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

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



SEVENTEENTH ANNUAL EEPOET 



WORCESTER INSANE ASYLUM 



WORCESTEE, 



rOR THE 



Year e:nding September 30, 189 i. 



BOSTON : 

WRIGHT & POTTER PRINTING CO., STATE PRINTERS, 

18 Post Office Square. 

1896. 



OFFICERS OF THE ASYLUM. 



TRUSTEES. 

ROCKWOOD HOAR, . Worcester. 

FRANCIS C. LOWELL, . Boston. 

SARAH E. WHITIN, . Whitinsville. 

FRANCES M. LINCOLN, , Worcester. 

A. GEORGE BULLOCK, ....... Worcester. 

THOMAS H. GAGE, ........ Worcester. 

HENRY S. NOURSE, Lancaster. 



RESIDENT OFFICERS. 
ERNEST V. SCRIBNER, M.D., ..... Superintendent. 

HARTSTEIN W. PAGE, M.D., Assistant Fhysician. 

ABBIE S. FAY, ....... .t Matron. 



NON-RESIDENT OFFICERS. 

ALBERT WOOD, . Treasnrer. 

GEORGE L. CLARK, ........ Auditor. 

MARIAN D. CUDWORTH, ....... Clerk. 

FREDERICK H. BAKER, M D., . . . . . . Pathologist. 

WILLIAM SHERMAN, Engineer, 



Cnmmautealtlj d Ulassachisrfts. 



TRUSTEES' REPOET. 



To His Excellency the Governor and the Honorable Council. 

The trustees of the Worcester Lunatic Hospital, in charge 
of the Worcester Insane Asylum, would respectfully present 
their seventeenth annual report. The reports of the superin- 
tendent and of the treasurer, submitted herewith, contain in 
detail the history of the management and of the finances of 
the asylum, and are made a part of this report. 

Upon the resignation of the steward we have added his duties 
to those of the superintendent, with an increase in the salary 
of the latter. 

We have undertaken a change in the administration build- 
ing, which will increase somewhat its size and greatly improve 
its light and ventilation. Additional jjrotection against tire 
has been provided. The wards are in excellent condition, and 
are taxed to their utmost to care for the great numbers of 
patients that have been transferred to us. Many times during 
the past year the wards have been crowded to their utmost 
capacity. 

We would commend especially the constant and devoted 
attention of the superintendent during the clianges that have 
taken place in the last year. An increased responsibility has 
fallen upon the assistant superintendent also from the same 

causes. 

ROCKWOOD HOAR. 
FRANCIS C. LOWELL. 
SARAH E. WHITIN. 
FRANCES M. LINCOLN. 
A. GEORGE BULLOCK. 
THOMAS H. GAGE. 

HENRY S. NOURSE. 

Worcester, Mass., Oct. 1, 1894. 



84 



WOECESTER INSANE ASYLUM. 



[Oct. 



OFFICERS AND THEIR SALARIES. 



Ernest V. Scribner,M'D., Superintendent, 
Hartstein W. Page, M.D., Assistant Physician, 
Frederick H. Baker, M.D., PatJwlogist, 
Abbie S. Fay, Matron, . 
Albert Wood, Treasurer, . 
George L. Clark, AudAtor, . 
Marian D. Cudworth, Glej±, 
William Sherman, Engineer, 



. 




12,500 00 






],200 00 






100 00 






400 00 






400 00 






50 00 






480 00 






1,000 00 



YALUE OF STOCK AND SUPPLIES. 

Oct. 1, 1894. 



Live stock, ...... 

Produce of the garden on hand, . 

Carriages and agricultural implements. 

Machinery and mechanical fixtures, 

Beds and bedding in inmates' department. 

Other furniture in inmates' department. 

Personal property of State in superintendent's department 

Ready-made clothing. 

Dry goods. 

Provisions and groceries, 

Drugs and medicines, 

Fuel, .... 

Library, .... 

Other supplies undistributed. 



$325 00 


1,200 00 


650 00 


9,000 00 


9,500 00 


3,500 00 


9,500 00 


],498 16 


431 93 


2,400 00 


500 00 


3,500 00 


500 00 


1,500 00 


144,005 09 



1894.] 



