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ANNUAL REPORT ON THE PUBLIC HOSPITAL FOR THE INSANE OF THE PROVINCE OF BRITISH COLUMBIA FOR THE YEAR… British Columbia. Legislative Assembly 1903

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 ANNUAL  REPORT
-ON   THE-
PUBLIC HOSPITAL FOR THE INSANE
-OF   THE-
PROVINCE  OF  BRITISH  COLUMBIA
 FOR   THE-
YEAR    1902.
THE GOVERNMENTOF
THE PROVINCE OF BRITISH CDLUURCi
VICTORIA, B.C :
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REPORT
PUBLIC  HOSPITAL  FOR THE  INSANE,
1902.
To His Honour
The Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour :
The undersigned respectfully submits herewith the Annual Report of the Medical
Superintendent of the Public Hospital for the Insane for the year 1902.
W. W. B. McINNES,
Provincial Secretary.
Provincial Secretary's Office,
February 2nd, 190S. E 4 Public Hospital for the Insane. 1903
OFFICERS.
Medical Superintendent:
G. H. MANCHESTER, M. D.
Assistant Medical Superintendent: Bursar:
C. E. DOHERTY, M. D. M. J. KNIGHT, ESQ.,
Steward and Store-keeper: Engineer:
R. REES, ESQ., HEWISON STOUT, ESQ.,
Matron:
MARIA FILLMORE.
Chief Male Attendant: Chief Female Attendant:
THOMAS MAYES. MARIA FILLMORE (acting).
Carpenter:
JOHN HUGHES.
Plasterer and  Mason: Farmer:
EDWARD FITZGERALD. E. B. STINCHCOMBE.
*
Gardener:
W. T. L. HOUSE. 3 Ed. 7 Public Hospital for the Insane. E 5
REPORT
Medical  Superintendent of the Public Hospital for the
Insane, New Westminster, B. C.
For the Year Ending 31st December,  1902.
To the Honourable
The Provincial Secretary,
Victoria, B. G.:
Sir,—In compliance with established custom, I have the honour to submit to you the
Thirty-first Annual Report on the Public Hospital for the Insane at New Westminster,
embracing an account of the operations of that Institution for the year 1902, together with a
summary of the needs requiring immediate attention and the estimates for the approaching
fiscal year.
Accompanying and forming a part of this report are the usual statistical tables, a comparison of which with those for the previous year shows that increased numbers of patients
have been dealt with and that the work of the Hospital has been extended in every department.
I am sorry to have to confess that, in spite of our best efforts, some of these tables are
very incomplete and inaccurate, largely on account of the frequent inability on the part of the
police to locate some person who, as the Statute calls for, " shall have knowledge of the
antecedents of the patient." This being a new country with a large proportion of its population consisting of young men of a more or less roving disposition, who are here to-day and
away to-morrow, strangers for the most part to all about them, will account in some measure
for the difficulty experienced. It is from the ranks of this very same class that so many find
their way hither, and if we succeed in getting answers to the questions in Form C it is usually
by catechising the patients themselves.
Turning to the first table we find that the year was begun with 284 patients in residence
and 8 on probation; and that 95 males and 26 females, total 121, were admitted during the
year. The increase in admissions compared with the previous year shows 6, all males.
Discharges numbered 61 and deaths 26, which figures are almost identical with those of the
last report. The year closed with 16 patients still on probation, double the number of the
previous year. The number remaining in residence at the end of the year was 311, an increase
of 20 men and 7 women. This increase of 27 was the average increase of the number daily in
residence, the figures for the two years being 269.56 and 296.62 respectively. The highest
number present on any one day was 315, which is 5 above the nominal capacity of the Institution. 50.41 per cent, of the number admitted were discharged, not including the deaths,
24.8 per cent, recovered, and 25.6 per cent, not recovered.    The percentage of recoveries on E 6 Public Hospital for the Insane. 1903
admissions shows a reduction, when figures are compared with those of the previous year; but
since we discharged as many recovered as there were recoverable cases admitted, it will be
seen that the reason of the reduction mentioned was the poor class of material with which we
had to deal. The percentage of recoveries to recoverable cases admitted was 100, which shows
that, after all, the results of the year were satisfactory, all things considered. The percentage
of deaths to the whole number of cases treated was 6.06, being slightly lower than in the
previous year, and a fair average in comparison with that of other similar institutions.
Admissions.
The admissions consisted of 95 men and 26 women, of whom 94 were committed by the
ordinary method, 10 by urgency forms, 4 by Lieutenant-Governor's warrant, and 13 by order
of the Governor of the Yukon. No patient was admitted twice upon fresh papers, so that the
121 admissions represents that number of different individuals.
Ten of those admitted had been patients here upon former occasions, the one who was out
longest having been continuously absent for upwards of 8 years, while 13 months covered the
length of the briefest absence. The average length of the absences of the ten was 3 years, 2
months and 11 days. Five others gave a history of having been in other asylums, and there
were likely more amongst the large number concerning whose past we remain in the dark.
In social relations, 71 were single, 37 married, 6 widowed, and 1 unascertained. In
religion, there were 32 Roman Catholics, 28 Anglicans, and smaller representations of the
various other denominations. From the Coast districts there were 93 admissions, as against
28 from the Interior, showing that the Hospital is convenient to the chief source of its inmates.
Twenty-two patients were born in England, 18 in United States, 14 in Ontario, 9 in China
and 3 in Japan, the balance being from many other countries. Altogether, there were 39
natives of Canada, of whom 10 were born in this Province. Last year I had to record the
fact that for 1901 there had been no admission of a native of British Columbia, so that the
contrast between the two years in this regard is most striking, and would tend to show that
in course of time conditions here will be the same as those prevailing now in older countries,
in respect to the proportion of insane.
The various occupations of the people of the Province were fairly represented, among them
being 9 prospectors and miners, 10 farmers and 35 unskilled labourers. In the matter of age,
Table number 10 shows that every period of life from 18 to 85 was represented, but that middle-
aged cases predominated. If, however, it were possible to trace back the history of many of
the older cases, it is almost certain to be found that the primary symptoms of mental instability
were manifested in the early part of life, most often during that period which is devoted by so
many to the " sowing of wild oats." The harvest is always abundant, and it is a sad fact, in
consequence, that by far the largest class of patients that is admitted here is composed of young
single men, who have just arrived at that time of life when they should be achieving their
greatest successes and "making their mark in the world"; but, instead of that, are breaking
up and clearly evidencing their utter mental and moral unfitness to cope with true life any
longer, mostly their own fault, but often that of the parents.
The duration of insanity prior to admission in 26 cases was less than a month, in 64 other
cases less than a year, but in 23 cases it was definitely known to have existed for more than a
year, a fact of more than passing importance in the light of the records contained in Table 18,
which shows no recovery last year from the ranks of those who had been insane for a year
prior to admission.
In 27 cases there was a history of insanity in the blood relatives, in 25 there was said not
to be, while in 69 cases reliable information on this head could not be ascertained. 3 Ed. 7 Public Hospital for the Insane. E 7
Relative to causation, I have nothing new to demonstrate or remark different from what
was pointed out last year. The same causes are operative everywhere, namely, heredity,
intemperance, syphilis and onanism. They are all more or less co-related, the one leading up
to the other, and very frequently several of these causes operative in the same individual. The
causes alleged by the relatives, when they allege any at all, are often absurd, either through
ignorance or wilful deception, and are not always accepted by us. Wherever possible, we try
to have the real causes pointed out for the benefit of all concerned.
Fifty cases enjoyed average bodily health upon admission, while 66 were reduced, and 5
were extremely reduced and almost exhausted. Two insane criminals were admitted, and 4
criminal insane patients. Special provision for this class will, I trust, soon be provided, as
they steadily increase in numbers. There were 13 cases of general paresis admitted, compared
with 14 in the previous year; also 3 idiots. Thirteen patients were classed suicidal, 6
homicidal, and 2 others both suicidal and homicidal. Of the suicidal cases, 3 had been rescued
from watery graves, and 2 others arrived here with severe wounds of the throat. Of the
homicidal cases, one was a murderer from the Yukon, whose sentence had been commuted from
hanging to life imprisonment; another was the Chinaman who committed so many murders at
Ladner. Of the two who suffered from impulses of a mixed character, one had killed her
daughter prior to admission, while the other made some effort at homicide after his admission.
Discharges.
There were discharged during the year 61 patients, 46 men and 15 women, of whom 30
were recovered, 19 improved, 11 unimproved, and 1 not insane. The number of recovered was
10 less than in the previous year, which, as I have already pointed out, I consider to be due
to the unusually poor material, from a recoverable point of view, which came to our hand, there
being only 30 cases in the whole number admitted that were considered to have any prospects
of recovery.
Of the 16 men and 3 women discharged improved, 10 men and 2 women left the Province
to return to their homes or friends; 4 men and 1 woman continue to get along satisfactorily at
their homes in this Province; 1 man died shortly after his discharge ; and the remaining 1 is
now in this neighbourhood, working steadily and earning his own living.
Of the 11 discharged unimproved, 5 were transferred to other institutions for the insane ;
4 others, all females, were removed by their husbands, in two cases to leave the Province; 2
men escaped, and 1, a Chinaman, was deported to China on the return trip of the vessel which
had brought him out. This is a matter in which the Vancouver police authorities are too lax.
