1
10
10
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https://localhistory.tadl.org/files/original/da93da900c0a5eaa13f20fbfd7d4ecb6.pdf
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Traverse City State Hospital
Subject
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Asylums.
Psychiatric hospitals.
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Amy Barritt, 1984-
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Various.
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1885-1989
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Board of Trustees for the Traverse City State Hospital.
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English.
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TCSH-xxxx.
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Traverse City, Grand Traverse County, Michigan.
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Michigan State Hospitals Statistical Report, 1931-1934
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Psychiatric hospitals.
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An account of the resource
Tabulations covering twenty years of growth of institutions under State Hospital Commission, together with detailed statistics on population, admissions and discharges during four years from 1931 through 1934. Prepared by State Welfare Department, 1935.
From the Foreword: "Since 1915 there have been no periodic reports published covering the details of the operation of the several state hospitals which are providing care and treatment for the mentally ill of this state. Special reports have been published in this interval, one by Barrett in 1927, being a survey of mental diseases in the different hospitals, and one by Haskell in 1928, pointing out the needs to properly care for the mentally sick in Michigan."
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Michigan State Welfare Department.
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Michigan State Welfare Department.
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1935
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Michigan State Welfare Commission.
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See other reports from the Board of Trustees at various institutions in the "Traverse City State Hospital" Digital Collection.
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PDF.
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English.
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MSH0010
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Michigan, United States.
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f
STATE K.V
MEDICAL LIBR.-'
MICHIGAN STATE HOSPITALS
STATISTICAL REPORT
INSANE-MENTAL DEFECTIVES-EPILEPTICS
STATE WELFARE DEPARTMENT
1935
�KALAMAZOQ
S T A T E HOSPITAL
MEDICAL LIBRARY
M I C H I G A N
STATE H O S P I T A L S
S T A T I S T I C A L
REPORT
Tabulations covering twenty years of growth of institutions under State Hospital Commission, together with detailed statistics on population, admissions and discharges
during four years from 1931 through 1934.
*##•»****
Prepared By
STATE WELFARE DEPARTMENT
1935
�STATE H O S P I T A L
M E D I C A L LIBRAE?
F O R E W O R D
Since 1915 there have been no periodic reports published
covering the details of the operation of the several state
hospitals which are providing care and treatment for the mentally ill of this state. Special reports have been published
in this interval, one by Barrett in 1927, being a survey of
mental diseases in the different hospitals, and one by Haskell
in 1928, pointing out the needs to properly care for the mentally sick in Michigan.
In 1931 the State Hospital Commission inaugurated the
plan of collecting and compiling detailed information relating
to each patient in the various state hospitals on a type of
punched card for use in a mechaiical tabulator. The work of
collection and recording these data has been going on in the
State Welfare Department during the past four years, and the
resulting accumulation of records, relating to the state hospital population, is now more extensive and varied than has hitherto been available.
The accompanying report has been prepared for the purpose
of indicating the development that has taken place since the
year 1915 in the activities of these institutions, now under
the State Hospital Commission, showing increases in population,
investments and expenditures. Also this report provides detailed studies of admissions, deaths and discharges of patients over
the four year period from 1931 to 1934 inclusive. The work of
preparing and compiling tabulations included in this report has
been directed by Gilbert !<. Haigh, Statistician for the State
Welfare Department, under the guidance and supervision of the
Statistical Committee of the State Association of Medical Superintendents.
George P. Inch, M*D.
Albert M. Barrett, M.D.
Robert L. Dixon, M.D.
Robert H. Haskell, M.D.
Perry C. Robertson, M.D.
Statistical Committee
Honorable Fred L. Woodworth, Director
State Welfare Department
�S T A T E
W E L F A R E
C O M M I S S I O N
Rev. Fr. John R. Day, Chairman
Three Oaks
Mrs. Ufa. G. Rice
Houghton
Mrs. John J. Porter
East Jordan
Mr. Chas. P. Winegar
Grosse Polnte
Mr. Nathan Shapero
Detroit
Mrs. Pern Smith Hammond, Secretary
Pred L. Woodworth, Director
STATE WELFARE DEPARTMENT
�TABLE OP CONTENTS
Page
Description of Institutions
.
Deportation Report
Outpatient Clinic Report
Inventories, Investments and Expenditures (tables I to IV)
7
8
8
10
I - STATE MENTAL HOSPITALS
Population, Admissions and Deaths 1915-1935 (tables V to VII)
Capacities of Hospitals (tables VIII and IX)
Hospital Needs in Future Years
Charts of Population and Capacities
Movement of Mental Patient Population (table X)
Patients in Mental Hospitals (tables XI to XIII)
First Admissions (tables XIV to XXIV)
Readmissions (tables XXV to XXVII)
Total Admissions by Counties (table XXVIII)
Deaths and Discharges (tables XXIX to XXXIX)
Patients Paroled (table XL)
18
21
25
26
29
31
36
53
58
61
79
II - HOME AND TRAINING SCHOOLS
Resident Population 1915-1935 (table I)
Total Admissions to Schools 1915-1935 (table II)
Total Deaths 1915-1935 (table III)
Population and Capacities Compared 1915-1935 (table IV)
Charts of Population and Capacities
Movement of School Population (table V)
School Population by Age Groups, Mental Status, etc. (tables VI
to IX)
Admissions by Age Groups, Mental Status, etc. (table X and XI)
Discharges and Deaths Analyzed (tables XII to XV)
2
3
4
7
8
11
12
21
24
III - STATE EPILEPTIC COLONY
Resident Population 1915-1935 (table I)
Construction and Capacities 1915-1935 (table II)
Admissions and Deaths 1915-1935 (table III)
Movement of Population (table IV)
Resident Population (table V)
Admissions Analyzed (tables V to VII)
Discharges and Deaths Analyzed (tables VIII to X)
32
33
35
36
38
38
43
�S T A T E
H O S P I T A L
C O M M I S S I O
Mr. W. P. Gallagher, Chairman
Owosso
Dr. E. P. Wilbur, Secretary
Kalamazoo
Mrs. Ida D. Ayres
Grosse Points
Dr. Prank P. Bohn
Newberry
Mr. James P. Milliken
Traverse City
Mr. Fred C. Striffler
Oaro
Mr. E. P. White
Lapeer
�M I C H I G A N
S T A T E
H O S P I T A L S
The various institutions or mental hospitals under the State
Hospital Commission, which are included in the following tabulations
and within the scope of this report, may be separately grouped and
individually noted as follows:
The care and treatment of civil insane is provided in the state
hospitals at Kalamazoo, Pontiac, Traverse City, Newberry, and Ypsilanti.
In addition to these institutions, Wayne County provides similar care
in the hospital at Eloise and all patients remaining there continuously
in excess of one year, become state patients and are treated there at
state expense. The Psychopathic Hospital at Ann Arbor admits patients
committed for observation, as well as temporary commitments aid some
by voluntary admission. The proportion of these not actually discharged
after a limited period of stay at this hospital, are definitely committed and transferred to one of the state hospitals for more permanent
care and treatment. The record of admissions and discharges at the
Psychopathic Hospital are included for convenience with those for the
regular state hospitals, although the former institution is administered
by the regents of the University of Michigan instead of the State Hospital Commission. It is noted that the conditions of entrance and discharge of patients, together with the resulting high turn-over at Psychopathic Hospital, present a situation distinctly different from the
remaining institutions considered in this report, and proper allowance
will be made in making comparisons.
The state hospital at Ionia is for the dangerous and criminal insane, with its population containing a large proportion of male patients
and being more definitely fixed than is the case with the civil insane.
Care and treatment is provided by the state for mental defectives
in the Home and Training School, located at Lapeer. The Home and Training School for Wayne County is located at Northville, having been opened in 1927.
The population of this latter institution is included in
this report. Those inmates at the Northville school without reimbursement, who have remained there over a year, become state wards and their
maintenance is paid Tor by the state.
The Farm Colony, located at Wahjamega, provides care and treatment
for epileptics. Details covering the population of this institution
are contained in a later portion of this report.
The first series of tables in this report Indicate the growth of
population with admissions and discharges over a twenty year period
from 1915 to-date. The remaining tables include analytical studies of
psychoses of patients with relation to their age, sex, nativity, etc.,
as given in the series of years from 1931 to 1934 inclusive.
�MICHIGAN STATE HOSPITALS
DEPORTATION AND REPATRIATION OP PATIENTS
The State Welfare Department, working in conjunction with the
U. S. Immigration Service, as well as other states, has brought about
the deportation of some patients and repatriation of others, amounting
to a total of 92 for the twelve month period ending November 1, 1935.
Sixty-six of these were deported and four repatriated to their
native country, while twenty-two were transferred to other states in
which they had legal residence. The following list Indicates the institutions from which these patients were removed:
State
Deported
Repatriated
Transfer
Kalamazoo Hospital
2
2
2
Pontiac Hospital
2
Newberry Hospital
1
2
Traverse City Hospital
2
Ionia Hospital
31
Ypsllanti Hospital
12
12
Eloise (Wayne County)
18
Michigan Home and Training School
2
4
Totals
66
4
22
OUT PATIENT CLINICS
Members of the staffs of the different state hospitals have been
conducting mental hygiene clinics in different cities throughout the
state for some time past. These clinics are for the purpose of seeing
community cases, both children and adults, as well as paroled and discharged cases from the individual hospitals. This out-patient service
was started in the City of Kalamazoo in 1916 by members of the staff
from Kalamazoo State Hospital.
During the fiscal year ending June 30, 1935, there were held 456
of these clinics in thirty-one different cities and communities throughout the state in which a total of 5280 cases were examined, of which
3406 were new cases and 1874 were either paroled or discharged patients
from the hospitals, or cases previously examined at former clinics.
Number of Cases
Return
Total
Kalamazoo
48
7
80
438
Pontiac
42
4
107
409
Traverse City
73
11
419
1154
Newberry
6
28
43
155
Ionia
1
0
35
Not regular
Ypsilanti
1
12
387
417
1
Psychopathic
253
1834
858
2672
31
456
3406
1874
5280
Of the total new cases examined 41/6 were under 18 years of age. The
largest group of all new cases, 1461, was referred from the University
Hospital. 555 were from courts and 534 from public welfare and health
agencies.
Recommendations for these new cases included 735 for commitment to
a state institution and special care and definite treatment for 1575
others.
Number of
clinics
Number of
cities
New
358
302
735
112
35
30
�MICHIGAN STATE HOSPITALS
1 - INSTITUTION INVENTORIES AND PROPERTIES
This table gives a general statement of the Institutions
under the direction of the State Hospital Commission as of June 30,
1935, or at the close of the fiscal year.
In separate columns are shown in each case the investments
in real estate and buildings as a total, and also the total for personal property items, including stock, machinery, equipment, furnishings, and supplies. The values, as given for real estate and buildings, are derived largely from the original investment figures, and
are not comparable as they do not indicate present replacement values.
As to personal property totals the Inventory values as given
conform more closely to present values, as these items are naturally
being replaced at more frequent intervals.
In the case of the Mt. Pleasant branch of the Lapeer Home
and Training School, which property was recently acquired from the
United States Department of Interior, the figures given are for the
value of all usable properties in the original inventory by the
Federal government.
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�MICHIGAN STATE HOSPITALS
II a - b - o - INSTITUTION EXPENDITURES
These three tables Indicate the yearly expenditure for each
of the three groups of institutions over the 21 year period from
1915 to 1955, as shown by the annual reports of the Auditor General,
covering all vouchers paid during each fiscal year. These expenditures, as well as receipt shown later, are all of necessity based on
the fiscal year ending June 30th.
Table Ila covers these expenditures for the seven mental
hospitals noted in detail In Table I. The column for Operation and
Maintenance includes personal service, supplies and contractual service, as well as maintenance of buildings and equipment. Also included are the amounts paid annually to Wayne County for maintenance
of state patients at Eloise Hospital, a Wayne County Institution.
In the last column is indicated the proportional annual expenditure
for institution operation and maintenance for each resident patient,
based on the institution populations of June 30th of each year.
Under additions and improvements are shown amounts spent annually for added capital outlay, Including new buildings and equipment. The large expenditures shown from 1930 to 1933 cover erection
of the Ypsilanti Hospital and additions to Ionia, Traverse City,
and Newberry Hospitals.
Tables lib and lie similarly cover amounts expended over the
21 year period by the Home and Training Schools and the Epileptic
Colony. In table lib are included costs for maintaining each year
the total number of state patients at the training school built by
Wayne County at Northvllle and first occupied In 1926.
Increased expenditures for Additions and Improvements are
shown from 1922 to 1925 and in 1930 and 1931, when additional cottages
and colony buildings were erected at the Home and Training School at
Lapeer.
In table lie it will be noted that up to 1920 and In 1932 a
large portion of the total expenditure was required for erecting additional buildings at the Colony. This institution was first opened
in 1914.
11
�Table Ha
Year Ending
June 30
- MENTAL HOSPITAL GROUP-ANNUAL EXPENDITURES OVER 20 YEAR PERIOD 1915-1935
Total Expenditures
Operation & Maintenance
Addition & Improvement
Annual Maintenance
Expense for resident
patient
$194.00
204.00
219.00
266.00
1915
1916
1917
1918
$1,609,108.73
1,797,085.33
1,792,981.78
2,293,011.48
f1,457,030.38
1,553,620.40
1,698,632.84
2,089,536.86
$152,078.35
243,464.93
94,618.94
203,474.62
1919
1920
1921
1922
2,470,954.44
2,908,620.28
3,539,329.46
2,664,680.60
2,379,204.13
2,742,648.48
3,389,610.20
2,606,093.71
91,550.13
165,971.80
160,947.25
58,586.89
301.00
343.00
412.00
307.00
1923
1924
1925
1926
2,932,800.49
2,988,839.40
3,406,519.30
3,631,070.55
2,896,642.36
2,798,655.78
3,048,197.96
3,179,582.51
36,158.13
190,173.62
358,321.42
451,488.04
347.00
315.00
397.00
343.00
1927
1928
1929
1930
3,764,425.13
3,536,266.42
3,743,435.63
4,169,1^6.98
3>507>798.42
3,385,368.98
3,696,680.55
3,529,069.53
256,626.71
150>897.44
46,755.08
640,077.45
363.00
339.00
363.00
331.00
1931
1932
1933
1934
1935
7,194,667.06
4,555,525.22
3,527,398.33
3,368,958.74
3,756,421.86
3,433,883,49
3,311i467.96
2,996,582,70
3>204,095i24
3,668,225.59
3>760,783.57
1,244>057.26
530,815.63
164>863.50
88,196.27
303.00
269.00
231.00
244.00
270.00
Q
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�Table lib - EOME AND TRAININGS SCHOOLS-ANNUAL EXPENDITURES OVER 20 YEAR PERIOD
Total Expenditures
Operation and Maintenance
Addition & Improvements
Annual Maintenance
Per Patient
1915
1916
1917
1918
$306,708.?!
301,586.20
312,634.99
446,692.87
,986.52
231,439.82
279,993.14
383,681.06
$75,721.79
70,146.38
32,641.85
63,011.91
$197.00
181.00
192.00
247.00
1919
1920
1921
1922
463,343.24
502,841.32
620,858.11
731,360.41
406.253.68
489,515.20
601,464.58
508,514.93
57,089.56
13,326.12
19,293.53
222,845.40
257.00
299.00
358,00
302.00
1923
1924
1925
1926
886,838.08
801,504.39
999,625.96
726,215.54
635,523.38
591,281.94
664.018.18
724,474.39
251,314.70
210,222.45
315,607.78
3,741.15
277.00
251.00
268.00
261.00
1927
1928
1929
1930
777,117.87
863,755.83
1,055,123.15
1,381,348.60
771,691.11
868,818.16
1,013,059.75
975,834.87
5,426.76
937.67
42,063.40
405,513.73
274.00
277.00
300.00
291.00
1931
1932
1933
1934
1935
1,545,423.70
1,113,642.32
965,608.68
890,508.47
1,171,970.40
947,646.55
991,025.89
909,498.99
886,145.83
1,117,755,87
597,777.14
122,616.43
56., 109.69
4,362.64
54,214.53
246.00
25S.OO
225.00
218.00
257.00
Q
W
O
33
�Table lie - EPILEPTIC COLONY - ANNUAL EXPENDITURES OVER 20 YEAR PERIOD 1915-1935
Year
Total Expenditures
1915
1916
1917
1918
$ 170,467.17
171,930.92
212,544.21
254,945.12
$ 48,450.12
80,982.74
117,467.46
138,179.32
1919
1920
1921
1922
269,471.69
273,747.73
258,246.33
188,494.84
167,038.13
171,747.96
818,865.44
166,131.28
102,433.56
101,999.77
39,380.89
22,363.56
331.00
350.00
399.00
295.00
1923
1924
1925
1926
201,125.05
239,944.95
354,675.19
280,578.87
197,002.17
200,103.54
209,950.74
202,340.58
4,122.88
39,841.41
144,724.45
78,238.29
297.00
283.00
291.00
240,00
1927
1928
1929
1930
260,341.94
230,511.32
248,798.44
230,079.29
250,500.89
227,603.27
247,332.43
225,136.26
9,832.05
2,908.05
1,466.01
4,943.03
295.00
278.00
318.00
288.00
1931
1932
1933
1934
1935
227,909.14
483,828.30
305,099.07
218,715.53
203,473.17
226,575.46
222,352.56
238,894.96
213,579.01
196,583.91
1,333.68
261,475.74
66,204.11
5,136.52
6,889.26
280.00
271.00
256.00
218.00
198.00
Operation and
maintenance
Addition and
improvements
| 1-22,017.05
90,948.18
95,076.75
116,765.80
Annual Maintenance
per patient
$ 314.00
468.00
338.00
377.00
o
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69
O
00
�REIMBURSEMENTS BY PATIENT GUARDIANS AND ESTATES FOR MAINTENANCE
The amounts which have been received annually for the past 21 years from the above sources for the
maintenance of patients in these institutions are noted in this table.
In 1920 the change which centralized accounts at Lansing, provided better records and means of collecting these amounts as evidenced by the increased totals from that date. The large total for Epileptic
Colony given in 1923, results from an accumulation of amounts collected that year which were due from previous years.
These figures are taken from the annual reports of the Auditor General which are based on the fiscal
year ending June 30th.
Table III - RECEIPTS PROM INDIVIDUALS AND ESTATES
Year Ending June 50
1915
1916
1917
1918
Total Receipts
$ 34754.20
35640.99
32579.71
54497.97
Mental Hospitals
$ 26,551.67
31,365.08
30,742.27
47,081.13
Home & Training Schools
$ 8,202.53
4,043.30
1,555.04
5,341.60
Epileptic Farm Colony
$
232.61
282.40
2075.24
Q
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>
a
33
1919
1920
1921
1922
67836.66
210615.19
277395.64
273541.84
61,938.19
200,723.62
265,384.00
255,117.97
4,465.73
8,077.44
9,068.61
10,079.38
1432.74
1814.13
2943.03
8344.49
1923
1924
1925
1926
280832.87
281922.88
282120.06
275565.03
258,748.44
266,183.27
262,539.31
251,223.98
10,013.64
10,502.92
12,663.56
14,309.67
12070.79
5236.69
6917.19
8031.38
1927
1928
1929
1930
273924.10
267315.95
280335.64
299487.98
253,686.91
247,697.63
258,750.21
276,104.36
13,714.00
13,591.88
14,828.55
15,818.48
6523.19
6026.44
6756.88
7565.15
1931
1932
1933
1934
1935
251386.89
242893.52
205951.06
174510.91
206091.50
227,802.05
221,610.86
187,119.65
160,326.18
192,362.56
15,278.02
15,367.21
13,074.86
11,665.93
10,668.35
8306.82
5915.45
5756.55
2518.80
3060.59
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�MICHIGAN STATE HOSPITALS
IV- EXPENDITURES FOR FISCAL TEAR 1934 - 1935
The detail of the year's expenditures by individual institutions is given in this table. The additional expense of having
Wayne County maintain state mental patients at Eloise and mental defectives at Northville is shown in amounts under separate items.
The total expenditure by the state for all patients in mental
hospitals for the fiscal year ending June 30, 1935 was $3,756,421.86,
and for those in schools for mental defectives during the same period
was $1,171,970.40.
In the last column are shown the average amounts expended by
each institution for the maintenance of each patient during the fiscal year ending June 30, 1935. These figures are based on the average residence population for the year and the total operating expense, not including capital outlay for additions and improvements.
V
- POPULATION OF MENTAL HOSPITALS
This table gives the total number of patients being cared for
in mental hospitals in the state for the past twenty years, but does
not include those on parole. In addition to the patients in the
seven mental hospitals noted in Table IV, all patients in Wayne
County Hospital at Eloise are included. Those being cared for as
mental defectives and epileptics are in separate institutions and
are covered in detail in a later portion of this report.
Populations given are as taken June 30th of each year from
institution records from 1915 to 1935. An increase of QZ% in total
population has occurred during the period with the ratio of males
to females remaining about the same. The ratio of patients to each
100,000 of the state's concurrent population as shown by the last
three columns indicates a marked increase of patients to state population since 1932 due to additional space being provided in the new
Ypsilanti State Hospital, as well as to more overcrowding.
Figures
giving the population of the entire state as of July 1st of each year,
from which totals in the last three columns were computed, were obtained from the division of Vital Statistics in the State Department
of Health.
17
�Table V - TOTAL PATIENTS IN STATE MENTAL HOSPITALS 1915 - 1935
No. of Resident Patients
Population of Michigan
On
June 30
Female
Total
Number of Patients Each
100,000 State Population
Male
Female
Total
Male
Female
Total
Male
1915
1916
1917
1918
4078
4157
4206
4237
3370
3461
3532
3612
7448
7618
7739
7849
1694450
1744850
1785300
1829560
1544843
1580266
1625640
1667204
3339293
3325116
3410940
3496764
239.2
237.7
234.8
230.9
219.7
219.4
218.2
217.9
239.6
228.9
226.8
224.7
1919
1920
1921
1922
4274
4335
4468
4636
3611
3655
3756
3846
7885
7990
8224
8482
1879240
1928436
1990600
2059500
1703348
1739976
1795199
1844286
3582588
3668412
3785790
3903186
227.9
224.8
223.4
229,1
211.0
210.1
208.0
206.0
220.0
217.8
216.1
218.0
1923
1924
1925
1926
4710
4908
4939
5057
3877
3980
4075
4201
8587
8888
9014
9258
2118600
2175200
2241550
2309600
1901973
1962760
2013797
2063134
4020573
4137960
4255347
4372734
231.1
229.6
221.0
216.9
210.5
205.9
201.5
199.0
221.3
218.4
211.7
208.4
1927
1928
1929
1930
5274
5464
5685
5873
4340
4521
4680
4799
9614
9985
10365
10672
2361804
2428157
2494745
2519309
2128317
2179351
2230150
2323016
4490121
4607508
4724895
4842325
223.2
225.1
227,6
233.1
203.8
207.4
209.8
206.5
214.1
214.7
219.3
223.9
1931
1932
1933
1934
6208
6776
7167
7284
5102
5517
5780
5848
11310
12293
12947
13132
2608499
2713394
2667747
2694197
2322501
2415516
2375253
2398803
4931000
5128910
5043000
5093000
238.2
248.9
269.1
270.2
219.6
228.3
243.3
243.7
229.3
239.6
256.7
257.8
1935
7542
6035
13578
2717480
2420520
5138000
277.5
247.6
265.1
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�HOSPITAL ADMISSIONS
Total admissions, including firat and readmlssions but excluding transfers, to mental hospitals in
the state are shown for each calendar year from 1915 to and Including 1934.
These admissions cover those
at all seven mental hospitals, including State Psychopathic and Ionia, as well as the number admitted by
Wayne County at Elolse. In proportion to the state population, this table shows in column three a marked
decrease in the last two years in the total admission rate, compared to that being obtained In 1915 and
the years immediately following. The opening of the new state hospital at Ypsilantl in 1931 provided the
increase In admissions shown in 1931 and 1932.
Table VI - TOTAL ADMISSIONS - FIRST ADMISSIONS 20 YEAR PERIOD
Calendar
Year
Total
Admissions
Per 100,000
Population
1915
1916
1917
1918
1919
22Y9
2308
2173
2189
2332
70.5
69.4
63.6
62.9
65.1
1920
1921
1922
1923
1924
2276
2342
2554
2419
2447
62.0
61.5
65.6
62.3
60.1
2002
1976
51.5
48.5
1925
1926
1927
1928
1929
2463
2605
2543
2581
2510
57.9
59.5
56.8
56.9
53.2
2237
2225
2124
2143
2114
52.5
50.8
47.3
46.5
44.7
1930
1931
1932
1933
1934
2259
2964
3154
2655
2457
46.7
59.8
61.4
52.5
48.4
1811
2524
2686
2254
2110
37.4
51.1
52.1
44.7
41.7
Total First
Admissions
Admissions
Per 100,000
Population
GO
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>
1-3
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53
�Table VII - DEATHS IN HOSPITALS
The total number of deaths occurring each year among the total patients residing at the eight mental
hospitals, Including the Wayne County Hospital at Elolse, are here shown for each calendar year from 1923 to
1934 inclusive.
In the second column is given the total number of patients under treatment each year in these eight
hospitals, obtained by adding the total admissions during each year to the total number of patients in residence at the beginning of the year.
The death rate per thousand thus under treatment is calculated for each year and shown in the last
column, clearly indicating a definite decrease in the last ten years in this rate of hospital deaths.
In 1932 there was recorded the highest total of deaths in a decade, but the resulting proportionate
rate is much lower than that of eight or nine years before.
TOTAL DEATHS IN HOSPITALS WITH DEATH RITE PER 1000 UNDER TREATMENT
8
Calendar Year
Deaths Per
1000 under
Treatment
Total Deaths
Total Tinder
Treatment
1923
1924
1925
1926
819
835
832
865
10954
11185
11414
11741
75.6
74.7
72.8
73.6
1927
1928
1929
1930
875
809
891
798
11979
12381
12685
12777
73.0
65.3
70.2
62.6
1931
1932
1933
1934
757
933
824
846
13767
14934
15406
15753
55.0
62.5
53.4
53.6
1-3
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�MICHIGAN STATE HOSPITALS
VIII - HOSPITAL POPULATIONS AND CAPACITIES
The annual percentages of increase in both hospital population
of mental patients and capacities of state mental hospitals since the
year 1915 are herein noted. By June 30, 1935 the total population of
mental patients being cared for in the state was increased 82.3 per
cent over that of 1915, while on the same date the combined capacity
of all state mental hospitals shows an increase of but 4:2.2 per cent
over that of the same date in 1915.
The resultant overcrowding is indicated in the sixth column,
giving percentage of population in excess of capacity, as it would be
were the state institutions caring for all state patients. In figuring this item, there are added to the patients in state institutions
the state patients being maintained by Wayne County.
In^the seventh and eighth columns are shown the additional capacities available in the Wayne County Hospital at Elolse, and the
resultant actual lower per cent of overcrowding in state hospitals
due to this aid being given the state by Wayne County authorities.
HEW CONSTRUCTION
The building activities, which have been carried on since 1915,
to enlarge the capacity of the state for providing more adequate care
of the insane, have resulted in an increased capacity of 2631 beds
during that period. Included in this construction were permanent alterations to older buildings, as well as new dormitories, cottages
and hospitals at the several institutions; also the initial erection
and opening of the group of hospital buildings for the new institution!
at Ypsllanti. These additions are described herein in detail as to
buildings and location and the chronological order of their erection.
The amount of capital outlay involved in this construction is given
in Table Il-a of this report in the column covering Additions and Improvements*
In the year 1915 there were added 135 beds to the capacity of
the state hospitals for mental disease. 100 of these were at Pontiac
with the opening of the new woman's infirmary and 35 at Newberry with
a 20 bed addition to Cottage 0 and 15 beds more for the tubercular
ward.
In 1916 at Newberry, Cottage H was opened in October with 50
bed capacity and during this same year Ionia Hospital increased their
capacity by 45 beds.
At Kalamazoo Hospital the opening of Noble Lodge for employes
In November, 1917 provided dormitory space for 60 more patients.
There were no additions during 1918 and early in the year 1919
Cottage I at Newberry was opened with a capacity of 50 beds. This
same year at Pontiac one floor of the Sawyer Cottage for men was completed with a capacity of 50 beds.
22
�STATE MENTAL HOSPITALS
New Construction: continued.
During the year 1920 Ionia Hospital completed an addition which
provided 45 more beds at that institution.
For the next three years there was no additional bed capacity
provided at any of the hospitals, while changes involving Ionia Hospital in relation to Ionia Reformatory during 1922 resulted in a reduction of 116 beds for the former institution.
In 1924 the second floor of Sawyer Cottage at Pontiac provided
50 more beds on completion and Ionia Hospital opened new dormitories
having capacity of 100 beds.
No additions occurred during 1925 and in 1926 Ionia completed
changes in the location of their occupational therapy department which
made possible dormitory space for SO more patients.
During the next four years there was no construction which provided any added capacity of. consequence. New dining rooms at Traverse
City in 1928 and resulting changes in a number of cottages there provided additional dormitory space for not over six patients.
In 1931 a total of 1431 beds were added to the state'mental
hospital capacity. In January of that year Pratt Cottage was opened
at Kalamazoo with 60 added beds and the opening of the new nurses
home there at the same time provided dormitory space in various wards
for 100 more patients. In May, Traverse City opened a new tubercular
cottage and a new infirmary with a total capacity of 440 beds. This
total addition was subsequently reduced by the remodeling of hall 7
for employees quarters, making the net addition of beds 404.
In midsummer the official opening of the new hospital at Ypsilanti took
place, adding 867 beds to the total capacity that year.
During 1932 the new receiving hospital at Ionia was opened with
a capacity of 204 patients. At Ypsilanti this year the completion of
new dormitories took place which added their rated capacity of 450
beds. However, because of that Institution being as yet incomplete
as a unit and the need of added day room space for hospital patients,
this capacity is reduced to 381, making the total for that year 585
additional beds.
In 1933 the Ferguson receiving hospital at Newberry was opened
and added 120 beds to the total. This makes up the last building construction providing new bed capacity up to the close of the fiscal
year, June 30, 1935.
IX - HOSPITAL CAPACITIES AND OVERCROWDINQ
The normal capacities of each of the seven state mental hospitals is here given, together with the actual overcrowding, based on
the resident populations of each on June 30, 1935.
The determination of these hospital capacities is not based on
any unalterably fixed standard but results from an effort to obtain
23
�MICHIGAN STATE HOSPITALS
Hospital Capacities and Overcrowding: continued.
comparative figures as to actual overcrowding in these state institutions. A normal capacity rating has been used, requiring as a general
average at least 60 square feet of surface for individual bed space,
and at the same time taking into account such factors as type and
condition of patient, additional day space needed, single rooms in use,
windows available, and similar conditions of practical importance.
The hospital for criminal insane at Ionia requiring a higher proportion of single rooms to dormitories, is accordingly based on a higher
rating for individual bed space, viz., 70 square feet. The capacities
given in the table for all hospitals allow a total combined area per
patient for bed and day space of from 95 to 100 square feet.
The Wayne County Hospital at Eloise is also shown with their
resident population, thus giving the total population of all mental
hospitals covered in this report as of the above date.
Had the 2488 state patients, being cared for on June 30, 1935
at Eloise Hospital, been of necessity transferred to v state hospitals,
the rate of overcrowding in these state institutions would have shown
a total increase of 28.0 per cent.
Table IX - POPULATION, CAPACITIES AND OVERCROWDING
June 30, 1935
Patients
Capacities
Capacity
Kalamazoo
2742
2207
535
24,2
Pontiac
1761
1524
237
15.5
Traverse City
2286
1910
376
19.5
Hewberry
1233
1105
128
11.5
861
831
20
2.4
1248
234
18.7
1530
17.2
Mental Hospitals
Ionia
Tpsilanti
1482
58
60
10413
Eloise (Wayne County)
3164
8885
Aggregate Total
8885
Psychopathic
Capacity
Total State Hospitals
13577
2488*
# State Patients
24
4018
, 45.2
�STATE MENTAL HOSPITALS
FUTURE HOSPITAL REQUIREMENTS
The total number of mental patients who were being provided
treatment in state hospitals far the insane and also in Eloise Hospital
in Wayne County, amounted to a total of 13,578 on December 31, 1934,
there being that number in residence on that date. On the same date
there were approximately 1200 committed persons on the waiting lists
of the above hospitals, as well as an unknown number in infirmaries
and homes, and had it been possible to provide needed hospital care
for them, the total number of hospitalized patients per 100,000 population would then have been nearly 290 as a result.
Assuming that a rate of 300 patients per each 100,000 of the
state's population would provide sufficiently to meet present mental
hospital needs, the conditions as to hospital population and admissions
would be about as listed below, if this increase were provided over a
five year period or by the end of ,the year 1939.
Year
State
Population
Hospital Population Rate
Total
Population
Per 100,000
Admissions
Admission
Rate
Per 100,000
1935
5,138,000
13,600
265
2,375
46.3
1936
5,294,500
14,290
270
2,742
51.8
1937
5,389,000
15,180
280
3,107
57.7
1938
5,483,500
15,875
290
3,430
62.6
1939
5,578,000
16,720
300
3,520
63.2
The state's population as listed is in agreement with the rate
of increase over the last ten years. The hospital populations are
shown as increasing gradually over the five year period. The total admissions given are based on the experience noted in population movement over the last four years and allow for replacing patients who die
and are discharged during the period, as well as additional patients
made possible by added capacity as it would be supplied.
If this schedule were carried out, the rate of admissions per
100,000 population would, at the highest point indicated, be much lower
than the corresponding rate in 1915 as shown in table VI.
The number of additional beds required to bring about this increase would be about 3000, provided no effort were made to reduce the
present overcrowding in the different hospitals.
With this increase in beds brought up to 3,500 the present overcrowding could be reduced by fifty per cent with the assumption that
Wayne County would continue to provide for the same number of state
patients as at present.
25
�M I C H I G A N STATE HOSPITALS
7"A T if. NTS
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�MICHIGAN STATE HOSPITALS
X - MOVEMENT OF POPULATION
The movement of the patient population of the seven state
mental hospitals and of Wayne County hospital at Eloise for the two
year period from January 1, 1933 to December 31, 1934 is given in
detail "by institutions in this table.
The changes include admissions, discharges, transfers, and
deaths as indicated by detailed reports from the different institutions during the period noted.
These figures are of necessity on a calendar year basis and
are not comparable with previous tables on capacities and population
which are made up to conform with the fiscal year ending June 30th.
CHARTS ON POPULATION AND CAPACITIES
On page twenty-six the population and capacities of the
public hospitals of the state are shown graphically as they have increased each year from 1915 to date. The resident population of the
Wayne County Hospital at Eloise is included in the total for all
hospitals indicated by the dotted line. The population of the
Hospital for Criminal Insane at Ionia is included with the State
Hospitals. The capacities, expressed in beds as a unit, are determined as explained under Table IX and the difference between the
capacity line and the population line for state hospitals indicates
the amount of overcrowding in the state hospitals over this period
of years.
The chart on page twenty-seven graphically shows the relative
increases by years in state population, hospital population and
hospital capacities as expressed in percentages of the amounts
occurring in 1915. The figures for state population each year are
based on the figures furnished by the State Department of Health.
These graphs indicate that the state hospital population increase
exceeded the increase in state population from the year 1931 and
after.
28
�STATE MENTAL HOSPITALS
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�MICHIGAN STATE HOSPITALS
XI -
PATIENT POPULATION BY PSYCHOSES
The total resident population on December 31, 1954 in the eight
mental hospitals, as indicated in Table X, is here divided according
to psychoses with the resulting percentages in each case.
Of the total population 45.9 per cent have been diagnosed as
dementia praecox, while 10.8 per cent are listed as manic depressive.
The differences between the sexes in the various types of psychoses
are shown in the last two columns.
Males are shown to predominate with regard to general paralysis
and alcoholic psychoses, while females are in greater proportion in
cases of senility, manic depressive, and involution melancholia.
These figures apply only to patients living in the hospitals
as of the date given, while those on parole are similarly shown in
Table XL of this report.
XII - PATIENT POPULATION BY COUNTRIES
The total resident population of December 31, 1934 is again
divided in this table according to the country of birth or parentage
for each patient. All native born, both of whose parents are native
born, are shown under the United States. All native or foreign born,
having both parents born in another country, are listed under the head
of that country. With parents born in different countries, that of
the father is the one under which the patient is listed. The number
of people in the state's population by the 1930 U.S. census divided
by countries and determined on the basis already described, is shown
in the fourth column. The proportionate number of resident patients
connected with each country, as related to each 100,000 persons of
that country in the whole state population, is shown in the last
column. Austria, with 308 patients listed, shows the highest proportionate number of any country. Italy, while having nearly three
times the number of persons listed in the state's population, has 51
less patients in state hospitals than has Austria.
The possibility of making these comparisons with the state
population as of a 1934 census, instead of the 1930 basis, would obviously have a material effect on the total ratio, as well as on the
ratio between individual countries, were such a compilation available.
�Table XI - TOTAL INSTITUTION POPULATION DEC. 31, 1934 IN RELATION WITH TYPES OF PSYCHOSES
Total No. of Patients
'
Trainnatic
Senile
Cerebral Arterioscleroses
General Paralysis
Cerebral Syphilis
21
173
289
706
140
Huntington ' s Chorea
With Brain Tumor
Other Nervous Diseases
Alcoholic
Drugs and Toxins
18
2
153
14
270
162
216
81
35
443
451
922
221
.3
2.3
3.9
9.4
1.9
.2
4.5
2.7
3.6
1.3
.3
3.3
3.3
6.8
1.6
34
5
.2
.3
.2
233
2.0
4.7
.1
1.3
.6
.1
1.7
1.0
14.9
1.0
47.7
355
10
16
3
80
37
7
Other Somatic Diseases
Manic Depressive
Involution Melancholia
Dementia Praeeox
Paranoia & Paranoid condition
47
530
44
3336
355
60
902
59
2895
432
With Epilepsy
Psychoneuroses
With Psychopathic Personality
With Mental Deficiency
Undiagnosed Psychoses
Without Psychoses
135
102
214
137
315
174
461
79
121
65
216
114
246
7fiOS
RO7R
1357R
Tn-hol
-_
Psychoses Percentages
of total population
392
17
107
.6
1432
7.1
103
.6
44.4
4.7
6231
787
223
202
531
288
707
1.8
1.4
1.8
4.2
2.3
6.1
7.1
1.3
2.0
1.1
3.6
1.9
4.1
2.9
.1
.8
10.5
.8
45.9
5.8
1.6
1.6
1.5
3.9
2.1
5.2
Distribution by Sexes
in percentages
60.0
39.1
64.1
76.6
63.4
40.0
60.9
35.9
23.4
36.6
53.0
40.0
65.7
90.. 6
58.8
47.0
60.0
34.3
9.4
41.2
44.0
37.0
42.7
53.5
45.2
56.0
63.0
57.2
46.5
54.8
63.2
45.7
67.8
59.3
60.4
65.2
36.8
54.3
32.2
40.7
39.6
34.8
55.3
44.7
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�MICHIGAN STATE HOSPITALS
Table XII - TOTAL RESIDENT POPULATION DEC. 31, 1934
BY COUNTRIES OF BIRTH OR EXTRACTION
Population of
State by
Countries
Patients per
100,000
Population
34972
26818
499002
882.0
222.0
307.0
44602
198.0
50507
165848
74299
18085
325.0
255.0
510.0
399.0
365263
16175
106426
429.0
369.0
235.0
40434
524.0
83702
98048
555.0
262.0
33492
236.0
23117
320534
339.0
317.0
35
345
144
4*
7
283
20381
75656
65990
175.0
455.0
218.0
2149
53
82
18
11
7*
56
1*
2*
1*
4363
81
1195
3*
11066
23196
6024
2273
350.0
410.0
482.0
356.0
299.0
485.0
70489
273.0
2556192
19258
171.0
422.0
4842325
280.2
Total
Africa
Australia
Austria
Belgium
Canada
China
Czechoslavakia
Cuba
Denmark
England
Finland
France
M
F
3
1
2
214
34
812
5
49
1
37
219
212
43
Germany
Greece
Holland
Hungary
India
Ireland
Italy
Japan
Jugo Slav! a
Mexico
Norway
Poland
819
48
156
Roumania
Rus sis.
Scotland
South America
Spain
Sweden
Switzerland
Turkey
Wales
Bulgaria
Albania
Lithuania
Esthonia
Latvia
Luxemburg
United States
Other Countries
Unknown
Phillipine Islands
Porta Rico
West Indies
Totals
21
219
72
3
6
150
24
52
9
9
7
39
1
2
114
1
242
177
1
43
9
38
626
94
26
T
3»
3*
308
60
718 1530
1
6*
40
89
1#
28
204
65
423
165
29
377
72
747 1566
11
59
93
249
209
95
4*
3
466
224
80
257
1*
35
78
4
13*
40
78
393 1019
14
126
72
1
1
133
29
30
9
2
17
1
2310 2053
62
19
647
548
3
2
8*
4*
4
7503 6075 13578
^Included with total of "Other Countries."
68577
�STATE MENTAL HOSPITALS
XIII - PATIENT POPULATION BY ABES
The total population listed on the books of the eight institutions,
which includes those on parole 'in addition to those in residence, is
here divided according to the various ages of patients on December 31,
1934.
Of the entire population 22.8 per cent are shown to be 60 years
of age and over.
Kalamazoo Hospital has the highest proportion of older patients
with 31 per cent 60 years and over. Up to 60 years of age, males comprise 56 per cent of the population, but over 60 years females are in
the majority.
The average present age for the entire group of patients shown on
the books on the above date amounts to 47.9 years.
XIV - ANALYSIS OF FIRST ADMISSIONS
In this table are shown the total first admissions for the four
year period of 1931 to 1934 inclusive, arranged by institutions in relation with the different types of psychosis. Of this total 4,385 or
almost fifty per cent were received at Eloise Hospital and Ypsilanti
State Hospital. The predominance of males admitted at Newberry and
Traverse City, as compared with Pontiac and Psychopathic, is noted. The
high proportion of males admitted at Ionia is due to the criminal status
of all patients under care of that institution.
The greater portion of these admissions occured in 1931 and 1932
with the completion of new hospital units. The highest number was in
1932 when 2,685 patients were admitted for the first time.
XV - PSYCHOSIS PERCENTAGES OF FIRST ADMISSIONS
In this table all first admissions during the four year period
of 1931-1934 are included in the calculations to determine the relative
frequency of the various types of psychosis in the state as a whole.
The types of psychosis are listed in the order of their frequency, the
first four types including over half the total admissions. Under "all
others" are grouped four remaining types of psychoses having a relatively small number of cases. Here are also included separate columns showing the percentage relation of types of psychosis to total admissions
to each of the different institutions during the above period. Considerable variation may be noted as between institutions in the case of
certain types of psychosis.
33
�Table XIII - AGES OF PATIENTS ON BOOKS DECEMBER 31, 1934
Total
Eloise
Ionia
Kalamazoo
Under 15
M
P
T
1805
1506
3311
767
85
852
1537
1511
3048
772
602
1006
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
M
P
M
P
H
P
M
P
M
P
H
P
80
2
25
26
92
61
140
116
189
147
225
237
26
1
75
8
103
6
112
10
5
19
8
54
36
77
77
116
78
120
120
1374
10
6
19
25
53
33
49
55
59
41
880
1886
2
6
20
16
48
29
80
64
86
90
57
62
119
2
8
11
5
11
16
2
6
5
4
1402
1226
2628
3
11
13
70
36
82
59
89
65
107
106
Ypsilanti
930
921
1851
4
27
18
54
53
34
68
91
91
108
137
Total
8276
6793 15069
27
101
85
346
233
570
406
719
512
822
745
100 .
100.
1.2
1.2
4.2
3.4
6.8
5.9
7.5
9.8
11.0
Newberry
Pontiao
Psychopathic
Traverse City
Percentages
of groups
100.
1
2
0.3
1
0.1
8.7
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�Table XIV
-
PSYCHOSES OF FIRST ADMISSIONS 1931-1934 INCLUSIVE
State Totals
Elolse
M
F
T
M
24
Traumatic
300
Senile
Cerebral Arterioscleroses
590
819
Oeneral Paralysis
124
Cerebral Syphilis
16
Huntington's Chorea
4
Brain Tumor
Other Nervous Disease 167
331
Alcoholic
16
Drugs and Toxins
Other Somatic Disease: 96
Manic Depressive
436
Involution Melancholli i 18
1196
Dementia Praecox
Paranoia and Paranoid
161
Condition
101
Epileptic
Psychoneuroses
177
Psychopathic Personality
122
Mental Deficiency
160
Dndiagnosed Psychoses 205
576
Without Psychoses
6
320
620
Psychoses
Total
30
280 870
232 1051
45 169
10 26
3
7
99 266
42 373
32 48
125 221
639 1075
72 90
918 2114
146 307
57 158
288 465
42
109
179
290
164
269
384
866
Ionia
F
H
1
4
137 164
6
13
20
20
335
55
7
2
42
153
24
96
25
5
9
1
F
1
Newberry
Pont lac
8
7
1
5
1
1
342
101
1
28
31
23
28
13
20
19
5
4
1
26
10
26
16
37
33
126
232
46
23
11
15
3
1660 1133
294
Psychopathlc
M
F
H
F
M
F
H
11
19
2
39
2
33
1
27
2
14
14
2
1
247
131
20
1
98
36
4
1
34
34
8
20
10
2
37
38
6
2
12
11
5
1
1
26
22
13
43
209
8
251
3
34
122
1
Kalamazoo
23
14
39
7
2
6
9 16
68
69 .
5
30
179 210
9
23
3
4
5
49
108
3
92
1
49
7
2
3
6
16
P
M
2
4
2
1
9
9
9
1
2
29
4
4
32
61
1
10
70
33
38
1
77
130
82
8
1
Ypsilantt
F
H
F
42
1
24
2
34
45 103
30 163
1
15
1
2
79
2
66
3
2
1
16
5
Traverse
City
45
7
2
42 32
54
7
9
7
22 25
76 129
1
6
M
>
7
7
79
41
3
15
30
10
147
24
37
20
97
209
193
(-H
50
10
23
47
8
6
9
9
3
14
4
3
22
11
1
29
43 36
3
3
54 110
18
18
13
18
5
16
22
16
21
33
9
49
7
31
55
82
1
14
34
30
2
1
8
6
63
6
3
21
6
31
6
20
84
17
26
5
20
4
25
10
5
1
1
60
10
22
66
43
2
26
69
12
18
23
4
26
19
19
19
10
18
998
691
408
273
272
224
415
415
743
452
849
728
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�Table XV
1931-1934 FIRST ADMISSIONS IN PERCENTAGE RELATION WITH PRINCIPAL PSYCHOSES
Psychoses
Dementia Praecox
Manic Depressive
General Paralysis
Cerebral Arteriosclerosis
~
Period
Psycho- Traverse
Average Eloise Ionia Kalamazoo Newberry Pontiac pathic
City
Ypsilanti
22.14
11.24
10.98
8.93
21.3
11.8
15.5
1.6
32.7
.6
6.4
4.1
23.0
8.1
9.8
20.4
23.1
20.7
:
6.5
-•'.'•
7.9
14.3
12.3
9.9
9.9
Senile
Psychoneuroses
Alcoholic
Paranoia & Paranoid conditions
6.48
4.86
3.89
3.20
10.8
1.5
6.3
2.0
1.9
2.2
2.2
6.8
3.4
4.6
2.7
1.7
8.8
3.4
3.9
2.5
5.6
10.5
2.2
3.0
Other Somatic Diseases
Cerebral Syphilis
With Mental Deficiency
With Epilepsy
2.31
1.76
2.81
1.65
2.7
2.8
1.4
1.6
1.6
3.2
8.9
1.6
1.4
1.4
2.6
2.5
1.1
1.5
2.1
1.3
1.2
2.1
8.3
.9
25.6
13.0
13.2
11.5
18.8
15.8
2.4
.9
20.4
5.6
9.4
14.6
19.7
.6
9.6
9.0
2.4
3.4
3.0
3.7
4.4
3.9
3.5
1.7
3.2
3.0
1.4
2.7
1.6
.7
1.1
.7
3.9
1.9
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With Psychopathic Personality
Other Nervous Diseases
Involution Melancholia
All Others
1.72
2.78
.94
1.16
Without Psychoses
Uhdiagnosed Psychoses
9.06
4.09
2.0
1.3
3.0
.9
1.7
1.0
2.8
2.5
.3
2.3
4.7
.4
1.4
11.3
2.0
17.4
4.4
4.6
11.3
2.3
1.4
.5
1.7
.1
.6
1.5
3.0
.3
.4
2.2
2.1
1.9
5.1
3.8
6.6
5.2
13.1
1.2
1.3
2.4
.3
1.4
15.7
2.9
12.8
2.5
�MICHIGAN STATE HOSPITALS
XVI - PSYCHOSIS PERCENTAGES BY YEARS
The variation in percentage of total first admissions to all mental hospitals for each of the last four years for the various types of
psychoses are here shown. Dementia praecox shows marked variations each
year, which is true to a lesser degree in the case of psychoneuroses.
A comparison of the psychosis percentages for 1931 to 1934 with
those of 1922-1926, as given by Doctor Barrett's 1927 report on Michigan
Hospitals, is provided by the first two columns of this table. This indicates a definite increase for dementia praecox and a proportionate reduction in the instance of manic depressive, general paralysis and cerebral arteriosclerosis over the last four years.
XVII - COMPARISON OF SEX AND PRINCIPAL PSYCHOSIS
This table shows the relation of sex in the principal psychosis
for first admissions occurring from 1931 to 1934 inclusive. These figures
are here compared with a similar study for 1921 to 1926 from Doctor Barrett's report and additional data for 1906 to 1912 taken from a report
issued in 1915 by a commission appointed to investigate insanity in Michigan. A definite increase in the percentage of female cases is clearly
shown as occurring since 1906 for both dementia praecox and senile psychoses.
Since 1921 the percentage of female cases has shown marked increases in
the instances of cerebral arteriosclerosis, psychoneuroses and alcoholic
psychosis. Male cases indicate increasing percentages in the case of paranoid conditions and also for psychoses with other nervous diseases.
XVIII - YEARLY ADMISSIONS RELATED TO AGE GROUPS
The total first admissions occurring each year from 1931 to 1934
in all eight mental hospitals are shown divided for each year by age
groups, representing the ages of patients on their respective admission
dates. Each of these year's totals of admissions show slight variation
in their distribution over the different age groups and the average age
at admission has remained practically fixed as shown on the bottom line.
The two five year age groups within which the greatest number of admissions occur are those from 35 to 45 years, including therein about 23 per
cent of the total. Prom 15 to 35 years there are included fully one third
of the entire number admitted each year and from 70 years and over, about
one tenth.
In order to cite a definite trend of increase or decrease in any
of the above age groups, this study by years should be extended over a
much longer period. Table XIX contains figures taken from separate
periods several years apart.
38
�Table XVI
YEARLY COMPARISONS OP PSYCHOSES PERCENTAGES OP FIRST ADMISSIONS
Average
1922-1926
Average
1931-1934
1931
1932
1933
1934
19.24
13.56
13.45
9.19
22.14
11.24
10.98
8.93
24.80
11.03
10.09
8.95
20.17
10.92
11.13
8.88
20.50
11.47
11.80
8.68
22.57
11.12
10.81
8.95
Senile
Psychoneuroses and Neuroses
Alcoholic
Paranoia and Paranoid Conditions
7.23
4.50
4.10
4.00
6.48
4.86
3.89
3.20
6.75
3.96
3.73
3.19
5.78
4.85
3.94
3.31
6.43
5.55
3.54
2.74
6.98
4.96
4.20
3.53
With Other Somatic Diseases
Cerebral Syphilis
With Mental Deficiency
With Epilepsy
2.66
2.31
2.18
1.48
2.31
1V76
2.81
1.65
1.78
2.49
2.33
1.34
2.34
1.68
2.11
1.97
2.48
1.47
3.80
1.81
2.83
1.23
2.96
1.38
Psychopathic Personality
Other Nervous Diseases
Involution Melancholia
Drugs and Toxins
1.60
.91
.56
.39
1.72
2.78
.94
.51
1.22
1.85
.94
.59
1.49
3.35
.62
.78
2.20
3.02
.95
.34
1.69
2.87
1.26
.22
Traumatic
With Huntington's Chorea
Brain Tumor
With Pellagra
.21
.21
.13
.03
.31
.27
.07
.00
.23
.27
.00
.00
.30
.30
.00
.00
.13
.22
.08
.00
.61
.22
.09
.00
7.17
4.69
9.06
4.09
8.36
6.10
10.32
5.76
8.17
4.62
8.63
2.89
Psychoses
Dementia Praecox
Manic Depressive
General Paralysis
Cerebral Arteriosclerosis
Without Psychoses
Dndiagnosed Psychoses
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CD in CD in
i^, |^2
co -^ m in
• • • •
in m ^H co
in CD ^* t^
O> H rH (71
CO CD CO CO
•* to in oj
O CO CO O
H •* rH OJ
CO O OJ rH
^H
^H
S
CO
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H CD in m
CD rH CO OJ
a
CD CO O
rH
rH CO t- CO
1
CO S
01 CD
CO fe
H
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H O
roS
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to
at
rH
CD
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40
�Table XVIII
X
1931
P
FIRST ADMISSIONS BY YEARS AS RELATED TO ASE GROUPS
Percentage
Total of total
M
1932
F
Percentage
Total of total
M
1933
F
Percentage
Total of total
11
1934
F
Percentage
Total of total
Under 15 yrs. 35
14
49
1.9
37
19
56
2.1
16
3
19
0.9
4
7
11
0.5
15 - 19
67
38
105
4.2
96
55
151
6.6
60
43
103
4.6
54
33
87
4.1
20-24
114
82
196
7.8
125
91
216
8.1
99
71
170
7.6
113
78
191
9.1
25-29
116
96
212
8.4
112
109
221
8.2
126
90
216
9.6
113
93
206
9.7
30 - 34
170
100
270
10.7
149
118
267
9.9
133
105
238
10.5
123
79
202
9.6
35-39
175
102
277
10.9
153
148
301
11.2
154
115
269
11.8
112
105
217
10.2
40 - 44
179
124
303
12.0
187
136
323
12.1
162
91
253
11.2
142
93
235
11.2
45 - 49
132
112
244
9.7
164
90
254
9.5
147
81
228
10.1
117
97
214
10.2
50 - 54
130
83
213
8.4
122
80
202
7.5
108
75
183
8.2
118
71
189
9.0
55 - 59
93
66
159
6.3
93
63
156
5.8
78
50
128
5.7
72
52
124
5.9
60 - 64
91
56
147
5.8
82
51
133
4.9
59
59
118
5.3
66
53
119
5.6
65 - 69
59
30
89
3.5
70
41
111
4.2
61
41
102
4.4
67
, 31
98
4.6
169
91
260
10.3
171
123
294
10.9
132
89
221
9.8
129
82
211
10.0
Unascertained
0
Totals 1530
0
0
2524
0
100.0
0
1561
0
1124
0
2685
0
100.0
5
1340
1
914
6
2254
.3
100.0
3
1233
3
877
6
994
2110
.3
100.0
44.0
43.4
43.8 years
43.8
44.0
70 & over
Average Age
44.3
43.9
44.1 years
43.9 years
44.6
43.6
44.2 years
1
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�MICHIGAN STATE HOSPITALS
XIX - COMPARISON OF AOE GROUPS OVER DIFFERENT PERIODS
Here are shown at three different periods the admissions to state
mental hospitals divided by ages of patients on their admission date.
That for the year 1912 is taken from the committee report on insane
issued in 1915.
From Dr. Barrett's 1927 report is shown the group of
admissions occurring from 1917 to 1926 and compared with these is the
total of first admissions for the years 1933 and 1934.
It is noted that
the age group from 35 to 40 years is the one containing the largest per
cent of cases in all three of the periods given in the table. The percentage of those admitted in 1912 who were 70 years old and over is considerably less than for the same group in the two later periods.
XX - AOE GROUPS IN RELATION WITH PRINCIPAL PSYCHOSES
The first admissions to all eight mental hospitals during the
years 1933 and 1934 are here shown divided by age groups and also indicating how these same age groups are distributed over eight principal
psychoses.
In the fourth column the total admissions In each age group are
compared with each 100,000 of the same age as shown in Michigan's population by the 1930 census. This clearly indicates the age group, from
which the highest proportion are admitted for mental disorders, is that
of 70 years and over.
As regards the different psychoses and ages on admission, it is
shown that manic depressive and general paralysis are distributed quite
generally over the whole range of age groups. Those diagnosed as dementia praecox are most evident in early adult life with almost fifty per
cent of patients with this psychosis, occurring in 1933 and 1934, being
admitted at not over 30 years of age.
42
�Table XIX
COMPARISON OP ADMISSIONS BY AQE OROUPS IN PERCENTAGES
1912
Male
Female
Total
Male
.7
3.9
8.3
Under 15
15-19
20-24
25-29
.42
.43
4.22
8.65
10.75
4.00
8.13
11.05
.42
4.12
8.42
10.89
10.3
30 - 34
35-39
40-44
45-49
10.44
10.87
10.30
8.85
12.28
11.97
10.95
10.87
11.26
11.36
10.59
9.48
12.2
12.6
9.8
8.2
1917 to 1926
Female
Total
Male
2 yrs. 1933-1934
.7
3,9
7.0
10.6
.7
3.9
7.7
10.4
.8
4.4
8.3
9.2
12.2
12.4
12.8
18.5
10.0
10.4
10.5
10.1
11.4
10.8
9.7
8.8
Female
.5
4.2
8.1
10.2 •
10.3
12.1
10.1
9.9
Total
.7
4.3
8.2
9.7
10.2
11.8
11.1
10.1
H3
rt
H
g
H
H3
f
w0
02
50-54
55-59
60 - 64
13.99
65 - 69
9.70
8.77
9.28*
70 and over
Unascertained
8.5
3.3
6.53
2.36
7.63
2.99
# 10 year periods
13.24
13.66#
7.8
6.4
5.6
5.4
4.6
5.9
4.7
3.5
10.4
1.5
9.6
1.2
7.0
5.7
5.1
4.3
9.2
6.0
4.4
5.1
7.8
5.1
6.3
2.1
8.7
5.7
5.8
4.7
10.1
9.7
.3
9.3
9.6
•2
.8
1.4
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�STATE MENTAL HOSPITALS
XXI - ADMISSIONS BY COUNTRIES OF BIRTH AND PARENTAQE
The total first admissions for the four year period, 1931-1934,
with relation to psychoses, are here shown divided according to the birth
and parentage of the patient. Outside of those connected with United
States and Canada, patients born in, or having parents born in, Poland
and Germany make up about one third of the balance. The figures given
on the bottom line of the table indicate the average proportionate number admitted yearly in relation to each 100,000 persons of that particular country in the state's population by the 1930 census. Austria, Hungary and Ireland show proportionately high admission rates, almost double
the average rate. England and Scotland have rates near or below the
average, while Holland is the lowest of the group. As compared with a
similar compilation, shown by Table XII for current resident population,
almost the same countries appear as above or below the average in a varying ratio.
XXII -PSYCHOSES PERCENTAGES BY COUNTRIES OF PARENTAGE
This table shows the relative frequency with which the principal
psychoses occur in the first admissions, as divided between the important
countries noted in the preceding tabulation. Italy, Austria, Poland,
Russia and the Slavic countries have the highest percentages for dementia
praecox, with England, Ireland and Scotland the lowest for this disorder.
Finland is shown to be far ahead with manic depressive psychosis. England,
Ireland and Scotland lead in cerebral arteriosclerosis and senile psychoses
and Ireland, Austria, Poland and Slavic countries have the largest percentage in alcoholic psychosis.
XXIII - PSYCHOSES OF FIRST ADMISSIONS AS DIVIDED BY NATIVITY
In this table the first admissions for the four year period, 19311935, are divided between native and foreign born, showing a trifle over
74 per cent of them to be native born. Of these native born 52 per cent
have both parents who are also native born. Both the native and foreign
born are each divided according to psychoses and in the last two columns
are given the percentages of total cases for each psychosis for both native and foreign born groups. This shows dementia praeoox cases to be
relatively more numerous with the native born, while senility, arteriosclerosis and manic depressive are among the type of cases proportionately higher in number among the foreign born. With reference to general
paralysis and dementia praecox, there is a much smaller proportion of female cases shown as applying to the foreign born.
45
�9
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�Table XXI
continued:
PSYCHOSES OF FIRST ADMISSIONS 1931-1934 DIVIDED BY COUNTRIES OF BIRTH AND PARENTAGE
Hungary
M
P
Traumatic
Senile
Cerebral Arteriosclerosis
General Paralysis
4
2
10
2
1
2
Ireland
M
F
19
21
18
24
19
6
Italy
M
F
5
2
18
1
1
4
3
5
1
1
50
1
6
23
5
6
14
44
5
1
2
17
2
9
1
2
3
21
1
140
6
78
38
2
24
2
22
7
8
9
3
12
1
2
2
4
2
7
3
2
6
9
10
20
63
16
8
20
3
3
5
11
2
3
2
3
3
1
1
4
66 452
247
117
85
63
5
16
4
12
15
1
14
Involution Melancholia
Dementia Praeeox
Paranoia & Paranoid
conditions
With Epilepsy
Psyehoneuroses
With Psychopathic Personal'
7—
With Mental Deficiency
TJndlagnoaed Psychoses
Without Psychoses
0
19
3
17
1
23
2
11
39
19
1
0
3
3
8
4
2
6
3
5
5
1
5
5
3
1
1
6
4
1
1
3
5
1
2
3
3
2
5
16
13
64 161
105
124
2
18
1
5
5
12
23
7
3
1
14
5
0
2
11
3
10
9
10
4
Alcoholic
Drugs and Toxins
Other Somatic Diseases
Manic Depressive
2
Sweden &
Norway
M
F
4
6
20
4
4
2
1
Scotland
M
F
8
3
8
3
0
0
4
1
Russia
M
F
14
15
38
Cerebral Syphilis
Huntlngton's Chorea
Brain Tumor
Other Nervous Diseases
3
Poland
M
F
1
4
1
1
3
7
4
1
5 94 108
6 219 117
1 339 121
1
2
1
1
6
United
States
M
F
42
10
1
72
Others
M
F
Unknown
M
F
10
14
53
11
4
9
2
27
89
55
9
3
12
32
39
21
21
3
2
37
1
10
4
19
8
17
2
5
19
2
1
5
34
11
1
3
3
9
24
9
22
1
40
3
70
61
2
49
61 52
51 27
82 147
8
4
12
7
4
9
9
2
9
6
5
18
1
2
3
13
9
17
19
39
5
11
17
18
7
2
6
4
11
1
7
2 111
21
1
7 16
1 43 45
23 149 204
9
4
1
36
4
3 28
25 459 388
4
1
4
4
2
4
5
1
5
1
2
5
1
4
7
7
55
19
72 43
3 73 80
2 237 123
5
5
10
21
50 121
88 2187 1603
275
32
Total
8
80
3
6
153 419 275
1-3
32
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49
�MICHIGAN STATE HOSPITALS
XXIV - PSYCHOSES OP FIRST ADMISSIONS DIVIDED BY RACES
T&e total first admissions for the four year period, 1931 to
1954, are here again divided by psychoses shown in relation with the
different races, which classification agrees with the Dictionary of
Races in use by the Federal Immigration Commission.
In percentage of total cases the African group has a high
figure of 19.8 per cent for general paralysis and 26.5 per cent for
dementia praecox. Out of 106 cases among Hebrews 30 per cent are
listed as dementia praecox. Those listed under the Irish race indicate a relatively high percentage for senile dementia of 14.6 per
cent. With the Italian and the Magyar, manic depressive psychosis
is proportionately high with percentages of 16.5 and 17 respectively
of total cases admitted. For the English race there ia a comparative
low of 15.7 per cent for cases of dementia praecox, while with the
Italian 28.5 per cent of total admissions were reported as this psychosis.
XXV - READMISSIONS
1931-1934
The total readmissions received in all hospitals during the
four year period ending December 31, 1934, are here shown by institutions and in relation with the types of psychoses. Newberry and
Pontiac show the highest proportion of readmissions, with one fifth
and one quarter respectively of all their admissions being of this
type. In relation to sex, females show a higher proportion for readmissions than for first admissions. The proportions are 48 per
cent of the total readmissiona and 41 per cent of the total first admissions during the last four year period.
50
�FIRST ADMISSIONS BY RACE AND PSYCHOSES - 4 YEAR PERIOD 1931-1934
Table XXIV
Total
African
(black)
M
F
American
Indian
F
M
M
F
T
Senile
Cerebral Arterioscleroses8
General Paralysis
Other Nervous Diseases
300
590
819
167
320
280
232
99
620
870
1051
266
17
16
92
9
29
10
41
6
3
1
0
Alcoholic
331
96
436
18
42
125
639
72
373
221
1075
90
27
12
13
10
12
24
1
0
Other Somatic Diseases
Manic Depressive
Involution Melancholia
Hebrew
Irish
M
F
M
F
M
F
M
F
56
45
117
11
60
21
28
11
35
53
72
13
43
27
20
12
0
6
1
4
0
1
33
25
36
7
34
16
8
5
40
9
46
1
1
5
79
2
30
6
50
2
0
11
63
13
6
2
15
1
29
4
21
2
4
3
25
3
31
11
7
6
30
7
4
10
74
10
5
26
100
11
10
19
79
14
19
27
3
17
4
1
6
2
10
18
13
9
10
27
86
8
7
23
49
11
18
47
53
3
9
24
34
2
1
2
6
2
1
6
4
5
15
31
1
2
8
16
254
590
409
530
379
46
60
267
176
918
146
57
288
2114
307
158
465
117
10
10
2
64
7
3
5
.allty 122
160
389
576
42
109
275
290
164
269
617
866
15
12
32
26
6639
3934
9573
410
Total
1
German
85
14
14
20
Dementia Praecox
1196
Paranoia & Paranoid con itlon 161
101
With Epilepsy
Psychoneuroses
177
With Mental Deficiency
All Other Psychoses
Without Psychoses
1
1
English
1
1
1
1
H
-;
K
1
1-3
^
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o
co
5
t-3
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f
Ul
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g
3
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g
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t
c
fo
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h
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H to CM
MICHIGAN STATE HOSPITALS
OS Ol •* O
to rH
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10
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52
�Table XXV
READMISSIONS - 1931-1934 - BY PSYCHOSES
Elolse
M
M
Traumatic
Senile
Cerebral Arterioscleroses
General Paralysis
Cerebral Syphilis
Huntlngton's Chorea
Brain Tumor
Other Nervous Diseases
Alcoholic
Drugs and Toxins
Other Somatic Diseases
Manic Depressive
2
4
11
FF
Ionia
Kalamazoo
Kalamazoo
M
PF
M
FF
M
M
6
2
5
1
1
2
2
1
1
10
9
2
5
1
3
1
2
2
9
2
1
Pontlao
M
M
FF
1
1
3
Psychopathie
M
F
2
1
4
12
1
1
2
1
Traverse
City
Ypsllantl
M
P
P
M
1
1
1
2
1
1
6
5
M
Total
F
T
1
3
1
5
9
25
51
1
3
12
16
6
17
37
67
1
7
4
1
11
1
15
1 5
9
2 4
24
1
4
2
9
3
o
3
34
8
o
67
1 11
Involution Melancholia
Dementia Praeeox
57
38
Paranoia & Paranoid condition
>
>
tlon 4
4
4
2
With Epilepsy
2
Psychoneuroses
llty 6
6
With Psychopathic Personality
1
With Mental Deficiency
Undlagnosed Psychoses
5
15
Without Psychoses
Total
Newberry
M
M
PF
164
1
1
3
3
1
10
2
1
j.
51
47
35
28
63
63
' 4'
3
60
36
22
>2 • *3 • 3'
3
1
1
7
1
5
11
11
1
2
1
1
12
4
2
2
2
5
13
21
5
7
602
158
95
76
2
2
11
- 4•
2
3
2
4
21
1
7
5
1
4
170
45
1
1
2
2
2
2
• 1>
1
3
4
1
24
1
3
1 1 1
1
6
6
7
1
50
1
j.
40
36
1 11 2 2
6
27
29
6
*
•=
*
3
5
3
2
2
1
35
i
1
2
2
44
66
53 254 225 479
"2 " • 25
=
•12
" > > "47
>
2
11
14
25
1
2
e
31
1
j.
10
1
±
6
6
18
"
2
2
15
15
"
4
7
»
2
3
3
1
4
5
9
5
4
1
5
71
81
8
1
5
1
1
±
28
33
11
§
ra
38
6
44
3
2
5
7Y J 11. J 18
. J . B M
217 272 489
O
2
2
4
3
4
8
9
7
4
3
5
9
1
5
4
4
5
5
2
14
3
21
28
25
34
71
26
39
120
116
128
130
851
45
14
21
41
52
66
42
46
75
123
777 1628
^
f>
^
�MICHIGAN STATE HOSPITALS
XXVI - READMISSIONS BY PERCENTAGES
The readmissiona for four years in all hospitals are here
shown in relation with the different psychoses by percentages, as
well as with relation to each 100 first admissions having a similar
diagnosis during the same period. Almost 60 per cent of these readmissions were either cases of manic depressive or of dementia
praecox. As related to first admissions, there were 46.8 cases of
manic depressive readmitted to every 100 cases admitted for the
first time. With psychopathic personality there were 37.5 cases readmitted for every 100 first admissions. Dementia praecox cases
show almost one quarter as many readmitted as are first admitted.
XXVII - READMISSION AGE GROUPS WITH PRINCIPAL PSYCHOSES
The readmlssions entering all mental hospitals during the
four year period from 1931 to 1934 inclusive, are here tabulated to
age groups and principal psychoses the same as are first admissions
in Table XX.
As compared with first admissions there is evident a much
smaller proportion of readmissions in the age groups for both the
younger ones up to 20 years old and the aged patients of 65 and over.
Among the principal psychoses, dementia praecox indicates a
larger proportion of readmissions of patients with that disorder who
are from 30 to 50 years of age than occurs in the case of first admissions.
54
�1931-1934 READMISSION PERCENTAGES IH RELATION WITH FIRST ADMISSIONS
Table XXVI
Total First
Admissions
Traumatic
Senile
Cerebral Arteriosclerosis
General Paralysis
30
620
870
1051
Cerebral Syphilis
Huntington's Chorea
Brain Tumor
Other Nervous Diseases
169
Alcoholic
Drugs and Toxins
Other Somatic Diseases
Manic Depressive
373
26
7
266
Total Readmissions
Per Cent
of total
Per 100 First
Admissions
6
17
37
67
0.3
1.1
2.2
4.2
11
1
.7
6.7
24
1.5
9.8
44
5
18
489
2.7
0.3
1.0
20.0
2.9
4.3
6.6
GO
1-3
K
Involution Melancholia
Dementia Praecox
Paranoia & Paranoid conditions
With Epilepsy Psychoses
Psychoneuros es
With Psychopathic Personality
With Mental Deficiency
Undiagnosed Psychoses
Without Psychoses
Total
48
221
1075
307
158
6
479
47
25
465
164
269
384
866
65
43
46
75
123
9573
1628
90
2114
29.8
0.3
29.6
11.8
10.9
8.4
46.0
6.9
2.9
1.6
23.2
15.8
16.7
4.0
2.6
2.9
4.6
7.7
14.4
26.2
17.9
19.8
14.3
100.0
17.3
•z
w
O
03
hj
�MICHIGAN STATE HOSPITALS
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�Table XXVII continued
General Paralysis
Cerebral Arteriosclerosis
Alcoholic
Psychoneuroses
Paranoia and
Paranoid Condition
F
Under 15
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
5
.
2
2
0
1
8
10
8
9
2
1
0
4
6
1
4
1
6
1
1
4
7
8
1
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4
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53
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2
2
1
1
1
3
2
3
2
5
9
4
11
3
2
2
3
1
3
2
2
1
4
1
0
2
2
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1
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4
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1
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2
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2
0
0
0
2
22
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25
22
a
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50
55
60
65
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54
59
64
69
51
0
7
4
9
4
2
1
4
0
0
0
0
11
6
2
0
85
12
38
1
1
0
70 & over
Unknown
Total
1
16
4
os
�MICHIGAN STATE HOSPITALS
TOTAL ADMISSIONS BY COUNTIES
Total admissions, including readmissiona as well as first admissions, for the four year period from 1931 to 1934 inclusive are divided in this table according to counties from which received. The
average yearly total of admissions is shown for each county in the
third column and the number of admissions occurring annually proportionate to each 100,000 persons resident in the county by the 1930
census, is given in the fourth column. The counties of the state are
considered in four main groups, divided geographically over the state.
These conform with a similar grouping of counties appearing in the
1927 Barrett report, in which figures were given on admissions from
counties during 1915, 1920 and 1925. A comparison with this latter
report indicates that in the last four years there has been a marked
falling off in annual admissions from the most of the counties. Wayne
and Jackson counties are important exceptions.
Table XXVIII -
Counties
1931-1934 TOTAL ADMISSIONS BY COUNTIES
1930 County
Population
Admissions
Average
Rate Per
100,000
Population
Genesee
Huron
Lapeer
Livingston
211,641
31,132
28,348
19,274
249
43
41
43
61.5
10.7
10.2
10.7
29.1
34.3
36.1
55.4
Macomb
Monroe
Oakland
Sanilac
77,146
52,485
211,251
27,751
91
99
288
52
22.7
24.8
72.0
13.0
29.4
47.3
34.1
46.8
Shiawassee
St. Clair
Tuscola
Washtenaw
Wayne
39,517
67,563
32,934
65,530
1,888,946
63
112
51
236
4,643
15.7
28.0
12.7
59.0
1160.7
39.7
41.4
38.7
90.2
61.5
Total
2,753,517
6,011
1502.7
54.7
58
�STATE MENTAL HOSPITALS
Table XXVIII oont.
Counties
Alger
Baraga
Chippewa
Delta
Dickinson
Gogebio
Bought on
Iron
Keweenaw
Luce
Maokinac
Marquette
Menominee
Ontonagon
Schoolcraft
Total
TOTAL ADMISSIONS BY COUNTIES
1930 County
Population
9,327
9,168
25,047
32,280
29,941
31,577
52,851
20,805
5,076
6,528
8,783
44,076
23,652
11,114
8.451
318,676
Total
Admissions
55
18
87
106
48
74
151
47
26
31
23
104
61
28
31
890
Yearly
Average
13.7
4.5
21.7
26.5
12.0
18.5
37.7
11.8
6.5
7.7
5.7
26.0
15.2
7.0
7.7
222.5
Rate Per
100,000
Population
137.0
49.0
86.6
82.0
40.2
58.7
71.4
56.7
127.7
117.9
64.9
59.0
64.5
63.0
91.1
69.8
TOTAL ADMISSIONS BY COUNTIES
Counties
Allegan
Barry
Berrien
Branch
Calhoun
;Cass
Eaton
Hillsdale
Ingham
Jackson
Kalamazoo
Kent
Lenawee
Ottawa
St. Joseph
Van Bur en
Total
1930 County
Population
38,974
20,928
81,066
23,950
87,043
20,888
31,778
27,417
116,587
92,304
91,368
240,511
49,849
54,858
30,618
32,637
1,040,776
Total
Admissions
69
49
188
49
180
49
61
79
261
279
315
647
119
63
69
115
2592
59
Yearly
Average
17.2
12.2
47.0
12.2
45.0
12.2
15.2
19.8
65.2
69.7
78.7
161.7
29.7
15.7
17.2
28.7
648.0
Rate Per
100,000
Population
44.2
58.3
57.8
51.1
51.7
58.2
47.8
72.2
56.2
75.6
86.2
67.2
59.5
28.7
56.3
88.0
62.2
�MICHIGAN STATE HOSPITALS
Counties
1930 County
Population
Alcona
Alpena
Antrim
Arenac
Bay
Benzie
Charlevolx
Cheboygan
Clinton
Clare
Crawford
Burnett
Gladwln
Gd. Traverse
Gratiot
Ionia
losoo
Isabella
Kalkaska
Lake
Leelanau
Manistee
Mason
Mecosta
Midland
Missaukee
Mont calm
Montmorenoy
Muskegon
Newaygo
Oceana
Ogemaw
Osceola
Osooda
Otsego
Presque Isle
Ros common
Saglnaw
Wexford
Total
4,989
18,574
9,979
8,007
69,474
6,687
11,981
11,502
24,174
7,032
3,097
15,109
7,424
20,011
30,252
35,093
7,517
21,126
3,799
4,066
8,206
17,409
18,576
15,738
19,150
6,992
27,471
2,814
84,930
17,029
13,805
6,595
12,806
1,728
5,554
11,330
2,055
120,717
16,827
729,525
Non-residents
Total for State
Total
Admissions
Yearly
Average
Rate Per
100,000
Population
9
42
24
16
148
17
29
35
40
16
5
37
23
84
48
53
14
40
17
11
35
65
47
38
45
4
47
6
156
31
41
2.2
10.5
6.0
4.0
37.0
4.2
7.2
8.7
10.0
4.0
1.2
9.2
5.7
21.0
12.0
13.2
3.5
10.0
4.2
2.7
8.7
16.2
11.7
9.5
11.2
1.0
11.7
1.5
39.0
7.7
10.2
5.0
4.7
1.5
1.2
5.7
2.0
50.0
14.0
44.2
56.5
60.3
49.8
53.2
63.7
60.1
75.6
41.3
56.8
33.0
60.9
76.9
104.8
39.6
37.6
46.6
47.3
110.8
66.5
105.8
92.9
63.0
60.3
58.6
16.0
42.5
53.3
46.0
45.3
73.7
75.8
36.5
86.7
21.6
50.3
97.2
41.3
85.5
20
19
6
5
23
8
200
56
1560
390.0
177
11230
2807.5
60
53.6
�DEATHS AND DEATH RATES BY INSTITUTIONS
The total number of deaths occurring each year among patients in residence at each of the eight mental
hospitals is given in this table. These separate totals are compared with the total number of patients under
treatment during the year in each case and in the last four columns are given the resulting death rates in
proportion to each 1000 patients under treatment. The number of patients under treatment is made up of the
total number in residence at the beginning of the year plus all those admitted during the 12 months following*
Table XXIX
-
DEATH RATES IN HOSPITALS BY INSTITUTIONS 1931-1954
in
Total Deaths Per Year
1931
1932
1933
1934
Kalamazoo
Pontiao
Traverse City
Total Patients Under Treatment
1933
1934
1931
1932
Per 1,000 Under Treatment
1931
1932
1933
1934
229
270
182
180
3190
3282
3199
3175
71.7
82.2
56.9
56.7
84
77
80
85
1930
1917
1900
1905
43.5
40.2
42.0
44.6
130
181
158
147
2452
2601
2665
2686
53.2
69.2
59.2
55.0
1-3
>
H
H
g
H
te!
f
a
0
02
Newberry
91
82
72
108
1356
1342
1367
1452
67.2
61.2
52.6
74.2
n
Ionia
24
28
32
22
742
789
892
916
32.3
35.6
35.8
24.0
00
Ypsilanti
32
76
100
93
930
1492
1872
1819
34.4
50.8
53.3
51.2
1
3
2
3
303
348
295
203
3.3
8.6
6.8
14.7
166
216
198
208
2864
3163
3171
3597
57.8
68.1
62.4
57.9
757
933
824
846
13767
14934
15406
15753
55.0
62.5
53.4
53.6
Psychopathic
Eloise
Totals
�TOTAL DISCHARGES AND RATES OP DISCHARGE BY INSTITUTIONS
Here are noted the total number of patients discharged each year by each institution. These totals
include patients discharged outright from each institution, those taken from the books due to a continued absence on parole for over a year without reinstatement and those deported to another state or country. Also
Included are patients transferred to a different type of institution within the state, but all cases of shifting or transferring of patients from one mental hospital to another within the state hospital group are entirely separate from these discharge totals. As with the preceding table, these totals are compared with
totals under treatment and the corresponding rates of discharge given in the last four columns.
As noted in previous description of institutions, the Psychopathic Hospital has a large proportion of
patients on observation commitments who are discharged after a short stay at the hospital. This accounts for
the high ratio of discharge from that institution. Considering the remaining seven institutions only, their
combined rate of discharge for 1934 would be 75.4 per thousand under treatment. Adding this figure to the
combined death rate of 53.6 per thousand would give a total of 129 patients who have died or were discharged
for each thousand patients under treatment during 1934.
'
.
Table XXX
-
DISCHARGES BY INSTITUTIONS 1931-1934
Total Discharges Per Year
1931
1933
1934
1932
Kalamazoo
3175
1905
2686
1452
77.8
46.6
35.9
73.1
87.1
45.8
44.2
70.7
87.5
30.5
39.5
62.2
91.8
35.2
55.9
75.6
£
916
16.5
46.2
516.0
99.8
42.6
90.2
528.0
90.2
51.3
103.6
665.0
80.6
77.8
76.3
83.0
246
90
88
99
286
88
115
95
280
58
105
85
292
67
150
110
3190
1930
2452
1356
3282
1917
2601
1342
Ionia
Ypsilanti
Psychopathic
Eloise
11
13
172
316
13
69
180
316
38
169
156
286
47
189
135
319
742
930
1492
. 303
2864
3163
3171
3597
14.8
13.9
568.0
110.2
14934
15406
15753
75.2
Totals,
1035
1162
1177
1309
13767
348
892
1872
295
i
Ho
Pontiae
Traverse City
Newberry
789
X
Discharges Per 1000
Under Treatment
1933
1931
1932
1934
Total Patients Under Treatment
1932
1933
1934
1931
3199
1900
2665
1367
Q
1819
203
00
>
�STATE MENTAL HOSPITALS
XXXI - DEATHS BY INSTITUTIONS AND BY PSYCHOSES
The total deaths occurring during the four years ending December 31, 1934, among all patients on the books of each of the eight
mental hospitals are here tabulated according to the various psychoses
assigned to the different cases after diagnosis. About half of these
deaths are among patients having one of the three psychoses, general
paralysis, cerebral arteriosclerosis and senility. Sixty-three per
cent of the total who died were male patients.
XXXII - DEATH PERCENTAGES BY PSYCHOSES
Of the total deaths during the 1931-1934 period, the percentage
shown as applying to each psychoses is here indicated. These results
are compared with a similar study made in Dr. Barrett's report in 1927
over a five year period from 1922 to 1926 inclusive.
Those types of psychoses which indicate recently either an increase or a reduction in the percentage of deaths over ten years ago
in most cases similarly show a relative increase or reduction in the
percentage of first admissions, as between the same periods. Such
variations in admission percentages are given in Table XVI.
The important exception to this rule is in the case of cerebral
arteriosclerosis which shows a marked increase in percentage of deaths,
while having a small decrease in proportion of first admissions.
General paralysis has a decided decrease in the relative number of
deaths in the later period, although the decrease in admissions during the same interval has been relatively small.
63
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�MICHIGAN STATE HOSPITALS
XXXIII- CAUSES OP DEATH IN RELATION WITH PRINCIPAL PSYCHOSES
The causes of the total deaths occurring in the two years of
1933 and 1934 among mental patients on the books of all eight hospitals
are here given in relation with the principal psychoses. These death
causes conform to the International List of causes of death issued by
the Bureau of the Census in 1931.
Diseases of the heart and circulatory system account for a third of these, while cerebral hemorrhage,
general paralysis and other nervous diseases claim about another fourth
of the total. With dementia praecox, fifty one per cent of deaths are
indicated as from tuberculosis and heart disease. Deaths of manic depressive patients were led by heart disease with over 20 per cent of
the total. With general paralysis over 80 per cent of the death causes
were directly related to their disorder.
XXXIV - DEATH RATES RELATED TO PSYCHOSES
The total deaths reported by all hospitals among resident patients during 1934 are shown in this table divided as to psychoses and
compared with the total number of patients under treatment for each
type of psychosis during the same year. This number under treatment
consists of the number in residence at the beginning of the year plus
those admitted during the year.
The last three columns give the compiled death rates for each
psychosis with no calculation made for less than forty cases as a base.
The high death rates are noted for senile dementia, cerebral arteriosclerosis and also for other somatic disease cases. Among male patients
the death rate is proportionately much higher in cases of senile dementia and with other somatic diseases.
66
�STATE MENTAL HOSPITALS
Table XXXIII
CAUSES OP DEATH IN RELATION WITH PRINCIPAL PSYCHOSES - 1933 - 1934
Cerebral
ArterloSenile
M
P
Tuberculosis of Respiratory System
Tuberculosis of Other Organs
ise
Other Infectious or Parasitic Disease
Cancer and other Malignant Tumors
Other General Diseases
Diseases of blood & blood making organs]
1
Chronic Poisonings & Intoxications
25
Cerebral Hemorrhage
General Paralysis of Insane
1
Other Nervous Diseases
Pericarditis
Endocarditis & Myocarditis
Angina Pectoris
Other Diseases of the Heart
30
2
Arterioscleroses
17
3
Gangrene
Other Diseases of Arteries
7
im
Other Diseases of Circulatory system
Bronchitis
Bronchopneumonia
Lob arpneumoni a
>m
Other Diseases of Respiratory system
Total
2
1
5
3
1
3
3
1
3
2
4
1
4
5
1
2
1
35
0
3
17
30
1
2
55
2
34
1
1
11
74
2
24
9
3
3
1
10
3
42
108
31
3
29
9
4
3
5
1
8
3
3
1
1
1
12
8
2
1
Cirrhosis of the Liver
Other Diseases of the Digestive sys.
•
Nephritis
Diseases of the Bladder
Suicide
Accidental Traumatism
Other External Causes
Cause Unknown or Ill-defined
1
9
5
4
5
1
1
1
Ulcer of the Stomach & Duodenum
Diarrhea and Entritis
Appendicitis
Hernia and Intestinal Obstruction
Other Non-venereal diseases of the
Genitourinary system
Diseases of Skin & Cellular Tissue
Diseases of the Bones
Senility
8
4
General
sclerosis Paralysis Alcoholic
M
P
M
P
M
P
1
1
2
1
2
32
1
1
1
1
1
1
2
1
1
16
2
3
3
2
7
120
118
218
67
1
1
1
3
106
2
9
3
3
219
48
37
4
�MICHIGAN STATE HOSPITALS
Table XXXIII oont.
CAUSES OP DEATH IN RELATION WITH PRINCIPAL PSYCHOSES - 1933 - 1934
Manic Depressive
M
F
Tuberculosis of Respiratory systemi
5
Tuberculosis of Other Organs
Other Infectious or Parasitic disease
;ase
Cancer and other Malignant Tumors
Other General Diseases
Diseases of blood and blood making
organs
1
Chronic Poisonings & Intoxicationsi
1
Cerebral Hemorrhage
9
General Paralysis of Insane
Other Nervous Diseases
7
Pericarditis
Endocarditis & Myocarditis
Angina Pectoris
Other Diseases of the Heart
Arterioscleroses
Gangrene
Other Diseases of Arteries
Other Diseases of Circulatory
11
4
4
3
41
1
1
9
5
3
1
1
3
1
5
14
10
3
4
7
2
2
30
25
9
1
4
1
7
1
3
4
1
1
5
2
Cirrhosis of the Liver
Other Diseases of Digestive system
Nephritis
Diseases of the Bladder
Other Non-venereal diseases of the
Genitourinary system
Diseases of Skin & Cellular Tissue
Diseases of the Bones
Senility
3
1
13
4
1
11
1
1
6
3
10
2
5
1
5
1
2
1
3
3
5
2
sys.
Ulcer of the Stomach & Duodenum
Diarrhea and Entritis
Appendicitis
Hernia & Intestinal Obstruction
36
4
1
Bronchitis
Bronchopneumonia
Lobarpneumonia
Other Diseases of Respiratory sys.
Suicide
Accidental Traumatism
Other External Causes
Cause Unknown or Ill-defined
Involution
MelanDementia
Paranoid
oholia
Praecox Conditions
M
P
M
F_
M _...._.?_.
6
5
1
4
5
1
1
1
8
8
3
7
3
4
1
1
1
2
1
1
2
6
4
1
2
2
1
1
1
1
1
1
2
1
4
2
1
2
65
5
1
2
1
2
70
1
1
1
1
1
1
6
3
5
1
8 159 129
39
1 - Includes Group "Without Psychoses'
1
1
32
�STATE MENTAL HOSPITALS
Table XXXIII cent.
CAUSES OP DEATH IN RELATION WITH PRINCIPAL PSYCHOSES - 1933 - 1934
With
Epilepsy
M
P
Psychoneuroses
M
F
3
2
14
1
2
1
12
7
7
3
1
8
11
1
1
All Other (1)
Psychoses
M
F
M
1
1
2
With
Mental
Deficiency
M
P
2
1
1
6
1
2
1
3
2
1
1
1
15
1
6
3
4
75
4
25
21
8
79
2
17
2
6
4
153
109
82
6
58
29
40
12
4
211
138
122
1
191
5
9
2
144
6
7
3
335
11
16
3
1
1
1
35
2
2
1
25
5
7
1
120
7
8
2
58
3
3
4
178
10
11
6
3
5
47
49
9
32
32
4
79
81
15
10
5
3
15
7
10
1
9
1
10
2
1
1
1
1
1
1
2
1
2
7
5
1
8
1
1
2
3
10
9
1
5
8
4
15
17
3
4
1
17
1
1
32
4
4
2
49
16
5
6
41
1069
10
3
6
18
656
26
8
12
50
1725
1
1
1
1
3
1
13
1
19
1
9
1
8
18
12
23
8
154
6
42
14
16
7
1
1
T
19
1
21
1
1
Total
P
6
1
1
9
167
3
1
2
102
�Table XXXIV - 1934 DEATH RATES IN RELATION WITH TYPES OF PSYCHOSES
Patients Under Treatment
Male
Female
Total
Traumatic
Senile
Cerebral Arterioscleroses
General Paralysis
28
240
416
863
17
337
216
262
45
577
632
Cerebral Syphilis
Huntington's Chorea
Brain Tumor
Other Nervous Diseases
171
21
4
183
91
19
3
93
Alcoholic
Drugs and Toxins
Other Somatic Diseases
Manic Depressive
437
16
70
676
Involution Melancholia
Dementia Praecox
Paranoia & Paranoid conditions
With Epilepsy
Psychoneuroses and Neuroses
With Psychopathic Personality
With Mental Deficiency
Undiagnosed Psychoses
Without Psychoses
Total
Deaths For Year
Female
Total
3
62
104
99
1
59
53
25
4
121
157
124
262
40
7
276
12
2
1
18
4
3
46
17
91
483
33
161
1084
1760
1125
Male
Deaths Per 1000 Under Treatment
Male
Female
Total
258.0
250.0
114.8
175.0
245.0
95.5
87.2
210.0
249.2
110.2
70.2
44.0
61.1
135.0
7
16
5
1
25
98.4
75.2
90.5
18
1
14
27
1
2
12
33
19
3
26
60
41.2
21.7
200.0
40.0
132.0
30.4
39.3
91.0
161.5
34.1
5
72
20
11
5
148
42
21
21.4
55.8
65.4
67.5
23.5
42.8
122.2
41.6
22.4
48.8
86.6
3
3
21.6
17.5
20.7
50.6
29.7
15.2
39.0
17.3
34.3
28.9
17.9
24.0
19.2
44.0
29.4
58.3
47.9
53.6
0
46
74
120
3561
3060
6621
394
153
467
90
861
243
0
76
22
10
139
172
341
257
607
197
77
231
175
311
336
249
572
432
918
3
3
7
13
18
4
6
19
6
6
11
19
27
8795
6958
15753
513
333
846
o
ffl
Hi
H
w
O
OS
F
GO
�STATE MENTAL HOSPITALS
XXXV - AVERAGE AGE AND HOSPITAL LIFE
The total deaths occurring among all hospital patients on the
books for the four year period, together with the average hospital
life in each case and the average age at death, all divided according
to psychosis are listed in this table. Dementia Praecox and Paranoid
Conditions show the longest average life period with Senility and
General Paralysis among the shortest in length of life. In comparison
with the 1927 report on Michigan mental hospitals, the average life
for Dementia Praecox has lengthened from 11.8 years to 17.8 years,
while the general average has increased from 4.5 years to 6.6 years.
XXXVI - TOTAL DISCHARGES BY INSTITUTIONS AND PSYCHOSIS
This table covers all discharges for four years and gives the
number of patients under the different psychosis discharged by each
institution. These discharges are made up of different types as described under Table XXX. The psychosis showing the highest percentage
of discharges is that of Manic Depressive with an average of 20 per
cent, with Dementia Praecox next with 19 per cent. Hewberry shows onethird of its total discharges as Manic Depressives and 22 per cent of
Ypsilanti's total was discharged as Dementia Praecox. Cases diagnosed
as Cerebral Arteriosclerosis made up over 6 per cent of Kalamazoo discharges, while the total average for this psychosis was 2.8 per cent.
XXXVII - DISCHARGES - RATES OP RECOVERY
The total discharges for the four year period are shown as to
those recovered, improved and unimproved and in relation with the different psychoses. The rate of recovery, etc., per 100 admissions of
the specific psychosis during the same period has been determined in
each case and listed in this table. No calculations were made where
the number admitted was less than 25.
In the case of patients who are discharged after a period of a
year on parole, their condition on discharge will be determined in
different ways. When possible it may be ascertained by the visit of
a social worker or the patient visiting a clinic. If this cannot be
done at the end of the years absence, the condition of the patient at
the time of leaving the hospital is noted to specify condition on discharge.
71
�Table XXXV- AVERAGE AQE AT DEATH AND YEARS OP HOSPITAL LIFE 1931-1934
Psychoses
Average Length of Hospital Life
Total Deaths in Period
Male
Female
Total
Average Age at Death
M
F
T
Yrs.
Mos.
Yrs.
Mos.
Yrs.
Mos.
H
F
T
Traumatic
4
232
486
401
6
230
207
84
10
462
693
485
3
1
2
2
2
10
7
4
1
2
2
2
7
11
Cerebral Syphilis
Huntington's Chorea
Brain Timor
Other Hervous Diseases
58
18
2
62
18
6
1
28
76
24
3
90
4
4
0
2
2
3
4
8
4
6
0
2
Alcoholic
Drugs and Toxins
Other Somatic Diseases
Manic Depressive
72
4
45
119
7
4
61
139
79
8
106
258
7
22
2
4
11
11
3
18
11
2
9
8
1
10
Involution Melancholia
Dementia Praecox
Paranoia 8c Paranoid condition
n
Epileptic Psychoses
7
348
28
19
257
69
27
26
605
145
55
16
4
11
11
9
6
6
18
16
6
7
3
4
11
6
6
10
3
11
9
1
6
11
7
6
8
10
1
11
6
5
7
Senile
Cerebral Arterioscleroses
Oeneral Paralysis
2
4
2
2
2
2
6
6
6
4
57
77
70
49
78
76
72
45
65
77
70
48
7
4
S
4
4
0
2
9
55
52
24
49
58
52
24
48
55
52
24
49
9
14
2
8
10
5
65
56
52
58
59
63
54
58
3
5
8
58
70
55
58
7
66
50
65
47
55
54
66
52
58
52
66
49
a
ra
16
5
8
6
7
5
3
10
6
11
2
6
7
10
3
11
6
1
6
3
6
46
49
48
56
49
51
60
60
55
50
48
53
50
56
49
0
6
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57.5
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6
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g
h-(
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CO
Psychoneuroses
With Psychopathic Personality
y
With Mental Deficiency
Undlagnosad Psychoses
Without Psychoses
Totals
76
16
12
12
7
31
68
76
21
37
40
28
19
52
105
116
2165
1280
3446
7
17
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7
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74
�STATE MENTAL HOSPITALS
XXXVIII - DISCHARGE RATES IN RELATION WITH PSYCHOSES
The total discharges for the year 1934, listed according to
psychoses are here shown compared with the number of cases of the
same diagnosis which were under treatment during the year. This rate
of discharge is indicated as being relatively high in the case of
psychoneuroses, as well as psychoses due to drugs and toxins. The
rate for female patients discharged is especially high in the case
of the former.
XXXIX - DISCHARGES AND -TEARS OP HOSPITAL LIFE
Here the total discharges for the four year period are shown
in relation with the different psychoses and the average period during which patients under each psychosis have been on the records of
the hospital. This of necessity includes time during which the patient may have been away from the institution for periods of a year
or less. This indicates the fact that of these patients discharged,
but few have been listed on the hospital records for periods in excess of three or four years, with most of them limited to an interval
of between one and two years.
With an average period of one year and eleven months for the
total discharged and an average stay of six years and seven months
for the number who have died in the same four year interval, the
general average period during which the average patient is remaining
on the state hospital record is now three years and eleven months.
75
�w
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MICHIGAN STATE HOSPITALS
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76
�Table XXXIX
DISCHARGES 1931-1934 YEARS OP HOSPITAL LIFE IN RELATION WITH TYPES OP PSYCHOSES
Hale
Total Discharges
Female
Total
Male
Yrs.
Traumatic
Senile
Cerebral Arterioscleroses
General Paralysis
Cerebral Syphilis
Huntington's Chorea
Brain Tumor
Other Nervous Diseases
5
40
35
67
17
65
134
303
1
1
37
33
85
4
3
70
2
1
2
28
1
1
12
25
99
236
57
3
2
2
0
1
Average Length of Hospital Life
Female
Total
Mos.
Mos.
Mos.
Yrs.
Yrs.
1
1
10
8
1
3
11
4
2
4
1
1
1
2
9
10
9
0
9
4
3
11
1
0
0
1
7
3
3
5
2
1
0
1
10
6
99
8
7
7
1
1 1
1
2
2
1
11
1
1
9
7 7
7
11
11
2
2
2
1
11
5
4
6
1
4
6
5
6
11
2
2
5
1
3
8
N
Alcoholic
Drugs a n d Toxins
Other Somatic Diseases
Manic Depressive
._ _
212
24
20 2 0
27 2 7
80
37
400
538
400
538
236
47 4 7
117
938
938
1
1 1
1
1
,
Involution Melancholia
Dementia Praecox
Paranoid conditions
Epileptic
10
530
69
32
37
366
76
15
47
896
145
47
2
2
2
1
4
4
1
8
3
2
2
1
0
Psychoneuroses
Psychopathic Personality
Mental Deficiency
tfadiagnosed Psychoses
Without Psychoses
120
73
55
96
416
247
31
36
109
212
367
104
91
339
628
1
1
2
1
1
1
1
1
1
7
1
2
10
6
7
0
0
7
6
0
1
7
1
1
2
1
1
1
11
1
2
1
5
5 5
5
—
Totals
2630
2053
4683
1
11
^
g
^
�MICHIGAN STATE HOSPITALS
CHANSES IN HOSPITAL POPULATION
Prom the record of discharges over the four year period from
1931 to 1934 inclusive, it has been possible to determine the rate of
change in the hospital population of the entire state.
During the year 1931 there was a total of 3444 patients admitted to the state mental hospitals, including the large number transferred to the new Ypsilanti Hospital from other institutions. Of this
number 353, or 10.5 per cent, had been in the institution for periods
of three months or less before they were discharged. A total of 575.
or 16.6 per cent of the total group admitted, were discharged follow
ing a period of six months or less after admission to the institution,
and 756, or 21.95 per cent, had been discharged after being at the institution for a period of one year or less.
At the completion of the four years there were 979 patients, or
28.3 per cent of the total admitted in 1931, who had left the institution and were later discharged after remaining there for the four year
period or less.
The number admitted to the State Psychopathic Hospital is not
considered in this connection, as a large percentage of those were on
observation orders and the remainder later committed were transferred
in a few months to the different state hospitals.
On January 1, 1931 the total book population of the eight mental hospitals included in this report was 12025 patients. By the close
of the four year period to December 31, 1934,1770 of this group of
patients had died, 1812 had been discharged, and 346 of the original
group were still on parole. Of the number on the original date in
residence, 10776, there remained at the close of 1934y8097, or 75$.
XL - PAROLED PATIENTS
The number of patients paroled on December 31, 1934 and shown
in relation with each psychosis is here divided by institutions.
Of the civil insane and in proportion to individual populations
Ypsilanti has the highest number on parole and Eloise the lowest.
Forty two per cent of the cases paroled are either dementia praecox
or manic depressive. Pontiac indicates almost a third of patients
paroled as manic depressive.
These paroles do not include all absences and will vary with
figures for individual institutions showing total on books at a
specified date.
78
�PAROLED PATIENTS - DECEMBER SI, 19S4 IN RELATION WITH TYPES OP PSYCHOSES
Table XL
Paroled
Per Cent Of
Patients Total Patients
M
F
T
Traumatic
Senile
Cerebral Arte
iclerosis
General Paralysisi
3
9
19
86
3
16
7
81 40
36 122
0.2
1.1
2.7
Cerebral Syphilisi
Mervous Diseases
Alcoholic
Drugs and Toxins
19
17
69
3
4
12
10
5
1.6
2.0
5.4
0.5
20
29
9
113 205 318
13
18
5
156 144 300
Somatic Diseases
Manic Depressive
Involution Melancholl
•.holla
Dementia Praeoox
>ld conlit ions
Epileptic psychoses
ies
Psyohoneuroses
With Psychopat : Personal-
ity
With Mental Deficiency
jienoy
Dridlagnosed Psychoses
loses
Without Psychosesi
Totals
23
29
79
8
8.4
2.0
81.7
Kalamazoo
M
P
Pontiac
M
F
Traverse
'Psycho- Eloise
City
Newberry Ionia Ypsilantl pathio
M
F M F M F M
F H F M F
3
.
6
23
3
4
5
1
1
18
7
10
2
1
7
1
3
2
1
1
6
1.8
i
80.6
45
31
3
31
1
1
1
20
1
87
8
10
1
4
12
1
4
4
2
22
S
34
27
14
37
19
8
62
46
22
99
3.1
1.5
6.7
6
2
7
1
3
15
1
1
7
1
2
9
4
7
5
15
27
57
68
12
27
36
63
57 114
41 109
1.8
4.3
7.8
7.6
3
7
11
14
2
5
8
11
1
4
2
6
2
6
7
6
6
6
12
13
160
128
68
78
139
753
712 1466
100.00
2
6
1
4
2
2
2
2
1
1
6
1
1
1
1 1
84 10
6
32 13
3
3
6
1
6
1
11
3
11 5
6 16
117
68
3
4
22
1
3
6
20
1
2
25
3
83
11
24
1
4
' 4
1
1
1
8
6
68
3
2
9
1
1
3
1
16
10
1 150
7
4
1
2
10
4
20
9
1
1
1 28
3
S
1
6
50
2
29
1
5
1
9
4
5
2
6
2
6
1
6
81
5
11
1
'•.;.
16
5
178 24
15
1
23
2
1
7
1
2
4
2
8
43
26
7
1
5
3
1
1
6
10
9
1
2
7
7
24 140 118
�Part II
HOME AND TRAINING SCHOOLS
This portion of the report covers information relating to the inmates of the two schools located in the state for the care and training
of mental defectives. As previously mentioned in this report, the Michigan School is located at Lapeer, with a branch of this school which was
opened in 1934 at Mt. Pleasant. The county of Wayne maintains a similar
school at Northville, and the greater portion of its population are state
wards for whose maintenance the county is reimbursed by the state.
The tables which follow cover the population of both these institutions and give a complete picture of the group of mental defectives
which has been institutionalized for care and training over recent years.
1 -
POPULATION OP TRAIHIHG SCHOOLS
In this table is given the total actual resident population for
each of the twenty-one years from 1915 to 1935 inclusive, as shown on
June 30th of each year. These figures are divided as between male and
female and are further compared with the actual state population in the
last three columns. This number in residence, of course, does not include any individuals on parole or visit who are still included on the
books of the institution. At this season of the year (June 30th) this
number absent from the institution is comparatively large, due to the
number allowed to go home during this vacation period.
As regards the number of male and female residents, it will be
noted that in all the twenty year period males have exceeded females in
actual count, except in the year 1933.
Considered in proportion to the
male and female population of the entire state, females in the schools
have shown the higher ratio in the last five years and in over half of
the preceding years.
While the entire state population has shown a 58 per cent Increase over that of 1915, the resident population of these training
schools has increased 286 per cent over the figures of twenty years ago.
�TOTAL RESIDENT POPULATION 20 TEAR PERIOD 1915 - 1935
Table I
Resident Population
Male
Female
Total
Population of Michigan
Male
Female
Total
Number of Patients per
100,000 population
Male
Female
Total
715
784
540
603
710
718
1163
1252
1426
1508
1,694,450
1,744,850
1,785,300
1,829,560
1,544,843
1,580,266
1,625,640
1,667,204
3,239,293
3,325,116
3,410,940
3,496,764
36.8
37.2
40.1
42.9
34.9
38.1
43.6
43.1
35.9
37.4
41.7
43.2
1919
1920
1921
1922
803
807
842
845
713
765
792
778
1516
1562
1634
1623
1,879,240
1,928,436
1,990,600
2,059,500
1,703,348
1,739,976
1,795,199
1,844,286
3,582,588
3,668,412
3,785,799
3,903,186
42.7
41.8
42.3
41.1
47.9
44.1
44.2
42.2
42.3
42.6
43.2
41.6
1923
1924
1925
1926
1151
1147
1330
1361
1038
1095
1162
1224
2189
2242
2492
S585
2,118,600
2,175,200
2,241,550
2,309,600
1,901,973
1,962,760
2,013,797
2,063,134
4,020,573
4,137,960
4,255,347
4,372,734
54.5
52.8
59.3
58.9
54.4
55.8
57.7
59.3
54.4
54.3
58.5
59.2
1927
1928
1929
1930
1519
1681
1774
1908
1321
1435
1560
1602
2840
3116
3334
3510
2,361,804
2,428,157
2,494,745
2,519,309
2,128,317
2,179,351
2,230,150
2,323,016
4,490,121
4,607,508
4,784,895
4,842,325
64.3
69.2
71.2
75.7
62.2
65.9
69.8
69.1
63.2
67.5
70.6
72.6
1931
1932
1933
1934
1935
1992
2048
2073
2170
2322
2006
2011
2161
2100
2164
3998
4060
4234
4270
4486
2,608,499
2,713,394
2,667,747
2,694,197
8,717,480
2,322,501
2,415,516
2,375,253
2,398,803
2,420,520
4,931,000
5,128,910
5,043,000
5,093,000
5,138,000
76.3
75.4
77.6
81.2
84.5
86.2
83.3
91.1
87.7
88.4
81.0
79.2
83.9
84.1
86.2
1915
1916
1917
1918
623
649
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HOME AND TRAINING SCHOOLS
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jince then have been considerab]
innually in proportion to the ac
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�MICHIGAN STATE HOSPITALS
TOTAL DEATHS DURING 20 YEAR PERIOD
The total deaths occurring in the training schools each calendar year from 1915 to 1954 are shown in this table. The total under
treatment each year is made up of the total resident population at
the "beginning of each year plus the total admissions during the year.
The ratio of deaths to each 1000 under treatment, as shown in
the fourth column, indicates a generally decreasing death rate, with
the last year in agreement with the country's average death rate in
civil life.
Table III
TOTAL DEATHS DURING 20 YEAR PERIOD - 1915 - 1934
Year
Total Deaths
Total Under
Treatment
Deaths per 1000
Under Treatment
1915
1916
1917
1918
55
117
122
58
1434
1668
1767
1789
38.3
69.8
69.2
32.4
1919
1920
1921
1922
53
67
42
57
1868
1945
1884
2356
28.4
34.5
22.3
24.2
1923
1924
1925
1926
87
47
57
70
2675
2696
2973
3119
32,
17,
19,
21.9
1927
1928
1929
1930
54
52
82
53
3667
3843
4130
4279
14.8
13.6
19.8
12.4
1931
1932
1933
1934
59
75
65
65
4576
4902
5028
5707
12.9
15.2
12.9
11.3
�HOME AND TRAINING SCHOOLS
INCREASES IN POPULATION AND CAPACITIES OVER 20 TEARS
In the table which follows is shown the yearly increase, from
1915 to 1935, of the population and capacity of the state training
schools.
A review of the record of building construction shows what
buildings were completed each fiscal year, while the amount of these
capital expenditures is given in table II-S of this report. In the
year ending June 30, 1917 at the Home and Training School at Lapeer
colony building #2 and cottage #29 were completed, adding 107 beds to
the total capacity. In 1918 colony building #3 was added with 66 bed
capacity and in 1919 colony building #4 and building #5 were completed
with a capacity of 66 beds apiece. In 1923 the institution capacity
was increased by 459 beds when colony buildings #6, #7, #9, #10 and
#12 were opened with a capacity of 67 beds each. In 1924 the two
colony buildings #8 and #11 contributed & total of 134 beds on completion. In 1925 465 beds were added to the capacity of the Lapeer
school by opening colony buildings #13, #14 and #15, cottage #35 and
the girls hospital which latter building has a capacity of 202 beds.
In 1927 colony building #17 supplied 13 more beds and in 1930, the completion of colony building #16 with 12 more beds, cottages #33 and
#34 with 139 beds each and cottage #35 with 90 beds added a total of
368 beds to the Lapeer school for that year. Cottage #36, opened in
1933, was the last building erected at Lapeer to date, adding 24 beds
to make the present total capacity of 2795 beds. During the fiscal
year ending June 30, 1934 the arrangements were completed for transfer
of the Federal school property at Mt. Pleasant to this state and 110
beds were added to the total state capacity by rebuilding cottage B
at the Mt. Pleasant branch school.
An additional factor which has increased the total state capacity for care and training of mental defectives is the erection of a
new training school by Wayne County, located at Northville. This institution was opened in the fall of 1926 with about 150 beds, added
to its capacity each year until 1931, when it reached its present
maximum of 750 beds.
�MICHIGAN STATE HOSPITALS
IV - POPULATION AND CAPACITY INCREASES
The increases in population and capacities are shown for each
fiscal year in this table from 1915 to 1935 for the Home and Training
schools in the state. In the third column is given the percentages
of increase each year in the populations of these institutions over
that of 1915.
In the fifth column is given the percentage of increase
yearly over that of 1915 in the capacities of state institutions. Up
to 1927 capacity increases are shown to have kept pace with population
increases, but in the years following state capacities have fallen
far behind. In the sixth column is figuring the per cent of excess
population over state capacity, the total of state wards being housed
by Wayne County from 1927 on, are included in the calculations as
though housed in state institutions. Allowance has also been made
In this connection for the number of inmates at home on school vacation at this time of the year (June 30) for whom dormitory space has
to be reserved.
In the last column is shown the effect that Wayne County School
at Northville has in reducing this excess over capacity by caring for
several hundred state wards In addition to those being maintained
there at county expense.
Recent developments, not Included within the period covered
by the following table, will aid materially in Increasing the state
capacities of these schools. The opening of the rebuilt Cottage C
at the Mt. Pleasant branch school in July, 1935 adds capacity for 193
beds. The recent legislative act, creating the Childrens' Village at
the former Coldwater School, is being put into effect and will, in due
time, result in an increase of about 350 more beds for this training
school group.
POPULATION AND CAPACITY CHARTS
The chart on page eight shows graphically the totals for population and capacity each year from 1915 to date for the Home and
Training Schools in the state, as given each year on June 30th.
On page nine are graphs showing the percentage relation between the yearly increases in population and capacity of the training
schools in the state since 1915, and the corresponding increases in
the state's population. These show how much more the schools' population and capacity have increased as compared with that of the state
population.
�POPULATION AND CAPACITY INCREASES
Table IV
Tear
Ending
June 30
Resident
population
Increase In
Population
State
School
Capacities
Increase In Per Cent of
Excess Over
Capacities
State Capacity
Wayne
County
Capacity
Per Cent of
excess over
capacity including Wayne
County
1015
1071
1122
1188
5.5
10.5
16.0
20.6
22.8
33.3
34.0
20.6
22.8
33.3
34.0
30.3
34.4
40.4
39.6
1320
1320
1320
30.8
30.8
30.8
30.8
21.7
24.2
30.0
29.0
21.7
24.2
30.0
29.0
2189
2242
2492
2585
88.2
92.6
114.2
122.3
1779
1913
75.2
88.5
129.6
129.6
29.2
23.0
12.2
16.3
29.2
23.0
12.2
16.3
1927
1928
1929
1930
2840
3116
3334
3510
143.9
168.1
186.5
201.5
2346
2346
2358
131.2
131.2
131.2
132.3
22.9
33.0
41.8
49.8
300
500
600
650
12.7
14.9
18.8
22.5
1931
1932
1933
1934
1935
3998
4060
4234
243.4
248.6
263.8
268.5
2726
2726
2750
2860
2860
168.5
168.5
171.0
181.6
181.6
48.8
51.2
54.6
49.7
59.6
750
750
750
750
750
20.7
22.6
27.0
24.2
30.3
1915
1916
1917
1918
1163
1252
1425
1502
7.6
22. 6
29.1
1919
1920
1921
1922
1516
1562
1634
1623
1923
1924
1925
1926
4270
4486
286.2
1320
2333
2333
2346
5
t£
a
53
H3
a
53
a
95
�MICHIGAN STATE HOSPITALS
�j~
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HOMK AND TRAIXIXG SCHOOLS
I
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�MICHIGAN STATE HOSPITALS
V - MOVEMENT OP POPTJLATION
This table gives in detail the changes in population at Lapeer
and Northville for the years 1933 and 1934.
Here are shown the number of admissions, readmissions, transfers, discharges and deaths occurring in each of these institutions
during the above years.
The number away from the institutions but still on the books
at the close of the year is relatively high due to that being a vacation period.
VI - ENROLLMENT BY AGE GROUPS AND MENTAL CLASSIFICATION
In this table is included the enrollment of the two schools at
Lapeer and Northville, covering those in residence as well as those
on vacation and parole on December 31, 1934.
This tabulation shows that three quarters of the enrollment la
contained in the age group from five to nineteen years. The age
group including 10 to 14 years contains the largest number in any
single group. One third of the enrollment is contained in each of
the imbecile and moron groups. Females show a considerably higher
proportion of idiots, imbeciles and morons than do the males.
The ages making up the above groups are in accordance with
the date given above.
10
�MOVEMENT OP POPULATIOH 1933-1934
Patients on books January 1. 1953
In Institution
On Vacation or Parole
Admitted During Period
First Admissions 1933
First Admissions 1934
Readmlssions 1933
Readmlssions 1934
Transfers from other Institutions 1933
of same kind 1934
Total Admitted
Total under treatment during period
Discharged During Year
Discharged 1933
Discharged 1934
Died 1933
Died 1934
Transfers to other institutions of 1933
same kind 1934
Total reductions during period
Total on books December 51, 1934
In Institution
On Vacation and Parole
Michigan Home
and Training
School
M
F
1841
2025
1614
1766
230
263
All Training Schools
F
T
M
4777
2381
2396
2033
4083
2060
352
701
349
3
753
225
204
13
15
8
2
467
470
676
22
39
8
6
1220
3149
2848
141
195
39
34
22
8
439
2710
2296
414
142
162
31
34
27
5
401
2447
2071
376
245
472
9
24
106
355
9
24
Wayne County
Training School
M
P
555
356
436
267
119
89
139
117
54
64
3
497
171
140
13
15
8
2
349
256
118
5997
2338
2374
811
474
283
357
70
68
49
13
840
5157
4366
798
50
68
36
32
22
8
206
2132
1862
270
81
82
31
34
20
5
253
2121
1825
296
91
137
3
2
61
80
r
r—f
7
233
578
434
144
148
326
246
80
a
o
3
55
a
M'
§
a
o
o
�Table VI
CHRONOLOGICAL AGE AND MENTAL CLASSIFICATION DECEMBER 31, 1934
Male Enrollment
Moron
Imbecile
Idiot
Borderline • Dull Normal
Normal
I.Q. 0-24 I.Q. 25-49 ' I.Q. 50-69 I.Q. 70-79 I.Q. 80-89 I.Q. 90-up Undetermined
Age
0 - 4 yrs.
5-9
10 - 14
15 - 19
33
179
136
57
31
211
249
178
64
28
7
15
20
129
•:
336
.;.
276
4
23
127
82
1
7
22
15
2
1
2
14
3
1
2
Total
Percentage
12
42
49
69
103
592
921
677
3.79
21.77
34.24
24.90
17
11
8
1
218
74
. 25
28
8.02
2.72
.91
1.02
5
2
1
2
24
10
9
5
.88
.36
.33
.18
1 .
5
2
22
.81
225
8.30
2710
Q
t>
a:
20
25
30
35
-
24
29
34
39
31
15
7
6
40
45
50
55
-
44
49
54
59
5
2
1
1
60 & up
Unknown
4
Total
Per Cent
477
17.60
87
19
2
5
13
5
5
1 -../..
7
• , "'
814
30.04
1
1
1
1
2
1
1
2
3
882
32.56
255
9.40
1
50
1.84
7
0.26
.07
100.00
H
o
Ul
�Table VI continued
CHRONOLOGICAL AGE AND MENTAL CLASSIFICATION DECEMBER 31, 1934
Female Enrollment
Normal
Moron
Imbecile
Borderline Dull Normal
Idiot
I.Q. 80-89 I.Q. 90-up Undetermined
I. ft. 0-24 I.Q. 25-49 I.Q. 50-69 I.Q. 70-79
Age
0 - 4 yra.
5-9
10 - 14
15 - 19
241
276
2
25
62
71
2
6
10
11
87
40
34
32
108
38
20
19
17
2
2
1
4
18
7
4
5
8
2
1
7
3
817
33.39
808
33.03
43
161
120
64
27
148
235
173
35 - 39
34
21
18
9
40 - 44
45 - 49
3
7
15
77
3
3
1
Total
Percentages
7
22
21
24
99
439
692
620
4.04
17.95
5
12
5
4
255
28.29
25.35
W
o
g
H
>
a
1-3
S
20 - 24
25 - 29
30-34
50-54
55 - 59
Unknown
Total
Per Cent
•
5
485
19.83
79
65
10.43
4.62
3.22
2.65
1
31
19
5
6
1.26
.77
.20
.24
8
24
.98
2
3
1
184
7.52
34
1.38
7
.28
112
4.57
113
2447
100.00
Ed
2J
h-l
Q
50
O
HH
O
32
�Table VI eont- TOTAL ENROLLMENT BT CHRONOLOGICAL AGE AND MENTAL CLASSIFICATION DECEMBER 31, 1934
Imbecile
I.Q. 25-49
Moron
I.Q. 50-69
Borderline
I.Q. 70-79
76
340
256
121
58
359
484
351
35
206
577
552
6
48
189
153
3
13
32
195
57
22
24
31
2
3
2
7
1
9
3
3
1
2
Idiot
I.Q. 0-24
0-4
5-9
10 - 14
15 - 19
20
25
30
35
-
24
29
34
39
65
36
25
15
151
68
41
47
40
45
50
55
-
44
49
54
59
8
9
1
1
31
12
9
6
60 & up
Unknown
9
14
Total
Per Cent
Normal
Dull Normal
I.Q. 80-89 I.Q. 90-up
26
5
1
5
1
g
962
18.65
1631
31,63
1690
32.79
3
2
0
439
84
14
8.51
1.62
19
64
70
.27
Total
Per Cent
202
1031
1613
1297
3.92
20.00
31.31
25.14
5
473
187
104
93
9.16
3.63
2.01
1.80
5
5
1
3
55
29
14
11
1.07
.56
.27
.21
1
13
2
46
.04
.88
93
22
23
13
1
6
Undetermined
337
6.53
'
5157
100.00
S
%
5
S
GO
>
a
p
££
1^
t-1
X
�Table VII - NATIVITY AND PAREUTAQE BY MENTAL GROUPS - TOTAL ENROLLMENT DECEMBER 31, 1934
Mental
Groups
Native
M
F
Native Born Divided as to Parent age
Mixed
Unknown
F
11
F
F
M
Foreign
M
M
Total
F
T
M
938
10
Aggregate
F
Foreign Born
F
T
11
14
24
477
485
T
Idiot
I.Q. 0-24
236
813
116
138
61
62
64
58
467
471
Imbecile
I.Q. 25-49
361
342
166
184
80
93
172
168
769
787
1556
45
30
75
814
817
1631
Moron
I.Q. 50-69
354
350
125
182
77
75
296
217
854
764
1618
28
44
72
882
808
1690
Borderline
I.Q. 70-79
91
78
36
82
29
17
87
61
244
179
423
11
5
16
255
184
439
Dull Normal
I.Q. 80-89
23
16
7
5
3
3
13
8
46
31
77
4
3
7
50
34
84
s
t^
Normal
I.Q. 90 & up
Unknown
962
5
>
y
^
i-S
X
>
3
&;
0
5
2
1
0
1
2
0
3
7
7
14
0
0
0
7
7
14
so
o
135
68
39
33
32
8
11
11
217
110
327
8
2
10
225
112
337
o
h-t
Totals 1205
1068
480
604
283
260
633
526
2604
2349
4953
106
98
804
2710
2447
5157
The total enrollment of both, schools as of December 31, 1934 Is here divided as to native and foreign
born, with a further separation Into mental classifications based on Individual I.Q's.
Only a little over four per cent of the total are foreign born, with the division Into mental classifications for the foreign born showing about half the percentage of Idiots that the native born do. Of the native
born, those of foreign parentage indicate a proportion of Idiots about five per cent greater than do the ones
of native parentage.
�MICHIGAN STATE HOSPITALS
VIII - TOTAL ENROLLMENT BY COUNTRIES OP BIRTH OR EXTRACTION
In this table the enrollment of the schools at Lapeer and
Northville, as of December 31, 1934, is divided according to the
birth or parentage of each individual. Those born in the United
States, whose parents are likewise born in this country, are listed
under this head. Those born in the United States, with both parents
born in another country, are listed under the head of such country.
Those having parents born in separate countries are listed under the
country of birth of the male parent.
The third column lists the number of Inhabitants in the state,
divided as above, according to the 1930 census.
In the last column the number of enrolled cases thus related
to each country is shown in proportion to each 100,000 persons of that
same country included in the state population.
Austria, which shows an actual enrollment of 59 patients, has
the highest number in proportion to the related total in the state's
population, while Scotland is among the lowest.
16
�HOME AND TRAINING SCHOOLS
Table VIII
TOTAL ENROLLMENT - DEC. 31, 1934 DIVIDED BY. COUNTRIES OP PARENTAGE
Total Enrolled
Total in State
Per 100,000
Sen. Pop.
59
16
3
476
34,792
26,818
2,273
499,002
169.8
59.6
132.0
95.3
26
9
87
38
44,602
20,507
166,848
74,229
58.2
44.0
52,5
51.2
France
Germany
Greece
Holland
12
213
15
43
18,085
365,263
16,175
106,426
66.3
58.2
92.6
40.3
Hungary
Ireland
Italy
Jugoslavia
44
35
109
11
40,434
83,702
98,048
33,492
108.7
41.8
111.2
33.0
Lithuania
Korway
Poland
Roumania
6
8
307
11
20,489
23,117
320,634
20,381
29.3
34.5
95.7
54.0
Russia
Scotland
Spain
Sweden
80
26
1
48
75,656
66,990
2,149
68,577
105.8
38.0
46.4
70.0
12
34
2252
2
11,066
23,196
2,556,192
6,024
108.3
147.0
88.2
33.1
15
19,258
5157
4,842,325
Austria
Belgium
Bulgaria
Canada
Czechoslovakia
Denmark
England
Finland
Switzerland
Turkey
United States
Wales
Other Countries*
Unknown
Total Enrollment
77.9
106.3
•Includes Africa, Australia, Japan, Mexico and Other Countries
17
�MICHIGAN STATE HOSPITALS
IX - PRESENT ENROLLMENT DIVIDED BY COUNTIES OP RESIDENCE
The enrollment at the two schools on December 31, 1934 is
here divided according to the counties of the state from which the
patients were received. The population of each county by the IT. S.
census of 1930 is also given and the proportionate number enrolled
from each county per 100,000 population in each case is noted in
the last column.
