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ANNUAL REPORT ON THE HOSPITAL FOR THE INSANE, NEW WESTMINSTER, FOR THE YEAR 1901. British Columbia. Legislative Assembly 1902

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 ANNUAL REPORT
—ON  THE—
HOSPITAL  FOR  THE  INSANE
NEW   WESTMINSTER,
FOR  THE  YEAR 1901.
THE GOVERNMENTOF
THE, PROVINCE OF BRITISH DlttUM***
VICTORIA,  B. C.:
Printed by Richard Wolfenden, Printer to the King's Most Excellent Majesty,
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0 2 Ed. 7 Report on the Public Hospital for the Insane. 461
REPORT
ON   THE
PUBLIC HOSPITAL FOE THE INSANE.
1901.
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 1901.
J.  D. PRENTICE,
Acting Provincial Secretary.
Provincial Secretary's Office,
February 2nd, 1902. 462 Report on the Public Hospital for the Insane. 1902
OFFICERS.
Medical Superintendent:
G. H. MANCHESTER, M.D.,
Bursar:
M. J. KNIGHT, ESQ.
Steward and Store-keeper:
R. REES, ESQ.
Engineer:
HEWISON STOUT, ESQ.
Matron :
MARIA FILLMORE.
Chief Male Attendant: Chief Female Attendant:
THOMAS MAYES. MARIA FILLMORE.
Carpenter:
JOHN HUGHES.
Plasterer and Mason: Farmer:
EDWARD FITZGERALD. E. B. STINCHCOMBE.
Gardener:
W. T. L. HOUSE. 2 Ed. 7 Report on the Public Hospital for the Insane. 463
REPORT
MEDICAL SUPERINTENDENT OF THE PUBLIC HOSPITAL FOR THE
INSANE, NEW WESTMINSTER, B, C.
For the Year Ending 31st December, 1901.
To the Honourable
The Provincial Secretary, Victoria, B. G.:
Sir,—I have the honour to submit for your consideration the Annual Report for the
thirtieth year of the Public Hospital for the Insane at New Westminster. In doing so, I beg
permission to introduce by way of preface a brief review of the history of the Institution since
its inception thirty years ago, as I think this the most opportune time for doing so, inasmuch
as it has entered upon a new century under new management, and moreover has emerged
from comparative insignificance and obscurity and become the largest eleemosynary institution
under the care and support of the Province of British Columbia.
Another consideration that prompts me to take this course is that you may have at your
disposal, and at the disposal of the Government, a complete and convenient account of what
has been done by the various Governments of this Province for the insane under their care, as
well as to show how the Institution comes to be as it is to-day. For while this history will
show that a great deal indeed has been done during those thirty years to care for and cure
that class of unfortunate persons who suffer from the worst of illnesses, and much money spent
in buildings as well as in maintenance, yet a lot remains to be done to bring the Institution
up to the standard in point of equipment, and, therefore, I hope that it will cause no shock
when later in this report I point out the necessity for considerable alteration in the near future
in the accessory portions of the Hospital.
Before going further, I wish to acknowledge my indebtedness to Drs. J. S. Helmcken and
I. W. Powell, of Victoria, for their kind assistance in collecting the data which relates to the
earlier part of the history. Dr. Helmcken was the first physician in British Columbia to come
in contact officially with the insane, through his position as Gaol Surgeon in Victoria, which
post he has most creditably filled for the very extended period of fifty years.
Dr. Powell was the first Medical Superintendent appointed, but was, like several of his
successors, non-resident.
History.
The earliest record which I have obtained of an insane person in British Columbia dates
back to the year 1850, when a young Scotch immigrant became deranged soon after his arrival,
and proved himself to be a genuine maniac by making a most violent and unprovoked attack 464 Report on the Public Hospital for the Insane. 1902
upon Dr. Helmcken during a visit. He was sent home in a sailing vessel, and it was afterwards ascertained that he quite recovered his mental balance. Cases were not so rare when
the rush to the gold fields of the Cariboo was on, and during the years 1858 and 1859 many
new-comers broke down under the strain and hardships endured, and had to be taken care of
by the authorities. At this time there was no asylum nearer than the State of California,
and the only place suitable in this Province for safe-keeping those cases which were at all
violent or turbulent was the  " lock-up " at Victoria.
There were then no towns upon the Mainland, so that Victoria, which was a Hudson's Bay
Co's. post, was the outfitting depdt and last point of departure for the gold fields, and all
persons entering into and passing out of the country by the regular route passed through
Victoria, to which port they usually came from San Francisco. It was in this way that the
authorities began to send the insane who came under their notice in those days back to
California, where they were committed to one or other of the asylums belonging to that State.
This went on very well for a time until the Americans, although very obliging, gave our
authorities to understand that the practice could not continue, but that if the British Columbia
Government were willing to pay for their patients some arrangement might be made. However,
this suggestion was not acted upon, but the insane were kept in the Gaol at Victoria until it
became too full to hold any more, and then, as more violent and urgent cases presented themselves, the milder and more manageable ones were sent to the Royal Hospital.
The gaol of those early days was not large, and contained only 10 or 12 cells. It was built
of hewn logs at first, but some years later a brick administrative building, two stories in height,
was placed to the front of it, and it then presented the appearance shown in the first illustration
here. The site was the same as that now occupied by the Law Courts on Bastion Street. So
long as the patients proved to be of the male sex the gaol seemed to serve the purpose of an
asylum fairly well, but when female patients began to appear it was seen that something
further would have to be done for the insane and a proper place provided.
The Royal Hospital, above referred to, was a hospital for men only, and was situated
upon an Indian Reserve opposite the City, upon the other side of the harbour. It was
originally built for a pest-house, and this accounts for its location outside the City. As it
offered no accommodation for women the ladies of Victoria opened a woman's hospital on
Pandora Street, but this soon fell into financial difficulties, and it was then suggested that it
should amalgamate with the Royal Hospital if the latter would keep a ward open for women.
It was so arranged, and the building of the Royal Hospital vacated. Following this event,
two female patients came under Dr. Powell's notice, and he suggested to the Government that
they remodel the old Royal Hospital and make it into an asylum. This was done in the year
1872, and on October 12th was opened as the first Provincial Asylum, which function it was
destined to fulfil for the short space of five and a half years. The Provincial Secretary took
charge of the new Institution, and its management has been under his department ever since.
In describing the building, I may say that it was a very simple structure of most modest
appearance, as shown in the accompanying illustration. It was about fifty feet by forty, and
had an upper storey, the whole being of wood and whitewashed. A door from the upper storey
led out upon a balcony which possessed a fine view of the harbour, and altogether the situation
was a pleasant one. Inside, the building was somewhat re-arranged from the plan existing
when used as a hospital, and every available space was made up into cells or very small single
rooms.
On the opening day seven patients were admitted, and amongst them were the two
women referred to, who, by the way, were sisters, and still" another sister was admitted two
days after.      Dr. I. W. Powell was appointed Medical Superintendent, Mr. E. A. Sharpe as  2 Ed. 7 Report on the Public Hospital for the Insane. 465
" Superintendent of the Asylum" and Mrs. Flora Ross as Matron. There were three
" keepers " or male attendants, a cook and an Indian wash-woman. There were almost as
many employees as patients, which demonstrates the fact that the per capita cost of maintenance, especially in regard to salaries, has an inverse relation in proportion to the number
under treatment, and therefore small asylums are, pro rata, much more expensive to maintain
than large ones.
Crude as things must have been in this embryo asylum, there were malingering applicants
for admission. Dr. Helmcken tells of one who pretended to be not only insane but paralyzed,
but as his deception was suspected by a physician, the latter took a pail of water up to the
balcony while the man was in the front of the building and suddenly dashed the contents
upon the would-be lunatic, who suddenly made a complete recovery, and displayed good action
in his legs while hurrying away.
There is little doubt but that the structure was, internally, ill adapted for its work, as my
records go to show that a carpenter was kept fairly busy repairing the damage done by disturbed patients. To keep order, at times it was found needful to resort to restraint, and this
feature of the work developed and stayed with it for a considerable period of time.
There had been no Act upon the pages of the Provincial Statutes dealing with asylums
up to this time, but at the next sitting of the Assembly an Act was passed which continued
in force for twenty years. It was called the "Insane Asylums Act, 1873." It placed the
management, as already intimated, in the hands of a " Medical Superintendent" and a
" Superintendent of the Asylum," the former being non-resident and the latter a resident
layman, whose duty it was to look after the internal economy and discipline. This .Act was a
very short one, and provided that a lunatic should be committed to the asylum upon the certificates of two medical practitioners, who were to examine the patient in the presence of one
another, which you will note is the direct opposite to that now in force here and everywhere
else. It made no provision for a statistical form or form of history, and so it occurs that we
possess very little information about the patients treated in those early days, and what there
is on record appears to have been obtained by the Superintendent from the patients themselves.
At the close of the year 1873 Dr. Powell resigned, and was succeeded by Dr. J. B.
Matthews, who began duty on January 1st, 1874. Small improvements were continually
being made about the buildings, and fences were erected to form enclosed airing courts. At
the end of the year 1872 there were 16 patients; at the end of 1873 there were 14, and at the
end of 1874, 19 ; so it will be seen that the increase in population at first was not very rapid.
At the end of 1875, however, there were 32 patients, and as soon as spring opened in 1876 a
small addition which, in the photograph, looks more like a shed, was built. On July 1st of
that year, 1876, Mr. J. J. Downey replaced Mr. Sharpe as " Superintendent of the Asylum,"
and on December 1st of the following year, Dr. Matthews having resigned, Dr. MacNaughton
Jones took charge and went to live in the Institution as the first resident Medical Superintendent. At the close of this year there were 37 patients in residence, and the building could
accommodate no more, nor was it desirable nor suitable to extend the Institution upon that
site which, in the first place, did not belong to the Provincial Government and, in the next
place, possessed no feature that would be useful to a large Institution such as it was evident
that the Asylum was certain to become. The site was about as unsuitable as it could be from
an economical point of view, and a radical change had to be made in some direction and at once.
It was finally decided to remove the Institution to New Westminster and locate it upon a
Government reserve, in juxtaposition to that City. This reserve is beautifully situated on the
north bank of the world-famed Fraser River, between the main part of the City of New
Westminster  and   that  portion  called   Sapperton, which  was  once  the site  of  the Royal 466 Report on the Public Hospital for the Insane. 1902
Engineers' camp when they were on service in this country. The Dominion Government
reserve, upon which is located the Penitentiary, lies next and parallel to this reserve. The
bank of the Fraser, which forms the front of the reserve, rises to a considerable height, so that
the intervention of the C. P. R. track with Columbia and Front Streets, between the river
and the Institution, does not in the least break in upon the panorama of scenic grandeur as
viewed from any portion of the buildings. Mount Baker, with its perennially snow-clad peak,
is plainly seen in the eastern horizon directly opposite, while to the north are the seried ranks
of the Coast Range of the Rockies.
The reserve was then about 100 acres in extent and covered with its primeval suit of
evergreens, with dense undergrowth. The soil upon the river end, which was the part built
upon, was fairly good, being a sandy loam, but farther back it becomes more sandy and
gravelly, with many large boulders cropping up here and there, while still to the rear of that
we have brick-clay and then swamp. Looking toward the establishment of an Institution farm,
it presented no rich promise.
However, for convenience to the base of supplies, as well as to the centres where the most
patients were likely to be found, the site could not have been better chosen, while at the same
time it is said that one strong reason for placing the Institution here was to recompense New
Westminster to some extent for its abandonment as the seat of local Government.
The first building was erected during the fiscal year 1877-8, at a cost of about $24,000,
and was so placed as to ensure sufficient fall in the water-pipe which was to conduct the water
supply from a creek which runs through the adjoining Penitentiary property. This proved to
be the water supply for about fourteen years, and may, therefore, be accepted as sufficient
excuse for the error of placing the buildings too near the brow of the hill. This primary
structure was built of brick and made two stories high, 125 feet long by 25 feet wide, with
the main entrance in the centre, which part projected to the front about 20 feet. It faces east
and slightly south.
The internal arrangement was characteristic of that time and has been altogether altered,
so that no one would, from its present appearance, suspect its earlier style. A narrow hall ran
from the front door through to the rear, dividing the interior into two sections, with a ward
in each. The same plan prevailed up-stairs, making four wards in all. The rooms for patients
were all single, and of these each ward had seven, with a day-room and lavatory, but no water-
closets. These latter were situated outside, and necessitated the patients being taken out to
them by the attendants upon occasion, which was certainly not in accord with modern ideas.
A peculiarity of the wards was the unusual height of the window-sills from the floor, it being
so that no one eould see out of the windows unless he stood upon some object as high as a
table, which, as one of the annual reports says, was a very common way for patients to spend
hours. This defect, coupled with that of having heavy iron bars for window-guards, like a
prison, made the wards very gloomy, and as they possessed no decorations, no carpets nor
curtains, and very little furniture, which was home-made at the best, one can only wonder
how the patients put in the time, and marvel that suicides did not occur very frequently.