They do not seem to understand that it is not the wish of the Government to permanently
support all the foreign insane, who may be either accidentally or intentionally brought to our
provincial doors, and they gather them in with never a thought as to where they came from,
so long as they know an easy way of getting rid of them for the time being. I should think
that they ought to be instructed that it is their business to help protect the country from this
kind of imposition and make inquiry into the origin of every wandering lunatic, with a view
to repatriating him if possible.
In spite of the fact that every year the results of early treatment of the insane are shown
to have been preponderatingly superior to the delayed treatment, there remains a large portion
of the people who will persist in keeping their afflicted friends at home just so long as
circumstances will permit, and only when driven by dire necessity will they consent to have
them placed under treatment, where their chances of recovery are so much greater than they
are at home. I think that sufficient prominence is not given publicly to this fact, or better
recognition of it might obtain. E 8 Public Hospital for the Insane. 1903
We are indebted to His Imperial Japanese Majesty's Consul at Vancouver for kindly
arranging to relieve us of the care of the Japanese patients admitted in 1902, as his predecessor
had done for the previous year. In this way two were repatriated in 1902. The Federal
authorities were good enough to remove to safer quarters at the Kingston Penitentiary an
insane criminal whom they had sent here earlier in the year. This relieved us of one cause
for anxiety during the past year.
Discharges on Probation.
When the year opened there were 8 patients on probation. Of these, 4 were discharged
recovered, 1 improved, 2 unimproved, and 1 was returned. During the year 57 more were
allowed out on probation, of whom 12 had to be returned, 18 were discharged recovered, 9
improved, and 1 each unimproved and not insane at the termination of their probationary
periods.    Sixteen remained out on probation at the close of the year.
The provision whereby patients may be allowed out upon probation is a very useful one,
as it enables us to observe them for a time after they have passed from under our direct
supervision and control to enter upon the pursuit of their former vocations amidst the old
surroundings. It frequently happens that a patient who has regained the power to conduct
himself properly while under our supervision fails utterly to continue to do the same once he
has restored to him his former freedom of action in the outside world. On the other hand,
were it not for the ability to give selected cases a probationary trial, we might feel compelled
to keep many an eccentric person under care who was not needing it, and who could, if
permitted, gain his own livelihood without being a menace to the safety of anyone.
Escapes.
Eight escapes occurred during the year, a very small number indeed, considering how
many enjoyed parole, as well as the large number who were engaged in proximity to the thick
bush during the clearing of the rear acreage. One patient escaped twice, the first time by
dishonouring his parole pledge, and the second time by breaking open the sash of his room, a
very easy matter in most of the old rooms. This was the first case to break his parole since the
establishment of the " open-door ward " two years ago. One was not really an escape, but
was a case of getting lost while on a message to the City. Three of those who escaped managed
to successfully elude the searching party, but were all heard from later on, one having fallen
into the care of another asylum to the east, from which direction he had but recently arrived
prior to his admission here. The Institution having been rather overcrowded during the latter
part of the year, extra risk of escapes had to be taken by placing some doubtful cases on parole,
the last mentioned-case being a sample.
Deaths.
The number of deaths was the same as in the previous year, namely, 25. Of these 23
were men and 2 women. Six were married, the balance being either widowed or single. The
oldest had reached the advanced age of 85 years, while the youngest was but 23. The average
was 51 years. One had been continuously resident here for 25 years and 15 days, while at
the other extreme was a case of six weeks' residence, the average time in residence for the
entire number being 3 years, 7 months and 13 days.
The most fruitful cause of death was general paresis, which accounted for 9, general
debility in senile and broken-down cases for 5, epilepsy and heart disease for 3 each, and the
remainder as set forth in table 20. One case was due to phthisis, the only one in the past
two years. The immunity we enjoy from such serious inroads of tuberculosis as affect most
of the asylums in the eastern part of Canada is quite noteworthy, especially at a time when o
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2 3 Ed. 7 Public Hospital for the Insane. E 9
many similar institutions in older parts of the world are going to great expense to perfect
arrangements for isolating suspected cases and for stamping out the virus of infection. The
one death which was attributable to this cause in 1902, was that of an Indian, which further
demonstrates the tendency for these children of the woods, when taken from their natural
environment and placed in confinement, to develop tubercular troubles, even in the absence of
contact with other cases suffering from such disease.
One death was due to a contagious fever, namely, measles. The patient, a deformed idiot,
had been in the Hospital for nearly two years, during which time he had grown very fleshy
and unwieldy. The high fever which accompanied the development of the rash proved too
much for his fattily degenerated heart, and he suddenly succumbed within two days of the
onset of the attack. Two weeks previous to this a male patient had been admitted who almost
immediately developed the disease, and had gone through the course to a satisfactory convalescence, being well isolated in another ward. How the contagion spread from the one case to
the other I could never discover, as the patients had never seen each other, and all other
channels were supposed to have been guarded. However, these were the only two cases of
infectious disease with which we had to deal during the year. The one who brought the
infection in with him had no idea where he could have contracted it.
Owing to the untiring faithfulness to duty upon the part of the attendants of both the
day and the night staffs, I have no case of suicide or homicide to report, notwithstanding the
fact that there were many under our care whose impulses were at times in these directions.
Assaults and Accidents.
There have been but few accidents during the year, and none of a serious nature. Through
some misadventure with the junior attendant of the ward, one of the male patients had a fall
upon his shoulder, which resulted in a broken clavicle. This fracture healed speedily and the
patient is as well as he was before.
One of the Chinamen employed in the laundry made a most vicious assault upon the
Laundryman early in the year. Coming up from behind at an unguarded moment, he struck
the Laundryman a stunning blow with a brick, producing a large contused wound of the scalp.
Before the employee could recover himself for defence, the patient was upon him again, in an
attempt to follow up his advantage, and would probably have done much more serious damage
but for the timely arrival of the Carpenter, who helped to subdue the patient and place him
in safe quarters. This assault was most unprovoked and unexpected, and shows one of the
difficulties we labour under in not knowing the language of this peculiar race.
I trust that we shall soon be provided with special quarters for patients of a criminal
tendency, as it is most unfair to the rest that such cases should be allowed to mingle with
them.
The Residual Increase.
Deducting all the discharges and deaths from the admissions, we still have 27 patients
more at the close of the year than were present at the beginning. Last year the increase was
26, and the year before 24, and so on, as shown in table 2, every year an increase. This
proves that instead of the need of this Institution waning, it is waxing ; instead of the number
of patients being reduced through discharges, deaths and deportations, it is increasing rapidly.
Where is the increase from ] Certainly not from the natives of British Columbia, whom I
have shown to form such an insignificant proportion of the number of admissions. It is,
therefore, quite evident that the vast majority of the patients are coming in from other
countries. That such is the case we find fresh evidence every few days, when we are called
upon to admit some wandering lunatic who has not been in the Province more than a few days E 10 Public Hospital for the Insane. 1903
or weeks. If it is desired to put a check upon the importing of insane persons, the Government of the Province should take the matter up seriously without delay, or British Columbia
will soon lose the enviable position it has held in this matter in comparison with the standing
of the older Provinces, as set forth in the last census returns, Bulletin IX., from which I
extract the following :—
Per thousand
inhabitants.
Total number of insane in Canada 16,495 3.1
„ British Columbia         299 1.67
m ii Manitoba       565 2.21
ii ii New Brunswick    1,054 3.18
ii .. Nova Scotia    1,392 3.02
ii Ontario    7,511 3.44
ii ii Prince Edward Island       357 3.45
ii Quebec    5,245 3.18
ii H North-West Territories not completed.
It has often been remarked to me that this Province had a greater proportion of insane
than any other, but the above shows that to be a mistake, and shows that, on the contrary,
we have the smallest percentage of any. In England and Wales the proportion is 3.35, in
Ireland 5.61, which is an exceedingly high rate.
Treatment.
The methods of treatment pursued during the past year have not differed from those
employed in the year before as outlined in last report, and while they have been as successful
as usual, and results compare favourably with those obtained in other years, yet I would not
be doing my duty if I allowed you to think that our methods are as advanced as they should
be. We lack many facilities, even primary ones, for carrying on the most modern and scientific treatment of the insane, and narrowly escape ranking as a mere house of detention.
If you were to remove from this Institution all the patients' bedrooms, dining-rooms,
lavatories and closets, together with the kitchen and heating plant, officers and attendants'
quarters and the newly erected shops, what would be left 1 Almost nothing. The apartments
enumerated are what you would find in connection with any home; wherein, then, does the
hospital consist 1 True, we possess an up-to-date operating room as the sole mark of a hospital,
but even this is so badly set as to its immediate surroundings as to greatly curtail its usefulness. But where are the patients' examining rooms, the laboratories with their instruments
for the examination of blood, urine and sputum, the hydro-therapeutic and the electro-therapeutic appliances which are proving so useful in many places; where are the walks for an airing
and the gymnasium for exercise during the long winter months, and the campus for outdoor
recreation in summer? The truth is they are all lacking, and largely for the reason that they
were not considered necessary here in the past.