Many of the counties in the poorer, thinly populated districts
show the highest rates, of which Kalkaska, Otsego and Osceola are
examples.
X - TOTAL ADMISSIONS BY COUNTIES
Total admissions to the two schools for the four year period
from 1931 to 1934 inclusive are included in this table, being divided according to the coxuities from which received.
The average number received annually from each county is compared with the population of that county by the 1930 census and the
corresponding number per 100,000 population noted in the last column.
A high proportionate rate of admission is apparent in some of
the upper counties, which, in some cases, likewise have a high enrollment rate shown in the previous table.
18
�HOME AND TRAINING SCHOOLS
HOME AND TRAINING SCHOOLS - ANALYSIS OP PRESENT ENROLLMENT BY COUNTIES
December 31, 1934
Per Each
Table IX
100,000
population
County
of counties
Counties
Male
Population
Female
Total
Alcona
Alger
Allegan
Alpena
Antrim
Arenac
Baraga
Barry
Bay
1
3
11
5
6
4
16
35
5
Benzie
Berrlen
35
Branch
11
Calhoun
38
Cass
10
Charlevolx
5
Cheboygan
11
Chlppewa
15
Clare
5
Clinton
17
Crawford
3
Delta
14
Dickinson
14
Eaton
20
Bnnnet
8
Genes ee
90
Gladwin
2
Gogebic
15
Gd. Traverse 15
Qratiot
14
Hllladale
25
Hought on
25
Huron
22
Ingham
49
Ionia
28
losco
5
Iron
11
Isabella
13
Jackson
67
Kalamazoo
36
Kalkaska
6
Kent
107
1
Keweenaw
Lake
Lapeer
30
Leelanau
1
1
4
12
9
6
8
3
9
40
4
23
17
23
17
7
6
32
3
11
2
18
11
13
10
2
7
23
14
12
12
3
25
75
9
58
28
61
27
12
17
47
8
28
5
32
25
33
18
67
6
4
11
10
15
24
157
8
19
26
24
40
49
16
52
38
101
16
1
9
18
55
48
9
98
1
7
22
4
44
6
20
31
122
84
15
205
2
7
52
5
19
4,989
9,327
38,974
18,574
9,979
8,007
9,168
20,928
69,474
6,587
81,066
23,950
87,043
20,888
11,981
11,502
25,047
7,032
24,174
3,097
32,280
29,941
31,778
15,109
211,641
7,424
31,577
20,011
30,252
27,417
52,851
31,132
116,587
35,093
7,517
20,805
21,126
92,304
91,368
3,799
240,511
5,076
4,066
28,348
8,206
40.
75.
59.
163.
121.
150.
33.
119.
108.
136.
72.
117.
70.
129.
101.
147.
187.
113.
116.
162.
99.
83.
104.
118.
74.
107.
60.
130.
79.
145.
92.
122.
86.
125.
80.
96.
147.
132.
92.
395.
85.
39.
172.
183.
61.
�MICHIGAN STATE HOSPITALS
HOME AND TRAINING SCHOOLS - ANALYSIS OF PRESENT ENROLLMENT BY COUNTIES
Deoember 31, 1934
Table IX
Per Each
100,000
Continued:
population
County
Total
Female
Population
of counties
Male
Counties
Lenawee
18
Livingston
9
3
Luce
Maokinao
5
27
Macomb
Manistee
9
19
Marquette
4
Mason
Mecosta
7
11
Menominee
Midland
7
Missaukee
3
Monroe
15
Mont calm
20
Montmorency
5
Muskegon
38
Newaygo
5
Oakland
68
8
Oceana
4
Ogomaw
Ontonagon
6
Osceola
15
11
Ottawa
Oscoda
2
Ota ego
Presque Isle
8
Ros common
1
Saginaw
51
St. Glair
50
St. Joseph
21
Sanilac
31
Schoolcraft
4
SMawassee
24
Tuscola
23
Van Buren
24
Washtenaw
38
Wayne
1246
Wexford
14
Non-Residents 2
Total
2710
22
13
9
7
25
8
15
5
8
13
9
5
11
17
1
33
5
101
5
7
3
20
13
2
10
6
2
47
52
19
28
1
22
15
12
29
1053
12
2447
40
22
12
12
52
17
34
9
15
24
16
8
26
37
6
71
10
169
13
11
9
35
24
2
12
14
3
101
102
40
59
5
46
38
36
67
2299
26
2
5157
20
49,849
19,274
6,528
8,783
77,146
17,409
44,076
18,576
15,738
23,652
19,150
6,992
52,485
27,471
2,814
84,930
17,029
211,251
13,805
6,595
11,114
12,806
54,858
1,728
5,554
11,330
2,055
120,717
67,563
30,618
27,751
8,451
39,517
32,934
32,637
65,530
1,888,946
16,827
4,842,325
80.
114.
183.
136.
67.
98.
77.
48.
95.
101.
83.
115.
49.
135.
213.
84.
59.
80.
94.
167.
81.
273.
43.
116.
216.
123.
145.
84.
151.
130.
213.
59.
116.
115.
111.
102.
121.
154.
106.3
�HOME AND TRAINING SCHOOLS
Table X TOTAL ADMISSIONS DDHINQ 4 YEAR PERIOD - 1931-1934 BY COUNTIES
Male
Alcona
Alger
Allegan
Alpena
Antrim
Arenac
Baraga
Barry
Bay
Benzie
Berrlen
Branch
Calhoua
Cass
Charlevoix
Cheboygan
Chlppewa
Clare
Clinton
Crawford
Delta
Dickinson
Eaton
Emmet
Qeneaee
Bladwin
Hogeblo
Gki. Traverse
Sratiot
Hlllsdale
Eoughton
Huron
Ingham
Ionia
losoo
Iron
Isabella
Jackson
Ealamazoo
Kalkaska
Kent
Keweenaw
1
3
1
1
4
11
13
3
13
2
4
5
1
10
2
4
8
2
34
1
3
4
3
6
6
8
30
10
2
1
6
23
17
28
1
Female
Total
Average
Each Year
Per 100,000
Population
1
4
6
6
4
4
1
4
18
1
5
9
7
4
4
2
8
29
.25
1.25
2.25
1.75
1.00
1.00
.05
2.00
7.25
5.0
13.5
5.8
9.5
10.0
12.5
5.5
9.5
10.5
12
8
11
4
1
4
12
1
4
2
16
2
5
5
43
4
2
5
5
6
8
5
41
13
25
11
24
4
3
8
17
2
14
4
20
2
13
7
77
5
5
9
8
12
14
13
71
23
2
3
14
42
36
3
63
1
6.25
2.75
6.00
1.00
.75
2.00
4.25
.50
3.50
1.00
5.00
.50
3.25
1.75
19.25
1.26
1.25
2.25
2.00
3.00
3.50
3.25
17.75
5.75
.50
.75
3.50
10.50
9.00
.75
15.75
.25
7.7
11.5
7.0
4.8
6.2
17.5
17.0
7.1
14.5
32.5
15.5
1.7
10.2
11.5
9.1
16.8
4.0
11.2
6.6
11.0
6.6
10.5
15.0
16.4
6.7
3,6
16.6
11.5
9.8
19.8
6.5
4.9
2
8
19
19
3
35
�MICHIGAN STATE HOSPITALS
Table X
continued:
Male
Lake
Lapeer
Leelanau
Lenawee
Livingston
Luce
Mackinac
Macomb
Manistee
Marquett-e
Mason
Mecosta
Menominee
Midland
Missaukee
Monroe
Mont calm
Montmorency
Muskegon
Newaygo
Oakland
Oceana
Ogemaw
Ontonagon
Osceola
Ottawa
Oscoda
Otsego
Presque Isle
Ros common
Saginaw
St. Clair
St. Joseph
Sanilac
Schoolcraft
Shiawassee
Tuscola
Van Bur en
Washtenaw
Wayne
Wezford
Non-residents
Total
Femal e
Total
Average
Each Year
Per 100,000
Population
4
11
1
1.00
2.75
24.5
.25
1
10
4
6
8
6
4
3
13
2
6
15
10
4
4
23
6
12
3.75
2.50
1.00
1.00
5.75
1.50
3.00
3.0
7.5
2
1
8
4
2
12
7
10
2
10
9
5
3
15
14
4
22
14
2
31
1
5
1
7
4
4
6
2
19
36
3
3
1
5
1
12
1
51
6
1
8
6
2
6
3
15
15
5
12
21
27
5
14
11
7
6
15
707
1
10
4
5
11
690
5
1212
1328
7.5
8.6
6.8
.75
4.7
3.75
2.50
1.00
5.50
3.50
15.8
13.0
14.3
10.5
12.7
17.5
.50
7.75
9.2
1.4
87
6
1
21.75
1.50
10.3
10.8
.25
3.8
11
9
2
7
8
1
36
42
10
26
2.75
2.25
26
1397
6
2
2540
22
13.0
15.3
11.4
.25
21
11
11
2
9.7
.50
1.75
2.00
.25
9.00
10.50
2.50
6.50
5.25
2.75
2.75
6.50
349.25
1.50
21.5
4.1
28.'9
31.5
17.5
12.2
7.5
15.5
8.2
23.5
13.3
8.3
8.4
9.9
18.5
8.9
.50
635.00
13.1
�TOTAL ADMISSIONS - MENTAL STATUS RELATED TO RESIDENCE AND ECONOMIC CONDITIONS
In this table is shown the total admissions to the two training schools for the four years from 1931 to
1934, divided according to their mental classification, the type of residence, whether rural or urban, and
their condition in life economically. About 80 per cent of the admissions are from urban localities and fully
one half of those from both rural and urban sections are dependent. As to mental status, slightly more than
one third from urban sections are idiots or imbeciles, while about half of the rural admissions are made up of
those belonging in either of these two groups.
TOTAL ADMISSIONS DURING 4 YEAR PERIOD 1931-1934
MENTAL STATUS WITH RELATION TO RESIDENCE AND ECONOMIC CONDITION
Table XI
Marginal
M
F
Idiot
Imbecile
38
29
40
54
Moron
Borderline
39
14
65
13
26
5
55
10
Dull Normal
Normal
2
Unknown
9
4
1
11
2
1
16
Total
114
144
117
Independent
M
P
2
4
11
172
Unknown
M
F
2
1
1
2
1
53
O
Urban
Rural
Dependent
M
P
15
14
33
36
a
o
Dependent
M
P
Marginal
M
F
Independent
M
P
8 7
53
105
59
82
76
115
1 228
1
85
229
74
144
62
160
27
9
1
18
6
22
15
4
23
14
2
46
8
2
23
473
503
409
411
2 7
12
10
14
24
Unknown
M
P
1
1
4
9
1
35
16
17
13
1
S
1
Z
1
6
34
56
54
37
CO
o
I-H
O
S
02
�RATIO OF DEATHS TO EACH 1000 UNDER TREATMENT
Table XII
The total deaths occurring from 1931 to 1934 inclusive are here divided according to mental status.
The average number dying annually in each group is shown in the second column and the average number under
treatment, determined as noted in the preceding table, is given in the third column. The ratio of these
average deaths to the number under treatment is shown in the last column and indicates a relatively high rate
for those of the lowest mental status.
DEATHS PER 1000 UNDER TREATMENT
1931 - 1934
Table Xll-a
Total Deaths
Average Deaths
annually
Under Treatment
Deaths Per
1000 Under
treatment
s
. O
w
h-1
Q
GO
103
25.7
1000
85.7
Imbecile
66
16.5
1677
9.8
Moron
55
13.7
1840
7.4
Idiot
Borderline
4
Dull Normal
1
Normal
1
34
Unknown
Total
k
264
1.0
455
2.1
.26
101
2.4
.25
21
11.8
346
24.6
5440
12.1
8.5
66.0
S
03
g
£tf
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HOME AND TRAINING SCHOOLS
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25
�MICHIGAN STATE HOSPITALS
XIII
DISCHARGES IN RELATION TO MENTAL STATUS AND LENGTH OP RESIDENCE
The total discharges from the two schools, which have been made
during the four year period from 1931 to 1934 inclusive, are given in
this table and are divided by mental status. These are in addition to
transfers which may have been made between the two schools in the state,
and also to deaths which are given in a separate table. The length of
residence in the institution of those discharged averages about five
years and is greatest with those of the lower mental status.
XIV - DEATHS IN RELATION TO MENTAL STATUS AND LENGTH OF RESIDENCE
The total deaths for the four year period of 1931 to 1934 are
shown in this table, divided by mental status and giving average length
of residence. This time of residence includes the total elapsed time
in the interval between the date of admission and the date of death.
Those of the lower mental status show the longest periods of residence.
XV - CAUSES OP DEATH
The causes for the total deaths occurring in the schools from
1931 to 1934 inclusive are here listed in accordance with the International List, published by the Bureau of the Census. Over 45 per
cent of these deaths were from tuberculosis and pneumonia. Among the
idiots over 50 per cent of the deaths were from the same causes.
26
�HOME AND TRAINING SCHOOLS
Table XIII
TOTAL DISCHARGES BY MENTAL STATUS AND AVERAGE LENGTH OF RESIDENCE
1931 - 1934
•
Average Length of Residence
Male
Female
Total
Mental Status
Total
M
F
Yrs
Yrs.
Mos
Mos . Yrs.
Mos
47
17
30
4
1
8
6
6
4
Imbecile
118
42
76
7
10
5
2
6
1
Moron
541
281 260
5
1
4
5
4
9
Borderline
203
116
87
5
3
4
10
5
0
Dull Normal
66
38
28
4
8
4
3
4
5
Normal
26
14
12
3
9
5
7
4
7
unknown
30
13
17
4
1
8
6
6
7
521 510
5
2
5
0
5
1
Idiot
Total
1031
Table XIV
TOTAL DEATHS BY MENTAL STATUS AND AVERAGE LENGTH OP RESIDENCE
1931 - 1934
Mental Status
Total
Average Length, of Residence
Female
Total
Male
Yrs.
Mos
Yrs .
Mos
Mos. Yrs.
M
F
103
53
50
7
7
6
0
6
9
Imbecile
66
32
34
13
6
7
10
10
5
Moron
55
21
34
4
0
7
9
5
10
Borderline
4
2
2
6
10
2
7
4
8
Dull Normal
1
1
4
5
4
5
Normal
1
1
34
21
Idiot
Unknown
Total
264
4
4
13
7
4
5
9
6
1
131 133
8
4
6
10
7
10
�MICHIGAN STATE HOSPITALS
Table XT
CAUSES OP DEATH - 4 YEAH PERIOD 1931-1934
Idiots
M
F
Tuberculosis of resp. system
Tuberculosis of other organs
Other Infectious diseases
Cancers a n d other tumors
Other General Diseases
Diseases of blood and blood
making organs
Cerebral Hemorrhage
Epilepsy
Other diseases of nervous system
Endocarditis & Myocarditis
Other diseases o f heart
Other diseases of circulatory
Bronohopneumonia
Pneumonia
19
2
3
5
6
4
3
1
8
7
5
1
1
1
8
1
1
5
5
1
Total
7
1
Borderline
M
F
8
1
1
1
8
3
1
4
2
3
2
1
3
1
8
1
3
7
6
2
1
1
3
2
5
3
2
1
1
1
1
1
1
5
3
1
1
2
1
5
1
1
2
1
1
1
53
50
28
32
1
2
1
Congenital malformations
Disease o f early infancy
Suicide
Traumatism
Other accidental deaths
Unknown
All other causes
13
6
1
7
1
1 1
Morons
M
P
2
Other diseases o f resp. system
Diarahea
Appendicitis
Other diseases o f digestive sys.
Nephritis
Other diseases of genotourinary
Diseases of skin
Diseases of bones
Imbeciles
M
F
34
21
34
1
�HOME AND TRAINING SCHOOLS
Table XV
CAUSES OP DEATH - 4 YEAR PERIOD 1931-1934
continued:
Dull
Normal
M
F
Tuberculosis of reap, system
Tuberculosis o f other organs
Other infectious diseases
Cancers a n d other tumors
Normal
M
F
Unknown
M
F
1
1
1
8
1
Other diseases o f resp. system
Dlarahea
Appendicitis
Other diseases o f digestive sys.
6
1
1
Nephritis
Other diseases of genotourinary
Diseases o f skin
Diseases of bones
3
2
1
12
1
9
1
13
2
7
2
25
3
16
2
2
20
16
2
22
15
4
2
42
31
2
1
2
1
4
2
3
5
8
1
5
9
3
11
1
1
1
5
1
29
21
7
2
1
3
20
1
2
7
1
1
T
2
5
2
2
1
1
Congenital malformations
Disease of early Infancy
Suicide
Trawmatism
Total
1
2
Other diseases o f heart
Other diseases of circulatory
Bronchopneumonia
Pneumonia
Total
F
27 29 56
2
1
3
6
8 14
4
4
8
1
Other general Diseases
Diseases of blood and blood
making organs
Cerebral Hemmorrhage
Epilepsy
Other diseases o f nervous system
Endocarditis & Myocarditis
Other accidental deaths
Unknown
All other causes
M
1
13 131 133 264
�Part III
MICHIGAN EPILEPTIC COLONY
Care and treatment of epileptics within the state is provided
at the institution located at Wahjamega, a' few miles east of Saginaw,
near the village of Caro. This institution was first opened in 1914
and the tables which follow show its growth In capacity and population
from 1915 to date. They also include analysis of the present population and of admissions, discharges and deaths occurring during four
years, ending December 31, 1934.
1 - RESIDENT POPULATION 1915-1935
In this table is shown the resident population of the colony
as it stood on June 30th of each year from 1915 to date. The rated
capacity of the institution is also given and comparison with the
growth in population indicates that with a population increase of 538
per cent since 1915, the capacity increase has been considerably less
or 430 per cent in the same time.
The ratio of patients to the population of the state is given
in the last three columns. These show a definite increase in the
proportionate number of epileptics being given care and treatment by
the state with an almost equal proportion in the division between
males and females.
31
�Table I
As Of
June 30
TOTAL RESIDENT POPULATION FOR 20 YEAR PERIOD 1915 - '1935
Capacity
Male
Resident Population
Female
Total
Number of Patients Per 100,000 Population
Male
Female
Total
4.9
4.9
10.1
10.5
1915
1916
1917
1918
132
256
284
378
152
163
233
246
0
0
114
121
152
163
347
367
8.9
9.3
13.0
13.4
7.0
7.2
1919
1920
1921
1922
428
428
478
514
243
271
308
324
211
220
215
340
454
491
523
664
12.9
14.0
15.4
15.6
11.8
12.6
12.0
18.4
12.6
13.3
1923
1924
1925
1926
514
514
608
584
312
366
372
441
333
340
349
403
645
706
721
844
14.7
16.8
16.5
19.0
17.5
17.3
17.3
19.4
16.1
17.1
16.9
19.3
1927
1928
1929
1930
584
584
584
584
441
421
395
406
409
399
383
376
850
820
778
782
18.6
17.3
15.8
16.1
19.2
18.3
17.1
16.1
18.9
17.8
16.5
16.1
1931
1932
1933
1934
1935
584
699
699
699
699
413
418
484
519
508
395
403
448
461
463
808
821
932
980
971
16.4
15.4
18.1
19.3
18.5
16.9
16.7
18.8
19.2
18.8
16.3
16.0
18.5
19.2
18.7
13.8
16.6
g
o
W
h-f
Q
50
^
ft
a
o
CO
2
1
�STATE EPILEPTIC COLONY
CAPACITIES AND BUILDINGS
Table II
Tear
Capacity
beginning
year
Capacity
added beds
Buildings
Cottages 1 & 2
Cottages 3 & 4
Cottage 5
Capacity Per Cent Of
end of
Population
year
over capacity
432
18.8
256
19.5
284
25.7
1915
1916
1917
24
132
256
108
124
28
1918
1919
1920
284
378
428
94
50
0
Cottage 6
Cottage 7
378
428
428
10.2
18.4
1921
1922
1923
428
478
514
50
36
0
Cottage 8
Addition to #7
478
514
514
24.0
27.4
31.0
1924
1925
514
514
0
94
514
38.7
1926
608
0
608
584
29.4
44.5
1927
1928
1929
584
584
584
0
0
0
584
584
584
42.8
36.9
33.5
1930
1931
1932
584
584
584
0
0
115
584
584
699
36.2
39.3
25.3
1933
1934
1935
699
699
0
0
0
0
699
699
0
36.2
38.2
#8 Addition
Cottage #9
Cottage A burned
Hospital
33
8.4
�MICHIGAN STATE HOSPITALS
II - CAPACITIES AND BUILDINGS
The additions to the capacity of the colony which have "been
made from 1915 to date by the erection of new cottages and a hospital
building are included in this table. The amount of investment represented by these added buildings over this period is given in the
table II-c of this report covering expenditures.
The capacities as given are based on a unit figure of 750 cubic
feet of air space per patient. The type of construction of these
colony buildings provides large open dormitories with a maximum of
air circulation and separate day rooms in connection.
The last column of this table shows the proportion of overcrowding as indicated by the population at the close of each year
and based on the capacity ratings as noted.
Ill - ADMISSIONS AND DEATHS 1915-1934
The total admissions and the total deaths occurring each year
from 1915 to 1934 are included in this table. The rate of these admissions in proportion to each 100,000 of the state's population for
each successive year shows a varying ratio due to the additional
buildings erected.
Deaths are shown in relation to each 1000 patients under treatment. This number under treatment includes the total patients in
residence at the beginning of the year plus all admissions during the
twelve months following.
�TOTAL ADMISSIONS AND DEATHS 1915 to 1934 INCLUSIVE
Table III
Calendar Year
Total
Admissions
Admissions Per
100,000 Population
Total
Deaths
Total Under
Treatment
Deaths Per 1000
Under Treatment
1915
1916
1917
1918
157
157
145
187
4.8
4.7
4.2
5.3
8
13
59
78
181
318
440
544
44.3
41.0
134.0
143.5
1919
1920
1921
1922
171
99
207
67
4.8
2.7
5.5
1.7
68
69
41
29
620
606
711
706
110.0
113.5
67.5
41.2
1923
1924
1925
1926
89
128
126
173
2.2
3.1
2.9
3.9
53
56
49
62
747
788
832
912
71.0
71.0
58.9
68.0
1927
1928
1929
1930
99
36
59
95
2.2
0.8
1.2
1.9
59
69
68
54
928
875
838
867
63.5
78.8
81.2
62.3
1931
1932
1933
1934
106
141
151
178
2.1
2.7
2.9
3.5
74
65
86
118
899
1008
1112
1133
82.3
65.5
77.2
104.0
nits
IS
"a
HH
P
IS
O
o
�MICHIGAN STATE HOSPITALS
Table IV
POPULATION MOVEMENT 1933 and 1934
The movement and changes in patients during the two years
ending December 31, 1934 are detailed in this table. These admissions, discharges and deaths are made up from individual reports by
the institution covering each case.
The 42 cases received by transfer in 1933 were from the Home
and Training School at Lapeer. There are more male admissions during the period and similarly more male discharges and deaths, so
that the ratio of male and female population remains about the same.
POPULATION MOVEMENT - 1933 and 1934
Male
Patients on books January 1, 1933
In Hospital
On Parole
506
464
42
Admitted During Period
First Admissions - 1933
84
First Admissions - 1934
107
Readmissions - 1933
4
Readmlssions - 1934
1
Transfers from other institutions of
same kind 1933 22
Transfers from other Institutions of
same kind 1934
—
Total Admitted
218
Total Under Treatment
724
Female
Total
467
445
22
973
909
64
62
69
1
1
146
176
5
2
20
42
153
620
371
1344
Diacharged - 1933
Discharged - 1934
11
31
6
15
17
46
Died - 1933
Died - 1934
41
83
47
34
88
117
Total Reductions
166
102
268
Patients on books December 31, 1934
In Hospital
On Parole
558
495
63
518
471
47
1076
966
110
Transfers to institutions - 1933
Transfers to institutions - 1934
�STATE EPILEPTIC COLONY
V - TOTAL ADMISSIONS AND TOTAL POPULATION BY COUNTIES
In this table the total admissions from 19S1 to 1934 inclusive,
together with the total patient population on December 31, 1934, are
divided by counties from which received. The ratio of the total of
admissions for the four years and the patient population from each
county to each 100,000 actual population of each respective county by
the 1950 census is also tabulated.
Most of the counties having poor, sparsely settled districts
show the highest admission rate, as well as high patient population
rates. Examples are Arenao, losco, Kalkaska and Hontmorency.
VI- TOTAL ADMISSIONS BY AGE AND ECONOMIC STATUS
Here are divided the total admissions to the colony during the
four years ending December 31, 1934, by age groups and according to
the economic status of the patient or his family. Less than ten per
cent of those admitted were found to have resources sufficient to care
for immediate needs, while 43 per cent of them were actually dependent
upon charitable sources. Slightly less than half of those admitted
were under 20 years of age and 92 per cent of all admissions were
persons less than 50 years of age*
37
�MICHIGAN STATE HOSPITALS
Table V
TOTAL ADMISSIONS 4 YEAR PERIOD 1931-1934 AND TOTAL BOOK POPULATION
Admissions
1931-1934
Number Of
Admissions
Per 100,000
Population
Dec. 31, 1934
Number Of
Patients Per
100,000
T
Aloona
Alger
Allegan
Alpena
Antrim
Arenac
Baraga
Barry
Bay
2
2
2
3
1
1
7
Benzie
Berrien
5
1
Branch
Calhoun
8
1
Cass
Charlevoix
Cheboygan
Chippewa
8
Clare
Clinton
1
Crawford
Delta
3
Dickinson
2
Eaton
2
1
Emmet
Genesee
24
Sladwin
Gogebic
Gd. Traverse
Gratiot
2
Hillsdale
1
Houghton
3
Huron
3
Ingham
4
4
Ionia
1
losco
Iron
Isabella
Jackson
2
Kalamazoo
9
1
Kalkaska
Kent
12
Keweenaw
4
1
2
5
1
4
1
2
1
1
2
2
14
1
2
2
1
1
2
7
3
1
3
2
1
10
2
6
2
21
15
11
4
1
3
12
1
9
2
10
1
50
11
14
17
15
11
1
8
1
3
9
32
14
12
5
2
S
1
38
15
7
6
7
18
1
2
4
2
4
5
11
4
4
3
10
13
7
8
16
9
11
53
1
5
11
2
22
2
2
5
6
4
3
3
12
2
9
3
13
2
1
2
8
1
1
8
11
5
4
2
5
3
31
2
3
2
6
2
10
6
12
5
2
3
6
13
1
18
1
5
5
12
53
9
38
2
8
4
2
3
1
10
1
6
4
12
2
2
2
3
4
4
4
2
3
22
1
3
4
5
6
2
3
13
3
3
3
5
11
7
1
31
4
2
13
10
2
7
3
4
22
3
15
7
25
4
3
4
8
4
5
80
21
33
54
20
88
33
19
32
46
18
29
29
19
25
35
32
43
21
8
6
25
20
22
40
25
40
19
30
36
29
23
29
21
23
40
24
38
18
22
53
20
20
7
6
53
3
6
6
11
8
12
9
25
8
3
5
8
17
20
2
49
1
�STATE EPILKPTIC COLONY
Table V
continued:
Population
Dec . 31,
1934
Per 100,000
M
Lake
Lapeer
Leelanau
Lenawee
Livingston
Luce
Mackinac
10
Macomb
Manistee
Marquette
Mason
3
Mecosta
3
Menominee
2
Midland
Missaukee
5
Monroe
1
Montcalm
Montmorency
2
Muskegon
1
Newaygo
10
Oakland
2
Oceana
Ogemaw
1
Ontonagon
1
Osceola
3
Ot t awa
Oscoda
Otsego
Presque Isle
Roscommon
9
Saginaw
6
St. Clair
St. Joseph
2
5
Sanilac
Schoolcraft
1
Shiawassee
4
5
Tuscola
Van Buren
2
Washtenaw
5
Wayne
123
Wexford
2
Non-Residents
Total
339
1
4
1
1
6
1
9
2
1
2
10
1
5
4
4
3
4
25
21
12
18
10
15
23
13
6
11
21
25
13
21
15
1
6
2
1
3
1
25
3
11
7
35
3
6
12
22
1
3
3
2
4
6
18
31
11
4
1
19
3
1
1
1
5
19
12
3
9
1
8
9
4
6
203
2
16
18
10
32
12
20
27
12
9
11
12
1
2
1
15
13
2
5
2
8
7
4
8
165
4
576
12
558
1
1
1
1
10
6
1
4
4
4
2
1
80
237
8
5
3
1
11
1
8
1
6
8
2
7
3
F
Number of
Patients Per
100,000
T
1
9
2
12
7
4
3
16
3
14
6
8
10
5
1
12
8
1
10
1
43
5
2
1
3
9
25
32
24
24
36
60
34
21
17
32
32
51
42
26
14
23
29
35
11
6
20
36
30
9
23
16
12
16
4
7
1
9
4
6
5
157
2
1
2
3
1
27
29
6
12
3
17
11
10
13
322
6
1
36
26
48
22
43
19
43
36
43
33
31
20
17
36
518
1076
22
5
1
4
2
1
2
5
2
6
5
2
2
3
1
5
5
1
6
24
2
1
2
4
1
1
�TOTAL ADMISSIONS 1931 - 1934 SHOWING AGE GROUP AND ECONOMIC STATUS
Table VI
0- 4
5- 9
10 - 14
15 - 19
Total Admissions
Dependent
Marginal
Comfortable
Unknown
23
49
96
118
11
16
38
47
11
28
46
58
1
4
10
8
1
2
5
20
25
30
35
-
24
29
34
39
84
66
26
25
42
26
15
14
35
30
10
5
2
7
40
45
50
55
-
44
49
54
59
20
24
17
6
10
12
6
3
9
10
10
3
1
1
13
4
3
2
5
3
1
1
8
2
1
576
249
266
60 - 64
65 - 67
70 and over
Unknown
Total
4
5
4
1
2
1
1
1
38
23
g
p-3
H
a
o
02
�STATE EPILEPTIC COLONY
VII- ADMISSIONS BY AGE GROUPS AND NATIVITY
The total admissions occurring in the four year period from
1931 to 1954 are divided in this table according to nativity and age
groups. Less than seven per cent are foreign born, and of the native
born 55 per cent are of full native parentage.
The foreign born show a smaller proportion of females in the
total of their admissions. There are also a smaller number of the
younger age groups contained in the total of the foreign born admissions.
VIII - DISCHARGES AND YEARS OP HOSPITAL LIFE
The total discharges from 1951 to 1934 are shown here by age
groups and according to the number of years they have been on the
books of the institution. Seventy-eight per cent of all discharges
were less than 35 years old at the time of discharge. The same proportion as given above was true in the case of both sexes. The average time in the institution was also about the same for both sexes.
41
�»»
i> to
MICHIGAN STATE HOSPITALS
CO
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to
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ID PTI
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EH
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6
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ft
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CS
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sa
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S3 0
0 CD,
H
O
Hi
CM
H
CO ®
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as
tO <M CM TH
f_|
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S
0
t>
fe
0 S
« ft
rf
-P -H
O -P
CO
' 'a a
CM C- O
gj lit
Q co
< £5
j_q
^5
EH
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H
t!
<B
rH
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C8
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42
in
to
c~
CM
>
to
to
to
s
H
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•Jf
CM
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in
to
CM
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m
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to
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rit
to
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�Table VIII
Male
0-4
5-9
10 - 14
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
1
1
DISCHARGES DURING 4 YEAR PERIOD 1931 - 1934
Total Discharges
Female
Male
Total
1
2
12
Years
6
11
13
13
5
3
5
6
4
1
18
19
9
4
1
3
2
5
5
2
5
5
1
1
5
2
1
9
3
3
1
2
1
6
6
17
Mos.
2
2
4
3
7
.
5
10
7
5
2
Average Hospital Life
Female
Years
Mos.
Total
Years
Mos.
1
1
1
1
3
3
2
1
6
6
6
1
3
3
2
1
1
5
3
11
2
2
2
1
5
1
0
5
Unknown
Total
61
34
95
11
JTJ
h*
P
Q
**
c
o
h-l
5;
3
1
5
3
7
6
7
5
11
6
1
11
55 - 59
1
60 - 64
65 - 69
70 & over
1
K!
�MICHIGAN STATE HOSPITALS
IX - DEATHS AND YEARS OP HOSPITAL LIFE
Deaths occurring in the colony during the four year period
ending December 31, 1934 are divided in this table according to the
ages at which death occurred. The average number of years during
which each group has been on the institution books is also included.
About half of these deaths occurred among patients less than 35 years
old.
With the average time on the books of six years and ten months
for the 348 who died and with an average of two years and six months
for the 95 patients discharged, there is shown a general average life
of five years and 10.8 months for the total of 443 who died or were
discharged in the four year period.
X- CAUSES OP DEATH
For the total of 348 deaths listed in the four years from 1931
to 1934 inclusive are given the causes according to the International
List, published by the Census Bureau.
In addition to the 212 ascribed to epilepsy, the principal
other causes include tuberculosis, pneumonia and heart disease, in the
order named.
44
�DEATHS DURING 4 YEAR PERIOD 1931 - 1934
Table IX
Total Deaths
0 - 4
5 - 9
10 - 14
15 - 19
80 - 24
25 - 29
Male
Female
Total
3
11
2
1
13
13
5
12
30
32
15
16
40
42
15
14
31
17
19
85
Average Hospital Life
Female
Male
Years
Months
Years
3
1
2
9
5
3
4
6
11
6
5
5
4
10
3
7
11
1
3
2
6
9
5
12
8
3
30 - 34
35 - 39
26
16
10
40
45
50
55
16
6
17
5
13
11
12
10
29
17
29
15
9
5
12
6
15
11
11
8
11
8
16
9
11
1
7
197
151
-
44
49
54
59
60 - 64
65 - 69
70 and over
Unknown
Total
6
4
24
348
a
12
7
8
a
a
a
Months
1
1
5
a
Total
Years
Months
2
8
1
2
10
9
4
6
2
2
0
7
9
7
9
10
2
10
10
6
12
a
10
6
10
1
9
9
11
I
H
H
8
3
3
a
11
a
5
10
8
9
3
10
O
2
Kl
�MICHIGAN STATE HOSPITALS
Table X
TOTAL DEATHS 1931
to 1934
INCLUSIVE GIVING CAUSES OF DEATH
Causes of Death
Male
Tuberculosis of Respiratory System
Tuberculosis o f other organs
Other Infectious Diseases
Cancer a n d other Malignant Tumors
Other General Diseases
15
2
3
2
1
Diseases of Blood and Blood Making Organs
Chronic Poisoning
•
1
Epilepsy
110
Other Diseases o f Nervous System
5
Endocarditis
4
Other Diseases of the Heart
Other Diseases o f Circulatory System
Broncho Pneumonia
Pneumonia (lobar, unspecified)
Other Diseases o f Respiratory System
Female
14
1
4
1
102
2
6
Total
29
3
3
6
1
1
1
212
7
10
11
1
17
4
2
1
2
3
6
1
12
3
20
10
3
Diseases o f Digestive System
Nephritis
Diseases o f Bones
Gangrene
Congenital Malformations
2
4
1
1
2
2
3
1
1
4
7
2
1
3
Diseases of Early Childhood
Senility
Accidental Deaths
Cause Unknown
1
1
5
2
1
1
1
5
3
151
348
Total
46
197
�
asylums
-
https://localhistory.tadl.org/files/original/49c1e07b1098c032c6499d34bd06d51b.pdf
bf5d5859d2a8ee2eab07f70d456e326c
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Traverse City State Hospital
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Asylums.
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Amy Barritt, 1984-
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Various.
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1885-1989
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Board of Trustees for the Traverse City State Hospital.
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Michigan State Hospitals annual Statistical Reports, Movement of Population and Statistical Details for the Calendar Year of 1931
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Psychiatric hospitals.
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"The statistical data included in the tables contained in this report have been collected and compiled in the State Welfare Department from reports as made during the year 1931 by the different State Hospitals. These monthly reports cover the detailed information relating to each patient as he or she is admitted, paroled or discharged from the institution. By the machine tabulation method the summaries relating to the state as a whole are quickly and conveniently compiled and are readily made available for study and comparison, both with conditions in other states and with previous years in our own state."- from preface. Details the population numbers, especially admission by psychoses, age of individual, and origin of birth divided into native (to the United States) and foreign-born individuals.
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State Hospital Commission, State Welfare Department (Mich.)
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State Hospital Commission, State Welfare Department (Mich.)
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1931
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Board of Trustees at the State Hospitals across Michigan.
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Text
inuiniiiiiii]
|Q B|
-**-••«•
t^
T*
GAN
AN occuMarrs
Michigan State Hospitals
Annual
Statistical
Reports
Movement of Population and Statistical Details
for the
Calendar Year
of
1931
�State Hospital Commission
R. G. FergusorvChairman
SaultSte. Marie
Kalamazoo
Dr. E. P. Wilbur
BayCity
Mrs. May Belle Downing
Bradley T. Fowlkes
Grand B\apids
Mrs. J. C. Hoskins
Pontiac
Fred Warded
Detroit
Enoch T. White
Lapeer
William S. Carpenter^ Director
State Welfare Department
�MICHIGAN STATE HOSPITALS
Data collected and compiled under direction
of Gilbert R. Haigh, Accounting
Consultant.
�MICHIGAN STATE HOSPITALS
MICHIGAN STATE HOSPITALS
The statistical data included in the tables contained in
this report have been collected and compiled in the State
Welfare Department from reports as made during the year
1931 by the different State Hospitals.
These monthly re-
ports cover the detailed information relating to each patient
as he or she is admitted, paroled or discharged from the institution. By the machine tabulation
method the sum-
maries relating to the state as a whole are quickly and conveniently compiled and are readily made available for study
and comparison, both with conditions in other states and
with previous years in our own state.
�Table 1—Showing the population movement for all institutions of the hospital group for the year 1931.
In
Institution
Ypsilanti
Kalamazoo
Pontiac . .
Traverse City
Newberry
Ionia.
. .
Psychopathic
Eloise
Totals for Mental
Hospitals
Wahjamega
. ..
Lapeer
Northville
. ..
Totals for Epileptics and
Mental Defectives
AT BEGINNING OF YEAR
Absent
Total on Books
But on Books
M
0
1315
939
1117
640
612
27
1291
P
M
F
0
1291
795
970
512
75
30
1162
0
205
66
80
62
3
42
198
0
164
67
76
54
2
65
164
5941
4835 657
11
F
In
Institutions
T
0
0
1521
1455
F
T
19
222
68
99
58
4
37
186
476
1573
1007
1285
711
624
63
29
186
73
82
57
2
49
155 1524
458
1529
875
1132
567
84
79
1200
934
3102
1882
2417
1278
708
142
2724
5291 693
5924
13187
420
1801
782 427
39G 26
1695 108
267 79
633 7263
431
24 1681
106 506
60
4678 2405
2358 213
190 2618
2543
M
1197
1046
702
615
69
1489
566
77
95
1326
0 457
2976 1351
1867 939
2243 1186
1268 653
692 620
164 26
2815 1338
592 6598
5427
12025 6570
1005
862
413
1487
410
386 25
1252 172
260 63
19 440
142 1659
49 473
1394
2310
1898 260
210 2572
2106
403
309
AT CLOSE OF YEAR
Absent
Total on Books
But on Books
843 405
3053 1573
F
429
1343
802
1050
510
82
30.
1045
M
F
M
327
851
3482
833
5166
Aeeresrate
8251
6733 917
802 9170
7533
16703 8975
7649 906
823 9881
8472
18353
The detail of admissions as divided between first admissions, readmissions and transfers is shown on the next page. Also the
division of separations into discharges, transfers and deaths, is shown in detail.
�Table 1 Cent.—Details of total admissions and total separations for all institutions for year 1931.
First
Admission
M
F
ReAdmission
M
F
M
25
51
20
3.3
27
8
3
60
20 31?
40 ^
27
6
SO
8
22
1
1 26
5 0
52 12
1491
1029 230
197 372
Wahjanieg'a
. . 53
87
Lapeer
77
Northville
Totals for Epileptics
and Mental Defectives. 217
45 2
486 18
55 0
<j
19
0
586 20
25
Ypsilanti .
. . .
Kalamazoo
Pontiac
Traverse City
Newberry
Ionia
Psychopathic , . . . .
Eloise
Totals for Mental
Hospitals
Ag-p-reg'ate. .
161
309
91
181
95
13
97
544
1708
132
215
56
125
58
2
122
313
16J5 250
Total
Admissions
Transfers
to
F
325
5
4
10
0
6
0
11
M
503
362
117
225
123
47
100
616
F
477
260
8"
165
80
9
127
382
Discharges
M
Transfers
From
F
M
Total Separations
Deaths
F
M
12
80
30
37
33
1
1
63
27
310
115
137
114
38
106
581
F
4
154
46
36
55
8
72
170
3
3
7
94
8
35
5
40
0
44
7
0
100 34
142 305
2
12
9
2
2
1
42
303
3.31 2093
1587 545
458 369
373 514
0
2
0
0 55
1 107
0 77
51 14
506 62
55 43
• 9
59
37
1
0
1
0 47
0 23
0 0
27
40
0
62
85
44
36
99
37
?
1
239
612 119
105
2
0 70
67
191
172
362 2332
2199 664
563 371
373 584
222 374
20
149
61
96
59
23
0
106
M
F
19
186
74
79
79
2
143
508
o
ffi
I—I
o
257 1428
324 1619
1090
1262
M
o
co
�MICHIGAN STATE HOSPITALS
NOTE
The Wayne County Hospital at Eloise and the training school at Northville are not under the State Hospital Commission, but all the mentally diseased and
mentally defective patients contained in these two institutions are included in the scope of these tabulations.
�TABLE 2—First admissions and deaths in mental hospitals
psychoses
PSYCHOSES
„,
Total.
,
-
!
-
,
!
1931 in relation with
FIRST ADMISSIONS
Male
Traumatic
Senile
Cerebral Arteriosclerosis....
General Paralysis
Cerebral Syphilis
Huntington's Chorea
Brain Tumor
Other Nervous Diseases
Alcoholic
Drugs and Toxins
With Pellagra
Other Somatic Diseases....
Manic-Depressive
Involution Melancholia
Dementia Praecox
Paranoia
Epileptic
Psychcner oses and Neuroses
Psychopathic Personality....
With Mental Deficiency
Undiagnosed Psychoses
Diagnoses Deferred
Alcoholism without
Psychosis....
Drug Addiction '
"...
Psycho Personality"
"...
Mental Deficiency "
"...
Others without Psychosis..
during
Female Total
74
46
44'
13
3
•
o
„„_
Of
-.
o-.
149
181
204
57
6
0
11 39
70
13: 19
0
21 36
135 230
19! 21
196' 483
35 70
7 21
53 84
4 15
19 47
108
31 118
1
6
15
21
31
1300
22
10
40
50
78
862 2162
type of
DEATHS
Percent Male
0.1
6.9 51
8.4 116
9.5 79
2.6 14
o.: 5
i.
3.2
0.9
Female Total
45 96
33 149
21 100
3 17
1 6
13.0
20.2
13.5
2.3
0.8
18
19
2
2.4
2.5
0.3
18
52
4
139
16 39
8
5
3
7 17
20
5
2.4
7.0
0X3
18.9
5.3
1.1
0.7
0.5
2.3
2.7
0.7
14
19
2
1.1
9
10
27
0.9
1
22.-! 87
3.2 23
l.f
6
3.1 2
0.6
3
2.£ 10
5 0 12
5.5
4
Percent
25
1.0
0.6
1.9
23
3.6
1
2
9
5
1
2
13
5
0.1
0.2
1.8
0.7
100
501
237i 738
100.0
Does not include admissions and deaths in Ypsilanti State Hospital.
o
M
z;
CO
O
CO
�TABLE 3—First admissions during 1931 of mentally diseased.epileptic and mentally defective, showing different diagnosis
divided according to age of patients on admission date.
Under 15
Yrs. 35-39
Yrs.
Yrs. 30-34
Yrs. 25-29
15-19
Yrs. 20-24
Total
PSYCHOSES
Years
M
F
M
F
M
F
M
F
T M
M
F
M
F
F
1
1
4
4
Traumatic
75
74
149
Senile
46
181 1
Cerebral Arteriosclerosi: 135
1
6
2 25
2 23
1 6
160
44
204 1
I
2 1
General Paralysis
2 6
4
3 5
44
13
o7
Cerebral Syphilis
2
1
1 1
3
6
Huntingten's Chores. . . . 3
Brain Tumor
2
10
1
1 4
2
3 2
11
39
Other Nervous Diseases 28
4
1 8
2
63
7
70 1
Alcoholic
1
Q
1
1
6
13
19 1
Drugs and Toxins
Q
With Pellagra
1
O 1
9 0
1
2 1
21
36
Other Somatic Diseases 15
10 12
19
8
14 9
14
1 6
1 4
95
135
230
Manic-Depressive
2
19
21
Involution Melancholia .
42
36
25 49
28
6 55
Dementia Praecox
287
196
483 3
3^ 2
26
3 41
1
1
35
35
70 3
Paranoia
1
6
3
2
2
1
2
1
1
2 3
Epileptic
14
7
21 2
Psychoneuroses and
1 1
0 2
10
31
53
84
Neuroses
7 4
7 4
3 6
1
1
1
Psychopathic Personality 11
4
15
1
1
1 2
r
3
2 9
1
2
4 1
With Mental Deficiency. 28
19
47 1
5
2
5 3
5
4 7
Undiagnosed Psychoses . 51
57
108
5 4
5
3 12
Diagnoses Deferred . . . . 87
31
118 2
5 9
3 16
4
1 6
o
5
o
w
o
w
f
02
�TABLE 3 continued.
PSYCHOSES
Alcoholism without
Psychoses
Drug Addiction
without Psychoses . . . .
Psycho Personality
without Psychoses . . . .
Mental Deficiency with
Psychoses
Others without Psychosi
Total
Under lt>
Years
Total
M
F
T M
15-19
M
F
Yrs. 20-24
F
M
F
M
Yrs. 30-34
M
F
2
21
1
22
4
6
10
25
15
40
2
3 2
29
47
21
31
50
78
5
3 .4
1300
862
2162
90
2 2
4
6
3 2
100
1 A
Idiots
Imbeciles
Morons
Not Feeble Minded
Total Mental
Defectives
. .
Epileptics . .
...
26
24
65
36
117
161
1>36
62
143 91
185 21
231 56
98 34
151
60
uO>5
72
1 Q9
1R
9RR 10
°,1 14
11°
1 32
Afi-ereuate
1511
1440 2951 183
333 84
1 58 112
657
Yrs. 25-29
3
90 2
80
42 1
7fi
First admission patients at Ypsilanti State Hospital not included.
0 4
2 3
4
2 3
1 2
2 1
2
7
5 7
3
8Q 1 AQ
27
7t; 1fi1
4t
*
1 °,
F
1 1
3
9
1
M
F
1 1
15 1
OK
Yrs.
1
1',
i -j
If4
1 A
1
4
Yrs. 35-39
Sfi 1 3fi
4
6
1
>j
1
12 1
1
'99
1
4
7
Q
i2i- 106
1
115 140
1
*
0
5
1
o
M
—
O
>
z;
1-3
M
1A
3
103
1 K4
9
1 OR
O
w
�TABLE 3—continued.
PSYCHOSES
Traumatic
Senile
Crrcbral Arteriosclerosis . .
General Paralysis
Cerebral Syphilis
.. .
Huntingdon's Chorea
Brain Tumor
Other Nervous Diseases . . . .
Alcoholic
.
Drugs and Toxins
With Pellagra
Other Somatic Diseases . . . .
Manic-Depressive
Involution Melancholia
Dementia Praecox
Paranoia
Epileptic
40-44
M
1
Yrs. 45-49
Yrs. 50-54
F
F
M
M
2
£5
6
2
11 23
4 7
1
5 3
14 20
1 h'
5
10
1
12
4 1
1 1
1 0
1 2
1
10
1
30
4
2
Psychoneuroses and Neuroses 7
Psychopathic Personality . . 1
3
With Mental Deficiency
Undiagnosed Psychoses . . . . 3
16
Diagnoses Deferred
6
23 ! 1
32 10
4 6
7
1
2
4
4
2
5
4
7
1 1
16 13
6 I
21 1 -3
1 2
••>
5
1
6
9
3
1
2
8
7
'
Yrs. 55-59
Yrs. 60-64
Yrs. 65-69
Yrs. 70 and Over
K
F
F
F
M
1 1
1 2
2 9
3 15
1 4
M
6
5 29
3 6
2 2
1
M
13
r, 13
1 17
2
1
1
? 8
1
1
2 6
3
<5
2
14 10
5
4 3
5 3
2
3
3
3 3
1
1 4
2
2
U
4
G
7
9
3
4
3
9 8
2 3
M
4 54
6 72
2
1 1
1 2
1
4
F
50
23
1
1
g
1
o
ffi
2
2
2
2 •
1
4
2
(5 3
3 1
5
1 2
s
4 4
2
1
1
CO
1-3
M
O
m
T)
HH
H
>
f
02
�TABLE S Contined
40-44
PSYCHOSES
M
Alcoholism without Psychoses 1
Drug Addiction . "
". . . .
Psycho Personality " .". .
Mental Deficiency
Others
." .
" "
. ."
Totals
Idiots
Imbeciles
Morons
Not Feeble Minded
3
F
M
6
Yrs. 50-54
F
M
2
1 1
1 2
9
3 3
151
109 110
98 105
154
F M
1 1
1
1
2 4
..
Yrs. 55-59
1
2 1
Total Mental Defectives . . .
3
Epileptics
Aggregate
Yrs. 45-49
2 1
2
2
1
6 1
1 3
2
3 2
116 114
103 107
2
2
65 80
1
Yrs. 60-64
F
M
1
Yrs. 65-69
F
M
Yrs. 70 and Over
M
F
F
2
1 2
1
1 2
56 82
3
48 48
1 3
1
24 145
79
Q
>
1
1
1
1 1
z;
1
3
1
66 80
57 84
o
M
49 48
27 145
80
ffi
o
to
hj
t"
CO
�TABLE 4—First admissions in mental hospitals during 1931 divided into native and foreign born and in relation with types o.f
psychoses.
Native
M
Traumatic
2
26
Senile
Cerebral Arteriosclerosis . . . . -16
General Paralysis
71
Cerebral Syphilis
16
Huntington's Chorea
2
Brain Tumor .
Other Nsrvous Diseases . . . . 9
Alcoholic
16
Drugs and Toxins
1
With Pellagra
Other Somatic Diseases
8
Manic-Depressive
30
Involution Melancholia
Dementia Praecox
123
14
Paranoi'i . .
Epileptic
10
Psychonevr-OKe.; and Neuroses 18
Psychopathic Personality. . . . 5
With Mental Deficiency
9
Undiagnosed Psychosis
24
Diagnoses Deferred
35
Alcoholism without Psychosis 7
Drug Addiction "
"
2
Psycho Personality. " . . " . . . . 10
11
Mental Deficiency ".
Others without Psychosis . . . 16
Total
MJHLKiN
NATIVE BORN
PSYCHOSES
511
F
19
15
25
6
PARENTAGE
'
j
Unknown
Foreign
Mixed
F M
M
F M
F M
1
1
4
12
10 5
63
4 46
4 8
t> 92
15
4 23
18
6 16
a 3
1 108
9
4 5
32
2
1
1
1
3
5 2
3 10
8
2 C
1 10
3
11
1
9
4£ 20
4 4
33 13
5
39 26
4 3
1
12 2
1 1
7 5
10 10
5 4
4
1 1
4 2
7 5
7 •5
25
10
41
20 5
4 1
S
41
167 152
76 46
e 1
87 52
11 6
4 1
29 5
1 2
8 6
27 9
9 10
5
4
4 6
8 9
11 11
348 211
•
23
52
25
1
? 2
21
15
37
4
17
2 63
2
6 206
2 24
12
1 26
8
1 23
1 45
2 54
1 16
4
1 20
2 26
1 33
30 920
TOTALS
F
Aggregate
BORN
39
28
35
10
2
T
4
85
120
143
42
5
8
4
8
23
41
12
16
29
39
70
19
15
94
15
152
21
7
46
2
18
43
18
1
5
12
19
19
32
157
17
358
45
19
72
1 0
41
88
72
17
9
32
45
52
4
73
4
125
25
2
12
36
230
21
483
70
21
84
15
47
108
118
22
10
40
50
78
.< 541
621
621
64
61
61
15
1
r
C
O
6
20
46
5
1
8
5
26
4
149
181
204
57
6
2162
To'.al of native born are herein divided according to their parentage,' indicating over 55% have parents who also are native born.
Ypsilaati Hospital not included.
�MICHIGAN STATE HOSPITALS
The total of foreign born shown in Table 4 on opposite page is further divided in Table 5 indicating
the
numbers born in several of the principal countries of
Europe.
�TABLE 5—First admissions to mental hospitals during 1931 of patients who are foreign born, divided into countries of
birth in relation with types of psychoses.
PSYCHOSES
TOTAL— ALL COUNTRIES
M
F
T
29
43
52
12
35
18
9
3
1
64 1
61 1
61
15 1
1
13
26
2
3
3
5
16
29
7
1
29
3
44
4
44
14
1
7
2
1
13
13
18
Traumatic
Senile
Cerebral Arteriosclerosis . . .
General Paralysis
. ..
Cerebral Syphilis
....
Huntingdon's Chorea
....
Brain Tumor
Other Nervous Diseases
Alcoholic
. . .
Drugs and Toxins
..
With Pellagra
....
Other Somatic Diseases . . . .
Manic Depressive
Involution Melancholia
Dementia Praecox
Paranoia
.
.
Epileptic
Psychoneuroses and Neuroses
Psychopathic Personality
With Mental Deficiency
Undiagnosed Psychoses . . . . .
Diagnosis Deferred
....
Without Psychoses
81
11
1
5
3
5
7
33
27
Totals
380
Ypsilanti State Hospital not included.
241
M
4
73
4
125 4
25 1
2
12
5
6
20
46 2
45
621 10
Austria
England
F
M
1 1
2
1
Finland
M
F
3
2
I
11
Germany
F
M
4
] 7
1
2
1
2
2
11
32
4 4
1
4 1
6 3
1
25
1
12
2
2
2
2
178
Greece
F
M
10
3
2
1
11
1
33
B
a
J
H
O
OQ
1
15 30
o
31
1
2
2 2
3
F
1
1
31
27 9
�Table five continued
PSYCHOSES
Ireland
M
F
3
Cerebral Arteriosclerosis . . . . 1
Italy
M
1
1
Poland
F
M
1 5
2
4
1 10
2
4
7
2
France
F
3
1
i
M
Scotland
M
F
F
1
2
2
1 1
1
Others
Russia
M
1 2
F
M
1 15
24
30
4
1
5
F
1
!
<
1
Other Nervous Diseases . . . .
1
With Pellagra
Other Somatic Diseases . . . .
Manic-Depressive
1
Involution Melancholia
2
Dementia Praecox
Psychoneuroses and Neuroses
Psychopathic Personality ....
With Mental Deficiency
Undiagnosed Psychoses . . . .
I
Diagnoses Deferred
2
Without Psychoses
2 1
7
1
1
1
2 2
15
1 3
1
1
5
1
1
1 1
4
8
1
1
3
^
2
11
1
2
4
1
19
*
2
1
3
4
1 PV
9"
11
2
97
-j r
6
1
2
;
1
1
1
3
q
1
3
2
1
1
3
1 6
iU
2
n
]
-I
/
o
o5
CQ
H
H
ffi
O
02
hj
c
21
7 66
33
2 6
6 25
109
Totals
:
11
13 179
The percentage of first admissions who are foreign born is well over ten percent greater than the proportionate total of
foreign born in the states population. The proportions from Poland and Russia are indicated as particularly high in this
connection.
f
w
�TABLE 6-—Deaths and discharges occuring in 1931 in mental hospitals in relation with length of hospital life.
Condition at Discharge
HOSPITAL LIFE
1 to 3 months
3 months to 1 year . . . .
1 year to 3 years
3 years to 5 years
5 years to 10 years . . .
10 years to 20 years.
20 years to 30 years . .
30 years to 40 years . .
40 years to 50 years . .
50 years to 60 years . .
Total
Total
Discharges
M
F
T
63
72 135
43
65 108
353
274 627
51
39
90
21
19
40
9
8
17
1
1 2
2
1
1
Recovered
M
4
7
62
5
4
1
Improved
F M
8 17
9 19
36 235
3 37
1 14
1 6
1
Unimproved Without Psychoses & Unk
F
M
"F M "
20
20
21 22
4
9
32 8
5
38
29 18
1
8
12 1
1
1
7 2
1
1 1
F
23
20
204
23
10
6
1
1 1
542
479 1021 83
58 329
288 78
Deaths and discharges at Ypsilanti State Hospital not included.
102 52
M
11-3
85
84
52
57
36
30
29
10
2
31 501
Total
Deaths and
Discharges
DEATHS
F
40
45
39
24
26
29
17
7
8
2
T
156
130
123
7-3
S3
65
47
36
38
4
237
738
T
291
238
750
166
123
82
49
38
18
4
1759
�TABLE 7—Condition of patients at time of discharge: from mental hospitals during 1931 shown in relation with types of
psychoses.
"'"
~ '~
Without Psychoses
Unimproved
Improved
'Recovered
All
Conditions
and condition Unk.
PSYCHOSES
F
T M
F
T
M
F
T M
M
P
T M
, F
T
Trautmatic
Senile
... .
Cerebral Arteriosclerosis . .
General Paralysis
Cerebral Syphilis
Huntingdon's Chorea.
Brain Tumor
Other Nervous Diseases . . .
Alocholic Psychosis
..
Drugs and Toxins
With Pellagra
Somatic Diseases
Manic Depressive
Involution Meloncholia
Dementia Praecox
Paranoia
Epileptic Psychoses . . .
Psychoneuroses and Neuroses
Psychopathic Personality . . .
With Mental Deficiency . . . .
Undiagnosed
Diagnosis Deferred
Without Psychoses
3
4
19
51
21
0
12
» flu
8
9
3
16
29
59 4
30 3
7
46
4
1
5
6
4
1
12 2
52 12
8 1
3
75
2
141
17
5
19
4
12
24
11
73
29
142
9
90
21
6
43
7
5
29
6
37
32 1
217 26
11
231 10
38 1
11
62 6
11 1
17 1
53
17
110 14
1
1
1
3
25
5
1
11
1
6
3
16
4 45
3 12
8
7
6
9
3
8
23
51
21
3
3
2
6
3
3
1
6 1
6
3
6
2 4
13 28
2 3
1
4
5
2
1
8 1
33 4
5
1
2
4 2
1
4 2
51 41
2
15 97
2 10
3
17 11
2 3
1 9
6 19
5
17 16
21
90
6
56
11
3
25
3
4
17
2
8
23
131 7
8
153 30
21 4
6 2
36 1
6
13 2
36 3
7 5
24 5
5
23
3
29
9
3
6
3
1
5
3
3
288
617 78
102
1
3
1
1
1
O
1
5
30 1
3
59 3
13 2
5
7 1
3
3
8 2
8 1
8 39
2
4
5
3
2,
1
2
1
1
23
3
2
62
'
Totals
542
479
Not including Ypsilanti State Hospital.
1021 82
58
140 329
180 52
31
HI
83
K
W
O
VI
�MICHIGAN STATE HOSPITALS
TABLE &—Total deaths in mental hospitals during 1931 showing average age at
death with relation with type of psychoses.
PSYCHOSES
Traumatic
Senile
Cerebral Arteriosclerosis....
General Paralysis
Cerebral Syphilis
Huntington's Chorea
Brain Tumor
Other Nervous Diseases....
Alcoholic
Drugs and Toxins
With Pellagra
Other Somatic Diseases
Manic-Depressive
Involution Melancholia
Dementia Praecox
Paranoia
Epileptic
Psychoneuroses and Neuroses
Psychopathic Personality....
With Mental Deficiency
Undiagnosed Psychoses . . . .
Diagnoses Deferred
Alcoholism without Psychoses
Drug Addiction."
".. ..
Psycho. Personality.".."....
Mental Deficiency."
"....
Others Without Psychoses..
Totals .
Av. Yrs of Av. Age at
Hosp. Life
Death
Discharge by Death
M
M
51
ne
79
14
5
45
33
21
3
1
14
19
2
9
27
1
87
23
6
2
3
10
12
4
3.75
4.16
3.16
2.25
2.66
18 2.75
19 12.66
2 12.58
9
25
3
52
16
2
3
i
2
9
5
501
96
149
100
17
18
52
4
139
39
8
5
3
17
20
5
0.75
8.16
14.50
20.08
18.58
5.33
4.92
9.00
11.41
9.33
1.33
1 5.75
2 7.41
9 16.00
5 14.16
237
Ypsilanti Hospital not included.
Documents
738
8.08
F
M
75
71
51
51
52
76
71
46
47
62
7.00 48
57
4.08
1.83
2.75
0.92
5.66
53
54
55
61
72
51
67
52
55
64
11.25 51
3.25 67
1.25 37 2.25
6.92
7.08
19.08
17.00
5.66
1.50
49
79
18.00 51
69
6.92 57
50
56
55
55
68
69
47
39
56
56
55
56
�
asylums
-
https://localhistory.tadl.org/files/original/e8e8a8f613441148d6c2bb74e0b1cab1.pdf
0ebbb0fd7e1e1d012b808a9ee4d3c798
Dublin Core
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Title
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Traverse City State Hospital
Subject
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Asylums.
Psychiatric hospitals.
Description
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Items within this collection pertain to the Traverse City State Hospital, also known as the Northern Michigan Asylum for the Insane and the Traverse City Regional Psychiatric Hospital.
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Amy Barritt, 1984-
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Various.
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1885-1989
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Board of Trustees for the Traverse City State Hospital.
Various.
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Various.
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Various.
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English.
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Various.
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TCSH-xxxx.
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Traverse City, Grand Traverse County, Michigan.
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Papers, Discussions and Reports given at the regular mid-Summer meeting of the Joint Board of Trustees of Michigan State Hospitals held at Kalamazoo State Hospital, July 15, 1920
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Psychiatric hospitals.
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Report includes a list of those in attendance; a memorial for Chauncey F. Cook, a trustee of the Kalamazoo State Hospital Board who died February 5, 1920; Reports of the finance committee; an address given by Dr. Frankwood E. Williams on "The State Hospital in Relation to Public Health"; two addresses on the solvency and therapeutic qualities of state hospital farms; and individual reports given by the superintendents of each institution.
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Joint Board of Trustees of Michigan State Hospitals.
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Original document held by Traverse Area District Library.
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Lansing, Mich.: Wynkoop Hallenbeck Crawford Co., State Printers.
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1921.
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State of Michigan.
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This document is in the public domain.
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See other reports from the Board of Trustees at various institutions in the "Traverse City State Hospital" Digital Collection.
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PDF.
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English.
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Document.
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MSH0008.
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Michigan, United States.
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MICHIGAN DOC
PAPERS, DISCUSSIONS AND REPORTS
GIVEN AT THE
REGULAR MID-SUMMER MEETING
OF THE
JOINT BOARD OF TRUSTEES OF
MICHIGAN STATE HOSPITALS
HELD AT
KALAMAZOO STATE HOSPITAL
JULY 15, 1920
Lansing. Michigan
Wynkoop Hallenbeck Crawford Co.
State Printers
1921
�LIST OF THOSE IN ATTENDANCE.
Hon. Albert E. Sleeper. Governor.
From the Pontiac State Hospital—Trustees John G. Clark, C. C. Yerkes, A. E. Stevenson, with Dr. E. A. Christian, Medical Superintendent.
From the Newberry State Hospital, Trustees Thomas Conlin, Fred S. Case, R. G.
Ferguson, with Dr. E. H. Campbell, Medical Superintendent.
From the Traverse City State Hospital—Trustees Dr. C. E. Miller, Dr. S. E. Neihardt,
A. Marshal!, J. M. Harris, with Dr. James D. Munson, Medical Superintendent.
From the Ionia State Hospital—Trustee E. W. Ranney, with Dr. Robert Haskell,
Medical Superintendent.
From the Eloise Hospital—Trustee O. B. Gulley, with Dr. J. J. Marker, Medical
Superintendent.
From the State Psychopathic Hospital—Director Dr. A. M. Barrett.
From the Michigan Home and Training School—Dr. Harley Haynes, Medical Superintendent.
From the Kalamazoo State Hospital—Trustees T. J. Cavanaugh, F. E. Pulte, A. A.
Anderson, John H. Ryan, Dr. E. P. Wilbur, with Dr. Herman Ostrander, Medical Superintendent.
There were also present, representing the Stewards Association, the following: Mr.
E. H. Halsey, of the Pontiac State Hospital; Mr. W. J. Garrett, of the Newberry State
Hospital; Mr. George B. Pike, of the Traverse City State Hospital; and Mr. Howard H.
Buckhout, of the Kalamazoo State Hospital; Frank E. Gorman, State Treasurer, Fred B.
Perry, Secretary of the Board of State Auditors, Terry Corliss, Superintendent of Publications, and Mr. Charles Foot, Budget Commissioner; C. D. Betts, State Purchasing
Agent; various members of the medical staff of the Kalamazoo State Hospital and other
employees of the same; Mrs. A. E. Sleeper, Miss Carrie Carr, Mrs. C. E. Miller, Mrs.
A. Marshall, Mrs. S. E. Neihardt, Mrs. Thomas Conlin, Miss Conlin, Mr. and Mrs.
Holmes, Miss Holmes. Mrs. E. A. Christian, Mrs. John G. Clark, Mrs. C. C. Yerkes, Edward Yerkes, Mrs. E. W. Ranney, Mrs. A. M. Barrett, Edward Barrett; Hon. A. J.
Mills, Mrs. A. J. Mills, Miss Helen Mills, Mrs. Dwight B. Waldo, Miss Wilhelmina De
Yoe, Mrs. Helen Statler, Mrs. J. A. Pitkin, Mrs. C. F. Cook, Miss Florentine Cook, Miss
Mary Isabel Wright, Mrs. E. H. Halsey, Mrs. George B. Pike, Mrs. C. D. Betts, Mrs.
Charles R. Foote, Mrs. Caroline Kleinstuck, Mrs. Hubbard Kleinstuck, Mrs. Helen Cobb,
Miss Tomlinson, Mrs. T. J. Cavanaugh, Mrs. A. A. Anderson, Mrs. John H. Ryan, Mr.
D. J. Buck, and Dr. Frankwood E. Williams, Associate Medical Director of the National
Committee for Mental Hygiene, New York City.
�MEMORIAL SERVICES FOR THE HON. CHAUNCEY F. COOK, LATE TRUSTEE
OF THE KALAMAZOO STATE HOSPITAL BOARD.
ADDRESS BY HON. THOMAS .1. CAVANATJGH.
Ladies and Gentlemen: We have gathered here today, my friends, to pay a tribute
of respect and appreciation to one of our former associates.
Chauncey F. Cook, was born in the city of Hillsdale, March 9, 1857, and died in the
same city February 5, 1920.
Chauncey F. Cook's first educational training was in the public schools of the city of
his birth. Afterwards he attended Hillsdale College for awhile, and then entered the
literary department of the University of Michigan, graduating therefrom in 1879, and in
1882, he graduated from the law department of the same University. After this, he gave
his attention to the law and was in a law office in Toledo a short time, returning to Hillsdale where he opened an office on his own account. The legal profession however, did
not appeal to him, and in 1884 he organized the Hillsdale Savings Bank, entering the banking business with fixed principles of sound and conservative banking. He was elected its
first cashier and later, on the death of his father, he was made president, which position
he held until his death.
During his life, Mr. Cook was actively interested in public affairs, and a leader in
civic development. He took a prominent part in all matters that related to the civic and
intellectual development of his community. He was a member of the Board of Education
for a long period, and a trustee of Hillsdale College for a number of years, and because of
his unusual knowledge and grasp of public problems, together with his rare administrative
ability was an influential and valued member of both boards.
Long before the question of municipal ownership of public utilities became an economic problem in this country and when he was but 28 years of age, he advocated municipal
ownership of water works for the city of Hillsdale, and was elected Mayor of the city on
that issue and during the first of his administration the present water works system of
Hillsdale was installed and as a municipally owned and operated utility was and is a success.
For many years he served as a member of the Board of Public Works and has given
freely of his time to administering Hillsdale's public utilities.
Politically he was a Democrat and in 1891, he was appointed a trustee of this institution now the Kalamazoo State Hospital by Governor Winans, for a period of six years,
and thereafter, at the expiration of each succeeding term, without regard to which party
was in power, he was reappointed so that at the time of his death, he had served continuously for a period of 29 years.
He acquainted himself with all the details of the institution and was intensely interested in the care of the inmates thereof, advocating such improvements, diversions and attractions as would add to their comfort and the satisfaction of their friends and relatives.
He always took a prominent part in the discussions at joint board meetings and was
instrumental in suggesting and recommending legislation for the betterment of the hospitals
for the insane throughout the state.
He served as chairman of the Board in charge of the Psychopathic hospital at the
University of Michigan from the time of its establishment.
He held many other positions of trust which he filled with the same sound business
skill that obtained in his own business affairs.
In 1891 Mr. Cook was married to Miss Louise Stock. To this union were born one
son, Chauncey F. Cook, Jr., and one daughter, Florentine W. Cook. To these and their
bereaved mother, his death is indeed a calamity.
He entered upon his career possessed of a robust intellect, great energy, rugged honesty, and a worthy ambition. Everything was to him important. His strict honesty in
business, his loyalty to his friends, his faithfulness to every obligation and undertaking
were valuable assets during his whole life, which entitle him to be remembered as an ideal
citizen. Thus it may be said of him, he was true to his friends, faithful to his business,
and business associates, true to every problem of life that he undertook to solve—a man
of just and high ideals and one whom we might well hold up as an example for our young
men to follow.
It has been said that God erects men. Time destroys them, mouldering everything
�6
MEETING OF JOINT BOARD OF TRUSTEES.
from the monuments raised to perpetuate the memory of the patriot to the garland laid
by the hands of love on the tomb of the peasant and watered by the tears of sorrow. At
our birth, instead of beginning to enjoy the temporary pleasures of this life, we are merely
preparing to die, decaying, withering the moment we begin to exist—no place or condition
of life free—the sage and philosopher meditating over musty tombs until every medium
of thought is a living, sparkling gem, are chilled by the icy touch of death and the vaulting
ambition of a future filled with splendor wanes and passes down the slope of the eternal
in company with that of the ignorant barbarian and village peasant.
Cut off by grim death in the prime of life, full of promise, when the sun of mature manhood was shining bright—thus is the instability of human life evinced. Well may the
poet exclaim:
' 'Oh why should the spirit of mortal be proud!
Like a swift fleeting meteor, a fast flying cloud
A flash of lightning, a break of the wave
Man passes from life to his rest in the grave.
The leaves of the oak and the willow shall fade,
Be scattered around and together be laid,
And the young and the old, the low and the high
Shall moulder to dust and together shall lie.''
But though he be ashes and dust, in the years to come CHAUNCEY F. COOK will
live in our memory as a wise and good man, and Michigan's history will recite his name
among its valued pioneers.
REMARKS BY HON. FRED S. CASE OF THE NEWBEHRY STATE HOSPITAL BOARD.
Ladies and Gentlemen: I served with Mr. Cook on the Psychopathic Hospital Board
for about 15 years, and I am very glad that I knew him. I know he was my friend. I
never met him with his cherry, kindly greeting that I did not feel better. The last time
I saw him was at Ann Arbor, last fall, and after the meeting, he said to me "Case, come
over to the Martha Cook Building, with me. and I will show you the dormitory.'' On
the way he showed me half a dozen houses, and said ' 'I bought them for Will. He wants
to build a dormitory for the boys," and I remember the pleasure he had in doing that work.
He said "let's step over to see Butts of the Engineering Department. We went in and I
remember their greeting. Butts said, ' 'Cook, it is a mighty fine thing, what Will is doing
for the University." Mr. Cook replied that he does not look at it that way; that he feels
that everything he is, and all that he has worldly, is due to the University of Michigan,
and he is just paying part of the debt.'' It was a beautiful thing, and when I was at Ann
Arbor, and learned of his death, I thought that Ann Arbor had lost in him one of the best
friends the University of Michigan ever had. I had visited with him many times and
knew of his deep interest. It seemed to me that his name represented unselfish service.
Today his memory should remind vis of our public duties. He never said ' 'Let George
do it", but he met every problem frankly and fearlessly as though it was a pleasure and
his memory ought to inspire every one of a higher public service and more affection for his
fellow men.
REMARKS BY DR. WALTER HUME SAWYER, OF HILLSDALB.
For thirty-five years I knew Chauncey F. Cook. He never avoided a responsibility
or forsook a friend. In private life and public duty, he was true to himself, and being true
to himself, was never false to any man. Painstaking and conscientious in every task, he
brought to the cause in which he was enlisted, rare good sense and sound judgment. Having
determined for himself what was right and best, he never faltered or allowed himself to
be influenced from his course. With undaunted courage and energy, he strove for his
goal. With such characteristics, he could not have been other than a marked man and
a great public servant. His service to Society and to his State was invaluable, and his
contribution to general betterment will live to bless his name and his people.
"Oh, well for him whose will is strong!
He suffers, but he will not suffer long;
He suffers, but he cannot suffer wrong;
For him nor moves the loud world's random mock,
Nor all Calamity's hugest waves confound.
He seems a promontory of rock,
That compassed round with turbulent sound,
In middle ocean meets the surging shock,
Tempest-buffeted, citadel-crown'd.''
�6
MEETING OF JOINT BOARD OF TRUSTEES.
from the monuments raised to perpetuate the memory of the patriot to the garland laid
by the hands of love on the tomb of the peasant and watered by the tears of sorrow. At
our birth, instead of beginning to enjoy the temporary pleasures of this life, we are merely
preparing to die, decaying, withering the moment we begin to exist—no place or condition
of life free—the sage and philosopher meditating over musty tombs until every medium
of thought is a living, sparkling gem, are chilled by the icy touch of death and the vaulting
ambition of a future filled with splendor wanes and passes down the slope of the eternal
in company with that of the ignorant barbarian and village peasant.
Cut off by grim death in the prime of life, full of promise, when the sun of mature manhood was shining bright—thus is the instability of human life evinced. Well may the
poet exclaim:
' 'Oh why should the spirit of mortal be proud!
Like a swift fleeting meteor, a fast flying cloud
A flash of lightning, a break of the wave
Man passes from life to his rest in the grave.
The leaves of the oak and the willow shall fade,
Be scattered around and together be laid,
And the young and the old, the low and the high
Shall moulder to dust and together shall lie.''
But though he bo ashes and dust, in the years to come CHAUNCEY F. COOK will
live in our memory as a wise and good man, and Michigan's history will recite his name
among its valued pioneers,
REMARKS BT HON. FRED S. CASE OF THE NEWBERHY STATE HOSPITAL BOARD.
Ladies and Gentlemen: I served with Mr. Cook on the Psychopathic Hospital Board
for about 1.5 years, and I am very glad that I knew him. I know he was my friend. I
never met him with his cherry, kindly greeting that I did not feel better. The last time
I saw him was at Ann Arbor, last fall, and after the meeting, he said to me ' 'Case, come
over to the Martha Cook Building, with me, and I will show you the dormitory." On
the way he showed me half a dozen houses, and said ' 'I bought them for Will. He wants
to build a dormitory for the boys," and I remember the pleasure he had in doing that work.
He said ' 'let's step over to see Butts of the Engineering Department. We went in and I
remember their greeting. Butts said, ' 'Cook, it is a mighty fine thing, what Will is doing
for the University." Mr. Cook replied that he does not look at it that way; that he feels
that everything he is, and all that he has worldly, is due to the University of Michigan,
and he is just paying part of the debt.'' It was a beautiful thing, and when I was at Ann
Arbor, and learned of his death, I thought that Ann Arbor had lost in him one of the best
friends the University of Michigan ever had. I had visited with him many times and
knew of his deep interest. It seemed to me that his name represented unselfish service.
Today his memory should remind us of our public duties. He never said "Let George
do it", but he met every problem frankly and fearlessly as though it was a pleasure and
his memory ought to inspire every one of a higher public service and more affection for his
fellow men.
REMARKS BY DR. WALTER HUME SAWYER, OF HILLSDALE.
For thirty-five years I knew Chauncey F. Cook. He never avoided a responsibility
or forsook a friend. In private life and public duty, he was true to himself, and being true
to himself, was never false to any man. Painstaking and conscientious in every task, he
brought to the cause in which he was enlisted, rare good sense and sound judgment. Having
determined for himself what was right and best, he never faltered or allowed himself to
be influenced from his course. With undaunted courage and energy, he strove for his
goal. With such characteristics, he could not have been other than a marked man and
a great public servant. His service to Society and to his State was invaluable, and his
contribution to general betterment will live to bless his name and his people.
"Oh, well for him whose will is strong!
He suffers, but he will not suffer long;
He suffers, but he cannot suffer wrong;
For him nor moves the loud world's random mock,
Nor all Calamity's hugest waves confound.
He seems a promontory of rock,
That compassed round with turbulent sound,
In middle ocean meets the surging shock,
Tempest-buffeted, citadel-crown'd.''
�STATE HOSPITALS OF MICHIGAN.
7
REMARKS BY DR. ROBERT HASKELL, MEDICAL SUPERINTENDENT OF THE IONIA STATE HOSPITAL.
My knowledge of the relations that Chauncey Cook had to the early history of the
Ionia State Hospital is not sufficiently detailed to warrant dilating on that theme.
I do however feel under great personal obligation to Chauncey Cook and his teachings.
My acquaintance with him was quite different from that of you gentlemen who were associated with him so long as members of this Joint Board and as Superintendents of the
Hospitals for the civil insane and was practically limited to seeing him as a regular attendant
and guiding spirit at Board meetings at the Psychopathic Hospital. His encyclopaedic
knowledge of state hospital affairs was stimulating to me, a mere tyro, even many times
to the point of alarming. There never seemed to come up a question of policy or procedure that he couldn't settle right off the reel, and authoritatively. He took special
pride in the confidence that the people of Hillsdale County and the neighboring couifties
had in him as a surety for the welfare of their friends in the Kalamazoo Hospital and at
Ann Arbor; in fact he used to almost exult as he would tell me often that most of these
people would rather have his report about the progress of their sick ones than that of the
Doctors.
The one characteristic that made the deepest impression on me in those formative days
of hospital work was his feeling of personal responsibility to the people of the State of
Michigan for his Trusteeship and I am not certain that that characteristic was not the
crowning feature of his most honorable career. I can remember well in this connecton
the statement made to me by a member of the legislature which well illustrates this point
as he said, ' 'When Chauncey Cook comes over here with a proposition concerning the insane hospitals, you may know it's all right; if he isn't along, I don't mean to say the proposition isn't all right, mind you, but if he is there you may bank on it.'' This has helped
me many a time while pondering over some administrative difficulty as it would recur in
the query, "I wonder what Chauncey Cook would think of that."
I shall ever treasure it as a great privilege to have come even so remotely under his
influence.
REMARKS BY HON. A. J. MILLS, OF KALAMAZOO.
Mr Chairman; Ladies and Gentlemen: It is a sad pleasure to be able to be present
and to pay tribute to the life and memory of one of the best and dearest friends I ever had.
I became acquainted with Mr. Cook in February, 1893, when I was appointed to
membership- on this Board, and I served with him for nearly twenty years. He was appointed in 1891 by Governor Winans, who seemed to have a very keen insight into the
selection of men to serve on the State Boards. He appointed no man on any of these
boards for mere political reasons. They were selected because of their fitness for that
place, and when Governor Winans selected Mr. Cook, he made no mistake.
With Mr. Cook, was appointed Henry M. Fletcher, one of the ablest lawyers and one
of the best business men of Michigan. This institution was opened in 1859, and these
gentlemen came to membership on this board at a critical time. The institutions were
beginning to modernize. Dr. Van Deusen had been the superintendent here for a great
many years, and had been succeeded by one of his staff, and he was about to leave to take
up other work. The Trustees selected Dr. Edwards, and it was a very happy selection.
From that time this institution and the institutions caring for the insane in this state, began
to take on modern methods, and to become, as they are today, the equals of any similar
institutions in the world.
It was my pleasure, with Dr. Edwards, largely at the suggestion of Mr. Cook, to visit
many of the institutions in this State, and many of them abroad, and I am safe in saying
that Michigan's institutions are the equals of any anywhere.
Mr._ Cook's brain helped, however, to substantiate every reform, every work that was
carried on here for the long period of twenty-nine years. When he took office, the institution was certainly ' 'down at the heels.'' The buildings were out of repair; the furnishings
about the halls were meagre, and there was nothing about the asylum to suggest the place
of comfort it became in later years.
When Mr. Cook and Mr. Fletcher started on their work, there were two steam plants,
one at the female department, and one at the male department. They planned the present
central plant, which has been a suggestion to several other institutions in the State. They
planned this building in which we meet. Mr. Cook planned every building, every structure
connected with this institution, with the exception of the male department and the female
department. Mr. Cook's handiwork is shown in the beautiful grounds which surround
this institution. Mr. Cook took part in preparing the law under which the State Hospitals
are governed. There is no activity connected with the institutions with which he did not
have a large part from the time of establishment of the joint board down to the time of
his death.
�8
MEETING OF JOINT BOARD OF TRUSTEES.'
He was largely instrumental in the establishment of the Psychopathic Hospital, and
I well remember the day when he was selected as one of the Trustees of that institution, a
position he held until his death. He wag a man who never hesitated to speak out, when
he thought it was proper and necessary to do so. He was open, and frank, and vigorous.
He called a spade, a spade. He respected the opinions of others, and his conduct compelled others to respect him. He was no policy man. He marked out a course for himself,
and he hewed straight to the line.
Some people sometimes thought that Mr. Cook was desirous of having his own way,
and that he thought his own way was the best way. It was not so. Mr. Cook had his
own ideas, and he advocated them, and he was mighty glad when he found a man who had
the manhood and the strength to stand up and combat them, and many a time, when Mr.
Cook has met with defeat, he has gone to the man who has opposed the ideas he was presenting with the most vigor, and congratulated him, and thanked him for having held his
own ideas so well.
There was, in Mr. Cook's make-up, nothing but sincerety. He was always kind and
generous and capable. He did more for the insane and for the State Institutions in Michigan than any ten men in my judgment, that ever attempted such work, and he did it as
a labor of love.
Some of the older members of the joint boards particularly will remember the graveness and the skill with which he presented the financial problems of the Institutions at
the joint Board meetings. He was an encyclopedia of the affairs of these institutions.
As a Mathematician, I never met his equal. It seemed to me, sometimes, if he could have
a mouthful of figures, he enjoyed it better than the best meal that was ever set before him.
We used to meet at the July meeting to settle the rate of maintenance, and you would
find the Governor and one or two of the other Trustees at work until the middle of the
night, and very frequently until early morning, carefully going over the figures, and working out .the problems, and when they came down to breakfast next morning, we would
laugh at them about it, and they would tell us that Chauncey Cook had convinced them:
he had the whole matter ' 'right down pat,'' and he was never vanquished in any task of
that kind.
I could say a great many things of a personal nature with reference to Mr. Cook,
that I do not feel equal to saying at this time, because the departure of Mr. Cook to me
was a great personal loss. I have had some friends in this life, and I have a few left, but
I don't think I ever had a friend whose friendship. I prized as much as I did the friendship,
and as dear the memory of that man.
When he died, and the gates of Heaven opened to him, as they surely did, he was met
with this enconium:
"Well done, good and faithful servant. Enter thou into the joy of thy Lord."
The Hon. Harry C. Davis, of Traverse City, being unable to be present, forwarded
the following letter:
' 'I regret that I shall not be able to attend the meeting of the Joint Board of Trustees
on the 15th inst. I am sorry, but matters have intervened making it impossible.
The State, in the passing of Mr. Cook, lost a good man, but the results of his many
good deeds will continue. Mr. Cook, Mr. C. L. Whitney and myself were appointed on
our respective boards at the same time, nearly thirty years ago. My acquaintance with
Mr. Cook dates from that time, and I have met him frequently on the Joint Board, but
oftener on the Psychopathic Board. He was deeply interested in the management of our
State Hospitals and the welfare of the patients. He seemed to have and did have an abiding faith in the purposes, the success and the necessity of the Psychopathic Hospital. He
might, with propriety, be called the father of that institution. While I would not minimize his labor on the Kalamazoo Board, or the Joint Board, his heart and energy seemed
centered in the Psychopathic Hospital. In speaking of his characteristics, as they impressed me, I would say he was genial, purposeful, alert, positive and frank. It is refreshing always to come in contact with a positive character. Mr. Cooks firmness however
was not stubbornness, but a constancy born of deep conviction. We valued him as a
friend and a good citizen.''
Yours sincerely,
H. C. DAVIS.
�STATE HOSPITALS OP MICHIGAN.
REPORT OF THE FINANCE COMMITTEE.
July 15, 1920.
To the Joint Board of State Hospitals, Kalamazoo, Michigan:
Your committee would recommend for the consideration of the Board of State Auditors, a per diem rate of $1.00 for Traverse City State Hospital and Newberry State Hospital for the ensuing year, and $1.05 for Pontiac State Hospital, and $1.10 for Kalamazoo
State Hospital for the same period.
We also recommend for the consideration of the various Boards of Trustees, composing
this Joint Board, the following appropriation for officers' salaries, to be effective from July
1, 1920, these several amounts to be the total maximum salaries to be paid the officers of
the several institutions. Increases in the present salaries paid to the officers are to be
effective only when in the discretion of the Board it is necessary to make such a change.
Newberry State Hospital
Kalamazoo State Hospital
Pontiac State Hospital
Traverse City State Hospital
$15,730
29,720
21,870
23,920
00
00
00
00
Moved by Trustee Anderson and supported by Trustee Clark that the following resolutions be adopted:
RESOLUTION.
Resolved, That the report of the Finance Committee be accepted and that the rate of
maintenance for the Kalamazoo State Hospital be fixed at $1.10 per patient per day; that
the Pontiac State Hospital be fixed at $1.05 per patient per day; that the Traverse City
State Hospital be fixed at $1.00 per patient per day; and that the Newberry State Hospital
be fixed at $1.00 per patient per day; for the fiscal year beginning July 1, 1920; that in
addition to the above mentioned per diem allowances the cost of clothing, elopement expenses and cost of returning patients to their homes be reimbursed by the State.
(Adopted.)
2
�10
MEETING OF JOINT BOARD OP TRUSTEES.
THE STATE HOSPITAL IN RELATION TO PUBLIC HEALTH.
ADDRESS BY FRANKWOOD E. WILLIAMS, M. D., ASSOCIATE MEDICAL DIRECTOR, THE NATIONAL
COMMITTEE FOR MENTAL HYGIENE.
Overwearied as we may be from the hot enthusiasms and the sharp idealisms of the
war period, and deep as we may be in the depressive spiritual reaction from those days,
yet are we aware that a new spirit has come into the world. This spirit may be difficult
of definition, but we are made conscious of it in many ways and by activities in various
fields of human endeavor. It has something in it of aggressiveness, of the consciousness
of power that is born of success, of fearlessness in facing problems, of a keener sensitiveness to injustices and unfairnesses, whether in the political, the economic, or the social
field, a greater awareness and intolerance of needless evils. And to the elements of this
spirit may be added what to psychiatrists must give satisfaction, a desire to investigate,
to know facts, to be guided by facts, and to meet issues squarely.
A few years ago our good friend and onetime chief, Dr. E. E. Southard, from whom
we gained much inspiration, read a paper in which he discussed what he called the Kingdoms of Evil. Dr. Southard's contention was that the evils in the world are not numberless, as appears on a casual survey; that the myriad forms of evil that confuse and discourage us are but symptoms and signs; that when these are grouped and classified, a
number, not discouragingly large, of major evils will be found; that it were better for the
right-minded to save their energies in attacking numberless symptoms of evil in numberless ways and places and to turn the energies thus fruitlessly expended into carefully classifying the major groups; that once the major groups are identified it will be the prime business of all to make a concerted attack upon them. Toward this end Dr. Southard himself attempted a classification of the Kingdoms of Evil. In this classification he was not
concerned, of course, with the old chameleonlike moralities, but with the larger aspects of
evil.
In Dr. Southard's classification of evils one is not surprised to find sickness. Obviously it belongs there. But the world has not long realized that it belonged there. Sickness
has not been an evil in the minds of people. From being a punishment and scourge it had
come to be a thing to be expected and to be endured as the necessary part of the end of
man. But while the human machine must in time wear out, it need not be consumed by
conflagration. Sickness is an evil and men are fast coming to realize it and to organize
their forces on that basis.
Many lines of thought from various fields of human effort have contributed to the
development of this point of view, and some have been from fields far apart from medicine. Medicine, however, as it has become more socially conscious has been gradually
working in this direction. The treatment of disease is a negative social contribution—important to be sure, but negative and humanitarian. Thus to link the humanitarian with
the negative is not to underestimate his contribution, but it is to assay him critically, better, to estimate or revalue his worth, a proper psychiatric function. No one knows better
than the psychiatrist the significance of humanitarianism. Humanitarianism surely is
not the opus magnum of human evolution, with its leached instincts and sublimations—•
good in the sense that it is better than bad, but bad in the sense that it represents the defeat of better.
Socially conscious medical men could not long tolerate such a negative position once
an opportunity for greater positive contribution were presented. This opportunity came
with preventive medicine, and into the field of preventive medicine entered men of vision
whose instincts needed not so much sublimation as wider outlet. The prevention of disease represents a greater positive social contribution, but it is not free of negativism and
it was not to be expected that medicine with its great potential for positive good would
rest here. Medicine is preparing for another move forward. One observes in medical
literature, discussion, programs, and health campaigns a new note—not alone that the ill
shall be made well, that the well shall be prevented from becoming ill, but that the energies
of medicine shall be given to extending the power and happiness of man through developing to their maximum his physical and mental abilities. The campaign in social hygiene
is no longer for the prevention of venereal disease alone, but for an intelligent understanding of sex; the anti-tuberculosis campaign is not alone for more sanitaria for the tuberculous or a direct attack upon the incidence of tuberculosis, but for better health in general;
�STATE HOSPITALS OF MICHIGAN.
11
school physicians, while still performing the important function of inspecting adenoids
and tonsils, are giving their larger energies toward developing among children proper habits of health and hygiene; the attack upon infectious disease is continued with even greater
zeal, but attacks are also led against diseases of deterioration through campaigns for better health and more hygienic living in general. These endeavors represent positive social
contributions as opposed to the purely negative contributions of the past. Medicine has
therefore progressed from empiricism to scientific treatment, to prevention and, finally,
if you will, to productive medicine.
Has psychiatry any such positive contribution to make? Is psychiatry prepared to'
make such possible contribution? One cannot doubt the ultimate answer to these questions, but the immediate answer will depend upon how far psychiatry has advanced in
the preliminary steps of this evolution from empiricism through the negative aspects of
medicine—treatment and prevention.
As you are not unaware, the first hospitals for mental disease opened in this country
were as free of access as any other hospital. A patient with a sick mind could come as
freely to such hospitals as his brother with a broken hip could enter a hospital of another
kind. For some fifteen or twenty years this freedom continued. Gradually, for one reason
or another, fairly or unfairly, doubt and misunderstanding arose in the minds of the public;
the hopes with which these hospitals were built were disappointed, and from being the
' 'state's greatest charity'' the hospitals frequently became, with warrant or without warrant, the state's greatest source of scandal. In bitterness, disappointment and distrust,
legislatures built a legal stockade about the hospitals until prisons were more accessible
than hospitals, in fact procedure was much the same in both cases, with leniency in favor
of the jail. Hospitals became isolated, socially and medically. For almost forty years
hospitals have been endeavoring to free themselves from this tremenduous handicap and
have now largely succeeded. Laws permitting voluntary admission, temporary care, and
observation have been passed in many states, and again the psychiatric skill of the community is becoming accessible to those who need it.
Originally the institutions for the insane were called asylums, a beautiful name with
a beautiful meaning—a place of refuge. But unhappy connotations came to be built up
around the term asylum, and legislatures have seen fit to change the name to hospital.
But asylums cannot be changed into hospitals through legislative enactment. A building,
a physician, a nurse, and a patient do not make a hospital. Even less do a thousand patients, three physicians, and a few poorly trained attendants make a hospital. Are our
hospitals in name hospitals in fact? As one surveys the situation generally throughout
the country, one is convinced that there are many'excellent hospitals, that there are still
too many which have only good housekeeping and a low per capita to recommend them—
asylums in the proper sense—and that there are some that are but inferior jails. Putting
it in another way, one may say that most state hospitals are rendering a humanitarian
service, some are rendering a medical and scientific service, while still too few are rendering
a positive social service in spite of the fact that-they contain possibly the greatest potential for social service of any organized medical group.
The right of any state to call its institutions hospitals can properly be questioned, and
least of all can a superintendent or a board of trustees take pride in an institution as a hospital, unless such institution has met the requirements that experience has shown to be
needed in such institutions. These requirements are familiar to you, but they may be
briefly enumerated:
A reception or acute service.
Facility for proper classification and segregation of patients.
Facilities for active treatment, such as hydrotherapy and occupational therapy, and
these in the hands of competent persons.
Properly equipped and staffed laboratories.
An adequate medical and nursing staff with a training school for nurses.
Frequent and regular staff meetings.
A system of adequate case records.
A parole system.
Social service.
The number of hospitals in this country that maintain such a standard is not inconsiderable and the number becomes larger each year. Asylums are not made into hospitals
easily. AVhen made the transition has come through years of hard work and against many
obstacles by earnest superintendents who have given to it the best years of their lives.
There are hospitals in this country that stand as monuments to men who won them, not
in a moment of exalted heroism as is so frequently the case with our better known awards
of merit, but by courage sustained through long periods, through sweat and toil and sacrifice, and without the stimulus that comes from crowd action.
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MEETING OF JOINT BOARD OF TRUSTEES.
But no organization can live by maintaining past or even present excellencies. What
was excellent yesterday is mediocre today and retrogressive tomorrow. Hospitals for
mental disease have sat by the side of the road and performed their humanitarian service,
binding up the wounds, as it were, of the generations that have crowded past them. In
no generation have they been a vital dynamic part of the community life. And yet they
contain within their walls a potential force of unlimited value.
Once psychiatrists left their places by the road, took off their robes of negative humanitarianism, and put on the armor of the crusader. It was at a time when the best that
was in men was challenged. At first the change from robe to armor was not organized
and those about smiled and dubed these psychiatric officers "nut-doctors," and "nutdoctors' ' they would have remained to the end had their services been limited to the negative one of caring for the insane, valuable as a such a service would have been. But
these men soon became a dynamic force in the life of the army. Their contribution was a
positive one, and with it came the respect of their brother medical officers and line officers
alike. The handling of the problem of the war neuroses is familiar to you and need not be
elaborated in this connection except to point out that the problem of the war neuroses is
the problem of the civil neuroses. Two contributions not so well understood may be
mentioned briefly.
When the United States entered the war an official request was sent from Washington
to the commandant of the United States Disciplinary Barracks at Fort Leavenworth requesting an estimate on the increased provision it would be necessary to make in order to
take care of the prisoners to be expected from .an army of 3,000,000 men. After a study
of the figures of the Civil War, the Spanish-American War, and the operations on the Mexican Border, the commandant replied that it would be necessary to provide for 50,000
prisoners. As a matter of fact, the Disciplinary Barracks, including the two branches,
received approximately 5,000 prisoners; in other words, 10 per cent of the estimated number, based on previous experiences. This can be explained on only three grounds: (1)
the enforcement of prohibition in the army in general and especially in cantonments and
their neighborhood, (2) the activities of the War Camp Community Service in furnishing
recreation for men in their leisure, (3) the elimination by the psychiatric officers of the
potential delinquents of the army—the mental defectives, the insane, the psychopaths.
The effect of the work of the neuropsychiatric officers in eliminating these potential delinquents was clearly shown when a survey of the prisoners at the Fort Leavcnworth Disciplinary Barracks disclosed that the distribution of intelligence among them was practically that of the ordinary division of troops. Adler in his report of the survey points
put that ' 'there was an absence of the high proportion of defectives and psychopaths found
in nearly all of our civil prisons. Instead of the 30 or 40 per cent of feebleminded and
psychopaths found in the latter institutions, between 10 and 12 per cent were found among
the prison population at Fort Leavenworth."*
With men far away from home, living under unusually trying conditions, frequently
homesick and depressed, and with the means of suicide about them on all sides, it would
not have been surprising had the suicide rate in the A. E. F. been high. However, it was
strikingly low. The number of suicides in the A. E. F. was 94, representing an annual
rate of 4.7 per hundred thousand. The rate in the Regular Army in 1915 was 53 per hundred thousand, twice that of the adult male population of New York State. Had the same
rate existed in the A. E. F. as for the adult male population of New York State, there would
have been 1,060 suicides. One of the causes of the small number of suicides in the A. E. F.
was the extensive provision for the early care of mental cases, but probably more important was the elimination of the psychopathic material in the examinations in the United
States."**
These days are over, but from them have' come a multiplicity of complex problems.
The world is milling. The issues are considerably clouded by the dust that arises from the
process and there are earnest people who are conscientously analyzing the dust. Leaders
in various fields, however—the economist, the sociologist, the jurist, the statesman,—
have pushed through the dust screen and are making earnest efforts to find fundamental
causes of the disturbance. Some weak-hearted have returned in a state of panic. There
was another similar time. When thousands of men began to pour out of the trenches
blind, deaf, and paralyzed, and to stream back upon the hospitals, general medical men
who could find no organic lesions were puzzled and at their wits end what to do. But the
psychiatrist was not puzzled and, free of any feeling of panic, proceeded in a matter of fact
way to readjust these individuals and to return them to the line of duty. The present
situation is but slightly different. If there is any group that should be panic proof in the
*Discij>linary Problems of the Army. By Herman M. Adler, M. D. MENTAL HYGIENE, Vol. Ill, No.
4, October 1919.
**Address by Dr. Thomas W. Salmon at the meeting of the Military Training Camps Association, Hotel Knickerbocker, January 17, 1920.
�STATE HOSPITALS OF MICHIGAN.
13
face of restlessness, discontent, suspicion, jealously, cries of treachery, robbery and murder,
it is the psychiatrist, who at least has some insight into problems of human behavior.
In one respect, however, the situation is different. Many psychiatrists have removed
their crusading armor and have returned to their humanitarian robes. The civil line
officers—the state officials, the jurists, the educators—are left without special advice or
counsel. At another time in another difficult situation one of the most useful officers was
the division psychiatrist. The division psychiatrist was responsible for the mental health
of the men in his division. He was a constant advisor of his superiors, both of the line and
of the medical corps. It was his business to know his men, their weakness and their strength.
It was he who supervised the examination of the men in his division in the elimination of
the unfit. Through his assistants he was in constant touch with the morale of his organization. His constant inspection revealed weak spots as men began to break. Perplexing problems of discipline were brought to him for solution. With action imminent he
forestalled panic by plucking out those likely to precipitate panic. With his troop in
action he was immediately behind them with his special hospitals organized to take care
promptly of those who would find the task too difficiilt. Every officer and man had access
to him and to his trained advice and counsel as personal crises approached. He was a
dynamic force in his combat community. No one will gainsay the importance of such
an officer. But where is his counterpart in civil life?
Such force, such leadership is just as much needed today in every state and in every
hospital district in the country as it was two years ago on the division battlefields of France.
There is but one immediate source for such leadership and that is the state hospital. Most
states are divided into definite hospital districts. A hospital receives 'its patients from a
particular district. This is a definitely limited district usually not over large. The superintendent of the hospital may easily be familiar with every city, town, hamlet, and county
in the district. All about him in this district are earnest people struggling with perplexing problems—industrial, educational, correctional, charitable. He is not apart from this
community, but an integral portion of it. These problems are his problems and the problems of his staff, as much as they are any citizens problems. He observes his fellow citizens struggling with what he all too frequently considers their professional problems, and
as time goes on he receives into his refuge the by-product and sometimes the direct product
of the prodigious labors of his friends. He calls it waste, damnable, needless waste, and
yet the key to the solution of many of these problems remains locked in his own institution.
From 1915 to 1918, inclusive, the Michigan State Hospitals received some 6,700 new
patients, approximately 1,700 patients each twelve months. There will be a new 1,700 in
the next twelve months. Where are these individuals and who are they? They are not
a mysterious group that will descend upon the state like a plague from some far off place
and from some unexpected direction. They are our neighbors, our friends, and their
children. They are not a group peculiar to New York or California or Texas, but citizens
and children of Kalamazoo, of Grand Rapids, of Ann Arbor, of Pontiac, and of Traverse
City. Their course is about run and they will soon be with us. But in the offing there
is another 1,700 and as far as we can see yet another and another. It is a veritable army
of living, breathing, unhappy individuals—1,700 within one year of us; 3,400 within two
years; 5,100 within three years; 6,800 within four years; 8,500 within five years; 17,000
within ten years.
Some that we can'see just over the horizon are mere toddlers who are today having
their first brush with what is to them a surprisingly unfriendly environment and reacting
to it badly and in a manner that is significant; nearer is the boy or girl just beginning to
edge away from the crowd; the boy who has just found the false way around an obstacle;
the lad who is beginning to doubt himself, but who is finding an explanation of his failure
in the unfairness and unfriendliness of others; the boy or girl who today has just dropped
his or her head in-unhappy recognition of his or her inferiority, or the other fellow in the
group who has just thrown up his head, frightened at the inadequacy he has found within
himself, but who has buckled on an armor of self-defense, stands breathing defiance and
ready to challenge authority. With increased puzzlement and confusion, misery and unhappiness, pitiful and tragic, these boys and girls will be moved along toward us year by
year. Inefficiency, failure and humiliation will be heaped upon them. As without understanding and without guidance they are pushed forward by the crowd about them, it
will be but an accident whether some first reach us or the prisons. But in the years that
are to intervene parents will labor with them, the schools will work with them, the judges
of the juvenile court and the probation officers will do the best they can with some and with
some the higher courts, reformatories, and prisons will have to take a hand. Energy and
money will be expended upon them without avail. But whatever the intervening steps,
the end is failure. How difficult of readjustment they will be when once they reach the
reformatory or finally find a refuge with us. And yet, pliable as they are today, how simple
in many cases would the readjustment be now—how simple the psychiatrist who met yet
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MEETING OF JOINT BOARD OP TRUSTEES.
more difficult problems of readjustment in the army know, and Campbell and Richards
in Baltimore, Glueok and Brown in New York, Healy and Bronner in Boston, who in school
or court have worked with these children, have pointed out. We are inclined to think of
these individuals in the terms of end reactions as we see them on their admission to the
hospital and to be discouraged; it were better did we think of them in the terms of beginning reactions.
We have been speaking of the child we could just discern as we looked ahead, but the
older brothers and sisters of these children are at hand. They are in the schools today,
they are in the court today, they are entering industry today. And does anyone presume
to deny that these individuals whether in school, court, or industry, unassisted, unrecognized for what they are, unassayed at their true value, misunderstood and misunderstanding, are the source of many of our most perplexing educational, judicial, industrial, and
political problems? Problems of conduct lie in the province of psychiatry. And not
alone insane conduct.
Economic and social problems are to be solved only in a spirit of fairness and upon the
basis of ascertained facts; but with the sifting of data in the ascertaining of facts, and in
the determination of what is fair and just, there must be discussion, division, and even
heated differences of opinion. It is not, however, from such fair differences of opinion,
no matter how sharp, nor from such contentious discussion as may grow from it that many
of our difficulties and disturbances arise, but from the partisan agitation of individuals
who, unhappy and disturbed by unsolved problems in their own personality, make an
effort to maintain their self-respect against a feeling of failure, defeat, and inadequacy,
either by rationalizing their difficulties in terms of the injustices of others, or by transferring the emotions born of their own sense of failure to elements in their environment.
In the understanding of these individuals, whether partisans of one group or another, and
the significance of their passionate outbursts, the atmosphere may be kept clearer for a
proper evaluation and judgment of the issues involved. In assisting these individuals
in the solving of their own problems, not only may neuroses and possibly psychoses be
prevented, but by proper reconstructive efforts the individual may be led to an adaptive
plane, upon which he may find happiness and social usefulness.
We should not overestimate the amount of our knowledge or our ability in helping to
solve some of these problems, but false modesty and an attitude of self-depreciation are
equally wrong. This is not a time for sensitiveness. The need for trained men .who ars
not afraid is greater today than in 1917. Building for peace is an infinitely greater task
than preparing for war, and rebuilding after war has always tried men's souls. But everywhere are strong men engaged in the process of construction. Professional group distinctions are not so marked. There is a new community of interest. In idle days we were
jealous of our problems; interlopers must keep away. Today we seek advice and counsel
in contiguous fields—the jurist calls upon the educator, the industrialist calls upon them
both, and all are asking questions of the psychiatrist. Psychiatry cannot shirk its part of
the burden in such a program of construction. Contacts with these community problems
may be made through a more extensive development of the out-patient departments of the
state hospital, through a well organized and active psychiatric social service department,
and through assuming advisory relationships with boards of education, boards of
charity, courts, labor and industrial organizations.
The state hospital in its district contains the potential for an inestimable service
greatly needed. State hospitals all too frequently are pursuing a negative policy of humanitarianism, a part of, but apart from, the community. With the evolution of medicine
from negative humanitarianism to positive constructive contribution, psychiatry and its
hospitals will undoubtedly become vital dynamic forces in their districts, pooling with
others in a general community interest what they have of special knowledge.
DISCUSSION BY DB. BABRETT OF ANN ABBOB.
Ladies and Gentlemen: Dr. Williams has presnted to us a view of the work of a State
hospital for mental disorders that makes a strong appeal to us. Its practical thought is
that hospitals for mental disorders must adapt themselves to changing situations that are
inevitable in the development of the practice of medicine, and no matter what ideas may
have determined their course in the past they cannot rightfully escape the responsibility
of doing whatever has shown to be of value in curing or preventing mental disorders.
Hospitals for the insane more than any other hospital organization are best prepared
to assume responsibilities for the treatment of the mental disorders that affect the public
health.
Our hospitals for mental disorders have passed through several phases in their development. Their inception and early problems of care, arose out of custodial needs. They
were to care for those who by reason of diseased minds disturbed the life and progress of
the social group. There naturally followed this a phase in which treatment and ideals
�STATE HOSPITALS OF MICHIGAN.
15
of cure were emphasized, and this purpose in varying degrees of prominence has determined the medical activities of these hospitals up to the present time.
There now comes a phase in which they are to adapt their activities to efforts for
preventing mental disorders, and one might look still further into the future and conceive
of a plan in which they might be concerned with efforts towards improving the mental
health of the community.
Although a considerable percentage of the mental disorders that require hospital care
are the result of factors that at present seem impossible to attack with any degree of success, there are many others that are of such nature that they can be cured or prevented.
While we have been convinced of this from our work with patients in pur hospitals,
it has become more obvious as we have come in contact with individuals, in the special
classes, in the schools, in dispensaries, and in our out patient services, who are beginning
to drop below the level of normal mental health.
Like many experiences, mental disorders often have their beginnings in simple situations and conditions that can be prevented from becoming more complex and disabling
by proper attention and treatment.
The question that now arises is. What organization can assume a responsibility in
bringing this about? Obviously it is a field of work that comes within the scope of the
activities of a state hospital for mental disorders. No other organization is prepared by
experiences or has such good facilities for doing this work.
Such interests should be welcomed by all hospitals as factors that will stimulate their
medical spirit and keep them in close relations with other medical activities concerned
with problems of public health.
The details of how this is to be done or just what there is to do need not be discussed
at present. The essential point is that State hospitals for mental diseases must recognixe the correctness of the proposition that they must adapt themselves and their activities to all matters that concern the mental health of the State. That they must be active
forces ready to attack conditions at their sources and not be solely concerned with caring
for the mentally sick after their break down has occurred.
DISCUSSION BY DH. ROBERT HASKELL OF IONIA STATE HOSPITAL.
Ladies and Gentlemen: I would like to say a few words on one phase of what Dr.
Williams in his excellent paper chooses to call a positive function of state hospital work.
I refer to positive research on criminologic lines. This may seem to the casual observer
a far-fetched association but just a brief attention to recent studies shows that idea entirely unjustified.
The states of New York, Massachusetts and Illinois have injected into their penal
systems some professional interest and that professional interest is being provided by psychiatrists. The National Committee for Mental Hygiene established at Sing Sing Prison
a Psychiatric Clinic under the directorship of Bernard Glueck. Illinois in its central
Bureau of Public Welfare created a State Criminologist and this official has a member of
his staff, a trained psychiatrist, resident in every penal, reformative and correctional institution in the state. Massachusetts' work has not been so widely organized and has
depended more upon the excellence of several of its prison and reformatory physicians
and certain of its Boston court clinics. Some of these men have contributed work of definite value to the problem of criminology.
The most clear cut researches have been those of Glueck. He examined 608 adult
prisoners consecutively admitted to Sing Sing Prison in a nine months period. Of this
group of 608 unselected adult prisoners he shows that:
' '66.8 per cent were not merely prisoners but individuals who had shown throughout
life a tendency to behave in a manner at variance with the behavior of the average normal
person, and this deviation from normal behavior had repeatedly manifested itself in a
criminal act.
"2. Of the same series of 608 cases, 59 per cent were classifiable in terms of deviations from average normal mental health.
"3. Of the same series of cases, 28.1 per cent possessed a degree of intelligence equivalent to that of the average American child of twelve years or under; of the ninety-eight
native-born defectives 80.6 per cent were recidivists in crime, whose average number of
sentences to penal or reformatory institutions was 3.5; and 85.7 per cent of the group will
have been returned again into the general community within a period of five years.
"4. Of the 608 cases 18.9 per cent were constitutionally inferior, or psychopathic,
to so pronounced a degree as to have rendered extremely difficult, if not impossible, adaptation to the ordinary requirements of life in modern society. This lack of capacity for
adjustment is reflected, on the one hand, in the fact that of the ninety-one native born in
this group 86.7 -per cent were recidivists in crime, whose average number of sentences to
penal or reformatory institutions was 3.9, and, on the other hand, in the fact that a very
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MEETING OP JOINT BOARD OF TRUSTEES.
significant number of them have been total economic failures thus far. Furthermore,
82.4 per cent of these cases will have been discharged again into the general community
within a period of five years.
"5. Of the 608 cases 12 per cent were found to be suffering from distinct mental
diseases or deteriorations, in a considerable number of whom the mental disease was directly or indirectly responsible for the antisocial activities."
There is no reason to believe that conditions in Michigan are any different from those
just summarized. We see constantly in the Judges' statements accompanying convicts
to the prisons a recognition of the fact that there must be something wrong with the man
before him for sentence but an admission of helplessness so far as any ability for comprehension of what that something is or opportunity to get that information except in flagrant
cases. Let me just read the Judge's statement on one A. P., committed to the Michigan
Reformatory on November 16, 1916, at the age of 23 years, to serve a sentence of 2 to 10
years for arson:
"This boy burned up about $12,000 worth of buildings for his father and he has an
apparent niania for setting fires. He is an innocent looking youngster but is certain to
fire anything he gets a chance to touch a match to.
"He burned his father's barn and later burned the house without cause or excuse.
Either he is a Mental Pervert or else he has an insane mania to burn buildings. I do not
know what else to do with him. His parents are very much afraid of him and wish him
retained for full time of his maximum sentence.''
A perfectly candid confession of helplessness, don't you agree? This child is now
eligible for parole and in any case will have to be discharged April 18, 1924.
What is the nub of this particular situation? A. P. was admitted to the State Psychopathic Hospital in 1913 on an observation. He was an overgrown child that you would
take to be about eight or nine years old to look at but whose parents say he is seventeen.
The family is questionably normal. He walked early enough but didn't begin to talk
until 3 and he was 7 or 8 before he could talk at all plainly. He had a double congenital
inguinal hernia and a long adherent foreskin. He had continual nocturnal enuresis until
8 years old.
When nine years old he stole a dollar from a neighbor and ran away for several days.
At 10, 12, and 14, he again ran away for varying lengths of time. Besides this he was constantly in mischief of one sort or another so the last time they sent him to the Industrial
School at Lansing. He was paroled home after a year. He immediately commenced
running away again, breaking into houses and stealing food and money. He was recommitted to the Industrial School where he stayed until 17 years. On coming home he again
began running away and within a few weeks was found by a family in a neighboring town
seated at their table gorging himself on their choicest viands in the middle of the evening.
Complaint was made to the police and the boy came to the attention of the probate
court. The Court was struck with the manifestly puerile appearance of the lad. Doctors
were appointed to examine him; in their official report THEY CERTIFIED TO THE
COURT THAT IF THE BOY'S FORESKIN WERE AMPUTATED AND HIS HERNIA REPAIRED THAT HIS THIEVING AND RUNNING AWAY FROM HOME
WOULD BE CURED. This 17 year old boy by the Binet test is less than 10 years old
intellectually.
He was discharged with a bad prognosis for criminal recidivism and the recommendation that he be committed to Lapeer. There was no room for him there. He got into
further trouble culminating in the Arson for which he was finally sent to prison. No advantage has been taken of the advice available for this case and none will be.
We could detail countless such cases. This one suffices to present the problem.
There is a big field for criminologic research in the State of Michigan. Whether it
shall be started in the prisons which requires a professional spirit to initiate it and push it
through: whether it should be started from the institutions dealing with the insane: whether
it shall be started by private organizations like the newly organized Mental Hygiene Society for example: or whether it shall be started by a state survey on the line of the late
Michigan Commission on Mental Disease, I am not now prepared to recommend. It
would be a very practical way to have a small group composed of a psychiatrist, a psychometrist, a social worker and a stenographer to rotate among the several prisons, including the Detroit House of Correction and also the juvenile reformatory institutions
at Lansing and Adrian. In the beginning, by having in each of these institutions, some
one trained to prepare preliminary records for each new admission, for every person coming
up for parole and for the disciplinary cases as well as the suspected insane, such an ambulant group of examiners could immediately become of inestimable value to the four prison
executives and to the Pardon Board and before a year was over these persons would personally recognize the value of such studies and would demand at least one such positively
trained worker on the prison staffs constantly.
�STATE HOSPITALS OF MICHIGAN.
17
Education of the people as to what possibilities present research offers as a means
toward preventing crime is the hope. This is a big field for the extension activities of all
the state hospitals and is just as much a problem of Public Health as syphilis.
DISCUSSION BY DR. J. D. MUNSON OF TRAVERSE giTY STATE HOSPITAL.
Gentlemen: I congratulate Dr. Williams upon his valuable address. It points out
the possibilities for a wider field of usefulness for a state hospital. It has been very stimulating and I am sure that I shall go home with new courage to promote the work. I shall
not attempt, even in a general way, to discuss all of the topics covered but shall limit myself to those questions in which I have been most interested. We believe that the state
hospitals has an ever widening influence for good in relation to the general population,
especially with reference to the causes and prevention of mental disease.
The relation of the state hospital to the public may be discussed from two standpoints;
—first, the duty of the state hospital to the public, i. e., what it owes to the public;—second,
the duty the public owes to the state hospital.
The fundamental duty of the state hospital is to provide the most modern medical
treatment for its patients. It no longer suffices to provide him perfunctory or routine care
and treatment,—he must be surrounded by trained nurses and psychiatric physicians, be
skilfully and kindly led through his mental and nervous conflicts, that he may escape
mental splitting, dissociation and regression if within the bounds of possibility. The
hospital must guarantee to every case thorough study and careful clinical, laboratory and
psychological investigation and records of the same must be made. This much the state
hospital owes to the public and may be referred to as intra hospital duties.
There are certain other duties which the hospital owes to the public which are extra
hospital and relate not only to the over sight of discharged patients but to the study and
prevention of the causes that lead to mental and physical deficiencies. The extra hospital
trend is to provide over sight for the patient in his home, to correct, as far as possible,
faulty conditions in his environment, habits, occupation, etc. As Dr. Russell has recently
pointed out it is by extending the activities of the hospital beyond the present limits so as
to deal with mental disorder in closer relation with the conditions in which they arise and
in which they interfere with social welfare that the state hospital as an organized agency
can contribute most to the advancement of the aims of the mental hygiene movement.
By this extension, the knowledge and skill which have been acquired in the study and treatment of patients in the hospitals can be brought to bear on the problem of mental disorder
as it exists in the home, in society and in the individual in his natural environment. The
widely prevalent view that the study and practice of psychiatry, and that hospital organizations can be of service only in hopeless conditions may thus be dispelled and their value
in individual and social conditions which are remediable will be practically demonstrated
and accepted. This result has in some measure already been accomplished, and an increasing respect and demand for the services of psychiatrists are distinctly noticeable. I
would respectfully refer to the work of the mental clinics and the value of such work at
Ann Arbor and Kalamazoo and in other places where they have been established.
To carry on such work, i. c., the intra and extra hospital work will require a body of
trained workers. These workers should be a part of the public health service. They
would make community serveys, assist in juvenile court work, study individual cases as
they present.themselves in the home environment, determine social maladjustments and
study the interplay of all those circumstances which in any way might contribute to the
mental illness. In such service the most careful investigation will be given to disease
and poverty. Poverty and disease work in a vicious circle in which cause and effect often
change places. It is certain that disease is one of the most fertile causes of poverty, using
the word poverty in a sense of privation of one or other essentials of physical being.
The extension of the extra hospital service will be a measure of assurance against the
pauperism bred of disease. We are rapidly approaching this broad field of civics and have
made tremendous strides within the last five years, more particularly since our army entered in actual warfare in France. All communities are interested in the health of every
person in the population. A very large part of those who have come to be charges upon
the public are those reduced because of ill health, poverty, destitution, and public dependents are very largely public health problems. Fundamentally they all relate to physical health but there is recognized now as a vast public interest the subject of mental health.
The conclusion is that the importance of health in its broad sense gives the public service
a certain unity which is bound sooner or later to be recognized. (See editorial Detroit
News, Jan. 1920.)
Our institutional facilities for training schools should be enlarged so that they may
train young men and women for public service for an intelligent insight at least into all
the factors which make for public well being. Mental Hygiene associations will be of
great importance and through such agencies some form of conference will bring together
�18
MEETING OP JOINT BOARD OF TRUSTEES.
in the public institution official and unofficial workers, dealing with social progress with
hospital and extra hospital activities.
Our state hospitals are fast becoming indispensable to the people. The progressive
community endeavors to place hospital facilities at the service of all suitable cases, per
contra the progressive hospital should endeavor to place sufficient trained psychiatric and
mental hygiene nurses and social workers in each community so as to eliminate as far as
possible all preventable causes of disease. It is unquestionably true that the trend is also
for closer cooperation between intra and extra hospital physicians from the practical value
of the psychiatric work, the mental clinic, etc. In this manner we are developing an increased realization of the need for more exact knowledge of the relation between the psychopathic conditions and crime, pauperism and other social maladjustments.
The Traverse City State Hospital during its existence has cared for about nine thousand patients. These patients have been admitted from almost every neighborhood in
the state. Every such community is directly interested in the work of the hospital and
the success attained in its medical and other work. On the other hand the state hospital
has never had a direct interest in communities. "It has never had means of knowing,
first hand, about the personal and domestic hygiene of such neighborhood, its heredity or
social psychology and has taken no part in examination or training of its children or in a
measure looking to the prevention of ill health and on the sequels that result therefrom.
Our hospitals must be more than medical and custodian institutions, they must be of highest value in scientific work and of highest social value to the public, in as much as they
protect the community from the menace of insane people and others who perform unsocial
deeds. In this sense the state hospital is highly social and we maintain that they should
endeavor to provide to many or all communities the services of trained physicians and
nurses to investigate and report to some proper authority all suitable cases and to work
in cooperation with all organized bodies that are interested in the public health service,
to the end that mental deficiencies may be lessened and the sufferers afforded immediate
medical care and treatment."
The duty of the public to the state hospital is no less important. Communities must
aid and support mental hygiene movements and health organizations which have for their
object the control of ail those conditions which lead to ill health and as a consequence to
poverty, pauperism, mental shipwreck and delinquencies. There are many complex
factors involved in this great field of effort. The public must insist upon the inactment
of health laws, which will be of general applicability to protect and give commensurate
authority to the conditions of legitimate efforts. To this new field of civics the medical
profession, educators, including school boards, jurists and legislators, and all organized
bodies must cooperate to promote the public health. We must not forget that a new situation is arising and its proper solution will have much to do in deyeloping the ^greatest
asset that any state can possess, sound minds and sound bodies, a high degree of health.
We believe that the hospital has the ability to take a leading part in this movement. It
is within the bounds of possibility that the state hospital will establish its own health department, one that will work in harmony with every other organized health organization
of the state, become a coordinate part of the public health service and yet one which will
not be subordinate to any other. We believe it should have a direct part in the very important field of mental hygiene, as well as in all others, which have for their object the
prevention of mental and physical ill health.
�STATE HOSPITALS OF MICHIGAN.
19
DO STATE HOSPITAL FARMS PAY FROM A BUSINESS STANDPOINT?
PAPER BY MR. G. B. PIKE, STEWARD OP TRAVERSE CITY STATE HOSPITAL.
Ladies and Gentlemen: This question has frequently been raised and there are some
who persist in declaring that State Hospital farms do not pay. Some have even asserted
that the splendid herds of pure bred Holstein cattle do not pay and that the State might
better own grade herds and scrub cows.
It is a fact, however, that the state hospital farms are a source of profit and that the
pure bred Holstein cattle, with at least three of the four herds producing an average of
12,000 to 13;000 pounds of milk per cow per year—the remaining herd being not very far
behind that figure—play an important part in producing that profit and stand today a
monument to the sagacity of the men who were instrumental in inaugurating them as
state hospital farm adjuncts.
The sales of surplus cattle alone from the Traverse Herd in the last two years have
amounted in round numbers to the magnificent sum of twenty-five thousand dollars, the
last three cows sold bringing an average price of more than $1,500 each. The last cow
sold from the Pontiac Herd brought the splendid sum of $2,050.
Much might be said about the winning of prizes and prize money for advanced registry work, the development of World's record cows and heifers; about these herds obtaining an international reputation of high degree all of which is bound to result in greater
and greater profits in the future. But besides that is the fact that the one best food of all
foods for human consumption, pure, wholesome milk, is produced in abundance for the
needs of the patients.
The hospital farms maintain droves of swine which are kept immunized, in recent
years, against hog cholera by treating the pigs, when weaned, with the double treatment of
serum and virus. These droves of swine are a source of great profit, and besides, through
them, that most troublesome problem of all civic problems, the disposal of garbage, has
been most satisfactorily solved.
The orchards, vineyards, and small fruits are another source of profit. These adjuncts are an especial feature at Traverse City, producing an abundance of apples, cherries,
plums, peaches, and berries, so that the purchase o_f these healthful foods is unknown at
that Institution. Large quantities are consumed in the fresh state and the balance is
canned. The annual production of cherries and berries runs into the thousands of crates.
