Annual report of the Worcester Insane Asylum at Worcester

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

EIGHTEENTH ANNUAL KEPOET

WORCESTER INSANE ASYLUM

"WORCESTER,

Year ending September 30, 1895.

BOSTON:

WRIGHT & POTTER PRINTING CO., STATE PRINTERS,

18 Post Office Square.

1896.

OFFICERS OF THE ASYLUM.

TRUSTEES.

FRANCIS C. LOWELL, Bostox.

SARAH E. AVHITIN Whitinsville.

FRANCES M. LINCOLN, Worcester.

A. GEORGE BULLOCK, Worcester,

THOMAS H. GAGE, Worcester.

HENRY S. NOURSE, Lancaster.

ROCKWOOD HOAR, Worcester.

RESIDENT OFFICERS.

ERNEST V. SCRIBNER, M.I)., .... Superintendent.

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

ABBIE S. FAY, Matron.

NON-RESIDENT OFFICERS.

ALBERT WOOD, Treasurer.

GEORGE L. CLARK, Auditor.

MARIAN D. CUDWORTH, Clerk.

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

WILLIAM SHERMAN, . ...... Engineer.

Commanfoealt^ ai "^^R^sud^xxBtits.

TRUSTEES' EEPORT.

To His Excellency the Governor and the Honorable Council.

The trustees of the Worcester Lunatic Hospital, having the
care of the Worcester Insane Asylum, present their report for
the year ending Sept. 30, 1895, being the eighteenth annual
report of the institution. With it they transmit the report of
the superintendent, which contains full tables of statistics.
The treasurer's report, which, in the temporary absence of the
treasurer, Dr. Albert Wood, is signed by the superintendent
as acting treasurer, is also submitted.

The condition of the asylum is satisfactory and its finances
are in good condition.

The improvements which for many years past have been
made by Doctors Quinby and Scribner in the wards of the
hospital, transforming them into cheerful quarters with the best
modern appliances for the care of the insane, during the past
year have been extended to that part of the building used for
administrative purposes. Here little change had been made
for more than a generation, and considerable changes were
needed and have been carried out. These alterations have a
double advantage ; they provide suitable accommodations for
the superintendent and his subordinates, the tools to which
good workmen are entitled, and they please and relieve the
feelings of many of those who visit our unfortunate inmates.
The old reception room was dull and forbidding. The recep-
tion room as now arranged is bright and cheerful and suitably
furnished. Extensive changes in the north Johonnot have also
been undertaken, and will be pressed as rapidly as convenient.

86 WOECESTER INSANE ASYLUM. [Oct.

No changes have taken place in the stajQf of the hospital, and
Dr. Scribner and his subordinates have shown the same intel-
ligent devotion to those committed to their care that they have
manifested in past years.

FRANCIS C. LOWELL.

SARAH E. WHITIN.

FRANCES M. LINCOLN.

A. GEORGE BULLOCK.

THOMAS H. GAGE.

HENRY S. NOURSE.

ROCKWOOD HOAR.

WORCESTEE, Oct. 1, 1895.

1895.]

PUBLIC DOCUMENT — No. 23.

87

OFFICERS AND THEIR SALARIES.

Ernest V. Scribner, M.D., Superintendent^
Hartstein W. Page, M.D., Assistant Physician,
Frederick H. Baker, M.D , Pathologist, .
Abbie S. Fay, Matron, .
Albert AVood, Treasurer, .
George L Clark, Auditor, ,
Marian D. Cud worth. Clerk,
William Sherman, Engineer,

$2,500 00

1,300

00

100

00

400

00

400

00

60

00

480

00

1,000

00

YALUE OF STOCK AISTD SUPPLIES.

Oct. 1, 1895.

Live stock, .,..,...,.
Produce of the garden on hand, ......

Carriages and agricultural implements, ....

Machinery and mechanical fixtures, .....

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

Other fui'niture 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,

. $200 00

1,800

00

650

00

. 9,000

00

. 9,500

00

. 3,500

00

. 9,500

00

. 1,900

00

. 1,000

00

. 2,043

91

425

00

. 3,800

00

500

00

. 1,635

66

$15,454 57

88

WORCESTER INSANE ASYLUM.

[Oct.

TREASURER'S REPORT.

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

Insane Asylum.

I herewith submit the eighteenth annual report on the finances

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

1895.

^Receipts.

