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



SIXTEENTH ANNUAL EEPOET 



WORCESTER INSANE ASYLUM 



WORCESTER 



Year ending September 30, 1893. 



BOSTON: 

WRIGHT & POTTER PRINTING CO., STATE PRINTERS, 

18 Post Office Square. 

1894. 



Digitized by the Internet Archive 

in 2010 with funding from 

University of IVIassachusetts Amherst 



http://www.archive.org/details/annualreportofwo75worc 



OFFICERS OF THE ASYLUM. 



TRUSTEES. 

HENRY S. NOURSE, Lancaster. 

ROCKWOOD HOAR, Worcester. 

FRANCIS C. LOWELL, Boston. 

ELLEN S. HALE Boston. 

FRANCES M. LINCOLN, Worcester. 

A. GEORGE BULLOCK, Worcester. 

THOMAS H. GAGE, Worcester. 



RESIDENT OFFICERS. 

ERNEST V. SCRIBNER, M.D Superintendent. 

HARTSTEIN W. PAGE, M.D Assistant Physician. 

CLARENCE R. MACOMBER Clerk and Steioard. 

ABBIE S. FAY Matron. 



WILLIAM SHERMAN, Engineer. 



TREASURER. 
ALBERT WOOD Worcester. 



Cnmmoixtojealtl^ 0f P^assarl^usdts* 



TRUSTEES' REPORT. 



To His Excellency the Governor and the Honorable Council. 

The Trustees of the Worcester Lunatic Hospital, in their 
capacity as overseers of the Worcester Insane Asylum, respect- 
fully submit their sixteenth report of the management and 
condition of the latter institution, — it being for the year clos- 
ing with Sept. 30, 1893, — and present therewith the reports 
received from the superintendent and treasurer, including the 
usual tabular statements. 

That the aifairs of the Worcester Insane Asylum during the 
past twelve months have been administered with energy, 
economy and good judgment, is attested by its financial pros- 
perity, the valuable improvements which have been effected in 
its buildings and grounds, and the satisfactory condition of 
the patients. No grave accidents or epidemic disease have 
detracted from the successful work of the year. The wards 
have been overcrowded, even more than in the past; perhaps 
without very serious discomfort to the majority of the unfortu- 
nate inmates, but certainly with greatly increased labor and 
anxiety to the official staff and attendants. 

The average number of patients has been 447, twenty more 
than for the year 1892, and 82 more than the normal capacity 
of the institution. 

The death rate has been notably higher than usual, but a 
careful study of the cases shows that this is not chargeable to 
acute disordei's, but is plainly attributable to the enfeebled con- 



84 WORCESTER INSANE ASYLUM. [Oct. 

dition of those transferred to the asyhim from other institutions, 
or to age and disease of long standing. 

The more noteworthy improvements in the institution have 
been : the extension and entire reconstruction of the three 
north centre dining rooms, with their closets and plumbing ; 
the replacing of the wooden dumb-waiter shaft in the south 
wing with one of fire-proof materials, and the extensive 
renewal of floors and ceilings in the older sections of both 
wings. The work upon the alterations, as well as that of the 
necessary repairs, has been done without permanent increase 
of the force of mechanics always required for the general care 
of the buildings and machinery ; and the labor of able-bodied 
patients has been constantly utilized. All changes made have 
been in the direction of better protection from the danger of 
fire, and in pursuance of well-studied plans determined upon 
several years ago, — plans which, when satisfactorily completed, 
will make this asylum, though by far the oldest in the State, 
hardly inferior to the most modern hospital building in its con- 
venient equipment for its purpose, its thorough ventilation, 
sanitary plumbing, sun-lighted and attractive wards. 

Miss Sophia N. Graves, who for nearly sixteen years has 
rendered faithful service in the capacity of matron of the 
asylum, died on July 17, 1893. The position thus vacated 
has been filled by the appointment of Miss Abbie S. Fay. No 
other changes have occurred in the list of officers. The trus- 
tees desire again to place upon record their high appreciation 
of the skill and untiring devotion to the welfare of the institu- 
tion shown by the superintendent and assistant physician. 

HENRY S. NOURSE. 
ROCKWOOD HOAR. 
FRANCIS C. LOWELL. 
ELLEN S. HALE. 
FRANCES M. LINCOLN. 
A. GEORGE BULLOCK. 
THOMAS H. GAGE. 
Worcester, Sept. 30, 1893. 



1893.] 



PUBLIC DOCUMENT — No. 23. 



85 



OFFICERS AND THEIR SALARIES. 



Ernest V. Scribner, M.D., Superintendent, 
Hartstein W. Page, M.D., Assistant Physician, 
Clarence R. Macomber, Clerk and Steivard, . 

Abbie S. Fay, Matron, 

William Sherman, Engineer, .... 
Albert Wood, Treasurer, 



$2,000 00 
1,200 00 
1,000 00 

400 00 
1,000 00 

400 00 



VALUE OF STOCK AND SUPPLIES. 

Oct. 2, 1893. 



