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Full text of "Annual report of the Worcester State Asylum at Worcester"

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;. 



THIRTY-SEVENTH ANNUAL EEPOKT 



WORCESTER STATE ASYLUM 



WORCESTER, 



FOK THE 



Year ending November 30, 1914. 



CONTENTS. 



PAGE 

Report of Trustees, . . . . . . . . . . 61 

Report of Superintendent, 66 

Report of Treasurer, ' . . 83 

Statistics, 91 



Digitized by the Internet Archive 

in 2010 with funding from 

University of IVIassachusetts Amherst 



http://www.archive.org/details/annualreportofwo117worc 



OFFICERS OF THE ASYLUM. 



TRUSTEES. 



ELLEN A. SHEEHAN, Worcester. 

GEORGIE A. BACON Worcester. 



TIMOTHY J. FOLEY, Worcester. 



RESIDENT OFFICERS. 



H. LOUIS STICK, M.D., . . 
HIRAM L. HORSMAN, M.D., . 
ARTHUR E. PATTRELL, M.D., 
DONALD R. GILFILLAN, M.D., 
GEORGE K. BUTTERFIELD, M.D. 
MARY JOHNSON, M.D., . . 
MINNIE SCHRIBER, . 



Superintendent and Treasurer. 
Assistant Physician. 
Assistant Physician. 
Assistant Physician. 
Assistant Physician. 
Assistant Physician. 
Matron. 



NONRESIDENT OFFICERS. 
GEORGE L. CLARK, .... Examiner. 
SUSIE G. WARREN, .... Clerk. 
FREDERICK H. BAKER, M.D., . . Pathologist. 
FOREST A. SLATER, .... Engineer. 



CONSULTING SURGEON. 

LEMUEL F. WOODWARD, M.D., . 



Worcester. 



JOHN McRAE, . . 
THOMAS O. LONG, 
ROBERT S. SAWYER, 



Business Assistant, 
Colony Supervisor. 
Practical Farmer. 



^\)t (HommontDealtt) of itla00ac()usettB, 



TRUSTEES' REPORT. 



To His Excellency the Governor and the Honorable Council. 

The trustees of the Worcester State Hospital, having in 
charge the Worcester State Asylum and its Gra^fton colony, 
herewith present their thirty-seventh annual report, and, for 
a detailed statement concerning the patientS; employees, farm- 
ing and building operations, and other activities incident to the 
life of the institution, as well as its immediate needs, would 
respectfully call your attention to the appended reports of the 
superintendent and treasurer. 

The year ending Nov. 30, 1914, has witnessed the comple- 
tion of various things authorized by the Legislature of 1912, 
1913 and 1914, namely, two dormitories for 50 patients each; 
a male nurses' home; a female nurses' home at colony No. 2; 
a service and dormitory building at the same colon}-, made 
possible by addition to and alterations in the original dormi- 
tory; the setting of three boilers (one at the central heating 
plant, the others in the boiler house at colony No, 3); the in- 
stallation of an additional motor generator; the construction of 
a reservoir with a storage capacity of at least 2,000,000 gallons; 
and an appreciable addition to the sewage filtration system. 

In addition to the above, a service building at the Oaks, a 
building of the custodial type at the Elms, to provide for 100 
male patients^ and one at the Pines group for 100 female 
patients, also an infirmary building at the Elms, have been 
completed. The administration building, two dormitories (one 
for 50 male and the other for 50 female patients), the carpenter 
shop, and a cottage for employees are well under way. All of 
these were authorized as a result of the legislative act of 1912 



62 WORCESTER STATE ASYLUM. [Dec. 

for the removal of the asylum to Grafton, and for which an 
appropriation of $400,000 was granted. 

As the number of patients under treatment annually has in- 
creased from 1,194 in 1910 to L511 in 1914, and as the State 
Board of Insanity has given the number to be cared for in 
1915 as 1,575, the trustees are perplexed and troubled regarding 
adequate accommodations. 

The appropriation granted for the removal of the asylum 
will provide for the housing of only 400 patients. The number 
at the present time at the asylum is 627, at the colony, 773. 
The older custodial buildings at the colony are already over- 
crowded, the service building at the Pines has reached its 
utmost limit, and the failure to secure a sufficient appropriation 
to erect a service building at the Elms has made conditions 
there almost intolerable. Until these conditions can be reme- 
died and other buildings necessary for the care, treatment and 
diversion of the patients can be erected, it seems neither wise 
nor possible to comply with the provisions of the removal act. 
The Legislature of 1914 granted an extension of time, and a 
further extension will be necessary. 

Before the new custodial and infirmary buildings can be 
opened three things are imperative : — 

1. An extension of the heating and hot-water system. For 
this we ask an appropriation of $5,000. 

2. The erection of a service building at the Elms. The Leg- 
islature of 1913 granted an appropriation of $48,000 for this 
purpose. This was based upon the estimate of a reputable 
contractor, but fell short of the actual figures submitted by the 
lowest bidder. Last year the trustees asked for an additional 
appropriation of $14,000, the sum necessary to build in accord- 
ance with the plans approved by the State Board of Insanity. 
We renew this request for an appropriation of $14,000. 

3. The enlargement of the service building at. the Pines. 
This building now provides for the preparation and serving of 
food to 322 patients and 57 employees. To secu''e the neces- 
sary additional space, we renew our request of last year for an 
appropriation of $20,000. 

With each increase in the number of patients, with the open- 
ing of new buildings, and with the extension, of farming opera- 



1914.] PUBLIC DOCUMENT — No. 23. 63 

tions comes a corresponding increase in the number of employees. 
To provide for this increase and to furnish accommodations 
that will counteract the lure of the city and make for the most 
wholesome living, we renew our request of last year for an 
appropriation of $16,000 to build two cottages for employees. 
We also ask for an appropriation of $20,000 to construct four 
cottages of the bungalow type, these to be occupied by single 
families. 

Ever since the inception of the colony the trustees have been 
eager to own what is known as the Sinclair farm. Two years 
ago they secured an option on it, and requested an appropria- 
tion for its purchase. This request was renewed last year, but 
not granted. The condition of the old barn at colony No. 1 is 
a disgrace to the State; patched, propped, it is unsafe for man 
or beast, and further expenditure for its renovation would, in 
our opinion, be unwarranted. The purchase of the Sinclair 
farm would relieve this situation, and, with slight changes, 
provide not only a horse barn but accommodations for 20 to 
25 employees. The land would make available considerable 
acreage for farming purposes. We therefore ask for the third 
time for an appropriation of $10,000 to purchase and alter this 
property. 

With the present accommodations it is impossible to house 
and care for all our stock properly and to provide for a larger 
herd, which must be maintained if the institution is to produce 
the necessary amount of milk. We therefore renew our request 
of the past two years for an appropriation of $9,000 to build 
a cow barn. 

To provide for the care and distribution of the quantity of 
supplies necessary to maintain the larger institution, the store- 
house at the colony, which was built by means of an appro- 
priation granted by the Legislature of 1911, will be altogether 
too small. At the time of its construction it was so arranged 
that a refrigerating system could be installed later on. That 
system is much needed at the present time. To enlarge the 
present structure and equip it for cold-storage purposes, we ask 
for an appropriation of $47,500. 

Hydrotherapy has proved an effective agent in the treatment 
of insanity. At three different times the trustees have asked 



64 WORCESTER STATE ASYLUM. [Dec. 

for an appropriation to provide the means for such treatment 
at the colony. Again we renew the request and ask for the 
sum of $5000 to install a hydriatric outfit in the new in- 
firmary. 

To minister to the spiritual needs and to relieve the tedium 
of confinement and exacting occupation, the institution must 
provide religious services, educational opportunities and varied 
entertainment. The only available place at the colony for this 
purpose is a day space in one of the custodial buildings. This 
location is inconvenient, its use is a disturbing factor to many 
of the inmates of this particular building, and its capacity is 
much too small even now. To provide adequate accommoda- 
tions for present and future needs, we renew our request of last 
year and ask for an appropriation of $75,000. 

The appropriation requested last year for further extension 
of the sewage filtration plant was only granted in part, there- 
fore we ask for $6,000 this coming year that we may more 
easily approach the amount of filtration deemed necessary by 
the State Board of Health. 

Last year an appropriation for fireproofing certain rooms in 
the administration building, now in process of construction, 
was not granted. The building itself being fireproof, it seems 
best to postpone a renewal of this request. 

Certain minor repairs are much needed at the asylum proper, 
but no special appropriation is asked for at this time. 

During the year the trustees have met with a real mis- 
fortune in the resignation of a majority of their members. 
The interest, the zeal, the knowledge of past conditions and 
the realization of future needs which they brought to their 
work have made their places difficult to fill. 

Another resignation, which the trustees accepted with regret, 
was that of Miss Abbie S. Fay, w^ho, on account of ill health, 
has retired to private life after thirty-one years of conscien- 
tious, devoted service as matron of the institution. 

The faithfulness with which the superintendent, the members 
of the staff and the employees have performed their several 
duties merits our appreciation and thanks. 