Cash on hand Sept. 30, 1894 :— -
Cash belonging to the asylum, . . •. • .$7,07159
Deposits of mmates, ........ 1,195 93

Amounts received : —

From the Commonwealth for support of patients, $22,771 73

From cities and towns for support of patients, . . 55,735 34

From other sources, 870 15

From inmates, ........ 44 67

3,267 52

79,421 89
$87,689 41

The expenditures for the year have been as follows : —

Salaries and wages, .

Provisions and supplies : —
Meat of all kinds,
Fish of all kinds.
Fruit and vegetables, .
Flour, ....
Meal for table, .
Hay and grain, .
Tea and coffee, .
Sugar and molasses, .
Milk, butter and cheese.
Salt and other groceries,
All other provisions, .■

Clothing and material,

Fuel

Lights,

Amou7its carried forward,

J23,284 14

. $3,304

92

. 783

32

. 2,284

78

. 2,928

27

62

30

. 325

15

. 588

50

. 985

38

. 6,459

92

. 395

18

. 2,051

86

—

— 20,169 58

. f 4,763

50

. 4,642

37

. 1,065

91

),471 78

5,453 72

181)5.]

PUBLIC DOCUMENT —

Amounls brought forward.

Medicine and medical supplies,

Furniture and furnishings,

Crockery,

Beds and bedding,

Transportation, .

Travelling, .

Trustees' expenses,

Soap, ....

Water,.

Stationery, .

Undertaking,

Repairs (ordinary), .

All other current expenses,

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

Total amount expended.
Cash on hand Sept. oO, 1895,

Resources.
Cash on hand, ......

Due from Commonwealth for support,
from cities and towns,

Liabilities.

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

Total surplus, .....

0. 23.

89

$10,471

78

$43,453 72

. 376

69

. 1,806

93

. 159

57

. 734

43

. 216

96

. 108

22

15

02

. 709

62

. 404

84

. 160

46

. 455

00

. 9,896

03

. 1,504

97

27,020 52

,

$70,474 24

. |5,500

00

52

71

5,552 71

.

176,026 95

■

11,662 46

$87,689 41

$11,662 46

. 5,316

61

. 14,114

25

—

131,093 32

.$3,966

69

. 1,937

73

. 1,187

39

7,091 81

8 >

$24,001 51

Respectfully submitted,

Worcester, Mass., Oct. 1, 1895.

E. V. SCRIBNER,

Acting Treasurer.

Worcester, Mass , Oct. 25, 1895.
The undersigned has this day carefully compared the treasurer's statement of expen-
ditures for the year ending Sept. 30, 1895, with the vouchers which are on file at the
asylum, 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.

90 WORCESTER INSANE ASYLUM. [Oct.

SUPERINTEIS'DEI^T'S REPORT.

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

Insane Asylum.

Allow me to submit for your consideration the eighteenth
annual report of the superintendent of the Worcester Insane
Asylum.

The present official year begun with 463 persons inmates of
this institution, — 234 males and 229 females. There have
been 41 persons admitted, — 20 males and 21 females, — mak-
ing a grand total of 504 cases, — 254 males and 250 females.
There have been discharged 1 female recovered, 2 females
much improved, 4 males and 1 female improved, 2 males not
improved, 1 male not insane, and 22 males and 24 females
have died ; leaving in the institution Sept. 30, 1895, 447 per-
sons,— 225 males and 222 females. Of those admitted, 20
males and 10 females came from the Worcester Lunatic Hos-
pital, 10 females from Taunton and 1 female was returned from
boarding out. Of those discharged, 5 were removed by the
Board of Lunacy and Charity, 3 went home with relatives or
friends and 3 escaped. I am pleased to report that no person has
been removed for the purpose of commitment to an almshouse.

Among the probable causes of insanity in those admitted
heredity does not play as important a part as usual, but intem-
perance still stands high on the list. The character of the
admissions has not changed particularly, so far as the mental
aspect of disease is concerned, from that of last year, save,
perhaps, that there is a greater tendency towards dementia, —
a dementia usually secondary, however, to some other and
acute form of mental disease. It seems to be true that, in
those cases of chronic insanity derived from the cities, — too
often the direct product of misery, want and crime, — the ten-
dency towards dementia is steadily growing greater. This is
doubtless an incident, though not of necessity a product, of a
higher civilization, due to dissipation and an artificial life of

1895.] PUBLIC DOCUMENT — No. 23. 91

excitement. The cities, too, receive and retain more largely
that unstable element whose emigration is encouraged by
foreign governments. General paralysis, an acknowledged
product of the towns, is no longer invariably attended by
those expansive delusions which were formerly so character-
istic of that disease. While those delusions, possibly, still
manifest themselves in the majority of cases, there is a greater
tendency toward a rapid decay of the mental faculties, in-
ducing a condition of dementia.

