers' relief, 765 70 

from farm and farm products, 3,010 26 

from sale of buggy, rags and old iron, . , . 246 81 

from sale of grease, hides and bones, . . . 568 45 

from sale of barrels and tubs, 116 52 

belonging to patients, 3,076 65 

from other sources except appropriation, . . 1,795 06 



from Commonwealth on account of appropriation, . 



3,676 81 
6,972 79 

1240,549 60 



The expenditures for the year have been as follows : — 



Salaries and wages, . 

Provisions and supplies, viz. 
Meat, .... 
Fish, . . 
Fruit and vegetables, 
Flour, 

Grain and meal for table. 
Grain and meal for stock. 
Tea, coffee and chocolate, 
Sugar, syrup and molasses, 

Amounts carried forward, 



$69,404 86 



114,850 


30 


2,819 


16 


6,101 


16 


6,734 


90 


753 50 


6,802 


64 


1,901 


48 


6,631 


84 


$43,494 98 



),404 86 



1901.] PUBLIC DOCUMENT - 


-JSTo. 23. 




9 


Amounts brought forward. 




$43,494 98 


$69,404 86 


Butter and cheese, .... 




7,166 


10 




All other groceries, . 




8,477 


96 




All other provisions, .... 




1,361 


91 




Total for provisions and supplies, 








60,500 95 






Ready-made clothing, 




$8,030 72 




Dry goods, .... 






2,660 


43 




Fuel, 






17,301 


72 




Lights, 






5,654 74 




Water, 






4,255 


36 




Medicine and medical supplies, 






1,859 


11 




Pathological department, . 






1,463 


13 




Furniture, 






818 


18 




Beds and bedding, 






2,962 


14 




Transportation, .... 






213 


24 




Expenses of trustees, 






42 


91 




Ordinary I'epairs, 






9,031 


60 




All other current expenses, 






18,077 


65 










72,370 93 






Total current expenses, 


$202,276 74 


Extraordinary expenses : — 






Clothing furnished on discharge of patients, . $658 


64 




Undertaking, 237 00 




Returning escaped patients, .... 75 56 




Cash refunded 73 35 




Cash refunded to patients, .... 2,779 64 




Coal shed extension, 5,168 


57 




Laundry extension, 5,833 45 




On account of appropriation for new building, 6,410 05 




Total extraordinary expenses, . 






21,236 26 






Total expenditures, 


$223,513 00 


Cash on hand Sept. 30, 1901, 


' 


17,036 60 




$240,549 60 


Resources. 






Cash on hand Oct. 1, 1901, .... $17,036 60 




Bills due from Commonwealth, 






13,634 45 




due from cities and towns. 






28,857 


36 




due from individuals, 






13,902 


15 




due from soldiers' relief, . 






296 


19 





due from Commonwealth for bills paid 
for material and labor on account of 
new building, 



2,159 03 



$75,885 78 



10 



WOECESTEK mSANE HOSPITAL. 



[Oct. 



Liabilities. 

Due belonging to patients, . . . . $2,064 99 

maintenance paid in advance, ... 86 21 

salaries, wages and laboi% . . . . 5,915 68 

for all other current expenses, . . . 15,329 28 

Respectfully submitted, 



$23,896 16 



ALBERT WOOD, 

Treasurer. 



Oct. 1, 1901. 



Special Appropriation. 





Appropriation. 


Balance 
unexpended. 


Expended. 


Balance 
Oct. 1, 1901. 


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

Bill No. 35 cancelled and 
credited to appropria- 
tion, .... 


f79,998 44 


131,066 85 


$77,719 83 
45 43 


1 

$2,278 61 
45 43 




$77,674 40 


$2,324 04 






1901.] 



PUBLIC DOCUMENT — No. 23. 



11 



IIS^COME OF LIBKARY FUNDS. 



Lewis Fund. 

Cash on hand Sept. 30, 1900, $32 05 

Interest on Springfield bond, 70 00 

Cash for sale of atlas, ...... 7 50 



Deposit in Worcester County Institution for Savings, f 20 00 

Expended for books, 76 67 

Expended for rebinding books, 7 25 

Cash on hand Sept. 30, 1901, . . . ... 5 63 

Wheeler Fund. 

Cash on hand Sept. 30, 1900, $101 46 

Cash for binding book, ...... 25 

Dividends and bank tax rebate, . . . . . 199 18 

Expended for books $185 81 

Expended for rebinding books, 45 55 

Expended for rent in State Safe Deposit Company, . 5 00 

Cash on hand Sept. 30, 1901, . . . . . 64 53 

Income of Lawn Fund. 
Balance in Mechanics Savings Bank, . . . $1,167 85 

Dividends, 45 91 

Expended for trees, . $50 00 

Balance in Mechanics Savings Bank, . . . 1,163 76 

Income op Manson Fund. 

Dividends, $48 92 

Funds. 

Lewis Fund Investment. 

Springfield bond, $1,070 00 

Worcester County Institution for Savings, . . 215 14 

I Cash on hand Sept. 30, 1901 6 63 



$109 55 
$109 55 

$300 89 

$300 89 

$1,213 76 
$1,213 76 

$48 92 



$1,290 77 



12 



WORCESTER INSAIS^E HOSPITAL. 



[Oct. 



Wheeler Fund Investment. 
Seven shaves Central National Bank, 
Three shares Worcester National Bank, . 
Worcester County Institution for Savings, 
Worcester Five Cents Savings Bank, 
Cash on hand Sept. 30, 1901, . 



$770 00 

540 00 

1,445 86 

1,719 47 

64 53 



$4,539 86 



Manson Fund. 
Worcester County Institution for Savings, 



• I 1,272 14 



1,272 14 



Lawn Fund. 
Worcester Mechanics Savings Bank, 



. $1,163 76 



1,163 76 



J,266 53 



Land Account. 



Cash on hand Sept. 30, 1901, 

Respectfully submitted, 



$58 52 



ALBERT WOOD, 

Treasurer of Corporation. 



Oct. 1, 1901. 



Worcester, Mass., Oct. 23, 1901. 
I hereby certify that I have this day compared the treasarer's statement of disburse- 
ments for the year ending Sept. 30, 1901, 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. 



1901.] PUBLIC DOCUMENT — No. 23. 13 



SUPEKI]SrTE:N^DE]S^T'S KEPORT. 



To the Trustees of the Worcester Insane Hospital. 

I herewith respectfully submit the following report of the 
hospital for the year ending Sept. 30, 1901, it being the sixty- 
ninth annual report. 

