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

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



NmETEENTH ANNUAL KEPOET 



WORCESTER INSANE ASYLUM. 



WOKCESTER, 



FOE. THE 



Year endhstg September 30, 1896. 



BOSTON : 

WRIGHT & POTTER PRINTING CO., STATE PRINTERS, 

18 Post Office Square. 

1897. 



OFFICERS OF THE ASYLUM. 



TRUSTEES. 



SARAH E. WHITIN, 
FRANCES M. LINCOLN, 
A. GEORGE BULLOCK, 
THOMAS H. GAGE, 
HENRY S. NOURSE, 
ROCKVVOOD HOAR, 
FRANCIS C. LOWELL, 



Whitinsville. 

Worcester. 

Worcester. 

Worcester. 

Lancaster. 

Worcester. 

Boston. 



RESIDENT OFFICERS. 



ERNEST V. SCRIBNER, M.D., 
HARTSTEIN W. PAGE, M.D., 
ABBIE S. FAY, 



Superintendent. 
Assistant Physician, 
Matron. 



NON-RESIDENT OFFICERS. 



ALBERT W^OOD, . 
GEORGE L. CLARK, 
MARIAN D. CUDWORTH, 
FREDERICK H. BAKER, M.D 
WILLIAM SHERMAN, . 



Treasurer, 

Auditor. 

Clerk. 

Pathologist, 

Engineer, 



Digitized by the Internet Archive 

in 2010 with funding from 

University of IVIassachusetts Amherst 



http://www.archive.org/details/annualreportofwo81worc 



Cnmmnnfo^altl^ 0f ^assar^sdts. 



TRUSTEES' REPORT. 



To His Honor the Lieutenant Governor, Acting Governor, and the Honorable 

Council. 

The trustees of the Worcester Lunatic Hospital, having the 
care of the Worcester Insane Asyluna, present the nineteenth 
annual report of the institution, together with statistical tables 
prepared by the superintendent. 

The additions that were commenced last year in the northern 
part of the building on the women's side are nearly completed 
and portions are already occupied. By the changes made in 
the past two years the character of the old building, which was 
dark and cheerless, has been entirely altered, and is now as 
bright and attractive as a modern hospital. Thus to increase 
the capacity of a long-established institution is a practical way 
of providing for the insane, at a comparatively small cost per 
bed per patient, as our experience proves. 

The personnel of the staff continues the same as last year. 
Dr. Scribner and his assistants have evinced the same interest 
in and assiduous care of the inmates as heretofore. In their 
earnest endeavor to treat all as though cure were possible, 
they have been rewarded, notably, in the case of a patient 
who had been a sufferer for fifteen years, and has been dis- 
charged. Such results are encouraging, and we trust that the 
cure is permanent. 

The management of the house has been most satisfactory ; 
neatness, order and cleanliness prevail, and the conditions are 
conducive to health and comfort. 

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

WORCESTEH, Oct. 1, 1896. 



62 



WORCESTER 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., Pathologist, 
Abbie S. Fay, Matron, 
Albert Wood, Treasurer, . 
George L. Clark, Auditor, 
Marian D. Cudworth, Clerk, 
William Sherman, Engineer, 



$2,500 00 

1,300 00 

100 00 

400 00 

400 00 

50 00 

600 00 

1,000 00 



VALUE OF STOCK AND SUPPLIES. 

Oct. 1, 1896. 



Live stock, ............ |375 00 

Produce of the garden on hand, 1,067 74 

Carriages and agricultural implements, 500 00 

Machinery and mechanical fixtures, ...... 9,000 00 

Beds and bedding in inmates' department, 9,000 00 

Other furniture in inmates' depai'tment, ..... 3,500 00 

Personal property of State in superintendent's department, . 9,500 00 

Ready-made clothing 2,154 64 

Dry goods, 623 00 

Provisions and groceries, 2,279 59 

Drugs and medicines, 425 00 

Fuel 3,500 00 

Library 550 00 

Other supplies undistributed, 1,146 25 

$43,621 22 



1896.] 



PUBLIC DOCUMENT — No. 23. 



63 



TREASURER'S REPORT. 



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

Insane Asylum. 

I herewith submit my nineteenth annual report on the finances 

of the Worcester Insane Asylum for the year ending Sept. 80, 

1896. 

Receipts. 

