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ANNUAL REPORT ON THE PUBLIC HOSPITAL FOR THE INSANE OF THE PROVINCE OF BRITISH COLUMBIA, FOR THE YEAR… British Columbia. Legislative Assembly 1904

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 ANNUAL REPORT
-ON   THE-
PUBLIC HOSPITAL FOR THE INSANE
-OP  THE—
PROVINCE   OF   BRITISH   COLUMBIA,
-for the-
YEAR    1903.
THE GDVERNMENTOF
THE PROVINCE OF BEITISH COLUMBIA
PRINTED BY
AUTHORITY  OF  THE   LEGISLATIVE  ASSEMBLY.
VICTORIA, B. O.:
Printed by Richard Wolfkndsn, I.S.O., V.D., Printer to the King's Most Excellent Majesty
1904.  4 Ed. 7 Public Hospital for the Insane. I 3
REPORT
ON  THE
PUBLIC HOSPITAL FOR THE INSANE,
1903,
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 1903.
Provincial Secretary's Office,
March, 1903.
RICHARD McBRIDE,
Provincial Secretary. I 4
Public Hospital for the Insane.
1904
OFFICERS.
Medical Superintendent:
G. H. MANCHESTER, M. D.
Assistant Medical Superintendent:
C. E. DOHERTY, M. D.
Bursar:
M. J. KNIGHT, ESQ.
Steward and Store-keeper:
R. REES, ESQ.
Engineer:
HEWISON STOUT, ESQ.,
Matron:
MARIA FILLMORE.
Chief Male Attendant:
THOMAS MAYES.
Chief Female Attendant:
MARIA FILLMORE (acting).
Carpenter :
J. D. HOPKINS.
Plasterer and Mason:
EDWARD FITZGERALD.
Farmer :
E. B. STINCHCOMBE.
Gardener:
W. T. L. HOUSE.
Tailor :
W. F. BEGGS.
Shoemaker:
D. McQUARRIE. w
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REPORT
OF  THE
MEDICAL SUPERINTENDENT OF THE PUBLIC HOSPITAL FOR THE INSANE,
NEW WESTMINSTER, B, C.
For the Year Ending 31st December, 1903.
The Honourable
The Provincial Secretary,
Victoria,  B.  C. :
Sir,—I have the honour to present to you the Thirty-second Annual Report of the Public
Hospital for the Insane, covering the operations carried on therein during the year 1903.
The nature and extent of these operations are detailed in the statistical tables hereto attached,
which evidence the fact that during the year 1903 a far greater number of patients were
treated than during any previous year.
The results were very satisfactory, notwithstanding the conditions prevailing during the
year, which were those of overcrowding and general lack of facilities. There is no doubt in
my mind but that better results could have been shown had the institution been properly
equipped, and there is no adequate reason why it should not have been so.
While the recovery rate has not come up to the standard of previous years, it would be a
mistake to charge the deficiency all up to the faults I have already intimated, but the class of
material brought to us for treatment must be taken into account; and in this connection I
must say that in no previous year, to my knowledge, were so many chronic and permanently
defective cases admitted as during 1903.
I shall reserve for a later position in the report any further remarks upon the conditions
I have mentioned, and will now respectfully direct your attention to the statistical tables.
Table No. 1 gives a complete summary of the whole work and shows that we began the
year with a population of 311 patients, and that 16 were out on trial. During the year 139
patients were admitted, which is 18 more than in the previous year, and is the greatest number
that has ever been admitted in any one year since the inception of the institution. There
were 75 discharged and 26 died, while 16 went out on probation, whose names still remained
on the roll in that relationship at the close of the year. The year ended with 349 in residence,
which was a net increase of 38 patients. The daily average number was 332.23. The percentage of recoveries upon admissions was 27.34, while the death rate was 5.57 per 100 under
treatment. I 6 Public Hospital for the Insane. 1904
Admissions.
The admissions consisted of 101 males and 38 females, all of whom were committed by
the ordinary forms, except 3 men who were sent in on urgency forms, and 3 by Lieutenant-
Governor's warrant. The Yukon Territory contributed its usual quota. No patient was
admitted twice, which means that the total number of admissions represents that many
different individuals.
Eight had been patients in this institution on former occasions. Five were women and 3
men. Two had been absent for almost 7 years each, while the shortest absence was a trifle
over 11 months. The average length of the absences was 3 years, 1 month and 29 days.
Eight gave a history of having been in other asylums. Of those admitted, 75 men and 5
women were single, 19 men and 24 women were married, showing the predominance of single
men and married women among the insane in this Province. In education 1 had superior
advantages, 126 had a common school education of greater or less degree, while only 8 could
not read or write, most of whom were Indians or Asiatics. Table No. 7 shows that England
was the birthplace of the largest number of those admitted in 1903, viz., 26, while Ontario
came next with 20, followed by the United States and China with 15 each. British Columbia
was represented by the same number as in the previous year, viz., 10, 7 males and 3 females.
Three of these were Indians and 1 a half-breed.
The coast districts sent in 107 patients, as compared with 32 from the interior of the
Province. Labourers and housewives were the most largely represented of any class of the
community, as shown by the occupation table. There were 5 boys and 2 girls admitted during
the year, which has been an unusual advance in that direction. In the past we have been to
a large extent free from congenital mental defectives, but it would seem as if we would soon
have a fair proportion of that class to care for, a rather unfortunate circumstance for both the
Hospital and the feeble-minded themselves, who should be kept in an institution different from
this, where they could receive proper education.
In 68 cases the attack was said to be the first, in 12 the second, in 2 the third, in 1 the
fifth, and in 1 the seventh. This shows that in the vast majority the first attack is the last.
The patient either is permanently insane (66 %), dies (6 %), or recovers (28 %), in which latter
case only can there be a second, third or fourth attack, as the case may be. Table 12 shows
that only about 50 patients were brought in during the really acute stage of the disease, or
about 35 %. It is unfortunate that through either ignorance or carelessness this should be
the case, because, as shown in table 18, it is only in the acute stages, that is the early stages,
of mental disease that we can look for recovery. A. history of hereditary taint was said to
exist in only 24 cases, denied in another 24, and unascertained in the balance, owing to the
impossibility of getting proper histories. Onanism was alleged to be the chief exciting cause
operating in those admitted in 1903. lt affected 27 young men and seems to be doing much
to undermine the youth of the land, especially such as are handicapped by any hereditary
weakness in their nervous constitution. Heredity was alleged to be the cause in 16 cases, and
it certainly played a considerable part in the histories of those mentioned as due to onanism.