There remained at the hospital Oct. 1, 1900, 1,090 patients, — 
499 men and 591 women. During the year 588 patients — 291 
men and 297 women — were admitted, 446 patients — 193 men 
and 253 women — were discharged, and 69 men and 65 women 
died, leaving at the end of the official year 1,098 patients, — 
528 men and 570 women. Of this number, 341 were supported 
by the State, 589 by cities and towns and 168 by friends. Of 
the 446 persons discharged, 91, including 8 habitual drunkards 
(women), were reported recovered; 94, including 2 habitual 
drunkards (women), much improved; 82 improved and 177 
not improved ; 2 were discharged not insane. Twelve men 
and 16 women were removed by the overseers of the poor ; 26 
men and 16 women were discharged to the care of the Board 
of Insanity, to be removed from the State ; 41 women to 
Tewksbury ; 27 women to the Worcester Insane Asylum ; 15 
men and 30 women to Medfield ; 1 man and 1 woman to the 
School for Feeble-minded ; and 1 woman each to Westborough 
and McLean. One woman and 9 men escaped, and were not 
returned to the hospital or accounted for at the end of the 
oflBcial year. 

There remained at the end of the year 8 more patients than 
at the beginning. The smallest number under treatment on any 
one day was 1,043 and the largest 1,150. The daily average 
number was 1,087.9. 

The percentage of recoveries, calculated upon the number of 
discharges and deaths, was 15.68 ; calculated upon the number 
of admissions, it was 15.47. 

The death rate was 7.98, calculated on the whole number of. 
patients under treatment ; and 12.31, calculated upon the daily 
average number. 



14 WORCESTER IKSAKE HOSPITAL. [Oct. 

There has been no unusual amount of sickness in the hospi- 
tal during the year, and but few deaths from causes other than 
those directly incident to mental disease. One attendant and 
two patients suffered from an attack of diphtheria. Each case 
occurred singly, and under such conditions that it was impos- 
sible that one could have been communicated from the other. 
In one patient, a woman who was admitted in a state of acute 
maniacal excitement, the disease proved suddenly fatal after a 
few days' residence at the hospital. The other two cases re- 
covered promptly, and no further infection followed from either 
of them. A small-pox epidemic in the city of Worcester and 
in the neighboring towns, during the winter, caused the man- 
agement of the hospital a great deal of anxiety, and more 
especially from the reason of the outbreak of the disease in two 
of our local hospitals, from each of which we had at the time 
received patients. As a preventive measure, our entire house- 
hold was vaccinated, and it is a matter of sincere congratulation 
that we were fortunate enough to have escaped infection. 

During the year a somewhat unusual number of patients have 
escaped and been unaccounted for. These are almost without 
exception cases of alcoholic insanity, — cases which, as a rule, 
regain their normal condition rather rapidly under enforced 
abstinence, and remain sane as long as they refrain from the 
use of intoxicants. They are generally anxious to work, and, 
in fact, form the most intelligent part of our working force. 
To shut them up in enforced idleness is neither for their good 
nor that of the hospital, while to allow them the certain amount 
of liberty which must be given to our workers affords them 
more or less opportunities for escape ; and it is hardly to be 
wondered at that many of them sooner or later avail themselves 
of the opportunity. In fact, they are practically well when al- 
lowed their liberty, and the only reason for holding them is the 
knowledge that an early discharge results in an almost immedi- 
ate return to their evil habits ; while there is a hope that a long 
detention with regular habits may so build them up both bodily 
and mentally as to enable them to control their appetites. 
Many of these cases on leaving the hospital go directly home, 
and so are accounted for ; but many of them have no regular | 
abiding place, but have long been wanderers in the land, and it 
is these that are difficult to follow and apprehend. 

I am happy to report that the institution as a whole is in a 



1901.] PUBLIC DOCUMENT — 1^0. 23. 15 

most prosperous condition, and that nothing has occurred dur- 
ing the year to interfere with the efficient and harmonious 
working of its various departments. Four hundred and forty- 
six patients were discharged and 588 were admitted. Some 
idea of the amount of work entailed by this rapid change of 
population may be gained when it is remembered that not only 
the material wants of this large number of persons — which are 
seldom few or easily satisfied — must be provided for, but that 
the physical and mental condition of each must be carefully in- 
vestigated, and as far as possible their entire history ascertained 
and recorded before an accurate diagnosis of the case can be 
made and the proper treatment entered upon. This is never a 
matter of a single sitting, but requires long and painstaking 
examinations of the patient on the part of the physician, as 
well as interviews and correspondence often voluminous with 
relatives and friends and with physicians formerly having the 
case in charge. With the above number of admissions, it will 
be readily seen that it is only through the utmost diligence on 
the part of the medical staff that they have been able to keep 
abreast with their duties. That they have done this to a greater 
degree than in any year since this work was undertaken I am 
sure ; and I am also pleased to note that there has been a de- 
cided advance in the character of their work and in the records 
of the different cases. 

The chapel wing extension, a detailed description of which 
will be found in my report for 1899, is now completed, and 
will be occupied as soon as the necessary furniture is received. 
In connection with this work the chapel itself has been enlarged 
some twenty feet, by taking out the old stage and carrying it 
back into the new wing. The chapel has also been repainted 
and frescoed. It was necessary while this was going on to dis- 
continue our Sunday services and our usual week-day entertain- 
ments, and these will now be resumed. 

During the year we have also enlarged our laundry and made 
extensive alterations therein, to make room for the additional 
machinery which the greatly increased number of patients has 
made necessary ; and have provided therein room for an all- 
metal clothes dryer to take the place of our old dry room, 
which was of wood construction, and which had become a con- 
stant menace to the hospital on account of the danger from fire. 
We have also raised the roof of our old boiler room and coal 



16 WOECESTER IKSA:N'E HOSPITAL. [Oct. 

shed, and thereby provided additional room for our various 
mechanical departments. This work, which was only under- 
taken after having received the approval of the Board of In- 
sanity, has been carried out for the most part by our own corps 
of mechanics, assisted largely by patients, and has been paid 
for out of the funds of the hospital. 

Our water supply at the Hillside farm in Shrewsbury has 
never been satisfactory, and for several months during the sea- 
sons of 1899 and 1900 it gave out entirely, obliging us to draw 
water from a long distance for our cattle. To obviate this dif- 
ficulty in the future, we have put in a driven well and a wind- 
mill. The well is 160 feet deep (the last 9 feet being in rock), 
and is lined with 151 feet of 8-inch pipe. 

The Legislature of 1901 authorized the trustees of the 
Worcester Insane Hospital to spend a sum not exceeding 
$45,000 for the construction, furnishing and equipping of a 
building sufficient for the accommodation of 60 nurses. To 
carry out the above act and in compliance with your instruc- 
tions plans were drawn for a building of brick, entirely plain 
both as to exterior and interior finish. These plans having met 
your approval, bids were asked for and were received from three 
responsible builders. The lowest bid was $43,373, complete 
except furnishings. To this is to be added the architect's fees, 
$2,168.65, making the total cost of the building $45,541.65. 
The estimated cost of furnishing is $5,000. After carefully 
going over the plans, with reference to bringing the cost of the 
building within the appropriation, it was at once apparent that 
this could be done only in one of two ways, — by cutting down 
the size of the rooms, or materially cheapening the character of 
the work, neither of which seems advisable. I would recom- 
mend, therefore, that the whole matter of building be delayed 
until the meeting of the coming Legislature, and that an addi- 
tional appropriation be asked for. 