Cash on hand Sept. 30, 1895 : — " . 

Cash belonging to the asylum, .... f 10,475 07 
Deposits of inmates, 1,187 39 



Amounts received : — 
From the Commonwealth for support of patients, $20,003 49 
From cities and towns for support of patients, . . 54,476 06 

From other sources, . 684 19 

From inmates 51 43 



[1,662 46 



75,215 17 



5,877 63 



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, 

Amounts carried forward, 





$23,124 14 


$3,018 59 




656 79 




1,799 00 




1,981 35 




31 10 




421 81 




486 27 




1,046 92 




7,120 84 




386 90 




1,954 01 
$3,167 05 


18,903 58 


4,226 41 




823 17 





18,216 63 142,027 72 



64 



WORCESTER INSANE ASYLUM. 



[Oct. 



Amou7its 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 deposits), 

Total amount expended. 
Cash on hand Sept. 30, 1896, 

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

Due from Commonwealth for support, 

fx'om cities and towns, 

from other sources, .... 

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

Total surplus, 



58,216 63 $42,027 72 

375 23 

4,069 76 

62 24 

902 83 

273 82 

104 11 

25 03 

297 88 

393 45 

109 12 

187 00 

8,887 42 

2,522 80 

26,427 32 

. $68,455 04 



$10,000 00 
64 26 



10,064 26 

f78,519 30 
8,358 33 

$86,877 63 



$8,358 33 

4,725 32 

13,062 33 

32 40 



.12,943 00 
. 1,937 67 
. 1,174 56 



5,178 38 



6,055 23 



),123 15 



Respectfully submitted, 



ALBERT WOOD, 

Treasiirer. 



WoRCESTEE, Mass., Oct. 1, 1896. 



Worcester, Mass., Oct. 24, 1896. 
The undersigned bas this day carefully compared the treasurer's statement of expen- 
ditures for the year ending Sept. 30, 1896, with the vouchers which are on file at the 
Worcester Insane Asylum, and finds it to be correct. He has also compared the amount 
of bills rendered for the board of patients with the estimated earnings of the institution 

for one year, and finds them to agree. 

GEO. L. CLARK, 

Auditor of Accounts. 



1896.] PUBLIC DOCUMENT — No. 23. 65 



superi:ntendent's report. 



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

Insane Asylum. 

I respectfully submit to your board the nineteenth annual 
report of the superintendent of this institution. 

Oct. 1, 1895, 447 persons were inmates of this asylum, — 
225 men and 222 women. There have been admitted since 20 
women, making a grand total of 467 cases under treatment, — 
225 men and 242 women. There have been discharsfed 1 
woman recovered, 2 men and 2 women improved and 2 women 
not improved. Death has removed 16 men and 19 women, 
making a combined total of deaths and discharges of 42 per- 
sons, — 18 men and 24 women. Sept. 30, 1896, there remained 
425 patients, — 207 men and 218 women. Of those admitted, 
the whole number, 20 women, came from Westborough. Of 
those discharged, 1 man was removed by an officer of the city 
of Boston, 1 man escaped and was never returned, 1 woman 
was sent out of the State by the Board of Lunacy and Charity, 
1 woman went on a visit and was not returned, 2 women were 
transferred to the Medfield Asylum and 1 woman recovered. 

The small number of patients admitted during the year ren- 
ders it difficult to draw any specially valuable deductions 
from this source. Some estimate as to the prospect for final 
recovery in these cases can be made when we learn that the 
average duration of insanity, before admission here, was nearly 
eight and one-half years. Epilepsy and heredity lead in the 
assigned causes of disease, a finding, perhaps, not so surprising 
in cases of such long standing, when we remember that these 
patients are the accumulation of other institutions, and a 
selected accumulation at that. Of this number, considerably 
over 50 per cent, were hopelessly demented and 25 per cent. 



66 WORCESTER INSANE ASYLUM. [Oct. 

were epileptic. Three or four were inclined to be somewhat 
helpful, and an equal number were quite as inclined towards 
destructiveness. The average age was that of middle life, and 
there was less than the usual proportion of extremely feeble 
cases. 