Since I took charge, less than two years ago, I have sent the patients out to work in large
numbers for the first time, the first object of our labours being to reclaim the balance of this
reserve from the surrounding bush and place it under cultivation. While one gang was thus
employed another was building the set of shops mentioned in my last report. The two seasons
have seen about ten acres of new ground cleared and cropped and in course of preparation to
provide the campus and walks so needful for the welfare of the patients. However, the
structural deficiencies of the Hospital itself are the greatest with which we have to contend,
and the rapid increase of inmates renders it difficult for the Government to do more than keep
pace with the demand for more accommodation. I sincerely hope, nevertheless, that in spite
of the difficulties attendant upon financing the development of this new country, the Govern- 3 Ed. 7 Public Hospital for the Insane. E 11
ment will see fit to make such improvements here that before many years a different tale shall
be told of the efficient preparedness to be found in this place for meeting and dealing with all
classes of the insane.
Diet.
The dietary arrangements have been about the same as in the previous year, when the
allowances were shown to have compared well with the standard set up in other well-regulated
asylums. That the food has been ample in its proportions is attested by the general well-
nourished appearance of the patients, and that it has been satisfactory in quality has been
ensured by very strict inspection of the supplies, both as received and as served upon the
tables. To provide an occasional treat for the patients, fowl being debarred through excessive
prices and our inability to produce sufficient quantities ourselves, Belgian hare meat has been
given a trial, with satisfactory results. However, to carry the project out successfully would
require taking it up more seriously than we did last year, getting the best and largest stock
possible and erecting a small building to protect the animals during the winter. I am of the
opinion that it would be well worth the small initial expense.
Paying Patients.
There have never been any special arrangements made in this Hospital to cater to the
needs of a self-maintaining class of patients, and the result has been that all such have simply
had to take their places amongst the " free patients," sharing the same rooms with them and
eating at the same tables the same simple bill of fare. This is certainly contrary to the commonest sense of justice, and while it may not be the intention of the Government to encourage
the committal of this class of patient to the Institution, they should do either one of two
things, namely, refuse to accept the money which these patients are able and willing to pay,
or give them some better consideration in return for it. There happens to be no private
institution for the care of insane in this Province, and, until there is, a portion of these
buildings could be laid apart for them and suitably furnished and tended.
Recreation and Amusement.
As already pointed out, the absence of walks, campus and a gymnasium has made outdoor recreation almost impossible here, with our very limited grounds and our long rainy
season.    I am hoping that 1903 will see this matter much improved.
The weekly dances in the winter season have been carried on as usual, with much profit
to the patients, who eagerly look forward to this one break in the somewhat monotonous life
of the week. Even in this matter we have to overcome a grave difficulty in the marked
disproportion between the numbers of the sexes. Our female jaatients and staff stand to the
male side in the proportion of about 1 to 4, so that, to balance things in the dancing arrangements, many kind lady friends of the employees come weekly to help us out, and in so doing
they add very materially to the brightness and success of the entertainments.
The City Band gave an open-air concert one evening in the summer, and the City
Amateur Dramatic Club produced " Colleen Bawn," to the great delight of the largest audience
of patients ever congregated since the opening of the Institution. We are greatly indebted
to the members of the City Band, under the leadership of Mr. Derville, as well as to Mr.
Livingston and his excellent company of performers, for these entertainments. There are very
few local organisations devoted to music or the drama, which will account for the small
number of such events to be chronicled here, but I am hoping that in the near future we shall
have things so arranged that the employees themselves will be encouraged to make some
such efforts to brighten the life of the Institution. E 12 Public Hospital for the Insane. 1903
About the same number attended the local exhibition as did the previous year, namely
95, through the kindness of the directors, who granted free admission to the patients. Later
in the year the Horticultural Society, through Mr. Dashwood-Jones, remembered us in the
same way when they held their annual flower show. The usual amount of reading material,
daily and weekly papers, books and magazines have been supplied upon the wards. The piano
has continued to be a source of much pleasure to the female patients, and I now desire to see
one placed upon the best male ward, where I am sure it would be greatly appreciated.
Divine Service.
Service has been held as usual every Sunday throughout the year, and has been well
attended. The pastors of the City attend upon occasion, and their ministrations are much
appreciated by the patients.
Employment.
Patients in increased numbers have been employed about the Institution during the past
year, the total number of days' work performed by them being 54,918, as compared with
48,307 for the preceding year. No new department in the field of labour was entered, but
as shown in table 22, the most of the work outside was upon the farm, garden and front
grounds. The general labour of clearing and cultivating lands, making roads and paths,
erecting fences and small buildings, is such as lends itself most admirably to meeting the
requirements for employment in a place of this kind, and this is just the sort of work which
has chiefly engaged our attention in the past year, and will continue to do so for another
couple of years before we shall have brought into use the rest of this reserve.
We have struggled along through another twelve months with the laundry in the same
shape as that depicted in my last report, and the Chinese have done the washing by hand-
However, it affords us the greatest satisfaction to see that our appeal for improvements has not
been in vain, but is even now bearing fruit, to the extent that the contractors are upon the
ground pushing forward the contemplated changes.
The new shops have all been in use during the year. In the cabinet-shop several large
and valuable pieces of furniture, as well as smaller articles, have been manufactured by one of
the skilled patients. Much making and repairing has been achieved through the medium of
the carpenter-shop, blacksmithy and plumbing-shop, the value of which it would be difficult to
estimate. Suffice it to say that the shops are all proving very useful and convenient, not to
mention the important matter of economy.
In the tailor-shop and shoemaker-shop the work of providing the patients' clothing and
shoes, as well as the attendants' uniform, has gone on as usual, the amount accomplished being
set down in Table number 23. In order to cope with the increased amount of repairing work
in the tailor-shop during the year, I found it necessary to secure the services of a tailoress, the
same person being also required to relieve as a nurse on the wards at meal time.
Products op the Farm and Garden.
The results of the year in the farm and garden were rather disappointing, owing to the
ravages of certain pests, which attacked and destroyed the cabbage and turnips to such an
extent that, while fully 2,000 more cabbage plants were set out in 1902 than in 1901, there
was not above one-quarter the crop. A new piece of ground was added, making the area
under cultivation larger than ever; but as a result of the other improvements carried on in
the immediate proximity of the new area, the natural moistness of the ground was carried off
early in the season, and when the dry months arrived the light soil was reduced to dust,
preventing further growth until the early fall rains set in. In fact, very little of the land
here can be made productive from one cause and another ; but notwithstanding the many drawbacks, we think that we have succeeded for the first time in raising sufficient potatoes to carry 3 Ed. 7
Public Hospital for the Insane.
E 13
us through the year, which in itself constitutes an important advance in that department.    The
lists given below show the products of the farm and garden respectively and the contract values
of the same :—
Farm Products.
Quantities. Value.
Artichokes         500 lbs. $ 10 00
Beets     5,163   „ 36 14
Cabbage      2,758   „ 41 37
Carrots    25,137   „ 188 52
Cauliflower         334   „ 13 36
Corn (in the ear)         549J dozen 82 42
Cordwood           63J cords 206 37
Ducks             9 6 75
Eggs    143 dozen 35 75
Fowl     16 9 60
Parsnips    18,480 tt>s. 129 36
Pork      8,153| „ 733 81
Potatoes   71,292   .. 534 69
Pumpkins      1,620   „ 48 60
Squash         240   „ 7 20
Turnips     8,297   n 49 78
Products of Garden.
Quantities.
Beans (French)  329 fts.
Cabbage, early  497   n
Carrots  527  n
Cauliflower ,  45  n
Celery  27$ ii
Cucumbers  15  n
Leeks  100  „
Lettuce  250 dozen
Onions  2,517 lbs.
Peas  953  n
Potatoes  668  n
Radishes  804 bunches
Rhubarb  1,262 lbs.
Squash  221   n
Tomatoes  1,023  n
Turnips  124  n
Apples  4,054  n
Blackberries  79   n
Cherries  100  n
Chestnuts  39   n
Currants, black  208  ,i
ii         red  370  „
n         white  20  n
Gooseberries  458  n
Grapes  60  n
Peaches  114  n
Pears  532  n
Plums  347  .,
Prunes  649   n
Raspberries  244   n
Strawberries  65   n
Walnuts   	
$2,133
72
Value.
$ 6
85
7
45
3
95
1
80
10
80
40
3
00
37
50
37
75
33
35
5
01
20
10
63
10
6
63
82
84
1
24
101
35
3
16
8
00
3
90
8
30
18
50
1
00
22
90
3
00
11
40
18
62
6
94
19
47
19
52
5
20
1
00
$574 03 E 14 Public Hospital for the Insane. 1903
Chief Events of the Year.
During the past year the work of the Hospital has gone on smoothly, and harmony has
prevailed throughout the Institution, with the natural result that the main purpose for which
it exists has been more efficiently served.
The entire management, which was carried on by the Medical Superintendent alone for a
year, was found to be too great a task for any one person to long continue to compass, so that
early in the year search was made for a suitable man to fill the vacant position of assistant
medical superintendent. The result was that a most eligible and likely officer was located in
the person of Dr. C. E. Doherty, who had but recently resigned from the post of medical
superintendent of the Nelson General Hospital, where he had put in two most successful years,
and was about to enter into private practice. This appointment has brought to this service
the energies of a most devoted and capable officer, and a gentleman who has won his way into
the hearts of patients, employees and officers alike. Dr. Doherty arrived on May 29th and
began duty at once, much to the relief of the Superintendent.