Even the bedsteads were home-made and furnished with straw ticks and straw pillows. The
wards were heated by means of open fireplaces and stoves, and for light coal oil lamps were
used.
There was one dining-room for all, and the patients from the different wards dined
serially, the women first and the men afterwards. The Superintendent and the Matron had
their suites in the central part, and what with accommodation for the employees and storerooms, not much space could have been devoted to the wards.    In fact, this one small building  2 Ed. 7 Report on the Public Hospital for the Insane. 467
had to accommodate the entire staff and the 38 patients whom they brought over with them
from Victoria.
The kitchen and laundry were contained in one small wooden shed at the rear, connected
to the main building by a narrow wooden passage. Such was the first Asylum, in structure
and fittings, that was built for the purpose of an Asylum in this Province.
The transfer of the patients took place during the month of May, 1878, and two or three
separate trips were made, but by the 17 th all were removed, together with household goods to
the value of about $800.
The 38 patients, as will be readily seen, more than filled the 28 rooms, and from the very
start there was a degree of overcrowding that was not freely relieved for seven years, by the
end of which time the day-rooms, corridors and lavatories were all being used as sleeping-
rooms.
As soon as the patients had been made as comfortable as possible in their new quarters,
Dr. Jones resigned, leaving the service at the end of July to return to Victoria and take up
general practice. Thereupon the old system of management was reverted to, and Mr. James
Phillips was promoted to the office of "Superintendent of the Asylum," while Dr. T. R.
Mclnnes, our recent Lieutenant-Governor, was appointed Medical Superintendent, to be nonresident.
Coming now to the year 1883, we find that the annual report for the previous year was
printed and distributed for the first time. It showed that the number of inmates had
increased up to 49, and that the overcrowding was becoming irksome, combined as it was with
so many defects in the structure and in the various services, such as the water, heating and
lighting. It mentioned that very little outside work could be done on account of the proximity of the bush and the danger of escape, and altogether one gathers that the treatment was
simply that of custodial care.
On January 22nd Dr. Mclnnes resigned, and was followed in the work by Dr. J. A.
Sivewright, who was himself succeeded on May Slst by Dr. R. I. Bentley.
During 1884 plans were prepared for throwing out a wing to the north. This addition
was made 99 feet long by 33 feet wide, being shorter, but wider, than the original building,
with which it forms a right angle. The interior was differently planned, the intention being
to provide dormitories instead of single rooms, and the corridors were made wide. The cost
of this building was $26,000, and $4,700 more was spent on Lands and Works in the way of
boundary fences and a residence for the Superintendent. At the same time, improvements
were made in the old buildings to the extent of lowering the window-sills and building a
balcony for each ward, so that access could be had to it by a door from the day-room. This
was a specially welcome feature in this place, where the winter season is so unsuitable for
patients to go out of doors in search of recreation, on account of the incessant rains and the
water-soaked earth. The building of 1884 retains one feature, as will be seen from the photograph of it, which is not in vogue in modern asylums, and that is the heavily barred windows,
but when one is dealing with insane criminals this, after all, is the safest window guard. It
also possessed a front entrance of its own and was used as an administration building for a
time.
Some attempt was now made for the first time at decoration, and pictures were framed
and placed on the wards, and by using one of the larger rooms it was possible to have divine
service once a week, a matter that had been neglected hitherto. The capacity of the Institution
was raised to about 70 beds, with about 60 patients in residence.
At this time Dr. Bentley introduced an important innovation in the treatment of the
patients, in allowing them to go out to work in the grounds, clearing and cultivating the land 468       Report on the Public Hospital for the Insane       1902
enclosed within the new boundary fences. This afforded the unfortunate inmates a chance to
be out in the open air and sunshine, as well as a pleasant diversion, and from the report of
that year they seem to have thoroughly benefited by it in every way. Greater efforts were
put forth also in the wards to amuse the patients by games and dancing, but as yet there was
no amusement hall, that indispensable adjunct to every asylum.
On January 1st, 1885, Dr. Bentley, who had hitherto been visiting physician, became
resident with increase of salary, and was placed in full charge of the Institution, while the
hitherto " Superintendent of the Asylum " was made steward. It was arranged that the
Medical Superintendent should occupy the new residence built for him and devote all his time
to his work, although he was permitted to still attend to the Royal Columbian Hospital for a
while longer, a duty which he had previously been performing.
During the next three or four years the Superintendent lost no opportunity of pointing-
out to the Government that the services of water, heat and light were thoroughly bad and
needed alteration. The water-pipe coming for such a long distance through hillocks and
ravines over the Penitentiary grounds was choked with sand, and was continually breaking in
weakened spots, while every repair was becoming more difficult, owing to the fact that the
Penitentiary authorities had enclosed their property with a high boundary fence. However,
as it was apparent that the future water supply of this Institution was going to be a serious
matter, and no solution was visible other than to wait until the City installed its water-works,
it was left in abeyance and so remained for some years.
By the end of the year 1887 the Superintendent was urgently calling for more accommodation to be provided for patients, as the wards were again becoming very crowded. Nothing
was done, however, until 1889, when it was decided to add an administration building and
another wing, both extending, in the order mentioned, to the south. At the same time radical
changes were planned for the old structure to make it conform to new ideas, and so it was
widened by adding 12 feet to the front of it, making it 125 feet by 37 feet. Of course, to
enable this work to be .carried out, the building had to be abandoned by the patients, and 20
men were chosen and sent to the gaol, for the time being, while the rest moved into the 1884
building.
The new administration building now forms the centre of the main block, and is 65 feet
by 43 feet, built of brick, and three stories in height. It was at first arranged to contain the
officers' quarters and administrative offices as well as the steward's stores, a dispensary and a
reception room for visitors, while the entire top floor was one large hall to be devoted to
amusement purposes. As for the new wing, it was slightly larger than either of the others,
being 127 feet by 38 feet, and arranged in the most accepted style of the time, with a wide
central corridor and all the bedrooms leading off it, the day-room and lavatories being in the
centre. It would accommodate 55 patients in all, while the alterations in the old building
made it of like capacity. The only possible objection to the changes in the old building was
the doing away with the balconies. This was a distinct loss which it is hoped will yet be
remedied, but the substitution of the new window screens for the iron bars partly made up for
it. A brick kitchen was also built in the rear and that service improved. Connections were
made with the New Westminster Gas Company's pipes, and gas was installed for lighting the
wards, but the attendants' rooms were not so provided, which still necessitated the use of coal
oil lamps. Two hot water furnaces were placed in the basements, and the wards were heated
by this means, which was a great improvement in that system. We now hear for the first
time the mention of a work-shop, and this was when the old kitchen was allowed to the carpenter for his use. When all these operations were completed the Government had spent
$55,000, and the Institution had a capacity of 165 patients. 2 Ed. 7 Report on the Public Hospital for the Insane. 469
The 20 patients in the gaol, whose number had been augmented to 27 during the twelve
months while the building operations were in swing, were brought back in August of 1890,
and the population was found to be 117.
The acquisition of an amusement hall led to greater development along the line of amusement than anything that had been previously attempted, and during the following winter the
female patients danced three times a week to music sung by one of their number, there being
as yet no piano.
The men had a violin and concertina which could be heard all day long, but it was not at
that time customary for them to dance with the women. The chief event that transpired
during the year 1891 was the purchase of a piano for the amusement hall.
At this time the water supply, which had not been remedied with the other defective
systems, was in a state of collapse. The water used was what was dipped up with buckets
from a ditch at the back of the Asylum yard.
However, during the year 1892 connection was made with the service pipes which had
recently been installed in the City, and for the first time since its transfer to New Westminster
was the Asylum furnished with an unlimited supply of pure, fresh water, such as has made
New Westminster famous amongst the Coast Cities.
It brought with it also an increased degree of fire protection, as hydrants were placed in
all the wards as well as in the front grounds, all of which possess streams of high pressure.
The greatest need now felt in the Institution was that of a better laundry, and this was
supplied in the year 1894, when the present brick laundry building was erected. It was
furnished with a cement floor and a veiy faulty dry-room, but the other internal fittings were
left in a rather primitive state. No machinery of any kind has, up to the present, been
installed in it, and the washing is being done in tubs by the Chinese patients. Until recent
years part of the laundry was used for a shoe-maker shop and another part for the plumber.
During the years that Dr. Bentley was in charge the work of clearing the land surrounding the Institution went on rapidly, and the grounds were very greatly improved as well as
the lot of the patients.
Towards the close of 1894 a Royal Commission, comprised of Dr. C. F. Newcombe, of
Victoria, and Dr. Edward Hasell, of the same place, was appointed, for the purpose of investigating the affairs of the Institution. As the result, Dr. Bentley resigned his position and
retired from office at the end of the year. Dr. Newcombe was placed in charge temporarily
for a month, and was relieved on February 1st, 1895, by Dr. G. F. Bodington.
As it was deemed advisable that the Superintendent should live in the Institution, it was
arranged that quarters for his accommodation should be provided by the erection of an addition
to the front of the main centre building. This work, together with the erection of a gatekeeper's lodge, was completed within the year, at a cost of $6,555, and the former Superintendent's residence was converted into a detached cottage for female patients. This cottage
was lighted by electricity from the City plant, and the same system was installed in the new
residence, so that this was the beginning of the period of electric lighting, which later on
extended to the entire Institution.
The arrangement of the front grounds was greatly altered and improved, by doing away
with the old entrance and providing a more direct road from the corner of the property nearest
to the City. This new avenue of entrance is quite level, and has been made very attractive
in appearance. A lodge was built at the entrance for the accommodation of those attending
the gate. During these two years the number of patients yvas gradually increasing, until at
the close of 1896 we find the wards full to overflowing, there being 171 in residence, with 470 Report on the Public Hospital for the Insane. 1902
accommodation for 165. Plans for extensive additions were now prepared, and work begun
in the summer of 1897 upon the first of two new detached buildings, which were to be located
to the south of the then existing Institution.
Each of these structures was built to accommodate about 55 patients, and an effort was
made to have the appointments along modern lines. They stand detached, their only connection with one another and with the centre block being by means of a wooden corridor in
the rear.
Internally they present some marked contrasts, when compared with the old wards.
There is, first of all, a proper day-room, large, bright and commodious, with a beautiful view
from the windows. There is no dark wainscotting, which lends so much sombreness to the
other wards, while the lavatories and bath-rooms are tiled and more commodious. There is
ample light in every part of these buildings, and had the work of construction been well done,
there is no doubt but that they would have satisfactorily met the expectation of the management. The 1897 building possesses an isolation apartment for noisy patients, while that
attached to the 1898 building is in the shape of a pavilion.
As soon as the first building was completed in 1898, it was occupied by male patients.
The other cottage was finished the next year, 1899, and was furnished suitably for occupation
by the female patients. It was not occupied, however, until the 20th of February, 1900. This
afforded great relief to the female department, as it provided two wards for the accommodation
of those female patients who had, up to this time, been accommodated in one small ward. It
further enabled the management to place by themselves those patients who presented some
hope of recovery. At the time that these additions were undertaken, provision was made for
one general system of heating, which it was decided should be by steam.
With this object in view, a central boiler-house was located to the rear of the main building, and to secure sufficient fall in the return pipes the boiler-room was placed fifteen feet
below the surface of the ground. Three new large safety boilers were installed, while all the
coils and radiators in the old building were re-arranged to correspond with the system placed
in the new buildings.
Two stories were built above the boiler-room, the first one being on the ground level and
affording accommodation for the steward's several store-rooms. To the rear of this and
attached was built a two-storied structure, 64 feet by 40 feet, the ground floor being taken up
with a kitchen, scullery and pantries, while the up-stairs was arranged for a combined
associate dining-room and amusement hall, with the corridors which connect the buildings in
the rear running into it.
During 1899 the old amusement hall, yvhich had been abandoned for the new, was
remodelled and made into an infirmary ward, with a large and well-lighted operating room in
conjunction. The ward, which will accommodate six patients, has not yet been opened, but is
in readiness. At the same time a new brick mortuary was erected at a convenient place in
the rear grounds. It is provided with a well-lighted room for post-mortem examinations, and
the floors all through are of cement. The last alteration was the enlargement of the Superintendent's office by the addition of a bay window. Altogether, the years 1898 and 1899
witnessed the greatest expenditure that has ever taken place in connection with this Institution.     It totalled $105,000.
When this work was completed it wTas suggested that the waste steam from the laundry
be used to provide power to light the Institution by electricity, but when the plant was
installed it was found that a much higher pressure of steam would be required to run it than
that usually carried in our boilers, so that the plant really became a separate and distinct one
by itself, and has proved very efficient up to a certain point, but is very much too small to be
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The only attempts that had been made to provide work-shops was a shed which the
carpenter had set up for himself and which served as a carpenter shop and general lumber
room, while the plumber usurped a corner of the laundry.