Intemperance was alleged in 11 cases, which was an unusually small number, while 10 were
said to be due to domestic trouble, of whom 9 were married women. Sixty-six enjoyed
average bodily health on admission, 56 were reduced and 17 were in very reduced condition,
of whom two were almost moribund One of these was not insane, but was suffering from
delirium caused by excessive elevation of temperature, due to septic absorption from pulmonary
abscess. He died shortly after admission. I think that the police authorities cannot be too
particular in cases of this kind to make certain that they are not throwing into a police cell a
man who should be taken with all speed to a hospital. 4 Ed. 7 Public Hospital for the Insane. I 7
According to the classification of table 16, it will be seen that there were 17 cases of
general paresis admitted, a disease which seems to be gaining ground steadily in this Province.
It will also be seen that a large proportion of those admitted were lost to all prospect of
recovery from the first of their appearance here. I do not consider that over 40 recoverable
cases were admitted during the year.
Two criminals were admitted from the penitentiary and placed amongst the other patients
upon our wards. There is a section of the Statutes which prohibits this, but owing to the
lack of accommodation for such cases we have been compelled to ignore it. Besides these
insane criminals, several criminal insane were admitted, for whom proper accommodation is
also lacking. Ten men and 7 women with suicidal tendencies were received, also 7 men who
were said to have homicidal tendencies.
Discharges.
The number of discharges during the year reached a total of 75, of whom 58 were men
and 17 women. Thirty-eight were recovered, 13 improved, 22 unimproved, 1 not insane, and
1 was written off as escaped. The total exceeded that of the previous year by 14, and was
the greatest number discharged in any one year. As I have already pointed out, the possibly
recoverable cases numbered 40 amongst the admissions, while the number actually discharged
as recovered was 38. The discharge of so many who were not recovered calls for some
explanation. Of the 13 discharged as improved, 10 left the Province for their homes in other
countries. Some of these would have made complete recoveries had they been left longer.
Of the 22 sent out unimproved, 10 were sent to their native places in Eastern Canada, 7 to
the Old Country, 2 to China, 1 to United States, and 1 transferred to another asylum, but 1
remaining in the Province. One, a feeble-minded Indian, was discharged as not insane, and
1 escaped.
Discharges on Probation.
Of the 16 patients who were out on probation when the year opened, 8 were subsequently
discharged recovered, 3 improved, 1 unimproved, while 4 were returned to our care.
During the year, 58 were allowed out on probation, of whom 33 were ultimately discharged
completely, 9 were returned and 16 were still out at the close of the year.
Escapes.
The year witnessed three escapes, the smallest number in. the history of the institution.
The first was not retaken, but was traced far down into the States, whence he wrote an
impudent letter. The second was retaken after being two days at large ; but the third was
not so fortunate. The case was that of the man Joseph Vogel, who escaped on July 23rd
and whose body was found floating in the Pitt River on August 12th. He had evidently
been endeavouring to cross the river at some point above the bridge when the mishap befel
him which caused his death. An inquest was held and a verdict rendered of " found
drowned."
Deaths.
Twenty-one male and 5 female patients died during the year, which is a percentage of
5.57 on the whole number under treatment, being also the lowest death rate in a number of
years, and compared with the death record of other similar institutions it is a very favourable
showing.
The chief cause of death was general paresis, which accounted for 11. Pneumonia caused
3 deaths, disease of the heart 2, apoplexy 2, and general debility in aged persons 2. We had
but one death due to pulmonary tuberculosis, which, considering the havoc this disease is
playing in many of the eastern asylums, is very gratifying to us. In order, however, that we
may continue to enjoy comparative immunity from tuberculous diseases it is necessary that no I 8 Public Hospital for the Insane. 1904
time be lost in providing proper facilities for isolating such cases as are bound to crop up from
time to time in such a large institution.
I am very highly pleased that another year has passed without our having to report any
suicides, although many attempts at self-destruction have been made, all of which were
successfully frustrated by the watchfulness of the attendants, who deserve every praise. To
fully appreciate these results it is only necessary to call your attention to the very large number
of suicides which have taken place in various parts of this Province during the past year.
Treatment.
In the past we have sought to follow along similar lines in our treatment as are found in
vogue in most other similar institutions.
The acute cases from which we draw our recoveries require the very best care and attention that can be bestowed upon them, and it is generally conceded now that the ward best
adapted to the care of such a class should resemble to a very large degree a ward in a general
hospital. This, as you know, we have not got, but are compelled to place our recent cases
upon wards crowded to the doors with chronic cases in all stages of dementia.
Our main dependence in the treatment of the vast majority, however, is upon
employment, recreation and amusement. Even these are to a large extent denied the
patients, owing to lack of facilities. In summer, when the weather is fine, the lack of employment is not felt, owing to the abundance of pick and shovel work, but in the winter there is
no escape from the wards. The few shops we have are excellent in themselves, but are few in
number, small in size, and are not adequately equipped or manned. As to recreation, we
have not had any campus for games in summer nor gymnasium for winter exercise. The
wards are so small and overcrowded that even makeshift measures, such as I have seen
adopted in other asylums, are impossible here. Having to take the former amusement hall
for an associate dining hall has robbed us of the only source of pleasure which the patients
had. This was the only place where the weekly dances could be held or assemblies for church
service take place. We have had no dances this winter and no church for almost a year. It
is, therefore, plain that the institution in its present state is not able to carry on the work to
the best advantage for which it exists, and no time should be lost in remedying it.
Farm and Garden.
