Annual report of the Worcester Insane Asylum at Worcester

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THIRTIETH ANNUAL EEPOET

WORCESTER INSANE ASYLUM

WORCESTER,

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y Year ending November 30, 1907.

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CONTENTS,
i .

FAQB

Report of Trustees, . . . . . . . .51

Report op Superintendent, ....... 53

Report of Treasurer, ........ 60

Statistics, 67

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OFFICERS OF THE ASYLUM.

TRUSTEES.

LYMAN A. ELY, .
THOMAS H. GAGE, Jr.,
THOMAS RUSSELL,
SARAH E. WHITIN, .
FRANCES M. LINCOLN,
SAMUEL B. WOODWARD,
GEORGE F. BLAKE, .

Worcester.

Worcester.

Boston.

Whitinsville.

Worcester.

Worcester.

Worcester.

RESIDENT OFFICERS.

ERNEST V. SCRIBNER, M.D.,
H. LOUIS STICK, M.D.,
ARTHUR E. PATTRELL, M.D.,
WILLIAM T. HANSON, M.D.,
CHARLES H. WHEELER, M.D.,
ABBIE S. FAY, .

Superintendent.
Assistant Physician.
Assistant Physician.
Assistant Physician.
Assistant Physician.
Matron.

NON-RESIDENT OFFICERS

ALBERT WOOD, .
GEORGE L. CLARK, .
SUSIE G. WARREN, .
FREDERICK H. BAKER, M.D.,
FOREST A. SLATER, .

Treasurer.

Examiner.

Clerk.

Pathologist.

Engineer.

®0mm0n;teElt^ ai '^msKtl^nBtUB.

TRUSTEES' EEPORT.

To His Excellency the Governor and the Honorable Council.

The trustees of the Worcester Insane Hospital, having in charge
the Worcester Insane Asylum, respectfully present the thirtieth
annual report of the latter institution.

During the year the numbers at the main institution in Worcester
have remained without essential change; at the Grafton colony
there has been considerable increase in the number of male pa-
tients, a large building for excitable men having been nearly filled.
The daily number of patients for the whole institution has been
933, as against 767 of last year, an increase of about 20 per cent.

No extraordinary work will be undertaken at the institution in
Worcester, and no special appropriation for use there will be
required.

At the Grafton colony another building is needed for the accom-
modation of female patients, this building to be located near the
present power house and industrial building. We ask that an
appropriation of $50,000 be granted for the erection and furnish-
ing of this building, providing for the accommodation of 62 pa-
tients.

The increase in our population has been somewhat out of pro-
portion to the increase in the amount of milk produced, and dur-
ing the coming year quite a number of additional cows will be
needed. Farm development should also be pushed more rapidly,
as a greater hay production is necessary and better pasturage
should be provided for our herds. To accomplish this work, at
least two more pairs of horses should be purchased, together with
the necessary carts, harnesses and other equipment. Two addi-
tional silos are needed for producing ensilage for the winter feeding
of the cattle. For the accomplishment of the above purposes we
ask that an appropriation of $3,500 be granted.

With the opening of the new building and the general colony
development there has come an increased demand upon our elec-

52 WOKCESTEE INSANE ASYLUM. [Dec.

trie plant. The engines and generators can still provide ample
power, but additional wires, poles and other transmission equip-
ment are needed. For this purpose we ask that an appropriation
of $1,500 be granted.

At the Grafton colony a water supply has been obtained which
meets our present needs; plans for an increase of this water supply
and for a general system of sewage disposal are being prepared in
conference with the State Board of Health. An appropriation is
asked for the carrying out of this work, a detailed estimate of which
will be presented later.

We are again pleased to note that the general health of the insti-
tution is up to the usual standard. There has been but little acute
illness.

The only change in the medical staff has been the addition of
Dr. Charles H. Wheeler, who has been appointed assistant physi-
cian at the Grafton colony.