The Assistant Medical Superintendent having been installed, it was now possible for the
Medical Superintendent to take a much-needed holiday, and so he decided to attend the annual
meeting of the American Medico-Psychological Association at Montreal, making it the first time
that this Institution has ever been represented at this important gathering of specialists. These
gatherings together of the numerous medical officers of institutions for the treatment and care of
the insane are productive of the greatest good to this branch of the medical science, and afford
about the only chance there is for the members, who hold in their hands the welfare of
thousands upon thousands of the insane of this continent, to rub up against each other and
exchange views upon the topic that interests them mostly. Every Province in the Dominion
was represented except Manitoba, as well they should have been, seeing that this Association
meets in Canada but once in a score of years. In this connection I think that the Government of British Columbia should do as the Governments of the other Provinces and States,
namely, send their medical superintendent to the annual convention of this body every so
often, as shall be decided upon. It could not be expected that he would be sent every year,
on account of the long distance (for the meetings are usually held in the East) and the attendant
expense, but it is very much in the interests of this Hospital that he should be sent as often
as possible, say once in every two or, at the least, every three years.
The changes in the personnel of the Hospital staff during the past year have been few, and
almost all were for reasons of a satisfactory nature. Three additions were made, two of which
I have already referred to, namely, an Assistant Superintendent and a tailoress. The third
was an extra male attendant, whom it was found necessary to engage to allow of appointing a
deputy to assist the Chief Male Attendant, whose health has been seriously threatened. This
deputy has been able not only to relieve his chief, but has been of much service to the
executive offices, by bringing into their immediate proximity an available officer for the
hundred and one special duties arising daily therein.
Two small fires occurred during the year, one in B Ward and one in F Ward. The cause
may have been due to patients' carelessness in smoking, but it is just as likely that they
originated by spontaneous combustion. They were identical in their nature. Each occurred
by the side of a steam pipe passing through the floor, there being space enough between the
pipe and the floor to allow the fine dust from the ward to drop down where it would accumulate in a small fluffy pile and form an excellent starting point for a blaze. The damage in each
case was nil, owing to its immediate detection, the first time by a patient and the second time
by a night-watch.    The chances of a fire gaining much headway in a place like this are rather 3 Ed. 7 Public Hospital for the Insane. E 15
small, when so many people are constantly about, yet I desire to remark that if a fire once did
gain headway here it would require a much better supply of water to cope with it than is
available now ; therefore, I trust that the amount asked for as an appropriation later on in
this report will be provided, in order that a new pipe line may be laid this year.
Improvements and Repairs.
Improvements have gone on in every direction, the chief of which consisted in clearing
more land in the rear and cultivating it, putting in order the front ornamental grounds,
extending the boundary fence so as to include the balance of the reserve, making new roads,
one being for the public use and outside our new boundary, to replace the two which formerly
crossed the reserve and had to be closed to traffic.
The farmer put in several more tile underdrains, while the gardener removed all the
unsightly mounds of earth which used to exist on Columbia Street, in front of our fence.
In the wards some good work was done, especially on the female side, where both wards
were finished off with a coat of plaster of Paris in the usual manner. When those wards were
built the finishing coat of plaster was omitted, for some supposed a3sthetic effect; however, the
result was anything but aesthetic, but most decidedly unsanitary, on account of the manner in
which the rough plaster caught the dust and held it, forming a most undesirable lurking place
for disease germs. These wards were also decorated and now present a bright and attractive
appearance. Ward A was alabastined throughout and redecorated, bedrooms and all, with
pleasing results.    A new floor was laid in B Ward alcove.
The medical superintendent's house was overhauled by the plasterer and painter before
being occupied by the present tenant. The north wall of this residence became so much loaded
with water every rainy season as to render the house unsafe to live in, and to remedy this a
heavy coat of cement was applied by the Plasterer, with satisfactory results. A neat and
roomy balcony was also added to the front, where a convenient recess offered an excellent site.
This has much improved not only the residence itself but the appearance of the entire front of
the Administration Building.
An old and decayed balcony which had gone out of use was torn away from the 1884
building, to which it was causing damage every winter. This has given greatly increased light
to Wards E and F and permitted the sunshine to flow into their corridors for the first time.
A break occurred in the main sewer at the water front which entailed a good deal of
labour before it was remedied.
New Buildings.
The " Shops-building " mentioned in the last report as having been well begun has been
almost completed during the year, by the continued labours of our staff of mechanics and the
patients. The class of workmanship that has gone into this building has been the very best, and
the result is a credit to the Institution. The carpenter-shop, cabinet-shop, tailor-shop, and
shoemaker-shop have all been occupied, and the employees in each department express great
satisfaction at the splendid light and convenient arrangements with which they are now
surrounded. The rooms for the mechanics are as fine as I have ever beheld devoted to that
purpose, and had the entire building to be planned again it could not be improved upon.
A small building, 30 by 20 feet, was erected for the purpose of a temporary laundry while
the old one is being reconstructed, and when not further required for that purpose will be
turned into a warehouse for the steward, a building we have very much needed in the past.
Hitherto we have had no place in which to store the crops of vegetables, which have had
to be pitted in the fields, a plan attended with considerable loss. We have also lacked a shed
to protect the farm implements and waggons. To meet these requirements we have commenced
another building of considerable dimensions, being 75 feet long by 30 feet wide. The lower
part is all masonry, affording a clear space of 8 feet, and is for the vegetables. The upper
story, which has been brought to the level of the ground by excavating into the side of a hill
before building the basement, is for the storage of implements. This work has all been done
by our staff and patients and is of a substantial nature so far as it has gone. It will be
completed this year. E 16 Public Hospital for the Insane. 1903
Expenditure.
The current expenditure for the past year amounted to the sum of $55,345.65, which is
$60.43 less than that for the previous year. The grand total of expenditure was $62,195.22,
or $345.44 less than the grand total for the previous year. The grand total includes not only
the expenditure for maintenance but that for new equipment, new buildings and permanent
improvements.
These figures should prove very satisfactory, in view of the fact that an average of 27
more patients have been in residence throughout the year, while the efficiency of the Institution has been well sustained and even advanced. The fact that a larger number has been
treated at a reduced cost means a greatly reduced per capita cost, as shown in the attached
tables. Table A, to which I would direct your attention, shows that the per capita cost for
1902 is the lowest in the past 8 years, being $186.59, or about $19 less than it was in 1901.
Table B sets forth the analysis of the per capita cost, the most striking feature of which is
the fact that in the matter of heat and light the cost last year was less than half what it was
two and three years ago. In Table C it is observed that the heat and light expenditure
dropped another $450, as compared with the previous year, notwithstanding the fact that for
a portion of the year an additional building was being heated. This is very satisfactory indeed,
and leaves no room for improvement in my humble estimation. The credit is due to the continued efforts of the Engineer to improve the heating system, by adding traps and altering
steam pipes where considered advisable, until now it would appear that the plant is working
about as efficiently and economically as possible. The amount of fuel consumed in the furnaces
under the boilers was 799 tons of washed nut coal, an average of 2.18 tons per day. This
amount has sufficed to heat the entire Hospital in winter, all the hot water used for bathing
purposes the year round, also that used for dish-washing in the kitchen, scullery and wards,
and in the laundry for washing the clothes; it has furnished the steam for the laundry dry-
room, the steam jacketed boilers in the kitchen and the engine of the lighting plant. I do not
believe that further reduction can be brought about in the expenditure under this head until
we are supplied with a wharf on the river and a scow with which to bring the coal from the
mines and do the delivering of it ourselves with patients' labour.
The expenditure under capital account was less than in the previous year, being $6,849.57,
as compared with $7,134.58. However, for lands and works, being new buildings and permanent improvements, there was an increase of expenditure to the extent of about $400.
The amount expended for additional new furniture and equipment was $1,157.47, for additional
new surgical outfit $19.20, additions to medical library $111.48, and for lands and works
$5,561.42, which was paid out as follows :—
Shops-building $2,984 04
Boundary fence       836 01
Implement shed and root cellar       491   16
Steward's warehouse (temporary laundry)       329 08
Farm improvements, tile, etc       268 48
Improvements to wards       215 22
ii .       Medical Superintendent's house       155 24
u steam plant         74 32
Extending the gas service to new buildings         64 88
H water service in front grounds         51 84
Temporary vehicle shed         44 92
Improvements to entrance walk          18 70
Seeding down new lawns         12 00
Electric light poles, spikes, etc        7 35
Breeding hutches for Belgian hares  6 28
Screen doors to Lodge  2 90
$5,561 42 3 Ed. 7
Public Hospital for the Insane.
E 17
Table A.
Showing the average number of patients in residence each year, the total amounts spent for
maintenance and the per capita cost.
year.
Average number
in residence.
Maintenance
expenditure.
Per capita
cost.