At the close of the year 1898, there retired from the service an officer who had served the
Institution in various capacities for the period of almost 24 years. I refer to James Phillips,
our late steward. The service he rendered was marked by the most conscientious and faithful
performance of duty, and what he was worth as an officer in charge of an all-important department can never.be estimated. He joined the service as an attendant on March 1st, 1875, was
made "Superintendent of the Asylum" September 1st, 1878, and finally steward on January
1st, 1885, retiring at the ripe age of 75 years.
During the year 1899, the Medical Superintendent being laid aside with a severe illness,
an assistant was appointed, and the writer was chosen as the first to hold that appointment.
Thus at the close of the century this Institution, whose name had been changed by the
new " Hospitals for the Insane Act " of 1897 from " The British Columbia Asylum " or " The
Provincial Asylum " to " The Public Hospital for the Insane," had grown until it possessed
ten wards and a cottage, with a total capacity of 310 patients. These continued extensions
had taken a great deal of the land that had been improved and used for garden purposes, and
this will explain, in a large measure, how it is that, after thirty years, the extent of ground
under cultivation is so small.
Little can be added as regards important events to what has been set down in the foregoing history, although much more might have been done in the way of embellishment, which
I did not consider needful.
I now beg to submit the accompanying statistical tables, some of which are entirely new,
whilst others have been altered. A report of this description is of interest not only within
the Province, but in all other places where institutions of this kind exist, for the purpose of
statistical information and comparison, and if this Report is to accomplish this purpose, the
tables should be made to conform with those in vogue everywhere else.
It is in this way, by the exchanging of Reports by the Superintendents of Asylums the
world over, that much valuable information is obtained. I trust that this will be sufficient
explanation for the course I have adopted in altering the tables submitted.
Admissions.
The admissions for the past year have been more than in any previous one. They consist
of 89 male and 26 female patients, making a total of 115, which is 2 more than in 1900. Five
were admitted upon urgency forms from outlying districts, attesting the value of this statutory
provision. The Yukon Territory contributed the same number of patients as in the previous
year, viz , 10. Single men predominated in the number of male admissions, there being 53,
compared with 27 married, a matter easily accounted for by the predominance of single men
throughout the Province as a whole. Twenty of the women were married, 5 single, and 1
widowed. In the matter of education, 102 had either a common or superior education, and
the most of the remaining 13 were Asiatics, about whose attainments I was not informed. As
to place of birth, England leads with 25, while 20 were born in United States and 19 in
Ontario, the rest being distributed generally. Four Japs and 4 Chinese were admitted, but
it is remarkable that not one native British Columbian, either white or red, was admitted.
Table No. 8 shows that the coast district, including the Yukon and Atlin, supplied 83 of the
admissions as against 32 from interior points. The ages of those admitted ranged all the way
from 18 years to 80, although the most common ages were between 35 and 45, also between
50 and 60 years.    Sixty-six were said to be first admissions, as were also, possibly, a large 472 Report on the Public Hospital for the Insane, 1902
proportion of those classed unknown. A fairly good proportion were admitted early in the
course of the disease, and close observation of our discharge records will show that the vast
majority of the recoveries came from the ranks of the early admissions. It is a great mistake
for the friends of patients to keep them at home until all hope of recovery is gone, and to send
the patient in only as a last resort, after he has become to them unmanageable.
As will be observed in Table No. 13, a great majority of the patients could not be classified in respect to heredity, but in 17 cases it was clearly ascertained that mental or nervous
troubles existed in one or more of the blood relatives. Table No. 14 shows, that the chief
alleged causes of the disorder were similar to what we find in other reports, namely intemperance and vicious habits. No less than 20 of the 115 admissions were due directly to intemperance, and in how many of those cases classified as unknown who can say ? I feel that if
men throughout the Province at large, who are given to over-indulgence in stimulants, could
behold for a brief space what in language is indescribable in connection with the closing scenes
in the lives of many of these unfortunate and unhappy wrecks from intemperance and vice,
there would be an improvement in these statistics.
In 35 cases the bodily health was average on admission, while in 63 cases it was reduced
and in 17 others greatly reduced, two or three being practically moribund. Only one case
was admitted twice during the year. The table of diagnosis, which is offered for the first
time, shows that out of the 115 patients admitted only 47 presented any prospect of recovery,
while 51 were either completely demented or progressing rapidly toward that state. Three
cases were congenitally deficient, and thus hopeless. There were 14 cases of general paresis
admitted, which formed 12 % of the total number—a rather startling fact, when one considers
that it is one of the worst forms of disease and always incurable. Whether the climate has
anything to do with the virulence displayed by this disease in this country, I am not prepared
to say, since I find it so difficult to get a correct history in such a large percentage of the cases.
Before leaving this section I would devote a few lines to the matter of admitting patients
of criminal tendency. During the year we admitted 7 criminal insane and 1 insane criminal,
which, with those already in residence, brings these undesirable classes into prominence here.
It has always been the common practice to ignore section 26 of the Act, and to place these
patients on any ward where it was convenient, which cannot be avoided so long as the wards
are so full and no special provision is made for this special class. On the other hand, we cannot escape having them, since this is the only Institution in the Province that cares for the
insane, but certainly special accommodation should be prepared soon for such cases.
Discharges.
The total number of discharges for the year is 60, 44 males and 16 females. Forty were
recovered, 14 improved, 5 unimproved, and 1 not insane. The number of recoveries is the
highest reached in any one year, though the percentage on admissions does not come up to
that of some past years, as set forth in Table No. 2; but those figures must not be taken
too seriously, since I have discovered instances in the records of those years where even
cretins were discharged recovered. I shall spare no pains to have the records added to this
table by me correct, and shall not place doubtful cases under any but the proper heading.
I would draw your attention to Table No. 18, which shows that 25 of the 40 who recovered
were admitted during the first month of the malady, and 8 more within the second month,
showing, as already mentioned, the wisdom of early removal to the Hospital. I do not claim
that cases do not recover at home sometimes, but I do insist that the percentage of such cases
is very small, and that before deciding to adopt this course the friends should get medical
advice as to whether the case is a suitable one for home treatment or not. 2 Ed. 7 Report on the Public Hospital for the Insane. 473
Among the discharges unimproved was the entire lot of Japs, 3 in number, whom the
Japanese Consul kindly undertook to send home, provided I placed them on board the steamer,
which I gladly did. In the same way I have not lost any opportunity of deporting an Asiatic,
and have succeeded in getting rid of a great number; but during the past year I had a new
experience, in having one of them return from China and enter the country the second time,
so that it would not seem as if all that were necessary was to send them back home, but they
require to be kept there.
Discharges on Probation.
There have been 46 patients discharged on probation during the year, of whom only 3 had
to be returned. This statutory provision is a most useful one, but in this Province, where so
many of the patients are friendless, I think its scope is not wide enough. Before a patient
can leave on probation, some friend has to come and sign the bond; but where there is no
friend, the Medical Superintendent should have the power to grant probation, and, by means
of the Provincal Police service, keep a friendly eye upon the patient for a time.
Escapes.
On account of the greatly increased number of patients who were engaged during the year
in clearing land and building shops, there was an increase in the number of attempts at escape,
and of these some were successful, but in no instance was the patient long unaccounted for.
Altogether 12 succeeded in getting from under the eye of the employees for a longer or shorter
space of time. Seven were away less than one hour; one reached home, where he was allowed
to stay for some months. Three were inebriates who had recovered from their acute alcoholic
condition, and were shortly to be discharged at any rate. They went to their compatriots and
o-ot work, so were left unmolested. The last was an interesting case, in that he suddenly recovered
the next day after his escape, and while making for the mountains. As a result, he wheeled
about and made for the Coast, where he got work, and when he had satisfied himself that he
was quite well he reported to me his whereabouts, and being allowed probation, is doing well.
From this it would appear as if escapes were at times not an unmixed evil," yet everything is
being done to prevent such occurring; but I feel prompted to say that there is no Hospital
for the Insane, that is treating its patients at all fairly, that does not have an occasional elopement, since a certain degree of liberty is absolutely essential to recovery. The moral nature
of a patient has to be appealed to constantly, and his sense of honour stimulated. It is worthy
of notice that, of the large number of patients who have occupied the "open-door ward," which
was instituted during the year, not one broke his pledge; however, this good record cannot
always be expected, and occasionally a patient will fall from grace and, throwing his pledge to
the winds, run away. Notwithstanding that, the system is good and the benefit accruing
compensates a thousand times for any disadvantage.
Accidents.
The accidents of the year were not numerous, but at least one might have had a serious
termination if prompt surgical measures had not been taken. A gang of Chinese patients
were out working on the grounds in charge of an attendant, when, without warning, one who
was working with a pick attacked another, inflicting a wound in the left lumbar region which
extended into the kidney itself. Surgical measures were adopted, with such success that the
patient soon recovered.
The Chinese are peculiar, and we suffer from the disadvantage of not knowing their
language, so are ignorant of what friction may occur between them until some overt act
reveals their frame of mind. However, such viciousness as evidenced above is unusual, and
can only be guarded against when once it is known to exist. 474 Report on the Public Hospital for the Insane. 1902
During a slight scuffle, while coming in from the airing court, one patient threw another
down and broke the point of one of his ankle bones; but this man also made a complete
recovery, although advanced in years. The last case was one of partial suffocation in a female
paretic, from attempting to swallow a large piece of meat without chewing it. This case was
resuscitated after life had apparently fled, and she completely recovered from the effects.
Deaths.
The general health of the inmates and staff has been very fair, and no epidemic of any
kind has occurred amongst us. A case of measles was admitted, but isolation was successfully
carried out. I usually seize upon the long winter months, when the patients are confined to
the wards mostly, to vaccinate all who have not been vaccinated by me before, and so I trust
we shall never be caught napping while small-pox prevails to such an extent on the American
coast.    In this way last year I performed over 100 vaccinations, yvith fair results.
The total number of deaths for the year was 25, being four less than in 1900. General
paresis was the cause of death, directly or indirectly, in 12 cases, or about half the entire
number. Not only is this disease very prevalent on the Coast, but it is very virulent in its
nature. In the older parts of Canada it is not uncommon to see cases lasting from eight to
ten years, but the average duration of the disease here is about eighteen months. One of the
old-timers dropped dead while working on the front grounds. He was one of the first admissions in 1872. I regret that the year did not pass without leaving me to record a suicide.
The ease was that of a Chinaman who had been three and a half years resident and had
come to be much trusted. He was naturally cheerful in disposition and a good worker, and
such a thought as that he might be suicidal had never been for a moment entertained. The
Chinese ward becoming crowded, this man was allowed to sleep in a room that had belonged
to an attendant, but was not so used just at the time of this occurrence. The electric lighting
fixtures were not altered, as it was expected that the room would again be used by an
attendant. The wire to the electric lamp was very long, to permit of its free removal from
place to place as required, and this was the agent used to bring about death. Some time in
the early morning hours he sat up in bed and deliberately wound this cord about his neck,
throwing the lamp over the other part at the side of his head and thus avoiding knots. He
then gently let himself over the edge of the bed so that his weight would produce a strain,
and yet careful not to break the rosette from the ceiling. Thus, with his legs still on the bed
and his hips almost touching the floor, he died without a struggle. An inquest was held, but
no blame was attached to any one.
Another attempt was made in which a Yukon patient figured, but he was not successful;
although he had succeeded in suspending himself with a towel in the lavatory, he was instantly
detected by the attendant, to whom all praise is due for his watchfulness. However, when I
consider the number of suicidal patients who have been under care during the past year, I
am thankful that we have no other fatalities to record, and feel that every credit is due those
who have the direct oversight of the patients.
In these days, when the scourge of tuberculosis is so rampant in every charitable institution, it should be a matter of much gratification to the Government of this Province to find
that it possesses so large a hospital as this, showing no death from that disease for the past
year, and no case in residence, which fact, I think, places the Institution in a unique and
enviable position amongst the Asylums of the continent.
TrEAToMENT.
The methods of treatment at present pursued in Hospitals for the Insane differ greatly
from those in vogue thirty years ago, and that this applies to this particular Institution will o-l
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be observed from a perusal of the history. That we have not yet reached the desired point of
efficiency and excellence I must confess, and if we are ever going to, much will have to be done
in the way of improving the equipment; and if our percentage of recoveries is to be increased
by such a procedure, then we should not stop short of the required expenditure to place ourselves beyond the reproach of these unfortunates whom the law commits to our care and
control when they have lost the ability to perform these functions for themselves. Restraint,
which so characterised the early plan of treatment in this Institution, is dying away, and we
are finding each successive year less need for the measures once used.
The cure of the insane is not to be compassed by the use of medicines alone, nor of any
other single measure, but rather by every means that will tend to put the body in good condition and divert the mind from its morbid action. The most useful medicines we possess in
this work are the nervine tonics, but there are no specifics. Dessicated thyroids have an
action that is sometimes very beneficial in a certain type of disease, but its exact manner of
working is not as yet clearly understood. It has seemed to aid recovery in a few cases during
the past year. Another animal product was offered during the year, but its trial was not
attended with success in my hands.