The Board has long believed that our nurses have served too
many hours during the day and have received inadequate com-
pensation therefor. In our estimates for the maintenance appro-
priation for the ensuing year we have asked for an allowance
which, if granted, will enable us to increase the wages of nurses
and to diminish their hours of labor. This will mean an increase
of 25 in our nursing staff. To provide proper furnishing for this
additional number of employees we ask that there be granted an
appropriation of $1,500.

Throughout the whole institution the work of repair and im-
provement has been pushed as fast as possible, — special effort
being made to employ patients as much as is desirable, having in
view always their best good.

The trustees wish to express to the superintendent, officers and
employees their high appreciation of the honesty, ability and devo-
tion shown for the best interests of the institution.

»

LYMAN A. ELY.
THOMAS H. GAGE, Jr.
THOMAS RUSSELL.
SARAH E. WHITIN.
FRANCES M. LINCOLN.
SAMUEL B. WOODWARD.
GEORGE F. BLAKE.

1907.] PUBLIC DOCUMENT — No. 23. 53

SUPERIIS^TENDENT'S REPORT.

To the Trustees of the Worcester Insane Hospital, acting for the Worcester

Insane Asylum.

I respectfully submit for your consideration the thirtieth annual
report of the superintendent of the Worcester Insane Asylum.

During the statistical year, which ended Sept. 30, 1907, 510
men and 542 women, a total of 1,052 cases, were inmates of the
institution. Of this number, 362 men and 478 women — 840
persons — were present at the beginning of the year. There were
admitted 148 men and 64 women, — 212 persons. During the
year 30 men and 31 women died, 3 men and 2 women were trans-
ferred elsewhere, and 5 men and 2 women were allowed to go out
on visit, leaving 469 men and 506 women — 975 persons — as
inmates of the institution on Sept. 30, 1907.

The physical condition of those admitted has been a little better
than usual, and the dementia, which is always present in the ma-
jority of chronic cases, seems not of such a deep and hopeless type
as has usually been the case in the transfers of previous years.
While occasionally some dement wakes, in a degree, from his
stupor, more promise seems to come from the excited and active.
In the opening of the building at Grafton for excitable men it has
been found that, under their new surroundings, many patients
have seemed to show a renewed interest in life. An effort is being
made there to induce as many as possible to lead an active, out-
of-door life and to become interested in occupation. This effort
is meeting with considerable success. Many patients who form-
erly led an inactive life, refusing all employment, have now volun-
tarily gone to work, some of them becoming valuable helpers.
There is every reason to believe that this number can be greatly
increased in the future by the employment of attendants whose
special work shall be the training of our patients into habits of
industry, which means practically the establishment of a manual
training school for the insane. Though a majority of our patients

54 WORCESTER INSANE ASYLUM. [Dec.

are of middle age or beyond, only a little more than 5 per cent, are
confined to their beds.

The general health of the institution has been good and the
death-rate remains low, despite the fact that a large percentage
of our patients are enfeebled by age, and are also, by their mental
affection, rendered less able to withstand the attacks of physical
disease. Pulmonary tuberculosis, pneumonia and chronic valvu-
lar heart disease have been the chief causes of death, in the order
given. The causes of death have been more varied than usual,
and, although tuberculosis still leads the list, the percentage of
deaths from this cause is no longer as high as in former years.
The numbers of cases of tuberculosis which develop during their
hospital residence are lessened, and in many tubercular cases a
permanent arrest of the disease takes place.

During all of the early part of the year very great difficulty was
experienced in obtaining a sufficient number of employees to prop-
erly carry on the work of the different departments. The situation
was perhaps the most acute in the nursing staff, due, no doubt, to
the fact that the work, if conscientiously performed, is exacting
and sometimes unattractive. The general prosperity of the coun-
try made it possible for a large percentage of the more desirable
persons to seek and obtain work that was more congenial and
better paid. The business recession which is now making itself
felt, together, probably, with the approach of winter, has now
made it possible to make some selection in the applicants for
positions, with a corresponding improvement in the character of
the service rendered.