1872 (81 days)	
16.57
16.07
16.76
27.42
36.41
34.61
36.52
38.17
45.42
47.18
47.86
48.73
48.70
54.67
59.11
73.55
79.43
71.30
78.78
119.87
125.24
133.92
148.64
162.97
171.43
188.91
216.53
226.44
243.24
269.56
296.62
$ 2,265 25
7,841 94
8,232 41
9,892 38
12,558 18
12,917 17
13,985 05
10,253 72
10,552 18
10,691 76
11,343 65
11,829 11
11,843 94
15,555 87
15,334 43
15,945 22
16,261 06
15,657 79
17,577 80
21,757 03
23,518 37
25,904 98
26,495 83
31,587 89
32,001 40
36,224 76
46,420 25
54,917 45
59,349 20
55,406 08
55,345 65
$6)6 00
1873	
1874	
1875	
1876	
1877    	
487 98
491 20
360 77
344 91
373 26
1878	
1879	
1880	
382 93
268 63
232 32
1881	
226 62
1882	
1883	
237 02
242 75
1884	
243 20
1885	
284 54
1886	
1887	
1888	
259 42
216 70
204 72
1889	
219 60
1890	
1891	
1892	
1893	
1894	
1895	
1896	
1897	
223 13
181 50
187 80
193 36
178 25
193 83
186 67
191 75
1898	
1899	
214 38
242 52
1900	
1901	
1902	
244 00
205 54
186 59 E 18
Public Hospital for the Insane.
1903
Table B.
Showing analysis of the per capita cost.
Year.
1872.
1873.
1874.
1875.
1876
1877.
1878.
1879.
1880.
1881.
1882.
1883.
1884.
1885.
1886.
1887.
1888.
1889.
1890.
1891.
1892.
1893.
1894.
1895.
1896.
1897.
1898.
1899.
1900.
1901.
1902.
Salaries.
$279 38
221 48
231 10
153 82
143 34
177 15
176 16
134 27
111 84
112 44
121 51
123 81
124 02
169 05
159 03
127 80
118 34
131 70
121 54
88 35
94 25
95 50
87 76
90 83
89 13
89 09
94 68
113 31
116 04
99 16
87 47
Provisions,
8184 03
166 81
152 10
113 40
114 45
126 75
124 23
95 10
87 71
81 14
84 52
92 56
90 64
84 33
69 35
59 10
60 47
59 11
62 77
54 79
56 74
53 55
57 07
61 15
55 93
58 18
69 43
72 91
72 62
66 65
61 13
Clothing.
$55 81
14 55
22 07
13 98
18 68
20 69
30 43
3 25
5 74
6 86
7 05
6 03
7 03
6 33
5 49
5 88
4 41
7 20
9 02
3 83
4 69
5 43
5 25
9 90
6 30
8 36
9 94
8 31
9 06
10 12
7 95
Fuel and
Light.
$22 44
23 65
23 98
16 88
22 75
4 66
13 94
15 91
14 06
12 73
12 30
11 04
12 43
15 05
16 20
15 38
13 90
12 93
17 31
20 43
20 53
22 60
18 83
20 41
20 29
19 11
21 82
33 96
32 10
18 52
15 25
Furniture.
$15 55
21 59
28 36
25 45
17 90
20 75
7 20
6 39
6 00
5 55
4 54
4 26
4 14
3 90
3 72
3 88
3 11
4 13
4 00
3 40
3 35
3 39
2 98
2 51
2 56
2 95
2 76
2 50
2 15
3 25
4 13
Medicines.
$10 18
7 74
7 78
6 73
2 86
3 74
9 16
6 31
3 63
2 56
3 49
2 24
2 77
2 93
1 59
93
2 09
2 07
1 29
1 89
1 80
2 69
1 43
3 10
3 63
3 86
5 12
2 73
1 71
1 07
1 20
Miscellaneous.
$49 30
32 16
25 81
30 51
24 93
19 52
21 82
7 40
3 34
5 34
3 61
2 82
2 18
2 95
4 04
3 81
2 40
2 46
7 19
8 81
6 42
10 20
4 93
5 93
8 83
10 20
10 62
8 80
10 32
6 77
9 46
Total.
$616 69
487 98
491 20
360 77
344 91
373 26
382 93
268 63
332 32
226 62
237 02
242 75
243 20
284 54
259 42
216 78
204 72
219 60
223 12
181 50
187 80
193 36
178 25
193 83
186 67
191 75
214 37
242 52
244 00
205 54
186 59 3 Ed. 7
Public Hospital for the Insane.
E 19
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GCG0COCO00G0COQ0GOX)00O0GOGOXiQ0G000COCCGO0OGOGOQ0GOXCOO5a:O; E 20 Public Hospital for the Insane. 1903
Revenue.
The revenue collections which were handed in to the Government for the past year
amounted to $10,926.23. This was about $1,900 less than for the year before, which is
explained by the large amount of arrears collected in 1901, as a result of the change in
management.    The annual collections since opening have been as follows :—
1873  $1,440 99 1888  $    750 00
1874  680 00 1889  220 00
1875  1,342 50 1890  599 24
1876  730 31 1891  761  15
1877  799 91 1892  2,418 43
1878  479 42 1893  1,585 40
1879  867 38 1894  2,709 53
1880  1,433 04 1895  4,409 23
1881  614 99 1896  3,74171
1882  505 18 1897  3,816 80
1883  298 24 1898  4,003 79
1884  98 35 1899  4,769 04
1885  00 00 1900  6,893 33
1886  50 00 1901  12,800 76
1887  720 59 1902  10,926 23
Requirements.
In my last report I mentioned that the needs of an institution of this nature were often
quite numerous, but that some were more urgent than others. I also intimated that I did not
intend to make a long list of the shortcomings of the Hospital, just to show how many there
might be, but would point out what seemed to me to be urgently required to advance the work,
and at the same time well within the possibility of achievement. I am more than gratified
to observe that the urgent requirements pointed out in last report are all being met, and the
year that has elapsed since making that report has only served to deepen my conviction that
when these present improvements have been completed the results will be most beneficial.
The principal requirement at the present time is increased accommodation for patients.
The nominal capacity of the Institution is 310, while we begin the year with 311 patients in
residence. If the same increase in numbers occurs this year as last we shall close the year
with 340 patients, which can only be done by greatly overcrowding the wards. This requirement is urgent, since by reason of the large amount of time that would be consumed in
preparing plans, securing the funds, calling for tenders and awarding the contracts, another
year will have passed while the increase goes steadily on, until the doors shall have to be
closed and the insane to be sent to the gaols, which are themselves about as crowded as the
asylum. I hope that this deplorable state of affairs will not come to pass, but I much fear it
will unless steps are taken at once to erect another building here.
The wards in the older part of the Institution are small and very ill-adapted to overcrowding. In fact, they themselves should be vacated for repairs and improvements before
long and not overcrowded.
I think that we shall have to have another building with wards, no temporising method
being in view, and in the best interests of the Hospital that is what I have to recommend.
There remains a very convenient and suitable site to the north of the present buildings, upon
which I would suggest building a detached wing with capacity for 150 patients. It is not
advisable to go on erecting these small cottages such as were last constructed, having a
capacity of only 60, since the increase of two years alone suffices to fill them. The smaller
class of buildings such as we have are very useful up to a certain  point, as they allow of a 3 Ed. 7 Public Hospital for the Insane. E 21
better classification, but when it comes to dealing with large numbers of the chronic insane
the larger buildings are more economical, and allow of all the care and attention that such
cases require for their happiness and welfare.
In looking back over the cost of the buildings that have been erected here since the first,
I find that the original building of 1887, accommodating 28 patients when completed, cost
$24,000, or $857 per bed ; that of 1884, accommodating 42, cost $26,000, or $619 per bed ;
that of 1890, accommodating 56, cost $35,000, or $625 per bed; and those of 1897 and 1898,
accommodating 56 each, cost $40,000 each, or $714 per bed ; and all those buildings were put
up cheaply (I refer to their material construction), and not at all what I trust the next
building will be. Considering these figures and the prices of materials to-day, I do not think
that a suitable building can be constructed, such as we require, for less than $800 per bed,
which means an appropriation of about $125,000.
I recognize that this is a very large sum of money to ask for, but there is no other course
that I can see. The insane are increasing every year in this Province, and so long as social
conditions remain as they are we can look for no reduction, so that there is nothing for us to
do but to provide the necessary means for their care and treatment.
In connection with the contract that is now under way, I observe that it provides for the
expenditure of all the money appropriated for a new lighting plant, which is to be installed as
soon as a place is prepared for it, as it will be when this work is completed. It will be necessary on this account to make provision for that plant, consisting of an engine and dynamo of
about 600-light capacity, and other machinery in connection with the ice-making and cold-
storage plant. Last year $2,500 was appropriated for this purpose, but I scarcely think that
that will be sufficient, and would suggest $4,000.