Live stock, 

Produce of the garden ou 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, , , 



$425 00 
1,800 00 

650 00 
9,000 00 
9,500 00 
3,500 00 
9,500 00 

275 00 
1,200 00 
1,800 00 

350 00 
3,000 00 

500 00 
1,300 00 



$42,800 00 



86 



WORCESTER INSANE ASYLUM. 



[Oct. 



TREASURER'S REPORT. 



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

Insane Asylum. 

I herewith submit my sixteenth amiual report on the finances 
of the Worcester Insane Asylum for the year ending Sept. 30, 
1893. 

Receipts. 

Cash on hand Sept. 30, 1892 : — 

Cash belongnig to asylum, $2,779 56 

Deposits of himates, 1,087 27 



5,866 83 



Amounts received : — 
From the Commonwealth, for support of patients, $24,465 45 
From cities and towns, for support of patients, . 48,966 91 

From other sources, 258 58 

From inmates (on deposit), 45 57 



73,736 51 



$77,603 34 



The expenditures for the year have been as follows : — 
Salaries and wages, 



Provisions and supplies 
Meats of all kinds, 
Fish of all kinds. 
Fruit and vegetables. 
Flour, . 

Meal for table, . 
Hay and gi'ain, . 
Tea and coifee, . 
Sugar and molasses, 
Milk, butter and cheese. 
Salt and other groceries, 
All other provisions, . 

Clothing and material. 
Fuel, .... 

Amounts carried forward. 



523,110 56 



. $3,639 


32 


. 1,013 


11 


. 2,808 


18 


. 3,305 


41 


. 102 


95 


. 276 


58 


809 


06 


. 1,126 


81 


. 7,389 


08 


. 661 


64 


. 2,248 


53 


. $5,298 


88 


. 6,724 


93 



23,380 67 



fl2,023 81 $46,491 23 



1893.] 



PUBLIC DOCUMENT — No. 2^ 



87 



Amounts brought fonvard, 

Lights, .... 

Medicine and medical supplies, 
Furniture and furnishings, 
Crockery, . 
Beds and bedding, 
Transportation, . 
Travelling, . 
Trustees' expenses, 
Soaj) and water, . 
Stationery, . 
Undertaking, 
Repairs (ordinaiy), . 
All other current expenses. 



Total current expenses. 
Repairs and improvements (extraordinary), 
Refunded inmates (on deposits), 

Total amount expended, 
Cash on hand Sept. 30, 1893, 

Resources. 

Cash on hand, 

Due from the Commonwealth for suj^port, 

from cities and towns, 

from other sources, .... 



$12,023 81 $46,491 23 



Liabilities. 



Due for supplies and expenses, 
for salaries and wages, 
inmates (cash on deposit),, 



Total surplus, 



1,098 42 




537 55 




2,078 66 




491 36 




1,175 68 




46 98 




65 77 




39 75 




1,001 75 




71 29 




483 00 




3,000 00 




1,915 93 


24,029 95 


, , 


$70,521 18 


$4,264 60 




17 50 


4,282 10 


, 


$74,803 28 


• 


2,800 06 




$77,603 34 


f2,800 06 




6,095 71 




18,160 40 




438 00 


$27,494 17 


f3,664 25 




1,939 88 




1,115 34 


6,719 47 


• a 


$20,774 70 



Respectfully submitted, 



ALBERT WOOD, 

Treasurer . 
Worcester, Mass., Oct. 2, 1893. 

Worcester, Mass., Oct. 28, 1893. 
The undersigned has this day carefully compared the treasurer's statement of expendi- 
tures for the year ending Sept. 30, 1893, with the vouchers which are on file at the 
asylum and finds it to be correct. He has also compared the amount received for board 
of patients with the estimated earnings of the institution for one year, and finds them 
to agree. 

GEO. L. CLARK, 

Auditor- of Accounts. 



88 WOECESTER INSANE ASYLUM. [Oct. 



SUPERi:t^TE]S^DENT'S REPORT. 



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

Bisane Asylum. 

The sixteenth annual report of the superintendent of the 
Worcester Insane Asylum is herewith presented for the con- 
sideration of your Board. 

There were remaining in the asylum at the beginning of the 
present year 233 males and 216 females — a total of 449 pa- 
tients. There have been admitted 70 persons — 40 males and 
30 females — making a total of 519 cases — 273 males and 246 
females. Of this number 4 males and 3 females have been 
discharged and 38 males and 20 females have died, leaving in 
the asylum Sept. 30, 1893, 454 patients — 231 males and 223 
females. Of those discharged 1 went home with her husband, 
1 was transferred to the State Farm at Bridgewater, 1 was 
transferred to the Taunton Lunatic Hospital, 2 were removed 
to the almshouse by the Overseers of the Poor, 1 was boarded 
out by the Inspector of Institutions, and 1 escaped. Of the 
70 admissions, 20 males came from the Worcester Lunatic 
Hospital, and 20 males and 30 females from Taunton. 

Chronic dementia has been the predominant form of mental 
disease among those admitted. This is to be expected when 
we learn that the average duration of insanity in these cases 
on reception here was 8 years. Intemperance, heredity, and 
epilepsy hold the chief places in the table of causes. Intem- 
perance alone is responsible for over 20 per cent, of the cases. 