Nothing, however, is more important in the treatment of insanity than good feeding;
that is, the food provided must be good in quality, plentiful in quantity, and properly prepared
and served; and in this regard I feel that some advance has been made during the past year,
to which I will refer at greater length under another heading. In looking over some reports
I had received, I discovered what is stated to be the ration list prepared by Prof. Austin
Flint for use in the New York State Hospitals, where great attention is paid to dietary treatment.    This list is as follows:—
Daily per capita
allowance.
Meat (bone included), fish and poultry    12    ozs.
Flour, corn meal, macaroni    12
One egg      2
Sugar      2
Butter      2
Cheese ,      1
Rice, hominy and oatmeal          1-|-
Beans and peas      1-|-
Coffee, in berry and roasted        §-
Tea (black)        £
with fresh vegetables and fruits.
This is what should be consumed per capita by the Institution as a whole—officers,
employees and patients—and not, as one might think at first glance, the amount to be actually
consumed by each patient daily.
I have not been able to make our table conform exactly to that of Prof. Flint's, as we do
not bake our own bread and so do not know the weight of flour used.    However, I venture to
submit the following for comparison, the amounts here mentioned being those consumed per
capita in this Institution last year:—
Ounces.
Meat (with bone included), salted meats, fresh and salted fish, poultry. .   12.98
Bread and buns    17.57
Flour, cornmeal, cracked wheat, macaroni and corn starch       .     2.08
Eggs 187
Sugar      2.00
Syrup 658
Butter        1.50
Cheese 063
Rice, barley, oatmeal, sago and tapioca      2.06 476 Report on the Public Hospital for the Insane. 1902
Beans and peas 65
Dried fruits, prunes, apples, peaches, raisins and currants 98
Coffee 172
Tea      1.88
In glancing over these lists, one cannot help but note the great disparity in the quantities
of eggs and cheese allowed. The latter has never been furnished the patients here on account
of the expense, but the extra allowance of meat may be regarded as an equivalent. However,
I would like to see my patients getting more eggs and milk, which I regard as better for them
than meat. Most asylums can afford to do this because they possess their own herd of cows
and their own poultry ranches, but here we have to purchase these commodities, as we do all
our other supplies, and we shall never be able to do any differently until we have a farm
colony of our own. As for eggs, I have not yet heard of any other hospital for insane which
has to pay 25c. per dozen the year round, as we do, to remedy which we should have to engage
extensively in poultry-keeping. At present eggs are not allowed except to sick patients, or
private patients, so that, except in cake, the generality of the inmates taste them but once a
year, namely, at Easter. There is also a shortage in small fruits in season, because our garden
is so small, but each year I trust we shall be able to add to it somewhat.
Next in importance to proper feeding comes regularity in the living habits and long hours
of rest. As these are always inseparable from asylum life, we may take it for granted that
they are provided ; on the other hand, this part of the treatment may be overdone, and I
fear that with us some of the patients are kept in their rooms too long at night, a matter
which, I hope, we can remedy shortly.
I would now deal with measures that form an efficient adjunct to those already mentioned
for the cure of insanity, as well as for the alleviation of its distress in chronic cases. I refer
to employment, amusement and recreation, but most of all to employment.
I regard employment for the insane as an absolute necessity, and of its beneficial results
there can be no question. Without it the life of many patients in the Hospital would be
simply intolerable, on account of the monotony and ennui which must result from inactivity
amidst never-changing surroundings. I have always considered the provision of occupation
for the patients under my care as one of my foremost duties, and I know that in this I am
only following in the footsteps of the leading alienists of the day. That there are many difficulties and dangers attendant upon the employing of the insane I will admit, but these must
simply be surmounted in the interests of the patients themselves. Happily, it occurs that in
affording our patients employment we are also furthering the economical maintenance of the
Institution, a matter of no small moment, but one, indeed, which exercises the management
a good deal at times. With these facts before us we cannot be too thankful to see springing
up about us a set of work-shops, which will soon embrace a good variety of trades, and render
it possible to afford employment in winter as well as in summer.
Like employment, amusement and recreation are essential and fundamental requirements
in the treatment of the insane. They form, in fact, so important an element that they should
receive constant attention, and not be undertaken in the desultory and indifferent manner so
commonly seen. It is a matter that has received but little attention here, because of
structural deficiencies, and I know of no similar Institution where there are so few provisions
under this head as here, where not even a campus is available. I trust that I shall be enabled
this year, with your kindly co-operation, to make some necessary advance along these lines.
Amusement.
The customary fortnightly entertainments and dances have been held during the yvinter
months.    These are looked upon by the patients as reel-letter days and afford much enjoyment, 2 Ed. 7 Report on the Public Hospital for the Insane. 477
which, I am satisfied, could be increased by adding to their frequency. Special treats were
afforded by a visit from the Robson Orchestra early in the year, and by the local Banjo and
Guitar Club, under the leadership of Mr. Cunningham, of Vancouver, later, while at exhibition
time a large number of patients attended the fair as usual. Of the 82 who attended, 42 were
admitted free by the kindness of the directors. When the Horticultural Society held their
first annual Chrysanthemum Show we were not forgotten, and by the kindness of Mr. Dash-
wood-Jones, eight of our female patients attended and enjoyed the beautiful floral display.
Two more billiard tables were secured and placed on the male wards, where they have
been greatly appreciated and enjoyed, not to mention the improvement in the appearance of
the wards so adorned. For the women a piano was purchased and placed on the upper ward,
and this has made a great change for those patients. Music is something that possesses a
place of its own in the lives of most all persons, and nothing can take its place. To say that
it is a great treat to the patients of this Institution but feebly states the case, and if it were
possible I would like to place a piano upon every ward, and hope some day it may even come
to pass.
A fair amount of reading matter has been distributed about the wards in the shape of
daily papers and magazines, some of which we purchase, but most of which are sent in by kind
friends of the Institution. When our new bindery is equipped I hope to be able to bind such
magazines as I procure and place them in permanent libraries in the various wards.
There is a great deal to be accomplished here yet in the field of amusement before we
shall have advanced beyond its outer borders, but at present we are limited by various existing
circumstances that time will wear away.
Divine  Service.
Service has been held, as usual, every Sunday afternoon in the general assembly hall,
conducted either by the Medical Superintendent or by some of the clergymen of the City. A
goodly attendance has marked their course throughout the year. Quite a few of the patients
have enjoyed the privilege of attending the City Churches regularly. In some cases nothing
else could have afforded the solace and satisfaction that this privilege has given, and in no
instance has there been anything occur to mar the repose of confidence thus placed. The
Roman Catholic patients had their one service, as usual, conducted by one of the parish priests.
Work.
There was a great increase in the number of patients that were sent out to work during
the past year, and, consequently, there was a great increase in the amount accomplished.
Referring again to the tables, we see that the patients did 48,307 days' work in one way or
another. Table No. 22 shows a marked increase in the number working on the grounds, and
with the carpenter, for the reason that in these two departments special efforts were being-
made to improve the premises.
On the wards there was an increased number of workers, while in the kitchens and in
some other departments the work was about the same as last year. In the tailor and shoemaker shops the products were about as usual, while the women not only increased their
labours but branched out along new lines, and began to make mats for the adornment of their
wards, which has been a very welcome innovation. A great deal of work has been accomplished in the laundry, notwithstanding its lack of appliances, and much credit is due to the
laundryman, who has so skilfully handled his gang of Chinamen, whom it is not always easy
to keep in good washing humour. In the carpenter shop many fine articles of furniture have
been manufactured by a skilful patient. Among these things were a fine maple desk for the
chief attendant's office, a type-writer cabinet for the Medical Superintendent's office, a key *
478 Report on the Public Hospital for the Insane. 1902
cabinet for the same office, and a very large filing cabinet, all of which are beautifully constructed and worth a good sum of money. In the new blacksmith shop several patients have
been employed at times, the chief work being the sharpening of picks for the excavating gang,
and drills for the rock splitters. This work was formerly done in the City, and so a saving-
has been effected with benefit to the inmates.
Products of the Farm and Garden.
The year has been a good one in general with our farm and garden departments, although
the cut-worm was abroad in large numbers, and for a time threatened to exterminate some of
the vegetables, but the men in charge took hold promptly, using such measures as were advised,
and apparently with good results. The early cabbage was also attacked by a small worm that
bored into the root of it just at the time when it was delighting the eye of the Gardener. Not
much of the crop was left to us. A frost in July damaged the fruit a great deal and the
returns were rather behind that of the previous year.
The Farmer had the misfortune to lose several of his pigs through some disease, the nature
of which could not be cleared up, although a Veterinary made an examination. However,
when changes were made in the location and housing of the herd all signs of disease completely
disappeared.
A value has been set upon the produce of the farm upon the basis of our contract prices,
and where these did not cover the product we marked them at market value, and by so doing
we find that our farm saved us $2,251.71 last year, likewise the garden, which I have kept
separate, as it is under separate management, $445.12. Of course the latter does not represent
all the returns for the labour of the Gardener, and it is only fair to that officer to say that the
garden is but a very small portion of his domain, as he has all the ornamental grounds to look
after as well, which in area are about equal to all the rest under cultivation. Besides this,
the fruit garden is not enclosed, so that nothing is more easy than for the paroled patients to
take pleasant walks through these attractive quarters and incidentally prevent the Gardener
from scoring all the fruit that ripens. A reference to Table No. 24 is interesting, inasmuch
as it will show that for the first time in the history of the Institution the Matron preserved
fruit for the use of the employees in winter, as is done in other places. Hitherto it had been
the custom to use the fruit as fast as it came from the gardens, and when winter came to
depend upon dried apples and prunes altogether.
The following schedule shows the products of the farm :—
Artichokes  760 tt>s. $ 15 20
Beets  1,380   „ 9 66
Cabbage  13,972   „ 244 49
Carrots  18,362   „ 82 63
Cauliflower  205   „ 4 10
Cordwood  37 cords 120 00
Corn (ears)  430 dozen 64 50
Ducks  15 9 00
Eggs,  25 dozen 6 25
Fowl  12 4 80
Hay  1| tons 15 00
Parsnips  24,158 lbs. 169 11
Pork consumed  5,144   n 462 96
ii    sold  7,006   „ 447 27
Potatoes  48,842   „ 451 79
Turnips  24,158   „ 144 95
$2,251  71 2 Ed 7 Report on the Public Hospital for the Insane. 479
Products of Garden.
Beans (string)  357 lbs.
Cabbage  2,999 .,
Carrots  1,288 „
Cauliflower.  263 n
Celery  228 i.
Leeks    ...  473 ..
Lettuce  244 dozen
Onions  120 lbs.
Peas  100 ii
Potatoes  1,182 „
Radishes  239 n
Rhubarb  292 n
Squash  100 n
Tomatoes  352 n
Turnips  28 n
Apples  5,181 ii
Blackberries  50 n
Cherries  33 n
Currants, black  221 n
ii        red and white  153 n
Gooseberries  401 n
Grapes  14 n
Peaches  96 m
Pears  205 n
Plums  547 ii
Raspberries  362 n
Strawberries  266 n
$ 7
14
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$445 12
Chief Events of the Year.
Change of Management.
Early in the year the Hospital received a visit from Dr. C. K. Clarke, Medical Superintendent of the Rockwood Hospital (for insane) at Kingston, Ontario. He came under
instructions from your Department to inspect the Institution and examine into its workings
and report to the Government. After a most searching investigation, which began on January
18th and lasted nearly a week, Dr. Clarke recommended that certain changes should be made
in the system, with a view to introducing greater economy in the use of supplies, and to make
the general plan of management to conform to that which has proved to be the most successful
at the present day.
It was apparent that to bring about the required changes would entail an immense amount
of work, and Dr. Bodington felt constrained, through the advance of his years, to relinquish
the labour to younger hands, and seek well-earned rest and retirement in the land of his birth
surrounded by the members of his family and his friends. In this connection I can truthfully
testify that no greater general sorrow has been witnessed throughout the Institution than that
occasioned by the departure of the one who had taken the helm at a very trying time, and
had safely piloted the Hospital through some difficult passages, giving to it his best energy
and utmost attention, though never in robust health, and having already arrived at that period
of life when men hope to be able to forget labour and worry. Dr. Bodington's resignation was
accepted by the Government, who voted him a retiring allowance for his faithful services, which
terminated on February 28th, after 6 years of most arduous toil, during the greater part of
which he was alone in charge of the Institution. His Assistant, the present incumbent of the
chief executive office, was appointed his successor. 480 Report on the Public Hospital for the Insane. 1902
It was found advisable to make certain changes in the staff to begin with, in order that
proper co-operation might be secured in carrying out the new system of management, which it
was at once seen was not in favour with some. With loyal co-operation upon the part of the
staff in an institution of this kind, a superintendent of very mediocre ability might successfully
carry on a good work, but it would be impossible for a man even of the highest endowments
to do justice to his patients and his employers, while a lot of underhand scheming is going on
amongst his assistants, with a view to making trouble. The very first change attempted
precipitated a crisis, as the result of which one male attendant was dismissed and five others
were permitted to leave at once, all of which vacancies were filled immediately by young men
from the City. This matter would have been trifling in itself, had it not been for the disturbance made in the public press as a result of the sensational and lying reports circulated by the
disgruntled malcontents whom we had dropped from the staff', but as soon as the truth became
known my attitude was upheld.