Our laborers, workmen and mechanics have for some time
served an eight-hour day. While it does not now seem possible
to accord this full measure to all of our other employees, I believe
that we should make every concession looking to a lessening of
the hours of service and a raising of the rate of wages to that level
which will attract and retain desirable persons longer in the ser-
vice of the institution. With this end in view it is proposed, if
the necessary maintenance funds be granted, to accord to the
nursing staff a service of sixty hours per week, with one day off
in seven. It is expected that the institution, during the coming
year, will be required to care for an average of about 1,000 patients.
Estimating on this basis it will require 25 more nurses under the

1907.] PUBLIC DOCUMENT — No. 23. 55

proposed new conditions than under the old ones. As a tempo-
rary expedient these additional nurses must be cared for in rooms
now occupied by patients. This will, however, necessitate fur-
nishing the rooms anew. The expense of newly furnishing these
rooms for the additional 25 nurses I estimate as $1,500, and I
respectfully recommend that your Board ask for an appropriation
of this amount. At a later time special building provision must
be made for these new employees.

Two farm cottages which were acquired with the colony prop-
erty have hitherto remained unoccupied, because they were not
suitably located or adapted for the housing of patients. One of
these cottages has now for some time been occupied by one of
our employees, who maintains his family there. The second cot-
tage is being prepared for occupancy, and another of our em-
ployees proposes to soon move in with his family. I believe that
in our future provision looking to the betterment of conditions
under which our employees can serve us the furnishing of private
cottages for the making of individual homes should be an impor-
tant feature. The more we can assimilate asylum life, for both
patients and employees, to the conditions obtaining in the outside
community the better it will be for both.

At the main institution in Worcester no new undertakings have
been entered into in the line of reconstruction and repair, our
efforts having been directed to the completion of work already
begun. Besides carrying on this work the asylum has also given
material assistance to the colony operations. This assistance has
made it possible to postpone the opening of several of the colony
departments, with a consequent economy in working forces. The
increasing numbers at Grafton necessitate an immediate opening
of our laundry there. The work of the other departments will be
gradually assumed, as our needs demand.

At the Grafton colony another building is needed for the accom-
modation of women patients. This building should be located
near our power house, in order that it may house our industrial
workers near at hand, and that the basements may provide good
and conveniently located work rooms for our various departments
in which women are specially employed. Two large buildings,
besides the power house itself, are already heated from the central
plant, which produces our electric power. The power house and

56 WORCESTER INSANE ASYLUM. [Dec.

one of the existing buildings are now successfully heated by the
exhaust steam from the engines. With the increase of our elec-
trical load it is believed that this proposed new building can also I
be heated in large part, and probably wholly, by the larger amount
of waste steam which will be produced. It is proposed that the ji
patients who are expected to occupy this building will at first be
given their meals at one of the already existing near-by buildings.
I recommend that an appropriation of $50,000 be asked for to
provide for the erection and furnishing of the building described ij
above. 1

In the establishment of our central lighting and power plant at
Grafton care was. taken to install engines and generators of gener-
ous capacity, so that they are still able to give us adequate service,
with some reserve power yet to draw upon. Our steadily increas-
ing use of this power, however, makes necessary considerable
extension and addition to our lines for electrical transmission. An
extra wire should be carried to our Oakes colony to provide for
the better operation of motors in the work of ensilage cutting and
the filling of silos, and other operations requiring a motor service.
With larger numbers of both patients and employees a consider-
able extension of our street lighting service should be made. Be-
sides the work of installation it means considerable purchases of
wire, poles, transformers, lamps, fixtures and other articles neces-
sary for the proper equipment of an electric service. To provide
for the carrying out of this work I recommend that an appropria-
tion of $1,500 be asked for.