One of the most pressing needs of the hospital at the present 
time is an electric plant for furnishing light and power to the 
institution. That such a plant is not only desirable but abso- 
lutely essential in an institution of this size and character, no 
one will, I think, attempt to gainsay ; and our only reason for 
not urging this matter before was the feeling that the hospital 
had other and still more important needs which should first be 
provided for. Now, however, the time seems to have come 



1901.] PUBLIC DOCUMENT — No. 23. 17 

when this work can be properly undertaken. The estimated 
cost of wiring the building, making the necessary alterations 
and additions in the engine and boiler room, installing new 
boilers and the necessary engines, dynamos and motors, is 
$65,000. 

I would also urge the importance of providing a mortuary at 
the hospital, as the present arrangements for caring for our 
dead are in the highest degree unsatisfactory and unsanitary. 
This building should include rooms for preparing and preserv- 
ing the remains, an autopsy room, a waiting room for the 
friends of the patients, and a small chapel where services may 
be held, — as is often desirable when relatives come from a dis- 
tance and wish to provide burial for their friends here. The 
estimated cost of this building, furnished and equipped, is 
$13,000. 

The following changes have taken place in the staff of the 
hospital : Dr. Revere R. Gurley resigned on account of ill 
health, Drs. Frank T. Budd and Margaret A. Fleming to enter 
general practice. Of the junior assistants, Drs. George H. 
Kirby and Harry A. Cotton were promoted during the year to 
the regular staff. Dr. Cornelia B. J. Schorer was appointed to 
fill the vacancy of female physician. 

The current expenses, less the amount received from articles 
sold, have been $197,406.09; dividing this by 1,087.9, the 
daily average number of patients, gives $181.45 as the annual 
cost of support, which is equivalent to a weekly cost of $3.48. 

With the rapid growth of the institution, its steadily increas- 
ing number of inmates and the new demands that have come 
from efforts toward the introduction of modern hospital methods 
in the care and treatment of our patients, the duties of its man- 
agement have become so varied and intricate that the superin- 
tendent is forced to depend more and more largely upon the 
intelligent and faithful co-operation of his associates, and to 
them is largely due whatever measure of success has crowned 
our efforts during the past year ; and I wish to thank them for 
their loyal assistance and the several members of your Board 
for their continued support. 

HOSEA M. QUINBY, M.D., 

Superintendent. 
Worcester Insane Hospital, Sept. 30, 1901. 



18 WOECESTER INSANE HOSPITAL. [Oct. 



SPECIAL REPOET OF MEDICAL WORK. 



The fifth year of the present organization of the medical 
work has brought an increase of labor both on the clinical side 
and on the side of the post-mortem investigation. Considering 
further the extension of the scope of the work laid out as a 
routine in each case, we find ourselves before a much greater 
output of work than in the previous years. 

The number of admissions was 588, that of discharges 580, 
and the total of careful records is thus brought near the number 
of 2,500. The autopsies reached the number of 80, i.e., 60 
per cent, of the deaths, as in previous years. 

With four senior and four junior assistants on the clinical 
side and one assistant on the autopsy work, practically all the 
time and energy at our disposal have been taken up with the 
routine, and the general result has been that the work done is 
decidedly of greater permanent usefulness than in the previous 
years. The chief improvements are: (1) in the greater ac- 
curacy of the clinical records and greater clearness in their 
arrangement ; (2) the greater number of examinations for spe- 
cial features of the urine, of the blood and the gastric contents ; 
and (3) a much more uniform and reliable material from the 
autopsies. 

The chief results are that a much more definite attitude has 
been reached concerning the interpretation of many phenomena. 
In the field of pathological anatomy an important result has 
been reached concerning some findings of the character of a 
parenchymatous degeneration of systems of nerve-fibres and of 
cell-types in certain forms of melancholia, of alcoholic-senile 
processes, etc., presented to Boston Medico-Psychological So- 
ciety and published in "Brain." The principal result is that 
the anatomical condition is far more extensive than had been 
supposed by Turner, Worcester and others who had come 



1901.] PUBLIC DOCUMENT — ]J^o. 23. 19 

across it since my first publication in 1897, and that Turner 
forced the facts when he thought he had found in the condition 
an explanation for both melancholia and mania. The degenera- 
tion is found in many parts which are not supposed to have any- 
thing to do with the mental symptoms, and this leads us to 
insist upon an important practical hint at variance with the 
recommendations of the leading German students in this field, 
viz. : their claim that the pathological anatomy of mental dis- 
eases is to be sought in the cerebral cortex. Our findings and 
the hasty conclusions of Turner together show that the day has 
not come when restriction of work on too narrow parts of the 
nervous system will not lead, of necessity, to narrow and 
easily wrong views. 

The studies on special cell-types have been continued, but 
they have been withheld from publication because a number of 
points require clearing up, and because it is not desirable that 
the literature should be swelled with simple descriptions before 
sufficiently useful explanations can accompany them. A sum- 
mary of the principal facts is now in preparation for an article 
on the general pathology of insanity for the " American Eefer- 
ence Handbook of Medical Science." 

In the studies of the blood, as in the other lines, much of the 
results tend to invalidate hasty claims of the existing literature ; 
and a certain attitude of distrust which was entertained con- 
cerning the curious wave of " blood work" in previous reports 
can hardly be said to have been dispelled. Some interesting 
studies have been carried further by Dr. Hoch on the blood 
changes in a case of episodic epileptic insanity. They will be 
published in connection with some allied material. 

An interesting study has been made on the question of excre- 
tion of indican in various types and stages of mental disorders, 
by Dr. Coriat. His contribution will soon be in shape for 
publication. 

A leave of absence granted me made it possible to see some 
of the leading research stations in Europe, to attend several 
important European conventions, and to add to the foundation 
for some topics of clinical research by work in various clinics. 
A few words of comment concerning the impressions obtained 
may accompany my expression of thanks to the administration 
of this hospital. 



20 WORCESTER IJSTSANE HOSPITAL. [Oct. 

My first visits were paid to the central laboratories of the 
Scotch and London asylums. Both these establishments are 
the outcome of a desire for progress and for the utilization of 
autopsy material of interest The Edinburgh laboratory, under 
the direction of Dr. Ford Robertson, is quite detached from the 
asylums. The London laboratory, under the direction of Dr. 
F. W. Mott, is attached to the large Claybury Asylum, but 
also without direct official connection. Dr. Ford Robertson is 
a very efficient worker and originator in neurological technique, 
and has made a number of interesting contributions to the his- 
tology of the neuroglia and a number of conditions met with in 
the insane, such as othaematoma, chronic leptomeningitis, heemor- 
rhagic pachymeningitis, etc., collected in his " Pathology of In- 
sanity." Dr. Mott, whose connection with the Charing-Cross 
Hospital secures a large neurological material, has devoted 
much work to the problem of neuro-syphilis and the etiological 
importance of syphilis in general paralysis. Together with 
Professor Halliburton, he has established the existence of cholin 
in the cerebro-spinal fluid of general paralytics, and, moreover, 
the parallelism existing between amount of cholin and amount 
of decay of myelin-sheaths. There are also extensive studies 
on tabes in progress, and his assistants and collaborators have 
devoted much work to brain-lesions, etc. 