As in the past, the farm and garden have been cultivated to their fullest extent, thus
affording us an outlet for the superabundance of labour to be found amongst the able bodied
patients. They have therefore served a two-fold purpose, in that while they afforded us an
opportunity to employ the patients, the products have been utilised in such a manner as to
save expense for vegetables and fruit. If, instead of the miserable gravel bed which we call
our farm and garden, we had some good soil, our returns would be all the greater.
It is only fair to the gardener to remark that the returns in fruit from the garden would
undoubtedly have been much greater had the latter been properly protected by a fence ; but
as it was, there is no doubt but that a good deal of the fruit reached the consumer without
having gone through the usual channels.
It has been with much difficulty in the past two years that the crops of cabbages and
onions could be saved from the pests that feed upon these, and all the remedies so far tried
have apparently proved useless.
The farmer had the misfortune to lose 16 valuable young hogs through a blunder upon
the part of someone in connection with the kitchen or scullery, who, it would appear, dumped
the contents of the pickling barrel into the swill barrels. Where so many patients are
employed in the various departments it is difficult to prevent an occasional accident of this 4 Ed. 7
Public Hospital for the Insane.
I 9
nature.    The produce brought in to the steward for use from each of the above departments
was as follows :—
Field Products.
Quantity.
Beets  7,494 lbs.
Brussels sprouts  185    n
Cabbage  17,437    ,.
,.        red  538    „
Carrots  23,523    n
ii      white      5,220    n
Cauliflower  307    n
Chickens  42
Corn  115 doz.
Cordwood  72 cords
Ducks     ,  24
Eggs ,  255 doz.
Parsnips  13,398 lbs.
Pork  10,675    i.
Potatoes   84,454    n
Pumpkins  952     n
Turnips  15,596     n
Vegetable marrows  243    n
Contract value.
$     56 20
9 25
261 55
10 75
172 91
39 15
12 28
22 75
17 35
200 70
20 00
63 75
100 50
1,067 50
422 27
28 56
89 79
7 29
Total   $2,602 55
Products of Garden.
Beans, wax  567 lbs.
Cabbage, early  213    m
Cauliflower  33     n
Carrots, early  300    n
Cucumbers   88    n
Lettuce  236 doz.
Celery  123bunches
Leeks  308 lbs.
Onions  977     n
Peas  1,308    „
Potatoes, early  917     n
Radishes  421 bunches
Rhubarb  1,383 lbs.
Spinach  281     n
Tomatoes  379    n
Turnips, early  192    n
Vegetable marrows  204    n
Apples  11,426
Blackberries . . .
Currants, black.
ti red . .
ii        white
Cherries	
Gooseberries . ..
Peaches	
Pears	
Plums	
Raspberries ....
Strawberries .. .
Walnuts	
60
140
321
30
36
371
86
187
694
209
181
14
14 17
63 39
32
50
64
35 40
9 84
6
12
16
21
45 78
9 17
10 52
69 15
14 05
30 32
5 75
6 12
228 52
2 40
5 60
16 05
1
50
2
88
18
55
8
60
4
54
13
88
16
72
18
10
2
10
Total   $679 93 I 10 Public Hospital for the Insane. 1904
Improvements and Repairs.
The year was marked by some important improvements in the plant, the most extensive
one being the reconstruction of the kitchen building and of the laundry. In the matter of
the kitchen, it was removed from the ground floor and placed upon the second floor, which
necessitated the elevation of the heavy slate roof of that building, and the building in of an
extra flat. At the same time a commodious bakery was constructed, capable of baking
sufficient for an institution twice our present capacity. There is also improved accommodation
for those patients who assist in the work of those departments. The space vacated by the
kitchen has been converted into an engine-room, in which has been installed a new 95 horsepower high speed steam engine, with dynamo direct-connected. This plant will be able to
furnish ample power for running the motor in the laundry as well as one to be installed in the
carpenter shop, and at night to light the premises.
The small 20 horse-power upright marine engine which has been doing service for the
past four years was brought up from the boiler-room, where it had been originally placed, and
installed in the new engine-room, to be kept in readiness in case of emergency or accident to
the larger one.
The room formerly used as an amusement hall, which is on the first floor of the same
building, has been transformed into an associate dining hall, and at present about 140 men are
dining there.
The laundry was doubled in size by adding another flat to it, and its capacity for work
has been multiplied several times by the installation of machinery.
The combined implement shed and root cellar, which was mentioned in my last report as
having been begun, has been successfully completed and utilised during the past season for the
storage of our vegetable crops.
The "shops-building" has been finally completed by the addition of the finishing room
and the finishing of the attic for employees' quarters.
The boundary fence was completed in the rear and the old boundary fences removed. A
new lattice fence was erected at the rear of the " Lodge," to afford the occupants of that
building much needed space, while preserving the proper appearance of the grounds at the
entrance to the institution.
The main sewer at the river front was altered and extended so as to overcome the stoppage caused by the building of the new railroad, which had thrown ballast over the outlet.
Additional areas of land were cleared and improved, and a bridge composed of the debris
from the clearing operations was thrown across the ravine, giving us ready access to a portion
of our grounds from which in the past we have been almost cut off.
Stone and cinder walks were laid part of the way toward the new park for the ladies, in
which there were constructed a summer-house and other conveniences, including several rustic
benches.
The wooden steps at the end of " F " ward, having been knocked to pieces by the passage
of vehicles delivering goods, were pulled away and replaced by an ornamental and durable set
built of concrete and so arranged as to escape contact with passing rigs.
The floor of one of the rooms in the octagon of the female wing having rotted away was
replaced by concrete as an experiment. This has been so satisfactory that the coming summer
will see the same treatment applied to the remaining seven rooms. 4 Ed. 7 Public Hospital for the Insane. I 11
The attic of the Medical Superintendent's house, which had never been finished by or
since the original contract, was attended to in order to make the top rooms of the house
inhabitable. A rough floor was first laid, which was covered with a coat of cement and sand
two inches thick, to act as deadening and to stop draughts.
The work of terracing the front grounds was carried on to some extent during the year,
and with what we hope to accomplish this year will probably see the finish of this work.
An  inexpensive system of telephones was installed  in the offices and proved of great
service.
Expenditure.