The overcrowding of the asylum continues. The evils inci- 
dent to this condition have been brought to your attention in 
former reports, and need not again be mentioned. I cannot 
say that any particularly disastrous results have occurred di- 



1893.] 



PUBLIC DOCUMENT — No. 23. 



89 



rectly traceable to this cause. Much discomfort and annoy- 
ance have ensued. A long continuance of this state of affairs 
must eventually make itself felt in an increase of mortality 
and a lowering of the general health of the house. The large 
number of patients, however, has added considerably to the 
revenues and has thus served to lessen the average weekly cost 
of support. 

Ratio of Deaths from the Opening of the Asylum to Oct. 1, 1893. 









u 

SI 

a £ 

§, 1 


Daily Average 
Number of 
Patients. 


Deaths. 


Per Cent, on 
Whole Number 
of Patients 
treated. 


ol® 


OFFICIAL YEAU. 


"3 


■5 
a 

a 





Per Cent 
Daily Av 
N u m b e 1 
Patients, 


1877-78, . 




. 


429 


382.98 


18 


8 


26 


6.05 


6.78 


1878-79, . 






422 


367.41 


22 


11 


33 


7.82 


8.98 


1879-80, . 






413 


363.15 


15 


8 


23 


5.56 


6.33 


1880-81, . 






401 


363.09 


18 


6 


24 


5.98 


6.62 


1881-82, . 






439 


375.59 


21 


11 


32 


7.28 


8.51 


1882-83, . 






461 


384.33 


37 


24 


61 


13.23 


15.84 


1883-84, . 






438 


390.69 


22 


20 


42 


9.58 


10.75 


1884-85, . 






448 


391.12 


20 


14 


34 


7.58 


8.69 


1885-86,. 






476 


400.28 


23 


15n 


38 


7.98 


9.49 


1886-87, . 






414 


393.52 


21 


17 


38 


8.55 


9.65 


1887-88, . 






451 


393.95 


23 


14 


37 


8.20 


9.39 


1888-89, . 






431 


385.56 


27 


11 


38 


8.81 


9.85 


1889-90, . 






428 


330.23 


27 


4 


31 


7.24 


9.38 


1890-91,. 






464 


394.66 


22 


12 


34 


7.32 


8.61 


1891-92,. 






499 


427.82 


22 


15 


37 


7.41 


8.64 


1892-93, . 






519 


446.94 


38 


20 


58 


11.17 


12.97 



90 WOECESTER INSANE ASYLUM. [Oct. 

Acute disease of a serious nature has been rare. Two cases 
of measles have occurred among the employees. In one the 
only known source of contagion was a letter received from the 
person's home, where this malady prevailed in the family. In 
both cases the disease was mild and followed by a rapid and 
complete recovery. Death has resulted almost exclusively 
from those chronic and wasting diseases which are always 
the chief causes among the chronic insane. In very many of 
our patients the power of resistance to physical disease is 
feeble, and slight causes easily operate to produce fatal results. 
The mortality has been chiefly among persons of middle life 
and past, — the average age at the time of death being some- 
what in excess of fifty years. 

Pulmonary consumption has been the cause of death in about 
one-third of all the cases. An erroneous impression formerly 
prevailed in the public mind, and to some extent, also, in that 
of the profession, regarding the communicability of this disease. 
As its nature was not well understood it was impossible to 
adopt efficient measures against it. Pathological investigation 
has established the fact that infection can take place and is 
accomplished by micro-organisms called bacilli. Proper sani- 
tary precautions can do much to limit the spread of this disease. 
To be thoroughly efiectual this means the intelligent co-opera- 
tion of the patient. In the majority of cases among the insane 
this could not be secured. An indiscriminate herdino; tog-ether 
of all consumptives would accomplish little and tend to hasten 
the course of disease. Consumption is not contagious in the 
sense that measles, scarlet fever and small-pox are, but is 
propagated by the inoculation of tuberculous matter, accom- 
plished in various ways. Personal contact and even intimate 
association do not imply contagion if no transference of infect- 
ive matter takes place. Painstaking care will prevent this. 
A system already weakened by chronic mental disease offers 
less resistance to the entrance of these micro-organisms. The 
lung is the most common seat of attack, and pulmonary con- 
sumption results. Public sentiment is not sufficiently alive 
to the danger from this source, and any radical movement 
for the suppression of this disease would be likely to meet 
with serious opposition from the people at large. Many 
cases are received at this asylum either in an advanced 



1893.] PUBLIC DOCUMENT — No. 23. 91 

stage of consumption or with the seeds of infection already 
•sown. The transfers quite often consist of many feeble persons 
who are destined at an early date to figure in the mortuary 
tables of the institution. Phthisis is not commonly recognized 
as a cause of insanity in anything save a very small percentage 
of cases. 