In closing, we again express our regret at the large number 
of custodial and terminal cases that are committed to our 
care. 



1914.] PUBLIC DOCUMENT — No. 23. 65 

We renew our belief that a change in the nature of the in- 
stitution should be made, — that it should become a reception 
hospital. 

We register, for the first time, our protest against the aban- 
donment of the asylum buildings. 

The cry of the times is economy in city, State and national 
government; the burdens of taxation are becoming greater each 
succeeding year; a reverence for the past and the preservation 
of historic sites are being considered more and more; and the 
prevention of disease, even more than its cure, is the aim of 
the medical profession. 

The asylum, through the dignity of its construction, is a 
tribute to the architectural development of the past. The first 
institution maintained by the State for the care of the insane, 
it is of more than passing worth; its destruction will lessen the 
available accommodations for the mentally sick and be a loss 
to the State of hundreds of thousands of dollars. Its location 
is ideal for a much needed psychopathic hospital in this vi- 
cinity. It is our desire that it be retained. 

Respectfully submitted, 

ELLEN A. SHEEHAN. 
GEORGIE A. BACON. 
TIMOTHY J. FOLEY. 



WORCESTER STATE ASYLUM. [Dec. 



SUPERINTENDENT'S REPORT. 



To the Trustees of the Worcester State Hospital, acting for the Worcester 
State Asylum. 

Ill obedience to the laws of the Commonwealth, I have the 
honor to submit to you for your consideration the thirty-seventh 
annual report of the Worcester State Asylum and its colony. 

On Oct. 1, 1913, 1,330 persons were inmates of this institu- 
tion, — 618 men and 712 women. During the year there were 
admitted 181 cases, — 100 men and 81 women, — making a 
grand total of 1,511 cases under treatment for the year, — 
718 men and 793 women. Of this number, 12 men and 9 
women were transferred to .boarding out or to other institu- 
tions; during the year 36 patients were allowed home on 
visit, — of this number 11 were discharged from visit, 16 were 
returned for institution care, and on Sept. 30, 1914, 8 patients, 
— 4 men and 4 women, — were still on visit; 40 men and 36 
women died. 

On Sept. 30, 1914, there remained in the institution 648 men 
and 737 women, — 1,385 persons, — which is 55 more than the 
pr'evious year. The total number leaving the institution by 
death, transfer and discharge was ll3, 29 more than last year. 
Three men and 1 woman were discharged as recovered; 5 men 
and 3 women as capable of self-support; 2 men and 2 women 
as improved; and 2 men and 3 women as not improved, though 
able to be cared for in homes outside of an institution. 

Of the different cases admitted, primary dementia, as last 
year, stands first, alcoholism, second, chronic delusional insan- 
ity, imbecility, general paresis, manic-depressive insanity, 
senile dementia, epilepsy, constitutional inferiority, chronic 
dementia, arteriosclerosis, defective delinquent, puerperal in- 
sanity and idiot, in the order named. 

We received 181 admissions during the year, which is 88 less 



1914.] PUBLIC DOCUMENT — No. 23. 67 

than last year. A larger number of boarding-out cases were 
received than the year before, but the largest number of ad- 
missions was by transfer from other institutions. 

The average age of all cases admitted this year was a little 
higher than last year. A smaller number of imbeciles and con- 
stitutional inferior cases, and but one idiot, were admitted. 
The patients admitted during the year were even more turbu- 
lent, destructive and violent than last year. Among those 
admitted were three badly homicidal and a large number of 
suicidal cases, which makes it still more difficult to care for 
them properly with the small number of attendants and 
nurses at hand. 

Figured on the whole number of patients treated, the death 
rate was 4.99 per cent., or .37 per cent, higher than last year; 
while figured on the daily average number of patients, the death 
rate is 5.49 per cent., which is .18 per cent, higher than last 
year. Tuberculosis was the cause of the largest number of 
deaths, there being 15 oases this year against 11 of last year, 
acute enteritis was second, cardiorenal third, valvular heart 
disease and cerebral hemorrhage were equal in number, and 
pneumonia takes fifth place instead of second as last year. 

The asylum population Nov. 30, 1914, consists of 1,400 cases 
with the following analysis : — 

Cases. 

Chronic alcoholic insanity, 160 

Chronic delusional insanity, 272 

Primary dementia, 489 

Primary delusional insanity, 5 

Senile dementia, 28 

Epilepsy, .111 

Manic-depressive insanity, 64 

General paresis (dementia paralytica), . . . . . . .16 

Imbecile (different grades), 188 

Constitutional inferiorit}'', . . 38 

Constitutional psychopathic, 1 

Defective delinquent, 1 

Idiot, 5 

Involution melancholia, 11 

Puerperal insanity, 3 

Organic dementia, 2 

Arteriosclerotic insanity, 3 

Syphilitic insanity, 3 



68 WORCESTER STATE ASYLUM. [Dec. 

The hospital residence of the above cases ranges from forty- 
seven years to less than one year. We have a number of cases 
which were here when the asylum became an institution for 
the temporary care of the insane in 1877. 

During the early part of the year we had two sporadic cases 
of typhoid fever, one at the asylum and one at the colony. 
The patient at the asylum died as a result. As a matter of 
precaution, 27 nurses were treated with typhoid vaccine. 
During the past four years 174 cases have been treated. 

At the asylum during the months of July, August and Sep- 
tember, we had 6 cases of erysipelas, with no fatal results. At 
the colony we had 1 case of German measles during the month 
of July. 

On March 1 a nurse at the asylum developed a severe attack 
of diphtheria. She was immediately isolated, and several 
thousand units of diphtheria antitoxin were given when she 
was sent to the Worcester Isolation Hospital, where she grad- 
ually improved. She apparently was convalescing when she 
developed a paralysis the third week of April, and died on 
the 23d. The usual precaution was taken and 14 nurses who 
had come in immediate contact with the nurse were given 
antitoxin treatment. 

We had from 40 to 50 sporadic cases of tonsillitis, both mild 
and severe. These cases were entirely among the attendants and 
nurses, and seemed to have developed soon after they came 
to the institution. 

In July, 4 night nurses of the female custodial group de- 
veloped a severe attack of dysentery. Three of them were in 
a critical condition for about five weeks, but all made a grad- 
ual recovery when they were sent elsewhere for recuperation. 
They have since returned to their different duties. Soon after 
this we had a number of cases develop in July, August and 
September among the patients. There were 13 on the female 
side and about 40 on the male side in the Elms group. Five 
deaths resulted from this disease. An attendant contracted 
the disease during the latter part of September. He became 
critically ill, it being necessary to have him under constant 
observation for more than two weeks, during which time he 
developed an articular infection of both knees and ankles. 



1914.] PUBLIC DOCLMENT — No. 23. 69 

He is now recuperating, but is unable to resume his duties. 
The blood and dejecta of nurses and attendants were ex- 
amined several times to demonstrate the typhoid or para- 
typhoid germ, but the cultures proved it to be the dysentery 
germ instead. This infection was first noticed among the 
nurses and attendants rather than among the patients, which 
would almost demonstrate the fact that it was originated 
outside of the colony. The epidemic we had last year de- 
veloped during the latter part of May and the early part of 
June, while this year no evidence was noted until the latter 
part of July. We had no cases at the asylum. 

A case of pellagra was discovered on the female wards at the 
asylum last July. The patient rapidly grew worse and was 
confined to her bed until relieved by death three months later. 
She was a native of Ireland and came to the United States in 
1875. She was admitted to the Worcester State Hospital the 
first time in 1893 for acute alcoholism, and a few weeks later 
was discharged. In 1895 she was again committed, when her 
hospital residence became permanent. She came to the asylum 
in 1902. A marked mental change had been noticed for the 
past fourteen months. From a garrulous, semi-violent person 
she became quiet, tractable and agreeable, though her grandiose 
delusions always remained. In 1909 she weighed 145 pounds, 
and this gradually diminished until just previous to her death 
her weight was but 89 pounds. The left upper lobe was in- 
fected presumably with tuberculosis. The Wassermann blood 
test was negative. 

Wassermann blood tests were made of the different patients 
of the institution to the number of 1,355. One thousand one 
hundred and eighty specimens were negative, 105 positive and 
70 doubtful. A spinal puncture was made in most of the posi- 
tive cases to determine the cellular count of the spinal fluid. 
This examination has cleared up doubt as to the cause of the 
psychosis in some cases. The number of positive cases among 
the imbecile and epileptic class was much smaller than had at 
first been anticipated. The whole number of positive cases is 
low, but 75 per cent, more prevalent among the male than the 
female. Of the positive cases, 16 have been diagnosed as cases 
of dementia paralytica. A complete analysis of these 1,355 



70 WORCESTER STATE ASYLUIVI. [Dec. 

cases, as to age, sex, habits, residence (rural or urban), occu- 
pation and mental psychosis, will be published later. 