The current expenditure for maintenance during the past year amounted to the sum of
$59,353.57, which is $4,007.92 more than it was in the previous year. The expenditure on
capital account was an additional $10,291.93, while $1,499.50 was spent in deporting incurable
patients to their homes in other parts of the world, an item of expense not properly chargeable
to either maintenance or capital account.    The grand total of expenditure was $71,145.
The daily average number of patients in residence during the year was 332.23, and
dividing the expenditure for maintenance by this number gives us $178.65 as the per capita
cost for the year. This is almost $8 less than the per capita cost for the previous year, and
comes within 40 cents of being the lowest since the inception of the institution.
The increase of $4,000 in round numbers was composed of $1,500 in salaries, $1,000 in
provisions, $400 in fuel and light, $300 in medicines and $300 in miscellaneous. The increase
in provisions was partly due to an increase in prices, as was also the case with fuel. Bread,
milk and fish were all advanced in prices above any figure hitherto paid for these supplies.
The amount expended upon permanent additions and improvements to plant was
$8,426.70, apart from the amount expended by the Department of Lands and Works, over
which we had no control, and which amounted to the neighbourhood of $18,000. The amount
expended under our supervision was absorbed by the following :—
New 95 horse-power engine and dynamo, foundation for same,
new foundations for old engine and dynamo, feedwater heater,
oil extractor, reducing valve,  steam gauge,  cement, stone,
brick and wood work $4,183  15
Implement shed and root cellar    1,028 66
Completion of " shops-building "       663 30
New camp for 50 male patients , . .      607 55
Improvements to wards       561  85
New locks to change male into female ward        265 89
Improvements to administration building       212 74
Improvements to rear grounds       159  64
Taking out building stone       122 50
Expenses providing temporary laundry       101  29
Painting roofs and other new work         88 08
New lattice fence at entrance " Lodge "         61  74
New garden fence         60 00
Extending lighting service, gas and electric         47 45
Extension of water service         41  12
Shelving steward's new store-room         40 37
Block plan of institution and grounds         30 00
Moving barn, finishing rear boundary fence         51  20
Connections with city electric plant         23 48
Rain troughs to 1897 and 1898 buildings  .        22 95
Improvements to " Lodge "         22 12
Improvements to Medical Superintendent's house         20 50
Extending the main sewer         11  12
$8,426 70 I 12
Public Hospital for the Insane.
1901
The following tables show the financial results of the past year in comparison with those
of previous years :—
Table A.
Showing the average number of patients in residence each year, the total amounts spent for
maintenance and the per capita cost.
Year.
Average number
in residence.
Maintenance
expenditure.
Per capita
cost.
1872 (81 days)	
16.57
16.07
16.76
27.42
36.41
34.61
36.52
38.17
45.42
47.18
47.86
48.73
48.70
54.67
59.11
73.55
79.43
71.30
78.78
119.87
125.24
133.92
148.64
162.97
171.43
188.91
216.53
226.44
243.24
269.56
296.62
332.23
$ 2,265 25
7,841 94
8,232 41
9,892 38
12,558 18
12,917 17
13,985 05
10,253 72
10,552 18
10,691 76
11,343 65
11,829 11
11,843 94
15,555 87
15,334 43
15,945 22
16,261 06
15,657 79
17,577 80
21,757 03
23,518 37
25,904 98
26,495 83
31,587 89
32,001 40
36,224 76
46,420 25
54,917 45
59,349 20
55,406 08
55,345 65
59,353 57
$616 00
1873	
1874	
1875	
1876	
1877	
1878	
487 98
491 20
360 77
344 91
373 26
382 93
1879	
268 63
] 880	
232 32
1881    	
1882	
226 62
237 02
1883 ,	
242 75
1884	
243 20
1885	
1886  	
1887	
1888	
1889  	
1890	
1891	
1892	
284 54
259 42
216 70
204 72
219 60
223 13
181 50
187 80
1893	
1894	
1895	
193 36
178 25
193 83
1896	
186 67
1897	
1898	
191 75
214 38
1899	
242 52
1900	
244 00
1901	
205 54
1902	
186 59
1903	
178 65 4 Ed. 7
Public Hospital for the Insane.
I 13
Table B.
Showing analysis of the per capita cost.
Year.
1872.
1873.
1874.
1875.
1876.
1877
1878.
1879.
1880.
1881.
1882.
1883.
1884.
1885.
1886.
1887.
1888.
1889.
1890.
1891.
1892.
1893.
1894.
1895.
1896.
1897.
1898.
1899.
1900.
1901.
1902.
1903.
Salaries.
$279 38
221 48
231 10
153 82
143 34
177 15
176 16
134 27
111 84
112 44
121 51
123 81
124 02
169 05
159 03
127 80
118 34
131 70
121 54
88 35
94 25
95 50
87 76
90 83
89 13
89 09
94 68
113 31
116 04
99 16
87 47
82 36
Provisions.
$184 03
166 81
152 10
113 40
114 45
126 75
124 23
95 10
87 71
81 14
84 52
92 56
90 64
84 33
69 35
59 10
60 47
59 11
62 77
54 79
56 74
53 55
57 07
61 15
55 93
58 IS
69 43
72 91
72 62
66 65
61 13
57 86
Clothing.
$55 81
14 55
22 07
13 98
18 68
20 69
30 43
3 25
5 74
6 86
7 05
6 03
7 03
6 33
5 49
5 88
4 41
7 20
9 02
3 83
4 69
5 43
5 25
9 90
6 30
8 36
9 94
8 31
9 06
10 12
7 95
8 58
Fuel and
Light.
$22 44
23 65
23 98
16 88
22 75
4 66
13 94
15 91
14 06
12 73
12 30
11 04
12 43
15 05
16 20
15 38
13 90
12 93
17 31
20 43
20 53
22 60
18 83
20 41
20 29
19 11
21 82
33 96
32 10
18 52
15 25
14 77
Fui
niture.
$15 55
21 59
28 36
25 45
17 90
20 75
7 20
6 39
6 00
5 55
4 54
4 26
4 14
3 90
3 72
3 88
3 11
4 13
4 00
3 40
3 35
3 39
2 98
2 51
2 56
2 95
2 76
2 50
2 15
3 25
4 13
3 24
Medicines.