One woman recovered, and was discharged to the care of her 
friends. This was a case of mania, with occasional outbursts of 
excitement. She had been insane for about fifteen years. Five 
years ago she was discharged to the care of her brother, as 
much improved. It was thought then that she might continue 
to improve in her new surroundings, and eventually complete 
her recovery without a return to a hospital. It proved, how- 
ever, that she had not regained suflScient mental stability to 
endure the strain of personal responsibility, and she was very 
soon returned to an institution, a little later being again trans- 
ferred here. After a more or less eventful experience she 
again improved to such an extent that she was once more dis- 
charged to the care of her brother, this time as recovered. She 
has now remained well for some months, and possibly may 
continue so, though the probability of relapse in recoveries 
from mental disease of lono- standino; is orreater than in acute 
cases. Recovery from mental disease may be complete, so far 
as any evident manifestation is concerned, and yet the predis- 
position remain, and be even strengthened, rendering a relapse 
perhaps probable, and from slighter provoking causes than in 
the case of the first attack. Bearing this fact in mind, it has 
been claimed that a continued high rate of recovery among the 
insane would eventually exert an unfavorable influence upon 
the increase of insanity, by returliing to the ordinary walks of 
life persons whose impress upon posterity would lead to the 
perpetuation of an unstable mentality. 

Some special investigation has been undertaken during the 
past year, looking to establish the value of certain remedial 
measures in their influence upon the course of chronic mental 
disease. The somewhat striking success which has followed 
the administration of the thyroid extract in certain forms of 
acute insanit}'^ has led to the hope that something might also be 
accomplished by its use in the chronic stage of disease. A 
thorough trial of this remedy has given, in my hands, nothing 



1896.] PUBLIC DOCUMENT — No. 23. 67 

but negative results, a finding not wholly unexpected. Much 
more of promise has seemed to attend a more careful regulation 
of the diet, and an attempt to correct faulty digestive proc- 
esses, — a fact which shows the importance of always providing 
good, wholesome and nutritious food for the insane. The 
slight success which too often follows treatment in the chronic 
class should prove rather an incentive to renewed investigation 
than a discouragement to further effort. The large and con- 
stantly increasing numbers of these most unfortunate people 
demand that every measure shall be taken which gives any 
hope of relief. The establishment here of a laboratory furnish- 
ing increased facilities for the study of disease and for the scien- 
tific investigation of the medical problems of the institution 
would greatly further the work of the hospital, and increase its 
efficiency for the relief of its patients. Though the study of 
disease in its chronic forms is not usually as attractive as in 
its acute manifestations, I believe that the results of investiga- 
tion are more than sufficient to reward the effort. The division 
of mental disease into acute and chronic forms is, to a certain 
extent, artificial, as many acute cases are practically incurable 
when admitted, while, on the other hand, many cases of long 
standing are susceptible of improvement, or even recovery, as 
the experience of this institution shows. 

The policy has been continued of granting as great personal 
liberty to patients as seemed consistent with the proper man- 
agement of the institution. This freedom has been very gen- 
erally appreciated by our people and abused by but few, as is 
evidenced by the fact that only one successful escape occurred 
during the year. Notwithstanding the fact that the more help- 
ful patients are seldom transferred here, much valuable work 
has been accomplished, nearly two-thirds of our number having 
been profitably employed during the greater portion of the 
time. Pecuniary result has not been the sole measure of effort, 
and many persons have been encouraged to work solely for the 
benefit which would accrue to the individual, sometimes at a 
direct money loss to the institution. Recognizing, also, the 
fact tliat out-of-door exercise is an essential requisite for the 
proper maintenance of health, constant effort has been made to 
keep our patients as much as possible in the open air. 



68 



WORCESTER INSANE ASYLUM. 



[Oct. 



Ratio of Deaths from the Openiyig of the Asylum to Oct. 1, 1896. 













u 

si 


Deaths. 


Per Cent, on 
Whole Number 
of Patients 
treated. 


°|° 


OFFICIAL YEAR. 


S 


a 


6-( 


Per Cent 
Daily AV( 
Number 
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 


1.3.23 


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 


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 


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 


1893-94, . 








515 


442.23 


22 


21 


43 


8.35 


9.72 


1894-95, . 








504 


460.68 


22 


24 


46 


9.13 


9.99 


1895-96, . 