I again strongly urge that the custom of transferring patients 
from the hospitals to the asylum should be discontinued. 
The Medfield Asylum has been made a reception hospital. 
This asylum should not only be made an institution for acute 
cases but it should be made into a psychopathic hospital. 
Worcester is the logical place for the second or central district, 
where the acute cases can be brought and cared for, and where 
the general public can receive advice and treatment at all 
times. I most strongly urge that the Legislature be petitioned 
to create a law to this effect. The asylum was used for an 
acute hospital for forty-five years. It has many features that 
are not duplicated in any of the more recently built hospitals. 

The reduction of violence on the wards at the asylum and 
colony can only be accomplished by a larger nursing force and 
classification of cases into smaller units. I would again strongly 
urge smaller units for not more than 20 to 25 patients. These 
could be erected in our custodial groups, and would relieve the 
larger wards from violence, turbulence and acute excitements. 

Out-of-door work at the colony has been carried on more 
extensively than in former years. More patients have been 
working, — about 55 per cent, of the men and about 15 per 
cent, of the women. They have done more and better work 
than in previous years. This greatly benefits the patient as 
well as the institution. The many ward disturbances are more 
easily and effectively reduced by the open-air agrarian occu- 
pations. 

The work done in our garden was more effective this year 
than ever, more patients and nurses took part in the outdoor 
occupations, and more have spent all of their time in the open 
air. The garden area was enlarged; the individual plots were 
more intensively cared for; the crops were larger and more 
prolific. The vegetables were used by the patients and nurses, 
who took much pride in preparing the same for their own use 
or for others who were less fortunate than themselves. We 
shall make strenuous efforts to double our acreage and the 
number of patients taking part in this open-air occupation the 
coming year. A large per cent, of these patients was trans- 
ferred from our out-of-door crew. 



1914.] PUBLIC DOCUMENT — No. 23. 71 

A much larger number of male patients has been working- 
out-of-doors this year than last. The wheelbarrow and grading 
crews were enlarged, but the number immediately occupied in 
actual farming was not increased because of the type of these 
patients. Much grading has been done in the Willows, Oaks 
and Elms groups. The number of transfers of closed ward 
patients to the Oaks has been larger. The reservoir has been 
wholly excavated, and the ice pond at the Willows enlarged. 

The industrial work has been progressing under the instruc- 
tion of our new industrial teacher, who has introduced many 
new ideas and ways of occupation for the indolent ward pa- 
tients. The nurses, as well as the patients, receive instruction. 
The nurse is taught in class, and the knowledge thus obtained 
is used in encouraging the patients to do something whereby 
their minds may be occupied in useful ways. This has resulted 
in a larger number of patients assisting with the mending and 
in making new clothing, all of which greatly reduces the large 
amount of work done in the sewing rooms. 

In September we had an exhibit at the Worcester County 
Fair of work done in the industrial departments. The general 
public was invited to see how the patients' time is occupied, 
and what the institution is doing in general for their care. 

The industrial work on the male wards has been more di- 
versified and- much more has been accomplished, so that at 
present all of our brooms, baskets, rope mats and most of our 
brushes are of our own manufacture. Most of the chairs, which 
in previous years were repaired in the carpenter shop, are now 
looked after in the industrial shops at the asylum and colony. 
All chair caning is done herC; and all straw and hair mattresses, 
all pillows, and many other articles valuable to the institution 
are made. In the cobbler shop 165 pairs of shoes and slippers 
were made and about 1,800 pairs were repaired; 123 harnesses 
were repaired and many other small repairs were made. This 
form of labor has been of assistance in reducing ward disturb- 
ance, destructiveness and violence. 

More than 20 acres of land have been redeemed during the 
past two years, and about 5 added to the farm for tillage. 
The farm has become more productive, and more intensive 
farming has been accomplished. Our apple crop was very 
large and our vegetables almost double. 



72 WORCESTER STATE ASYLUM. [Dec. 

The social work of the institution was conducted by the 
female assistant physician of the staff. About the same number 
of families were visited, and all homes were visited before 
patients were allowed to go home for a visit or before their 
discharge. The number of patients sent out on visit has been 
the largest in the historj^ of the institution. There is no doubt 
but what the visits of the social worker have produced a better 
feeling among the public, relatives and friends. 

The rotation of employees has been about 2.7 times, which 
is less than last year. The stability seems better, and the type 
of nurses and attendants seems a little higher. The male 
nurses' home at the colony has been opened, and this, with 
the opening of the female nurses' home, has made it more 
pleasant and agreeable for the employees by getting them 
away from the wards after their hours of duty. 

Our training school for nurses was established eleven years 
ago. To date we have had 71 graduates, 20 of whom are still 
in our employ. The course of study covers a period of two 
years with a probation period of three months, after which the 
candidate, if satisfactory, is required to wear the standard 
uniform of the school. At the end of the two years' course 
those who successfully pass the final examinations are given a 
diploma. The nurse must then take a post-graduate course of 
from six to twelve months in a general hospital with which 
we are affiliated. At present one of our graduates, who has 
taken a year's course at the Boston City Hospital, is at the 
Boston Lying-in Hospital, and two are at the Burbank General 
Hospital at Fitchburg. All nurses are compelled to take the 
training, and must give satisfactory evidence that they will 
remain the full two years. More studies have been added, and 
the lectures and demonstrations are more varied; a course in 
dietetics has been prepared by Miss Schriber, our matron; a 
course in industrial occupation will be given by our industrial 
instructor; and a course in surgical technique by our visiting 
surgeon. A course of 12 lectures has been added for the male 
nurses which is obligatory, so that all nurses and attendants 
who come in contact with the patients receive instruction. 
All nurses are required to do a certain amount of collateral 
reading, which it is hoped will help to broaden their general 



1914.] PUBLIC DOCUMENT — No. 23. 73 

knowledge. We also have a number of attendants taking 
the regular course of training with the nurses. 

A kindly and sympathetic spirit on the part of the public 
will help very materially to raise the general standard of our 
nursing force. A slight increase in compensation may help, but 
environment with a higher standard of requirements is of the 
greatest importance. 

An out-patient department was opened at the asylum October 
9 for Friday evening of each week from 7 to 9 o'clock; also, 
since November 16 on Friday from 2 to 4 p.m. 

We tested our herd twice during the year, once in April and 
again in October, for tuberculosis. We had one reaction in the 
spring and two this fall. The one reacting in the spring was 
killed, the other two will be observed for a few months longer, 
after which time a third test will be made. Last spring four of 
the young stock reacted. As in previous years these were 
turned loose in the open pasture in April and allowed to re- 
main there until October, when they were brought in and a 
second test made with negative results. Of the five calves 
that reacted in the spring of 1913, all gave a negative reaction 
to both tests made this year. Our herd is much improved. 
The average production of milk per cow for the year has been 
8;358.5 pounds, which is about 78.02 pounds higher than the 
previous year. Eight of the cows had their first calf this year. 
We have disposed of all cows giving less than 4,000 pounds 
per year. We have 20 thoroughbred cows, 28 heifers and 
5 bulls, so that in the course of a few more years our herd 
will consist of only registered stock. I think much of this 
improvement in our herd is due to the constant attention in 
the care and feeding of them by those now in charge of this 
department. 

We have made many improvements at the colony, but little 
repairing has been done at the asylum. 

The addition to the portico of the colony No. 1 dormitory 
has been completed. The cow barn at colony No. 1 again had 
to be reshored and propped up on the north side and east end 
to keep it from falling to pieces. This is a constant source of 
expense and anxiety, which can only be obviated by replacing 
it with a new structure. Several small sheds were built in 



74 WORCESTER STATE ASYLUM. [Dec. 

which the gardener keeps his tools and vegetables. The wagon . 
shed is being enlarged for the automobile truck. Colony No. 1 
has been connected with the new heating lines, the old one 
being discontinued. The old line leading from Maple cottage 
to dormitory 1 has to be replaced. 

At the Oaks the hen house is being enlarged. Twelve new 
hen pens for about a dozen chickens have been built. 

The two-colony type dormitories of 1912 have been com- 
pleted and are now occupied. The male nurses' home has 
been completed and occupied since August. The matron's 
cottage will soon be finished. The infirmary and 100 men's 
building have been completed since October, but as we have 
no central dining room these buildings could not be occupied 
because of lack of dining space. No appropriation for heating 
these two buildings was granted last year, so that local plants 
were established within the buildings to protect them from the 
elements. 

The new administration building is nearing completion. 

The new dining room and service building at the Willows is 
about completed and has been partly occupied since November 
24, when the patients were moved from the old farmhouse 
preparatory to eating their Thanksgiving dinner in the new 
home. 

The new female nurses' home has been completed and will 
soon be heated, when it will be partly occupied. 

The Cedars or 100 women's building has been finished, but 
is not occupied because of inadequate dining space. An addi- 
tion to the service building in this group will be absolutely 
necessary before this building can be occupied. 

The addition to the old boiler house has been finished and 
occupied since the early part of May. The carpenter shop is 
rapidly nearing completion. The service building at the Oaks 
is completed except for the floors in the dining rooms, scullery 
and kitchen, which are rapidly being put in. The new boiler 
house is completed, and the two new boilers of 1912 and 1913 
have been purchased and installed. 