$10 18
7 74
7 78
6 73
2 86
3 74
9 16
6 31
3 63
2 56
3 49
2 24
2 77
2 93
1 59
93
2 09
2 07
1 29
1 89
1 80
2 69
1 43
3 10
3 63
3 86
5 12
2 73
1 71
1 07
1 20
1 91
Miscellaneous.
849 30
32 16
25 81
30 51
24 93
19 52
21 82
7 40
3 34
5 34
01
82
18
95
04
81
40
46
19
81
6 42
10 20
4 93
5 93
8 83
10 20
10 62
8 80
10 32
6 77
9 46
9 93
Total.
$616 69
487 98
491 20
360 77
344 91
373 26
382 93
268 63
332 32
226 62
237 02
242 75
243 20
284 54
259 42
216 78
204 72
219 60
223 12
181 50
187 80
193 36
178 25
193 83
186 67
191 75
214 37
242 52
244 00
205 54
186 59
178 65 I 14
Public Hospital for the Insane.                                  1904
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00000OC»COQ0O0O0Q0CJOcx;Q0G0CX>XCZ)Q0Q0a)C»0OCX)CO0OCX)cZ)0^ 4 Ed. 7 Public Hospital for the Insane. I 15
Revenue.
The amount of revenue collected at this office during the past year amounted to
$13,639.64, which is $2,700 more than in the year previous and the largest amount ever
collected here in one year. Much additional revenue might be collected if something in the
nature of private accommodation could be afforded those patients able and willing to pay.
In some instances where friends used to pay they are withdrawing from doing so any longer,
because of the fact that no advantage accrues to the patient from the fact that their friends
paid for their maintenance.
The following table shows what revenue has been annually paid in to the Government
from this office :—
1873  $1,440 99 1889  220 00
1874  680 00 1890  599 24
1875  1,342 50 1891  76115
1876  730 31 1892  2,418 43
1877  799 91 1893  1,585 40
1878  479 42 1894  2,709 53
1879  867 38 1895  4,409 23
1880  1,433 04 1896  3,74171
1881  614 99 1897  3,816 80
1882  505 18 1898  4,003 79
1883  298 24 1899  4,769 04
1884  98 35 1900  6,893 33
1885  00 00 1901  12,800 76
1886  50 00 1902  10,926 23
1887  720 59 1903  13,639 64
1888  750 00
Requirements.
As already indicated in my  remarks under  " Treatment," our  requirements are both
numerous and very urgent.    Every year, as the institution increases in size, new requirements
are bound to spring up; and when year after year these  requirements are not satisfied they
are bound to increase in number and urgency, and this is our present position.
The Hospital, with its normal capacity for 295 patients, has become so overcrowded that
at the close of the year we had 349 patients upon the wards—wards that in no way lend
themselves readily to such service, since they possess no extra rooms of any description that
can be used as bedrooms in an emergency of this kind.
As pointed out in my last report, a building for 150 patients is required at once, the cost
of which will be about $125,000. Besides this, the need for better fire protection, mentioned
by me in last report, is still with us. An electric nightwatch clock would guarantee us a
good service at night, not that there is in my mind any doubt but that our nightwatches are
faithful in their duties, but with such a necessary safeguard all doubts would be forever set
at rest.
Some provision for attendants when they are off duty is much needed. At present no
such accommodation being at their disposal, they are forced to seek it elsewhere in town,
which is detrimental to all concerned.    The nurses suffer the same need.
The engineer should be provided with a residence upon the premises as soon as possible.
I think it an exceedingly bad plan to have such an important officer living at such a distance
from the institution as is the case with our engineer, and I know of no other asylum where
such a condition exists. I 16 Public Hospital for the Insane. 1904
Probably our most pressing need, next to that for more wards, is the provision of an
amusement hall where the weekly dances and Sunday services can be held. Without the use
of such an adjunct in the care of the insane, life in the institution is altogether different, and
the loss is felt by each and everyone.    This ought to be remedied at once.
The old wards require a general overhauling, with re-wiring and re-plumbing. Each
should have an outside balcony. It would be hard to find anywhere more cheerless wards
than those of the main block.
Visitors.
The days upon which the friends of patients may visit them include every day in the
week except Sunday, and the numbers who avail themselves of this opportunity have been
gradually increasing each year, until we find that last year almost 2,000 persons registered in
our visitors' book. Beside these, we had visits from Cabinet Ministers as follows :—March
24th, Hon. W. W. B. Mclnnes, Provincial Secretary; June 15th, Hon. R. McBride and Hon.
R. F. Green.    More frequent visits of this nature would be very helpful to the work.
Acknowledgments.
As in years past, we have been favoured by the publishers of the various daily papers of
the coast cities with free copies as follows :—"Daily Colonist" and "Daily Times," of Victoria,
two copies each ; " Daily World," of Vancouver, two copies of the daily and two of the weekly ;
" Daily News-Advertiser," " Daily Province," and " Daily Ledger," of Vancouver, one copy
each ; " Daily Columbian," of New Westminster, two copies ; Kamloops " Sentinel," one copy ;
for all of which we tender our best thanks.
Several of our citizens have, as in past years, contributed reading material in the shape of
magazines and novels, while the City Club has kept us in playing cards. Messrs. Malins &
Coulthard and T. R. Pearson contributed fruit.
The heads of the various departments have been faithful in all their labours and deserve
every credit, as also the attendants and other employees who have sought to promote the
welfare of the institution and the happiness and comfort of its wards.
I extend to you, sir, my best thanks for the deep interest you have taken in the work and
the encouragement you have afforded me at all times; and I feel confident that when it is
within your power to supply the many existing needs of the institution it will be done.
I have the honour to be,
Sir,
Your obedient servant,
G. H. MANCHESTER, M. D.,
Medical Superintendent. 4 Ed. 7
Public Hospital for the Insane.
I 17
STATISTICAL   TABLES.
Table No.  1.
Showing operations of the Hospital for the year 1903, in summary form.
.Movement of Population.
Male.
Female.
Total.
Male.
Female.