There should be no longer any delay in ensuring a good water supply in case of fire, and
with that object in view I would ask for $1,500 to enable us to procure enough iron pipe and
hydrants to lay a new and independent line from the corner of Royal Avenue along the rear
roadway past the shops-building and laundry. There exists already a line of 4-inch pipe in
the front of the premises, but it affords no protection in the parts to be reached by the new
line, and at best would supply only two or three streams of water where a dozen might be
needed. We have no fire-fighting apparatus at present except hose. I would like to have a
small building constructed to use as a fire hall, in which to keep a reel or two of hose, a
supply of ladders, axes, and whatever it is thought advisable to install. It is useless to try
to form a local fire brigade and arouse enthusiasm in its drills if we have no apparatus with
which to practise, and no place to assemble at the signal. If $500 is appropriated for the
material we can construct the necessary building.
The present conservatory is done. It was practically put out of use by the change made
in the heating system a few years ago, and has only been ornamental since. It is falling to
decay and would require extensive repairs if it were worth it, but the present site is unsuitable
and the building too small and inadequate to be worth repairing. It is proposed to place a
new one in connection with the garden if the material for construction is provided, which will
cost about $1,500.    Such a building would be of great use to the Hospital in many ways.
A new piggery is also required to provide for the increased herd of swine. Machinery
is required in the shops, such as a motor, a band saw, planer, lathe and other small machines
for the manufacturing of furniture for the Hospital. The garden must be fenced with wire
and wooden walks laid around the premises, and other sundry works performed which are
unforeseen at present, but all of which together will require about $2,500 additional to
accomplish.    This  makes   $10,000 asked for to  enable us  to   supply  ourselves  with  such E 22 Public Hospital for the Insane. 1903
necessities as I have already mentioned, and which being done by ourselves will effect a great
economy.    The estimates for the fiscal year beginning July 1st, 1903, are as follows :—
Salaries :
Medical Superintendent $ 2,500
Assistant Medical Superintendent  1,200
Bursar    1,200
Steward      960
Engineer  900
Gardener  720
Farmer  720
Carpenter  720
Plasterer and mason  720
Tailor  720
Shoemaker  570
Teamster  360
Chief cook  720
Assistant cook  570
Chief male attendant  672
Matron  600
Two firemen  1,200
Two night-watchmen  1,140
Laundryman  540
Eighteen male attendants  9,000
Seven female attendants  2,500
Two housemaids  264
Seamstress  360
Two laundresses  540
Portress  150
Temporary assistance as required  1,000
$30,546
Supplies :
Provisions      $20,000
Heat and light      5,500
Water          1,200
Medicines         600
Clothing      3,000
Furniture  ,      2,000
Miscellaneous      3,000
$65,846
Capital account:
Additional new furniture and equipment $ 1,500
Medical library         200
Lands and Works    10,000
$77,546
Visitors.
The number of visitors to the Hospital has, as usual, been large and increasing, and
among the number have been the following :—Mr. Richard McBride, M. P. P., and Mr. E. C.
Smith, M.P.P., paid a visit on February 14th and made a brief tour of inspection. On May 14th
and on October 29th the Grand Juries of the Spring and Fall Assizes respectively made their
customary inspections. Hon. J. D. Prentice, while acting as Provincial Secretary, visited the
Hospital on July 18th and again on October 1st, in company with His Honour the Lieutenant-
Governor, and made an inspection of the entire Institution. On July 21st, Dr. McFadden,
the Medical Superintendent of the Asylum at Brandon, Manitoba, visited and inspected the 3 Ed. 7 Public Hospital for the Insane. E 23
Institution, speaking favourably of its general condition. On August 9th, the Honourable the
Chief Commissioner of Lands and Works made a short visit, in connection with the improvements now being carried on.
Acknowledgments.
The following newspapers are received gratuitously and regularly through the kindness
of the respective publishers, the list having been somewhat augmented since last report:—
The "Daily Colonist" and the ".Daily Times," of Victoria, two copies each; the "Daily
World," of Vancouver, and the " Daily Columbian," of New Westminster, two copies each;
the " Daily News-Advertiser" and the " Daily Province," of Vancouver, and the " Semi-
weekly World," one copy.
It is with sincere thanks that I have to acknowledge the many kind little attentions on
the part of the numerous friends of the Hospital and its inmates, in which they have contributed their services towards entertaining the patients, or donated reading material, games or
fruit, or given their services in other ways. The following have sent in papers, books and
magazines :—Mesdames Taylor, Tovey, Bell, Pearson, B. Burr, E. A. White, Jenns, Rae,
Fraser, Alex. Cunningham, Cross, McLeod, John McKenzie, Rees, Homer, H. L. DeBeck,
Miss Henderson, Col. Whyte, Messrs. Major, Pearson, Lee, Dingle, Minthorne, Rev. Mr.
Lennie, Rev. Mr. McEwen, Rev. Mr. Scoular, Capt. Knight and Mrs Lister. Mrs. J. D.
Taylor and Mr. W. J. Armstrong also contributed fruit; Mr. Arthur Malins, for the City Club,
donated all the playing cards used in the year, and Mr. Southon kindly loaned a gramophone
for a patients' entertainment.
I have much pleasure in acknowledging the kind interest taken in the Hospital by the
Warden of the Institution next door, Col. Whyte, who has a keen and accurate knowledge of
many things pertaining to the economical administration of public institutions. I have found
help from time to time from comparing notes with him.
The Warden of the Gaol, Mr. Armstrong, has kindly assisted with some of our out-door
work, by lending us his team when not engaged elsewhere; and at different times has sent us
in his surplus of seed potatoes, which we have been able to make good use of.
I cannot speak too highly of the excellent service that has been rendered by the Assistant
Medical Superintendent, Dr. Doherty. He has shown unusual aptitude in the work and
possesses the characteristics of a most reliable, faithful and painstaking officer. Our association
in the work for the time that he has been here has been most happy. The Bursar, Mr. Knight;
has as usual kept the office books in good order, while Mr. Rees, the Steward, has been most
zealous in his department, to which faithful service much of the economical achievement of the
past two years has been attributable. To do justice to the entire staff I should have to name
them one by one, which would, I fear, be too long a process for this report, but each in his own
department has done good work and deserves much praise. The mechanics of the out-door
department are doing so much toward the improvement of the premises that the entire aspect
of the place is changing rapidly for the better. Mr. Fitzgerald has accomplished an unusual
amount of stone-work, brick-work, slate-work, cementing, plastering, and his work, perhaps
more than that of any other, is bringing into shape the deformities of the buildings themselves.
The patients' gang, under Mr. Pumphrey, is also worthy of mention for what they have achieved-
My deepest obligations, however, are due the attendants, who have, taking all things into
consideration, rendered most acceptable service in the care and treatment of the insane. It is
to them that we must entrust to a large extent the carrying out of the treatment of the
patients, and from the faithfulness displayed and the interest taken I deem it to be the case
with many—I may say that I know it to be the case—that they serve not to please men alone E 24 Public Hospital for the Insane. 1903
but a Higher Authority, Who is able to mark every faithful ministration as well as any neglect
or harshness, and Who will reward at the last. A faithful attendant is of priceless value in
this work, and I think we have some.
I find it difficult to obtain words with which to express my appreciation of the interest
taken in the Hospital by the Hon. J. D. Prentice, Minister of Finance, who acted as Provincial
Secretary during most of the year. This support has meant everything during the past two
years to the honest effort put forth by the management to improve conditions and bring to a
higher level the working efficiency of the Hospital. I can only reiterate what I said last year;
that had the Government pursued any different policy here at this time it would have been
impossible to show the advance that we have made, and few persons in the Province seemed
to grasp the situation as did the Honourable Minister under whose care we were.
Finally, I acknowledge the watchful care of a protecting Providence which has brought
us as individuals and as an institution safely through the dangers visible and invisible of
another year, and we trust that the same will continue with us to the end.
I have the honour to be,
Sir,
Your obedient servant,
G. H. MANCHESTER, M. D.,
Medical Superintendent.
New Westminster, February 1st, 190S. w
0
ffi
P
J
l-H
13
CQ
GO
oa
00
p
ffi
<
03
00
w
ffi
h 3 Ed. 7
Public Hospital for the Insane.
E 25
ANNUAL STATISTICAL REPORT
Of the Operations op the Public Hospital for the Insane, New Westminster, for
the Year ending 31st December,  1902.
Table No.  1.
Showing operations of Hospital for the year 1902, in summary form.
Movement of Population.
Male.
Female.
Total.
Male.
Female.
Total.
Remaining in residence January 1st, 1902	
Out on probation on               »                «     	
224
3
60
5
284
8
227
95
65
26
292
Admitted during the year :—
71
8
3
13
23
2
1
0
94
10
4
13
By urgency forms	
By Lieutenant-Governor's Warrant	
From the Yukon Territory	
121
322
78
91
24
413
Discharged during the year :—
22
16
7
1
46
9
23
8
3
4
0
15
7
2
30
19
11
1
Total 	
61
16
25
Discharged on probation and still out Dec. 31st ..
Died	
102
244
1039
67
293
311
Total number of patients admitted since opening.
«                            a       discharged         »
//                            a       died                    n
1332
503
283
179
40
682
323
786
253
219
1005
74
327
Daily average population during the year  296.62
Maximum number present on any one day, December 23rd        315
Minimum n // February 6th       283
Percentage of discharges on admissions (deaths excluded)     50.41
it recoveries on admissions     24.8
» // recoverable cases admitted      100
a deaths on whole number under treatment       6.06
Number of "paying patients" admitted during the year.
n " free patients'' n n
33 E 26
Public Hospital for the Insane.