The two dormitories of 1913 at the Willows and the Oaks 
are under roof, lathed and ready for plastering in the spring. 

The reservoir, which is connected by an 8-inch pipe with the 



1914.] PUBLIC DOCUMENT — No. 23. 75 

main water system, has been completed and is now in use. 
This will give us a storage capacity of about 2,000,000 gallons, 
and ample fire protection for all of the buildings at the colony. 

The new motor generator has been placed and in use since 
May. We are now able to take care of any emergency which 
is liable to occur, for a long time to come. 

The entire group at the Willows is being heated from the 
central boiler plant. The whole system has been fully installed, 
the hot-water heater and storage tank changed, and a new 
pump placed to circulate and feed the four boilers now in use. 

The filter beds, for which an appropriation was granted in 
1913, have been completed and are in use. The three new beds 
authorized in June of this year are rapidly being constructed. 
When these beds are finished we shall have about four-fifths 
the amount of filtration surface recommended by the State 
Board of Health. 

No special appropriation will be asked for the asylum this 
year, excepting for maintenance. 

Most of the appropriations I recommend to your Board are 
made necessary by the failure of the Legislature to grant the 
same last year, so that we shall not only be compelled to ask 
for the same appropriations, but the amounts in several in- 
stances will be considerably larger. These appropriations are 
most urgent and very necessary. 

I have recommended the purchase of the Sinclair farm and 
buildings for the past two years, and feel that the need of this 
place is more imperative to us than ever. As stated in my 
report last year, the horses and cows at colony No. 1 are poorly 
housed and should be properly cared for in up-to-date buildings, 
if not to uphold the dignity of the State, for the general welfare 
and hygienic improvement of these animals. The old barn is 
now being propped up and shored to keep our animals from 
being injured. I feel that the money which has been expended 
on these buildings has been, in a sense, wasted. The farm with 
its different buildings can be purchased for $10,000. The house 
will give the same accommodations as two of our present em- 
ployees' cottages, which cost us about $14,000. The barn will 
give us accommodations to care for our horses, now poorly 
housed. This farm of 83 acres of good land will produce more 



76 WORCESTER STATE ASYLUM. [Dec. 

than $3,000 worth of hay and other products the first year. 
By purchasing this property, I feel that the State would make 
one of the very best investments and procure more adequate 
accommodations for our employees and horses, while the farm 
will give us the proper location for a new cow barn which is 
most urgent. I would recommend that $10,000 to purchase 
this farm and buildings be asked for by your Board. 

I would suggest four bungalows this year instead of two, the 
number asked for last year, these to care for single families, 
which will make homes for employees who haA^e families and 
who cannot, at present, live at the colony because we are not 
so situated that we can give them this accommodation which, 
as you well know, will mean more stability and efiiciency with 
our help. At present such employees are compelled to live in 
North Grafton or Westborough, and I believe that if they could 
remain nearer the institution, we would be better served and it 
would tend to lessen the yearly routine of help. The sum of 
120,000 will be necessary to build, heat, light and partly fur- 
nish the same. I recommend that your Board petition the 
Legislature for the above sum.. 

We are in need of two employees' cottages of the same type 
as we have been building and of the same size as the matron's 
cottage located in the administration group. Both of these 
buildings are needed for the employees necessary to care for 
the farm, gardens and grounds, and the night watches of these 
different groups. The sum of $16,000 will be necessary for the 
erection, heating, lighting and furnishing of the same, which 
sum I would recommend your Board to ask for this coming year. 

The colony has no central place of gathering, no recreation 
hall, no place of amusement and no chapel for religious serv- 
ices. A chapel and recreation hall should be so located that 
it will be in about the center of the colony geographically, as 
well as the center of the different groups of buildings, especially 
the custodial groups. If the colony is to be developed to a 
capacity of 1,600 cases by Jan. 1, 1916, and to 2,000 later, this 
building should accommodate at least 1,200 to 1,400 persons. 
This building should be of fireproof construction and so ar- 
ranged as to have services and entertainments in the main 
•auditorium. The basement or ground floor should be so ar- 



1914.] PUBLIC DOCUMENT— No. 23. 77 

ranged as to care for special classes in calisthenics for patients, 
attendants and nurses, as well as classes of all kinds for the 
patients. It would also be used for the social gatherings of the 
attendants, nurses and other employees. All entertainments for 
the patients, weekly dances and other gatherings are now held 
in the day spaces of the Birches or Pines, making it necessary 
to remove the patients to another part of the building, causing 
congestion, or to another building, which causes much dis- 
turbance among the excitable and turbulent patients. The pa- 
tients who sleep in the dormitory part of the building above 
these day spaces must necessarily be disturbed. Should we fail 
to receive the appropriation for this building, our class gradua- 
tions and entertainments for the patients or employees must of 
a necessity take place in the already overcrowded buildings. 
It has been estimated that for the erection of the same, heating, 
lighting, plumbing and grading, a sum of $75,000 will be 
necessary. I would recommend that your Board petition the 
Legislature for this amount. 

Extension of our Heating and Hot-water System. — This ex- 
tension of the heating and hot-water system is to connect fully 
the new buildings now completed at our colony No. 1 and the 
Elms, the new administration group, the new service building, 
infirmary, 100 men's building and dormitory at the Oaks. All 
of these buildings are erected and completed, but, as an appro- 
priation for this extension was not granted last year, they must 
of a necessity stand without heat this winter or a temporary 
local heating plant must be erected to prevent deterioration 
from the elements. The heating capacity of colony No. 3, or 
the Oaks, is overtaxed at present, and you may readily see that 
the new dining room and service building and the new dormi- 
tory now under roof and about to be plastered cannot be 
heated with the present equipment. Two new boilers have 
been purchased and are now fully installed in the new heating 
plant of this group, yet we have no way of transmitting the 
heat to and from the boiler house to the other buildings. It 
has been estimated that to purchase all the material, dig the 
trenches, lay the pipes and cover the same, the sum of S5,000 
will be necessary, for which sum I recommend that your Board 
ask the pending Legislature. 



78 WORCESTER STATE ASYLUM. [Dec. 

We are in greater need of a cow barn this year than at any 
time, because of the increased size of our herd necessary to pro- 
duce the required amount of milk, and because of the. extremely 
dilapidated condition of the present barn. During the last two 
summers the underpinning gave way several times, so that we 
have been compelled to remove some of the horses and place 
them in a shed or part of the horse shed used for storing grains 
and feed. At one time this past summer the south side of the 
floor dropped over 14 inches. This had to be jacked up and 
underpinning put in. We must do the same thing again be- 
cause of the poor, decayed condition of the girders and old 
underpinning. It is indeed unsafe to keep cattle in such a 
structure. We were compelled to prop two sides of the building 
to keep it from spreading any more by heavy bulging. The 
roof had to be repaired in order to keep the cattle and hay dry. 
To date we have spent a little over $1,300, which amount 
should have gone- towards the erection of a new barn. A new 
and modern barn must be erected, and should be located at a 
much greater distance from the present dormitories, kitchen 
and administration center. The size of the building should be 
such as to take care of at least 65 to 70 cows. The type and 
construction would be similar to the one at the Oaks, with the 
exception that it would have the modern improvements. The 
milk room should be large and farther away from the main 
structure. A basement should be located in the main part of 
the barn to take care of the manure, or a manure shed should 
be erected some distance away. There should be a basement 
under the milk room where a furnace can be maintained to 
heat this part of the building and to supply the hot water 
necessary. This building should be located on the Sinclair 
farm. I therefore recommend that your Board ask the Legisla- 
ture for the sum of $9,000 to erect and equip this barn accord- 
ing to the plans and specifications used in the erection of the 
cow barn at the Oaks, built in 190G, but to accommodate 65 
instead of 50 cattle. 

Storehouse and Cold Storage. — -.The storehouse at the colony, 
w^hich is to be used for our cold storage, has been erected for 
three years, but on account of the removal scheme, it will be 
absolutely necessar\- to have a larger building for this purpose 
bv Jan. 1, 1916. To care for all the material necessary at the 



1914.] PUBLIC DOCUMENT — No. 23. 79 

present time and allow for an increase in our stock, the present 
building will need to be enlarged by at least 75 feet, 50 feet to 
be added to the west end towards the railroad and 25 feet to the 
east end. The west end will be used for general storage pur- 
poses, while most of the old part and the east end will be oc- 
cupied by the cold-storage outfit, rooms to keep meat, eggs, 
butter and cheese, fowl, fish, apples, other fruits, and vegetables. 
The first floor will be used for the storage of flour, sugar, beans, 
dried fruits and other bulky material, such as molasses, syrup, 
salt, oils of all kinds, heavy hardware and supplies for the 
farm, and garden implements. I therefore would recommend 
your Board to ask for an appropriation of $47,500 to erect this 
addition, purchase and install machinery and insulate the 
different rooms. 