467 


427.36 


16 


19 


35 


7.49 


8.19 



The death rate, reckoned upon the daily average number of 
patients, is lower than it has been before at any time for four- 
teen years. I ascribe this to three causes : a less number of 
feeble cases than usual having been received during the year ; 
the fact that the weaker ones of our old cases had earlier suc- 
cumbed to the ravages of disease ; and, finally, the constantly 
improving sanitary condition of the institution. There has 
been very little acute disease in the house. The chief cause of 
death has, as usual, been phthisis. There has been a remark- 
able freedom from those annoying cases of severe tonsillitis 
which were formerly so prevalent among the help, a fact doubt- 
less due in great measure to the admission of more air and sun- 
shine to the wards. 

The new building, which was in process of construction at 
the time of my last annual report, is nearly completed, and for 
some time has afforded sleeping accommodations for patients. 
The water section alone remains unfinished. This building not 
only increases the capacity of the institution, but also furnishes 



1896.] PUBLIC DOCUMENT — No. 23. 69 

water-closet and bathing facilities for three of the old wards. 
The construction is of the most substantial kind. The entire 
water section and the stairway are fireproof; the remainder of 
the building is slow-burnins: construction. Provision is made 
for the rain bath on every iloor, a room of moderate size being 
set apart for this purpose in each ward. This arraogement is 
adopted in preference to one large room for all, as being far 
more convenient and securing greater privacy and personal 
attention for patients. I doubt the expediency of bathing large 
numbers of the insane at the same time in the same room. 

The opening of this new building has afforded almost com- 
plete relief from the crowding which has existed here for so 
many years. The numbers in the female department are now 
nearly at the normal capacity and in the male department a few 
vacant rooms exist. The very favorable showing as to per 
capita cost in the erection of this building would seem to indi- 
cate that the enlargement of already existing institutions fur- 
nishes, to a certain limited extent, an economical and efficient 
way of providing for a future increase of the insane. When, 
however, numbers greatly in excess of one thousand are 
grouped under one administrative head, the wisdom of a still 
further enlargement of that particular institution seems to me 
problematical. 

It is greatly to be regretted that we have not as yet been able 
to equip the asylum with electricity for lighting purposes. Our 
revenues have not been sufficient to complete the work already in 
hand and to undertake so expensive an operation as the installa- 
tion of an electric plant. The experience of other institutions 
leads me to believe that the change from gas to electricity would 
be productive of most desirable results, both in a sanitary and 
a financial way, and would give a lighting agent far safer and 
easier to control. Our new building has already been equipped 
with iron-armored conduit for the passage of electrical wires. 
The engine which furnishes power for the laundry and for the 
general purposes of the hospital has been long in service, and 
is of an antiquated type. While, under our present conditions, 
it is fairly eflScient in operation, it is wasteful of steam, and, 
with the introduction of the electric light, would probably not 
respond in a satisfactory manner to the added burden of a 
dynamo. This engine should be replaced with a modern 



70 WORCESTER INSANE ASYLUM. [Oct.;96. 

machine at such early date as the finances of the institution 
will warrant. 

The work of enlaro-ino- the windows in the older wards has 
been continued slowly, and much general work of repair has 
been accomplished. Several changes have been made in the 
wash room of the laundry building, which have added greatly 
to the efficiency of the service. The last of the old wooden 
washers has been discarded, and replaced with a modern 
metallic machine. That portion of the plumbing which was 
beneath the floor has been removed, heavy iron being sub- 
stituted for the old cement pipe, which has been in place for 
many years. Some necessary furnishings have been added to 
the public reception room and the business ofiices. 

Earnest and faithful work has been done by the oflScers of the 
institution, and the employees, with few exceptions, have shown 
an attention to duty which has been commendable. 

The usual services and amusements have been held in the 
chapel. Our winter entertainments have been eagerly looked 
forward to by the patients, and largely attended. 

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

E. V. SCRIBNER, 

Superintendejit. 



REVISED TABLES 



Uniform Statistics 



MASSACHUSETTS HOSPITALS AND ASYLUMS 
FOR THE INSANE. 



Approved by the State Boaed op Lunacy and Charity, 
March 10, 189]. 



72 



WORCESTER INSANE ASYLUM. 



[Oct. 



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PUBLIC DOCUMENT — No. 23. 







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74 



WORCESTER INSANE ASYLUM. 



[Oct. 



3. — Received on First and Suhsequent Admissions, 





Cases admitted. 