Beside the money profit from these crops there is an unknown profit obtained from the
consumption of these fruit-foods, the health betterment of the patients, that does not appear in our figures.
More could be said about the soils, the growing of special crops and crop rotations,
experimentation with fertilizers, lime, rock phosphates, etc., but space forbids, and it is
not especially germain to the question—whether state hospital farms pay or not, so the
following table is presented showing the value of farm products and cash receipts, expense
of operation and maintenance, value of products consumed on the farm and net profits
for a series of years. These figures are compiled from data contained in the biennial reports.
�20
MEETING OF JOINT BOARD OF TRUSTEES.
Year ending Year ending Year ending Year ending Year ending Year ending Year ending
June 30,
June 30,
June 30,
June 30,
June 30,
June 30,
June 30,
1916
1914
1915
1917
1918
1913
1919
For Kalamazoo State Hospital:
Farm Products and Cash Receipts
$70,796 60 $71,332 52 $75,917 20 876,418 59 $81,591 12 J101.018 71 8115,472 07
Farm Disbursements
•
48,866 20 46,824 47 51,646 18 50,086 67 48,533 47 48,801 26
69,771 06
Gross Surplus
21,930 40 24,508 05 24,271 02 26,331 92 33,057 65 52,217 45
45,701 01
Less Products Consumed on
Farm
16,943 08 20,371 22 14,139 30 15,524 26 13,302 58 15,240 25
14,506 95
Net Surplus
4,987 32
4,136 83 10,131 72 10,807 66 19,855 07 36,977 20
31,140 06
For Traverse City State Hospital:
Farm Products and Cash Receipts
38,455 49 38,157 30 36,063 12 37,170 69 63,262 53 72,763 17
90,064 54
Farm Disbursements
25,003 51 24,547 78 20,343 96 29,571 62 32,174 54 47,490 77
57,994 46
7,599 07 31,087 99 25,272 40
Gross Surplus
13,451 98 13,609 52 15,719 16
32,070 08
Less Products Consumed on
Farm
9,059 74 11,891 18 11,002 95
8,421 72
7,865 55
7,388 76
13,098 17
Net Surplus
5,187 80
7,853 61 •1,460 67 19,196 81 14,269 45
6,063 22
18,971 91
For Poatiac State Hospital:
Farm Products and Cash Re48,555 77 38,481 71 66,029 26
ceipts
82,773 28
21,899 03 23,450 38 38,002 69
Farm Disbursements
42,073 14
Gross Surplus
26,656 74 15,031 33 28,026 57
40,700 14
Less Products Consumed on
14,234 64
8,249 99 17,987 20
Farm
22,089 65
12,422 10
Net Surplus
6,781 34 10,039 37
18,610 49
For Newberry State Hospital:
Farm Products and Cash Receipts
18,758 73 22 758 74 20,340 17 26,340 18 40,401 03 40,401 04
Farm Disbursements
14,666 84 19,143 25 17,029 11 22,439 91 25,820 19 30,399 38
3,615 49
3,311 06
3,900 27 14,580 84 10,001 66
Gross Surplus
4,091 89
Less Products Consumed on
3,339 27
3,339 28
3,702 01
3,339 29
Farm
3 339 26
3,167 75
560 99 10,878 83
6,662 37
752 63
276 22
153 31
Net Surplus
•Deficit.
It will be seen from the above table that the net profit at Kalamazoo for the 7 years
beginning July 1st, 1912, and ending June 30th, 1919, was $118.035.86, an average per
year of $16,862.27.
The net profit at Traverse City for the same 7 years was $70,126.13 an average per
year of $10,018.02.
The net profit at Pontiac for the 4 years beginning July 1st, 1915, and ending June
30th, 1919, was $47,853.30 and average per year of $11,963.32.
The net profit at Newberry for the 6 years beginning July 1st, 1912, and ending June
30th, 1918, was $19,284.35 an average per year of $3,214.05.
On July 1st, 1919, a new system of accounting was inaugurated by the Auditor General's department for the state farms. This system involves a complete farm inventory
as of July 1st, each year; interest on investment is taken into account; the food furnished
the hospital is credited to the farm as well as the labor performed for the hospital, while
we are compelled to charge against the farm the patients' labor and the maintenance of
hired help working on the farm.
We present herewith the farm statement according to this new system for the Traverse
City State Hospital for the last fiscal year ending June 30th, 1920. Like reports for the
other state hospitals not being at hand, they cannot be presented at this time.
Analysis of Farm Receipts and Disbursements for the fiscal year ending June 30, 1920.
TRAVEKSE CITY STATE HOSPITAL.
RECEIPTS:
Bulls sold
Heifers sold
Prize money
Service of sire
Feed sacks sold
Old sprayer engine sold
Ear tags sold
Products paid for from Institution Food account
Teaming and labor charged to Institution
$3,900 00
8,119 67
191 00
100 00
174 62
15 00
2 00
69,516 02
12,405 00
t,423 31
�STATE HOSPITALS OP MICHIGAN.
DISBURSEMENTS:
Feed
Straw
Registry and testing
Advertising stock
Milking Machine Parts
Harness
Veterinary services
Traveling expense
Spraying supplies
Seed
Coal
Farm Tools, Implements, etc
Freight
Rent of land
Sundries
Wages
Employees maintenance
Interest at 5% on total farm investment
21
$33,456 88
1,690 55
1,520 46
433 58
109 18
134 81
428 26
143 94
316 68
776 51
917 56
879 76
3,415 21
325 00
500 74
19,514 44
2,923 23
8,278 74 $75,765 53
Increase in Farm Inventory
$18,657 78
7,554 51
$26,212 29
(Accrual of Inmates Maintenance, $7,335 09.)
We would respectfully call your attention to the fact that the net profit of the State
Hospital Farm at Traverse City as shown by this statement was $26,212.29 which is 15.83
per cent of the total farm valuation as shown by the July 1st, 1919, inventory. Charging
out the patients' labor, performed on the farm, the net profit was $18,877.20.
DISCUSSION BY A. E. STEVENSON OF PONTIAC STATE HOSPITAL BOARD.
Ladies and Gentlemen: I think the paper was very interesting. I will admit when
this question came up, I was advised by Dr. Ostrander I would be expected to discuss it
to some extent. In looking over our own farm, I was somewhat surprised. I have taken
this question to discuss absolutely from the farm standpoint. I have not taken up the
herd proposition, which Mr. Pike raises, because we know the farmer always suggests you
will make money out of your herds in a way and lose it in another way. So I have studied
this from a point solely as a farm proposition.
We produced at the Pontiac State Hospital last year net products of over $57,000.00.
That docs not take into consideration any sale of cattle nor any increase in the value of
cattle. We produced $57,396.00 and the Pontiac State Hospital got the products. We
produced in milk alone, $22,000 at $3.80 per hundred. I took it this might come up in
answer to some of the criticisms we have heard about these State institutions. We produced it at a cost of $36,000. In other words, we made from the farm alone and garden,
not taking into consideration the increased value of the herds or anything of that kind,
not taking into consideration the cattle sold, or anything of that kind, we made $21,000,
right from the farmer's standpoint.
In getting out these figures, we have allowed for everything we paid out in labor and
•board, over $10,000. We paid out for feed, in order to feed the cattle and horses and
everything on the farm, over $17,000.
I thought possibly the question was aimed purely at the farming proposition, and not
taking into consideration the herds, and I think the average member of the Legislature
in discussing this question, will discuss it without the herd proposition.
So, from the financial standpoint, it seems to me this question can be answered in,
two ways. Are State Hospital farms profitable. I say, yes, if they don't make a dollar,
because it is necessary that State Hospitals have, as the speaker pointed out, a sufficient
supply of good pure milk, and it is impossible to get it in quantities or in quality in any
other way.
Then another thing he pointed out, that we have a great saving in the garbage from our
farm. This past year we produced over 32,000 pounds of pork, so that we can take the
pork, the milk, the apples, and the potatoes, and pay all bills in connection with the farming operation.
Now in that statement, we have avoided padding. The potatoes we raised were put
in at 36 cents a bushel, because we bought potatoes last fall at that. The pork could
not be bought at figures set up. It was put in at seventeen and a half a hundred. It
�22
MEETING OF JOINT BOARD OF TRUSTEES.
should have been that live weight. I am merely showing how our figures are arrived at
to show that there was nothing put up to increase the value.
Now, can anyone say, in the face of those figures, gone over by the auditors, approved
by the auditors, that State farms do not pay?
As I say, I would answer that in two ways. Do they pay? Yes, even if they do not
make any money, on account of the milk and on account of having the garbage for your
pigs. And then, are they a success financially, institutions that are making from ten to
twenty thousand dollars a year, are they a success financially? I am saying that without
the herd because we are in a very embarrassing position with reference to the herd. In
fact, it looks to some of us on the Board when we are offered big prices, that we should accept them. I feel that the State is entitled to have a good herd notwithstanding outsiders offer good prices for them. So, going into the herd side of it, we could increase our
profits on this side of it, very materially.
As I said, we are talking purely and solely from a farming position. In five years,
our cattle have increased four times the amount of milk. Now, stop and think, a herd
of cattle that is coming gradually along, not in increased value, but from the actual amount
of milk they are producing, and they have increased that amount, and we have furnished
it at S3.80 per hundred, and I defy any institution to buy it for that by the year and get
quantity and quality.
So I agree with Mr. Pike fully, and say they do pay. And, judging from our farm, I
do not think there is any question about being able to convince any level headed farmer
that State Farms pay.
�STATE HOSPITALS OF MICHIGAN.
23
ARE STATE HOSPITAL FARMS PROFITABLE FROM A THERAPEUTIC
STANDPOINT?
BY DK. H. A. HAYNES, SUPERINTENDENT MICHIGAN HOME AND TRAINING SCHOOL, LAPEER.
The therapeutic value of institution farms is well known to the members of this organization, but for reasons some of which are beyond our control, the farms may not have
been used to their fullest capacity towards the rehabilitation of our patients.
The general idea is, that a farm is purchased for an institution for the purpose of supplying fresh vegetables, milk, meat, etc., for the patients and like most farms it should
return profit. It appears to have been forgotten that it is more expensive and important
to produce men than to produce beans and corn. For that reason institutions are sometimes criticized when the profits from their farms fail to reach the average earnings of
similar acreages used only to produce crops.
Institution farms must not be considered of value only in proportion to the financial
returns, for their primary object is to add to the health and happiness of the patients by
the products furnished and the occupations offered. The man and not the product. The
farmer of necessity has as his primary object—profit. He frequently sacrifices health and
happiness to attain this end. The trend of modern times makes us all think of the money
value, and the value of occupational therapy and the needs of general health and happiness
are overlooked.
The amount of labor that may be performed by patients should be considered incidental, if by the doing their conditions may be made better. In other words the farm should
be considered as much a part of the medical treatment of a patient as the gymnasium is
in the education of the school boy. The fact that so many of our patients formerly lived
on farms and the breakdown was the result of keen competition in congested cities, affords
a large group who have already had farm training an opportunity to again work on the
farm under good supervision and adds to the general content and improvement of the
patient.
The routine of farm work without the noise, hurry, and crowds found in the industrial
rooms and cottages, and the sunshine of great outdoors furnishes that something for the
unfortunate which cannot be supplied from the pharmacy.
Not only must the farm be considered as a large industrial room but also as a recreational center and sun parlor where patients may become interested in caring for the crops
they like best. Often times this activity will change the line of thought from that of worry
and discontent to that of happiness.
The idea of occupational therapy is neither new nor on the other hand, has it reached
its greatest development. It is perhaps as old as civilized man, as the savage, probably,
when depressed or out of sorts, turned to the making of a new arrow or spear head for diversion.
The earliest recorded history we have of occupational therapy, however, is in 1798
when Dr. Rush of the Pennsylvania State Hospital requested his Board of Managers to
provide certain employment for the deranged who were still capable of working. Among
the activities suggested in this letter, were for the men, grinding Indian corn in a hand mill
for food for the institution cattle and horses, cutting straw, sawing boards and working
in the gardens. For women, he suggested, spinning, sewing, churning, etc.
In 1835 the Friends built a circular railroad for the use of patients in their hospital
for the insane. They had for this, a car which two people could propel. Later they
placed animals in the patients yards and furnished material for drawing, writing, and
reading when within doors.
From 1836 to 1850 several hospitals reported that many of their patients were working at various industries such as carpentering, gardening, and farming, and a few were allowed to care for anmials. About this time libraries began to find a place in the hospitals.
Thus we find the idea growing and developing but it was over a century before it became
systematized.
The first course of training given was as late as 1906 when Miss Susan Tracy gave a
course of ten lessons designed to educate a nurse to care for different classes of patients.
Since then, however, many schools have opened up courses for such training. The World
War has given the greatest impetus to such training and work.
Occupational Therapy falls naturally under three heads: Invalid Occupation, Occu-
�24
MEETING OF JOINT BOARD OF TRUSTEES.
pational Therapy, Vocational Education. Invalid Occupation, is, as its name implies
chiefly diversional, aiming to divert the mind of the patient from his own ills and then to
create interest and cheerfulness. Occupational Therapy has as its chief object the improvement of function, either physical or mental and the third, or vocational education,
seeks to train for the future and may only find a place under this general head as it aims to
reestablish a function, and to form a more normal view of life.
Any form of work to be curative must be able to create interest for the patient. Increased interest in the occupation goes hand in hand with progress towards recovery. In
assigning an occupation it may be that some work which is entirely new to the patient
will do more to stimulate interest. On the other hand we sometimes find that patients
do better when given work with which they are already familiar. It is better that patients
do bad work than none at all. In other words it is better to be employed in useless work
than to be idle.
Our problem to-day, the institutional farm, covers all three headings. For some patients, it is invalid occupation. This is especially true in an institution for the feebleminded. The work is done almost entirely by the patients. Many are assigned to farm
duties as a diversion, others, of course, are assigned for the definite purpose of physical
and mental improvement. Occupational Therapy would find its chief strong hold in
hospitals for the insane and the tubercular. The man or woman who has been closely confined to the office or other indoor work and, as a result of such activity, directly or indirectly becomes mentally disturbed and is placed in a hospital will have need of industrial
training such as is best afforded in farm activities.
What hospitals suffer from more than anything else is suppression—spiritual suppression. In order that the human spirit may develop, it must express itself. Recent
demonstrations show that in the last analysis emotions cannot be successfully suppressed,
that they find expression in some way and if not directed along healthy, normal constructive lines, prove terribly destructive.
It is an established fact that many people have in them the tendency to mental illness but because of particularly favorable surroundings never develop into institutional
cases. Equally true is it that many of the mental patients in our hospitals and institutions to-day are there because of unfavorable surroundings and we wonder if the marked
tendency of the people of this country to leave the farm and seek the high wage and the
excitement of the city is not responsible for at least a small percent of the mental misfits.
High wages and to the city movement, means strong competition. Strong competition means worry and frequently despondency, also an effort to be one hundred percent on
the job and all this means highly increased mental strain. The excitement of the city,
the complexity of it, as compared with the quiet life, brings too great a drain upon the
nervous system. Granting this to be true, what better antidote could we supply than a
return to the rest and quiet of the farm. The air, the sunshine, the soil and the absence
of driving bosses allows the overwrought nervous system to relax, rest and recuperate.
This applies also to the feebleminded. A high grade feebleminded person placed in
a highly complex surrounding is as we all know, an object of pity. He is jostled about in a
helpless fashion, is the laughing stock of some and the tool of others. Place the same individual in a simple environment such as the farm offers and he at once becomes a more
efficient person. His defect is not so apparent and he feels that he is a useful member of
society.
This is even more true in the institution, for here his co-workers are more nearly his
own level. He ceases to indulge in self pity and builds his simple aspirations. He becomes interested in the work at hand and is proud of the product of his labor.
But there is still another angle from which to view the benefits of the institutional
farm, that is as a normalizer of the institution. Dr. Mary Lawson Neff has written a fine
article on normalizing the institutional life of the insane and what she says holds true in
a large measure for all institutions for the mental and nervous abnormalities. She points
out that we, as institutional heads, take excellent care of. the physical side of pur patients
but too frequently fail to get back to the fundamentals of their psychological welfare.
She aptly points out that the normal psychological life is a series of responses to the main
motives of life, necessity, and ambition, and that in committing a person to an institution
we cut off these motives for the most part. For the greatest good of these patients these
motives must be replaced in so far as possible.
The patient resists the monotony of the four walls of the ward or cottage; his pent up
energy refuses to allow him to sit apathetically and do nothing. He wants the normal
amount of change. As we think over these points, which Dr. Neff gives us, the farm looms
up as a solution to a great number of our psychological as well as the physical needs. Where
can ambition be better stimulated and repaid than on the farm? The boy has a team to
care for and he keeps them sleek and shiny. They are naturally admired by all visitors
who come to the farm and that means a great deal to that boy. You can see it in his man-
�STATE HOSPITALS OF MICHIGAN.
25
ner and expression; in the pride with which he informs the admirer of his relation to the
well being of the horses. Another assists in preparing the soil and planting the seed. His
mind is quite taken up with the task and he waits with eager expectancy the first show of
green. It has aroused in him a real ambition and pride.
Of course the farm affords the necessary variety. He is planting to-day, working
about the barn to-morrow due to a shower, preparing the soil for the crop of harvesting it.
The farm garden, the small fruits and the canning, offer splendid opportunities for the female patients.
Farm work, as well as any other occupational therapy should be given under the direction of a physician who knows the patient mentally and physically, and who will watch
and measure the effect of the task upon the patient. Even good things may be overdone.
It should be borne in mind that the institutional farm is first and last'for the benefit of
the patient and not the patient for the farm.
This is not a mere theory that I am giving you to-day. As I have said we have a
farm and our patients work on it. They are well physically and happy mentally. They
feel it is a fine privilege to be allowed to work on the farm and resent being kept in a day
when it is thought best for physical reasons.
They take great pride in the way they care for the stock, the buildings and land. They
are happy in it to the extent that when I am tired from the worries of the Institution, I
go over to get a fresh hold on myself and let their optimism rekindle mine.
Often times instead of having the patients do work that is worth while they are assigned to some sort of busy idleness. The insistent demand of patients for something to.
do, should never go unheeded. Establish small colonies for twenty five or thirty patients
conveniently located on the farms. Here they can care for certain portion of the herd,
chickens, ducks, pigs, etc., and are happy in the doing. We known the best results must
come from individual expression, and that we must respect that individuality, it matters
not what the intrinsic or economic value of the finished article may be. Bear in mind that
we are not conducting arts and crafts schools. Let a few of the difficult patients get on
the farm as audience, if need be, for weeks, before we become discouraged. Don't defeat
the purpose of the physician by an effort toward getting the patient to work.
The fundamental principles of occupational therapy are that the work should be
carried on with cure as the main object. The work must be interesting. The patient
should be carefully studied. That one form of occupation should not be carried to the
point of fatigue. That it should be carried on with others. That work resulting in a poor
or useless product is better than idleness. Man to be happy must have something to
work for, something to hope for and something to love, and it is up to us to supply the
needs for those under our supervision.
Without the institutional farms, many patients would be deprived of the therapy
most needed for their cure. We like our farms and would not be without them, but hope
the day will soon come when they will be considered a real part of the hospitals and not
as appendages for profit and be maintained for the therapeutic value they offer our unfortunate population.
DISCUSSION BY DR. B. A. CHRISTIAN. SUPERINTENDENT PONTIAC STATE HOSPITAL.
Ladies and Gentlemen: There are three minutes that intervene between now and
the next feature on the program, and in that time, I think I can say all that can be said
on the subject. I do not know how to discuss a question that has but one side to it.
I never heard of anybody opposing the view that occupation on the farm was valuable
therapy. The answ_er to the question, if there is any question is to be found in experience
only, and the experience of all the hospital superintendents that I know of has been emphatically to the point that farm occupation is of great benefit for promoting the comfort
of the patients, and for diminishing the expenses. It would be a very interesting question,
if we could determine just what the value of patient farm labor is. Unfortunately, human
effort is not capable of the same mechanical measurement that machine activities are.
I would venture a guess, that from a financial point of view, it would take four or
five average insane men to be as productive as one ordinary farm hand. But that is not,
the point in the matter of financial returns. Man is an animal. If he is kept in confinement, he will get like any other animal, he will become resistive, discontented, and he will
find expression in destruction, all of which adds to the upkeep of the plant, and we know
from experience to put a patient to work, particularly in a form of labor that is productive
and not ornamental, it adds very much to the peace and contentment of mind, and that
works for the benefit of the patient and reduces his restlessness, and produces economy.
�26
MEETING OP JOINT BOARD OF TRUSTEES.
STATISTICAL ANALYSIS OF THE BIENNIAL REPORT OF MICHIGAN STATE
HOSPITALS FOR THE INSANE FOR THE BIENNIAL PERIOD 1915-1918.
BY ALBERT M. BABHETT, M. D., MEDICAL DIRECTOR OP THE STATE PSYCHOPATHIC HOSPITAL.
Ladies and Gentlemen: There is no report published in Michigan that shows in one
series of tables, the combined statistics of the various state institutions caring for the insane. The separate biennial reports that are published by the State hospitals for the insane relate solely to their own problems and local institutions, and no where is there any
statistical consideration of the problems of the care of the insane as they affect the State
as a whole.
Unless this knowledge is available it is impossible to formulate any satisfactory constructive policy for future developments.
It is also of much interest to the subject to ascertain what factors are active in the
production of mental disorders and whether or not there are changes for better or worse.
In 1915, a commission appointed by the legislature made a report on the extent to
which insanity existed in Michigan at that date, and various factors that bore a relation
in its occurrences. Some comment was also made of changing relations that had taken
place in the progress of years.
It is my purpose in this discussion to continue some of these statistics to the present
date and to present some comments as to existing conditions in the hope that they may
be an aid in determining future policies.
Table 1:—Number under treatment in Michigan State Hospitals for the Insane on
June 30th of each year.
1915
M
Pontiac
Traverse City
Newberry
State Psychopathic Hospital
Ionia
...
Wayne County Hospital . . . .
Total . .
Ratio per 10,000 population
F
I 917
1916
T
M
F
T
M
F
1918
T
M
F
T
1162 1065 2227 1145 1102 2247 1162 1116 2278 1110 1097 2207
788 665 1453 812 689 1501 816 682 1498 791 684 1475
882 779 1661 916 777 1693 916 816 1732 988 867 1855
561 413 974 565 425 990 564 440 1004 560 460 1020
25 35 60 26 28 54 26 28 54 24 37 61
393 62 455 413 64 477 421 62 483 425 66 491
298 320 618 368 360 728 390 375 765 339 402 741
4109 3339 7448 4245 3445 7690 4295 3519 7814 4237 3613 7850
24.2
24.6
24.6
24.3
In Table 1 are given the number of insane under treatment in the state Hospital for
insane in the years 1915-1918. Statistics for the years previous to this may be found in
the report of the legislature commission published in 1915.
There were under treatment in all of the state hospitals caring for the insane on June
30, 1918:—7850 patients. The population of the State at that time was estimated to be
3,230,512. The number of insane under treatment in State hospitals bore a ratio of
24.3 to each 10,000 of the state population.
These figures concern only the insane that were in hospitals supported by the state.
There are a considerable number of insane cared for in County infirmaries and in private
institutions. We have no figures regarding this number for the year 1918, but in 1914 it
amounted to 673 patients.
There is a little difference in the rate per 10,000 population between 1915 and 1918
it seems that they correspond closely, with other states having a similar geographic position, and equal hospital facilities. The rate to population of insane in state hospitals
directly depends upon the hospital facilities that are provided for the insane. These
facilities vary much among the states.
�STATE HOSPITALS OF MICHIGAN.
27
HOSPITAL ADMISSION.
Table 2:—Number of annual admissions to Michigan State Hospitals for the Insane.
Kalamazoo
Pontiac
Traverse City
Newberry
State Psychopathic Hospital
Ionia
Wayne Co. Hospital
M
F
391
236
215
165
94
51
101
286
185
158
115
114
1 91 7
1 91 6
1915
T
677
421
373
280
208
51
69 170
M
F
400
261
237
152
126
45
139
288
178
152
97
125
T
688
439
389
249
251
45
103 242
19 1 £
-M
F
T
M
F
T
388
254
220
164
110
45
137
242
165
133
87
138
1
89
630
419
353
251
248
46
226
339
235
173
163
91
50
152
273
163
146
115
136
1
151
612
298
319
278
227
51
303
1253 927 2180 1360 943 2303 1318 855 2173 1203 985 2188
Total
Ratio per 10,000 population
7.1
7.3
6.9
6.8
In table 2 are given the annual admissions to the state hospitals for the insane for the
years 1915-1918.
In 1918 there were admitted to all of the Michigan State hospitals caring for the insane 2188 patients. This bore a ratio to 10,000 population of the state of 6.8. Between
1915 and 1918 there has been a slight decrease in the admission rate. In the former year
it was 7.1 in 1916, 7.3 and in 1917 it was 6.8.
The comments made thus far relate to the total number of insane in relation to the
State as a whole. In order to more clearly comprehend the problems of care that concern
the districts hospitals, a matter that is of much importance for determining future policies,
a separate statistical statement is given in Table 3, regarding the number under treatment
and the admissions for the year 1918.
As a state problem the main provisions for the care of the insane, concern the four district hospitals, Kalamazoo, Pontiac, Traverse City and Newberry. With these must be
included the Wayne County Hospital at Eloise, which shares with Pontiac the care of the
insane in the Eastern district of the State. The population of the several districts is taken
from the official estimates of the Secretary of State. There is a considerable variation in
the populations of the various districts.
Table 3:—Number under treatment and admissions in relation to Hospital districts
District
Kalamazoo
Pontiac & Wayne
Co. Hospital
Traverse City
Newberry
State Total
Under
Rate per
Treatment
10,000
Population June 30, 1918 Population
Admissions
1918
Rate per
10,000
population
898 059
2 207
24 5
612
6 8
1,290,778
640,882
400,793
2,216
1,855
1,020
17.2
29 0
25.5
701
319
278
5.4
4 9
6 9
3 230 512
7 298
22 5
1 910
5 9
The four district hospitals, and the Wayne County Hospital, on June 30, 1918, had
under treatment 7,298 patients. This bore a ratio of 22.5 to each 10,000 population of
the entire state. There is wide variation between the population of the different hospitals
districts, and while there is no reason to believe from the character of the population of
the different districts that one should have a higher percentage of insanity in its population
than another, there are marked differences in the ratio of the number under treatment
in a district and also in the admission rate.
There are two hospitals in the state that are able to receive all that apply for admission.
These are Kalamazoo and Newberry. The ratios for these hospitals are 24.5 and 25.5
per 10,000 of the districts population. The other two hospitals have ratios that vary
much from these. That of Pontiac and the Wayne County Hospital being much smaller
and Traverse City much larger.
�28
-MEETING OF JOINT BOARD OF TRUSTEES.
There is much uncertainty in attaching a meaning to these differences, but the fact
is known that the Pontiac and Wayne County Hospital have for some time been unable
to care for all of the inside in the eastern district and that the Traverse City Hospital has
had sufficient accommodations to receive for treatment patients who have been transferred
from other districts.
In the matter of admissions there is also much variation in ratios to population. Kalamazoo and Newberry are about equal, while the other two hospitals much lower than the
average for the state as a whole.
AGE AT ADMISSION.
The matter of the age of patients at admission is of importance as showing at what
periods of life insanity is most likely to occur. In Table 4 is given a comparison of the
relative frequency for age periods of the admissions for the year 1892 and 1918.
Table 4:—Percentage frequency of ages at admission for years 1892 and 1918.
Below 15
.
15-19
10-29
30-39
40-49
50-59
60-70
70 and above . . .
.
. .
...
1892
1918
41
5.3
23 4
25 5
2
2.4
17.8
22.2
19.0
13.2
13.2
11.5
19 7
12.2
87
50
..
In both years the largest number of admissions occur between the ages of 30 and 39.
It is of interest to note as bearing upon the problem of care of patients, that there
has been a marked increase in the relative frequency of admissions after the age of 50. In
1892: 22 percent of the patients admitted were over 50 years and in 1918 the percentage
of patients admitted above the age of 50 was 38.4. This corresponds to the relative increase in the same period of the clinical forms of mental diseases that are incident to the,
later years of life, a fact that receives comment in the discussion of table 6, which gives
the clinical types of the admissions.
NATIVITY OF PATIENTS.
In table 5 is given the relative proportion of foreign born patients among the insane
admitted to the Michigan Hospitals for the insane, for the biennial period, 1914, 1916, and
1918.
Table 5 percentage of foreign born patients admitted to State Hospitals for biennial
periods 1914, 1916, 1918.
Kalamazoo
Pontiac
Traverse City . . . .
Newberry
.
1914
1916
1918
21 5
41.3
26.0
60 4
19 8
33 9
27.9
61 6
29 9
38 5
30.7
52 8
'For their relative proportion in the population of the State the foreign born contribute
more largely to the admission to the insane hospitals than do those who are born in this
country. In 1914 the rate of the foreign born among the insane admitted to the hospitals
for the insane in Michigan was 8.9 per 10,000 of the foreign population of the State, and
for the native born was 5.4 per 10,000 native population. Considerably over one-half of
the admissions to the Newberry State Hospital were foreign born.
�STATE HOSPITALS OF MICHIGAN.
29
Table 6:—Frequency of clinical forms of mental disorders among admissions.
1916
1918
4 9
.98
11
6.98
5.94
2.87
4 17
12.98
4.3
4.5
28
11.6
2.3
.02
2.59
2 3
2.61
1.2
6
1 85
9 4
1.25
10.3
2.57
.08
12 95
9 1
2.4
.006
11 506
5 1
9.08
03
.08
.21
05
02
3.42
24
18 23
6 3
10 2
06
01
.5
1914
Intoxication Disorders :
Alcoholic Insanity
Chronic Alcoholism
.
.
...
Total
Infectious Metabolic Disorders:
Pellagra
Thyrogenic
..
Infectious —Exhaustive
Miscellaneous Somatic Disorders
Total
Syphilitic Disorders:
General Paralysis
Cerebral Syphilis
Tabes
Total
...
....
Organic Brain Disorders:
Senile Insanity
...
Cerebral Arteriosclerosis
Cerebral Tumor
Traumatic injuries
. .
Huntington's Chorea
Sydenhams Chorea
Multiple Sclerosis
Epilepsy
Miscellaneous Organic Disorders
Total
10 65
...
...
....
4 7
1 3
21 24
Endogenous—Psychogenetic Disorders :
Manic Depressive Insanity .
....
Melancholia
Dementia Praecox
Paranoid Disorders
...
Paranoia
Hysteria
Psychasthenia
.
...
Neurasthenia . . . .
Total
Constitutional Inferiority :
Psychopathic Inferiority
Feeblemindedness
Sexual perversions
Total
Unclassified
..
Not insane
. . ..
7 5
7 4
14
03
.17
...
22 7
5
14 3
4 4
.38
8
43.08
...
2 06
5 13
....
7 19
70
15
....
18 7
14 9
36
.48
1 06
16
29
39.19
19
6 1
13
8 13
4 35
1 52
005
005
2.7
2
20 02
19 5
01
16 5
4 1
1 i
12
4
42 81
15
5 3
6 8
4 7
7
In table 6 is given a statistical analysis of the clinical forms of mental disorders admitted to the Michigan State Hospitals for the insane for the biennial periods 1914, 1916,
and 1918. The various disorders are tabulated in the percentages they occur among the
admissions of each period.
Somewhat arbitrarily these have been grouped under headings, that in a more or less
specific way indicate their etriological relations. A summary of these groups shows rather
clearly the problems of causes and may suggest directions for efforts at prevention.
�30
MEETING OF JOINT BOARD OF TRUSTEES.
Endogenous —Psychogenetic
Organic brain disorders . . '
Syphilitic disorders
Intoxication disorders
Constitutional Inferiority
Infectious — Metabolic . .
Not insane
1914
1916
1918
43
21
10
6
7
2
7
1
39 19
18 23
12 95
12 98
8 13
2 61
4 35
1 52
42 81
20 02
11 51
11 6
6 8
1 85
4 7
7
08
24
65
98
19
3
0
5
The largest group of mental disorders is represented by those whose etiological relationship is least known. Their most outstanding causes seem to be inherent in the
mental constitution of the individual that makes difficult the maintenance of a normal adjustment of mind to the demands of life. It is in this group that we find the highest percentage of hereditary influence. The attack against the group must be directed against
the perpetuation of impaired family stock, and efforts should be directed towards a more
careful training of mental habits during childhood, and a regulation of the environment
for those who are ill adapted for meeting the responsibilities of life in the usual way.
In the organic group are placed those disorders that are the result of demonstrable
changes in the normal structure of the brain. The causes of these pathological conditions,
in part lie in hereditary factors such as in in Huntington's Chorea; in infections as in Sydenham's chorea, and in the effects of toxic and metabolestic influences which seem to have
a part in the production of arteriosclerosis and senile brain atrophy. As our understanding of the pathology of these disorders becomes more complete it may be that ways may
be opened up that may lead towards their prevention, but at the present moment we know
little definitely regarding the factors that are active in their production.
Both senile dementia and cerebral arteriosclerosis are occurring in greater frequency
among hospital admissions than in former periods.
The statistics relating to epilepsy and feeblemindedness show that in spite of special
state hospitals for these disorders, they still are admitted to the hospitals for the insane
in considerable numbers.
The disorders due to syphilis are third in order of frequency among the general groups.
This is the group whose etiological relationship is best known, but whose prevention forms
one of the most difficult social problems.
The most hopeful method of attack seems to lie in a more general education of the
public as to the effects of venereal diseases, and a more thorough treatment of these disorders during their early stages.
The group of disorders caused by intoxication is still of serious size, but is one that
promises to be progressively diminished in future time. A considerable number of patients
of this group were admitted under the statutes providing for the treatment of inebriates
and drug addicts in hospitals for the insane, and were not definitely insane.
The remainder of the clinical groups is composed of disorders that occur in relatively
small numbers.
The number of unclassified cases has diminished perceptibly in the last two biennial
periods.
While no definite recommendations for future policy are formulated in this statistical analysis, it gives to us a better idea of the problems we are dealing with than is otherwise obtainable.
It is to be hoped that in future time the state will provide for a more complete and continued presentation of the statistics of our work in connection with the treatment of the
insane. As long as this is lacking it will be difficult to formulate a satisfactory constructive policy.
�STATE HOSPITALS OF MICHIGAN.
31
REPORTS OF MEDICAL SUPERINTENDENTS
KALAMAZOO STATE HOSPITAL.
BY DR. OSTANDER.
To the Joint Board of Trustees:
Herewith is submitted a brief report of the operations of the Kalamazoo State Hospital
during the past fiscal year:
MOVEMENT OF POPULATION.
Patients remaining July 1, 1919
Admissions during the year, 1st adm..
Readmissions
Returned on old order
Total number under treatment.
Of the Admissions there were:
Voluntary
Drug
Inebriate
Inebriate and drug
Trans, from other hospitals
Regular commitments....
Returned on old order
Discharged:
Recovered
Improved
Unimproved
Died
Not insane
Escaped
Trans, to Ionia
Trans, to Wahjamega....
Trans, to Alton, 111
Trans, to Lapeer
Trans, to Chicago
Deported to Canada
Men. Women.
1,102
1,072
247
327
42
25
44
20
Total.
2,174
574
67
64
1,485
1,394
2,879
406
296
702
1,079
1,098
2,177
Men. Women. Total.
14
29
15
7
19
26
2
2
0
2
2
4
11
6
17
238
325
563
44
64
20
Men. Women. Total.
47
18
65
83
67
150
32
50
82
123
314
191
5
4
9
2
35
37
2
2
37
37
1
1
1
1
2
2
1
1
1
1
Remaining July 1, 1920
There was a net increase in the population of only 3.
BOARD OF TRUSTEES.
The only change in the personnel of the board was that caused by the death of Trustee
Cook. At present there are but 5 members of the board.
CHANGES IN THE MEDICAL STAFF.
Doctor—formerly Lieut. Roy A. Morter resumed his duties on July 15, 1919, after an
absence of 10 months, 15 days during which time he was in the service both in the United
States and overseas. Major S. W. Perry began service in the institution on August 2,
1919, as physician at the Colony Farm in place of Dr. David Weissman who resigned on
�32
MEETING OF JOINT BOARD OF TRUSTEES.
July 31st. Dr. C. C. Jones gave his resignation to take effect June 30, 1920. Dr. James
Denton terminated his services as pathologist on August 10, 1919 because of the sudden
death of his wife, and Lieut. F. C. Potter, a graduate of the Medico Chirurgical College
of Philadelphia and late in the service was appointed to succeed him.
Miss Alice Campbell has served the institution during the past year as psychologist,
her chief duties consisting in making mental tests, taking histories and assisting in the outclinic work. The work of the staff will be supplemented by the services of a psychiatric
social worker as soon as a suitable one can be obtained.
OCCUPATIONAL THERAPY.
At the solicitation of the Newberry Home in Detroit arrangements were made to receive a limited number of its under-graduates as pupil occupational therapists, they to
receive credits for work done here. This affliation will be continued during the present
year. The staff of instructors has been increased so that the work may be carried on at
the Colony Farm and extended to the wards of the Male and Female Departments. A
very creditable exhibit of the work of this department illustrating its benefit to patients
was made at the meeting of the American Medico Psychological Association last month.
RECREATIONS.
Classes in physical exercise and games are being conducted daily among women patients, the object being to not only place amusements and recreations under intelligent
supervision but to awaken some activity among the old dementia Prsecox cases and reeducate them to better habits. This kind of service will be extended to the Male Department some time in the fall.
OUT-CLINICS.
It is the aim and policy of the board of trustees to extend this service in this hospital
district, as rapidly as a suitable staff can be obtained and funds made available for the purpose. Public sentiment is such that the counties where the clinics are held may be easily
persuaded to bear the greater share of the expense. At present our activities are still
limited to Kalamazoo, Kent, Ingham, and Jackson Counties. I desire to present a brief
resume of the work accomplished during the past four years or since the starting of these
clinics.
1732 cases have been examined. The accompanying chart shows a decrease in the
number of cases examined during the past year. During the first year of clinic work, many
cases were brought in merely for Wassermann or neurological"examination, and the name
of the patient, and the result of that examination, only were recorded. During the.past
year, complete histories and thorough examinations were made of all patients coming to
the Clinics, and a greater number have come than could be examined during the limited
time. No effort has been made on the part of the hospital during the past year to obtain
Clinic patients, but the number referred to Clinics by charitable organizations, schools,
relatives and physicians has increased 7.5%; 3.9%; 21.8%; 5.9% respectively. In tabulating nationality, those whose parents were not American-born were considered Foreign.
Of the total number of histories obtained 85% showed insane, feebleminded or criminal
and moral taints. It is quite probable that many of the negative histories would not
prove such, if thoroughly investigated. Feeblemindedness comprises 32% of the total
number of cases, and delinquency 24%. Two hundred ninety-seven delinquents were
given mental tests. Of these two hundred fifty-eight were feebleminded, making 63% of
the tested delinquents feebleminded. 18% of the whole number of cases examined had a
definite psychosis. Of the 1240 Wassermanns examinations made, 18% were positive.
Two hundred twenty family groups were represented. Of this number 38.6% were syphilitic. The cases for whom no recommendation was made, include the normal patients,
relatives accompanying patients, and those coming for Wassermann, which proved to be
negative. One hundred thirty-nine women suffering from venereal diseases were examined for the government. Recommendations for the disposition of these cases included
commitment, supervision, and release from supervision. The column under disposition,
headed ' 'At large'' includes the cases released from supervision by the court, those known
to have left the State, and those who are now able to live without being disturbing to their
environment. It is interesting to note that 21% of the total number received no more
than 4th grade education. This percent does not include Juveniles who would normally
be in the first four grades.
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Undiagnosed.
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Positive.
% Positive.
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% Syphilitic.
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�.STATE HOSPITALS OF MICHIGAN.
35
FUTURE NEEDS.
Since my connection with the Kalamazoo State Hospital, 32 years, the institution has
not refused to take patients because of lack of room it being deemed by the board of trustees more humane to over crowd the institution than to leave these people uncared for in
their homes; in the county houses, and jails. Beds have been set up in corridors, parlors
and other places intended and needed for other purposes. Two beds have been placed in
single rooms intended for one. Dormatories intended for 4 to 6 persons are crowded to
8, 10, and even 12. The hope has always been that the legislature would meet this condition by providing sufficient room in some way. Matters have gone on in this way until
we have gradually come to measure the normal capacity of the institution by the number of
beds now in use, which is 2295. I have recently had our architect measure the cubic capacity of all the sleeping quarters for patients and make a detailed report of the ventilation.
The older buildings contain a large number of single rooms, 498 in all, while the more
modern buildings are constructed largely on the dormitory plan. The average cubic content of the single rooms is 1220 cubic feet, a few a little larger. Very many of these rooms
house two patients. If each single room housed but one patient, and if the other patients were
allowed an average of 750 cubic feet of air space it woudl be necessary to remove 550 beds.
In other words, we have for years crowded beyond our normal capacity by about 450
patients.
The tubercular wards are particularly crowded and these cases are housed in shacks
that the great State of Michigan ought to be ashamed of. I am opposed to increasing the
number of patients, but I am most certainly in favor of enough buildings to decently house
what patients we have.
Furthermore, this institution needs more rooms, more baths, assembly rooms and
better home life for it's employes. In answer to a recent advertisement for physicians I
had a number of promising applicants. They were married men, however. We haven't
suitable quarters for all the married members of our present staff. If it is urgently necessary that the law requiring medical officers to live in the institution should remain operative, the state should build homes for these men, so that some semblance to family life
might be enjoyed. Personally I see no reason why institutions of this size should not have
sufficient night force on duty to take care of emergencies, pay its officers money in lieu of
food and lodging and let them buy homes of their own. Indeed, this policy might be extended to other departments with benefit to both the institution and the employe.
�36
MEETING OP JOINT BOARD OF TRUSTEES.
PONTIAC STATE HOSPITAL.
BY DR. CHRISTIAN.
I wish, very briefly, to summarize the conditions as at present existing at Pontiac and
the activities of the past year.
I want to say at the outset, our energies have been confined to keeping an organization at work that would meet with the minimum requirements of such an institution, to
keep it functioning. What the difficulties are, you very well know, but to illustrate what
the condition is, I might cite that at the end of the last year, just closed, out of the normal
force that we should have on the pay roll of 80 men attendants, we had 55; out of a female
force of about the same number of women attendants, we had something over sixty. We
have not been able to give the patients the personal attention that is required, nor have we
been able to meet the needs of the hospital activities in the way of working parties out of
doors on the farm and various other activities because we lack the attendants to eare for
them.
We have had a waiting list of insane women that we have not been able to receive and
for whom application has been made, because of lack of accommodations. We have a new
building almost completed which would give adequate relief for at least a year, and perhaps more. If that building were completed today, and thrown open to patients, I couldn't
open it because of lack of attendants to man it.
Those are some of the adverse conditions under which we have been trying to work.
Another illustration: The pay roll for last June, 1920, as compared with the pay roll
for June, 1919, showed a 25% increase of expenditure in dollars and cents with 10% less
names on the pay roll. In other words, we made an effort, by increasing the wage scale
to attract, and with indifferent success. When unskilled workmen can command, in the
Pontiac factories from ten to fourteen and fifteen dollars a day, you can see what we are
up against. We secure enough men and women to work. They come to us and remain
a few days, until such time as they can secure a position in a factory and perhaps a lodging
place in town and then leave us. The consequence is that our turn over of labor is enormous.
We are still short on our medical staff. Salaries offered are no attraction, and I want
to emphasize my hearty accord with what Dr. Ostrander has said relative to the necessity
of the State offering decent, normal conditions of life as an attraction for medical men and
women who wish to enter this service, and until that approximates the normal standard
of living, we cannot look forward to anything but deterioration in our medical services.
Our population, as you can infer, has not changed much in the past year. We have
not been able to increase census of women, because of lack of room. It is an interesting
fact, that notwithstanding the fact we have been able to care for all the men who have applied, the number of admissions is no greater for the past year than normal.
Another interesting fact is that notwithstanding the very great increase in population
in the district of the Pontiac State Hospital, the number of new cases of insanity arising
and coming to us is less than it has been in any preceding year for sometime, which means
that there has been an unmistakable decrease in the occurrence of new cases.
�STATE HOSPITALS OF MICHIGAN.
37
TRAVERSE CITY STATE HOSPITAL.
BY DH. MUNSON.
The movement of patients during the year ending June 30th, 1920, was as follows:
Male. Female.
997
849
155
107
37
44
56
2
9
7
Patients in hospital June 30, 1919
First admissions during year
Readmissions
Transfers from other institutions
Drug Addicts, Alcoholic
Total Admitted
Total under treatment
257
1,254
Discharged:
Recovered
Improved
Unimproved
Not Insane
Transferred
Died
1601,009
Total.
1,846
262
81
58
16
417
2,263
20
41
24
22
18
126
18
35
10
8
1
65
38
76
34
30
19
191
Total Discharged
251
137
388
Census June 30, 1920
1,003
872
1,875
There was an increase of twenty-nine patients during the year. Barring transfers to
and from other hospitals there was a decrease of ten patients during the year. Of the four
hundred seventeen only three hundred thirty-six were first admissions. The number of
alcoholics and drug cases was sixteen,—a steadily decreasing number,—and the death rate
based on the whole number of patients under treatment was_ low,—slightly exceeding eight
percent. Theie was some influenza during the winter but it was not so prevalent as last
year. There were about fifteen cases of small pox and a few cases of measles, scarlet fever
and diphtheria among patients,—all in mild form and without fatality.
The medical work of the hospital has been well sustained, notwithstanding several
changes in the personnel of the staff. During the last few months an effort has been made
to resume staff meetings and other research and scientific work that was impossible during
the war period and much more personal care of patients has been possible.
The industrial departments are in excellent condition and the institution has been kept
in a high state of repair, in fact we are able to report that it never was in better physical
condition.
The general hospital continues to be successful. During the year it received 406
patients—360 surgical and 46 medical. The net earnings for the last fiscal year were
$4,528.80. We hope to be able to enlarge this department to fifty beds. This would enable the institution to maintain an independent training school'. The supply of trained
nurses is entirely inadequate to meet the demands of the institution to say nothing of the
public and private service. There is great need at the present time for institutional nurses,
private nurses and nurses for social welfare, community and public health service work.
With a modern and thoroughly equipped general hospital and training school our institution would be able to aid in general mental hygiene work, in after care of patients and cooperate with the public health department.
PERSONAL SERVICE.
The expenditures under this head show a deficit for the fiscal year ending June 30th
1920, of over $18,000.00. and owing to the greatly increased cost of supplies and especially
of the increased cost of labor, etc., there is an estimated deficit of over $60,000.00 for the
ensuing year, or that of 1921. This matter has been one of grave concern to the management and has been carefully considered with the budget commissioner. The situation is
�38
MEETING OF JOINT BOARD OF TRUSTEES.
such that unless this money can be supplied the institution will'be compelled to close at
least a portion of its doors. In other words unless provisions are made to meet these increased over head charges the institution will be unable to carry on the work for which it
was created.
COST OF MAINTENANCE.
The daily cost of maintenance computed on the former basis was 74.74 cents per patient per day. If the cost of farm products consumed by patients is included the cost is
85.00 cents. The gross amount spent for food this fiscal year was $138,203.54 or 20.04
cents per patient per day. The previous year it was 20.35 cents. If the cost of foods
raised on the farm is added the daily food cost was 23.67 cents per patient per day. If
the cost of production of food supplies raised on the farm is not deducted then the cost of
foods was 30.30 cents per patient per day. The gross cost of foods produced by the hospital farm was $69,516.02 and the disbursement was $44,960.74, or a net value of food
supplies of $24,555.28. It might be of interest to enter into further details of the value
of the farm to the state but, our Steward, Mr. G. B. Pike, has presented to you careful
details during this meeting.
There was very little building during the year. During the coming year, a new store
will be completed at a cost of $28,000.00, a new boiler installed as well as coal crushing and
ash handling machinery.
Scarcity of help continues to be a problem. ' At this date the institution is twentyfive percent short of women nurses. On the men's side the supply about meets the demand.
The outlook for this service is more promising for the coming year. AYe have been so depleted that it has been a source of great anxiety and the officers have been compelled
to remain at home for fear of accident.
The introduction of the new method of accounting, the new system of purchasing for
the institution as well as the limitations of the budget have added much to the labor of
the institution as well as to the responsibility of its management. The writer believes
that the budget will work out satisfactorily, and the accounting systems. The writer
does not, however, believe that the central purchasing method can ever be made as practical as the unit plan formerly in use. It would seem that our institutions are old enough,
large enough and capable enough to do this work as well, and I believe better, than any
other method thus far devised.
There has been no untoward event in the institution during the year just closed worthy
of mention in this connection.
�STATE HOSPITALS OF MICHIGAN.
39
NEWBERRY STATE HOSPITAL.
BY DR. CAMPBELL.
1 beg to present a brief synopsis of the conditions of the Newberry State Hospital
during the fiscal year ending June 30, 1920. The following table shows the movement of
the population.
MOVEMENT OF POPULATION.
Men. Women. Total.
562
454
1,016
136
112
248
Number of patients under treatment June 30, 1919
Total admissions during the year
Total number of patients under treatment during year.
Discharged:
Recovered
Improved
Unimproved
Not Insane
Died
Men. Women.
17
25
47
41
7
13
1
4
53
29
Total.
42
88
20
5
82
Total number of patients under treatment June 30, 1920...
698
566
1,264
125
112
237
573
454
1,027
The year ends therefore, with an increase of 11 patients in the Hospital population.
The total number of admissions is considerably less than the preceding year and the same
is true with the discharges, indicating that the service of the Hospital has been less active.
For instance, during the year ending June 30th, 1919, the total number of patients under
treatment during the year was 1306 as compared with 1,264 during this past year. The
number of first admissions, 189, is also less than the number of first admission the preceding year. A number of causes have produced this result; some of which are probably permanent—others more or less transitory. The enactment and in our district, at least, the
fairly strict enforcement of the prohibition law, has had an affect. No cases of definite
alcoholic insanity have been admitted, while prior to this enforced prohibition the admission rate of this disorder was approximately 5%. In addition we formerly received a
considerable number of inebriates.
This period of great prosperity through which the country is passing, has undoubtedly
in many ways been a factor in lessening the number of persons admitted to the Hospital.
Anyone who wishes may now work at wages that a few years ago would have been regarded as fabulous. There is at present no competition which drives out the unfit. Because
of the shortage of labor and the prosperity of families it has been easy to arrange for the
discharge of many patients, who in ordinary times would remain in the Hospital.
We have departed somewhat from traditional methods in the discharge of patients.
An effort has been made during the past few years to weed out those who seem capable of
supporting themselves—those patients who succeeding in getting a fair adjustment of their
difficulties in the Hospital. Work has been procured for many of them and they have been
discharged on parole, reporting about once a month to the Hospital either in person by
letter. The result has been surprisingly good. One realizes, however, that an industrial
depression would change all of this. In such an event, many of these individuals would
return to the Hospital and there would undoubtedly occur a greater rate of admissions necessitating more accommodations than are present.
The original plan at Newberry of a number of cottages arranged in a quadrangle have
been completed. The number of beds originally planned was 975; divided as follows:
For men, 540; for women, 435; On July 1st, 1920, there were present 1,027 patients,
showing an over-crowding to the extent of 52. This condition, of course, should be remedied soon—more especially so when one considers the causes that for the past few years
have produced the low rate of admissions.
At Newberry, we are facing a somewhat perplexing condition in view of the fact that
future buildings must be erected at some distance from the original quadrangle, necessitating the extension of water and steam mains, sewers, etc. Another thought is that not only
�40
MEETING OF JOINT BOARD OF TRUSTEES.
a different type of building might be built but also that by its location, etc., it might be to
a considerable extent, disassociated in the public mind, at least, from the Hospital proper.
It might be that our usefulness would be greater were we able to care for a somewhat different type of mental disorder or at least receive more individuals at an earlier period of
their difficulty. Patients apparently enter the Psychopathic Hospital at Ann Arbor, with
little hesitation, and the public does not evince toward them, that peculiar feeling that
they do toward those patients committed to the State Hospital. We have in mind something along this line.
The matter of securing efficient and adequate help has been exceedingly troublesome;
more so I believe the past year than at any time during the period of war. Wages have
been increased a number of times. At present male attendants receive a minimum of
$50.00 per month with a maximum of $84.00 after ten years' service; women a minimum of
$40.00 and a maximum of $60.00. Graduate nurses, $65.00, pupil nurses, $30.00 all with
maintenance. Under present conditions there seems to be no relief. There is always a
limit to the amount of wages and that may be justly paid for a certain type of duty and it
is possible that limit has nearly been reached.
Practically no building has been done through the year although an effort in spite of
shortage of labor, has been made to keep the plant in as good repair as possible. The last
legislature appropriated $13,000 for additional boilers which have been purchased and
erected.
�STATE HOSPITALS OF MICHIGAN.
41
IONIA STATE HOSPITAL.
BY DR. HASKELL.
The following is presented as a report of some of the activities of the Ionia State
Hospital for the past hospital year.
Male Female Total
Population 6-30-1919
438
68
506
Admitted
59
5
64
Discharged
37
0
'37
Remaining June 30, 1920
'.
460
The patients were admitted from the following sources.
Civil Insane
Hospitals
Penal Institutions.
M F
M F T
Jackson
24 0 24
Kalamazoo. . . 2 0
Ionia
1 0 1
Pontiac
3 2
Traverse City 0 1
Marquette
9 0 9
Newberry. . . . 0 0
Det. H. of C... . 1 0 1 11
1 0
E^oise
44
1 45
73
533
Courts.
T
2
5
1
0
1
Circuit....
Recorders..
M
5
4
9
6 3 9
T
6
4
1 10
Last year I said something about the increase in the number of negroes. The same
condition has continued. The last year we admitted
Male Female Total
Negroes
18
2
20
In other words 33% of all the patients admitted last year were negroes.
Of Foreign Born patients there were admitted:
Male. Female.
17
0
Total.
17
That is, approximately 28% of admissions were foreign born. Thirteen of these men
came from the prisons; 1 from the Hospitals and 3 from the Courts.
Another 16 patients, 15 men and 1 woman, had one or both parents Foreign P/orn.
While we are speaking about admissions I may say that these patients, 12 men and 1
woman, had committed at least one murder. They originated as follows:
Male. Female. Total.
From Prisons
..........
7
0
7
From Hospitals
From Courts
12
13
This group constituted 21% of all admissions for the year.
We are obliged to refuse admission to one male patient during the year.
DISCHARGED 1919-20.
Recovered. . .
Improved.. . .
Unimproved..
Died
Not Insane...
Eloped
Suicide. .
M
4
2
3
16
7
1
1
34
F
0
00
0
0
0
0
0
T
4
2
3
16
7
1
1
34
�42
MEETING OF JOINT BOARD OP TRUSTEES.
MANNER OF DISCHARGE.
Returned to Prison
Dismissed
Deported
Eloped
Dead
'
:
M
6
6
4
1
17
F
0
0
0
0
0
T
6
6
4
1
17
34
0
34
We have been particularly interested the past year in getting rid of patients who are
not legal charges against the State of Michigan. We have actually got rid of four such
cases. This month since July first we have sent two negroes back to their points of origin.
Our laws are not flexible enough. A foreigner who is sent to prison for 6 months for
some simple crime within 5 years from the date of his entry into this country and there
becomes, or is found to have been already, insane can be deported.
A foreigner who
murders, even within a 5-year period, and is found to be insane and for that reason is committed to the Ionia State Hospital cannot be deported even though he can be shown to
have been insane at the time of his immigration to this country. Similarly a foreigner
who murders and is sent to prison for life and then becomes insane can't be deported, even
within 5 years, because one must wait for the termination of his sentence which is "at
death."
These restrictions may all be reasonable but I can't reconcile myself to them.
Increases in salary the past year, particularly in those positions that carry no, or little,
responsibility, have been considerable and range from as low as 20 per cent in the case of
executives to 150 per cent on the wards.
That increases alone will not get the men one can see from the fact that we much are
shorter than ever, even during the then hard days of actual war time. The following
tables explain themselves.
July 1, 1910
July 1, 1915
July 1, 1920
No. of Patients.
429
455
533
No. of Employees
60
72
56
Ratio.
1:7
1:6.3
1:9.5
We have on our wards today 20 day attendants. We are short 12 today on a norma 1
working basis. In other words we are 37.5% short of a normal minimal working force.
We could not get along if it were not for the fact that today we have by all odds a higher
class and more efficient group of attendants than at any time in 10 years.
We are very hopeful over the ward problem. The following table gives us good reason,
we believe.
Number of Employees in Service Over 12 Months.
July 1,1910
July 1, 1915
July 1, 1920
Total No. Employees.
60
72
56
In Service over 1 yr.
21
21
31
Percentage.
35%
28%
53.3%
The Board is now planning to evacuate a Patient's Building, turn it over into a Male
Employees's Home and put the employees' rooms on the wards into use for patients. We
probably shall ask the legislature for funds to build 5 or 6 small cottages for married employees on the hospital grounds.
Better accommodations for all and particularly facilities for real home life in a separate cottage with better rates of pay would settle all these problems. I believe this Joint
Board should consider the matter of Insurance and Pensions. I have seen Insurance introduced in some local factories this year with good results.
In connection with the labor problem I w_onder if we are not competing too much
among ourselves. Here are three instances which serve to illustrate my query: (1) One
state institution, 93 miles from Ionia, runs an advertisement for one week in the Ionia daily
paper seeking applicants for attendants. (2) An attendant in another hospital, the 7th
position in Michigan insane hospitals in a twelve-month period, let go from here because
of agitating activities trying to organize a strike, allures a man to that institution from our
employ merely out of spite, warning the man however that he must not let on that he had
been working in any other Michigan hospital. (3) The third and more recent is a man
writing to another Michigan institution for a position, sending a self-addressed and stamp-
�STATE HOSPITALS OF MICHIGAN.
43
ed envelope, the return address showing So and So's cigar store, Ionia. The position was
offered him at a certain figure. He wasn't satisfied with the wage offered and wrote back
saying he wanted more money. His request was granted and they increased their offer
$10.00 a month. He then asked us to let him go right off to accept this offer and was considerably put out because we wouldn't let him go without working out a two week's notice.
Wise in his day, he wired his new situation for a two week's period in, which to report for
duty so he could work out his notice and be eligible to come back here again when he found
the grass in the new field to be no greener than in the present pasture, which extension was
granted him—by wire. He then slept over the situation and finally turned the seductive
offer down. His reasoning was this: "If I had stayed on here in years past instead of
leaving at the end of each year or so, I'd have charge of a ward now, I'd be getting $30.00
a month more than I am now and $45.00 more than they offered me there and probably
I'd have quite a stake in the bank. I guess I'll give up this drifting from this place to that
and always trying to get back here.''
I don't know how you are going to correct all these evils. I can't help thinking that,
if all the insane hospitals in the state were to send in to some one office all the men coming
and all the men going each week and attach thereto some label of the reasons why, the result would be beneficial for all concerned, employees as well as institution. With regard
to the last case personally we do not correspond with any man in a city either in this state
or in any other state where the Directory of the A. M. A. shows an institution to be located,
without in any case first learning from the Hospital Superintendant that that man has already handed in his notice,—usually we do not answer his letter for we don't have a very
high regard for his type. We have today only four men who have ever worked in any other
hospital and two of that number worked here first.
Apart from these cottages mentioned, the Hospital's needs most urgent now are a new
Kitchen and Dining Room Building. This would release an old building which could
easily be turned into a patients' building and furnish us space adequate to expansion in
the male department for 10 years to come. We need greatly expanded office room. We
need a medical clinic building. Our other serious needs can be met gradually by expansion
of present facilities.
�44
MEETING OF JOINT BOARD OF TRUSTEES.
STATE PSYCHOPATHIC HOSPITAL.
BY DB. BARRETT.
Report of the State Psychopathic Hospital at the University of Michigan for the year
ending June 30, 1920.
To the Joint Board of Trustees of the Michigan State Hospitals for the Insane.
Gentlemen: As Medical director of the State Psychopathic Hospital at the University
of Michigan I have the honor of submitting the following report of the general work of the
hospital for the year ending June 30, 1920.
MOVEMENT OF POPULATION.
M
24
F
36
T
60
126
6
132
1
133
157
118
12
130
....
130
166
244
18
262
1
263
323
5
35
26
27
33
4
37
8
43
24
29
24
6
32
13
78
50
56
57
10
69
OUT PATIENT SERVICES OF THE HOSPITAL.
Ann Arbor Service:
Referred from University Hospital
214
Other sources
63
212
68
426
131
280
557
Patients in hospital July 1, 1919
Admissions during year:
First admissions
Preadmissions
Total admissions
Transfers from other hospitals
Total received during year
Total under treatment during year
'.
Discharged during year:
Recovered
Improved
Unimproved
Not insane
Transfer to other institutions
Died during year
Remaining in hospital at close of year
Total
Detroit Service (Wayne County Psychopathic Clinic):
Referred from Courts
Referred from Police Department
Referred from City Schools
Referred from Charitable organizations
Referred from General hospitals
Referred from industries
Referred from private physicians and families
Referred from state institutions
Total
Total patients examined in hospitals and out patient services
277
277
24
10
217
76
24
21
7
656
1536
�STATE HOSPITALS OF MICHIGAN.
45
SEROLOGICAL WORK.
The following table shows the number of serological examinations made in the laboratory of the hospital foi the year ending June 30. 1920.
Kalamazoo
Pontiac
Traverse City
Newberry
State Psychopathic
Wayne Countv Hospital
Ionia
Social Services
Total Hospitals for Insane
University Hospital . . . .
Private Examinations
Total
...
Blood.
Spinal
Fluid.
859
343
378
519
314
332
5
150
335
84
35
37
90
10
2 900
11,112
216
14,228
2
593
1,711
18
2 322
Total.
1,194
427
413
556
404
342
5
152
3,493
12,823
234
16,550;
There has continued a cordial cooperation in scientific work with the State Hospitals,
During the year the laboratory of the Psychopathic Hospital has examined many specimens of neuropathologica! interest that have been received from the various state hospitals.
Reports of studies of this material have been sent to the hospitals sending the specimens.
During the year the medical director has visited each of the State hospitals, spending,
several days at each in conference with the medical officers.
Respectfully,
ALBERT M. BARRETT,
Medical Director.
G. F, INCH, M. D.,
Secretary,
�
asylums
-
https://localhistory.tadl.org/files/original/c5b5bdc9a77880738de11f8562960a1f.pdf
727583a56205d624fad509ec22c44569
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Title
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Traverse City State Hospital
Subject
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Asylums.
Psychiatric hospitals.
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Items within this collection pertain to the Traverse City State Hospital, also known as the Northern Michigan Asylum for the Insane and the Traverse City Regional Psychiatric Hospital.
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Amy Barritt, 1984-
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Various.
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1885-1989
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Board of Trustees for the Traverse City State Hospital.
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TCSH-xxxx.
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Traverse City, Grand Traverse County, Michigan.
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Nineteenth biennial report of the Board of Trustees of the Michigan School for the Deaf at Flint, for the years 1889-90
Subject
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Psychiatric hospitals.
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An account of the resource
Document includes reports from both the superintendent and the treasurer of the institution. Although often thought of together with other asylums in the state for mental health, this was truly a school, consisting of pupils with special needs. Traditional schooling and industrial or skilled trades were taught at this institution.
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Board of Trustees of the Michigan School for the Deaf at Flint
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Lansing: Robert Smith & Co., State Printers and Binders.
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1891.
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State of Michigan.
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MSH0007
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Flint, Genesee County, Michigan
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Text
NINETEENTH BIENNIAL REPORT
BOARD OF TRUSTEES
DEAF
FLIISTT,
For the Years 1889-9O.
BY AUTHOEITY.
LANSING:
BOBEKT SMITH & CO., STATE PKINTEES AND BINDERS.
1891.
�TRUSTEES AND OFFICERS OF THE MICHIGAN
SCHOOL FOR THE DEAF.
BOARD OF TRUSTEES.
PRESIDENT.
- TREASURER.
E. O. GBOSVENOR,
GEORGE T. WARREN,
E. T. CARRINGTON,
SECRETARY.
M. T. GASS, M. A.,
E. F. SWAN,
MRS. GRACE I. GASS,
MISS LIDA RICHMOND,
A. A. THOMPSON, M. D.,
SUPERINTENDENT.
STEWARD.
MATRON.
ASSISTANT MATRON.
PHYSICIAN.
TEACHERS.
THOMAS L. BROWN,
WILLIS HUBBAED,
JOHN J. BUCHANAN,
GEOKGE W. COOK,
THOMAS MONROE,
THOMAS J. ALLEN,
ELLA J. CRAWFORD,
MINNIE TYKRELL,
ADDIE HENDERSHOT,
EMMA KNIGHT,
HELEN L. PALMER,
MRS. H. R. J. MERCER,
NORA V. LONG,
LINA HENDERSHOT,
M. T. BENNETT,
JESSIE BARNEY,
MRS. CELIA A. ALLEN,
IDA M. JACK.
SUPERVISORS.
E. HOWARD LARKIN,
SARAH R. JONES,
C. M. PIERCE.
EDWIN BARTON, Foreman of Cabinet Shop.
W. G. BRYANT, Foreman of Printing Office.
JOHN LYNCH, Foreman of Shoe Shop.
Miss AGNES BALLANTYNE, Forewoman of Sewing Department.
GEO. L. McQuiGG, Engineer.
THOMAS LAKE, Foreman of Farm.
�REPORT OF THE BOARD OF TRUSTEES.
"To His Excellency, Cyrus G. Luce, Governor, and the Honorable the Legislature of
the State of Michigan:
SIRS—In compliance with the statute requiring it, the Board of Trustees
of the Michigan School for the Deaf submit their nineteenth biennial
report, for the years beginning July 1, 1888 and ending on June 30, 1890.
Accompanying this are also the reports of the Treasurer, Superintendent,
Physician and Steward, made a part of this report, and from these may be
obtained detailed information in regard to the school.
During the period covered by this report the work for which the school
was established has been carried forward with earnestness and zeal and
substantial progress has been made in all departments.
The general health of the pupils has been excellent, there having been
no serious sickness during the two years and no deaths for a period of
nearly five years. This state of things is due to the good sanitary conditions in which the buildings are always kept, the regular habits under
which pupils are placed and the constant care given to their welfare and
comfort. The school physician visits them daily and any symptoms of
ailment are brought to his notice and treatment rendered if necessary.
Thus prompt action, too, no doubt, in many instances warded off serious
consequences. It is, indeed, gratifying to the board, as it must be to
parents, that the rate of mortality here, shows so great a security against
the ravages of disease and epidemics. The children seem contented and
happy in their school life here and appreciative of what is done for them,
.and in return they are kindly responsive in the performance of duties
imposed upon them. A mutual good feeling exists between officers,
employe's and pupils, and all are cooperating with each other to promote
the best interests of the school.
In the school and study the younger pupils are occupied seven hours
each day, besides doing one and a half hours domestic work about the
buildings; and the older pupils spend four and one half hours in school and
study and four hours in the shops. It will be observed then that each
pupil is employed from seven and one half to nine hours each day, either
in the pursuit of his studies or some industrial work.
The results of their work in school is truly gratifying, and the proficiency shown in their studies is such as would do credit to more fortunate
children in a hearing school, while in the shops the degree of skill attained
has made a special demand in some quarters for mechanics trained here.
As most of these children are to maintain themselves by their industrial
work we feel that this is an important part of their education, and it is in
�6
MICHIGAN SCHOOL, FOE THE DEAF.
this skillful training that they get, rather than in the value of the articles
that they manufacture that we should look for the greatest good of these
departments.
It is difficult, however, to fully appreciate what the school is doing for
these children, unless one understands the extent of their misfortune and
the consequences of a deaf child growing up without an education. With
no language the deaf have no means of communication, and no means of
acquiring knowledge. Children growing up thus, untrained, become men
and women with very limited conceptions of right or wrong, and with a
capacity to enjoy very little more than is craved by their appetites or
passions. To take such children and make intelligent beings of them,
with all the qualities that constitute a refined manhood, to make Godfearing, law-abiding, self-sustaining citizens of them, is indeed a noble
work and a work well worth all it costs the State.
In its financial management the school has received our constant care and
attention and we believe all moneys appropriated by the legislature have
been wisely expended, and judiciously applied to purposes for which they
were designed. At the date of this report some small balances on a few
of the special appropriations remain unexpended, but will be needed during the season at hand to complete work already begun or to more fully
accomplish the objects for which they were made.
The present state of the current funds indicate that they will be sufficient
to carry the work of the school through the next six months, the full time
for which they were to provide. It has been our effort to keep within the
limits of the appropriation and at the same time to make all provisions
necessary to the health and comfort of the pupils and to the successful
prosecution of the proper work of the school. To this end they have been
furnished comfortable quarters, plain, wholesome food and efficient teachers
and officers, and as to how well the work has been accomplished, we are
willing that the results alone should speak.
The number under instruction during the two years is • 356 with an
average attendance of 298. What the number for the next two years will
be is somewhat conjectural, but probably some greater than for the two
years past. To provide for this and some slight increase in expenditures
we have estimated as necessary current expenses for
1891
1892
$58,000 00
58,000 00
Special.
Steam mangle
Painting and calcimining
Library and apparatus
Fencing, tiling and grounds
Painting outside walls
Decorating chapel, hospital, etc
Bedsteads and mattresses
Eentalof land
400 00
1,200 00
1,00000
500 00
2,800 00
500 00
500 00
200 00
For a fuller description of the purposes and necessity of these various
appropriations you are referred to the Superintendent's report.
We have carefully examined his recomendations and the estimates above
�REPOET OF THE BOARD OF TRUSTEES.
7
made, and are fully satisfied that the amounts are not only desirable, but
really necessary to the best interests of the school.
A communication from the State Board of Charities and Corrections
with their recommendation on these various appropriations is attached
hereto.
Lansing, Nov. 3, 1890.
M. T. Gass, Superintendent Michigan School for the Deaf:
DEAK SIB—your communication to the State Board of Corrections and
Charities, submitting for its consideration and opinion the proposed
appropriation for your institution for the next two years has been
received.
The Board visited the School for the Deaf as required September 16,
and " investigated the condition and needs of the same." We have carefully considered the appropriation proposed, and respectfully submit herewith our opinions of the same.
Current expenses $58,000 for each of the years 1891 and 1892. While
comparison shows some little decrease in some items, from estimates of
two years ago, an increase in the force employed, advance of salaries in a
few instances, and larger estimates in the items of medical expenses,
renewing of bedding and furniture, and repairing of buildings, more than
absorbs this decrease. In our opinion all these items, causing a net
increase, could be reduced, and the institution be maintained by an appropriation no larger than that of two years ago, namely, $57,000, per annum,
and must therefore approve of only such amount for the purpose.
Painting and calcimining $1,200, approved.
Library, $1,000 ($500 each year). While the need of an appropriation
for this purpose is, in our opinion, beyond question, $300 each year we
believe would serve the purpose, and therefore approve this item at such
figure.
Brick painting, $2,800. A large appropriation is needed for current
expenses to maintain your institution. This appropriation is asked largely,
as a matter of taste in the outward appearance of buildings; with this
consideration in mind we must decline to approve of this appropriation.
Steam mangle $400, approved.
Bedsteads and bed-springs $500, approved.
Fencing, tiling and grounds, $500. Not having been supplied with the
details of this item, this Board is unable to determine as to the amount of
work contemplated, or its cost, and therefore can express no opinion as to
the appropriation needed. In regard to the order of expenditure noted,
this Board would recommend that it be reversed, and that the tiling necessary be first thoroughly done.
Annual rental of 54 acres of meadowland, $200 for each year, approved.
Papering, decorating and improving chapel, study room and hospital
$500. Approved.
Yours respectfully,
GEO. D. GILLESPIE,
L. C. STOKES, Secretary.
Chairman.
In closing this report the trustees desire to again express their entire
confidence in the ability and integrity of the Superintendent and his
efficient corps of teachers and assistants. The past two yeal-s has, in all
�8
MICHIGAN SCHOOL FOR THE DEAF.
that the school is designed to accomplish, been a period of unexcelled
prosperity, and under the present management and organization we feel
assured of its continued success. The State has been liberal in the support of all and especially of its educational institutions, and anxious only
for results. The good work done here in the education of a class incapable of instruction elsewhere and who without this special means of training must grow up in the grossest ignorance, is such as to bear a most
favorable comparison with the work done in any of our schools. It is, too,
of such character as to reflect credit upon the institution and State and to
commend the needs of the school to the same generous and favorable consideration that they have received in former years.
Eespectfully submitted,
B. O. GEOSVENOE, President.
E. T. CAEEINGTON, Secretary.
GEO. T. WAEEEN, Treasurer.
Elint, Mich., June 30, 1890.
�TREASURER'S REPORT
FISCAL YEARS ENDING
JUNE 30, 1889 AND JUNE 30, 1890.
�10
MICHIGAN SCHOOL FOE THE DEAF.
George T. Warren, Treasurer School for the Deaf.
DEBIT.
$1,012 30
July 1. To balance
1889.
June 30. To Cash received during fiscal year:
State Treasurer, Sec. 1, Act 98, Laws of 1887
State Treasurer, Sec. 2, Act 98, Laws of 1887:
Furniture and bedding
Fencing, tiling, coal shed, sewers and grounds
$57,576 58
$1,500 00
. 1,500 00
State Treasurer, Sec. 18, Act 233, Laws of 1881:
Indigent pupils
3,000 00
3,630 46
Farm and garden
Shoe shop
Cabinet shop
Sewing department
Printing office
Postage
Heating apparatus
School books, etc
Medical expenses
Pupils' expense account.
Fuel...
$253 62
924 18
358 76
284 68
151 26
57 33
356 65
18 83
3 50
1,177 23
5 00
$37 00
89 85
Walks
Indigent pupils.
64,207 04
$3,591 04
126 85
3,717 89
. 16,000 00
Flint, National Bank loan.
$84,937 28
George T. Warren, Treasurer School for the Deaf.
DEBIT.
1889.
July 1. To balance on hand
1890.
June 30. To Cash received during fiscal year:
State Treasurer, Sec. 1, Act 154, Laws of 1889
State Treasurer, Sec. 2, Act 154, Laws of 1889:
Stock shed
Roof and gutters
Library..
Sidewalks
Painting and calcimining
Watersupply
New buildings
_.
_.
$57,000 00
._
..
State Treasurer, Sec. 16, Act 223, Laws of 1881:
Indigent pupils . . . . .
_
...
Farm and garden
Shoe shop
Cabinet shop
Sewing department
Printing office
Heating apparatus
Pupils' expense account. _
Bedding
Board and tuition
Furniture. _
Crockery and cooking utensils
Fuel
'.. _
Postage
Miscellaneous expenses..
Indigent pupils
Balance
$357 05
_
-
..._
$50000
500 00
200 00
500 00
1,20000
154 31
1,139 51
4,193 82
3,863 75
$65,057 57
$51798
1,416 48
31 71
26408
143 25
101 21
1,03858
50 00
20671
10 00
3240
1475
60 97
11 08
$3,894 15
19057
3,61571
$73,115 05
�TREASURER'S REPORT.
11
George T. Warren, Treasurer School for the Deaf.
CREDIT.
1889.
June SO. By Cash disbursed as per vouchers surrendered to Auditor General:
Current expenses
'.
Special purposes:
Indigent pupils
Steam pipe covering
Painting and calcimining
Walks
.
Roofs and gutters
..
Hospital
...
..
Laundry
Printing office
Furniture, new building
Library
Fencing, tiling and ornamenting grounds
Jacket, soup kettles, etc. „
$63,362 OS
..
Flint National Bank loan
Balance...
8,720 31
$152 76 **»
219 77
39 51
25553
999 83
288 09
139 29
1 19
41 18
251 77
78 92
2,497 84
25,00000
857 05
$84,937 2S
George T. Warren, Treasurer School for the Deaf.
CREDIT.
1890.
June 30. By Cash disbursed as per vouchers surrendered to Auditor General during fiscal year:
Current expenses
$63,89200
Special purposes:
Stock shed
$50000
Roofs and gutters
9115
Library
14407
Sidewalks
500 00
Indigent pupils
4,054 32 "»
Painting and calcimining
1,077 02
Furniture and bedding
1,389 26
Fencing, tiling, coal sheds, sewers and grounds
1,251 55
Fencing, tiling and ornamenting grounds
215 68
$73,115 05
�12
MICHIGAN SCHOOL FOR THE DEAF.
STATE OF MICHIGAN, in Account with George T. Warren, Treasurer
Furn- Fenci'g,
tiling, Indigent
ture and coal
sh'd pupils.
bedding. sewers
and
grounds Abstract
Abstract Abstract
Bb.
Bb.
Bb.
Credits.
Date.
•
Steam Painting
and Walks.
pire cov- Calciering. mining.
Repairing Hospital
roof
and
gutters.
A bstract Abstract Abstract Abstract Abstract
Bb.
Bb.
Bb.
Bb.
Bb.
1888.
$152 76 $249 77
Jnlv 1. By Balance (on hand) _ ,_.
1889.
Jnn. 30.
Cash from State Treasury— _ $1,50000 $1,50000 $3,63046
Loan from Flint Nat'l Bank
Cash from earnings of inst'n
89 85
$2 51 $255 53 $999 83
37 00
Total available during fiscal year $1,50000 $1,50000 $3,72031 $152 76 $249 77
By balance (overdrawn) to new
$39 51 $255 53 $999 83
$1 50000 .$1,50000 $3,72031 $152 76 $249 77
$39 51 $255 53 $999 83
Abstra't Abstract Abstract Abstract Abstract Abstract Abstract Abstract
B.
B.
B.
B.
B.
B.
B.
B.
Debits.
1888.
July 1. To Balance (overdrawn)
1889.
Disbursements (exclusive of
Jun. 80.
loans paid)
Loans paid to Flint National
Bank
$3,72031 $152 76 $249 77
$39 51 $255 53 $999 83
Total debits during fiscal year..
$3,72081 $152 76 $249 77
To bal. (on hand) to new acc't- $1,50000 $150000
$39 51 $255 53 $999 83
Footings
._
$1,50000 $1,50000 $8,72031 $152 76 $249 77
$39 51 $255 53 $999 83
�TREASURER'S RETORT.
of the School for the Deaf, for the fiscal year ending June 30, 1889.
Fenci'g, Jacket FurniPrinting Library. tiling
soup
Water
New
ture,
Aggregate
and
Total of Current
Laundry office.
new
Supply. buildi'gs building,
exclusive
orna- kettles,
builoi'g.
etc.
etc.
expenses.
Aggregate
of balmenting
special,
ances and
grounds
etc.
Abstract Abstract Abstract Abstract Abstract Abstract Abstract Abstract
transfers.
Bb.
Bb.
Bb.
Bb.
Bb.
Bb.
Bb.
Abstract
Bb.
Aa.
$288 09 $189 29
$41 18 $467 45
$78 92
$1 19
$1,382 70
$1,012 30
6,630 46 $57,576 58 64,207 04 $64,207 04
16,000 00 16,000 00 16,000 Oft
2,359 54 2,359 54 2,359 54
126 85 1,231 50 1,358 35 1,358 35$288 09 $139 29
$41 18 $467 45
$78 92
$1 19
$8,140 01 $77,167 62 $84,937 23
$154 31 $1,139 51
$288 09 $139 29
$41 18 $467 45
$78 92
1,564 81
$1 19 $154 31 $1,139 51 $8,140 01 $78,732 43 $84,937 23 $83,924 93
Abstract Abstract Abstract Abstract Abstract Abstract Abstract Abstract
B.
B.
B.
B.
B.
B.
B.
B.
Abstract
A.
$154 31 $1,139 51
$288 09 $139 29
$41 18 $251 77
$78 92
$1 19
$37040
$6,218 15
53,362 03 $59,580 18 $59,580 18
25,000 00 25,000,00
25,000 00
$288 09 $139 29
$41 18 $251 77
215 68
$78 92
$1 19 $154 31 $1,139 51 $6,218 15 $78,732 43 $84,580 18
1,921 81
35705
$288 09 $139 29
$41 18 $467 45
$78 92
$1 19 $154 31 $1,139 51 $8,140 01 $78,732 43 $84,937 23 $84,580 18
Loans outstanding, July 1,1888
Loans made during fiscal year ending June 30,1889
Loans paid during fiscal year ending June 30, 1889
.
$9,000 00
16,000 00
$25,000 00
25,000 00
�14
MICHIGAN SCHOOL FOB THE DEAF.
STATE OF MICHIGAN, in Account with George T. Warren
Date.
Stock
Shed.
Credits.
Boofs
and
gutters.
Library.
Sidewalk*.
Indigent
pupils.
Abstract Abstract Abstract Abstract Abstract
Bb.
Bb.
Bb.
Bb.
Bb.
1889.
July 1.
1890.
June 80.
cash from State treasury
_
, ._ ._ .
$500 00
$500 00
$200 00
$500 00
$3,863 75
190 57
Total available during fiscal yaar
Footings
disbursements (exclusive of loans paid) _ _
Footings _
_ -_
$500 00
$200 00
$500 00
$4,054 82
$500 00
$500 00
$200 00
$500 00
$4,054 32
Abstract Abstract Abstract Abstract Abstract
B.
B.
B.
B.
B.
Debits.
1889.
July 1.
1890.
June 30.
$500 00
,_
$500 00
$91 15
$144 07
$500 00
$4,054 32
$500 00
$91 15
408 85
$144 07
55 93
$500 00
$4,054 82
$500 00
$500 00
$200 00
$500 00
$4,054 32
�15
TEEASUEER'S REPORT.
Treasurer of School for the Deaf for the year ending June 30, 1890.
Painting Furni- Fencing,
tiling, Fencing,
tiling
Water
Total of
and
New
coal
shed and
ture
and
orna- supply. buildings buildcalcimin- bedding. sewers
menting
ing.
ing,
and
grounds.
special,
Abstract
Abstract
Abstract Abstract grounds.
Abstract
etc.
Abstract
Bb.
Bb.
Bb.
Bb.
Bb.
Bb.
$1,500 00 $1,500 00
$215 68
$1,200 00
Current
expense.
Abstract
Aa.
$1,921 86
$154 31 $1,139 51
8,057 57
190 57
Aggregate,
exclusiye
of
Aggregate. balances
and
transfers.
$357 05
$57,000 00
2,596 81
1,297 34
65,057 57
2,596 81
1,487 91
$65,057 57
2,596 81
1,487 91
$1,200 00 $1,500 00 $1,500 00
$215 68
$154 31 $1,139 51 $10,170 00
$60,894 15
4 562 66
$69,499 34
3 615 71
$1,200 00 $1,500 00 $1,500 00
$215 68
$154 31 $1,139 51 $10,170 00
$65,456 81
$73,115 05
$69,142 29
$73,115 05
Abstract Abstract Abstract Abstract Abstract Abstract
B.
B.
B.
B.
B.
B.
Abstract
A.
'$1,564 81
$154 31 $1,139 51
$1,077 02 $1,389 26 $1,251 55
$215 68
$9,223 05
63,892 00
$73,115 05
$1,077 02 $1,389 26 $1,251 55
122 98
110 74
248 45
$215 68
$154 31 $1,139 51 $9,228 05
94695
$65,456 81
$73,115 05
$1,200 00 $1,500 00 $1,500 00
$215 68
$154 31 $1,139 51 $10,170 00
$65,456 81
$73,115 05
$73,115 05
�SUPERINTENDENT'S REPORT.
To the Board of Trustees :
GENTLEMEN—Under provisions of the statute, I herewith submit the
nineteenth biennial report for the Michigan School for the Deaf, which
covers the period of two years, beginning on July 1, 1888, and closing on
June 30, 1890.
It is with pleasure that I again call your attention to the history of the
past two years. In no period of its existence, I think, has greater harmony
prevailed and at no time have more earnest efforts been put forth toaccomplish the work we have to do. The inspiring motive of all has
seemed to be to attain the best results possible, and steady and encouragingprogress has been made in all departments.
ATTENDANCE.
Total enrollment for two years
Average attendance for two years
3501
298
Number in attendance in 1888-89—Boys
Girls _.
171
131
TotaL.
302
Number in attendance in 1889-90—Boys
Girls._
165
134
_......
Total-
299
New pupils admitted in 1888-89—Boys
Girls _
Total _ _ .
26
14
. ._.
40
New pupils admitted in 1889-90—Boys
Girls
Total _
Total admission for two years
23
23
..............
......
46
86
�SUPERINTENDENT'S REPOET.
17
There have been graduated or honorably dismissed during the past two
years as follows:
1889—Boys
12
Girls _
..
12
Total
24
1890—Boys
Girls _
19
8
Total ..
Dismissed as incapable during two years
The cause of deafness of the 350 enrolled is as follows:
Congenital
Spinal fever
Spinal meningitis
Spinal disease
Cerebro spinal meningitis
Affection of spine
Spinal and brain trouble
Brain fever with cerebrum congestion
Spinal and brain fever
Brain fever
Affection of brain
Inflammation of brain
Spotted fever
Scarlet fever
:
Typhoid fever
Billions fever
Fever
Lung fever
Winter fever
Unknown
,
Measles
Disease
Cold
Gathering in head
Whooping cough
Catarrh
Ulceration
Fits
Inflammation in ear
Paralysis
Convulsions
Croup
Fall
Scrofula
of middle ear
Earache
Canker sore mouth
Swelling in head
King's Evil
3
27
5
!__
92
49
14
11
5
2
1
1
1
12
1
2
2
39
15
2
5
1
1
20
10
8
7
5
4
3
3
3
3
3
2
2
2
2
1
1
1
1
1
�18
MICHIGAN SCHOOL FOE THE DEAF.
I
Erysipelas
1
Headache
1
Quinine
.
1
Fright
1
Epizootic
1
Mumps
1
Whooping cough and measles.
1
Constitutoinal causes
1
Falling into water
1
Inflammation
* __
1
Teething
1
Diphtheria..
Twenty-three per cent of the above are reported as congenital mutes.
Including the twenty the cause of whose deafness is stated as unknown,.
and the most of whom were probably so born, and the per cent of congenital deaf is thirty-two. Twenty-eight per cent were made deaf by some
form of spinal or brain disease, eleven per cent by scarlet fever and four
per cent by typhoid fever.
The attendance by counties is as follows:
6
Alcona
1 Lapeer
4
Alger
1 Lenawee
1
Allegan
5 Livingston
2
Alpena
2 Mackinac
3
Antrim
1 Macomb
6
Arenac
1 Mason
5
Barry
1 Manistee
6
Bay
13 Marquette
3
Benzie
1 Mecosta
3
Berrien
17 Menominee
2
Branch
4 Midland
12
Cass
1 Monroe
5
Calhoun
5 Montcalm
Cheboygan
3 Montmorency
1
4
Clinton
3 Muskegon
'
3
Eaton
9 Newaygo
__•_ 11
Emmet
1 Oakland
2
Genesee
12 Oceana
4
Gogebic
1 Osceola
1
Grand Traverse
1.. 2 Otsego
9
Gratiot
4 Ottawa
15
Hillsdale
4 Saginaw
... 12
Houghtoii
3 St. Glair
4
Huron
8 St. Joseph
5
Ingham
8 Sanilac
1
Ionia
9 Schoolscraft
3
losco
3 Shiawassee
4
Iron
1 Tuscola
4
Isabella
3 Van Buren
8
Jackson
4 AVashtenaw
44
Kalamazoo
5 AVayne
5
Kalkaska
1 Wexford
1
Kent
.... 11 Mississippi (noil, res.)
Lake ..
2
�19
SUPEBINTENDENT'S REPORT.
Since 1865 the enrollment for each year is as follows:
1865 the term closed with 94 pupils. 1877-8 pupils in attendance 257
1878-9
259
1866
109
1867
116
1879-80
257
242
1868
119
1880-1
1869
1881-2
249
135
262
1870
133
1882-3
1883-4
148
271
1871
1884-5
266
1872
159
1873
1885-6
304
153
1874
183
1886-7
303
1875
196
1887-8
301
1876
212
1888-9
302"
1889-90
299
The number of pupils admitted each year from the foundation of the
school to the present time is shown in the following table:
Years.
Blind.
Blind.
Deaf.
Total.
1854-5
1855-6___.
1856-7
1857-8. ._
1858-9
1859-60
1
9
19
11
3
5
11
30
18
15
16
13
12
39
37
26
19
18
1872-3
1873-4.
1874 5
1875-6
1876-7
1877-8
10
13
7
8
6
7
27
41
34
39
28
38
37
54
41
47
34
45
1860-1
1861-2 _I
1862-3
1863-4
1864-5
1865-6 .
2
5
6
12
20
23
25
33
19
1878-9
1879-80
1880-1
1881 2
1882-3
1883-4
8
2
29
35
55
51
42
36
37
37
11
5
10
15
17
25
22
14
1866-7...
1867-8
1868-9
1869-70
1870-1
1871-2 II
6
8
6
6
8
6
17
19
21
21
25
26
23
22
27
27
33
32
1884-5 „
1885-6
1886-7
1887-8
1888-9
1889-90
Blind admitted _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Deaf and dumb admitted
Years.
Deaf.
Total.
40
58
35
30
40
46
_ ..
173
1,041
In the table that follows are shown the number born deaf, or if not born
deaf, at what age and by what deafness was occasioned, and the number
admitted at dif 'erent ages:
�Causes of Deafness.
Pupils.
1888-1889.
•8 .
a'S.
.gw
Statistics Concerning New
Pupils.
&D
ff
'%
I
S3
2o
o
1
h
New Pupils.
12
1
7
4
9
1
3
3
2
4
1
3
4
1
3
3
2
2
2
2
1
1
2
2
2
1
1
1
1 1
2
Spinal
1 Fever.
Scarlet Fever.
1
1 1
....
Typhoid
1 1 Fever.
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2
3
3
4
1
1
13
8
4
8
5
4
3
1
4
1
2
2
21
12
9
4
4
3
2
11
4
1
5
4
5
1
2
1
1
2
1
1
1
2
1
1
1
Sex.
2
1
1
1
1
2
2
2
1Brain Fever.
1 1
1
1
Convulsions.
1
1
Paralysis.
Earache.
Headache.
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Cerebro-Spinal
Meningitis.
1
1
1 ....
Measles.
1
1
Affection of Spine.
1 1 1 1
2
Inflammation in
Ears.
King's Evil.
1
1
Spinal Meningitis.
Age When Admitted.
ife ga
i1
£ oiH
(§ b
!
49
13
5
13
11
7
3
37
8
2
11
7
3
3
86
21
7
24
18
10
6
3 20
1 13
2
6
2 11
11
13
2
10
31
26
8
21
37
49
87
OS
Congenital.
Age when deafness occurred . __ 21
Total
1(3
11
i
1
1
1
1
1
1
1
i
i
1
1
8
2
2
4
1 6
2
1
8
49
86
�SUPERINTENDENT'S REPORT.
21
Of the above 21 or 24 per cent of the entire number were born deaf;
eight are unknown, and of the 57 who are deaf from causes named, nine
are from scarlet fever and 23 from spinal and brain affection.
Seven became deaf before one year of age, 24 between the ages of one and
three, 18 between the ages of three and six, and ten after six years of age.
Two children in the above list were born deaf; each have parents who
were second cousins, and one has a brother born deaf, and the other has a
brother deaf from earache, and also two second cousins who are deaf.
There are in the above from one family, two brothers born deaf and two
sisters deaf from unknown causes, and they have a cousin deaf, who
entered school with them, yet beyond these five there are no traces of deafness in the family.
Another who entered school during the last two years has three sisters
in school with her and all born deaf, with deaf father and mother.
Among the other cases of congenitals one has two deaf sisters, three
have each one deaf brother or sister, one has two cousins, one a second cousin, and another a distant relative deaf.
Of those made deaf by sickness, one from spinal fever, has both parents
and an aunt deaf. One has a second cousin born deaf. Another deaf from
cold has a sister who became deaf from a fall. One who became deaf from
convulsions has an aunt deaf. A girl deaf from constitutional causes at
ten or twelve years of age has a brother deaf from a like cause and three
aunts also deaf.
Of those reported with cause of deafness unknown, one has a brother
born deaf and a sister deaf from catarrh; another has two brothers born
deaf and a cousin also deaf.
0
ADMISSION.
The school is open to all deaf children, nine years of age or over, and
under twenty; and it is entirely free to those whose parents are residents
of the State, there being no charge whatever for instruction or maintenance. Children whose parents are in such circumstances that they cannot
furnish the necessary clothes, are, under the provision of legislative enactment, clothed at the expense of the counties of which they are residents.
Every obstacle to the admission of the deaf to the school is removed so far
as the State can provide, and there should be as little delay on the part of
parents as possible, after the age of nine in bringing their children here.
Children who fail to enter school till they are somewhat advanced in years
beyond the age of nine or ten seldom do so well in their school work as
those who come at the proper age, and the longer such delay the greater
detriment to the child. Deaf children generally grow up in their homes
with very little, if any, intellectual training, and as they advance in years
their habits of conduct and thought, however erroneous, become more and
more fixed, and the difficulty of correcting the wrong and instilling the
right into their minds is correspondingly increased. As promptly as
possible after nine years of age, every child who is a proper subject should
be placed under instruction in the school.
The only conditions necessary are that the child is too deaf to make
progress in a hearing school and that they shall be possessed of good health
and a sound mind. I wish to emphasize especially these three conditions.
This institution is a school and only a school, and as such cannot afford a
retreat for those that are afflicted in body. Children who have any physi-
�22
MICHIGAN SCHOOL FOR THE DEAF.
cal ailments that would unfit them for daily attendance in school at homeare not proper subjects for school here. Children who have their hearing
and have never learned to talk are, as a rule, feeble minded, and as this is
a school essentially for the deaf and all our methods of instruction are
adapted to this class of children, those who hear can be better instructed
elsewhere, and should be. This leads me to remark as I have in former
reports, the great need of a school for feeble minded children. Nearly all
of the neighboring States have made provision for the education of this
class of unfortunates, in the establishment of schools designed especially
for their instruction; and while Michigan stands abreast of all other States
in her philanthropic and educational work, yet she is delinquent and far
behind many of them in this particular. I have visited several of these
schools and the work they are doing is really a grand one. The work I
have seen done in them is such as would be a credit to any of our public
schools, and the making of useful citizens out of those that, without
instruction would be a sore affliction to thousands of homes and a burden
to society, is an undertaking that should commend itself to our State
officers and legislators. From the numerous communications I have concerning such children, whose parents are ever seeking to get them into
our institutions; and from the ratio that I have observed they bear to the
number of deaf in States, where means are provided for their education, I
am sure there are at least four hundred feeble minded in Michigan who
are of school age. Certainly it is a class of such condition and numbers
as demands serious consideration.
CHANGES.
Mrs. Emma Cook, at the close of the year in June, resigned. She had
been a teacher in the school eight years. She was a thorough and efficient
teacher and by the faithful performance of her duties had attained the
highest degree of promotion. She retires from the profession with the
regrets and most sincere respect of all those with whom she was associated,
to attend to domestic duties in her own household.
At the same time Miss Marion Hendershot, who had been a teacher
since 1885, resigned to take a position in the Philadelphia school. Miss
Hendershot had done five years of most excellent service for the school
here and the call she has received to go elsewhere at an increased salary
is a substantial recognition of this fact. Her call being the fifth one from
this school to go into the same corps of teachers is a rather flattering testimonial of the good training they receive here, and is indeed, about all
the comfort we can get out of this systematic purloining. In the spring of
1889 Miss Nora Long was employed to give instruction to an oral class
and this enabled us to dispense with one teacher in the sign department.
Mr. A. H. Power whose term of service expired in June of the same year,
was not, therefore, re-employed.
On October 1, 1890, Dan H. Church, who had occupied the position of
steward for some seventeen years declined a re-appointment. He had been
a long and faithful servant of the school but on account of ill health felt
it necessary to retire to his farm where he has since been engaged, and
where we all most sincerely hope he may find the better health he seeks.
Mr. E. F. Swan was elected to fill his place and we deem ourselves fortunate in being able to secure the services of a man with his years of
experience in this line of work and so well adapted to the position.
�SUPERINTENDENT'S REPORT.
23
SCHOOLS.
Our system of instruction continues upon the same plan as indicated in
former reports. Our object is, of course, to first give these children the
English language and whatever there may be in methods, to best accomplish this result we are always ready to employ. It being a well tested
theory that the best way to learn a language is to use it, we aim on all
possible occasions, to have pupils express themselves and converse in
English. By this means recitations are conducted and nearly all communication is carried on between teachers and pupils. It is the language of
the school room, and signs are only used for the purposes of illustration or
in instances where the English attained is not sufficient to convey the
idea.
The language is employed both by writing and spelling upon the
fingers, and with those who can make the best progress by oral methods
the spoken language is used. We have consequently an oral department,
where those are placed who show an ability to speak or read lips and here
all communication is by speech. This department has been in operation
a little over one year, and one class consisting of twelve pupils under the
instruction of Miss Nora Long, has been taught wholly by this method.
Sufficient time has not yet been given to this kind of work here to
demonstrate its possibilities so as to fully determine its value as compared
with other methods of instruction for the deaf. From what has been
done, however, in other schools where it has been more thoroughly tried,
and from what has been accomplished in this department of our own
school, with only a year's work and that under disadvantages, confirms me
in the belief that with some pupils it is a successful, and hence best
method of instruction; for while they are learning to write the language
they are also learning to speak it and to read it from the lips of those
with whom they converse. I am not yet convinced, however, that it is a
method by which all the deaf can best learn. While all, perhaps, might
learn to speak a few words, very few of them only would, if taught
exclusively by this method, acquire a knowledge of the language that
would enable them to use it intelligently. To learn words simply as the
names of things is one thing,—to learn them so as to make an intelligent
use of them in the construction of sentences to express thought, is quite
another.
The crucial test of a child's knowledge of a language, is his ability to
use it in communicating ideas, and not the great number of words of
which he knows only the dictionary meaning.
I believe experience has shown that, while some few can succeed best
by oral instruction, a large majority of the deaf will acquire a better use
of language and a clearer and fuller knowledge of other subjects taught
them by use of combined methods. The success of the few we have in
this department has so far, fully justified our expectations, and I believe
that it is a kind of work that should receive all encouragement to the end
that every deaf child who can best succeed by this method, should have
the full benefit of this kind of instruction. Among the higher classes a
system of department work has been adopted during the last year. Mr.
Brown has the subject of history, Mr. Cook arithmetic, Mr. Hubbard
grammar and geography and Mr. Monroe sciences. Every teacher has a
special taste for certain studies and in these he excels both as a student,
and as an instructor. In the contemplation of this plan it was the theory
�24
MICHIGAN SCHOOL FOR THE DEAF.
that each teacher could do better class work in teaching a favorite study
than one for which he had little taste. Also that by giving his whole
attention to one or two subjects he could treat them better than though
he had a diversity of subjects as was the case under the old plan of
recitations.
As now arranged every class goes to one teacher for instruction in
arithmetic, another in history, another in sciences and so on. By this
means the classes not only receive better instruction but the pupils themselves seem to have a keener appreciation of the importance of their
studies and to pursue them with greater zeal and interest. They come to
their class rooms better prepared for their recitations, and seem to perform their tasks more for the good they get out of them than for the
purpose of complying simply with the requirements of teachers to prepare
them. The entire school work is more voluntary and seems less forced
than under the old method of recitation and at the same time better
progress, I think, is made.
The regular school course consists of two departments, primary and
grammar, embracing the first eight years. All pupils are entitled to this
course or so much of it as they may be able to complete in the eight years
allowed them in school. In it are included such branches of study as are
generally taught in our common schools and these and the acquiring of a
language constitutes the work of these departments. An academic department is added, in which are included besides further work in language and
arithmetic, philosophy, physiology, natural history and civil government.
This course is open to those who upon the recommendation of the superindent may be permitted by the board to pursue it, and the privilege is
granted only to those who have shown ability to successfully enter upon
such studies.
The art department is still carried on under the instruction of Mrs.
H. B. J. Mercer, and pupils have made commendable progress in this
branch of their work. During the last two years in addition to the drawing done in this department, a number of pupils have been taught
wood carving. This comes in direct line of their work in drawing, and
designing, and although but recently introduced, considerable skill has
been shown in some of the work turned out.
The school has, I think, never been better organized, or prepared to do
better work than at present, nor have better results ever been accomplished
within my knowlege of the school, than during the past two years. It is,
indeed, comforting to note the devotion that all, both teachers and pupils,
have shown to the duties they have to preform, and to observe that year
by year a little better results are accomplished, that we are not only holding our own, but that our line of progress is steadily advancing, and that
our standard of attainments each year is a little higher than for the year
preceding. In matter and methods of instruction we seek not for the good
alone but for that which is best, and will best serve the interests of
those in whose behalf we labor.
INDUSTEIES.
Pupils after five years of continuous work in school are placed in the
shops for industrial instruction. During all of their subsequent course
they are one-half of each day in school and the other half in the shops or
at some industrial work.
�SUPERINTENDENT'S REPORT.
25
In the cabinet shop during the last two years there has been an average
of about thirty-seven boys under the training of Mr. B. Barton, the
foreman and Mr. J. Foss his assistant.
Their time has been occupied in making such repairs and improvements
about the premises as were needed, and in making some pieces of furniture.
Our efforts with the boys in this department have been to make skillful
wood working mechanics of all of them possible, and to utilize their labor
as far as possible in supplying the immediate needs of the school in their
line of work. That we do not make skilled workmen of them all, goes
without saying, but all learn to be industrious and to apply themselves in
some useful way. Many of our boys do, however, become very expert in
their trade as many jobs or little pieces of work on the grounds will show.
Very few boys whom we turn out from this department as mechanics, go
long without finding remunerative work, and just before the close of the
last school year, the proprietor of a large establishment, in our State, for
manufacturing furniture, wrote us that he would take all the boys we coiild
recommend from this department, and in response to this request several
of our boys are now there, employed as carvers or cabinet makers,
In the shoeshop about twenty boys have during the two years received
daily instruction from Mr. John Lynch. They are occupied mostly in
furnishing foot wear for the children in school. Some little work, however, is done for people outside, and that too for those who patronize our
shops upon the merits of the work turned out. Many of our boys from
this department are occupying good positions and at good salaries.
It is a good trade for those who master it, as many of our boys do, and
not a bad one for those who succeed indifferently; for there is always
plenty of cobbling near home.
The printing office is still crowded but doing excellent work under the
management of "W. G. Bryant. There are generally in this department
about twenty pupils, four o£ whom during the last two years have been
girls. Our paper, the Mirror, is published each week, and besides all the
necessary printing for the school is done in the office. As in other departments, not all of those who learn this trade, follow it after they have left
the school, but a large proportion of our pupils who have learned the
printer's art here find remunerative employment in this kind of work when
they go out to do for themselves.
A sewing department is carried on under the instruction of Miss Aggie
Ballantyne. Here girls are taught for three hours each day, to cut, fit,
sew and to make their own clothes. In this department also much of the
bedding for the school is made and table linen and many other needed
articles. The girls are also employed each day in the ironing room, in the
kitchen, in the dormitories and about the buildings where they can be
employed to advantage, and where they can learn to do such work as will
likely be required of them in their own homes.
Some boys are also employed in the bakery, some in the fitting room or
engineering department and others upon the farm and in the care of the
stock.
As far as possible we try to give to each child a kind of industrial training in the line of his own taste or the choice of his parents, and to teach
him such things as he will employ to the best advantage in his own selfsupport when he leaves us.
4
�26
MICHIGAN SCHOOL FOR THE DEAF.
To this end foremen are employed in each department, skilled each in
his or her particular trade and competent to give instruction in the same.
HEALTH.
It is with the greatest pleasure, satisfaction and gratefulness to an overruling providence, that I am able to report another two years without a
single death, and I may add further, that it is now over five years since
death has occurred among the children in the school
This is, indeed, a remarkable record when we consider the frail constitutions that many of our children have and their susceptibility to diseases.
Children return to us with their ailments, or bring contagious diseases to
us from their homes, and afflictions of various kinds frequently creep in
upon us, but with the prompt and skillful treatment they receive and the
excellent care we are able to now provide for the sick, no diseases prevail
to any great extent.
The children are kept upon a wholesome diet, are required to observe
regular habits, and have warm, comfortable rooms to sleep in. These
conditions with all of the sanitary arrangements in and about the buildings
as good as they can be made, and kept, with constant attention, and the
watchful care given for the welfare of the children, has secured to us the
very healthful record I am able to report. For further details upon this
subject I refer you to the report of the physician.
IMPROVEMENTS.
The twelve hundred dollars appropriated for painting and calcimining
has all been expended in renewing and repairing in such portions of the
buildings as most needed it in order to preserve them and keep them in
proper condition for occupancy.
The two hundred dollars for library has all been expended; a portion of
it for new books, but the larger part of it however, for repairing and
rebinding books already on hand and in such condition to make such
repairs necessary in order to save them.
About fifty rods of artificial stone walk have been built tipon the
grounds, and thirty rods of plank walk upon the streets, besides some
repairs to the old walks, with the five hundred dollars granted us for this
purpose.
For furniture, beds and bedding there was appropriated a sum of fifteen
hundred dollars. This has been expended in replacing such furniture,
bedding and other articles as needed renewing, and to furnish apartments
necessary to provide additional room to accommodate our increased number
of pupils.
The roofs and gutters have been kept in repair during the last year out
of the fund provided for this work, and there is considerable work required
on them which will need the balance of the five hundred dollars.
A shed for stock has been built. This is a much larger and better
building than could have been constructed out of the appropriation alone.
But by expending the five hundred dollars for the purchase of material
and doing all the work with the boys in the shop we have made for the
State a very excellent and serviceable building at the very moderate cost of
the appropriation.
From the amount appropriated for fencing, tiling, sewers and grounds,
�SUPERINTENDENT'S EEPORT.
27
some eight hundred rods of tile have been put in, four hundred rods of
fence built and rebuilt, sewers quite extensively repaired and grounds
graded, improved and extended.
ESTIMATES.
For the two years to come, I have carefully calculated the needs of the
school and submit the following:
Current expenses, 1891..
.$58,00000
1892
58,000 00
The amount asked for current expenses is determined by the amount
actually expended during the last two years. This was, per capita,
$190.80, as shown by dividing the total expenditure by the average number
of pupils, 298. To provide for a slight, necessary increase in the salaries
of a few teachers who are in the line of promotion, and a probable increase
of six or seven in attendance, a number very likely to be reached, would
upon the above basis, make necessary an appropriation of $58,000.00 per
annum.
This can be, in no sense, considered an extravagant estimate, but a very
economical one, when compared with the cost of educating the deaf in
other like institutions where the average is upwards of $225.00 per year, or
$30.00 or more in excess of our own per capita cost.
Statements are frequently prepared showing the cost of maintaining our
different State institutions. From the bare figures of which they, perhaps,
solely consist, comparisons are made. It is needless to say that the conclusions thus reached, are far from just, when they are determined in a
manner that places all institutions upon the same basis. Nearly all of
them are maintained for classes that are entirely different and they require
the employment of means for the accomplishment of their purposes, that
involve a greater necessary expenditure in some than in others.
In addition to nearly all that is required in other State institutions, we
maintain a school department, in. which a corps of thoroughly trained and
expert instructors are necessary to the successful prosecution of the work.
This is done ,at an annual cost of about $50.00 per pupil, for instruction
alone, and this statement of fact, I am sure, will satisfy the query so often
raised in regard to the discrepancies that appear in the tabulated statements of the expenditures of our State institutions; at least so far as our
own is concerned.
I am sincere in the belief that we could not, with proper regard to the
performance of the work we have to do and the best interests of the school
and those to be benefited thereby, ask for less than the amount named for
current expenses. The following is the estimate in detail:
Salaries, Officers and Employes.
Superintendent
Steward
Matron
Assistant Matron
Mending Woman
Watchman
Choreman
Visitors' Attendant
Clerk Hire
$1,800
1,200
500
350
200
480
360
200
100
$5,190 00
�28
MICHIGAN SCHOOL FOR THE DEAF.
Baker and Domestics
Baker
Cook
Assistant Cook
5 Domestics, $141
8
"
$117.50
Institute Extra Help
500
208
705
940
150
Teachers and Supervisors,
4 Teachers, $1,200
1
1
1
2
$580
4
$500
1
2
$320
2
$200
3 Supervisors for
—
,
Medical expenses:
Salary of physician
Nurses
Medicines, hospital supplies, etc
Laundry:
.
Salary of two washerwomen
Salary of two ironers
Soap, starch, repairs, etc
$4,800
950
775
600
1,160
2,000
350
640
400
1,100
$500 00
250 00
450 00
352 50
282 00
600 00
Farm and Garden:
Salary of farmer
Salary of stockman
Salary of teamster
Extra labor
Tools, seed and repairs
Cows
.
Feed
54000
216 00
24000
20000
80 00
20000
200 00
Printing Office:
Salary of foreman
Supplies and repairs
600 00
100 00
Heating apparatus:
Salaryof engineer
Salary of assistant engineer
Salary of
fireman
Tools, repairs, etc
,
1,08000
630 00
57000
1,220 00
Cabinet Shop:
Salary of foreman
Salaryof assistant foreman
Stock, tools, etc
75000
626 00
500 00
$2,963 00
12,775 00
1,200 00
1,234 50
1,676 00
70000
3,500 00
1,876 00
$31,114 50
Shoe Shop:
Salary of foreman
Supplies, tools, etc
$70000
700 00
Groceries.,
Meat and
Butter, lard and eggs
Flour and meal
5,000 00
3,20000
2,42650
1,600 00
1,05000
fish
-
..
14QQ OQ
13,276 50
�29
SUPERINTENDENT'S REPORT.
Fuel
Lights
Furniture
Bedding
Crockery cooking utensils
School books, and school supplies
Printing, stationery, etc
Postage, telegraph and telephone
Freight, drayage and express
Repairs on buildings
Wagon, harness, horseshoeing, etc.
"Water supply
Miscellaneous expenses, pails, brooms, brushes,
traveling expenses
Interest
Sewing Department:
Salary of sewing women
Supplies for sewing and mending rooms
$7,703
1,500
400
300
200
300
175
225
150
1,500
200
900
50
00
00
00
00
00
00
00
00
00
00
00
500 00
358 06
180 00
145 00
$14,411 56
325 00
$60,527 56
2,527 56
Less estimated earnings.
$58,000 00
SPECIAL.
Painting and calcimining, $1,200.00.
This amount has, in past years, been found necessary to keep the buildings in a proper state of preservation. There is a great amount of wear
in the interior of the buildings, especially in those parts frequented by
pupils, and some portions of them need renewing almost every year. A
large part of this fund is required to keep such apartments of the buildings in cleanly condition, and to make them wholesome and suitable for
the occupancy of the children. This amount has been usually granted
and has never been found too much for the purpose.
Library and apparatus, $1,000.00.
For many years, the legislature has, at each session, granted us twohundred dollars for the library and school apparatus. This, when the
school was small, more amply supplied the need of reading matter. With
the present number of pupils, however, and the increased use that is made
of the library it is barely sufficient to re-bind the books and renew copies
of those that have become worn out. The fact is there are today fewer
volumes in the library than six years ago, and the number we now have
can not be much increased with an expenditure of only one hundred
dollars per year.
Our children are, as a rule, great readers and it is the principal source of
information and entertainment for them, and the advantages of a well
selected and ample library can hardly be overestimated. Certainly one
thousand dollars can, during the next two years, be very profitably
invested for this purpose and supplying such apparatus as is needed in
school work.
Painting outside brick-work, $2,800.00.
Ten of our buildings are made of brick and have been erected at different times covering a period of about thirty-five years. Consequently, different materials or different kinds of brick have been used in their construction, and some are new and some are old, and look antiquated, all of which
�30
MICHIGAN SCHOOL FOR THE DEAF.
makes a very motley collection in appearance. Very few buildings, either
for public or private purposes, are made of common brick now-a-days and
left unpainted, and most of our State institutions have anticipated us in
this improvement. In order therefore, that our buildings may be better
preserved, and more uniform in their appearance, and correspond more
nearly to their surroundings and the modern style of architecture, our
board asks for a sum sufficient to do this work.
It is found by measurements that there are 17,600 square yards of surface to be covered, and the lowest estimates for doing the work as it should
be, are sixteen cents per square yard. This provides for a "slush" or
cement coat and two coats of paint of solid red color and also for the necessary pointing around the windows. Reckoning upon this basis the full
amount of two thousand eight hundred dollars would be required.
Steam Mangle, $400.00.
The present machine has been in use twelve or fourteen years and was
one of the first patents. By long service it has become so worn as to be
useless. The machines are, we are informed, not now manufactured, and
could not be repaired, if it were profitable to do so. The need of such a
machine today, is much greater than when the present one was purchased,
and with the amount of work that must be turned out of the laundry each
week, nearly six thousand pieces, it is indispensable.
Bedsteads and wire mattresses, $500.00.
About one hundred and seventy-five of our bedsteads are of an old iron
pattern and they have been in use twenty or twenty-five years. They are
now so worn out and broken as to be unfit, many of them, for further
service.
To supply our immediate and pressing needs and give the children a
respectable and comfortable bed, the amount of five hundred dollars is
necessary.
Tiling and fencing, etc., $500.00
Considerable portions of the institution farm are a heavy clay soil, and
of a character that is much benefited by under draining. During the last
four years a part of the farming lands have been tiled, and the greater ease
with which such lands can be tilled and their increased and more certain
crops, have fully demonstrated the utility of such an investment. About
forty acres yet remain undrained and the amount asked or so much of it as
can be used for this purpose after the building of such fences as may be
needed will go far towards placing them in a much more remunerative
condition.
Eental of lands, $400.00.
There are in the farm belonging to the school 147 acres of land. Taking
out the grounds occupied by buildings it leaves only about one hundred
acres for pasture, meadow and necessary tillage. We are now keeping
thirty cows and four horses and this amount of land has been found
insufficient for their proper care. It has therefore been found necessary
to rent fifty acres adjoining. This has been done at an annual cost of two
hundred dollars, and the estimate made is to provide for the same two
years to come.
Decorating and improving chapel, hospitals, and sitting rooms, $500.00.
In order that the children may receive the full benefit given in their
chapel instruction, and the many entertainments held there, it is necessary
that they should be able to see well. The seats are now so arranged on a
level that they obstruct each other's view. The chapel is also poorly
�SUPERINTENDENT'S REPORT.
31
lighted and dingy. It is desired to improve the seats by elevating them,
to change the lighting and to improve the appearance of the interior by
frescoing the walls and providing pictures for them so as to make it a more
attractive place than it now is. We also desire with a part of this appropriation to procure some pictures for the walls of the study rooms and
hospitals that they may not appear as cheerless as they do now.
The foregoing estimates have been prepared after a careful study of
what seemed to be the real needs of the school. It is the policy to run the
school with the strictest economy consistent with thorough work, and with
this end in view the above estimates have been made. I feel confident
that a careful examination of what the school is accomplishing, and a comparison of cost with similar work in other institutions will fully sustain
these conclusions.
In closing this report I feel it my duty to mention the spirit of good will
that pervades every department of the school and has seemed to actuate
every one of its employes; pupils, too, under the same motives are respectful
to all proper authority, and uniformly courteous to teachers and officers
and kind and considerate with each other; and year by year it is, indeed,
gratifying to note this increased kindly feeling as a coiitroling power
among them.
To the board, I wish to express my most sincere gratitude for their support and cooperation. All recommendations have been honestly and fairly
considered, and in all efforts to promote the interests of the school I am
sure I have been duly sustained. The good degree of success we have
attained, I feel is due largely to the liberal, generous policy of the board,
and under the continuance of such policy its interests will not suffer.
Aided by your counsels and encouraged by your many expressions of
appreciation, the burden of my duties has been much lightened, and for
this, and your fidelity and confidence I again extend you most sincere
thanks.
Respectfully submitted,
M. T. GASS, Supt.
Jane 30, 1890.
�PHYSICIAN'S REPORT.
To the Board of Trustees of the Michigan School for the Deaf:
GENTLEMEN—Since my last report this Institution has been provided
with a good hospital. It is well lighted, well heated, well ventilated and
well furnished with everything necessary for the treatment and comfort of
the sick. Its capacity is ample for all ordinary demands. It is provided
with quarantine apartments for the treatment of epidemic diseases, and
these rooms are so located as to make the quarantine absolutely perfect.
The hospital is so nearly part and parcel of the institution proper, that
the expense for heating, lighting, cooking, and attendance is the very least
possible, much less than if it were a separate building. When it is remembered that most deaf and dumb children have become so through
some nearly fatal sickness which has undermined their constitutions and
ruined the health for life, it will be readily appreciated that there will be
much sickness and general feebleness among them.
They furnish the best of soil for the development and ravages of all
endemic, epidemic and contagious diseases. Consequently, a good hospital
is a prime necessity, and it is a wonder that the institution has not sooner
been provided for in this respect. Then too in these children a part of
their senses being locked up, they have less judgment about diet, exposure
and danger, than other children, and they need more attention, and supervision from the superintendent, the matrons, the nurses, the teachers, the
care-takers, and the physician than healthy hearing children require in
any other of our public institutions.
The school rooms, dormitories, study rooms, work rooms and closets of
the institution are all perfectly and evenly heated and are well lighted and
ventilated. The sewerage about the institution and adjoining premises is
as nearly perfect as it can be made, and the water supply is abundant
and of good quality.
The average number of pupils attending the institution during the last
two years is three hundred.
The number of pupils admitted to the hospital for the school year of
1888-89 was 480 and the number admitted for the corresponding period of
1889-90 was 573. Of these there were 144 cases of mumps, 20 cases of
chicken pox, 126 cases of roethelii or dutch measels, 225 cases of la grippe
and one case of scarlatina which was discovered early and so perfectly
quarentined that no other cases occurred, although the disease was very
prevalent in the city.
�PHYSICIAN'S REPORT.
33
Of the other diseases treated in our hospital during the last two years,
severe colds and malarial fever were the most prevalent but there were
many cases of pneumonia, rheumatism, consumption, anaemia, amenorrhea, conjunctivitis, eczema, itch and injuries of every kind and degree.
Pupils come from all parts of the State and bring all sorts of diseases with
them.
There has not been a death in the institution during the last two years.
I am, gentlemen,
Your obedient servant,
A. A. THOMPSON A. M., M. D.
5
�PUPILS PRESENT IN 1888-9.
GIELS.
Name.
Avery Ida Belle
Alexander Katie
Allen, Katie
^.dams Helen J.
Anderson, Berthllda
Allen, Hattie R.
Bussler, EUHUH
Blashill, Margaret
Babcock Nellie
Boven, Mary
Busha, Alice
Brierton, Mary L
Baird, Hattie
Burling, Bertha M.
Brown, Lillie E
Ballard, Clara
Bell, Mazzie
Bradley, Edith
Baker, Melissa
B use, Susannah A.
Cluno. K^ita Afrn&R
Crosby, Nettie R.
Carrol, Lyla Bell
Choate, Lena M.
Charbona, Hose
Cromer, Cora May
Clark, Amelia H.
Caruthers, Jennie June
Cochran Fannie A.
Carr, Ethel M.
Drew, Clara Jane
Doughty, Nellie A
Daoust, Mary
Donal, Martha A.
Engel^au, Mary
Esh. Mary Agnes
Ellsworth, Blanche B.
Ellis, Nettie
Fry, Catherine_ _ ... -_.
Falker, Jennie
Flater, Anna
Fairbanks, Ettie_ . .
Fuhrmann, Ellen
Fleischer, May bell „
Frace, Georgie
P. O. Address.
Detroit
Wacousta
Lynn
Flint
Flint
East Lake __
Manistique
Ludington
Crosswell
Flint
Graafschap
County.
Wayne.
Clinton.
_ _ St. Glair.
Genesee.
Genesee.
Manistee.
. . Schooloratt.
Mason.
Sanilac.
Genesee.
Allegan.
Grosse Isle
.- _.L Wayne.
Huron.
Kinde
St Joseph
Berrien.
Berrien.
Buchanan
Newaygo.
Woodville
Oakland.
Clarkston
Saginaw.
Saginaw
Jackson.
Jackson
Montcalm.
Edmore
Grand Rapids
Kent.
Marquette.
Marquette
Berrien.
New Buffalo
Cass.
Cassopolis
Harbor Springs
Emmet.
Mackinac.
St. Ignace
Berrien.
St. Joseph
Kalamazoo.
Vicksburg
Buchanan
Berrien.
Van Buren.
Bangor
Muskegon.
Muskegon
Berrien.
Pipestone
Saginaw.
Saginaw
Montcalm.
Stanton
Ionia.
Matherton
St. Clair.
St. Glair
Cheboygan.
Cheboygan
Gratiot.
Elm Hall
Oceana.
Bird
St. Clair.
Brockway Center
St. Clair.
Port Huron
Stetson . . _ Oceana.
St. Johns
. _ Clinton.
Monroe.
Athlone
Oakland.
Holly _
Eaton.
Ainger
�35
LIST OF PUPILS.
GIRLS—CONTINUED.
Name.
Fay Edith Maria
Failing Louise f\, Delia
Gage, Kittie May
Gray Ivy M
Gilbert Emma J.
Grattan, Lavonia
Gillispie Margaret E.
Gagnon Mary J.
Golden, Catherine
Gillniore Fannie
TTiimmAl, Mahftl
Hadrill, Ida M.
Hardenburgh Jenny
TTnrdenhiirgh, Abv
Huggart, Lottie
Hawley Ella Blanche
Hamilton, Grace L.
Howell, Lilly B.
Hamilton Elizabeth
Holtz, Bertha
TTfirhst
Anna, Ma,gpip
Herrington, Millicent
Hazen Myrtle H
Inman, Ida C
Johnston, Christina
Johnston Sarah E
Johnson, Millie
Jones, Nellie D
Jones, Malvina M.
Jones, Grace
Kamps, Gezina
Knight, Grace P.
Kopp, Emma
Kelly, Joanna
Krugler, Bertha
Lloyd, Mary E.
La Brush Maude
Ladley, Alice
Leidlein, Sophia
Lyons, Augusta
Latrondres, Rosella
Maher, Nellie
Mosher, Diana
Myers, Lulu I.
Martin, Grace I
Miller, Nettie L.
Mars, tEthel Mav
Mars, ' Josephine
Mercier, Mary J.
Maxwell, Gertrude E
Mattoon, Nellie
McColl, Frankie B. '
McColl, Ida M
McLellan. Elizabeth
P. 0. Address.
Swartz Creek
Tekonsha _ __._
Detroit
Erie
Sturgis „_ _
Detroit
Manton
Williamston .
Orville
Saginaw.._
Dennison_
Eaton Rapids
Nashville
Pontiac _.
Pontiac
Pontiac _ _ _ _ ._
Flint..
Mason
Detroit
Garland . _ _
Alpena
Homer _ _
Bay City
Rochester Lansing
Pipestone
Negaunee
Grindstone City
Grindstone Citv
Cato
West Bay City
Farwell
Ypsilanti
Zeeland
Flint
Clinton ,
Niles
Bangor
Sears
...
Chippewa Lake
Port Huron
South Saginaw _
Mason
Carrolton _
Grand Haven
Hoytville
Sturgis
Detroit
Detroit
Berrien Springs _
Berrien Springs.