1903
Table No. 2.
Showing in summary form the operations of the Hospital since its opening.
w
a
o
ta
'g
-a
Discharged.
ID
-S
ri
Q>
P.
CO
-i^   ID
a >>
&*
.ffi: cj
09  tf
QJ   ffi
U <+_,
U  O
ffi   o
rQ     CO
6
tn
ri
O
V
a
6
"6
o
fi
s
s a
s «
o  «
Percentage of recoveries to admissions.
Percentage of discharges  to   ad"
missions.
deaths
lumber
tment.
Year.
•6
OJ
u
tD
>
O
O
o
na
CD
fci
V
si
O          rQ
rr,   1>   t.
Jj3  fc.
•Jog
© "*" -1
rH
1872	
1873	
1874	
18
15
12
29
22
14
16
18
17
13
7
8
10
20
27
36
26
41
52
49
52
44
80
62
64
74
81
101
113
115
121
1
10
4
3
11
4
7
4
5
5
3
4
2
5
10
15
12
14
17
19
17
14
13
29
23
20
27
31
38
40
30
0
2
o
o
3
4
3
1
0
3
1
1
4
0
6
5
6
5
6
4
10
18
19
11
25
8
13
32
27
20
31
1
5
3
10
5
3
8
8
5
5
2
3
2
5
6
5
3
4
12
20
13
14
19
20
9
14
19
21
29
25
25
16
14
19
32
35
38
36
41
48
48
49
49
51
61
66
77
82
100
117
123
135
133
162
164
171
203
221
234
258
284
311
0
5
13
3
3
5
7
0
2
2
18
31
26
48
54
49
54
54
58
61
55
57
59
71
88
102
103
123
152
166
175
179
213
224
228
246
285
327
356
377
413
5.55
66.66
33.33
10.34
50.00
28.57
43.75
22.22
29.41
38.46
42.85
50.00
20.00
25.00
37.03
41.66
46.15
34.15
32.69
38.77
32.69
31.81
16.25
46.77
35.93
27.03
33.33
30.69
33.63
34.78
24.79
5.55
80.00
33.33
26.89
63.63
78.57
62.50
27.77
29.41
61.54
57.14
62 50
60.00
25.00
59.25
55.55
69.23
46.34
44.23
46.94
51.92
72.72
40.00
64.51
75.00
37.83
49.38
62 37
57.52
52.17
50.41
5.55
16.12
11.53
1875	
1876	
1877	
20.83
9.35
6.12
1878	
1879	
16.16
14.81
1880	
8.62
1881	
8.19
1882	
1
""%
10
5
11
5
18
17
6
12
29
2
7
32
18
13
24
26
27
2
3.63
1883	
5.26
1884	
3.33
1885	
1886	
1887	
6.94
6.81
4.80
1888	
1889	
1890	
2.87
3.25
7.64
1891	
1892	
1893	
1894	
11.69
6.95
7.60
8.92
1895	
1896	
1897	
1898	
1899	
1900	
1901 	
8.92
3.94
5.69
6.66
6.42
8.14
6 63
1902	
6.06
Table No. 3.
Showing the number of admissions, discharges and deaths for each month during the year 1902.
Month.
January . .
February ,
March
April	
May	
June 	
July	
August ...
September
October...
November
December .
Totals,
Admissions.
Male.     Female.     Total.
4
7
5
5
8
17
5
7
7
15
5
10
95
0
3
2
1
1
4
2
4
2
3
3
1
26
4
10
7
6
9
21
7
11
9
18
8
11
121
Discharges.
Male.     Female.     Total.
4
0
2
4
3
5
4
1
6
-2
4
11
46
0
3
3
0
1
0
2
0
2
1
0
3
15
4
3
5
4
4
5
6
1
8
3
4
14
61
0
2
0
1
5
1
2
4
2
2
1
3
23
Deaths.
Male.     Female.     Total
4
2
2
1
4
25 3 Ed. 7
Public Hospital for the Insane.
E 27
Table No. 4.
Showing the civil state of the patients admitted during the year.
Civil State.
Male.
Female.
Total.
64
24
6
1
7
13
6
0
71
37
12
1
Total	
95
26
121
Table No. 5.
Showing the religious denomination of those admitted during the year.
Denomination.
Male.
Female.
Total.
24
1
2
13
4
7
9
11
23
4
3
1
0
0
3
3
2
9
1
0
28
4
3
13
4
Methodist ■	
10
12
13
32
1
1
1
Total	
95
26
121
Table No. 6.
Showing the degree of education in those admitted during the year.
Degree of Education.
Superior	
Common school	
Cannot read nor write .
Unascertained    ...
Total
Male.
Female.
2
1
77
23
8
2
8
0
95
26
Total.
3
100
10
8
121 E 28
Public Hospital for the Insane.
1903
Table No. 7.
Showing the native country of those admitted during the year 1902.
Place of Birth.
Male.
Female.
Total.
Assyria   	
1
1
1
11
6
3
3
7
9
1
17
1
1
3
1
0
0
0
3
2
0
1
3
0
0
5
0
0
1
0
1
1
1
0
0
2
0
6
1
1
1
Canada:
14
8
3
4
10
9
1
22
Finland	
1
1
4
1
1
2
3
3
1
6
2
12
3
4
3
1
8
2
18
Total	
95
26
121
Table No. 8.
Showing the Districts contributing patients during the year 1902.
Place of residence at time of committal.
Yukon District:
Dawson	
Atlin District:
Taku   	
Vancouver Island and other Coast Islands :
Port Simpson	
Cape Scott    	
Cracroft Island	
Mushlat Arm	
Union Bay	
Cumberland   	
Extension	
Nanaimo 	
Ladysmith	
Granite Island	
Victoria	
Esquimalt	
Lower Mainland :
Vancouver	
New Westminster	
Steveston 	
Ladners	
Chewasin	
Otter   	
Surrey	
Langley	
Nicomen Island	
Mission  	
Sardis	
Sumas	
Carried forward.
Male.     Female.
13
/
1
21
9
1
1
1
72
0
0
0
0
0
0
0
0
1
0
9
0
6
1
0
0
0
1
0
1
I
0
0
0
20
Total.
13
1
16
92 3 Ed. 7
Public Hospital for the Insane.
E 29
Table No. 8.—Concluded.
Place of Residence at time of Committal.
Male.
Female.
Total.
72
3
3
1
20
0
0
0
1
0
0
0
1
0
2
1
0
0
0
0
0
0
1
92
Kamloops Bistrict:
3
3
1
1
2
1
2
2
1
Okanagan District:
2
1
West Kootenay :
1
2
1
4
1
1
1
1
1
1
3
1
1
Moyie	
1
East Kootenay :
1
1
Boundary District:
3
1
95
Total	
26
121
Table No. 9.
Showing the occupations of those admitted during the year 1902.
Occupation.
Assayist	
Barber    	
Blacksmith	
Book-keeper	
Carpenter	
Civil Service clerk . ..
Clerk	
Constable	
Cook	
Electrician	
Farmer    	
Fisherman	
Fortune teller	
Hotel-keeper	
House-keeper	
Housewife	
Labourer	
Locomotive engineer.
Logger	
Machinist	
Master mariner	
Mendicant	
Merchant	
No occupation.   ....
Prospector and miner
Prostitute	
Reporter	
Sailor	
Shepherd 	
Ship carpenter	
Shoemaker	
Stoker (Navy)	
Total.
Male.
1
2
3
1
1
1
4
1
2
1
10
2
35
1
2
1
1
1
4
1
9
95
Female.
0
0
0
0
0
0
0
0
0
0
0
0
1
0
6
14
0
0
0
0
0
0
0
2
0
3
0
0
0
0
0
0
26
Total.
1
2
3
1
1
1
4
1
2
1
10
2
1
1
6
14
35
1
2
1
1
1
4
3
9
3
1
3
1
2
2
1
121 E 30
Public Hospital for the Insane.
1903
Table No. 10.
Showing the ages of those admitted during the year 1902.
Age.
Male.
Female.
Total.
2
5
16
10
19
13
11
9
8
1
1
95
0
1
4
4
6
0
26
2
a    20 a 25     a    	
6
,,     25 ,t 30     ,i    	
20
a    30 n 35     a    	
14
»     35 t, 40      ti    	
25
»     40 a 45      n    	
14
n     45 n 50      -/    	
12
»     50 a 60      «    	
16
„     60 „ 70      „    	
9
</     70 » 80      a    	
2
1
Total	
121
Table No.  11.
Showing the number of the attack in those admitted during the year 1902.
Number of Attack.
Male.
Female.
Total.
First	
38
7
1
15
2
0
1
0
1
7
0
26
53
9
Third    	
1
Fourth	
1
Fifth	
1
2
45
1
95
1
3
52
1
Total    	
121
Table No. 12.
Showing the alleged duration of the attack, prior to admission, in those admitted during the
year 1902.
Duration of Attack.
Male.
Female.
Total.