A very large percentage of our colony lands were, at the time of
purchase of the property, either sprout and pasture lands which
had never been brought under cultivation, or fields, the tillage of
which had long been neglected. A special effort is being made to
redeem and reclaim such lands. Every year as large an acreage
as possible has been ploughed up and cultivated. The clearing of
this land from roots and stones has been largely done by the labor
of patients, and has not only been of great benefit to them but has
distinctly assisted in increasing the productiveness and value of
our farm lands. The chief need now in our farming operations is
for a greater acreage of hay and pasture land. The rapid increase
in the number of our patients makes necessary frequent additions j
to our herds. The number of cows should again be added to, in '

ta

1907.] PUBLIC DOCUMENT — No. 23. 57

order that the milk supply may continue adequate for our needs.
To enlarge our capacity for more rapid redemption of our wild
lands, and to further the general work of colony development,
more horses should be purchased, with the necessary harness, carts
and other equipment which go to carry on this work. In the
present condition of our pasture lands considerable feeding of our
cows is necessary, even during the summer months. The feeding
of ensilage has been so successful that I believe two additional silos
should be added to our equipment. For the accomplishment of
the above purposes I recommend that your Board ask for an ap-
propriation of S3, 500.

At the colony test wells have been made which furnish a water
supply commensurate with our present needs. This supply will,
however, need extension. A plan is now being prepared, in confer-
ence with the State Board of Health, which will make provision
for a future increase of our water supply and will enlarge and per-
fect our methods of sewage disposal. A further study of our needs
makes it seem advisable to undertake, in this direction, a work of
greater magnitude than was at first anticipated. An estimate of
the amount of money which will be needed for this additional
work will be presented in time for the consideration of the Legis-
lature.

For the past two seasons the freight congestion on the Boston
& Albany has rendered it difficult to secure coal delivery at the
Grafton colony with that degree of promptness and certainty
which the character of our work there demands. Our coal con-
tracts were made in the summer, and the coal company furnish-
ing us has, no doubt, made reasonable effort to secure delivery in
quantities adequate to our needs. A reserve from a previous con-
tract has averted a coal famine at the beginning of winter, but this
situation shows the wisdom of carrying a large coal pile, which
accounts in part for the increased expenditures for fuel during the
past year. Our private side track leading from the Boston & Al-
bany railroad has been completed, so that coal can now be un-
loaded directly at the engine house, where by far the greater part
of our coal is consumed. Buildings remote from this power house
group are furnished by cartage from this central supply.

It is again a pleasure to commend the work which has been
done by the official staff and to express my indebtedness to its

58 WORCESTER INSANE ASYLUM. [Dec.

members for faithful work efficiently performed. The only change
among the officers has been the appointment of Dr. Charles H.
Wheeler as an additional assistant physician at the colony.

Thanks are due to the publishers of the "Worcester Evening
Gazette" for a copy of their paper. The Hospital Newspaper
Society and the Worcester Club have contributed books and
papers. To Mrs, Charles H. Doe and to Miss Mabel Gage we are
indebted for generous contributions of reading matter.

The Worcester Employment Society has again done a large
amount of sewing for the institution.

For the assistance and support of your Board, which never have
been wanting, I am deeply grateful.

E. V. SCRIBNER,

Superintendent.

1907.1

PUBLIC DOCUMENT — No. 23.

59

i

OFFICERS AND THEIR SALARIES.

Ernest V. Scribner, M.D., Superintendent,
H. Louis Stick, M.D., Assistant Physician,
Arthur E. Pattrell, M.D., Assistant Physician,
William T. Hanson, M.D., Assistant Physician,
Charles H. Wheeler, M.D., Assistant Physician,
Frederick H. Baker, M.D., Pathologist,
Abbie S. Fay, Matron, .
Albert Wood, Treasurer,
George L. Clark, Examiner,
Susie G. Warren, Clerk,
Forest A. Slater, Engineer,

^3,000 00

1,400 00

1,000 00

900 00

700 00

100 00

500 00

400 00

50 00

480 00

1,000 00

YALUE OF STOCK AND SUPPLIES.

Dec. 1, 1907.