TIMKS PBEVIOUSLT 
KhCOVKKED. 


NUMBER OF THE ADMISSION. 


Males. 


Females. 


Totals. 


Males. 


Females. 


Totals. 


First, . . . , . 


- 


20 


20 


- 


- 


- 


Total of cases, . 
Total of persons, 


— 


20 
20 


20 

20 


— 


- 


- 



4. — Relations to Hospitals of Persons admitted. 



HOSPITAL RELATIONS. 


Males. 


Females. 


Totals. 


Never before in any hospital for insane, 
Former inmates of this asylum onl3% . 
Former inmates of other hospitals only. 


- 


20 


20 


Total of persons, 


- 


20 


20 



5. — Parentage of Persons admitted. 





MALE8. 


Females. 


Totals. 


PLACES OF NATIVITY. 


Father. 


Mother. 


Father. 


Mother. 


Father. Mother. 


Unknown, 


- 


- 


20 
20 


20 


20 


20 


Total, 


- 


- 


20 


20 


20 



1896.] 



PUBLIC DOCUMENT — Xo. 23. 



tD 



6. — jResidence of Persons admitted. 



PLACES. 


Males. 


Females. 


Total. 


Massachusetts: — 








Suffolk County, 


- 


12 


12 


Middlesex County, 


- 


3 


3 


Essex County, 


3 


3 


Norfolk County, ....... 


- 


1 


1 


Bristol County, 


- 


1 


1 


Totals 


- 


20 


20 


Viz. : cities and towns,* 


- 


17 


17 


country districts 


- 


3 


3 



* Containing not less than 10,000 inhabitants. 



7. — Civil Condition of Persons admitted. 



NUMI5ER 


Unmarried. 


Married. 


Widowed. 


Unknown. 


Totals. 


MISSION. 


Ma. 


Fe. 


Tot 


Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Ma. 


Fe. 


Tot. 


Ma. 


Fe. , Tot. 


First, 


- 


9 
9 


9 
9 


- 


9 
9 


9 
9 


- 


2 
2 


2 


- 


- 


- 


- 


20 


20 


Totals, . 


- 


2 


20 


20 



8. — Occupation of Persons admitted. 



FEMALES. 



Housewives, 

Domestics, 

Dressmaker, 



No occupation, 
Total, . 



20 



WIFE OR DAUGHTER OF 



Unknown, 
Total, 



20 
20 



76 



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1896.] 



PUBLIC DOCUMENT— No. 23. 



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1896.] 



PUBLIC DOCUMENT — No. 23. 



79 



12. — Reported Duration of Disease before Last Admission. 







First Admission 

TO ANT HoSriTAL. 


All Other 
Admissions. 


Totals. 


PREVIOUS DURATION. 


« 

3 


■3 

a 


■3 


■3 


S 
3 


H 




1 





Congenital, 
Under one 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, 




~ 


- 




- 


1 

3 
6 

7 

~ 
3 


1 

3 
6 

7 

3 

20 

20 

8.47 


- 


1 

3 
6 

7 

3 


1 

3 

6 

7 

3 


Total of cases, . 
Total of persons, 
Average in years. 


_ 


- 


- 


- 


20 

20 

8.47 


20 

20 

8.47 


20 

20 

8.47 



80 



WORCESTER INSANE ASYLUM. 



[Oct. 









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p 

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i 1 1 1 1 1 1 IIII 


1 1 


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1 1 


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FORM OP DISEASE. 


*■''■'" i 

-...,- 


A. — Insane: — 

Dementia, chronic, 
epileptic, 
paralytic 
General paralysis. 
Mania, chronic. 
Melancholia, cljronl 
Paranoia, . 
Congenital mental 
ftcieucy, 

B. — Habitual drunkards, 

C. — Voluntary patients, 

D. — Not insane, 


Total of cases, . 
Total of persons. 



1896.] 



PUBLIC DOCUMENT — No. 23. 



o 









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82 



WORCESTER INSANE ASYLUM. 



[Oct. 






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1896.] 



PUBLIC DOCUMENT — No. 23. 



83 






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ne : — 
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6 to 

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84 



WORCESTER INSANE ASYLUM. 



[Oct. 



Z 



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1896.] 



PUBLIC DOCUMENT — No. 23. 



85 






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WORCESTER INSANE ASYLUM. 



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