In Amsterdam the neurological clinic at the central hospital 
and the psychiatric department of a second city hospital are 
both in the hands of Professor Winkler, the chief weight lying 
on the excellent neurological clinic and laboratories. 

In Utrecht Professor Ziehen is constructing a psychiatric 
clinic with a psychological and neurological laboratory, to replace 
the present clinic, situated in an old city asylum. Clinic and 
laboratories are institutes of the university, — a very excellent 
side of the union of State and university interests existing on 
the European continent. 

The conditions in Vienna and in Berlin, Giessen and Heidel- 
berg are so well known that no special description is needed, 
beyond the mention of the new clinic which is in construction 
at the Charite in Berlin. As in the other university towns of 
Germany, there exists already, or there is planned, a clinic for 
mental diseases, consisting of a small hospital of 40 to 150 beds, 
usually close by the other university hospitals, and supplied 



1901.] PUBLIC DOCUMENT — No. 23. 21 

with laboratories. These clinics are under the same rules as 
the ordinary State hospitals, but naturally with better provi- 
sions for research and the teaching of research, and provided 
with an especially well-selected staff. 

In Florence the very large but well-arranged asylum is under 
the direction of Professor Tanzi. The hospital is divided into 
several relatively independent services and an admission divi- 
sion which is used as clinic, and has an excellent staff with very 
good laboratory facilities. 

In Switzerland the conditions are similar to those in Germany. 
I visited the new asylum near Geneva, the clinic Waldau near 
Bern, the asylum for chronic cases in Rheinau (with large 
agricultural colony) and the Burgholzli. The use of ordinary 
farm-houses at Bern appealed to me very much. They are in 
every respect merely improved farm-houses, not asylum build- 
ings. 

This is not the place to enter upon the details of investiga- 
tions and their possible influence on our own plans of work. 
Everywhere, also in the congress at Berlin, one sees strong 
efforts towards getting more solid foundations in clinical 
psychiatry. It is striking how everywhere the laboratory work 
is given the position of an adjunct, not of the centre, as is un- 
fortunately the tendency in Anglo-Saxon countries. In this 
direction Edinburgh is likely to take the first step towards the 
construction of hospital wards for the central institute of 
psychiatry. 

On the feelings concerning our own work here the whole re- 
view of European efforts has had the effect of a wholesome 
corroboration of the intentions with which we started out in 
this hospital, and the only regret is that they had to be adapted 
to such a large material. 

I cannot suppress one observation which seems to me very 
suggestive. In one asylum in Great Britain, in which I found 
a remarkably wide-awake spirit for psychiatric work, the con- 
ditions were so strikingly different from those usually met with 
in this country that I wish to mention them. The asylum has 
about 300 patients, and 80 admissions per year. The superin- 
tendent and his assistant find it possible to get through their 
routine duties between 10 o'clock and 2. The rest of the day 
can be devoted to special work, and I must say it is devoted 



22 WOECESTER mSAKE HOSPITAL. [Oct. 1901. 

to work which shows the wholesome influence of a feeling of 
one's having done one's duty and of one's doing in addition the 
labor of love for science. I hope to review the work of this 
asylum more fully when some of the very promising studies 
carried on there will be published and open to discussion. A 
happier and more hopeful and satisfied feeling I never carried 
away from a short visit to an asylum than from this Murdoch 
Asylum and Dr. L. Bruce. 

If an application of the various experiences may be made to 
our condition, it is this : that it is to be regretted that only very 
large hospitals should be allowed to be seats of research. For 
a satisfactory expansion of one's spirit of work a certain ease 
of action is necessary, free from the dead pressure of excessive 
expectations, and, moreover, a feeling that there is some time 
to spare ; that a loss of time on a set of experiments that turn 
out negatively is not a waste of time which would mean neglect 
of duty. 

I conclude this account with the expression of my thanks for 
the co-operation of the authorities, and especially for the un- 
tiring and faithful work of my associates. 

Yours respectfully, 

ADOLF MEYER. 



STATISTICAL TABLES. 



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26 



WORCESTER INSANE HOSPITAL. 



[Oct. 





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1901.] 



PUBLIC DOCUMEI^T — No. 23. 



27 



3. — Received on First and Subsequent Admissions. 





Cases admitted. 


Times previously 
kkcovebed. 


NUMBER OF THE ADMISSION. 
















Males. 


Females. 


Totals. 


Males. 


Females. 


Totals. 


First, . 




236 


256 


492 


- 


- 


- 


Second, 




40 


26 


66 


13 


5 


18 


Third, . 




10 


9 


19 


6 


5 


11 


Fourth, 




2 


4 


6 


1 


3 


4 


Fifth, . 




1 


- 


1 


~ 


- 


- 


Sixth, . 




- 


2 


2 


- 


2 


2 


Seventh, 




1 


- 


1 


1 


- 


1 


Eighth, 




1 


- 


1 


1 


- 


1 


Total of cases, 


291 


297 


688 


22 


16 


37 


Total of persons, 




282 


297 


679 


20 


15 


36 



4. — Relation to Hospital of Persons admitted. 



Males. 



Totals. 



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., 

Danvers, .... 

Danvers and Westborough, 

Medfield, .... 

McLean and Westborough, 

Northampton, 

Montreal, Canada, 
Total of cases. 



212 
51 
24 



291 



237 
34 
19 

1 
1 

2 
1 
1 
1 



449 
85 
43 

1 
3 
1 
3 
1 
1 
1 



297 



588 



28 



WORCESTER INSANE HOSPITAL. 



[Oct. 



5. — Parentage of Persons admitted. 











Males. 


Females. 


Totals. 


PLACES OF NATIVITY. 
















Father. 


Mother. 


Father. 


Mother. 


Father. 


Mother. 


Massachusetts, . . ■ . 


45 


38 


29 


33 


74 


71 


Other States : — 














Maine, .... 


9 


8 


8 


13 


17 


21 


New Hampshire, 
Vermont, . 




2 
6 


6 
5 


7 
4 


3 
3 


9 
10 


8 
8 


Rhode Island, 






2 


3 


3 


2 


5 


5 


Connecticut, 






4 


4 


1 


1 


5 


5 


New York, . 






7 


7 


2 


3 


9 


10 


New Jersey, 
Pennsylvania, 
Virginia, 
North Carolina, 






1 
2 
3 


2 
2 

2 


1 
2 


2 


2 
2 
3 
2 


2 
2 
2 
2 


Georgia, 






- 


1 


- 


- 


- 


1 


Other countries : — 














Canada, .... 


16 


17 


7 


6 


28 


23 


Nova Scotia, 




3 


4 


6 


4 


8 


8 


New Brunswick, 




3 


5 


4 


3 


7 


8 


Newfoundland, . 