PUBLIC DOCUMENT — No. 23. 



85 



TREASURER'S REPORT. 



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

Insane Asylum. 

I hereby submit my seventeenth annual report on the finances 

of the Worcester Insane Asylum for the year ending Sept. 30, 

1894. 

Receipts. 

Cash on hand Sept. 30, 1893 : — 
Cash belonging to the asylum, ..... ^,684 72 
Deposits of inmates, 1,115 34 



Amounts received : — 
From the Commonwealth for support of patients, |23,820 00 
From cities and towns for support of patients, . . 56,600 87 

From other som-ces, 725 01 

From inmates, 82 24 



$2,800 06 



81,228 12 
$84,028 18 



The expenditures for the year have been as follows : — - 

Salaries and wages, . 

Provisions and sup> plies ; 
Meat of all kinds. 
Fish, . 

Fruit and vegetables, 
Flour, . 

Meal for table, . 
Hay and grain, . 
Tea and coffee, ' . 
Sugar and molasses. 
Milk, butter and cheese, 
Salt and other groceiies, 
All other provisions, . 

Clothing and material. 
Fuel, .... 
Lights, 

Amounts carried forward, .... . f 9,917 54 $46,62357 



• 


$23,646 18 


$3,900 62 




869 41 




2,103 58 




3,141 14 




115 65 




316 96 




916 01 




1,398 67 




7,144 04 




606 77 




2,434 54 
f 1,939 90 


22,977 39 


4,015 98 




961 66 





86 WORCESTEE 


INSANE 


ASYLUM. 


[Oct. 


Amounts brought forivard, $9,917 54 


$46,623 57 


Medicine and medical supplies, 










601 32 




Furniture and furnishings, . 










2,446 30 




Crockery, . 












26 62 




Beds and bedding. 












1,218 75 




Transportation, . 












224 70 




Travelling, . 












113 22 




Trustees' expenses, 












27 66 




Soap, .... 












756 51 




Water, 












709 47 




Stationery, . 












201 79 




Undertaking, 












274 00 




Repairs (ordinary), . 












5,061 12 




All other current expenses. 










2,056 44 






23,635 44 


Total current expenses, 


$70,259 01 


Repairs and improvements (extraordinary), . .$5,500 00 




Refunded inmates (on deposits), .... 1 65 






5,501 65 


Total amount expended, 


$75,760 66 


Cash on hand Sept, 30, 1894, 


8,267 52 




$84,028 18 


Resources. 




Cash on hand, f 8,267 52 




Due from Commonwealth for support, . . . 5,56180 




from cities and towns, 13,670 40 




from other sources, 8 50 







$27,508 22 


Liabilities. 




Due for supplies and expenses, $3,530 16 




for salaries and wages, 1,926 64 




inmates (cash on deposit), 1,195 93 






6,652 73 


Total surplus, 


$20,855 49 



Eespeclfully submitted, 



ALBERT WOOD, 

Treasurer. 



Worcester, Mass., Oct. 1, 1894. 



Worcester, Mass., Oct. 27, 1894. 
The undersigned has this day carefully compared the treasurer's statement of expen- 
ditures for the year ending Sept. 30, 1894, with the vouchers which are on file at the asy- 
lum, and finds it to be correct. He has also compared the amount of bills rendered 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. 



1894.] PUBLIC DOCUMENT — No. 23. • 87 



SUPEEINTEKDENT'S EEPOKT. 



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

Insane Asylum. 

I beg to present to your Board the seventeenth annual report 
of the superintendent of the Worcester Insane Asylum. 

At the beginning of the present official year there remained 
in the asylum 454 patients, — 231 males and 223 females. 
There have been admitted 30 males and 31 females, making a 
total of 515 cases. Of this number 1 male and 1 female have 
been discharged much improved, 2 males and 2 females im- 
proved, 2 males and 1 female not improved, and 22 males and 
21 females have died. This leaves 234 males and 229 females 

— 463 persons — as inmates of this institution Sept. 30, 1894. 
Of the persons admitted, 21 males came from the Worcester 
Lunatic Hospital, 9 males and 30 females from Taunton, and 1 
female was returned from boarding out. Of those discharged, 
1 male was transferred to the State Farm at Bridgewater, 1 
male and 3 females were removed by the overseers of the poor, 
1 male went to the Tewksbury Almshouse, 1 male and 1 female 
were discharged to the care of relatives, and 1 male escaped. 