Live stock, .....

Produce of farm on hand.

Carriages and agricultural implements.

Machinery and mechanical fixtures, .

Beds and bedding in inmates' department.

Other furniture in inmates' department.

Personal property of State in superintendent's department

Ready-made clothing,

Dry goods.

Provisions and groceries,

Drugs and medicines,

Fuel,

Library,

Other supplies undistributed,

. $9,783

45

. 4,829 83

. 3,316

17

. 43,512

39

. 24,989

72

. 9,591

65

, 10,000 00

. 3,328 88

1,745

25

1,897

70

400 00

. 4,000 00

1,125

00

1,149

97

$119,670 01

60

WORCESTER INSANE ASYLUM.

[Dec.

TREASURER'S REPORT.

To the Trustees of the Worcester Insane Hospital, acting for the Worcester

Insane Asylum.

I herewith submit my thirtieth annual report of the finances of
the Worcester Insane Asylum, for the year ending Nov. 30, 1907 : —

Available funds Nov. 30, 1907: —

With State Treasurer : —

Maintenance appropriation, .

$11,689 23

At asylum, . . . . . .

2,000 00

$13,689 23

Amounts received during the year : —

From reimbursed cases, ....

$4,199 40

From other sources, ....

932 98

Collected by the State Board of Insanity, .

85 00

5,217 38

Appropriation by the Commonwealth for support of patients,

180,000 00

$198,906 61
The expenditures for the year have been as follows : —

Salaries and wages,

. $66,043 63

Food: —

Beans, $459 50

Butter,

8,611 63

Bread and crackers.

745 89

Cereals, rice, meal, etc.,

1,210 71

Cheese,

714 30

Eggs, .

1,511 58

Fish, .

1,710 11

Flour, .

6,824 20

Fruit, .

1,981 61

Meats, .

9,414 24

Milk, .

453 15

Molasses,

337 86

Amounts carried forward,

5,974 78

5,043 63

p

1907.]

PUBLIC DOCUMENT — No. 23.

Amounts brought forward,

$33,974 78

Sugar, ......

2,331 16

Tea, coffee and cocoa,

1,961 54

Vegetables, .....

3,563 53

Sundries, .....

1,781 83

Clothing and clothing material : —

Boots, shoes and rubbers,

$1,776 49

Clothing, .....

5,680 05

Dry goods for clotliing, and small wares, . 2,290 26

Furnishing goods, ....

18 91

Hats and caps, ....

116 62

Sundries, .....

191 81

Furnishings : —

•

Beds, bedding, table linen, etc..

$4,424 91

Brushes, brooms, etc..

419 18

Carpets, rugs, etc.,

88 38

Crockery, glassware, cutlery, etc..

816 73

Furniture and upholstery.

67 60

Kitchen furnishings.

673 86

Wooden ware, buckets, pails, etc., .

156 15

Sundries, .....

1,381 59

Heat, light and power : —

s

Coal,

$21,444 33

Gas, ......

12 82

Oil,

513 97

Sundries, .....

297 17

Repairs and improvements : —

Cement, lime and plaster.

$587 21

Electrical work and supplies, .

559 80

Hardware, . ...

2,004 00

Lumber, .....

855 29

Machinery, etc., . . " .

513 00

Paints, oils and glass.

2,189 50

Plumbing, steam fitting and supplies,

1,648 43

Mechanics and laborers (not on pay ro

11), . 2,137 67

Sundries, .....

1,835 81

Farm, stable and grounds : —

Blacksmith and supplies,

$395 94

Carriages, wagons and repairs,

401 15

FertiUzers, vines, seeds, etc., .

1,600 31

61

3,043 63

43,612 84

10,074 14

8,028 40

22,268 29

12,330 71

Amounts carried forward,

1,397 40 $162,358 01

62

WORCESTER INSANE ASYLUM.

[Dec.

Amounts brought forward,

Hay, grain, etc.,

Harness and repairs,

Horses,

Cows, ....