1 


1 


3 


4 


4 


5 


Prince Edward Island 




2 


2 


- 


_ 


2 


2 


Scotland, . 




6 


5 


2 


1 


7 


6 


England, 






17 


15 


8 


6 


26 


21 


Ireland, 






92 


91 


105 


107 


197 


198 


Sweden, 






9 


9 


13 


12 


22 


21 


France, 






2 


2 


1 


- 


3 


2 


Denmark, 






- 


- 


1 


1 


1 


1 


Germany, 
Austria, 






4 
1 


4 
1 


5 


6 


9 
1 


10 

1 


Armenia, 






1 


1 


- 


- 


1 


1 


Hungary, 
Roumania, 






1 


1 


1 


1 


1 

1 


1 

1 


Spain, . 
Italy, . 
Turkey, 
Finland, 






4 
1 
2 


4 
1 
2 


1 
2 

4 


2 
4 


1 
6 
1 
6 


6 

1 
6 


Poland, 






- 


- 


1 


1 


1 


1 


Russia, 






2 


2 


2 


2 


4 


4 


Australia, 






- 


- 


1 


1 


1 


1 


Unknown, . 




35 


38 


74 


76 


109 


114 


Total of pel 


sons, 




282 


282 


297 


297 


679 


579 



1901.] 



PUBLIC DOCUMENT — Ko. 23. 



29 



6. — Birthplace of Persons admitted. 



PLACES OF BIKTH. 


Males. 


Females. 


Totals. 


Massachusetts, 


105 


1 

95 


200 


Other States : — 








Maine, 


7 


13 


20 


New Hampshire, 










3 


6 


8 


Vermont, . 










4 


5 


9 


Rhode Island, 












1 


5 


6 


Connecticut, 












3 


2 


5 


New York, . 












8 


5 


13 


New Jersey, 












1 




1 


Pennsylvania, 












3 


_ 


3 


Ohio, . 












1 


3 


4 


Virginia, 












2 


_ 


2 


North Carolina, 














3 


3 


South Carolina, 












_ 


1 


1 


Illinois, 












1 


1 


2 


Louisiana, . 












2 




2 


Tennessee, . 












1 


_ 


1 


Kansas, 














1 


1 


California, . 












- 


1 


1 


Other countries : — 








Canada, 


17 


15 


32 


Nova Scotia, 










6 


9 


15 


Cape Breton, 










1 




1 


Prince Edwai'd Island 


, 








3 


_ 


3 


New Brunswick, 










6 


6- 


12 


Newfoundland, . 










2 


6 


8 


Scotland, 












3 


1 


4 


England, 












10 


9 


19 


Ireland, 












48 


72 


120 


Sweden, 












8 


12 


20 


France, 












1 




1 


Denmark, . 














1 


1 


Finland, 












2 


4 


6 


Poland, 














1 


1 


Germany, . 












4 


4 


8 


Austria, 












1 


2 


3 


Hungary, , 














2 


2 


Armenia, . 












2 


1 


3 


Roumania, . 












1 




1 


Spain, . 














1 


1 


Italy, . . . 












4 


2 


6 


Greece, 












1 




1 


Turkey, 












1 


_ 


1 


Russia, 












3 


2 


5 


Unknown, . 












16 


7 


23 


Totals, 


282 


297 


579 



30 



WORCESTER INSANE HOSPITAL. 



;[Oct. 





7.- 


— Residence of Persons admitted. 






PLACES. 


Males. 


Females. 


Totals. 


Massachusetts (by counties) : — 










Bristol, .... 


• 


2 


- 


2 


Essex, . 












2 


- 


2 


Hampden, 












- 


1 


1 


Hampshire, 












- 


1 


1 


Middlesex, 












97 


84 


181 


Norfolk, 












7 


6 


13 


Suffolk, 












40 


65 


105 


Worcester, 












134 


140 


274 


Totals, 












282 


297 


579 


Cities or towns. 












282 


297 


679 



1901.] PUBLIC DOCUMENT — No. 23. 



31 



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1—1 


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s 


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32 



WORCESTEK INSANE HOSPITAL. 



[Oct. 



Occupation of Persons admitted. 

FEMALES. 



Artists, 2 


Saleswoman, . . . . 1 


Attendant, 






1 


Scrubwoman, 








Canvasser, 






1 


Seamstress, . 








Clerks, . 






2 


Stenographer, 








Cooks, . 






3 


Stitcher, 








Domestics, 






57 


Students, 








Dressmakers, 






5 


Teacher, 








Housekeepers, 






47 


Waistmaker, . 








Housewives, . 






69 


Waitresses, . 








Laundresses, . 






3 


Washerwoman, 








Merchant, 






1 


Wireworker, . 








Milliners, 






3 


Unknown, 






13 


Music teacher. 






1 


No occupation, 






63 


Operatives, . 
Physician, 






11 

1 


Total, . . . .297 



Agent, 1 


Confectioner, . . . 1 


Architect, 






1 


Cooks, . 






3 


Baker, . 






1 


Core maker, . 






1 


Barbers, 






2 


Cracker salesman. 






1 


Bartenders, . 






2 


Currier, . 






1 


Blacksmiths, . 






2 


Dentists, 






2 


Bobbin maker. 






1 


Druggists, 






4 


Butchers, 






3 


Engineer, 






1 


Cabinet maker. 






1 


Express agent, 






1 


Carpenters, . 






6 


Farmers, . . 






16 


Carriage painter. 






1 


Fireman, 






1 


Chair maker. 






1 


Fisherman, . 






1 


Choreman, 






1 


Foreman, 






1 


City treasurer. 






1 


Gardeners, 






3 


Clerks, . 






10 


Grocer, . 






1 


Coachmen, 






2 


Hostlers, 






2 


Collector, 






1 


Hotel porter, . 






1 


Comb maker. 






1 


Insurance agents, 






2 



1901.] 



PUBLIC DOCUMENT — No. 23. 



33 



9. — Occupation of Persons admitted — Concluded. 

MALES — Concluded. 



Ironworker, . 

Janitor, . 

Laborers, 

Last maker, . 

Lineman, 

Longshoreman, 

Machinists, . 

Marble cutter, 

Master mariner, . 

Masons, . 

Mechanics, . 

Medicine manufacturer, 

Metal spinner, 

Motormen, 

Nurse, . 

Office boy, 

Operatives, . 

Optical works, 

Oyster opener. 

Painters, 

Paper hanger and painters. 

Physicians, 

Plumber, 

Policeman, 

Printer, . 

Railroad employees. 

Real estate agent, . 

Retired, . 



60 



12 



Roofer, 1 

Rope maker, .... 1 

Rubber works, ... 3 

Salesmen, .... 2 

Sailor, 1 

Sculptor, .... 1 

Steam fitters, ... 2 

Steel worker, ... 1 

Steward, .... 1 

Shoe business, ... 2 

Shoemakers, .... 6 

Shop keeper, .... 1 

Soldier, 1 

Spinner, .... 1 

Stone cutters, ... 2 

Students, .... 4 

Teacher, .... 1 

Teamsters, .... 3 

Trader, 1 

Watchman, .... 1 

Watchman and gardener, . 1 

Wood moulders, ... 2 

Woodworker, ... 1 

Unknown, .... 13 

No occupation, ... 28 

Total, . . . .282 



34 



WORCESTEK mSANE HOSPITAL. 