Over two-thirds of the admissions to this institution during 
the past year have been cases of chronic dementia. How little 
probability offers of the recovery of these people is evidenced 
both by the character and the long duration of their disease. 
The cities and towns, with their unhealthy and disturbing ner- 
vous influences, furnish proportionately the greater numbers, 

— nearly 74 per cent. Recent investigations in this line show 
that the numbers of the insane are not increasing in a rapid 
ratio in the country communities, if indeed they are increasing 
at all. In 14 of the admissions heredity is assigned as the 



88 ■ WORCESTER INSANE ASYLUM. [Oct. 

probable cause of mental disease. That hereditary influence 
plays a great part in the filling of our hospitals and asylums is 
shown by its yearly prominence in our statistical tables. 

The amount of restraint has been less than in many former 
years, and there has been no case of continuous seclusion. 
Notwithstanding the liberty which has been allowed patients, 
but one successful escape has occurred. The earlier asylums 
were doubtless established more as places of incarceration for 
the detention of such insane persons as proved dangerous to 
the community, and of course were more like prisons than any- 
thino- else. The insane have now come to be recognized as the 
victims of disease, whose commitment to a hospital is demanded 
that they may receive care and treatment. The hospital for 
the insane, while securing to the public that protection which 
it has a right to expect and to receive, should never degenerate 
into a prison ; and the hospital attendant should partake of the 
character of nurse rather than of keeper. The selection of 
proper material for this branch of the service is not always 
easy. Knowledge and experience count for as much in the 
attendant upon the insane as in the trained nurse of general 
practice ; and too close attention cannot be given in making 
choice of those persons who are to be most intimately associ- 
ated with the patients, and whose iniiuence is great to soothe 
or to excite the unstable minds with which they come in con- 
tact. The rate of compensation which it is at present possible 
to ofi'er nurses is, in many cases, not sufficient to long retain 
the most desirable. 

Although the institution has been greatly crowded, the gen- 
eral health of the house has been good. Several cases of 
measles have occurred, chiefly among the employees, a few 
patients being attacked. The character of the disease was mild, 
and no fatalities ensued. There has been little other acute 
disease of a serious nature. 



1894.] 



PUBLIC DOCUMENT — No. 23. 



89 



Ratio of Deaths from the Opening of the Asylum to Oct. 1, 1894. 











J3 


Dally Average 
Number of 
Patients. 


Deaths. 


Per Cent, on 
Whole Number 
of Patients 
treated. 


o -'■' = 


OFFICIAL YEAR. 


"a 


1 




Per Cent 

Daily Av 
N u m b e 1 
Patients. 


1877-78, . 








429 


382.98 


18 


8 


26 


6.06 


6.78 


1878-79, . 








422 


367.41 


22 


11 


88 


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 


18.28 


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 


28 


15 


88 


7.98 


9.49 


1886-87, . 








444 


393.52 


21 


17 


88 


8.55 


9.65 


1887-88, . 








451 


893.95 


28 


14 


87 


8.20 


9.39 


1888-89, . 








431 


885.56 


27 


11 


38 


8.81 


9.85 


1889-90, . 








428 


330.23 


27 


4 


81 


7.24 


9.38 


1890-91, . 








464 


894.66 


22 


12 


84 


7.32 


8.61 


1891-92,. 








499 


427.82 


22 


15 


87 


7.41 


8.64 


1892-93, . 








519 


446.94 


88 


20 


58 


11.17 


12.97 


1893-94, . 








515 


442.23 


22 


21 


48 


8.35 


9.72 



A glance at the above table of mortality statistics shows the 
death rate at about its normal averasfe. Phthisis has asjain 
been the chief cause of death. 