Our filter beds are now more than overtaxed. x\t present we 
are filtering but one-half of our sewage on the old beds. When 
our present filter beds are completed and connected with the 
old beds, we will have sufficient filter surface to care for most 
of the sewage, but will not be able to give these beds the rest 
necessary to good filtering. At present our colony No. 1 is 
surface-drained, • — not a single new building has been added. 
When these beds are finally completed, we have been advised 
by the State Board of Health to discontinue the field drainage. 
The sewage from our power house and laundry building, cold 
storage and carpenter shop is taken care of by the Assabet 
valley beds. , These beds are also to be discontinued and the 
sewage is to be put into the new beds. To do this it will be 
necessary to pump the same, which will require the erection &f 
a pumping station. However, we shall have to put in one or 
two more beds. To build these new beds will require about 
$8,000, but as we will have to connect all the new buildings 
with the present system and finish the grading of our old beds, 
it has been estimated that to build the beds, purchase and 
place the pipe, a sum of from $16,000 to $20,000 will be 
necessary. However, I feel that it would be better to connect 
the new buildings and rearrange the old sewage pipes this year 
and make the other extension of beds next year. I therefore 
recommend that your Board ask for a sum of $6,000, the 
amount necessary to do this work. 

Two years ago we asked for an appropriation to build, fur- 



80 WORCESTER STATE ASYLUM. [Dec. 

nish and complete a new service building, with a dormitory, in 
the Elms group. This request was granted, and the sum asked 
for was appropriated by the Legislature of 1913. When the 
building was put on the market, it was found that among the 
number of different contractors the lowest bid was about $8,000 
higher than the estimate made for this building, namely, 
$48,000. The estimate was made by a local contractor who 
made a mistake in his figures, which was the real cause. Had 
we been able to build two years ago, an amount of $7,500 
would have been sufficient to complete the same, but as this 
was not sanctioned by the Commission on Economy and Effi- 
ciency, the same was not granted. It has been estimated that 
to erect this building an additional sum of $14,000 will be 
necessary. This building is absolutely necessary before we can 
open two of the new buildings, the infirmary and 100 men's 
building, now finished. It is also most essential before the 
asylum population can be moved to the colon\^ I therefore 
recommend that your Board ask the Legislature for $14,000 in 
addition to erect, fully equip and furnish this building. 

We should have a new hydriatric outfit for this institution. 
The same should be installed in our new infirmary building now 
completed, in order that we may care for our patients by more 
scientific and up-to-date methods. At present we have no 
facihties for caring for our patients who should have con- 
tinuous tub, spray or shower baths, or any of the hydriatric 
measures necessary for so many mental and nervous cases. 
This apparatus, with the arrangement of the same, together 
with the preparation of the room in the basement of the new 
infirmary building, will require a sum of $5,000, for which I 
recommend that your Board ask the coming Legislature. 

I would again renew the request for an addition to our pres- 
ent service building at the Pines group. When the building 
was erected in 1910, it was to care for 400 patients, and at 
that time we had less than 300. The kitchen, scullery and 
storerooms were considered small at that time. The new build- 
ing for 100 women, the Cedars, is now completed, but we can- 
not occupy this structure until we have a place to feed the 
patients. It is very necessary to secure other space for this 
purpose, and this can only be done by making an addition to 



1914.] PUBLIC DOCUMENT — No. 23. 81 

the present kitchen department. This space can be obtained 
by extending the kitchen department 24 feet, which will necessi- 
tate the rearrangement of the cold-storage room, the pantries 
and scullery facilities, this to be on the ground floor. The 
second story is to be used for a nurses' and employees' dining 
room. This same appropriation was asked for last year and 
passed upon by the State Board of Insanity. A sum of $20,000 
has been estimated as necessary to erect this addition. I there- 
fore recommend that your Board ask the Legislature for the 
above sum to erect and complete this new addition. 

Miss Abbie S. Fay, who was matron of the asylum since 
1893 and previous to this was assistant matron at the Worcester 
State Hospital for over ten years, resigned in October. Through 
her resignation I consider that the State has lost one of the 
most faithful, energetic and industrious servants. The success 
of the institution was her constant thought. Miss Minnie 
Schriber has been secured to fill this vacancy. 

Dr. Effie A. Stevenson resigned in August to take up work in 
an acute private institution in Connecticut. Dr. Mary 
Johnson has been secured to fill this vacancy. Miss Alice L. 
Lake, superintendent of nurses, resigned in June and since has 
taken a position in an acute hospital in Detroit, Mich. Miss 
Elsie C. Hartshorne has been secured as our industrial in- 
structor. 

Regular monthly staff meetings have been held throughout 
the year at which meetings a paper is presented by a member. 
Numerous conferences have been held, and all patients who are 
candidates for discharge or for trial visit are discussed in staff 
meetings. At this time the patient is examined, and the 
fitness of his or her condition is determined as well as the 
home surroundings, a report of which has previously been made 
by the social worker. 

I recommend that another physician be secured to take 
charge of the dispensary and laboratory work, which latter 
work should become more acute than it has been. He would 
also relieve on the wards when necessity demanded it. 

I would also recommend a second female physician, who 
would devote her whole time to the social service problem and 
eugenics. Because of her medical knowledge she should be 



82 WORCESTER STATE ASYLUM. [Dec. 

able to investigate homes and draw conclusions from a medical 
and mental point of view in a better way than the lay mind or 
the nonmedical social service worker. She can also be called 
upon to assist with a certain amount of medical work as well. 

During the year the regular weekly dances at the asylum and 
colony have been held, monthly entertainments have been given 
by local talent both here and at the colony, and a regular 
monthly entertainment has been given by outside talent. Such 
entertainments have been arranged for the coming year as well. 

The work this year has been carried on by the industrial 
instructor. Several trips were made by the patients to the 
colonj^ to pick berries. These outings, though perhaps not 
profitable, were very popular, as they usually meant an auto- 
mobile ride. The regular field day on July 4 was the most 
successful of any we have had. A corn roast, which was a 
real success, was given the female patients near Long Pond in 
the Willows group in September. The usual number of patients 
attended the different circuses and the New England fair. 

The officers of the institution have given me their assistance 
and hearty support during the year. The employees have 
apparently been more loyal in the performance of their differ- 
ent duties. 

The resignation of the older members of the Board has been 
a great loss to our institution, as only by their unselfish assist- 
ance, guidance and constant supervision have we made such 
advancement in the treatment and care of the insane. 

We are indebted to the "Boston Journal" and the "Worces- 
ter Evening Gazette" for copies of their daily papers; to the 
Hospital Society of Boston for books, pamphlets, magazines 
and Christmas cards; to the Worcester Employment Society 
for a large amount of sewing for the institution; to Miss 
Frances Lincoln for books, magazines and papers; to Mrs. 
Kinnicutt for books, magazines and pictures; and to the 
several members of your Board for most generous contributions. 

Respectfully submitted, 

H. LOUIS STICK, 

Superinte7ide7it. 
Worcester, Mass., Nov. 30, 1914. 



1914.1 



PUBLIC DOCUMENT — No. 23. 



83 



TREASURER'S REPORT. 



To the Trustees of the Worcester State Hospital acting for the Worcester 
State Asyhmi. 

I respectfully submit the following report of the finances of 
this institution for the fiscal year ending Nov. 30, 1914: — 



Balance Dec. 1, 1913, 



Cash Account. 



$12,511 46 



Receipts. 



Institution Receipts. 




oard of inmates : — ■ 




Reimbursements, insane, 




lies: — 
Food 


$139 70 


Clothing and materials, . 


455 23 


Furnishings, . 


20 


Repairs and improvements. 


14 84 


Miscellaneous, 


329 24 



Farm, stable and grounds: — ■ 
Cows and calves, $190 00 
Pigs and hogs, . 16 00 

Hides, . . 26 17 



),362 36 



Miscellaneous receipts : — 
Interest on bank balances, 
Sundries, 
Board of Retirement, 



$282 68 
100 80 
38 61 



Sales account of industries fund, . 

Wages refunded account of 1913 expenses, 



10,955 83 

82 81 

7 98 



Receipts from Treasury of Commonwealth. 
Maintenance appropriations : — • 

Balance of 1913, 

Advance money (amount on hand November 30), 
Approved schedules of 1914, . $301,626 07 

Less returned, . . . 16 86 



Special appropriations. 
Industries fund. 



$5,870 20 
13,483 35 



320,962 76 

362,168 69 

61 24 

$706,750 77 



84 



WORCESTER STATE ASYLmi. 



[Dec. 



Payrnents 
To treasury of Commonwealth: — 

Institution receipts, . . . . 

Industries fund, ..... 
Wages refunded account of 1913 expenses. 



$10,955 83 

82 81 
7 98 



Maintenance appropriations: — 
Balance November schedule, 1913, 
Eleven months schedules, 1914, 
November advances, 

Special appropriations : — 
Approved schedules, 
Less advances, last year's report, 

November advances. 



$362,168 69 
1,089 38 



$19,471 04 
301,609 21 

4,544 27 



$361,079 31 

7 43 



325,624 52 



361,086 74 



Industries fund : — 

Approved schedules, ........ 61 24 

Balance, Nov. 30, 1914: — 

In bank, $8,626 57 

In office, 305 08 

8,931 65 

Total, $706,750 77 

Maintenance. 