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1901.] PUBLIC DOCUMENT — No. 23. 



35 



I IH I I I I I 



I I-l I I I I I I I I I I I I I 



I I I I I I I I 



I I I 



I I I I I I I I I 



I I I I I I I I I I I I I I I 



I I I I I I I 



I I I I I r 



I iM I- e^ •* 1-1 N ■* I I I 



1 I I eO iH 00 iH 



I IH I IH CO I I-l CO I 



I ■« I I I 



!-!•.» IN IINCO I-H lOlC^ 



I I '<# I I-l I rl 



r-ll Ir-llneOI I llNiHIlN 



I I-l I I I I 



[III 



I iH I 



I I I I I I I I I I I 



t I I I I I I I I I I I I I 



^OOOICl<Ob-i-IO'<il'^C^r-l'*i<efl(M 
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I to r-l in O 





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ftP a '^ a a ^ ^ il 



36 



WOKCESTER INSAITE HOSPITAL. 



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1901.] 



PUBLIC DOCUMEITT — No. 23. 



37 



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







Persons First admitted 
TO Ant Hospital. 


Persons died. 


AGES. 


AT 

first attack. 


WHEN 
ADMITTED. 


AT 
riRST ATTACK. 


AT 

time of death. 




Ma. 


Fe. 


Tot. 


Ma. 1 Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Congenital, 




3 


2 


5 


- 


- 


- 


- 


- 


- 


- 


- 


- 


15 years and less, 




1 


5 


6 


1 


2 


3 


1 


2 


3 


- 


- 


- 


From 15 to 20 years, 




12 


3 


15 


13 


8 


21 


1 


3 


4 


- 


1 


1 


20 to 25 years, 




18 


22 


40 


24 


19 


43 


4 


5 


9 


3 


4 


7 


25 to 30 years, 




28 


22 


50 


34 


29 


63 


3 


4 


7 


3 


2 


5 


30 to 35 years, 




22 


30 


52 


22 


31 


53 


2 


2 


4 


3 


3 


6 


35 to 40 years, 




19 


29 


48 


30 


39 


69 


5 


7 


12 


4 


3 


7 


40 to 50 years. 




25 


31 


56 


30 


47 


77 


17 


11 


28 


15 


11 


26 


50 to 60 years, 




15 


18 


33 


17 


29 


46 


8 


11 


19 


8 


14 


22 


60 to 70 years, 




9 


11 


20 


14 


11 


25 


15 


8 


23 


14 


7 


21 


70 to 80 years. 




8 


11 


19 


14 


17 


81 


10 


8 


18 


16 


14 


30 


Over 80 years, . 




3 


2 


5 


6 


4 


10 


1 


1 


2 


3 


6 


9 


Unknown, . 




49 
212 


51 

237 


100 
449 


7 


1 

237 


8 
449 


2 


3 


5 


- 


- 


- 


Total of persons. 


212 


69 


65 


134 


69 


65 


134 


Mean ages in years, . 


87.6 


38.7 


38.1 


40.0 


39.9 


39.9 


51.0 


46.3 


48.6 


55.7 


55.3 


55.5 



13. — Reported Duration of D 


isease before Last Admission. 




PREVIOUS DURATION. 


First Admission 
to ANT Hospital. 


All Other 

Admissions. 


Totals. 




Ma. 


Fe. Tot. 


Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Congenital. 


2 


2 


4 


4 


- 


4 


6 


2 


8 


Under 1 month, 








65 


53 


118 


21 


11 


32 


86 


64 


150 


From 1 to 3 months 








24 


37 


61 


10 


14 


24 


34 


51 


85 


3 to 6 months 








12 


20 


32 


4 


6 


10 


16 


26 


42 


6 to 12 months 








10 


10 


20 


3 


1 


4 


13 


11 


24 


1 to 2 years, 








23 


14 


37 


2 


5 


7 


25 


19 


44 


2 to 5 years, 








17 


20 


87 


8 


3 


11 


25 


23 


48 


5 to 10 years. 








4 


11 


15 


1 


- 


1 


5 


11 


16 


10 to 20 years. 








5 


4 


9 


1 


1 


2 


6 


5 


11 


Over 20 years, . 








- 


1 


1 


2 


- 


2 


2 


1 


3 


Unknown, . 








50 


65 


115 


23 


19 


42 


73 


84 


157 


Total of cases. 


212 


237 


449 


79 


60 


139 


291 


297 


588 


Total of persons, 








212 


237 


449 


70 


60 


130 


282 


297 


679 


Average in years. 






1.23 


1.62 


1.42 


3.57 


.83 


2.2 


2.4 


1.22 


1.81 



38 



WORCESTER INSAIS'E HOSPITAL. 



[Oct, 



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fa 


• • • o 


Periodic insanity : — 
Manic and delirious forms. 
Circular forms. 
Depressed forms, . 

Senile dementia, . 

Traumatic insanity, . 
B. — Habitual drunkards, 

Not insane 


o 
e 

IfH 

o 

"a 
o 


a 
o 
u 

p. 
"S 
"3 
o 
H 


A, — Insane .• — 

Alcoholic insanity. 
Climacteric melancho 
Constitutional inferioi 
Delirium (infectious, 

and asthenic), . 
Dementia, prsBcox, 
Epileptic insanity. 
General paralysis, 
Hunlington's chorea. 
Hysterical insanity. 
Imbecility, . 
Katatonia, . 
Morphinism, 
Paranoia, 
Paranoic condition. 



PUBLIC DOCUMENT — No. 23. 



39 












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40 



WORCESTER INSANE HOSPITAL. 



[Oct. 



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•-4(NlllrHIIIirillllll 




•BIB^Oi 


r-l(Mirai-l|,-H.-l.-(iH|pHI IrHliHrll 


•sa[Btna^j 


rHMiOiHI Ir-lliHIiHI 1 r 1 liHI 


•saiBj5 


lOJOl IrHtrHI 1 1 1 lillrHI | 




•BIBJOX 


dOOQOI IIMII-II ll-(l 1 1 1 1 1 1 


•eaiBtaa^ 


1 1 rH 1 1 1 1 11 r 1 1 1 1 1 1 1 1 1 


•BaiBjj 


(NO0t-ll(Mllllr-tlllllll 


1 

<1 


•BIBIOX 


eCr-(0>iHr-l«5rHTtlr-lrH<0rHiHrHr-l>0iHi-t 
iH eo « 


•saiBraaj 


OJlO(NlHr-( Ir-irHiH (TtrHrH ll-CNiHfH 


•eaiBK 


■*«Ot-l linicOlrHCll liHIDJI 1 




W 
Eh 
< 

to 

O 

OQ 

m 
& 
<1 
O 


Phthisis pnlmonalis 

Broncho-pneumonia 

Broncho-pneumonia and gastro-enteritis. 