Our system of ward ventilation is a good one, and quite sat- 
isfactory in its practical workings. The large number of 
patients cared for during the past few years, however, has 
taxed it to its utmost. The institution is at present lighted by 
gas, and during the long winter evenings the withdrawal of 



90 WORCESTER INSANE ASYLUM. [Oct. 

the oxygen consumed in this way causes a very appreciable 
dilference in the purity of the air, which is rendered still 
further unfit for respiration by being loaded with the products 
of combustion. If the electric light were introduced, not only 
would this source of atmospheric contamination be removed, 
but it would be possible, with the same power, to operate 
electric fans in any liue whose draft was faulty, causing a 
direct and positive circulation of air in those places most 
needed. 

The operations of the past year in the way of repairs have 
been of a somewhat varied nature. Not the least in value has 
been the renovation of the old rooms in the south Johonnot 
wards, which have long been in an unsatisfactory condition. 
The dining-rooms in the south wings have been made over and 
new sinks put in. The work of reconstruction which has been 
going on in this asylum, and which has so greatly altered the 
character and increased the efficiency of the institution, has 
hitherto been directed chiefly to the wards. Early in the 
spring attention was turned to the administration building, 
where for many years little has been done in the line of repairs. 
The offices and waiting rooms were dark, and no adequate sys- 
tem of ventilation existed. The work of improvement has been 
undertaken here, and is now in progress. Considerable paint- 
ino- of the walls and ceilings has been done throughout the 
wards, which has not only rendered easier the maintenance of 
that proper cleanliness which is so essential to asylum existence, 
but has also added something to the attractiveness of the house. 
An additional line of high-service water pipe has been laid in 
the yard, and another h3^drant put in. A stand-pipe connected 
with the same supply has also been introduced into the male 
wards, displacing the old low-pressure service, and consider- 
able new hose purchased. 

As in former years, patients have been largely employed in 
the work of the various departments. Admission to this insti- 
tution being only by transfer from other hospitals, the most 
industrious, as would be expected, are rarely sent here, and it 
has often been more difficult to find workers than to furnish 
em pi 03^ men t. 

The average weekly cost of support has been $3.04. 



1894.] PUBLIC DOCUMENT — No. 23. 91 

Regular entertainments have been held in the chapel during 
the winter, and have been greatly enjoyed by the patients. 
Religious services have been conducted as usual. 

I desire to thank your Board for the assistance and support 
which has at all times been given me. 

E. V. SCRIBNER, 

Superintendent, 
Worcester, Mass., Oct. 1, 1894. 



REVISED TABLES 



Unifobm Statistics 



MASSACHUSETTS HOSPITALS AND ASYLUMS 
FOR THE INSANE. 



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



94 



WORCESTER INSANE ASYLUM. 



[Oct. 






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Patients in asylum Oct. 1, 1893, 
Admitted within the year, . 
Whole number of cases within t 
Discharged within the year, 
Viz. : as recovered,* 

much improved,* 

improved,* 

not improved,* . 


not insane,* 
Deaths, .... 
Patients remaining Sept. 30, 189 
Viz. : supported as State patient 
town patient 
private patie 
Number of different persons wit 
Persons admitted, 
Persons recovered. 
Daily avei-age number of patien 
Viz. : State patients, . 

town j^atients, . 



1894.] 



PUBLIC DOCUMENT — No. 23. 



95 









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447.10 
449.68 


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221.30 
227.58 


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220.53 


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222.10 


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1893. 

October, 

November, ...... 

December, 


















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Total of cases, . 
Total of persons, 
Daily average, . 




January, 

February, 

March, 

April, 

May, . 

June, 

July, 

August, 

September 



96 



WORCESTER INSANE ASYLUM. 



[Oct. 



3. — Received on First and S^lbsequent Admissions. 





Cases Admitted. 


Times Pbbviodslt 
Eecovkeed. 


NUMBER OF THE ADMISSION. 


Males. 


Females. 


Totals. 


Males. 


Females. Totals. 


First, 

Second, 


30 


29 
2 


59 

2 


- 


- 


- 


Total of cases, 
Total of persons. 


30 
30 


31 
31 


61 
61 


- 


- 


- 



4. — Relations to Hospitals of Persons Admitted. 



HOSPITAL EELATIONS. 


Males. 


Females. 


Totals. 


Never before in any hospital for insane, . 