Total,
Remaining in residence January 1st, 1903	
Out on probation on            //                    /;     	
244
9
67
7
311
16
74
38
112
32
80
331
253
101
327
Admitted during the year :—
By ordinary forms	
By urgency forms	
Bv Lieutenant-Governor's Warrant	
82
3
3
13
36
2
118
3
3
15
139
354
85
466
Discharged during the year :—
27
9
20
1
1
11
4
2
0
0
38
13
22
1
1
As unimproved	
Total 	
Discharged on probation and still out Dec. 31st ..
Died	
58
6
21
17
10
5
75
16
26
117
269
1140
349
Total number of patients admitted sinoe'opening .
a                         a         discharged          //
it                        a        died                     it
1471
561
304
196
45
757
349
865
275
241
1106
90
365
Daily average population during the year  332.23
Maximum number present on any one day, December 31st.  349
Minimum                n                        u                 January 1st  311
Percentage of discharges on admissions (deaths excluded)  53.96
a               recoveries              n              27.34
a                        a         on recoverable eases admitted  95.00
//               deaths on whole number under treatment  5.57
Number of "paying patients " admitted during the year  33
//            " free patients"              //                    //                   106 I 18
Public Hospital for the Insane.
1904
Table No. 2.
Showing in summary form the operations of the Hospital since its inception.
th
C
O
'at
tit
3
'r
Discharges.
tit
A
Jtl
c3
CD
P
Number resident at
the close of each
year.
CD
CO
c3
r
o
0)
CD
u
O
CD
fi
rt
ID
J-      .
3.8
a ce
CD   Z
Percentage of recoveries to admissions.
Percentage   of   discharges to admissions (deaths ex-
eluded).
Percentage of deaths
to whole number
under treatment.
Year.
r
u
CD
0
r
r
PC
•ts
CD
-
If
O
cj
ftftj CD
O   In
rA
1872	
1873	
1874	
18
15
12
29
22
14
16
18
17
13
7
8
10
20
27
36
26
41
52
49
52
44
80
62
64
74
81
101
113
115
121
139
l
10
4
3
11
4
7
4
5
5
3
4
2
5
10
15
12
14
17
19
17
14
13
29
23
20
27
31
38
40
30
38
0
2
3
3
4
3
1
0
o
o
1
1
4
0
6
5
6
5
6
4
10
18
19
11
25
8
13
32
27
20
31
37
1
5
3
10
5
3
8
8
5
5
2
3
2
5
6
5
3
4
12
20
13
14
19
20
9
14
19
21
29
25
25
26
16
14
19
32
35
38
36
41
48
48
49
49
51
61
66
77
82
100
117
123
135
133
162
164
171
203
221
234
258
284
311
349
0
5
13
3
3
5
7
0
2
2
18
31
26
48
54
49
54
54
58
61
55
57
59
71
88
102
103
123
152
166
175
179
213
224
228
246
285
327
356
377
412
466
5.55
66.66
33.33
10.34
50.00
28.57
43.75
22.22
29.41
38.46
42.85
50.00
20.00
25.00
37.03
41.66
46.15
34.15
32.69
3S.77
32.69
31.81
16.25
46.77
35.93
27.03
33.33
30.69
33.63
34.78
24.79
27.34
5.55
80.00
33.33
26.89
63.63
78.57
62.50
27.77
29.41
61.54
57.14
62.50
60.00
25.00
59.25
55.55
69.23
46.34
44.23
46.94
51.92
72.72
40.00
64.51
75.00
37.83
49.38
62.37
57.52
52.17
50.41
53.96
5.55
16.12
11.53
1875	
20.83
1876	
9.35
1877	
6.12
1878	
16.16
1879	
14.81
1880	
1881	
8.62
8.19
1882	
1883	
1
3.63
5.26
1884	
1885	
2
10
5
11
5
18
17
6
12
29
2
i
32
18
13
24
26
27
38
2
3.33
6.94
1886	
1887	
1888	
6.81
4.80
2.87
1889	
1890	
3.25
7.62
1891	
1892	
1893	
11.69
6.95
7.60
1894	
8.92
1895	
1896	
8.92
3.94
1897	
1898	
1899	
1900	
5.69
6.66
6.42
8.14
1901 	
6.63
1902	
1903	
6.06
5.57
Table No. 3.
Showing the number of admissions, discharges and deaths for each month during 1903.
Month.
January..
February.
March . . .
April	
May	
June	
July	
August ..
September
October..
November
December
Admissions.
Male.
Female.
Total.
11
6
17
7
3
10
9
1
10
6
1
7
9
11
20
4
3
7
11
1
12
12
3
15
7
1
8
13
1
14
4
2
6
8
5
13
101
38
139
Discharges.
Male.     Female.    Total
4
15
3
4
4
3
10
5
58
1
1
0
5
0
2
1
1
2
1
1
2
17
1
9
4
20
2
2
4
5
6
4
11
7
75
1
1
' i
i
i
7
"2
2
21
Deaths.
Male.     Female.     Total
2
3
26 4 Ed. 7
Public Hospital for the Insane.
I 19
Table No. 4.
Showing the civil state of the patients admitted during the year.
Civil State.
Male.
Female.
Total.
75
19
6
1
5
24
9
0
80
43
15
1
Total  	
101
38
139
Table No. 5.
Showing the religious denomination of those admitted during the year.
Denomination.
Male.
Female.
Total.
25
3
17
8
6
12
8
20
1
1
7
4
0
1
7
11
1
5
1
1
32
7
17
9
Methodist    	
13
23
9
25
2
2
Total...   	
101
38
139
Table No. C.
Showing the degree of education enjoyed by those admitted during the year.
Degree of Education.
Male.
Female.
Total.
1
89
7
4
0
37
1
0
1
120
8
4
Total. .
101
38
139 I 20
Public Hospital for the Insane.
1904
Table No. 7.
Showing the native country of those admitted during the year.
Place of Birth.
Male.
Female.
Total.