The amount of restraint is small and seclusion is never 
resorted to for any extended period. The added experience 
of another year strengthens me in my belief that the chronic 
insane have in the past often been deprived of personal freedom 
to a far greater extent than was necessary. I do not by this 
statement mean to advocate the leaving of the insane more 
to their own devices and fancies. I do believe that they 
should be led rather than coerced into a more rational way of 
thinking and doing. If the patient can be induced to feel that 
he is in the care of friends and helpers, rather than jailers and 
enemies, the iirst step has been taken towards a return to a 
more normal condition of mind. I have not found that the 
carrying out of this idea has added to the number of escapes. 

The work on the north centres has been pushed forward as 
rapidly as it has been possible with our small force of work- 
men, and is now fast approaching completion. For some 
little time the dining-rooms on these wards have been occu- 
pied and have proven well adapted to their use. A por- 
celain sink with hot and cold water has been put in, and 
a fire-proof shaft built for the food lift. In all new work 
special reference has been had to limiting the possibility of fire. 
Metallic lathing has been used on ceilings, and construction 
fire- stopped in every case. Matters have constantly occurred 
to interrupt this work and to divert our forces into various 
unexpected but necessary channels. One wooden waiter shaft 
remained on the south wings which communicated with the 
attic. It was the plan to remove this in the near future in the 
general course of construction. It was such a menace to the 
safety of the asylum, however, that it has been torn out and 
rebuilt with brick. This removes from the wards the last of 
the old waiter shafts, and now no wooden flue communicates 
with the attics in any portion of the house which is occupied 
by patients. The plumbing in the water-section of the chapel 
wing was old and on inspection found to need such extensive 



92 WOECESTER INSANE ASYLUM. [Oct. 

repairs that it was deemed cheaper and more satisfactory to 
put in entirely new work. This has been done and adds greatly* 
to the comfort and convenience of the occupants of that portion 
of the building. 

As soon as the finances of the institution will permit I should 
advise that something be done in the way of general repairs in 
the administration building and chapel wing. These now need 
attention more than any other portions of the asylum. The 
sanitary condition is good so far as the plumbing goes, but the 
ventilation is poor, and much can be done to better the general 
arrangement. The reception room for visitors should be ren- 
dered more attractive, and the general office needs renovation. 
By another season the outside woodwork of the buildings will 
need painting all around. 

Two attendants have been constantly engaged in taking out 
patients to work. No difficulty has been experienced in find- 
ing profitable occupation for them. They have maintained a 
general supervision of the grounds, kept the walks and road- 
ways in repair, done a great amount of grading and filling, and 
assisted the carpenter and mason in various ways. A long 
retaining wall has been built, beside the drive-way at the rear 
entrance of the asylum, almost wholly by patients' labor. 
This serves to better enclose the orchard and improves the 
appearance of the approach. Several of our inmates are 
skilled mechanics and have rendered valuable assistance. 

Much difficulty has been experienced in the past in the 
proper inspection and supervision of the Hermitage pond, 
which is the chief source of the asylum water supply. The 
trees and bushes, growing close to the water's edge and in 
many places overhanging, formed a screen and barrier which 
favored the collection of vegetable matter and prevented its 
easy removal. In the autumn, at the falling of the leaves, 
they proved a further source of trouble. Last winter these 
trees and bushes were removed all around the reservoir for a 
space of perhaps twenty feet from the water line. Though the 
cleared space should undoubtedly have been wider, a marked 
improvement has resulted. 

During the past year the asylum has lost a faithful servant 
by the death of Miss Graves, its matron. She had served the 



1893.] PUBLIC DOCUMENT — No. 23. 93 

institution in this capacity ever since its organization — a 
period of nearly sixteen years. She passed away after a long 
and painful illness. I desire to record my appreciation of her 
worth and character, both as a matron and as a woman. 

The weekly entertainments in the chapel have been largely 
attended during the winter. Sunday services have been held 
as usual. 

The average weekly cost has been $3.03. 

The publishers of the " Worcester Evening Gazette" regu- 
larly contribute a copy of their paper, and the Hospital News- 
paper Society kindly remembers us each year with a supply of 
illustrated papers, magazines, and miscellaneous reading matter. 

E. V. SCRIBNER, 

Sujjerinlendent. 
Worcester, Mass., Oct. 2, 1893. 



REYLSED TABLES 



Uniform Statistics 



MASSACHUSETTS HOSPITALS AND ASYLUMS 
FOR THE INSANE. 



Approved bt the State Board of Lunacy and Charity, 
March 10, 1891. 



96 



WORCESTER INSANE ASYLUM. 



[Oct. 



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1893.] 



PUBLIC DOCUMENT — No. 23. 



97 





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i 


CO 1 T-l 


G<lG<lG^COCOr-( |(Mi-l 







G^ 


1 






?0 CO CO 


CO 1-1 1 -^ G^ CO G<» CO CO 


00 

CO 


CO 

CO 


1 




o 

s 


1 


a> CO -* 


«DC0G^t^'O-^C^t^C0 
I— 1 





«5 


1 




i 


CO 1 1-1 


coG^c^ieocoi-i ItMco 


CO 


CO 
G^ 


1 




« 
s 


CO CO CO 


9 

COi— 1 I'^G^COG^IiOO 
1-1 


G^ 


G^ 


1 




o 

s 


■3 



1 1 


1 1 1 1 1 1 1 

CO c<i 








1 




■3 

a 


III 1 1 1 1 1 1 1 1 

CO 



CO 

1 




CO 


1 




1 


1 1 

G^ 


1 1 1 1 1 1 1 1 








1 






w 
K 
H 




1893. 