- 


- 


- 


Former inmates of this asylum only. 


- 


- 


- 


of other hospitals only, . 


30 


29 


59 


of this asylum and other hos- 
pitals, 


- 


2 


2 


Total of persons, 


30 


31 


61 



1894.] 



PUBLIC DOCUMENT — No. 23. 



97 



5. — Parentage of Persons Admitted. 





SlALES. 


Females. 


Totals. 


PLACES OF NATIVITY. 


Father. 


Mother. 


Father. 


Mother. 


Father. 


Mother. 


Unknown, 


30 


'30 


31 


31 


61 


61 


Total, 


30 


80 


31 

1 


31 


61 


61 



6. — Residence of Persons Admitted. 



PLACES. 


Males. 


Females. 


Totals. 


Massachusetts : — 








Suffolk County, 


14 


11 


25 


Plymouth County, 


2 


11 


13 


Worcester County, 


9 


- 


9 


Bristol County, 


- 


8 


8 


Middlesex County, 


5 


- 


5 


Norfolk County, ...... 


- 


1 


1 


Totals, 


30 


31 


61 


Viz. : Cities or towns,* .... 


22 


23 


45 


Country districts, .... 


8 


8 


16 



* Containing not less than 10,000 inhabitants. 



98 



WORCESTER INSANE ASYLUM. 



[Oct. 



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Second, .... 


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1894.] 



PUBLIC DOCUMENT — No. 23. 



99 



8. — Occupations of Persons Admitted. 



MALES. 


FEMALES. 


Laborers, 






7 


Housewives, 




12 


Farmers, 






2 


Domestics, . 




7 


Operatives, . 






2 


Housekeepers, 




2 


Messengers, . 






2 


Cooks, . 




2 


Engraver, 








Laundress, . 






Druggist, 








Seamstress, . 






Stone cutter, . 








Stitcher, 






Loom fixer, . 








Dressmaker, 






Shoemaker, . 








Unknown, . 






Teamster, 






3 

7 


No occupation, . 
Total, . 




3 


Patternmaker, 


31 


Unknown, 
No occupation, 


WIFE OR DAUGHTER OF 




Unknown, .... 




Total, . 


30 


31 








Total, . 


• 


31 



100 



WORCESTER INSANE ASYLUM. 



[Oct. 



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s 



Ci 



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K 

O 


sg 

w n 

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ii 

> -< 

a H 


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1 1 1 1 i 1 1 1 1 1 1 r 1 1 


•S8IBUi9^ 


1 I 1 1 1 i 1 1 1 ( 1 1 1 1 


•sgiBj^ 


......... . . . 1 . 


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li 


•SIB^Oi 


1 1 1 1 1 1 1 1 1 III 1 


•89[Bin9^ 




1 


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li 


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1 1 1 1 1 1 1 1 1 III 1 


•99tBtU9£ 


1 1 1 1 1 1 1 . 1 11, 1 


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1 1 1 1 1 1 1 1 1 3 1 ' 1 3 
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1 1 1 1 1 1 1 1 1 00 1 1 


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1 1 1 1 1 1 1 1 1 oil 


to 


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02 






1. Physical: — 

Intemperance, 
Epilepsy, 
Climacteric,. 
Senility, 
Over study, . 
Injury to head, . 
Congestion of brain. 
Softening of brain. 
Syphilis, 

2. Mental : — 

Heredity, 
Grief, . 
Unknown, . 


p 



1894.] 



PUBLIC DOCUMENT — No. 23. 



101 



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102 



WORCESTER INSANE ASYLUM. 



[Oct. 






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o 









CO 



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5 

o 


A 

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a 

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1 
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1—1 i-l 


43 

47.98 


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a 


1 |i-i|i-lTlH(MiCiOCOI 1 1 1 


21 
43.32 


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1 1 |i-lrH|C^iOCOt>(Mi-l| 1 


22 

52.27 


o 

■< 

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S 


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I— 1 


43 
34.06 


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§ 


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21 
31.31 


rt 

S 


lTHrHl<M^(MlO'-l»-l| 101 


22 
36.65 


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a 
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n 


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1 1 1 1 1 1 i 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 i 


1 1 


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


1 1 


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1 1 


AGES. 