Portsmouth
Detroit
Novesta
Chelsea
Chelsea
Saginaw
County.
Genesee.
Calhoun.
Wayne.
Monroe.
St. Joseph.
Wayne.
Wexford.
Ingham.
Mackinac.
- - Saginaw.
Ottawa.
Eaton.
Barry.
Oakland.
Oakland.
Oakland.
Genesee.
Ingham.
Wayne.
Shiawassee.
Alpena.
Calhoun.
Bay.
Oakland.
Ingham.
Berrien.
Marquette.
Huron.
Huron.
Montcalm.
Bay.
Clare.
Washtenaw.
Ottawa.
Genesee.
Lenawee.
Berrien.
Van Buren.
. Osceola.
Mecosta.
St. Clair.
Sagmaw.
Ingham.
Saginaw.
Ottawa.
Eaton.
St. Joseph.
Wayne.
Wayne.
Berrien.
Berrien.
Bay.
Wayne.
Tuscola.
Washtenaw.
Washtenaw.
Saginaw.
�36
MICHIGAN SCHOOL FOR THE DEAF.
GIRLS—CONTINUED.
Name.
McCuaig, Annie .McKenzie, Nona S.
Nyland, Angie
Nichols, Zade M.
Nadeau, Emily
O'Connor, Mary
Idfield, Gertrude A.
arks, Winnie
Pratt, Eda T.
Priest, Emma J.
Perkins, Henrietta
Purdy, Lucy A.
Pouquette, Rosie
Quinn, Margaret
Rowack, Pauline
Reidy, Lizzie J.
Roberts, Louise
Reeves, Susan
Remer, Ida
Rice, Lillie May
Roberts. Josephine
Scott, Almina M.
Scott, Clara Belle
Sturtevant, C. Pearl
Schrikkema, Belle
Sinclair, Lillie May
Schwind, Emma C.
Shumway • Phoebe C.
Shumway, Ida
Shumway, Laura
Shumway, Bessie
Sessions, Mary
Smith, Carol infi
Spence, Alwildia M.
Slonecki, Cecilia
Schindehette, Clara
Turner, Jane
Thompson, Elizabeth
Tebow, Carrie
Tallon, Calla
Thompson, Agnes A. _
Vincent, Melvina
Vosberg, Preederica
Wade Eunice
Washburn, Flora
Warne, Charlotte S.
Williamson, Mamie
Weller, Adeline
Willson, Lizzie
Welch, Maggie
Ypma, Jessie
Zwiemka, Mary
P. O. Address.
County.
Carson City
Montcalm.
Negaunee
Marquette.
Tecumseh _ _ _ _ _
Lenawee.
Leonidas
St. Joseph.
Monroe
Monroe.
Elmira
Otsego.
Detroit
Wayne.
St. Louis
_ _ Gratiot.
Elm Hall
Gratiot.
Bartlett
Grand Traverse.
Armada _ _
_ _ Macomb.
Marshall
Calhoun.
Midland
Midland.
Detroit
Wayne.
Detroit
Wayne.
Kenokee _ _
St. Clair.
Stephenson
Menominee.
Cone Station
Monroe.
Saginaw
_
_ _ Saginaw.
Alpena
Alpena.
Stephenson
Menominee.
Saranac
Ionia.
Flint
Genesee.
Morenci _
Lenawee.
Grand Rapids
Kent.
Ellsworth
Antrim.
Traverse City. .
Grand Traverse.
Pewamo
Ionia.
Pewamo
__
Ionia.
Pewamo
_ Ionia.
Pewamo
Ionia.
Lapeer
Lapeer.
Ellington
Tuscola.
Martinsvillfe _
Wayne.
Manistee
Manistee.
Bay City
Bay.
Ionia ..
._
Ionia.
Bay City
Bay.
Holstein
Oceana.
Saginaw
Saginaw.
St. Joseph
Berrien.
Cheboygan.
Cheboygan
Cadillac _
Wexford.
Peach Belt
Allegan.
Okemos
Ingham.
Hillsdale
Hillsdale.
Bay City
Bay.
Pipe Stone..
. _ Berrien.
Kalkaska.
Leetsville _
Valley Center _
Sanilac.
Jamestown
Ottawa.
Filer City
Manistee.
T
•
�LIST OF PUPILS.
37
BOYS:
P. O.* Address.
Name.
Ackelius, William
Allera, Prank
Berry, Charles Stanley
Bartsch, Conrad C.
Baker, Christopher
Brodwolf, William C.
Barron, Felix
Bassett, Miles S.
Brownrigg, Stephen,
Bradway, James
Barnhart, Michael
Bailey, Harry P.
Burke, Thomas P.
Burkle, Fred
Born, John F.
Bertrand, George A.
Bell, William G.
Barrett, William A.
Brosseau, Senophil
Brown, Harry J.
Carpenter, Roy C.
Carpenter, LeRoy C.
Cowden, Fred
Cranston, George
Carlton, Claude A.
Cummiford, Willie J.
Colomb, Martine
Collett, Frank E.
Connor, Robert
Closson, Milo J.
Calkins, Thomas
Chenery, James S
Cope, Frank
Canneld, Charles A.
Chapman. DeWitt C.Corcoran, Thomas J.
Crips, Hubert Chrouch. Cornelius. .
Day, Halsey T.
Detrich, William. .
Drew, Charles Elson
__
Dodds, Mortimer R. .
Dzikowski, Stanislaus
De'Vlieger, Abraham ..
Dwyer, James- __
Diederick, John
Durocher, Thomas A.
Danielski, Frank. _
Fry, William James .
Flater, WalterFaxon, William E.
Fletcher, George S.
Flanagan, William
Graham, Charles
Gebraad, Peter
Grose, Thomas
.
Birch Run
Norris
Mecosta
Detroit
Lapeer
New Buffalo
Whitehall
Union City
South Saginaw
_ __
Bronson
Kilkenny
Buchanan
Attica
Marshall _ _ _ _
Monroe
Hersey
Millington
Detroit
Carrollton
Jackson
Flint
Flint
Chippewa Lake
Belmont
Corunna
South Saginaw
Arenac
Lansing
Hillman
Manton
Grand Rapids
Kalamazoo
Amboy
Scotts
Ammon
Bay City
Ouster
Detroit
Oakfield Center
Saginaw
Pipe Stone
South Haven
Verona
. „ Grand Rapids
.
Ishpeming
Jackson
Monroe
Detroit
Brockway Center
Stetson
Jacksoi.
Ypsiianti
Deer Lake
Carsonville
Grand Rapids
Hancock
County.
Saginaw.
Wayne.
Mecosta.
Wayne.
Lapeer.
Berrien
Muskegon.
Branch
Saginaw
Branch.
Huron.
Berrien
Lapeer
Calhoun.
Monroe.
Osceola
Tuscola
Wayne.
Saginaw.
Jackson.
Genesee.
Genesee.
Mecosta.
Kent.
Shiawassee.
Saginaw.
Arenac.
Ingham.
Montmorency.
Wexford
Kent.
Kalamazoo.
Hillsdale.
Kalamazoo.
Wayne.
Bay.
Mason.
Wayne.
Kent.
Saginaw.
Berrien.
Van Buren.
Huron.
Kent.
Marquette.
Jackson.
Monroe.
Wayne.
St. Clair.
Oceana.
Jackson
Washten aw.
Lake.
Huron
Kent.
Houghton.
�38
MICHIGAN SCHOOL FOR THE DEAF.
BOYS—CONTINUED.
Name.
•
Gagnier, Arthur
Grimm, MichaeU.
_.
Gabel, George
Gruetzmacher, Charles
Garber, Dorsey
Hardenburgh, Frank
Hardenburgh, Julius
Hastings, Eddie N.
Herrington, Russell
Hintz, John
Harris, Charles W.
Hackert, George Henry
Hall, James M.
Hamilton, Robert
Hanson, George Brown
Haden, William
Hardenburgh, Bert
Johnson, Delbert
Jackson, Theodore
Janiski, John
-
Jacobs, Fjmarmftl
Jenks, Martin S.
Johnson, George F
Kabrofskie, John
Knight, Ralph Allen
,
Lillie, Elias Nahumn
Laurenz, Charles F. W.
Lapanse, Henry
-.
Lypsmmbj T^rfl.nk
Lee, Clarence E.
Lynch, Lawrence
Larkins, Thomas
Larkins, George B.
Lament, Charles G.
Loomis, Earl A,
Lincoln Luther M
Langkam, John
Loh, Bruno
Lawrason Fred
LeClear, Walter C.
L'heureux, Peter
Lee, William Charles
Larkins, William
Loeffler Charles M.
Moore, Stewart
Maher, William E.
Mnfifielmartj Albert, F
Miller, Alfred
Miller, Arthur R.
Miller, Charles
Mohan, Thomas P.
Mars, Loran
Mercier, Gilbert
Marquis, George
Miller, John Joseph
Meyers, John
.- „_
P. O. AddrevSS.
County.
Detroit
Wayne.
Detroit..
Wayne.
Reed City
Osceola.
Wellsville .
Lenawee.
Charlotte
Eaton.
Pontiac
Oakland.
Eagle
Clinton.
Eaton Rapids
Eaton.
Grand Rapids.
Kent.
Eastman ville
Ottawa.
Fostoria
Tuscola.
Star Citv
_
Misssukee.
Lansing
Ingham.
Attica..
. ._._.--_ Lapeer.
Bay City
Bay.
East Saugatuck
Allegan.
Pontiac .
Oakland.
Flint
Genesee.
Pontiac
Oakland.
Manistee
.
__ Manistee.
Detroit
Wayne.
Corunna
Shiawassee.
Midland
Midland.
Detroit
Wayne.
Gogebic.
- Iron wood .
Saranac
Ionia.
Saginaw .
Saginaw.
St. Clair.
Anchorville Fair Haven
St. Clair.
Ganges ._
Allegan.
Bay City
Bay.
Springwells
Wayne.
Springwells
Wayne.
Scottville
Mason.
Hobart
Wexford.
Brockway Center
St. Clair.
Hersey
Osceola.
Bronson..
Branch.
Grand Rapids
Kent.
Grattan Center.
Kent.
Trenton .
__ Wayne.
Muskegon
Muskegon.
Springwells
_ Wayne.
Monroe
Monroe.
Black River
Alcona.
Ottawa.
Grand Haven
Huron.
Pinnebog
Brinton
. _ Isabella.
Wayne.
Detroit..
.
Fair Haven
St. Clair.
Wayne.
Detroit
_
Wayne.
Detroit
Berrien.
Berrien Springs
Portsmouth
Bay.
Iron.
Crystal Falls
Wayne.
Detroit
Bay.
Bay City
-.
�39
LIST OF PUPILS.
BOYS—CONTINUED.
P. O. Address.
Name.
Myer, Marcus H.
Maher, Henry
McColl, Eugene A
McHugh, Joseph
McCuaig, Alexander
McDonald, Curtis A.
McKeever, Frank
McHugh, Frank
Nink, Jacob. _
Nickel, Otto
Nichols, Wm. J
Oleson, Raymond _ _ „ _
Oberski, Marshall
Palmer, William,
Pashby, Ernest
Piper, Cecil
Polk, Peter
Polk, John
Peltier, Napoleon
Pettit, Charles L
Pettit, Howard L.
Quick, George
Robinson, Velorious
Roizowiez, Mike
Reynolds, Albert
Ryan, William M.
Rixom, Elzeworth D.
Ramage, Francis O.
Riley, Carlton D.
Rutherford, John J
Russow, Fred
Rosenfield, Emil
Ravell, Jesse A.
Rice, Charles C.
Reams, Henry
Simmons, Guy
Streiber, William
Sprague, William G.
Sherburne, Charles F.
Stanley, George H.
Stanley, Lewis F
Stenroos, Karl A.
Smith, Norman F.
Smith, Frank. .
Seibert, George
Shamping, Lewis E.
Sheppard, Albert
Stewart, William A.
Saine, Dewald
Sutton, William A.
Spence, Seth W.
Schwingschlegl, Anton
Schlupkowski, Charles
Sickles, Daniel M.
St George, Peter
Sweeney, Eugene
Schneider, August R. . .
.__
...
Oxford, Mississippi.,
Grand Haven
Chelsea
St. Ignace
Carson City _
Greenbush
Wixom
Detroit
North Dorr, _ . . .
Detroit
St. Louis - _ _ _
Ishpeming
__ _
Parisville
Lansing.
Constantine
Petersburgh _
Wyandotte . .
Wyandotte
Mt. Clemens
Chester
Chester
Calumet
Baldwin
East Lake
_
Coldwater
Detroit
Tecumseh-Port Huron
Greenville
North Branch
Monroe
Detroit
Flint
Albion
Mt. Pleasant .
Rogerville
Cheboygan
Kendall
__
South Blendon
2Btna
2Etna
Muskegon
Galien
_
Ypsilanti . _ _
Flint
Grosse Point
Big Run, Pennslyvania.
Saginaw
Cadillac . . -_._ — _
Armada
Martinsville .
Monroe .
Detroit
Attica
Au Sauble
Detroit
.
Detroit...
Connty.
Ottawa.
Washtenaw.
Mackinac.
Montcalm.
Alcona.
Oakland.
Wayne.
Kent.
WTayne.
Gratiot.
Marquette.
Huron.
Ingham.
St. Joseph.
Monroe.
Wayne.
Wayne.
Macomb.
Eaton.
Eaton.
Houghton.
Lake.
Manistee.
Branch.
Wayne.
Lenawee.
St. Glair.
Montcalm.
Lapeer.
Monroe.
Wayne.
Genesee.
Calhoun.
Isabella.
Genesee.
Cheboygan.
Van Buren.
Ottawa.
Newaygo.
Newaygo.
Muskegoa.
Berrien.
Washtenaw.
Genesee.
Wayne.
Saginaw.
Wexford.
Macomb.
Wayne.
Monroe.
Wayne.
Lapeer.
losco.
Wayne.
Wayne.
�40
MICHIGAN SCHOOL FOR THE DEAF.
BOYS—CONTINUED.
P. O. Address.
Name.
Sturm, Arthur
Snow, Clarence N.
Schweiss, George
Tobey, George L
Terry, Ray
Tripp George F
Thompson, Edward
Taylor, Charles M.
Tucker, Albert
Vaughn, Walter Scott
Voisine, John
Webb, Joseph H.
Walter, Arthur
Wittman, Tobias
Wattlino-, Earl E.
Wolski, John
Warren, Emory P.
Warner, William
Wrobleski, Stanislaus
Wilkinson, George R.
T^im merman, .Tnhn
Zeh, William J.
_ _
_ _ . . Saline
Kalamazoo
Wyandotte
Galesburgh
West Bay City
Detroit
Melvin
Mulliken
Charlotte
Reading
Banks..
Sears
South Lyons
Detroit
Dundee
Calumet Oscoda .
Grand Rapids
Port Austin
Conklin
Marquette
Newport
County.
.
Washtenaw.
Kalamazoo.
Wayne.
Kalamazoo.
Bay.
Wayne.
Sanilac.
Eaton.
Eaton.
Hillsdale.
Bay.
Osceola.
Osceola.
Wayne.
Monroe.
Houghton .
losco.
Kent.
Huron.
Ottawa.
Marquette.
Monroe.
�ACKNOWLEDGMENTS.
Grateful acknowledgments are due for the following favors, which have
•contributed no little to the pleasure, convenience and interests of the pupils
and to the welfare of the institution:
To ex-Governor Alger, for his generous gift at Christmas time.
To the officers of the Flint & Pere Marquette Railroad, Chicago & Grand
Trunk, Grand Rapids & Indiana, Michigan Central, Michigan Southern,
Detroit, Grand Haven & Milwaukee, and other roads, for favors extended
in the transportation of pupils to their homes.
To the department of education, for pamphlets and reports.
To publishers of the following papers and periodicals:
Name.
•Globe
Citizen
Dftmortrat
Journal
Public Leader,
..
Courier
Michigan Farmer...
Sower
Times
Journal
Michigan Dairyman. __
Granger
Telegraph..
College Index
Republican
Herald
.
Dispatch
Independent
Democrat
Recorder
Democrat
__
Enterprise
Church Helper
Republican
_ __ .
Ypsilantian
Telephone .
Herald
Advertiser
Herald
....
Democrat
News
Normal News. .._ . ....
_
Traverse Bay Eagle. ..
State.
City.
Flint
Micl ilgan
FlintFlint
Flint
Detroit
.
Detroit
Detroit _,
Detroit
Detroit
Detroit
Grand Rapids
Grand Rapids
Kalamazoo
Kalamazoo
Lansing
. East Saginaw .__.
Maple Rapids
Fenton ._
Hillsdale
Albion
Cheboygan
Otter Lake
Hastings
Midland
Ypsilanti
Reading..
Quincy
Holly
Big Rapids. _
Clare
Calumet
YpsilantiTraverse City..
i
i
�MICHIGAN SCHOOL FOR THE DEAF.
ACKNOWLEDGMENTS-CONTINUED.
Name.
Witness
Mail and Express
Our Little People
_
Journal
The Sign
Clionian _ _
_ _ .
The Eagle
Register D & D
Deaf Mute Voice
Silent Hoosier
Advocate
. _
Silent Worker
News
Silent World
Deaf Mute
Observer
Journal D & D.
Tablet
Gazette
Star
_„
Mutes Chronicle
Companion
Record
New Method
Deaf Mute Times
Hawk Eye
Ranger
Deaf Mute Optic
Bulletin
Index,
Deaf Mute Advance
Messenger
Pelican
Deaf Mute Critic
Bugle
_
State.
City.
-
New York
New York
Rochester
New York
Salem
Portland
.
Salt Lake City
Rome
Jackson
Indianapolis
Sioux Falls
Trenton
Berkley
Philadelphia Danville
Knoxville
Omaha
Romny
Staunton
Olathe.
Columbus
Faribault
____
Fulton
Englewood
Delevan
Council Bluffs
Austin
Little Rock
Frederick
Colorado Springs
Jacksonville
Talladege
Baton Rouge
Dubuque
Blutfton
New York.
a
tt
n
ti
tt
tt
Oregon.
Oregon.
Utah.
New York.
Mississippi.
Indiana.
Dakota.
New Jersey.
California.
Pennsylvania.
Kentuckv.
Tennessee ,
Nebraska.
West Virginia.
Virginia.
Kansas.
Ohio.
Minnesota.
Missouri.
Illinois.
Wisconsin.
Iowa.
Texas.
Arkansas.
Maryland.
Colorado.
Illinois.
Alabama.
Louisiana.
Iowa.
Indiana.
�OFFICERS, TEACHERS, AND EMPLOYES.
J U N E 30, 1890.
Name.
Position.
M T. Gass
E. F. Swan
Steward
Matron
Willis Hubbard
Rate.
$1,800 00 per year
1,200 00
500 00
350 €0 "
500 00 "
_
1,300
1,200
950
925
925
'
t
<•
Addie Hendershot . .
Maggie T. Bennett
M. E Tyrrell
Emma Z. Cook
(
_... .. _
Jessie Barney.
-
E. H. Larkin
0. M. Pierce
Edwin Barton.
..
c
500 00
580 00
500 00
500 00
500 00
I
i
i
i
i
580
600
500
440
340
i
i
i
Ida M, Jack
Celia A Allen
i
t
00
00
00
00
00
(J
Foreman cabinet shop
"
printing office .
...
Resident.
«
"
"
Resident.
u
"
Resident.
u
Non resident.
"
"
*'
u
t[
280 00
24000
240 00
300 00
850 00
*
Win. G. Bryant
00
00
00
00
00
Residence.
"
"
"
"
300 00
750 00
2 00 per day
650 00 per year
60000
„
Non resident.
»'
i'
l(
"Fanny Cnbh
Ella E J- CTawfnrd
George L. McQuigg
Engineer
Assistant pn gin our
Farmer
Albert Welch"
Edwin Cole
Thomas Johnson _ _ , ,
Win. Leigh
Edward Starks
Choreman
Wat,nhmRn
Baker.
Cook
1 wash worn an .
1
"
1
*
1
6
8
"
"
"
4
4
1,080
670
50
00 "
00 per year
00
Resident.
Non resident.
u
530 00 "
«'
540 00
18 00 per month Resident.
20 00
20 00 "
Non resident.
40 00
10 00 per week.. Resident.
50 00 per month
"
4 00 per week__
"
3 00
t;
350
2 50
4 00
"
3 75
300
"
"
*'
«
a 50 "
.((
"
"
��
asylums
-
https://localhistory.tadl.org/files/original/996244641005744a5e80d0319de7fadb.pdf
487dede12e245a99313741a97192bc72
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Traverse City State Hospital
Subject
The topic of the resource
Asylums.
Psychiatric hospitals.
Description
An account of the resource
Items within this collection pertain to the Traverse City State Hospital, also known as the Northern Michigan Asylum for the Insane and the Traverse City Regional Psychiatric Hospital.
Creator
An entity primarily responsible for making the resource
Amy Barritt, 1984-
Source
A related resource from which the described resource is derived
Original documents held by the Traverse Area District Library.
Publisher
An entity responsible for making the resource available
Various.
Date
A point or period of time associated with an event in the lifecycle of the resource
1885-1989
Contributor
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Board of Trustees for the Traverse City State Hospital.
Various.
Rights
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Content in this collection may be protected by copyright law. Contact the Traverse Area District Library for permission to reproduce, display or transmit this image.
Relation
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Various.
Format
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Various.
Language
A language of the resource
English.
Type
The nature or genre of the resource
Various.
Identifier
An unambiguous reference to the resource within a given context
TCSH-xxxx.
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
Traverse City, Grand Traverse County, Michigan.
Document
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Text
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Text embedded from PDF Extractor.
Original Format
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Paper booklet.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Proceedings of the meeting of the Joint Board of Trustees of the Asylums of Michigan held at Traverse City, July 16, 1908
Subject
The topic of the resource
Psychiatric hospitals.
Description
An account of the resource
Meeting proceedings, mostly discussion amongst trustee members representing various asylums from across the state of Michigan.
Creator
An entity primarily responsible for making the resource
Joint Board of Trustees of the Asylums of Michigan.
Source
A related resource from which the described resource is derived
Original document held by Traverse Area District Library.
Publisher
An entity responsible for making the resource available
Lansing, Mich.: Press of the Industrial School for Boys.
Date
A point or period of time associated with an event in the lifecycle of the resource
1908
Contributor
An entity responsible for making contributions to the resource
State of Michigan.
Rights
Information about rights held in and over the resource
This document is in the public domain.
Relation
A related resource
See other reports from the Board of Trustees at various institutions in the "Traverse City State Hospital" Digital Collection.
Format
The file format, physical medium, or dimensions of the resource
PDF.
Language
A language of the resource
English.
Type
The nature or genre of the resource
Document.
Identifier
An unambiguous reference to the resource within a given context
MSH0006
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
Michigan, United States
PDF Text
Text capture metadata for PDF documents
Text
PROCEEDINGS
MEETING OF THE
Joint Board of Trustees
ASYLUMS OF MICHIGAN
TRAVERSE CITY,
JULY 16, 1908
LANSING, MICH.
PRESS OF THE INDUSTRIAL SCHOOL FOR BOYS
1908
�NORTHERN MICHIGAN ASYLUM.
TRAVERSE CITY, MICH., July 16, 1908.
The regular semi-annual meeting of the Joint Board of Trustees of the
Michigan Asylums was called to order at 10:30 a. m., by Trustee Bates, President
of the Board of Trustees of the Northern Michigan Asylum for the Insane.
The Chairman welcomed the members and other guests with well chosen
remarks.
Invocation by Chaplain Cochlin.
Dr. Munson moved that the Chairman appoint a committee to invite the
ladies and other guests to the meeting. Motion supported and carried.
Chairman Bates appointed Trustees Vinton, Morgan and Edwards to
constitute this committee.
The following members of the Board and Medical Superintendents were
present:
From the Michigan Asylum—Trustees A. J. Mills, C. F. Cook, H. B,
Osborn, M. D., C. S. Palmerton, C. L. Edwards, C. E. Belknap, and Dr. A.
I. Noble, Medical Superintendent.
From the Eastern Michigan Asylum—Trustees G. J. Vinton, Edward M.
Murphy, Peter Voorheis, J. F. Cartwright, W. J. Kay, M. D., and Dr. E.
A. Christian, Medical Superintendent.
From the Upper Peninsula Hospital for the Insane—Trustees E. P. Bohn,
M. D., D. T. Morgan, J. H. Parks, Fred S. Case, Perry Leighton, and Dr.
E. H. Campbell, Medical Superintendent.
From the State Asylum—Trustee Belknap.
From the Northern Michigan Asylum—Trustees T. T. Bates, H. C. Davis,
M. F. Quaintance, William Lloyd, and Dr. James D. Munson, Medical
Superintendent.
There were present as invited guests, the Governor, the Honorable Fred M.
Warner; Dr. H. P. Mowry, wife and son, of the State Board of Corrections
and Charities; J. P. Draper, Superintendent of the University Hospital at Ann
Arbor; Dr. J. J. Marker, Superintendent of the Wayne County Asylum;
Stewards John Hoffman of Kalamazoo, E. C. Smith of Pontiac, R. C. Bradley
of Newberry, C. L. Whitney of Traverse City; Rev. D. Cochlin, Chaplain of
the Northern Michigan Asylum, Mrs. Edward M. Murphy, Mrs. J. F.
Cartwright and daughter Gladys, Miss Mills, Mrs. C. F. Cook, Mrs. F. P.
Bohn, Mrs. J. W. Belknap, Mrs. H. C. Davis and daughter Josephine, Mrs.
and Miss Quaintance, Mrs. William Lloyd, Miss Clara Bates, Mr. and Mrs.
Samuel Garland, Mrs. Elsie Hannah, Mrs. A. S. Rowley; and members of the
medical staff of the Noithern Michigan Asylum.
Chairman: The first order of business is the approval of the minutes of the
last Joint Board Meeting.
Moved and carried that the minutes stand approved.
�6
PROCEEDINGS OF TRUSTEES
Chairman: The next order of business is the consideration of unfinished
business. No unfinished business.
The next in order will be the presentation and consideration of communications from Trustees.
THE TRUSTEES.
TRUSTEE A. J. MILLS
In 1848 the Legislature of this stale enacted: "That there shall be estatr
lished in this state, institutions under the title and style of the 'Michigan
Asylum for the Educating of the Deaf and Dumb and Blind,' and 'Michigan
Asylum for the Insane,' and that fifteen sections of the state salt-spring lands
be and are hereby appropriated for the erection of suitable buildings therefor."
"The government of said asylums shall be vested in a Board of Trustees, to
consist of five members, who shall be elected annually by the Legislature of this
State in joint convention: Provided, The Governor shall have the
authority to appoint the first Trustees under this act."
"The Trustees authorized pursuant to the foregoing section, shall constitute
a body corporate with the name and title of the Trustees of the Michigan
Asylum,' with the right as such of suing or being sued, of making and using a
common seal, and altering the same at pleasure."
So the first Board of trustees provided for in the management of the insane
asylums in this state was created a body corporate with a corporate seal.
"The Trustees shall have power, and it shall be their duty, to enact laws
for the government of said asylums, and also to appoint a principal for each
institution, whose respective salaries shall not exceed eight hundred dollars per
annum."
In 1850 the duties of the Boards evidently became quite onerous. We find
that the Legislature enacted: "That the Auditor General be, and he is hereby
authorized and required to audit and allow to the members of the board of
trustees of the Michigan Asylums, and to the members of the board of education,
the expenses necessarily incurred by them in the discharge of their duties; also,
twn dollars per day for their services actually and necessarily performed, upon
their certifying the same to be correct, and draw his warrant upon the treasury
therefor."
In 1855 the first provision for the actual care of the insane of this state was
taken up in a revision of the charter of the city of Detroit. I wish I had time
to call the attention of this Board to all the provisions of that act relating to
the insane and the care of defective people, because it shows that the people of
the city of Detroit as early as 1855 were alive to many of the things which are
now regarded as modern reforms.
"The common council are hereby vested with full power and authority to
provide by ordinance for the organization, regulation, control and support of an
alms house department, including therein an alms house proper, for the relief
and support of the poor ot said city, hospitals for the care of the sick, asylums
for the insane and blind, nurseries for poor and destitute children, houses for
the confinement, correction or punishment of males over sixteen and females
�OF ASYLUMS OF MICHIGAN.
7
over fourteen years of age, who shall be convicted before any court of law, of
violating any law of the State of Michigan."
That is a pretty modern conception of things.
"Every person confined, supported, maintained or relieved in said department,
whose age and health will permit, shall be employed in some useful labor, and
the officers in charge thereof shall use their best endeavors to provide for all
persons under their care, such labor as on trial shall be found to suit the
capacity of the individual. It shall be the duty of the officers to keep and
employ separate and apart form each other, the paupers and criminais, and as
far as possible to classify the latter, so that the novice in crime may not be
contaminated by the evil example and converse of the more hardened and confirmed. There shall be an accurate account kept with all paupers, charging
them with the expenses incurred by fhe city for their board and maintenance,
and crediting them with a fair and reasonable compensation for tiie labor performed by them; and when they shall leave the department if any balance shall
be found due them it shall be paid to them in cash at the time of their discharge:
Provided, That the common council may, in their discretion, order said
balance to be paid to some discreet citizen, who shall expend or invest the
same for the benefit of such pauper, and shall fully report his action in the
matter to said council. The officers in charge of said department may receive
and provide for, or confine any insane, or blind or idiotic person, or male under
sixteen or female under fourteen years of age, who shall be brought to them by
the director of the poor, or other proper officer of any township in this state,
or by the parent, guardian, or friend of any such person." So you see the
institution provided for more than the city of Detroit in 1855, and became the
first legal custodian of the insane of the state as well as the city. "Provided,
That such officer, parent, guardian or friend, shall give ample and satisfactory
security for the payment, at least once a month, of all expenses that may be
incurred on account of the person so received; and provided further, that nothing herein contained shall be so construed as to make any person who may be
brought to said department for confinement or maintenance, a citizen of
Detroit." They are willing to receive the insane of the state, but they did
not propose to make them citizens of the city of Detroit.
In 1857 the law of 1848 was amended so, "That the Governor, by and with
the advice and consent of the Senate and House of Representatives, in joint
convention assembled, shall, during the session of the Legislature in the year
eighteen hundred and fifty-seven, appoint three Trustees for the Michigan
Asylum for the Insane, to hold their offices as follows: One shall be elected
for the term of six years, one shall be elected for the term of four years, and
one for the term of three years, whose terms of office shall commence on the
second Tuesday of February, of the year in which they are elected, and shall
continue untill their successors are appointed and qualified, and who shall
constitute the Board of Trustees of the said asylum; and at each succeeding
session of the Legislature there shall be appointed in like manner one Trustee,
who shall hold his office six years and until his successor is appointed and
qualified. The Legislature shall also fill, by election as aforesaid, all vacancies
that may occur in said board."
"The government and sole and exclusive control of the Michigan Asylum
for the Insane shall be vested in said Board of Trustees, and two of them shall
reside within five miles of said asylum." The law of 1859 then provided for an
appointed board.
�g
P R O C E E D I N G S OK TRUSTEES
In 1859 or about that time, as I understand it, the Michigan Asylum for the
Insane was opened. Some 'days ago a lady who was one of the very first
patients, who lived in that institution for forty-nine years and one hundred ami
forty-four days, departed this life and was returned to Coldwater for buriai.
This illustrates the length of time that the State may be required to maintain
some patients, and the importance of seeing to it t h a t the rights of the State
in the matter of the support of such patients should be carefully conserved.
The law of 1859 continued without much change until 1877, when the
Eastern Michigan Asylum for the Insane was provided for and the law was
practically revised. That law provided that: "The district of the Eastern
Michigan Asylum shall be composed of all countries lying east of the meridian
line, or traversed by that line, excepting the countries of Jackson, Mackinaw,
and Chippewa. The district of the Michigan Asylun for the Insane shall be
composed of the remaining part of thf State."
,
"The Board of Trustees of the Michigan Asylum for the Insane shall consist of six, and be appointed and hold their offices in accordance with the laws
heretofore enacted organizing and regulating that institution."
"The Governor, on or before the completion of the Eastern Michigan
Asylum, shall appoint six trustees, who shall constitute the board for said
asylum." "The government and sole and exclusive control of the Michigan
asylums for the insane, shall be vested in said board of trustees, and two of
each board shall reside within three miles of their respective asylums."
With the passage of this act came the first law which delegated to the
trustees the right to fix the rate of maintenance. "The rate of charge per
week to be paid for the board and necessary treatment of all patients of the
asylums, who are residents of this State, shall be annually fixed by the trustees
of the asylums, and shall not exceed the actual cost of support and attendance, exclusive of officers' salaries; but this provision shall not be construed so
as to prevent the furnishing of extra care and attendance to patients by special
contracts with parties chargeable therefor." The law of 1877 continued in
force practically without amendment until 1885, when, owing to the establishment of this institution, it became necessary to revise the law, and to provide
an additional board of trustees.
In 1885 the Legislature enacted: "The board of trustees for each asylum
for the insane now or hereafter organized, shall consist of six members to be
appointed and hold office for a term of six years, two to be appointed every
succeeding two years." And then provided for the appointment of a board of
trustees for the Northern Michigan Asylum. "The government and sole and
exclusive control of the several asylums for the insane shall be vested in the said
several boards of trustees, and two of each board shall reside within three miles
of their respective asylums."
'Then came the creation of the Joint Hoard of Trustees in 1885.
"It shall
be the duty of the boards of trustees to meet jointly at least twice each year,
meetings being held at the different asylums, and at such times as may be
prescribed by their joint by-laws to adjust all questions that may arise pertaining
to said institutions; and the said joint board, acting under such rules and by-laws
as they may adopt, may transfer patients from one asylum to another if for any
cause it may become necessary or desirable; the expense of such transfer to be
chargeable to the person, or county, or state responsible for the maintenance of
the patient so transferred."
"The rate of charge per week to be paid for the board and necessary
�OF ASYLUMS OF MICHIGAN.
9
treatment of all patients of the asylums, who are residents of this state, shall be
annually fixed by the trustees of the several asylums, in joint session, and shall
not exceed the actual cost of support and attendance, exclusive of officers'
salaries; but this provision shall not be construed so as to prevent the furnishing
extra care and attendance to patients by special contracts with parties chargeable
therefor."
I need not read any of the provisions of the subsequent acts of the Legislature
with reference to the duties of the joint board of trustees because you are all
familiar with them. I thought that I might as a preface to my paper call
attention to these early statutes and refresh the recollection of the members of
the Board of the early legislative history of the asylums and of the board of
trustees.
1 have traced in a general way the history of the governing boards of the
asylums for the care of the insane in this state covering a period of over fifty
years, during which time no public scandal has involved the management.
No dishonesty has been charged and a record has been inade which places them
in the first rank. This enviable standing has been made possible because from
first to last the activities of politics and politicians have not been permitted to
gain a footing in these homes of sorrow. The governors have for the most
part been wise enough to recognize that a place upon these boards, though one
of honor, ought not to be a reward for mere political service and that only
suitable men, willing to serve for the work's sake, are worthy of that opportunity.
A roll call of the men who have labored in this blessed work and laid down the
task would disclose names among the choicest of those who have graced the
roster of Michigan's citizenship.
The medical superintendents have always been men of excellent attainments,
strong executive officials, humane, progressive and distinguished alienists. They
have received the cordial and loyal assistance and encouragement of their
respective boards of trustees and in turn have faithfully carried out the directions
which have from time to time been given them by the boards.
Each hospital has maintained a medical staff composed in the main of gentlemen, who have not only been enthusiastic, well equipped and up to date, but
jealous of the advancement of the noble cause to serve which they educated
themselves and to which many of them have consecrated their lives. Certainly,
it cannot be truthfully said that only routine duty has been done or that there
has been stagnation in their labors along the lines of their specialty.
*(
The industrial departments have been honestly and efficiently officered. The
people of Michigan have never had just cause to accuse the stewards of grafting,
extravagance or of any lack of fidelity in the-discharge of their important and
most responsible duties. .1 must not be misunderstood as claiming that in all
the years gone by there have been no things done which ought not to have
been done, or no things left undone which ought to have been done, but as
insisting that on the whole exceedingly satisfactory results have been obtained.
I am emboldened to make, this assertion because at the gatherings of the
national associations of charities and of those who are informed, this has been
repeatedly conceded. You may perhaps wonder why I take your time to
applaud the accomplishments to which I have referred. I assure you it has not
been done in a spirit of boastfulness, but because as you are, so I am, jealous
«f this good work. It is near to our hearts. It is our great pride, for which
we would willingly make any reasonable sacrifice to insure its continuance and
excel the record. We all know that stagnation means retrogression and our
�10
PROCEEDINGS OF TRUSTEES
motto is "Excelsior." We are not so self-satisfied as to proclaim that the best
results have been secured, or that no plan could be adopted which would not
place these hospitals upon a better or more humane and economical footing,
but in the light of what has been accomplished, we have the right to urge that
no mere experiments be tried and that well enough be let alone until the people
are convinced by something more substantial than the insistence of agitators
without experience in the work that the policies which have been so successfully
pursued in the past are wrong as applied to the future.
You all know that criticism has from time to time been made of our work
and that, generally, it has come from the mouths of the uninformed and from
those who have hardly seen the inside of one of the hospitals under our care and
management and have had no experience in the work.
We have been told by well-meaning people and through well-meaning agencies
that our duties have been perfunctorily performed and that the best commercial
methods have not been employed in the expenditure of the taxpayers' money in
the purchase of supplies. For one, I trust the day may never dawn when
Michigan's charitable hospitals and homes shall be cursed with a policy of
commercialism which would surely make of them poorhouses and the abode of
paupers. The mere commercializing and institutionalizing of these charities is a
microbe which has from time to time infected a good many people who are well
intentioned and others who are agitators and self-conceited reformers. The
disease is a contagious one and needs the prompt application of an efficient
anti-toxin if it is not to spread in Michigan to the detriment of the deserving
and afflicted people who must find their only refuge in the homes and hospitals
furnished by the state.
We have been informed that our tendencies have been to make local rather
than state institutions of the hospitals and that we who are striving, not for the
almighty dollar but in sweet charity's cause, have not and are not likely to
attain to the success which might attend the efforts of a highly salaried central
board of control.
It would be distictly un-American to adopt mere commercial and institutional
methods, overlooking as they generally do and most likely would, the permissable
and fitting homelike features and influences which ought to abound even more
than they do in the places which the people sustain as a charity not merely for
the poor but for all needing them within the meaning of the word "charity,"
which denotes "all the good affections men ought to bear to each other."
Our hospitals for the insane are not inhabited and will never be peopled by
mere paupers, but in the large majority by a class of unfortunates, most of
whom deserve well of the state, who have helped to bear its burdens and in
one way or another have contributed to its growth and material prosperity.
The desideratum is not tha minimum of cost, but sane economy within permissible and reasonable bounds. No humane thinking Michigan taxpayer has yet
had any just occasion for complaint as against the administration of Michigan's
charities, nor is any considerable number of the taxpayers finding their contributions toward the maintenance of her hospitals and homes upon present standards
unduly burdensome. On the contrary, they have evidenced their appreciation
and approval of what has been accomplished and are glad to provide means for
the proper and suitable support of them.
Our fellow citizens have, however, been urged in some quarters to dispense
with boards of trustees and to create a paid central board to administer the
public charities. If this cannot be defended, it is a heresy which we owe it to
�OF ASYLUMS OF MICHIGAN.
H
ourselves to combat upon the basis not only of practical business, but of
humanity. For myself, I make bold to predict that it will presently be discovered
wherever the plan has been or will be tried, that it will not conserve the hopes
or predictions of its advocates anywhere, because I am convinced that it has
been the experience .wherever such boards have been created that local boards
of trustees cannot be dispensed with and proper standards maintained and that
the saving in the cost of maintenance has been very inconsiderable. This has
notably been the case in the States of New York and Minnesota and will be
so everywhere it is tried except possibly in places where the people are content
to house their afflicted friends or relatives in the sort of institutions which
abound in and disgrace Europe and against which most of our people would
rise in rebellion.
It has been found that each institution has its own peculiar requirements;
that local environments are an important factor; that the red tape methods
which necessarily accompany the work of a central board is often obstructive,
generally tends to friction, delay, unnecessary annoyances and many times to the
positive hardship and detriment of the inmates. Instances of such occurrences
have been given me by superintendents and trustees who have had experience
under such a system. A paid central board might remedy evils in some directions, but on the whole its remedial measures would turn out to be more
undesirable than the troubles intended to be remedied.
The system which has been in vogue in Michigan for so many years has
proven itself so far to be all right and is all right. We Michiganders are not
so wedded, however, to the accomplishments of the past as not to be willing to
consider the virtues of proposed reforms, nor do we shut our eyes as against
improved methods for the future, and I believe it will be the sentiment of the
members of this Board, as one matter of reform, that every state institution in
Michigan ought to be able to purchase as far as may be o.n equal terms and
that there might well be a closer union in the effort to furnish the most
possible to the inmates of all of them at minimum expense. We certainly have
not been dilatory in this regard.
Tnis Board, in requiring the stewards to attend its meetings and in providing
for stated meetings by them for discussion and comparison of purchases and
experiences, took a step in the right direction from which much good has
resulted. The creation of our Finance Committee and the report which our
by-laws provide shall be furnished this Committee in advance of our Julymeeting was another step forward. The Legislature, in requiring the State
Board of Auditors to act with us in fixing the rate of maintenance and inrecognizing that the powers delegated to this Board in that regard being;
legislative in character should be subject to veto by the Executive, conserved
public interests and strengthened our hands.
The Governor took a most helpful and practical step in advance in requiring
stated monthly statements of the purchases made on account of the several public
institutions for the use and comparison of purchasing agents, superintendents
and boards of control. These statements could be much improved upon and
will no doubt in the near future be made more useful than at present. The
Governor lately supplemented these monthly statements by calling together the
superintendents and stewards of all the institutions at Lansing for a conference
and discussion concerning the economic affairs thereof and if such meetings
may become, so far as the stewards are concerned, at least a quarterly feature
of their work, out of them will grow a plan by which all the institutions can
�12
PROCEEDINGS OF TRUSTEES
purchase, at least the staples used by them, on even terms, the smaller being
thus aided by the larger. In this manner, a correctly constituted and practical
purchasing board could be provided at little additional expense, which would
answer all legitimate purposes and avoid the objections which have been
experienced in the states that have experimented with a paid three man central
board. Under the plan suggested, a keen rivalry would be stirred up among
the stewards which might result in considerable benefit and saving to the state.
In the near future, is it not possible a way may be found without encroaching upon the rights of labor to provide as much employment as is rensonably
permissible and useful for those of our patients who can and are willing to
work. We do this to some extent, but not as completely I believe as is useful
and possible. I think you will agree that idleness is a feature which, as we pass
about our asylums, appeals to us as something in the conservation of the
contentment and health of the patients to be avoided as much as possible.
The strict and active enforcement and amplification of the laws which require
those who can without hardship to themselves or their families to contribute
to the cost of the support of patients under the visitation of insanity should
receive our constant encouragement as conducive to the best interests of the
patients, as conserving the rights of the tax payers and as being calculated to
place the burden of caring for the insane more nearly where it rightfully
belongs.
This work has been carried forward very successfully by the State of
Massachusetts and only indifferently in Michigan. C o u l d we not take
measures to secure the appointment of some person, or persons, who could give
attention steadily to this important matter. Might we not also, in the interest
of fairness and peace, employ the services of someone, a medical man by
preference, who could be detailed to visit each of the hospitals regularly to
hear, investigate and advise as to such complaints as are made by patients or
their friends; as is done in the State of New York, where the plan has resulted
beneficially, or might not this duty be delegated to the State Board of
Corrections and Charities or to some official directly answerable to it.
Experience has taught that it is most necessary to require the maintenance
'of sound discipline among the nurses and employes and to insist upon uniform
courtesy and kindness toward the patients at all times. This has been accomplished in large measure in the past through faithfulness, intelligence and loyalty
of our employes, but has not been followed up, I am inclined to believe, as
carefully in all respects as is really necessary to our safety. The investigations
which have been carried on in the State of Illinois and the disclosures which
have resulted therefrom surely mark this as a very important matter for our
candid consideration. On the other hand, it is but just to ask, have we done
all we might or could for our employes in requiring of them not only fair hours
of duty, in granting them adeqate compensation for good service and in
providing them with suitable resting places and homes when not on duty. I
believe we might and could do much more in this direction and that the people
of the State would, if made to understand the necessity, support us in any
reasonable recommendations we may make to conserve such ends. I call to
mind a paper, which I think was read at this place some two years ago, covering this topic in part. It was pigeon-holed, as most of the papers are which
we listen to at our meetings and very little, if any, attempt has been made to
carry out its suggestions. I wish the wealthy men of our state, when
bequeathing of their means to charity as so many do, would remember our
�OF ASYLUMS OF MICHIGAN,
13
nurses and that a nurses' home might be deemed sometimes a fitting memorial
to the memory of good citizenship.
In conclusion, gentlemen, while the Michigan plan has been a success in the
past, its future record will depend upon the appointments which are made
upon the boards by future governors and the unselfiish zeal of their membership. If non-partisan gentlemen, who are really interested in the cause and are
ever ready at much sacriince to assist in an active, but non-officious manner, in
the work for the work's sake and for the chance it affords of being helpful to
their unfortunate fellowmen and women are appointed and serve, all will be
•well and continued success assured, while the reverse may be expected to follow
the appointment and service of a different class of men.
In the past, we have worked harmoniously for the common good of all our
institutions and this must be our watchword for the future. I am sure I am as
proud of the successes and the good things accomplished at any of the hospitals
as I am of what is done at the Michigan Asylum. Our rivalry is honorable,
well intentioned and good natured. We all strive for the best and we can afford
to be generous toward each other in our efforts as well as in our criticisms. As
we have pressed forward in the past with honor and success, so may we proceed
in the future and may the people of our state never have just cause to feel
anything less than pride in the manner of the performance of our duties and
may the generous and enlightened policies which have been pursued continue
for the future only with more zeal and intelligent persistence, and entitle
Michigan to retain the place she has maintained so long in the very front rank
among her sister states and the nations of the world in caring for the mentally
distressed and in advancing the cause of psychiatry.
Chairman: I am sure we have all listened with great interest to the historical and suggestive paper of Trustee Mills. The paper, if there are no
objections, will be accepted and placed on record. Discussion of the paper is
now in order.
Trustee Davis: There is one feature of that paper I want to speak about
that is very valuable, and that is the work that Judge Mills has put upon it in
bringing out the early legislation. This information cannot be obtained except
by a lot of investigation, and I think it is very valuable for future reference.
It gives the history of the asylums up to the present time, except the present
laws, and it is too valuable to be lost sight of.
Dr. Christian: The contents of that paper are likely to come in as very
valuable material in some future years. We do not know how soon we may
move for radical change in our methods. I think we should have of that paper
a sufficient number in print to make use of at any time, more than we would
care to have printed perhaps of the full proceedings of the Board, and I offer
this suggestion that if the full proceedings of the Joint Board are printed, that
an extra number of this paper be made.
Considerable discussion was elicited with reference to the printing of Joint
Board proceedings, and it developed that there was no provision of law whereby
proceedings of any Joint Board could be printed at state expense. Dr. Mowry,
of the State Board of Corrections and Charities, spoke as follows: "I think
the proceedings of the Joint Board can be printed at the Industrial School at
Lansing. From Mr. Lawson I learned that he is very glad to secure printing
for his boys simply for experience, and I believe he would be glad to do the
work. All the expenses necessary would be for the material used." After
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PROCEEDINGS OF TRUSTEES
some discussion on these remarks if was decided to refer the question to Dr.
H. P. Mowry before any further action should be taken.
Chairman: The next matter for consideration will be the presentation and
consideration of communications from Medical Superintendents.
REPORTS OF SUPERINTENDENTS.
MICHIGAN ASYLUM FOR THE INSANE,
Kalamazoo, Mich., July 16, 1908.
To the Joint Board of Trustees:
Gentlemen—I present here with a brief report concerning themovement of
population and other conditions existing at the Michigan Asylum for the Insane
during the year ending June 30, 1908.
Men.
Women.
Total.
Patients remaining July 1, 1907
896
882
1778
Admitted during the year.
259
' 175
434
Discharged
Recovered
. Improved .,
Unimproved
Died
Transferred
Not Insane (Voluntary)
Escaped
Patients remaining June 30, 1908
1155
1057
2212
30
35
13
99
4
3
2
56
29
20
67
3
I
2
86
64
33
166
7
4
4
186
969
178
879
364
1848
The admissions this year were 434 as compared with 425 last year, while the
discharges this year were 364 and last year 404. We have, therefore, made a
net gain of seventy patients. This gain is confined wholly to the department
for men, since the discharges in the department for women exceeded the
admissions by three. The reverse of this was true last year, when there was a
loss of seven men and a gain of twenty-eight women.
This gain of ninety-one patients in the biennial period was anticipated in the
provisions of the last legislature, and the ordinary gain of the next two years
can be taken care of without asking for further special appropriations.
�OF ASYLUMS OF MICHIGAN.
15
The recoveries exceed by seven those of last year, and represent a recovery
rate based upon the admissions, of twenty per cent. The deaths are less by
twenty-seven than they were the previous year and represent a mortality rate
based on the daily average census, af about nine per cent.
The general health of the household has been good, and we have suffered
from no serious epidemic, although nearly all the more common acute
infectious diseases including small pox, have been represented in the Asylum
by One or more cases during the year.
Tuberculosis was reported to the Board of Health in twenty-nine patients
and one male nurse, who contracted the disease elsewhere. Twelve patients
died of this disease, and we have thirty-four tuberculosis cases in the institution
at present.
Van Deusen Hospital has been finished and is now occupied. This building
will easily accommodate the one hundred and four patients specified in the
legislative enactment. In design and equipment it is well adapted to its
purpose, that of a receiving ward for women.
Hall L, one of the two new wards at the male department, gained by raising
the roofs over the extremities of the wings, 'was opened for patients in April.
The corresponding hall, M, can be finished at short notice whenever additional
room is required. Each of these wards is made up largely of a sitting room
and a dormitory. They prove to be very convenient and pleasant additions to
the department and afford comfortable quarters for forty patients each. This
in a measure, remedies the original defect the building of in lacking dormitory
space, and enables us to assemble certain of our epileptics and general paralytics
who need to be under constant observation night and day, one step in the
segregation of epileptics which we have lately undertaken.
A new continuous bath room was opened in the basement of Edwards
Hospital during the year. It practically constitutes an additional ward for
disturbed patients, and has a capacity of four tubs and ten beds. It has been
in constant use now six months and has fully met our expectations in affording
the most approved means for treating successfully some of our most trying
cases, not only recent admission, but chronic patients, subject to periodical
attacks of agitation and excitement, who may be thus rendered much more
comfortable during their disturbed episodes, while the outbreaks possibly may
be modified in duration and intensity.
Seven new porches contribute greatly to the comfort of the patients, while
other important improvements are well under way and when completed, will
give the Asylum a capacity.of twenty-one hundred patients.
The plan of caring for restless, destructive and otherwise vicious patients in
bed under observation has been extended. It is vastly superior to the common
recourse of single room seclusion, a form of solitary confinement, no more
conducive to the well being of an insane man than to that of a sane one. For
similar reasons we have extended the night service, locking in their rooms and
leaving to their fears and devices fewer patients at night.
While we are, and shall continue to be, largely engaged in the fundamental
work of the institution, yet it is a constant regret of the medical staff that we
have no suitable laboratory, autopsy room and morgue. This is an important
demand of continued scientific advancement, and it is our earnest hope that the
next legislature will take the same view of the situation.
Considering our facilities, however, the amount of laboratory work accomplished has been creditable. In a general way, this included the examination of
�l-Q
PROCEEDINGS OF TRUSTEES
urine., blood, sputum, spinal fluid, stomach contents, stools, various inflammatory
ex.udates and the gross microscopical specimens obtained from autopsis,. of
which there were twenty-eight.
The therapeutic value of healthy occupation for a very large per cent of the
insane has not been lost sight of, and at the present time we have thus employed,
exclusive of bed patients, fifty three per cent of our inmates.
Most of the work done is that ordinarily preformed about an institution of
this sort, although we have successfully established basket making by the patients,
and it is our purpose to take up something further during the coming year
along the line of manual training and possibly during the winter, graded
calisthenics.
I am very glad to acknowledge continued cordial relations with the Psychopathic Hospital and valuable help from Dr. Albert M. Barrett, the Director, whose
efiorts to stimulate the institutions to work harmoniously along the scientific
lines are thoroughly appreciated.
Respectfully submitted,
A. I. NOBLE,
Medical Superintendent.
EASTERN MICHIGAN ASYLUM, Pontiac, Mich.
To the Joint Board of Trustees:
Gentlemen—The following table shows the movement of population for the
fiscal year, 1907-08.
Men. Women. Total.
Under treatment June 30, 1907
607
602
1209
Admitted from July 1, 1907 to June 30, 1908
155
133
288
Total number under treatment during 1908
Discharged:
Recovered
Improved
'Unimproved
Died-N o t insane--
Remaining under treatment June 30, 1908
762
22
30
17
49
.
735
1497
21
26
10
49
43
56
27
98
5
2
123
108
231
639
627
1266
The number of admissions, 288 in all represent 228 individuals who have
never before been received into the asylum, and is a larger admission rate than
the asylum has ever before been called upon to care for under normal conditions.
It cannot be accounted for by any considerable number awaiting the creation of
room for them, because at the close of the last fiscal period there was no
waiting list. A new building for women .had only-recently been opened for
occupancy, and for several years the demand for room for men had not outrun
our capacity. I am inclined to regard it as merely an instance of one of those
fluctuations, which, without apparent cause, now and then show themselves
independent of prevailing conditions. It will be noted by the above that the
net increase for the year has been fifty-seven.
�OF ASYLUMS OF MICHIGAN.
17
The past year has been crowded with activity in lines of new construction
and in alterations in the existing plant. All this has not included new
buildings for patients. Only indirectly and incidentally to the carrying out of
other plans, will the institution secure an increase in its capacity for caring for
a larger number of the insane. Most of the work carried on has had for its chief
aims, increased efficiency and greater economy in the operating expenses of a
plant now a generation old. With the advent of winter we shall be in possession, for the first time, of a central heating plant for most of the detached
buildings and for the central block. This has involved the construction of
nearly half-a-mile of underground tunnels, together with the piping necessary
for-steam heat and for hot water consumption.
A steel water tower, destined for years to corne to be the most conspicuous
feature in the landscape for miles around, completed but not yet in commission,
will soon replace the old system of attic storage tanks. This only awaits the
near completion of the house piping to relieve us once and for all of the
constant vexations and expenses of the former system. The ever present fear
of fire, to be fought with a possibly insufficient water supply,—a fear amounting
to an obsession in the superintendent and imparted to his board of trustees, is
likely to receive its-quietus with the completion of work on two new ten inch
walls to be actuated by an air-lift apparatus already installed and ready for work.
With these in operation, it is expected that any default in the city water supply
will be compensated for by the delivery to our own fire pump of a thousand
gallons of water a minute. This work is still uncompleted. To the above
additions to the mechanical equipment must be added also in this relation, a
new power boiler and a small electrical unit for the night load.
A decidedly new departure for the institution,—one involving much in its
possibilities for good, we believe, is the construction out of our old chapel room,
(situated with respect to the wards somewhat like this assembly room,)of a
large central dining hall, where we expect to gather at meal hours, from six to
seven hundred patients. Room for this number has been secured by the building of wings on either side, affording, altogether, nearly 8,000 square feet of
floor surface. These wings are at this writing under roof.
To complete the scheme, a new building with an assembly room in a lower
story somewhat below grade, and a chapel on the second floor a trifle above
grade, is already erecting its front.
It is hoped that the discarding of most of the ward dining rooms for this
central gathering place, will effect a noticeable saving in food and in dishes,
a better'service of viands, and on the whole, a more wholesome atmosphere at
meal time. Incidentally, the institution gains considerable dormitory space.
In this connection may be mentioned an innovation which is perhaps not
yet beyond the experimental stage with us, but which we are planning to
extend to the new dining hall. Small square tables with polished tops and
without cloths, we are inclined to look upon as more attractive than the long
table with a cloth that is always objectionable unless immaculately white, and
much more apt to be "holey" than wholesome. Besides there is the saving
in the laundry account. Next to the abolition of the old dust shafts, which
unsanitary device we are no longer possessed of, I look to this move as most
promising of satisfactory results in the search for cleanliness, at not too great
a sacrifice of the esthetic.
A year ago we had just inaugurated, what was for us, a new system of caring
for our feeble and infirm women. No move for the better nursing and for
�18
PROCEEDINGS OF TRUSTEES
greater comfort and convenience in the management of the bed-ridden and semibedridden body of patients (I do not speak of the acutely sick or hospital cases),
for the confused, restless and untidy ones has met with such signal success as
the creation of these two wards in an infirmary building, devoted exclusively to
these uses. It has been welcomed with such warmth of appreciation by nurses
and physicians, and has been commented on so pleasantly by visitors, and
especially by former nurses visiting the institution, as an addition to the nursing
equipment, notable for its convenience, its cheerfulness and general hospital
air, that I feel justified in referring to it in this report. There are no separate
rooms. Each floor is practically an open ward, with only such walls as are
necessary for supporting the floors above and for carrying the fire walls that
extend to the roof. Here, all the infirm and helpless are gathered, as many as are
necessary in beds, arranged along the walls. Former occupants of disturbed
wards are here. Many who were troublesome in smaller rooms here find that
comfort'in numbers that leads to quiet. Although not included in the original
plan, it has been found the ideal method of caring for cases of acute depression,
with anxiety, fear and suicidal tendencies; and at a minimum cost of attention
consistent with their needs. There is a noticable absence of odors. The
fewer corners, the lessened wall space and base, and the general openness all of
course lend themselves to this. Such privacy as is occasionally necessary, is
easily secured by light hospital bed screens. For those who are not bed-ridden,
spacious verandas are accessible, and on the coldest days of last winter, formerly
restless patients could be found seated there, bundled in blankets and shod with
felt boots. I feel that here we have found for 100 patients of a certain class,
the secret of combining the maximum of comfort with a minimum of cost of
construction.
Our experience with this open ward method of caring for a large group,
leads me to advocate its extension to other classes of patients. I recognize the
necessity for single rooms in certain cases, because of tumultuous behavior, or
for reasons of privacy in the convalescent or semi-convalescent patient, but I
look upon the small dormitory with its enclosed space, shut off from the main
ward, as an abomination and a relic of former days, when hospital ideas in the
care of the insane had not yet crystalized. There is among the insane, a
contagion of example, which often makes for peace in numbers when molded
by watchful and intelligent attendance. There is, too, for many, an assurance,
gained from large associations, that supports while it banishes mystery, secrecy
.and doubts. It is the night more than the day that loads with its sense of
responsibility, those who care for the insane. Open space and numbers bring
relief as witness the crowded day corridors, the large walking parties, the
gatherings at chapel and entertainments, and the associate dining halls.
Regular staff meetings have been the order through the year as they have
been for a number of years past with particular attention given to the study
and critical analysis of cases presented. The spirit of study and work in the
medical staff, with a desire to impart the same to the members of the training
school for attendants have been conspicuous. A close affiliation with the
pathological laboratory at the psychopathic ward has been striven for, and I
believe, with good results. Nearly forty per cent of the deaths have come to
autopsy. This is a decided increase over past years, and is itself evidence of
good faith. This coming year we expect to do even better.
In the basement of one wing of the dining room structure referred to above,
a set of rooms has been set apart for laboratory purposes. This will supply a
�OF ASYLUMS OF MICHIGAN.
19
long felt want, and enable us to follow more closely the aims of the director of
the pathological laboratory.
No serious epidemics have visited the institution during the past year, and
but one incident has marred the uniform smoothness of operations in the
administration department. In June, the laundry was visited by fire. This
had its origin in the most vulnerable spot in all institutions of this character,
namely, the dry room. Before the flames were extinguished, the damage
wrought was sufficient to place the laundry almost completely out of commission, from which disastrous consequences we are but just now emerging.
Respectfully submitted,
E. A. CHRISTIAN,
Medical Superintendent.
UPPER PENINSULA HOSPITAL FOR THE INSANE,
Newberry, Michigan, July 16, 1908.
To the Joint Board of Trustees:
Gentlemen— I present you herewith a brief report concerning the movement
of population and other conditions existing at the Upper Peninsula Hospital
for the Insane, during the year ending June 30, 1908.
Men.
Women.
Total.
There were under treatment June 30, 1907
390
285
675
Admitted from July 1, 1907 to June 30, 1908-- - 109
65
174
Total number under treatment during the year
Discharged:
Recovered
Improved
Unimproved
Died
Total number under treatment June 30, 1908-
499
350
849
32
32
4
18
20
5
50
52
9
23
13
36
91
408
56
294
147
702
-
The above table shows a net increase in our population of twenty-seven
during the year. The total number of admissions is four less than during the
former year, while the discharges are twenty-three less. The deaths, thirty-six
in all, is a little more than four per cent of the whole number under treatment.
The majority of deaths were due to chronic diseases. Ten were due to
paresis. Five to general pulmonary tuberculosis. Seven to exhaustion
incident to their mental disease, and six to organic brain disease other than
paresis. Twelve patients have been deported during the year. Figuring the
number of recoveries on the number of first admissions, during the year, the
percentage is thirty-six and two-tenths per cent. I regret to report one death
from suicide. The cases of tuberculosis seem to have increased with us
during the past two years, and we are, at present, building a small tubercular
pavillion with canvas drop curtains for side walls. The buildings is connected
with our infirmary in such a way that, should the weather become too severe,
fhe beds may be run into the cottage. We have had a few cases of typhoid
tever, but, aside from this, we have been free from acute infectious diseases.
The medical work has been conducted along the same lines as last year.
�20
PROCEEDINGS OF TRUSTEES
Regular meetings of the medical staff have been held, and I believe the
insane are receiving much more individual attention than ever before. Quite a
number of improvements have been made; such as an extension to the green
house, also the erection of a milk house, and a hennery, placing burlap on the
walls of the cottages, and steel ceilings have been put up in various places.
Our per capita cost has exceeded our per capita income considerably, but
this is largely due to the almost total failure of our farm crops last year. From
the legislative appropriations of last year, we are erecting an administration
building, and a cottage. When these buildings are completed our capacity
will be increased by one hundred. We have at the present time thirty eight
patients over our normal capacity.
Respectfully submitted.
E. H. CAMPBELL,
Medical Superintendent.
NORTHERN MICHIGAN ASYLUM,
Traverse City, Mich., July 16, 1908.
To the Joint Board of Trustees.
Gentlemen:—The movement of population at the Northern Michigan Asylum
for the fiscal year just passed was as follows:
Men.
Women. Total.
Census June 30, 1907
Admitted during the year
Discharged:
Recovered-Improved
Unimproved-
Died
Census June 30, 1908
-- 709
597
1306
148
105
253
857
702
1559
21
21
14
26
28
8
47
49
22
62
42
104
118
739
104
598
222
1337
From this table it may be shown that three and a half per cent of the whole
number under treatment were discharged recovered, three per cent improved,
one and a half per cent unimproved, and six and six-tenths per cent died.
The death rate while large, was not so great as that of the previous year,
notwithstanding a goodly number of aged people and patients suffering from
organic diseases were received. The deaths from tuberculosis were seventeen
and three-tenths per cent of the deaths from all causes;—a decrease of three
and a half per cent over last year. On the male side, where isolation was
imperfect, there was an increase in tuberculosis cases;—on the women's side,
where provisions for isolation were more perfect, the number of deaths from
tuberculosis was only half as many as last year. It would not be fair to assume
that this lessened death rate was due solely to better isolation, but it may be
assumed that it was princpally due to this cause. In this connection I may say
that during the last two or three years the amount of draperies, carpets, etc., on
the wards has been lessened, believing that they harbored germs and that the
�OF ASYLUMS OF MICHIGAN
21
hospital would be more sanitary without them. It is possible that the absence
of these furnishings lessens, to a certain extent, the comfort of the patients,
but it certainly lessens the danger from infection from tuberculosis and other
germ diseases. On the men's side, during the last year, greater efforts than
ever have been made to isolate tuberculous cases. A part of Hall Six was set
apart for this purpose, and dishes of special coloring, and special bedding have
been furnished for the tuberculosis cases, that others could not be endangered
from the use of dishes or bedding used in the care of these patients. With the
instruction to the nurses, in the training school, relative to the care of tuberculous cases, a much better comprehension of the hygiene in the care of this
class of patients has been developed.
The financial statement of the receipts and disbursements of the institution
for the fiscal year has been placed in the hands of the Finance Committee.
The year just passed was a difficult one from a financial standpoint in some
ways. The cost of the up keep of the institution has been great, owing to the
fact that much of the heating plant had to be rebuilt, and the general repairs
were more than usual. The price of food supplies was higher than for years; but
if the cost of preparation of food is deducted, the cost per patient per day does
not much exceed the average of the last ten years. The change in the manner
of classifying accounts, which came into effect this year, makes exact comparison
of cost under separate ledger headings impossible; and it cannot be determined
exactly what the food stuffs cost per day in comparison with last year, since the
preparation and cost of foods are included in the same heading. I believe,
however, we may deduct three cents a day for preparation, which brings the
cost of food to about twelve and a half cents or thirteen cents per patient per
day. Greater stndy has been given to foods and their economic value than
ever before, and notwithstanding the high prices that have prevailed, neither
the quality nor the variety of food furnished to patients has been lessened, and
if anything the cooking has been better than in years gone by.
The general improvements have been great. At the greenhouse a new boiler
was installed. A portion of the greenhouse was destroyed by the falling of the
chimney during a tornado. This necessitated quite a large outlay. A large
percentage, however, of the cost of repairs has been' in connection with the
heating plant. The fact is, the entire heating system will have to be replaced
in the very near future.
During the year, a Stirling boiler, with automatic stoker, was installed, and
many changes effected in the boiler room. After the new boiler was installed
it was found that the hot-water pumps were too small, and consequently a new
pump had to be installed.
The extensions to the asylum are in process of construction. These
extensions have been designed with special reference to hospital purposes.
They will be provided with electric elevators,—with hydrotherapeutic rooms
and appliances,—with offices for stenographers and doctors, and with mortuary
rooms; in fact with every convenience of the up-to-date hospital. Separate
dining rooms are being constructed for each flat, on both the north and south
wings. By this means twelve dining rooms will be abandoned and converted
into dormitories. By these means the tranportation of food from the central
kitchen to the wards through cold corridors and elevators will be obviated. It
should be added that in these new buildings, diet kitchens will be Constructed,
so that special cooking may at all times be provided for the sick.
�22
PROCEEDINGS OF TRUSTEES
An additional section has been built to the greenhouse, and you are cordially
invited to inspect it as well as all other parts of the institution.
I would respectfully report that a training school for nurses has been carried
on successfully, and marks a step forward in the care of the insane at this
hospital. I may add that the medical work has improved in quality, and much
of the obscurity of mental diseases has been cleared away, thanks to better
clinical methods and researches of psychiatric clinics and laboratories throughout
the world.
In this connection I would like to present a few words concerning "The
New Asylum." It seems to me that the last year has been the turning point
in asylum methods, and marks the advent of the hospital for the insane, in the
broadest sense of the word, in contradistinction to the asylum for the insane as
it has existed for so many years. The day has passed when a nervous or mentally sick person can be placed in an asylum, and his feeding, nursing and medical
treatment carried out in a perfunctory routine manner. Everything that
pertains to the patients' welfare must receive constant supervision from trained
men and women, which adds comforts immensely to the patient, at less cost to
the public and with immensely increased prospects of recovery. To accomplish
this requires trained physicians, skilled nurses, pleasing environment, hygienic
surroundings and the best of foods scientifically prepared; and all these things
with reference to the highest good of the individual. If the individual patient
receives such care, then the mass of patients will receive such care.
I would speak a moment of the medical work. Here, as in all other lines of
human effort, progress has been slow, but to demonstrate that progress, and
progress of very great value, has been made in the knowledge of mental diseases,
one need only to compare the written records of patients of ten years ago with
those of today. With the advent of the laboratory, a new era commenced in
psychiatry, and a great stride forward was taken for the relief and cure of
mental and nervous conditions. Many of you can bear witness to the fact that
it was hard to break away from the traditions of years; from the routine path
that had been followed so long, and take the new road science was carving out.
I remember when striving for the establishment of a laboratory at this institution that the question was immediately propounded, and with much force,
whether laboratory methods and other research work would enable the hospital
to cure more patients. An affirmative answer could not be positively given; it
could only be stated more recoveries should result. It can now be positively
asserted that more patients are restored to a comfortable degree of health than
ever before. Our records show that the net gain in patients for the last two
years has been fourteen and a half patients per year,—for the previous twenty
years and a half the average yearly net gain was forty-six and a half, and for the
last preceding biennial period there was a net gain of seventy-five and a half
patients per year. The saving to the state on the basis of the difference in the
averages given for twenty years and a half and the last two years, at $180 per
patient, was $5,760 per year, and over the last preceding biennial period it was
$10,980 per year, or almost enough to pay the salaries of the medical staff. I
am pleased to state that the number of insane women has decreased in the
district during the last two years, and so far as I know there is no insane person
awaiting admission to the institution. It may be said that these results are
accidental, but if we take into consideration the fact that the admissions to the
institution have increased, it is only fair to assume that such results are due to
better work on the part of the hospital. These results are extremely stimulat-
�OF ASYLUMS OF MICHIGAN.
23
ing; and it is not believable that any one would seriously wish to hamper, or
abandon the work. I believe the value of the work will be still greatly enhanced
as time goes on. In addition to the methods in use, chemical pathology and
chemical research are beginning to take an important part in the diagnosis,
prognosis and treatment of many diseases, and they cannot be left out of
consideration in the work of the new asylum.
This new science promises brilliant results to the mentally afflicted. The
modern methods of the examination and treatment of patients, require much
more knowledge on the part of the physicians than formerly, and have led to
some changes in the mode of conducting the medical work. No attempt is
made to take the mental status of a case in longhand. The mental examination requires a stenographer, so that questions and answers may be recorded
verbatim. Anything less than verbatim reports of these examinations render
the work worthless from a scientific standpoint. Every physician on the staff
if not a shorthand writer himself, should be furnished a stenographer to assist
in his work and to write out the examinations. This has been done during
the last two years at this institution, with great advantage to the patients. It
has been stimulating to all of us to further and better efforts, and certainly
tends to increase our insight into the activities of the mind whether normal or
abnormal. This departure from the old way has been quite revolutionary. It
has led to the establishment on the hospital wards of an office for the examination of patients, and insures to every patient. not only a thorough examination immediately after admission, but it assures him of the friendship and
interest of the physicians in his recovery. These methods bring the staff in
very close relationship with the patients, brings out all that is best in them,
often enables the physician to give special direction to nurses, and often excites
a deep interest, in the patient himself, in the welfare of fellow-patients. The
trend at this hospital is to the establishment of regular hours of service for the
staff and for each physician to spend the time on the ward, or in the laboratory, as his work may necessitate. It is believed that in this way still better
results will be attained, and that our asylums will become hospitals: in fact
great centers for investigation and research work in psychiatry, and also centers
for instruction in mental and nervous diseases, that shall be open to physicians
and to all directly interested in the work.
The introduction of better clinical methods, and of the training school, has
brought about another important improvement in the institution, i.e., the
establishment of a domestic science department. The object of this department is not only to instruct nurses and others in the science of dietetics, but to
teach that intelligent, systematic supervision of the domestic duties in public
institutions means economy in the running expenses, and greater proficiency
in the performance of duty. It has already been found that this department
renders it possible to train workers to realize food values, to prepare wholesale
diet and serve it acceptably, and it has also taught that there are personaidiosyncrasies among the insane that must not be despised under any
circumstances. It has been found that the work already done has brought an
atmosphere of contentment among patients, and enthusiasm on the part of
employes; which is but the natural consequence of bringing these people into
touch with the achievements of scientific men and women by means of lectures,
bulletins, text books and other literature bearing on the science of not simply
nutrition, but hygienic living. We are quite sure that in this department
progress will be slow but certain, just as experience has taught that progress
�24
PROCEEDINGS OF TRUSTEES
has been slow in all lines of asylum improvement. Young men and women
are glad to learn the best there is to be taught. Such knowledge lessens the
drudgery in household duties, it will produce more faithful service in the institution, and it will tell in the sick-room; and further it will educate home makerst
which is another item of value to the state, for whatever elevates the home raise,
the standard of good citizenship. Every person, whether patient or attendans
or worker in any department of the institution, when he leaves it, carries with
him a better, a higher standard of good living as a result of his training in the
hospital. I believe the day has forever gone when coarse foods, unskilfully
prepared, will be furnished, or that men and women who are uneducated and
untrained, will be allowed to care for people who are bereft of any part of their
senses.
I believe from these few remarks that you will gain some idea at least of
what I mean by "The New Asylum."
All of which is respectfully submitted.
JAMES D. MUNSON.
Medical
Superintendent.
STATE ASYLUM, Ionia, Mich.
Hon. Joint Board in session,
Gentlemen: In addition to the report to the Finance Committee, I herewith
briefly summarize some items pertaining to the Institution for the fiscal year
ended June 30, 1908:
Number of patients in the Institution at close June 30, 1907: males, 298;
females, 49; total, 347. Number of patients in the institution at close of June
30, 1908: males 320; females, 54; total, 374. Number admitted during the
year, 46. Discharged during the year, as follows: by death, 7; not insane, 1;
recovered, 8; improved, 2; eloped, 1; total, 19.
T^egular Employes and Salaries Paid.
HOW EMPLOYED
NO. OF
Clerk and Bookkeeper
Assistant Clerk
Stenographer
Interne
Atts., Male (Total, 19)
Supervisor
Ward Attendant
Ward Attendant
Ward Attendants
Ward Attendant
Ward Attendants
Atts.,'Female (Total, 7)
Supervisoress
Ward Attendant
Ward Attendants
Ward Attendants
Seamstress
1
1
1
1
PER YEAR
RATE
PER MONTH
$1200 00
$35 00,
30 00'
60 00
1
1
1
5
1
9
60 00
35 00
32 00
30 00
28 00
26 00
1
1
2
2
1
35 00
30 00
20 00
18 00
16 00
PER DAY
�OF ASYLUMS OF MICHIGAN.
HOW EMPLOYED
NO. OF
PER YEAR
25
, RATE
PER MONTH.
Engineer
Fireman
Fireman
Carpenter
Painter
Launderer
Laundress
Laundress
Cook
Cook
Cook (Supt. Res.)
Housemaid (Supt. Res.)
Baker
Farmer
Assistant Farmer
Dairyman
Teamster
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Gardner
Nightwatchman
Nightwatchman
1
1
1
30 00
50 00
45 00
Nightwatchman
1
40 00
p£R DAy
$1000 00
40 00
35 00
$2 50
50 00
40 00
20 00
14 00
800 00
50 00
16 00
16 00
40 00
45 00
30 00
32 00
34 00
(Above taken from pay roll June 30, 1908, and shows less number attendants than average niontly pay roll.)
Total value of farm products for the fiscal year ending June 30, 1908, was
$6,641.33
O. R. LONG,
Medical Superintendent,
The report of Dr. C. R. Long was read by Trustee J. W. Belknap, who
added the following:
"During the past year we have made some improvements in our institution.
First, to our water system. Today we have wells with a flowage of thirty-three
gallons per minute. We have constructed a tank on the lower lands and we
force this water three thousand feet to a tank on the upland, and by gravity
we supply Our institution with water. We have put in during the past year a
refrigerating and ice plant, which I believe to be one of the most economical,
and best equipped of any institution in the country. It is capable of holding
all our meat, butter, eggs and all things necessary, at the proper temperature,
and is running smoothly without any expense except the electricity. Ten hours'
run of dynamo produces twenty-four hours of refrigeration. I invite an
inspection of the plant, and eventually I believe that all of our institutions will
be equipped in this manner. We are building this year a womans' building
from an appropriation of $40,000, and we are endeavoring to make it as near
fire proof as possible with wood floors. I believe our buildings of the future
should be fire proof and built for the future, not today. It is not economy to
build shabby buildings. I hope the buildings in the future will be built with a
view to permanency, and it will likewise be economy."
�26
PROCEEDINGS OF TRUSTEES
Chairman: Comments on the preceding papers are now in order.
No comments.
Chairman: The next order of business will be the report of committee on
paper of Trustee Vinton, by E. C. Smith, Secretary of Board of Stewards,
chairman.
EASTERN MICHIGAN ASYLUM,
Pontiac, Mich., July 16, 1908..
To the Joint 'Board of Trustees.
Gentlemen—The paper on asylum purchases presented by President Vinton
to the Joint Board in January and referred to the stewards with instructions to
report at this meeting, has been the principal subject of discussion at the two
quarterly meetings of the stewards since that time. Papers have been presented and carefully discussed, and even while inspecting the institutions where
the meetings where held, as it is customary for us to do, to compare prices and
qualities of commodities purchased, the chief subject of conversation was along
the lines of this paper.
While there are differences of opinion among the different stewards on some
of the questions raised by this paper, on others there is a remarkable unanimity.
On the question of a central purchasing agency- there seems to be but one
opinion, especially since the convention of purchasing agents of all the
institutions in the state held at Lansing upon the call of the governor, where
these matters were very thoroughly discussed. Mr. Clark, at the instance of
Governor Warner, had visited and inspected all the state institutions, especially
with regard to their business methods, and when the superintendents, and
purchasing agents were convened at Lansing we had the benefit of his
experience and opinions gained in these institutions. Both he, and Governor
Warner oppose a central purchasing agency, but all seem to favor an occasional
meeting, such as that held at Lansing, of all the purchasing agents for the
purpose of consultation and comparison of methods. This would be simply an
enlarged copy of the system for many years in use by the stewards of the four
larger asylums, of meeting quarterly.
The paper under discussion has been divided under ten headings, and the
views of each of us upon each of the ten subjects has been tabulated, and the
tabular statement is presented herewith.
There are some radical differences in the views of different individuals as to
the methods of providing beef, clothing, and some other items, also on the
question of the use of butterine; but since there is a law at present on the
statute book forbidding the institutions to use it, there is very little likelihood
that any Michigan legislature can be prevailed upon to repeal that law for a
long time.
�OF ASYLUMS OF MICHIGAN.
27
1 Is it better to purchase supplies in open market month by month or to make
contracts covering a long period?
MICHIGAN
ASYLUM
EASTERN ASYLLM
G e t quotations
on as many commodities as possible a n d g e t
them often; groceries, p r o v i sions, etc. every
month, B u t t e r
and E g g s every
Watch the markets closely, and
t a k e advantage
of favorable conditions; get bids
on coal only.
NORTHERN
ASYLUM
UPPER PENINSULA
HOSPITAL -
STATE PSYCHOPATHIC HOSPITAL
Would ask quotations and buy
on open market
when it would be
to the advantage
of the institution
to do so. Most
of the purchases
should be in
quantities for 3
months.
I believe it better to buy in
open market on
bids as far as pos
sible than by
contract with the
exception of coal
Contract for one
or two or three
months s u p p l y
after getting
competitive bids
2 What quality of meat ought Asylums to buy? Is it better to buy beef on the
hoof or dressed beef?
1
Buy young feeders and f a t t e n
them as rapidly
as possible.
Well meated not
too fat steers of
575 Ibs to 600 Ibs
Buy fat cattle
and slaughter, Or Would buy fat buy beef on hoof
buy dressed beef, cattleandslaugh- if r e a d y to kill
w h i c h e v e r i s t e r , when t o and near home.
cheapest. N o t an advantage to Would not be of
land enough to purchase in that advantage to us
to ship cattle in
fatten beef pro- form.
and feed' to fatfitably.
ten as is necessary at present.
Steers and Heifers of good quality more economical than cheaper
'
3 What quality of tea and coffee should we use?
Good quality, not
fancy. Same for
p a t i e n t s as for
officers and employes.
Good q u a l i t y .
Fix price and
have s a m p l e s
submitted at that
price; select the
best and buy it.
W o u l d always
get the best quality for the price.
We have found
a blend of our
own make the
best.
A good quality
but not a fancy
article for general use. Use a
better quality for
officers.
Fair grade which
will be consumed
not wasted, as it
will be if not
good.
4 What is the most economical kind of coal to use?
Smokeless -New
River, or Pocahontas.
C o n t r a c t for
units of heat and
pay according to
B. T. U. Calorimeter tests.
Quality of coal
must depend upon heating apparatus used.
We a r e using
traveling grates
or stokers and
can use a cheaper quality of coal
Owing to limited
e x p e r i e n c e in
coal burning can
not discuss this
intelligently.
Buy the coal that
will produce the
greatest number
of heat units to
the ton.
�28
PROCEEDINGS OF TRUSTEES
5 What ought to be done about lumber combine?
Has had no difficulty in obtaining p r i c e s on
lumber.
Dealers and
Manufacturers
bid all right, but
Pontiac bidders
are almost a l wavs lowest.
Have no difficulty in obtaining
fair p r i c e s on
l u m b e r , especially when t h e
Manufacturers
are s e e k i n g a
market.
Do not have this
difficulty.
If present laws
a r e insufficient
amend the laws.
'
6 Would an occasional meeting of Asylums Stewards with those of other Institutions be ol value?
Y e s . Meetings
should be held ; The recent meeta-t frequent in- mg at Lansing
t e r v a l s and a | was proof of its
general consul- being of value.
tation take place
Emphatically,
Yes. Has been
u r g i n g it for
some time.
Recent meeting
at Lansing called
by the Governor
demonstrates the
great benefit of
such meetings.
7 What are the advantages of our present system over a Central Board for all?
'Our present system seems to us I ha-;0 seen but
T ,. .
. _, ,
to be far better l i t t l e of
the
Buffalo ^,
,•
£ ^
Advantages too Visited
,
, ,
than any central workings of the
n u m e r o u s t o Asylum and the board <, an . b e . Centra? B o a r d
mention. H a s Steward pointed From
knowl_
svst
j saw a
v i s i t e d many out many defects edge of Jthe cen ^ b l a n k e t bought
States that have m the Central f r a l board by t h e MinnesoBoards of Con- ; B o a r d system. tem {n w j s
ta Board at $2.00
trol and they do Governor \\ar- Iowa and ^ y ; tha{ was QQt as
not get best re- ner is opposed to j wou](l m o s t ; , good asMichigan
sults.
Central system. ce rt a inlv fa v o r asylums w e r e
continuing the ' buyng for $1.75
system we have.
Mr. J . B. Clark
after v i s i t i n g
every Institution
says a Central
Board would not
be as economical
as the present
system.
8 What is the best method of providing clothing?
Jielievesitis better for each Institution to make
its own clothing.
Believesit is better to buy men's
suits and overcoats.
Believe it is better to buy suits
and overcoats in
the market, selecting those best
adapted for purposes for which
t h e y a r e purchased.
Make the men's
. ,
, . ^
as much of women's apparel as
possible.
Buy
men's suits, overcoats etc , ready
made.
Make it or buy it
whichever is
cheapest for the
taxpayers.
9 Should the law be changed allowing Institutions to use butterine?
No, does not believe in substitutes of any kind.
Yes; would use
it if the law allowed, and save
taxpayers thousands of dollars
yearly.
Must say no, as
in buying creamery b u t t e r we
know about what
we are buying.
Yes; would use
it if permitted
to; for cooking
purposes. Butter
for table use.
Yes; Mr. Vinton
has shown that
it would save the
t a x p a y e r s $40,
ooo a year.
�OF ASYLUMS OF MICHIGAN.
29
10 Suggestions relative to checking and auditing.
•
Likes the system
in use at Kalamazoo.
Have a system
of checking and
auditing in use
I-ikes the system at this institution
in nse at Pontiac many years and
believe it to answer our pu rpose well.
'
Our storekeeper
records in a book
the goods reed.
Billsare checked
and goods examined by steward.
The storekeeper
does not handle
t h e invoices.
Bills subject discount are vouchered and paid at
once. Other bills
approved by
Auditing Committee before being paid.
Advocates a uniform sv.stem of
c h e c k i n g and
auditing.
Very respectfully.
E. C. SMITH,
Secretary.
Chairman: The next order of business will be a report of committee on
papers of Trustee Cook and Wash burn, by Trustee Vinton.
Mrr. Chairman, Members of the Joint Board, Ladies and Gentlemen:
At the January meeting of the board we listened to some very important
papers, and Dr. Christian, in accordance with his often expressed opinion that
the excellent papers read before this board, in the past, had not been fully
digested and appreciated, made the following motion which was unanimously
adopted: "I move that the papers of Trustee Cook and Trustee Washburn
be referred to a committee of trustees which will report back to this board at
the next meeting, what action, if necessary, shall be taken on these papers."—
The chairman appointed to act on this committee: Trustees Vinton, C. E.
Belknap, J. W. Belknap, Quaintance and Case. Your committee has carefully considered these papers and believe that the paper read by Trustee Washburn, last January, and omitted from the printed reports of that meeting,
should be printed in the report of the July meeting of the joint board, and this
committee especially commands the attention of the board to the paragraph
referring (1) to the building of permanent structures, (2) the beautifying'and
improving of the grounds and (3) some sort of a club or library, etc., for the
attendants; and this committee recommends that all permanent buildings in
the f u t u r e should be of fire proof construction, that everything possible should
be done to improve and beautify the grounds, and that the board of each asylum
should do more for the amusement and recreation of the attendants.
Trustee Cook's paper we have taken up in detail. He says:
"Having the power to fix the rate of maintenance, how should we exercise
it? The law of 1905 attempted to lay down a method. As far as it applied to
the improvement and repair account, the Legislature undoubtedly intended to
extend our authority so that we would not have to get special appropriations for
�30
PROCEEDINGS OF TRUSTEES
many small items which, it was thought, we would not charge to maintenance
account. Under that law we are allowed to make and charge to maintanance
all such improvements to buildings as do not amount to a new structure.
The authority given us to make repairs and improvements is very general.
We should all act under the authority, or we should all limit the authority to
the keeping of our buildings in repair as they are and go the Legislature for any
betterments to the plants, a position that the Legislature did not want us to take
or they would not have passed the law of 1905.
I am of the opinion that we
should make all improvements we can under the law and charge to improvement and repair account, and see to it that the rate of maintenance provides for
it."
This committee believes that every member of the joint board will realize the
importance and justice of this idea, and all boards act according to the above
suggestion.
He says: "To bring about uniformity it might be best to have the Insanity
law so amended that all requests for appropriations be passed on by the joint
board before being submitted to the Legislature. The trustees of the joint
board would certainly be qualified to act intelligently. They would refuse to
recommend appropriations when the expenditure should come from one of the
current funds, and the refusal would likely defeat the request.
If the joint board was directed to act on all of the appropriations and either
recommend or withhold its recommendation we could get the one advantage
that a single board of control would have, that is the limitation of the appropriations for additional room to the wants of the entire state, and the keeping
within reasonable limits other requests."
This committee is in sympathy with this suggestion, but feels that the board
of corrections and chatities now has general supervision ofQappropriations, and
further action by this board would only complicate the method of getting such
appropriations. The committee recommends that each board ask for only what
they absolutely need and be able to prove such need.
Mr. Cook says: "Returning to the subject of fixing the rate of maintenance.
The trustees, heretofore have not considered carefully the amount of cash on
hand the statements should show an June 30, of each year. When one of the
members of your finance committee attempted to persuade the governor and
the state board of auditors that we should be allowed forty-nine cents per day,
the statement came out very quickly that the institution he represented could
run at a loss of a cent a day and still have a good working balance, and the
statement was true.
"June 30 is not, in my opinion, the best day on which to estimate what the
cash balance should be. It is often thought best tojfill up the coal bins in the
fall and early winter to provide against blockades of any kind, and certain of the
food supplies are purchased in the fall for the winter and spring use. Our
asylum books always show that under normal conditions our per capita cash
outlay is larger the first six months. To determine then what the lowest cash
balance should be I would say that on December 31st there should be enough
cash in the treasury to meet the pay roll due January 1st, if the payment is to be
made before the 7th. If the pay roll is paid before the 1st, it should not be considered. Add to that amount such a sum as will pay all outstanding bills on
which there is a discount which must be taken advantage of before the 10th of
the month and you have all that you should have. Any monies that you have
above such a total first benefits your banks, and second the institution to the
�OF ASYLUMS OF MICHIGAN
31
amount of interest the banker pays. Such benefits would hardly justify the
accumulating of a large working balance."
Your committee believes that the exact application of this idea would be impracticable and that each institution should have a cash balance on hand January 1, to carry on the business and take care of emergencies such as we have
met in the high prices of the past year. The cash balance on hand should be
enough to pay pay rolls and all bills for a month provided the state pays the institutions monthly or enough to pay the same items for a quarter, if the state
pays the institution quarterly, and in addition to these sums, cash balances on
hand should include five per cent, of the total expenses of the year to provide
for a rise in prices or other emergencies.
Mr. Cook says: "Our yearly financial statement perhaps should have a little
notice before I close. These statements have ever been a source of annoyance.
As chairman of your finance committee I have given much thought on the subject and have assisted in getting out blanks which I thought would provide for
sufficient data to enable the committee to make a close estimate on the per
capita cost of several institutions. The old form we know did not. When
they were in use, an institution could by increasing or decreasing supplies near
the end of the year and by holding out or anticipating bills, make the per diem
show very near the fixed rate. The printed reports did net show the net cost.
Under the new form I think we have arrived at more accurate results but yet
not entirely satisfactory. There has not been a year, since we changed the
form that all the asylums have made their reports to conform therewith.
Whether the bookkeeper in making the report could not understand the blank
or thought it was of little account, I am unable to say. The repeated action
of the board directing that they should be filled out seems to have been of no
avail.
"I realize that with the reports properly made it is impossible to get an
accurate balance from which we could figure the exact cost of maintaining a
patient. To some extent we are obliged to rely on annual inventories of supplies and materials on hand. The inventories are made by different persons
and in a different way. There is always some loss and there are some profits.
The estimating of these will vary somewhat. But allow all those slight variations, yet the report should be near enough to use as a basis in fixing the
rate.
"The form of the report doubtless can be improved upon and the finance
committe would gladly receive suggestions to that end. It is important, however, that whatever form is sent out by the finance committee should be fully
and accurately filled out. If there are any deductions to be made not provided
for or qualifications to be considered let them be in a supplementary report."
Your committee believes that the finance committee has achieved admirable
results in the new form of statements and that each institution should fill out
the accepted form of blanks in exactly the same manner. We recommend
that in order that this matter should be fully understood and that all figures
should be made on the same basis, the finance committee send an expert
accountant to all the institutions or that the accountants of all the institutions
meet with the finance committee soon, on a date to be set by the chairman of
the finance committee, for instruction and consultation. The finance committee
to be empowered to make any necessary changes and put them into immediate
effect.
�32
PROCEEDINGS OF TRUSTEES
Your committee earnestly recommends the serious consideration of these
matters by the joint board.
G. Jay Vinton.
Chairman..
J. W. Belknap.
M. F. Quaintance.
Fred S. Case.
Committee.
Chairman: The report will be accepted if there are no objections.
Trustee Mills: I move that the recommendations contained in the paper be
adopted. Motion supported and carried.
Chairman: It will be next in order to fix the rate of maintenance for the
ensuing year. We will hear from the finance committee.
Trustee Cook: The finance committee had a lengthy session last evening
and compared the cost of maintenance at the different institutions and found it
to be as follows:—Kalamazoo 48.01 cents, Pontiac 51.77 cents, Traverse City
50.93 cents, Newbury 54.25 cents; and Ionia including the officers' salaries
50.81 cents. Your finance committee by unanimous vote recommend that
the rate of maintenance for the asylnms of the lower peninsula be fixed at
fifty cents per day, and in addition thereto the cost of clothing, expense of
returning patients home and elopement expenses; and for the upper peninsula
hospital for the insane that the rate be fifty-two cents per day, and in addition
thereto the cost of clothing, expense of returning patients home and elopement
expenses.
Trustee Mills: I move that the report of the finance committee be adopted,
and that the secretary of the joint board be directed to notify the governor of
said action, as required by law. Motion supported and carried.
Chairman: The next order of business will be the reports of committees.
The first is the Committee on the Psychopathic Hospital with Trustee Cook as
chairman.
Trustee Cook: I was not aware that there was any report due from the
Psychopathic Board at this time. Originally the report was made by a joint
committee, and then I think the committee reported from one meeting of the
Joint Board to another. Under the new law they are elected for one year,
and I think a report is not due from that board until the end of the year. Dr.
Barrett is not present today on account of his absence from the country. I
wish to express my appreciation for the kindly reference made to the work in
the Superintendents' reports.
Chairman: The next committee is on Uniformity of Classification of official
reports, Dr. E. A. Christian, chairman.
Dr. Christian: This Committee has already reported to the Joint Board the
adoption of one table. No further progress has been made in the matter, owing
to the absence of the Director of the Psychopathic Ward, who is now in
Europe. The committee will have to be continued. The committee has one
suggestion: We note there is a scarcity of copies of the report allowed each
institution by statute. Five hundred copies go to each institution. The
number of institutions for the insane in the country is steadily increasing, which
calls for a larger exchange list. There are over two hundred institutions in the
country now that we wish to exchange with, besides there are many individuals
who are interested along these lines, libraries and organizations of various kinds,
who desire the report. We feel that each institution should be allowed a
�OF ASYLUMS OF MICHIGAN
33
sufficient number to distribute to the employes, especially those of long service.
We therefore request of the Joint Board that this matter be considered with a
view to securing an amendment to the statute which will allow a larger number of the reports so each institution.
Chairman: The report will be referred to the Committee on Legislation.
The Committee on legislation will bear in mind the suggestion made by Dr.
Christian, and take the matter up at the proper time.
Chairman: The next will be a report from the Committee on Legislation, •
Trustee A. J. Mills, chairman.
Trustee Mills stated that there was nothing to report at this time.
Chairman: The next in order is miscellaneous business, At this time we
shall fix the salaries of the officers. The secretary will please call the roll of the
asylums, and the reports will be made. ,
The chairmen of the various asylums presented the following salary tables
for officers for the ensuing year:
MICHIGAN ASYLUM.
Medical superintendent Assistant medical superintendent
First assistant physician
Second assistant physician - -- —
Third assistant physician
Fourth assistant physician-Woman physician
Steward
Chaplain.. ..
....
—
$3,500.00 with maintenance
2,000.00
- - - 1,800.00
1,800.00
- - 1,300.00
800.00 "•
800.00 "
2,500.00 without
250.00 non-resident
EASTERN MICHIGAN ASYLUM.'
Medical superintendent —
Assistant superintendent First assistant physician--•
Second assistant physician
Third assistant physician
Fourth assistant physician
Woman physician-—
Steward - - -'
Chaplain $5.00 for each service.
— —
-•--
Non-resident
$3,500.00 with maintenance
, 2,000.00
1,200.00
1,000.00
800.00
700.00
900.00
1,800.00 without
.
UPPER PENINSULA HOSPITAL FOR THE INSANE.
Medical superintendent - —
Assistant superintendent —
Assistant physician
Assistant physician (Woman)
Steward
Chaplain
-
$3,000.00 with maintenance
1,800.00
1,000.00
1,000.00
1,800.00 without
260.00 non-resident
NORTHERN MICHIGAN ASYLUM.
Medical Superintendent
Assistant superintendent
-First assistant physician
Second assistant physician (Woman)
$3,500.00 with maintenance
2,800.00 without
1,600.00 with
1,200.00
�34
PROCEEDINGS OF TRUSTEES
Third assistant physician
Fourth assistant physician
Fifth assistant physician
Steward
Chaplain
1,200.00
1,200.00
800.00
1,800.00
260.00
with maintenance
without
with
without
non-resident
Report accepted and placed on file.
Moved and carried that the officer's salaties of the several asylums be approved
as presented.
Trustee Mills: At this time and under this head, I submit the following for
consideration of the board, and move its adoption: That it is the sense of
this board that the words "Asylum for the Insane," as applied to the Michigan
Asylum, State Asylum, Eastern Michigan Asylums, and Nothern Michigan
Asylum be dropped; that the words "Hospital for Mental and Nervous
Diseases," be substituted; and in regard to the Upper Peninsula Hospital for
the Insane, that the words "For the Insane," be dropped and that the words
"For Mental and Nervous Diseases," be substituted. And that the Legislature be asked to sanction this change, in order to get rid of the words "Insane
Asylum."
Dr. Noble: To make it more brief, how would it be to leave out the words
"For Mental and Nervous Diseases?"
Dr. Christian: I think we have got to come to this in time. I believe in
natural response to public s e n t i m e n t we have got to adopt the word
"Hospital." I think the change should come with little hinderance to our
bookkeeping, etc., and I sanction Dr. Noble's suggestion. I would like to see
a system adopted like that in use in New York state. Why not in speaking of
the Kalamazoo Asylum, say the Kalamazoo State Hospital, or the Pontiac
State Hospital, etc.
Trustee Mills: I think that is a good suggestion.
Trustee Voorheis: Would that name be at all misleading to people? It
would be a state hospital, but would not the people think it was for other
things than mental and nervous diseases,—otherwise I think the abbreviation is
all right.
Trustee Mills: I move that this be referred to the committee on legislation for report at the next meeting. Motion supported and carried.
Trustee Vinton: I ask that the legislative committe be allowed to introduce
a law whereby any part of the minutes or any important papers of the joint
board may be printed. Motion supported and carried.
Trustee Mills: I move t h a t the committees of the joint board be
continued. Motion supported and carried.
Trustee J. W. Belknap: In behalf of the management of the state asylum,
I would invite the joint board to meet with us at the January meeting.
Chairman: You have heard the invitation as presented to the board.
What is your pleasure?
Trustee Mills: I move that it be accepted. Motion supported and carried.
There being no futher business to come before the joint board the meeting
adjourned.
A. S. ROWLEY,
Secretary.
�OF ASYLUMS OF MICHIGAN
35
TRAVERSE CITY, MICH.
To the Honorable Fred M. Warner, Governor:
You are hereby respectfully notified that at the meeting of the Joint Board
of Trustees of the several asylums for the insane, of this state, held at the
Northern Michigan Asylums for the Insane pursuant to law, on the sixteenth
day of July, inst., the rate of maintenance for the ensuing year was fixed as
follows:
For the asylums of the lower peninsula the rate fixed is fifty cents ($.50)
per day, and the charge per week perscribed is three dollars and fifty cents
($3.50), and in addition thereto the cost of clothing, elopement expenses and
expenses of returning patients home.
The rate for the Upper Peninsula Hospital for the Insane was fixed at fiftytwo cents ($.52) per day, and the charge per week prescribed is three dollars
and sixty-four cents ($3.64), and in addition thereto the cost of clothing,
elopement expenses and expenses of returning patients home.
And the Secretary was directed to notify you thereof as required by law, and
this notice is given in accordance therewith.
Dated July 16, 1908.
A. S. ROWLEY,
Secretary.
STATE OF MICHIGAN,
COUNTY OF GRAND TRAVERSE
A. S. Rowley, being sworn, says that on the 16th day of July, 1908, he
served Hon. Fred M. Warner, as governor of the State of Michigan, a notice of
which that hereto attached is a true copy, delivering the same to him personally
at the Northern Michigan Asylum for the Insane on said day.
A. S. ROWLEY
Subscribed and sworn to before me this sixteenth day of July,
1908.
A. L. WHITNEY,
Notary Public.
�
asylums
-
https://localhistory.tadl.org/files/original/0cb746c9de17ff779f599e0555d9df27.pdf
c72a6012e872137dcb635b677dc8170e
Dublin Core
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Title
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Traverse City State Hospital
Subject
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Asylums.
Psychiatric hospitals.
Description
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Items within this collection pertain to the Traverse City State Hospital, also known as the Northern Michigan Asylum for the Insane and the Traverse City Regional Psychiatric Hospital.
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Amy Barritt, 1984-
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Original documents held by the Traverse Area District Library.
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Various.
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1885-1989
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Board of Trustees for the Traverse City State Hospital.
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English.
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TCSH-xxxx.
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Traverse City, Grand Traverse County, Michigan.
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Sixth biennial report of the Board of Trustees of the State Psychopathic Hospital at the University of Michigan for the Biennial Period ending June 30, 1918
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Psychiatric hospitals.
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Fifth biennial report of the Board of Trustees of the State Psychopathic Hospital at the University of Michigan for the Biennial Period ending June 30, 1916. Delivered to the State Legislature. Trustees again brought to the attention of the Legislature the inadequate facilities provided for the work of the hospital, in both size and arrangement of buildings. Due to the First World War, a cooperative agreement with the Surgeon General of the Army led to the instruction of officers of the Medical Corps of the Army beginning in June 1917. An additional cooperative agreement with the State Board of Health led to the extension of the out-patient ward, to examine women for mental disorders who might come under the care of the State Board for the spread of venereal diseases. Reports by the medical director and treasurer included.
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Board of Trustees, State Psychopathic Hospital at the University of Michigan.
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Original document held by Traverse Area District Library.
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Fort Wayne, IN: Fort Wayne Printing Company, Contractors for Michigan State Printing and Binding.
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1919
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State of Michigan.
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See other reports from the Board of Trustees at various institutions in the "Traverse City State Hospital" Digital Collection.
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Ann Arbor, Washtenaw County, Michigan
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SIXTH BIENNIAL REPORT
OF THE
BOARD OF TRUSTEES
OF THE
State Psychopathic Hospital
AT THE
UNIVERSITY OF MICHIGAN
FOR THE
BIENNIAL PERIOD ENDING JUNE 30, 1918.
BY AUTHORITY
FORT
WAYNE PRINTING COMPANY
CONTRACTORS FOR MICHIGAN STATE PRINTING AND BINDING
FORT WAYNE, INDIANA
1919
��OFFICERS OF THE STATE PSYCHOPATHIC HOSPITAL.
TRUSTEES.
Chauncey F. Cook
Fred S. Case
Dr. Walter H. Sawyer
Wm. L. Clements
Benjamin S. Hanchett
Frank B. Leland
Albert C. Stevenson
William Lloyd
Hillsdale
-. . . Sault Ste. Marie
Hillsdale
Bay City
Grand Rapids
Detroit
Port Huron
Manistee
OFFICERS.
Albert M. Barrett, A. B., M. D
Arnold L. Jacoby (absent on leave)
Bertrand L. Jones, A. M., M. D
Raymond F. .Wafer, M. D
James M. Stanton, M. D
Robert G. Greve
Adeline E. Gurd, M. D
Sobei Ide, M. D
Agnes Tennant, R. N
Medical Director
First Assistant Physician
Acting First Assistant Physician
Second Assistant Physician
Resident Physician
Business Officer
Pathologist
Serologist
Head Nurse
�REPORT OF TRUSTEES.
To ilie Legislature of the State of Michigan:
The Board of Trustees of the State Psychopathic Hospital at the
University of Michigan has the honor of submitting the following report.
The membership of the Board continues the same excepting that
M. F. Quaintance, member from the Board of Trustees of the Traverse
City State Hospital, has been succeeded by William Lloyd, from the
same Board, and Albert E. Stevenson has succeeded Dr. Stewart Galbraith
from the Board of Trustees of the Pontiac State Hospital.
Meetings of the Board of Trustees have been held at intervals at the
Hospital and the Trustees have maintained an active interest in the
work of the institution. Detailed statements of the medical work of
the hospital and its business administration are given in accompanying
reports of the Medical Director, the Business Officer and the Treasurer
of the Hospital.
The number of patients treated during the period was 538 as against
510 of the previous period. There continues, as in other years, a greater
demand for the admission of patients than the capacity of the hospital
can accommodate.
The Board of Trustees must again bring to the attention of the Legislature the inadequate facilities, both in size and arrangements that have
been provided for the hospital. Many patients for whom the Hospital
might do much by treatment must be refused admission. The progressive development of the medical, research, and teaching work of the
hospital has reached a point where no further extensions are possible,
until more space is provided.
The pressing needs of the Hospital can only be met by the erection of
a new building. It is hoped that the public may become more familiar
with the important service the Hospital is giving to the State and that
adequate provision for the work will be made at an early date.
The average per capita cost for the maintenance of patients during
the period was $1.34 per diem.
The per diem cost for the entire hospital administration, including
salaries, current expenses of the laboratory and repairs and improvements was $2.16. The increase of the per diem costs over that of previous years is accounted for by the increased cost of supplies and extensions
of the medical work of the hospital.
The out-patient services of the hospital located in Detroit and Ann
Arbor have become most important features of the work of the hospital.
During the past period they have treated a far larger number of patients
than in previous years, and through these agencies the influence of the
hospital throughout the State has been greatly extended.
�6
STATE OF MICHIGAN.
In cooperation with the State Board of Health, the trustees have
approved an extension of the out-patient ward of the hospital to aid
in the examinations for mental disorders of women who might come
under their care in connection with the efforts of the Board of Health
against the spread of venereal diseases.
The War has presented to the Psychopathic Hospital opportunities
for helpful service to the Government. At the request of the Surgeon
General of the Army the trustees have gladly offered the facilities of the
hospital for instruction of officers of the Medical Corps of the Army who
were to be assigned to the care of mental and nervous disorders in the
Army. Courses of instruction began in June 1917 and have continued
through the period.
Signed:
CHAUNCEY F. COOK,
WALTER H. SAWYER,
FRED S. CASE,
WM. L. CLEMENTS,
BENJ. S. HANCHETT,
FRANK B. LELAND,
ALBERT C. STEVENSON,
WILLIAM LLOYD.
�PSYCHOPATHIC HOSPITAL.
ORGANIZATION.
The State Psychopathic Hospital of the University of Michigan was
established in 1901. Its purposes are defined by legislative statutes of
1907, as follows:
Act 278, Public Acts 1907, Sec. 15—Patients admitted to the Psychopathic Hospital are divided into two classes:
First: Public patients are such as are kept and maintained by the
State.
Second: Private patients are such as are kept and maintained without
expense to the State.
Sec. 17.—Patients may be admitted to the Psychopathic Hospital
at the University of Michigan in accordance with the following provisions :
First: Persons adjudged insane according to the provisions of act two
hundred seventeen, sections fifteen and sixteen, public acts of nineteen
hundred three, may be committed to the Psychopathic Hospital at the
University of Michigan, whenever, in the opinion of the judge of probate,
it may be deemed advisable: Provided, That before such patient be sent
to said hospital, he shall obtain the approval of the director of the Psychopathic Hospital for such action. But, if an insane patient committed
to the Psychopathic Hospital cannot be received because of lack of room,
he shall be committed to the proper asylum in the district in which he
resides and receive treatment until there is room for him at the Psychopathic Hospital, and if it appears in the course of his treatment in such
asylum that he would not probably be benefited by treatment at the
Psychopathic Hospital, he shall remain at said asylum. In all orders
made by the judge of probate for the admission of an insane person to
the Psychopathic Hospital at the University of Michigan, it shall be
specified that in case such patient shall not recover after a satisfactory
period of observation and treatment, or whenever, in the opinion of the
director of the Psychopathic Hospital at the University of Michigan,
further residence in said hospital is inadvisable, such patient shall be
transferred to the asylum in the district of which said patient was a
legal resident or to such other asylum as the judge of probate may designate in such order of committal: Provided, That whenever an insane
person is to be so transferred, due notice of such transfer shall be given
to the judge of probate and the person making application for such
admission and to the superintendent of the asylum to which such patient
is to be transferred.
Second: When, in accordance with section sixteen, act two hundred
seventeen, public acts of nineteen hundred three, in the hearing as to
the insanity of a person, it may seem advisable to the court, that on
account of doubt as to the sanity or insanity of a person, or if in the
opinion of the court, a permanent order of insanity is inadvisable, or if
in the opinion of the court and examining physicians, the case presents
complicating diseases which may be treated by the clinical physicians
�8
STATE'OP MICHIGAN.
in the general hospital of the University, and by such treatment their
mental or nervous disability be cured or benefited, the court may continue said hearing in said court not to exceed thirty-five days, and direct
that such person shall be sent to the Psychopathic Hospital at the University of Michigan, as a public or private patient, as a person afflicted
with some nervous or mental disease and that said person be there confined, observed and treated for a period not longer than thirty-five days.
Before the expiration of this period the director of the Psychopathic
Hospital shall return to the judge of probate the results of his observation
and treatment of said patient, and an opinion stating whether said patient,
is insane or sane. If observation has shown that the patient is insane, then
the court shall notify said patient, the relatives and the person making
the application for said admission to the asylum, and may pass judgment
of insanity and order that said person to be confined as an insane patient
in the Psychopathic Hospital at the University of Michigan, or in the
State asylum for the insane in the district of which said patient is a legal
resident, or in such other asylum for the insane in the State of Michigan
as may seem advisable; and it sha'l thereupon be further ordered that said
patient be transferred to the State asylum for the insane of the district
of which said patient was a legal resident, or to such asylum as said
judge of probate may designate, when in the opinion of the director of
the Psychopathic Hospital further residence in said hospital would not
result in recovery or would be inadvisable: Provided, That whenever
an insane patient is to be transferred to an asylum in accordance with such
provision, due notice of the intention of such transfer shall be given to
the judge of probate, the person making application for the admission
of said patient into an asylum, and the superintendent of the State asylum
for the insane, to which said patient is to be transferred. If the results
of the observation of said person show that, in the opinion of the director
of the Psychopathic Hospital, said person is not insane, then the order
for confinement, observation and treatment shall be vacated and the
patient discharged from the Psychopathic Hospital.
Third: Persons who are residents of the State of Michigan, who are
afflicted mentally, or with serious nervous disorder, but who are not
insane, nor been legally adjudged insane, may be admitted to the Psychopathic Hospital at the University of Michigan as voluntary patients,
either at the discretion of the director of said hospital, or in accordance
with the statutes providing for the admission of voluntary patients to
the Michigan State Asylums for the insane. Such voluntary patients,
when so received, shall be subject to the general rules and regulations
of the Psychopathic Hospital. All voluntary patients shall be supported
without expense to the State, and the amount agreed upon for the maintenance of such voluntary patients in the Psychopathic Hospital shall
be secured by a properly executed bond to be approved by the medical
director, and there shall be made such advance payments as may be
required by the action of the board of trustees of the Psychopathic
Hospital at the University of Michigan, and bills for their maintenance
shall be collected monthly. Voluntary patients so received may be
discharged at any time by the medical director, and in case any voluntary
patient in the Psychopathic Hospital at the University of Michigan
is believed to be insane, the proceedings shall be carried out as provided
for such contingency by act two hundred seventeen, section twentynine, public acts of nineteen hundred three;
�PSYCHOPATHIC HOSPITAL.
9
Fourth: In case the superintendent of any one of the asylums for the
insane in the State of Michigan shall be of the opinion that the condition
of mind of any person who is confined in such asylum may be benefited
by residence and treatment at the Psychopathic Hospital at the University
of Michigan, he may cause said patient to be conveyed to said hospital,
and, in case said patient, while there confined, shall be restored to sanity,
such patient shall be discharged; but, in case such patient shall be found
incurable, such patient may be returned to the asylum from which said
patient was received, or may be discharged or paroled from the Psychopathic Hospital by its director, with the consent of the superintendent
of the asylum from which such patient was received. Whenever, in
accordance with the above provisions, a patient shall be transferred
from any asylum to the Psychopathic Hospital, the superintendent of
such asylum shall notify the guardian, if any, of such patient and the
judge of probate of the county of which such patient was a resident, and
when said patient is discharged, paroled or returned to the asylum from
which said patient was received, the director of the Psychopathic Hospital
shall inform said guardian, if any, and the judge of probate, before taking
such action.
Voluntary patients may be admitted at public expense in accordance
with Public Acts 1915, Act 27. The hospital may admit
any
resident of this State who is desirous of submitting himself to treatment
as a patient, and who makes written application therefor, and whose
mental condition is such as to render him competent to make such application: Provided, The approval of the judge of probate of the country in
which such person resides shall be obtained in writing and such person
shall not be detained for more than three days after having given notice
in writing of his intention or desire to leave such institution. The rate
of charge for insane patients, and the rules for admission of insane patients
so far as not inconsistent, shall apply to such voluntary patients.
Section 21. Par 2, Any insane patient of the Psychopathic Hospital
may be transferred to the State Asylum for the Insane in the district
of which said patient was a legal resident, or to such asylum as the judge
of probate may' designate in his order of admission, whenever, after a
satisfactory period of observation and treatment, it is found that said
patient is incurable, or that further confinement in the Psychopathic
Hospital at the University of Michigan is inadvisable: Provided, That
whenever an insane person is to be transferred, due notice of such transfer
shall be given to the judge of probate, and to the person making the
application for the admission of said patient to an asylum, and to the
superintendent of the asylum to which patient is to be transferred.
�10
STATE OF MICHIGAN.
REPORT OF THE MEDICAL DIRECTOR.
In accordance with the statutes of this State, I have the honor of submitting to the legislature of the State of Michigan my report as Medical
Director of the State Psychopathic Hospital covering its sixth Biennial
Period.
During this period the general policy of the operation of the hospital
has continued along much the same lines as previously. In common
with all institutions the hospital has felt the influence of the situation
brought about by the war. The problem of maintaining former standards
has been difficult. In addition to this the hospital was called upon to do
special work in connection with the instruction of medical officers of the
army.
The hospital has treated a somewhat larger number of patients than
in any previous period. It is not to be expected that any marked increase
in the number treated can occur until the capacity of the hospital is
increased. Under present conditions there is always a waiting list of
patients desiring admission as soon as vacancies occur. It would be
possible to increase the admissions if it were possible to make transfers
of patients, whose problems are custodial, more rapidly to the State
Hospitals. The greater number of admissions are from the eastern part
of the State and the present crowded condition of the Pontiac State
Hospital offers far fewer opportunities for transfer than could be utilized.
In spite of the clear definition in the statutes of the State, as to the
field of work of this hospital, it is found difficult to adhere to these owing
to the great pressure that is continually present for the admission of
patients. Friends of patients and committing authorities are not able
or willing to recognize the unsuitability of many patients for admission
to this hospital. The desire to keep the hospital filled to its capacity
and to be of as much service to the State as possible results in the admission
of many patients quite unsuited to the purposes and facilities of the
hospital.
CLINICAL AND LABORATORY WORK.
A detailed account of the clinical work is given in another section.
The foundation of the clinical work is the routine intensive study of
each patient's personal history and the clinical manifestations of his
disorder. The results of these are presented at frequent conferences of
the medical staff.
The activities of the laboratory have chiefly been centered in the
intensive study of the nervous system of patients, whose clinical course
has been well studied. A tabulation of this work is given in another
section.
�PSYCHOPATHIC HOSPITAL.
11
SOCIAL SERVICE.
During the period the hospital added to its staff a worker trained in
the social aspects of mental disorders. It thus became possible to undertake a more thorough study of the social relations of patients in their
pre-institutional life, and to keep in touch with their progress after
discharge.
A systematic study was made of the after life of a large number of
patients who had been discharged from the hospital in the earlier, years
of its existence. The results of this will be published during the coming
year.
MEDICAL INSTKUCTION.
In this work the hospital has one of its most interesting and usefu
activities. The instruction of former years has already shown results
among medical practitioners, especially those who have gone out from
the Medical School of the University within recent years. There is
a more widespread interest in psychiatry and the standards of medical
examinations for hospital commitment have improved.
At the present time students of the fourth year medical class receive
45 hours of clinical lectures on psychiatric medicine and 16 hours of
practical work at the bedside.
MILITARY MEDICAL WORK.
Soon after the beginning of the war the Surgeon General of the Army
requested that certain hospitals devoted to mental and nervous disorders
should arrange courses of instruction in neuro-psychiatry. To these
would be assigned- for intensive training medical officers, who would
later on be given charge of the care and treatment of mental and nervous
disorders in the medical organization of the army. The hospitals so
selected to do this were: The Henry Phipps Psychiatric Clinic at Baltimore, The Government Hospital for the Insane at Washington, The New
York Neurological Institute, The Philadelphia General Hospital, and the
Psychopathic Hospital at Ann Arbor.
The Medical Director of this hospital was appointed Military Director
of the hospital and in cooperation with Professor Camp of the Department of Nervous Diseases of-the University, Professor Slocum of the
Department of Ophthalmology, and Dr. Furstenberg of the Department
of Otology, a course of instruction was conducted.
This work has continued through the last year of the period. In all
79 officers have been in attendance remaining for instruction from 4
to 6 weeks.
OUT-PATIENT SERVICES.
This work which had its beginning during the preceding period has
been greatly extended during this. The hospital now conducts two
services for out-patients. One, locally in connection with the medical
work of the General Hospital of the University, examined during the
period 407 patients; and one in Detroit examined and gave advice to 978
�12
STATE OF MICHIGAN.
patients during the period. This latter service known as the Wayne
County Psychopathic Clinic, Wayne County Out-Patient Service of the
State Psychopathic Hospital, was organized in 1916. This service is
located in rooms in the Wayne County Juvenile Court Building in Detroit.
Its work is conducted by a trained psychologist and a social service
worker. It is supervised by the State Psychopathic Hospital. At intervals
a physician of this hospital attends the clinic and gives advice to such
cases as have been referred from the regular routine work of the clinic.
The financial support of the clinic is provided in part by Wayne County
public funds and in part by ph lanthropic individuals of Detroit.
Since the beginning of the war the Michigan State Board of Health
has been active in systematic efforts to prevent the spread of venereal
diseases among the soldiers in mobilization camps. In carrying this out,
women who were found to be infected were interned in hospitals for
treatment. As it has long been appreciated that women of this class
were frequently mentally deficient or disordered, it was felt that the
present occasion offered an unusual opportunity for studying this problem.
It was also believed that the results of such studies would be a great aid
in determining the after-care of those who were treated.
The Psychopathic Hospital was requested to supervise an organization
that would make systematic mental examinations of these individuals.
A group of trained workers were provided by the Board of Health and
the Work placed under the direct supervision of the Detroit Out-Patient
Service of this hospital. Detailed reports of the work of the various
out-patient services is given in another section.
RELATIONS WITH THE STATE HOSPITALS.
There continues the same cooperation of the State Hospitals treating
mental disorders and the Psychopathic Hospital in the investigation
of problems common to their work. This cooperation has resulted in
decided advances in medical standards in the State Hospitals and the
maintenance of a live interest in clinical problems of mental disorders.
Extensions of the work of former years has not been advisable owing to
the depleted personnel of the medical staff of the hospitals and the difficulties of administration incident to war conditions.
FUTURE DEVELOPMENTS.
The Psychopathic Hospital is in urgent need of a new building for
its work that will be adequate in size and arrangements. Anyone who
is familiar with the construction and arrangements of the present building
must realize how poorly it is adapted to the treatment of patients with mental
disorders and how unsuited it is to carry on its purposes of investigation
and teaching. Those who are interested in the administration of the
hospital urgently request that at some early date the legislature make
provision for a building better adapted in size and plans for its needs.
It is planned to further extend the out-patient services to other cities
convenient to access to Ann Arbor as soon as arrangements can be made.
�PSYCHOPATHIC HOSPITAL.
13
OFFICIAL CHANGES.
The following changes in the Medical Staff have occured during the
period.
Dr. Arnold L. Jacoby, first assistant physician, was granted leave of
absence in April 1917 in order to enter the medical service of the navy.
Dr. Earl Palmer was appointed acting first assistant physician in May
1917.
Dr. Harold S. Hulburt resigned as second assistant physician in January
1917. He was succeeded by Dr. Raymond F. Wafer, appointed in July
1917.
Dr. W. I. Lillie resigned as resident physician in July 1916 and was
succeeded by Dr. Robert Hale, who served until July 1917, leaving to
enter military service.
Dr. Bertrand L. Jones was appointed resident physician in July 1917,
serving in this capacity until May 191-8 when he succeeded to the position
of acting first assistant physician.
Respectfully submitted,
ALBERT M. BARRETT,
Medical Director.
�14
STATE OF MICHIGAN.
CLINICAL REPORT.
Information regarding the medical work of the hospital is considered
in two sections. The first of these consists of a tabulation of the admission
and discharges considered from various aspects of social, causative and
treatment relations. The second is a detailed analysis of the more
important clinical groups.
GENERAL STATISTICAL TABLES,
Information given in these tables may be compared with similar tabulations made by other State Hospitals for the Insane, but in doing so
the peculiar relations under which the State Psychopathic Hospital
operates should be given consideration. This hospital receives patients
from the entire State of Michigan, rather than from any one section of
the State. The small capacity of the hospital and its special field of
work require that admission should as far. as possible be restricted to
mental disorders in their earlier stages and to functional nervous abnormalities which are not regarded as commitable to the larger State Hospitals.
A constantly pressing demand for the admission of patients necessitates
a somewhat rapid change of patients and this results in a far shorter
period of treatment for most individuals than in the larger State Hospitals
for the Insane.
TABLE No. 1.—Showing the number of patients admitted and discharged and remaining
June SO, 1918.
Year ending
June 30, 1917.
Year ending
June 30, 1918.
Total
since beginning.
M.
M.
M.
•
Admission by court commitment.
Public maintenance
Admission voluntary
Transferred from State
Hospitals
State maintenance
Total number admitted
Patients in hospital at beginning
of year
Discharged
With psychosis
Died .
- Without psychosis
Died
F.
F.
T.
F.
T.
71
6
89
160
10
55
76
10
131
13
3
30
42
6
72
0
33
4
46
1
0
1
1
0
0
2
0
1
2
1
0
]
0
112
139
251
94
139
233 1,147 1,194 2,341
26
138
28
167
54
305
26
120
28
167
54
287
16
38
44
7
7
61
54
5
23
99
98
12
9
34
37
5
14
44
58
7
23
78
95
12
154
371
498
52
1
4
2
0
0
4
7
1
1
8
9
1
1
3
7
0
1
0
6
0
2
3
13
0
2
7
39
0
139
251
96
130
24
37
112
Patients in hospital at close of period . .
T.
4
79
701
103
3
299
303
10
602
3
3
0
11
8
22
8
4
15
19
12
37
755 1 , 456
102 205
159 313
397 768
522 1,020
44
96
1
4
29
1
3
11
68
1
226 1,123 1,157 2,280
61
�PSYCHOPATHIC HOSPITAL.
15
The above table shows the number and legal relations of those admitted
during the biennial period, and from the beginning of the work in this
hospital. It also shows the results of treatment of those who were
discharged. The total number of admissions is about six percent larger
than in the previous period.
The number of those entering the hospital as voluntary patients was
considerably larger than in any previous period. Since 1915 it has been
possible for patients to be admitted as voluntary public charges. This
provision is not yet as widely known throughout the State as is desirable.
In the present period 10 patients of this class were admitted. Voluntary
admissions form 33 percent of all admissions to the hospital.
One-third of all admissions are maintained privately. The comparative
increase of admissions each year since the opening of the hospital is as
follows:
1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. 1914. 1915. 1916. 1917. 1918.
27
Female
39
40
48
59
78
26
70
89
92
96
96
118
101
109
88
117
104
94
114
126
126
112
139
94
139
53
79
107
148
181
192
219
197
221
208
252
251
233
The admission for the period by months has been:
July 1, 1916 to June 30, 1917.
Male
Female
7.
8.
9.
7
14
10
13
11
13
21
23
24
11.
12.
1.
2.
3.
4.
5.
6
Total
10
8
13
15
13
10
7
9
7
7
10
17
7
11
6
11
11
11
112
139
18
28
23
16
14
27
18
17
22
251
10.
July 1, 1917 to June 30, 1918.
Female
7.
8.