Tools, farm machines, etc..

Sundries,

Miscellaneous : —

Books, periodicals, etc., .

.

$268 08

Chapel services and entertainments.

641 40

Freight, expressage and transportation.

2,460 97

Funeral expenses, .

297 60

Hose, etc., ....

.

41 48

Ice, . . . . " .

58 68

Medicines and hospital supplies,

_

1,271 63

Medical attendance, nurses, etc.

(extra).

204 00

Postage, ....

.

162 29

Printing, ....

.

40 00

Return of runaways.

.

49 56

Soap and laundry supplies,

.

1,517 69

Stationery and office supphes.

384 35

Travel and expenses (officials),

.

177 44

Telephone and telegraph.

.

421 26

Tobacco, ....

.

578 76

Water, .....

,

1,669 27

Sundries, ....

•

1,042 23

52,397 40 $162,358 01

7,217 51

345 67

1,250 00

749 00

47 58

471 03

12,478 19

11,386 69

Total, $186,222 89

Amount of 1907 appropriation reverting to State treasury, . 292 40

Balance with State Treasurer : —

Maintenance appropriation, . . . $4,173 94

Collections paid since Jan. 1, 1907, . 5,217 38

At asylum, 3,000 00

12,391 32

Resoueces,
Balance of 1907 appropriation Dec. 1, 1907,

$198,906 61
$7,173 94

Liabilities.

Salaries and wages.
Deficit,

10,797 79
$3,623 85

1907.] PUBLIC DOCUMENT — No. 23. 63

Inmates' Funds.

Cash on hand Dec. 1, 1906, $2,454 57

Received from inmates, ....
Received from interest on account, .

$596 38
51 22

647 60

$3,102 17
331 02

I

Cash refunded, .....

Balance, $2,771 15

Respectfully submitted,

ALBERT WOOD,

Treasurer.
Worcester, Mass., Dec. 1, 1907.

Worcester, Mass., Dec. 13, 1907.

I hereby certify that I have made a monthly examination of all bills and pay
rolls representing the current expenses ,of the Worcester Insane Asylum for the
year ending Nov. 30, 1907 ($186,222 . 89), and have found them properly scheduled
and correctly cast.

GEORGE L. CLARK,

Examiner of Accounts.

V

64

WORCESTER INSANE ASYLUM.

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I

STATISTICAL TABLES

[FOHM PRESCRIBED BY StATE BoARD OF INSANITY.]

4'

STATISTICAL TABLES.

1. — General Statistics

of the Year.

■

Insane.

f

Males.

Females.

Totals.

Patients in asylum Oct. 1, 1906, .

362

478

840

Admitted within the year, .

148

64

212

., Viz. : by transfer, ....

145

64

209

P from escape, ....

2

-

2

from escape, nominally, .

1

-

1

Whole number of cases in year, .

510

542

1,052

Dismissed within the year, .

41

36

77

Discharged, .....

3

1

4

Viz.: as recovered at time of leaving

asylum, ....

-

-

-

as capable of self-support.

-

-

-

as improved, ....

-

-

-

as not improved.

3

1

4

Died,

30

31

61

Transferred, .....

3

2

5

Escaped, ......

-

-

-

On visit Oct. 1, 1907, . . .

5

2

7

Patients remaining Sept. 30, 1907,

469

506

975

Viz. : supported as State patients.

458

489

947

as private patients, .

-

-

-

as reimbursing pa-

tients, .

11

17

28

Number of different persons within the

year,

509

542

1,051

Nvimber of different persons admitted, .

147

64

211

Number of different persons dismissed, .

35

34

69

Number of different persons recovered, .

-

-

-

Number of different persons discharged

capable of self-support.

-

-

-

Daily average number of patients,

432.45

478.85

911.30

Viz. : State patients.

420.70

464.56

885.26

private patients.

-

-

-

reimbursing patients.

11.75

14.29

26.04

70

WORCESTER INSANE ASYLUM.