Hypostatic pneumonia and pleurisy with effusion, 

(Edema of lungs, 

Pulmonary haemorrhage, 

Mitralinsufficiency 

Heart failure 

Rupture of heart 

Endocarditis, 

Heart failure and chronic nephritis, 

Nephritis 

Enteritis 

Gastro-enteritis, . 

Chronic enteritis 



PUBLIC DOCUMENT — 1^0. 23. 



41 



1 


1 


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1 


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1 


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42 



WORCESTEE INSANE HOSPITAL. 



[Oct. 



o . 

O m 


•SlBIOi 


r-lTHIIIIIr-lllrHtllli-lll 


•saicoia^ 


IH 1 1 1 1 I 1 1 1 1 tH 1 1 1 1 1 1 1 


•saiBH 


IrHllllliHIIIIIIIlHIl 


M 

Q 


•BlBJOi 


r-IC4llllll-lllllrHlllri 


•9a[Bmaj 


1 .-( 1 1 1 1 1 1 1 1 1 1 1-1 1 1 1 1 1 


•saiBjs 


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E" S 

t= 2 
SS 

&< H 

Om 
O 


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'aajBnia^ 


rHIIIrlllllllllllr-ltl 


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1 1 1 t 1 1 1 1 1 1 1 1 1 I 1 1 1 • 


2t^ 

2S 

SI 


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rl^llllllllllllllliH 


■BaiBcnaj 


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•saiBpj 


1 rl 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 


M 

o 

« 

1 


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l(MIIIIIIIi-lrHIII|i-lll 


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llHIIIIIIItlHIIIIlHIl 


•saiBj^ 


1 rH 1 1 1 1 1 1 1 iH 1 1 1 1 1 1 1 1 


1 


■eiBJox 


IrHllllllllrHltlliHIl 


•8a[Bcaa^ 


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


■saiBH 


IrHllllllllrdllllrHII 


< . 


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-^liHllllllllr-llllllll 


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Tj< ( 1 1 1 1 1 1 1 1 i-l 1 1 1 r 1 1 1 


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1 •-I 1 1 1 1 1 1 1 r 1 1 I 1 1 1 1 1 




< 
O 

09 


Phthisis pulmonalis, 

Broncho-pneumonia, 

Broncho-pneumonia and gastro-enteritis, .... 

Hypostatic pneumonia and pleurisy -with effusion, 

CEdema of lungs, 

Pulmonary haemorrhage, 

Mitral insufficiency, 

Heart failure, 

Endocarditis, 

Heart failure and chronic nephritis, 

Nephritis 

Gastro-enteritis, 



1901.] 



PUBLIC DOCUMENT — No. 23. 



43 



1 1 1 1 1 1 1 1 1 1 1 1 1 t 1 1 1 1 1 1 1 1 


>o 


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


<M 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 [ 1 1 1 1 1 


CO 


1 1 1 1 1 1 r 1 1 1 1 r 1 1 1 1 1 1 r rH 1 r 


<o 


1 1 1 1 1 t 1 1 1 1 1 1 1 1 1 1 1 1 1 r1 1 1 


05 


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


CO 


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


CO 


1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 i 1 1 1 


1 


'-''''■■'■' ^ , w ^1^ 


lllllllllllllllllltlrHr-ITH 


li-HllllllllllllllllrHIIICO 


1-lll|llllllrHllliHlrHI||ll(3> 


tHIII r-llllrtlr-lllllll- 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 i 1 1 1 r 1 1 <M 


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


eo 


1 1 1 1 1 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 r 1 1 1 1 1 1 CO 


iirHirtiiiiiiiHiiiiiiiiiilen 


llrllr^llllllI-tllllllllllloD 


1 1 1 1 1 1 1 1 1 i t 1 i 1 1 1 1-1 


Pancreatic, hepatic and intestinal hsemorrhage. 

Volvulus of sigmoid 

Peritonitis, 

Acute peritonitis and rupture of colon 

Brain tumor 

Encephalomalacla, 

Cerebral haemorrhage, 

Convulsions 

Status epilepticus, 

Carcinoma of larynx 

Carcinoma of stomach 

Carcinoma of duodenum, 

Carcinoma of breast 

Carcinoma of liver 

Stomatitis ulcerosa 

Exhaustion 

Septicaemia, 

Gangrene of foot 

Tubercular spinal caries 

Tubercular meningitis, 

Pernicious ansemla, 

Diphtheria 


1 
o 



44 



WORCESTER IISTSANE HOSPITAL. 



[Oct. 





>4 




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sane :- 
Under 
From 

Over 2( 
Unkno 


m 


a 


"Si" 

1^1 5 


m 


a 

M 








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a 

M 

1 


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<i 




^ 


oa 




■< 



PUBLIC DOCUMENT — No. 23. 



45 













«» 




o 




«M t>. Ti^ QO <M (M O iCi ■* 1 


-* 


"O 




Cl« 


•SlBJOi 


CN i-H .— 1 i-l (I<l (N rH 


CO 

1— ( 


CO 




2g 








CO 
















J-ICCItOlOtMiUCO'-l-^tl 1 


iC 


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1—1 




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o 




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ri o c ^ ^ ^ ^ 








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46 



WOECESTER INSANE HOSPITAL. 



[Oct. 



s 



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a, 






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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 




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03 


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 




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> 

i 

ta 


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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 r I 1 


03 


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


n 

o 
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1 1 I 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 


o5 


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C8 


1 1 1 r 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 c 1 1 1 J 




K 
R 


O 
EH 


u:St-IMt-CO-*05C<Jt^t^OOCDi005»Oir3COOC0050i-HiaoOi«r-(iOW^ 


6 


^i-d-H^Or-lt-Wrfi-HOOCOW-racOt-t-CDOOMtOinOtOOCOOCM 
^■nTfiffltOt-t-t-tOt-OOOffli-lOiOOiOOOir-i — (MOOOOMt-t-Ol 


a 


rHtOi-l«lMCOC^-*COtO«tD(MCDOC*tOMt-.-'t-iOOOOCSi-IINOOIM 
00«OOiOt^OO<©eDiOt-05a50000r-(0500SOO>00<©l>-OOCaOOaOO 
H rH 1-1 i-( i-H i-l 


So 

05 ft 














co"-*'ii5 tot-Too oTo •-< IN «■"* la oTi-roooro rH(M n-^iatot£(xi oTojj 
ooooqoooooooooqoooqooooooooocoqooooocoooqooooooooooooocooo 



1901.] PUBLIC DOCUMENT — 1^0. 23. 47 



1 1 1 1 1 1 1 1 1 r 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 > I •-• 


'^ 


1 1 r 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 t 1 r 1 1 


. 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 r 1 I r 1 1 1 1 1 1 1 1 1 1 1 1 ■ 1 1 1 1 1 i-i 


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48 



WORCESTER INSANE HOSPITAL. 



[Oct. 