October, . . ... 

November, 

December, ..... 


M 


ai" 

(S 





CO 



CO 
(D 

=4-1 

c 



H 


be 
ci 




January, . 

February, 

March, . 

April, 

May, 

June, 

July, 

August, . 

September, 



98 



WORCESTER INSANE ASYLUM. 



[Oct. 



3. — Received on First and Subsequent Admissions. 





Casks Admitted. 


Times Previously 
Kecoveked. 


NUMBER OF THE ADMISSION. 


Males. 


Females. 


Totals. 


Males. 


Females. 


Totals. 


First, 

Second, 

Third 


39 
1 


30 


69 

1 


- 


- 


- 


Total of cases, 
Total of persons, . 


40 
40 


30 
30 


70 

70 


- 


- 


- 



4. — Relation to Hospitals of Persons admitted. 



HOSPITAL RELATIONS. 


Males. 


Females. 


Totals. 


Never before in any hospital for insane, . 


- 


- 


- 


Former inmates of this asylum only, 


- 


- 


- 


of other hospitals only, . 


39 


30 


69 


of this asylum and other hos- 
pitals, ..... 


1 


- 


1 


Total of persons, 


40 


30 


70 



1893.] 



PUBLIC DOCUMENT — No. 23. 



09 



5. — Parentage of Persons admitted. 





Males. 


Fkmales. 


Totals. 


PLACES OF NATIVITY. 


Father. 


Mother. 


Father. 


Mother. 


Father. 


Mother. 


Unknown, .... 


40 


40 


30 


30 


70 


70 


Total, .... 


40 


40 


30 


30 


70 


70 



G. — Residence of Persons 


admitted. 






PLACES. 


Males. 


Females. 


Totals. 


Massachusetts : — 
Suffolk County, . 








7 


22 


29 


Bristol County, . 








9 


2 


11 


Worcester County, 








9 


- 


9 


Norfolk County, . 








4 


5 


9 


Middlesex County, 








8 


- 


8 


- Plymouth County, 








2 


1 


3 


Dukes County, 








1 


- 


1 


Totals, . 


40 


30 


70 


Viz : Cities or towns,* 








24 


26 


50 


counti'y districts. 








16 


4 


20 



Containing not less than 10,000 inhabitants. 



100 



WORCESTER INSANE ASYLUM. 



[Oct. 



'S 



'B 
s 



^ 



a 



O 


•SIBJOX 


as r-l 


o 


•B3lBni3J 


O 1 

CO 


o 

CO 


•SOITJM 


OS 1-1 

CO 


o 


o 
1 


•einioi 


1 1 


1 


•saiBcaaji 


1 1 


1 


•S3IBI\[ 


1 1 


1 




s 
o 


•eiBjox 


lO 1 


lO 


•saiBina^ 


Ttl 1 


-# 


•S3IBK 


i-H 1 


I-l 


Q 

S 


•smoi 


O T-l 

CO 


1—1 
CO 


•saiBinaj 


o 1 


o 


•S31BH 


O 1-1 


1—1 




•eiBjox 


-* 1 
CO 


CO 


•saiBras^ 


«o 1 

T— I 


CD 
1—1 


•saiBH 


GO 1 

1—1 


CO 




o 

o 

Ed 

a 
o 

!2i 


t 8 

fe CO 


O 

H 



1893. J 



PUBLIC DOCUMENT — No. 23. 



101 



8. — Occupations of Persons admitted. 



MALES. 


FEMALES. 


Laborers, 






10 


Housewives, 


10 


Machinists, . 






5 


Domestics, .... 


10 


Slioe-makers, . 






4 


Housekeepers, 


2 


Painters, 






2 


Seamstress, .... 


1 


Store-keei^ers, 






2 


Cook, 


1 


Farmers, 






2 


Unknown, .... 


2 


Boot-maker, . 








No occu]3ation. 

Total, . . . . 


^ 


Baker, . 


30 


Barber, . 






Stableman, 








WIFE OR DAUGHTER OF. 




Hostler, , 


Unknown, .... 


30 


Coachman, 












Plumber, 












Pattern maker. 












Mechanic, 












No occupation, 






6 


Total, .... 




Totals, . 


40 


30 



102 



WORCESTER INSANE ASYLUM. 



[Oct. 