[Dec.

2. — Received on First and Subsequent Admissions.

Cases admitted.

NUMBER OF ADMISSIONS

Males.

Females.

Totals.

First (to this asylum),

144

63

207

Second (to this asylum),

1

1

2

Third (to this asylum),

-

-

-

Total cases, ....

145

64

209

Total persons, ....

145

64

- 209

3. — Ages of Insane at First Attack and Death.

Persons died.

AT FIHST ATTACK.

AT TIME OF DEATH.

J

i3

e

J

f^

B

J

S

£

o

s

■fe

o
H

Congenital, ....

1

1

2

_

_

_

15 years and less,

1

1

2

-

-

-

From 15 to 20 years, . .

2

-

2

-

-

-

20 to 25 years, .

5

3

8

-

1

1

25 to 30 years, .

4

4

8

3

1

4

30 to 35 years, .

3

3

6

2

3

5

35 to 40 years, .

2

3

5

4

1

b

40 to 50 years, .

1

3

4

8

8

16

50 to 60 years, .

1

2

3

4

5

9

60 to 70 years, .

1

1

2

5

6

11

70 to 80 years, .

1

-

1

3

5

8

Over 80 years, ....

-

-

-

1

1

2

Unknown, .....

8

10

18

—

—

—

Totals,

30

31

61

30

31

61

Total persons,

30

31

61

30

31

61

Mean known ages (in years).

30.90

35.45

32.58

49.40

54.16

51.83

PUBLIC DOCUMENT — No. 23.

71

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fe

FORM OF DISEASE.

o
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.5

received by

form,
form, .
m.

A. — First admitted to any hospital when
from which transferred: —
Alcoholic insanity, acute,
AlcohoUc insanity, chronic.
Chronic delusional insanity.
Constitutional inferiority.
Dementia, primary.
Dementia, chronic.
Dementia, senile, .
Epilepsy, . . .
Epilepsy with dementia, .
General paresis.
Hereditary chorea with dementia.

Idiot

Imbecile, ....
Imbecile, with dementia, .
Involution psychosis, melancholia,
Manic depressive insanity, depressed
Manic depressive insanity, maniacal
Manic depressive insanity, mixed for
Organic brain disease.

1

'o

72

WORCESTER INSANE ASYLUM.

[Dec.

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B. — Other adrnissions: —

Alcoholic insanity, acute, ......

Alcoholic insanity, chronic, ......

Chronic delusional insanity, . . .

Dementia, primary, .......

Dementia, chronic, .......

Dementia, senile, ........

Dementia, organic, .......

Epilepsy,

General paresis, . . . .

Huntington's chorea with dementia, ....

Imbecile, .........

Imbecile with dementia, .......

Manic depressive insanity, maniacal form, ....

Manic depressive insanity, mixed form, ....

Totals B,

Aggregate cases, . . . ' .

Aggregate persons, ........

PUBLIC DOCUMENT — No. 23.

73

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PUBLIC DOCUMENT — No. 23.

75

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Chronic hepatitis, obstructive jaundice.

Compound fracture of skull and internal

injuries.
Enteritis and pulmonary congestion

with cedema.
Erysipelas, pneumonia, lobar.

Hepatic abscesses and general peri-
tonitis.

Interstitial nephritis and valvular heart
disease.

Ovarian cyst and chronic valvular heart
disease, shock.

Pernicious anaemia, tertian malaria.

Strangulated hernia, ....
Typhoid fever, .....

Respiratory system: —

Pneumonia, broncho.

Pneumonia, lobar, ....

Pneumonia, septic, ....

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Pulmonary and general tuberculosis,

Pulmonary tuberculosis and chronic

valvular heart disease.
Pulmonary and intestinal tuberculosis,

Pulmonary congestion and chronic
valvular heart disease.

Pulmonary and general miliary tubercu-
losis.

3

0

76

WORCESTER INSANE ASYLUM. [Dec. 1907.

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