One of the first changes inaugurated was that whereby the kitchen department was placed
under the control of the Matron. It had previously been managed solely by the cooks, who,
not being in touch with the wards, were unable to dispense the food to the best advantage in
order to prevent waste. The diet sheets are now made out fortnightly, to insure a healthy
degree of variety. In short, this service, which used to be the source of so much complaint
and unpleasantness, has been made thoroughly efficient and complaints are very rare.
In the outside department a distinction has been drawn between the farm and the garden,
and a separate officer is now in charge of each, with his domain distinctly outlined as wrell as
his duties.
As touching the wards, I saw that there were enough trustworthy patients who, if gathered
together, would till one ward, which they might be able to take care of themselves with some
oversight, and at the same time have the privilege of open doors; accordingly, the " open-door
ward " was established and has proved successful, so that two less attendants were required on
the staff. These patients were also allowed to remain up at night until 10 p. m., for reading
and social games. By another arrangement the patients who were willing and anxious to work,
but not on parole, were gathered together in one ward and went out to work every fine day,
which they seemed to enjoy very much.
In the offices I had a very busy year. The method of keeping the correspondence had
become so antiquated that it had to be all re-arranged, and in this connection all the admission
papers of every patient from the first had to be gone over and dealt with. New filing boxes
and a filing cabinet were made and installed in the office. In ascertaining the per capita cost
of maintenance, as I will intimate in this report later, I spent a great deal of time, and every
voucher in our possession had to be dealt with separately, in order to classify the expenditures
according to the plan to be mentioned under the section on expenditure.
Improvements.
During the year improvements were effected in nearly every department. In the centre
building it was found that the new Infirmary was impracticable in the form in which the contractors had left it. A partition was built at the head of the stairs, affording the required
means of security against escape from the ward, as wTell as of isolation in case of need. In the
basement another partition was built, to shut off the dust and steam coming from the boiler
room. An office was made for the Chief Attendant by appropriating two rooms in B ward ;
this has the advantage also of enabling that officer to keep some oversight of B ward, which is
the " open-door " ward. Suitable clothes-rooms were arranged in A, D and F wards to replace
the small dark closets formerly used for that purpose.    D ward was generally overhauled and 2 Ed. 7 Report on the Public Hospital for the Insane. 481
decorated, so that now it presents a most home-like appearance and is by far the most handsome ward that this Institution has ever known. This work will be carried on until every
ward in the house is made what it should be. The capacity of the ward was incidentally
increased by three beds. The Superintendent's residence had to be completely gone over by
the Plasterer, and the opportunity was taken advantage of to install gas-pipes in the principal
rooms.
The Gate-Lodge was practically reconstructed and made more sanitary. It had formerly
contained but four rooms, in which eight persons had to live, and contained no modern conveniences. It now has six rooms, besides a bath-room and water closet, also an entrance hall.
The public entrance at the gate was also greatly improved in connection with this same alteration, and two porticos of handsome design were placed about it, the one on the inside and the
other on the outside of the gate. The whole structure was artistically painted by ourselves,
in colours not quite so sombre as those prevailing here in the past.
The eastern ends of the 1897 and 1898 buildings were cemented to keep the rain from
soaking through the brick, and rendering parts of those buildings uninhabitable in the winter.
Paint and oil were used as a finishing coat, and the appearance of the buildings has been somewhat enhanced. A stone retaining wall was built at the side of the kitchen and capped with
cedar, with a protecting rail over that. On account of the frequent blocking of the sewers
from the '97 and '98 buildings, it was decided to build brick traps in such a position as to
catch foreign bodies before they would lodge in that part of the pipe, which is now from 12 to
15 feet below the ground. One was built for each building and securely covered. It was
found necessary to take up the steam pipe to the laundry and replace it, as it had become completely rusted through and had been causing a great loss of steam intended for the dry-room.
New pipes were laid and covered with asbestos in a tunnel built of brick and cement. A
steam trap was placed on this connection, and has resulted in a great saving of steam and thus
fuel.
The old iron sinks in the scullery rusted through and were replaced by porcelain ones.
The front bank, where all the excavated earth for any number of years had been dumped, was
graded and sodded by the Gardener, with the aid of patients. More remains to be done
during the current year. The excavating which had been left unfinished by the chain-gang
at the rear of the 1898 building was completed by us, and the high bank graded and sodded.
A drain 600 feet long was put in at the top of the bank to prevent percolation of water
through the bank. The telephone and electric light poles were removed from the front
grounds, where they were unsightly, and were placed in the rear.
Chairs were substituted in two dining rooms for benches, and knives and forks were
placed upon the tables, as well as spoons for the patients to eat with. In the past spoons only
were allowed, except upon special occasions, such as Christmas.
Increased fire protection was afforded by the installation of a fire-alarm box of the same
pattern as those used by the City, and connected with the City system. A hydrant, which
was located in an unsuitable place, was moved to a better one, while the house for the hose-
reel was moved and painted. The hose in all the wards was tested and defective portions
discarded and replaced. The babcocks were attended to regularly and the lawn house supplied
with new fire pails, of a better pattern than those on the wards. I feel that we should make
some good ladders this year and keep them in readiness as we do the other fire apparatus. I
hope to institute fire practice when the new shops-building is completed, and the outside
employees are gathered there in the living quarters being prepared for them. Thanks to our
proximity to the City, we have never felt that in case of fire we were utterly dependent upon
our own exertions, and for that reason I suppose this department, usually so well equipped 482 Report on the Public Hospital for the Insane. 1902
and trained in other institutions of this kind, has been rather neglected here. However, it is
advisable that whatever available men we have for the purpose should be trained so as to be
able to assist the City Fire Brigade in the-event of fire.
The Engineer recommended that steam traps be placed upon those portions of the system
that were in his opinion causing the greatest loss of heat, and that the return pipes generally
should be covered. To test the matter, three steam traps were installed and considerable covering done to the pipes, the results of which have been so satisfactory that we shall secure and
place in position several more traps, in order to thus control the entire system and render it
as economical as possible.
In no previous year has so much been accomplished in improving the ornamental and
cultivated land belonging to the Hospital. A large area of new land, I should say about five
acres, was cleared of trees, stumps and stones and placed under crop. Some days as many as
70 patients were engaged in this work. The results, both in improved health to the patients
and in increased returns from the soil, were eminently satisfactory, and encourage us to go on
and achieve greater results this year. In the fall, attention was turned to draining, and about
2,000 feet of tile were laid, so that the land should be in even better condition for the next
crop. A lot of old shacks were cleared away in the rear and the pig-yards pushed farther
away from the proximity of the buildings. A small house was erected and fitted up for killing
and dressing our own pork, which has proved an economical procedure. The boundary fence
was continued up the boulevard as far as possible, with the material on hand, and it is expected
that the new appropriations will enable me to have it carried completely around the rear of
our property, so that we may have a park for the ladies and a campus for the men.
New Buildings.
An attempt was made during the year to fill, so far as the funds would allow, a long-felt
want—namely, workshops. The first to be undertaken was a combined blacksmithy and
plumbing shop. It was built of fir and measures 37 feet by 12 feet, with a lean-to at one end
for a store-room for the Steward. The blacksmithy was fitted up with a brick furnace and
large bellows, anvil, vise, and a general assortment of tools, many of which were manufactured
there. The plumbing-shop has no fittings other than three good benches and plenty of room
for those things which had been occupying space in the laundry for years. This work of
construction was done by the patients, under the direction of the carpenter.
In the same way a paint-shop was built on a line with the other. It measures 24 by 12
feet, and is nicely fitted up with drawers, etc.
The chief undertaking of all, however, was the erection of a building 101 feet long by 36
feet wide, with a basement, two storeys and an attic, which for want of a better name I have
called the "shops-building." This is the building the plans for which I had the honour to
submit to you last spring. The first floor contains a carpenter-shop 50 by 36 feet, attached to
which is a cabinet-shop and a finishing-room. There are also rooms for book-binding, brush
and broom-making, mattress-making, lock and clock repairing, with a tailor-shop and shoemaker-shop up-stairs. The second-storey also accommodates about ten employees, while the
attic has four good-sized rooms. The basement is built with ten feet of masonry, and will
occupy one-half the space under the building. The floor will be cemented and a hot-air furnace
will be installed for the heating. The only outside assistance which we had to secure for this
work was a master-mason for a month and an extra carpenter. The patients, under the
direction of the employees, have carried on the greatest part of the operations, from the
excavation to the shingling, which is about as far as we had reached at the close of the year.
The completion of this building will be an important event in the history of the Institution, .,oo,»«.OVoo««
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and I trust that the new appropriations will enable us to complete it, in order that we may
prove what we have always contended, that the establishment of shops would be a great boon
to the Hospital.
Expenditure.
Before submitting to you the figures that represent the amount of our expenditure for the
past year, I would venture upon a few remarks.
I understand that it was owing to dissatisfaction under this head that the Government
appointed a Royal Commission to investigate the working of this Institution last winter, and
I know that during the investigation the Commissioner endeavoured to ascertain the exact per
capita cost of maintenance and could not, because of the system employed by us in keeping
the accounts.    This was not the fault of the Clerk at all, but of the system in use.
To remedy this matter, the Commissioner recommended that the Clerk be made Bursar,
and be allowed to perform every function of such an office ; that all accounts should pass
through his hands, so that he might properly classify them, which is an indispensable requirement to satisfactory administration. This change was concurred in by yourself, and the
appointment made with increase of salary, but as yet no change has taken place in the duties,
and matters are no better than they were.
To explain how the accounts should be kept, in order that the per capita cost may be
correctly computed, I would state as follows :—This Hospital for the Insane is an indispensable
Government Institution, and as such is a Government asset, like all the other Government
institutions of the land. It must, therefore, have two accounts, the one, capital, including the
money spent in construction, improvements and primary equipment, every item of expenditure
under this head having something tangible to show for it and being a permanent asset. The
other account is that for maintenance, and includes the money spent on salaries, provisions,
water, fuel, clothing, medicines and miscellaneous, as well as for repairs to plant and equipment, expenditures which leave no asset, but are incurred simply in carrying on the work for
which the Institution exists.
Now the mistake that has been made here is simply this : The primary furnishing and
equipment has been charged to maintenance, and no account taken of the $17,000 worth of
furniture and fittings that we now possess, and so it has been made to appear that maintenance
was more costly than it really was, which was greatly to the disadvantage of the management,
when comparisons were instituted between our per capita cost and that of other similar
institutions.
Of course the original equipment deteriorates and wears out, but it is always maintained
at a proper degree of fitness by the substitution of new articles from time to time, and these are
charged to maintenance, so that the original equipment remains a permanent asset of full value.
On the other hand, I found that some amounts were charged to capital account that really
belong to maintenance, and that some other departments were sharing our expenses. For
instance, we never see our telephone or telegraph bills, while stationery comes from the King's
Printer free of charge. These all belong to maintenance. However, the figures that I propose
to submit have been placed under their proper heads, and have been taken from the vouchers
submitted by us to the department for payment. They cover the entire period of the existence
of the Hospital, and consumed a great deal of my spare time during the past year in compilation. The totals tally exactly with those in our books, only the headings being changed. I
went to this trouble with the entire lot, since it is apparent, that to submit the figures for the
past year under a different arrangement from those of the previous years would be very unfair
to my predecessors, the results of whose management, from a financial point of view, are shown
up in better light by the new adjustment. Our expenditure for maintenance for the past year, as shown in Table A, herewith
appended, was $55,406.08, being about $4,000 less than it was in 1900, notwithstanding the
fact that we had an average of 26 patients more throughout the year. Dividing this amount
by 269.56, which was the daily average number in residence, we get $205.54 as the per capita
cost. For the previous year it was $244, so that there was a gratifying reduction of $38.46
per patient. Had the per capita cost been the same as it was the previous year, $10,370 more
would have been spent for the same results, so that this figure represents the real saving.
Table B shows the per capita cost analysed under its various divisions, and a moment's
reflection will show you that while the amounts mentioned in Table A are ever on the increase,
those in B should remain stationary or decrease, and if any undue expenditure should occur it
can be localised at once in this table.
Comparing the items for the past year with those for the one previous to it, we note that
the reductions were chiefly in salaries, provisions, fuel and miscellaneous, but most marked in
fuel, while there was an apparent rise in clothing. This latter is explained by the fact that
the shoemaker was paid from the vote for "boots, etc.," instead of from that for salaries.