One case of recovery is reported. The type of disease in
the persons transferred here has always been such as to render
the number of recoveries few. This patient was a woman.
She was discharged to the care of her friends, and when she
left the institution seemed perfectly sane. Her disease was
of some duration, and of course the possibility of a relapse is
greater for that fact. Should her stay outside a hospital be
even for a limited time, there is still cause for congratulation.

The daily average number of inmates has been 460,68, —
the largest in the history of the asylum. Notwithstanding this
fact, the house has been comparatively free from acute disease.
There has been a marked diminution in the number of cases of
those diseases of the digestive tract which are usually so preva-
lent during the summer months. This I attribute to improved
sanitary surroundings, a more careful regulation of the diet
and the more scientific treatment which it is now possible to
accord to such ailments. The victims of mental disease require
a more nourishing diet, and one more easily assimilated, than
that usually provided for other dependent classes.

Although we speak of mental and physical disease in a gen-
eral way, as distinct and separate affections, it is difficult to
conceive of mental ailment as existing apart from physical
change. The insane, like those afflicted with the ordinary
forms of physical disease, have periods of depression, when
the power of resistance is low. If the vital energy can be sus-
tained during this period and the patient returned once more
to a normal condition of bodily strength, the opportunities for a
return to mental strength are greatly enhanced. In many
cases of mental disease the cause is evident, in most it is
obscure. When that delicate and subtle relation which exists
between mind and body has been more clearly demonstrated,

92

WORCESTEE INSANE ASYLUM.

[Oct.

the suijo-estion of remedial measures can be more definite.
Interesting experiments, which seem to have some measure
of promise, have been made by several observers in the admin-
istration of the animal extracts. It is yet too early, however,
to venture any definite predictions as to the final result. The
mental condition of the individual varies with the varying
conditions of the blood supply of the brain. To distinguish
here between cause and effect is not always easy. Too much
must not be expected from pathological research alone. The
significance of morbid change must be interpreted, if practical
results are to be hoped for.

The death rate, as shown in the accompanying table, is a
trifle larger than that of the last report, cbiefly because of the
poor physical condition of those transferred here during the
year. Of the 41 persons admitted, 10 died, — nearly 25 per
cent. This number is also nearly 22 per cent, of all the deaths.
Insanity is essentially an exhausting disease, and, as might
be expected in persons of low vitality, phthisis figures largely
among the causes of death, 18 persons having died from this
disease. General paralysis was the cause in 6 cases.

Ratio of Deaths from the Opening of the Asylum to Oct. 1, 1895.

a i

3

f: o

Daily Average
Number of
Patients.

Deaths.

Per Cent, on
Wliole Number
of Patients
treated.

o |io

OFFICIAL YEAR.

"3

"a

a

a
o

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

18.S4-85, .

448

391.12

20

14

34

7.68

8.69

1885-86, .

476

400.28

23

15

38

7.98

9.49

1886-87, .

444

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

88

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

1893-94, .

515

442.23

22

21

43

8.35

9.72

1894-95, .

504

460.68

22

24

46

9.13

9.99

1895.] PUBLIC DOCUMENT — No. 23. 93

An effort has been made to find among our patients persons
suitable for boarding out, but without success. In fact, one
woman, a former inmate here, has been returned to the institu-
tion from her boarding place during the year. People who
can be safely cared for in private families are seldom included
in the transfers to this asylum, and the fact that in past years
numbers of our quieter patients have already been boarded out
leaves us now with poor material to choose from.

The work upon that portion of the administration building
which was in process of reconstruction at the time of my last
annual report has been practically completed. It only remains
to finish a few unimportant details and to furnish. Bay
windows have been thrown out in front, giving a greatly im-
proved architectural effect as well as adding considerably to the
floor space. The business offices and the public reception
room have been rendered lighter and more commodious, and a
system of ventilation has been introduced, where before no
adequate provision existed. The method of heating has been
changed from the direct to the indirect, enabling the removal
of steam pipes and radiators from nearly all of the rooms and
corridors. The new heating system was in operation during a
portion of last winter, and was very satisfactory. With the
fan revolving at its ordinary speed it is easy to deliver, through
each register, five hundred cubic feet of air per minute, — a
supply which should be ample, under all circumstances, for
both heat and ventilation. At the end of the corridors leading
to the wards, iron stairways have been constructed, giving a
broader and easier step, and affording a safer exit in case of
fire. Increased light has also been secured here by the intro-
duction of larger windows.