Congenital, . 

15 years and less, . 

From 15 to 20 years, 
20 to 25 years, 
25 to 30 years, 
30 to 35 years, 
35 to 40 years, 
40 to 50 years, 
50 to 60 years, 
60 to 70 years, 
70 to 80 years. 

Over 80 yeax's. 

Unknown, 

Not insane, . 


Total of pei'sons, 
Mean ages. 



1894.] 



PUBLIC DOCUMENT — No. 23. 



103 



12. — Reported Duration of Disease before Last Admissioyi. 





First Admission 
TO ANT Hospital. 


All Other 
Admissions. 


Totals. 


PREVIOUS DUKATION. 


"3 


"3 

a 


"3 
o 


« 

^ 


■3 
a 


■3 
1 


1 



a 


i 



Congenital, 


- 


- 


- 


- 


- 


- 


- 


- 


- 


Under 1 month, 


- 


- 


- 


- 


- 


- 


- 


- 


- 


From 1 to 3 months, 


- 


- 


- 


- 


- 


- 


- 


- 


- 


3 to 6 months. 


- 


- 


- 


- 


- 


- 


- 


- 


- 


6 to 12 months. 


- 


- 


- 


- 


- 


- 


- 


- 


- 


1 to 2 years, . 


- 


- 


- 


4 


1 


5 


4 


1 


5 


2 to 5 years, . 


- 


- 


- 


6 


5 


11 


6 


5 


11 


5 to 10 years, . 


- 


- 


- 


5 


6 


11 


5 


6 


11 


10 to 20 years, . 


- 


- 


- 


5 


8 


13 


5 


8 


13 


Over 20 years, . 


- 


- 


- 


1 


3 


4 


1 


3 


4 


Unknown, .... 






~ 


9 


8 


17 


9 


8 


17 


Not insane. 


- 


-- 


- 


- 


- 




30 


31 


- 


Total of cases, . 


- 


- 


- 


30 


31 


61 


61 


Total of persons, 


- 


- 


- 


30 


31 


61 


30 


31 


61 


Average in years. 


- 


- 


- 


7.76 


10.49 


9.16 


7.76 


10.49 


9.16 



104 



WORCESTER INSANE ASYLUM. 



[Oct. 



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1894.] 



PUBLIC DOCUMENT— No. 23. 



105 



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106 



WORCESTER INSANE ASYLUM. 



[Oct. 



'fe^ 



s 
6 






< 

H 
O 

Eh 


■SIBJOi 


Cq ^ CO <-! r^ r-( T-H rH ^ ,-1 CO Id 
1— 1 


CO 


•BaiBiiiSji 


i-H 1 1 1 O — 1 --H 1 CO i-H (>l <N 


(M 


•sai^H 


i-H^COt-I t>l l»-l i-lli-HCO 




a 

<i 

U 

< 
In 

a 

D 
O 
> 


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till II II 1 1 1 1 


1 


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1 1 1 1 II II 1 1 1 1 


, 


•sai«M 


1 1 1 1 II II 1111 


I 


R 
M 

g 

o 
►J 
< 

n 


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1 1 1 1 II II 1 1 1 1 


1 


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1 1 1 1 II II 1 1 1 1 1 


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1 1 1 1 II II 1 1 1 1 


I 




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(N^coi— 1 r^i-H T-ii— 1 '^i— icoiolco 
.-1 ^ 


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T-H 1 1 1 O tH .-1 1 CO T-H CT (M 
I-H 


i-H 


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I— l-:JHCOi-H t>.| li-H »-H|t-HCO 






CO 
H 
CO 
t> 

O 


Nervous system : — 

Apoplexy, 

Epilepsy, 

General paralysis, 

Paralysis, ....... 

Resinralory system : — 

Phthisis with hemorrhage, .... 

Digestive system : — 

Dysentery, 

Internal hemorrhage, 

General : — 

Bright's disease, 

Cancer, 

Exhaustion, ....... 

Heart disease, 


o 

H 



1894.] PUBLIC DOCUMENT — No. 23. 



107 





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108 



WORCESTER INSANE ASYLUM. 



[Oct. 






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