While a reduction was effected in the expenditure for salaries, it was not by cutting the wages
of anyone in the service (with one exception, which was accidental), but was due to the
reduction of the staff by instituting the "open door ward," dropping the barber, plumber and
teamster and one medical officer.
In the matter of expenditure for salaries, we cannot expect to compare figures with
eastern institutions, where I know that the general run of employees are shamefully underpaid, and that, too, in a service that requires the best type of person that the country can
produce. Nor yet can we hope to compare figures with those larger institutions which handle
from one to two thousand patients, for the simple reason that a small institution requires nearly
as many officers as a large one, but we may rest assured that as our numbers increase the per
capita cost will go down and compare favourably with any Institution, under similar circumstances.
As already intimated in this Report, our expenditure for provisions must always be high
while we depend upon the general purveyor for all the supplies used upon the table. A farm
colonjr is the remedy.
As was anticipated, the most satisfactory reduction was in the fuel bill, and in this connection I would praise the Engineer for the careful way in which he handled the coal supplies.
He set out to cut the fuel bill in two, and he almost succeeded, at the same time furnishing all
the heat required as hitherto. We hope to make further reductions in this expense by improvements to the heating plant during the coming summer, but I do not think that we shall
reach much below the present figure until we have a wharf and scow of our own to enable us
to do our own delivering and deal directly with the mines.
The expenditure under capital account was greater than it was in the previous year. It
amounted to $7,134.58, of which $1,840.53 was spent upon new furniture and equipment,
$104.20 on the medical library, and $14.65 on new surgical appliances, the remaining $5,175.20
being spent upon lands and works in the manner following :—
Outstanding accounts left by previous management $ 166 75
Installation of weigh-scales    150 00
Clearing- and improving land for cultivation  243 81
Slaughter-house for farm  23  54
Re-constructing gate-lodge  408 24
Carried forward      $992 34 2 Ed. 7
Report on the Public  Hospital for the Insane.
485
Brought forward.  $992 34
Plumbing and blacksmith shops   233 80
Paint shop ,  120 03
New " shops-building "  2,143 70
Improvements to wards and infirmary, painting, etc  206 92
Improvements to interiors other than wards  298 44
Cementing the north ends of 1897 and 1898 buildings  108 86
Steam traps, valves and asbestos covering for heating plant .... 318 87
Extensions to lighting service  29  96
Extensions to hot and cold water service  81  27
New brick culvert to laundry for steam pipes  129 35
Fire-alarm box, moving hydrant, etc  161  38
Improvements to sewers, brick traps, etc  38 30
Fixing grounds next to buildings to protect the latter  48 50
Retaining wall in rear of kitchen      17  95
Netting about tennis lawn     10 45
Sundry small works, fencing, laying sidewalks, etc  125 00
Goods in stock not yet used, paint, glass, hardware, etc  110 08
$5,175 20
Including all in a grand total, we have expended $62,540.66 during the year 1901, which
is about $1,000 less than the grand total for the year 1900.
Table A.
Showing the average number of patients in residence each year, and  the total amount spent
for maintenance, with the per capita cost.
Year.
Average number
in residence.
Maintenance
expenditure.
Per capita
cost.
1872 (81 days)	
1873	
1874	
1875 , 	
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
$ 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
$616 00
487 98
491 20
360 77
1876	
1877	
1878	
344 91
373 26
382 93
1879	
268 63
1880 	
1881	
232 32
226 62
1882	
237 02
18S3	
1884	
242 75
243 20
1885	
1886	
284 54
259 42
1887	
1888	
1889	
1890	
216 70
204 72
219 60
223 13
1891	
181 50
1892	
1893	
1894	
1895	
1896	
187 80
193 36
178 25
193 83
186 67
1897	
1898	
191 75
214 38
1899 .
242 52
1900	
1901	
244 00
205 54 486
Report on the Public Hospital for the Insane.
1902
Table B.
Showing analysis of the per capita cost.
Year.
Salaries.
Provisions.
Clothing.
Fuel and
Light.
Furniture.
Medicines.
Miscellaneous.
Total.
1872	
$279 38
$184 03
$55 81
$22 44
$15 55
$10 18
$49 30
$616 69
1873	
221 48
166 81
14 55
23 65
21 59
7 74
32 16
487 98
1874	
231 10
152 10
22 07
23 98
28 36
7 78
25 81
491 20
1875	
153 82
113 40
13 98
16 88
25 45
6 73
30 51
360 77
1876	
143 34
114 45
18 68
22 75
17 90
2 86
24 93
344 91
1877	
177 15
126 75
20 69
4 66
20 75
3 74
19 52
373 26
1878	
176 16
124 23
30 43
13 94
7 20
9 16
21 82
382 93
1879	
134 27
95 10
3 25
15 91
6 39
6 31
7 40
268 63
1880	
111 84
87 71
5 74
14 06
6 00
3 63
3 34
232 32
1881	
112 44
81 14
6 86
12 73
5 55
2 56
5 34
226 62
1882	
121 51
84 52
7 05
12 30
4 54
3 49
3 61
237 02
1883	
123 81
92 56
6 03
11 04
4 26
2 24
2 82
242 75
1884	
124 02
90 64
7 03
12 43
4 14
2 77
2 18
243 20
1885	
169 05
84 33
6 33
15 05
3 90
2 93
2 95
284 54
1886	
159 03
69 35
5 49
16 20
3 72
1 59
4 04
259 42
1887	
127 80
59 10
5 88
15 38
3 88
93
3 81
216 78
18S8	
118 34
60 47
4 41
13 90
3 11
2 09
2 40
204 72
1889	
131 70
59 11
7 20
12 93
4 13
2 07
2 46
219 60
1890	
121 54
62 77
9 02
17 31
4 00
1 29
7 19
223 12
1891	
88 35
54 79
3 83
20 43
3 40
1 89
8 81
181 50
1892	
94 25
56 74
4 69
20 53
3 35
1 80
6 42
187 80
1893	
95 50
53 55
5 43
22 60
3 39
2 69
10 20
193 36
1894	
87 76
57 07
5 25
18 83
2 98
1 43
4 93
178 25
1895	
90 83
61 15
9 90
20 41
2 51
3 10
5 93
193 83
1896	
89 13
55 93
6 30
20 29
2 56
3 63
8 83
186 67
1897	
89 09
58 18
8 36
19 11
2 95
3 86
10 20
191 75
1898 	
94 68
69 43
9 94
21 82
2 76
5 12
10 62
214 37
1899	
113 31
72 91
8 31
33 96
2 50
2 73
8 80
242 52
1900	
116 04
72 62
9 06
32 10
2 15
1 71
10 32
244 00
1901	
99 16
66 65
10 12
18 52
3 25
1 07
6 77
205 54
The average for each decade is as follows, and shows a gradual reduction, as one would expect
to find.
1872 to 1881
174 10
124 57
19 21
17 10
15 47
6 07
22 01
378 53
1882 to 1891
128 51
71 76
6 23
14 70
3 91
2 13
4 03
231 27
1892 to 1901
96 97
62 40
7 74
22 84
2 84
2 72
8 29
203 80 2 Ed. 7
Report on the Public Hospital for the  Insane.
487
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XXXXXXXXXXXXXXXXXXXXXXXXXXXXCiOl 488 Report on the Public Hospital for the Insane. 1902
Revenue Derived.
The cash receipts handed over to the Government by this Institution during the past
year amounted to the sum of $12,800.76, against $6,893.33 for the year 1900—nearly double
it. This was owing partly to the collection of arrears, but was due chiefly to increased
numbers of paying patients and enforced promptness of payments. The following table gives
the annual receipts since opening :—
1873 $1,440 99 1888 $   750 20
1874  680 00                1889  220 00
1875  1,342 50                1890  599 24
1876  730 31               1891  76115
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                  1900  6,893 33
1886  50 00                1901 12,800 76
1887  720 59
Requirements.
In an Institution of this kind the list of requirements is generally more or less lengthy
and were one aiming at ideality the list with us would be very long. However, I trust that
this will not be considered a reason why the needs should not be met gradually in the order
in which they become urgent.
The urgent requirements to be considered this year are four in number, as follows :—
(1) Re-construction of the laundry; (2) More light; (3) Installation of power; (4) More
accommodation for patients. As the matter presents itself to me, the first three requirements
mentioned are linked together, and one measure will meet them, as I will endeavour to explain
later on.
Our present laundry building was erected in 1894 and, as mentioned in the historical
sketch, is very good so far as it goes, but it is utterly lacking in equipment. The Chinese
patients do the washing by hand, but very few of them are willing to do it, because they
receive no remuneration, and when they refuse they cannot be compelled like convicts. In the
face of these facts, and considering the condition of some of the articles sent to the foul laundry,
it is simply wonderful what is accomplished by those patients under the skilful handling of
the laundryman. Of course the female patients do some washing on two half-days each week,
but while they are in the laundry the Chinese are not, so that time is lost. As for mangling,
only those things which the women attend to with common sad-irons, on the two half-days
already mentioned, are ever ironed, and, as a consequence, the towels and the bedding go back
to the wards as they come from the dry-room and are folded, the towels so rough that one
would think twice before using them.
Attention has been called to this matter by the grand juries of the past two or three
years, as well as by my predecessor in his reports. The laundry really must have something
done to it this year, and I am satisfied that the results would amply repay the outlay.
I would suggest that another story be added to it, to enable the female patients to work
a portion of every week-day, and attend to the finer part of the laundry process after the
washing is done, which latter could still be carried on by the Chinese, aided by a washing
machine and an extractor.    We should require a mangle, also a motor besides the above.    I 2 Ed. 7 Report on the Public Hospital for the Insane. 489
have had plans prepared which I think provide for every modern convenience, and if carried
out would give us an up-to-date laundry, capable of doing the work of the Institution even
should it triple its capacity, which it will do some day. The cost of alterations and machinery
would be about $5,000.
With reference to more light, I would say that at the close of the current year we shall have
about 450 electric lights installed, and the number will be always increasing as more buildings
are added. To supply the current of electricity for these lights we have a small engine that
is unable to run the present dynamo at its full capacity, which is only 250 lights, so that you
can see how far short it falls of providing the light necessary.
For two years we have managed to get along with so little light upon the wards that
patients could not properly see to read or play games, while the attendants could not see the
length of their wards. It is evident that this cannot go on always. Besides that, we have no
light at all from 11 p. M. until 5.30 A. M., because our dynamo is not run during these hours on
account of the frailty of the engine, which was smashed up twice by being run all night. If
fire should occur during the hours referred to, it would be very awkward, and for this reason,
if for no other, some change must be provided for this year.
There are two ways to remedy this need. One is to sell this plant and install a larger
one, substituting a gas engine for the kind we have been using, which has the advantage of
being capable of starting instantly and developing full speed almost at once in case of emergency.
The other way would be to connect with the City system and take light from there again, with
which the City Council have offered to supply us at 6.66c. per 1,000 Watts. In any event, I
would recommend having connection with the City plant in case of a break-down here, and
the same might be said in regard to depending upon the City plant—I think we should have
a plant of our own. It would have many advantages, among which would be the possibility
of supplying ourselves with power for the motor already mentioned in connection with the
laundry, and one which will be required in the new carpenter-shop. Besides this, we could
install a small cold-storage plant, the need of which is much felt every summer and will be
more so each succeeding year.
I have taken the opportunity of personally visiting many of the power plants in Vancouver, as well as in New Westminster, where gas engines are working, and upon inquiry from
the proprietors I found in every instance great satisfaction was afforded by this method of
developing power. All agree that at proper rates—which, by the way, the Gas Company is
willing to guarantee us—gas is the most economical fuel.
Estimates have been furnished me showing that a 40-horse power gas engine, of the best
make, can be installed for about $2,000.
A 500-light dynamo, with the cold-storage apparatus, meat chopper and bone mill, would
require about $500, as well as the proceeds of the sale of the present plant.
To connect with the City plant, which would require two or three large transformers and
considerable wiring, about $600 would be required.
It is certain that such a plant as the one suggested could not be installed where the
present one stands, beside the boilers, and to provide a proper power-room and cold-storage
chambers we should require the place now occupied by the kitchen, which is poorly adapted to
its present uses, but would be admirably suited to the purpose suggested.
The kitchen should be two stories above where it now is, to enable us to operate it
economically. There are a host of advantages that would accrue from this change which
would be too long to explain here, but they are such as would soon repay the Government for
the outlay necessary to make the change.    I have had plans drawn that provide for another 490 Report on the Public Hospital for the Insane. 1902
storey to the kitchen building, where we could have a much better kitchen than the present
one, as well as a large bakery, which would enable us to do our own baking in future, which
would be another step in the direction of economy. The cost would be $8,000 for the
additional flat.
The third requirement, the installation of power, has been almost completely dealt with.
As already mentioned, the laundry will require power, but besides this, the new carpenter-shop
should have a small motor to run the lathe aud whatever other small machinery will be
installed in it. Only two kinds of motor would be suitable, either electric or water; the
latter, unless we could get a much better rate on water than we have now, would be altogether
too expensive.