9.
10.
11.
7
11
7
10
6
13
6
12
9
9
18
17
19
18
18
1.
2.
3.
4.
5.
0.
Total
7
9
7
15
10
12
9
10
11
10
8
17
7
11
94
139
16
22
22
19
21
25
18 233
12.
The average monthly admissions was 20. The largest number admitted
in any one month was 28.
The variety of clinical forms given in the following table is about as
in former years. By far the most frequent form of psychoses are those
belonging in the manic depressive group.
The relative frequency of disorders that remained undiagnosed was
2.5 per cent of admissions.
�16
STATE OF MICHIGAN.
TABLE No. II.—Showing the forms of insanity in patients admitted and discharged during
the biennial period.
Year ending
June 30, 1917.
Admitted.
M.
Traumatic Psychoses:
1
Traumatic delirium .
Senile Psychoses:
1
Presbyophrenic type
Psychoses with cerebral arterio5
sclerosis
General Paralysis:
Demented type
14
1
Expansive type
Agitated type
1
1
Juvenile type
Psychoses with Cerebral Syphilis. .
Vascular type
0
Meningitic type
0
Psychoses with Brain Tumor
3
Psychoses with other Brain or
Nervous diseases:
Multiple sclerosis
0
Multiple neuritis
0
1
Meningeal hemorrhage
Tabes
0
Alcoholic Psychoses :
Pathological intoxication
0
1
Korsakow's psychosis
Chronic paranoid type
4
Psychoses due to drugs and other
exogenous toxins:
Opium intoxication
3
Chloral intoxication
0
Veronal intoxication
0
Psychoses with pellagra
0
Psychoses with other somatic diseases :
Delirium with septicaemia
0
Delirium typhoid fever
0
Exhaustion delirium
0
1
Delirium with uraemia
Delirium of unknown origin. . . . 2
Psychoses with Basedow's
disease
0
Psychoses with rheumatism. . . . 1
Psychoses with pernicious
0
anaemia
0
Psychoses with tetany
0
Psychoses with Glaucoma
Manic Depressive Psychoses:
8
Manic type
17
0
Mixed type
1
Dementia Praecox
0
3
12
Hebephrenic type
4
Year ending
June 30, 1918.
Discharged.
Admitted.
Discharged.
M.
F.
T.
M.
F.
T.
1
1
13
1
1
0
0
0
0
1
1
0
1
1
0
0
0
1
1
1
1
5
0
0
0
18
2
0
0
4
1
1
0
1
2
0
0
5
3
1
0
6
2
2
1
1
2
0
0
7.
4
2
1
1
1
1
1
0
1
1
1
3
2
0
0
4
1
2
1
2
1
1
1
1
1
3
0
0
0
1
0
O
1
1
0
0
0
0
1
1
0
0
1
1
0
0
0
0
0
0
1
2
0
0
1
2
0
0
0
1
4
0
0
0
0
1
4
0
4
1
0
0
0
1
0
4
0
2
1
0
0
0
0
2
4
0
1
0
2
0
0
1
0
1
0
1
3
0
1
1
0
0
0
0
1
0
0
0
1
0
1
1
0
0
1
0
0
0
0
1
0
0
1
1
1
0
0
0
0
0
1
1
0
0
1
1
0
0
0
1
1
0
1
1
1
0
0
0
2
0
4
0
0
0
10
28
1
0
4
7
14
1
F.
T
M.
F.
0
0
6
1
1
11
1
1
8
0
0
5
5
0
0
0
19
1
1
1
13
2
0
0
2
1
2
2
1
5
0
0
2
2
0
1
0
1
0
1
1
1
0
0
1
0
0
0
0
0
1
4
0
1
0
1
1
1
0
0
0
0
3
1
T
1
0
2
0
3
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
1
0
18
45
1
1
8
18
0
1
32
1
0
11
19
50
1
1
6
14
1
0
15
28
1
9
21
42
2
9
4
10
26
5
1
2
12
4
5
7
12
2
6
9
24
6
4
5
8
4
7
8
6
2
11
13
14
6
1
0
1
1
1
0
0
0
1
0
0
0
1
0
1
1
1
0
0
0
2
1
2
2
1
1
2
0
1
0
1
1
0
1
0
2
0
0
1
2
0
0
1
6 12
10 26
1 0
0
5
3
6
6
4
5
8
8
0
1
3
1
3
0
1
1
18
36
1
5
8
14
14
4
�PSYCHOPATHIC HOSPITAL.
17
TABLE No. II—Continued.
Year ending
June 30, 1917.
Discharged.
Admitted.
M.
Paranoia and Paranoiac Conditions :
Paranoia
Paraplirenia systematica
Presenile paranoiac condition. . .
Paranoiac condition with impaired hearing '
Undiflerentiated paranoiac conditions
Epileptic Psychoses
Neuroses and Psychoneuroses :
Hysterical type
Psychasthenic type
Neurasthenic type
Anxiety neurosis
Compulsion neurosis
Psychoses with Constitutional
Psychopathic Inferiority . . . .
Psychoses with Mental Deficiency
Undiagnosed Psychoses
Not Insane:
Epilepsy without psychosis . . . .
Drug addiction without psychosis
Constitutional psychopathic
inferiority without psychosis
Mental deficiencywithout
psychosis
Subnormal
Feebleminded
Idiot
Constitutional syphilis without
psychosis
Total
P.
Year ending
June 30, 1918.
T.
1
1
0
0
0
7
1
3
1
2
4
1
0
0
M.
2
2
0
7
4
1
1
0
0
5
9
0
0
1
9
10
1
0
1
0
2
0
0
0
6
6
2
1
0
0
F.
T.
Admitted.
Discharged.
M.
F.
T.
M.
1
2
0
0
3
4
2
1
0
0
3
1
1
5
1
1
2
2
1
4
2
0
3
0
0
4
1
0
7
1
0
0
0
1
1
1
1
4
1
5
0
6
3
2
5
5
7
0
0
1
11
9
1
0
1
2
1
0
2
0
7
6
0
0
0
9
7
0
2
0
F.
T.
1
1
2
5
2
6
2
0
7
7
0
0
0
9
8
0
2
0
5
8
13
3
11
14
6
8
14
8
9
17
0
1
2
6
2
7
0
1
1
4
1
5
1
0
2
5
3
5
1
0
3
7
4
7
0
0
0
0
0
0
2
0
2
2
0
2
1
0
1
1
0
1
1
1
2
1
1
2
5
6
11
6
6
12
5
5
10
5
4
9
0
0
0
5
0
0
0
0
6
0
5
6
0
5
4
1
4
5
0
4
2
3
0
3
7
1
5
2
1
0
3
0
3
5
1
3
0
0
0
0
0
0
0
0
0
0
1
1
0
1
1
1
0
0
1
0
0
1
0
1
112 139 251 113 138 251
94 139 233
95 131 226
Some information regarding the family constitution was obtained in
89 percent of all admissions. In all cases in which information was
available influences regarded as of significance in their relation to insanity
among descendants were present among 68.2 per cent. These occurred
among the parents in 57.8 per cent of instances; among the grandparents
in 9.2; among collateral lines in 17.7 per cent and among the brothers and
sisters in 15.3 per cent. The following table shows the hereditary factors
in patients admitted:
�TABLE No. III.—Showing the occurrence of hereditary factors in patients admitted.
Period ending June 30, 1918.
-
Direct.
M. F.
Insanity
Apoplexy and paralysis .
Psychopathic conditions
Alcoholism
23
10
14
19
45
11
30
18
Atavistic. Collateral.
Brothers
and
Sisters.
Total since beginning.
Total.
Direct.
Atavistic. Collateral.
Brothers
and
Sisters.
Total.
T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T.
M.
68
21
44
37
334
7
4
1
2
6 13 12 30 42 12 14 26 54
3 7 1 4 5 1 1 2 16
0 1 3 1 4 7 6 13 25
4 6 0 1 1 1 3 4 22
95 149
19 35
37 62
48 66
126 164 290 45 39 84 101 126 227 62 76 138
78 61 139 30 37 67 7 10 17 10 8 18
46 78 124 8 3 11 16 11 27 17 29 46
66 53 119 8 8 16 5 4 9 9 6 15
125
87
88
F.
405
116
121
71
T.
739
241
208
159
50
H
[>
1-3
H
<-,
Total heredity
66 104 170 14 13 27 16 36 52 21 24 45 117 177 294 316 356 672 91 87 178 129 151 280 98 119 217
634
713 1,347
g
h-1
0
Negative
Unknown
66 71 137
23 30 53
318
. .195
Total
89 101 190
1.147 1,194 2,341
330
151
648
346
3
3
�PSYCHOPATHIC HOSPITAL.
19
TABLE No. IV.—Showing the age of patients admitted.
Year ending
June 30, 1917.
M.
From 0 to 4 years
From
From
From
From
From
From
From
From
10 to
15 to
20 to
25 to
30 to
35 to
40 to
45 to
14 years
19 years
24 years
29 years
34 years
39 years
44 years
49 years
From 55 to 59 years
From 60 to 64 years
From 65 to 69 years
From 70 to 74 years
From 75 to 79 years
From 80 to 84 years
Age unknown
...
..
..
Total
F.
Year ending
June 30, 1918.
T.
0
1
0
0
0
0
5
14
15
12
22
23
17
13
8
6
0
2
1
1
0
0
0
0
7
23
29
25
35
44
30
19
14
12
6
4
1
2
0
0
112
139
251
0
0
2
9
14
13
13
21
13
6
6
6
6
2
M.
F.
M.
F.
1
8
' 27
84
131
0
2
13
99
131
131
165
170
153
121
83
57
27
7
7
3
1
24
1
10
40
183
262
279
295
318
263
233
161
136
66
25
17
9
2
41
233 1,147 1,194
2,341
T.
0
0
1
0
2
2
9
9
13
21
14
15
13
23
13 ' 25
14
9
17
9
4
8
2
2
2
3
1
1
1
0
0
0
0
0
0
0
89
139
Total
since beginning
0
1
4
18
34
29
36
38
23
26
12
4
5
2
1
0
0
0
148
130
148
110
112
78
79
39
18
10
6
17
T.
From this table we see that the largest number of admissions occurred
between the ages of 30 and 40.
TABLE No. V.—Showing civil condition of patients admitted.
Year ending
June 30, 1917.
M.
Single
Widowed . .
Total
. ..
F.
T.
Year ending
June 30, 1918.
M.
F.
44
68
0
0
0
49
79
7
1
3
93
147
7
1
3
49
41
2
1
1
54
76
5
2
2
112
139
251
94
139
Total
since beginning
T.
M.
F.
103
117
7
3
3
501
574
35
33
4
413
663
79
32
7
914
1,237
114
65
11
233 1,147 1,194
2,341
T.
�STATE OF MICHIGAN.
20
TABLE No. VI.—Showing degree of education of patients admitted.
Year ending
June 30, 1917.
M.
Illiterate
Common school
College
Unascertained
Total
F.
Year ending
June 30, 1918.
T.
M.
F.
1
8
65
19
9
10
1
5
87
32
7
7
2
13
152
51
16
17
' 2
4
46
20
14
8
1
1
81
43
5
8
112
139
251
94
139
Total
since beginning
T.
M.
F.
T.
3
5
127
63
19
16
17
82
688
201
100
59
3
54
766
263
51
57
20
136
1,454
464
151
116
233 1,147 1,194
2,341
TABLE No. VII.—Showing the occupation of those admitted during the current period
and from beginning.
Year ending
June 30, 1917.
M.
Professional
Mercantile and trading
Personal service, police and
military
Laboring and servants
Manufacturing and mechanical industry
Agriculture, transportation
and other outdoor
Student
No occupation
Total
15
18
2
1
F.
T.
26
31
2
1
0
, 29
15
24
0
3
1
4
11
13
0
0
0
12
0
0
85
8
5
5
15
24
112
139
Year ending
June 30, 1918.
M.
85
11
6
9
13
16
0
5
1
2
14
3
1
0
0
10
0
0
88
7
9
7
251
94
139
0
41
21
10
1
3
1
21
F.
T.
35
13
2
3
1
31
13
16
88
12
10
9
Total
since beginning
M.
F.
112
99
112
40
81
64
9
4
18
196
140
325
0
107
12
0
46
41
18
233 1,147
T.
0
782
40
75
20
193
163
121
44
18
303
152
325
782
86
116
38
1,194
2,341
�21
PSYCHOPATHIC HOSPITAL.
TABLE No. VIII.—Showing the nativity of patients admitted.
Year ending
June 30, 1917.
Total admissions
Total born in Michigan
Total born in United States.
Unascertained
Armenia
Austria . . . ,
Bohemia
Canada . . .
England
..
...
Germany
Holland
Hungary
Italy
Poland
M.
F.
T.
112
70
139
78
104
27
8
0
0
1
0
0
15
1
0
2
2
1
0
1
0
1
0
1
0
1
1
251
148
188
48
15
0
0
3
0
0
22
1
3
4
3
1
0
1
0
2
0
3
2
1
1
0
0
0
8
0
1
0
15
84
21
7
0
0
2
0
0
7
0
3
2
1
0
0
0
0
1
..
0
2
2
0
0
0
1
0
Scotland
Sweden
Syria.
Wales
West Indies .
Year ending
June 30, 1918.
7
M.
94
59
74
14
6
2
0
0
0
0
3
0
2
3
0
0
0
0
0
0
0
1
1
0
0
0
0
0
fi
Total
since beginning
M.
F.
F.
T.
139
86
109
16
14
0
0
0
0
0
7
0
3
0
1
233 1,147 1,194
685
741
145
183
920
956
187
30
170
20
57
51
2
3
0
1
0
0
4
4
0
0
2
0
1
0
0
10
55
76
1
0
2
24
5
15
3
32
40
1
10
8
2
0
6
1
0
0
2
2
1
1
0
0
3
6
0
1
0
0
11
9
2
2
8
5
0
4
7
1
1
2
1
0
0
2
0
0
1
0
0
25
28
20
0
0
1
0
0
0
1
1
1
0
0
0
0
14
T.
2,341
1,426
1,876
357
108
3
1
8
2
1
131
3
39
72
18
8
1
4
1
9
1
20
13
11
3
1
2
1
53
The above table shows that the number of foreign-born patients was
much larger than in any previous period. Foreign born formed 21 per
cent of admissions.
TABLE No. IX.—Showing the natimtlj of parents.
Year ending
June 30, 1917.
Year ending
June 30, 1918.
Total
since beginning
•'
M.
One foreign born, one
One foreign born, one
One native born, one
Unascertained
Total
F.
T.
44
38
10
3
2
15
51
50
21
4
6
7
95
88
31
7
112
139
M.
F.
8
22
28
38
7
2
5
14
40
57
21
2
3
16
251
94
139
T.
68
95
28
4
8
30
M.
F.
365
508
127
9
404
769
494 1,002
163
290
11
20
18
28
104
232
10
128
T.
233 1,147 1,194 2,341
From the above table it is seen that patients whose parents were foreign born almost equal those of native-born parents among the admissions,
�22
STATE OF MICHIGAN.
TABLE No. X.—Showing counties from which patients have been received.
Year ending
June 30, 1918.
Year ending
June 30, 1917.
M.
0
0
1
0
0
0
0
0
2
0
Alpena
Bay
Benzie
0
2
2
0
0
Cass
Cheboygan
Clare
Clinton
Delta
Eaton
Emmet
Gladwin
Gogebic
Gratiot
Hillsdale
0
0
0
0
0
....
....
.
losco
Iron
.
....
1
0
2
0
3
1
0
0
0
2
1
0
7
1
0
0
1
e
i
Kent
Lake
Lena wee
Luce .
Menominee. . . .
Monroe
0
3
0
0
4
0
2
0
0
0
0
1
0
0
1
0
0
1
0
2
0
F.
0
0
0
0
0
1
1
0
0
0
0
2
1
0
1
1
0
0
1
1
1
0
5
1
5
0
0
0
3
1
1
0
3
2
0
0
1
11
1
0
10
0
1
3
0
1
2
0
0
0
0
0
0
0
0
0
0
1
2
1
F.
M.
T.
0
0
1
0
0
1
1
0
2
0
0
4
3
0
1
1
0
0
1
1
2
0
7
1
8
1
0
0
3
3
2
0
10
3
0
0
2
13
2
0
13
0
1
7
0
3
2
0
0
0
1
0
0
1
0
0
1
1
4
1
0
1
4
0
0
0
0
0
3
1
0
0
1
0
0
0
1
0
2
0
0
0
3
1
3
0
0
1
1
1
1
3
4
0
0
0
0
2
0
0
5
0
2
1
0
1
1
0
0
2
0
0
0
0
0
0
0
1
0
0
Total
since beginning.
M.
T.
1
0
0
0
1
1
0
1
1
1
1
0
4
1
0
0
0
0
0
0
1
0
3
0
9
0
0
1
2
2
1
2
5
0
0
0
0
9
2
0
2
0
1
1
1
1
2
0
0
3
1
0
0
0
0
0
0
2
3
1
1
1
4
0
1
1
0
1
4
' 2
1
0
5
1
0
7
2
17
9
0
4
0
3
31
2
5
21
18
2
5
0
1
0
2
0
1
0
6
1
12
10
2
0
10
3
1
1
17
3
38
2
1
2
19
32
6
6
33
18
5
0
5
30
9
0
73
0
4
13
0
23
16
0
1
10
5
3
12
5
2
2
1
22
18
0
0
0
2
3
3
2
5
9
0
0
0
0
11
2
0
7
0
3
2
1
2
3
0
0
5
1
0
0
0
0
0
0
3
3
1
F.
4
0
10
3
5
3
1
6
22
1
6
9
25
4
2
9
0
3
7
3
3
0
26
8
57
2
0
2
22
28
8
5
44
15
4
0
8
57
6
0
69
1
2
18
2
18
19
2
0
15
3
2
9
0
1
0
1
14
20
2
T.
11
2
27
12
5
7
1
9
53
3
11
30
43
6
7
19
2
3
17
6
4
1
43
11
95
4
1
4
41
60
14
11
77
33
9
0
13
87
15
0
142
1
6
31
2
41
35
2
1
25
8
5
21
5
3
2
2
36
38
2
�PSYCHOPATHIC HOSPITAL.
23
TABLE No. X.—Concluded.
Year ending
June 30, 1917.
M.
Muskegon
Oakland
F.
Year ending
June 30, 1918.
M.
T.
T.
4
0
1
1
0
13
1
14
1
0
10
2
17
3
2
23
3
31
4
2
2
0
0
2
0
0
0
0
5
0
2
0
0
7
1
6
0
1
40
0
9
0
1
50
1
15
0
2
90
11
2
0
0
0
1
1
0
1
0
2
0
0
1
0
3
1
0
3
2
53
11
0
1
2
62
9
1
4
4
115
20
1,
2
2
1
1
0
6
4
3
1
1
2
1
1
0
1
5
2
1
0
1
7
3
2
0
2
21
19
9
2
14
25
21
7
3
5
46
40
16
5
19
13
35
0
0
11
39
0
2
24
74
0
2
9
24
1
1
8
41
2
0
17
65
3
1
147
190
5
5
128
215
3
2
275
405
8
7
112
139
251
94
139
7
0
3
0
0
0
0
0
0
3
1
0
0
0
4
Presque Isle. ...
Saginaw
Schoolcraft ....
0
0
5
1
0
0
0
6
1
0
St Glair
Tuscola
4
2
2
0
1
Total
F.
3
0
0
1
0
3
0
3
0
0
Washtenaw . . . .
M.
T.
1
0
1
0
0
0
4
0
0
0
0
1
0
0
0
1
Ontonagon
Oscoda
F.
Total
since beginning.
0
0
233 1,147 1,194 2,341
This hospital is open to patients from any county of Michigan. Patients
not resident in Michigan are not received. During this period 71 of the
83 counties of the State sent patients for treatment.
�STATE OF MICHIGAN.
TABLE No. XI.—Showing the form of insanity of patients discharged and the results of
treatment.
Period ending June 30, 1918.
•
Recovered.
Traumatic psychoses:
Traumatic delirium
Senile psychoses :
Presbyophrenic type
Psychoses with cerebral arterioGeneral paralysis:
Psychoses with cerebral syphilis:
Psychoses with brain 'tumor
Psychoses with other brain or
nervous diseases:
Multiple neuritis
Tabes
Alcoholic psychoses:
Psychoses due to drugs and other
exogenous toxins:
Chloral intoxication
Veronal intoxication
Psychoses with pellagra
Psychoses with other somatic
diseases:
Delirium with septicaemia
Delirium with typhoid fever . . .
Delirium of unknown origin. . . .
Psychoses with Basedow's
Psychoses with rheumatism . . . .
Psychoses with pernicious
Psychoses with glaucoma
Manic-depressive psychoses :
Manic type
Mixed type
Dementia praecox:
Simple type
Paranoia and paranoiac conditions
Presenile paranoiac conditions.
Paranoiac conditions with impaired hearing
Undifferentiated paranoiac con
Epileptic psychoses
Neuroses and psychoneuroses :
Improved.
Unimproved.
Died.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
T.
2
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
5
1
0
0
2
0
0
0
7
1
0
0
14
2
18
4
2
1
0
0
0
0
0
2
1
4
2
0
0
0
0
0
0
0
0
0
0
0
1
2
0
1
2
0
0
0
2
0
2
1
1
0
4
0
0
0
0
1
0
0
0
0
2
0
5
0
2
7
0
0
0
0
1
0
0
0
0
3
0
0
1
0
1
0
1
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
1
0
0
0
0
1
0
1
0
0
3
0
0
0
0
0
3
0
0
2
0
0
0
0
0
2
1
2
0
0
0
1
0
0
0
0
0
1
1
0
1
0
0
0
0
1
0
0
0
0
0
0
0
1
1
1
0
0
0
0
1
1
0
0
0
0
1
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
1
2
0
0
0
2
0
2
1
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
1
2
8
1
0
0
0
0
0
1
0
1
0
0
1
0
1
2
0
0
0
1
0
2
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
5
8
0
0
4
3
0
2
9
11
0
2
5
13
0
1
6
29
1
0
11
42
1
1
4
3
1
0
12
22
0
3
16
25
1
3
0
4
0
0
0
0
0
0
0
0
1
1
1
1
0
0
1
5
8
2
4
3
9
0
5
8
17
2
3
3
10
6
5
10
11
2
8
13
21
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
2
0
1
2
1
3
0
1
5
1
2
8
1
0
0
0
0
1
1
0
0
0
1
0
0
1
0
0
3
1
1
1
4
2
0
2
1
1
3
2
0
0
0
4
2
0
0
0
7
3
1
2
0
7
0
0
0
1
14
9
1
2
1
0
0
0
0
0
2
6
0
0
0
0
0
1
1
0
1
0
0
0
0
0
0
0
1
0
1
1
1
1
1
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
1
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
1
1
1
4
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
4
7
0
0
0
2
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
1
�PETCHOPATHIC HOSPITAL.
25
TABLE No. XI—Concluded.
Period ending June 30, 1918.
Recovered.
Psychoses with constitutional
Psychoses with mental deficiency
Undiagnosed psychoses
Not insane:
Epilepsy without psychosis . . . .
Drug addiction without psychosis
Constitutional psychopathic
inferiority without psychosis .
Mental deficiency without psyIdiot *
Constitutional syphilis without
psychosis
Total
Improved.
Unimproved.
Died.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
1
0
0
0
0
0
0
5
0
0
13
2
3
18
2
3
5
1
1
6
2
7
11
3
8
0
0
0
0
0
0
2
0
0
0
2
0
0
0
0
0
0
0
0
0
1
0
0
0
3
0
0
0
0
0
0
27
22
49
2
0
0
0
0
0
1
F.
T.
7
5
12
4
5
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
1
0
0
8
0
7
0
10
1
7
0
0
0
0
0
1
0
1
0
1
0
1
0
0
0
0
0
0
0
0
1
1
2
0
0
0
90 125 215
12
13
25
79 109 188
1
0
1
1
0
1
0
0
0
0
0
0
In Table XI are given results of treatment in all patients discharged
according to their various clinical disorders. Patients are regarded as
recovered when they are in their normal mental condition at discharge;
as improved when their mental condition at discharge is more or less
improved over that at admission; as unimproved when their mental
condition has not changed for the better.
According to these standards 10.3 per cent were discharged as recovered;
39.4 per cent as improved; 45.0 per cent as unimproved, and 5.2 per cent
died.
�26
STATE OP MICHIGAN.
TABLE No. XII.—Showing duration of residence in months of all cases discharged.
Recovered.
M. F.
Improved.
Unimproved.
Died.
Total.
T.
M. F.
T.
M. F.
T.
M.
F.
T.
M.
F.
0
0
1
2
6
1
0
3
7
14
1
2
3
15
26
0
1
7
7
31
1
3
10
22
57
5
5
7
8
20
11
4
9
15
32
16
9
16
23
52
3
1
2
1
2
1
2
3
3
1
4
3
5
4
3
10
8
14
29
56
12 22
7 15
20 34
27 56
70 126
0
1
1
0
0
0
0
10
2
0
1
0
0
0
0
0
16
5
0
2
1
0
0
0
0
5
7
8
2
3
3
1
1
0
20
16
7
7
3
0
2
2
2
25
23
15
9
6
3
3
3
2
14
7
12
3
1
0
2
0
0
17
13
8
7
3
1
2
1
1
31
20
20
10
4
1
4
1
1
1
1
1
0
0
0
0
0
0
2
0
0
0
0
0
0
3
1
1
0
0
0
1
0
0
26
18
21
6
5
3
3
1
0
49
31
15
15
6
1
5
3
3
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
2
2
0
0
3
3
0
0
2
2
1
1
0
1
0
0
2
3
1
1
0
0
0
0
0
0
0
0
0
0
0
0
3
.3
1
1
2
3
0
0
Total. . . 27
22
49
90 125 215
12
1 week or less . . . 1
2 weeks
0
2
5
8
2 months
6
4 months
5 months
. . .3
7 months
9 months
10 months
11 months
....
12 months
14 months
18 months
24 months
79 109 188
1
0
13
T.
75
49 •
36
21
11
4
8
4
3
5
6
1
1
25 208 269 477
TABLE No. XIII.—Showing age of patients discharged recovered.
Period ending
June 30, 1918.
-
/
From 20 to 24 years
From 35 to 39 years .
Total
..
Total
from beginning
....
...
M.
F.
T.
M.
F.
T.
0
0
1
1
4
3
1
5
1
1
8
4
4
9
0
13
13
15
16
25
3
16
22
27
16
22
3
29
35
42
32
47
3
2
4
2
0
0
4
0
1
0
0
0
7
2
5
2
0
0
21
14
12
6
1
2
19
10
6
2
1
0
40
24
18
8
2
2
27
23
50
156
161
317
4
1
3
4
�PSYCHOPATHIC HOSPITAL.
27
TABLE No. XIV.—Showing the causes of death.
Biennial
period.
M.
F.
Total since
beginning.
T.
M.
2
1
1
0
1
0
4
1
0
1
1
6
2
1
1
5
3
3
0
2
1
4
1
1
0
6
4
1
2
1
0
1
1
1
0
1
0
0
2
1
1
1
1
3
1
2
0
1
2
1
2
1
0
0
2
4
1
1
2
2
1
2
0
0
1
1
1
1
3
2
2
3
1
4
3
0
0
0
4
1
2
1
1
0
4
2
1
1
4
1
1
1
0
A
m'n '
'r'miQ ' ' ' '
Ttrnnrhn TiTipiirnnnia
^ptlpral Tiaralvsis
Cystitis
. .
0
1
0
1
1
1
0
1
0
1
0
1
1
1
0
1
1
1
0
1
1
0
p
.'
lv •
r»nn
i
ilofmiV ' ' '
0
1
0
0
Tetany
1
4
1
1
1
. 1
0
1
1
1
0
0
1
1
0
1
2
2
1
1
1
1
1
1
0
0
0
1
1
1
1
1
1
1
3
0
0
0
7
3
1
3
1
7
6
13
25
52
45
0
2
....
i
3
T.
1
1
0
I
Total
1
F.
12
1
3
1
0
3
97
�28
STATE OF MICHIGAN.
TABLE No. XV.—Showing the age of patients who
Year ending
June 30, 1917.
M.
From 10 to 14 years
F.
Year ending
June 30, 1918.
T.
M.
F.
Total
since beginning.
T.
M.
F.
T.
1
0
1
0
0
0
0
2
5
2
1
0
3
5
2
0
0
1
1
1
1
0
1
1
34 years
39 years
44 years
49 years
54 years
1
0
0
2
0
1
2
0
1
1
2
2
1
2
1
1
0
1
1
1
2
0
2
3
2
3
0
4
6
5
5
8
2
1
9
11
3
6
7
14
16
11
From 55 to 59 years
From 60 to 64 years
From 65 to 69 years
1
1
2
1
0
0
2
1
2
0
0
0
0
1
0
0
1
0
4
8
6
0
1
2
5
4
1
1
0
0
9
12
7
1
1
2
7
6
13
5
7
12
51
46
From 20 to 24 years
From 25 to 29 years
From
From
From
From
From
30 to
35 to
40 to
45 to
50 to
From 75 to 79 years
Unascertained
Total
97
TABLE No. XVI.—Showing the number of patients transferred between the State Psychopathic Hospital and other State Institutions.
Transferred to.
Received from.
Biennial
Period.
M.
F.
Pontiac State Hospital
Kalamazoo State Hospital
1
1
0
0
Michigan Farm Colony for
Epileptics . . .
Michigan Home and Training
1
0
Total
3
0
Biennial
Period.
From
Beginning.
From
beginning .
M.
F.
T.
M.
F.
T.
1
1
18
18
2
0
11
8
0
1
29
26
2
1
20
10
5
0
0
25
7
5
1
0
45 140 148 288
17 101 87 188
10 49 41 90
1
5
5 10
0
G
7 13
1
1
0
1
1
0
T.
3
39
20
59
36
38
1
M.
F.
T.
2
0
2
0
1
1
74 303 289 592
Thus it is seen that of all patients discharged, 15.5 per cent were
transferred directly to one of the other State Hospitals.
OUT-PATIENT SERVICE.
The Psychopathic Hospital operates two services for patients who do
not enter the hospital for treatment. One of these is a local service in
connection with the admission service of the General Hospital of the
University of Michigan. The other is located in Detroit and operates
as a mental clinic in connection with the Wayne County Juvenile Court
and the Associated Charities of Detroit.
�29
PSYCHOPATHIC HOSPITAL.
TABLE No. I.—Showing Diagnoses made in Psychiatric Out-Patient Service of the
General Hospital.
Traumatic delirium
Pre-senile depression
.
Migraine . . .
...
.
Alcoholic hallucinosis . .
Drug addiction, morphine
Pernicious anemia .
. .
Deliria of unknown origin
.
No diagnosis made
Total
...
...
...
Paranoiac conditions
Epilepsy .
.
Neurosis and psychoneurosis :
Neurasthenic type
....
...
.
.
.
.
Year ending
June 30, 1918.
M.
T.
M.
P.
T.
0
1
2
2
2
0
1
3
12
12
0
2
0
0
1
1
5
0
3
10
2
0
0
1
0
6
0
0
1
1
2
0
0
0
0
3
1
1
0
0
2
1
1
0
3
1
1
1
1
3
0
3
9
1
1
1
0
0
0
0
0
1
0
0
0
0
0
0
0
1
5
0
0
0
1
1
0
1
6
1
0
0
2
0
0
0
0
0
1
3
16
11
0
7
1
10
3
2
3
4
26
14
2
10
9
3
1
2
1
2
11
8
0
3
0
2
0
1
3
20
11
1
5
8
8
3
3
24
11
0
3
32
19
3
6
13
5
11
8
13
10
1
4
2
10
1
4
13
7
3
1
4
5
9
13
2
8
18
3
10
0
11
15
1
5
0
2
11
26
15
12
12
4
15
0
13
26
123
93
216
114
77
191
0
0
1
10
10
4
0
0
0
1
1
0
0
1
.,
Cerebro-spinal syphilis .
Tabes
Multiple sclerosis. . .
...
Year ending
June 30, 1917.
F.
1
�30
STATE OF MICHIGAN.
TABLE No. II.—Showing the number and source of out-patients.
July, 1, 1916
to
June 30, 1917.
General hospital clinic of neurology
General hospital clinic of surgery
General hospital clinic of gynecology
General hospital clinic of genito-urinary surgery . . .
General hospital clinic of orthopedic surgery
General hospital clinic of contagious diseases
University students' health service
Miscellaneous sources
Total
July 1, 1917
to
June 30, 1918.
M.
F.
T.
M.
F.
T.
10
28
16
6
7
2
21
17
5
5
12
49
33
11
12
26
20
28
2
4
12
18
11
3
3
38
38
39
5
7
6
3
0
1
4
3
1
6
5
2
9
4
6
6
6
5
5
0
2
3
4
3
11
1
1
9
8
11
3
4
0
0
0
12
21
9
2
1
1
0
13
9
2
1
1
12
34
18
2
0
0
10
1
.6
0
3
0
0
2
5
2
3
0
-10
3
11
123
93
216
114
77
191
�PSYCHOPATHIC HOSPITAL.
31
WAYNE COUNTY OUT-PATIENT SERVICE
OF THE
STATE PSYCHOPATHIC HOSPITAL.
RESIDENT OFFICERS.
Nellie L. Perkins, Ph. D., Psychologist.
Margaret Wylie, A. B., Assistant Psychologist.
Ethel Plumb, A. B., Registrar and Chief of Social Service.
Sarah Dunlap, A. B., Field Worker.
This Branch of the Out-Patient Service has now been open nearly
three years. From the first, the work has been of the most practical
nature, namely, an attempt to solve the problems of maladjustment
arising in the community served by the clinic. This was necessarily
the case as the funds for maintaining the resident staff were subscribed
by individuals, and the real worth of a work of this kind had to be demonstrated before provisions for a permanent organization would be made.
The results have been gratifying, and already the value of the work done
has been recognized and appreciated to the extent that the County is
willing to contribute toward the support and holds out the hope that
eventually it will take over the entire organization, making it part of
the Court system.
A review of the types of cases handled and organizations served shows
a steady growth of the work with an ever-increasing active part in the
social service carried on in Wayne County. The function of the clinic
seemed to have been definitely indicated after a short period of practice.
From the beginning, it has been used as a center for advice in the handling
of problems in social adjustment. Whenever an organization found a
case that did not improve under the usual methods of relief, especially
if there were several organizations working with the family group, it was
referred to the clinic for study and advice, the purpose being to determine
whether mental defect or abnormality were responsible for the existing
conditions. It is of interest to note that about 80% of the problem cases
which have been troublesome for years were found to be distinctly in
need of study in a clinic of this kind. Among the cases referred, there was
a large group of feebleminded, a surprising number of definite psychoses
and the ever present borderline cases made up of psychopaths that are
not so easily classified as either of the other groups, but frequently more
difficult relative to diagnosis, prognosis and care. Where the examination did not show the presence of a psychiatric condition, very often the
study led to the discovery of peculiar temperaments or unusual attitudes
which, when understood, made social service possible where it had not
been before. Considerable assistance of this kind has been given with
fairly satisfactory results in many cases.
The main interest
however, has been placed in detecting abnormal mental conditions
with a view to ridding the community of this group in order that
the reconstruction attempted by social agencies would not be
lost. The examinations have led to many commitments to
institutions, and have already relieved conditions somewhat. Advice
�32
STATE OF MICHIGAN.
given in cases where custodial or hospital care was not necessary, but
where much depended upon a better understanding of the individual
temperament, has in many instances materially changed the methods
of handling certain groups with the result that some of the problem cases
are no longer giving trouble. As the workers become acquainted with
our methods and learn how to handle cases under direct:ons, the clinic
can serve a larger group and the work of the social agencies will also be
more effective. Not only have the efforts led to educating the community
to a more intelligent understanding of a social behavior, but it has also
meant closer cooperation between social agencies, and less duplication
of work, all of which makes necessary more careful planning of case work.
Perhaps the change in the point of view, due to the recognition of the
fact that there is a certain group of individuals that cannot be helped
and must be regarded as social waste, has been as valuable as some of the
more positive results, in that it has re-directed efforts which were practically lost. This has been one of the most difficult tasks, due to the old
sentimental approach and lack of scientific backing for case work.
�PSYCHOPATHIC HOSPITAL.
33
NUMBER OF PATIENTS EXAMINED, AGENCIES REFERRING
THEM AND REASONS FOR REQUESTING
A PSYCHIATRIC EXAMINATION.
COURTS.
JUVENILE COURT:
Feebleminded
Subnormal
Retarded
Feebleminded and epileptic
Epileptic
Psychopathic personality
Neurasthenia
Hysteria
Anxiety neurosis
Symptomatic mental state
Pathological irritability. . :
Unclassified insane
Manic depressive
Dementia praecox
Supernormal
No psychiatric condition
No diagnosis made
Deferred
157
80
5
2
4
17
2
17
1
1
1
4
3
1
1
76
5
22
399
JUVENILE DIVISION OF POLICE:
Feebleminded
Subnormal
Psychopathic personality
No psychiatric condition
5
3
1
2
MOTHEE'S PENSION AND NEGLECT:
Feebleminded
Subnormal
Epileptic
Psychopathic personality
Hysteria
Anxiety neurosis
Unclassified insane
General paralysis
No psychiatric conditionDeferred
No diagnoses made
31
12
1
2
2
1
3
1
8
5
1
11
67
POLICE, CIRCUIT AND RECOKDEB'S COUKTS:
No diagnosis made
2
COUNTY AGENT:
Psychopathic personality
No diagnosis made
1
1
o
o
PROBATE COURT, INSANE DIVISION:
Feebleminded
Subnormal
Feebleminded and epileptic
Psychopathic personality
Unclassified insane
Dementia praecox
No psychiatric condition
Deferred
No diagnosis made
'
:
11
1
1
2
3
3
5
1
2
29
510
�34
STATE OF MICHIGAN.
While all the cases referred have in some way shown atypical behavior,
those sent by the courts, with the exception of the Mother's Pension
and Neglect groups, have been the more serious offenders, and their
conduct has been sufficiently anti-social to have brought them into conflict
with the law. In many of these individuals the defect is quite apparent
and they are referred for examination without Court hearing. Upon
receipt of a positive diagnosis, the charges are withdrawn, it being the
opinion of the Court that it is useless to prefer charges against a feebleminded or insane individual, and the case is often referred to the Insane
Division of the Probate Court for hearing for commitment to the proper
institution.
A second large group referred by the Juvenile Court is composed of those
cases whose offense is serious enough to warrant commitment to the
Industrial Schools. To be effective, these Institutions must work with
reformable types, those capable of receiving training. The Court therefore
does not wish to flood them with the mentally abnormal or definitely
defective, so that all questionable cases are examined before commitment
and the disposition depends upon the diagnosis.
The group sent by the Mother's Pension Department is particularly
interesting, not so much because of their troubling others, as themselves.
These cases are generally reported because they are unsuccessful, even
with the financial aid and supervision of the Court, and do not use to
advantage what is given them. They fall into two groups; those who
spend funds unwisely, and those whose conduct is questionable, the
result of poor judgment and general lack of ability to live up to certain
standards insisted upon by the Court. This type of relief provides not
only financial aid, but attempts supervision in the more difficult cases.
The visiting housekeepers are called in to supervise the family budget
and give concrete lessons in management; the pension officers advise
and look after the conduct of the various members of the family. In
case of failure to meet the requirements, the pension may be revoked.
Before the establishment of the clinic, the giving of a pension was a
matter of experiment, and in many cases proved expensive and unreliable.
Now whenever it is felt that the applicant is mentally incompetent, the
case is referred for examination, and whether a pension is granted depends
upon the findings and recommendation. There will always be some
borderline cases where experiment is the only possible fair test, but after
an examination the court worker has the benefit of the study, and can
handle the case more intelligently because of suggestions which are
possible only after an investigation of this type. The results seem to
indicate that many of these families have succeeded with a pension
because of the special provisions made to meet their requirements, whereas
they might have failed if left to themselves as formerly. The per cent of
feeblemindedness and insanity runs very high in this group. This is also
true of those referred by the Neglect Division of the Juvenile Court,
as is shown by the table. Work with these groups is the most difficult
and often the least successful because ths problem is always complicated
by so many social conditions, over which we have little control, but we
hope to change some of this when we have passed over the experimental
stage and are better acquainted with the possibilities at our disposal.
The records show a marked increase in the number of cases referred
by the Insane Division of the Probate Court. This is due to the fact
�PSYCHOPATHIC HOSPITAL.
35
that the Judges are using the clinic more frequently in those cases o
conflicting or indefinite diagnosis where it is a question of commitment
to the State Hospitals. Cases are referred whenever there is any disagreement on the part of the certifying physicians, especially if it is a
question of commitment to the State Psychopathic Hospital. There is a
hesitancy on the part of the general practitioner to recommend the State
Hospitals especially if he is not certain of the diagnosis or if the family
objects. An observation order for the Psychopathic Hospital is frequently
used as a simple way out of the difficulty because it not only relieves him
of the responsibility of a correct diagnosis, but also shifts the family's
disfavor. This is not always a wise disposition of the case as many of
them have old psychoses and are distinctly custodial types. They could
be committed directly to Pontiac and save the unnecessary expense and
extra time by going directly to the State Hospital, thus leaving the
Psychopathic Hospital for those cases with borderline conditions or
psychoses of more recent onset. The clinic, situated as it is and because
of its relation to the Court, has the opportunity to select cases and tries to
direct types to Ann Arbor which will be of some value in demonstration
teaching, and while it is not always possible to do this because of the
existing conditions, among them public opinion and certain legal and
medical obstacles, there have been occasions when we could serve in this
capacity. In time we hope to develop this side of the work.
DEPARTMENT OF EDUCATION.
BOABD OF EDUCATION, CHILD STUDY DEPARTMENT:
Feebleminded
Subnormal
Supernormal
Feebleminded and epileptic
Psychopathic personality
Hysteria
Dementia praecox
No psychiatric condition
Deferred
TRUANCY DEPARTMENT:
Feebleminded
Subnormal
No psychiatric condition
1
4
3
1
3
2
1
4
4
23
2
1
1
RECREATION COMMISSION:
Feebleminded..
1
1
28
The Detroit schools have an exceptionally good Child Study Department but so far most of the emphasis has been put on the feebleminded
and subnormal child, with no provision for those who are not feebleminded
but a-typical, due to emotional and volitional peculiarities. Neither
has anything been done with the High School groups. These two classes
are now being referred to this clinic as the Board of Education appreciates
that work with types of this kind is essential, but as yet they are not
equipped to handle it. We have found a surprising number of psychopathic children, several of whom made interesting studies.
: The Board of Education has offered this clinic the use of their Special
rooms for borderline mental defectiveness, speech classes, fresh air rooms
for tubercular children, and classes for crippled children, making it
�36
STATE OF MICHIGAN.
possible for us to care for many of the children in their homes where
social nursing, rather than Institutional care would be more effective
provided that they could receive the advantages of special educational
methods so essential in their training.
CHARITABLE
ORGANIZATIONS.
CHILD CAKING AGENCIES.
CHILDREN'S AID SOCIETY:
Feebleminded
.......................................................
Subnormal
..........................................................
Retarded
..................
.
......................................
Epileptic . . . :
.......................................................
Psychopathic personality
.............................................
Hysteria
...........................................................
Unclassified insane
.....................................
..
.............
Manic-depressive
....................................................
Deferred
...........................................................
No psychiatric condition
...............................
..............
No diagnosis made
..................................................
ST. VINCENT DE PAUL SOCIETY:
Feebleminded
.......................................................
Subnormal
.....................................................
Retarded
...........................................................
Feebleminded and epileptic
...........................................
Pathological irritability
..............................................
Unclassified insane
...................................................
Dementia praecox
..............................................
Deferred
...........................................................
No psychiatric condition
.............................................
PROTESTANT ORPHAN ASYLUM:
Subnormal
NEIGHBORHOOD HOUSE:
No psychiatric condition
.........................................................
.............................................
26
28
3
1
2
I
3
1
10
35
1
-
Ill
22
.... 12
2
1
1
2
..... 1
1
6
- 48
1
1
1
161
These agencies place children in boarding homes or for adoption and
in either case a mental examination is quite essential, especially if there
is any question of abnormality or defect because such a child is not
suitable for adoption, and as the State provides Institutional care for
them at a much lower cost than is possible in an ordinary boarding home,
the agencies encourage commitment of Institutional types. It not only
costs more to care for these children, but it is the exceptional woman
who can manage them with no more than the ordinary equipment found
in an average home. The schools frequently expel them and they are
sent home for indefinite periods which necessitates providing daily occupation and amusements. They get into mischief and often become neighborhood nuisances. This leads to changing them from boarding home to
boarding home, which neither solves the difficulty nor is fair to the
patient. It has been found that the wiser plan was to have an examination
made, and then provide special boarding homes for the a-typical children.
Temporary provisions have now been made. The children are kept in
little colonies until there are vacancies for them in the State Institution.
The length of stay varies somewhat,' and may be^as long as eighteen
months or two years, depending upon the waiting list, but these provisions
have proved much more satisfactory than the old system of random
placing which amounted to long drawn out and ill-controlled experiments
which seldom succeeded.
�PSYCHOPATHIC HOSPITAL.
37
AGENCIES PROVIDING MATERIAL RELIEF.
ASSOCIATED CHARITIES:
Feebleminded
Subnormal
Compulsion neurosis
Deferred
No psychiatric condition
.
4
2
1
2
1
VISITING HOUSEKEEPER'S ASSOCIATION:
Feebleminded
1
POOH COMMISSION:
Feebleminded
Subnormal
Psychopathic personality
Unclassified insane
Alcoholic dementia
General paralysis
No psychiatric condition
1
2
1
1
1
1
1
10
j
8
UNITED JEWISH CHARITIES:
Feebleminded
Subnormal
Psychopathic personality
Hysteria
Unclassified insane
General paralysis
Manic-depressive
No psychiatric condition
6
2
1
3
2
1
1
1
———~
17
AMERICAN RED CROSS CIVILIAN RELIEF:
Feebleminded
1
1
37
These organizations supplement the work done by the Mother's Pension
and Neglect divisions of the Juvenile Court, and provide for those cases
which do not come under any of the headings of the Mother's Pension
law and therefore cannot receive aid from the Court. As would be
expected, they closely resemble in type the cases discussed under the
Pension group. They too have failed to make the required social adjustment and many of them are incapable of competing with others. Examination shows many of them to be low grade feebleminded, and for the most
part, distinctly Institutional types. Some are recommended for commitment to the State School, but more often not because of the difficulty
of having them committed when it means provision for a large family
of children. We have instances where the mother and several of all
of the children were found to be feebleminded, and the entire family
is now at Lapeer, but the solution is seldom so simple.
�38
STATE OP MICHIGAN.
AGENCIES CARING FOR GIRLS AND YOUNG WOMEN.
GIRL'S PROTECTIVE LEAGUE:
Feebleminded
Subnormal
Feebleminded and epileptic
Epileptic
Psychopathic personality
Hysteria
Anxiety neurosis
Psychaesthenia
Insane
Deferred
..'
6
1
1
1
3
6
I
1
1
1
22
B U R E A U OF CATHOLIC CHARITIES:
Feebleminded
Subnormal
No psychiatric condition
Deferred
2
1
2
1
FLORENCE CRITTENDEN HOME:
Feebleminded
Subnormal
Psychopathic personality
Manic-depressive
No psychiatric condition
Deferred
ST. AGNES HOME:
Feebleminded
Subnormal
Retarded
Dementia praecox
3
1
1
1
1
1
2
3
1
1
43
By far the most interesting group of cases are those referred by this
group. These organizations provide for girls 17 years of age or older,
or that group just beyond the jurisdiction of the Juvenile Court, and while
the main purpose is not the solution of problems of delinquency but is
rather protective, there are a large number of young women who have
offended against the law and these are referred by the Police Courts to
these agencies, so that the delinquent also is prominent in this group.
The reasons for referring some of them to the clinic are much the same as
in other cases, namely, the ordinary way of providing for them is not
successful, or they persist in their anti-social reactions apparently in
spite of themselves and the efforts of the Protective League. For the
most part, these have proved to be psychoneurotic individuals, with a
few definite psychoses.
The Florence Crittenden and Salvation Army Homes have arrived at
a practical, even if not always accurate criterion to warrant requesting
a psychiatric examination, namely, two or more illegitimate pregnancies.
It is of interest to note that in practically every case referred for this
reason, the patient was found to be either feebleminded or insane.
�PSYCHOPATHIC HOSPITAL.
39
MEDICAL GROUP.
HARPER HOSPITAL:
Feebleminded
Subnormal
Retarded
Hysteria
Insane
No psychiatric condition
'.
4
7
1
1
1
5
"WOMAN'S HOSPITAL:
Feebleminded
Subnormal
Psychopathic personality
Insane
No psychiatric condition
6
2
1
1
1-
GRACE HOSPITAL:
Hysteria
1
1g
11
CHILDREN S FKEE HOSPITAL:
Subnormal
Epileptic
Deferred
:
1
1
1
FORD HOSPITAL:
Hysteria
1
CITY BOARD OF HEALTH:
Feebleminded
Subnormal
Feebleminded and epileptic
Psychopathic personality
Deferred
7
1
1
1
1
11
VISITING NURSES ASSOCIATION:
Feebleminded
Subnormal
Epileptic
.'
Psychopathic personality
Hysteria
Unclassified insane
Dementia praecox
No psychiatric condition
BABIES MILK F U N D :
Feebleminded
4
1
2
1
1
4
1
1
,
1
PRIVATE PHYSICIAN AND F A M I L Y :
Feebleminded
Subnormal
Psychopathic personality
Hysteria
Unclassified insane
Dementia praecox
Manic-depressive
No psychiatric condition
Deferred
7
2
1
3
3
1
3
3
1
24
86
�40
STATE OF MICHIGAN.
STATE BOARD OF HEALTH.
Feebleminded
Subnormal
Retarded
Feebleminded and epileptic
Epileptic
Psychopathic personality
Dementia praecox
Manic-depressive
No psychiatric condition
35
27
5
1
1
7
1
1
12
90
176
As there are no clinics in any of the hospitals for the diagnosis or treatment of mental cases, most of these are referred to this clinic. Work
with the medical group has been particularly satisfactory, and has led
to many interesting consultations in case work. The physicians make
physical examinations, X-Rays, etc., and the hospitals have opened
their clinics and given hospital care to bed patients referred from this
clinic. The Visiting Nurses have done unusually good social nursing
on cases returned to their homes where special care was needed.
Private physicians frequently refer cases, sometimes with the request
that we diagnose and report back to them, but more often release the
cases to us, largely because with the numerous demands made upon
them they have little time to devote to the endless petty details of having
a patient committed to a State Institution, and they know that the
clinic is equipped to handle this part of the work. Some time ago we
found that we obtained better results with little effort to ourselves, and
much less inconvenience to the patient's family, if we took charge of the
preliminary work in connection with commitments.
In March, 1918, the clinic was asked by the State Board of Health
to make mental examinations of all cases interned for venereal disease
in Detroit hospitals. This request came at the suggestion of the Social
Workers who were handling the follow-up work in an attempt to rehabilitate the patients when released, as it was apparent that constructive
work was out of the question with many of them as they were definitely
defective and incapable of self-support under ordinary conditions of
employment. While mental defects and abnormalities were not altogether responsible for the failures in adjustment, they occurred in sufficient
numbers to make practical a systematic examination of all patients
with a view to segregating the a-typical as a group which could then
be dealt with accordingly and not allowed to hamper the work and confuse
results. We expected to find mental disabilities among this group, but
the number found far exceeds any of our early estimates. Feeblemindedness is the most frequent condition.
�PSYCHOPATHIC HOSPITAL.
41
INDUSTRIAL GROUP.
FORD MOTOR COMPANY:
Feebleminded
Neurasthenia
Unclassified insane
Dementia praecox
Manic-depressive
No psychiatric condition
Deferred
No diagnosis made
DODGE BROTHERS:
Compulsion neurosis
Dementia praecpx
General paralysis
1
1
5
2
1
2
1
2
15
2
1
1
SOLVAY PROCESS COMPANY:
Epileptic
j. L. HUDSON COMPANY:
Anxiety neurosis
2
1
2
1
UNION TRUST COMPANY:
Psychopathic personality
1
1
23
Among the more recent developments is the use of the clinic made by
the Welfare Departments of the industries. The types referred vary in
age and condition because the Welfare Departments look after the entire
family, as well as the employees, probably the father or older brother.
This leads to the discovery of many feebleminded and epileptic children
who are being cared for at home to the neglect of the others. Insane
and feebleminded wives are also frequently the cause of inability to meet
the requirements' laid down by the factory for employees. Of all cases
referred these have the promptest and most thorough after-care. All
recommendations are acted upon without question. Whether it is
because the industries want immediate relief from the disturbing factors
for economic reasons, or it is simply another instance of their prompt and
efficient methods which is part of their routine, the fact remains
that their social supervisors carry out all directions immediately upon
recommendation, and the case is not closed unt 1 advice is carried out or
the employee in whose interest the case was taken up leaves the factory.
�42
STATE OF MICHIGAN.
SUMMARY.
DIAGNOSIS:
Feebleminded
Subnormal
Retarded
Feebleminded and epileptic
Epileptic
Psychopathic personality
Hysteria
Psychoneuroses other than hysteria
Unclassified insane
Dementia praecox
Manic-depressive
Paranoia
General paralysis
Alcoholic dementia
Symptomatic mental state
Deferred
No psychiatric condition
No diagnoses made
347
198
20
8
13
49
36
12
33
13
11
1
4
1
1
50
167
14
978
RECOMMENDATIONS.
INSTITUTIONS HOSPITALS:
Lapeer
Wahjamega
Pontiac
Eloise
State Psychopathic Hospital
St. Joseph's Retreat
258
6
39
10
52
1
366
INSTITUTIONS, CORRECTIONAL:
House of Good Shepherd
Adrian
Lansing
Ford Republic
House of correction
9
7
15
19
3
CO
EDUCATION:
Special room
Public schools
School for crippled children
Fresh air school
Private schools
16
2
1
1
3
COURT CARE:
Mother's pension
Remove from home
Remove the children
Release to parents
Release from House Good Shepherd
Release from Ford Republic
Probation
Parole
6
16
3
1
6
1
121
2
SOCIAL CARE:
Supervision and social nursing
Deport
Bay Court
Florence Crittenden Home
220
17
1
1
MEDICAL CARE:
Harper Hospital
University of Michigan Hospital
Receiving hospital
RETURN TO PSYCHOPATHIC CLINIC:
NO ADVICE GIVEN:
1
5
1
83
51
978
23
156
239
�PSYCHOPATHIC HOSPITAL.
43
This table gives an idea of the type of after-care recommended. The
proportion of Institutional cases is high, as would be expected, but the
more interesting fact brought out is, that while many of them do
not require custodial care,, very few can manage for themselves unless
conditions can be specialized for them, and some sort of social service
is necessary if they are to succeed. The table would indicate that very
little medical work was done, but this is the fault of the method of compiling the statistics. The medical care recorded in the table refers only
to those cases where the problem was purely medical and not psychiatric.
All other cases are lost because the clinical picture is dominated by the
mental condition, rather than the physical, as is shown by the recommendations.
WAYNE COUNTY PSYCHOPATHIC CLINIC
BY NELLIE L. PERKINS.
Psychologist.
December 1, 1918.
�44
STATE OF MICHIGAN.
REPORT OF THE CLINICAL GROUPS.
MANIC-DEPRESSIVE INSANITY.
During this biennial period there were admitted 139 cases of manicdepressive insanity of which number 47 were males and 92 females.
The following table shows the frequency of this form of disorder among
the admissions to this hospital.
Male.
Female
Total
No.
Per cent.
No.
Per cent.
No.
Per cent.
206
47
22's
278
92
'33'i' '
484
139
' '28'7' '
There are considered among those under treatment during this period
five males and fourteen females who were admitted during the previous
period but were discharged in this. In all 158 cases of manic depressive
insanity were under treatment.
There was a relative increase of 3.3% in the number of admissions
with this disorder over that of the previous period. This increase was
almost wholly distributed among the female cases.
The following table shows the relative frequency of the several forms
of this disease. The diagnosis was determined from the course of the
disease of each case during the residence of the patient in the hospital.
Female.
Male.
Mixed
Total.
No.
Per cent.
No.
Per cent.
No.
14
31
1
1
29.1
66.0
2.5
2.5
25
56
2
9
27.6
60.8
2. 1
9.5
39
87
3
10
Per cent.
28.8
62.5
2.
6.7
Except in the so-called "circular group," it was the phase of the disorder
present at the time of admission which determined the diagnosis.
It will be seen from the above table that the depressive phase was the
most frequent. Both the manic and the depressive phase are more
frequent in the male sex; while the circular is more frequent in the female.
In the previous period the depressive phase was more frequent among
females.
�PSYCHOPATHIC HOSPITAL.
45
The three following tables show the number of patients who have
had at least one attack other than the one at present; the form of the
first attack in those having more than one attack, and the form of the
first attack in all cases admitted.
Male.
Female.
20
27
40
52
Total.
60
79
The form of the first attack in those patients having more than one
attack is shown in the following table.
Male.
4
Mixed . . . .
13
1
1
1
Female.
12
22
0
0
6
Total.
16
35
1
1
7
The form of the first attack in all cases of manic-depressive insanity
admitted was as follows:
Manic
Mixed. . . .
Male.
Female.
11
25
53
2
6
32
2
1
1
47
Q
92
Total.
36
85
4
7
7
139
These tables show that a previous attack had occurred in 42.5% of
all male and 43.4% of all female cases of this disorder. These percentages
are almost identical with those of the previous period. In the group as a
whole, previous attacks had occurred in 43.1% of all cases admitted.
In eleven, or approximately 8% of the cases, the first attack presented
a phase different from the one of this admission.
The form of the first attack in all cases admitted was manic in 25.9%;
depressive in 56.1%; mixed in 2.8%; circular in 5%, and unknown in 5%.
The following table shows the age of patients at the time of the first
attack and the age of patients at the time of their admission.
�Admission.
First attack.
Depressive.
Manic.
M.
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
.
.
Total
....
F.
Mixed.
T.
M.
F.
T.
M.
F.
T.
0
0
1
1
0
0
F.
T.
M.
F.
T.
M.
Mixed.
T.
M.
F.
T.
M.
1
0
2
5
14
13
15
15
8
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
3
1
9
0
1
3
3
1
3
0
2
0
0
3
7
1
4
2
2
2
2
0
4
10
4
5
5
2
4
2
0
0
1
0
0
0
0
1
4
1
1
1
0
0
1
2
3
4
8
4
2
1
0
1
3
11
9
7
11
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
0
1
0
2
0
0
0
2
4
1
0
0
0
5
1
1
0
0
0
7
5
2
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
2
3
1
9
10
14
25
39
31
56
87
1
1
6
6
4
6
2
2
0
1
1
7
10
8
6
5
2
1
1
0
0
2
5
7
4
4
5
0
1
2
3
5
14
6
5
5
5
1
2
5
10
21
10
9
10
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
2
3
1
1
0
0
0
2
1
0
0
0
2
5
2
1
0
0
2
0
0
0
0
0
0
13
30
43
32
51
83
1
1
1
1
Oil culai
F.
0
0
1
0
4
0
1
0
0
1
1
0
0
0
0 • 0
1
0
0
1
4
4
0
3
0
1
0
1
M.
Depressive.
Manic.
Circular.
1
1
0
1
1
1
F.
0
1
3
1
1
2
0
0
0
1
T.
�PSYCHOPATHIC HOSPITAL.
47
From the above table it is evident that, where the first attack was
manic in character, 41.8% occurred under the twenty-fifth year. Where
the first attack was depressive in character, only 9.6% occurred under
the twenty-fifth year. This is less than half the number in the previous
period. In all cases admitted, the first attack occurred before the twentyfifth year in 23.8% and before the fiftieth year in 85.6%.
There is one group of the depressive cases which calls for separate
consideration, those in which there seems to be some connection with
the involution period. There were five cases admitted in the period, or
3.6% of all cases admitted. Four of the five cases were females, and
their ages were respectively 46, 48, 49 and 54. The one male was 55.
Four of the five had had no definite previous attack. All were apprehensive, and agitated. Three of the five died apparently from exhaustion
and starvation. Mechanical feeding was necessary in four of these cases.
There is also a group of six cases, or 4.3% in which there was a strong
paranoid tendency; of these, five were females, and all occurred between
the 34th and 53rd year.
One other group of manic-depressive cases should be noted at this
point; namely, those with unmistakable evidences of mental deficiency.
Two such cases were admitted during the period. Both were mild manic
cases, the so-called "hypomanic" phase, and are not inciuded in the
table on page 74, under the group headed "Psychosis with Mental
Deficiency". The reason for not including these two cases under this
last named group is that both came into the hospital primarily because
of manic excitement and manic tendencies. One was a male age 48; he
had shown a change of character and temperament for a year precedingadmission, and was regarded as improved when discharged. The other
was a female age 23, and had had a sub-acute course dating back for a
period of nearly three years. The male showed, by psychometric test,
a mental age of 9 years, and the female a mental age of 9.16 years.
Both individuals judged by economic and social, as well as educational
criteria, had a history that confirmed the results of psychometry.
HEREDITY.
Information concerning the occurrence of nervous and mental disorders
in the families of the patient with this disorder was obtained in 129 of the
139 cases admitted.
The nature of the distribution of these are shown in the following table.
In 72% of the families where information was available, there were
instances of mental abnormalities other than those of the patient.
In the families of the 93 cases showing abnormalities of the family
and antecedents, there were 34 in which there was one other instance
of abnormality. There were 31 families with two, fifteen with three,
six with four, six with five, two with six, two with seven, and two with
eleven instances of abnormalities. In the 93 families, there were 318
abnormal individuals.
�STATE OF MICHIGAN.
48
Direct.
Atavistic. Collateral.
Brothers
and
Sisters.
Total.
M. F. T. M. F. T. M. F. T. M. F. T. M. F. T.
Psychopathic Inferiority
Total heredity .
8 20 28
3 7 10
1 10 11
3 2 5
2
1
1
1
2
0
0
0
4 5 15 20 5
1 1 1 2 0
1 0 0 0 0
1 0 1 1 0
5 10 20 42 62
0 0 5 8 13
0 0 2 10 12
0 0 4 3 7
15 39 54
5
2
7
5 10 31 63 94
6 17 23
5
14 22 36
Unknown
2
Total . . . .
...
7
9
47 92 139
ETIOLOGY.
Of the 139 patients admitted, eighteen were reported by the informants
as having peculiarities of personality preceding the acute outbreak.
In 107 cases there were experiences closely associated with the onset
of the disorder, which were regarded by their friends as of causative
importance. Many of these experiences may be better regarded as
precipitating factors than as true etiological factors. They seem to
appear at a time when the individual is under stress which, either because
of his make-up or because of his physical condition, he is not able to
meet.
In ten cases the onset was associated with the puerperium. In three
instances the attack appeared to be influenced by the appearance of the
menses or associated with menstrual disorders. In 18 instances financial
or occupational difficulties seemed to precipitate the attack. Physical
illness or surgical treatment was given in 17 instances.
Illness or death in the family occurred in sixteen cases. Conjugal
troubles including quarrels, desertion, divorce, etc. were assigned as
causes in eight instances. Insanity in the family was thought to precipitate in three instances; enlistment of a son or husband in five instances;
religion was held as responsible in three cases; disappointment in love
in five, and the menopause in one.
Wassermann examinations of the blood serum were made in 135 of the
139 cases admitted. It was found strongly positive in one case only.
Three cases gave a doubtful reaction on the first examination, but all
of these were returned as negative on subsequent examination. One
male shows a cell count of six cells in the spinal fluid. In none of these
doubtful cases was there a history or clinical evidence of a luetic infection.
The one case in which the blood Wassermann was strongly positive,
was a wonian, twenty years of age. Her family history was bad, her
mother being a neurotic; her father suicidal, one sister mentally deficient,
one brother insane and two paternal uncles alcoholic. She was of limited
education. She was of an excitable temperament, em . tionally unstable,
�PSYCHOPATHIC HOSPITAL.
49
and even before her attack always seemed to do things as if under high
tension. She married at seventeen. She had no previous attacks.
The present trouble dated one month previous to admission. She
suddenly became elated following child birth. Physical and neurological examinations negative. Blood Wassermann + + + +. 6 cells.
Nonne-Apelt, phase one, two dilutions doubtful. Gold sol, almost a
flat curve, 00011000000. She entertained delusions of reference. The
predominating mental symptoms were those of a manic excitement: she
was resistive, irritable, exhibited a pressure of speech, was profane,
destructive, and had to be tube fed. She also had auditory and visual
hallucinations.
EESULTS OF TREATMENTS.
The following table shows the condition of the cases of manic-depressive insanity at the time of discharge from the hospital. There are
considered here the cases admitted during this period and 19 cases of
this disorder remaining over from the previous period.
The average duration of treatment for males was 77 days, for females,
103 days; for both sexes, 94.3 days. All the patients were discharged
to their homes, except nine who died, and sixteen who were transferred
to the various State Hospitals.
Manic.
Depressive.
Mixed.
Circular.
Total.
M. F. T. M. F. T. M. F. T. M. F. T. M. F. T.
Unimproved
Died
Remaining
-
5 4 9 8 3 11
5 6 11 13 29 42
4 12 16 2 23 25
0 1 1 4 4 8
1 4 5 7 10 17
0 0 0 0
0 1 1 1
1 0 1 0
0 0 0 0
0 1 1 0
2
0
3
0
4
2 13 9 22
1 19 36 55
3 7 38 45
0 4 5 9
4 8 19 27
It may be seen from this table that of the 130 patients discharged,
16.9% were discharged recovered; 42.3% improved; 34.6% unimproved;
and 6.9% died.
Of the 37 cases of the manic phase, 24.3% were discharged recovered,
and 30% improved. Of the 86 depressive cases, 12.7% were discharged
recovered, and 48.8% improved.
Grouping the recoveries and improvements together we find from this
table that 65.7% of the manic cases and 56.9% of the depressive cases
were benefited by their hospital treatment. Nine patients died from
inter current disorders.
It was possible to make a laboratory study of the central nervous
system in one of these.
Case 1945—Manic-depressive, depressed phase. Male, age 55. Stationary Engineer, One sister insane. Always a hard and conscientious
worker, particular about details, and of good habits. No previous
attacks. Present trouble sub-acute, and of about' one year's duration
previous to admission. Financial losses due to playing margins in the
stock market seem*i'o have been the precipitating situation. Physical
�STATE OF MICHIGAN.
50
examination showed little except a general adenopathy, a scaphoid
abdomen, and blood pressure, systolic, 150. Neurological examination
also showed little except a slight oedema of the nerve head and the retina
with slight arteriosclerotic changes. Serological examinations negative
except for a count of six cells in the C. S. F.
His sleep was extremely disturbed. He lost 18 pounds in weight
during his residence here of 18 days. He expressed delusions of selfaccusation, and was deeply depressed, and agitated. Mechanical feeding
became necessary.
Autopsy was performed 1J^ hours after death. In the gross, the brain
appeared normal, but small. It weighed 1190 grams. No pathology
in the chest organs. Stomach greatly contracted, and its mucosa much
congested. Capsules of both kidneys adherent. Adrenals hypertrophied and very firm. All the muscular tissues deeply colored, probably
the result of starvation. No gross cause of death was found.
Histological examination of the cortex showed nothing distinctly
pathological except an excess of fatty pigments in the pia and in the
endothelia of all blood vessels, even to the finest capillaries, and in the
glia cells.
The left adrenal showed irregular light-colored patches in which the
cell nuclei were much reduced in number and the cell bodies large and
pale. Many small hemorrhages and a general venous congestion were
also seen.
DEMENTIA PRAECOX.
There were admitted 89 patients whose mental disorder was diagnosed
as Dementia Praecox. This number formed 18.4% of all patients admitted.
Per cent.
No.
Dementia praecox
206
40
Total.
Female.
Male.
•
19.4
No.
Per cent.
No.
Per cent.
17.6
484
89
18.4
' 278
49
The 40 male cases formed 19.4% of all males admitted and the 49 female
cases 17.6% of all females admitted.
The 89 cases occurred in the following clinical forms:
Female.
Male.
Paranoid type
Hebephrenic type
Simple type
Total
No.
Per cent.
4
8
20
8
10
20
50
20
40
No.
Per cent.
No.
Per cent.
20.4
32.6
40.8
6.1
15
23
40
11
16.8
25.8
44.9
12.4
11
15
20
3
49
Total.
f
89
�51
PSYCHOPATHIC HOSPITAL.
AGE.
The following table shows that the onset of the mental disorder
occurred before the 25th year in 48.6% of the male cases and 34.8%
of the females or 40.8% of all cases of Dementia Praecox admitted.
The youngest age of onset was 12 and the oldest 43.
Admission
Onset.
F.
M.
10-14
15-19
20-24
25-29. . .
30-34
35-39. .
40-44. .
45-49
50-54 .
55-59 . . . .
9
11
6
1
2
3
11
8
10
10
4
10
20
19
16
11
6
11
8
8
1
2
3
2
. . .
....
3
3
F.
M.
T.
T.
2
2
10
10
11
13
2
16
21
19
21
6
1
1
2
1
1
0
0
1
1
4
6
The relative frequency of occurrence before the 25th year of the various
clinical types was:
Per cent.
Paranoid type
Catatonic t y p e . . . .
Hebephrenic type.
Simple type
20.0
43.4
37.5
63.6
Information regarding hereditary influences was obtained in 80 cases.
Among these there were 54 or 67.5% in the families of which there was
a history of insanity or some other predisposing factor.
In these 54 families there were 163 individuals who were mentally
or nervously disordered. The following table gives the details:
Direct.
M.
Apoplexy or
Psychopathic. . . .
7
2
3
2
Total heredity . . . 14
Unknown
Total .
Atavistic.
T.
M.
F.
7 14
1
7 10
4
6
19 33
2
1
0
3
3
6
3
9
F.
Brothers
and sisters.
Collateral.
Total.
T.
M.
F.
T.
M.
F.
T.
M.
F.
1
3
2
4
6
2
1
3
2
3
1
2
3
13
3
2
4
6
3
3
6
4
2
22
15
3
13
3
9
7
32
11
6
26
6
13
9
54
26
9
40
49
89
T.
�52
STATE OF MICHIGAN.
ETIOLOGY.
Information regarding the personal constitution of the patient was
obtained in 61 cases.
In 35 instances there were abnormalities of personality that had attracted the attention of others. The most frequently observed peculiarities were unusual reticence or seclusiveness, various oddities of character,
and indefinite nervous manifestations.
In 29 instances there were quite definite precipitating causes. These
were reactions to experiences of strong emotional quality or in relation
with some physical disorder or accident. In 4 instances the acute attack
occurred after confinement.
RESULTS OF TREATMENT.
The results of treatment are given in the following table. Among these
are included 10 cases remaining over from the previous period.
M.
0
16
22
0
7
Died
F.
2
1G
28
1
7
T.
2
32
50
1
14
Per cent.
23
37.6
58 8
1.1
Of those discharged 53 returned to their families and 31 were transferred
to one of the larger State Hospitals for the Insane.
PARANOID TYPES.
There were admitted 15 patients that belonged to this group,
of these were males and 11 were females.
The ages at onset and at admission were:—
\dmission
Onset.
M.
20-24
25-29
30-34
35-39
2
1
0
1
F.
T.
1
3
5
2
Four
3
4
5
3
M.
F.
1
0
T.
1
3
7
4
0
3
5
3
2
1
Hereditary predisposition was present in 10 of 13 cases regarding
whom information was available.
The results of treatment were:—
M.
Unimproved.
0
1
3
1
F.
T.
1
4
5
2
1
5
8
3
�PSYCHOPATHIC HOSPITAL.
53
CATATONIC TYPE.
There were admitted 23 cases belonging in this group. Eight of these
were males and 15 were females, as may be seen in the following table:
Admission
Onset.
M.
0
1
10 14
15-19
20-24
25-29
30-34
35-39
40-44
2
4
0
o
1
o
P.
T.
M.
1
1
2
4
2
2
3
I
1
2
6
6
2
I
2
F.
T.
1
2
6
2
2
8
5
3
3
2
1
o
3
1
0
1
3
1
2
Hereditary factors were present in the families of 68.4% of cases.
The results of treatment are given in the following table: This includes
two patients remaining over from the previous period.
M.
Recovered
Died
.
0
5
3
0
1
F.
1
3
10
1
1
T.
1
8
13
1
2
One patient with acute catatonic stupor died. This was F. D. 2185,
a young woman aged 21 at her admission to the hospital. Her father
for several years showed marked psychopathic traits, became addicted
to the use of chloroform and died from heart disorder. She was born
at a difficult instrumental labor. In childhood she was delicate, suffered
much from gastro-intestinal disorder, and required for a long time a
carefully regulated diet. Temperamentally she was rather serious and
was always regarded as being a nervous child. She did well in school
and had completed two years in college when she developed mental
peculiarities. On account of straightened family circumstances she was
obliged to work while attending college. She at times showed unhappiness over her situation, and complained of being tired and unable to
do her work as well as formerly. Her mood became continuously mildly
depressed. She withdrew from companionship of others and about
a week before her admission suddenly broke into tears. When given a
hypodermic she became greatly agitated, asserting that it would cause
her to fall asleep and she would not awake. For a few days she became
more normal in her behavior, then she began to make a peculiar humming
noise with her mouth and smack her lips. This persisted for some days.
She no longer showed her usual interest in things around her. This
attitude lead to her admission here.
The physical examination showed the following: Good development
and nutrition, muscles in general are moderately spastic. The heart
rapid and at times arrhythmic. Respirations increased in frequency
�54
STATE OF MICHIGAN.
and shallow. Her behavior was unusual, she held herself in a rather
stiff attitude, her pupils were widely dilated and she usually would keep
her gaze away from the one talking with her. Her motor reactions soon
took on a stereotyped character. She stood in strange attitudes. She
kept up a peculiar rhythmic noise and for a long time continuously
smacked her lips. Finally she resisted whatever was done for her and
refused to talk or eat. The first few days she would at times give attention
to questions, but usually she was quite out of touch with things around her.
When she would attend her comprehension was clear. Her stream of
thought was hesitating and interrupted by frequent blocking. Her
productions of thought were few, they largely concerned her family
and were at times expression of fear of harm coming to herself or mother.
There were frequent instances of ambivalent thought. Three days
after her admission her attitude was extremely negativistic. She refused
to talk or do anything for herself. Her facial expression was one of
troubled perplexity. Her physical failure was rapid. In spite of artificial feeding and saline infusions her nutrition failed. Her hands and
feet became cyanotic, the surface of her body was cool and moist. Her
heart was rapid and shallow. There was no rise in temperature. Death
occurred 11 days after admission. The autopsy showed no gross pathological changes in the body organs. There was no gross change in the
thyroid or thymus glands.
The brain appeared under tension and somewhat more voluminous
than usual. It weighed 1350 grams. The membrane was clear. The
veins of the pia mater were slightly filled. The brain substance was
excessively moist, but not softened.
The histological studies of the brain showed very marked pathological
conditions among nerve cells and glia, and blood vessels. The nerve
cells especially in the second and third layers of the cortex were excessively
filled with fat, and many showed granular degeneration. The nucleus
was frequently folded and of irregular outline. The glia in the molecular
layer was increased. Many abnormal glia cells were present in all layers.
There were many of the ameboid type. Endothelium of the blood vessels
was frequently observed in a state of proliferation, many of the nuclei
showed mitoses.
The changes present in this case agree with those that have previously
been observed in rare instances of sudden death in dementia praecox,
and show definitely that at least in some cases of this disease there is
associated a definite structural disorder of the brain.
�PSYCHOPATHIC HOSPITAL.
55
HEBEPHBBNIC TYPE.
There were admitted 40 cases whose mental disorder was of this type.
The cases were equally divided between the two sexes.
The ages at onset and admission were:
Admission
Onset.
F.
M.
15-19
20-24
25-29
30-34
35-39
40-44
45-49
T.
I
F.
M.
T.
4
6
5
4
4
3
3
5
10
8
7
3
7
5
3
0
3
5
4
3
10
10
7
0
0
7
1
7
1
2
1
1
6
1
1
8
1
1
2
0
0
Hereditary factors were present in 63 per cent of the cases, regarding
which information was available.
The results of treatment are shown in the following table; this includes
four patients admitted in the previous period.
M.
Recovered
F.
8
10
4
Died
T.
9
11
17
21
2
6
SIMPLE TYPE.
Eleven of the cases admitted belonged in this group. Eight of these
were males and three were females.
The ages at onset of the disorder and at admission were:
\dmission
Onset.
M.
10-14
15-19
20-24
25-29
30-34
35-39
50-54 . .
55-59
F.
M.
T.
F.
T.
2
1
1
1
0
2
3
1
3
2
I
1
1
3
2
2
0
2
2
0
2
1
1
1
1
0
0
2
1
1
2
0
2
�56
STATE OF MICHIGAN.
Hereditary factors were present in 63% of the cases.
The results of treatment are shown in the following table:
This includes two patients remaining from the previous period.
M.
Recovered
Unimproved
Died
Remaining
•
...
T.
F.
2
6
0
2
2
8
1
2
3
PARANOIA AND PARANOIAC CONDITIONS.
Under this heading are placed a number of cases in which the mental
symptoms were of a paranoiac type, but in which the clinical course was
different from that of the paranoid form of dementia praecox and it did
not seem possible to find a relationship with any specific cause.
Some of these cases in their clinical course correspond to the group
which Kraepelin has described and defined as paraphrenia systematica;
some show distinct presenile features; some are associated with impaired
hearing; and some are less clear in their clinical position and as a consequence are grouped together as a general group of undifferentiated
paranoid conditions.
The following shows the total number of such conditions admitted
during the period. Nine are males, and fourteen are females, or 4.7%
of all admissions.
Female.
Male.
1
4
0
0
4
Paranoiac conditions with impaired
Undifferentiated paranoiac conditions
Total
Paranoiac conditions including
Total.
1
7
2
2
11
2
1
7
1
3
9
23
14
No.
Per cent.
No.
206
9
4.3
278
14
Per cent.
5
No.
Per cent.
484
23
4.7
It is interesting to note that but two cases of true paranoia were admitted during the period, or .4 of one per cent. Of paranoid cases associated
with impaired hearing there was but one, or .2 of one per cent. Presenile
paranoiac conditions number the same as those of paranoia.
�PSYCHOPATHIC HOSPITAL.
57
PAEAPHRENIA SYSTEMATICA.
Eleven cases admitted during the period were grouped under this
heading, four of them males, and seven females; in all they make 2.2%
of the total admissions.
Male.
No.
Total.
Female.
Per cent.
206
4
2
No.
Per cent.
No.
Per cent.
278
7
2.5
484
11
2.2
The following table is interesting in that it shows the onset in 63.7%
of the eleven cases of paraphrenia sytesmatica occurred before the
thirtieth year, and 100% before the 45th year.
Onset.
M.
15 to
20 to
25 to
30 to
35 to
40 to
45 to
50 to
55 to
19
24
29
34
39
44
49
54
59
F.
M.
T.
1
0
0
2
2
Total
\dmission .
1
F.
T.
0
2
1
0
0
0
1
0
1
3
0
3
1
1
3
2
0
0
0
0
1
0
0
0
1
1
0
0
2
1
0
0
7
11
4
7
11
2
0
0
2
2
0
4
0
0
0
0
2
0
0
4
2
0
Hereditary factors were present among the ancestry in five instances,
or 46.5% of the cases.
RESULTS OF TREATMENT (PARAPHRENIA SYSTEMATICA).
The following table shows the results of treatment in the cases of
paraphrenia systematica discharged during the period. One case
improved. This stands in contrast to eight discharged as unimproved.
It is needless to say that the prognosis in this condition is bad.
M.
Improved
Unimproved
Died
Total
.
...
. . .
. .
. .
F.
T
0
1
3
0
0
0
5
0
0
1
8
0
4
5
9
�58
STATE OF MICHIGAN.
Of those discharged seven were returned to their families and two were
transferred to some one of the State Hospitals.
PARANOIAC CONDITIONS UNDIFFERENTIATED.
There were admitted during the period a number of individuals whose
mental disorder was characterized by more or less elaborated delusions,
and which showed symptoms and course different from the paranoid
conditions grouped elsewhere.
There were seven of these cases, four males, and three females, in all
forming 1.4% of all admissions.
PARANOID DISORDERS
UNDIFFERENTIATED.
Male.
No.
Hospital admissions
Paranoid disorders, (undifferentiated
206
4
Female.
Per cent.
2
No.
278
3
Total.
Per cent.
1
No.
Per cent.
484
7
1.4
The ages at onset and admission are shown in the following table:
\dmission
Onset.
M.
25
30
35
40
45
to
to
to
to
to
29
34
39
44
49
50 to 54
55 to 59
60 to 64
Unknown
Total
F.
M.
T.
F.
T.
1
1
0
0
1
1
1
0
1
0
2
2
0
1
1
1
1
0
0
1
0
1
1
1
0
2
1
1
1
0
o
0
I
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
4
3
4
3
7
1
1
1
Hereditary factors were present among the antecedents in five instances,
three of these being in the direct line.
The results of treatment are given in the following table:
M.
Unimproved
1
0
2
1
F.
T.
0
2
2
0
1
2
4
1
All of the above cases were returned to their families, some against
advice, and one, by escape.
�PSYCHOPATHIC HOSPITAL.
59
The following tables show at a glance the heredity in all of the twenty three cases of the entire group of paranoia and paranoiac conditions.
The first table shows the number of separate instances in each of the
different sub-groups. Forty-seven per cent of the cases show that
hereditary factors were denied or unknown. The positive instances
are almost equally distributed between paraphrenia systematica and the
undifferentiated cases.
The second table shows the different forms of hereditary taint in the
twenty-three cases. Apoplexy and paralysis lead with 33|%; and
insanity and alcohol each with 25% of the total instances with positive
heredity.
•
M.
Paranoia
Paraphrenia
Systematica. . . .
Presenile condition
Deaf. .
Unclassified
0
1
0
0
Total heredity
2
Denied
M.
F.
T.
M.
F.
T.
M.
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
2
0
2
1.
1
3
1
0
0
0
1
0
1
0
0
1
5
7
0
0
0
1
1
2
2
F.
0
1
1
1
1
.
.
Total .
....
T.
..
.
Direct.
Total
T.
M.
F.
0
1
0
0
0
0
2
0
0
1
0
2
0
0
3
0
3
1
1
2
0
5
1
1
5
1
3
5
7
12
4
0
5
2
9
2
9
14
23
F.
. .
..
Atavistic.
Brothers
and
sisters.
Collateral.
T.
Total.
T.
T.
M.
F.
T.
M.
P.
T.
M.
F.
T.
M.
F.
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
1
0
1
0
1
0
1
0
0
0
0
0
1
0
1
0
2
3
3
0
1
4
0
3
1
1
0
1
1
2
1
3
0
2
4
2
3
5
7
12
4
0
5
2
9
2
9
14
23
Total heredity
Denied
Unknown
Total.
F.
M.
Insanity
Apoplexy or paralysis
Psychopathic. . . .
Alcoholism
Brothers
and
sisters.
Collateral.
Atavistic.
Direct.
....
2
�60
STATE OF MICHIGAN.
RESULTS OF TREATMENT.
Results of treatment in the cases of paraphrenia and the undifferentiated cases have already been noted. The following table shows the
results for the entire group of paranoia and the paranoiac conditions.
Of the 21 cases discharged, 15 were regarded as unimproved, or 71.4%.
Only 1 case recovered, and that was an undifferentiated case, a male of
60, who had delusions of marital infidelity. He entered the hospital
physically under-nourished: As he gained in weight and as his sleep
became more regular, his mental condition improved and at the end of a
month's treatment he was discharged as recovered.
M.
Recovered
Improved
Unimproved
F.
T.
1
1
6
0
2
2
1
5
15
4
4
Q
Of the 21 cases discharged, 17 were returned to their respective families,
and 4 were transferred to the State Hospital.
MENTAL DISORDERS DUE TO SYPHILIS.
During the biennial period, 39* cases were admitted in which the
mental disease was due to syphilitic involvement of the central nervous
system. Clinically these cases were classified as follows:
F.
M.
8
23
1
0
Tabes
FREQUENCY
OF SYPHILIS AMONG CASES
T.
31
7
1
6
1
ADMITTED.
Of the 484 patients admitted during the period, 433 had the Wassermann
test made on their blood, and of these 93 had the Wassermann test made
on their cerebrospinal fluid. The results of these tests were as follows:
Blood.
Positive
Cerebrospinal fluid.
M.
F.
T.
27
168
21
217
48
385
M.
24
25
F.
16
28
T.
40
53
*Two cases, 1 male and 1 female, with constitutional syphilis but not insane were admitted
for examination.
�PSYCHOPATHIC HOSPITAL.
61
Of the total admissions, 48 or about 9.92% had syphilis. Deducting
39 cases whose mental disease was directly due to syphilis and 2 cases
of constitution syphilis not insane, leaves 7 cases, or 1.45%, who had
syphilis but whose mental disturbance was of a non-syphilitic type.
Distinguishing between the sexes, 27 cases, or 13.05 % of males admitted
and 21 cases or 7.55% of females admitted gave positive Wassermann
test. It is interesting to note that of the 7 cases classified as cerebrospinal
syphilis, 6 were females while only 8 of the 31 cases of general paralysis
were women.
FAMILIAL SYPHILIS.
For several years it has been the practice of this hospital, whenever
possible, to examine for the presence of syphilis, members of the family
of patients who have had syphilitic forms of mental disease. Difierent
members of the family are examined neurologically and a Wassermann is
made on their blood. When this is found strongly positive, they are
usually advised to enter the hospital for a lumbar puncture and for further treatment.
During the present period Wassermann tests were made upon the blood
of the wives in seventeen cases of male general paralytics. The result of
this showed that eight wives exhibited the presence of syphilis, or a percentage of forty-seven.
Tests made upon the blood of the husbands of six women, who had
general paralysis, showed that five of these had syphilis, a percentage of
83.3.
There were six cases of wives who had cerebro-spinal syphilis; the husbands of five of these showed the presence of syphilis, a percentage of
83.3.
In twenty-nine cases of mental disorder due to syphilis in which members of the family were examined, the mate showed the evidence of
syphilis in eighteen instances, or a peicentage of 62.
Examination of the blood of sixteen children distributed through these
cases gave only one positive Wassermann reaction. In one case of juvenile paresis, the blood of the parents was positive.
GENERAL PARALYSIS.
During the biennial period, 23 male and 8 female, or a total of 31 cases
of general paralysis were admitted. The ratios and percentages as related
to total admissions were as follows:
Male.
General paralysis
Female.
Total.
No.
Per cent.
No.
Per cent.
No.
Per cent.
206
23
'ii'ie' '
278
8
' '2\87' '
484
31
6.40
�62
STATE OF MICHIGAN.
CLINICAL FOKMS.
The majority of the cases were of the demented type. In one case of
juvenile paralysis, both parents were luetic. Two cases of the demented
and 1 of the expansive types also had the Lissauer syndrome. The
cases were classified as follows:
M.
Demented
Agitated
Delirious
F.
16
4
2
0
1
T.
6
2
0
0
0
22
6
2
0
1
AGE.
Leaving out 1 case of juvenile paralysis aged 13 years, the average
age at time of admission for males was 36.1 and for females 36.5.
The following table shows the age at the time of onset of the disease
and age at time of admission of patients to the hospital:
Admission.
Onset.
Age.
M.
F.
1
0
10-14 .
20-24
25-29
30-34
35-39. .
40-44
45-49
4
11
5
0
M.
1
1
3
4
14
7
1
0
1
1
0
3
2
1
2
,
T.
F.
1
0
2
4
11
5
0
T.
1
1
3
4
14
7
1
0
1
1
0
3
2
1
HEREDITY.
Hereditary factors were found in 19 of the 31 cases admitted, or 61.22%
of cases in which information was obtained. 10 cases gave negative
histories for instances of hereditary factors.
Among the antecedent and collateral relatives of the 31 cases of general
naralysis, there were 61 instances of mental abnormalities.
Direct.
Insanity
Apoplexy or paralysis
Psychopathic. . . .
Alcholic
Total heredity . . .
Total
Brothers
and
sisters.
Collateral
Atavistic
Total
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
2
1
2
2
1
0
0
0
3
1
2
2
2
0
0
0
1
0
0
0
3
0
0
0
0
0
0
0
2
2
0
0
2
2
0
0
1
0
0
1
0
0
1
2
0
1
1
5
2
5
2
0
1
10
3
3
3
11
10
2
8
0
0
19
1O
2
23
8
31
1
3
T.
�PSYCHOPATHIC HOSPITAL.
63
PRODROMAL PERIOD.
The approximate date of syphilitic imection was obtained in 21 of the
31 cases. The average interval between the date of infection and onset
of mental symptoms was 11.95 years.
Time in years
5
7
8
9
10
11
12
13
14
15
16
24
1
1
1
1
5
2
1
3
2
1
2
1
NEUROLOGICAL DISTURBANCES.
No.
of cases. Per cent.
Pupil
23
20
17
70.97
70.97
41.93
51.61
25.81
22 58
58 06
83 87
6 45
74 19
64.52
54 84
10
32.26
22
Unequal
.
Reaction sluggish
22
13
16
8
7
18
26
2
Both
Apoplectiform or epileptiform
In 6 cases the pupillary reflex to light was absent on 1 side only, but
in each of these cases the light reflex was sluggish on the opposite side.
Tabetic symptoms were present in 10 cases, all of which showed disturbance in locomotion.
SEROLOGICAL CONDITIONS.
Wassermann test on the blood of the 31 cases showed a strong positive
reaction in 27 cases, + in 1 case, and + + in three cases. The Wassermann test on the cerebro-spinal fluid showed a strongly positive reaction
in 30 cases. In one case, the fluid was not examined.
The number of cells per cu. mm. in the cerebrospinal fluid in 29 cases
examined was as follows:
No. of cells per cu. mm
No of cases
5
to
11
to
16
to
21
to
31
to
41
to
60
100
61
to
Over
1
5
7
3
4
6
2
1
10
15
20
30
40
100
�64
STATE OF MICHIGAN.
In all except 3 cases, the albumen content of the cerebrospinal fluid
was greatly increased. In 5 cases, the Nonne-Apelt (Phase I) test was
positive in 5 dilutions of the fluid; in 19 cases, the fluid showed positive
test in 10 dilutions; and in 3 cases was positive in 15 dilutions.
Quantitative test by the Nissl-Esbach method gave the following
results in 29 cases examined:
Per cent, albumen
No of cases .
03 +
04 +
05 +
06 +
1
0
0
6
07 + .08 + .09 + .10 +
2
10
5
5
The Colloidal gold test was made on 28 cases with the characteristic
curve of general paralysis in 26 cases and with the curve of cerebrospinal
syphilis in 2 cases, 1 of which later gave the typical curve of general
paralysis.
RESULTS OF TREATMENT.
Energetic anti-syphilitic treatment of general paralysis, by known
methods, appears to be of benefit only to cases in which the disease
has made slight progress. In favorable cases, the progress of the disease
appears to be arrested and notable improvement has been observed.
Our methods of treatment have been varied from time to time with hope
of finding some manner of treatment which would give more encouraging
results than methods used up to the present have given.
Salvarsan or closely related substitutes have been given intravenously
in all cases treated. In addition mercurial inunctions and periodical
withdrawal of varying amounts of cerebrospinal fluid and the introduction of from 0.3 mg. to 1.2 mg. of Salvarsan into the spinal canal have
been resorted to.
In only 1 instance of a series of about 9 cases which received energetic
treatment were the results satisfactory.
This case (No. 2009) was admitted to the hospital, February 2, 1917.
Primary infection occurred 5 years prior to onset of mental symptoms. At
the time of admission to the hospital, the abnormal mental condition was
indicated by the patient's euphoric mood, mildly grandiose ideas, overactivity, unreliability, irritability, defective memory, and disturbance of
attention. Neurological examination showed deafness in left ear, sluggish
and irregular pupils, exaggerated knee and tendo-achilles reflexes, tremors
of the tongue and fingers.
Laboratory examination of the blood and cerebrospinal fluid showed:
Blood-Wassermann + + + +, Cerebrospinalfluid-Wassermann+ + + +,
cells in csf. 157 per cu.mm., pressure greatly increased (Nonne-Apelt
test 10 dil. + ), (Nissl-Esbach Method 0.09%.)' Collodial-gold curve
55555542000.
This patient received 17 intravenous and 24 intraspinal injections
of Salvarsan at intervals of 1 week each. He remained in the hospital
40 days after first admission and then returned every week for treatment.
The amount of cerebrospinal fluid withdrawn each week varied from 15
c.c. to 70 c.c. and at no time was there serious reaction following the
withdrawal of the fluid. The fluid was withdrawn as soon as possible
following the intravenous injection of Salvarsan. The dosage of Sal-
�PSYCHOPATHIC HOSPITAL.
65
varsan was usually 0.6 gm. The dosage of Salvarsan injected intradurally immediately following withdrawal of the fluid was 0.3 mg. increased
gradually to 1.2 mg.
Examination after treatments were discontinued, showed neurological
conditions unchanged. Wassermann test on the blood was ±. Wassermann test on the cerebrospinal fluid showed 0.10 c.c. = + + + +.
0.08 c.c. = _ + +, 0.05 c.c. = ±. Other fluid findings were: Color =
clear, pressure increased, cells = 8 per cu. mm., Nonne-Apelt = 2 dil.
+ , 5 dil. ±, Nissl-Esbach .026 per cent albumen.
The patient has continued at work but has shown minor irregularities
of conduct which are gradually interfering with his domestic and business
relations.
Of 14 cases of general paralysis receiving various degrees of treatment,
6 showed improvement and 5 of these returned to their homes. Only 1
untreated case showed improvement. 1 treated case with extensive
focal lesion and Lissauer's syndrome died.
The following table shows the condition of patients discharged. Four
male patients admitted in the previous biennial period are included.
Re covered.
Improved.
Unimproved.
Died.
General paralysis.
M.
Demented
Expansive
....
P.
T.
M.
P.
5
1
2
0
T
7
1
M.
14
P
T
2
2
4
2
0
18
4
2
1
0
1
M
1
P
0
T
1
Of 34 patients discharged, 19 were transferred to one of the State
Hospitals and 14 returned to their homes.
The average period of residence of patients of this group was 104.2 days.
Case H. M. 2144. A male aged 36 at admission. Temperamentally
he was neurotic, emotional and unstable. At 24 probably luetic infection. No serious after -effects were noted. Nine months before admission there developed an unusual irritability, and unreasonableness.
There was a tendency to sleep during the day. These symptoms gradually
increased. Six months after the first symptoms there occurred a convulsion followed by unconsciousness. From this there was seemingly
good recovery. Two weeks later another attack of unconsciousness
lasting a number of hours. During the next week there were a number of
similar attacks. After this period he showed marked mental change.
He had a profound memory disturbance for retention and recall of names.
There was a marked paraphasia with inability to name many objects or
call them by their proper name. His mood was expansive, and he expressed numerous grandiose ideas.
On admission to this hospital he
showed no serious condition of the body organs, but there were numerous
and severe neurological disturbances. The pupils were dilated, irregular in outline, and reacted sluggishly to light. All tendon reflexes
were much increased.
There was a severe dysarthria and paraphasia with amnesia for names. Mentally he was euphoric and
�66
STATE OF MICHIGAN.
showed a rather characteristic mental state of paresis. Focal disturbances were always prominent. At one time there was a transitory
paralysis of the tongue, and the aphasic condition did not improve.
About 5 weeks after admission the knee jerks disappeared and he developed
a marked ataxia in gait and arm movements. From this time on there
was retention of urine. The neurological findings were as follows. The
blood always gave a strongly positive Wassermann reaction. Six examinations of the spinal fluid all showed increase of cells, varying between 14
and 41. The albumen was usually increased about twice over normal.
The colloidal gold reaction was always that of a typical paretic process.
The Wassermann reaction was always strongly positive. Death occurred
from cystitis and infection from a deep decubitus about 4 months after
admission. The study of the nervous system gave the following results.
The brain at autopsy weighed 1310 grams. Characteristic histological
changes of general paralysis were present throughout the cortex, but
varied greatly in intensity in different regions. The pia was slightly
thickened and in only isolated places were plasma cells present. There
was a moderate purulent meningitis present in all regions. In the left
frontal and left temporal regions the changes were of extreme severity.
Here there was marked distortion of the normal architecture and vessel
infiltrations were intense. Nerve cell degenerations were severe and rod
cells numerous. In other regions the changes were extremely slight.
The spinal cord showed a characteristic tabetic type of dorsal column
degeneration. The distribution of the changes in the brain is of much
interest in view of the clinical symptoms.
CEEBBROSPINAL SYPHILIS.
Seven cases, admitted during this biennial period, were classified as
syphilis of the central nervous system of the non-parenchymatous form.
It is interesting to note that, of these 7 cases, six were females and 1 case
remaining from the proceeding period was a female.
The relation of these to total admissions was:
Male.
Female.
Total.
No.
Per cent.
No.
Per cent.
No.
Per cent.
206
1
' '6'4s' '
278
6
' ' z.ih' '
484
7
' ' i '. 45
�67
PSYCHOPATHIC HOSPITAL.
AGE.
The average age at time of onset of the disease for the females was
39.7 years.
Age.
Admission.
Onset.
M.
30-34 . .
40-44
F.
1
M.
T.
2
4
1
3
4
T.
F.
3
2
4
4
PRODRO-MAL PERIOD.
In 2 of the 7 cases admitted the date of primary infection was not
known. Of the other 5 cases the interval between date of infection and
onset of symptoms was given as 3, 5, 10, 8 and 9 years.
HEREDITY.
Of the 7 cases admitted, 4 gave negative histories of hereditary factors
among antecedents or collaterals; two gave instances of insanity of direct
antecedents and 1 gave a history of apoplexy in a female collateral relative.
CLINICAL.
In 3 cases of this group, the symptoms were mostly due to vascular
involvement and in 4 cases the symptoms were of the meningeal type.
NEUROLOGICAL CONDITIONS.
Pupil.
[Irregular
Unequal
Reaction sluggish
[Reaction absent
Knee reflex
5
4
5
»
2
(Absent.. .
•! Unequal. .
I Increased.
Speech defect
6
Babinski on both sides.
1
Tremor..
Hands
Tongue
Both..
Apoplectiform or epileptiform attacks
6
5
. 5
2
One case had the knee reflex absent on one side and increased on the
opposite side. The same case had absent pupillary reflex on the right
side and sluggish on the left.
�68
STATE OP MICHIGAN.
SEROLOGICAL TESTS.
Colloidal gold curve.
Wassermann
Cells
Number
C.S.P.
2014. .
2027
2036 . . .
2294
2320
2324
2330
....
++
1
|j
""
Esbach
Before treatin't After treatment.
+
+
++ I 1 1 1
1
1 _|_ _|_
_|
[_
+
1
Apelt
O.S.F.
Blood.
1
_j
|
I
+ ++ +
.06
10
.09
04
11122100000
45553321000
11232220000
01223210000
11122210000
22343300000
00133321000
00122100000
5+
08
5+
.06
.08
11223332000
12234321000
00000000000
11233100000
11233210000
00122100000
2
25
18
2
2+
10 +
2+
2+
94
31
21
2+
Case 2330 gave a negative Wassermann test after a course of treatment.
RESULTS OF TREATMENT.
Of 4 cases discharged, including 1 case remaining from the preceding
biennial period, all showed great improvement except 1, and all were
returned to their homes. The treatment of cases of cerebrospinal syphilis
was essentially the same as for general paralysis. Experience has shown
that energetic treatment of cerebrospinal syphilis gives much better
results than treatment of general paralysis from which fact the conclusion
has been derived that the tissues affected in the non-parenchymatous
type of syphilis are much more accessible to medication than in the
parenchymatous type.
The average period of residence of patients of this group was 152 days.
TABES WITH PSYCHOSIS.
One case of Tabes with mental symptoms was admitted. The mental
symptoms were those of hysteria with anxiety attacks. This patient
would not remain for a sufficient period of treatment and was discharged
against advice as unimproved. This was the patient's second admission
because of hysterical symptoms.
ALCOHOLIC MENTAL DISORDERS.
Ten patients, all males, whose mental disorders were attributed to the
excessive use of alcohol, were admitted during this period. This is only
55.5% of the number of cases, classified in the same group, admitted in
the preceding period and was only 4.85% of the total male admissions
and 2% of total admission of both sexes. This is a decrease of 1.9% in
the admission rate of this class of mental disorder as compared to the
preceding period and practically the same decrease as shown in the
preceding period.
�PSYCHOPATHIC HOSPITAL.
69
CLINICAL GROUPING.
F.
M.
Acute alcoholism
Delirium tremens
Korsakow's psychosis .
Chronic alcoholism
.
1
0
1
8
.
Two cases had had previous attacks and 2 cases had had previous
institutional treatment for alcoholic mental disorders. Wassermann
tests on the blood of all cases were negative.
HEREDITY.
Atavistic.
Direct.
M.
P.
T.
Insanity
Apoplexy
1
0
1
Psychopathic . . .
Alcoholic
3
0
3
M.
F.
Brothers
and
sisters.
Collateral.
T
M.
F
T
-
Total heredity
Negative . .
Unknown
Total . . .
M.
F
T
Total.
T
0
1
3
0
' '3
4
0
4
3
3
0
0
3
3
10
0
10
No.
of cases.
6
Unequal
0
5
2
0
Pupils:
Unequal
2
0
2
0
Achilles-tendon reflex :
T
1
N E U R O L O G I C A L CONDITIONS.
Conditions.
F
1
1
0
�STATE OF MICHIGAN.
70
RESULTS.
Recovered.
Acute alcholism
1
Chronic alcoholism . . .
2
Improved.
3
Unimproved.
3
Died.
1
Total.
1
1
8
The average period of residence for cases of this group was 48.6 days.
Six of these patients returned home and 2 were transferred to one of the
State Hospitals.
The clinical and laboratory report o'n the case that died is as follows:
Case W. S., 1887, male aged 59 at admission to this hospital. His
father had been insane and a sister was mentally and physically defective.
In early life was an excessive user of alcohol. He married and had six
normal children. At the age of 49 he showed evidences of cardiac disease.
These were not very troublesome until the age of 57 when he had periods
of dyspnoea and cyanosis. Under rest his condition improved. Three
months before admission the cardiac symptoms were severe. At all times
he showed a slight degree of memory impairment and there were episodic
occurrences of confusion. These led to his admission to this hospital.
The examinations then showed marked cardiac hypertrophy with dilatation, aortic regurgitation, and arrhythmia. Mentally he had a clear
comprehension but there was an extreme retentive memory disorder.
He was unable to learn the names of his physicians or nurses. He had a
tendency towards spontaneous confabulations and made up fanciful
accounts of recent experiences. While usually good humored, he became
irritable when opposed. There were from time to time acute attacks of
heart failure in one of which he died 4 months after admission.
The autopsy showed the following:—Cardiac hypertrophy. Weight
880 grams, ascites, mitral insufficiency, aortic stenosis, passive congestion
of the lungs, liver and kidneys.
The brain weighed 1465 grams. Its consistency was much softened
from a general oedema. The large arterial trunks were severely sclerotic.
Histological studies of the cortex showed: hyperplasia of the connective tissue of the pia mater, with moderate infiltration of phagocytic
cells. The medium sized and smaller vessels showed sclerotic changes.
The nerve cells in general showed but slight changes, but there were
isolated cells showing very severe alterations. These were sclerosed and
showed the axonal type of toxic reaction. The glia, both fibrous and
cellular, was increased and always of a regressive type. There were
rather numerous ameboid glia cells lying throughout the nerve cell layers.
The changes in the nervous system were indicative of a chronic toxic
process. They agree with changes not uncommonly met with in chronic
alcoholism.
�PSYCHOPATHIC HOSPITAL.
DRUG INTOXICATIONS.
There were admitted 9 patients who were addicted to the use of narcotic
drugs. Six of these presented mental symptoms of a fairly definite
psychosis. Three patients showed little beyond the weakness of will
and character deterioration, commonly present in chronic users of drugs.
Seven cases were due to the chronic use of morphine; 1 to the use of
veronal, and 1 of chloral.
Cases of drug addiction formed 1.8% of all admissions:
Males.
Drug intoxications
Females.
No.
Per cent.
No.
206
5
2.4
278
4
Total.
Per cent.
1.4
No.
Per cent.
484
9
1.8
Seven patients used opium in some form. Five used morphine hypodermatically. The maximum quantity taken by any of these patients was
16 grams daily. One patient had for some time been taking 8 to 10
ounces of paregoric daily, and another 3 drams of the tincture of opium
each day.
The beginning of the habit with 4 patients was for relief from discomforts incidental to some physical or nervous disorder.
Results of treatment:
M.
Recovered
Improved
Unimproved .
Died
Remaining
T.
P.
3
1
2
1
1
0
0
1
5
2
1
1
The average duration of treament in the cases discharged as recovered
was 7 weeks The abstract and anatomical findings in the case that died
are here given:
Case A. D., 1954, a man aged 35, whose sister had epilepsy, was admitted
to the hospital by reason of addiction to morphine. At the age of 18
he contracted gonorrhoea. Treatment over a period of 7 years did not
bring a cure. Cystitis developed and an operation at the age of 25
brought little improvement. At this time he began the use of morphine
for relief of pain. At the end of a few months he was taking 4 grains
daily. This was gradually increased and for a long period he took 25
grains each day. For several years he had been a heavy drinker.
At his admission he was stuporous, and seemingly under the influence
of alcohol. He was restless and uneasy, movements were accompanied
by marked tremor and there was general muscular weakness. His
�72
STATE OF MICHIGAN.
attention was distractible.. His comprehension was for the most part
clear, but on fatigue he soon became confused. He was unable to sleep.
The second morning he showed extreme apprehension. He was afraid
of the nurses or physicians. At times he was unclear and hallucinated.
He saw bats and flying creatures around him. There was extreme
physical prostration. Then he developed vomiting and a severe diarrhoea.
There rapidly developed a cardiac weakness, and death occurred on the
third day after admission.
The autopsy showed myocarditis, cardiac dilation, fatty degeneration
of the liver, passive congestion of the kidneys, acute dilation of the stomach.
The brain showed oedema of the membranes. The brain substance was
soft and wet, but otherwise showed no gross pathology Histological
studies of the brain showed hyperplasia of the connective tissue of the
pia-arachnoid without infiltration. The nerve cells were not definitely
altered from normal and the neuroglia was not pathological. The
pituitary body showed several relatively large cysts with colloid contents
lying between the nervous and glandular portions.
EPILEPSY.
Fourteen cases of epilepsy were admitted during the period. Twelve
of these were males and 2 were females. The entire number formed 2.8%
of all admissions.
In their clinical form 10 showed typical epileptic convulsions with
mental deterioration. Two of these were in etiological relation to head
injuries, both showing convulsions of a Jacksonian type. Two cases
were admitted in a state of mental unclearness. Both had at times
typical epileptic convulsions. Two cases had characteristic convulsions
without the existence of any definite psychic disturbance in the intervals
between attacks.
Hereditary factors were present in two-thirds of the cases.
The ages of onset and admission were as follows:
Onset.
M.
0- 4
5-9
10-14
15-19. .
20 24
25-29
30-34
35-39 . . . . . . . .
40-44
45-49 . . .
50-54. .
54-59
60-64. .
65-69
Admissions.
T.
P.
M.
F.
T.
1
0
1
2
3
0
0
2
3
1
2
0
0
1
2
3
1
0
0
3
2
1
2
2
2
0
1
1
1
1
0
0
2
0
0
0
0
2
2
1
0
1
2
1
1
0
2
1
1
1
1
�PSYCHOPATHIC HOSPITAL.
73
Included among results of treatment is 1 case admitted in a previous
period:
M.
Unimproved
Died
3
8
1
I
F.
1
1
0
0
T.
4
9
I
1
An abstract of the case that died is here given:
Case R. H., 2238, Family History: Desertion by father during infancy.
Mother was nervous in disposition. As a child he was backward in
learning to walk. At the age of two he fell about 6 feet and was supposed
to have injured his spine. He stuttered for many years. In school
from the age of 6 to 12. He was extremely backward and at leaving
had only reached the third grade. At the age of 12 a trephine was made
in the right parietal bone for the purpose of relieving a supposed pressure.
Following this he appeared brighter and his speech defect was less marked.
From 15 to 27 he was profitably employed as an industrial laborer. He
then developed attacks of unconsciousness and periods of confusion in
which he would wander off. In January 1916 another trephine operation
was made, removing a button of bone from the left parietal bone. Three
days later there developed a paralysis of the right hand and face with
motor aphasia. After a week the aphasia and paralysis disappeared,
but from then on he was subject to attacks of Jacksonian epilepsy involving the right arm and face and sometimes the right leg. Then he developed
mental deterioration with depression and irritability. This lead to his
admission to this hospital. The chief points of interest concerned the
neurological feature of the case. There was present a tactile agnosia
of the right hand without motor paralysis. While there was considerable
loss of the appreciation of light touch in this hand, there was a total inability to name any object placed in the hand. When the same object
was placed in the left hand it was at once correctly named. At times he
complained of paraesthesia of the right hand. There were subjective
feelings of numbness and cold localized in a narrow band extending vertically through the right face over the vertex and down the right half of the
back. Both knee jerks were increased and there was a Babinski reflex in
the right foot. The Wassermann reaction on the spinal fluid and blood
was negative. Attacks of a Jacksonian type were frequent. At times
there were periods of confusion, and when at his best there was a characteristic epileptic type of mental deterioration.
Death occurred about three weeks after admission during a series of
convulsions.
The examination of the brain showed a defect caused by the second
trephine operation involving the middle portion of the left post central
convolution, and leaving the anterior central convolution intact. The
brain tissue in this place was broken down and adherent to the overlying dura.
Histological examination of this region showed the reactions characteristic
of softening with hyperplastic changes in the pia-arachnoid and dura.
Nerve cells had largely disappeared and the glia showed marked proliferative changes.
�STATE OF MICHIGAN.
74
Several regions of the cortex away from the focal injury were studied.
In none of these were there normal relations. Nerve cells generally
showed changes of a toxic type. These varied from cells with slight
granular degeneration to others showing severe disintegration. Many
cells presented the changes characteristic of fibre injury. The protoplasmatic glia was present in excess and in all sections there were many
amoeboid forms of glia.
PSYCHOSES WITH MENTAL DEFICIENCY.
This series of cases, five in number, are grouped separately, because the
psychotic features are not so pronounced as the features of mental deficiency. Otherwise they could have been included under the various
psychoses without mental deficiency. In other words the psychotic
picture in each case is that of a brief or an episodic attack, and while
this attack may have been the factor that induced the relatives to bring
the patient to the hospital, yet during the patient's residence here, the
most pronounced feature was that of subnormal intellectuality or "hypophrenia."
The following table shows the form, and frequency relative to the
total hospital admissions for the period. The percentage of all cases is
approximately 1%.
Male.
,
With hypomanic features
With epileptiform features
With hysterical features
No.
0
1
0
206
Total.
Female.
Per cent.
0
4
0
No.
2
0
2
278
Per cent.
7
0
7
No.
2
1
2
Per cent.
4
2
4
484
Hereditary factors were reported in 4 of the 5 individuals, 3 in the
direct line; 1 showing insanity in the ancestry, and 2 showing hysteria.
Results of treatment, of course, have reference to the psychotic symptoms, and not to the mental deficiency. Two were discharged as
improved, and 2 as unimproved. One remained; none were removed to
State Hospitals.
�PSYCHOPATHIC HOSPITAL.
75
MENTAL DEFICIENCY WITHOUT PSYCHOSES.
This group of cases, 10 in all being admitted during the period, includes
1 subnormal individual, and 9 definitely feebleminded. No idiots were
admitted. As mental deficiency is so manifestly in each case a restive
matter, and a matter of degree, no attempt is made to classify them as
"imbeciles," morons, "high,"-and "low-grade" "feebleminded," etc.,
etc. Social, economic, pedagogic, and physical factors all play so large
a part and in such complicated relationships, that the simplest grouping
possible seems to be the most helpful. The mental ages varied from
8.5 to 13.5. For statistical purposes they are grouped together in the
following table.
MENTAL DEFICIENCY
Male.
Per cent.
No.
Mental deficiency , .
.
206
3
...
Total.
Female.
1.4
No.
Per cent.
No.
Per cent.
278
7
2.8
484
10
2
In all they make up 2% of all admissions. Four are adults, and 6
are juveniles. The youngest age was 15, and the. oldest 41. Of the
juveniles, all except 2 were guilty of some delinquency; 3 females were
sexually del nquent.
Hereditary factors were present among 7 (63.6%) of all cases, and in
90% of all cases in which information was available.
The following tables show how the heredity is distributed:
Direct.
Atavistic.
Brothers
and
sisters.
Collateral.
Total.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
Subnormal
Feebleminded. . . .
Idiot
. .
0
1
0
0
4
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
1
0
0
0
0
0
1
0
0
2
0
0
5
0
0
7
0
Total heredity
1
4
5
0
0
0
0
1
1
1
0
1
2
5
7
1
0
1
1
2
1
3
7
10
Denied
Total
T.
�STATE OF MICHIGAN.
76
Direct.
Atavistic.
Brothers
and
sisters.
Collateral.
Total.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
0
0
0
2
0
2
0
2
0
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
1
3
0
2
0
3
0
3
1
2
5
7
Unknown
1
0
1
1
2
1
Total
3
7
10
Insanity
Apoplexy or paralysis
Psychopathic. . . .
Alcoholism
1
1
0
•
Total heredity
T.
RESULTS OF TREATMENT.
The following table shows the results of treatment; as would be
expected none improved or recovered. What benefit might come from
M.
0
0
1
Died
0
2
F.
T.
0
0
7
1
0
0
0
8
1
2
hospital residence must necessarily be in regulated habits, and consequent physical improvement.
Of those discharged, 5 returned to their families, 1 was transferred to a
State Hospital, 2 to the custody of the court, and 1 died.
The case which died showed the following clinical history and pathology.
Case 1900. Female, age 15. Father and paternal grandfather both
insane. Mother feebleminded. Seven siblings of the patient all subnormal. The patient was slow in development during childhood, and
did not talk until 4 years old. In spite of this she was the main support
of the family at time of admission. Physical stigmata: absent nipples.
Developed Pott's disease during residence in hospital. Blood Wassermann negative.
Wassermann on fluid negative. Gold sol. curve,
11110000000.
Mental examination negative except for definite evidence of mental
deficiency. Mental age 8 years + . Died three weeks after admission
of an intercurrent tubercular meningitis.
Autopsy showed, in gross findings, the following: Apex of left lung
firmly adherent. Abdominal organs negative except spleen which was
large and adherent to stomach and mesentery, at lower pole and around
the hilus. Brain removed—. Calvarium rather thin, otherwise negative.
�PSYCHOPATHIC HOSPITAL.
77
Histological examination of brain and cord showed: Process in the cord
is characteristic of a severe tubercular compression myelitis, with the
associated tubercular pachymengitis. The pia-arachnoid over the
cortex shows the beginning of meningitis, undoubtedly of tubercular
origin. Nothing of importance relative to the mental subnormality was
observed unless it was the difference in the thickness of the two hemispheres, the left measuring 11 c.m., the right 10 c.m.
PSYCHONEUROSES.
There were admitted 39 patients whose mental disorder belonged
in the group of neuroses and psychoneuroses. Of these eleven were males
and 28 females. This number formed:
Female.
Male.
'
Per cent.
No.
206
11
5.3
Total.
No.
Per cent.
No.
Per cent.
278
28
' 'io'i' '
484
39
8.0
These cases were distributed among the various clinical types of these
disorders as follows:
*
M.
F.
1
2
6
2
0
T.
1
0
0
12
15
1
2
18
17
1
Information concerning hereditary influences was obtained in 71
instances. In 23 families of this group there were 40 individuals who had
shown mental or nervous abnormalities. The following table gives details.
Direct.
Apoplexy and
Psychopathic. . . .
Total heredity
Total
Atavistic.
M.
F.
T.
M.
F.
T.
0
3
3
0
1
2
1
2
2
1
1
4
5
3
1
4
1
7
2
4
8
12
4
8
12
1
1
4
Brothers
and
sisters.
Collateral.
5
M.
1
1
I
F.
1
1
1
T.
2
2
2
Total.
M.
F.
T.
0
2
2
' '6'
0
M.
F.
T.
7
7
1
6
3
2
10
1
1
i
i
1
4
1
4
4
6
17
23
3
2
9
2
12
4
11
28
39
4
4
4
�78
STATE OF MICHIGAN.
The ages at the onset of the nervous symptoms and at admission of
the cases of this group as a whole were:
Admission.
Onset.
M.
F.
1
0
5
1
0
2
0
2
0
10-14
15-19
20-24
25-29
30-34
35-39. .
40-44
45-49
Unknown
T.
6
3
3
4
4
2
2
1
3
M.
7
3
8
5
4
4
2
3
3
HYSTERIA.
F.
0
0
4
3
0
1
0
3
T.
3
3
5
3
3
7
3
1
3
3
9
6
3
8
3
4
_
The clinical course of 18 cases was that of various hysterical manifestations largely of a conversion character.
Four of these cases had convulsions at some time during thair course.
Seven showed episodes of unclearness. Two of these had fugues lasting
from a few hours to several weeks. Two cases were of a traumatic type,
the symptoms developing immediately following an accident.
PSYCHASTHENIC TYPE (Anxiety Hysteria).
Seventeen cases belonged in this group. In all there were noted either
frank attacks of anxiety, or various mental or nervous manifestations
that at some time or other had relations to anxiety episodes.
HESULTS OF TREATMENT.
Recovered.
M.
Total
F
Improved.
Unimproved.
Remaining.
T.
M.
F.
T.
M.
F.
T.
M.
F.
7
3
0
2
1
7
6
1
0
0
14
9
1
2
1
0
0
2
6
2
6
0
0
1
2
1
2
27
0
8
8
0
3
3
1
0
3
2
4
2
1
5
G
13
14
T.
�PSYCHOPATHIC HOSPITAL.
79
PSYCHOPATHIC INFERIORITY.
In 48 patients there was present a constitutional state of mental instability that had resulted in failures to meet successfully common experiences in life or to adapt themselves to social regulations. These failures
were not'due to intellectual deficiency nor to the presence of one of the
principal psychoses. They resulted rather from an inherent weakness of
character, to lack of emotional control or to more or less well defined
paranoid traits.
Male.
No.
Psychopathic inferiority
206
21
Female.
Total.
Per cent.
No.
Per cent.
No.
Per cent.
10.2
278
27
9.7
484
48
''gig
In 27 of these, 11 males and 16 females, the mental reactions of the
individual at the time of his admission were of such a character as to
indicate the existence of a more or less well-defined psychotic disorder.
In most instances these were transitory in their occurrence, and manifested
themselves as outbursts of emotional excitement with disorderly behavior,
or unusual behavior with paranoid traits. These cases were in the general
statistical tables of this report, considered as belonging among the group of
psychoses.
Among those showing psychopathic inferiority there were 21 patients
in whom the mental abnormalities, manifested previous to admission and
while under treatment, were more those of their inherent consitutional
peculiarities rather than an acute psychotic episode. The larger number
of these were under 25 years of age. In most instances these had come
into conflict with home discipli ne or had been involved in various criminal
delinquencies. A considerable number of this type had entered the hospital
from its out-patient services.
AGE AT ADMISSION.
With psychoses
M.
10-14. .
15-19
20-24
25-29
30-34
35-39
40-44. .
45-49
50-54
55-59
60-64 . .
1
1
1
0
0
2
3
0
0
2
1
F.
1
1
3
2
2
1
1
4
1
0
0
Without psychoses
T.
2
2
4
2
2
3
4
4
1
2
1
M.
F.
T.
1
1
7
0
1
6
1
2
13
1
0
0
0
1
3
1
1
3
�80
STATE OF MICHIGAN.
Hereditary nervous or mental factors were present in 73.3% of these
cases regarding which information was known.
Direct.
Atavistic.
Brothers
and
sisters.
Collateral.
Total.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
T.
Insanity
Apoplexy and
paralysis . .
Psychopathic. . . .
Alcoholism .
2
1
2
3
3
0
2
6
5
1
4
9
1
1
0
0
1
1
4
5
9
0
1
1
1
0
1
Total heredity
8
11
19
3
0
3
M.
F.
T.
7
9
2
2
4
0
2
7
16
2
4
11
15
18
33
Unknown
6
0
6
3
12
3
Total
21
27
48
4
5
9
1
0
1
The results of treatment in the two groups of patients were:
Psychoses with Psychopathic Inferiority:
M.
Recovered
Unimproved . .
Died
Remaining .
1
.
5
5
0
F.
T.
1
18
0
13
6
1
n
1
Psychopathic Inferiority without Psychoses:
M.
Recovered
Unimproved
Died
7
4
F.
T.
5
5
12
9
1
1
Of those discharged, 11 were returned to their homes and 10 passed into
efficient custody.
�PSYCHOPATHIC HOSPITAL.
81
PSYCHOSES WITH SOMATIC DISEASES.
In this group are placed 19 cases in which the mental disorder was in
close etiological relation with some somatic disease. In the larger number
of instances this disorder was of an infectious or exhaustion type.
In 18 cases the etiological factors were fairly definite. In 4 cases the
symptoms and course were those of a toxic disorder but the nature of
the process could not be determined.
This group formed 3.9% of all patients admitted.
Male.
No.
Hospital admissions
Psychoses with somatic diseases
206
7
Female.
Total.
Per cent.
No.
Per cent.
No.
Per cent.
' s'i'
278
12
4.3
484
19
3.9
M.
F.
The etiological relationships were as follows:
Psychosis with pellagra . . . .
1
1
0
0
1
0
0
1
0
2
T.
0
1
5
2
1
0
1
0
0
1
6
2
1
1
1
1
1
1
4
2
AGE OF ADMISSION:
M.
20-24
25-29
30 34
35-39
40-44
45-49
50 54
.
.
..
. .
. ...
.
.
.
.
T.
1
0
1
0
2
1
3
3
3
1
4
3
0
3
0
0
3
1
4
1
.
F.
4
�STATE OF MICHIGAN.
82
Hereditary factors were present in 52% of cases in this group. In
10 families there were 27 individuals who had shown some nervous or
mental abnormality.
1
Atavistic.
Direct.
M.
Apoplexy and
Psychopathic. . . .
1 1 Total heredity
Total
F.
T.
1
1
2
1
1
1
0
3
0
1
4
1
4
4
8
3
6
9
6
10
13
M.
F.
Brothers
and
sisters.
Collateral.
T.
M.
F.
T.
0
2
2
0
0
2
2
M.
F.
Total.
T.
M.
F.
1
1
1
1
3
0
3
0
4
1
4
6
10
3
6
9
7
12
19
2
2
T.
4
1
RESULTS OF TREATMENT.
M.
3
4
1
2
0
Died
F.
T.
4
3
2
2
1
7
7
3
4
1
In this group there was a relatively larger number that died than in
any other group.
PSYCHOSIS WITH PELLAGRA.
