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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
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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
WORCESTER INSANE ASYLUM.
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Pregnancy,
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2. — Mental : —
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Unknown, .
"3
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1896.]
PUBLIC DOCUMENT— No. 23.
77
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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.
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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.
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PUBLIC DOCUMENT — No. 23.
83
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PUBLIC DOCUMENT — No. 23.
85
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WORCESTER INSANE ASYLUM.
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PUBLIC DOCUMENT — No. 23.
87
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