In reference to the need of more accommodation, I would simply remark that the wards
are about full. In another year they will be crowded, and there will then have to be another
building erected. There is but one site left, and it possesses room for just such a building as
I trust will be provided. However, before such a building could be inhabited, in order to get
the food supplies to it, the kitchen would have to be raised to where I am now suggesting, and
for that reason I would further urge that this change be made this year.
A recapitulation of the above items is as follows :—
Re-construction of laundry and installing machinery    $ 5,000
New gas engine, dynamo, connection with City, &c        3,100
Building another story on kitchen, bakery, oven, &c        8,000
Total    $16,100
The above constitute the major needs, which I respectfully commend to your favourable
consideration. There are a few minor ones, which I trust you will enable me to look after
myself as formerly, by providing- the usual vote for " Lands and Works."    They are as follows:
The boundary fence should be completed in the rear. A poultry house should be erected,
also a waggon shed to protect our vehicles and farm implements. New eaves-troughs are
required on all the buildings erected by the last contract. The old ones have nearly all fallen
off, from faulty construction, and the buildings are suffering in consequence. There are
several of the wards requiring thorough overhauling, new floors, new beams and joists in the
basements, etc.
There are many more things, including improvements to the heating plant, further clearing
of land, painting, etc., which are too numerous to mention, and will require about the same
amount as was voted the last time, namely, $5,000.
For the staff another physician is required, as the work has become too great for one to
compass alone. Besides that, there has been no one in the past to regularly clean the offices,
and by having such a person as suggested, these offices can be attended to daily. With these
remarks, I respectfully submit the estimates for the next fiscal year.
Estimates, 1902-3.
JRevenue.
The estimated revenue will be    $12,000
Expenditure.
Salaries :—
Medical Superintendent $ 2,500
Assistant Medical Superintendent      1,000
Bursar      1,200
Steward and store-keeper         960
Carried forward ,     $5,660 00
Go-
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01 2 Ed. 7 Report on the Public Hospital for the Insane. 491
Brought forward  $5,660
Salaries—Concluded:
Engineer  900
Gardener  720
Farmer  720
Carpenter  720
Plasterer and mason  720
Tailor  720
Shoemaker  570
Chief cook  720
Assistant cook  540
Chief male attendant  660
Matron  600
Two firemen ($600 each)  1,200
Nightwatchman  600
Second nightwatchman  540
Laundryman  540
Sixteen male attendants  8,100
Six female attendants      2,250
One relieving nurse and housemaid  180
One housemaid  180
Laundress  240
Portress  150
Teamster  360
Temporary assistance as required      1,000
Total $28,590
Supplies :—
Provisions $19,000
Fuel and light  6,500
Water     1,200
Medicines  500
Clothing, boots and shoes      3,000
Furniture  1,200
Miscellaneous  3,000
Capital Account:—
New furniture  2,000
Medical library  200
Surgical appliances  300
Lands and Works  5,000
$70,490
This total is $230 greater than that for the current year.
Visitors.
As already intimated, at the beginning of the year the Institution was visited by Dr. C,
K. Clarke of Kingston, Ont. The Grand Juries of the spring and fall assizes visited as usual.
Yourself, as the Honourable Provincial Secretary, paid us a visit on May 9th, while the
Honourable the Chief Commissioner of Lands and Works, with a party of friends, called on
June 15th. Shortly after his appointment, Hon. J. C. Brown called and inspected portions of
the Institution, particularly that part relating to the lighting. Messrs. Thomas Gifford and
Thomas Taylor, members of the Legislature, paid a visit and were taken over the Institution,
with the condition of which they expressed satisfaction. Dr. Williamson, the Assistant
Medical Superintendent of the Oregon State Insane Asylum at Salem, Oregon; Dr. James 492 Report on the Public Hospital for the Insane. 1902
Russell, Medical Superintendent of the Hamilton Asylum, Ontario, and Dr. D. A. Harrison,
ex-Medical Superintendent of the Long Island State Hospital for New York 'State, each paid
us a visit and were interested in what they saw, although each is or has been connected with
much larger and finer Institutions than this. Visits of this nature are very welcome in this
isolated Asylum, and are not without benefit to us, and possibly to all concerned, and I hope
that this Government may be able to see its way clear to do as others, namely, to allow its
Medical Superintendent to visit other similar Institutions periodically, in order to note the
character of the work as carried on in other places, and thus keep abreast of the times.
Besides those mentioned above, there were 1,517 persons entered their names in the
visitors' book, most of whom came to see friends, but the majority of the whole number interviewed the Superintendent, so that you can gain some idea of the amount of time that must
be spent daily in this manner.
Acknowledgments.
I desire to acknowledge with sincere thanks the kindness of those numerous friends of
the Institution who have assisted us from time to time in our entertainments, and to assure
them that the patients thoroughly appreciated their services. I would also thank the proprietors of the following newspapers for gratuitous copies which have been furnished regularly :—
Victoria Colonist, 2 copies ; Vancouver Daily World, 1 copy; Semi-Weekly World, 1 copy ;
News-Advertiser, 1 copy ; Province, 1 copy; Daily Columbian, 2 copies. I wish this list were
longer, and trust that I shall next year be able to add the names of others from the interior.
The following have kindly donated books, magazines, papers and playing cards for the
diversion of the patients, which are hereby acknowledged with thanks :—The New Westminster
City Club, through Mr. Arthur Malins; Mesdames B. Burr, Tovey, Webster, Parnell, Bryson,
Lister, Lee, MacFarlane, Curtis, Gordon, Major, Samson, J. A. Cunningham, T. R. Pearson,
R. Kennedy, Jenns, Thornber, H. L. DeBeck, Gilley and Dickenson ; Miss Simpson, Messrs.
Turner, Harvey, Minthorne, J. C. Brown, Rees, Rev. Mr. Scoular and Capt. Knight.
I would also thank the Directors of the Agricultural Society, and of the Horticultural
Society, for their kindness in furnishing free admission to patients to their respective shows.
Manv thanks are due to Chief Watson of the City Fire Brigade, for the kind attention
he has given us in respect to installing the new fire-alarm box and various other matters connected with fire protection.
I feel that I can but feebly express my appreciation of the faithfulness of the staff of
which I have the honour to be the head. The success that has attended us during the past
year has been due, in no small measure, to their loyal co-operation in the efforts put forth to
bring about necessary reforms. True, it was not without some friction, but I know this was
due to a misunderstanding, for which, perhaps, we were all a little to blame. However, since
the occurrence recorded in a former part of this Report, there has been greater harmony,
which, I trust, will always mark our future course.
I would make special mention of the Chief Male Attendant, Thos. Mayes, who has
strenuously endeavoured to assist me in the work, and to such good purpose that I have
scarcely missed the assistance of a second medical officer. If there was such a thing as a distinguished service order in this work, I would recommend him for it.
The Matron, Miss Fillmore, is also worthy of mention for the readiness and enthusiasm
with which she took up her new work and carried it on, and I feel that, from the least to the
greatest in the house, all will admit that she has vastly improved their lot. In regard to the
other officers, I can only reiterate what Dr. Bodington said last year : They have done well. 2 Ed. 7 Report on the Public Hospital for the Insane. 493
Lastly, I acknowledge with gratitude the splendid support and encouragement which I
received at your hands. The undertaking of the past year would have been absolutely impossible had you pursued a different course, and again expressing my sincere appreciation of
your great kindness.
I have the honour to be,
Sir,
Your obedient servant,
New Westminster, February 1st, 190%.
G. H. MANCHESTER, M. D.,
Medical Superintendent. 494
Report on the Public Hospital for the Insane.
1902
ANNUAL  STATISTICAL  REPORT
Op the operations of the Public Hospital  for  the  Insane,   New  Westminster,  for
the Year ending 31st December,  1901.
Table No.  1.
Showing operations of Hospital for the year 1901, in summary form.
Movements of Population.
Male.
Female.
Total.
Male.
Female.
Total.
Remaining in residence, January 1st, 1901	
Out on probation,                          »                  	
199
3
56
4
255
7
202
89
60
26
86
26
262
Admitted during the year:—
73
4
3
9
24
1
0
1
97
5
3
10
By Lieutenant-Governor's Warrant	
From the Yukon Territory	
115
291
67
377
Discharged during the year:—
26
12
5
1
14
2
0
0
40
14
5
1
As improved	
As unimproved 	
Total	
44
3
20
16
5
5
60
8
25
Discharged on probation and still out Dec. Slst ..
93
224
975
748
60
298
233
284
Total number of patients admitted since opening.
ii                       discharged       »
//                         died                   a
1273
488
260
195
38
683
298
981
227
65
292
Daily average population during the year 1901  269.56
Maximum number present on any one day, December 18th  286
Minimum                n                         n                January 1st  255
Percentage of discharges on admissions      52.17
»            recoveries            //              34.78
//                    /;          on recoverable cases admitted  85.10
a             deaths on number under treatment  6.63
Number of "paying patients" admitted during the year.
Number of " free patients " » n
28
87 2 Ed. 7
Report  on the Public Hospital for the Insane.
495
Table No. 2.
Showing in summary form the operations of the Hospital since its opening.
m
o
'S3
te
1
<
Discharged.
in
O-O
ie
OO
a
40.
c3   sol
"K ®
H     CO-o
°     H
313
SS a
oo oo
=40
u   O
8   CD
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SS
16
14
19
32
35
37
36
41
48
48
49
49
51
61
65
77
82
100
117
123
135
133
162
164
171
203
221
234
258
284
CD-
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CIS
to
O
rH
CD-
CO
cS
CD
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CD
P
00
s
O   CD
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o g
0?   4-0
18
31
26
48
54
49
54
54
58
61
55
57
60
72
88
104
106
123
157
171
187
184
213
224
228
246
285
327
356
377
>!   in
cj .2
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■g'S
rrj
CD   eg
SPo
a   co
S £
u '£
s»
Ph
5.55
66.66
33.33
10.34
50.00
43.85
47.05
27.77
23.52
38.46
42.85
50.00
45.45
23.81
59.26
53.84
65.51
46.34
38.59
37.03
28.12
42.85
16.25
46.77
35.93
27.03
33.33
30.69
33.63
34.78
Percentage of discharges to admissions.
Percentage of deaths
to   number   under
treatment.
Year.
00
so.
00
0
o
CO
CO
P3
1
10
4
3
11
6
9
5
4
5
3
4
5
5
16
21
19
19
22
20
18
21
13
29
23
20
27
31
38
40
T3
00
CD
O
o
CO
401
O
1872	
18
15
12
29
22
14
17
18
17
13
7
8
11
21
27
39
29
41
57
54
64
49
80
62
64
74
81
101
113
115
2
3
3
3
1
1
3
1
1
2
1
1
1
2
6
8
21
16
19
11
25
8
13
32
27
20
i
5
3
10
5
o
8
8
5
5
2
3
2
5
6
5
3
4
12
20
13
14
19
20
9
14
19
21
29
25
5.55
80.00
33.33
26.89
63.63
64.28
58.82
27.77
29.41
61.54
57.14
62.50
63.63
28.57
62.96
58.71
72.41
46.34
49.12
51.85
60.93
75.51
40.00
64.51
75.00
37.83
49.38
62.37
57.52
52.17
5.55
1873	
1874	
5
13
3
2
5
7
1
2
1
16.12
11.53
1875	
1876	
1877	
20.83
9.35
6.12
1878	
16.16
1879	
1880	
1881	
14.81
8.62
8.19
1882	
1883	
3.63
5.26
1884	
1885	
2
10
4
12
5
18
17
6
12
29
2
7
32
18
13
24
26
2
3.33
6.94
1886	
1887	
1888	
1889	
6.81
4.80
2.87
3.25
1890	
7.64
1891	
11.69
1892	
1893	
1894	
1895	
1896	
1897	
1898	
6.95
7.60
8.92
8.92
3.94
5.69
6.66
1899	
1900	
1901	
6.42
8.14
6.63
Table No. 3.
Showing the number of admissions, discharges and deaths for each month during the year 1901.
Month.
January ..
February .
March	
April	
May  	
June	
July  	
August ..
September
October . .
November
December .
Total .
Admissions.
Male.     Female.     Total.
o
4
6
5
13
14
7
5
9
6
10
89
1
1
0
1
4
2
2
1
4
4
1
26
10
5
7
14
18
9
7
10
10
14
US
Discharges.
Male.     Female.     Total.
2
■2
/
6
6
7
"3
44
1
3
1
0
3
2
2
1
16
6
9
8
6
9
9
2
4
60
Deaths.
Male.     Female.     Total.
1
3
2
2
3
1
2
1
1
4
20
3
4
2
' 2
3
1
1
2
1
1
5
25 496
Report on the Public Hospital for the Insane.
1902
Table No. 4.
Showing the civil state of the patients admitted during the year.
Civil State.
Male.