In the process of reconstruction wood has not been employed
in the new work as a basis of support for plaster, and its use in
any way in walls and ceilings has been avoided, so far as
possible. The old wooden furring on the outer walls has been
removed, and terra-cotta substituted. The wooden shaft for
the food lift has also been replaced in brick. Absolutely fire-
proof construction, however, has not been attempted, as under
the circumstances it has not seemed feasible. Believing that a
construction which from its nature must be temporary is a false
economy, when building for the insane, the repairs on this

94 WORCESTER INSANE ASYLUM. [Oct.

institution have been so conducted that, while economy has
been a special study, the woik has been substantial. The
recent adaptation of iron for structural purposes has rendered
this easier, and has made possible results that formerly could
not have been attained, save at such expense as would have
been prohibitory.

In all our work it has been the aim to utilize the labor of
patients as largely as possible, not only because in this way the
expense could be lessened, but because of the great direct and
personal benefit which the individual derives from occupation.
A growing interest and responsibility in daily work have often
marked the beo;innino: of a return to reason, or at least the
return to a more comfortable condition of mind, a condition
where life again becomes worth living. Occupation, or even
attempted occupation, discloses personal peculiarities, and
enables such individual treatment as gives best results. In
treating the chronic insane, results being less immediate and
striking than in acute cases, routine is to be carefully avoided,
or the individual loses his identity, and becomes, as it were,
merely the part of a great machine. The more nearly treat-
ment can become personal, the more nearly will it approach to
the ideal and the greater measure of success will be attained.

For some years it has been evident that a change must be
made in the water section of the Johonnot wards of the female
side. The closet and bathing facilities are inadequate, and can
be more conveniently arranged. In the corresponding male
wards it has been the plan to have two water sections, and
rather widely separated. Under the new arrangement it is
proposed to centralize, and, while having but one section, to
have greatly increased facilities. Plans with this in view
having received the approval of your Board, the work is now
being prosecuted as rapidly as possible.

In the laundry a new machine has been placed, specially
constructed for the washing of clothing from untidy patients.
It is built entirely of metal, and has a fan attachment. It is
also designed to be used for such purposes of sterilization as
can be accomplished, with steam at atmospheric pressure.
Being strictly metallic, it can be rapidly and thoroughly
cleansed, and used immediately for the ordinary laundry pur-
poses. It is proving very successful in its practical operation.

1895.] PUBLIC DOCUMENT — No. 23„ 95

Our other washers are old, and have been many times repaired.
The purchase of another machine is likely to become a matter
of necessity at an early date.

Considerable out-of-door work has been done by patients in
the care of the grounds, and in rendering assistance in the
general work of reconstruction and repair. The roadway at
the rear entrance has been covered with concrete for a short
distance on either side of the door. If this material proves to
be adapted to our purposes, an extension of the work is con-
templated for another season. The renovation of the patients'
rooms in the older wards has been continued, and the outside
woodwork of the buildings has been painted. Much still
remains to be accomplished in this line, as it has been very
difficult, with the large number of patients of the last year, to
find opportunity for such work.

It is with pleasure that I acknowledge the assistance that
has been given me by the officers in the management of the
affairs of the institution. Their support has been cordial and
efficient. The employees as a rule have been faithful to duty.

Weekly entertainments have been held in the chapel during
the winter, and Sunday service has been conducted as usual.
The circus and fair have been events eagerly looked forward
to and enjoyed by those of our people whose condition per-
mitted attendance. To Mrs. C. H. Doe of Worcester we are
indebted for a most generous contribution of books. Mis-
cellaneous reading matter has been kindly furnished by the
Hospital Newspaper Society, and the publishers of the
"Worcester Evening Gazette" have contributed a copy of
their paper.

E. V. SCRIBNER,

Superintendent.

KEYISED TABLES

Uniform Statistics

MASSACHUSETTS HOSPITALS AND ASYLUMS
FOR THE INSANE.