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1901.] PUBLIC DOCUMENT — No. 23. 



49 



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50 



WOKCESTER INSANE HOSPITAL. 



[Oct. 





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1901.] 



PUBLIC DOCUMENT — No. 23. 



51 







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52 



WORCESTER INSANE HOSPITAL. 



[Oct. 



LIST OF perso:n^s 

Employed in the Worcester Insane Hospital, Sept. 30, 1901. 



Superintendent and physician, per year, 
Assistant superintendent and physician, per year. 
Assistant physician, per year (non-resident) , 
Assistant physicians (two), each, per year, 
Assistant physician, 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 (two), per month. 

Stenographers and typewriters (two), per week. 

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

Assistant supervisoi's (two men), each, per month. 

Supervisors (three women), each, per month. 

Marker of clothing, etc., per month, . 

Seamstresses (three), per month, 

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

Attendants (fifty-three women), per month. 

Night attendants (seven men), per month, . 

Night attendants (eight women), per month. 

Baker, per month, 

Assistant baker, per month, . 

Steward's assistant, per month, . 

Kitchen men (three), per month. 

Cooks (two), per month, 

Laundry man, per month, . 

Laundress, per month, . 

Assistant laundry man, per month. 



$60 00 
10 00 



18 00 
23 00 
14 00 
25 00 



25 00 
25 00 



$3,000 00 


1,800 00 


2,000 00 


1,000 00 


800 00 


400 00 


1,200 00 


600 00 


720 00 


500 00 


75 00 


and 30 00 


and 8 00 


45 00 


40 00 


25 00 


20 00 


and 22 50 


to 28 00 


to 18 00 


to 28 00 


18 00 


50 00 


30 00 


30 00 


to 45 00 


and 28 00 


30 00 


20 00 


25 00 



1901.] 



PUBLIC DOCUMENT — :No. 23. 



53 



Laundry girls (eight), per month, 

Kitchen girls (five), per month, . 

House girls (eight), per month, . 

Office girl, per month, . 

Carpenter, 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 engineer, 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. 



fl4 00 to $18 00 
14 00 to 18 00 
14 00 to 16 00 
16 00 
3 00 

2 50 

3 26 
2 25 

75 00 
2 50 
40 00 
60 00 
20 00 

23 00 to 30 00 
30 00 

14 00 to 18 00 
45 00 
25 00 
25 00 
80 00 
25 00 



54 



WOKCESTEE IKSANE HOSPITAL. 



[Oct. 



PRODUCTS OF THE FAEM 



On Hand Oct. 1, 1901, and not delivered at the Hospital. 



Apples, . 
Barley fodder, 
Beans, lima, 
Beets, . 
Cabbages, 
Carrots, . 
Cauliflower, 
Celery, . 
Corn, sweet, 
Corn fodder, 
Ensilage, 
Hay, . 
Hay, swale. 
Mangolds, 
Oat fodder. 
Onions, . 
Parsnips, 
Rowen, . 
Rye, 
Squash, . 
Straw, rye. 
Tomatoes, 
Turnips, 



167 barrels. 
10 tons. 
75 bushels. 
575 bushels. 
5,000 heads. 
280 bushels. 
50 heads. 
5,000 heads. 
360 dozen. 

2 tons. 
500 tons. 
300 tons. 
8 tons. 
200 bushels. 
12 tons. 
400 bushels. 
200 bushels. 
70 tons, 
40 bushels. 
16,525 pounds. 
6 tons. 
200 bushels. 
1,000 bushels. 



1901.] PUBLIC DOCUMENT — Ko. 23. 55 



FAEM ACCOUNT. 



De. 

Bread, $312 58 

Butter, 421 04 

Current expenses, • . 2,887 42 

Fertilizer, 579 05 

Fish 183 90 

Fuel, 1,336 80 

Furniture 129 67 

Grain and meal, 6,595 24 

Groceries, etc., 1,961 82 

Ice, 9 64 

Lights 234 39 

Live stock 1,552 03 

Meats 1,839 23 

Repairs, 1,364 56 

Seeds, 171 63 

Sugar, 411 63 

Wages, 6,464 04 

Water, ; 193 72 

$26,648 39 

Cb. 

Apples, No. 1, 545 barrels $772 00 

Apples, No. 2, 85i barrels, 72 42 

Asparagus, 10 dozen bunches, 14 63 

Beans, lima, 45| bushels, 88 63 

Beans, string, 27 bushels, 18 50 

Beets, 363 bushels . . . 197 95 

Beef, 4,977 pounds 38539 

Bones, sold 7,915 pounds, 51 98 

Cabbage, 202 barrels, 208 33 

Canteloupes, 264, 13 20 

Carrots, 139| bushels, 81 32 

Cauliflower, 18 heads, 2 70 

Chickens, 55 pounds, 8 80 

Celery, 60 dozen, 67 75 

Cider, 3,174 gallons, 314 40 

Amount carried forward, $2,298 00 



56 



WOECESTER INSANE HOSPITAL. [Oct. 1901. 



Amount brought forward. 

Corn, 3,714^ dozen, 

Cucumbers, 730, . 

Pickles, 14,400, . 

Dandelions, 150 bushels, 

Eggs, 49^ dozen. 

Eggplant, 91, 

Hay, 21,275 pounds, . 

Hay, sold, cash, . 

Hides, 800 pounds, 

Ice, 750 tons, 

Ice sold, cash for 490 tons. 

Iron, junk sold, . 

Kale, b\h bushels. 

Lettuce, 38 U dozen, . 

Live stock sold, 7 cows. 

Live stock sold, 62 calves, 

Mowing machine sold, cash, 

Milk, 310,570 quarts, 

Oats, 313 bushels. 

Onions, 315 bushels, 

Parsley, 

Parsnips, 234| bushels, 

Pears, 6 bushels, 

Peas, 45i bushels. 

Plants sold, cash, 

Pork, 34,708 pounds. 

Pork, hogs and pigs sold, 106, 

Radishes, 2,289 dozen, 

Rhubarb, 7,259 pounds. 

Spinach, 84 bushels, . 

Squash, 31,600 pounds. 

Squash, summer, 23 dozen, 

Straw, rye, 29,404 pounds. 

Strawberries, 847 quarts. 

Tomatoes, 268f bushels. 

Tomatoes, green, 1^ bushels, 

Turnips, 173 bushels, . 

Vegetables sold, . 

Watermelons, 80, 

Deficit against farm, . 



2,298 00 



371 


45 


7 


30 


42 


90 


68 


75 


10 


72 


5 83 


222 


50 


7 


30 


44 


75 


120 


00 


115 


50 


5 84 


36 


50 


169 


73 


147 


00 


183 


00 


10 00 


12,422 80 


112 


91 


250 80 


1 


49 


177 


26 


6 


63 


93 


53 


28 


95 


2,414 87 


617 00 


507 


33 


185 


32 


63 85 


462 72 


9 


25 


282 


13 


128 


05 


232 


55 




60 


70 49 


152 


67 


8 00 


4,652 


12 


126,648 39