Female.
Total.
53
27
8
1
89
5
20
1
0
26
58
47
9
1
Total  	
115
Table No. 5.
Showing the religious denomination of those admitted during the year.
Denomination.
Male.
Female.
Total.
17
2
3
5
0
4
1
0
2
4
1
3
2
0
3
0
1
22
2
7
1
7
6
9
1
14
7
1
20
1
1
8
Methodist	
13
2
17
9
1
23
1
2
Total  	
89
26
115
Table No. 6.
Showing the degree of education in those patients admitted during the year.
Degree of Education.
Superior	
Common School	
Can read only	
Cannot read nor write
Not known	
Total 	
Male.
Female.
6
1
72
23
2
1
1
1
8
0 .
89
26
Total.
7
95
3
2
115 2 Ed. 7
Report on the Public Hospital for the Insane.
497
Table No. 7.
Showing the native country of those admitted during the year 1901.
Place of Birth.
Australia   	
Austria	
Canada—Ontario
Quebec
New Brunswick   ....
Nova Scotia	
Prince Edward Island.
China	
England..   ...
France 	
Germany	
Ireland  	
Italy	
Japan   	
New Zealand..
Scotland	
Sweden  	
Switzerland. ..
United States
Unknown
Wales	
West Indies ..
Total
Male.
1
13
3
3
1
1
4
21
4
4
3
1
4
1
5
4
1
13
1
89
Female.     Total.
1
0
6
0
1
0
0
0
4
0
0
2
0
0
0
2
2
0
7
0
1
0
26
1
1
19
3
4
1
1
4
25
4
4
5
1
4
1
1
20
1
1
1
115
Table No. 8.
Showing the districts contributing patients during the year 1901.
Place of Residence at time of Committal.
Male.
Female.
Total.
Yukon District:
9
2
15
2
1
1
1
0
4
0
3
0
1
0
0
9
1
0
1
0
0
0
0
0
0
10
Atlin District:                                                                  *
Atlin 	
2
Vancouver Island and other Coast Islands:
19
2
4
1
1
1
2
17
6
2
1
2
Lower Mainland:
26
7
2
1
1
1
2
1
3
2
1
1
Yale	
2
1
Kamloops District:
3
2
68
20
88 498
Report on the Public Hospital for the Insane.
1902
Table No. 8.—Concluded.
Showing the districts contributing patients during the year 1901.
Place of Residence at time of Committal.
Male.
Female.
Total.
68
1
20
1
1
1
1
2
88
Okanagan District:
1
1
1
1
3
6
1
1
West Kootenay:
2
3
6
1
1
3
1
2
1
4
East Kootenay:
1
2
1
Boundary District:
2
Columbia       	
1
89
1
Total 	
26
115
Table No. 9.
Showing the occupations of those patients admitted during the year 1901.
Occupations.
Male.
Female.
Total.
2
1
2
18
2
1
1
1
26
2
1
2
4
1
4
3
1
2
2
2
9
2
2
2
2
4
1
4
Clerks                	
3
1
2
2
2
9
2
2
2
2
18
17
2
1
1
16
2
2
1
17
2
1
1
16
4
2
1
1
1
1
3
1
1
1
4
1
1
1
1
1
89
1
]
1
Total	
115 2 Ed 7
Report on the Public Hospital for the Insane.
499
Table No. 10.
Showing the ages of those admitted during the year 1901.
Age.
Under 15 years
From 15 to 20
„      20   i,   25
,     25  „   30
,     30  n   35
,     35 n   40
/      40  »   45
,     45  „   50
,      50  „   60
,     60  „   70
,     70  ,i   80
years.
Total
Male.
Female.
2
3
5
2
6
4
18
2
12
8
17
1
3
1
18
5
5
3
89
26
Total.
5
7
10
20
20
18
4
23
5
3
115
Table No. 11.
Showing the number of the attack in those admitted during 1901.
Number of Attack.
Male.
Female.
Total.
First   	
50
7
1
1
16
4
2
2
1
1
66
11
Third   	
3
Fifth	
Sixth	
1
2
2
27
1
3
28
1
Total	
89
26
115
Table No. 12.
Showing the alleged duration of the attack, prior to admission, in those admitted during
the year 1901.
Duration of Attack.
Male.
Female.
Total.
5
16
17
7
3
2
6
4
4
3
4
7
5
2
1
1
3
1
1
1
26
9
23
22
9
3
„        9   a   12      „        	
2
6
5
5
6
n      10   ,/  20     a       	
1
2
19
1
89
3
20
1
Total	
115 500
Report on the Public Hospital for the Insane.
1902
Table No. 13.
Showing statistics of heredity in those admitted during the year 1901.
Hereditj'.
Paternal branch	
Maternal       n       	
Paternal and maternal branches	
Lateral branches (brothers and sisters)
Insane children    	
Insane relatives, history obscure	
Said not to be hereditary	
History unascertained	
Not insane	
Total
Male.
1
13
66
1
89
Female.
12
26
Total.
1
1
25
72
1
115
Table No. 14.
Showing the alleged exciting causes of insanity in those admitted during the year 1901.
Cause.
Male.
Female.
Total.
1
3
3
6
i
1
3
2
1
1
4
1
Childbirth	
3
2
2
3
2
1
2
9
2
2
20
8
1
3
10
Ill-health	
2
2
20
3
2
1
1
10
1
1
2
3
1
2
2
26
1
10
2
1
2
3
1
2
2
30
Total 	
89
26
115
Table No. 15.
Showing the state of the bodily health on admission.
Bodily Condition.
Male.
Female.
Total.
30
48
11
5
15
6
26
35
63
Greatlv reduced  .   .  .   	
17
Total    	
89
115 2 Ed. 7
Report on the Public Hospital for the Insane.
501
Table No. 16.
Showing the form of mental disorder in those admitted during the year.
Form of Disorder.
Male.
Female.
Total.
4
1
4
2
1
1
6
3
1
2
2
1
1
2
8
3
1
1
11
3
15
6
6
6
1
1
13
4
14
17
6
16
a          senile    	
6
6
8
3
1
Alcoholic                     a	
13
5
14
Morphinism	
1
1
1
2
2
2
Total	
89
26
115
Table No. 17.
Showing the number of patients discharged on probation during the year, with results.
Results.
Discharged recovered	
a improved	
/; unimproved	
// not insane	
Returned to hospital	
Still out at close of the year	
Total number to whom probation was given
Male.
Female.
17
11
4
1
1
1
1
2
3
5
27
19
28
5
1
1
3
46
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.
16
5
1
2
9
3
1
1
14
25
8
1
3
1
2
26
2
Total       	
40 502
Report on the Public Hospital for the Insane.
1902
Table No. 19.
Length
of residence
of those
receiving
treatment
January  1st,
1902.
Duration
of  treatment
of those
discharged
recovered
during the
year.
Duration
of  treatment
of those
discharged
improved
during the
year.
Duration
of  treatment
of those
discharged
unimproved
during the
year.
Under  1 month	
6
12
10
8
2
2
9
7
3
2
3
4
47
32
20
20
10
5
14
10
8
29
6
9
6
3
4
3
6
4
4
3
4
1
1
3
2
1
1
1
not insane, 1
„       3    „    4       n      	
„       5    /.    6       i,      	
„       7    „    8       n      	
1
„       9    „ 10       a      	
1
1
1
1
1
„            10        CO    11                II	
1
3
3
1
„       3    „   4       ,i      	
1
1
„       7    «    8       „      	
1
1
„       8    a    9       a      	
„       9    „ 10       n      	
10    a 15       a      	
a      15    c/20       a      	
/;        20      //25           /;          	
it     25 years and upwards	
Total	
284
40
14
6
Table No. 20.
Showing the age, length of residence, and certified cause of death in those cases which ended
fatallyT during the year.
Register
Initials.
Sex.
Age.
Residence in Hospital.
No.
Years.
Months.
Daj's.
Certified cause of death.
1,019
681
1,104
F. P.
L. F. J.
J. VV.
I. MoF.
H. H.
J. R.
W. R. B.
E. H. K.
W. H. L.
N. M.
T. C.
A. F.
J. H.
A. T. H.
J. D. S.
M.
F.
F.
F.
M.
M.
M.
M.
M.
M.
M.
M.
M.
M.
M.
35
32
36
79
40
67
39
41
40
56
60
30
54
37
43
4
8
10
10
4
4
5
16
3
21
10
General paresis.
Exhaustion of epilepsy.
Exhaustion (puerperal melancholia).
General senile debility.
General paresis.
Ruptured aortic aneurism.
Exhaustion of mania.
General paresis.
General paresis.
General paresis.
General peritonitis.
Marasmus.
General paresis.
General paresis.
Pneumonia, with paresis.
1,059
998
218
1,050
505
902
14
8
2
2
4
2
6
11
8
7
1
904
716
1,043
874
1,141
1
7
10
6
3
29
25
15
16
889
2
5 2 Ed. 7
Report on the Public Hospital for the Insane.
503
Table No. 20.—Concluded.
Showing the age, length of residence, and certified cause of death in those cases which ended
fatally during the year.
Register
Initials.
Sex.
Age.
Residence in Hospital.
No.
Years.
Months.
Days.
Certified cause of death.
1,161
M. J. P.
G. L.
T. Y.
A. McD.
T. D.
L. D.
R. R. B.
C. T.
G. A.
VV. W.
F.
M.
M.
M.
M.
M.
M.
M.
F.
M.
43
41
30
63
66
40
64
36
18
35
12
27
29
26
27
19
10
27
15
16
1,015
1,159
1,169
14
840
1,162
1,193
1
29
3
4
1
1
2
5
4
General paresis.
Exhaustion of acute mania.
General paresis.
Apoplexy.
Strangulation.
General paresis.
Septicaemia (cerebral abscess).
Exhaustion of epilepsy.
General paresis.
1,174
1,129
3
7
Table No. 21.
Classification as to race of those patients remaining in residence January 1st, 1902.
Class.
Male.
Female.
Total.
Whites	
Total	
195
1
2
26
59
254
1
Chinese	
1
3
26
224
60
284
Table No. 22.
Showing forms of employment engaged in by the male patients during the year, and the
number of days upon which they worked.
Employment.
Assisting the carpenter  	
a farmer	
» gardener 	
a painter    	
» plumber	
;/ plasterer	
» tailor 	
Working in the blacksmith shop	
i, a      kitchen and scullery	
// a      laundry	
a a      engine-room	
w        on the wards	
Tending the front door	
Total
No. of clays.
1,495
6,805
1,395
212
178
387
109
181
4,297
2,774
429
29,684
361
48,307 504
Report on the Public Hospital for the Insane.
1902
Table No. 23.
Showing the articles made and repaired on the wards and in the shops during the year.
Name of Article.
Female Wards:—
Aprons	
Blankets (eut in two, hemmed and repaired)
Chemises	
Covers,  bureau	
it        billiard table	
//       table	
a       tray    	
Dresses, gingham ,	
n       serge  	
n        night	
Drawers, pairs	
Dusters	
Handkerchiefs	
Mats  	
Napkins for table    ....
Neckties	
Pillow-slips ,	
Rugs	
Sheets  	
Sofa cushions	
Shirts   	
Socks, pairs	
Ticks, bed	
Towels    	
Table cloths    	
Trousers 	
Vests	
Window curtains	
Hose, pairs	
Petticoats	
Drawers (men's) '    ...
Male Wards:—
A good deal of mending that has been unrecorded, a matter which
is now being set right.
Tailor-shop:—
Bed-ticks	
Blankets lined	
Coats	
Combination suits	
Flag	
Jackets, long-sleeved	
Pillow-ticks 	
Shirts     ,   	
Trousers  	
Uniforms for attendants    	
Waistcoats    	
Sundry miscellaneous work	
Shoemaker-shop:—
Shoes, pairs	
Slippers, pairs	
Harness, pieces	
Sundry miscellaneous work	
Carpenter-shop:—
Considerable furniture made and repaired of which no record was
kept.    These records receiving attention for next report.
Blacksmith-shop, plumbing-shop and tinsmithy:—
Same note applies to these.
Made.
47
21
8
2
41
6
27
15
3
24
87
7
24
158
334
15
197
2
234
8
28
40
3
44
16
5
35
26
39
42
90
Repaired.
58
369
500
46
146
351
186
249
2,153
759
3
10
17
132
213
378
574
1,094
27
77
4
1
20
2
350
36
180
181
5 2 Ed. 7
Report on the Public Hospital for the Insane.
505
Table No. 24.
Showing the quantity of fruit preserved by the Matron during the year.
Blackberries  6 quarts.
Cherries  9
Crabapples  4
Currants  43
Gooseberries  25
Peaches  10
Pears    11
Plums      53
Raspberries      44
Rhubarb  19
Strawberries  61
Tomatoes, pickled  59
Tomato catsup  4
VICTORIA, B. C.:
Printed by Richard Wolfenden, Printer to the King
1902.
I Most Excellent Majesty. 

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