'^ 



d 



Ci 



H 
K 

■< 
n 

3 

o 

> 


15 

(H O 
B -71 

w S 

go 
«^ 


•spjioi 


1 r 1 1 1 1 1 1 1 J 1 1 1 1 1 1 1 


1 


■soiTJiuaj 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ' 1 


1 


•S8ICJH 


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


1 


la H 


•9[TJ10X 


1 1 1 1 1 1 1 1 1 1 1 [ 1 1 1 1 ' ' 


•ssiBcua^ 


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


•saiBj^ 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ' 1 ' 




R 
B 

K 



3 


H o 

Ah 


•SIBJOX 


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


1 


•s3[Braa^3 


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


1 


•saiBH 


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


1 


Si5 

2d 


•siBiox 


Ill 1 1 1 1 1 1 


1 


•saiEtna^ 


1 Ill 1 1 1 


•saiEK 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 '1 




, 1^ 

Si 

ft 


•SIBIOi 


'^^^ < '^ ' t- , 1 Ir. ^ 


^ 


•S9H!iuaj[ 


lllllllllrHl COIIIr-l 1 


^ 


•B9[CJ^ 


e-> w r-( 1 1 1 1 1 1 1 1 -* 1 1 1 1 r- 


c 


II 

Pi < 


•SIBIOi 


lllllllllll Mllll rtjc^ 


•99[Eni9^ 


III Ill rH 1 1 1 1 1 


^ 


■saiBpi 


1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 T-l 




P 

H 

H 


•< 

z; 
w 


< ^ 

i 


•siBiox 


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


1 


■sgjBuig^ 


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




•S9IUH 


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






•S1B}0X 


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




•B9XBni9^ 


1 1 1 1 1 1 1 1 1 i 1 1 1 1 1 1 1 




•S9[BJS|; 


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




1 


•BIE'JOX 


C-ICOCO-^CNO^fMi-tlHrHrH t-(Mi-ti-H.-l ^ 


o 


•S9iBni9j3; 


<M (M ICOIM'-r-l 1 Ir-r-l CO rH r-1 rH rH O 


o 

CO 


•S9IBJ^ 


OOCOrHlrHrHrHrHI | "^rHl 1 | rnlo 
i-< rH Tf 


CAUSES. 










1. Physical : — 

Intemperance, 
Epilepsy, 
Sunstroke, . 
Sickness, 
Overwork, . 
Injury to head. 
Senility, 
Paralysis, . 
La Grippe, . 
Puerperal, . 
Climacteric, . 

2. Mental : — 

Heredity, 
Fright, . 
Worry, 
Grief, . 
Abuse, . 

Unknown, . 


o 



1893,] 



PUBLIC DOCUMENT — No. 23. 



103 






'« 



6 

o 






< 

o 
a 

K 
O 

o 
< 


c 


01 1 1-1 1 1 t^ C-5 1 


^ 


1 1 1 1 1 1 1 

CO CO 


« 
S 


01 1 --1 1 1 t^ CM 1 

^ CO 


H 
55 

-< 

Pi 

« 

<: 

H 

a 
& 

.J 
o 
>■ 


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 


■< 

H 
3 

X 


o 


1 1 1 1 1 1 1 1 1 


■3 

a 


1 1 1 1 1 1 1 1 1 


■3 


1 1 1 1 1 t 1 1 1 










a 


1 1 1 1 1 1 1 

CO CO 


a 
S 


01 1^1 1 t^ CM 1 

-*i CO 




E 
I 


c 

^ 

q 

< 


Admitted, 

Discharged : recovered, 

much improved, .... 

improved, 

not improved, .... 

not insane, . . , . 
Died, ......... 

Remaining Sept. .SO, 1893, . . . ; . 

Number likely to recover or improve, . . 



104 



WORCESTER INSANE ASYLUM. 



[Oct. 






»« 
^ 



OS 



















I— 1 






m 






(M 






ci 


1 1 1 (M T-l lO G^ CO 00 CO 1 1 


CO 










T-< T-H 7-1 


"O 







a 


1 






10 




Eh 

























s 






10 
CM 




o 


13 


1 1 I |i-IC0T-I^CC>O(Mr-l| 1 









a 




CM 


<M 




a 






>0 




s 


S, 






















in 
H 
< 
















CO 


















^ 


1 1 l<NIC^^QOlOlO«5rH| 1 


CO 






us 




CO 


ci 




g 






•rH 


5 












m 






• 






!a 












o 










01 


K 




M 






CO 






"5 


O1rt<-*Olt^OC<l00^<Mi-H l<M 1 


CO 








t— 1 T— 1 


lO 


"^ 






o 






CO 




M 












a 












< 












•«) 


"3 


T-<T-l|T-l->#lOi-HG<Ir-l| 1 l-^l 





CO 




H 


a 




(M 


(M 




K 








CO 






&H 










Si 




















•«1 
















s 


.-ICO-^'-ltO'OrHCOCOC^lT-l IGO 1 


CO 








d 




zn 


CO 






s 






CO 






m 












"3 


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


1 


1 






+-> 








hj 


d 


o 
E-i 








•01 


H 
g 










H 


• 








&< 












CO 


a 










O 

a 




C3 


1 1 1 1 1 ! 1 < 1 1 1 1 1 1 


1 


1 


N 


Z 

a 


fe 








55 










< 




en 








O 






1 1 1 1 1 1 1 1 1 1 i 1 1 1 


1 


1 


. H 




■3 













s 








a 












H 
















































n 




as 


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


1 


1 


<4 
H 




1 








s 


< 










oa 








£ 




■5 


1 i 1 1 1 1 1 1 1 1 1 1 1 1 


1 


1 


15 


H 


a 








O 
P5 


S 


fa 








[^ 










S 












Ph 


< 


1 


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


1 


1 










m 









i 


t/Tcc m m ^ in m w xn 


1-^ 










• • %, U %i %t 'rJ U 'l-l '-1 t-J ' ' ' 