Approved by the State Board or Ltjnact and Chaeitt,
March 10, 1891.

98

WORCESTEE INSANE ASYLUM.

[Oct.

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1895.]

PUBLIC DOCUMENT — No. 23.

99

H

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Females. Totals.

461.71

455.37
450.77

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18941

October, .
November,
December,

w" •■•••• ° * •

Januaiy, .

February,

]\larcli,

April,

May,

June,

July, .

August, .
September,

100

WORCESTER INSANE ASYLUM.

[Oct.

3. — Received on First and Subsequent Admissions.

Cases admitted.

Times Prbviocslt

KhCOVERED.

SfUaiBEB. OF THE ADMISSIOH.

Males.

Females.

Totals.

Males.

Females-.

Totals.

First, .....
Second, .....
Third,

19
1

20
1

39

1
1

1
1

Total of cases.
Total of persons, .

'20
20

21
21

41
41

-

-

4. — Relations to Hospitals of Persons admitted.

HOSPITAL EELATI0N9.

Males.

Females-

Totals.

Never before in any hospital for insane, .

—

:

Former inmates of this asylum only.

-

-

\

Former inmates of other hospitals only, .

19

20

\ m

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

1

1

2

Total of persons, .....

20

21

41

1895.]

PUBLIC DOCUMENT — No. 23.

101

5. — Parentage of Persons admitted.

Males.

Females.

Totals.

PLACES OF NATIVITY.

Father.

Mother.

Father.

Mother.

Father.

1

Mother.

Unknown, ....

20

20

21

21

41

41

Total, ....

20

20

21

21

41

41

6. — Residence ojf Persons admitted.

PLACES.

Males.

Females.

Totals.

Massachusetts : —

Suffolk Couuty,

9

6

15

Worcester County, .....

5

4

9

Middlesex County, .....

3

4

7

Bristol County, ......

-

4

4

Essex County, ,..,..

2

1

3

Plymouth County, .....

-

2

2

Norfolk Couuty, .....

1

-

1

Totals,. ......

20

21

41

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

16

15

31

Country districts, ....

4

6

10

* Containing not less than 10,000 inhabitants.

102

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PUBLIC DOCUMENT — No. 23,

10^

8. — Occupation of Persons admitted.

MALES.

FEMALES.

Laborers, ....

2

Housewives, ....

10

Clerks, . « . . .

2

Domestics, . . <. .

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Carpenters, ....

2

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1

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Card tender, ....

1

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1

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1

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No occupation.

Total, ....

5

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21

Fireman, ....

■

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Piasterer, . . ^ .1

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3

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WIFE OR DAUGHTEK OF —

UnknowB,

1
3

No occupation.

Unknown, ....

21

Total, ....

20

Total, ....

21

104

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PUBLIC DOCUMENT — No. 23.

107

12. — Reported Duration of Disease before Last Admission.

First Admission
TO Ant Hospital.

All Other
Admissions.

Totals.

PKEVIOUS DUKATION.

■3

■3

i

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0

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1

3

3

1

Congenital,
Under one month,
From 1 to 3 months, .

8 to 6 months, .

6 to 12 months,

1 to 2 years, .

2 to 5 years, ,
6 to 10 years, .
10 to 20 years, .

Over 20 years, .
Unknown, .
Not insane,

-

-

-

2

1
4
5
4
3
1

20

20

8.90

1

3

7
5
5

21
21

6.78

3

1
7

12
9
8
1

41

41

7.79

2

1
4

5
4
3
1

20

20
8.90

1

8

7
5
5

_

3

1
7
12
9
8
1

Total of eases,
Total of persons,
Average in years,

21

21

6.73

41

41

7.79

108

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A. — Insane; —

Dementia, chronic,
epileptic,
paralytic,

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Mania, chronic,

recurrent, .

Melancholia, chronic, .

Adolescent insanity,

Congenitnl mental de-
ficiency,

B. — Habitual drunkards,

C. — Voluntary patients, .

D. — Not insane.

10

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1895.]

PUBLIC DOCUMENT — No. 23,

109

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A. — Insane: —

Congenital, ....
Under 1 month,
From 1 to 3 months,

3 to 6 months,

6 to 12 months,

1 to 2 years, . ,

2 to 6 years, .
5 to 10 years, .

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

Totals, ....

Average of known cases, .

B —Habitual drmikards,.
C. — Voluntary patients, .

112

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PUBLIC DOCUMENT — No. 23.

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