Under 1 week	
4
15
13
7
4
2
5
6
3
4
0
7
6
5
.1
0
2
0
1
1
1
1
1
0
26
4
22
19
12
„    6 „   9     »        	
5
2
7
„     2 a   3     »    	
6
4
„     5 » 10      a    	
5
//   10 a 20     a      	
1
2
29
1
3
30
Not insane    	
1
Total	
95
121 3 Ed. 7
Public Hospital for the Insane.
E 31
Table No. 13.
Showing statistics of heredity in those admitted during the year 1902.
Heredity.
Paternal branch	
Maternal branch	
Lateral branches (brothers and sisters)
Insane children	
Insane relatives, history obscure	
Said not to be hereditary	
History unascertained	
Total    	
Male.
Female.
7
1
3
3
4
o
2
1
3
1
13
12
63
6
95
26
Total.
6
6
3
4
25
69
121
Table No. 14.
Showing the alleged exciting causes of insanity in those admitted.
Cause.
Change of life	
Chinese reform matters	
Child birth	
Epilepsy	
Financial disappointment, loss and worry
Grief	
Hardship and exposure	
Heredity	
Ill health	
Intemperance	
Lactation    	
Mercury poisoning	
Morphinism  	
Not insane	
Old age 	
Onanism	
Overwork    	
Sunstroke	
Syphilis	
Trauma.
Vicious life and habits .
Unascertained	
Total.
Male.
2
6
1
15
1
5
19
2
2
26
Female.
95
1
0
3
0
1
1
0
4
3
0
2
0
1
0
0
0
0
0
0
0
3
7
26
Total.
1
1
3
1
8
1
2
10
4
15
2
1
1
1
5
19
2
2
2
4
3
33
121
Table No. 15.
Showing the state of the bodily health on admission.
Bodily Condition.
Male.
Female.
Total.
42
51
2
95
8
15
3
26
50
66
Total	
121 E 32
Public Hospital for the Insane.
1903
Table No.  16.
Showing the form of mental disorder in those admitted during 1902.
Form of Disorder.
Mania, acute	
a        recurrent   . .
Melancholia  	
Dementia, primary
it terminal.
a        senile   ..
(/ prsecox   	
Chronic delusional insanity.
Alcoholic »
Paranoia	
General paresis    	
Neurasthenia	
Cerebral syphilis	
Idiocy 	
Not insane	
Total.
Male.     Female.     Total
8
4
11
7
26
2
11
6
13
1
1
2
1
95
4
1
2
4
0
0
0
0
0
1
0
26
6
1
15
6
15
8
28
6
11
6
13
1
1
3
1
121
Table No.  17.
Showing the number of patients given probation in 1902, and the results.
Results.
Discharged, recovered...
n improved ...
// unimproved.
// not insane . .
Returned	
Still out on probation ...
Total.
Male.     Female.     Total,
16
1
9
9
43
22
7
23
1
9
3
3
0
1
4
13
7
16
65
Table No. 18.
Showing the alleged duration of insanity prior to admission in those discharged recovered
during the year.
Duration of Insanity.
Male.
Female.
Total.
Less than 1 month	
11
5
2
1
2
1
22
4
0
2
1
0
1
15
„      2    ,,      3        „       	
4
»      3    ,i      6        „       	
2
„      6    i,    12        „       	
2
2
Total	
8
30 3 Ed. 7
Public Hospital for the Insane.
E 33
Table No. 19.
Showing length of residence of those remaining under treatment on January 1st, 1903, and
of those who were discharged during 1902.
Length of Residence:
Of those
under
treatment
January 1st,
1903.
Of those
discharged
recovered
during the
year 1902.
Of those
discharged
improved
during the
year 1902.
Of those
discharged
unimproved
during the
year 1902.
Under   1   month	
11
3
2
2
7
18
6
7
7
22
10
38
39
27
22
19
11
5
9
9
35
10
8
7
6
5
0
4
2
3
2
5
0
o
2
3
2
1
0
6
1
0
]
„        2    „    3        ./       	
3
3    t,    4        „       	
1
0
„       5    n   6       ,,      	
0
6    a    9       a      	
0
9    „ 12        „       	
1
2    n   3      t,    	
2
1
„       3   a    4      »    	
4    „    5      a    	
5   a   6      //    	
„       6    »    7      »    	
„        7    „    8      „    	
,,       8    /,    9      n    	
„       9    n 10      »    	
„      10   « 15      n    	
15    a 20      //    	
n     20   « 25      „    	
Total   	
327
30
19
12
Table No. 20.
The death record for the year 1902.
Register
Initials.
Sex.
Age.
Time in Hospital.
No.
Years.
Months.
Days.
Certified cause of death.
1,065
947
465
1,206
572
1,202
1,074
1,233
599
1,054
1,147
1,204
100
1,232
1,222
982
1,148
S. A.
H. H.
W.G.A.G.
C. T.
R. w. r.
F. F.
W. B.
R. B. L.
P. M.
M. T.
J. G.
H. C. M.
H. S.
T. C.
D. f. c.
J.
J. M.
M.
M.
M.
M.
M.
M.
M.
M.
M.
F.
M.
M.
M.
M.
M.
M.
M.
70
27
33
58
62
50
31
40
60
44
42
43
65
52
68
50
45
1
2
11
7
1
7
1
1
25
2
1
5
4
11
4
11
5
7
1
7
11
0
8
0
4
5
7
2
18
16
18
27
6
23
26
14
26
2
12
0
15
3
22
25
11
General senile debility.
Epilepsy.
Epilepsy.
General debility.
Cirrhosis of the liver.
General paresis.
Measles.
General paresis.
Pneumonia.
Pneumonia with general paresis.
Morbus cordis.
General paresis.
Morbus cordis.
Colitis.
General senile debility.
Phthisis.
General paresis. E 34
Public Hospital for the Insane.
1903
Table No. 20.—Concluded.
The death record for the year 1902.
Register
No.
Initials.
Sex.
Age.
Time in Hospital.
Years    ' Mouths.     Days.
Certified cause of death.
597
1,109
750
1,276
1,157
1,173
1,080
1,142
N. P.
H. M.
J. P. C.
P. C.
D. M.
J. E. J.
M. A. H.
J. L. D.
M.
61
7
11
29
M.
33
1
7
9
M.
68
5
5
20
M.
85
3
20
M.
60
1
4
21
M.
23
1
3
8
F.
75
2
1
5
M.
43
1
6
17
Morbus cordis.
General paresis.
Epilepsy.
General senile debility.
General paresis.
General paresis.
General' senile debility.
General paresis.
Table No. 21.
Race classification of those remaining in residence on January 1st, 1903.
Class.
Male.
Female.
Total.
Whites	
209
2
2
31
66
0
1
0
275
2
3
31
Total	
244
67
311
Table No. 22.
Showing the forms of employment engaged in by the patients during the year, and the
number of days' work performed by them.
Employment.
Assisting the carpenters	
// farmer	
« gardener 	
a painter 	
» engineer 	
a plasterer 	
// tailor	
Working in the blacksmith shop....
« /;     kitchen and scullery
n a      laundry	
it a      wards	
Tending the front door	
Total	
No. of days.
1,960
6,933
1,344
733
40S
579
79
277
4,325
3,035
34,880
365
54,918 3 Ed. 7
Public Hospital for the Insane.
E 35
Table No. 23.
Showing the articles made and repaired during the year.
Name of Article.
Aprons (nurses' and patients')	
Blankets    	
it       (double made into singles)
Blouses    	
Chemises       .
Counterpanes	
Covers, bureau	
//       table    	
n      tray   	
Doilies   	
Dresses, gingham  	
;/        serge	
»        uniform	
a        night	
Drawers, pairs	
Dusters	
Flags 	
Handkerchiefs	
Hose	
Mats, floor	
Napkins, table	
Neckties	
Pillow slips	
Sheets	
Sofa cushions	
Shirts, outside	
n        under	
Skirts   	
Socks, pairs	
Tea bags	
Ticks, bed	
Towels	
Trousers 	
Undervests	
Window curtains, pairs	
Work of Tailor-,
Bed-ticks....   	
Blankets, lined	
Coats	
Combination suits and camisoles .
Shirts	
Suits, complete for patients	
Suits, uniform for attendants   ..
Trousers	
Vests...	
Work of Shoe-
Shoes, pairs  	
Slippers, pairs	
Harness repaired, key straps made, and other miscellaneous work.
Made
93
25
2
54
12
7
42
26
20
18
9
32
24
71
9
119
4
74
150
120
221
14
34
io2
283'
18
2
4
4
6
28
35
8
32
40
Repaired.
439
303
148
443
177
S3
612
139
1,745
1,560
435
564
1,511
1,364
771
2534
90
112
269
206
193
56
633
95
187
188 E 36 Public Hospital for the Insane. 1903
Table No. 24.
Quantities of Fruit preserved by the Matron.
Blackberries      16 quarts.
Cherries  17      n
Currants, black     7     a
red  13      „
a        jelly  36 glasses.
Gooseberries  41 quarts.
Peaches  12      «
Pears  32     »
Plums  23     ,i
Prunes  58     n
Raspberries  46     //
Rhubarb  43     „
Strawberries   19      u
Tomatoes, pickled  54     »
Tomato catsup   30     n
VICTORIA  B.C.:
Printed by Richard Wolfendrn, Printer to the King's Most Excellent Majesty.
1903.

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