ifi 






^ 


-CwC3cic3c3cuC3c5c5 






D 


i/!aj(D(D(Da:i<i5<Da)ai 








^ 


11 


■^^OiOOOOOOOOaf " " 


s 










Oh 


- 








'-fSoobooooooo ^qT 


^M 













co' 








C3 (jJ+J-UH-i^J+J-U-U+J-tJ ^^^ 

•rH !y2iOOiOOiOOOOO,_,'fe^ S 


'^ 


be 











c3 








Con 
15 y 
Froi 

Ove 

Unk 
Not 




ci 













1893.] 



PUBLIC DOCUMENT — No. 23. 



105 






e 
^ 






o 



S 
C) 

'« 



o 








< 

H 

O 


o 


I 1 1 |(?q(M(Mu;5CNco^i 

tM 1— 1 1— 1 r-l 


000 
t> t> 

CO 




a 


1 1 1 |(MCM05»0^T-lt>| 


00^ 

CO CO 1—1 




rf 
s 


1 1 1 1 1 |eooQOCot>l 

r-H 1— 1 


CO 

^ Tt^ "O 
06 




Z 

o 

a 
< 

a 

H 

O 
iJ 
< 


"3 

EH 


1 1 1 |(MC><(MiO(MeO'*| 

<M T-( T-H tH 


000 
t> t^ 

CO 




■3 

a 


1 1 1 |(M(Ma5iO-*i-l|>| 


00^ 

CO CO 1-H 




"3 


1 1 1 1 1 icoooo(Mr>l 

I— 1 I— 1 


00 
'^ ^ »o 

CO 




< 

K 
o 
M 

■<! 

o 

H 

o 

ft 
n 

K 
£1 


3 



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


1 1 1 




"3 

a 


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 








< 

& 

Q 


> 


Congenita], ' . 

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, 

Unknown, ........ 

Not insane, 


Total of cases, 

Total of persons, 

Avei'age in years, ...... 



10(i 



WORCESTER INSANE ASYLUM. 



[Oct. 



C) 



a 



'« 



a 



^ 



^ 



CO 



a 

a 

X 

O 
a 
< 


H 
-< 
O 

« 

o 




O lO CM CO (M T-l CM 1 1 

r-H CO .-H 

1 


CO CO 


CO Tj^ 1 »0 1 1 .-1 1 1 


CO CO 

(M CM 


S 


t> — ' C<l 00 (M tH r-l 1 1 
(M 


(M <M 


S 


o 

Eh 


l> (M (M (M <N T-( (N 1 1 

CO r-l 


00 00 

lO 'O 


S 


r-H -# 1 '^ 1 1 rH | | 
I— 1 


o o 

(M CM 


f^ 


CO 00 (M 00 CM i-H r-( 1 1 


CO 00 

CO CO 


! 
Not Ijipboved. 




t-H T-l I »— 1 1 1 1 1 1 


CO CO 


l-H 1 1 »-l 1 1 1 1 1 


(M CM 


1 <-l 1 1 1 1 1 II 


r~( T— 1 


1 


♦J 

o 

H 

« 

s 


"-I <M 1 1 1 1 1 11 


CO CO 


r-< 1 1 1 1 1 1 1 1 


tH t-H 


1 (M 1 1 1 1 1 1 1 


(M CM 


d 
w 

o 

K 

a, 
o 




o 

E- 


•-< 1 1 1 1 1 1 1 ( 


rH 1-1 




1 1 1 1 1 t 1 1 1 


1 1 


'-' 1 1 1 1 1 1 II 


1-1 1-1 


d 
« 

o 
o 

X 




1 1 1 1 1 1 1 1 1 


1 1 


Iih 


1 1 1 1 1 1 1 II 


1 1 


^ 


1 1 1 1 1 1 1 1 1 


1 1 


Q 
U 

H 

o 

u 
o 


o 
H 


lO (M CM t^ (M C<1 1 1 1 
CM CO 


O O 


CO o 1 i-i 1 1-1 1 1 1 

1— 1 Y— 1 


o o 
CO CO 


0! 

a 


t^ CM CM CO <M t-H 1 1 1 
(M 


o o 




CO 

Q 

En 
O 

O 




A. — Insane : 

Mania, chronic, . 
Dementia, chronic, 

paralytic, . 

epileptic, . 

senile. 
General paralysis, 
Congenital deficiency, 

B. — Habitual drunkards, 

C. — Voluntary patients. 


Total of cases, 
Total of persons, 



1893.] 



PUBLIC DOCUMENT — No. 23. 