Case S. G., 1835, Male aged 68. Unknown family history, foundry
worker by occupation. At the age of 66 he had several operations for
hemorrhoids and following these a gradual physical decline. It was
observed that he looked yellow and waxen and that the skin of his hands
was dry. Several months after his admission to this hospital in May 1916
there were symptoms of mental disorder. His thought at times was incoherent. His memory was severly impaired and finally he became unable
to properly care for himself. He entered the Dermatological Clinic of
the University. At that time he showed a dermatitis of both hands, diarrhoea and advanced mental deterioration. A diagnosis was made of pellagra
with mental disorder. He was transferred to the Psychiatric Clinic. The
�PSYCHOPATHIC HOSPITAL.
83
skin on the hands, feet and face was deeply fissured and pigmented, and
the skin over his body was of an appearance resembling ichthyosis.
Bowel movements were frequent and often bloody. The Wassermann
reaction on the blood was negative. The cerebrospinal fluid showed no
increase of cells or albumen. The Wassermann reaction on the spinal
fluid was negative. The blood and urine were not pathological.
Mentally he was unclear in comprehension, at times much disturbed
by visual hallucinations, marked disorientation. Generally he was dull
and mildly stuporous. At times he was for brief periods somewhat more
alert and would respond to questions, his replies showing an unclear
comprehension and disorientation. His physical failure was progressive.
The skin condition became somewhat improved, but his general strength
was weakened. About 3 weeks after his admission he developed coarse
tremors, especially marked on fatigue. Often there were choreiform
movements of the arms and hands. Failure was continuous and death
occurred five months after his admission.
The nervous system presented the following changes: The brain
showed no gross abnormalities. In microscopical studies the pia was
slightly thickened and showed many small endothelial thickenings on its
free surface. The lymph spaces of the pia-arachnoid contained many
small lymphocytes and similar cells were rather numerous in the adventitial spaces of the small cortical vessels, especially in the medullary
portion of the convolution. Isolated plasma cells were present in the
pia-arachnoid and there were large numbers of medium sized phagocytic
cells and a few megaloblasts. The nerve cells of the cortex were generally
more pale and more homogenous in structure than under usual conditions.
An occasional cell showed a characteristic axonal type of reaction. The
glia in the molecular layer of the cortex, both fibrous and cellular, was
considerably increased and showed regressive changes. The protoplasmatic glia was much increased in the medullar part of the convolutions
especially in the cerebellum and around the blood vessels.
The spinal cord showed large numbers of corpora amylacea, chiefly
in the dorsal columns. In these regions there was an increase in the
fibre-bearing glia cells. .
The histological changes in the central nervous system were those
of a parenchymatous degeneration of a toxic type, and infiltration and
hyperplastic changes of a subacute inflammatory reaction in the interstitial tissues.
PSYCHOSIS WITH TETANY.
Case G. C., 2274, a man.aged 46 at his admission to this hospital.
In disposition he was good-natured, abstinent from alcohol and was
never regarded as nervous or mentally ill until recently. At the ages
of 31 and 34 he had a Neisser infection and a luetic infection at the age of
42. At the age of 42 he had a sharp pain below the right knee cap.
Soon afterwards as he walked his right foot dragged and the muscles
of the leg "knotted up." The muscles of the right leg gradually became
stiff, and later the leg became similarly affected. This condition grew
progressively worse until about two years before admission, when his
eyesight began to fail. At times he would have attacks of sudden contractions in the leg muscles that caused him to fall to the ground. In
some of these the entire body was involved; his legs and arms would be
�84
STATE OF MICHIGAN.
flexed on his trunk and his back bent forward. In the following months
he progressively lost more control of his muscles. Tetanoid attacks were
frequent. About six months before admission he had a sudden attack
of confusion in which he was extremely unclear and unable to help himself.
At times he was agitated and expressed an apprehensive content of thought.
This condition continued for several weeks, when there were at intervals
periods of clearness and later he was continuously clear, but there persisted an impaired memory The tetanoid contractures gradually became
more general and severe. He became quite helpless and was brought to
the General Hospital of the University. Soon after his admission there he
became unclear and finally he passed into a stupor in which condition he
entered this hospital.
The physical examinations showed him to be moderately well nourished
with a general hypertonicity of the muscles of the body. The skin over
the back and hands was atrophic with beginning trophic erosions over the
shoulders and back. The gums of the lower jaw were ulcerated, moderate
inguinal and cervical adenitis. Heart and lungs were not abnormal.
Blood pressure was 130 systolic and 90 diastolic. Moderate leucocytosis.
The blood gave a negative Wassermann reaction. The cerebrospinal
fluid showed no pathological changes. The urine contained many
hyaline casts, but no albumen.
The neurological abnormalities were: irregular pupils, arteriosclerotic
changes of the fundus of the eyes, sluggish pupillary reactions, tremors
of the lids, tongue, lips and extremities, marked dysarthria, extreme
hypertonicity of all muscles, increased tendon reflexes, Babinski's sign
in the right foot. Three days later all tendon reflexes were greatly
decreased. There was almost constant twitching of the muscles of the
hands, arms and face. At brief irregular intervals there were tonic
contractions of the muscles of the body and extremities. These could
sometimes be elicited by tapping the muscles. There was no control
of the sphincters.
Mentally he was always unclear and usually deeply stuporous. At
times he was extremely apprehensive. The stupor deepened and death
occurred 1 week after admission.
•
DELIRIUM OF UNKNOWN ORIGIN.
Case F. K., 2310, a woman aged 31 at her admission. So far as known
her family and early personal history showed nothing notable. She was
married at 18 and owing to the conduct of her husband was soon divorced.
Two months after this she remarried and.by this marriage had one miscarriage, and had one living normal child. Temperamentally she was
always impulsive, easily angered and difficult to get along with. Aside
from occasional episodes of temper and irritability there were no pronounced mental difficulties until about a month before her admission.
She then became over-active and talkative. She at times complained of
headache and sometimes appeared confused and unclear as to her surroundings. Showed an extreme jealousy of her husband and developed
a paranoid content of thought. These centered about her husband,
with ideas of poisoning and hypnotism. She refused food. She could
not sleep and was given rather frequent and heavy doses of chlorotone.
At her admission she .was deeply stuporous and quite helpless. The
physical examination showed that she was well nourished. The pulse
�PSYCHOPATHIC HOSPITAL.
85
was always rapid and weak, varying between 120 and 160. The blood
count showed 12,695 leucocytes with 74% polynuclears. The urea
content was a little increased, 0.58. The Wassermann reaction was
negative. The urine showed an excessive amount of indican and acetone.
Blood cultures were negative. The cerebrospinal fluid was not pathological. The fundus examination showed neuro-retinitis of both eyes
and a slight swelling of the left nerve head. The knee jerks were about
normal until a few hours before death when they could not be obtained.
There was double ankle clonus. The pupils varied in width at first
were almost pinhead in size, and later they dilated widely and remained so
with only slight reaction to light. The last few days of her illness showed
a slight internal strabismus.
On a few occasions there were slight haemorrhages from the bowels.
A week after her admission there was a sudden rise of temperature to
103.4 and a fall to normal the next day, and never again rising. A few
weeks later she developed an acute otitis media. This seemed to be
entirely localized in the ear and yielded well to treatment. Mentally
she continued in deep stupor. Only on a few occasions when irritated
did she show any spontaneous talk or interest and then only for a brief
period. She was during her entire residence fed mechanically. There
was a progressive physical failure and death occurred 25 days after her
admission.
The autopsy showed the following: A few scattered small pus cavities
in the right lung. The heart was not pathological. The liver showed
many small pin-head sized whitish areas scattered through its substances.
Otherwise the body organs showed no gross pathology. The brain
weighed 1190 grams. In appearance and topographical relations it
showed no gross abnormalities. Histological studies showed extreme
changes in nerve cells of all regions. These were swollen and their
granular contents were pale and atrophic. The glia cells were increased
in number around the smaller blood vessels and many had undergone
retrograde changes. The changes as a whole were such as are occasionally
met with in toxic disorders affecting the nervous system. The liver
showed a most extreme degree of fatty degeneration. This affected the
parenchymal cells in all parts of the lobules. To a lesser degree the
kidney parenchymal cells showed the same changes.
While the etiological agent in this case was unknown, the changes within
the nervous system and body organs were definitely toxic in character.
Case M.M., 1991, age 22 at admission. She was backward in childhood development, not talking till the age of four. In school she showed
mental retardation and at the age of 17 she had only advanced to the
fifth grade. After school life she remained at home; there was regarded
as "odd, a poor eater, and unusually dependent on others."
Three weeks before admission she became irritable and over-active.
She talked much, spoke of hearing voices. This condition brought about
her admission to the hospital.
The examinations showed her to be poorly developed physically and
showing a number of stigmata of deviation. The teeth were badly
decayed and the lips and tongue covered with sores. The skin over the
body showed an erythematous blush. ' The thyroid was much enlarged.
There was a loud systolic heart murmur. The urine showed a trace of
albumen and many hyaline and a few granular casts. The blood at the
�86
STATE OF MICHIGAN.
early examinations showed a slight leucocytosis. Later on this was more
pronounced. The Wassermann reaction was negative. The spinal
fluid showed four cells and a slightly increased albumen content. The
tendon reflexes were greatly increased. There was double ankle clonus
and a frequent fibrillary contraction of the muscles of the trunk and
extremities.
During the first few days she was clear in comprehension and her
distractibility and over-activity suggested a manic excitement. Later
she progressively became more unclear and her condition was that of a
delirium. With this unclearness there occurred a slight rise in temperature, leucocytosis and albuminuria. At no time during the course
did the temperature exceed 99.4 degrees. At times there were evidences
of cortical irritation such as muscular twitchings and choreiform movements, and a general increase in muscular tonus. There was progressive
physical failure and death occurred three weeks after admission.
The autopsy showed: chronic vegetative endocarditis of the mitral
valve, cystic degeneration of the thyroid gland. The brain weighed
1180 grams. The pia-arachnoid showed a number of haemorrhagic
effusions. The longitudinal sinus of the dura showed a large thrombus
in its posterior portion with extensions into the confluent veins and into
the right lateral sinus and right internal jugular.
Histological studies of the internal organs showed a chronic fibrous
thickening of the edge of the mitral valve, multiple small haemorrhages
in the liver, and an occluding septic thrombus of the longitudinal sinus
of the dura.
The nerve cells of the cortex as a whole were fairly normal. Some cells
showed acute swelling and a few showed severe disintegrative changes
of the cell granules. The chief interest lay in the condition t>f the blood
vessels. The larger veins of the pia were completely closed by thrombi,
some advanced in process of organization. There was in many vessels
of the pia a marked proliferation of the fibroblasts in their walls. The
connective tissue of the pia showed very marked proliferative changes.
The reactions in the brain were probably all secondary to the vascular
disturbance.
PSYCHOSES WITH BRAIN TUMOR.
There were admitted 7 cases of brain tumor with mental disorder
during this period. Four of these were males and 3 were females. This
number included 1.4% of all cases admitted.
Four cases were discharged unimproved and 3 died. Brief abstracts
of the clinical course and pathological findings are here given:
Glioma of left posterior frontal region:
Case M. B., a woman aged 60 at her admission. Six weeks previous
to this she had a sudden attack of confusion with almost total motor
aphasia. She could only repeat "yes" or "no." Her confusion soon
passed away but the aphasia persisted.
At her admission there were few notable abnormalities of the body
organs. The heart was a little enlarged to the left. The blood pressure
was 140 systolic and 80 diastolic. The blood on two occasions showed
a moderate leucocytosis. Wassermann's reaction on the blood was
negative. The neurological disturbances were: residuals. of a slight
right hemiplegia, weakness in muscular power of right hand and leg,
�PSYCHOPATHIC HOSPITAL.
87
increased right knee jerks, Babinski's reflex was present in the left foot
but not the right. There was almost a total motor aphasia. She could
repeat a few monosyllables and familiar words. Usually she would
repeat part of the question, but beyond this there was little spontaneous
speech. She understood many simple questions, recognized familiar
objects, but could not name them. She could not read nor write. Most
of the time she was dull and stuporous. The right hand became completely helpless. She gradually became comatose and died three weeks
after admission.
The autopsy showed a gliomatous tumor of large size involving the
foot of the left third frontal convolution, the operculum and the region
up to the left lenticular nucleus.
Histological studies showed the tumor to be composed of closely
packed glia cells with larger numbers of intermixed glia fibres. In
places the cells had broken through the margins of the cortex and extended
out into the arachnoid lymph spaces. In many places the tumor had
undergone regressive changes with formation of small cystic cavities with
colloid contents. The nerve cells of the cortex away from the region of
the tumor were oedematous and showed considerable fatty degeneration.
Glioma of frontal lobes:
Case A. 0., 2309., a male aged 44 at his admission. Six months earlier
he developed severe headaches which became so severe as to force him
to give up his work. He showed at about the same time a definite mental
change. He became more dull and often fell asleep in his chair. He
expressed delusions of suspicion and feared that he was being harmed and
pursued. At times he would show brief episodes of confusion and unclear
comprehension.
At his admission the chief physical disorders were residuals of an old
fracture of the left leg and a mitral insufficiency.
The neurological abnormalities were: headaches, choked discs with
haemorrhages of the retina in both eyes, evenly contracted visual fields,
tremors of the hands, hypotonus of muscles of arms and legs, normal
tendon reflexes, at times loss of bladder and bowel control. No disordered
sensibility. His attitude and behavior was of one physically weak.
His comprehension varied. During the first few weeks it was generally
clear but at intervals there were brief episodes of inability to understand
questions on his situation. Towards the last he gradually became more
dull and stuporous, finally becoming comatose. The stream of thought
was slow and at times somewhat rambling. Memory was inaccurate
for both recent and remote experiences. The content of thought was
generally fairly normal in its relation to his situation, and at other times
showed a marked paranoid trend with fairly well elaborated delusions
of suspicion. This mood was usually good humored, often jocose. At
other times he was dull and apathetic. As there was definite evidence
of intracranial pressure, two decompression operations were done.. These
were followed by a slight improvement in the fundus changes, but mentally
he became more dull and finally deeply stuporous. Towards the last
.he developed a severe and continuous hiccoughing. Death occurred
following several days of coma.
The autopsy showed a large gliomatous tumor involving the septum
and anterior region of the fornix and extending out into the central
substance of the right and left frontal regions and into the lateral ventri-
�88
STATE OF MICHIGAN.
cal cavities. The tumor in places showed many small cavities filled
with a colloid like substance and a few with recent haemorrhages. The
cavity of the acqueduct was entirely occluded by proliferation of the
neuroglia.
Histological studies of the tumor showed it to be a glioma with two
quite different methods of growth, one very slow in its development in
which enormous masses of fibres are present. These in places had
undergone degeneration, with haemorrhages and softening, which has
lead to the production of large amounts of connective tissue. The other
type of growth is a very rapid proliferation of neuroglia cells with practically no glia fibres or connective tissue formation.
The cortex in the regions of decompression showed severe changes.
The pia was packed with infiltrating cells, mostly small lymphocytes.
All the vessels adjacent to the area of injury showed proliferative changes
of their endothelial cells. The nerve cells were seriously altered from
normal. Many have degenerated and disappeared. The neuroglia
cells were increased in size and numbers. Large numbers of rod cells
were scattered through the cortex.
The cortex aside from the areas affected by the decompression operation
showed a pia mater comparatively normal in thickness, but with spots
where the endothelium was in early stages of proliferation. The nerve
cells were all pale and oedematous.
Glioma of the right occipital lobe:
Case A. H., 1917, a man aged 54 at his admission to this hospital.
Nervous or mental abnormalities do not appear to have been present
until the age of 53, when, following what was called an attack of influenza
he developed herpes zoster. The pain from this was intense and he
lost much in weight. He was admitted to the University Hospital where
a diagnosis of multiple neuritis was made. The skin condition seems to
have improved but there developed severe headaches and a failing of
vision. There gradually progressed a motor weakness and loss of sensation in the left arm. Later this involved the left leg and foot. Three
weeks before his admission to this hospital he became greatly depressed
and threatened suicide. His memory became poor and his comprehension slowed and at times unclear.
The physical examination at his admission showed him to be much
under-nourished. There was a leucoderma involving the skin over the
greater part of the body. The skin over the backs of the hands was
atrophic. The scars from the previous herpetic eruption extended around
the right side between the 9th to 12th ribs. Heart and lungs were
normal. Blood pressure was 135 systolic and 90 diastolic. Urine, and
blood Wassermann were negative.
Neurological abnormalities were striking. There were Romberg's
symptoms. The gait was ataxic. Both legs were somewhat spastic
and the left leg was weak in its motor force. At rest the right leg was kept
flexed on the body. The arm and knee jerks were increased and somewhat
more on the right than the left side. The left Achilles jerk was absent.
There was no definite Babinski's sign. On the left side of the body from
the neck to the anterior part of the sole of the foot there was complete
loss of touch sensibility. Pain appreciation was absent over the anterior
and outer surfaces of the left upper arms. Astereognosia of the left hand.
No sense of position of upper or lower extremities. Both fundi showed
swelling of the dies and there was left homonomous hemianopsia.
�PSYCHOPATHIC HOSPITAL.
89
Mental symptoms consisted chiefly of a mild depression and a tendency
towards stupor. He gradually became more dull and died after several
days in coma.
The autopsy showed a large brain weighing 1560 grams. There was
a larger area of tumor substance filling in the central part of the right
occipital lobe. While the posterior limb of the capsule seemed uninvaded
by the tumor its position was so close to the position of the sensory
radiations that they might well have been injured by the growth. Posteriorly and externally the tumor extended into the surface of the cortex.
In consistency the tumor was firm. In many places it showed small
cysts of degenerations and scattered haemorrhages.
Histological studies showed the tumor to be a rapidly growing glioma.
It was composed of thickly packed glia cells of every size and shape.
Mitoses were numerous.
PSYCHOSES WITH CEREBRAL ARTERIOSCLEROSIS.
In 11 patients admitted tthis mental disorder was due to structural
changes in the brain associated with arteriosclerosis of its blood vessels.
Five of these were males and 6 were females.
These cases formed 2.3% of all admissions.
Male.
Female.
Total.
No.
Per cent.
No.
Per cent.
No.
Per cent.
206
5
• '2' 4' '
278
6
2.2
484
11
2.3
Hereditary factors were present in 7 of 8 cases in which information
was obtained. These all occurred in the parents or brothers and sisters
of the patient. In these seven families there were 23 abnormal individuals.
The earliest age of onset was between the years 30 and 34. Two-thirds
of the cases developed between the 45th and 60th year.
In 7 cases the patients had at one time or another attacks of an apoplectiform or epileptiform type. Heart murmurs were present in 6 cases.
Increased systolic blood pressure was present in 9 cases. In 3 cases the
pressure ranged between 110 and 150. In 5 between 160 and 200, and in
3 between 210 and 240. In 8 cases arteriosclerotic changes were present in
the vessels of the fundus of the eye.
In 8 cases the cerebrospinal fluid was examined. The cells in these
ranged in numbers between 2 and 8. All had negative Wassermarm
reactions.
RESULTS OF TREATMENT.
Recovered . . . .
Died
M.
F.
1
5
1
T.
6
8
�90
STATE OF MICHIGAN.
Included among these are 3 cases admitted in the previous period.
Five of these cases were transferred to one of the other State Hospitals.
SENILE DEMENTIA.
There were admitted two men whose mental disorder was due to senile
brain atrophy. The ages of onset were 64 and 73, respectively. Both
were discharged in an unimproved condition.
TRAUMATIC PSYCHOSES
There were admitted 2 men in delirium that had its development following injury to the head. At their admission they were unclear, hallucinated, and confused in their thinking. Both cases made a complete
recovery, 1 after 2 weeks treatment and 1 after 4 weeks.
MULTIPLE NEURITIS.
Two women were under treatment with a mental disorder showing
unclearness, marked disturbance of retentive memory, and the neurological disorder of multiple neuritis. In neither case was the etiology
clear. Neither had used alcohol nor had they been exposed to any
toxic agent commonly producing multiple neuritis. One woman was
somewhat improved at her discharge, the other was unchanged.
UNDIAGNOSED PSYCHOSES.
There were under treatment 12 cases of mental disorder that could
not be definitely diagnosed. The reasons for this were largely too short
a period of observation, or lack of information regarding the early development of the disorder.
The number of this group admitted during the period formed 2.5%
of all admissions.
Male.
-
Total.
Female.
No.
Per cent.
No.
Per cent.
No.
Per cent.
206
1
' 'b'.b' '
278
11
' '4^9'
484
12
2.5
All of these cases were discharged in the period, three as improved,
8 as unimproved, and 1 died.
REPORT OF THE PATHOLOGICAL LABORATORY.
The laboratory of the State Psychopathic Hospital operates as a
central laboratory for all Michigan Hospitals for the Insane.
Its problems have been largely centered in the study of the nervous
system of such cases of mental disorder, as have been adequately studied
during life,
�PSYCHOPATHIC HOSPITAL.
91
These studies have in many instances made it possible to have a clearer
understanding of the pathology associated with mental disorders, and
in their cumulative results will contribute much to the field of psychiatry.
The results of material sent from the State Hospitals are communicated
to the institutions interested and by this their medical standards are
improved.
The hospital makes Wassermann Examinations for all of the State
Hospitals and for the General Hospital of the University.
The number examined for the various State Hospitals is given in accompanying tables. •*
TABLE No. I.—Number of cases received between July 1, 1916 and June 30, 1918
and sources.
Year ending
Year ending
June 30, 1917. June 30, 1918.
Pontiac State Hospital
Traverse City State Hospital
Michigan Home and Training School Lapeer
University of Michigan Hospital
56
21
16
7
1
8
Total
for period
49
28
1
105
49
16
8
11
2
7
11
3
15
Total from Michigan State Hospitals . .
Outside sources
109
1
98
1
207
2
Total number received
110
99
209
�STATE OF MICHIGAN.
TABLE No. II.—Clinical Diagnosis of cases studied in Laboratory.
Year
Year
Total
ending ending
June
30,
for
June 30,
1918.
Period.
1917.
Alcoholic mental disorder, chronic
Alcoholic mental disorder, Korsakow's psychosis
Alzheimer's disease
Amaurotic idiocy
Cerebral arteriosclerosis
Dementia praecox
Drug addiction
Epilepsy
Involution melancholia
Imbecility
Manic-depressive insanity
Myelitis, tubercular
Meningitis, purulent
Meningitis, tubercular
Non-psychotic, traumatic
Not insane
Paralysis agitans
Pernicious anemia
Pellagra
Senile dementia
.'
Syphilis, central nervous system, general paralysis
Syphilis, central nervous system, meningo-vascular
Syphilis, central nervous system, vascular
Syphilis, tabo-paresis
Traumatic psychosis
Toxic psychosis, undiflerentiated
.-.
Toxic psychosis, endocarditis
Tumor, central nervous system
Tetany
Material unstudied or undiagnosed
Cases diagnosed under two or more heads:
Arteriosclerosis and senile dementia
Arteriosclerosis and multiple softenings
Arteriosclerosis and brain tumor
Arteriosclerosis and syphilis
Alcoholic insanity and acute meningitis
Alcoholic insanity, chronic, and senile dementia
Alcoholic insanity, chronic and cerebral syphilis
Dementia, organic and trumatic epilepsy
Dementia praecox and multiple melanotic sarcomata
Huntington's chorea and tabes dorsalis
Senile dementia and epilepsy
Syphilis, general paralysis and acute meningitis
Syphilis, central nervous system, meningo-vascular, gummatous
Syphillis, central nervous system, vascular and general paralysis
Syphilis and tuberculosis
Total
2
0
2
•0
11
5
1
6
1
0
3
1
2
1
1
1
0
2
1
3
9
5
0
0
1
o
1
3
0
39
1
0
1
9
6
0
0
0
0
2
1
0
2
4
4
0
1
3
0
1
0
5
1
30
1
1
1
0
1
1
1
o
0
1
1
1
o
0
0
110
99
TABLE No. III.—Number of cases reported to the State Hospitals during the period.
This includes 54 cases received during previous periods but reported in this.
Kalamazoo State Hospital
Pontiac State Hospital
Traverse City State Hospital
Newberry State Hospital
Michigan Home and Training School, Lapeer.
Total number reported.
�Number of Wassermann Tests made between July 1, 1916 to June 30, 1918.
Year ending
June 30, 1918.
Year ending
June 30, 1917.
C. S. P. Blood.
Kalamazoo State Hospital . .
.
Traverse City State Hospital
Newberry State Hospital
State Psychopathic Hospital
Ionia State Hospital
Wayne County Hospital
Michigan Home and Training School. . .
..
'
Blood.
1,840
452
389
346
367
17
305
94
233
228
915
190
30
78
175
35
0
8
2
0
3,617
755
590
555
694
135
529
289
1,408
433
4,532
945
620
633
869
170
529
297
1,410
433
IK
Kl
O
3,512
4,271
1,433
9,005
10,438
Q
1,485
13,942
15,427
2,918
22 , 947
25,865
O. S. F.
Blood.
1,327
355
362
299
304
13
305
86
233
228
2,290
400
228
256
390
2692
493
231
287
502
31
0
0
2
0
122
224
203
1,175
205
153
224
203
1,177
205
513
97
27
47
63
4
0
8
0
0
674
5,493
6,167
759
Total.
C. S. F.
Total.
402
93
3
31
112
Total for
period.
Total.
679
6,901
7,580
706
7,041
7,747
1,353
12,394
13 , 747
1,465
10,553
12,018
td
o
hj
w
O
02
�94
STATE OF MICHIGAN.
REPORT OF THE SECRETARY AND BUSINESS OFFICER.
Ann Arbor, Mich., June 30, 1918.
To the Board of Trustees:
Gentlemen—I have the honor to present the report of the business
transactions of the hospital for the biennial, period ending June 30, 1918.
During this period the expenses of running the Hospital have been
considerably higher than they were for the two years just preceding.
By referring to the following tables it can easily be seen that this was due
almost entirely to the increased cost of food supplies and of hospital help
covered by the classification of the Medical Department. Both of these
increases were due to the conditions brought upon us by the war.
A small building was built for the housing of animals for the laboratory
at a cost of $773.90 but aside from that only the necessary repairs on the
building were made.
Our total number of patient days for the two years amounted to 41,634.
The average daily cost to the State per patient per day was $1.341, the
highest rate for any one month being $1.45 and the lowest rate $1.25.
DISBURSEMENTS.
ON ACCOUNT OF CURRENT EXPENSES.
July 1, 1916 to June 30,. 1918.
Food
Clothing
Laundry Expenses
Heating and Light
Medical Department
Office, Stationery, Etc
"
Amusement and Instruction
Furniture and Household Supplies
Improvements and Repairs
Miscellaneous Expenses
Refunds
'.
Total for Biennial Period.
$27,701
193
2,635
3,670
15,550
2,369
319
6,442
3,385
839
1,339
24
81
08
14
61
33
05
90
20
29
48
$64,446 13
�PSYCHOPATHIC HOSPITAL.
95
DISBURSEMENTS.
ON ACCOUNT OP CLINICAL LABORATORY.
July 1, 1916 to June 30, 1918.
Officers' Salaries
Animal Food
Heating and Light
Medical Department
Amusement and Instruction
Office, Stationery, Etc
Improvements and Repairs
$17,680 02
328 19
71 76
6,700 16
11 17
1,732 38
801 32
Forward
$27,325 00
Brought Forward
Clothing
Farm, Garden and Stock
Miscellaneous Expenses
$27,325 00
8 82
34 00
486 07
Total for Biennial Period
$27,853 89
RECEIPTS.
ON ACCOUNT OF CURRENT EXPENSES.
July 1, 1916 to June 30, 1918.
From
From
From
From
From
From
State for County Patients
State for State Patients
Private Patients
Interest Accounts
Refund on Pay Roll
Miscellaneous Sales
Total for Biennial Period
$44,630 48
961 03
22,006 39
1,478 41
40 78
112 47
$69,229 56
�96
STATE OF MICHIGAN.
RECEIPTS.
ON ACCOUNT OF CLINICAL LABORATORY.
July 1, 1917 to June 30, 1918.
Special Appropriation
Wassermann Tests
From Miscellaneous Sales..
$27,000 00
1,261 00
391 89
Total for Biennial Period
$28,652 89
Table showing the number of hospital days and the daily per capita
costs by months from July, 1916 to June 30, 1918.
Patient
hospital
days.
From July 1, 1916 to June 30, 1918:
July, 1916
August, 1916
September, 1916
October
November, 1916
December, 1916. .
January, 1917
February, 1917
March, 1917
April, 1917
May
June, 1917
July, 1917
August, 1917
September, 1917
October, 1917
November, 1917
December, 1917
January, 1918
February, 1918
March, 1918
April, 1918
May, 1918
June, 1918
1,712
1,846
1,800
1,800
1,651
1,667
1,701
1,595
1,729
1,806
1,701
1,539
1,727
1,768
1,718
1,814
1,752
1,724
1,764
1,614
1,877
1,737
1,781
1,813
.
.
Daily
per capita
cost
to state.
$1 26
1 25
1 25
125
1 25
126
1 28
1 3O
1 30
1 30
130
134
1 36
1 36
1 41
141
136
1 43
1 40
1 45
142
1 43
1 38
1 43
SUMMARY OF INVENTORY, JUNE 30, 1918.
Hospital buildings
Furniture
Fixtures
Apparatus
Books
Supplies
Total
$2 ,990
676
5,837
1,202
6,608
99
00
11
58
19
$79,043 13
17,314 87
$96,35800
Respectfully submitted,
ROBERT G. GREVE,
Secretary.
�PSYCHOPATHIC HOSPITAL.
97
REPORT OF TREASURER.
July 1, 1918.
To the Board of Trustees of the State Psychopathic Hospital:
Gentlemen—Herewith I hand you report of the State Psychopathic
Hospital for the biennial period ending June 30, 1918.
RECEIPTS.
Balance in the Treasury July 1, 1916
By cash from State Treasurer, annual appropriation laboratory (Sec. 28 Act 278, Public Acts 1907)
By cash from State Treasurer (Support of State Patients'). .
By cash from State Treasurer (Support of County Patients)
By cash from Private Patients
By cash from Earnings Institution (Interest, etc.)
$21,704 44
27,000
961
44,510
22,137
3,274
00
03
05
02
35
$119,586 89
DISBURSEMENTS.
Clinical Laboratory Accounts
Current Expenses (Running Account)
Balance June 30, 1918
$27,853 89
64,446 13
27,286 87
'$119,586 89
Very respectfully submitted,
R. A. CAMPBELL,
Treasurer.
�
asylums
-
https://localhistory.tadl.org/files/original/1d544ef03f6eac40943eb975272bc87c.pdf
6dba8498474a00da00c83564b07f3357
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Traverse City State Hospital
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Asylums.
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Amy Barritt, 1984-
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Various.
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1885-1989
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Board of Trustees for the Traverse City State Hospital.
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Fifth biennial report of the Board of Trustees of the State Psychopathic Hospital at the University of Michigan for the Biennial Period ending June 30, 1916
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Psychiatric hospitals.
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Fifth biennial report of the Board of Trustees of the State Psychopathic Hospital at the University of Michigan for the Biennial Period ending June 30, 1916. Delivered to the State Legislature. Strong emphasis made by the Trustees in regards to the inadequate facilities provided for the work of the hospital, in both size and arrangement of buildings. Details on the newly developed out-patient services established at Ann Arbor and the hospital in Detroit are included in this report. Reports by the medical director and treasurer included.
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Board of Trustees, State Psychopathic Hospital at the University of Michigan
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Lansing: Wynkoop Hallenbeck Crawford Co., State Printers
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1917
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Text
FIFTH BIENNIAL REPORT
OF THE
BOARD OF TRUSTEES
OF THE
STATE-PSYCHOPATHIC HOSPITAL
AT THE
UNIVERSITY OF MICHIGAN
FOR THE
BIENNIAL PERIOD ENDING J U N E 30 1916.
BY AUTHORITY
LANSING, MICHIGAN
WYNKOOP HALLENBECK CRAWFORD CO., STATE PRINTERS
1917
��REPORT OF TRUSTEES.
To the Legislature of the State of Michigan:
The Board of Trustees of the State Psychopathic Hospital at the
University of Michigan has the honor of submitting the following report:
The membership of the Board remains the same as during the previous
period excepting that Harry C. Davis, member from the Board of Trustees of the Traverse City State Hospital, has been succeeded by M. F.
Quaintance from the Same Board.
Meetings of the Board have been held at the Hospital and the Trustees have maintained an active interest in the work of the institution.
The various detailed statements of the medical work and business
administration are given in the accompanying reports of the Medical
Director, the Business Officer and the Treasurer. The Board wishes to
express its appreciation of the faithful service of the former Business
Officer of the hospital, Mr. J. B. Draper, who lost his life by accident
in November, 1915. His work in organizing the business affairs of the
institution during its formative years was unusually valuable.
The number of patients treated during the period was 510 as against
465 in the previous period. There continues as in former years a greater
demand for the admission of patients than the limited capacity of the
hospital can satisfy. There have been no notable changes of the buildings or grounds of the hospital during the period.
The Board must again emphasize the very inadequate facilities which
are provided for the work of the hospital. Both in size and arrangements the building is quite unsuited for the successful conduct of the
work of an organization of its type. These difficulties can only be
remedied by the erection of a new building planned with an appreciation
of the work it is to do. It is hoped that the public will become more
familiar with the great service the institution is doing and that adequate provision will be made for its needs at an early date.
The average rate for the maintenance of public patients was fl.257
per diem. The increase of this rate over that of previous years is largely due to the increased cost of food stuffs.
The most notable feature of the work of the period has been the development of the out-patient service at Ann Arbor and the establishment
of a similar psychopathic clinic directed by the hospital in Detroit.
The Board of Trustees acting in harmony with the research purposes
of the Psychopathic Hospital have appreciated that insanity is not
a disease to be studied only in its manifestations in the individual himself or in the morbid structure of the brain. It has its causes in ab-
�6
STATE OP MICHIGAN.
normalities present in the family from which he is derived and in forces
active in the environment in which he has lived; such factors are not
open to study within the walls of the hospital. To understand these
it is essential that the interests and activities of the hospital reach out
into the homes and among the families and into the public life of our
communities. To make it possible to carry on investigations along
these lines the Board of Trustees have approved of the organization of
out-patient services or psychopathic clinics under the direct control of
the medical officers of the Psychopathic Hospital.
A beginning of this phase of the hospital's activities has been made
in the establishment of an out-patient service in Detroit in connection
with the Wayne County Probate Court.
It is planned to establish similar organizations in other centers of
larger population whenever local co-operation can be secured.
The Board of Trustees feel that institutions of the type of the State
Psychopathic Hospital must assume the position of leaders in the work
of public service in matters pertaining to mental disorders. Such activities will extend its functions far beyond the traditional lines limiting institutions caring for the insane. It is largely by efforts for public
education and through extra-mural activities that we may expect to
achieve success in attacking the sources for the production of insanity
and mental disorders.
Signed,
CHAUNCEY F. COOK,
WALTEE H. SAWYER,
FRED S. CASE,
WM. L. CLEMENTS,
STUART GALBRAITH,
BENJ. S. HANCHETT,
FRANK B. LELAND,
M. F. QUAINTANCE,
�PSYCHOPATHIC HOSPITAL.
REPORT OF THE MEDICAL DIRECTOR.
In accordance with the statutes of this State, I have the honor of submitting my report as Medical Director of the State Psychopathic Hospital for the period covering July 1st, 1914, to June 30, 1916.
The close of the period marks the end of the first decade of the Hospitals' existence. Such a length of time should be sufficient for the institution to have established its field of work among the other organizations of the State caring for mental disorders. It should also have
determined the lines of activity which would be most promising for
its future development.
While the statutes establishing the hospital specified certain lines of
activity as its work, its functions as concerned the class of patients it
was to treat have been largely determined by its later experiences. Its
designation as a psychopathic hospital implied that it was to maintain
certain distinctive differences from the other hospitals maintained by
the State for the care of the insane.
In the development of its laboratory and research activities, there
was little difficulty in maintaining this distinction. Its relationship
to the class of mental disorders it was to treat has been less easy to
establish. As the hospital was a State institution, it was necessary to
receive patients from any part of the State. By reason of its snial]
capacity, namely, sixty-two beds, it was obvious that some restrictions
to admission would be desirable.
The term, psychopathic, as used in its official designation, suggested
that its work should be confined to those mental abnormalities not
usually classed as states of insanity. Experience early showed that
this would not be possible. The information usually available from prehospital examinations was rarely adequate to determine any distinctions between these two classes. This likewise prevented any distinctions between curable and non-curable disorders.
As the hospital was provided with unusual facilities for treatment,
in any case where treatment would be of any use,, it became essential
to select from those admitted to the hospital all who might be expected
to react favorably to what the hospital might do. In the case of the
others, what was needed was competent observation and advice as to
the best method for their future care. To accomplish this it was necessary to develop to the utmost the diagnostic side of the hospital's activities.
The institution has thus assumed to a considerable degree the functions of a clearing house for mental disorders and has equipped its
laboratories and developed its medical routine to best serve this purpose.
The results of its treatment are indicated in the fact that less than
one-fourth of those discharged go from the hospital to one of the other
State institutions.
�8
STATE OF MICHIGAN.
CLINICAL AND LABORATORY WORK.
As in previous years, the hospital has followed the plan of routine
intensive study of the clinical symptomatology of its patients with a
systematic consideration of the results of this in each individual admitted. The discussion of these studies at frequent conferences of the
medical officers serves to keep up an orderly routine and increase the
thoroughness of the medical work.
The activities of the laboratory have chiefly concerned the study of
the material received from the State Hospitals, by the modern methods
of neuro-pathology. On account of the considerable amount of material
received it has been found necessary to limit the work to that which has
come from cases well observed during their hospital life or to that
material which presented interesting pathological problems. The results of many of these studies have been communicated to the hospital
interested in the case. Some of these have been published in the medical literature of the period.
The serological work of the laboratory has greatly increased in
amount. At the present time, the laboratory of this hospital makes
Wassermann tests for all of the Michigan institutions caring for mental
disorders.
PUBLISHED CONTRIBUTIONS.
There have been reported on various occasions and published in the
medical literature of the years 1914-1916 the following contributions by
members of the hospital staff.
Barrett, Albert M.—Clinical and anatomical study of a case of Dementia praecox with acute death. Journal Michigan State Medical
Association, January, 1915, page 61.
Barrett, Albert M.—Extra mural responsibilities of State Hospitals
for the Insane. Proceedings Joint Board of Trustees of State Hospitals of Michigan, July, 1915.
Barrett, Albert M.—Multiple carcinoma involving the brain. Transactions Hospital Clinical Society, University of Michigan, January,
1916. Vol. 7.
Barrett, Albert M.—Syphilitic Psychoses associated with Manic Depressive symptoms and course. Journal American Medical Association. December 2, .1916. Page 1,639.
Jacoby, Arnold L.—Constitutional Syphilis associated with an hallucinatory mental disorder. Transactions Hospital Clinical Society, University of Michigan. April, 1916.
Haskell, Eobert H.—Acute Alcoholic Hallucinosis in General Paralysis, with Herpes Zoster following intraspinous treatment. Transactions
Hospital Clinical Society, University of- Michigan. February, 1915.
Vol. 6.
Hulbert, Harold S.—Technical improvement in Lange's colloidal gold
test. Transactions Hospital Clinical Society, University of Michigan.
October, 1915.
�PSYCHOPATHIC HOSPITAL.
9
OUT-PATIENT WORK.
In the development of the medical activities of the hospital, it has become increasingly apparent that many of the problems relating to the
mental disorders of patients have ramifications far beyond the confines
of the hospital. The most striking of these relate to the influence of
environment and habits of the patient. The interest in this aspect of
mental disorders became awakened in the studies of familial syphilis
which the hospital has been carrying on during recent years.
These interests have lead to the organization of out-patient services
under the direct supervision of the Psychopathic Hospital. The first of
these was developed in connection with the out-patient services of the
General hospital of the University.
Somewhat later, a service was organized in Detroit in relation with
the Wayne County Juvenile Court. This service known as the Detroit
Psychopathic Clinic, has the assistance of a trained psychologist and
a social service worker. This assistance has been made possible by the
Associated Charities of Detroit and the Wayne County Probate Court.
On one day each week a physician from the Psychopathic Hospital
is in attendance at the Clinic. The Clinic examines all cases of mental
abnormalities referred to it from any of the Charitable organizations of
Wayne county. The brief time that this organization has existed has
shown its value not alone in giving helpful advice to those mentally
ill, but in bringing the medical and research interests of the Psychopathic Hospital in contact with mental diseases at their earliest phases
and the sources responsible for the production of a large variety of
problems directly the concern of an institution such as this. It is planned to organize similar services in other cities of the State whenever
local conditions will insure their successful maintenance.
GELATIONS WITH THE STATE HOSPITALS.
There has continued through the period the same helpful co-operation
between the State institutions caring for those mentally disordered and
the Psychopathic Hospital.
The medical director in his capacity of pathologist to the State Hospitals for the Insane has made visits, as time permitted, to the several
hospitals. At these occasions there have been conferences with the
medical officers, and demonstrations of material sent from the hospital
to the laboratory of the Psychopathic Hospital.
There have been held at the Psychopathic Hospital several meetings
of the Superintendents of the Michigan State Hospitals. At these there
was presented a clinical program by the staff of this hospital, and there
were discussions of problems of mutual interest to those engaged in
the care of those mentally diseased. As a result of these, psychiatric
work in Michigan has been advanced in a number of specific directions.
The plan has been inaugurated during the period of having a medical
assistant from one of the State Hospitals detailed to the Psychopathic
Hospital for the period of a month. During this time he receives special
instruction in clinical problems and methods.
�10
STATE OF MICHIGAN.
FUTURE DEVELOPMENTS.
Extensive developments of the work of the hospital are impossible until the institution is provided with a building adequate to its needs. Anyone who is familiar with the construction and arrangements of the present building must realize how poorly it is adapted to the cure of patients
with mental disorders, and how unsuited it is to carry on its purpose of
investigation and teaching. Those interested in the administration of
the hospital feel that this situation should be appreciated by the people
of the State and that within the next few years the legislature should
make provision for a new building adequate to its needs.
The interest which has been taken in the organization of out-patient
services has shown that along this direction of activity it will find a field
of great usefulness.
The awakening of the people of Michigan to the menace of mental abnormalities, in particular the feeblemindedness, makes it opportune for
the Psychopathic Hospital to interest itself in efforts for public education as to the causes and prevention of mental disorders. Plans for undertaking this are now being formulated.
OFFICIAL CHANGES.
The following changes among the officials of the Hospital have occurred during the period.
Dr. Eobert H. Haskell resigned his position as First Assistant Physician on April 1, 1915 to become Superintendent of the Ionia State Hospital. Dr. Arnold L. Jacoby has been appointed to this position.
In July, 1915—Dr. Harold S. Hulbert was appointed Second Assistant Physician.
In Octobei', 1915, Dr. W. I. Lillie was appointed Eesident Physician.
Dr. Adeline E. Gurd was appointed Pathologist in the hospital in November, 1915.
Following the death of Mr. J. B. Draper, in November, 1915, Mr.
Robert G. Greve was appointed Business Officer of the hospital.
Respectfully submitted,
ALBERT M. BARRETT,
Medical Director.
�PSYCHOPATHIC HOSPITAL.
11
CLINICAL EEPORT.
As iii former reports, the information regarding the clinical work of
the hospital is considered in two divisions. The first of these includes a
tabulation of the general statistics relating to the clinical disorders
which have been treated during the period; the second is a detailed analysis of the various clinical groups.
GENERAL STATISTICAL
TABLES.
Information given in the general tables may be compared with that
given in similar tabulations by other State institutions for the insane,
but in doing so the peculiar relations under which the State Psychopathic Hospital operates must be borne in mind.
This hospital receives patients from the entire State rather than from
any one district. Admissions, so far as possible, are restricted to mental
disorders in their earlier stages of to those functional mental abnormalities which are not regarded as cominitable to the larger State Hospitals.
The small capacity compared with the other institutions caring for
the insane, and an active demand for admission to a hospital of its
special character, results in a far shorter period of treatment for any individual case than is afforded by the larger institutions.
TABLE No. I.—Showing the number of patients admitted and discharged and remaining
June 30, 1916.
Year ending
June 30, 1915.
M.
Admitted on original commitments .
Public
Year ending
June 30, 1916.
T.
F.
M.
F.
Total
since beginning.
T.
M.
F.
T.
66
1
27
76
5
33
142
6
60
81
10
35
87
8
30
168
18
65
575
94
236
590
88
215
1,165
181
451
By transfer from State institutions .
Public . . .
Private
State. . .
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
8
7
21
6
2
15
14
»
36
Total number admitted . . . .
94
114
208
126
126
252
941
916
1,857
16
36
39
1
1
12
55
35
1
7
28
91
74
2
8
10
56
51
2
6
11
60
58
1
3
21
116
109
3
9
129
299
417
30
40
138
292
410
16
32
267
591
827
46
72
93
110
203
125
133
258
915
888
1,803
26
28
54
Voluntary
Discharged:
As recovered
As improved . .
...
As not insane
Died
Total number discharged . . .
Remaining June 30 1916
"
"
�STATE OF MICHIGAN.
12
In this table are given the number and character of the admissions
and discharges of the period and from the beginning of the work of the
hospital.
The total number of admissions is about 10% greater than for the previous period.
Only one patient was received by transfer from one of the other State
Hospitals.
One hundred and twenty-five patients voluntarily sought treatment
without court commitment. This forms about 27% of all admissions.
The comparative increase each year since the opening of the hospital
is as follows:
1906. 1907. 1908.
Male
Female
1909.
1910.
1911.
1912.
1913.
1914.
1915.
1916.
27
28
39
40
48
59
78
70
89
92
96
96
118
101
109
88
117
104
94
114
126
126
53
79
107
148
181
192
219
197
221
208
252
6.
Total.
The admission for the period by months has been:
July 1, 1914, to June 30, 1915.
7.
8.
10.
11.
12.
1.
2.
3.
4
K
-
Male
Female .
11
6
5
8
12
13
8
9
6
6
4
4
9
9
9
16
8
10
7
10
13
11
94
114
17
13
25
17
12
11
13
16
25
18
17
24
208
�PSYCHOPATHIC HOSPITAL.
13
July 1, J.915, to June 30, 1916.
8
9
10
11
12.
1
2
3.
4
9
12
12
10
7
10
14
11
9
9
12
10
6
12
12
13
8
7
12
16
16
9
9
126
126
16
24
17
24
20
21
16
24
21
19
32
18
252
7
Male
it*.
The average monthly admission for the period was 19.
number admitted during any one month was 32.
6
Total.
The largest
�TABLE No. II.—Showing the forms of insanity in -patients admitted and discharged from the beginning until June 30, 1916.
Year ending June 30, 1915.
Admitted.
Discharged.
Paraphrenia systematica . . . .
Melancholia, involutional . .
Neuraesthenia . . . .
Anxiety neuroses
Constitutional criminalities .
Psychopathic personalities, adult
Psychopathic personalities, juvenile.
Alcoholic mental disorders . .
..
.
...
General paralysis
.
...
Cerebral arteriosclerosis . .
Cerebral tumor . . .
Huntingdon's chorea . . .
.
...
....
Discharged.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
21
15
1
0
0
28
25
1
49
40
2
7
0
21
20
1
0
0
30
25
1
5
0
51
45
2
5
0
28
15
0
3
0
41
23
5
0
0
69
38
5
3
0
29
15
0
2
0
40
28
4
2
0
69
43
4
4
0
203
165
!1
252
171
27
455
336
38
10
11
198
160
11
2
3
240
166
26
7
8
438
326
37
9
11
0
2
0
1
0
0
12
0
0
0
0
14
0
0
13
0
0
0
0
16
0
0
7
0
0
0
0
20
0
0
0
0
27
0
0
0
0
5
0
0
0
0
19
0
0
0
0
24
0
0
0
11
21 (a) 125
27
17
1
3
2
0
14
146
44
3
19
27
0
0
3
0
1
0
11
120
17
1
0
14
'139
44
4
2
2
0
0
6
3
0
0
0
2
0
2
0
0
8
3
2
0
0
5
3
1
1
0
1
1
14
4
2
31
14
0
2
0
6
4
0
1
12
6
0
0
1
5
0
26
22
5
5
1
4
12
1
3
0
1
3
0
2
0
0
3
0
ll
I
Presenile mental disorders . . .
Admitted.
T.
8
..
Discharged.
Admitted.
F.
?
Imbecility
Total since beginning.
M.
Insane conditions:
Dementia praecox
Year ending June 30, 1916
I
0
n
0
I
•s
I
I
0
0
0
0
0
0
4°
5
I
i
0
0
0
0
0
:
8
'•
T.
0
0
20
0
0
0
0
7
0
0
0
0
11
0
0
0
0
18
0
10
3
2
13
9
5
1
0
22
5
()
0
0
7
0
0
0
0
13
0
15
0
6
3
35
14
12
9
5
1
0
19
5
f
0
1
9
12
3
0
0
3
0
3
0
0
4
12
6
0
0
12
5
0
0
6
0
4
0
0
3
12
9
0
0
9
80
11
1
2
30
3
12
0
0
16
83
23
1
2
46
80
11
1
2
30
3
12
0
0
15
83
23
1
2
45
20
1
4
1
4
16
3
3
1
0
2
1
2
1
1
18
4
17
1
3
1
0
4
3
3
1
0
21
7
6
2
0
136
17
26
15
4
27
11
17
11
14
163
28
43
26
18
132
17
25
15
4
27
10
17
11
13
159
27
42
26
17
4
0
1
0
0
9
1
0
0
0
1
2
0
0
0
10
3
0
0
0
1
2
1
0
0
I
41
19
1
0
0
0
13
60
6
3
4
38
4
2
0
3
19
2
1
1
4
3
6
0
i
7
57
6
3
1
7
�Traumatic insanity
Psychoses associated with pernicious anemia
Psychoses associated with articular rheumatism . . .
Psychoses associated with nephritis
Psychoses associated with paralysis agitans
Delirium, toxic. .
....
...
Non-insane conditions—adult :
Sydenham's chorea . .
.
Miscellaneous . .
..
..
Non-insane conditions—juvenile :
Juvenile criminals . . , .
Total . .
...
....
0
0
0
0
1
0
1
0
0
2
3
4
0
2
3
5
3
3
0
4
1
4
3
2
7
6
7
0 I
2
2
4
3
3
0
4
1
4
3
2
6
5
7
0
0
0
0
0
0
0
0
0
4
0
0
0
0
4
0
1
1 (a) 1
0
1
5
4
9
1
2
1
6
13
1
0
0
1
4
0
2
1
5
9
u'Vl
0
0
0
4
0
0
0
3
0
0
0
1
0
0
0
4
0
5
0
36
1
12
4
66
1
17
4
102
0
5
0
36
1
12
4
66
102
0
0
0
0
0
0
0
2
0
0
0
2
0
0
0
0
0
0
0
2
1
2
2
20
0
2
0
12
1
4
2
32
1
2
2
20
0
2
0
12
1
4
2
32
0
0
0
0
0
5
2
7
5
2
252 125 133 258
941
916 1,857
915
888
0
3
0
0
2
3
3
0
0
1
0
1
0
0
3
3
4
0
0
0
3
i
0
0
0
0
1
0
2
0
0
2
0
2
0
0
3
0
1
0
0
0
0
0
0
0
4
0
1
0
0
4
0
0
0
5
0
0
0
2
0
1
0
3
0
1
0
5
0
0
0
3
0
0
0
1
1
0
1
1
0
0
0
0
0
1
0
0
0
1
0
1
0
0
0
1
1
0
0
0
0
2
0
1
1
0
1
1
0
1
0
0
0
0
0
0
0
0
0
0
3
0
0
1
1
3
0
0
0
0
1
0
1
0
0
2
0
1
0
0
3
0
0
0
2
0
0
0
3
0
0
0
1
0
0
0
94 114 208
1
93 110 203 126
3
3
(a) Female: in former period diagnosed hysteria, rediagnosed and discharged as psychosis associated with pellagra.
1
6
31
1
17
02
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0
K
O
W
1,803
Q
g
W
�16
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STATE OF MICHIGAN.
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a
Total heredity
1
S
.
Insanity
Apoplexy and paralysis
Psychopathic conditions
Alcoholism
�17
PSYCHOPATHIC HOSPITAL.
The variety of clinical forms given in this table is about as in former
years. The chief clinical groups occur in about the same relative numbers.
The relative frequency of conditions which could not be classified is
1.9%, a number relatively much smaller than in previous years.
It was possible to obtain some information as to the occurrence of
factors important from the aspect of heredity in 81.9% of all the insane
admitted. In all cases of insanity in which information was obtained,
hereditary influences were present among the ancestors in 67.4%' of instances. These were among the parents in 59.4% of instances; among
the grandparents in 10.8% ; among collateral lines in 14.8% ; and among
the brothers and sisters in 14.8%.
In many families there were several instances of mental abnormalities. In the families of 277 insane individuals there were 825 individuals who showed mental abnormalities.
TABLE No. IV.—Shelving the age of patients admitted.
Year ending
June 30, 1916.
Year ending
June 30, 1915.
M.
From 0 to 4 years
0
2
4
From 15 to 19 years.
From 20 to 24 years .
]2
From 25 to 29 years
From 30 to 34 years .
From 35 to 39 years
18
9
12
6
From 45 to 49 years .
From 50 to 54 years .
From 60 to 64 years .
From 80 to 84 years .
Total .
. . .
7
6
11
0
0
0
0
0
0
94
F.
T.
M.
0
2
4
22
22
0
1
2
5
10
6
3
0
1
0
0
0
34
28
24
20
18
12
18
3
0
1
0
0
0
20
12
20
17
7
7
10
7
4
3
0
0
1
114
208
0
0
0
15
.10
16
19
12
14
11
126
F.
0
0
3
6
16
21
17
14
16
11
9
9
3
0
0
1
0
0
126
Total
since beginning.
T.
0
1
5
11
26
41
29
34
33
18
16
19
10
4
M.
F.
1
7
23
66
104
0
2
6
76
95
3
1
0
1
121
104
114
88
97
68
71
30
15
9
5
1
17
104
120
122
122
91
67
49
25
4
6
2
1
24
252
941
916
T.
1
9
29
142
199
225
224
236
210
188
135
120
55
19
15
7
2
41
1,857
The largest number of admissions occurred between the ages of 20 and
28. The greater number of admissions occurred at earlier ages than in
previous periods.
�STATE OF MICHIGAN.
18
TABLE No. V.—Showing civil condition of patients admitted.
Year ending
June 30, 1915.
M.
Single
Married . .
Divorced .
...
Total
F.
Total
since beginning.
Year ending
June 30, 1916.
T.
46
44
2
1
•1
40
62
10
2
0
86
106
12
3
1
94
114
208
M.
49
68
4
4
1
126
T.-
M.
F.
44
70
8
4
0
93
138
12
8
1
408
465
33
32
3
310
508
67
29
2
718
973
100
61
5
126
252
941
916
1,857
F.
T.
TABLE No. VI.—Showing degree of education of patients admitted.
Year ending
June 30, 1915.
M.
6
Academic. . . .
Common school
Read only .
Total
F.
Year ending
June 30, 1916.
T.
M.
F.
Total
since beginning.
T.
M.
F.
T.
1851
13
2
2
2
5
23
74
7
0
0
5
11
41
125
20
2
2
7
13
20
60
18
1
7
7
2
36
69
16
0
1
2
15
56
129
34
1
8
9
67
162
583
64
3
14
41
39
188
606
47
0
1
42
106
350
1,189
111
3
15
83
94
114
208
126
126
252
934
923
1,857
TABLE No. VII.—Showing the occupation of those admitted during the current period
and from beginning.
Year ending
June 30, 1915.
M.
Professional
Personal service, police and military . . .
Manufacturing and mechanical inAgriculture, transportation
Total
and
F.
Year ending
June 30, 1916.
T.
M.
Total
since beginning.
T.
F.
M.
F.
T.
3
10
7
0
4
8
1
1
7
18
8
1
12
10
15
2
11
11
0
0
23
21
15
2
76
71
109
36
56
48
8
4
132
119
117
40
2
13
17
0
3
2
16
4
15
0
8
4
23
17
146
0
85
17
231
2
19
25
4
29
112
12
124
26
0
9
6
1
0
82
6
c
2
26
82
15
11
3
37
0
3
3
0
0
85
3
4
0
37
85
6
7
0
285
0
38
39
12
0
609
25
61
8
285
609
63
100
20
94
114
208
126
126
252
941
916
1,857
�PSYCHOPATHIC HOSPITAL.
19
TABLE No. VIII.—-Showing the nativity of patients admitted.
Year ending
June 30, 1915.
Holland .
Ireland
Italy . -. .
Poland . .
...
Total
since beginning.
F.
T.
M.
F.
T.
M.
F.
T.
94
63
81
11
2
114
75
99
13
208
138
180
24
4
126
64
92
24
10
126
78
101
21
4
252
142
193
45
14
941
556
762
135
44
916
577
743
144
29
1,857
1,133
1,505
279
73
0
0
0
1
0
0
0
0
0
1
1
0
0
0
1
0
0
0
1
1
0
0
0
1
2
0
0
1
0
2
0
1
3
0
0
1
1
5
2
1
12
0
2
3
0
7
0
5
4
0
10
0
1
4
1
17
0
6
8
1
45
2
19
27
7
54
0
12
38
99
2
31
65
14
0
1
0
0
0
0
0
0
0
0
1
0
1
2
1
2
0
2
5
0
0
1
0
0
0
0
1
5
7
1
2
1
7
1
0
0
3
1
2
1
1
8
5
4
1
0
7
4
6
0
1
15
9
10
1
0
1
0
14
1
1
1
12
0
0
0
6
1
1
1
18.
M.
Total born in United States . . . . . .
Year ending
June 30, 1916.
0
0
4
0
?
I
0
I
?
0
0
0
I
I
i
i
0
1
1
Sweden . . .
Syria
0
0
0
0
0
0
0
2
1
0
2
0
0
0
Wales . .
0
0
0
2
0
0
0
2
0
0
0
4
0
1
0
10
0
0
0
4
0
1
1
1
1
1
O
1
TABLE No. IX.—Showing the nativity of parents.
Year ending
June 30, 1915.
M.
Both native born
One foreign born, ons native born . .
One foreign born, one unknown . . .
One native born, one unknown . . . .
Unascertained
Total
F.
34
36
10
1
2
11
36
44
17
3
4
10
•04
114
Year ending
June 30, 1916.
T.
70
80
27
M.
F.
Total
since beginning.
T.
M.
F.
606
819
231
9
12
180
1 , 857
41
52
21
2
5
o
84
105
29
5
6
23
293
432
110
6
21
43
53
8
3
1
18
3
99
313
387
121
o
9
81
208
126
126
252
941
916
4
4
T.
In tables VIII and IX it is shown that 15.7% of those admitted were
foreign born and 52.4% had one or both of their parents foreign born.
63.3% of those admitted were born in Michigan.
�20
STATE OF MICHIGAN.
TABLE No. X.—Showing counties from which patients have been received.
Year ending
June 30, 1915.
M.
Allegan
Antrim
Bay
Benzie .
Calhoun
Chippewa
Clare
Clinton
F.
Year ending
June 30, 1916.
M.
T.
0
0
2
0
0
0
0
1
0
1
0
0
3
0
1
0
0
0
3
0
0
0
0
6
0
0
0
0
9
0
0
2
1
0
0
1
0
3
0
0
1
2
4
0
0
0
0
0
0
0
2
0
0
0
0
2
0
0
0
0
F.
2
1
1
3
0
1
0
0
4
0
0
3
0
1
0
1
0
0
1
0
0
0
1
0
2
0
1
0
2
2
0
1
3
4
0
0
2
4
1
0
8
0
1
3
0
3
2
0
0
0
1
i
2
0
4
0
2
0
5
1
1
4
0
9
0
0
0
0
2
1
0
0
3
2
1
0
0
3
4
1
1
7
1
0
0
0
7
4
2
1
1
14
5
2
Iron
Isabella
Jackson
Kalamazoo
0
0
3
0
0
0
0
5
2
0
Kent . •.
8
0
0
0
0
6
0
0
4
0
14
0
0
4
0
1
3
0
0
1
1
1
1
0
3
2
4
1
0
4
0
0
0
3
0
0
0
0
0
0
0
0
0
,3
0
2
0
0
0
1
0
0
0
0
3
0
0
0
0
4
0
0
0
2
2
0
Delta
Dickinson
Emmet
Gogebic
Grand Traverse
Gratiot
Hillsdale
Lapeer
Leelanau
Lenawee
Luce
Manistee
Marquette
Mason
Menominee
Midland
Missaukee
0
0 '
0
8
2
0
1
1
1
0
Total
since beginning.
T.
M.
0
0
0
3
0
0
0
1
4
2
1
1
6
0
1
0
1
8
0
0
o
0
0
1
0
1
1
0
0
0
5
1
9
0
0
0
2
1
3
0
1
0
1
4
0
7
1
12
9
0
3
0
10
3
4
4
0
3
26
1
1
0
5
21
0
5
19
15
2
5
5
7
20
3
1
0
1
2
0
10
1
0
8
3
8
0
3
6
2
0
0
6
1
11
0
1
12
2
32
1
0
18
7
43
0
0
4
3
1
1
1
18
29
2
0
1
3
1
7
5
1
4
3
22
17
5
0
3
8
o
1
1
0
1
o
o
0
4
26
8
0
7
0
0
15
0
1
4
0
65
0
2
8
0
7
4
0
0
2
20
15
0
1
8
2
0
1
1
2
4
3
12
4
2
0
0
2
2
0
2
0
21
16
0
i
0
4
2
0
0
2
1
0
0
0
0
0
0
0
0
0
T.
F.
17
25
6
3
36
13
4
0
7
37
3
0
57
1
0
14
1
16
15
2
0
12
2
2
9
0
1
0
1
11
15
0
10
1
22
12
4
5
0
8
47
1
10
26
35
5
6
18
1
3
14
5
1
1
30
9
75
3
1
2
35
54
10
6
58
30
9
0
11
63
11
0
122
1
2
22
1
36
30
2
1
20
6
5
21
4
3
2
1
32
31
0
�21
PSYCHOPATHIC HOSPITAL.
TABLE No. X.—Concluded.
Year ending
June 30, 1916.
Year ending
June 30, 1915.
M.
Otsego .
St Clair .
St Joseph .
Tuscola
Van Buren . . .
Washtenaw
Wexford
Total .
...
P.
T.
1
0
0
0
0
0
0
0
0
3
0
0
1
2
0
0
3
2
0
0
9
24
1
1
2
0
0
0
1
0
0
0
0
2
0
0
6
1
0
2
1
0
0
0
12
20
0
0
3
0
0
0
1
0
0
0
0
5
0
0
7
3
0
2
4
2
0
0
21
44
1
1
94
114
208
M.
F.
Total
since beginning.
T.
16
23
0
1
1
0
2
1
0
0
0
0
0
7
0
0
1
3
0
1
0
1
0
0
17
27
1
0
5
0
3
1
0
0
0
0
0
13
0
0
2
5
0
1
4
1
0
1
33
50
1
1
126
126
252
4
0
1
0
0
0
0
0
0
6
0
0
1
2
0
0
4
0
0
1
M.
F.
T.
4
2
14
2
2
0
9
0
1
42
0
2
54
8
1
12
3
27
3
2
0
13
0
2
79
3
4
101
17
1
4
4
18
17
5
2
4
109
135
1
0
33
33
11
4
16
234
266
5
4
941
916
8
1
13
1
0
0
4
0
1
37
3
2
47
9
0
15
16
6
2
12
125
131
1,857
Tlie State Psychopathic Hospital is an institution to which any county
of the State may send patients. Since the opening of the Hospital, patients have been received from 78 of the 83 counties of the State. During this period, patients were admitted from 59 different counties. The
largest numbers came from Wayne, Washtenaw and Kent.
�TABLE No. XI.—Showing the form of insanity of patients discharged and the results of treatment.
Total since beginning.
Period ending June 30, 1916.
Recovered.
Improved.
Unimproved.
Recovered.
Not
insane.
Died.
Improved.
Unimproved.
Not
insane.
Died.
M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T.
Insane conditions:
Manic depressive insanity
Dementia praecox
Paraphrenia systematica
Psychopathic conditions
Constitutional criminalities
Psychopathic personalities, adult . . .
Psychopathic personalities, juvenile.
Alcoholic mental disorders
Cocaine intoxication.
Imbecility
General paralysis
Cerebral syphilis . . .
Amyotrophic lateral sclerosis
16 12 28 20 29 49 13 28 41
0 1 1 14 26 40 21 26 47
0 0 0 0 3 3 1 2 3
0 0 0 1 4 5 1 3 4
0 0 0 0 0 0 0 0 0
1
0
0
0
0
0
0 63 64 127 70 72 142 59 101 160
0 1 3 4 47 47 94 111 116 227
0 3 1 4 5 10 15 3 14 17
0 0 0 0 1 4 5 1 3 4
0 0 0 0 1 0 1 2 8 10
8
0
1
0
0
0
0
6
0
0
0
0
7
0
0
0
0 0 0
5 22 27
0 0 0
1 0 1
0 0 0
0
2
0
0
0
0
4
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0 0 0 1 1
5 40 45 10 57 67
6 3 9 14 9 23
0 0 0 3 1 4
2 0 2 0 0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
2
0
0
0
C
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
7
1
0
1
0
0
2
0
0
0
0 1C
7
3 1 3
0 0 0 0
1 0 0 0
0 2 0 4
1
0
0
0
1
0
0
c 0
7 16
80
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 31
0 ' 5
0 0
0 2
0 0
1 32 33
7 12 6
1
0 C
0
0
0 ( 4
2 35 13 0 13
4 10 0 1 1 I
0 1 0 0 0 0
0 0g 0 0 0 0
1
26 24 40 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
4
0
0
0
0
3
2
0
1
7
2
0
1
23 12 35
0 ( 0
6 A 8
1 j: 3
1 £
1
1
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0 17
1 11
0 11
0 2
] 0
1 18 107 25 132
7 18 4 3 7
3 U 14 14 28
0 2 11 10 21
6 6 2 7 c
8
1
0
2
0
0
0
0
1
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
1
0
1
0
0
5
0
1
0
0
0
2
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 16
0 0
( 0
0 0
0 0
7 23 17 10 27
0 0
0
1 1
0
1 ]
0 0 (
1 1
3 6
5
1
0
0
0
2
2
0
0
0
C
0
0
iS2
1 01
0
11
0
2£
'±
£
1
0
0
0
£
3
t
1
1
0
0
1
0
0
0
0
6
1
1
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
80
0
0
1
(
0
3
0
0
0
0
3 9 12
4 21 25
10
5
0 g 0
0 0 0
5 1 6 2
^C 3 1 4 0
0 1 0 1 1
0 12 17 29 0
0 6 3 9 3
0
0
0
3
2
2
0
1
3
5
6
2
0
0
0
3
0
1
0
0
9 0
2 0
1 0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
1
2
0
0
0
1
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
d
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1 9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
7
�TABLE No. XL—Concluded.
Period ending June 30, 1916.
Improved.
Recovered.
Unimproved.
Total since beginning.
Not
insane.
Died.
Recovered.
Improved.
Unimproved.
Not
insane.
Died.
M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T.
Basedow's disease
Psychoses associated with pernicious
Psychoses associated with articular
Psychoses associated with nephritis .
Psychoses associated with myxoePsychoses associated with pellagra . .
Psychoses associated with paralysis
agitans . . . . . .
Delirium, toxic. .
Delirium, collapse. .
Post infectious psychoses
Unclassified conditions
Non-insane conditions — adult :
Sydenham's chorea . .
Tabes dorsalis
Miscellaneous
Non-insane conditions —juvenile:
Total .
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
fl
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
2
0
0
0
1 0
2 0
2
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
3
0
1 1
0
1 a
0
0
0
0
3
0
0
0
1
0
0
0
4
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0'
0
0
o
0
0
0
0
0
0
0
0
0
0
0
1
1
0
4
2
5
0
1
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
1 1
26 23 49 92 115 207 90 93 183
0
0
0
0
1
0
0
0
0
0
0
0
0
2
1
0
0
0
0
0
0
0
0
0
0
0
4
0
2
3
0
2
7
0
0
0
0
0
0
0
0
0
3
0
0
1
4
2
4
1 0 0 0 0 0 0
7 0 4 4 0 0 0
2 0 1 1 0 1 1
4 15 19 34 18 36 54
0
1
0
3
0
0
1
2
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1 1 0
0
0
0
0
0
0
0
0
7 10 17
3
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
1 1
1
1
0
0
3
3
1
4
3
5
1
0
0
1
0
0
1
0
2
0
1
0
1
2
0
0
1
0
1
0
0
0
0
0
0
2
2
4
0
0
0
1
0
0
0
1
0
1
2
0
0
1
2
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
2
1
0
0
0
1 1 1 0
0 0 0 2
1 1 1 3
1
2
4
0
0
0
0
0
0
0
0
0
0
4
0
6
0
5
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 1 0 1
0 2 2 4
0 2 0 2
0 20 12 32
0
0
0
2
5
0
0
2
0
0
7
5 129 138 267 299 292 591 417 410 827 40 32 72 30 16 46
�TABLE No. XII.—Showing the duration of residence in months of all cases discharged.
Recovered.
M.
F.
Improved.
T.
M.
F.
Unimproved.
M.
T.
F.
Died.
M.
T.
F.
Not insane.
M. .
T.
F.
Total.
T.
M.
F.
T.
2
0
0
4
12
0
0
0
3
5
2
0
0
7
17
2
0
4
13
26
0
0
3
8
34
2
0
7
21
60
9
6
5
9
20
6
3
8
6
21
15
9
13
15
41
0
1
1
1
1
0
3
1
3
1
0
4
2
4
2
0
0
0
1
1
0
0
0
1
1
0
0
0
2
2
13
7
10
28
60
6
6
12
21
62
19
13
22
49
122
4
0
0
1
2
7
2
0
2
2
11
2
0
3
4
19
5
9
5
2
18
9
11
11
6
37
14
20
16
8
11
11
5
29
19
13
9
3
2
0
0
1
0
1
0
0
5
18
8
8
4
3
3
0
0
2
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
37
16
14
12
4
44
19
19
18
11
81
35
33
30
15
8 months. . .
9 months
10 months . . .
1
0
0
0
2
0
0
0
3
0
0
0
2
2
0
1
3
5
0
4
5
7
0
5
3
2
2
0
0
2
1
1
4
3
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
4
2
1
5
7
1
5
11
11
3
6
14 months . .
18 months
25 months . .
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
1
1
1
0
3
1
1
0
1
1
0
0
2
0
1
1
3
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
1
0
0
3
1
2
1
6
2
2
1
26
23
49
92
115
207
90
93
183
7
10
17
3
2
5
218
243
461
1 week or less
2 weeks . . . .
3 weeks . .
4 weeks . . . .
2 months . .
3 months.
4 months. . . .
5 months. . .
7 months . .
Total
...
1
0
1-3
H
O
W
�PSYCHOPATHIC HOSPITAL.
25
In table XI are given the results of treatment according to clinical
type. Patients are classified as recovered when they are in their normal
mental condition at the time they are discharged; as improved when
their mental condition is improved over that at the time of their admission; as unimproved when their mental condition has not changed for
the better at the time of their discharge.
According to the above standards, 13.5% of those discharged were recovered, 31.7% improved, and 50.5% unimproved. The deaths numbered
2.8% of those discharged.
Table XII gives the length of residence of the patients discharged.
Of those discharged 22.4% remained in the hospital one month or less;
66.4% remained three months or less, and 12.3% remained longer than
t> months.
More than three-fourths of the recoveries occurred with a period of
treatment that did not exceed three months.
TABLE No. XIII.—Shoieing the age of patients discharged recovered.
Period ending
June 30, 1916.
M.
From 10 to 14 years. .
From 15 to 19 years . . . .
From 20 to 24 years . . .
From 25 to 29 years
From 30 to 34 years . . .
From 35 to 39 years ...
From 40 to 44 years
From 45 to 49 years . . .
From 50 to 54 years
From 55 to 59 years
From 60 to 64 years
From 65 to 70 years . . .
Unascertained
Total . . .
..
,
...
.
0
3
3
1
1
4
5
2
3
3
1
0
0
26
F.
Total
since beginning.
M.
T.
0
3
3
4
2
1
0
6
6
5
3
5
2
4
2
1
1
0
0
23
F.
T.
7
6
5
4
2
0
0
0
13
9
14
13
21
18
14
12
8
4
1
2
2
15
18
24
15
17
15
14
10
5
2
1
0
2
28
27
38
28
38
33
28
22
13
6
2
2
49
129
138
267
�STATE OF MICHIGAN.
26
TABLE No. XIV.—Showing the causes of death.
Period ending
June 30, 1916.
M.
Abscess, cerebral
Broncho-pneumonia
...
Broncho-pneumonia, general paralysis
....
Cystitis . . .
...
..
....
Exhaustion in delirium
Exhaustion, general paralysis
Gangrene, senile
Gastric ulcer, haemorrhage
Suicide, by cutting throat with pin
Total
T.
0
1
0
0
0
I
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
Nephritis, acute parenchymatous
F.
Total
since beginning.
M.
0
3
0
0
0
0
0
1
0
0
0
0
0
o1
1
1
1
1
1
0
0
0
0
0
0
1
0
1
1
2
0
Q
0
1
T.
0
4
0
1
4
1
1
0
0
0
0
2
1
6
0
1
0
1
1
0
2
0
1
0
3
2
4
1
2
0
1
1
0
0
2
1
0
0
40
32
0
1
0
2
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
7
10
17
1
1
1
2
1
0
3
3
0
2
1
1
1
1
F.
0
3
1
2
1
6
1
1
7
4
1
2
1
1
1
1
3
3
6
2
1
1
2
3
4
2
3
2
5
1
1
2
1
3
72
TABLE No. XV—Showing age of patients who died.
Year ending
June 30, 1915.
M.
From
From
From
From
From
From
From
10 to 14 years
20 to 24 years
25 to 29 years .
30 to 34 years .
35 to 39 years
40 to 44 years . . .
50 to 54 years
From 60 to 64 years
Total
..
F.
Year ending
June 30, 1916.
M.
T.
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
2
0
1
0
0
0
0
0
0
0
0
0
0
0
0
5
2
0
0
0
0
0
0
1
0
0
0
0
0
0
3
0
0
0
0
2
6
8
5
1
0
0
0
1
F.
Total
since beginning.
T.
0
0
0
0
0
1
0
0
0
0
0
2
1
0
0
0
4
M.
0
0
0
0
0
2
0
0
0
1
0
5
1
0
0
0
9
F.
T.
1
0
1
0
0
3
3
4
4
6
3
7
4
0
1
2
0
0
1
3
2
1
0
7
7
3
4
3
1
1
0
0
39
33
1
2
3
2
4
3
11
11
9
7
10
5
1
o.
2
72
�27
PSYCHOPATHIC HOSPITAL.
TABLE No. XVI.—Showing the number of transfers between the Psychopathic Hospital and
the State Insane Hospitals.
K. S. H.
P. S. H.
M.
Received by transfer from
Transferred to
F.
'.in' 'si'
F.
T.
M.
52
13 ' i t '
1
T. C. S. H.
T.
M.
F.
T.
M.
F.
1
30
8
13
21
1
1
Epileptic
Farm
Colony.
W. C. H.
M. I F.
M.
F.
N. S. H.
M.
2
Total
since
beginning.
Lapeer.
T.
T.
F.
T.
M.
F.
T.
' '6'
' i
37
45
25
63
61
108
1
Received by transfer from
Transferred to
0
i
i
. .„
6
i ' 'i'
Of all patients discharged, 23.4%' were transferred directly to one of
the State Hospitals for the Insane.
OUT-PATIENT
SERVICES.
During the present period the State Psychopathic Hospital has undertaken a new line of activity, by the establishment of out-patient services.
For several years the Hospital has been interested in what might be
designated as extra-mural problems of mental disorders. This interest,
and an appreciation that it was possible to make the hospital more
widely useful to the State, has lead to the organization of out-patient
services.
At the present time, two of these have been established, one at Anu
Arbor, and one in Detroit.
PSYCHIATRIC OUT-PATIENT SERVICE, UNIVERSITY HOSPITAL.
In May, 1915, the Psychopathic Hospital organized a local out-patient
service in psychiatry in connection with the General Hospital of the
University of Michigan.
The patients are referred directly to the service by the admitting physician of the General Hospital or from one of its clinical services.
The following table gives statistical information regarding this work:
�STATE OP MICHIGAN.
28
TABLE I.—Showing the number and source of out-patients.
Admitting physician—general hospital.
Clinic of neurology
Clinic of dermatology
Clinic of internal medicine
Clinic of otology
Clinic of gynecology
Clinic of surgery
Clinic of obstetrics
Clinic of genito-urinary surgery.
Clinic of ophthalmology
University health service
Total.
Male.
Female.
Total.
19
32
14
12
10
22
5
14
0
11
3
3
0
0
0
29
54
19
26
91
68
159
TABLE II.-—Showing diagnosis made in out-patients examined.
Male.
Manic depressive insanity.
Dementia praecox
Anxiety neurosis
Hysteria
Presenile mental disorder. .
Epilepsy
Imbecility
Cerebral arteriosclerosis. . .
Senile insanity
General paresis
Cerebral syphilis
Symptomatic mental state.
Alcoholic mental disorder..
Unclassified mental state. .
Pituitary disease
Hereditary syphilis
Tabes dorsalis
Infantile hemiplegia
Juvenile delinquency
Miscellaneous
Total. . .
Female.
Total.
11
5
5
12
7
4
16
4
23
12
5
7
4
0
21
5
1
2
0
5
1
1
3
5
12
5
1
24
1
4
0
25
5
2
12
1
2
2
1
2
5
92
160
�PSYCHOPATHIC
HOSPITAL.
29
DETKOIT PSYCHOPATHIC CLINIC.
RESIDENT OFFICEES.
Nellie B. Perkins, Ph. D., Psychologist.
Ethel Plumb, Social Service Assistant.
In February, 1916, an out-patient service was established in Detroit.
This service was organized in connection with the Wayne County Juvenile Court and the Associated Charities of Detroit. The clinic is located
in the Wayne County Detention Home.
Through the financial aid of the Associated Charities of Detroit, it
has been possible to provide resident assistants, who are in local charge
of the work of the clinic, and to conduct the work with systematic
thoroughness.
The Psychopathic Clinic will examine any individual with mental disorder referred to it from any of the organized charities of Wayne County,
and give advice as to treatment. Patients entering the clinic are first referred to the social service assistant,who prepares a personal history of the
patient. The information embodied in this is obtained from investigations
into the family and social life of the patient, and the relations which may
have occurred with various charitable or correctionary organizations.
With this record, the patient comes to the psychologist of the clinic,
who makes a mental examination of the patient. After these preliminary examinations have been made the patient is presented at a clinical
conference held each week by a physician from the staff of the State
Psychopathic Hospital. Further examinations may then be made and
advice given as to the patients future care and treatment.
The following tables give statistical information concerning the work
of the clinic.
�STATE OF MICHIGAN.
30
TABLE I.—Showing the number of patients examined and the sources from ivhich they were
referred to the clinic.
Probate Court, Juvenile Division
Probate Court, Insane Division
Probate Court, Mothers' Pension Division
Associated Charities, Main Office
Associated Charities, Children's Aid Society
Associated Charities, Woman's Hospital
Associated Charities, Salvation Army
Associated Charities, Y. W. C. A
Poor Commission
Board ol Health
Board of Education
Jewish Charities
Catholic Charities
Federated Clinics
Family or private physicians
Visiting Nurse, Dodge Bros
Circuit or Police Court
Florence Crittenden Home
Ford Motor Co., Social Service
Edison Electric Co
Girls' Protective League
House of the Good Shepherd...
Total
35
6
10
8
19
5
1
1
3
11
2
3
125
TABLE II.—Showing diagnosis made in patients examined.
Feeblemindedness
Subnormality
Psychopathic personality. . ..
Manic depressive insanity. . .
Dementia praecox
Cerebral syphilis
Symptomatic mental disorders.
Alcoholic insanity
Paranoid condition
Hysteria
Unclassified conditions. .
Total.
30
11
2
1
7
2
2
10
40
125
�PSYCHOPATHIC HOSPITAL.
31
REPORT OF THE CLINICAL GROUPS.
MA,NIC DEPRESSIVE INSANITY.
During this biennial period there were admitted 118 cases of manic
depressive insanity of which number 49 were males and 69 females. The
following table shows the frequency of this form of disorder among the
admissions to this hospital.
Female.
Male.
Per cent.
No.
Manic depressive insanity
220
49
22.3
No.
Total.
Per cent.
240
C9 "28^7'
Per cent.
No.
460
118
25.4
There are considered among those under treatment during this period
G males and 13 females who were admitted during the previous period
but were discharged in this. In all, 137 cases of manic depressive insanity were under treatment.
There was a relative increase of 2.7% in the number of admissions with
this disorder over that of the previous period. This increase was about
equal for the two sexes.
The following table shows the relative frequency of the several forms of
this disorder. The diagnosis was determined from the phase of the
disorder present at the time of admission.
Male.
No.
Manic
Depressive. . .
Mixed
19
29
1
Female.
Per cent.
38.8
59.1
2.0
No.
23
44
2
Per cent.
33.3
63.7
2.9
Total.
No.
42
73
3
Per cent.
35.6
61.8
2.5
It will be seen from this table that the depressive phase was the most
frequent type. It appears to be the more frequent in the female sex,
while the manic phase was more frequent in the male sex. The admissions in the mixed phase showed a decrease of 9% from those of the previous period, only 2.5% of the manic depressive cases showing this phase.
The three following tables show the number of patients who have had
at least one attack other than the one at present; the form of the first
attack in those having more than one attack, and the form of the first
attack in all cases admitted.
�32
STATE OP MICHIGAN.
Male.
More than one attack
First attack.
Female.
21
28
Total.
51
67
30
39
The form of the first attack in those patients having more than one
attack is shown in the following table.
Male.
Manic
Female.
8
38
2
3
5
24
0
1
3
14
2
2
Mixed
Total.
The form of the first attack in all cases of manic depressive insanity
admitted was as follows :
Male.
Female.
16
29
2
2
18
49
1
1
Manic
Mixed
Total.
34
78
3
3
These tables show that a previous attack had occurred in 42.8% of all
male and 43.4% of all female cases of this disorder. In the group as
a whole, previous attacks had occurred in 43.2% of all cases admitted.
In seven, or 5.9% of the cases, the first attack presented a phase different from the one at this admission.
The form of the first attack in all cases admitted was manic in 28.8%;
depressive in 66.1%; mixed in 2.5% and unknown in 2.5%.
The following table shows the age of patients at the time of the first
attack and the age of the patients at the time of their admission.
Admission.
First attack.
Depressive.
Manic.
Manic.
Mixed.
Mixed.
Depressive.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
10-14.
15-19.
20-24.
25-29.
30-34.
1
4
1
5
2
2
9
5
3
10
0
3
4
2
4
0
1
7
8
5
0
4
11
10
9
0
0
0
1
1
0
0
1
5
2
8
6
4
9
0
0
2
0
2
0
0
3
3
4
0
0
5
3
6
0
0
2
1
4
4
2
4
0
0
1
4
2
0
0
0
0
0
0
0
0
0
0
0
35-39.
40-44.
45-49.
50-54.
55-59.
0
1
0
0
1
1
1
2
1
0
1
2
1
3
3
7
9
8
4
5
1
11
9
7
8
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
2
2
1
3
1
0
2
1
3
3
2
6
2
3
3
9
7
9
4
6
8
13
11
7
9
17
1
0
0
0
0
0
0
0
0
0
0
0
0
0
60-64.
65-69.
70-74.
75-79.
Unk..
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
2
0
0
0'
0
1
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
1
6
2
4
2
2
1
1
0
0
0
0
0
1
1
1
1
1
0
0
1
1
T.
1
1
1
�PSYCHOPATHIC HOSPITAL.
33
It may be observed from this table that where the first attack was
manic in phase that 38.1% were under the age of 25. Where the first
attack was one of depression, 20.5% were tinder the age of 25. In all
cases admitted, the first attack occurred before the 25th year in 27.2%
and before the 50th year in 83.8% of instances.
HEREDITY.
Information concerning the occurrence of nervous and mental disorders in the families of the patients with this disorder was obtained in
105 of the 108 cases admitted.
The nature and distribution of these are shown in the following table.
In 82% of the families where information was available, there were
instances of mental abnormalities other than those of the patient.
In the families of the 87 cases showing abnormalities of the family and
antecedents there were 35 in which there was one other instance of abnormality. There were 23 families with 2, 18 with 3, 6 with 4, 3 with 5,
1 with 6, and 1 with 8 instances of abnormalities. In the 87 families,
there were 270 abnormal individuals.
Atavistic.
Direct.
Apoplexy or paralysis . .
Psychopathic . . . .
M
F
T
13
15
6
28
4
5
5
8
30
50
?
Total heredity . . . . 20
Q
M.
4
1
p
Collateral.
T
M.
F
Brothers
and
sisters.
Total.
T.
M.
F.
T.
M
F
5
T
3
2
0
0
7
3
1
1
8
0
1
0
7
1
0
1
15
1
1
1
1
0
0
0
4
1
0
I
0
26
4
3
4
29
10
5
6
55
14
8
10
5
12
9
9
18
1
6
7
37
50
87
6
6
12
7
18
13
49
69
118
Total
ETIOLOGY.
Of the 118 patients admitted, 18 were regarded by their friends as
showing peculiarities of personality preceding the acute outbreak.
In 77 cases there were experiences closely associated with the onset of
the disorder, which were regarded by their friends as of causative; importance.
In 11 cases the onset was associated with puerperal experiences. In
one instance short manic episodes of a week to ten days duration occurred at the menstrual period. In 11 instances, financial difficulties were
assigned as the cause. Physical illness or surgical treatment was noted
in 8 instances. Overwork or illness in the family were regarded as
causes in 26 instances.
Wassermann examinations of the blood serum were made in 117 of the
�34
STATE OF MICHIGAN.
118 admissions. It was found strongly positive in three cases. The first
of these was a woman of 24 admitted in a frank manic excitement. The
history showed a previous depressed phase. The neurological examination and the examination of the cerebrospinal fluid was negative. Her
mental condition returned to normal after four months.
The second case was a woman 32 years old who showed in her previous life many episodes of abnormal irritability and finally was admitted
to the hospital, showing the characteristic symptoms of the manic phase.
There were no evidences of involvement of the central nervous system by
syphilis shown in the neurological or spinal fluid examinations.
The third case was a male 32 years of age at the time of his admission.
The history showed many manic episodes for the seven years prior to his
admission. In the hospital he showed a mild euphoria with a slight
paranoid trend and a pressure of thought and motor activity. No pathology was revealed by the neurological examination but the Wassermann
examination of the cerebrospinal fluid was slightly positive. There was
no increase in the albumen or globulin content nor in the cellular elements.
One patient, a male 39 years of age, in his second attack of depression
showed a doubtful Wassermann on the blood serum without other evidence of luetic involvement, but the history revealed the fact that his
wife died of general paresis a few months prior to his last attack.
RESULTS OF TREATMENT.
The following table shows the condition of the cases of manic depressive insanity at the time of discharge from the hospital. There are considered here the cases admitted during this period and 19 cases of this
disorder remaining over from the previous period.
The average duration of treatment was 117.9 days. All the patients
were discharged to their homes, except 35 who were transferred to the
various State Hospitals.
Manic.
Unimproved . .
Died
Depressive.
Mixed.
M.
F.
T.
M.
F.
T.
M.
F.
6
9
5
0
3
7
8
0
2
9
16
13
0
10
10
8
1
4
8
21
19
1
10
18
31
27
2
14
0
1
0
0
0
1
1
1
0
1
3
0
Total.
T.
1
2
1
0
0
M.
F.
16 12
20 29
13 28
1
1
5 12
T.
28
49
41
2
17
It may be seen from this table that of the 120 patients discharged
23.3% were discharged recovered; 40.8% improved; 34.1% unimproved;
and 1.7% died.
Of the 38 cases of the manic phase 23.7% were discharged recovered
and 42.1% improved. Of the 78 depressive cases 23.5% were discharged
recovered and 39.7% improved.
Grouping the recoveries and improvements together we find from this
table that 65.8% of the manic cases and 62.8%' of the depressive cases
�PSYCHOPATHIC HOSPITAL.
35
were benefltted by their hospital treatment. Two patients died from intercurreut disorders. It was possible to make a laboratory study of the
central nervous system in one of these.
Case 1727. Agitated depression:—A male in whose family were two
other instances of mental abnormalities. Throughout his life he had
been regarded as one who was extremely irritable. At the age of 50 he
was definitely depressed following some neighborhood trouble, but was
not in a hospital. At 58 his wife left him and instituted divorce proceedings because of his extreme irritability. He again became depressed and
continued so for two months. After this, his wife returned to him. Two
months before his admission, at the age of 60, she again left him and be
became depressed and attempted suicide. The examinations showed him
moderately emaciated with evidences of arteriosclerosis. His blood pressure was 150. He was extremely weak and his mood Was that of deep
depression. He talked but little and what he said coincided well with
his mood. He expressed self pity, talked of being poisoned, and made
feeble attempts at suicide. He became more deeply depressed and gradually failed in strength, in spite of supportive and stimulating measures. After five weeks he developed a severe diarrhoea and passed into
a deep stupor, in which he died on the third day.
The autopsy showed an early carcinomatous change of the pylorus.
The gross examination of the brain showed slight arteriosclerosis of the
basal trunks and a moderate degree of leptomeningitis.
Histological examination of the cortex showed a moderate fatty degeneration of the nerve cells. The vessel lymph spaces held large accumulations of fatty pigments. The process as a whole appeared to be one
of recent origin. Aside from this, the cortex showed little that was pathological.
DEMENTIA PREACOX.
There were admitted 78 patients whose mental disorder was diagnosed
dementia praecox. This number formed 16.9% of all patients admitted.
Male.
No.
Hospital admissions
220
30
Per cent.
' 'ii'.e'
Female.
No.
240
48
Per cent.
'ao.'o'
Total.
No.
460
78
Per cent.
16.9
The 30 male cases formed 13.6% of all men admitted and the 48 female
cases 20.0% of all women admitted.
The 78 cases occurred in the following types.
�STATE OF MICHIGAN.
36
Male.
No.
Dementia simplex
Female.
Per cent.
Catatonia
5
19
4
2
Total
30
No.
16.6
63.3
13.3
6.6
Total.
Per cent.
4
g
6
8.3
56.2
22.9
12.3
No.
Per cent.
9
46
15
8
48
11.5
59.0
19.2
10.2
78
AGE.
The onset occurred before the 25th year in 36.6% of the male cases
and 50% of the females, or 44.7% of all cases of dementia praceox which
were admitted.
The youngest age of onset was 10 years and the oldest 41.
Admission.
Onset.
M.
T.
F.
M.
F.
T.
10-14..
15-19
20-24 .
25-29 . . . .
30-34 .
1
3
7
14
2
2
7
14
9
7
3
10
21
23
9
0
3
6
16
2
1
8
9
16
6
1
11
15
32
8
35-39 . . .
40-44
45-49
3
0
0
0
5
2
0
2
8
2
0
2
3
0
0
0
4
3
1
0
7
3
1
0
The relative frequency of occurrence before the 25th year of the various clinical forms was:
Per
cent.
Dementia simplex
Hebephrenic
Catatonic
Paranoid
88.8
39.1
53.3
0.0
Information concerning hereditary influences was obtained in 71 instances. Of these, there were 41 or 57.7%, in which there was insanity
or some other predisposing factor present among the ancestors or
families.
�PSYCHOPATHIC HOSPITAL.
Direct.
M
4
2
2°
Total heredity. . . .
8
T
M
F
j
T
M.
F
I
Brothers
and
sisters.
Collateral.
M.
T
F
Total,
T
3
3
4
3
5
4
5
2
1
0
0
4
0
0
3
5
5
0
0
1
0
1
0
5
0
0
0
6
0
1
0
1
0
0
0
2
0
0
0
COOOO
Insanity
Apoplexy or paralysis . .
F
Atavistic,
37
13
21
3
7
10
2
5
7
1
2
3
Total
M.
F
T.
8
3
1
2
13
7
4
3
21
10
5
5
14
27
41
12
4
18
3
30
30
48
78
In 39 families there was more than one occurrence of disease, and in
families of the 78 cases of dementia praecox there were 153 known instances of mental and nervous abnormalities.
ETIOLOGY.
In 21 instances the onset of the disease was associated directly with
some unusual experience in the life of the individual. In five instances,
the first symptoms followed a physical injury. In 5 there were unusual
sexual complications at the onset. Four cases developed following childbirth.
RESULTS OF TREATMENT.
The results of treatment are shown in the following table. In addition
to those admitted during the period, there are included 10 males and 10
females who were admitted previous to the present period.
M.
F.
0
Unimproved . . .
Died
14
...
21
0
5
Per cent.
T.
1
26
26
0
5
1
40
47
0
10
51 3
62.5
12.8
Of those discharged, 56 returned to their families and 31 were transferred to one of the State Hospitals for the insane.
DEMENTIA SIMPLEX.
There were admitted 9 cases of dementia praecox, 5 male and 4 female,
in which the course was that of a simple deterioration, without delusions or hallucinations.
�STATE OF MICHIGAN.
38
This number formed 11.5% of all cases of dementia praecox admitted.
The ages at onset and at admission are shown in the following table:
Onset.
M.
10-14..
15-19
20-24. .
25-29
.
F.
1
2
. .
Vdmission
T.
1
]
1
1
2
0
F.
M.
2
3
3
1
T.
1
1
1
1
0
3
1
1
1
4
9
2
In 88.8 per cent of the cases the disease developed before the age of 25.
The results of treatment of the patients of this group are shown in the
following table. This includes 1 male admitted in the previous period.
M.
F.
0
2
3
1
T.
0
3
1
0
0
4
1
All of those discharged were returned to their homes.
HEBBPHBENIC FORM.
There were admitted 46 cases of this form of dementia praecox. Of
there, 19 were males and 27 were females. This number constituted 59%
of all cases of dementia praecox admitted.
The ages at onset and at admission were:
Onset.
M.
10-14. .
15-19
20-24 .
25-29
30-34
35-39. .
40-44
Unknown
Admission
T.
F.
M.
1
5
7
6
1
6
11
18
1
1
t
0
0
0
2
3
5
0
2
0
1
4
12
4
F.
T.
0
0
4
13
0
6
4
11
0
6
8
24
1
1
2
3
4
1
0
0
0
3
1
0
In 39.1% of these cases, the onset occurred before the age of 25.
The following table gives the results of treatment. In this are included 5 males and 6 females admitted in the former period.
�PSYCHOPATHIC HOSPITAL.
39
M.
F.
0
T.
0
14
16
3
15
2
0
21
31
Of the 32 patients who were discharged, 12 males and 12 females were
transferred to one of the other State Hospitals. The remainder were returned to their homes.
CATATONIC FORM.
There were admitted 15 cases which showed the clinical course of the
catatonic form of dementia praecox. Four of these were males and 11
females. This group constituted 19.2% of all cases of dementia praecox
admitted.
The ages at onset and admission were:
1Admission
Onset.
M.
F.
0
1
15-19
20-24
25-29 .
30-34
35-39 . .
2
0
1
T.
1
0
I
2
1
F.
M.
1
0
1
3
2
0
1
9
2
T.
1
1
5
5
4
3
2
1
2
2
The onset in 53.3% of the cases was before the age of 25.
The results of treatment are shown in the following table, included
in this is one case admitted during the previous period.
M.
F.
0
3
1
1
T.
1
4
5
1
1
7
6
2
PARANOID FORM.
There were 8 cases of the paranoid form of dementia praecox. Two
of these were males and 6 were females.
7
�40
STATE OF MICHIGAN.
The ages at onset and admission were:
Onset.
F.
M.
25-29
30-34 . .
35-39
40-44
45-49
l Admission
T.
1
3
0
0
1
1
0
1
o
0
T.
1
0
1
1
0
4
1
2
2
o
F.
M.
1
. 3
2
1
2
1
0
2
1
o
The disease developed in all instances after the age of 25. The earliest
age of onset was 28 and the latest 41.
The results of treatment are shown in the following table. Included
in this are 3 males and 3 females admitted in the previous period.
M.
Recovered .
Improved
.
.
F.
0
2
2
1
T.
0
4
4
1
0
6
6
2
Five of those discharged were transferred to another State Hospital.
PARANOID MENTAL DISORDERS.
Under this heading are placed a number of cases in which the mental
symptoms were of a paranoid type, but in which the clinical course was
different from that of the paranoid form of dementia praecox and
it did not seem possible to find a relationship with any specific cause.
Some of these cases in their clinical course correspond to the group
which Kraeplin has arranged as paraphrenia systematica. Others having certain features in common but less clear in their clinical position
are placed in a general group of paranoid conditions.
PARAPHRENIA SYSTEMATIC^.
The mental disorders of ten individuals admitted during the period
are grouped under this heading. Three of these were males and 7 females. This number formed 2.2% of all admissions.
Female.
Male.
No.
Paraphrenia svstematica,
220
3
Per cent.
1 .4
No.
240
7
Total.
Per cent.
2.V
No.
460
10
Per cent.
2^2
�41
PSYCHOPATHIC HOSPITAL.
Of those discharged, 5 were transferred to one of the other State Hospitals for the Insane.
The ages at onset and admission were:
1Admission
Onset.
M.
F.
1
20-24 . .
25-29 . . . .
30-34 . .
35-39
40-44 .
45-49 . . .
50-54 .
55-59
. .
F.
M.
T,
0
0
0
1
0
5
1
3
0
5
0
1
1
1
0
0
1
4
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
1
0
0
1
2
...
T.
0
1
2
5
1
0
0
1
Hereditary factors were present among the ancestry in three instances.
RESULTS OF TREATMENT.
The results of treatment were:
Recovered
.
Unimproved . . . .
.
.
.
T.
F.
M.
0
0
4
3
0
0
1
1
1
. .
5
4
1
Of those discharged, 7 were returned to their families and 2 were transferred to one of the State Hospitals.
PARANOID DISORDERS (UNDIFFERENTIATED) .
There were admitted during the period a number of individuals whose
mental disorder was characterized by more or less elaborated delusions,
and which showed symptoms and course different from the paranoid
conditions grouped elsewhere.
There were 7 of these cases, 1 male and 6 females; in all, forming 1.5%
of the admissions.
Male.
No.
Hospital admissions
Paranoid disorders (undifferentiatedl
220
1
Per cent.
" ' 0 '. 5 '
Total.
Female.
No.
240
6
Per cent.
2^5
No.
460
7
Per cent.
1.5
�42
STATE OP MICHIGAN.
The ages at onset and at admission were:
Admission
Onset.
F.
M.
30-34
35-39
40-44
45-49
50-54
55-59
T.
0
0
0
0
0
2
0
1
1
2
o
0
1
1
M.
2
0
1
0
1
1
3
F.
0
0
0
0
1
0
0
T.
0
2
1
1
1
1
0
0
0
2
1
1
2
I
Hereditary factors were present among the antecedents in 3 instances:
The results of treatment are given in the following table:
F.
M.
0
0
1
0
T.
0
3
2
1
0
3
3
1
Five of these returned to their families and one was transferred to a
State Hospital.
SYPHILITIC MENTAL DISORDERS.
There were admitted during the period 50 cases in which the mental
disease was due to syphilis of the central nervous system. Clinically
these were represented as follows:
M.
General paralysis
Cerebrospinal syphilis .
Tabes
.
28
5
1
F.
T.
12
4
0
40
q
1
SYPHILIS IN RELATION TO ADMISSIONS.
Routine examinations by the Wassermann test of the patients admitted
during the period showed that among 449 individuals tested, there were
74 in whom the Wassermann reaction was positive. This indicates that
about 16.5% of all admissions to .this hospital had syphilis. If there is
deducted from these the 50 cases of definitely syphilitic types of nervous
disorders, there remain 24 cases, or 5.3%, who had syphilis but whose
mental disturbance was of a non-syphilitic type.
�PSYCHOPATHIC HOSPITAL.
43
EFFECTS OF SYPHILIS IN THE FAMILIES OF PATIENTS HAVING SYPHILIS OF
THE CENTRAL NERVOUS SYSTEM.
For several years it has been the practice in this hospital, whenever
possible, to examine for the presence of syphilis, members of the families
of patients who have syphilitic forms of mental disease.
During the present period, Wassermann tests were made upon the
blood of some member of the family of 26 patients. Of 22 mates of
patients, 5, or 22.7%, gave a positive Wassermann reaction on the blood.
One parent gave a positive Wassermann reaction on the blood.
In 3 other families there was a definite history of syphilis of the nervous system of the mate of the patient.
In 26 families, syphilis was present in 9 members apart from the
patient, or in 34.6%.
Among the mates of 20 general paralytics, syphilis was present in 5,
or 25%.
There were examined 15 children from the families of 11 cases of general paralysis. Seven of these showed stigmata of hereditary syphilis
and the blood of 4 gave a positive Wassermann reaction.
GENERAL PARALYSIS.
During the present biennial period there were admitted 40 cases of
general paralysis. Twenty-eight were males and 12 were females. This
number constituted 8.7% of all cases admitted. Of all male patients
admitted 12.7% belonged to this group, and 5% of all females. The relative frequency of the disease as it concerned the sexes was as 2.?> to 1.
Female.
Male.
No.
General paralysis . . . .
220
28
Per cent.
12.7
No.
240
12
Total.
Per cent.
5
No.
460
40
Per cent.
's'.7
CLINICAL FORMS.
The majority of the cases coursed as the demented type. Cases of the
agitated and expansive types were relatively more frequent than in the
previous period.
One case was of more than usual interest in that it occurred at the late
age of 71.
There was admitted one case of juvenile paresis, the child of a tabetic
mother.
�44
STATE OF MICHIGAN.
Demented
Agitated
Delirious . . .
J uveuile
19 '
5 i
2
1 ;
''
T.
F.
M.
1 ;
8
1
•
0
27
6
5
1
1
o
AGE.
Excluding two cases associated with extreme variation from the usual
age, viz 7 and 64, the average age of onset of the disease of the males was
:>4.3 years, and 36 years of the females.
Onset.
M.
5-9
10-14. .
15-19 .
20-24. .
25-29
F.
1
0
1
2
30-34 . .
35-39
40-44 . . .
45-49
50-54
4
g
55-59
60-64..
65-69
70-74 . .
0
4
2
0
1
0
0
j Vdmission
T.
M.
F.
T.
1
0
1
2
6
0
1
0
0
4
0
o
0
o
o
6
1
2
1
0
10
9
6
3
0
4
10
4
4
0
4
1
2
2
1
g
11
6
6
1
1
1
1
0
0
0
0
0
1
1
0
0
1
0
0
1
0
0
0
0
1
0
0
0
1
o
0
1
0
5
HEREDITY.
Hereditary factors were found among the ancestors or families of
62.5% of the cases in which information was available. Among the
families of these 40 cases of general paralysis, there were G4 instances
of mental abnormalities.
�PSYCHOPATHIC HOSPITAL.
Direct.
F.
Brothers
and
sisters.
Collateral.
Atavistic.
M
45
M.
2
0
0
0
4
0
0
0
5
1
1
3
2
1
0
2
7
2
1
5
2
4
10
5
15
Negative . . . .
Unknown
6
12
3
4
9
16
Total . .
28
12
40
3
M
1
0
0
0
0
0
0
0
1
0
0
0
0
2
2
2
1
5
oooo
Total heredity . . . .
I
T
oooo
Insanity
Apoplexy or paralysis . .
Alcoholism
M
F
T.
T.
T.
F
F.
M.
F
Total.
2
0
0
0
3
10
1
0
1
0
0
0
2
T.
DATE OF SYPHILITIC INFECTION.
In 20 cases the date of infection was approximately determined. The
average interval between infection and onset of the symptoms of general
paralysis was 14.3 years.
0.
11.
14.
15.
18.
20.
23.
25.
1
1
3
2
2
1
1
31.
•
1
1
ALCOHOLIC INFLUENCES.
A history of more than moderate alcoholism was obtained in only 6
instances. There was one case presenting a complication of alcoholic
hallucinosis with general paralysis.
NEUROLOGICAL DISTURBANCES.
The most constant neurological abnormalities were in the pupils and
tendon reflexes. In 50% of the cases the pupils were irregular; in 35%
the pupils were unequal; in 40% the reaction was sluggish and in 25%
the light reactions were absent. In 22.5% the knee jerks were absent.
In 10% they were unequal and in 17.5% they were increased. Babinski's reflex was present in 5% of the cases. Tremors were present in
55%' of instances. In 10% of the cases there was a history of either
apoplectiform or epileptiform attacks.
SEROLOGICAL.
In all cases examined the serological findings were characteristic of
this disease. The blood in 38 cases gave a strongly positive Wassermann reaction and in 2 cases the reaction was weakly positive. The
cerebrospinal fluid was examined in 37 cases and in all instances gave
�46
STATE OF MICHIGAN.
a strongly positive Wasserinanii reaction. The cells varied between a
minimum of 5 and a maximum of 320.
During the latter part of the period, interest has been shown in the
application of Lange's colloidal gold test. Of 21 cases tested, 19 gave a
curve characteristic of general paralysis and 2 gave a type of curve of
cerebrospinal syphilis. That these latter cases were cases of general
paralysis was proven by other diagnostic points.
KESTJLTS OF TREATMENT.
During the period an active interest has been shown in the medicinal
treatment of cases of general paralysis. Some cases have been treated
by intraspinal injections of salvarsan, after the method of Swift and
Ellis; others have been given salvarsan intravenously, and others went
through an energetic treatment with mercury. While in some cases it
was possible to influence for good the serological findings, in no case
did the spinal fluid become normal. In some cases the progress of the
clinical symptoms seemed to be benefltted but this was only temporary.
On the whole, it has seemed as if no certain benefits had been obtained
from treatment.
The following table shows the condition of patients discharged. Included in this are 5 males who were admitted in the previous period.
F.
M.
Recovered
Improved .
Unimproved . .
Died.
.
0
5
23
1
. .
4
T.
0
0
12
0
0
0
5
35
1
4
Of the 40 patients discharged, 22 were transferred to one of the State
Hospitals and 18 returned to their families.
CEREBRO-SPINAL SYPHILIS.
There were admitted during the period 9 cases of syphilis of the
central nervous system, with mental disorders.
The relation of these to admissions was:
Male.
No.
Hospital admission
Cerebrospinal syphilis. . .
220
5
Female.
Per cent.
2.2
No.
240
4
Total.
Per cent.
i.6
No.
460
9
Per cent.
1.9
�PSYCHOPATHIC HOSPITAL.
47
AGE.
The ages at admission ranged between 22 and 59. The interval between infection and the outbreak of mental symptoms varied from 5
months to 27 years.
HEREDITY.
Hereditary factors were present in 3, or 37.5%, of 8 cases in which
information was obtained.
CLINICAL.
In 3 cases the symptoms were referable largely to vascular involvement. In 4 the process was meningeal. In 8 cases there were noted
prolonged disturbances of the consciousness. Some of these were in
association with apoplectiform attacks. Wassermann reaction was positive on the blood of all cases, and on the cerebrospinal fluid of 6 cases.
In 3 cases the fluid was negative in dilutions up to 0.8 cc.
RESULTS OF TREATMENT.
M.
Recovered
Died
F,
0
4
.
...
0
1
0
T.
0
3
0
0
1
0
7
0
1
1
Energetic treatment with salvarsan was carried out in 8 cases. This
was given either intravenously or intraspinally after the method of
Swift and Ellis. Improvements were marked under both methods.
Neither method semed to produce results superior to the other. One
patient, whose disease was complicated with severe general arteriosclerosis and nephritis, died.
Case No. 1587. Syphilitic endarteritis: Male, aged 54 years at admission. His mother died of apoplexy at 68. He himself was a moderate user of alcohol. No information as to occurrence of syphilitic infection. Since the age of 34 he believed that he had kidney and heart
trouble. At 51 he complained of severe pains in the left arm and leg,
with much impairment of ability to use the left arm. Ten months before
his admission he had an apopletic attack followed by prolonged unconsciousness. There was no motor paralysis following this attack.
After four days he showed no change in his conduct and took up his
business affairs. Following this attack, the pain which had previously
given him much concern did not return. A month later a second stroke
occurred. During and following this attack there was paralysis of the
left side and difficulty in speaking. The effects of this never passed
away and after that he was unclear in his comprehension most of the
time. Two months later a third attack occurred, followed by a condition of stupor lasting two weeks. The mental confusion grew worse
and at no time was he lucid. In the succeeding months he had several attacks of cardiac and respiratory disturbance.
�48
STATE OF MICHIGAN.
His examination at admission showed chronic interstitial nephritis;
hypertension; hypertrophy of left ventricle, and marked mycardial
changes. The urea content of the blood was at the high normal limit.
Blood pressure was 180. The pupils were irregular. Their direct light
reaction was slowed. There was a well marked Rhomberg's symptom.
The knee jerks were greatly increased. At times Babinski's reflex was
obtained. There was tremor of the fingers but not of the tongue or lips.
The left hand grasp was much weaker than the right. The fundus examination showed advanced arteriosclerotic changes, edema of the
retina, and retinal hemorrhages. Wassermann reaction was positive
on blood and spinal fluid. There were 6 cells per cu. mm.; Nonne-Apelt
test gave slight reaction in Phase I; Lange's test gave a slight change
in the luetic zone.
Mentally he continued unclear and usually showed a mild delirious
restlessness. There was a profound memory defect with slight romancing at times. Towards the last, there were paraphasic disturbances. The
heart symptoms increased and death occurred 10 weeks after his admission.
The pathological diagnosis was—Acute purulent broncho-pneumonia;
syphilitic changes in aorta and kidneys; syphilitic orchitis; general
arteriosclerosis; organized thrombus of pancreatic artery. The gross examination of the brain showed widespread syphilitic endarteritis of the
vessels at the base and in the pia, recent hemorrhage into the pia-arachnoid, and an area of focal softening in the right lenticular nucleus.
The microscopic study of the brain showed thickening of the pia with
infiltration of lymphocytes and rarely a plasma cell. The endothelium
of the vessels of the pia was enormously proliferated, in some vessels almost closing the lumen. The elastic coat was split and broken in places.
Around the vessels were large numbers of lymphocytes and occasionally
a mast cell. The marginal glia, especially the fibrous part, was excessively thickened. In the medullary substance of the convolutions, there
was marked hypertrophy of the glia cells.
The nerve cells showed varying degrees of changes. Many were practically normal and others, especially some of the small pyramidal cells,
were sclerosed. Some cells showed characteristic axonal reaction type
of change. In a number of places there were focal devastations and miliary softenings.
Summary: The changes, both gross and microscopic, were typical of
syphilitic endarteritis and secondary reactions in the nervous parenchyma, and a slight syphilitic meningitis. There was also changes of a
type met with in toxic conditions such as uraemia or alcohol.
TABES.
One case of tabes was under treatment. The mental symptoms were
chiefly of a neuraesthenic type. There was little improvement under
active treatment by intra-spinal injections of salvarsan in small doses.
�PSYCHOPATHIC HOSPITAL.
49
ALCOHOLIC MENTAL DISORDERS.
During this period there were treated 18 cases, all males, of mental
disorders caused by alcohol. This number represents 8.18% of the male
admissions for the period and 3.9%' of the total admissions of both sexes.
This is a decrease of 2% in the admission rate of this class of disorder
over the former period.
The classification into clinical groups was made as follows:
M.
Delirium tremens. .
..
1
6
1
...
1
6
1
2
8
0
0
0
0
0
2
Chronic alcoholism . . .
T.
F.
8
There was a decrease in numbers compared with previous years of
cases of delirium tremens and chronic alcoholism. One case of delirium
tremens was of unusual interest in that the patient was said to have had
delirious episodes, similar to the one at the time of admission, about
once each year for 18 years.
HEREDITY.
Positive heredity was noted in nine cases. In the remaining nine cases,
the family history was given as entirely negative or no information regarding this was obtained. The following table shows the distribution
of the hereditary influences:
Apoplexy or paralysis . .
Total heredity . . . .
Unknown
Total .
Atavistic.
Brothers
and
sisters.
Collateral.
M.
F.
T.
M.
F.
T.
M.
1
0
0
4
0
0
0
0
1
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
5
0
5
0
0
0
2
F.
Total.
T.
M.
F.
T.
M.
F.
0000
Direct.
T.
1
0
0
1
1
0
0
1
0
0
0
0
1
0
0
1
3
0
0
6
0
0
0
0
3
0
0
6
0
2
2
0
2
9
0
9
3
6
0
0
3
6
18
0
18
Three of the cases of delirium tremens had had previous attacks and
four of the cases of chronic alcoholism had previously been in institutions for treatment for some form of alcoholic mental disorder.
�50
STATE OF MICHIGAN.
A study of the Wassermann reactions of this series revealed two positive cases and sixteen negative. One of these was a bartender, admitted
in an attack of delirium tremens. The examination of his cerebrospinal
fluid was negative except for a slight increase in the globulin. He presented no neurological abnormalities of cerebrospinal syphilis. The other
case of positive Wassermann reaction was a man 33 years old with gummatous necrosis of the bones of the face, which had existed for about six
years and was still active. The examination of his cerebrospinal fluid
was entirely negative as was also a Wassermann examination of the
blood of his wife. The examination of the cerebrospinal fluid of the two
cases of Korsakow's psychosis revealed a very high albumen content.
Neurological examinations revealed abnormalities in all the cases, the
most constant disturbance noted being tremors and irregularities in the
outline of the pupils. Irregular pupils were noted in every case and
tremors in 13 cases. Inequality in the size of the pupils was present in
6 cases and diminished reaction to direct light in a like number. The
Achilles reflex was absent in two and unequal in one case. Unequal knee
jerks were noted in two cases.
The average duration of treatment for this group of cases was 57 days.
The following table shows the condition at the time of discharge:
Hecovered.
Acute alcoholism
Delirium tremens
Alcoholic paranoia
Chronic alcoholism
Korsakow's psychosis
1
4
0
2
0
Improved.
0
2
0
6
2
Unimproved .
Died.
0
0
1
0
0
.
0
0.
0
0
0
Total.
1
6
1
8
2
DRUG INTOXICATION.
In this group are included 11 patients,6 males and 5 females, constituting 2.19% of the total admissions for the period. This number is an increase of five cases over the previous period, or an increase of .79%. This
increase is no doubt due to the enactment of the Harrison Act.
In one of these cases the family history reveals the fact that the
mother, grandmother and father were all drug users. This was a boy of
16 years who had been using both morphine and heroin, given him first
by his grandmother, since he was nine years old. He was infantile in
physical development and subnormal mentally. He presented evidences
of disorder of function of the glands of internal secretion.
In another case the father and paternal grandfather were morphine
users, and the father had suicided. This patient was a woman 30 years
of age, who had used morphine, whiskey and paregoric for nine years,
following a surgical operation. The Wassermann reaction was positive
on both the blood serum and the spinal fluid. Albumen and globulin
were also increased.
�PSYCHOPATHIC HOSPITAL.
51
Another case, a man 57 years old, who had used drugs and whiskey
for 11 years, presented a positive Wassermann reaction on his blood
serum. The Wassermann reactions of the other 9 cases were negative.
One of these had a scar of an old gummatous necrosis.
The previous history of each of the 11 cases showed the patients to be
of neurotic makeup, and in two of the cases there were numerous hysterical episodes throughout the previous life. The reason given by the patient, or his family, for the use of the drug, was in 9 instances some form
of physical illness. The amount of drug used daily based on the statement of the patient varied from "seven cents worth of gum opium" in one
case to 20 grains of morphine and 30 grains of cocaine in another. The
method of treatment used was the immediate withdrawal of the drug. In.
one case there was a delirium with auditory hallucinations of a day's
duration, followed by diarrhoea and motor restlessness for a few days.
In another case there was an hysterical dream state of a few hours duration following the withdrawal, in which the patient acted out the part of
receiving an injection from his father. The average length of residence
of these cases was 39 days. All of the cases were discharged to their
homes, except one case which was transferred to a State Hospital.
The following table shows the division of these cases according to the
drug used, together with the condition at the time of discharge:
Recovered.
M.
Morphine . . .
Morphine and alcohol
Heroin . . . .
0
1
0
0
1
F.
Improved.
M.
T.
1
0
0
1
1
0
1
2
0
2
0
0
1
1
0
F.
Unimproved.
2
0
1
0
0
'•
M.
T.
4
0
3
0
0
0
0
0
0
0
T.
0
0
0
0
0
0
0
0
0
0
EPILEPSY.
There were admitted during the period 10 cases of epilepsy. This number constituted 2.1% of all patients admitted.
Male.
No.
Hospital admissions
Epilepsy .
. .
220
6
Per cent.
• -j-y-
Female.
No.
240
4
Per cent.
' 'i'.e'
Total.
No.
460
10
Per cent.
2.1
The ages at admission varied widely. The youngest patient was aged
7 and the oldest 49. Hereditary factors were present in 7 of 8 cases, or
87.5%, in which information was obtained.
�STATE OF MICHIGAN.
52
The Wassermann reaction was positive in the blood in one case but
the cerebrospinal fluid was not pathological. Under active anti-syphilitic
treatment, these attacks occurred less frequently.
The result of treatment of all cases discharged was:
M.
Recovered .
.
F.
0
0
6
1
T.
0
0
2
2
8
1
9
0
Of those discharged, 4 were transferred to other State Hospitals and
the remainder returned to the custody of their families.
IMBECILITY.
This group includes all cases of feeblemindedness admitted during the
period, excepting those in which there was in addition to the mental defectiveness a well differentiated psychosis. There were 19 cases which belong here; 11 were males and 8 were females.
Male.
No.
220
11
Female.
Per cent.
5.0
No.
240
8
Total.
Per cent.
3.3
No.
460
19
Per cent .
4.1
AGE.
Eleven of these were adults and 8 were juveniles. The youngest age
was 13 and the oldest 43. The mental age in no case execeeded that of
11 years. The lowest mental age was 7.
�PSYCHOPATHIC
HOSPITAL.
53
HEREDITY.
Hereditary factors were present among 15 or 93.7%, of 16 cases in
which information was available.
Direct.
Atavistic.
f
0
0
.1
1
4
2
2
oooo
2
9
0
Insanity, .
Apoplexy or paralysis . .
Psychopathic
i
7
M.
F.
Total.
F.
T.
M.
F.
T.
M.
F.
1
0
1
0
oooo
T.
Brothers
and
sisters.
oooo
F.
Collateral.
1
0
1
0
1
0
1
0
1
0
1
0
0
0
6
1
3
1
1
0
2
1
7
1
5
2
0
2
0
2
2
2
4
11
4
15
1
3
1
3
8
19
T.
M.
oooo
M.
:
0
'
Total . . .
11
T.
There were 21 children born to the 4 patients who were married. In 4
cases there were found stigmata of hereditary syphilis, but only one case
gave a positive Wassermann reaction on the blood. In 9 cases there were
neurological abnormalities.
FORENSIC RELATIONS.
Fifteen of these 19 cases had come into conflict with the courts over
various legal offenses. All three of the juvenile females were sex
offenders.
RESULTS OF TREATMENT.
Recovered . .
"Unimproved
. .
.
.
T.
F.
M.
0
2
9
0
0
0
7
1
0
2
16
1
Of those discharged, 11 returned to their families, 3 were transferred
to another institution, and 4 were returned to the custody of the probate
court.
�STATE OF MICHIGAN.
HYSTERIA.
There were admitted 41 cases of hysteria. Of these, 9 were males and
32 were females. This number formed 4.1% of the males admitted,
13.3% of the females, and 8.9% of all patients who were admitted during the period.
Male.
Per cent.
No.
Hysteria .
. .
Female.
220
9
4.1
Total.
Per cent.
No.
240
32
13.3
Per cent.
No.
460
41
8^9
In 14 of these, conversion symptoms dominated in the clinical manifestations. There were 27 cases in which the symptoms centered chiefly
around attacks of anxiety.
The ages of onset and admission are shown in the following table:
jAdmission
Onset.
F.
St.
10-14..
15-19...
20-24 .
25-29
0
1
2
0
5
11
4
3
30-34 ...
35-39 . . .
40-44
45-49
0
50-54
55-59
60-64
0
0
0
1
1
0
0
M.
T.
F.
T.
0
1
7
0
1
7
0
6
13
0
0
0
6
11
3
3
2
4
3
2
1
4
2
1
1
0
1
3
1
0
1
4
0
0
0
0
2
0
1
0
2
0
1
2
2
1
7
3
2
1
1
0
0
17
6
e
�PSYCHOPATHIC HOSPITAL.
55
HEREDITY.
Information regarding the hereditary factors was obtained in 33 cases.
Direct.
Apoplexy or paralysis . .
Brothers
and
sisters.
Collateral.
M.
F.
T.
M.
F.
T.
M.
F.
0
1
1
3
1
1
1
4
2
2
0
0
0
0
1
0
0
0
1
0
0
0
1
0
0
0
0
1
0
3
6
9
0
1
1
1
2
Alcoholism
Total heredity . . . .
Atavistic.
Total.
T.
M.
F.
T.
M.
F.
2
0
0
0
0
4
0
1
0
4
0
1
0
1
1
1
1
7
3
3
1
8
4
4
2
0
5
5 | 4
14
18
2
3
13
5
15
8
9
32
41
?
0
T.
3
Total
The foregoing table shows that hereditary factors were present in
54.5% of the cases belonging in this group. Among the families of 41
individuals, there were 68 instances of mental or nervous abnormalities.
ETIOLOGICAL FACTORS.
In 11 instances the onset of the disease was intimately related to an
inability to adequately adjust themselves to situations occurring in their
married life. In 7 other instances there were unusual emotional situations intimately related to the outbreak of the symptoms.
RESULTS OF TREATMENT.
The results of treatment are shown in the following table:
F.
M.
1
5
2
2
T.
6
22
4
4
7
27
6
6
Of those discharged, 39 returned to their homes, and 2 were transferred to one of the State Hospitals. The average length of time under
treatment was 3.07 months.
�STATE OF MICHIGAN.
56
PSYCHONEUROSES (Excluding Hysteria).
There were admitted 4 patients who are included in this group. According to their clinical symptomatology, they were represented as follows:
F.
M.
3
1
T.
0
0
3
1
The age of admission of these cases was:
F.
M.
1
1
2
15-19 . . .
20-24
25-29
T.
0
0
0
1
1
2
Hereditary factors were present in 2 of the 4 cases.
ANXIETY NEUROSIS.
This group includes 3 males. Two were discharged from treatment as
improved and 1 remains into the next period. All returned to their
homes. In addition, one woman admitted in a former period was transferred to a State Hospital in an unimproved condition.
COMPULSION NEUROSIS.
A man who suffered from compulsive thoughts and impulses was under treatment for 5 weeks, and was discharged in an improved condition.
�57
PSYCHOPATHIC HOSPITAL.
PSYCHOPATHIC PERSONALITIES.
There were admitted a considerable number of individuals who had
definite mental abnormalities but could not be adequately placed among
other groups in this analysis. These abnormalities consisted of constitutional defects of character and peculiar habits rather than any definite
psychosis.
There were in this group 31 individuals, 16 males and 15 females.
Male.
Per cent.
No.
220
16
Psychopathic personalities . . .
Female.
No.
240
15
• '^2'
Total.
Per cent.
6.2
Per cent.
No.