At sea	
1
1
1
7
1
10
6
2
4
15
18
2
4
1
3
3
1
1
1
2
2
5
2
8
101
0
0
0
3
0
10
1
1
0
0
8
1
1
0
0
0
0
0
0
0
0
5
1
7
38
1
1
Barbadoes                  	
1
Canada:
British Columbia	
10
Manitoba            	
1
Ontario  	
20
New Brunswick	
3
4
China	
15
26
Finland	
3
5
1
3
3
1
Newfoundland	
1
1
2
Poland	
2
10
3
United States	
15
Total	
139
Table No. 8.
Showing what districts contributed patients during the year.
Place of residence at time of committal.
Yukon District:
Dawson  	
White Horse	
Vancouver Island District:
Skeena River	
Valdez Island	
Alert Bay	
Rock Bay	
Alberni  	
Grantham	
Nanaimo	
Ladysmith	
Chemainus	
Somenos	
Gabriola Island	
Saanich	
Esquimalt	
Victoria	
Lower Mainland District:
Vancouver   	
Port Moody  	
Eburne	
Ladners	
New Westminster . .
Otter  	
Carried forward
Male.
12
1
1
1
2
2
1
1
1
2
1
1
22
1
1
1
10
1
71
Female.
2
0
0
0
0
0
1
0
1
0
0
0
1
0
0
13
8
1
0
0
5
0
32
Total.
14
1
1
1
2
2
2
1
2
2
1
1
1
2
1
19
30
2
1
1
15
1
103 4 Ed. 7
Public Hospital for the Insane.
I 21
Table No. 8.—Concluded.
Place of Residence at time of Committal.
Male.
Female.
Total.
Lower Mainland District.—Concluded.
71
1
1
1
1
1
1
32
0
0
0
0
0
0
1
1
1
0
0
0
0
0
0
0
1
1
1
0
0
0
103
Kamloops District:
5
Okanagan District :
1
1
1
1
1
1
1
5
West Kootenay District:
Fire Valley                                             	
Trail	
1
3
3
East Kootenay District:
3
Boundary District:
3
Total	
101
38
139
Table No. 9.
Showing the occupations of those admitted during the year.
Occupation.
Male.
Female.
Total.
Agent	
1
1
1
1
1
3
1
1
1
5
8
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
2
1
27
0
0
1
1
1
1
1
Carpenter	
3
1
Carriage builder                 ..   .                    	
1
Clerk	
1
Cook	
5
8
Fisherman	
1
Gardener                        	
1
2
Housemaid	
1
Housewife	
27
3
1
30
3
Jeweller	
1
30
60 I 22
Public Hospital for the Insane.
1904
Table No. 9.—Concluded.
Occupation.
Male.
Female.
Total.
30
40
4
1
1
6
1
30
0
0
0
0
0
0
1
5
0
0
0
2
0
0
0
0
0
0
38
60
Labourer	
40
4
1
1
Miner	
6
1
1
3
1
1
5
S
1
1
5
2
1
3
1
1
1
1
1
3
1
Tailor	
1
1
1
Total	
101
139
Table No. 10.
Showing the ages of those admitted during the year.
Age.
Male.
Female.
Total.
2
3
10
20
12
12
13
7
9
5
5
1
2
2
0
1
4
7
6
7
5
2
2
2
0
0
38
4
3
,i     20 n 25     ;/                                            	
11
n     25 ,; 30      a     	
24
//     30 n 35      »                             	
19
i,     35 „ 40      //           	
18
/,     40 ,/ 45     «                      	
20
12
ti     50 ,/ 60      »                       	
11
/;       60   /;   70        ii                                                  	
7
//     70 « 80     n     	
7
1
2
Total	
101
139 4 Ed. 7
Public Hospital for the Insane.
I 23
Table No. 11.
Showing the number of attack in those admitted during the year.
Number of Attack.
Male.
46
8
1
Female.
Total.
First	
22
4
1
1
1
2
5
2
0
38
68
12
Third .                 	
2
Fifth                                          	
1
1
5
32
7
2
101
7
37
9
2
Total	
139
Table No. 12.
Showing the alleged duration of the attack prior to admission in those admitted during
the year.
Duration of attack.
Under
From
1 week.
1
1
3
bo
to 1 month.
3 months . ..
6      „
9
1
2
3
5
10
Over 20 years
Congenital . .
Unknown   ...
Not insane. .
12       „
2 years
3 ,,
5    //
10    ,,
20     „
Total.
Male.     Female.     Total
3
20
14
8
4
1
2
5
1
2
1
5
33
2
101
6
4
3
1
0
3
3
2
1
1
2
7
0
38
4
25
20
12
7
2
2
8
4
4
2
1
7
40
2
139
Table No. 13.
Showing statistics of heredity in those admitted during the year.
Heredity.
Paternal branch	
Maternal branch	
Lateral branches (brothers and sisters)
Insane relatives, history obscure	
Said not to be hereditary   	
History unascertained	
Total	
Male.
Female.
5
1
1
7
3
5
2
0
15
9
75
16
101
38
Total.
2
24
91
139 I 24
Public Hospital for the Insane.
1904
Table No. 14.
Showing the alleged exciting causes of the attack in those admitted.
Alleged cause.
Abuse of drugs and old age. ..
Abuse of drugs and alcohol . .
Domestic infelicity and worry
Epilepsy   	
Grief and shock   	
Head injury	
Heredity	
Ill health	
Intemperance	
Lactation	
Loss of property ....   	
Not insane	
Onanism   	
Overwork   	
Pelvic disease .	
Senile decay	
Solitude	
S.yphilis	
Unknown   	
Total
Male.
2
27
6
2
8
29
101
Female,
0
2
9
4
3
0
9
2
4
1
0
0
0
1
1
2
0
0
3
38
Total.
1
2
10
3
3
3
16
5
11
1
3
2
27
1
1
8
2
8
32
139
Table No. 15.
Showing the state of bodily health on admission.
Bodily condition.
In average bodily health	
In reduced health	
In very greatly reduced condition
Total	
Male.
Female.
49
42
10
101
17
14
7
38
Total.
66
56
17
139
Table No. 16.
Showing the form of mental disorder present in those admitted during the year.
Form of Disorder.
Acute mania	
Melancholia     	
Dementia, primary
n terminal.
« senile ...