Appropriation, $315,000; from 1913, $88.69, $315,088 69 

Expenses (as analyzed below), ....... 321,053 56 

Deficit, . . $5,964 87 



Analysis of Expenses 
Salaries, wages and labor: — 

H. Louis Stick, M.D., superintendent 

General administration, . 

Medical service, 

Ward service (male). 

Ward service (female), 

Repairs and improvements, 

Farm, stable and grounds. 



Food: — 
Butter, . 
Beans, . 
Crackers, 

Cereals, rice, meal, etc. 
Cheese, 
Eggs, . 
Floiir, . 
Fish, . 



Amounts carried forward, 



$3,000 00 




43,556 14 




7,226 67 




24,176 40 




24,280 94 




8,215 55 




23,466 58 






$133,922 28 




$11,615 34 




982 33 




628 33 




1,133 48 




945 78 




1,492 39 




10,427 49 




2,911 26 




$30,136 39 


$133,922 28 



1914. 



PUBLIC DOCUMENT 



Amounts brought forward, 



•No. 23. 85 

$30,136 39 $133,922 28 



Food — Con. 






Fruit (dried and fresh) 


3,015 81 




Lard, . 


1,124 80 




Meats, 


22,546 77 




Milk, 


7,206 86 




Molasses and syrup 


370 63 




Spices, seasonings, salt, etc.. 


348 26 




Sugar, 


4,178 93 




Tea, coffee, broma and cocoa, ... 


3,043 96 




Vegetables 


6,420 98 




Yeast, 


146 77 




Sundries, ...'... 


643 89 


79,184 05 






Clothing and materials : — 






Boots, shoes and rubbers. 


$2,349 71 




Clothing, 


8,805 46 




Dry goods for clothing and small wares. 


1,807 44 




Furnishing goods, ..... 


92 80 




Hats and caps, 


47 69 




Leather and shoe findings. 


267 69 




Materials and machinery for manufacturing. 


465 52 




Sundries, ...... 


266 66 


14,102 97 






Furnishings : — 






Beds, bedding, table linen, etc.. 


$9,003 05 




Brushes, brooms, ..... 


415 38 




Carpets, rugs, etc., .... 


130 58 




Crockery, glassware, cutlery, etc.. 


1,512 62 




Furniture and upholstery, 


533 74 




Kitchen furnishings 


1,113 74 




Materials and machinery for manufacturing. 


872 84 




Wooden ware, buckets, pails, etc., . 


128 51 




Sundries, ...... 


1,965 25 


15,675 71 


Heat, light and power: — 




Coal, 


$27,049 37 




Freight on coal, ..... 


6,918 53 




Gas, 


14 81 




Oil, 


325 58 




Sundries 


647 43 


34,955 72 






Repairs and improvements : — • 






Cement, lime and plaster. 


$313 16 




Doors, sashes, etc., .... 


12 65 




Electrical work and supplies, . 


1,292 89 




Hardware, ...... 


2,696 11 




Lumber, ...... 


749 22 




Machines (detached), ..... 


379 22 




Paints, oil, glass, etc., .... 


1,665 18 




Plumbing, steam fitting and supplies. 


3,420 25 




Roofing and materials 


120 60 




Sundries, ...... 


1,046 34 


11,695 62 






Amount carried foward, 


$289,536 35 



WORCESTER STATE ASYLUM. 



[Dec. 



Amount brought forivard, 

Farm, stable and grounds: — ■ 
Blacksmith and supplies, 
Carriages, wagons, etc., and repairs. 
Fertilizers, vines, seeds, etc.. 
Hay, grain, etc.. 
Harnesses and repairs. 
Horses, .... 
Other live stock, 
Tools, farm machines, etc., 
Sundries, 





$289,536 35 


$208 47 




1,307 05 




2,447 97 




6,770 99 




69 25 




285 00 




52 80 




902 94 




1,064 48 






13,108 95 



Religious services. 



1,419 25 



Miscellaneous : — 

Books, periodicals, etc., . 

Cuspidor supplies, .... 

Entertainments, .... 

Freight, expressage and transportation, 
Funeral expenses, .... 

Hose, etc., ..... 

Ice, ...... 

Medicines and hospital supplies, 
Medical attendance, nurses, etc. (extra). 



Printing and printing supplies. 
Printing annual report, . 
Return of runaways. 
Soap and laundry supplies. 
Stationery and office supplies, . 
Travel and expenses (oflRcials), 
Telephone and telegraph. 
Tobacco, . . . . 

Water, . . . . , 

Sundries, . . . . 



Total expenses for maintenance, . 
Wages refunded account of 1913 expenses, 



Balance Dec. 1, 1913, 
Appropriations for fiscal year, 







$492 62 








19 


49 








825 


35 








3,108 


20 








478 


00 








201 


02 








22 


13 








1,410 79 








244 


36 








338 


15 








513 


39 








139 


71 








213 


40 








2,699 34 








577 


77 








404 


18 








797 


08 








959 


50 








1,085 


20 








2,467 


31 


16,996 99 










$321,061 54 








7 98 




$321,053 56 


RIATIONS. 






$447,254 00 










22,500 00 



Total, $469,754 00 

Expended during the year (see statement annexed), $362,168 69 

Reverting to treasury of Commonwealth, . . 1 30 

362,169 99 



Balance Nov. 30, 1914, 



$107,584 01 



1914.1 



PUBLIC DOCmiENT — No. 23. 



87 



Resources and Liabilities. 
Resources. 
Cash on hand, ....... 

November cash vouchers (paid from advance 
money) : — 

Account of maintenance, . $4,544 27 

Account of special appropria- 
tions, .... 7 43 



Due from treasury of Commonwealth balance of 
appropriation, ...... 



Schedule of November bills, 



$8,931 65 



4,551 70 




4 11 






$13,487 46 






$19,452 33 



Per Capita. 
During the year the average number of inmates has been l,c 
Total cost for maintenance, $321,053.56. 
Equal to a weeldy per capita cost of $4.51. 
Receipt from sales, $1,171.38. 
Equal to a weekly per capita of $0,016. 
All other institution receipts, $9,784.45. 
Equal to a weekly per capita of $0,137. 



Industries Fund. 

Balance Dec. 1, 1913, 

Receipts credited, ....... 

Expenditures, approved schedides (see statement annexed), 
Balance Nov. 30, 1914 



$10 55 


82 


81 


$93 36 


$61 


24 


32 


12 





Industries. 






Expenditures. 




Instructors, 






Materials: — 






Booth at fair, 




$20 00 


Cotton waste, 








8 30 


Doilies, patterns, cotton, etc.. 








13 14 


Electricity at fair, . ' . 








1 60 


Expenses to and from fair, 








4 85 


Shpper soles, . 








25 


Yarn 








40 



$12 80 



$61 24 



WORCESTER STATE ASYLUM. 



[Dec. 



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1914.1 PUBLIC DOCUMENT — No. 23. 



INMATES' FUND. 



Cash on hand Dec. 1, 1913, $4,456 91 

Received from inmates, $1,267 13 

Interest, Worcester Trust Company, . . 41 04 

Interest, Mechanics Savings Bank, . . 102 08 

— 1,410 25 



$5,867 16 
Cash refunded inmates, . 869 30 



Balance (Worcester Trust Company, $2,327.94; Mechanics 

Savings Bank, $2,629.12; drawer, $40.80), .... $4,997 86 

Worcester, Dec. 19, 1914. 

I hereby certify that I have made a monthly examination of all bills and pay 
rolls representing the current expenses of the Worcester State Asylum for the year 
ending Nov. 30, 1914 ($321,053.56), and have found them properly scheduled and 
correctly cast. 

I also find in the hands of the treasurer $4,997.86 belonging to patients. 

GEORGE L. CLARK, 

Examiner. 



STATISTICAL TABLES 



[Form prescribed by State Board of Insanity.] 



>'^Tt<QO-^iO'y30»OCOiOC 



r ^s^ 






!t2S" ^? 



) »0 CO T-H --^ CO »0 I ^Ht^OOr 



1 O O -# ■# 00 o 



fl a S 
o s ^ 



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II 



3as-§^^-£S.i§ 

2 2 2 0'^ =0 10 m m M 



w-S-t^ » S g S" 

5 ca-S g g g g § 

■S,3-cl i i i i o 

■" a o, ft a a 



■"11 



Si' 



^PQ^ 






3 a c3 a c a 

(D (U (B 01 o 

^^^to^ (D a ^ ^ 

0) 0) S o » ^ >M ft S 

a a a a a ":^^ 

3 3 3 3 3 ca> 



94 



WORCESTER STATE ASYLUM. 



[Dec. 



2. — Received on First and Subsequent Admissions. 








NUMBER OF ADMISSION. 














Males. 


Females. 


Totals. 