460
31
6.7
While having in common abnormalities of personality, the ways in
which these were manifested varied too widely to permit of more than
a loose arrangement according to clinical type.
M.
13
3
Psychopathic personalities, juvenile
T.
F.
15
0
28
3
AGE.
The- ages at admission were:
F.
M.
5- 9
10-14
15 19.
20-24
25-29 . . . .
30-34 .
35-39
40-44.
45-49 . . .
50-54 . . . .
5 5 59 .
60-64 . .
.
..
.
.
.
.
.
T.
1
1
1
2
0
0
2
2
1
1
3
4
4
0
1
1
1
3
3
1
3
4
2
2
1
2
2
0
0
1
4
1
2
1
0
�STATE OF MICHIGAN.
58
HEREDITY.
Hereditary abnormalities were present in 22 or
& of 25 cases in
which information was available.
In 20 families there were 79 abnormal individuals.
Direct.
Atavistic.
Brothers
and
sisters.
Collateral.
Total.
M.
F.
T.
M
F.
T.
M
Insanity
Apoplexy or paralysis . .
Psychopathic . . . .
3
0
1
2
2
0
1
4
5
0
2
6
2
0
8
0
0
0
0
2
0
0
0
2
0
0
0
1
0
0
0
3
0
0
0
0
0
0
0
2
0
1
1
2
0
1
1
Total heredity . . . .
6
7
13
2
0
2
2
1
3
0
4
4
F
T
M
F
T
M
5
0
2
5
12
0
3
7
10
12
22
2
3
1
3
3
6
15
!
T
0
1
2
Negative . .
Unknown
Total. . .
F
26
31
RESULTS OF TREATMENT.
M.
14
1
1
T.
•F.
11 i
2 i
3 !
j
25
3
4
Only one of those discharged was transferred to another institution,
the remaining going to their families, or on their own responsibility.
SENILE DEMENTIA.
There were admitted one man .ancL'two women whose mental disorder
was due to senile atrophy of the brain. This number formed 0.6% of
all patients admitted.
The ages at admission were 72, 75 and 72 respectively.
All were discharged in an unimproved condition. Of these, 2 were returned to their homes and 1 was transferred to the Kalamazoo State
Hospital.
�PSYCHOPATHIC HOSPITAL.
59
PRESENILE MENTAL DISORDERS.
Under this heading are considered 5 patients whose mental disorder
was a severe depression with marked anxiety coming on in the late
adult years. The clinical position of this group is uncertain but all of
these cases showed much similarity in their symptomatology and age of
occurrence.
Male.
Per cent.
No.
Hospital admissions
Female.
220
1
.45
Total.
Per cent.
No.
240
4
1.6
Per cent.
No.
460
1.1
Hereditary factors were present in but one case.
The aee at onset and admission was:
Admission
Onset.
50-54. . . .
55-59
60-64 . .
T.
F.
M.
0
1
0
2
2
0
M.
2
3
0
F.
T.
0
1
2
0
1
2
2
1
1
Hereditary factors were present in but one instance.
The results of treatment were:
M.
Recovered
Improved
Unimproved
Remaining
F.
0
0
1
0
T.
0
1
2
1
0
1
3
1
Three of these patients were transferred to one of the State Hospitals.
�STATE OF MICHIGAN.
60
CEREBRAL ARTERIOSCLEROSIS.
During the biennial period there were admitted 13 individuals whose
mental disorder resulted from arteriosclerotic changes in the brain.
Eleven of these were males and 2 were females.
This group represented 2.8% of all admissions.
Female.
Male.
Per cent.
No.
220
11
Cerebral arteriosclerosis
Total.
Per cent.
No.
240
2
5.0
Per cent.
No.
460
13
.8
2.8
Age at onset and admission:
Admission
Onset.
40-44 .
45-49 . .
50-54
55-59 . .
60-64
65-69 . .
"Unknown .
T.
F.
M.
...
T.
F.
M.
2
0
0
4
0
0
0
1
2
0
0
2
0
1
4
0
0
0
2
0
2
2
1
0
3
2
2
2
0
3
2
1
1
0
0
1
1
1
5
0
0
HEREDITY.
Hereditary factors were present in 6 of the 10 cases in which information was available.
Atavistic.
Direct.
Total heredity . . . .
4
Negative .
Total
M.
F.
T.
2
0
11
0
0
0
0
0
0
0
0
6
0
0
8
2
M.
F.
M.
F.
T.
0
0
0
0
oooo
1
2
T.
0
0
0
0
0
0
0
0
0 j
0
0
0
0
0
0
0
0
0
0
0
0
0
i1
. . . .1
!
T.
M.
F.
0
1
1
2
2
0
0
0
2
1
1
2
c
Insanity. .
Apoplexy or paralysis . .
Psychopathic
Alcoholism
F.
Total.
ooco
M.
Brothers
and
sisters.
Collateral.
4
'
6
4
3
4
3
2
|
1
11
T.
13
�PSYCHOPATHIC HOSPITAL.
61
As somatic abnormalities associated with the cerebral arteriosclerosis,
lesions of the heart were found in 58% of instances. In 43% there were
evidence of nephritis. In one-half of the cases there were sclerotic
changes in the superficial arteries of the arm. The blood pressure was
above 175 in 83% of instances. Among neurological disturbances, a
history of apoplectiform attacks was obtained in one third of the cases.
In 83%' there were vascular changes in the fundus of the eye.
In no instance was there a positive Wassermann reaction obtained
either on the blood serum or on the cerebrospinal fluid.
The average period of residence of those discharged was 7 weeks. Of
those who were discharged, 8 returned to their homes and 3 were transferred to one of the State Hospitals.
RESULTS OF TREATMENT.
M.
Recovered .
Unimproved . .
Died
Remaining
....
F.
0
4
5
0
1
1
0
0
3
SYMPTOMATIC
T.
0
6
0
3
0
MENTAL DISORDERS.
In this general class are grouped 24 cases, 11 males and 13 females. In
each of these cases the mental disorder was considered as symptomatic
of an existing physical disease. The following table shows the relative
frequency of these disorders among the admissions to this hospital.
Female.
Male.
No.
Hospital admissions
Symptomatic mental disorders
Per cent.
220
11
5
No.
240
13
Total.
Per cent.
5 .4
Per cent.
No.
460
24
5.2
In 17 of the cases the etiological factor was a definitely recognized
physical disease and in 7 cases the causative factor was not clearly demonstrated. The following table shows the etiological relations:
M.
Mental
Mental
Mental
Mental
disorders associated with nephritis
disorders associated with pellagra .
disorders associated with acute articular rheumatism
disorders associated with pernicious anemia
F.
T.
3
1
4
1
1
6
4
2
0
2
2
4
4
7
�62
STATE OF MICHIGAN.
MENTAL DISORDERS ASSOCIATED WITH NEPHRITIS.
Five of the cases classified as disorders associated with nephritis
showed a paranoid trend with irritability and episodes of delirium or
stupor. Both acute and chronic forms of nephritis were present.
One case, a woman of 48, in addition to nephritis, had a colon infection of one kidney with extreme emaciation. Mentally there were short
periods of unclearness and extreme fatigability. As her kidney condition improved, there was corresponding mental improvement. One of
the cases was in an individual who had been an excessive user of alcohol.
There were two deaths among the cases of this group. In one it was
possible to make a laboratory study of the central nervous system.
Case A. B. No. 1270. Psychosis associated with nephritis:—Male, aged
67 at admission. One brother had died of heart failure and the daughter
of the patient suffered from multiple sclerosis. Our patient had two
severe injuries in his early life, about which we were able to learn little
except that one of them confined him to a hospital for three months.
At 66 he began to be troubled with dyspnoea and other symtoms of
cardiac failure. Five weeks before admission he was delirious for a few
hours and from then on became very irritable, although usually clear in
his grasp. He was committed to the hospital because of an aggressive
attack upon his wife.
Upon admission he was unclear and stuporous. There was much air
hunger and his respiration soon became Cheyne-Stokes in character. The
physical examination showed a markedly enlarged heart to the left and
an atypical aortic pulse. There was marked edema of the ankles and
general anasarca. Wassermann on the blood was doubtful. The physical
diagnosis was made of chronic uremia, double aortic lesion, chronic interstitial nephritis. His condition became progressively worse and he
died after nine days in the hospital.
The autopsy showed an enormous heart with hypertrophy and dilatation of the left side. The whole arterial system showed marked sclerosis. The arch of the aorta was much dilated and showed areas of calcification. All the heart valves, especially the aortic, were thickened and
incompetent. All organs showed chronic passive congestion and the kidneys showed the changes of old interstitial nephritis. The brain weighed
1225 grams. The dura was diffusely adherent. The diploe of the calvarium was greatly congested. Histological examination of the brain showed
the pia to be moderately thickened. There were scattered fibroblasts
and epitheloid cells. In some vessels there were short chains of streptococci. The finer vessels of the cortex were not pathologically altered.
The cortex showed normal topographical arrangements. The nerve cells
were not notably changed. There was no pathology of the glia. None
of the changes could be regarded as of diagnostic importance.
MENTAL DISORDERS ASSOCIATED WITH PELLAGEA.
The disorder of one male and one female was associated with, well defined pellagra, (^astro-intestinal disturbances and the skin manifestations were quite characteristic. The mental picture in each case was
that of a mild stupor with delirious episodes. The female patient showed
�PSYCHOPATHIC HOSPITAL.
63
a delusional trend of a paranoid type. One patient died and a study of
the central nervous system showed interesting pathological changes.
Case S. M. No. 1417. Psychosis associated with pellagra:—A female
4-2 years of age upon admission. One sister of the patient died of some
unknown spinal trouble at the age of 15. Her early life was uneventful but her married life was unhappy on account of alcoholic and shiftless habits of her husband.
A year before admission her health began to fail and she became unstable emotionally. She expressed mild delusions of persecution. Five
weeks before admission she developed a peculiar skin condition of her
face and arms. The delusions became more and more prominent. Upon
admission it was noted that she was restless, unclear, and rambling in
her talk. There was a definite weakness of the right arm but an accurate
neurological examination was impossible on account of her mental condition. The skin condition of the arms was considered pellagra on account of the symmetrical pigmentation and sharp limitation of the erythema with its predilection for the extensor surfaces. Her confusion
continued and on the tenth day she died.
In the cortex there was an absence of coarse focal changes. In all sections the nerve cells showed severe changes. These consisted of dissolution of the chromophilic substance of the cell body and in the larger
pyramids of a displacement of the nucleus towards the cell wall. The
glia was much increased in the molecular and to a lesser degree in the
deeper layers. The form of- the cell was that characteristic for regressive
changes. An occasional rod cell was noted. The spinal cord showed no
pathological changes. The changes as a whole were of the type met with
in chronic intoxications. They have often been observed in chronic alcoholism and pellagra.
MENTAL DISORDERS ASSOCIATED WITH ACUTE ARTICULAR RHEUMATISM.
There were four cases belonging in this group. These were all males,
aged respectively 32, 40, 41 and 44 at the time of admission. They correspond to that group of cases discussed in a paper appearing from this
hospital and published in the American Journal of Insanity, 1914.
One of these patients died and the nervous system was studied in the
laboratory.
Case No. 1817. Psychosis associated with rheumatism and endocarditis:
•—Male, aged 32 at admission. His father was an alcoholic. He was 32
when admitted. At about the age of 22 he had a severe attack of rheumatism and at 30 a second attack. At that time, red blotches appeared
on the arms and body. These areas swelled rapidly and soon disappeared.
Sometimes they reached the size of a half walnut. He had worked as a
bartender and had been a steady drinker but never drunk. Two or three
months before admission he had a third attack of rheumatism with the
same skin lesions as in the former attack.
When admitted to the hospital his comprehension was unclear. He
did not know where he was and he talked of his food being poisoned and
of other patients being syphilitics. He was very active and the associations shown in his talk were loosely formed. Later he said he was John
the Baptist and that he heard his mother calling to him.
�64
STATE OF MICHIGAN.
The examinations showed his heart to be enlarged and atypical murmurs. His blood pressure was 150, the Wassermann on his blood was
negative, and the spinal fluid examination was negative except for an increase of albumen. While in the hospital, there appeared on his body,
in various places, irregular painful red swellings, which disappeared in
a few hours. He failed rapidly in spite of all supportive measures until
he died 20 days after admission.
An autopsy was made. The pathological diagnosis of the internal organs was malignant endocarditis of the mitral valve; eroupous pneumonia; grey hepatization; empyema. The brain weight was 1294 grams.
There was thrombosis of several venous branches near the longiturinal
sinus. The pia was transparent and its veins moderately congested. The
brain itself showed no gross changes. Histological studies of the brain
showed a recent thrombosis of the longitudinal sinus and some of its confluent veins. The pia was greatly thickened by a recent increase of connective tissue. In some places there was an enormous proliferation of
flbroblasts. There was no appreciable loss of nerve cells. In all regions
there were a few nerve cells, in which there was a mild disintegration of
the tigroid of the cell. Many of the arteries, both of the pia and the cortex, showed recent proliferative changes in the intima. There were no
marked changes in the cortex topography. Many nerve cells in all layers
showed slight breaking up of the tigroid and a tendency of the ground
substance to stain. In several regions of the cortex, the glia of the first
layer was enormously increased in thickness and there was active proliferation among the glia cells. Throughout the cortex and medulla, many
glia cells were in stages of active progression. The changes in the brain
were apparently recent in their origin and were apparently directly related to the toxic process associated with the bacterial endocarditis.
MENTAL DISORDERS ASSOCIATED WITH PERNICIOUS ANEMIA.
This group was represented by two females, aged 39 and 42 years, and
two males, aged 46 and 60 years. The mental symptoms were those of
an asthenia with episodes of unclearness and delusions of a paranoid
trend.
Two patients died. The clinical course and pathological findings are
given in the following abstracts:
Case W. C. A. No. 1812. Psychosis associated with pernicious anemia:
—Male, aged 60 at admission. Until a year previously he had been a
successful physician. At that time he complained of feeling tired, appeared listless, and sometimes was observed talking to himself. These
symptoms followed an injury to the back and wrist upon entering a moving street car. Six months later there appeared paraesthesiae of the
hands and feet, and he staggered in walking. He became irritable and
unstable, and extremely excitable. Upon admission he showed a clear
comprehension, a marked retentive memory defect, and circumstantiality: The examination of the blood showed 2,710,000 reds and 70%
haemoglobin. The smear showed anisocytosis and poikilocytosis. The
neurological examination then showed a marked ataxia of the lower extremities, with sensory changes of hands and feet. Stereognosis was lost
in the left hand. There was a loss of vibration sensibility in the bones
of the extremities. The knee jerks and Achilles jerks were lost. There
�PSYCHOPATHIC
HOSPITAL.
65
was a Babinski reflex on the right side. He failed rapidly and gradually
passed into deep stupor, which continued until his death 27 days after
admission.
The autopsy showed that aside from a general anaemia, there was little pathological found in the examination of the internal organs. Thd
brain after hardening showed no gross focal changes. Histological studies of the nervous system showed the pia to be slightly thickened, the increase being largely cellular, with many phagocytes and a small number
of plasma cells. The margin of the cortex was thickly studded with
corpora amylacea. There was much increase in the cellular glia of the
marginal layer. Changes in the nerve cells were slight and scattered.
A few cells of the deeper layers showed absence of tigroid and a displacement of the nucleus. In the cortex of the frontal region were scattered
placques of the type first noted in this laboratory as occurring in the
brain in pernicious anaemia. In one lamella of the cerebellum was a
small focal softening. The cord at all levels showed areas of degeneration of the type so frequently met with in this disease. In distribution,
they occurred in all of the columns of the cord.
Case M. T. No. 1556. Psychosis associated with Pernicious anemia:—•
Female aged 42. Aside from the death of a sister from anemia at the
age of 40, her family history was not important. At the age of 34 she
complained of stomach trouble, and about the same time there was an
acute change in her mental condition. She had several attacks of acute
fear which she explained afterward by saying that she thought she had
given birth to a child. She then became sad and expressed ideas of un\vorthiness, and occasionally she talked of suicide. In this condition,
she was admitted to the hospital. Her blood count then showed 4,027,400
reds and 80% to 90% haemoglobin. The differential count showed nothing abnormal. She had excellent insight into her condition and after f>7
days was discharged recovered. Her blood condition was then considered suggestive of pernicious anemia, so she continued treatment for this
at irregular intervals at home. Eight years later she had an attack of
mumps and from then on complained much of nervousness and weakness. She had fainting attacks and gastro-intestinal upsets. For these
things she was admitted to the Medical Clinic of the University Hospital
where her blood count showed 1,150,000 reds and 27% haemoglobin.
The blood smears were typically those of pernicious anemia. She rapidly
passed into a deep coma and was transferred to this hospital after six
days. Here her stupor was of varying depths, but she never was entirely
clear. The only idea expressed by her were sad, of having "to die and
burn forever and forever." Her temperature ranged from 100 to 102 by
axilla and there were periods of mild delirium. On account of the deep
stupor a satisfactory neurological examination was not possible. The
knee jerks were present and slightly increased. Death occm-red 13 days
following her admission.
The pathological diagnosis of the body was: acute purulent appendicitis, general septicaemia, subserous haemorrhages, dilatation of the
heart, severe anaemia, hyperplasia of lymphoid marrow and of haemolymph nodes, fibrosis of spleen, multiple telangiectasis of skin, diffuse
hemorrhage into pericrania! tissues.
The brain weighed 1230 grams. There were numerous small haemorrhages on the inner surface of the dura and in the pia. The cerebrospinal
�STATE OF MICHIGAN.
fluid was increased and the brain was edematous. The cortex showed interesting pathology. The pia mater showed a slight increase of cells
among the fibres. There was no coarse disturbance of the nerve cell arrangement. There were many cells, chiefly of the larger size, which
showed mild degrees of eccentric dissolution of the tigroid and displacement of the nucleus. A few cells showed severe disintegrative changes
with glia cells clustered about the fragments of the cell body. There were
many unusual forms of cells scattered through the nerve cell layers. Some
of these were large rod cells. Others were glia cells in various stages of
progressive and regressive changes. In the medullary part of the convolutions there Avere in sections from several regions, focal accumulations
of glia and epitheloid cells, arranged concentrically about an area free
of cells. Their characteristics were quite like the placques which have
been noted in the nervous system of pernicious anemia. There was a
slight degree of endarteritis among the capillaries of the cortex, but no
arteriosclerotic changes among the larger vessels. Serial sections of the
spinal cord showed an entire absence of the changes commonly found in
this disease.
MENTAL DISORDERS OF A TOXIC TYPE BUT UNKNOWN ETIOLOGY.
Among the cases included here were 1 male and 6 females whose mental picture was that of more or less unclearness of consciousness associated with hallucinations and delusions more or less bizarre. In one
case there was a history of long continued use of alcohol. One case Avas
that of a delirium with a valvular heart lesion and attacks of angina. In
two cases there were severe gastro-intestinal symptoms such as severe
vomiting and diarrhoea. In none of these cases which came to autopsy
were there any changes in the central nervous system of diagnostic importance.
HBEEDITY.
The occurrence of hereditary factors among the patients included in
this group of symptomatic disorders is given in the following table:
Apoplexy and paralysis.
Alcoholic
Total heredity . . . .
Total.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
T.
M.
F.
1
1
2
1
1
0
2
0
2
1
4
1
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
2
0
0
0
3
1
0
0
2
2
2
1
4
0
2
0
6
2
4
1
5
3
8
0
1
1
0
0
0
2
2
4
7
6
13
o
2
5
2
7
4
11
13
24
Negative
—
Total. . .
Brothers
and
sisters.
Collateral.
Atavistic.
Direct.
T.
—
�PSYCHOPATHIC HOSPITAL.
BRAIN
67
TUMOR.
Three cases of brain tumor were under treatment during this period.
Case No. 1825, a male, 43 years old, was admitted with the following
symptoms: headaches, projectile vomiting, general epileptiform seizures,
nystagmus, choked disc, left sided Babinski, and progressive mental deterioration and dullness. It was thought that there was a tumor rather
deep in the right frontal lobe. He was discharged unimproved.
Case No. 1709, was a female, 33 years of age, who died after 25 days
in the hospital. The autopsy showed multiple carcinomata throughout
the brain, with a large cystic broken down carcinoma in the left temporal region. The primary tumor was probably in the head of the pancreas with metastases in the heart, liver, peritoneum, mesentery, all the
glands of the thorax and abdomen, and in the left tube and ovary. A
detailed report of this case may be found in the Proceedings of the Clinical Society of the University of Michigan, June, 1916.
Case No. 1715 was a female, 61 years of age, who at the age of 20 had
been in a sanitarium for nervous or mental trouble, from which she completely recovered. At fifty, she underwent a decided change. She became irritable and moody and from then on was not considered normal.
Six months before admission a facial paralysis on the left side and a
memory defect were noted by the family. It was thought that she had a
stroke of paralysis. Her conduct became more difficult to control and
the memory defect became more pronounced. She frequently had trouble in walking. She complained of headaches and vomited frequently.
Upon admission the examinations revealed a general arteriosclerosis and
a blood pressure of 200. There was a Babinski reflex on the right side
and she fell to the left when in the Ehomberg position. There was no
choked disc and the Wassermann on the blood serum and cerebrospiual
fluid was negative. The latter showed an increase in the albumen content. She was confused and wandered about, frequently losing herself
on the ward. The retentive memory defect was most pronounced. After
a month there appeared weakness and spasticity of the whole left side,
which disappeared after a few days. She gradually became weaker and
soon there appeared a double choked disc, 4 diopters 011 the right and 3
on the left. An X-ray examination failed to show positive findings.
Mentally, the deterioration advanced until she passed into a stupor of
varying depths. Forced movements of the left arm and hand of a Jacksoniau type were observed on numerous occasions. There was weakness of the extrinsic muscles of the left eye. A brain puncture was made
in the right frontal region but the bit of brain removed showed no evidence of tumor. She became more stuporous and the forced movements
of the left arm became more frequent. After 162 days in the hospital,
she died. The autopsy showed a very large alveolar sarcoma in the right
occipito-temporal region extending to the surface. A smaller one was in
the right lenticular region. The cerebral vessels showed a moderate degree of arteriosclerosis.
�68
STATE OF MICHIGAN.
MULTIPLE SCLEROSIS.
Two cases of this disease were admitted during this period. One of
these, Case No. 1597, was a girl of 19, whose mother was hysterical. The
meutal examination was entirely negative but the neurological examination showed nystagmus, intention tremors, ataxia, and reflex disturbances of this disease. The Wassermann on her blood was negative. The
cerebrospinal fluid showed 8 cells, slight increase in globulin and albumen and with the Lange colloidal gold it gave an atypical meningitic
curve. After 35 days she was discharged as not insane and immediately
admitted to the University Hospital Neural Clinic.
The other case, No. 1554, was a boy of 12 with the characteristic neurological findings. He showed advanced mental deterioration and after
24 days he was discharged unimproved.
SYDENHAM'S CHOREA.
There was admitted a girl, aged 15, on account of chorea and recent
acts of sexual delinquency. Observation demonstrated valvular disease
of the heart and mild choreiform movements of the head, trunk and
extremities. There was no definite mental disorder and she was discharged to her family after a few weeks treatment, the chorea being
greatly improved.
NON-INSANE
CONDITIONS.
ADULTS.
There were admitted a few individuals whose conduct had been such
as to raise the question of a mental disturbance, but whose hospital observation showed nothing to warrant their being adjudged insane or
that their actions had been the result of any serious mental abnormalities.
Two of these were male adults. One of these had been arrested on suspicion of participating in a munition conspiracy. The other was a man
who by reason of domestic incompatibilities had acted in an unusual
manner. Both were discharged at the end of the observation period.
JUVENILE DELINQUENTS.
There were admitted during the period a number of youthful individuals because of various acts of delinquency. The greater number of
these were found to be feebleminded and have been classed in the group
of imbecility. One girl, aged 19, remains over, in whom no mental disorder can be found. Her conduct was that of one of depraved character
and unrestrained impulses.
�PSYCHOPATHIC HOSPITAL.
69
UNCLASSIFIED CONDITIONS.
There were admitted 9 individuals whose mental disorder could not
be placed among any of the preceding groups. Five of these were males
and 4 were females. In some instances, the individual was under observation for too brief a period. In others, there were difficulties of interpretation, which made it unwise to give to the disorder a definite diagnosis.
In all, this group formed 1.9% of those admitted during the period.
Male.
Female.
Per cent.
No.
220
Per cent.
No.
2.1 |
5
Total.
240
4
1.7
Per cent.
No.
460
9
1.9
HEREDITY.
Hereditary factors were present among the ancestors in 4 instances in
which information was obtained.
RESULTS OF TREATMENT.
M.
Recovered
Unimproved . .
Died
Remaining . .
....
....
...
F.
0
2
3
0
0
t.
0
1
1
2
0
0
3
4
2
0
Of 7 individuals who were discharged 5 returned to their families and
2 were transferred to a State Hospital.
�STATE OF MICHIGAN.
70
EEPOET OP THE PATHOLOGICAL LABOEATOEY.
The laboratory of the State Psychopathic Hospital is a central laboratory to which the State Hospitals may send material for study.
The following tables rive statistical information relating to the work
done:
TABLE No. 1.—Number of cases mewed between July 1, 1915, and June 30, 1916, with
Kalamazoo State Hospital
Pontiac State Hospital .
Newberry State Hospital .
Traverse City State Hospital
State Psychopathic Hospital
Outside sources. . . .
...
.
Year
ending
June 30,
1915.
Year
ending
June 30,
1916.
62
65
32
6
8
127
65
17
8
13
112
3
118
5
230
8
115
123
238
33
11
0
6
Total
for
period.
�PSYCHOPATHIC HOSPITAL.
71
TABLE No. 2.—Clinical diagnosis oj cases studied in tne laboratory.
Year
ending
June 30,
1015.
Alcoholic insanity, chronic
Alcoholic insanity, delirium tremens
Alcoholic insanity, Korsakow's psychosis
Alzheimer's disease
Cerebral arteriosclerosis
Cerebral haemorrhage, traumatic
Cerebral haemorrhage, fat emboli
Chorea, Huntington's
Dementia praecox
Encephalitis
Epilepsy
Imbecility
Manic depressive insanity
Myelitis, compression
Pellagra
Pernicious anemia
Presenile depression
Senile dementia
Syphilis, central nervous system, general paralysis. .
Syphilis, central nervous system, gumma
Syphilis, central nervous system, meningo-vaseular.
Toxic psychoses, rheumatism
Toxic psychoses, nephritis
Toxic psychoses, undifferentiated
Tumor, central nervous system
Material unstudied or undiagnosed
Miscellaneous neuro-pathological material
Total. .
Year
Tn*.,i
ending ! J ° tdl
June 30, I period.
1016.
2
0
0
0
2
1
1
2
4
1
1
26
13
0
0
0
39
1
1
1
4
1
7
1
5
1
3
1
1
6
1
11
1
1
1
1
21
2
4
0
0
32
115
2
1
4
3
1
13
6
2
2
1
1
1
3
57
- 2
1
1
3
4
89
4
123
238
TABLE No. 3. —Number of cases reported to the State Hospitals during the period.
indudes 188 cases received during previous periods but reported in this.
4
6
This
Kalamazoo State Hospital. . .
Pontiac State Hospital
Traverse City State Hospital.
Newberry State Hospital....
56
104
35
Total number reported.
228
33
�72
STATE OF MICHIGAN.
TABLE No. 4.—Number of Wassermann tests made between July 1, 1914, and June 30,
1916, and their sources.
Year ending
June 30, 1915.
Year ending
June 30, 1916.
CSF. Blood . Total. CSF.
Kalamazoo State Hospital
Traverse City State Hospital
Newberry State Hospital.
State Psychopathic Hospital
Ionia State Hospital
Michigan Home & Training School .
Total .
173
142
20
49
99
802
416
315
270
270
975
558
335
319
369
0
0
0
0
8
69
0
0
8
69
0
0
483 2,150 2,633
Blood . Total. CSF. Blood . Total.
296 1,019 1,315
121
423
544
9
431
440
234
42
276
113
368
481
3
0
0
0
Total
for period.
427
230
189
243
430
230
189
243
469 1,821
263
839
29
91
212
746
504
638
2,290
1,102
775
595
850
3
0
0
0
435
299
189
243
438
299
189
243
584 3,564 4,148 1,067 5,714
6,781
REPORT OF THE SECRETARY AND BUSINESS OFFICER.
Ann Arbor, Mich., June 30, 1916.
To the Board of Trustees:
Gentlemen—I have the honor to present the report of the business
transactions of the hospital for the biennial period ending June 30, 191.6.
The whole number of patient days was 42,122; the average daily cost
per patient per day was fl.257; the highest rate for any one month was
|1.29; the lowest $1.25 per patient per day.
In comparing these rates with those of the two years just proceeding
it will be noticed that they have increased considerably. This is due almost entirely to the increased cost of food stuffs.
�PSYCHOPATHIC HOSPITAL.
DISBURSEMENTS.
ON ACCOUNT OF CURRENT EXPENSES.
July 1, 1914 to June 30, 1916.
Pood
Clothing
Laundry Expenses
Heating and Light
Floral, Greenhouse and Grounds
Medical Department
Office, Stationery, Etc
Amusement and Instruction
Furniture and Household Supplies
Improvements and Repairs
Miscellaneous Expenses
Farm, Garden and Stock
Refunds
Total for Biennial Period
123,745 19
122 03
2,564 73
3,578 95
307 96
11,977 25
1,835 60
336 75
5,818 93
4,809 81
2,848 61
3 25
158 28
158,107 34
DISBURSEMENTS.
4
;,
ON ACCOUNT OF CLINICAL LABORATORY.
July 1, 1914 to June 30, 1916.
Officers' Salaries
Animal Food
Heating and Light
Floral, Greenhouse and Grounds
Medical Department
Amusement and Instruction
Office, Stationery, Etc
Furniture and Housekeeping Supplies
Improvements and Repairs
Farm, Garden and Stock
Miscellaneous Expenses
Total for Biennial Period
f 14,001 68
27 33
48 19
8 85
6,417 93
20
1,107 94
1 70
49 59
49 61
475 65
$22,188 67
�74
STATE OP MICHIGAN.
RECEIPTS.
ON ACCOUNT OF CURRENT EXPENSES.
July 1, 1914 to June 30, 1916.
From
From
From
From
From
From
State for County Patients
.........................
State for State Patients
...........................
Private Patients
.................................
Interest Accounts
...............................
Refund on Pay Roll
..............................
Miscellaneous Sales
..............................
Total for Biennial Period
$45,016 44
994 58
18,176 42
815 95
3 87
73 82
$65,081 08
RECEIPTS.
ON ACCOUNT OF CLINICAL LABORATORY.
July 1, 1914 to June 30, 1916.
Special Appropriation
Wassermann Tests
Refund on Pay Roll
From Miscellaneous Sales
Total for Biennial Period
$27,000 00
427 50
30 00
100 80
$27,5P« 30
�PSYCHOPATHIC
HOSPITAL.
75
Table showing the number of hospital days and the daily per capita
costs by months from July 1, 1914 to June 30, 1916.
Patient
hospital
days.
From July 1, 1914, to June 30, 1916:
July, 1914
August, 1914
September, 1914
October, 1914
November, 1914
December, 1914
January, 1915
February, 1915
March, 1915
April, 1915
May, 1915
June, 1915
July, 1915
August, 1915
September, 1915
October, 1915
November, 1915
December, 1915
January, 1916
February, 1916
March, 1916
April, 1916
May, 1910
June, 1916
1,775
1,818
1,731
1,787
1,688
1,698
1,800
1,593
1,808
1,765
1,704
1,717
1,846
1,793
1,700
1,692
1,757
1,803
1,852
1,743
1,822
1,677
1,862
1,691
Daily
per capita
cost.
-
$1 27
1 291 26
1 27
1 25
126
1 2»
1-26
1 27~
1 26
126
1 25
1 25
1 25
1 25
1 2'6
1 .26;
1 25
1 25
1 25
125
1 25
1 25
1 25-
SUMMARY OF INVENTORY, JUNE 30, 1916.
Hospital buildings
Furniture
Fixtures
Apparatus
Books
Supplies
Total...
S3,109
707
5,550
1,140
3,983
43
33
43
36
07
$78,269 23
14,490 62
$92,759 85
Respectfully submitted,
ROBERT G. GREVE,,
Secretary.
�76
STATE OP MICHIGAN.
REPORT OF TREASURER.
I
• •
;
'
July 1, 1916.
To -the Board of Trustees of the State Psychopathic Hospital:
Gentlemen—Herewith I hand you report of the State Psychopathic
Hospital for the biennial period ending June 30, 1916:
RECEIPTS.
Balance in Treasury July 1, 1914
By cash from State Treasurer, annual appropriation, laboratory (Sec. 28, Act 278, Public Acts 1907)
By cash from State Treasurer (Support of State Patients).
By cash from State Treasurer (Support of County Patients)
By cash from Private Patients
By cash from Earnings Institution (Interest, etc.)
f 9,359 07
27,000 00
994 58
44,649 02
18,543 84
1,453 94
$102,000 45
DISBURSEMENTS.
Clinical Laboratory Accounts
Current Expenses (Running Account)
Balance June 30, 1916
f22,188 67
58,107 34
21,704 44
$102,000 45
Very respectfully submitted,
R. A. CAMPBELL,
Treasurer.
�
asylums
-
https://localhistory.tadl.org/files/original/24dce56636f49837c57c4175607913e7.pdf
0a1e0464c67b15b4fa523e3ed00f4293
Dublin Core
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Title
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Traverse City State Hospital
Subject
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Asylums.
Psychiatric hospitals.
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Items within this collection pertain to the Traverse City State Hospital, also known as the Northern Michigan Asylum for the Insane and the Traverse City Regional Psychiatric Hospital.
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Amy Barritt, 1984-
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Original documents held by the Traverse Area District Library.
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Various.
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1885-1989
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Board of Trustees for the Traverse City State Hospital.
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English.
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Various.
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TCSH-xxxx.
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Traverse City, Grand Traverse County, Michigan.
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Report of the Board of Managers, Medical Superintendent and Treasurer of the Michigan Asylum for Insane Criminals at Ionia, Michigan, for the Biennial Period ended June 30, 1890
Subject
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Psychiatric hospitals.
Description
An account of the resource
Report of the Board of Managers, Medical Superintendent and Treasurer of the Michigan Asylum for Insane Criminals at Ionia, Michigan, for the Biennial Period ended June 30, 1890. Includes details on the appropriation of land, buildings and other equipment for the facility's use. Report was delivered to Governor Cyrus G. Luce.
Creator
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Board of Managers, Michigan Asylum for Insane Criminals at Ionia, Michigan
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Original held by the Traverse Area District Library, Traverse City (Mich.)
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Lansing: Robert Smith & Co., State Printers and Binders.
Date
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1890
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Medical Superintendent and Treasurer of Michigan Asylum for Insane Criminals at Ionia, Michigan
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See other reports from the Board of Trustees in the "Traverse City State Hospital" Digital Collection.
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PDF.
Language
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English.
Type
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Document
Identifier
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MSH0003
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Ionia, Ionia County, Michigan
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Text
REPORT OF THE BOARD OF MANAGERS,
MEDICAL SUPERINTENDENT
TREASURER
IONIA, MICHIGAN,
BIENNIAL PEKIOD ENDED JUNE 30, 1890.
BY AUTHORITY.
LANSING:
EGBERT SMITH & CO., STATE PRINTERS AND BINDERS,
1890.
�BOARD OF MANAGERS.
H. RICH, PRESIDENT,
JEEOME CEOUL,
MOBEAU 8. CEO8BY,
IONIA.
DETROIT.
GRAND EAPIDS.
OFFICEES.
O. E. LONG, M. D.,
A. S. DOLAN, M. D.,
P. D. CUTLEE, W. D, AENOLD,
MEDICAL SUPERINTENDENT.
- ASSISTANT PHYSICIAN.
TREASURER.
- CLERK AND STEWARD.
�REPORT OF THE BOARD OF MANAGERS.
OFFICE OF THE
)
ASYLUM FOB DANGEROUS AND CKIMINAL INSANE, >
Ionia, Michigan, August 8, 1890.
}
HON. CYBUS G. LUCE, Governor of Michigan :
SIR—In conformity with the requirements of law, we, the undersigned,
managers of said institution, herewith present for your consideration, our
biennial report, ending with June, 1890.
The period which has elapsed since our last report, has been well
improved in all departments of work pertaining to the care of patients and
property under the supervision of our efficient Superintendent.
The mortality among the patients, and the small amount of sickness are
quite phenomenal, when we consider the physical and mental condition of
these unfortunates as they come to us.
The accidents to patients referred in the Superintendent's report to us,
which is here furnished, is of course greatly to be regretted, and would
not have occurred, but for a positive disobedience of orders on the part of
attendants, which was promptly and properly followed, by their dismissal.
Great care has always been taken by the Superintendent, that the
patients are carefully cared for and kindly treated, and it has been a matter
•of great surprise to us, that they have been so quiet and manageable, considering the slight restraint placed upon them here as compared with what
it was considered necessary to put them under, before coming here. We
consider the institution in all departments a model of cleanliness and good
order, growing out of the excellent executive ability and vigilence of Doctor
Long.
The total appropriation made by the last Legislature, for buying a farm,
building a cottage, building a barn, and furnishing the cottage, and various
other needed expenditures was twenty-four thousand one hundred and
seventy-five dollars, which amount has been disbursed as shown by the
treasurer's report herewith; in the appropriation for a barn was five hundred dollars, which sum was all expended for a basement wall and material, leaving the work all to be paid for from the current expenses. You
are conversant with the fact that with your consent, we bought a portion
of the Freeman farm, on the south side of Grand river for the location of
the asylum cottage. The farm consisted of ninety-eight acres, without
any timber for a grove, which we all deemed of great importance. This
induced us to buy ten acres of a beautiful grove of timber from Mr. James
Loomis, lying contiguous and adjoining, and seventy acres of the Freeman
farm, making eighty acres, all the law permitted us to buy. The remaining twenty-eight acres of said farm was bought by Mr. W. D. Arnold at
our request, for which he paid eight hundred dollars, giving us a contract
�6
MICHIGAN ASYLUM FOR INSANE CRIMINALS.
to deed the same to the State for same amount, and interest, when we
obtained authority from the Legislature to purchase it, and for which we
expect to ask the Legislature to make an appropriation.
We let the contract to Waterbury & Wright for building the cottage
complete, including steam heating, gas and water piping, bath tubs, water
closets, etc., for the sum of thirteen thousand five hundred dollars, they being
the lowest bidders of four or five who competed, and it gives us pleasure to
be able to say, that they gave us a good building, and have proved themselves
worthy of special mention, although we fear they were not adequately paid
for the job.
In addition to the aforenamed sum, we paid the contractors two hundred
and seventy-four dollars and seventy-six cents for extras. We have paid
for furniture and furnishings, nine hundred and sixty-five dollars and
twenty-four cents; paid the architect for plans and supervision, two hundred and seventy dollars, making the total cost of the cottage, furnished,
fifteen thousand dollars.
The needs of the institution for the next two years, and for which an
appropriation will be asked, in addition to the eight hundred dollars to
pay for the remainder of the Freeman farm, are given in the Superintendent's report, and are fully concurred in by us.
Tour attention is respectfully called to the Superintendent's report for
more minutia of detail than we desire to cover; suffice to say it is very full
and satisfactory, and in closing we cannot but feel grateful to you for the
uniform and earnest interest you have always manifested in behalf of the
most unfortunate class of the wards of the State, also for your advice and
encouragement.
Respectfully,
HAMPTON EICH,
MOEEAU. S. CEOSBY,
JEEOME CEOUL,
Board of Managers*
�REPORT OF THE MEDICAL SUPERINTENDENT.
Honorable Board of Managers of the Michigan Asylum for Insane
Criminals:
GENTLEMEN—The biennial report, showing business, important occurrences, etc., for the period ending June 30, 1890, is herewith respectfully
submitted.
I have also taken occasion to call your attention to the needs of the institution for the ensuing two years, with suggestions, and added the usual
statistics of interest to alienists, if not to all for whose benefit the report
is issued.
The following is a summary of the movement of patients for the time
covered by the report:
Population of the asylum June 30, 1888, 111, Admitted during the
period, 46, of which 38 were males and eight females. Discharged males,
30; females, three; total discharged, 33. Remaining June 30, 1890, 124.
Average daily population, 116. Total number under treatment, 157.
The condition of discharged patients at date of discharge was as follows:
Recovered, 18; improved, seven; unimproved, one; died, seven.
The admissions were from the Detroit House of Correction, 12; Michi,n State House of Correction and Reformatory, 14; Michigan State Prison,
1; Michigan Asylum for the Insane, six; Eastern Michigan Asylum, three.
Of the 46 admitted, there were discharged cured, 11; improved, one; by
death, one; by elopement, one; remaining in asylum, 32. Of the patients
admitted, nine had been in other asylums for treatment.
The present population overcrowds the institution and this number
would not have been admitted but for the prospects of speedy relief from
this condition, by our being able to transfer patients to our farm cottage
within 30 days from date.
Two occurrences much to be regretted and the first of the kind since the
organization of the institution we experienced during the year 1889. They
consisted of the death of patient, James T. Jackson, at the hands of patient
Olaf Algren, and that of Margaret Stone by gaining access to medicine
intended for another patient and taking sufficient to produce the result
mentioned.
The following are the circumstances regarding their death: James
Jackson was a demented patient who rendered some assistance in the
patients' kitchen, Olaf Algren was a patient with homicidal tendencies
admitted as a transfer from the Eastern Michigan Asylum, Dec. 31, 1885,
and during the nearly four years in this asylum he was kept almost constantly secluded and never allowed to go to the dining room for meals, or
associate with other patients. It had been the custom to occasionally have
�8
MICHIGAN ASYLUM FOR INSANE CRIMINALS.
Algren taken to the airing court by a special attendant, at a time when
no other patient was in the court, and strict orders had been given that the
accompanying attendant should keep constantly at his side, and use every
precaution to prevent his getting possession of anything that could be used
as a weapon. On the morning of July 12, 1889, attendant J. L. Clark,
who had been in charge of Algren for three preceding months, and knew
of his dangerous proclivities, took him to the airing court, and at the
patient's suggestion accompanied him to the kitchen to get a drink of
water; after drinking Algren seized a carving knife and without provocation, and only because Jackson was the nearest person, he stabbed him, the
knife entered the heart and death resulted almost instantly. It was with
difficulty the knife was wrested from Algren, as the sight of it and the act
incited him to kill all within reach. Jackson was 55 years of age, had
been an inmate of an asylum for seven and a half consecutive years, and
was incurably insane.
Margaret Stone's death was due to her taking a poisonous dose of the Fl.
Ex't of Gelsemium, under the impression it was whiskey. Nov. 18,1889,
Dr. Dolan, the assistant physician of the institution prepared for a patient
a recipe consisting of five drachms of Fl. Ex't of Gelsemium and four
ounces of water, with directions to administer one teaspoonful at a dose
three times daily. The medicine was placed in the chief attendant's room
which is a room that under the printed rules should be locked at all times.
About 3 o'clock, p. m., the-18th, the seamstress and an attendant were in
the room, both leaving at the same time, and by a misunderstanding each
depended upon the other to lock the door, and both failed to do so. About
4:45 p. m., nearly half the medicine was missing, and almost at the same
time, Mrs. Stone was found suffering from its affects. The medical officers
were summoned at once, and every effort put forth to counteract the effects
of the drug, but it was of no avail, death resulted within 45 minutes, and
as near as could be estimated about two and a half hours after taking the
Gelsemium. Mrs. Stone was subject to attacks of Recurrent Mania, and
from the frequent attacks had become demented. She was 56 years of age,
had been an inmate of an asylum for eleven consecutive years, the last four
of which were spent in this institution. She was incurable.
The mortality rate for the period was very low for a hospital of this
character. Including the two accidental deaths it was but 3 % of the whole
number treated for the two years.
THE COTTAGE SITE.
The land purchased by you for a cottage site is admirably adapted for
the purpose and could not be improved upon as a site for the entire
institution, which it will probably ultimately be.
The building site is a plauteau of about 30 acres, 130 feet above Grand
river, which it overlooks-, and affords one of the finest views of its
valley and the city of Ionia to be had in this vicinity. Adjoining this is a
grove of oak, beech, and maple that for a park and recreation grounds
cannot be excelled.
While the beautiful view afforded, and facilities for perfect drainage,
etc., are desiderata, not always obtainable, one of the rarest and most
important advantages here afforded is the natural spring water supply
within 100 rods of and 33 feet above grade at the building site. Two
of these springs now empty into a reservoir connected with the cottage
�REPORT OF MEDICAL SUPERINTENDENT.
9
building and will supply at least four hundred barrels daily, the natural
pressure being sufficient to permit its distribution to all parts of the building, which is three stories in height. As we have utilized but a small
fraction of the water available the supply is unquestionably ample for the
demands of the entire institution, and as no pump is necessary for its distribution one of the largest single items of expense of an institution is dispensed with, while a supply of pure spring water is of inestimable value.
COTTAGE BUILDING.
The cottage building, now almost completed, is situated about threequarters of a mile on an air line from the main building, is of brick with
stone foundation—block work above grade—and main partitions, brick. It
•will accommodate 50 patients easily and consists of a main building three
stories above the basement, and a wing two stories above basement. The
extreme length is 95 feet and greatest width 59 feet. The basement story
is nine feet in height, being four feet below and five feet above grade, and
•contains the general dining room, kitchen, cold storage room, two rooms
for supplies, boiler room, two fuel rooms, emergency laundry, lavatory,
water closet, and one broom and mop closet. The first floor contains vestibule, reception room, principal keeper's bed room, private bath room and
water closet, one day room for patients, 18x44 feet, an eight foot hall the
entire length of building, nine single rooms for patients, attendants' room,
lavatory and water closet, and one broom closet. The second floor contains 11 single rooms for patients, one four-bed dormitory, one eight-bed
dormitory, one attendant's room, one servant's room, one clothes room, one
bath room, lavatory and water closet and one broom closet. The third
story contains seven single rooms for patients, one eight-bed dormitory,
one three-bed dormitory and one broom closet. The attic of the wing
serves for general storage room.
Hot and cold water on all floors, stand pipe with hose connection on
•each floor. An iron fire escape at rear of building connects with each flat.
The building is heated by steam, supplied by a Bates automatic damper,
self feed boiler. The radiators for indirect radiation are the gold pin
radiators.
All sewage is conveyed to a catch basin within 20 feet of the building,
and from this an eight-inch sewer extends to Grand river.
A private telephone line connects it with the main building.
OTHEB NEW BUILDINGS.
The other new buildings erected during the period were, one farm barn,
an addition to ice house, and greenhouse. The barn is 36x46 feet, with
basement, and 20 feet posts. The addition to ice house is 16x36 feet and
gives ample storage capacity for the ice required at the main building.
The greenhouse is small but enables us to furnish all wards with plants,
adding to the cheerfulness of wards and conducing to the benefit of
patients in many ways.
IMPROVEMENTS.
The principal improvements made during the period were laying
encaustic tile floors in the general kitchen and a majority of the bath
2
�10
MICHIGAN ASYLUM FOR INSANE CRIMINALS.
rooms and water closets, furnishing some water closets with automatic
flushing tanks, adding to the battery of boilers one 4x12 feet high pressure
boiler used to supply steam for cooking purposes, running laundry
machinery, machines in engineer's shop, sewing machine, and heating
water for bathing. A John Van range was placed in the general kitchen^
making our cooking apparatus complete.
The windows of the general kitchen, attic, fire and boiler room, fuel
room, engineer's machine shop, carpenter's shop, and paint shop, were all
securely barred, enabling us to assign patients to work in these various
departments whom it has heretofore been necessary to confine to the
wards, as they had an unexpired sentence to serve and the facilities for
escape were too great to assume the risk. The present arrangement is a
decided benefit to the patients and a financial gain to the state. The
walls of the administration building were papered, or painted and kalsomined. Minor improvements too numerous to mention, but aggregating a
large amount of labor, were made in all departments.
NEEDS.
The needs of the institution are numerous, some are imperative, others
depend upon the policy it is deemed best to adopt in regard to the continuance of the care of patients in the present main building.
Four hundred dollars is needed for fencing farm, all fences require
rebuilding, and at least three hundred and fifty rods of new board fence
is needed.
Five hundred dollars should be appropriated for improving grounds, this
includes laying all necessary walks.
One hundred and fifty dollars expended for fruit and ornamental trees,,
grape and berry vines, would be a profitable investment.
Tool sheds, hog pens, a root cellar, and other out buildings, will be a
necessity, and six hundred dollars should be the minimum asked for, for
these purposes.
The institution now owns seven cows, the milk supply is not sufficient,
and as the population increases the shortage will be considerable, and as
there is sufficient pasture on lands not tillable, at least five or six cows
should be added to our herd, and the cost would be about one hundred
and seventy-five dollars.
The cornices of main building, and all painted portions, require repainting. And in almost every department more or less repairs are required
that to neglect would be extravagance. Three hundred dollars could be
judiciously expended under the head of General Repairs.
The institution has now attained such a size as to make it no longer
economical to purchase the bread consumed, therefore an oven should be
provided. There are patent ovens manufactured that can be purchased
for $150 to $200 that would serve our purpose well. Other than economic
reasons could be adduced to show the necessity of this appropriation.
Soft water for culinary and steam purposes is desirable, and one hundred
and twenty dollars should be appropriated for two cisterns and connections.
As is well known Governors Alger, and Luce, the State Board of Corrections and Charities, all Legislative committees to the institution, and
other officers that have given the subject attention, were of the unanimous
opinion that the original building was not properly located for asylum
purposes, and opposed its extension. The reason for this conclusion have
�REPOKT OF MEDICAL SUPERINTENDENT.
11
been so fully set forth and frequently alluded to that it is unnecessary torepeat them. The farm recently purchased by you was selected with special reference to its fitness for the location of the entire institution at any
time it is deemed advisable to do so. And as to the advisability of an
appropriation sufficient for the erection of a building or buildings of sufficient capacity to accommodate all of the patients now in the asylum and
the probable increase for four years, and abandon the present main building for asylum purposes, or provide for the erection of a single cottage to
care for the prospective increase only, are questions that it would probably
be advisable to leave to a consensus of opinion of the Governor, the Legislative committees to the institution, and your Honorable Board, after a full
consideration of the best interests of the State and inmates. That it will
be necessary to provide for the accommodations of more patients than can
be properly cared for with our present available room there can be no
question.
As the expense of the measure adopted will be an important factor to beconsidered I submit what in my judgment would be the cost of both.
For accommodation of all patients on the cottage plan:
Three cottages with a combined capacity of 160 patients
$60,000 OO1
Administration building and Superintendent's residence
10,000 00
Laundry building
1,500 00
Boiler and fuel building
3,000 00
General dining hall
2,500 00
Reservoir and water distribution, including pumps for fire
protection
_
5,000 00
Boilers and engine
3,000 00
Steam heat
3,000 00
Total
r
$88,000 00
Cost of building with capacity of 160 patients, and detached
Administration building and Superintendent's residence.- $88,000 00'
Cost of single cottage for accommodation of 60 patients
20,000 00'
COST OP MAINTENANCE.
In accordance with the statutes, at the beginning of each year an estimate of the cost of maintenance of patients for the ensuing year has been
made, and each year we have been enabled to make a considerable reduction. We are now charging 52 cents per capita per day for the maintenance of patients, which includes, wages and expenses of all employes about
the institution, medicines furnished, etc. I would recommend a further
reduction of charges for maintenance for the ensuing year of at least three
cents per day, notwithstanding the prospective increase of cost of commissary supplies.
There could be a further decrease of cost of maintenance, with increaseof population, as it would not be necessary to increase that class of employes
who receive the highest salaries. With double the number now in the
asylum, those now in charge of departments could meet the demands made^
upon them.
�12
MICHIGAN ASYLUM FOR INSANE CRIMINALS.
CASE OF PATIENTS.
In the appendix of this report will be found the asylum rules, and as
every effort is made to enforce them, the care the patients receive can be
fairly estimated. All mechanical restraint on male wards has been practically abolished, and on the female wards has been reduced to a minimum
consistent with safety, considering the limited number of female employes,
and the large per cent of homicidal patients. Where patients are dominated by the desire to commit homicide, tact and vigilence will accomplish
much, but a test of strength will often be found necessary, and nonrestraint can in such cases be resorted to only where help sufficient for
safety, is at all times available.
ACKNOWLEDGMENTS.
Revs. J. J. Phelps, W. H. Scott and A. M. Gould, of Ionia City have
conducted our religious services, and Miss Winnie Hersey presided at the
organ. All connected with the institution appreciate their kindness, and
the sacrifices they made for our benefit.
We are under special obligations to Mr. John L. Pierson, of 150 Nassau
street, New York, for his interest in our patients, and his generosity. At
Christmas time he sent illustrated cards containing greetings, and compliments of the season, to all who had any appreciation of them. He also
presented for our patients' library, 80 volumes of bound books and a number of periodicals. To add to the cheerfulness of the wards and the
amusements of patients he presented us 48 chromos, 20x28 inches, and two
sets of dominos.
No charitable act is more fully appreciated by the inmates of the asylum,
as well as the officers, than is the contribution of the regular weekly issue
of the following newspapers by their publishers:
Argus, Hart, Mich.
Allegan Journal, Allegan, Mich.
Barry County Democrat, Hastings, Mich.
Big Rapids Herald, Big Rapids, Mich.
Cassopolis Vigilant, Cassopolis, Mich.
Charlotte Republican, Charlotte, Mich.
Detroit Courier, Detroit, Mich.
De Gronduet, Holland, Mich.
Flint Globe, Flint, Mich.
Germania, Grand Rapids, Mich.
Grand Rapids Eagle, Grand Rapids, Mich.
Grand Traverse Herald, Traverse City,
Mich.
Hart Journal, Hart, Mich,
Hillsdale Standard, Hillsdale, Mich.
Herald Times, West Branch, Mich.
Inter Lake, Vernon, Mich.
Ionia Sentinel, Ionia, Mich.
Kalamazoo Gazette, Kalamazoo, Mich.
Kalamazoo Leader, Kalamazoo, Mich.
Lapeer Clarion, Lapeer, Mich.
Le Patriot, Bay City, Mich.
Manistique Tri-Weekly Pioneer, Manistique, Mich.
Northville Record, Northville, Mich.
Ontonagon Miner, Ontonagon, Mich,
Otsego County Herald, Gaylord, Mich.
Owosso Weekly Press, Owosso, Mich.
Plain Dealer, Detroit, Mich.
Pilgrims Progress, Elk Rapids, Mich.
Public Leader, Detroit, Mich.
Reform Press, Dunnville, Canada.
Saginaw Valley News, Saginaw, Mich.
Shelby Republican, Shelby, Mich.
South Haven Messenger, So. Haven, Mich.
St. Glair Republican, St. Clair, Mich.
State Republican, Lansing, Mich.
Traverse Bay Eagle, Traverse City, Mich.
Wayne County Review, Wayne, Mich.
Weekly Expositor, Yale, Mich.
Weekly Globe, Mendon, Mich.
Wolverine Citizen, Flint, Mich.
Weekly Palladium, Benton Harbor, Mich.
Ypsilantian, Ypsilanti, Mich.
�REPORT OF MEDICAL SUPERINTENDENT.
13
I have endeavored to promptly and fully carry out your directions, and
realize that the task might have been otherwise than the pleasure that it
was, had those in charge been less considerate or without practical knowledge of business. To the existence of these qualities in you, is to be
attributed the perfect harmony that has existed between us, and while we
may hope to improve in other directions, in this there is room for none.
Very respectfully yours,
O. E. LONG,
July 1, 1890.
Medical Superintendent.
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Laborer.
M | Molder.
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Steamfitter.
M | Baker.
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Servant.
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Hostler.
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Lather.
Wagonmaker.
M
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Cook.
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f
1
�15
MEDICAL STATISTICS.
TABLE No. 2.—Showing the class of patients admitted during the biennial period
ended June 30, 1890, the length of sentence imposed and the form of insanity.
3
5
1
1
4
2
57
510
11
5
6
6
3
60
90
1
1
3
a
2
2
2
4
1
4
5
6
1
1
1
1
10
12
25
Life.
3
3
6
17
7
1
1
2
i
i
2
a
1
2
6
6
1
1
1
1
1
4
1
1
1
a
3
1
2
1
1
jj
0
1
1
1
1
2
1
1
3
i
11
Paretic
dementia.
101+
^ V
•5*
o
Masturbatic
insanity.
6
P
*i
Epileptic
dementia.
3
1
5
2
!*
4$
fl
Melancholia.
38
o
Acute mania.
If
o
Indefinite.
S £
Months.
Homicidal,
•8
Form of insanity.
Term of sentence.
Dementia.
Class.
1
1
1
1
1
1
NOTE.—To obtain the totals under "Term of Sentence" multiply the number of years, months or days
respectively by the corresponding number of patients and add the results.
�16
MICHIGAN ASYLUM FOR INSANE CRIMINALS.
TABLE No. 3.—Showing the educational condition of patients received during the
biennial period ended June 30,1890, their religious proclivities and age at date of
reception.
7
4
5
1
4
10
9
7
46
Totals
.
46
16
1
1
1
22
54
23
30
1
1
1
1
43
43
Unknown
1
26
21
11
44
22
26
49
1
1
31
32
28
54
26
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
20
26
19
35
18
30
36
27
35
21
1
1
1
Unknown
30
35
41
85
32
8
1
1
1
i
i
i
i
i
i
i
i
i
i
i
i
1
1
1
1
1
1
1
1
i
11
1
1
1
22
29
28
38
23
36
49
51
88
27
Pa
1
1
1
1
Unknown
1
1
1
1
I
Irreligious.
Catholic.
Protestant.
4
I
Ages.
Unknown
1
1
Aggregate.
•S"|
Religious proclivities.
Common school.
Bead and write.
1
Bead only.
Illiterate.
Unascertained.
Educational condition.
1
1
1
1
i
i
1
i
1
i
1
1
i
1
1
�17
MEDICAL, STATISTICS.
TABLE No. 4.—Showing the conjugal relations, color and sex of those admitted during
the biennial period ended June 30, 1890, and their habits in the use of tobacco and
intoxicants.
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
44
1
1
1
1
1
1
1
1
1
1
3
1
1
1
O>
Totals.
1
2
3
4
5
i
38
1
1
i
I
8
1
1
1
21
1
1
6
7
8
9
10
1
1
1
1
1
1
1
1
1
1
11
12
13
U
15
1
1
1
1
1
1
1
1
1
1
1
16
17
18
19
20
1
1
1
1
1
1
1
1
1
1
21
22
23
24
25
1
1
1
1
1
1
1
1
1
1
1
1
26
27
28
29
30
1
1
1
1
1
31
32
33
34
35
1
1
1
1
1
1
1
1
36
87
38
39
40
1
1
1
_____
1
1
1
1
1
1
41
42
43
44
45
46
1
1
1
1
1
1
14
1
1
1
1
1
1
1
1
1
1
11
1
S
S
B*
21
1
1
I
1
l
1
1
1
1
1
1
o
1
1
1
1
1
1
1
I
l
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
I
1
1
1
1
1
1
1
1
1
1
1
l
1
1
1
1
1
1
1
1
1
1
1
1
1
4
1
10
1
1
1
1
1
1
1
1
1
15
Unascertained.
1
tobacco.
Dse Tobacco.
10
ii
Use of
intoxicants
Intemperate.
31
g
a
>
Number.
1
Mulatto.
«
1
ft
Widowed.
b
Married and
separated.
1
Use of
Sex.
Temperate.
Color.
Conjugal relations.
1
1
1
1
1
1
1
1
�Oheboygan.
Baton _ _ _
Jackson
Kent.
Ottawa _ ...
Washtenaw
^^
35'
5 £,
W'M"
M P
.-
h-I
1-
0,
1-
M
B
o
•*
1-
1-
h^
t*
I
•a 5
1 •4
co
HI
M-
N,
h-
|
K1
|
»—'
ii'
O
!
J
0, M
§
Q_
3*
w
M
|
~
i
|
;
i
|
;
^
]
1-
h-i
15
M
^
-
]
^
K
f-*
^
i
>-
^
B
h-
^
M
-
1
g
|
|
^1
i-
;
MM
!•
M
5
i—i -
-
;
-
M
i-
3
9 U
H H^
M
-
;
i-
?§
M
1
~
i-
r-*
H1
!
i
1 H*
H'
3
r
MM
5-
M
I
1
O
& Unascertained.
-* United States.
~ Pennsylvania.
i- New York.
^
M
CO
Germany.
England.
Sweden.
i- fr Ireland.
^ w a fc>
3 3D §
t
M
Holland.
Euesia.
^
M Sweden.
MEngland.
CO
Germany.
rK
Canada.
^ 0 Ireland.
^ CD Unascertained.
>M.
Maine.
Wisconsin.
1—
Indiana.
w Illinois.
•» Vermont.
c^ Pennsylvania.
CO
1New York.
oo Michigan.
M
! !
•II
o
?a.
1
o
1
1
a
o
i
^
«5 S
a'o
.
•* I
-Ej
B
�TABLE No. 6.—Showing Asylum population at the close of each day, the total number of days of Asylum life for each month, and the
daily average for each month, with corresponding totals for the year ended June 30, 1889,
Months.
I)ays of month.
Totals.
July,
1888.
Average daily number, . 114.23+
Totals
1
2
3..
4.
5
6
7..
8
9
10..
11
12..
13
15
IB
17
18..
20 .
2122 .
28...
24
25
26..
27
2829..
30
81-
August, Septemb'r, October, November, December, January, February, March,
1888.
1888.
1888.
1889.
1889.
1889.
1888.
1888.
117 - 116.61+
April,
1889.
118-
May
1889.
117.58+
June,
1889.
110.32+
110.61+
111.03+
110.55+
111.53+
113.90+
115.97+
41,696
3,420
8,429
3,331
3,427
3,346
3,531
8,595
3,276
3,615
3,540
3,646
1,370
1,369
1,368
1,867
1,368
1,368
1,369
1,869
111
111
111
110
110
110
110
110
111
111
111
111
111
111
111
111
110
110
110
110
110
110
109
109
112
111
111
111
111
111
111
111
110
110
110
110
111
111
111
111
118
113
112
112
112
112
115
115
115
115
115
115
115
115
115
115
117
117
117
117
117
117
117
117
117
117
117
117
117
117
116
116
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
1,368
1,368
1,868
1,369
1,369
1,372
1,370
1,371
110
110
110
110
110
110
110
110
111
111
111
111
111
111
111
111
109
109
109
109
109
112
112
112
112
112
112
112
112
112
110
109
111
• 111
111
112
112
112
112
112
114
114
114
114
114
114
114
114
115
115
115
115
115
115
115
116
117
117
117
117
117
117
117
117
116
116
116
116
116
116
116
117
118
118
118
118
118
118
118
118
117
117
117
117
117
117
117
117
118
118
118
118
118
118
118
118
1,371
1,372
1,372
1,373
1,373
1,373
1,373
1,372
110
110
110
110
110
110
110
110
111
111
111
110
110
110
110
110
112
112
112
113
118
113
113
112
109
109
109
110
110
110
110
110
112
112
112
112
112
112
112
112
114
114
114
114
114
114
114
114
116
117
117
117
117
117
117
117
117
117
117
117
117
117
117
117
117
117
117
117
116
116
llfi
116
118
118
118
118
118
118
118
118
117
117
117
117
118
118
118
118
118
118
318
118
118
118
118
118
1,373
1,373
1,374
1,376
1,259
1,260
799
111
111
111
111
111
111
111
110
110
110
110
110
110
110
112
112
112
112
112
112
110
110
110
110
110
110
110
112
112
112
112
112
113
114
114
115
115
115
115
115
117
117
117
117
117
117
117
117
117
117
117
116
116
116
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
118
1183,540
�TABLE No. 7.—Showing the asylum population at the close of each day, the total number of days of asylum life for each month, and
the daily average for each month, with corresponding totals for the year ended June 30, 1890.
Months.
Days of month.
Totals.
Nov.,
1889.
Dec.,
1889.
Jan.,
1890.
Feb.,
1890.
April,
1890.
May,
1890.
119.46+
118.27+
118:32+
120.36-
121.74+
119.77-
119.06+
121.80
3,584
3,663
3,668
3,370
3,774
8,593
3,691
3,654
117
118
118
118
118 •
120
120
119
118
118
117
117
117
117
117
120
120
120
121
121
120
120
121
121
121
122
121
121
121
121
119
119
119
119
119
120
120
120
120
120
120
120
119
119
119
118
118
118
118
118
118
119
119
119
119
117
118
118
118
119
121
121
121
121
121
121
122
122
122
122
121
119
119
119
119
119
119
119
119
119
120
120
120
120
120
119
119
119
119
119
119
119
117
117
117
120
120
121
121
121
119
119
119
119
119
119
119
119
119
119
121
121
' 121
120
120
122
122
122
122
122
119
119
119
119
119
119
119
119
119
119
121
121
121
122
121
116
116
116
118
in
119
119
119
118
118
117
117
117
117
117
121
121
120
120
120
118
118
118
118
118
119
119
119
119
119
120
120
120
120
120
122
122
122
122
122
119
121
121
121
121
119
119
119
119
119
121
121
121
121
124
117
117
117
117
117
117
117
117
117
117
118
118
118
119
119
117
117
117
117
117
120
120
120
120
120
118
118
117
117
117
119
119
119
119
119
120
120
120
120
120
122
122
122
122
122
120
120
119
119
119
119
119
119
119
119
124
124
124
124
124
117
117
117
117
117
116
117
117
117
117
119
119
119
119
120
120
120
117
117
117
117
117
117
120
120
120
120
120
117
117
117
117
117
117
118
118
118
118
118
118
120
120
120
122
122
122
122
122
122
119
119
119
119
119
119
119
119
119
120
120
124
124
124
124
124
July,
1889.
Aug.,
Sept.,
1889.
117.26-
116.48+
118.93+
48,469
8,685
3,611
8,568
3,658
5
1,427
1,428
1,428
1,428
1,428
118
118
118
118
118
115
116
116
116
116
119
119
119
119
119
120
120
120
120
120
6
7
8
9..
10
1,428
1,429
1,428
1,428
1,429
118
118
118
118
118
116
116
116
116
116
119
119
119
119
119
11.
12..
18..
14.. .
15
1,432
1,431
1,429
1,4*9
1,429
118
117
116
116
117
116
116
116
116
116
16 ..
17
18
19
20
1,428
1,480
1,429
1,428
1,432
117
117
117
117
117
21
22
1,431
1,481
1,429
1,430
1,430
1,429
1,429
1,430
1,310
• 1,313
829
Average daily number
Totals
1
2.
8
4.
OO
24
25
26..
27
28.
29
80
31
119.06+
Oct.,
1889.
118-
March,
1890.
June,
1890.
bo
o
�TABLE No. 8.—Showing the number discharged, the form of insanity, time under treatment, and showing in correlation thereto
the per cent of recoveries to the total number under treatment, the per cent of recoveries to the average population, and also
the per cent of recoveries to the total number admitted during the biennial period ended June 30, 1890.
No. Case
No.
Form of insanity.
Time under treatment.
> t. d
§ >a
S«|
Result of treatment.
°S%
Remarks.
1s!
°S»o
fei^S
JH
Years. Months. Days.
1
2
8
4
5
123
135
13
155
176
6
7
8
9
10
163
165
107
174
172
11
12
13
It
15
117
179
177
151
194
16
17
18
19
20
189
192
197
45
169
21
22
23
24
25
131
81
152
85
141
26
27
28
29
80
186
56
167
139
33
81
32
33
66
150
42
Melancholia- _
1
1
3
3
3
3
2
2
2
2
2
Dementia
Dementia
2
1
3
4
1
7
2
1
5
1
2
29
8
19
17
9
10
8
11
29
ll
4
22
26
8
9
8
2
21
6
7
26
1
Discharged.
tt
it
"
,(
11
tt
tt
it
((
it
»
tt
tt
Returned to Michigan State Prison.
Discharged.
Returned to State House of Correction and Reformatory.
Discharged.
„
Returned to State House of Correction and Reformatory.
4
8
1
11
5
16
8
26
It
10
9
7
8
1
25
27
14
20
1
I,
8
9
1
6
10
21
14
19
24
5
2
11
3
1
12
21
26
Returned to State House of Correction and Reformatory.
Discharged.
tt
tl
Discharged.
Discharged by elopement.
(t
't
tt
Unim proved
Discharged by death.
11+
15+
89+
�TABLE No. 9.—Showing the name and age of patients deceased, from where received, the date of reception and of death, the causes of
death, the duration of insanity, the per cent of deaths to the daily average population and also to the total number under treatment
during the biennial period ended June 30, 1890.
Received.
Name.
Age.
Cause of death.
I
Henry Chamberlain. .
Anna ( 'ook
James T. Jackson
Margaret Stone .
James Forze
William Wild
29
Not known .
47
55
56
32
49
Died.
From where received.
a
8
Sept. 29 1885
Michigan State Prison
Detroit House of Oorrect'n Oct.. 20 1888
Eastern Michigan Asylum. . Aug. 27 1887
Sept, 7 1885
Dec. 17 1885
Detroit House of Oorrect'n Jan. 14 IHXs
Sept. 29 1885
bo
Duration
of
Insanity.
Form of insanity.
|
1
July. 13 1888
Dec.. 9 1888
Mar. 21 1889
July. 12 1889
Nov. 18 1889
Dec.. 16 1889
Jan.. 26 1890
Q
Phthisis Pulmonalis.-Epileptic convulsionsParalysis
* Killed by a patient
* Accidental poisoning.
6 years.+
1 year. —
2 years. +
16 years. +
11 years. +
M
I—(
O
Dementia.
Paralytic insanity.
Dementia.
Recurrent mania.
Imbecility.
Paralytic insanity.
6—
*+
* See text of Superintendent's report.
Month.
O
Month.
�TREASURER'S REPORT.
STATEMENT OF RECEIPTS AND DISBURSEMENTS BY PHILO D. CUTLEE, TEEASUREE OF
ASYLUM FOE INSANE CEIMINALS, FOE THE TWO YEARS FEOM
JUNE 30, 1888 TO JUNE 30, 1890.
Amounts.
CURRENT
Balances.
EXPENSE.
Balance as per last report
$6,821 70
Received from O. R. Long, Supt., sales
Maintenance of connty patients
State treasurer, maintenance
Act 190,1888, Sec. 20
State treasurer, maintenance
Act 190,1883, Sec. 26
State treasurer, maintenance
Act 190,1883, Sec. 27
State treasurer, maintenance
Act 190,1883, Sec. 28
State treasurer, maintenance
Act 48, 1887, Sec. 27
.
-
$1,025 00
1,502 00
of State patients under
$6,821 70
2,527 00
$14,254 40
of State patients under
11,791 25
of State patients under
16,247 66
of State patients under
2,152 66
of State patients under
4,43172
48,87769
$58,226:
Disbursements
48,718 50
Balance on hand in current expense
$9,507 89
SPECIAL APPROPRIATIONS.
Mattress and woven wire springs—
Balance on hand as per last report
Disbursed
.
$65 64
65 64
One rangeBalance on hand as per last report
Disbursed.
$150 00
124 12
Hose for fire protection and lawn—
Balance as per last report
Disbursed
$1 00
1 00
Material for painting—
Balance as per last report
Disbursed
.
I
25,'
$5 01
5 01
Engineer and carpenters' tools—
Balance as per last report
Disbursed
$28 07
28 07
Miscellaneous ward furniture—
Balance as per last report
Carpets for male ward department—
Balance as per last report-_._
Disbursed
-
One engine—
Balance as per last report.__
__.
Balance carried forward
- -
.
_.
.
$786
__.<....
$300
3 00
$9,537 03
�24
MICHIGAN ASYLUM FOR INSANE CRIMINALS.
SPECIAL APPBOPRIATIONS.—Continued.
Balance brought forward
1890.
Officers' salaries—
Jim-j 30.
Received from State treasurer
Disbursed
•>
$5,815 67
5,815 67
1889.
Papering and kalsomining—
July 31.
Received from State treasurer
Disbursed.,.
$15000
150 00
1889.
General repairs—
July 31.
Received from State treasurer
1890.
Feb. 28.
Disbursed
$70000
70000
1889.
One range asylum buildingJuly 81.
Received from State treasurer
1890.
M'ch 31.
Disbursed
1889.
Furniture for asylum—
Juiy 31.
Eeceived from State treasurer..
1890.
Jan. 31.
Disbursed
__
._..
$22500
223 66
..
$20000
19981
1889.
One musical instrument—
July 31.
Received from State treasurer
Nov. 30.
Disbursed
$10000
100 00
Hose—
Received from State treasurer
Disbursed
'.
$250 00
25000
1889.
Surgical instruments—
July 31.
Received from State treasurer
1890.
June 30.
Disbursed
$10000
1889.
LandSept. 30.
Received from State treasurer
Disbursed
$5,200 00
5,200 00
1889.
LibrarySept. 30.
Received from State treasurer
1890.
May 81.
Disbursed
$200 00
1889.
One boilerJuly 31.
Received from State treasurer.-.
Nov. 80.
Disbursed
$55000
549 65
1889.
July 31.
64 40
14358
1889.
Asylum building—
Nov. 30.
Received from State treasurer
1890.
Feb. 28.
"
"
"
"
_.
May 31.
"
"
"
"
June 30.
"
"
"
"
.....
$3,00000
..
4,00000
3,000 00
5,00000
$15,000 00
9,377 36
Disbursed
1889.
CowsDec. 31.
Received from State treasurer
1890.
June £0.
Disbursed
1889.
TeamDec. 31.
Received from State treasurer.. _
1890.
May 21.
Disbursed
$30000
188 00
__
$30000
30000
1890.
Barn—
M'ch 31.
Received from State treasurer
June 30.
Disbursed
$50000
28 16
1890.
Farming utensils—
M'chSl.
Received from State treasurer
June 30.
Disbursed
$40000
148 70
Total balancesCurrent expense
Special appropriations
..
$9,507 89
6,585 82
�25
TREASURER'S REPORT.
RECAPITULATION.
Dates.
Amounts.
1888.
Balance as per last report —
June 80.
Current expense.._ _ . _
„____
June 30. Received from State treasurer —
Maintenance of State patients
Special appropriations . i _
Received from sundry persons —
Maintenance county patients _.
O. B. Long, Med. Supt., sales
__
.,.
.--_
._.
__ - _ _ .
„
Amounts.
Balances.
$6,821 70
260 84
$48,877 69
344 80
29,990 67
$1,157 20
1,025 00
Totals to be accounted for
2 182 20
$88,477 90
$88,477 90
DI SBUBSEMENTS .
$48,718 50
Special appropriation-
$65 64
124 12
1 00
Engineer and carpenters' tools „
Officers' salaries- -_
.-
Furniture for asylum
Surgical instruments
Land
Team
Balances to new account—
__
_
5 01
28 07
7 86
5,815 67
150 00
700
228
199
100
250
00
66
81
00
00
64
5,200
143
549
9,877
40
00
58
65
36
188
300
23
148
00
00
16
70
$52 384 19
$9,507 89
6,585 82
�MISCELLANEOUS.
�28
MICHIGAN ASYLUM FOR INSANE CRIMINALS.
TABLE No. 1.—Earnings and Analysis of Current Expense Vouchers from July 1,
1888,'to June 30, 1890.
EAEHINGS.*
State—
For maintenance of patients
Counties—
For maintenance of patients
SalesMiscellaneous
$48,654 79
1,583 98
972 26
ANALYSIS OF VOUCHEES.
Attendants
BarnHay, grain, straw, etc
Labor
._
..
Blacksmithing
Harness, robes, blankets, etc
Tools, implements, etc
Plumbing
Horses, carriages, etc
Miscellaneous
$473 61
333 00
55 96
62 85
12 70
25 63
140 00
28 19
.
Clothing, boots, shoes, underwear, etc
Damages, etc
Dispensary—
Drugs and medicines __
L. Instruments and ware
Alcohol, liquors and wines
Freight
__.
Entertainment
Furniture and furnishing—
Cabinet furniture, etc
Woodenware, brooms, brushes, etc
Hardware, tinware, etc
Crockery, glassware, silverware
Dry goods
Bedding
Carpets, curtains, etc
Soap
Lab9r
Additional machinery
Turpentine, wax, etc
Tobacco (furnished patients).
Miscellaneous
.
'..
__
'
GardenLabor
Pigs
Seeds and plants
Miscellaneous
GroundsLabor
Trees, shrubs and plants
Implements..
Seeds
.
_
_
...
Heating and ventilating—
Labor
Fuel
Implements, oil, etc
Steam, gauge, valve, etc
Grates, solder, leather and printing...
Provisions!
Farm
MiscellaneousLabor
Traveling expenses
Patients discharged, gratuity
Chapel services ...
Elopements
Coffins.
Telegrams
___„
$203 85
125 88
276 22
277 32
974 47
311 07
49 87
15846
194 13
46 43
15 37
34682
169 49
$15400
15 00
98 57
43 55
$138 19
11345
69 56
5 55
$1,221 70
2,454 79
28193
144 62
61 71
_.
.--
.
....
_
$164 00
45 58
60 55
7 73
--
.
.
$1,818 05
392 06
94 37
133 75
2300
7000
42 27
�MISCELLANEOUS.
TABLE No. 1.—CONTINUED.
Miscellaneous.—Continued—
Telephone and messages
Hardware
Printing and advertising
Freight, expressage, etc
'..
Fuel
..... ._ -.
Implements, instruments, etc
Plumbing
Expenses attendance National Association
Miscellaneous...
$82 35
44 34
159 45
110 90
57 35
40 50
SO 78
.
18148
Office, stauonery, etc.—
Salaries
Stationery
Postage and express.
Blanks, printing, etc
Blank books
Cyclostyle duplicating apparatus
Type writer
Subscriptions, daily papers, etc
Fuel (treas. office)-~
*.
Kitchens—
Labor
Fuel
.
Icefor refrigerator
Stove castings
Miscellaneous. _ _
,
4194
__
Water distributionWater, S. H. of C
Telephone—
Kental, repairs, etc
Messages
Total.__
2,947335
$1,35394
672 71
182 22
26 70
40 92
2362
6 00
:
Laboratory and library
Outbuildings...
.
Outbuildings, farm
Light-Gas
Bepairs—
Labor
Hardware
Lumber
Miscellaneous
Brick, tiling, cement, etc..
Paints, oils, etc
Renewals and additions—
Labor .
...
.
Hardware, tin, glass, etc
Lumber
Paints, oils, brushes, etc
Plumbing ....
Lime, cement, etc
Sewer pipe, brick, etc
Miscellaneous
1,925199
$2,013 63
76567
117 62
.„.
LaundryLabor
Fuel
Soap
Sal. soda and caustic soda
Starch, white wax and indigo
Implements,fixtures,etc..
Printing laundry lists
$3,366 95
$1,662 92
52 34
11273
37 78
10 25
12 00
15 70
17 27
500
2,206 11
23143
60 00
1,197 28
$757 01
36 64
17 47
91 95
67 18
185 i
_
.
_
_-_•_
.._.
__.
.
1,155 31
$386 91
187 99
168 92
12412
66 60
7 25
47 60
15 19
.
1,004 58
400 00
$15205
606
.
.
158111
-
$48,88685
* The difference between earnings as shown above and receipts of the Treasurer arise from the fact that
the accounts for maintenance of patients for the quarter ending June 30,1888, were received during the
following month or quarter, and the account for miscellaneous sales for June, 1888, were also received by
the Treasurer the following month.
fFor details of Provisions consumed see "Commissary Supplies" Table.
�COMMISSARY SUPPLIES.
TABLE No. 2.—Showing maximum, minimum and average prices paid, and total
cost of Provisions purchased and produced for the Asylum, from July 1, 1888, to
June 30,1890.
Price.
Quantity.
Articles.
Total Cost.
Number.
Apples, dried
___
Avena _
__
_
.
.
_.
Apricots, dried
28
121
48
63,369K
300
Bananas
Beef
Beef, dried
Beans, white.
131V6
869
46%
570%
7,84813-16
BeetsButter.
Buttermilk. _
Bread
Beet greens..
196
100,860
17%
50
279
Coffee, ;A
Coffee, B
.
Crackers _
Codfish
Chocolate
Cabbage
Cocoanut. _.
235V.
1,3761/2
534
133
33
. _
Corn meal.
Corn starch
Cinnamon
Cucumbers _
Carrots
Cloves.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
...
Measure.
bush
.
Ibs
Ibs
P kg V—
bunches..
Ibs
Ibs
doz
Ibs
Ibs
bush
bush
qts
Ibs
Highest.
Lowest.
Average.
$1 00
06
30
12i/3
12i/s
$0 25
04
18
$0 39 1-7+
04J419+
20
50
40
15
07*4
1 75
08
1 00
16
30
111/2
121/2-
15
10
25
03%
05
151/2
21%
2954
05H
06%
05
1 00
01%
25
06
10
1 3634
02' 7-16
41%
09%
14-
4
25
14
3,244
18
35
55
08
46
50
179 08
21 21
19 86
56 73
1,194 96
28
05
03 1-50
44
05
29%
9
3,048
8
2
82
80
63
81
50
50
131/2
05
05'/2
06
08
15K
11 8-9
05 5-6
06 5-7
13 4-5
474
188
89
115
167
04
12
90
69
68
8*
08«
03
25
10%
32i/2
09%
03 3-529 2-5
53
6
22
162
4
58
83
28
13
41
04%01%
055,
05%
30
26
27
3
4
2
15
98
44
07
10
08 2-5
60
34 2-5
32
07 2-3
24 15
3 00
19 60
1 18
7 67
gals.
Ibs
bush...
Ibs
Ibs..
04
50
03
32
40
3,093i/2
1,590
1,520
1,6861/a
1,23254
Ibs..
cans
Ibs.
Ibs
Ibs
23
23
07
09
20
198
21
235
4,490
15
Ibs
Ibs
bunchesheads. __
Ibs..
15
38
14
15
35
554%
2,449
65
74
7
doz
Ibs
Ibs
Ibs.
Ibs
15
01 1-10
05'/2
06
04
288
5
57i4
sy2
doz
70
03
bush
Ibs
qts
40
40
16
25
25
05
100
8^
$92 17
58 52
1 05
16 55
2 74
01 !/2
04^
05
�31
MISCELLANEOUS.
COMMISSARY SUPPLIES.—Continued.
Quantity.
Price.
Articles.
Total Cost.
Number.
15&
28i %
i
p
Citron
Cider
Egg8
Grapes.
12%
3,002%
400
5
1,582
Jjard.
.Lettuce
165
572%
869
1,308%
40,080
, . .
Mutton and lamb
MilkMustard .
Mustard. ._ . _ _ . _ . _
45
21
127
17
2
Mace
MackerelNuts
Olives,. _.
_.
Orange and lemon peelOysters ._
Oysters
Pie plant
Pork
Parsnips.
Pepper
qt
doz
Ibs
1
40
748
387
8
•Ginger.
,
_
_..
Ibs
1
1,637%
18,275
298
572
1,586
525
Fish, freshFish, salted.
Ibs
gals
bot
18%
Flour
Flour, graham
Ibs
bush
Ibs
35
1
12
V-A
Extract vanilla-
Measure.
53)4
134
150
39
2
3,600
169
93
286
2%
142
100
&M
315
14,831
1,405
45
36%
Ibs
Ibs.
Ibs
Ibs
Ibs
...
Lowest.
08
08!4
440
30
22
32 4-5
84
10
14
ii}4
13
io
15
1 25
03 3-5
03
01 3-5
01%
10
08%
08
02K
10
20
08
18
15
1254
05
06
11
35
25
1 00
15
25
08
16
07
bot
Ibs
Ibs
Ibs.. ._.
qts.
Ibs.
Ibs
Ibs.
Ibs.
I
..
doz
Ibs
gals .
Ibs
qta
Ibs
bot.s ._„__
Ibs
oz._
25
30
40
15
Jbs
Ibs
15
1 00
20
45
1 75
Ibs
bunches .
03 1-5
03%
S 20
05
40
Ibs.. _..
bots
doz
Ibs
cans
shell
Ibs.
Ibs
bush
bush
bush
842
Ibs
»A
102
17
25
60
bush
Ibs
bots
Ibs
Average.
08'/2
2i
85
1 40
Ibs. .
Ibs
Highest.
OWss
20
07 %
10
12%
09
85
07%
17
1 25
14 3-10
69%
1 33 1-5
02 2-5
01 9-10+
03
0903 8-9
20
08)4
03%
25
ISM
06%01%+
22
08+
26i4
07 1-20
24%
08 2-5
03
22 2-9
12 2-5
18%
14M
10
09 2-5
88
12%
26%
1 50
02 8-9
02 9-10
53%
02 3-5
02
25
03
25
#
40
23
28 7-10
60
05
09
§6
01
04 3-20
42U
02 1-10
05%-
15
40
60
81 1-12
40 6-7
96%
2 00
60
2 00
12%
3 60
25
35
25
04)4
2 00
15
20
06)4
052 94
19
28%
10%
$1 28
1 53
1 68
1 35
25
1 23
2 04
3 50
60
1 56
25
234 11
5 93
17 43
88
316 66
5 66
17 16
141 62
20 63
25
8 00
62 19
13 43
2 00
1 67
205 16
7 15
1 10
127 12
43
40
216
110
1,202
39
37
34
36
40
10
2
23
2
00
65
52
43
20
4 99
1 10
18 70
10 33
3 00
104
4
49
10
00
94
73
46
; 70
40
2
10
6
812
67
75
40
62
03
436 65
18 30
35 18
1 75
42 75
23
19
4
2
58
40
75
63
60
�32
MICHIGAN ASYLUM FOE INSANE CRIMINALS.
COMMISSARY SUPPLIES.—Continued.
Quantity.
Price.
Articles.
Total Cost.
Number.
Plums
66
207
208
1,026
Radishes,
Eice
_
Bait.
Veal..
Wheat grits
Yeast
- _
Highest.
Lowest.
Average.
$0 10
05
25
08
$0 02
03
06 K
05
$0 02 8-11
03%
08 1-9
05%
10
13+
1554
M
11
l
Sugar, B
Tea, "A"
Tea, "B"
Tomatoes.
bush
bunches .
do a
Ibs
Ibs
80
Sauce L. & P
Sausage .
Sage
Sugar, pow'cL.
<A
Measure.
6,558
Ibs. ....
Ibs
Ibs
09 1 5
06%
07J4+
7,598
197
140
1,503
4754
Ibs
Ibs
Ibs
Ibs
Ibs
08
12
10
05H
09
06^+
06%
08 3-10
11
33
777
1,820
5,145
3,045
Ibs
Ibs
Ibs
Ibs
Ibs
08
OB'i
04
05
03
01
99
122
1,581
2.583
152
Ibs
Ibs
Ibs
Ibs ....
bush
10
50
22
10
60
1,106
503
21&H
502H
878
Ibs
Ibs
30
16
Ibs
Ibs
07
35£
4
430
40
105
170
Ibs
10
my,
0954
iok
09 4-7
05 6-11
03K+
01^400'/2 +
01*4
10
8 93
69
1 10
85
476 95
495
19
13
120
5
19
95
25
77
23
1 83
26 08
21 52
25 81
45 68
06 3-11
38+
205$01%
24y3+
6
46
320
84
87
20
60
40
31
31
20
13
24%+
"H
05
06
273
72
28
52
52
85
97
29
75
68
04
10
10
0854
05 J4
F
IF
20
Ibs
gals.
Ibs
Ibs ..
$0 73
1 79
7 71
16 88
58 00
75
10
43 00
4 00
3 43
7 99
�GARDEN PRODUCTS.
TABLE No. 3.—Garden Products.
Articles.
Cucumbers, dozen. _. _ .
Lettuce, Ibs.
"
bushels.
.
-.
.-
Quantity.
Kate.
Value.
27
$0 77
46%
41V4
17
49
4,418
03'4
546%
04%
$'0 79
19 86
8 83
154 63
24 57
262
5
526
103
1M
05%
14 41
60
3 00
06
31 56
02 5-6 2 92
1 00
1 25
11
35%
53
207
876
35
95%
02
oiy,
3 86
34 03
1 06
7 77
10 95
Milk, quarts.
2,493
lOOii
9%
37
5,866
01 14
24%
15
40
03
28 04
24 71
\8
14 80
175 98
Pork, Ibs.
Parsnips, bushels..
18
286
149
2,338
2534
05
90
03 3-5 10 29
02 6-7 4 24
05}^ 124 42
40 4-5 10 30
Potatoes, bushels
._
Radishes, bunches
Berries, quarts
_ ... _
, '
_.
08%
�SUMMARY OF INVENTORY.
JUNE 30, 1890.
TABLE No. 4.—Summary of Inventory.
Real EstateBuildings
Thirteen acres of land
Buildings (cottage)
Eighty acres of land (Berlin)
_
Medical DepartmentOffice—furniture
Dispensary—drugs and medicines
Instruments
__
Ware, fixtures, etc
Library—State
Restraining appliances
Chapel—organ
Telephone
Clerk and Steward's Department—
Office—furniture
books and stationery
Store-room—furniture, elc
crockery
clothing, boots, shoes, etc.
provisions a n d sundry supplies _
Painter's Department—
Paints, oils, etc
Tools, brushes, etc
Glass
_ _
_
Barn and Garden—
Five horses
Wagons and sleighs
Harness, robes, etc
Hay, feed, etc
TooJs, plow, cultivator, etc
Ten hogs and 18 pigs
Seven cows
Furnace kettle
Miscellaneous
_
$333 65
116 85
24 75
68 82
1,141 19
42478
_ _ „ _
_
_
_
_
__.
$33 97
1741
2 81
$67350
908 40
128 45
358 !
32 00
12 00
398 35
102 65
__,_
_ .
..
Carpenter's DepartmentTools, etc
Supplies, etc
$64000
290 00
19400
7 00
2800
147 00
25800
25 00
18 00
$38 10
7 55
LaundryUtensils
Supplies, soap, etc
General Dining Room—
Furniture, etc
Crockery, glassware, etc.
$84,50000
1,500 00
9,181 19
5,200 00
$217 75
109 01
317 67
35 22
199 87
89 37
100 00
146 50
..
.'
Engineer's DepartmentLaundry machinery
Engines, boilers, etc
Belting, shafting, etc
Hose, hose carts, reels, etc
Woodandcoal
Bell
.
Tools, etc.
Supplies, oils, etc. _
_.
-.
__
$55 40
5 80
$227 50
114 00
$100,331 19
1,165 39
2,110 04
54 19
2,614 25
1,607 00
45 65
$61 20
341 50
�35
MISCELLANEOUS.
TABLE No. 4.—Continued.
General Kitchen—
Furniture, utensils, etc
Coffee and tea urns
Range
Steam kettles
$94 20
75 00
200 00
150 00
_. _
Supervisor's Department—
Furniture, etc
tailor shop
bedding, etc., employes rooms
hall No. 1
3 I
$105 00
64 50
130 70
556 85
46985
700 20
206 65
805 40
5
Matron's Department—
Residence—furniture
bedding
crockery, plated ware, etc.
kitchen
-
Sewing Room, Furniture, etc
_
•Gardener and Florist's DepartmentPlants and bulbs
_
Vases, pots, boxes, etc
Tools and seeds
Lawn hose, reels, etc.
__
Total........
.....
NOTE.—Buildings at cost.
$1,377 75
175 00
15000
250 00
....
_
__
....
_
__
..
$178 25
51 50
40 75
3750
$519 20
2,539 15
1,952 75
91 74
308 00
$113,74125
�LIST OF OFFICERS AND EMPLOYES.
TABLE No. 5.—Showing salaries paid each at close of biennial period, June 30, 1890.
Name.
O. B. Long
A. Stanley Dolan
W. D. Arnold
P. D. Cutler
Occupation.
Ass't physician
Treasurer
Salary
per
Annum.
Remarks.
$1,900 00 And. board and washing for family,
900 00
1,000 00 Non resident.
192 00
And board and washing.
Per Month.
E. M. Townsend and wife.
J. D. D. Perry
Engineer
T. E. Williams
Starr Alvord
John Grant
E. 8. Waterbury
E. E. Swan
Warren Sturgis
C. T. CadweU
JohnMowatt
Elmer Pouch
Stella Phillips
Pvisnilla, TCipp
Wm. Corey
Cook.
Chas. Peterson
Painter
B. F. Proctor.
A. F. Willett
Jennie Kipp .
Lena Kruger
Teamster _
Seamstress
65 00 And board and washing for family.
60 00 Non -resident,
35 00
40 00
arid one-third board,
50 00
50 00 And. board and washing.
82 00
32 00
25 00
24 00
22 00
20 00
20 00
20 00
18 00
14 00
12 00
50 00
16 00
40 00
30 00
25 00
20 00
14 00
14 00
�MATRON'S REPORT
OF ARTICLES MADE IN THE SEWING BOOMS FROM JULY 1, 1888, TO
CLOSE OF BIENNIAL PERIOD, JUNE 30, 1890.
Aprons
" Kitchen. _
" Dining Room
" Barber
" Laundry
" Oil Cloth.
" Rubber
Bed Ticks...
€oats
Collars
Chemises
Curtains
_
..Carpet rugs
Dresses
Drawers, Women's, pairs...
"
Men's, pairs
Dress Waists
Skirts
Handkerchiefs
Hose, Women's, pairs
Mittens
Table Cloths
Napkins
Neckties
Nightdresses
Stand Cloths _
_
Sheets, Patients
"
Attendants
Rubber....
Mattresses
Mats
Tidies
Overalls
Pillow shams
"
" Attendants
" cases
"
"
" Patients
Pillow Ticks
Pants
Underskirts
__
_
Skirts
Socks
... _ _
.
Towels, Bath
"
Toilet .
Roller
Dish
Wrappers, Men's
"
Women's
Vests..._
_
_. _ _
----
•
.
.
... ...
..
_ _ _ _ _
,
-
_
_
.
_ . _ _ ....
_
..
119
5
60
2
1
4
1
2
108
39
47
158
4
92
40
35
8
4
1
58
10
6
30
4
15
_
16
360
30
19
1
7
2
4
100
8
47
316
6
135
_
14
390
902
399
173
118
221
33
37
105
�BY-LAWS, EULES AND REGULATIONS
MICHIGAN ASYLUM FOR INSANE CRIMINALS,
IONIA, MICH.
ADOPTED BY THE BOARD OF MANAGEKS, JANUARY, 1890.
BY-LAWS.
BOARD OP MANAGERS.
The meetings of the Board of Managers will be held monthly at such date as may be
designated upon adjournment of preceding meeting. Special meetings may be called
by the President, and it shall be the duty of the Clerk to give due notice thereof.
The Clerk of the Asylum shall act as Secretary of the Board, and keep an accurate
record of its proceedings.
All questions brought forward for the consideration of the Board shall be submitted
in writing, and decided by a majority of the members present.
The order of business at regular meetings of the Board shall be:
1. Reading and approval of the minutes of the preceding meeting.
2. The consideration of unfinished business therein referred to.
3. The consideration of the minutes of the Visiting Committee.
4. Auditing accounts and bills.
5. The consideration of communications from the Medical Superintendent.
6. The consideration of communications from the Treasurer.
7. Reports of Special Committees.
8. General business.
RESIDENT OFFICERS.
1. The Medical Superintendent, Assistant Physician and Matron shall comprise the
Resident Officers at the Asylum.
TREASURER.
1. The Treasurer shall receive, hold and disburse all the moneys which may be
granted by the Legislature, or obtained from other sources for the use of the Asylum.
2. Said moneys shall be disbursed only for the use of the Institution, upon the
written order of the Superintendent, specifying the object of payment, item by item,,
and countersigned by the President or resident Member of the Board.
�RULES AND REGULATIONS.
39
3. The Treasurer shall from time to time advance to the Superintendent on his own
order, specifying that it is to pay petty current expenses, a sum not exceeding one
hundred dollars.
4. The Superintendent shall keep an accurate account, in detail, of all expenses paid
out of the sum so advanced to him by the Treasurer. The Treasurer shall receive a
certified account of each sum of one hundred dollars before any further advance shall
be made to the Superintendent as aforesaid.
5. He shall keep clear and methodical acounts of all moneys received or paid out by
him for the Asylum, and shall exhibit these accounts to the Managers once a month at
the meeting of the Board, and oftener if required. He shall balance all accounts on his
books on the last day of June, at the close of each fiscal year, and make a statement of
the balance thereon, and an abstract of receipts and payments, which he shall deliver to
the Board as required by them.
6. The Treasurer is authorized, under the direction of the Board, to collect from any
person, town, county, or State, liable for the support of any patient, the cost of his
maintenance in the Asylum and the amount of all actual disbursements for his clothing
and necessary traveling expenses; and he shall determine, when required, the legal settlement of any insane person sent to the Asylum, in accordance with the provisions of
the statutes.
7. He is also authorized to collect all sums due on any note, bond, or mortgage in his
hands belonging to the Asylum; and he shall cancel or release the same when paid,
and make satisfactory acknowledgment thereof. He is further authorized to collect
any and all sums which may be due to the Asylum.
8. The Treasurer shall settle annually with the State Board of Auditors, and shall
conduct such correspondence with the State and county officers, as may pertain to his
official duties.
9. It shall be the duty of the Treasurer to be present at meetings of the Board of
Managers, and to furnish such information in reference to the finances of the Institution as may from time to time be required.
10. The Treasurer shall hold his office during the pleasure of the Board.
RULES AND REGULATIONS.
MEDICAL STJPEBINTENDENT.
1. The Superintendent, being by law the chief executive officer of the Asylum, and
required to reside on the premises and devote his time to its welfare, is the head of the
establishment.
2. And having the general superitendency of the buildings, grounds, and farm,
together with the furniture, fixtures, and stock; and the direction and control of all
persons therein, with power to assign them their respective duties. It shall be his
special duty to see that all the employes are energetic, industrious, punctual, exact, and
in all respects faithful in the performance of their several duties.
3. He shall obtain, as far as practicable, a complete history of every patient admitted
into the Asylum; and shall cause to be kept for the use of the Institution, a register of
the same, a.nd as full a record of the subsequent treatment and results as he may deem
likely to promote the interests of science and humanity.
4. All the correspondence of the Institution shall be conducted by him, or by his
authority and under his direction.
5. He shall cause to be kept a record of the names and residences of all persons
employed in the Institution, with the time and terms of their respective engagements,
and the date and causes of their dismission.
7. At each visit of the Managers he shall, if requested, exhibit the records of the
Institution, and inform them minutely of its affairs, giving a brief statement of its general condition, and the names of the patients admitted and discharged. At each annual
meeting of the Board he shall present a tabular view of the operations of the Institution for the year, with full and minute details from the records, and accompany it with
a condensed report of other.interesting and useful facts and circumstances, experiments
and opinions, illustrating its management, condition, and prospects.
�40
MICHIGAN ASYLUM FOR INSANE CRIMINALS.
8. All moneys belonging to the Institution collected or received by the Superintendent, or by persons employed by him, shall be immediately paid over to the Treasurer of
the Asylum.
ASSISTANT PHYSICIAN.
1. The Assistant Physician shall act as the immediate Medical Attendant in the
wards. He shall visit all the wards at least twice daily, commencing the morning visit,
which shall be the main visit of the day, punctually at 9 o'clock, seeing each patient
individually and prescribing for such as require it, ordering each patient's medicine
separately and under his own name, with specific directions, in writing, as to the mode
and time of administration. He will be expected to spend a proper length of time on
the wards, conversing with and examining the patients, inspecting every part of the
wards, observing the temperature and ventilation, the condition of the attendants' and
patients' rooms, the bedding and clothing, dining rooms, bath rooms, closets, etc. He
shall regularly make an afternoon visit to the wards, and also, when necessary, additional visits to patients requiring especial attention. He shall also make occasional
visits, as often as once a fortnight, to the wards, at 10 p. m., and at the rising hour in the
morning, for the purpose of observing the condition of the wards and patients at night,
and the manner in which attendants and" others perform their duties.
2. He shall accompany the Medical Superintendent in his visits to the wards, whenever required to do so, calling his attention to the new cases and to any patients concerning whom he desires fresh advice.
3. He shall see that the attendants are faithful and kind, attentive to the reasonable
wants of the patients and vigilant in the discharge of their duties; that the views and
directions of the Medical Superintendent regarding the management of patients are
faithfully executed, and shall report immediately to the Medical Superintendent any
instance of misconduct, unfaithfulness or neglect of duty observed by him, or of which
he may receive information.
4. He shall daily report to the Medical Superintendent the general condition of the
wards, the particular state of such patients as may be seriously ill or greatly excited,
and of thosa requiring removal, seclusion or special attention, and promptly and cheerfully carry out directions in regard to them given by the Superintendent, and attend
personally to all forcible feeding of patients.
5. He shall keep descriptive records of all patients, including their symptoms, the
changes in their condition, the methods of treatment and all facts of interest connected
therewith. He shall promptly record all admissions and discharges and the particulars
of all accidents and escapes, and constantly keep the register, time book, post mortem
record, etc., fully written up, and shall permit no person to have access to the medical
records or case books without the consent of the Medical Superintendent.
6. He shall attend to visitors when necessary, and be always ready to perform any
service that may be required of him by the Medical Superintendent, and at all times be
subject to his control. He shall also perform the duties and be subject to the responsibilities of the Medical Superintendent in his sickness or absence.
STEWARD.
1. The Steward shall be the custodian of all supplies other than medical stores, and
shall personally attend to their receipt, distribution and care. He shall keep accurate
accounts in books to be provided for the purpose, of all supplies and materials received
and distributed by him for the use of the Asylum; shall have charge of the store rooms,
under the general direction of the Medical Superintendent, and shall be held personally responsible to him for the safe keeping, proper disposal and economical use of everything confided to his charge. He shall issue no supplies othe? than those regularly
required for the kitchens, except on requisitions approved in writing by the Medical
Superintendent.
2. Under the direction of the Medical Superintendent, and not otherwise, the Steward may personally purchase any supplies for the use of the Asylum. He shall see that
the patients' food is properly prepared and distributed; that the rooms, halls, yards,
bakery, shops, laundry, kitchen, outbuildings and other apartments under his care are
kept cleanly and in order, and that the cook and others in his department observe his
orders and in all respects do their duty; and he shall promply report to the Medical
Superintendent any instance of neglect or misconduct on the part of employes
which may in any way come to his knowledge.
�RULES AND REGULATIONS.
41
3. He shall keep an accurate and itemized record of the products of the farm and
garden, showing the estimated value of each class of articles raised, also an account of
sundry sales.
1. The Matron shall look carefully to the female patients and spend as much time
with them as her other duties will allow; she will see that they are kindly treated; that
their attendants are well instructed and faithful; that their food is properly served and
distributed; that their apartments are clean, warm and properly ventilated; and that
their clothing and bedding are always clean, well aired and in good order, and their
wearing apparel properly mended and preserved.
2. It shall be her special duty to see to those that are sick, that they have constant and
kind attention and proper care in every respect. She shall observe the conduct of the
female attendants and other female employes; see that they do their duty in all respects,
and shall immediately report to the Medical Superintendent any instance of misconduct or neglect which may in any way come to her knowledge.
3. It shall be her duty to personally supervise the work in the sewing room, and see
that all new articles are properly made and marked, and all old ones that require it
neatly mended. She shall also attend to articles of clothing and bedding not in use,
and shall, as far as practicable, cause all clothing for female patients use to be made
in the house, and shall condemn, with the approval of the Medical Superitendent, worn
out bedding and clothing, except such portions as may be reserved to repair clothing
and bedding in use.
4. She shall, unless otherwise directed by the Medical Superintendent, oversee the
kitchen and laundry of administration building; see that the cooking, washing and ironing are properly done; that the public reception room is kept in order, and frequently
inspect every department and constantly endeavor to preserve a neat appearance of the
whole house. It is expected that she will devote her whole time to the Institution and
make every effort to promote the comfort of its inmates.
5. She shall perform such other duties as the Medical Superintendent may from
time to time prescribe, and shall at all times be subject to his control.
THE CLEBKS.
1. The Clerk shall be familiar with bookkeeping, and shall render such service in the
Institution as he may be, from time to time, directed by the Superintendent.
2. The Clothing Clerk shall receive all clothing of the patients received, mark and
enter a correct list of it in a book provided for the purpose, together with any money,
jewelry, or other articles of value which shall be deposited, properly labeled, in the
Steward's office. When patients are to be discharged, they shall cause them to be
prepared properly, the clothing neatly packed, and any articles of value brought with
the patient to be returned. They shall, as often as once a week, make an inspection of
the patients' wardrobes, and clothes rooms, and prepare a list of clothing required by
any patient, which, when approved by the Superintendent, shall be sent to the Steward.
Such lists to be receipted by the attendant or others appointed to receive the clothing
after it is delivered.
CHAPLAIN.
1. The duties of the Chaplain of the Asylum are denned to be the holding^of a service
every second Sunday in the assembly room or chapel; a weekly visitation to the wards
of the Asylum; visitation of the sick when their necessities seem to require; attendance
upon the burial of the dead when he may appropriately do so.
WARD SUPEKVISOK.
1. There shall be designated in the male department, a Supervisor, or Chief Attendant, whose duty it shall be, in addition to the other duties of an Attendant, to have a
general oversight of the department. He shall make frequent visits to the several
wards, observing the manner in which the attendants perform their duties, and report
to the Medical Superintendent any instance of misconduct or negligence.
6 •
�42
MICHIGAN ASYLUM FOB INSANE CRIMINALS.
2. He shall take charge of new Attendants, instruct them respecting their duties and
explain to them the rules and requirements of the Institution. He shall call at the
dispensary at the hours designated by the Medical Superintendent, receive the medicines and administer the same if directed by the medical officers and shall report to
them any patients who refuse to take their medicines.
3. He shall be the medium of communication between the wards and the administration building. All changes in the condition of patients or other information that may
be deemed important, shall be promptly reported to the office through the Supervisor.
He shall see that the wards are properly supplied with furniture, and make a requisition
upon the Steward for all articles required for use, which requisition must be properly
endorsed by the Superintendent. He shall assist in the arrangements for the burial of
the dead, and be ready at any time to attend to any extraordinary service when required.
4. He shall assist in the reception of new patients; see that tliey are thoroughly
searched, bathed and appropriately clad before being sent to the ward, and that they
are properly introduced and informed of the rules of the ward and their fears quieted
by kind attention and friendly assurances; also that the violent and suicidal are carefully watched. He shall in all things endeavor to carry out the plans of the Superintendent, and shall constantly study to promote the comfort and welfare of the patients,
and for these purposes shall visit every part of his department several times daily. He
shall also attend to the transfer of patients from one ward to another, when so directed.
He shall make frequent reports to the Superintendent concerning the condition and
wants of the patients and the deportment of Attendants, and shall perform such other
services as the Superintendent may direct.
5. He shall, in the discretion of the Medical Superintendent, examine the contents of
all trunks, boxes, packages or parcels taken at any time from the Institution by any
employe, patient, or other person. He shall visit clothes rooms and closets several
times a weekj see that they are neatly arranged, that clothes and blankets are aired
frequently and protected from moth. The general cleanliness of the institution will be
under his care.
ATTENDANTS.
1. There shall be two or more Attendants assigned to each ward, one of whom shall
be designated as " Chief Attendant," who, in addition to the usual duties of Attendant,
will have general charge of the ward to which he is assigned, preserve order, attend
especially to the sick, see that they are treated with great care and kindness and in all
things assist in carrying out the views and instructions of the Medical Officers, in reference to the treatment of patients and care of wards. He must give special attention to
homicidal and suicidal patients and never permit an inexperienced attendant to take
such patient off the ward or attend alone to the wants of a homicidal patient.
If a Chief Attendant shall knowingly conceal the infringement of any rule by any
attendant in his ward the penalty attached to the infringement of the particular rule
shall thereby be incurred by him.
2. Attendants will be held responsible for the cleanliness, good order and general
appearance of their respective departments, and to this end shall make every effort to
perform their duties creditably to themselves and acceptably to the Medical Superintendent. They must expect an unceasing observation of the manner in which they
perform their duties, and the suggestions, Dy an officer, of "omissions on their part, or
needed improvements, are to be received kindly and without offense, and an effort made
to carry them out.
3. Attendants are expected to be always neatly dressed, to avoid all ungentlemanly
habits; not to indulge in boisterous talking or laughing; nor to use profane or vulgar
language; nor to play at any games with one another, or the patients, except by permission of the Medical Superintendent. Patients will look to Attendants for a good
example; let Attendants, therefore, be careful never to set them a bad one.
4. Attendants are at all times required to treat patients with kindness, gentleness and
forbearance and under all circumstances to speak mildly and calmly, endeavoring to
soothe them when irritated and to cheer and encourage them when depressed.
Patients are never to be pushed, collared or rudely handled.
In order to
induce them to move, gentle measures will in most cases suffice. Under no
circumstances will an Attendant be excused for laying violent hands upon a
patient or striking a blow, except in the clearest case of self-defense or to prevent
his committing serious injury to himself or others. The striking of a blow is never
excusable if there is more than one Attendant on the ward. Attendants must never
irritate, mock, deride, or ridicule patients, and they are especially forbidden to commu-
�RULES AND REGULATIONS.
43
nicate their names, histories or peculiarities to strangers, either in the Asylum or out of
it.
5. Attendants should hear with patience and answer with caution; should never
promise what cannot safely be performed, and having made a promise be faithful in its
execution.
6. Attendants are never to apply any restraining apparatus to the person of apatient,
nor to seclude a patient, except in case of great emergency, and then they must immediately notify a Medical Officer.
7. The Attendants shall rise, in the morning, at the ringing of the bell, and at once
commence the duties of the day. On opening the doors of the sleeping rooms, they shall
greet the patients kindly, see that they arise from their bed, are neatly dressed, properly
washed, and their hair and clothes well brushed, in time for breakfast at the prescribed
.hour.
8. Immediately after the patients have arisen from bed, the Attendants shall have all
the chamber vessels removed, emptied and thoroughly cleansed; the beds spread open
for airing, and soiled beds and bedding removed from the wards. The beds are then to
be made, and the halls, bath rooms, passages and stairs to be swept, and the whole premises put in complete order, as soon as it can be done, so that a thorough inspection may
be had of the house by the Assistant Physician, commencing at 9 o'clock.
9. At meals, the Attendants must always be present to serve and distribute food to those
who are incompetent to do it for themselves, and to see that every one is properly supplied.
They must see that no patient carries away a knife, fork, or any other article from the
table. If a knife, fork, spoon or other article is missed it must be reported to the Medcal Officers or General Supervisor at once. Food is not to be carried to the rooms of
patients, nor is any one to be absent from the regular meals, (except in cases of illness
or violence) without permission of one of the Physicians.
10. Attendants must never allow a patient to obtain any razor, knife, scissors, rope, cord,
medicine, or any dangerous weapon or article. To prevent this, patients must be constantly watched, their beds frequently searched and the knives, forks and spoons
counted after each meal. An Attendant must never deliver a letter or any writing,
from or to a patient, withoi: t permission of the Medical Superintendent, nor retain in his
or her possession any writing of a patient.
11. No Attendant is ever allowed to leave the ward to which he is assigned without
permission of the General Supervisor or one of the Medical Officers except in case of
great emergency. One Attendant must constantly be in each ward with the patients,
and must not leave, under any circumstances, except when relieved. The Attendants
in each ward are responsible for the safe keeping of the patients therein, and must not
leave them, unless permitted to do so by a Medical officer. There is an obvious impropriety in Attendants sitting in their rooms engaged in reading or writing, during the
hours of duty—i. e., from the time the patients get up in the morning until they retire at
night. Nor should they be in their rooms at any time during the hours of duty any
longer than may be necessary to adjust their own dress. All these hours, with this
single exception, must be devoted to the patients, endeavoring to keep them tidy, to
prevent improper conduct, bad postures (such as lying on the floor, etc.,), and to
instruct, comfort and amuse them, by talking with them, reading to them and the like.
12. No patient's door is to be left unlocked at night, without special permission of
the Medical Superintendent. In locking the door, be careful always to hear the bolt
slip. At the retiring hour, the Attendants must see that every patient is actually in
his or her room (unless otherwise ordered by the Medical Superintendent) and that his
or her clothing is neatly folded and placed outside the door. Attendants on duty at
night must never enter a patient's room alone.
13. Every patient must be in charge of some responsible person at all times, unless
permitted to be at large by the Medical Superintendent. The person who takes a
patient from a ward shall be accountable for his or her safe keeping until returned to
the same. Attendants must carefully examine and search, upon their return to the
wards, all patients who have been out, and see whether they have concealed anything
about them which might be used as a weapon.
14. Attendants must constantly observe the habits and conduct of patients, and
inform the Assistant Physician, at his daily visit, of all circumstances, such as loss of
appetite, costiveness, tendency to suicide, etc.
15. If any patient is discovered to be missing, the fact must be immediately reported
to one of the Physicians.
16. Attendants must report all damages done by male patients, and all their wants of
clothing or other articles to the Supervisor. Damages done by, and also the wants of
female patients must be reported to the Assistant Physician or Matron.
17. Attendants must never give up a key, nor admit any person into the wards without
�44
MICHIGAN ASYLUM FOE INSANE CRIMINALS.
permission of the Medical Superintendent or Assistant Physician. No male attendants
shall enter the apartments occupied by females, without special permission of the medical Superintendent.
18. The Chief Attendant must give personal supervision to bathing patients, be particular to see that the water is of proper temperature and renewed for each patient, and
that finger and toe nails of each patient are carefully and neatly trimmed.
19. Two Attendants must always be present during the operation of shaving, and no
patient is to be sent from the chair until his face is smooth, clean and dry, and his hair
properly trimmed and brushed.
20. Attendants must wear their coats in the wards, except while doing the morning
work and bathing the patients. Talking of matters concerning the Asylum with or
before any of the patients, or to outsiders, is strictly forbidden.
21. The Chief Attendant must always keep near the Medical Officers when they visit
the wards, to answer questions or give information.
22. The Chief Attendants must make written reports daily, of all the incidents of the
previous day, in the manner directed by the Superintendent.
23. It is expressly understood that Attendants will not carry a knife while on duty.
24. As the duties of each Attendant are confined almost exclusively to a single ward
they can have no reason to be in any other unless by direction of the proper officer. In
going from one part of the building to another they will avoid passing through wards
unless absolutely necessary.
NIGHT WATCHMAN.
1. The Night Watchman's hours of duty will begin at 7 p. m. and will continue until
6 a. m. the following day; at the hour of going on duty he will call at the Medical
office for special instructions for the night. While on duty he shall be constantly
awake, faithful and vigilant. He shall visit each ward in the male department at least
every hour during the night or oftener if directed by the Superintendent. He must
never converse in a loud tone with any one, and must move about and open and shut all
doors as quietly as possible.
2. In the treatment of patients, he must observe the same rules as the Attendants.
He must be attentive to the sick, and faithfully execute any orders respecting them.
He must provide the patients with water, if they require it, and attend to any reasonable wants expressed by them. He must be on the alert for any unusual noise in the
patients' rooms, ascertain the cause, and, if necessary, notify the Attendant. He must
never open a door or enter a patient's room alone.
3. He shall visit the halls of the administration building and pass out to the front
and to the rear of the Asylum frequently during the night, and shall attend to the fires
in. the kitchen, laundry, etc., and record the number of gauges of water in the boiler
each hour during the night.
4. He will ascertain if all the Attendants are in their rooms at the hours prescribed,
and after that hour through the night, opening the doors of their rooms for the purpose,
if necessary, and report any deviation from the rules.
5. If a fire occurs in any part of the premises he will make every effort to extinguish
it, and, if he cannot succeed, will quickly and quietly summon the Supervisor, Attendants, Engineer and Medical Officers.
6. He shall report in writing, to the Medical Superintendent, each morning, any
unusual circumstance requiring attention, any violation of the rules of the Asylum,
that may have come under his notice, and also how new patients have passed the
night, and give the names of those who have been wakeful or noisy.
7. He must see that no unnecessary lights are burning, and report employes who
leave their rooms without turning out the light.
8. He shall ring the bell at night and in the morning at such times as directed, and
shall at all times perform any service required by the Medical Superintendent.
1. The Cook shall, under the direction of the Superintendent and Steward, see to the
safe keeping and economical use of the supplies issued to him. He shall see that the
food is properly cooked and distributed, and that nothing is wasted; and shall be particularly careful that the food intended for patients is not appropriated by others. He
shall see that no extra or unusual articles are cooked for those in the kitchen, nor sent
into the wards, without an order from one of the Medical Officers.
�RULES AND REGULATIONS.
45
2. He shall prepare special diet for patients upon the written order of any Medical
Officer and shall do so cheerfully at any hour required.
3. He shall keep the kitchen and kitchen store rooms and all their appointments clean
and tidy; see that his assistants are not wasteful, and shall report to the Steward any
instance of wastefulness on the part of Attendants or patients. He shall endeavor to
preserve order and harmony among his assistants; prevent smoking, quarreling or idleness, and permit no persons to enter the kitchen, except on special business. He shall
be responsible for the safe custody of patients detailed to assist him, and must not permit them to stray beyond the limits prescribed by the Medical Superintendent.
LAUNDEY ATTENDANTS.
1. The overseer of the laundry shall collect the clothing and other articles to be
washed, as directed by the Supervisor and Matron, and see that they are properly
classified, washed, dried, and conveyed to the ironing-room. It shall be his duty to see
that those employed are attentive and faithful throughout the hours of labor and that
good order and cleanliness prevail in the laundry.
2. The person in charge of the ironing-room will see that clothing and other articles
delivered from the washing-rooms are properly ironed and correctly distributed.
She shall have the custody of clothing that is not legibly marked, and furnish a list of
the same to the Matron.
GAKDENEK.
1. The Gardener, under the direction of the Medical Superintendent and Steward,
shall have the care of the garden, pleasure grounds and 'greenhouse, and will see that
they are kept in good order.
2. He shall also have charge of all implements belonging to his department, and see
that they are properly preserved.
3. Patients detailed to assist him must be treated with kindness and respect, and
must not be compelled or permitted to work beyond their strength or in bad weather.
4. He Will consult the Medical Superintendent and Steward respecting such seeds as
may be required, and the amount and variety of vegetables, etc., it is desirable to
raise.
5. He will see that the kitchens are promptly supplied each morning, or at other
times of the day, if so directed, with such vegetables as may be in season.
6. He shall not exhibit the greenhouse or grounds to visitors without special permission of the Medical Superintendent, and must, as far as possible, prevent any depredations being committed in the garden or grounds, and keep a correct account of all the
products of the garden, and shall report the same to the Steward, in writing, at the end
of each month.
ENGINEER AND STEAM FITTER.
1. The Engineer and Steam Fitter, under the direction of the Medical Superintendent, shall have the personal charge of the steam fitting shop, boilers and steam machinery, warming and ventilation, fire extinguishing and steam cooking apparatus, dumb
waiters, sewers, pipe-fitting, gas and water supplies, water closets, etc., and shall also be
responsible for the conduct of the fireman and those detailed to assist him.
2. He shall permit no patient or other person to enter the boiler room, or steam fitting shop, without special permission of the Medical Superintendent, or upon a necessary errand.
3. It shall be his duty to supply steam for heating in cold weather, and for cooking
and washing; to keep the tanks well supplied with water, and furnish sufficient hot
water for all purposes required.
4. He will make such alterations and repairs of the apparatus under his care as may
be needed, and shall frequently confer with the Medical Superintendent respecting the
needs of his department.
5. He will have charge of all tools and stock in his department; see that they are
carefully preserved, and that good order and system prevail. He will carefully regulate
the consumption of fuel, prevent all waste of steam, water or coal, and see that the fire
hydrants and hose are kept ready for use at a moment's warning.
�46
MICHIGAN ASYLUM FOR INSANE CRIMINALS.
DUTIES OP THE MESSENGER.
1. The Messengers of the administration building will always be prompt in answering
the door bell, will receive every visitor with the utmost courtesy, and having ascertained
the object of the call, will see that it is attended to without delay. Whatever be the purpose of the visit, one of the physicians must first be consulted. If no one of the physicians is in the office, he will lose no time in finding one, in order to avoid the unnecessary detention of visitors, or persons having business at the Institution. All information in regard to the patients must be given by the physicians.
CARPENTER.
1. He shall call at the Superintendent's office to receive orders for repairs, daily, at
12 o'clock m.
2. He shall have the immediate care of the carpenter shop, and be responsible for the
economical use of lumber and all materials purchased for his department.
3. He shall not allow any one to make use of the tools, lumber or other material
under his charge without permission of the Medical Superintendent.
4. In performing work on wards he will be expected to have no surplus tools and have
an Attendant always present.
5. In making repairs in rooms the room in which he is engaged must if practicable be
locked.
RULES IN REGARD TO WARDS AND PATIENTS.
1. Every part of the wards is to be kept scrupulously neat, clean and well ventilated
at all times.
2. If a vessel is used during the day by a patient or if any bedroom or part of the
ward is soiled it is to be attended to at once.
3. Whenever the bed or furniture of a room is disarranged it must be promptly put
in order.
4. Sweeping, mopping or other work will be done as often each day as is necessary to
keep every part of the building perfectly clean and in order.
5. A clean sheet and pillow case are to be put on each bed at least once a week and
spreads, blankets, sheets and ticks must be changed as soon as soiled and the pieces
taken to the laundry at once.
6. All beds are to be well aired at least once a week.
7. Patients are to have their laundried clothes changed regularly.
8. The clothing of patients is to be kept neat and clean and well brushed at all times.
If buttons are lacking or holes are found in a garment repairs are to be made at once.
Untidy patients must be kept clean and dry at all times.
9. All male patients are to be shaved twice each week unless otherwise ordered by a
Medical Officer.
BATHING PATIENTS.
1. Each patient must be bathed at least once a week unless otherwise ordered by a
Medical Officer.
2. In preparing a bath the cold water is always to be turned on first.
3. Before the patient enters the bath the temperature is,to be ascertained and is not
to be below 88 degrees nor above 98 degrees.
4. A patient's head is never to be put under water.
5. Especial care must be taken to dry and clothe quickly those patients who are feeble and helpless.
6. A patient must never be allowed to bathe without an attendant being, present.
7. After a bath the finger and toe nails of each patient must be trimmed.
8. The bath tub is to be emptied and cleansed after each patient.
DIRECTIONS FOR THE CARE OP SICK AND PEBBLE PATIENTS.
1. When a patient complains of being sick or is supposed to be sick report should
be made at the medical office at once.
�RULES AND REGULATIONS.
47
2. In making the beds of sick and feeble patients, care must be taken not to raise
them suddenly from a horizontal to an upright position, for fear of an attack of syncope.
If a patient is very feeble a second bed should be provided.
3. Food should be brought to sick patients in neat dishes upon salvers supplied with
clean spreads and especial pains taken to render the appearance of the food inviting and
appetizing.
4. The hands and faces of sick patients should be freshly bathed, the hair neatly
brushed, the nails cleaned, and the bed re-arranged previous to their taking food.
5. Every article of clothing or bed clothing should be changed as soon as it becomes
soiled, wet or offensive.
6. In cases of diarrhea or dysentery a careful disinfection of all discharges is enjoined.
The room must be scrupulously neat and well aired from time to time.
7. In giving a sponge bath precaution must be taken not to exhaust the strength of
the patient. The room should be warm, a portion only of the body should be exposed
and bathed, and the part bathed should be carefully dried and re-covered before proceeding to another part.