/; pracox   	
Chronic delusional insanit3'. .
Toxic //
Epileptic n
Hysterical «
Paranoia	
General paresis	
Idiocy   	
Imbecile (1 not insane)	
Simple delirium (not insane).
Total	
Male.
10
8
27
10
17
3
3
1
101
.Female.
1
1
2
0
1
0
0
38
Total.
4
17
4
16
10
29
7
11
3
1
12
17
4
3
1
139 4 Ed. 7
Public Hospital for the Insane.
I 25
Table No.  17.
Showing the number of patients allowed out on probation during the year and the results.
Results.
Male.
Female.
Total.
21
1
1
1
7
6
7
1
1
0
2
10
28
2
n            unimproved	
2
1
9
16
37
21
58
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.
14
2
2
1
1
7
27
5
0
2
1
1
2
11
19
2
4
„     3    n     6       a       	
2
„     6    „   12       „       	
2
9
Total. .
38
Table No. 19.
Showing length of residence of those remaining under treatment on January 1st, 1904, and
of those who were discharged during the year 1903.
Length of Residence.
Of those
under
treatment
January 1st,
1904.
Of those
discharged
recovered
during the
year 1903.
Of those
discharged
improved
during the
year 1903.
Of those
discharged
unimproved
during the
year 1903.
„      2 it    3    ll        	
12
6
13
6
10
11
23
21
53
29
30
24
20
18
11
5
10
34
14
6
9
•2
5
9
3
2
4
3
4
3
3
0
3
1
0
1
0
3
1
1
1
2
1
not insane, 1
4
1
„     3 „   4    ,i        	
2
„      4 a    5    „         	
0
0
6 ,/    9    -/        	
3
„      9 „  12    ,,         	
0
3
n        In     3     n            	
2
n       3 //     4     n           	
2
1
1
,,     7 a   8   /,        	
,,     8 „    9    „        	
„        9   ;/   10     n            	
„    10 ii 15   «        	
2
»    15 // 20   //        	
,,   20 » 25    ,/        	
365
38
13
23 I 26
Public Hospital for the Insane.
1904
Table No. 20.
Record of deaths for the year 1903.
Register
No.
220
1,344
1,321
1,200
1,218
971
1,260
1,366
1,340
1,241
1,229
983
1,334
1,250
1,311
809
1,427
1,319
1,429
1,297
1,398
1,421
1,443
1,160
431
1,465
Initials.
J. W.
M. H. L.
J. B.
S. F.
G. L. B.
E. J. M.
A. McA.
S. P.
A. D.
S. H. R.
M. J. V.
W. W.
M. C.
R. J.
C. G.
H. G.
L. S. S.
W. C. S.
p.
J. E.
J. Y. S.
G. M.
T. L.
T. S.
S. E.
F. S.
Sex.
Age.
M.
53
M.
27
M.
42
M.
50
M.
35
F.
30
F.
70
M.
21
F.
83
M.
36
F.
56
M.
51
M.
29
M.
65
M.
45
M.
42
M.
27
M.
42
M.
50
M.
35
M.
43
M.
73
M.
68
M.
50
F.
77
M.
43
Time in Hospital.
Years.
Months.
2
12
2
11
1
5
6
1
10
7
11
3
3
1
4
4
Days.
0
7
24
27
18
1
8
6
18
11
13
17
20
28
22
8
20
26
25
21
6
14
11
14
25
12
Certified cause of death.
Chronic Bright's disease.
Empyema.    (Not insane.'
General paresis.
General paresis.
General paresis.
Phthisis.
General debility.
Exhaustion of mania.
Pneumonia.
General paresis.
General debility.
General paresis.
Peritonitis.
Apoplexy.
General paresis.
Broncho pneumonia.
Morbus cordis.
General paresis.
Pneumonia.
General paresis.
General paresis.
General paresis.
Apoplexy.
General paresis.
Mammary cancer.
Morbus cordis.
Table No. 21.
Showing race classification of those remaining in residence on January 1st, 1901.
Class.
Male.
Female.
Total.
Whites	
225
3
37
3
1
269
79
0
0
1
0
80
304
3
37
4
1
349 4 Ed. 7                            Public Hospital for the Insane.
I 27
Table No. 22.
Showing the forms of employment engaged in by the patients during the year, and the
number of days' work performed by them.
Employment.
No. of days.
1,498
7,532
1,413
447
814
602
207
4,273
3,273
33,073
734
Total	
53,866
during the ye
Table No. 23.
Showirg the articles made and repaired on the Wards
ar.
Name of Article.
Made.
Repaired.
139
371
422
14
44
42
11
2
16
6
242
453
193
24
17
9
23
12
42
180
102
190
n        serge    	
455
70
Drawers, pairs   	
206
2,096
2,350
Mats, floor	
5
40
104
342
357
Neckties	
Pillow slips	
485
574
1,642
1,777
Skirts  	
18
715
3,218
142
15
52
82
Ticks for beds ,	
136
317
267
206
412 I  28
Public Hospital for the Insane.
1904
Table No. 23.—Concluded.
Name of Article.
Work of Tailor-shop.
Coats
Combination suits and camisoles ,
Shirts  	
Suits for patients  	
Suits of uniform for attendants .
Trousers (extra) n
a        for patients	
Vests n 	
Work of Shoe-shop.
Shoes, pairs    	
Slippers	
Harness repaired, key straps made, and other miscellaneous work.
Made.
32
13
4
37
30
1
30
33
29
Repaired.
253
69
2
075
115
15S
108
Table No. 24.
Quantities of Fruit preserved by the Matron.
Blackberries    12 quarts.
Cherries         7 »;
Crab apples    10 n
Currants, black    19 n
red   18 „
Gooseberries     22 n
Peaches   14 ;/
Pears    18 »
Plums   42
Raspberries    70 u
Rhubarb      37 n
Strawberries     33 «
   44 j
Jelly	
Raspberry vinegar     6 quarts.
Tomato pickles      62      n
VICTORIA, B.C. :
Printed by Richard Wolfenden, I.S.O., V.D., Printer to the King's Most Excellent Majesty.
1901. 

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