First (to this asylum), 


98 


76 


174 


Second (to this asylum), 


- 


3 


3 


Third (to this asj^lum), 


- 


- 


- 


Total cases, 


98 


79 


177 


Total persons, 


98 


78 


176 



3. — Ages of Insane at Fii'st Attack and Death. 





Died. 




AT 


FIRST ATTACK. 


AT TIME OP DEATH. 




Males. 


Females. 


Totals. 


Males. 


Females 


Totals. 


Congenital, .... 


_ 


2 


2 








15 years and less, . 


3 


1 


4 


- 


- 


- 


From 15 to 20 years, . 


1 


1 


2 


- 


_ 


- 


20 to 25 years, . 


2 


3 


5 


- 


2 


2 


25 to 30 years, . 


2 


4 


6 


1 


1 


2 


30 to 35 years, . 


3 


3 


6 


1 


1 


2 


35 to 40 years, . 


4 


1 


5 


3 


6 


9 


40 to 50 years, . 


7 


2 


9 


10 


3 


13 


50 to 60 years, . 


2 


5 


7 


11 


5 


16 


60 to 70 years, . 


1 


2 


3 


6 


7 


13 


70 to 80 years, . 


- 


— 


- 


8 


7 


15 


Over 80 years, 


- 


- 


- 


- 


1 


1 


Unknown, .... 


15 


11 


26 


- 


2 


2 


Totals, . . . 


40 


35 


75 


40 


35 


75 


Total persons. 


40 


35 


75 


40 


35 


75 


Mean known ages (in years). 


34.56 


34.08 


34.32 


53.92 


51.31 


52.70 



1914.] 



PUBLIC DOCUMENT — No. 23. 



95 



M 


•s[B^ox 


1 •* 1 OO 1 '^;*-< 1 <MC^-H-* 1 -^M-<:0 1 


s 




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1 rt 1 TH 1 -HOO 1 1 <N-( 1 r-< 1 rHCq-^CO 1 


J5 




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1 CO 1 -* 1 1 O^ 1 1 ^^CO 1 1 ^ 1 CO 1 


?§ 




i 

Q 


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,0 ICO I^;h^ |o,<^.^^ l^oo^co 1 


^ 




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1^ 1^ ,^=o 1 ic^ 1^ I^O,^^ 1 


S 




•sai^K 




S 




< 

a 




•sib;ox 


''''''"''''' 


CO 




■eaiBraa^ 


1 1 1 1 . 1« , 11 1 1 1 1 1 11 1 1 


c. 




■saiBjv 


1 1 1 1 1 1 -( 1 1 1 1 1 1 1 1 1 1 1 1 


" 




Q 


•SIB:^ox 


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 




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-^ 




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'-^' ''''■'' ' "' 


^ 




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- 




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1 - 1 1 1 1 1 1 1 1 1 1 , 1 1 , , o. , 


CO 




i 

P5 


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c 




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


1 




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1 =^ 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 






a 

i 


•sp;ox 


'--^S--?™;:— -- 


i 




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1- lO^ l« 1 |« ,«^ lo.^ 1^^ 


s 




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,«^0= I^C.^^ lO, ,0^=0^ l« , 


s 




s 
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1 1 

'aS-ij . ... 




g£ 




A. — First admitted to any hospital whe 
by institution from which trans 
Alcoholic insanity, acute. 
Alcoholic insanity, chronic, . 
Arteriosclerotic insanity. 
Chronic delusional insanity. 
Constitutional inferiority, . 
Dementia, chronic. 
Dementia prrecox. 
Dementia prsecox, paranoid form 
Dementia, presenile, . 
Dementia, senile, . 
Epilepsy, .... 
Epilepsy dementia. 
General paresis, . 

Idiot 

Imbecile, .... 
Imbecile dementia. 
Involutional psychosis. 
Manic-depressive, . 
Puerperal insanity, 





96 



WORCESTER STATE ASYLUM. 



[Dec. 





•si^^oi 


|mMCO|.OTt<rHC-)|-*rt| INCOIC 


S; § § 


•sai^ma^ 




2 S 5 


•sapH 


1 ^^^ 1 CNN^^ 1 CO 1 1 1 1 -HCO 


2 S S 


o 
Q 
1 


•siB^ox 




S5 S S 


•sajBuia^ 


1 1 ,-irt 1 m^ 1 -1 1 rt^ 1 1 -HM 1 


2 i§ S 


•sai^H 


1 TXrt,-! 1 C^C<1 1 ^ 1 (M I 1 1 1 rt 1 


3 § § 


d 
< 
Q 


Is 


•sp^ox 


'''''''■'' '~ 


C. u, ^ 


■saiBoia^ 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 -^ 


rt CO N 


•saiBpf 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ^ 


rt (M C^ 


i 
> 


•sp^ox 


' 1 1- 1 ' 1- ' 1 ' 


^ CO .. 


•saj'Buiaj; 


1 1 1 - 1 1 1 ' 1 1 


^ - , 


■saiBH 


1 1 1 1 1 1 1 ^ 1 1 1 1 1 1 1 1 1 


^ c. o, 


n 5 
< 3 


•si^^ox 


l-l ^,,,^1^ 


^ CO CO 


•saiBuia^ 


1 ^ 1 1 1 1 1 1 1 1 1 1 1 1 - 1 1 


« CO CO 


•saiBj^ 


1 1 1 1 1 1 1 1 1 1 -. 1 1 1 1 1 ^ 


■^ "" "= 


> 


•sib:^ox , 




c. ^ ^ 


•saiBraa^ 


1 1 1 1 1 1 1 1 1 1 '- 


^ ^ ^ 


•saiBK 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 TH 


^ CO oo 


d 

i 

Q 


■siB^ox 


,e.^co^,>o,^-^,^^-|u. 


^ g s 


■sai^raa^ 


,^^„^,«,„^, , ,^^,00 


s g g 


■saiBjv- 




s § s 






H 

p 

O 
g 


B. — All other admissions: — 

Alcoholic insanity, acute 

Alcoholic insanity, chronic, .... 
Chronic delusional insanity. 
Constitutional inferiority, .... 
Constitutional psychopathic. 

Dementia, chronic, 

Dementia prajcox, 

Dementia praecox, paranoid form, 

Dementia, senile, 

Defective delinquent, 

Epilepsy, 

P^pilepsy dementia, 

General paresis 

Imbecile 

Imbecile, moral, 

Imbecile dementia, 

Manic-depressive, 


Totals B 

Aggregate cases, 

Aggregate persons, 



1914.1 



PUBLIC DOCUMENT — No. 23. 



97 







■sF^ox 


§ 


T:t^ T-f 


§ 






S 














^ 


•saiBtaaj 


^ 


CO T-H 


CO 






H 














•saiBpi 


lo 


-H 1 




?? 







•siB^ox 


t- 


CO -— 1 




,^ 




•sa^Bniaj; 


co 


CO ^ 


CO 


^ 


►j:; 


•saiBpi 


^ 


1 1 


^ 


^ 


















■siB^ox 


^ 


^ 1 


»o 


CO 


rjj 


a 












i 


II 


•sapuia^ 


CO 


1 1 


CO 


c^ 




























1 




•saiBjn 


^ 


-H 1 


c^ 


*-* 














'^ 




■s^ox 


CO 


1 1 


CO 


^ 


s 


m 
























o 


o 


•sapmaj 


•-< 


1 1 


^ 


' 




s 
























g 




•sapH 


cq 


1 1 


(M 


^ 




























^ 


§«■ 


•si'b:jox 


GO 


1 1 


00 


-* 


'tS 


H S 












!■ 


?} 


•saiBniaj 


CO 


1 1 


CO 


" 


1 


"eg 


•sai^JK 


»o 1 1 


»Ci 


CO 




•sib:>ox 


^ 


1 1 


T*H 


<M 














i^s 
















•sa^Bina^ 


" 


' ' 


'"* 


1 


"^ 


•sai^H 


CO 


1 1 


CO 


c^ 


i= 




























•?s 












t^.X-r^ 


^ 












S"^ ^ 














o « ^ 














7 




o 








5"^-^ 

Ki 


"^ 




2 

Q 

fa 
O 






1 










1 


i 1 


H 


H 






















kn 


S H 







WORCESTER STATE ASYLUM. 



[Dec. 