ADMINISTRATION OF MEDICINE.
1. Medicine will be administered only as directed in writing by one of the physicians.
2. The utmost gentleness is to be used in giving medicine. When it is positively
refused its forcible administration is not to be resorted to without a physician being
present, or a special order from a medical officer.
3. Any unexpected effect in the operation of medicine is to be promptly reported to
one of the physicians.
SUICIDAL
PATIENTS.
1. When a patient has a disposition to commit suicide or injury to his person, there is
no security but constant watching. Care must be taken to place out of reach all the
means that would likely be resorted to and the patient kept constantly in sight. In a
case where the desire to suicide is strong a single minute is sufficient for them to
accomplish their design.
2. Especial care must be taken of such patients about twilight meal time, and all
times when the general attention is distracted, as these are the times when attempts
are most likely to be made.
3. Especial care must be taken at all times that patients do not get in their posession
knives, razors or dangerous weapons of any kind. Frequent search for such articles
must be made in the wards.
4. Anything seen lying about the wards, yards or grounds that might prove dangerous in the hands of a violent person, should be promptly and carefully removed.
HOMICIDAL AND DANGEROUS PATIENTS.
1. The foregoing in regard to suicidal patients applies equally to homicidal and
dangerous patients.
PATIENTS NOT TO DO WORK FOR
EMPLOYES.
1. Patients are not to do any sewing or other work for the private benefit of Attendants or other employes.
PRECAUTIONS AGAINST ACCIDENTS.
1. Knives, forks and spoons must be counted after each meal, and positive knowledge
had that none are missing before patients are allowed to leave the dining room.
2. Bread and carving knives are never to be entrusted to patients, and special care
must be taken of them.
3. No patient is to be allowed upon any pretext to go to the kitchen, carpenter shop,
engine or boiler room, or any place where dangerous weapons may be secured, except
by written order of the Medical Superintendent.
4. Dining room and kitchen doors are to be locked at all times, except when passing
through.
�48
MICHIGAN ASYLUM FOE INSANE CEIMINALS.
5. The towel rollers must always be properly secured, and the doors of elevators, dust
and clothes shafts always locked.
6. All steam and water leaks, broken glass, lack of heat, impairment of locks, etc.,
must be promptly reported.
7. Patients must never be allowed in Attendants' rooms. When necessary for Attendants to enter their rooms during the day they will close and lock the doors on entering
and leaving.
8. Special care of tools must be taken and watchfulness of patients exercised when
engineer, carpenter or other mechanic are engaged in making repairs on wards.
PRECAUTIONS AGAINST FIKE.
1. Never leave rags saturated with oil or grease in contact with wood. Never throw
them down shafts, as there is danger of their igniting spontaneously.
2. Never trust patients with matches. Never throw down burning match ends.
3. Never leave clothing in contact with steam pipes.
4. Draw and leave standing after the retiring hour all bath tubs full of water, and
leave at least five water pails beside each tub.
5. The Night Watch will report any omissions to leave water in bath tubs, and the
specified number of pails beside each tub.
ALARM OF FIRE.
1. If fire is discovered use the pails of water from bath rooms and attach and turn on
. the ward hose. Notify at once the Medical Superintendent, Engineer and Supervisor.
HOW TO SUPPRESS PIKE.
1. Use water provided in bath tubs, pass it in pails to the desired point. If necessary
form a line of trusty patients for this purpose.
2. Attach hose to stand pipes. After bringing nozzle end as near the fire as possible,
turn on water. If it will not reach fill pails from it until additional hose can be
brought from wards not in immediate danger.
3. If smoke escapes from a dust or clothes shaft turn water down it from pails or hose.
If from heating flues place mattresses against them. When smoke is dense there is
always a stratum of pure air at the floor. Therefore, in order to discover the source of
smoke, or to, escape, creep along the floor with the head as low as possible.
CARE OP PATIENTS IN CASE OF PIRE.
1. The first thought in case of fire should lie the safety of the patients. All efforts
to save the building must be subordinate to this consideration.
2. If fire originates in center of building congregate patients at end of ward farthest
from the fire. An Attendant must enter each patient's room, see that no patient is in, and
lock the door to prevent patients from returning to them. Unless absolutely necessary,
patients should not be taken from the building except by direction of a Medical Officer
or General Supervisor.
3. In the absence of a Medical Officer or General Supervisor, or specific orders, those
in charge of patients must do what is thought best to care for them in the safest manner possible. Be sure no patient is left behind. Restrain disturbed and dangerous
patients if possible.
4. There will probably be abundant time for the removal of all patients. Do not
take patients out insufficiently clad if practicable.
SUGGESTIONS.
A few special facts and principles should be constantly kept in mind by all persons
connected with the management of the insane, but more especially by the Attendants
to whose care and keeping they are entrusted.
1. Insanity is generally associated with and dependent upon some bodily disease or
infirmity.
�RULES AND REGULATIONS.
49
2. There is usually a loss or serious impairment of the sense of moral obligation and
an inability to act upon such a distinction, hence the patient is not responsible for his
words and actions.
3. There is usually a full appreciation of all acts of kindness or courtesy, and frequently a recollection of them after a restoration to health.
4. There is usually a morbid or exalted sensitiveness in relation to what is due to
them in attention and general deportment and consequently irritation, excitement or
anger, at either real or imagined neglect or improprieties of treatment, and the recurrence of such paroxysms or outbursts of excitement or anger aggravates and perpetuates the disease.
5. The more the mind dwells upon or is in any way reminded of hallucinations or
delusions, the more permanently they are fixed; so is the reverse true, that the more
entirely they are excluded from the mind by occupation with other thoughts and ideas,
the sooner do they disappear altogether.
1. For the purpose of enabling the public to obtain a correct knowledge of the
arrangement and management of an asylum for the insane, and of doing so without
interference with the regular duties of the officers and the transaction of necessary business, visitors may, by obtaining a permit from the Medical Superintendent, be admitted
to such portions of the house as may be occupied by quiet patients between the hours
of two and four in the afternoon of every day of the week except Sunday, Saturday,
and the holidays.
2. Exceptions to this rule may be made in favor of public officers, persons connected
with public institutions, and relatives of patients.
3. Friends of attendants, assistants, and officers, are requested, as far as pocsible,
to confine their visits to these hours, and will not be allowed to enter the wards
except under the prescribed restrictions.
4. The person appointed to conduct visitors through the wards will not be permitted
to converse about patients by name or to point them out, and visitors are requested to
observe an appropriate discretion in this respect.
5. Persons wishing to see patients, or learn their condition, will make inquiry of the
Superintendent or Assistant Physician, at the medical office. As a rule, information
concerning patients will not be furnished, unless to relatives and public officers, and
only by the medical officers.
GENERAL KTTLES.
1. All persons employed in the Asylum are expected to see their department is kept
in perfect order and neatness. No part will be regarded as clean, if it can be made
cleaner.
2. They are to consider that their whole time, except what is required for personal
duties, belongs to the Asylum, and they are not to leave their duties, or the premises,
without express permission of the Medical Superintendent, or, in his absence, the
Assistant Physician. They are expected to perform cheerfully, and to the best of their
ability, all duties assigned them by the Medical Superintendent.
3. All persons employed in and about the Asylum are expected to treat the patients,
and those having business at the Asylum, and each other, with civility and respect.
4. No employe shall buy of or sell to a patient anything whatever, nor receive gratuities or presents from patients, or their friends, except by permission of the Medical
Superintendent.
5. When abroad, employes are to avoid speaking of the names or peculiarities of
patients, and are never to speak disrespectfully of the Asylum or any of its officers.
6. No male employe, except officers, shall enter any portion of the building or grounds
occupied by female patients, or female employes, without express permission of the
Medical Superintendent or Assistant Physician.
7. No person, friends or acquaintances of employe's, shall be lodged or fed in the Asylum, or admitted into the offices, wards, kitchens, bakery, wash-house, boiler room, carpenter shop, or other department of the Asylum where they are not employed, without
express permission of the Medical Superintendent or unless upon a necessary errand, or
in accordance with such rules as the Medical Superintendent may establish; and
employes, when on errands, must not be absent from their post longer than is absolutely necessary.
7
�50
MICHIGAN ASYLUM FOB INSANE CRIMINALS.
8. When abroad on leave, the hour for return is 10 o'clock, at which time the doors
will be locked, and no person admitted afterwards, without being reported to the Medical Superintendent. It is the wish of the Medical Superintendent to allow as much
relaxation as possible to those who faithfully discharge their duties, and to such will be
granted as much leave of absence as the interests of the service and the welfare of the
Asylum will permit; but whenever, for any reason, the absence of employes is deemed
likely to be prejudicial to the interests of the Institution, they are expected to willingly
remain at their posts. Application for leave of absence beyond the regular hours, must
be made to the Ward Supervisor before 9 a. m., and the number of hours desired must
be stated in each instance. Promptness in returning at the hour to which leave of
absence was given is always to be carefully observed. If unforseen circumstances positively prevent this for any length of time, word should be sent to the Asylum. Without special permission no employe is to leave the premises at any time or for any purpose.
9. No conversation must ever be held through the windows, by subordinate employes
or visitors, nor must anything be thrown through the windows.
10. No light must be carried about the buildings except in a lantern, and the greatest
care must be taken in the use of matches that none be left exposed, and no matches
carried by any employe except the safety match, adopted for the use of the institution.
Carelessness in this particular may be followed with the most serious consequences.
11. No person shall be retained in the service of the institution who is found at any
time in a state of intoxication. Whenever any one is discharged for violation of rules
or improper conduct, no notice will be given in advance or payment made, except on
the terms of the printed agreement made with employes.
12. All persons employed in any capacity upon the premises whose duties are not
especially defined here will nevertheless be expected to conform to the general spirit of
the rules in every particular.
13. Steam in employes rooms must be turned off when they leave them for the day's
work.
14. Lights must be turned out when the occupant or occupants leave the room.
15. The rising bell shall be rung for two or three minutes at 4:45 o'clock a. m., in
May, June, July, August and September, and at 5 o'clock a. m., in October, November,
December, January, February, March and April. All persons having duties to perform
in the Asylum, will rise promptly at the ringing of the morning bell. The "retiring "
bell will be rung at the hour designated by the Superintendent.
16. Breakfast will be served precisely one hour and a half after the ringing of the
rising bell. Dinner will be served at 12 m., the year round; and supper at 6 p. m., in the
spring, summer and fall, and 5 p. m. in the winter.
17. Sunday is to be a Sabbath or day of rest and quiet at the Asylum. The grounds
are not to be exhibited to visitors on this day, nor shall any visitor be admitted into the
wards or Attendants' rooms, except upon express permission of the Medical Superintendent.
18. The officer or employe to whom this pamphlet is presented will receive the same
in an official capacity, and its contents as an official notification of the duties required
of him or her. After its receipt, ignorance of the Rules of the Asylum will not be
admitted as an excuse, upon the part of any officer or employe, for dereliction of duty.
19. The recipient of this pamphlet must preserve it in good order, and in the event of
his or her resignation or dismissal, must return it with his or her keys, to the Superintendent before a final settlement ^yill be made.
20. The loss, destruction or mutilation of or writing of names in this pamphlet will
involve a forfeiture of one dollar, unless it can be satisfactorily shown to have occurred
accidentally.
21. During the hours of duty employes are not to take a general bath, shave or do
any work for their private benefit. And after hours of duty female employes are not
allowed to make new garments in the institution.
22. Medicines sent to wards must be placed in a locked drawer or cupboard and
never left exposed in a room.
23. Violation of any of the foregoing rules ie sufficient cause for discharge in the
discretion of the Medical Superintendent.
�
asylums
-
https://localhistory.tadl.org/files/original/a05946683be2f0fd3dc23564a9f692e7.pdf
63142713c8fc6be5729bd09f72714c92
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Title
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Traverse City State Hospital
Subject
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Asylums.
Psychiatric hospitals.
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Items within this collection pertain to the Traverse City State Hospital, also known as the Northern Michigan Asylum for the Insane and the Traverse City Regional Psychiatric Hospital.
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Amy Barritt, 1984-
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Original documents held by the Traverse Area District Library.
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Various.
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1885-1989
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Board of Trustees for the Traverse City State Hospital.
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TCSH-xxxx.
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Traverse City, Grand Traverse County, Michigan.
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Report of the Board of Trustees of the Michigan Asylum for the Insane for the years 1857-1858.
Subject
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Psychiatric hospitals.
Description
An account of the resource
Report created by the Trustees of the Michigan Asylum for the Insane to the Legislature of the State of Michigan, covering fiscal years 1857 and 1858. The Michigan Asylum was located in Kalamazoo. This report details the devastating fire, likely an act of arson, which destroyed one-fifth of the center building on the campus, the building in which most communal activities took place; no one was injured.
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Board of Trustees of the Michigan Asylum.
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Lansing: Hosmer & Kerr, Printers to the State.
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1859
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State of Michigan.
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MSH0002
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Michigan, United States.
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Text
R E P
OF THE
B O A R D OF T R U S T E E S
OP TEE
MICHIGAN ASYLUM
O R,
T IT
A MK
Hosmer & Kerr, Printers to. the Siate,
1859,.
V-
-
�OFFICERS OF THE ASYLUM.
TEUSTEES.
LUTHER H. TRASK,
President.
J. P. WOODBURY,
.Secretary.
HENRY MONTAGUE,
Acting Oom'r.
E. H. VAN DEUSEN, M. D.,... .Medical Superintendent.
�STATE OP M I C H I G A N
No. 13.
LEGISLATIVE, 1859.
REPORT of the Trustees of the Michigan Asylum for the Insane.
To the Legislature of the State of Michigan:
In obedience to the requirements of the statute, the Board
of Trustees of the Michigan Asylum for the Insane respectfully submit the following Report, for the two years ending November 30th, 1858 :
When we assumed the charge of the Institution, in the
spring of 1857, we found the center building and the extreme division of the south wing erected and slated. The
two-story portions of the wing were built up and ready for
roofing. The walls of the first transverse division had
been carried up as high as the second floor, and the second
transverse division was also ready for slating.
In this connection, we would express our entire approval
of the plans adopted, and the course pursued by our predecessors. Prom the knowledge we have been able to acquire in reference to the peculiar architectural requirements of such institutions, we are convinced that the building is very perfectly adapted to the purposes of its erection;
1
�6
Doc.
and we find that it loses nothing, when compared with
even the more expensive asylums in sister States. The
patients' rooms are large and airy; the corridors are spacious and cheerful, and, with but one exception, open out
directly to the atmosphere at either end. The sitting and
work-rooms are commodious and well lighted. When finished, the facilities for separating the various classes will
be very complete. In fine, nothing, as far as the building
is concerned, which could contribute to the comfort and
restoration of tha inmates, seems to have been overlooked.
They have given a thoroughly professional basis to the
Institution, by adopting for their rule of action the embodied experience of the "Association of Medical Superintendents," as expressed in a series of " PBOPOSITIONS " on
Construction of Asylums, unanimously adopted at a convention held in Philadelphia, May, 1851. By the early appointment of a medical officer, "with the view of having
the building erected so far under his supervision as to secure his approbation when finished," all capricious modifications and changes in plan and policy have been avoided.
Dr. Van Deusen, who received the appointment of Medical
Superintendent, has rendered us invaluable assistance in
every stage of the work. Though retaining his position
as First Assistant Physician in the N. Y. S. Lunatic Asylum, at Utica, until October last, when directed by the
Board to assume his duties here, he has been in frequent
correspondence with us, and has visited the State whenever
his services were required.
Previous to 1857, the affairs of the Institution at Flint,
and of the Asylum for the Insane, were under the direction
of a joint Board of Trustees. The Legislature of that
year dissolved this connection; and, to give greater permanency to tha Board assigned to each Institution, very judiciously arranged their appointment in such manner that
the term of office of but a single member should expire at
one time. The wisdom of this course is very apparent.
�No. 13.
7
At the same session," the sum of twenty-five thousand dollars for the year 1857, and a like sum for 1858," were appriated for the use of this Institution.
The Board was at once organized according to the provisions of the Act, and the work of construction was urged
on as rapidly as the limited appropriation at our disposal
would allow. During the succeeding summer and fall, theextreme division of the south wing was plastered, glazed,
and partially floored; joists were laid throughout the
entire wing ; the walls qf the second transverse division
were carried up, and the entire wing slated. The cupolas
were also built, tinned, and put in connection with the
foul air ducts. Stairways were erected upon the second
and third floors of the extreme division of the wing, and
in the attic of the center building.
At this stage of the work, the Institution sustained a
very serious loss in the burning of the center building, by
which accident nearly one-fifth of the portion erected was
laid in ashes. Very fortunately, with the exception of the
stairways and a few squares of flooring, but little of the
inside work had been finished. The building was ninetysix by seventy-two feet, four stories high,, with two octagonal projections in front, and surmounted by a cupola. It
contained the officers' apartments, kitchen and diningrooms, the business and medical offices, the general storerooms, and patients' reception rooms. Though not very
extensive when compared with the remainder of the Institution, it is essential to, and serves the most important
purposes in its operations.
At eleven o'clock on Thursday night, Feb. llth, flames
were discovered in the upper stories, at the south-west
corner of the building. The alarm was promptly responded to by the fire-department, and the citizens generally of Kalamazoo. Little, however, could be done to
save the building. Those first upon the ground, found the
entire upper portions wrapped in flames, and the cupola
�8
Doc.
and its attachments fell almost immediately thereafter.
The fire-proof division between the wing and the center,
which will interpose aii effectual barrier to the passage of
fire from one to the other, was unfortunately in an unfinished condition, and the danger of the extension of the
flames to the wing was at one time imminent. At thig
juncture, however, the master builder at the Institution,
and the mechanics employed with him, stationed themselves upon the roof of the wing, and with the walls of the
center building tottering over their heads, remained at
their self-assigned post until all danger had passed.
We avail ourselves of this opportunity to express the
deep indebtedness of the Institution to their heroism, and
our high appreciation of the self-sacrificing and disinterested spirit they exhibited on that occasion. Though
each, in the destructiou of a valuable set of tools, sustained
a very serious loss, there is left to them the pleasing consciousness " of having well performed a manly part."
From a judicial investigation, instituted immediately
after the fire, it appeared that every ordinary precaution
had been observed, to prevent such an accident. The
person to whom was assigned the care of the stoves used
by the workmen, had performed his duties in the usual
manner ; and that the fire could not have been communicated in that manner was made apparent by the fact that
the part of the house in which they were was the last
burned. The only stove near the part first discovered to
be burning, was in a small room upon the lower floor; and
subsequently, in clearing the ruins, rolls of working-plans,
which were left tying about this room, were found crushed
by the falling walls, but untouched by fire.
The only plausible explanation of the cause of the accident is, that some person had visited the house for the
purpose of theft, and that the fire had ignited from a cigar
or pipe, or perhaps from the match used in striking a light.
This view is sustained by the evidence of two individuals,
�No. 13.
9
both of whom, from different positions, saw a light moving
from room to room but a short time previous to the alarm.
The pecuniary loss, as nearly as can be estimated, is
122,000. Of the material selected from the ruins to be
used in reconstruction, a portion, perhaps, may prove unfit
for the purpose, but we think that the sum named will
fully cover the loss. IE reviewing this accident, we feel it
our duty to call the attention of the Legi?lature to the increased risk of loss and damage to the Asylum, incurred
by the delay in its completion. A distinguished writer on
" Insurance" remarks, that " unfinished buildings, even of
fire-proof construction, are never free from danger, and
that insurance rates should, in such cases, be proportionably higher."
It is now nearly five years since the Asylum was commenced, and any one who has had experience in building,
even to the extent of a farm-house, knows that the policy
of making small appropriations at long intervals, is anything but an economical one. No private individual or
corporation could afford to adopt such a policy. The
course hitherto pursued is certainly not a judicious one.
A sense of duty and justice compels every thinking man
in the State to say that the Asylum should be completed,
and the miserable condition of four huadred insane fellow
creatures scattered all about us, many in chains and cells,
demands its immediate opening. What advantage can
there be in delay ?
Facts which came to our knowledge almost immediately
after entering upon our official duties, convinced us that
no time should be lost in prepariug at least a part of the
Institution for the reception of patients. Letters were
constantly coming to us from the friends of insane persons
in almost every county, containing sad tales of the trials
and anxieties and dangers growing out of the afEiction
which had befallen them, all bearing the same inquiry—
" When will the Asylum be ready for patients 1"
2
�10
Doo.
County Superintendents of the Poor, also forwarded communications, representing the serious inconveniences under
which they labored in endeavoring to provide for the insane committed to their charge. They had found, that
even with every facility they possessed, they could do
nothing to cure them, and but little to better their condition. None were discharged restored, a few occasionally
wandered away, and death came to the relief of more or
less each year, and still the number was gradually increasing. They were anxious to know if something could not
be done to lessen this accumulating amount of misery and
taxation.
We, therefore, felt it obligatory upon us to do all in our
power to meet, this necessity, and shaped our course accordingly. The fourth section of the Act under which we were
appointed, invests us with the " control and management of
the Asylum, and all its affairs in as full and ample manner
as the existing Board of Trustees." On referring to the
original statute establishing the Institution, we find its
early opening evidently anticipated, and with this special
view, certain powers and duties were delegated to that
Board which, by the Act passed at the last session of the
Legislature, were transmitted to us.
Until the occurrence of the accident of February llth,
everything was favorable to the attainment of the end to
which we were impelled by our duty, both as almoners of
the charity of our State, and as citizens whose eyes had
been opened to the fearful extent of the sufferings they
were expected to contribute in alleviating. By the loss of
the center building, very serious obstacles were interposed
to the carrying into effect of our plans for the early opening of the Institution. We found that the unexpended
balance of the appropriation would only suffice te replace
the loss, and that the Asylum would be no farther advanced, as far as the treatment of patients is concerned, than
it was at the commencement of the year. The same bal-
�No. 13.
11
ance would also finish the wing for the reception of patients, but leave the officers unprovided for, and. in the absence of all arrangements for cooking, laundry work, &c.,
the Asylum could not even then be used. At this juncture, we directed the Acting Commissioner to communicate
with the Medical Superintendent, in regard to the feasibility of arranging apartments for the officers in some portion of the wing, and preparing for the treatment of at
least a limited number of patients,
We knew very well how essential the center building
was to the convenient and advantageous operation of the
Institution. It was planned to fulfill certain purposes, and
of course no other portion of the house could be made to
answer those purposes as well. We were aware, also, of
the many disadvantages under which the Medical Superintendent would labor in carrying on a partially finished
Asylum, even with the center building ; and we desired to
remove as many of the obstacles to its successful management as we possibly could. At the same time, we felt that
any farther delay in its opening should be no fault of ours.
Dr. Van Deusen's reply was to the effect, that the first.
and second floors of the first transverse division would afford temporary quarters for the officers, and that its third
floor, and the portions of the wing to the left of it, would
accommodate about ninety patients of one sex; that the
re-construction of the center building, and the erection of
the chapel containing the general kitchen, and the Infirmary, would render the first longitudinal division, with
accommodations for fifty-four additional patients, also available; and thus, that one hundred and forty-four, about
half of each sex, could be treated with a fair degree of
advantage.
This plan was adopted as the one which the interests of
the insane and the State most imperatively demanded, and
the balance of the appropriation has been expended ac-
�12
Doc.
cordingly. We now earnestly recommend to the Legislature that it be carried into immediate and full effect.
DuriDg the past season, all labor about the Institution
has been directed with a special view to the completion of
the portions as above designated. To this end. there has
been required a large outlay for purposes other than those
for erection simply. Gas-pipes, for instance, had to be
laid throughout the house previous to the flooring, and the
attic tanks procured and riveted before the upper ceilings
were plastered. All work of this kind has been well and
permanentiy done, and not a single cent expended for temporary fixtures.
The tanks, three in number, constructed of the best
English boiler iron, three-sixteenths of an inch in thickness, are placed in the attics of the three-story divisions.
Their combined capacity is about nine thousand gallons.
These will be supplied by means of a force-pump from the
stream in the rear of the Institution, To serve in case of
emergency and accident, two large cisterns have also been
built in convenient and accessible locations in the rear
yards. They are of brick, laid in water-lime, thirty feet
long, eight feet wide, and seven and a half feet deep.
Their combined capacity is twenty-seven thousand gallons,
and they will be supplied from the roofs. A main sewer,
about four hundred feet in length, designed to serve the
purposes of the entire Institution, has been laid in the
ravine in tront of the center building. The branch sewers
of the scuth wing have also been finished and put in connection with the main trunk. They are furnished throughout with the most approved traps, constructed of the very
•best material, and in the most durable manner.
In the rear of the center building, there has been erected
a one story building, one hundred and seventy-eight feet
long and twenty feet wide. In the extreme rear is the
Toom for the reception of the boilers to be used in generating steam for laundry and cooking purposes, and for
�No. 13.
13
warming the Institution. It contains, also, an engine,
laundry, drying and ironing-rooms, and a carpenter's shop,
Its external and division walls are of brick. The roof ia
covered with slate laid in mortar, and ventilating towers
with louvre sides, are placed over all the rooms.where
such provision was required. A large brick flue extends
from the boiler to the fan-room, in the extreme front, for
the passage of the steam-mains and service pipes. An
underground air-duct, eight feet wide and two hundred
and twenty feet long, has also been constructed, to connect
the fan-room with the distributing chambers, beneath the
building.
Messrs. Nason & Dodge, to whom our predecessors
awarded the contract for heating and ventilating the Institution, are now engaged in putting in as much of the apparatus as will be required for warming the portions of the
building we propose to occupy. Upon this contract there
will soon be due $5,000, less twenty per cent., reserved in
accordance with the requirements of the statute. The
proportionate expense of warming the portions designated
is, of course, greater thaa the entire contract would seem
to require. This apparent disproportion is explained by
the fact that the steam pump, mains, &c., are of the full
size whioh will bo required for the whole building. Here,
as elsewhere, we have studiously avoided all expenditures
for temporary fixtures and expedients.
The interests of the State, in every point of view, would
undoubtedly have been far better subserved had the first
appropriation been sufficient to construct the entire Institution. Contracts for labor, material and transportation^
could obviously have been made on more advantageous
terms. The Asylum would now have been in operation,
and we might even in this report have been able to present a gratifying account of high purposes fulfilled, of
great good accomplished, of misery alleviated, of reason
restored, and of afHicted fellow-creatures returned to them-
�14
Doc.
selves, to their families and the world. The past, however, cannot ba recalled, and it is only left us now to
advise that course which its experience has suggested, and
which the present condition of the Institution, and the
insane in our State, demand.
First, as regards the insane and their condition. That
it is the duty of the State to make special provision for
this afflicted class, all will admit. Whatever may be the
social position of the patient, the same necessity exists.
The most liberal county, with every advantage which generous appropriations and the most enlightened effort can
secure, must fail to give its insane poor the peculiar treatment their disease requires. This is not a merely speculative conclusion, but the experience of many counties in
other States, acquired by costly experiments, which it
would be worse than idle for us to repeat. Again, in more
favored positions, every comfort, luxury and attention
which wealth and the tenderest affection can bestow, is of
little avail. The restoration of the patient, in almost
every case, absolutely requires removal from home, and a
resort to those means of treatment, medical and moral,
which a special institution alone affords. "Although, with
great inconvenience, the affluent might provide suitable
private accommodations, a large proportion of our best
citizens, all in moderate circumstances, no less than those
dependent on their daily exertions for support, without
some public provision, must be deprived of much that is
desirable, almost as completely as the pauper portion of
the community. The simple claims of a common humanity, then, should induce each State to make a liberal provision for all its insane, and it will be found that it is no
less its interest to do so, as a mere matter of economy."
Eleven years have elapsed since the passage of an act
for the establishment of an Asylum for the Insane in this
State. It is not to be supposed that the effort then made
was at all premature ; and if there really existed a neces-
�No. 13.
15
sity for such provision at that time, how great must be
that necessity now! Providence has not arrested the progress of the disease, because the State has neglected to
provide for its victims. On the contrary, the causes which
produce it have continued in full and constant operation,
and the penalty of that neglect has necessarily followed.
No institution in our country has cured less than fifty per
cent, of all committed to its charge, and in recent cases
the proportion of recoveries is far greater. We have no
means of ascertaining definitely, but we know that a majority of those upon whom this affliction has fallen during
the last ten years, have been allowed to sink into hopeless
incurability, and the expense of their life-long maintenance
entailed upon the public. The number of insane in the
State is now about four hundred and fifty, of whom at
least three hundred are, at the present moment, proper
subjects for Asylum treatment.
The utterly wretched condition of a large proportion of
these helpless things, is well known. "We do not desire
to give greater publicity of the instances of inhuman neglect now disgracing our State. If required, to establish
the necessity of at once opening the Institution, the following extract from a late report of the Superintendents
of the Poor of one of our counties, upon the condition of
its jail, will suffice:
" The whole number of persons confined in said jail, during the six. months preceding the first day of November,
was one thousand and sixty-four, and they were confined
for the following causes, viz : Murder, three ; arson, one ;
burglary, six; grand larceny, eight; drunkedness and disorderly conduct, two hundred and thirty-eight; insane,
eighteen. * * * The prison is in a reasonable state of
cleanliness. * * * The prisoners say that they have
enough to eat; but many are in want of proper clothing.
* * * Some are shirtless, and some are without panta-
�16
Doe,
loons. The turnkey of the prison says that those that are
destitute have destroyed their clothing. * * * * *
"There are four apartments, four cells in each. Three
apartments are for males and one for the females. The
prisoners dan freely converse with each other in their respective apartments, and it is impossible to prevent it.
" The jail is in a dilapidated condition. The cupola is
yet seriously complained of on account of its leaking every
time that it rains, materially damaging the building, and
making several of the rooms and halls damp and wet, and
the plastering to fall off."
The Superintendents of the Poor, who make the above
report, are not so devoid of humanity or so blind to the
interests of the county they represent, as to sanction any
such course as this. However painful to them, it is their
only alternative. The disease fastens it: elf upon one and
another,—eighteen in the short period of six months in
that single county—and they must be cast into a prison,
because the State has neglected to make the provision she
should for their care. It is for no crime committed that
they are thus thrust into a jail, and compelled to herd
with thieves and murderers. They are suffering under
the severest form of disease flesh is heir to, the poor victim may be one whose reason has tottered beneath the
cares and responsibilities of some of labor, duty and affection. A father, perhaps, of broken constitution, who has
sunk beneath his anxieties to provide for a suffering family; a mother, whose night-watches by the sick bed have
been exchanged for the sleepless vigils of insanity; or, as
was really the fact, a daughter, whose efforts to support a
widowed mother and an orphaned family, had been too
much for her frail strength. It matters not in what manner Q-od has visited the affliction upon them, they are insane, and the jail is their only refuge and security.
We need not speculate as to the probable condition of
�No. 13.
17
these unfortunates thus cruelly incarcerated, nor be Burprised if some in their wretchedness should tear the clothing from their bodies and rend themselves. Njr need we
ask how many of those eighteen will go forth from that
jail "clothed and in their right mind," and be again restored to the domestic circle and to the benefits of society.
Justice, economy and humanity, therefore, make it the
duty as well as the policy of tha State to make suitable
provision for all of its insane. This obligation has been
already recognized and discharged as f,tr as tin establish- '
ment and partial erection of the building is c >acerned.
We have shown the urgent necessity for its immediate
completion, and it now remains for us to suggest, and
urge upon your honorable body the adoption of the course
best calculated to meet the present exigency. As before
stated, a portion of the Asylum is now completed. The
Medical Superintendent who was directed in October last
to assume his position in order to supervise its internal arrangements, and to assist and advise us in preparing for
its opening, is here. We have succeeded, with the limited
means at our disposal, in preparing apartments for ninety
patients of one sex, and that number can be received as
soon as means are provided us for procuring the necessary
furniture and fixtures.
When finished, no other institution in our country will
be provided with more perfect facilities for the complete
classification of its patients, and tho entire separation of
the sexes. The portion of the house now prepared for
use, however, constitutes about two-thirds of the msde department, and of course has no provision for such separation. We are fully aware that the relief aff irded in receiving only one sex, will be but partial; but we dare not
jeopardize the success of our Medical Superintendent, or
peril the reputation of the institution, by incurring the
risks which would attend an attempt to treat both sexes
3
�18
Doo.
without any means for Keeping them apart. The force of
this will be readily perceived. Indeed, when Dr. Van
Deusen assented to the plan proposed, it was under an aseurance we felt no hesitation in giving, that there should
be no delay in preparing the entire wing for patients, in
order to secure to him and the Asylum advantages for successful treatment, bearing some comparison to those enjoyed by his professional colleagues in sister institutions.
Nevertheless, the reception of ninety patients, even of
one sex, will afford great relief throughout the State. But
it is quite as necessary, both for the Asylum and the insane, that provision should be immediately made for the
other sex. This can be readily accomplished by the reconstruction of the center building, which will render the
first longitudinal wing, with accommodations for fifty patients, available, and without which the entire wing will
be useless. It will also be necessary to erect the chapel,
beneath which are the general kitchen and store rooms, an
infirmary, for the purpose of isolation in cases of infectious
disease, and the barn and out-buildings.
From estimates carefully prepared in detail, we find that
the sum required for this purpose will be 190,500 00, and
we respectfully, but very earnestly, urge upon the Legislature the appropriation of that amount. The Asylum
can then be opened for the immediate reception of ninety
patients, and in the following fall, the number will be increased to one hundred and forty-four.
In addition to this appropriation, there will also be required the necessary statutory provision for the administration of the affairs of the Asylum, and the control of the
officers. This is a matter of the highest importance, as
upon the proper organization of the Institution its success
solely depends. It defines the position of the officers,
assigns their duties, and creates those close restrictions
•uposii the exercise of power, essential to the perfect discipline of the Asylum, and without which virtue, talent and
�Mo. 13.
19
fidelity, however well directed and combined, would labor
under every possible disadvantage. It has been said that
" a good organization makes good officers, good officers
make good attendants, and good attendants invariably good
patients." Poor vessels, properly officered and disciplined,
may weather destructive storms, and make successful voyages ; but we look for the certain loss of the ship, however good and staunch, which is insufficiently manned and
officered, and guided by incompetency and misrule.
Experience, when available, is the surest and safest
guide in all these matters ; and we are fortunately enabled
to secure that of the entire profession devoted to the
treatment of insanity in America. As the result of years
of observation, they have given us two series of propositions, the one on " Construction" and the other on " Organization," to serve as a guide in the establishment of
Institutions for the Insane. By the use of the former, we
have secured a building acknowledged to have no superior ;
and as the more important matter of organization is left
with the Legislature, we advise a close adherence to the principles embodied in the latter ; and for this purpose present
these "PROPOSITIONS" in the appendix of the present report.
A reference to the estimates in detail, as presented on
another page, will show that the sum above given, $90,500,
is the least which can be advantageously used, a less
amount will seriously embarrass the operations of the Institution, make it necessary to leave a large portion of the
building useless and unoccupied, and materially increase
the expense of treating the limited number received.
We urge the claims of the Institution the more strenuously, because of a feeling very general throughout the
State, that there has been great remissness and an unwarrantable delay in providing for the insane. We have endeavored faithfully and conscientiously to discharge the
duty delegated to us, and now leave the matter with the
Legislature trusting that they will feel the great respon-
�20
Doc. No, 13.
sibility which is resting upon them, and will hasten to extend that relief which is required by justice and humanity,
a sound economy, an enlightened policy, and the gratitude
we owe a merciful Providence for our exemption from this
terrible affliction.
LUTHER H. TRiSK,
J. P. WOODBURY,
HENRY MONTAGUE.
�APPENDIX,
�STATEMENT of Receipts and Iswoursetnents on account
of the Michigan Asylum for the Insane, for the years
1857-8.
BECEIPTS.
By warrants drawn on the State Treasurer,.... $44,000 00
From other sources,
208 40
Total
$44,208 40
DISBUBSEMENTS.
For lumber,
$ 4,273 81
carpenter and joiner work,
10,688 62
blacksmithing,
352 15
bricks,
;. 3,100 00
cast-iron window-sash,
2,825 41
common labor and team-work,
2,701 87
painting, glass and glazing,
2,122 65
hardware, tin, copper, nails and tinning,.. 2,781 51
stone,
1,023 14
slating roofs, .,
3,417 66
mason work,
7,252 20
gas-pipe and
fittings,
473 02
freight charges, M, C. R. R.,
525 67
water-lime,
569 30
wood,
45 50
wages of watchman,
275 00
castings,
284 83
hot-water boiler,
,
239 21
expenses and services of Medical Sup't,...
513 33
Nason & Dodge, on heating and ventilating
contract,
427 46
contingent expenses,
118 89
Cash on hand,
119 17
$44.208 40
HENRY MONTAGUE,
Acting Commissioner.
KAIAMAZOO, December 1, 1858.
�ESTIMA TES of Moneys required for Material, Labor,
Furnilui-e and Fixtures, to complete the Asylum for the
reception <>f one huwlred and forty -fuur patients. Arranged from estimates in detail.
Bath-tubs, water-closets, connections, &c.,
$ 2,621 97
Apothecary shop, stock arid
fixtures,.
700 00
Gas
fixtures,
325 00
Finishing and fitting up boiler room,
350 00
"
"
engine room,
78240
"
"
laundry,
2,249 30
"
"
drying room,
1,220 00
"
"
ironing room,
280 00
"
"
shops,
758 80
Ranges, steam-cooking apparatus, <fec,
1,400 00
Barns, out-buildings, stock, implements, &c.,... 4,500 00
Re-construction of the center building,
22,000 00
Finishing
"
"
8,000 00
Building fur chapel, general kitchen, <fec.,
12,000 00
Male Infirmary,.
5,000 00
Finishing first longitudinal division,
8,437 53
Finishing and fitting up Infirmary,
700 00
Additional tanks and connections,
1,000 00
Heating and ventilating,
13,300 00
Fitting up general store-rooms
700 00
Gas fixtur s for first long, division and center,.
275 00
Expenses conveying gas to the Asylum,
2,500 00
Connecting sewers for kitchen and center,
400 00
Fencing and grading grounds,
1,000 00
$90500 00
For the erection of the north wing, not yet commenced,
there will be required the sum of $90,000.
�INFIRMARY
FOR
FEMALES
rnrnq
Urn:
i
—i
pin ii urn i
JlIID\. i[TTTTl
W A R D S
FOR
MALE
MICHIGAN
P A T I E N T S
ASYLUM
W A R D S
FOR
THE
INSANE,
F O R
F E M A L E
KALAMAZOO.
PATIENTS
�EXPLANATION OP THE PLATE.
In the accompanying plate, all portions of the Institution represented in shaded lines are already built, with
the exception of the "infirmary for males," and the chapel
and kitchen (U). The foundation and basement walls of
the centre building, immediately in front of the chapel (U),
are in condition to receive the superstructure. The portions represented in outline are not yet commenced.
" Hall No. 1" constitutes the portion known as the first
longitudinal division. Adjoining it at the left, is the first
transverse division, which is connected with the second
transverse division by the second longitudinal division,
marked "Hall No. 3." "Hall No. 5," and the wards beyond it, are collectively known as the extreme wing. The
transverse divisions are three, and all other portions of the
wing, two stories high.
The first transverse division, and all to the left of it, are
finished for use. The officers will temporarily occupy the
rooms N, K and 0, immediately over the word "MALE,"
The rooms N. and K in the basement beneath, will be used
as kitchens. This will afford accommodation for ninety
patients, and that number can be received as soon as the
rooms are furnished. The first longitudinal wing, containing apartments for fifty-four additional patients, can be
brought into use as soon as the center, and chapel and
kitchen building (U), are ready for occupancy.
RBPEBBNCBS.—A, public parlor ; B, general office; C,
matron's room; D, business office ; E E, reception rooms;
F, officer's dining room ; G, apothecary shop; H, anteroom and stairway; 111, store-rooms; K, associated dormitories ; L, attendants' rooms; M, day-rooms; N, workingrooms ; O, dining-rooms ; U, chapel, having beneath it the
general kitchen and store-rooms; 1, boiler room; 2, engine
room; 3, laundry; 4, drying-room; 5, iroaing-room; 6,
carpenter shop ; 7, covered passage-ways; 8, fan-room; 9,
smokestack.
�28
Doe.
penditures and general operations of the hospital, as to
give to the community a proper degree of confidence in the
correctness of its management.
TV. The Physician should be the Superintendent and
chief executive officer ot the establishment. Besides being a well-educated physician, he should possess the mental, physical and social qualities to fit him for the post.
He should serve during good behavior, reside on or very
near the premises, and his compensation should be so liberal as to enable him to devote his whole time and energy to the Avelfare of the hospital. He should nominate
to the Board suitable persons to act as Assistant Physician,
Steward, and Matron. He should have entire control of
the medical, moral and dietetic treatment of the patients,
the unrestricted power of appointment and discharge of
all persons engaged in their care, and should exercise a
general supervision and direction of every department of
the Institution.
V. The Assistant Physician, or Assistant Physicians,
where more than one are required, should be graduates of
medicine, of such character and qualifications as to be able
to represent and to perform the ordinary duties of the
Physician during his absence.
VI. The Steward, under the direction of the Superintending Physician, and by his order, should make all purchases for the Institution, keep the accounts, make engagements with, pay and discharge those employed about the
establishment; have a supervision of the farm, garden,
and grounds, and perform such other duties as may be assigned to him.
VII. The Matron, under the direction of the Superintendent, should have a general supervision of the domestic
arrangements of the house, and, under the same direction,
do what she can to promote the comfort and restoration of
the patients.
�No. 13.
29
VIII. In Institutions containing more than two hundred
patients, a second Assistant Physician and an Apothecary
should be employed; to the latter of whom, other duties,
In the male wards, may be conveniently assigned.
IX. If a Chaplain is deemed desirable as a permanent
officer, he should be selected by the Superintendent, and,
like all others engaged in the care of the patients, should
be entirely under his direction.
X. In every hospital for the insane, there should be one
supervisor for each sex, exercising a general oversight of
all the attendants and patients, and forming a medium of
communication between them and the officers.
XI. In no Institution should the number of persons in
immediate attendance on the patients be in a lower ratio
than one attendant for every ten patients; and a much,
larger proportion of attendants will commonly be desirable.
XII. The fullest authority should be given to the Superintendent to take every precaution that can guard
against fire or accident within an Institution, and to secure
this, an efficient night-watch should always be provided.
XIII. The situation and circumstances of different Institutions may require a considerable number of persons
to be employed in various other positions; but in every
hospital, at least all those that have been referred to, are
deemed not only desirable, but absolutely necessary, to
give all the advantages that may be hoped for from a liberal and enlightened treatment of the insane.
XIV. All persons employed in the care of the insane
should be active, vigilant, cheerful, and in good health.
They should be of a kind and benevolent disposition; be
educated, and in all respects trustworthy; and their compensation should be sufficiently liberal to secure the services of individuals of this description.
�
asylums
Traverse City State Hospital
-
https://localhistory.tadl.org/files/original/3bac2a5c8a8124ba403603adb19de8d6.pdf
94e506cd217f039654b52d8a8e02388e
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Traverse City State Hospital
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Asylums.
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Amy Barritt, 1984-
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Various.
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1885-1989
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Board of Trustees for the Traverse City State Hospital.
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Biennial Reports of the Trustees of the Michigan State Asylums for the Insane, and for the Deaf and Dumb and the Blind, for the years 1855-6.
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Psychiatric hospitals.
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Report created by the State Trustees of the Michigan Asylums, reporting to the State legislature for the 1855 and 1856 fiscal years. Traverse City State Hospital was not in operation until 1886.
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Trustees of the Michigan State Asylums.
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Lansing: Hosmer & Fitch, Printers to the State.
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1857
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State of Michigan.
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Text
BIENNIAL
REPORT
OF
THE TRUSTEES
OF THE
MICHIGAN STATE ASYLUMS
For the Insane, and for the Deaf and Dumb and the Blind,
FOR THE TEARS 1855-6.
LANSING:
HOSMSR ii FITCH, PRINTERS TO THE STATE.
1857.
�OFFICERS OF THE MICHIGAN ASYLUMS,
TRUSTEES.
ZESTA PITCHER, of Detroit.
ISEAEL KELLOGG-, of Kalamazoo.
LUTHEE H. TKASK, of Kalamazoo.
JAMES B. WALKER, of Flint.
BELA HUBBAED, of Detroit.
PKESIDENT—ZINA PITCHEE.
OLEEK—BELA IIUBBAED.
Resident Officers of the Asylum for the Education of the
Deaf and Dumb and of the Blind, at Flint.
PRINCIPAL—B. M. FAY, A. M.
MATRON—MES. B. M. FAY.
TEACHEBS—B. M. FAY,
WILLIAM L. M. BEEG,
JAMES DENISON,
MES. B. M. FAY.
TEACKEB OF Music—LAWEENCE D. TAYLOE.
�INFIRMARY
FOR FEMALES.
mELrnrf?
iwqpsqg]
s
HALL
jjjito^^
\L H? i
W A R D S
FOR
MALE
MICHIGAN
W A R D S
PATIENTS
ASYLUM
FOR
THE
INSANE,
FOR
F E M A L E
KALAMAZOO.
N<? 3
PATIENTS
Seals 100 feet to 111 moh
�REFERENCES.
A. Public Parlor.
B. General Office.
C. Matron's Room.
D. Steward's Office.
E. E. Reception Rooms.
F. Officers' Dining Eoom.
G. Apothecary Shop.
H. Ante-Room.
I. Steward's Store Room.
n. Matron's Store Room.
K. Associated Dormitories.
L. Attendants' Room.
M. Day Rooms.
N. Parlors.
O. Dining Room.
P. Clothes Room.
Q. Lavatories.
R. Bath Rooms.
S. Water Closets.
T. Infirmaries.
U. Chapel.
1. Boiler House.
2. Engine and Fan Room.
3. Laundry.
4. Drying Room.
5. Ironing Room.
8.6 . 6. Work Shops.
7. 7. 7. Covered Corridors.
�REPORT
OF THE
TRUSTEES OF THE MICHIGAN ASYLUMS.
To the Legislature of the State of Michigan :
ASYLUM FOR THE DEAF MUTES AND THE BLIND.
This Board had the satisfaction in their former report, December, 1854, of announcing the favorable opening of the
School, and of exhibiting the progress made by the pupils by
an exhibition before the Honorable Legislature during its
then session.
In view of the time required to erect the contemplated
buildings and of the urgent wants of a large portion of our
population, so long excluded from those means of education
which the State had liberally extended to all who are capable
of enjoying them, the Board had decided to open the School
in a house hired for the purpose in the city of Flint.
Into this School had been admitted, up to the first of Jannary, 1855, 19 deaf mutes and 4 blind persons.
Efforts were also made by publishing circular notices, and
by personal visits of Mr. Fay, the principal, in various parts
of the State, to awaken an interest, and make known the nature of the benefits which the State sought to confer upon
this hitherto-neglected portion of our population.
The progress which has been made, under the unfavorable
�8
BEPOBT OF TRUSTEES
circumstances of limited accommodation and an unfinished
building, and the present condition of the School, and its
prospects for the future, are fully detailed in the accompanying Eeport of the Principal, and we refer to that document
for particular and ample information.
The pupils now number 51 Deaf Mutes, and 15 Blind.
The rapid progress of the pupils, the almost entire exemption from disease, and the general good order and system
which prevail in the Institution, are due mainly to the talents
and indefatigable exertions of our excellent Principal and his
worthy matron and assistants.
In addition to the means heretofore adopted for circulating
and obtaining information, the Board during the past season
resorted to the expedient of mailing circulars to every County
and Town Clerk, Supervisor and Superintendent of the Poor,
in every organized township of the State. A copy of this
circular is given in the Appendix.
It is believed that the existence, location and character of
the Institution are now so widely known and appreciated
that no future special effort will be required (except by those
immediately interested) to bring within its benefits nearly all
the admissible candidates within the State.
One further purpose of this circular has not been so fully
attained, namely, of more full and particular returns of the
number, ages and conditions of the Deaf Mutes, and the
Blind.
Returns from only twenty-four counties have been received,
and these too imperfect to be relied upon as an exhibit of the
number of those classes of our population. Taken in connection, however, with the census returns of 1854, they exhibit a
generally increased number in the towns which are reported,
and give additional means of estimating the number that are
proper candidates for admission into the Asylum. They also
exhibit the names and residence of many deaf mutes and
�OF MICHIGAN ASYLUMS.
9
blind, with other information which it is desirable to possess
for future reference.
The State census compiled in May, 1854, returns the number of Deaf and Dumb as 206, and Blind 176, in a population of 509,374. The ascertained' proportion of Deaf Mutes
to the population in other States, is 1 in 2,000. There is a
frequent unwillingness, on the part of parents and others, to
make known the existence of these iinfortunates, so that,
allowing for the necessary imperfections of the census returns,
and for the increase of our population, (now numbering probably not less than 700,000,) it may be presumed that we have
of Deaf and Dumb 350, and of Blind 300.
Of these it is safe to suppose that at least one-half are, by
age and character, entitled to admission into the Asylum; so
that it appears that the State already contains from 300 to
350 of these unfortunate beings, between the ages of 10 and
30, qualified by age and mental capacity to become educated
and useful members of society, but who are now not only
shut out from the sweet sights and sounds of nature, but excluded also from those intellectual advantages which it is the
glory and boast of our State to have furnished to all her hearing and seeing children.
How will it add to our boast, to have so opened the aven_
ues to intellectual light and knowledge, that our Blind and
Deaf may have equal cause to rejoice in their privileges !
PROGEESS OF THE BUILDING.
At the date of our last report, little more than a commencement had been made, in the erection of the edifice designed
for the reception of the Deaf, Dumb and Blind pupils. That
portion of the Asylum building denominated the " School
Wing," has been completed, and was opened to the pupils on
the first day of May last.
Owing to the excessive wet weather in the summer of
1855, and the consequent failure of contractors to furnish
2
�10
REPOKT OF TRUSTEES
brick, it was impossible to have the building in a state for
occupation before last spring, and then for two months or
more it was occupied conjointly by teachers and pupils, masons and joiners.
The building now finished is occupied as the residence of
the Principal and his family, as the boarding-house, dormi- •
tory, school and exercise rooms of the pupils, as well as for
all other domestic purposes. The whole is so constructed as
to be readily adapted to its ultimate purpose—that of the
school apartments only—when the remaining portion of the
edifice shall be completed.
It is thought that this building will compare favorably, in
style and strength of construction, with any public building
in the State, if not, considering its cost, anywhere in thecountry.
The necessity of doing all the plastering and much of thejoiner work during a winter of excessive cold, greatly increased the expense; but this it was thought advisable ta
incur, rather than be unable to occupy the building during
the following summer.
The portion of the Asylum building now completed is intended to occupy one side (the rear) of a quadrangle, the
Chapel and domestic offices constituting a centre building,
connected by passages with the front and rear. Its size is 60
by 100 feet, and three stories in height, besides the basement,
which on this side of the quadrangle, owing to the descent of
the ground, is a full story.
In the plan it is entirely detached from the rest of the
structure, except by the covered passage connecting it with,
the Chapel. The whole structure is designed to cover a
breadth of 200 feet by 240 feet in depth, enclosing the Chapel'
building in the middle of a central open area, the whole to
be three stories, which with basement will be 56 feet in/,
height.
�OF MICHIGAN ASYLUMS.
11
ESTIMATES OF COST.
The estimated cost of the Asylum edifice, as reported by
the Board to the last Legislature, was $100,000. The experience acquired in the construction of so considerable a portion of the work, enables the Board to give such confirmation
or correction of our former estimate as the case requires.
In referring to those estimates, it must not be overlooked,
that the prices of materials and labor have very materially
advanced within the past two years, being at this time, higher
by one-fourth, if not one-third, than at that date. These prices
have, in fact, been constantly on the increase.
The estimate of $18,000 required to complete the school
wing, has been exceeded by about the proportion stated,
though much of this excess is attributable to the increased
expense arising from other causes and disadvantages, above
enumerated.
The whole expense chargeable to building account, as appears by the statement of Mr. Walker, Trustee Superintendent of the building, appended to this report, is about $24,000.
The amount expended up to the date of our last report
was f 6,540, making a total of about $30,500, the cost of the
present building.
Assuming the present erection to be one-fourth of the
whole structure, and adding one-fourth to the amonnt for increased prices of material and labor, the entire cost of the
Asylum Building, when erected according to the plan, may
be set down at $150,000. This estimate includes cost of gaspiping and plumbing, and flues with registers for ventilating, but not the cost of the boilers and other apparatus for
warming. It is proposed to effect this object concurrently
with a system of thorough ventilation, by a similar apparatus
to that recommended in the last report of the Board, for
adoption at the Asylum for Insane, viz.: a forced ventilation
and heating by means of a steam engine and blower and
steam coils, placed in a separate building.
�12
EEPOKT OF TRUSTEES
Should this plan be adopted it would add a cost of about
$15,000.
The basement of the wing now erected, and which is at
present used with much inconvenience for a dining room,
and for the various domestic purposes connected with the establishment, may be fitted up as work-shops; thus saving the
cost of a separate building for that purpose.
The portion of the building already completed is so nearly
filled to its utmost capacity that in all probability many pupils must be refused admittance for want of room, long before the remaining portions are completed, even if their erection should be pushed forward with all possible dispatch.
The completed building is expected to accommodate not
more than 350 pupils; a number which is but little, if at all,
over our estimate of the Deaf and Dumb and the Blind now
within our State, who are qualified for admission into the
Asylum. The necessity for an immediate construction of the
entire plan is therefore so apparent as to need no farther
comment from us.
LOCATION AND GROUNDS.
The location of the Asylum building is near the westerly
side of the ground procured by exchange and purchase from
the Farmers' and Mechanics' Bank. The laud adjoining this
side comprises very desirable locations for residences and
other buildings. The Board deem it desirable that this land
should be controlled by them, so far as to prevent the erection of buildings which, by their proximity to the Asylum,
might prove annoying. On the east, also, of the Asylum,
and between it and the city of Flint, is a small parcel of land
extending from the Asylum grounds to the low lands upon the
Thread Biver, which, if covered with buildings, would very
much obstruct the view from the Asylum. They have accordingly procured propositions from the Bank for the sale of the
�OF MICHIGAN" ASYLUMS.
13
parcel of land first named, amounting to about fifty-three
acres, for the sum of $100 per acre, and from Riissel Bishop
for the other parcel, amounting to about five acres, for the
sum of $200 per acre.
The whole of the additional tract proposed to be purchased
from the Bank, as well as the immediate site of the buildings,
is covered with the native forest, and extends to and includes
a portion of Schwartz Creek, a fine rapid stream of pure water, from which it is intended to supply the Asylum. The
whole extent of land belonging to the State, for the purposes
of this institution, should the above mentioned purchases be
confirmed, will be about ninety-one acres. It occupies an
elevation which commands pleasing views, and those natural
beauties and advantages which are so desirable.
The Trustees cannot but refer with satisfaction to the act
of the Legislature of 1855, by which tuition and board in the
Asylum are made free to all candidates from this State, believing that public sentiment and the increased benefits will
fully justify this example of a wise liberality first proclaimed;
by our State.
The law, though making admission free, requires that
clothing and traveling expenses shall be borne by parents or
guardians. Many cases have become known to us where
even these' expenses have been attended with great hardship
and difficulty, for such is the poverty of very many parents
of these unfortunate beings, such their ignorance of or indifference to the benefits proposed to be conferred upon their
children, as to call forth little exertion on their part to realize them. Even after this exertion has been made, pupils are
sometimes thrown upon the care of the State, without provision or thought for their future expenses of. any kind. The
location of the Asylum is at present much removed from the
great thoroughfares of travel, and unfortunately the Directors of the Detroit and Milwaukee Railway, which is the
�J-tt
EEPOET OF TEUSTEES
only ready line of communication for three-fourths of the distance from Detroit to Flint, have not yet learned that hu^
mane policy which has induced most other roads to carry
such persons free or at half price.
The Board therefore recommend that they be authorized
by law to draw upon the State Treasury for clothing and
traveling expenses of pupils, in such cases as their judgment
may approve, and that these payments be made a charge
upon the county or town to which such pupils respectively
belong.
ASYLUM FOR THE INSANE.
In the last report of the Board of Trustees it was announced
that the post of Medical Superintendent of the Hospital for
the Insane had been tendered to and accepted by Dr. John
P. Gray. Although the services peculiar to this post are not
required until the building is prepared for the reception of
patients, the services of Dr. Gray were of very great importance in the determination of the plans, and to some extent)
in the oversight of the construction. In a work of this magnitude, importance and intricacy, no set of men unaccustomed to the detail and management of such an institution,
can possibly be competent to superintend its construction
without such aid, and it was deemed a wise and economical
policy to secure the supervision and approbation of the future medical head of the Institution, during its erection.
These services Dr. Gray performed at the small salary of
$800, out of which were paid his traveling expenses in the
several visits which were made by him to this State and
elsewhere, in furtherance of the object.
The subsequent election of Dr. Gray to the Superintendency of the New York State Lunatic Asylum, made this post
in Michigan vacant, and upon the unanimous recommendation of the managers of the New York Asylum, as well as'of
Dr. Gray and other influential medical men, the post was
�OF MICHIGAN ASYLUMS.
15
filled by the appointment of Dr. Edwin H. Van Deusen,
then acting first assistant in the 'New York State Asylum.
Dr. Yan Deusen has accepted the appointment, with the understanding that no salary attaches until his services shall
be required as Medical Superintendent proper, of the Institution. He has, nevertheless, twice visited our State, and bestowed much time upon the subject, in his anxious desire to
further the interests in view to the utmost.
NUMBER AND CONDITION OF THE INSANE OF THE STATE.
With a view of presenting more fully to the Legislature,
the wants of the State in regard to her Insane, and to arrive
at the facts with greater minuteness and particularity than
are exhibited by the bald returns of the census, the Board
directed the President and Clerk to institute inquiries in
every township of the State, by correspondence with the
physicians, and with the county and town officers.
A circular was accordingly addressed to the persons alluded to, a copy of which is appended to this report, together
with a list of inquiries, embraced in a tabular schedule, to be
filled up by the persons addressed. About 1,300 of these circulars were sent out early in August, post office stamps being
enclosed, to insure a more certain reply.
Keturns have been received from about 160 towns, giving
the names, residence, condition and circumstances of about
200 lunatics and idiots. The towns from which returns have
been made, embrace about one-third only of the organized
towns of the State, the Upper Peninsula not being included;
so that from two-thirds of the State no returns were made.
The census statistics of May, 1854, enumerate 428 lunatics
and idiots in the State, the population being then 509,374.
Assuming the population to have increased to 700,000, with
a proportionate increase of insane, and comparing the results
with those deducible from the statistics obtained by the
Board, we arrive at the conclusion that the number of insane
�16
REPORT OF TRUSTEES
in this State amount to 600. Of this number lunatics are in
somewhat larger proportion than idiots, so that the number
of lunatics who are fairly subjects for immediate medical
treatment with a view to cure, may be estimated at not less
than 350.
About one-half of the number reported to the Board, are
maintained by friends at home, the remainder being county
and town paupers. A few only are maintained in institutions for the insane abroad. The comparatively small number of these, results less from reluctance of friends to send
them abroad, or to pay the necessary expenses, than from the
crowded condition of the Asylums, most State Asylums
being filled with patients from the State where they are situated, and refusing admittance to applicants from other States.
The expense of maintaining a patient from this State in a
foreign institution, varies from $100 to $600 per annum.
The high prices charged at these asylums, and the great
difficulty of obtaining admission at any price, are a source of
extreme suffering, and constitute an appeal for home aid
which is irresistible.
. Of the number maintained in county and town poor
houses, very few receive any medical treatment whatever,
and are subject to influences which tend rather to confirm
than to remove their disease, while the worst possible moral
effect is produced upon all who are thus associated.
PLAN AND PROGRESS OF THE BUILDING.
At the assembling of the Legislature of 1855, the trustees
were enabled to report full plans and drawings of the Asylum Buildings, and a commencement made in their erection.
The foundations of the center building had been laid, and
the walls carried up two stories.
For the manner in which the appropriation (|67,000) made
by that Legislature has been expended, reference is made to>
�OF MICHIGAN ASYLUMS.
17
the statement of Mr. Kellogg, Superintendent of the building,
appended to this report. The amount there specified has
been used in completing the mason work, roof and dome,
stuccoing the front, priming and glazing the center building,
and in the construction of nearly the whole mason work of
the south wing. The extreme transverse portion of this wing
was built up and roofed in 1855, with a view of finishing
this part and the center building for occupation. But upon
consultation with several Superintendents of Eastern Asylums, the Board were confirmed in their objections to such a
plan, as fully expressed in their report of December, 1854.
It was the unanimous opinion established by the experience
of other institutions, that it was the worst economy to attempt to carry on such an institution with a small portion
only finished. The expenses would be greatly disproportionate to the results obtained, as compared with those attending
the management of affairs in a fully completed building.
The classification of the Insane would be prevented, a very
important element in the successful treatment of the Insane,
and the confusion and disturbance attending the operation
of the builders upon the unfinished portions would go far to
counteract the good effects that the Institution is intended to
produce.
It was therefore resolved that the Superintendent should
expend the balance of the appropriation in advancing the
remaining portions of the south wing, so far as the means at
command would permit.
The work has been pushed with vigor, and, it is believed,
with all possible economy. The walls of the two-story portions of the wing are completed, and one-half of the threestory transverse portions. None but the best mechanics
have been employed, and the work has been performed in
the most substantial manner, with the view that when completed no repairs will be required for a great length of time.
The statement of Mr. Kellogg, hereto appended, exhibits
3
�18
BEPOBT OF TKUSTEES
an expenditure of $63,539 22. The estimated value of materials on hand is $3,800, and there is due to contractors
about the same amount. Lumber sufficient for the whole of
the center building and south wing is contracted for, and is
now " stuck up " at the mill and seasoning, but on which
nothing has been paid, and which is not included in the
above estimate of materials on hand.
ESTIMATES OF COST.
It was stated in our report of 1854, that the Asylum for the
Insane, the plans and general description of which were then
submitted, was intended when finished to accommodate about
350 patients. Some improvements have been added which
will enlarge the capacity to the accommodation of 288 patients. A greater number than this could not be advantageously cared for in one Institution, the experience of others
being our best guide, in respect to the proper character and
extent of the accommodation.
It will be also apparent, from the statistics above submitted,
that nothing short of the speedy and entire completion of the
"buildings will satisfy even the present pressing need of the
State.
"While, therefore, the funds at our disposal have been expended in such a manner as to permit the completion and
occupation of the center building and the south wing, (containing the wards for male patients,) before any outlay is
made upon other portions, the Board strongly advise the immediate appropriation of a sura sufficient to complete the
entire structure. The pressing exigencies of so large a number of insane in our population, would alone induce to this
conclusion, apart from the many strong considerations of humanity and science which might be urged.
We are now enabled to submit somewhat close and detailed estimates of the cost of the several portions of the Asylum buildings, fixtures and furniture, based partly upon con-
�19
OF MICHIGAN ASYLUMS.
tracts already made and ascertained prices, as well as upon
experience of other similar Institutions.
Estimate of whole amount of materials, labor, dec., required
for the entire completion and furnishing of the Michigan
Asylum for the Insane, arranged,from estimates in detail.
CENTER BUILDING.
Carpenters' work and materials,
$3,500
"
" upon basements and
eornices,
1,000
Painting and glazing,
900
Plumbing, tin and copper work,
1,700
Tanks and drainage,
1,500
Mason work, including stone steps and
verandah in front,
6,500
$15,100 00
SOUTH WING (NOW
IN PROCESS OF ERECTION).
Carpenters' work and materials,
$16,500
Painting, glazing, window-weights, cords,
pulleys, &c.,
7,500
Plumbing, tin and copper work,
5,800
Tanks and drainage,
6,500
Stone steps and verandahs,
1,500
Slating roof,
3,000
Cementing walls,
4,000
Mason work,
9,000
$53,800 00
NORTH WING (NOT
Whole expense of erection,
COMMENCED).
$102,000 00
�20
REPORT OF TBUSTEES
ENGINE HOUSE, CHAPEL, INFIEMAKY, BABNS, &C.
Engine house,
Chapel and kitchen,
Gas works,
Heating and ventilating apparatus,
Two infirmaries,
Barns, &c.,
Grading grounds,
Fencing and materials,
> $ 6,000
10,000
6,000
23,000
10,000
2,000
600
2,500
$60,100 00
Furniture of entire establishment, inclusive of
farm stock, furniture of laundries, kitchen,
shops, &c.,
22,000 00
Moneys already expended,
87,000 00
$340,000 00
Making the entire cost of the Institution, with all necessary out-buildings, farming implements, farm stock, fences,
gas apparatus, a complete system of drainage and sewerage,
warming and ventilating, and furnished throughout, ready
for occupation, three hundred and forty thousand dollars.
Of the sum thus stated as the entire cost of the establishment, the amount properly belonging to the cost of erection
would be $275,000 only.
For the purpose of comparing this with the cost of similar
Institutions in other States, we subjoin the following table:
Name of Asylum.
Capacity.
Cost.
State Lunatic Asylum, Utica, N. Y., 130 acres. 440 patients. $517,400
Maryland Hospital, Baltimore,
213,600
12
130
321,000
McLean Asylum, Somerville, Mass., 32 •
200
330,000
Pennsylvania Hospital, Philadelphia, 113
230
Friends' Asylum, Frankfort, Pa.,
85,593
62
60
250,000
State Lunatic Asylum, Trenton, N.J., 100
250
150,712
Maine Hospital for the Insane,
115
175
Mt. Hope Institution, Baltimore, Md. 18
100,000
120
116,000
Butler Hospital, Providence, R. I., . .115
140
250,000
State Lunatic Asylum,Taunton,Mass, 120
250
Experience in the erection of Asylums for the Insane, both
in this country and elsewhere, has shown that the average
�OF MICHIGAN ASYLUMS.
21
cost of such institutions is about one thousand dollars for
each patient accommodated ; though in several of the larger
Asylums in the United States, it has been much greater. In
the Michigan Asylum, it will be observed that the cost has
« not exceeded this average.
Reviewing the architectural details of the building, and its
general arrangement, and recollecting that the amount of
cubic space allotted to each patient, is about one-third more
than usual; that the number accommodated in single, instead
of associated dormitories, is proportionably greater, (being
214 of the whole number;) also, that the estimate includes
the erection of a well arranged infirmary for each sex, external to the walls, (a very important feature, peculiar to this
institution, though common to all recently erected Asylums
!in England,) it will be observed that the plan is most complete, and embraces all the modern improvements.
The plans have been submitted to and have secured the
approval of the Association of Medical Superintendents, at
their last session, and all possible care has been exercised to
secure in the construction the most durable materials within
our means.
The Board believe that the moneys thus far appropriated
have been judiciously and economically expended, and that
the estimates presented are as low as the actual cost of labor
and materials will allow. Nor do they hesitate in declaring
that our State will possess, in the finished buildings, a model
institution, the best for its size and cost in the United States,
if not in any other country.
With this report is presented a steel engraving of the Asylum, in perspective, as it will appear when finished; also a
ground plan of the first story, showing the general design
and arrangement, with reference to an explanation on another
page, and general description of the details of the plan.
The number of insane in the State requiring medical treat-
�22
REPOKT OK TRUSTEES
ment, and the numerous rejected applications for admission
into Eastern Asylums, which have come to the knowledge of
the Board, many qf them attended with circumstances of
affliction, sad in the extreme, would seem to make the immediate completion of a portion of the Asylum, very desirable.
The objections to the opening of partially finished institutions
for the admission of patients, have been before alluded to;
but if, in view of the urgency of the case, such a course should
be determined upon, the Board consider that it would be rendered practicable only by the finishing and furnishing of the
entire south wing and center building, and the erection of
the chapel, beneath which are placed the kitchen, bakery
and other indispensable offices. It would also require the
construction of the engine house, with the laundry, drying
and ironing room, together with the heating and ventilating
apparatus, an infirmary and gas house and fixtures. This
will involve an outlay, as will be seen from the annexed statement, prepared from the preceding estimate, of one hundred
and thirty-four thousand dollars:
STATEMENT.
Finishing centre building,
$ 15,100 00
" south wing,
53,800 00
Building engine house,
6,000 00
Heating and ventilating apparatus,
17,000 00
Chapel, with kitchen, &c.,
10,000 00
Gas house and
fixtures,
6,000 00
Infirmary,
5,000 00
Grading grounds,
600 00
Fencing,
2,500 00
Barns, carriage house, &c.,
2,000 00
Furnishing center building,
3,000 00
"
south wing,
6,000 00
Stocking farm, furnishing laundries, kitchen,
shops, &c.,
7,000 00
Total,
$134,000 00
�OF MICHIGAN ASYLUMS.
23
If it be decided to open the south wing for patients as soon
as it can be finished, without waiting the completion of the
rest of the building, it will become incumbent upon the
present Legislature, in additition to the appropriation for
building purposes, to make the necessary statutory provisions
for the administration of the affairs of the institution, during
at least one year of the ensuing biennial term.
It is now almost universally admitted that insanity is a
disease, in a large proportion of cases very curable in its early
stages, but requiring for its successful treatment certain means
and appliances, both medical and moral, which can be rendered available only in special institutions; and also, thalfthe
insane, as a class, should in no case be the inmates of county
poor-Louses, jails, and other receptacles.
In view of this fact, and believing that their claims and
necessities are so universally acknowledged that no appeal is
required to urge their recognition, your Board have deemed
it necessary to present only a report of progress in the construction of the building, and such suggestions as may seem
of service in the early and entire completion of the work.
ZINA PITCHEE,
JAMES B. WALKEE,
ISEAEL KELLOGG,
LUTHEE B. TEASE.
BELA HTJBBAED.
DETROIT, December, 1856.
�RE POET
OF THE PRINCIPAL OF THE ASYLUM FOR THE
DEAF MUTES AND THE BLIND.
To the, Board of Trustees of tlie Michigan Asylums:
GENTLEMEN :—In presenting my second Biennial Report,
I would first of all recognize the hand of a kind Providence
•extended to us thus far, crowning our efforts with success, especially in preserving the lives and healths of our pupils.
Of the seventy-five pupils who have been connected with the
Asylum, all are now living, and all but one in the enjoyment
•of their accustomed health. "We take little credit to ourselves
for this, but so far as human instrumentality is concerned, it
must be ascribed to the systematic course of life in the institution; the regular hours allotted to school, study, out-door
exercise and sleep; to the means of ventilation in our building, affording us a plentiful supply of pure air; to the cleanliness attempted to be enforced throughout the establishment;
to the weekly bath, and to the attention and skill of our Physician.
The date of my first report was November first, one thousand eight hundred and fifty-four. With the same pupils
then reported we continued the school to the last of the succeeding July, with our usual success, and with nothing worthy
of special notice, unless it be our pleasant visit to Lansing,
where the exhibition of our pupils was attended by both
4
�26
EEPOET OF TRUSTEES
branches of the Legislature, the Governor and other State
officers, all of whom manifested a hearty interest in our cause,
and expressed high approbation of our pupils' attainments.
The appropriation of funds made to us during their session,
though not so large as we asked, and as the result has proved,
not sufficient to complete our present building and defray the
current expenses of the institution, was notwithstanding a
handsome and liberal appropriation.
A highly important change in the terms of admission of
pupils to the Asylum was also obtained at that session of the
Legislature. By a previous legislative enactment, parents
who were unable to pay the expense of board and tuition,
were required to produce a certificate of their inability before their children could enjoy the benefits of the Asylum.
N~ovi its doors are open alike to all the Deaf and Dumb and
the Blind, of suitable age and character, in the State of Michigan. It is believed that this change in the original organization of the institution is one that meets the approbation of
the citizens of this State, and one that has already and will
in future years contribute more to its prosperity and usefulness than any other act of State patronage it has ever received.
For the courtesy and favor with which we were received
by the gentlemen who composed the last Legislature, and for
the more substantial benefits they conferred upon the institution, we desire here to record our most grateful acknowledgments.
"We would respectfully siiggest that another rule, adopted
at the organization of the Asylum, should receive the attention of the next Legislature. I refer to that by which the
Board of Trustees all go out of office at the same time. This,
in its practical operation, will be highly detrimental to the
welfare of the Asylum. The office of a part only should expire at the same time, a part still remaining who are already
familiar with the complicated affairs of the institution, who
�OF MICHIGAN ASYLUMS.
27.
know all that has been done, and consequently know better
than others can what should be done in future ; have themselves had just that experience which is the highest qualification for the future. A Board composed of entirely new.
members will find great difficulty in ascertaining precisely
what has been done and how done ; and even then they cannot act as efficiently as those who have once performed the
same work which in a measure is to be done over again.
Yourselves, gentlemen, when you first entered upon your duties, must have found some difficulty in ascertaining what
your predecessors had done, though they had not attempted
great things, having scarcely made a beginning.
This is a matter of special importance in the present condition of the Asylums, both at Kalamazoo and Flint, where,
buildings are in process of erection. It is almost a necessity
that some of those who have had experience in the construction of these buildings thus far should be retained for the
farther prosecution of them.
"When our yearly term of school closed in July, eighteen
hundred and fifty-five, it was expected that we would be able
to occupy the new building in the succeeding autumn ; but
in this we were disappointed, owing to the fact that the individual who had contracted to furnish the brick for the building failed to meet his contract.
The number of pupils had increased to such an extent that
all could not possibly be received in our rented apartments,
and it was judged best to continue the school during the
winter with the blind pupils only. It was a real disappointment as well as real detriment to the deaf mute piipils to wait
seven months beyond the time they had expected to return
to the Asylum. During this time they lost much of their
interest in study, and forgot no small portion of what they
had previously acquired.
We took possession of the new building on the first of May
last.
�'28
EEPOET OF TRUSTEES
This building is one hundred feet long by sixty in width,
,and four stories in height, including the basement story. It
is surmounted by a circular dome, rising about fourteen feet
above the roof, by eleven feet in diameter, and extending
downward through the attic, opens into and affords additional light to a large hall, about fifty feet square, designed
for the chapel and lecture room.
The height of the first principal story is fourteen feet in
the clear ; the second, thirteen; the third, fourteen and a
half feet. The highest point of the cupola is eighty-five feet
above the ground at the base of the building.
Lengthwise through the basement, and through the first and
-second principal stories, extend halls about fifteen feet in
width.
In the basement are seven rooms, which are used for the
following purposes, viz.: the kitchen, the dining room, store
room, girls' washing and bathing room, boys' wishing and
bathing room, sleeping room for domestics, and trunk room.
There not being rooms enough for all the household purposes,
"the girls' washing and bathing room is (with much inconvenience) the laundry ; the boys' washing and bathing room is
also used (by necessity) for household purposes.
In the first principal story are eight rooms, four of which
are school rooms; one the boys' sitting and study room, where
•they spend their evenings; one the music room, which is also
used for the blind girls' sitting room; one the reception room
for visitors, and one the Principal's office.
In the second story the rooms are also eight in number.
'Three are boys' sleeping rooms; one the hospital in case of
sickness; one a room for teachers; one the guest chamber,
and two are family rooms.
The third story contains five rooms; one is the chapel and
lecture room; one the girls' sitting or study room; two are
.girls' sleeping rooms, and one a room for teachers.
Thus it will be seen that all .the rooms in the building are
�OF MICHIGAN ASYLUMS.
29'
now occupied for necessary purposes. The sleeping and
study rooms are crowded to excess. Two rooms in the basement, and one in the first principal story, are each, at great
inconvenience, occupied for double purposes.
The building is well ventilated throughout, by means of
flues constructed for the purpose. Flues are also constructed,
opening into each room and hall, for the introduction of
heated air, by which it is intended to warm all the buildings
when the whole shall have been completed.
Pipes are laid through all the apartments for the introduction of gas, when the remaining structures contemplated in
your plan, shall have been erected.
The present building has been constructed of the best materials, and in the most substantial and durable manner.
Though little has been added for mere ornament, yet the
symmetry of its proportions, and the propriety manifest in
its style of architecture and finish, are such as to impress all
beholders that it is a beautiful and imposing structure.
In the process of its construction the most rigid economy
lias been consulted, consistent with the enlarged scale on
which the State should erect all her public buildings. We
think all will regard it as highly creditable to the Board of
Trustees under whose auspices the work has been accomplished, and an honor to the State of Michigan.
For this noble edifice, as you are aware, we are especially
indebted to the member of your Board who resides in Flint.
From the first spade of earth excavated for the foundation
wall, to the finishing stroke on the summit of the dome, he
has superintended it; has been present in person nearly every
day, and witnessed every inch of its progress; has persevered
steadily through all the perplexities and embarrassments incident to such an undertaking. His maxim seems to have
been that there is only one right way of doing a thing, and
he has the reputation of being very tenacious of having
things done in that way.
�30
BEPOET OF TEUSTEES
The Architectural Draughts of the building were executed
"by A. Jordan, Esq., of Detroit, who deservedly merits the
high reputation which he sustains as an artist. The masonry
has been performed by Messrs. Tobias and John T. Johnson,
who always do their work thoroughly, whether it take a
longer or shorter time, and whether they gain or lose by the
contract. The head carpenter was Eeuben Van Tifflin, Esq.,
who manifested a laudable pride in having his labor planned
and executed in the most workmanlike manner, and finished
"in an appropriate and tasteful style. The painting, undertaken by Joseph "Woolhouse, Esq., and the glazier work, by
Francis Gurnea, Esq., were each promptly and faithfully
performed.
This part of the plan of our Asylum buildings, now completed, was designed for school rooms and nothing else. It
is well adapted to its design, but is not adapted to the purposes for which we are now temporarily occupying it, for a
boarding establishment and all the other uses required in a
public institution of this kind. It is not adapted to the domestic work of cooking, baking, washing and ironing, nor for
foath rooms, study rooms, and dormitories for the pupils. It
"is not suited to the important object of having all the apartments of the males and females respectively, in separate
wings of the building.
We every day feel the want of apartments suited to our
condition, and shall until the future contemplated structures
are completed.
But though this building were ever so well adapted to the
•objects for which it is used, still there is not enough of it.
As already stated, the rooms are now all occupied, and some
of them excessively crowded. "We see not how more pupils
can be admitted to this building, unless we convert our lecture room into dormitories. But more pupils will ask for
admittance next year and years following, just as they have
done years past. The first year we had eleven; the second
�OF MICHIGAN ASYLUMS.
31
year twenty-three; and now we have seventy. This increase
will continue in future years. It may justly be estimated
that three years from this time there will be one hundred and
fifty pupils desiring an education in this institution. Hence
the necessity of commencing the erection of the remaining
portion of the buildings early the next spring, as it will probably require nearly three years to complete them.
"We also need workshops, in which the deaf and dumb and
the .blind boys may spend some time each day, when not in
school, in acquiring some useful trade or handicraft by which
they will be able in part, and many of them altogether, to
support themselves, when they shall have left the Asylum.
This is not only an important part of their education, but by
employing all their idle hours, serves to keep them out of
mischief, and prevents their being discontented. I would
suggest that as soon as we are able to occupy the other buildings, the rooms in the basement of the present buildings may
be used for workshops. If this be practicable, hence the
further necessity of erecting the other buildings as soon as
possible.
Since my last report, some of our teachers have resigned
their offices, and others have been appointed in their stead.
At the close of the term, one year ago last July, Mr. Nordyke, who had taught for one year, resigned for the sake of
further prosecution of his studies in the Indiana institution.
He is now a teacher in that institution. Mr. "William L. M.
Breg, a deaf mute, who was educated at the New York institution, and was under instruction ten years, was appointed
to fill the vacancy occasioned by the resignation of Mr. Nbrdyke, and entered upon his duties the first of May last. His
literary attainments and general character were commended
to us in unqualified terms by the President of the New York
institution, and by his son, (the latter had been his instructor
for the last three years,) but the result of our acquaintance
with him thus far has more than equaled our expectations.
�32
BEPOET OF TRUSTEES
In his superior education he is a rare specimen of what can
be accomplished for the unfortunate deaf mute. Added tothis, his amiable disposition and correct deportment, his
energy, industry and perseverance, his love of order and
discipline, eminently qualify him for the station he occupies.
The addition of a new class of pupils last May, rendered
it necessary to employ another teacher, and Miss Caroline
A. Sharpe was appointed. Owing to feeble health, she resigned at the close of the first term. Her class made satisfactory improvement under her instruction, and we were
sorry to lose her services. I shall nominate her successor as
soon as a competent person can be obtained.
Measures have recently been taken to secure a music
teacher for the blind, but we are not now able to announce
any definite results.
Our present number of pupils is fifty-three deaf and dumb,
and seventeen blind. More than this will appear in the catalogue at the end of this report, as we insert the names of all
who have been pupils since our last report. Five of those
who were with us last term are not expected to return. One
has gone with his parents to reside in another State; one was
a graduate of another institution, and came for only a limited
time; two others had recently become deaf, but were not
dumb, had a previous knowledge of language, and one of
them more than an ordinary education, and it was thought
they could pursue their studies to better advantage elsewhere
than in an institution for the deaf and dumb; one other, who
had been under instruction for twenty months, thinks he has
attended school long enough, and can do better to stay at
home and work at his trade. Such instances of mistaken
views as to the time required for an education, often occur
among the deaf and dumb, and more often still among their
relatives. In some cases their services are valuable at home,
�OF MICHIGAN ASYLUMS.
33
and their parents think that two or three years, at the longest, is sufficient to complete their education. They consequently take them away, and they pass in the community as
specimens of what an education does for the deaf and dumb,
whereas they had only commenced their education. Hearing
and speaking children generally attend school from the time
they are five or six years of age, till they are eighteen or
twenty, and some for a still longer period. How then can
one who neither hears nor speaks, whose mind in most cases
is entirely uncultivated up to the time he enters the institution; who commences with the alphabet, and learns the
names of objects and meaning of words only one at a time,
and then does not remember it till it has been explained and
written many times; and when, by this slow method, he has
acquired a small vocabulary of words, he has before him the
still more difficult task of trying to learn the grammatical
structure of sentences; all of which the hearing child acquires
without going to school at all, by hearing the language spoken, and speaking it himself with his brothers and sisters or
other associates at home. The wonder is that any deaf mute
acquires a tolerable use of written language in seven years,
less than half the period allotted to the education of those
who can hear and speak.
In some institutions for the deaf and dumb in other States,
it is required as a condition of admittance that the pupil is
not to leave the institution till he has pursued the full course
of six or seven years. Such a regulation secures a benefit
to the pupil, and saves the institution from being judged by
a false standard, viz.: the acquirements, or rather no acquirements, of those who have pursued only a partial course.
One blind pupil of last term had his sight perfectly restored, and of course will not return. There are, at present,
other absentees, who are expected soon to return to the
school.
�34:
EEPOET OF TRUSTEES
Our deaf and dumb pupils are divided into three classes;
one is taught temporarily by my son until we can secure a
permanent teacher, one by Mr. Breg, and the other by myself. The blind are taught by Mrs. Fay.
The causes assigned for the deafness and blindness of our
pupils, so far as ascertained, are as follows: The deafness of
twenty-two was congenital; by sickness, without specifying
the disease, seven; sores in the head, four; brain fever, two;
spotted fever, two; scarlet fever, two; measles, two; whooping cough, three; colds in the head, two; scrofula, one; erysipelas, one; swallowing a German silver button, one; unknown, six.
The blindness of seven was congenital; by inflammation,
seven; brain fever, one; cataract, one; others unknown.
The father and mother of nine deaf mutes, and of one
blind pupil, were cousins. The parents of one deaf mute
are uncle and neice.
i From one family we have two deaf mutes, brothers; from
another, two, twin sisters; from another, brother and sister;
from another, brother and two sisters.
"We have one deaf and dumb girl who can call no living
creature kindred. She was found in Lenawee county, on the
line of the Southern railroad. It is supposed that she was
put out of the cars and left there. She was named Lenawee,
and is still called by that name.
Blind persons are sometimes sent to the Asylum for the
purpose of having their sight restored, under the mistaken
notion that ours is a curative establishment; whereas, education is the sole object. "We do not take, and think that none
but parents or near relatives should take, the responsibility
of having surgical operations performed on the eye. Our
physician applies mild remedies, where there is a prospect
of affording relief. About a year ago, a boy was sent to us
�OF MICHIGAN ASYLUMS.
35
from the Upper Peninsula, for the purpose of having his
sight restored. We informed those who sent him that such
was not the object of our institution, and put him into the
regular course of school exercises. Our physician prescribed
applications for his eyes, which, together with attention to
diet, regular exercise, and systematic life, resulted in perfectly restoring his sight, and he returned to his home. But
such cases are exceedingly rare.
We are often asked what we accomplish for our deaf mute
and blind pupils, or in what consists their education. Though
the answer to this question was implied in our last report,
yet for the benefit of those wishing the information, we will
answer it again.
For the deaf and dumb, what we attempt first of all, and
above all, is to impart a knowledge of the English language;
such that they can read, and understand it, when written or
published by others, and write it correctly themselves. This
is that of which the uneducated deaf mute is entirely destitute, and that which he most urgently needs. Some, before
they come -to the institution, have had such advantages by
traveling, visiting different places, witnessing the various
pursuits and busy scenes of life, that they are not entirely
destitute of ideas, but have no language by which they can
communicate their ideas, or none in common with speaking
persons. They have a language of signs, or pantomime, by
which they can converse with each other; and in the school
room they are taught to tpanslate this pantomime into written
language. They are thus restored to society, can converse
with their relatives and acquaintances by pen and paper, or
by slate and pencil, can read and write letters, and transact
business. Having acquired a knowledge of written language,
they are prepared to pursue other branches of learning, such
as history, the general sciences, and mathematics. We teach
them, however, arithmetic, geography, and the elenaents of
�36
EEPOET OF TKtfSTKES
other sciences, before they have acquired a correct use of
language, while the latter is regarded as the grand object to
be attained," through the whole course of their education.
Much important information is conveyed by means of the
sign language, while they are unable to understand any
other. Those who have more recently entered the institution,.
are constantly receiving information in this way, from those
who entered at an earlier period; and all are receiving it,
every day, in the school rooms, from their teachers.
In this way they are each day deriving moral and religious
information. Our school is opened each morning by assembling the pupils in the chapel, and explaining a verse of
Scripture, accompanied with prayer, all in the language of
signs. At the close of school, in the afternoon, they are
again assembled and questioned on the Scripture explained
in the morning; are required to remember the book, chapter,
and verse, the definition of words in the verse, and some of
them spell the whole on their fingers.
On each Sabbath morning and afternoon, we have stated
services, in which moral and religious truths are explained
and enforced by means of the sign language.
Some pupils are so far advanced in age when they enter
the institution, and others naturally so deficient in intellect
that they will never be able to use written language correctly,
and some few not intelligibly; still it is well for them to be
in the institution, for the sake of the information they gain
through the language of signs.
In consequence of the influences above alluded to, our
pupils, during the term of their education, are greatly improved in moral character. Previous to instruction, none of
ttem (unless they have associated with educated deaf mutes)
have any correct views of the being of God, or of the existence and immortality of the soul. These and other kindred
truths they first learn in the institution where they are educated. Some bring with them vicious habits and propensi-
�OF MICHIGAN ASYLUMS.
37
ties. One deaf mute boy who came at the age of nine years,
and whose home had been in a large city, his mother informed us had often been away from home all night long for four
nights in succession, and she knew not where he was, only
that he was with vagrant boys in the street, and trained in
the worst forms of vice. "We expect, by the blessing of
Heaven, so to transform him that when he leaves us he will
lead a life of correct moral deportment. Some uneducated
deaf mutes are addicted to lying, thieving, and fighting, but
it is owing quite as much to their ignorance as to their depravity, for the removal of both of which, influences are
constantly at work while they are in the institution, and
results are in some cases speedily seen.
Our pupils are not only improved in their intellects and
morals, but also in their manners. Their parents and friends
notice this, and sometimes express their surprise at the
change. One writes of a boy who had returned home for
vacation, after having been in the school one term, thus:
"After his return he appeared like a changed child, so orderly, quiet, and peaceable." Another says of his daughter in
vacation: " When she goes into company now, her behavior
is entirely different from what it formerly was."
It is interesting to the teachers, both of the deaf mutes .and
the blind, to witness the gradual development of mind and
improvement in manners. Some, having before scarcely
been out of sight of their homes, come with a vacant and
stupid expression of countenance, and the most uncouth,
awkward manners. But gradually, as the mind expands,
there is a lighting up of intelligence in their faces, they become neat in person and dress, gentle and refined in behavior,
and we are ready to exclaim, can this be the same individual
whom we first saw with so forlorn and forbidding demeanor ?
The blind pupils have been taught Orthography, and the
definition of words, History, Grammar, Arithmetic, Algebra,
Natural History, Philosophy, Astronomy, and reading by
�38
EEPOET OF TRUSTEES
the sense of touch, such books as are printed in raised letters
for their especial benefit. Of these we have now Howe's
Elind Child's First Book, six copies; Howe's Blind Child's
Manual, four copies; Howe's Geography; English Reader,
second part; English Grammar; Principles of Arithmetic;
Natural Philosophy; Astronomical Dictionary; the Constitution of the United States; Political Class Book; The Harvey Boys; Life of Melancthon, two copies; Psalms and
Hymns, two copies; Pilgrim's Progress; Baxter's Call; Book
of Psalms, two copies, and the entire Bible, in eight volumes.
Nearly all the blind pupils can read raised letters, and
some of them promptly, with interest and profit. One has
committed to memory the Book of Psalms, as far as the
eighty-fifth, and can repeat verbatim, a considerable portion
of the United States Constitution. This memorizing he does
voluntarily, in his leisure hours, by use of the embossed
books.
The uneducated blind, mentally, are not in so hopeless and
dependent condition as the uneducated deaf and dumb. The
former, in most instances, acquiring information at home, as
other children do, by conversation, public lectures, preaching, and hearing others read. But physically, they are in a
much more dependent condition. The task of instructing
them is not so slow and difficult, but the care of them in
supplying their physical wants is much greater.
In some instances, the change of character produced by
education, is as strikingly apparent as in the deaf and dumb.
Sometimes there is a young man from twenty to thirty
years of age, who has passed two-thirds of his previous life
in sleep, and the other third in sullen despondency in the
chimney corner; and the entire range of his ideas has been
limited to the distance between the chimney corner and the
bed. He enters an institution designed for his education;
his mind acquires the power and the habit of concentration
by thorough application to mathematics; it ranges over the
�OF MICHIGAN ASYLUMS.
39
world's history; it stores away, in its memory, the deductions
of chemistry and geometry; it holds communion with constellations and planets. A new world has been opened to
him. He is not only a wiser and better, but an inexpressibly
happier man. He no longer murmurs and repines at his
infirmity, but rather congratulates himself on his superior
attainments; and he is really superior to other students, at
least in the faculty of concentrating his mind on what he
studies. It is by this faculty that educated blind persons so
notoriously excel others in demonstrating the most difficult
mathematical problems.
Another may sometimes be found, the most of whose previous life had been spent in the grog shop, or with boon companions of such places. Having a retentive memory, as is
common with the blind, he has made great proficiency in the
literature of such localities. He can repeat, statim et verbatim, every vulgar jest, story and song laid down in the programme. But he goes to an institution more benevolently
adapted to his unfortunate condition, and there learns what
he never knew before, that besides the sensual there is such
a thing as mental and spiritual enjoyment. If he can bear
for a while the rein which seems to him so very taut, he at
length learns to despise his former mode of life, and begins
to aspire after something higher, nobler, more worthy his
immortal nature. He comes out in the end a reformed and
educated man; has learned self-reliance and self-respect, and
under the guidance of Divine Providence is indebted to his
education for being a more happy, useful citizen.
Thus have we attempted briefly to answer the question,
"What do siich institutions accomplish for the deaf mute and
the blind ?
As I look back to the date of my last report, the time
seems short; it has passed rapidly and pleasantly away.
Though necessarily filled with unremitting care and toil, yet
�40
REPORT OF TRUSTEES
the consciousness of success has been an ample compensation. In addition to the greater accommodations furnished
by the new building, the large accession of pupils and the
progress they have made, it is believed that our institution
has also grown in the confidence of the citizens of the State;
that the parents and friends of the deaf mute and the blind
are ardently attached to it; that none have aught to say
why it should not go on and prosper; and that future Legislatures will grant the funds to carry out the cherished plans
of our Board.
"We render our grateful acknowledgments to the Board of
Trustees, for their encouragement and aid in our arduous and
responsible duties.
Respectfully submitted,
B. M. FAT,
Principal.
MICH. ASYLUM TDK THE DEAF AND DUMB AND THE BLIND, )
Flint, November 12,1856.
)
�41
OF MICHIGAN ASYLUMS.
OF PUPILS IN THE ASYLUM DURING THE YEAR 1856.
Deaf and Dumb.—Males.
NAMES.
Armstrong, Joseph A.,
Armstrong, Laughlin M.,
Blair, Joseph,
Bigelow, Samuel,
Bingham, Robert,
Blue, Malcolm,
Bowen, Ezra,
Bradley, James,
Chubb, Samuel J.,
Drummond, Timothy,
Eancher, Eli,
Hewitt, James H.,
Holland, George "W.,
JIurd, Samuel,
Innis, Thomas,
Kellogg, Marvin,
Xrouse, "Wallace H.,
Lowry, John M".,
McCartney, Samuel,
Philips, Oscar F.,
Pierce, Stephen,
Pomaville, Maximo,
Rose, George L.,
Shirkey, Orson L.,
'Thorn, James "W.,
Tracy, John,
White, John C.,
COUNTY.
Van Buren.
a
St. Joseph.
Newaygo.
Jackson.
"Wayne.
Washtenaw.
Genesee.
Ottawa.
Wayne.
Lapeer.
Eaton.
Hillsdale.
Cass.
St. Clair.
Jackson.
Kalamazoo.
Macomb.
Saginaw.
Oakland.
Allegan.
Macomb.
Livingston.
St. Clair.
Washtenaw.
Mackinac.
Allegan.
�REPORT OF TRUSTEES
Deaf and Dumb.—Females.
NAMES.
Alderman, Mary,
Armstrong, Mary,
Armstrong, Sarah,
Berthelote, Sarah J.,
Brumfield, Emma A.,
Chubb, Henrietta,
Chubb, Sarah,
DeArmond, Eachael,
Doty, Pluma J.,
Eastman, Lois,
Elliott, Mary E.,
Fairbane, Elspeth,
George, Adelia M.,
Grob, Caroline F.,
Harwood, Lenawee,
Hildreth, Mary E.,
Hollon, Sarah,
Kellogg, -Harriet,
Knight, Almena R,
Lepper, Cordelia,
MclSTames, Mary,
Merril, Elizabeth,
Morgan, Ann E.,
Norton, Jane,
Prouty, Sarepta,
Eansom, Isabella,
Savage, Clarissa J.,
Vought, Lucy Ann,
"Wood, Almira D.,
COUNTY.
Oakland.
Jackson.
«
Monroe.
Wayne.
Ottawa,
tt
Kalamazoo.
Clinton.
Lenawee.
Ingham.
Wayne.
Jackson.
Monroe.
Lenawe^e.
Eaton.
Calhoun.
Jackson.
Kalamazoo.
Lenawee.
Oakland.
Livingston.
Lenawee.
Kalamazoo.
Barry.
St. Joseph.
Lenawee.
�43:
OF MICHIGAN ASYLUMS;.
BUnd.—Males.
COUNTY.
NAMES.
Benedict, James G.,
Blunt, Charles,
Bullock, George,
Kershaw, James,
Lamb, Henry,
Mendham, James,
!Newday, Henry,
Philips, Chester B.,
Priest, James,
Reed, George W.,
Robinson, Eli,
Torrey, Clark W.,
Wesley, John,
Wayne.
Oakland.
(C
Barry.
Calhoun.
Ontonagon.
Clinton.
Lenawee.
Wayne.
Washtenaw.
Cass.
Genesee.
Barry.
Blind.—Females.
NAMES.
Fenn, Huldah J.,
Hoff, Mary,
Nichols, Matilda,
Eeed, Mary Ann,
Stearns, Amelia A.,
Sullivan, Margaret,
Wood, Lucy Jane,
COUNTY.
Washtenaw.
a
Barry.
Washtenaw.
Genesee.
Wayne.
Lenawee.
�EEPOBT OF TBUSTEES
NUMMARY.
Deaf and Dumb,
Blind,
Moles.
Females.
Total.
27
13
29
7
56
20
Whole number,
from Allegan county,
Barry
"
Calhoun
"
Cass
"
Clinton
"
Eaton
"
Genesee
" —
Hillsdale
«
Ingham
"
Jackson
" .Kalamazoo "
Lapeer
"
•Lenawee
"
(Livingston "
Mackinac "
Macomb
"
Monroe
"
Newaygo "
Oakland
"
Ontonagon "
Ottawa
"
Saginaw
"
;St, Glair
"
St^Joseph "
"Van Buren "
•Washtenaw "
"Wayne
«
76
-
2
4
2
2
2
2
3
1
1
6
4
1
9
2
1
i2
2
1
5
1
3
1
2
2
4
4
1
�OF MICHIGAJT ASTLTJMS.
45-
ACKNOWLEDGMENTS.
Our thanks are due to the Editors and Proprietors of the
following newspapers, which have been sent to the Asylum
gratuitously:
Wolverine Citizen, published at Flint.
Genesee Democrat,
"
"
Detroit Tribune,
"
Detroit.
Michigan State Journal, published at Lansing.
Our thanks are also due to the Superintendent of the
Michigan Central Eailroad, for having invariably granted
free tickets to our pupils when going to or returning from
the Asylum, and for the prompt and gentlemanly manner in*
which the favor has been bestowed.
�TERMS OF ADMISSION.
The Asylum, is free to all the deaf and dumb and the
blind in Michigan, between the ages of ten and thirty years,
who possess a good natural intellect, a good moral character,
and have no contagious disease. All such are entitled to an
education, without charge for board or tuition.
Parents or guardians provide clothing for pupils, and pay
their traveling expenses.
The regular time for admission is at the close of the vacation, which extends from the last Wednesday of July to the
first Wednesday of October. Pupils will not be received at
other times, except in extraordinary cases.
Persons wishing to place pupils in the Asylum, should
address the Principal, stating the name, age, and residence
of such pupil. No certificate of any kind is required.
Pupils' clothing must T>e marked with durable ink.
Those persons bringing pupils to, or taking them away,
cannot be furnished board, lodging, or horse-keeping at the
Asylum.
�APPENDIX.
�APPENDIX.
STATEMENT of Receipts and Disbursements on account of the
Asylum for the Deaf Mutes and the Blind, at Flint,
EECBIPTS.
There have been received from the State since the first of January,
1855, for the benefit of the Asylum for the Deaf and Dumb and the
Blind,
-$37,468 26
DISBUKSEMENTS.
There has been paid B. M. Fay, balance of salary
as Principal for 1854,
$200 00
Salary for 1855,...
800 00
Three quarters salary for 1856,
750 00
$1,750 00
Mrs. B. M. Fay, as Matron, balance of salary for
1854,...
$ 60 00
Salaryfor 1855,
20000'
Three quarters salary for 1856,
225 00
475 0©
B. Nordyke, balance of salary for 1854,
$ 50 00
For salary in 1855,
100 00
150 00
W. L. M. Breg, traveling expenses, by resolution of
Board,.
$20 00
Salary as teacher in 1856,
82 33
103 33
Mias Caroline Sharpe, salary as teacher in 1856,
67 50
�32
APPENDIX.
Salary of J. B. Walker, as acting Trustee for 1854, $800 00
«
"
«
1855, 800 00
«
«
«
1856, 800 00
$2,400 00
Paid for carpenter and joiner work,
$6,894 51
" masonvrork,
6,218 79
" lumber and shingles,
3,167 93
" brick
1,97521
" iron, nails, stoves, copper, gas pipe
trimmings, &e.,
2,962 27
" furniture, carpets, beds, bedding, &c.,. 1,708 07
" paints, oil and glass,
1,040 87
" painting and glazing,
752 05
" team work,
1,024 25
« labor,
1,30596
" stone,
15080
* blacksmithing,
9525
" freight, storage, &c.,
380 02
" waterlime,
6541
" insurance,
25300
" R. D. Lamond, for medical services, by
resolution of Board,
L.
29 92
By resolution of Board, refunded money paid
for benefit of J. G. Benedict,
30 00
By resolution of Board, paid traveling expenses
of B. M. Fay,
75 00
Paid traveling expenses of J. B. Walker, as
Trustee,
193 35
Paid incidental expenses of Asylum,
4,199 67
32,522 43
$37,468 86
There have also been collected on notes donated by citizens of Flint
and vicinity, $1,453 00, principally in labor and building materials,
making the total expense of building and carrying on the institution
two years, $38,921 26.
J. B. WALKER,
Superintendent of Building.
Fmrr, NOVEMBER 28, 1856.
�APPENDIX.
53
STATEMENT of Receipts and Disbursements on account of the
Asylum for the Insane, since January 1st, 1855.
RECEIPTS.
Rec'din warrants drawn on the Treasurer at sundry times,.$62,905 24
Unexpended balance of 1854,
47460
Balance of collections of citizens' notes,
159 38
Total,
.$63,539 28
DISBTTKSEMENTS.
Forbrick,
$11,106 90
Eouble stone,
1,00752
Dimension stone,
704 51
Lumber,
5,343 64
Glass,
45456
Freight on M. C. R. R,
1,131 03
Mason work, including lime, sand, stone cutting, removing brick, &c.,
22,940 28
Carpenter and joiner work,
5,743 97
Teaming,
2,020 22
Common labor,
_
161 85
Painting,
612 99
Slating roof
1,634 56
Castings,
3,28079
Nails, iron, tin and copper work, (fee.,
2,990 4§
Iron pipe,
378 89
Water works, for raising water to building,
1,462 50
Water and right of way for race,
225 00
Blacksmithing,
1..
102 68
Lightning rod,
29 75
Bricking up well,
40 00
Sundries,
65 35
Grubbing and clearing up land,
60 00
Making fence,
31 83
�54:
APPENDIX.
Salary of Superintendent, 2£ years,
Surveying, leveling, &c.,
Balance over receipts,
Total,
,..
$1,800 00
24 00
1S6 45
.$63,539 22
ISEAEL KELLOGG,
Superintendent of Bwlding,
NOVEMBER 28,1856.
�CIRCULARS
EEFEEEED TO IN" THE KEPOKTS, ETC.
MICHIGAN ASYLUM FOB THE INSANE.
SIE—At a recent meeting of the Trustees of this Institution, a resolution was passed directing the President and
Clerk " to correspond with the Clerks, Supervisors, and Superintendents of the Poor of the several counties and towns,
and physicians throughout the State, with a view of obtaining statistics of Insanity in this State." The object is, that
the Board may be enabled more fully and intelligently to
present to the next Legislature the wants of the State in regard to the proper care of its Insane; and as the information
required is such as can be obtained only very imperfectly
from the census returns, the undersigned respectfully and
urgently request that you will favor them with replies to the
inquiries in the accompanying Schedule, in as full and complete a manner as you are enabled to do from all the sources
of information within your reach. It is important that these
be forwarded to us as early as possible—by the first of November, if practicable.
Respectfully yours,
Z. PITCHEE,
President of the Board.
B. HUBBAED,
Clerk of the Board.
DETROIT, August 1, 1856.
�56
APPENDIX.
Answers are solicited to the inquiries contained in the following Schedule, relative to the persons and condition of all
the Insane within your knowledge:
1. Name or initials.
2. ^Residence.
3. Sex.
4. Color.
5. Age.
6. Country of birth.
7. Single, married, widowed.
8. Lunatic or idiot.
9. Present and usual condition; whether mild, manageable, troublesome, excitable, furioiis or dangerous.
10. Length of time insane.
11. Whether State or town pauper; where and by whom
maintained.
12. Number in Institutions in other States.
13. Amount paid for their support in those Institutions.
MICHIGAN ASYLUM FOR THE EDUCATION OF THE DEAF AND
DUMB AND THE BLIND.
SIB—This Asylum is located in the City of Flint, Genesee
County. It is a State Institution, and is now free to all the
Deaf and Dumb and Blind in Michigan, between the ages
of ten and thirty years, who possess a good natural intellect,
a good moral character, and have no contagious disease. All
such are entitled to an education, without charge for board
or tuition.
Parents or guardians provide clothing for pupils, and pay
their traveling expenses. Pupils in going to and returning
from the Asylum, generally obtain a free pass on railroads.
The next session will commence on the first Wednesday
of October, 1856, and continue to the last Wednesday of
July, 1857, when there will be a vacation of two months.
�APPENDIX.
5T
Persons wishing to place pupils in the Asylum at the commencement of the next session, should write the Principal—
stating the name, age, and residence of such pupil. No certificate of any kind is required.
It is important that pupils should be brought to the Asylum punctually at the commencement of the term, and their
clothing should all be marked.
If there are in your vicinity Deaf and Dumb and Blind
persons, of suitable age and character, according to the conditions above stated, will you please make known to their
parents or friends the contents of this circular, that they may
avail themselves of the means of an education so liberally
provided for them by the State of Michigan ?
You are also respectfully requested to forward to B. Hubbard, at Detroit, Clerk of the Board, a list embracing the
names, residence and age, of all the Deaf and Dumb and
Blind within your vicinity and knowledge.
Tours, respectfully,
B. M. FAT,
Principal of the Asylum.
J. B. WALKEB,
Treasurer of the Board of TrusteesFLINT, August 1, 1856.
�DESCRIPTION
OF THE
MICHIGAN ASYLUM FOE THE INSANE.
SITUATION.—The Michigan Asylum for the Insane is situaied at Kalamazoo, upon the Michigan Central Eailroad, one
hundred and forty-three miles west of Detroit, and fifty-one
miles south-west of the Capitol at Lansing. The location is
probably as central and convenient as any that could have
been chosen, having reference both to the present means of
•-communication with the various parts of the State, and to
•any other routes of travel likely to be projected hereafter.
The site selected for the building is upon an irregular eminence, about one mile from the village, and sufficiently elevated above the valley of the Kalamazoo river to secure an
extended prospect, and yet well-sheltered and easy of access
from the plain below. The location is in every respect
healthful and desirable, and well adapted to the purposes
•and objects of an institution for the treatment of mental
"disease.
FABM.—The amount of laud originally purchased for the
use of the Asylum was one hundred and sixty acres, but 'to
secure a more desirable site for the buildings, an adjacent
'tract was subsequently added, making the whole amount of
land in the possession of the institution one hundred and
�60
APPENDIX.
sixty-eight acies (167 76-100ths). Most of this land is finely
timbered with the original growth of oak, hickory, and other
trees, affording every facility which could be desired for
beautifying the grounds. That in the rear of the building is
broken, and falls, by a series of ravines covered with trees,
about eighty feet to the valley below, through which flows a
small but rapid stream of pure water. The buildings themselves will cover an area of one and one-third acres. It is
designed to preserve about fifty acres in groves and woodland, with walks and drives, and the remainder will be devoted to ordinary agricultural purposes.
ARCHITECTURE.—The plans selected by the Board of Trustees were placed in the hands of A. H. Jordan, Architect, of
Detroit, for the necessary elevations, details, &c. The style
adopted is the Italien, it being the lightest, most cheerful,
and least expensive for the effect required in such an extensive range of building.
MATERIALS.—The material used in construction has been
brick, covered with Eoman cement and sand, and finished
to represent freestone. The window caps, sills and brackets,
belt-courses and capitals in front, are of white limestone,
from the Athens quarries, near Chicago. The division walls
throughout are of brick. The Asylum is built upon a system
of fire-proof construction, nearly all the floors being laid
upon brick arches sprung from iron girders, which besides
providing against fire, give additional security to the building, and ensure its durability.
GENERAL PLAN.—The ground plans were furnished by Dr.
John P. Gray, the accomplished Superintendent of the New
York State Lunatic Asylum, at Utica, under whose direction
the work was commenced. It might here be remarked, that
the principles laid down in a series of propositions relative
to the construction and arrangement of Hospitals for the
Insane, unanimously adopted by the "Association of Medical Superintendents of American Institutions for the Insane,"
�61
APPENDIX.
have been fully carried out in the plans adopted by the
Board. The form and internal arrangement of the Institution will be readily understood by reference to the accompanying ground-plan. The Asylum building proper, the main
front of which has an easterly aspect, consists of a center
and six wings. The center portion of the main building is
divided by the entrance hall into two nearly equal parts.
That to the right contains in front the principal office of the
Institution, the apothecary shop, and an ante-room communicating by a private stairway with the Superintendent's
apartments above; and in the rear, the matron's room and
ladies' receptiort room; while that to the left contains in front
the public parlor and officers' dining room, and immediately
behind these, the steward's office and men's reception room.
The second floor is appropriated exclusively to the use of the
Medical Superintendent. Upon the third floor are the apartments of the assistant physicians, steward and matron. The
basement contains the laboratory connected with- the apothecary shop, and the officers' kitchen and store rooms. Immediately behind the center building is the chapel, and still
further in the rear the engine and boiler house. Extending
from the center building, towards the south for males and
towards the north for females, are the several wards of the
Institution, nine on each side, including the infirmaries.
APPROPRIATION OF WARDS.—The various wards in the Institution are appropriated as follows:
Classification,
No*.
1 and 2 Convalescent and quiet,
3 and 4 Less disturbed,
5 and 6 More
"
¥
Demented,
8
"
and Infirm,
9
Acute cases. &c., (Infirmaries.}
Total,
No.
No. of Beds.
TotsI of
of
each sex
Wards Single r'ms.| Ans'd Dorm & clatl.
4
4
4
2
a
2
18
BO
56
60
20
12
12
10
32
96
88
60
20
12
12
240
48
288
The division of the sexes is equal. Eight of these wards,
�Oij
APPENDIX.
inclusive of the infirmaries, are upon the first floor, six uport
the second, and four upon the third floor of the transversewings. It is considered that by means of these, any desirable classification of patients may be readily carried out.
ARRANGEMENT OF WARDS.—Each ward has the usual arrangement of corridors, sleeping-rooms, day-rooms and dining-rooms; with two stairways, a clothes-room, lavatory, bathroom, water-closet, soiled clothes shaft, drying shaft and dust
flue, to each. The corridors in the first, second, and third
wings, are respectively, one hundred and fifty-five, one hundred and sixty, and seventy feet long; and in the third stories of the first and second transverse wings, one hundred
and nineteen and thirty-four feet long. They are uniformly
twelve feet wide, and in common with all other rooms, sixteen
feet in height upon the first and third floors, and fifteen upon
the second. The dimensions of the single sleeping rooms
are eight and ten by eleven feet, with an average cubic capacity of fourteen hundred feet. The associate dormitoriesare fourteen by twenty-one feet, and the parlors or recreation
rooms, eighteen by twenty. Lateral recesses, extending into
the projecting towers in front, form additional day rooms in
the first and second wings, on either side. The dining-rooms
are sufficiently capacious to accommodate the number for
whom they are intended, and are supplied with detached
sinks, cupboards, and dumb waiters. The closets, bath-rooms,
lavatories and clothes-rooms open upon an adjacent and not
upon the main hall, giving a very desirable privacy. The
bath and closet fixtures are of approved construction, and to
prevent all possible danger from leakage, the service pipesare conveyed in a separate pipe-shaft, an arrangement which
also facilitates and cheapens any repairs that may become
necessary. Drying-shafts having lattice-work floors, and
communicating directly with the renti'lating cupolas, furnish
a ready means of drying mops, wet cloths, damp brooms^
&c., and thus materially assist in promoting the cleanliness
�APPENDIX.
63
and healthfulness of the corridors. To prevent exposure, the
bath-rooms and lavatories have communicating doors, in
order that the latter may serve in " bathing days " as dressing rooms to the former.
INFIRMARIES.—In a detached building in the rear of the
first transverse wings, but connected with the wards by means
of a covered corridor, an infirmary is provided for each sex.
Fitted up with every convenience, they provide a very desirable plan for the treatment of acute cases, of those who are
seriously ill, or of any requiring special care and frequentmedical attention. They can be reached at all hours of the
night without disturbing any other portion of the house;
they provide the means of isolation in case of the occurrence
of any infectious or contagious diseases in the institution,
and give to the friends of dying patients an opportunity of
administering to them in their last moments.
WINDOWS.—The windows are fitted throughout with a castiron sash, the upper half of which, alone, is glazed. Posterior to the lower half, and immediately against it, is a wooden
sash of corresponding size and shape, moving free, and suspended by a cord and weight, the former being attached to
the bottom of the sash, and passing over a pulley near its
top, is always entirely concealed. The panes of glass are
six by nine inches in size. The windows, where deemed desirable, are protected by a shutter of framed wicker-work,
sliding into the wall, and retained there, as also in its position, by one and the same lock.
FLOORING.—The floors in all uncarpeted rooms are formed
of one and one-half inch oak planks, grooved and tongued,
and none of them being more than three and one-half inches
in width. The sleepers and the iron girders supporting the
arches, rest upon an offset in the wall, which, when finished,
also form the cornice in the room below.
PROVISION AGAINST FIRE.—The horrible sacrifice of human
life on the occasion of the burning of an institution for the
�64
APPENDIX.
Insane in one of the Eastern States, and the peculiar liability
of these buildings to take fire, as shown by the frequent occurrence of such accidents, determined the Board of Trustees, although it would somewhat increase the price of construction, to make the Asylum fire-proof. The more recent
partial destruction by fire of another institution, has confirmed the wisdom of this decision. The use of iron girders
and brick arches as support for the floors, was consequently
determined upon, and to secure additional safety, all connection between the wing and the center building is entirely cut
oft' by the interposition of a verandah of iron and glass, with
communications from one to the other only through iron
doors. The location of the heating apparatus and the kitchen
in detached buildings under the institution, quite exempt
them from danger of destruction by fire.
CHAPEL.-—A separate building immediately in the rear of
the center building, seventy by forty feet in size, contains
upon its first floor a room for Chapel purposes, capable of
seating three hundred and eighty persons. It communicates
with the different wards by means of covered corridors, is
appropriately fitted up, properly warmed, and lighted with
KITCHEN.—One central kitchen is intended to supply the
whole institution. It is placed immediately beneath the
Chapel room, with store-rooms near at hand, and communicates with the dumb-waiters of the different dining-rooms, by
means of a small car moving upon a covered railway. The
building containing the Chapel room and kitchen is surmounted by a bell and clock tower.
WABMING AND VENTILATION.—It is now admitted as a principle that the warming and ventilation of buildings corresponding in size and purpose with institutions for the insane,
should be effected by one and-the same process; and also,
that means should be adopted for expelling the foul air to
the same extent and simultaneously with the. admission of
�APPENDIX.
65
fresh. The fact is also established, and in many Asylums
has been confirmed by a costly experience, that the ordinary
system of making the ventilation depend upon the spontaneous action of warm air currents, has failed to give satisfactory results. A perfect and equable distribution of fresh
air, either warm or cold, or the necessary rapidity in the
discharge of foul air, under all circumstances and in all seasons, can be secured only by a system of forced ventilation.
This is found to be most efficiently and economically effected
by means of a fan driven by a steam engine; effectual, because at all times under perfect control, and economical, because the warm air is more thoroughly and rapidly distributed. The primary cost is not great; it is not liable to get out
of order, and the motive power is that required for other
purposes.
The system decided upon is a modification of that in use
at the New York State Lunatic Asylum, the efficiency of
which is shown by the fact that in five similar institutions in
other States, it has since been adopted, in place of furnaces
and other means of heating and ventilation already in operation. It consists of boilers, an engine, a fan, heating surface and distributing ducts and inlet flues, with exit flues,
foul-air ducts and ventilating cupolas. The boilers are four
in number; these with the engine and fan, (the latter peculiar, from the circumstance of its delivering the air in the
direction of its axis,) and the heating surface, consisting of a
series of wrought iron pipe, are all in a separate and detached
building. The air, after its delivery from the fan, passes
directly forward beneath the Chapel. The main duct conveying it gives off a small branch to the Chapel, and another
to the center building. It then branches towards either wing,
and another sub-division is made, one portion passing beneath the first longitudinal wing, and the other entering the
proximal end of the second wing, passes on to the end of the
extreme wing. The air passage beneath the building occu-
�66
APPENDIX.
pies the middle portion of the basement, or rather the space
immediately beneath the floors of the corridors, and the distributing flues pass up in the walls upon either side of them.
Exit flues are carried up in the same walls, taking their departure from two points, one near the ceiling, and the other
near the floor of the rooms on either side. These again conjoin in the attics to form the foul air ducts, and empty out
into the open air through the ventilating cupolas. Downward currents of air, for the ventilation of the water closets,
will be secured through an arrangement of pipes terminating
in the fire-boxes of the boilers. This very important department has been entrusted to Joseph Nason, Esq., of New
York City.
LAUNDRY AND WORK SHOPS.—The right wing of the engine
and boiler house contains the wash room, drying and ironing
rooms, and a similar wing upon the other side furnishes convenient rooms for the usual work shops. A close partition
, running from the rear of the Chapel to the engine house,
with a covered passage-way on either side, provides ready
and protected access to the shops and ironing room from the
various wards in the house, and at the same time prevents all
communication between the sexes.
WATER.—Water for drinking piirposes is drawn up from
a well, while that for bathing and laundry purposes is forced
up from a stream flowing in the valley immediately in the
rear of the institution.
DRAINAGE AND SEWEBAGE.—Cast iron pipes will be used
for connecting drainage in the rear of the wings, and will
pass forward beneath the building at a single point only on
either side. The drains and branch sewers will unite in front
and pour into the common sewer, which is of brick, egg
shaped, three feet high and two feet wide; this runs down
the ravine in front of the Institution, and empties into a depot
for the collection of solid material.
ILLUMINATION.—It is now universally conceded that gas is
�APPENDIX.
6T
the only proper material to be iised in lighting Asylums for
the Insane. To obviate the only objection to its manufacture
upon the premises, the gas-house will be placed just below
the depot referred to. The gas-main will be carried up to
the Institution in the sewer attached to its upper arch,
The general plan and arrangement of the building, as given in the preceding sketch, has been submitted to and received the unqualified approval of many of the more experienced physicians in charge of similar institutions. From
those most capable of judging, the Board has received the
gratifying assurance that their effort to combine in one the
acknowledged excellencies of several recently-erected Institutions, with such improvements as careful study and experienced assistance suggested, has not been unsuccessful.
Until actually engaged in their labors, those to whom a
State has delegated the duty of providing an Institution for
its Insane can form but little idea of the extent of this field,
and the magnitude of the work before them. Insanity, unlike almost every other form of affliction, does not raise itself
into prominence before the public; the community almost
involuntarily turns from its contemplation, and its attendant
sorrows are far too distressing to be obtrusive. The extent
of the disease is truly startling, and even public officers, the
nature of whose duties we would expect to familiarize them
with the subject, are scarcely prepared for the developments
of carefully compiled statistics.
Its relation to the public in another connection, has also
been very generally misapprehended. Concealed from observation in almost all but the humblest walks of life, we
, have learned almost habitually to regard it as one of the circumstances, to say the least, of penury and want; but an
intelligent investigation of the whole subject in a neighboring
State, has shown that it stands third on the list of CAUSES of
�.
68
APPENDIX.
pauperism! How important, then, for a State, with a view
to economy only, to say nothing of higher motives, to make
liberal provision for its early treatment and cure!
The most striking feature in the history of insanity is the
great success which has attended the modern treatment of
the disease, and later efforts to meliorate the condition of the
Insane, as a class. Very little progress seems to have been
made in this respect until the commencement of the present
century; previous to which time the condition of the Insane,
and the neglect and cruelty to which they were subjected,
fills one of the darkest pages in the history of human sorrow.
Soon after this period, with reference rather to the comfort
and safety of the community, than to the wants and necessities of the lunatic, " mad houses" and receptacles were
erected—prisons in every respect save the name—with
stone floors, dark cells, narrow grated doors and windows,
into which they were thrust indiscriminately and abandoned
to utter helplessness and hopelessness. "With these buildings and their brutal "keepers," with whips, chains and
manacles, was associated every thing that was terrible. Says
one, in describing them, " there were no amusements, no
cheerful occupation, no books, no animating change or variety of any kind, no scientific medical treatment, no religious
consolation. No chapel bell assembled th e patients for prayer,
or suspended the fierce and dreadful thoughts and curses
of the dungeon; no friendly face did good like a medicine."
For reasons now very apparent, efforts to cure and relieve
under circumstances such as these, were altogether ineffectual; no connected and philanthropic system of medical and
moral treatment could be carried out with any prospect of
success.
A more enlightened public opinion, urged on and supported by science and humanity, has since wrought a thorough revolution. Liberally constructed and well appointed
�APPENDIX.
69
Asylums are, one after another, springing into existence, and
the results of treatment are becoming more and more successful. True, the same prosperity has not attended all. In
a few, weighty obstacles, not, however, obscure in their nature, nor difficult of removal, seem to clog their operations;
still, the Annual Reports of the Asylums for the Insane
throughout the land, constituting as they do, year by year,
the history of insanity, bear evidence of steady advancement.
To inform themselves, therefore, of those principles upon
the recognition of which this progress was founded, became
one of the earliest duties of the Board. The inconvenience,
and almost impossibility, of wading through page after page
of hundreds of annual reports and printed matter relating to
the subjects, was very apparent. The uselessness of traveling from institution to institution, finding something here
worthy of imitation, and something there, when in fact the
excellencies might necessarily be peculiar to that locality,
and of gathering these together to form a plan, was soon
demonstrated. It was the wish of the Board to avoid multiplying mistakes, and repeating inconveniences, which some,
from deep attachment to their institutions, and long association with them, had half learned to admire, and inclined to
recommend. Another, and what has proven the wiser
course, was adopted—the early appointment of a physician
experienced in the speciality, to whose supervision the building, with all its details, might be intrusted. The frequent
and expensive repairs of institutions erected without such
supervision, led them to look upon this as a matter of economy. Many of the Asylums of the • United States were
erected according to plans furnished ,by architects only, or
by Trustees, without practical medical experience, and when
supposed to be finished, have been found so ill arranged and
defective as to call for large additional expenditures before
they could be used.
�70
APPENDIX.
It is, therefore, with what the Board venture to consider a
feeling of justifiable pride, that they present it for the consideration of the Legislature and the State. And they would
repeat their confident belief that no institution of the kind
In any country, more perfectly embraces with economy of
construction, all the necessary accommodations and conveniences, which the experience of modern times has suggested.
It is a matter of regret, even simply as far as the increase in
cost of erection is concerned, that it could not have been
completed at once. As before expressed in this report, the
Board feel that no appeal is required in its behalf. The
wants and necessities of the insane are generally recognized,
and we feel assured of prompt and liberal action on the part
of the Legislature. The need of an Asylum in Michigan is
urgently felt. Among other instances somewhat similar, we
have recently been made acquainted with the following: One
of our citizens upon whose wife this heavy affliction had
fallen, was obliged to go elsewhere for that relief not provided
here. He went eastward. The crowded condition of the
first institution at which he applied prevented her admission,
and he journeyed on—but before he could reach another, she
sank from exhaustion and died in his arms. As might be
expected, more or less afflicting instances, from time to time,
Iiave come to the knowledge of the Board, which they do
not deem it desirable or necessary to record here.
In conclusion, the Board of Trustees would express their
earnest hope that the institution will at once be completed
and opened, and that those enlightened principles of organization and administration which have formed the basis of the
prosperity of many others, will be recognized and acted upon,
In order to secure to it a future of the highest measure of
success and usefulness.
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asylums