107 






'« 

^ 









•0 
H 

o 

Eh 


•SIBJOJ, 


O 'C 
CO 


CO CO 


•saii;rao^h[ 


o CO 


CO CO 
C-l (M 


•saiupi 


O CM 


(M fM 


Not Insane. 


•smox 


1 1 


1 1 


1 1 


1 1 


•saiTJK 


1 1 


1 1 


Died. 


•8IB10X 


CO to 


cc CO 


•saiBtnaj 


t> CO 

T-l 


o o 

M (M 


•sainH 


CO 


CO cc 

CO CO 


Not Improved. 


■SIBIOX 


CO 1 


CO CO 


■Bait'uiaji 


(M 1 


C<l (M 


•saiBH 


"—I 1 


r-l T~( 


ft 

K 

a 


•SIBJOJ, 


CO 1 


CO CO 


•saiBinojT 


1—1 1 


i-l I— 1 


•B9(13M 


(M 1 


<N <M 


d 

w 

o 

K 

ft. 

K 
u 


•8I«J0J, 


r-< 1 


1— 1 1-H 


•sDn;iu3,i| 


1 1 


1 1 


•SdlBK 


i-H 1 


1-1 rH 






Q 

K 
« 

O 
O 


•SIBJOX 


1 1 


1 1 


•saimiiaj 


1 1 


1 1 


■80[BI\[ 


1 1 


1 1 




(73 

o 

o 

o 
« 

a 


First, 

Second, . . . . 


Total of cases. 
Total of persons, . 



108 



WORCESTER INSANE ASYLUM. 



[Oct. 



s 

s 



to 









r-l O '^ r-l lO 


Oi 


T— 1 


CO CM r-l CO 00 


GO 






•SIBJOX 


T— 1 


— H 






lO 








rH (>1 1 1 CM 


OS 


1 


i-H 1 1 CO (M 


o 




<5 


•saicraaji 














O 
















H 


















1 00 "+1 i-i CO 


o 


I— 1 


(M !M rl 1 ;0 


00 






•S9IBI\r 




»-( 






CO 






•S11!}0X 


1 1 1 1 1 


1 


1 


1 1 1 1 1 


1 




















H 
































U 


















•eSIBOTO^ 














< 
















H 
















a 
































>j 
















o 




1 1 1 1 1 


1 


1 


1 1 1 1 1 






> 


•S31BH 
















•stupx 


1 1 1 1 1 


1 


1 


1 1 1 1 1 


1 




K 
















-U 
















M 

a 


































1 1 1 1 1 


1 


1 


1 1 1 1 1 


1 




•saiBraaj 














>j 
















D 






























S 
















•S31BI^ 














a 




















1-H O '^ 1-H »0 


(55 


r-t 


CO (M T-i CO CO 


00 






•bid;ox 


T-l 


J— 1 






"O 




H 
Z 

-< 




^ <M 1 1 (M 


05 


1 


rH 1 1 CO C^ 


o 




•saivtnaj: 










CM 




Z 


































1 CO Tfl r-l CO 


o 


I— 1 


CM C<l rH 1 O 


<x> 






•saiBK 




I— 1 






CO 








oT 














03 
















H 


• • o • • 














cc 


m 














& 


S 














-^ 


• -^.S • 


1 • 














1 8^ 


a 


1 


(D 
CO 










s system : - 
oplexy, . 
ilepsy, 
ileptiform 
neral paral 
L-alysis, 


a 

» 3 


1: — 

art disease 
bercxxlosis, 
Ight's disea 
I age, 
haxxstion, . 


Is 

o 








>"n 










3 Oh Jl, a, « cj 


•X3 oj 


.^^P ^'i '^ 










o<tjHHOP-i 


cfi Oh 


'5 K H CQ O W 












OT 
















O) 














!^ 


P^ 


Q 


O 





1893.] 



PUBLIC DOCUMENT — No. 23. 



109 







t< 






1 1 1 1 1 1 1 1 1 1 1 














O 






1 1 1 1 1 1 i 1 1 1 1 


1 


1 




1 






a '^' 


c3 


















2z 


1 


















K a 




















'A Cl 




















■^ m 


S 




1 1 1 1 1 1 1 1 1 1 1 


, 


1 




, 








■3 

a 




1 1 1 t 1 1 1 1 1 1 1 


1 


1 




1 






O J 




















2 S 


S 




































Hfe 


m 




1 1 1 1 1 t t 1 ! 1 1 


1 


1 




\ 




M 




iJ 


















1 
















H 




















< 


Cm 


















J 


O 


-S 




1 1 1 1 1 1 1 1 1 1 1 


1 


1 




1 






ft 


03 



































^ m 


CO 
























1 1 1 1 t t 1 1 1 1 ( 


1 


1 




1 






5 ft 


03 


















od 


a 


















^2 


&i 


































a2 


• 




1 1 1 1 1 1 1 1 1 1 1 


1 


1 




1 






►J S 






1 1 1 1 1 1 1 1 1 1 1 














o 








































a 


^ 




1 1 1 1 1 1 1 1 1 1 1 


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1893.] 



PUBLIC DOCUMENT — No. 23. 



113 



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