< 

i 
1" 


•si^^oj, 




•saiBuiaj 


llll 1^,1,1^1 lllll^lllll 


•sajBH 


-■III 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 




•SIB^Oi 


III, , 1 , IC , , ,,,,,, ,^, ,^ 


.-saiBinaj 




•S9i^K 


llll 1 1 1 lO, , 1 1 1 , 1 1 , , 1 , 1 ,-H 


1 


•sp^ox 


llll 1 1 1 N 1 1 -H-< 111^. „ 


•saiBTn9j[ 


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


•SSIBJV 


llll 1 1 1 -^ 1 1 1 1 1 1 1 1 1 1 1 1 1 1 » 


m 


•SlB^Oi 


,11, 1 , ^^ , ^^ , , ^ 


•sajBraaj 




■S8IBI\[ 1 1 1 1 1 1 1 1 1 - 1 1 1 1 1 1 1 1 1 1 1 1 1 


III 


■SJB^OX 




•S9IBni9J 


llll 1 1 1 1 1 1 1 1 1 1 1 - 1 1 1 , 1 1 1 


•S91BK 


llll ^,^,„,,, , ,0. 1 1 , , , > , 


ill 


•sp^ox 


llll 1 1 1 1 1 1 1 1 111111111,1 


■s9IBniej 


llll 1 1 1 1 1 1 1 1 111111111,1 


•S9IBH 


llll 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 


i 

O 

§ 

< 


•sib:>ox 




•S9IBin9J 


, ^ , „ , ^„^ , , CO« 1 ^ 1 M. 1 -H^-,^ , , 


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i. 

o 


1 . . . 

s 

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1 111 niMi b Jl llll 

ill! 1111 Hi. 1 ^liiiiiillli 
iiiil lllilllli If llllillil 



1914.] PUBLIC DOCUMENT — No. 23. 



99 



1 1 1 . 1 1 1 1 1 1 < , . < 1 , 1 f . 


^ 


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 


-^ 


,^^,^,^, „^, , ,^,^. , , , 


2 


, , , 1^1 , , ^, , , ,^^, , , , 


CO 


1 rt-H III^I l^lll^lllll 


QO 


1 1 1 1 1 1 1 1 II 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 1 1 , 1 1 1 |«^ 1 1 ,,^^ 1^ 


2 


- 1 1 1 1 1 1 1 


o 


1 1 1 1 1 1 1 1 1 1 -H 1 1 1 1 ^^ 1 ^ 


« 


^111, III ^,,,,„,|,^| 


2; 


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


-^ 


-.11,1111 ^|,,|„|,|^| 


2 


11,11111 1 1 1 1 1 1 1 1 1 1 1 


1 


' ' ' 1 1 1 1 , 1 1 1 1 1 


' 


' ' ' ■ 


' 


^^^ « ^^ 


K 


1,1, ^^^^ ^ 1 , ^^o« 1 1 1 1 


J§ 


^„^„ , ,,^ , ^^^ ,^=o 1^^^^ 


§ 






volvulus, . 

icute tubercular, 

3, chronic heart disease, 

s, acute enteritis, 
s, chronic endocarditis, 
s, ischiorectal, . 
liary, .... 




Intestinal obstruction, 
Pernicious anemia, 
Peritonitis, 
Peritonitis, shock, . 
Tubercular enteritis. 
Typhoid fever. 
Uremia, acute. 
Uterine carcinoma. 

Respiratory system: — 
Asphyxia, 

Pneumonia, broncho. 
Pneumonia, bronch,o, 
Pneumonia, hypostati 
Pneumonia, lobar, 
Pulmonary tuberculos 
Pulmonary tuberculos 
Pulmonary tuberculos 
Pulmonary tuberculos 
Tuberculosis, acute m 
Tuberculosis, general, 





100 



WORCESTER STATE ASYLUM. 



[Dec. 



11 


•SIb:jox 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 «^ 1 


■saiBtnaj: 


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


•saiBH 


I'll 1 II 1 1 ,,,,., 1-1 


ft'"' 


•smox 


, , , , ,,,,,,-, , , ,^, ,^, , , , 


•saiBuia^ 


, , , , < 1 1 . 1 > 1 . , , 1^1 ,^, , , , 


■saiBH 


1 1 1 '-I 'I'll 


u 


•sib;ox 


,.., ,,,,,,,, ,,-,,,,,,,,, 


•sa|Bniajj 


1- ,,,,,,,,,,, 


•saiBH 


, ^^ , -,,,,,,,, ,.,,,,,,.,, 


1^" 


•siB^ox 




•saiBiuaj; 




•saiBH 




j 
1 
s 


•sib:jox 


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


■saiBtuaj[ 


, , , , , , 1^1 , , , , , 1^1 , , , , , , 


•saiBM 




1 


■SIB^OX 


, , ,^ , , ,^, , ,^ , ,^1 ,,,,,, , 


•saiBTnaji 


, , ,^ , , ,^, , ,^ ,,,,,,.,,,, 


•saiBH 






P 

m 
H 

O 


Nervous system: — 
Ascending disseminated sclerosis. 

General paresis, 

General paresis, general septicemia, . 

Status epilepticus, 

Circulatory system: — 
Arteriosclerosis, endocarditis, .... 

Arteriosclerosis, general 

Cardiorenal, 

Cardiorenal, vascular, 

Cerebral hemorrhage, 

Cerebral thrombosis, 

Chronic valvular heart disease 

Heart disease 

General system : — 

Carbuncle, ^ . . 

Carcinoma of breast 

Dysentery, 

Enteritis, acute, 

Enterocolitis, acute 

Enterocolitis, chronic 

Enteritis, chronic, 

Exhaustion following maniacal excitement, 

Gastroenteritis 

Heat exhaustion, 

Intestinal obstruction, acute, .... 



1914.] PUBLIC DOCUMENT — No. 23. 



101 



i 



I 





, , , , 


, ,,,,,,,,,,, 


c 




" ' ' ' ' ,,,,,.,, 


- 


,,,,,,,, ,,,,,,,,>,, 


^ 


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


V 


,,,,,,,, ,,,,,,,■:., 




' ' ' ' ,,,,,,,,,, 


- 


1 1 .--i 1 1 1 I.I. .1 




" " " " " - ' ' 


^ 


,,,-,,,, 1 < < . 1 1 , 1 1 < 1 


. 


.,,,,. ,^ ,,,,,,,,,,, 


- 


,,,,,, ,^ ,,,:,,,,,,, 


- 






, , , , 1^^, , , , ,^^, , , , , 


- 


1 i . . .-- ^^, . , , , 


o 


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


- 


I < < , < 1 , < ■ , , , ^., , , , , , 


- 




CO 


.,,,,,,, ,,,,..,,,,, 


^ 








i 

1 . 
g 

ill 

III 


J ■ 

fe 3 >.>: 


Respiratory system: — 
Asphyxia, ....... 

Pneumonia, broncho, acute tubercular, 
Pneumonia, broncho, hemiplegia abscess, . 
Pneumonia, hypostatic, chronic heart disease. 

Pneumonia, lobar, 

Pulmonary tuberculosis, .... 
Pulmonary tuberculosis, acute enteritis. 
Pulmonary tuberculosis, chronic endocarditis. 
Pulmonary tuberculosis, ischiorectal, . . , 
Tuberculosis, acute miliary. 
Tuberculosis, general, .... 


1 





102 



WORCESTER STATE ASYLUM. 



[Dec. 





i 



< 

SI 

1 

<; 


ii 

O tJ 

is 


•SIB^OX 


, ,^,^, , , , 


c, , 






•S9iBraaj 




^ ■ 


- ;: 




•sai^H 


,,.,,,,,. 


^ , 




•^ 


Ii 

^ a 
Si 


•siB^oi 


, 1^,^, , , , 


. , 


IM 03 




•S8|BUia^ 


. , , ,^, , , , 


-H 1 


rH T)< 


g 


•sai^H 


, ,^, , , , , , 


« . 




5~ 


O 

B 
1 
« 


H 

si 

f! 

o 

i 

i 

(5 


o 

1 




•sits^ox 


,,,,,,,,, 


, . 


.. , 




•sajBoia^ 


1 1 1 1 1 1 1 1 1 


■ 1 


1 1 


•sai^H 


■ " 


, . 


C. , 


1 


-<1 


•sib:jox 




.. . 


"^ S 


•S8IBUI9j[ 





1 1 


1 , 


^ 


•S9I^K 




C. , 


« S 


:3 


O 

is 

Q 


■siu^ox 




, c. 




§ 
^ 
'♦i^. 


•saiBoiaj 


1 1 1 1 1 1 1 1 1 


1 1 


' • 




•sai^H 




, . 


(M 1 






C 

c 
t 
p 




Jfllll: 

1 




a 
4 o 

< 



1914.1 



PUBLIC DOCUMENT — No. 23. 



103 






1 1 1 1 -HC^t~O5 00 


S^ ' 


^ i 


1 1 1 1 ^^nmio 


S ' 


CO ° 




■* 1 




1 1 1 1 1 1 ^coto 




^ S 


1 1 1 1 1 1 ,-(MCO 




CO 




ro la 


^ i 


1 1 1 1 '^^^'^^ 


g 2 


§ 




CD to 


g 






CO S 


, .^^=o..o. 




o s 

^ § 


1 1 1 rt(M«t^C0tO 


- ' 




1 1 T-fl 1 ■* <N 0= t> CO 


§ ' 


2 


OtHIMCO'UMM-h 1 


g s 


^s 


WCO 1 «M<MM 1 1 


CO CO 


s 1 


— -' 


s s 


^8 


B. — Died: — 

Under 1 month. 
From 1 to 3 months, 
3 to 6 months, 
6 to 12 months, 

1 to 2 years, . 

2 to 5 years, . 
5 to 10 years, . 

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




Totals 

Average of known cases (in months).